Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a case-referent study on the possible role of selenium in human mammary carcinogenesis, serum selenium was found to be 79 +/- 12 micrograms/l in 66 cases and 81 +/- 12 micrograms/l in 93 referents. An internal trend in serum selenium was observed among cases (TNM stage I 81 +/- 11 micrograms/l and TNM stage II 76 +/- 13 micrograms selenium/l), indicating disease-mediated changes. The evaluation of selenium as a risk indicator in human breast cancer was therefore restricted to TNM stage I patients (n = 36). Multiple logistic regression analyses including variables associated with selenium levels revealed no association between selenium levels and breast cancer risk.
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PMID:Selenium in human mammary carcinogenesis: a case-referent study. 184 79

The pathologist is a consultant in breast cancer management whose responsibility is to establish the histologic diagnosis of cancer as well as its anatomic extent once sufficient tissue has been provided. The consultation also provides data that may be used to aid in selecting primary or adjuvant therapy, evaluating new therapies, estimating prognosis, and assessing outcome. Examples of such data are the TNM histopathologic classification of the anatomic extent of the cancer used for the stage grouping (T = the extent of the primary tumor, N = the absence or presence and extent of regional lymph node metastasis, and M = the absence or presence of distant metastasis); tumor size, histologic type, and histologic and/or nuclear grade; assessment of blood vessel and lymphatic vessel invasion; analysis of steroid receptors, and other special studies as appropriate.
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PMID:The role of the pathologist in the management of breast cancer. 187 85

Staging systems for breast cancer, unlike those of neoplasms in distant or recessed sites, allowed for the early development of clinical staging evaluation. It was established that clinical assessment of the breast lesion was often wrong compared with the pathologic examination (benign vs. malignant); clinical measurement of the tumor in centimeters was often larger than histologic size; and clinical assessment of axillary nodes (clear or metastatic) was incorrect in about 30% of cases. Although both clinical and pathologic staging provide effective discriminants for prognosis of treated patients, prognosis is more accurately determined by the pathologic stage. The single most important prognostic indicator is the axillary nodal status, and when positive, the number of positive nodes. The American Joint Committee on Cancer and the Union International Contra Cancer have agreed on a TNM staging for breast carcinoma, and this is the preferable staging system. Follow-up of treated patients is of most value in detecting local recurrence on the chest wall (after mastectomy) or in the irradiated breast (after lumpectomy), and also in early detection of contralateral breast cancer. Physical examination and periodic mammography are most useful. There is a tendency to overinvestigate asymptomatic patients (with bone scans, blood tests, etc.), but this has been correctly criticized in recent years.
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PMID:Staging and follow-up of breast cancer patients. 199 Dec 79

Patients with invasive breast cancer and pathologically negative lymph nodes (NO) have a favorable 10-year survival rate, particularly with small (less than 1 cm) primary tumors. Overall, however, 20% to 35% will experience recurrence with local therapy only. Adjuvant chemotherapy or tamoxifen have prolonged disease-free survival (DFS), but not overall survival (OS). Unanswered questions of optimal end point (DFS or OS) and the risk of treating many to benefit few have prompted clinicians to use prognostic indicators to facilitate treatment recommendations. Currently, the most readily available and accurate information comes from TNM staging, pathologic features, and hormone receptors. Ploidy, S-phase fraction, HER-2-neu amplification or over-expression, and cathepsin-D may be useful prognostic indices. Until a more precise system of weighing several prognostic variables is developed, the decision to recommend adjuvant systemic therapy in this generally good prognosis group will have to be thoughtfully considered by patient and physician. Whenever possible, patients should be encouraged to enter clinical trials.
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PMID:Adjuvant therapy for node-negative breast cancer. The use of prognostic factors in selecting patients. 200 69

We present the results of 186 breast cancer patients treated initially for locoregional disease by radiotherapy alone, combining cobalt therapy with external electron beam or interstitial iridium implants. According to the TNM classification, the patients were distributed as follows: 3 T1N0, 2 T1N1, 33 T2N0, 36 T2N1, 16 T3N0, 26 T3N1, 6 T3N2, 14 T4N0, 29 T4N1, 9 T4N2 and 12 T4N3. The 5- and 10-year survival rates (52.7% and 36.5%, respectively, for all patients) were directly correlated with the size and location of the breast tumor, and the extent of lymph node involvement. Locoregional recurrence was observed in 39.8% of the cases, metastasis alone in 26.8% of the cases, and a combination of local recurrence and distant metastasis in 14.5% of the cases. The local recurrences and metastases were directly correlated with the extent of locoregional involvement. Late complications and sequelae were mostly minor and occurred in less than 25% of the cases; severe sequelae occurred in no more than 2% of the cases. They depended on the initial tumor volume and the tumor dose. Our results, along with those in the literature, indicate that radiotherapy administered alone is a valid therapeutic option in breast cancer.
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PMID:Exclusive radical radiation therapy in breast carcinoma. 202 Jul 52

A study of clinical and pathological features, patterns of relapse and prognosis of breast cancer in various religious communities--viz. Hindu, Muslim, Christian and Parsi--was undertaken among 4377 evaluable cases treated at Tata Memorial Hospital between 1965 and 1982. Of these 82.4 per cent were Hindus, 7.3 per cent Muslims, 7.4 percent Christians and 2.7 percent Parsis. The mean age at diagnosis was 55 years for Parsis which was 7 to 8 years older than that for the other communities. There were no remarkable differences in histological tumour type or grade; except that parsis had higher incidence of uncommon histological types, such as dust carcinoma in situ and colloid carcinoma, and had a slightly more favourable grade distribution. When classified according to the TNM system (UICC 1978), the Parsis had the most favourable stage at presentation followed by Christians, Hindus and Muslims in that order. This trend was highly statistically significant (p less than 0.001). Despite this significant differences between stage of disease at diagnosis, no differences in the overall 5-year survival was observed between the communities. This remained true even after matching for disease stage and menopausal status. Even the Parsis, in whom the disease was detected relatively early, failed to register a survival advantage. Much work need to be done with regard to early detection of Breast Cancer in India.
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PMID:Clinico-pathological features and prognosis of breast cancer in different religious communities in India. 209 May 78

Male breast carcinoma is a truly rare tumor the treatment and prognosis of which have been recently considered similar to female cancer. In this work we reviewed the clinical histories of 21 patients with breast cancer attended in our hospital over a period of fifteen years. Mean age was 60 years. The main cause of consult was the presence of painless nodules most frequently localized in the left breast. We have found a great latency period between the detection of the first symptoms and medical consult (almost 20 months) which by itself justifies that almost fifty percent of patients were either in stage III or IV. Global surveillance was 60% after 5 years excluding other causes of death that were not directly related with the tumor. Statistic analysis did not reveal any significant relationship, probably due to the small number of patients, between the prognosis of the disease and the presence of factors such as cutaneous involvement, duration of symptoms, thelorrhagia, patient age, lymph node [correction of ganglionar] involvement, or deep plane involvement, although a significant relationship (p less than 0.05) was found with TNM stage.
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PMID:[Breast carcinoma in men: a review of 21 cases]. 209 Nov 11

The prognostic significance of conventional TNM staging remains the standard for determining prognosis in breast carcinoma. The presence (or absence) of axillary lymph node metastases remains the single most important parameter for predicting patient outcome. The presence of regional lymph node metastases implies that the primary tumor has the capacity for successfully completing the steps of the metastatic cascade. However, the absence of regional lymph node metastases does not ensure that distant or systemic seeding of tumor cells has not occurred, only that it is less likely. Staging data appear to be refined by addition of several standard morphological parameters. Although there is considerable overlap and interaction between these factors, as well as with staging data, there is strong evidence that grade, necrosis, inflammatory cell "immune response," and possibly pattern of invasion and intravascular tumor each independently supplement staging information. Some data appear to have independent significance only when applied to specific patient subsets, raising serious question as to their biologic importance. Nevertheless, morphological data are subjective and susceptible to observer variation and have less statistical power in predicting patient outcome than staging data. It was initially thought that DNA analysis of breast cancer by flow cytometry might supplant morphological data in assessing tumor behavior. The following conclusions can now be drawn: (1) there is no clear association between aneuploidy and SPF and stage; (2) aneuploid tumors are associated with higher SPF and shorter disease-free survival while diploid-range tumors generally have lower SPF and longer disease-free survival; (3) aneuploid DNA content is significantly associated with markers of decreased morphological (grade) and biochemical (ER status) differentiation. Determination of S-phase fraction by FCM appears to be a rapid and potentially easy method for obtaining kinetic information on individual breast tumors, although the technology for improving the accuracy of SPF measurements is still under development (e.g., tumor cell gating, debris subtraction). SPF appears to be comparable to other kinetic measurements, such as TLI, and shows many of the same associations with morphological and clinical data as ploidy. This is due to the close association of ploidy and SPF. Which of these parameters is more important for predicting patient outcome has not been clearly defined. Additional technological refinements for determining SPF may result in a more prominent prognostic role for this measurement. Three problems have limited our ability to draw specific conclusions about the biologic significance of tumor ploidy and SPF.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Prognostic significance of morphological parameters and flow cytometric DNA analysis in carcinoma of the breast. 215 77

The pathologist is a consultant in breast cancer patient management whose first responsibility is to establish the histologic diagnosis of cancer as well as its anatomic extent when sufficient tissue has been provided. The consultation also provides data that may be used to aid in selecting primary or adjuvant therapy, evaluating new therapies, estimating prognosis and assessing outcome. Examples of such data are the TNM histopathologic classification of the anatomic extent of the cancer used for the stage grouping (T: the extent of the primary tumor; N: the absence or presence and extent of regional lymph node metastasis; M: the absence or presence of distant metastasis), size, histologic type, histologic and/or nuclear grade, blood vessel and lymphatic vessel invasion assessment, steroid receptor analysis, and other special studies as appropriate.
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PMID:The role of the pathologist in breast cancer management. 220 66

The aim of the study was to assess the value of routine bone scintigrams, independent of the primary tumor stage or the presence of symptoms, in the postsurgical follow-up of breast cancer patients for the early detection of bone metastases. For this purpose 1,000 patients with postsurgical breast cancer without previous documentation of metastatic disease, who were admitted to the special oncology hospital, Onkologische Klinik Bad Trissl, entered a prospective study in 1987-1988. The parameters followed were the TNM stage of the primary tumor, the presence of pain, bone pain as revealed by a thorough physical examination, and the patient's history for the assessment of risk factors. In addition, a whole-body skeletal scintigram, supplementary X-rays, and additional diagnostic measures were performed, if necessary, to detect bone metastases. It was shown that in 856 of 894 patients (groups 1-6) without clinical symptoms, the clinical examination and radiological and scintigraphic diagnostic measurements, demonstrating the absence of bone metastases, gave matching results, but in 12 of the 894 patients the results of all examinations remained questionable. In another 12 of the 894 patients (groups 1-3) radiological and/or scintigraphical evidence for the presence of bone metastases was found. In 14 of 79 cases (groups 7-10) with clinically suspicious symptoms these were proven to be signs of metastases by subsequent scintigrams, supplementary X-rays, and additional diagnostic measures. In 65 of the 79 patients with clinically suspicious symptoms, bone metastases could not be confirmed by obtaining bone scintigrams or X-rays while in the other 14 patients (groups 9 and 10) evidence for the presence of bone metastases was found in the scintigrams and/or X-rays. However, 10 of these 14 patients were high-risk patients for developing bone metastases as they had axillary lymph node infiltration. The other 4 patients were of the low-risk group as they had positive receptor status or no axillary lymph node infiltration at the time of primary diagnosis. In 13 of 27 patients (groups 11-14) with clinical symptoms indicating the presence of bone metastases this diagnosis was confirmed by scintigrams and/or X-rays (groups 11 and 12), while it was possible to exclude the presence of bone metastases in spite of the symptoms in 11 of the 27 patients. In the other 3 patients the results of the additional examinations remained questionable.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Value of bone scanning in the follow-up of breast cancer patients. A study of 1000 cases. 222 39


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