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Query: UMLS:C0006142 (breast cancer)
 160,383 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prognostic value of estrogen (ER) and progesterone (PgR) receptor status and the influence of hormonal adjuvant therapy on disease-free survival (DFS) in breast cancer were evaluated in 680 women after radical and modified radical mastectomy. The effect of 17 variables, including clinical data, TNM, hormone receptor status, histology and adjuvant therapy, on the DFS observed was analyzed, using a multivariate proportional hazard model. Multifactorial analysis revealed that DFS was strongly related to the number of positive axillary nodes (P less than 0.001) and the histological grade of the tumor (P = 0.05). Moreover, the DFS of ER-positive patients with node involvement was significantly improved by hormonal adjuvant therapy (tamoxifen). Combination of adjuvant chemotherapy with hormonal therapy did not enhance its effectiveness. Recurrence rates of either node-negative or ER-negative patients were not affected by either adjuvant therapy. When no systemic therapy was given, no significant relationship between ER or PgR content of the tumor and the DFS was observed. These findings suggest that hormone receptor status is not an independent prognostic factor but provides reliable information on responsiveness to adjuvant hormonal therapy which is very effective in patients selected on the basis of ER assay.
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PMID:The influence of hormone receptors and hormonal adjuvant therapy on disease-free survival in breast cancer: a multifactorial analysis. 375 15

To determine if body weight and serum cholesterol are associated with advanced primary breast cancer, the authors compared levels of both by TNM stage and estrogen receptor protein (ERP) concentration in a population of 148 premenopausal and 167 postmenopausal white women with histologically confirmed Stage I, II, and IIIa breast cancer. The women were admitted to Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City between 1982 and 1984. Overweight, whether measured as body weight in pounds, Quetelet index, or body surface area, was not found to be associated with TNM tumor stage, tumor size, extent of axillary node disease, or ERP concentration at mastectomy. Elevated serum cholesterol, either alone or in combination with overweight, also showed no association. When assessed in light of earlier studies, the study findings suggest that if overweight, as defined in this study, and/or elevated serum cholesterol do influence early breast cancer recurrence, they do so other than through an association with advanced primary disease. Suggestions for future research are proposed.
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PMID:Body weight, serum cholesterol, and stage of primary breast cancer. 376 33

From 1958 to 1982, 1,035 patients with breast cancer were treated by operation in our hospital. The follow up rate was 100% and 804 were followed for more than 5 years. Radical mastectomy was performed in 695 of the 804 patients, the rest were treated by simple mastectomy, modified radical mastectomy and extended radical mastectomy. The 5, 10, 15 and 20 year survival rates were 71.8%, 58.2%, 48.8% and 41.8%. According to the UICC TNM classification, the 5, 10, 15 and 20 year survival rates of stage I were 84.5%, 77.0%, 58.3% and 75.0%, of stage II, 72.8%, 57.4%, 53.5% and 58.8%, and of stage III, were 55.3%, 44.7%, 36.5% and 8.0%, respectively.
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PMID:[Prognosis of breast cancer--20 years experience in radical mastectomy]. 376 43

Vascular and lymphatic invasion of cancer cells, type of histology, histopathological TNM classification, level of tumor invasion, menopausal status, and age were reported as prognostic factors for breast cancer. We determined the discriminatory power of these prognostic factors for predicting breast cancer recurrence in 98 patients with the method of quantification theory type II, using a computer, model Hi-TAC M-150. The discriminatory rate of these combined seven factors for recurrence was 82.609%. We calculated the probability of breast cancer recurrence using the method of quantification theory type II. The probability of breast cancer recurrence (P) was given as follows. P = 1/1 + 7.333e5.468X. The score X is given by the sum of category weight of seven prognostic factors. Averages of P values of patients with recurrence and without recurrence were statistically different (p less than 0.01). The rate of having more than 30% of P values was 78% in 23 patients with breast cancer recurrence, and it was only 3% in 75 patients without breast cancer recurrence. The difference was statistically significant (X2 = 61.83, p less than 0.001). These results suggest that we can discriminate a high-risk patient with breast cancer recurrence using this method.
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PMID:Determination of discriminatory power of prognostic factors for recurrence of breast cancer. 377 7

Serum concentrations of IgG, IgA, IgM, IgE, and allergen-specific IgE were measured in presurgical serum samples from 400 women admitted to a multidisciplinary study of primary breast cancer. The relationships between the serum immunoglobulins and patient survival were analyzed with the use of a Cox proportional hazards linear model. After adjustment for TNM stage, tumor histopathologic grade, and estrogen receptor (E2R) status, lower IgM concentrations were associated with longer survival. Lower IgE concentrations were also associated with longer survival, but only in patients whose tumors were E2R positive. IgG and IgA were not related to survival. Serum IgM and IgE concentrations, allergen-specific IgE scores, and the tumor E2R status were combined to construct a three-level risk classification that was more prognostic than any of the individual components. Cox model analysis demonstrated that this combination of immunologic and hormonal variables provided significant new information beyond that obtained from TNM staging and histopathologic grading of the tumors (P = .01). This new information may be useful to physicians in advising patients with primary, operable breast cancer about the relative risks and benefits of adjuvant therapy and in designing clinical trials of adjuvant therapy.
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PMID:Presurgical serum immunoglobulin concentrations and the prognosis of operable breast cancer in women. 386 98

Immunologic parameters were examined preoperatively in 104 patients with breast cancer, staged according to the TNM classification and in 95 age-matched healthy women. The immunologic evaluation in the peripheral blood included lymphocyte and monocyte counts, determination of E-rosette-forming T-lymphocytes (SER+) and B-lymphocytes (MER+), T-lymphocyte subsets defined with monoclonal antibodies (Leu-1, Leu-2a, Leu-3a) and with lectin fractionation (soybean agglutinin), lymphocyte transformation test with phytohemagglutinin (PHA) and concanavalin A (ConA), and colony formation of T-lymphocytes in agar (T-lymphocyte colony-forming cells, [TL-CFC]). Two age groups (Group A: 30-50 years; Group B: 51-70 years) and the different tumor stages (Stage I-IV) were analyzed. Patients and controls did not differ in the absolute numbers of lymphocytes, T- and B-cells. In patients of Group B, the absolute number of monocytes was increased slightly in Stage II and III and significantly in Stage IV (P less than 0.05). Similarly, the lymphocyte response to PHA was significantly reduced in Stage IV Group B only (P less than 0.05). ConA-induced lymphocyte proliferation and TL-CFC capacity were not different in patients and controls. In the small number of patients and age-matched controls in whom T-lymphocyte subsets were determined, the absolute numbers of T-cells with helper or suppressor phenotype as defined with Leu-3a, Leu-2a, or lectin fractionation with soybean agglutinin were similar. This study demonstrates that in patients with early breast cancer (Stage I-III), immunocompetence as defined by either functional in vitro studies or surface marker analysis is not significantly altered at the time of diagnosis. In contrast, patients with advanced disease (Stage IV) show a significant increase in the absolute number of monocytes and a depressed PHA responsiveness of mononuclear cells.
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PMID:Unaltered immunocompetence in patients with non-disseminated breast cancer at the time of diagnosis. 387 58

Cancer of the lung is rapidly increasing in incidence in both sexes and soon will overtake breast cancer as the most deadly cancer in women. Selection of patients with non-small-cell carcinoma for surgical resection is largely based on preoperative clinical staging, using the American Joint Committee on Cancer's TNM-based group staging protocol. Determining the presence or absence of mediastinal nodal metastasis is paramount and is currently best achieved by computed tomographic scanning of the chest and biopsy of enlarged nodes via mediastinoscopy. Certain types of stage III lesions, previously excluded from surgical treatment, are now recognized as operable.
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PMID:Selection of patients with non-small-cell lung carcinoma for surgical resection. 390 42

The usefulness of postoperative radiotherapy for breast cancer was investigated in 152 patients. A dose of 50 Gy was given to the axillar, supraclavicular and internal mammary lymphnode areas using a 12 MeV electron and to the chest wall using a 6 MeV electron. The five and 10-year survival rates were 79.1% and 50.8%, respectively. The five-year survival rates according to the TNM staging were 100% for stage I, 78.4% for stage II, 58.8% for stage III and 0% for stage IV. The local recurrence rate was 8.8%, the metastasis rate was 33.1% and the recurrence rate in the ipsilateral supraclavicular regions previously treated by prophylactic irradiation was 2.6%, while it was 8.9% in the ipsilateral chest wall.
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PMID:[Postoperative radiotherapy with the electron beam in breast cancer]. 393 17

The serial levels of fibronectin (FNp) in plasma from 65 patients with benign and malignant breast disease and from 74 healthy control women were assayed by the use of the rocket immunoelectrophoresis procedure. Mean FNp levels in patients with breast cancer were age-matched with control subjects, but no clear correlation was found between FNp levels and the presence of primary tumor. Mean FNp values for fibroadenoma patients did not differ either from controls or from patients with malignant disease. Patients were also categorized according to TNM classification, to the number of positive axillary nodes, to the histologic grade of malignancy, and to the presence of estrogen receptors. Although differences were not significant, a higher number of patients with levels greater than the normal 95% percentile were found only in the group with four or more positive axillary nodes and in the group with a greater number of histologic malignancies. Marked fluctuations in FNp concentrations were found in individual patients during the follow-up period, independently of the treatment received. FNp seems unsuitable as a tumor marker because, besides its apparent lack of specificity for cancer, it reflected neither the host-tumor burden nor the response to treatment.
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PMID:Serial analysis of fibronectin concentration in plasma of patients with benign and malignant breast diseases. 394 15

Locoregional recurrences are reported in 493 consecutive with T1 T2 N0 N1 breast cancer patients who were treated with radical external beam irradiation and interstitial 192 Ir. implant between 1961 and 1979. Follow-up ranges from 5-23 years (mean 10 years) with 195 patients having 10-23 years follow up (mean 12 years). Tumorectomy was performed in 130/158 (88%) T1 and 73/335 (22%) T2 patients. There were 51 (10%) locoregional recurrences with 34 mammary, 14 combined mammary/axillary and 3 isolated axillary recurrences. The 10 year relapse rate was 20/195 (10%). The risk, timing and site of relapse varied according to TNM stage and tumorectomy. The risk was higher for T2 (42/335, 12.5%) than T1 (9/158, 5.5%) due to a larger number of recurrences occurring in the first 5 years (T2 32/335, 9.5% vs T1 4/158, 2.5%). Between 5-10 years, risk of relapse equalized to around 3% for both groups and only 1 relapse was seen after 10 years. Of the 48 mammary recurrences, 25 (52%) occurred in the implant volume, 7 (14%) occurred on the margin of the implant, 12 (25%) occurred at sites remote from the primary and in 4 (9%), the exact site could not be defined. 14/48 mammary recurrences were accompanied by axillary relapse, there were 3 isolated axillary recurrences and supraclavicular metastases accompanied axillary relapse in 3 cases. The overall risk, of axillary relapse was 3% (17/493) and there was significant correlation with initial N stage. Salvage surgery generally mastectomy and axillary dissection, was possible in 45/51 (90%) recurrences. 23/45 (50%) survive NED 0.2-9 years (mean 3 years) after salvage. 8/23 (35%) followed longer than 5 years after salvage survive NED. Our results have been compared with other series in the literature and changes in our current protocol are described.
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PMID:Locoregional recurrences following radical external beam irradiation and interstitial implantation for operable breast cancer--a twenty three year experience. 395 43


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