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)

The use of oral contraceptives should at all times be under physician's control. Most contraindications and complications from oral contraceptives are now a thing of the past, when higher doses were prescribed. However oral contraceptives are still responsible for many side effects and complications. Some of these are gastrointestinal problems; menstruation disorders, such as spotting or amenorrhea; decreased libido; increase in body weight; mastodynia; blood coagulation effects; lipid and carbohydrate metabolic effects; ophthalmological and dermatological problems; and, possibly, an increase in susceptibility to some infectious diseases. Patients with hypertension; with heart or hepatic diseases; with a history of family thrombolic accidents; with diabetes; or hyperthyroidism should utilize another form of contraception. Oral contraceptives are totally contraindicated for obese or emotionally depressed people, for pregnant or nursing mothers, for women with uterine or breast cancer, and for adolescents.
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PMID:[Principle complications and contraindications of the use of oral contraceptives]. 15 84

The role of reconstruction in the management of patients with problems related to breast cancer is of increasing importance. Immediate reconstruction is particularly applicable in those situations where prophylactic mastectomy is performed. High-risk groups who warrant such prophylactic mastectomy and reconstruction include those with florid cyst disease, a strong family history of breast cancer, the finding of lobular carcinoma in situ, multiple previous biopsies, and those who have severe and progressive mastodynia. In those with smaller amounts of breast tissue, reconstruction is based on a double layer tissue over a graft, one layer consisting of pectoral muscle and the other of breast skin. In those with more abundant breast tissue, the two layers placed over the graft are both derived from skin flaps, the inner layer a free, denuded dermal graft from the inferior flap and the second layer, the superior breast skin flap itself.
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PMID:Immediate postmastectomy reconstruction. 94 95

The majority of benign breast disorders may be classified as developmental and involutive. Mastalgia and breast nodularity represent the greatest groups of these disorders, while epithelial hyperplasia is a complex benign disorder which is most difficult to be evaluated. Sixty women with diagnosis of cyclic mastalgia and 30 with noncyclic breast pain were followed-up. Patients were administered bromocryptine, danazol or a local progestogel. Better treatment results were achieved in cyclic mastalgia than in women with noncyclic mastalgia. One hundred and forty-five biopsies of the benign breast tissue were examined histologically. Nonproliferative forms were found in 66.9% of the women, proliferative without atypia in 29.65%, and proliferative with atypia in 3.45% of the patients. Atypical ductal hyperplasia and atypical lobular hyperplasia increase four-to fivefold the risk for breast cancer. Prophylactic subcutaneous or total mastectomy is not as a rule indicated in atypical epithelial hyperplasia, only regular follow-up is required.
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PMID:[Developmental and involutional breast disorders]. 134 37

The Norplant implant is described: the release rates and serum levels of levonorgestrel, the mode of action, the indications and contraindications, the effectiveness, incidence of ectopic pregnancy related to Norplant use, metabolic effects, advantages and disadvantages, insertion, the role of counseling, and management of side effects (menstrual bleeding changes, headache, weight changes, mastalgia, and acne), continuation rates and reasons for termination, and removal. Norplant is currently the most effective method of contraception. Counseling is important in order to provide women with as much information for informed consent and to increase awareness and interest in Norplant. In a clinical trial in California, 95% expressed a high level of satisfaction upon implant removal and 71% desired Norplant again; 91% recommended Norplant to friends. 82% reported the side effect of menstrual change; 66% reported 2 or more side effects. Clinical development is ongoing for other sustained release contraceptives. Norplant was developed by the International Committee for Contraceptive Research of the Population Council, and manufactured by Huhtamaki Oy/Leiras Pharmaceuticals in Turku, Finland. Clinical trials have been conducted since 1975. 20 nations have approved its use, and more than 1.5 million women use it. Silastic rubber tubing encapsulates 6 capsules of 36 mg/capsule crystalline levonorgestrel, a strong progestin. Implantation is done just under the skin in a fan shape; levonorgestrel is released at 80 mcg/day for 6 months, and 30-35 mcg/day for the remainder of use. The mode of action is not completely understood, but the assumption is that it is similar to the progestin-only pills. The mechanisms that alter fertility are 1) the change in hypothalamic-pituitary level to inhibit midcycle luteinizing hormone surge, while follicle stimulating hormone and estradiol levels remain within the normal range, 2) the thickening of the cervical mucus which prevents the entry of sperm into the upper genital tract, and 3) the suppression of the estrogen-induced cyclical maturation of the endometrium. It is not an abortifacient. Contraindications are few, but include active thrombophlebitis, undiagnosed abnormal genital bleeding, known or suspected pregnancy, benign or malignant liver tumors, and known or suspected breast cancer of progestin-dependent neoplasms.
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PMID:Innovations in contraception: the Norplant system. 159 35

Data on 210 nonmenopaused women who had been diagnosed with breast cancer before age 45 at the Institut Curie in Paris, France were compared with 210 matched controls living in Paris to determine whether cyclical mastalgia could be a marker of estrogen susceptibility in relation to breast cancer. Women were more likely to develop breast cancer than controls if they had a family history of breast cancer (26% vs. 11%; adjusted relative risk [RRa] = 2.89, personal history of being breast diseases (24% vs. 6%; RRa = 5.55 [RRa for fibrocystic disease = 9.11]), oral contraceptive (OC) use )30% vs. 20% for 72 months; RRa = 2.8; p .01 for trend), and cyclical mastalgia (46% vs. 23%; RRa = 2.12). The risk of developing breast cancer increased steadily with duration of cyclical mastalgia (RRa = 1.12 for 6-48 months, 2.24 for 49-96 months, and 5.54 for 97 months; p .001 for trend). OC use for more than 48 months before the first full-term pregnancy posed a significantly higher risk than never use of OCs (RRa = 3.26; p .05 for trend). OCs' effect on breast cancer risk was still significant, but not as large, after the first full-term pregnancy (RRa = 2.02; p .05). Since cyclical mastalgia is sensitive to estrogen and a marker of breast susceptibility to estrogen, these results indicated that it could be used, along with other predictors, as a predictor of breast cancer. Prospective studies are needed to validate its significance.
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PMID:Cyclical mastalgia as a marker of breast cancer susceptibility: results of a case-control study among French women. 161 69

One out of 11 women is destined to develop breast cancer. All women should be "under observation". Does a "normal" breast really exist? A discharge from a single orifice could suggest a papillomatosis, a real borderline lesion, the adenofibroma practically never degenerates, the essential problem is that of the fibrocystic disease, (or mastosis) which was the object of a recent detailed analysis (W. Dupont and D. Page), pre-menstrual mastodynia does not seem to be a risk factor. On the other hand, certain dystrophic lesions constitute a high risk, such as atypical epithelial hyperplasia, especially if it is associated with a direct family history of breast cancer. Recent studies on mammary cysts insist on their hormone and electrolyte content, the presence of EGF, as well as that of certain proteins (GCDFP 15). They also insist on the local tissue enzymatic activities, the importance of myoepithelial cells and of fibroblasts. On a practical level, the attention is drawn on: cysts whose diameter exceeds 5 mm, certain histological lesions found during the biopsies. The value of mammography and thermography in the assessment of the high risk is discussed. Finally, the present well-established notions are recalled: the family history, late pregnancies, the diet, the weight, certain pathological associations, the endogenous hormonal balance bearing on E2/P and the blood prolactin level, the exogenous hormone intake.
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PMID:[What is mastopathy at risk? Epidemiologic and clinical basis]. 206 85

Cyclical breast pain or mastalgia occurs in up to 70% of the female population. After exclusion of breast cancer and proper reassurance, only 15% of patients initially presenting will require drug treatment. Using bromocriptine, danazol and evening primrose oil some 77% of patients treated can obtain useful relief of their symptoms.
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PMID:Management of cyclical breast pain. 225 95

In a case-control study, 178 women diagnosed with fibroadenoma (FA) between 1976 and 1982 were compared with 178 age-matched controls in order to assess the risk factors for FA. Women who had a previous diagnosis of breast disease were excluded. The odds ratios (OR) of FA were calculated for different risk factors of breast disease from bivariate analysis as well as multivariate regression analysis. The highest ORs were found for a previous premenstrual mastalgia before first childbirth and a familial history (FH) of breast cancer (BC). Oral contraceptive (OC) use before a first full-term pregnancy (FFTP) does not modify this risk. Also current use of standard oral contraceptives (SOC) containing 50 micrograms of ethinyl estradiol per pill appeared to be protective and the correlation with FA was negative. These findings underline: (a) the predictive value of premenstrual mastalgia for the subsequent development of breast disease; (b) only current high-dose OC use is protective.
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PMID:Risk factors for breast fibroadenoma in young women. 276 21

Results of randomised trials and open studies in 291 patients with severe persistent breast pain in whom breast cancer had been excluded showed that drug therapy produced a good or useful result in 77% of those with cyclical mastalgia and 44% of those with non-cyclical mastalgia. In patients with cyclical mastalgia good or useful responses were obtained with danazol in 70%, with bromocriptine in 47%, and with evening-primrose oil in 45%. The equivalent response rates in patients with non-cyclical mastalgia were 31%, 20%, and 27% respectively. Progestagens were not effective in either group. Failure to respond to one drug did not preclude response to a different drug. Patients with Tietze's syndrome did not respond to drug therapy, but 7 out of 10 responded to injection of lignocaine and hydrocortisone around the affected costochondral junction.
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PMID:Clinical experience of drug treatments for mastalgia. 286 23

The agent tamoxifen plays an important part in the treatment of breast cancer. Although it acts as an antioestrogen by binding to oestrogen receptors, it also has oestrogen agonistic effects on the liver. Recent toxicity studies in rats have revealed that after high dosages both cataracts and hepatocellular carcinomas develop. For these reasons it has been suggested that use of tamoxifen be discontinued for the treatment of benign conditions such as severe cyclical mastalgia and also for trials on the prevention of breast cancer. It is argued that the development of hepatocellular carcinomas in rats is the result of the known oestrogen agonist activity of tamoxifen, with similar results being found in a few women receiving oral contraceptives, the use of which still continues. Studies of the use of the agent for benign conditions should evolve in the context of controlled clinical trials in order that important new indications for tamoxifen are not overlooked.
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PMID:Tamoxifen and benign breast problems. 288 76


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