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

Detection of non-palpable (T0) breast cancer by pathological nipple discharge is possible 3 years or more earlier than tumorous breast cancer. However, the definite diagnosis of T0 breast cancer has been considered to be very difficult because the standard diagnostic method such as exfoliative cytology and ductography were not totally reliable. In 1985 we first demonstrated the significance of CEA measurement in nipple discharge for diagnosis of T0 breast cancer. Since then CEA activity in nipple discharge was estimated in 60 patients with breast diseases by means of enzyme immunoassay using monoclonal anti CEA antibody. They include 17 with T0 breast cancer, 9 with borderline lesion, 20 with intraductal papilloma and 14 with fibrocystic diseases. When the cut off value of CEA concentration was set at 600 ng/ml, the sensitivity, specificity and accuracy were 76.5%, 100% and 92.2%, respectively. These levels were higher than those for mammography or cytology. In the past 7 years, 13 cases of T0 breast cancer were detected in our hospital. They accounted for 2.5% of total breast cancer cases. In conclusion, CEA measurement in nipple discharge is a useful method for the diagnosis of non-palpable breast cancer.
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PMID:[Early detection of non-palpable (T0) breast cancer: the diagnostic procedure for pathological discharge from the nipple]. 803 75

During the recent 5 years between 1988 and 1992, 254 cases of breast cancer were experienced in the Tsukuba University Hospital. Of them, 80 cases were palpable cancers measuring less than 2cm and 37 cases were nonpalpable cancers. The total of early cancers was 117 cases, 43.3% of all cases. Noninvasive carcinoma without minimally invasive carcinomas were 35 cases, 13.2% (ductal ca: 27, lobularca: 2, Paget ca: 6). According to the palpability of tumour mass, the sensitivity and accuracy rate of palpable early masses are 56.6% and 88.4% by physical examination, 57.9% and 96.4% by mammography, 77.6% and 82.5% by echography respectively. Those of nonpalpable diseases are 29.0% and 88.8% by physical examination, 42.9% and 91.2% by mammography, and 32.1% and 76.8% by echography. The sensitivity of echography for palpable breast cancer is extremely high. On the other hand, mammography is the most effective for nonpalpable cancer. For the detection of noninvasive carcinoma, characteristics of nipple discharge, measurement of CEA in nipple discharge and erosion of the nipple are other important factors.
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PMID:[Clinical diagnosis of early breast cancer]. 803 76

To improve the survival in breast cancer, it is important to detect and treat breast cancer early. Physical examination (PE), mammography (MMG), ultrasonography (US), and aspiration biopsy cytology (ABC) are routinely assessed in the diagnosis of breast cancer. When three procedures including ABC are positive in a diagnosis of breast cancer, it is an absolute indication for surgery. Of all 238 breast cancers between 1987 and 1992, 86 cases were T1. The sensitivity of each procedure was PE 58.9%, MMG 70.0%, US 74.4% and ABC 86.2%, indicating that PE was less sensitive for small cancer. The recent accuracy of ABC in our series was satisfactory, and the combination diagnosis had a good result for T1 tumor because the findings from these procedures were complimentary. The high accuracy of ABC therefore suggests that lumpectomy has two aspects, definite diagnosis, and therapy as conservative surgery for breast cancer. The nineteen cases of T0 cancer encountered were almost entirely detected by nipple discharge or MMG. In conclusion, the combination diagnosis including ABC was very effective, and it is very important to detect and diagnose clinically small or non-palpable breast cancer.
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PMID:[Diagnosis in early breast cancer]. 803 77

We have investigated the effects of preoperative radiotherapy on T1 N0 breast cancer and studied the relationships between residual cancer after lumpectomy and II clinicopathological factors. Radiotherapy was basically ineffective against intraductal carcinoma. However, in the preoperative radiation group, there were more hormone-receptor positive and histologically well-differentiated cases than in the non-radiated stage I patients. Mitotic figures were also significantly reduced after radiotherapy, whereas the expression of c-erb-B-2 protein was unchanged between the two groups. Residual cancer rates were 40% and significantly higher in patients with: 1) tumor diameters of 3.1 cm or larger; 2) tumors beneath or in the vicinity of the nipple-areola; 3) malignant calcifications noted in mammography findings; 4) serous or bloody nipple discharge, particularly with positive cytologic findings; 5) papillotubular carcinoma; 6) lymphatic invasion by tumor cells; and 7) a high degree (n > or = 4) of lymph node metastases. Our date indicate the varying radiosensitivity of breast cancer cells, the indications for hormone therapy and the prognostic usefulness of these seven clinicopathological factors in breast conservation therapy.
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PMID:[Problems of breast conservation therapy--residual cancers after lumpectomy and effects of preoperative radiotherapy]. 803 84

In order to evaluate the local residual cancer following breast conservation therapy (BCT) with lumpectomy, we investigated the relationships between residual cancer and age, tumor location, tumor diameter (T), mammography findings, nipple discharge findings, histopathological type, lymphatic and/or vascular invasion by tumor cells, histological grading, histological lymph node metastases (n), and estrogen receptor (ER) status, in 1494 patients with breast cancer that involved diagnostic excisional biopsy. Residual cancers were found in 581 of 1448 (40%) mastectomy specimens, after 46 (3.1%) with multicentricity had been excluded. No correlation was observed between residual cancer and age, histological grading, and ER. However, residual cancer rates were significantly higher in patients with: (1) tumor diameters of 3.1 cm or larger; (2) tumors beneath or in the vicinity of the nipple-areola; (3) malignant calcifications noted in mammography findings; (4) serous or bloody nipple discharge, particularly with positive cytologic findings; (5) papillotubular carcinoma diagnosed by biopsy, (6) lymphatic invasion by tumor cells; or (7) a high degree (n > or = 4) of lymph node metastases. The above seven clinicopathologic factors are thus considered useful prognostic indicators for local recurrence in BCT with lumpectomy.
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PMID:Prognostic factors for local recurrence in breast conservation therapy: residual cancers after lumpectomy. 832 33

Mammary duct ectasia is a benign disease of the mammary gland, characterized by a frequently long history of tumour formation, nipple discharge, nipple retraction and mastalgia. Non-puerperal mammary abscess, which may be the presenting symptom, is also part of the syndrome. Diagnosis can often be made on the basis of the history and the clinical findings of nipple discharge, nipple retraction, tenderness on palpation, fistula formation and subareolar tumour/abscess formation. Mammography may guide diagnosis. Breast cancer is the most important differential diagnosis. If the clinical picture resembles cancer, it is necessary to perform diagnostic biopsy. Causal therapy of mammary duct ectasia is not available. Until now excision of the central mammary tissue and larger ducts has been used as treatment for the clinical manifestations of abscess, fistula and nipple discharge, apparently with good results.
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PMID:[The duct ectasia syndrome--an overlooked disease entity]. 839 Nov 77

Duct carcinoma in situ (DCIS) has become an important, however controversial, focus of breast cancer management only since the advent of effective film mammography and the development of an increased interest and utilization of breast conservation therapy. Prior to 1975, DCIS remained an infrequent biopsy finding in patients who presented with a palpable mass, nipple discharge, or clinical Paget's disease. The vast majority of such patients harbored extensive noninvasive disease and frequently were found to have occult invasive breast cancer at mastectomy, which was the only method of available treatment. The significance of small foci of DCIS as detected mammographically and the implications of DCIS in conjunction with invasive carcinoma for breast conservation therapy were slowly learned over the next two decades. This paper reviews current studies of DCIS with a particular focus on practical applications for management.
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PMID:Duct carcinoma in situ: biological implications for clinical practice. 861 47

The incidence of intraductal carcinomas (IDC) of the breast is increasing. However, few cases have been reported in young women. Based on a series of 13,168 women treated for breast cancer at the Institut Curie over a 12-year period, this article analyses the prevalence, clinical presentation, prognosis and treatment of IDC in patients younger than 35 years. Of this series of 13,168 cancers, 882 occurred in women under the age of 35 years (6.7%). Sixteen of these cases (2%) were strictly intraductal lesions and therefore constituted the study population. The frequency of IDC in women under the age of 35 years was identical to that of IDC in the general population of this study. The circumstances of discovery were: palpable tumour in seven cases (44%), mammographic discovery in four cases (25%), nipple discharge in five cases (31%). Histological examination revealed a well-differentiated IDC in two cases, moderately differentiated in seven cases and poorly differentiated in five cases (two cases not specified). Conservative treatment by lumpectomy and irradiation was performed in nine patients, and another seven patients were treated by mastectomy and low axillary lymph node dissection. The mean follow-up was 83 months (range: 5 to 156 months). A single patient has relapsed: an isolated invasive mammary recurrence, 6 years after conservative treatment. This patient in now in complete remission after mastectomy. All patients are therefore alive, with no evidence of disease, at 83 months. In the group of women younger than 35, the frequency of IDC appeared to be identical to that observed in the general population. Their prognosis after treatment is excellent, and identical to that of IDC in older women. Conservative treatment is justified in localized forms, but mastectomy with immediate reconstruction must be performed in the presence of extensive disease.
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PMID:[Intraductal cancer of the breast in women under age 35 years]. 868 92

To improve breast cancer control among Latinas, it is important to understand culturally based beliefs that many influence the way women view this disease. We did a telephone survey of randomly selected Latinas and non-Hispanic white (Anglo) women in Orange County, California, to explore such beliefs using questions from previous national surveys and an ethnographic study of breast cancer. Respondents included 803 Latinas and 422 Anglo women. Latinas were more likely than Anglo women to believe that factors such as breast trauma (71% versus 39%) and breast fondling (27% versus 6%) increased the risk of breast cancer, less likely to know that symptoms such as breast lumps (89% versus 98%) and bloody breast discharge (69% versus 88%) could indicate breast cancer, and more likely to believe that mammograms were necessary only to evaluate breast lumps (35% versus 11%) (P < .01 for each). After adjusting for age, education, employment status, insurance status, and income, logistic regression analysis confirmed that Latino ethnicity and acculturation levels were significant predictors of these beliefs. We conclude that Latinas' beliefs about cancer differ in important ways from those of Anglo women and that these beliefs may reflect the moral framework within which Latinas interpret diseases. These findings are important for the development of culturally sensitive breast cancer control programs and for practicing physicians.
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PMID:Differing beliefs about breast cancer among Latinas and Anglo women. 868 96

It is almost impossible to diagnose early cancers by elevated tumor markers in serum. However, it is possible by detecting tumor associated biomarkers in the excreted specimens such as nipple discharge, urine and feces. Elevated CEA in nipple discharge is indicative of non-palpable "To" early breast cancer, elevated fecal CEA indicated hemoccult test-negative colon cancer, basic fetoprotein and beta-hCG core fragment in the urine for urogenital malignancies, and urinary VMA or HVA for asymptomatic neuroblastomas. Detection of abnormal genes is more sensitive than cytology and suggests cancers or precancerous changes. PCR-SSCP method enabled to determine Ki-ras gene mutation in pancreatic juice and in duodenal juice in pancreatic cancer patients.
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PMID:[Tumor associated biomarker for early diagnosis of cancer]. 896 52


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