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

There is no well defined group of patients with primary breast cancer which benefits from combination chemotherapy as an adjuvant treatment, since, at present, the effect of this therapy in respect to the duration of disease-free interval, survival, and possible long-term side effects remain unknown. Therefore, controlled studies need to be initiated. Similarly, there seems to be no beneficial effect from unspecific immunotherapy. As far as combination chemotherapy in advanced breast cancer is concerned, we review on four different protocols which proved to be quite successful in our hands: adriamycine/cyclophosphamide (AC), cyclophosphamide/methotrexate/5-fluorouracil (CMF), CMF/vincristine/prednisone (CMFVP), and adriamycine/vincristine plus CMF plus Tamoxifen.
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PMID:[Current status in the treatment of breast cancer. II. Adjuvant chemotherapy, palliative polychemotherapy, chemoimmunotherapy--rating and results (author's transl)]. 9

Administration of antiestrogen has recently been incorporated into the management of breast cancer. To explore the endocrine consequences of this therapy 5 healthy premenopausal volunteers were observed and treated with daily administration of the antiestrogen Tamoxifen. During the treatment period all subjects continued to have regular menses and basal body temperature; estradiol (E2) levels increased but followed a regular pattern, and its concentration at midcycle and during the luteal phase were twice as high as during nontreatment. On the other hand, concentrations of LH and of ESH were not greatly changed. In the presence of higher concentrations of E2 and of progesterone the endometrium showed a retarded development, thus demonstrating the antiprogestational effect of Tamoxifen. The lack of gonadotropin suppression also suggests a major antiestrogen action on the hypotalamus and pituitary glands.
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PMID:Endocrine consequences of continuous antiestrogen therapy with tamoxifen in premenopausal women. 11 Aug 34

High dosage MAP (medroxyprogesterone acetate) was used in the treatment of very advanced breast cancer. 25 patients were included in the study all of whom had measurable lesions which had been unsuccessfully treated by other methods, hormonal or combination chemotherapy. Tables present information on previous treatments, results of pre-MAP therapy examinations, and results of post-MAP therapy examinations. Treatment dosage is explained. Results with this high MAP-dosage therapy compare favorably with the rate of remission obtained through other primary hormonal therapies by other researchers. Promising results without noteworthy adverse effects were obtained; remissions, however, were short. 7 of the 25 had partial remission with a median duration of 5+ months. Another 7 patients obtained a stationary status of the disease. Even some patients who had not responded previously to Tamoxifen achieved partial remission with MAP therapy, indicating that the MAP does not operate directly on the tumor cells. The incidence of partial remissions was not adversely affected by previous combination chemotherapy and hormonal treatment. Acceptability of the treatment was good.
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PMID:High dose medroxyprogesterone-acetate treatment in advanced mammary carcinoma. A phase II investigation. 16 70

Since metastasizing breast cancer is hormone-related, hormonal therapy is based on control of tumor growth by elimination of the hormonal influence, hormone ablatives, or administration of steroid hormones to change the hormonal milieu of thehost organism. The time span during which hormonal therapy may be effective is extremely limited; therefore, this is not recommended for patients with an interval of less than 2 years between primary treatment and 1st manifestation of metastasis, patients with visceral metastasis, or women less than 5 years in the postmenopause. According to cooperative European and American studies remission rates for different types of endocrine therapy include: ovariectomy, 25-40%; adrenalectomy, 30-40%; hypophysectomy, 30-40%; androgen, 20%; and estrogens, 20-35%. Studies are underway concerning the use of antiestrogens (Nafoxidine and Tamoxifen) andinhibition of prolactin secretion. Investigations have shown that patients with proven estrogen receptors in the tumor tissue are particularly responsive to hormonal therapy. For patients with no determinable estrogen receptors, however, chemotherapy is perferable. Ovariectomy is recommended as the 1st measure for women in the premenopause, hormone additives for women longer than 5 years in the postmenopause, and for women in the 1st years after menopause ovariectomy in combination with a form of polychemotherapy. For patients with short free intervals polychemotherapy with another endocrine measure, for pleuracarcinosis and liver metastosis high corticosteroid dosages, and for metastases in the central nervous system radiatio treatment with high corticosteroid dosages are recommended.
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PMID:[Hormone therapy of breast cancer]. 18 Mar 75

ZR-75-1, a human breast cancer cell line, has been grown in hormone-supplemented medium without serum. The factors required for optimal growth include 17beta-estradiol, insulin, transferrin, dexamethasone, and L-triiodothyronine. If estradiol, insulin, or L-triiodothyronine is omitted, cells cease division within 7 days, but viability is retained for at least 14 days. Omission of transferrin leads to cell death within 7 days. The cells have been continuously maintained in this environment without morphological alteration or cessation of growth for more than 5 months. Addition of the anti-estrogen, Tamoxifen (10(-6) M), inhibited cells below the growth rate seen when estradiol was omitted from the medium, even when Tamoxifen was added 4 days and two medium changes after the removal of estradiol from the medium, thus suggesting an action of Tamoxifen which may be independent of competition with estradiol. The availability of a human breast cancer cell line that can be propagated in hormone-supplemented medium without serum should aid in the study of the mechanisms by which hormones effect cell growth.
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PMID:Growth of a human breast cancer cell line in serum-free hormone-supplemented medium. 21 80

Tamoxifen is a specific estrogen antagonist used in the treatment of breast cancer. In a previous study, corneal and retinal changes were reported in four patients receiving high-dose tamoxifen therapy for greater than 1 year. Nineteen patients treated with tamoxifen for periods of 3 months to 4 years at normal dose levels have been studied and no ocular changes attributable to the drug were observed.
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PMID:Ocular assessment of patients treated with tamoxifen. 52 17

Seventy-eight advanced breast cancer patients, most of whom had had prior treatment, were treated with the synthetic antiestogen tamoxifen. The overall objective response rate was 27% (21/78). An additional 19% (15/78) showed disease stabilization. Sixty-seven percent (14/21) of the responses were in soft tissue sites, 24% (5/21) on bony sites and one each occurred in liver and nodular lung disease. Forty percent of patients with soft-tissue disease alone responded, while less than 10% of patients with visceral disease showed responses in visceral sites. The response rate was 28% among patients with a known positive estrogen receptor (ER) assay. It was 21% among patients who had previously received cytotoxic drugs. Toxicity was mild and was seen in nausea and vomiting, hot flushes and vaginal bleeding, and occasional myelosuppression. One patient was withdrawn from the study because of a rash. In two patients the disease flared, once with concomitant hypercalcemia. Tamoxifen is a useful agent for advanced breast cancer even in some patients with visceral disease.
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PMID:Phase-II trial of tamoxifen in advanced breat cancer. 53 27

The effects of tamoxifen on cortisol binding globulin (CBG) and sex hormone binding globulin (SHBG) were studied in 25 women and one man with breast cancer. These patients were in various endocrine states according to age (15 post-menopausal women) or previous endocrine surgery (ovariectomy, two patients; ovariectomy plus adrenal surgery, five patients; hypophysectomy, three patients; ovariectomy plus hypophysectomy, two patients). The administration of tamoxifen (20-40 mg/day) resulted in increases in the level of CBG in all patients (mean rise in binding capacity 10.8 microgram cortisol/100 ml plasma) and in the level of SHBG in 21 patients (mean rise in binding capacity 0.79 microgram dihydrotestosterone/100 ml plasma for all patients). These increases were positively correlated. They were not associated with any alteration in the association constants of the steroid binding globulins. The effect of tamoxifen on CBG diminished with increasing age. The changes in the levels of CBG and SHBG were independent of the endocrinological state of the patient. It is inferred that tamoxifen has a direct oestrogen-like action on the liver which results in increased production of CBG and SHBG. Tamoxifen therapy for carcinoma of the breast appeared to be least effective in those patients in whom the drug caused the highest increase in the concentration of CBG.
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PMID:Increases in steroid binding globulins induced by tamoxifen in patients with carcinoma of the breast. 56 84

86 postmenopausal women with disseminated breast cancer have been treated orally with 30 mg of Tamoxifen per day (ICI 46474, Nolvadex) for periods of 2 months or more. The overall responders were 28/86 (32.5%) with a median remission duration of 9 months. In 30 patients already shown to be resistant to cytotoxic chemotherapy. Tamoxifen was used as first hormonal agent; the remission rate in this group was 12/30 (40%), while it was 28.5% (16/56) in the others who had already received different hormonal treatments. In 6 early menopausal cases, the treatment had to be stopped for a dangerous "worsening syndrome". Other side effects were trivial. In 28/35 cases (80%), we have found the reappearance of a pattern of estrogenic activity in vaginal smears during treatment. Hence a "simil-estrogen", more than an "anti-estrogen" mechanism of action is postulated and a selection of patients for treatment in the "mid postmenopausal age" is recommended.
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PMID:Tamoxifen in disseminated breast cancer. 60 76

Tamoxifen (ICI 46474), an antiestrogen, was given to 89 selected patients with stage IV breast cancer at a dose of 20 mg orally every 12 hours. Forty-seven percent of the patients had objective tumor regression averaging 11+ months with 25 of 42 women still in remission. In the first 39 patients where the minimum follow-up period is 16 months the average duration of remission is more than 15 months with 8 of 19 patients still in remission. These results are approaching those of surgical hypophysectomy, where, in our experience the average remission lasts about 18 months. Thus, Tamoxifen is a highly effective antitumor agent and is probably the initial treatment of choice for women with hormone responsive breast cancer. Antiestrogen induced objective remissions in 5 of 19 patients who had previously responded to surgical hypophysectomy, and 5 additional patients showed no progression of disease lasting 15+ months. Estradiol and estrone were detectable in the serum of these patients whereas, prolactin and growth hormone were not detectable. Thus, antiestrogen can induce remissions in some patients in the absence of the pituitary gland, and this constitutes additional palliation and provides evidence that estrogens can directly stimulate tumor growth. Four of 7 patients who obtained remissions from Tamoxifen obtained further improvement from hypophysectomy, and 1 of 8 patients who failed to benefit from antiestrogen improved after hypophysectomy. These results suggest that prolactin and growth hormone may also play a role in stimulating tumor growth in some patients.
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PMID:Treatment of breast cancer with antiestrogen: approach to medical hypophysectomy? 61 66


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