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

After all records of patients with breast cancer who received primary treatment at Memorial Hospital in 1960 were reviewed, 304 women with operable, infiltrating carcinoma were identified and classified clinically according to the TNM system of the American Joint Committee for Cancer Staging and End Results Reporting. There were 66 patients (22%) classified under Stage I, 176 (58%) under Stage II, and 62 (20%) under Stage III. There were 82 patients (27%) in whom the nodal status was misclassified clinically. The observed 10-year survival was 59.7%. The 10-year end results (with 95% confidence limits) diminished significantly in relation to advancing clinical stage of disease--90.9% (+/-6.9%) for Stage I, 57.1% (+/-7.3%) for Stage II, and 33.9% (+/-11.8%) for Stage III patients. The 10-year survival in patients with pathologically negative axillary nodes was 71.5%, and in the patients with pathologically positive axillary nodes, 48.3%.
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PMID:Ten-year results of the treatment of primary operable breast carcinoma: A summary of 304 patients evaluated by the TNM system. 97 86

Surface immunoglobulins were determined on human lymph node lymphocytes by the use of immunofluorescence technique in 59 breast cancer patients undergoing radical mastectomy. In 10 of these cases, lymphocyte surface immunoglobulins were also studied on lymphocytes infiltrating the primary cancer mass. The most outstanding finding was a difference between the IgM lymphocyte populations in the lymph nodes of patients with and without lymph node metastases. When cancer tissue was present in one or more lymph nodes, the tumor-free as well as the tumor-positive nodes showed a higher percentage of IgM positive lymphocytes than did lymph nodes from patients without nodal metastases. The greatest difference was found when IgM lymphocytes from tumor-bearing lymph nodes were compared with those from the lymph nodes of patients without nodal metastases (p is less than .005). The lymphocyte populations infiltrating 5 of the 10 primary cancer masses studied showed no surface immunoglobulins; in the remainder, both IgG and IgM positive lymphocytes were found but in variable proportions. While the findings are not definitive, this is the first study dealing with the quantitation of immunoglobulin specific lymphocytes in the lymph nodes and tumor tissue of patients with breast cancer.
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PMID:Surface immunoglobulin positive lymphocytes in human breast cancer tissue and homolateral axillary lymph nodes. 108 36

A discussion of the management of breast cancer in young women is presented. The rate of growth of breast cancer is not influenced by the age of the patient, as reflected in the fact that the expected survival rate for women of all ages is 50% at 5 years. Although it has been reported that the time lapse for the recurrence of cancer was less for younger women with affected nodes than older women, the literature is not in agreement on this point. The prognosis for women in whom cancer is diagnosed in late pregnancy, or during lactation, is usually grave. Pregnancy subsequent to treatment of breast cancer poses problems, though it has been reported that the survival rate of pregnant women following mastectomy is improved. It is recommended that a young, nulliparous woman should not be discouraged from having children after the removal of a small localized tumor. Permanent sterilization may be preferable to oral contraception for women who probably should not have another pregnancy. In the United Kingdom, the mortality rate from breast cancer in women aged 35-44 has increased by almost 20% from 1968 to 1972. A marked reduction in the early recurrence of breast cancer in premenopausal women with nodal deposits has been reported as a result of adjuvant systemic chemotherapy.
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PMID:Editorial: Breast cancer in young women. 113 69

At present, through public awareness and the use of improved diagnostic aids, increasing numbers of patients are being seen with localized "minimal" breast cancer. In our own experience, the average measured size of the primary tumor has diminished from 3.2 cm in 1955 to 2 cm in 1974. Although the incidence of axillary node metastases has diminished only from about 50% to 42% during this interval, the extent of involvement and the distribution of nodal disease has improved markedly with a marked decrease in apical node involvement. Mammography has been responsible for the detection of more than 50% of our "minimal" breast cancers. This improved patient material presents a great potential for improved control of this disease. In planning the choice of surgery for primary breast cancer, its multicentric origin, and regional nodal spread to axillary and internal mammary nodal areas must be considered. There is no single ideal operation for all breast cancers. The scope of surgery should be correlated with the clinical and pathologic extent of disease in the individual patient with the aim of removing all disease present while preserving appearance and function-the main goal being removal of disease. We have utilized three operative procedures: total mastectomy with axillary dissection, radical mastectomy, and extended radical mastectomy. With this approach a 10-year survival rate of 61% with a local recurrence rate of 7.7% has been attained in a group of 565 patients with 40% axillary node involvement. The best salvage obtained in patients with "minimal" breast cancers-noninfiltrating cancers and infiltrating cancers under 1 cm in diameter with clinically negative axillae-was 95% survival at 10 years following modified radical mastectomy (total mastectomy with axillary dissection). When disease has extended to the axillary nodes the more extensive procedures have proved more effective in achieving long term control-54% 10 year survival in patients with axillary node metastases treated by the extended radical mastectomy. An increasing number of patients are being seen who can be treated adequately by less than a radical mastectomy. Careful clinical judgment and close liason with a competent pathologist must be combined in selecting the proper operative procedure for each individual patient. Statistics concerning therapeutic effects based on current material, unless they are based on accurate data covering extent of disease, cannot be compared with previous data because of the improved patient material now being encountered. Adjuvant multiple chemotherapy appears promising as a supplement to surgical treatment of breast cancer. However, it should not be used to replace or minimize the role of primary surgery, but should be combined with the optimum procedure for each individual patient.
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PMID:Changing patterns of breast cancer. Lucy Wortham James lecture (clinical). 124 47

Detection of earlier breast cancer, especially in its preclinical stage, offers the only method available today for reducing mortality from this disease. The Health Insurance Plan study, conducted since 1963 under contract with the National Institutes of Health, has achieved a one-third reduction in death rate in a study group compared to a matched control which has persisted in 7 years of follow-up. The Guttman Institute, founded in 1968 to develop practical methods for large scale screening, is operating a tandem approach using interview, clinical examination, improved mammography, and thermography for greatest yield. Emphasis is placed on motivation to accept the examination, teaching and encouragement of breast self-examination, and emphasis on periodic reexaminations. At the present time, almost 300 women receive this complete examination per day at the Institute's fixed facility. Periodic examinations leads to marked increase in number of cancers detected free of axillary nodal involvement. The tandem approach emphasizes substantial percentage of cancers detected on only one modality, two-thirds of which are without nodal involvement. Breast self-examination is necessary to detect "interval" cancers in more localized stage.
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PMID:Results of mass screening for breast cancer in 50,000 examinations. 124 63

One hundred fifty-eight patients with axillary nodal metastases recovered from radical mastectomy specimens for operable, invasive breast cancer were divided into those in whom such metastases were confined within the node and those in whom one or more nodes manifested extranodal extension. The relationships of these patterns to 33 pathologic and seven clinical features of these cases were investigated by contingency table analysis. Statistically significant associations (p less than .05) between extranodal extension of such metastases and short-term treatment failure, as well as the presence of four or more involved nodes, infiltrating ductal NOS histologic tumor type, stellate tumor border, and nipple involvement, were found. When the metastases were confined to the node there was a significantly greater likelihood that the cancers were either medullary or tubular histologic types. Associations with severe cell reaction and a nuclear grade of 1 were also found, but appeared to reflect the high frequency of medullary carcinomas in this group. The results suggest that evaluation of extranodal extension of axillary nodal metastases in patients with breast cancer may represent an important prognostic discriminant.
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PMID:Pathologic findings from the national surgical adjuvant breast project. (Protocol no. 4). III. The significance of extranodal extension of axillary metastases. 126 7

Estrogen receptor (ER) analysis in breast cancer has been used in three clinical situations: to select patients with advanced breast cancer for hormonal therapy, as a prognostic parameter, and for selection of women with early breast cancer to adjuvant hormonal treatment. ER has traditionally been measured using labelled hormone in binding assays--often in dextran-coated charcoal assays (DCC). Monoclonal antibodies to ER has permitted development of a solid phase enzyme immunoassay (ER-EIA) used for quantitative determination of ER in tissue homogenates, and have also been used for determination of ER using an immunohistochemical assay in frozen sections (ER-ICA) or in formalin-fixed, paraffin-embedded tissue (ER-PAR). A large number of studies has compared ER-EIA with ER-DCC assays. There is a good linear correlation between the two types of assay but ER-EIA measure more ER and classify a larger fraction of tumors ER-positive than conventional ER assays. Lack of clinical data makes the significance of this uncertain. Numerous studies have reported on the correlation between ER-ICA and ER-DCC or ER-EIA. There is a good correlation among the assays on classification of ER status with a median 86% concordance, but a somewhat poorer correlation between semiquantified ER of immunohistochemical assays and ER determined by the quantitative methods (median coefficient of correlation 0.67). There is a large variation in the cut-off level for definition of ER-positive in immunohistochemical assays emphasizing the need for quality control studies. The major problem involved in ER analysis in paraffin-embedded tissue is a considerable loss of immunoreactivity compared to sections from frozen tissue. This can partly be overcome by modifications of the immunohistochemical technique using enzyme pretreatment and other amplification systems, but the sensitivity of ER-PAR remains lower than ER-ICA despite these modifications, and the ER status is less reliably determined in tumors with low ER contents (< 100 fmol). The prognostic value of ER-PAR was evaluated with a multivariate analysis. The endpoint was disease-free interval in systemically untreated patients with early breast cancer, and the variables used were: ER-DCC, ER-PAR, age, tumor size, tumor grade, and nodal status. A total of 133 patients from the Danish Breast Cancer Cooperative Group's (DBCG) 77c protocols had a complete set of variables. The analysis showed that only nodal status, ER-DCC, and tumor grade were significant and independent prognostic variables. An overview of larger multivariate studies on mainly node-negative patients failed to show independent prognostic significance of ER-DCC.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Determination of estrogen receptors in paraffin-embedded tissue. Techniques and the value in breast cancer treatment. 128 48

To investigate the characteristics of interval breast cancer in mass screening, comparisons were made of the following three groups: interval group (21 interval breast cancer cases), mass screening group (87 breast cancer cases detected by mass screening) and outpatient group (266 breast cancer cases diagnosed at outpatient clinics). There were no differences among the three groups in terms of the case distribution by age or obesity, but significant differences in the case distribution according to nodal involvement and tumor size. Histological grading of the malignancy of the primary tumors disclosed that the incidence of breast cancer showing frequent mitoses was high in the interval group compared to the mass screening and outpatient groups. The 7-year cumulative disease-free survival rate was 75.3% in the interval group, 90.0% in the mass screening group and 83.1% in the outpatient group. The mean tumor size of the interval cases at the time of mass screening, back-calculated on the basis of the estimated tumor doubling time, was 1.5 cm in diameter, smaller than that of the mass screening group. It is surmised that interval breast cancer is characterized by marked proliferation of the tumor cells and has a poorer prognosis than the other group cases. These findings might be due to the marked proliferation of interval breast cancer rather than because of cases having been overlooked at the time of the last screening.
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PMID:The characteristics of interval breast cancer in mass screening. 129 27

Overexpression of p53-protein appears to be a common event in primary breast cancer. It has been proposed that the presence of elevated levels of this protein may be an independent prognostic factor and may be important for the ability of a tumor to metastasize. This study was performed to evaluate the influence of immunohistochemically detectable mutant p53-protein on metastasis-free survival of patients with breast cancer. Immunohistochemistry was performed on 117 paraffin-embedded biopsy specimens of consecutive patients with stage T1-T4 breast cancer, using a monoclonal antibody against p53 suppressor gene product. 29 (24.8%) specimens showed positive staining, whereas in 88 (75.2%) a negative staining reaction for p53 was found. Comparing time intervals to diagnosis of metastasis, using Kaplan-Meier curves, Log-Rank test revealed no significant differences in metastasis-free survival between p53 positive and negative patients (P = 0.32), whereas statistically significant differences were noted for tumor stage (P < 0.01), nodal status (P < 0.01), histological grading (P < 0.01) and estrogen receptor status (P = 0.03). Mutant p53-protein, as detected by immunohistochemistry in paraffin embedded tumor tissue, does not appear to influence metastasis-free survival in patients with breast cancer.
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PMID:Immunohistochemical detection of mutant p53-suppressor gene product in patients with breast cancer: influence on metastasis-free survival. 129 80

Data on all new breast cancer cases in the Auckland area during the nine years September 1976 to September 1985 were used to obtain epidemiological information on breast cancer in the Auckland region. Breast tumours were found in 2706 women (300 per year), yielding a lifetime risk of breast cancer of one in 15. No significant difference in breast cancer incidence was detected between European, Maori and Pacific Island Polynesian women. Confidence limits for incidence were wide in the later groups. Fifty-one percent of women presented with intermediate sized (2-5 cm) tumours, and most (66%) were node negative. Eleven percent had evidence of metastatic disease at presentation. When the relationships between race, tumour size, nodal status and metastases were examined, Pacific Island women more frequently presented with large tumours and metastases, whereas Maori women were more frequently node positive. Eighty-five percent of tumours were invasive ductal carcinomas, 55% grade II, 35% grade III, and 10% grade I. Sixty-seven percent of tumours were oestrogen receptor positive (ER+ve) and ER status was significantly related to age; the proportion of ER+ve tumours was greater in older women. Fifty-seven percent of tumours were progesterone receptor positive (PR+ve), and PR distribution was bimodal with age. These data from the Auckland region are similar to breast cancer figures from other western countries, with some ethnic differences in tumour size and frequency of metastatic disease at presentation.
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PMID:Incidence and clinical features of breast cancer in the Auckland region. 131 56


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