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

Archival surgical specimens from 1,210 female breast cancer patients treated between 1968 and 1971 and with a 19-year follow-up were reanalyzed with special reference to several parameters, such as size of the primary tumor, axillary nodal involvement, histologic grade, degree of inflammatory infiltrate (LPI) of the tumor and expression of the neu oncoprotein (p185) as detected by immunohistochemistry. In a multifactorial analysis the 4 former factors were found to be independent prognostic parameters. Over-expression of p185 was found to be related to tumor size and grade and to LPI but not to pathologic nodal status. Over-expression of p185 showed a negative impact upon survival in node-positive but not in node-negative patients. However, in the subset of node-negative patients without LPI, p185 over-expression showed the same correlation with a poor prognosis as in node-positive patients. In contrast, in node-negative and LPI-positive patients, p185 over-expression correlated with a good prognosis. Also, the prognosis of patients with positive nodes, presence of LPI and no p185 over-expression was similar to that of patients with negative nodes, absence of LPI and p185 over-expression.
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PMID:Prognostic significance of HER-2/neu expression in breast cancer and its relationship to other prognostic factors. 167 34

Features of 111 mammary carcinomas derived from breast cancer screening were compared with those of 69 carcinomas presenting 'clinically'. Screen detected cancers were smaller, had less likelihood of nodal metastases, included a higher proportion of in situ tumours and if invasive, tended to be of lower grade. Using immunohistochemical methods, the expression of c-erbB-2 oncoprotein, epidermal growth factor receptor (EGFR) and cathepsin D were compared in the two groups. A similar proportion of screened and unscreened tumours expressed c-erbB-2 oncoprotein and EGFR but expression of the oestrogen regulated protein cathepsin D was significantly more frequent in the screened group (P less than 0.05). Although a relatively small series, the results suggest a biological difference between 'screened' and 'clinical' tumours.
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PMID:Immunohistochemical and other features of breast carcinomas presenting clinically compared with those detected by cancer screening. 168 Mar 69

An immunocytochemical assay using a monoclonal antibody specific for estrogen receptor (ER-ICA) was performed on needle aspirates and on histologic sections (mastectomy and biopsy specimens) from 55 patients with breast cancer. A total of 82 ER-ICAs were performed, with matched cytologic and histologic specimens in 27 patients, cytology alone in 15, and histology alone in 13. ER-ICA results were described by a histochemical score (H score) based on intensity-weighted percentages of staining cells. The H scores were compared with results of sucrose density gradient (SDG) analysis of histologic specimens (mastectomy, resection, or biopsy). An H score greater than or equal to 10 and an SDG value greater than or equal to 10 fmol/mg protein were considered positive. The sensitivity of cytologic ER-ICA was 94%, the specificity 100%. The sensitivity of histologic ER-ICA was 67%, the specificity 90%. Correlating cytologic H score with Black's nuclear grade showed that grade 1 (the most anaplastic) carcinomas demonstrated the lowest H scores (mean, 7.3 +/- 29.8), whereas the highest H scores were noted in grade 3 tumors (mean, 150.0 +/- 88.1). Both SDG and ER-ICA showed ER values to be lower in premenopausal than postmenopausal women. There was no correlation between H score and presence of axillary nodal metastases or tumor size. An overall good correlation was demonstrated between immunohistochemical methods and biochemical analysis.
Breast Cancer Res Treat 1990 May
PMID:Comparison of immunocytochemical and biochemical assays for estrogen receptor in fine needle aspirates and histologic sections from breast carcinomas. 169 28

Axillary lymph node metastases at the time of diagnosis of breast cancer is the most accurate predictor of long-term prognosis. However, in patients treated by conservative surgery lymph node status often remains unknown. We have investigated the relation between changes in glycosylation of primary breast cancer cells, as judged by lectin binding, and the presence of axillary lymph node metastases. In a 24-year retrospective study, paraffin-embedded sections of 373 primary breast cancers were stained for the binding of Helix pomatia lectin (HPA). There was a strong association between HPA binding and presence of lymph node metastases, but no association with tumour size, histological grade, S-phase fraction, or patient age at diagnosis. This relation was confirmed by multiple regression analysis (in both survival and relapse free survival models) in which the prognostic significance of HPA binding was lost once nodal status had been introduced into the models. Life tables calculated for lymph-node positive versus lymph-node negative and HPA staining versus non-staining patients were almost identical over 15 years of follow-up. We propose that HPA recognises a glycoprotein that is associated with metastasis (to axillary lymph nodes and elsewhere) and poor prognosis in breast cancer. HPA binding to paraffin sections of primary tumour could aid difficult treatment decisions by providing an additional assessment of staging and likely long-term patient prognosis.
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PMID:Prediction of lymph node involvement in breast cancer by detection of altered glycosylation in the primary tumour. 171 41

We examined axillary lymph nodes from 80 women with node-negative breast cancer, by immunohistochemistry, utilizing polyclonal antibodies to cytokeratins and carcino-embryonic antigen and monoclonal antibodies to cytokeratins and milk fat globulin. Occult metastatic tumor, undetectable in hematoxylin and eosin stained slides, but visible by immunohistochemistry, was detected in 23 of 80 patients (29 per cent). Occult tumor was observed in patients with invasive ductal carcinoma (21/76-28 per cent) and in individuals with invasive lobular carcinoma (2/4-50 per cent). In patients with occult metastases the primary tumors were slightly larger (mean 2.39 cm, range 1.00-5.00 cm) than those of patients whose nodes were negative for tumor cells (mean, 2.03 cm, range, 0.60-4.50 cm). Information concerning clinical outcome is available for 61 patients followed for between 1 and 7 years (mean 3.2 years). Three of 17 patients (18 per cent) who had occult tumor in the nodes developed distant metastases, all less than 3 years after initial surgery. One of the 44 patients (2 per cent) whose nodes were free of occult tumor developed distant metastases 5 years following surgery. Local recurrences in the area of the mastectomy occurred in one of 17 patients with occult nodal tumor (6 per cent), less than 1 year after surgery. Local recurrences were seen in three of 44 patients without occult metastases (7 per cent), in two patients 5 years after mastectomy and in one patient 7 years after mastectomy.
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PMID:Occult metastases in the axillary lymph nodes of patients with breast cancer node negative by clinical and histologic examination and conventional histology. 172 33

The traditional surgical procedure to treat operable endometrial cancer is the removal of the uterus and both adnexa. In the trend of modern gynecological oncology this standardized operation should be changed in favour to a more individual procedure adapted to preoperative and intraoperative stage of the disease. A carefully fractioned curettage (of the cervix and the corpus uteri) is necessary to differ stage I (T1) and stage II (T2). Further important prognostic factors as myometrial invasion, nodal status, lymph vessel and blood vessel involvement and the intraabdominal findings (T3) are details of the post-surgical evaluation. A differentiated surgical treatment of the endometrial cancer includes for a stage I disease hysterectomy, bilateral adnectomy and pelvine lymphonodectomy. We recommend this additional procedure in all stages of the disease: The nodal status is for almost all genital cancers and breast cancer the most important prognostic factor. Postoperative adjuvent therapy (radiotherapy, hormonal therapy, chemotherapy) may be indicated by that. The surgical procedure for stage II (corpus and cervix involved) disease is a radical hysterectomy (Wertheim), bilateral adnectomy and pelvine lymphonodectomy. A paraaortal lymphonodectomy may be recommended, but most of the patients are 70 years and more and have a multimorbidity. Therefore, we indicated this additional procedure only in 7.5% of the operated patients. The surgical strategy in the (rare) stage III individual cancer is similar to the procedure in progressive ovarian cancer: Cytoreduction and debulking (e.g. omentum majus, peritoneum, involved bowel) has to be performed subsequent to hysterectomy, bilateral adnectomy and lymphonodectomy to improve the poor prognosis.
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PMID:[Differentiated operative therapy of endometrial carcinomas]. 172 46

In 186 women with breast cancer, there was a progressive increase in the proportion of axillary nodal involvement as the number of pregnancies increased from zero to two or more (P = 0.026). Logistic regression analysis demonstrated that this effect was independent of the known relationship of age and tumor size to nodal involvement. Race and history of breast feeding had no influence on nodal involvement.
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PMID:Past pregnancy is associated with axillary node involvement in women with breast cancer. 843 73

This paper is concerned with the relationship between the occurrence of metastases and the size of primary cancers. We consider two probabilistic characterizations of this relationship. First is the distribution function of tumor sizes at the point of metastatic transition; second is the probability that detectable metastases are present when the cancer comes to medical attention. The equation relating these two functions is developed and conditions for their being identical are explored. Since the tumor size at the point of metastasis is not usually observable, estimation of the first distribution requires the use of the EM algorithm. Nonparametric methods of estimating both functions are explored, with attention to the fact that tumors often fail to be measured, particularly those that are known to be metastatic. The methods are applied to the estimation of primary tumor size at the point of distant metastasis in lung cancer (epidermoid and adenocarcinoma) and colorectal cancer and at the point of nodal metastasis in breast cancer. Monte Carlo experiments confirm that the bias inherent in the methodology is acceptably small.
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PMID:Nonparametric estimation of the size-metastasis relationship in solid cancers. 174 51

The optimal extent of axillary dissection in patients with breast cancer remains unclear. We report 278 total axillary lymphadenectomies (levels I, II, and III and Rotter's [interpectoral] nodes) that were performed in 264 closely followed up private patients. There have been no axillary recurrences to date (mean follow-up, 50 months). If only level I and II nodes had been removed, the false-negative staging error would have been only 2.6%. However, 29 (31.5%) of 92 pathological node-positive axillae contained apical and/or Rotter's metastases. The incidence of complications was comparable with that reported for partial lymphadenectomy. Arm lymphedema developed in 6% of nonirradiated patients; postoperative radiotherapy and gross nodal disease were significant risk factors for lymphedema. Total axillary lymphadenectomy largely prevents axillary, recurrence, eliminates the small staging error inherent in partial lymphadenectomy, and has acceptable morbidity, provided radiotherapy to the regional nodal areas is avoided.
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PMID:Total axillary lymphadenectomy in the management of breast cancer. 174 46

The present study is based on the data of a homogeneous series of 736 women with stage I and II operable breast cancer. The same methodology was used for treatment and follow-up. Eighty-seven patients were under 40 and 649 between 40 and 70 years ols. No statistical difference was noted between the distribution in these 2 groups regarding tumor size, the axillary or internal mammary nodal status or hormonal receptor levels. Small tumors were noted more frequently in the under 40 yr group. Overall survival was the same in both groups, independently of tumor size, axillary nodal status or hormonal receptors. Disease-free survival differed between the 2 groups: local relapse risk was 1.6 times higher for women under 40 yr, in relation to a higher frequency of conservative treatment in this group. No difference was noted for DFS in relation a tumor size, axillary nodal status of hormonal receptors.
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PMID:[Prognosis of operable breast cancers in women aged under forty years]. 175 33


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