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

The elderly (aged 70 years or more) constituted 201 (37%) of 548 first-time admissions to a single institution for breast cancer between 1976 and 1985. The pattern of disease was studied and contrasted with that seen in younger patients (less than 70 years old). Currently, 5000 new breast cancers are diagnosed in Australia each year. It is projected that the proportion of new breast cancer patients who are elderly will rise from 37 to 60% by the year 2031. In general, the disease was similar to that seen in younger patients. Minor histological differences occurred and there were tendencies towards late presentation and clinically less aggressive disease. Tumour size, the presence of metastases and UICC staging were useful predictors of outcome but nodal status and hormone receptor levels did not discriminate. An unexpected finding was the relative longevity of elderly patients with breast cancer. The stage-specific 5-year survival rates (UICC stages: I--73%; II--65%; III--42%; IV--10%;) did not differ significantly from those seen in younger patients.
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PMID:Breast cancer in the elderly: pattern of disease. 175 68

This study of the natural history of human breast cancer was based on the analysis of a series of 3000 patients treated by radical mastectomy at a single institution (Institut Gustave Roussy) at a time when adjuvant chemotherapy was not prescribed. The follow-up of the patients ranged from 15 to 30 years; for each patient the tumor size, the number of involved axillary nodes, and the histological grade were prospectively registered. A highly significant correlation was found between tumor size and the probability of distant metastatic dissemination. The distribution of tumor sizes at metastatic spread was log-normal with a median diameter equal to 3.5 cm. The patients were subdivided into 3 groups according to the histological grade. In each subgroup there was a significant correlation between tumor size and the probability of distant spread; the distributions were log-normal and the median size was markedly larger for grade 1 tumors. Moreover the proportion of grade 1 tumors was higher in small tumors than in large ones while the reverse was observed for grade 3 tumors; these data suggest that during their growth tumors progress towards higher grades. One of the chief fundamental characteristics of a tumor seems to be its propensity for axillary node invasion. The orderly pattern of nodal involvement makes it possible to calculate the tumor size at invasion of the first axillary node in each subset of patients. A strong and highly significant correlation exists between the size of the tumor at initiation of distant metastasis and at invasion of the first lymph node. However the capacity for lymphatic spread is, on average, acquired much earlier than the capacity for metastatic spread. With a simple model based on these data it was possible to compute the proportion of patients with occult metastases as a function of tumor size, histological grade, and number of involved axillary nodes. Early invasion of axillary nodes is associated with a rapid growth rate of the primary tumor (or a high S-phase fraction). However each of these variables has an independent prognostic significance; the S-phase fraction appears as one of the strongest prognostic indicators. A model of tumor growth was used to assess the impact of screening procedures on the proportion of patients with distant metastases. The predictions of the model are consistent with the results of the screening programs.(ABSTRACT TRUNCATED AT 400 WORDS)
Breast Cancer Res Treat 1991 Aug
PMID:Natural history of human breast cancer: recent data and clinical implications. 175 55

Evaluation of prognostic factors for breast cancers is important for therapeutic decisions both at the time of surgery and during postoperative surveillance. In 1979, H. Rochefort described an induced protein with a molecular weight of 52,000 Daltons identified as procathepsin D. Total cathepsin D (TCD) (52K + 48K + 34K), expressed in pmol/mg protein, can be measured by an immunoradiometric method commercialized by Cis-Biointernational. Total cathepsin D was assayed in 413 breast cancer tumors from patients who underwent surgery between January 1, 1978, and December 31, 1985. Using a cut-off of 35 pmol/mg protein, patients with an elevated level had a significantly poorer survival than those with a low level (p = 0.03). This difference was not found for node-negative patients but was very significant for node-positive patients (p less than 0.008). The survival of node-positive patients with a low total cathepsin level was not statistically different from that of node-negative patients. Analysis of the N+ subgroup of patients who did not receive adjuvant chemotherapy revealed that TCD no longer had any prognostic value, whereas it was still important for the N+ subgroup who received an adjuvant treatment. Cox multivariate analysis of prognostic value for survival placed total cathepsin D in third position, after nodal invasion and progesterone receptor status, for the entire population, and in first position before progesterone receptor status for the node-positive population. The association of a low cathepsin level and positive progesterone receptors characterized the subgroup of patients with the longest survival. TCD levels played the same role for prediction of the outcome of metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)
Breast Cancer Res Treat 1991 Oct
PMID:Prognostic value of total cathepsin D in breast tumors. A possible role in selection of chemoresistant patients. 175 72

Prognosis of 141 women with pT1 breast cancer from a defined urban area was investigated. Only one of the 47 women with a primary tumor diameter less than or equal to 10 mm in diameter (pT1a or pT1b) died from breast cancer within 5 years after the diagnosis. The 5-year survival rate corrected for intercurrent deaths of the women with pT1c cancer (from 11 to 20 mm in diameter, n = 94) was 83%; 96% in pT1cN0 and 62% in pT1cN+ cancer respectively (p less than 0.0001). In a multivariate analysis axillary nodal status and S-phase fraction determined by flow cytometry were independent prognostic factors. The excellent survival of women with pT1a or pT1b breast cancer, and women with pT1cN0 breast cancer with no axillary nodal metastases, does not support the policy of giving adjuvant treatment to all women with breast cancer.
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PMID:Prognosis of breast cancer with small primary tumor (pT1). 176 68

Albumin content has been reported to be significantly different in cytosols from benign and malignant breast tumors, with a higher level in benign lesions. Low albumin content is suggested to be associated with a higher tendency to axillary nodal involvement in breast cancer patients. Albumin contributes greatly to the total amount of protein in tumor cytosol, and is easily measured. Albumin was measured in cytosols from 382 patients with breast cancer stage I and II, to evaluate correlations to other tumor variables and to investigate whether it may add information as a prognostic factor. The albumin content was expressed in percentages of total cytosol protein, with a median value of 18.5% for the study population. It was found to be significantly inversely correlated to estrogen receptor (ER) content. Cytosol protein content was inversely correlated to albumin. In addition to tumor size and axillary nodal involvement, albumin content was found to be an independent prognostic factor for relapse-free survival in an analysis of different prognostic variables in patients not given adjuvant endocrine treatment. Low albumin content (less than median) seems to predict effect of adjuvant tamoxifen treatment.
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PMID:Cytosol albumin content in operable breast cancer. Correlations to steroid hormone receptors, other prognostic factors and prognosis. 176 69

Clinical, radiographic (mammograms) and ultrasonographic data were compared retrospectively for 171 patients to evaluate the utility of ultrasound for the follow-up of breast cancer patients treated medically or by conservative surgery. When used to follow-up patients treated medically by induction or exclusive chemotherapy, ultrasonography accurately quantified tumor and nodal regression. After conservative surgery, sonograms are an ideal means to diagnose (and sometimes to treat) early complications (hematoma, lymphocele, abscess). Ultrasonography was more sensitive than mammography for the detection of recurrent disease (95.5% sensitivity for radiography versus 90% for ultrasonography). After radical surgery and breast reconstruction, ultrasonography is the only procedure required to follow-up of patients with breast implants, because it can determine the size and penetration of cutaneous recurrences. The fact that 30% of patients treated by lumpectomy and irradiation ultimately develop malignant or benign abnormalities justifies systematic ultrasonography for the follow-up of treated breast cancers. All sonographically demonstrable abnormalities warrant ultrasound-guided puncture biopsy.
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PMID:[Ultrasonographic surveillance of treated breast cancer]. 178 33

Two hundred and fifty bone marrow and 140 lymph nodal biopsies were analyzed immunocytochemically, using a mouse monoclonal antibody b-12 (M Ab b-12), which reacts with MCA (mucinous-like carcinoma-associated antigen). The presence of MCA in bone marrow specimens was demonstrated in 102 out of 105 (97.1%) breast cancer metastases, 5 out of 8 (62.5%) gastric cancers, 5 out of 6 (83.3%) colon cancers, 3 out of 5 (60%) prostate cancers, 11 out of 26 (42.3%) lung cancers and 25 out of 30 (83.3%) unknown primary cancers, while no positivity to anti-MCA antibody was found in 30 cases of normal bone marrow biopsies, 5 cases of non epithelial malignancies and 30 cases of hemolymphoproliferative disease. Normal lymph nodes and non-epithelial lymph node metastases did not show any reaction to M Ab b-12; on the contrary MCA positive staining was observed in 75 out of 75 (100%) lymph nodal metastases in breast cancer. These results suggest that application of M Ab b-12 in immunohistochemistry is valid for the detection of bone marrow and lymph nodal micrometastases of epithelial origin.
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PMID:Demonstration of mucinous-like carcinoma-associated antigen in bone marrow and lymph node biopsies from patients with breast carcinoma. 179 10

Several biochemical parameters quantitated in tumor cytosols from malignant breast tumors have been evaluated as possible prognostic factors. Cytosol protein content has always been regarded as a reference parameter, to correct for cellularity and representativity of tumor samples. But recent studies have suggested an altered protein distribution in malignant tissues. The present study on 382 women with histologically proven breast cancer, Stage I and Stage II, therefore evaluates whether cytosol protein content by itself may add information as a prognostic factor in the clinical management of breast cancer. Cytosol protein content was found to be significantly correlated (p less than 0.001) to tumor size, and inversely correlated to progesterone receptor (PgR) content (p = 0.015) and age at operation (p = 0.021). Using the median value of protein (4.15 mg/ml) as a cut-off value, two groups could be constructed. The number of node-positive patients in the protein-poor group was significantly decreased (p = 0.018) compared to the protein-rich group, which also contained a significantly (p less than 0.001) lower number of patients with estrogen receptor (ER) positive tumors (i.e. ER greater than or equal to 10 pmol/g). An increased number of events was observed in the protein-rich group (p less than 0.001), with a great contribution to the number of deaths due to breast cancer. In a multivariate analysis of the likelihood to predict axillary nodal involvement, protein category was found to be a significant (p less than 0.031) independent predictive factor. As to relapse free survival (RFS), protein category did not reveal any prognostic power.(ABSTRACT TRUNCATED AT 250 WORDS)
Breast Cancer Res Treat 1991 Dec
PMID:Cytosol protein content and prognosis in operable breast cancer. Correlations with steroid hormone receptors and other prognostic factors. 181 67

Survival data of a cohort of 160 patients with breast cancer, who were still alive 10 years after the primary diagnosis, and who had been followed up for at least 22 years, were investigated to find out those factors that predict late mortality from breast cancer. The 13 factors investigated included age at diagnosis, histological type and grade, mitotic count, type of tumour margin, inflammatory cell reaction, extent of tumour necrosis, primary tumour size, axillary nodal status, DNA ploidy and index, S-phase fraction and occurrence of a second primary breast cancer. Advanced age at diagnosis (greater than 49 years, P = 0.002), occurrence of a second primary breast cancer during the follow-up (P = 0.01), and primary tumour size (T3-4, P = 0.03) were significantly associated with mortality from breast cancer after the 10th year of follow-up in a multivariate analysis, and the ductal invasive histological type (P = 0.03) and a large DNA index (greater than 1.2; P = 0.06) in univariate analyses.
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PMID:Factors predicting late mortality from breast cancer. 182 67

The degree of nodal involvement in a consecutive series of 400 patients with invasive ductal breast cancer is presented. A positive correlation was observed between the number of metastatic nodes identified and the number of axillary nodes examined for poorly but not moderately differentiated tumours. The relevance of this observation to breast cancer trials is discussed.
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PMID:Nodal involvement in poorly differentiated breast cancer. 185 Feb 34


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