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Query: UMLS:C0006826 (cancer)
 1,092,456 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study was aimed at determining the role of high-frequency (7.5 MHz) US combined with cytology in the diagnosis of complex breast nodules (complex cysts--cystic tumors). The study population included 60 patients presenting with complex breast nodules selected on the basis of US patterns among 3,000 cases. All patients were also submitted to US-guided fine-needle aspiration biopsy (FNAB). Cytology of nipple discharge was always performed when discharge was present (15 cases), mammography was performed in 50 cases and pneumocystography in 10. US allowed the identification of the lesion in all patients and the diagnosis of nature in 73%; with FNAB the figure reached 96.7%. Mammography identified the lesion in 95% of patients, but failed to reveal the complex nature of the nodule. In a small number of cases mammography proved to be a useful complementary tool demonstrating malignant features not recognizable on US images. On the contrary, pneumocystography yielded no further information with respect to US. Diagnostic control was obtained by means of surgery in 30 patients and of clinical-US follow-up in the extant 30 cases. On the basis of their US features the lesions were classified into two groups: I) nodules having a mainly liquid component--i.e., hemorrhagic, septic, multilocular cysts, papillary cystadenoma; II) nodules having a mainly solid component--i.e., solitary intraductal papilloma, intracystic carcinoma, mixed carcinoma, phylloid adenoma, sarcoma. As to the former group, US proved reliable in making a diagnosis in the cases with typical hemorrhagic, septic and multilocular cysts. In the atypical cases, FNAB of the solid component of the nodule was necessary to differentiate irregular clots, thick septa or inflammatory thickening from different conditions. As to the latter group, FNAB of the solid component and/or mammography proved useful in making a diagnosis, even though to this aim US revealed peculiar patterns which were highly suggestive. In our experience, combined US and FNAB are of basic importance in the diagnosis of breast lesions, thus replacing pneumocystography which has been widely employed so far. As regards mammography, its role seems limited to pointing out the peculiar characters of malignancy which could not be demonstrated otherwise.
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PMID:[The diagnostic imaging of complex breast nodules]. 141 Jun 63

A review is presented of 2,000 consecutive new, patients with breast complaints. Emphasis is placed on the specific complaint as correlated with patient age and the incidence of breast cancer. The initial complaints were a lump (50%), an abnormal mammogram (32%), other complaints (8%), breast pain (6%), and nipple discharge (4%). Follow-up information was available for 1,889 patients. The majority of the patients (68%) were under 50 years of age. Of 831 patients to whom a biopsy was recommended, 720 ultimately had a biopsy and 147 cancers were identified. Sixty-five per cent of the cancers were in women aged 50 years or greater. Of the patients aged 50 years or older, 16.1 per cent had breast cancer, while only 4.0 per cent of the patients less than 50 years and 0.8 per cent of the patients less than 30 years of age had breast cancer. The author concludes that the overwhelming majority of patients (92%) referred to a breast surgery practice do not have malignancy. Thus, primary physicians undoubtedly see even a smaller per cent of breast complaints ultimately result in the diagnosis of breast cancer. There is a need to better inform the public as to the significance of breast complaints and to establish more specific criteria for biopsy, particularly in the young, professional, liability threats not withstanding.
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PMID:The significance of breast complaints as correlated with age and breast cancer. 161 86

A fiberoptic ductoscopy system was successfully developed by means of which we were able to observe the duct cavity of the breast. Two kinds of silicafiberscopes with outer diameters 0.80 and 0.45 mm were used in the present study. Fiberoptic ductoscopy was applied to 52 ducts in 46 patients with nipple discharge for whom no tumor was palpable; the intraductal appearance could be observed in 47 ducts from 41 patients (90.3%). Fourteen ducts from 13 patients were operated upon and were histologically diagnosed as carcinoma (four cases), intraductal papilloma (nine ducts from eight patients) and mastitis (one case). The internal surface of a normal duct was lustrous and smooth. Cancer growing on the surface of a duct wall appeared white and was slightly elevated, forming a bridging structure. The intraductal papillomas formed intraductal solid nodules, being yellow in most cases and red at the site of hemorrhage. Fiberoptic ductoscopy can be used to recognize the growth of minute intraductal lesions in cases of nipple discharge. Clinical endoscopic diagnosis for minute intraductal lesions will make an important contribution to the early detection of cancer and the evaluation of nipple involvement in intraductal carcinoma.
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PMID:Fiberoptic ductoscopy of the breast: a new diagnostic procedure for nipple discharge. 165 13

We report two cases of neuroendocrine carcinomas of the breast displaying unusual histological features: numerous spindle cells and argyrophilic signet-ring cells. Both patients were older than 70 years, and both presented with a bloody nipple discharge. The tumor in both cases was predominantly intraductal. The tumor cells showed little pleomorphism or cytological atypia; because of the presence of spindle cells, benign diagnoses, such as ductal epithelial hyperplasia and intraductal papilloma, were considered for the in situ component. Recognition of the palisading arrangement of the peripheral cells, intracytoplasmic lumina, mitotic figures, and mucin permitted the diagnosis of intraductal carcinoma. Invasive nests composed of identical cells confirmed the diagnosis of malignancy in both cases. Our cases, along with those previously reported, suggest that neuroendocrine carcinoma with mucin production is a distinct breast tumor that usually occurs in older patients who experience bloody nipple discharge. The prognosis may be more favorable than that of the usual type of breast carcinoma. Common histological features include predominantly intraductal growth, an absence of desmoplasia, and low-grade atypia. Awareness of morphological variants of this tumor, such as those reported here, is necessary to avoid erroneous diagnoses.
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PMID:Spindle-cell argyrophilic mucin-producing carcinoma of the breast. Histological, ultrastructural, and immunohistochemical studies of two cases. 171 95

Of the three commonest symptoms found in 3294 patients referred to a specialty breast clinic--mass, nodularity and pain--only nodularity was age related. Only 30% of the patients had a clinically localized abnormality, and only 19% of these abnormalities were suggestive of carcinoma. The majority of suggestive lesions were in women over 55 years of age. Of the patients seen because of a breast lump, 46% were found to have a significant mass. Most abnormalities were found in patients presenting with a mass or nipple discharge, and the significance was age related. Symptoms associated with the lowest rate of positive biopsies were nodularity, pain and skin or nipple changes. The biopsy and cancer rates were significantly age related. The cancer rate in women 40 years of age and under was 0.8%, between 41 and 55 the rate was 5%, and in those over 55 it was 21%. The predominant finding in young women was a fibroadenoma. In the middle age range fibrocystic change was most common, and in postmenopausal women most of the lesions were malignant.
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PMID:Age-related breast diagnosis. 173 90

A case review of 225 patients with abnormal breast nipple secretions (NS) was done to determine diagnostically useful clinical and cytologic features. The cytologic specimens and medical records from all patients and 45 concurrent breast biopsies were reviewed. Nipple discharge was attributed to fibrocystic disease (FCD) in 81 cases, physiologic disturbances in 62, papillomas in 18, ductal carcinoma (CA) in 5, miscellaneous benign disorders in 14, and unknown causes in 45. Although cytologic examination of NS was very specific in identifying malignancy, the sensitivity of cytology was low. Carcinoma was diagnosed or suspected cytologically in only three of the five CA cases, with no false-positive cytopathologic interpretations. Malignant NS were usually unilateral, hemorrhagic, mass-associated, and in older patients. Males with nipple discharge had a significantly higher incidence of breast cancer (two of nine; 22%) than women with abnormal NS (3 of 216; 1.5%). Papilloma NS were generally unilateral and hemorrhagic; FCD and physiologic NS were mostly serous or milky. Benign NS were not cytologically distinguishable. We conclude that cytologic examination of NS is a specific but insensitive method to identify underlying malignancy. Additional clinical features, including patient age, laterality and character of NS, and radiographic findings, were found to be diagnostically useful.
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PMID:Cytologic and clinicopathologic features of abnormal nipple secretions: 225 cases. 156 18

Nipple discharge is one of the most common breast complaints in women. Galactorrhea (milky discharge) may occur during pregnancy or breast-feeding or as a result of drug therapy, hypothyroidism, or hyperthyroidism. Nonbloody discharge is most common and is usually benign. Bloody discharge should be considered a sign of cancer until proved otherwise. Persistent galactorrhea and nonbloody discharge can be treated by transecting the mammary ducts. Simple mastectomy may be appropriate in patients with persistent bloody discharge who have a strong family history of breast cancer.
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PMID:Nipple discharge in women. Is it cause for concern? 199 59

The detection of breast cancer in women under 35 is quite an uncommon event, accounting only for 3.2-3.4% of all breast cancers. To determine the indications for mammography in women under 35, the authors correlated clinical, mammographic, and US findings with fine-needle aspiration/surgical biopsy and follow-up results in 1040 symptomatic women examined at the Center of Senology of the Institute of Radiology-University of Perugia, Italy, from 1984 to June 1990. Of 1040 women, 482 (41.6%) had normal findings; benign disease was diagnosed in 558 (53.7%) cases, and malignant disease in 49 (4.7%). Mammography was very useful to diagnose malignancy in palpable breast lesions, as well as to suggest the need for biopsy, to detect metachronous cancers and to define lesion sizes. In inflammatory process--e.g., mastitis and abscesses--both mammography and US were capable of evaluating the real extent of the process, as well as its remission after therapy. Galactography had a specific role in the evaluation of the mammary duct and demonstrated intraductal pathologic conditions. In the authors' experience, mammography never showed occult breast cancers in women with no palpable breast lesions or hematic nipple discharge.
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PMID:[Role of mammography in women under 35 years of age]. 200 38

Three hundred and thirty-six patients with nipple discharge and neither physical signs at breast examination nor pathological findings at mammography, were observed from 1984 to 1988 and studied by means of ductogalactography and cytology of discharge. Of this group, 76 patients (22.6%) underwent surgery and histology. In 65/76 cases proliferative pathologic conditions were demonstrated: 51 single/multiple papillomas and 14 carcinomas. Ductogalactography suggested proliferative pathologic conditions in 59 cases and cytology of discharge showed blood in 44 patients, papillary clusters in 23, and atypical cells in 15 (both as single occurrences and in association). In cancer patients discharge appeared to be mostly spontaneous, monoductal and blood-stained. In papillomas, induced discharge was almost as frequent as spontaneous discharge, serous discharge was almost as frequent as blood-stained discharge, and milky discharge was also present. Ductogalactography confirmed its value in the diagnosis of proliferative pathologic conditions of the mammary ducts, being especially useful to detect carcinomas without palpable tumors. Cytology of discharge had poorer diagnostic significance.
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PMID:[Proliferative pathology of the mammary ducts. Diagnostic value of ductogalactography and cytologic correlations]. 205 82

Sixteen cases of male breast cancer seen over a 20-year period were reviewed. The causes of cancer of the male breast are no better understood, but major alterations in hormonal environment could be a significant factor. Some clinical characteristics correspond well with the results of other series. The median age at presentation was 61.7 years. The most frequent initial symptom was a painless mass, and the incidences of nipple discharge, central tumor location, and axillary node involvement were high. Males also had a higher incidence of local advancement which was associated with a longer delay in seeking treatment and small breast tissue. The pathologic type was infiltrating ductal type in all cases except one, and all cases showed favorable nuclear grade. Estrogen receptor analysis was performed from the tumor of 2 patients. Both of them showed a high receptor level. There was no locoregional relapse in 5 patients who received adjuvant radiotherapy in contrast to the 2 relapses in 3 patients who underwent surgery alone. And three of the five patients who received radiotherapy suffered from systemic metastasis which suggested the important role of adjuvant chemotherapy as well as radiotherapy. In light of the encouraging results about adjuvant chemotherapy in the treatment for female breast cancer with axillary lymph node involvement, it would be desirable to extend this policy to male breast cancer.
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PMID:Male breast cancer--a 20-year review of 16 cases at Yonsei University. 217 38


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