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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Breast cancer is the most common malignant neoplasm in women, and 6% will develop it during their normal life expectancy. There is a group who have a high risk of developing breast cancer. The recent improvement in cure rates seems to be jue chiefly to earlier diagnosis rather than to improved methods of therapy. The physician, by careful periodic breast examinations and by the judicious use of diagnostic aids such as mammography and thermography, especially in the high risk group, has a golden opportunity to pick up cancer in a localized stage where the prognosis for cure with appropriate therapy is excellent. A tentative diagnosis of breast cancer (Table XI) can be made with a fair degree of accuracy by taking a careful history, utilizing and combining available statistics about the frequency, median age, characteristic symptom complexes of the common breast lesions and factors related to a high mammary carcinoma risk, and by a systematic and thorough breast examination supplemented with diagnostic aids when appropriate. However, biopsy and histologic examination is mandatory in all patients with a) true, three dimentional, dominant lumps even if diagnostic aids are negative except for cysts which can be safely aspirated under controlled conditions; b) suspicious lesions found by diagnostic aids even though there are no clinical findings; c) serous, serosanguineous, bloody, or watery nipple discharge; and d) other signs of cancer, i.e. eczema of the nipple, axillary adenopathy, etc., in order to determine with absolute accuracy whether the lesion is benign or malignant.
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PMID:Clinical diagnosis of breast cancer. 16 76

Carcinoma of the breast is relatively uncommon in men. Represents somewhere between 0.9 to 1.5 of all tumors of the breast. Most patients are within the 7th to 8th decade of life. The most common symptoms at the time of presentation are a tumor mass in either breast, ulceration of the nipple or nipple retraction or fixation of the skin. Extension to the axiliar nodes takes place early in the course of the disease. The presence of nipple discharge should be considered expression of carcinoma of the breast unless otherwise proven. The final diagnosis is established by biopsy. The most common form of carcinoma of the breast is the ductal carcinoma. The surgical management takes basically that followed in carcinoma of the breast in the female patient. Also orquiectomy has been used which is equivalent to ovariectomy in woman. In the presence of metastasis both estrogens and androgens have been used. Hypophysectomy and post-op radiation therapy has been used. Most recently chemotherapy has been widely used in those cases with widespread metastasis. However, in spite of all these efforts carcinoma of the breast in the male still carries a very serious prognosis. We present our experience in 16 cases.
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PMID:[Breast cancer in men]. 23 66

A clinical and galactographic investigation was carried out on 103 patients with hematic, serous-hematic, and serous nipple discharge. The age of the patients ranged from 18 to 72 years. A single papilloma was found in 20 cases, diffuse papillomatosis in 2 cases, atypical ductal hyperplasia in 8 cases, and ductal carcinoma in 4 cases (3 of these were infiltrating and 1 was noninfiltrating associated with a diffuse papillomatosis). Mammography gave no indications of carcinoma in any of the 4 cases. In the remaining 49 patients, pictures of ductal hyperplasia, periductal mastitis or sclerosis, sclerosing adenosis, or ductal ectasia were observed. The various types of lesions were often associated. Lacunae, stenosis, or occlusion of the ducts, evidenced by galactography, correlated well with the histologic findings of proliferative lesions of the ductal epithelium. Nevertheless, in practice, it should be the type of discharge that indicates surgery rather than galactographic or cytologic data, which appeared to have little diagnostic value. The frequency with which preneoplastic (or limit) lesions, and also nonsuspect carcinomas were found in patients with a significant nipple discharge confirm the importance of this symptom for a secondary prevention of early diagnosis of mammary neoplastic lesions originating from galactophorous ducts. Finally, complete resection of the galactophorous ducts must be considered as the best treatment in all patients with a suspicious nipple discharge that requires surgery.
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PMID:Nipple discharge as a sign of preneoplastic lesions and occult carcinoma of the breast: clinical and galactographic study in 103 consecutive patients. 38 91

The pathologic diagnosis of 282 consecutive breast lesions seen in 255 black patients over a 3-year period (January 1975-December 1977) at Harlem Hospital Center were reviewed and analyzed. The most common lesion was fibroadenoma, accounting for 34.7% of all lesions and 48% of benign breast lesions, followed by carcinoma (28%) and fibrocystic disease (17%). Other major benign breast lesions in order of frequency were intraductal papilloma, sclerosing adenosis, chronic mastitis, and fat necrosis. One each of the following rare lesions was observed: papillomatosis, ducatal ectasia, cystosarcoma phylloides, and granular cell tumor. Multiple lesions were found in 1 or both breasts in 15% of all benign breast disease cases, with fibroadenoma being the most common lesion. 94% of the patients presented with a breast mass, 5% with nipple discharge, 5% with pain, and 2% with a history of trauma to the breast. The lesions varied in size from 0.5-10 cm, and had been present for a few days to 20 years before medical treatment was sought. The upper quadrant of the breast was the most common site for lesions. Peak age incidence for all benign breast lesions was 20-35 years; for fibroadenoma, peak age incidence was 16-25 years and for fibrocystic disease, 40-50 years. The surgical literature shows that in a predominantly white population, peak age of incidence for benign lesions is 30-49 years; this disparity in age distribution may be due to the high percentage of adolescent patients with fibroadenoma in the Harlem Hospital series. Median age of patients with breast carcinoma in this series is 61 years. 24 patients (13.7%) with benign breast disease had taken oral contraceptives before the breast biopsies were performed. However, the study population is to small and follow-up time to short to draw any conclusion regarding the relation of oral contraceptive use to the subsequent development of breast cancer. This study shows that compared to the white population, fibroadenoma is more frequent than cancer in black women while cancer is more frequent than fibroadenoma in white women.
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PMID:Analysis of benign breast lesions in blacks. 45 72

As a result of health education programs that have stressed self-examination and the importance of early diagnosis and treatment, less than 5 percent of breast lesions seen in clinical practice today are malignant. Nevertheless, breast cancer is the leading cause of deaths due to cancer in women and the second most common breast lesion. Chronic cystic mastitis, the most common breast lesion seen in women, can often be treated conservatively by aspirating the cystic fluid. Close follow-up is necessary so that if carcinoma develops, it can be treated early. Carcinoma is unpredictable but not hopeless. Although controversy exists regarding treatment, radical mastectomy is still the preferred treatment in most cases. Other breast diseases include adenofibroma, a common lesion requiring excisional biopsy for positive diagnosis; nipple discharge, which should be carefully examined cytologically; and relatively rare breast lesions, including intraductal papilloma, adenosis, traumatic fat necrosis, and cystosarcoma phylloides.
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PMID:Diseases of the breast. 116 67

Breast carcinoma-in-situ constitutes 4.1% of 707 breast cancers diagnosed between 1988 and 1990. Among these 30 patients, intraductal carcinoma-in-situ (DCIS) outnumbers lobular carcinoma-in-situ (LCIS) by 9-fold. They are mostly symptomatic - 87% present as breast lumps and/or nipple discharge, with 52% of lumps exceeding 2cm size. Three patients were detected by screening mammography and it is expected that more breast carcinoma-in-situ will be detected through mammographic screening. Two-thirds of the patients had mastectomy while the rest had lesser procedures. The different surgical procedures and adjuvant therapy instituted for the patients are reflections of the differing opinions regarding optimum therapy for carcinoma-in-situ and the differing rationale for DCIS and LCIS lesions.
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PMID:Breast carcinoma-in-situ: an emerging problem in Singapore. 132 32

Ductal carcinoma in situ of the breast is very rare in men, representing 0-7% of all male breast cancers. We analysed 15 cases from a retrospective multicentric series of 404 patients (3.7%). It occurs earlier than infiltrating carcinoma (mean age: 55 years), sometimes before 40 years of age. The main symptoms are bloody nipple discharge or retro areolar mass. Modified radical mastectomy constitutes the basic treatment. Lower axillary dissection can eventually be indicated in comedocarcinoma or in tumors larger than 25 mm. The main histologic subgroup is papillary carcinoma, pure or intracystic. As is the case in women, local recurrence, invasive or not, rarely occurs. Theoretically, the cure rate approaches 100%. However, as in all cases of breast cancer in men, an important number of deaths due to secondary cancer or intercurrent disease have been noted. Until now, no clear etiologic factors have been found.
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PMID:[Breast cancer in males: a study of 15 cases of pure ductal carcinoma in situ]. 133 68

A milky discharge from the nipple and breast hypertrophy are often seen in mature infants, but bloody nipple discharge is very rare in infancy and childhood. In adults, a bloody discharge may be associated with breast carcinoma, but in infants it is a benign, self-limited condition that should be managed conservatively. Surgical procedures should be avoided, because injury to the breast bud may cause permanent damage. We report a 3-month-old girl who presented with a bloody discharge from the left nipple. The discharge diminished gradually in the course of time and ceased completely at the age of 9 months.
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PMID:[Bloody nipple discharge in an infant]. 139 18

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

We measured carcinoembryonic antigen (CEA) in 43 cases with abnormal nipple discharge by means of enzyme immunoassay utilizing monoclonal anti-CEA antibodies. When the cut-off value was set at 400 ng/ml so that the cases where measured values are not less than this value may be interpreted to be positive, the sensitivity and specificity were 60% and 75% respectively. The clear relationship was virtually observed between the concentration of CEA in nipple discharge and the cytological diagnosis. 9 of 10 malignant cases showed positive in both or either of the CEA assay and the cytological examination. And we could find 1 case of the zero stage of breast cancer and 4 cases in non-invasive carcinoma (Tis) through the combined diagnosis. On the other hand, only 2 of 8 benign cases showed false positive results. The correlation between the CEA concentration in nipple discharge and intratumoral expression of CEA was also observed. In this study, we concluded that the combined use of the enzyme immunoassay and the cytological examination would be more effective in the detection of early breast cancer accompanied with abnormal nipple discharge.
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PMID:[Clinical usefulness of carcinoembryonic antigen measurement in nipple discharge as an adjunctive tool for diagnosis of breast cancer]. 154 28


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