Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007124 (ductal carcinoma in situ)
 3,833 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The optimal management of ductal carcinoma in situ of the breast is controversial. With the introduction of the National Mammographic Breast Screening Programme the condition will be encountered more frequently. We have reviewed 76 patients from a 12-year period treated by one surgeon (R.W.B.) at the Nottingham City Hospital. Fifty-nine patients had either ductal carcinoma in situ or lobular carcinoma in situ; 17 patients had Paget's disease. The mean age at diagnosis was 54 years and the commonest mode of presentation was with a palpable breast lump. Pre-operative mammography was performed in 31 patients with ductal carcinoma in situ and 28 were reported as showing malignancy. Patients with a lesion in the breast parenchyma were treated either by mastectomy (simple, subcutaneous or 'wedge'--see text) or by lumpectomy and radiotherapy. Patients with Paget's disease were treated by simple mastectomy, wedge mastectomy or a cone excision of the nipple and underlying tissue. The mean follow-up period was 65 months. Patients treated by any of the procedures less than simple mastectomy had a significant chance of developing local recurrence. A detailed histological review was made and grade, microinvasion, calcification, necrosis and completeness of excision were assessed for each tumour. None of these factors was correlated with subsequent local recurrence.
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PMID:In situ carcinoma of the breast. 254 62

In a mammography screening programme for the early detection of breast cancer 66 cases of ductal cancer in situ of the breast (DCIS) were diagnosed between 1978 and 1984 and prospectively followed up. In the beginning of the study period, DCIS was treated by mastectomy without axillary clearance but sector resection has been performed increasingly. Since 1982 the latter procedure has become standard treatment. Radical resection was confirmed by specimen X-ray and histopathological examination of whole organ sections. No postoperative radiotherapy was given. Twenty-eight women had mastectomy and 38 had sector resection. The median follow-up times were 77 and 60 months respectively. In the mastectomy group postoperative monitoring did not reveal any local recurrence but one contralateral new invasive cancer was discovered. In the sector resection group five recurrences were found. Three of the latter were new cases of DCIS and two appeared as small invasive cancers (stage I). Mastectomy will cure ductal cancer in situ but has a greater morbidity. Sector resection has been established as the method of choice in stage I invasive cancer and is probably also safe in DCIS. The possible beneficial effect of postoperative local radiotherapy after sector resection for DCIS is currently being analysed in a randomized trial which started in Sweden in 1987.
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PMID:Follow-up of two treatment modalities for ductal cancer in situ of the breast. 254 51

The authors retrospectively analyzed the mammograms of 190 women with biopsy-proved ductal carcinoma in situ (DCIS). Excluded from the current study were 117 (62%) women whose radiographs showed suspicious clustered microcalcifications, a well-known finding in DCIS. Of the remaining 73 (38%) women, 30 (16%) had negative mammograms, and 43 (23%) had mammographic manifestations of breast malignancy other than microcalcifications. Of the latter 43, 15 had circumscribed masses, and 12 had various focal nodular patterns. The remaining 16 patients showed other mammographic signs of malignancy, including asymmetry (n = 1); dilated retroareolar ducts (n = 2); ill-defined, rounded tumor (n = 2); focal architectural distortion (n = 4); subareolar mass (n = 3); and developing density (n = 4). Of the 73 women in the study, 60 presented with clinical findings related to the tumor. Since DCIS has a high survival rate with proper treatment, radiologists should be aware of the unusual radiographic manifestations of this disease.
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PMID:Ductal carcinoma in situ: atypical mammographic appearances. 215 85

To evaluate the usefulness of fine-needle aspiration biopsy of the breast in separating ductal carcinoma in situ (DCIS) from infiltrating ductal carcinoma, the authors reviewed 16 preoperative fine-needle aspiration biopsies from biopsy-proven exclusive DCIS and 39 fine-needle aspiration biopsies from infiltrating ductal carcinomas with or without an in situ component. Seven (44%) of the DCIS and eight (21%) of the infiltrating ductal carcinomas had inadequate material for diagnosis on the aspiration biopsy. Five (32%) of the DCIS and 29 (74%) of the infiltrating ductal carcinomas caused suspicion or had positive results for malignancy. Four (25%) of the DCIS and two (5%) of the infiltrating ductal carcinomas showed atypical cells. Morphologic features of the atypical or malignant cells in the adequate specimens from these two lesions were similar except that the cells from the infiltrating ductal carcinomas showed more irregular nuclear spacing (94% vs. 44%, P less than 0.01) and more pronounced nuclear overlapping (65% vs. 33%) than those from the DCIS. In addition, the fine-needle aspiration biopsies of the DCIS tended to be hypocellular (less than 10 cells/10X) (44% vs. 6.5%, P less than 0.05) and to contain benign epithelial cells (22% vs. 6.5%) and macrophages (33% vs. 13%). Although the suspicion of DCIS might be raised when hypocellularity, benign epithelial cells, and macrophages are noted in a fine-needle aspiration biopsy of the breast that has positive results or causes suspicion for malignancy, fine-needle aspiration biopsy cannot be relied upon to distinguish DCIS from infiltrating ductal carcinoma.
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PMID:Comparative features of ductal carcinoma in situ and infiltrating ductal carcinoma of the breast on fine-needle aspiration biopsy. 255 17

Carcinoma in situ is the earliest histologically recognisable form of malignancy and as such provides an opportunity to treat the disease in a curative way. However, due to the comparative rarity of in situ breast carcinoma, there is no available information derived from controlled clinical trials. The two major variants, ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) will be considered separately as the two conditions have divergent natural histories. DCIS is increasing in incidence since microcalcification, which is a frequent accompaniment, may be detected radiologically in the screening of asymptomatic women. The extent of microcalcification may not indicate the extent of disease. It has yet to be determined whether there is a difference in behaviour of the tumour forming and the asymptomatic types of DCIS. After a biopsy has shown DCIS there will be residual DCIS at the biopsy site in one-third of patients, and multifocal DCIS in another third. A coexistent infiltrating carcinoma may be present in up to 16%. Due to sampling problems areas of invasion may be missed. Axillary nodal metastases are found in only 1% of patients with histological DCIS. Radical surgery by total or modified mastectomy is almost curative, but 3% of patients will die of metastases. Taking results of uncontrolled trials, local relapse rates are as follows: excision alone 50%, wide excision 30%, wide excision plus radiotherapy 20%. Two prospective trials are underway run by the EORTC and NSABP in which patients with DCIS are treated by wide excision with or without external radiotherapy. LCIS is usually an incidental finding with a bilateral predisposition to subsequent infiltrating carcinomas. Curative procedures such as bilateral mastectomy with reconstruction may represent overtreatment. A systemic rather than local approach would seem appropriate and a trial is now underway run by the EORTC in which patients with histologically confirmed LCIS are randomised to observation alone or to receive tamoxifen 20 mg daily for 5 years. Cooperative studies will provide the way of acquiring important data on treatment regimens of both DCIS and LCIS. It is timely that treatment regimens for in situ carcinoma of the breast be examined by controlled clinical trials.
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PMID:The treatment of in situ breast cancer. 255 95

In situ breast cancer, both ductal and lobular, is being diagnosed more often today because of improved screening programs and more sensitive mammography. Unfortunately, treatment options in the disease are based on retrospective studies with the natural history obscured. While considered a noninvasive cancer, it has been theorized that ductal carcinoma in situ is a preinvasive stage that will eventually evolve into an invasive cancer. The author reviews results of studies comparing treatment methods, including wide local excision, mastectomy, and radiation, and concludes that prospective studies must be performed before optimal therapy can be determined.
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PMID:Noninvasive breast cancer: Part 1. Ductal carcinoma in situ--incidence, presentation, guidelines to treatment. 256 80

The expression of the neu oncogene product was investigated in invasive and non-invasive ductal carcinomas of the breast, non-neoplastic lesions of the breast, fragments of normal adult and fetal breasts and in several other normal and fetal tissues at different weeks of pregnancy by means of an immunohistochemical study with monoclonal antibodies. The staining pattern along the cytoplasmic membrane was specific for malignancy and occurred in 29% of the breast carcinomas. It was observed in invasive carcinomas as well as in ductal carcinoma in situ and it showed a significantly higher expression in premenopausal women than in postmenopausal women. This higher expression was also present in oestrogen receptor-negative tumours. The tubules of the fetal and adult kidney, the absorption cells of the fetal and adult small and large intestine, the sebaceous glands of the fetal and adult small and large intestine, the sebaceous glands of the fetal and adult skin, the adult endocervix, the endometrium, the C-cells of the thyroid, hepatocytes and all ductal cells of the fetal breast showed a constant diffuse intracytoplasmic granular staining. staining. The same granular intracytoplasmic staining pattern was focally observed in rare cases of normal breast tissue in adults and in some cases of epitheliosis, aprocrine metaplasia and some breast carcinoma cells, which did not express neu oncogene product on their membrane. Western blot experiments showed that the cytoplasmic protein had a molecular weight of 155 kD (kilodaltons); the membrane protein is the known 185 kD neu protein.
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PMID:The expression of the neu oncogene product in breast lesions and in normal fetal and adult human tissues. 257 31

The occurrence of breast and thyroid multiple primary neoplasms has been evaluated using data from the Israel Cancer Registry. During the 16 years 1960-1976, 3,072 cases of thyroid cancer were registered in Israel. The occurrence of a second primary tumour was reported in 92 of these patients. In this latter group were 25 female patients (27%) with breast cancer, developing synchronously in 7 cases and metachronously in the remaining 18. The average age at the time of appearance of breast cancer was 50 years. Most of the patients (84%) were of European origin. The most common histological types were ductal and intraductal carcinoma and scirrhous adenocarcinoma. The possible aetiological factors common to breast and thyroid cancer are discussed. Efforts aimed at improving the survival of patients with thyroid cancer must incorporate strategies for the early detection and treatment of secondary breast cancer.
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PMID:Multiple primary thyroid and breast cancer in Israel, 1960-1976. 259 4

A retrospective immunoperoxidase staining study for a glycoprotein isolated from human breast gross cystic disease fluid (GCDFP-15) in 562 primary breast carcinomas in 539 patients was conducted to correlate its immunohistochemistry with pathologic and clinical factors. Overall, 55% of the carcinomas studied stained positively for GCDFP-15. In certain histologic subtypes, the percentage of carcinomas that stained positively was greater: those subtypes with apocrine histologic features (75%), intraductal carcinoma (70%), and infiltrating lobular carcinoma with signet-ring cell differentiation (90%). In contrast, only 5% of medullary carcinomas exhibited positive staining. Only 23% of breast carcinomas without apocrine features stained positively for GCDFP-15. Carcinomas that stained positively were more likely to have involved axillary lymph nodes (P less than 0.054). The staining was independent of nuclear grade, mitotic index, tumor size, and estrogen receptor status. Positive staining was related to a history of gross cystic disease but not to age, parity, menopausal status, or age at first birth. A positive stain was not related to risk of recurrence or survival.
Cancer 1989 Jun 01
PMID:Expression of GCDFP-15 in breast carcinomas. Relationship to pathologic and clinical factors. 265 63

A breast biopsy was performed in 19 patients for the finding of new mammographic calcifications without an associated palpable or mammographic mass after breast-conserving surgery and definitive irradiation for early stage breast cancer. The interval postradiotherapy was 9 to 96 months with a median of 34 months. Eleven of the biopsy specimens (58%) were positive for recurrent breast cancer and eight (42%) were negative. The pathologic results from the positive biopsy specimens showed four with invasive ductal carcinoma, two with microinvasive ductal carcinoma, four with intraductal carcinoma, and one with lobular carcinoma in situ (LCIS). Treatment consisted of mastectomy in eight patients, mastectomy plus chemotherapy in one patient, and biopsy for the patient with LCIS. One patient refused a recommended mastectomy. All 11 patients with recurrent carcinoma are alive with no evidence of disease after salvage therapy, although follow-up is short (median, 14 months; range, 0-48 months). Calcifications which developed in a quadrant different from the initial tumor tended to be malignant with four of five having a positive biopsy result. Microcalcifications were not commonly associated with the initial tumor with only five of 19 having microcalcifications. These results show that the development of new calcifications in the postirradiated breast is associated with a positive biopsy rate of 58% and that the tumors which are found tend to be early and potentially salvageable. The positive biopsy rate of 58% in the postirradiated breast is in marked contrast to the lower positive biopsy rate for microcalcifications in the nonirradiated breast as reported in the literature.
Cancer 1989 May 15
PMID:Biopsy results of new calcifications in the postirradiated breast. 270 68


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