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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1979 and 1985 surgical resections from 680 cases of primary breast cancer were examined histologically. The patients were divided into four groups: (i) patients aged between 45 and 69 years who had been screened (n = 316); (ii) those younger than 45 who had not been screened (n = 55); (iii) those aged between 45 and 69 who had not been screened (n = 104); and (iv) those older than 69 who had not been screened (n = 205). The material was compared in terms of the association between in situ and invasive carcinoma. There was a low incidence of lobular carcinoma in situ (LCIS) in all groups and a high incidence of ductal carcinoma in situ (DCIS) which declined with age. Ninety nine group i patients had in situ carcinoma or early invasive carcinoma (less than 1 cm in diameter) compared with 19 of group iii cases. Screened patients had fewer multicentric cancers and a lower incidence of large invasive cancer compared with unscreened patients. Group ii patients had a higher incidence of whole quadrant in situ carcinoma, multiple cancer, and lymph node metastases. Group iv patients had a lower incidence of in situ cancer, and more low grade cancer than the other groups. Cases were divided into four types on the basis of this analysis.
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PMID:Topographical and histological presentation of mammographic pathology in breast cancer. 283 Mar 18

The study documented in this article was performed to define the clinical and morphologic features of cystic hypersecretory carcinoma (CHC) and cystic hypersecretory hyperplasia (CHH) of the breast. Both lesions are characterized by the formation of cystically dilated ducts containing a homogeneous eosinophilic secretion that resembles thyroid colloid. In most cases CHC features micropapillary intraductal carcinoma, occasionally giving rise to a high-grade, invasive carcinoma that is absent from CHH. Electron microscopy of the cystic component in one case of CHC showed ultrastructural characteristics of metabolically active cells, but few secretory granules. Twenty-nine patients with CHC were observed for up to 23 years. Twenty-five women who had intraductal carcinoma were well or died of other causes. Of the four patients who had invasive carcinoma, one died 9 months after being diagnosed as having systemic metastases, and the other three remained disease-free. Ten cases of CHH were reviewed; follow-up information was available for eight patients for up to 5 years. Six women were alive and well. One woman died of contralateral invasive carcinoma, and a second was well having had a modified radical mastectomy for a separate, coexisting intraductal carcinoma in the same breast. These findings indicate that intraductal CHC has the same low-grade clinical course as other forms of intraductal carcinoma. Because invasive carcinoma arising in this setting appears to be histologically high-grade, it is important to recognize and promptly treat the lesion while still in its in situ phase. Foci with the appearance of CHH may be found in CHC, but in this study progression from CHH to CHC was not observed. A thorough histological examination is needed to distinguish between CHC and CHH. Lesions judged to be CHH are adequately treated by wide excision. Additional long-term, follow-up studies will be necessary to define the precancerous potential of CHH.
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PMID:Cystic hypersecretory hyperplasia and cystic hypersecretory duct carcinoma of the breast. Pathology, therapy, and follow-up of 39 patients. 283 48

Clinicopathologic data were analysed of 15 patients with recurrence of carcinoma after breast conserving treatment and who underwent salvage mastectomy with curative intent. Twelve recurred in the same site as the original tumor after an average interval of 29 months; the remaining three arose elsewhere in the breast after an average, 83 months. Ten patients presented with palpable lumps, one with Paget's disease of the nipple and four with mammographical microcalcifications. Thirteen patients are alive without evidence of disease (mean follow-up 20 months), one patient died of chest wall recurrence 10 months after mastectomy and one is alive with metastatic disease 9 months after mastectomy. Extensive ductal carcinoma in situ, which was found in 53% of the initial excisions in this series, may be associated with a high risk of local recurrence.
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PMID:Recurrence of breast carcinoma after breast conserving treatment. 283 39

Between 1976 and 1983, 40 women with intraductal carcinoma of the breast without invasion underwent excisional biopsy and irradiation as an alternative to mastectomy. The median age was 53 years (range, 28 to 77 years) and the median follow-up time since initiation of radiation was 44 months (range, 14 to 97 months). Twenty-seven patients presented with a palpable mass; in 13 patients the tumor was detected only by mammography. A limited axillary dissection was performed in 13 patients, and all lymph nodes removed were negative. Treatment was administered to the breast and adjacent chest wall to a dose of 4,600 to 5,000 rad, with 26 patients also receiving a boost dose of 1,000 to 2,000 rad to the site of the primary. Four patients have developed a recurrence in the treated breast, at 17, 19, 35, and 63 months after the beginning of radiation therapy. The 5-year actuarial rate of local recurrence is 10%. Three of the recurrences were in those four patients who presented with a nipple discharge and a central primary. In two cases, the recurrence consisted of only intraductal carcinoma; in the other two, both intraductal and invasive cancer were found. All four patients with recurrence underwent mastectomy and are well without evidence of distant metastases at 1, 12, 15, and 15 months since mastectomy. Cosmetic results were excellent. No patient has developed distant metastases. Since the number of patients treated is small and the period of follow-up is short, one must be cautious in the interpretation of these results. Nonetheless, the treatment of intraductal carcinoma of the breast by excision and irradiation appears to give acceptable local control and excellent survival when suitable precautions of patient selection and evaluation are taken.
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PMID:Intraductal carcinoma of the breast: results of treatment with excisional biopsy and irradiation. 299 97

A proliferating mastopathy with severe epithelial atypia as well as with so-called radial scars, intraductal papillomatosis, and findings of so-called lobular cancerisation are regarded as possible precursors of mammary carcinoma. The histological differential diagnosis can be difficult between atypical epithelial proliferations in mastopathy and noninvasive intraductal carcinoma, between tubular formations in radial scars and tubular carcinoma, papilloma and papillary carcinoma as well as between primary and secondary lobular cancerisation. Noninvasive and invasive breast carcinomas can be diagnosed according to the WHO classification (12) with a relatively good reproduceability. Besides the histological type, other macroscopic (tumour size, number of metastatically involved lymph nodes, distant metastases), microscopic (tumour grading) as well as biochemical findings (receptor status) are also important for treatment and prognosis of breast carcinoma.
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PMID:[Histologic classification of breast cancer and its precancerous stages]. 303 49

Carcinoembryonic antigen (CEA) has been shown to be a useful tumor marker in patients with breast carcinoma. The unlabeled antibody immunoperoxidase technique was used to localize CEA in 93 cases of primary breast carcinoma, 15 cases of atypical duct papillomatosis, and 4 cases of duct papilloma. Normal breast epithelium and breast epithelium in fibrocystic disease did not stain positively for CEA. Twenty-four of 27 (88%) intraductal carcinomas, and 47 of 69 (68%) infiltrating duct carcinomas were CEA positive. In contrast, only 5 of 21 (23%) in situ lobular carcinomas and 8 of 24 (33%) infiltrating lobular carcinomas were positive for CEA. All 15 cases of atypical epithelial papillomatosis were negative, whereas 1 of the 4 cases of duct papilloma exhibited microscopic foci of weak CEA positivity. There was a trend for infiltrating duct carcinomas, 3 cm in diameter or smaller, staining strongly positive for CEA, to be associated with synchronous axillary lymph node metastases (P = 0.09). Tumor heterogeneity was a constant feature of CEA staining with positivity varying from region to region and even from cell to cell. Positive immunohistochemical staining for CEA may play an adjunctive role in discriminating intraductal carcinoma from atypical papillary ductal proliferations.
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PMID:The distribution of carcinoembryonic antigen in breast carcinoma. Diagnostic and prognostic implications. 619 97

Twenty-eight women with ductal carcinoma in situ (DCIS) of the breast treated by biopsy only were identified in a histologic review of 11,760 biopsies performed between 1950 and 1968. Seven of the 25 women followed for more than three years developed invasive breast carcinoma, all in the same breast with a previously detected DCIS. Average follow-up interval for the 18 women not developing invasive carcinoma was 16 years. The invasive carcinomas presented clinically from three to ten years (average, 6.1) after the biopsies demonstrating DCIS. Four women with invasive carcinoma developed distant metastases following mastectomy. This study suggests that 28% of women treated with biopsy only for DCIS presenting as an incidental histologic finding will develop invasive carcinoma in a follow-up period of approximately 15 years.
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PMID:Intraductal carcinoma of the breast: follow-up after biopsy only. 627 78

The management of intraductal carcinoma of the breast at the present time is necessarily diverse because there is difficulty in detecting it, as well as understanding its basic biology and natural history. Therapy has ranged from excisional biopsy with or without radiation to radical and extended radical mastectomy. The effects of radiation therapy upon these well-differentiated in situ lesions is undefined. The popularity of total mastectomy stems from a concern for the fate of breast tissue left in situ after removal of the focus of preinvasive carcinoma. Intraductal carcinoma of the breast has been shown to be a multicentric disease process in a large percentage of patients. Indeed, all breast tissue in these patients appears to be at risk for the eventual development of preinvasive and invasive carcinoma. However, the clinical significance of such residual foci of in situ carcinoma or ductal hyperplasia and dysplasia following resection of the breast, as in papillary carcinoma of the thyroid, is still open to question. Similar concern exists for a significant "sampling error" involved in biopsies of lesions of the breast: there were six instances of this in the present series (11 per cent). A "sampling error" of 6 per cent was found in a similar study of a group of patients with intraductal carcinoma. An error rate of 18 per cent was reported in another study. Again, the clinical significance of this "sampling error" remains open to question. The difficulty encountered in evaluating remaining breast tissue after a partial mastectomy has also been reason to consider total mastectomy in these patients. Residual or recurrent carcinoma in such altered breast tissue is difficult to diagnose at an early stage, either by physical examination or by the results of mammography. None of the patients in the present series had axillary nodal metastases and, theoretically, intraductal carcinoma should not be associated with axillary nodal metastasis. The small percentage of patients found to have invasive carcinoma following mastectomy for in situ carcinoma are likely to have minimally invasive lesions with, at most, a 23 per cent incidence of positive axillary nodes. The advantage gained by performing full axillary dissection or extensive nodal sampling in 60 per cent of the patients in this series, as well as in patients in other series, is difficult to ascertain without further study. The most logical choice of therapy would appear to be total mastectomy with limited axillary node sampling.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Intraductal carcinoma of the breast. 632 Apr 80

Two constituents of basement membrane, type IV collagen and laminin, were studied by immunoperoxidase methods in a group of breast lesions, exhibiting a range of neoplastic transformation. In normal breast, fibroadenoma, sclerosing adenosis, intraductal hyperplasia, and intraductal carcinoma there was intact basement membrane surrounding the ducts and lobules, as evidenced by an extracellular linear staining pattern with antibodies to type IV collagen and laminin. In intraductal carcinoma with microinvasion, there was fragmentation and absence of the basement membrane at the areas of microinvasion. Infiltrating carcinoma and metastatic breast carcinoma were usually devoid of surrounding extracellular basement membrane containing type IV collagen and laminin. However, a few well-differentiated carcinomas showed scattered extracellular deposits of this matrix material. Individual metastatic carcinoma cells, such as those in lymph nodes, contained intense cytoplasmic immunoreactivity with these antibodies. These results support the concept of basement membrane degradation associated with invasion. Furthermore, at least some metastatic tumor cells retain the ability to synthesize laminin and type IV collagen, but do not exhibit an extracellular basement membrane. This may mean that the metastatic cells are degrading and/or failing to deposit the extracellular matrix.
Invasion Metastasis 1981
PMID:Stages of neoplastic transformation of human breast tissue as monitored by dissolution of basement membrane components. An immunoperoxidase study. 632 85

The pathologist has critically important responsibilities as a consultant in the management of patients with breast cancer. The clinical evaluation of the anatomic extent of cancer before treatment, the clinical-diagnostic stage, crudely estimates whether the cancer is localized to the breast, or whether there are regional or distant metastases. The pathologist establishes the diagnosis of cancer microscopically in a biopsy and reports the significant characteristics which can be used in the selection of therapy. The pathologist's additional gross and microscopic examinations after mastectomy, which more precisely document the anatomic extent of the cancer, are the basis of the postsurgical treatment-pathologic stage and provide additional information used to estimate prognosis and determine whether adjunctive therapy is needed. The pathology information used in staging includes the tumor size, histologic type, histologic grade, and presence or absence of axillary of other metastases. These and other pathological factors of significance which are discussed include the gross contour of the tumor as well as the presence or absence of necrosis, and any of the spectrum of cancers that we categorize as "minimal breast cancer" (in situ lobular carcinoma, intraductal carcinoma, invasive carcinoma smaller than 0.5 cm). Furthermore, the prognostic implications of the various histologic types are considered, as well as histologic and cytologic differentiation (grade), multicentricity, vascular invasion, cellular infiltration, and various other factors such as mucin or lipid production, steroid hormone receptors, and the nature of the tumor bed. The presence or absence of axillary lymph node metastases remains the single most significant variable in estimating prognosis for most breast cancers. In addition, combinations of the parameters noted above may have greater prognostic significance than any considered individually. Therefore, the pathologist, through the routine examination and documentation of breast biopsies and mastectomies, can provide important information which can be used to aid in the selection of treatment and in the estimation of prognosis.
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PMID:Pathological parameters useful in predicting prognosis for patients with breast cancer. 637 48


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