Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-eight women with minimal invasive breast cancer were treated at the Istituto Nazionale Tumori of Milan, in the decade 1970-1980. Their tumors were smaller than 0.5 cm in diameter and were clinically assessed as T1N0M0; surgery, consisting of radical or limited procedures, was performed, always with complete axillary dissection. Pathologic assessment showed that axillary lymph nodes presented with metastases in 21.5% of cases. In 1 of N-positive cases, more than 3 nodes were affected, and in 5 cases extracapsular invasion was observed. Five-year actuarial survival, calculated by the life table method, was as high as 90%, demonstrating that these have a favorable prognosis, even when they are treated by limited surgery followed by radiotherapy on the residual breast, provided that the axilla is completely dissected. Minimal invasive breast cancer should consequently be clearly distinguished from other pathologic entities termed as "minimal", such as lobular carcinoma in situ and intraductal carcinoma, for which complete axillary dissection is not worthwhile.
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PMID:Comments on a series of 88 invasive microcarcinomas of the breast. 662 57

Intracystic papillary carcinoma of the breast (IPC) was distinguished from the more common papillary intraductal carcinoma (DCIS) and infiltrating duct carcinoma with a papillary pattern. IPC was defined as a solitary tumor with a pattern recognizable as carcinoma which is confined to a dilated duct. A series of 41 such cases was collected from three institutions. Twenty-nine patients underwent mastectomy; 11 of them had axillary dissections. None of these patients had metastatic disease in the axillary lymph nodes or recurrence in the follow-up period which averaged five years. Eleven patients did not have mastectomy or radiotherapy. Eight of these patients (followed for an average of ten years) had no recurrence. The only patients who developed invasive carcinoma were those with DCIS as well as IPC in the excisional biopsy. The data suggest that IPC is much more likely to be cured by local treatment than is IPC accompanied by DCIS.
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PMID:Intracystic papillary carcinoma of the breast. After mastectomy, radiotherapy or excisional biopsy alone. 685 May 36

A thorough histologic examination of the pancreas was performed on autopsy material from 83 military veterans aged 35-88 years. Hyperplastic, preneoplastic and neoplastic alterations were recorded by severity, multiplicity, location and age. From this material, two patients had clinically known primary, and three had secondary (metastatic), pancreatic cancer. The following occult malignant lesions were found: two early cancers (one adenocarcinoma and one adenosquamous cell carcinoma), one ductal carcinoma in situ and seven ductular carcinomas in situ. Among patients with ductular carcinoma in situ, three had pancreatic caner and the remaining four had cancers of other sites (ethmoid, ear, colon, prostate). One patient who was clinically diagnosed as having lung cancer with selective metastases to the pancreas was found to have pancreatic adenosquamous cell carcinoma with lung metastases. Hence, the incidence of neoplastic exocrine lesions was around 10%. In addition, hyperplasia of the ductal and ductular epithelium (in 57% and 39% of the patients, respectively), squamous cell metaplasia of the ductules (in 48% of the cases), as well as endocrine tumors (islet cell adenoma, 10%; mixed ductular-insular adenoma, 3%) were found. Most lesions occurred in the pancreatic head, a few in the tail. These data and other reports led to the conclusion that, first, the overall incidence of pancreatic cancer appears to be higher than previously reported. Malignant lesions seem to remain clinically occult, either because patients die of other diseases or because of the significantly long latency between premalignant lesions and clinically recognizable invasive cancer. Second, the ductular cells appear to be the progenitor cells of a variety of tumor types, including squamous cell cancer and islet cell tumors, as in the authors' experimental model.
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PMID:Hyperplastic, preneoplastic and neoplastic lesions found in 83 human pancreases. 703 98

Breast cancer is often detected as multiple lesions clinically and/or histopathologically. To examine if the origin of such lesions can be identified objectively by comparison of their loss of heterozygosity (LOH) patterns, LOH on chromosome 16q was analyzed in a total of 60 cases of multiple breast cancer by Southern blot analysis. Based on continuity among tumors and satellite nodule features, 30 cases of unilateral multiple cancer were classified morphologically into 3 groups: A, multicentric origin (11 cases); B, multifocal invasion of one intraductal carcinoma (15 cases); and C, intramammary metastases (4 cases). As controls, group D, synchronously bilateral breast cancers (11 cases), and group E, sets of a primary tumor and a lymph node metastasis (19 cases), were also examined. On a highly probable assumption that LOH on 16q occurs randomly in 50% of breast cancer cases at an early stage, the number of cases showing a concordant LOH pattern on 16q among tumors was compared between observed data, and the value was estimated from a normal distribution model in each group. In groups A and D, the allele pattern on 16q among tumors was concordant in 5 of 11 cases each, thus supporting their independent occurrence and multicentric origin, whereas the LOH pattern among tumors was identical in all of the cases in groups B, C, and E, thus supporting their monocentric origin. This comparison of the LOH pattern in multiple breast cancer was shown to yield results compatible with the morphological classification and was suggested to be of diagnostic value.
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PMID:Identification of multiple breast cancers of multicentric origin by histological observations and distribution of allele loss on chromosome 16q. 761 78

The histopathologic diagnosis with the description of the size of the tumor, its growth pattern, grading, lymph node involvement, hormonal receptor status and pTNM-classification are basic requirements the treatment of breast cancer. In addition to the conventional methods new bio- or immunohistochemical factors can be determined, which have variable predictive values. The pTNM-classification is essential for the evaluation of clinical treatment results and prognosis. This histopathologic survey summarizes frequent and rare types of breast cancer, of which about 24 entities and 22 subtypes are known. The clinically important criteria of the intraductal carcinoma and of the lobular carcinoma in situ are described and their differentiation forms are mentioned. This review will illustrate the development in the detailed histopathologic diagnosis of breast cancer. Finally some aspects of lymphatic spread are outlined and the incidence and the sits of metastases.
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PMID:[Pathology of breast carcinoma]. 770 16

Lymph node status is still the single most important prognostic factor in breast cancer and surgery remains the only reliable means of providing this information. This study evaluates using a highly specific radiolabeled monoclonal antibody to provide equivalent information. The optimum labeling conditions for radiolabeling a monoclonal antibody against the gene product of the protooncogene c-erbB-2 with Tc99m were established. This immunoconjugate was next evaluated in a mouse model system and averaged 20% localization of the total injected dose per gram of tumor at 24 h. Ten patients have had this immunoconjugate, with planar and tomographic reconstructed images being obtained at 24 h. The resulting images were compared to histopathological examination of the surgical specimens. Three patients acted as normal controls, two patients were selected on the basis of inappropriate sampling of adjacent ductal carcinoma in situ, three patients demonstrated only moderate antigen expression, and two patients demonstrated excellent tumor localization in both breast primary and regional node metastases. The high specificity of this antibody, ease of labeling, and excellent localization performance with a good antigen target encourage the development of this system as a method of localization and a potential means of antibody-guided therapy.
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PMID:Clinical radioimmunolocalization with a rat monoclonal antibody directed against c-erbB-2. 773 45

Intraductal papillary growth of mucin producing hypersecreting, columnar cells characterizes a group of rare pancreatic exocrine neoplasms which we propose to call intraductal papillary-mucinous tumors (IPMT). We analysed the histopathology of 26 IPMT in relation to gastro-enteropancreatic marker expression, genetic changes and biology. Four IPMT showing only mild dysplasia were considered to be adenomas. Nine tumours displayed moderate dysplasia and were regarded as borderline. Severe dysplasia-carcinoma in situ changes were found in 13 IPMT which were therefore classified as intraductal carcinomas. Six of these carcinomas were frankly invasive and two of these had lymph node metastases. The invasive component resembled mucinous non-cystic carcinoma in all but one tumour which showed a ductal invasion pattern. Immunohistochemically, an intestinal marker type was found in most carcinomas, while gastric type differentiation prevailed among adenomas or borderline tumours. K-ras mutations (seven at codon 12 and one at codon 13) were found in 31% of IPMT (2 adenomas, 1 borderline, 5 carcinomas). Nuclear p53 overexpression was detected in 31% of IPMT (6 carcinomas and 2 borderline IPMT) and correlated with p53 mutations (one at exon 8 and the other at exon 5) in two carcinomas. p53 abnormalities were unrelated to K-ras mutation. c-erbB-2 overexpression was observed in 65% of IPMT, with various grades of dysplasia. Twenty-two of 24 patients are alive and well after a mean post-operative follow-up of 41 months. Only two patients, both with invasive cancer at the time of surgery, died of tumour disease. It is concluded that pancreatic IPMT encompass neoplasms which, in general, have a favorable prognosis, but are heterogeneous in regard to grade of dysplasia and marker expression. Adenoma, borderline tumour, intraductal carcinoma and invasive carcinoma can be differentiated. p53 changes but not K-ras mutation or c-erbB-2 overexpression are related to the grade of malignancy. Most IPMT differ in histological structure, marker expression and behaviour from ductal adenocarcinoma.
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PMID:Intraductal papillary-mucinous tumours represent a distinct group of pancreatic neoplasms: an investigation of tumour cell differentiation and K-ras, p53 and c-erbB-2 abnormalities in 26 patients. 782 Mar

It is clear that breast cancer progression is associated with inactivation of a number of different recessive oncogenes. The most widely evaluated tumor suppressor gene, p53, is mutated in approximately 30-50% of sporadic breast cancers. Mutations usually occur early in malignant progression. Loss of heterozygosity (LOH) studies have identified numerous chromosomal regions where other recessive oncogenes relevant to breast cancer may be located. Each LOH is seen in a varying proportion of breast cancers and may appear either early or late in progression. High-grade ductal carcinoma in situ (DCIS) and invasive carcinoma have similar genetic lesions, showing that aberrations can occur before invasive disease. Direct evidence that the same aberrations can be acquired later in progression comes from a study of multiple metastases from the same patient; other studies found that primary invasive cancers are characterized by marked intratumor heterogeneity for each lesion examined. The model we propose to account for these results hypothesizes that multiple genetic lesions can accomplish each phenotype required for malignancy (i.e., dysregulated proliferation, invasion, angiogenesis, etc.) and that, for a given tumor, at least one aberrant gene for each phenotypic change is stochastically selected. Biological heterogeneity of breast cancer results from the stochastic acquisition of various genetic aberrations. We further propose that the lymphocytic reaction in high-grade DCIS may select for aggressive tumor subpopulations capable of escaping immune surveillance. Another aspect of tumor heterogeneity may be the multiple mechanisms employed by various tumors to escape immune surveillance.
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PMID:Molecular aspects of early stages of breast cancer progression. 800 93

Perturbations of oncogenes in breast carcinoma include amplifications of the HER-2/neu and PRAD1 genes, as well as p53 mutations. Some of these lesions frequently appear in early cancers such as ductal carcinoma in situ and are stable as the tumors become invasive and metastasize. Thus these findings suggest that oncogene mutations may define a point of origin for a given breast cancer, and are fixed lesions during tumor progression. Such germline abnormalities may occur at the BRCA1, H-RAS VNTR, and p53 loci. The rational use of genetics may be to identify women at high risk for the development of breast cancer so that they may be enrolled in future chemoprevention trials.
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PMID:Oncogenes, breast cancer, and chemoprevention. 800 94

We have investigated the effects of preoperative radiotherapy on T1 N0 breast cancer and studied the relationships between residual cancer after lumpectomy and II clinicopathological factors. Radiotherapy was basically ineffective against intraductal carcinoma. However, in the preoperative radiation group, there were more hormone-receptor positive and histologically well-differentiated cases than in the non-radiated stage I patients. Mitotic figures were also significantly reduced after radiotherapy, whereas the expression of c-erb-B-2 protein was unchanged between the two groups. Residual cancer rates were 40% and significantly higher in patients with: 1) tumor diameters of 3.1 cm or larger; 2) tumors beneath or in the vicinity of the nipple-areola; 3) malignant calcifications noted in mammography findings; 4) serous or bloody nipple discharge, particularly with positive cytologic findings; 5) papillotubular carcinoma; 6) lymphatic invasion by tumor cells; and 7) a high degree (n > or = 4) of lymph node metastases. Our date indicate the varying radiosensitivity of breast cancer cells, the indications for hormone therapy and the prognostic usefulness of these seven clinicopathological factors in breast conservation therapy.
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PMID:[Problems of breast conservation therapy--residual cancers after lumpectomy and effects of preoperative radiotherapy]. 803 84


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