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)

The clinical and pathological features of 77 cases of intraductal (intracystic) papillary carcinoma (IPC) of the breast are reported. It should be recognized as an intraductal carcinoma variant and distinguished from invasive papillary carcinoma. Intraductal papillary carcinoma remains a difficult diagnosis as there are four different epithelial growth patterns any of which may predominate. Low grade nuclear features occur in one third of cases, a so-called "stratified spindled cell" epithelial proliferation with bland morphology occurs in one quarter of cases, and a dimorphic population of malignant cells, which may in part be confused with myoepithelial cells, occurs in one quarter of cases. The 77 cases studied were from the 10-year interval 1970 to 1979. The effect on prognosis of cytoarchitectural features, duct wall and stromal invasion, and associated intraductal carcinoma were evaluated. The contribution of immunohistochemistry to the diagnosis using antibodies to smooth muscle actin, S-100 protein, and CAM 5.2 was examined. The 10-year survival rate was 100%, and the 10-year disease-free survival rate was 91%. Mastectomy had been performed in 72% of patients. Three of the patients developed metastases; two were alive with tumor and one died of other causes. Six patients had local recurrence in the chest wall; one was alive without disease, two were alive with tumor, and three died of other causes. An associated intraductal carcinoma of usual nonnecrotic or comedo type was present in 40% of all cases. When IPC recurred or metastasized, it did so as invasive papillary carcinoma in six of seven cases. Stromal invasion was found in 13 patients. Local recurrence developed in two of these. Invasion was not seen in any of the three patients who developed metastases. However, this may be a function of sampling as there was an average of 5.2 tumor sections per case. Patients with low grade tumors had no recurrence or metastasis, and in the absence of invasion may be treated by local excision. Patients with higher grade tumors have an increased risk of recurrence and metastasis.
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PMID:Intraductal (intracystic) papillary carcinoma of the breast and its variants: a clinicopathological study of 77 cases. 805 21

Eleven cases of salivary duct carcinoma were studied clinicopathologically. The clinical features are as follows: men outnumber women; arise most frequently within the parotid glands; rapidly enlarging mass; obvious symptoms of invading nerves; high rates of cervical lymph node and distant metastases; poor patient's prognosis. Its histologic features were shown by the various stages of development of duct carcinoma including dysplasia, carcinoma in situ, papillary, cribriorm, solid and commedo patterns. In addition to the intraductal carcinoma, there is the invasive carcinoma with obvious infiltration into the surrounding tissues. Its treatment requires the combination of radical surgery with postoperative radiotherapy.
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PMID:[Salivary duct carcinoma (clinicopathologic study of 11 cases)]. 827 1

The majority of breast cancer patients succumb to metastatic disease. We summarize published and recent research concerning the nm23 gene in breast cancer metastasis. In a murine developmental study, nm23 expression increased with the functional differentiation of the mammary gland in nulliparous and pregnant animals. In human breast cancer, five studies have now demonstrated a significant association between reduced nm23 expression, at the RNA or protein levels, and aggressive tumor behavior. Nm23-negative tumor cells have been observed in comedo ductal carcinoma in situ lesions in two independent studies, indicating that decreases in nm23 expression begin prior to actual histologically identifiable invasion. Transfection studies, in which human nm23-H1 cDNA was expressed in the metastatic human MDA-MB-435 breast carcinoma cell line, indicate that nm23-H1 suppresses in vivo metastatic potential by 50-90%. Finally, our data in melanoma and breast carcinoma transfection systems suggest that the biochemical mechanism of nm23 suppressive activity is likely not due to its nucleoside diphosphate kinase activity, association with GAP proteins, or secretion from cells.
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PMID:Nm23 and breast cancer metastasis. 834 49

Experience with mammography in patients with augmentation mammoplasty has been limited by the younger age of the patients and the bias of the physicians that mammography may be ineffective in imaging the breast with a prosthesis. With recent advances in imaging of the augmented breast and the increase in popularity of augmentation mammoplasty, more of these patients are undergoing mammography. We reviewed the mammograms and clinical history of 25 women with breast implants and breast cancer. Seven (28%) of the 25 women were asymptomatic and referred for screening mammography. Mammography or sonography was positive in 22 (88%) of the 25 women. There was no nodal involvement in 11 of 18 patients with infiltrating duct carcinoma, 5 women with intraductal carcinoma, and 2 women with lobular carcinoma in situ. In this study, women with implants who developed breast cancer presented with nodal metastases in only 28% of cases. Modified position views should be performed in all patients, and sonography may be helpful in evaluating palpable masses even when mammography is normal. Breast cancer can be detected in the augmented breast by mammography even if clinically occult.
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PMID:Imaging of breast cancer after augmentation mammoplasty. 838 38

From 1960 to 1986, 397 cases of non-metastatic male breast cancer (MBC) treated in 14 French regional cancer centres were reviewed. The median age was 64 years (range 25-93). TNM classification (UICC, 1978) showed seven T0, 79 T1, 162 T2, 31 T3, 74 T4 and 44 unclassified tumours (Tx). Clinical positive lymph nodes were found in 31% of the patients. 24 patients received radiotherapy only, and 373 underwent surgery, 247 of these with postoperative irradiation. Adjuvant chemotherapy and hormonal therapy were used in 71 and 68 patients, respectively. There were 382 infiltrating carcinomas and 15 pure ductal carcinoma in situ. Lymph node involvement was found in 56% of infiltrating carcinoma. The oestrogen (ER) and progesterone (PgR) receptors were positive in 79% and 77%, respectively, of examined cases. Isolated local and regional recurrence were observed in 8.8% and 4.5% of cases, respectively and 40% of patients developed metastases. The crude survival rates by Kaplan-Meier method were 65% and 38% at 5 and 10 years, respectively, and the disease-specific survival rates (without death due to intercurrent disease or second cancer) was 74% at 5 years and 51% at 10 years. The disease-specific survival rate for pN- and pN+ groups were 77% and 39% at 10 years. The prognostic factors were clinical size (T) and histological axillary status (pN-/pN+). The relative risk of death for pN- was 1.0, 2.0 and 3.2 in the T0-T1, T2 and T3-T4 groups, respectively. For pN+, these relative risks increased 1.9, 3.9 and 6.0 in the same groups. The optimal treatment include modified radical mastectomy and irradiation for cases with risk factors of local relapse (nodal invasion, large tumour with cutaneous or muscular involvement). Locoregional failure had unfavourable prognosis. First-line adjuvant treatment seems to be tamoxifen, due to the very high rate of positive hormonal receptors and the old age of the patients, which contraindicate chemotherapy in many cases. The prognosis of patients with breast cancer is the same in male and female patients when disease-specific survival rate, tumour size and axillary involvement are compared.
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PMID:Male breast cancer: results of the treatments and prognostic factors in 397 cases. 856 48

The progression of ductal carcinoma in situ (DCIS) to infiltrating and metastatic cancer of the breast is thought to be a consequence of clonal expansions of neoplastic cells with progressively more genetic alterations. To study this progression, we first dissected multiple foci from each of 23 breast tumors with DCIS only and 20 cases with synchronous DCIS and infiltrating cancer. We than tested microsatellite markers by PCR for allelic losses in the individual foci for loci on chromosomes 6q, 9p, 11q, 13q, 16q, 17q, and 17p. The patterns of allelic losses identified in the in situ cancers were generally conserved in the synchronous infiltrating tumors, supporting the paradigm that the infiltrating tumors are clonally derived from the in situ lesions. However, in 8 (40%) of the 20 cases with synchronous in situ and invasive cancer, heterogeneous patterns of allelic loss at one or more chromosomal loci were observed in adjacent DCIS foci. Moreover, some of the allelic losses recognized in in situ portions of the tumors were not conserved in the clonal progression to the synchronous invasive tumor. Such allelic loss heterogeneity was noted in only 1 of the 20 infiltrating tumors and only 3 of the 23 cases of DCIS without invasion that were studied in a similar manner. This heterogeneity indicated genetic divergence during the clonal evolution of breast cancer, particularly at the time when in situ cancers progress to invasive cancers.
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PMID:Genetic divergence in the clonal evolution of breast cancer. 860 91

A 48 yr old HIV seropositive female presented with a right breast mass and bilateral axillary lymphadenopathy. Fine needle biopsy (FNB) revealed an adenocarcinoma with abundant mucin production and features suggestive of a cribriform and micropapillary ductal carcinoma in situ (DCIS). Histopathological examination of the tumor confirmed an invasive mixed colloid carcinoma with extensive DCIS. There have been 4 previous reports in the literature of breast carcinoma associated with HIV seropositivity. This case initially diagnosed by FNB is the first case reported in Australia. In spite of the somewhat more favourable histological type of breast carcinoma, this tumor shows numerous unfavourable prognostic factors and has had an aggressive clinical course with relapse of disease in the contralateral breast and distant metastases within 4 wks of surgery, probably related to the patient's immunodeficiency.
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PMID:FNB diagnosis of breast carcinoma associated with HIV infection: a case report and review of HIV associated malignancy. 871 81

The aim of the study was to evaluate the possible role of scintimammography (SMM) with technetium-99m tetrofosmin in breast cancer. Thirty-three patients with breast disease and ten normal controls were included in the study. Planar scintigraphic images in supine anterior, prone lateral and lateral views, with the patient lying in lateral recumbency, were acquired. A qualitative analysis evaluating both breasts and lymph nodes was performed. All breast lesions were verified after surgery and/or by fine-needle aspiration. In 8 of the 33 patients, mammography was inconclusive because of mastectomy or dense breasts. For mammography, a sensitivity of 95.6%, a specificity of 66.7% and an accuracy of 89.6% were obtained. At SMM, 26 out of 28 malignant lesions (average size 2.8 cm, range 0. 4-12 cm), including two recurrences, were detected with a 92.8% sensitivity, a 100% specificity and a 95.1% accuracy. The smallest detectable carcinoma measured 0.6 cm. Two false-negative results on SMM were found in a 0.4-cm intraductal carcinoma and in the only mucinous papillary carcinoma in our series. With regard to lymph node analysis, 11 out of 12 axillary metastases (sensitivity=91.6%) were detected. A false-positive result, yielding a specificity of 92. 3% was also obtained. A metastatic involvement of the internal mammary chain was observed. No uptake was seen in 11 benign mammary lesions or at the level of the breast and axilla when neoplastic involvement was absent. In conclusion, SMM with 99mTc-tetrofosmin is an effective technique for the evaluation of primary breast carcinomas, recurrences and lymph node metastases.
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PMID:Scintimammography with technetium-99m tetrofosmin in the diagnosis of breast cancer and lymph node metastases. 875 82

There is a strong body of opinion that favours conservative surgery in early breast cancer, with certain provisos. If an operation that is less than a mastectomy is to be performed, it is essential that by histological assessment, the resection margins be > or = 10 mm clear, preferably 20 mm. Extensive DCIS is a serious stumbling block, as it suggests the possibility of multicentricity. It would seem that postoperative radiotherapy is always indicated on the grounds of an unacceptable local recurrence rate and thus an expression of a later higher risk of distant metastases. Because of the fact that recurrence both local and distant, are expressed by the nodal state, it is essential to assess the axillary lymph nodes. If they are positive, there are two choices, namely total axillary clearance or postoperative axillary radiotherapy; opinion is divided as to the best management. Because of the good prognosis in well treated pT1pN0 patients, it appears logical to offer these patients conservative surgery, postoperative radiotherapy and adjuvant therapy. The complications of this therapy are far outweighed by the advantage of a cure. In the node-positive patient, it is essential to offer the triumvirate of treatment, surgery, radiotherapy and adjuvant therapy (chemotherapy and tamoxifen) to try and reduce local and regional recurrence and distant metastases.
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PMID:Future prospects in limited surgery for early breast cancer. 882 8

The management of ductal carcinoma in situ (DCIS) is one of the most controversial topics in the treatment of breast cancer. With the introduction and utilization of screening mammography, clinically occult or microscopic DCIS has become the most frequent presentation of this disease. Recent advances in the characterization of DCIS according to histologic subgroupings, size and extent of disease, and nuclear grade have provided important information regarding the natural history of this heterogeneous group of lesions. Critical issues such as multicentricity, occult invasion, and potential for local recurrence and axillary metastases have been addressed in recent series. Prospective, single institution trials and data from the National Surgical Adjuvant Breast and Bowel Project (NSABP-B17) protocol have demonstrated that in many patients with mammographically detected DCIS, mastectomy may be over-treatment. Treatment issues for DCIS now focus on the clinical selection process to identify patients best suited for wide local excision alone vs. wide local excision and breast irradiation.
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PMID:Management of ductal carcinoma in situ. 887 17


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