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

In 614 breasts tumours assumed to be harmless cysts on palpation were aspirated. In 430 cases aspiration was the definitive treatment. In the other 184 cases excision was necessary in order to obtain histology. 11 cysts were radiologically suspect after air filling. In one case excision demonstrated an undifferentiated milk duct carcinoma. 12 cysts had radiologically suspicious areas outside their margins. In 4 cases lobular carcinoma in situ was present. 161 excisions were necessary because no fluid was aspirated at puncture of the tumour. In 10 cases histology showed malignancy: half of these were metastases from a known primary tumour and half were primary breast carcinomas. Out of 17 precancerous states neoplasia could be demonstrated in two cases in addition to papillary and proliferative duct changes. We have classified this neoplasia as lobular carcinoma in situ.
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PMID:[Histological results of lumps excised from the breast after aspiration (author's transl)]. 19 85

One hundred twenty-nine biopsies from 121 patients with a frozen or paraffin section diagnosis of noninvasive breast carcinoma were studied. Eight women had bilateral noninvasive carcinoma. Seven biopsies reported as intraductal on frozen section contained invasive carcinoma on paraffin section. Of the remaining 122 biopsies proven to have noninvasive carcinoma on paraffin section, 39 (34%) were reported at frozen section and as noninvasive carcinoma, 24 (20%) as atypical and 59 (48%) as benign. Intraductal carcinoma (IDC) was identified more often at frozen section (45%) than was lobular carcinoma in situ (19%). Among 41 patients who had bilateral carcinoma with invasive disease in one breast, 76% of contralateral noninvasive carcinoma was LCIS. After excisional biopsy, carcinoma was found in 56% of 103 mastectomy specimens, including invasive carcinoma in 6% of breasts with IDC and 4% with LCIS. Residual noninvasive carcinoma was usually of the same type found at biopsy (90% IDC and 88% LCIS) and involved quadrants other than the biopsy site in 33% with IDC and in 80% with LCIS. When the frozen or paraffin section diagnosis of a generous excisional biopsy was noninvasive breast carcinoma, there was a substantial risk that foci of the same type of noninvasive carcinoma were also present in other quadrants. However, occult foci of invasive carcinoma were quite infrequent and the risk of axillary metastases was very low. Adequate treatment for noninvasive carcinoma requires elimination of all residual foci of noninvasive disease. At present this can best be accomplished by total mastectomy if the operation is properly performed. To insure removal of the axillary extension of the breast and for staging, in continuity dissection of the lowest axillary lymph nodes is also prudent.
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PMID:Noninvasive breast carcinoma: frequency of unsuspected invasion and implications for treatment. 21 6

Increased demands are made upon the pathologist to work closely with the surgeon and the mammographer in the interest of early detection. The smallest of cancers and the very earliest phases of neoplastic development are being detected, necessitating fine discriminations between cancer and noncancer. Agreement is not always uniform at these new frontiers of diagnosis, and accuracy is paramount. Tumors are populations of heterogeneous cells. Their morphology lends itself poorly to simple categorization, and their biology is not always accurately reflected in their gross and histologic appearances. Clearly evident to the pathologist are the limitations of morphology, of the light microscope and of routine techniques for examining surgical specimens. Paradoxically, "noninvasive" cancers occasionally metastasize, and lymph nodes originally "free" of cancer are found to contain metastases on more meticulous re-examination. Notwithstanding these limitations a prognostic statement can be made with relative confidence with regard to certain morphologic types of carcinoma. Pure intraductal carcinoma and lobular carcinoma in situ entail negligible threat to normal life expectancy if the breast is thoroughly removed. Other types with a favorable prognosis are intracystic papillary carcinomas and pure mucinous carcinomas. Tumors classified as well differentiated or tubular adenocarcinoma infrequently metastasize and have excellent prospects for cure. Unfortunately, these and other favorable histologic types comprise less than one quarter of all mammary carcinomas. Most carcinomas are without such distinctive features. In this category the degree of anaplasia and the nature of the tumor borders, as well as the presence or absence of blood vessel invasion, dermal lymphatic invasion and metastases in regional lymph nodes, are of major importance in arriving at an estimate of prognosis.
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PMID:Cancer of the breast. Gross and histologic pathlogy. 22 70

Twenty-five patients with tubular carcinoma of the breast were reviewed. All of the lesions were small, averaging 0.9 cm in diameter, and none exceeded 2.0 cm in diameter. Regardless of treatment, the prognosis proved favorable. Only three of the patients manifested axillary lymph nodal metastases, and none died of recurrent or metastatic neoplasm. These neoplasms frequently were associated with intraductal carcinoma and, to a lesser extent, with lobular carcinoma in situ. It is concluded that tubular carcinoma represents a slow-growing expression of invasive mammary carcinoma; nevertheless, it is likely that, if inadequately treated, these lesions will evolve into more common patterns of invasive carcinoma.
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PMID:Tubular carcinoma of the breast. 53 58

Breast cancer was detected in 156 of 17,526 asymptomatic women, (8.9/1000), aged 45-64 years, screened by mammography, thermography, and physical examination, Twenty-six percent of 149 pathologically reviewed cases metastasized to axillary nodes. Thirty-six percent of tumors were in situ, minimally invasive, or low grade tubular carcinomas, none of which metastasized. Increased rates of detection were shown for intraductal and tubular types. Frankly invasive ductal and lobular carcinomas had a mean diameter of 2.3 cm., 46% of which had axillary lymph node metastases. Seventy-percent of these were to only one to three nodes, however. Multicentricity with intraductal and lobular carcinoma in situ was frequently observed. Metastatic potential was related to tumor size, degree of stromal invasion, lymphatic permeation, and histologic grade. Few histological parameters other than size could be considered favorable. Forty-two percent of tumors were not palpable, the majority being in situ, minimally invasive, and tubular types. Only five nonpalpable invasive carcinomas metastasized. While the initial results of mass screening appear favorable, prolonged follow-up is needed to determine its impact on the population at risk.
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PMID:The pathology of breast cancer detected by mass population screening. 90 76

Twenty-four patients (average age, 46 years) with 29 instances of lobular carcinoma in situ of the breast have been treated from 1952 to 1971 at the Henry Ford Hospital (incidence, 1%). Six patients had bilateral lesions, one synchronous and 5 metachronous. The initial complaint in 23 of 24 patients was a mass in the breast. Diagnosis was based on permanent histologic section as mammorgraphy and frozen section analysis were inconclusive. Treatment consisted of radical mastectomy in six, modified radical mastectomy in five, and simple mastectomy in 20. All lymph nodes recovered showed no metastatic disease. All patients are alive and well with no evidence of disease. Based on our experience, we recommend a simple mastectomy for treatment of lobular carcinoma in situ with contraleteral bipsy examination in those instances when clinical or roentgenographic evidence suggests a pathologic process.
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PMID:Lobular carcinoma of the breast in situ. Are we too radical in its treatment? 113 Sep 98

Of 1433 consecutive patients who underwent mammography, 90 were subsequently found to have histologically confirmed carcinoma of the breast (85 invasive carcinoma, three lobular carcinoma in situ, two intraduct carcinoma). Sixty (67%) of the mammograms of the patients with cancer were reported correctly as carcinoma. There were 27 (30%) false negative reports and three (3%) equivocal reports. In 14 (16%) patients with false negative reports the biopsy was delayed by between 2 and 24 months. The false reassurance of the mammogram report was responsible for the delay in diagnosis in nine and may have contributed in the remainder. The mammogram was most likely to be misleading when used as an investigation for a palpable lump in the breast. The mean age of patients with a false negative mammogram (44 years) was significantly less than that of patients with a true positive mammogram (57 years). In 23 of the 60 patients with positive mammograms management was changed as a result of the investigation. The mammogram was most helpful when no breast lump was palpable and there was either some other clinical evidence of local malignancy (ten patients, 11%) or metastatic disease (three patients, 3%), or the mammogram had been performed to screen a high-risk patient (three patients, 3%). The positive mammogram was also useful in two patients with residual or recurrent disease following local excision of a breast cancer. There were 15 patients with bilateral breast cancer (17%). Three (3%) were diagnosed within 2 months of the first tumour but mammography did not contribute to the diagnosis of any of these.
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PMID:Mammography in hospital patients: use and misuse. 128 62

Pleomorphic lobular carcinoma of the breast is a recently recognized subtype of invasive lobular carcinoma (ILC). Cytologic features are pleomorphic to a degree that contrasts with the cytologic uniformity of classic ILC. It is this feature that simultaneously gives its name to the tumor and highlights the difficulty of identifying it correctly and distinguishing it from ductal carcinoma. In our series of 10 cases, six tumors also contained lobular carcinoma in situ. Nodal metastases were typically sinusoidal. All tumors showed the dissociated, linear, and single file pattern of classic ILC, together with a targetoid distribution. Intracytoplasmic lumina were present in 50% of the tumors. An eosinophilic, slightly granular cytoplasm suggests the possibility of apocrine differentiation, a suggestion derived also from the frequent presence of foamy cells, a cell type previously identified in histiocytoid lobular carcinoma and shown to have apocrine features. The GCDFP-15 apocrine marker was positive in all 10 tumors, while all control ILCs were negative, confirming the presence of apocrine differentiation in pleomorphic lobular carcinoma. Six of 10 patients died within 42 months of diagnosis. Three other patients developed recurrence or distant metastases at short intervals. Pleomorphic lobular carcinoma is a very aggressive tumor. This behavior is perhaps predictable on the basis of tumor size at presentation and the frequency of nodal metastases. Since grading of lobular carcinoma is difficult, recognition of the pleomorphic subtype is useful in identifying a lethal variant.
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PMID:Pleomorphic lobular carcinoma of the breast: an aggressive tumor showing apocrine differentiation. 159 88

From June 1985 to August 1989, 344 cases of mammographic non-palpable breast lesions were operated on at the National Cancer Institute in Milan. The mammographic findings consisted of clusters of microcalcifications in 162 cases (42.1%), suspicious opacities with irregular borders in 116 cases (37.7%) and opacities containing microcalcifications in 66 cases (19.2%). The mean age of the patients was 51 years (range 31-77 years). In all patients localization was performed 1 day before the operation, introducing a self-retaining anchor wire into the mammary parenchyma. The histological findings showed benign breast disease in 184 cases (53.4%); proliferative dysplasia without atypia in 150 cases (81.5%); proliferative dysplasia with atypia in 22 cases (12%); fibroadenoma in nine and papilloma in three cases. Of 160 patients with carcinoma, 37 had non-infiltrating carcinoma: 28 of these cases (17.5%) had non-infiltrating ductal carcinoma and nine cases (5.6%) had lobular carcinoma in situ. In the 123 cases with infiltrating breast cancer the histological types were ductal infiltrating carcinoma (32.5%), lobular infiltrating carcinoma (9.8%), and 34.1% of the cases an associated or prevalent intraductal carcinoma was found. In 138 cases (85.6%) a conservative surgical procedure (quadrantectomy or more limited excision) was done, and in 22 (14.4%) cases a total mastectomy was necessary because of the extent of the disease. Axillary dissection was performed in 116 of the 123 patients with histological invasive carcinoma. Nodal metastases were found in 24 cases (20.7%), and only one node was involved in nine of the cases (37.5%), two to three nodes in nine cases (37.5%) and four to ten nodes in six cases (25%).
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PMID:Preoperative localization and surgical approach in 344 cases of non-palpable breast lesions. 193 94

A morphometric study was carried out on proliferative lesions of the breast lobules, including cases of atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS) and infiltrating lobular carcinoma (ILC) with axillary metastases (META). Seven nuclear parameters were assessed, such as perimeter, area, shape factor, diameter of circle of equivalent area, longest axis, shortest axis and axes ratio. In comparison with nuclei of normal lobules, a statistically significant increase in the mean values of 5 nuclear parameters was observed in all pathologic lesions examined, whereas shape factor and axes ratio exhibited no significant difference. Nuclear area was found to be the most valuable parameter. No difference was observed between nuclear estimates of ALH and LCIS. Mean nuclear values were higher in ILC cases than in in-situ lesions, but no difference was detected between ILC and axillary metastases.
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PMID:Proliferative lesions of the breast lobules. A morphometric analysis. 209 Oct 11


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