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

The recent histological classifications of breast malignant epithelial tumours place increased emphasis on several concepts: in situ carcinoma, difference of lobular carcinoma from other forms of breast cancer and histological factors of prognosis. The authors propose to discriminate: non infiltrating duct carcinoma (intraductal carcinoma); lobular carcinoma (in situ and infiltrating); infiltrating duct carcinoma in their usual form (80 p. 100 about of all breast carcinoma); among them, histological types with a less ominous prognosis, although relatively rare, are stressed (infiltrating papillary and comedo-carcinomas, tubular carcinoma, medullary carcinoma, colloid carcinoma, cylindroma, certain metaplastic variants, Paget's disease of the nipple); some features in unusual hosts are related. They mention the criteria of the Scarff and Bloom's "grading" and its importance from the point of view of prognosis, mainly for the usual infiltrating forms. Other malignant tumours of the breast (malignant cystosarcoma phyllodes, sarcomas, mammary metastases) are more scarcely seen (I p. 100 of the mammary neoplasms): their classification is succinctly recalled.
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PMID:[Histological classification of malignant breast neoplasms. Recent concepts]. 17 53

Non-infiltrating intraductal carcinoma may be considered a type of "carcinoma in situ" of the breast. In a review of 47 cases diagnosed and treated at Gustave-Roussy Institute between 1956--1972, it appears that the early symptoms of this rare type of breast carcinoma (it occurs only in 2.4% of all breast cancers) were a bloody discharge (38%) or Paget's disease of the nipple (11%). The histological examination was of the utmost importance in these cases due to the diagnostic uncertainties between benign hyperplastic lesions and authentic carcinomas as well as between infiltrating carcinomas and strictly intraductal carcinomas. Frozen section was only accurate in 30% of cases. The high frequency of multicentric foci (76%) contrasted with the absence of lymph node involvment (none of the 23 cases in which at least one node was excised, showed lymph node metastases). Treatment was only of ablation of the whole mammary gland, except in 6 patients who had a tumorectomy, two of whom also received radiotherapy. Local recurrence occurred in 4 patients, 3 of whom had only tumorectomy. The contralateral breast was affected in 2 cases. No patient under follow-up died of cancer within 5 years. The peculiar and highly favorable course of non-infiltrating intraductal carcinoma calls for an adequate therapy which could later be followed by a plastic reconstructive surgery should the patient wish to have this procedure.
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PMID:[Non-infiltrating intraductal carcinoma of the breast (author's transl)]. 21 70

A total of 48 women with Paget's disease of the nipple (nipple eczema containing Paget cells but without a palpable lump) presented to one surgeon over a 13-year period. Temporary healing of the nipple eczema occurred in six patients. In all, 21 of 34 patients with in situ (DCIS) or invasive ductal carcinoma had mammographic abnormalities. Treatment was by simple mastectomy (37 cases), cone excision of the nipple-areola complex (ten cases) and tamoxifen (one case). DCIS was found in 45 operative specimens (96 per cent); eight had associated invasion. The DCIS was predominantly large cell solid/comedo in type and was multifocal in seven cases (19 per cent). At a median (range) follow-up of 56 (18-96) months, four of the ten patients treated by cone excision have developed a local recurrence, two of these patients have also developed metastases. Two of the 37 patients who underwent mastectomy developed loco-regional recurrences; both had invasive foci at their first operation and remain disease free at 8 years. We no longer feel that cone excision is appropriate treatment.
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PMID:Paget's disease of the nipple. 164 87

A rational approach to the local treatment of intraductal breast cancer continues to generate considerable debate. However, the finding of an invasive component in intraductal breast cancer is widely regarded as an appropriate indication for axillary node dissection as part of the local treatment and staging of this disease. Despite this view, the natural history of patients with intraductal breast cancer with foci of microinvasion is poorly defined. Between 1965 and 1988, 41 patients with this pathologic finding of intraductal carcinoma with foci of microinvasion were seen at the UCLA Medical Center. Twenty-three patients presented with mammographic abnormalities, while 17 patients presented with a palpable mass. One patient presented with Paget's disease of the nipple. Thirty-three patients underwent axillary node dissection as part of their local treatment. No lymph node metastases were identified. The median follow-up in 37 patients was 47 months. There have been no local recurrences and no deaths from recurrent breast cancer. Intraductal breast cancer associated with microinvasion appears to be an extremely favorable lesion with minimal risk of nodal metastases.
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PMID:The impact of microinvasion on axillary node metastases and survival in patients with intraductal breast cancer. 217 53

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

Fifty cases of Paget's disease of the breast treated surgically at The Johns Hopkins Hospital during the past 30 years were studied. Nineteen patients had Paget's disease confined to the nipple and 31 had an associated palpable tumor. An underlying intraductal or infiltrating duct carcinoma of the breast was present in each case. In six cases, the underlying tumor was 2 cm or more from the nipple with no apparent anatomic connection to the Paget lesion, and one case was encountered in whom intradermal Paget's disease develop in the area of a congenitally absent nipple. These findings support the theory of an intradermal origin for the Paget cell. Survival rates of patients with Paget's disease and a palpable breast mass were similar to those of patients with infiltrating duct carcinoma, the presence of axillary node metastases being the most important prognostic factor. Actuarial five- and ten-year survival rates were 22% and 9.9% for patients with positive nodes. The modified radical mastectomy is recommended as primary therapy for this group of patients. In contrast, none of the patients with Paget's disease of the nipple and no evidence of a palpable breast mass developed recurrent carcinoma. A total mastectomy without an axillary node dissection is the treatment of choice in this type of patient.
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PMID:Pathogenesis and treatment of Paget's disease of the breast. 626 59

Among the evolving entities and changing concepts in breast pathology are those relating to columnar cell hyperplasia, pseudoangiomatous stromal hyperplasia, mucocele-like lesions, pleomorphic lobular carcinoma in situ, pseudo-Paget's disease of nipple, microinvasive carcinoma of breast, spindle cell metaplastic carcinoma, and minimal metastatic disease in axillary lymph nodes. Pathologists, as well as physicians involved in the management of breast diseases, need to be aware of these recent developments in breast pathology since the recognition and understanding thereof may have considerable clinical relevance.
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PMID:Evolving entities and changing concepts in breast pathology. 1463 6