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)

We reviewed the records of 120 women, age 35 years or younger, with the diagnosis of breast cancer at ten hospitals in the Milwaukee metropolitan population of 1 million between 1970 and 1980. We analyzed epidemiologic factors, methods of diagnosis, treatment, and mortality. While 57 per cent of the patients sought medical attention within 6 weeks of the first symptom, 34 per cent waited longer, and physicians postponed biopsy more than 2 months in another 7 per cent. Most often, the first symptom was a painless lump (61%) and the histology was ductal carcinoma (73%). Only 61 per cent of the patients had preoperative mammography, and 52 per cent of the radiographs were interpreted as benign or negative. Estrogen receptors were obtained in only 38 per cent. At the time of presentation, only 3 per cent had evidence of distant metastases. Mastectomy with or without nodal dissection and/or pectoral muscle excision was performed on 97 per cent of the patients. Twelve per cent of the patients had or developed bilateral breast cancer. Chemotherapy, irradiation, and hormone manipulation were used alone or in combination (with or without mastectomy) in 76 per cent. Although complete 10-year survival data are not yet known, 25 per cent of the 120 patients are dead of the disease and 10% are lost to follow-up and presumed dead. These data indicate that in women age 35 years or younger with breast cancer, patient and physician delay in diagnosis has been common. Estrogen receptors and mammography have been underutilized in this patient population. However, in this community, young patients fared no worse than older women.
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PMID:Breast cancer in 120 women under 35 years old. A 10-year community-wide survey. 669 29

Patients with bulky prostate cancer have usually been treated by palliative measures because the likelihood of tumor control with definitive irradiation has been low and the development of distant metastases high. The addition of estrogen to irradiation has not been shown to be of value. However, we believe the method of estrogen administration may have been the cause for the apparent lack of benefit. Estrogen had been started either concurrent with irradiation or had been used for palliation and was given for long and unscheduled time periods prior to irradiation. We have used estrogen for two months prior to and concurrent with irradiation. We postulated that in those patients with estrogen responsive cancer, the reduced tumor burden prior to irradiation could enhance tumor control and survival. Between 1975 and 1980, 25 patients with bulky prostate cancer received sequential estrogen and irradiation, 12 patients irradiation alone and six patients irradiation after having become refractory to long-term estrogen use. One patient was lost to follow-up. Eighteen of 25 (72%) treated by sequential estrogen and irradiation, 14/17 (82%) with estrogen responsive cancer and 4/8 (50%) with estrogen resistant cancer had a complete tumor response. Six of 11 (55%) patients treated by irradiation alone and 2/6 (33%) treated by irradiation for estrogen refractory cancer had a complete tumor response. Disease-free survival was observed in 13/25 (52%) treated by sequential estrogen and irradiation, and 8/17 patients (47%) with irradiation. It is also possible the improved survival in the estrogen responsive group was a direct result of improved local control. Persistent local disease can act as a source for distant metastases. Distant metastases was observed in 15% of patients when the primary tumor was controlled and 30% when there was persistent or recurrent local disease. Also, progressive local disease can be an important cause of death. This was most evident in our patients with estrogen refractory cancer. Almost all patients in this group had progressive local disease that caused serious urinary bleeding and urinary infection that were considered the major cause of death. Our results suggest bulky prostate cancer should be aggressively treated when first diagnosed. The value of adjunct estrogen is unproven. Our results with the use of estrogen prior to and concurrent with irradiation is encouraging. Estrogen may shrink the cancer and allow for a more favorable geometry for external irradiation. Tumor control and survival may be thereby improved.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Improved control of bulky prostate carcinoma with sequential estrogen and radiation therapy. 674 58

In a retrospective study, response to systemic polychemotherapy was analyzed in 72 female patients having advanced breast cancer and correlated with estrogen receptor (ER) status. Estrogen receptors were analyzed by agar-gel electrophoresis or uptake competition technique in tumor biopsy specimens derived from the primary tumor or from metastases. The borderline between positive and negative ER values was declared to be 20 fmol/mg tissue protein. Most of the patients have had an extramural review. We did not find statistically significant differences between the ER-positive (ER+), and ER-negative (ER-) groups in these characteristics: age; menopausal status; disease-free interval; dominant site of involvement. Chemotherapy regimens utilized in the two groups were comparable. According to criteria formulated by the European Organization on Research and Treatment of Cancer (EORTC), there is no evidence that response to chemotherapy is correlated with the presence or absence of estrogen receptor. Thirteen of 31 ER+ patients responded objectively to chemotherapy (42%) and 17 or 41 ER- patients gained such remission (41%). Given the retrospective nature of the data, this result should be interpreted cautiously. More clinical studies are warranted to determine whether response to cytotoxic agents is affected by ER status.
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PMID:Estrogen receptor status and response to polychemotherapy in advanced breast cancer. 700 25

The effectiveness of combination therapy with diethylstilbestrol, cyclophosphamide, and 5-fluorouracil (DES + CTx + FU) was compared with DES alone or CTx + FU in 87 postmenopausal women with advanced breast cancer. Therapy was randomized according to the tumor estrogen-receptor (ER) status. In 30 patients with ER-rich tumors and 35 patients with ER-unknown tumors, combination therapy yielded a higher response rate than DES therapy (87% vs. 64% and 59% vs. 23%, respectively). The pooled data from these two groups of patients suggest that the improved response rate from DES + CTx + FU against DES becomes more apparent in patients with visceral involvement (89% vs. 47%) (P less than 0.025) and that patients treated initially with combination therapy (DES + CTx + FU) appeared to have a longer survival than those treated with sequential therapy (DES leads to CTx + FU) (P = 0.06). The survival data in 22 patients with receptor-poor tumors were significantly inferior to those with receptor-rich tumors (P = 0.001). The ER status and presence of visceral metastases are significant factors in the selection of treatment programs.
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PMID:Combination therapy of hormone and cytotoxic agents in advanced breast cancer. 701 60

Estrogen receptors (ER) status was investigated in 101 primary breast carcinomas and their axillary lymph node metastases to determine if the malignant cells retained or changed this phenotypic feature during the metastatic process. Immunohistochemistry with the ER-ICA kit (Abbott Laboratory) on formalin-fixed paraffin-embedded tissue was used (paraffin ER-ICA). The ER status in primary and secondary tumours was concordant in 80 patients (79%) and discordant in 21 (21%). Eighteen of these twenty-one patients had ER-positive primary tumours and ER-negative lymph node metastases. This discordance, which may be due to loss of ERs in the metastatic cells or tumour heterogeneity, could explain the well-known failure of endocrine treatment in some of the patients with ER-positive primary tumours. A new monoclonal antibody ID5 (DAKO) against ERs was applied on formalin-fixed paraffin-embedded tissue from 83 of these 101 primary carcinomas. These analyses and paraffin ER-ICA analyses were compared to prior analyses of the same 83 tumours using the ER-ICA kit on fresh frozen tissue ("gold standard", frozen ER-ICA). Kappa coefficient, sensitivity and specificity were 0.74, 0.96 and 0.75 for ID5 antibody, and 0.59, 0.72 and 0.96 for ER-ICA antibody on paraffin sections.
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PMID:Immunohistochemical study of estrogen receptors in primary breast carcinomas and their lymph node metastases including comparison of two monoclonal antibodies. 769 87

The purpose of this study is to find out the biological feature of laryngeal cancer and metastatic lymph nodes with DNA Image Analysis, Argyrophilic Nucleolar Organizer Region (AgNOR), Carcinoembryonic Antigen (EA) and Estrogen Receptor (ER) 30 patients were included in this study. It was found that carcinomatous tissues showed a statistically significantly higher DNA content, AgNOR content, and positive reaction of CEA and ER than those of normal tissue (P < 0.01). Paired comparisons were performed in primary tumor and metastases and didn't show statistical difference (P > 0.05). The group with survival time over 5 years had a significantly lower DNA content, AgNOR content, CEA positive reaction of metastases and higher ER positive reaction of metastases than those with less than 5 years survival (P < 0.01). But there no was consistant relationship between primary tumor CEA or ER positive reaction and survival time (P > 0.05). The patients who accepted radiotheraphy had better prognosis than those who didn't (P < 0.05). The above results indicate that the combined analysis of metastases and primary tumor will provide a good feature for biological activity. In addition, radiotherapy before and after operation will be beneficial.
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PMID:[Biological study on prognosis of laryngeal carcinoma with regional metastatic lymph nodes]. 780 26

Though vertebral fractures were required to make the diagnosis of osteoporosis prior to the advent of methods for accurate bone measurement, osteopenia is readily defined by a decrease of bone mineral density by 2 to 2.5 SD from the peak bone density. After excluding other metabolic bone diseases such as primary hyperparathyroidism, osteomalacia, renal osteodystrophy, multiple myeloma and tumor metastases by means of X-ray studies and biochemical studies on serum and urine, by far the largest proportion of patients with osteopenia are usually found to have osteoporosis. Primary osteoporosis is found in males and females after middle age, and secondary osteoporosis at any age with definite causes such as corticosteroid excess, immobilization, rheumatoid arthritis or vitamin C deficiency. Estrogen withdrawal in young women is classified as secondary osteoporosis, but postmenopausal osteoporosis with similar cause is usually classified into primary osteoporosis, creating a confusion. Rapid bone loss occurring only during a few years after menopause should be clearly distinguished from the life-long process of bone loss common to males and females and should not be classified as a "type" of osteoporosis.
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PMID:[Osteoporosis--concept, classification and epidemiology]. 796 67

The authors report the case of a patient aged 27 suffering from a clear cell adenocarcinoma of the vagina which was related to her mother taking Diethylstilboestrol or Distilbene (DES) during her pregnancy. This young woman presented with pulmonary metastases for which several trials of chemotherapy ended in failure. The case raises several problems amongst which are epidemiologies of cancers induced by Diethylstilboestrol (DES), their prognosis as well as the therapeutic strategies at the time of diagnosis and the recurrences which occur as metastases.
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PMID:[Pulmonary metastases from a hormone-induced clear cell adenocarcinoma of the vagina]. 812 25

A 62-year-old man having prostate cancer presenting with hemolytic jaundice is reported. The hemolytic jaundice was cured by diethylstilbestrol diphosphate (DES-P) treatment, but the patient died one year and two months later from relapse of prostate cancer. An autopsy confirmed the diagnosis of prostate cancer with multiple metastases. Sudden anemia caused by bone metastasis might have caused the hemolytic jaundice. DES-P cured bone metastasis and then improved anemia when associated with transfusion. Consequently, hemolytic jaundice was cured.
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PMID:A case of extremely advanced prostate cancer presenting hemolytic jaundice. 817 48

Low-grade adenosquamous carcinoma of the breast is an uncommon neoplasm of uncertain pathogenesis, clinical behavior, and malignant potential. This report describes the clinical and pathologic features of 32 cases of low-grade adenosquamous carcinoma. All patients presented with palpable tumors ranging from 0.6 to 8.6 cm (mean, 2.8 cm). Origin from an intraductal papillary tumor was found in 12 cases, including three with adenomyoepitheliomatous features. Electron microscopy disclosed glandular and squamous differentiation; the squamous cells often lined ducts that were structurally analogous to the acrosyringium of the eccrine sweat gland. Treatment consisted of mastectomy (13 patients) or excisional biopsy (19 patients). A single lymph node in one patient with a 3.5-cm primary carcinoma harbored metastatic adenocarcinoma. Axillary dissection revealed no metastases in 11 other patients. Another patient with an 8.0-cm breast tumor had metastatic adenosquamous carcinoma in the lung at initial diagnosis. After follow-up of 12 to 124 months, 20 of 25 patients had no recurrence. Five women treated by excisional biopsy had local recurrences in the breast. In one patient, the local recurrence was ultimately fatal due to invasion of the hemithorax. Estrogen and progesterone receptor studies were negative in 13 of 15 cases studied by biochemical analysis. The two tumors that were hormone-receptor positive were histologically associated with a papilloma and an adenomyoepithelioma, respectively. In the latter case, immunohistochemical studies showed the carcinoma to be hormone-receptor negative. Hormone receptor activity was limited to the adenomyoepitheliomatous component. This study confirms the largely indolent, but locally aggressive, clinical course of low-grade adenosquamous carcinoma of the breast. Although complete limited excision of small lesions may be curative, tumors greater than 3.0 cm may require more aggressive therapy.
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PMID:Low-grade adenosquamous carcinoma of the breast. A clinocopathologic study of 32 cases with ultrastructural analysis. 843 5


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