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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of male breast carcinoma is reported, whose only clinical sign was a serous nipple discharge. The presence in the cytologic smears of atypical epithelial cells organized in a papillary structure suggested a papillary neoplasia, which at the histologic examination was found to be a ductal carcinoma in situ.
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PMID:Male breast carcinoma in situ. Report of a case diagnosed by nipple discharge cytology alone. 765 52

More than 27 items have been used as tumor markers in Japan. However, their usefulness is limited mostly for monitoring of cancer patients. The screening is achieved by several markers such as those secreted in urine, breast discharge and feces. Biological and oncodevelopmental characteristics are reflected on these markers and may provide the suitable treatments. Occult metastasis or recurrence can be detected by serial determinations of the serum markers.
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PMID:[Clinical significance of present tumor markers]. 768 65

Forty-nine women with ductal carcinoma in situ (DCIS) treated with lumpectomy and irradiation were studied retrospectively. The median age was 50 years (range, 29 to 73 years) and the median follow-up time from initiation of therapy was 86 months (range, 17 to 230 months). Twelve patients presented with palpable masses (0.4 to 4 cm), three with breast thickening, and three with nipple discharge. In 31 patients the tumors were detected by mammography. Intraoperatively, excision of lesions was confirmed by specimen x-ray (38 specimens) or gross inspection (five specimens) and was recorded to be complete. No record was available in the other six patients. Margins of excision free of DCIS were microscopically confirmed in 25 specimens. The size of impalpable DCIS lesions recorded in 25 patients ranged from 0.4 to 5.0 cm (mean, 1.5 cm). Using Lagios' classification system, there were 18 classic comedocarcinomas, high nuclear grade (NG) with necrosis; seven cribriform/papillary, high NG with necrosis; 17 cribriform/micropapillary, intermediate NG with or without necrosis; and seven cribriform/micropapillary, low NG without necrosis. In two patients residual malignant calcifications were present on the postoperative mammogram. Disease recurred in the treated breast at the site of incision in five patients at 18 months and 8, 11, and 12 (two patients) years from initial therapy. The rate of local disease recurrence was 2% at 5 years and 6% at 10 years; three recurrences showed invasive ductal carcinoma and two were DCIS. To evaluate risk factors the following characteristics were considered: necrosis, NG, histological type, periductal fibrosis, periductal lymphoid infiltrate, margin status, age, and method of tumor detection. The end points chosen were recurrence and death from any cause (because only one patient died of disease). Although the recurrences were attributed to residual disease in two patients, of the clinical and pathological parameters evaluated, only periductal fibrosis showed a significant relationship with outcome, with a P value < or = .05 by the Wilcoxon test. On the other hand, using the proportional hazards model, necrosis was a significant predictor for recurrence (P = .02), as was the pair fibrosis and tumor detection when taken together (P = .05). Fibrosis significantly associated with high NG, Lagios' histological subtypes I and II, periductal lymphoid infiltrate, and necrosis (P < or = .0006).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Ductal carcinoma in situ treated with lumpectomy and irradiation: histopathological analysis of 49 specimens with emphasis on risk factors and long term results. 860 51

The levels of c-erbB-2 oncoprotein (ErbB-2 protein) in nipple discharge were evaluated together with those of carcinoembryonic antigen (CEA) in 9 patients with breast cancer, 2 patients with borderline lesions, 8 patients with intraductal papilloma, and 19 patients with fibrocystic change. When the tentative cutoff value was set at 40 ng/ml in the nipple discharge, elevated ErbB-2 protein levels were found in all 3 patients with palpable breast cancer and 3 of the 6 patients with nonpalpable cancer. Two of the 8 patients with intraductal papilloma had high ErbB-2 protein levels. A combination test with CEA resulted in positive detection in all cancer patients. Two patients with borderline lesions, 2 with intraductal papilloma and 2 with fibrocystic change were positive in a combination test. In addition, elevated ErbB-2 protein levels in nipple discharge correlated well with the overexpression of ErbB-2 protein in the tumor. All the patients with ErbB-2 protein levels over 100 ng/ml in their nipple discharge had comedo or solid intraductal carcinomas. Thus, measurement of ErbB-2 protein levels in nipple discharge can assist in the diagnosis of intraductal carcinoma and also in detecting tumors with a high proliferation rate and an overexpression of ErbB-2 protein: usually comedo or solid carcinomas.
Tumour Biol 1993
PMID:ErbB-2 protein levels in nipple discharge: role in diagnosis of early breast cancer. 790 88

To improve the survival in breast cancer, it is important to detect and treat breast cancer early. Physical examination (PE), mammography (MMG), ultrasonography (US), and aspiration biopsy cytology (ABC) are routinely assessed in the diagnosis of breast cancer. When three procedures including ABC are positive in a diagnosis of breast cancer, it is an absolute indication for surgery. Of all 238 breast cancers between 1987 and 1992, 86 cases were T1. The sensitivity of each procedure was PE 58.9%, MMG 70.0%, US 74.4% and ABC 86.2%, indicating that PE was less sensitive for small cancer. The recent accuracy of ABC in our series was satisfactory, and the combination diagnosis had a good result for T1 tumor because the findings from these procedures were complimentary. The high accuracy of ABC therefore suggests that lumpectomy has two aspects, definite diagnosis, and therapy as conservative surgery for breast cancer. The nineteen cases of T0 cancer encountered were almost entirely detected by nipple discharge or MMG. In conclusion, the combination diagnosis including ABC was very effective, and it is very important to detect and diagnose clinically small or non-palpable breast cancer.
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PMID:[Diagnosis in early breast cancer]. 803 77

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

In a series of 9,312 women who consulted one of the authors with a complaint of disease of the breast between 1959 and 1991, nipple discharge was the presenting symptom in 448 (4.8 percent). Nipple discharge was spontaneous in 243 (2.6 percent) and provoked in 205 (2.2 percent) of the patients. The ages of the patients ranged from 13 to 75 years (mean of 42.5 years) in the spontaneous and 16 to 70 years (mean of 37.8 years) in the provoked discharge group. When a palpable mass was found, biopsy was undertaken, while in instances of nipple discharge only, subareolar exploration was performed. Of the 115 patients in the spontaneous and 25 patients in the provoked groups who underwent biopsy, the most frequent cause of nipple discharge was intraductal papilloma (47.8 percent). Nipple discharge was the result of carcinoma in 35 patients (14.4 percent) in the spontaneous and six patients (2.9 percent) in the provoked group, respectively. In patients with a palpable mass, the incidence of carcinoma was 61.5 percent compared with 6.1 percent in patients with nipple discharge only. Patients presenting with nipple discharge should undergo biopsy or subareolar exploration based on the presence or absence of a palpable tumor. The patients in whom no clinical findings could be detected should have follow-up evaluation at regular intervals.
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PMID:Management of nipple discharge. 816 84

In order to evaluate the local residual cancer following breast conservation therapy (BCT) with lumpectomy, we investigated the relationships between residual cancer and age, tumor location, tumor diameter (T), mammography findings, nipple discharge findings, histopathological type, lymphatic and/or vascular invasion by tumor cells, histological grading, histological lymph node metastases (n), and estrogen receptor (ER) status, in 1494 patients with breast cancer that involved diagnostic excisional biopsy. Residual cancers were found in 581 of 1448 (40%) mastectomy specimens, after 46 (3.1%) with multicentricity had been excluded. No correlation was observed between residual cancer and age, histological grading, and ER. However, residual cancer rates were 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 diagnosed by biopsy, (6) lymphatic invasion by tumor cells; or (7) a high degree (n > or = 4) of lymph node metastases. The above seven clinicopathologic factors are thus considered useful prognostic indicators for local recurrence in BCT with lumpectomy.
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PMID:Prognostic factors for local recurrence in breast conservation therapy: residual cancers after lumpectomy. 832 33

The treatment of intraductal breast carcinoma, ranging from local incision alone to modified radical mastectomy, remains controversial. Seventy-nine patients were treated for intraductal breast carcinoma, noncomedo type at our institution from 1975 to 1991. There were 78 females and one male with a mean age of 58 years and a range from 32 to 90 years. Clinical presentation included a palpable mass in 25 patients, abnormal mammogram in 60 patients, and nipple discharge in 12 patients. Treatment consisted of local excision in 19 patients, simple mastectomy in 25 patients, and modified radical mastectomy in 35 patients. Twenty-five patients underwent simultaneous prophylactic contralateral mastectomy. Choice of treatment was determined by physician preference and no differences were seen in family history, parity, nipple discharge, history of fibrocystic disease, presence of palpable lymph nodes, tumor size, tumor location, patient age, or mammographic findings. Forty-five patients had multicentric tumors on final pathology. One patient demonstrated an axillary lymph node metastasis following modified radical mastectomy raising the question of undetected invasive carcinoma. All patients were free of disease at last evaluation and no differences in survival were noted between different treatment groups with a mean follow up of 5 years. We conclude that local excision is an appropriate option for treatment of intraductal breast carcinoma noncomedo type.
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PMID:Treatment of intraductal breast cancer--noncomedo type. 838 87

Although reports on primary squamous cell carcinoma of the breast have been increasing in number, the morbidity rate of the disease is comparatively low. Its onset in pregnant women, especially, is quite rare. We herein report a case of primary squamous cell carcinoma of the breast in a pregnant woman. A 33-year-old woman was admitted with a lump in the right breast and an abnormal bloody nipple discharge. The breast mass was 5.6 x 5.4 cm in size, and both ultrasonogram and CT scanning showed that it consisted of a cystic tumor for the most part. A large amount of bloody cystic fluid was aspirated by fine-needle aspiration; squamous cell carcinoma of the breast was suspected by a cytological study on the fluid. Twelve days after an induced abortion was performed, a modified radical mastectomy was carried out. Histological findings of the resected specimen demonstrated that the tumor was squamous cell carcinoma which had been well differentiated with partial keratinization and cancer pearls. Noninvasive ductal carcinoma was also observed in a very small region of the specimen, which indicated that the tumor was probably originally adenocarcinoma which later transformed into squamous cell carcinoma.
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PMID:Primary squamous cell carcinoma of the breast in a pregnant woman: report of a case. 839 67


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