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Query: UMLS:C0278488 (metastatic breast cancer)
 7,812 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metastatic breast cancer is the most common primary tumor metastasizing to the ocular structures. An analysis of 30 patients demonstrated a wide spectrum of ophthalmic manifestations including cranial nerve involvement, brain involvement with papilledema, Horner's syndrome, and choroidal and orbital tumors. The mean age of patients presenting with an ophthalmic sign was 54 years and the mean interval from the diagnosis of breast cancer to the development of the ophthalmic sign was 4.9 years. The carcinoembryonic antigen (CEA) was useful in confirming the diagnosis of metastatic disease as it was elevated in 18 of the 22 patients in whom it was measured. The estrogen receptor assay, performed on metastatic tissue removed from the orbit, can indicate the sensitivity of the breast cancer to hormonal therapy.
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PMID:Ophthalmic manifestations of metastatic breast cancer. 724 1

To determine the influence of cytoplasmic estrogen receptor (ER) status on response to chemotherapy among patients with recurrent breast cancer amenable to biopsy, we studied 65 patients who had ER determinations performed on metastatic lesions. The response to combination chemotherapy and duration of survival were determined in 49 of these patients who receive cytotoxic chemotherapy as their sole modality of treatment. Compared to patients with ER levels less than 3 femtomols/mg, patients with an ER concentration greater than or equal to femtomols/mg had a higher response rate (57% vs 21%, P less than 0.05) and a longer survival (35 vs 13 patients was attributable to response to subsequent hormonal manipulations. These differences between ER-positive and ER-negative patients were lessened by redefining ER-positive as greater than 10 femotomols/mg. Nevertheless, at our institution patients with ER-positive metastatic breast cancer have a higher response rate to chemotherapy and survive longer than their ER-negative counterparts.
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PMID:Influence of estrogen receptor status on response to combination chemotherapy for recurrent breast cancer. 727 11

The determination of hormone receptors in tumor tissue samples today is accepted as a necessary step with in a selective treatment plan for patients with breast cancer. The following way discussed our clinical knowledge about hormone receptors in breast cancer. Besides a therapy concept for metastatic breast cancer an adjuvant treatment trial for stage II breast cancer patients based on the estrogen receptor status will be presented.
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PMID:[Hormonreceptors in the therapy concept of breast cancer (author's transl)]. 733 46

Aminoglutethimide (AG) is an effective chemical ablative form of therapy for metastatic breast cancer in postmenopausal women. Estrogen receptor (ER) status in breast cancer is useful in predicting the response to the hormonal treatments. Of 134 postmenopausal metastatic breast cancer patients treated with AG, ER analysis was done in 63 patients, 52 of whom are now evaluable. ER biopsy was performed prior to Ag therapy in 61 patients, but the results were not known to the investigators. ER value greater than or equal to 10 fmol/mg cytosol protein was considered ER positive (ER+), 4-9.9 fmol/mg borderline, and less than 4 fmol/mg ER negative (ER-). In 38 ER+ patients, objective response rate was 50% (three complete response, 16 partial response) and eight stabilization. Median duration of objective response was 15 months. Forty-three percent of the patients with borderline estrogen receptor level responded objectively (three partial response) with the median duration of response eleven months. Fourteen percent of ER- patients responded objectively (one complete response). Hence the estrogen receptor level predicts response in ER+ and ER borderline patients treated with AG.
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PMID:Influence of estrogen receptor status on response of metastatic breast cancer to aminoglutethimide therapy. 735 95

This report summarizes some of the clinical correlations of cytosol estrogen receptor (RE) and progesterone receptor (RP) measurement and presents methods of improving the accuracy of receptor assays in selection of patients for endocrine treatment of breast cancer. Clinical data from 99 metastatic breast cancer patients were reviewed. Patients with RE positive tumors had a significantly greater response rate overall to endocrine therapy than those with estrogen negative tumors. The difference between the RE positive and RE negative groups was significant whether or not patients with static disease were included in the remission category. 2 of 3 RE negative patients who responded to endocrine treatment were premenopausal. In 57 treatments in which both RE and RP measurements were available, RP assay did not improve the discrimination between responding and nonresponding patient groups. In particular, the response rate in the RE positive groups was equally divided between those tumors which were RP positive and RP negative. Tumor RE concentration also had an influence on tumor responsiveness; when the level of RE was 100 fmol/mg, all tumors responded to hormonal treatment, whereas the response rate in tumors with RE 50 fmol/mg was significantly greater than in tumors of RE content between 5 and 50 fmol/mg (P .05). Retrospective analysis of the disease-free interval for a patient group in remission showed that RE positive patients had significantly longer disease-free interval (37+ or -28 months) than RE negative patients (22.7+ or -20 months) (P .002).
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PMID:Clinical applications of receptor measurements in breast cancer. 736 74

Tamoxifen blood levels were measured in patients with metastatic breast cancer after single-dose and continuous administration, using a traditional dose schedule of 10 mg/m2 twice daily, a single daily dose schedule of 20 mg/m2; and several loading dose schedules of 20-80 mg/m2 twice daily x 7 days, then a 20-mg/m2 single daily dose thereafter. Using the traditional 10-mg/m2 twice daily schedule, values after continuous administration at the time clinical responses were observed were greater than or equal to 10 x peak values observed after a single dose. Using a loading dose schedule of greater than or equal to 40 mg/m2 twice daily x 7 days, values known to be associated with a response were present by 3 hours, as opposed to greater than or equal to 7 days with the traditional schedule. Levels obtained at peak and trough times with the once-daily schedule suggest tamoxifen may safely be given on a once-daily basis, particularly after the first 8 weeks of therapy. Half-life of tamoxifen after continuous administration is prolonged, and levels obtained for up to 6 weeks after drug discontinuation suggest that false-negative cytoplasmic estrogen receptor (ER) determinations may be obtained if tissue for ER is sampled within 4-6 weeks of prolonged tamoxifen administration.
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PMID:Clinical pharmacology of tamoxifen in patients with breast cancer: comparison of traditional and loading dose schedules. 742 61

Estrogen receptors in breast tumors were assayed in 55 premenopausal women undergoing bilateral oophorectomy and in 120 postmenopausal women undergoing bilateral adrenalectomy for treatment of metastatic breast cancer. The data show that 20 (60%) of the 32 patients with estrogen receptor-positive (ER+) tumors had objective remission after oophorectomy, and 44 (51%) of the 87 patients with ER+ tumors responded to adrenalectomy. In contrast, of those patients with estrogen receptor-negative (ER-) tumors, only 3% had an objective remission following oophorectomy and 9% following adrenalectomy. It is concluded that major endocrine ablative procedures are not justified in patients with ER- tumors. The data also conclusively demonstrate the significance of 4S receptors in predicting the response to endocrine therapy. In this study, it was found that although the response rate to endocrine ablation was substantially higher (71-83%) in patients whose tumors contained both estradiol and progesterone receptors, between 50 and 60% of ER+ tumors lacking progesterone receptors had objective remission after endocrine ablative therapy.
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PMID:Steroid receptors and response to endocrine ablations in women with metastatic cancer of the breast. 744 20

The usefulness of estrogen receptor (ER) analyses was assessed in a variety of clinical situations. The predictive accuracy of the test is substantially increased by quantification. ER analyses accurately predict objective responses to endocrine therapy independently of other clinical prognostic criteria. In addition, ER positivity is associated with a decreased response rate to cytotoxic chemotherapy in patients with metastatic breast cancer. Finally, the presence of ER is positively associated with a prolonged disease-free interval independent of menopausal status, tumor size, and axillary lymph node involvement.
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PMID:Quantitative estrogen receptor analyses: the response to endocrine and cytotoxic chemotherapy in human breast cancer and the disease-free interval. 744 29

Measurement of cytoplasmic estrogen (REc) and progesterone (RPc) receptors in human breast tumors together with estrogen receptor activity in the residual pellet ("nuclear" REN) provides a more accurate prediction of hormonal dependence that REc alone. Of 74 patients with advanced metastatic breast cancer, 57% of those with REc+ tumors had an objective response to endocrine manipulation. Of 51 patients whose tumor was assayed for both REc and RPc activity, 9 of 12 patients with REc+ RPc+ tumors showed remission, whereas only 3 of 30 patients with REc- RPc-, 2 of 6 with REc+ RPc-, and 2 of 3 with REc- RPc+ tumors had a clinical response. In a group of 19 patients where triple assay was performed, 5 of 6 with tumors positive for all three receptors responded, whereas 9 patients with triple negative tumors all showed no remission. Fifty-nine percent of primary and 60% of metastatic tumors with REc+ activity were also shown to be RPc+. Thirteen percent of REc- tumors were RPc+. Patients with REc+ RPc+ primary tumors tended to have a longer disease-free interval than patients with RPc- tumors, irrespective of whether the tumors were REc+ or REc-. In the light of the possibility of employing receptor status of the primary tumor to predict hormonal responsiveness in subsequent recurrences, a comparison is made of receptor status measured in primary tumors and metastases.
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PMID:The clinical value of multiple steroid receptor assays in breast cancer management. 744 41

Aminoglutethimide (AG) with Dexamethasone has been utilized in 26 patients with metastatic breast cancer who had prior response to hormonal manipulation and/or positive estrogen receptor. Objective tumor response (CR + PR) has been achieved in 13 of 26 patients. Responses were seen in soft tissue, bone, and pleura. Six of 26 patients had stable disease and seven of 26 patients had progressive disease. The median duration of response is 12.8 months. The median survival for the responders has not been reached. Non-responding patients had a median survival of five months. Side effects were minimal, including mild lethargy, rash, fever, and weight gain. This regimen is well tolerated and can be used effectively in metastatic hormone-receptor-positive breast cancer.
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PMID:Aminoglutethimide in the management of metastatic breast cancer. 746 86


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