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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Breast cancer histologies show important differences in their incidence pattern, method of detection and management. Aggregation of breast cancer occurs also in families diagnosed for cancer at sites different from the breast. Therefore, the familial association of histology specific breast cancers with cancers at other sites is of great interest. The nationwide Swedish Family-Cancer Database was used to calculate standardised incidence ratios (SIRs) for breast cancer when parents or sibling were diagnosed with cancer at the most common sites. Significant SIRs were found when parents had breast, ovarian, laryngeal, endometrial, prostate, lung and colon cancers. If women were diagnosed before the age of 50 years, the SIRs were significant when parents were diagnosed with breast, ovarian, and prostate cancers, and leukaemia, and when siblings were diagnosed with squamous cell skin, pancreatic, breast and endometrial cancers. If mothers were diagnosed with breast cancer, histology-specific SIRs were ranked as comedo > tubular > ductal > lobular; SIR for medullary carcinoma was not significant but it was high when mothers presented with ovarian cancer. Other associations were between the upper aerodigestive tract and lobular, colon and comedo, larynx and ductal cancer. Moreover, cervical cancer was associated with comedo and endometrial cancer with the medullary histology. In conclusion, histology-specific breast cancers were associated with specific cancer sites and the strength of the association varied among histologies.
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PMID:Familial association of histology specific breast cancers with cancers at other sites. 1496 83

Ductal carcinoma in situ develops in the milk ducts without invading the surrounding connective tissue. Progression to invasive carcinoma is slow and infrequent and is thus difficult to predict. Screening mammography has increased the number of women diagnosed with early-stage ductal carcinoma in situ. What is the best management strategy for patients whose breast biopsy suggests ductal carcinoma in situ? Is watchful waiting a reasonable option? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. Surgical resection is usually proposed to women with ductal carcinoma in situ but has not been compared with watchful waiting. Resection does not appear to have a major impact on mortality: trials of screening mammography showed no major reduction in breast cancer mortality, but screening does increase the number of diagnoses of ductal carcinoma in situ and, thus, the number of women who undergo surgery. When ductal carcinoma in situ is diagnosed by biopsy, histological examination of the surgically resected tumour reveals invasive breast cancer in about 13% to 24% of cases. Surgical removal of the tumour is usually proposed to women with ductal carcinoma in situ. Excision may be either localised (lumpectomy) or extensive (mastectomy). We found no randomised trials comparing the two approaches. Lumpectomy is usually proposed when the tumour is small (less than 20 mm) and appears to be amenable to complete excision with acceptable cosmetic results. A follow-up study of nearly 2000 women showed a recurrence rate of about 27% between 8 and 10 years after lumpectomy without further treatment. Mastectomy is usually proposed when the tumour appears to be extensive on mammography, or when complete resection with acceptable cosmetic results does not appear feasible, or when the patient chooses this option. Following mastectomy, the risk of carcinoma is similar to that of the general female population. Mastectomy and lumpectomy can both result in persistent pain, which is severe in about 13% of women. Systematic reviews of data for more than 10 000 women have shown that the following factors are statistically associated with an increased risk of recurrence after lumpectomy: age less than 50 years at diagnosis, tumours larger than 25 mm, high-grade tumours, and comedo-type necrosis. Healthy surgical margins of at least 2 mm are associated with a lower risk of recurrence. The impact of radiation therapy after lumpectomy for ductal carcinoma in situ has been evaluated in four randomised trials including a total of 3925 women. Radiation therapy reduced the risk of recurrence but did not prevent death from breast cancer. Irradiation carries a risk of skin burns and long-term cardiovascular and pulmonary toxicity. It also increases the risk of persistent post-surgical pain. In two randomised placebo-controlled trials of lumpectomy with or without radiation therapy for ductal carcinoma in situ, tamoxifen (an antiestrogen) did not affect either overall or breast cancer mortality, but it reduced the risk of recurrence by about one-quarter. Adverse effects of tamoxifen include venous thrombosis and pulmonary embolism, and endometrial cancer. In practice, women diagnosed with ductal carcinoma in situ have a number of options, none of which seems to have a clearly superior harm-benefit balance. Surgical excision reduces the risk of progression but can lead to persistent pain. Following radical mastectomy, the risk of breast cancer is similar to that of the general population. Lumpectomy is associated with a higher risk of recurrence and thus requires closer monitoring. Radiation therapy reduces the risk of recurrence in high-risk situations but has noteworthy adverse effects. Simple clinical monitoring is a valid option for asymptomatic patients: it carries a risk of progression to invasive cancer but avoids exposing many women to the adverse effects of surgery and radiation therapy.
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PMID:Treatment of ductal carcinoma in situ: an uncertain harm-benefit balance. 2460 Jul 34