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Biomedical subjects

A P Forrest

Publications and source records attributed to A P Forrest.

At least 91 records · Page 5Linked to original sources
PubMed1984

Clinical assessment of tumour size in primary breast carcinoma.

In a consecutive series of 100 operable breast carcinomas clinical and mammographic assessment of tumour size each resulted in only 75% being placed in the correct T category when compared to the actual tumour size. In a further 50 breast carcinomas it was shown that an accurate assessment of actual tumour size could be obtained by subtracting the thickness of the skin, fat and subcutaneous tissue in the corresponding area in the contralateral breast from the clinical measurement obtained using calipers (adjusted clinical size). The T category using this method was correct in 49 out of the 50, significantly better than clinical measurement or mammographic assessment of tumour size (p less than 0.003 McNemar's Test). Analysis of the regression lines obtained comparing clinical measurement, mammographic assessment and adjusted clinical size with actual tumour size showed that: clinical measurement overestimated actual tumour size by 0.5 to 1 cm; mammographic assessment overestimated small tumour and underestimated larger ones, whereas the adjusted clinical size never differed by more than a fraction of a centimeter from the actual size. This new method of assessment of tumour size allows accurate pre-operative selection of patients into appropriate treatment options.

Biopsy, Needle↗
PubMed1983

Elastosis and primary breast cancer.

One hundred sixty-five patients with primary operable breast cancer were followed for up to 60 months. Each patient had the amount of focal elastosis and the estrogen-receptor activity within the tumor determined, as well as the tumor size, axillary nodal palpability, and nodal involvement. The risks of recurrence and death were compared by constructing life tables and assessing differences in various subgroups. There was no demonstrated association between tumor elastosis and the patients' age, menstrual status, the palpability of axillary lymph nodes, or the pathological states of these nodes at mastectomy. A tendency for larger tumors to have less elastosis was noticed. A significant association between the grade of elastosis and the presence, or absence, of estrogen-receptor activity was seen. The degree of focal elastosis in the primary tumor, alone, was disappointing as a prognostic factor. A strong suggestion that estrogen-receptor activity is a better indicator of prognosis was present.

Axilla↗
PubMed1983

Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy.

64 women with operable breast cancer were randomly allocated at the time of mastectomy to a group receiving immediate breast reconstruction or to a control group to whom breast reconstruction was offered 12 months later. The objective of the trial was to determine whether immediate breast reconstruction affected the psychosocial morbidity of mastectomy. Immediate reconstruction reduced the psychiatric morbidity assessed 3 months after operation, predominantly in women with unsatisfactory marriages. Women who underwent reconstruction had more freedom of dress and were less likely to be repulsed by their own naked appearance than women who did not undergo reconstruction. Sexual and social morbidity were not affected.

Breast↗
PubMed1983

The effect of breast biopsy on reactive changes in the axillary lymph nodes.

The reactive changes in the axillary lymph nodes of 50 breast cancer patients treated by mastectomy immediately following frozen section diagnosis have been compared with the changes in the nodes of 50 patients whose biopsy preceded mastectomy by between 2 and 5 days. The frequency of sinus histiocytosis was significantly greater in those patients who had been subjected to previous biopsy. This finding suggests that prior breast biopsy may negate the prognostic significance of sinus histiocytosis in breast cancer.

Axilla↗
PubMed1983

Mammary duct ectasia.

A total of 108 patients with mammary duct ectasia have been reviewed. Patients who presented with breast pain or a lump were significantly younger than those with nipple retraction. A histological review of the 88 patients who underwent biopsy showed severe periductal inflammation around non-dilated ducts occurred in younger patients and was associated with the symptom of breast pain or a lump, whereas older patients had duct dilatation as the most prominent feature, frequently associated with nipple retraction. These findings suggest periductal mastitis precedes duct dilatation and is the initial disorder in this condition. Data on parity and breast feeding for the 108 patients with duct ectasia were compared with age-matched groups of 505 patients with breast cancer, 199 with fibroadenoma, 240 with cysts and 912 'normals'. There were no differences in parity or breast-feeding history between the patients with duct ectasia and any other group, indicating that neither parity nor breast feeding is an important aetiological factor in this condition.

Adenofibroma↗
PubMed1983

The morphological basis of human breast cyst populations.

Forty human cysts have been examined to determine the relationship between the epithelial lining and the content of sodium (Na+) and potassium (K+) in the cyst fluid. The ratios of Na+ to K+ for cysts lined by flattened epithelium were higher in all cases than the values obtained for cysts lined by apocrine epithelium. These findings suggest a morphological basis for the two populations of human breast cyst fluids which can be defined on cationic content.

Breast Diseases↗
PubMed1983

Localization and excision of occult breast lesions.

Between 1976 and 1982, 190 non-palpable mammographic abnormalities considered to be suspicious of malignancy were excised using a needle localization technique. The indications for biopsy, technique for localization, method for confirmation of excision and histopathological preparation are presented. The histopathological diagnosis of these lesions were 150 benign and 40 malignant. There was no clear correlation between the mammographic appearances and the occurrence of cancer. Compared with 100 consecutive women with palpable breast cancer the impalpable and mammographically detected tumours were smaller, more often non-invasive and associated with negative axillary nodes.

Adult↗
PubMed1983

Effects of drugs associated with hyperprolactinemia on plasma steroids and on steroid receptors and metabolism in human breast cancer.

Certain commonly taken pharmaceutical preparations induce increased levels of plasma prolactin. The effects of these drugs on (a) tumor steroid receptors and metabolism, and (b) plasma hormones and hormone binding proteins have been studied in postmenopausal women with breast cancer. Two groups have been compared, 18 patients on drug treatment for at least 2 months and 15 subjects with no history of drug ingestion. Patients taking medication had significantly higher levels of plasma prolactin compared with control women. No significant difference was observed between the groups with regard to the plasma concentrations of dehydroepiandrosterone (DHA) and its sulphate (DHS), testosterone, estrone, estradiol-17 beta, sex hormone binding globulin (SHBG), and albumin. Similarly, no difference was observed between these two groups with regard to estrogen receptor (ER), progestogen receptor (PR), or androgen receptor (AR) levels in the tumors nor their ability to metabolize (7(-3)H) testosterone. It is considered that the ingestion of these drugs does not affect tumor mechanisms involving steroids.

Aged↗
PubMed1983

Hormone receptors and breast cancer--an occasional survey.

Hormone receptors are proteins, localised in the membrane, cytosol, mitochondrion or nucleus of target cells; binding of hormone to the receptor leads to alterations in intracellular activity or growth. The development of antagonists which competitively bind to receptor sites has been used clinically to block, for example, the action of androgen, histamine, adrenaline and oestrogen. In patients with breast cancer, measurements of hormone receptor activity are valuable (1) in predicting which patients with advanced disease will respond to endocrine therapy, (2) as an additional independent guide to the patients' prognosis. The anti-oestrogen, tamoxifen has few side-effects and is therefore particularly useful in the treatment of advanced disease. In addition, two trials, performed in the USA, suggest that this receptor-blocker may be valuable in the adjuvant treatment of early disease. In the UK, further trials are underway to confirm this and to assess the relationship of hormone receptor status in the primary tumour to benefit from treatment.

Breast Neoplasms↗
PubMed1983

Classification of human breast cysts according to electrolyte and androgen conjugate composition.

One hundred human breast cyst fluids have been analysed for sodium (Na+), potassium (K+) and dehydroepiandrosterone (DHA) sulphate. Concentrations varied greatly between individual cyst fluids, Na+ from 20 to 185 mmol/l, K+ from 5 to 160 mmol/l and DHA-sulphate from 1.5 to 87 mumol/l. Analysis of the inter-relationships between Na+, K+ and DHA sulphate revealed two major sub-populations of cyst fluids--one group in which Na+ levels were markedly in excess of K+ and DHA sulphate concentrations were low and the other in which K+ was the predominant cation and DHA sulphate concentrations were high.

Androgens↗
PubMed1982

Cellularity and the quantitation of estrogen receptors.

Fifty estrogen receptor (ER)-positive breast cancers have been studied to determine the best way of correcting for differences in cellularity when expressing ER concentration. ER concentration expressed on wet weight and tumour cytosol protein bases showed a positive correlation with tumour cellularity. In contrast, ER concentrations expressed on a DNA basis were not significantly related to cellularity. Although such a mode of correcting for differences in cellularity was imperfect, it did yield a receptor concentration which was less dependent upon tissue cellularity and which may reflect more accurately the inherent receptor status of the tumour cells.

Breast Neoplasms↗
PubMed1982

Simple mastectomy and axillary node sampling (pectoral node biopsy) in the management of primary breast cancer.

Axillary node sampling was introduced as a means of defining those patients whose primary breast cancer was treated by simple mastectomy in whom postoperative radiotherapy could be avoided safely. The authors have initiated controlled randomized trials in Cardiff and Edinburgh which have indicated that, provided that nodes are identified for histologic examination, simple mastectomy, node sampling, and selective radiotherapy give equal survival rates to routine radical treatment, whether this is by surgery or radiotherapy. Provided sampling of nodes is adequate and histologically proven, locoregional control also is satisfactory. A current randomized trial comparing this policy with Patey mastectomy has allowed comparative studies of axillary node status. These and follow-up data indicate that for a valid assessment, three to four nodes should be identified by the surgeon for histologic examination, the false negative rate being less than 10%.

Axilla↗