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Biomedical subjects

A Wallgren

Publications and source records attributed to A Wallgren.

At least 55 records · Page 3Linked to original sources
PubMed1987

Estrogen receptor levels and survival of breast cancer patients. A study on patients participating in randomized trials of adjuvant therapy.

A series of 1,022 patients taking part in clinical trials to compare postoperative radiation therapy with postoperative CMF chemotherapy, and postoperative tamoxifen with no adjuvant therapy, had their tumors analyzed for estrogen receptor content. Isoelectric focusing of the receptor in polyacrylamide gel was used for receptor assay and the results were related to tumor DNA content. The estrogen receptor content was significantly correlated to prolonged survival both for premenopausal and postmenopausal women. It was confirmed that postmenopausal women have increased median receptor values, and for this group values of more than approximately 0.3 fmol per microgram DNA were correlated to prolonged survival. For premenopausal women, a lower level of more than 0.1 fmol per microgram of DNA defined patients with prolonged survival. Lymph node involvement and receptor level were independent prognostic indicators. Patients randomized to tamoxifen or CMF tended to live longer as compared with control patients but this was not statistically significant. Moreover, there was no tendency for adjuvant tamoxifen to further increase the survival of patients with receptor-containing tumors as compared with control patients with similar receptor values.

Adult↗
PubMed1987

Overview of randomized trials of postoperative adjuvant radiotherapy in breast cancer.

An overview of the mortality results of the mature trials in which radiotherapy was a randomized option after simple or radical mastectomy is presented. The principal aim of the overview was to study long-term survival, and recent trials, often including chemotherapy options, have not been included. A total of 7941 patients were entered into these trials and 4148 deaths occurred. No differences were found in survival in the first 10 years of follow-up, in trials employing either radical mastectomy or simple mastectomy. Follow-up information after 10 years came mostly from trials employing radical mastectomy with or without irradiation, and in these trials a significant excess of deaths was observed among patients given radiotherapy (P less than 0.001, all trials; P = 0.002, radical mastectomy trials only). Further data collection will be necessary to determine which causes of death are elevated.

Breast Neoplasms↗
PubMed1987

Factors associated with prognosis in human breast cancer. VII. A comparison between a Cuban and a Swedish study.

Prognosis in human breast cancer is important since therapeutic plans can be adjusted to individual probability of relapse. Comparative studies are not very frequent in literature. Prognostic factors are not assessed in the same way in different countries, thus contradictory results can be obtained. This paper summarizes the studies performed in two different populations of Swedish and Cuban patients. A group of prognostic factors was compared: age, tumor size, lymph node status, hormone receptors and DNA distribution. Some differences were obtained in these parameters and in short-term relapses. Lymph node status was more important in Swedish series, whereas ER content and DNA pattern were of more predictive value in the Cuban series. Biological interpretations of the results is suggested.

Adult↗
PubMed1986

Prognostic relevance of postirradiation lymphocyte reactivity in breast cancer patients.

The prognostic relevance of phytohemagglutinin (PHA) and purified protein derivative (PPD) lymphocyte reactivity at diagnosis and after radiotherapy was evaluated in breast cancer patients. The patients were followed up to 13 years and the prognostic value expressed as ratios between observed number of deaths and "estimated" number of deaths under the null hypothesis. There was no significant association between the initial PHA and PPD reactivity and the survival of the patients. On the other hand, mortality up to 8 years after radiotherapy was significantly higher for patients with low PHA and PPD reactivity at completion of treatment. Furthermore, patients who had higher than average PPD reactivity 6 to 10 months after radiotherapy, seemed to have a higher survival rate. The prognostic relevance of postirradiation lymphocyte reactivity was only to some extent explained by clinical stage.

Breast Neoplasms↗
PubMed1986

Radiation therapy in operable breast cancer: results from the Stockholm trial on adjuvant radiotherapy.

In a randomized trial, 960 women with Stage 1-3 operable breast cancer were treated by a modified radical mastectomy alone, or by the same procedure, preceded or followed by radiotherapy (4500 rad to the breast/chest wall, and internal mammary, axillary and supraclavicular lymph nodes). Up to ten years after treatment, there is an increasing gap between the recurrence-free survival of the irradiated patients and the surgical controls. Between the two types of radiotherapy, there was no difference. There were significantly fewer distant metastases and a tendency for improved survival in node positive patients treated with postoperative radiotherapy, compared to the surgical controls, this difference was, however, statistically not significant.

Aged↗
PubMed1986

Proliferative index, cytosol estrogen receptor and axillary node status as prognostic predictors in human mammary carcinoma.

The predictive value of tumor cell estrogen receptor (ER) content, DNA ploidy, proliferative index (PI) and lymph node involvement was examined in 210 women operated on for primary breast cancer in 1979. At a minimum follow-up of 60 months the highest relapse free survival was observed in patients whose tumours had ER greater than 0.30 fmole/micrograms DNA (ER rich) and PI less than 5% (PI low). Subclassification of tumors in euploid and aneuploid groups gave no prognostic information. When examined by axillary node status (no nodal involvement - involved nodes) both ER and PI contributed prognostic information. Multivariate analysis using Cox proportional hazards model showed that nodal involvement was the strongest predictor of recurrence (p = 0.0007). However, ER and PI contributed significant independent prognostic information (p = 0.048 and p = 0.038), respectively.

Adult↗
PubMed1985

The effect of adjuvant radiotherapy on the time of occurrence and prognosis of local recurrence in primary operable breast cancer.

A retrospective study was conducted of all patients with an isolated locoregional recurrence of carcinoma of the breast after modified radical mastectomy was performed with or without adjuvant radiotherapy. The findings are summarized as follows: adjuvant radiation therapy delayed the appearance of local recurrence; there was no difference in the length of time to the diagnosis of distant dissemination between the irradiated and nonirradiated patients after the treatment of locoregional relapse. 35% of the irradiated patients and 25% of the nonirradiated patients remained clinically free of disease for relatively long periods after the treatment of locoregional relapse.

Breast Neoplasms↗
PubMed1985

Long-term survival of 458 young breast cancer patients.

The authors report the long-term survival of 458 young breast cancer patients with follow-up times ranging from 20 to 51 years. Patients with distant metastases at diagnosis were not included in the study. An excess breast cancer mortality was observed for at least 40 years after diagnosis. At 40 years, the actuarial breast cancer survival for all patients was 32% +/- 3% (standard error). For patients with localized and regional disease, it was 53% +/- 6% and 19% +/- 3%, respectively. A persistent excess mortality after 40 years, however, could not be ruled out because too few patients remained at risk. It is concluded that a cured fraction of patients defined as a group subject only to normal mortality risks, in practice, can only be identified in young patients with a low expected mortality, since older patients give only minor contributions to long-term survival results. In an unselected series of breast cancer patients, an excess breast cancer mortality will probably persist during a period that is longer than the life expectancy of the average patient. A parametric survival model, the log-normal model, was found to provide a good fit to the observed survival data. The cured fraction of patients predicted by the model was similar to the actuarial breast cancer survival at 40 years. These results suggest that the model could be used as a tool for analyzing observed survival patterns in breast cancer. It might thus provide an alternative to the conventional 5- to 10-year rates. The good fit of the model also suggests that late recurrences represent one end of a continuous, broad spectrum of behavior in disseminated breast cancer.

Actuarial Analysis↗
PubMed1985

Adjuvant tamoxifen treatment in postmenopausal patients with operable breast cancer.

Between November 1, 1976 and December 31, 1981, 826 post-menopausal females with operable breast cancer were included into a trial comparing tamoxifen 40 mg daily for 2 years with no endocrine treatment. Patients without axillary lymph node metastases and tumors less than 30 mm received no other treatment whilst those with more advanced disease were in addition superrandomised to receive postoperative irradiation or 12 courses of CMF. With a mean follow-up of 44 months tamoxifen significantly reduced the incidence of recurrence. There was no significant interaction between the effect of tamoxifen and any other treatment or prognostic subgroup.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Receptors for retinoic acid and retinol in human mammary carcinomas.

The cellular content of receptors for retinol (CRBP) and retinoic acid (CRABP) was measured in 148 human mammary carcinomas. High levels of CRABP were found in lobular carcinomas while those of the papillary subgroup had low levels of the receptor. Intermediate values for CRABP were observed for ductal, colloid and medullar carcinomas. The cellular levels of CRBP were high in ductal carcinomas and low in papillar carcinomas. A positive correlation was observed between the receptor for estradiol and CRABP. However, no significant correlation was found between the tumor cell DNA pattern and the content of CRABP and CRBP respectively. Recurrence of disease could be predicted by the nodal status and the level of estradiol receptor while the DNA pattern and the content of receptors for retinoic acid and retinol failed.

Adenocarcinoma, Mucinous↗
PubMed1985

Undernotification of diagnosed cancer cases to the Stockholm Cancer Registry.

A study of undernotification to the Stockholm Regional Cancer Registry comprised cancer diagnosed in 1978. Non-notified cases were identified by linking the cancer register with two independent sources of information viz. the Swedish cause-of-death register (fatal cases) and the regional in-patient care register (non-fatal cases). The estimated deficit in the cancer register for 1978 was 4% of the total cancer incidence for that year. The unreported non-fatal cases were followed up for five years, during which time more than half of the cancer diagnoses were entered on death certificates. If the cancer register had been supplemented with information from death certificates, therefore, only about 1% of all non-notified cases would have remained unregistered five years after diagnosis.

Death Certificates↗
PubMed1984

Is breast cancer a curable disease? A study of 14,731 women with breast cancer from the Cancer Registry of Norway.

The question whether breast cancer is curable remains controversial. Late recurrences and death from the disease are not infrequent. Long term follow-up of a large patient population is necessary to study this issue. The authors report a study of 14,731 cases of breast cancer reported to the Cancer Registry of Norway with follow-up times ranging from 5 to 18 years. A model in which the logarithms of the survival times were assumed to be normally distributed, the lognormal model, fitted the data well for individual stages, age groups, and periods of treatment. The cured fraction, i.e., consisting of those only subject to normal mortality risks, was estimated from the model to 35 +/- 1% standard error. In Stages 1, 2, 3, and 4 it was 54 +/- 3%, 27 +/- 1%, 19 +/- 2%, and 2 +/- 1%, respectively. It is concluded, however, that the estimated cure rate in Stages 3 and 4 should be regarded with caution in view of the methodological problems involved in the analysis and the small number of patients with long follow-up. The estimated cured fraction in both the individual stages and in the entire material was significantly higher in patients younger than 55 years of age than in older patients. The median survival of non-cured patients was estimated to be 3.6 years for the entire material. In Stage 1, 2, 3, and 4 it was 7.6 years, 3.4 years, 2.1 years, and 0.7 years, respectively. The lognormal model seems to be a good approximation of breast cancer survival. The model is consistent both with late excess mortality and with the presence of a cured fraction. It is noteworthy that an excess mortality was observed during the whole follow-up period. Extrapolations from the model should therefore be cautiously judged until supported by observed data.

Aged↗
PubMed1984

Breast-conserving treatment for breast cancer in Stockholm, Sweden, 1977 to 1981.

Since 1977 patients living in Stockholm with Stage I breast cancer fulfilling specific criteria are offered breast-conserving treatment. The treatment includes a partial mastectomy and a low-axillary dissection followed by radiotherapy, 5000 rad, to the remaining breast. Between 1977 and 1981, 262 patients underwent the breast conserving therapy. One hundred eighty-six patients had pathologic Stage I tumors. Radiotherapy was given to 158 of those patients. During the follow-up time (6 months to 5 years), 4 of 186 patients had recurrence to the breast. Two of those had not received radiotherapy. Recurrent tumor in regional lymph nodes occurred in 4/186, and distant metastases in 10/186 patients. Six patients have died of their disease. The cosmetic results were favorable overall, but often impaired when surgical complications occurred. A comparison between these results and those obtained in similar patients treated with modified radical mastectomy with a low-axillar dissection followed by radiotherapy to the remaining breast seems to be an alternative treatment to modified radical mastectomy. Longer follow-up time is needed before final conclusions can be drawn.

Adult↗