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Biomedical subjects

C S Dowle

Publications and source records attributed to C S Dowle.

25 records · Page 2Linked to original sources

Tumour aneuploidy, prognostic parameters and survival in primary breast cancer.

Cellular DNA content of primary tumours from 280 patients with operable breast cancer was determined by flow cytometry using nuclei from paraffin sections stained with DAPI, and 199 of these patients were followed for 8-13 years after surgery. Tumours from 67 patients have also been analyzed for their DNA content using single cell suspensions from fresh tumour tissue stained with mithramycin and ethidium bromide, and the results compared with those obtained from paraffin blocks of the same tumours. Overall 60% of the tumours contained cells with abnormal DNA content (DNA-aneuploid populations). Survival and disease free interval were not significantly different in patients with DNA-diploid and DNA-aneuploid tumours when analysed by Mantel's life table method. There was however, an early advantage for patients with DNA-diploid tumours: during the first 30 months after surgery DNA-aneuploidy was associated with higher rate of recurrence and shorter survival. DNA-aneuploidy was strongly related to histological grade. Thus 11/49 (22%) grade I, 60/102 (59%) grade II, and 96/129 (74%) grade III tumours were DNA-aneuploid. Although there was no significant difference in survival of patients with DNA-diploid and DNA-aneuploid tumours overall, there appears to be an unexpected association between DNA-aneuploidy and better survival in grade II patients (P less than 0.01); a similar trend was observed for grade I patients. Although the proportion of DNA-aneuploid tumours was similar in oestrogen receptor positive and negative tumours, DNA-aneuploidy was associated with lower levels of oestrogen receptors in comparison to DNA-diploid tumours. Comparison between the modal DNA values of fresh and paraffin embedded samples showed high rate of comparability (64/67, P less than 0.0001).

Aneuploidy↗

The breast pain clinic: a rational approach to classification and treatment of breast pain.

Three hundred and fifty women complaining of breast pain symptoms of sufficient severity to interfere with their normal lifestyle were reviewed in a special breast pain clinic over a 5 year period. Seventy-two patients (21%) had spontaneous resolution of breast pain and they required reassurance only before discharge. Of the remaining 278 patients, accurate classification of breast pain syndromes was achieved in 89%, the commonest syndrome being cyclical breast pain which accounted for 54% of the women followed up. The remaining womens' breast pain was classified as trigger zone (14%), continuous (8%), Tietze's disease (5%), spinal root (4%), duct ectasia (4%) and psychological depression (2%). In the remaining 25 patients (9%) the breast pain could not be classified. The experience from this clinic is that a majority of women complaining of severe breast pain symptoms can be accurately classified and appropriate therapy instituted.

Breast↗

The EEA stapler in colorectal surgery: a Wellington experience.

The EEA stapler has been used at Wellington Hospital in 83 patients. The use of the instrument in 72 patients with colorectal disease is described. Fifty-one patients had malignant disease. Prior bowel preparation and perioperative antibiotics were used routinely. A 'low' anastomosis was performed in 26 patients. Complications relating to the integrity of the anastomosis occurred most frequently in low rectal cases and did not appear to be influenced by the presence or absence of a diverting colostomy. Tumour clearance was compromised (less than two centimetres) in 10 out of 23 patients with 'low' tumours. Two staple line recurrences occurred in this group.

Colon↗

Fine needle aspiration cytology of tubular carcinoma of the breast.

OBJECTIVE: To analyze six cases of tubular carcinoma involving the breast in which the diagnosis was made by fine needle aspiration cytology (FNAC). STUDY DESIGN: All patients were females between the ages of 28 and 67 years. The aspiration findings were confirmed by subsequent cell blocks of the aspirates and tissue examination of the breast mass. The aspirate was obtained using multiple passes in the breast masses while maintaining negative pressure. RESULTS: The cytohistologic features in all cases were characterized by a bland and orderly appearance of cells, few cell atypias, variable numbers of myoepithelial cells, tubular structures and somewhat angular epithelial clusters. The value of immunocytochemical study in the diagnosis was uncertain. CONCLUSION: The uncommon occurrence of tubular carcinoma of the breast, the bland and orderly appearances of cells in FNAC samples (as in tissue) and the difficulties in the cytodiagnosis can be found in other breast conditions. A cautious attitude toward the diagnosis of tubular carcinoma from FNAC samples is necessary, and cell atypias, when seen, should be reported with a recommendation for removal of the breast lump for detailed tissue examination.

Adenocarcinoma↗

Value of fine needle aspiration cytology of the breast, with an emphasis on the cytodiagnosis of colloid carcinoma.

The fine needle aspiration (FNA) cytologic evaluation of 6,941 lesions of the breast was reviewed, with an emphasis on the cytodiagnosis of colloid carcinoma. The most common benign breast diseases in this series were fibroadenomas, cysts and fibrocystic conditions. All cases with an FNA diagnosis of suspicious were biopsied; a number of these were found to be carcinoma of the breast. In cases with an FNA diagnosis of carcinoma of the breast, a plan of management was immediately adopted on the basis of that diagnosis. Thirteen cases of colloid (mucinous) carcinoma of the breast were diagnosed by FNA cytology; in all, the cytodiagnosis was confirmed by the subsequent histologic diagnosis. The distinctive cytologic criteria that may be useful for making an FNA diagnosis of colloid carcinoma of the breast are discussed, and the FNA differences between the pure and mixed types of colloid carcinoma are noted.

Adenocarcinoma, Mucinous↗

The value of needle aspiration cytology of the breast, with an emphasis on the diagnosis of breast disease in young women below the age of 30.

Our experience with 4,739 needle aspirations of the breast was reviewed, with an emphasis on the diagnosis of carcinoma in young women under the age of 30 years. Among benign diseases, fibroadenomas were most frequently seen in younger women (24.3% of 919 cases) while cysts were most frequently seen in women 30 years of age and older (20.0%). Fibrocystic conditions were identified in approximately 30% of the women in each group. All younger women with suspicious diagnoses had fibrocystic disease at biopsy; in older women, 75% of the suspicious cases proved to be carcinomas while 25% proved to be fibrocystic diseases. Carcinomas were diagnosed cytologically in 1.3% of younger women and in 9.7% of older women. In young women, in whom breast carcinoma is a rare disorder, it is important that carcinoma be diagnosed without delay so that an appropriate plan of management can be adopted. These findings suggest that needle aspiration cytology can accurately make that diagnosis.

Adolescent↗