Biomedical subjects

D B Fischer

Publications and source records attributed to D B Fischer.

32 records · Page 2Linked to original sources

PubMed1983

Oral contraceptive use and fibrocystic breast disease with special reference to its histopathology.

The relationship between use of oral contraceptives and fibrocystic breast disease was examined in a hospital-based case-control study undertaken in New Haven, Connecticut, from 1977 to 1979. Particular emphasis was placed on the extent of epithelial atypia and other histopathologic characteristics found in the biopsy specimens from the cases. Women who had ever used oral contraceptives were at a somewhat decreased risk for fibrocystic disease as a whole. Cases with high atypia and controls had similar patterns of oral contraceptive use, whereas cases with low and intermediate atypia had less oral contraceptive use than controls. Cases with intermediate atypia reported the lowest oral contraceptive use. Subjects with biopsy specimens exhibiting gross cysts, microscopic cysts, or papillomatosis were about 50% less likely to have used oral contraceptives than controls.

Adult↗

PubMed1982

Effect of age at first childbirth on risk of developing specific histologic subtype of breast cancer.

Epidemiologic variables related to breast cancer risk were assessed in a case-control study of 332 women with breast carcinoma and 1353 comparison women. Risk factors for breast cancer as a whole included nulliparity, late age at first childbirth, early age at menarche, late age at menopause, personal history of benign breast disease, family history of breast cancer, and among postmenopausal women, body weight. These risk factors were then analyzed with respect to histologic subtype of breast cancer involved, i.e., duct-derived or lobular tumors, to determine whether the association between any of the risk factors and breast cancer varied according to histopathologic subtype. Histologic subtype for the 316 cases reviewed included 284 duct cancers and 32 lobular carcinomas. Although slight differences were noted among some of the risk factors and the variety of cancer, none of the differences was marked except for the variable age at birth birth. For ductal carcinoma, the risk was highest among nulliparous women and decreased the younger a woman was at the time she gave birth to her first child. The risk of infiltrating lobular carcinoma, however, was lowest among nulliparous females or those who had given birth at a young age and increased the older a woman was when she gave birth to her first child.

Age Factors↗

PubMed1982

A case-control study of cancer of the endometrium.

A hospital-based case-control study of the epidemiology of endometrial cancer in women aged 45-74 years was carried out in Connecticut from 1977 to 1979. In total, 167 cases and 903 controls were included. Elevated risks were associated with the following factors: overweight, nulliparity, few pregnancies, use of estrogen replacement therapy, older age at menopause, and a history of ovarian or endometrial cancer in mother or a sister. Whites were more frequently affected than blacks, and better-educated women more often than less-educated women. Use of oral contraceptives was associated with a decreased risk, although the decrease did not reach statistical significance.

Age Factors↗

PubMed1981

An epidemiologic study of epithelial carcinoma of the ovary.

A case-control study to identify risk factors for epithelial ovarian cancer was undertaken among women in the age group 45-74 years who had been admitted to seven hospitals in Connecticut between July, 1977, and March, 1979. Characteristics that were found to increase the risk of epithelial ovarian cancer included being white, never having been pregnant, having a late age at menopause, having a family history of cancer of the ovary or endometrium, and having a long estimated number of years of ovulation. Prior use of post-menopausal estrogens did not alter the risk for epithelial ovarian cancer, but there was some indication that oral contraceptives protect against ovarian cancer. Women with ovarian cancer were somewhat more likely to have had a history of an underactive thyroid and were somewhat less likely to have had a history of an overactive thyroid than controls, although these trends were not statistically significant.

Aged↗

PubMed1981

Exogenous estrogens and other factors in the epidemiology of breast cancer.

In a hospital-based case-control study of the epidemiology of breast cancer undertaken in Connecticut from 1977 to 1979, there was no evidence of an increase in risk for breast cancer among women who had used oral contraceptives or estrogen-replacement therapy. In fact, there was some suggestion of a decrease in risk for breast cancer with increasing length of use of oral contraceptives. Higher than average risks were found among women who had never give birth to a child, women with a late age at menopause, women, with an early age at menarche, women who had given birth to their first child at a relatively late age, women with previous benign breast disease, and women with a history of breast cancer in a sister or mother. Heavy women were at high risk for premenopausal breast cancer. The association between heaviness and postmenopausal breast cancer was strongest among women who had had their last menstrual period more than 5 years before the diagnosis of breast cancer.

Age Factors↗

PubMed1980

Curative potential of combined modality therapy for advanced Hodgkin's disease.

During the period from 1969 through 1977, 124 patients with advanced Hodgkin's disease underwent treatment with combination chemotherapy and radiotherapy. Sixty-three cases were previously untreated, and 61 were relapses following radical radiotherapy for localized Hodgkin's disease. No patient in this series had received prior chemotherapy. Of 102 patients (84%) who have entered complete remission, 92 remain in complete remission with a median follow up time of five years, 10 patients having relapsed, and acute leukemia having developed in 2. The cumulative survival rate for all 124 patients is 80% at five years; the relapse-free survival rate is 74%. In many, if not most cases, the Hodgkin's disease appears to be cured. We have also identified two subgroups of patients for whom the prognosis is worse than for patients with advanced-stage disease as a whole. Patients over the age of 40 years have a five-year survival rate of only 45%, compared with 89% for all other patients. Those Stage IV patients with multiple extranodal sites of involvement have a five-year survival rate of 48%, compared with 81% for other Stage IV patients with only a single extranodal site involved.

Adult↗

PubMed1979

Results of radiotherapy in control of stage I and II non-Hodgkin's lymphoma.

We retrospectively analyzed 114 patients with non-Hodgkin's lymphoma, clinical stages I and II, classified by the criteria of Rappaport and treated by radiotherapy alone. Of 84 patients classifiable, one-third were nodular and two-thirds diffuse lymphomas. Berkson-Gage actuarial and relapse-free survivals were determined for these two groups and for subgroups stratified by histology, stage, and by presence or absence of extranodal disease. Five year relapse-free and overall survivals were 83% and 100%, respectively, for the nodular group and 37% and 59% for the diffuse group. Extranodal involvement was less frequent in the nodular (19%) than in the diffuse (52%) group, where it was associated with Stage IE disease and increased relapse-free and actuarial survival. Histopathological subtype in the diffuse group (histiocytic versus combined lymphocytic poorly differentiated and mixed lymphocytic-histiocytic) did not influence survival. Extranodal involvement and stage I disease were associated with better survival in the diffuse histiocytic group. Successful radiotherapy for all stages of disease, all histologies, was not correlated with extended versus involved fields, and 89% of the relapses in the entire series were by wide dissemination.

Biopsy↗

PubMed1977

Intracranial calcifications in childhood leukemia. An association with systemic chemotherapy.

Children with acute lymphocytic leukemia were examined for evidence of intracranial calcifications with roentgenograms of the skull and computerized tomography. Of 39 children in their initial complete remission, ten were found to have subcortical cerebral calcifications. Significant associations were found between the presence of cerebral calcifications and systemic treatment with large cumulative doses of methotrexate.

Adolescent↗

PubMed1976

Long term remissions with combined modality therapy for advanced Hodgkin's disease.

A new treatment program for advanced Hodgkin's disease employing five-drug combination chemotherapy and low dose radiation to the sites of bulk disease (nodal or parenchymal) was designed in 1969. Eighty patients have now been treated, 60 of whom have achieved a complete remission. More significantly, only 5 of the 60 completed responders have relapsed with follow-up from 1-6 years. The cumulative survival at 5 years of patients entering complete remission is 92%. For those patients not sustaining a complete remission, it is 19% at 2 years. This program has resulted in substantially lower relapse rates than previously reported by other investigators, probably because of the administration of radiotherapy in the manner described. Hopefully, a significant number of these patients may be cured of their disease.

Adult↗

PubMed1971