Biomedical subjects

G Sakamoto

Publications and source records attributed to G Sakamoto.

At least 73 records · Page 4Linked to original sources

PubMed1995

[Histopathological diagnosis of papillary lesion of the breast].

We call intraductal lesions of the breast, for example, intraductal papilloma, duct papillomatosis and noninvasive ductal carcinoma, "papillary lesions". Borderline lesions, if such exist in the breast, are included among papillary lesions. So accuracy of histopathological diagnosis is very important for research of precancerous lesion. To clarify the present conditions and problems of histopathological diagnosis of papillary lesion of the breast, fifty consecutive papillary lesions out of consultation cases were diagnosed using three categories, benign, borderline and malignant, by five pathologists. The rate of agreement of all diagnoses by five pathologists was only 20%. The borderline incidence was widely distributed from 0% to 46%. These results revealed that histopathological differential diagnosis between benign and malignant of papillary lesion was very difficult. This difficulty seems to be caused by various histological features and different criteria of histological atypia from other organs of papillary lesion of the breast.

Breast Neoplasms↗

PubMed1994

Genetic studies of 457 breast cancers. Clinicopathologic parameters compared with genetic alterations.

BACKGROUND: Human breast cancers frequently show loss of heterozygosity (LOH) and/or amplification at specific chromosomal regions. METHODS: To investigate the roles of these genetic alterations during tumor development and/or progression, 457 cases of primary breast cancer were examined for LOH at chromosomal regions 16q24, 17p13.3, and 17q21, and for amplification of the erb-B2 locus at 17q11.2 and the c-myc locus at 8q24. The genetic changes then were compared with lymph node metastasis, histologic type, and tumor stage. RESULTS: The LOH at 17q21 was observed more frequently in tumors of the solid, tubular type (41 of 75 [55%]) than in other types (48 of 187 [26%]) (P < 0.0001). The LOH at 17p13.3 was more frequent in scirrhous and solid, tubular tumors (77 of 141 [55%] and 48 of 88 [55%]) than in other types (29 of 89 [33%]) (P = 0.0004). Generally, mutations were seen more often in tumors with axillary lymph node metastases, undifferentiated tumors, and large or invasive tumors than in tumors considered less aggressive histopathologically. However, 22 tumors bearing three or more genetic alterations were found among 187 tumors histologically diagnosed as free of axillary lymph node metastasis; similarly, 12 of 122 t1 classification tumors and 4 of 89 histologically well differentiated tumors each contained three or more genetic alterations. Although these tumors would be regarded as having a relatively good prognosis on the basis of conventional clinicopathologic diagnosis, the authors suspect that, in fact, they do not. CONCLUSIONS: Patients whose tumors contain multiple genetic alterations should be treated as a new high risk group with respect to operative and/or postoperative management.

Blotting, Southern↗

PubMed1994

[Our experience with breast conservation].

In the Cancer Institute Hospital, two kinds of breast conservation have been adopted. Q + Ax is applied for cancers at the upper--outer quadrant and LUART is applied for those at other quadrants. The method, clinical matters, pathological findings and results are discussed together with the LUART of the national BCT group study funded by the Japanese Ministry of Welfare.

Adult↗

PubMed1993

Time dependency of the influence of prognostic factors on relapse in breast cancer.

BACKGROUND: A number of factors concerning the prognosis of cancer patients have been reported, but the evaluation of individual factors is not always consistent. The author considered that the discrepancies may lie in part in that factors may have a changing influence on relapse with time. The present study was intended to reveal the phenomenon and its clinical significance in patients with breast cancer. METHODS: Eleven pathological prognostic factors in 462 patients with primary breast cancer were analysed with special reference to the influence on relapse and its changes with time. The Cox regression analysis was performed for whole and three stratified non-overlapping observation period (within 2, 2-5 and 5 years more), using factors including extent of nodal involvement (N), nuclear grade (NG), tumor infiltrating lymphocytes (TIL), tumor size, fat infiltration (F) and others. RESULTS: Cox regression analysis for whole observation period showed N followed by NG, TIL, F and others as the most important factors on relapse. But the analysis performed for 3 stratified intervals revealed that the influence on relapse decreased with time for N and NG, but tended to increase with time for F. The suppressive effect of TIL on relapse was not evident up to 2 years but was significantly emphasized after 2 years postoperatively. CONCLUSIONS: In conclusion, a distinct time-dependency with varied patterns was found in the influence of some prognostic factors on relapse, which implies the assessment of prognostic factors may vary according to the length of the observation period.

Adipose Tissue↗

PubMed1993

Proliferative and nonproliferative breast disease in atomic bomb survivors. Results of a histopathologic review of autopsy breast tissue.

BACKGROUND: The risk of female breast cancer in association with radiation dose is well established, on the basis of follow-up studies of the atomic bomb survivors and other exposed populations. This association is especially strong for women exposed before 20 years of age and appears to be much weaker among women exposed after 40 years of age. METHODS: Breast tissue samples from 88 high-dose and 225 low-dose autopsy cases from the Radiation Effects Research Foundation Life Span Study sample were examined in detail to determine whether nonproliferative and proliferative breast lesions are associated with radiation dose. RESULTS: Prevalence of proliferative disease in general and atypical hyperplasia in particular were positively associated with radiation dose. The associations were strongest for subjects who were between 40 and 49 years of age at the time of the bombing. CONCLUSIONS: It is hypothesized that the strongest association in women 40 to 49 years of age may be related to the age dependence of radiation-induced breast cancer, in that potential cancers induced in this age group by radiation exposure may receive too little hormonal promotion to progress to frank cancers.

Adolescent↗

PubMed1992

Correlation of loss of alleles on the short arms of chromosomes 11 and 17 with metastasis of primary breast cancer to lymph nodes.

To examine the role of loss of heterozygosity (LOH) during tumor development and/or progression, we looked for correlations between metastasis of breast cancer to a regional lymph node(s) and LOH of chromosomal arms 11p, 13q, 16q, 17p, and 17q, where frequent losses in primary tumors have been detected. No correlation between lymph node metastasis and LOH of chromosomes 13q, 16q, or 17q was observed. However, tumors showing LOH of chromosomes 11p (chi 2 = 10.82, P less than 0.01) and 17p (chi 2 = 6.78, P less than 0.01) revealed a significantly higher incidence of metastasis to a regional lymph node(s) than tumors without LOH on these chromosomal arms. Furthermore, only four of 30 (13%) patients with tumors that retained both 11p and 17p had metastasis to a regional lymph node(s), compared with 24 of 32 (75%) patients with tumors that had lost both 11p and 17p. Analysis of LOH with markers on chromosomes 11p and 17p in a large number of tumors indicated that the peritelomeric region of each of these chromosomal arms contains a tumor suppressor gene that may be associated with tumor progression, particularly metastasis to a regional lymph node(s).

Alleles↗

PubMed1992

Clinicopathologic characteristics and prognosis of breast cancer patients associated with pregnancy and lactation: analysis of case-control study in Japan.

Clinicopathologic characteristics and prognosis of breast cancer patients associated with pregnancy and lactation were clarified by means of a case-control study of matched non-pregnant and non-lactating patients with breast cancer. From 18 institutions in Japan, a total of 192 subjects with breast cancer diagnosed during pregnancy (72 cases) and lactation (120 cases) were collected between 1970 and 1988, accounting for 0.76% of all breast cancer patients. The duration of symptoms was longer and tumor size was larger in the study subjects. Although the disease-free interval was longer than that in the control patients, the survival time was shorter. There was no characteristic difference in histologic type. Vascular invasion and lymph node metastasis were found more frequently in the subjects. The positive rates of estrogen receptor and progesterone receptor were lower in the subjects. The 5- and 10-year survival rates of the study patients were 65% and 55%, respectively, and these survivals were significantly lower than those of the control (P < 0.001). The survival rates were poorer in the subjects, in accordance with stage and lymph node metastasis. The results suggest that most of the patients with breast cancer diagnosed during pregnancy and lactation are in a more advanced stage because of a delay in detection and diagnosis, and hence have unfavorable prognosis. Therefore, it is important to diagnose and treat early for improvement of prognosis in patients with breast cancer during pregnancy and lactation.

Adult↗

PubMed1992

Invasive ductal carcinoma of the breast with a predominant intraductal component: cooperative clinicopathologic study in seven Japanese centers.

A nationwide multicenter joint study was undertaken to investigate the clinicopathologic characteristics of invasive ductal carcinoma of the breast with a predominant intraductal component, a diagnostic entity proposed in the histologic typing of breast tumors by the World Health Organization in 1981. A total of 368 tumors, of which 218 were studied pathologically between 1983 and 1987 and 150 between 1971 and 1977, were accumulated for the present study from seven medical institutes in Japan. The incidence of such types of tumor was higher in the latter period than in the former, as was that of pure intraductal carcinomas. Seventy of the 368 tumors displayed metastatic nodal involvement and nine tumor deaths were observed from 150 tumors followed up for over 10 years following radical mastectomy, the overall quantity of the extraductal stromal invasion clearly acting on lymph node metastases and patients' outcome. We consider a total stromal invasion of greater than 5 mm to be critical in the prognosis of patients with tumor of this type.

Breast↗

PubMed1992

[The spread of breast cancer and indications of breast preserving operation].

Pathological investigations for intramammary spread of breast cancer of 205 partially resected specimens were performed by making continuous section every 5 mm width of the whole specimen. The materials were 167 quadrantectomized and 38 lumpectomized specimens. The results showed that the margin of 15.6% of quadrantectomized and 28.9% of lumpectomized specimens were positive for cancer, main causes of which were intraductal spread of cancer occupying 65% of positive margin in quadrantectomy and 91% in lumpectomy, multiple cancer, interstitial spread of cancer and so on. Multiple cancers were found in eleven (6.6%) quadrantectomized and in one (2.6%) lumpectomized specimens. Second cancers were 11 noninvasive ductal and 3 invasive cancers, including two triple cancers. Fifteen cases of quadrantectomy and 4 of lumpectomy were changed to be mastectomized because of positive margin or nodal involvements. Radiotherapy was performed for 33 cases. The median 31 months follow-up results of 186 partially mastectomized breast in 184 patients were as follows; one local recurrence in lumpectomy, two new cancers in residual breast, two distant metastases and one death for other cause of death. Quadrantectomy plus axillary dissection without radiotherapy assured of pathological complete resection was safe enough at the present.

Breast Neoplasms↗

PubMed1991

Accumulation of genetic alterations and progression of primary breast cancer.

In order to detect common regions of deletion, 219 breast tumors were examined for loss of heterozygosity at several loci on chromosomes 3p, 16q, and 17 by restriction fragment length polymorphism analysis. Allelic deletions of loci on chromosomes 3p, 13q, 16q, and 17, and amplification of the erbB2 oncogene, were analyzed and compared with histopathological and clinical features. Common regions of deletion were detected within chromosomal bands 3p13-14.3, 16q22-23, 17p13 (two separated loci), and 17q21. Concordant losses of alleles on chromosomes 3p, 13q, 16q, 17p, and 17q were observed. A significant association was detected between loss of heterozygosity on chromosomes 17p and 17q and amplification of the erbB2 oncogene (17p, P = 0.000721, by Fisher's exact test; 17q, P less than 0.001, chi 2 = 12.135). Furthermore, tumors showing highly malignant phenotypes had accumulated more genetic changes at the loci studied than those having less malignant phenotypes on the basis of histopathological classification, lymph node metastasis, and tumor size. These results suggested that accumulation of genetic alterations, including loss of function of tumor suppressor genes on chromosomes 3p, 13q, 16q, and 17, and amplification of the erbB2 oncogene, may contribute to tumor development and/or progression in primary breast cancer.

Alleles↗

PubMed1991

Duct endoscopy and endoscopic biopsy in the evaluation of nipple discharge.

Microdochectomy is usually performed on patients with nipple discharge caused by intraductal proliferative lesions, such as intraductal papilloma and carcinoma. But this operation often sacrifices large amounts of normal mammary gland even when the lesion is a benign intraductal papilloma a few millimeters in diameter. We have developed duct endoscopy for the mammary duct system, and have reliably performed biopsies for intraductal proliferative lesions intraductally. From June 1989 to April 1990, we examined 22 cases by duct endoscopy, and performed endoscopic biopsy in 16 cases. The method of endoscopic biopsy is as follows. First, a bougie is inserted, without anesthesia other than Xylocaine jelly, into the orifice of the duct to enlarge it. Second, the outer cylinder and the inner needle are inserted; then the inner needle is removed, and the endoscope is inserted. After examination, the outer cylinder is moved up to the lesion to be biopsied and the endoscope is taken out. Then a sample is taken into the outer cylinder by aspiration. We diagnosed 10 cases of benign lesion and 5 cases of malignant lesion by cytological and/or histological examination. In conclusion, endoscopic biopsy, aided by duct endoscopy, is a useful and harmless diagnostic procedure in the evaluation of nipple discharge.

Biopsy↗

PubMed1991

Pathology of breast cancer: present and prospect in Japan.

Breast cancer among Japanese females is characterized by its relatively low incidence and better prognosis than among Caucasian females. The annual mortality due to breast cancer among Japanese is about one-fifth that among Caucasians. Comparison of case distribution by histological type indicates that the ratio of well-differentiated carcinoma is slightly higher among Japanese, while the ratio of poorly differentiated carcinoma is slightly higher among Caucasian females. It is noteworthy that the incidence of in situ and invasive lobular carcinoma among Japanese is much lower than among Caucasian females. The age distribution shows that breast cancer is more frequent among middle-aged females in Japan, but more common among aged females in the West. Breast cancer among Japanese females shows a better prognosis than among Caucasian females as a whole, even with equal tumor size and lymph node metastasis. As mentioned above, the morbidity and mortality rates of breast cancer among Japanese females are very low, but recently, both morbidity and mortality rates in Japan have been steeply increasing. For example, the mortality rate of breast cancer in Japan almost doubled during the past 20 years. Moreover, biological behavior of breast cancer among Japanese females has been recently changing. Time-trend data clearly indicate that breast cancer in Japan in the future will be much more like that in the West, and nowadays it is already westernizing.

Adult↗

PubMed1991

The morphologic feature of mucus leakage appearing in low papillary carcinoma of the breast.

This report summarizes the clinicopathologic findings in 11 cases of low papillary carcinoma of the breast accompanied by the morphologic feature of mucus leakage into the mammary stroma. These cases were characterized by two morphologic findings. First, abundant mucus produced by the tumor cells filled the intraductal spaces where neoplastic epithelium formed very low papillary projections, ie, a feature of mucinous-producing low papillary carcinoma in situ. Second, there was expansive leakage of mucus into the mammary stroma occasionally accompanied by a few epithelial cells. All the cases showed a high level of mucus production and contained no elements of invasive ductal carcinoma or ordinary invasive mucinous carcinoma. These cases have no evidence of direct invasion of the mammary stroma by malignant cells. The average age of the 11 patients was 41 years. Foci of microcalcification were seen in some tumors (seven cases; 64%). There were no cases with lymph node metastases. All the patients underwent mastectomy with no adjuvant therapy, and they are currently alive and well.

Adenocarcinoma, Mucinous↗

PubMed1990

Allelotype of breast cancer: cumulative allele losses promote tumor progression in primary breast cancer.

Allele loss on a specific chromosome has implied the existence of a tumor suppressor gene such as the p53 gene and the RB gene. In order to determine which chromosome(s) carries a tumor suppressor gene(s) that contributes to tumor progression in primary breast cancer, we analyzed the loss of heterozygosity for each autosomal chromosome arm by using 39 restriction fragment length polymorphism markers including 25 variable numbers of tandem repeat probes. In 79 primary breast cancers, we found the frequent loss on the long arm of chromosome 13 (21%), the long arm of chromosome 16 (45%), and the short arm of chromosome 17 (56%). Interestingly, breast cancers in which loss of both chromosomes 13q and 17p was detected showed more malignant histopathological features, and a group of the tumors in which chromosome 16q loss was detected presented with frequent lymph node metastasis. Furthermore, the result of the deletion mapping on chromosome 17p implied the existence of a tumor suppressor gene distal to the p53 gene as well as the p53 gene itself for primary breast cancer. These results suggest that at least 4 tumor suppressor genes exist on chromosomes 13q, 16q, and 17p for primary breast cancer.

Blotting, Southern↗

PubMed1990

In vitro and in vivo release of soluble erbB-2 protein from human carcinoma cells.

An enzyme-linked immunosorbent assay (ELISA) was developed to measure soluble erbB-2 protein in culture supernatants of various human cell lines and sera of patients suffering from recurrent breast carcinoma. Soluble erbB-2 protein was demonstrated in culture supernatants of cell lines that expressed high levels of erbB-2 protein as shown by western blot analysis of cell lysates. Increased levels of the protein, 40- to 190-fold higher than in healthy controls, were demonstrated in sera of 3 out of 12 patients with breast carcinomas. On immunohistological study of tumor tissues from 9 patients, high immune reaction with the anti-erbB-2 protein antibody was observed in 2 cases. These were two of the three patients who had elevated levels of erbB-2 protein in serum (a sample was not available from the third patient). These results raise the possibility that soluble erbB-2 protein level in serum can be used as an indicator for spread of carcinomas that overexpress erbB-2 protein.

Adenocarcinoma↗

PubMed1990

[Natural history of breast cancer among Japanese and Caucasian females].

Breast cancer among Japanese females is characterized by its relatively low incidence and better prognosis than among Caucasian females. The annual mortality due to breast cancer among Japanese is about one-fifth that among Caucasians. Comparison of case distribution by histological type indicates that the ratio of well-differentiated carcinoma is slightly higher among Japanese, while the ratio of poorly differentiated carcinoma is slightly higher among Caucasian females. It is noteworthy that the incidence of in situ and invasive lobular carcinoma among Japanese is much lower than among Caucasian females. The age distribution shows that breast cancer is more frequent among middle-aged females in Japan, but more common among aged females in the West. Breast cancer among Japanese females shows a better prognosis than among Caucasian females as a whole, and even with equal tumor size and lymph node metastasis. It seems that postmenopausal breast cancer among Caucasian has a worse prognosis than the premenopausal one, although no remarkable difference in prognosis is found between premenopausal and postmenopausal patients in Japan. This suggests that the menopausal status is a critical factor for prognosis among Caucasians, but not among Japanese. As mentioned above, the morbidity and mortality rates of breast cancer among Japanese females are very low, but recently, both morbidity and mortality rates in Japan have been steeply increasing. For example, the mortality rate of breast cancer in Japan almost doubled during the past 20 years. Moreover, biological behavior of breast cancer among Japanese females has been recently changing. And time-trend data clearly indicate that breast cancer in Japan in future will be much more like that in the west, and nowadays it is westernized.

Adult↗

PubMed1990

[Analysis of prognostic factors of node negative breast cancer].

Prognostic factors of 229 patients with node negative breast cancer were analysed using Cox's proportional hazard regression model. From 11 pathological factors, four factors nuclear grade, pectoral invasion, fat infiltration and tumor size were selected under condition of p less than 0.05. When the three factors (moderate or poorly differentiated nuclear grade, marked fatty infiltration and tumor size 2 cm) were provided as poor prognostic factors, node negative breast cancer was successfully classified from the number of the poor prognostic factors: namely, the recurrence rate of subgroups with the number of 0,1,2,3 was 2%, 7%, 21%, 39%, respectively.

Breast Neoplasms↗

PubMed1990

[Study of breast cancers during pregnancy and lactation].

From breast cancer cases that were mastectomized between 1970 and 1987 at the Cancer Institute Hospital, 43 breast cancers during phases of pregnancy and lactation (pregnancy 11 cases, lactation 32 cases) have been analyzed. Taking the patient's age and the calendar-year at the time of diagnosis into account, we collected 43 cases as controls and compared the result. It was found that breast cancers during pregnancy and lactation metastasized to the lymph nodes at the same frequency as in the control cases, in lymph node-positive cases and in tumors of the same size the metastases involved more lymph nodes than in the control cases. Further, the survival rate of breast cancers during pregnancy and lactation was poorer in the lymph node-positive cases than in the controls. Therefore, we have concluded that pregnancy and lactation promote the progress of a metastatic cancer.

Adult↗