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J L Peterse

Publications and source records attributed to J L Peterse.

At least 91 records · Page 5Linked to original sources
PubMed1996

[Identification of the sentinel node in patients with breast carcinoma].

OBJECTIVE: To investigate the hypothesis that lymphatic metastasis of breast cancer progresses in a sequential fashion, and whether the first lymph node on a direct drainage pathway (first-echelon node, sentinel node) can be identified in a mastectomy specimen. DESIGN: Descriptive analysis. SETTING: The Netherlands Cancer Institute (Antoni van Leeuwenhoek Hospital), Amsterdam, the Netherlands. METHODS: In 22 patients with clinically localized breast cancer and five with breast cancer and axillary lymphadenopathy, patent blue dye was administered preoperatively into the primary tumor. After mastectomy and axillary lymph node dissection, blue stained lymphatic channels were dissected down to the first draining lymph nodes. These sentinel nodes were removed from the specimen and examined separately for presence of metastatic disease. RESULTS: In 2/5 patients with palpable axillary metastases and in one patient with a tumour in the medial upper quadrant, no sentinel node was found. A total of 35 first-echelon nodes was identified in the 22 patients without palpable lymphadenopathy, on average 1.6 nodes per patient (range: 1-4). In 10 of these patients, metastatic tumour was found in the sentinel nodes. In 6 of these 10 patients, no metastatic disease was detected in the remaining axillary nodes. Metastasis was never found in the other axillary nodes if the sentinel node was disease-free. CONCLUSIONS: Dissemination of breast cancer to the axillary nodes appears to occur in a sequential fashion. Patent blue dye drains from the tumour in the breast to the axillary lymph nodes in mammary cancer patients. These blue nodes can be identified in the surgical specimen.

Adult↗
PubMed1996

Sex steroid receptor expression in 'carcinoid' tumours of the breast.

Nine 'carcinoids' of the breast (argyrophilic carcinomas) were examined for the presence of estrogen receptor (ER), progesterone receptor (PR), and androgen receptor (AR), using immunohistochemistry. The tumours were selected on the basis of their histo-morphological appearance and positive Grimelius stain. All cases were immunoreactive for neuron-specific enolase (NSE). In one case the tumour cells were intensely chromogranin A positive. All cases were ER positive, while 5 cases expressed AR and 5 cases PR. Immunostaining for ER and simultaneous demonstration of argyrophilia or chromogranin A expression in chromogranin A positive argyrophilic carcinoid tumour of the breast provided further evidence that neuroendocrine cells in breast tumours express sex steroid receptors. The similarity in sex steroid receptor expression pattern in 'carcinoids' of the breast and the more common categories of breast cancer suggests an identical responsiveness to endocrine therapy.

Adult↗
PubMed1996

Microcalcifications in ductal carcinoma in situ of the breast: histochemical and immunohistochemical study.

Thirty cases of ductal carcinoma in situ (DCIS) of the breast, showing histological microcalcifications, were studied to clarify their mechanism of formation. Undecalcified sections revealed three types of calcium precipitates: type I and II granular calcifications (GCs) and laminar calcifications (LCs). In type I GCs the core on which the calcium had deposited was constituted mainly by nuclear debris. Type II GCs were predominantly composed by mucosubstances. LCs were the result of calcium deposits on mucoid or proteinaceous material, arranged in concentric lamellae. LCs and type II GCs were mainly present in well and intermediately differentiated DCIS. Type I GCs were observed in only DCIS with necrosis, frequently being present in intermediately and poorly differentiated DCIS.

Adult↗
PubMed1996

Efficacy of up-front 5-fluorouracil-epidoxorubicin-cyclophosphamide (FEC) chemotherapy with an increased dose of epidoxorubicin in high-risk breast cancer patients.

The prognosis of patients with stage IIIB breast carcinoma with tumour spread to the apical axillary lymph nodes has hardly improved despite adequate locoregional control and the introduction of systemic adjuvant therapy. A combined modality regimen that includes anthracyclin-based chemotherapy, high-dose chemotherapy with peripheral stem cell support and radiation and hormonal therapy is currently under investigation in this subset of patients. The present study aims to document the efficacy and feasibility of dose-intensive epidoxorubicin in combination with a standard dose of 5-fluorouracil and cyclophosphamide as up-front chemotherapy in this setting. A preoperative chemotherapy regimen consisting of three courses of 5-fluorouracil 500 mg m-2, epidoxorubicin 120 mg m-2 and cyclophosphamide 500 mg m-2 (FE120C) was administered at 21 day intervals without haematopoietic growth factors to 70 patients with apex node-positive disease. All patients were below 60 years of age and had not had prior chemotherapy or radiotherapy. Sixty-six patients were evaluable for clinical response and histopathological examination could be performed in 62 of these. Thirteen patients achieved a clinical complete response (20%). Of these patients, microscopic examination of the mastectomy specimen revealed absence of malignant cells in two and exclusively ductal carcinoma in situ (DCIS) in another two patients. In addition, of the 46 patients (70%) with a clinical partial response, at pathological examination one patient had sclerosis only and four had DCIS. This results in a pathological complete response in three (5%) of all patients and absence of invasive carcinoma in 10%. None of the patients progressed during chemotherapy. The major toxicity was moderate bone marrow suppression with a median white blood count (WBC) nadir of 1800 microliters-1 (range 500-4900). Other toxicities were mild. The full planned dose could be given without delays in 66 of 70 patients FE120C is well tolerated and is highly effective as up-front chemotherapy in relatively young patients with high-risk breast cancer, with a 90% (CI 74-98%) clinical objective response rate.

Adult↗
PubMed1996

Iododeoxyuridine labelling of S-phase fraction in fine needle aspirates from breast carcinomas.

The suitability of measuring the S-phase fraction in human breast cancer by labelling tumour cells from fine needle aspirates (FNAs) in vitro with iododeoxyuridine (IdU) was studied in 11 patients. The S-phase fraction was measured both in preoperative FNAs labelled in vitro with IdU, and in FNAs taken from the same tumour when surgically removed after intravenous administration of IdU. Frozen sections were also immunostained for incorporated IdU. The mean S-phase fraction measured in FNAs after in vitro or in vivo labelling and in sections after in vivo labelling was 4.0, 3.6, and 3.1, respectively. Results of in vitro and in vivo labelling of FNAs with IdU were similar. However, as the S-phase fraction in breast cancer is generally low, the variation between the different measurements is too large; therefore, the S-phase fraction is not a suitable indicator of response to treatment.

Biopsy, Needle↗
PubMed1995

Adenomyoepithelioma of the breast associated with low-grade adenosquamous and sarcomatoid carcinomas.

Six cases of invasive breast carcinoma with unusual morphological features are reported. The ages of the female patients ranged from 46 to 79 years (mean 60.5). All tumours had areas typical of an adenomyoepithelioma. In three cases adenomyoepithelioma gradually merged with low-grade adenosquamous carcinoma. In the other three patients a sarcomatoid carcinoma was associated with adenomyoepithelial areas. A common origin is proposed for these neoplasms, which extends the morphological spectrum of epi-myoepithelial cell tumours.

Aged↗
PubMed1994

Evidence for a gene on 17p13.3, distal to TP53, as a target for allele loss in breast tumors without p53 mutations.

In breast cancer, loss of heterozygosity (LOH) on 17p is a frequent event and a likely target is the p53 gene on 17p13.1. However, several LOH mapping studies have indicated that, in some breast tumors, LOH affects only the most distal 17p markers, suggestive of a second tumor suppressor locus in 17p13.3. In order to distinguish which gene has most probably served as the target for LOH on 17p, we have screened 141 breast tumors for somatic mutations in the p53 gene in conjunction with detailed LOH mapping on the short arm of chromosome 17. A total of 32 mutations were detected in 31 tumors, 15 of which have never been reported in breast cancer before. The majority are point mutations leading to an amino acid change in the protein. In addition, we have stained a subset of 87 tumors for the p53 protein by immunohistochemistry. In 21 of these tumors (24%), nuclear staining was detected in over 25% of the tumor cells with the anti-p53 antibody DO7. A positive correlation was found between p53-positive staining and p53 mutation (P < 0.001). A strong association was observed between p53 mutation and LOH at the TP53 locus but not between p53 expression and LOH on 17p. In breast tumors without a detectable p53 mutation but with LOH on 17p, the 17p13.3 region is always involved and, in some cases, even exclusively involved. These results suggest that a second tumor suppressor gene, located distal to TP53, is targeted by LOH on 17p in some breast tumors and that a substantial number of breast tumors stabilize p53 through mechanisms other than mutation.

Alleles↗
PubMed1994

Solitary fibrous tumour (myofibroblastoma) of the breast.

Three new cases of the spindle cell tumour of the breast, usually termed myofibroblastoma, are reported. The histology and the immunological profile (expression of vimentin, CD34 antigen and of muscular markers) appear similar to those of solitary fibrous tumours recently described in various sites. It is proposed to include these mammary lesions into the group of solitary fibrous tumours and to regard breast as an additional site of origin.

Aged↗
PubMed1994

Ductal carcinoma in situ: a proposal for a new classification.

Details of a proposed new classification for ductal carcinoma in situ (DCIS) are presented. This is based, primarily, on cytonuclear differentiation and, secondarily, on architectural differentiation (cellular polarisation). Three categories are defined. First is poorly differentiated DCIS composed of cells with very pleomorphic, irregularly spaced nuclei, with coarse, clumped chromatin, prominent nucleoli, and frequent mitoses. Architectural differentiation is absent or minimal. The growth pattern is solid or pseudo-cribriform and -micropapillary (without cellular polarisation). Necrosis is usually present. Calcification, when present, is amorphous. Second, at the other end of the spectrum is well-differentiated DCIS, composed of cells with monomorphic, regularly spaced nuclei containing fine chromatin, inconspicuous nucleoli, and few mitoses. The cells show pronounced polarisation with orientation of their apical border towards intercellular spaces usually resulting in cribriform, micropapillary and clinging patterns, although a solid pattern of well-differentiated DCIS also occurs. Necrosis is uncommon. Calcifications, when present, are usually psammomatous. The third category, intermediately differentiated DCIS, is composed of cells showing some pleomorphism but not so marked as in the poorly differentiated group. There is, however, always evidence of polarization around intercellular spaces, although this is not so pronounced as in the well-differentiated group. These two criteria, cytonuclear differentiation and architectural differentiation, have been found to be more consistent throughout a DCIS lesion than previously employed criteria of architectural pattern or the presence or absence of necrosis.

Breast Neoplasms↗
PubMed1993

Malignant schwannoma of the parapharyngeal space in von Recklinghausen's disease: a case report and review of the literature.

Neurofibromatosis (NF) or von Recklinghausen's disease is frequently accompanied by malignant tumours, which can occur at any site in the body. These malignancies are mainly of soft tissue origin. Of all head and neck malignancies, the number of soft tissue sarcomas is limited and in combination with NF this type of tumour is a rare event. In this report we describe the clinical course of a young female patient with NF, who presented with a massive malignant schwannoma in the parapharyngeal space, and review the pertinent literature.

Adolescent↗