Biomedical subjects

Kwok Leung Cheung

Publications and source records attributed to Kwok Leung Cheung.

4 recordsLinked to original sources

PubMed2006

The reliability of assessment of oestrogen receptor expression on needle core biopsy specimens of invasive carcinomas of the breast.

AIM: To assess the reliability of assessment of oestrogen receptor expression on needle core biopsy specimens of invasive carcinomas of the breast. Previous studies have mostly been small, with a range of agreement from 62% to 100%. METHODS: Retrospective audit of 338 tumours surgically excised within 60 days of core biopsy, that had had oestrogen receptor assessed on both the core biopsy and tumour specimens. Surgical specimens were incised when fresh to ensure good fixation. External controls including a weakly positive tumour were included in each immunohistochemistry run. RESULTS: Oestrogen receptor expression was bimodal, with H score in both specimens of either 0 or >50 in 96% of tumours. Using H score cut-off of 10 for positivity, there was an agreement between core and excision in 334 of 338 tumours (98.8%). All discrepancies were between weakly positive and negative tumours. Intratumoral heterogeneity could explain the one tumour that was negative on core and positive on excision. H score tended to be slightly higher on core than excision (means 146 and 136). Better fixation on the core is the most likely explanation for this and for the three tumours that were positive on core and negative on excision. Repeat staining on tumours with discrepant results gave similar results in all except one case. An internal control was present in 97% of excisions and 55% of cores of oestrogen receptor-negative tumours; the internal control stained positively in all except two sections. CONCLUSION: Oestrogen receptor can be assessed reliably on needle core biopsies of invasive carcinomas of the breast.

Adenocarcinoma↗

PubMed2006

Concepts of seroma formation and prevention in breast cancer surgery.

BACKGROUND: Seroma formation is the commonest early sequel to breast cancer surgery especially when axillary dissection is undertaken. It is associated with significant morbidity and financial burden. The main pathophysiology of seroma is still poorly understood and remains controversial. The optimal ways to reduce the incidence of seroma formation are unknown. The aim of this paper is to review the concepts of pathophysiology of seroma formation following mastectomy and breast-conserving surgery for cancer. The various techniques in practice to reduce its incidence and treatment are outlined. METHOD: MEDLINE search of published work on the subject with respect to its pathophysiology, prevention and treatment was carried out. Manual retrieval of relevant articles in the reference lists of the original papers from the MEDLINE was then carried out. RESULT: The pathophysiology and mechanism of seroma formation in breast cancer surgery remains controversial and not fully understood. Methods of prevention and treatment of seroma remain varied and inconclusive. CONCLUSION: Evidence suggests an increase in the incidence of seroma because of thermal trauma from electrocautery dissection, but this is indispensable for surgical haemostasis. Obliteration of dead space by various flap apposition techniques has been shown to be advantageous in reducing incidence and volume of seroma. Low-pressure suction drainage reduces seroma volume and duration of drainage leading to earlier drain removal. Preventive measures have to be tailored according to individual patient and operative factors.

Antineoplastic Agents, Hormonal↗

PubMed2005

Approach to a lump in the breast: a regional perspective.

The clinical presentation, investigation and treatment of women with breast lumps are greatly influenced by geographical factors. These impact disease patterns and their presentation (e.g. socioeconomic/educational status and cultural/religious beliefs) and the availability of specialist health care personnel and facilities. The differential diagnoses of a breast lump include breast cancer, benign solid and cystic lumps and inflammatory conditions. The likelihood of a diagnosis relates more to geographical area, age, ethnic origin, family history of breast cancer, presence of high-risk pathology, endemic infection, smoking, pregnancy and lactation history, puerperal care and health education. Investigations and treatments vary more according to the availability of expertise and facilities (e.g. combined diagnostic clinic staffed by breast surgeon and radiologist; breast radiologist to carry out image-guided diagnostic and therapeutic procedures). This article discusses the clinical assessment and investigation of breast lumps and possible treatments from an Asia Pacific perspective.

Breast Cyst↗

PubMed2002

Fulvestrant.

Fulvestrant, a novel oestrogen receptor (ER) downregulator, is a pure anti-oestrogen which completely blocks the trophic actions of oestrogens without exerting any partial agonist effects. It reduces expression of oestrogen receptor, progesterone receptor and proliferative and cell turnover indices. The drug is well-tolerated with minimal systemic side effects. Large randomised trials have demonstrated similar efficacy to anastrozole in the treatment of postmenopausal advanced breast cancer. While results of a Phase III trial comparing fulvestrant with tamoxifen as first-line endocrine therapy for postmenopausal advanced breast cancer are awaited, future studies on its role in adjuvant and neoadjuvant settings, as well as in premenopausal women are required. With the role of tamoxifen as the gold standard of first-line therapy being challenged by the third generation aromatase inhibitors, direct comparison of the latter with fulvestrant in the first-line setting may also be worthwhile.

Animals↗