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Biomedical subjects

R E Mansel

Publications and source records attributed to R E Mansel.

172 records · Page 10Linked to original sources
PubMed1976

Clinical syndromes of mastalgia.

232 patients attending a breast clinic with breast pain as the primary presenting symptom were studied prospectively to define clinical syndromes and to attempt to elucidate aetiological factors. Those women in whom mastalgia was a minor aspect of their complaint, or who were primarily seeking reassurance that they did not have cancer, were excluded. Most mastalgia patients could be placed into well-defined subgroups on the basis of clinical, radiological, and pathological features. After excluding causes of pain arising outside the breast, six specific groups with widely differing aetiological bases were defined, leaving only 7% unclassified lithout known aetiology. The six defined groups were cyclical pronounced mastalgia, (believed to be hormonally based), duct ectasia. Tietze syndrome, trauma, sclerosing adenosis, and cancer. Psychological factors were found to be less important than has been previously suggested. Classification of patients with mastalgia into homogeneous subgroups is a prerequisite of any therapeutic study.

Adolescent↗
PubMedDate not supplied

Management of breast pain and nodularity.

The management of mastalgia consists of classification into its various patterns: reassurance, drug therapy for severe cases, and, rarely, surgery. Differentiation into cyclical and noncyclical patterns on a simple pain chart is useful for objective assessment of pain severity and for selection of appropriate drug therapy and subsequent monitoring of response. About 85% of new patients will be satisfied with adequate reassurance, but some 15% will have persistent pain and warrant medical treatment. Only a small number of drugs have been adequately tested in controlled trails and have been demonstrated to be more effective than placebo; these are bromocriptine, danazol, evening primrose oil, and tamoxifen. No ideal agent exists and the choice of drug will depend on efficacy, side effects, and cost. Noncyclical pain has a lower response rate compared to cyclical mastalgia, but differentiation of a subgroup with chest wall pain leads to an overall 90% response to treatment by local infiltration with steroid and lignocaine. Newer agents such as LHRH agonists are currently undergoing evaluation in double-blind controlled trials against placebo. The management of nodularity is based on the clinical differentiation of the normal spectrum of physiological change within the breast (ANDI), requiring simple reassurance, from a true dominant breast nodule that will require excision biopsy to exclude malignancy. When pain and lumpiness coexist, some reduction in overall nodularity (with the use of agents given for mastalgia) may occur.

Breast↗
PubMedDate not supplied

Does local therapy affect survival rates in breast cancer?

BACKGROUND: The goal of this study was to challenge the hypothesis that local recurrence of breast cancer does not affect survival rates, by determining whether survival rates differ for conservative and radical surgical policies. METHODS: This study used prospective long-term follow-up monitoring of two contemporaneous groups of patients, within a single unit, who were treated identically except for the one variable of local treatment policy, i.e., conservative or radical. A total of 451 patients with operable breast cancer were chosen from 567 consecutive patients with breast cancer who were treated between 1970 and 1979 in the University Department of Surgery. The rate of survival 132 months after treatment was used as an outcome measure. RESULTS: Two hundred forty-one patients were treated using a conservative approach and 210 were treated using a radical approach. At 132 months, the survival rate (58% vs. 42%) and median survival time (> 132 vs. 100 months) were significantly improved for the radically treated group (P < .01). The treatment groups were comparable in terms of age, menopausal status, tumor size, histologic grading, and Nottingham Prognostic Index values. The advantage of the radical policy persisted when examined in relation to each of these prognostic factors. CONCLUSIONS: Use of radical local treatment yielded a highly significant survival benefit (comparable to that obtained with adjuvant therapy), compared with a conservative approach. This was related to a reduced locoregional recurrence rate and provides evidence that local therapy influences long-term outcomes for patients with breast cancer. High-quality locoregional control should be emphasized, as is systemic therapy, in management policies. Assessment of surgical techniques, particularly in relation to locoregional recurrence rates, should be included in all studies in which surgery is a component of therapy.

Axilla↗
PubMedDate not supplied

Immunohistochemical staining patterns of benign breast biopsies by 323/A3 and Ca1 monoclonal antibodies related to epidemiological and radiological risk criteria.

Monoclonal antibodies 323/A3 and Ca1 have been suggested as markers of breast cancer risk in benign breast disease. We have studied the staining profiles in benign biopsies of 323/A3 and Ca1 in 146 patients. We then compared the staining patterns grouped according to whether the patients were at "high or low" risk of breast cancer by conventional epidemiological or radiological criteria. The results show that the staining profiles are similar between risk groups and that on the risk criteria used in this study 323/A3 and Ca1 will not distinguish patients at risk of developing breast cancer.

Antibodies, Monoclonal↗
PubMedDate not supplied

Regulation of motility and invasion of cancer cells by human monocytic cells.

Tumour tissues are frequently seen with monocyte/macrophage infiltration. This study was to establish the role of monocytes on the motile and invasive behaviour of human cancer cells. By using a co-culture technique, we have shown that both human peripheral blood monocytes and a monocytic cell line, U937, stimulated colon and breast cancer cell colony scattering, motility, and invasion into a basement membrane (Matrigel). This effect was enhanced when monocytic cells were stimulated by a particulate stimulus. IL-4 and IL-10 reduced these effects of monocytes. We conclude that monocytic cells enhance the motility and invasion of tumour cells. These effects can be regulated by inhibitory cytokines of monocytes.

Cell Division↗
PubMedDate not supplied

Expression of catenins in human cancer cells and its regulation by n-6 polyunsaturated fatty acids.

Catenins (alpha, beta, and gamma) are a group of proteins linking E-cadherin with the cytoskeleton. Reduced expression of alpha catenin has been shown in some cancer lines and tissues and is related to the invasive nature of tumour cells. This study examined the effects of n-6 PUFAs on the expression of catenins in a range of human cancer cells by Western blotting. Although most of the cell lines expressed similar levels of beta and gamma catenins, a number of cell lines expressed low levels of alpha catenin. Treatment of cells with gamma linolenic acid (GLA) increased alpha catenin expression in most cell lines, while beta catenin levels were reduced, and gamma catenin expression was unchanged. Linoleic acid and arachidonic acid had not significant effects. We conclude that in human cancer cell lines, the expression of alpha and beta catenins can be regulated by gamma linolenic acid.

Arachidonic Acid↗