Search PubMed⌕ Search

Biomedical subjects

T J Anderson

Publications and source records attributed to T J Anderson.

At least 217 records · Page 12Linked to original sources
PubMed1986

Fine-needle aspiration of breast cancer. Relationship of clinical factors to cytology results in 689 primary malignancies.

Between 1980 and 1983, 689 women with primary breast cancer at the Royal Infirmary of Edinburgh and associated Hospitals had fine-needle aspiration biopsies prior to definitive surgery. Clinical factors relating to the success of these aspirations were evaluated. The most significant factor was which physician performed the aspiration. Size of the lesion was also an important variable; however, size difference could not account for the marked variation between different individuals performing the aspiration. There was no difference between node-positive and node-negative patients when matched by tumor size. A significantly lower rate of positive aspirations occurred in the 45 to 55 year age group which could not be accounted for by tumor size. Location of the mass was not significant, although there was a persistent lower rate of positive aspirates from the upper inner quadrants. Aspiration cytology was positive or suspicious in 65 percent of patients with primary breast cancer who had clinical diagnoses of benign breast lesions. It is concluded that the most significant variable in the accuracy of breast aspiration biopsy is the size of the lesion and the proficiency of the individual performing the procedure. With a skilled physician, positive aspiration results were obtained in over 80% of breast cancers.

Biopsy, Needle↗
PubMed1986

Comparative pathology of prevalent and incident cancers detected by breast screening. Edinburgh Breast Screening Project.

In the Edinburgh Breast Screening Project 210 cancers were detected from commencement in 1979 up to December, 1984. By this time the full initial cohort had completed at least 3 visits and a proportion had attended for up to 5 visits, so pathological characteristics for prevalent and incident cancers could be compared. The main differences are in distribution of histological type of cancer, detection of occult invasive disease, and lymph-node positivity among incident tumours. Only the first of these was statistically significant. This evaluation shows that cancer detection by screening in Edinburgh conforms with screening theory, in which detection of good prognosis tumours is favoured at the prevalence screens, and faster growing, aggressive tumours are found at the incidence screens. Qualitative histopathology may provide a better measure than standard quantitative judgments of size and lymph node status to compare the varieties of cancer detected by screening programmes and to understand the biology of the disease.

Aged↗
PubMed1986

A classical osteogenic sarcoma of the breast: histology, immunohistochemistry and ultrastructure.

A classical osteogenic sarcoma of the breast is described and the results of light microscopy, including immunohistochemistry for epithelial and mesenchymal markers, and of electron microscopy are presented. No epithelial features were detected by any of the methods used, the tumour being considered a true osteogenic sarcoma. The tumour appears to have arisen de novo, and not from a pre-existing fibroadenoma.

Antibodies↗
PubMed1986

An ultrastructural study of mucoid carcinoma of the breast: variability of cytoplasmic features.

The ultrastructural characteristics of 14 cases of mucoid carcinoma of the breast, with different histological appearances, have been examined. Thirteen of the tumours were observed to consist of two populations of tumour cells, one showing secretory changes while the other group showed no evidence of activity. In one tumour only synthetically active cells were observed. Ultrastructurally, six different types of cytoplasmic granules, comprising typical mucin plus glycoprotein or protein-containing granules, were identified within the synthetically active tumour cells. The number of types of granules and the relative proportion of the various granules varied between tumours with only mucin granules present in all tumours. It would appear that synthetic pathways are activated in certain tumours which result in protein/glycoprotein granules associated with the argyrophilia observed histologically. In addition, the tumours varied with respect to luminal differentiation, presence of intracytoplasmic lumina, intracytoplasmic mucin pools, lipid droplets, ciliated cells and areas of calcification. The marked heterogeneity of the ultrastructural features of the mucoid carcinoma of the breast prevents the tumours from being readily divided into distinct subgroups.

Adenocarcinoma, Mucinous↗
PubMed1985

Long-term survivors after breast cancer.

A retrospective analysis of two groups of patients, one surviving 16-20 years and the other dying within 10 years after diagnosis and treatment of primary breast cancer has been undertaken to determine whether there were particular clinical or histological features associated with long-term survival. The striking histological difference between the tumours of the two groups of patients was the prevalence of tumours of 'special' invasive types (cribriform, tubular, lobular and medullary) in the long-term survivors. Micro-invasive and non-invasive carcinomas were also more common in the survivors. The tumours of the surviving group which were not of a 'special' type more commonly had a better histological grade than those tumours of patients dying early from breast cancer. In the overall group elastosis was present in significantly more tumours of the survivors whereas tumour necrosis, vascular and lymphatic invasion were all significantly more common in the short-term survival group. Although there was a significantly increased incidence of earlier stage tumours in the long-term survivors, the histological distinctions between the two groups were independent of the differences in clinical features.

Adult↗
PubMed1985

Radial scars of benign and malignant breasts: comparative features and significance.

From a study of tissue from 34 cancerous breasts and 34 benign breasts the nature and occurrence of radial scars has been assessed. The frequency of detection was influenced more by the amount of tissue assessed and by the diligence of search than by any association with cancer. Bilaterality and multifocality were features in cancerous and benign breasts and a similar range of scar histological appearance was apparent in both types. The histological features of 103 radial scars were tabulated to compare the association of characteristics within individual scars, and the information used to formulate modes of development and progression. The 'early' stage appeared to correlate with central chronic inflammatory response, many spindle cells and minor fibroelastotic distortion of parenchyma; the 'late' stage showed few spindle cells and dominant fibroelastosis with considerable distortion and separation of parenchymal elements. No support was found for the concept that the lesion is premalignant. Rather it belongs to the spectrum of sclerosing alterations affecting the breast parenchyma which ranges from physiological through to clearly pathological changes. Position in the spectrum depends upon the extent and degree of change.

Adult↗
PubMed1985

Myofibroblast activity of radial scars.

Radial scars from 38 cases, comprising 12 associated with cancer and 26 with benign lesions, have been examined by electron microscopy. One-third of the lesions, regarded as being at an early stage of development, showed abundant spindle cells, which displayed the ultrastructural characteristics of myofibroblasts. These included many profiles of endoplasmic reticulum, prominent myofilaments and a close association with collagen and elastic fibres. The remaining 'mature' radial scars showed relatively few myofibroblasts, sparsely distributed in the stroma. The stromal cells associated with the 'early' lesions were seen in close proximity to degenerating parenchymal structures, which frequently showed loss of basal lamina. Obliteration of the central parenchymal component appeared to be a prominent feature of radial scar formation. The ultrastructural appearances are consistent with a progressive development of the lesion, associated with sporadic myofibroblast activity.

Adult↗
PubMed1985

Distribution of dense core granules in normal, benign and malignant breast tissue.

In this study breast tissue from 114 patients has been examined ultrastructurally for dense core granules (DCG). The tissue included examples of normal 'resting', pregnant and lactating breast plus various benign and malignant lesions. DCG were observed in low numbers in the apical cytoplasm in a proportion of the examples of 'resting' and pregnant breast tissue but were absent in the lactating patients. The incidence appeared to relate to hormonal changes. They were present in 50 per cent of the benign lesions examined. DCG were also observed in a high proportion of the ductal, lobular and tubular carcinomas examined and were associated with luminal differentiation. In the mucoid carcinomas over half the tumours possessed some DCG with large numbers of DCG present within certain of the malignant cells in two cases. It is possible that the granules could be related to mucin secretion. Therefore, in normal, benign and malignant (with the exception of mucoid carcinoma) breast tissue the presence of DCG would appear to be related to hormonal changes and represent prelactational differentiation rather than providing evidence of neuroendocrine differentiation. We emphasize the need for a comprehensive knowledge of the normal morphological variations within a tissue before attempting to interpret its tumours.

Adolescent↗
PubMed1984

Fine needle aspiration cytology, in relationships to clinical examination and mammography in the diagnosis of a solid breast mass.

The accuracy of clinical examination, mammography and fine needle aspiration cytology in identifying malignancy has been assessed in 1655 breast masses from two time periods. Clinical examination and mammography remained consistent at identifying malignancy but 9 per cent of all breast carcinomas were considered benign by both techniques (sensitivity 91 per cent). Fine needle aspiration cytology, when performed by multiple aspirators in the first study period, had a sensitivity of only 66 per cent for malignancy. During the second period of study, when all aspirates were performed by a single aspirator, sensitivity rose to 99 per cent. The two patients with false negative cytology in this latter period had both clinical and mammographic evidence of malignancy. No patient with malignant cytology was subsequently shown to have benign disease. It is concluded that a combination of clinical examination and mammography, with fine needle aspiration cytology performed by committed individuals with aptitude for the technique and interpreted by experienced pathologists, can identify all patients with breast cancer before surgery.

Adult↗
PubMed1984

The Edinburgh randomised trial of screening for breast cancer: description of method.

Edinburgh was selected as one of the centres in the UK Seven-year Trial of Breast Screening of women aged 45-65 which began in 1979. Subsequently, our study was extended to a randomised trial with its own control population within the city. Half the practices were randomly allocated for screening, giving a cluster sampling of women. The total number in the trial is 65,000. Women with previously diagnosed breast cancer are excluded. Women allocated for screening are invited to the clinic and screened according to the procedures specified in the U.K. protocol, having clinical examination every year and mammography on alternate years. The two modalities of screening are assessed independently and the role of nurses is being evaluated. Breast cancer incidence is monitored by pathology register and the local cancer registry office and deaths from the General Register office. Long-term follow-up will be obtained through flagging at NHS Central Register. To determine the value of screening, standard statistical methods will be used to compare breast cancer mortality rates in the whole of the screening population with that of the controls. This trial has a power of 83% of detecting a reduction in mortality of 35% after 7 years of follow-up and a power of 95% of detecting a similar reduction at 10 years (alpha = 0.05, one-sided test).

Breast Neoplasms↗
PubMed1984

Clinical assessment of tumour size in primary breast carcinoma.

In a consecutive series of 100 operable breast carcinomas clinical and mammographic assessment of tumour size each resulted in only 75% being placed in the correct T category when compared to the actual tumour size. In a further 50 breast carcinomas it was shown that an accurate assessment of actual tumour size could be obtained by subtracting the thickness of the skin, fat and subcutaneous tissue in the corresponding area in the contralateral breast from the clinical measurement obtained using calipers (adjusted clinical size). The T category using this method was correct in 49 out of the 50, significantly better than clinical measurement or mammographic assessment of tumour size (p less than 0.003 McNemar's Test). Analysis of the regression lines obtained comparing clinical measurement, mammographic assessment and adjusted clinical size with actual tumour size showed that: clinical measurement overestimated actual tumour size by 0.5 to 1 cm; mammographic assessment overestimated small tumour and underestimated larger ones, whereas the adjusted clinical size never differed by more than a fraction of a centimeter from the actual size. This new method of assessment of tumour size allows accurate pre-operative selection of patients into appropriate treatment options.

Biopsy, Needle↗
PubMed1983

Infiltrating lobular carcinoma of the breast: an evaluation of the incidence and consequence of bilateral disease.

A histological review of 1003 invasive breast carcinomas identified 103 patients with infiltrating lobular carcinoma, for whom clinical and survival data were collected in each case. Six patients had bilateral carcinoma at diagnosis and 14 developed a contralateral carcinoma during the period of follow-up. The major factor predicting patients at risk of developing a contralateral carcinoma was histological type. Analysis of survival data on the patients with bilateral disease showed poor survival in the group with synchronous bilateral disease, but no difference in survival between patients with metachronous bilateral and unilateral disease. This suggests that the development of a metachronous contralateral carcinoma does not necessarily reduce the probability of survival of patients with infiltrating lobular carcinoma.

Breast Neoplasms↗
PubMed1983

Mammary duct ectasia.

A total of 108 patients with mammary duct ectasia have been reviewed. Patients who presented with breast pain or a lump were significantly younger than those with nipple retraction. A histological review of the 88 patients who underwent biopsy showed severe periductal inflammation around non-dilated ducts occurred in younger patients and was associated with the symptom of breast pain or a lump, whereas older patients had duct dilatation as the most prominent feature, frequently associated with nipple retraction. These findings suggest periductal mastitis precedes duct dilatation and is the initial disorder in this condition. Data on parity and breast feeding for the 108 patients with duct ectasia were compared with age-matched groups of 505 patients with breast cancer, 199 with fibroadenoma, 240 with cysts and 912 'normals'. There were no differences in parity or breast-feeding history between the patients with duct ectasia and any other group, indicating that neither parity nor breast feeding is an important aetiological factor in this condition.

Adenofibroma↗
PubMed1983

An ultrastructural study of lactation in the human breast.

In this study the morphological features of lactation in the human breast were examined by scanning and transmission electron microscopy. The lactating lobules comprised large numbers of interconnecting acini which were lined by a single layer of epithelial cells with underlying myoepithelial cells. Marked variations were noted in the shape of the epithelial cells. The myoepithelial cells formed an open meshwork of interconnecting cytoplasmic processes packed with myofibrils. The basal cytoplasm of the epithelial cells was packed with rough endoplasmic reticulum while the apical cytoplasm contained a hypertrophic Golgi body, numerous vacuoles (a few of which contained casein micelles), a number of lipid droplets and small coated and uncoated vesicles. The lipid droplets were released by progressive protrusion from the apical surface. They remained covered by the plasmalemma and were finally budded off into the lumen. In certain cases a portion of cytoplasm was released with the lipid droplet. The vacuoles and small vesicles fused with the plasmalemma and released their contents by exocytosis. Within the samples the majority of epithelial cells were actively lactating although examples of undifferentiated "resting" and dead (lysed) cells were also identified.

Breast↗