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Biomedical subjects

W B Hutchinson

Publications and source records attributed to W B Hutchinson.

12 recordsLinked to original sources
PubMed2002

Alcohol, tobacco and breast cancer--collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease.

Alcohol and tobacco consumption are closely correlated and published results on their association with breast cancer have not always allowed adequately for confounding between these exposures. Over 80% of the relevant information worldwide on alcohol and tobacco consumption and breast cancer were collated, checked and analysed centrally. Analyses included 58,515 women with invasive breast cancer and 95,067 controls from 53 studies. Relative risks of breast cancer were estimated, after stratifying by study, age, parity and, where appropriate, women's age when their first child was born and consumption of alcohol and tobacco. The average consumption of alcohol reported by controls from developed countries was 6.0 g per day, i.e. about half a unit/drink of alcohol per day, and was greater in ever-smokers than never-smokers, (8.4 g per day and 5.0 g per day, respectively). Compared with women who reported drinking no alcohol, the relative risk of breast cancer was 1.32 (1.19-1.45, P<0.00001) for an intake of 35-44 g per day alcohol, and 1.46 (1.33-1.61, P<0.00001) for >/=45 g per day alcohol. The relative risk of breast cancer increased by 7.1% (95% CI 5.5-8.7%; P<0.00001) for each additional 10 g per day intake of alcohol, i.e. for each extra unit or drink of alcohol consumed on a daily basis. This increase was the same in ever-smokers and never-smokers (7.1% per 10 g per day, P<0.00001, in each group). By contrast, the relationship between smoking and breast cancer was substantially confounded by the effect of alcohol. When analyses were restricted to 22 255 women with breast cancer and 40 832 controls who reported drinking no alcohol, smoking was not associated with breast cancer (compared to never-smokers, relative risk for ever-smokers=1.03, 95% CI 0.98-1.07, and for current smokers=0.99, 0.92-1.05). The results for alcohol and for tobacco did not vary substantially across studies, study designs, or according to 15 personal characteristics of the women; nor were the findings materially confounded by any of these factors. If the observed relationship for alcohol is causal, these results suggest that about 4% of the breast cancers in developed countries are attributable to alcohol. In developing countries, where alcohol consumption among controls averaged only 0.4 g per day, alcohol would have a negligible effect on the incidence of breast cancer. In conclusion, smoking has little or no independent effect on the risk of developing breast cancer; the effect of alcohol on breast cancer needs to be interpreted in the context of its beneficial effects, in moderation, on cardiovascular disease and its harmful effects on cirrhosis and cancers of the mouth, larynx, oesophagus and liver.

Adult↗
PubMed1988

Transrectal ultrasound study of prostate.

Better detection of prostate cancer has been achieved in this study of a limited number of patients by the combined use of digital rectal examination and transrectal ultrasound examination. With more experience and modern equipment improved detection of prostate cancer can be expected.

Aged↗
PubMed1987

The surgeon's future role in the conquest of cancer.

This article is a brief review alluding to the multidisciplinary modalities including basic science technologies that are available in the treatment of today's cancer victim. The roles are discussed of the general surgeon and of the surgical fellow, later a surgical oncologist, as they merge into their respective positions to practice their art. The necessity of limiting the number of surgical oncologists with helpful hints on how they can survive in a nonacademic atmosphere are presented. The multidisciplinary approach to treatment of cancer is stressed.

Forecasting↗
PubMed1983

Carcinoma of the pancreas: progress or stalemate?

Has treatment for cancer of the pancreas progressed or has a stalemate been reached? This is a difficult question to answer. Cancer of the pancreas has several unique features. First, it has been an extremely difficult tumor to study because of its anatomic location and our present invasive and non-invasive studies have failed to provide for truly early detection of this disease when cure may be possible. Second, assuming that we are able to diagnose early, radical surgical resection (our best treatment to date) still carries a substantial morbidity and mortality. The direction certainly has to be in early detection and screening in the asymptomatic patient. To date all of our therapy is directed to the patient who already has symptoms. Diagnosis prior to this stage of the disease is imperative. This would entail the use of biological and serum antibody-type screening procedures with specific tumor markers and better epidemiologic studies to identify risk factors which would aid in screening procedures. It is apparent that present day techniques in the diagnosis and directions are needed before any significant improvement in survival rates are realized.

Aged↗
PubMed1982

Exogenous estrogens and other risk factors for breast cancer in women with benign breast diseases.

A group of 1,439 white women who were initially treated for biopsy-proved benign breast diseases from 1942 to 1975 in a single private surgery practice were followed through 1976 for development of breast cancer. Information on age, parity, and use of noncontraceptive estrogens was collected on all women at the time of their initial benign lesions. At follow-up, ages at menarche, menopause, and birth of first child were obtained, as was information on use of estrogens after the initial lesion. Slides from the initial lesion were reinterpreted and classified by a panel of pathologists. The influence of gross and microscopic features of the initial benign conditions on subsequent risk of breast cancer was ascertained and reported previously. This paper presents results of additional analyses based largely on Cox's proportional hazards model. Risk of breast cancer was related to nulliparity and ages at menarche and birth of first child and to a lesser extent to age at artificial menopause. Exogenous estrogen taken prior to the initial benign lesion did not alter risk of breast cancer. Subsequent use, primarily of conjugated estrogens, eliminated the protective effect of an artificial menopause and appeared to act synergistically with epithelial hyperplasia or papillomatosis in the initial lesion and calcification of that lesion to increase the risk of breast cancer. A marked increase in risk of breast cancer in succeeding birth cohorts was unexpectedly found that could not be explained by temporal changes in any of the other risk factors considered.

Adult↗
PubMed1980

Risk of breast cancer in women with benign breast disease.

A group of 1,489 white women were treated in a private surgery practice from 1940 through 1975 for biopsy-proved benign breast disease, and 1,441 were followed through 1976 for the development of breast cancer. Average duration of follow-up was 12.9 years for a total of 18,617 person-years of observation. Information was collected from a set of questions devised in 1941 and asked of all subjects at the time of their initial office visit, follow-up interview conducted in 1976, and a standardized histology review of the slides from the initial benign lesions and the subsequent cancers. The current pathology review indicated that 66 of the women developed breast cancer. The incidence rate was 3.55 per 1,000 person-years, which is 2.10 times that of the general population. When multiple disease types and other variables were controlled for, excess risk of breast cancer was related to the presence of fibrocystic disease. In women with fibrocystic disease, excess risk was particularly related to the presence of epithelial hyperplasia and/or papias not related to the presence of fibroadenoma alone, but it was related to the presence of fibroadenoma in women with concomitant fibrocystic disease. The excess risk was also directly related to the estimated size of the initial benign mass and was greater for women with bilateral than with unilateral benign lesions.

Adult↗
PubMed1977

The establishment of a cancer center.

This article describes the designated comprehensive cancer center in the Pacific Northwest section of the United States. The local financial, political, and medical problems associated with the initial establishment of this center are discussed. The general philosophy of the approach to cancer, cancer research, and care are included. The programs described differ very little from other similar centers with exceptions that are noted. These are the establishment of the major clinical facilities or units outside of the center proper. The utilization, not duplication, of already existing surgical, irradiation, and hospital facilities representing a departure from the usual custom is discussed. Active participation with real input by the physicians of our region through the extramural council is described.

Hospital Planning↗
PubMed1977

Carcinoma of the esophagus.

We review 10 years' experience with cancer of the thoracic esophagus with an additional minimal six-year observation period of a few surviving patients. Differences must exist in this tumor because therapeutic response, especially irradiation varies in different localities. Very few intrathoracic cancers in our series were resectable. Operation or operation with irradiation produced the only longtime survivors. The number of candidates for resection can probably be increased by preoperative irradiation. Considering the lack of good methods of early detection, the technical problems of the fraility of the tissues involved and their locations, the survival time of the resected patients was surprisingly good. Until entirely new concepts of treatment are introduced, our efforts should be directed toward earlier detection if improved results are to be anticipated.

California↗
PubMed1976

Breast masses in males with carcinoma of the prostate.

Breast masses in male patients who have prostatic carcinoma may represent gynecomastia secondary to estrogen therapy, metastasis of the prostatic carcinoma to the breast, or a primary carcinoma of the breast. Accurate diagnosis of this lesion by biopsy and, if possible, histochemical determination of acid phosphatase is essential to determine prognosis and treatment. The patient with breast metastases from a primary prostatic carcinoma will survive on the average only 4 mo. However, in the patient with prostatic carcinoma, surgical treatment for a primary breast carcinoma may extend survival considerably.

Adenocarcinoma↗
PubMed1971

Duodenotomy.

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Aged↗