PubMed · 2092372
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J P Chavoin. 1990. [Underdeveloped breasts].. https://pubmed.ncbi.nlm.nih.gov/2092372/
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A 7-year-old girl with Rubinstein-Taybi syndrome (RTS) who had a history of neuroblastoma and premature thelarche is reported. The neuroblastoma was detected at age 6 months on a nation-wide neuroblastoma screening program, surgically removed, and took a favorable clinical course with minimal therapy. She developed isolated breasts at age 6 years, had normal plasma levels of estradiol, follicular-stimulating hormone (FSH), and luteinizing hormone (LH), and showed a FSH-predominant pattern on the LH-releasing hormone stimulation test. In view of these findings, she was diagnosed to have premature thelarche. Premature thelarche may not be uncommon in girls with RTS.
Genotoxic agents of environmental or dietary origin may play a role in breast cancer initiation. The ability of extracts of human milk to cause mutations in S. typhimurium TA1538 and YG1019 and to induce micronuclei and DNA strand breaks in MCL-5 cells was investigated. Twenty samples from different donors were analysed and of these, 6 were adjudged to produce a positive mutagenic response in one or both bacterial strains. The same samples also induced significant micronucleus formation in MCL-5 cells. In the comet assay, 13/20 samples caused DNA strand breaks in MCL-5 cells. Viable exfoliated breast cells were recovered from fresh milk samples and the ability of milk extracts to cause DNA damage in these cells was demonstrated. The results show that human milk can contain components capable of causing genotoxic damage in test systems and in human breast cells, events that may be significant in the initiation of breast cancer.
PURPOSE: To design a practical breast shield and to investigate its efficacy in reducing scattered radiation to the contralateral breast of patients undergoing radiation therapy for breast cancer. METHODS AND MATERIALS: We constructed a mobile shield consisting of (a) a mobile base and a counterweight; (b) a vertical column adjustable in height and a diagonal arm adjustable in angle; (c) a curved, 2.5-cm thick lead sheet with a 1-cm thick polystyrene liner for blocking scattered radiation; and (d) diode detectors to verify that the edge of the lead sheet is not in the useful beam in addition to the use of the field light. Measurements were performed with thermoluminescent dosimeters on 10 patients without the shield and on an anthropomorphic phantom with a pair of wax breasts with and without the shield. All of the patients were treated with 6-MV photons (Varian 6/100). The scattered radiation from the medial and lateral fields was measured separately. RESULTS: The contribution of the medial field to the total scattered dose was 70% to 75%, whether a medial wedge was used or not. However, without a medial wedge, the scattered dose was reduced by nearly 33% at 3 to 9 cm away from the medial border. In the anthropomorphic phantom study with wax breast, the mobile shield reduced the medial field contribution to the total scatter dose to less than the contribution from the lateral field without a shield. With a prescribed dose of 50 Gy and a medial wedge, the median scatter dose to the contralateral breast from 6 patients was 5.3 Gy; without a medial wedge, it was 3.8 Gy from 4 patients at 6 cm from the medial border. In the phantom study, with the shield the total dose to the contralateral breast was 1.0 Gy at 6 cm from the medial border with a same prescribed dose. CONCLUSION: The mobile shield reduced the scatter dose to the contralateral breast from the linear accelerator (Varian 6/100, 6-MV photons) by a factor of 3 to 4. The shield greatly reduced the scattered dose in the wax phantom. Equivalent reductions in patients may be clinically significant by reducing the risk of radiation-induced breast cancer in the contralateral breast of woman undergoing radiation therapy for breast cancer. The shield is safe and easy to adjust to each patient.