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PubMed1991

Knowledge-based computer system to aid in the histopathological diagnosis of breast disease.

A knowledge-based computer system, designed to assist pathologists in the histological diagnosis of breast disease, is described. This system represents knowledge in the form of "disease profiles" and uses a novel inference model based on the mathematical technique of hypergraphs. Its design overcomes many of the limitations of existing expert system technologies when applied to breast disease. In particular, the system can quickly focus on a differential problem and thus reduce the amount of data necessary to reach a conclusion. The system was tested on two sets of samples, consisting of 14 retrospective cases and five hypothetical cases of breast disease. Its recommendations were judged "correct" by the evaluating pathologist in 15 cases. This study shows the feasibility of providing "decision support" in histopathology.

Breast↗
PubMed1989

[Study on follow-up of patients with biopsy-proven breast disease].

Eight hundred forty-one patients with biopsy-proven benign breast disease were followed annually in prospective manner for 1-10 years to analyse breast cancer development at aspect of histologic features, age at entry and mammographic patterns by Wolfe. No association was found between patients who developed cancer and those who did not with respect to the initial histologic features. The rate of breast cancer development in patients in thirties was the highest. The breast cancer development was found most often in less than three years follow-up period. The breast parenchymal patterns at entry related to cancer development. In 10 cancer patients, 8 patients showed DY pattern and 2 showed P2 patterns. The present results demonstrate that the patients with biopsy-proven benign breast disease in thirties, in less than 3 years follow up period and have parenchymal patterns of P2 or DY should be followed carefully.

Adult↗
PubMed2000

Cytologic features of proliferative breast disease: a study designed to minimize sampling error.

BACKGROUND: Assessment of cytologic features that allow accurate classification of proliferative breast disease has been hampered by sampling errors when fine-needle aspirations have been compared with their corresponding histologic sections. METHODS: To allow for optimal cytohistologic correlation, 2 smears (1 hematoxylin and eosin-stained and 1 Diff-Quik-stained) were prepared from each of 98 breast biopsies without mass lesions and compared with the corresponding histologic sections of the scraped area. Each smear was reviewed in a blinded fashion and assessed for cellularity, background elements, cytoarchitectural features of cell groups, and nuclear features by 2 reviewers. Smears were then classified as nonproliferative breast disease (NPBD), proliferative breast disease without atypia (PBD) or with atypia (PBDA), or DCIS, based on review of the corresponding histologic sections. RESULTS: When comparing NPBD/PBD (n = 86) with PBDA/DCIS (n = 12), smears from PBDA/DCIS were significantly (by the Fisher exact test or Wilcoxon rank sum P values with adjustment for multiple comparisons) more likely to be cellular; contain single cells and necrosis; exhibit nuclear overlap and cytoplasmic vacuoles; have large nuclei, macronucleoli, pleomorphism, clumped chromatin, and hyperchromasia; and were less likely to have complex cell groups, monolayers, swirling, cohesion, and myoepithelial cells in epithelial sheets and the smear background. When NPBD (n = 53) and PBD (n = 33) were similarly compared, smears from PBD were more likely to exhibit larger and more complex cell groups, but they were otherwise similar to smears from NPBD. CONCLUSIONS: There are many cytologic features that will allow a distinction of NPBD/PBD from PBDA/DCIS, but relatively few that can aid in separating NPBD from PBD.

Biopsy↗
PubMed1990

Surgical management of breast disease in an obstetrics and gynecology group.

The surgical management of breast disease from 1978 through 1988 by the Women's Health Center of Logansport is reviewed. Three hundred twelve biopsy procedures resulted in the diagnosis of 59 cancers. Biopsy and mastectomy procedures were performed by the authors (obstetrician-gynecologists). There were no significant complications and all patients had an adequate surgical result. Preoperative needle localization techniques proved to be a safe and effective method to identify and remove nonpalpable mammographic abnormalities. Because women depend on their gynecologist for advice regarding reproductive organs including the breasts, it is logical for the gynecologic surgeon to become involved in the surgical management of breast disease.

Adult↗
PubMed1998

Breast cancer and benign breast disease patients evaluated in relation to oxidative stress.

In this study, breast cancer (n = 23) and benign breast disease (n = 15) patients were evaluated in relation to oxidative stress. The extent of lipid peroxidation was assessed by measuring thiobarbituric acid reactive substances (TBARS) in plasma. Erythrocyte glutathione peroxidase (GSH Px), CuZn speroxide dismutase (CuZn SOD), glutathione (GSH) and plasma vitamin E, cholesterol Fe, Zn, Cu levels were analysed in both groups GSH Px (p < 0.01), vitamin E (p < 0.001), Zn (p < 0.01), Cu (p < 0.05) and cholesterol (p < 0.01) concentrations were found to be significantly increased, TBARS level (p < 0.01) significantly decreased in breast cancer patients in comparison to benign breast disease group.

Breast Diseases↗
PubMed1993

Prognostic significance of benign proliferative breast disease.

BACKGROUND: Recent studies concerning an association between benign breast diseases and risk of subsequent breast cancer have focused on benign proliferative lesions recognized in biopsy specimens. Some have implicated atypical hyperplasia as being associated with the greatest risk. METHODS: The histologic sections of specified benign breast lesions from 1799 women were reviewed and reclassified, using published criteria for proliferative disease. Prognostic significance was assessed by relating the pathologic findings to the development of breast cancer observed during an average 21 years of follow-up, in which time 157 women developed the disease. RESULTS: Benign proliferative changes were recognized in 85% of the patients, with a corresponding relative risk of subsequent carcinoma equal to 2.2 times population rates (95% confidence limits, 1.9 and 2.6). Increasing levels of hyperplasia and atypia in lobules or ducts were associated with modest increases in risk, ranging from 2.1 to 2.3 to 3.0 for proliferative changes with no atypia, mild atypia, and moderate to severe atypia, respectively. This trend was not statistically significant. The most significant risk indicators in this study were the presence of adenosis (relative risk, 3.7), and moderate or severe atypia in ducts (relative risk, 3.9). CONCLUSIONS: Benign proliferative breast disease recognized in biopsy specimens is associated with an increased risk of future breast cancer, but fine distinctions among levels of hyperplasia and atypia did not significantly distinguish risk among patients in this study.

Adolescent↗
PubMed1985

Evidence that adrenal oestrogens are not involved in benign breast disease.

We have studied 30 women with symptomatic benign breast disease in order to test the hypothesis that in some it might be caused by an enzyme variant leading to excessive adrenal production of oestrone. Synthetic 1-24 ACTH (Synacthen) was given intramuscularly after overnight suppression with dexamethasone, during the early follicular phase of the menstrual cycle. In no subjects did plasma oestrone levels show a consistent and significant response to ACTH despite the expected consistent rises in androstenedione and cortisol. We conclude that it is unlikely that adrenal oestrogens play a significant role in the pathophysiology of even a minority of patients with benign breast disease.

Adult↗
PubMed1989

[Determining binding proteins of progesterones in patients with breast diseases].

We estimated serum levels of progesterone and the most important binding proteins in follicular and luteal phase at women without breast disease with biphasic or anovulatory cycle and female patients with benign or malignant breast diseases. There was an increase of the median value of acidic alpha-1-glycoprotein in the luteal phase at female patients with premenopausal breast cancer. The importance of serum levels of the bioavailable sexual steroids for the recognition of women with breast diseases is discussed.

Biological Availability↗
PubMed1991

Smoking habits and risk of benign breast disease.

The relationship between smoking habits and the risk of benign breast disease (BBD) was analyzed using data from a case-control study conducted between 1981 and 1983 in the greater Milan area, Northern Italy. Cases (n = 288) were women with histologically confirmed BBD (203 dysplasia, 85 benign tumours) referred to the National Cancer Institute of Milan for biopsies. Controls were women (n = 291) seen on selected days for a cytological smear for cervical cancer in outpatient clinics of the same Institute. No consistent association emerged between various indicators of smoking habits (smoking status, number of cigarettes smoked per day, duration of smoking) and the risk of BBD. Compared with never smokers the relative risk (RR) of all BBD combined was 0.7 (95% confidence interval, Cl: 0.4-1.3) in exsmokers, 1.4 (95% Cl: 0.8-2.5) in smokers of less than 10 cigarettes per day, and 1.1 (95% Cl: 0.7-1.7) in smokers of 10 or more cigarettes per day. There was some suggestion that the risk may be below unity post-menopause, but the relative risks for smokers were not statistically different in pre- (RR = 1.2; 95% Cl: 0.8-1.8) and post-menopausal (RR = 0.6; 95% Cl: 0.2-1.7) women. The risk of benign tumours (chiefly fibradenoma) was higher in current smokers, but this finding was not statistically significant (RR = 1.5; 95% Cl: 0.9-2.6) and the highest risks were observed in the strata of lighter smokers and those with shorter duration of smoking. Overall these results fail to support a negative association between smoking habits and benign breast disease.

Adenofibroma↗
PubMed1985

An epidemiologic study of fibrocystic breast disease with reference to ductal epithelial atypia.

A case-control study of 255 women with fibrocystic breast lesions and 790 controls was conducted at two hospitals in New Haven, Connecticut during 1977-1979. Cases were found to weigh significantly less than controls, and were more likely than controls to have: a first-degree female relative with a history of breast cancer; a higher level of education; a recent history of regular gynecologic checkups; and (if under age 45 years) a later age at first pregnancy. They were less likely to have had a surgical menopause. The degree of ductal epithelial atypia in breast biopsy specimens was evaluated in order to see whether epidemiologic characteristics differed according to the degree of ductal atypia. The only variable to show a linear relationship with ductal atypia was a recent history of regular gynecologic checkups; those with no or minimal atypia were more likely to have had recent checkups than those with high atypia scores. This study thus gives no evidence that known risk factors for breast cancer are more strongly associated with fibrocystic breast disease with a high degree of atypia than with fibrocystic breast disease with a low degree of atypia. It also provides data to support the belief that women having frequent gynecologic checkups are more likely to be included as cases in case-control studies of fibrocystic breast disease, and particularly in the groups with no or minimal atypia, than those not having frequent checkups.

Adult↗
PubMed1994

Identification of genes expressed in premalignant breast disease by microscopy-directed cloning.

Histopathologic study of human breast biopsy samples has identified specific lesions which are associated with a high risk of development of invasive breast cancer. Presumably, these lesions (collectively termed premalignant breast disease) represent the earliest recognizable morphologic expression of fundamental molecular events that lead to the development of invasive breast cancer. To study molecular events underlying premalignant breast disease, we have developed a method for isolating RNA from histologically identified lesions from frozen human breast tissue. This method specifically obtains mRNA from breast epithelial cells and has identified three genes which are differentially expressed in premalignant breast epithelial lesions. One gene identified by this method is overexpressed in four of five noncomedo ductal carcinoma in situ lesions and appears to be the human homologue of the gene encoding the M2 subunit of ribonucleotide reductase, an enzyme involved in DNA synthesis.

Base Sequence↗
PubMed1988

[Digital noninvasive microwave thermography in the diagnosis of breast disease].

Thermography is a noninvasive technic of examination. Liquid-Crystal Thermography and Infrared Thermography have provided great help in the general survey of breast diseases during the past twenty years but not without some limitations. Recently, by applying the microwave technic clinically, progress has been made to measure minute temperature changes in the deeper tissues. Differential diagnosis of breast disease is possible by statistical calculating the temperature difference of the two breasts. A prospective study was done in 96 women who had both X ray mammography and digital noninvasive microwave thermography. 70/96 were proved by pathology. In this group of patients, the accuracy rate was 70.00% for digital microwave thermography, 81.82% for X ray mammography and 95.50% for the two combined. The false positive rates and false negative rates, advantages, disadvantages and the for general survey of breast disease of the digital microwave thermography discussed.

Adenofibroma↗
PubMed1987

Effects of danazol on incidence of progesterone and oestrogen receptors in benign breast disease.

Results from a continuing clinical trial in benign breast disease indicate that danazol may induce progesterone receptors and that this effect persists after treatment. In women given danazol the number of biopsy specimens that were positive for progesterone receptors rose from 14 out of 31 before treatment to 23 out of 30 at the end of six months' treatment and remained raised at 21 out of 31 six months later. The number of biopsy specimens that were positive for oestrogen receptors rose transiently from eight out of 31 to 12 out of 30 and then fell to six out of 31. A satisfactory clinical response was achieved in 26 of the 31 patients but was maintained in only 11 six months or more after the end of treatment. It was only in this group that a significant and long-standing increase in progesterone receptors was observed. These findings suggest that in some women with benign breast disease who have been treated with danazol changes occur that may have long term benefit.

Adult↗
PubMed2002

Family history of breast cancer, age and benign breast disease.

A major risk factor for breast cancer is having a first-degree family history of the disease. Benign breast disease (BBD), particularly atypical hyperplasia, is also associated with an increased risk of breast cancer. However, the relationship between family history of breast cancer and BBD is unclear. From 1989 through 1997, 80,995 participants in the Nurses' Health Study II were followed; 16,849 reported a first diagnosis of BBD. Pathology slides were reviewed for 1,465 women who reported having a tissue biopsy, and these were classified as nonproliferative BBD, proliferative BBD without atypia or atypical hyperplasia. Women with a family history of breast cancer were more likely to report a physician diagnosis of BBD [rate ratio (RR) = 1.38, 95% confidence interval (CI) 1.29-1.46]. The magnitude of this association declined with age from RR = 1.96 (95% CI 1.55-2.47) at 25-29 years to RR = 1.20 (95% CI 0.95-1.52) at age 45-50 years. Among women with proliferative disease, those with a family history of breast cancer were almost 3 times as likely to have atypia (prevalence odds ratio = 2.72, 95% CI 1.23-5.89) than those with no family history. In conclusion, women with a family history of breast cancer appear to be at increased risk of being diagnosed with BBD, in particular the high-risk types of BBD associated with a greatly increased risk of breast cancer. This link adds weight to the belief that BBD with atypia is a precursor or marker lesion for breast cancer.

Adult↗
PubMedDate not supplied

Benign breast disease.

When faced with a suspicious clinical or mammographic finding, patients may be anxious about the possibility of breast cancer. Because many of these findings are benign, clinicians attempt to make a rapid and accurate diagnosis to definitively rule out carcinoma. Imaging plays a key role in diagnostic strategies. This article addresses some of the more common benign breast diseases and their differential diagnosis from malignant breast disease.

Biopsy↗
PubMed2002

Dietary fat, fat subtypes, and breast cancer risk: lack of an association among postmenopausal women with no history of benign breast disease.

A recent study among 13,707 postmenopausal women without benign breast disease (BBD) from the Breast Cancer Detection Demonstration Project (BCDDP) cohort found breast cancer risk associated with greater total fat, unsaturated fat, and oleic acid intake. We assessed the associations between cumulative averaged dietary intake from 1980, 1984, 1986, and 1990 with breast cancer risk through 1994 among 44,697 postmenopausal participants without BBD in the Nurses' Health Study (NHS). Multivariate Cox proportional hazard models, with age as the time variable, provided the estimated rate ratios (RRs) with 95% confidence intervals (CIs) from the 14 years of follow-up and the 1,071 breast cancer cases. In the Nurses' Health Study, breast cancer rates over the time period from 1980 to 1994 did not increase significantly with greater total fat [quintile (Q) 5 versus Q1 RR, 0.94; 95% CI, 0.77-1.15], saturated fat (RR(Q5 to Q1), 0.88; 95% CI, 0.70-1.12), unsaturated fat (RR(Q5 to Q1), 1.16; 95% CI, 0.92-1.46), oleic acid (RR(Q5 to Q1), 1.13; 95% CI, 0.81-1.57), linoleic acid (RR(Q5 to Q1), 0.93; 95% CI, 0.74-1.16), trans fatty acid (RR(Q5 to Q1), 0.9184; 95% CI, 0.73-1.13), or energy intake (RR(Q5 to Q1), 0.81; 95% CI, 0.67-0.99). A parallel analysis restricted to the same time period as the BCDDP study did not differ substantially. We found no increase in the rate of breast cancer with greater intake of dietary fat and fat subtypes among postmenopausal women without a history of BBD.

Adult↗
PubMed1997

Molecular forms of prostate-specific antigen in the serum of women with benign and malignant breast diseases.

Using a highly sensitive immunofluorometric procedure, we measured the total prostate-specific antigen (PSA) concentration in 632 sera obtained from female blood donors and women with idiopathic hirsutism, breast cancer or benign breast diseases. A total of 50 sera with total PSA > 15 ng l(-1) were fractionated by high-performance liquid chromatography (HPLC) in order to resolve the two immunoreactive molecular forms, i.e. free PSA (approximately 30 kDa) and PSA bound to alpha1-antichymotrypsin (PSA-ACT, 100 kDa). We found that breast cancer patients have presurgical serum total PSA levels similar to those of blood donors. Total serum PSA concentration decreases with age in women with idiopathic hirsutism, in cancer patients and in patients with benign breast diseases. The major molecular form of PSA in the serum of all normal and hirsute women (n = 15) is PSA bound to the proteinase inhibitor alpha1-antichymotrypsin. The major molecular form in 44% of presurgical cancer patient sera is free PSA. A total of 58% of benign breast disease patients also have in their serum mainly free PSA. We conclude that about half the patients with breast cancer or benign breast diseases have free PSA as the major molecular form in their serum, whereas patients without breast pathologies (normal blood donors, idiopathic hirsutism) have PSA bound to alpha1-antichymotrypsin as the major molecular form. The ratio of PSA/PSA-ACT may have value as a simple biochemical test for diagnosis of breast pathologies including breast cancer.

Adolescent↗