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PubMed2002

[Effects and safety of SERM in animal study].

SERM (estrogen receptor modulator) has the different effects of both estrogen agonist and antagonist depending on the organs. Raloxifene has been developed as a medicine for the treatment of postmenopausal osteoporosis, which reduces bone loss by suppressing bone resorption after ovariectomy (estrogen agonist for bone), while not increasing the proliferation of uterine endometrium or estrogen sensitive mammary cancer (estrogen antagonist for uterus or mamma).

English Abstract↗
PubMed2005

Screening mammography interpretation test: more frequent mistakes.

PURPOSE: To present the mammographic cases most commonly misinterpreted by the participants in the mammography self-test proposed by the Italian Society of Medical Radiology (SIRM) National Congress in Rimini, Italy, 2002, by analysing the findings responsible for errors, suggesting reasons for the errors, and assessing possible inadequacies in the format of the test. MATERIALS AND METHODS: The self-test was performed on the mammograms of 160 cases (32 positive and 128 negative for cancer as confirmed by histology). The mammograms had been taken in the four standard projections and placed on four multi-panel diaphanoscopes, each displaying a set of 40 cases comprising benign and malignant cases in equal proportions. The participants were given pre-printed forms on which to note down their diagnostic judgement. We evaluated a total of 134 fully-completed forms. Among these, we identified the 23 cases most frequently misread by over 15 participants in percentages varying between 40-90%. Of these cases, 10 were malignancies and 13 were negative mammograms. On review, we also assessed the diagnostic contribution of complementary investigations (not available the participants). RESULTS: The 134 fully-completed forms (all of the 40 cases) yielded a total of 5360 responses, 1180 of which (22.01%) were incorrect. Of these, 823 out of the 4288 cases expected to be negative (19.2%) were false positive, and 357 out of the 1072 cases expected to be positive (33.3%) were false negative. As regards the 23 most frequently misread cases, these were 10/32 (31.25%) mammograms positive for malignancy and 13/128 (10.15%) negative mammograms or mammograms showing benign disease. The 10 malignancies included 7 infiltrating ductal carcinomas, 1 infiltrating cribriform carcinoma, 1 infiltrating tubular carcinoma, and 1 carcinoma in situ. The 13 cases of benign disease--as established by histology or long-term follow-up--mistaken for malignancies by the test participants were fibrocystic breast disease in 5 cases, surgical scar in 1 case, ABBI scar in 1 case, radial scar in 2 cases, microcalcifications that had remained stable for years in 2 cases, focal sclero-adenosis in 1 case and sclero-elastosis in 1 case. CONCLUSIONS: The errors were due to microcalcifications, benign disease simulating a neoplasm, overlapping tissue, visibility of a lesion in one projection only, lesion site in relation to the corpus mammae, missed areas of asymmetry. Attention must be paid to these signs of focal breast disease since, if correctly evaluated, they enable the early diagnosis of low-grade carcinomas that frequently carry a favourable prognosis.

Adenocarcinoma↗
PubMed2005

Application of restriction fragment differential display-polymerase chain reaction in study on differential expression profiles of human diseases.

OBJECTIVE: To establish the restriction fragment differential display-polymerase chain reaction (RFDD-PCR) as an efficient technique for constructing and studying the gene expression profile of human tissues. METHODS: The tissues of mamma adenocarcinoma (T), cancerometastasis lymph node (L) and normal mammary (N) from one mammary infiltrating ductal carcinoma case were collected, and the gene expression profile of each kind of tissue was constructed using RFDD-PCR technique at equal pace according to the operating manual of Qbio-gene Company. Then all fragments of the three gene expression profiles were separated and displayed by electrophoresis. With the use of gene database at the website http://www.Qbio-gene.com/display, the authors identified the names of the probable fragments by bioinformatics analysis. Through comparison of the three profiles, the numbers and types of most differentially expressed gene fragments were displayed. RESULTS: The expression profiles of the three kinds of tissue have been constructed covering 1716 fragments of mammary adenocarcinoma, 1769 of cancerometastasis lymph nodes and 1922 of normal mammary tissue. Among these 5407 fragments, 39.39% were exactly the same. While 33.9% sequences of T and L showed differences in abundance or presence, 40.9% of T and N and 39.6% fragments of L and N were observed differentially expressed. These differentially expressed gene fragments were found to relate with metastasis, differentiation, inflammation and so on. CONCLUSION: RFDD-PCR is an efficient technique for research in human diseases genomics as a mass screening for complete gene expression profile with high-flux. Through comparison among three or more profiles, the screening for candidate genes of a certain disease can be accomplished, and there is probably a chance to identify novel gene or expressed sequence tag.

Adenocarcinoma↗
PubMed2005

[New view in the mammary asymmetry treatments].

AIM: Breast asymmetry is a huge chapter of breast abnormalities. Surgical therapy is the exclusive one. The breast of women can vary in shape, volume and position, thus creating esthetic, social and psychological problems. METHODS: We classified breast asymmetry into 6 categories and then we treated them with different surgical techniques: reduction mammaplasty according to Planas; augmentation mammaplasty with prosthesis; grafts or both; ultimately mamma-prosthesis (association of mastopexy and prosthesis). We obtained satisfactory esthetic results often with one surgery procedure. Rarely we performed 2 or more procedures of symmetry. We treated 77 patients suffering from breast asymmetry. We excluded in this study the giant-mammary asymmetry (anomaly determined by severe and asymmetric mammary hypertrophy). RESULTS: We found a low number of complications at short and long term. These results are likely due to the ability of the surgeon in the appropriated preoperative evaluation of the patients and of their expectancy and correct surgical techniques. CONCLUSIONS: We tried to obtain 3 results: shape and position of the sick breast as same as possible to the contralateral breast and less evident scars located in hidden regions.

Adolescent↗
PubMed2005

Human cancer cells exhibit in vitro individual receptiveness towards different mistletoe extracts.

In vitro cytotoxic effects of three aqueous mistletoe extracts on cell physiology against different human tumor cell lines and primary cancer cells were investigated in order to compare the receptiveness of different cancer cells against different mistletoe products. Therefore cell proliferation (BrdU-incorporation assay), mitochondrial activity (MTT-testing) and necrotic cell toxicity (LDH assay) were assayed over serial dilutions of the test products. Data obtained with HELA-S3, MOLT-4, MFM-223, COR-L51, KPL-1 and VM-CUB1 tumor cell lines and Iscador M (20 mg/ml), Iscador Q (20 mg/ml) and Abnobaviscum Fraxini -2 (20 mg/ml) indicated significant growth-inhibition of all cell lines, but also different cell susceptibilities against the different extracts. These variations were not only monitored on established cell lines but also on primary mamma carcinoma cells from surgical resectates. Concerning cell proliferation and mitochondrial activity Abnobaviscum Fraxini exhibits stronger inhibitory effects compared to products from the Iscador series. In case the evaluation was standardized on the active contents of VAA-I within the different products, the Iscador extracts possess higher cytotoxic activity. Pure viscotoxins and mistletoe lectins exhibited less effects than the extracts. The simultaneous presence of pure mistletoe lectins and mistletoe polysaccharides diminished the VAA-mediated cytotoxic effects. The presence of fetal calf serum (FCS) in cultivation media during in vitro testing diminished the cytotoxic effects of mistletoe extracts. It was shown that in vivo application of mistletoe preparations led to the formation of antibodies against unknown compounds of the extracts, diminishing the cytotoxic effect.

Antineoplastic Agents, Phytogenic↗
PubMed1992

[Doppler ultrasound study of breast tumors using color Doppler ultrasound, duplex ultrasound and the CW Doppler ultrasound].

The preoperative examinations by doppler-sonography of 83 patients with tumors of the breast are presented. The examinations are done with newest technique: duplex-sonography in slow-flow-technique (AI 3200, Dornier); colour-sonography in MEM-technique (AI 5200, Dornier) and synchronical colour-doppler++ (Quantum 2000, Siemens) and CW-doppler-sonography (Vasocope 3, Kranzbühler). There is a markable difference between the side of carcinoma and the normal side as well as pre- and postmenopausal patients. No difference is shown in cases of benign tumors and the normal side. The increasing blood flow of a malignant tumor is showed in changing the doppler parameters (A/B-ratio and resistance-index) and in the doppler wave form. The number of vessels found in or around a tumor is not a good criteria to find malignant diseases, the best criteria is the difference between sides of the mamma.

Blood Flow Velocity↗
PubMed1992

[Late diagnosis of advanced breast cancer--a challenge for health services].

From 1982 to 1987, 1,637 cancers of the breast were diagnosed in Oslo. 235 were classified as advanced according to one or more of the following criteria: tumour size greater than or equal to 5 cm (T3) or T4, metastasis within 4 months, pathological diagnosis pT3, pT4 or pN2. These were further studied. The distribution of women with advanced cancer mammae was uneven. For no obvious reason, incidence was significantly higher in one out of four hospitals in Oslo. 169 of the patients discovered the tumour themselves. Many patients delayed seeking help. 93 waited for more than eight weeks before doing so. For patients with metastasis at time of diagnosis, survival was slightly more than one year, and for patients without metastasis it was four and a half year. The length of stay in hospital increased with increasing admissions.

Adult↗
PubMed1991

[Malignant cystosarcoma phyllodes].

In this paper we report a case of cystosarcoma phyllodes malignum in a 45 years old female patient. A local relapse occurred 20 months after ablatio mammae. This tumor was histologically a benign fibroadenoma. 69 months postoperative metastases of the pleural diaphragma were found: the appearance was similar to that of a mesothelioma. The CEA was helpful in revealing the metastases and in indicating the progression. This case is discussed and compared to the review of the literature. Because of the high rate of local relapses a postoperative irradiation of the chest wall is proposed.

Breast Neoplasms↗
PubMedDate not supplied

Options and limits of surgery after pre-operative chemotherapy in breast cancer.

The primary administration of chemotherapy leads to a reduction in size of tumors, increasing the possibility of breast-conserving surgery in both locally advanced, inoperable and primary operable mamma carcinomas. This, however, increases the rate of local relapse and the rate of mastectomy over the course of the disease, even although the EUSOMA guidelines are not exceeded. Whether the pre-surgical administration of chemotherapy with pathological complete remission actually increases the disease-free rate and overall survival remains to be determined. Further clinical studies are required to establish the reliability of sentinel lymph-node biopsy; currently, axillary lymphadenectomy is still the standard therapy. The response of the tumor to therapy, in correlation with predictive factors and the molecular-genetic profile, could make more individualized treatment regimes possible in the future.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[The criteria and place of limited surgery in treating breast cancer].

The evolution of conceptions regarding the treatment of "operable" mammary cancer has balanced during the past 25 years between amputation of the mamma and non-mutilating treatments. The main achievements concerning the evolution of this site of cancer, as well as the selection criteria for a limited operation, such as they result from the literature and from the studies performed by the authors, are pointed out. These criteria, although numerous, should be very rigorously observed. The cooperation surgeon-radiotherapist-anatomo-pathologist is absolutely compulsory. Authors report 16 cases of women with mammary cancer, in 9 of whom the criteria were carried out. The results obtained are for the time being favourable but as the group is very small, definitive conclusions cannot be drawn.

Breast Neoplasms↗
PubMed2002

[Reduction mammaplasty in Reykjavik, Iceland 1984-1993; An outcome analysis.].

UNLABELLED: Breast reduction is an established and effective operation in reducing symptoms of macromastia (Hyperplasia mammae). This is one of the most common operation done by plastic surgeons today. OBJECTIVE: The purpose of this retrospective descriptive analysis was to determine the results of bilateral reduction mammaplasty in the period 1984-1993, at the department of Plastic Surgery, National University Hospital, Reykjavík, Iceland. MATERIAL AND METHODS: Three plastic surgeons performed most of the operations (96%) and used different operation methods. Data from 277 patient charts was reviewed, and a total of 258 women were included in the study. Calculation of the complication rate was made for the whole group and each surgeon. A questionnaire form was sent to all of the 258 women that underwent bilateral reduction mammaplasty due to macromastia. Preoperative symptoms, the experience of the operation and lastly the patients opinion of the overall result of the operation were evalueted. 195 (75.5%) of the patients responded. RESULTS: 28 patients or 11.5% had major complications (needed reoperation) and 69 patients or 28.5% had minor complications. The minor complications healed in a short time (a few weeks), but it is possible that the surgeons did not register all the minor complications equally. Of the major complications half needed reoperation within the first two days because of bleeding/hematoma and the other half needed reoperation later for other resons. The rate of major complications varied from 9% to 14.5% between the surgeons. The most common complication was necrosis of the skin (39% of the complications). Other common complications were minor wounds (18.5%), bleedings (15.5%), infections (11.5%), and dehiscence (8%). Data from the questionnaire indicated that 94% of the patients had physical symptoms and 82% had also emotional symptoms preoperatively. 81% thought the overall result was very good or good. 44% of the patients thought the main disadvantage of the operation was scar appearance. 84% thought the operation met their expectations in all (50%) or most regards (34%). 91.5% of the women would recommend operation to a friend. 66% said that macromastia was in the family. CONCLUSION: The overall results of this study indicate that reduction mammaplasty is an effective method in relieving symptoms due to macromastia and that, despite the complications, the majority of the operated women were pleased with the results.

English Abstract↗
PubMed2006

[Impacts and impact mechanisms of "dioxins" in humans and animals].

"Dioxins" are used to specify polychlorinated dibenzo-p-dioxins (PCDD), dibenzo-furanes (F) and dioxin-like polychlorinated biphenyls (PCB's). Many of the congeners proved to be highly toxic; 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD) is the most toxic congener, and probably the most toxic compound ever synthesized by man (the natural occurance of this substance is very low). The total concentration/-toxicity of a mixture of congeners (WHO-PCDD/F-TEQ, or including the PCB's WHO-PCDD/F-PCB-PCB-TEQ) is calculated by addition of the individual concentrations multiplied by respective toxicity equivalence factors TEF; the most toxic congener TCDD is defined as 1. The tolerable weekly intake TWI set by the European Commission is 14pg WHO-PCDD/F-TEQ/kg bw. The "body burden" of adults in industrial countries is about 2-6 ng WHO-PCDD/F-TEQ/kg bw., or about double this value if PCB's are also considered. There is a very broad range of toxic effects of "dioxins". Many of the congeners can induce toxic responses at very low "body burdens". The most sensitive effects are immunosuppression, developmental and reproductive toxicity, as well as neurological behavioral effects. These effects occur at "body burdens" whih are close to background exposure of the human. Cancerogenic effects are induced at higher exposure (Seveso, industrial exposure). TCDD was considered a "complete carcinogen" by the IARC (Group 1). There is a broad range of carcinogenic effects, and there is no "hallmark" effect. Most toxic effects induced by TCDD are mediated by binding to the Ah-receptor (Ah-R) which binds together with a second protein, ARNT, to the respone elements of a number of target genes, and thus modulates gene expression. "Dioxins" are strong promotors, but weak initiators. The multitude of interactions of the Ah-R and ARNT ("receptor cross-talk") results in numerous molecular and cellular effects. The TCDD-Ah-R complex can also bind to the response element of the estrogen receptor, and thus can block the effects of es-trogens. This explains the fact that TCDD can be an estrogen antagonist reducing or preventing mamma carcinoma. Other Ah-R ligands occur in vegetables (e.g. indoles, flavones) and will possibly be developed in the future as functional substances. PCB's have similar properties to TCDD if they can exist in a planar configuration (dioxin-like PCB's). The non-dioxin-like PCB's always occur together with "dioxins"; their toxixty cannot be adequately determined although they occur in high concenrations. The consumption of food contaminated with "dioxins" need not directly lead to a toxic effect. Due to the continous cumulation of "dioxins" repeated ingestion of contaminated food could result in an increase of the "body burden" and thus chronic toxicity. This shows that the exposure of the human to dioxins should be minimized wherever possible.

Animals↗
PubMed2006

[Analysis and treatment of the complications post polyacrylamide hydrogel injection for augmentation mammaplasty].

OBJECTIVE: To inquire into the reason why the postoperative complications of augmentation mammaplasty by injecting polyacrylamide hydrogel took place and to find the best method to deal with the complications. METHODS: 12 patients who accepted polyacrylamide hydrogel injection for augmentation mammaplasty were included in this study. Operations were performed to remove the polyacrylamide hydrogel. RESULTS: All patients didn't argue with the result, but the outside shape of mamma was not good post-operation. CONCLUSIONS: So-called standard injection method can't avoid the postoperative complications. The considerable therapy for the complications of polyacrylamide hydrogel was removing it by operation.

Acrylic Resins↗
PubMed1991

Antigens recognized by two human monoclonal IgM anticolon cancer antibodies, 16.88 and C-OU1 (B9165).

We have compared by SDS-PAGE Western blotting the molecules detected by two human monoclonal antibodies, C-OU1 and 16.88. The antibodies have previously been shown to detect a cytoplasmatic antigen with an Mr of 43 kD present in colon adenocarcinoma cell lines and in colon cancer tissues. We now demonstrate that these antibodies differ significantly in their fine specificity, resulting in a quite dissimilar tumor selectivity. The antibody 16.88, in addition to reactivity with the 43-kD molecule, also recognizes a 190-kD molecule present both in melanoma cells and in cells previously reported as 16.88 antigen positive. The 16.88 antibody does not detect a 43-kD molecule in extracts of melanoma cells. The 190-kD component was not detectable in hepatoma or mamma carcinoma cells, both of which showed presence of the 43-kD molecule. The C-OU1 antibody shows no reactivity with the 190-kD molecule in any of the cells tested or with other proteins in melanoma cells. Radiolabeled 16.88 antibody shows better localization to melanoma cancer than to colon cancer xenograft transplanted onto nude mice. These findings indicate the presence of a tumor-associated antigen not previously described and have obvious implications for potential clinical uses of the antibodies.

Animals↗
PubMed1976

[Diagnosis of breast carcinoma. Value of x-ray findings for the diagnosis of carcinoma in situ of the breast from the clinical point of view].

The x-rays-results of 35 mammae with a carcinoma in situ are presented and compared with those of 2 groups without carcinoma. In contradiction to invasive malignancies the carcinoma in situ do not show pathognomonic signs on x-ray examination. However, suspicion is raised by the appearance of microcalcifications and by striped differences in tissue density. These findings should compell to perform a biopsy, even though the clinical and roentgenologic findings may otherwise suggest a fibrocystic disease. Therefore, provided the discrete signs described in this paper are carefully considered, the technique of mammography may contribute to the pre-operative presumptive diagnosis of carcinoma in situ.

Adult↗
PubMed1991

[Optimization of verification photographs in thoracic wall irradiations (so-called tangential field technique) in breast carcinoma. A short technical-methodical report].

When irradiating under high voltage condition, verification photographs prove to be difficult to take if the Gantry position is not aligned to 0 degree respectively 180 degrees, since the patient is being irradiated diagonally. Under these conditions it is extremely difficult to align the X-ray-cartridge vertically to the central beam of the therapeutic radiation. This results in, amongst others, misprojections, so that definite dimensions of portrayed organ structures become practical impossible to determine. This paper presented describes how we have solved these problems on our high voltage units (tele-gamma cobalt unit and linear-accelerator). By using simple accessories, determination of dimensions of organ structures, as shown on the verification photographs, are made possible. We illustrate our method by using the so-called tangential fields technique when irradiating mamma carcinoma.

Breast Neoplasms↗
PubMed1991

[Breast-preserving surgery in breast carcinoma. 10-year experiences].

From 1979-89, 211 women with cancer mammae were irradiated at the Norwegian Radium Hospital after breast-conserving surgery performed at different hospitals in Norway. 181 of these patients were called in for re-examination to check the procedures for treatment and the cosmetic results. Only 37% of the patients had undergone mammography prior to surgery and 48% of the patients had had two or more operations before the irradiation. The cosmetic results were not very satisfactory in 45% of the patients. Reduced cosmesis was mainly due to less than optimal surgery. We propose better standardisation of the treatment programme for breast preservation. Optimal results require close collaboration between radiologists, surgeons, oncologists and pathologists. The treatment must be organized in a way that facilitates this collaboration.

Adult↗
PubMedDate not supplied

Expression of oncogenes in human breast cancer specimens.

More than 60 breast cancer specimens were screened for their expression status of 25 different proto-oncogenes. The screening method is based on in vitro synthesis of a radioactive cDNA copied from the total cellular RNA of tumor tissue. This cDNA is hybridized to cloned oncogene probes which are immobilized to a GeneScreen membrane. Frequently multiple oncogenes were found expressed although expression levels were rather moderate. 25-30% of the analyzed tumors showed significant expression of either erbB, src, raf1, lck or H-ras. Although neu expression--an oncogene believed to be particular relevant as prognostic parameter for mamma carcinoma--was screened for most of the tumors with a heterologous gene probe, expression signals could be detected in about 20% cases. The only notable correlation with classical clinical parameters such as tumor size and proliferation stage, hormone receptor status and different DNA indices was the observation that tumors lacking the progesterone receptor frequently express multiple oncogenes. Advantages and limitations of the cDNA/dot-blot screening for oncogene expression are discussed.

Animals↗