Epidemiology and endocrinology of benign breast disease.
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The levels of cyclic adenosine 3':5'-monophosphate (cAMP) and cyclic guanosine 3':5'-monophosphate (cGMP) were studied in dimethylbenz(a)anthracene (DMBA)-induced mammary tumors of Sprague-Dawley rats and in human breast cancer. In the rat carcinomas, these levels were significantly lower than in non-malignant tissues when calculated on the basis of DNA content, but higher (cAMP) or equal (cGMP) when calculated on the basis of weight. In human breast cancer the cyclic nucleotide levels were higher than in non-malignant tissues according to both methods of calculation. No correlation was found in human carcinomas between the cyclic nucleotide levels and mitotic index, nuclear grade, tumor size, or lymph node involvement. The rat tumors were subclassified according to state of differentiation, mitotic index, and state of development. Not all the sub-groups had cAMP levels different from normal values. Differences in cAMP levels between the sub-groups could not be correlated with tumor growth rates and/or mitotic index. Thus, cyclic nucleotides may not be useful in prognosis of breast cancer.
Fine needle aspiration cytology (FNA) was performed on 168 breast masses. In all cases aspirates were reacted with monoclonal antibody (MAb) B72.3 using the ABC immunoperoxidase technique. MAb B72.3 demonstrated reactivity in nine of 90 malignant cases in which the cytologic diagnosis was not positive. In eight benign cases in which the cytopathologist made a suspicious diagnosis, MAb B72.3 demonstrated cytoplasmic reactivity in only one case. In three cytologically benign cases MAb B72.3 reacted strongly positive. The overall diagnostic accuracy of this immunoperoxidase technique was approximately 95 percent. In about five to 10 percent of cases, monoclonal antibody B72.3 can be a valuable diagnostic adjunct to routine cytopathologic diagnosis. False positives present pitfalls that must be considered.
The purpose of this study was to assess the influence of caffeine on the incidence of benign mammary tumors in carcinogen (DMBA) treated female Sprague-Dawley rats. Four different animal models were used in these studies, i.e., the administration of DMBA to: [1] 55 day old virgin rats; [2] 53 day old ovariectomized, estrogen treated virgin rats; [3] 135 day old virgin rats and [4] 135 day old parous rats. A high incidence of benign mammary fibroadenomas was observed in each of the four animal models. In addition, in the estrogen treated ovariectomized animals, a high incidence of secretory mammary gland cysts was observed. Caffeine (500 mg/L drinking water) was administered daily throughout the study commencing 3-31 days after carcinogen treatment. Caffeine treatment significantly (P less than 0.05 to P less than 0.001) reduced the incidence of benign mammary fibroadenomas in the 55 day old virgin rat model (P less than 0.01), in the 53 day old estrogen treated ovariectomized virgin rat model (P less than 0.05 to P less than 0.001) and in the 135 day old virgin rat model (P less than 0.05). The number of benign mammary fibroadenomas was reduced by caffeine in the 135 day old parous rat model but this reduction was not significant (P less than 0.10). In addition, in the estrogen treated ovariectomized virgin rat model, caffeine significantly (P less than 0.05 to P less than 0.001) reduced the incidence of mammary gland cysts. Caffeine treatment either increased or had no significant effect on body weight gains, depending upon the animal model.(ABSTRACT TRUNCATED AT 250 WORDS)
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We interviewed 33 women with non-puerperal galactorrhea, 5 (15%) of whom had HPRL levels greater than 18 ng/ml and 24 controls, namely women with benign breast lesions. We used a semi-structured interview covering the duration of symptoms, preceding life events and the effect on the relationship of the couple. We also used the Beck depression inventory, the Strauss and Appelt body image questionnaire and an 8 item Visual Analogue Scale (VAS). Galactorrheic women were more depressive (P less than 0.1), had more prior life events (P less than 0.001), longer duration of symptoms (P less than 0.01), and less fear of their disease (P less than 0.05) than did controls. Both groups had similar results with the body image questionnaire. Within the study group, results were independent of prolactin (HPRL) levels or amenorrhea.
Malignant endometrioid cystadenofibroma is recognized as a distinct category of epithelial ovarian cancer and yet is rarely reported. Three patients from the University of North Carolina experience are described to emphasize similarities between this unusual tumor and common epithelial ovarian cancer with respect to clinical behavior, surgical staging, and treatment.
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Two patients with adenofibromyomatous hyperplasia located at the distal end of the extrahepatic bile duct are reported herein. The chief symptom in both patients was upper abdominal pain and the lesions found involved the proliferation of submucosal mucous glands and fibrous elements. Further progress in imaging diagnostic techniques would increase the frequency with which such lesions are discovered. But, even now, if mural irregularities and shadow defects are found in the extrahepatic bile duct, particularly in the distal end of the common bile duct, the possibility of a benign lesion such as adenofibromyomatous hyperplasia should be taken into consideration when making a diagnosis.
A 47 year old woman with two isolated lumps in her right breast underwent an excisional biopsy and the histological findings of both lesions revealed fibroadenoma with an in situ lobular carcinoma. Patey's modified radical mastectomy was performed after which careful follow-up was continued. To date, a total 161 cases of carcinoma arising in a fibroadenoma have been reported in the world literature and a review of these literature is given following the case report.
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Dose-related effects of long-chain highly unsaturated n-3 fatty acids on the development of N-nitrosomethylurea (NMU)-induced rat mammary tumors were assessed in female F344 rats. Four test groups (36 rats/group) were fed the following high-fat (HF) diets (23% fat, w/w): Group 1, 18% menhaden oil (MO) and 5% corn oil (CO); Group 2, 11% MO and 11.8% CO; Group 3, 5% MO and 18% CO; Group 4, CO alone. A fifth group, serving as an internal control, was fed a low-fat diet containing 5% CO alone. Experimental diets were begun after initiation with NMU, and the experiment was terminated 31 wk later. Total tumor numbers in the five groups were 28, 16, 32, 26 and 11, respectively, indicating that the promotion phase of NMU-induced carcinogenesis was significantly suppressed only when equal parts of CO and MO (Group 2) were fed or when CO alone was fed at 5% (w/w). At high (Group 1) or low (Group 3) levels of MO, tumor numbers were indistinguishable from the HF CO group (Group 4). The same pattern was observed when assessed in terms of cumulative tumor incidence and multiplicity. However, when expressed in terms of final tumor incidence, dietary MO did not suppress tumor promotion in a statistically significant fashion at any concentration. Animals fed MO gained weight at the same rate as those fed CO, indicating that the presence of MO in the diet did not result in food avoidance behavior. Measurement of total serum cholesterol indicated an inverse trend with respect to the MO content of the diet.(ABSTRACT TRUNCATED AT 250 WORDS)
Female rats have been fed high fat diets containing either polyunsaturated or saturated fat. After being fed either of the diets for 4 weeks, some of the animals received an intragastric dose of 7,12-dimethylbenz(a)anthracene (DMBA). At this point, the diets of half of the animals were interchanged so that animals previously fed the polyunsaturated fat diet were fed the saturated fat diet and vice versa. The cumulative incidence of tumor-bearing rats among DMBA-dosed rats was greater when the polyunsaturated fat diet was fed. The mean induction time of tumors decreased and the proportion of tumor-bearing rats which developed malignant tumors increased when the polyunsaturated fat diet was fed. This promotional effect of the polyunsaturated fat diet was exerted only when the diet was fed after DMBA administration.
Rapid proliferation of mammary epithelial cells derived from biopsy specimens of human fibroadenomas was observed when medium was supplemented with ten percent fetal bovine serum and hydrocortisone (5 microgram per ml-1). Hydrocortisone in combination with FBS also led to a 2.5-fold increase in cell cluster attachment and subsequent colony formation. A similar effect was not observed with human serum. In contrast to fibroblast cell systems, insulin did not significantly alter cell growth. The results show that a mitogenic response to glucocorticoids by mammary epithelium may depend on the presence of factors in sera.