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PubMed1990

Intraductal breast carcinoma. Review of a multicenter series of 350 cases. Coordinating Center and Writing Committee of FONCAM (National Task Force for Breast Cancer), Italy.

A multicenter series of 350 intraductal breast cancers (DCIS) is reported. Mammography was the most sensitive test but suspicion arose only at palpation in 13% of cases whereas in 10% of cases biopsy was recommended for a benign lesion and DCIS was an unexpected finding. Mammography, physical examination and cytology must be combined to achieve optimal sensitivity. Systematic biopsy of apparently benign masses would increase DCIS detection rates but the cost-effectiveness of such a policy is questionable. A trend of conservative surgery was evident over time (from 1968-79, 28%; 1985-1989, 50%) but breast irradiation followed only in one fourth of the cases. The local recurrence rate was significantly higher in cases of limited surgery (with or without irradiation) with respect to mastectomy (1.2 vs 0.2 x 100 patient-years at risk). Most recurrences (7 of 8) in the conserved breast were infiltrating, but no recurrence was seen in subclinical DCIS cases. Three patients died of breast cancer after local recurrence in the conserved breast (2 cases) or mastectomy scar (1 case). Eligibility for conservative surgery of DCIS needs to be carefully discussed to avoid under-treatment. Contralateral breast cancer was recorded in 44 cases and the incidence of further metachronous cancer to the other breast was ten times higher than expected in normal breasts. Four patients died of contralateral breast cancer, free of ipsilateral recurrence. A careful follow-up of the contralateral breast in DCIS cases looks as important as surveillance of the conserved breast.

Adult↗
PubMed1998

Family history and treatment outcome in young women after breast-conserving surgery and radiation therapy for early-stage breast cancer.

PURPOSE: To evaluate the safety and efficacy of breast-conserving therapy for young women with a family history (FH) suggestive of inherited breast cancer susceptibility. MATERIALS AND METHODS: A total of 201 patients aged 36 or younger at diagnosis treated with breast-conserving surgery and radiation therapy (> or = 60 Gy) for early-stage breast cancer were categorized by FH. FH was considered positive in 29 patients who, at the time of diagnosis, had a mother or sister previously diagnosed with breast cancer before age 50 or ovarian cancer at any age. Clinical, pathologic, and demographic variables; sites of first failure; disease-free survival; and overall survival (OS) were compared between FH-positive and -negative groups. Median follow-up time was 11 years. RESULTS: Patient and tumor features were similar between those with and without an FH. Regression analysis of sites of first failure at 5 years demonstrated a risk ratio (RR) of 5.7 for opposite breast cancer for FH-positive patients. Rates of local, regional, and distant failure and disease-free survival or OS did not differ between FH-positive and -negative patients. Age at diagnosis and Ashkenazi heritage were not significantly predictors of patterns of failure. CONCLUSION: Breast-conserving surgery combined with radiation therapy is not associated with a higher rate of local recurrence, distant failure, or second (non-breast) cancers in young women with an FH suggestive of inherited breast cancer susceptibility compared with young women without an FH. However, their increased risk of opposite breast cancer should be taken into account when considering breast conservation as a treatment option.

Adult↗
PubMed2004

Risk of breast cancer and breast cancer characteristics in women after treatment for Hodgkin lymphoma.

Radiotherapy is important in the treatment of Hodgkin lymphoma. Although the risk of recurrent Hodgkin lymphoma decreases in long-term survivors, the incidence of radiation-induced cancers increases with time. Breast cancer is the main long-term concern for women. Risk factors associated with breast cancer development include age at irradiation, time since treatment and radiation dose received. The risk of developing breast cancer appears to be limited to women treated before age 30 years. The median time to breast cancer after radiotherapy is 15 years. Higher radiation doses are associated with higher risks. While the histology of breast cancers occurring after treatment for Hodgkin lymphoma appears similar to that of spontaneously occurring breast cancers, the age at diagnosis in these women is significantly younger, often at an age before regular breast screening is implemented. In this article, we review findings from retrospective studies on Hodgkin lymphoma and breast cancer including the risk factors, breast cancer characteristics, breast cancer management and options for primary and secondary prevention. The treatment goals for young female patients with Hodgkin lymphoma include: 1) manipulation of radiation dose and fields without compromising the outcome of the primary malignancy; 2) possible reversible manipulation of hormonal status without permanent effects on fertility; and 3) development of nonsurgical options for primary prevention of radiation-induced breast cancers. Carefully designed studies addressing these strategies and their interplay are needed.

Age Factors↗
PubMed2005

Longitudinal investigation of the relationship between breast milk leptin levels and growth in breast-fed infants.

BACKGROUND: It has been shown that leptin is present in breast milk and human mammary epithelial cells are able to synthesize leptin. It has been suggested that leptin in human milk might be involved in the regulation of postnatal nutrition and growth. AIMS: To investigate whether there is a relationship between leptin levels in human milk and weight gain in the postnatal period and to compare variations of milk-borne maternal leptin concentrations for small for gestational age (SGA), large for gestational age (LGA) and appropriate for gestational age (AGA) infants. INFANTS AND METHODS: Forty-seven healthy lactating women aged from 17-38 years and their infants were included in the study. The infants were separated into three groups according to birth weight as SGA (n = 11), LGA (n = 14) and AGA (n = 22). All infants were fed with breast milk during the study period. Anthropometric measurements were performed on the 15th day of life and at 1, 2, and 3 months of age, and the body mass index (BMI) of the infants' mothers was calculated. Breast milk leptin levels were analyzed by radioimmunoassay. RESULTS: Breast milk leptin levels were found reduced in the SGA group and increased in the LGA group compared to the AGA group at 15 days of life (13.4 +/- 2.2, 28.5 +/- 4.4 and 18.4 +/- 2 ng/ml, respectively; p <0.05). At 1 month of age, leptin levels in breast milk were significantly lower in the LGA group than in the AGA group (15.5 +/- 4.9, 19.4 +/- 1.7 ng/ml, respectively; p<0.05). There was no difference among the three groups at 2 and 3 months of age (p>0.05). There was a positive correlation between birth Weight and breast milk leptin levels on the 15th day (r = 0.47, p = 0.001). A negative correlation was found between weight gain during the first 15 days and 1 month of life and breast milk leptin levels on the 15th day (r = -0.44, p = 0.002; r = -0.40, p = 0.005, respectively). No relationship could be determined between breast milk leptin levels and BMI of the mothers. CONCLUSION: Maternal milk of SGA, LGA and AGA infants had different leptin levels, especially during the first month of life. More rapid growth was shown in the SGA infants during the first postnatal 15 days compared to AGA and LGA infants, and human milk leptin levels were significantly reduced in the SGA group. However, LGA infants gained more weight during the second 15 days of life and breast milk leptin levels were dramatically decreased in LGA and increased in SGA infants at the end of first month of life. These findings suggest that the presence of leptin in breast milk might have a significant role in growth, appetite and regulation of nutrition in infancy, especially during the early lactation period, and the production of leptin in breast tissue by human mammary epithelial cells might be regulated physiologically according to necessity and state of the infant.

Adolescent↗
PubMed2002

CBFA2T3 (MTG16) is a putative breast tumor suppressor gene from the breast cancer loss of heterozygosity region at 16q24.3.

Numerous cytogenetic and molecular studies of breast cancer have identified frequent loss of heterozygosity (LOH) of the long arm of human chromosome 16. On the basis of these data, the likely locations of breast cancer tumor suppressor genes are bands 16q22.1 and 16q24.3. We have mapped the CBFA2T3 (MTG16) gene, previously cloned as a fusion partner of the AML1 protein from a rare (16;21) leukemia translocation, to the 16q24.3 breast cancer LOH region. The expression of CBFA2T3 was significantly reduced in a number of breast cancer cell lines and in primary breast tumors, including early ductal carcinomas in situ, when compared with nontransformed breast epithelial cell lines and normal breast tissue. Reintroduction of CBFA2T3 into different breast tumor derived cell lines with decreased expression of this gene reduced colony growth on plastic and in soft agar. CBFA2T3 was shown to function as a transcriptional repressor when tethered to the GAL4 DNA-binding domain in a reporter gene assay and, therefore, has the potential to be a transcriptional repressor in normal breast epithelial cells. Taken together, these findings suggest that CBFA2T3 is a likely candidate for the breast cancer tumor suppressor gene that is the target for the frequent 16q24 LOH in breast neoplasms.

Breast Neoplasms↗
PubMed2002

High-risk screening: multi-modality surveillance of women at high risk for breast cancer (proven or suspected carriers of a breast cancer susceptibility gene).

Familial breast cancer accounts for about 10% of all breast cancer cases. Subjects with mutations in one of the breast cancer susceptibility genes face an about 90% lifetime risk to develop breast cancer. In addition, more than half of the patients will develop breast cancer already before the age of 50, and a significant number even before the age of 35. Screening for familial breast cancer needs to start, therefore, at the age of 30. Detection and differential diagnosis of breast cancer in such a young patient cohort is difficult to achieve with mammography. Our experience with a multi-modality screening program tailored to the needs of these specific high-risk individuals are reviewed in this article. Our data suggest that the prospective use of breast MR imaging offers a substantial increase in tumor detection rates compared to the combined use of two-view mammography and state-of-the-art breast US. Interestingly, the considerable improvement in diagnostic sensitivity as offered by breast MRI was not traded off by a reduced specificity. On the contrary, MRI helped avoid many unnecessary biopsies that have been caused by false-positive high-frequency breast ultrasound findings.

Breast Neoplasms↗
PubMedDate not supplied

Breast cancer risk in symptomatic women spontaneously undergoing clinical breast examination.

Breast cancer (BC) is the most common cancer among women. However, few studies consider the possible relationship between the main breast complaints referred to by non-screened patients and cancer onset. The objective of this study was to evaluate the relationship between the principal breast complaints (breast pain, breast lump and nipple discharge) and the risk of BC. A group of 347 symptomatic women (median age 59 years, range 35-83) with confirmed BC (cases) was age-matched with a population-based group of 351 symptomatic women (controls) who were followed-up for at least three years (median 78 months, range 36-146) to exclude the presence of a missed BC. Breast pain was the most common (p < 0.05) complaint in younger patients (50 years or less = 39.0%, 51-60 years = 51.2%), while breast lump was most common in patients aged > 60 years (65.4%). Since the odds ratio (OR) ranged from 0.80 to 1.20 at a 95% confidence interval (CI) of 0.54-1.80, there was no overall significant association between breast complaints and risk of BC. There was some evidence of increased risk among patients with breast lump (OR = 1.20, 95% CI 0.80-1.80), and no risk in those with breast pain (OR = 0.86, 95% CI 0.54-1.36) and nipple discharge (OR = 0.8, 95% CI 0.37-1.74). In conclusion, a relationship between breast complaints and the onset of BC does not seem to exist.

Age Factors↗
PubMed2004

[Modified radical operation for early breast cancer for preserving nipple-areolar complex and breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap].

BACKGROUND & OBJECTIVE: Modified radical mastectomy (MRM) operation has become an important surgical therapy for early stage breast cancer, but how to reconstruct breast and preserve nipple-areolar complex (NAC) is controversial. In this study, we applied a modified radical mastectomy for early stage breast cancer for preserving NAC and breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap. METHODS: During operation we performed the subcutaneous glandular excision and axillary dissection, and reconstructed the breast using TRAM flap in 10 patients with early stage breast cancer; meanwhile, maximam extent of breast skin and NAC were preserved. RESULTS: The appearance of the reconstructed breast was better preserved after operation. No local recurrence and distant metastasis occurred in the patients during the follow up time (range 24-48 months). No skin flap necrosis, atrophy, and scleroses surround the NAC were observed; and no abdominal wall hernia occurred at the donor site. The nipple sensation was recovered half a year after surgery. CONCLUSION: Modified radical operation for preserving NAC and breast reconstruction using TRAM flap may be a better way for breast cancer patients in early stage who request well preserving of breast. More samples are needed for proving the effects of this operation.

Adult↗
PubMed2004

A prospective study of breast cancer risk using routine mammographic breast density measurements.

Mammographic breast density is a major risk factor for breast cancer but estimates of the relative risk associated with differing density patterns have varied widely. It is also unclear how menopausal status influences this association and to what extent the effects of density are due to its correlation with other risk factors. Most recent investigations of breast density have been case-control studies, which provide indirect estimates of relative risk. We have prospectively followed 61,844 women for an average of 3.1 years to directly estimate risk among women in the four mammographic breast density categories defined by the American College of Radiology's Breast Imaging Reporting and Data System (BI-RADS). The study was population-based and used density assessments routinely made by community radiologists. Cox regression was used to obtain age-adjusted relative risk estimates and to control for other risk factors. Risk increased with density and the risk associated with extremely dense breasts, relative to entirely fatty breasts, was 4.6 (95% confidence interval, 1.7-12.6) for premenopausal women and 3.9 (95% confidence interval, 2.6-5.8) for postmenopausal women. Estimates for pre- and postmenopausal women did not differ significantly. Although breast density was significantly related to body mass index, age at first childbirth, and postmenopausal hormone use (P < 0.001), adjustment for these variables only slightly altered the relative risk estimates. Our results correspond well to those from case-control studies using more quantitative measures of mammographic breast density and suggest that routine Breast Imaging Reporting and Data System density measurements may be useful in models for assessing breast cancer risk in individual women.

Adult↗
PubMed2005

The impact of breast cancer screening on breast cancer registrations in New Zealand.

AIMS: To investigate the impact of the national breast cancer screening programme, BreastScreen Aotearoa, on breast cancer registrations in New Zealand. METHODS: Age-specific breast cancer incidence rates for women aged 50-64 years were compared before and after the establishment of BreastScreen Aotearoa. The degree of spread of breast cancers diagnosed at screening was compared with the degree of spread of breast cancers registered before the introduction of population screening in New Zealand. RESULTS: As expected, there was a marked increase in the age-specific incidence of breast cancer in New Zealand women aged 50-64 years in the first year of screening. There was a shift towards earlier diagnosis in women diagnosed with breast cancer at screening, compared with the diagnosis of breast cancers in women aged 50-64 registered before the introduction of population screening for breast cancer in New Zealand. CONCLUSIONS: BreastScreen Aotearoa has had the expected impact on breast cancer registration for a screening programme that detects breast cancer early.

Age Distribution↗
PubMed2005

The application of breast MRI in staging and screening for breast cancer.

Contrast-enhanced breast magnetic resonance imaging (MRI) is a relatively new but increasingly used modality for the detection of breast cancer. MRI has demonstrated utility in identifying additional tumor foci and extent of disease in patients with known breast cancer. This is especially useful with invasive lobular carcinoma, which is difficult to evaluate on mammography. MRI has been found to identify the primary tumor in 70% to 86% of cases of occult breast cancer. Contrast-enhanced breast MRI has shown some usefulness in the detection of residual cancer following surgery but is limited by postoperative changes. In patients who have undergone neoadjuvant chemotherapy, breast MRI is most accurate in those patients in whom there is little or no response to chemotherapy. The use of contrast-enhanced breast MRlfor breast cancer screening is controversial. It has only been used in afew small studies of high-risk patients. The limitations of breast MRI include uptake in benign lesions and normal tissue, sensitivity for ductal carcinoma in situ, cost, and availability. This paper will discuss the uses, benefits, and limitations of contrast-enhanced breast MRI in the staging and screening of breast cancer.

Breast Neoplasms↗
PubMed2005

[A prospective multicenter clinical trial of breast conserving therapy for early breast cancer in China].

OBJECTIVE: To demonstrate the feasibility of breast conserving therapy (BCT) and establish a multimodality BCT model for early breast cancer in China. METHODS: A prospective multicenter case control study consisting of 4461 patients was carried out by the Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and nine other hospitals across China from November, 2001 to November, 2004, the result of BCT and mastectomy on early stage breast cancer were compared. Patients entry-primary tumor < or = 3 cm, primary tumor in periphery quadrant, pathology showed infiltrating carcinoma and clinical absence of locoregional lymphatic or distant metastasis. Patients rejection-multiple center cancer or diffused malignant calcified spots, previous radical radiation therapy in the chest, accompanying collogenolytic vascular granuloma and simultaneous pregnancy. RESULTS: Of these 4461 patients, breast conserving surgery was performed in 872 (19.5%) patients who were eligible for BCT, accounting for 9.0% of all operated breast cancer patients during the same period. The rates of local recurrence, metastasis and death were 1.0% (9/872), 1.3% (11/872) and 0.1% (1/872) in BCT group, versus 0.5% (18/3589), 1.4% (49/3589) and 0.1% (4/3589) in the mastectomy group. No statistical significant difference was found between these two groups (P > 0.05). Cosmetic evaluation of breast in BCT group was carried out postoperatively at points of six months, one year and two years with 89.7%, 91.1% and 86.6% of the patients assessed as excellent or fine cosmetic state respectively. CONCLUSION: Breast conserving therapy for early stage breast cancer is feasible in China, with no ominous effect on the survival and recurrence rate. Breast conserving therapy is able to improve not only the quality of life but also enhance the confidence of the patients, in addition to quasi-perfect cosmetic results. Standard comprehensive BCT involving multi-centers all concentrating on combination treatment should be widely adopted in China in the future. However, breast conserving surgery should selectively be used only for early stage breast cancer, and should be combined with postoperative radiotherapy, chemotherapy and hormone therapy in order to guarantee success.

Adult↗
PubMed1997

Breast composition and radiographic breast equivalence.

The composition of the female breast is an elusive variable in screen-film mammography that has a vital role in determining both the radiographic image quality and breast radiation dose. Despite the large volume of research in mammography only two studies known to the author define the chemical composition of the two major breast constituents, fibrous glandular tissue and adipose tissue. Unfortunately there is not complete agreement between these two studies. Upon this basis, a variety of breast phantom materials have been suggested and developed. This paper examines the radiographic equivalence of some of these materials dealing notably with formulations given by Hammerstein et al and ICRU Report 44, as well as BR12, water, and lucite. Radiographic equivalence was calculated using a computer simulation of mammographic spectra (after the example of Birch and Marshall and Tucker et al, and fitted to available FDA data) applied to attenuation data of phantom materials, in turn based on elemental linear attenuation coefficient data. A software algorithm was written that iteratively calculates the thickness of a nominated material required to match the attenuation of another material of particular thickness. The equivalence of 2-8 cm of lucite to various phantom materials was calculated for molybdenum target, molybdenum filter (Mo/Mo) x-ray beams from 25 to 35 kVp and for Mo/Rh and Rh/Rh beams from 27 to 35 kVp. It was found that for Mo/Mo beams the equivalent thickness of breast phantom material for certain thicknesses of lucite was largely independent of x-ray beam energy with the range of thickness equivalences being less than 3% at 8 cm of lucite and less than 0.5% at 2 cm of lucite. The RMI 156 breast phantom was found to be equivalent to 42 mm of Hammerstein et al. 50% glandular/50% adipose phantom material for Mo/Mo beams at 27 kVp, increasing to 43 mm for the range of Rh/Rh beams. While some questions remain on the accuracy of the present composition of breast constituents, it is clear that various breast compositions can be successfully simulated by using an appropriate thickness of lucite material. The use of lucite breast phantoms is then seen as an effective and reliable way of evaluating mammographic image quality and for calculating breast dose for varying required breast compositions.

Adipose Tissue↗
PubMed1996

Evidence for immune facilitation of breast cancer growth and for the immune promotion of oncogenesis in breast cancer.

Autoimmune diseases have been extensively studied in man and experimental animal models and salient points are reviewed, as a clear understanding of the immune mechanisms involved is essential if one is to understand the potential of immune interactions with established cancer cells or in the premalignant period of hyperplasia. Such reactions may be of benefit to the host, with down regulation of tumor growth, or unfavourable, with facilitation of oncogenesis and cancer growth. In particular, evidence is cited that supports a beneficial effect of the host response to non-small-cell lung cancer and the association of a poor prognosis in established breast cancer caused by a heightened immune response to the tumor. Histologic evidence supports these conclusions, as do studies of specific and nonspecific immune reactivity in breast cancer patients. The potential for cytokines to stimulate breast cancer growth, increase angiogenesis and decrease cell adhesion is reviewed, also recent evidence for autologous lymphocyte stimulation of breast cancer. Parallels between immune promotion of breast cancer in mice, caused by the mouse mammary tumor virus, and the development of breast cancer in women are also reviewed. If the mouse model has relevance for human breast cancer, one could predict that there would be a reduced incidence of breast cancer in a population of chronically immunosuppressed women following organ transplantation. Such is the case. This finding, plus the fact that all treatments that have shown efficacy in breast cancer have one thing in common, they are immunosuppressive, strongly support the role of immune facilitation of breast cancer growth and immune promotion of oncogenesis in breast cancer in a substantial number of growth.

Animals↗
PubMed1995

Breast cancer after breast augmentation with silicone implants.

BACKGROUND: Although epidemiological studies have failed to demonstrate an increased incidence of breast cancer in women who had undergone prior prosthetic augmentation mammoplasty (PAM), it has been reported that when breast cancer arises in this group it presents mostly in a palpable form and at a more advanced stage. This is thought to be secondary to suboptimal mammographic evaluation caused by the masking effect of the implant. This study was undertaken to determine, in our experience, whether breast cancer arising in women who had undergone PAM could be detected in a prepalpable form by mammography and whether it presented at a more advanced stage as compared with nonaugmented women with breast cancer. METHODS: The charts of 22 patients, treated by at least one of the authors, in whom 23 breast cancers developed after PAM (group A) were retrospectively reviewed. The comparison groups consisted of 611 nonaugmented patients who underwent 636 procedures for the treatment of primary breast cancer at our institution (group B) and the surveillance, epidemiology, and end results (SEER) data (group C). Parameters studied were mode of detection, tumor size, axillary lymph node involvement, and histopathology. RESULTS: No significant differences between the groups were found in mean tumor size (group A vs. group B), the incidence of preinvasive cancer (group A vs. group B) or axillary lymph node involvement (group A vs. group B and group A vs. group C). Breast-preserving surgery was performed significantly less in augmented patients (group A vs. group B). CONCLUSION: We conclude that prepalpable and preinvasive breast cancer can be detected in the PAM patient by mammography and that the stage of presentation in this group is not significantly different than in nonaugmented patients. Total mastectomy is preferred over breast-preserving procedures for the treatment of breast cancer in the PAM patient.

Adult↗
PubMed2002

Medical radiation, family history of cancer, and benign breast disease in relation to breast cancer risk in young women, USA.

OBJECTIVE: In previous studies breast cancer risk has been increased among women who received high doses (above 100-200 cGy) of ionizing radiation or those exposed to lower doses prior to age 20. Some evidence suggests that such risk may be distinctly elevated among women with a family history of breast or ovarian cancer (probably only carriers of specific gene mutations) and women with benign breast disease (BBD). METHODS: A population-based case-control study in Los Angeles County obtained interview data from 744 women who were aged 40 or younger and diagnosed with breast cancer during 1983-1988, and from 744 matched controls. Women with a positive family history of breast or ovarian cancer reported cancer in a mother, sister, or grandmother. Women with BBD reported a physician diagnosis. Radiation exposure was defined as a history of either radiation therapy or moderate exposure to medical radiography. RESULTS: Breast cancer risk was elevated among women exposed to medical radiation prior to age 20 years (odds ratio (OR) = 1.4, 95% confidence interval (CI) = 1.2-1.8), relative to unexposed women. This increased risk was observed only among women with a history of BBD (OR = 2.4, 95% CI = 1.6-3.7). Overall, risk was not associated with exposure to medical radiation after age 20 years, although among women with a positive family history of breast or ovarian cancer, exposed women had an increased risk (OR= 1.8, 95% CI = 1.0-3.1). Breast cancer risk was not increased among women with a family history of breast/ovarian cancer exposed to medical radiation before age 20 years or those with BBD exposed to medical radiation after age 20 years. DISCUSSION: Study participants may have received radiation doses that are no longer common, hampering study generalizability. Although differences in recall between cases and controls cannot be completely excluded, women with BBD or a family history of breast cancer appear to have greater breast cancer risk following relatively low ionizing radiation exposure than other women in this study.

Adult↗
PubMed1995

[Differential breast tumor diagnosis by comparing blood circulation of the tumor with the contralateral breast using color coded, pulsed Doppler ultrasound].

74 breast tumor patients were preoperatively examined by means of colour and pulsed-wave Doppler sonography using the ultrasonic instrument ALT Ultramark 9 HDI with a broad-band linear scanner, 5-10 MHz. The Doppler flow velocity waveforms, from the vessels of the mammary lesion (affected breast) and the corresponding quadrant of the contralateral breast (non-affected breast), respectively, were compared in respect of the four parameters maximal systolic velocity, minimal diastolic velocity, pulsatility index (PI) and resistance index (RI). In 48 cases we succeeded in representing arterial vessels both inside the affected and the contralateral breast. The aim of the study was to examine whether these parameters show a significantly different degree of deviation in correlation with the tumours being either benign or malign. In cases with benign lesions (n = 24) we did not find any significant differences in all the parameters that we examined. In cases with cancer, however (n = 18), a significantly higher systolic velocity was found in the affected breast compared to the contralateral breast, but there were no differences in the other parameters. Although the quantitative Doppler measurements are angle-dependent parameters, the study showed that the maximal velocity in the affected breast compared to the contralateral breast is the most useful parameter in differential diagnosis of breast tumours.

Blood Flow Velocity↗
PubMed1978

Breast self-examination practices and breast-cancer stage.

To determine the relation between breast self-examination performance and the clinical and pathological stage of breast cancer at first diagnosis, we studied 335 patients with breast cancer. Approximately one fourth of the patients reported that they had been practicing monthly breast self-examination, and half that they had never practiced breast self-examination. More frequent performance of breast self-examination was associated with more favorable clinical stage and fewer axillary-lymph-node metastases on histologic examination. On pathological examination, the age-adjusted maximum tumor diameter of patients practicing monthly breast self-examination was 1.97 +/- 0.22 cm (mean +/- S.E.M.) as compared to 2.47 +/- 0.20 for those performing self-examination less often than monthly and 3.59 +/- 0.15 for patients never performing breast self-examination. These data associating more favorable clinical and pathological stages of breast cancer with more frequent breast self-examination need to be extended by determination of the survival rates of the various self-examination groups.

Adult↗