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At least 595 records · Page 33Linked to original sources
PubMed1997

Incidence of primary malignancies other than breast cancer among women treated with radiation therapy for benign breast disease.

This report presents data on the long-term risks of developing malignancies other than breast cancer after exposure to scattered doses of ionizing radiation. The estimates were based on a cohort of 3,090 women who were diagnosed clinically with benign breast disease between 1925 and 1961. A total of 1,216 women were treated with radiation therapy. The breasts received a mean absorbed dose of 5.84 Gy. Mean absorbed doses owing to scatter to 14 other organs were also determined. The lung received the highest mean scattered dose (0.75 Gy; range 0.004-8.98 Gy) and rectum the lowest (0.008 Gy; range 0-0.06 Gy). Median age at first exposure was 40 years. The follow-up lasted up to 61 years after treatment (mean follow-up 27 years). End-point data were obtained from population-based registers. With internal reference the relative risk for non-breast solid tumors was 1.2 (95% confidence interval 1.0-1.5). However, this excess was not apparent when comparison with the general population was made (standardized incidence ratio = 0.95; 95% confidence interval 0.84-1.07). Among individual sites no significantly increased risks were observed. For stomach cancer there was a linear increase with dose (ERR/Gy = 1.3; two-sided P = 0.05). No increased risk was observed for leukemias. In two earlier reports, breast cancer incidence has been shown to be significantly increased in this cohort of irradiated women. Our results suggest that the scattered doses from the breast irradiation may have increased the risk of cancers of other sites, but the small number of cases in different locations precludes strong interpretations.

Breast Diseases↗
PubMed1993

Nutritional profile of women with fibrocystic breast disease.

The relationship between nutritional factors including eating habits and the presence or absence of fibrocystic breast disease (FBD) with regard to other known risk factors has been investigated in women participating in the National Breast Screening Study (NBSS) in Montreal, Canada. Included in this case-control study were 334 patients with FBD aged 40-59 years at entry to NBSS and 340 controls. Personal and family history was collected from medical records and by interview conducted by a research nurse. Nutritional assessment was done by 24-hour dietary recall, by a food frequency questionnaire and by identification of changes in eating habits 5 years prior to diagnosis. Women > or = 50 years with FBD had higher intake of energy, carbohydrate, fibre, vitamin D, free folacin, calcium, sodium, potassium and magnesium but lower intake of cholesterol than controls. In women < 50 years body mass index and lower protein, niacin and zinc intake, were associated with FBD. In logistic regression analysis, breast pain and education > 12 years were among the most important predictive variables for FBD. The use of oral contraceptives, cholesterol intake > or = 300 mg/day, the proportion of energy provided by fat and saturated fatty acid intake above 10% of energy had a protective effect. The comparison of FBD patients diagnosed by biopsy and those by clinical examination indicated that increasing age had a significant association with the risk of biopsy and a rather weak association with the percentage of energy supplied by fat.

Adult↗
PubMed2000

The value of ultrasound scanning in breast disease.

Ultrasound is the modality of choice for imaging breast masses. Most benign and malignant lesions can be accurately categorized as a result of improvements in grey scale imaging and the development of sensitive colour Doppler vascular mapping. Ultrasound contrast agents, harmonic imaging, elasticity imaging and other advances will further enhance the utility of breast ultrasound.

Adult↗
PubMed1982

[System for organizing the active screening of breast diseases at industrial enterprises].

The scheme of detection of breast tumors includes such measures of complex screening as self-examination, questionnaires, examination by shop floor doctor, fluoromammography and thermography followed by consultation of an oncologist, needle biopsy and use of surgical manuals. Out of 12,862 females examined by the scheme, 52 (0.4%) had breast tumors (early forms in 23 cases -- 44.2%), 254 (2%) -- benign tumors and cysts; 981 (7.6%) -- dyshormonal mastopathy and 522 (4.0%) -- local fibroadenomatosis.

Adult↗
PubMedDate not supplied

The integration of diagnostic tests and the role of outpatient surgery in the management of breast disease.

The aim of the earliest possible diagnosis of breast carcinoma achieved through the integration of clinical, mammographic, sonographic and cytologic data has determined an increased detection of breast lesions and a greater accuracy in their description. Nevertheless, the nature of some of these lesions cannot be well-defined because of their biological characteristics and their physical, radiological or cytological aspects. The need to obtain a definitive diagnosis in any case has given rise to a paradoxical increase in histologic examinations: in specific conditions and for certain kinds of lesions, outpatient surgery under local anesthesia could very well represent a supplementary tool in the diagnostic and therapeutic strategy for the management of breast lesions. The data here reported concern 397 breast lesions for which it was thought appropriate to complete the diagnostic procedure with the surgical excision on an outpatient basis under local anesthesia. Excluding the 3 breast lymphomas and the 19 loco-regional recurrences, for which the purpose of outpatient surgery was therapeutic, at the histologic examination 35% benign lesions, of which 91 associated with an increased risk of breast cancer, were found, as well as 11 in situ and 10 invasive carcinomas (false negatives), with a therapeutic option error of 2.5%. Now that one of the principal aims of public management is to put a check on health expenditures, outpatient surgery would contribute to obtaining the correct balance between proper management of breast lesions and low cost/effective ratio.

Adult↗
PubMed1997

Surgical management of early stage invasive breast cancer (stage I and II). Provincial Breast Disease Site Group.

GUIDELINE QUESTION: What is the optimal surgical management of early stage invasive breast cancer (stage I and II)? More specifically, what is the relative efficacy (and safety) of breast conservation therapy (lumpectomy with axillary dissection) compared with modified radical mastectomy? OBJECTIVE: To make recommendations about surgical management and techniques in the treatment of early stage invasive breast disease (stage I and II). OUTCOMES: Survival, local recurrence (for lumpectomy patients) and quality of life are the primary outcomes of interest. PERSPECTIVE (VALUES): Evidence was selected and reviewed by 6 members of the Ontario Cancer Treatment Practice Guidelines Initiative, Disease Site Group for Breast Cancer (Breast DSG). Earlier drafts of this evidence-based recommendation have been reviewed, discussed and approved by the Breast DSG, which comprises surgeons, medical oncologists, radiation oncologists, epidemiologists, a pathologist and a medical sociologist. There was no consumer participation in the development of this guideline. QUALITY OF EVIDENCE: There are 7 randomized controlled trials (RCTs) comparing breast conservation therapy with mastectomy in women with early stage breast cancer. BENEFITS: In 6 RCTs, no statistically significant differences were detected in survival rate between the mastectomy and conservative therapy (lumpectomy) groups. In 1 RCT, a statistically significant differences was detected in favour of the mastectomy arm; however, this was an early trial with substantial methodologic weaknesses. HARMS: None. PRACTICE GUIDELINE: Women with early stage invasive breast cancer (stage I and II) who are candidates for breast conservation therapy (see discussion of technical factors) should be offered the choice of either breast conservation therapy (excision of tumour with clear margins and axillary dissection) or modified radical mastectomy. The choice is an individual one for the patient, and thus she should be fully informed of the options, including the risks and benefits of each procedure. She should be informed that breast irradiation is part of the procedure for breast conservation therapy. In addition, she should be aware of the potential need for further surgery if the margins are positive. For further information about the use of radiotherapy in the management of early stage breast cancer, please refer to the Ontario Cancer Treatment Practice Guidelines Initiative's practice guideline Breast Irradiation in Women with Early Stage Invasive Breast Cancer Following Breast Conserving Surgery.

Breast Neoplasms↗
PubMed1980

Risk of breast cancer in women with benign breast disease.

A group of 1,489 white women were treated in a private surgery practice from 1940 through 1975 for biopsy-proved benign breast disease, and 1,441 were followed through 1976 for the development of breast cancer. Average duration of follow-up was 12.9 years for a total of 18,617 person-years of observation. Information was collected from a set of questions devised in 1941 and asked of all subjects at the time of their initial office visit, follow-up interview conducted in 1976, and a standardized histology review of the slides from the initial benign lesions and the subsequent cancers. The current pathology review indicated that 66 of the women developed breast cancer. The incidence rate was 3.55 per 1,000 person-years, which is 2.10 times that of the general population. When multiple disease types and other variables were controlled for, excess risk of breast cancer was related to the presence of fibrocystic disease. In women with fibrocystic disease, excess risk was particularly related to the presence of epithelial hyperplasia and/or papias not related to the presence of fibroadenoma alone, but it was related to the presence of fibroadenoma in women with concomitant fibrocystic disease. The excess risk was also directly related to the estimated size of the initial benign mass and was greater for women with bilateral than with unilateral benign lesions.

Adult↗
PubMed1992

Type 1 IGF receptor in human breast diseases.

The first step of the action of IGF1 and IGF2 (IGFs) is their binding to membrane receptors. IGF binding sites have been characterized by competitive binding and cross-linking techniques in human breast cancer cell lines as well as in human breast cancers and in human benign breast diseases. IGF2 is a good competitor of 125I-IGF1 binding to IGF1-R; insulin competes but with a potency 1/100 lower than the IGF1 potency. Chemical cross-linking experiments revealed that the apparent molecular weight of the IGF1-binding sites is 130,000. Alpha IR-3, a murine monoclonal antibody against the IGF1-R, blocks IGF1-binding to this receptor. This antibody inhibits the IGF1-stimulated growth of breast cancer cells. Therefore, the IGF1 specific binding sites correspond to the previously described type 1 IGF receptors (IGF1-R) in normal tissues. Cross-linking experiments with labeled IGF2 resulted in a major band of apparent Mr 260,000-270,000 that was inhibited by unlabeled IGF2 but not by insulin, and corresponds to the type 2 IGF receptor; a second band of apparent Mr 130,000 was inhibited by excess IGFs and insulin (Type I receptor). The alpha-IR3 inhibition of the IGF2 mitogenic activity suggest that IGF1-R partially mediates the growth effect of IGF2 in these cells. We and others have demonstrated that most breast cancer cell lines contain IGF1-R.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast↗
PubMed1998

Breast disease: dynamic spiral MR imaging.

PURPOSE: To compare various subjective, empiric, and pharmacokinetic methods for interpreting findings at dynamic magnetic resonance (MR) imaging of the breast. MATERIALS AND METHODS: Dynamic spiral breast MR imaging was performed in 52 women suspected of having or with known breast disease. Gadolinium-enhanced images were obtained at 12 locations through the whole breast every 7.8 seconds for 8.5 minutes after bolus injection of contrast material. Time-signal intensity curves from regions of interest corresponding to 57 pathologically proved lesions were analyzed by means of a two-compartment pharmacokinetic model, and the diagnostic performance of various parameters was analyzed. RESULTS: Findings included invasive carcinoma in 17 patients, isolated ductal carcinoma in situ (DCIS) in six, and benign lesions in 34. Although some overlap between carcinomas and benign diagnoses was noted for all parameters, receiver operating characteristic analysis indicated that the exchange rate constant had the greatest overall ability to discriminate benign and malignant disease. The elimination rate constant and washout were the most specific parameters. The exchange rate constant, wash-in, and extrapolation point were the most sensitive parameters. DCIS was not consistently distinguished from benign disease with any method. CONCLUSION: Dynamic spiral breast MR imaging proved an excellent method with which to collect contrast enhancement data rapidly enough that accurate comparisons can be made between many analytic methods.

Breast↗