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At least 865 records · Page 48Linked to original sources
PubMed1996

Factors affecting outcome of patients with impalpable breast cancer detected by breast screening.

Factors affecting completeness of excision and outcome, whether conservation or mastectomy, in 152 patients with localized impalpable breast cancer undergoing therapeutic needle-guided wide local excision were assessed by univariate and multivariate analyses using multiple logistic regression. Independent factors related to completeness of excision at the first operation were operator experience (P = 0.0001), and size of the lesion (P = 0.005). Factors related to outcome were operator experience (P = 0.0003), more experienced operators having a higher rate of breast conservation, and tumour size (P = 0.0001), larger lesions being more likely to be treated by mastectomy. Patients initially operated on by the two most experienced surgeons were more than four times less likely to undergo mastectomy than those whose initial wide local excision was performed by a less experienced surgeon.

Biopsy, Needle↗
PubMed2006

Provider's volume and quality of breast cancer detection and treatment.

For many health conditions, the process or result of medical procedures improves with increasing caseload. The evidence about breast cancer has not been thoroughly assessed. This review synthesizes the literature about provider's volume and performance in either breast cancer screening with mammography or treatment. Articles published in English between 1990 and 2006 were identified by a computerized search and by review of reference lists. In screening with mammography, the reading volume of the radiologist and the screening volume of the facility influence different components of performance. The most conclusive evidence for breast cancer treatment concerns the association between the surgeon's caseload and the process or end-results of therapeutic interventions. Although the mechanisms of these associations still need to be clarified, large provider's volume in screening mammography or breast cancer treatment is often related to the quality of medical interventions.

Breast Neoplasms↗
PubMed1994

Voluntary screening program for prostate cancer: detection rate and cost.

In a community-wide screening program conducted in Jacksonville, Florida, 564 participants received free screening for prostate cancer. Frequency of positive results of prostate-specific antigen measurement and digital rectal examination was comparable to that found in similar programs in other communities. The estimated cost for each participant was $231, and the cost to discover each cancer was $7,240. If one also includes initial therapy in cost estimates, then the cost per participant was $520, and the cost to find and treat each patient was $16,300. The value of screening for prostate cancer must be judged by treatment outcome and underlying costs.

Aged↗
PubMed1996

[Chromosomal numerical aberrations in bladder cancer detected by fluorescence in situ hybridization (FISH)].

BACKGROUND: Chromosomal aberration and DNA ploidy pattern are regarded as prognostic markers of the bladder cancer. In this paper, numerical chromosomal aberrations were analysed by interphase fluorescence in situ hybridization (FISH) for the cases with bladder cancer. METHODS: FISH was carried out on touch smear of 35 cases of transitional cell carcinoma of the urinary bladder. DNA probes were digoxigenin labeled alpha/beta-satellite probes for chromosome 1, 7, 9, 11, 17, Y. FISH signals were counted using confocal laser microscope (LSM GB 200, OLYMPUS. Touch smear preparations were also examined with image cytometer (CAS 200, Becton Dickinson) and DNA index was obtained. RESULTS: Numerical chromosomal aberrations were observed in 9 of 21 (42.9%) diploid cases and in all 14 non-diploid cases. Among 6 kinds of chromosome examined imbalance was observed and most common imbalance was loss of chromosome 9 (11 cases, 32.4%). CONCLUSION: Even in the diploid tumors, chromosomal aberration was observed. Combined analysis of chromosomal aberration and DNA ploidy pattern was easily and quickly performed in our series. Clinical application could be possible and possess diagnostic and prognostic value.

Adult↗
PubMed2001

Disseminated cytokeratin positive tumor cells in the bone marrow of patients with prostate cancer: detection and prognostic value.

PURPOSE: Previous investigations have shown that cytokeratin 18 positive bone marrow cells in localized and lymphatically spread prostate cancer correlates with neither established prognostic factors nor with the biochemical and clinical course after radical prostatectomy. Since the well-known down-regulation of cytokeratin 18 in tumor cells may lead to false-negative results, we asked whether staining with a pan-cytokeratin antibody recognizing a common epitope of cytokeratins 8, 18 and 19 would result in different data. MATERIALS AND METHODS: Preoperative bone marrow aspirates of 82 patients with localized (N0) and lymphatically spread (N1) prostate cancer were examined using the monoclonal antibody cytokeratin 2 and the pan-cytokeratin antibody A 45-B/B3, called A 45. RESULTS: In contrast to findings with the cytokeratin 18 antibody, those with the pan-cytokeratin antibody correlated with the biochemical course. At a median followup of 1,477 days (4 years) patients with pan-cytokeratin positive cells in the preoperative bone marrow aspirate had biochemical progression significantly earlier than those with pan-cytokeratin negative results (mean time to prostate specific antigen relapse 886 versus 1,409 days, p < or =0.004). Compared with other parameters, such as prostate specific antigen, pathological stage and Gleason score, preoperative pan-cytokeratin findings proved to be an independent prognostic factor. CONCLUSIONS: Cytokeratin positive cells in the bone marrow also have prognostic relevance in prostate cancer. The comprehensive analysis of these cells, studies of the individual course of these findings and sufficiently long followup allow us to discuss whether and under what conditions metastasis may develop from 1 or several cytokeratin positive cells.

Adult↗
PubMed1997

Comparison of the relative incidence of impalpable invasive breast carcinoma and ductal carcinoma in situ in cancers detected in patients older and younger than 50 years of age.

PURPOSE: To compare the relative incidence of impalpable ductal carcinoma in situ (DCIS) and invasive breast carcinoma detected mammographically in women younger than 50 years of age and those aged 50 years and older. MATERIALS AND METHODS: Needle-wire localization and surgical biopsy were performed in 4,428 impalpable lesions in 3,734 patients. A total of 1,179 breast cancers were found. Histologic findings were reviewed retrospectively, and lesions were classified as invasive cancer or DCIS. The patients were categorized into two groups: those aged 50 years and older and those younger than 50 years of age. RESULTS: A total of 294 cancers were found in women younger than 50 years of age. Of these cancers, 137 (46.6%) were DCIS and 157 (53.4%) were invasive. In women aged 50 years and older, 885 cancers were found. Of these, 325 (36.7%) DCIS and 558 (63.1%) invasive cancers were found. CONCLUSION: For mammographically detected breast carcinomas, there is a higher relative incidence (46.6% vs 36.6%) of DCIS in the younger age group, which may lend further support for aggressive screening of women younger than 50 years of age.

Biopsy, Needle↗
PubMed1998

Outcome of 67 patients with hepatocellular cancer detected during screening of 1125 patients with chronic hepatitis.

OBJECTIVE: We performed this prospective screening trial in chronic hepatitis virus-infected patients to determine the incidence of hepatocellular cancer (HCC) and the resectability and long-term survival rates of these HCC patients. SUMMARY BACKGROUND DATA: Chronic hepatitis B or C virus infection is a major etiologic factor in human HCC. It is not clear if routine screening of chronic viral hepatitis patients improves the survival of patients who develop HCC. METHODS: Screening for HCC was offered to patients chronically seropositive (>5 years) for hepatitis B or C infection. All patients underwent percutaneous core liver biopsy to assess the histologic severity of chronic liver injury. Patients were screened initially and every 3 months thereafter with serum alpha-fetoprotein and transabdominal ultrasound evaluations; HCC was confirmed by needle biopsy of liver tumors. RESULTS: Screening was performed on 1125 hepatitis-positive patients (804 with hepatitis C, 290 with hepatitis B, 31 with both). On liver biopsy, 800 patients had mild chronic active hepatitis and 325 had severe chronic active hepatitis, cirrhosis, or both. Initial screening detected HCC in 61 patients. HCC was detected in six more patients during follow-up; thus, the incidence of HCC was 5.9% (67/1125). However, 66 of the 67 HCC cases (98.5%) arose in the 325 patients with severe chronic active hepatitis or cirrhosis (66/325 [20.3%] vs. 1/800 [0.1%], p < 0.0001 [Wilcoxon signed rank]). Median follow-up of the 67 HCC patients was 24 months. Locally advanced or metastatic, unresectable HCC occurred in 43 patients (64.2%); 24 patients (35.8%), including the 6 patients detected during follow-up screening, underwent margin-negative resection. The median survival for the 24 resected patients was 26 months, compared to 6 months for the 43 patients with unresectable cancer (p < 0.0001, Wilcoxon signed rank). CONCLUSIONS: HCC was found to arise in 20.3% of patients with chronic hepatitis B or C infection and severe liver injury. Initial screening detected resectable lesions in less than half the HCC patients. Routine screening of chronic hepatitis B or C virus-infected patients with ultrasound and alpha-fetoprotein determination should be reserved for patients with severe chronic active hepatitis, cirrhosis, or both.

Adult↗
PubMed2004

Clinical pathway for the evaluation of postmenopausal bleeding with an emphasis on endometrial cancer detection.

Postmenopausal bleeding (PMB) accounts for about 5% of all office gynaecology visits. The causes of PMB are varied. Many women with endometrial cancer present with this symptom. Although many investigations are described, the most appropriate approach is often unclear. In a patient with no obvious local cause, the emphasis should be on uterine and adnexal evaluation. Based on a literature review, the evidence favours a conservative approach if the endometrial thickness (ET) is < 4mm, unless there are risk factors. All patients with ET 4 mm should have outpatient endometrial sampling. If this is unsuccessful, then outpatient hysteroscopy with directed biopsy or inpatient hysteroscopy is favoured. The role of ancillary investigations are described.

Biopsy↗
PubMed2005

Lung cancer detection in patients with airflow obstruction identified in a primary care outpatient practice.

INTRODUCTION: This prospective study describes a community-based lung cancer identification project focusing on high-risk patients who receive general care in a primary care outpatient practice. Within 1 calendar year, a simple questionnaire was completed in 1,296 patients > 50 years old to identify 430 patients at high risk of lung cancer (smoking, family history of aerodigestive tract cancer, or occupational exposures). Spirometric abnormalities were found in 126 of these patients. METHODS: Chest posteroanterior radiographs, thoracic CT scans, and sputum cytology were offered to subjects with airflow obstruction (n = 126). Eighty-eight patients underwent all tests. Thirty-eight patients refused or could not consent in a timely fashion. RESULTS: Six cancers were found in the screened group, and all were treated. Two more cancers were found in the nonscreened patients with airflow obstruction. Both were treated by surgical resection or radiation therapy. Costs per cancer found were $11,925 per patient. CONCLUSIONS: Case finding in high-risk patients in a primary care population can be accomplished at a relatively low cost.

Aged↗
PubMed1998

Breast cancer detection: maps of 2 San Francisco Bay area counties.

OBJECTIVES: This study describes the incidence of late-stage and in situ breast cancer among White women, using specialized mapping techniques that reflect incidence adjusted for the population at risk, and applies these maps to characterize areas with high and low risk of breast cancer. METHODS: Data from the Surveillance, Epidemiology, and End Results (SEER) database and the US Census Bureau were used to study the geographic distribution of breast cancer at the census-tract level in 2 San Francisco Bay Area counties for the years 1978 through 1982. Sociodemographic characteristics of areas with high and low incidence of the stage-specific disease were compared by means of a linear discriminant function. RESULTS: For late-stage breast cancer, the most important variables in discriminating high-risk from low-risk areas were college education, percentage of residents over age 65, and median income. The strongest ecologic indicators of high risk for in situ breast cancer were median income and percentage unemployed. CONCLUSIONS: This study demonstrates the usefulness of census tracts and sociodemographic measures of income and education in describing in situ and late-stage breast cancer.

Adolescent↗
PubMed1989

[A case report of large cell lung cancer detected in the course of antituberculous therapy after a giant bullectomy].

A case of a 60-year-old who male developed lung cancer after surgical resection of a emphysematous giant bulla. At first, he showed a emphysematous giant bulla associated with infected bulla in the right lung on the chest roentgenograph. After a giant bullectomy the resected specimen, suggested possible pulmonary tuberculosis. Thereafter, he was followed for one year with antituberculous therapy. Nevertheless, the chest roentgenograph taken one year after surgery, showed a new tumor density (1.5 x 2.0 cm) in the right lung. Due to the rapid growth of the lung tumor, right upper lobectomy was performed. The histological diagnosis was a large cell lung cancer (giant cell type). The postoperative staging of the tumor proved to be T2N0M0. He was treated with systemic chemotherapy of CDDP 120 mg, VDS 4.5 mg, and MMC 12 mg. Unfortunately, he died of cancer recurrence 5 months after lobectomy. Clinical evaluation of the emphysematous giant bulla associated with lung cancer was performed.

Carcinoma, Small Cell↗
PubMed1983

[A hormonal impact on DMBA-induced rat ovarian cancer--detection of estrogen receptors, and resultant morphologic changes after estrogen application].

Hormonal dependencies of 7,12 dimethylbenz (a) anthracene (DMBA)-induced rat ovarian cancer were studied. To reveal intratumoral estrogen receptors, dextran coated charcoal (D.C.C.) methods were utilized. In order to change the hormonal level in the rat during the period of tumor induction, serial weekly administrations of estrogen were performed from 5 to 20 weeks after the application of DMBA. Resultant morphologic changes in the induced tumor after the hormonal impacts were observed by light and electron microscope and the results obtained were as follows; 1) Estrogen receptor existed in 80% of the rat ovarian cancers induced by DMBA 2) In the estrogen injected group, a higher incidence and larger growth of the induced tumor were observed than in the hormonally non-treated group 3) A major difference between the histologic features of estrogen group and non-treated group was that the ovarian adenocarcinoma of the former, but not the latter, was associated with a significant proliferation of connected tissues and contained many signet ring cells involving intracytoplasmic canaliculi 4) Ultrastructural findings of these cells were characterized by well developed microvilli, mitochondria, golgi complexes and abundant lipid droplets 5) The proliferation of the DMBA-induced cancer cells in culture was promoted by 17 beta-estradiol application, suggesting its hormonal dependence.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed2003

Expansion of natural killer cells in patients with head and neck cancer: detection of "noninhibitory" (activating) killer Ig-like receptors on circulating natural killer cells.

BACKGROUND: In a group of patients with head and neck cancers (H&NC), the expansion of the population of CD3-,CD16+ natural killer (NK) cells in the peripheral blood was studied. METHODS: Cytofluorimetric analysis of the expression of killer Ig-like receptors (KIR, namely p58.1, p58.2, p58.3, p70, and p140) and CD94-NKG2a was performed. Cytolytic activities were studied using 51Cr release assay. T and NK cell cloning was performed using limiting dilution culture conditions. Cytokine production was analyzed using commercial enzyme immunoassays. RESULTS: Phenotypic analysis showed that the expanded populations were heterogeneous. Even in the presence of a large number of circulating NK cells, "nonspecific" cytolytic capacities were heavily reduced, whereas cytolytic capacity related to T cells was virtually normal. Unlike NK cell clones derived from healthy donors, most NK cells derived from H&NC patients expressed surface "activating" NK cell receptors (KAR) for HLA, detected by use of a redirected cytolytic assay. Analysis of the CD4+ subpopulation at the clonal level demonstrated that they had a severe proliferative defect. CONCLUSION: These experimental data indicated that H&NC patients have a polyclonal expansion of functionally deficient NK cells expressing KAR. In addition, the proliferative capacity of patients' "helper" cells was strongly inhibited, thus accounting for a severe impairment of cytolytic activity of the expanded NK cells.

Cohort Studies↗
PubMed2001

Differences in genetic alterations between primary lobular and ductal breast cancers detected by comparative genomic hybridization.

Infiltrating ductal (DC) and lobular carcinoma (LC) of the breast represent the most frequently observed varieties of invasive breast cancer, characterized by differences in their histological and clinical properties. Although comparative genomic hybridization (CGH) of invasive breast carcinomas has revealed a complex and consistent pattern of DNA copy number changes, the data with regard to type specific aberrations are limited. A comprehensive study was therefore performed on 19 LCs and 29 DCs to ascertain type-specific differences of unbalanced DNA copy number changes by CGH. Statistical analysis revealed significantly higher frequencies for underrepresentation of chromosomes 16q (p<0.01), 22 (p<0.05), and 17q (p<0.05), and a lower frequency for overrepresentation of chromosome 8q (p<0.01) in LC. Similar frequencies of non-random chromosomal changes in LC and DC were obtained for gain of 1q (74%/59%) and loss of 19p (53%/52%), parts of 1p (42%/41%) and 11q (21%/24%). Less frequently, gains mainly involving parts of chromosomes 20q, 20p, 3q, and 5p and partial losses of chromosomes 17p and 13 were observed in both groups of tumours. Minimal regions of overlapping amplifications were mapped to 17q23 exclusively in DC (17%) and 11q13-q14 in both DC and LC (21% and 11%, respectively). High occurrences of DNA copy number decreases were detected at the distal part of chromosomes 1p, 19 and 22, but further analysis is required to confirm these imbalances. It is suggested that the observed differences are involved in the development of type-specific properties of DC and LC.

Adult↗
PubMed2004

Ovarian cancer detected non-invasively by contrast-enhanced power Doppler ultrasound.

Overall, about one-third of women operated upon because of suspected ovarian cancer turn out to have benign disease. This proportion will be even higher when the tumours are small. A more accurate method of determining which are malignant would reduce the number of unnecessary referrals to the cancer centre and increase the scope for conservative management. This pilot study of ultrasound and intravenous microbubble contrast in 20 women with small ovarian tumours enabled the identification of all four malignant lesions with good inter-observer agreement. These preliminary findings suggest that intravenous contrast improves the ultrasound identification of small ovarian malignancies and may provide an accurate way of selecting women who require to be referred urgently for surgery under the auspices of a gynaecological oncologist. The remainder might be considered for laparoscopic surgery or even for observation in some cases.

Adult↗
PubMedDate not supplied

The significance of mammographic calcifications in early breast cancer detection.

3,126 medical reports on women sent to mammary biopsy following breast examination at the Florence Center for the Study and Prevention of Cancer in November 1978-July 1982 were reviewed in order to assess the diagnostic significance of mammographic microcalcifications. All mammographies were examined in order to assess the presence and morphological aspects of the microcalcifications on the bioptic site. Microcalcifications were classified on the basis of the following morphological criteria: spatial disposition (isolated, clustered, diffuse); total number; number per cm; morphological aspect (dot-like, stick-like or ramified); shape (regular or irregular); radiological density; association with mammographic opacity; maximum and average diameter. Microcalcifications were encountered in 19.7% of 157 breast cancer diagnosed in a mammographic screening programme conducted on the asymptomatic population in 19.5% of 953 breast cancers diagnosed in self-referring women (most with symptoms). Among cases where subsequent histological examination revealed a benign pathology, microcalcifications were more frequent in the cases deriving from the screening programme (14.5% of 198 cases) than among self-referred cases (4.5% of 1818 cases). The presence of microcalcifications is in itself a predictive sign of the presence of a carcinoma (positive predictive value = 66.2%) but this radiological sign is only present in 20% of breast cancers. Among the various parameters considered in assessing the diagnostic significance of microcalcifications, irregular shape was the most indicative of carcinoma with a predictive value of 80% and presence in 88% of carcinoma with microcalcifications. Other microcalcification parameters with a particular predictive significance are diffuse spatial disposition, total number (over 10) and number per cm (over 50), site contiguous with a mammographic opacity and a mean diameter of 0.6-0.9 mm. Unfortunately these latter parameters are only 24% of tumour cases with microcalcifications. The incidence of microcalcifications in cancer does not vary according to age, but is strongly correlated with the tumour stage. In particular microcalcifications are found in about 1/3 of in situ carcinomas. In invasive cancers, the presence of microcalcifications tends to increase with the diameter of the lesion. No correlation was found in breast cancers between the presence of microcalcifications, lymph node condition and histological type.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenofibroma↗
PubMed1994

Clinical significance of prostate specific antigen for early stage prostate cancer detection.

The characteristics of serum prostate specific antigen (PSA) in normal Japanese men were studied in 1480 subjects examined by mass screening (MS) for prostate cancer (Pca) in Gunma Prefecture in 1992. The serum PSA concentration was correlated with patient age. The average serum PSA level increased by 0.04 ng/ml/year. The upper normal limits (95 percentiles) of age specific PSA for normal men are 1.33 ng/ml for those aged 39-49 years, 3.65 ng/ml for those aged 50-59 years, 4.06 ng/ml for those aged 60-69 years, 5.09 ng/ml for those aged 70-79 years and 5.66 ng/ml for those aged 80-89 years. Among 227 normal men examined by our MS in 1991 and 1992, the PSA velocity (PSAV) was calculated to be 0.05 ng/ml/year. Among 10 Pca patients with normal PSA levels (< 6 ng/ml) detected previously by our MS, three had an abnormal PSAV. We demonstrated the possibility that PSA density could distinguish between Pca and benign prostate hypertrophy. The significance of PSA as a Pca screening modality should be evaluated across multiple age ranges and in combination with previous PSA data and/or prostate volume estimated by sonography.

Adult↗