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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↗
PubMed1986

[Benign pathology of the breast. Diagnostic protocol and therapeutic indications].

The frequency of benign mammary disease and the need to differentiate between benign and malignant tumors without the indiscriminate use of instrumental examinations and biopsies have prompted the Cooperative Interdisciplinary Group on Mammary Neoplasms to adopt the diagnostic protocol and propose a number of therapeutic indications. Though involving a progressive reduction in biopsies, the use of the protocol has not led to failure to recognize carcinomas, the number of identified malignancies being maintained within the anticipated limits.

Adenofibroma↗
PubMed1986

Occult lesions of the breast.

The biopsy of 148 clinically occult lesions of the breast found at mammographic examination yielded 21 instances of carcinoma (14.2 per cent). Five malignant lesions were lobular or in situ carcinoma, 16 were infiltrating ductal carcinomas and 11 were minimal carcinoma of the breast. Carcinomas found by mammographic examination were smaller and less likely to be associated with metastases to the axillary nodes than carcinomas of the breast diagnosed by palpation during the same time period. Biopsy of the breast was performed by several methods: 1, quandrantectomy with the patient under general anesthesia (the results of 29 biopsies yielded five instances of carcinoma, 17.2 per cent); 2, generous excision of breast tissue with the patient under general anesthesia and the lesion being localized by geometric co-ordinates based upon the mammograms (the results of 35 excisions yielded four instances of carcinoma, 11.4 per cent), and 3, mammogram-directed needle localization (the results of 84 procedures yielded 12 instances of carcinoma, 14.3 per cent). Because needle-directed biopsy causes less distortion of the breast, we prefer it to other biopsy techniques in the evaluation of occult lesions of the breast.

Adenofibroma↗
PubMed1986

Application of aspiration biopsy cytology in the diagnosis of breast diseases.

Fine-needle aspiration biopsy of the breast was performed in 198 patients; 158 benign and 8 malignant lesions were found, 24 samples were considered unsatisfactory and 8 suspicious. The cytological diagnosis was correlated with clinical follow-up and histological findings. The Author discusses the value of aspiration biopsy cytology in the clinical assessment of breast disease and describes the cytological appearances and diagnostic criteria in the major benign and malignant breast diseases.

Adenocarcinoma, Mucinous↗
PubMed1987

Fibroadenomas with stromal cellularity. A clinicopathologic study of 21 patients.

Data on clinical and pathologic features of tumors from 21 patients who had breast tumors compatible with juvenile (cellular) fibroadenomas (JCF) were reviewed. All patients were black females ranging in age at time of presentation from 10 to 39 years, with a median age of 15 years. Follow-up (median period, six years) was obtained for 20 patients. Patients were categorized into two groups; 13 had solitary lesions and eight had multiple and successive lesions. No histologic differences were observed between JCF occurring as solitary or multiple tumors or between lesions occurring in patients younger and older than age 20 years. The JCF was shown to be a fairly distinct clinicopathologic entity that characteristically occurred in adolescents, but which was occasionally seen in young adults. It had a benign course, characterized by synchronous and metachronous multicentricity, rather than local recurrence.

Adenofibroma↗
PubMedDate not supplied

Semiquantitative cytochemical estimation of glucose-6-phosphate dehydrogenase activity in benign diseases and carcinoma of the breast.

The level of glucose-6-phosphate dehydrogenase (G6PDH) activity was semiquantitatively evaluated in fresh imprints of infiltrative ductal carcinoma, fibrocystic disease and fibroadenoma of the breast. A significantly higher level of G6PDH activity was found in the carcinomas. The results suggest that the estimation of G6PDH activity could be a valuable method for evaluating the cells in benign and malignant breast lesions. It is possible that the intensification of G6PDH activity in carcinomas is a sign of the shift of the carbohydrate metabolism from an aerobic path or that the activity of the pentose shunt is higher because of the increased need for nucleic acid precursors in tissues with faster growth rates.

Adenofibroma↗
PubMed1988

Evaluating benign breast disease.

Benign breast diseases are present in some form in nearly all women. A basic understanding of breast anatomy and physiology, underlying pathology and methods available for evaluating breast problems provides the ability to assess the client's breast complaint. Four common breast problems--fibrocystic disease, fibroadenoma, mammary duct ectasia, and intraductal papilloma--are described along with guidelines for assessment and referral or follow-up. Current breast-imaging options are discussed in terms of their usefulness and limitations. The value of consumer education regarding benign breast problems cannot be overstated. The National Cancer Institute offers free consumer information explaining benign breast diseases and evaluation techniques.

Adenofibroma↗
PubMedDate not supplied

Evaluation of flow in nodular tumors of the breast by Doppler and duplex scanning.

Evaluation of flow in nodular tumors of the breast may be performed by Doppler and computerized frequency analysis. In 46 nodules of the breast (22 malignant) the nodular flow velocity and frequency analysis revealed a faster flow with a significantly higher peak frequency and mean velocity. The intensity of sound which may be considered an index of the entity of flow in the nodule was larger than that observed in the normal surrounding breast tissue. In malignant nodules and generally in fast growing nodules the flow velocity and intensity was even larger. The flow intensity and velocity was also well correlated with the growth rate as reported by single patients. In elder patients a slow rate of growth even in tumors of larger size was associated with a significantly increased flow in comparison with the normal breast tissue but this increase was not particularly large when compared with fast growing nodules in younger subjects. In conclusion the evaluation of flow characteristics (mainly velocity, frequency analysis and intensity) may be a useful index of the growth rate of nodular tumors of the breast and these data may be useful to evaluate and monitor the evolution and pathophysiology of these nodules.

Adenofibroma↗
PubMed1988

Clinical utility of the combined use of plurime tumor markers in human breast cancer.

Many biological substances are commonly used as markers for malignant neoplasms, but no single marker with high specificity and sensitivity has been found for cancer to date. In this study we evaluated simultaneously the serum levels of five biomarkers of malignancy: phosphohexose-isomerase (PHI), creatine kinase isoenzyme BB (CK-BB), alpha 1-acid glycoprotein (AAG), beta 2-microglobulin (BMG), and ferritin. In 89 female patients with breast lesions, we identified 30 benign lesions, 32 primary breast cancers, and 27 metastatic breast cancers (pulmonary and/or bone metastases). Each marker was assayed individually and in a combination and was compared with other markers. The results revealed that in benign lesions only 7% had PHI values higher than our cut-off limit value, while 3% had elevated values of AAG, BMG, and ferritin. In primary breast cancer we discovered pathological values of CK-BB and AAG in 71%, of PHI in 69%, of BMG in 50%, and of ferritin in 47%. Metastatic disease was associated with elevated values in 88% of CK-BB, in 70% of PHI and AAG, and in only 55% of BMG and ferritin. Combined pathological values for primary and metastatic breast cancer were 79% for CK-BB, 71% for AAG, 70% for PHI, and only 55% for BMG and ferritin. These data were assessed by the Student t test, which revealed for each marker a significant capacity (P less than 0.01) to discriminate between benign lesions and neoplastic diseases. The same capacity to distinguish between primary and metastatic cancer was obtained by the simultaneous use of three markers (CK-BB, PHI, and AAG).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenofibroma↗
PubMed1986

Demonstration of human breast carcinoma cells in cryosections and primary monolayer cultures of surgical biopsies by neotetrazolium reductase cytochemistry.

The present study describes a cytochemical approach to demonstrate human breast carcinoma cells in cryosections and in primary monolayer cultures from surgical biopsies. The material consisted of biopsies from 52 carcinomas and 29 benign lesions. Cryosections and cultures were incubated to demonstrate NADPH-neotetrazolium reductase in an atmosphere of 99.5% oxygen. Incubation time and section thickness were adjusted to accomplish the same level of reaction in cells of cryosections and corresponding cultures. Positive reaction was thus confined to epithelial elements and to the wall of some smaller blood vessels. More than one-half of the carcinoma cells showed moderate to strong reaction in cryosections from 29 of 52 carcinomas whereas no reaction was seen in ductules of normal appearance adjacent to these carcinoma cells. Positive reaction was seen in epithelial cell islets in primary cultures of 16 of the 40 carcinomas cultured. In cryosections from fibroadenomas and fibrocystic disease specimens only apocrine metaplasia consistently showed positive reactions compared with less than 10% of other ductular profiles in a given cryosection. This pattern of reaction was reflected in the derived primary cultures in which positive reaction was found in epithelial cell islets in only one of 19 biopsies cultured. The presence of human milk fat globule membrane antigen was used to demonstrate the epithelial nature of the cell islets seen in cultures of biopsies from both benign lesions and carcinomas. NADPH-neotetrazolium reductase positive islets from carcinoma biopsies were frequently aneuploid whereas most negative islets from carcinoma biopsies were diploid as were all islets from benign tissues.

Adenofibroma↗
PubMed1986

Effect of moderate vitamin A supplementation and lack of dietary vitamin A on the development of mammary tumors in female rats treated with low carcinogenic dose levels of 7,12-dimethylbenz(a)anthracene.

We examined the effect of moderately increased and of marginal continued dietary supplementation of vitamin A (retinyl acetate) and the effect of lack of dietary vitamin A on the initiation and promotion stages of mammary tumorigenesis in female Sprague-Dawley rats treated with a single low (0.5 mg/100 g body weight) or very low (0.1 mg/100 g body weight) dose of i.v.-administered 7,12-dimethylbenz(a)anthracene. The number of mammary tumors was significantly (P less than 0.05) reduced if prior to and during initiation with 7,12-dimethylbenz(a)anthracene the rats were fed a moderately increased (30 micrograms/day) or marginal (3 micrograms/day) amount of vitamin A, compared to rats fed an adequate (10 micrograms/day) amount of vitamin A. The number of mammary tumors was also significantly (P less than 0.05) reduced when a moderately increased or marginal amount of vitamin A was provided during the tumor promotion phase. In addition, the number of mammary tumors was significantly (P less than 0.05) reduced by the lack of dietary vitamin A during both the initiation and promotion stages of this tumorigenic process, when compared to vitamin A adequate, ad libitum-fed rats, but not when compared to vitamin A adequate, food-restricted controls. The reduction in numbers of mammary tumors observed in these studies was reflected primarily in significant (P less than 0.05) decreases in mammary fibroadenomas; the number of mammary carcinomas was often reduced, but due to a low frequency of the carcinomatous lesions, this reduction did not reach the 5% level of statistical probability. Plasma and liver vitamin A levels were determined during both the initiation and promotion stages. As the dietary supplementation of vitamin A increased from 0 to 30 micrograms/day, there was an increase in mean liver and plasma vitamin A levels. No consistent correlation between plasma and liver vitamin A levels and the occurrence of mammary tumors was observed, except with the moderately increased (30 micrograms/day) intake of vitamin A, that resulted in a small, but statistically significant (P less than 0.05) increase of serum retinol at initiation; this may account for the observed reduction in mammary tumors. These results provide evidence that moderate alterations in vitamin A consumption can modulate low-dose chemically induced mammary gland tumorigenesis. Most importantly, suppression of mammary gland tumorigenesis can be achieved by moderately increased, frequent, and regular consumption of vitamin A; prolonged consumption of vitamin A-deficient diets or diets marginal in vitamin A does not enhance the risk of mammary tumor development.

9,10-Dimethyl-1,2-benzanthracene↗