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Biomedical subjects

G N Peters

Publications and source records attributed to G N Peters.

31 records · Page 2Linked to original sources

Tumor hormone receptor status and recurrences in premenopausal node negative breast carcinoma.

To ascertain the prognostic significance of tumor hormone receptor status in node negative, premenopausal patients with breast cancer, a retrospective view of 199 patients fitting these criteria was conducted. Of these 199 patients, 147 had estrogen receptor data available. There were 104 patients (71%) who were estrogen receptor negative, and 16 (15%) had developed local or distant recurrence with a median follow-up of 44 months. Five patients had died of breast cancer. Of the 43 patients who were estrogen receptor positive, there was one recurrence, and no breast cancer deaths. This difference in recurrence is statistically significant (P less than 0.01) by the log-rank probability test. Of the 17 patients with recurrent disease, 14 (82%) had primary tumors 2 cm or larger in size. If only those patients with tumors 2 cm or larger are considered, 23% (13/57) who were estrogen receptor negative and 5% (1/19) who were estrogen receptor positive recurred. This remains statistically significant (P less than 0.025). We conclude that tumor hormone receptor status and size of tumor are significant prognostic factors in identifying premenopausal, node negative women at risk for recurrent disease.

Adult↗

Tuberculosis of the breast: rare but still extant. Review of the literature and report of an additional case.

Tuberculosis of the breast is a rare malady that is usually manifested by a unilateral mass suggestive of carcinoma or sometimes of abscess. Mammography also suggests carcinoma in most instances. However, at operation, the discovery of necrotic tissue or abscess may lead to the suspicion of infectious or inflammatory disease rather than neoplasm. The diagnosis of tuberculosis may be established by the demonstration of acid-fast bacilli in excised tissue, by culture studies, or by guinea pig inoculation; however, the diagnosis is usually not suspected. In the past, mastectomy was the usual treatment. Today, successful treatment combines antituberculous drug therapy with the removal of infected breast tissue. The prognosis for complete cure is excellent. One case of secondary tuberculous mastitis has been reported herein. The patient, an Egyptian woman residing in the United States since 1973, was treated in Egypt for pulmonary tuberculosis at age 17. She presented in 1982 with a breast mass that mimicked carcinoma on physical examination and mammograms, but excisional biopsy and histologic examination revealed a breast abscess that contained caseous material and a solitary acid-fast bacillus. The patient was cured of her disease after appropriate operation and a course of antituberculous drugs. This has been the only documented case of mammary tuberculosis at our institution. Despite its rarity, tuberculosis of the breast should not be forgotten in this age of world travel.

Adult↗

What constitutes adequate study of axillary lymph nodes in breast cancer?

This study was undertaken to determine the value of the clearing technique and multilevel sectioning of lymph nodes to aid in optimally examining axillary dissections for lymph node metastases. One hundred consecutive mastectomy specimens with axillary dissections were initially examined by our routine technique: examination of fat for lymph nodes by inspection and palpation and examination of one microsection from each lymph node. The remaining axillary tissue was then cleared using the technique of Durkin and Haagensen and each of the originally examined lymph nodes was resectioned at two additional deeper levels. In our routine examination, 2203 lymph nodes were found with 211 lymph nodes containing metastatic tumor. Clearing disclosed 412 additional lymph nodes, of which 17 contained metastatic tumor. The two additional microsections of lymph nodes revealed tumor in only two lymph nodes which were initially free of tumor. The extended study of the axilla did not add significantly to our routine examination.

Axilla↗

Adenoid cystic carcinoma of the breast. Report of 11 new cases: review of the literature and discussion of biological behavior.

Eleven new cases of adenoid cystic carcinoma of the breast are added to the 95 previously reported. They were studied for their biological behavior, and an attempt was made to correlate histologic features with prognosis. A comparison was made with analogous tumors in extramammary sites, and possible relationship with carcinoid tumors of the breast explored. The patients in the study followed a biological course very similar to that described by previous studies, i.e., slow progression, local recurrence if inadequately resected, and absence of lymph node metastases. Only one patient developed distant metastases after an interval of ten years following radical mastectomy. If the diagnosis of adenoid cystic carcinoma is reserved for those lesions displaying the distinctive appearance and typical epithelial-stromal relationships which have been described, the authors feel that simple mastectomy with careful follow-up surveillance is the treatment of choice.

Adult↗

Tubular carcinoma of the breast. Clinical pathologic correlations based on 100 cases.

One hundred tubular carcinomas were reviewed, analyzed and compared with previously reported studies in the literature. Our cases were subdivided into five groups, according to the proportion of the carcinoma which was tubular. In the case of pure or almost pure tubular carcinomas (76% or more), tumor size was small, no metastases were found, no recurrences developed, and there were no deaths attributable to the carcinoma. As the proportion of the carcinoma which was tubular decreased, the size and biologic aggressiveness of the tumor increased; this it is likely that tubular carcinoma may represent an early form of carcinoma. A right-sided preponderance was found of the "pure tubular" carcinomas; and lesions of the central sector of the breast were rare in all five groups. The incidence of bilateral cancer was greater than that expected for breast cancer in general and included three patients with bilateral tubular carcinomas. On the basis of our findings, we suggest that lesions which are composed 90% or more of tubular carcinoma may be treated by simple mastectomy, and that axillary dissection is not necessary. For all carcinomas with a lower proportion of tubular elements, at least total mastectomy and axillary dissection are indicated, although the safest treatment probably is radical mastectomy.

Adenocarcinoma↗

Effect of major dietary modifications on immune system in patients with breast cancer: a pilot study.

A pilot study was conducted to evaluate the effect of diet on immune function in nine premenopausal, post-therapy patients with breast cancer. The patients were instructed on following the American Cancer Society dietary guidelines and were told to do so from day 0 to day 28. These guidelines recommend a high-fiber, low-fat diet. On day 29, the patients continued the diet but included fish high in omega-3 fatty acids until day 56. Twenty-four-hour urine and blood samples, and 3-day diet records were obtained on days 0, 28, and 56. The following parameters were monitored: lymphocyte subsets, T-cell function (proliferation and cytolytic response), and urinary prostaglandin E2 (PGE2). Results throughout the study suggested a benefit from decreasing dietary fat intake, and increasing fish intake. Helper T-cell (CD4) percentage increased from day 0 to days 28 and 56 (P = 0.048). Cytotoxic/suppressor T-cell (CD8) percentage decreased from day 0 to days 28 and 56 (P = 0.002). The CD4/CD8 cell ratio increased by days 28 and 56 (P = 0.0004). The proliferation of CD4 cells increased from day 0 to days 28 and 56 (P = 0.005). Significant changes were not found in the cytolytic activity of T cells, natural killer cells, total T and B cells, or urinary prostaglandin E2. Results suggest that patients with breast cancer may benefit from following American Cancer Society dietary guidelines and consuming cold-water ocean fish.

Adult↗