PubMed Health⌕ Search

Biomedical subjects

J Brisson

Publications and source records attributed to J Brisson.

At least 73 records · Page 4Linked to original sources
PubMed1989

Psychological distress after initial treatment for breast cancer: a comparison of partial and total mastectomy.

This study of the relation between type of mastectomy and psychological distress was based on all newly diagnosed breast cancer patients with localized or regional disease who were surgically treated in seven Quebec City hospitals in 1984. Among 235 eligible patients, 227 (96%) participated in a home interview 3 months after diagnosis and 205 of these women gave a second interview approximately 15 months later. The Psychiatric Symptom Index (PSI) was used to measure the severity of symptoms of psychological distress. At 3 months, 38.8% of partial mastectomy patients had high PSI scores compared to 25.8% of women treated by total mastectomy (OR = 1.8, p = 0.044). Fifteen months later, percentages with high scores were identical, 35.1%, in the two treatment groups. Age appeared to modify the surgery-distress relation. These results suggest that partial mastectomy does not protect against psychological distress after breast cancer. Moreover, they highlight the importance of adequate preparation and support for all breast cancer patients, regardless of type of initial surgery.

Adult↗
PubMed1989

Body weight and prognostic indicators in breast cancer. Modifying effect of estrogen receptors.

The relations of body weight, height, and Quetelet index to axillary node involvement at diagnosis, estrogen receptor status, and histologic features of the primary tumor were examined in 656 patients with a newly diagnosed infiltrating breast carcinoma first treated in Québec City from July 1982 to December 1984. Node involvement increased with body weight and Quetelet index. This association was more regular and much stronger among patients with estrogen receptor-positive tumors than among those with estrogen receptor-negative breast cancers. Among patients with estrogen receptor-positive tumors, the percentage with involved nodes at diagnosis increased regularly from 32.9% among lean patients (Quetelet index less than 21 kg/m2) to 65.6% among obese women (Quetelet index greater than 27 kg/m2). This trend was seen even after adjustment for age and tumor size. In contrast, among patients with estrogen receptor-negative breast cancers, the association of weight and Quetelet index with node involvement were weak and irregular. The modifying effect of estrogen receptor status on the relation of obesity to node involvement was apparent in pre- and post-menopausal women. Body weight and Quetelet index were not related to estrogen receptor status or to any of the measured histologic features of breast tumors including nuclear grade, histologic grade, tubule formation, mitotic activity, and size of nucleus of cancer cells. These findings suggest that the observed deleterious effect of obesity on breast cancer prognosis is unlikely to be an artifact of delayed diagnosis in overweight patients. It may be due to hormonal changes associated with increases in body weight.

Axilla↗
PubMed1989

Diet, mammographic features of breast tissue, and breast cancer risk.

This case-control study was designed to reevaluate the association of the morphology of breast tissue seen on mammograms with breast cancer risk and to assess the relation of diet, especially intake of fat and vitamin A, to the high-risk mammographic images. The cases included 290 patients with newly diagnosed breast cancer who were first treated in Quebec in 1982-1984. The controls included 645 women who participated in the Canadian National Breast Screening Study. Risk of breast cancer was higher among women with the P2 or DY parenchymal pattern (relative risk (RR) = 3.7, 95% confidence interval (Cl) 2.0-7.0) than it was among those with the N1 pattern. Moreover, risk increased regularly with the extent of nodular and homogeneous densities on the mammogram. Relative risk was 5.5 (95% Cl 2.3-13.2) for women in whom 60% or more of the volume of the breast showed either nodular or homogeneous densities compared with women without such densities. Among controls, increase in energy-adjusted saturated fat intake was associated with an increase in extent of high-risk mammographic features. Energy-adjusted polyunsaturated fat or cholesterol intake did not, however, appear to influence the morphology of breast tissue seen on the mammogram. Increasing carotenoid and fiber intakes were associated with a reduction of the extent of densities on the mammogram, but retinol intake seemed to have little or no effect on mammographic features. These data suggest that elevation in saturated fat intake and reduction in carotenoid and fiber intakes may be related to an increase in breast cancer risk through effects of these nutrients on breast tissue morphology.

Adult↗
PubMed1989

The effect of cigarette smoking on the risk of preeclampsia and gestational hypertension.

This case-control study assessed the relation of cigarette smoking during pregnancy to the risk of preeclampsia and gestational hypertension. All subjects were primiparous women without a history of high blood pressure who gave birth in Quebec City or Montreal, Canada, hospitals between 1984 and 1986. Cases (172 women with preeclampsia and 251 with gestational hypertension) and 505 controls were interviewed at the hospital after delivery. Adjusted relative risks were estimated by polychotomous logistic regression. Compared with women who had never smoked, women who were smokers at the onset of pregnancy had a reduced risk of preeclampsia (relative risk = 0.51, 95% confidence interval 0.34-0.77). Relative risks of preeclampsia decreased with increases in the number of cigarettes smoked daily at the onset of pregnancy: Relative risks among smokers of less than 11, 11-20, and more than 20 cigarettes per day were 0.79, 0.56, and 0.38, respectively (test for trend: p = 0.0002). The protective effect of smoking on preeclampsia was stronger for women who continued to smoke after 20 weeks of pregnancy. While smoking tended to reduce the risk of gestational hypertension, this effect was less evident than that for preeclampsia. Relative risks varied little with severity of disease as based on gestational age at the onset of hypertension, maximal blood pressure and, for preeclampsia, amount of proteinuria. The reduction in mean birth weight attributable to smoking during pregnancy was similar among cases and controls. Nicotine inhibition of thromboxane A2 production might explain the decreased risk of pregnancy-induced hypertension among smokers. Despite these findings, the harmful consequences of smoking on pregnancy outcome outweigh its protective effect against pregnancy-induced hypertension.

Birth Weight↗
PubMed1989

The effect of leisure time physical activity on the risk of pre-eclampsia and gestational hypertension.

STUDY OBJECTIVE: To assess the relation between leisure time physical activity (LTPA) during the first 20 weeks of pregnancy and the risk of developing pre-eclampsia and gestational hypertension. DESIGN: Case-control study carried out over a 28 month period with retrospective data collection. SETTING: Six hospitals in Quebec City and four hospitals in Montreal. PARTICIPANTS: 172 women with pre-eclampsia, 254 with gestational diabetes, 505 controls. All were primiparous, with no history of high blood pressure before pregnancy (unless due to oral contraceptive use), or during the first 20 weeks of gestation. Cases were defined using recognised criteria, and 97% of those eligible agreed to be interviewed. Controls delivered in same hospital immediately after cases and had no more than one reading of elevated blood pressure during pregnancy; 96% of those eligible agreed to be interviewed. MEASUREMENTS AND MAIN RESULTS: Participants were interviewed in hospital a few days after delivery using a questionnaire. Information was collected on type, frequency and average duration of any LTPA performed regularly during the first 20 weeks of pregnancy, together with medical, obstetric and sociodemographic details. It was found that women who performed regular LTPA had a reduced risk of pre-eclampsia (adjusted RR 0.67, 95% CI 0.46-0.96) and gestational hypertension (aRR 0.75, 95% CI 0.54-1.05), and the relative risks decreased as the average time spent in LTPA increased (aRR for pre-eclampsia among women with low, moderate and high energy expenditure: 1.00, 0.77 and 0.57, p = 0.01). The same trend was present for gestational hypertension (1.00, 0.80 and 0.71, respectively, p = 0.08). CONCLUSIONS: Leisure time physical activity during the first half of pregnancy is likely to reduce the risk of pre-eclampsia and gestational hypertension.

Case-Control Studies↗
PubMed1989

Carcinoma of the lung. Evaluation of satellite nodules as a factor influencing prognosis after resection.

Satellite nodules are considered to be predictive of poor prognosis in breast cancer and in melanoma. In lung cancer, there is no information as to their definition, prevalence, or implication as a prognosis factor of survival after resection. Over the past 18 years (1969 to 1987), 84 patients underwent pulmonary resection for primary lung cancer accompanied by satellite nodules. These nodules were defined as well-circumscribed accessory carcinoma foci clearly separated from the main tumor but with identical histologic characteristics. All were smaller than the primary carcinoma and most were located within the same lobe. Survival rates of patients with satellite nodules were compared to those of 1021 patients without satellite nodules who underwent resection during the same time interval. The 1-, 3-, and 5-year survival rates for all patients classified as having no satellite nodules were 78%, 54%, and 44%, respectively, and the median survival for the entire group was 30 months. In patients with satellite nodules, these survival rates were 60.9%, 32.7%, and 21.6%, respectively, with a median survival of 15 months. The deleterious effect of satellite nodules was more significant in patients with stage I disease (p = 0.0008) than in patients with stage II (p = 0.0354) or stage III (p = 0.0145) disease. Survival data obtained by comparison of satellite nodule status and histologic characteristics shows that 5-year survival figures are better for patients with no satellite nodules in both the squamous and the nonsquamous groups. This study demonstrates that satellite nodules associated with lung cancer are indicative of locally advanced and/or premetastatic disease. These patients should be included in the stage group IIIa of the TNM stage grouping classification.

Adult↗
PubMed1988

Mammographic parenchymal features and breast cancer in the breast cancer detection demonstration project.

The Breast Cancer Detection Demonstration Project (BCDDP) screened 283,222 U.S. women for breast cancer by use of mammography and breast palpation. A sample of participants was followed up to determine the subsequent occurrence of breast cancer cases and deaths. We have used information from the BCDDP to evaluate the relation of mammographic parenchymal features to the incidence of and mortality from breast cancer, and to examine changes in this relation with duration of follow-up. We also reevaluated the relations of age, body weight, height, menopause, parity, and age at birth of first child to mammographic features of breast tissue. Among women 35-49 years of age at entry, those whose mammographic features were "glandular" or "homogeneously dense" had a 2.8-fold increase in risk of breast cancer compared to women whose mammographic features were "atrophic or fatty". The increased risk was observed up to 9 years after entry. Among women 50-74 years of age at entry, the risk of breast cancer was elevated by a factor of 1.7 for women with glandular or dense breast parenchyma compared to those with atrophic or fatty breasts. The increase in risk, however, diminished with increasing follow-up. The percentage of women with glandular or dense parenchymal features decreased as age, body weight, and parity increased. The percentage with glandular or dense features increased as height increased, and the percentage decreased with menopause. Mammographic parenchymal features were not associated with age at birth of first child.

Adult↗
PubMed1988

Breast cancer incidence and mortality in the breast cancer detection demonstration project [published errtum appears in J Natl Cancer Inst 1989 Oct 4;81(19):1513].

The Breast Cancer Detection Demonstration Project (BCDDP) was a program of five annual screening examinations for breast cancer that was conducted at 29 centers in the United States. This report presents data on breast cancer incidence and mortality among the participants. A total of 283,222 women were enrolled. Our analysis is based on 55,053 white women who were 35-74 years of age at entry and who were selected for follow-up. For the first 9 years after entry, the cumulative incidence of breast cancer was estimated as 243.6 per 10,000, which is 1.34 times the expected incidence derived by use of data from the Surveillance, Epidemiology, and End Results (SEER) program. In contrast, 9-year cumulative mortality from breast cancer was only 79.6% of that expected in women with the age distribution of BCDDP participants who did not have diagnosed breast cancer at the start of observation. The ratio of observed to expected breast cancer mortality was 0.89 for women 35-49 years of age at entry, 0.76 for women 50-59 years of age at entry, and 0.74 for women 60-74 years of age at entry. Breast cancer incidence and mortality were lower for women who entered the BCDDP for routine screening than they were for women who entered for a reason such as concern about breast disease, family history of breast cancer, or a physician's recommendation. Among cases diagnosed within 5 years of entry, the 5-year case fatality attributed to breast cancer was 8.5%. Case fatality for all stages combined was greater than 50% lower for cases that were screen-detected than it was for cases that were not screen-detected. Case fatality was lower for cases diagnosed within the first 5 years of entry (which encompassed the period of screening) than it was for cases diagnosed in the sixth or seventh years.

Adult↗
PubMed1988

Dietary fat in relation to prognostic indicators in breast cancer.

The relation of diet, especially fat intake, to recognized prognostic indicators for breast cancer was investigated in 666 women with a newly diagnosed infiltrating breast carcinoma. Diet during the year preceding diagnosis was assessed by interview using a food frequency questionnaire covering the intake of 114 food items. Prognostic indicators included axillary node involvement at diagnosis, estrogen receptor status, and selected histologic features of the primary tumor such as nuclear grade, histologic grade, tubule formation, mitotic activity, and nuclear size of tumor cells. After adjustment for total energy intake, age, body weight, and tumor size at diagnosis, an increase in saturated fat intake was related to an increased frequency of node involvement at diagnosis among postmenopausal patients. In contrast, an elevation in polyunsaturated fat intake was related to a reduction of the percentage of patients with positive nodes at diagnosis. This relation was observed among both premenopausal and postmenopausal patients. Dietary fat was not related to the estrogen receptor status of tumors. No association was found between dietary habits and histologic features of the primary tumor. These data suggest that dietary fat may have an effect on the growth or spread of breast cancer during the preclinical phase of the disease and that this effect may vary according to the type of fat considered.

Aged↗
PubMed1988

Relationship between mammographic and histologic features of breast tissue in women with benign biopsies.

Mammograms and histologic slides of a group of 320 women who had breast symptoms and a biopsy without cancer being found were reviewed. The mammographic features assessed were the parenchymal pattern and extent of nodular and homogeneous densities. In addition to the pathologic diagnosis, the histologic features assessed included epithelial hyperplasia and atypia, intralobular fibrosis, and extralobular fibrosis. Among premenopausal women, those with marked intralobular fibrosis were more likely to have large (3+ mm) nodular densities on the mammogram. Among postmenopausal women, epithelial hyperplasia or atypia was related to having nodular densities in at least 40% of the breast volume. In both groups, marked extralobular fibrosis was related to the presence of homogeneous density on the mammogram. We conclude that mammographic nodular densities may be an expression of lobular characteristics, whereas homogeneous density may reflect extralobular connective tissue changes.

Adult↗
PubMed1988

Condyloma and intraepithelial neoplasia of the uterine cervix: a case-control study.

Cervical condyloma and cervical intraepithelial neoplasia are related to human papillomavirus infections, some of which may be involved in the etiology of cancer of the uterine cervix. This case-control study was designed to assess the relation of age at first sexual intercourse, number of sexual partners, and cigarette smoking to the risk of cervical condyloma and cervical intraepithelial neoplasia. Cases and controls were premenopausal women under age 50 years who had been referred for examination at the Colposcopy Clinic of Saint-Sacrement Hospital in Quebec from 1982 to 1985. These were 136 cases of histologically confirmed cervical condyloma and 247 cases of cervical intraepithelial neoplasia. The 137 controls were women without anogenital condyloma, dysplasia, or carcinoma. Information on personal characteristics and exposures of subjects was obtained by interview. Associations observed with age at first intercourse were different for condyloma and cervical intraepithelial neoplasia. Relative risk of condyloma varied little with age at first intercourse. In contrast, relative risk of cervical intraepithelial neoplasia increased as age at first intercourse decreased. For the two types of lesions, relative risk was elevated among women with more than one sexual partner and increased steadily with increasing number of cigarettes smoked per day. The association with cigarette smoking was, however, somewhat stronger for cervical intraepithelial neoplasia.

Adult↗
PubMed1987

The classical and alternate pathways of complement in oral contraceptive users.

Whole complement (CH50), C3, C4, the alternate pathway activity of complement (APH50) and factor B were measured in 159 women currently taking oral contraceptives and in 186 women who were not taking the pill. The mean levels of all components of the complement, except APH50, were found to be elevated in current users compared to non-users. The elevation in serum levels was seen in the first year after initiation of oral contraceptive use. Thereafter, levels changed little with duration of use. Among women who stopped using oral contraceptives, complement levels were similar to those of women who had never used the pill. Results appeared to be similar irrespective of the type of progestagen included in the oral contraceptive. These data provide support for the view that oral contraceptives have no adverse effect on the classical and the alternate pathways of complement.

Adolescent↗
PubMed1986

Endogenous sex hormones, prolactin, and mammographic features of breast tissue in premenopausal women.

The relationship between levels of certain endogenous hormones and the mammographic features of breast tissue was evaluated in 110 premenopausal women who were referred to hospital-based radiology units for a routine xeromammogram. This analysis was based on specimens collected during the luteal phase of the menstrual cycle. Plasma 17 beta-estradiol, progesterone, and prolactin were measured, as well as urine estrone, estradiol, estriol, and pregnanediol. The main xeromammographic features of the breast assessed were Wolfe's parenchymal pattern and the percentages of the breast showing nodular densities and homogeneous density. In these data, endogenous hormones were not strongly associated with mammographic features of breast tissue. However, women with the N1 and P1 parenchymal patterns had somewhat higher levels of estrogens and prolactin and somewhat lower levels of progesterone than women with the P2 and DY patterns.

Adult↗
PubMed1984

Height and weight, mammographic features of breast tissue, and breast cancer risk.

A case-control study was conducted to evaluate the association of body size with morphologic features of breast tissue visible on mammograms, and to analyze the interrelations of these factors with breast cancer risk. The cases were 362 women with newly diagnosed breast cancer identified in 1978-1979 in three large hospital-based xeromammography units in Boston, Massachusetts, and one unit in Livingston, New Jersey. The controls were 686 women referred to these units in the same period for a "routine" mammogram. The parenchymal pattern (N1, P1, P2, DY) and the per cent of the breast showing nodular densities were the principal mammographic features assessed. Among controls, body weight was strongly but inversely associated with the per cent of women who had the high risk P2 or DY patterns and with the mean per cent of the breast showing nodular densities. Body weight and the amount of nodular densities were both directly related to breast cancer risk. The strengths of the relations of body weight and of nodular densities to risk were each increased when the other factor was taken into account.

Body Height↗
PubMed1984

[The patient's weight and height and the stage of breast cancer at the time of diagnosis].

The aim of this study was to evaluate the relation of body weight and height to the stage of breast cancer at the time of diagnosis. Information on weight, height and stage was abstracted from the medical records of 466 women with newly diagnosed breast cancer treated at the Hôpital du Saint-Sacrement in Quebec City from Jan. 1, 1975 to Mar. 31, 1981. The percentage of patients with regional disease or distant metastases was found to increase from 35.5% among women weighing less than 55 kg to 51.2% among those 65 kg or more. Palpation (including breast self-examination) may be less valuable or breast cancer biologically more aggressive in obese women.

Body Height↗
PubMed1982

The reproducibility of intrapartum cardiotocogram assessments.

Five obstetrician-gynecologists experienced in fetal monitoring assessed 150 intrapartum cardiotocograms obtained with an external transducer. There were three successive blind readings, the first two without any clinical data apart from gestational age. The reviewers indicated whether the tracings showed definite, possible or no abnormalities. The interpretations given by each reviewer for any one tracing were fairly consistent, but they varied markedly from one reviewer to another. The proportion of tracings interpreted as normal ranged from 39% to 74%, and the proportion assessed as abnormal ranged from 3% to 43%. All five observers agreed on the interpretation of 29% of the tracings. Inter-reviewer reproducibility scarcely changed when clinical data were provided. These findings emphasize the need to evaluate all methods of fetal monitoring before they become widespread.

Evaluation Studies as Topic↗
PubMed1982

Mammographic features of the breast and breast cancer risk.

The authors conducted a case-control study at two Boston, Massachusetts, are hospitals to evaluate the relation of anatomic features of the breast, visible on the xeromammogram, to the risk of breast cancer. The cases were 408 women with newly diagnosed breast cancer and the controls were 1021 women without signs or symptoms of breast disease. The features of the breast assessed were the "parenchymal pattern" as defined by Wolfe (Am J Roentgenol 1976; 126:1132-9), and specific radiologic characteristics which are components of the parenchymal pattern classification. Women whose mammogram showed the P2 or DY parenchymal patterns were at elevated risk compared to women with the N1 pattern. Further, risk increased regularly with increases in the percentage of the breast that showed nodular densities and with increases in the average size and concentration of these densities. Women with extensive homogeneous density were also at elevated risk. These findings were observed only among women aged 20-59 years. In this group, women with nodular densities in 60% or more of the breast appeared to have a five-fold increase in risk compared to women without nodular densities in the breast.

Adult↗