Has genetic testing for breast cancer come of age?
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Adult↗
Biomedical subjects
M Haid
Publications and source records attributed to M Haid.
Digital rectal examination, serum prostate specific antigen, and prostatic ultrasound: how effective is this diagnostic triad?
Ninety-nine of 105 consecutive men who underwent transrectal prostatic ultrasound (TRUS) at Highland Park Hospital had the results correlated with digital rectal examination (DRE), serum prostate specific antigen (PSA), and biopsy results. Ninety-six cases had evaluable ultrasound studies. Thirty-two of the 99 who underwent biopsy had primary carcinoma of the prostate. Prostate volume, predicted PSA, a ratio of observed/predicted PSA, and Gleason score were examined. There was no correlation between age and prostate volume, volume and the presence of carcinoma, or PSA and Gleason score. Thirty-one point six percent of the abnormal DREs, 36.6% of the abnormal TRUSs, and 40.6% of the elevated PSAs occurred in men with prostatic carcinoma (PCa). If PSA was normal (less than or equal to 4.0 ng/ml) and either DRE or TRUS was abnormal, then the risk of carcinoma was 2.9%. If PSA was elevated, regardless of the other two tests, the risk of finding PCa was at least 38%. If all three tests were abnormal, the risk of carcinoma was 38% in our series and 68% in a meta-analysis. Many men with PSA values between 4 and 10 ng/ml have benign biopsies. However, close future follow-up with consideration of repeat biopsy should be strongly considered.
Aged↗
Metastasis from adenocarcinoma of the lung producing acute appendicitis.
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Adenocarcinoma↗
Silicone elastomer catheter for chronic vascular access.
The Evanston and Glenbrook Hospitals' series of 157 consecutive silicone elastomer central venous catheter insertions is reviewed. The total experience was 12,721 patient days (34.85 patient years). The complication rate of insertion was 1.91%, but no patient required chest tube drainage. Seven catheters clotted and could not be salvaged. Seventeen catheters were removed for suspected bacterial infection. Peripheral blood culture was not predictive of catheter tip contamination, while culture of blood drawn through the catheter and insertion site cultures proved most useful. Five bona fide infections were documented for an infection rate of 3.18%. This corresponds to one infection per 2,544 patient days (6.97 patient years). The mean duration of service of the catheter was 81 days with a median of 36 days. The longest duration was 707 days. The silicone elastomer catheter provides safe, dependable venous access for most patients and may be inserted in an outpatient and therefore cost-effective setting.
Bacteria↗
Serum pseudocholinesterase levels in murine C3H mammary adenocarcinoma.
Serum pseudocholinesterase (PSC) levels may be depressed in persons with malignancy. Deficiency of this enzyme can lead to prolonged apnea in patients who receive succinylcholine. An animal model was developed to study this phenomenon in a controlled setting. C3H/HeJ mice inoculated subcutaneously with C3H mammary adenocarcinoma demonstrated lowering of their PSC levels. This decrease was attenuated by chemotherapy with intraperitoneal cyclophosphamide which also prolonged survival. Non-tumor bearing control animals identically treated with cyclophosphamide experienced a transient drop in PSC on the 29th day which reverted to control values by the 36th day. No gradient of PSC could be demonstrated across a tumor's vascular bed. The effect of other chemotherapy agents on PSC is unknown. A possible role for PSC as a non-specific marker for malignancy is worthy of further study.
Animals↗
An immunosorbent assay for blood group I antigens in breast carcinoma.
Tumor cells elaborate and release into the circulation a variety of glycoproteins. An enzyme-linked immunosorbent assay (ELISA) was developed to monitor carbohydrate structures secreted into the circulation. Among these antigens are the structures specific for the blood group I antigens, which are incompletely converted to ABH antigens on the membranes of tumor cells. The I antigens in the sera of 67 women with breast carcinoma (BCa), 58 with benign breast disease (BBD), and 47 controls were measured by the ELISA. In this assay, I antigen from ovarian cyst mucin was bound to the wells of polystyrene microtiter plates. The monoclonal human anti-I antibody (Hy) was added to the wells along with perchloric acid extracts of patient and control sera at five different dilutions. The anti-I binding to the solid-phase I antigen was determined after incubation steps with peroxidase-labeled anti-human IgM and substrate. The amount of sera extracts giving 50% inhibition of anti-I (Hy) binding was determined from the inhibition curves which were corrected by integrating the slope values into that of the standard curve obtained with extracts of normal sera. The I antigens were significantly higher in pathologic stage (PS) IV sera (P less than 0.001), and comparable in PS I, PS II, and PS III and BBD sera to those in control sera. The anti-I (Hy) binds strongly Gal 1,4 GlcNAc 1,6 Gal (alpha GalNAc); Gal 1,4 GlcNAc 1,6 (Gal 1,4 GlcNAc 1,3) Gal; and to a lesser extent Gal 1,4 GlcNAc 1,3 Gal 1,4 GlcNAc (0.06, 0.09, and 0.35 mM, giving 50% inhibition, respectively). It was concluded that similar or related structures may be expressed on the membrane of metastatic BCa cells.
Antibodies, Neoplasm↗
Phase II trial of aminothiadiazole in previously treated and untreated patients with advanced colorectal carcinoma: an Illinois Cancer Council Trial.
Eighty-three patients with advanced colorectal carcinoma were entered on a phase II trial of weekly iv aminothiadiazole (125 mg/m2) plus daily oral allopurinol (300 mg). There were five partial responses. Median survival of all patients on study was 36 weeks from entry (48 weeks for those without prior therapy and 34 weeks for those with previous chemotherapy). Toxicity was generally mild and consisted predominantly of stomatitis. In the dose given, aminothiadiazole has limited activity against metastatic colorectal cancer.
Clinical Trials as Topic↗
Aziridinylbenzoquinone in recurrent, progressive glioma of the central nervous system. A Phase II study by the Illinois Cancer Council.
Aziridinylbenzoquinone (AZQ) was studied in a Phase II protocol for persons with glioma of the central nervous system (CNS) recurrent or progressive after surgery and radiotherapy. Patients received AZQ, 30 mg/m2 intravenously every 3 weeks if previously untreated or 27.5 mg/m2 if previously exposed to cytotoxic drugs. Partial response was defined as a reduction of at least 50% reduction in the product of the two longest perpendicular diameters of the indicator lesion persisting for a minimum of 28 days. Twenty-eight patients are evaluable for response at this time. Objective response (OR) occurred in four (14.3%): two complete and two partial. Stabilization of disease (SD) was seen in 7 (25.0%). Median survival, in weeks, was greater than 46.0 for responders, 41.7 for SD, and 19.3 for those with progressive disease. The survival experiences are significantly different (P = 0.030 [Breslow]). The OR rate was 21.1% in 19 without prior chemotherapy and 0% in 9 previously treated patients. There were two AZQ-related deaths in patients with prior exposure to nitrosoureas (1 CNS hemorrhage; 1 aspiration pneumonia). One patient had an anaphylactic reaction. Three patients whose tumor initially increased in size subsequently had marked tumor shrinkage. AZQ is an active agent that must be used with added caution in patients who have received nitrosoureas. Initial tumor enlargement may precede response. Although response appears to prolong survival, the correlation between stabilization of disease and survival is not well-defined.
Adolescent↗
Additive cytotoxicity of adriamycin and a naturally occurring growth inhibitor extracted from bovine aorta.
A factor of nominal molecular weight 6K-10K Daltons, isolated from bovine aorta, has previously been shown to inhibit neovascularization and tumor growth in vivo and the growth of some tumor cells as well as endothelial cells in culture. This factor, termed A-10, was tested alone and in combination with Adriamycin against TA3Ha mammary adenocarcinoma cells in tissue culture. It was found to have cytotoxicity additive to that of Adriamycin in inhibiting the growth of these cells. In vitro and animal studies show that the sequence of Adriamycin----A-10 is superior to either agent alone in delaying the appearance of palpable tumors after subcutaneous injection of 10(5) pre-treated tumor cells in the tail of strain A mice. While the growth rate of the primary tumor was not affected by such treatment, survival was prolonged to a greater degree by the this sequence than by either of these agents used alone. A-10 treatment reduced the number of metastases to the adrenal gland but not to lung, liver, or lymph nodes. It did, however, reduce the size of metastases to para-aortic lymph nodes.
Animals↗
Primary lymphoma of the brain: a case report and review of the literature.
A case of primary lymphoma of the brain is presented. The disease is rare and thus firm guidelines for therapy are lacking. Whole-brain irradiation therapy, the accepted treatment of choice, when given to a dose of 5000 rads, is associated with improved survival. However, the overall prognosis is poor due to local recurrence in the central nervous system and the tumor's ability to diffusely infiltrate the meninges. Twenty-six percent of the cases may have positive cerebrospinal fluid cytology. Whether the addition of intrathecal chemotherapy with agents such as methotrexate will improve upon the results obtained with irradiation therapy alone would be an appropriate subject for a cooperative prospective randomized study.
Brain Neoplasms↗
Treatment of breast carcinoma recurrent after adjuvant chemoimmunotherapy.
Between July 1975 and June 1979, 194 patients with State II or III breast carcinoma were randomized to receive either L-phenylalanine mustard (L-PAM), cyclophosphamide and 5-fluorouracil and prednisolone (CFP), or CFP and BCG. Sixty-one patients have recurred despite the adjuvant chemoimmunotherapy trial. Fifty-three are evaluable for survival and 36 for response to chemo-hormonal therapy. Those treated with a chemo-hormonal regimen for their first recurrence exhibited a 53% objective response rate to cytotoxic therapy or a 35% response to hormonal therapy. Prior exposure to L-PAM, cyclophosphamide, or 5-fluorouracil did not preclude response to "salvage" therapy regimens containing those agents. Neither menopausal status, estrogen receptor content, size of the primary tumor, adjuvant treatment, nor extent of the recurrence had any effect on subsequent survival. Overall, the entire group exhibited median survival of 37 months from initial diagnosis and 13 months from recurrence. Unlike recurrent Hodgkin's disease, there was no demonstrable relationship between the length of the disease-free interval and the likelihood of subsequent response to cytotoxic or hormonal treatment. Comparison is made to the results of "salvage" therapy administered after three other large adjuvant treatment series.
Adjuvants, Immunologic↗
Serum cold agglutinin and IgM levels in breast carcinoma.
Breast carcinoma (BCa) cells produce I antigen or I antigen-like substances that may influence serum anti-I. We determined cold hemagglutinins in 170 BCa patients, 97 women with benign breast disease, and 37 female controls of comparable ages to the patients. The results were expressed as an anti-I score. Serum IgM was measured by radial immunodiffusion. The data for the BCa patients were analyzed by pathologic stage (PS) and histologic category. The anti-I score for PS III (28.1 +/- 13.0; mean +/- S.D.) was higher (p less than 0.02), and that for PS IV (11.4 +/- 7.4) lower (p less than 0.02) than the control value (17.7 +/- 10.2). IgM concentrations of the BCa patients as a group or by PS were similar to those of the controls. The mean anti-I scores were higher in mucinous (31.1 +/- 14.9, p less than 0.001) and apocrine BCa (28.6 +/- 16.2, p less than 0.02) compared to the control value. IgM concentrations were elevated in mucinous (218.1 +/- 85.8 mg/dl, p less than 0.01) and apocrine BCa (241.9 +/- 99.0, p less than 0.005) compared to the control value (157.1 +/- 66.9). The results suggest an association of anti-I scores and PS of BCa and suggest an antigenic difference of mucinous and apocrine from infiltrative ductal BCa.
Adenocarcinoma↗
Immunofluorescent evidence of prior herpes simplex virus type-2 infection in prostate carcinoma.
The finding of herpes simplex virus type-2 (HSV-2) particles in prostatic carcinoma (PCa) tissue has led to speculation that the virus might cause this disease. We studied 27 PCa and 33 benign prostatic hyperplasia (BPH) specimens for the presence of HSV-2 antigens by indirect immunofluorescent staining to HSV-2 using commercially prepared rabbit anti-HSV-2 and fluorescein-tagged goat and anti-rabbit antibody. The slides were randomly number coded by an impartial referee then read independently by each investigator. In cases of disagreement, new slides were prepared and read until agreement. The code was then broken. Seven of 27 PCa specimens and 8 of 33 BPH specimens showed positive staining. By contingency table analysis, the results were not statistically different (chi 2 = 0.0224; p greater than 0.8). In our series, there is no difference in the prevalence of HSV-2 staining between PCa and BPH. Further examination of our data failed to show any difference in the prevalence of staining for HSV-2 based on whether the source of the tissue was surgical or autopsy. We conclude that HSV-2 infection of the prostate is common (15/60 = 25%) but probably has no causal relationship to PCa.
Antigens, Viral↗
People and dollars: the experience of one hospice.
The Hospice of the North Shore (HONS) provides home hospice care, using local hospitals when inpatient care is essential. The actual cost of 4,779 patient days of care delivered from May 1, 1980 through Dec 31, 1981 was $14.26 per patient day. The median length of service was 31.5 days, with a mean of 66.4 days. Care was provided to 22.3% of all those dying of cancer during 1981 within the service area of the HONS. It is estimated that each patient receiving hospice care avoids 11.05 days of traditional inpatient care, resulting in a saving of $3,167.06 during the index period of this study. If this saving were extrapolated to a national scope, it is conservatively predicted that approximately $266,000,000 could be saved annually. The experience of the HONS strongly supports further development of outpatient, home care hospice organizations.
Adolescent↗
Malignant Brenner tumor of the ovary. Electron microscopic study of a case responsive to radiation and chemotherapy.
A patient with malignant Brenner tumor of the ovary is presented. The tumor responded to combined therapy with radiation plus doxorubicin + cyclophosphamide despite earlier failure on a single alkylating agent (levophenylalanine mustard). The patient next exhibited a brief response to chemotherapy with hexamethylmelamine + cyclophosphamide + amethopterin + 5-fluorouracil. The histologic findings and ultrastructure of the tumor are discussed in detail. The morphologic features are consistent with the proposed origin of Brenner tumors from coelomic epithelium through a process of secondary urothelial metaplasia.
Aged↗
Effect of interferon therapy on indomethacin-sensitive immunoregulation in the peripheral blood mononuclear cells of renal cell carcinoma patients.
The effect of interferon (IFN) therapy on prostaglandin (PGE)-synthesizing immunoregulatory cell function was assessed in the peripheral blood mononuclear cells of renal cell carcinoma patients. Ten patients were treated daily for 28 days with either 1 X 10(6) IU (five patients) or 10 X 10(6) IU (five patients) of leukocyte IFN. Patient cells were assessed for phytohemagglutinin (PHA) responsiveness in the presence and absence of the PGE synthetase inhibitor indomethacin. Progressive impairment in PHA responsiveness was found in all patients by the end of 28 days of therapy. It was associated with increased levels of indomethacin-sensitive suppressor function. Change in any of the patients studied was not correlated with IFN dose level. There was no correlation between clinical response to IFN and alterations in these parameters of immune function. In co-culture experiments, preincubation of glass-adherent cells with IFN led to increased indomethacin-sensitive regulatory function. These results suggest that IFN can produce progressive impairment of PHA-induced lymphoproliferation by increasing PGE-synthesizing immunoregulatory cell activity.
Adenocarcinoma↗
Breast carcinoma: expected results with prevailing therapy.
Computer-stored tumor registry data were scanned to produce the set of patients whose breast carcinoma was either diagnosed or first treated at Evanston Hospital between the years 1973 and 1977, inclusive. Of 560 evaluable patients, 184 were less than or equal to age 50 (LE 50), and 376 were greater than age 50 (GT 50). Comparisons of projected survival show that the survival of all patients is 8% at 5 years and 72% at 7 years. The survival of patients LE 50 is nearly identical to that of the GT 50 age group. Survival of Stage III GT 50 patients, however, is better than Stage III LE 50 (P less than 0.001). Comparison with earlier studies shows an historical trend toward better 5-year survival. Data were generated in this study which allow prediction of prognosis based upon age and stage at diagnosis.
Age Factors↗