N Apostolikas — Page 3

PubMedDate not supplied

Tamoxifen associated uterine pathology in breast cancer patients with abnormal bleeding.

The purpose of this study was to evaluate the underlying pathology in breast cancer patients treated with tamoxifen who present with abnormal bleeding. A total of 56 cases were studied and the histopathologic features of 50 curettage and 18 laparotomy specimens were reviewed. All patients were under tamoxifen treatment (10-40 mg daily) for a period ranging from 5 months to 15 years. Cervical and endometrial polyps were the most common finding in the D and C material (44%). Hyperplasia was the most frequent feature identified at hysterectomy, often combined with leiomyomas, adenomyosis and ovarian tumors. Five primary adenocarcinomas of the endometrium, most of them Stage I beta, Grade I minimally invading, were found as well. These data support the hypothesis that tamoxifen exerts a proliferative estrogen-like effect on the uterus. Abnormal bleeding in women under TAM treatment warrants prompt investigation and careful follow up of the patients.

Adenocarcinoma↗

PubMedDate not supplied

Cathepsin D may help in discriminating node-negative breast cancer patients at risk for local-regional recurrence.

OBJECTIVE: The objective of this retrospective study was to define the prognostic value of cathepsin D (CD) in the node-negative (N-) and node-positive (N+) subsets of breast cancer (BC) patients. PATIENTS AND METHODS: In primary tumor cytosols of 348, stage I-III, BC patients, with a complete standard histological examination and a 56 months mean follow-up, the ER, PR and CD concentrations were measured by standardized assays. CD values were then compared to the classical prognostic factors, the type of treatment and the outcome, in terms of Disease-Free-Survival (DFS) and type of Relapse, after stratification according to the nodal status. Statistical methods used were Cox regression and logistic regression. RESULTS: Using univariate analysis, CD > 60 pmol/mg prot in N- patients was significantly associated with shorter DFS as well as local-regional recurrence (LRR) while in multivariate analysis the same CD levels, together with T status, are the best predictors of short DFS. However, CD > 60 is the only potent predictor of LRR in N- patients. No prognostic value of CD was identified in N+ patients. The cutoff value of CD should be 60 pmol/mgprot. The combination of tumor size, ER status and CD concentration may yield reliable prediction of primary BC outcome in N- patients. CONCLUSION: CD is a marker of invasiveness, particularly loco-regional in node-negative breast cancer. The integration of this marker, in the routine of initial prognostic evaluation of this subset of patients is proposed.

Adult↗