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Biomedical subjects

N M Gibbs

Publications and source records attributed to N M Gibbs.

At least 55 records · Page 3Linked to original sources
PubMed1988

Immunohistochemical distribution of c-erbB-2 in infiltrating and in situ breast cancer.

An immunohistochemical study of c-erbB-2 expression was performed on invasive and in situ breast cancer. Strong membrane staining was seen in 16% of the infiltrating ductal carcinomas and 44% of the in situ lesions. c-erbB-2 was overexpressed in ductal rather than lobular tumours. Our results indicate that a small sub-group of breast carcinomas are associated with over-expression of this oncogene which may define an important subgroup of in situ and infiltrating ductal carcinomas.

Breast Neoplasms↗
PubMed1988

c-erbB-2 expression in benign and malignant breast disease.

An antibody, 21N, raised against a synthetic peptide from the predicted sequence of the c-erbB-2 protein has been used immunocytochemically in a retrospective study of formalin fixed paraffin embedded breast biopsies. Fourteen out of 103 infiltrating ductal carcinomas exhibited positive membrane staining. Fifty-four of these tumours had lymph node involvement of which nine contained stained cells. These were all cases where the primary tumour was positive. In this series there was no correlation between c-erbB-2 overexpression and lymph node status. In five of the positive cases studied there was an associated in situ component which was also positively stained. Ten out of 24 pure intraduct carcinomas showed membrane staining, but none of the 149 benign conditions studied, which included 22 radial scars and 13 cases of atypical ductal proliferation, demonstrated the pattern of staining associated with overexpression. It is concluded that the c-erbB-2 protein is overexpressed in a minority (approximately 14%) of infiltrating ductal carcinomas and only in cells that are cytologically malignant. Overexpression of c-erbB-2 is considered in relation to pathogenesis.

Breast Neoplasms↗
PubMed1988

Topographical and histological presentation of mammographic pathology in breast cancer.

Between 1979 and 1985 surgical resections from 680 cases of primary breast cancer were examined histologically. The patients were divided into four groups: (i) patients aged between 45 and 69 years who had been screened (n = 316); (ii) those younger than 45 who had not been screened (n = 55); (iii) those aged between 45 and 69 who had not been screened (n = 104); and (iv) those older than 69 who had not been screened (n = 205). The material was compared in terms of the association between in situ and invasive carcinoma. There was a low incidence of lobular carcinoma in situ (LCIS) in all groups and a high incidence of ductal carcinoma in situ (DCIS) which declined with age. Ninety nine group i patients had in situ carcinoma or early invasive carcinoma (less than 1 cm in diameter) compared with 19 of group iii cases. Screened patients had fewer multicentric cancers and a lower incidence of large invasive cancer compared with unscreened patients. Group ii patients had a higher incidence of whole quadrant in situ carcinoma, multiple cancer, and lymph node metastases. Group iv patients had a lower incidence of in situ cancer, and more low grade cancer than the other groups. Cases were divided into four types on the basis of this analysis.

Adult↗
PubMed1986

Clearance technique for the detection of lymph nodes in colorectal cancer.

Lymph node metastases are an important determinant of prognosis following surgery for colorectal cancer. A xylene alcohol clearance technique has been employed in Guildford to facilitate the identification of lymph nodes in the mesorectum of rectal cancer specimens. The numbers of lymph nodes and lymph node metastases were compared with seven other centres and St. Mark's Hospital, where clearance techniques were not employed in patients undergoing a randomized trial of pre-operative radiotherapy for rectal cancer. The total number of lymph nodes identified per patient in the mesorectum of patients at Guildford (mean = 23.1 +/- 1.18) was significantly higher when compared with patients at St. Mark's Hospital alone (mean = 13.1 +/- 0.86) and the seven combined "non-cleared' centres (mean = 10.5 +/- 0.6) (P less than 0.001). The number of lymph node metastases per patient was significantly higher in the Guildford series (mean = 3.21 +/- 0.58) when compared with the seven combined centres (mean = 1.9 +/- 0.3) (P less than 0.05). The numbers of lymph node metastases found in the lowest part of the specimen close to the levator ani were significantly higher in the Guildford patients (mean = 1.2 +/- 0.4) compared with St. Mark's Hospital (mean = 0.13 +/- 0.1) and the seven combined 'non-cleared' centres (mean = 0.56 +/- 0.1). This clearance technique identified not only a greater number of lymph nodes but also more metastases within those nodes, particularly in the supralevator area of the mesorectum.

Colonic Neoplasms↗
PubMed1985

Prevalence of polyps in an autopsy series from areas with varying incidence of large-bowel cancer.

The results of this multicentre autopsy study emphasize the relationship between the prevalence of adenomas and the incidence of large-bowel cancer. The highest proportion of autopsies with adenomas was observed in the area with the highest incidence of large-bowel cancer. The segmental distribution of adenomas within the colon was found to be similar to the site distribution of cancer. However, the lowest proportion of adenomas was found in the rectum, the segment in which cancer is most frequent. The latter finding suggests that either the adenoma-carcinoma sequence is a less important pathway in the pathogenesis of rectal cancer, or that more rectal than colonic adenomas become malignant. The high proportion of hyperplastic polyps in the rectum, and statistically significant regional differences following the same patterns as the incidence of rectal cancer suggest that there could be at least an indirect relationship between hyperplastic polyps and cancer of the rectum. Adenomas of both colon and rectum were more frequent in men than in women, contrary to findings with colon cancer. However, as for colon cancer, the sex ratio of adenomas changed with age, from slightly below unity in persons under 65, to above unity for those aged 65 and over. A major difficulty that emerged was the histological identification of "polyps" because of the degree of autolysis of epithelial cells in the mucous membrane, and this difficulty largely contributed to the poor consistency of histological reporting. Regular consistency surveys of histological preparations should be recommended in any type of multicentre study in which histological examination is included.

Adult↗
PubMed1985

Comparative study of the histopathology of breast cancer in a screened and unscreened population investigated by mammography.

The histopathology of 360 surgical resections for breast cancer in a consecutive series of patients aged 45-69 years from 1979-1983 is described. Two hundred and seventeen patients who were offered screening (screened patients) were compared with 143 patients who were referred as out-patients with breast problems and were not offered screening (unscreened patients). Both groups were investigated by mammography. Comparisons between tumour staging, grading and quadrant involvement are reported. In the screened patients 31% were in the in-situ stage or had an invasive carcinoma less than 1.0 cm in maximum diameter, compared with 7% in the unscreened patients. Conversely 26% of the screened patients had cancers greater than 2.0 cm compared with 52% in the unscreened group. The percentage of cancer patients with lymph node metastases was comparable in both 1.0-2.0 cm and greater than 2.0 cm groups of invasive carcinoma. There were more multiquadrant cancers in the unscreened patients (32%) than screened patients (17%) and this was mainly due to differences in the incidence of carcinomas 1.0-2.0 cm in diameter. This suggests that invasive tumours of comparable size are more likely to produce symptoms leading to detection if multiquadrant. Multicentric cancers were more common in unscreened patients. Differences in the histological grading related to tumour size were found within the screened and unscreened groups but not between the two groups.

Adenocarcinoma↗
PubMed1984

Pressure infusors: variability in delivered infusion pressure.

A pressure infusor was used to apply external pressures of 300, 250, 200, and 150 mm Hg to 500-ml plastic bags of saline. At constant applied pressure, 50-ml aliquots of saline were periodically withdrawn. The delivered pressures were less than the applied pressures, and the difference increased as the volume of saline within the bag decreased. This inherent pressure difference should be considered when the system is used with a continuous flush device.

Catheterization↗
PubMed1983

The mammographic features of infiltrating epitheliosis.

The clinical, radiological and histological findings are described in nine cases of infiltrating epitheliosis. In seven cases the mammogram revealed 2.5-5.0 cm discoid radial scars which conformed with the histological features and there was no associated significant clinical abnormality. It can be difficult to differentiate the mammographic appearance of infiltrating epitheliosis from those of carcinoma with confidence but, taken in conjunction with the absence of clinical findings, the changes in the larger lesions are sufficiently distinctive to arouse considerable suspicion. The prevalence of the condition is estimated at 0.4/1000 women in the 45-65 years age range.

Breast↗
PubMed1983

Invasive breast cancer--the tip of an iceberg.

Use of large (6 in. X 4 in.) paraffin sections in the routine examination of specimens from patients with operable breast cancer has revealed multiple quadrant involvement by carcinoma in 20% of 186 consecutive cases. Eighty-nine per cent of patients had invasive carcinomas, which were associated with carcinoma in situ (CIS) in 71%. CIS was frequently extensive, and in 47% was remote from the principal invasive lesion. Fourteen patients had multifocal invasive disease with 34 separate primary tumours. The involvement of 32% of sampled axillary nodes by tumour, combined with this significant incidence of multiple quadrant disease, brings into question the rationale of local surgery in most cases even of early breast cancer. Mastectomy with node sampling permits full assessment of the extent of disease, which is essential for the logical selection of patients for adjuvant therapy. The potential role for limited surgery in non-invasive and very small invasive tumours in combination with radiotherapy remains under evaluation.

Adult↗
PubMed1982

Large paraffin sections and chemical clearance of axillary tissues as a routine procedure in the pathological examination of the breast.

The technique of large paraffin sections of the breast and lymph node dissection of axillary tissues after chemical clearance as used in a routine histology laboratory is described and discussed. The findings in 155 cases of breast malignancy derived from routine surgical patients and also from the breast screening clinic are described and analysed. There were 21 cases of in-situ carcinoma alone and an additional 17 cases with minimal invasive carcinoma (MIC). The maximum area of each lesion in one plane was measured and the size varied between less than 1 cm2 and 30 cm2, with an average of 7 cm2. The large lesions had the highest incidence of MIC. There were 117 palpable invasive carcinomas and they were divided into two groups, namely single quadrant (80%) and multiquadrant malignancy (20%). The clinical implications of this are discussed. Lymph node metastases were found in 36 (27%) of all invasive carcinomas but no metastases were found in either in-situ carcinoma alone or when combined with MIC in the eight cases which had a radical operation.

Adenocarcinoma, Mucinous↗
PubMed1981

Features of mammorgraphically negative breast tumours.

Mammography is a highly sensitive and specific technique in the diagnosis of breast cancer, but some tumours show no radiological features of malignancy. A total of 9.3 per cent of 323 consecutive patients with operable breast cancer had negative mammographic reports, and the clinical radiological and pathological findings in these cases are compared with those in the mammographically diagnosed group. Misinterpretation of carcinoma as a benign lesion and diagnostic difficulties in the dense dysplastic breast were found to be the main causes of error.

Adult↗
PubMed1980

Secondary carcinoma of left atrium simulating myxoma.

Three cases are presented in which secondary carcinoma in the left atrium mimicked atrial myxoma or infective endocarditis. Constitutional features of weight loss, fever, anaemia, leucocytosis, raised erythrocyte sedimentation rate, and systemic emboli were prominent clinical features. The association of these systemic manifestations with both secondary deposits in the atrium and atrial myxomata may be the result of an immune response to circulating tumour antigens. Mitral stenosis was present in two of the three patients suggesting that left atrial thrombus may provide a site for the seeding of malignant cells.

Adult↗
PubMed1978

The relationship between microcalcification and in situ carcinoma of the breast.

The relationship of microcalcification to lobulo-ductal dysplasia and non-invasive carcinoma was studied in 20 women with in situ carcinoma of the breast. All had microcalcification on the mammogram and in half there was also mammographic evidence of disruption of the breast structure. Three-quarters of the women presented with breast symptoms. Multifocal carcinoma was found in seven patients and the histology suggested that not all foci may progess to extensive duct infiltration or invasion. Calcification was found to occur both in carcinoma and in adjacent benign breast lesions and in three cases no evidence of calcification was found in the carcinoma, but was present in adjacent epitheliosis. The origin and distribution of microcalcification appears to be the same in epithelial hyperplasia, non-invasive carcinoma and invasive carcinoma and there may be a relationship between the amount of calcification and the activity of the epithelial cells. Microcalcification is not specific to breast cancer, but is a product of increased cellular activity in the lobulo-ductal complex and may be extruded into the surrounding interstitial tissue. This implies that microcalcification on the mammogram, particularly if sparse, demonstrates a high risk area of breast rather than a certainty of the presence of carcinoma.

Adult↗