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Biomedical subjects

P Boiesen

Publications and source records attributed to P Boiesen.

11 recordsLinked to original sources
PubMed2005

Preoperative assessment of small tumours in women with breast cancer.

BACKGROUND AND OBJECTIVES: In patients with breast cancer, planning of the surgical strategy may rely on preoperative tumour size. The optimal method for assessment of small tumours has not been established. We compared findings from preoperative mammography and ultrasonography with histopathological tumour size in patients treated with breast-conserving surgery. MATERIAL AND METHODS: The study was retrospective and the setting a single institution clinic with free referral of patients. The patients were examined before the operation with mammography, ultrasonography, and findings were compared with postoperative histopathological tumour size. RESULTS: The study included 131 patients (median age was 59) years with grade I, II, and III cancers in 47, 71 and in 13 patients, respectively. The medium histological tumour size was 14 mm, range 4-45 mm. A wide 95% confidence interval between histopathological tumour size and preoperative mammography (standard deviation 4.8 mm) and ultrasonography (standard deviation 4.8 mm) was found. The combination of mammography and ultrasonography did not improve the results (standard deviation 4.3 mm). Preoperative mammography tended to over estimate the tumour size compared with histological tumour size whereas preoperative ultrasonography tended to underestimate the tumour size. CONCLUSION: In this retrospective study with preoperative evaluation of small breast cancers by mammography and ultrasonography, wide 95% confidence intervals for the methods were found and they should therefore be used with caution in the planning of the surgical strategy.

Breast↗
PubMed2001

S-phase fraction and urokinase plasminogen activator are better markers for distant recurrences than Nottingham Prognostic Index and histologic grade in a prospective study of premenopausal lymph node-negative breast cancer.

PURPOSE: Histologic grade, Nottingham Prognostic Index (NPI), estrogen receptor (ER) and progesterone receptor (PgR) status, and tumor size have previously been shown to be important prognostic indicators for distant recurrence of breast cancer. The purpose of this study was to compare the prognostic value of these factors with flow cytometric S-phase fraction (SPF), urokinase plasminogen activator (uPA), and plasminogen activator inhibitor type 1 (PAI-1) in premenopausal patients with lymph node-negative breast cancer. PATIENTS AND METHODS: In 237 consecutive premenopausal patients with lymph node-negative breast cancer and freshly frozen tumor material available, SPF, ER and PgR status, uPA and its inhibitor PAI-1, histologic grade, and NPI were evaluated. RESULTS: SPF was univariately the most powerful prognostic factor for distant recurrence, followed by uPA, histologic grade, PgR, age, ER, NPI, and PAI-1, the latter being nonsignificant. Multivariate analysis revealed that neither NPI nor histologic grade was significant after adjustment for SPF, a fact that may be explained by the strong association between these factors. uPA was, however, an independent prognostic factor in addition to SPF, NPI, or histologic grade. CONCLUSION: In this prospective study, SPF and uPA were found to be independent prognostic factors in premenopausal women with lymph node-negative breast cancer. We suggest that SPF, if performed under standardized conditions, can replace histologic grade as a selection instrument for adjuvant medical treatment. The value of the combination of SPF and uPA needs to be confirmed in an independent prospective trial.

Actuarial Analysis↗
PubMed2000

Ipsilateral local recurrence in relation to therapy and morphological characteristics in patients with ductal carcinoma in situ of the breast.

METHOD AND RESULTS: A standardized histopathological protocol has been designed, in which different histological characteristics of ductal carcinoma in situ (DCIS) are reported: nuclear grade (ng), growth pattern according to Andersen et al., necrosis, size of the lesion, resection margins and focality. Using this protocol a re-evaluation of a population-based consecutive series of 306 cases of DCIS has been done as well as a thorough clinical follow-up. After a median follow-up of 63 months, 13% have developed ipsilateral local recurrences, invasive and/or in situ. Ipsilateral local recurrence-free survival (IL-RFS) was significantly better for patients operated with mastectomy (ME) or breast conserving therapy (BCT) with radiotherapy (RT) than for patients operated with BCT without RT (5-year IL-RFS 96% vs 94% vs 79%, P<0.001). In the subgroup of BCT without RT there were significant differences in IL-RFS between histopathological subgroups: ng 1 + 2 (non-high grade) vs ng 3 (high grade; P=0.014), non-high-grade without comedo-type necrosis vs non-high-grade with comedo-type necrosis vs high-grade (the Van Nuys classification system; P=0.025). Growth pattern (not diffuse vs diffuse) and margins (free vs involved or not evaluated) showed a tendency (P=0.07 and 0.05, respectively) to be associated to IL-RFS. In contrast, no significant differences in IL-RFS were found in subgroups based on mode of detection, focality or size. Ninety-four per cent of the local recurrences after BCT appeared at the previous operation site. CONCLUSIONS: In the BCT without RT group, combinations of either non-high grade and not a diffuse growth pattern or non-high grade and free margins identified groups (constituting approximately 30% of the patients) were at low risk of developing ipsilateral recurrences (6-10%), compared to a 31-37% recurrence risk in the remaining groups during the observed follow-up time. The beneficial effect of post-operative RT for these low-risk groups can be questioned, and should be studied further.

Adult↗
PubMed2000

Histologic grading in breast cancer--reproducibility between seven pathologic departments. South Sweden Breast Cancer Group.

Histologic grade, including tubular formations, nuclear grade, and mitotic activity, is a well-documented prognostic factor in breast cancer. In comparison with other prognostic parameters, the evaluation of histologic grade is cheap and can be performed, in principle, in all cases of breast cancer. One possible disadvantage is that the evaluation may vary between different pathological departments. The aim of the present work was therefore to study the reproducibility of the histologic grading system by distributing haematoxylin-erythrosin-stained slides from 93 invasive breast cancers to the seven pathology departments within the southern healthcare region of Sweden. The evaluation was performed blindly and without any knowledge of other clinical parameters. In 31% of the cases the same histologic grade was obtained for all departments. The overall mean kappa was 0.54, indicating a moderate reproducibility. Of the three factors included in histologic grade, the agreement was best for tubular formations and poorest for nuclear grade and mitotic activity. The overall moderate reproducibility should be considered when the clinical usefulness of histologic grading is compared with other prognostic instruments.

Adult↗
PubMed1991

Retroperitoneal malignant cyst. Case report.

Forty years after removal of a benign mucinous cyst from the left retroperitoneal space, a malignant cyst with both sarcomatous and carcinomatous components was removed from the same site in a 75-year-old woman. Within 6 months the lesion recurred as a carcinoma penetrating the left colon and the abdominal wall.

Adult↗
PubMed1987

Experience of screening for carcinoma-in-situ of the testis among young men with surgically corrected maldescended testes.

One hundred and twelve young men with maldescended testes which had been surgically corrected were examined for premalignant/malignant changes in the testes. Bilateral testicular biopsies were made in ninety-four patients. Three had carcinoma-in-situ of the testis in the biopsy. Invasive tumour of seminomatous type was found in two of these testes after orchidectomy had been performed. No correlation was found with testicular localization pre- or postoperatively, with testicular volume or with tumour markers.

Adult↗
PubMed1985

Large rhabdomyosarcoma of the urinary bladder in an adult. Case report.

A 56-year-old woman presented with frequency of micturition, haematuria and cardiac decompensation. Intravenous urography showed a large bladder tumour and an expansive lesion in the left kidney. The bladder tumour, removed by TUR, was found to be a rhabdomyosarcoma, and the resected tissue weighed about 310 g. Bilateral, selective renal angiography revealed a large arteriovenous aneurysm in the right kidney and a solid malignant tumour in the left. The aneurysmal vessels were ligated and cystourethrectomy and left nephrectomy were performed 2, 3 and 10 months, respectively, after the TUR. The excised urinary bladder contained no resicual tumour. A renal cell carcinoma was found in the excised left kidney. The patient recovered well, and three and a half years after TUR of the rhabdomyosarcoma she is fully active, with normal renal function and no evidence of disease.

Female↗
PubMed1984

Seminoma after orchiopexy. A case report.

A 29-year-old man had been operated on for bilateral cryptorchism at the age of 11. The right testis was not found and was considered to be aplastic. The left testis was placed surgically in the scrotum. When he entered a follow-up study for early detection of testicular cancer, the right testis was found intraperitoneally and was removed. A left testicular biopsy showed carcinoma in situ and orchiectomy was performed. This testis contained an invasive seminoma.

Adult↗
PubMed1978

Pituitary-testicular function in patients with chronic alcoholism.

Testis and liver histology, and pituitary-testicular function were studied in thirty chronic alcoholics. Severe reduction of spermatogenesis was found in 30% and in these patients serum follicle stimulating hormone and prolactin concentrations were significantly higher. There was no correlation between abnormalities in the liver and testis. The serum testosterone was normal in most cases. Sexual dysfunction and testicular atrophy occurred in more than half of the patients and were not related to liver disease. Testicular disorder in chronic alcoholism may be independent of liver disease.

Alcoholism↗
PubMed1978

Sex steroids and sex-hormone binding globulin in males with chronic alcoholism.

Thirty men with chronic alcoholism were studied. Biopsies of the liver and testis were performed in all. Serum concentrations of total and non-protein bound (free) testosterone and oestradiol, dihydrotestosterone and sex-hormone binding globulin (SHBG) were determined. Testosterone and dihydrotestosterone concentrations were normal in most patients, whereas oestradiol and free oestradiol were above normal in approximately 50% of the patients. None of the hormones measured differed significantly between patients with and without cirrhosis. SGBG was significantly higher in men with severely reduced spermatogenesis compared to those with intact germinal epithelium, but there was no difference between men with and without cirrhosis. No relation could be demonstrated between clinical signs of hypogonadism and any of the hormones measured. The results support the view that hormonal and sexual disturbances may occur in chronic alcoholism independent of the presence of liver disease.

Adult↗