Biomedical subjects

R T Senie

Publications and source records attributed to R T Senie.

39 records · Page 3Linked to original sources

PubMedDate not supplied

Carcinoma of the male breast: analysis of prognosis compared with matched female patients.

BACKGROUND: Considerable debate exists concerning the prognosis of breast cancer in male patients compared with that in female patients. Some studies have observed worse prognosis for men; others suggested the higher mortality rates were primarily due to delayed diagnosis. METHODS: Survival time from diagnosis with invasive disease to death resulting from breast cancer of 58 men treated between 1973 and 1989 was compared with survival of 174 women treated between 1976 and 1978 who were matched by stage of disease and age at diagnosis. All patients were treated by mastectomy and axillary dissection. RESULTS: Tumors were < or = 2 cm in 70% of cases and 55% were free of axillary metastases. The histology of the tumors differed significantly by gender (p < 0.05). Significantly more men had estrogen receptor-positive tumors (87%) than did women (55%, p < 0.001). Survival at 10 years was similar for male and female patients. Multivariate analysis controlling for tumor size, number of positive axillary lymph nodes, age at diagnosis, histology, and receptor status indicated no significant difference in survival of male compared with female patients. CONCLUSIONS: These data conflict with the conventional wisdom that breast cancer in men carries a worse prognosis than the disease in women. Although histology of the tumor and receptor status differed by gender, these factors did not have an impact on survival in these paired patients. Our data indicate that breast carcinoma in males is not biologically more aggressive than in females.

Aged↗

PubMedDate not supplied

Possible related risks to breastfeeding.

Animal studies have identified a mouse mammary tumor agent transmitted through lactation that increases the incidence and reduces the age for tumor development in offspring. A similar viral particle has been detected with greater frequency in the milk of humans with a family history of breast carcinoma than in the milk of those with no history. Animal studies also indicate that a male offspring who has been breastfed, at low risk himself, could possibly transmit the agent through seminal fluid. The health team is encouraged to consider these factors when discussing infant feeding methods with women who have a positive family history of breast carcinoma.

Adult↗

PubMedDate not supplied

Health promotion and disease prevention in HMOs: a survey of newly established IPAs in New York City.

Independent Practice Associations (IPAs) are the fastest growing segment of the Health Maintenance Organization (HMO) industry, but little is known about their provision of health promotion and disease prevention to subscribers. To examine the extent to which IPA policies encourage health promotion and disease prevention, we interviewed medical directors and other senior administrators of six newly developing IPA-HMOs in New York City. We also reviewed promotional literature to assess how extensively health promotion and disease prevention were marketed to the potential subscriber. Although medical protocols for preventive screening exist in most IPAs, compliance with guidelines is left largely to the individual physician's judgment for implementation. IPA respondents suggested that their physician panels are oriented toward prevention, but there is uncertain evidence in this regard, and incentive payments could discourage referrals for screening. Health education programs are sporadic. Health promotion and disease prevention do not appear to be a high priority among six newly established IPAs in New York City. We recommend several steps that would encourage IPA-HMOs to increase their health promotion activities.

Adult↗