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Plasma and erythrocyte total antioxidant status in patients with benign and malign breast disease.

The study was carried out on 25 women with breast cancer, 25 with fibrocystic breast disease and 19 healthy subjects. Antioxidant enzyme activities and total antioxidant status (AOX) were measured in erythrocyte and plasma of patients and healthies. Among the studied parameters, the erythrocyte Glutathione Peroxidase (GSH-Px) and Catalase (CAT) activities of patients with breast cancer were significantly different as compared to the control group values (p < 0.002 and p < 0.001) respectively. There was no correlation between total antioxidant status and any of these enzymes in erythrocyte and plasma activities of subjects. However, the positive correlation was found between erythrocyte and plasma Superoxide Dismutase [SOD(CuZn)] activities in all groups. Our results indicate that enzymatic and nonenzymatic antioxidants are differentially altered in human breast tumors. Since the total antioxidant status measurement isn't sufficient to evaluate the oxidant damage in breast disease, antioxidant enzymes must be measured separately in order to get additional information.

Adolescent↗

Theophylline and fibrocystic breast disease.

After literature reports linking fibrocystic breast disease (FBD) to methylxanthine ingestion, a pilot study was undertaken to investigate the possible contribution of theophylline to this effect. The major goal of this project was to measure the effect of theophylline therapy on FBD in asthmatic women. All women attending an allergy clinic or an obstetrics/gynecology clinic over a 9-month period were examined to clinically assess FBD and were asked to complete a detailed questionnaire covering health history, other risk factors, and drug and dietary methylxanthines. The sample included 62 asthmatic women, 66 allergic but not asthmatic women, and 72 nonallergic and nonasthmatic women. By use of the FBD clinical taxonomy with its 19-point scale going from 0 to 18 that was developed for this study, the three groups did not differ significantly in terms of mean severity of FBD. On analyzing the effect of each of the methylxanthines on FBD severity, there is clear evidence that total methylxanthines was a contributing factor in FBD severity with or without adjustment for relevant variables, such as age, menopause, pregnancies, and groups. Theophylline was significant only when adjustments were made for age, pregnancy, and menopause in contrast to caffeine that was only significant with no adjustments.

Adult↗

In vivo 1H-MRS evaluation of malignant and benign breast diseases.

This study was purposed to evaluate malignant and benign breast diseases on the basis of detecting choline compounds by in vivo localized 1H-MR spectroscopy. Thirty-five patients, prior to surgical treatments, including 19 cancers and 16 benign diseases were examined with breast imaging coil and inversion recovery 1H-PRESS (TR/TE/TI: 2000 ms/288 ms/160 ms) MR spectroscopy. Detection of choline was compared with the results of biopsy in each case. Choline was observed in all 19 cancer patients, while it was not detected in all other benign diseases. Detecting sensitivity of choline widely varied over the cancer cases in the range of 2.4-12.7 (average SNR value of 5.4) depending on the water/fat suppression and voxel size. Localized 1H-MRS using breast imaging coil can provide excellent sensitivity and spectral resolution to detect choline compounds present in reasonably small voxel (<1.5 cm3) of breast cancer lesion. Substantially this finding would be useful for differential diagnosis between malignant and benign breast diseases on the basis of choline observation by 1H-MRS when combined use with MR imaging.

Adolescent↗

Clinical and histologic aspects of proliferative and non-proliferative benign breast disease.

It has been known for years that benign breast disease is correlated with an increased risk for the development of breast cancer. Over the years, there have been many studies linking histological changes in benign breast biopsies and subsequent risk of breast cancer. In many of these reports, there was no attempt to standardize criteria and often the patient population under study was relatively small. Over the past decade, three large groups have agreed to use the same definition of benign changes and a unified set of criteria for the diagnosis of these lesions. The results from these three groups [Nashville, Nurses Health Study (NHS), and the Breast Cancer Detection Demonstration Project (BCDDP)] are strikingly similar. All three studies reported that if the biopsy revealed proliferative disease without atypia, the subsequent risk was approximately 1.5x. If the biopsy revealed atypical hyperplasia (AH), the risk was approximately 4.5x. If the patients with AH had a family history of breast cancer, their subsequent risk approached that of patients with in situ carcinoma (approximately 8-10x). In addition to family history, menopausal status seemed to play a role. In patients with AH, the breast cancer risk was much higher in pre- than post-menopausal patients. While the classification scheme proposed by Page and co-workers is useful in assigning different levels of risk to women with benign breast disease, it has not been universally accepted. Our major short-term goal should be to encourage pathologists to apply these criteria in a reproducible manner in their daily practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Diseases↗

The impact of postoperative nausea and vomiting on the practice of day surgery for Chinese women with breast diseases.

Background: Day surgery for breast disease is becoming popular but a key limiting factor of success is the development of postoperative nausea and vomiting (PONV). Methods: A prospective study of PONV was conducted on 62 patients undergoing breast surgery under general anaesthesia. Lumpectomy was performed in 40 patients. The other 22 patients underwent major breast operations including modified radical mastectomy and wide local excision and axillary dissection. A total of 10 mg of metoclopramide was injected intravenously on induction of anaesthesia and oral metoclopramide was prescribed as required to treat PONV. Results: PONV occurred in six (15%) and 14 (63.6%) patients undergoing minor and major operations respectively. The onset of PONV occurred earlier following minor than major operations. Eleven patients required antiemetics. Univariate analysis showed that the incidence and the first onset of PONV was significantly associated with major breast operation and duration of operation. Multiple regression analysis demonstrated that duration of operation was the only independent factor that affects the rate of PONV. However, the onset of nausea was associated with major surgery and the onset of vomiting with the duration of the operation. Patients with minor breast surgery were all discharged on the day of surgery. None of the six patients with PONV required readmission. Conclusion: Minor breast surgery can be readily performed as a day case. More effective antiemetic measures against PONV may be required in major breast surgery.

Journal Article↗

Depression and social stress among patients with benign breast disease.

One hundred and forty women referred to the Southampton breast clinic had a psychiatric interview at home, before their first clinic attendance. The 107 subsequently diagnosed as having benign breast disease had a high rate of depressive symptomatology in comparison with women in published surveys of the general population. In the year before referral, 25 (23 per cent) had had definite depression and 19 (18 per cent) had had borderline depression: at the time of interview 9 (8 per cent) had major depression and 22 (21 per cent) had minor depression. Depression in these patients was associated with recent life events and social difficulties. Mood disturbance and psychosocial stress may lead to medical consultation about benign breast disease, or even contribute to its development. Severe depression was less common in the 33 patients who turned out to have breast cancer, though more of them had minor depression, and they reported fewer recent life events.

Adult↗

Total and lipid-bound serum sialic acid in benign and malignant breast disease.

Elevation in the total sialic acid (TSA), TSA/total protein (TSA/TP) and lipid-bound sialic acid (LASA) concentration in serum occurs in breast cancer and we have studied the applicability of the assays in classification of undefined breast tumors. Sialic acid was determined by HPLC and the statistical evaluation included the receiver operating characteristic (ROC) and Youden's index analyses. In cancer patients, the serum LASA and TSA concentration was significantly higher (p < 0.05) than in patients with benign breast disease and all the markers were significantly higher (p < 0.0001) than in normal controls. All the markers had a low accuracy (AUCs < 0.75) in differentiating between breast cancer and benign breast disease and at the specificity level of 0.95 the corresponding sensitivities were 0.32 (TSA), 0.14 (TSA/TP) and 0.23 (LASA). The results indicate that both breast cancer and benign breast disease cause elevation of TSA, TSA/TP and LASA values in serum and do not provide reliable classification of undefined breast tumors.

Adolescent↗

[Ultrasonic diagnosis of breast diseases].

The main interest of diagnostic ultrasound for breast diseases is the differentiation between solid and cystic masses, between benign and malignant tumors, the precise measurement of tumors. From 601 cases compiled in the litterature, ultrasonic correct diagnosis reach 88% and more than 90% if tumor size is 2 cm or more. Differentiation between cancerous and benign tumor is based on the sensitivity graded tomograms method.

Breast Diseases↗

Diagnosis of breast disease and the role of the gynecologist.

The American Board of Obstetrics and Gynecology has recognized the special role of the obstetrician/gynecologist in the diagnosis and treatment of breast disease and indicated in 1985 that it would require a knowledge of breast disease in its certification process. It was also recommended that the obstetrician/gynecologist provide adequate information concerning screening and perform simple diagnostic studies including aspiration of cysts, fine-needle aspiration, and appropriate follow-up studies for patients treated for breast cancer. Because open biopsy often becomes part of the treatment for breast cancer, the Board stopped short of recommending that every obstetrician/gynecologist perform this procedure. The American College of Obstetricians and Gynecologists also has increased its efforts to more clearly define the role of the obstetrician/gynecologist in the diagnosis and treatment of breast disease. Questions have been raised concerning the lack of national standards to evaluate training in the diagnosis of breast disease surgery, and the College has convened a number of workshops to address these issues. This review discusses the issues raised both by the Board and the College. Diagnostic studies including simple procedures such as aspiration of cysts, fine-needle aspiration, and open biopsy are discussed. The role of the obstetrician/gynecologist in the screening examination is emphasized.

Biopsy, Needle↗

The influence of family history on breast cancer risk in women with biopsy-confirmed benign breast disease: results from the Nurses' Health Study.

BACKGROUND: An association between histologic category of benign breast disease (BBD) and breast cancer risk has been well documented. However, the influence of a positive family history (FH) on breast cancer risk among women with biopsy-confirmed BBD is less certain. METHODS: The authors conducted a nested case-control study of BBD and breast cancer risk among 2005 women who were enrolled in the Nurses' Health Study. Cases were women with breast cancer who had a previous benign breast biopsy (n = 395 women). Controls were women who also had previous biopsy-confirmed BBD but were free from breast cancer at the time the corresponding case was diagnosed (n = 1610 women). BBD slides were reviewed and categorized as either nonproliferative lesions, proliferative lesions without atypia, or atypical hyperplasia (AH). RESULTS: Compared with women who had nonproliferative lesions and no FH, women who had proliferative lesions without atypia and a positive FH had a higher breast cancer risk (odds ratio [OR], 2.45; 95% confidence interval [95% CI], 1.61-3.70) than women with no FH (OR, 1.51; 95% CI, 1.12-2.06; P = .07). Among women who had AH, the OR for the development of breast cancer was 4.38 (95% CI, 2.93-6.55) for those with no FH and 5.37 (95% CI, 3.01-9.58) for those with a positive FH (P = .57). There was no significant interaction between the type of BBD and FH (P = .74). CONCLUSIONS: A positive FH of breast cancer slightly increased the breast cancer risk among women who had proliferative lesions without atypia. The increase in risk of breast cancer associated with FH was not significant among women who had AH.

Adult↗

Benign breast diseases in an Afro-Caribbean population.

BACKGROUND: The diagnosis and effective treatment of benign breast disease still remains a clinical challenge and the need for surgical intervention has not been clearly defined. OBJECTIVES: To determine the patterns of benign breast disease in an Afro-Caribbean population in order to define the patterns of disease encountered and to review the approach to diagnosis and treatment. METHODS: A review of all breast biopsy operations performed for benign disease at the Kingston Public Hospital, Jamaica was made by examining a total of 333 patient records over a two year period. RESULTS: Of the cases reviewed this study clearly showed that the majority of benign breast lesions were due to fibrocystic disease (41%) and fibroadenomas (33%). Intraduct papillomatosis which accounted for 6.7% was the next in frequency. Other diseases found included fat necrosis 12 (4.4%) with breast abscess and mammary duct ectasia in eight patients (3%) each. Fourteen patients (5%) had no diagnostic abnormality. The mean age of patients with fibroadenoma was 20 years whereas the mean age of patients with fibrocystic disease was 40 years. The co-existence of fibrocystic disease with malignancy was reported in 15 cases. CONCLUSION: Benign breast disease in this population occurs mainly in young women less than 30 years of age. Eighty per cent of breast biopsies done in patients with palpable lumps are for benign disease. The data support a more conservative approach to diagnosis and management of these patients.

Adult↗

Obesity and breast disease. The role of the female sex hormones.

An Australian study of 513 women evaluated associations between obesity and both benign and malignant breast disease, and in particular investigated the role of female sex hormones. Women who gained more than 10 kg from early womanhood had a two-fold increase in risk of developing breast cancer, whereas lean women had a greater risk of being treated for benign breast disease. Obese women with breast cancer were more likely to have Stage II tumors but there was no significant association between obesity and tumor size or estrogen and progesterone receptor status. Obesity was strongly associated with the proportions of nonprotein-bound and albumin-bound estradiol, and inversely associated with sex hormone binding globulin (SHBG) levels and the proportion of SHBG-bound estradiol. In addition, age at menarche was inversely associated, and age at menopause directly associated with recalled weight at those time periods. These data demonstrate weight gain as a risk factor for breast cancer, and suggest a possible mechanism supporting its development.

Adolescent↗

Influence of oral contraceptives on breast diseases.

Three sources of information are available pertaining to the effect of oral contraceptive hormones on the breast: 1) toxicity experiments in animals; 2) histologic examinations of breast tissue from women taking hormones; and 3) epidemiologic studies of women using hormones. Animals treated with hormones at doses equivalent to the human contraceptive level have not developed cancer of the breast at a greater than expected frequency. Monkeys, the one experimental animal with a reproductive cycle similar to humans, have not developed cancer during long-term hormone administration except for a single animal which likely represents a chance occurrence. In humans, histologic studies of breast tissue have failed to identify abnormalities which could be attributed to hormones with rare exceptions of secretory change indistinguishable from normal lactating breast. Epidemiologic studies have usually shown a decreased frequency of benign breast disease and neither an increase nor a decrease in carcinoma of the breast. The one exception to the latter statement is a possible increased risk of cancer in long-term users who have had previous surgery for benign breast disease.

Adenofibroma↗

Fibronectin concentration in the plasma of patients with malignant and benign breast disease.

Fibronectin concentration was determined in plasma from 97 patients with benign or malignant breast disease and from 62 controls. Median plasma fibronectin concentration (microgram FN/ml plasma) appeared to be significantly higher in patients with non-metastatic or metastatic breast cancer as compared to age-matched controls (P less than 0.01 and P less than 0.03, respectively); however, statistical significance disappeared when results were expressed as a function of total plasma protein content (microgram FN/mg total plasma protein). In patients with benign breast disease plasma fibronectin values were not significantly different from control levels. Our data indicate that the clinical usefulness of measuring FN in breast cancer patients appears to be very limited.

Adult↗

Characterization of RhoC expression in benign and malignant breast disease: a potential new marker for small breast carcinomas with metastatic ability.

The most important factor in predicting outcome in patients with early breast cancer is the stage of the disease. There is no robust marker capable of identifying invasive carcinomas that despite their small size have a high metastatic potential, and that would benefit from more aggressive treatment. RhoC-GTPase is a member of the Ras-superfamily and is involved in cell polarity and motility. We hypothesized that RhoC expression would be a good marker to identify breast cancer patients with high risk of developing metastases, and that it would be a prognostic marker useful in the clinic. We developed a specific anti-RhoC antibody and studied archival breast tissues that comprise a broad spectrum of breast disease. One hundred eighty-two specimens from 164 patients were used. Immunohistochemistry was performed on formalin-fixed tissues. Staining intensity was graded 0 to 3+ (0 to 1+ was considered negative and 2 to 3+ was considered positive). RhoC was not expressed in any of the normal, fibrocystic changes, atypical hyperplasia, or ductal carcinoma in situ, but was expressed in 36 of 118 invasive carcinomas and strongly correlated with tumor stage (P = 0.01). RhoC had high specificity (88%) in detecting invasive carcinomas with metastatic potential. Of the invasive carcinomas smaller than 1 cm, RhoC was highly specific in detecting tumors that developed metastases. RhoC expression was associated with negative progesterone receptor and HER-2/neu overexpression. We characterized RhoC expression in human breast tissues. RhoC is specifically expressed in invasive breast carcinomas capable of metastasizing, and it may be clinically useful in patients with tumors smaller than 1 cm to guide treatment.

Animals↗

Inadequate corpus luteal function in women with benign breast diseases.

The corpus luteum function of 109 patients with benign breast disease was appreciated by way of plasma progesterone and estradiol determinations during the luteal phase. These patients had ovulatory cycles according to a biphasic basal body temperature curve; blood samples for plasma progesterone and estradiol estimation were collected between the first and the last day of the thermal plateau following the thermal nadir. Results obtained were compared to those observed in 50 normal ovulatory women. In the patients' group, the mean daily levels for progesterone ranged from 3.5 +/- 0.4 (SE) ng/ml to 8.1 +/- 3.8 (SE) ng/ml according to day of blood collection. These values are significantly different from the corresponding daily values observed in normal women. No significant difference was observed concerning plasma estradiol between patients and normal women. These findings indicate that women with benign breast disease have an inadequate corpus luteum function which may be secondary to an ovulation disorder. Pathophysiological implications resulting from this observation are discussed.

Adolescent↗

[Intracytoplasmic lumina of benign and malignant breast diseases--a light and electron microscopic study].

Intracytoplasmic lumina (ICLs) of 70 cases with breast carcinoma and 29 cases with benign breast diseases were observed by light and electron microscopy. ICLs were morphologically divided into two types. Type A was characterized by the presence of secretory materials stained with eosin in the lumen and Type B by the cytoplasmic vacuoles under light microscope. Electron microscopic observation on Type A ICLs showed numerous filiform microvilli projecting towards the lumen and various amounts of secretory materials in the lumen. Type B of ICLs only had scanty and short microvilli and rarely secretory materials in the lumen. The results indicated that: 1. The frequency of ICLs in breast cancer was significantly higher than that in benign breast disease (P less than 0.01). 2. The frequency of ICLs in breast cancer showed strong negative correlation with its histological grades but not with its histological types. 3. ICLs had similar frequency under both light and electron microscopes. As a relatively specific structure in breast carcinoma cells, ICLs may be helpful in the diagnosis of breast carcinoma and establishment of the breast origin for metastatic carcinoma.

Adenofibroma↗