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[Infrared light scanning in differentiating benign and malignant breast diseases].

One hundred and fifty patients with various breast diseases were studied using infrared light scanning. The results were compared with those of X-ray mammography and BUS. In 42 cases of breast cancer, 97% were correctly diagnosed using infrared light scanning. The method was significantly superior to X-ray (60%) and BUS (83%). To detect benign diseases, including adenofibromas (30 cases) and hyperplasias (21 cases), infrared light scanning was useful in this series in contrast to X-ray and BUS.

Adenocarcinoma↗

Immunocytochemical demonstration and significance of p21 ras family oncogene product in benign and malignant breast disease.

It has been suggested that the immunocytochemical demonstration of the p21 ras oncogene product is a useful marker of malignancy in breast disease. We have studied the reactivity of a series of specimens of benign and malignant breast disease with the anti ras p21 monoclonal antibody Y13-259, and shown widespread positive staining in both benign and malignant (including metastatic) disease as well as in adjacent 'normal' epithelium. In addition some staining of stromal cells as well as nerve fibres was observed. Our results suggest that the presence of ras p21 protein as demonstrated by this antibody is not a useful marker of malignancy or of proliferating epithelium but is rather a normal feature of certain cell types.

Adenofibroma↗

A sebotrophic stimulus in benign and malignant breast disease.

The sebum-excretion rate (S.E.R.) has been found to be increased in patients with benign as well as malignant breast disease. The S.E.R. was not increased in patients undergoing surgery for other diseases. It is considered that the sebotrophic hormone may also be mammotrophic. Drugs such as reserpine and the phenothiazines which increase sebum production may perhaps provoke benign as well as malignant breast disease.

Acne Vulgaris↗

Prognostic significance of residual breast disease and axillary node involvement for patients who had primary induction chemotherapy for advanced breast cancer.

BACKGROUND: We performed this study to determine the prognostic significance of clinical tumor size, pathologic measurement of residual tumor, and number of positive axillary nodes in the surgical specimen relative to overall survival for patients who underwent primary induction chemotherapy for advanced breast cancer. METHODS: Data, collected prospectively between 1997 and 2002, included clinical tumor-node-metastasis stage, age at diagnosis, hormone receptor status, type of preoperative chemotherapy, histological type, surgical procedure, pathologic measurement in centimeters of residual breast tumor, and the number of positive axillary nodes in the surgical specimen. Univariable correlates of residual breast disease were assessed by using the chi2 test. Recursive partitioning analysis was used to determine the prognostic significance of clinical tumor size, residual tumor size, and pathologic node involvement relative to overall survival. Survival was estimated by using the method of Kaplan and Meier and compared by using the log-rank test. A P value of <.05 was considered significant. RESULTS: Data were available for 85 patients with advanced breast cancer. Although univariable analysis identified increasing age, clinically involved axillary nodes, and a higher clinical tumor-node-metastasis stage as predictors of an increased risk of residual disease, recursive partitioning analysis identified more than three involved axillary nodes in the surgical specimen, with or without any measurable residual breast disease, as the most significant predictor of decreased survival (P<.001). CONCLUSIONS: Pathologic axillary node involvement was the most significant predictor of decreased survival for patients who had undergone primary induction chemotherapy for advanced breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗

Hydroxyproline and zinc excretion in patients with neoplastic breast disease.

Hydroxyproline and zinc excretion was evaluated in 87 patients with neoplastic breast disease; 40 of these had carcinoma, without radiological and scintigraphy demonstration of bone metastases. In the group of patients with breast cancer, the mean values of hydroxyproline and zinc excretion were found to be significantly higher than in the group with benign breast disease; only 12 of the patients with histologically detected breast cancer had hydroxyprolinuria levels which were higher than the upper limit of the values obtained in the control group. The authors, therefore, conclude that the patients in this group must be considered as being at greater risk.

Adolescent↗

Pathologic features of breast cancers in women with previous benign breast disease.

To compare pathologic features of the cancers arising after different types of benign breast disease (BBD), we reviewed the invasive breast cancer slides of 169 women with a previous benign biopsy result. Lesions were categorized previously as nonproliferative, proliferative without atypia, or atypical hyperplasia. Pathologic features of the cancers were evaluated without knowledge of the previous BBD category. Estrogen and progesterone receptor immunohistochemistry was performed on available tissue blocks. The median times between a benign result and cancer were 100, 124, and 92 months for women with nonproliferative lesions, proliferative lesions without atypia, and atypical hyperplasia, respectively. Cancers in the 3 groups did not differ significantly in tumor size, axillary lymph node status, or histologic grade, and there was no significant difference in the distribution of histologic types of breast cancer. Lymphatic vessel invasion, extensive intraductal component, and hormone receptor status did not differ among BBD categories. The pathologic features of breast cancers that develop in women with a previous benign biopsy result do not vary according to the histologic category of the previous BBD.

Adenocarcinoma↗

The mismanagement of benign breast disease. A report of 3 cases.

Three cases are presented of complications after bilateral subcutaneous mastectomy with immediate prosthetic replacement, performed for benign breast disease in women who ranged in age from 24 to 32 years, by surgeons outside the field of plastic surgery. This article is submitted as a plea to curb a rapidly increasing tendency by general surgeons to perform a basically mutilating operation on young women with benign breast disease.

Adenofibroma↗

Biochemical subgrouping of benign breast disease to define premalignant potential.

To determine which subgroups of benign breast disease are likely to progress to malignant degeneration, a biochemical analysis of 3'5' cyclic adenosine monophosphate (cAMP) was run on several samples of breast tissue. cAMP is elevated in a progressive fashion from normal breast tissue to fibrosis, cystic mastitis, ductular hyperplasias, and finally to carcinoma. Correlation of cAMP levels in breast lesions with histopathologic grading of increasing epithelial proliferation confirmed the concept that there are subgroups within those lesions that have greater malignant potential. Benign breast lesions with significantly higher cAMP levels, although still lower than those of cancer, must be considered at higher risk for eventual malignant change.

Adenylyl Cyclases↗

Benign breast disease and consumption of beverages containing methylxanthines.

The relationship between methylxanthine (Mx) consumption and benign breast disease was evaluated in a case-control study of 288 women with histologically confirmed benign breast lumps (203 dysplastic lesions and 85 benign tumors) and 2 groups of control women--285 patients in the hospital for acute conditions apparently unrelated to the consumption of Mx-containing beverages and 291 outpatients. The relative risk estimates of dysplastic breast lesions (fibrocystic disease), with allowance for all identified potential distorting factors, for women who drank 1-2 or 3 or more cups of coffee per day were 4.1 and 6.4, respectively, when the hospital controls were the comparison group and 2.0 and 3.7, respectively, when the outpatient controls were the comparison group. The relationship was even stronger when the total consumption of Mx-containing beverages (coffee plus tea) was considered and increased with increasing duration of use. The association was not explained by any of the major risk factors for fibrocystic breast diseases or by differences in general characteristics or other lifestyle habits between cases and controls. Mx consumption was not related to the risk of benign breast tumors (fibroadenomas). These findings support the hypothesis that Mx consumption is related to the risk of dysplastic lesions of the breast.

Adult↗

[Study of an antioxidant dietary supplement "Karinat" in patients with benign breast disease].

A randomized double blind placebo-controlled trial of efficiency of a dietary supplement "Karinat" in patients with benign breast disease was carried out. Karinat contains beta-carotene 2.5 mg, alpha-tocopherol 5 mg, ascorbic acid 30 mg and garlic powder 150 mg per one tablet. Out of 66 patients, 33 patients were given karinat, 33 were given placebo. The patients reccived a tablet of karinal or placebo twice a day during 6 months. Examinations of the patients included clinical estimation of symptoms of mastopathy and dysalgomenorrhea, breast sonography and mammography. It was found that karinat reduced the severity of mastalgia, premenstrual syndrome, dysmenorrhea and algomenorrhea and caused regression of palpable symptoms of the breast fibromatosis. On the whole karinat had positive action in 75.8% that was significantly greater by 45.5% as compared with placebo. Karinat may be useful for the treatment of patients with benign breast disease.

Adult↗

Clinical and biochemical studies on methylxanthine-related fibrocystic breast disease.

The results of this study show that the consumption of methylxanthines through dietary sources appears to be associated with the etiologic development of benign fibrocystic disease in the American woman. Complete abstention from methylxanthine consumption resulted in complete resolution of the disease in 82.5% and significant improvement in 15% of those studied. Thus 97.5% showed clinical benefit from total methylxanthine abstention. The results of a clinical questionnaire answered by 500 women consuming methylxanthines, one half of whom had fibrocystic breast disease, suggest that women with fibrocystic disease may have a genetic predisposition for both benign breast disease and cancer. Biochemical studies implicate increased sensitivity of the adenylate cyclase system to catecholamines in patients with fibrocystic disease. Methylxanthines are known to increase circulating catecholamines.

Adenylyl Cyclases↗

[Interobserver reproducibility in the pathologic diagnosis of borderline ductal proliferative breast diseases].

OBJECTIVE: The aim of this study involving general pathologists was to assess interobserver reproducibility in the pathologic diagnosis of borderline ductal proliferative breast diseases. METHODS: Ten general pathologists independently reviewed 43 specimens chosen to represent the spectrum of borderline ductal proliferative breast lesions. All slides were blindly reviewed without given standardized criteria, and were classified as either mild usual hyperplasia, moderate-severe usual hyperplasia, mild atypical hyperplasia, moderate-severe atypical hyperplasia, ductal carcinoma in situ, or ductal carcinoma in situ with invasion. According to the years of training, these 10 general pathologists were divided into the experienced group and the less trained group. Interobserver agreement was statistically analyzed using Kappa statistic. Then, by comparing all the diagnoses of individual pathologist with the consensus opinion confirmed by two breast pathologists in terms of Page standard, we acquired the diagnostic accuracy and ascertained the undue diagnosis. RESULTS: The ten general pathologists' interobserver reproducibility in the diagnosis of borderline ductal proliferative breast diseases was rather low, especially that in their diagnosis of atypical hyperplasia. The reproducibility and accuracy were slightly higher in the experienced pathologists than in the less trained pathologists. Some pathologists made over-diagnosis or under-diagnosis of the lesions to different degrees. However, when the categories of diagnostic terms were simplified, the interobserver reproducibility increased. CONCLUSION: The use of standardized criteria is an important approach to increasing the diagnostic reproducibility and accuracy.

Adult↗

Benign breast disease and cancer.

A study of 7000 women attending a diagnostic breast clinic and the Breast Screening Clinic in Edinburgh has failed to show a significant relationship between the occurrence of previous symptomatic breast disease and a risk of cancer.

Adult↗

Prolactin secretion in benign breast diseases.

In order to evaluate the importance of prolactin in the pathogenesis of benign breast diseases (BBD), serum prolactin (PRL) levels were determined before and during a TRH challenge test in 50 patients affected by various BBD studied during the luteal phase of their cycle. They were compared to 15 normal women also studied during the luteal phase. In all the subjects estradiol (E2) and progesterone (P) were also measured. The patients were studied as a total group and in different subgroups according to the type of their disease, before and after 3 months of treatment with a potent progestin, lynestrenol. No significant differences appeared between any group of patients and the control group either on the basal prolactin secretion or on its dynamic secretory pattern after TRH injection before and during treatment. The only significant difference observed between patients and controls was the progesterone values, respectively 6.86 +/- 0.9 ng/ml and 21.2 +/- 1.4 ng/ml. It can therefore be concluded that benign breast diseases are more likely to be related to an inadequate luteal phase than to any abnormality of prolactin secretion.

Adult↗