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PubMed1980

[Color contact thermography in the diagnosis of breast diseases].

One hundred of women with diseases of the mammary gland were examined. Breast cancer was found in 31 patients, 65 patients had various benign tumors, 4 women had chronic mastitis. Breast cancer was manifested by pronounced focal elevation of temperature over the tumor, temperature asymmetry of mammary glands, uneven boundaries of hyperthermia focus with "pathways" of hyperthermia running from the tumor to regional lymph nodes (in 75% of cases) even when no metastases are found histologically. Patients with alterations in the mammary glands referred to as precancerous, are thermographically characterized by focal hyperthermia with distinct boundaries. Nonproliferating forms of fibroadenoma, as a rule, do not manifest themselves by focal pictures without changes in the general background of the thermogram.

Adolescent↗
PubMed1982

A pathologic study of benign breast diseases in Tokyo and New York.

Two hundred thirty-two biopsies of benign breast conditions from the National Cancer Center Hospital in Tokyo and 263 comparable biopsies from Memorial Hospital in New York City were reviewed. The component lesions of benign breast disease were identified and evaluated according to their relative frequency for different ages. Apocrine cysts, apocrine hyperplasia, intraductal hyperplasia, sclerosing adenosis, blunt duct hyperplasia, and atypical lobular hyperplasia were at least twice as common in biopsies from American women. Solitary papillomas were twice as common among biopsies from Japanese patients and tended to show more epithelial proliferation and sclerosing papillomatosis than did Americans. No major differences were found in the frequency of cysts, duct stasis, periductal mastitis, sclerosing intraductal papillomatosis, fibroadenomatoid mastopathy or fibroadenomas. Assuming intraductal hyperplasia and atypical lobular hyperplasia may represent premalignant epithelial changes, the high frequency of these lesions in New York biopsies when compared to Tokyo biopsies correlates well with the higher rate of breast cancer in the United States as compared to Japan. The greater frequency of lobular proliferative lesions and apocrine disease in New York suggests that these lesions may be produced by factors which also predispose American women toward breast cancer.

Adenofibroma↗
PubMed1982

Spectrum of breast disease in outpatient surgical practice.

Seven hundred and fifty-three new referrals with problems relating to the breast were seen as outpatients in a general surgical clinic during 1980 and 1981. The age distribution and final diagnoses are reported with a breakdown into the varying pathological groups. The relationship of diagnosis to previous benign breast disease, parity and breastfeeding is discussed.

Adolescent↗
PubMed1994

Breast disease in elderly women.

Breast cancer incidence and mortality increase with advancing age. In spite of this, screening for breast cancer by physical examination and mammography is underutilized in older women compared with their younger counterparts. Studies suggest that even for elderly women with mild to moderate co-existing illnesses, the use of screening mammography reduces breast cancer mortality. The local therapy of breast cancer is well tolerated by the majority of elderly women. Mastectomy has a 30-day operative mortality of less than 1% in women older than age 65 and provides excellent local control. However, mastectomy has no survival advantage over lumpectomy and radiotherapy. If breast preservation is undertaken, radiotherapy is an important part of the treatment. Local failure in the breast in the absence of radiotherapy usually occurs in the first 4 postoperative years and is likely to become a problem during the patient's lifetime. Radiation to the breast is well tolerated, and the incidence of complications does not appear to be age related. Many older women are anxious to preserve their breasts and should be offered this treatment option. In the older woman with severe co-morbid conditions in whom the risk of operative morbidity and mortality is high, tamoxifen, 20 mg daily, may be used as an alternative to surgical therapy. Complete and partial response rates of 50% to 80% are reported with tamoxifen therapy, and this often results in control of local disease during the patient's lifetime. However, this should not be considered standard therapy for the otherwise healthy older woman. The majority of older women benefit from tamoxifen therapy postoperatively, and cytotoxic chemotherapy, when indicated, can be delivered with acceptable toxicity. The failure to use adjuvant therapy when indicated is one of the most frequently identified problems in the management of breast cancer in the elderly. Breast cancer in older women carries a significant mortality, even in spite of the presence of concurrent diseases. In a number of studies, old age is noted to be a negative prognostic factor. Whether this is due to the biology of the disease or the undertreatment of older women is unclear, but it is evident that breast cancer in the elderly should not be considered an indolent disease. Breast cancer therapy should be determined by a woman's physiologic age and psychological needs rather than her chronologic age.

Aged↗
PubMed2002

Diagnostic accuracy of stereotactic large-core needle biopsy for nonpalpable breast disease: results of a multicenter prospective study with 95% surgical confirmation.

Stereotactic large-core needle biopsy is increasingly applied for the diagnosis of nonpalpable breast disease. Our study examines whether this minimally invasive technique is sufficiently accurate to replace surgical breast biopsy. In a prospective multicenter study, 973 consecutive women with 1,029 nonpalpable breast lesions were offered stereotactic 14-gauge needle biopsy. If the needle biopsy yielded breast cancer, the patient was offered therapeutic surgery. Surgical biopsy was proposed in cases of needle biopsies without malignancy. An expert panel reviewed all discrepancies in histologic diagnosis between the needle biopsy and open biopsy. Forty-five patients withdrew from participation and 113 (11%) planned needle biopsy procedures were cancelled. Of the 871 successful biopsy procedures, 95% were confirmed surgically. In 13 cases (1.5%), insufficient material was obtained for histologic assessment. Fifty-five percent of the needle biopsies were diagnosed as malignant (290 invasive cancers, 190 ductal carcinoma in situ). Thirteen of the 322 lesions (4%, 95% CI 2-7%) with a benign needle biopsy diagnosis contained malignancy after surgery. Six of the 26 (23%, 95% CI 9-44%) lesions with a high-risk diagnosis (atypical ductal or lobular hyperplasia or lobular carcinoma in situ) were diagnosed as malignant after surgery. Five of the 30 lesions containing normal breast tissue held malignancy (17%, 95% CI 6-35%). Guidelines for the management of different categories of needle biopsy diagnoses were made. Application of these guidelines to the present findings resulted in sensitivity and specificity rates of 97% (95% CI 95-98%) and 99% (95% CI 97-100%), respectively. Stereotactic large-core needle biopsy is an accurate diagnostic instrument for nonpalpable breast disease. It may safely replace needle localised open-breast biopsy provided that high-risk and normal breast tissue diagnoses are followed by needle or open-breast biopsy.

Adult↗
PubMed1985

A case-control study of caffeine and methylxanthines in benign breast disease.

A dietary case-control study of 854 histologically diagnosed cases of benign breast disease (BBD), 755 matched surgical controls, and 723 matched neighborhood controls was conducted in Israel between 1977 and 1980. No association between coffee consumption and BBD was found. Analyses by histological type, degree of ductal atypia, age, sex, and ethnic origin, controlling for several confounding factors, confirmed the lack of association. The estimated mean intake of methylxanthines was also similar for cases and controls (302, 312, and 313 mg for cases, surgical controls, and neighborhood controls, respectively). No evidence of a dose-response was noted. Our results suggest that there is no association between coffee or methylxanthine consumption and BBD, although we had a 70% chance of finding a risk ratio of 1.5 with an error of 5%.

Adult↗
PubMedDate not supplied

Couples' adjustment to breast cancer and benign breast disease: a longitudinal analysis.

A comprehensive comparison of couples' adjustment to benign (n = 73 couples) and malignant breast disease (n = 58 couples) at the time of diagnosis and at two follow-up assessments at 60 days and 1 year is reported. Specific objectives were to: (a) compare the concurrent stress, resources, appraisal, and patterns of adjustment of couples in the benign and malignant groups; (b) compare the psychosocial responses of patients versus spouses; and (c) determine the amount of correspondence in levels of adjustment reported by patients and their husbands over time. Multiple instruments with reported reliability and validity were used to measure study variables: Smilkstein Stress Scale, Dyadic Adjustment Scale, Family APGAR, Social Support Questionnaire, Mishel Uncertainty in Illness Scale, Beck Hopelessness Scale, Brief Symptom Inventory, and Psychosocial Adjustment to Illness Scale. Mixed design analyses of covariance (ANCOVA) were used to assess differences between and among couples and examine changes in study variables over time. Significant differences were found in the resources, appraisal, and patterns of adjustment reported by couples in the benign and malignant groups. Couples facing breast cancer reported greater decreases in their marital and family functioning, more uncertain appraisals, and more adjustment problems associated with the illness. In addition, there was a high degree of correspondence between the levels of adjustment reported by women with breast cancer and their husbands over time. Couples who reported high distress or a high number of role problems at diagnosis were likely to remain highly distressed at 60 days and 1 year. Study findings underscore the importance of assisting couples, not just patients, to manage the adjustment difficulties associated with breast cancer.

Adaptation, Psychological↗
PubMed1984

Hormonal profile of benign breast disease and premenstrual mastodynia.

The Authors report their own results concerning plasma hormonal dosages in Benign Breast Disease (BBD) and Premenstrual Mastodynia (PM). Dosages were realized during the second phase of the cycle, 4 to 8 days following ovulation, according to the basal body temperature. 171 Patients were studied: fibro-cystic disease 82 cases; BBD + severe PM 71 cases; and isolated PM 18 cases. It was shown that the levels of Estradiol and Progesterone were within normal ranges in a great majority of cases; it was the same for the PG/E2 Ratio. The Prolactin levels were within the physiological norms; the responses to TRH were normal, and elevated only in a few cases. Based only on hormonal dosages, we concluded that there was no estrogeno-luteal imbalance nor dysprolactinemia in BBD and/or PM.

Adult↗
PubMed1987

Effect of a low-fat diet on hormone levels in women with cystic breast disease. I. Serum steroids and gonadotropins.

For examination of the effect of a low-fat diet on serum estrogen, progesterone, and gonadotropin levels, 16 patients with cystic breast disease and cyclic mastalgia were studied before dietary intervention and at 2 and 3 months thereafter. Four-day food diaries indicated that total fat intake was reduced from a prediet average of 69 g (35% of total kilocalories/day) to an average of 32 g (21% of total kilocalories) after 3 months. Highly significant reductions (P less than .001) occurred in dietary cholesterol and less changes occurred in protein and total kilocalorie consumption (P less than .05); fiber intakes were not affected. After 3 months on this low-fat diet, there were significant reductions in luteal-phase serum total estrogens (P less than .001), estrone (P less than .005), and estradiol (P less than .01); progesterone, luteinizing hormone, and follicle-stimulating hormone levels were unchanged. Two of the 16 patients were excluded from the hormone statistical analyses because the serum progesterone levels were not consistent with sampling in the luteal phase of the menstrual cycle. It is concluded that a reduction of dietary fat intake to 20% of the total kilocalories will result in significant decreases in circulating estrogens in benign breast disease patients and that this effect is achievable without increasing dietary fiber consumption. Absence of changes in serum progesterone and gonadotropins during the dietary intervention is consistent with altered enterohepatic circulation of estrogens rather than with effects on the pituitary-ovarian axis.

Adult↗
PubMed1992

Benign breast disease in Papua New Guinea.

In this study 302 biopsy-confirmed benign breast lesions in Papua New Guinean (Melanesian) women during a ten-year period were reviewed. Inflammatory breast disease was the most frequent type. Chronic mastitis, chronic suppurative mastitis and abscesses formed 32% of benign breast lesions and 71% of the group of mastitides. 10 cases of tuberculous mastitis were recorded. Fibrocystic disease was observed at a lower age (31.9 +/- 8.2 years) than has been reported from Black United States and West Indian populations. The high frequency of mastitis is an important finding. This is most likely to be associated with lactation. Proper hygiene during breastfeeding and the judicious use of antibiotics should reduce this high frequency. Education of women about these matters should form part of health education programs in Papua New Guinea.

Adult↗
PubMed2003

Breast diseases: a histopathological analysis of 3279 cases at a tertiary care center in Pakistan.

OBJECTIVE: To know the frequency of breast diseases in Pakistani females. METHODS: A retrospective analysis of 3279 breast specimens received over a period of 4 years (1993-1996) at the department of pathology, the Aga Khan University Hospital. RESULTS: Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change 13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of them showed 3 or >3 positive lymph nodes. Grade I tumours were 11.38%, grade II 59.17% and grade III tumours 29.47%. Correlation of grade with lymph node metastases (3 or >3+ve nodes) showed 15 cases (1.53%) of grade I, 178 cases (18.25%) of grade II and 68 (6.97%) cases of grade III tumours. CONCLUSION: This study shows that in Pakistani females, the most commonly encountered lesion in carcinoma of the breast followed by the benign lesions such as fibro adenoma, fibrocystic disease & others. Breast carcinoma occurs at a younger age group with predominance of high-grade lesions and with frequent lymph node metastasis.

Adult↗
PubMed2002

Alcohol consumption and incidence of benign breast disease.

We evaluated whether moderate alcohol consumption is associated with increased risk of developing benign breast disease (BBD), a potential "precursor" or marker for breast cancer development. This study evaluated associations between reported alcohol consumption and BBD diagnosis among 75,826 women in the Nurses' Health Study II. Between 1989 and 1997, 16,035 women reported a first diagnosis of BBD (317/10,000 person-years), of which 2,999 diagnoses were confirmed by tissue biopsy (59/10,000 person-years). Of the pathology specimens reviewed, 532 were nonproliferative benign breast conditions, and 932 were proliferative conditions. Person-time models provided estimates of the rate ratio (RR) and 95% confidence interval (CI). Reported recent adult consumption of alcohol was not associated with increased BBD incidence. Compared with women who did not drink alcohol, the age- and body mass index (BMI)-adjusted RRs for any reported BBD were 0.98 (95% CI, 0.95-1.02) for those who consumed <5 g/day, 0.93 (95% CI, 0.89-0.98) for those who consumed 5-14.9 g/day, and 0.90 (95% CI, 0.83-0.98) for those who consumed >or=15 g/day. The adjusted RRs for biopsy confirmed BBD and any proliferative benign condition were similiar. However, reported alcohol consumption of >or=15 g/day between ages 18 and 22 years was associated with higher rates of biopsy-confirmed BBD (age- and body mass index-adjusted RR = 1.14; 95% CI, 1.00-1.30), nonproliferative BBD (RR = 1.46; 95% CI, 1.09-1.96), and any proliferative BBD (RR = 1.33; 95% CI, 1.05-1.69), but not atypical hyperplasia. In this study, recent alcohol consumption was associated with slightly lower rates of reported BBD. However, greater alcohol consumption earlier in life (ages 18-22 years) was associated with higher proliferative BBD rates, suggesting that timing of exposure may be relevant to disease incidence.

Adult↗
PubMed1993

Reproducibility and validity of pathologic classifications of benign breast disease and implications for clinical applications.

BACKGROUND: Research studies on the relationship between benign breast diseases and cancer risk typically identify certain conditions as risk factors, and others as carrying no prognostic significance. This study addresses several issues concerning the relevance of such research results for advising individual patients in a clinical setting. METHODS: Data were obtained as part of a "blinded" retrospective pathology review of benign breast biopsies. A random sample of cases was reviewed twice, providing information about reliability. Comparisons with diagnoses that used information from the operative reports and gross pathology descriptions as well as microscopic histology were used to assess validity. RESULTS: Among cases that were reviewed twice, excellent agreement was achieved for diagnosing carcinoma and lobular neoplasia, good agreement for adenosis and intraductal papilloma, and relatively poor agreement about levels of hyperplasia and atypia, and whether ducts or lobules were involved. Distinctions among levels of hyperplasia also apparently were influenced by the number of slides available for review. The "blinded" review diagnoses frequently differed from the diagnoses that used all information available at the time of surgery in detecting the presence or absence of gross cystic disease, and in distinguishing solitary from multiple papillomas. CONCLUSIONS: Problems with reliability of precise distinctions among levels and sites of hyperplasia and atypia seem to limit the usefulness of such classifications as guidelines for individual patient care. For conditions with some clinical manifestations, diagnoses based exclusively on histologic review of biopsy specimens often are not accurate.

Breast↗
PubMed1983

Plasma levels of estrone, estrone sulfate, and estradiol and the percentage of unbound estradiol in postmenopausal women with and without breast disease.

To investigate the possibility of increased tissue exposure to estrogen in breast cancer patients, plasma levels of estrogens and the percentage of unbound estradiol were measured in postmenopausal women with benign or malignant breast disease and compared with levels in normal postmenopausal women. The percentage of unbound estradiol in breast cancer patients [1.85 +/- 0.35% (S.D.)] was significantly higher (p less than 0.001) than in normal postmenopausal women [1.52 +/- 0.33%] and was still significantly higher when patients were matched with control subjects for weight (p less than 0.001) or ideal body weight (p less than 0.001). The binding capacity of sex hormone binding globulin was similar in both groups of women. No significant differences in the plasma levels of estrone, estradiol, or estrone sulfate were detected between breast cancer and normal subjects. It is concluded that, given similar concentrations of estradiol in plasma of normal and breast cancer subjects, the significant increase found in the unbound estradiol fraction may result in a very small increment in tissue exposure to estrogens in breast cancer subjects. However, even such a small increase in tissue exposure to estradiol may be significant, given the length of time required for breast tumor development.

Aged↗
PubMed1978

Diagnosis of malignant breast disease by axillary lymphoscintigraphy: a preliminary report.

The ability of regional lymph nodes to take up 99Tcm-labelled antimony sulphide colloid from the breast tissue was studied in 50 patients with mammary symptoms by gamma-camera scanning. Thirteen out of 14 patients with histologically confirmed carcinoma of the breast had a depressed uptake of labelled colloid in ipsilateral nodes, i.e. a positive scan. Twenty-nine out of 32 patients with benign breast disease had a negative scan. The method promises to aid both the precise diagnosis of breast disease and the definition of the extent of mammary cancer.

Adolescent↗
PubMed1994

P53 gene mutations in women with breast cancer and a previous history of benign breast disease.

Mutations of the p53 tumour suppressor gene are the most common genetic lesions in human cancers and have been reported in breast cancer as part of the Li-Fraumeni syndrome. In the present study, we determined frequencies and types of the p53 mutations in breast cancer tissues in women with a history of benign breast disease (BBD) identified in Florence, Italy, with (n = 6) or without (n = 10) a family history of breast cancer. Among the cases with a family history of breast cancer and BBD, 2 out of 6 had p53 gene mutations in cancer samples. 1 patient had a mutation at codon 248 and the other had double mutations at codons 243 and 241. In these cases, the p53 gene was also analysed in the tissue samples from previous BBD lesions; however, no mutations were observed (0 out of 6). These results suggest that the p53 mutations occur during advanced stages of tumour progression. In sporadic breast cancer cases with a history of BBD, p53 point mutations were observed of tumour progression. In sporadic breast cancer cases with a history of BBD, p53 point mutations were observed in four samples (4 out of 10). Two of these mutations turned out to be silent changes and one of the samples showed triple mutations at amino acid positions 267, 277 and 296. No p53 gene mutations were found in the breast tumour tissues of 10 additional women from the same area with a family history of breast cancer, but no previous BBD (0 out of 10). Family history of breast cancer does not appear to affect the frequency of p53 mutations in women with a previous history of BBD.

Base Sequence↗