Treatment of benign breast disease.
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Adenofibroma↗
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Results for “BREAST DISEASES”
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[Ultrasonic mammography: its importance in integrated diagnosis of breast diseases (author's transl)].
Sonography of the breast is gaining in importance with the spread of diagnostic methods based on ultrasound in general and the increasing technical perfection of the equipment in particular. Over and above this, the increase in incidence of carcinoma of the breast at an increasingly early age represents a permanent challenge to achieve further optimisation of diagnostic methods. The following conclusions have been arrived at after evaluating 493 ultrasonic examinations of the breast, 212 of which were verified histologically (90 carcinomas): 1. If the indication is precise, sonography possesses a high degree of sensitivity in diagnosing any changes occurring in the breast. 2. The method offers particular advantages in patients with manifest signs having a dense parenchyma; in fact, with such patients sonography is often superior to mammography. 3. The additional use of sonography in diagnosis of diseases of the breast improves the results and often facilitates a less aggressive procedure (insofar as biopsies can be omitted). The main drawbacks are the great amount of time required for performing the examination, and the problem of documentation. This has been the major obstacle to using sonography in screening. The article discusses the indications, the typical sonographic criteria and problems of differential diagnosis in relation to the most frequently encountered diseases of the breast.
Abscess↗
Thyroid autoimmunity in patients with malignant and benign breast diseases before surgery.
BACKGROUND: Previous studies have demonstrated a high prevalence of thyroperoxidase antibodies (TPOAb) and autoimmune hypothyroidism in breast cancer (BC). These studies have been performed in BC patients generally 20-30 days after mastectomy. It is known that stress may have an influence on the immune system and a relation between stressful events and the onset or worsening of autoimmune thyroid disorders has been reported by several authors. The aim of the study was to evaluate the prevalence of autoimmune thyroid disease in patients with nodular breast disease selected for surgery before any treatment. Our hypothesis was that the high prevalence of thyroid autoimmune disorders in BC is independent of stressful events represented by surgery and/or anaesthetic procedures. METHODS: Our series included 61 consecutive women aged 52.8 +/- 10.2 yrs (mean age +/- s.d.) with nodular breast disease selected for breast surgery: 36 out of 61 of them (59%) had BC and 25 out of 61 had benign breast disease (BBD). Controls included 100 healthy age-matched women. All patients and control subjects were submitted to clinical, ultrasound thyroid evaluation and serum-free thyroxine (FT4), serum-free tri-iodothyronine (FT3), TSH, TPOAb and thyroglobulin antibodies (TgAb) determination. RESULTS: Mean FT3, FT4 and TSH concentration showed no differences between BC patients, BBD patients and controls. The prevalence of TPOAb in BC patients (12/36: 33.33%) was significantly higher than in BBD patients (5/25: 20%) (P < 0.01) and in controls (8/100: 8%) (P < 0.01). Similarly, the prevalence of TgAb in BC patients was 12 out of 36 (33.33%) significantly higher than that detected in BBD patients (4/25: 16%) (P < 0.01) and in controls (12/100: 12%) (P < 0.01). Of the 36 BC patients, 20 showed a diffuse hypoechogenicity of the thyroid gland to ultrasound evaluation, significantly higher than in BBD (7/25: 28%) (P = 0.03). Of the 20 BC patients who showed a hypoechogenic pattern of thyroid gland, 10 (50%) were associated with antithyroid antibodies positivity (TAb). This finding was present in two of seven BBD (28.57%) (P < 0.0001). Only two controls showed focal hypoechogenicity of the thyroid gland. Generally, 24 out of 36 (66.7%) of BC and 9 out of 25 (36%) of BBD (P = 0.02) had signs of thyroid autoimmunity consistent with the hypoechogenic pattern of thyroid gland associated or not with TAb; 2 out of 36 (5.55%) of BC and 1 out of 25 (4%) of BBD patients had autoimmune hypothyroidism and no hypothyroidism was found in controls. CONCLUSIONS: The results of this study confirm the strong relation between thyroid autoimmunity and BC. This finding is independent of stressful events represented by surgery or anaesthetic procedures. The present data call attention to the usefulness of screening for autoimmune thyroid disorders in patients with nodular breast disease selected for surgery.
Adult↗
beta-Glucuronidase levels in patients with fibrocystic breast disease.
Certain enzymes in tissues and body fluids may, through reversal of the detoxification process, influence the composition and availability of steroid hormones, toxins, and carcinogens. The ubiquitous enzyme beta-glucuronidase, which hydrolyzes glucuronide conjugates, thereby reversing one of the main detoxification and excretion pathways, was found to vary in concentration in different cysts over a 300-fold range. The distribution was a continuum, devoid of discrete sub-populations. Evidence obtained on selected cyst fluids of high and low beta-glucuronidase activities indicated that the level of the enzyme significantly influenced the ratio of unconjugated: glucuronidated estradiol. The patients with fibrocystic breast disease fell into 2 distinct subpopulations on the basis of their serum beta-glucuronidase activity. In one group the activity was near normal, while in the second group the average serum beta-glucuronidase activity was 3-fold higher than in the women who did not have benign breast disease.
Adult↗
Hormone therapy: three perspectives. Fibrocystic breast disease: contraindication for oral contraceptive therapy.
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Adult↗
Evaluation of mucinous-like cancer antigen (MCA) in women with breast disease: preliminary results.
Mucinous-like cancer antigen (MCA) is a substance which is recognized by a novel monoclonal antibody, designated b12, when directed against a mixture of human breast cancer cell lines. The present study was carried out by means of a solid phase enzyme immuno assay to determine, prior to treatment, circulating levels of MCA in 131 women with malignant and in 99 with benign breast diseases (BBD). Statistical analysis did not reveal any significant difference between MCA values in healthy controls vs. BBD patients. By contrast, MCA levels were significantly higher in cancer patients as compared to the other groups (p less than 0.001). In particular, patients with metastatic disease had the highest MCA concentrations. The sensitivity and specificity of the test were 25.5 and 97.5%, respectively. The characteristics of MCA (low sensitivity, high specificity) encourage its evaluation as an indicator of tumor burden.
Adolescent↗
A double blind trial of the prolactin inhibitor bromocriptine in painful benign breast disease.
A double blind crossover trial of the prolactin inhibitor bromocriptine in painful benign breast disease is reported. Twenty-nine women with cyclical mastalgia and 11 with non-cyclical pain were treated with bromocriptine, 5 mg daily, and placebo over six menstrual cycels. Assessment of response to treatment was made by a linear analogue system and clinical examination together with plasma prolactin estimations. Bromocriptine produced a significant improvement in breast symptoms and a significant fall in prolactin levels in the cyclical pain group, but had no effect in the non-cyclical group. These results suggest that bromocriptine offers a new and effective approach in the management of cyclical breast pain.
Breast Diseases↗
Management of female breast disease by Southampton general practitioners.
One hundred and two Southampton general practitioners were interviewed about female breast disease. There was agreement about clinical management and the need to both teach and promote breast self-examination. The general practitioners, however, were divided as to whether any breast screening facilities were needed in Southampton. Records kept by the general practitioners of women seen with breast symptoms showed that one-quarter of all new episodes were referred to hospital at the first visit. That the general practitioners considered early diagnosis to be important was made evident from a number of the results. This attitude is encouraging in view of the evidence showing that long-term survival may be greater when delays are shorter.
Attitude of Health Personnel↗
Couples' adjustment to breast disease during the first year following diagnosis.
The objectives were to determine (a) the extent to which psychosocial, demographic, and medical variables predict women's and husbands' adjustment to breast disease during the first year following diagnosis; (b) the degree of autocorrelation among and intercorrelation between partners' adjustment scores; (c) the extent to which baseline levels of adjustment predict adjustment 1 year later; and (d) the extent to which one partner's adjustment affects the other partner's adjustment. A stress-coping framework guided this study. The sample consisted of 131 couples, 58 couples received a cancer diagnosis and 73 received a benign diagnosis. Couples were interviewed at 1 week, 2 months, and 1 year postdiagnosis. Structural equation modeling was used to analyze the data. The strongest predictors of adjustment for women were severity of the illness and hopelessness and for husbands, their own baseline level of adjustment. Husbands' and wives' levels of adjustment at 1 year had a significant direct effect on each other's adjustment.
Adaptation, Psychological↗
The patient's appraisal of the cosmetic result of segmental mastectomy in benign and malignant breast disease.
Women's appraisal of the cosmetic result and their psychosocial adjustment after a standardized segmental mastectomy for benign or malignant breast disease was analyzed on the basis of a mailed questionnaire, which was satisfactorily answered by 263 (92%) of 285 women operated on consecutively. The overall result was favorable: 96.5% of the patients found the new appearance of their breast very good (30.7%), good (44.0%), or acceptable (21.8%). Women with a benign diagnosis ran a two-fold higher risk of being discontented with the new appearance of the breast than those with breast cancer. Complications of radiation therapy, preoperative concern that the breasts are important for the appearance, and anxiousness about the cosmetic result were associated with a significantly elevated risk of being less satisfied with the outcome. The main finding that it is possible to perform a locally radical operation that is highly acceptable to the woman is relevant to the surgical management of potentially malignant mammographic lesions and also to the scientific strategies for future evaluation of breast-conserving treatment modes in malignant disease.
Aged↗
Cytochrome P450dbl phenotypes in malignant and benign breast disease.
129 female patients with breast cancer and 79 controls undergoing biopsy for benign breast conditions had debrisoquine hydroxylator phenotype established. 129 female hospital patients with known hydroxylator phenotype were used as another control group. The breast cancer cases differed significantly from the benign controls in their debrisoquine phenotype, with 10% being poor metabolisers compared with none of the controls (P less than 0.01). However, while a comparison of the distributions of metabolic ratio (an inverse measure of debrisoquine metabolism) of breast cancer patients and hospital controls showed a significant difference by rank, there was no significant difference in the proportion of poor metabolisers in these two groups. The cases with benign disease differed from the hospital controls in both metabolic ratio distribution (P less than 0.001) and frequency of poor metabolisers (P less than 0.05). Although there was a shift in metabolic ratio distribution, debrisoquine hydroxylator phenotype was not a genetic marker for breast cancer. Why no patients undergoing biopsies for benign conditions were poor metabolisers is unknown.
Adult↗
von Willebrand factor antigen levels in plasma of patients with malignant breast disease.
von Willebrand factor (vWF) is a protein that mediates platelet adherence to the subendothelium during primary hemostasis. High plasma vWF concentrations have been reported in patients with various types of cancer, such as head and neck, laryngeal and prostatic cancer, probably representing an acute phase reactant. In the present study we determined the plasma levels of vWF antigen (vWF:Ag) by quantitative immunoelectrophoresis in 128 female patients with breast cancer as well as in 47 women with benign breast disease and in 27 healthy female controls. The levels of vWF:Ag were 170.7 +/- 78 U/dl in patients with cancer, 148.4 +/- 59 U/dl in patients with benign disease and 130.6 +/- 45 U/dl in controls (P<0.005). We also detected a significant increase in the levels of vWF:Ag (P<0.0001) in patients with advanced stages of the disease (stage IV = 263.3 +/- 113 U/dl, stage IIIB = 194.0 +/- 44 U/dl) as compared to those with earlier stages of the disease (stage I = 155.3 +/- 65 U/dl, stage IIA = 146.9 +/- 75 U/dl). In conclusion, vWF levels were increased in plasma of patients with malignant breast disease, and these levels correlated with tumor progression.
Adolescent↗
Hormonal and non-hormonal medical therapy of benign breast disease.
Mastopathy or nodular painful breast can be managed by several non-hormonal and hormonal treatments. Little data exist for effectiveness of the former. Whilst the hormonal treatments are considered to be very effective, their use can be limited by unpleasant side effects.
Breast Diseases↗
Oral contraceptives and breast disease.
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Breast Diseases↗
The 'cues' to diagnosis: describing the monitoring activities of women undergoing diagnostic investigations for breast disease.
Waiting to ascertain the nature of an undiagnosed breast abnormality is an intensely stressful experience for many women. Uncertainty surrounding the aetiology of symptoms is underpinned by the threat of malignancy, and the 'need to know' the diagnosis is of primary concern at this time. Seeking out threat-relevant information through a process known as 'monitoring' attempts to fulfil this need. This paper details the qualitative phase of a multimethod research study that investigated the psychological impact of diagnosing breast disease. This involved focus interviews with a subset of 40 women from the original study cohort. Several types of threat-related cues were identified by respondents and were categorized as temporal, interpersonal, procedural and spatial. In the context of uncertainty (and in some cases suspicion) these cues were interpreted as 'indicators' of the pending diagnosis. The manner in which particular aspects of the environment are identified, interpreted and designated as 'threat-relevant' cues is discussed. Furthermore, the implications for health professionals working with patients during this stage of 'pre-diagnosis' are considered.
Adult↗
The effect of gestanone and ethynyl estradiol on benign breast disease.
The evidence related to the effects of Ocs on the breast benign diseases and their secondary relation to malignancy is studied. Our data are in concordance with other epidemiological studies, that showed no influence on breast mitosis and apoptosis and that there was a reduced incidence of benign breast disease; we also believe that it has a beneficial effect and that this method of contraception is the best.
Adult↗
I. URINARY EXCRETION OF NEUTRAL 17-KETOSTEROIDS AND PREGNANDEIOL BY PATIENTS WITH BREAST CANCER AND BENIGN BREAST DISEASE.
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17-Ketosteroids↗