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PubMed2001

[Diagnosis of breast-duct disease by breast duct endoscope].

OBJECTIVES: To study the pathological characteristics of breast-duct disease under breast duct endoscope in diagnosis and treatment of breast diseases. METHODS: The images of breast duct of 62 patients with nipple discharge were obtained by hard breast duct endoscope (Olympus Inc) and computer assistant analysis system. RESULTS: Of the 62 patients, malignant tumor was found in 4, premalignancy in 6, intradutal papilloma in 15, and mammary duct or plasma cell mastitis in 37. CONCLUSIONS: Intraductal lesions of patients with nipple discharge can be observed and be followed up with breast duct endoscope. The accuracy of etiological diagnosis of patients with nipple discharge, after the use of breast duct endoscope can partly modify the indications for operation in patients with nipple discharge.

Adolescent↗
PubMed2006

Polymorphisms in estrogen-metabolizing and estrogen receptor genes and the risk of developing breast cancer among a cohort of women with benign breast disease.

BACKGROUND: A cohort study was conducted to examine the role of genetic polymorphisms in three estrogen metabolizing enzymes (COMT, CYP1A1, CYP1B1) and the two estrogen receptors (ESR1, ESR2) in the progression of benign breast disease (BBD) to breast cancer. METHODS: Among participants in an ongoing cohort study, 1438 Caucasian women had a breast biopsy for BBD and were successfully genotyped for at least one of the polymorphisms examined in this study. Genotypes were determined using DNA extracted from blood specimens collected in 1989. Incident cases of breast cancer occurring subsequent to BBD diagnosis up to 2003 were identified through cancer registries. RESULTS: Among all participants, the ESR2 *5772G allele was associated with a significant decrease in the risk of breast cancer among women with BBD (Odds Ratio (OR) 0.38; 95% Confidence Interval (CI) 0.15, 0.96). Compared to the reference wild-type genotypes, marginally significant associations with the development of breast cancer were observed between carriers of the variant ESR1 - 104062T allele (OR 0.70, 95% CI 0.45, 1.09), the variant ESR2 *38A allele (OR 1.40; 95% CI 0.88, 2.25), and the variant CYP1B1 453Ser allele (OR 1.48, 95% CI 0.95, 2.32). CONCLUSION: The results indicate that specific polymorphisms in the CYP1B1, ESR1, and ESR2 genes may play a role in progression of BBD to breast cancer among Caucasian women. Although additional studies are needed to confirm or refute our findings, these results suggest that genetic markers may aid in the identification of women who are at risk for progression of BBD to cancer.

Breast Neoplasms↗
PubMed1986

[Endocrine markers in benign breast diseases].

Estimations of estradiol, progesteron and other biochemical analyses support the hypothesis of a relative unopposed hyperestrogenism as cause of benign breast diseases. Additional factors are insufficient luteal phases combined with hyperprolactinemia or transient prolactin pulses. Progestagen treatment applied either topically or both orally and topically can correct the imbalance and perhaps prevent breast cancer.

Breast↗
PubMed1994

Immunolocalization of alpha-transforming growth factor in the developing rat mammary gland in vivo, rat mammary cells in vitro and in human breast diseases.

Immunoreactive alpha-transforming growth factor (alpha-TGF) was shown by immunocytochemistry to be present in the rat mammary gland at various stages of development, the staining being most intense in mature myoepithelial cells. Alpha-TGF was also detected in the secretions of the mammary glands of pregnant and lactating rats. alpha-TGF in the extracts of rat mammary glands at each stage of development, and in several rat mammary cell lines and in culture medium in which they had been grown, was shown by Western blotting to consist primarily of a protein of molecular weight 50 kDa. The amount of this protein was greater in the mammary gland of the lactating rat than in resting or involuting glands. alpha-TGF was also found in some, but not all, human breast carcinomas, and in benign hyperplastic breast diseases.

Animals↗
PubMed1992

Double-blind trial of promegestone (R 5020) and lynestrenol in the treatment of benign breast disease.

One hundred thirty-two women between the ages of 19 and 50, with various forms of benign breast diseases received 1 mg promegestone, or 0.5 mg promegestone, or 10 mg lynestrenol daily (double-blind), for 15 days per cycle, during three cycles. The groups were identical before treatment, with the exception of a longer history of mastodynia and mastopathies in the 1 mg promegestone group than in the lynestrenol group (P = 0.04) and a greater proportion of mastosis zones in the lynestrenol group as compared to the 0.500 mg promegestone group (P = 0.05). The effectiveness of lynestrenol both in terms of symptomatology (evaluated as good or excellent in 66.6% of the cases) and of clinical observations (evaluated as good or excellent in 59% of the cases) is not significantly different statistically from that of promegestone at 1 mg, whose effectiveness on symptomatology was good or excellent in 65.9% and 57.1% of the cases, respectively, or from that of promegestone at 0.5 mg/day (with 65% and 51.3% effectiveness, respectively). Clinical tolerance was rated good or excellent for 73.9% of the women on 1 mg promegestone and for 59.5% of the women on 0.500 mg promegestone, compared to 66.7% of the women on lynestrenol. No statistically significant difference was observed, neither between lynestrenol and promegestone 1 mg nor between lynestrenol and promegestone 0.5 mg. This study shows a clear improvement in functional and physical signs in patients treated with promegestone. Promegestone's efficacy is close to that of lynestrenol, a nonsteroidal progestin.2+ off

Adult↗
PubMed1990

Immunocytochemical evaluation of neoplastic and non-neoplastic breast diseases with Mab A-80.

Five hundred breast tissue samples from 404 cases were immunostained with A-80, a murine IgM Mab that recognizes a mucinous glycoprotein associated with exocrine differentiation. Samples included 196 primary breast carcinomas, 30 breast carcinoma metastases, 118 fibrocystic disease (FCD), and a further group of 84 samples of FCD from cases known to have breast carcinoma. These samples represented a broad spectrum of common and rare variants of carcinoma and FCD. Samples of fibroadenomas, lactating adenomas, cystosarcoma phylloides, gynecomastia, and normal breasts were similarly studied. The vast majority of carcinomas, 203/212 (95.7%) were immunoreactive; staining varied in extent and intensity, and was virtually unrelated to histologic type and to the presence or absence of recognizable glands. In samples including in-situ and infiltrating ductal or lobular carcinoma, reactivity was frequently stronger in the infiltrating components. No significant difference in reactivity between primary and metastatic carcinomas was noted. Of the group of 118 FCD, 27 were negative whereas 91 showed focal and weak staining. Seventy-two/84 FCD with associated carcinoma were immunostained; in 13 of those 72, staining was strong and extensive. Fibroadenomas, lactating adenomas, gynecomastia, and normal "resting" and lactating breast samples stained focally or not at all. Our findings indicate that Mab A-80 is an excellent immunohistochemical marker for the overwhelming majority of breast carcinomas whereas it marks weakly or not at all the majority of benign neoplasms and normal breast. Moreover, Mab A-80 recognizes a subset of FCD that includes proliferative variants associated with an increased incidence of carcinoma, and FCD in association with carcinoma. Questions regarding rare breast carcinomas that do not react with Mab A-80 remain unclear; yet, we believe that Mab A-80 is a highly promising marker of malignant and dysplastic breast epithelium.

Antibodies, Monoclonal↗
PubMed1990

Immunohistochemistry in the differential diagnosis of breast diseases.

Immunohistochemical techniques provide previously unavailable information about the composition of breast lesions. These data must be evaluated in the pathologic context and must not be used to support a diagnosis inconsistent with the morphological appearance. In the diagnosis of breast lesions, we have found immunohistochemistry of most use in classifying poorly differentiated and spindle-cell tumors.

Breast Diseases↗
PubMedDate not supplied

Benign breast disease in systemic sclerosis (SSc). A case-control study.

We hypothesized that Systemic Sclerosis (SSc) may affect the breast in the form of Benign Breast Disease (BBD). For the purpose of this study BBD was defined as breast symptoms either detected by the patient resulting in physician consultation, or detected by a physician during the course of a routine consultation, or detected by a physician during the course of a routine physical exam. Forty-one of 47 women with SSc were matched to case controls from two disease groups (RA and OA). Case matching was done for age (+/- 5 years), disease duration (+/- 3 years) and gender. A structured telephone interview was administered to all subjects and controls to determine the frequency of BBD and associated risk factors. The SSc group had a higher prevalence of BBD compared to the RA group (12/41 versus 4/41, p less than 0.04). However, a similar proportion of the SSc patients and OA case controls had BBD (7/28 versus 9/28). These differences could not be attributed to any of the evaluated risk factors. The RA group had a higher frequency and longer duration of NSAID use, suggesting that the increased use of NSAIDs in the RA patients may account for the lower prevalence of BBD, although genetic, hormonal or undetermined factors may be operative. Without an age-matched, "healthy" general population control group it is impossible to determine if the observed difference in prevalence of BBD represents a less than normal prevalence in RA or a greater than normal prevalence in SSc and OA.

Adult↗
PubMedDate not supplied

Nonendocrine theories of the etiology of benign breast disease.

This article summarizes 15 years of clinical and laboratory studies that have continued the search for a biochemical basis for the development and resolution of symptomatic benign fibrocystic disease. The clinical response to diet modifications is presented along with simultaneous laboratory tissue and serum studies. An ongoing study of the clinical response to complete and total methylxanthine abstention, especially caffeine, is presented in the initial part of the article. Following the clinical observations, is a series of laboratory studies, some of which actually preceded the clinical investigation and, in fact, pointed out that a beneficial clinical response might occur in some women following complete abstention. In the last paragraph, we present current information that may identify which women are susceptible to fibrocystic breast disease development.

Breast Diseases↗
PubMed1985

Histochemistry of estrogen sulfatases in human breast diseases.

Two estrogen sulfatases, arylsulfatase C-estrone sulfatase (ASC-ES) and d-equilenin sulfatase (EqS) were demonstrated histochemically in the normal human female breast, in benign breast diseases and in infiltrating mammary ductal carcinomas to study their significance in the pathogenesis of epithelial proliferations. By hydrolyzing estrone sulfate, the amount of which in female blood is about ten times greater than that of estradiol or estrone, estrogen sulfatases can produce a high local concentration of estrogens. A simultaneous azo-coupling method for histochemical demonstration of ASC-ES is described in the present study; EqS was demonstrated by a previously described method. Estrogen sulfatases were not found in the normal female breast. Both estrogen sulfatases were found in epithelial cells in some examples of mastopathic disease and in fibroadenomas, while ASC-ES was found in periductal fibroblasts. In some cases of infiltrating ductal carcinomas, estrogen sulfatases were present in carcinoma cells. In most of these tumors ASC-ES activity was observed in fibroblasts around infiltrative cell cords. There was no correlation between the presence of estrogen sulfatases and of hormone receptors in carcinomas. It is concluded that estrogen sulfatases play no role in the early stages of benign or malignant epithelial proliferations. However, the induction of estrogen sulfatases may promote epithelial proliferation in some cases if estrogen receptors are present in epithelial cells.

Adult↗
PubMedDate not supplied

[Modern radiology in the differential diagnosis of breast diseases accompanied by calcium micromasses].

The study was undertaken to enhance the efficiency of diagnosis of breast cancer shown up as calcium micromasses since breast diseases appear as clusters of 50-600-um calciferous inclusions that are not inclined to the formation of conglomerates without a visible node on a X-ray film, may be a manifestation of both sclerosing adenosis and nonpalpable cancer. Of the examined 4500 females aged 15 to 83 years, breast calcium masses were detected in 207. Of them, 39 females were found to have clustered calcium micromasses without a node on a X-ray film; in them cancer and sclerosing adenosis were diagnosed in 28 (71.8%) and 11 (28.2%) females, respectively. Examination was made by using clinical, mammographic, and sonographic studies. Intervention radiology and pathomorphological studies were studied. This has yielded a number of signs that are characteristic of malignant and benign diseases attended by clusters of calcium micromasses in a restricted area without a visible node on X-ray films that assist in making a correct preoperative conclusion with a greater probability in 80%.

Adolescent↗
PubMed1982

[Content of 17 beta éstradiol, progesterone and glucocorticoid receptors in patients with benign breast diseases].

The levels of estradiol-17 beta, progesterone and glucocorticoids were assayed in tumor tissues from 41 patients with benign breast tumors. Histologically, 21 tumors were identified as fibroadenomas of various types, 14--as fibrous-cystic non-proliferative mastopathy and 6--proliferative mastopathy. Tumor tissue contained estradiol receptors in 51% of cases, all three types of receptors--in 7% and none of the receptors was found in 29% of tumors. The levels of estrogen and glucocorticoids in cases of benign tumors were lower than those in cancer patients. However, in proliferative fibrous-cystic mastopathy group, estrogen receptor level was higher than in the other two groups.

Adenofibroma↗
PubMed1984

Patient characteristics and age-dependent sub-populations in severe fibrocystic breast disease--the Hjørring project.

This study aimed at providing a detailed anamnestic, clinical, and mammographical characterization of 109 patients with fibrocystic breast disease, who were selected on the basis of pronounced mastodynia, prominent palpable structure and mammographical confirmation of the clinical diagnosis. Since these patients were selected for subsequent therapy, and most of them also underwent various hormonal investigations, accurate differential diagnosis was considered essential. Therefore, X-ray mammography was supplemented as required with adenography, galactography, and aspiration of cysts followed by aerography. Additionally, the results for most study variables were recorded by means of standardized scoring systems. On the basis of this characterization, three diagnostic sub-groups of fibrocystic disease could be distinguished: 20 patients with prominent glandular structure but no visible cysts (group A), 43 patients with prominent glandular structure as well as small (less than 1 cm) cysts (group B), and 46 patients with both small and large (greater than or equal to 1 cm) cysts. The three groups differ significantly in mean age (33.1 +/- 5.5 (SD), 39.2 +/- 4.9, and 43.7 +/- 4.6 years in groups A, B, and C, respectively). There was a significant trend towards increasing duration of breast complaints, and patients with a history of greater than 5 years account for 45, 65, and 74% in groups A, B, and C, respectively. Moreover, most of the study variables, viz. mastodynia, palpable structure, amount of glandular tissue, non-cystic nodularity, small cysts, duct ectasia, nipple discharge, and fibrosis, also tended to increase significantly in intensity and/or frequency from group A to B to C.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Psychosocial issues in breast disease.

The awareness of cultural and psychosocial factors and attitudes toward the breast and the inclusion of these factors in the total care of the patient facilitates management of breast disease to the benefit of the patient, her family, the medical staff, and, ultimately, to society as a whole.

Breast↗
PubMed1978

Fibrocystic breast disease in oral-contraceptive users. A histopathological evaluation of epithelial atypia.

Epidemiological studies show a lower frequency of fibrocystic breast disease among long-term users of oral contraceptives than among women who have never used them. Fibrocystic disease may be a precursor of breast cancer; yet the incidence of breast cancer does not appear to differ between pill-takers and nontakers. To resolve this conflict, we examined the problem from a histologic standpoint in 205 premenopausal women, and found that this decreased frequency applied only to fibrocystic disease in which epithelial atypia was minimal or absent. In women with marked atypia there was no significant difference in frequency among long-term users as compared to women who have never used oral contraceptives. These findings suggest that a spectrum of cystic disease exists and that the long-term use of oral contraceptives protects against the forms of fibrocystic disease that are not firmly associated with an increased risk of breast cancer, but not against the premalignant forms.

Adult↗