[Selective surgical therapy of breast neoplasms].
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To evaluate the accordance of size measurements of malignant breast lesions 65 women with 76 malignant lesions were preoperatively examined with triple diagnosis (mammography was performed in three views with additional views if necessary) and dynamic MR imaging using a subtraction technique with a 3D T1-weighted sequence. Maximum lesion size at histopathology was used as gold standard and compared with maximum lesion size at MRI and mammography. All measurements were made independently for each method. Histopathology verified 48 invasive, 5 in situ, and 23 mixed lesions. No significant difference was found for the pure invasive lesions ( p=0.366). In the mixed lesions a slightly better result for MRI was indicated ( p=0.116), although there was a great spread. Only five pure in situ lesions were assessed, too few to draw any statistical conclusions ( p>0.5). An overall difference indicated a slight superiority of MRI ( p=0.097). The MR imaging and mammography are both good at measuring the size of detected invasive breast malignancies. The total sizes of mixed lesions are frequently underestimated by both MRI and mammography, although the invasive parts were equally well described and measured with both methods.
New biological knowledge and new diagnostic tools for breast cancer diagnosis may have an important impact on the strategies followed by oncologists in breast cancer management. So far, it has not been possible to label a nucleotide or its precursor with technetium-99m (99mTc) for use in in vivo studies. In this paper, we report the labelling of a precursor, the nitrogenate base thymine, with 99mTc. It has been used to evaluate breast lesions. After animal studies and with the consent of patients, it was employed for evaluation in humans. Thirty-nine women were studied: 32 patients and seven healthy volunteers. Twenty-three malignant lesions showed uptake of labelled thymine. Of the 12 benign cases, there was one false-positive uptake. Labelled thymine was also taken up by one case of malignant microcalcifications. Labelled thymine can be used as a diagnostic method in the identification of malignant anatomo-radiologic palpable lesions of the breast, observed by mammography, possibly avoiding unnecessary biopsies.
BACKGROUND: The most important identified pathogenic factor for breast cancer is the presence of mutations in BRCA1 gene. These are associated with familial breast cancer in up to 80% of cases. The most frequent mutation of BRCA1 gene in Caucasian populations is the exon 2 185AG deletion. AIM: To study the presence of 185AG deletion in Chilean women with sporadic or familial breast cancer. PATIENTS AND METHODS: We studied 15 women with familial breast cancer, in whom at least one close relative was affected, and 40 women with sporadic breast cancer. In genomic DNA obtained from a blood sample, an allele specific polymerase chain reaction was done. This reaction allows the identification of 185AG deletion and uses two pairs of primers. One for the native form that renders a 118 base pairs product and one for the deletion that renders a 170 base pairs product, both with a respective 280 base pairs internal control. RESULTS: The diagnosis of breast cancer was done at 40 +/- 5 and 65 +/- 10 years old in women with familial and sporadic breast cancer, respectively. In none of the samples, the amplification of the 170 base pairs band that corresponds to 185AG deletion, was obtained. In both groups, the product of the amplification was the 118 base pairs band, that corresponds to the native form of BRCA1 gene. The polymerase chain reaction was optimized for a duration of 90 minutes. CONCLUSIONS: 185AG deletion of BRCA1 gene was not detected in this group of Chilean women with sporadic or familial breast cancer.
Of 282 patients, who had been treated for breast cancer between 1968 and 1973, bilateral carcinoma was diagnosed in 23 women. In these, a simultaneous second carcinoma was found seven times; in 16 cases, the second carcinoma developed during the further course of the disease, wherein the free intervals amounted to maximally 20 years. Attention is drawn to the relatively high risk of up to eight or ten per cent for the development of a carcinoma in the contralateral breast following the previous unilateral carcinoma. This reason calls for a half-yearly, clinical and radiological check-up examination of women having been treated for carcinoma of the breast. Finally, the problem of differentiation of a primary, autonomous second carcinoma from metastases of the first carcinoma on the contralateral side is considered and discussed with regard to the corresponding references in literature.
UNLABELLED: Male breast cancer is a rare disease, therefore our knowledge of the disease is limited. AIM: Comparison of prognosis of male breast cancer and not-otherwise specified (NOS) invasive ductal female breast cancer and invasive lobular female breast cancer. MATERIAL AND METHODS: From 1.01.1997 to 31.03.2000 in Clinical Department of Surgical Oncology, Medical University of Łódź, 3862 patients were operated on breast cancer. There were 24 males (0.6%) and 3838 females (99.4%). Full clinical and pathological data concerning 22 males were collected; these males composed a studied group. Females with invasive lobular breast cancer (65 women) and with invasive ductal NOS breast cancer (474 women) operated on in our Department from 1977 to 1982 composed comparison groups. P-value of = 0.05 was considered as statistically significant. RESULTS: Comparison of survival between males with breast cancer and females with invasive ductal NOS breast cancer: Gehan-Wilcoxon test P = 0.914; Mantel-Cox test P = 0.825; log-rank test P = 0.865; Peto-Peto test P = 0.901. Comparison of survival between males with breast cancer and females with invasive lobular breast cancer: Gehan-Wilcoxon test P = 0.443; Mantel-Cox test P = 0.305; log-rank test P = 0.413; Peto-Peto test P = 0.421. CONCLUSION: Prognosis of male breast cancer is not statistically different from that of female invasive ductal NOS and invasive lobular breast cancer.
One particularly interesting problem in the treatment of breast carcinomas relates to the strategy to be adopted in locally advanced forms. In 10-25% of cases surgery in itself offers no guarantee of radicality and the prognosis is particularly poor. Once considered suitable only for radiation treatment, such cases now tend to be treated by mixed therapy adopting different modes and sequences. The present paper fully and carefully examines current concepts and treatment possibilities.
Breast cancer has been studied by mail survey up to 34 years in 571 of 606 women treated with x-rays for acute postpartum mastitis. The incidence of neoplasms was compared with that of three nonirradiated control groups--nonirradiated sisters of the treated women, women with acute postpartum mastitis not treated with X-rays, and their nonirradiated sisters. For the irradiated group, with mean dose of 247 rads to both breasts, the overall relative risk of breast cancer was 2.2 for years 10-34 post irradiation and 3.6 for years 20-34. The dose response for malignant and benign breast neoplasms was compatible with a linear fit. For comparable total doses, fractionation of exposure did not reduce carcinogenic action. Women over age 30 years at radiation treatment had as great an excess risk of breast cancer as did younger women. The overall excess risk of developing breast cancer was about 8-10 cases per million women per rad per year, an increase of about 0.5% per rad.