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At least 19 recordsLinked to original sources
PubMed1988

Association of breast cysts and breast cancer.

A review of 915 consecutive patients with breast cancer and 812 with breast cysts showed that an association between the two is uncommon--5% of breast cancers were associated with cysts and 4% of cysts were associated with breast cancer. Four types of association were identified: (a) cystic cancers--easily diagnosed because of the characteristic features of the aspirate, failure of the mass to disappear and early recurrence in a patient whose age and menstrual status were not usually associated with cysts; (b) cancers occurring simultaneously with breast cysts--recognized because they did not contain cyst fluid; (c) cysts occurring after breast cancer--diagnosed by aspiration of the mass in premenopausal women; (d) cancers in patients who have had breast cysts--usually occurring many years after the cyst aspiration when menses had ceased. These associations were not sufficiently frequent to justify specific follow-up, but all suspected cysts should be successfully aspirated to confirm the clinical diagnosis.

Adult↗
PubMed1990

Identification of a unique biological tumor marker in human breast cyst fluid and breast cancer tissue.

Breast cyst fluid from 35 women was stratified into risk groups based on personal and family history of breast cancer. Mitogenic activity in breast cyst fluid of women at highest risk to develop breast cancer was significantly higher than the activity in the lowest-risk group. There was a direct dose-dependent relationship between mitogenic activity and increased risk of developing breast cancer. Size-exclusion chromatography showed that breast cyst fluid from women at highest risk contained two peaks of growth factor activity: less than 6 kilodaltons (kd), identified as human EGF (epidermal growth factor), and 6 to 18 kd. Moderate-risk group samples demonstrated only the single less than 6 kd peak, whereas the lowest-risk group had insignificant growth-promoting activity. Breast cancer tissue analyzed in a similar manner revealed a predominant 6- to 14-kd peak of mitogenic activity demonstrating the same acid- and heat-stability found in breast cyst fluid.

Biomarkers, Tumor↗
PubMed1988

Breast cyst type does not predict the natural history of cyst disease or breast cancer risk.

The sodium (Na) and potassium (K) concentrations were measured in the fluid of 169 breast cysts aspirated from 101 consecutive patients presenting to a single clinic. The Na/K ratio was used to define cysts as either apocrine (Na/K less than 3) or flattened (Na/K less than 3) in type. There was no consistency in the type of cyst for individual patients. Cyst type was not predictive of further cyst development, neither was a particular cyst type associated with the development of, or a history of, breast cancer.

Age Factors↗
PubMed2000

Lack of utility in clinical practice of cytologic examination of nonbloody cyst fluid from palpable breast cysts.

OBJECTIVE: This study was undertaken to answer the following question: Does cytologic evaluation of nonbloody fluid aspirated from breast cysts contribute to appropriate clinical management? STUDY DESIGN: A retrospective review of palpable breast cyst fluid cytologic reports and associated medical records was undertaken to determine whether the cytologic findings affected patient management. Breast cyst size, fluid volume, fluid color, and patient age were abstracted from 689 medical records (1988-1999) of women whose palpable cysts had been aspirated at the Breast Diagnostic Center, Women's and Children's Hospital, Los Angeles. These observations were correlated with the fluid cytologic reports. RESULTS: Except for frankly bloody fluid, all breast fluid cytologic reports listed the results as acellular, inadequate for cytologic diagnosis, or no malignant cells identified. CONCLUSION: In clinical practice only frankly bloody fluid should be submitted for cytologic analysis. All other cyst fluid should be discarded.

Adolescent↗
PubMed1988

Urokinase and tissue-type plasminogen activators are present in breast cyst fluids.

Breast cyst fluids obtained by needle aspiration from 20 patients were analysed for the presence of urokinase-like (u-PA) and tissue-type (t-PA) plasminogen activators. Plasminogen, the natural substrate for these PAs, was also measured. u-PA activity was detected in 18 samples (mean +/- S.D. = 1.11 +/- 1.08 IU ml-1) and t-PA activity in 16 samples (0.35 +/- 0.28 IU ml-1). Plasminogen was detected in 10 samples (mean = 37 micrograms ml-1), range 28-85 micrograms ml-1) and was below the assay detection limit in the other samples. While both u-PA and t-PA specific activities were greater in the 10 cyst fluids categorized as Group A (Na+ to K+ concentration ratio less than 4) than in the 10 samples categorized in Group B (Na+ to K+ concentration ratio greater than 4), the differences were not statistically significant. Nevertheless, this is the first evidence that u-PA and t-PA are present in active forms in breast cyst fluids. The significance of such activities must be hypothetical, but it is possible that a study of factors influencing the levels of u-PA and t-PA within the breast may yield information about pathophysiology of cystic and other diseases of the breast.

Enzyme Precursors↗
PubMed1988

Fibrocystic breast disease: the significance of beta-human chorionic gonadotropin and other polypeptides in breast cyst fluid.

Breast cyst fluids from 118 women, aged 29 to 69 years, were analyzed by radioimmunoassays for beta-human chorionic gonadotropin (beta-hCG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), and thyroid-stimulating hormone (TSH). Blood was drawn at the same time in many cases to compare hormonal levels in serum with those in the breast cyst fluids (BCF). The levels of beta-hCG in BCF were relatively high, with a mean (+/- standard error of the mean [SEM]) of 58.9 +/- 16.8 mIU/ml; serum levels of beta-hCG were negligible. LH and TSH also were elevated in BCF compared with serum levels, exhibiting mean values (+/- SEM) of 26.7 +/- 4.3 mIU/ml and 6.4 +/- 0.44 muIU/ml, respectively. The levels of FSH and PRL in BCF were equivalent to the levels in the serum. The presence of biologically active hCG was suggested in several BCF samples using the rat ovarian hyperemia test. Samples of BCF were assessed for the capacity to stimulate Leydig cell testosterone production in vitro in the presence or absence of an anti-hLH antiserum. Testosterone production was significantly (P less than 0.05) enhanced, even in the presence of the antiserum. These data suggest that BCF contains biologically active hCG.

Adult↗
PubMed1990

Epidermal growth factor and oestradiol in human breast cyst fluid.

Gross cystic breast disease is a common condition in women. Women with apocrine breast cysts (breast cyst fluid Na+/K+ less than 3) may be at higher risk of breast cancer than women who have cysts lined by flattened epithelium (Na+/K+ greater than or equal to 3). Breast cyst fluid concentrations of epidermal growth factor were significantly higher in the low electrolyte ratio group than in the high electrolyte ratio group (356.2 ng/ml vs 104.1 ng/ml, P less than 0.0003). A negative correlation was obtained between intracystic epidermal growth factor concentrations and Na+/K+ (rs = -0.666, P less than 0.001). No significant difference was found between the total oestradiol concentrations in the two cyst groups. However, the unbound oestradiol concentrations on a limited number of samples were significantly higher in the low electrolyte ratio group than in the high electrolyte ratio group (P less than 0.05). The higher concentrations of EGF in cyst fluid with Na+K+ less than 3 may explain why women with apocrine breast cysts may be at increased risk of developing breast cancer.

Apocrine Glands↗
PubMed1994

Steroid biochemistry and categorization of breast cyst fluid: relation to breast cancer risk.

Patients bearing macrocysts of the breast are at higher risk of later developing cancer. The fluid filling the cysts (breast cysts fluid, BCF) contains unusual amounts of steroid conjugates, first androgen and estrogen sulfates. Measuring BCF cations (K+,Na+) allows categorization of cysts into two major subsets (type I and type II) that are associated with a different degree and/or turnover of apocrine metaplastic cells in the lining epithelium. Type I cysts (high K+/Na+ ratio) accumulate hugh amounts of dehydroepiandrosterone sulfate, estrone sulfate, androstane-3 alpha,17 beta-diol glucuronide, androsterone glucuronide and contain more testosterone and dihydrotestosterone than type II. Conversely, type II cysts (low K+/Na+ ratio) contain more progesterone and pregnenolone. A cohort study was started in 1983 at the Cancer Prevention Center, Ravenna, Italy, with the aim of evaluating the relationships between the biochemistry of BCF and the incidence of breast cancer in women with gross cystic disease (GCD) of the breast. The bimodal distribution of the cationic pattern has been confirmed from data obtained in 798 patients aspirated. The risk of cyst relapse was significantly higher among women with type I cysts or with multiple cysts at presentation. Twelve incident cases of breast cancer have been diagnosed among women whose BCF was categorized. Eleven out of 12 cases had type I or multiple cysts. The cumulative incidence of breast cancer among patients bearing type I cysts was 2.5%. We conclude that women with GCD bearing type I cysts have an increased breast cancer risk when compared with the counterpart bearing type II cysts or the general population.

Adult↗
PubMed1999

Risk of breast cancer in women with palpable breast cysts: a prospective study. Edinburgh Breast Group.

BACKGROUND: 7% of women in the western world develop palpable breast cysts. Studies of the relation between cysts and breast cancer have conflicting results. There are two clearly defined types of cyst. We investigated whether one cyst type is associated with a higher rate of breast-cancer development than the other. METHODS: We studied 1374 women with palpable breast cysts presenting between 1981 and 1987, who had cysts aspirated between 1981 and 1989. Cysts were classified as type I if the sodium/potassium (Na+/K+) ratio in the cyst fluid was less than 3, or type II if the Na+/K+ ratio was 3 or more. Data on incidence of breast cancer were available until January, 1995, and we compared them with the expected numbers of cancers calculated from age-specific breast-cancer incidence in Scotland in 1988. FINDINGS: 65 cancers developed during follow-up. The overall standardised incidence rate of breast cancer in patients with palpable cysts was 2.81 (95% CI 2.17-3.59). The relative incidence rate was increased for all cyst types. The standardised incidence rate of developing breast cancer among women younger than 45 years was highest at 5.94 (2.97-10.63), with a significant trend for decreasing relative incidence rate with age (p<0.05). Women older than 54 years had a standardised incidence rate of 1.73 (0.86-3.10). The standardised incidence rate of breast cancer was highest in the first year after aspiration (7.02 [3.73-12.00]) but the risk was still raised after 5 years (2.68 [1.84-3.76]). INTERPRETATION: Women with breast cysts are at an increased risk of breast cancer, especially at younger ages. The type of cyst did not alter the associated relative incidence rate of breast-cancer development.

Adult↗
PubMed1981

Antigens and antibodies cross-reactive to the murine mammary tumor virus in human breast cyst fluids.

Human breast cyst fluids were shown to contain low concentrations of IgA (15-78 micrograms/ml) and IgG (33-145 micrograms/ml). The IgA:IgG ratios in individual breast cyst fluids ranged from 1:0.6 to 1:4. These levels are considerably higher than their ratio in serum (1:7). IgA from 33% of the 40 fluids examined, and IgG from 10% of the fluids, reacted with the murine mammary tumor virus (MuMTV). The reactivity was detected by an enzyme-linked immunosorbent assay that measures antibody binding to both the envelope glycoprotein and core protein of the virus. In a second series of experiments. IgA from 28% of 40 breast cyst fluids reacted only with MuMTV while IgA from 30% of the fluids was reactive with both MuMTV and the Rauscher murine leukemia virus. Antigen reactive with antiserum to the 28,000-dalton MuMTV core protein (p28), was also identified in a 165,000-g pellet fraction from breast cyst fluids. In individual fluids, the extent of IgA binding to MuMTV was positively correlated (P less than or equal to 0.01) with the binding of anti-p28 antibody to the pellet of the breast cyst fluid. Fractions with the buoyant density of retroviruses (1.16-1.18 g/ml) or their cores (1.21-1.25 g/ml) were isolated from breast cyst fluids. These fractions contained a DNA polymerase capable of utilizing the reverse transcriptase-specific template, dG12-18 x poly rCm. In addition, they reacted with antiserum to MuMTV p 28 but not with antiserum to the 30,000-dalton Rauscher murine leukemia virus core protein.

Animals↗
PubMed1992

Categorization of cysts and steroid levels in breast cyst fluid.

Several reports indicate that patients with macrocysts have a two- to fourfold higher risk of developing cancer. The fluid filling the cysts (breast cyst fluid, BCF) contains unusual amounts of biologically active substances, including hormones and metabolites. The accumulation of steroid conjugates, such as androgen and estrogen sulfates, deserves interest. Measuring BCF cations (K+, Na+) permits classification of cysts into two major subsets (type I and type II), conceivably associated with a different degree and with a turnover of apocrine cells in the lining epithelium. Type I (high K+/Na+ ratio) and type II (low K+/Na+ ratio) cysts display different patterns of steroid analytes and steroid-binding proteins. There are many gaps in our understanding of the relationship between local steroids and hypersecretion of fluid in the terminal duct lobular units with eventual appearance of cysts. Accumulating biochemical and epidemiological data, however, point to recurrent, multiple type I cysts as a marker of endocrine risk, i.e., of a whole-organ promoting status toward proliferative premalignant lesions.

Breast Neoplasms↗
PubMed1986

Breast cyst fluid proteins and breast cancer.

A specific breast cyst fluid protein was purified by the following steps: ultracentrifugation, gel filtration, DEAE and Con A chromatography, and gel filtration with guanidine, 6 M. The protein was pure, having a molecular weight of 17,800 daltons on SDS-PAGE and 68,000 daltons on gel filtration. The GCDFP 17,800 is immunologically distinct from other breast cyst fluid components and known milk and plasma proteins. A specific radioimmunoassay was developed and used to determine GCDFP 17,800 in 158 samples of breast cancer cytosol. The GCDFP 17,800 levels were significantly different between grade I tumors (mean of 813 ng protein per mg +/- 430 SEM) and grade III tumors (mean 184 ng protein per mg +/- 59 SEM) and were correlated with progesterone receptor values in postmenopausal women (Spearman's correlation, p = 0.03) but not in premenopausal women. The value of GCDFP 17,800 did not differ between the pre- and the postmenopausal women. By immunocytochemistry the intracellular localization of the GCDFP 17,800 was also found in relation to tumor grading and in correlation with PR values. GCDFP 17,800 appears as a hormone-induced protein of the breast cells. Its intracellular detection by means of radiolabeling allows a more sensitive and precise evaluation of the hormone-dependence of the breast cancer cells and emphasizes the heterogeneity of the tumor cell population.

Amino Acids↗
PubMed1995

Epidermal growth factor content of breast cyst fluids from women with breast cancer or proliferative disease of the breast.

The intracystic electrolyte content is generally used to identify different breast cyst subpopulations: cysts containing high K+ levels have been associated with an increased risk of subsequent breast cancer. In order to define whether other biochemical features of breast cyst fluid (BCF) might further explain such an increased risk, we determined the content of epidermal growth factor (EGF), a known mitogenic factor for normal and transformed breast epithelium, in cysts of women with breast cancer or proliferative lesions of the breast (atypical ductal or lobular hyperplasia and proliferative disease without atypia). Median intracystic EGF levels were significantly higher in patients with breast cancer or atypical hyperplasia than in cysts of women without any clinical or instrumental evidence of proliferative disease chosen as controls (p < 0.05 and p < 0.01, respectively). In patients affected by proliferative disease without atypia, intracystic EGF levels were not different either from controls or from the other study groups. No significant difference among groups was observed in the prevalence of Na+/K+ < 3 cysts, this being the most frequently observed type of cysts in all groups except in that with proliferative disease without atypia. No significant difference in EGF levels between cysts ipsilateral or contralateral to the biopsy was observed within each histological group. Our results indicate that EGF levels are higher in cysts aspirated from breasts with an associated proliferative pathology, either benign or neoplastic. The determination of intracystic EGF, combined with that of electrolyte content, might help to identify a subset of patients with gross cystic disease of the breast at potentially higher risk of developing breast cancer.

Adult↗
PubMed2003

Breast cyst aspiration.

The breast mass is a clinical problem commonly encountered by family physicians. Fine-needle and core biopsy techniques require training and cytopathologist support. In contrast, breast cyst aspiration using a 21- or 22-gauge needle is a simple, cost-effective, minimally invasive procedure. The technique is easy to learn and can be practiced on a breast model. Breast cyst aspiration may be attempted in many women who present with a palpable, dominant breast mass. If clear fluid is aspirated and the mass resolves, malignancy is unlikely, and breast cyst is the probable diagnosis. In this situation, reevaluation in four to six weeks is appropriate; if the cyst has not recurred, only routine mammographic surveillance is required. Referral for fine-needle or excisional biopsy is indicated if the aspirate is bloody or extremely tenacious, if no fluid can be aspirated, or if there is residual mass after aspiration. Complications such as local discomfort, bruising, and infection are uncommon.

Biopsy, Needle↗
PubMed1995

Metabolism of dehydroepiandrosterone sulphate by breast cysts: possible role in the development of breast cancer.

Women with palpable breast cysts may have a higher risk of developing breast cancer. High concentrations of androgens and oestrogens have been found in breast cyst fluid, some of which may be implicated in mammary carcinogenesis. The aim of this study was to investigate whether breast cysts were capable of metabolizing radiolabeled dehydroepiandrosterone sulphate and, if so, to identify the metabolites formed. Breast cysts were found to possess the enzyme systems required for converting dehydroepiandrosterone sulphate to dehydroepiandrosterone, androstenedione, androstenediol, and testosterone. Steroid metabolism by breast cysts may play a role in the development of breast cancer.

Breast Neoplasms↗
PubMed2000

[Tumour markers in human breast cyst fluid in gross cystic breast disease (GCBD)]

AIM: Parallel measurements of tumour markers in the serum and breast cyst fluid in a high risk group (GCBD) of breast cancer. The identification of individuals belonging to this group and their follow-up. MATERIALS AND METHODS: In the breast cyst fluid of 108 patients with GCBD (mean age 47 years) we measured the levels of CA 15-3, TPA, CEA and beta HCG completed by PCT determinations. Simultaneously, the serum CA 15-3 and TPA concentrations were also measured using the Luminescent Immunoassay techniques. RESULTS: Strikingly high TPA values were found in 98% of the patients. The CA 15-3 levels, however, were pathological only in 24%of them. The CEA and beta HCG levels showed hardly any rise and the PCT concentration remained normal. CONCLUSIONS: The lack of any rise in PCT concentration precludes the inflammatory origin of the cystic fluid and the normal serum arker levels exclude ultrafiltration. The increased TPA concentration in the breast cystic fluid and the occurrence of pathological CA 15-3 level in the above percentage of the cases suggest that GCBD represents not only a high risk group but possibly a precancerous state, too.

Journal Article↗
PubMed1994

Growth factor profiles in breast cyst fluid identify women with increased breast cancer risk.

Gross cystic disease and breast cancer are hormonally induced diseases that may share a common biochemical environment conducive to abnormal proliferative responses. Breast cyst fluid samples were analyzed for specific growth factors and levels were compared with breast cancer risk. Growth factor profiles identified both women at increased breast cancer risk and subgroups of women with distinct clinical manifestations of gross cystic disease. Women at increased risk for breast cancer demonstrated in their breast cyst fluid lower levels of platelet-derived growth factor and transforming growth factor (TGF)-beta, compared to women at lower risk. The presence of multiple cysts was associated with increased mitogenic activity, increased epidermal growth factor (EGF) and TGF-beta breast cyst fluid levels, and recurrent cysts were associated with higher levels of EGF. Unique growth factor profiles were associated with each risk group or clinical state, suggesting that distinct proliferative environments, associated with different clinical outcomes, are present in the breast tissue of women with gross cystic disease.

Adult↗