Showing papers on "Breast cancer published in 1970"

Age at first birth and breast cancer risk.

Abstract: An international collaborative study of breast cancer and reproductive experience has been carried out in 7 areas of the world. In all areas studied, a striking relation between age at first birth and breast cancer risk was observed. It is estimated that women having their first child when aged under 18 years have only about one-third the breast cancer risk of those whose first birth is delayed until the age of 35 years or more. Births after the first, even if they occur at an early age, have no, or very little, protective effect. The reduced risk of breast cancer in women having their first child at an early age explains the previously observed inverse relationship between total parity and breast cancer risk, since women having their first birth early tend to become ultimately of high parity. The association with age at first birth requires different kinds of etiological hypotheses from those that have been invoked in the past to explain the association between breast cancer risk and reproductive experience.

Specific Estrogen Binding by the Cytoplasm of Human Breast Carcinoma

Abstract: Increased recognition of the importance of selective hormone binding in initiation of steroid action in target tissues led us to study estrogen binding by human breast cancer. Mastectomy specimens were obtained from 4 premenopausal and 11 post-menopausal women ranging in age from 37 to 83 yr. They were characterized histologically as infiltrating ductal carcinoma in 9, adenocarcinoma in 5, and colloid carcinoma in one. The capacity of the high-speed ultracentrifugal supernatant (cytosol) of homogenates of mammary carcinoma, glandular tissue and fat, was tested for the ability to bind tritiated 17β-estradiol (E2-3H) by the radioligand binding technique we previously described for uterus. Glandular tissue and fat from all 15 mastectomy specimens failed to bind E2-3H, as did 7 tumors. One tumor had slight steroid binding activity which was unsaturable and nonspecific. Seven tumor cytosols had E2 binding capacities in excess of 0.8, 0.8, 5.1, 10.0, 10.5, 19.5 and 21.3 × 10−14 moles/mg protein. Testos...

Lactation and cancer of the breast. A summary of an international study.

Abstract: An international collaborative study has been carried out to test the hypothesis that prolonged lactation protects women against cancer of the breast. While pregnancy itself seemed to confer some protection against breast cancer in all areas studied, no consistent differences in duration of lactation were found between breast cancer patients and unaffected women, once the fact that breast cancer patients have fewer pregnancies had been allowed for. Even in areas where some women had lactated for a total of 5 years or more, such women occurred proportionately no less frequently among breast cancer patients than among unaffected women. In the light of this and other recent evidence, it is unlikely that lactation has any protective effect against breast cancer in women, and other explanations must be sought for the remarkable international differences in the frequency of this disease.

Host resistance and survival in carcinoma of breast: a study of 104 cases of medullary carcinoma in a series of 1,411 cases of breast cancer followed for 20 years.

Abstract: This paper deals with a special type of mammary carcinoma, generally of high-grade malignancy, which carries a remarkably good prognosis-the so-called "medullary carcinoma of the breast with lymphoid infiltrate." Probably the increased lymphoid tissue seen in these tumours is concerned with cell-mediated and humoral immunological reactions and reflects a strong host-defence mechanism which is responsible for the remarkably high survival rates following radical treatment. Since the evidence for host resistance to malignant disease is based largely on animal data, the opportunity to study a group of patients followed for 20 years, in whom this type of defence reaction appears to exist, is of considerable clinical interest.Among 1,411 cases of breast cancer there were 104 with medullary carcinoma (7.4%), for which the corrected 5- to 20-year survival rates have been calculated. After 20 years 74% of cases with operable medullary tumours were alive, compared with 14% of cases with similar stage non-medullary cancer. In the presence of histologically proved axillary metastases the 20-year survival rate was 61% for medullary cases, compared with only 13% for other types of breast cancer.In 30 cases of medullary cancer in which the axilla was free, the corrected 20-year survival rate was 95% following a combination of radical operation and radiotherapy. No evidence could be found that axillary dissection or postoperative irradiation is harmful to women with operable highly malignant breast cancer in whom a well-marked host resistance is thought to be present. A combination of radical mastectomy and postoperative irradiation appears to be the most effective treatment for such cases. The present grounds for rejecting a radical approach to treatment of breast cancer, based on current immunological considerations, are regarded as being quite inadequate.

Comparison of age, sex, and incidence rates in human and canine breast cancer

Abstract: A 5-year collection of cases of human breast cancer in males and females from the Alameda County Tumor Registry and a 5-year collection of canine cases from the Alameda-Contra Costa Counties Animal Neoplasm Registry were compared on age distribution, crude and age-adjusted incidence rates, and agespecific incidence rate pattern. To facilitate comparisons, ages of dogs were converted to human equivalents. The median ages and overall proportional distribution by age were in close agreement for the 2 sexes of both species. When canine and human incidence were adjusted to the same population distribution, canine age-adjusted incidence rates were 3 times larger in females and 16 times larger in males. Female age-specific rates increased at the same magnitude for both species until the start of the ages of natural menopause in women; then the human rates continued to increase, but slowly, while the canine rates continued to increase at approximately the same exponential value as in the younger age groups. Important similarities and differences between species that may affect breast cancer risk are discussed in the context of the natural history of human breast cancer.

Radiation-induced lymphocyte-immune deficiency. A factor in the increased visceral metastases and decreased hormonal responsiveness of breast cancer.

Abstract: A systemic effect of localized postmastectomy radiation upon the lymphocyte is described. Total lymphocytes were determined in 103 women preoperatively and two or more years after mastectomy. The total lymphocyte count of those not radiated was unchanged, but in the radiated patients it decreased. At time of recurrence, the count of those not radiated was unchanged and of those radiated showed a decrease. Low counts may persist for more than ten years after radiation. The failure of radiation to improve survival after mastectomy may be a consequence of an induced defect in cellular immunity, as reflected in the decrease of lymphocytes, that negates the tumor destructive effect of radiation. The reported reduction in responsiveness of breast cancer metastases to hormone therapy may be a consequence of the widespread use of postmastectomy radiation.

Clinical features of tumor metastasis to the pituitary

Abstract: The clinical features of 11 patients with metastases to the posterior pituitary are described. Carcinoma of the breast was the most common primary tumor. Diabetes insipidus was the presenting feature of pituitary involvement and occurred in 0.95% of the patients with breast cancer. Metastatic destruction of the posterior pituitary was the cause in 20% of the patients seen with diabetes insipidus since 1954. Anterior pituitary insufficiency was not seen. Metastasis to the posterior pituitary is more common than is generally thought and should be considered in all patients with cancer, and especially in those with breast cancer, who develop polyuria and polydypsia.

Cell cycle characteristics of human solid tumors in vivo

Abstract: The duration of the DNA synthetic phase of solid tumors in six patients was determined in vivo by local injections of tritiated thymidine into tumor nodules on the skin and serial biopsies of the lesions. Labeled mitosis curves constructed from the data obtained revealed a distinct wave of labeled mitoses but no evidence of a second wave of DNA synthesis in all six patients. The duration of S phase was 24, 22 and 24 hr in the three patients with malignant melanomas and 19, 22 and 24 hr in the three patients with breast cancer. The method is relatively simple and requires much lower doses of tritiated thymidine; reproducible data are obtainable in patients with solid tumors in a much shorter period of time than with previous experiments.

Lactation and reproductive histories of breast cancer patients in Tokyo, Japan.

Abstract: Epidemiological characteristics of breast cancer have been studied in Tokyo, an area of relatively low breast cancer rates, as part of an international collaborative study. Breast feeding of infants is customary for Japanese women, but even very prolonged lactation did not appear to be associated with a reduction in breast cancer risk. Late age at menarche and early age at first pregnancy were both associated with reduced breast cancer risk. The protective effect of early pregnancy seems much greater than has previously been recognized, and may indeed be greater in Japan than in other areas. However, the average age at first pregnancy is not lower in Tokyo than in areas than in areas where breast cancer rates are high.

Radiation-induced sarcoma after treatment of breast cancer.

Abstract: Two case reports are presented of radiation-induced sarcomas occurring 23 years and 7 years after radiotherapy for breast carcinoma. One patient developed an undifferentiated sarcoma of the scapula believed to be induced by a calculated dose to the soft tissue component of bone of 8,195 rads in 3 weeks. The second patient had a fibrosarcoma involving the soft tissues of the axilla. Both patients died several months after diagnosis of the second neoplasm. A review of the literature disclosed 12 other cases in which a malignant tumor developed under similar circumstances. An analysis of these 12 cases and the 2 reported here showed that the most frequent site for the development of a malignant tumor was the scapula, and osteogenic sarcoma was the predominant histologic type encountered in these cases. Treatment with radical surgery or radiation was usually unsuccessful because most patients developed metastases early. A study of the reported cases brought out the fact that incompletely reported dosages made it impossible to calculate accurately doses of radiation absorbed in the target tissues. The authors present a scheme for presenting precise and informative physical data when future cases of radiation-induced tumors are encountered. In order to diagnose these cases more accurately, criteria for evaluating the patient are presented.

The Present and the Future

Abstract: There is now evidence that the sex linkage in breast cancer can be accounted for by differences in the hormonal environment between men and women. The incidence in men can be increased probably to a rate similar to that in the female by the administration of oestrogens or by feminising conditions; also, there is evidence that men with breast cancer metabolise oestrogen abnormally.

The importance of breast-feeding.

Abstract: Some aspects of the lactating process and its management are discussed. The incidence of lactation failure and related factors advantages and disadvantages of breast-feeding mixed feeding and supplementation and weaning problems and their amelioration are covered. Lactation continues as long as there is suckling. Maternal undernutrition does not greatly affect the protein and carbohydrate (lactose) concentrations of the milk but it does decrease the volume and the milk fat and other constituents may be lowered. The advantages of breast-feeding are numerous for both infant and mother. It has no disadvantages except under certain specific conditions: 1) drugs taken by the mother might be passed on and 2) uncertain cancer factors are present in mice which may be present in humans also. Breast-feeding is on the decline. The trend towards shortening of the duration of lactation and more extensive use of breast milk substitutes in the developing countries must be discouraged. Factors influencing the decline are: 1) economic development and industrialization; 2) the availability of artificial milk commercial pressure and simplicity of bottle-feeding; 3) medical factors; and 4) maternal factors. Weaning should be done gradually when the baby has doubled its weight at about 4-6 months. The success of weaning depends on the foods to be given and how they are given. Some new elements have been added to weaning which have not been helpful: 1) solid food and early supplementation 2) unnecessary reasons for weaning and 3) oversupplementation with vitamins.

Abnormal estrogen metabolism and tissue estrogen receptor proteins in breast cancer

Abstract: This report summarizes those aspects of estrogen receptor proteins and competition for them by various estrogens which may be of future importance in the prevention or treatment of breast cancer. Also the carcinogenicity of estriol as a major "impeded" estrogen is correlated with some modifying uterine and breast development functions. Those compounds termed "impeded" estrogens are only weakly uterotropic themselves but inhibit estradiol-induced uterine growth when coadministered to spayed rats. It is believed that their molecular configuration prevents full estrogenic activity to be manifest. Estradiol-17 beta and weaker uterotopic metabolites oxidized on C2 C6 and C16 (impeded estrogens) mutually compete for cytoplasmic proteins of uterus vagina and breast which appear implicated in the initial concentration of C18 steroids activating target tissues. Experimental and human endemiologic evidence suggests that the relative concentration of estradiol-17 beta and of estriol the principal human impeded estrogen sustained chronically in the vincinity of breast tissues may influence the risk of mammary carcinogenesis. Impeded estrogens have not yet been proven to be carcinogenic in any species. Estriol has failed to induce breast tumors in 30 Sprague-Dawley female rats over 250 days of observation. Estriol along with progesterone is one of the 2 major hormones produced and excreted in pregnancy. It inhibits several of the tissue tropic actions of estradiol-17 beta presumably by displacing the latter from receptor proteins of the cytoplasm and nucleus which has been demonstrated for uterine vaginal and mammary tissues. Investigations by different analytic methods indicate a relative deficiency of estriol production and excretion from adrenocortical and gonadal sources in about 1/4 of healthy nonpregnant Caucasian premenopausal women. Of patients with fibrocystic disease of the breast or with untreated breast cancer 2/3 may excrete subnormal estriol concentrations. In induced rat mammary cancers estriol can inhibit estradiol binding to homogenates. The hypothesis is advanced that estriol plays a significant anticarcinogenic role in the human female accounting in part for the reduced expectancy of mammary cancer in Japanese women in whom low estriol excretion has not yet been reported and in women with multiple pregnancies in their early child-bearing years or after early castration. Estriol should be an effective form of endocrine therapy for hormone-dependent breast cancer since it retains much of its capacity to bind to estrogen receptor proteins in tissues substituting for estiadiol-17 beta.

Direct lymphography of the breast.

Abstract: The surgical treatment of breast cancer has been developed on the basis of the topographic anatomy of lymphatic vessels and regional lymph nodes. The axillary and infraclavicular lymph nodes of the breast as well as their afferent lymphatic vessels and the pectoral muscles are removed in continuity. Provided that the lymphatic anatomy of the patient is normal, the operation seems to be radical indeed: yet recurrences and late metastases are often observed (8). In the diagnosis of regional lymph nodes palpation has remained the most common method of examination. However, axillary palpation is not suitable for the demonstration of the collateral lymphatic system developing as a result of blocked main lymphatic channels by tumour deposits. Examination of the axillary lymph nodes by palpation gives according to data in the literature (6, 9, 10) an incorrect diagnosis in about 30 per cent of cases. More accurate methods of examination with regard to diagnosis, prognosis, and therapy are needed to be chosen. With more accurate examinations patients who seem operable according to the classical methods of investigation, but who already have metastases outside the field of operation, can be selected. In order to come closer to the "correct diagnosis" we used direct lymphography of the breast in a group of patients with breast cancer. In recent related literature two authors had reported of similar investigations. Lewis (7) performed successful lymphangioadenography at two patients with benign tumour of the breast, while Halsell (5) studied the anatomy of mammary lymphatics by the method of lymphangiography, also in 7 benign cases.

Carcinoma of the breast in women less than thirty years old.

Abstract: 135 cases of carcinoma of the breast in women under 30 years (4 were 22 years or younger) were on file at the Armed Forces Institute of Pathology in Washington D.C. The gross characteristics of the carcinomas were the same as those in older women with the same types of cancer. The percentages of patients with and without axillary metastasis still well at last contact were 25% and 66%. The proportions of surviving patients with the 3 main types of tumors were infiltrating duct (70%) medullary (50%) and intraductal (11%). The prognosis was worse with larger tumor sizes. 61% 75% and 36% of patients with upper outer quadrant lesions lower outer quadrant lesions and inner quadrant or subareolar tumors were well at last contact. Only 4 (29%) of the 14 patients pregnant at tumor diagnosis were living and free of neoplasms at last contact. 10 diagnoses were at 5 months postpartum and 1 patient at diagnosis was 18 months postpartum but breast feeding. 54% of these 11 women were living and well at last contact. No relationship was found within the age limits of the study between age of patient and survival. Favorable factors influencing survival in women under 30 are the relative high proportion of favorable-type tumors and the relative rarity of deaths from unrelated causes. Unfavorable factors include the frequent association of the tumor with pregnancy or lactation a high incidence of axillary metastasis unusually poor survival in patients with 1 or 2 involved axillary lymph nodes and a high incidence of carcinoma of the opposite breast. Women under 30 appear to have a slightly poorer prognosis than do older women. Women taking oral contraceptives among the breast cancer patients were underrepresented (4-5 expected in 47 women from 1960-1964 1 found).

Surgical treatment of breast cancer. Trends and factors affecting survival.

Abstract: Survival trends were reviewed among 12,641 women operated on for breast cancer at the Mayo Clinic from 1910 through 1964. Factors affecting survival among the 2,571 women operated on from 1955 through 1964 were analyzed. Axillary nodal involvement was the main determinant in survival; five- and ten-year survival rates were 86% and 72%, respectively, for patients without nodal involvement and 50% and 32%, respectively, for those with such involvement. When axillary nodes were not involved, survival after standard radical mastectomy was not much different from that after a modified radical procedure. When axillary nodes were involved, the data suggested that radical mastectomy might be associated with longer survival, but this remained unsettled. Postoperative irradiation did not influence survival, irrespective of axillary nodal involvement. Certain epidemiological aspects of breast cancer were reviewed from a community study (Olmsted County, Minnesota); survivorship changed only slightly, and specific incidence rates increased with age.

New Species of Hybridizable Nuclear RNA in Breast Cancer Cells

Abstract: Summary The rapidly labeled nRNA in normal mammary cells and in transplantable breast cancer cells of mice and rats were compared by the techniques of RNA-DNA hybridization and hybridization-competition. The RNA9s from the normal and neoplastic cell types showed similar reactivity toward DNA9s from various species and reacted with them in proportion to known genetic relatedness. The specificity of the competition reaction between breast cancer RNA- 3 H and homologous DNA was shown by the competition of heterologous RNA from various species in proportion to the known relatedness of the DNA9s from which they were transcribed. While the unlabeled breast cancer RNA9s competed with RNA- 3 H from breast cancer cells to 92 to 94% of the theoretical value for identical RNA populations, unlabeled normal mammary RNA competed to only approximately 50 to 65% of this value. Unlabeled RNA from breast cancer cells competed completely with labeled RNA from normal mammary cells. These findings indicate that these breast cancer cells synthesize species of nuclear RNA which either are not formed by normal mammary cells or are present in nonneoplastic mammary cells in undetectably low concentrations.

Paget's disease of the breast.

Abstract: More than a hundred years ago Velpeau first described the nipple lesion we now know as Paget’s disease of the breast. However, it was James Paget who in 1874 observed the association between the nipple erosion and breast cancer. Since then, in almost a century, the pathologic aspects of the disease have been the subject of considerable discussion. There is general agreement today that the Paget cell, first described by Darier in 1889, and seen in the nipple epidermis, is a carcinoma cell invading the epidermis of the nipple and originating from an intraductal carcinoma of the underlying duct system of the nipple or breast. Uncertainty still exists, however, about the clinical behavior of this type of carcinoma and its treatment. Poor over-all survival, even with radical mastectomy, has been reported by Colcock and Sommers [I], Helman and Kliman [2], Maier et al [3], and Kay [4]. These generally unfavorable results are particularly disturbing in view of the fact that Paget’s disease is one of the most slowly evolving forms of cancer. Possible explanations of this paradox may be found in the smallness of the reported series of cases and lack of precise information as to the classification and stage of advancement of the disease. The purpose of this report is to elucidate the behavior of Paget’s disease in correlation with its clinical classification, stage, and pathologic extent in a large series of patients treated uniformly and followed up for a long period of time.