Showing papers on "Breast cancer published in 1974"
TL;DR: A cohort of 1458 breast cancer patients treated by radical mastectomy in the years 1940–1943 has been followed since that time, and sixty‐nine seem to have been definitely lost to followup, while followup is active but incomplete for 30 others.
Abstract: A cohort of 1458 breast cancer patients treated by radical mastectomy in the years 1940–1943 has been followed since that time. There are 184 known alive an average of 30.6 years later. Of the others, 836 have died of either their first or second breast cancers, and 349 have died of other causes. Sixty‐nine seem to have been definitely lost to followup, while followup is active but incomplete for 30 others. The actuarial 30‐year survival rate is 38%, and the cumulative rate of clinical second primary breast cancers is 16.4%.
302 citations
TL;DR: Case records were reviewed of 201 patients that developed active tuberculosis complicating neoplastic disease at Memorial Hospital between 1950‐1971 and over‐all mortality due to TB was 17%, compared with 48% in patients with lymphoproliferative disorders.
Abstract: Case records were reviewed of 201 patients that developed active tuberculosis (TB) complicating neoplastic disease at Memorial Hospital between 1950-1971. TB occurred in 44 patients with lung cancer, 45 with head and neck cancers, 28 with breast cancer, 29 with lymphoproliferative disorders, 20 with gynecologic cancers, 7 with leukemia, 9 with, stomach cancer, and 19 with other neoplasms. Patients with lung cancer, reticulum cell sarcoma, lymphosarcoma, and Hodgkin's disease had a TB prevalence of 92, 78, 88, and 96 cases per 10,000 patients, respectively, with each neoplasm. Patients with head and neck, stomach cancer, and acute lymphatic leukemia and acute myelogenous leukemia had a prevalence of 51, 55, 37, and 28 per 10,000 patients at risk, respectively. The prevalence in breast cancer, colon, and genitourinary cancer was 5 to 20 per 10,000. TB generally occurred when the neoplasm first developed in patients with lung and head and neck cancers, and after antineoplastic therapy for advancing disease in lymphoproliferative disorders and breast cancer. TB occurring after antineoplastic therapy caused more severe TB infection with a high mortality rate. Patients treated with adrenocorticosteroids also had more severe tuberculous infection. TB caused masses and adenopathy plus fatal pneumonias and disseminated infection. Over-all mortality due to TB was 17%, compared with 48% in patients with lymphoproliferative disorders. Early diagnosis and treatment of TB is stressed.
301 citations
TL;DR: Thoracentesis with or without nitrogen mustard instillation was distinctly inferior to the tube and nitrogen mustard method, and pleurectomy in selected cases proved worthwhile.
Abstract: This report reviews a 5-year experience in the treatment of malignant pleural effusion with particular emphasis on the use of closed-tube thoracostomy drainage with nitrogen mustard instillation. Of the 133 patients treated at the Barnes Hospital for malignant pleural effusion between January 1 1964 and December 31 1968 bilateral effusions were present in 21. Carcinoma of the breast bronchogenic carcinoma and lymphomas were the most frequent tumors causing malignant pleural effusion. All of the patients had histologic confirmation of the primary tumor and cytologies were positive in 67% of the 125 effusions examined. Patients were followed for an average of 61/2 months. Of 66 hemithoraces (60 patients) treated with tube thoracostomy and nitrogen mustard 37% were free of effusion 3 months later and 29% at 6 months after therapy. At 12 months 17% had no recurrent effusions. Most failures occurred during Month 1 after treatment when there was a 35% recurrence of symptoms. At 6 months 53% of patients were asymptomatic at 1 year 39%. Other methods had proved less successful. With thoracentesis alone (94 cases) average recurrence time was 4.2 days and 97% had recurrence of effusion in 1 month after treatment. Radiation therapy was used only after failures of the tube and nitrogen mustard method. The method of chest tube insertion and nitrogen mustard instillation is important. Nausea and pleuritic chest pain are controlled by antiemetics and analgesics. Patients with breast carcinoma seemed to have the best response rates. There were no deaths attributable to the therapy. Thoracostomy alone without nitrogen mustard (7 cases) was less successful as all had recurrence of effusion within 1 month. Other methods used in selected cases proved worthwhile.
271 citations
TL;DR: There was a pronounced effect of body weight and height on breast cancer risk; the significance of this in explaining international differences in incidence is stressed.
Abstract: A prospective study of breast-cancer risk in postmenopausal women has been carried out with the cooperation of 50 general practitioners. A total of 7,259 women have been followed up for an average period of 5.4 years (maximum 8.1 years); 70 cases of breast cancer occurred. The main finding was a pronounced effect of body weight and height on breast cancer risk; the significance of this in explaining international differences in incidence is stressed. High parity counteracted the risk of high weight regarding breastcancer. Single women did not show a high risk because of their relatively low body weight. The relative risk in women with a previous mastectomy was five-fold.
202 citations
TL;DR: Serum CEA was evaluated in 69 patients with breast cancer and 17 with benign breast disease and the trends of serial CEA values correlated with response to treatment.
Abstract: Serum CEA was evaluated in 69 patients with breast cancer and 17 with benign breast disease. Serum CEA was elevated (above 2.5 ng/ml) in 6 of 22 patients (27%) with primary cancer without clinical evidence of distant metastases, and in 37 of the 47 (79%) who had metastatic disease. Sixteen of 17 patients (94%) with benign cystic disease had values less than 2.5 ng/ml (1 was 2.9 ng/ml). Fourteen patients with metastases undergoing chemo- and hormonal therapy were studied by serial CEA estimations for 3 to 18 months, with a mean of 14 months. The trends of serial CEA values correlated with response to treatment.
201 citations
TL;DR: A group of women was identified whose risk for breast cancer was 47‐to 51‐fold higher than that experienced by control women, and the disease in these families developed premenopausally, often bilaterally, and was seemingly associated with ovarian function.
Abstract: A group of women was identified whose risk for breast cancer was 47-to 51-fold higher than that experienced by control women. These high-risk women were sisters of patients whose mothers had breast cancer. The disease in these families developed premenopausally, often bilaterally, and was seemingly associated with ovarian function. Since disease susceptibility was transmitted from an affected mother to approximately 30% of her daughters, this early, bilateral form of breast cancer appeared to be strongly heritable. Another, less heritable form was identified in families comprised of at least two affected sisters and unaffected mothers. The risk in these families was 3-fold higher than that of controls, and the disease was primarily postmenopausal, unilateral, and was not strongly associated with ovarian function. No difference was observed in the transmission of breast cancer through paternal and maternal lines of descent.
197 citations
TL;DR: A positive association between reserpine use and breast cancer was observed in cases of newly diagnosed breast cancer and in controls admitted for elective surgery for benign conditions.
187 citations
TL;DR: An association between breast cancer and the use of rauwolfia derivatives was found and became statistically significant at the 5% level when other neoplasms previously suggested to be associated with reserpine use were removed from the control group.
180 citations
TL;DR: An increased mortality in early breast cancer can be correlated to the routine use of local postoperative irradiation, and controlled clinical trials demonstrate decreased survival of between 1 and 10% in irradiated patients when compared with those treated by mastectomy alone.
173 citations
TL;DR: Hormone administration at natural menopause was found to be associated with decreased risk of breast cancer and the familial aggregation of the disease appeared to be related to an altered state of estrogen excretion or metabolism.
Abstract: A case-control study was conducted in an attempt to discover epidemiological evidence that might support a milk-transmitted virus in the etiology of breast cancer in young women. The Department of Pathology at the University of Southern California has maintained a Cancer Surveillance Program for Los Angeles County since 1971. Physicians who reported current breast cancer cases with onset below age 65 were asked for permission to interview their patients. Approximately 70% of the sequentially reported breast cancer patients of suitable age were reached and interviewed. A patient without a prior history of malignancy was selected as an individually matched control for each case from the outpatient population of the index cases referring physician. Regardless of the patients age at diagnosis of breast cancer no evidence of an increased risk associated with breast feeding was found. Increased familial risk of breast cancer occurred in both paternal and maternal lines. The familial aggregation of the disease appeared to be related to an altered state of estrogen excretion or metabolism. The mothers of breast cancer patients had the delayed age at 1st delivery and at menopause characteristics of the patients. Hormone administration at natural menopause was found to be associated with decreased risk of breast cancer.
151 citations
TL;DR: Due to the use of estrogen, delays were effected in the onset of osteoporosis, and these resulted in an improvement of the incidence of the skeletal fractures which might be anticipated in this age group.
TL;DR: Detailed hormonal studies of normal and abnormal human reproductive cycles have led to the conclusion that inadequate corpus luteum secretory function was one of the characteristic features of infertile and/or irregular menstrual cycles.
Abstract: Inadequate corpus luteum function is discussed in a pathophysiological interpretation of human breast cancer epidemiology. Detailed hormonal studies of normal and abnormal human reproductive cycles have given evidence that inadequate corpus luteum secretory function is 1 of the characteristic features of infertile and/or irregular menstrual cycles. Age at menarche and menopause parity and androgen and estrogen secretion have all been related to breast cancer development. Treated independently these risk factors have been of little assistance in the identification of individuals with a predisposition to breast cancer development. The hypothesis that breast cancer risk factors are the manifestation of inadequate corpus luteum function can be tested epidemiologically. If correct an attempt can be made early in reproductive life to identify and treat those who manifest luteal phase inadequacy. The hypothesis was strongly suggested that estrogenic stimulation in the absence of sufficient cyclic progesterone secretion may provide a setting favorable to the development of mammary carcinoma. It is apparent that limited luteal phase progesterone secretion occurs in the presence or absence of gross irregularity of the menstrual cycle. The importance of these findings was strengthened by a study of premenstrual endometrial biopsies from 87 women with breast cancer and 50 normal women. Normal secretory endometrium was found in 68% of controls and only 17% of breast cancer patients.
TL;DR: The excellent results obtained by adequate treatment of minimal breast cancers attest to the need for reliable mass screening techniques to detect occult, asymptomatic breast cancer, and for the availability of these techniques to the public at large.
Abstract: Modified radical mastectomy was performed in 162 patients with minimal breast cancer between 1953 and 1972 (JAU). The majority of lesions were small infiltrating cancers (52), non-infiltrating duct cancer (37), lobular carcinoma in situ (49), Paget's disease with non-infiltrating cancer (12), and also a small group of miscellaneous low-grade cancers (7), and malignant cystosarcoma phyllodes (5). Major indications for surgery were the presence of a mass, nipple ulceration, positive mammograms, and the discovery of an occult cancer on contralateral biopsy. Mammography was accurate in 60% of patients with minimal breast cancer. Contralateral biopsy proved to be a very sensitive diagnostic technique, and was positive in 35 patients, most of whom were negative by clinical examination and mammography. Residual cancer was found in the mastectomy specimens in 52% after generous excisional biopsies. Sixteen percent of patients with minimal infiltrating cancer and clinically negative axillae had micrometastases (2mm or less) in axillary nodes. The crude survival rate free of disease was 93 of 95 patients (98%) at 5 years, and 42 of 44 patients (95%) at 10 years. There were no local recurrences. No postoperative radiation was used on these patients. Modified radical mastectomy is recommended as the ideal treatment for minimal breast cancer as it yields excellent long term salvage, complete local control, and is more acceptable cosmetically than the classical radical mastectomy. It is to be preferred over extended lumpectomy (tylectomy) with radiation therapy since it avoids the potential long-term carcinogenic effects of ionizing radiation. The excellent results obtained by adequate treatment of minimal breast cancers attest to the need for reliable mass screening techniques to detect occult, asymptomatic breast cancer, and for the availability of these techniques to the public at large.
TL;DR: Unequivocal evidence is presented for the synthesis of œstradiol-17β from an androgen precursor by a human breast carcinoma.
TL;DR: The familial incidence and distribution of all malignancies for a group of 145 breast cancer patients were determined and compared to that of 139 randomized control patients and significantly higher incidences of only uterine, prostatic, and breast cancer were found among both maternal and paternal relatives of the Breast cancer patients.
Abstract: The mammary gland is one part of an integrated genital organ system. The various parts of this system have distinctive shared biological and pathologic characteristics. Because of the frequent association of mammary, uterine, and ovarian cancer in the same individual, it is hypothesized that some common etiologic factor exists which might also have a familial expression in other parts of this genital organ system. Based upon this, the familial incidence and distribution of all malignancies for a group of 145 breast cancer patients were determined and compared to that of 139 randomized control patients. Significantly higher incidences of only uterine, prostatic, and breast cancer were found among both maternal and paternal relatives of the breast cancer patients.
TL;DR: Twenty-five patients with advanced metastatic breast cancer were treated with the combination of methotrexate and 5-fluorouracil intravenously and by mouth daily for the first 14 days of a 28-day cycle, with no correlation between the length of the metastasis-free interval after previous treatment and subsequent response to chemotherapy.
Abstract: Twenty-five patients with advanced metastatic breast cancer were treated with the combination of methotrexate 60 mg/M2 and 5-fluorouracil 700 mg/M2 intravenously on the first and eighth days, and cyclophosphamide 100 mg/M2 and prednisone 40 mg/M2 by mouth daily for the first 14 days of a 28-day cycle. The patients had had no previous chemotherapy or extensive radiotherapy and all but two had not responded to hormonal therapy or endocrine ablation. The major metastatic lesions were: lung (12 patients), liver (four patients), bone (four patients), soft tissue (three patients), nodes (two patients). Seventeen of the 25 patients (68%) responded to treatment with seven complete remissions; these included patients suffering metastatic lesions in the lung, nodes, and soft tissue. The overall median duration of response was nine months (range 6-26 months). Toxicity was primarily haematological, but the group received an average of at least 75% of their calculated dose for each monthly cycle. Haematological toxicity was most pronounced in patients with liver dysfunction and bone marrow involvement. Out of eight nonresponders seven died, with a median survival of six months. Only six of 17 responders died, and the median survival in this group will exceed thirteen months. There was no correlation between the length of the metastasis-free interval after previous treatment and subsequent response to chemotherapy.
TL;DR: It is suggested that breast-cancer patients as a group have a level of thyroid function which is lower than that found in women in hospital with conditions unrelated to the breast, and that this lowered function is of primary thyroid and not of pituitary or hypothalamic origin.
TL;DR: Among the prememopausal women, increased breast cancer was associated with early menarche, and among oral contraceptive users, there was a trend toward greater risk with increasing age at 1st use of OCs.
Abstract: PIP: In the effort to determine if the risk factors for breast cancer differed between premenopausal and postmenopausal women, a case control study was conducted. The study sample included 95 premenopausal and 278 postmenopausal women with breast cancer admitted to the Ontario Cancer Foundation Clinic in London, Canada during the June 1967 to February 1971 period. The controls were 106 premenopausal and 480 postmenopausal women with benign and malignant diseases of sites other than breast admitted to the same clinic during the same period. The breast cancer risk increased with increasing age at 1st pregnancy among postmenopausal women only. Among the prememopausal women, increased breast cancer was associated with early menarche. Late age at natural menopause was an important risk factor for postmenopausal women. The risk in women experiencing natural menopause over the age of 55 was 2.5 times as great as that of women undergoing menopause before age 40. A longer interval between age at menarche and age at 1st pregnancy increased the risk in both groups. Oral contraceptive use, or duration of use, did not increase the risk of breast cancer. Among oral contraceptive users, there was a trend toward greater risk with increasing age at 1st use of OCs.
TL;DR: In both cases and controls, subsequent mortality was associated with reports of disability and ill health on the questionnaire but not with psycho‐social variables, with the possible exception of a pessimistic view of the future.
Abstract: Quality of survival as defined by physical and psychosocial criteria was found to be remarkably similar among 134 breast cancer patients and 260 controls. Most of the cases had been diagnosed 5 or more years prior to this study. Physical disability was reported by 19% of the cases and 16% of the controls. The slight excess of disability among the cases was related to surgical treatment. There was no evidence of increased psycho-social disability among the cases. The principal effect of breast cancer was to triple mortality over a 28-month period. In both cases and controls, subsequent mortality was associated with reports of disability and ill health on the questionnaire but not with psycho-social variables, with the possible exception of a pessimistic view of the future.
TL;DR: Statistical evaluation demonstrated that breast-cancer patients and controls may be regarded as one population but that the prolactin levels in the high-risk group represent a different population.
TL;DR: A method has been devised to calculate breast volumes from mammograms and this has been applied to mammograms from 42 women with breast cancer and 42 age-matched normal controls, finding no difference in breast volumes.
Abstract: A method has been devised to calculate breast volumes from mammograms. This has been applied to mammograms from 42 women with breast cancer and 42 age-matched normal controls. No difference in breast volumes was noted.
TL;DR: A current and unselected group of cases diagnosed at any U.S. Air Force hospital from 1957 to 1972 shows that, unlike the general impression, the prognosis is neither abysmal nor aggravated by delay in the institution of therapy.
Abstract: Most of the literature on breast cancer in men gives a distorted picture of this condition as it exists today. This is because many of the reported cases date back many years and because the reported cases are almost all selected and not typical of the problem as it really exists. A current and unselected group, consisting of all cases diagnosed at any U.S. Air Force hospital from 1957 to 1972, shows that, unlike the general impression, the prognosis is neither abysmal nor aggravated by delay in the institution of therapy. In males, this tumor generally occurs at younger ages than the literature suggests. Compared to women, men with breast cancer have a similar pattern of primary malignancies in other organs.
TL;DR: Data from Iceland show that breast cancer has increased very markedly in Iceland during this period, and that as the overall incidence has risen, so the age‐incidence curve has changed in shape, the relation between the shape and theOverall incidence being the same as that now observed in other countries.
Abstract: Among different populations, the shape of the age-incidence curve for breast cancer is strongly related to the overall incidence of breast cancer in the respective population. Data are available from Iceland for the period 1911–1972. These data show that breast cancer has increased very markedly in Iceland during this period, and that as the overall incidence has risen, so the age-incidence curve has changed in shape, the relation between the shape and the overall incidence being the same as that now observed in other countries. The change in shape is shown to be explicable entirely as a cohort phenomenon, each decade of birth cohort having an age-incidence curve of similar shape, but with different overall incidence. Data from some other regions of the world indicate that many of the present differences in the shape of the age-incidence curve may be the reflection of cohort phenomena.
TL;DR: It is shown that in an optimal schedule the interval between examinations is proportional to the square root of the age-specific incidence probability of the disease.
Abstract: A model is developed to aid in determining examination schedules for the detection of an age-dependent disease. It is shown that in an optimal schedule the interval between examinations is proportional to the square root of the age-specific incidence probability of the disease. To illustrate the methodology, optimal schedules are developed for breast cancer examinations.
TL;DR: The retrospective or case-control method of epidemiologic investigation is described and compared with the prospective (cohort) method, which has the weakness of being observational or nonexperimental in nature.
Abstract: The retrospective or case-control method of epidemiologic investigation is described and compared with the prospective (cohort) method. Both methods have the weakness of being observational or nonexperimental in nature. 2 methods employed in retrospective studies for reducing (but never eliminating) the likelihood of spurious inferences through indirect association are matching controls to cases with respect to possible confounding factors and statistical adjustment. Some etiologic factors or susceptibility-associated factors that have been identified by studies of this type are smoking in relation to lung cancer and other conditions; oral contraception in relation to intravascular thrombosis; features of the reproductive history in relation to breast and cervical cancer; and maternal rubella in relation to congenital defects. The results of properly designed and conducted retrospective studies rarely disagree to any extent with those of equally well-conducted prospective studies. The retrospective method is both valid and useful. (authors)
TL;DR: It is put forward, based on previous experimental evidence, that a suboptimal level of circulating thyroid hormones may abnormally sensitise mammary epithelial cells to prolactin stimulation, leading to dysplasia and eventual neoplasia.
TL;DR: The data corroborate previous observations on the unique antigenicity of in situ carcinoma and emphasize the need for careful correlations between clinicopathologic findings and in vitro measurements.
Abstract: Cellular hypersensitivity against autologous and homologous breast cancer was evaluated by means of a leukocyte migration procedure. The antigens employed were cryostat sections of breast tissue. The relative leukocyte migration in the presence of the antigen as compared with migration without antigen was termed the migration index (MI), and used to quantify the response. The cryostat sections were also used for parallel studies of cellular hypersensitivity against autologous breast cancer by means of the skin window procedure. Both procedures demonstrated a stage‐response relationship against autologous breast cancer; in situ < Stage I < Stage II. Both procedures demonstrated the persistence of hypersensitivity in patients who were apparently free of cancer more than 2 years postoperatively. Cross reactivity (MI procedure) was uncommon against homologous invasive breast cancer, but was found in approximately half of the tests against homologous in situ carcinoma tissue. Such reactivity against homologous in situ carcinoma was observed in Stage II patients as frequently as in Stage I patients. The data corroborate our previous observations on the unique antigenicity of in situ carcinoma and emphasize the need for careful correlations between clinicopathologic findings and in vitro measurements.