Showing papers on "Breast cancer published in 1977"
TL;DR: A system is proposed by the UICC for assessing response to treatment of advanced breast cancers and its application in clinical practice is proposed.
Abstract: A system is proposed by the UICC for assessing response to treatment of advanced breast cancers.
824 citations
Journal Article•
TL;DR: The usefulness of estrogen receptor measurements in primary breast tumors in the prediction of early recurrence was examined in a series of 145 patients and the absence of estrogenceptor in such tumors was associated withEarly recurrence independent of other known prognostic factors.
Abstract: The usefulness of estrogen receptor measurements in primary breast tumors in the prediction of early recurrence was examined in a series of 145 patients. The absence of estrogen receptor in such tumors was associated with early recurrence independent of other known prognostic factors such as axillary lymph node status and tumor size.
731 citations
TL;DR: Age, race, sex, smoking, drinking, education, income, parity, foreign birth, marital status, and geographic location were used as stratification variables separately or in combination when appropriate to assess and control for their potentially confounding affects and to examine results in different strata to assess interaction.
Abstract: From personal interviews obtained for 7,518 incident cases of invasive cancer from the population-based Third National Cancer Survey, the quantitative lifetime use of cigarettes, cigars, pipes, unsmoked tobacco, wine, beer, hard liquor, and combined alcohol were recorded, as well as education and family income level. In an initial screening analysis of these data, Mantel-Haenszel 2 X 2 contingency tabulations and multiple regression analyses were used to compare each specific cancer site with controls from other sites to test for associations with the "exposure variables." Significant positive associations with cigarette smoking were found for cancers of the lung, larynx, oral cavity, esophagus, stomach, pancreas, bladder, kidney, and uterine cervix. Other forms of tobacco were associated with cancers of the oral cavity, larynx, lung, and cervix. Consumption of wine, beer, hard liquor, and all combined showed positive associations with neoplasms of the oral cavity larynx, esophagus, colon, rectum, breast, and thyroid gland. College educaton and high income both showed positive associations with cancers of the breast, thyroid gland, uterine corpus, and melanomas in males. These same indicators of high socioeconomic status showed inverse associations with invasive neoplasms of the uterine cervix, lung, lip-tongue, and colon in females. College attendance (but not income) showed an inverse association with stomach cancer and positive association with pancreatic cancer in males. Still other tumor sties showed "suggestive" associations with each of these exposure variables. In the analyses producing these results, age, race, sex, smoking, drinking, education, income, parity, foreign birth, marital status, and geographic location were used as stratification variables separately or in combination when appropriate to assess and control for their potentially confounding affects and to examine results in different strata to assess interaction.
644 citations
TL;DR: Based on current findings in the HIP study, there appears to be strong support for periodic screening at ages 50 years and over with clinical examination and mammography; to justify screening under 50, new information from other studies is required.
Abstract: Results in the breast cancer screening project of the Health Insurance Plan of Greater New York that started the end of 1963 have been updated through December 31, 1975. The HIP study is a randomized trial designed to test whether periodic screening with clinical examination and mammography results in reduced breast cancer mortality among women aged 40–64 years at the start. Study women were offered screening examinations; 65% appeared for initial examinations and a large majority of these women had at least one of the three additional screenings at annual intervals. The control group of women continued to receive their usual medical care. New data support earlier reported results on benefits. During the nine years following date of entry there were 128 breast cancer deaths in the control group as compared with 91 in the study group (screenees plus refusers). The impact of the screening program continues to be confined to women 50 years of age and over with no benefit at ages 40–49 years. Seven-year case fatality rates show similar relationships. Several issues related to screening benefit are considered. Of major importance is the observation of no reduction among women under 50 in breast cancer mortality. The possibility that under different screening conditions (e.g., with current mammography equipment) a benefit would be found needs to be investigated. There is a clear need for rapidly determining whether a new randomized trial is the only way to answer the question and whether experience in the 27 NCI-ACS demonstration projects can provide useful data. Another critical issue concerns the incremental value of mammography in a screening program. Over an eight-year period after diagnosis, breast cancer cases that were positive only on mammography when screened had a case fatality rate of 14%; this compares with 32% for cases positive only in the clinical examination and 41% for cases positive on both modalities. Excluding mammography would have reduced the benefit of screening by an estimated one-third. With regard to risk associated with screening, it is concluded that the increment in risk resulting from radiation exposure in mammography does not offset the benefits of screening above 50 years of age. Below that age, although the risk increment is small, the risk-benefit balance is negative because of the absence of a demonstrated benefit. Another source of risk is related to the possible increase in biopsies. Assessment of the HIP experience suggests that only timing of biopsies was affected, but the potential for considerable variation if screening is adopted widely exists. Based on current findings in the HIP study, there appears to be strong support for periodic screening at ages 50 years and over with clinical examination and mammography; to justify screening under 50, new information from other studies is required.
515 citations
TL;DR: Preliminary clinical correlation of ER, PgR and response to endocrine therapy is encouraging, and it is found that the response rate is significntly higher if the tumor contains both ER and PgG than if the tumors contains ER alone.
Abstract: Regardless of the type of endocrine therapy employed objective tumor regression occurs in only 20-40% of breast cancer patients. With added combination chemotherapy an objective remission in 60% of patients may be achieved. Mammary glands contain specific receptors for hormones cytoplasmic proteins for steroids and cell surface receptors for polypeptides. Hormone-dependent tumors contain receptors but autonomous tumors often do not. The presence of estrogen receptor (ER) in a tumor does not guarantee that the tumor will behave in a hormone-dependent manner. The receptor sediments primarily at 8S in low salt sucrose gradients and at 4S in high salt sucrose gradients. ER values in primary tumors have ranged from 0 to 1000 fmol/mg of cytosol protein. ER values have been helpful in predicting results of endocrine therapy for matastatic breast cancer. When the ER value of the tumor is positive the response to endocrine therapy is 55-60%. Receptors for prolactin progestins and androgens have also been identified in breast tumors. Simultaneous analyses of these receptor proteins may be helpful in explaining the 45% with positive ER values who do not respond to hormone manipulation. In metastatic tumors when both progesterone receptor (PgR) and ER were present response to therapy was 81%. In some cases patients whose tumors have failed to regress after high doses of estrogens have responded to a combination of estrogen and progesterone. The synthetic progestin R5020 has been used to demonstrate PgR. Further studies of the biological responses of tumors not only to estrogens but also to glucocorticoids and progestins may permit a more precise description of the biochemical lesion in a tumor and the specific treatment to which it will respond.
401 citations
TL;DR: The discovery that leaving behind positive axillary nodes has as yet not been influential in enhancing the incidence of distant metastases or the overall proportion of treatment failures and that a disproportionate number of treatments failures in the total mastectomy group occurred in those patients who subsequently required axillary dissection provides reinforcement to the view thatpositive axillary lymph nodes are not the predecessor of distant tumor spread but are a manifestation of disseminated disease.
Abstract: In 1971, the National Surgical Adjuvant Breast Project (NSABP) implemented a prospective randomized clinical trial to compare the worth of alternative treatments with radical mastectomy in women with primary operable breast cancer. Information has been obtained from 1,665 patients eligible for follow-up from 34 NSABP member institutions in Canada and the United States. Results from that trial, at present in its sixth year with patients on study for an average of 36 months, (26 to 62 months), fail to demonstrate an advantage for those who had a radical mastectomy. No significant difference in the treatment failure or survival has as yet been observed in clinically negative node patients who have been randomly managed by conventional radical mastectomy, total mastectomy with postoperative regional radiation or total mastectomy followed by axillary dissection of those patients who subsequently develop positive nodes. Similarly, there presently exists no difference between patients with clinically positive nodes treated by radical mastectomy or by total mastectomy followed by radiation. Of particular interest is the observation that based upon findings from radical mastectomy patients, there may be as many as 40% of patients having a total mastectomy who had histologically positive nodes unremoved, to date only 15% have developed positive nodes requiring an axillary dissection. The persistence of such a difference in incidence would have profound biological significance. The discovery that leaving behind positive axillary nodes has as yet not been influential in enhancing the incidence of distant metastases or the overall proportion of treatment failures and that a disproportionate number of treatment failures in the total mastectomy group occurred in those patients who subsequently required axillary dissection provides reinforcement to the view that positive axillary lymph nodes are not the predecessor of distant tumor spread but are a manifestation of disseminated disease.
382 citations
TL;DR: Malignant human breast tumours produced more prostaglandin-like material during homogenisation than did benign tumours or normal breast tissue, and the highest "basal" amounts tended to occur in tumours showing spread histologically.
273 citations
TL;DR: Present results confirm the efficacy of 12 CMF cycles in premenopausal patients and suggest postmenopausal women probably require a more intensive and prolonged adjuvant chemotherapy.
Abstract: In a prospective randomized study adjuvant combination chemotherapy with CMF was administered for 12 monthly cycles to 207 patients subjected to radical mastectomy (Halsted or extended) and treatment failure was compared to that observed in 179 patients whose primary therapy consisted only of radical surgery (control group). All patients of both groups had histologically positive axillary lymph nodes. At three years from mastectomy the total failure time distribution was 45.7% in control patients compared to 26.3% in women given CMF (P less than 0.0001). New disease manifestations were higher in the subgroup with four or more nodes (64.9% vs 41.5%) compared to that with one to three nodes (37.9% vs 19.1%). Premenopausal controls showed a progressively higher incidence of treatment failure compared to CMF patients (P=0.00001). The decreased recurrence rate in postmenopausal women given CMF was appreciable only during the first 12 months. From this time on, the difference no longer existed. The cumulative percent of recurrence in patients without or with drug-induced amenorrhea (27.2% vs 9.2%) was not statistically significant. At three years 21.4% of control patients have died of progressive cancer compared to 10.4% of CMF patients. The difference in the survival curves was not significant (P=0.08). Toxicity was moderate and reversible. No drug induced neoplasm was observed. Present results confirm the efficacy of 12 CMF cycles in premenopausal patients. Postmenopausal women probably require a more intensive and prolonged adjuvant chemotherapy.
247 citations
TL;DR: The low rate of use of conjugated estrogens in Olmsted County, Minnesota over the past 30 years apparently has not had an appreciable impact on the incidence of endometrial cancer.
240 citations
231 citations
Journal Article•
TL;DR: It is concluded that, in spite of the lack of specificity controls inherent in the sophisticated standard assays, the simplified DCC assay might be useful if the biopsy specimen is too small to provide the number of aliquots for a standard D CC assay or sufficient protein for a sucrose gradient analysis.
Abstract: Standard dextran-coated charcoal (DCC) and sucrose gradient centrifugation assays for estrogen receptor were compared in a series of human breast cancer tissues. From a quantitative standpoint the results were remarkably similar. A simplified version of the DCC assay compared to the sucrose gradient assay yielded acceptable results. We conclude that, in spite of the lack of specificity controls inherent in the sophisticated standard assays, the simplified DCC assay might be useful if the biopsy specimen is too small to provide the number of aliquots for a standard DCC assay or sufficient protein for a sucrose gradient analysis. It also might be useful in research laboratories attempting to develop assays for multiple receptors or other constituents in a single tumor biopsy specimen.
TL;DR: Women over age 30 years at radiation treatment had as great an excess risk of breast cancer as did younger women and the dose response for malignant and benign breast neoplasms was compatible with a linear fit.
Abstract: 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.
TL;DR: Findings from the second protocol confirm those previously reported indicating that L‐PAM lengthens the disease free interval following mastectomy and lend support to the thesis that since breast cancer is an eponym to describe a heterogeneous group of tumors residing in a heterogenous group of women, it is unlikely that uniformly qualitative and quantitative systemic regimens of therapy will be required for every patient.
Abstract: In 1972, a prospective, randomized, multi-institutional, cooperative clinical trial was begun to evaluate the efficacy of prolonged 1-phenylalanine mustard (L-PAM) administration following operation in lengthening the disease free interval of patients with primary breast cancer That protocol using a single agent was the first of a series directed toward evaluating successively more complex chemotherapeutic regimens in an attempt to define subsets of patients which might be responsive to less therapy than others When it was observed that L-PAM prolonged the disease free interval, particularly of premenopausal patients, findings were reported and a new evaluation comparing L-PAM with L-PAM plus 5-fluorouracil (5-FU) was begun Upon completion of patient accrual in that protocol, an additional trial comparing L-PAM and 5-FU with L-PAM, 5-FU and Methotrexate was implemented The present report updates findings from the initial study and presents those from the second It compares results across the first two protocols as well as between groups within a protocol While insufficient time has elapsed for determining the ultimate worth of the modalities employed, findings from the second protocol confirm those previously reported indicating that L-PAM lengthens the disease free interval following mastectomy The combination of L-PAM with 5-FU resulted in a reduction of treatment failure at 12 months which is as good or better than that observed with L-PAM in the first protocol lending further credibility to the earlier findings While at the end of the first year following mastectomy there was alomst a 50% reduction in treatment failures in patients aged 50 or over (post-menopausal), by 18 months the reduction was 23% and at two years, based on small numbers of patients, only 5% Examination of results from the first protocol (placebo vs L-PAM) after two years reveals a most highly significant effect of L-PAM in pre-menopausal women with one to three positive nodes There is an 89% reduction of treatment failures A similar but less striking effect is noted for those under 50 with ≥four positive nodes In older patients in both nodal categories, the early observed effect for L-PAM has decreased with time Inter-protocol comparisons relative to survival are premature At two years survival in L-PAM patients is 36% greater than in those receiving placebo It is somewhat better in every subgroup for those receiving L-PAM Information relative to the effect of these agents on patient toxicity and loco-regional treatment failures is presented All of the findings stress the urgency for obtaining results on subsets of patients rather than on a population as a whole and they lend support to the thesis that since breast cancer is an eponym to describe a heterogeneous group of tumors residing in a heterogeneous group of women, it is unlikely that uniformly qualitative and quantitative systemic regimens of therapy will be required for every patient
TL;DR: Investigation of women's health beliefs about breast cancer and breast self-examination and the extent of BSE practice found other factors such as embarrassment or religious upbringing influence health beliefs and practices.
Abstract: To investigate the nature of women's health beliefs about breast cancer and breast self-examination (BSE) and the extent of BSE practice, a questionnaire was administered to 122 women Ninety-seven percent (118) scored high in perceived benefits of BSE in reducing the threat of breast cancer and 87 percnet (106) scored high in perceived susceptibility to breast cancer Forty percent (48) practiced BSE monthly, but over 20 percent of the sample had high beliefs and were nonpracticers Thus, it cannot be concluded that beliefs cause behavior Other factors such as embarrassment or religious upbringing influence health beliefs and practices, it was found A majority of women who did practice BSE, furthermore, were unsure of their ability to detect abnormalities A separate group of 20 women with a history of breast lumps or cancer surgery had higher susceptibility beliefs, a higher rate of practice, no embarrassment in examining themselves, and more confidence in ability to detect abnormalities than the remainder of the sample
TL;DR: Tumors containing estrogen receptors and those that responded to previous hormonal manipulation tended to respond to tamoxifen (antiestrogen), 60% and 69%, respectively, and patients with receptor-negative tumor or with a history of failure of previous hormonal treatments did not respond.
Abstract: Fifty-nine postmenopausal women with advanced breast cancer were treated with tamoxifen (antiestrogen), 20 mg orally twice a day for at least 2 months. They had been previously treated with other types of hormonal therapy or intensive chemotherapies, or both. Nineteen of the 59 patients (32%) had either a complete response (seven patients) or partial response (12 patients). The median duration of response was 9+ months. Tumors containing estrogen receptors and those that responded to previous hormonal manipulation tended to respond to tamoxifen (60% and 69%, respectively). Patients with receptor-negative tumor or with a history of failure of previous hormonal treatments did not respond to tamoxifen therapy. Tamoxifen is effective against advanced breast cancer. Side effects of the treatment were mild.
TL;DR: Observations strongly suggested that the presence of atypical cells in aspirated breast fluids has important clinical application for early detection of breast cancer.
Abstract: The availability and cell content of aspirated breast fluid from 1,706 women were evaluated to determine the usefulness of breast fluid cytology as an indicator of breast disease. A newly developed aspirator was used to obtain cells adequate for diagnosis from approximately 50% of the women tested. Fluids were most readily available from women between the ages of 30 and 50 years. Although abnormal cytologies were observed in all age groups, the relative proportion of abnormal specimens as well as the degree of abnormality increased as a function of age. More women over 40 years of age with a high risk of breast cancer had cells classified in the more abnormal categories than did women in the normal risk group. To localize otherwise occult lesions, contrast ductography was performed on all women with very abnormal ductal cells. Women with atypical hyperplastic cytologies most commonly had benign and premalignant breast disease at subsequent biopsy. Of 27 women with fluids classified as suspected carcinomas 18 (66%) had small carcinomas. These observations strongly suggested that the presence of atypical cells in aspirated breast fluids has important clinical application for early detection of breast cancer. One limitation of cytology was that the technique rarely detected carcinomas greater than 1 cm.
TL;DR: In appropriate cases radiotherapy alone can yield results as good as laminectomy combined with radiotherapy, and it is essential that patients undergoing radiotherapy for spinal cord compression be followed closely by a neurosurgeon.
Abstract: ✓ A retrospective series of 12,478 patients with breast cancer included 2467 patients with spinal metastases. Local treatment was not necessary in 688 patients. Neurological deficit did not develop in 1735 patients who underwent radiotherapy. Forty-four patients developed myelopathy due to spinal cord compression as demonstrated by neurological examination and myelography. Twenty-six of these patients were initially treated by laminectomy and 18 were initially treated with radiotherapy. The two groups did not significantly differ in their outcome with respect to motor power, pain relief, or ability to walk. Six patients who underwent radiotherapy deteriorated during 2 months of treatment. Four of these patients were not operative candidates because of poor general condition (three patients) or long duration of paraplegia (one patient). Of two patients who underwent emergency laminectomy, one became paraplegic; however, the other patient was significantly improved. For this reason it is essential that pati...
TL;DR: A clinical trial involving 462 colon, rectum, and breast cancer patients randomized among four different dosage regimens of 5‐FU has shown a significantly better response among colon‐rectum cancer patients for the intravenous loading course.
Abstract: A clinical trial involving 462 colon, rectum, and breast cancer patients randomized among four different dosage regimens of 5-FU (an intravenous loading course, a weekly intravenous schedule, a nontoxic schedule, and an oral schedule) has shown a significantly better response among colon-rectum cancer patients for the intravenous loading course. In addition, duration of response and time to progression are also significantly better. Overall survival is approaching significance for the colon rectum group (p value .082). In contrast, breast cancer patients show little difference between treatments. Toxicity is somewhat higher for the loading course.
TL;DR: High C1q BA values were found most frequently in sera of patients who had been diagnosed relatively recently and who had evident residual disease after surgical treatment, and could not be explained by the presence of antiglobulin antibodies.
Abstract: Sera from 134 selected patients with various types of cancer were tested for soluble antigen-antibody complexes by the C1q binding method. Sera from 85 healthy blood bank donors served as normal controls. C1q binding activity (C1q BA) values above the 95th percentile for healthy subjects were found in 83% of sera from patients with neoplastic diseases. The incidence of abnormal C1q BA values among patients with malignant melanoma was 83%, with breast cancer 74%, with colon cancer 75%, with lung cancer 88%, with leukemia and lymphoma 85%, and with miscellaneous tumors 94%. High C1q BA values were found most frequently in sera of patients who had been diagnosed relatively recently (within 5 mo) and who had evident residual disease after surgical treatment. Recurrence or progression of tumor growth occurred significantly more frequently in lung cancer patients with high C1q BA. DNA was not detected in cancer patients' sera and treatment with DNase did not decrease in C1q BA. C1q BA in sera could not be explained by the presence of antiglobulin antibodies. Sucrose density gradient ultracentrifugation studies of the serum C1q BA in 4 cancer patients showed that the major binding activity was found between 19S and 7S.
TL;DR: Careful lifelong follow‐up seems to be the rational treatment for women whose breast biopsy shows LCIs and the development of invasive breast cancer (IBC) had no relation to the patient's age, nor could any correlation be drawn between the time periods which elapsed from the time of the diagnosis of the in situ cancer to theDevelopment of IBC.
Abstract: A review of 3299 benign breast lesions was carried out. Lobular carcinoma in situ (LCIs) was discovered in 52 cases; and of these, 44 had been treated by biopsy alone. During the follow-up period averaging 15.9 years, 11 patients developed invasive breast cancer (IBC): 9 ipsilateral lesions, and 4 contralateral. This was about 12 times the frequency expected. The development of IBC had no relation to the patient's age, nor could any correlation be drawn between the time periods which elapsed from the time of the diagnosis of the in situ cancer to the development of IBC. The ipsilateral occurrence of IBC was not isgnificantly different from the contralateral. Careful lifelong follow-up seems to be the rational treatment for women whose breast biopsy shows LCIs.
TL;DR: Comparisons of histologic types, sizes and calculated volumes of invasive tumors, and clinical data among patients with a single focus and with multicentric foci of breast carcinoma were compared suggest an association between the extent of the in situ lesion and the likelihood of occult invasive carcinoma.
Abstract: Occult multicentric foci of carcinoma, separate from the tumor that directed biopsy (reference tumor), were documented in mastectomy specimens with a correlated serial subgross and radiographic method of examination (Egan et al2). The relative frequencies of histologic types, sizes and calculated volumes of invasive tumors, and clinical data among patients with a single focus and with multicentric foci of breast carcinoma were compared. Multicentric foci of carcinoma occurred in 18 of 85 cases (21%). Half of the occult lesions were second invasive carcinomas, and in three cases the occult second invasive tumor was larger and/or more poorly differentiated than the reference tumor. However, in no instance was a metastasis documented from an occult carcinoma. On the average, the invasive carcinomas in breasts with multicentric foci of cancer were significantly smaller in diameter and calculated volume was than that of unicentric invasive carcinomas. Patients with multicentric breast carcinoma were more likely to have a positive family history of breast cancer and to have had contralateral cancer than were patients with a single focus of disease. Compared with other types of invasive cancers, tubular carcinomas were significantly more likely to be associated with multicentric invasive carcinomas in this study; half of the reference tubular carcinomas were so associated. Duct carcinoma in situ (DCIS) less than 25 mm in extent was unassociated with occult invasive or significant in situ multicentricity, whereas more diffuse DCIS frequently was associated with occult invasive carcinoma. These latter data suggest an association between the extent of the in situ lesion and the likelihood of occult invasive carcinoma.
TL;DR: Plasma-A2 fell after chemotherapy in the postmenopausal group; the other hormones were unchanged; the beneficial effects of adjuvant chemotherapy for breast cancer may result, in part, from suppression of ovarian function.
TL;DR: The results indicate that the radiation dose is of significance, and suggest, particularly in patients with medially located tumors who have 4 or more axillary lymph nodes involved, that the prognosis will be improved by post-operative radiotherapy in adequate doses.
Abstract: The results of a randomized clinical trial concerning the value of post-operative radiotherapy as an adjuvant to radical mastectomy, are presented in this manuscript. A total of 1090 patients have entered the study. In the first part a conventional roentgen unit was used, and in the second part a 60 Co unit, with considerably increased dosage and altered treatment plan. No effect of post-operative radiation was demonstrated in Stage I regarding survival, disease-free survival, local recurrence, regional and distant metastases. In Stage II roentgen irradiation reduced the incidence of local recurrences and regional metastases, whereas the survival was not affected. Besides reduction of local and regional metastases 60 Co radiation in patients with Stage II disease also reduced significantly the relapse rate as well as the cumulative survival rate up to 5 years. Thus, the results indicate that the radiation dose is of significance. Further analyses suggest, particularly in patients with medially located tumors who have 4 or more axillary lymph nodes involved, that the prognosis will be improved by post-operative radiotherapy in adequate doses.
TL;DR: The predictive significance of quantitative assessment of estrogen receptors in tumor tissue was analyzed in women with advanced breast carcinoma and suggested that all patients are possibly hormone dependent, although to variable degrees.
Abstract: The predictive significance of quantitative assessment of estrogen receptors in tumor tissue was analyzed in women with advanced breast carcinoma. Receptor concentration was measured by the 3H-estradiol binding capacity of the cytosol fraction of biopsies taken before initiation of the treatment. The E. O. R. T. C. criteria for the assessment of the patients' response were used. In a total of 34 assessments, 25 biopsies contained receptors; the remaining ones were negative. Objective remission to various endocrine therapies was recorded in only eight of the receptor-positive patients. Responses occurred along the whole scale of receptor concentrations with an apparent crowding in the region of the higher values. Linear logistic regression analysis revealed that among 12 variables of known prognostic value, receptor concentration was the most significant in relation to therapeutic response. Other significant variables were bone involvement and age. Computations yielded formulas that are presented in graph form and provide an estimate of the probability of a given patient to respond to endocrine treatments. On the other hand, the results suggest that all patients are possibly hormone dependent, although to variable degrees. The latter concept has very definite therapeutic implications.
TL;DR: There is evidence to suggest that the mammary cancer may become colonized at the expense of the epidermis, which is focally depleted of melanocytes.
Abstract: Colonization of mammary cancers by melanocytes with attendant pigmentation of cancer cells by melanin occurs in most cases of breast cancer in which the dermal--epidermal interface is reached by the tumour cells. There is evidence to suggest that the mammary cancer may become colonized at the expense of the epidermis, which is focally depleted of melanocytes. Melanocytes can even be found in groups of tumour cells within lymphatics. Colonization and pigmentation of breast cancer is usually only easily detected by selective staining methods. In very rare cases it can be gross and easily detectable in routine stains. The implications of this migratory phenomenon are discussed in terms of the biology of the melanocyte.
TL;DR: In breast cancer patients in Rotterdam and The Hague those with metastases in axillary nodes were significantly heavier but not taller than those without nodal involvement, suggesting a hormonal factor related to body weight and/or height might be responsible for the increased incidence and the more rapid course of breast cancer in women with a large body mass.
Abstract: A study was made in the cities of Rotterdam and The Hague, the Netherlands, and in Aichi prefecture, Japan, to assess the effect of weight and height (and their combinations) on the age-specific incidence of breast cancer. It is based on a comparison between 1006 cases of breast cancer and 4201 women from the general population, 35–69 years old. The results suggest that about one-half of the differences in incidence between the regions in Holland and Japan can be attributed to differences in body weight and height. In breast cancer patients in Rotterdam and The Hague those with metastases in axillary nodes were significantly heavier but not taller than those without nodal involvement. A hormonal factor related to body weight and/or height might be responsible for the increased incidence and the more rapid course of breast cancer in women with a large body mass.
TL;DR: There is an upward trend in the breast cancer incidence as the atypia score rises, a finding which confirms conclusions from a retrospective case‐control study by Black et al.
Abstract: Over an average period of seven years 2,900 cases of benign breast lesions diagnosed by biopsy between 1948 and 1973 in the Department of Pathology, Kaiser Foundation Hospital, Oakland, were followed for breast cancer development. When classified according to traditional diagnostic categories, the cancer incidence per 1,000 person-years varies between 2.7 and 7.9 and appears to be elevated in comparison to expectations obtained from the Third National Cancer Survey, San Francisco Bay Area. Two thousand four hundred biopsies were also scored by the Black-Chabon method. There is an upward trend in the breast cancer incidence as the atypia score rises, a finding which confirms conclusions from a retrospective case-control study by Black et al.1
TL;DR: The number of breast cancers occurring after irradiation was found to be four times the expected number and the breast cancer incidence rate in the irradiated breasts is dependent on the age of the patient at the first irradiation.
Abstract: During the period 1927 to 1957 1,115 women were treated at Radiumhemmet, Sweden with ionizing radiation for different non-neoplastic conditions of the breast. The average follow-up period was 31.5 years. The number of breast cancers occurring after irradiation was found to be four times the expected number and the breast cancer incidence rate in the irradiated breasts is dependent on the age of the patient at the first irradiation.