Showing papers on "Breast cancer published in 1982"

Ten- to Fourteen-Year Effect of Screening on Breast Cancer Mortality

Abstract: Results from the randomized trial conducted by the Health Insurance Plan (HIP) to determine the efficacy of breast cancer screening with mammography and palpation are reported for longer periods than previously available. By the end of 10 years after entry, the study group's mortality due to breast cancer was about 30% below the control group's. Arithmetic gains due to screening were maintained through year 14; relative gains declined. With increases in the period of follow-up, cumulative survival rates among cases detected by mammography alone (palpation negative during screening), decreased more rapidly than rates among other subgroups, but survival rates for mammography cases remained relatively high. Study women aged 40-49 years at entry began to show lower breast cancer mortality than those in the control group as duration of follow-up increased. Reservations are advanced about the acceptance of this finding as evidence of the efficacy of screening under age 50 under the conditions of the HIP study. The reservations are based on the observation that the decrease of mortality among the study group aged 45-49 at entry is concentrated entirely among cases diagnosed after they reached 50 years of age.

A prognostic index in primary breast cancer.

Abstract: From a multiple-regression analysis of prognostic factors and survival in a series of 387 patients with primary breast cancer, a prognostic index has been constructed, based on lymph-node stage, tumour size and pathological grade. This index is more discriminating than lymph-node stage alone, and enables a larger group of patients to be identified with a very poor prognosis.

Detection of antibodies against the cellular protein p53 in sera from patients with breast cancer.

Abstract: Antibodies reacting with the host protein p53 were found in the sera of patients with primary or secondary carcinoma of the breast. Fourteen out of the 155 sera from breast cancer patients tested were positive for anti-p53 antibodies (9%) and no positives were detected among 164 control sera from normal women tested. The locations of the first metastasis in patients with positive sera were unusual, with more lung metastases and fewer bone metastases than expected. The detection of anti-p53 antibodies indicates that p53 is altered in amount, type or presentation in breast tumors so that it becomes immunogenic.

Cigarette smoking and urinary estrogens.

Abstract: IT is known that women who smoke have an earlier menopause than those who do not1 , 2 Noting recent data suggesting that breast cancer might be somewhat less frequent in smokers than in non-smokers,3 4 5 we thought it would be worthwhile to compare the estrogen profiles of smokers and nonsmokers A difference might shed light on the mechanisms whereby smoking is associated with early menopause and with a reduction in the risk of breast cancer Smoking histories were obtained from women for whom urinary estrogen concentrations had been determined previously As compared with nonsmokers and exsmokers, smokers had substantially and significantly lower

Diet in the epidemiology of breast cancer

Abstract: A variety of studies have shown that diets high in fat, particularly polyunsaturated, have enhanced the production of tumors in animals challenged with chemical carcinogens. Other studies have found an apparent contradiction of no difference in the incidence of breast cancer among women with varying levels of serum cholesterol as measured decades earlier. The present study concerns 2024 breast cancer cases and 1463 control patients without neoplasms or pathology of the reproductive and digestive organs, seen at Roswell Park Memorial Institute from 1958 to 1965. Based upon the assessments of their varying ingestion of fats from their own reports of diets, no difference in risk was found. Similarly, there was no difference in risk of breast cancer associated with ingesting diets containing various levels of either vitamin C or the cruciferous vegetables. Risk for breast cancer in women 55 years of age and older increased somewhat with decreases in ingestion of foods containing vitamin A.

Decreased Nocturnal Plasma Melatonin Peak in Patients with Estrogen Receptor Positive Breast Cancer

Abstract: Plasma melatonin concentrations were determined over a period of 24 hours in 20 women with clinical stage I or II breast cancer. In ten of the patients, whose tumors were estrogen receptor positive, the nocturnal increase in plasma melatonin was much lower than that observed in eight control subjects. Women with the lowest peak concentration of melatonin had tumors with the highest concentrations of estrogen receptors. A significant correlation was found between the peak plasma melatonin concentration and the tumor estrogen receptor concentration in 19 of the patients. These data suggest that low nocturnal melatonin concentrations may indicate the presence of estrogen receptor positive breast cancer and could conceivably have etiologic significance.

Prospective study of a family cancer syndrome.

Abstract: Risk of cancer was studied prospectively in four families described in 1969 as having diverse neoplasms, especially breast cancer and soft-tissue sarcoma. Between 1969 and 1981, in ten of 31 surviving family members, there developed 16 additional cancers (expected, 0.5). There were five breast carcinomas, four soft-tissue sarcomas, and seven other cancers. In eight patients, multiple primary cancers developed, including three softtissue sarcomas and one mesothelioma at sites of prior radiotherapy. (JAMA1982;247:2692-2694)

Multicentric breast carcinomas: Clinical‐radiographic‐pathologic whole organ studies and 10‐year survival

Abstract: Selection of breast cancer patients with microscopically limited disease but with excess mortality or women with regional disease and lessened mortality has remained an unsolved and critical challenge. The many usual histologic features such as tumor size, stage of disease or tumor differentiations were found reduced to lessened significant prognostic factors by the presence of multicentricity of tumors and multiplicity of histologic types of carcinoma. This observation was noted upon review of 161 clinical, radiographic and histopathologic whole breast studies on 156 patients with follow-up from 11–15 years. Epidemiologic, clinical, and radiographic data had been compiled prospectively prior to diagnosis. Women with a single site and single type of carcinoma had a better prognosis (2.5% mortality per year) than those with multiple sites and multiple types (15% mortality per year) even though the stage of the disease may be similar. When the latter groups contained a scirrhous type duct carcinoma, the annual mortality rate appraoched 25%.

Sounding board. Fibrocystic "disease" of the breast--a nondisease?

Abstract: Is fibrocystic disease really a distinct entity? Is it a diagnosis that can be made clinically or histologically? Does this designation imply an increased risk of breast cancer? Should we attempt t...

Radiation therapy with or without primary limited surgery for operable breast cancer: A 20-year experience at the marseilles cancer institute

Abstract: Since 1960 more than 3000 consecutive patients with operable infiltrating breast carcinoma were treated by radiation therapy with or without primary limited surgery, which usually consisted of local excision. For tumors smaller than or equal to 5 cm the ten-year crude survival rate is 77% for patients without palpable axillary nodes (T/sub 1-2/N/sub 0/) and 63% for patients having axillary adenopathy (T/sub 1-2/N/sub 1/). For operable tumors exceeding 5 cm in diameter (T/sub 3/N/sub 0-1/) the ten-year crude survival is 34%. Thirty-five percent of the patients alive free of disease at ten years required a secondary operation for presumed local or regional tumor persistence or recurrence, although no residual disease was found in 24% of the operative specimens. Local-regional recurrence had no adverse effect on ten-year survival. This conservative approach offers most women with operable breast cancer an excellent chance at breast preservation with the same chance for ten-year survival as with radical mastectomy.

Breast cancer: A 21 year experience with conservative surgery and radiation

Abstract: Evidence is presented from a study of 680 patients followed over a period of 21 years that conservative treatment of breast cancer by local excision of the primary tumor followed by breast irradiation yields results equivalent to the traditional radical approach, with the added benefit of an excellent cosmetic result and improved quality of life. The relative survivals were 83% at 5 years and 71% at 10 years. There was no difference in survival when radiation was given. Breast irradiation significantly reduced relapse in the breast, but axillary irradiation did not influence relapse at this site. Relapse in the breast alone was not detrimental to survival if treated appropriately. Axillary relapse indicated a much poorer prognosis as might be expected.

Monoclonal antibodies to the human mammary gland. I. Distribution of determinants in non-neoplastic mammary and extra mammary tissues.

Abstract: Mouse monoclonal antibodies have been raised to the human milk fat globule membrane. The distribution of the antigens detected by four of the antibodies has been examined in formalin-fixed, paraffin-embedded human tissues by light microscopic immunocytochemistry. The four antibodies stain lactating breast and normal resting breast. Two exclusively stain the luminal membranes of breast epithelial cells. A third antibody stains in addition the lateral membranes of duct epithelial cells. The fourth antibody stains both epithelial and myoepithelial cells. None of the antibodies is breast specific, nor do they stain every epithelial cell within the breast. Instead, each antibody reveals a complex and heterogeneous distribution of staining throughout the normal tissues. Within the breast, the staining by a given antibody is usually segmental and conforms to secretory units and their associated ducts. Similarly heterogeneous patterns of staining are also observed in the extramammary normal tissues. Despite the apparent morphological identity between breast epithelial cells when examined by conventional light microscopy, the hitherto unrecognised “functional” heterogeneity, which has been revealed by the monoclonal antibodies could have importance in understanding the biology of the normal breast and the pathology of breast cancer.

The cancer research campaign (King's/Cambridge trial for early breast cancer: Clinico-pathological aspects

Abstract: Analysis of pathological data in the 10th year of follow-up of a multicentre trial of the management of operable breast cancer has confirmed the correlation of prognosis with tumour grade, tumour size and lymph-node status. For each factor examined there was no difference in survival between the 2 treatment groups ("watch policy" and radiotherapy) but patients in the WP group whose tumours were of Grade II or III or greater than 2 cm, or with lymph-node metastases, had a greater chance of local recurrence. Cellular reaction had no relationship with prognosis, except in patients with Grade III tumours. The clinical relevance and application of these results are discussed.

Serum concentrations of total and non-protein-bound oestradiol in patients with breast cancer and in normal controls.

Abstract: In premenopausal women with breast cancer, total serum oestradiol (E2) concentrations are normal but nonprotein-bound E2 concentration are significantly raised This is not due to low sex-hormone-binding-globulin (SHBG) binding capacities which are within the normal range and is unlikely to be due to the small but significant decrease in albumin concentrations In post-menopausal patients, both total and non-protein-bound E2 are significantly raised: this may be explained partially by lower SHBG binding capacities In patients and controls there is a highly significant correlation between non-protein-bound E2 and SHBG but, for a given SHBG binding capacity, the patients have more non-bound E2 than controls It is concluded that the breast in women with breast cancer may be exposed to elevated levels of biologically active E2 although the reasons for this remain obscure

Mammographic signs as risk factors for breast cancer

Abstract: We have carried out a case-control study to examine the relationship between mammographic signs and breast cancer. The mammographic signs assessed were prominent ducts and dysplasia. The cases were a group of 183 women with histologically verified unilateral breast cancer. The controls were a group of women attending a screening centre. Cases and controls were individually age-matched. Mammograms from the non-cancerous breast of the cases were randomly assembled with those of the controls and classified by 3 radiologists without knowledge of which films were from cases and which from controls. Mammographic dysplasia was found to be strongly associated with breast cancer, particularly in women aged less than 50. Prominent ducts were only weakly associated with breast cancer. Multivariate analysis showed that the association between dysplasia and breast cancer could not be explained on the basis of other risk factors for breast cancer, and that classification of dysplasia discriminated more strongly between cases and controls than did classification of Wolfe's mammographic patterns. These results show that mammograms contain information about risk of breast cancer. Mammographic dysplasia is strongly associated with breast cancer, is present in a substantial proportion of patients with the disease, and may offer opportunities for prevention.

Risk Factors for Breast Cancer in Women in Northern Alberta, Canada, as Related to Age at Diagnosis

Abstract: A population-based case-control study involving interviews with 577 female breast cancer patients and 826 controls in northern Alberta. Canada, revealed that some determinants of breast cancer varied according to age. Among women under age 45, risk factors included a younger age at menarche, late age at last birth, high parity, and recent use of oral contraceptives. At older ages risk was related to natural as opposed to surgical menopause, late age at first birth, low parity, late age at natural menopause, and tonsillectomy. At all ages there was an increased risk of breast cancer associated with difficulty in conceiving, benign breast disease, not having breast fed, and a history of breast cancer among mothers or sisters. For some variables the age differences were pronounced; the combination of low parity and late age at first birth was associated with a sevenfold increase in breast cancer risk at risk at ages 55-80 but a slight decrease at ages under 45. The effect of tonsillectomy steadily increased with age and represents a new lead, but certain features of the data suggest that the link to oral contraceptives among among younger women and the inverse relation to breast feeding at all ages may not be causal. Even though design limitations (cases interviewed in a different setting from controls) appeared not to influence conclusions, the results may have been subjected to interview bias and thus should be interpreted cautiously.

Identification of lymphocyte subpopulations in human breast cancer tissue and its significance: an immunoperoxidase study with anti-human T- and B-cell sera.

Abstract: Subpopulations of the infiltrating lymphocytes in breast cancer tissue from 31 patients were identified by indirect immunoperoxidase technique with antihuman T- and B-cell sera. In all noncancerous lesions examined (seven cases), B-cells were predominant and T-cells were scarcely found. In contrast, T-cells were predominant in breast cancer tissues (17 in 21 cases). T-cells tended to contact closely with cancer cells or cancer cell nests and accumulated around and in the walls of venules draining the cancer, while B-cells tended to cluster focally apart from cancer cell nests. T-cell infiltration was scanty in scirrhus carcinoma, whereas it was ample in infiltrating papillotubular carcinoma which had a better prognosis. There was a significant reverse correlation between the intensity of the T-cell infiltration and the clinical stages. The intensity of the T cell infiltration was significantly high in patients without lymph node metastasis. These facts suggest the possibility that the infiltrating T-cells in cancer tissue represent host resistance against cancer and that the intensity of the T cell infiltration correlates with the clinical prognosis of the breast cancer patients.

Mammographic features of the breast and breast cancer risk

Abstract: The authors conducted a case-control study at two Boston, Massachusetts, are hospitals to evaluate the relation of anatomic features of the breast, visible on the xeromammogram, to the risk of breast cancer. The cases were 408 women with newly diagnosed breast cancer and the controls were 1021 women without signs or symptoms of breast disease. The features of the breast assessed were the "parenchymal pattern" as defined by Wolfe (Am J Roentgenol 1976; 126:1132-9), and specific radiologic characteristics which are components of the parenchymal pattern classification. Women whose mammogram showed the P2 or DY parenchymal patterns were at elevated risk compared to women with the N1 pattern. Further, risk increased regularly with increases in the percentage of the breast that showed nodular densities and with increases in the average size and concentration of these densities. Women with extensive homogeneous density were also at elevated risk. These findings were observed only among women aged 20-59 years. In this group, women with nodular densities in 60% or more of the breast appeared to have a five-fold increase in risk compared to women without nodular densities in the breast.

Natural history of hereditary cancer of the breast and colon

Abstract: The natural history of 106 patients from eighteen families manifesting hereditary breast cancer syndromes, and 117 affected patients from twenty families manifesting nonpolyposis hereditary colon cancer were evaluated. Findings were compared with the American College of Surgeons (ACS) long-term audits for breast and colon cancer respectively. The cardinal features of hereditary cancer were observed within the study group, including: (1) a significant younger age of onset (49 years, breast; 46 years, colon); (2) an excess of proximal lesions in the hereditary colon series (49%); and (3) an excess of bilaterality in the hereditary breast cancer patients. The clinical stage at presentation was similar for the hereditary and ACS audit patients. Five-year survival was significantly improved (P less than .05) for both hereditary cancer populations as compared to the ACS audits (67% hereditary breast cancer and 52% nonpolyposis hereditary colon cancer). Improved survival in hereditary colon and breast cancer patients may have a bearing on the design of future clinical protocols.

Circulating human mammary epithelial antigens in breast cancer.

Abstract: Heterologous specific antisera against human mammary epithelial antigens (HME-Ags), which are present in the human milk fat globule membrane and breast epithelial cells, were used in a solid-phase radioimmunoassay to determine the presence of these antigens in the sera of patients with disseminated cancer of the breast and other organs. Breast cancer patients carry high levels of HME-Ags in their circulation, while patients with disseminated nonbreast cancer, as well as normal female controls, do not. A similar release of HME-Ags in the circulation was shown by us in a model system. To further corroborate these findings, a three-step procedure for the extraction and identification of HME-Ags from the sera was devised. In this analytical procedure, circulating HME-Ags are recovered on a solid phase carrying their corresponding antibody (anti-HME) and radioiodinated in situ. Later, the labeled HME-Ags are released from the solid phase and characterized by NaDodSO4 gel electrophoresis. With this procedure, HME-Ags were isolated from sera of breast cancer patients but not from sera of nonbreast cancer patients or of normal female controls. The extracted HME-Ags had molecular masses of 150,000, 70,000, and 46,000 daltons. To further support these findings, a monoclonal antibody, BLMRL-HMFG-Mc3, directed to the 46,000-dalton HME-Ag was also used to extract its corresponding antigen from sera. Breast cancer patient sera contained such antigen while the sera of the other patients and controls did not. This highly sensitive methodology offers a specific approach to breast cancer diagnosis as well as further insight into the nature of circulating antigens with a view to increasing our understanding of breast cancer biology.

Prognostic indicators in breast cancer--morphometric methods.

Abstract: Morphometric methods were applied to predict the clinical course of individual patients with breast cancer. Measurement of tumour diameter, assessment of mitotic and cellular indices, and quantitative microscopy of nuclear features were assessed together with nuclear features and histological grades. Of the tumours from 78 patients investigated, 42 had died from metastases within 6.5 years ('non-survivors'), while the other 36 were alive and well without evidence of metastases at the end of the follow-up period (minimum 6.5 years) ('survivors'). If the tumours of the 42 non-survivors are compared with those of 36 survivors, there are many reproducible significant differences, the most important being cellularity index and mitotic activity index, followed by quantitative microscopical nuclear parameters and nuclear and histological grade. Discriminant analysis, of the quantitative microscopical data alone showed 82% of all patients to be correctly classified as survivor or non-survivor. By contrast with the axillary lymph node invasion status alone, or the tumour diameter and axillary lymph node status together, 59% and 64% of the patients were predicted correctly as survivor or non-survivor. With a more realistic statistical approach of discriminant analysis, 78% of the patients were classified correctly with quantitative microscopy, in place of 54% with the axillary lymph node status, 56% with the TNM-system and 64% with a combination of TNM system and nuclear and histological grade. Morphometry thus seems possible to predict the outcome of individual patients more accurately than with the usual staging/grading methods. This technique might therefore prove to be useful in the selection of patients for adjuvant chemotherapy.

Mammographic parenchymal patterns. Risk indicator for breast cancer

Abstract: Mammographic parenchymal patterns, originally presented as a new risk factor for breast cancer, have been prospectively studied in a large (27,157 examinations) consecutive screening population. Although there is a significantly higher risk of breast cancer in the so-called dysplastic breasts (P2 and DY pattern groups), the classification is of little practical value, as more than 72% of the cancers in the prevalent population were found in the so-called low-risk breasts (N1 and P1 pattern groups). A similar trend occurred at repeated screening of younger women, in which most of the "incident" cancers were found in the "low-risk" breasts. These patterns should not be used to influence patient management or screening programs. (JAMA1982;247:185-189)