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  • 1
    ISSN: 1573-7217
    Keywords: breast cancer ; recurrence ; prognosis ; post-recurrence survival ; metastasis ; S-phase ; mammography screening ; static cytofluorometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Using static cytofluorometry, S-phase was determined on the primary tumors of 421 patients with breast carcinomas in stages I–III diagnosed 1981–85 during the second and third screening rounds of a randomized trial evaluating the effect of mammographic screening. Through December 1988, 82 patients had developed local and/or distant recurrence, 51 of whom had died of cancer during the same period. The distribution among sites of recurrence differed between patients with tumors detected by mammography screening and cancers diagnosed due to clinical symptoms. The mean S-phase fraction was highest in patients with liver or brain metastases and lowest in patients with metastases in subcutaneous and cutaneous tissue and lymph nodes only. In univariate analysis, survival after first recurrence was significantly associated with the site of primary recurrence, the disease-free interval, and node status and tumor size at diagnosis, as well as the S-phase level. The median survival period was 31.3. months for patients with a S-phase fraction below 6%, and 10.7 months in cases with S-phase exceeding 10%. Neither ploidy nor the estrogen receptor content had significant influence on post-recurrence survival. In Cox's multiple regression analysis, only metastatic site, disease-free interval, and S-phase fraction showed significantly independent prognostic value.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-7217
    Keywords: breast neoplasm ; pathology ; grading ; screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Histopathological malignancy grading ysing the Bloom-Ricardson classification of ductal cancers was performed for 248 invasive ductal breast cancers ≤10mm operated 1978-1985. There weresignificantly more grade 1 lesions in the prevalence screening round. Grade 3 was correlated with aneuploidy, higher S-phase (SPF), and more receptor negative tumours. There were also significantly more positive lymph nodes in grade 3 lesions, 18% compared to 5% and 12% respecrively for grades 1 and 2 (p〈0.05). In life table analysis for survival, when the high risk group of grade 3 lesions was compared to the grade 1 and 2 lesions combined, five-year disease-free survival was 84.6% vs. 99.1% (p〈0.001). With good training and care from the pathologist, malignancy grading seems useful for prognostication of eventual recurrence and death. In umours 10mm or smaller only grade 3 lesions need to be included in follow-up systems and should probably have adjuvant treatment Malignancy grading is especially good in small ductal brast cancers whre grading can always be performed while other prognostic determinations are hampered by shortage of material. Lymph node positivity is also low in this group
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-7217
    Keywords: estrogen and progesterone receptor ; S-phase fraction ; tamoxifen ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A Swedish cooperative trial demonstrated that 5 years of adjuvant tamoxifen was more beneficial than 2 years of tamoxifen in the treatment of postmenopausal women with estrogen receptor (ER) positive, early stage, invasive breast cancer. The main aim of the present study was to investigate the importance of progesterone receptor (PgR) and ER concentration levels for patients participating in the trial and still distant recurrence free two years after the primary operation. Subgroup analyses revealed that only patients with ER positive and PgR positive breast cancer had improved distant recurrence free survival (DRFS) by prolonged tamoxifen therapy (p=0.0016). Patients with ER negative and PgR negative as well as ER positive and PgR negative tumors showed no significant effect of prolonged tamoxifen (p=0.53 and p=0.80, respectively). The percentage of ER negative and PgR positive breast cancers was too small (2.2%) for any meaningful subgroup analysis. There was a significant positive trend that the concentration level of PgR (high positive vs. low positive vs. negative) decreased the recurrence rate for those with prolonged therapy. No corresponding pattern was found for the ER content. S-phase fraction did not correlate to the recurrence rate of PgR positive breast cancers. Patients recurring during tamoxifen therapy had receptor negative tumors to a greater extent than those recurring after tamoxifen treatment. In conclusion, prolonged tamoxifen therapy for 5 years instead of 2 years was found to be beneficial for patients with ER positive and PgR positive breast cancer, whereas three extra years of tamoxifen had little or no effect for patients with ER positive but PgR negative tumors as well as for steroid receptor negative patients.
    Type of Medium: Electronic Resource
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