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  • 1
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Sixty breast carcinomas previously indexed as medullary carcinomas over a 24-year-period were reviewed and reclassified according to definitions suggested by Ridolfi et al. as typical medullary carcinoma, atypical medullary carcinoma, and non-medullary carcinoma. Paraffin sections of tumour tissue were examined by an avidin-biotin complex method using two keratin 19-specific monoclonal antibodies (BA17, DAKO and clone 170–2–14, Boehringer) and a monoclonal oestrogen receptor antibody (DAKO). For comparison 52 ductal carcinomas of grade II and grade III were immunostained as well. The results showed that all 60 tumours with medullary features and all 52 ductal carcinomas reacted moderately to strongly positive with anti-keratin 19 (Boehringer). The staining was diffuse in all cases, except one case of ductal carcinoma (grade III), which stained focally. Immunostaining with the second keratin 19 antibody (BA17) revealed similar results with positive staining in 59 (95%) cases of carcinomas with medullary features and 51 (98%) cases of ductal carcinomas. Only one case in each group did not express keratin 19 (BA17), one re-classified case of non-medullary carcinoma with neuroendocrine features and one case of ductal carcinoma of grade III. None of the 13 cases of typical medullary carcinoma were oestrogen receptor positive and only seven (12%) of the carcinomas with medullary features (2 atypical, 5 non-medullary) were oestrogen receptor positive with quantitative values from 20 to 100%. The 52 ductal carcinomas of grade II and III were oestrogen receptor positive in 56% and 47% of cases. It is concluded that keratin 19 staining is of no particular value in differentiating medullary from poorly differentiated ductal carcinoma. A carcinoma with positive oestrogen receptor staining is not likely to be a typical medullary carcinoma.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachusetts, 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 6 (1996), S. 0 
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In an attempt to create uniform nationwide guidelines for the management of all stages of endometrial carcinoma, and to limit the use of adjuvant radiation therapy in stage I disease to high-risk patients only, a protocol was developed by the Danish Endometrial Cancer group (DEMCA). From September 1986 through August 1988, 1214 women in Denmark with newly diagnosed carcinoma of the endometrium have been treated according to this protocol. This figure represents all endometrial carcinomas diagnosed in Denmark during this 2-year period. The primary treatment was total abdominal hysterectomy and bilateral salpingo-oophorectomy and no preoperative radiation therapy was delivered. In 1039 cases no macroscopic residual tumor and/or microscopic tumor tissue in the resection margins was found following surgery. Based on surgery and histopathology, these patients were classified as: P-stage I low-risk (grade 1 & 2 and 〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:1048891X:IJG06010038:les" location="les.gif"/〉 50% myometrial invasion), P-stage I high-risk (grade 1 & 2 and〉 50% myometrial invasion, and grade 3), P-stage II and P-stage III (Group 1). Distribution was as follows: P-I low-risk 641 patients, P-I high-risk 235, P-II 105 and P-III (Group 1) 58 patients. No postoperative radiation therapy was given to P-I low-risk cases. P-I high-risk, P-II, and P-III (Group 1) cases received external radiation therapy. Recurrence rate at 68–92 months follow-up was 45/641 (7%) in P-I low-risk, 36/235 (15%) in P-I high-risk, 30/105 (29%) in P-II, and 27/58 (47%) in P-III (Group 1) cases. Fifteen of 17 vaginal recurrences in P-I low-risk cases were salvaged (mean observation time 61 months).
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Histopathology 30 (1997), S. 0 
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this study was to make prognostic comparisons between the modified scheme of Pedersen et al. the definitions of Tavassoli and the Ridolfi criteria for medullary carcinomas. Sixty breast carcinomas primarly diagnosed as medullary carcinomas were reclassified into typical medullary carcinoma (TMC), atypical medullary carcinoma (AMC) and non-medullary carcinoma (NMC) according to the three classifications. The Ridolfi classification proved to be superior to the two other schemes in discriminating survival differences between the three groups TMC, AMC and NMC. All 13 patients with TMC are still alive indicating an excellent prognosis, while 29% and 39% of the 47 patients in the AMC and NMC category, respectively, have died of their disease. In the simplified system of Pedersen et al. the survival at 10 years for TMC patients decreased to 75% and no significant survival difference between the three groups could be demonstrated. As the prognosis for AMC proved to be worse compared to TMC and in fact was similar to NMC with values of 43% at 10 years in the Ridolfi classification, we find no reasons to maintain this category. We conclude that as long as no alternative and more easily applicable diagnostic method exists, pathologists should still apply the Ridolfi criteria on these tumours with medullary features leaving two diagnostic possibilities: TMC or NMC (i.e. poorly differentiated ductal carcinoma). Only lesions that fulfil all six criteria without any doubt should be diagnosed as TMC, thus avoiding overdiagnosis and a resulting risk of undertreatment.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Au cours d'une année nous avons été amenés à examiner les seins de 2909 femmes par examen clinique et mammographie alors qu'elles se plaignaient d'une atteinte mammaire. Chez 44 d'entre elles (1,5 pour cent) la mammographie a permis de déceler 45 lésions impalpables susceptibles d'Être de nature néoplasique. La biopsie fut pratiquée systématiquement en s'aidant d'un repère métallique inséré au niveau de la lésion par un procédé particulier. En effet nous avons pratiqué la mammographie en comprimant le sein avec une plaque perforée d'orifices visibles sur les clichés puis en introduisant le repère au niveau de la zone suspecte. La méthode s'est montrée d'une grande précision. Dans 96 pour cent des cas le repère fut placé à moins d'un centimètre de la lésion et la biopsie fut toujours possible encore que parfois il ait fallu procéder à plusieurs prélèvements. Le taux de lésions malignes s'est élevé à 29 pour cent des biopsies pratiquées et 30 pour cent des malades examinées. Les ganglions axillaires étaient déjà envahis dans 17 pour cent des cas. Les types histologiques des lésions découvertes se sont montrés très variables et composés d'éléments cellulaires différents. A la suite de cette étude une corrélation radiologique et histologique a pu Être établie et la valeur de la méthode pour découvrir le cancer du sein a son début a pu Être démontrée.
    Notes: Abstract During a 1-year period, 2,909 symptomatic women were referred for physical examination of the breast and mammography. In 44 women (1.5%), mammography discovered a total of 45 impalpable breast lesions that might represent an early cancer. Mammographic wire-guided biopsy was performed using a self-retaining hook wire for the marking of the lesion. The radiographic localization was facilitated by using a perforated compression plate with holes visible on the mammograms. The biopsy method showed high precision and accuracy. Only 1 guide wire was needed in each instance. In 96% of cases, the wire transfixed the lesion or was placed in close proximity (within 1 cm) to the lesion. Correct biopsy was achieved in all instances, but in some cases more than 1 biopsy was necessary. The malignancy rate was 29% of biopsies and 30% of patients. The metastatic rate to axillary lymph nodes was 17%. Generally, the histologic pattern showed great variety with several different components in most specimens. The radiologic-histologic correlation is tabulated and the significance of preclinical breast cancer detection is emphasized. The biopsy method described is reliable and highly recommended. We found the procedure easy to handle and time-saving. The method was fully acceptable to patients and the cosmetic results were excellent.
    Type of Medium: Electronic Resource
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