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  • 1
    Electronic Resource
    Electronic Resource
    Diagnosis of Metachronous Contralateral Breast Cancer (2001)
    Boston, MA, USA : Blackwell Science Inc
    The @breast journal 7 (2001), S. 0 
    Details
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of this study was to compare the characteristics of primary breast cancers (PBCs) and metachronous contralateral breast cancers (MCBCs). Between 1984 and 1996, 236 women treated with curative intent for PBC who developed a MCBC 〉6 months after initial diagnosis (without previous evidence of distant metastases) were retrospectively evaluated for clinical and pathologic characteristics and method of diagnosis of their tumors. There were more noninvasive cancers among the MCBCs than the PBCs (11.4% and 5.1%, respectively, p 〈 0.02). Among the invasive cancers, the mean size of the MCBCs was smaller than the PBCs (1.94 versus 2.55 cm, p 〈 0.001). MCBCs were more likely than PBCs to be mammographically detected (46.2% versus 19.9%, p 〈 0.001). Tumor size was correlated with the method of diagnosis. The mean tumor size was 1.39, 2.02, and 2.69 cm for mammogram-, physician-, and patient-detected tumors, respectively. Among patients having axillary lymph node dissections, mammogram- and physician-detected tumors were less likely to have lymph node metastases than patient-detected tumors (22.0% versus 41.2%, p 〈 0.005). Regular follow-up of breast cancer patients diagnoses MCBCs when they are smaller and less likely to have nodal metastases than PBCs mainly because of early mammographic detection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1524-4741.2001.07605.x
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  • 2
    Electronic Resource
    Electronic Resource
    Increased Use of Adjuvant Regional Radiotherapy for Node-Positive Breast Cancer in British Columbia (2004)
    Oxford, UK : Blackwell Science Inc
    The @breast journal 10 (2004), S. 0 
    Details
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  This study was to determine if the use of regional radiotherapy (RT) changed in British Columbia after publication of new randomized trial data in 1997. Women with pathologic T1–3N1, nonmetastatic breast cancer treated with a mastectomy or breast-conserving surgery (BCS) were included. The use of regional RT was compared in two cohorts: cohort 1, July 1, 1995–June 30, 1997 (n = 834); and cohort 2, July 1, 1998–June 30, 2000 (n = 1072). All p-values were two-sided. Adjuvant systemic therapy was given to 96% and 95% of women in cohorts 1 and 2, respectively. Forty-five percent of cohort 1 and 48% of cohort 2 had BCS. Regional RT was received by 44% of cohort 1 and 66% of cohort 2 (p 〈 0.001). Eighty-eight percent and 90% of women with four or more positive nodes in cohorts 1 and 2 received regional RT, respectively. For women in cohorts 1 and 2 with one to three positive nodes, regional RT use increased from 32% to 54% after mastectomy, and from 23% to 59% after BCS, respectively (p 〈 0.001 for both). Publication of randomized trials and a coordinated guideline implementation process in British Columbia was associated with a significant increase in the use of regional RT in women with one to three positive nodes. 
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1524-4741.2004.09605.x
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  • 3
    Electronic Resource
    Electronic Resource
    Local and Regional Therapy for Women with Breast Cancer in British Columbia (2003)
    Oxford, UK : Blackwell Science Inc
    The @breast journal 9 (2003), S. 0 
    Details
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  British Columbian provincial practice guidelines (PPGs) have recommended breast-conserving surgery (BCS), axillary node dissection, and radiation therapy following BCS for specific subgroups of breast cancer patients. Patient-, disease-, and physician-specific factors associated with these therapies were investigated in nonmetastatic invasive breast cancer patients. Temporal trends in BCS and physicians’ experiences with PPGs were also examined. Sources of data for patient, disease, treatment, and treating physician factors included medical records, source documents, and the British Columbia Medical Directory for 967 nonmetastatic invasive breast cancer patients diagnosed in British Columbia in 1995. BCS utilization among 496 patients with pathologically node-negative breast cancer (NNBC) was compared to earlier British Columbian data. Family physicians and surgeons were surveyed in 1997 regarding their experience with PPGs. 57% of “ideal” candidates received BCS; 87% of patients received axillary node dissection; and 95% of women treated with BCS also received radiation therapy. Tumor size, tumor location, and extent of ductal carcinoma in situ (DCIS) were associated with BCS use; age, tumor size, and tumor location were associated with axillary node dissection; and age alone was associated with radiation therapy following BCS. Fifty-four percent of NNBC patients received BCS in 1995, compared to 44% in 1991, with increases seen in most patient-, disease-, and physician-specific comparisons. The increase in BCS, and high proportion completing radiation therapy, are encouraging and may be due in part to greater exposure to PPGs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1524-4741.2003.09310.x
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  • 4
    Electronic Resource
    Electronic Resource
    Prognosis, treatment, and recurrence of breast cancer for women attending or not attending the Screening Mammography Program of British Columbia (1999)
    Springer
    Breast cancer research and treatment 54 (1999), S. 73-81 
    Details
    ISSN: 1573-7217
    Keywords: breast cancer ; outcomes ; prognosis ; screening mammography ; treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Breast cancer screening programs have been initiated in many countries in the past decade. To determine the impact of the Screening Mammography Program of British Columbia (SMPBC), disease and treatment outcomes for women with breast cancer diagnosed in BC between 1989 and 1996 were compared on the basis of attendance at the SMPBC. An SMPBC attender was a women diagnosed with breast cancer within three years of an SMPBC screen, regardless whether the cancer was detected as a result of that screen. Of the 13,636 women aged 40–89 years diagnosed with breast cancer in BC during the study period, 2,647 (19.4%) were SMPBC attenders. 73.5% of SMPBC attenders (N=1,946) and 74.2% of non-attenders (N=8,149) were referred to the BC Cancer Agency and had pathology, staging, treatment, and outcome information available. SMPBC attenders compared with non-attenders were more likely to have in situ disease alone, and those with invasive cancers had smaller tumors which were less likely to have grade III histology and less likely to have spread to axillary lymph nodes (all P〈0.001). SMPBC attenders were more likely to be treated with breast conservation and less likely to receive adjuvant chemotherapy or tamoxifen (P 〈 0.001). Log-rank tests showed local (P = 0.017), distant (P 〈 0.001), and overall (P 〈 0.001) disease-free survival were better for SMPBC attenders. These favorable surrogate endpoints suggest that the benefits of breast screening as demonstrated by randomized trials can be translated into community practice by an organized breast screening program.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006152918283
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  • 5
    Electronic Resource
    Electronic Resource
    MR imaging of brachial plexopathy in breast cancer patients without palpable recurrence (1999)
    Springer
    Skeletal radiology 28 (1999), S. 318-323 
    Details
    ISSN: 1432-2161
    Keywords: Key words Brachial plexus ; Plexopathy ; MR imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To investigate the role of MR imaging in detecting brachial plexus (BP) abnormalities in breast cancer patients with plexopathy but without palpable masses. Design. MR imaging of the BP was performed on 26 breast cancer patients with brachial plexopathy without palpable regional masses, using 0.5 T and 1.5 T imaging systems. Findings were correlated with the clinical diagnoses. Patients. Twenty-six patients with brachial plexopathy and history of breast cancer were enrolled in the study. All patients presented with plexopathy symptoms. Fourteen patients were positive and 12 patients were indeterminate for BP metastasis according to clinical criteria. Results and conclusion. MR imaging demonstrated masses involving the BP representing metastases in two patients. Nine patients had other regional abnormalities with a normal brachial plexus. It is concluded that MR imaging is useful in the assessment and direction of therapy of brachial plexopathy in breast cancer patients by detecting both metastases to the BP as well as other abnormalities, unrelated to the BP, which may explain the patient’s symptoms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050524
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  • 6
    Electronic Resource
    Electronic Resource
    Quantitative evaluation of malignant potential of early breast cancer using high resolution image cytometry (1993)
    New York, N.Y. : Wiley-Blackwell
    Journal of Cellular Biochemistry 53 (1993), S. 107-113 
    Details
    ISSN: 0730-2312
    Keywords: Early breast cancer ; image cytometry ; malignant potential ; nuclear features ; Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: We have been testing two independent hypotheses which postulate that the malignant potential of early breast cancer can be objectively assessed by measuring nuclear features of the diagnostic-malignant cells (hypothesis I) and/or normal-appearing epithelial cells found in the vicinity of the carcinoma (hypothesis II). In preliminary experiments, we tested some of these hypotheses using historical samples and a high resolution image cytometry apparatus. Tissue sections were stained with our stoichiometric stain and over 60 nuclear features, primarily texture features describing the DNA distribution in the nuclei, were employed in the multivariate analyses. Data derived from measurements of ductal carcinoma in situ (DCIS) with and without the invasive component indicated that the malignant potential of these lesions can be estimated with a sensitivity and specificity of at least 80%. The analysis of the tissue surrounding an invasive breast carcinoma showed that the existing malignancy can be predicted solely from the measurements of normal nuclei (normal-appearing breast lobules) in more than 85% of patients. This result indicates that the analysis of benign tissues also could give prognostically valid information.These results can be greatly improved using larger sample sizes and other improvements, including technical improvements of the cytometry device. We believe that this approach can be developed into a practical diagnostic and prognostic tool for better management of early breast cancer.
    Additional Material: 5 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/jcb.240531121
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