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  • 1
    Electronic Resource
    Electronic Resource
    Expression of TERT in early premalignant lesions and a subset of cells in normal tissues (1998)
    [s.l.] : Nature America Inc.
    Nature genetics 19 (1998), S. 182-186 
    Details
    ISSN: 1546-1718
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Medicine
    Notes: [Auszug] Activation of telomerase, the enzyme that synthesizes the telomere ends of linear chromosomes, has been implicated in human cell immortalization and cancer cell pathogenesis. Enzyme activity is undetectable in most normal cells and tissues, but present in immortal cells and cancer tissues. ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/554
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  • 2
    Electronic Resource
    Electronic Resource
    Six-Year Follow-Up of Patients With Microinvasive, T1a, and T1b Breast Carcinoma (1999)
    Springer
    Annals of surgical oncology 6 (1999), S. 591-598 
    Details
    ISSN: 1534-4681
    Keywords: Early breast cancer ; Minimal breast cancer ; Microinvasive breast cancer ; Axillary lymph node metastases ; Axillary dissection ; Regional metastases ; Prognosis disease-free survival ; Sentinel node biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Management of patients with breast cancers ≤1 cm remains controversial. Reports of infrequent nodal metastases in tumors ≤5 mm has led to suggestions that axillary dissection should be selective, and that tumor characteristics should guide adjuvant therapy. Methods: A retrospective review of 290 patients with breast cancer 1 cm in size or smaller from 1989 to 1991 was done. Distant disease-free survival (DDFS) was the primary outcome measure. Results: There were 95 T1a (≤5 mm) and 196 T1b (6–10 mm) cancers. Nodal metastases were found in 8 T1a and 26 T1b tumors. Larger size, poorer differentiation, and lymphovascular invasion (LVI) were associated with more nodal metastases, but none of these trends reached statistical significance. The 6-year DDFS was 93% for node-negative and 87% for node-positive patients (P = .02). Overall, breast cancers with poorer differentiation and LVI trended toward a poorer outcome. For patients with node-negative tumors, LVI was associated with a poorer outcome (P = .03). The size of the primary tumor was not predictive of outcome. There were no nodal metastases or recurrences in the 18 patients with microinvasive breast cancer. Conclusions: Lymph node status is the major determinant of outcome in breast cancers 1 cm in size or smaller. Accurate axillary assessment remains crucial in management of small breast cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s10434-999-0591-5
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  • 3
    Electronic Resource
    Electronic Resource
    Incidence of axillary lymph node metastases in T1a and T1b breast carcinoma (1998)
    Springer
    Annals of surgical oncology 5 (1998), S. 23-27 
    Details
    ISSN: 1534-4681
    Keywords: Early breast cancer ; Axillary lymph node metastases ; Axillary dissection ; Regional metastases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: We investigated the incidence of axillary lymph node metastases in patients with T1a (⩽0.5 cm) and T1b (〉0.5 cm and ⩽1.0 cm) breast cancers. Methods: The charts of 2000 patients who underwent axillary lymph node dissection for breast cancer at our institution from 1989 to 1991 were reviewed. Of these, 81 patients had T1a and 166 had T1b primary breast cancers. Results: Among the 247 patients with T1a and T1b breast cancers, nodal metastases were present in 30 (12.1%), with a 7.4% positivity rate for patients with T1a and 14.5% positivity rate for T1b tumors. Of the 212 patients who had ⩾10 nodes dissected, 29 (13.7%) had positive nodes. Of those, 6 of 60 (10.0%) patients with T1a and 23 of 152 (15.1%) with T1b tumors had positive nodes. The presence of lymphovascular invasion (LVI) predicted a significantly higher nodal positivity rate (27.8% vs. 10.9%,p=0.05). Conclusions: Of patients with adequately evaluated axillae, 10% with T1a and 15% with T1b cancers were found to have nodal metastases. Although LVI was significantly associated with a higher risk of lymph node metastases, we could not characterize any subgroup at acceptably low risk of nodal positivity. Until a more useful prognostic indicator is discovered, axillary dissection should continue to be part of the mainstay of management for small breast cancers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02303759
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  • 4
    Electronic Resource
    Electronic Resource
    Is Routine Intraoperative Frozen-Section Examination of Sentinel Lymph Nodes in Breast Cancer Worthwhile? (2000)
    Springer
    Annals of surgical oncology 7 (2000), S. 651-655 
    Details
    ISSN: 1534-4681
    Keywords: Sentinel lymph nodes ; Frozen section ; Macrometastases ; Micrometastases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Routine intraoperative frozen section (FS) of sentinel lymph nodes (SLN) can detect metastatic disease, allowing immediate axillary dissection and avoiding the need for reoperation. Routine FS is also costly, increases operative time, and is subject to false-negative results. We examined the benefit of routine intraoperative FS among the first 1000 patients at Memorial Sloan Kettering Cancer Center who had SLN biopsy for breast cancer. Methods: We performed SLN biopsy with intraoperative FS in 890 consecutive breast cancer patients, none of whom had a back-up axillary dissection planned in advance. Serial sections and immunohistochemical staining for cytokeratins were performed on all SLN that proved negative on FS. The sensitivity of FS was determined as a function of (1) tumor size and (2) volume of metastatic disease in the SLN, and the benefit of FS was defined as the avoidance of a reoperative axillary dissection. Results: The sensitivity of FS ranged from 40% for patients with T1a to 76% for patients with T2 cancers. The volume of SLN metastasis was highly correlated with tumor size, and FS was far more effective in detecting macrometastatic disease (sensitivity 92%) than micrometastases (sensitivity 17%). The benefit of FS in avoiding reoperative axillary dissection ranged from 4% for T1a (6 of 143) to 38% for T2 (45 of 119) cancers. Conclusions: In breast cancer patients having SLN biopsy, the failure of routine intraoperative FS is largely the failure to detect micrometastatic disease. The benefit of routine intraoperative FS increases with tumor size. Routine FS may not be indicated in patients with the smallest invasive cancers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s10434-000-0651-3
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  • 5
    Electronic Resource
    Electronic Resource
    Sentinel Lymph Node Biopsy: Is It Indicated in Patients With High-Risk Ductal Carcinoma-In-Situ and Ductal Carcinoma-In-Situ With Microinvasion? (2000)
    Springer
    Annals of surgical oncology 7 (2000), S. 636-642 
    Details
    ISSN: 1534-4681
    Keywords: Breast carcinoma ; Ductal carcinoma-in-situ ; Microinvasion ; Sentinel lymph node biopsy ; Intraductal carcinoma ; Micrometastases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Axillary lymph node status is the strongest prognostic indicator of survival for women with breast cancer. The purpose of this study was to determine the incidence of sentinel node metastases in patients with high-risk ductal carcinoma-in-situ (DCIS) and DCIS with microinvasion (DCISM). Methods: From November 1997 to November 1999, all patients who underwent sentinel node biopsy for high-risk DCIS (n = 76) or DCISM (n = 31) were enrolled prospectively in our database. Patients with DCIS were considered high risk and were selected for sentinel lymph node biopsy if there was concern that an invasive component would be identified in the specimen obtained during the definitive surgery. Patients underwent intraoperative mapping that used both blue dye and radionuclide. Excised sentinel nodes were serially sectioned and were examined by hematoxylin and eosin and by immunohistochemistry. Results: Of 76 patients with high-risk DCIS, 9 (12%) had positive sentinel nodes; 7 of 9 patients were positive for micrometastases only. Of 31 patients with DCISM, 3 (10%) had positive sentinel nodes; 2 of 3 were positive for micrometastases only. Six of nine patients with DCIS and three of three with DCISM and positive sentinel nodes had completion axillary dissection; one patient with DCIS had an additional positive node detected by conventional histological analysis. Conclusions: This study documents a high incidence of lymph node micrometastases as detected by sentinel node biopsy in patients with high-risk DCIS and DCISM. Although the biological significance of breast cancer micrometastases remains unclear at this time, these findings suggest that sentinel node biopsy should be considered in patients with high-risk DCIS and DCISM.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s10434-000-0636-2
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  • 6
    Electronic Resource
    Electronic Resource
    Absence of p16 gene (CDKN2) deletions in microdissected primary breast carcinoma specimens (1997)
    Springer
    Annals of surgical oncology 4 (1997), S. 416-420 
    Details
    ISSN: 1534-4681
    Keywords: p16 ; (CDKN2) ; MTS1 ; Breast carcinoma ; Microdissection ; Genetic alterations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The p16 gene (CDKN2), a tumor suppressor gene located on chromosome 9p21, has been demonstrated to be mutated or deleted with high frequency in a variety of tumor cell lines, including breast. While previous studies have not demonstratedCDKN2 mutations in primary breast carcinomas, it is possible that gene deletion in neoplastic DNA was masked by the presence of contaminating normal stromal DNA in breast carcinoma specimens. Methods: We investigated the incidence of homozygous deletion ofCDKN2 by analyzing 20 microdissected pure populations of primary breast carcinoma cells. Using polymerase chain reaction (PCR) techniques, the entire coding region and intervening introns ofCDKN2 were amplified. The PCR products were resolved by agarose gel electrophoresis and single-strand conformation polymorphism (SSCP) analysis. Results: We detected no deletions or mutations of the p16 gene. Conclusions: CDKN2 is not deleted with high frequency in primary breast carcinomas, and the p16 gene does not play a role in breast carcinogenesis via this mechanism.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02305555
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