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  • Electronic Resource  (4)
  • 1995-1999  (4)
  • 1
    Electronic Resource
    Electronic Resource
    Mammographic Screening: A Surgeon's Perspective (1997)
    Oxford, UK : Blackwell Publishing Ltd
    The @breast journal 3 (1997), S. 0 
    Details
    ISSN: 1524-4741
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Prospective randomized trials demonstrate breast cancer mortality reduction in patients offered mammographic screening, conclusively for ages 50–69 and (with longer follow-up) likely for ages 40–49. The 25–30% degree of mortality reduction observed is particularly striking in view of the number of confounding variables in each trial, most of which would act to diminish the observed benefit. Few studies have examined the impact over time of more frequent mammography usage on women found to have breast cancer. During the period in which mammography came into general usage, how did means of cancer diagnosis change, and what was the impact of mammography on stage of disease?1096 patients were treated in the author's practice for intraductal (DCIS) and invasive breast cancer between 1979 and 1993. Grouped into 5-year treatment intervals, and stratified by age and primary means of diagnosis, trends in tumor size, axillary node status, and tumor histopathology were compared.Over time, patients were increasingly likely 1) to have had mammography previously, 2) to have had their cancers diagnosed mammographically, 3) to have T1a/b (0.1–1.0 cm) tumors, 4) to be axillary node negative, and 5) to have DCIS pathologically. These trends were observed for patients both younger and older than age 50. There was no trend toward earlier-stage disease among patients either self- or physician-diagnosed, supporting the impression that the 15-year trend in this practice toward earlier diagnosis is entirely due to an increased usage of mammography. Mammography every 1–2 years is indicated in all women 40 and older, and every effort should be made to promote mammography among the substantial number of women who have still never had one.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1524-4741.1997.tb00203.x
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  • 2
    Electronic Resource
    Electronic Resource
    Intradermal Radiocolloid and Intraparenchymal Blue Dye Injection Optimize Sentinel Node Identification in Breast Cancer Patients (1999)
    Springer
    Annals of surgical oncology 6 (1999), S. 450-454 
    Details
    ISSN: 1534-4681
    Keywords: Breast cancer surgery ; Sentinel node biopsy.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Radiotracer and blue dye mapping of sentinel lymph nodes (SLN) have been advocated as accurate methods to stage the clinically negative axilla in breast cancer patients. The technical aspects of SLN biopsy are not fully characterized. In this study we compare the results of intraparenchymal (IP) and intradermal (ID) injection of Tc-99m sulfur colloid, to establish an optimal method for SLN localization. Methods: 200 consecutive patients had SLN biopsy performed by a single surgeon. Of these, 100 (Group I) had IP injection and 100 (Group II) had ID injection of Tc-99m sulfur colloid. All patients had IP injection of blue dye as well. Endpoints included (1) successful SLN localization by lymphoscintigraphy, (2) successful SLN localization at surgery, and (3) blue dye–isotope concordance (uptake of dye and isotope by the same SLN). Results: Isotope SLN localization was successful in 78% of Group I and 97% of group II patients (P 〈 .001). When isotope was combined with blue dye, SLN were found in 92% of group I and 100% of Group II (P 〈 .01). In cases where both dye and isotope were found in the axilla, dye mapped the same SLN as radiotracer in 97% of Group I and 95% of Group II patients. Conclusions: The dermal and parenchymal lymphatics of the breast drain to the same SLN in most patients. Because ID injection is easier to perform and more effective, this technique may simplify and optimize SLN localization.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s10434-999-0450-4
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  • 3
    Electronic Resource
    Electronic Resource
    Internal mammary node status: A major prognosticator in axillary node-negative breast cancer (1995)
    Springer
    Annals of surgical oncology 2 (1995), S. 32-37 
    Details
    ISSN: 1534-4681
    Keywords: Breast cancer ; Metastasis, internal mammary and axillary ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The internal mammary lymph nodes (IMN) have received little attention in recent years, yet are a well-documented site of metastasis and a major prognostic factor in early-stage breast cancer. Methods/Results: Ten-year follow-up of the final 195 patients treated by extended radical mastectomy (ERM) in this practice (selected largely on the basis of medial tumor location, and comprising 15% of all patients treated from 1965 to 1978) found IMN + in 24% of all cases: 36% of AX + versus 18% of AX -patients (p=0.0023). In a multivariate analysis, the disease-free survival impact of IMN + (p=0.004) was second only to axillary node involvement (p〈0.0005), and surpassed tumor size (p=0.077). IMN + was equally frequent for tumors less than, or greater than, 2 cm (24%), and was not significantly related to patient age. Among AX - patients, there was a twofold greater risk of recurrence or death at 10 years for IMN + than for IMN -. Among T1N0 patients, 19.6% were IMN +. Conclusions: Failure to consider IMN status in the steadily enlarging cohort of T1N0 breast cancers may result in the undertreatment of a significant proportion of stage I patients. Systemic adjuvant therapy should be considered for T1N0 patients with central or medial tumors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02303699
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  • 4
    Electronic Resource
    Electronic Resource
    ErbB-2 protein in sera and tumors of breast cancer patients (1998)
    Springer
    Breast cancer research and treatment 49 (1998), S. 261-270 
    Details
    ISSN: 1573-7217
    Keywords: erbB-2 protein ; serum ; tumor ; age ; nulliparity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared levels of erbB-2 oncoprotein among three groups: Group I included 60 asymptomatic women; Group II had 51 women with benign breast biopsies; and Group III had 67 women with node-negative breast cancer. Serological levels of erbB-2 protein were measured in all participants; tumor levels were measured for Groups II and III. Forty-three percent of usable tumors (25/58), including three of seven lobular tumors, were erbB-2 positive. Tumor and blood oncoprotein levels were unrelated. Blood levels, however, were positively related to tumor volume, but only when the tumor had both a ductal carcinoma in situ (DCIS) component and an invasive component, suggesting a role for erbB-2 protein in progression of DCIS to invasive carcinoma. In Groups I and II serological levels of erbB-2 protein were directly related to age, and inversely related to having had a live birth. Therefore, a model that determined the threshold levels of serological erbB-2 positivity in Group III included age and nulliparity as independent variables. Only three of the 67 women (4.5%) in Group III were positive for serological erbB-2. In a multivariate model, with serological erbB-2 as the dependent variable, and in which the independent variables included Study Group, there was a statistical trend for younger women, in which Group III had the highest serological levels of erbB-2, followed by Group II, and then Group I. In women who were over the age of 50 years the trend was reversed; i.e., levels of erbB-2 tended to be lowest in Group III, followed by Group II, and finally Group I.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006033214721
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