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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Annals of surgical oncology 2 (1995), S. 32-37 
    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
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  • 2
    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
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