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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 51 (1998), S. 195-208 
    ISSN: 1573-7217
    Keywords: breast cancer ; prognosis ; histology ; tumor type ; tumor grade ; pathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diagnosis coupled with prognostication is the challenge for and charge of the pathologist. In this time of rapidly developing basic knowledge and increasing sophistication in the evaluation of prognostic information, there has also been an important re- evaluation of the validity, reliability, and relevance of classic histopathology. Also, the precision of and criteria for evaluating tumor size and status of regional lymph nodes is under study. Our emphasis in this review is tissue pathology and further, its practical relevance to patient management. Histopathology remains the basis of diagnosis universally; the addition of other elements will increase precision of prediction, particularly of responsiveness to individual therapies. Histologic grade may be integrated to substratify high and low stage cases into prognostically more useful subsets. Histologic types also interact with size and nodal status to predict patients with excellent prognosis. Further refinement of these parameters may occur by analysis within clinical, pathologic, or therapeutic subsets.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 28 (1993), S. 157-166 
    ISSN: 1573-7217
    Keywords: breast cancer precursors ; cytology ; ductal carcinoma in situ ; fine needle aspiration ; histology ; hyperplastic lesions ; risk
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Anatomic indicators of increased breast cancer risk have regularly been identified as hyperplastic lesions, analogous to other body sites. Most of these have been shown to indicate a later increased risk anywhere in either breast and should thus be regarded as indicators or markers of increased risk. Unfortunately, these are largely identified incidentally to current methods of detection. Specific combined histologic and cytologic criteria for the definition of these lesions have been evaluated for both their reproducibility of diagnosis and outcome variables. Several studies agree that usual patterns of hyperplasia of at least moderate degree indicate an increased risk of later breast carcinoma between 1.5 and 2 times that of the general population. The specifically defined examples of atypical hyperplasia, lesions of relative rarity, are found in 4–5% of biopsies (depending upon method of detection) and recognize a risk in the range of 4–5 times that of the general population controlled for age and duration of follow-up. Thus, several cohort studies using comparable criteria for definition of the anatomic lesions have found similar clinical outcomes. Other approaches to histologic definition have produced a lesser degree of separation between the non “atypical” and other forms of hyperplasia. Although it is not clear whether we are dealing with continuous variables or discrete histologic/cytologic variables, it is clear that when combined criteria are used, a greater degree of predictability is obtained. Other related risk features include most predominantly family history, which when present with atypical hyperplasia indicates an increased risk beyond that of either alone. Other means of detection of these various lesions, such as fine needle aspiration cytology, have not been verified. True non-obligate precursors of breast cancer are probably confined to low grade and non-comedo ductal carcinomas of the breast.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1335
    Keywords: Endothelial cells ; Inflammation ; Cancer therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A group B streptococcus (GBS) isolated from human neonates diagnosed with sepsis and respiratory distress (“early-onset disease”) produces a polysaccharide exotoxin (GBS toxin) that, when infused in sheep, causes lung pathophysiology similar to that seen in humans. Histological studies have demonstrated that GBS toxin induces a strong inflammatory response in the lung, with pulmonary sequestration of granulocytes and extensive capillary endothelial damage. The susceptibility of humans to GBS toxin is age-dependent and limited to about 4 days after birth. It is rarely evident thereafter. This suggests that the binding of GBS toxin to the target endothelium occurs via specific components in the developing lung endothelial cells of the newborn that are later lost. We report here that GBS toxin can also bind to developing endothelium associated with neoplasia and induce an inflammatory response. GBS toxin was shown by immunohistochemistry to bind to capillary endothelium of human large-cell carcinomas. In nude mice bearing human tumor xenografts, intravenously administered GBS toxin caused tumor necrosis and hemorrhagic lesions, and substantially inhibited the rate of growth of the tumors. In BALB/c mice bearing Madison lung tumors, GBS toxin induced an inflammatory response resulting in marked changes in tumor morphology, including vasodilation, endothelial and tumor cell necrosis, invasion of lymphocytes and macrophages, and capillary thrombosis. In these tumor models, no evidence of toxicity to the vasculature of other tissues was observed. The reported pathophysiology of GBS in human neonates, the lack of disease in non-neonates colonized with GBS, and these results suggest that GBS toxin may have potential as a well tolerated agent in cancer therapy of some human tumors.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1335
    Keywords: Cancer therapy ; Inflammation ; Endothelial cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract GBS toxin is a polysaccharide exotoxin produced by group BStreptococcus. This organism causes sepsis and respiratory distress in human neonates (so-called early onset disease). This disease is marked by a strong inflammatory response only in the lung, with pulmonary sequestration of granulocytes and extensive capillary endothelial damage, and occurs only during the first few days after birth. We have found that a similar inflammatory response can be induced by i.v. infusion of picomole quantities of GBS toxin in the developing vasculature of transplanted tumors in mice and can significantly retard the tumor growth. When optimum treatment with GBS toxin was started shortly after tumor implantation, a majority of tumors in the mice regressed and the mice remained tumor-free for over 5 months. Some tumors regressed in mice receiving short-term treatment with GBS toxin, but recurred after the treatment was stopped. Median survival times were extended by all regimens and all doses of GBS toxin tested. No evidence of toxicity to the vasculature of other tissues was observed. GBS toxin is being tested for cancer therapy in humans.
    Type of Medium: Electronic Resource
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