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  • 1
    ISSN: 1436-2813
    Keywords: biopsy ; breast cancer ; radical mastectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects on the prognosis of breast cancer, of the delay between biopsy and radical mastectomy were studied in 394 patients. No delay had been experienced by 148 cases (no delay group), no biopsy had been performed in 166 cases (no biopsy group) and 80 cases had experienced a delay of 1 day or longer after having had a biopsy taken at a different institution (delay group). The recurrence rate of the no delay group was 10.8 per cent (16/148), whereas that of the delay group was 18.8 per cent (15/80). The relapse free survival rate of the no delay group was superior to that of the delay group (Kaplan Meier’s method: p〈0.05). The delay group was further divided into two groups according to the duration of delay, namely: a group whose delay was less than 7 days and another whose delay was longer than 8 days. There was no significant difference between the relapse free survival rates of the no delay group and the less than 7 days group, however, a significant difference was observed between the no delay group and the longer than 8 days delay group (p〈0.05). The acceptable delay between biopsy and radical mastectomy may therefore be concluded as less than 7 days.
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  • 2
    ISSN: 1436-2813
    Keywords: kidney transplantation ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Immunosuppressive therapy is not only an etiologic factor ofde novo malignant disease but it also accelerates progression of the already developed malignant disease in immunosuppressed recipients. Two cases ofde novo breast cancer arising in kidney transplant recipients are reported herein. A 25 year-old woman, transplanted one haploidentical kidney transplant 4 years and 9 months ago, developed a left breast tumor. Within one month the tumor had rapidly enlarged from 3.5 cm to 8 cm in diameter by the time she underwent a radical mastectomy. Nine axillary lymph nodes were positive for metastasis. Although her graft function had been poor due to chronic rejection, she was treated with standard immunosuppressive therapy, but not adjuvant therapy. Since local recurrent disease appeared two months postoperatively, the immunosuppressive therapy was ceased and60Co therapy started. Recurrent disease progressed rapidly, however, and she died 7 months after her operation. A 27 year-old woman, having allograft from an identical sibling, noted a right breast tumor, 8 years and 7 months later. Again the tumor had grown rapidly from 1.8 cm to 3 cm in diameter within one month. She underwent a standard radical mastectomy. One axillary lymph nodes was positive for metastasis. She has been treated with standard immunosuppressive therapy and adjuvant endocrinochemotherapy. Presently, she is alive with a well functioning graft and no disease.
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  • 3
    ISSN: 1436-2813
    Keywords: breast cancer ; modified radical mastectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We have developed a new type of modified radical mastectomy, the method and clinical results of which are reported herein. In this operation, axillary dissection is performed by the following two approaches. Firstly, the axillary contents are dissected from the highest possible subclavicular point to the pectoralis minor muscle, after partially cutting the sternocostal origin of the pectoralis major muscle. The second approach is from the posterior aspect of the pectoralis minor muscle to the lateral portion of the latissimus dorsi muscle. Parasternal dissection can also be performed for stage II and IIIa cancers with a central or medial tumor. After lymph node dissection, the detached edge of the sternocostal origin of the pectoralis major muscle is resutured to cover the parasternal region. Thus, complete dissection of the axillary nodes is performed whilst preserving the pectoralis major and pectoralis minor muscles. Good clinical results were achieved with respect to radicality, cosmetic effects and function in 28 patients with stage I, II and IIIa breast cancers who were followed up for between 5 to 8 years. This new operation may therefore be adopted for the majority of patients with Stage I, II, or IIIa cancers, unless massive infiltration into the pectoralis major muscle has occurred. Preservation of both the pectoralis major and pectoralis minor muscles results in a good cosmetic appearance, good functioning of the arm and easy reconstruction of the breast following mastectomy.
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  • 4
    ISSN: 1436-2813
    Keywords: estrogen receptor ; breast cancer ; endocrine therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Estrogen receptor (ER) expression was investigated by ER-immunocytochemical assay (ICA) and the dextran coated charcoal (DCC) method in 10 recurrent or primary-advanced breast cancer patients treated with endocrine or chmmo-endocrine therapy. In 6 of these 10 patients, ER was examined both before and after treatments by the 2 methods. ER contents measured by the DCC method were found to be decreased after treatments, however, no change in the immunoreactivities of ER-ICA was observed. In the remaining 4 patients, the ER of new lesions refractory to endocrine or chemo-endocrine therapy was examined. ER status was determined as negative in 3 of the 4 patients by the DCC method, whereas by ER-ICA, the proportion of ER stained cells was about 70 per cent, those cells being diffusely distributed in the section. A discrepancy between ER-ICA and the DCC method was thus demonstrated in breast cancer patients treated by endocrine therapy.
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  • 5
    ISSN: 1436-2813
    Keywords: cancer cell emboli ; pectoral lymphatics ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to investigate the possibility of local recurrence in the pectoral muscles of patients who undergo modified radical mastectomies, the cancer cell involvement of the lymphatics associated with the pectoralis major muscle was studied in 39 patients who underwent a standard radical mastectomy for Stage I–III breast cancer. Cancer cell emboli were found in the transpectoral lymphatics of 2 patients (2/39=5.1 per cent) and in the pectoral fascial lymphatics of 6 patients (6/39=15.4 per cent). Two patients with fascial lymphatic cancer cell emboli were from a group of 14 patients with intramammary lymphatic tumor emboli of a low degree (ly 1). The other 6 patients with cancer cell emboli in either the pectoral fascia or the transpectoral lymphatics were from a group of 11 patients with intramammary lymphatic tumor emboli of a moderate degree (ly 2). There was a significant relationship between the intramammary and the pectoral lymphatic cancer cell emboli (Chi square test: p〈0.05). The results of this study therefore indicate that lymphatic cancer cell emboli in the pectoral fascia and muscle are an important risk factor for patients who undergo a modified radical mastectomy.
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  • 6
    ISSN: 1436-2813
    Keywords: breast cancer ; regional lymph node dissection ; modified extended mastectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of an analysis done on the regional lymph node metastases of 300 patients with operable breast cancer, who were treated in the Department of Surgery (II), Kanazawa University Hospital from 1973 to early 1988 are reported herein. It was found that the metastases of the axillary and internal mammary lymph nodes were closely related to the survival of patients, but they were hardly diagnosed before the operation. Only the dissection of these lymph nodes proved useful for providing the prognostic information. Moreover, in a retrospective study comparing theen bloc extended radical mastectomyversus the other types of mastectomy, the extended radical mastectomy was seen to greatly improve the survival of patients with 3 or less than 3 metastatic axillary lymph nodes. Thus, the extended radical mastectomy provides the maximum diagnostic and prognostic information, and gives the best chance of loco-regional control of the disease. The anterior chest deformity created by the extended radical mastectomy, however, should be avoided in those patients without internal mammary involvement. We therefore propose the modified extended mastectomy as a staging operation.
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  • 7
    ISSN: 1436-2813
    Keywords: metastatic carcinoma of the esophagus ; breast cancer ; surgical resection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of progressive dysphagia due to metastatic carcinoma of the esophagus from breast cancer is described herein. The patient was a 55 year-old Japanese woman who had undergone a right radical mastectomy for carcinoma of the right breast 9 years previously. We performed a subtotal esophagectomy and reconstruction, using the stomach. She is now well and working without any further symptoms, five years after surgery. Thus, palliative surgery for the complications caused by metastatic carcinoma of the esophagus may be worthwhile.
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  • 8
    ISSN: 1436-2813
    Keywords: breast cancer ; tumor marker ; CA15-3 ; CEA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serum carbohydrate antigen (CA15-3) values were examined in 300 normal subjects in order to determine the standard value of this antigen. The clinical relevance of repeatedly assaying this marker in patients with or without recurrent breast cancer postoperatively was compared with assaying the serum carcinoembryonic antigen (CEA) values. The upper limit of CA15-3 was calculated as being 25.3 U/ml in the normal subjects and the distributions of CA15-3 values were not markedly different among the normal subjects, even if they had been selected according to sex or age. Moreover, no differences were observed among normal women who had been randomly selected according to the age distribution of the breast cancer patients. Thirty samples taken from the breast cancer patients postoperatively revealed values of higher than 25 U/ml and 73 samples showed lower levels. The serum CEA values were positive in 16 samples and negative in 85 samples. Although the accuracy of the CEA assay was about 10 per cent higher than that of the CA15-3 assay, its low positive rate was unsatisfactory for effective use in the breast clinic. The results of this study suggest that serum CA15-3 is not detectable unless there is a relatively large number of tumor cells. The higher false positive rate of the CA15-3 assay should therefore be considered as suggesting recurrence.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Journal of behavioral medicine 12 (1989), S. 605-611 
    ISSN: 1573-3521
    Keywords: mammography ; compliance ; appointment keeping ; breast cancer ; incentives
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Psychology
    Notes: Abstract Compliance with screening mammography recommendations is low. Consequently, a community-wide program offering $50 mammograms at 29 radiology facilities was implemented. The program was promoted on a local TV news show and women 35 years and older were instructed to call a referral phone bank. If the caller met eligibility criteria, she received an information packet that assigned her to one of the facilities; it was her responsibility to schedule the appointment. At one facility, a strategy to increase compliance was piloted using a controlled design. Of the 96 subjects assigned to that clinic, 47 received an incentive coupon combined with a prompt in addition to the information packet and 49 received no coupon. The coupon was redeemable for a nutrition information kit when the subject appreared at her appointment. Results indicated that the incentive group had a significantly higher rate of appointment making than the control group (81 vs. 59%). Of subjects in both groups who made appointments, nearly 100% kept them. The intervention appeared to be cost-effective with a self-referred sample.
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  • 10
    ISSN: 1573-0646
    Keywords: doxorubicin ; iproplatin ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Forty-eight patients with advanced breast cancer were treated in a disease-specific phase I trial of doxorubicin and iproplatin combination chemotherapy. The doses of doxorubicin ranged between 30 and 50 mg/m2, and the doses of iproplatin ranged between 150 and 250 mg/m2. Myelosuppression was observed at all levels, but was dose-limiting at the highest level. In addition, nausea, diarrhea and malaise were prominent toxicities. Neither cardiac nor renal toxicity was encountered. Nine of 26 (35%) of previously untreated patients, and 5 of 22 (23%) previously treated patients demonstrated partial or complete responses. Although this combination possesses therapeutic activity, given its toxicities, further evaluation of doxorubicin in combination with iproplatin is not recommended.
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  • 11
    ISSN: 1573-7217
    Keywords: age ; breast cancer ; multiple primary cancers ; race
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The occurrence of multiple primary cancers was evaluated among 17,944 white and black female residents of Metropolitan Detroit diagnosed with breast cancer between 1973 and 1983. Invasive second primary cancers were diagnosed among 1106 of these women, almost twice the expected number. Subsequentin situ cancers were detected four times more often than expected. Fifty-six percent of the subsequent invasive cancers were of the breast (Standardized Incidence Ratio, SIR = 3.80). Black women experienced higher risk of subsequent breast cancers (SIR = 5.30) than white women (SIR = 3.62). Highest risk was seen among women first diagnosed before age 40 (SIR for black women = 26.15, SIR for white women = 10.87) and within five years of initial diagnosis. These findings suggest that young breast cancer patients, especially black women, are at high risk of developing a second primary breast cancer soon after their initial diagnosis and should be under continued medical surveillance. The occurrence of multiple primary breast cancers among young women suggests a genetic component to risk. Identification of this subpopulation would be useful in the study of molecular and genetic markers for cancer. Subsequent colon (SIR = 1.24) and cervical (SIR = 1.54) cancers also were diagnosed significantly more often than expected, as were ovarian cancers among white women (SIR = 1.45). These findings are consistent with common etiologic factors associated with these cancers.
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  • 12
    ISSN: 1573-7217
    Keywords: breast cancer ; enzyme immunoassay ; immunocytochemical assay ; progesterone receptor ; radioligand binding assay
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Progesterone receptors were determined on frozen sections from 74 primary human breast tumors by an immunocytochemical assay using an indirect avidin-biotin peroxidase method. In the same tumors, cytosol estrogen (ERc) and progesterone receptors (PgRc) were determined by ligand binding assay, and nuclear estrogen (ERn) and progesterone receptors (PgRn) were determined by an immunoassay. Immunocytochemical staining was seen in 36% of tumors. It was predominantly nuclear and there was extensive cell to cell heterogeneity. When the immunocytochemical results were compared to PgRc the agreement rate was 63%, but it was 77% when compared to PgRn. About one third (38%) of PgRc positive tumors were immunocytochemically defined as negative. Thus a significant discordance exists between this immunocytochemical assay for PgR and both the conventional radioligand assay (used for PgRc) and the relatively new enzyme immunoassay (used for PgRn). However discordance rates were critically influenced by the arbitrary cutoff levels that were used to define receptor positivity in the biochemical assays. Our studies support the addition to, rather than the substitution of, immunocytochemical methods, to the conventional biochemical assays for PgR, until long-term follow-up studies of patients with PgRn and immunocytochemical PgR determinations become available.
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 14 (1989), S. 77-90 
    ISSN: 1573-7217
    Keywords: breast cancer ; epidermal growth factor receptor ; estrogen receptor ; prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prognostic significance of EGFR (epidermal growth factor receptor) was studied in a cohort of 68 node-positive patients with breast cancer, who entered a controlled protocol of adjuvant therapy between February 1980 and June 1984. EGFR radioligand binding assay was carried out on frozen stored samples. Twenty five (37%) of 68 primary sites and 9 (41%) of 19 lymph node metastases assayed were EGFR-positive with a cut off value of 5 fmol/mg membrane protein; there is no statistical difference between the two distributions. EGFR was significantly correlated to ER and histological grade. EGFR-positive tumors and high levels of EGFR were mainly found in the ER-negative group of tumors (p = 0.008) and in histological grade III (p = 0.007). Fifty five patients could be followed for 40 to 92 months. EGFR was an independent prognostic factor for survival after 40 months (p = 0.05). EGFR+/ER− patients had the lowest survival probability, but statistical significance was not reached (p = 0.06). The EGFR phenotype appeared as a prognostic parameter in node-positive patients, individualizing subgroups of patients with different early outcome, with potential therapeutic implication especially in the group of ER-negative patients. These results emphasize the need for a standardized assay methodology and for further clinical studies, particularly in protocols where adjuvant hormonal therapy is prescribed on the basis of steroid hormone receptor status, in order to assess the respective prognostic worth of EGFR and ER (or PR).
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 14 (1989), S. 235-243 
    ISSN: 1573-7217
    Keywords: breast cancer ; cell kinetics ; flow cytometry ; growth curves ; nude mice ; xenografts
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The immune-deficient nude mouse with human tumor xenografts is an appropriate model system for performing detailed growth kinetic examinations. In the present study one estrogen and progesterone receptor-negative (T60) and three receptor-positive (Br-10, MCF-7, T61) human breast cancer xenografts in nude mice were investigated. The proliferative tumor characteristics were examined by growth curves, thymidine labelling technique, and flow cytometric DNA analysis performed on fine-needle aspirations. The results showed that the tumors had growth kinetics comparable to other human tumor types with cell generation times of 42 to 60 hours. The three receptor-positive tumors had slower growth rate, larger tumor volume doubling time, and smaller growth fraction and labelling index than the receptor-negative tumor. However, no single proliferation parameter was sufficient to characterize the growth kinetics of individual tumors or to describe proliferative differences between the tumors.
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  • 15
    ISSN: 1573-7217
    Keywords: antigens ; breast cancer ; CA 15–3 ; CEA ; markers ; relapse
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Circulating CA 15-3 antigen levels were evaluated in patients with benign diseases and breast cancer patients with no clinical evidence of disease after surgery (NED). Patients with breast cancer NED were followed for tumor recurrence or death during a median of 12.9 months (range 1 to 25 months). CA 15-3 and carcinoembryonic antigen (CEA) were compared in the same breast cancer NED patient population. Elevated CA 15-3 levels (〉40 U/ml) were observed in 38 of 1220 patients with benign diseases (3.1%) and in 25 of 350 breast cancer NED patients (7.1%). Elevations of CEA (〉5ng/ml) were observed in 23 patients with breast cancer NED (6.5%). Benign diseases that produced significant elevations of CA 15-3 were chronic hepatitis (42.9%), liver cirrhosis (13.3%), sarcoidosis (16.7%), tuberculosis (9.7%), and systemic lupus erythematosous (6.7%). In breast cancer NED, initial elevations of CA 15-3 were observed in 12 of the 297 patients that remained free of disease during the follow-up, and in 13 of the 40 patients that relapsed (4.0% vs. 32.5%, p〈0.001). Initial CEA levels were elevated in 16 patients that remained NED and in 7 patients that relapsed (5.3% vs. 17.5%, p〈0.001). Serial determinations of CA 15-3 in patients continuously NED showed persistent elevations in 4 cases. Three of these exhibited concomitant benign diseases. In relapsing patients, serial tumor marker determinations showed that elevations of CA 15-3 before any other clinical evidence of recurrence occurred significantly more frequently than elevations of CEA (45% vs. 25%, p〈0.001). Overall, two or more serial elevated values of CA 15-3 were observed in 7 cases, and 6 of them (85%) eventually relapsed. Median survival from study entry was 18.3 months in patients with breast cancer NED that had initial elevated CA 15-3, compared to 25+ months in those with negative CA 15-3 (p〈0.0001). We conclude that circulating levels of CA 15-3 antigen can be elevated in some patients with nonmalignant diseases, and that serial determinations of CA 15-3 may be useful in the postsurgical follow-up of patients with breast cancer when specific types of benign diseases that may cause elevations of the antigen are excluded. Additionally, CA 15-3 is more sensitive than CEA in the early diagnosis of breast cancer recurrences, and the simultaneous assay of CEA does not add information to that of CA 15-3 alone.
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  • 16
    ISSN: 1573-7217
    Keywords: adjuvant chemotherapy ; breast cancer ; conservative treatment ; lumpectomy ; mastectomy ; radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 399 patients with early breast cancer were randomly allocated to treatment by either modified radical mastectomy or lumpectomy and radiotherapy. 169 had histologically involved axillary nodes and were randomised to receive either adjuvant cytotoxic chemotherapy (76 patients) or no systemic adjuvant treatment (93 patients). Chemotherapy comprised a combination of oral cyclophosphamide and intravenous methotrexate and 5-fluorouracil (CMF) for 12 cycles over one year. Patients in the mastectomy group received a significantly higher percentage of the planned chemotherapy dose compared with those in the radiotherapy group (median 85% v. 71% p 〈 0.05). Patients treated with radiotherapy were more frequently nauseated and developed more severe alopecia, but these differences were not statistically significant. At median follow-up of 37 months the relapse-rate and pattern of relapse were similar in both groups of patients receiving CMF.
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  • 17
    ISSN: 1573-7217
    Keywords: observer variability ; medullary carcinoma of the breast ; breast cancer ; histopathology ; diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary One hundred thirty-one breast carcinomas with medullary features, registered in the Danish Breast Cancer Cooperative Group from 1977–1982, have been histopathologically reviewed by two senior pathologists and classified as typical medullary carcinoma (TMC), atypical medullary carcinoma (AMC), and non-medullary carcinoma (NMC). Diagnostic criteria were based on those put forward by Ridolfiet al. and Fisheret al. The procedure was repeated with an interval of about one year by both pathologists. The diagnostic interobserver agreement was 72% with a Kappa of 0.55. The intraobserver agreement was 77% and 63% with Kappa values of 0.64 and 0.44, respectively. To see whether the observed inter- and intraobserver variability had any prognostic implications, diagnostic subgroups for both pathologists were analyzed with Kaplan Meier plots for recurrence-free survival (RFS) and with log rank tests. In the first evaluation pathologist 1 segregated a group of TMC with a significantly better RFS than for the NMC group, and pathologist 2 segregated a group of TMC with a corresponding strong trend. These findings could not, however, be reproduced in the second evaluation. The study indicates that the criteria of TMC and AMC as proposed by Ridolfiet al. need to be sharpened and simplified in order to reduce inter-and intraobserver variability. Larger studies with a control group of infiltrating ductal carcinomas are mandatory to elucidate the clinical importance of the diagnoses of Typical and Atypical Medullary Carcinoma of the breast.
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  • 18
    ISSN: 1573-7217
    Keywords: antiestrogens ; estrogen receptor ; ICI 164384 ; keoxifene ; tamoxifen ; breast cancer ; mixed agonist-antagonist
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The agonistic/antagonistic properties of two non-steroidal antiestrogens, namelytrans-4-monohydroxy-tamoxifen (OH-TAM) and keoxifene (LY156758), and the new steroidal antiestrogen ICI164384, a 7β-alkylamide derivative of estradiol (E2), were assessed by measuring their effect on the proliferation of ZR·75-1 cells, an estrogen-responsive human breast cancer cell line. While subnanomolar concentrations of both OH-TAM and LY156758 had significant estrogenic stimulatory activity on cell growth in the absence of estrogens and higher concentrations were inhibitory, ICI164384 behaved exclusively as a growth inhibitor and more potently so than the two other compounds. The three antiestrogens had similar potency to inhibit the mitogenic effect of E2 and at 300 nM, all antiproliferative effects were completely reversible by the estrogen. ICI164384 was a weaker competitor of3H-labeled E2 or R2858 (moxestrol) uptake in intact ZR-75-1 cells in a 1-hour assay, partly because of a slower intracellular access to estrogen specific binding sites. Moreover, ICI164384 interacted in a rapidly (~ 6 h) reversible manner with estrogen-specific binding sites, while the non-steroidal antiestrogens induced a longer-acting (〉 24 h) down-regulation of specific [3H]R2858 uptake. The present data indicate that, among the antiestrogens studied, ICI164384 is the only compound acting as a pure antiestrogen in ZR-75-1 breast cancer cells, while LY156758 and OH-TAM behave as antiestrogens endowed with partial agonistic activity in this system.
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  • 19
    ISSN: 1573-7217
    Keywords: breast cancer ; antiprogesterones ; tumor models ; rats ; mice ; differentiation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the transplantable MXT mammary tumor model of the mouse and in the DMBA- and MNU-induced mammary tumor models of the rat, the progesterone antagonists ZK 98.299 and RU 38.468 were shown to have potent antitumor activity. The weight and/or morphology of the ovaries, uterus, and vagina, as well as the effects on serum hormone levels, indicate that the antitumor activity of both antiprogesterones in these models does not depend on a blockade of the ovarian and pituitary functions and does not depend on a non receptor-mediated cytotoxic effect. On the other hand, the morpholoy of the MXT and the DMBA-induced mammary tumors after treatment with the progesterone antagonists is completely different from that observed after ovariectomy. Treatment with the antiprogesterones seems to trigger differentiation of the mitotically active polygonal tumor cells towards glandular structures and acini with a massive sequestering of secretory products, as well as towards spindle-shaped necrobiotic subpopulations. By contrast, the induction of tumor cell degeneration and cytolysis is the predominant feature of the mammary tumors after ovariectomy. In conclusion, our results indicate that the main mechanism of the antitumor action of antiprogesterones in these models is a direct progesterone receptor-mediated antiproliferative effect at the level of the mammary tumor cells, most probably via the induction of terminal differentiation associated with terminal cell death. This antiproliferative effect seems to be dissociated from the antihormone (antiprogestational) activity of these progesterone antagonists.
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  • 20
    ISSN: 1573-7217
    Keywords: breast cancer ; recurrence ; prognosis ; post-recurrence survival ; metastasis ; S-phase ; mammography screening ; static cytofluorometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Using static cytofluorometry, S-phase was determined on the primary tumors of 421 patients with breast carcinomas in stages I–III diagnosed 1981–85 during the second and third screening rounds of a randomized trial evaluating the effect of mammographic screening. Through December 1988, 82 patients had developed local and/or distant recurrence, 51 of whom had died of cancer during the same period. The distribution among sites of recurrence differed between patients with tumors detected by mammography screening and cancers diagnosed due to clinical symptoms. The mean S-phase fraction was highest in patients with liver or brain metastases and lowest in patients with metastases in subcutaneous and cutaneous tissue and lymph nodes only. In univariate analysis, survival after first recurrence was significantly associated with the site of primary recurrence, the disease-free interval, and node status and tumor size at diagnosis, as well as the S-phase level. The median survival period was 31.3. months for patients with a S-phase fraction below 6%, and 10.7 months in cases with S-phase exceeding 10%. Neither ploidy nor the estrogen receptor content had significant influence on post-recurrence survival. In Cox's multiple regression analysis, only metastatic site, disease-free interval, and S-phase fraction showed significantly independent prognostic value.
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  • 21
    ISSN: 1573-7217
    Keywords: breast cancer ; DNA ploidy ; viability ; enzymatic dissociation ; mechanical dissociation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Approximately 70% of breast cancers contain cell populations with hyperdiploid (〉G0/G1) DNA content; however, cells cultured from breast cancers have only diploid DNA contents and karyotypes. Mechanically dissociated cells rarely, if ever, grow in culture, while enzymatically dissociated cells do grow in most cases. To determine if cell dissociation techniques used to prepare cells for culture and other laboratory procedures select for cells with specific features, and if tumor cells are killed in the process, breast cancer cells obtained by mechanical dissociation and by enzymatic dissociation were examined for DNA content and cell viability (measured by dye exclusion). Mechanical dissociation yielded more dead cells and cells with hyperdiploid (〉G0/G1) DNA than did enzymatic dissociation. Hyperdiploid cells were also found in the dye-excluding population with each dissociation technique, suggesting that the hyperdiploid cells were not always dead. We conclude that,in vivo, tumors contain cellular subpopulations with low viability and hyperdiploid (〉G0/G1) DNA patterns. The extent to which these subpopulations are present in a sample depends on the dissociation technique employed. That only diploid cells are found in cultures of primary breast cancers may be because enzymatic dissociation, used to prepare cells for culture, yields predominantly diploid cells. These observations also have important implications for interpreting measurements made on dispersed cells,e.g., viability, DNA content, and other cytochemical markers.
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  • 22
    ISSN: 1573-7217
    Keywords: androgens ; breast cancer ; glucocorticoids ; hydroxyflutamide ; medroxyprogesterone acetate ; progestins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Medroxyprogesterone acetate (MPA) is a synthetic progestin, currently used in the adjuvant treatment of advanced breast cancer, which induces remission rates (30–40%) comparable to those obtained with other types of endocrine therapies. Since, in addition to its progestin-like action, MPA exhibits androgen- and glucocorticoid-like activities in other tissues, the present study was designed to assess the relative contribution of the different steroid receptor systems in the direct action of MPA on breast cancer cell growth, using the ZR-75-1 human mammary carcinoma cell line as anin vitro model. Unlike pure progestins, MPA potently inhibited the proliferation of ZR-75-1 cells in a concentrationdependent manner either in the presence or in the absence of estrogens, and the addition of insulin had only marginal effects on its growth-inhibitory activity. On the other hand, both hydroxyflutamide (OHF, a non-steroidal monospecific antiandrogen) and RU486 (a potent antiglucocorticoid and antiprogestin also endowed with antiandrogenic activity) competitively reversed MPA antiproliferative effects. MPA further decreased the growth of ZR-75-1 cells co-incubated with maximally inhibitory concentrations of either 5α-dihydrotestosterone (DHT) or dexamethasone (DEX), although at about 300-fold higher MPA concentrations with DHT-treated than with DEX-treated ZR-75-1 cells, thus demonstrating a highly predominant androgenic effect. However, MPA had no effect on the growth of ZR-75-1 cells co-incubated with DHT and DEX simultaneously, thus supporting the predominant role of androgen and glucocorticoid receptors in MPA action. A 12-day preincubation of ZR-75-1 cells with increasing concentrations of MPA (10−12 to 3 × 10−6M) decreased the specific uptake of [3H]estradiol (E2) by intact cell monolayers to the same extent as 10 nM DHT, an effect which was competitively blocked by the addition of OHF (3 µM). MPA action on ZR-75-1 cell growth also significantly differed from that of progestins in being additive to the inhibition of E2-stimulated growth by the steroidal antiestrogen ICI164384. The present data indicate that the main action of MPA on ZR-75-1 human breast cancer cell growth is due to its androgen receptor-mediated inhibitory action, while its glucocorticoid-like activity could play an additional role at high concentrations.
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  • 23
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    Breast cancer research and treatment 14 (1989), S. 299-306 
    ISSN: 1573-7217
    Keywords: breast cancer ; androgens ; dihydrotestosterone ; androgen receptor ; dimethylbenz[a]anthracene ; estrogens ; hormone-sensitive ; antiandrogen ; Flutamide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Constant release of the androgen 5α-dihydrotestosterone (DHT) in ovariectomized rats bearing DMBA-induced mammary carcinoma caused a marked inhibition of tumor growth induced by 17β-estradiol (E2). That DHT acts through interaction with the androgen receptor is supported by the finding that simultaneous treatment with the antiandrogen Flutamide completely prevents DHT action. Particularly illustrative of the potent inhibitory effect of DHT on tumor growth are the decrease by DHT of the number of progressing tumors from 69.2% to 29.2% in E2-treated animals and the increase by DHT of the number of complete responses (disappearance of palpable tumors) from 11.5% to 33.3% in the same groups of animals. The number of new tumors appearing during the 28-day observation period in E2-treated animals decreased from 1.5 ± 0.3 to 0.7 ± 0.2 per rat during treatment with DHT, an effect which was also reversed by the antiandrogen Flutamide. The present data demonstrate, for the first time, that androgens are potent inhibitors of DMBA-induced mammary carcinoma growth by an action independent of inhibition of gonadotropin secretion, and suggest an action exerted directly at the tumor level.
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  • 24
    ISSN: 1573-7217
    Keywords: breast cancer ; cell lines ; image analysis ; infiltrating ductal carcinoma ; polypeptides ; two-dimensional polyacrylamide gel electrophoresis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The protein populations of epithelial cells cultured from two neoplastic and five non-neoplastic human breast tissues were resolved and displayed by two-dimensional polyacrylamide gel electrophoresis and silverstaining. With a computer-based image analysis system, we identified eight polypeptides which are present in both of the neoplastic cell lines, but absent from all five of the cultures of non-neoplastic breast cells. The eight polypeptides are not unique to cells cultured from neoplastic breast, because they are also found in cells cultured from non-breast tissues, both neoplastic and non-neoplastic. Two of the eight polypeptides (∼ Mr 25,000/pI 4.4 and ∼ Mr 31,000/pI 5.5) are present in the patterns of whole tissue samples from infiltrating ductal carcinomas and absent in most normal breast tissue.
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  • 25
    ISSN: 1573-7217
    Keywords: beta-adrenergic receptor ; catecholamines ; DMBA-induced rat mammary carcinoma ; spontaneous mammary tumors ; estrogen-sensitive cancer ; progesterone receptor ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to gain further knowledge about the potential role of catecholamines in mammary carcinoma, we have used the potent β-adrenergic antagonist cyanopindolol (CYP) as iodinated ligand to characterize β-adrenergic receptors in membranes prepared from mammary tumors induced by dimethylbenz(a)anthraene (DMBA) administration in the rat. The binding of [125I]CYP to membrane preparations of DMBA-induced rat mammary tumors is rapid at room temperature, reaching half maximal specific binding at 30 min of incubation. Scatchard analysis of the data indicates that [125I]CYP binds to a single class of high affinity sites (114 ± 2.1 fmoles/mg protein) at an apparent KD value of 38.0 ± 0.3 pM. The order of potency of a series of agonists to compete for [125I]CYP binding is consistent with interaction with a β2-subtype receptor: zinterol 〉 (−)isoproterenol 〉 (−)epinephrine» (−)norepinephrine. In addition, the potency of a series of specific β1, and β2 synthetic compounds to displace [125I]CYP in mammary tumors is similar to their potency in typical β2-adrenergic tissues. The binding of [125I]CYP to DMBA-induced rat mammary tumors shows a marked stereoselectivity, the (−)isomers of isoproterenol and propranolol being 150 and 80 times more potent, respectively, than their respective enantiomers. The autoradiographic localization of [125I]CYP performed on frozen sections revealed the presence of specific β-adrenergic receptors in all the malignant cells. Spontaneous mammary tumors of aging (18–22 months) female rats have high levels of β-adrenergic receptors. Castration decreased the concentration of [125I]CYP binding sites in DMBA-induced mammary tumors. A close correlation was observed between progressing, static, and regressing tumors after ovariectomy and β-adrenergic receptor concentration. The presence of β-adrenergic receptors in mammary tumors as well as the modulation of their level by ovarian hormones provides a mechanism for catecholaminergic influence in mammary cancer tissue.
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  • 26
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    Breast cancer research and treatment 13 (1989), S. 79-87 
    ISSN: 1573-7217
    Keywords: breast cancer ; mammography ; screening ; stage ; advanced cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In screening programmes it is important to assess a preliminary effectiveness of the screening method as soon as possible in order to forecast survival figures. In March 1981 a controlled single-view mammographic screening trial for breast cancer was started in the south of Stockholm. The population invited for screening mammography consisted of 40,000 women aged 40–64 years, and 20,000 women served as a well-defined control group. The main aim of the trial was to determine whether repeated mammographic screening could reduce the mortality in the study population (SP) compared to the control population (CP). The cumulative number of advanced mammary carcinomas in the screening and the control populations from the first five years of screening have shown a tendency towards more favourable stages in the screened population aged 40–64 years. A breakdown by age suggests an effect in age group 50–59 years, but not yet in age groups 40–49 and 60–64 years. When comparing the rates of stage II+ cancer, an increased number is found in the study group. As the total rate of breast cancer is higher in SP than in CP, there ought to be a concealed group of stage II+ cancers in the CP which makes the comparison biased. A new approach has been designed, where an estimation of the ‘hidden’ number of stage II+ cancers in CP is added to the clinically detected cases, and in this respect a comparison has shown a decrease in the cumulative number of advanced cancers in the SP in relation to the CP (p〈0.05). According to this it could be important to add the estimated number of undetected, hidden cases in the control group in order to utilize the difference in detection rate in the screening- and control group respectively.
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  • 27
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    Breast cancer research and treatment 13 (1989), S. 143-151 
    ISSN: 1573-7217
    Keywords: age ; breast cancer ; menopausal status ; obesity ; oral contraceptives ; prognosis ; risk factors ; survival ; weight
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 1,121 women in northern Alberta diagnosed as having breast cancer between 1971–74 were followed for 10 years. Risk factors for breast cancer were studied with respect to their possiblé influence on survival by comparing survival curves, using both Logrank and Cox's regression model, and controlling for intercurrent death, stage and axillary node status. A complex interaction was found between age and menopausal status and survival rates. Premenopausal women aged 45–55 had a better survival rate than postmenopausal women of the same age. However, one subgroup of premenopausal women aged 35–39 had a significantly worse prognosis than those aged 40–44 as did a group of post menopausal women aged 70–74. No cause was found other than the effect of age. There was a significant trend to worsening survival with heavier weight at time of diagnosis and with breast feeding. Parity of five or more and family history of breast cancer were less consistently associated with worse survival. Oral contraceptive use was only associated with worsened prognosis significantly when stage was controlled for; there was no overall effect. Age at menarche and age at first birth did not influence prognosis. Theories to explain the findings are discussed.
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  • 28
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    Breast cancer research and treatment 13 (1989), S. 191-203 
    ISSN: 1573-7217
    Keywords: breast cancer ; frequent mutations ; loss of heterozygosity ; prognostic indicators ; tumor biology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A serious effort has been made to identify and characterize mutations that frequently occur during the evolution of primary human breast cancer. Some of these mutations involve amplification of protooncogenes (c -myc, c-erbB-2, andint-2) that have been shown to contribute to experimentally induced breast cancer in mouse model systems. Tumor development in mice containing the c -myc or c -erbB-2 transgene suggests that the cellular and developmental contexts in which the genes are expressed define their relative contribution to tumorigenesis. Homozygous deletions or loss of heterozygosity (LOH) represent another type of mutation that has been frequently observed on four chromosomes (1q, 3p, 11p, and 13q) in tumor DNA. They are thought to unmask recessive mutations (LOH) that inactivate or remove (homozygous deletion) suppressor genes that regulate normal cell proliferation. Attempts to determine whether specific mutations are associated with certain clinical parameters have led to the controversial hypothesis that some mutations may be useful prognostic indicators of the post-surgical course of the disease. The current results underscore the necessity for much larger, better control studies to unambiguously define the potential of such mutations as clinical markers.
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  • 29
    ISSN: 1573-7217
    Keywords: breast cancer ; adjuvant therapy ; prognosis ; lymphocytes ; phytohaemagglutinin responsiveness
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The response of peripheral blood lymphocytes from 153 breast cancer patients to the T-cell mitogen phytohaemagglutinin (PHA) was measured prior to surgery and patients assigned to either high (Hi/PHA) or low (Lo/PHA) PHA response groups. Patients were followed up for between 8 and 12 years, or until death. Clinical characteristics were similar in Hi/PHA and Lo/PHA groups. In the 96 patients who received no postoperative adjuvant therapy, overall and relapse-free survival was significantly longer in Hi/PHA than in Lo/PHA patients (p 〈 0.005, and p 〈 0.025 respectively); relative risk of death within 12 years was 0.52 and of relapse was 0.64. In 47 patients who were treated with radiotherapy postoperatively, there was no correlation between the PHA response and overall or relapse-free survival. The implications of these findings for the selection of breast cancer patients for adjuvant treatment following surgery are discussed.
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  • 30
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    Breast cancer research and treatment 13 (1989), S. 265-276 
    ISSN: 1573-7217
    Keywords: breast cancer ; progestins ; progesterone receptor ; antiprogestin ; insulin ; estrogens ; antiestrogens
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of R5020 [17,21-dimethyl-19-nor-4,9-pregnadiene-3,20-dione], a synthetic progestin, was studied in the hormone-responsive ZR-75-1 human breast cancer cell line. Following a 12-day incubation with increasing concentrations of R5020, the mitogenic effect of 17β-estradiol (E2,1 nM) was partially (60–80%) antagonized by the progestin, with a half-maximal effective concentration measured at about 30 pM. This effect of R5020 was completely reversed by the addition of physiological concentrations of bovine insulin, as well as by the potent antiprogestin RU486 [17β-hydroxy-11β-(4-dimethylaminophenyl)-17α-(1-propynyl)-4,9-estradien-3-one], but not by the antiandrogen hydroxyflutamide (α,α,α-trifluoro-2-methyl-4′-nitro-m-lactotoluidide). Moreover, the effect of R5020 required the presence of estrogens, thus further indicating a progesterone receptor (PgR)-mediated effect. Low (〈100 nM) concentrations of R5020 increased the specific binding of [125I]-insulin up to 2- to 2.5-fold in intact ZR-75-1 cells, an effect which was reversed by RU486. The effect was rapid, being nearly maximal after 24 h of incubation with R5020. The PgR-mediated effect of R5020 on cell proliferation was abolished by the addition of a pure steroidal antiestrogen. The present results suggest a physiological role for progestins in increasing the responsiveness to insulin, which could, in turn, reverse the antiproliferative effect of progestins on estrogen action and thus decrease the efficacy of progestins in the treatment of breast cancer.
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  • 31
    ISSN: 1573-7217
    Keywords: anti-oestrogens ; breast cancer ; prevention ; tamoxifen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The hypothesis that oestrogen is an important promotor of human breast cancer raises the possibility that endrocrine intervention could prevent the disease. Various methods of reducing oestrogenic activity have been proposed including dietary control, progestin therapy, and ovarian ablation. Tamoxifen is a synthetic anti-oestrogen of low toxicity with proven anti-proliferative activity in endocrine sensitive breast cancer which makes it an attractive alternative for a trial of endocrine prevention. We have undertaken a doubleblind placebo-controlled pilot study to assess the feasibility of mounting a large multicentre study of tamoxifen in the prevention of breast cancer in high risk women. Two hundred women were randomised to tamoxifen or placebo during an 18 month accrual period. Acute toxicity was mild and serial studies of blood lipids, clotting factors, and bone mineral density suggested that no long-term deleterious effects are likely to be seen. It is estimated that 10,000 women would be required with a 10–15 year follow up in order to detect a 25% prevention effect.
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  • 32
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    Breast cancer research and treatment 14 (1989), S. 57-64 
    ISSN: 1573-7217
    Keywords: breast cancer ; estrogen receptor ; RFLP ; alleles
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A human estrogen receptor (ER) cDNA probe was used to examine genomic DNA extracted from 59 primary invasive breast cancers. The tumors were also studied histopathologically, and their ER status was assessed by hormone-binding assay and immunohistochemical analysis. Southern blots of genomic DNA samples digested with restriction endonucleases (BamHI, EcoRI, HindIII, PvuII, XbaI) revealed identical restriction fragments for each tumor, indicating preservation of gross ER gene integrity regardless of ER status, clinical stage, or histopathologic appearance. Digestion with PvuII identified a single, two-allele polymorphism with band(s) at 1.6 and/or 0.7 kb. The homozygous 1.6 kb pattern was present in 14 (24%) patients, the heterozygous 1.6/0.7 kb pattern in 29 (49%) patients and the homozygous 0.7 kb pattern in 16 (27%) patients. The PvuII restriction fragment length polymorphism (RFLP) within the ER gene showed no correlation with the results of the ER binding assay, the immunohistochemical analysis, clinical stage, or histopathologic appearance. A significant correlation was found between the genotypes and patient age at the time of tumor diagnosis. Tumors with the homozygous 1.6 kb and the heterozygous 1.6/0.7 kb patterns were observed in older women with mean ages of 64.6 and 64.4 years, respectively. In contrast, patients with tumors containing the homozygous 0.7 kb pattern were significantly younger, with a mean age of 50.4 years (p-value = 0.0024). The mechanism by which the homozygous 0.7 kb genotype is associated with breast cancer in the premenopausal age group is unknown.
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  • 33
    ISSN: 1573-7217
    Keywords: mitoxantrone ; liver dysfunction ; breast cancer ; performance status ; bilirubin elevation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine the safety and efficacy of mitoxantrone use in hyperbilirubinemic breast cancer patients, a prospectively determined dosage schedule was evaluated in a multi-center trial. Pretreatment bilirubin prospectively defined three groups: Controls (with normal bilirubin) and two Study groups (with either moderate or severe bilirubin increase). Bilirubin determined initial mitoxantrone dose as well: bilirubin 〈 3.5 mg/dl, 14 mg/m2; and bilirubin ≥ 3.5 mg/dl, 8 mg/m2. Mitoxantrone at 14 mg/m2 was well tolerated in patients with moderate hepatic dysfunction. Patients with severe hepatic dysfunction demonstrated a mixed toxicity picture, with performance status (ECOG level 3) defining a population with limiting myelosuppression and/or early death. The survival of Study patients with severe hepatic dysfunction (median 17 days) was significantly worse than both Control (p 〈 0.01) and Study (p 〈 0.05) patients with lower bilirubin. Entry performance status (ECOG level 0–2 versus level 3) profoundly influenced survival (median survival 222 days versus 25 days, respectively, p 〈 0.0001). Objective responses were seen in patients with both normal and elevated bilirubin. Bilirubin reduction following mitoxantrone commonly occurred, representing at least an indicator of favorable prognosis. Recommendations for mitoxantrone use include: 1. Patients with moderate bilirubinemia tolerate 14 mg/m2 mitoxantrone with reasonable chance for benefit. 2. Patients with severe hepatic dysfunction and poor performance status should not be given mitoxantrone. A definitive recommendation regarding use of reduced 8 mg/m2 mitoxantrone in patients with severe hyperbilirubinemia and favorable performance status requires further study.
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  • 34
    ISSN: 1573-7217
    Keywords: breast cancer ; DNA ploidy ; estrogen receptor ; prognosis ; microspectrophotometry ; nodal status ; tumor size
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The prognostic value of nuclear DNA distribution pattern in relation to tumor size, axillary lymph node status, and estrogen receptor (ER) content was studied in 464 patients with primary, operable mammary adenocarcinoma. The median follow-up time was 3 1/2 years. Slide cytophotometric DNA analysis was performed on morphologically identified Feulgen-stained tumor cells. The tumors were classified into four subgroups according to their DNA histogram type. DNA content was significantly related to tumor size and ER level but not to nodal status. When all variables were stimultaneously introduced into Cox's proportional hazards model, tumor size, nodal status, and DNA profile remained as significant predictors of recurrence. Restricting the analysis to node-negative patients, both DNA profile and tumor size showed a significant prognostic value. DNA did not contribute significant prognostic information in node-positive patients. However, the trends in recurrence-free survival were similar to those in the node-negative subgroup: patients with aneuploid tumors tended to fare worse than those with euploid carcinomas.
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  • 35
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    Breast cancer research and treatment 13 (1989), S. 61-69 
    ISSN: 1573-7217
    Keywords: breast cancer ; adrenal steroids ; androst-5-ene-3β ; 17β-diol ; androstenedione ; aminoglutethimide ; aromatase inhibitors ; antiandrogens ; flutamide ; dimethylbenz[a]anthracene (DMBA)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of the adrenal steroids androst-5-ene-3β,17β-diol (Δ5-diol) and androstenedione (Δ4-dione) was studied on the growth of mammary carcinoma induced in the rat by dimethylbenz[a]anthracene (DMBA). The plasma levels of the two steroids were maintained at values within the range of those found in the circulation of post-menopausal women by constant release from osmotic pumps in ovariectomized animals. Δ5-diol and Δ4-dione, at the daily release rate of 500µg, led to plasma levels of 1.26±0.19 and 1.72 ± 0.75 ng/ml, respectively. At these physiologically relevant plasma concentrations, both Δ5-diol and Δ4-dione caused a marked stimulation of tumor growth while having minimal or no effect on uterine weight or on plasma prolactin and LH levels. Concomitant treatment with the aromatase inhibitor aminoglutethimide completely blocked the stimulatory effect of Δ4-dione released from silastic implants on tumor growth, while simultaneous administration of the antiandrogen flutamide had no significant effect. On the other hand, when aminoglutethimide was administered with Δ5-diol, the stimulatory effect of the adrenal steroid on tumor growth was not affected. Such data indicate that, under the present experimental conditions, transformation of Δ4-dione into androgens plays a minor role, the predominant effect of the adrenal steroid being stimulation of tumor growth through conversion into estrogens, while Δ5-diol exerts a direct estrogenic effect independent from aromatase activity. The minimal or absent effect of the same treatment on uterine weight and on plasma prolactin and LH levels indicates the tissue specificity of the effects observed, the mammary tissue being most sensitive to the action of adrenal steroids.
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  • 36
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    Investigational new drugs 7 (1989), S. 231-234 
    ISSN: 1573-0646
    Keywords: elliptinium ; Phase II study ; breast cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Eighteen patients with advanced measurable breast cancer were treated with elliptinium acetate 100 mg/m2 × 3 days every 3 weeks. Fourteen of these patients had failed prior chemotherapy. Two patients had an objective tumor response of greater than 4 weeks. Myelosuppression, renal insufficiency and thrombophlebitis were rarely encountered and alopecia was not seen at all. This study demonstrates that elliptinium has minimal activity in recurrent breast cancer with a favorable toxicity profile.
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  • 37
    ISSN: 1573-0646
    Keywords: gallium nitrate ; infusion ; breast cancer ; lymphopenia ; anemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary We evaluated the role of gallium nitrate infusion in the treatment of metastatic breast cancer. Gallium nitrate was administered at 300 mg/m2/day for 7 days every 3 weeks by continuous infusion concomitantly with oral calcium supplement of 500 mg twice daily and oral hydration. Fifteen patients with refractory metastatic breast cancer received such treatment for a total of 30 courses. Median age was 51, and median performance status (Zubrod scale) was 1. These patients had minimal prior chemotherapy (median 1 regimen). All patients were evaluable for toxicity and 14 for response. Nine patients had one to two metastatic sites, five patients had three to four sites. No major objective response was seen, but one patient had a minor response (10 weeks), and another showed no change in disease (16 weeks). Diverse low-grade toxicities were observed, including nausea and vomiting in 11 patients, anorexia in 11, diarrhea in eight, stomatitis in five, dysgeusia in six, musculoskeletal pain in five, skin rash in seven, partially reversible tinnitis and/or mild hearing loss in four and sensory neuropathy in two. A consistent drop in hemoglobin (median of 3.2 g/dL per patient) necessitated blood transfusion in seven patients. There was no granulocytopenia or thrombocytopenia; however, significant lymphopenia was noted. Reversible, moderate nephrotoxicity occurred in two patients. The hypocalcemic effect was consistent, with a median drop in serum calcium of 1.25 mg/dL per course. There was no hepatic toxicity. While no single toxicity was severe, overall toxicity adversely influenced treatment tolerance. Gallium nitrate by continuous infusion, as given in this study, has no activity in metastatic breast cancer.
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