ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Breast cancer remains the leading cause of death in American women 30 to 70 years of age, and research in the field of breast cancer continues at an explosive pace. Our understanding of the molecular basis of familial breast cancer has advanced significantly through investigation of the tumor suppressor geneBRCA1, as has our knowledge of the role of theATMgene and predisposition to breast cancer in ataxia-telangiectasia carriers. In addition, progress has been made in understanding the role of HER-2/neu as a prognostic factor in breast cancer. In this review, some of the recent advances in breast cancer biology that are relevant to these areas of study are highlighted.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Globally, breast cancer is the third most common form of cancer and the most common among women. The age-adjusted incidence rates of breast cancer are 176% higher in developed than in developing nations. Male breast cancer is rare, but important studies provided risk factor information for comparison with studies of female breast cancer.There has been considerable interest in a possible role of organochlorines and polychlorinated biphenyls in the etiology of breast cancer, but the results of several null studies indicate the likelihood of such associations is extremely remote, providing reassuring news for the public.Prophylactic mastectomy was observed to significantly reduce a woman’s chances of developing breast cancer, but it does not lower the risk to zero. Tamoxifen was found to be an effective chemopreventive agent in the Breast Cancer Prevention Trial, but this result was not replicated in two randomized trials in Europe. Striking reductions in the risk for breast cancer were observed for raloxifene in a randomized, placebo-controlled trial that had been designed for the prevention of osteoporosis. A large-scale, randomized trial of tamoxifen-verus-raloxifene among women at increased risk for developing breast cancer is now underway.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Evaluation of tissue and cellular samples for diagnosis, risk assessment, and prognosis in breast cancer is the subject of this review. We emphasize indicators of elevated risk for breast cancer and carcinomasin situand indicators of good prognosis in invasive breast cancer. The importance of ductal carcinomain situto considerations in breast conservation and prevention is highlighted. Special types of breast cancer, immunohistochemistry, histologic grading, and the relevance of core biopsy to diagnostic certainty are considered. We also add a brief note about the escalating role of nodal micrometastases and sentinel node biopsy in the definition of minimal regional disease.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This year (1999) has been filled with new information on the prevention of breast cancer and new literature trying to address some of the long-term adverse consequences of our surgical therapies. As the complexities of our therapies continue to increase at exponential rates, we now also have the ability to more accurately predict the consequences of both our therapeutic actions and our failure to act. Nowhere is this more evident than in the literature devoted to long-term consequences of treatment for breast cancer. As we are more successful in achieving our goals of increased survival from this dreaded disease, the future needs of these long-term survivors must play an ever-increasing role in our current management. Advances reported this year are laying down a new basis for efforts to improve the quality of life for breast cancer survivors.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Randomized trials have demonstrated the efficacy of radiation therapy in the treatment of breast cancer. A reduction in the risk of recurrence has been shown in breast conservation for ductal carcinoma in situ and in invasive cancers after breast conservation and mastectomy. The importance of local control in breast cancer is becoming more apparent. Defining the groups of patients who most benefit from the therapy and improving treatment delivery systems to enhance the therapeutic index are ongoing challenges.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

New data continue to refine our knowledge of systemic therapy for breast cancer. These include the third Oxford Overview on adjuvant systemic therapy, a small advantage of anthracycline regimens over CMF (cyclophosphamide, methotrexate, and 5-fluorouracil), and renewed interest in the “classic CMF” regimen. Primary chemotherapy offers a greater chance of breast conservation (although no survival advantage), and tamoxifen also benefits women with noninvasive disease. New data are available on biphosphonates, ovarian ablation, anti-estrogens, anti–HER-2 (human epidermal growth factor receptor-2) antibody, and HER-2 expression as a predictive or prognostic factor. Early results of high-dose chemotherapy have been released, and the role of taxanes in early and advanced disease continues to expand. This article reviews these and other recent advances.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Recent investigation further defines the role of p53 and of signaling events upstream and downstream of p53 in apoptosis following drug-induced DNA damage. The transcription factors NF-κB and AP-1 can be activated, and then directly transactivate FasL in response to chemotherapeutic agents. Death receptors for FasL (Fas) and for TRAIL (DR4, DR5) are emerging as important regulators of drug-induced apoptosis in human cancers, mediated by caspase activation. Apoptosis has been accepted as the predominant mechanism of drug-induced cell death in preclinical experimental models and in clinically sensitive tumors. However, drug-induced cell death can include acute or delayed apoptosis, necrosis, or a delayed mitotic death, and require further delineation for their relative contribution to tumor responsesin vivo.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

DNA topoisomerases catalyze changes in the topology of DNA. Recently, other functions have also been reported for these enzymes. For example, topoisomerase I participates in transcription by RNA polymerases I, II, and III, and also has a kinase activity. Topoisomerase I binds directly to at least two helicases, nucleolin and SV40 T antigen, and mechanistic studies show that T antigen alters the function of topoisomerase I. Additional protein and nucleotide interactions for both topoisomerases I and II suggest that each protein is multifunctional. It may be that the multifunctional nature of these enzymes is the basis for the antitumor activity seen with inhibitors of these enzymes. Clinical trials with combinations of CPT-11 and 5-fluorouracil for the treatment of colon cancer, and preclinical studies with CPT-11 and vincristine are particularly encouraging. Protracted schedules of administration of topoisomerase inhibitors will likely have greater antitumor effect than more concentrated, higher dose exposures, but a systematic determination of optimal schedules of administration is needed.

ISSN:1040-8746    

出版商:OVID    

年代:1999

数据来源: OVID