ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00231.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00232.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:The spectrum of epithelial proliferations within the mammary duct system includes lobular, ductal, and papillary patterns of proliferation. Among those with a ductal growth pattern, the highest proportion qualifies as ordinary intraductal hyperplasia (IDH), a small proportion shows atypical intraductal hyperplasia (AIDH), and a steadily increasing percentage is composed of intraductal carcinomas (IDCA). AIDH and some variants of IDCA share many characteristics and their distinction can be quite troublesome, in some cases relying completely on an arbitrary quantitative criterion. IDH, however, is quite distinctive from both a morphologic and biologic standpoint and should not be confused with AIDH.This review discusses our criteria for diagnosing IDH, AIDH, and IDCA, followed by a review of the common subtypes of IDCA and a presentation of our approach to grading IDCA. The clinical significance and expression of estrogen and progesterone receptor (ER and PR), as well as expression of Ki67 and p53 in IDH, AIDH, and various grades of IDCA are presented.

ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00233.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:It is generally accepted that women with axillary node‐negative minimally invasive breast cancers (≤1 cm) are not candidates for systemic therapy because of their low risk for distant metastases and excellent overall prognosis. However, recent studies have suggested that a subset of these patients may have a significant risk of failure. In this study, 188 women with axillary node‐negative minimally invasive breast cancer (≤1 cm) were treated with conservative surgery and radiation. Their median age was 56 years. The median followup was 6.2 years. The following factors were analyzed for their ability to predict for freedom from distant metastases, distant disease‐free survival, and cause‐specific survival: patient age, method of detection of the primary, tumor size, estrogen and progesterone receptor status, and lymphatic invasion.The ten year actuarial distant disease‐free survival, cause‐specific, and overall survival were 80%, 94%, 92% respectively. There were no significant prognostic factors for freedom from distant metastases or distant disease‐free survival although young women and those with estrogen receptor negative tumors had a 20–25% risk of distant disease at ten years. The median interval to distant metastases was five years. Estrogen receptor negativity was a significant prognostic factor for cause‐specific survival (ten year 81%).We have identified a subgroup of patients with axillary node‐negative minimally invasive breast cancer (≤ 1 cm) whose risk of distant failure at ten years is 20% or greater. These patients are characterized by young age and estrogen receptor negativity and may be candidates for adjuvant systemic therapy. We await confirmation

ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00234.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:The timing of surgery of breast cancer patients has been reported to impact recurrence and survival. It is well known that surgical manipulation of tumor induces micrometastasis. During the menstrual cycle, profound hormonal changes occur affecting the local environment of the breast and breast cancer. A significant amount of scientific research now suggests that estrogen may establish an environment more likely to produce micrometastasis, and an immune system less likely to manage micrometastasis. Progesterone may protect against the effects of estrogen, leading to improved disease‐free and overall survival during the luteal phase. The studies examining this association are conflicting, but claim a 30% advantage for those patients undergoing surgery during progesterone predominance. A solid prospective study examining this possible benefit has yet to be performed. Until then, no harm can come from scheduling patients for surgery during the early luteal phase, and these patients may actually have a significant improved survival over those whose tumors are excised during the follicular phas

ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00235.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:Results of estrogen and progestin determinations are used routinely to predict a breast cancer patient's response to endocrine therapy and to assess prognosis. Because the sizes of breast carcinoma biopsies are decreasing with earlier detection, the enzyme immunoassay procedure is used with greater frequency. This investigation compared the levels of estrogen and progestin receptors determined with this method in three size groups (≤ 0.1 g, 0.1–0.2 g,>0.2 g) of biopsies of 1,945 primary breast carcinomas and 201 lymph node metastases. Similar comparisons were made with biopsies of endometrial and ovarian carcinomas. Using the Kruskal‐Wallis and the Mann‐Whitney statistic analyses, an insignificant difference in results was obtained for either estrogen or progestin receptors in the lowest (≤ 0.1 g) size group compared to either the group containing the biopsies weighing between 0.1 and 0.2 g or the group weighing more than 0.2 g. These data support our contention that the enzyme immunoassay can be used with confidence to measure steroid hormone receptors in biopsies weighing as little as 50–100 mg. We recommend the immunohistochemical analysis should be employed primarily for biopsies weighing less

ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00236.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00237.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00238.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:1075-122X    

DOI:10.1111/j.1524-4741.1995.tb00239.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY