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1. De Cesare A, Burza A, Fiori E, Bononi M, Volpino P, Leone G, Crocetti A, Cangemi V: Assessment of surgical treatment in elderly patients with breast cancer. Tumori; 2008 May-Jun;94(3):314-9
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  • [Title] Assessment of surgical treatment in elderly patients with breast cancer.
  • AIMS AND BACKGROUND: The incidence of breast cancer increases with advancing age and in clinical practice approximately 50% of new cases occur in women over the age of 65 years.
  • Although breast cancer in elderly patients presents more favorable biological characteristics than similar-stage cancer in younger women, disease control still remains uncertain and is becoming a major health problem.
  • PATIENTS AND METHODS: Between 1984 and 2006, 133 patients aged over 65 with operable breast cancer underwent surgical treatment.
  • Patients with ductal or lobular carcinoma in situ, bilateral breast cancer or a previous malignancy were excluded.
  • Breast-conserving surgery was performed in patients with early breast cancer (T1, T2 < 2.5 cm), while most patients with advanced tumors (T2 >2.5 cm, T3, T4) were treated by modified radical mastectomy.
  • Eighty-nine patients underwent adjuvant therapy (chemotherapy, hormonal therapy).
  • The overall mortality from breast cancer was 11%, whereas the cancer-unrelated mortality was 9%.
  • CONCLUSION: There is no evidence that breast cancer has a more favorable prognosis in the elderly and surgical procedures should be carried out as has been established in younger women.
  • However, in the absence of serious comorbid disease, they are able to withstand standard multimodal treatment options as well as do younger patients.
  • [MeSH-major] Breast Neoplasms / pathology. Breast Neoplasms / surgery. Mastectomy
  • [MeSH-minor] Aged. Aged, 80 and over. Axilla. Biomarkers, Tumor / analysis. Carcinoma in Situ / surgery. Carcinoma, Ductal, Breast / surgery. Carcinoma, Lobular / surgery. Disease Progression. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Neoplasm Staging. Receptors, Estrogen / analysis. Receptors, Progesterone / analysis. Retrospective Studies. Treatment Outcome

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  • (PMID = 18705397.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Receptors, Estrogen; 0 / Receptors, Progesterone
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2. Maughan KL, Lutterbie MA, Ham PS: Treatment of breast cancer. Am Fam Physician; 2010 Jun 1;81(11):1339-46
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  • [Title] Treatment of breast cancer.
  • Understanding breast cancer treatment options can help family physicians care for their patients during and after cancer treatment.
  • This article reviews typical treatments based on stage, histology, and biomarkers.
  • Lobular carcinoma in situ does not require treatment.
  • Ductal carcinoma in situ can progress to invasive cancer and is treated with breast-conserving surgery and radiation therapy without further lymph node exploration or systemic therapy.
  • Stages I and II breast cancers are usually treated with breast-conserving surgery and radiation therapy.
  • Radiation therapy following breast-conserving surgery decreases mortality and recurrence.
  • Sentinel lymph node biopsy is considered for most breast cancers with clinically negative axillary lymph nodes, and it does not have the adverse effects of arm swelling and pain that are associated with axillary lymph node dissection.
  • Choice of adjuvant systemic therapy depends on lymph node involvement, hormone receptor status, ERBB2 (formerly HER2 or HER2/neu) overexpression, and patient age and menopausal status.
  • In general, node-positive breast cancer is treated systemically with chemotherapy, endocrine therapy (for hormone receptor-positive cancer), and trastuzumab (for cancer overexpressing ERBB2).
  • Anthracycline- and taxane-containing chemotherapeutic regimens are active against breast cancer.
  • Stage III breast cancer typically requires induction chemotherapy to downsize the tumor to facilitate breast-conserving surgery.
  • Inflammatory breast cancer, although considered stage III, is aggressive and requires induction chemotherapy followed by mastectomy, rather than breastconserving surgery, as well as axillary lymph node dissection and chest wall radiation.
  • Prognosis is poor in women with recurrent or metastatic (stage IV) breast cancer, and treatment options must balance benefits in length of life and reduced pain against harms from treatment.
  • [MeSH-major] Breast Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Humans. Mastectomy. Neoplasm Staging. Sentinel Lymph Node Biopsy

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  • [CommentIn] Am Fam Physician. 2010 Jun 1;81(11):1330-2 [20521750.001]
  • [CommentIn] Am Fam Physician. 2011 Mar 1;83(5):507; author reply 507 [21391515.001]
  • [CommentIn] Am Fam Physician. 2011 Mar 1;83(5):502-6; author reply 507 [21391514.001]
  • [CommentIn] Am Fam Physician. 2010 Jun 1;81(11):1347-9 [20527363.001]
  • (PMID = 20521754.001).
  • [ISSN] 1532-0650
  • [Journal-full-title] American family physician
  • [ISO-abbreviation] Am Fam Physician
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 63
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3. Stearns V, Coop A, Singh B, Gallagher A, Yamauchi H, Lieberman R, Pennanen M, Trock B, Hayes DF, Ellis MJ: A pilot surrogate end point biomarker trial of perillyl alcohol in breast neoplasia. Clin Cancer Res; 2004 Nov 15;10(22):7583-91
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  • [Title] A pilot surrogate end point biomarker trial of perillyl alcohol in breast neoplasia.
  • PURPOSE: Efficient strategies to screen promising agents in early phase development are essential for rapid progress in breast cancer chemoprevention.
  • We report our experience with the natural compound perillyl alcohol (POH) administered in a short-term surrogate end point biomarker (SEB) protocol, using the "window" between diagnostic and definitive surgery.
  • EXPERIMENTAL DESIGN: Eligible patients included those with a diagnosis of atypical ductal hyperplasia, ductal carcinoma in situ, lobular carcinoma in situ, or invasive carcinoma (<3 cm in size) that required further surgery.
  • The power to observe changes in candidate SEB was diminished by a 44% incidence of cases in which the index lesion was not present in the definitive surgical specimen.
  • CONCLUSIONS: Preoperative POH exposure was safe and suitable for a more definitive phase II SEB study.
  • Further investigations must overcome logistical obstacles to accrual, and they must focus on approaches to maximize tissue collection and to incorporate genomic analysis of target lesions.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Biomarkers, Tumor. Breast Neoplasms / drug therapy. Monoterpenes / therapeutic use
  • [MeSH-minor] Aged. Apoptosis. Biomarkers. Biopsy. Carcinoma in Situ. Carcinoma, Intraductal, Noninfiltrating / drug therapy. Cell Proliferation. Cohort Studies. Female. Humans. Immunohistochemistry. Middle Aged. Pilot Projects. Time Factors. Treatment Outcome

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  • (PMID = 15569989.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CN / N01-CN-65003
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers; 0 / Biomarkers, Tumor; 0 / Monoterpenes; 319R5C7293 / perilla alcohol
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4. Tong AW, Papayoti MH, Netto G, Armstrong DT, Ordonez G, Lawson JM, Stone MJ: Growth-inhibitory effects of CD40 ligand (CD154) and its endogenous expression in human breast cancer. Clin Cancer Res; 2001 Mar;7(3):691-703
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  • [Title] Growth-inhibitory effects of CD40 ligand (CD154) and its endogenous expression in human breast cancer.
  • We examined the growth outcome of CD40 ligation in human breast cancer cells, using CD40+ (T47D and BT-20) and CD40-negative (MCF-7, ZR-75-1) cell lines as defined by flow cytometric analysis, immunohistochemistry, and reverse transcription-PCR.
  • Treatment with the soluble recombinant CD40 ligand (CD40L) molecules gp39 or CD40L-trimer significantly reduced [3H]thymidine uptake in BT-20 and T47D cells by up to 40%, but did not affect the growth of CD40-negative MCF-7 or ZR-75-1 cells.
  • Untransfected L cells and non-CD40L-expressing lymphocytes did not produce significant growth inhibition.
  • Pretreatment with two different soluble recombinant CD40L constructs (CD40L and gp39) produced similar xenograft growth-inhibitory effects [67 +/- 24% (n = 4), and 65 +/- 14% (n = 8) inhibition, respectively], which were reversed by co-treatment with the CD40L-neutralizing antibody LL48.
  • Thirty-one and 27% of gp39-treated T47D and BT-20 cells underwent apoptosis, respectively, as compared with 56 and 65% from the same cell lines after treatment with the Fas agonistic antibody CH-11.
  • To explore the clinical relevance of CD40L-CD40 interaction, retrospective immunohistochemical analysis was carried to characterize in situ CD40- and CD40L-expression in breast cancer patient biopsies.
  • All of the infiltrating ductal (5 of 5 cases tested) and lobular (4 of 4 cases) breast carcinomas, carcinomas in situ (6 of 6 cases), and mucinous carcinoma tested (1 case) expressed CD40.
  • Varying proportions of tumor cells also expressed CD40L in the majority of infiltrating ductal (3 of 5 cases) and lobular (3 of 4 cases) carcinomas, and carcinomas in situ (4 of 6 cases), as determined by immunohistochemistry and validated by RT-PCR detection of the CD40L message in only CD40L positive-staining cases.
  • Tumor infiltrating mononuclear cells from infiltrating carcinomas and carcinomas in situ expressed CD40 (10 of 10 cases), but less commonly CD40L (1 case of infiltrating lobular carcinoma, 2 cases of carcinoma in situ).
  • Our findings indicate that the CD40 signaling pathway is active in human breast carcinoma cells.
  • However, tumor-infiltrating lymphocytes from primary tumor tissues may be limited in their capacity to directly modulate tumor growth through the CD40L-CD40 loop.
  • [MeSH-major] Breast Neoplasms / drug therapy. Breast Neoplasms / metabolism. CD40 Ligand / biosynthesis. CD40 Ligand / pharmacology
  • [MeSH-minor] Animals. Annexin A5 / metabolism. Antigens, CD40 / metabolism. Apoptosis. Blotting, Western. Carcinoma / metabolism. Cell Division / drug effects. Dimerization. Flow Cytometry. Humans. Immunohistochemistry. In Situ Nick-End Labeling. Leukocytes, Mononuclear / metabolism. Mice. Mice, SCID. Neoplasm Transplantation. Recombinant Proteins / metabolism. Reverse Transcriptase Polymerase Chain Reaction. Ribonucleases / metabolism. Thymidine / metabolism. Time Factors. Transfection. Tumor Cells, Cultured. Up-Regulation

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  • (PMID = 11297266.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Annexin A5; 0 / Antigens, CD40; 0 / Recombinant Proteins; 147205-72-9 / CD40 Ligand; EC 3.1.- / Ribonucleases; VC2W18DGKR / Thymidine
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5. Sasson AR, Fowble B, Hanlon AL, Torosian MH, Freedman G, Boraas M, Sigurdson ER, Hoffman JP, Eisenberg BL, Patchefsky A: Lobular carcinoma in situ increases the risk of local recurrence in selected patients with stages I and II breast carcinoma treated with conservative surgery and radiation. Cancer; 2001 May 15;91(10):1862-9
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  • [Title] Lobular carcinoma in situ increases the risk of local recurrence in selected patients with stages I and II breast carcinoma treated with conservative surgery and radiation.
  • BACKGROUND: Lobular carcinoma in situ (LCIS) is a known risk factor for the development of invasive breast carcinoma.
  • However, little is known regarding the impact of LCIS in association with an invasive carcinoma on the risk of an ipsilateral breast tumor recurrence (IBTR) in patients who are treated with conservative surgery (CS) and radiation therapy (RT).
  • The purpose of this study was to examine the influence of LCIS on the local recurrence rate in patients with early stage breast carcinoma after breast-conserving therapy.
  • METHODS: Between 1979 and 1995, 1274 patients with Stage I or Stage II invasive breast carcinoma were treated with CS and RT.
  • The median follow-up time was 6.3 years.
  • RESULTS: LCIS was present in 65 of 1274 patients (5%) in the study population.
  • LCIS was more likely to be associated with an invasive lobular carcinoma (30 of 59 patients; 51%) than with invasive ductal carcinoma (26 of 1125 patients; 2%).
  • Ipsilateral breast tumor recurrence (IBTR) occurred in 57 of 1209 patients (5%) without LCIS compared with 10 of 65 patients (15%) with LCIS (P = 0.001).
  • The 10-year cumulative incidence rate of IBTR was 6% in women without LCIS compared with 29% in women with LCIS (P = 0.0003).
  • In both groups, the majority of recurrences were invasive.
  • The 10-year cumulative incidence rate of IBTR in patients who received tamoxifen was 8% when LCIS was present compared with 6% when LCIS was absent (P = 0.46).
  • Subsets of patients in which the presence of LCIS was associated with an increased risk of breast recurrence included tumor size < 2 cm (T1), age < 50 years, invasive ductal carcinoma, negative lymph node status, and the absence of any adjuvant systemic treatment (chemotherapy or hormonal therapy) (P < 0.001).
  • LCIS margin status, invasive lobular carcinoma histology, T2 tumor size, and positive axillary lymph nodes were not associated with an increased risk of breast recurrence in these women.
  • CONCLUSIONS: The authors conclude that the presence of LCIS significantly increases the risk of an ipsilateral breast tumor recurrence in certain subsets of patients who are treated with breast-conserving therapy.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma in Situ / pathology. Carcinoma, Lobular / pathology. Neoplasm Recurrence, Local / diagnosis

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  • [Copyright] Copyright 2001 American Cancer Society.
  • (PMID = 11346867.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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6. Cocquyt V, Van Belle S: Lobular carcinoma in situ and invasive lobular cancer of the breast. Curr Opin Obstet Gynecol; 2005 Feb;17(1):55-60
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  • [Title] Lobular carcinoma in situ and invasive lobular cancer of the breast.
  • PURPOSE OF REVIEW: The incidence of lobular carcinoma in situ and invasive lobular carcinoma of the breast is increasing.
  • Recent data suggest that lobular carcinoma in situ is an indolent precursor for breast cancer, rather than a pure risk factor.
  • The risk of contralateral carcinoma and of multifocality of invasive lobular carcinoma is higher than for invasive ductal carcinoma.
  • Conventional mammography or ultrasonography cannot always give useful preoperative information about the extent of lobular cancers.
  • RECENT FINDINGS: The risk of invasive carcinoma after lobular carcinoma in situ is increased.
  • Invasive carcinoma is usually located at the index point of lobular carcinoma in situ and is of lobular histology.
  • Dynamic contrast-enhanced magnetic resonance imaging can be useful in the detection and preoperative staging of invasive lobular carcinoma.
  • The risk of local recurrence is high in patients with invasive lobular carcinoma.
  • Mastectomy and breast reconstruction could be an option in selected patients.
  • The response to preoperative chemotherapy is worse for invasive lobular carcinoma compared with invasive ductal carcinoma, with a greater need for rescue mastectomy.
  • SUMMARY: Lobular carcinoma in situ and invasive lobular carcinoma are different entities from ductal carcinoma in situ and invasive lobular carcinoma.
  • Their biological profile should be studied further in order to make the fine tuning of treatment possible.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Breast Neoplasms / surgery. Carcinoma in Situ / surgery. Carcinoma, Lobular / surgery
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Humans. Incidence. Magnetic Resonance Imaging. Mastectomy, Radical. Mastectomy, Segmental. Neoplasm Invasiveness. Neoplasm Recurrence, Local / epidemiology. Neoplasm Recurrence, Local / etiology. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Preoperative Care. Prognosis. Risk Factors. Sentinel Lymph Node Biopsy. Survival Rate

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  • (PMID = 15711412.001).
  • [ISSN] 1040-872X
  • [Journal-full-title] Current opinion in obstetrics & gynecology
  • [ISO-abbreviation] Curr. Opin. Obstet. Gynecol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 38
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7. Mathieu MC, Rouzier R, Llombart-Cussac A, Sideris L, Koscielny S, Travagli JP, Contesso G, Delaloge S, Spielmann M: The poor responsiveness of infiltrating lobular breast carcinomas to neoadjuvant chemotherapy can be explained by their biological profile. Eur J Cancer; 2004 Feb;40(3):342-51
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  • [Title] The poor responsiveness of infiltrating lobular breast carcinomas to neoadjuvant chemotherapy can be explained by their biological profile.
  • The aim of this study was to determine the chemosensitivity of infiltrating lobular breast carcinoma (ILC) in comparison with infiltrating ductal carcinoma (IDC).
  • Between 1987 and 1995, 457 patients with invasive T2>3 cm-T4 breast carcinomas were treated with primary chemotherapy (CT), surgery, radiation therapy.
  • Clinical response, the possibility of breast preservation, pathological response and survival were evaluated according to the histological type.
  • ILC was an independent predictor of a poor clinical response (P=0.02) and ineligibility for breast-conserving surgery after neoadjuvant chemotherapy (P=0.03).
  • Preoperative CT did not allow a high rate of conservative treatment for ILC and therefore the use of neoadjuvant CT for ILC patients should be questioned.
  • [MeSH-major] Breast Neoplasms / drug therapy. Carcinoma, Ductal, Breast / drug therapy. Carcinoma, Lobular / drug therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Female. Follow-Up Studies. Humans. Immunohistochemistry. Mastectomy / methods. Middle Aged. Survival Analysis. Treatment Failure

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  • (PMID = 14746851.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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8. Chen P, Hu WM, Wang PH, Suen JH: Recurrent breast cancer presents as a single solid ovarian mass and ascites. Taiwan J Obstet Gynecol; 2006 Dec;45(4):356-9
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  • [Title] Recurrent breast cancer presents as a single solid ovarian mass and ascites.
  • However, aside from the primary origin, a metastatic lesion should be considered, since the ovary is frequently metastasized from cancers of other organs, such as the genital tract, gastrointestinal tract, and breast.
  • Herein, we report the case of a patient with a left adnexal mass and ascites to emphasize consideration of metastatic ovarian tumors from non-gynecologic organs.
  • CASE REPORT: A 47-year-old woman with a history of right breast infiltrating lobular carcinoma, T3N0M0, grade 3, was treated with modified radical mastectomy and axillary lymph-node dissection in July 2001.
  • Therefore, she underwent palliative radiotherapy and various kinds of chemotherapy.
  • Ovarian cancer was suspected, and exploratory laparotomy was performed.
  • However, metastatic carcinoma of the ovary of breast origin was finally diagnosed.
  • [MeSH-major] Ascites / etiology. Breast Neoplasms / pathology. Carcinoma / secondary. Ovarian Neoplasms / secondary

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  • (PMID = 17175500.001).
  • [ISSN] 1875-6263
  • [Journal-full-title] Taiwanese journal of obstetrics & gynecology
  • [ISO-abbreviation] Taiwan J Obstet Gynecol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
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9. Hershman D, Sundararajan V, Jacobson JS, Heitjan DF, Neugut AI, Grann VR: Outcomes of tamoxifen chemoprevention for breast cancer in very high-risk women: a cost-effectiveness analysis. J Clin Oncol; 2002 Jan 01;20(1):9-16
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  • [Title] Outcomes of tamoxifen chemoprevention for breast cancer in very high-risk women: a cost-effectiveness analysis.
  • PURPOSE: To estimate the effects on survival, quality-adjusted survival, and health care costs of using tamoxifen for primary prevention in subgroups of women at very high risk for breast cancer.
  • PATIENTS AND METHODS: A decision analysis was performed using a hypothetical cohort of women that included subgroups with atypical hyperplasia, Gail risk greater than 5, lobular carcinoma-in-situ, or two or more first-degree relatives with breast cancer.
  • Data sources were the Breast Cancer Prevention Trial, the Surveillance, Epidemiology, and End-Results program, time trade-off preference ratings, the Group Health Cooperative of Puget Sound, and the United States Health Care Financing Administration.
  • CONCLUSION: Chemoprevention with tamoxifen may be particularly beneficial to women with atypical hyperplasia, 5-year Gail model risk greater than 5%, lobular carcinoma-in-situ, or two or more first-degree relatives with breast cancer.
  • The benefits may be greater if tamoxifen is initiated before age 50 years rather than after and if the breast cancer risk reduction conferred by tamoxifen lasts longer than 5 years.
  • For women with a very high risk of invasive breast cancer, chemoprevention with tamoxifen seems to be cost-effective.
  • [MeSH-major] Anticarcinogenic Agents / therapeutic use. Breast Neoplasms / prevention & control. Drug Costs. Quality-Adjusted Life Years. Tamoxifen / therapeutic use
  • [MeSH-minor] Adult. Breast / pathology. Carcinoma in Situ / drug therapy. Carcinoma, Lobular / drug therapy. Cost-Benefit Analysis. Decision Support Techniques. Female. Humans. Hyperplasia / drug therapy. Markov Chains. Middle Aged. Risk

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  • [CommentIn] J Clin Oncol. 2002 Jan 1;20(1):1-3 [11773145.001]
  • (PMID = 11773148.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA 13696-26; United States / NCI NIH HHS / CA / T32-CA 09529
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anticarcinogenic Agents; 094ZI81Y45 / Tamoxifen
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10. Kramer R, Brown P: Should tamoxifen be used in breast cancer prevention? Drug Saf; 2004;27(13):979-89
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  • [Title] Should tamoxifen be used in breast cancer prevention?
  • Breast cancer is the most commonly diagnosed cancer in women.
  • The risk of developing breast cancer can be lowered by maintaining a healthy bodyweight and avoiding long-term use of combined estrogen and progestogen replacement after menopause.
  • However, many women are at an increased risk of developing breast cancer secondary to age, early menarche, a family history of breast cancer or a personal history of benign breast disease.
  • These women may now be offered tamoxifen as a chemoprevention therapy.
  • Five years of tamoxifen treatment results in a reduction in the relative risk of developing estrogen receptor-positive breast cancer of 48%.
  • The randomized clinical trials evaluating standard-dose tamoxifen versus placebo as chemoprevention therapy are reviewed and analyzed to determine which particular women are most likely to benefit and least likely to experience a tamoxifen-related adverse event.
  • Tamoxifen decreases the risk of breast cancer associated with aging, having a first-degree relative with disease, and a personal diagnosis of atypical ductal hyperplasia or lobular carcinoma in situ.
  • Women who have had a hysterectomy and are at low risk of a thromboembolic event have a decreased risk of adverse effects associated with tamoxifen therapy.
  • The strengths and weaknesses of the Gail model (frequently used to assess an individual's risk of developing invasive breast cancer over the next 5 years) are highlighted.
  • Alternative breast cancer chemoprevention strategies are considered, including the use of aromatase inhibitors.
  • This article discusses the pros and cons of these various preventive therapies and concludes that at this time, tamoxifen remains the gold standard for breast cancer prevention.
  • [MeSH-major] Anticarcinogenic Agents / therapeutic use. Breast Neoplasms / prevention & control. Tamoxifen / therapeutic use

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  • [Cites] Lancet. 2002 Sep 14;360(9336):817-24 [12243915.001]
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  • (PMID = 15471505.001).
  • [ISSN] 0114-5916
  • [Journal-full-title] Drug safety
  • [ISO-abbreviation] Drug Saf
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P50 CA58183
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] New Zealand
  • [Chemical-registry-number] 0 / Anticarcinogenic Agents; 094ZI81Y45 / Tamoxifen
  • [Number-of-references] 58
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11. Buzdar AU: Tamoxifen's clinical applications: old and new. Arch Fam Med; 2000 Sep-Oct;9(9):906-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The American Cancer Society estimates that this year more than 180, 000 women in the United States will develop breast cancer and more than 40,000 women will die of the disease.
  • According to a National Cancer Institute model, 5 years of preventive therapy with tamoxifen citrate reduced the risk of invasive breast cancer by 49% (P<.00001) in women at increased risk for breast cancer.
  • The reduction in risk was greater in women with a history of lobular carcinoma in situ (LCIS; 56% relative risk reduction) or atypical hyperplasia (86% relative risk reduction).
  • Because elevated risks of uterine cancer and thromboembolic disease have been associated with tamoxifen therapy, appropriate counseling should be given to any woman considering tamoxifen as a means of reducing breast cancer risk.
  • [MeSH-major] Anticarcinogenic Agents / therapeutic use. Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms / drug therapy. Breast Neoplasms / prevention & control. Tamoxifen / therapeutic use
  • [MeSH-minor] Adult. Aged. Breast Neoplasms, Male / drug therapy. Breast Neoplasms, Male / mortality. Breast Neoplasms, Male / prevention & control. Carcinoma in Situ / drug therapy. Europe / epidemiology. Female. Humans. Male. Middle Aged. North America / epidemiology. Patient Selection. Receptors, Estrogen. Survival Analysis

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  • (PMID = 11031399.001).
  • [ISSN] 1063-3987
  • [Journal-full-title] Archives of family medicine
  • [ISO-abbreviation] Arch Fam Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Anticarcinogenic Agents; 0 / Antineoplastic Agents, Hormonal; 0 / Receptors, Estrogen; 094ZI81Y45 / Tamoxifen
  • [Number-of-references] 30
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12. Lewis JP: The Breast Cancer Continuum: insights from the tamoxifen trials impact future drug development strategies. Ann N Y Acad Sci; 2001 Dec;949:327-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The Breast Cancer Continuum: insights from the tamoxifen trials impact future drug development strategies.
  • The Breast Cancer Continuum includes women at high risk, as in the Breast Cancer Prevention Trial; those with a history of atypical ductal hyperplasia (ADH) or lobular carcinoma in situ (LCIS); women with ductal carcinoma in situ (DCIS); those with <1 cm invasive disease or node-negative or node-positive disease; and those at risk of developing contralateral breast cancer.
  • Women in all these categories benefit from therapeutic intervention with tamoxifen because each clinical state is associated with a certain probability of having early undiagnosed invasive breast cancer responsive to tamoxifen.
  • This framework, relating these disorders to each other through their 5-year incidence of developing invasive breast cancer, leads to important conclusions relative to pharmaceutical drug development strategies, including chemoprevention investigations.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms / drug therapy. Breast Neoplasms / prevention & control. Selective Estrogen Receptor Modulators / therapeutic use. Tamoxifen / therapeutic use
  • [MeSH-minor] Clinical Trials as Topic. Disease Progression. Drug Design. Female. Humans. Treatment Outcome

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  • (PMID = 11795371.001).
  • [ISSN] 0077-8923
  • [Journal-full-title] Annals of the New York Academy of Sciences
  • [ISO-abbreviation] Ann. N. Y. Acad. Sci.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Selective Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen
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13. Silberfein EJ, Hunt KK, Broglio K, Shen J, Sahin A, Le-Petross H, Oh J, Litton J, Hwang RF, Mittendorf EA: Clinicopathologic factors associated with involved margins following breast conserving surgery for invasive lobular carcinoma (ILC). J Clin Oncol; 2009 May 20;27(15_suppl):e11528

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinicopathologic factors associated with involved margins following breast conserving surgery for invasive lobular carcinoma (ILC).
  • This has resulted in difficulty obtaining negative margins at the time of breast conserving surgery.
  • Clinical data including radiographic appearance, biopsy method, initial surgical procedure (segmental vs. total mastectomy), and use of neoadjuvant chemotherapy were noted.
  • Pathologic data included margin status (negative (>2mm), close (0-2mm), or positive), multifocality, multicentricity, ILC subtype, grade, associated LCIS or DCIS, hormone receptor status and HER2 status.
  • RESULTS: 110 (52%) patients underwent total mastectomy and 101 (48%) underwent segmental mastectomy as their initial procedure.
  • Having an excisional biopsy for diagnosis was also associated with need for multiple surgeries (p < .0001).
  • Breast conserving surgery was ultimately successful in 86 patients (85%).
  • CONCLUSIONS: The majority of patients with ILC can undergo successful breast conserving surgery.
  • Diagnosis by excisional biopsy makes subsequent imaging less reliable and results in the need for multiple surgeries to ensure adequate excision.

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  • (PMID = 27964633.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Shin SJ, DeLellis RA, Ying L, Rosen PP: Small cell carcinoma of the breast: a clinicopathologic and immunohistochemical study of nine patients. Am J Surg Pathol; 2000 Sep;24(9):1231-8
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  • [Title] Small cell carcinoma of the breast: a clinicopathologic and immunohistochemical study of nine patients.
  • Small cell carcinoma of the breast is an uncommon neoplasm that has been reported rarely in the literature.
  • Nine examples of mammary small cell carcinoma were retrieved from the authors' consultation files and reviewed.
  • Two patients had a previous history of cutaneous malignant melanoma and one had prior lobular carcinoma in situ and atypical duct hyperplasia in the same breast as the small cell carcinoma.
  • Eight patients presented with a mass in the breast; one patient had an axillary tumor.
  • Histologically, the nine tumors had characteristics of small cell carcinoma with high mitotic activity and necrosis.
  • In one instance, this consisted of small cell carcinoma merging with invasive lobular carcinoma.
  • In three cases, small cell carcinoma was present together with invasive, poorly differentiated duct carcinoma; invasive carcinoma with "lobular and gland-forming elements"; and focal squamous differentiation, respectively.
  • An in situ component was seen in seven tumors; five were of the small cell type in ducts and two were of the ductal type with high nuclear grade.
  • Eight underwent an axillary dissection that revealed metastatic carcinoma in four patients.
  • Seven patients received adjuvant chemotherapy and four patients received radiation.
  • Two patients also received tamoxifen treatment.
  • Metastases developed in two patients (22%) with a follow-up period of 11 and 32 months.
  • All patients were alive at last follow up 3 to 35 months after treatment.
  • When compared with published reports of mammary small cell carcinoma, our results show that the prognosis in these patients may not be as poor as previously suggested.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Small Cell / pathology
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Immunohistochemistry. Keratins / metabolism. Middle Aged. Receptors, Estrogen / metabolism

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  • [CommentIn] Am J Surg Pathol. 2001 Jun;25(6):831-2 [11395567.001]
  • (PMID = 10976697.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Receptors, Estrogen; 68238-35-7 / Keratins
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15. Wood WC: Should the use of contralateral prophylactic mastectomy be increasing as it is? Breast; 2009 Oct;18 Suppl 3:S93-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The choice of surgical procedure is primarily influenced by the recommendations of physicians and surgeons.
  • As smaller breast cancers are detected by improved breast screening, and larger breast cancers are reduced in size by neo-adjuvant chemo- and endocrine therapy, breast conservation therapy (BCT) has been applicable to more women.
  • No one would advocate CPM with the breast primary was to be treated by BCT.
  • The ability to better define inherited breast cancer risk by genetic analysis of BRCA1 or 2 mutations does identify a group of patients at greatly increased lifetime risk of contralateral breast cancer (CBC).
  • It appears that many physicians and surgeons believe the risk of contralateral breast cancer to be sufficiently high to justify advising CPM.
  • Invasive lobular carcinoma is considered by some physicians to represent an increased risk of contralateral cancer, but that has not proved to be correct.
  • Women with lobular carcinoma in situ or atypical ductal hyperplasia found at the time of their cancer diagnosis are sometimes advised to consider CPM.
  • Treatment with tamoxifen has shown a 50-75% reduction in risk from these tissue findings.
  • Chemotherapy for the primary breast cancer also lowers contralateral risk by about 20%.
  • The use of skin-sparing mastectomy has greatly reduced the incidence of any surgery needed for symmetry on the contralateral breast.
  • MRI used to "stage the breast" can raise questions by noting small foci of enhancement in the contralateral breast.
  • Some women elect CPM rather than biopsy or further imaging of the contralateral breast.
  • Its increase raises questions of the awareness of breast oncologists, medical and surgical, of the true risk data.
  • [MeSH-major] Breast Neoplasms / prevention & control. Mastectomy / adverse effects. Neoplasms, Second Primary / prevention & control
  • [MeSH-minor] Decision Making. Humans. Male. Risk Factors

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  • (PMID = 19914552.001).
  • [ISSN] 1532-3080
  • [Journal-full-title] Breast (Edinburgh, Scotland)
  • [ISO-abbreviation] Breast
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
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16. Cummings FJ: Evolving uses of hormonal agents for breast cancer therapy. Clin Ther; 2002;24 Suppl C:C3-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evolving uses of hormonal agents for breast cancer therapy.
  • BACKGROUND: During the past decade, a number of new hormonal therapies (HTs) have been developed, including the selective estrogen receptor modulators (SERMs), aromatase inhibitors (AIs), and estrogen receptor (ER) antagonists.
  • Their uses in breast cancer are continually evolving as new clinical trial results become available.
  • Although tamoxifen, the most widely used HT for breast cancer, was originally approved for and used in the treatment of metastatic breast cancer (MBC), its effectiveness as MBC therapy led to its subsequent assessment and use as adjuvant and risk-reduction therapy for breast cancer.
  • However, tamoxifen is not universally effective in these settings and is associated with infrequent known toxicities such as increased risk of thromboembolism and endometrial cancer; therefore, a search for more effective and more tolerable HTs has evolved.
  • OBJECTIVE: This article reviews the data supporting the use of newer HTs as initial treatment of MBC and their potential use as adjuvant, neoadjuvant, and chemopreventive therapies.
  • METHODS: Articles for inclusion in this manuscript were identified through the following searches, limited to English-language publications: MEDLINE (mid 1960s to January 2002), American Society of Oncology abstracts (1997-2001), and San Antonio Breast Cancer Symposium abstracts (2001 and 2002).
  • The following search terms were used: breast cancer, breast cancer guidelines, hormonal therapies, tamoxifen, toremifine, letrozole, anastrozole, exemestane, megestrol acetate, fulvestrant, and ICI 182,780.
  • RESULTS: Recent studies have focused on newer agents as initial and subsequent treatment of MBC, adjuvant or neoadjuvant treatments of breast cancer, and chemopreventive agents in both healthy women and women with a history of ductal carcinoma in situ (DCIS).
  • Results of clinical trials comparing AIs with tamoxifen as first-line MBC treatment show that AIs are as effective as, or more effective than, tamoxifen and are associated with fewer serious adverse events.
  • Tamoxifen remains the gold standard for adjuvant therapy.
  • Both tamoxifen and the AIs have been shown to be active in the neoadjuvant treatment of breast cancer.
  • Trial results have shown that tamoxifen is effective for breast cancer prevention in patients at high risk of developing breast cancer but who are otherwise healthy, patients with a history of DCIS, and patients with lobular carcinoma in situ.
  • CONCLUSIONS: Although tamoxifen has been the gold standard of HT for breast cancer, results of ongoing trials assessing the newer HTs as initial, neoadjuvant, adjuvant, and chemopreventive therapies may substantially change our current clinical practice patterns.
  • [MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Breast Neoplasms
  • [MeSH-minor] Carcinoma, Intraductal, Noninfiltrating / drug therapy. Chemotherapy, Adjuvant. Clinical Trials as Topic. Dose-Response Relationship, Drug. Female. Humans. Nitriles / adverse effects. Nitriles / therapeutic use. Tamoxifen / adverse effects. Toremifene / administration & dosage. Toremifene / adverse effects. Toremifene / therapeutic use. Triazoles / adverse effects. Triazoles / therapeutic use

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  • (PMID = 12117074.001).
  • [ISSN] 0149-2918
  • [Journal-full-title] Clinical therapeutics
  • [ISO-abbreviation] Clin Ther
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Nitriles; 0 / Triazoles; 094ZI81Y45 / Tamoxifen; 2Z07MYW1AZ / anastrozole; 7NFE54O27T / Toremifene
  • [Number-of-references] 45
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17. Heinig A, Lampe D, Kölbl H, Beck R, Heywang-Köbrunner SH: Suppression of unspecific enhancement on breast magnetic resonance imaging (MRI) by antiestrogen medication. Tumori; 2002 May-Jun;88(3):215-23
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Suppression of unspecific enhancement on breast magnetic resonance imaging (MRI) by antiestrogen medication.
  • AIMS AND BACKGROUND: The value of breast MRI may be impaired by unspecific enhancement.
  • This may leave patients with difficult-to-assess breast tissue with an uncertain diagnosis.
  • We examined whether this unspecific enhancement (which is mostly due to proliferative or hyperplastic changes of benign breast tissue) may be suppressed by antiestrogen medication.
  • METHODS: In a trial of treatment, 10 peri- or postmenopausal patients who exhibited diffuse and/or focal enhancement on breast MRI before tamoxifen medication agreed to undergo a short-term tamoxifen treatment.
  • MRI monitoring was performed 2, 4 and 8 weeks after onset of antiestrogen therapy (tamoxifen, 30 mg per day).
  • One of the three patients with unchanged enhancement proved to have diffuse lobular carcinoma in situ.
  • CONCLUSIONS: Part of the unspecific enhancement seen on breast MRI can probably be suppressed by short-term antiestrogen medication.
  • [MeSH-major] Antineoplastic Agents, Hormonal / administration & dosage. Breast / pathology. Breast Neoplasms / diagnosis. Breast Neoplasms / prevention & control. Estrogen Receptor Modulators / administration & dosage. Magnetic Resonance Imaging. Tamoxifen / administration & dosage
  • [MeSH-minor] Adult. Drug Administration Schedule. Female. Humans. Middle Aged. Predictive Value of Tests

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  • (PMID = 12195760.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Estrogen Receptor Modulators; 094ZI81Y45 / Tamoxifen
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18. Bollet MA, Sigal-Zafrani B, Mazeau V, Savignoni A, de la Rochefordière A, Vincent-Salomon A, Salmon R, Campana F, Kirova YM, Dendale R, Fourquet A: Age remains the first prognostic factor for loco-regional breast cancer recurrence in young (&lt;40 years) women treated with breast conserving surgery first. Radiother Oncol; 2007 Mar;82(3):272-80
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  • [Title] Age remains the first prognostic factor for loco-regional breast cancer recurrence in young (<40 years) women treated with breast conserving surgery first.
  • PURPOSE: To ascertain the loco-regional recurrence (LRR) rate and its major prognostic factors in patients younger than 40 and to determine the influence of age on the features of breast cancer and its treatment in two age groups: 35 years and [36-39] years.
  • METHODS AND MATERIALS: Between 1985 and 1995, 209 premenopausal women, younger than 40, were treated for early breast cancers with primary breast conserving surgery followed by radiotherapy+/-chemotherapy.
  • RESULTS: LRR rate was 38% at 10 years, contralateral breast cancer rate 12%.
  • The annual risk of local recurrence peaked between 2 and 3 years after the initial diagnosis and returned to the level of contra-lateral breast cancer at 10 years.
  • The younger population had infiltrating carcinomas that were significantly more commonly ductal, less commonly lobular, and of higher grade - they received chemotherapy more often.
  • CONCLUSION: Using conventional methods we could find no explanation as to why age remained the most important prognostic factor for breast cancer LRR.
  • [MeSH-major] Breast Neoplasms / surgery. Carcinoma, Ductal, Breast / surgery. Carcinoma, Lobular / surgery. Neoplasm Recurrence, Local / epidemiology
  • [MeSH-minor] Adult. Age Factors. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Humans. Lymph Node Excision. Mastectomy, Segmental. Prognosis. Survival Rate

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  • [CommentIn] Radiother Oncol. 2008 Feb;86(2):286-7; author reply 287-8 [17963905.001]
  • [ErratumIn] Radiother Oncol. 2007 May;83(2):215
  • (PMID = 17287037.001).
  • [ISSN] 0167-8140
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Ireland
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19. Rakha EA, Gill MS, El-Sayed ME, Khan MM, Hodi Z, Blamey RW, Evans AJ, Lee AH, Ellis IO: The biological and clinical characteristics of breast carcinoma with mixed ductal and lobular morphology. Breast Cancer Res Treat; 2009 Mar;114(2):243-50
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  • [Title] The biological and clinical characteristics of breast carcinoma with mixed ductal and lobular morphology.
  • Although invasive ductal (IDC) and lobular (ILC) breast carcinomas are well characterised in the literature, the biological and clinical significance of mixed tumours with both ductal and lobular components has not been investigated.
  • In the current study, we have examined a well-characterised series of breast carcinoma with a long term follow-up that comprised 140 mixed tumours, 2170 IDC and 380 pure ILC.
  • DCIS was detected in 123 (89%) and LCIS in 43 (31%) (both DCIS and LCIS were found in 39 cases).
  • The majority of tumours were predominantly (>50 of tumour area) of ductal type (57%).
  • There was an association between histologic type of carcinoma in LN metastasis and the predominant histologic type of the primary tumour.
  • No clinically meaningful differences in survival were found between these mixed carcinomas and pure IDC or ILC of the breast or between mixed tumours with predominantly ductal or lobular phenotype.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Ductal, Breast / pathology. Carcinoma, Intraductal, Noninfiltrating / pathology. Carcinoma, Lobular / pathology
  • [MeSH-minor] Adult. Aged. Biomarkers, Tumor / metabolism. Female. Follow-Up Studies. Humans. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / drug therapy. Prognosis. Retrospective Studies. Survival Rate

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  • (PMID = 18404368.001).
  • [ISSN] 1573-7217
  • [Journal-full-title] Breast cancer research and treatment
  • [ISO-abbreviation] Breast Cancer Res. Treat.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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20. Cutuli B, Cottu PH, Guastalla JP, Mechin H, Costa A, Jourdan R: A French national survey on infiltrating breast cancer: analysis of clinico-pathological features and treatment modalities in 1159 patients. Breast Cancer Res Treat; 2006 Jan;95(1):55-64
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A French national survey on infiltrating breast cancer: analysis of clinico-pathological features and treatment modalities in 1159 patients.
  • BACKGROUND: Despite the approximate 42,000 yearly new cases of breast cancer in France, there have been very few exhaustive studies on the clinicopathological features and treatment options of this disease.
  • METHODS: Thus, a prospective, non-selective, nationwide survey on infiltrating breast cancer (IBC) was conducted in France from September 2001 to April 2002, in order to assess the epidemiological features of newly diagnosed disease, the prognostic and predictive variables with a special emphasis on hormone receptors, and the current approaches to therapy in everyday clinical practice.
  • RESULTS: In total, 1159 patients were evaluable (median age 57 years); two-thirds of women were postmenopausal and 38% had undergone hormonal replacement therapy (HRT).
  • Ductal and lobular infiltrating cancers represented 82.3% and 11.6% of cases, respectively.
  • IBC diagnosed in women under HRT presented significantly better clinico-pathological features than in non-users.
  • All patients underwent surgery as first treatment: 77.5% breast-conserving surgery (BCS) and 22.5% mastectomy; 1024 patients also underwent axillary surgery.
  • Adjuvant chemotherapy was delivered in 58.7% of patients and hormonal treatment was provided in 76.5% of patients; tamoxifen was the most widely used hormonal treatment.
  • Postoperative treatments were widely used, in accordance with national and international guidelines.
  • [MeSH-major] Breast Neoplasms / epidemiology. Health Surveys
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Carcinoma, Ductal, Breast / epidemiology. Carcinoma, Ductal, Breast / pathology. Carcinoma, Ductal, Breast / therapy. Carcinoma, Lobular / epidemiology. Carcinoma, Lobular / pathology. Carcinoma, Lobular / therapy. Chemotherapy, Adjuvant. Combined Modality Therapy. Estrogen Replacement Therapy. Female. France / epidemiology. Humans. Mastectomy. Menopause. Middle Aged. Prognosis. Prospective Studies. Receptors, Estrogen / metabolism. Receptors, Progesterone / metabolism. Survival Rate

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  • (PMID = 16261401.001).
  • [ISSN] 0167-6806
  • [Journal-full-title] Breast cancer research and treatment
  • [ISO-abbreviation] Breast Cancer Res. Treat.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Receptors, Estrogen; 0 / Receptors, Progesterone
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21. Mokbel K, Kirkpatrick KL: Recent advances in breast cancer (the Twenty-fourth San Antonio Breast Cancer Symposium, December, 2001). Curr Med Res Opin; 2002;18(1):26-9
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  • [Title] Recent advances in breast cancer (the Twenty-fourth San Antonio Breast Cancer Symposium, December, 2001).
  • This paper reviews the Twenty-fourth Annual San Antonio Breast Cancer Symposium.
  • The preliminary results of the ATAC study have shown that Arimidex is superior to tamoxifen in postmenopausal women with ER-positive early breast cancer in terms of DFS, adverse effects and prevention of contralateral breast cancer.
  • However, longer follow up is required to assess the drug safety regarding bone mineral density and cognitive function.
  • Letrozole seems to be superior to tamoxifen as a first-line therapy in ER-positive advanced breast cancer in postmenopausal women.
  • Although the incidence of acute myeloid leukaemia is significantly increased (cumulative incidence at 5 years = 1.1%) in breast cancer patients receiving cyclophosphamide and anthracyclines, the risk of this complication is easily outweighed by the benefits of chemotherapy.
  • Adjuvant clodronate was found to be associated with a significant reduction in the incidence of bone metastases during the treatment period.
  • A randomised trial comparing axillary dissection and axillary radiotherapy (RT) for early breast cancer reported no significant difference in survival at 15 years.
  • However, axillary recurrence was significantly increased in the RT group. hTERT protein expression by IHC was found to correlate significantly with breast cancer-specific survival.
  • LCIS is currently considered as a non-obligate precursor to breast cancer rather than just a risk factor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Breast Neoplasms
  • [MeSH-minor] Carcinoma in Situ / pathology. Carcinoma, Lobular / pathology. Female. Humans. Sentinel Lymph Node Biopsy. Texas

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  • (PMID = 11999142.001).
  • [ISSN] 0300-7995
  • [Journal-full-title] Current medical research and opinion
  • [ISO-abbreviation] Curr Med Res Opin
  • [Language] eng
  • [Publication-type] Congresses
  • [Publication-country] England
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22. Paciucci PA, Raptis G, Bleiweiss I, Weltz C, Lehrer D, Gurry R: Neo-adjuvant therapy with dose-dense docetaxel plus short-term filgrastim rescue for locally advanced breast cancer. Anticancer Drugs; 2002 Sep;13(8):791-5
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  • [Title] Neo-adjuvant therapy with dose-dense docetaxel plus short-term filgrastim rescue for locally advanced breast cancer.
  • Neo-adjuvant, dose-dense docetaxel, 100 mg/m(2) every 2 weeks x 4 cycles, was administered to 12 patients with locally advance breast cancer (LABC) (10 stage IIIa and three stage IIIb).
  • Filgrastim [granulocyte colony stimulating factor (G-CSF)] was started 1 day after chemotherapy and was given for 6 days.
  • The median age was 45 (range 34-73) and pre-treatment pathology revealed poorly differentiated infiltrating duct carcinoma in 11 and infiltrating lobular cancer in one, with positive ER/PR status in five.
  • Three patients (of whom two with stage IIIb) had progressive disease and went on to receive neo-adjuvant therapy with AC.
  • There was one instance of grade 3 hematologic toxicity (neutropenic fever in one G-CSF non-compliant patient).
  • There were two instances of grade 3 extra-hematologic toxicity: one patient had severe pain and one had treatment-related fatigue.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Breast Neoplasms / drug therapy. Granulocyte Colony-Stimulating Factor / administration & dosage. Paclitaxel / administration & dosage. Paclitaxel / analogs & derivatives. Taxoids
  • [MeSH-minor] Adult. Aged. Female. Filgrastim. Humans. Middle Aged. Neoadjuvant Therapy. Recombinant Proteins

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  • (PMID = 12394262.001).
  • [ISSN] 0959-4973
  • [Journal-full-title] Anti-cancer drugs
  • [ISO-abbreviation] Anticancer Drugs
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Recombinant Proteins; 0 / Taxoids; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 15H5577CQD / docetaxel; P88XT4IS4D / Paclitaxel; PVI5M0M1GW / Filgrastim
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23. Bassarova AV, Sedloev T, Christova SL, Trifonov DY, Nesland JM: Invasive lobular carcinoma in a hypoplastic breast. Ultrastruct Pathol; 2002 Nov-Dec;26(6):411-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Invasive lobular carcinoma in a hypoplastic breast.
  • Breast hypoplasia is encountered as part of genetic syndromes or as a result of iatrogenic factors.
  • The incidence of this malformation and the occurrence of breast carcinoma in such cases are unknown.
  • The authors present a 66-year-old patient with a severe breast hypoplasia and invasive lobular carcinoma.
  • The advanced clinical stage required neoadjuvant chemotherapy.
  • The pathological report revealed an infiltrating lobular carcinoma with combined classical and alveolar growth and with minor morphological changes after the chemotherapy.
  • The tumor expressed a high bcl-2/low bax ratio and lacked p53 immunoreactivity, which could explain the resistance to neoajuvant therapy.
  • To the authors' knowledge this is the first case of an invasive lobular carcinoma in a hypoplastic breast reported in the English literature.
  • [MeSH-major] Breast Neoplasms / pathology. Carcinoma, Lobular / pathology
  • [MeSH-minor] Aged. Breast / pathology. Female. Humans. Immunohistochemistry. Mastectomy, Modified Radical. Neoplasm Invasiveness / pathology


24. Ebert AD, Rosenow G, David M, Mechsner S, Magalov IS, Papadopoulos T: Co-occurrence of atypical endometriosis, subserous uterine leiomyomata, sactosalpinx, serous cystadenoma and bilateral hemorrhagic corpora lutea in a perimenopausal adipose patient taking tamoxifen (20 mg/day) for invasive lobular breast cancer. Gynecol Obstet Invest; 2008;66(3):209-13
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  • [Title] Co-occurrence of atypical endometriosis, subserous uterine leiomyomata, sactosalpinx, serous cystadenoma and bilateral hemorrhagic corpora lutea in a perimenopausal adipose patient taking tamoxifen (20 mg/day) for invasive lobular breast cancer.
  • CASE REPORT: A 54-year-old perimenopausal woman on tamoxifen (20 mg/day), gravida 0, with surgically treated invasive lobular breast cancer and extensive lobular carcinoma in situ (pT2 (m) pN0 (snl) pL0 G2 pTis (LCLIS) R0 M0 Ki-67 1%, ER+, PR+, Her-2-neu-negative) was referred for evaluation of a pelvic mass.
  • The CA-125 level was normal (9.4 U/ml).
  • CONCLUSION: The possibility of tamoxifen-induced or tamoxifen-driven endometriosis in peri- or postmenopausal patients with breast cancer should be considered.
  • [MeSH-major] Breast Neoplasms / drug therapy. Cystadenoma, Serous / chemically induced. Endometriosis / chemically induced. Fallopian Tube Diseases / chemically induced. Leiomyoma / chemically induced. Tamoxifen / adverse effects. Uterine Neoplasms / chemically induced
  • [MeSH-minor] Antineoplastic Agents, Hormonal / adverse effects. Antineoplastic Agents, Hormonal / therapeutic use. Carcinoma, Lobular / drug therapy. Carcinoma, Lobular / surgery. Corpus Luteum / drug effects. Corpus Luteum / pathology. Female. Hemorrhage / chemically induced. Humans. Immunohistochemistry. Middle Aged. Ovarian Diseases / chemically induced


25. Tse GM, Yeung DK, King AD, Cheung HS, Yang WT: In vivo proton magnetic resonance spectroscopy of breast lesions: an update. Breast Cancer Res Treat; 2007 Sep;104(3):249-55
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  • [Title] In vivo proton magnetic resonance spectroscopy of breast lesions: an update.
  • In vivo proton magnetic resonance spectroscopy ((1)H-MRS) has been demonstrated to be successful in the differentiation of benign and malignant breast lesions in a non-invasive manner by detecting increased levels of composite choline (Cho) compounds.
  • Currently there is molecular evidence of increased Cho metabolism in breast cancer cells.
  • In breast malignancies, (1)H-MRS achieved a high-overall sensitivity (82%).
  • Most test cases were infiltrating duct carcinoma, but infiltrating lobular, medullary, mucinous and adenoid cystic carcinomas were also positive by (1)H-MRS.
  • Another potential of (1)H-MRS is to assess patients' response to neoadjuvant chemotherapy.
  • In ductal carcinoma in situ, the results of (1)H-MRS on the limited number of cases were negative.
  • Most of the assessed benign breast lesions including fibroadenoma, fibrocystic changes, cysts and galactoceles, papilloma, tubular adenoma and phyllodes tumours and were mostly negative by (1)H-MRS, with an overall false positive rate was about 8%.
  • Normal breast tissue was almost always negative by (1)H-MRS, whereas, lactating breast tissue showed positivity with a slightly different spectrum on further analysis.
  • With these improvements, (1)H-MRS may potentially be useful in detection of smaller malignant lesions, characterization of malignant lesions into non-invasive or invasive, and as an invaluable tool in disease progression monitoring.
  • [MeSH-major] Breast Neoplasms / diagnosis. Breast Neoplasms / pathology. Magnetic Resonance Spectroscopy / methods
  • [MeSH-minor] Breast / pathology. Carcinoma / metabolism. Carcinoma, Ductal, Breast / diagnosis. Carcinoma, Ductal, Breast / pathology. Choline / metabolism. Disease Progression. False Positive Reactions. Female. Humans. Protons. Reproducibility of Results. Sensitivity and Specificity

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  • (PMID = 17051424.001).
  • [ISSN] 0167-6806
  • [Journal-full-title] Breast cancer research and treatment
  • [ISO-abbreviation] Breast Cancer Res. Treat.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Protons; N91BDP6H0X / Choline
  • [Number-of-references] 36
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