Unintended pregnancy during the first year after breast cancer diagnosis.

Objectives: Young women experience high levels of anxiety and distress during cancer diagnosis and therapy, and it can be devastating to become pregnant in this vulnerable state. Pregnancy during cancer treatment is strongly discouraged, as radiotherapy and chemotherapy administered during the first trimester of pregnancy result in increased congenital malformations.

Methods: In this study, we analysed an unselected, consecutive cohort of young breast cancer (BC) patients with regard to unintended pregnancy during the first year after BC diagnosis.

Use of Palliative Endocrine Therapy in Patients with Hormone Receptor-Positive Distant Metastatic Breast Cancer: How Often, How Effective, How Long?

Background: This study provides real-world clinical evidence regarding palliative endocrine therapy (ET) in breast cancer (BC). The main questions to be answered were: how often and how long did patients receive ET? A particular aspect was the analysis of compliance and persistence with ET.

Methods: An analysis of a nonselected/consecutive cohort of women with distant metastatic hormone receptor-positive BC (n = 205) was conducted.

Contraception counseling for young breast cancer patients: A practical needs assessment and a survey among medical oncologists.

Background/methods: We analyzed an unselected, consecutive cohort of young breast cancer (BC) patients (≤40 years, n = 100) with regard to the contraceptive methods used at the time of diagnosis. Based on this data, we assessed the individual need for contraceptive counseling before cancer therapy. Secondly, in a study-specific self-report questionnaire, we surveyed 101 medical oncologists with the aim of evaluating attitudes towards contraception and how young patients are being counseled in the practical clinical setting.

Family ties: young breast cancer patients and their children.

Background: This study assessed the interaction of "family ties" in a cohort of young breast cancer patients.

Methods: Based on the Basel Breast Cancer Database, we analysed an unselected, consecutive cohort of patients who were ≤40 years at breast cancer diagnosis (n = 100).

Results: Sixty patients had children at the time of diagnosis (mean number of children: 1.

Epidemiology in ovarian carcinoma: Lessons from autopsy.

Objective: We challenge epidemiologic knowledge regarding ovarian carcinoma (OC) by bridging the gap between clinical and autopsy data.

Methods: Autopsy reports, histological slides and clinical files from 660 patients in whom OC was diagnosed from 1975-2005 were studied (autopsy cohort, n=233; Clinical Cancer Registry from the local gyneco-oncologic center, n=427).

Results: Out of the autopsy cohort, we identified four distinct subgroups of patients: 1) OC was diagnosed before autopsy, n=156 (67.

Personal or first-degree family breast cancer history: which has higher impact on tumor detection and tumor size in breast cancer.

Purpose: A woman's risk of developing breast cancer (BC) is increased if she has a personal history (PH) or family history (FH) of the disease. We compared the impact of the two risk factors PH and FH on tumor detection and tumor size at diagnosis in a cohort of BC patients.

Methods: The study cohort comprised 1,037 invasive BC patients (≤70 years at diagnosis).

Self-detection and clinical breast examination: comparison of the two "classical" physical examination methods for the diagnosis of breast cancer.

Unlabelled: This is the first comprehensive analysis comparing specific aspects of tumor detection between the two "traditional" breast cancer detection methods self-detection (SD) and clinical breast examination (CBE). a) Which method is better in detecting smaller tumors? Both methods showed similar mean tumor diameters (SD: 22.1 mm vs.

The impact of overweight and obesity on breast cancer: data from Switzerland, so far a country little affected by the current global obesity epidemic.

This review presents results from the project "The Impact of Overweight/Obesity on Breast Cancer: data from Switzerland". Swiss data is interesting because the general female population is distinctive in two areas when compared to that of most other industrialized countries: Switzerland has comparatively low rates of overweight (22-23%) and obesity (7-8%) and has rather stable rates of overweight and obesity. The entire project comprised three major issues: (I) etiology of breast cancer (BC).

Radiotherapy in patients with distant metastatic breast cancer.

Background: The study evaluates frequency of and indications for disease-related radiotherapy in the palliative breast cancer (BC) situation and analyzes in which phase of the palliative disease course radiotherapy was applied.

Patients & Methods: 340 patients who developed distant metastatic disease (DMD) and died (i.e.

Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapy.

Background: The study evaluates the frequency of and indications for bone-metastases (BM)-related surgery and/or radiotherapy in the palliative breast cancer (BC) situation and analyzes in which phase of the palliative disease course surgery and/or radiotherapy was applied.

Methods: 340 patients who developed distant metastatic disease (DMD) and died (i.e.

Primary and secondary distant metastatic breast cancer: two sides of the same coin.

Objectives: This study evaluated the differences between breast cancer (BC) patients who present with primary distant metastatic disease (PMD) and those who develop distant metastases during the course of their illness (secondary metastatic disease [SMD]) with regard to clinicopathological characteristics, patterns of metastatic sites, palliative therapy and survival.

Patients & Methods: Based on a cohort of patients with newly diagnosed BC (n = 1459), we analyzed all patients who had PMD (n = 92, 6.3%) and those who developed SMD (n = 277, 20.

Impact of breast cancer family history on tumor detection and tumor size in women newly-diagnosed with invasive breast cancer.

This study evaluated the impact of family history (FH) on tumor detection, the patient's age and tumor size at diagnosis in breast cancer (BC). Furthermore, we investigated whether the impact of FH on these features was dependent on degree of relationship, number of relatives with a BC history, or the age of the affected relative at the time that her BC was diagnosed. Out of the entire cohort (n = 1,037), 244 patients (23.

Breast cancer in women 80 years of age and older: a comprehensive analysis of an underreported entity.

Background: Approximately 10% of breast cancer (BC) patients are over the age of 80. We present the first comprehensive review on this particular group of patients.

Patients And Methods: The treatments and disease courses of an unselected cohort of patients, whose age at first diagnosis was ≥ 80 years (n = 151), were compared to those of a group of women, who were aged 56-66 years (n = 372).

Impact of overweight and obesity on postmenopausal breast cancer: analysis of 20-year data from Switzerland.

Purpose: Greater body fatness has been identified as a risk factor for postmenopausal breast cancer. For countries with low overweight/obesity rates, data on prevalence and time course of overweight/obesity in women with breast cancer in comparison to women in the general population is limited. The Swiss female population is distinctive for two reasons: (a) low rates of overweight/obesity compared with other western countries, and (b) no obesity epidemic, i.

Strictly defined familial male breast cancer.

The term "familial male breast cancer" is often misleading, because in the breast cancer families reported in the literature, the vast majority of the patients were women and only a few were men. In this report, we present the rare case of a strictly defined familial male breast cancer (MBC) in which exclusively men were diagnosed with breast cancer. Three of four brothers developed the disease between the age of 46 and 64 years within a period of 21 years whereas all female relatives remained unaffected.

Breast cancer with non-inflammatory skin involvement: current data on an underreported entity and its problematic classification.

We evaluated 166 breast cancer cases with non-inflammatory skin involvement (NISI), which were classified in the TNM classification as T4b. The distribution of tumour sizes and stages was: < or =3 cm:24.1%, 3.

Is the current concept of recurrent ovarian carcinoma as a chronic disease also applicable in platinum resistant patients?

Purpose: The treatment of recurrent ovarian carcinoma (ROC) has become increasingly oriented according to the therapy principles of a chronic disease. We evaluated whether it is justifiable to also apply this concept to the treatment of platinum resistant patients with their known poor prognosis and short overall survival (OS).

Methods: We analyzed the overall courses of 85 unselected ROC patients and defined the following groups: A, platinum resistant patients (n=39); subgroup A.

Systemic therapy of metastatic breast cancer: the truth beyond the clinical trials.

Objective: To depict a clear and coherent picture of the overall course of palliative treatment in an unselected study cohort over the course of time.

Methods: We compared therapy type and course of 242 women whose distant metastatic disease was diagnosed from 1990 to 2006 and who ultimately died of the disease. We divided the patients into two subgroups depending on the year of diagnosis of metastases (group A: 1998-2006 vs.

Systemic therapy developments and their effects regarding the current concept of recurrent ovarian carcinoma as a chronic disease.

Purpose: To demonstrate how the current concept of recurrent ovarian carcinoma (ROC) as a chronic disease resulted in developments in the systemic treatment strategies and outcome over time.

Methods: We compared therapy type and course of a population-based cohort whose recurrent disease was diagnosed from 1990 to 2006. We divided the patients into two subgroups depending on the year of diagnosis of ROC (group A 1990-1997, n = 70; group B 1998-2006, n = 63).

Distant metastatic breast cancer as an incurable disease: a tenet with a need for revision.

Purpose: Published reports provide level-III evidence in support of the hypothesis that distant metastatic breast cancer (MBC) might be curable in up to 3% of cases through a multidisciplinary approach including combination chemotherapy regimens in selected patients, usually young, and with limited metastases. Our study evaluates the rate and characteristics of long-term survivors based on a nonselective study cohort.

Patients And Methods: We analyzed the data from 149 patients in whom distant MBC was diagnosed from 1990 to 1999.

Tumor size and detection in breast cancer: Self-examination and clinical breast examination are at their limit.

Background: This study investigates to what extent tumor detection methods in breast cancer have changed and how this has influenced tumor size at initial diagnosis.

Methods: 1054 breast carcinomas < or =5 cm, newly diagnosed between 1990 and 2006, were evaluated for the tumor detection methods used, namely self-detection (SD, n=568), clinical breast examination (CBE, n=212), and radiological breast examination (RBE, n=237), and their corresponding tumor sizes.

Results: During the study period, the proportion of cases found by RBE increased (p<0.

Three-dimensional pathological size assessment in primary breast carcinoma.

Maximal tumor diameter (MD) is traditionally an important prognostic factor in breast cancer. It must be questioned, however, how well a one-dimensional parameter alone can represent the actual morphologic condition of a three-dimensional body. Along with the pathologically assessed MD and two perpendicular diameters (PDs) of a lesion, eccentricity (EF) and the three-dimensional parameters tumor volume (TV) and surface area (TSA) of 395 ductal invasive breast carcinomas of limited size (10-40 mm) were calculated.

Metastatic patterns at autopsy in patients with ovarian carcinoma.

Background: Previously published studies concerning autopsy findings in ovarian cancer failed to consider the broad differences in factors that influence the course of disease. Furthermore, those studies were conducted when the currently accepted standards in diagnostics and therapy had not been fully established. The objective of the current study was to determine the frequency and sites of metastases in patients with ovarian cancer with particular attention to the clinical course and therapy.

T4 breast cancer under closer inspection: a case for revision of the TNM classification.

The presence of skin involvement in breast cancer results in the classification of the tumor into the highest tumor category, and accordingly into the highest non-metastatic disease stage (current TNM classification: T4/stage III). This traditional view is no longer justifiable, as tumors that show non-inflammatory skin involvement (T4b) make up a considerably heterogeneous group with a high percentage of small-sized tumors. Classifying all lesions demonstrating this feature together results in the combination of tumors with widely differing prognostic and therapeutic implications into a single group.