Histopathology grading in small breast cancers < or = 10 mm--results from an area with mammography screening.

Histopathological malignancy grading using the Bloom-Richardson classification of ductal cancers was performed for 248 invasive ductal breast cancers < or = 10 mm operated 1978-1985. There were significantly more grade 1 lesions in the prevalence screening round. Grade 3 was correlated with aneuploidy, higher S-phase (SPF), and more receptor negative tumours.

Update of the Swedish two-county program of mammographic screening for breast cancer.

The results of the Swedish two-county trial of mammographic screening for breast cancer are presented, updated to December 31, 1990, which is an average of 10.8 years follow-up per person. The main result of the trial in terms of breast cancer mortality remained the same: compared with the control group, the group invited to screening had a relative breast cancer mortality of 0.

Breast screening, prognostic factors and survival--results from the Swedish two county study.

The results of the Swedish two-county study are analysed with respect to tumour size, nodal status and malignancy grade, and the relationship of these prognostic factors to screening and to survival. It is shown that these factors can account for much of the differences in survival between incidence screen detected, interval and control group cancers but to a lesser extent for cancers detected at the prevalence screen where length bias is greatest. Furthermore, examination of the relationships among the prognostic factors and mode of detection indicates that malignancy grade, as a measure of inherent malignant capacity, evolves as a tumour grows.

Cytometric and histopathologic features of tumors detected in a randomized mammography screening program: correlation and relative prognostic influence.

Cytometric determination of S-phase fraction and ploidy type was performed on 430 tumors detected within a randomized trial of mammographic screening. The results were compared to several histopathologic features. A high S-phase fraction was estimated in tumors with a high grade of malignancy and other histopathologic findings related to rapid tumor progression, including lack of tubule formation, a high mitotic index, marked nuclear pleomorphism, multifocal cancer growth, tumor emboli in lymphatic and blood vessels, tumor necrosis, and inflammatory reaction.

Influence of S-phase fraction on metastatic pattern and post-recurrence survival in a randomized mammography screening trial.

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.

Cytometric characterization and clinical course of breast cancer diagnosed in a population-based screening program.

A randomized controlled trial evaluating mammographic screening was started in two Swedish counties in 1977. In one of these, Ostergötland county, the authors performed static cytofluorometry on 161 cancers detected at the second and third screening rounds, 50 interval cancers, and 219 cancers appearing in the nonscreened control group during the same time period. The median follow-up time was 42 months.

Follow-up of two treatment modalities for ductal cancer in situ of the breast.

In a mammography screening programme for the early detection of breast cancer 66 cases of ductal cancer in situ of the breast (DCIS) were diagnosed between 1978 and 1984 and prospectively followed up. In the beginning of the study period, DCIS was treated by mastectomy without axillary clearance but sector resection has been performed increasingly. Since 1982 the latter procedure has become standard treatment.

Secretory carcinoma of the breast in adults: emphasis on late recurrence and metastasis.

Secretory (so-called juvenile) carcinoma of the breast, first described in children, occurs also in adult women, predominantly in the third decade. Less commonly it is seen in older age groups, up to the eighth decade. We report five patients with this tumour; one, a female aged 73, is the oldest age at which the tumour has been recorded, and one is the first report in an adult male in whom the disease recurred after 20 years, only the second recorded death attributable to this tumour type.

Surgical biopsy of non-palpable mammary lesions. Technique and results.

In a randomized controlled trial with mammographic screening for early detection of breast cancer, 314 non-palpable breast lesions were examined by open biopsy between 1978 and 1983. These biopsies were performed after the lesions had been indicated by the hooked wire technique. In 185 cases the findings turned out to be benign while 129 proved to be malignant.

Effects of repeated mammographic screening on breast cancer stage distribution. Results from a randomised study of 92 934 women in a Swedish county.

A randomised controlled trial of mass screening for breast cancer by single-view mammography was begun in Sweden in 1977. All women aged 40 and older and resident in the counties of Kopparberg and Ostergötland were enrolled. The present report is confined to the Ostergötland study, which started in 1978 and comprised 92 934 women.

Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare.

A randomised controlled trial to investigate the efficacy of mass screening with single-view mammography in reducing mortality from breast cancer was started in Sweden in 1977. 162 981 women aged 40 years or more and living in the counties of Kopparberg and Ostergötland were enrolled in the study and divided at random into 2 groups. Each woman in the study group was offered screening every 2 or 3 years depending on age.

Paraganglioma involving the larynx.

Paraganglioma is a rare tumor in the upper respiratory tract. More than 30 paragangliomas have been reported arising in the larynx but only a few in the trachea. The organoid arrangements of the cell nests reproduce the classic 'Zellballen' of the normal gland.

Photometric studies on nuclear DNA content and area in different laryngeal epithelia.

A photometric study of different laryngeal epithelia was performed. The nuclear DNA content and area for epithelia with keratosis, hyperplasia, and moderate dysplasia were comparable to normal. These lesions cannot therefore be considered to be premalignant photometrically.

Juvenile laryngeal papilloma: histologic and photometric evaluation of atypia.

Juvenile papillomas are the most common proliferative laryngeal lesion in children. Atypia may be present but is difficult to interpret owing to the basically benign character of the lesion. A histologic and clinical classification of 23 cases of juvenile laryngeal papillomas was performed following the criteria suggested by Quick and co-workers in 1979 and intended to enable the clinical course to be more accurately predicted.

Origin of carcinoma in secretory endometrium--a study using a whole-organ sectioning technique.

Uteri from four patients with endometrial adenocarcinoma and concomitant "functioning" endometrium were examined by a whole-organ sectioning technique. All showed one or several "progesterone-refractory" mucosal areas or polyps, mainly in the tubal recesses. In one patient the adenocarcinoma obviously originated in a fundal polyp, and in the others the tumors could have arisen in mucosal areas not adequately responding to progesterone.

A fast and reliable system for microcomputerized DNA cytofluorometry in tumour pathology.

A microcomputerized cytofluorometry system based on a Leitz MPV 3 cytophotometer, and intended for DNA measurements in tumour pathology is described. The system has been equipped with a reference channel for correction of excitation light instability. The importance of the adjustment of the epi-illumination for optimal performance of the reference channel is stressed, and a detailed description is provided.

Histopathological subgrouping of WHO II urothelial neoplasms by cytophotometric measurements of nuclear atypia.

The grade of nuclear atypia was objectively assessed in 21 cases of non-invasive WHO II transitional cell bladder neoplasm. Measurements were performed by stage scanning absorbance cytophotometry, registering nuclear optical density, nuclear area, and the variability of these two factors, in 5 microns thick Feulgen-stained paraffin sections. The material was subgrouped into a 2- and a 2+ group according to the degree of histopathological atypia.

Cytophotometric characterization of the WHO grades of transitional cell neoplasms.

The WHO classification of urothelial bladder tumours is widely used, but does not seem to be entirely satisfactory. The main problem is the unhomogeneous WHO II group, and borderline cases in particular are difficult to evaluate histopathologically. Objective assessment of atypia would allow more reliable correlation between morphology and biological behaviour of the tumours to be made.

Residual carcinoma after intracavitary irradiation of endometrial carcinoma, stage I. A study of whole-organ sections.

Surgical specimens from 87 patients with endometrial carcinoma, stage I, preoperatively treated by intracavitary irradiation were investigated by a whole-organ sectioning technique. Re-examination of the curettage material showed cancer stage 0 in 8 (9%) and carcinoma state I in 79 cases (91%). In the stage I cases 57% showed residual carcinoma localized mainly to the myometrium of the uterine body and cornuae.

HISTOSCAN: computer program for cytophotometry in tissue sections and its application in the evaluation of nuclear atypia.

The grading of nuclear atypia has a great and well recognized value when predicting the malignancy of neoplastic processes. Although the basic criteria for the grading are generally agreed upon, in the individual case, the final judgement is to some extent still a matter of subjectivity, which naturally impairs reproducibility. The present paper describes a method for quantification of variability of nuclear size and Feulgen-stainability.

Malignant degeneration of a juvenile laryngeal papilloma--a follow-up study.

The patient, a non-smoking woman aged 51, had been suffering from recurrent juvenile papilloma for 38 years. After eight years during which there was increasing atypia, an extensive malignant papillary tumor, with extralaryngeal spread, was diagnosed. Only seven cases of malignant degeneration of non-irradiated juvenile laryngeal papilloma have been reported; at least four were heavy smokers.

Chondrosarcoma of the larynx.

A chondrosarcoma arising in the posterior cricoid plate is presented. The tumour gave rise to increasing inspiratory stridor: laryngectomy was performed. The tumour consisted of loose cartilaginous tissue with great predominance of highly differentiated cartilage cells and only small areas with nuclear polymorphism.

The DNA content and nuclear size in normal, dysplastic and carcinomatous laryngeal epithelium. A spectrophotometric study.

The aim of the present study was to obtain a more objective evaluation of nuclear hyperchromasia and polymorphism in laryngeal epithelium. The method is based on a photometric assay of nuclear size and DNA content in Feulgen stained slides. The DNA content of hyperchromatic nuclei should exceed the mean for nuclei of normal epithelium by more than twice the standard deviation.