Annual Rhythm in the Growth of Human Breast Carcinomas as Reflected in the Histology of Their Growing Edge.

This histologic study of breast carcinoma, based on 100 consecutive cases, identifies a dynamic scenario at the tumor edge. Three main types of tumor edge were identified. An inactive edge, seen throughout the year, consisted of tumor cells lying in fibrous tissue that merged into the adjacent fatty tissue.

'Missed' micrometastases--the extent of the problem.

The value of detecting micrometastases in patients with breast cancer has been debated for many years. The aim of this study was to determine whether and why such tumour deposits are missed at the time of reporting. The series comprised 272 patients treated surgically for breast carcinoma.

Efferent vascular invasion in the axillary nodes in breast carcinoma: a potent prognostic factor.

Tumour cells in the efferent vessels of the axillary nodes in breast cancer (EV status) have been associated with poor prognosis since 1979. A prospective study (1980-1989) of all the nodes from 1037 consecutive female patients with unilateral breast cancer whose treatment included axillary node dissection yielded 471 node-positive cases. Tumour cells were found in the efferent nodal vessels of 210 patients, while 252 were negative.

Is a woman's date of birth related to her risk of developing breast cancer?

Some previous reports have shown seasonality in the date of birth in patients with breast cancer, others have not. In this study of 1,110 women with unilateral breast carcinoma significantly more cases had been born in the first than the second half of the year. This finding could, however, not be linked to the later development of breast cancer as their case-matched controls showed a similar trend.

Laser conization of cervical intraepithelial neoplasia grade 3: free resection margins indicative of lesion-free survival.

Background: Various grades of cervical intraepithelial neoplasia may occur following laser conization for grade 3 lesions. The aim of this study was to assess lesion-free survival after laser conization in cases with/without free resection margins, and to test whether detection of human papillomavirus infection and/or p53 expression in the cone lesion were useful predictors of lesion-free survival.

Methods: In 598 women treated for cervical intraepithelial neoplasia grade 3 the state of the resection margins was recorded and related to the findings on follow-up, up to 15 years post-operatively.

Prognostic implications of cervical intraepithelial neoplasia in a single cervical smear. an age-matched case-control study of women with negative smear histories.

Our aim was to investigate the prognostic implications of a single cervical smear showing cervical intraepithelial neoplasia (CIN) in a group of women with a previous series of negative smears, and to estimate their risk of developing histologically confirmed CIN 3. A retrospective case-control study was set up. It consisted of 171 cases and 513 age-matched controls, all with at least 3 negative and no positive smears between 1981 and 1988 inclusive.

Nodal tumour growth in breast cancer: the time-span of its biological progression.

This series of 1,154 women with unilateral breast carcinoma was treated by modified radical mastectomy with axillary dissection. Histological staging of nodal tumour growth in the axilla distinguished 4 populations in which the numbers of patients presenting for operation over the months of the year differed markedly. The findings are used to develop a hypothesis on nodal tumour growth in which the length of time needed to complete the growth sequence, from the entry of a micrometastasis to exit of tumour cells via the efferent nodal vessels, could be estimated.

Staging nodal growth in breast cancer on a histological basis.

This study describes the axillary tumour-load in 484 women with breast carcinoma with spread to one or more nodes. The aim was to relate tumour-load to nodal histology. The tumour area and that of residual lymphoid tissue was measured from standardised nodal sections.

The size of a micrometastasis in the axilla in breast cancer: a study of nodal tumour-load related to prognosis.

Much has been written on micrometastases to the axilla in breast cancer but there is no consensus as to their size. In this study three levels of nodal tumour-load are defined following measurement of nodal tumour area on histology. The two cut-points described are both of clinical interest.

Breast cancer: poor short-term prognosis in cases with moderate lymphocyte infiltration at the tumour edge: a preliminary report.

Lymphocyte infiltration in breast carcinoma has long been associated with favourable prognosis, however it has also been related to poor prognosis. In this study of 128 consecutive cases lymphocyte infiltration, its absence, or presence and degree was recorded at the tumour edge adjacent to fatty tissue in 100 cases, to other tissues in the remaining 28 in which no such edge was found. In the former there was a highly significant prognostic difference between those with moderate infiltration, which was of poor short-term prognosis, and those with other degrees of infiltration (none, slight and marked).

Heparin coating of human breast carcinoma cells in vivo.

Mast cells, the only source of heparin in the body, are common in breast carcinoma. Due to metachromatic staining of heparin-proteoglycans released from the mast cells toluidine blue may stain connective tissue a reddish-purple. This study shows that tumour cells in the vicinity may also be coated with metachromatic substance.

Breast cancer.

Seasonal variation has been demonstrated in connection with several aspects of primary breast carcinoma. This report describes a seasonal variation in the growth of breast carcinoma in the axillary nodes that has not been reported previously and has prognostic implications. The nodes from a series of 301 node-positive breast cancer patients were investigated prospectively for the presence/absence of tumour cells in their efferent lymphatic vessels, the former being of poor prognosis.

Expression of E-cadherin and catenins in invasive mammary carcinomas.

E-Cadherin has been shown to be an invasion tumor suppressor gene, but few epidemiological studies have revealed relationships between loss of E-cadherin expression and invasive tumor growth and/or metastasis. The adhesive function of E-cadherin is dependent on the integrity of the catenin components which link E-cadherin to the actin filaments. In order to achieve a better correlation between the loss of cell adhesion and metastasis in cancer, we decided to investigate both E-cadherin and the catenins.

Human papillomavirus infection in progressive and non-progressive cervical intraepithelial neoplasia.

Human papillomavirus (HPV) infection is common in cervical intraepithelial neoplasia (CIN) and is widely held to be responsible for its progression to grade 3. This thesis is examined here. Comparison of the level of HPV changes in 133 lesions that had not progressed to that in those from 197 women with histologically proven CIN 3 failed to reveal significant differences in their level of HPV infection on cytology, histology or in situ hybridization.

Prognostic role of oestrogen and progesterone receptors in patients with breast cancer: relation to age and lymph node status.

Aims: To consider the prognostic role of oestrogen receptor and progesterone receptor status in relation to the age at surgery, length of follow up and lymph node status.

Methods: The study population comprised 977 patients with histologically confirmed breast carcinoma, with a median follow up of nine years. The actuarial life table method was used to test for survival differences.

Breast cancer: two micrometastatic variants in the axilla that differ in prognosis.

Measurement of the area of the tumour deposits present in routine sections from the axillary nodes from a series of 1069 breast cancer patients showed that 138 cases had a single micrometastasis (0.2 cm2 or less), while in 29 a similar load was spread over two or more nodes. These 167 cases represent 15% of the patients in the series.

Node-positive breast cancer: axillary micrometastases, their incidence and some implications.

In node-positive breast carcinoma, the presence of tumour cells in the efferent vessels (EV) of the axillary nodes (positive EV status) was shown to be of poor prognosis in 1979. Later the presence of nodal micrometastases was also related to survival. This report describes a new subgroup in this system that is of potential therapeutic interest.

Micrometastases to the axilla in breast cancer: their size and season of presentation.

In a series of 1,069 breast cancer patients there were no significant differences in the numbers of node-negative or node-positive cases undergoing operation in the two halves of the year. This held also for cases with nodal micrometastases (0.2 cm2 or less).

The differences in the cytological histories of women with high- and low-grade cervical intraepithelial neoplasia.

This study concerns 330 women from each of whom we had received a cervical smear showing cervical intraepithelial neoplasia in 1989. They were divided into two groups. One consisted of 197 cases that had progressed to histologically confirmed cervical intraepithelial neoplasia grade 3 between 1989-90, the other of those that had not done so.

The cervical smear record: its relevance to the subsequent development of cervical neoplasia.

Background: Our aim was to investigate the previous smear history in women with cervical intraepithelial neoplasia grade 1-3 or squamous carcinoma and define its relevance to the lesion present in 1989.

Methods: All 850 women with a laboratory record of cervical intraepithelial neoplasia or cervical squamous carcinoma in 1989 were studied. We retrieved their cytological and histological cervical diagnoses for the period 1981 to 1992 from the laboratory files.

Lymph node-negative breast cancer: the prognostic role and time dependency of age, tumor diameter and mean nuclear area.

This study of 786 node-negative breast cancer patients demonstrates that the prognostic effect of age at operation, tumor diameter and mean nuclear area (MNA) changed over time. Identifying patients at higher risk of dying after 5 years may be of clinical importance. These are patients who may have had a low metastatic tumor burden at the time of operation and in whom cytostatic adjuvant treatment could be of value.

Missed nodal metastases in breast-cancer.

The routine use of immunohistochemistry has been suggested in the examination of the axillary nodes from patients with node-negative breast cancer in order to detect possible micrometastases. In this study, comprising 70 axillary specimens, we found missed micrometastases in 5 lymph nodes from a total of 40 cases following staining with epithelial membrane antigen. These metastases were also visible in the original haematoxylin and eosin stained slides, but missed on first examination.

Mast cell association with collagen fibres in human breast stroma.

Whirl-like structures consisting of strands and bundles of collagen fibres with a central space are described in human breast stroma. Association between these structures and connective tissue mast cells is demonstrated. Mast cells in these whirls, in contrast to those in loose connective tissue, showed signs of secretory activity.

Reactive changes in lymph-nodes draining breast-carcinoma and their relation to tumor spread.

The changes in anatomical structure and functional composition found in lymph nodes draining breast carcinoma are commonly termed 'reactive'. These features are described in relation to nodal tumour growth. The nodes studied showed increasing structural complexity with increasing size.

The role of micrometastases in nodal colonization of the axilla in breast-cancer.

The view that micrometastases are illusive prompted the recommendation that more extensive study of the nodes in the axillary specimen should be introduced in cases of breast cancer. The present study based on morphometric analysis of hilar sections from nodes from 430 axillary specimens showed that micrometastases (i.e.