The association of cytokeratin-only-positive sentinel lymph nodes and subsequent metastases in breast cancer.

Introduction: The purpose of this study was to better characterize the clinical significance of cytokeratin immunohistochemistry (IHC)-only-positive lymph node metastases among patients with breast cancer.

Methods: We performed a retrospective review of 334 patients who underwent sentinel lymph node (SLN) biopsy from 1 February 1997 through 31 July 2001. SLN biopsies were evaluated using standard hematoxylin and eosin (H&E) techniques.

Spirituality and healing.

Spirituality can exert a tremendous impact on ones health and promote recovery from trauma and illness, including cancer. Throughout the history of mankind, spirituality and religion have played a major role in healing a variety of physical and mental illnesses. Cancer is one of the most devastating illnesses, as it affects ones physical, emotional, psychological, and spiritual well-being.

Routine mammography is associated with earlier stage disease and greater eligibility for breast conservation in breast carcinoma patients age 40 years and older.

Background: Reduction in breast carcinoma mortality is a major benefit of screening mammography and has been demonstrated in multiple randomized clinical trials and service screening programs. Another benefit from screening is that it allows the patient a wider choice of treatment options, particularly the possibility of conservation surgery. The current study analyzed the impact of mammography in the staging and treatment of breast carcinoma.

Intracystic breast carcinoma in a male: Unusual case presentation and literature review.

Breast carcinoma in males is rare and accounts for 0.5-1.5% of all breast carcinomas.

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.

Local recurrence of breast cancer in the stereotactic core needle biopsy site: case reports and review of the literature.

Early mammographic detection of nonpalpable breast lesions has led to the increasing use of stereotactic core biopsies for tissue diagnosis. Tumor seeding the needle tract is a theorectical concern; the incidence and clinical significance of this potential complication are unknown. We report three cases of subcutaneous breast cancer recurrence at the stereotactic biopsy site after definitive treatment of the primary breast tumor.

Phase I trial of TALL-104 cells in patients with refractory metastatic breast cancer.

The human cytotoxic T-cell line TALL-104 displays antitumor effects in animals with implanted and spontaneous malignancies. A Phase I trial was conducted to determine toxicity of TALL-104 cell therapy in women with metastatic refractory breast cancer. Fifteen patients with metastatic infiltrating ductal (n = 12), lobular (n = 2), or medullary (n = 1) carcinoma received escalating doses of lethally irradiated TALL-104 cells (three patients/group received 10(6), 3 x 10(6), 10(7), 3 x 10(7), and 10(8) cells/kg) for 5 consecutive days (induction course).

Pancreatic carcinoma deemed unresectable at exploration may be resected for cure: an institutional experience.

Only a minority of patients with a diagnosis of pancreatic adenocarcinoma (PA) have disease amenable to curative resection. Between April 1987 and March 1999, 40 patients with pancreatic adenocarcinoma deemed unresectable at exploration at other institutions were considered for neoadjuvant treatments and then re-evaluated for possible re-exploration. We retrospectively compared the clinical outcomes, including overall survival (OS), among three groups: Group A, 22 previously unresectable patients who were subsequently successfully resected, 20 after induction therapy; Group B, 31 patients who received preoperative chemoradiotherapy before their only operation; and Group C, 33 patients who were primarily resected, 27 of whom were then treated with adjuvant therapy.

Should internal mammary lymph nodes in breast cancer be a target for the radiation oncologist?

Purpose: The elective treatment of internal mammary lymph nodes (++IMNs) in breast cancer is controversial. Previous randomized trials have not shown a benefit to the extended radical mastectomy or elective IMN irradiation overall, but a survival benefit has been suggested by some for subgroups of patients with medial tumors and positive axillary lymph nodes. The advent of effective systemic chemotherapy and potential for serious cardiac morbidity have also been factors leading to the decreased use of IMN irradiation during the past decade.

Perioperative nutrition support for patients undergoing gastrointestinal surgery: critical analysis and recommendations.

There is a high incidence of malnutrition in hospitalized patients undergoing gastrointestinal surgery. Malnutrition is clearly associated with increased morbidity and mortality after major gastrointestinal surgery. The efficacy of perioperative nutrition support to reduce surgical complications and mortality significantly has been an area of active clinical investigation over the past three decades.

A simplified procedure for creating a urinary conduit in patients with a colostomy.

A simplified procedure for constructing a urinary conduit is described in patients who have already undergone fecal diversion with colostomy. Two patients are described in whom this method was utilized to create a urinary conduit without the need for an intestinal anastomosis. This procedure is especially suited to high-risk surgical candidates with comorbid medical conditions, multiple previous surgical procedures or prior pelvic radiotherapy in whom avoiding an intestinal anastomosis can significantly reduce postoperative morbidity.

Correlation of lesion appearance and histologic findings for the nodes of a breast MR imaging interpretation model.

An interpretation model for evaluating magnetic resonance (MR) images of the breast was constructed that allowed differentiation of benign from malignant palpable or mammographically visible abnormalities. Architectural features define each node of the model. Investigation was subsequently made of the histologic findings in individuals within each node and of the frequency with which each histologic finding manifested as a particular architectural feature to determine whether nodal location and specific histologic findings are mutually predictive.

Spontaneous pelvic hematoma simulating neoplasm: case report and literature review.

Spontaneous hematomas are rare and can present with acute or chronic symptoms. Our patient presented with deep vein thrombosis of the lower extremity associated with a spontaneous pelvic hematoma. This lesion was radiologically and clinically indistinguishable from a soft-tissue neoplasm.

The effects of a soybean extract on tumor growth and metastasis.

In vitro genistein (soybean-derived isoflavone/phytoestrogen) has been reported to suppress angiogenesis. We have produced a soybean extract (SE) enriched in phytoestogens which are heat stable. Heat sterilization (hs) of SE destroys soy protease inhibitor activity and increases isoflavone concentrations.

Cell therapy of a highly invasive human breast carcinoma implanted in immunodeficient (SCID) mice.

Although enormous progress has been made in the detection and treatment of localized (nonmetastatic) breast cancer, there has been relatively moderate progress toward the effective treatment of advanced disease. This study investigates the antitumor efficacy of a potent MHC nonrestricted cytotoxic human T cell line (TALL-104) upon transfer into a clinically relevant mouse model of metastatic breast cancer. Fragments from a surgical specimen of a patient with infiltrating ductal carcinoma were implanted s.

Unique presentation of a granular cell tumor as a paratracheal mass.

An unusual presentation of a granular cell tumor is reported with a review of the natural history and pathologic characteristics of this tumor. Our patient was asymptomatic and presented with a mass in the inferior right neck on routine physical examination. Preoperative radiologic evaluation suggested a parathyroid adenoma but the normal parathormone level was inconsistent with this diagnosis.

Evidence for selective use of bone scans in early stage breast cancer.

To determine the usefulness of bone scans in detecting metastatic disease in women with early stage breast cancer, records of 193 patients who had bone scans preformed and underwent breast conservation therapy at a single institution were reviewed. Patients with invasive T1 or T2 breast carcinomas were eligible for this study; patients with a true positive bone scan were excluded from conservation therapy and, thus, were excluded from this study. The incidence of false positive bone scans in this study population was 32.

Growth characteristics and metastatic properties of human breast cancer xenografts in immunodeficient mice.

We evaluated the growth and metastatic potential of two human breast cancer cell lines and 16 patient-derived biopsy specimens, representing the most common histological types of breast carcinomas, upon subcutaneous implantation into severe combined immunodeficient (SCID) mice. The method of engraftment we used, based on implantation of intact tissue specimens and complete immunosuppression of the host, provided an easier system to grow human breast carcinoma specimens in mouse models and resulted in a 50% success rate of tumor take. No correlation was found between growth in SCID mice and pathological diagnosis, grading, or estrogen/progesterone receptor expression by the tumor biopsy specimen.

Catamenial mononeuropathy and radiculopathy: a treatable neuropathic disorder.

Object: The aim of this study was to investigate the indications and treatment options in patients with lower-extremity neuropathies and radiculopathies caused by endometriosis.

Methods: The authors identified five patients whose symptoms included catamenial pain, weakness, and sensory loss involving the sciatic and femoral nerves and multiple lumbosacral nerve roots. Radiographic studies supported the diagnosis of catamenial neuropathy or radiculopathy, but definitive diagnosis depended on surgical and pathological examination.

Myofibroblastoma associated with bilateral gynecomastia: a case report and literature review.

Myofibroblastoma of the breast is a recently recognized benign mesenchymal mammary tumor that typically occurs as a unilateral, solitary lesion. Myofibroblastomas are well-circumscribed, unencapsulated tumors characterized by spindle cells in fascicles which exhibit varying degrees of myogenic and fibroblastic differentiation. Our case reports a mammary myofibroblastoma occurring in an 82-year-old male with gynecomastia and reviews the reported incidence of this benign spindle cell tumor in the world literature.

Diagnostic performance characteristics of architectural features revealed by high spatial-resolution MR imaging of the breast.

Objective: Our objective was twofold: to determine which architectural features revealed by high spatial-resolution MR imaging of the breast contribute to diagnostic accuracy and to evaluate the diagnostic performance characteristics of those architectural features.

Materials And Methods: Eligible patients with suspicious mammographic or palpable findings or both underwent MR imaging. Ninety-three patients whose MR images revealed lesions that corresponded to the mammographically visible or palpable findings were included in the study.

Breast MR imaging: interpretation model.

Purpose: To develop an interpretation model based on architectural features of suspicious breast findings on magnetic resonance (MR) images.

Materials And Methods: One hundred ninety-two patients with mammographically visible or palpable findings underwent T1- and fat-saturated T2-weighted spin-echo and contrast agent-enhanced fat-saturated gradient-echo MR imaging. Patients underwent subsequent excisional biopsy for histopathologic confirmation.

Effect of protein intake on tumor growth and cell cycle kinetics.

Previous research has documented significant acceleration of tumor growth in animals receiving short-term parenteral nutrition. This study was performed to determine the effect of long-term enteral protein intake on tumor cell cycle kinetics in the tumor-bearing host. Fifty Lewis/Wistar rats with subcutaneous mammary tumor implants (AC-33) were randomized to receive a standard protein diet (22.

Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy.

Purpose: To investigate the effect of contrast material-enhanced magnetic resonance (MR) imaging on staging of breast cancer in patients with mammographically or clinically suspected tumor.

Materials And Methods: One hundred seventy-six patients underwent breast MR imaging at 1.5 T before excisional biopsy of a suspicious mammographic or palpable abnormality.