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Researches of Breast Cancer

Home > Pueraria Mirifica > Researches of Breast Cancer

Breast reduction and subsequent cancer: A prophylactic perspective

Author : Beniamino Palmieria,, Giorgia Benuzzia, Alberto Costab, Simone Grappolinic
a. Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia, Clinica Chirurgica, Via del Pozzo, 71, 41100 Modena, Italy
b. Department of Surgery, Fondazione Maugeri, Pavia, Italy
c.Department of Plastic Surgery, Fondazione Clinica Humanitas, Milano
Abstract :

The aim of this paper was to evaluate the impact of breast-gland remodelling, for cosmetic or functional purposes, on cancer incidence during longterm post-surgical follow-up. We reviewed the literature investigating the ratio between the amount of breast tissue resected and cancer incidence during followup. Our analysis of the published data suggested that hypertrophic breast remodelling decreases the risk of breast and other types of cancer in post-operative patients. The actual risk reduction for patients over 40 years of age is related to the weight of the surgical specimens during the previous operation. Our conclusions support the use of breast-reduction surgery as a preventive measure in patients complaining of symptomatic breast enlargement, especially those with a family history of breast cancer.

Published : 29 September 2005
Keywords : Breast cancer; Breast hypertrophy; Breast reduction; Gigantomastia

Inverse Planning of Energy - Modulated Electron Beams in Radiotherapy

Authors : JOHN R. GENTRY, M.S., RICHARD STEEVES, M.D., PH.D., and BHUDATT A. PALIWAL, PH.D.
Department of Human Oncology, Comprehensive Cancer Care Center, University of Wisconsin-Madison,
Madison, WI 53792
Abstract :

The use of megavoltage electron beams often poses a clinical challenge in that the planning target volume (PTV) is anterior to other radiosensitive structures and has variable depth. To ensure that skin as well as the deepest extent of the PTV receives the prescribed dose entails prescribing to a point beyond the depth of peak dose for a single electron energy. This causes dose inhomogeneities and heightened potential for tissue fibrosis, scarring, and possible soft tissue necrosis. Use of bolus on the skin improves the entrant dose at the cost of decreasing the therapeutic depth that can be treated. Selection of a higher energy to improve dose homogeneity results in increased dose to structures beyond the PTV, as well as enlargement of the volume receiving heightened dose. Measured electron data from a linear accelerator was used as input to create an inverse planning tool employing energy and intensity modulation using bolus (e-IMRTT). Using tools readily available in a radiotherapy department, the applications of energy and intensity modulation on the central axis makes it possible to remove hot spots of 115% or more over the depths clinically encountered. The e-IMRTT algorithm enables the development of patient-specific dose distributions with user-defined positions of peak dose, range, and reduced dose to points beyond the prescription point.

Published : 14 March 2005
Keywords : Electron energy/intensity modulation, Inverse treatment Planning, Breast cancer

Is the Clinically Positive Axilla in Breast Cancer Really a Contraindication to Sentinel Lymph Node Biopsy?

Authors : Michelle C Specht, MD, Jane V Fey, MPH, Patrick I Borgen, MD, FACS, Hiram S Cody III, MD, FACS
Abstract :

Background: Clinically positive axillary nodes are widely considered a contraindication to sentinel lymph node (SLN) biopsy in breast cancer, yet no data support this mandate. In fact, data from the era of axillary lymph node dissection (ALND) suggest that clinical examination of the axilla is falsely positive in as many as 30% of cases.Here we report the results of SLN biopsy in a selected group of breast cancer patients with palpable axillary nodes classified as either moderately or highly suspicious for metastasis.

Study Design: Among 2,027 consecutive SLN biopsy procedures performed by two experienced surgeons, clinically suspicious axillary nodes were identified in 106, and categorized as group 1 (asymmetric enlargement of the ipsilateral axillary nodes moderately suspicious for metastasis, n62) and group 2 (clinically positive axillary nodes highly uspicious for metastasis, n44

Results: Clinical examination of the axilla was inaccurate in 41% of patients (43 of 106) overall, and was falsely positive in 53% of patients (33 of 62) with moderately suspicious nodes and 23% of patients (10 of 44) with highly suspicious nodes. False-positive results were less frequent with larger tumor size (p  0.002) and higher histologic grade (p  0.002), but were not associated with age, body mass index, or a previous surgical biops.

Conclusion: Clinical axillary examination in breast cancer is subject to false-positive results, and is by itself insufficient justification for axillary lymph node dissection. If other means of preoperative assessment such as palpation- or image-guided fine needle aspiration are negative or indeterminate, then SLN biopsy deserves wider consideration as an alternative to routine axillary lymph node dissection in the clinically node-positive setting.

Published : 2005
Keywords : Phytoestrogens, Pueraria mirifica, Hippocampal neuron, 17β-estradiol, Synaptophysin, Synaptic density

Menstrual and Reproductive Risk Factors and Risk for Gastric Adenocarcinoma in Women: Findings From the Canadian National Enhanced Cancer Surveillance System

Authors: SARAH FRISE, MSC, PHD, NANCY KREIGER, MPH, PHD, STEVEN GALLINGER, MD, GEORGE TOMLINSON, PHD, AND MICHELLE COTTERCHIO, PHD
Abstract:

Purpose:The role of menstrual and reproductive risk factors for gastric cancer has not been well studied.

Methods: This population-based case-control study included 326 women aged 20 to 74 years with gastric adenocarcinoma. Controls were 326 women frequency matched on age. Data for reproductive and/or hormonal exposure and gastric cancer risk factors were captured through self-administered questionnaire.

Results: Later age at menarche was associated with increased risk for adenocarcinoma compared with menarche onset at younger than 13 years of age (13 to 14 years: odds ratio [OR], 1.45; 95% confidence interval [CI], 1.00-2.10; >15 years: OR, 1.93; 95% CI, 1.19-3.13). Compared with premenopause, natural menopause was associated with increased risk for adenocarcinoma (OR, 1.99; 95% CI, 0.98-4.05). Compared with nulliparity, 4 or more births were associated with decreased risk for gastric cancer, as was being pregnant for 5 months or longer if the first pregnancy occurred at younger than 24 years (OR, 0.55; 95% CI, 0.31-0.96) or 25 years or older (OR, 0.67; 95% CI, 0.38-1.18). Oral contraceptives and hormone replacement therapy were associated with a non-statistically significant decreased risk.

Conclusion :These findings suggest that hormonal factors associated with greater exposure to estrogen and/or progesterone may be associated with decreased risk for gastric cancer. Ann Epidemiol 2006;16:908-916.

Published : 2006
Key words : Epidemiology, Hormones, Menstruation, Risk Factors, Stomach Cancer, Women
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