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Clinical features of male breast cancer
ThursLia?;
Poster Srssion I. Biolo,qy
13 Marc.h 2003
Patients & Method: Among about 6500 primary breast cancer patients who underwent mastectomy at Cancer Institute Hospital, from 1984 through 1996, 156 patients suffered from brain metastases by 2000. 27 of those primary breast carcinoma ware without lymphatic permeation and axillary lymph node metastases (no group) and 129 were with lymphatic permeation or node positive (n+ group). Pathology of primary tumor. clinical course of those patients and their treatment outcomes were analyzed retrospectively. Results: According to Japanese classification, invasive ductal carcinoma is classified into several subgroups, for example, papillo-tubular. solid tubular, schirrhous carcinoma and so on. Solid tubular carcinoma which is characterized with solid growth of large cancer cells with large nucleus showed significantly high ratio in n0 group (52% of n0 group vs. 32% of n+ group). The presence of lung or pleural metastases was diagnosed in 27 patients (100%) of n0 group and all but one experienced brain metastases subsequently to those metastases, whereas only 63% of n+ group had lung or pleural metastases. Although disease free interval after mastectomy tended to be longer for n0 group, there was no significant difference in survival time between n0 and n+ group. The median age at diagnosis was 51 for n0 and 45 for n+ group. Most of n0 patients were adjuvant free, whereas most of n+ patients underwent CAF or CMF. Conclusions: A subgroup of n0 breast cancer tends to metastasize to brain in early stage via lung or pleura. n0 group is not always a prestage of n+ group, but some aggressive subgroup of n0 group might metastasize to other organs via alternative route other than axillar lymphatic vessels.
c
P47
Unilateral multicentric
breast cancer
J. FajdiC.D. Hod.%, I. BagariC.Department 0fSufg.q Departmentof GynecologyDepatiment of Pathology; Pojega Counv General Hospitat, Po.?ega, Croatia
Goal: Clinical characteristics of unilateral multicentric breast cancer (UMBC) were explored in the group of surgically treated patients various ages, especially depending on relapse rate, disease-free period and surgical method. Methods: Study included 296 women with breast cancer, surgically treated between June 1992 and June 2002. UMBC was histologically proved in 31 (10.5%) of those patients. Multicentricity was defined as followed criteria: a) tumor with minimum one satellite node in the same or other quadrants of the breast b) minimum one cut through the breast without tumor cells c) histopathologically, discontinued tumors with intra-ductal invasion Results: Average age of patients was 63.4 (range 36-85). Average followup period was 6,5 years (range 0,2-12 years). Primary tumor dimensions were 1 ,O-6,O cm, average 1.9 cm. There were IO women with one satellite node, 7 women with two satellite nodes, and 14 women with three or more satellite nodes. At the operation, axilla was positive in 21 (67,7%) women. In 14 (45.2%) women satellite tumors were found in more quadrants of the same breast. Steroid receptors were highly positive in 12 (38,7) out of 31 patients. Primary and secondary tumors were the same hystological type in 28 (90.3%) out of 31 patients. Local recurrence was found in only 3 (9,7%) patients. Five-year disease-free period was occurred in 26 (83,8%) women. All patients with UMBC were surgically treated by modified radical mastectomy (MRM). Conclusion: Those results showed slightly lower disease-free period than among patients with monocentric breast cancer (MOBC). So, we concluded that multicentricity does not increase the risk of poor prognosis, especially in lower stage tumors, T 1-2, N O-l.
S29
cases the size of tumor was I-2 cm. In some cases tumors were larger (4x5 cm). Among the histological types, intraductal cancer was the most common type (in 12 patients). Adenocarcinoma was detected in 9 patients, 4 patients had lobular carcinoma. Other histological types were detected less often. Operation most frequently performed was modified radical mastectomy with axillary dissection (28 operations). In two cases only mastectomy without axillary dissection of lymph nodes was performed. In cases with N+ the patients were treated with radiotherapy (40-42 Gy) and chemotherapy (11 patients). In cases of NO, patients received only tamoxifen. Median survival of patients with stage I disease was 38,6 months, stage II - 24,3 months, stage Ill -13.7 months and stage IV - 10 months. Eight patients died of disease progression, 2 patients died from other diseases. 14 patients are alive without recurrences. We did not find any predisposing risk factors (radiation exposure or estrogen administration) in our patients. The patients did not have female relatives with breast cancer.
w
Features of current and the prognostic male breast cancer (MBC)
factors of the
ES. Hoto, V.P. Letyagin. Uzhgorod National Universitt,! Ukraine and Blokhin Cancer Research centec Russia
Goals: The analysrs of cases of the MBC with the aim of investigation of the flowing of this disease and study the regularities of its development. Besides the task was put to reveal the factors of the prognosis of the MBC. Methods: Retrospective analysis of 168 cases of MBC who were under treatment from 1950 till 2000. Analysis of data was carried out according the following criteria: age, body mass index (BMI). stage, T and N categories, quantity of the lymph nodes struck with metastasizes, grade of the tumour malignancy, receptor status of the turnour, etc. Results: Average age of the patients is 56.1m11.2. Overwhelming majority of them had the excess weight (average BMI 26.75m4.18). Two of the patients (1.2%) had 0 stage (TisNOM)), 22 (13.1%) - I st. 52 (31 .O%) - II St., 53 (31.6%) - III st. and 27 (16.1%) - IV st. of the process. Average duration of anamnesis reached 13.9 months for all group. Average tumour size was 3.59m2.32 cm and in 82.0% cases it was located subareolary. Using morphologic investigation in most cases the carcinoma of II grade of malignancy was observed (44.5% of cases). 75.41% of patients had ER positive tumours and 43.64% - PR positive turnours. Conclusions: The peak of the morbidity of MBC is observed on the sixth decade of life. In half cases this illness is revealed in late stages of the process. MBC is taking an aggressive form; the disease rapidly develops into inoperable stage. The most significant prognostic factors of MBC are the tumour size and its local spreading, and also the degree of metastaticdefeats of the regional lymph nodes. The grade of the malignancy is also the most significant characteristic of the tumour, which influence on the disease prog nosis. The level of ER and PR of the tumour is not a significant factor of the prognosis of MBC.
THURSDAY, 13 MARCH 2003
Biology
de,
El
P48
use of oral contraception Clinical features of male breast cancer
A. Mudenas.A. Jackevicius,S. Bruzas, A. Luksyte.tnstitute of Oncobg~ Wnius LJniversi& Depattment of Breast Surge%
Wnius, Lithuania
Male breast cancer is relatively rare disease. In Lithuania, the incidence of male breast cancer is 3.6 - 4.9 cases per million males. In this study, we analysed disease characteristics in 30 males with breast cancer treated at Surgery Clinic of the Institute of Oncology, Vilnius University. Mean age of patients was 70.2 years (range 51 - 87 years). The stages of the disease at diagnosis were the following: 3 patients had stage I, 11 patients - stage II, 13 patients - stage Ill. 3 patients - stage IV disease. Thus, the majority of patients had stage 11-111 disease. The distribution of patients according to TNM classification was the following: 3 patients had TINOMO, 9 patients T2NOM0, 1 patient - TINIMO, 2 patients - T2NIMO. 3 patients -TINPMO, I patient-T3NIM0, 1 patlent - T3N2M0, 7 patients -T4NO-I,2 MO, 3 patients had distant metastases (Ml). Majority of patients had tumor in the region of nipple (23 cases). Ulceration of tumor was present in 7 patients. In most
and nultiparity
R. Cericatto’ A. , Pozzobor?.J. B&its’,
C. Menke’ ,I. Silva2, P. Spritze?. de Ctinicas de Port0 Atege - Bmzi7, Breast Service, Port0 Alegre - RS, Brazit ’ Univefsidade Federal do Rio Gmnde do Sul, Deparfment of Physiologg)!Port0 Alegre - RS, Bmzil
’Hospital
This study was developed to evaluate mechanisms involved in cellular proliferation and tumorigenesis in normal breast tissue and in benign breast nodules (fibroadenomas). Fifty seven premenopausal women, presenting with breast lumps suggestive of fibroadenomas, at the Breast Service of Hospital de Clinicas de Porto Alegre, Brazil, were selected during 2001. At the surgical day, blood sample was drawn for progesterone dosage, and fragments from the nodule and normal adjacent breast tissue were separated and immediately frozen in liquid nitrogen for posterior RNA extraction (guanidiniumthiocyanate-phenol-chloroform method). cDNA amplification was followed by RT-PCR assays, to determine ER-alpha. bcl-2 and c-myc mRNA levels in matched normal breast-fibroadenomas pairs. Patients were divided into four categories according to the phase of menstrual cycle, progesterone levels
Poster Srssion I. Biolo,qy
13 Marc.h 2003
Patients & Method: Among about 6500 primary breast cancer patients who underwent mastectomy at Cancer Institute Hospital, from 1984 through 1996, 156 patients suffered from brain metastases by 2000. 27 of those primary breast carcinoma ware without lymphatic permeation and axillary lymph node metastases (no group) and 129 were with lymphatic permeation or node positive (n+ group). Pathology of primary tumor. clinical course of those patients and their treatment outcomes were analyzed retrospectively. Results: According to Japanese classification, invasive ductal carcinoma is classified into several subgroups, for example, papillo-tubular. solid tubular, schirrhous carcinoma and so on. Solid tubular carcinoma which is characterized with solid growth of large cancer cells with large nucleus showed significantly high ratio in n0 group (52% of n0 group vs. 32% of n+ group). The presence of lung or pleural metastases was diagnosed in 27 patients (100%) of n0 group and all but one experienced brain metastases subsequently to those metastases, whereas only 63% of n+ group had lung or pleural metastases. Although disease free interval after mastectomy tended to be longer for n0 group, there was no significant difference in survival time between n0 and n+ group. The median age at diagnosis was 51 for n0 and 45 for n+ group. Most of n0 patients were adjuvant free, whereas most of n+ patients underwent CAF or CMF. Conclusions: A subgroup of n0 breast cancer tends to metastasize to brain in early stage via lung or pleura. n0 group is not always a prestage of n+ group, but some aggressive subgroup of n0 group might metastasize to other organs via alternative route other than axillar lymphatic vessels.
c
P47
Unilateral multicentric
breast cancer
J. FajdiC.D. Hod.%, I. BagariC.Department 0fSufg.q Departmentof GynecologyDepatiment of Pathology; Pojega Counv General Hospitat, Po.?ega, Croatia
Goal: Clinical characteristics of unilateral multicentric breast cancer (UMBC) were explored in the group of surgically treated patients various ages, especially depending on relapse rate, disease-free period and surgical method. Methods: Study included 296 women with breast cancer, surgically treated between June 1992 and June 2002. UMBC was histologically proved in 31 (10.5%) of those patients. Multicentricity was defined as followed criteria: a) tumor with minimum one satellite node in the same or other quadrants of the breast b) minimum one cut through the breast without tumor cells c) histopathologically, discontinued tumors with intra-ductal invasion Results: Average age of patients was 63.4 (range 36-85). Average followup period was 6,5 years (range 0,2-12 years). Primary tumor dimensions were 1 ,O-6,O cm, average 1.9 cm. There were IO women with one satellite node, 7 women with two satellite nodes, and 14 women with three or more satellite nodes. At the operation, axilla was positive in 21 (67,7%) women. In 14 (45.2%) women satellite tumors were found in more quadrants of the same breast. Steroid receptors were highly positive in 12 (38,7) out of 31 patients. Primary and secondary tumors were the same hystological type in 28 (90.3%) out of 31 patients. Local recurrence was found in only 3 (9,7%) patients. Five-year disease-free period was occurred in 26 (83,8%) women. All patients with UMBC were surgically treated by modified radical mastectomy (MRM). Conclusion: Those results showed slightly lower disease-free period than among patients with monocentric breast cancer (MOBC). So, we concluded that multicentricity does not increase the risk of poor prognosis, especially in lower stage tumors, T 1-2, N O-l.
S29
cases the size of tumor was I-2 cm. In some cases tumors were larger (4x5 cm). Among the histological types, intraductal cancer was the most common type (in 12 patients). Adenocarcinoma was detected in 9 patients, 4 patients had lobular carcinoma. Other histological types were detected less often. Operation most frequently performed was modified radical mastectomy with axillary dissection (28 operations). In two cases only mastectomy without axillary dissection of lymph nodes was performed. In cases with N+ the patients were treated with radiotherapy (40-42 Gy) and chemotherapy (11 patients). In cases of NO, patients received only tamoxifen. Median survival of patients with stage I disease was 38,6 months, stage II - 24,3 months, stage Ill -13.7 months and stage IV - 10 months. Eight patients died of disease progression, 2 patients died from other diseases. 14 patients are alive without recurrences. We did not find any predisposing risk factors (radiation exposure or estrogen administration) in our patients. The patients did not have female relatives with breast cancer.
w
Features of current and the prognostic male breast cancer (MBC)
factors of the
ES. Hoto, V.P. Letyagin. Uzhgorod National Universitt,! Ukraine and Blokhin Cancer Research centec Russia
Goals: The analysrs of cases of the MBC with the aim of investigation of the flowing of this disease and study the regularities of its development. Besides the task was put to reveal the factors of the prognosis of the MBC. Methods: Retrospective analysis of 168 cases of MBC who were under treatment from 1950 till 2000. Analysis of data was carried out according the following criteria: age, body mass index (BMI). stage, T and N categories, quantity of the lymph nodes struck with metastasizes, grade of the tumour malignancy, receptor status of the turnour, etc. Results: Average age of the patients is 56.1m11.2. Overwhelming majority of them had the excess weight (average BMI 26.75m4.18). Two of the patients (1.2%) had 0 stage (TisNOM)), 22 (13.1%) - I st. 52 (31 .O%) - II St., 53 (31.6%) - III st. and 27 (16.1%) - IV st. of the process. Average duration of anamnesis reached 13.9 months for all group. Average tumour size was 3.59m2.32 cm and in 82.0% cases it was located subareolary. Using morphologic investigation in most cases the carcinoma of II grade of malignancy was observed (44.5% of cases). 75.41% of patients had ER positive tumours and 43.64% - PR positive turnours. Conclusions: The peak of the morbidity of MBC is observed on the sixth decade of life. In half cases this illness is revealed in late stages of the process. MBC is taking an aggressive form; the disease rapidly develops into inoperable stage. The most significant prognostic factors of MBC are the tumour size and its local spreading, and also the degree of metastaticdefeats of the regional lymph nodes. The grade of the malignancy is also the most significant characteristic of the tumour, which influence on the disease prog nosis. The level of ER and PR of the tumour is not a significant factor of the prognosis of MBC.
THURSDAY, 13 MARCH 2003
Biology
de,
El
P48
use of oral contraception Clinical features of male breast cancer
A. Mudenas.A. Jackevicius,S. Bruzas, A. Luksyte.tnstitute of Oncobg~ Wnius LJniversi& Depattment of Breast Surge%
Wnius, Lithuania
Male breast cancer is relatively rare disease. In Lithuania, the incidence of male breast cancer is 3.6 - 4.9 cases per million males. In this study, we analysed disease characteristics in 30 males with breast cancer treated at Surgery Clinic of the Institute of Oncology, Vilnius University. Mean age of patients was 70.2 years (range 51 - 87 years). The stages of the disease at diagnosis were the following: 3 patients had stage I, 11 patients - stage II, 13 patients - stage Ill. 3 patients - stage IV disease. Thus, the majority of patients had stage 11-111 disease. The distribution of patients according to TNM classification was the following: 3 patients had TINOMO, 9 patients T2NOM0, 1 patient - TINIMO, 2 patients - T2NIMO. 3 patients -TINPMO, I patient-T3NIM0, 1 patlent - T3N2M0, 7 patients -T4NO-I,2 MO, 3 patients had distant metastases (Ml). Majority of patients had tumor in the region of nipple (23 cases). Ulceration of tumor was present in 7 patients. In most
and nultiparity
R. Cericatto’ A. , Pozzobor?.J. B&its’,
C. Menke’ ,I. Silva2, P. Spritze?. de Ctinicas de Port0 Atege - Bmzi7, Breast Service, Port0 Alegre - RS, Brazit ’ Univefsidade Federal do Rio Gmnde do Sul, Deparfment of Physiologg)!Port0 Alegre - RS, Bmzil
’Hospital
This study was developed to evaluate mechanisms involved in cellular proliferation and tumorigenesis in normal breast tissue and in benign breast nodules (fibroadenomas). Fifty seven premenopausal women, presenting with breast lumps suggestive of fibroadenomas, at the Breast Service of Hospital de Clinicas de Porto Alegre, Brazil, were selected during 2001. At the surgical day, blood sample was drawn for progesterone dosage, and fragments from the nodule and normal adjacent breast tissue were separated and immediately frozen in liquid nitrogen for posterior RNA extraction (guanidiniumthiocyanate-phenol-chloroform method). cDNA amplification was followed by RT-PCR assays, to determine ER-alpha. bcl-2 and c-myc mRNA levels in matched normal breast-fibroadenomas pairs. Patients were divided into four categories according to the phase of menstrual cycle, progesterone levels