MedWorm: Carcinoma in Situ

Microarray analysis of suppression subtracted hybridisation libraries identifies genes associated with breast cancer progression.

Cellular Oncology — Wed, 10 Mar 2010 13:06:02 +0100

Conclusions: The combination of subtracted cDNA libraries and microarray analysis has thus identified potential diagnostic/prognostic biomarkers and targets for cancer therapy, which have not been identified from common prognostic gene signatures. PMID: 20208137 [PubMed - in process] (Source: Cellular Oncology)

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Genomic profiling of gastric carcinoma in situ and adenomas by array-based comparative genomic hybridization

The Journal of Pathology — Wed, 10 Mar 2010 00:00:00 +0100

In this study, we investigated CNAs of 20 gastric CISs (Vienna category 4.2) and 20 adenomas including seven low-grade adenomas (LGA; Vienna category 3) and 13 high-grade adenomas (HGA; Vienna category 4.1), using oligonucleotide-based array CGH. The most frequent aberrations in CIS were gains at 8q (85%) and 20q (50%), and losses at 5q (50%) and 17p (50%), suggesting that these CNAs are involved in the development of CIS. We found that the pattern of CNAs in HGA was quite different from that in LGA. The most frequent CNAs in HGA were gains at 8q (62%) and 7pq (54%), whereas those in LGA were gain at 7q21.3-q22.1 (57%) and loss at 5q (43%). Interestingly, gains at 8q and 7pq, both of which occurred most frequently in HGA, were not detected in any cases of LGA. Of note, 8q gain was detected...

Neuroendocrine ductal carcinoma in situ of the breast: cytological features in 32 cases

Cytopathology — Fri, 05 Mar 2010 00:00:00 +0100

Conclusions: NE-DCIS has distinctive cytological features and can therefore be diagnosed as a neuroendocrine tumour in most FNAs and some nipple discharge smears by cytological examination employing immunohistochemical techniques. We emphasize that a breast lesion with these features may be in situ and not invasive, and also that there is a risk of under-diagnosis. (Source: Cytopathology)

Mechanisms of epigenetic silencing of the Rassf1a gene during estrogen-induced breast carcinogenesis in ACI rats

Carcinogenesis — Thu, 04 Mar 2010 15:26:25 +0100

In conclusion, we demonstrate that epigenetic alterations precede formation of preneoplastic lesions indicating the significance of epigenetic events in induction of oncogenic pathways in early stages of carcinogenesis. (Source: Carcinogenesis)

Ductal Carcinoma In Situ of the Breast: A Systematic Review of Incidence, Treatment, and Outcomes

Medscape Radiology Headlines — Tue, 02 Mar 2010 16:38:35 +0100

How have DCIS rates changed and what factors influence incidence rates over time? Journal of the National Cancer Institute (Source: Medscape Radiology Headlines)

High-grade hydronephrosis predicts poor outcomes after radical cystectomy in patients with bladder cancer.

J Korean Med Sci — Mon, 01 Mar 2010 00:00:00 +0100

We examined whether the presence and severity of preoperative hydronephrosis have prognostic significance in patients who underwent radical cystectomy for transitional cell carcinoma of the bladder. The medical records of 457 patients who underwent radical cystectomy for bladder cancer between 1986 and 2005 were retrospectively reviewed. Following the Society for Fetal Urology grading system, patients were divided into low-, and high-grade hydronephrosis groups. Clinicopathologic factors associated with preoperative hydronephrosis and survival were evaluated. Of a total of 406 patients, unilateral hydronephrosis was found in 74 (18.2%), bilateral hydronephrosis in 11 (2.7%), and no hydronephoris in 321 (79.1%). Low-grade hydronephrosis was found in 57 (12.2%) patients and high-grade hydron...

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The Adjacent Vessel Sign on Breast MRI: New Data and a Subgroup Analysis for 1,084 Histologically Verified Cases.

Korean J Radiol — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: The adjacent vessel sign was significantly associated with malignancy. Thus, it can be used to accurately assess breast lesions on bMRI. In this study, the AVS was particularly associated with advanced and invasive carcinomas. PMID: 20191065 [PubMed - in process] (Source: Korean J Radiol)

Pseudoneoplastic mimics of prostate and bladder carcinomas.

Archives of Pathology and Laboratory Medicine — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions.-Pseudoneoplastic lesions in the prostate include those of prostatic epithelial origin, the most common being atrophy, adenosis (atypical adenomatous hyperplasia), basal cell hyperplasia, and crowded benign glands, as well as those of nonprostatic origin, such as seminal vesicle epithelium. Such lesions often mimic lower-grade prostatic adenocarcinoma, whereas others, such as clear cell cribriform hyperplasia and granulomatous prostatitis, for example, are in the differential diagnosis of Gleason adenocarcinoma, Gleason grade 4 or 5. Pseudoneoplastic lesions of the urinary bladder include lesions that could potentially be confused with urothelial carcinoma in situ, such as reactive urothelial atypia, and others, such as polypoid/papillary cystitis, where papillary urothelial ne...

Pseudoneoplastic lesions of the female genital tract.

Archives of Pathology and Laboratory Medicine — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions.-Many benign hyperplastic or reactive processes that occur in the female genital tract may be mistaken for neoplasms both clinically and pathologically. Awareness of the features of such lesions will aid in their correct diagnosis and prevent overtreatment of benign processes. PMID: 20196667 [PubMed - in process] (Source: Archives of Pathology and Laboratory Medicine)

Tumor Multiplicity is an Independent Prognostic Factor of Non-muscle-invasive High-grade (T1G3) Bladder Cancer

Japanese Journal of Clinical Oncology — Fri, 26 Feb 2010 16:57:32 +0100

Conclusions T1G3 cancers with multiple lesions showed high risks of intravesical recurrence and progression. Although bacillus Calmette–Guérin instillation reduced the risk of intravesical recurrence, no effect was observed on disease progression. (Source: Japanese Journal of Clinical Oncology)

Differential diagnosis of mammographically and clinically occult breast lesions on diffusion-weighted MRI

Journal of Magnetic Resonance Imaging — Thu, 25 Feb 2010 00:00:00 +0100

To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for mammographically and clinically occult breast lesions.The study included 91 women with 118 breast lesions (91 benign, 12 ductal carcinoma in situ [DCIS], 15 invasive carcinoma) initially detected on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and assigned BI-RADS category 3, 4, or 5. DWI was acquired with b = 0 and 600 s/mm2. Lesion visibility was assessed on DWI. Apparent diffusion coefficient (ADC) values were compared between malignancies, benign lesions, and normal (no abnormal enhancement on DCE-MRI) breast tissue, and the diagnostic performance of DWI was assessed based on ADC thresholding.Twenty-four of 27 (89%) malignant and 74/91 (81%) benign lesions were hyperintense on the b = 60...

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Expression profiles of ProEx C and Ki67 in squamous cell carcinoma in situ of the skin and their relationship with human papillomavirus genotypes

Journal of Cutaneous Pathology — Wed, 24 Feb 2010 00:00:00 +0100

Conclusions: ProExC expression is not associated with HPV in SCCIS of the skin. Proliferating cells are better delineated in SCCIS by ProExC which may be useful to assess the extent of these lesions. Different immunohistochemical profiles seen in neoplasic and non-neoplastic skin lesions suggest diverse alteration of cell-cycle kinetics. Sánchez-Hernández M, Conesa-Zamora P, García-Solano J, Corbalán-Vélez R, Martínez-Barba E, Pérez-Guillermo M. Expression profiles of ProEx C and Ki67 in squamous cell carcinoma in situ of the skin and their relationship with human papillomavirus genotypes. (Source: Journal of Cutaneous Pathology)

Incidence, management, and outcome of incidental gallbladder carcinoma: analysis of the database of the Swiss association of laparoscopic and thoracoscopic surgery

Surgical Endoscopy — Tue, 23 Feb 2010 07:08:22 +0100

Conclusion IGBC has a low incidence (0.28%). We present a large study of patients with IGBC, comparing the overall survival by different histological findings. We observed a significant benefit for the group with pT2 and pT3. Therefore we recommend extended resection of the gallbladder bed and the regional lymph nodes for patient with incidental histologically confirmed pT2 and pT3 carcinoma of the gallbladder after performance of laparoscopic cholecystectomy. For patients with pT1b stage no recommendations can be given based on this study. Content Type Journal ArticleDOI 10.1007/s00464-010-0952-yAuthors Philippe Marc Glauser, Hospital of Liestal Department of Surgery 4410 Liestal SwitzerlandDaniel Strub, Hospital of Liestal Department of Surgery 4410 Liestal Swit...

Cyclooxygenase-2 Inhibition Does Not Improve the Reduction in Ductal Carcinoma In situ Proliferation with Aromatase Inhibitor Therapy: Results of the ERISAC Randomized Placebo-Controlled Trial.

Clinical Breast Cancer — Tue, 23 Feb 2010 00:00:00 +0100

CONCLUSIONS: Exemestane reduces proliferation in ER-positive DCIS. Aromatase inhibition is a potential alternative to tamoxifen in patients who have undergone breast conservation for ER-positive DCIS. Clin Cancer Res; 16(5); 1605-12. PMID: 20179229 [PubMed - as supplied by publisher] (Source: Clinical Breast Cancer)

Cancerous Breast Lesions on Dynamic Contrast-enhanced MR Images: Computerized Characterization for Image-based Prognostic Markers [BREAST IMAGING]

Radiology — Mon, 22 Feb 2010 20:50:30 +0100

Study results show that our MR imaging computer-aided diagnosis algorithm, with use of a combination of computer-extracted MR imaging kinetic and morphologic features, has the potential to be extended to two prognostic tasks: (a) classification of noninvasive (ductal carcinoma in situ) versus invasive (invasive ductal carcinoma [IDC]) lesions and (b) further classification of IDC lesions into lesions with positive lymph nodes (LNs) and lesions with negative LNs. (Source: Radiology)

Early Diagnosis of Lung Cancer

Clinics in Chest Medicine — Mon, 22 Feb 2010 15:57:19 +0100

Early detection and surgical resection is essential for the treatment of lung cancer. Although the introduction of low-dose spiral computed tomography (CT) is considered to be one of the most promising clinical research developments, CT screening is used for detecting small peripheral lesions. Tumors arising in the central airways require other techniques for early detection. Centrally arising squamous cell carcinoma of the airway, especially in heavy smokers, is thought to develop through multiple stages from squamous metaplasia to dysplasia, followed by carcinoma in situ (CIS), progressing to invasive cancer. It would be ideal to be able to detect and treat preinvasive bronchial lesions defined as dysplasia and CIS before progressing to invasive cancer. Great efforts have been made to de...

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MAGE-A antigens in lesions of the oral mucosa

Clinical Oral Investigations — Sat, 20 Feb 2010 06:51:50 +0100

Abstract Oral squamous cell carcinoma develops continuously out of predamaged oral mucosa. For the physician and pathologist, difficulties arise in distinguishing precancerous from cancerous lesions. MAGE-A antigens are tumor antigens that are found solely in malignant transformed cells. These antigens might be useful in distinguishing precancerous from cancerous lesions. The aim of this study was to verify this assumption by comparing MAGE-A expression in benign, precancerous, and cancerous lesions of the oral mucosa. Retrospectively, biopsies of different oral lesions were randomly selected. The lesions that were included are 64 benign oral lesions (25 traumatic lesions (oral ulcers), 13 dental follicles, and 26 epulis), 26 oral lichen planus, 123 epithelial precursor le...

Expression of Vascular Notch Ligand Delta-Like 4 and Inflammatory Markers in Breast Cancer.

The American Journal of Pathology — Thu, 18 Feb 2010 00:00:00 +0100

We examined 296 breast adenocarcinomas and 38 ductal carcinoma in situ tissues that were represented in tissue microarrays. Additional whole sections representing 10 breast adenocarcinomas, 10 normal breast tissues, and 16 angiosarcomas were included. Immunohistochemistry was then performed by using validated antibodies against Dll4, CD68, CD14, DC-SIGN, CD123, neutrophil elastase, CD31, and carbonic anhydrase 9. Dll4 was selectively expressed by intratumoral endothelial cells in 73% to 100% of breast adenocarcinomas, 18% of in situ ductal carcinomas, and all lactating breast cases, but not normal nonlactating breast. High intensity of endothelial Dll4 expression was a statistically significant adverse prognostic factor in univariate (P = 0.002 and P = 0.01) and multivariate analyses (P = ...

Epidermotropic Merkel cell carcinoma: A case series with histopathologic examination

Journal of the American Academy of Dermatology — Tue, 16 Feb 2010 14:09:30 +0100

Conclusion: The data presented reinforce the differential diagnosis of tumors with an epidermotropic growth pattern and the importance of immunohistochemical staining in the histologic workup of such tumors: squamous cell carcinoma in situ, melanoma, mycosis fungoides, eccrine porocarcinoma, sebaceous carcinoma of the eyelid, mammary and extramammary Paget disease, MCC, and epidermotropic metastases. It is notable that 3 of 6 identified tumors were located on the eyelid; further study of epidermotropic MCC may shed more light on this finding, either as an unusual coincidence or a finding with unexplained significance. (Source: Journal of the American Academy of Dermatology)

[Ductal carcinoma in situ of the breast (DCIS). Histopathological features and treatment modalities: analysis of 1,289 cases.]

Bulletin du Cancer — Tue, 16 Feb 2010 00:00:00 +0100

Authors: Cutuli B, Lemanski C, Fourquet A, de Lafontan B, Giard S, Lancrenon S, Meunier A, Pioud-Martigny R, Campana F, Marsiglia H, Mery E, Penault-Llorca F, Fondrinier E, Tunon de Lara C From March 2003 to April 2004, were prospectively collected in France 1,289 ductal carcinoma in situ (DCIS) with data on diagnosis, patient and tumour characteristics, and treatments. Median age was 56 years (range, 30-84). DCIS was diagnosed by mammography in 87.6% of patients. Mastectomy (M), conservative surgery alone (CS) and conservative surgery with radiotherapy (CS + RT) were performed in 30.5, 7.8 and 61.7% of patients, respectively. Sentinel node biopsy (SNB) and axillary dissection (AD) were performed in 21.3 and 10.4% of patients, respectively. Hormone therapy was administered to 13.4% of ...

Time-Resolved Fluorescence Spectroscopy as a Diagnostic Technique of Oral Carcinoma: Validation in the Hamster Buccal Pouch Model [Original Article]

Archives of Otolaryngology — Mon, 15 Feb 2010 20:50:39 +0100

Conclusions The addition of time-resolved fluorescence-derived parameters significantly improves the capability of fluorescence spectroscopy–based diagnostics in the hamster buccal pouch. This technique provides a potential noninvasive diagnostic instrument for head and neck cancer. (Source: Archives of Otolaryngology)

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DCIS and the Power of Words

Medscape Today Headlines — Fri, 12 Feb 2010 22:10:28 +0100

The word carcinoma impacts how patients and physicians think about ductal carcinoma in situ. Dr. Kathy Miller considers whether a change in name could influence a change in practice. Medscape Hematology-Oncology (Source: Medscape Today Headlines)

Time- and Spectral-resolved two-photon imaging of healthy bladder mucosa and carcinoma in situ

Optics Express — Thu, 11 Feb 2010 05:00:00 +0100

Combined non-linear imaging techniques were used to deeply image human ex-vivo fresh biopsies of bladder as well as to discriminate between healthy bladder mucosa and carcinoma in situ. Morphological examination by two-photon excited fluorescence and second-harmonic generation has shown a good ... (Source: Optics Express)

Number of lymph nodes removed in sentinel lymph node-negative breast cancer patients is significantly related to patient age and tumor size

Cancer — Thu, 11 Feb 2010 00:00:00 +0100

Sentinel lymph node (SLN) biopsy has been well-established for axillary lymph node staging for patients with breast cancer. For lymph node-negative patients, planned "backup" axillary lymph node dissection (ALND) is rarely indicated. Among patients with negative SLNs, the authors observed variation by tumor size and patient age in the total number of lymph nodes removed (SLNs plus non-SLNs). They hypothesized that this variation is an unrecognized source of bias for studies examining the morbidity of SLN biopsy.Retrospective review of this institution's SLN database identified 4103 SLN biopsy procedures between 1997 and 2004 in which SLN biopsy was performed for prophylactic mastectomy, ductal carcinoma in situ, or T1 to T2 invasive cancers, and the SLNs were benign.The mean number of SLNs...

Following DCIS Diagnosis, Psychosicail Interventions Recommended

Dermatology News From Medical News Today — Tue, 09 Feb 2010 11:00:00 +0100

Following DCIS Diagnosis, Psychosicail Interventions Recommended

Health News from Medical News Today — Tue, 09 Feb 2010 11:00:00 +0100

A new analysis has found that women with medium or low levels of income are particularly susceptible to anxiety and depression after being diagnosed with the precancerous breast condition, ductal carcinoma in situ (DCIS). Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the study suggests that women with financial hardship may benefit from psychosocial interventions that are designed to accommodate their unique needs... (Source: Health News from Medical News Today)

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Financial hardship and anxiety

Medicineworld.org: New Article Alert — Mon, 08 Feb 2010 14:04:47 +0100

A new analysis has observed that women with medium or low levels of income are especially susceptible to anxiety and depression after being diagnosed with the premalignant breast condition, ductal carcinoma in situ (DCIS). Published early online in Cancer, a peer-evaluated journal of the American Cancer Society, the study suggests that women with financial hardship appears to benefit from psychosocial interventions that are designed to accommodate their unique needs........ (Source: Medicineworld.org: New Article Alert)

Financial hardship contributes to diagnosis anxiety

EurekAlert! - Social and Behavioral Science — Mon, 08 Feb 2010 05:00:00 +0100

(American Cancer Society) Women with medium or low levels of income are more susceptible to anxiety and depression after ductal carcinoma in situ diagnosis. (Source: EurekAlert! - Social and Behavioral Science)

Financial hardship contributes to diagnosis anxiety

ScienceDaily Headlines — Mon, 08 Feb 2010 05:00:00 +0100

Women with medium or low levels of income are more susceptible to anxiety and depression after ductal carcinoma in situ diagnosis. (Source: ScienceDaily Headlines)

The role of socioeconomic status in adjustment after ductal carcinoma in situ

Cancer — Mon, 08 Feb 2010 00:00:00 +0100

This study also explored whether social support explained the association between SES and distress and whether social support buffered the impact of low SES on distress.A total of 487 women with newly diagnosed DCIS were enrolled in the study. Participants completed questions about sociodemographic, psychosocial, and clinical characteristics at the time of enrollment and 9 months after their diagnosis.Financial status was inversely associated with anxiety and depression at the 9-month follow-up. Financial status also predicted change in anxiety and depression. Women with high financial status reported a decline in anxiety and depression during the study period, whereas women with medium or low financial status reported an increase in anxiety and depression. In addition, the probability of ...

Diagnostic value of vacuum-assisted breast biopsy for breast carcinoma: a meta-analysis and systematic review

Breast Cancer Research and Treatment — Wed, 03 Feb 2010 17:58:00 +0100

Abstract As mammography screening has its limitation in diagnosis in breast carcinoma, minimally invasive procedures offer a better option. We conducted a systematic review to establish the overall value of Vacuum-assisted breast biopsy (VAB) for the diagnosis of breast cancer. After a review and quality assessment of 21 studies, sensitivity, specificity and other measures of accuracy of VAB for evaluating breast lesions were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall accuracy. Underestimate rate of atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) were also calculated. The summary estimates for VAB in diagnosis of breast carcinoma were as follows: sensitivity, 0.981 (95% confidenc...

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Lesion size is a major determinant of the mammographic features of ductal carcinoma in situ: findings from the Sloane project

Clinical Radiology — Wed, 03 Feb 2010 15:36:27 +0100

Aim: To assess the radiological features of calcific ductal carcinoma in situ (DCIS) in a large, multicentre dataset according to grade and size, and to investigate the possibility that DCIS has different mammographic features when small.Materials and methods: The dataset consisted of all Sloane Project DCIS cases where calcification was present mammographically and histological grade and size were available. The radiology data form classifies calcific DCIS as casting/linear, granular/irregular, or punctate. The pathology dataset includes cytonuclear grade and microscopic tumour size. Correlations were sought between the radiological findings and DCIS grade and size. The significance of differences was assessed using the chi-square test and chi-square test for trend.Results: One thousand, ...

Vasohibin-1 as a potential predictor of aggressive behavior of ductal carcinoma in situ of the breast

Cancer Science — Wed, 03 Feb 2010 00:00:00 +0100

In this study, we first evaluated mRNA expression of vasohibin-1 and CD31 in 39 Japanese female breast carcinoma specimens including 22 invasive ductal carcinoma (IDC) and 17 ductal carcinoma in situ (DCIS) using a real-time quantitative RT-PCR (QRT-PCR) with LightCycler system. In addition, we also immunolocalized vasohibin-1 and CD31 and compared their immunoreactivity to nuclear grades and histological grades of 100 carcinoma cases (50 IDC and 50 DCIS). There were no statistically significant differences of CD31 mRNA expression and the number of CD31 positive vessels between DCIS and IDC (P = 0.250 and P = 0.191, respectively), whereas there was a statistically significant difference in vasohibin-1 mRNA expression and the number of vasohibin-1 positive vessels in DCIS and IDC (P = 0.022...

Vasohibin-1 as a potential predictor of aggressive behavior of ductal carcinoma in situ of the breast

Cancer Science — Wed, 03 Feb 2010 00:00:00 +0100

National Institutes of Health State-of-the-Science Conference Statement: Diagnosis and Management of Ductal Carcinoma In Situ September 22-24, 2009

JNCI — Tue, 02 Feb 2010 21:01:32 +0100

Conclusions Clearly, the diagnosis and management of DCIS is highly complex with many unanswered questions, including the fundamental natural history of untreated disease. Because of the noninvasive nature of DCIS, coupled with its favorable prognosis, strong consideration should be given to elimination of the use of the anxiety-producing term "carcinoma" from the description of DCIS. The outcomes in women treated with available therapies are excellent. Thus, the primary question for future research must focus on the accurate identification of patient subsets diagnosed with DCIS, including those persons who may be managed with less therapeutic intervention without sacrificing the excellent outcomes presently achieved. Essential in this quest will be the development and validation of accura...

Ductal Carcinoma In Situ of the Breast: A Systematic Review of Incidence, Treatment, and Outcomes

JNCI — Tue, 02 Feb 2010 21:01:32 +0100

Conclusions Scientific questions deserving further investigation include the relationship between mammography use and DCIS incidence and whether imaging technologies and treatment guidelines can be modified to focus on lesions that are most likely to become clinically problematic. (Source: JNCI)

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Researchers Tackle Ductal Carcinoma in Situ and Its Many Unanswered Questions

JNCI — Tue, 02 Feb 2010 21:01:31 +0100

(Source: JNCI)

Expression of metalloproteases and their inhibitors by tumor and stromal cells in ductal carcinoma in situ of the breast and their relationship with microinvasive events

Journal of Cancer Research and Clinical Oncology — Tue, 02 Feb 2010 17:48:18 +0100

Conclusions There are significant differences in the expression of MMPs and TIMPs, so in tumor cells and stromal cells, between pure DCIS and DCIS with microinvasive foci. Therefore, these staining patterns might display potential applications as biological markers, such as in evaluating microinvasion in resection specimens of breast tumors. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00432-010-0782-2Authors L. O. González, Unidad de Investigación, Hospital de Jove Avda. Eduardo Castro s/n 33920 Gijón Asturias SpainS. González-Reyes, Unidad de Investigación, Hospital de Jove Avda. Eduardo Castro s/n 33920 Gijón Asturias SpainS. Junquera, Unidad de Investigación, Hospital de Jove Avda. Eduardo Castro s/n 33920 Gijón Asturias SpainL. Marín, ...

The role of genetic diversity in cancer

Journal of Clinical Investigation — Tue, 02 Feb 2010 16:14:14 +0100

The role of genetic heterogeneity within neoplasms is increasingly recognized as important for understanding the dynamics of cancer progression, cancer stem cells, and therapeutic resistance, and there is interest in intratumoral heterogeneity measurements as potential biomarkers for risk stratification. In this issue of the JCI, Park et al. characterize this genetic diversity in carcinoma in situ and in invasive regions from 3 types of human breast cancers and lay the groundwork for translation of these measures to the clinic. (Source: Journal of Clinical Investigation)

Cancerous Breast Lesions on Dynamic Contrast-enhanced MR Images: Computerized Characterization for Image-based Prognostic Markers [BREAST IMAGING]

Continuous Publishing articles — Mon, 01 Feb 2010 14:54:27 +0100

Clinicopathologic factors associated with involved margins after breast-conserving surgery for invasive lobular carcinoma.

Clinical Genitourinary Cancer — Mon, 01 Feb 2010 00:00:00 +0100

Conclusion: Core needle biopsy is the preferred method of diagnostic biopsy before surgical intervention. With appropriate patient selection, most patients with early-stage ILC can undergo successful BCS. PMID: 20133259 [PubMed - in process] (Source: Clinical Genitourinary Cancer)

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Papilloma and papillary carcinoma

Seminars in Diagnostic Pathology — Mon, 01 Feb 2010 00:00:00 +0100

Papillomas and papillary carcinomas differ in their 3 fundamental characteristics: the geometric properties of their fronds, the amount of their stroma, and the characteristics of their epithelium. Fibrosis at the edge of papillomas often entraps glands and creates the spurious impression of invasion. The proliferation of surface epithelial cells of papillomas does not give rise to unexpected diagnostic difficulties, but glandular proliferation within the stalks of papillomas often simulates the appearance of cribriform ductal carcinoma in situ. Needle biopsies of papillomas can deposit clusters of benign cells in a distribution that resembles an invasive carcinoma. Although papillomas overrun by ductal carcinoma in situ exhibit a papillary architecture, other features differentiate them f...

Clinging carcinoma: an American perspective

Seminars in Diagnostic Pathology — Mon, 01 Feb 2010 00:00:00 +0100

In 1979, Professor John Azzopardi introduced the term “clinging carcinoma” to describe what he considered to represent examples of ductal carcinoma in-situ (DCIS) characterized by “neoplastic cells…limited to the periphery of the containing structures.” He emphasized that these lesions can be easily missed “since the alteration is cytological rather than anatomical.” Two types of clinging carcinoma were described by Azzopardi. He considered the first to represent a variant of high-grade DCIS, and most pathologists concur with that view. In contrast, pathologists have been much more reluctant to accept Azzopardi's second type of clinging carcinoma as a type of DCIS, particularly in the United States. This second type is characterized by cells with low grade, monomorphic-type c...

Flat ductal intraepithelial neoplasia of the breast: evolution of Azzopardi's “clinging” concept

Seminars in Diagnostic Pathology — Mon, 01 Feb 2010 00:00:00 +0100

Thirty years ago, John G. Azzopardi described a mainly cytologically defined atypical intraepithelial lesion of the breast, which he called “clinging carcinoma in situ,” a variant of “ductal carcinoma in situ.” The lesion was characterized by replacement of native epithelial cells by very few cell layers of mildly to severely atypical epithelial cells. Based on the degree of cytologic atypia, Azzopardi distinguished type 1 with highly atypical nuclei and type 2 with merely subtle cytologic (nuclear) atypia. Although this distinctive lesion remained widely unrecognized and/or ignored by many pathologists for a long period, several recent studies strongly suggest its neoplastic nature. The aim of this review is to focus on the “clinging” concept and its evolution after the first ...

Ureteral frozen sections at the time of radical cystectomy: reliability and clinical implications.

Canadian Urological Association Journal — Mon, 01 Feb 2010 00:00:00 +0100

CONCLUSION: The incidence of CIS and tumour on FS during radical cystectomy for UC is low. The costs associated with FS are substantial. Frozen section analysis should only be performed in select patients undergoing radical cystectomy. PMID: 20165574 [PubMed - in process] (Source: Canadian Urological Association Journal)

[Histopathologic Analysis of Adenoma and Adenoma-related Lesions of the Gallbladder.]

Korean J Gastroenter... — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Gallbladder adenoma is a rare disease, although malignant transformation occurs frequently. Adenoma is a precancerous lesion and the adenoma-carcinoma sequence is one of the gallbladder cancer carcinogenesis. PMID: 20168058 [PubMed - in process] (Source: Korean J Gastroenter...)

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Anal Neoplasms.

The Surgical Clinics of North America — Sun, 31 Jan 2010 02:12:17 +0100

Authors: Garrett K, Kalady MF A variety of lesions comprise tumors of the anal canal, with carcinoma in situ and epidermoid cancers being the most common. Less common anal neoplasms include adenocarcinoma, melanoma, gastrointestinal stromal cell tumors, neuroendocrine tumors, and Buschke-Lowenstein tumors. Treatment strategies are based on anatomic location and histopathology. In this article different tumors and management of each, including a brief review of local excision for rectal cancer, are discussed in turn. PMID: 20109639 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)

Natural history of bronchial preinvasive lesions

Cancer and Metastasis Reviews — Fri, 29 Jan 2010 12:17:42 +0100

Abstract Preinvasive bronchial lesions defined as dysplasia and carcinoma in situ (CIS) have been considered as precursors of squamous cell carcinoma of the lung. The risk and rate of progression of preinvasive lesions to invasive squamous cell carcinoma as well as the mechanism of progression or regression are incompletely understood. While the evidence for the multistage, stepwise progression model is weak with relatively few documented lesions that progress through various grades of dysplasia to CIS and then to invasive carcinoma, the concept of field carcinogenesis is strongly supported. The presence of high-grade dysplasia or CIS is a risk marker for lung cancer both in the central airways and peripheral lung. Genetic alterations such as loss of heterozygosity in chrom...

Chromosomal Alterations in Pure Nonneoplastic Breast Lesions: Implications for Breast Cancer Progression

Annals of Surgical Oncology — Wed, 27 Jan 2010 19:58:36 +0100

Conclusions Pure CCL and ADH lesions demonstrate lower levels of genetic alterations than DCIS, invasive carcinomas or CCL/ADH lesions from cancerous breasts; alterations of chromosomes 16q and 17p were not detected. Pure CCL and ADH lesions are not genetically advanced, and molecular profiles do not support these lesions as obligatory precursors to more advanced disease. Molecular differences between pure and synchronous lesions support re-evaluation of current models of disease initiation, progression, and risk. Content Type Journal ArticleCategory Translational Research and BiomarkersDOI 10.1245/s10434-010-0910-xAuthors Rachel E. Ellsworth, Henry M. Jackson Foundation for the Advancement of Military Medicine Clinical Breast Care Project Windber PA USADarrell L. E...

Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer

World Journal of Surgical Oncology — Wed, 27 Jan 2010 00:00:00 +0100

Background: The impact of sentinel lymph node biopsy on breast cancer mimicking ductal carcinoma in situ (DCIS) is a matter of debate. Methods: We studied the rate of occurrence of sentinel lymph node metastasis in 255 breast cancer patients with pure DCIS showing no invasive components on routine pathological examination. We compared this to the rate of occurrence in 177 patients with predominant intraductal-component (IDC) breast cancers containing invasive foci equal to or less than 0.5 cm in size. Results: Most of the clinical and pathological baseline characteristics were the same between the two groups. However, peritumoral lymphatic permeation occurred less often in the pure DCIS group than in the IDC-predominant invasive-lesion group (1.2% vs. 6.8%, p=0.002). One patient (0.39%) wi...

DCIS size underestimated in third of cases

MedWire News - Oncology — Wed, 27 Jan 2010 00:00:00 +0100

UK study results show that pre-operative imaging underestimates the extent of disease in a third of patients undergoing breast-conserving surgery for ductal carcinoma in situ, resulting in a need for further surgery in these patients. (Source: MedWire News - Oncology)

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DCIS size underestimated in third of cases

MedWire News - Breast Cancer — Wed, 27 Jan 2010 00:00:00 +0100

[Lobular intra-epithelial neoplasia: Atypical lobular hyperplasia and lobular carcinoma in situ.]

Journal de Gynecologie, Obstetrique et Biologie de la Reproduction — Wed, 27 Jan 2010 00:00:00 +0100

Authors: Ansquer Y, Santulli P, Colas C, Jamali M, Tournigand C, Duperray L, Duperray B, Jannet D, Carbonne B OBJECTIVE: To review main knowledge about lobular intra-epithelial neoplasia with special interest for daily practice management. MAIN RESULTS: Intra-epithelial lobular neoplasias (ILN) are non invasive proliferations within the terminal ducto-lobular unit of monomorphic loosely cohesive small cells. A lack of expression of the E-cadherin adhesion molecule is often observed as in invasive lobular breast cancer. ILN are infrequent, however, a rise in incidence partly, due to the generalization of mammographic screening, is observed. Actually ILN are usually asymptomatic and diagnosed after breast biopsy for unspecified microcalcifications. ILN are associated with an increased ri...

Tamoxifen Malabsorption After Roux-en-Y Gastric Bypass Surgery: Case Series and Review of the Literature

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Tue, 26 Jan 2010 00:00:00 +0100

Pharmacotherapy 30(2): 217-217 Abstract Roux-en-Y gastric bypass is a gastric reduction duodenal switch with a combination of restrictive and malabsorptive procedures. It is the most common gastric bypass procedure performed in the United States. Malabsorption causing nutritional deficiencies does occur, yet a PubMed literature search (1955-2009) returned no reports of malabsorption of anticancer agents after gastric bypass. To our knowledge, this is the first report of three cases of malabsorption of the anticancer agent tamoxifen after this procedure. The first patient was a 58-year-old woman who underwent Roux-en-Y bypass for morbid obesity. Two years later, she developed estrogen receptor-positive ductal carcinoma in situ of the breast, underwent lumpectomy and irradiation, and tamoxif...

Heterogeneity for Stem Cell-Related Markers According to Tumor Subtype and Histologic Stage in Breast Cancer.

Clinical Cancer Research — Tue, 26 Jan 2010 00:00:00 +0100

CONCLUSIONS: Our findings suggest that in breast cancer, the frequency of tumor cells positive for stem cell-like and more differentiated cell markers varies according to tumor subtype and histologic stage. Clin Cancer Res; 16(3); 876-87. PMID: 20103682 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Sentinel Lymph Node Biopsy May Not Be Necessary in All Patients Undergoing Prophylactic Mastectomy But Should Be Considered in Patients with Inflammatory Breast Cancer and/or Extensive Ipsilateral Axillary Disease

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:51 +0100

Conclusion: The incidence of occult malignancy in the setting of contralateral mastectomy is low (2%), and this may call into question the need for routine sentinel node biopsy in all patients undergoing this procedure. However, patients with ipsilateral inflammatory breast cancer and/or extensive axillary disease are at higher risk of having contralateral malignancy, and sentinel lymph node biopsy may be warranted on the prophylactic side in these patients. (Source: Journal of Surgical Research)

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The Use of Breast MRI Surveillance in Women with Prior Curative-Intent Therapy for Breast Cancer

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:33 +0100

Conclusion: Prospective studies are needed to determine which patients would potentially benefit from breast MRI surveillance following curative-intent treatment. The lack of standardized guidelines may result in excessive or inappropriate use, unnecessary follow-up procedures, and a concomitant low yield. (Source: Journal of Surgical Research)

Role of magnetic resonance imaging in managing selected women with newly diagnosed breast cancer.

Breast — Mon, 25 Jan 2010 00:00:00 +0100

Authors: Scomersi S, Urbani M, Tonutti M, Zanconati F, Bortul M The purpose of this study is evaluation of therapeutic impact of magnetic resonance imaging (MRI) in breast cancer patients that cannot be imaged adequately with traditional radiology: dense breasts, microcalcifications suspicious for carcinoma in situ or discordance between mammography and ultrasound. A review was performed of 493 patients' records: determination of breast MRI effect on clinical management was made for the selected 70 cases by analysing pre-MRI and post-MRI therapeutic plans. Analysis of final pathology was useful to determine if the change in surgical plan prompted by MRI was appropriate. Breast MRI added clinical information in 52.9% of patients that resulted in 44.3% of management changes that were jud...

Long-term efficacy of maintenance bacillus Calmette-Guérin versus maintenance mitomycin C instillation therapy in frequently recurrent TaT1 tumours without carcinoma in situ: a subgroup analysis of the prospective, randomised FinnBladder I study with a 20-year follow-up

International Braz J Urol — Sat, 23 Jan 2010 15:25:40 +0100

Conclusion: The therapeutic system was found to be dermatologically non-irritant and hence, a therapeutically effective amount of alfuzosin hydrochloride can be delivered via a transdermal route. (Source: International Braz J Urol)

Histology after lumpectomy in women with epithelial atypia on stereotactic vacuum-assisted breast biopsy

European Journal of Surgical Oncology — Fri, 22 Jan 2010 13:47:57 +0100

Conclusion: ADH diagnosed by vacuum-assisted breast biopsy frequently corresponds to cancer on open surgical biopsy. Surgical excision of all breast lesions containing atypical hyperplasia on percutaneous biopsy can be recommended. (Source: European Journal of Surgical Oncology)

The impact of margin status in breast-conserving therapy for lobular carcinoma is age related

European Journal of Surgical Oncology — Fri, 22 Jan 2010 13:47:57 +0100

Conclusions: Positive margins for invasive carcinoma seem to be a strong predictor for local recurrence in particular for women≤50-years. Our study showed grade 3 and tumour size to be strong predictors of DMFS, DFS, and DSS. Margin status was not. (Source: European Journal of Surgical Oncology)

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Scientists At Columbia University Target Bladder Cancer

Cancercompass News: Other Cancer — Fri, 22 Jan 2010 00:00:00 +0100

Early-stage bladder cancer occurs as two distinct forms: namely, low-grade superficial disease and high-grade carcinoma in situ (CIS), which is the major precursor of muscle-invasive bladder cancer. Although the low-grade form is readily treatable, few, if any, effective treatments are currently available for preventing progression of nonmuscle-invasive CIS to invasive bladder cancer, scientists in the United States report. (Source: Cancercompass News: Other Cancer)

Solitary Dilated Duct Identified at Mammography: Outcomes Analysis

American Journal of Roentgenology — Thu, 21 Jan 2010 20:14:22 +0100

CONCLUSION. Solitary dilated duct is a rare mammographic finding, this series being the largest reported to date. Although few cases are studied, solitary dilated duct appears to have a greater than 2% likelihood of malignancy, sufficiently high to suggest that a suspicious (BI-RADS 4a) assessment may be appropriate. (Source: American Journal of Roentgenology)

Ductal carcinoma in situ of breast needs to be stratified further according to risk of progressing

BMJ Online First — Wed, 20 Jan 2010 12:40:31 +0100

(Source: BMJ Online First)

Axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for carcinoma of the breast

Cancer — Wed, 20 Jan 2010 00:00:00 +0100

The timing and accuracy of axillary sentinel lymph node biopsy (SLNB) in patients who are receiving neoadjuvant chemotherapy (NACT) for breast cancer are controversial. To examine the accuracy of SLNB after NACT, the authors performed SLNB after chemotherapy on all of patients who received NACT at their institution starting in January 1997.Seventy-nine women who underwent NACT between 1997 and 2008 comprised this study and were divided as follows: 4 women had stage I disease, 60 women had stage II disease, and 15 women had stage III disease, including 10 women who had multicentric disease. Thirty-nine women (49.4%) had clinical evidence of axillary metastasis (N1-N2) at the time of diagnosis. The regimen, the duration of treatment, and the number of cycles of NACT depended on clinical resp...

Breast cancer screening

NHS News Feed — Tue, 19 Jan 2010 19:25:00 +0100

Conclusion This review presents its authors’ opinions on the 2008 review of the NHS Breast Cancer Screening Programme. They support some areas of their discussion using the findings of other research and statistics from national databases. They conclude that undue emphasis has been placed on the benefits of breast screening, and not enough on its harms. The balance of benefits and harms is an important consideration for any screening programme. But the complexity of the evidence means that this balance can be difficult to judge, and different people may interpret the evidence in different ways. None of the groups involved would deny that screening can have harms, but the precise balance of benefits and harms of breast screening is a controversial issue. The complexity of the issues ...

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Socioeconomic disparities in the decline in invasive breast cancer incidence

Breast Cancer Research and Treatment — Tue, 19 Jan 2010 17:45:47 +0100

We examined the decline in breast cancer incidence according to county-level socioeconomic indicators using data from the Surveillance, Epidemiology and End Results (SEER) program. Since socioeconomic status is associated with mammography screening, we also examined the relation between incidence of ductal carcinoma in situ (DCIS; a strong marker of mammography utilization) and the decline in invasive breast cancer. The reduction in invasive breast cancer incidence between 1998–2001 and 2003–2006 in the SEER 9 registries was greatest among women living in counties with higher median household income (−16% change for ≥$85,000 vs. -4% for <$35,000; P trend < 0.01) and a higher percentage of adults aged 25 years or older with a bachelor’s degree (−13% ch...

Researchers tackle ductal carcinoma in situ and its many unanswered questions

ScienceDaily Headlines — Tue, 19 Jan 2010 07:00:00 +0100

In a new paper, researchers review available data on diagnosis and management of ductal carcinoma in situ (DCIS), and offer recommendations for the field. These include identification of better risk stratification methods, consideration of the elimination of the word "carcinoma" from the name, and further investigation into whether imaging technology and guidelines can be modified to focus on high-risk lesions. (Source: ScienceDaily Headlines)

The Use of Oncoplastic Reduction Techniques to Reconstruct Partial Mastectomy Defects in Women with Ductal Carcinoma In Situ

The Breast Journal — Tue, 19 Jan 2010 00:00:00 +0100

This study suggests that although oncoplastic reduction techniques are a reasonable approach for women with DCIS, stricter patient selection and improved confirmation of negative margins will minimize the need for either re-excisions or completion mastectomy and reconstruction. (Source: The Breast Journal)

Organ-preserving neodymium-yttrium-aluminium-garnet laser therapy for penile carcinoma: a long-term follow-up

BJU International — Tue, 19 Jan 2010 00:00:00 +0100

Study Type [ndash] Therapy (case series)Level of Evidence 4 To retrospectively analyse the long-term follow-up of 54 patients treated with organ-preserving laser therapy for penile carcinoma, as such therapy provides excellent cosmetic and functional results, but recurrence rates are high, which might impair the oncological outcome and worsen tumour-related survival. Between 1979 and 2008, 54 patients with penile carcinoma were treated with the neodymium-doped yttrium-aluminium-garnet (Nd:YAG) laser at our institution; 11 were classified as having carcinoma in situ (Tis), 39 as T1 and four as T2. There was local recurrence in 16 patients (42%); the mean (range) time to local recurrence was 53 (9[ndash]132) months. In half the patients the time to local recurrence was >53 months, with the l...

The Role of Pathology Review of Transurethral Bladder Tumor Resection Specimens in the Modern Era

The Journal of Urology — Tue, 19 Jan 2010 00:00:00 +0100

Conclusions: Second review of transurethral bladder tumor resection specimens shows differences of interpretation in 26.7% to 33.3% of cases, which is sufficient to alter management. There was no significant difference in the rate of discrepancies before and after genitourinary pathology subspecialization. Referral centers must assume responsibility for establishing the diagnosis before consultation and/or therapy. (Source: The Journal of Urology)

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Editorial Comment

The Journal of Urology — Tue, 19 Jan 2010 00:00:00 +0100

In-house pathology review of all specimens before treatment of referred patients certainly is a wise best clinical practice for all entities. It is all the more important for malignancies. In the current manuscript the authors show that this practice remains especially important for patients with bladder cancer. There are many reasons why pathology interpretation of bladder cancer results in greater variation between the primary and secondary or tertiary center review than for any other GU malignancy. Limited tissue samples provided by small cup biopsies and electrocautery artifact are 2 common limitations. Misinterpretation of tumor extension into muscularis mucosa as muscularis propria involvement may lead to tumor over staging. Furthermore, it may be difficult for pathologists to distin...

Overexpression of the oncogenic signal transducer Gab2 occurs early in breast cancer development

International Journal of Cancer — Tue, 19 Jan 2010 00:00:00 +0100

Gab2, a docking-type signaling protein with demonstrated oncogenic potential, is overexpressed in breast cancer, but its prognostic significance and role in disease evolution remain unclear. Immunohistochemical detection of Gab2 in a large cohort of primary human breast cancers of known outcome revealed that while Gab2 expression was positively correlated with increased tumor grade, it did not correlate with disease recurrence or breast cancer-related death in the total cohort or in patients stratified according to lymph node, estrogen receptor (ER) or HER2 status. Interestingly, analysis of a "progression series" that included premalignant and preinvasive breast lesions as well as samples of metastatic disease revealed that Gab2 expression was significantly enhanced in the earliest lesion...

Pigmented Bowen disease of the palm: An atypical case diagnosed by dermoscopy

Journal of the American Academy of Dermatology — Fri, 15 Jan 2010 14:02:08 +0100

We report an exceptional case of pigmented BD of the palm clinically suspicious for melanoma, whose correct diagnosis was suggested by dermoscopy. (Source: Journal of the American Academy of Dermatology)

Predictors of invasion in needle core biopsies of the breast with ductal carcinoma in situ

Modern Pathology AOP — Fri, 15 Jan 2010 00:00:00 +0100

Authors: Edna May L Go, Siu-Ki Chan, Joaquim S L Vong, Philip C W Lui, Anthony W H Chan, Tony K F Ma, Mark A Ang, Bonita K B Law, Puay-Hoon Tan & Gary M Tse (Source: Modern Pathology AOP)

Ductal Carcinoma In Situ And Its Many Unanswered Questions

Health News from Medical News Today — Thu, 14 Jan 2010 13:00:00 +0100

An article and commentary published online January 13 in the Journal of the National Cancer Institute review available data on diagnosis and management of ductal carcinoma in situ (DCIS), and offer recommendations for the field. These include identification of better risk stratification methods, consideration of the elimination of the word "carcinoma" from the name, and further investigation into whether imaging technology and guidelines can be modified to focus on high-risk lesions... (Source: Health News from Medical News Today)

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Ductal Carcinoma In Situ And Its Many Unanswered Questions

Cancer / Oncology News From Medical News Today — Thu, 14 Jan 2010 13:00:00 +0100

Researchers tackle ductal carcinoma in situ and its many unanswered questions

EurekAlert! - Cancer — Wed, 13 Jan 2010 05:00:00 +0100

(Journal of the National Cancer Institute) An article and commentary published online Jan. 13 in the Journal of the National Cancer Institute review available data on diagnosis and management of ductal carcinoma in situ (DCIS), and offer recommendations for the field. These include identification of better risk stratification methods, consideration of the elimination of the word "carcinoma" from the name, and further investigation into whether imaging technology and guidelines can be modified to focus on high-risk lesions. (Source: EurekAlert! - Cancer)

Immunohistochemical analysis of oxidative stress and DNA repair proteins in normal mammary tissue and breast cancer tumors

BMC Cancer — Mon, 11 Jan 2010 00:00:00 +0100

Conclusions: Our studies suggest that oxidative stress and DNA repair proteins not only protect normal cells from the damaging effects of ROS, but may also promote survival of mammary tumor cells. (Source: BMC Cancer)

Frequent aberrant DNA methylation of ABCB1, FOXC1, PPP2R2B and PTEN in ductal carcinoma in situ and early invasive breast cancer

Breast Cancer Research — Thu, 07 Jan 2010 00:00:00 +0100

IntroductionDuctal carcinoma in situ (DCIS) is a non-invasive lesion of the breast that is frequently detected by mammography and subsequently removed by surgery. However, it is estimated that about half of the detected lesions would never have progressed into invasive cancer. Identifying DCIS and invasive cancer specific epigenetic lesions and understanding how these epigenetic changes are involved in triggering tumour progression is important for a better understanding of which lesions are "at risk" of becoming invasive. Methods: Quantitative DNA methylation analysis of ABCB1, CDKN2A/p16INK4a, ESR1, FOXC1, GSTP1, IGF2, MGMT, MLH1, PPP2R2B, PTEN and RASSF1A was performed by pyrosequencing in a series of 27 pure DCIS, 28 small invasive ductal carcinomas (IDCs), 34 IDCs with a DCIS componen...

Frequent aberrant DNA methylation of ABCB1, FOXC1, PPP2R2B and PTEN in ductal carcinoma in situ and early invasive breast cancer

Breast Cancer Research — Thu, 07 Jan 2010 00:00:00 +0100

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Anal Neoplasms

Surgical Clinics of North America — Wed, 06 Jan 2010 15:26:09 +0100

A variety of lesions comprise tumors of the anal canal, with carcinoma in situ and epidermoid cancers being the most common. Less common anal neoplasms include adenocarcinoma, melanoma, gastrointestinal stromal cell tumors, neuroendocrine tumors, and Buschke-Lowenstein tumors. Treatment strategies are based on anatomic location and histopathology. In this article different tumors and management of each, including a brief review of local excision for rectal cancer, are discussed in turn. (Source: Surgical Clinics of North America)

The Ductal Carcinoma In Situ (DCIS) Dilemma

Academic Radiology — Wed, 06 Jan 2010 15:11:38 +0100

Detecting, classifying (grading), treating, and managing ductal carcinoma in situ (DCIS), and other high-risk abnormalities (eg, atypical ductal hyperplasia [ADH]), of the breast remains an ever-evolving, complicated, extremely expensive, and controversial area of interest. (Source: Academic Radiology)

Ductal Carcinoma In Situ: Should the Name Be Changed?

JNCI — Tue, 05 Jan 2010 21:01:46 +0100

(Source: JNCI)

StatBite: Relative Survival and Incidence Rates: Ductal Carcinoma In Situ

JNCI — Tue, 05 Jan 2010 21:01:46 +0100

(Source: JNCI)

Radiological and pathological size estimations of pure ductal carcinoma in situ of the breast, specimen handling and the influence on the success of breast conservation surgery: a review of 2564 cases from the Sloane Project

British Journal of Cancer AOP — Tue, 05 Jan 2010 00:00:00 +0100

Authors: J Thomas, A Evans, J Macartney, S E Pinder, A Hanby, I Ellis, O Kearins, T Roberts, K Clements, G Lawrence & H Bishop (Source: British Journal of Cancer AOP)

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Do liquid-based preparations of urinary cytology perform differently than classically prepared cases? Observations from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology.

Archives of Pathology and Laboratory Medicine — Fri, 01 Jan 2010 00:00:00 +0100

CONCLUSIONS: Liquid-based preparations performed significantly better in urinary cytology challenges when evaluating malignant categories in the College of American Pathologists interlaboratory comparison program. The liquid-based preparation challenges also performed better for the exact reference interpretation of HGUCA, but no difference was observed for adenocarcinoma challenges. Cytotechnologists perform better than pathologists for all slide types, as well as those demonstrating HGUCA. These results suggest that liquid-based preparations facilitate a more accurate diagnosis than conventional preparations. PMID: 20073599 [PubMed - in process] (Source: Archives of Pathology and Laboratory Medicine)

[Critical reappraisal of cholecystectomy in patients with asymptomatic gallstones for early diagnosis and removal of dysplasia and cancer.]

Korean J Gastroenter... — Fri, 01 Jan 2010 00:00:00 +0100

Conclusions: Extending indication of prophylactic cholecystectomy in patients with asymptomatic GS without polyp to prevent GB dysplasia or cancer beyond the existing indication does not seem to be justifiable in Korea. However, further studies are needed in patients with asymptomatic GS and polyp of any size. PMID: 20098067 [PubMed - in process] (Source: Korean J Gastroenter...)

Taurine - a possible fingerprint biomarker in non-muscle invasive bladder cancer: A pilot study by ;{1}H NMR spectroscopy.

Cancer Biomarkers : Section A of Disease Markers — Fri, 01 Jan 2010 00:00:00 +0100

Taurine - a possible fingerprint biomarker in non-muscle invasive bladder cancer: A pilot study by <formula>;{1}</formula>H NMR spectroscopy. Cancer Biomark. 2010 Jan 1;6(1):11-20 Authors: Srivastava S, Roy R, Singh S, Kumar P, Dalela D, Sankhwar SN, Goel A, Sonkar AA Urinary bladder cancer is a major epidemiological problem that continues to grow each year. It opens avenues for investigative research for the identification of new disease markers and diagnostic techniques. In this pilot study, utility of non-invasive <formula>;{1}</formula>H NMR spectroscopy has been evaluated for probing the metabolic perturbations occurring in non-muscle invasive urinary bladder cancer. <formula>;{1}</formula>H NMR spectra of urine of bladder cancer patient...

Deregulation of EZH2 expression in human spermatogenic disorders and testicular germ cell tumors

World Journal of Urology — Wed, 30 Dec 2009 16:43:58 +0100

Conclusion Our data strongly suggest that in TGCT EZH2 does not exert its often assumed oncogenic properties during malignant transformation and progression. High EZH2 levels in normal testicular tissue and the inverse association of its expression levels with the severity of spermatogenic failure point to its potential value as a molecular marker for spermatogenic defects and may indicate an important physiological role of EZH2 during intact spermatogenesis. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00345-009-0498-6Authors Stefan Hinz, Universitätsmedizin Berlin Department of Urology Charité, Campus Mitte, Charitéplatz 1 10117 Berlin GermanyAhmed Magheli, Universitätsmedizin Berlin Department of Urology Charité, Campus Mitte, Charitépla...

The predictive value of testicular ultrasound abnormalities for carcinoma in situ of the testis ...

UroToday — Tue, 29 Dec 2009 23:00:00 +0100

Andrology unit, Department of Urology, Erasmus MC - University Medical Centre Rotterdam, Josephine Nefkens Institute, Rotterdam, The Netherlands. (Source: UroToday)

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Use of Lugol's iodine in the resection of oral and oropharyngeal squamous cell carcinoma

The British Journal of Oral & Maxillofacial Surgery — Fri, 25 Dec 2009 00:00:00 +0100

Abstract: We evaluated the use of Lugol's iodine in achieving surgical margins free from dysplasia, carcinoma in situ, and invasive carcinoma by an observational study of two series of 50 consecutive patients having resection of oral and oropharyngeal squamous cell carcinoma (SCC) between November 2004 and March 2007.The standard group had resection of the primary tumour with a macroscopic 1cm margin and removal of adjacent visibly abnormal mucosa. The Lugol's iodine group had identical treatment with resection of any adjacent mucosa that did not stain after the application of Lugol's iodine (where this was feasible).In the standard group 16 patients (32%) had dysplasia, carcinoma in situ, or invasive SCC at a surgical margin. In the Lugol's iodine group two patients (4%) had dysplasia or ...

Cooperation of Notch and Ras/MAPK signaling pathways in human breast carcinogenesis

Molecular Cancer — Wed, 23 Dec 2009 00:00:00 +0100

Conclusions: High level expression of Notch receptors and ligands, and its increased activation in several breast cancers and early precursors places Notch signaling as a key player in breast cancer pathogenesis. Its cooperation with the Ras/MAPK pathway in transformation offers combined inhibition of the two pathways as a new modality for breast cancer treatment. (Source: Molecular Cancer)

Overdiagnosis in organised mammography screening in Denmark. A comparative study

BioMed Central — Tue, 22 Dec 2009 00:00:00 +0100

DiscussionOne in four breast cancers diagnosed in the screened age group in the Danish screening programme is overdiagnosed. Our estimate for Denmark is lower than that for comparable countries, likely because of lower uptake, lower recall rates and lower detection rates of carcinoma in situ. (Source: BioMed Central)

Gene amplification in ductal carcinoma in situ of the breast

Breast Cancer Research and Treatment — Mon, 21 Dec 2009 23:02:34 +0100

Abstract Multiple different biologically and clinically relevant genes are often amplified in invasive breast cancer, including HER2, ESR1, CCND1, and MYC. So far, little is known about their role in tumor progression. To investigate their significance for tumor invasion, we compared pure ductal carcinoma in situ (DCIS) and DCIS associated with invasive cancer with regard to the amplification of these genes. Fluorescence in situ hybridization (FISH) was performed on a tissue microarray containing samples from 130 pure DCIS and 159 DCIS associated with invasive breast cancer. Of the latter patients, we analyzed the intraductal and invasive components separately. In addition, lymph node metastases of 23 patients with invasive carcinoma were included. Amplification rates of p...

New Type Of Breast Cancer Stops Women In Their Tracks

Cancercompass News: Breast Cancer — Sat, 19 Dec 2009 00:00:00 +0100

Laufer was diagnosed with a perplexing condition called ductal carcinoma in situ, or DCIS, a growth of malignant cells inside the milk ducts of the breast. Though some doctors describe the condition to patients as a very early breast cancer, others compare it to a precancer. (Source: Cancercompass News: Breast Cancer)

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Multimodality Screening of High-Risk Women: A Prospective Cohort Study [Breast Cancer]

Journal of Clinical Oncology — Thu, 17 Dec 2009 23:02:56 +0100

Conclusion The addition of MRI to mammography in the high-risk group has the greatest potential to detect additional mammographically occult cancers. The incremental cancer yield of WBUS and DM is much less. (Source: Journal of Clinical Oncology)

Widespread and multifocal carcinomas in situ (CISs) through almost the entire pancreas: report of a case with preoperative cytological diagnosis

Langenbeck's Archives of Surgery — Wed, 16 Dec 2009 07:01:27 +0100

Conclusions From our experience, we conclude that examination for CIS of the pancreas must be recommended whenever dilatation of relatively large pancreatic ducts is found by ultrasound or computed tomography. We should therefore advance to magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography and then cytological and/or pathological assessment of the pancreatic duct whenever non-continuous narrowing, localized dilatation, or other irregularities are encountered. Content Type Journal ArticleCategory Case Management and Clinical ConsequencesDOI 10.1007/s00423-009-0579-4Authors Makoto Seki, Cancer Institute of the JFCR Departments of Surgery 3-10-6 Ariake, Koto-ku Tokyo 135-8550 JapanEiji Ninomiya, Kasumigaseki-Building Clinic De...

Reproducibility of new classification schemes for the pathology of ductal carcinoma in situ of the breast

Advances in Anatomic Pathology — Tue, 15 Dec 2009 15:00:31 +0100

No abstract available (Source: Advances in Anatomic Pathology)

SABCS: Adjuvant Therapy for DCIS Reduces the Risk of Recurrence (CME/CE)

MedPage Today Hematology/Oncology — Tue, 15 Dec 2009 13:29:59 +0100

SAN ANTONIO (MedPage Today) -- Adjuvant therapy for ductal carcinoma in situ (DCIS) significantly reduced the risk of breast cancer recurrence, but radiotherapy and tamoxifen affected recurrence patterns differently, according to long-term data from a large, randomized clinical trial. (Source: MedPage Today Hematology/Oncology)

Benefits Of Shortened Breast Radiation Course Presented At SABCS

Health News from Medical News Today — Mon, 14 Dec 2009 12:00:00 +0100

New research being presented this week at the 32nd Annual CTRC-AACR San Antonio Breast Cancer Symposium by an investigator at The Cancer Institute of New Jersey (CINJ) highlights the benefit of a shortened radiation course to patients with the most common type of non-invasive breast cancer. Sharad Goyal, MD, instructor of radiation oncology at UMDNJ-Robert Wood Johnson Medical School, is the lead researcher on a poster discussion, which focuses on patients with ductal carcinoma in situ (DCIS), who have had a lumpectomy... (Source: Health News from Medical News Today)

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Intravesical agent is effective option BCG-refractory bladder cancer

Modern Medicine — Sat, 12 Dec 2009 14:23:44 +0100

Intravesical valrubicin (Valstar) provides an effective and tolerable alternative to cystectomy for some heavily pretreated patients with carcinoma in situ that is refractory to bacillus Calmette-Guerin, according to a University of Chicago study. (Source: Modern Medicine)

Ductoscopy in the Evaluation and Management of Nipple Discharge

Annals of Surgical Oncology — Fri, 11 Dec 2009 06:54:33 +0100

Conclusions We believe that, as the technology quickly improves, ductoscopy will become more widely accepted and applied for breast disorders, not only as a diagnostic tool but also as a privileged therapeutic option for certain pathologies. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-009-0820-yAuthors Sedat Kamali, Okmeydani Training and Research Hospital General Surgery Istanbul TurkeyÖmer Bender, Okmeydani Training and Research Hospital General Surgery Istanbul TurkeyMehmet T. Aydin, Okmeydani Training and Research Hospital General Surgery Istanbul TurkeyEnis Yuney, Okmeydani Training and Research Hospital General Surgery Istanbul TurkeyGülçin Kamalı, Okmeydani Training and Research Hospital Pathology Istanbul Turkey Journal Ann...

The effect of gender on response to bacillus Calmette-Guérin therapy for patients with non-muscle-invasive urothelial carcinoma of the bladder

BJU International — Fri, 11 Dec 2009 00:00:00 +0100

Study Type [ndash] Therapy (case series)Level of Evidence 4 To determine the influence of gender on the outcome of patients with high-risk non-muscle-invasive bladder cancer treated with intravesical bacille Calmette-Guérin (BCG) therapy, as the role of hormone status in the pathogenesis of urothelial carcinoma and the response to treatment remains subject to debate. We reviewed 1021 consecutive patients (756 men and 265 women) who were treated with induction BCG between 1978 and 2006 for multiple or recurrent high-grade Ta, T1, and/or carcinoma in situ (CIS) bladder cancer. All patients had [ge]5 years of follow-up. The endpoints of initial response to BCG and the time to disease recurrence and progression were correlated with gender using Kaplan-Meier methods and multivariate Cox regres...

Pathological stage review is indicated in primary pT1 bladder cancer

BJU International — Thu, 10 Dec 2009 00:00:00 +0100

Study Type [ndash] Diagnosis (case series)Level of Evidence 4 To evaluate the effect of a pathology review on the clinical outcome of patients with primary pT1 bladder cancer (BC), as the clinical course of such patients is variable. The slides of 164 primary (first diagnosis) pT1 bladder tumours from two university hospitals were reviewed by one pathologist for stage and grade (World Health Organization 1973 and 2004). Patients were initially managed conservatively with bacille Calmette-Guérin (BCG). Uni- and multivariate analyses compared the predictive value of age, gender, hospital, carcinoma in situ (CIS), tumour-size, reviewed grade and reviewed stage. With a mean follow-up of 6.4 years, there was disease progression in 48 (29%) patients and 26 (16%) died from BC. Associated CIS was...

SUO 2009 - Efficacy and safety of intravesical valrubicin in patients with carcinoma in situ of ...

UroToday — Tue, 08 Dec 2009 23:05:00 +0100

BETHESDA, MD, USA (UroToday.com) - Gary Steinberg presented data on the efficacy of valrubicin (Val) for CIS patients with bladder... (Source: UroToday)

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SUO 2009 - Efficacy and safety of intravesical valrubicin in patients with carcinoma in situ of ...

UroToday — Tue, 08 Dec 2009 23:05:00 +0100

BETHESDA, MD, USA (UroToday.com) - Gary Steinberg presented data on the efficacy of valrubicin (Val) for CIS patients with bladder... (Source: UroToday)

Differential developmental expression of transcription factors GATA-4 and GATA-6, their cofactor FOG-2 and downstream target genes in testicular carcinoma in situ and germ cell tumours.

European Journal of Endocrinology — Mon, 07 Dec 2009 00:00:00 +0100

Conclusions Differential expression of the GATA-4 target genes suggested cell-specific functions of GATA-4 in the germ and somatic cells. The GATA-4 expression in early fetal gonocytes, CIS and seminoma cells but the absence in more mature germ cells, is consistent with the early fetal origin of CIS cells and sug-gests that GATA-4 is involved in early germ cell differentiation. PMID: 19969558 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)

The role of neutrophils and TNF-related apoptosis-inducing ligand (TRAIL) in bacillus Calmette–Guérin (BCG) immunotherapy for urothelial carcinoma of the bladder

Cancer and Metastasis Reviews — Fri, 04 Dec 2009 21:18:12 +0100

Abstract Intravesical Mycobacterium bovis bacillus Calmette–Guérin (BCG) immunotherapy is a highly effective treatment for carcinoma in situ of the bladder, as well as high-risk nonmuscle invasive urothelial carcinoma of the bladder. Despite over 30 years of clinical experience with BCG, the therapy’s mechanism has remained enigmatic. Observations regarding the role of neutrophils in BCG immunotherapy have led to exciting discoveries regarding the potential role of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in creating the therapeutic benefit of BCG immunotherapy. In this paper, we will review the scope of the disease, highlight our understanding of the role for BCG in urothelial carcinoma of the bladder, explain the recent discoveries regardin...

Bowen disease over photoprotected site in an Indian male.

Dermatol Online J — Thu, 03 Dec 2009 20:46:04 +0100

Authors: Gupta S, Nutan N, Dogra S, Kanwar AJ Bowen Disease is squamous cell carcinoma in situ in which the basement membrane is intact on histopathology. Lesions are usually solitary but may be multiple in 10-20 percent of cases. About three-quarters of these lesions are situated on the lower limb. It typically presents as an erythematous enlarging plaque having irregular borders with scaling and crusting. Our patient presented with a lesion on the chest that was not sun exposed thus leading to a diagnostic dilemma. PMID: 19951634 [PubMed - in process] (Source: Dermatol Online J)

MRI Contrast-Uptake Kinetics Is Telling in DCIS

OncologySTAT Latest News — Wed, 02 Dec 2009 13:47:54 +0100

CHICAGO (EGMN) - Contrast-uptake kinetics at MRI had a 99% negative predictive value in excluding the presence of invasion in a prospective study of 134 women with ductal carcinoma in situ on core biopsy."MRI... (Source: OncologySTAT Latest News)

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Abstract IA-14: Molecular alterations that predict premalignancy in breast cancer

Cancer Research — Wed, 02 Dec 2009 04:15:38 +0100

Approximately 15–30% of women diagnosed with ductal carcinoma in situ (DCIS) develop a subsequent tumor event within 10 years after surgical lumpectomy. To date, little is known about the molecular pathways that confer this differential risk for developing subsequent disease. Since DCIS is non-obligate precursor of invasive carcinoma, the majority of DCIS lesions are not associated with subsequent invasive tumors. Likely, many women diagnosed with DCIS who opt for surgery, with or without adjuvant treatment, are being overtreated. Identification of characteristics of DCIS that predict subsequent tumor development would advance our understanding of breast cancer and allow us to stratify a woman's individual risk for subsequent invasive tumors and avoid over- and undertreatment of wome...

Abstract C53: The genetic evolution of oral cancer fields

Cancer Research — Wed, 02 Dec 2009 04:15:35 +0100

Conclusion: Our results indicate that the genetics of the oral cancer field is extremely dynamic, where different clones are evolving in the field. Genetic alterations occurring early in the genetic pathway may be important events that prime the area for further development of cancer. These findings provide evidence for the importance of implementing optical technologies in defining surgical margins as well as the importance of tailored targeted therapies to effectively treat different subclones of a field.Citation Information: Cancer Res 2009;69(23 Suppl):C53. (Source: Cancer Research)

Abstract C31: Identification of causal genetic events in oral cancer progression

Cancer Research — Wed, 02 Dec 2009 04:15:34 +0100

The objective of this study is to determine the essential gene alterations underpinning oral cancer progression.Hypothesis: Since cancers arise through the accumulation of genetic alterations, gene changes detected in the earliest stages of disease are the foundation of observed cancer phenotypes and essential for oral tumorigenesis.Experimental Approaches: Oral premalignant lesions and tumor samples were obtained from the Oral Biopsy Service of British Columbia and are associated with well annotated patient information (including disease outcomes). High resolution tiling-path array comparative genomic hybridization was used to define segmental DNA changes for each sample. Recurring regions of DNA alteration detected in premalignant lesions known to progress and preserved in later stage di...

Abstract B19: An integrative in vivo analysis of PIK3CA, PTEN and AKT alterations in head and neck squamous cell carcinoma

Cancer Research — Wed, 02 Dec 2009 04:15:28 +0100

In conclusion, our data demonstrate an oncogenic role of PIK3CA and AKT, and a tumor suppressive role of PTEN in head and neck tumorigenesis in vivo. Our inducible head and neck specific mouse models are powerful tools to evaluate the roles of PIK3CA, PTEN, and AKT during each stage and site involved in head and neck tumorigenesis, and to test novel therapeutics targeting this important signaling pathway.Citation Information: Cancer Res 2009;69(23 Suppl):B19. (Source: Cancer Research)

Abstract A42: Small molecule activators of p53 for the treatment of inflammatory breast cancer

Cancer Research — Wed, 02 Dec 2009 04:15:23 +0100

Although rare, inflammatory breast cancer (IBC) is the most aggressive form of breast cancer with a 5 year survival of 40% compared to 85% for ductal carcinoma in situ. The standard therapy for this disease is chemo- and radiation therapy; however there are currently no targeted therapies for IBC. Histopathology data suggests that 40–70% of IBC tumors express wild type p53, while approximately 40% are estrogen receptor positive (ER+). The disease is characterized by early and diffuse intravasation of the breast lymphatic vessels by the tumor cells which form emboli that block the drainage of the ducts leading to swelling of the affected breast and erythema. Efforts to increase survival from this often lethal disease have been hindered by the paucity of model systems for studying the ...

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Reactive antibodies against bacillus Calmette-Guerin heat-shock protein-65 potentially predict the outcome of immunotherapy for high-grade transitional cell carcinoma of the bladder

Cancer — Wed, 02 Dec 2009 00:00:00 +0100

The objectives of this study were to identify a marker for measuring the BCG-induced immune response and to predict the outcomes and potential improvements of BCG immunotherapy.Because host immunoresponse mediates BCG activity, the authors screened a combinatorial random peptide library on the circulating pool of immunoglobulins (Igs) purified from an index patient after successful BCG immunotherapy to identify the corresponding target antigen(s).An immunogenic peptide motif was selected, isolated, and validated from M. bovis BCG heat-shock protein 65 (HSP-65) as a dominant epitope of the humoral response to treatment. Increasing IgA and IgG anti-HSP-65 titers specifically predicted a positive patient outcome in a cohort of patients with bladder cancer relative to several cohorts of contro...

Addition of pathology and biomarker information significantly improves the performance of the Manchester scoring system for BRCA1 and BRCA2 testing

Journal of Medical Genetics — Tue, 01 Dec 2009 18:04:20 +0100

Discussion: Data from breast pathology allowed adjustment of BRCA1 and combined BRCA1/2 scores alone. There was a lack of pathological homogeneity for BRCA2, therefore specific pathological correlates could not be identified. Upward adjustments in BRCA1 mutation prediction scores were made for grade 3 ductal cancers, oestrogen receptor (ER) and triple-negative tumours. Downward adjustments in the score were made for grade 1 tumours, lobular cancer, ductal carcinoma in situ and ER/HER2 positivity. Application of the updated scoring system led to four and nine more mutations in BRCA1 being identified at the 10% and 20% threshold, respectively. Furthermore, 65 and 58 fewer cases met the 10% and 20% threshold, respectively, for testing. Moreover, the adjusted score significantly improved the t...

Analysis of stromal signatures in the tumor microenvironment of ductal carcinoma in situ

Breast Cancer Research and Treatment — Tue, 01 Dec 2009 08:33:05 +0100

This study is a first characterization of these signatures in DCIS. These signatures have significant clinicopathologic associations and tend to be conserved as the tumor progresses from DCIS to invasive breast cancer. Content Type Journal ArticleCategory Preclinical studyDOI 10.1007/s10549-009-0654-0Authors M. Sharma, Stanford University Hospital Department of Pathology Room L235, 300 Pasteur Drive Stanford CA 94305 USAA. H. Beck, Stanford University Hospital Department of Pathology Room L235, 300 Pasteur Drive Stanford CA 94305 USAJ. A. Webster, Stanford University Hospital Department of Pathology Room L235, 300 Pasteur Drive Stanford CA 94305 USAI. Espinosa, Stanford University Hospital Department of Pathology Room L235, 300 Pasteur Drive Stanford CA 94305 USAK. Montgomery, Stanfo...

Fibroblast Hepatocyte Growth Factor Promotes Invasion of Human Mammary Ductal Carcinoma In situ

Cancer Research — Tue, 01 Dec 2009 05:08:12 +0100

Stromal-derived hepatocyte growth factor (HGF) acting through its specific proto-oncogene receptor c-Met has been suggested to play a paracrine role in the regulation of tumor cell migration and invasion. The transition from preinvasive ductal carcinoma in situ (DCIS) to invasive breast carcinoma is marked by infiltration of stromal fibroblasts and the loss of basement membrane. We hypothesized that HGF produced by the infiltrating fibroblasts may alter proteolytic pathways in DCIS cells, and, to study this hypothesis, established three-dimensional reconstituted basement membrane overlay cocultures with two human DCIS cell lines, MCF10.DCIS and SUM102. Both cell lines formed large dysplastic structures in three-dimensional cultures that resembled DCIS in vivo and occasionally developed inv...

Editorial Comment

Urology — Tue, 01 Dec 2009 00:00:00 +0100

Guzzo et al found that patients with high-grade T1 bladder cancers or carcinoma in situ (CIS) often (42% and 38%) were upstaged (pT2) at cystectomy, and they had a worse recurrence-free survival than correctly staged patients operated for de novo muscle-invasive disease. The authors concluded that inaccurate staging, treatment delay such as receiving BCG therapy, or both may have contributed to worse outcomes. It is likely that inadequate staging was the primary culprit, as unfavorable biology alone cannot account for such high understaging rates. (Source: Urology)

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Editorial Comment

Urology — Tue, 01 Dec 2009 00:00:00 +0100

The photodynamic agent 5-aminolaevulinic acid (5-ALA) was introduced into urology practice about 15 years ago, followed 5 years later by its hexyl ester derivative hexaminolevulinate (HEX, also referred to as HAL). Robust evidence from various multicenter, prospective, controlled or randomized trials on hundreds of patients reveals that photodynamic diagnosis using these agents improves the detection rate of non–muscle-invasive papillary bladder tumors (Ta-T1 and carcinoma in situ), and decreases the amount of residual cancer following transurethral resection of the bladder (TURB), leading to a reduction in rates of tumor recurrence at 9 months. (Source: Urology)

Is excisional biopsy indicated for patients with lobular neoplasia diagnosed on percutaneous core needle biopsy of the breast?

American Journal of Surgery — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Excisional biopsy for lobular neoplasia did not identify understaged carcinoma or alter the rate of subsequent carcinoma. The subsequent carcinoma risk is diffuse and bilateral; it does not correlate with the site at which lobular neoplasia was diagnosed. (Source: American Journal of Surgery)

Young With DCIS? Recurrence Risk Is Higher

Ob.Gyn. News — Tue, 01 Dec 2009 00:00:00 +0100

Women younger than age 45 years who were treated with lumpectomy and radiation for ductal carcinoma in situ were 68% more likely than were older women to have a local recurrence, a large population-based study found. (Source: Ob.Gyn. News)

The management of BCG failure in non-muscle-invasive bladder cancer: an update.

Canadian Urological Association Journal — Tue, 01 Dec 2009 00:00:00 +0100

Authors: Zlotta AR, Fleshner NE, Jewett MA Up to 40% of patients with non-muscle-invasive bladder cancer (NMIBC) will fail intravesical bacillus Calmette-Guérin (BCG) therapy. There is unfortunately no current gold standard for salvage intravesical therapy after appropriate BCG treatment. Indeed, outcomes are at best suboptimal. The vast majority of low-grade NMIBC are prone to recur but very rarely progress. Failure after intravesical BCG in these patients is usually superficial and low-grade. At the other end of the spectrum, failure to respond to BCG in high-risk T1 bladder cancer and/or carcinoma in situ (CIS or TIS) is more problematic, since those tumours often have the potential to progress to muscle invasion. In these cases, radical cystectomy remains the mainstay after BC...

Field Treatment of Actinic Keratoses - Focus on COX-2-Inhibitors.

Actas Dermo-Sifiliograficas — Tue, 01 Dec 2009 00:00:00 +0100

Authors: Ulrich M, Stockfleth E Actinic keratoses (AK) represent the most common carcinoma in situ of the skin and show continuously increasing incidences worldwide. Clinically, AK occur as multiple lesions in sun-exposed areas, which has been referred to as field cancerization. Novel treatment modalities for actinic field cancerization include 3 % diclofenac in 2.5 % hyaluronic acid (HA). Recent investigations have gained insights in the mode of action of diclofenac in HA, showing that the induction of apoptosis is the major mode of action of this treatment. Herein, we give an overview about actinic keratosis focusing on treatment with the COX-2 inhibitor diclofenac 3 % gel and summarize current concepts of its antineoplastic mode of action. PMID: 20096163 [PubMed - as supplied by...

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[Excision of carcinoma in situ of the glans penis with reconstructive plastic surgery.]

Der Urologe. Ausg. A — Sat, 28 Nov 2009 00:00:00 +0100

CONCLUSION: A close follow-up with timely treatment of recurrences allows suitable tumour control without worsening the prognosis and is the most important requirement for an organ-preserving treatment of Bowen's disease. PMID: 19943030 [PubMed - as supplied by publisher] (Source: Der Urologe. Ausg. A)

Screening: Is breast cancer overdiagnosed?

Nature Clinical Practice Oncology — Fri, 27 Nov 2009 13:44:17 +0100

Authors: Andrea Veronesi & Diego Serraino Jørgensen and Gøtzsche quantified the degree of overdiagnosis of breast cancer in five publicly organized mammography screening programs in different parts of the world. Overall, they estimated a total degree of breast cancer (including carcinoma in situ) overdiagnosis of 52%, while overdiagnosis for invasive breast cancer was 35%, a finding with potential implications for both clinical practice and public health. (Source: Nature Clinical Practice Oncology)

Fluorescence-guided laser therapy for penile carcinoma and precancerous lesions: Long-term follow-up.

Urologic Oncology — Thu, 26 Nov 2009 00:00:00 +0100

CONCLUSIONS: Local recurrence rate of laser therapy can be reduced by fluorescence guidance without impairing cosmetic or functional results. The necessary equipment is available in many centers that perform PDD for urothelial bladder cancer. PDD, therefore, can be considered to be cost-effective and easy to perform. Prospective multi-center studies to directly compare recurrence rates between white light and fluorescence-guided laser therapy for penile carcinoma are required. PMID: 19945305 [PubMed - as supplied by publisher] (Source: Urologic Oncology)

Mammographic features of breast cancer: Analysis of 118 cases

The Chinese-German Journal of Clinical Oncology — Tue, 24 Nov 2009 07:05:39 +0100

Conclusion The microcalcifications are the most frequently basal X-ray signs in DCIS. Architecture distortion and focal asymmetric density are special X-ray signs that were easily missed. The abnormal vessels are also important accompaniment signs of breast cancer. The use of coned compression technique is particularly important to improve the radiological diagnosis of breast cancer. Content Type Journal ArticleDOI 10.1007/s10330-009-0155-yAuthors Zhijian Cao, Kunming Women and Children Healthcare Hospital Department of Radiology Kunming 650031 China Journal The Chinese-German Journal of Clinical OncologyOnline ISSN 1613-9089Print ISSN 1610-1979 Journal Volume Volume 8 Journal Issue Volume 8, Number 11 / November, 2009 (Source: The Chinese-German Journa...

Nuclear detection of Y-box protein-1 (YB-1) closely associates with progesterone receptor negativity and is a strong adverse survival factor in human breast cancer

BMC Cancer — Tue, 24 Nov 2009 00:00:00 +0100

Conclusions: Monoclonal YB-1 antibody F-E2G5 should be of great value for prospective studies to validate YB-1 as a novel biomarker suitable to optimize breast cancer treatment. (Source: BMC Cancer)

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Low-grade dysplasia component in early invasive squamous cell carcinoma of the esophagus

Journal of Gastroenterology and Hepatology — Tue, 24 Nov 2009 00:00:00 +0100

Conclusion: Our results indicate the possibility that the lesion was formed by a combination of small lesions that arose as a multicentric occurrence of squamous cell carcinoma and dysplasia. Our results also suggest that an LGD component would transform to carcinoma along with tumor progression. However, the concept of 'basal cell layer type carcinoma in situ' may be suitable for squamous cell lesions with a high degree of cytological abnormalities confined to the lower half of the epithelium. (Source: Journal of Gastroenterology and Hepatology)

Clonal Relationship Between Closely Approximated Low-Grade Ductal and Lobular Lesions in the Breast: A Molecular Study of 10 Cases.

American Journal of Clinical Pathology — Mon, 23 Nov 2009 04:50:41 +0100

In this study, we analyzed loss of heterozygosity (LOH) in 10 cases of coexistent ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), and invasive carcinoma. DNA from the separate components of each lesion was subjected to LOH analysis using 13 markers on 7 chromosomes. In 7 cases, the DCIS and LCIS shared loss of a common allele, suggesting a clonal relationship. The invasive component shared loss of the same allele in 5 tumors. This finding indicates that coexistent lobular and ductal carcinomas exhibit shared genetic abnormalities, contradicting the conventional concept that these lesions represent separate, exclusive pathways of breast neoplasia. Instead, these traditionally segregated classes of breast cancer may, in fact, share common precursor lesions. PMID: 19926...

The need to reassess studies on detection of potentially premalignant and malignant oral lesions

Oral Oncology — Mon, 23 Nov 2009 00:00:00 +0100

This study confirmed the results of a previous study performed by the same research team, where kappa for lesion diagnosis was 0.59 (95% CI:0.45, 0.72) for the entire study population. With recategorization of the lesions into three groups as “no abnormality/hyperkeratosis”, “mild, moderate or severe dysplasia” and “carcinoma-in situ and carcinoma”, the agreement between the pathologists increased to 0.70 (95% CI:0.56, 0.84). Lesions without inflammation had higher kappa values when compared to that of the lesions with inflammation (kappa values 0.67 (95% CI:0.53, 0.80) and −0.10 (95% CI:0.27, 0.07), respectively). Thus, the reliability of histopathology to estimate the risk of progression of a potentially malignant lesion continues to be of concern, because variability in in...

Quantitative Diffusion-Weighted Imaging as an Adjunct to Conventional Breast MRI for Improved Positive Predictive Value

American Journal of Roentgenology — Fri, 20 Nov 2009 19:03:24 +0100

CONCLUSION. DWI shows potential for improving the PPV of breast MRI for lesions of varied types and sizes. However, considerable overlap in ADC of benign and malignant lesions necessitates validation of these findings in larger studies. (Source: American Journal of Roentgenology)

Short-Term Follow-Up of Palpable Breast Lesions With Benign Imaging Features: Evaluation of 375 Lesions in 320 Women

American Journal of Roentgenology — Fri, 20 Nov 2009 19:03:24 +0100

CONCLUSION. Short-term follow-up is a reasonable alternative to biopsy of palpable breast lesions with benign imaging features, particularly for young women with probable fibroadenoma. (Source: American Journal of Roentgenology)

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Columnar cell lesions and pseudoangiomatous hyperplasia like stroma: is there an epithelial-stromal interaction?

International Journal of Clinical and Experimental Pathology — Thu, 19 Nov 2009 10:38:02 +0100

Authors: Recavarren RA, Chivukula M, Carter G, Dabbs DJ The significance of association between cancer and its microenvironment has been increasingly recognized. It has been shown in animal models that interaction between neoplastic epithelial cells and adjacent stroma can modulate tumor behavior. Carcinoma associated stromal cells can transform normal epithelial cells into neoplastic cells. In breast, columnar cell lesions are non-obligate precursors of low grade ductal carcinoma in situ. Columnar cell lesions can be seen intimately associated with PASH-like-stroma, a lesion we termed as CCPLS. Our aim is to investigate epithelial-stromal interactions in CCPLS and compare them to PASH without columnar cell lesions in breast core needle biopsies. Normal terminal duct lobular unit (TDLU...

Clinical Implications of Subcategorizing BI-RADS 4 Breast Lesions associated with Microcalcification: A Radiology–Pathology Correlation Study

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

Abstract: Currently radiologists have the option of subcategorizing BI-RADS 4 breast lesions into 4A (low suspicion for malignancy), 4B (intermediate suspicion of malignancy), and 4C (moderate concern, but not classic for malignancy). To determine the clinical significance of BI-RADS 4 subcategories and the common pathologic changes associated with these mammographic lesions, a retrospective review of 239 consecutive stereotactic-needle core biopsies (SNCB) for microcalcifications was performed. All 239 SNCBs were BI-RADS 4 lesions, and of these, 191 were subcategorized to 4A, 4B or 4C. Ninety-four of 191 (49%) were 4A, 73 (38%) were 4B, and 24 (13%) were 4C. Fibrocystic change was the most common finding (66/239; 28%) followed by ductal carcinoma in situ (DCIS) accounting for 23% of cases...

Magnetic Resonance Imaging Screening of the Contralateral Breast in Women With Newly Diagnosed Breast Cancer: Systematic Review and Meta-Analysis of Incremental Cancer Detection and Impact on Surgical Management [REVIEW ARTICLE]

Journal of Clinical Oncology — Wed, 18 Nov 2009 23:02:37 +0100

Conclusion MRI detects contralateral lesions in a substantial proportion of women, but does not reliably distinguish benign from malignant findings. Relatively high ICDR may be due to selection bias and/or overdetection. Women must be informed of the uncertain benefit and potential harm, including additional investigations and surgery. (Source: Journal of Clinical Oncology)

Declining recurrence among ductal carcinoma in situ patients treated with breast-conserving surgery in the community setting

Breast Cancer Research — Wed, 18 Nov 2009 00:00:00 +0100

Conclusions: The marked increase in the 1990s in the use of adjuvant therapy for DCIS patients treated with BCS in the community setting only partially explains the 50% decline in risk of recurrence risk. Changes in pathology factors have likely also contributed to this decline. (Source: Breast Cancer Research)

Ketamine cystitis as a mimic of carcinoma in situ

Histopathology — Mon, 16 Nov 2009 00:00:00 +0100

Conclusions: Ketamine can lead to reactive urothelial changes that can mimic carcinoma in situ, but the long-term cancer risk remains unknown. (Source: Histopathology)

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Excision alone inadequate for high grade DCIS

MedWire News - Oncology — Fri, 13 Nov 2009 13:48:26 +0100

Excision alone is inadequate treatment for patients with high-grade ductal carcinoma in situ, but may be suitable for patients with low- or intermediate-grade lesions, US study findings indicate. (Source: MedWire News - Oncology)

Excision alone inadequate for high grade DCIS

MedWire News - Breast Cancer — Fri, 13 Nov 2009 13:48:25 +0100

Can breast MRI computer-aided detection (CAD) improve radiologist accuracy for lesions detected at MRI screening and recommended for biopsy in a high-risk population?

Clinical Radiology — Thu, 12 Nov 2009 15:24:38 +0100

Conclusion: The breast MRI CAD system used could not improve the radiologists' accuracy for distinguishing all malignant from benign lesions, due to the poor sensitivity for DCIS detection. (Source: Clinical Radiology)

Correction: Parathyroid Hormone-Related Protein Protects against Mammary Tumor Emergence and Is Associated with Monocyte Infiltration in Ductal Carcinoma In situ

Cancer Research — Thu, 12 Nov 2009 05:08:18 +0100

(Source: Cancer Research)

Expression of cell cycle-associated proteins in non-muscle-invasive bladder cancer: Correlation with intravesical recurrence following transurethral resection.

Urologic Oncology — Thu, 12 Nov 2009 00:00:00 +0100

The objective of this study was to evaluate the expression patterns of cell cycle-associated proteins in newly diagnosed non-muscle-invasive bladder cancer (NMIBC) to clarify the significance of these proteins as prognostic predictors in 161 consecutive patients undergoing transurethral resection (TUR). Expression levels of 7 cell cycle-associated proteins, including Aurora-A, c-erbB2, cyclin-D1, Ki-67, p21, p27, and p53, in TUR specimens were measured by immunohistochemical staining. Of the 7 proteins, weak expression of p21 was significantly associated with the incidence of intravesical recurrence (P = 0.012). Univariate analysis identified expression level of p21, tumor size, T stage, and concomitant carcinoma in situ (CIS) as significant predictors for intravesical recurrence (P = 0.00...

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Combination of Multiple Molecular Markers Can Improve Prognostication in Patients With Locally Advanced and Lymph Node Positive Bladder Cancer

The Journal of Urology — Thu, 12 Nov 2009 00:00:00 +0100

Purpose: We tested whether the combination of 4 established cell cycle regulators (p53, pRB, p21 and p27) could improve the ability to predict clinical outcomes in a large multi-institutional collaboration of patients with pT3-4N0 or pTany Npositive urothelial carcinoma of the bladder. We also assessed whether the combination of molecular markers is superior to any individual biomarker.Materials and Methods: The study comprised 692 patients with pT3-4N0 or pTany Npositive urothelial carcinoma of the bladder treated with radical cystectomy and bilateral lymphadenectomy (median followup 5.3 years). Scoring was performed using advanced cell imaging and color detection software. The base model incorporated patient age, gender, stage, grade, lymphovascular invasion, number of lymph nodes remove...

Telomere lengths in the oral epithelia with and without carcinoma

European Journal of Cancer — Thu, 12 Nov 2009 00:00:00 +0100

Abstract: Aging appears to be intrinsically related to carcinogenesis. Genomic instability due to telomere shortening plays an important role in carcinoma development. In order to clarify telomere dysfunction in carcinoma development, we examined the uninvolved epithelium adjacent to carcinoma in situ (CIS), i.e. background of CIS, and CIS itself, compared to control without carcinoma, using an improved quantitative fluorescence in situ hybridization (Q-FISH) method. We also estimated anaphase bridge (AB), which is inferred to be related to chromosomal instability. In all cell types (basal, parabasal, and suprabasal), mean telomere lengths were significantly shorter in the background than in the control. We also demonstrated increased incidences of AB, not only in CIS, but also in the back...

A unique proteolytic fragment of alpha1-antitrypsin is elevated in ductal fluid of breast cancer patient

Breast Cancer Research and Treatment — Mon, 09 Nov 2009 18:26:47 +0100

In conclusion, elevated C-41/42 is likely the result of elevated AAT synthesis, and the activity of specific MMPs present within the tumor. As other C-terminal fragments of AAT are reported to function as tumor-derived suppressors to the host immune-system, elevated C-41/42 may also be predictive of a poor outcome. Content Type Journal ArticleCategory Preclinical studyDOI 10.1007/s10549-009-0625-5Authors Junma Zhou, Johns Hopkins Medical Institutions Department of Pathology Baltimore MD 21287 USABruce Trock, Johns Hopkins Medical Institutions Department of Urology Baltimore MD 21287 USATheodore N. Tsangaris, Johns Hopkins Medical Institutions Department of Surgery Baltimore MD 21287 USANeil B. Friedman, Hoffberger Breast Center at Mercy Hospital Baltimore MD 21202 USADeanna Shapiro,...

Breast Cancer Deception Month: Hiding the Truth beneath a Sea of Pink, Part V

NaturalNews.com — Sun, 08 Nov 2009 07:00:00 +0100

(NaturalNews) As we near the end of Breast Cancer Awareness Month, once again our country has been awash from shore to shore in a sea of pink - from pink ribbons and donation boxes to pink products, charity promotions, celebrities by the score and even pink cleats on NFL players. Tragically, most people are unaware of the dark history of Breast Cancer Awareness Month (BCAM) and of the players past and present who have misused it to direct people and funds away from finding a true cure, while covering up their own roles in causing and profiting from cancer.In this installment of the series, we will examine the dangers of over-screening for cancer and the lack of progress in breast cancer prevention and cures.The Dangers of Over-Screening for CancerA new analysis published this month in the ...