Further studies on the prognostic importance of Barr body frequency in human breast cancer: with discussion on its probable mechanism

Based on the Barr body frequency, a total of 285 unselected breast cancer tissues were categorised as negative and positive tumours; incidence of these two groups in our series was 2:1, respectively. When 2-years' disease-free interval and 10-years' survival were considered, it was seen that patients harbouring negative tumours had significantly early recurrence and shorter duration of survival as compared to those having positive tumours. As vascular spread is the prerequisite of early recurrence, the shorter survival in the patients having negative tumours could be explained on the basis of blood vessel invasion, in that 73% of the negative tumours had blood vessel invasion, in contrast to only 24% in the positive tumours.

Paranodal vascular spread in breast cancer with axillary node involvement

The presence of tumour cells in the efferent paranodal vessels of tumour-bearing axillary lymph nodes from patients with operable breast carcinoma was associated with a significant reduction in survival time at 5 yr compared to cases with node involvement in which these vessels did not contain tumour cells.

[Kaposi sarcoma of the breast with osseous and pulmonary involvement (author's transl)]

The authors report on a rare case of a Kaposi-Sarcoma of the mamma with osseous and pulmonary participation. The angiographic findings of a Kaposi-Sarcoma of the right mamma is demonstrated.

Tumor cells in venous blood draining mammary carcinomas

Tumor cells were identified in mammary vein blood in ten of 38 (26.6%) patients during total mastectomy with axillary dissection performed as the primary therapy for breast carcinoma (pathological stages I and II). This finding was analyzed with respect to 35 histological characteristics of the primary tumors. The presence of blood-borne tumor cells was inversely related to perineural space invasion, whereas there was no apparent relationship with the remaining 34 characteristics. The significance of blood-borne tumor cells remains unknown.

The anatomy of the arteries and veins of the breast

Textbook accounts of this subject are inadequate. This review considers the work of Cooper and Salmon and reproduces some of their figures. Applications in the diagnosis and treatment of cancer are discussed. The largest mammary arteries are the lateral (from the axillary) and the anterior medial and posterior medial (from the internal thoracis). The branches of these arteries do not follow the duct system, but instead form a plexus in the anterior fat layer. Normally there are no hypervascular or hypovascular areas. The contribution of the mammary branches of the posterior (aortic) intercostal arteries is minor. There are superficial and deep sets of veins, the latter associated with arteries. Mammary vessels of living women are demonstrated by infrared photography, thermography, and mammography. In the diagnostic use of these methods there is a tendency to rely upon the concept of normal vascular symmetry, but this is a fallacy.

Cancer in the "cold" breast thermogram

The hallmark of the normal breast thermogram is relative symmetry of vascular configuration and thermal content with preservation of the breast contour. Accepted criteria of abnormality are predicated upon graphic and thermal asymmetry with emphasis placed upon elevated temperature, an increase in the number of discernible vessels, and distorted vascular patterns. The association of a confirmed breast cancer and an avascular thermogram has been labeled a false negative. Avascularity ("cold" breast), particularly in the lower half, with normal vessels in the same location of the opposite breast is suggested as an additional characteristic of abnormality. Illustrative cases are presented.

Significant prognostic factors in breast cancer of Japanese women: special reference to nuclear grade and sinus histiocytosis

Based on clinicopathological observations of 91 female patients with breast cancer in Miyagi Prefecture, TNM stage, histologic type, grade of infiltrative growth tendency (INV), vessel involvement, lymph node metastasis, nuclear grade and sinus histiocytosis were assessed in relation to prognosis. Follow-up studies indicated that 73.6% of the patients survived more than five years after operation. Among the factors submitted to histologic evaluation, nuclear grade, INF, vessel involvement and lymph node metastasis were apparently correlated to prognosis, while sinus histiocytosis was not significantly related to it, except for patients with positive nodes.

How good is thermography in breast cancer screening?

With the present level of experience and with current equipment, thermography does not seem sufficiently reliable to substitute for either clinical examination or mammography in breast cancer detection. It is, however, of adjunctive value and can be used in frequent screening and in younger individuals. Women with positive thermograms should be followed more closely, both clinically and radiographically, than the average patient.

[Vascularization of tumors of the mammary glands]

The study of peculiarities of the blood supply of pre-tumour foci and cancer tumours of mammary glands of humans and mice of highly cancerous strains "A" and "C3H" by means of injectional, histological, histo- and enzymochemical and electron microscopical methods has shown that vascularization of corresponding zones alters with development of pre-cancerous growings in mammary glands. The most pronounced alterations are observed in the vessels of cancer tumours depending on the developmental stage, histological structure and differentiation degree. Changes in the character of "angioplastic" reaction, ultrastructural and histochemical reorganization of the vascular wall explain the peculiarities of microvascularization and metastazing of cancer.

[Results of nuclear medical, electroencephalographic, and angiographic examinations after brain tumor operations]

The methods of nuclear medicine and electro-encephalography allow, in combination, in almost every case the answer to the question of the cerebral tumour relapse. Our evaluation confirms the discovery of the greater sensitivity of the isotopic methods with relapses of glioblastomas, while relapses of meningiomas, astrocytomas, oligodendrogliomas and spongioblastomas can be recognized more frequently only by electro-encephalographic methods. The value of angiography is limited in cases of cerebral tumour relapses without pathological vascularisation, since the swelling can spread in the resection cavity without retroaction on the surrounding areas. For this reason vascular displacement (an only be observed very late on. Clinical judgement is furthermore complicated by the fact that after the removal of the primary tumour, often no reposition of the arteries ensues. After our exainations, a negative angiographic condition can be rule out a diagnosis of a relapse which has been established by electro-encephaolographic and isotopic methods.

Skin temperature over an artificial heat source implanted in man

The medical application of infrared thermography makes use of the skin temperature as an indication of an underlying pathological process. In order to study the relation between the heat production from a source in living tissue and the overlying skin temperature, artificial heat sources were implanted subcutaneously in human volunteers. The experimental results show that a detectable surface temperature increase over the heat sources presupposes high power output or superficial implantation. The effect of forced convective heat loss from the skin surface and lowered ambient temperature was studied. Forced convection markedly decreased the temperature contrast. An implicit conclusion from experimental and theoretical work is that a localized 'hot spot' can only exceptionally be attributed to metabolic heat production conducted to the skin surface from a buried pathological process. The thermal pattern over a breast tumour, a septic or aseptic inflammation or a tissue injury mainly reflects the vascular reaction.

[Dynamic telethermography in mammary carcinoma]

Dynamic telethermography, a still new technique, enables to obtain original data on the behaviour of mammary carcinomas both in space and time. It deserves to be used in conjunction with the other clinical and paraclinical methods in the "non bloody combined diagnosis" of such tumors. In spite of 5 per cent of false positive and 8 to 16 per cent false negative results, it helps to correct over one half of erroneous radioclinical diagnosis. It often brings accurate data on extension, multifocality and topography of these carcinomas and plays an efficient part in post-therapeutical systematic periodical surveillance, more especially when the breast has been preserved. Capable of detecting small non-palpable adenocarcinomas, it could be used as a thuthworthy screening procedure. Finally, it demonstrates "cold" cancers and too "hot" cancers, the former of probably slow development, the latter developing rapidly. Beyond a simple positive diagnosis, it is contributory to the first steps of clinical physiology of breast carcinomas, which is all the more remarkable because it is a true non-traumatic tele-measurement.