Clinical observations of axillary involvement for tubular, lobular, and ductal carcinomas of the breast

BACKGROUND AND OBJECTIVES

Recently, there has been much interest in identifying primary breast cancer characteristics which have predictive value for axillary metastases. We studied breast cancer patients to determine variables associated with the incidence/extent of axillary involvement and to construct a modeled analysis.

METHODS

Patients with invasive ductal, lobular, and tubular breast cancer (group 1, n = 15,719) were analyzed by tumor size and histology for the probability/extent of axillary metastases. A subgroup of patients was analyzed separately for any association of axillary involvement and other variables (group 2).

RESULTS

In group 1, the incidence and extent (number of positive lymph nodes) of axillary metastases correlated significantly with histology and increasing tumor size of ductal and lobular histologies. Significant associations for < or = 10% axillary involvement in group 2 were age and S phase for tubular histology and differentiation for ductal histology. In a multivariate analysis, increasing tumor size was the only statistically significant correlate for axillary involvement (group 2) and for increasing number of positive nodes (group 1).

CONCLUSIONS

A multivariate model of tumor size and age combined with staging techniques can successfully confirm or assess extent of axillary metastases in breast carcinoma.

Normal evoked otoacoustic emissions with a profound hearing loss due to a juvenile pilocytic astrocytoma

An interesting case is reported of an 11-year-old girl who experienced a sudden, profound right-sided hearing loss at the age of 5 years after hearing a "pop" and the sound of rushing water in her right ear. At that time the patient was thought to have Mondini's deformity, and a perilymphatic fistula of the oval window in the right ear. Six years later she was diagnosed with a juvenile pilocytic astrocytoma of the pons with an exophytic component extending into the cerebellopontine angle. Of particular interest in this case is the presence of evoked otoacoustic emissions in the right ear with a profound neural hearing loss. The presence of transient evoked and distortion product otoacoustic emissions confirmed normal sensory outer hair cell function and an intact peripheral auditory system in a clinically deaf ear, thus indicating hearing loss due to a neural component instead of a sensory component, which was previously assumed.

The representation of the auditory and somatosensory systems in the external nucleus of the cat inferior colliculus

Parallel single unit and retrograde tracing experiments were carried out in the anesthetized cat to elucidate the representation of the auditory and somatosensory systems in the external nucleus of the inferior colliculus (ICX). Units responding to tonal stimuli were more commonly encountered in ICX and the adjacent intercollicular area (ICA) than were units with identified tactile receptive fields. Concomitantly, a larger number of retrogradely labeled cells were identified in midbrain auditory structures, following injections of horseradish peroxidase (HRP) into CRX, than were found in the combined dorsal column nuclei. Microelectrode recording revealed that the entire accessible body surface was represented in ICX, and receptive fields of individual units were usually large and mostly located on the contralateral side. HRP-labeled cells were scattered throughout the contralateral cuneate, gracile, and spinal trigeminal nuclei. tations of tone pips. Responses to complex sound were commonly observed. Binaural stimuli influenced the firing of the majority of auditory units. Labeled auditory neurons following ICX injections were found mainly in the inferior colliculus of both sides. Spread of tracer into the central and pericentral nuclei was associated with labeling of many neurons in hind brain auditory structures. Only vague suggestions of somatotopy or tonotopy were observed in the electrophysiological experiments; similarly, no topographical relationship between HRP injection site and locus of retrograde label in a given projecting nucleus could be discerned. Speculations were made, in the light of the dual convergent sensory representation in ICX, about the role of this structure in acoustico-motor mechanisms.