bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast Cancer Diagnostic Methods: Screen-Detected and Clinical Cases. An Italian Survey of Women's Experiences
Authors: Rossi Paolo Giorgi , Camilloni Laura , Mantellini Paola , Barile Vincenzo , Borgia Piero , Federici Antonio , Mangia Marialuisa , Paci Eugenio , Vella Alessandro , Zappa Marco 
Published: February 2018

Aims and Background The real practice of breast cancer diagnosis and treatment is often very different from guideline recommendations. Screening programs should minimize deviations from “best practice”. The aim of the study was to compare cases detected by screening programs with cases that were not part of the public screening program, analyzing the diagnostic pathways from the first suspected breast problem to therapeutic intervention for breast cancer. Methods We interviewed a random sample of 268 women aged 49–70 years in three Italian regions (Lazio, Tuscany, Basilicata) who were treated for breast cancer, stratified by screening participation. Results In the nonscreened group, 48% of women were symptomatic and 50% were diagnosed by preventive tests. The proportion of women treated within 30 days of diagnosis was significantly lower in the screened group, 21.3% vs 35.8% (P = 0.0003). The mean number of tests (mammography, ultrasonography, cytology and histology) performed in the screened group was significantly higher than in the nonscreened group, 3.7 vs 2.8 (P = 0.001). The percentage of women treated without a preoperative histological or cytological diagnosis was lower in the screened group than in the nonscreened group, 14% vs 25% (P = 0.024). Conclusion Participation in screening programs seems to lead to more appropriate disease management even for breast cancer cases treated at the same hospital.
Adenomyoepithelioma of the Breast
Authors: Huang Chun-Ying , Sheen-Chen Shyr-Ming , Eng Hock-Liew , Ko Sheung-Fat 
Published: February 2018

Adenomyoepithelioma of the breast is an uncommon tumor characterized by the presence of both epithelial and myoepithelial cells; its first full description was published in 1970 by Hamperl. A 45-year-old woman presented a left breast lump that had been palpable for 4 weeks. There was no family history of breast cancer. Neither axillary nor supraclavicular lymph nodes were palpable. Craniocaudal mammography showed a 1.6 cm, well-defined nodule with several punctate intranodular calcifications in the subareolar region of the left breast. Color Doppler sonogram showed an ovoid, well-defined, homogeneous hypoechoic subareolar nodule with prominent peripheral vessels in the 6 o'clock position of the left breast. Operation was arranged and intraoperative frozen section examination revealed proliferation of round, oval or tubular glandular elements with intervening islands and bands of polygonal myoepithelial cells. Adenomyoepithelioma of the breast was the impression. Wide excision with adequate removal of the tumor and preservation of the left breast contour was successfully achieved. The diagnosis of adenomyoepithelioma of the breast was confirmed by immunohistochemical studies.
Negative Impact of Heat Exposure on Cosmesis after Conservative Treatment for Breast Cancer
Authors: Chie Eui Kyu , Kim Kyubo , Noh Dong-Young , Choe Kuk Jin , Kim Tae-You , Im Seok-Ah , Bang Yung-Jue , Ha Sung W 
Published: February 2018

Aim and background To identify the factors influencing cosmesis after conservative treatment in breast cancer. Methods Retrospective analysis was done on 424 patients who underwent postoperative radiotherapy after conservative surgery for breast cancer from February 1992 to January 2002. Most of the patients underwent quadrantectomy. Whole breast irradiation up to 50.4 Gy was delivered in 28 fractions followed by a 10 Gy boost in 5 fractions to the tumor bed. Regional lymph node irradiation was administered if indicated. Breast cosmesis was scored in 4 tiers. Breast symmetry was analyzed by the relative distance from the sternal notch to the nipple, using photos taken prior to radiotherapy and 2 years after its completion. Median follow-up was 64 months. Results Breast cosmesis was excellent in 15%, good in 63%, fair in 19%, and poor in 3% of the patients. In multivariate analysis, tumors >2 cm ( P = 0.0109), lower quadrant location ( P = 0.0026), lymph node irradiation ( P = 0.0028), and heat exposure ( P = 0.0152) were related to poor cosmesis. The cosmesis score after radiotherapy compared to the pre-radiotherapy score was deteriorated in patients who had undergone lymph node irradiation ( P <0.0001) and heat exposure ( P = 0.0027). Breast symmetry was worse for patients who had tumors >2 cm ( P <0.0001), upper quadrant tumor location ( P <0.0001), chemotherapy in combination with radiotherapy ( P = 0.0136), lymph node irradiation ( P = 0.0006) and heat exposure ( P = 0.0355). Changes in symmetry by radiotherapy were greater for lymph node-irradiated patients ( P <0.0001). Conclusions With larger tumor size, lymph node irradiation, and chemotherapy in combination with radiotherapy, heat exposure was found to have a negative impact on cosmesis in patients undergoing conservative treatment for breast cancer. Patients should therefore be advised to avoid heat exposure after breast irradiation.
Metamorphosis of melanoma. Trends in size and thickness of cutaneous melanoma over one decade at the Istituto Nazionale Tumori, Milan
Authors: Bono Aldo , Tolomio Elena , Bartoli Cesare , Carbone Antonino , Tomatis Stefano , Zurrida Stefano , Santinami Mario 
Published: February 2018

Aims and background Messages about the description of the clinical features of cutaneous melanoma (CM) have remained unchanged since 1985, when the ABCD (Asymmetry, Border irregularity, Color variegation, Diameter >6 mm) rule for melanoma detection was formulated. Given the significant shift to the diagnosis of earlier-stage CMs over the past decades, it is reasonable to think that also the clinical aspects of the disease might have changed. The aim of this study was to examine trends in the presentation of CM over the last decade at our Institution, focusing on two characteristics of the disease: size and thickness. Methods A retrospective study was conducted including 1,603 primary invasive CMs seen and treated at the Unit for Melanoma Detection at our Institute between January 1997 and December 2006. Results The results showed a trend towards smaller CMs, with a difference of 3 mm in median size from the beginning to the end of the period. Detection of small (≤6 mm) CMs increased at a rate of about 1.5% per year, with a current ratio of 25% with respect to all CMs. Thickness remained substantially unchanged over time. Conclusions Physicians must be aware that the characteristics of melanoma have undergone a metamorphosis over the years and the ABCD signs cannot be relied on for adequate sensitivity to further the early detection of CM.
Comorbidity and Prognosis in Advanced Hypopharyngeal-Laryngeal cancer under Combined Therapy
Authors: Montero Elena Hernández , Trufero Javier Martínez , Romeo Javier Azúa , Terré Fernando Clau 
Published: February 2018

Aims and background The success of combined treatment in head and neck cancer resides largely in its completion, which can be compromised when the patient's general health status is precarious. The objective of this investigation was to study the role of comorbidity as a prognostic factor in a large, homogeneous population affected by locally advanced pharyngeal-laryngeal cancer, under a combined protocol treatment. The a priori hypothesis is that comorbidity strongly conditions overall survival and specific overall survival in these patients and can aid in the selection and individualization of treatments. Methods After a 24-month follow-up, a univariate and multivariate retrospective analysis of survival and prognostic factors was performed using 14 clinical, pathological and molecular variables including the comorbidity index calculated following the Picarillo method. The settings were the Otolaryngology, Oncology and Pathology Departments of the Miguel Servet University Hospital, Zaragoza, Spain, a referral center of the National Health System. Of the original 114 patients selected, 15 were withdrawn because the tumor spread to maxillofacial areas, or due to the lack of attendance at the clinic, incomplete clinical data or coexistent primary tumors. The group under analysis consisted of the 99 remaining patients affected by stage III and IV laryngeal and/or hypopharyngeal cancers that had not received previous treatments. The main outcomes to analyze were overall survival, specific overall survival and relative risk. Results Overall survival at 2.5 years was 68.1% (95% CI, 57.7–78.5). Specific overall survival at 2.5 years was 74.8% (95% CI, 64.9–84.6). In the multivariate analysis, tumor staging, neoadjuvant chemotherapy response and comorbidity (RR = 1.55 and 1.44 for overall and specific overall survival, respectively) present themselves as three prognostic factors independent of overall and specific overall survival. Conclusions The role of comorbidity as an independent prognostic factor in patients affected by laryngeal and/or hypopharyngeal cancer treated with chemo-radiotherapy should be taken into account in the tailoring of treatments and the improvement of therapeutic results.
Can Axillary and Supraclavicular Radiotherapy be Avoided after Breast-Conserving Surgery and Axillary Dissection in Women with Multiple Involved Axillary Nodes?: Experience at the European Institute of Oncology
Authors: Galimberti Viviana , Leonardi Maria Cristina , Rotmensz Nicole , Botteri Edoardo , Iodice Simona , Sagona Andrea , Sahium Rafaela Cecilio , Bassani Gulliermo , Berrettini Anastasio , Monti Simonetta , Gentilini Oreste , Sangalli Claudia , Luini Alberto , Orecchia Roberto , Veronesi Umberto 
Published: February 2018

Aims and background Although some guidelines recommend adjuvant radiotherapy (RT) to the axilla and supraclavicular nodes if 4 or more axillary nodes are involved, the current practice at our Institute is not to irradiate the axilla but to perform complete axillary dissection in which all 3 Berg levels are removed. We performed a retrospective analysis of patients with 4 or more axillary nodes involved and sufficient follow-up to provide indications as to whether our current treatment is adequate. Methods We retrospectively analyzed 287 T1–T3 patients with a median follow-up of 5 years and 4 or more involved nodes treated by quadrantectomy and breast RT but no axillary RT; supraclavicular RT was given only when prognostic factors were unfavorable. Results A total of 170 (59.2%) patients did not receive supraclavicular RT, while 117 (40.8%) patients received supraclavicular irradiation. No patient received axillary RT. After a median follow-up of 5 years (range, 4–105 months), 4.7% had died and 13.5% had developed distant metastases in the no supraclavicular RT group, compared to 12.0% dead (P = 0.028 log rank) and 24.8% (P = 0.201 log rank) in the supraclavicular RT group. No patients with supraclavicular RT developed supraclavicular metastases compared to 4 in the no supraclavicular RT group. There were no axillary recurrences. Conclusions Complete axillary dissection appears adequate treatment in patients with 4 or more involved nodes. The low breast recurrence rate also suggests that breast conservation is adequate treatment in such patients. Supraclavicular RT appears to reduce the number of supraclavicular metastases but confers no survival advantage. Although a small number of cases were examined in this retrospective single-center series, all received highly uniform treatment.
The Management of Gastric Adenocarcinoma with Postoperative Chemoirradiation. A non-randomized comparison of oral UFT and 5-FU
Authors: Surenkok Serdar , Beyzadeoglu Murat , Oysul Kaan , Ozyigit Gokhan , Ataergin Selmin , Arpaci Fikret , Ozet Ahmet 
Published: February 2018

Aims and background We assessed the therapeutic results and tolerability of postoperative chemoradiotherapy with either oral UFT or 5-fluorouracil for carcinoma of the stomach. Methods and study design Forty-six patients treated with chemoradiotherapy following total or subtotal gastrectomy for gastric carcinoma formed the cohort evaluated. The group included 39 males and 7 females whose ages ranged from 21 to 74 years (median, 53 years). In all patients, surgical therapy was the initial approach with a curative intent. The types of operations performed were total gastrectomy in 11 or subtotal gastrectomy in 35 patients. Radiotherapy began from 14 to 161 days after surgery (median, 55 days). Twenty patients received concomitant oral UFT (200 mg/m2), and 26 patients were given 5-fluorouracil (425 mg/m2, iv bolus) concurrently with irradiation consisting of one or two cycles, usually as a 3-day bolus at the start and last 3 days of irradiation therapy for radiosensitizing purposes. The patients were treated using either cobalt-60 or 6 MV photons, and irradiation doses delivered to the tumor bed and regional lymphatics ranged from 40 to 50 Gy (median, 46 Gy). Results Median follow-up for the entire group was 24 months (range, 2–67). The 2-year overall survival of the entire group of patients was 64%. The 2-year overall survival rates for 5-fluorouracil and oral UFT groups were 72% and 66%, respectively (P = 0.3). Treatment-related factors were reviewed to identify any impact on survival. Analyses included type of surgery and dissection, fraction size, the total dose of irradiation and the type of chemotherapy. A significant detrimental effect in survival in the patients treated with D2 dissection compared to the patients treated with D1 dissection was noted (P = 0.01). Overall grade II-III toxicity of oral UFT was significantly lower than 5-FU (4 patients vs 14 patients, P = 0.03). Conclusions Concomitant use of oral UFT with radiation seems to be more tolerable and an equally effective regimen in the treatment of locally advanced gastric cancer compared with 5-fluorouracil. D2 dissection was found to have detrimental effects on survival in this cohort.
Upper Urinary Tract Transitional Cell Carcinoma. A 10-year Experience
Authors: Papatsoris Athanasios G , Chrisofos Michael , Skolarikos Andreas , Varkarakis Ioannis , Lekas Alexandros , Dellis Athanasios , Koritsiadis Sotirios , Deliveliotis Charalambos 
Published: February 2018

Objective To present our 10-year experience with patients surgically treated for upper urinary tract transitional cell carcinoma. Patients and methods We reviewed the medical records of 264 patients (218 males and 46 females), aged 37–93 years (mean, 69.5), treated surgically for upper tract transitional cell carcinoma during the period January 1996 to December 2005. Results During the mean follow-up of 58 months (range, 12–120), local relapse was diagnosed in 14% of the patients. The mean time to recurrence was 13 months (range, 1–102). The overall mortality was 14%, and the mean survival was 109 months. Survival was significantly influenced by the following parameters: male gender (P = 0.0151), age over 80 years (P = 0.0012), location in both the pelviocaliceal system and the ureter (P = 0.051), a two incision operation (P = 0.0075), grade III (P = 0.0314), stage T3 and T4 (P <0.0001). Conclusions Tumor stage was identified as the most important determinant in predicting recurrence and survival. Other predictors of survival included male gender, age over 80 years, location in the pelviocaliceal system and the ureter, a two incision operation, and high grade.
Human Papillomavirus Infection in Patients with Residual or Recurrent Cervical Intraepithelial Neoplasia
Authors: Takač Iztok 
Published: February 2018

Aims and background The main purpose of this longitudinal study was to evaluate the frequency of HPV infection in patients with residual or recurrent CIN. Methods 797 consecutive patients with CIN, treated with conization, were included. In 38 patients with residual or recurrent CIN in whom reconization was performed, infection with high-risk HPV types was analyzed. Results Reconization was performed in 4.8% of patients. Before reconization, 21 patients (55.3%) were infected with high-risk HPV and 17 patients (44.7%) were HPV negative. Among the HPV-negative patients, two (11.8%) had CIN 1, five (29.4%) CIN 2, nine (52.9%) CIN 3 and one patient (5.9%) had microinvasive cancer of the uterine cervix. The difference in frequency of infection with high-risk HPV was not significant (chi-square 0.372; p>0.05). Conclusions On the basis of the study results it is not possible to recommend the HPV test as the only method of detection of residual or recurrent CIN after conization.
Hamartoma of the Breast: An Underrecognized Disease?
Authors: Lee Wei-Feng , Sheen-Chen Shyr-Ming , Chi Shun-Yu , Huang Hsuan-Ying , Ko Sheung-Fat 
Published: February 2018

Hamartomas of the breast are benign tumors composed primarily of dense, fibrous tissue with variable amounts of fat and associated ducts. A 48-year-old woman had noted a lump in her right breast for a number of years. She came to our clinics because of the recent progressive enlargement of this lump. Physical examination revealed a large, mobile, round, painless mass in the lower inner quadrant of the right breast. There were no palpable axillary lymph nodes. Mammography showed a circumscribed, 4.5 × 2.5 cm mass with a radiolucent periphery and moderately radiopaque center. On the basis of the clinical and mammographic findings, hamartoma of the breast was highly suspected. A lumpectomy was performed and histological examination of the specimen revealed overgrowth of mammary lobules and ductules, forming a well-circumscribed lesion with admixed fat tissue. Hamartoma of the breast was confirmed. With the awareness of this entity and good correlation of imaging findings, the clinical diagnosis of hamartoma of the breast should not be difficult. If careful attention is paid to the clinical information, histological underdiagnosis of hamartoma of the breast can be avoided.
Adenoid Cystic Carcinoma of Trachea Treated with Adjuvant Hypofractionated Tomotherapy. Case Report and Literature Review
Authors: Alongi Filippo , Di Muzio Nadia , Motta Micaela , Broggi Sara , De Martin Elena , Bolognesi Angelo , Cattaneo Mauro , Calandrino Riccardo , Fazio Ferruccio 
Published: February 2018

Adenoid cystic carcinoma, also called cylindroma, is the second most common histological type of tracheal malignancy but represents 1% of all respiratory tract cancers. We report a case of a 59-year-old patient submitted to an incomplete resection of the trachea and subsequently treated with adjuvant tomotherapy. There have been no reports in the literature regarding intensity-modulated radiation therapy with linac or tomotherapy systems in adenoid cystic carcinoma of the trachea. The present clinical case demonstrates the feasibility of adjuvant intensity-modulated radiation therapy techniques for optimizing the dose coverage of the tumor bed while sparing surrounding normal tissues. A dosimetric comparison between the tomotherapy plan and a 3-dimensional conformal radiotherapy plan is also reported. We demonstrate that tomotherapy permits an increase in the dose per fraction without important acute adverse effects. At 24 months’ follow-up, our patient shows no evidence of disease with negative histological findings.
Early Phase Technology Assessment of Nanotechnology in Oncology
Authors: Retèl Valesca P , Hummel Marjan JM , Van Harten Willem H 
Published: February 2018

To perform early Technology Assessment (TA) of nanotechnology in oncology. The possibilities of nanotechnology for detection (imaging), diagnosis and treatment of cancer are subject of different research programs where major investments are concerned. As a range of bio- nanotechnologies is expected to enter the oncology field it is relevant to consider the various aspects involved in especially early TA. This article provides two cases of early assessment of (predecessors of) nanotechnologies: Microarray Analysis and Photodynamic Therapy implementation, which methodology can be extrapolated to other nanotechnologies in oncology. Constructive Technology Assessment (CTA) is used for the introduction of technologies that are still in a dynamic phase of development or in an early stage of diffusion. The selection of studied aspects in CTA is based on: clinical aspects (safety, efficacy, and effectiveness), economic (cost-effectiveness), patient related (QoL, ethical/juridical and psychosocial), organizational aspects (diffusion and adoption) and scenario drafting. The features of the technology and the phase of implementation are decisive for choices and timing of the specific aspects to be studied. A framework was drafted to decide on the relevant aspects. In the first case, early implementation of Microarray Analysis; clinical effectiveness, logistics, patient centeredness and scenario drafting were given priority. Related to the diffusion-phase of Photodynamic Therapy however other aspects were evaluated, such as early cost-effectiveness analysis for possible reimbursement. Often CTA will result in a mixed method design. Especially scenario drafting is a powerful instrument to predict possible developments that can be anticipated upon in the assessment. CTA is appropriate for the study of early implementation of new technologies in oncology. In early TA small series often necessitate a mix of quantitative and qualitative methods. The features of nanotechnology involved are decisive for the selection of CTA aspects, most likely: safety -especially possible interactions with other technologies-, ethics, cost-effectiveness and patient centeredness.
Lipid-Rich Carcinoma of the Breast. A Clinicopathological Study of 49 Cases
Authors: Shi Peng , Wang Mingming , Zhang Qinghui , Sun Jingzhong 
Published: February 2018

Aims and Background Lipid-rich carcinoma is a very rare variant of breast cancer with an aggressive clinical course and poor prognosis. The present study aimed to explore its clinicopathologic characters. Methods and Study Design We reviewed 3,206 cases treated in two centers in the last 10 years. They all met the criteria of positive oil red O staining, were PAS negative and had the typical histological features included in the study. Their clinical data were collected. The expression of estrogen and progesterone receptors, HER2 and Ki67 was evaluated by immunohistochemistry. Results Forty-nine patients were diagnosed with lipid-rich carcinomas. They were all female and ranged in age from 22 to 72 years (mean, 45). The presenting symptoms included a breast mass or lump and nipple discharge. Axillary lymph node metastases were found in 79.2% of the patients at the time of surgery. Respectively 100% and 89.8% were negative for estrogen and progesterone receptors, whereas 71.4% were positive for HER2. All patients received surgery plus chemotherapy with or without radiotherapy. In vitro MTT assay showed taxol- or platinum-based chemotherapy to be the most effective. The 2- and 5-year overall survival rates were 64.6% and 33.2%, respectively. Conclusions Lipid-rich carcinoma has a biopathological profile significantly different from other types of breast cancer, with a predominance of unfavorable prognostic parameters. Early diagnosis and active treatment may be helpful to increase its overall survival.