Posted by James
We found that African-American women possess the same histological types of breast cancer, in similar locations in the breast, and have the same left/right breast distribution as Caucasian Americans. However, as with previous research in this area, our results found that African-American race is a predictor of advanced breast cancer stage at diagnosis. In addition, similar to Lannin et al., controlling for Medicaid insurance did not explain all of the racial variation in breast cancer stage. However, different from previous studies, we found no difference between the races for AJCC stage-4 breast cancer.
Read the rest of this entry »
Posted by James
Five-thousand, seven-hundred-fifty-one patients (5,119 Caucasians, 632 African Americans) were eligible to be included in the study. There was no significant difference for menopausal status, topography, morphology and laterality of their breast cancers. African Americans were significantly younger, with a younger onset of menopause, less family history of breast cancer, fewer positive estrogen and progesterone receptors, more cigarette smokers, more Medicaid insured and more single and divorced individuals compared to Caucasians Americans (Table 1, p O.05). Multivariate analysis found no difference between the races for stage 0, stage 2 and stage 4 (Table 2). African Americans had significantly less stage-1 breast cancer (RR 0.80, 95% CI: 0.67-0.96), less combined stage 0 and 1 (RR 0.75, 95% CI: 0.63-0.89) and more combined stage-3 (RR 1.50 95% CI: 1.11-2.01).
Read the rest of this entry »
Posted by James
We conducted a retrospective cohort study. Inclusion required a diagnosis of breast cancer, and it reported to the TriHealth tumor registry from 1991-2003. There are three TriHealth hospitals in Cincinnati, OH. This is the largest tumor registry in this geographical area. This region is approximately 89% Caucasian and 11% African-American. TriHealth dedicates a full-time nurse whose exclusive responsibility is the oversight of the tumor registry data. This nurse collects data from the patient, their chart and the treating physician. Patients are followed over time for the purposes of prognosis. For each patient, we collected data on race; AJCC stage at diagnosis; and 12 potential confounding variables, including topography, morphology, laterality, age, menopausal age, smoking status, estrogen and progesterone receptor status, marital status, menopausal status, family history of breast cancer in a first-degree relative and insurance status. Due to small number of patients in some stages, AJCC breast cancer stages 0 and 1 were analyzed as separate and combined stages, and stages 2A and 2B, and stages ЗА, 3B and 3C were collapsed in the analysis into stages 2 and 3, respectively. Use of the AJCC stage for research purposes has been utilized by previous authors. Races other than Caucasian and African-American were excluded due to small numbers (N=60).
Read the rest of this entry »
Posted by James
INTRODUCTION
Breast cancer is the most common cancer among women in the United States. It is diagnosed in approximately 240,000 women and kills an estimated 40,000 women each year. It is suspected that as the baby boomer population ages the absolute number of women diagnosed will rise by one-third over the next 20 years, increasing the number to 320,000 females diagnosed annually. The peak age of diagnosis is 45-65 years, with approximately 77% occurring in females age >50. Though screening recommendations vary among organizations, American Cancer Society guidelines for breast cancer screening consist of optional monthly self-breast exams starting at age 20, and clinical breast exams every 2-3 years until the age of 40, then annually. Yearly mammograms are initiated at the age of 40 as well, or earlier, based on preexisting risk factors. Multiple risk factors for breast cancer have been identified including: increasing age, presence in a first-degree relative, early menarche, nulliparity, delayed first pregnancy, prior personal history of breast cancer, endometrial cancer, abnormal breast biopsy, exogenous estrogen use, radiation exposure, geographical influence, diet and white race.
Read the rest of this entry »
Posted by James
CASE 2
A 60-year-old postmenopausal woman presented with 10 months history of painless left breast mass that increased rapidly in size three months prior to presentation. There was an associated productive cough, which subsided with cough mixture. Patient was a known hypertensive on generic adalat, moduretic and canadian atenolol. There was no history of previous surgery. Family and social history was not contributory. Physical examination revealed a middle-aged woman who weighed 63 kg. Her pulse was 96 beats/min, full, regular and blood pressure was 140/90. Respiratory rate was 22 cycles/min. The chest was clinically clear with good air entry bilaterally. She had an enlarged firm left breast with inverted nipple and peau d’orange skin change. There was associated ipsilateral non-tender, matted axillary lymph nodes and a few discrete, firm, nontender contralateral axillary lymph node enlargements. Hematological and serum biochemistry results were essentially normal. However, radiological examination of the chest showed widespread cannon-ball metastasis in both lung fields (Figure 3). Abdominal ultrasound showed stones in the gall bladder but no evidence of metastasis in the liver. Electrocardiogram (ECG) showed left atrial enlargement. FNAC of the left breast mass and ipsilateral axillary lymph node was positive for malignant cells.
Read the rest of this entry »
Posted by James
The patient was sedated overnight with oral diazepam 10 mg and premedicated with another 10 mg diazepam orally just before being transferred to the theater on the morning of operation.
Read the rest of this entry »
Posted by James
Mastectomy is a common surgical procedure for breast malignancies. General anesthesia is traditionally favored for the operation. However, there are situations when general anesthesia may be considered unsuitable. Regional anesthesia was chosen for mastectomy in our patients due to compromised pulmonary status, resulting from widespread malignant infiltrations of the lungs.
Read the rest of this entry »
