Abstract:
:Aim: Nodal status remains one of the most important prognostic factors in breast cancer. The cellular and molecular reasons for the spread of tumor cells to the lymph nodes are not well understood and there are only few predictors in addition to tumor size and multifocality that give an insight into additional mechanisms of lymphatic spread. Aim of our study was therefore to investigate whether breast characteristics such as mammographic density (MD) add to the predictive value of the presence of lymph node metastases in patients with primary breast cancer. Methods: In this retrospective study we analyzed primary, metastasis-free breast cancer patients from one breast center for whom data on MD and staging information were available. A total of 1831 patients were included into this study. MD was assessed as percentage MD (PMD) using a semiautomated method and two readers for every patient. Multiple logistic regression analyses with nodal status as outcome were used to investigate the predictive value of PMD in addition to age, tumor size, Ki-67, estrogen receptor (ER), progesterone receptor (PR), grading, histology, and multi-focality. Results: Multifocality, tumor size, Ki-67 and grading were relevant predictors for nodal status. Adding PMD to a prediction model which included these factors did not significantly improve the prediction of nodal status (p = 0.24, likelihood ratio test). Conclusion: Nodal status could be predicted quite well with the factors multifocality, tumor size, Ki-67 and grading. PMD does not seem to play a role in the lymphatic spread of tumor cells. It could be concluded that the amount of extracellular matrix and stromal cell content of the breast which is reflected by MD does not influence the probability of malignant breast cells spreading from the primary tumor to the lymph nodes. ZUSAMMENFASSUNG:Ziel: Der Nodalstatus ist nach wie vor einer der wichtigsten Prognosefaktoren für Patientinnen mit Mammakarzinom. Die zellulären und molekularen Gründe hierfür sind nicht gut verstanden, und es gibt nur wenige Prädiktoren außer Tumorgröße und Multifokalität, die einen zusätzlichen Einblick in die Mechanismen der lymphatischen Metastasierung geben. Ziel unserer Studie war es daher zu untersuchen, ob die mammografische Dichte (MD) als Korrelat der Stroma- und Extrazellularmatrixmenge mit dem Auftreten von Lymphknotenmetastasen korreliert. Methoden: In dieser retrospektiven Studie sind Patientinnen mit pimärem, metastasenfreien Mammakarzinom eingeschlossen wurden, die in einer Institution behandelt wurden. Von allen Patientinnen musste die MD bekannt sein, genauso wie die Staging-Informationen. Die MD wurde semiautomatisiert als prozentuale MD (PMD) von 2 unabhängigen Gutachtern beurteilt. Logistische Regressionsanalysen mit dem Nodalstatus als Zielvariable wurden durchgeführt, um den zusätzlichen prädiktiven Wert von PMD zusätzlich zu Alter, Tumorgröße, Ki-67, Östrogenrezeptorstatus (ER) und Progesteronrezeptorstatus (PR), Grading, Tumortyp und Multifokalität zu bestimmen. Ergebnisse: Multifokalität, Tumorgröße, Ki-67 und Grading waren relevante Prädiktoren des Nodalstatus. Die Hinzunahme von PMD zu diesen Faktoren konnte die Vorhersage des Nodalstatus nicht signifikant verbessern (p = 0,24, Likelihood-Ratio-Test). Schlussfolgerung: Der Nodalstatus konnte relativ gut durch die Parameter Multifokalität, Tumorgröße, Ki-67 und Grading vorhergesagt werden. PMD scheint keine Rolle zu spielen bei der Lymphknotenmetastasierung aus dem Primärtumor. Somit scheint die Menge an Extrazellularmatrix und Stroma, welche das Korrelat der MD ist, keinen Einfluss auf die Wahrscheinlichkeit zu haben, mit der Brustkrebszellen lymphatisch metastasieren.
journal_name
Geburtshilfe Frauenheilkdjournal_title
Geburtshilfe und Frauenheilkundeauthors
Hack CC,Häberle L,Geisler K,Schulz-Wendtland R,Hartmann A,Fasching PA,Uder M,Wachter DL,Jud SM,Loehberg CR,Lux MP,Rauh C,Beckmann MW,Heusinger Kdoi
10.1055/s-0032-1328291subject
Has Abstractpub_date
2013-02-01 00:00:00pages
136-141issue
2eissn
0016-5751issn
1438-8804journal_volume
73pub_type
杂志文章abstract::The human leukocyte antigen (HLA) genes are cell-surface proteins, essential for immune cell interaction. HLA-G is known for their high immunosuppressive effect and its potential as predictive marker in breast cancer. However, nothing is known about the HLA-J and its immunosuppressive, prognostic and predictive featur...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1128-6664
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abstract::In 270 cases of T1 and T2 carcinomas of the breast with ten or less axillary lymph nodes having been examined, the prognostic relevance of the histopathological statement of nodal negativity was assessed in a retrospective study. In this collective study, the mean number of lymph nodes examined was 4.1 +/- 1.9 for the...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035755
更新日期:1989-03-01 00:00:00
abstract::With the development of a National Cancer Plan published in 2012, Germany has followed the recommendations of the WHO and the EU. The first area of action listed in Germany's National Cancer Plan is improving the early detection of cancer. Both citizens and medical specialists are encouraged to take responsibility the...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0032-1328303
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abstract::Microinsemination techniques are increasingly applied to achieve fertilisation of the oocyte in cases of male fertility disorders. Thus, spermatozoa can directly interact with the oolemma or the ooplasm, thereby obviating the need for penetration through cumulus oophorus and zona pellucida. However, problems associate...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1022831
更新日期:1995-09-01 00:00:00
abstract::Several decisions of the Federal Supreme Court during the past 2 years judged questions of the admissibility of sterlizations by physicians. These decisions of the Supreme Court are fundamentally important since there is no statutory regulation. Based on the decisions of the Court, the physician must know the follow...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1037268
更新日期:1982-03-01 00:00:00
abstract::Routine screening of maternal antibodies showed presence of anti-Fya (from the antigen Fya of Duffy Blood Group System) in a 25 years old second time pregnant woman. The spectroscopic examination of amniotic fluid has been carried out and gave values which decrease within Zone II. In the beginning of 39. week of gesta...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract::The introduction of percutaneous nephrostomy under xc-ray control or ultra-sonic control makes it possible to do the operation even in patients with a bad general condition. The decision for palliative urinary diversion in cases of cancer of the pelvis is therefore largely an ethical question. A group of patients with...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1037150
更新日期:1982-10-01 00:00:00
abstract::The study of menstrual pattern and further pregnancy after clomiphene-induced pregnancy showed a comparatively high rate of improved menstrual pattern and of spontaneous conception. 12 of 29 women, who concluded a clomiphene-induced pregnancy more than 2 years ago, showed an improvement of menstrual pattern. Spontaneo...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-10-01 00:00:00
abstract::The presence of vulvar condylomata acuminata shows evidence HPV infection of the vulva. 49 patients with such lesions came to our hospital for laser treatment. At that time, none of the patients were aware of their cervical disease. Colposcopy and biopsy of the cervix revealed in eight (16%) of the 49 patients CIN I a...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023791
更新日期:1992-08-01 00:00:00
abstract::With reference to the urodynamic results in 21 women with mild stress incontinence who underwent conservative treatment with pelvic floor exercises over a period of three to six months prior to possible surgery, the author comments on the value of this therapy. At the time of follow-up examination 11 of the women were...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036370
更新日期:1985-08-01 00:00:00
abstract::Marriage according to religious denomination is no longer important because of the philosophical changes in recent times. Reproductive behaviour is no longer dependant on religion for the same reasons. Faith in the naturalness and ordainment by God of the roles of the sexes is no longer prevalent. From 1960--1976 the ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-06-01 00:00:00
abstract::The suspicion of an interchange of babies in two Portuguese families could not be dissipated in the first course of testing the following systems being considered: AB0, MNSs, Rhesus, Kell, Cellano, Duffy. Including further markers in an additional opinion, multiple father- and mother-exclusions could be made in the sy...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1037185
更新日期:1981-06-01 00:00:00
abstract::Breast cancer is one of the most common malignancies which appear during pregnancy. Since women are increasingly not giving birth until they are at a more advanced age, it can be assumed that the incidence of pregnancy-related breast cancers will continue to increase in the future. Because of pregnancy-induced changes...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-0880-9295
更新日期:2019-06-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023775
更新日期:1992-07-01 00:00:00
abstract::From 1976 through 1984, 48 primary caesarean hysterectomies were performed in the Department of Obstetrics and Gynaecology of the Medical School of Hannover. The indications for the operation, the risk factors and the postoperative course were analysed and compared with a control group of patients with a Caesarean sec...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036139
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abstract::The prognostic significance of the lysosomal protease cathepsin D in breast cancer was evaluated in a retrospective study. Cathepsin D was measured in 346 deep-frozen (-70 degrees C) cytosol specimens of primary breast carcinomas (1982-1990). Among the established prognostic factors, only axillary lymph node involveme...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022337
更新日期:1994-10-01 00:00:00
abstract::Since the publication of the updated German guideline in 2015, the recommendations for performing pelvic lymphadenectomy (LAE) in patients with vulvar cancer (VSCC) have changed considerably. The guideline recommends surgical lymph node staging in all patients with a higher risk of pelvic lymph node involvement. Howev...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1120-0138
更新日期:2020-12-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036953
更新日期:1981-09-01 00:00:00
abstract::Clinical data on 607 patients with invasive squamous cell carcinoma of the vulva seen between 1952-1980 are reported. All of these patients were eligible for 5-year evaluation. The crude survival for these patients was 60.3%, and the cleaned 5-year survival for 530 patients was 69% (stage I [n = 158]: 87.3%, stage II ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036264
更新日期:1986-09-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036214
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036786
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
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更新日期:2015-10-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036215
更新日期:1985-02-01 00:00:00
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journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036332
更新日期:1984-10-01 00:00:00
abstract::This investigation pursued the question of how many patients with precancerous endometrial hyperplasia were not recommended for screening programs solely because of the lack of risk factors. The median age of precancerous hyperplasia patients in Erlangen is 54, 8 years before the median age for endometrial carcinoma. ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::In a study, the clinical use of prostaglandin F2 alpha in local and systemic application in women with ectopic pregnancies were studied (1, 9). Two different treatment schedules were defined and applied. In group A, patients with a diagnosed ectopic and beta-HCG level lower than 850 mIU/ml were treated with prostaglan...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1026416
更新日期:1991-08-01 00:00:00
abstract::In 170 primary invasive carcinomas of the breast, morphological criteria of the primary tumour--tumour size, WHO classification, malignancy according to Bloom, number and status of foci, lymphangiosis carcinomatosa, stroma reaction--were compared with the axillary lymph node status. In addition, the numbers of resecte...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036505
更新日期:1984-11-01 00:00:00
abstract::This is a study about changes in blood clotting and thrombocyteaggregation in 55 patients with gynecological carcinomas undergoing radiotherapy. The usual thromboembolism prophylaxis were supplemented by 10000 USP-U Heparine administered subcutaneously in 12-hour-intervals. After radiotherapy there was no change in bl...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1975-06-01 00:00:00
abstract::Prognostic factors influencing survival in 235 very low birthweight prematures (< or = 1500 g) born between 1986 and 15.11. 1993 at the Department of Obstetrics and Gynaecology, University Hospital of Cologne, were retrospectively evaluated. Chromosomal anomalies and severe congenital malformations were excluded. Of 1...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022794
更新日期:1995-03-01 00:00:00
abstract::Introduction In recent decades, there has been a continuous rise in the average age at which women give birth. A maternal age of 35 years and above is considered an independent risk factor in pregnancy and birth, due to higher rates of intervention. This study investigates the influence of maternal age on birth proced...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-0859-0826
更新日期:2019-11-01 00:00:00