Abstract:
BACKGROUND:Although delay to diagnosis after a breast screening abnormality causes anxiety, its effect on prognosis is unknown. METHODS:Using pooled data from five Canadian organized breast cancer screening programs, the authors used unconditional logistic regression to evaluate the effect of delay to diagnosis on prognostic indicators among 4465 women with invasive breast carcinoma diagnosed in the ipsilateral breast within 3 years of an abnormal screen performed during 1990-1996. RESULTS:Women with high-suspicion screens (n = 1569) compared with those without (n = 2896) were more promptly investigated (median days from screen to diagnosis, 31 vs. 47; P < or = 0.0001), had larger tumors (79.4% vs. 55.9% > 10 mm; P < or = 0.0001), and were more likely to be lymph node positive (33.9% vs. 17.3%; P < or = 0.0001). For delays beyond > 12 to < or = 20 weeks, a linear trend of increased tumor size and lymph node positivity began to emerge. Controlling for suspicion, the authors found that odds ratios for tumor size greater than 10 mm were 0.9 (95% CI, 0.66-1.17), 1.2 (95% confidence interval [CI], 0.88-1.56), 1.5 (95% CI, 1.05-2.16), and 2.1 (95% CI, 1.15-3.86) for delays of > 12 to < or = 20, > 20 to < or = 52, > 52 to < or = 104, and > 104 < or = 156 weeks, respectively (p(trend) < or = 0.0001), compared with delays of > 4 to < or = 12 weeks. Similarly, odds ratios for lymph node metastasis were 1.0 (95% CI, 0.67-1.42), 1.2 (95% CI, 0.84-1.69), 2.2 (95% CI, 1.48-3.15), and 3.2 (95% CI, 1.84-5.55) for the same time intervals (p(trend) = 0.0033). CONCLUSIONS:The authors' findings suggest that delays to diagnosis of asymptomatic breast carcinoma of 6 to 12 months are associated with progression of breast carcinoma as measured by increasing risk of lymph node metastases and larger tumor size. A policy of early recall rather than biopsy for low suspicion mammographic abnormalities may introduce delays of this magnitude. The tendency to more expediently investigate women with high-suspicion, worse prognosis screens (suspicion bias) obscures whether delays shorter than 20 weeks also worsen prognostic indicators. Suspicion bias should be considered when interpreting the effect of delay on prognosis.
journal_name
Cancerjournal_title
Cancerauthors
Olivotto IA,Gomi A,Bancej C,Brisson J,Tonita J,Kan L,Mah Z,Harrison M,Shumak Rdoi
10.1002/cncr.10453subject
Has Abstractpub_date
2002-04-15 00:00:00pages
2143-50issue
8eissn
0008-543Xissn
1097-0142journal_volume
94pub_type
杂志文章相关文献
CANCER文献大全abstract::The lymphocytotoxic effect of therapeutic irradiation may lead to immune depression. The significance of such effects is yet to be determined in many malignancies, especially in light of the persistant immune depression in many "cured" patients. The present review examines the effects of age, type of cancer, and stage...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(197702)39:2+<737::aid-cncr282039
更新日期:1977-02-01 00:00:00
abstract:BACKGROUND:Granular cell tumors (GCTs) are uncommon tumors of putative schwannian derivation that are rarely malignant. Although recent studies have addressed a histologic correlation with malignant behavior, similar studies have not been done on cytologic material. METHODS:The authors evaluated 3 malignant GCTs and 1...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.10143
更新日期:2001-12-25 00:00:00
abstract::Elective irradiation of sites of potential occult tumor spread is often part of a patient's radiation therapy program. The required radiation dose (D) depends on the probability that occult disease exists (P(occ)), the number of sites at risk (A), the number of tumor clonogens present (Ni), their radiation sensitivity...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19901215)66:12<2498::aid-cncr282
更新日期:1990-12-15 00:00:00
abstract:BACKGROUND:Prognostic implications of overexpression of the HER-2 gene in nonsmall cell lung carcinoma (NSCLC) are a matter of controversy. Many conflicting results have been reported from different laboratories. METHODS:A metaanalysis of published studies was performed for this quantitative review of the effects of H...
journal_title:Cancer
pub_type: 杂志文章,meta分析
doi:10.1002/cncr.20957
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:In Western countries, esophageal squamous cell carcinoma is usually advanced at presentation and is rarely diagnosed in situ. The authors studied an in situ squamous cell carcinoma that occupied the entire mucosa of a 9 cm length of esophagus, causing dysphagia for solid food in a woman aged 68 years. METHO...
journal_title:Cancer
pub_type: 杂志文章
doi:
更新日期:1997-05-15 00:00:00
abstract::In 14 patients by bilateral retroperitoneal lymph node dissection for nonseminoma tumors of the testes, several sexual functions before and after node dissection were compared. All patients had normal sexual function before the operation. After the operation, antegrade ejaculation was found to have disappeared complet...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19821215)50:12<2967::aid-cncr282
更新日期:1982-12-15 00:00:00
abstract::Earlier literature suggests a high incidence of multicentricity and bilaterality, with an overall poor prognosis, in patients with invasive lobular carcinoma of the breast. Consequently, there is considerable disagreement regarding appropriate local management of this disease. To determine the influence of invasive lo...
journal_title:Cancer
pub_type: 杂志文章,评审
doi:10.1002/1097-0142(19920601)69:11<2789::aid-cncr282
更新日期:1992-06-01 00:00:00
abstract::Transforming growth factors (TGF) are polypeptides that stimulate anchorage-independent growth of various nontransformed cells in vitro. Transforming growth factors have been found in tumor extracts and in the urine of cancer patients. The specific questions of our study were whether TGF activity can be detected in ma...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19880501)61:9<1832::aid-cncr2820
更新日期:1988-05-01 00:00:00
abstract::Chemokines are chemoattractant cytokines that regulate the trafficking and activation of leukocytes and other cell types under a variety of inflammatory and noninflammatory conditions. Over the past few years, studies have increasingly shown that chemokines play an important role in several aspects of tumor progressio...
journal_title:Cancer
pub_type: 杂志文章,评审
doi:10.1002/cncr.22706
更新日期:2007-06-15 00:00:00
abstract::Four patients with benign giant cell tumor and one patient with probable benign giant cell tumor associated with Paget's disease of bone are reported. The familial and geographic clustering of these cases is unique in that three patients were related and all patients traced ancestral roots to the same area of southern...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(197908)44:2<742::aid-cncr2820440
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:In oligodendroglial tumors, allelic losses on chromosome arms 1p and 19q are not only diagnostic molecular markers but also statistically significant predictors of both chemosensitivity and longer recurrence-free survival. In the current study, the authors attempted to analyze 21 patients genetically and cli...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.11322
更新日期:2003-05-01 00:00:00
abstract::The German Society of Pediatric Oncology in 1981 initiated the Cooperative Ewing's Sarcoma Study (CESS 81) using a four-drug combination of chemotherapy prior to definitive local control with surgery and/or radiation. From January 1, 1981 until February 28, 1985, 93 patients were registered at the trial office from 54...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19880101)61:1<23::aid-cncr282061
更新日期:1988-01-01 00:00:00
abstract::Extremely high concentrations of human chorionic gonadotropin in the cerebrospinal fluid were found in a 5-year-old boy presenting sexual precocity and leg pain. An intramedullary spinal cord tumor was revealed by myelogram and metrizamide computerized tomography, and a biopsy specimen taken at laminectomy. Histologic...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19850615)55:12<2845::aid-cncr282
更新日期:1985-06-15 00:00:00
abstract:BACKGROUND:The goal of this study was to compare health-related quality of life (HRQL) from diagnosis to 10 years postdiagnosis among breast cancer survivors (BCS) and women without cancer over the same period and to identify BCS subgroups exhibiting different HRQL trajectories. METHODS:Our analysis included 141 BCS a...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.32757
更新日期:2020-05-15 00:00:00
abstract::Therapy for acute lymphocytic leukemia (ALL) has been less successful in adults than in children. Many centers treat all adult leukemia with the same regimen. We have used vincristine and prednisone for initial therapy in 14 adults with ALL since 1971 and have followed a treatment regimen developed for childhood ALL f...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(197608)38:2<672::aid-cncr2820380
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:Ifosfamide has previously been shown to be active as a single agent and in combination with doxorubicin, etoposide, and teniposide in pediatric solid tumors and adult acute leukemia. The authors performed a dose-escalation trial of ifosfamide with a fixed dosage of etoposide, with mesna uroprotection, in chi...
journal_title:Cancer
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/1097-0142(19930901)72:5<1790::aid-cncr2820
更新日期:1993-09-01 00:00:00
abstract::The experience of 260 patients with endometrial carcinoma was reviewed. The influence of factors such as age, stage of disease, grade and degree of myometrial penetration on the survival was presented, showing that survival decreases in elderly patients, in patients with advanced stage of disease, when the tumor is un...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(197702)39:2<675::aid-cncr2820390
更新日期:1977-02-01 00:00:00
abstract:BACKGROUND:Despite known benefits to needle biopsy for suspicious breast lesions, variability in the use of this technique has been documented in practice. We sought to study the use of needle biopsy and open surgical biopsy in women with breast cancer, predictors of needle biopsy use, and the effect of biopsy choice o...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.24085
更新日期:2009-02-15 00:00:00
abstract::Small-cell lung cancer (SCLC) represents 15% to 20% of all lung carcinomas. Approximately 30% to 40% of these cases are diagnosed in patients older than 70 years of age. Staging of SCLC classifies patients as having either limited or extensive-stage disease. The standard treatment for limited-stage disease is platinum...
journal_title:Cancer
pub_type: 杂志文章,评审
doi:10.1002/cncr.24833
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Angiotropic large cell lymphoma (ALCL) is characterized by the intravascular proliferation of malignant lymphoid cells in small and medium-sized blood vessels. In the current study, the authors report an unusual case in which the initial presentation of the ALCL was that of superior vena cava (SVC) syndrome....
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(20001215)89:12<2515::aid-cncr1>3
更新日期:2000-12-15 00:00:00
abstract:BACKGROUND:The authors evaluated the efficacy of adjuvant chemotherapy with 5-fluorouracil (5-FU) plus doxorubicin in gastric carcinoma after D2-3 curative resection. They also evaluated the effect of dose-related factors (delivered total dose/m(2), actual dose intensity [ADI], relative dose intensity [RDI]) of this re...
journal_title:Cancer
pub_type: 临床试验,杂志文章
doi:10.1002/1097-0142(20010601)91:11<2016::aid-cncr122
更新日期:2001-06-01 00:00:00
abstract::Two hundred-eighty patients were randomized to receive either BCNU, hydroxyurea and imidazole carboxamide (BHD), BHD plus levamisole, or high-dose DTIC plus actinomycin D. There was no difference in response rate in the three groups (24%, 25% and 22%). Females responded better than males and, as expected, those with a...
journal_title:Cancer
pub_type: 临床试验,杂志文章
doi:10.1002/1097-0142(19840215)53:4<833::aid-cncr28205
更新日期:1984-02-15 00:00:00
abstract::A 24-year-old woman was found to have a diffuse large cell lymphoma arising within thyroid tissue within a mature cystic teratoma of the ovary. To the authors' knowledge, this is the first reported case of malignant lymphoma arising within a teratoma of the ovary. ...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19861201)58:11<2459::aid-cncr282
更新日期:1986-12-01 00:00:00
abstract::Twenty-eight peritoneovenous shunts were placed to relieve ascites in 26 patients with a variety of underlying malignancies. Nine of the patients had documented liver metastases and hyperbilirubinemia. Severe thrombocytopenia with laboratory evidence of disseminated intravascular coagulation (DIC) occurred in four of ...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19850601)55:11<2718::aid-cncr282
更新日期:1985-06-01 00:00:00
abstract::From 1959 to 1986, 24 patients with primary malignant tumors of the trachea received radiotherapy as all or part of treatment. Common presentations included respiratory symptoms in 20 patients and hemoptysis in 15. Thirteen patients had squamous carcinomas with undifferentiated and adenoid cystic cancers in five and f...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19890615)63:12<2429::aid-cncr282
更新日期:1989-06-15 00:00:00
abstract:BACKGROUND:Most patients with cutaneous squamous cell carcinoma (cSCC) of the head and neck (HN) are at low-risk (<5%) of developing metastatic SCC to regional lymph nodes. However, patients with unfavorable clinicopathologic factors often are under appreciated by clinicians but remain at higher risk for developing met...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.21898
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Malignant fibrous histiocytoma (MFH) is a neoplasm of late adult life and often is reported in the pediatric population. It is thought to behave more benignly in children than in adults. METHOD:Clinical and pathologic features, treatment, and outcome of nine pediatric patients seen at British Columbia's Chi...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19930615)71:12<4077::aid-cncr282
更新日期:1993-06-15 00:00:00
abstract:BACKGROUND:US breast cancer mortality is declining, but thousands of women still die each year. METHODS:Two established simulation models examine 6 strategies that include increased screening and/or treatment or elimination of obesity versus continuation of current patterns. The models use common national data on inci...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/cncr.28087
更新日期:2013-07-15 00:00:00
abstract::Five hundred forty three adult patients with acute leukemia were entered on the study designed to: (1) test efficacy of vincristine and prednisone used as primary drug therapy in patients with good prognosis as judged by a circulating blast cell count less than 30,000 cm2; (2) investigate the use of either simultaneou...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19830915)52:6<958::aid-cncr28205
更新日期:1983-09-15 00:00:00
abstract::Nine years after biopsy and radiation therapy for an extramedullary plasmacytoma of the nasal cavity, a 64-year-old man developed locally recurrent tumor. Repeat biopsy revealed tumor identical in hematoxylin and eosin stain (H & E) appearance to that found originally, leading to the diagnosis of recurrent extramedull...
journal_title:Cancer
pub_type: 杂志文章
doi:10.1002/1097-0142(19870701)60:1<88::aid-cncr282060
更新日期:1987-07-01 00:00:00