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PURPOSE: Paget's disease of the breast (PDB) occurs in approximately 1~3% of all primary breast carcinomas. This study aimed to determine the optimal surgical treatments for PDB in this study. METHODS: The medical records of 16 patients with PDB who had been treated between January 1986 and December 1998 were clinically reviewed retrospectively. Results: 13 patients had nipple changes consistent with clinical Paget' disease (CPD) including 8 who had an associated breast mass, and 5 who had no associated mass. Of the 13 patients with CPD, 12 were treated with a modified radical mastectomy while 1 was treated with a radical mastectomy. Breast cancer (BC) was found in all of 13 patients (100%) with CPD. The BC was centrally located in 46% of patients including 38% in CPD associated with the mass and 60% in CPD not associated with the mass. Out of 8 CPD patients associated with the mass, 7 (88%) had invasive cancer, 1 (12%) had a ductal carcinoma in situ (DCIS), and 2 (25%) had pathologic axillary nodes (PAN). The 5 year survival rate was 87.5%. Of the 5 CPD patients not associated with the mass, 4 (80%) had an invasive cancer, 1 (20%) had a DCIS and none had PAN. Their 5 year survival rate is 100%. CONCLUSION:All the patients with CPD had an associated BC. BC is more frequently centrally located in the CPD not associated with the mass (60%) than those associated with the mass (38%). Contrarily, the BC in CPD that was not associated with the mass was located more peripherally (40%). Therefore, the treatment of patients with CPD must be individualized in order to avoid under or overtreatment.
Breast ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Medical Records ; Nipples ; Paget's Disease, Mammary* ; Retrospective Studies ; Survival Rate

10.In vitro Stimulation of Tumor - Draining Lymph Node Lymphocytes with the 30 kDa Antigen of Mycobacterium tuberculosis Leads to the Differentiation of Th1 Cells and Cytotoxic Effector Cells.

Jeong Kyu PARK ; Tae Hyun PAIK ; Seok Shin KOH ; Hwa Jung KIM ; Eun Kyeong JO

Korean Journal of Immunology 1997;19(1):59-72

Tumor-draining lymph node (TDLN) lymphocytes contain immunologically sensitized to tumor but functionally deficient T cells. The 30 kDa protein antigen, a major secreted protein antigen of Mycobacterium tuberculosis, exhibits strong T cell stimulatory effect. In this study, it examined that the feasibility of using M tuberculosis 30 kDa antigen to stimulate tumor-draining lymph node cells for the generation of specific immune effector cells. Freshly isolated TDLN lymphocytes could directly respond to the 30 kDa antigen alone and their proliferative responses were markedly augmented by stimulation with rIL-2. TDLN cells were stimulated with the 30 kDa antigen for various time intervals and examined for the induction of IFN-r and IL-4 mRNA using RT-PCR. The expression of IFN-r mRNA was greatly augmented after 1 wk, whereas IL-4 mRNA is markedly decreased after 1 wk. Cytotoxic T cell activities induced by the 30 kDa antigen was also evaluated. TDLN cells stimulated with the 30 kDa antigen alone were able to generate remarkable cytotoxic response to K562 or Daudi cell lines after 6 days of culture. And their cytotoxic effects were highly augmented by stirnulation with rIL-2. These results suggest that the 30 kDa antigen of M. tuberculosis may selectively activate Thl cells of TDLN lymhocytes and induce the cytotoxic T cell activities. In conclusion, the 30 kDa antigen can be used as a biologic response modifier in tumor immunology.
Allergy and Immunology ; Cell Line ; Interleukin-4 ; Lymph Nodes* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; RNA, Messenger ; T-Lymphocytes ; Th1 Cells* ; Tuberculosis

1.Pathophysiology of tuberculosis.

2.The Author's Response: Objective Assessment of Surgical Restaging after Concurrent Chemoradiation for Locally Advanced Pancreatic Cancer.

3.Biological detection of enterotoxigenic E. coli.

4.Lymphocyte proliferation and antibody response against 30-kDa protein antigen of mycobacterium tuberculosis.

5.Purification and immunochemical charaterization of alpha-antigen from the culture filtrate of mycobacterium tuberculosis.

6.Determination of antibody activities of alpha- and beta-protein antigens of mycobacterium tuberculosis in cerebrospinal fluid by ELISA for the diagnosis of tuberculous meningitis.

7.Detection of mycobacterium tuberculosis in sputum samples by polymerase chain reaction.

8.Purification of 30-kDa and 32 kDa protein antigens from mycobacterium tuberculosis and activation of human monocytes by lymphokines.

9.Paget's Disease of the Breast.

10.In vitro Stimulation of Tumor - Draining Lymph Node Lymphocytes with the 30 kDa Antigen of Mycobacterium tuberculosis Leads to the Differentiation of Th1 Cells and Cytotoxic Effector Cells.

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