PURPOSE: As neoplasia is the result of unbalanced cell growth and cell death, alternations in the growth control pathway including the immunity within the individual host-tumor relationship has been attributed to the development of breast cancer. Interferon(IFN)-gamma based immunity was recently reported to have an antitumor effect and some new methods to assess the state of interferon-gamma based immunity have been introduced. Interferon regulatory factor(IRF)-1 and interferon regulatory factor(IRF)-2 are transcriptional factors that mediate the effects of Interferon-gamma. It was suggested that the loss of IRF-1 expression is associated with the loss of tumor suppression and the development of IRF-2 expression is associated with oncogenic activation. Thus, we studied the significances of the IRF-1 and IRF-2 expressions as they are related with some clinicopathological parameters to determine the biological behavior of breast cancer including the menopausal status, tumor size, lymph node status, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the expression of p53 protein. METHODS: Formalin-fixed paraffin embedded specimens from 82 patients with invasive ductal carcinoma were used to evaluate the expression of IRF-1 and IRF-2 by performing immunohistochemical staining with using an avidin-biotin-peroxidase complex technique. RESULTS: The expression of IRF-1 was observed in 80.5 % of the study group. However, the expression of IRF-1 did not show any correlation with menopausal status, tumor size, histologic grade, the expression of steroid receptors, the expression of c-erb B2 oncoprotein and the p53 expression. Only lymph node metastasis showed a decreasing tendency of IRF-1 expression, but this was without statistical significance (p=0.075). The expression of IRF-2 was observed in 58.5% of the study group and it did not show any significant relationship with any of the above mentioned clinicopathological parameters. CONCLUSION: This study suggests that the expression of IRF-1 and IRF-2 does not affect the previously established parameters for determining such biological behaviors of breast cancer as the tumor size, lymph node metastasis, the histologic grade, the expression of steroid receptors, the expression of c-erb B2 and the expression of p53. In spite of these results, We'd like to recommend that another study be done to evaluate the role of IRF-1 and IRF-2 for the proper selection of the patients who are suitable for immunotherapy.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cell Death ; Humans ; Immunotherapy ; Interferon Regulatory Factors* ; Interferon-gamma ; Interferons* ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Receptors, Steroid

The mainstay of treatment in primary breast cancer is still a radical mastectomy. In the case of advanced breast cancer, preoperative chemotherapy is an alternative treatment method to induce surgical therapy. Although the number of elderly patients with breast cancer is increasing, the knowledge about the possible differences in the biology and clinical outcomes of breast cancer according to age is limited. In addition, elderly patients have difficulties with surgical treatment because of the higher rate of coincident systemic illness, high anesthetic risk and high rate of operation refusals for an operation than those in young patients. As it was well known that elderly patients have better prognoses than younger patients and more estrogen and progesterone receptors in tumor tissue, it was expected that oral chemoendocrine and radiation therapy could be an alternative in elderly patients who refuse surgery. Good results were experienced in our three elderly breast cancer patients when applying these non-surgical treatments.
Aged* ; Biology ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Estrogens ; Female ; Humans ; Mastectomy, Radical ; Prognosis ; Receptors, Progesterone

PURPOSE: Bone is the most common site of metastasis from breast cancer. An abnormal bone scan finding, however, is not specific in differentiation of bone metastasis from traumatic or inflammatory bone diseases. The purpose of this study was to identify clinical findings that could help evaluate the etiology of solitary costal hot spots on a bone scan. METHODS: The study included 32 patients (all women, mean age 51+/-1 years) showing solitary costal hot spots on postoperative bone scans performed between January 1998 and December 2002. In order to classify the etiology of solitary costal hot spots as non-malignant or malignant, all available clinical, scintigraphic, laboratory and other radiographic examinations were taken into consideration. RESULTS: The mean follow-up period was 42.5 months. Among 32 hot spots, 7 (21.8%) were metastatic, and the remaining 25 (78.2%) non-malignant. The mean period of first detection after operation was 17.0+/-16.3 months in the metastatic and 26.0+/-21.3 months in the non-malignant groups. The metastatic group was significantly associated with advanced breast cancer. In the localization of rib lesion, 20 (62.5%) of the solitary costal hot spots were in the anterior arc, 5 (15.6%) in the lateral arc and 7 (21.9%) in the posterior arc. In the group with a location at the anterior arc, 16 (80%) were non-malignant, whereas 4 (20%) were malignant. In those localized at the anterior arc, 12 (60%) were on ipsilateral and 8 (28%) were on contralateral. The difference between the hot spots in the ipsilateral and contralateral locations was not significant. The carcinoembryonic antigen (CEA) and CA15-3 were elevated: in 5 (51%) and 3 (43%) patients with metastatic spots, and in 4 (16%) and 1 (4%) patient with non-malignant lesions, which were significantly different. CONCLUSION: It was found that an advanced state of primary breast cancer and the increase of tumor markers (CEA and CA15-3) were the significant factors for the direction of the nature of solitary costal hot spots on postoperative bone scans in patients with breast cancer.
Bone Diseases ; Breast Neoplasms* ; Breast* ; Carcinoembryonic Antigen ; Female ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Ribs ; Biomarkers, Tumor

Leptomeningeal metastsis (LM) is a disease where the tumor cells involves the leptomeninges. Breast cancer, of all solid tumors, is the primary tumor most frequently associated with leptomeningeal metastasis. Leptomeningeal metastasis originating from breast cancer is usually detected at an advanced stage, so its evaluation and aggressive treatment are difficult. Leptomeningeal metastasis, from solid tumors, has been reported to inexorably lead to death within 4 to 6 weeks if left untreated. Intrathecal or Intraventricular chemotherapy and radiotherapy are the mainstays of treatment. Even though controversial, systemic chemotherapy, with regional radiotherapy, can also improve the neurological outcome and survival, without neurotoxicity. Here, two patients with leptomeningeal metastasis, originating from breast cancer, their clinical course and treatment modalities are reported.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Humans ; Neoplasm Metastasis* ; Radiotherapy

PURPOSE: Cells of mammary gland as well as breast cancer uptake iodide through sodium/iodide symporter (NIS). The pathophysiologic importance of NIS is not evaluated well. The purpose of this study is to find relationships between the expression of NIS and other findings of breast cancer including ER, PR, C-erbB2, topoisomerase IIa, p53, and histologic grade of breast cancer. METHODS: Fresh frozen specimens from 21 female breast cancer patients (mean age 50 13 years) with breast cancer were examined by RT-PCR for NIS mRNA. Immunohistochemical staining for ER, PR, C-erb B2, topoisomerase IIa and p53. Staging and degree of differentiation of cancer cells were also performed to evaluate the biological behavior of breast cancer. RESULTS: NIS mRNA was expressed in 90% of the evaluated breast cancer tissues. The mean semiquantitative value of NIS mRNA in PR positive group was 2.02+/-0.35, which was higher than that of PR negative group (1.11+/-0.18; P=0.001). ER positive group showed higher value of NIS mRNA (2.02+/-0.35) than ER negative group (1.19+/-0.63; P=0.002). In addition, NIS mRNA values was significantly different according to differentiation of cancer cells (well differentiated type, 2.20+/-0.37 vs. less differentiated type, 1.39+/-0.63, P=0.01). However, there was no significant association between NIS mRNA levels and the other biologic characteriscs such as C-erb B2, topoisomerase IIa, and p53. CONCLUSION: The results showed that the expression of NIS in breast cancer may be associated with the presence of PR and ER as well as the degree of differentiation of breast cancer cells.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Ion Transport* ; Mammary Glands, Human ; RNA, Messenger*

PURPOSE: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. MATERIALS AND METHODS: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age 50+/-11 years) of papillary thyroid cancer. Among them 43 patients were treated with < or =7.4 GBq, while 15 patients with > or =9.25 GBq. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. RESULTS: MPD measured by CF method using tracer and therapeutic doses were 13.3+/-1.9 and 13.8+/-2.1 GBq, respectively (p=0.20). They showed a significant correlation (r=0.8, p< 0.0001). Exposed doses to blood measured by CF and biological methods were 1.54+/-0.03 and 1.78+/-0.03 Gy (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). CONCLUSION: Measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.
Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Male ; Metaphase ; Mortality ; Recurrence ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: Differentiation of parathyroid and thyroid nodule is often difficult even with aids of ultrasonography and computed tomography. Tc-9m sestamibi (MIBI) scintigraphy is useful in the detection of hyperfuntioning parathyroid nodules. However, its role in the differentiation between parathyroid and thyroid nodules including malignancies is not well studied. Therefore, the purpose of this study is to evlauate the role of Tc-99m MIBI imaing in the differentiation of parathyroid adenoma from thyroid malignancy. METHODS: Six patients (4 women, 2 men, mean age 43 years) with parathyroid adenoma and 4 patients (2 women, 2 men, mean age 56 years) with thyroid papillary cancer were enrolled. Ten and 180 minutes after injection of 740 MBq Tc-99m MIBI, pinhole image of the anterior neck was obtained. Nodule-to-thyroid ratio (N:T) was measured from same sized region of interests over nodule and normal thyroid bed. Retention Index (RI) was calculated as N:T 10 minus N:T 180 divided by N:T 10. RESULTS: as those with thyroid cancer (1.09 ± 0.35, 1.24 ± 0.36, respectively, P>0.05 ). However, RI of parathyroid patients was higher than thyroid cancer patients (0.64 ± 0.29, -0.12 ± 0.20, respectively, P<0.05). CONCLUSION: Parathyroid adenoma showed higher retention rate of Tc-99m MIBI than thyroid cancer. Therefore, differntiation of parathyroid and thyroid nodule could be possible using Tc-99m MIBI scintigraphy.

PURPOSE: Despite the fact that the primary factor to determine the prognosis of breast cancer is the metastatic lesion rather than the primary tumor, most studies concerning the prognostic factors related with tumoric biological behavior have focused on the primary tumors. A better understanding of changes of biological behavior in the metastatic lesions will provide a clue to more effective and rational approaches for treating metastatic breast cancer. METHODS: This study was designed to investigate the biological characteristics of metastatic cancer cells in breast cancer and to compare them to those of the primary tumors. Eighty-two breast cancer patients with metastatic axillary lymph nodes were selected for study. The evaluated tumoric biological characteristics used in this study were histologic grade, estrogen receptor, progesterone receptor, bcl-2, c- erbB2, p53, and P-glycoprotein. Evaluations were carried out with H-E and immunohistochemical stainings. The subjects were divided into positive cases and negative cases, according to extent and degree of staining. McNemar's test and Spearman's rho correlation coefficient were used for statistical analysis and cases showing a p-value of 0.05 or less were taken as being statistically significant. RESULTS: The results were as follows: 1) Metastatic nodes showed higher histologic grade than primary tumors. 2) No significant pattern was observed concerning changes in biological characteristics, including estrogen receptor, progesterone receptor, bcl-2, c-erbB2, p53, and P-glycoprotein between primary tumor and metastatic lymph nodes. 3) Neither wea any significant difference observed in biological behavior among the metastatic lymph nodes. CONCLUSION: This results indicate that the meaningful biological characteristic of metastatic lesion is higher histologic grade alone, and suggest that this change in histologic grade is the single, specific factor determineing the prognosis for metastatic breast cancer.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Lymph Nodes* ; P-Glycoprotein ; Population Characteristics ; Prognosis ; Receptors, Progesterone

PURPOSE: Despite the fact that the primary factor to determine the prognosis of breast cancer is the metastatic lesion rather than the primary tumor, most studies concerning the prognostic factors related with tumoric biological behavior have focused on the primary tumors. A better understanding of changes of biological behavior in the metastatic lesions will provide a clue to more effective and rational approaches for treating metastatic breast cancer. METHODS: This study was designed to investigate the biological characteristics of metastatic cancer cells in breast cancer and to compare them to those of the primary tumors. Eighty-two breast cancer patients with metastatic axillary lymph nodes were selected for study. The evaluated tumoric biological characteristics used in this study were histologic grade, estrogen receptor, progesterone receptor, bcl-2, c-erbB2, p53, and P-glycoprotein. Evaluations were carried out with H-E and immunohistochemical stainings. The subjects were divided into positive cases and negative cases, according to extent and degree of staining. McNemar's test and Spearman's rho correlation coefficient were used for statistical analysis and cases showing a p-value of 0.05 or less were taken as being statistically significant. RESULTS: The results were as follows: 1) Metastatic nodes showed higher histologic grade than primary tumors. 2) No significant pattern was observed concerning changes in biological characteristics, including estrogen receptor, progesterone receptor, bcl-2, c-erbB2, p53, and P-glycoprotein between primary tumor and metastatic lymph nodes. 3) Neither wea any significant difference observed in biological behavior among the metastatic lymph nodes. CONCLUSION: This results indicate that the meaningful biological characteristic of metastatic lesion is higher histologic grade alone, and suggest that this change in histologic grade is the single, specific factor determineing the prognosis for metastatic breast cancer.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Lymph Nodes* ; P-Glycoprotein ; Population Characteristics ; Prognosis ; Receptors, Progesterone

PURPOSE: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. METHODS: Therapeutic effects of MPD was also evaluated in 58 patients (49 females and 9 males, mean age 50±11 years) of papillary thyroid cancer. Among them 43 patients were treated with ≤7.4 GBq, while 15 patients with ≥9.25 GBq. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. RESULTS: MPD measured by CF method using tracer and therapeutic doses were 13.3±1.9 and 13.8±2.1 GBq, respectively (P=0.20). They showed a significant correlation (r=0.8, P<0.0001). Exposed doses to blood measured by CF and biological methods were 1.54±0.03 and 1.78±0.03 Gy (P=0.01). They also showed a significant correlation (r=0.86, P=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (P=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, P=0.46). CONCLUSIONS: measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.
Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Male ; Metaphase ; Methods* ; Mortality ; Recurrence ; Therapeutic Uses ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*