Breast cancer surveillance in patients treated by radiotherapy for Hodgkin's lymphoma.

PURPOSE: The authors evaluated the relative risk of developing radiation-induced breast cancer (BC) in women treated with radiotherapy for Hodgkin's disease (HD) and analysed the imaging features of these breast neoplasms. MATERIALS AND METHODS: We retrospectively studied 54 women who had all undergone radiotherapy between 1980 and 2010 (median age, 36.6 years). Women aged ≤30 years were screened with clinical breast examination, ultrasound (US) and, if necessary, mammography; women >30 years had clinical breast examination, US and mammography. Three women underwent magnetic resonance (MR) imaging as well. RESULTS: Mammography detected seven invasive breast cancers in 6/54 women (11.1%). Median age at diagnosis was 26.1 years for HD and 42.4 for breast cancer. Breast cancer was diagnosed following a median latent period from radiotherapy of 15.1 years. Mean radiation dose was 37.6 Gy in women who developed breast cancer and 31.3 Gy in the other women. CONCLUSIONS: In our study, women who were exposed to radiation for HD had a 6.2-fold higher risk of developing breast cancer than the general population. In consideration of the young age and high breast density, women aged ≤30 years should be monitored by US and MR imaging; women aged >30 years should be monitored by US, mammography and, when necessary, MR imaging.

Shielding, but not zeroing of the ambient magnetic field reduces stress-induced analgesia in mice.

Magnetic field exposure was consistently found to affect pain inhibition (i.e. analgesia). Recently, we showed that an extreme reduction of the ambient magnetic and electric environment, by mu-metal shielding, also affected stress-induced analgesia (SIA) in C57 mice. Using CD1 mice, we report here the same findings from replication studies performed independently in Pisa, Italy and London, ON, Canada. Also, neither selective vector nulling of the static component of the ambient magnetic field with Helmholtz coils, nor copper shielding of only the ambient electric field, affected SIA in mice. We further show that a pre-stress exposure to the mu-metal box is necessary for the anti-analgesic effects to occur. The differential effects of the two near-zero magnetic conditions may depend on the elimination (obtained only by mu-metal shielding) of the extremely weak time-varying component of the magnetic environment. This would provide the first direct and repeatable evidence for a behavioural and physiological effect of very weak time-varying magnetic fields, suggesting the existence of a very sensitive magnetic discrimination in the endogenous mechanisms that underlie SIA. This has important implications for other reported effects of exposures to very weak magnetic fields and for the theoretical work that considers the mechanisms underlying the biological detection of weak magnetic fields.

Intracystic epidermal growth factor level is predictive of breast-cancer risk in women with gross cystic disease of the breast.

Women affected by gross cystic disease of the breast have an increased risk of breast cancer. We report here the incidence of breast cancer by cyst type and intracystic epidermal growth factor (EGF) concentration. Our retrospective study included 504 women who had at least 1 cyst aspiration between 1985 and 1993. Cyst fluids were processed for electrolyte concentration (n = 378), EGF concentration (n = 347) or both (n = 337). Age-standardized incidence ratios (SIRs) were estimated using the population of the Genoa Cancer Registry. A multivariate Poisson regression model was used to estimate relative risks (RRs) when the study groups were compared directly. By June 1999, 19 invasive breast cancers had developed in the cohort of women. The age SIR of breast cancer calculated for the whole cohort was 3.32 (95% confidence interval 2.00-5.18). The ratio was not affected by age and was only moderately increased in women with a positive family history of breast cancer and type I cysts (i.e., those with a Na+/K+ ratio <3). However, it was significantly increased in women with high EGF concentrations. Direct comparisons confirmed that age, cyst type and family history only moderately increased the RR, whereas EGF concentration was a strong predictor of risk. Our results confirm that women affected by palpable cysts have an increased risk of developing breast cancer and suggest that the risk is higher in women with high intracystic EGF concentrations.

[Chemotherapy of pulmonary carcinoma. Considerations and a proposal of a system of the evaluation of clinical course]. / Chemioterapia nel carcinoma polmonare. Considerazioni e proposta di un indice di valutazione dell'evoluzione clinica.

With absolutely no attempt to reject chemotherapy of lung cancer as useless, particularly now that extremely effective antiblastic products are available, it is however suggested that we should think carefully before adopting treatments of doubtful efficacy that may prolong the patient's life but also increase his suffering in that they produce extremely unpleasant side effects without having much influence on the basic symptoms. In such cases it may be the physician's painful duty to withhold treatment.

[Chest pain]. / Il dolore toracico.

After a thorough description of the physiological background, the problem of chest pain is examined with extensive documentation including pictures. It is suggested that meticulous clinical assessment is of even greater value than laboratory tests or instrumental explorations for the accurate diagnosis and appropriate treatment of the condition causing the pain. In other words laboratory and instrumental assessments should be based on and used to confirm an approximate diagnosis formed on clinical data.

[A documented case of typical Hamman-Rich interstitial pulmonary fibrosis]. / Su di un caso accertato di tipica fibrosi polmonare interstiziale di Hamman-Rich.

Following a brief mention of the classification of Hammer-Rich disease within idiopathic diffuse pulmonary fibrosis, the main clinical, radiological and laboratory features of these disease are outlined in brief. A personal case, subsequently controlled neroptically and histologically, is then described. From comparison between reported data and findings in the personal case, it is concluded that it was a typical, rare case (less than 150 others have so far been reported in all world literature) of Hamman-Rich disease. Other diagnostic hypotheses can be rejected because they are less correspondent to the typical picture and for various other considerations.