Prevalence of antibodies to IBR and BVD viruses in dairy cows with reproductive disorders.

We determined the prevalence of antibodies to infectious bovine rhinotracheitis virus (IBRV) and bovine viral diarrhea virus (BVDV) in sera of dairy cows on 4 different farms in the Republic of Croatia. A high percentage (60.8%) of cows had various reproductive disorders. The results showed that seroprevalence of infectious bovine rhinotracheitis (IBR) was 85.8% and that of bovine viral diarrhea (BVD) was 79.2% in tested cows. Antibodies to both viruses were found in 80.8% of cows with reproductive disorders but in only 46.8% of cows without reproductive disorders. This difference was statistically significant (P<0.01), and indicated a connection between reproductive disorders and simultaneous infections with IBR and BVD viruses in dairy cows.

Differences between male and female breast cancer. II. Clinicopathologic features.

The aim of this study was direct comparison of clinicopathologic features in male and female breast cancer patients. The study included 100 male and 500 female patients with pathohistologically confirmed breast cancer, who were treated at the University Hospital for Tumors in Zagreb, Croatia, between 1970 and 1990. The results revealed significant sex-related differences in the following characteristics: patients age at diagnosis (36% vs. 66% below the age of 60, respectively, p < 0.001), delay in treatment (29% vs. 58% within the first 3 months, p < 0.001), tumor size (45% vs. 58% up to 5 cm, p < 0.001), number of affected regional lymph nodes (74% vs. 87% up to 5 nodes, p < 0.01), TNM-stage distribution (49% vs. 56% in stages I-II, p < 0.001), estrogen receptor values (69% vs. 32% > 10 fmol/mg protein, p < 0.001) and progesterone receptor values (67% vs. 48% > 10 fmol/mg protein, p < 0.05). No significant sex-related differences in breast cancer patients were found regarding histologic grade of malignancy (males: grade I-36%; II-34%; III-30%; females: grade I-33%; II-36%; III-31%), affected breast (left in 58% males vs. 50% females), and type of surgical treatment (modified radical mastectomy in 64% male vs. 61% female patients). This study confirmed the well-known facts that male breast cancer develops at an older age and with a much higher proportion of positive tumor hormone receptors. Furthermore, the authors found the male patients in Croatia to be insufficiently informed about the possibility of breast cancer development in male sex, which resulted in a significantly prolonged treatment delay and, consequently, higher TNM stage of the disease, bigger tumors and more affected lymph nodes at the time of diagnosis in comparison to female patients.

Differences between male and female breast cancer. III. Prognostic features.

The aim of this study was direct comparison of prognostic features in male and female breast cancer patients. The study included 100 male and 500 female patients with pathohistologically confirmed breast cancer, who were treated at the University Hospital for Tumors in Zagreb, Croatia, between 1970 and 1990. Stage-adjusted univariate analysis of differences in five-year overall survival revealed similar prognosis in both sexes when the disease was in TNM-stages I and II (males: 95% and 80%; females: 90% and 79%, respectively). However, the study showed that in TNM stages III and IV, male patients had a significantly worse five-year overall survival (males: 39% and 5%; females: 61% and 27%, respectively; p < 0.05). The impact of ten clinicopathologic characteristics on survival in males and females was also analyzed through the multivariate statistical analysis, in this case by multiple regression. Analyzed characteristics included patient age at diagnosis, delay in treatment, tumor size, number of affected lymph nodes, TNM-stage, histologic grade, affected breast, estrogen and progesterone receptor values, and type of surgery. An extremely intriguing finding was that the percent of survival variance explained by ten selected predictors (R2) amounted to as much as 78.7% in males, in comparison to only 23.1% in females. Three predictors that explained most of the survival variance in males were TNM-stage (21.0%), number of affected lymph nodes (19.5%) and delay in treatment (16.2%). The most important corresponding prognostic factors in females were number of affected lymph nodes (12.7%), histologic grade (6.6%) and tumor size (5.9%). The authors concluded that, from the prognostic point of view, male and female breast cancer represent two quite different diseases: in males, the outcome can be very precisely predicted from the basic clinicopathologic characteristics of the disease, while in females there is probably a wide spectrum of other factors with a significant influence on the prognosis, which require additional studies.

Fibromatosis of male breast.

Fibromatosis is a relatively benign, though locally invasive neoplasm. About 100 cases of fibromatosis of the breast have been reported to date, none of them in a male. We present a 60-year-old man who was admitted to the University Hospital for Tumors in Zagreb, Croatia, on May 25, 1992, with a 3-month history of gradually enlarging, painless subcutaneous mass, 6 x 5 cm, that was located in the upper outer quadrant and partly beneath the areola of his left breast. The diagnosis was confirmed by immunoperoxidase studies, that showed positivity for vimentin, whereas the staining for cytokeratin AE1, glial fibrillar acid protein (GFAP) and collagen IV was negative. The tumor was removed by en bloc resection, and the greater pectoral muscle was spared. Today, 3 years after the operation, the patient is alive and in good health.

Locally recurring primary myxoma of the breast: an evidence of malignant alteration.

Breast is an extremely rare localization of myxoma. To date, only five cases have been reported, including one case of nerve sheath myxoma. In this report, the authors present a 37-year-old female patient who was admitted to the University Hospital for Tumors in Zagreb, Croatia, in 1979, with a 2-month history of gradually enlarging, painless subcutaneous mass in her right breast. On physical examination, a firm, relatively well circumscribed mass measuring 3 x 2 cm was detected in the upper outer quadrant and partly beneath the areola. The mass was freely movable to the overlying skin, causing no retraction. There was no family history of a breast disease or cancer. Patient's past history revealed no major illnesses or trauma. The tumor was removed by simple local excision, but it recurred locally in three episodes between 1981 and 1986. After that, the tumor underwent malignant alteration to myxosarcoma on its fourth (in 1992), and to myxoid liposarcoma on its fifth recurrence (in 1993). No such sequence of events has been reported in the literature so far.

Differences between male and female breast cancer. I. Epidemiological features.

The authors' interest was focused on the direct determination of differences between the salient features of breast cancer in men and women in a large number of patients. Various epidemiological features were analyzed in a group of 386 male and 21,491 female breast cancer patients registered in the Cancer Registry of the Republic of Croatia from 1968 until 1988. This was a population-based study, and all male and female breast cancer cases recorded during the mentioned period were included in the study. During this 21-year period, the total incidence rate of breast cancer in men was about 0.83/100,000, and the mortality 0.2,/100.000. In the same interval, in women the rates doubled from 30 to 60/100,000, and 13 to 29/100,000, respectively. The highest incidence rates were recorded in the 80-84 age group in men, and 60-64 age group in women. The mean age at diagnosis was 63.4 years in men and 58.2 years in women. The distribution in terms of TNM-stages in men was: stage I-10.10%; II-40.67%; III-32.40%; IV-16.83%; in women; I-12.19%; II-49.36%; III-27-58%; IV-10.86%. The results showed that breast cancer in men had epidemiological characteristics of a sporadic disease, occurring continuously at a specific mean frequency in the general population and being little affected by environmental impacts. Conversely, in women affected by the disease there was a tendency of continuous rise in the morbidity and mortality, which might have been due to the trigger action of one or more environmental factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast cancer prognosis. I. Prognostic factors in patients with node-negative (N0) breast cancer.

Predictors of breast cancer survival were investigated among 196 node-negative (N0) breast cancer patients treated at the Department of Surgery of the University Hospital for Tumors in Zagreb between 1969-1988. Selected prognostic factors included patient age, delay in treatment, tumor size, histologic grade of malignancy, estrogen receptor status, progesterone receptor status, tumor site, and type of surgical treatment. Among these predictors, only tumor size (p < 0.001) and pathohistologic grade of malignancy (p < 0.001) caused significant differences in 5-year overall survival rates (T1-92.1%, T2-89.8%, T3-64.1% and T4-45.4%; grade I-95.0%; II-80.6%; III-63.6%). The authors conclude that among eight selected clinical characteristics, only tumor size and pathohistological malignancy grade can serve as helpful predictors in determination of the probability of 5-year overall survival among node-negative breast cancer patients.

Breast cancer prognosis. II. Prognostic factors in patients with node-positive (N1-3) breast cancer.

Predictors of breast cancer survival were investigated among 282 node-positive (N1-3) breast cancer patients treated at the Department of Surgery of the University Hospital for Tumors in Zagreb between 1969-1988. Selected prognostic factors included patient age, delay in treatment, tumor size, type of lymph-node affection, pathohistological grade of malignancy, estrogen receptor status, progesterone receptor status, tumor site, and type of surgical treatment. Among these predictors, only tumor size (p < 0.001), type of lymph-node affection (p < 0.001), malignancy grade (p < 0.001), and progesterone receptor status (p < 0.001) revealed a significant impact on a 5-year overall survival rates (T1-100%, T2-64.5%, T3-54.5% and T4-23.7%; N1-60.2%, N2-20.8%, N3-30.3%; grade I-85.5%, II-59.4%, III-30.5%; PgR+ 63.8%, PgR--26.4%). The authors conclude that among nine selected characteristics, only tumor size, type of lymph-node affection, pathohistological malignancy grade, and progesterone receptor status can be helpful predictors in the determination of the probability of 5-year overall survival among node-positive breast cancer patients.

Breast cancer prognosis. III. Prognostic factors in patients with distant metastases (M1) at the time of diagnosis.

Predictors of breast cancer survival were investigated among 66 patients who had distant metastases at the time of diagnosis (M1). All of these patients were treated at the Department of Surgery of the University Hospital for Tumors in Zagreb between 1969-1988. Selected prognostic factors included patient age, delay in treatment, tumor size, type of lymph node affection, response to palliative surgical treatment and administered chemotherapy or hormonal therapy, and site of metastasizing. Among these predictors, several of them revealed a significant impact on a median survival (in months) of these patients: the most important was the response to chemotherapy (p < 0.001), followed by site of metastasizing (p < 0.05) and primary tumor size (p < 0.05). Palliative surgical treatment, apart from improvement of life quality, played no role in determining the survival among breast cancer patients with a distant disease.

Estrogen and progesterone receptors as prognostic factors in breast cancer.

The relation between estrogen receptors (ER) and/or progesterone receptors (PgR) and some clinical factors such as tumor size, axillary node involvement, histological tumor grade, and disease-free interval (DFI) in 500 patients with operable (TNM stage I-III) breast cancer was studied. ER-positive (ER+) tumors were commoner in older patients, whereas PgR-positive (PgR+) tumors were similarly distributed within the age groups. The concentration of ER+ protein also increased with age in contrast to PgR+ protein concentration. However, receptor status was not associated with menopausal status independently of age. Axillary node involvement influenced neither ER nor PgR status, but there was a statistically significant relation between tumor size and positivity of ER or PgR. There was no association between histologic tumor grade and either steroid receptor phenotype. DFI was longer in patients with ER+ than those with ER- tumors, independently of axillary nodal status. The positivity of PgR in patients with ER+ tumors contributed to an even longer DFI, suggesting that the combination of ER/PgR is a better indicator of DFI than ER or PgR alone.

Primary adenocarcinoma of the duodenum. Report of two cases.

Between 1969 and 1982, two patients were treated for malignant primary tumors of the duodenum in the Central Institute for Tumors and Allied Diseases in Zagreb. Adenocarcinoma of the posterior wall of the third part of the duodenum was histologically confirmed in the first patient. Today, 11 years after surgery and radiotherapy, there are no signs of the disease. Invasive papillary adenocarcinoma of the third part of the duodenum was histologically confirmed in the second patient. This patient died in cachexia 2 years after the diagnosis. The autopsy confirmed the initial diagnosis, and metastasis in the liver and periduodenal lymph nodes. When establishing the differential diagnosis of undefined pathologic processes in this region, one should consider a primary tumor of the duodenum. Palliative surgery can also be valuable in the overall outcome of treatment.