ABSTRACT
PURPOSE: Because of the increasing use of sonography to rule out cancer in women with palpable breast abnormalities, this study was performed to determine the rate of sonographically occult malignancy in this clinical setting. METHODS: Women who were recommended for biopsy based on mammographic and/or clinical findings underwent breast sonography. This study retrospectively analyzed the subset of patients with palpable malignant lesions. Lesions were classified as visible or occult on mammography and sonography. Patients without a tissue diagnosis of tumor were excluded. RESULTS: Of 1,346 masses that underwent biopsy or aspiration, 616 lesions were palpable, and of these, 293 were malignant. Sonography detected all 293 palpable malignant lesions (95% confidence interval for sensitivity, 99-100%). Eighteen lesions were mammographically occult. The median lesion size as determined by sonography was 1.8 cm; for the lesions that were mammographically occult, the median size was 1.6 cm. The most common histopathologic diagnosis for both groups of lesions was infiltrating ductal carcinoma. CONCLUSIONS: All palpable malignant breast lesions were visible by sonography in patients in whom a biopsy was recommended. However, we caution that until the false-negative rate of sonography for equivocal palpable abnormalities is determined prospectively, sonography cannot be accurately applied to rule out malignancy in this setting.
Subject(s)
Breast Neoplasms/diagnosis , Carcinoma, Ductal, Breast/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Needle , Carcinoma/diagnosis , False Negative Reactions , Female , Humans , Mammography/methods , Middle Aged , Palpation , Physical Examination , Retrospective Studies , Sensitivity and Specificity , Ultrasonography, Doppler, Color/methodsABSTRACT
This phase II study of liarozole fumarate (R85246, liarozole), a novel imidazole with retinomimetic and aromatase inhibitory effects, was designed to determine the efficacy and tolerability in postmenopausal women with advanced breast cancer in progression, to correlate these effects with hormonal levels, and to evaluate quality of life. Twenty-nine women with ER-positive or unknown metastatic disease who received > or = 2 prior hormonal therapies were treated with 150-300 mg liarozole twice daily until disease progression. All patients were evaluable for toxicity and 25 for response. Four patients (16.0%, 95% CI 5.3-37.4%) had partial remission (PR) of their disease for a median of 7.4 months (range 1.2-12.9) and 7 (28%) had disease stabilization for a median of 4.8 months (1.6-16.0). Estradiol decreased from pre-treatment levels of 9.2-52 pM (mean 17.1) to below detection (9.2 pM, p = 0.0005) after 1 month. Similarly estrone levels fell from 14-307 pM (mean 92.7) to below detection (9.2 pM, p = 0.0001). The most common toxicity was dermatological (96.6%) with features compatible with hypervitaminosis A syndrome such as rash, pruritus, dry skin, and brittle nails. The majority of these were mild to moderate in severity. No significant improvement in quality of life scores (FLI-C) were noted. Liarozole is an active new treatment for breast cancer in patients heavily pre-treated with hormone therapies. Further studies are needed to confirm its relative efficacy in both receptor positive and negative postmenopausal breast cancer.
Subject(s)
Antineoplastic Agents, Hormonal/therapeutic use , Breast Neoplasms/drug therapy , Imidazoles/therapeutic use , Postmenopause , Aged , Aged, 80 and over , Antineoplastic Agents, Hormonal/adverse effects , Breast Neoplasms/pathology , Disease Progression , Estrogens/analysis , Female , Humans , Imidazoles/adverse effects , Middle Aged , Quality of Life , Receptors, Estrogen/analysis , Skin Diseases/chemically inducedABSTRACT
This Phase II study was designed to determine the efficacy and tolerability of vorozole (R83842), a new nonsteroidal aromatase inhibitor, in postmenopausal women with advanced breast cancer in progression being treated with tamoxifen, and to correlate these effects with the hormonal profile and plasma drug levels. Twenty-nine eligible women with estrogen receptor-positive or unknown disease were treated with 2.5 mg vorozole once daily p.o. until disease progression. All 29 are evaluable for toxicity and 27 for response as assessed by International Union Against Cancer (UICC) criteria. After a median follow-up of 8 months, 3 patients (11%) had partial remission of their disease for 14, 15, and 16 months and 14 patients had disease stabilization for 7-24 months (median, 12). Patients with a normal carcinoembryonic antigen level (
Subject(s)
Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Tamoxifen/therapeutic use , Triazoles/therapeutic use , Aged , Aged, 80 and over , Aldosterone/blood , Androgens/blood , Antineoplastic Agents/adverse effects , Antineoplastic Agents/pharmacokinetics , Aromatase Inhibitors , Breast Neoplasms/blood , Breast Neoplasms/pathology , Disease Progression , Estrogens/blood , Female , Follicle Stimulating Hormone/blood , Humans , Hydrocortisone/blood , Luteinizing Hormone/blood , Middle Aged , Neoplasm Metastasis , Neoplasm Staging , Postmenopause , Receptors, Estrogen/analysis , Receptors, Progesterone/analysis , Triazoles/adverse effects , Triazoles/pharmacokineticsABSTRACT
The psychometric properties of the Autism Behavior Checklist (ABC; Krug, Arick, & Almond, 1980a, 1980b), a 57-item screening checklist for autism was investigated. Professional Informants completed the ABC on 67 autistic and 56 mentally retarded and learning-disabled children. The autistic children were the total population of autistic children aged 6-15 in two circumscribed suburban and rural regions. Using the total score, the ABC accurately discriminated 91% of the children, with 87% of the autistic and 96% of the nonautistic group correctly classified. Moreover, the accuracy of classification was virtually identical when only the more heavily weighted checklist items were used. A 3-factor model accounted for 32% of the total variance in the checklist. Seventeen items loaded .4 or more on Factor 1, 12 items loaded on Factor 2, and 10 items loaded on Factor 3. The present results fail to provide empirical support for a single unidimensional scale for autism. Also, there is little support for subdividing the checklist into five subscales based on symptom areas.
Subject(s)
Autistic Disorder/diagnosis , Personality Assessment/statistics & numerical data , Adolescent , Autistic Disorder/psychology , Child , Diagnosis, Differential , Female , Humans , Learning Disabilities/diagnosis , Learning Disabilities/psychology , Male , PsychometricsABSTRACT
Two experiments were carried out to determine whether expressive asymmetries in facial stimuli might underlie evidence of differential hemispheric responses to positive and negative emotion. Experiment 1 systematically varied stimulus orientation; Experiment 2 included both normally oriented and reversed (mirror-image) faces. We replicated previous reports of a left field advantage for happy faces and a right field superiority for sad faces only when normally oriented faces were used. Mirror-image stimuli tended to produce the opposite pattern of results, and a combination of the two (Exp. 2) eliminated the visual field differences for each emotion. The findings underscore the importance of controlling for stimulus asymmetries in visual laterality studies, and are discussed in terms of current notions about the lateralization of both the perception and expression of emotion.
