Androgen receptors as a prognostic and predictive factor in breast cancer.

Many theoretical and experimental models indicate that androgen receptors can play an important role as prognostic factors in breast cancer. The aim of this study was to evaluate the correlations between the presence of androgen receptors on cancer cells and other selected prognostic and predictive factors with established clinical significance in women with breast cancer after radical surgical treatment. 488 adult females were included in the study, who underwent primary radical surgery for breast cancer. 428 patients (87.7%) had Patey's conservative radical mastectomy and 60 (12.3%) Halsted's radical mastectomy. The mean age at operation was 54.3, ranging from 32 to 79. The mean length of hospitalization was 7.2 days for the patients after Patey's mastectomy and 9.8 days for those after Halsted's mastectomy. The androgen receptor is the most frequently detected steroid receptor on breast cancer cells. Therapeutic efficacy of adjuvant hormone therapy was higher in the group of androgen receptor-positive patients than in androgen receptor-negative ones. The prognosis for androgen receptor-positive patients who underwent adjuvant hormone therapy was better than for those androgen receptor-positive patients who did not receive hormone therapy after primary radical surgery for breast cancer. Assessment of androgen receptor levels on cancer cells should become a routine procedure with patients undergoing primary radical surgery for breast cancer, as it seems to be an important predictive factor.

Molecular markers (c-erbB-2, p53) in breast cancer.

The aim of our study was to evaluate the correlation between clinical characteristics, histopatologic features and c-erbB-2 as well as p53 expression in cancer tissues. Breast cancer tissue was obtained from 184 female subjects with primary breast cancer. According to hormonal status patients were divided into two groups - 64 belonged to the premenopausal group and 120 to postmenopausal group. Each patient underwent mammectomy and axillary lymphadenectomy. c-erbB-2 protooncogene was detected in 54% cases, and was correlated with infiltrating type of cancer growth, as well as larger tumor size. The presence of p53 antioncogene was observed only in 33% of cases, mainly in infiltrating duct carcinomas. The incidence of c-erbB-2 and p53 positive cases was higher among subjects, whose ultrasound and mammography revealed malignancy. There was no correlation found between of c-erbB-2 expression and axillary lymph nodes involvement It seems probable, that c-erbB-2 and p53 status of cancer tissue may prove to be useful in assessment of the level of biological aggressiveness in breast carcinomas and hence can be used as a prognostic factor.

Jan Mikulicz-Radecki: one of the creators of world surgery.

This paper presents the life and achievements of Professor Jan Mikulicz-Radecki and his contribution to European and world surgery. He was born in 1850. Four periods can be distinguished in his surgical career: (1) Vienna period, 1875-82, when he worked by the side of the great Theodor Billroth: he introduced a number of new diagnostic and operative techniques, aseptic and antiseptic procedures, published research papers. He made the first endoscope for examining the esophagus and stomach. (2) Cracow period, 1882-87, when he was head of the Department of Surgery: he inaugurated his work with a lecture in Polish, which started: Gentlemen, I have been accused that I do not know the Polish language--which is my mother tongue to me as well as to any of you. He published papers on the use of iodophorm for healing wounds, was the first surgeon who sutured a perforated gastric ulcer (1885) and invented pyloroplasty (1887), nowadays called Heinecke-Mikulicz pyloroplasty. (3) Konigsberg period, 1887-90: he improved the technique of gastric resection, worked on surgery for peptic ulcer and advocated aseptic and antiseptic procedures. (4) Wroclaw (Breslau) period, 1890- 1905: Mikulicz was appointed head of a newly founded Surgical Department. He rebuilt it and designed one of the largest and most modern operating theaters in Europe that time. He introduced silk gloves for operations for the first time in the world. In 1892 he described bilateral swelling of salivary and lacrimal glands, called Mikulicz's syndrome; in 1902 he published his experience with two-stage colon resection; and in 1904 he described ostitis fibrosa cystica juvenilis. Called "a king in the kingdom of surgeons", he was one of the fathers of the world's modern surgery; having a brilliant surgical mind, he was a pioneer of many new operations and an inventor of surgical tools, permanently assimilated in the world's surgery.