[en] The long term risks of the exposure of the female breast to ionizing radiation in general and in the framework of mammography screening in particular are reviewed. Updated quantitative evaluation of these risks is based on the analysis of the results of several epidemiological studies. Among these studies are those of the Japanese atomic- bomb survivors and of several groups of women who underwent radiotherapy or medical diagnosis procedures involving multiple chest fluoroscopes. the review is based on recruit UNSCEAR, NCRP and other publications. In general the great majority of the epidemiological studies indicate an increased incidence or mortality from breast cancer following irradiation. Some of file findings of these studies are: A linear dose-response function reasonably fits the epidemiological data. There is a latent period of at least 5 years between exposure and the start of risk increase. The results are consistent with a relative risk model. The fatalities of radiation induced breast cancer is similar to that for other breast cancers. The risk is file highest for young women and is substantially reduced with age at exposure. The dose rate has no major effect on Use risk. The NCRP concludes in its recent report related to mammography 12, that the number of excess breast cancer death cases expected in a population of 100,000 women subsequent to an annual screening examination up to the age of 69 is 18 casts if they start Dee annual screenings at age 40 (a total of 30 screenings), 9 cases if they start at age 45, 4 cases if they start at age 50 and 2 cases only if they start at age 55 (a total of 15 screenings). The total mean glandular dose assumed in these calculations is 4 mGy for each examination. These numbers have to be compared to 16,131, 15,591, 14,569 and 13,211 breast cancer cases expected in that population, subsequent to the above ages, respectively, in Dee absence of screening. The conclusion of the NCRP is that: In summary, it is clear that in terms of breast cancer mortality, the risk of radiation induced mortality, even given n series of 30 annual screenings, is offset by even a minimal benefit in reduced breast cancer mortality from screening as low as one percent' Seven epidemiological studies are reviewed in the NCRP report. All of these, but one, resulted in a significant reduction of 9-32 % in the breast cancer death rate in the screened population (as compared to the non screened population)

[en] Published in summary form only

No abstract available

[en] Published in summary form only

[en] Membrane vesicles released by neoplastic cells into extracellular medium contain potential of carrying arrays of oncogenic molecules including proteins and microRNAs (miRNA). Extracellular (exosome-like) vesicles play a major role in cell-to-cell communication. Thus, the characterization of proteins and miRNAs of exosome-like vesicles is imperative in clarifying intercellular signaling as well as identifying disease markers. Exosome-like vesicles were isolated using gradient centrifugation from MCF-7 and MDA-MB 231 cultures. Proteomic profiling of vesicles using liquid chromatography-mass spectrometry (LC-MS/MS) revealed different protein profiles of exosome-like vesicles derived from MCF-7 cells (MCF-Exo) than those from MDA-MB 231 cells (MDA-Exo). The protein database search has identified 88 proteins in MDA-Exo and 59 proteins from MCF-Exo. Analysis showed that among all, 27 proteins were common between the two exosome-like vesicle types. Additionally, MDA-Exo contains a higher amount of matrix-metalloproteinases, which might be linked to the enhanced metastatic property of MDA-MB 231 cells. In addition, microarray analysis identified several oncogenic miRNA between the two types vesicles. Identification of the oncogenic factors in exosome-like vesicles is important since such vesicles could convey signals to non-malignant cells and could have an implication in tumor progression and metastasis

[en] Background Breast compression is important in mammography in order to improve image quality, better separate tissue components, and reduce absorbed dose to the breast. In this study we use a method to measure and visualize the distribution of pressure over a compressed breast in mammography. Purpose To measure and describe the pressure distribution over the breast as a result of applied breast compression in mammography. Material and Methods One hundred and three women aged 40.7-74.3 years (median, 48.9 years) invited for mammographic screening consented to take part in this study. They were subjected to two additional breast compressions of the left breast (standard force and approximately 50% reduction). Pressure images of the compressed breast were obtained using force sensing resistor (FSR) sensors placed underneath the compression plate. Subjects rated their experience of pain on a visual analogue scale (VAS). Results Four pressure patterns were identified, fitting 81 of the 103 breasts, which were grouped accordingly. The remaining 22 breasts were found to correspond to a combination of any two patterns. Two groups (43 breasts) showed pressure mainly over the juxtathoracic part of the breast, had significantly greater breast thickness (P = 0.003) and had a lower mean pressure over dense tissue (P < 0.0001) than those with more evenly distributed pressure. Reducing compression force increased average breast thickness by 1.8 mm (P < 0.0001). Conclusion The distribution of pressure differed greatly between breasts. In a large proportion of breasts the compression plate did not provide optimal compression of the breast, the compression force being absorbed in juxtathoracic structures

No abstract available

[en] 239 Consecutive women with stage III carcinoma of the breast were treated by primary radiation therapy (RT) from 1977 to 1985. The response rate was 89%, the 5-year survival 40% and the local-regional tumor control (LTC) 59%. For the 27 non-responders, postirradiation chemotherapy was initiated but they died within 3 years. 105 Patients were subjected to mastectomy and axillary dissection after RT. In 107 cases, the RT was not followed by surgery. Systemic treatment consisted of hormonal therapy in both groups. The RT plus surgery group had better survival rate, 58% vs. 35% at 5 years. However, the incidence of less favorable cases was higher in the RT alone group. Histological findings in the operated group are analysed to determine prognostic significance of residual disease. No residual or only damaged microscopic disease was found in the breast in 36% of the cases. The axillary lymph nodes (ALN) were free of disease in 42% of the women. Patients with negative ALN after RT had significantly better 5-year survival (82% vs. 43%) and LTC (85% vs. 60%) rates. Decreased chest wall recurrence rate was associated with no residual or damaged microscopic disease in the breast (5% vs. 21%). The disease-free ALN were more common after 50-80 Gy telecobalt than after 40-50 Gy kV irradiation (51% vs. 33%). Primary tumor size (< 5 cm vs. > 5 cm) had no significant impact on histological findings or on prognosis. Residual disease is mainly a marker of tumor-host relationship which indicates the biological aggressiveness of the disease. 20 refs.; 4 figs.; 2 tabs

[en] The aim of this study was to optimize and evaluate the use of three dimensional surface re-timing allowed by the the 'AlignRT' system in the checking of the patients position during mammary radiotherapy. for a tolerance threshold of 5 mm the study of positioning by 'AlignRT' has shown that it would have to make a correction during one to four seances for a standard treatment of 25 seances. The area of interest has an important influence on the re-timing. the study has led to the optimal choice, including breast, axilla and sternum. a study is ongoing to know if the system 'AlignRT' could allow to limit the tagging of fields to the skin. (N.C.)

[en] Breast irradiation in the lateral decubitus (LD) position is a technique used at Institut Curie for more than 30 years in the breast-conserving management of patient with breast cancer. This technique is described here in detail. The patient's position allows the breast to flatten over a support, hence providing a rather homogeneous thickness throughout the treated volume. Dose at mid-thickness on the beam axis can be easily determined from entrance and exit dose measurements. Disadvantages and advantages of the LD techniques are discussed. This technique is recommended for patients with large breasts (more than 6cm thickness in LD position). (author). 6 refs.; 5 figs