Reinhard E. Zachrau
New York Medical College
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Cancer | 1974
Maurice M. Black; Henry P. Leis; Bella Shore; Reinhard E. Zachrau
Cellular hypersensitivity against autologous and homologous breast cancer was evaluated by means of a leukocyte migration procedure. The antigens employed were cryostat sections of breast tissue. The relative leukocyte migration in the presence of the antigen as compared with migration without antigen was termed the migration index (MI), and used to quantify the response. The cryostat sections were also used for parallel studies of cellular hypersensitivity against autologous breast cancer by means of the skin window procedure. Both procedures demonstrated a stage‐response relationship against autologous breast cancer; in situ < Stage I < Stage II. Both procedures demonstrated the persistence of hypersensitivity in patients who were apparently free of cancer more than 2 years postoperatively. Cross reactivity (MI procedure) was uncommon against homologous invasive breast cancer, but was found in approximately half of the tests against homologous in situ carcinoma tissue. Such reactivity against homologous in situ carcinoma was observed in Stage II patients as frequently as in Stage I patients. The data corroborate our previous observations on the unique antigenicity of in situ carcinoma and emphasize the need for careful correlations between clinicopathologic findings and in vitro measurements.
Cancer | 1996
Maurice M. Black; Reinhard E. Zachrau; Benjamin F. Hankey; Eric J. Feuer
Our previous studies indicate that the in situ phase of mammary carcinogenesis is characteristically associated with cell‐mediated immunity (CMI) against an immunogen shared by most breast carcinomas. Such reactivity is inversely correlated with stage and appears to impede in situ‐to‐invasive progression and lethality from invasive breast carcinoma. If in situ carcinomas are indeed associated with ambient, prognostically favorable immunity against such an immunogen, one would expect lethality from invasive breast carcinoma to be reduced in patients with a diagnosis of a prior, simultaneous, or subsequent in situ breast carcinoma. The present study provides a test of such relationships.
Archive | 1985
Maurice M. Black; Reinhard E. Zachrau
The literature provides ample evidence that mammary carcinogenesis is a nonrandom event influenced by such risk factors as ethnic group, family history, age, parity and, perhaps, nutritional factors (Lilienfeld 1963; Macklin 1959; Vakil and Morgan 1973). It is, therefore, not surprising that patients who develop a cancer in one breast are at a greatly increased risk of developing a second primary breast cancer (Harrington 1946; McCredie et al. 1975). In response to such observations some have gone so far as to recommend prophylactic removal of the “second” breast (Leis 1979). Certainly it is clinically and conceptually important to take note of the increased risk of second breast cancers. However, it may be of even greater importance to consider the paradox that among patients who have the necessary and sufficient requirements to develop breast cancer, only a small minority will develop a primary cancer in the second breast. This is all the more surprising in view of the similarity in microscopic structure, mammographic patterns, and physical proximity of the two breasts. Moreover, the relatively low incidence of second primaries persists regardless of the age at diagnosis of the first lesion, family history, parity, or any constellation of known risk factors.
Advances in Cancer Research | 1991
Maurice M. Black; Reinhard E. Zachrau
Publisher Summary This chapter examines data bearing on the antigenicity of breast cancer and the prognostically significant immunity of the host. Particular attention is paid to documenting the presence of such characteristics in the preinvasive phase of breast cancer and demonstrating the therapeutic and the prophylactic significance of in situ carcinoma (ISC)-associated antigenicity and immunity. Any serious consideration of the immunological control of morbidity and mortality from cancer should pay attention to those variables that are critical to the immunological control of infectious diseases. Successful immunoprophylaxis of cancer requires that preinvasive cancers be immunogenic, that the immunogen be similar in most, if not all, preinvasive lesions, and that the immunogen provoke an immune reactivity in the host that is capable of impeding the progression from preinvasive to invasive cancer. The immunological considerations in breast cancer may be prototypical, since ISC-associated immunogenicity and prognostically significant skin window reactivity occur in patients with carcinomas of nonbreast origin. Most importantly, the cohesive whole of the assembled data is consistent with the ultimate control of morbidity and mortality from breast cancer by the immunization of control women against the ISC-associated cell-mediated immunity (CMI) determinant .
Archive | 1990
Maurice M. Black; Reinhard E. Zachrau; Monique Katz
Immune reactivity in cancer patients has been documented in terms of microscopically demonstrable lympho-reticuloendothelial (LRE) responses and by in vitro and in vivo tests of cell-mediated immunity (CMI) against autologous breast cancer. (1–5) Extensive studies, using a skin window (SW) test of such reactivity, indicate that the aggressive behavior of nuclear grade (NG)-characterized breast cancer is impeded by host CMI, directed against a determinant which is commonly expressed by the autologous cancer cells. (6) The prognostically significant CMI determinant of breast cancer is similar to a CMI determinant of gp55, the principal envelope glycoprotein of the murine mammary tumor virus of the RIII strain. (7–10) This determinant is more regularly expressed by preinvasive than invasive breast cancers. (11–14) Reactivity against the gp55-like immunogen also seems to impede the development of second invasive breast cancers. (15) According to these observations regarding the prognostic significance of spontaneous CMI, immunotherapeutic agents should have the ability to increase the intensity and/or duration of such specific immunity. Moreover, the treatment-related reactivity should show the same prognostic correlations, associated with spontaneous reactivity.
Preventive Medicine | 1990
Maurice M. Black; Reinhard E. Zachrau
Radical mastectomy was introduced by Halsted (1) and by Meyer (2) as a logical approach to a disease that was presumed to be homogeneous and to progress in a stepwise fashion before spreading systemically. This concept of time-related growth and spread provided the raison d’etre for a classification by stage, programs aimed at “early” diagnosis, and en bloc radical mastectomy. In a 1956 appraisal of breast cancer surgery, Pack and Ariel (3) stated that “the radical mastectomy of Halsted and Meyer represents one of the finest cancer operations devised because it embodies the principle of treatment whereby the primary tumor, the intervening lymphatics and the regional lymph nodes are removed en mass.” Despite this authoritative enunciation of the prevailing opinion, there were those who, at that time, called attention to the failure of radical mastectomy to reduce the death rate from breast cancer and emphasized treatment-independent variations in the behavior of breast cancer in individual patients (4-6). Such intrinsic heterogeneity in the clinical course of breast cancer was generalized by MacDonald as the concept of Biological Predeterminism (7). This concept was a direct challenge to the classical stage/prognosis concept and its emphasis on educational campaigns, aimed at early diagnosis. While biological predeterminism emphasized the limited potential for controlling breast cancer by early diagnosis and radical surgery, it did not, per se, provide any insight into the basis of the heterogeneity in the clinical behavior of the disease. The existence of prognostically significant heterogeneity among cancer tissues was first demonstrated by Broders, who called attention to the importance of histological grading of the degree of cancer tissue differentiation (8). The prognostic value of such grading of breast cancers was emphasized by Bloom (9), while Black and Speer called particular attention to the prognostic significance of
Annals of the New York Academy of Sciences | 1986
Maurice M. Black; Reinhard E. Zachrau
The fact that the incidence of breast cancer shows striking variations according to sex, age, and geographic origin suggests that there are endogenous and exogenous features that influence the development of the This thesis is supported by observations that variables such as family history (FH) of breast cancer and parity characteristics influence breast cancer incidence differently in different age-defined populations.’6 These observations suggest that there are subpopulations of women that are particularly susceptible or resistant to breast cancer under definable conditions. If such populations could be recognized, they would provide a valuable resource for identifying endogenous and exogenous variables whose manipulation might alter the development or type of breast cancer. The importance of routinely collecting data on diverse endogenous and exogenous characteristics of breast cancer patients was emphasized by Black in 1970.’ In keeping with this orientation, clinical data were routinely sought from all patients whose breast lesions were examined by the Surgical Pathology Service of Flower & Fifth Avenue Hospitals (FFAH), New York, New York, from 1970 through 1978, and Westchester County Medical Center (WCMC), Valhalla, New York, from 1979 to 1984. The clinical information sought included age, parity characteristics, menstrual history, FH of breast cancer (all family members, maternal and paternal), and use of exogenous estrogens, such as oral contraceptives (OC) or replacement estrogens (E). Patients using OC or E for at least one year continuously were designated as positive, while users for a shorter continuous interval were included in the negative series. Mammary carcinogenesis appears to be a stepwise phenomenon which involves recognizable precursor (P) lesions, i.e., precancerous mastopathy (PCM) and in situ carcinoma (ISC).8,9 It is therefore important that such lesions be identified and distinguished from normotypic lesions in a standard fashion. Such diagnostic distinctions have been made routinely in our laboratory since 1970. The practice of routinely collecting epidemiologically pertinent data from patients with precisely defined types of invasive and noninvasive breast lesions generates a continuously expanding pool of information. This resource was used previously to examine the interactions between age, family history, and use of exogenous estrogens with respect to the development of invasive and noninvasive breast lesions?-” It was found that the parity characteristics of patients with invasive breast cancer were similar to those of age-matched patients
Cancer | 1975
Maurice M. Black; Reinhard E. Zachrau; Bella Shore; Dan H. Moore; Henry P. Leis
Cancer Research | 1974
Maurice M. Black; Dan H. Moore; Bella Shore; Reinhard E. Zachrau; Henry P. Leis
Cancer Research | 1976
Maurice M. Black; Reinhard E. Zachrau; Bella Shore; Henry P. Leis