Stephen S. Falkenberry

Absence of estrogen and progesterone receptors in glassy cell carcinoma of the cervix

Objective To review available evidence about the effectiveness of alternative therapies for nausea and vomiting of pregnancy. Data Sources MEDLINE and 13 additional US and international data bases were searched in 1996–1997 for papers that described use of alternative medicine in the treatment of pregnancy and pregnancy complications, specifically those addressing nausea, vomiting, and hyperemesis. Bibliographies of retrieved papers were reviewed to identify additional sources. Methods of Study Selection All relevant English language clinical research papers were reviewed. Randomized clinical trials addressing specifically the use of nonpharmaceutical and nondietary interventions were chosen for detailed review. Tabulation, Integration, and Results Ten randomized trials studying the effects of acupressure, ginger, and pyridoxine on nausea and vomiting of pregnancy were reviewed. Evidence of beneficial effects was found for these three interventions, although the data on acupressure are equivocal. Insufficient evidence was found for the benefits of hypnosis. Other interventions have not been studied. Conclusion There is a dearth of research to support or to refute the efficacy of a number of common remedies for nausea and vomiting of pregnancy. The best-studied alter-native remedy is acupressure, which may afford relief to many women; ginger and vitamin B6 also may be beneficial.

Risk factors for breast cancer.

Breast cancer is multifaceted, and multiple risk factors most likely contribute to each case of the disease. Through further elucidation of highly penetrant autosomal dominant mutations and, perhaps more importantly, weaker polygenic influences, rational therapies to treat or prevent malignancy may develop. Determining the nature and sequence of genetic changes in premalignant breast tissue may offer the greatest opportunity to alter the process of breast cancer development. Perhaps the most difficult challenge is to understand the environmental risk factors that predispose to breast cancer. Although endogenous factors such as hormonal influence on breast cancer risk have been established, this information has not greatly affected our ability to prevent or significantly reduce the risk of disease. National and regional collaborative efforts are needed to fund research directed at defining how the environment and lifestyle factors affect the risk of cancer development.

BREAST CANCER IN PREGNANCY

Breast cancer in pregnancy is likely to become more common because more women have been waiting to bear children until they are in their 40s. This article presents an overview of pregnancy-associated breast cancer and a review of surgical, chemotherapeutical, and radiation principles as they pertain to pregnancy.

Videoconferencing for gynaecological cancer care: an international tumour board.

Sharing expertise between health-care staff is particularly important in the care of cancer patients, for whom treatment, even at its best, is not always effective, readily obvious or available. All relevant therapeutic options should be considered before deciding on cancer management. Self-evident though this may be, it is not always easy to do in practice, as it requires substantial collaboration1–4. Using videoconferencing, large, geographically dispersed groups can be convened and can function in realtime5–10. Case-specific discussions can occur with colleagues over great distances. In October 1998, we created an international tumour board (ITB) to improve the care of gynaecological cancer patients and to exchange medical knowledge between multidisciplinary groups in Providence, Rhode Island, USA, and in Safed, Israel. The ITB consists of doctors trained in cancer surgery, chemotherapy, radiation oncology, diagnostic radiology and tumour pathology, as well as nurses, nutritionists and oncology social workers. The prospective, focused, multidisciplinary process brings special insight and balance to the formulation of treatment recommendations. The establishment of such boards is difficult even in the largest medical institutions. ITB equipment

Cystic Hypersecretory Hyperplasia of Breast

Cystic hypersecretory hyperplasia (CHH) is a benign intraductal proliferation that is frequently reported as a part of a spectrum of proliferative changes involving multiple lobules, ranging from pregnancy-like change, pregnancy-like change with atypia, and neoplastic CH-type carcinoma in situ. Herein we report findings from a pure CHH. We discuss differential diagnosis and relevance of this rare histology as an incidental finding. The patient was a 74-year-old postmenopausal woman with a 2.0 cm subareolar palpable breast mass. Cut surface of excised breast tissue revealed almost back-to-back thin-walled cysts filled with gelatinous material (Figure 1A). Microscopic examination revealed markedly dilated ducts/cysts lined by flat cuboidal/columnar epithelium, filled with homogenous, eosinophilic, colloid-like material with cracks and shrinkage artifacts (Figure 1B and C). Micropapillary architecture with mild cytologic atypia was noted focally (Figure 1D). 741979 IJSXXX10.1177/1066896917741979International Journal of Surgical PathologySingh et al research-article2017

The Breast Health Center at Women & Infants Hospital: origin, philosophy, and features.

The Breast Health Center, a component of the program in Womens Oncology at Women & Infants Hospital, is a multidisciplinary center devoted to the treatment and study of benign and malignant breast diseases. The philosophy, structure, and function of The Breast Health Center are described along with its specific components. The Breast Health Centers three fundamental missions of patient care, education, and research are discussed.