© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 23, 1761,
December 5, 2001
© 2001 Oxford University Press
IN THIS ISSUE |
Women with abnormal cytology in breast fluid obtained by nipple aspiration have an increased relative risk of breast cancer compared with women from whom no fluid was obtained and with women whose fluid had normal cytology. Wrensch et al. (p. 1791) extended their follow-up of a group of women who had undergone nipple aspiration and determined the breast cancer risk for a new group of women from whom nipple aspirate fluid was collected and studied. Overall, they found an increasing gradient of breast cancer risk with increasing severity of the cytological diagnosis, such that the risk of breast cancer was highest in women with a cytological diagnosis of atypical hyperplasia and lowest in women from whom no fluid was obtained or whose fluid had normal cytology. They conclude that these results confirm their previous findings that women with abnormal cytology in nipple aspirates of breast fluid have an increased breast cancer risk.
In an editorial, Fabian and Kimler (p. 1762) note that, because the risk of breast cancer in women from whom nipple aspirate specimens cannot be obtained is not well defined, doctors should be cautious about incorporating this procedure into clinical practice to assess breast cancer risk.
Radiation Pneumonitis in Breast Cancer Patients
Some chemotherapy (CT) drugs, including taxanes, may enhance the effectiveness of radiation therapy (RT). However, combining these therapies may increase the incidence of radiation pneumonitis, a lung inflammation. In a retrospective study, Taghian et al. (p. 1806) evaluated the incidence of radiation pneumonitis in breast cancer patients treated with RT and standard adjuvant CT using doxorubicin and cyclophosphamide, with or without paclitaxel. Paclitaxel and RT were given concurrently in some patients and sequentially in others. The crude rate of developing radiation pneumonitis was 14.6% in patients treated with RT + CT with paclitaxel and 0.9% in patients treated with RT + CT without paclitaxel. The mean time to development of radiation pneumonitis was shorter in patients who received paclitaxel than in those who did not. The authors conclude that the use of paclitaxel and RT in the treatment of breast cancer should be undertaken with caution.
HRT and Colorectal Adenoma Recurrence
Some epidemiologic studies have suggested that exogenous hormone use may protect women against the development of colorectal cancers and adenomatous polyps, the requisite precursors for most colorectal cancers. Woodson et al. (p. 1799) tested this hypothesis by evaluating the association between hormone replacement therapy (HRT) use and colorectal adenoma recurrence, ascertained by complete colonoscopy, among women with colorectal adenomas enrolled in a randomized dietary intervention study. The authors found no association between current hormone use and adenoma recurrence overall, but they observed a possible 40% reduction in the risk of distal polyps among women using HRT. They also found that HRT use was associated with a 40% reduced risk of adenoma recurrence among women older than 62 years. They conclude that, whereas HRT use did not protect against adenoma recurrence overall, it may reduce risk of recurrence in older women.
In an accompanying editorial, Martínez (p. 1764) discusses the association between HRT use and the risk of adenoma recurrence in light of the limitations and strengths of the study design and the overall risks and benefits associated with HRT.
T-cell Immunity Against HTLV-I-Associated Lymphomas
Human T-cell leukemia virus type I (HTLV-I) is etiologically linked to adult T-cell leukemia (ATL). This disease has high mortality and is resistant to chemotherapy; therefore, immunologic approaches to treatment could be of interest. Athymic rats inoculated with a syngeneic (i.e., with the same genetic background) HTLV-I-infected T-cell line (FPM1-V1AX) develop ATL-like disease, and the transfer of T cells from normal syngeneic rats immunized with FPM1-V1AX cells prevents disease development. Hanabuchi et al. (p. 1775) observed that both CD4 and CD8 cells from the normal immunized rats were capable of inhibiting tumor growth. The CD8 cells directed their cytotoxicity against the HTLV-I regulatory protein Tax and, specifically, against the epitope formed by amino acids 180–188 (Tax 180–188). Adoptive transfer of the cells from the Tax 180–188-specific cytotoxic T-cell line or freshly prepared T cells from normal rats vaccinated with Tax 180–188 oligopeptide prevented the development of FPM1-V1AX-cell-induced lymphomas in athymic rats. The authors suggest a potential therapeutic use of peptide-based vaccination against HTLV-I-induced lymphoproliferative disease.
Expression of Fibroblast Growth Factors in Prostate Cancer
A substantial fraction of human prostate cancers have increased expression of fibroblast growth factors (FGFs). Altered FGF signaling can have a variety of effects, including stimulating cell proliferation and inhibiting cell death. To determine the biologic significance of altered FGF signaling in human prostate cancer, Ozen et al. (p. 1783) disrupted signaling by transfecting prostate cancer cells with dominant-negative (DN) FGF receptor constructs. The DN FGFR-1 construct inhibited colony formation by more than 99%. Cells infected with an adenovirus expressing DN FGFR-1 experienced extensive cell death within 48 hours. Further analysis revealed that the DN FGFR-1 receptor led to arrest in the G2 phase of the cell cycle before cell death. The authors conclude that these results reveal an unexpected dependence of prostate cancer cells on FGF receptor signal transduction to traverse the G2/M checkpoint.
Risk Factors for Breast Carcinoma In Situ
Although the risk factors for invasive breast cancer are well defined, those associated with breast cancer in situ are not. To identify potential risk factors for breast cancer in situ, Claus et al. (p. 1811) performed a population-based, case–control study among female residents of Connecticut diagnosed with either ductal or lobular carcinoma in situ. The authors found that many of the risk factors associated with invasive breast cancer were also risk factors associated with ductal or lobular carcinoma in situ, including family history of breast cancer, previous breast biopsy, fewer full-term pregnancies, and older age at menopause. There was no increased risk associated with use of either oral contraceptives or hormone replacement therapy. The authors also found that patients with ductal carcinoma in situ were more likely to have had a mammogram or annual clinical breast examination.
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