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Home: Oncology Leader Commentary: J. Michael Dixon, MD

Click on the topic below for comments by Dr J. Michael Dixon to comment on. You will also find links to related articles and clinical trials.

Breast cysts as a cancer risk factor
Biochemistry of breast cysts
Intratumoral estrogen levels in breast cancer
Neoadjuvant endocrine therapy
Response rates with neoadjuvant endocrine therapy
Time to response with neoadjuvant endocrine therapy
Randomized trials of neoadjuvant Arimidex
Response criteria with neoadjuvant therapy
Biologic effect of endocrine agents
Combining endocrine agents
Quality of life with neoadjuvant endocrine therapy
Neoadjuvant endocrine therapy of locally advanced breast cancer
Neoadjuvant therapy of inflammatory breast cancer
Neoadjuvant therapy of elderly patients
Timing of surgery after neoadjuvant therapy
Neoadjuvant therapy with aromatase inhibitors

Biochemistry of breast cysts

Play Audio Below:

We did a lot of work on the biochemistry of cysts. Some of these cysts fluids contain levels of hormones 1,000 times greater than plasma. There’s all this hormone soup floating around in the breasts and it’s the same kind of idea. You know what’s happening in the tumor to their hormones and intratumor aromatase is the same kind of area of interest. What’s going on in these tumors? Why do postmenopausal women have the same levels of estrogen in their tumors as premenopausal women? And yet premenopausal women have much greater circulating levels. It’s rather odd really.

Dr. Love: Has that been duplicated anywhere else or been looked at?

Dr. Dixon: When you look at the previous data almost everybody who has looked at it has found similar results. And when you look at some of the analysis that have been done in papers previously many other papers have found exactly the same. So when you do a meta-analysis and combine all the results, they are all entirely consistent and part of the problem is that people confused the term cyst. They have equated cyst with microscopic cystic disease but what we are talking about is palpable cystic disease. And when you take out a series that is being published in palpable cysts, the findings are remarkably consistent. In fact, there is a table in our Lancet paper which summarizes all the previous studies and our results are entirely consistent with what everybody else has found.

Relevant Articles:

Risk of breast cancer in women with palpable breast cysts: a prospective study. Edinburgh Breast Group.
Dixon JM. McDonald C. Elton RA. Miller WR. Lancet. 353(9166):1742-5, 1999.

Lack of utility in clinical practice of cytologic examination of nonbloody cyst fluid from palpable breast cysts.
Hindle WH. Arias RD. Florentine B. Whang J. American Journal of Obstetrics & Gynecology. 182(6):1300-5, 2000.

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