(Andersen, 1981;Moskowitz, 1981; Tabiar et al., 1985), and from clinically based series of self-selected women (Betsill et al., 1978;Fisher et al., 1986;Moskowitz, 1983;Page et al., 1978;Page et al., 1982). However, as in situ breast carcinoma (in situ BC) is rarely symptomatic and the sensitivity of mammography in detecting malignancy is limited despite improved techniques (Holland et al., 1983), much uncertainty exists concerning these lesions.Histopathologic examination of the breast is a reliable method for detection of clinically and radiologically occult malignant and atypical lesions but extensive sampling is mandatory to detect these small lesions. The few autopsy studies using this technique have been carried out mainly on elderly women (Alpers & Wellings, 1985;Kramer & Rush, 1973;Nielsen et al., 1984).To obtain an estimate of the frequency and characteristics of clinically occult malignant and atypical lesions in younger Danish women, a series of medicolegal cases seemed to be a suitable sample. The results of an extensive histopathologic breast tissue examination and correlative specimen radiography in such a group of women are presented in this paper. Materials and methodsThe study group consisted of a series of 110 consecutive medicolegal autopsies on (Danmarks Statistik, 1985). During the sampling period about 10% of all deaths within the area underwent medicolegal examination and of these about 25% were subjected to autopsy.During the medicolegal autopsy, bilateral total mastectomy with partial axillary dissection (Cady, 1973) was performed in all cases, except for one woman who had undergone previous mastectomy for IBC and consequently only had a contralateral mastectomy.Each fresh breast specimen was weighed and radiographed intact in a single frontal projection in a Faxitron (model 43805N) using Kodak industrial M film. With the nipple as the center point, the specimen was then divided into the four quadrants and cut systematically from the deep fascia to the outer surface in 5 mm-thick slices. Each of these were radiographed and thereafter fixed in formalin. The slices were examined grossly after fixation and the relative proportion of glandular and fatty breast tissue was evaluated in 10% estimates. All tissue including fatty tissue was processed routinely for paraffin embedding. Axillary lymph nodes were also radiographed and processed for microscopic examination.The total number of paraffin blocks was 60,335 with each block containing -1.3 g of breast tissue. The average number of paraffin blocks from each breast specimen was 275 (range 57-683). The average number of lymph nodes from each woman was 21 (range 0-50). Sections for microscopic examination were cut from each paraffin block and stained with hematoxylin and eosin. In cases with suspicion of or with manifest in situ BC and atypical ductal hyperplasia (ADH), additional serial sections were prepared. The PAS-alcian stain was used to support the differentiation between LCIS and DCIS, based on the presence of intracytoplasmic lumi...

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Analyzing data obtained from web server logs, so-called "clickstreams", is rapidly becoming one of the most important activities for companies in any sector as most businesses become ebusinesses. Clickstream analysis can reveal usage patterns on the company's web site and give a highly improved understanding of customer behavior. This understanding can then be utilized for improving customer satisfaction with the web site and the company in general, yielding a huge business advantage.In this paper, we present the results of a clickstream analysis project at a large Danish mortgage provider. The paper first describes clickstream data and its usefulness, then it introduces the questions that the company wanted answered in the project. One of the major problems in clickstream analysis is sequences of clicks, which are difficult to handle using normal techniques. This problem is handled by introducing the concept of subsessions, which captures sequences of clicks explicitly. Techniques for overcoming the potential explosion in the number of subsessions and for filtering out unnecessary web requests are presented and the effectiveness of the techniques is evaluated. The proposed approach has been successfully implemented and tested and is currently being integrated in the company's web system architecture.

Several reports suggest that perioperative blood transfusion promotes recurrence and death after cancer surgery. We studied the effect of transfusion in 1599 patients who had mastectomy for carcinoma of the breast. In 228 transfused patients the disease recurred in 110 (48 per cent), compared with 647 (47 per cent) of 1371 non-transfused patients (P = 0.85). The 5-year recurrence-free survival rate was 0.54 in the transfused patients and 0.60 in the non-transfused group (P = 0.44). The transfused patients had a higher prevalence of risk factors than the non-transfused patients. Cox's multiple regression analysis confirmed that perioperative blood transfusion was of no importance. The study does not support the hypothesis that perioperative blood transfusion promotes recurrence after operation for breast cancer.

Eighty-four consecutive autopsies of women with a clinical diagnosis of invasive breast carcinoma (BC) were examined by extensive histopathologic methods for malignant changes of the contralateral breast. Sixty-eight percent of the women were found to have primary contralateral BC, of which 33% were invasive and 35% in situ lesions. Another 16% had metastases to the breast. Only two women had had treatment for their contralateral BC. In eight cases a malignant lesion was diagnosed or suspected clinically, but in the remaining cases, the malignancies were identified only by histopathologic examination. No clinical data or histologic characteristics of the first BC had any predictive value for the risk of contralateral BC. In the contralateral breast, a significant coincidence was found between fibrocystic disease and the Occurrence of primary malignant BC. The majority of the BC on both sides were of ductal type. Seventynine percent of the invasive contralateral BC were tumefacient, and 71% had axillary lymph node metastases. The mean survival time was comparable for women with and without contralateral primaries, but a significantly higher proportion of women with contralateral invasive BC died of disseminated BC. The frequency of contralateral malignancies is thus much higher than previously reported. The consequence of these findings may implicate a reevaluation of the treatment and control schedule regarding the contralateral breast in women with invasive BC.Cancer 57:897-903, 1986. OMEN WITH BREAST CARCINOMA (BC) have anW increased risk of BC developing in the other breast. The prognostic significance and the therapeutic consequences of this increased risk, however, are controversial.2 In the literature, the overall frequency of primary BC of the contralateral breast, either a simultaneous or a subsequent lesion, ranges from a few to more than 20%.5-8 Differences in study design between clinical and pathologic studies regarding patient selection and sampling technique may be expected to contribute to the large variation in the reported frequencies. Studies based on clinically diagnosed primaries have yielded the lowest figure, whereas higher frequencies have been found in studies based on random biopsy, prophylactic mastectomy, and/ or marnm~graphy.~-~ In histopathologic studies, in situ BC and clinically occult invasive BC, which may not be-

Angiogenesis is an important component of cancer growth, invasion and metastasis. Therefore, inhibition of angiogenesis is an attractive strategy for treatment of cancer. We describe existing clinical trials of antiangiogenic agents and the challenges facing the clinical development and optimal use of these agents for the treatment of breast cancer. Currently, the most promising approach has been the use of bevacizumab, a humanized monoclonal antibody directed against the most potent pro-angiogenic factor, vascular endothelial growth factor (VEGF). Small molecular inhibitors of VEGF tyrosine kinase activity, such as sorafenib, appear promising. While, the role of sunitinib and inhibitors of mammalian target of rapamycin (mTOR) in breast cancer has to be defined. Several unanswered questions remain, such as choice of drug(s), optimal duration of therapy and patient selection criteria.

Background The selection of patients with non-small cell lung cancer (NSCLC) for immune checkpoint inhibitor (ICI) treatment remains challenging. This real-world study aimed to compare the overall survival (OS) before and after the implementation of ICIs, to identify OS prognostic factors, and to assess treatment data in first-line (1L) ICI-treated patients without epidermal growth factor receptor mutation or anaplastic lymphoma kinase translocation. Methods Data from the Danish NSCLC population initiated with 1L palliative antineoplastic treatment from 1 January 2013 to 1 October 2018, were extracted from the Danish Lung Cancer Registry (DLCR). Long-term survival and median OS pre- and post-approval of 1L ICI were compared. From electronic health records, additional clinical and treatment data were obtained for ICI-treated patients from 1 March 2017 to 1 October 2018. Results The OS was significantly improved in the DLCR post-approval cohort (n = 2055) compared to the pre-approval cohort (n = 1658). The 3-year OS rates were 18% (95% CI 15.6–20.0) and 6% (95% CI 5.1–7.4), respectively. On multivariable Cox regression, bone (HR = 1.63) and liver metastases (HR = 1.47), performance status (PS) 1 (HR = 1.86), and PS ≥ 2 (HR = 2.19) were significantly associated with poor OS in ICI-treated patients. Conclusion OS significantly improved in patients with advanced NSCLC after ICI implementation in Denmark. In ICI-treated patients, PS ≥ 1, and bone and liver metastases were associated with a worse prognosis.