Breast cancer is known to metastasize to all organs of the human body, and its manifestations are protean. It is almost impossible to predict which organ system will be invaded. Since 1950, there are seven autopsy series of patients with breast carcinoma published in the English literature. All data came from American hospitals (total of 2,147 patients), and each report studied more than 100 patients with breast cancer. The reported incidence of involvement of different organ sites are presented in Table I. Although the data came from different institutions and spanned over 35 years (1943-1977), the findings regarding metastatic involvement of specific organs are fairly similar.
This is a retrospective and all inclusive study of 925 patients who had isolated lymph node biopsies for diagnosis from 1973 to 1977. Overall, 60% of the nodes had benign lesions, 28% carcinoma, and 12% lymphoma. The comparable figures for abdominal nodal biopsies were 63%, 33% and 4%; for intrathoracic nodes, 73%, 26% and 1%; for peripheral nodes, 56%, 29% and 15%. Detailed distribution according to specific site of nodal biopsy, histological subtypes, age, and sex of patients are presented. Statistically, age is the most important factor useful in estimating the probability of whether the lymphadenopathy is due to a benign or malignant process.
Twenty patients with solid tumors received 30 mg/M2 of adriamycin. Various tissue samples were intraoperatively obtained from 18 patients, about 1.5--5 hours after an intravenous (IV) bolus dose. Normal liver showed the highest levels of adriamycin uptake (2.3--19.8 micrograms/g); lymph nodes were second; muscle and bone marrow, next; fat and skin had the lowest adriamycin uptake (0.04--0.40 microgram/g). Tumor tissue, excluding that with much necrosis and hemorrhaging, had adriamycin concentrations which approximated those of the liver (1.1--9.2 micrograms/g). Six patients, all with hepatic malignancies, had prolonged plasma concentration studies after IV administration; 5 also had adriamycin administered directly into the hepatic artery catheter. Adriamycin-plasma-time courses were similar, whether the drug was administered by bolus directly into the hepatic artery or peripheral vein. The concentration of metabolites after hepatic intraarterial administration was definitely higher than that after IV administration. Patients with hepatic dysfunction had delayed plasma clearance and secondarily elevated levels approximately 160 and 300 minutes after administration.
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