Breast cancer in end stage renal failure

OBJECTIVE: Patients with end-stage renal disease are suggestive to have a higher risk for the development of some kinds of cancer. The aim of this study is to evaluate the possible association between malignancy and end-stage renal disease in Taiwan. METHODS: We used the data of the National Health Insurance system of Taiwan to assess this issue. The end-stage renal disease cohort contained 21 817 patients, and each patient was randomly frequency-matched with two people from the general population without end-stage renal disease based on their age and sex...

During chronic kidney disease (CKD), there is a progressive accumulation of toxic solutes due to inadequate renal clearance. Here, the interaction between uremic toxins and two important efflux pumps, viz. multidrug resistance protein 4 (MRP4) and breast cancer resistance protein (BCRP) was investigated. Membrane vesicles isolated from MRP4- or BCRP-overexpressing human embryonic kidney cells were used to study the impact of uremic toxins on substrate specific uptake. Furthermore, the concentrations of various uremic toxins were determined in plasma of CKD patients using high performance liquid chromatography and liquid chromatography/tandem mass spectrometry...

Palliative therapy using radioactive strontium (89Sr) was performed on 60 patients suffering from cancer. Seventy-one percent of the patients had stopped or reduced their opiates and/or analgesics. Pain relief continued for up to three months. Patients with breast and prostatic cancer showed the best pain reduction. However, pain reduction was limited for lung cancer patients. Repeated usage of 89Sr with/without opiate and analgesics served to maintain the reduced level of pain. Side effects of repeated usage of 89Sr were decrease of hemoglobin, WBC, and platelets...

AIMS: End-stage kidney disease registries inform outcomes and policy. Data quality is crucial but difficult to measure objectively. We assessed agreement between incident cancer reported to the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) and to the Central Cancer Registry (CCR) in New South Wales. METHODS: ANZDATA records were linked to CCR using probabilistic matching. We calculated agreement between registries for patients with > or =1 cancers, all cancers and site-specific cancer using the kappa statistic (kappa)...

Calciphylaxis is a rare, but potentially life-threatening condition usually observed in patients with end-stage chronic renal disease and characterized by small- and medium-sized blood vessel calcification leading to tissue ischemia. The clinical features are primarily cutaneous, consisting of skin necrosis and ulceration, mostly located in the lower extremities. We report a case of a 56-year-old woman with a previous history of renal disease and atypical lobular hyperplasia of the right breast, who developed painful skin necrosis on both breasts...

Patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD) are known to develop metastatic soft-tissue calcification, secondary to hyperparathyroidism, in tissues including the breast. Such calcifications in women could pose a problem for interpretation of mammograms, since they are thought to mimic malignant lesions and interfere with differentiation of benign from malignant disease. Investigation of this issue is important to provide high-quality, accurate breast care to women with CKD or ESRD, but little evidence is so far available...

Calciphylaxis is a rare disorder characterized by microcalcification of small- and medium-sized blood vessels causing cutaneous and soft tissue necrosis. Patients usually present with painful, violaceous skin discoloration in a livedo reticularis pattern. We present a case of a 59-year-old woman with end-stage renal disease (ESRD) who manifested signs and symptoms of inflammatory breast cancer. The patient underwent an open biopsy and subsequent mastectomy, with final pathology results of calciphylaxis. Due to recurrent hyperparathyroidism, she underwent a re-parathyroidectomy with reimplantation...

BACKGROUND: Clinical guidelines are systematically developed statements that influence medical practice, education, and funding. Guidelines represent the consensus of leaders, often based on systematic reviews of the literature, regarding the "state of the art." OBJECTIVE: To assess the degree to which end-of-life care is integrated into nationally developed guidelines for chronic, noncurable, life-limiting diseases. DESIGN: Four compendia were reviewed: The Healthcare Standards Directory ECRI, 2001; the Clinical Practice Guidelines Directory, 2000 edition; the National Guidelines Clearinghouse, (guideline...

BACKGROUND: Patients with end-stage renal disease (ESRD) have at least the same prevalence of breast and cervical cancer but a reduced life expectancy compared with the general population. Whereas cancer screening has been found to be effective in the general population, competing risks in ESRD patients may obviate any screening benefit in this population. The purpose of this study was to determine if patients with ESRD benefit, in terms of life expectancy, by screening for breast and cervical cancer...

The individual risk of developing end-stage renal disease (ESRD) and its overall impact on life expectancy is not known. This study's objectives were to determine the effect of ESRD on life expectancy for a cohort of 20-yr-olds and to compare this impact to that of several cancers for which population-based screening programs exist. A computer simulation, stratified by race (white, black) and by gender was used to calculate cumulative lifetime risk of ESRD, life-years lost to ESRD, and cumulative Medicare payments for ESRD...

CONTEXT: Postmenopausal women aged 55 years and older have 66% of incident breast tumors and experience 77% of breast cancer mortality, but other age-related health problems may affect tumor prognosis and treatment decisions. OBJECTIVE: To document the comorbidity burden of postmenopausal breast cancer patients and evaluate its relationship with age on disease stage, treatment, and early mortality. DESIGN AND SETTING: Data were collected on breast cancer patients' comorbidities by retrospective hospital medical records review and merged with information on patients' tumor characteristics collected from 6 regional National Cancer Institute Surveillance, Epidemiology, and End Results cancer registries...

Health maintenance includes secondary prevention through cancer screening. There are no established guidelines for cancer screening patients with end-stage renal disease (ESRD). Using an established method of estimating life expectancy, published literature on cancer screening, and information from databases on mortality and malignancy (US Renal Data System 1997 Annual Data Report and the SEER Cancer and Statistical Review, 1973-1994), a "real-time life expectancy calculator" was developed to guide the primary help provider in making informed decisions on the benefits of cancer screening in individual patients...

BACKGROUND: Previous studies have suggested that the frequency of cancer is higher in patients with end-stage renal disease (ESRD) than in the general population, but have not established whether this increase is confined to certain cancers or to certain categories of ESRD patients. The aim of this study was to examine the risk of cancer in a large cohort of patients treated by dialysis but not transplantation. METHODS: We assembled a cohort of 831,804 patients who received dialysis during the period 1980-94 for ESRD in the USA, Europe, Australia, or New Zealand...

P-gp (Pgp) is a cell surface ATPase which confers resistance to many of the most active chemotherapy drugs, including taxol, doxorubicin, and vinca alkaloids. Pgp can be detected in human cancers by immunohistochemistry, RNA probes, or by functional assays utilizing transported fluorescent dyes such as rhodamine. The expression of Pgp in untreated human cancers is highly variable, being almost universal in colon, hepatocellular carcinoma, and renal cell cancers, less common in breast, ovarian, and lymphoid malignancies...

BACKGROUND: The renal lesions in tuberous sclerosis complex (TSC) consist in multiple angiomyolipomas, often associated with cysts of variable size. Recently a few TSC patients with early-onset renal cysts resembling the autosomal dominant polycystic kidney disease (ADPKD) have been described. Virtually all of them showed deletions of both TSC2 and PKD1 genes. METHODS: Two unrelated families in which TSC and PKD co-segregate were investigate. 16p13.3-linked haplotype segregation, Southern blot, pulsed field gel electrophoresis, and loss of heterozygosity analyses were performed in both affected and unaffected family members...

We examined the relationship between coping responses and mood states among three samples of patients with human immunodeficiency virus (HIV) infection (n=26), end-stage renal failure (n=98), and breast cancer (n= 60). Avoidance scores differed significantly across the groups, being highest in those with HIV infection. The avoidance scores were significantly and positively correlated with depression scores. However, patients with HIV infection did not fulfill the diagnostic criteria for major depression. Although patients with HIV infection may have minor psychiatric symptoms, results suggest that the symptoms are not strong enough to warrant a psychiatric diagnosis of mood disorder...

Renal failure secondary to CDDP is due to acute tubular necrosis and is usually reversible. We report 4 cases of definitive renal failure secondary to administration of cisplatin (CDDP). Three women and one man, mean age 40 +/- 8 years (24 to 64 years), at onset of dialysis are reported. They had received 1 to 4 courses of CDDP for an endometrial carcinoma (n = 2), a breast carcinoma or a thymoma. The mean total dose of CDDP was 447 +/- 169 mg (160 to 900 mg). There was no additional nephrotoxic drug. Before treatment serum creatinine concentration was normal (77 +/- 7 mumol per liter) in all patients...