N J Williams

Royal Cornwall Hospitals NHS Trust, Truro, England, United Kingdom

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Publications (7)48.66 Total impact

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    ABSTRACT: We report a rare case of a breast carcinoma metastasis in the choroid presenting as the initial symptom of the primary disease.
    European Journal of Surgical Oncology 01/2001; 26(8):817-8. · 2.61 Impact Factor
  • C Leris, C Kouriefs, N Williams, K Mokbel
    Journal of Surgical Oncology 10/2000; 75(1):72-3. · 2.64 Impact Factor
  • Source
    Journal of Clinical Oncology 03/2000; 18(4):942-3. · 18.04 Impact Factor
  • K Mokbel, N J Williams
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    ABSTRACT: Telomeres are believed to be responsible for chromosomal stability during cellular proliferation. They are created by telomerase, an enzyme present in many human neoplasms. Telomerase is considered to be important in breast cancer since reactivation of the enzyme ensures cell stability allowing malignant cells to divide indefinitely. This article aims to discuss the role of telomerase in breast cancer and explore the future of telomerase research. We have reported on the literature to date in order to present this current review. Telomerase is found in significant levels in breast neoplasms and is reliably detected in fine needle aspirations aiding the diagnosis of breast cancer. There is also a correlation between telomerase and disease prognosis, and there is current work assessing if telomerase can be of benefit in monitoring the efficacy of systemic treatment. The role of telomerase in breast cancer is still being investigated however by understanding the action it has on chromosomal stability, and its detection in tumour cells, there are possibilities to enhance the methods employed to detect and treat breast cancer.
    International journal of surgical investigation 02/2000; 2(1):85-8.
  • British Journal of Surgery 01/2000; 86(12):1589. · 4.84 Impact Factor
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    ABSTRACT: We retrospectively reviewed the microscopic findings in 32 histologically confirmed radial scars in 31 women diagnosed in our unit during 1994-1998. The median age at diagnosis was 53 years (range 47-63 years). Thirty-one (97%) of 32 lesions presented as screen detected mammographic abnormalities (28 stellate lesions, 2 microcalcifications and only 1 architectural distortion). One lesion presented as a palpable breast mass. Stereotactic or ultrasound-guided fine needle aspiration cytology (FNAC) was performed in 28 cases. Cytological analysis of FNAs revealed malignant cells (C5) in 8 (29%) cases, highly suspicious cells (C4) in 3 (11%) cases, atypical benign cells (C3) in 7 (25%) cases and benign epithelial cells (C2) in 10 (35%) cases. All non-palpable lesions were surgically excised following wire localization. Histological examination of the breast specimens (mean weight=16 g) demonstrated, in addition to a radial scar, 6 invasive carcinomas (2 infiltrating ductal, 2 tubular, 1 mixed ductal/lobular and 1 secretory carcinoma) and 4 ductal carcinoma in situ lesions (2 high grade, 1 high grade with micro-invasion and 1 low grade) arising in the radial scar. Of the remaining cases the radial scar was associated with atypical epithelial hyperplasia in 2 cases and regular epithelial hyperplasia in 17 cases (4 florid and 13 mild to moderate). In the 10 cases associated with malignancy, 9 had FNAC and was reported as malignant (C5) in 6 (67%) cases, highly suspicious (C4) in 2 (22%) cases and atypical (C3) in 1 (11%). False positive FNAC (C5) occurred in two patients, one of whom presented with pleomorphic microcalcifications suggestive of ductal carcinoma in situ. This patient was treated with a wire guided segmental mastectomy. All invasive tumours were less than 20 mm in size (T1) and of these 4 were grade I and 2 were grade II. Axillary dissection was performed in 4 patients none of whom had axillary node metastases. Our study demonstrates a significant incidence of malignancy associated with radial scars (31%) suggesting that radial scars may be premalignant lesions. This is supported by detecting various stages of mammary carcinogenesis (atypical epithelial hyperplasia, ductal carcinoma in situ, and early invasive malignancy) in these lesions. Fine needle aspiration cytology seems to be unreliable in the diagnosis of radial scar associated malignancy (67% sensitivity and 91% specificity). Stellate lesions, therefore, should be excised to obtain an histological diagnosis regardless of cytological findings. Further studies examining the biology of radial scars are required.
    The Breast 01/2000; 8(6):339-42. · 2.49 Impact Factor
  • Source
    K Mokbel, N J Williams, A C Leris, C Kouriefs
    Journal of Clinical Oncology 01/2000; 17(12):3856-60. · 18.04 Impact Factor

Publication Stats

46 Citations
48.66 Total Impact Points

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Institutions

  • 2000
    • Royal Cornwall Hospitals NHS Trust
      Truro, England, United Kingdom