• Title/Summary/Keyword: Breast/pathology

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Impact of Using Intra-Operative Ultrasound Guided Breast-Conserving Surgery on Positive Margin and Re-Excision Rates in Breast Cancer Cases with Current SSO/ASTRO Guidelines

  • Thanasitthichai, Somchai;Chaiwerawattana, Arkom;Phadhana-Anake, Oradee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4463-4467
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    • 2016
  • Purpose: To review the impact of using intra-operative ultrasound guided breast conserving surgery with frozen sections on final pathological margin outcome with the current guidelines set forth by the Society of Surgical Oncology (SSO) and the American Society of Surgical Oncology (ASTRO). Materials and Methods: A retrospective review including all cases of intra-operative ultrasound guided breast conserving surgery was performed at the National Cancer Institute Thailand between 2013 and 2016. Patient demographics, tumor variables, intraoperative frozen section and final pathological margin outcomes were collected. Factors for positive or close margins were analyzed. Results: A total of 86 patients aged between 27 and 75 years with intra-operative ultrasound guided breast conserving surgery were included. Three cases (3.5%) of positive margin were detected by intra-operative frozen section and 4 cases (4.7%) by final pathology reports. There were 18 cases (20.9%) with a close margin (<1 mm). Factors affecting this result comprised multi-foci, presence of invasive ductal carcinoma (IDC) combined with ductal carcinoma in situ (DCIS) and invasive lobular carcinoma (ILC). Conclusions: With the current SSO/ASTRO for adequate margin guidelines, using intra-operative ultrasound to locate the boundary for resection with breast conserving surgery provided a high success rate in obtaining final pathology free margin outcomes and minimizing re-operation risks especially when combined with intra-operative frozen section assessment. The chance of finding positive or close margins appears higher in cases of IDC combined with DCIS, ILC and with multi-foci cancers.

Diagnostic Approach to Fine Needle Aspiration in a Breast Lesion (유방의 세침흡인 세포검사 : 진단적 접근)

  • Gong, Gyung-Yub
    • The Korean Journal of Cytopathology
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    • v.18 no.2
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    • pp.93-99
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    • 2007
  • Fine needle aspiration has been widely used to diagnose of breast lesions whether they are malignant or not. When applied by experienced and well-trained practitioners, its accuracy can approach that of histopathology. In order to make optimal use of FNAB in breast lesions, this article has reviewed the criteria for sample adequacy, the diagnostic terminology and the cytomorphologic approach to making a diagnosis and avoiding diagnostic pitfalls.

A Case Report of Breast Angiosarcoma in a Young Woman

  • Park, Jaeyeon;Kang, Bong Joo;Kim, Sung Hun;Lee, Jeongmin;Lee, Ahwon
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.2
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    • pp.135-140
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    • 2021
  • Breast angiosarcoma is a very rare manifestation. Herein, we report a case of breast angiosarcoma in a 21-year-old woman admitted to our hospital with a one-year history of a palpable mass with fullness and swelling of the right breast. The various imaging findings, including mammography, ultrasound (US), and magnetic resonance imaging (MRI), of this rare disease are described. The imaging findings of US and combined MRI of breast angiosarcoma were specific in this case. The imaging characteristics could be helpful in detecting and diagnosing breast angiosarcoma in young women with a palpable mass with fullness and swelling of the breast.

Clinical Characteristics Analysis of 58 Patients with Breast and Gynecologic Cancer in Oriental Hospital (한방병원에 내원한 유방암 및 부인암 환자 58명에 대한 임상적 특성 분석)

  • Joo, Jeong Hyun;Park, Su Wan;Kim, Seong Mo;Choi, Hong Sik;Kim, Kyung Soon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.5
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    • pp.571-575
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    • 2014
  • This study was aimed to obtain epidemiological information of cancer patients treated with Oriental medicine. 58 breast and gynecological cancer patients treated in Cancer Center of Daeguhanny Oriental Hospital from August 2012 to August 2013 were reviewed. Careful investigations were done by categorizing these patients by their origin, stage, treatment, conventional treatment type, chief complaint, etc. In tumor origin, breast cancer showed the largest proportion in total patients(74.1%) and inpatients(81.8%). 63.8% of the patients' tumors were stage III and IV. 48.3% of patients visited Oriental hospital for combination treatment with conventional medicine. 91.4% of the patients have under 5 years of cancer duration. Their cheif complaints are general weakness, postoperative pain and abdominal discomfort in general. This study presented the characteristics of breast and gynecological cancer patients treated by Oriental medical therapies, and thus would be valuable for futher studies of Oriental medical cancer treatments.

Fine Needle Aspiration Biopsy Cytology of Breast Tumors (세침 천자 검사로 진단된 유방종양의 세포병리학적 연구)

  • Kim, In-Sook;Lee, Jung-Dal
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.51-59
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    • 1990
  • Fine needle aspiration biopsy cytology (FNA) for diagnosis of a variety of breast tumors has been proven to be a simple, safe, and cost saving diagnostic methodology with high accuracy. Cytologic specimens from 1,029 fine needle aspirations of the breast during last 3-year period were reviewed and subsequent biopsies from 107 breast lesions were reevaluated for cytohistological correlation. FNA had a sensitivity of 81.6% and a specificity of 98.3%. One oui of 107 cases biopsied revealed a false positive result (0.9%) and the case was due to misinterpretation of apocrine metaplastic cells in necrotic backgound as malignant cells. A false negative rate was 8.4% (9 of 107 cases biopsied). Six of 9 false negative cases were resulted from insufficient aspirates for diagnosis, and remaining three of 9 false negative cases revealed extensive necrosis with no or scanty viable cells on smears. The results indicate that for reducing false positive and false negative rates of FNA, an experienced cytopathologist and a proficient aspirator are of great importance.

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Effect of Thesium Chinense Turczaninow on Breast Cancer Chemopreventive enzyme activity in In vitro (In vitro에서의 댑싸리하고초의 유방암예방효소 활성에 미치는 영향)

  • Shon, Yun-Hee;Kim, Mee-Kyung;Park, Sun-Dong;Nam, Kyung-Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.3
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    • pp.675-679
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    • 2006
  • The effect of water extract from Thesium chinese Turczaninow (TCTW) on proliferation of human breast cancer cells, nitric oxide production, nitric oxide synthase expression, and ornithine decarboxylase activity was tested. TCTW inhibited the growth of both estrogen-independent MDA-MB-231 and estrogen-dependent MCF-7 human breast cancer cells. Lipopolysaccharide-induced nitric oxide (NO) production was significantly reduced by TCTW at the concentrations of 1.0 (p<0.05) and 5.0 mg/ml (p<0.005). Expression of inducible nitric oxide synthase (iNOS) was also suppressed with the treatment of TCTW in Western blot analysis. TCTW inhibited induction of ornithine decarboxylase by 12-O-tetradecanoylphorbol-13-acetate (TPA), a key enzyme of polyamine biosynthesis, which is enhanced in tumor promotion. Therefore, TCTW is worth further investigation with respect to breast cancer chernoprevention or therapy.

Molecular Profiling of Breast Carcinoma in Almadinah, KSA: Immunophenotyping and Clinicopathological Correlation

  • Elkablawy, Mohamed A;Albasry, Abdelkader M;Hussainy, Akbar S;Nouh, Magdy M;Alhujaily, Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7819-7824
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    • 2015
  • Purpose: To subtype breast cancer (BC) in Saudi women according to the recent molecular classification and to correlate these subtypes with available clinicopathological parameters. Materials and Methods: Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (Her2/neu) immunostaining was semi-quantitatively assessed to define molecular subtypes of luminal A and B, HER-2 and triple negative (basal-like) in BC paraffin embedded sections from 115 Saudi female patients diagnosed between 2005 to 2015 at the Department of Pathology, King Fahd Hospital, Almadinah, Saudi Arabia. Results: The most common subtypes were luminal A (47%), followed by luminal B (27.8%) and basal like subtypes (18.3%), whereas HER-2 was the least common subtype (6.9%). Luminal A was predominantly found in the old age group, with low tumor grade (p<0.001) and small tumor size, whereas HER-2 and basal-like subtypes were significantly associated with young age, high tumor grade, lymph node metastasis and lymphovascular invasion (p<0.03, 0.004, 0.05 and 0.04 respectively). All subtypes showed advanced clinical stage at the time of presentation. Conclusions: Molecular subtypes of Saudi BC patients in Almadinah region are consistent with most of the worldwide subtyping. The biological behaviour of each molecular subtype could be expected based on its characteristic clinicopathological features. Along with other prognostic indicators, molecular subtyping would be helpful in predicting prognosis and management of our BC patients. We recommend screening and early diagnosis of BC in our population.

High Cytoplasmic CXCR4 Expression Predicts Prolonged Survival in Triple-Negative Breast Cancer Patients Treated with Adjuvant Chemotherapy

  • Shim, Bobae;Jin, Min-Sun;Moon, Ji Hye;Park, In Ae;Ryu, Han Suk
    • Journal of Pathology and Translational Medicine
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    • v.52 no.6
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    • pp.369-377
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    • 2018
  • Background: Chemokine receptor CXC chemokine receptor type 4 (CXCR4) and its ligand CXC motif chemokine 12 (CXCL12; stromal cell-derived factor-1) are implicated in tumor growth, metastasis, and tumor cell-microenvironment interaction. A number of studies have reported that increased CXCR4 expression is associated with worse prognosis in triple-negative breast cancer (TNBC), but its prognostic significance has not been studied in TNBC patients treated with adjuvant chemotherapy. Methods: Two hundred eighty-three TNBC patients who received adjuvant chemotherapy were retrospectively analyzed. Tissue microarray was constructed from formalin-fixed, paraffin-embedded tumor tissue and immunohistochemistry for CXCR4 and CXCL12 was performed. Expression of each marker was compared with clinicopathologic characteristics and outcome. Results: High cytoplasmic CXCR4 expression was associated with younger age (p=.008), higher histologic grade (p=.007) and lower pathologic stage (p=.045), while high CXCL12 expression was related to larger tumor size (p=.045), positive lymph node metastasis (p=.005), and higher pathologic stage (p=.017). The patients with high cytoplasmic CXCR4 experienced lower distant recurrence (p=.006) and better recurrence-free survival (RFS) (log-rank p=.020) after adjuvant chemotherapy. Cytoplasmic CXCR4 expression remained an independent factor of distant recurrence (p=.019) and RFS (p=.038) after multivariate analysis. Conclusions: High cytoplasmic CXCR4 expression was associated with lower distant recurrence and better RFS in TNBC patients treated with adjuvant chemotherapy. This is the first study to correlate high CXCR4 expression to better TNBC prognosis, and the underlying mechanism needs to be elucidated in further studies.

Impact of Non-Calcified Specimen Pathology on the Underestimation of Malignancy for the Incomplete Retrieval of Suspicious Calcifications Diagnosed as Flat Epithelial Atypia or Atypical Ductal Hyperplasia by Stereotactic Vacuum-Assisted Breast Biopsy

  • Chi-Chang Yu;Yun-Chung Cheung;hir-Hwa Ueng;Shin-Cheh Chen
    • Korean Journal of Radiology
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    • v.21 no.11
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    • pp.1220-1229
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    • 2020
  • Objective: Stereotactic vacuum-assisted breast biopsy (VABB) is considered a reliable alternative to surgical biopsy for suspicious calcifications. In most cases, the management of flat epithelial atypia (FEA) and atypical ductal hyperplasia (ADH) after VABB with residual calcifications requires surgical excision. This study aimed to evaluate the impact of pathology of non-calcified specimens on the underestimation of malignancy. Materials and Methods: We retrospectively reviewed 1147 consecutive cases of stereotactic VABB of suspicious calcifications without mass from January 2010 to December 2016 and identified 46 (4.0%) FEA and 52 (4.5%) ADH cases that were surgically excised for the retrieval of residual calcifications. Mammographic features and pathology of the calcified and non-calcified specimens were reviewed. Results: Seventeen specimens (17.3%) were upgraded to malignancy. Mammographic features associated with the underestimation of malignancy were calcification extent (> 34.5 mm: odds ratio = 6.059, p = 0.026). According to the pathology of calcified versus non-calcified specimens, four risk groups were identified: Group A (ADH vs. high-risk lesions), Group B (ADH vs. non-high-risk lesions), Group C (FEA vs. high-risk lesions), and Group D (FEA vs. non-high-risk lesions). The lowest underestimation rate was observed in Group D (Group A vs. Group B vs. Group C vs. Group D: 35.0% vs. 20.0% vs. 15.0% vs. 3.6%, p = 0.041, respectively). Conclusion: Considering that the calcification extent and pathology of non-calcified specimens may be beneficial in determining the likelihood of malignancy underestimation, excision after FEA or ADH diagnosis by VABB is required, except for the diagnoses of FEA coexisting without atypia lesions in non-calcified specimens.