• Title/Summary/Keyword: Breast Mass

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Predictive Value of the Pattern of β-Catenin Expression for Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer Patients

  • Elsamany, S;Elemam, O;Elmorsy, S;Alzahrani, A;Abbas, MM
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4089-4093
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    • 2016
  • Purpose: This study aimed to explore the association of ${\beta}-catenin$ expression pattern with pathological response after neoadjuvant chemotherapy in breast cancer (BC) patients. Materials and Methods: In this retrospective exploratory study, data for 50 BC patients who received neoadjuvant chemotherapy were recorded. ${\beta}-catenin$ expression in tumours was assessed using immunohistochemistry and classified as either membranous or cytoplasmic according to the pattern of staining. Distributions of different clinico-pathological parameters according to ${\beta}-catenin$ expression were assessed using the Chi-square test. Logistic regression analysis was used to assess any relation of the pattern of ${\beta}-catenin$ expression with the pathological response. Results: Cytoplasmic ${\beta}-catenin$ expression was detected in 34% of BCs. Among our cases, 52% were hormonal receptor (HR)-positive, 24% were HER2-positive, 74% were clinical stage III and 74% received both anthracycline and taxane-based chemotherapy. Patients with cytoplasmic expression were more commonly younger than 40 years at diagnosis (cytoplasmic, 41.2% vs. no cytoplasmic expression, 12.1%, p=0.03). By doing t-test, cytoplasmic ${\beta}-catenin$ expression was linked with a higher body mass index compared to membranous-only expression ($mean{\pm}SD$ $33.0{\pm}4.47$ vs. $29.6{\pm}6.01$, respectively, p=0.046). No significant associations were found between ${\beta}-catenin$ expression and other parameters such as HR and HER2 status, or clinical stage. Complete pathological response (pCR) rate was twice as great in patients with membranous expression but without statistical significance (membranous-only, 33.3% vs. cytoplasmic, 17.6%, OR= 2.3, 95% CI= 0.55-9.87, p=0.24). Conclusions: This study suggests that cytoplasmic ${\beta}-catenin$ expression may be linked with lower probability of achieving pCR after neoadjuvant chemotherapy. These data need to be validated in a larger cohort of patients.

The Impact of Perforator Number on Deep Inferior Epigastric Perforator Flap Breast Reconstruction

  • Grover, Ritwik;Nelson, Jonas A.;Fischer, John P.;Kovach, Stephen J.;Serletti, Joseph M.;Wu, Liza C.
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.63-70
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    • 2014
  • Background Perforator flaps minimize abdominal site morbidity during autologous breast reconstruction. The purpose of this study was to assess whether the number of perforators harvested influences the overall deep inferior epigastric perforator (DIEP) flap survival and flap-related complications. Methods A retrospective review was performed of all DIEP flaps performed at the Hospital of the University of Pennsylvania from 2006 to 2011. The outcomes assessed included flap loss and major complications. We compared flaps by the number of total perforators (1-4) and then carried out a subgroup analysis comparing flaps with one perforator to flaps with multiple perforators. Lastly, we conducted a post-hoc analysis based on body mass index (BMI) categorization. Results Three hundred thirty-three patients underwent 395 DIEP flaps. No significant differences were noted in the flap loss rate or the overall complications across perforator groups. However, the subgroup analysis revealed significantly higher rates of fat necrosis in the case of one-perforator flaps than in the case of multiple-perforator flaps (10.2% vs. 3.1%, P=0.009). The post-hoc analysis revealed a significant increase in the flap loss rate with increasing BMI (<30=2.0%, 30-34.9=3.1%, 35-39.9=3.1%, >40=42.9%, P<0.001) in the DIEP flaps, but no increase in fat necrosis. Conclusions This study demonstrates that the number of perforators does not impact the rate of flap survival. However, the rate of fat necrosis may be significantly higher in DIEP flaps based on a single perforator. Multiple perforators should be utilized if possible to decrease the risk of fat necrosis.

Mate Intake and Risk of Breast Cancer in Uruguay: a Case-Control Study

  • Ronco, Alvaro L;De Stefani, Eduardo;Mendoza, Beatriz;Deneo-Pellegrini, Hugo;Vazquez, Alvaro;Abbona, Estela
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1453-1461
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    • 2016
  • Regarding 'mate' intake (infusion of Ilex paraguariensis herb, a staple beverage in temperate South American regions), most epidemiologic studies showed positive associations with risk of some cancers, (e.g. upper aerodigestive tract), but evidence on breast cancer (BC) risk is limited to a previous multi-site study, which reported a non significant odds ratio [OR]=0.85, 95% confidence interval [95% CI] 0.67-1.09, p for trend=0.31) for the highest quartile of intake. The present study was conducted in order to further assess associations of 'mate' intake with BC risk. We combined two databases of women belonging to public and private healthcare hospitals. The sample included 572 BC incident cases and 889 controls interviewed with a specific questionnaire featured by socio-demographic, reproductive and lifestyle variables, and a food frequency questionnaire of 64 items, also analyzing 'mate' intake (consumer status, daily intake, age at start, age at quit, duration of habit, intensity of intake). ORs and their 95%CI were calculated through unconditional logistic regression, adjusting for relevant potential confounders. The highest quartile of 'mate' intake was inversely associated with BC risk (OR=0.40, 95%CI 0.26-0.57, p for trend <0.001). Stratified analyses also displayed strong significant inverse associations for 'mate' in frequent tea drinkers (OR=0.22), high energy intake (OR=0.23), high body mass index (OR=0.29) and in postmenopausal women (OR=0.36), among other results. As conclusions, we found evidence of a significant inverse association for 'mate' intake and BC risk.

Effects of Citri Reticulatae Viride Pericarpium on the Apoptotic Cell Death in Breast Cancer Cells (청피(靑皮)가 유방암세포의 Apoptosis에 미치는 영향)

  • Kim, Ji-Eun;Park, Soo-Yeon;Choi, Chang-Won;Kim, Kyeong-Soo;Kim, Kyeong-Ok;Wei, Tung-Shuen;Yang, Seung-Joung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.2
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    • pp.40-54
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    • 2015
  • Objectives : In the theory of Korean medicine, Citri Reticulatae Viride Pericarpium (CRVP) can soothe the liver to break qi stagnation, eliminate mass and relieve dyspepsia. This study was carried out to investigate the effects of CRVP on the apoptotic cell death in breast cancer cells. Methods : In the present experiment, the effects of CRVP on proliferation rates, type of cell death, cell cycle distribution, and intracellular oxidative stress were investigated using MDA-MB-231 cells in vitro. In addition, the effects on expression levels of caspase 3, caspase 9, Bax and Bcl-2 were also investigated. Results : Treatment with CRVP decreased proliferation rates in a dose dependent manner. ID50 (50% inhibitory dosage) was 175.4 μg/ml. In the CRVP treated group, cell volumes showed smaller than non-treated normal. In addition, CRVP increased percentage of apoptotic and sub G1 arrested cells respectively. 200 μg/ml of CRVP treatment increased intracellular ROS level significantly. Finaly the expression level of caspase 3 and Bax/Bcl-2 ratio were elevated by treatment with CRVP respectively. Conclusions : These results suggest that CRVP can trigger intrinsic apoptotic pathway in MDA-MB-231 cells.

Associations Between Mammography and Ultrasound Imaging Features and Molecular Characteristics of Triple-negative Breast Cancer

  • Li, Bo;Zhao, Xin;Dai, Shao-Chun;Cheng, Wen
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3555-3559
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    • 2014
  • Background: The triple-negative breast cancer (TNBC) is an aggressive cancer characterized by the absence of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Preoperative mammography and ultrasound features of TNBC may potentially suggest characteristics of the disease and assist in treatment decisions. Materials and Methods: The study covered 153 patients with TNBC from May 2011 to May 2012 who were confirmed by postoperative pathology results in our hospital. We compared the radiological findings among the patients and sought to determine the significant iconographic features. The biomarkers p53 and Ki-67 are regarded as significant factors in TNBC. They were therefore used to divide the TNBC into four groups for assessment of relationships with TNBC imaging features. Results: On mammography, most TNBCs exhibit obscure (44.3%) masses. On ultrasound, the majority of masses (95.4%) were predominantly indistinct (50.7%), irregular (76.0%) or featuring posterior echo enhancement/shadowing. Color Doppler flow imaging (CDFI) emphasized hypervascular (32.9%) masses. Differences in CDFI by ultrasound among the four groups were statistically significant (p=0.009). There were obvious differences in the percentages of spiculated margin (p=0.049) and intensive posterior echo (p=0.006) with spotty flow imaging by ultrasound between the Ki-67 (+) p53 (+) and other groups. Conclusions: A combination of mammography and ultrasound revealed the imaging characteristics of TNBC included an obscure mass with less attenuated posterior echoes and some vascularity. A worse prognosis was associated with spiculated margin and intensive posterior echoes with spotty flow imaging.

Analysis of Cancer Screening Recommendations by Physicians for Various Types of Cancer (의사들의 암 조기검진 권고 실태 분석 - 위암, 자궁경부암, 유방암을 중심으로 -)

  • Park, Yong-Mun;Yum, Keun-Sang;Koo, Jung-Wan;Yim, Hyeon-Woo;Lee, Kang-Sook;Kim, Hoon-Kyo;Lee, Won-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.1
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    • pp.99-108
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    • 2000
  • Objectives : The purpose of this study was to examine the present status of cancer screening recommendations(beginning age, interval, recommended screening methods, etc.) by physicians and analyze the association between physician's characteristics and the content of their recommendations. Methods : Data were collected from March 1 to April 30 of 1997, and 373 physicians who were from different hospital settings all over Korea were interviewed by telephone about their screening recommendations for stomach, cervical and breast cancer for these who provided cancer screening services. Results : For stomach cancer screening, respondents recommended that cancer screening begin at 40 years of age(57.8%), with a 1 year interval(77.2%), and by gastrofibroscopy (86.2%). For cervical cancer screening, respondents recommended that cancer screening begin at 25 years of age(42.0%), with a 1 year interval(67.8%), and by using a Pap smear(100.0%). For breast cancer screening, respondents recommended that cancer screening begin at 35 years of age(38.7%), with a 1 year interval(57.3%), and by mammography (97.3%). Conclusions : To establish appropriate cancer screening recommendations for Korea, if may be useful to consider the above results concerning medical care providers.

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Convergence of the Image Evaluation by BI-RADS Classification in Accordance with Algorithms in DR Mammography (디지털 유방촬영술에서 BI-RADS의 구분에 따른 알고리즘별 영상의 융복합적 평가)

  • Lee, Mi-Hwa
    • Journal of Digital Convergence
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    • v.13 no.9
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    • pp.489-495
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    • 2015
  • Image availability evaluated by the degree of agreement and sensitive using the process improve visualization according to the Algorithm modification in Image Post-Processing. Reliability measured by the Breast Imaging Reporting and Data System. 172 patients visit same period divided by BI-RADS, category five stages, and contents of breast parenchyma into Calcification, Nodule and Mass. Evaluated the TE/PV image reliability, visualization sensitive, agreement of diagnosis. Convergence analysis was an in various fields. According to the result of this research, PV has higher sensitive and accuracy about lesions than TE visual and there is a difference insensitive by contents of breast parenchyma. Therefore, practical use of Algorithm Modification(Tissue Equalization: TE, Premium View: PV) is expected to improve more accurate, useful diagnosis, which has not been easy until now.

Preoperative Magnetic Resonance Imaging Features Associated with Positive Resection Margins in Patients with Invasive Lobular Carcinoma

  • Jiyoung Yoon;Eun-Kyung Kim;Min Jung Kim;Hee Jung Moon;Jung Hyun Yoon;Vivian Y. Park
    • Korean Journal of Radiology
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    • v.21 no.8
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    • pp.946-954
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    • 2020
  • Objective: To investigate preoperative magnetic resonance imaging (MRI) findings associated with resection margin status in patients with invasive lobular carcinoma (ILC) who underwent breast-conserving surgery. Materials and Methods: One hundred and one patients with ILC who underwent preoperative MRI were included. MRI (tumor size, multifocality, type of enhancing lesion, distribution of non-mass enhancement [NME], and degree of background parenchymal enhancement) and clinicopathological features (age, pathologic tumor size, presence of ductal carcinoma in situ [DCIS] or lobular carcinoma in situ, presence of lymph node metastases, and estrogen receptor/progesterone receptor/human epidermal growth factor receptor type 2 status) were analyzed. A positive resection margin was defined as the presence of invasive cancer or DCIS at the inked surface. Logistic regression analysis was performed to determine pre- and postoperative variables associated with positive resection margins. Results: Among the 101 patients, 21 (20.8%) showed positive resection margins. In the univariable analysis, NME, multifocality, axillary lymph node metastasis, and pathologic tumor size were associated with positive resection margins. With respect to preoperative MRI findings, multifocality (odds ratio [OR] = 3.977, p = 0.009) and NME (OR = 2.741, p = 0.063) were associated with positive resection margins in the multivariable analysis, although NME showed borderline significance. Conclusion: In patients with ILC, multifocality and the presence of NME on preoperative breast MRI were associated with positive resection margins.

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.

Clinicopathologic and Demographic Evaluation of Triple-Negative Breast Cancer Patients among a Turkish Patient Population: a Single Center Experience

  • Somali, Isil;Ustaoglu, Bahar Yakut;Tarhan, Mustafa Oktay;Yigit, Seyran Ceri;Demir, Lutfiye;Ellidokuz, Hulya;Erten, Cigdem;Alacacioglu, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6013-6017
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    • 2013
  • Background: To evaluate the clinicopathologic and demographic characteristics of triple-negative breast cancer (TNBC) patients and to determine differences from non-triple-negative cases. Materials and Methods: A detailed review of the medical records of 882 breast cancer (BC) patients was conducted to obtain information regarding age, menopausal status, height and weight at the time of diagnosis, presence of diabetes or hypertension, and pathologic characteristics of the tumor (tumor size, lymph node status, histologic grade, ER status, PR status, HER2 status, p53 mutation). Body mass index (BMI) was calculated and a value of ${\geq}30$ was considered as indicative of obesity. Results: 14.9% (n=132) of the patients had TNBC. There was no difference among the patients in terms of median age, comorbid conditions and menopausal status. The proportion of medullary, tubular and mucinous carcinomas was significantly higher (15.9%) in the triple-negative (TN) group, while invasive lobular histology was more frequent (8.2%) among non-triple negative (NTN) cases (p<0.001). Grade 3 (G3) tumors were more frequent in the triple-negative group (p<0.001). The rate of p53 mutation was 44.3% in TN tumors versus 28.2% in the NTN group (p<0.001). The two groups were similar in terms of LN metastasis. In the NTN group, the rate of patients with BMI ${\geq}30$ was 53% among postmenopausal patients, while it was 36% among premenopausal women, and the difference was statistically significant (p<0.001). No significant difference was observed in terms of BMI between postmenopausal and premenopausal patients in the TN group (p=0.08). Conclusions: TNBC rates and clinicopathologic characteristics of the Turkish patient population were consistent with the data from Europe and America. However, no relationship between obesity and TNBC was observed in our study. The association between TNBC and obesity needs to be evaluated in a larger patient population.