• The Korean Journal of Cytopathology
• /
• v.18 no.1
• /
• pp.62-68
• /
• 2007

Invasive micropapillary carcinoma (IMPC) of the breast is recently described rare variant of invasive ductal carcinoma. This variant has a distinctive histological features and aggressive biological behavior. We reviewed the cytologic features of eight cases of IMPC. The cytologic smears showed moderate to high cellularity and the tumor tissue was composed of atypical, angulated, cohesive clusters of neoplastic cells with a papillary to tubuloalveolar architecture, and a morular growth pattern without fibrovascular cores was seen on the histopathology. IMPC of the breast has distinctive cytologic features and it is important to make an early diagnosis via fine needle aspiration cytology due to this tumor's aggressive behavior.

• The Korean Journal of Cytopathology
• /
• v.15 no.2
• /
• pp.106-111
• /
• 2004

Invasive micropapillary carcinoma (IMPCa) is a rare variant of invasive ductal carcinoma of the breast. This variant is associated with a set of peculiar cytological findings and aggressive biological behaviors. In most reported cases, IMPCa has involved massive axillary lymph node metastases at the time of diagnosis. We experienced four cases of cytological features of IMPCa, all of which were verified by histological examination. Fine needle aspiration cytology (FNAC) revealed malignant epithelial cells, which formed small, oval to angulated papillary clusters, which lacked central fibrovascular cores. The histological findings of the four cases revealed both pure and mixed forms of IMPCa, composed of cohesive malignant epithelial cells, surrounded by distinctive clear spaces and separated by thin fibrous septa. All patients evidenced axillary lymph node metastases at the time of diagnosis. It is important to identify the peculiar cytological findings which would differentiate IMPCa from other diseases.

• The Korean Journal of Cytopathology
• /
• v.18 no.1
• /
• pp.69-73
• /
• 2007

Mammary carcinoma with osteoclast-like giant cells is an unusual neoplasm characterized by giant cells, mononuclear stromal cells, and hemorrhage accompanying a low grade carcinoma. We present the cytological findings in a case of invasive ductal carcinoma with osteoclast-like giant cells that was initially confused with a fibroadenoma, due to its well-demarcated and soft mass and the young age of the patient. A 28-year-old female presented with a 4.5 cm, well demarcated, soft and nontender mass in the right breast. Fine needle aspiration cytology (FNAC) showed a combination of low grade malignant epithelial cell clusters and osteoclast-like giant cells. The atypical epithelial cells were present in cohesive sheets and clusters. Osteoclast-like giant cells and bland-looking mononuclear cells were scattered. An histological examination revealed the presence of an invasive ductal carcinoma with osteoclast-like giant cells. We report here the cytological findings of this rare carcinoma in a very young woman. The minimal atypia of the epithelial cells and its soft consistency may lead to a false negative diagnosis in a young woman. The recognition that osteoclastlike giant cells are rarely present in a low grade carcinoma, but not in benign lesion, can assist the physician in making a correct diagnosis.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.9
• /
• pp.4463-4467
• /
• 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.

• Korean Journal of Radiology
• /
• v.25 no.2
• /
• pp.134-145
• /
• 2024

Abnormalities on breast ultrasound (US) images which do not meet the criteria for masses are referred to as nonmass lesions. These features and outcomes have been investigated in several studies conducted by Asian researchers. However, the term "nonmass" is not included in the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) 5th edition for US. According to the Japan Association of Breast and Thyroid Sonology guidelines, breast lesions are divided into mass and nonmass. US findings of nonmass abnormalities are classified into five subtypes: abnormalities of the ducts, hypoechoic areas in the mammary glands, architectural distortion, multiple small cysts, and echogenic foci without a hypoechoic area. These findings can be benign or malignant; however, focal or segmental distributions and presence of calcifications suggest malignancy. Intraductal, invasive ductal, and lobular carcinomas can present as nonmass abnormalities. For the nonmass concept to be included in the next BI-RADS and be widely accepted in clinical practice, standardized terminologies, an interpretation algorithm, and outcome-based evidence are required for both screening and diagnostic US.

• Journal of Yeungnam Medical Science
• /
• v.15 no.1
• /
• pp.151-158
• /
• 1998

Traditionally posterior shadowing is regarded as a malignant criterion in the evaluation of breast mass by sonogram. But on the basis of our clinical experiences of breast sonogram, we often met a breast mass without posterior shadowing later confirmed breast carcinoma through pathologic examination. For the focus of what character of pathologic breast tissue influence the posterior shadowing in breast sonogram, we analyzed retrospectively the sonographic findings of 26 histologically proven invasive ductal carcinomas. Even though invasive ductal carcinoma is the only one of the many breast cancers, it represents the greater part of breast malignancy. The posterior echo pattern was compared with various histologic characteristics, such as the amount of connective tissue, degree of elastosis, necrosis, gross circumscription, accompanying inflammation, histologic differentiation, and mitotic index. Nine breast masses (35%) demonstrated posterior echo shadowing, while 17 masses (65%) showed enhancement. The tumors with posterior echo shadowing had more abundant connective tissue, increased elastosis, and poorly demarcated margin (p<0.05). Other histologic characteristics are not influence in posterior shadowing with significant in stastically. On the basis of our study, the phenomenon of posterior shadowing by sonogram is difficult to accept as a specific criterion for malignancy. It is only a phenomenon influenced by the amount of connective tissue volume and elastosis.

• Imaging Science in Dentistry
• /
• v.34 no.4
• /
• pp.195-197
• /
• 2004

Metastatic tumors to the jawbones are an infrequent but not rare phenomenon. The most common site of distant primary tumor metastasis to the jaw bones is the breast. The clinical signs and symptoms, and radiographic appearance of these lesions can be quite variable. In this report, an invasive ductal carcinoma of the breast that metastasized to the whole mandible is presented. The patient's medical history revealed that she had undergone a modified radical mastectomy on the right breast eight years ago.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.6
• /
• pp.2385-2390
• /
• 2015

Background: Invasive ductal (IDC) and lobular (ILC) carcinomas are the common histological types of breast carcinoma which are difficult to distinguish when poorly differentiated. Discoidin domain receptor (DDR1) and Drosophila dishevelled protein (DVL1) were recently suggested to differentiate IDC from ILC. Objectives: To assess the expression of DDR1 and DVL1 and their association with histological type, grading and hormonal status of IDC and ILC. Materials and Methods: This cross sectional study was conducted on IDC and ILC breast tumours. Tumours were immunohistochemically stained for (DDR1) and (DVL1) as well as estrogen receptor (ER), progesterone receptor (PR) and C-erbB2 receptor. Demographic data including age and ethnicity were obtained from patient records. Results: A total of 51 cases (30 IDCs and 21 ILCs) were assessed. DDR1 and DVL1 expression was not significantly associated with histological type (p=0.57 and p=0.66 respectively). There was no association between DDR1 and DVL1 expression and tumour grade (p=0.32 and p=1.00 respectively), ER (p=0.62 and 0.50 respectively), PR (p=0.38 and p=0.63 respectively) and C-erbB2 expression (p=0.19 and p=0.33 respectively) in IDC. There was no association between DDR1 and DVL1 expression and tumour grade (p=0.52 and p=0.33 respectively), ER (p=0.06 and p=0.76 respectively), PR (p=0.61 and p=0.43 respectively) and C-erbB2 expression (p=0.58 and p=0.76 respectively) in ILC. Conclusions: This study revealed that DDR1 and DVL1 are present in both IDC and ILC regardless of the tumour differentiation. More studies are needed to assess the potential of these two proteins in distinguishing IDC from ILC in breast tumours.

• Journal of the Korean Society of Radiology
• /
• v.84 no.3
• /
• pp.776-781
• /
• 2023

Commonly, epidermal inclusion cysts (EICs) are benign cutaneous lesions that are lined with stratified squamous epithelium and may occur in all body parts, including the breasts. EICs in the breast (EICB) are commonly encountered clinically; it may be under-reported because of their mild and nonspecific clinical presentation. Malignant transformation of EICs is extremely rare, occurring 0.011%-0.045%. Presently, we report a rare case of squamous cell carcinoma arising from an EICB of a woman with invasive ductal carcinoma.

• The Korean Journal of Cytopathology
• /
• v.14 no.2
• /
• pp.53-59
• /
• 2003

Fine needle aspiration cytology (FNAC) has been known as a very sensitive and effective method for preoperative diagnosis. We studied cases preoperatively diagnosed by FNAC and confirmed by the histopathologic examination to define the effectiveness of FNAC. A total of 567 cases including breast, thyroid gland, lymph node, and soft tissue confirmed histologically after FNAC were enrolled, among 2,844 FNAC cases from January 1996 to March 2000. Overall sensitivity and specificity of FNAC were 93% and 100%, respectively. Sensitivity and specificity of FNAC by sites or organs were 91% and 100% in breast, 100% and 100% in thyroid, 97% and 100% in lymph node, and 71% and 100% in soft tissue, respectively. Nine cases showed diagnostic discrepancy; eight cases of sampling error and one case of interpretation error. Five cases, diagnosed as fibrocystic change at FNAC but invasive ductal carcinoma after the histopathologic examination, were categorized as sampling error due to the presence of diffuse fibrosis or deep seated location. One case of breast, diagnosed descriptively as atypical ductal and stromal cells suggesting invasive ductal carcinoma at FNAC but malignant phyllodes tumor histologically, was categorized as interpretation error. Other cases of sampling errors were two cases of soft tissue, a case of lymph node, and a case of salivary gland.