• Title/Summary/Keyword: breast nodules

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Treatment of Pseudoangiomatous Stromal Hyperplasia of the Breast: Implant-Based Reconstruction with a Vascularized Dermal Sling

  • Jung, Bok Ki;Nahm, Ji Hae;Lew, Dae Hyun;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.630-634
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    • 2015
  • Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign mesenchymal lesion with incidental histologic findings. Surgical excision is recommended as the treatment of choice for PASH, although the recurrence rates after excision range from 15% to 22%. A 46-year-old-female presented with a six-month history of bilateral breast enlargement and painful sensation mimicking inflammatory carcinoma. Imaging studies demonstrated innumerable enhancing nodules in both breasts. Due to the growth of the lesions and progressive clinical symptoms, bilateral subcutaneous mastectomy was performed. Grossly, the specimens were round and well-circumscribed, and the histologic examination revealed PASH. After mastectomy, we created a pocket with the pectoralis major muscle and a lower skin flap, which was deepithelized. Anatomical mammary implants were inserted, and the nipple areolar complex was transferred to a new position as a free graft. The aesthetic result was satisfactory after twelve months of follow-up.

Anti-metastasis Activity of Black Rice Anthocyanins Against Breast Cancer: Analyses Using an ErbB2 Positive Breast Cancer Cell Line and Tumoral Xenograft Model

  • Luo, Li-Ping;Han, Bin;Yu, Xiao-Ping;Chen, Xiang-Yan;Zhou, Jie;Chen, Wei;Zhu, Yan-Feng;Peng, Xiao-Li;Zou, Qiang;Li, Sui-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6219-6225
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    • 2014
  • Background: Increasing evidence from animal, epidemiological and clinical investigations suggest that dietary anthocyanins have potential to prevent chronic diseases, including cancers. It is also noteworthy that human epidermal growth factor receptor 2 (ErbB2) protein overexpression or ErbB2 gene amplification has been included as an indicator for metastasis and higher risk of recurrence for breast cancer. Materials and Methods: The present experiments investigated the anti-metastasis effects of black rice anthocyanins (BRACs) on ErbB2 positive breast cancer cells in vivo and in vitro. Results: Oral administration of BRACs (150 mg/kg/day) reduced transplanted tumor growth, inhibited pulmonary metastasis, and decreased lung tumor nodules in BALB/c nude mice bearing ErbB2 positive breast cancer cell MDA-MB-453 xenografts. The capacity for migration, adhesion, motility and invasion was also inhibited by BRACs in MDA-MB-453 cells in a concentration dependent manner, accompanied by decreased activity of a transfer promoting factor, urokinase-type plasminogen activator (u-PA). Conclusions: Together, our results indicated that BRACs possess anti-metastasis potential against ErbB2 positive human breast cancer cells in vivo and in vitro through inhibition of metastasis promoting molecules.

Bilateral Breast Metastases from Epstein-Barr Virus-Associated Gastric Cancer during Pregnancy: Is There a Method to Its Madness?

  • Quaquarini, Erica;Vanoli, Alessandro;Frascaroli, Mara;Viglio, Alessandra;Lucioni, Marco;Presti, Daniele;Lobascio, Gessica;Pietrabissa, Andrea;Bernardo, Antonio;Paulli, Marco
    • Journal of Gastric Cancer
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    • v.20 no.1
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    • pp.106-114
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    • 2020
  • Breast metastases of extramammary malignant neoplasms are rare, with an incidence of 0.3%-2.7% among all malignant mammary tumors. Breast metastases from gastric carcinoma are very rare (<0.1%), and this event is even rarer during pregnancy. Herein, we describe a 39-year-old Caucasian woman with a history of an Epstein-Barr virus-associated gastric carcinoma (EBVaGC) that was characterized by prominent tumor infiltrating lymphocytes. Three years after undergoing radical surgery, the patient developed bilateral breast nodules during her pregnancy. A breast biopsy was performed, and histology confirmed a diagnosis of EBVaGC; tumor cells showed positivity for cytokeratin 8/18 and E-cadherin, and negativity for cytokeratin 7, cytokeratin 20, cytokeratin 5/6, caudal type homebox 2, androgen receptor, mammaglobin, gross cystic disease fluid protein-15, and estrogen and progesterone receptors. We also discuss the main diagnostic pitfalls. To our knowledge, this is the first report of an EBVaGC with lymphoid stroma that developed breast metastases during pregnancy.

Innumerable Small Bony Nodular Sclerotic Lesions with Negative Findings on Both Bone Scintigraphy and F-18 FDG PET : Osteopoikilosis in a Patient of Breast Cancer (골신티그라피와 F-18 FDG PET상 모두 음성인 무수히 많은 작은 결절성 골경화 병소들: 유방암환자에서의 Osteopoikilosis)

  • Jun, Sung-Min;Kim, Yong-Ki;Kim, In-Ju;Nam, Hyun-Yeol;Kim, Bum-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.3
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    • pp.256-258
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    • 2008
  • Osteopoikilosis is a rare, benign hereditary disease, which presents multiple osteosclerotic, and small round nodules in the bone. It is usually detected incidentally by radiological examination. A radionuclide bone scintigraphy is essential in distinguishing osteopoikilosis from osteoblastic metastases, because scintigraphic findings are usually normal in patients with osteopoikilosis. However, there have been no reports about F-18 fluorodeoxyglucose (FDG) PET findings in osteopoikilosis. Herein, we wish to report a case of osteopoikilosis with breast cancer, which could not be seen in either bone scintigraphy or F-18 FDG PET/CT.

Experience of Reconstruction of an Extensive Chest Wall Defect with Extended External Oblique Musculocutaneous Flap (거대 흉벽 결손에 대한 확장 외복사근 근피판을 이용한 흉벽재건 치험례)

  • Kim, Dae-Hee;Kim, Chung-Hun;Song, Seung-Yong
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.277-280
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    • 2010
  • Purpose: The resection of locally advanced or recurred breast cancers frequently result in large chest wall defects and it leads to a great challenges to cover. Generally simple skin grafts are not a practical option for patients because of their poor cosmetic appearance and prognosis. The latissimus dorsi and rectus abdominis musculocutaneous flap have traditionally been recommended for closure of these large defects. Though the cosmetic result of reconstruction using these flaps is often excellent, but has significant drawbacks. Therefore, we thought that chest wall reconstruction using the external oblique musculocutaneous flap can be an alternative method for extensive chest wall defect related to large, locally advanced breast carcinoma. Methods & Results: We present a case of a 50-year-old Korean female, refered to our department with a left breast tumor for 10 months. CT demonstrate a large tumor on the left anterior chest wall and multiple nodules of varying size in the cervical areas and liver. FDG-PET showed areas of hot uptake throughout the left chest wall, mediastinum and liver. Biopsy was consistent with invasive ductal carcinoma (Grade III). The initial tumor was considered inoperable, so a series of chemotherapy was initiated. Though the size of the breast mass was slightly decreased, the patient continued to suffer from purulent discharge, unpleasant odor and contact bleeding of the mass, the salvage mastectomy was performed. Conclusion: We could reconstruct $23{\times}16\;cm$ sized large chest wall defect, resulting from the resection of a locally advanced breast carcinoma, using an external oblique musculocutaneous flap successfully. Immediate postoperatively checked flap was healthy. Overall result was good without any significant complications and discharged 3 weeks after operation.

A Practical Implementation of Deep Learning Method for Supporting the Classification of Breast Lesions in Ultrasound Images

  • Han, Seokmin;Lee, Suchul;Lee, Jun-Rak
    • International journal of advanced smart convergence
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    • v.8 no.1
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    • pp.24-34
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    • 2019
  • In this research, a practical deep learning framework to differentiate the lesions and nodules in breast acquired with ultrasound imaging has been proposed. 7408 ultrasound breast images of 5151 patient cases were collected. All cases were biopsy proven and lesions were semi-automatically segmented. To compensate for the shift caused in the segmentation, the boundaries of each lesion were drawn using Fully Convolutional Networks(FCN) segmentation method based on the radiologist's specified point. The data set consists of 4254 benign and 3154 malignant lesions. In 7408 ultrasound breast images, the number of training images is 6579, and the number of test images is 829. The margin between the boundary of each lesion and the boundary of the image itself varied for training image augmentation. The training images were augmented by varying the margin between the boundary of each lesion and the boundary of the image itself. The images were processed through histogram equalization, image cropping, and margin augmentation. The networks trained on the data with augmentation and the data without augmentation all had AUC over 0.95. The network exhibited about 90% accuracy, 0.86 sensitivity and 0.95 specificity. Although the proposed framework still requires to point to the location of the target ROI with the help of radiologists, the result of the suggested framework showed promising results. It supports human radiologist to give successful performance and helps to create a fluent diagnostic workflow that meets the fundamental purpose of CADx.

Factor analysis using S-detect Method in Breast Ultrasound (유방 초음파 검사 시 S-detect 방법을 활용한 인자 분석)

  • Chun, Hye Ri;Jang, Hyon Chol;Cho, Pyong Kon
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.9-14
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    • 2019
  • This study aimed to investigate the performance of the S-detect method in breast ultrasonography and to determine how to reduce unnecessary biopsy by comparing the results of the S-detect method and biopsy. Thirty patients who had undergone breast ultrasonography between August and October 2018 and were scheduled to undergo biopsy because of the presence of breast nodules were retrospectively analyzed. The McNemar test was performed to determine whether detection of a malignant breast mass significantly differed between the S-detect method and biopsy. The following results were obtained from the analysis of the S-detect method: sensitivity, 90.9%; specificity, 84.21%; validity, 86.66%; positive predictive value, 76.92%; and negative predictive value, 94.11%. Analysis of the degree of agreement between the S-detect method and biopsy revealed a kappa value as high as 0.724 (p < 0.05), exhibiting good agreement between the two methods. The S-detect method in breast ultrasonography is diagnostically valuable in terms of distinguishing between malignant and benign breast masses, and if used properly before breast biopsy, unnecessary biopsy can be reduced.

Ultrasonographic Features of Triple-Negative Breast Cancer: a Comparison with Other Breast Cancer Subtypes

  • Yang, Qi;Liu, Hong-Yan;Liu, Dan;Song, Yan-Qiu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3229-3232
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    • 2015
  • Background: Triple-negative breast cancer (TNBC) is known to be associated with aggressive biologic features and a poor clinical outcome. Therefore, early detection of TNBC without missed diagnosis is a requirement to improve prognosis. Preoperative ultrasound features of TNBC may potentially assist in early diagnosis as characteristics of disease. Purpose: To retrospectively evaluate the sonographic features of TNBC compared to ER (+) cancers which include HER(-) and HER2 (+), and HER2 (+) cancers which are ER (-). Materials and Methods: From June 2012 through June 2014, sonographic features of 321 surgically confirmed ER (+) cancers (n=214), HER2 (+) cancers (n=66), and TNBC (n=41) were retrospectively reviewed by two ultrasound specialists in consensus. The preoperative ultrasound and clinicopathological features were compared between the three subtypes. In addition, all cases were analyzed using morphologic criteria of the ACR BI-RADS lexicon. Results: Ultrasonographically, TNBC presented as microlobulated nodules without microcalcification (p=0.034). A lower incidence of ductal carcinoma in situ (p<0.001), invasive tumor size that is>2 cm (p=0.011) and BI-RADS category 4 (p<0.001) were significantly associated with TNBC. With regard to morphologic features of 41 TNBC cases, ultrasonographically were most likely to be masses with irregular (70.7%) microlobulated shape (48.8%), be circumscribed (17.1%) or have indistinct margins (17.1%) and parallel orientation (68.9%). Especially TNBC microlobulated mass margins were more more frequent than with ER (+) (2.0%) and HER2 (+) (4.8%) cancers. Conclusions: TNBC have specific characteristic in sonograms. Ultrasonography may be useful to avoid missed diagnosis and false-negative cases of TNBC.

Computer-Aided Detection with Automated Breast Ultrasonography for Suspicious Lesions Detected on Breast MRI

  • Kim, Sanghee;Kang, Bong Joo;Kim, Sung Hun;Lee, Jeongmin;Park, Ga Eun
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.1
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    • pp.46-54
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    • 2019
  • Purpose: The aim of this study was to evaluate the diagnostic performance of a computer-aided detection (CAD) system used with automated breast ultrasonography (ABUS) for suspicious lesions detected on breast MRI, and CAD-false lesions. Materials and Methods: We included a total of 40 patients diagnosed with breast cancer who underwent ABUS (ACUSON S2000) to evaluate multiple suspicious lesions found on MRI. We used CAD ($QVCAD^{TM}$) in all the ABUS examinations. We evaluated the diagnostic accuracy of CAD and analyzed the characteristics of CAD-detected lesions and the factors underlying false-positive and false-negative cases. We also analyzed false-positive lesions with CAD on ABUS. Results: Of a total of 122 suspicious lesions detected on MRI in 40 patients, we excluded 51 daughter nodules near the main breast cancer within the same quadrant and included 71 lesions. We also analyzed 23 false-positive lesions using CAD with ABUS. The sensitivity, specificity, positive predictive value, and negative predictive value of CAD (for 94 lesions) with ABUS were 75.5%, 44.4%, 59.7%, and 62.5%, respectively. CAD facilitated the detection of 81.4% (35/43) of the invasive ductal cancer and 84.9% (28/33) of the invasive ductal cancer that showed a mass (excluding non-mass). CAD also revealed 90.3% (28/31) of the invasive ductal cancers measuring larger than 1 cm (excluding non-mass and those less than 1 cm). The mean sizes of the true-positive versus false-negative mass lesions were $2.08{\pm}0.85cm$ versus $1.6{\pm}1.28cm$ (P < 0.05). False-positive lesions included sclerosing adenosis and usual ductal hyperplasia. In a total of 23 false cases of CAD, the most common (18/23) cause was marginal or subareolar shadowing, followed by three simple cysts, a hematoma, and a skin wart. Conclusion: CAD with ABUS showed promising sensitivity for the detection of invasive ductal cancer showing masses larger than 1 cm on MRI.

Effect of resveratrol on the metastasis of 4T1 mouse breast cancer cells in vitro and in vivo

  • Lee, Hyun-Sook;Ha, Ae-Wha;Kim, Woo-Kyoung
    • Nutrition Research and Practice
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    • v.6 no.4
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    • pp.294-300
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    • 2012
  • We investigated the effects of resveratrol on metastasis in in vitro and in vivo systems. 4T1 cells were cultured in the presence of various concentrations (0-30 ${\mu}mol/L$) of resveratrol. For experimental metastasis, BALB/c mice were injected intravenously with 4T1 cells in the tail vein, and were orally administered various concentrations (0, 100, or 200 mg/kg Body weight) of resveratrol for 21 days. After resveratrol treatment, cell adhesion, wound migration, invasion, and MMP-9 activity were significantly decreased in a dose-dependent manner in 4T1 cells (P < 0.05). The numbers of pulmonary nodules were significantly decreased in mice fed the resveratrol (P < 0.05). The plasma MMP-9 activity was decreased in response to treatment with resveratrol in mice (P < 0.05). We conclude that resveratrol inhibits cancer metastasis both in vitro and in vivo, and this inhibition is likely due to the decrease in MMP-9 activity caused by resveratrol.