• Title/Summary/Keyword: invasive breast cancer

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Evaluation of Post-Neoadjuvant Chemotherapy Pathologic Complete Response and Residual Tumor Size of Breast Cancer: Analysis on Accuracy of MRI and Affecting Factors (신보강화학요법 후 유방암의 병리학적 완전 관해 예측 및 잔류 암 평가: 유방자기공명영상의 정확도 및 영향인자 분석)

  • Hyun Soo Ahn;Yeong Yi An;Ye Won Jeon;Young Jin Suh;Hyun-Joo Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.654-669
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    • 2021
  • Purpose To evaluate the accuracy of MRI in predicting the pathological complete response (pCR) and the residual tumor size of breast cancer after neoadjucant chemotherapy (NAC), and to determine the factors affecting the accuarcy. Materials and Methods Eighty-eight breast cancer patients who underwent surgery after NAC at our center between 2010 and 2017 were included in this study. pCR was defined as the absence of invasive cancer on pathological evaluation. The maximum diameter of the residual tumor on post-NAC MRI was compared with the tumor size of the surgical specimen measured pathologically. Statistical analysis was performed to elucidate the factors affecting pCR and the residual tumor size-discrepancy between the MRI and the pathological measurements. Results The pCR rate was 10%. The diagnostic accuracy of MRI and the area under the curve for predicting pCR were 90.91% and 0.8017, respectively. The residual tumor sizes obtained using MRI and pathological measurements showed a strong correlation (r = 0.9, p < 0.001), especially in patients with a single mass lesion (p = 0.047). The size discrepancy between MRI and the pathological measurements was significantly greater in patients with the luminal type (p = 0.023) and multifocal tumors/non-mass enhancement on pre-NAC MRI (p = 0.047). Conclusion MRI is an accurate tool for evaluating pCR and residual tumor size in breast cancer patients who receive NAC. Tumor subtype and initial MRI features affect the accuracy of MRI.

Multifocal Calcifications of the Falx Cerebri and Dura Presenting as Hot Spots in the Skull on Bone Scintigraphy (골 신티그래피상 두개골에 열소로 나타난 대뇌겸과 경수뇌막에 다발성석회화)

  • Sohn, Myung-Hee;Jeong, Hwan-Jeong;Lim, Seok-Tae;Yim, Chang-Yeol
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.64-65
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    • 2007
  • A 49-year-old woman with invasive ductal carcinoma of the right breast underwent Tc-99m MDP bone scintigraphy for an evaluation of skeletal metastases. Multiple focal hot spots in the midline and left frontoparietal skull region were observed. The plain radiographs revealed the typical findings of the calcification of the falx cerebri and dura. These findings might be mistaken for metastases of the skull in cancer patients. Therefore, a radiographic correlation is essential when multifocal hot spots in the skull are observed in cancer patients.

Micro-channel Embedded Soft Contact Lens for Tear Biomolecule Sampling (눈물의 생체 분자 추출을 위한 미세유관이 탑재된 유연한 콘택트 렌즈)

  • Kim, Ockchul;Park, HyungDal;Song, Young-won;Kim, Jinseok
    • Journal of Biomedical Engineering Research
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    • v.37 no.5
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    • pp.178-185
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    • 2016
  • Tear is a promising biological fluid for non-invasive health monitoring. It has been studied in the past to be a possible candidate for the diagnosis of certain systemic diseases, such as breast cancer, multiple sclerosis, prostate cancer, and diabetes. However, currently existing methods for collecting and extracting tear from the human eye causes inconsistencies in the biomolecule concentrations of the tear sample due to the irritating nature of the process. In response, we designed and fabricated a microfluidic system embedded soft contact-lens for the purpose of tear sampling. The lens was then tested with artificial tear for its tear sampling capability, and found to be able to find concentration equilibrium within 50 minutes. Additionally, simulation was carried out to further optimize the design so that tear sampling rate matched the natural tear turn-over rate of 1 microliter per minute.

Other Gynecologic Pathology in Endometrial Cancer Patients

  • Khunnarong, Jakkapan;Tangjitgamol, Siriwan;Srijaipracharoen, Sunamchok
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.713-717
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    • 2016
  • Background: To evaluate the prevalence and features of other gynecologic or surgical lesions in endometrial cancer (EMC) patients. Materials and Methods: Clinico-pathological data of EMC patients who were treated in the institution from 1995 to 2012 were collected. Data collected were age, stage of disease according to the FIGO 2009 criteria (FIGO), histopathology, tumor grade, adjuvant therapy, other gynecologic or surgical lesions, follow-up period, and living status. Results: The mean age of 396 patients was $56.7{\pm}10.64years$. Abnormal uterine bleeding was the most common presenting symptom (90.1%). Bleeding was accompanied with pelvic mass in 7.7% and 5.4% had only a pelvic mass. Abnormal cervical cytology was found in 3.8%. Approximately 75% had early stage diseases and 86% had endometrioid histology. We found 55.8% of EMC patients had other gynecologic lesions: 89.6% benign and 9.5% malignant. Some 4.5% had pre-invasive cervical/vulva/vagina lesions. The two most common gynecologic lesions were myoma uteri and ovarian tumors. Focusing on the latter, approximately 14% were benign while 8% were malignant. Among 364 patients with available data, surgical lesions were found in 11.8%, 5.7% benign and 9.2% malignant. The most common benign surgical condition was chronic appendicitis while breast and colon cancers were the two most common malignant lesions found. Conclusions: More than half of EMC patients had other gynecologic lesions including benign and malignant tumors. Surgical lesions were also found in more than one-tenth of patients. Careful pre-operative evaluation and intra-operative inspection are advised for proper management and better prognosis.

An Analysis of the Incidence and Related Factors for Radiation Dermatitis in Breast Cancer Patients Who Received Radiation Therapy (방사선 치료를 받은 유방암 환자의 방사선 피부염 발생 정도 및 관련 인자들의 분석)

  • Lee, Sun-Young;Kwon, Hyoung-Cheol;Kim, Jung-Soo;Lee, Heui-Kwan
    • Radiation Oncology Journal
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    • v.28 no.1
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    • pp.16-22
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    • 2010
  • Purpose: We analyzed the incidence and related factors of radiation dermatitis; at first, to recognize whether a decrease in radiation dermatitis is possible or not in breast cancer patients who received radiation therapy. Materials and Methods: Of 338 patients, 284 with invasive breast cancer who received breast conservation surgery with radiotherapy at Chonbuk National University Hospital from January 2007 to June 2009 were evaluated. Patients who also underwent bolus, previous contralateral breast irradiation and irradiation on both breasts were excluded. For patients who appeared to have greater than moderate radiation dermatitis, the incidence and relating factors for radiation dermatitis were analyzed retrospectively. Results: A total of 207 and 77 patients appeared to have RTOG grade 0/1 or above RTOG grade 2 radiation dermatitis, respectively. The factors found to be statistically significant for the 77 patients who appeared to have greater than moderate radiation dermatitis include the presence of lymphocele due to the stasis of lymph and lymph edema which affect the healing disturbance of radiation dermatitis (p=0.003, p=0.001). Moreover, an allergic reaction to plaster due to the immune cells of skin and the activation of cytokine and concomitant hormonal therapy were also statistically significant factors (p=0.001, p=0.025). Conclusion: Most of the breast cancer patients who received radiation therapy appeared to have a greater than mild case of radiation dermatitis. Lymphocele, lymphedema, an allergy to plaster and concomitant hormonal therapy which affect radiation dermatitis were found to be significant factors. Consequently, we should eliminate lymphocele prior to radiation treatment for patients who appear to have an allergic reaction to plaster. We should also instruct patients of methods to maintain skin moisture if they appear to have a greater than moderate case of radiation dermatitis.

Stromal cell-derived factor-1 (SDF-1) expression in the oral squamous cell carcinoma (구강편평상피암종에서 stromal cell-derived factor-1의 발현)

  • Kim, Kyung-Wook;Han, Se-Jin;Roh, Kyu-Seob
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.1
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    • pp.1-6
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    • 2010
  • Purpose: Chemokines are structurally related, small polypeptide signaling molecules that bind to and activate a family of transmembrane G protein-coupled receptors, the chemokine receptors. Recently, interaction between the chemokine receptor CXCR4 and its ligand, stromal cell-derived factor 1 (SDF-1 or CXCL12), has been found to play an important role in tumorigenicity, proliferation, metastasis and angiogenesis in many cancers such as lung cancer, breast cancer, melanoma, glioblastoma, pancreatic cancer and cholangiocarcinoma. Hence, the goal of this study is to identify the correlation of clinicopathological factors and the up-regulation of SDF-1 expression in oral squamous cell carcinoma. Material and methods: We studied the immunohistochemical staining of SDF-1, quantitative RT-PCR (qRT-PCR) of SDF-1 gene in 20 specimens of 20 patients with oral squamous cell carcinoma. Results: 1. In the immunohistochemical study of poor differentiated and invasive oral squamous cell carcinoma, the high level staining of SDF-1 was observed. And the correlation between immunohistochemical SDF-1 expression and tumor nodes metastases (TNM) classification of specimens was significant.($x^2$ test, P < 0.05) 2. In the SDF-1 gene qRT-PCR analysis, SDF-1 expression was more in tumor tissue than in carcinoma in situ tissue. Paired-samples analysis determined the difference of SDF-1 mRNA expression level between the cancer tissue and the carcinoma in situ tissue.(Student's t-test, P < 0.05) Conclusion: These findings suggest that up-regulation of the SDF-1 may play a role in progression and invasion of oral squamous cell carcinoma.

Ultrafast MRI and T1 and T2 Radiomics for Predicting Invasive Components in Ductal Carcinoma in Situ Diagnosed With Percutaneous Needle Biopsy

  • Min Young Kim;Heera Yoen;Hye Ji;Sang Joon Park;Sun Mi Kim;Wonshik Han;Nariya Cho
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1190-1199
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    • 2023
  • Objective: This study aimed to investigate the feasibility of ultrafast magnetic resonance imaging (MRI) and radiomic features derived from breast MRI for predicting the upstaging of ductal carcinoma in situ (DCIS) diagnosed using percutaneous needle biopsy. Materials and Methods: Between August 2018 and June 2020, 95 patients with 98 DCIS lesions who underwent preoperative breast MRI, including an ultrafast sequence, and subsequent surgery were included. Four ultrafast MRI parameters were analyzed: time-to-enhancement, maximum slope (MS), area under the curve for 60 s after enhancement, and time-to-peak enhancement. One hundred and seven radiomic features were extracted for the whole tumor on the first post-contrast T1WI and T2WI using PyRadiomics. Clinicopathological characteristics, ultrafast MRI findings, and radiomic features were compared between the pure DCIS and DCIS with invasion groups. Prediction models, incorporating clinicopathological, ultrafast MRI, and radiomic features, were developed. Receiver operating characteristic curve analysis and area under the curve (AUC) were used to evaluate model performance in distinguishing between the two groups using leave-one-out cross-validation. Results: Thirty-six of the 98 lesions (36.7%) were confirmed to have invasive components after surgery. Compared to the pure DCIS group, the DCIS with invasion group had a higher nuclear grade (P < 0.001), larger mean lesion size (P = 0.038), larger mean MS (P = 0.002), and different radiomic-related characteristics, including a more extensive tumor volume; higher maximum gray-level intensity; coarser, more complex, and heterogeneous texture; and a greater concentration of high gray-level intensity. No significant differences in AUCs were found between the model incorporating nuclear grade and lesion size (0.687) and the models integrating additional ultrafast MRI and radiomic features (0.680-0.732). Conclusion: High nuclear grade, larger lesion size, larger MS, and multiple radiomic features were associated with DCIS upstaging. However, the addition of MS and radiomic features to the prediction model did not significantly improve the prediction performance.

Success of a Cervical Cancer Screening Program: Trends in Incidence in Songkhla, Southern Thailand, 1989-2010, and Prediction of Future Incidences to 2030

  • Sriplung, Hutcha;Singkham, Phathai;Iamsirithaworn, Sopon;Jiraphongsa, Chuleeporn;Bilheem, Surichai
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.10003-10008
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    • 2014
  • Background: Cervical cancer has been a leading female cancer in Thailand for decades, and has been second to breast cancer after 2007. The Ministry of Public Health (MoPH) has provided opportunistic screening with Pap smears for more than 30 years. In 2002, the MoPH and the National Health Security Office provided countrywide systematic screening of cervical cancer to all Thai women aged 35-60 years under universal health care coverage insurance scheme at 5-year intervals. Objectives: This study characterized the cervical cancer incidence trends in Songkhla in southern Thailand using joinpoint and age period cohort (APC) analysis to observe the effect of cervical cancer screening activities in the past decades, and to project cervical cancer rates in the province, to 2030. Materials and Methods: Invasive and in situ cervical cancer cases were extracted from the Songkhla Cancer Registry from 1990 through 2010. Age standardized incidence rates were estimated. Trends in incidences were evaluated by joinpoint and APC regression models. The Norpred package was modified for R and was used to project the future trends to 2030 using the power of 5 function and cut trend method. Results: Cervical cancer incidence in Songkhla peaked around 1998-2000 and then dropped by -4.7% per year. APC analysis demonstrated that in situ tumors caused an increase in incidence in early ages, younger cohorts, and in later years of diagnosis. Conclusions: Both joinpoint and APC analysis give the same conclusion in continuation of a declining trend of cervical cancer to 2030 but with different rates and the predicted goal of ASR below 10 or even 5 per 100,000 women by 2030 would be achieved. Thus, maintenance and improvement of the screening program should be continued. Other population based cancer registries in Thailand should analyze their data to confirm the success of cervical cancer screening policy of Thailand.

Epidemiological Patterns of Cancer Incidence in Southern China: Based on 6 Population-based Cancer Registries

  • Liu, Jie;Yang, Xu-Li;Li, Ai;Chen, Wan-Qing;Ji, Lu;Zhao, Jun;Yan, Wei;Chen, Yi-Ying;Zhu, Li-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1471-1475
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    • 2014
  • Background: The epidemiological patterns of cancer incidence have been investigated widely in western countries. Nevertheless, information is quite limited in Jiangxi province, southern China. Materials and Methods: All data were reported by 6 population-based cancer registries in Jiangxi Province. The results were presented as incidence rates of cases by site (ICD-10), sex, crude rate (CR), age-standardized rates (ASRs) and truncated incidence rate (TR) per 100,000 person-years, using the direct method of standardization to the world population. Results: 8,765 new cancer cases were registered in our study during the period 2009-2011. Diagnosis of cancer was based on histopathology in 61.0%, clinical or radiology findings in 4.87% and death certificate only (DCO) in 3.0% of the cases. The median age at diagnosis was 62.0 years (mean, 61; standard deviation, 15). The ASRs were 170.8 per 100,000 for men and 111.2 for women. The ASRs for all invasive cancers from the urban areas (145.7 per 100,000) was higher than that of rural areas (137.1). Incidence rates for lung cancer were higher in rural (35.8) than in urban areas (27.0). Similarly, relatively high rates were observed for stomach cancer in rural (20.1) relative to urban areas (15.5). Conclusions: Our results reveal that the most common cancers were breast and lung in women and lung and liver in men. Interestingly, this study suggested a higher incidence rates for lung and stomach cancer in rural males than in urban population, which may suggest other potential causes, such as over-consumption of smoked meats and high prevalence of Helicobacter pylori infection, respectively. Public education and the promotion of healthy lifestyles should be actively carried out.

Association of Histopathological Markers with Clinico-Pathological Factors in Mexican Women with Breast Cancer

  • Bandala, Cindy;De la Garza-Montano, Paloma;Cortes-Algara, Alfredo;Cruz-Lopez, Jaime;Dominguez-Rubio, Rene;Gonzalez-Lopez, Nelly Judith;Cardenas-Rodriguez, Noemi;Alfaro-Rodriguez, A;Salcedo, M;Floriano-Sanchez, E;Lara-Padilla, Eleazar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8397-8403
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    • 2016
  • Background: Breast cancer (BCa) is the most common malignancy in Mexican women. A set of histopathological markers has been established to guide BCa diagnosis, prognosis and treatment. Nevertheless, in only a few Mexican health services, such as that of the Secretariat of National Defense (SEDENA for its acronym in Spanish), are these markers commonly employed for assessing BCa. The aim of this study was to explore the association of Ki67, TP53, HER2/neu, estrogenic receptors (ERs) and progesterone receptors (PRs) with BCa risk factors. Materials and Methods: Clinical histories provided background patient information. Immunohistochemical (IHC) analysis was conducted on 48 tissue samples from women diagnosed with BCa and treated with radical mastectomy. The Chi square test or Fisher exact test together with the Pearson and Spearman correlation were applied. Results: On average, patients were $58{\pm}10.4$ years old. It was most common to find invasive ductal carcinoma (95.8%), histological grade 3 (45.8%), with a poor Nottingham Prognostic Index (NPI; 80.4%). ERs and PRs were associated with smoking and alcohol consumption, metastasis at diagnosis and Ki67 expression (p<0.05). PR+ was also related to urea and ER+ (p<0.05). Ki67 was associated with TP53 and elevated triglycerides (p<0.05), and HER2/neu with ER+, the number of pregnancies and tumor size (p<0.05). TP53 was also associated with a poor NPI (p<0.05) and CD34 with smoking (p<0.05). The triple negative status (ER-/PR-/HER2/neu-) was related to smoking, alcohol consumption, exposure to biomass, number of pregnancies, metastasis and a poor NPI (p<0.05). Moreover, the luminal B subty was associated with histological type (p=0.007), tumor size (p=0.03) and high cholesterol (p=0.02). Conclusions: Ki67, TP53, HER2/neu, ER and PR proved to be related to several clinical and pathological factors. Hence, it is crucial to determine this IHC profile in women at risk for BCa. Certain associations require further study to understand physiological/biochemical/molecular processes.