Bilateral galactocele in a male infant with Down syndrome and congenital hypothyroidism.

Galactocele is an uncommon benign breast lesion. Its cause is unknown. Here, we report a male infant with Down syndrome and congenital hypothyroidism during the newborn period. At follow up, when he was 6 months old, bilateral mammillary swelling was detected and diagnosed as galactocele. Although thyroid hormone levels were normal, serum prolactin levels were elevated. Cyst aspiration was performed on the left side and 6 months after the aspiration of the cyst on the left side, both cysts had clinically and sonographically regressed. No recurrence was observed at the end of the 4th year.

Xanthogranulomatous reaction to a ruptured galactocele.

We describe a case of a 34-year-old, healthy, lactating female with a 2-month history of breast pain and an enlarging, tender mass on her right nipple. Her right breast was firm and mildly engorged without mass, warmth or erythema. A tender, yellow nodule was located on the superior aspect of the nipple, obstructing the flow of milk from this portion of the nipple. A biopsy showed epidermal erosion, sheets of cells with massively distended, foamy cytoplasm in the dermis, and a hypertrophied and occluded glandular duct, consistent with reactive squamous metaplasia. Immunostaining for CD68 confirmed the foamy cells were macrophages, and anti-human milk fat globulin-1 (HMFG1) labeled the substance within the macrophages consistent with human breast milk. Therefore, the lesion could be identified as a xanthogranulomatous reaction to a ruptured galactocele.

Discrepant cytologic and radiographic findings in adjacent galactocele and fibroadenoma: a case report.

BACKGROUND: Clinical, radiologic and pathologic evaluation of a breast mass during pregnancy and lactation often presents a challenge. We report a case of a longstanding benign breast mass that was negative on fine needle aspiration biopsy (FNAB) but sonographically appeared suspicious for carcinoma. CASE: A 41-year-old patient presented with a long-standing benign breast nodule that increased in size postpartum and became painful. The patient was breastfeeding when she developed mastitis in the surrounding area and was treated with antibiotics. The inflammation resolved, but the original mass persisted. FNA of the mass yielded thick, whitish material that on microscopic examination showed clusters of ductal cells with striking reactive, reparative and lactation changes admixed with amorphous material and crystals. The smear pattern was interpreted as negative. However, the sonogram revealed a solid lesion with mixed echogenicity suspicious for malignancy. The patient underwent lumpectomy, which showed concomitant fibroadenoma and galactocele. CONCLUSION: We suspect that in lactating patients preexisting breast masses may interfere with the milk flow, thus rendering the breast tissue around the mass prone to galactocele formation. This may result in erroneous clinical and radiologic impression of growth and transformation of a preexisting lesion.

[Ongoing breastfeeding with breast abscess]. / Aufrechterhaltung der Laktation bei Brustabszess.

Mastitis puerperalis can frequently be complicated by a breast abscess. Immediate diagnosis and treatment are crucial if breastfeeding is to be continued and for the prevention of further complications. Somatic and psychological interventions are of importance for recovery. Specialised nurses and midwives have an important impact on the promotion of well-being of affected mothers.

Cohort study of women at risk for breast cancer and gross cystic disease.

BACKGROUND: Gross cystic disease (GCD) is a common benign breast condition. Previous studies have reported conflicting results regarding the relationship of GCD and subsequent risk of developing breast cancer. This cohort study was conducted to investigate the association of GCD and breast cancer among women at high risk for breast cancer. METHODS: The Women At Risk Registry provided the study population. The variables of interest included age at enrollment, age at breast cancer diagnosis, body mass index (BMI), presence of lobular carcinoma in situ (LCIS), and Gail scores. Statistical significance was determined by calculating multivariable-adjusted rate ratios using Cox proportional hazards regression model with years of follow-up as the time scale. RESULTS: The study population included 1317 high-risk women, including 363 (28%) with GCD. The mean follow-up was 5.9 years for the GCD cohort, and 5.1 years for the non-GCD cohort (P < .001). The GCD and non-GCD groups differed by Gail score (P < .001), BMI (P < .01), presence of atypical hyperplasia (P < .001), presence of LCIS (P < .001), and family history of breast cancer (P < .001). Within the total population of 1317 women, 79 (6%) developed breast cancer; 28 (35%) out of the 79 had a prior history of GCD. Results from the Cox proportional hazards regression model showed a nonstatistically significant association of GCD and breast cancer (hazard ratio = 1.48, 95% confidence interval 0.88-2.51). The Kaplan-Meier overall survival estimate between the exposed and unexposed groups indicate that there are no differences in overall survival between the 2 groups (P = .5). CONCLUSIONS: These results do not support the contention that gross cystic disease is a significant risk factor for breast cancer.

A case of intracystic breast cancer.

The case of a 70-year-old female patient with family history of breast cancer come to the breast Unit for the presence of a nodular swelling in the right breast is discussed. On mammography and US a gross cystic neoformation with vascularized mural nodes was identified. Another contralateral solid nodular neoformation suggestive of malignancy was also present. Diagnostic completion with MRI confirmed the mixed solid, partly cystic nature of the right lesion, leading to the differential diagnosis with cystosarcoma phylloides and intracystic tumor. On the left side, MRI confirmed the presence of the second lesion whose morphologic and dynamic characteristics suggested a neoplastic lesion. At the anatomopathological examination the left lesion was shown to be an infiltrating ductal carcinoma; the right lesion was shown to be an intracystic tumor.

A case of intracystic papillary carcinoma with a multilocular cyst of the breast in male.

Intracystic papillary carcinoma of the breast in males is a very rare disease but has an excellent prognosis. We report the case of a 68-year-old man who had a right subareolar soft mass. Imaging examinations showed a multilocular cyst with an intracystic component, and benign disease was diagnosed. Fine needle aspiration of the cyst fluid revealed many malignant cells, and modified radical mastectomy was performed under general anesthesia. Histological examination showed intracystic papillary carcinoma with a multilocular cyst. No positive lymph nodes were involved. The diagnosis of intracystic papillary carcinoma of male breast should be made carefully to avoid misdiagnosing benign disease.

Do shorter wavelengths improve contrast in optical mammography?

The detection of tumours with time-resolved transmittance imaging relies essentially on blood absorption. Previous theoretical and phantom studies have shown that both contrast and spatial resolution of optical images are affected by the optical properties of the background medium, and high absorption and scattering are generally beneficial. Based on these observations, wavelengths shorter than presently used (680-780 nm) could be profitable for optical mammography. A study was thus performed analysing time-resolved transmittance images at 637, 656, 683 and 785 nm obtained from 26 patients bearing 16 tumours and 15 cysts. The optical contrast proved to increase upon decreasing wavelengths for the detection of cancers in late-gated intensity images, with higher gain in contrast for lesions of smaller size (<1.5 cm diameter). For cysts either a progressive increase or decrease in contrast with wavelength was observed in scattering images.