Breast conserving surgery for breast cancer involving the nipple.

We present two cases of invasive breast carcinoma with involvement of the dermis and epidermis of the nipple areolar complex (NAC), which were treated with an immediate breast reconstruction. Oncoplastic techniques were utilised in both cases: Latissimus Dorsi Mini Flap in the first and therapeutic reduction mammaplasty in the second. Both methods were used to fill the defect and also to recreate the NAC. We believe these techniques have an expanding role in the repertoire of surgical options for treating breast carcinoma.

Primary carcinoma of breast with small-cell differentiation.

We present a case of primary carcinoma of breast with neuro-endocrine small-cell features in a 58-year-old female. To the best of our knowledge this is the first reported case of this kind in the UK. The patient had regional nodal metastasis. She underwent breast conserving surgery and adjuvant chemotherapy. Immunocytochemistry was positive for neuro-endocrine origin of the tumour. We review the literature.

Nipple core biopsy for the deformed or scaling nipple.

The key to diagnosis for deformed or scaling nipple is cytology or histology. While scrape cytology and punch biopsy do not provide underlying breast tissue for histology wedge excision requires more time and resource. We present the technique of nipple core biopsy (NCB) in 40 patients with deformed or scaling nipple done as a part of triple assessment yielding both skin and breast tissue for histological examination. Histological diagnosis confirmed eczema in 24, Paget's disease of nipple in 9 and chronic inflammation in 2. Among 5 remaining patients with normal skin histology, underlying breast invasive ductal carcinoma was seen in 3, ductal carcinoma in situ (DCIS) in 1 and adenoma in 1. NCB identified 5(55%) significant breast pathologies in Paget's disease and detected a further 2 invasive cancers in the absence of a palpable mass. The technique also provides additional information in the form of oestrogen receptor, which can have direct impact on patient management.

Central neurocytoma: a correlative clinicopathologic and radiologic analysis.

BACKGROUND: Central neurocytoma was described as a well differentiated tumor of neuronal origin, distinct from ganglion cell tumors and neuroblastoma. An initially perceived benign biologic behavior has been questioned by subsequent reports of anaplastic and recurrent tumors. We report six cases of central neurocytoma, with variable clinical and pathologic features that stimulate discussion on the management of these tumors. METHODS: Of the 95 oligodendrogliomas treated in our institution in the last 40 years, three tumors were reclassified as central neurocytomas on histologic reappraisal. Three additional cases prospectively diagnosed as central neurocytomas are reported. The clinical, pathologic, and radiologic features are reviewed. RESULTS: Early recurrence, not related to malignant histologic features, was noted in two patients who had not received postoperative radiotherapy. Anaplastic histologic changes were not accompanied by malignant biologic behavior in another patient. Neither patient with recurrent tumor was controlled by radiotherapy alone. Chemotherapy with carboplatin reduced tumor size temporarily in one of these patients. CONCLUSION: An entirely benign nature for this tumor is questioned and it appears that there may be malignant variants. Surgery should aim for maximum possible excision, as the location of the tumor allows. The role of postoperative radiotherapy remains controversial and may be considered in cases of subtotal excision of tumors with anaplastic histologic features. Chemotherapy may be of benefit in cases recurring despite surgery and radiotherapy.