Vaginal microbiomes of breast cancer survivors treated with aromatase inhibitors with and without vulvovaginal symptoms.

Genitourinary syndrome of menopause (GSM) is the leading cause of vaginal symptoms in breast cancer survivors treated with aromatase inhibitors. However, there are currently no effective treatment options available for women with a history of breast cancer. Recent research has established that changes in the vaginal microbiome may be linked to GSM. Most studies have assessed the microbiome without accounting for the estrogen status. It remains unknown whether the vaginal microbiome differ among patients with a low estrogenic state with and without vulvovaginal symptoms. To address such research questions, our study compares the vaginal microbiomes among breast cancer survivors treated with aromatase inhibitors with and without vulvovaginal symptoms. A total of 50 breast cancer survivors treated with aromatase inhibitors were recruited, among whom 25 had vulvovaginal symptoms and 25 had no vulvovaginal symptoms. Vaginal swabs were collected. DNA extraction, followed by sequencing of the V3-V4 regions of the 16S ribosomal RNA gene, were performed. Differential abundance analysis was conducted by linear discriminant analysis effect size. Taxonomy assignment, alpha diversity and beta diversity were examined. The relative abundance of genus Sneathia and genus Gardnerella was significantly increased in vulvovaginal symptoms group with no differences in bacterial diversity and richness.

Focal fibrosis of the breast diagnosed by core needle biopsy under imaging guidance.

BACKGROUND: Focal fibrosis of the breast is an uncommon pathology, recognition of this lesion is important because it could mimic malignant lesions on both mammogram and ultrasonography (US). Concordance with the pathology result from core needle biopsy (CNB) and follow-up are essential to avoid false negative. OBJECTIVE: To characterize the mammographic and US features of focal fibrosis of the breast and to estimate the false negative rate for breast cancer when focal fibrosis was diagnosed by CNB. MATERIAL AND METHOD: The subjects were 82 patients diagnosed fibrosis of the breast by CNB during 7-year period. RESULTS: Of 38 mammographic visible lesions there were mass lesions in 12 (32%), calcifications in 14 (37%), mass with calcifications in four (11%), architectural distortion in one (3%) and asymmetrical density in seven (18%). Most of the lesions seen on the US were hypoechoic mass (81%). The suspicious features, which warrant CNB, included irregular shape in 37 (55%), indistinct margin in 38 (57%), and posterior shadowing in 28 (42%). Most of the lesions were categorized as Breast Imaging Reporting and Data System (BI-RADS) 4A (59%). Thirteen cases underwent surgical biopsy and all showed benign pathologic results. No false-negative cases were detected. CONCLUSION: Focal fibrosis had some features similar to malignant lesion. CNB showed reliable pathological result. No false negative result was found in the present study.

Diagnostic accuracy of vacuum-assisted stereotactic core needle biopsy for breast lesions.

OBJECTIVE: To evaluate the diagnostic accuracy of the vacuum-assisted stereotactic core needle biopsy (CNB) for breast lesions. MATERIAL AND METHOD: Sixty-four lesions that had undergone vacuum-assisted stereotactic CNB between January 2003 and December 2005 in Ramathibodi Breast diagnostic center were included in this study. Pathologic results of CNB were reviewed and correlated with pathologic results of subsequent open surgery. For benign lesions without surgery, the authors correlated the result of CNB with stability of the lesion at or more than 2-year interval follow-up. Agreement rate, high-risk under estimate rate, Ductal carcinoma in situ (DCIS) underestimate rate, false negative rate, and sensitivity were accessed RESULTS: The pathologic results for the CNB were malignancy in 20%, high-risk in 13%, and benign in 67%. The agreement rate was 93.8% (60 of 64). The under estimate rate for atypical ductal hyperplasia (ADH) was 50% (3 of 6). There was no underestimate for DCIS in the present study. Of 43 benign lesions, malignancy was found at subsequent open surgery in one lesion and false negative rate was 6%. Calculated sensitivity was 96%. CONCLUSION: Vacuum-assisted CNB is an accurate method for evaluating breast lesions. This procedure is an alternative to surgical excision for lesion assessments.