The Expression of P63 Marker in Malignant and Benign Breast Tumors

This is a retrospective study conducted on Sudanese patients from January 2021 to May 2021 at the radiation and isotope center in Khartoum. In this study we aimed to determine the expression of P63 marker in malignant and benign breast tumors. One hundred paraffin-embedded blocks previously diagnosed as breast tumors were collected. The study included 65 (65%) samples of malignant and 35 (35%) benign samples. All these samples were Immunohistochemically stained by using monoclonal antibodies (by indirect streptavidin-biotin technique) for p63. All immune-stained slides were scored as either positive or negative. Data collected from patient file and results were analyzed using social science statistic web SPSS computer program.

Direct-to-implant breast reconstruction after bilateral mastectomy: A comparison between endoscopic and conventional open surgery / 中国胸心血管外科临床杂志

@#Objective    To compare the differences of clinical effects between the bilateral endoscopic breast reconstruction and the open breast reconstruction. Methods    The clinical data of 28 female patients who underwent bilateral breast graft reconstruction in the Department of Breast Surgery of West China Hospital from January 2017 to January 2021 were analyzed retrospectively. The patients were divided into two groups: an endoscopic group (n=12, aged 41.3±8.9 years) and an open group (n=16, aged 41.6±8.8 years). The clinical data of the two groups of patients were compared. Results     There was no significant difference in demographic and oncological data between the two groups (P>0.05). There was a significant difference in the implants between the two groups (P=0.008). The operation time (298.2±108.6 min vs. 326.5±95.8 min, P=0.480) and anesthesia time (373.4±91.2 min vs. 400.3±97.1 min, P=0.463) were not significantly different. The total complications (P=0.035) and major complications (P=0.024) in the open group were more than those in the endoscopic group. For the comparison of breast satisfaction, psychosocial well-being and sexual well-being, the scores at six months and one year after surgery were higher in the endoscopic group than those in the open group (P<0.05). Conclusion    The endoscopic reconstruction is safe and effective, with high satisfaction rates regarding  breast reconstruction and quality of life, and is superior to conventional open surgery.

Tumor budding in invasive breast carcinoma: correlation with clinicopathological parameters, hormone receptor status, and survival: an observational study

SUMMARY OBJECTIVE: Tumor budding is currently thought to be associated with worse prognosis. This study aims to examine tumor budding in invasive ductal-type breast carcinoma and its relationship with other clinicopathological parameters and overall survival. METHODS: All the H&E slides of 198 patients were re-evaluated for the histological grade, angiolymphatic invasion, perineural invasion, lymph node status, extranodal extension, multicentricity, pT, presence of the tumor budding, tumor budding score (i.e., low, intermediate, or high). Overall survival was considered the period after surgery until death. SPSS was used for statistical analysis. RESULTS: Tumor budding was identified in 98 (49.5%) patients. Tumor budding score was low in 41 (41.8%) of 98 cases, intermediate in 25 (25.5%), and high in 32 (32.7%). We determined a strong correlation between tumor budding and poor prognostic variables such as tumor size, pT stage, angiolymphatic invasion, perineural invasion, number of metastatic axillary lymph nodes, overall survival, and extranodal tumor extension in metastatic lymph nodes. This strong correlation was also present for the tumor budding score. CONCLUSION: Tumor budding may be a prognostic indicator for breast cancer.

Surgical technique and clinical effect of endoscopic assisted transaxillary breast tumor resection with the help of HUAXI Hole 3 / 中国胸心血管外科临床杂志

@#Objective    To explore the surgical technique and clinical effect of endoscopic assisted transaxillary breast tumor resection in the treatment of benign and malignant breast tumors. Methods    The clinical data of 18 patients received endoscopic breast tumor resection from September 2020 to December 2021 in the Department of Breast Surgery, West China Hospital, Sichuan University, were retrospectively analyzed to evaluate the feasibility, tumor safety and postoperative cosmetic effect. There were 7 patients with benign breast tumors (a benign breast tumor group) and 11 patients with early breast cancer (a malignant breast tumor group). Breast-Q and Scar-Q questionnaires were used to evaluate postoperative quality of life and satisfaction of patients. Results    Endoscopic breast tumor resection was performed successfully in 18 female patients, among whom 12 patients received day surgery. The mean age of benign and malignant breast tumor groups was 29.6±11.6 years and 46.7±14.3 years, the mean tumor size in pathological examination was 3.3±2.1 cm and 2.0±0.8 cm, and the operative time was 138.9±57.0 min and 177.3±46.3 min, respectively. One patient had positive resection margin and underwent intraoperative extended resection in the malignant breast tumor group. All the patients were successfully followed up, and the mean follow-up time of benign and malignant breast tumor groups was 6.8±4.0 months and 8.7±4.9 months, respectively. No complications or tumor recurrence occurred. The scores of psychosocial status, sexual well-being, chest wall status and breast satisfaction decreased one month after surgery and basically recovered to the preoperative level in one year, and the score of scar appearance increased to 64.6±5.9 points one year postoperatively. Conclusion    Endoscopic assisted transaxillary breast tumor resection can effectively improve postoperative cosmetic effect and patient satisfaction on the premise of safety.

Application of 3D ResSE-Unet-based intelligent delineation of clinical target volume in postoperative radiotherapy for breast cancer / 中华放射医学与防护杂志

Objective:To evaluate the effectiveness and feasibility of 3D ResSE-Unet-based intelligent delineation of clinical target volume (CTV) in postoperative adjuvant radiotherapy for breast cancer.Methods:A total of 974 cases of breast cancer treated in the Cancer Diagnosis and Treatment Center of the Fourth Affiliated Hospital of Guangxi Medical University from September 2018 to June 2022 were enrolled in this study, including 614 cases receiving total mastectomy and 360 cases treated with breast-conserving surgery. They were divided into a training set, a validation set, and a testing set. The training set consisted of 874 cases and was used to build a model of 3D ResSE-Unet-based intelligent CTV delineation. The validation set comprised 40 cases and was used to evaluate the feasibility and effectiveness of the clinical application of AI-based CTV design in the radiotherapy for breast cancer. The testing set was composed of 60 cases and was used to test the accuracy of intelligent CTV. The Wilcoxon rank test was used to compare the Dice similarity coefficient (DSC), 95% Hausdorff distance (HD95), and average surface distance (ASD) obtained using the intelligent delineation model.Results:The intelligent delineation model showed high precision. The CTV of cases treated with total mastectomy (CTV cw) and the CTV of cases treated with breast-conserving surgery (CTV b) had DSCs greater than 0.80 and greater than 0.88, respectively. Therefore, compared with CTV cw, CTV b had a higher DSC (0.91 ± 0.03 vs.0.83 ± 0.05, t = 7.11, P < 0.05). Both CTV cw and CTV b had lower HD 95 [(7.56 ± 3.42) mm vs.(8.77 ± 5.89) mm] and ASD [(1.85 ± 0.71) mm vs.(1.86 ± 0.83)mm], without statistically significant difference ( P > 0.05). The left/right supraclavicular and infraclavicular CTV (CTV2) had DSCs greater than 0.8. CTV2 also had low average HD95 and ASD, without statistically significant difference ( P > 0.05). Conclusions:The 3D ResSE-Unet-based intelligent CTV delineation has better consistency and feasibility in postoperative adjuvant radiotherapy for breast cancer, especially the CTVs after breast-conserving surgery.

Células tumorales circulantes en una paciente con sospecha clínica de mieloma múltiple / Circulating tumor cells in a patient with clinical suspicious of multiple myeloma

Introducción: La circulación de células tumorales en la sangre periférica, conocido como carcinocitemia, es un fenómeno raro y muy poco comunicado en la literatura científica y su diagnóstico diferencial puede constituir un desafío en la práctica clínica. Objetivos: Describir las causas más frecuentes de carcinocitemia, los retos diagnósticos que representa y contribuir a elevar el índice de sospecha de esta entidad. Presentación del caso: Paciente femenina de 71 años de edad que acude por dolores óseos y palidez cutánea. En el examen de sangre periférica se observa células de gran tamaño que recordaron células plasmáticas. El inmunofenotipo por citometría de flujo fue sugestivo de mieloma múltiple isotipo IgM. El ultrasonido de mamas y la tomografía de tórax mostraron lesión tumoral en la mama izquierda. El estudio inmunohistoquímico de la biopsia de médula ósea fue compatible con adenocarcinoma de mamas. La paciente falleció sin haber comenzado tratamiento específico. Conclusiones: Se presenta paciente con células circulantes tumorales secundaria a adenocarcinoma de la mama donde la inmunohistoquímica de la biopsia de médula ósea descartó el diagnóstico de mieloma múltiple sospechado clínica, radiológicamente, por la morfología celular y el inmunofenotipo(AU)

Introduction: The circulating tumor cells in peripheral blood, known as carcinocythemia is a rare and poorly documented phenomenon, that can be a challenge diagnosis. Objectives: To describe the most frequents causes of carcinocythemia, the diagnosis challenges that it represents and to contribute raising awareness of this entity. Case presentation: Female patient, 71-year-old who complained bone pain and skin pale. The peripheral blood smear showed big size cells mimicking plasma cells. The immunophenotype by flow cytometry suggested IgM isotype multiple myeloma. Breast ultrasound and thorax tomography showed a tumor in the left breast. The bone marrow biopsy immunohistochemical was compatible with adenocarcinoma of breast. The patient died short after before receive specific treatment. Conclusions: We present a patient with circulating tumor cells secondary to breast adenocarcinoma where the bone marrow biopsy immunohistochemical ruled out multiple myeloma diagnosis suspected by clinical, image studies, cell morphology and immunophenotype(AU)

Combination of S-Detect and strain elastography in the conventional ultrasonic diagnosis of breast tumors / 中国综合临床

Objective:To explore the value of s-detect combined with elastography in the differential diagnosis of benign and malignant breast tumors.Methods:The ultrasound diagnosis data of 136 patients with breast mass examined by ultrasound in the First Affiliated Hospital of Shantou University Medical College from April 2018 to January 2020 were retrospectively analyzed. The breast lesions diagnosed as BI-RADS 3 or above were analyzed by conventional ultrasound, strain elastic imaging strain ratio (SR) and S-Detect Computer-aided Diagnosis (CAD) technology successively and were used for cross-sectional study. The corresponding benign and malignant judgment results were obtained, and the efficacy of individual diagnosis and combined diagnosis were compared and analyzed.Results:Conventional ultrasound, SR, S-Detect alone and conventional ultrasound+SR, conventional ultrasound+S-detect, conventional ultrasound + S-detect +SR combined diagnosis of breast tumors, the area under the receiver operating curve (AREA under the receiver operating curve) Characteristic curve, AUC) were 0.776, 0.839, 0.802, 0.861, 0.832 and 0.870, respectively. SR, S-Detect, conventional ultrasound +SR, conventional ultrasound + S-detect and conventional ultrasound +SR+ S-detect were compared with conventional ultrasound group, Z values were 1.49, 0.70, 2.76, 2.52, 2.96, respectively, and P values were 0.137, 0.484, 0.006, 0.012 and 0.003, respectively. The difference was statistically significant. The accuracy of conventional ultrasound +S-Detect+SR was the highest (84.1%), compared with pathological results, its Kappa value was 0.687, showing the strongest consistency. Conclusion:S-detect combined with strain elastography assisted by conventional ultrasound can significantly improve the diagnostic efficiency of benign and malignant breast tumors.

Population-based study: breast cancer mortality trend in women in the state of Paraná from 2000 to 2017

Objective: Breast cancer is one of the main challenges in Brazilian public health due to the high associated mortality. Mortality has different patterns according to age group, usually increasing with age. The demographic stability in Paraná, with the growth of the elderly population, has a direct impact on the epidemiology of this disease. This study aimed to assess, on a population-based basis, the rates and trends of mortality from breast cancer among the age groups of women in the state of Paraná from 2000 to 2017. Methods: A statistical descriptive retrospective series study was carried out to analyze, on a population-based basis, the trend in breast cancer mortality rates among the age groups of women in the state of Paraná, from 2000 to 2017. The trend analysis of annual mortality rates was carried out through the software and simple linear regression models. Results: The population-based analysis showed that women aged 45­54 and 55­64 years had the highest number of deaths during the study period. However, when calculating the mortality rates by age group, it was observed that the mortality pattern increases proportionally to the longevity of the female population in the state. Trend analyses indicated an upward trend in mortality among women aged 25­34 years throughout the study period. The same trend was observed in women aged 35­44 years, but in a shorter period, from 2005 to 2017. Conclusion: Mortality rates, per 100,000 women, were directly proportional to age, increasing with age, indicative of greater mortality from the disease in elderly women. There was a trend of increasing mortality, with statistical significance, in the age groups from 25 to 34 and 35 to 44. The others were considered stable trends.

Preliminary research on breast cancer organoids as a radiobiological model / 中华放射肿瘤学杂志

Objective:To construct breast cancer organoid culture system and conduct histological characterization and preliminary radiobiological characteristics study.Methods:Different molecular types of breast cancer cell lines and patient-derived tumor cells were cultured in vitro to form breast cancer organoids and characterize their tissue structure. In addition, Ki-67, ER, PR and Her2 markers were evaluated by immunohistochemical staining. Breast cancer organoids were irradiated with 4 Gy and 8 Gy. The numbe and diameter changes of breast cancer organoids at 0, 24, 48 and 96 h after irradiation were observed to evaluate the irradiation-induced damage to the organoids. Results:Breast cancer cell lines and patient-derived tissues formed organoid structures at 6 d. HE staining showed the microstructures, and the expression profile of markers was spatially heterogeneous. The expression patterns of markers were similar between patient-derived organoids and original tumor tissues. Irradiation of MCF-7 breast cancer organoids led to growth arrested, and some of the formed organoids collapsed and the proliferating trend gradually recovered from 48 h to 96 h. MDA-MB-231 breast tumor organoids showed radioresistance, growth arrested, but the structures remained intact, the recovery trend was still not observed at 96 h. The tissue-derived organoids from triple-negative patients also showed radiation tolerance. After irradiation, the organoids continued to grow without significant structural changes, whereas the growth trend was significantly smaller than that in the non-irradiated group.Conclusions:Breast cancer organoids formed by in vitro culture of breast cancer cells from different sources and different molecular types have microstructure and heterogeneity, which can reflect the expression of source tissue markers and show different radioresistance. Organoids derived from triple-negative breast cancer are more resistant to irradiation.

Structurally defined tandem-responsive nanoassemblies composed of dipeptide-based photosensitive derivatives and hypoxia-activated camptothecin prodrugs against primary and metastatic breast tumors

Substantial progress in the use of chemo-photodynamic nano-drug delivery systems (nano-DDS) for the treatment of the malignant breast cancer has been achieved. The inability to customize precise nanostructures, however, has limited the therapeutic efficacy of the prepared nano-DDS to date. Here, we report a structurally defined tandem-responsive chemo-photosensitive co-nanoassembly to eliminate primary breast tumor and prevent lung metastasis. This both-in-one co-nanoassembly is prepared by assembling a biocompatible photosensitive derivative (pheophorbide-diphenylalanine peptide, PPA-DA) with a hypoxia-activated camptothecin (CPT) prodrug [(4-nitrophenyl) formate camptothecin, N-CPT]. According to computational simulations, the co-assembly nanostructure is not the classical core-shell type, but consists of many small microphase regions. Upon exposure to a 660 nm laser, PPA-DA induce high levels of ROS production to effectively achieve the apoptosis of normoxic cancer cells. Subsequently, the hypoxia-activated N-CPT and CPT spatially penetrate deep into the hypoxic region of the tumor and suppress hypoxia-induced tumor metastasis. Benefiting from the rational design of the chemo-photodynamic both-in-one nano-DDS, these nanomedicines exhibit a promising potential in the inhibition of difficult-to-treat breast tumor metastasis in patients with breast cancer.

Progress of studies on anti-breast tumor mechanism of alkaloids / 中国中药杂志

Breast tumor has become one of the malignant tumors with the highest incidence, and is a serious threat to human health, especially to women. Chemotherapy is an important anti-breast tumor therapy, which can be used in almost every stage of breast tumor therapy alone or in the combination with surgery and radiation therapy. Alkaloids are a kind of ubiquitous natural products, and important active components of various medicinal plants. A large number of studies have shown that alkaloids could exert an anti-breast tumor effect by inhibiting proliferation, metastasis and angiogenesis, resisting mitosis, promoting apoptosis and autophagy, and triggering cell cycle arrest. The extensive anti-breast tumor effect makes alkaloids an important candidate drug source. This paper reviews the anti-breast tumor mechanism of natural products of alkaloids.

Biomarkers: An Important Tool for Diagnosing and Treating Breast Cancer

Breast cancer is a type of tumor in which individual cases deviate from each other in morphology, protein expression, molecular phenotype, genetic characteristics, and prognosis. Worldwide, breast cancer is the most-common invasive cancer in women. A patient with breast cancer may have the following symptoms:-lumps, skin dimples, nipple discharge, nipple height, nipple withdrawal, pain and burning sensation. There are many causes and risks of breast cancer, including family history (heriditary), obesity, active smoking, early and late childbearing, breastfeeding for less than two weeks, exposure to estrogen and oral contraceptive pills. Most breast cancers are diagnosed through estrogen receptor (ER) -positive determination and rely on estrogen for cell growth and survival. Breast cancer treatment has encountered a few progressions in the previous decades with the revelation of explicit prescient prognostic biomarkers that make conceivable the use of individualized treatments.Blocking estrogen biosynthesis by aromatase inhibitors (AI) has, subsequently, become a first-line endocrine treatment for menopausal ladies with ER-positive breast disease. Various conventional diagnosing and treating methods of breast cancer is available but there have limitation of accuracy and treating. For that reason now a day’s various biomarkers like Molecule or Biochemical biomarkers like Estrogen receptor, Progesterone receptor, human epidermal growth factor receptor 2 (HER2), human Mammaglobin(H-MAM), Osteopontin, Fibroblast Growth Factor Receptor 2 (FGFR2), Phosphatase and tensin homolog (PTEN), Physiologic Biomarkers like Carcinoma Antigen 15-3(CA 15–3), Cancer Antigen 125 (CA 125), Prostate specific antigen (PSA) and Anatomic Biomarkers Oncotype Dx, and Cystic fibrosis Trans-membrane conductance regulator(CFTR). These biomarkers are of great importance in the evaluation and diagnosis process, which leads to better patient’s care and protection of the patients. Due to its various advantages, biomarkers are considered as an innovative tool in the progression of breast cancer diagnosis and treatment.

Avaliação dos efeitos da Suplementação do Ácido Graxo ômega 3 em modelo de tumor de mama murino e mucosite induzida por 5-Fluouracil / Evaluation of the effects of Omega 3 Fatty Acid Supplementation in a model of murine breast tumor and mucositis induced by 5-Fluouracil

O ômega 3 é um ácido graxo poliinsaturado utilizado como agente terapêutico no tratamento de diversas doenças. Evidências sugerem efeito anti-inflamatório com sua utilização. A escolha do tratamento eficiente que minimize os efeitos adversos do tratamento oncológico tem sido desafiadora para a prática clínica. Dessa forma, ele seria interessante na prevenção e / ou tratamento da mucosite, uma inflamação que acomete as mucosas da boca ao ânus, decorrente da utilização de quimioterápico e radioterápico. As consequências deste agravo vão desde a perda de peso, anorexia e odinofagia, ao aumento do risco de translocação bacteriana, em virtude do aumento da permeabilidade intestinal (PI). Tais complicações podem levar à interrupção do tratamento quimioterápico até que o paciente se restabeleça. Trabalhos anteriores do nosso grupos de pesquisa demonstraram que o ômega 3 foi capaz de atenuar a perda de peso e reduzir a PI pela regulação da apoptose de células intestinais. Entretanto, possíveis efeitos da suplementação do ômega 3 no tumor não foram investigados. O presente estudo avaliou o efeito deste composto na mucosite induzida por quimioterápico em modelo de tumor de mama murino. Para tanto, camundongos Balb/c foram divididos nos grupos controle (CTL), controle tumor (CTLTU), tumor ômega 3 (TUW3), tumor 5-fluouracil (TU5FU) e tumor 5-fluouracil ômega 3 (TU5FUW3). Nos animais dos grupos com tumor foi realizada a inoculação das células tumorais (dia 1) e, uma vez que os tumores já se encontravam palpáveis (dia10), os grupos TUW3 e TU5FUW3 iniciaram a suplementação com ômega 3 pela ração por 10 dias, enquanto os demais animais receberam ração controle. Ao final desse período, os animais dos grupos TU5FU e TU5FUW3 receberam injeção intraperitoneal de 5-FU (300mg/kg) para indução da mucosite, enquanto os demais animais receberam a injeção de solução salina. Após 72 horas, os animais foram eutanasiados para coleta de dados. A suplementação com ômega 3 não foi capaz de prevenir a perda de peso em decorrência da mucosite. Entretanto, os animais do grupo TU5FUW3 apresentaram redução da PI por meio da recuperação das junções firmes ZO-1 e ocludina, além da preservação da arquitetura dos vilos. Os animais do grupo CTLTU também apresentaram aumento da PI e redução da expressão das proteínas de junção, provavelmente pela liberação de citocinas TNF-α e IL-1ß, conforme dosagem destas no baço. Nos animais suplementados com ômega 3 foi observado redução do tamanho do tumor e do número de metástases tumorais, além de redução da proliferação de células tumorais e aumento da afinidade das células tumorais ao quimioterápico, levando à apoptose destas. Este processo de citotoxicidade seletiva foi observado pela redução da toxicidade hepática. Diante desses resultados, pode-se concluir que a suplementação de ômega 3, por período de dez dias, foi capaz de atenuar os efeitos da mucosite induzida por quimioterápico, sem causar prejuízo à sua atividade antitumoral.

Omega 3 is a polyunsaturated fatty acid used as a therapeutic agent in the treatment of various diseases. It is widely accepted that its use can exert an anti-inflammatory effect. Thus, it would be interesting in the prevention and treatment of mucositis, which is described as an inflammation that affects mucosal membranes from the mouth to the anus, due to the use of chemotherapy and radiotherapy. Patients who suffer from this outcome, usually presents weight loss, anorexia and odynophagia,also there is an increased risk of bacterial translocation, due to the increase of the intestinal permeability (IP). Such complications can lead to the interruption of chemotherapy treatment until the patient is recovered. Previous work has shown that omega 3 was able to reduce weight loss and reduce IP by reducing intestinal cell apoptosis. However, the effects of omega 3 supplementation from the diet on the tumor remains unknown. This study aimed to investigate the effect of this compound on chemotherapy-induced mucositis in the murine breast tumor model. For that, BALB/ c mice were divided into the control (CTL), tumor control (CTLTU), omega 3 tumor (TUW3), 5-fluouracil tumor (TU5FU) and 5-fluouracil omega 3 tumor (TU5FUW3) groups. Tumor cells were inoculated (day 1) and, since they were already palpable (day 10), groups TUW3 and TU5FUW3 started receiving the chow supplemented with omega 3 for 10 days, while the other animals received control chow. At the end of this period, animals from groups TU5FU and TU5FUW3 received an intraperitoneal injection of 5-FU (300mg / kg) to induce mucositis, while the other animals received an injection of saline. After 72 hours, all animals were euthanized for data collection. Omega 3 supplementation was not able to prevent weight loss due to mucositis. However, animals from TU5FUW3 group showed a reduction in IP by recovering the tight-junctions ZO-1 and occludin, and by preventing the mucosal damage. Animals from CTLTU group also showed increased PI and reduced expression of tight-junction proteins, probably due to the release of cytokines TNF-α and IL-1ß, according to their dosage in the spleen. In addition, our results have demonstrated that animals supplemented with omega 3, have shown a reduction in the size of the tumor and the number of metastasis in lungs. We have found that the reduction was mediated through a reduction in the proliferation of tumor cells and also by an increased affinity of tumor cells to the chemotherapeutic drug, leading to their apoptosis. This selective cytotoxicity process leads to the reduction of liver toxicity. Given these results, we can conclude that omega 3 supplementation, for ten days, was able to attenuate the effects of chemotherapy-induced mucositis, without causing damage to its antitumor activity.

Accuracy of ultrasound-guided core-needle biopsy confronted with pathological findings and comparison of its costs with vacuum-assisted biopsy's costs

Introduction: Breast cancer screening has enhanced early­stage diagnosis by detection of impalpable tumors which require histopathological evaluation. Main percutaneous biopsy types are core-needle biopsy (CNB) and vacuum-assisted biopsy (VAB). CNB is less invasive and related to less bleeding and pain. VAB allows larger tissue samples and permits metal clip placement in biopsy bed for posterior localization in case of surgery. Access to VAB is restricted in Brazil due to its high costs. Objectives: To evaluate the agreement between pathological results of ultrasound (US) guided CNB with metal clip placement and surgery and settle false negative rates (FNR), sensibility, specificity, and accuracy of this method, for breast lesions < 20 mm. Methods: 388 US-guided CNB were retrospectively reviewed. Results: Surgical excision was performed in 317 patients. Overall FNR was 9.8%, (5.2% for lesions 10­20 mm), sensibility 90.2% (94.8% for lesions 10­20 mm), specificity 94.9% (94.1% for lesions 10­20 mm), and accuracy 91.1% (94.7% for lesions 10­20 mm). Cost of VAB varies from 2.2 to 12.5 times US-guided CNB. With metal clip placement, VAB costs 1.95 to 5.2 times US-guided CNB. Conclusions: For lesions that can be identified in US, CNB with metal clip placement has high sensitivity, specificity, and accuracy, as well as low FNR.

Accuracy of ultrasound-guided core-needle biopsy confronted with pathological findings and comparison of its costs with vacuum-assisted biopsy's costs

Introduction: Breast cancer screening has enhanced early­stage diagnosis by detection of impalpable tumors which require histopathological evaluation. Main percutaneous biopsy types are core-needle biopsy (CNB) and vacuum-assisted biopsy (VAB). CNB is less invasive and related to less bleeding and pain. VAB allows larger tissue samples and permits metal clip placement in biopsy bed for posterior localization in case of surgery. Access to VAB is restricted in Brazil due to its high costs. Objectives: To evaluate the agreement between pathological results of ultrasound (US) guided CNB with metal clip placement and surgery and settle false negative rates (FNR), sensibility, specificity, and accuracy of this method, for breast lesions < 20 mm. Methods: 388 US-guided CNB were retrospectively reviewed. Results: Surgical excision was performed in 317 patients. Overall FNR was 9.8%, (5.2% for lesions 10­20 mm), sensibility 90.2% (94.8% for lesions 10­20 mm), specificity 94.9% (94.1% for lesions 10­20 mm), and accuracy 91.1% (94.7% for lesions 10­20 mm). Cost of VAB varies from 2.2 to 12.5 times US-guided CNB. With metal clip placement, VAB costs 1.95 to 5.2 times US-guided CNB. Conclusions: For lesions that can be identified in US, CNB with metal clip placement has high sensitivity, specificity, and accuracy, as well as low FNR.

Multi-feature Extraction and Classification of Breast Tumor in Ultrasound Image / 中国医疗器械杂志

OBJECTIVE@#Feature extraction of breast tumors is very important in the breast tumor detection (benign and malignant) in ultrasound image. The traditional quantitative description of breast tumors has some shortcomings, such as inaccuracy. A simple and accurate feature extraction method has been studied.@*METHODS@#In this paper, a new method of boundary feature extraction was proposed. Firstly, the shape histogram of ultrasound breast tumors was constructed. Secondly, the relevant boundary feature factors were calculated from a local point of view, including sum of maximum curvature, sum of maximum curvature and peak, sum of maximum curvature and standard deviation. Based on the boundary features, shape features and texture features, the linear support vector machine classifiers for benign and malignant breast tumor recognition was constructed.@*RESULTS@#The accuracy of boundary features in the benign and malignant breast tumors classification was 82.69%. The accuracy of shape features was 73.08%. The accuracy of texture features was 63.46%. The classification accuracy of the three fusion features was 86.54%.@*CONCLUSIONS@#The classification accuracy of boundary features was higher than that of texture features and shape features. The classification method based on multi-features has the highest accuracy and it describes the benign and malignant tumors from different angles. The research results have practical value.

Bone metastasis from malignant phyllodes of the breast

Cystosarcoma phyllodes was described first in 1838 and originally was considered to be a benign tumor. It was not until 1931 that metastasis from a cystosarcoma phyllodes was reported. The incidence of cystosarcoma phyllodes is estimated to be 0.3% to 0.9% of all breast tumors. Sites most commonly affected by metastases are the lungs and bones. We present a case report  29-year old female patient presented with a voluminous breast mass at both of them  which was completely resected. The right side presented of malignant phyllodes and the left side is borderline phyllodes. Six months later, both of her legs became paralyzed and accompanied by swelling over her right upper arm. Biopsy was performed, and the diagnosis was metastatic malignant phyllodes tumor. Histologic review of the breast tumor revealed stromal overgrowth.

WT1 expression as a potential biomarker of malignancy in canine breast tumor / La expresión de WT1 como un biomarcador potencial maligno en un tumor de mama canino

SUMMARY: Veterinary oncology is very important nowadays to get a better understanding of human carcinogenesis. Estrogen receptor, progesterone receptor and Human Epidermal Growth Factor receptor 2 are frequently evaluated by immunohistochemistry (HIC) in human breast tumor. WT1 is an oncogene, its overexpression has been detected in leukemia and diverse solid tumors like breast cancer, lung cancer and mesothelioma in humans. WT1 expression was evaluated in 15 canine breast tumors (CBT) diagnosed by histopathological analysis to find its relationship with neoplasia and malignancy. IHC and RT-PCR were performed in CBT tissues. Fisher´s test was used to analyze WT1 relationship with malignancy. Of the 15 tumors, 9 (60 %) were diagnosed as benign and 6 (40 %) were malignant. With IHC, WT1 expression was positive only in biopsies diagnosed as malignant. Expression of WT1 by RT-PCR was detected in 14 of the 15 tumors (93.33 %) as well as in control healthy mammary gland. Clinical significance: This study describes for the first time a close correlation between CBT and a positive result for WT1 expression with IHC; hence, it can be used as a biomarker for this neoplasia and as an indicator of malignancy. RT-PCR analysis also showed to be good option to detect WT1 expression. These results will be useful to further investigations to elucidate WT1-related signaling pathways in CBT. Also to know molecules that regulate the translation of this protein as a marker for tumor progression.

RESUMEN: La oncología veterinaria es muy importante hoy en día para comprender mejor la carcinogénesis humana. El receptor de estrógeno, el receptor de progesterona y el receptor 2 del factor de crecimiento epidérmico humano se evalúan con frecuencia mediante inmunohistoquímica (HIC) en tumores de mama humanos. WT1 es un oncogén, su sobreexpresión se ha detectado en leucemia y en diversos tumores sólidos como el cáncer de mama, cáncer de pulmón y mesotelioma en humanos. La expresión de WT1 se evaluó en 15 tumores de mama caninos (TCC) diagnosticados mediante análisis histopatológico para encontrar su relación con la neoplasia y la malignidad. IHC y RT-PCR se realizaron en tejidos CBT. La prueba de Fisher se utilizó para analizar la relación de WT1 con la malignidad. De los 15 tumores, 9 (60 %) fueron diagnosticados como benignos y 6 (40 %) fueron malignos. Con IHC, la expresión de WT1 fue positiva solo en biopsias diagnosticadas como malignas. La expresión de WT1 por RT-PCR se detectó en 14 de los 15 tumores (93,33 %), así como en el control de la glándula mamaria sana. Importancia clínica: este estudio describe por primera vez una estrecha correlación entre la TCC y un resultado positivo para la expresión de WT1 con IHC; por lo tanto, se puede utilizar como un biomarcador para esta neoplasia y como un indicador de malignidad. El análisis por RT-PCR también demostró ser una buena opción para detectar la expresión de WT1. Estos resultados serán útiles para futuras investigaciones para dilucidar las vías de señalización relacionadas con WT1 en la TCC. También para conocer moléculas que regulan la traducción de esta proteína como marcador de progresión tumoral.

Two cases of granular cell tumor of the breast / 中华内分泌外科杂志

To investigate the clinicopathologic features of granular cell tumor(GCT) of the breast in order to make a diagnosis and give treatment strategy of this disease.Two cases of granular cell tumor (GCT) of the breast were reported,and the clinical presentation,pathological examination and surgical procedure were analyzed.Clinical presentations were atypical,and the tumor was characterized by clear or ill-defined boundary,abundant cytoplasm,full of eosinophilic granular,and infiltrative growth.Immunohistochemical study revealed that tumor cells were positive with S-100,CD68 and vimentin but negative with cytokeratin (CK) and epithelial membrane antigen(EMA).GCT of the breast is rare,most of which is benign tumor that may be misdiagnosed as malignancy.Wide resection is the main curative treatment.The prognosis is good.The understanding of this disease should be strengthened to avoid being operated excessively.Long-term follow-up should be performed.

Effect of para areola incision on the cosmetic surgery of multiple benign breast lumps / 中国基层医药

Objective To investigate the effect of para areola incision on the appearance of breast after excision of multiple benign breast lumps.Methods From February 2010 to November 2017,60 females of multiple benign breast tumor underwent surgical resection in the Fifth Peoples Hospital of Datong were selected and randomly divided into study group (n =30) and control group (n =30),respectively received periareolar incision and traditional incision surgery.The operation time and operation effect were compared between the two groups.VSS was used to compare the postoperative scar score between the two groups.The satisfaction for breast shape was also compared between the two groups.Results The operation time of the study group [(25.36 ± 7.69) min] had no statistically significant difference compared with that of the control group (t =0.264,P ＞ 0.05).The incision length and the amount of bleeding in the study group were (5.86 ± 2.49) mm,(9.69 ±e 5.68) mL,respectively,which were significantly lower than those of the control group (t =8.621,P ＜ 0.05;t =2.549,P ＜ 0.05).The obvious effective rate (53.33％ vs.43.33％),effective rate (40.00％ vs.33.33％) and total effective rate (93.33％ vs.76.67％) between the study group and control group had statistically significant differences (x2 =5.264,7.127,13.267,all P ＜ 0.05).The scar and breast shape scores of the study group were better than those of the control group[VSS:(4.35 ± 1.67)points vs.(7.92 ± 2.51) points,breast appearance:(1.38 ± 0.61) points vs.(4.92 ± 1.67) points,t =7.264,6.621,all P ＜ 0.05].Conclusion The resection of breast muhiple benign masses by parareone incision has less trauma,high resection rate,concealed incision and good cosmetic effect after operation,which meets the needs of the patients.