Invasive Pleomorphic-Type Lobular Carcinoma of the Breast Presenting as a Mucinous Carcinoma.

Invasive mucinous carcinoma of the breast is mostly associated with invasive carcinoma of no special type (NST) and sometimes with neuroendocrine type tumors such as solid papillary carcinoma. Extracellular mucin production in invasive lobular carcinoma (ILC) is extremely rare. To the best of our knowledge only 18 such cases have been described in the literature. Here we present a unique case of invasive pleomorphic-type lobular carcinoma (IPTLC) presenting as a mucinous carcinoma of the breast on core needle biopsy. Here we discuss the impact and ways to suspect such case.

Enhancement of breast cancer on pre-treatment dynamic contrast-enhanced MRI using computer-aided detection is associated with response to neo-adjuvant chemotherapy.

PURPOSE: To evaluate whether enhancement of breast cancer on pre-treatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as evaluated semi-quantitatively using computer-aided detection (CAD) is associated with response to neo-adjuvant chemotherapy. MATERIALS AND METHODS: A total of 84 women, (mean age, 51±10 [SD] years; range: 30-73 years) with 84 breast cancers who underwent MRI before neo-adjuvant chemotherapy were included in this retrospective study. The proportion of each type of signal intensity-time curve (SITC) (type 1: persistent; type 2: plateau; Type 3: washout) within the tumor volume was quantified semi-automatically using a CAD system (Aegis®, Sentinelle medical, Toronto, Canada) and was compared to histological features of the tumors and to pathological response to neo-adjuvant chemotherapy. RESULTS: Pathological complete response was obtained in 29 patients (35%). Proportion of SITC type 1 was greater in non-responders (P=0.019) while proportion of SITC type 3 was greater in responders (P=0.04). Sensitivity, specificity, and accuracy of proportion of SITC type 1 for the identification of incomplete response on pathology were 42% (95% CI: 29%-56%), 90% (95% CI: 73%-98%), and 59% (95% CI: 48%-70%), respectively. CONCLUSION: Proportion of SITC type 1 (persistent) in breast cancers on pre-treatment MRI as semi-automatically quantified using a CAD system is associated with absence of pathological complete response to neo-adjuvant chemotherapy with good specificity.

Establishing a clinic-based pancreatic cancer and periampullary tumour research registry in Quebec.

BACKGROUND: Enrolling patients in studies of pancreatic ductal adenocarcinoma (pdac) is challenging because of the high fatality of the disease. We hypothesized that a prospective clinic-based study with rapid ascertainment would result in high participation rates. Using that strategy, we established the Quebec Pancreas Cancer Study (qpcs) to investigate the genetics and causes of pdac and other periampullary tumours (pats) that are also rare and underrepresented in research studies. METHODS: Patients diagnosed with pdac or pat were introduced to the study at their initial clinical encounter, with a strategy to enrol participants within 2 weeks of diagnosis. Patient self-referrals and referrals of unaffected individuals with an increased risk of pdac were also accepted. Family histories, epidemiologic and clinical data, and biospecimens were collected. Additional relatives were enrolled in families at increased genetic risk. RESULTS: The first 346 completed referrals led to 306 probands being enrolled, including 190 probands affected with pdac, who represent the population focus of the qpcs. Participation rates were 88.4% for all referrals and 89.2% for pdac referrals. Family history, epidemiologic and clinical data, and biospecimens were ascertained from 91.9%, 54.6%, and 97.5% respectively of patients with pdac. Although demographics and trends in risk factors in our patients were consistent with published statistics for patients with pdac, the qpcs is enriched for families with French-Canadian ancestry (37.4%), a population with recurrent germ-line mutations in hereditary diseases. CONCLUSIONS: Using rapid ascertainment, a pdac and pat research registry with high participation rates can be established. The qpcs is a valuable research resource and its enrichment with patients of French-Canadian ancestry provides a unique opportunity for studies of heredity in these diseases.

Values of pathological analysis of lost tissue fragments in the vacuum canister during a vacuum-assisted stereotactic biopsy of the breast.

OBJECTIVE: Determine values of pathological analysis of the canister content during a vacuum-assisted breast biopsy (VABB). METHODS: Approval was obtained from the ethical committee. Prospective radiological and pathological analyses of the canister content collected during 231 VABBs performed on 231 patients were carried out. χ(2) test was used to determine predictors on canister pathology. RESULTS: The canister pathology was reported separately in 212 cases. It showed only blood in 78/212 (37%) cases and benign (including high-risk lesions) and malignant results in, respectively, 113/212 (53%) and 21/212 (10%) cases. Respective specimen analysis was benign, including high-risk lesions in 162/212 cases (76%) and malignant in 50/212 (24%) cases. Microcalcifications were documented on canister X-ray in 70/231 (30%) cases. There was significant association between the canister and the specimen pathology (p<0.0001). In none of the cases was microcalcifications seen exclusively in the canister content or pathological upgrading found in the canister content compared with the specimen. CONCLUSION: Small tissue fragments and microcalcifications may be lost in the canister during a VABB. Nevertheless, our results did not show any significant value for systematic analysis of the canister content. ADVANCES IN KNOWLEDGE: There is no added diagnostic value to retrieval and analysis of tissue lost in the canister during a VABB.

Claudin-2 is selectively enriched in and promotes the formation of breast cancer liver metastases through engagement of integrin complexes.

The liver represents the third most frequent site of metastasis in patients with breast cancer. We performed in vivo selection using 4T1 breast cancer cells to identify genes associated with the liver metastatic phenotype. Coincident with the loss of numerous tight-junctional proteins, we observe claudin-2 overexpression, specifically in liver-aggressive breast cancer cells. We further demonstrate that claudin-2 is both necessary and sufficient for the ability of 4T1 breast cancer cells to colonize and grow in the liver. The liver-aggressive breast cancer cells display a claudin-2-mediated increase in their ability to adhere to extracellular matrix (ECM) components, such as fibronectin and type IV collagen. Claudin-2 facilitates these cell/matrix interactions by increasing the cell surface expression of α(2)ß(1)- and α(5)ß(1)-integrin complexes in breast cancer cells. Indeed, claudin-2-mediated adhesion to fibronectin and type IV collagen can be blocked with neutralizing antibodies that target α(5)ß(1) and α(2)ß(1) complexes, respectively. Immunohistochemical analyses reveal that claudin-2, although weakly expressed in primary human breast cancers, is readily detected in all liver metastasis samples examined to date. Together, these results uncover novel roles for claudin-2 in promoting breast cancer adhesion to the ECM and define its importance during breast cancer metastasis to the liver.

The effect of the tarsal joint positions on the tibial nerve motor action potential latency in dog: electrophysiological and anatomical studies.

This study has been carried out to determine the effect of neutral position, hyperextension and hyperflexion of the tarsal joint on the tibial nerve, motor action potential latency and tarsal canal compartment pressure in dogs with the aid of electrophysiological and anatomical methods. Totally twenty healthy mongrel dogs were used. Latency of motor nerve action potential (MNAPL) studies of tibial nerve via surface stimulating and needle recording electrodes was performed on right hind limbs of all the dogs. The compartment pressures of the tarsal canal with the pressure transducer were determined from both limbs from ten of the dogs. In one dog, tarsal regions of both left and right limbs were demonstrated using magnetic resonance imaging (MRI). Two dogs were euthanatized and tarsal regions of the dogs were sectioned for correlative anatomy. Nerve conduction studies showed that the MNAP latency of the tibial nerve were 3.55 +/- 0.097 ms, 3.76 +/- 0.087 ms and 3.39 +/- 0.097 ms in neutral, hyperextension and hyperflexion positions, respectively. Hyperflexion of the tarsal joint caused prolongation of the MNAP latency of the tibial nerve with the highest pressure value being determined in tarsal canal. From the anatomical viewpoint, the distance between the flexor hallucis longus muscle and the superficial digital muscle was the shortest during hyperflexion and the plantar branch of saphenous artery, lateral and medial plantar nerves located more laterally in cadaver and MR imaging sections. As a result of this study, it is thought that tarsal region diseases as well as long time splint in the hyperflexion position as applied in the Ehmer sling can affect the compartment pressure and nerve tension because of occupying in the tarsal canal. Raising pressure and nerve stretching in the tarsal canal compartment could cause deficiencies in the conduction velocity of the tibial nerve. This might be a result of tarsal tunnel syndrome in the dog. Clinicians could consider this syndrome in cases of tarsal region diseases as well as application of long time splint in hyperflexion of tarsal joints in dogs.

Calcifying fibrous pseudotumor involving the neck of a five-week-old infant. Presence of factor XIIIa in the lesional cells.

Calcifying fibrous pseudotumor is an uncommon lesion characterized by hyalinized collagen, psammomatous or dystrophic calcifications, and a predominantly lymphoplasmacytic infiltrate. Although the pathogenesis is unclear, a possible relationship with other inflammatory "pseudotumors" has been proposed. We describe the pathology of two right neck calcifying fibrous pseudotumors present in a five-week-old female infant. The masses had many of the pathologic features of calcifying fibrous pseudotumor. The presence of a florid, mixed infiltrate, and the occurrence of more than one lesion in the same patient, favor the proposal that calcifying fibrous pseudotumor may be a sclerosing end stage of inflammatory myofibroblastic tumor. However, the presence of a previously undescribed participation of Factor XIIIa-positive cells suggests that the tumor may be of dermal dendrocyte origin.

Consanguineous marriages in the province of Trabzon, Turkey.

This study involved 999 married women, aged between 15 and 49, at the twelve health centres in the province of Trabzon in order to determine the ratio of consanguineous marriages, the factors affecting this situation, the ratios of abortion and the mortality of children in the first year. This ratio of consanguineous marriages was found 20 percent. The education levels of the great majority of these were low. The average age was 18. These were most frequently between children of paternal aunts and maternal uncles (39%) and these marriages, the ratio of abortion and children mortality were higher than others (P less than 0.05). Furthermore, it has been established that the kind of marriage has considerably decreased in Trabzon lately, but we believe that this reduction will be higher in the future since the education levels rapidly increase.