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1.
Breast J ; 2022: 2500594, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36051469

RESUMO

Introduction: Metaplastic breast carcinoma is a rare special type of breast cancer, which has distinguished clinical characteristics. We aimed to evaluate the clinicopathological features of metaplastic breast carcinoma compared with nonspecific invasive breast carcinoma and study the prognosis of metaplastic breast carcinoma. Methods: We reviewed metaplastic breast carcinoma cases (n = 37) from January 2000 to December 2021 and nonspecific invasive breast carcinoma cases (n = 433) from January 2019 to December 2020 extracted from our institution retrospectively. The following variables were recorded, including the patients' general information, complications, T stage, expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular subtyping, lymph node status, skin or chest wall involvement, vessel carcinoma embolus, therapy modality (surgical treatments, chemotherapy, and radiotherapy), and survival. Results: Patients with metaplastic breast carcinoma had more advanced disease than patients with nonspecific invasive breast carcinoma (T stage: P=0.0011). A greater proportion of metaplastic breast carcinoma presented with triple-negative breast cancer than nonspecific invasive breast carcinoma (79.41% vs. 12.47%, P ≤ 0.001). Our study showed that the skin or chest wall invasion was more frequent in metaplastic breast carcinoma patients (11.76% vs. 1.62%, P=0.005). The 5-year survival rate for metaplastic breast carcinoma patients was 57.66% (95% CI: 0.3195∼0.7667). No local recurrence was observed while distant metastasis occurred in 33.33% of patients with metaplastic breast carcinoma. Death due to disease occurred in 24.24% of patients with metaplastic breast carcinoma. Conclusion: The majority of metaplastic breast carcinoma patients had more advanced disease and triple-negative disease than nonspecific invasive breast carcinoma patients. Also, metaplastic breast carcinoma patients had frequent skin or chest wall invasion and a high rate of distant metastasis and mortality.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Neoplasias de Mama Triplo Negativas , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Feminino , Humanos , Metaplasia , Prognóstico , Receptor ErbB-2/metabolismo , Estudos Retrospectivos , Neoplasias de Mama Triplo Negativas/patologia
3.
Zhonghua Bing Li Xue Za Zhi ; 51(9): 838-842, 2022 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-36097899

RESUMO

Objective: To investigate the expression of Ki-67 and CD34 in the differential diagnosis of ductal carcinoma in situ (DCIS) and DCIS-like invasive breast cancer (DLIBC). Methods: A total of 100 cases of DCIS and 150 cases of DLIBC diagnosed pathologically in Yantai Yuhuangding Hospital from January 2019 to March 2022 were collected. The expression of p63, CK5/6, Ki-67 and CD34 in both groups were detected by immunohistochemical (IHC) staining and evaluated. Results: The 100 cases of DCIS included 11 cases of low-grade DCIS, 28 cases of intermediate-grade DCIS and 61 cases of high-grade DCIS. IHC staining of p63 and CK5/6 showed the myoepithelial cells around cancerous duct were complete or partial absence. Ki-67 expression showed two patterns: high expression in the basal layers and scattered expression within the tumor. Most cases showed mainly high basal expression (77/100, 77%), and the proportion of this pattern was significantly different between low grade and high grade DCIS (P<0.05). All cases showed complete CD34 expression surrounding the cancerous duct with different proportion (vascular necklace) suggested small vessels proliferation. The 150 cases of DLIBC included 142 cases of invasive ductal carcinoma (IDC) (three cases of basal-like breast cancer was included), two cases of secretory carcinoma, three cases of solid papillary carcinoma, two cases of adenoid cystic carcinoma and one case of acinar cell carcinoma. Among 142 cases of IDC, 13 cases were grade Ⅰ, 77 were grade Ⅱ and 52 were grade Ⅲ. IHC staining of p63 showed complete absence of myoepithelium. CK5/6 was negative in most cases and only positively expressed within the tumor in 3 cases of basal-like breast cancer. Ki-67 indicated a scattered expression pattern within the tumor. In most cases, CD34 immunostaining showed scattered positive blood vessels within the tumor while only two cases showed incomplete expression of CD34 around the tumor (2/150, 1.3%). The different expression patterns of Ki-67 and CD34 in DCIS and DLIBC was statistically significant (P<0.05). Conclusions: The different expression patterns of Ki-67 and CD34 are helpful to distinguish DLIBC from DCIS. The appearance of "vascular necklace" with CD34 and the high expression of Ki-67 around the cancerous duct highly support the diagnosis of DCIS, and the scattered expression pattern of CD34 supports DLIBC.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Intraductal não Infiltrante , Neuroblastoma , Antígenos CD34 , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Moléculas de Adesão Celular , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67
5.
J Coll Physicians Surg Pak ; 32(9): 1196-1201, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36089720

RESUMO

OBJECTIVE: To evaluate whether there are differences in invasive micropapillary carcinoma (IMPC) and invasive ductal carcinoma-NOS (IDC-NOS) according to the clinicopathological features and prognosis including molecular subtypes. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Pathology, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey, from 2003 to 2016. METHODOLOGY: Operated breast cancer cases (58 IMPC + 326 IDC-NOS), with long-term follow-up findings (cases followed up until 2020), were reviewed. The cases, whose other component was only IDC-NOS, were included in the mixed IMPC group. The clinical features, including clinical presentation, treatments, and follow-up information were obtained from the patient clinical database. The IMPC cases included in the study were re-examined, and micropapillary tumour components were confirmed based on the criteria set by the World Health Organisation (WHO). The clinicopathological findings, recurrence, and survival data of both groups were compared. In addition, IDC-NOS was divided into the molecular subgroups and compared with IMPC cases in terms of 5-year overall survival (OS). RESULTS: There was no significant difference between the two groups for the distribution of molecular subtypes. There was a statistically significant difference among the nuclear grade, tumour size, nodal status, lymphovascular, and perineural invasion. In the first 5-year period, the OS rate for IDC-NOS and IMPC was 90.8% and 86.2% (p<0.05). The 5-year OS rate of luminal A, luminal B, HER2, triple negative (TN), and IMPC patients was 97.6%, 91.3%, 90%, 70%, and 86.2%, respectively (p<0.05). The OS rate in patients with TN and IMPC was similar which was found significantly lower than the other groups (luminal A, luminal B, and HER2). The median OS was 51.3 months and 53.9 months for the patients with TN and IMPC, respectively (p<0.001). This difference disappeared in the 10th and 15th years of follow-up. CONCLUSION: The majority of the deaths in IMPC occurred within the first 5 years. The 5-year OS rates were similar in the TN and IMPC patients. The survival pattern of IMPC is parallel with TN, Therefore, clinical, therapeutic, and prognostic evaluation in IMPC can be done like TN. KEY WORDS: Invasive ductal carcinoma, Invasive micropapillary carcinoma, Survival.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Papilar , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Papilar/patologia , Feminino , Humanos , Prognóstico , Estudos Retrospectivos
6.
Int J Mol Sci ; 23(16)2022 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-36012443

RESUMO

Recently, the expression of NUCB2/NESF-1 has been linked to tumor development. We report NUCB2/NESF-1 expression and its relation to clinicopathological parameters in breast cancer cells. Immunohistochemical reactions were conducted on 446 cases of invasive ductal carcinoma (IDC) and 36 cases of mastopathy. The expression of NUCB2/NESF-1 was also examined at the mRNA and protein levels in breast cancer cell lines. A statistically significant higher level of NUCB2/NESF-1 in IDC cells was noted compared to that in mastopathy samples. The level of NUCB2 expression in the cytoplasm of IDC cells decreased with the increasing degree of tumor malignancy (G). Higher NUCB2 expression was found in tumors with estrogen receptor (ER)-positive and progesterone receptor (PR)-positive phenotypes compared to that in estrogen-receptor-negative and progesterone-receptor-negative cases. Moreover, a higher expression was shown in ER(+) and PR(+) MCF-7 and T47D cell lines compared to that in triple-negative MDA-MB-468 and normal human breast epithelial cells. The analysis of the five-year survival rate indicated that a positive NUCB2/NESF-1 expression in tumor cells was also associated with longer patient survival. The study results suggest that NUCB2/NESF1 may play an important role in malignant transformation and may be a positive prognostic factor in IDC.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Carcinoma Ductal de Mama/patologia , Citoplasma/metabolismo , Feminino , Humanos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo
7.
J Med Life ; 15(6): 845-849, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35928364

RESUMO

This study investigated the alteration of tumour necrosis factor (TNF-α) and interleukin-19 (IL-19) at different clinical disease stages, lymph node metastasis, and ductal carcinoma in women with breast cancer. Serum samples were collected from 90 individuals with an age range of 25-61 years. These individuals were divided into a control group (healthy people), consisting of 31 individuals, and a breast cancer patients (BCP) group, consisting of 59 individuals. The pathological data (tumour stage, lymph node metastasis, and ductal carcinoma) was obtained from the medical record of patients and confirmed by experienced histopathology. Enzyme-linked immunosorbent assay (ELISAs) technology was used to measure the serum concentrations of IL-19 and TNF-α. The results showed significant differences (P≤0.002) in the mean of BMI, interleukin-19, and TNF-α in BCP compared to controls, while the age factor did not play an important role. The stages of breast cancer caused clear differences in the levels of TNF-α and IL-19. According to the findings, BCPs had a greater level of TNF-α in lymph node metastases than healthy persons. The concentration of serum IL-19 in BCP with lymph node metastasis was significantly different in non-lymph node metastasis patients and healthy people. Additionally, BCP with ductal carcinoma showed significant differences in the mean levels of IL-19 and TNF-α in comparison with healthy people.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Interleucinas , Fator de Necrose Tumoral alfa , Adulto , Neoplasias da Mama/sangue , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/sangue , Carcinoma Ductal de Mama/patologia , Feminino , Humanos , Interleucinas/sangue , Metástase Linfática , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/sangue
8.
Radiat Oncol ; 17(1): 119, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799256

RESUMO

PURPOSE: Pure mucinous breast cancer is a rare subtype of invasive breast cancer with favorable prognosis, in which the effect of postoperative radiotherapy remains unclear. We aimed to investigate the prognostic value of postoperative radiotherapy in women with localized pure mucinous breast cancer after lumpectomy. METHODS: We conducted a retrospective cohort study to compare the effectiveness of postoperative radiotherapy (RT) and omitting postoperative radiotherapy (non-RT) in patients with first primary T1-2N0M0 (T ≤ 3 cm) pure mucinous breast cancer who underwent lumpectomy between 1998 and 2015 using the Surveillance, Epidemiology, and End Results (SEER) database. Breast cancer-specific survival (BCSS) was compared between RT and non-RT groups using Kaplan-Meier method and Cox proportional hazards regression model. Propensity score matching (PSM) was carried out to balance cohort baselines. In addition, an exploratory analysis was performed to verify the effectiveness of RT in subgroup patients. RESULTS: Of 7832 eligible patients, 5352 (68.3%) underwent lumpectomy with postoperative RT, 2480 (31.7%) received lumpectomy without postoperative RT. The median follow-up duration was 92 months. The median age was 66 years in the RT group and 76 years in the non-RT group.The 15-year BCSS was 94.39% (95% CI, 93.08% to 95.35%) in the RT group versus 91.45%(95% CI, 88.93% to 93.42%) in the non-RT group (P < 0.001). The adjusted hazard ratio for BCSS was 0.64 (95% CI, 0.49 to 0.83; P = 0.001) for RT group versus non-RT group. After propensity score matching, similar results were yielded. Adjuvant RT reduced the 15-year risk of breast cancer death from 7.92% to 6.15% (P = 0.039). The adjusted hazard ratio for BCSS were 0.66 (95%CI, 0.47 to 0.92; P = 0.014) for RT group versus non-RT group. The benefit of RT was well consistent across subgroup patients. CONCLUSION: Among women with T1-2N0M0 (tumor size ≤ 3 cm) pure mucinous breast cancer, the addition of RT after lumpectomy was significantly associated with a reduced incidence of breast cancer death compared with non-RT, and the magnitude of benefit may be modest. This suggests that postoperative RT is recommended in the treatment of localized pure mucinous breast cancer.


Assuntos
Adenocarcinoma Mucinoso , Neoplasias da Mama , Carcinoma Ductal de Mama , Adenocarcinoma Mucinoso/radioterapia , Adenocarcinoma Mucinoso/cirurgia , Idoso , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/patologia , Feminino , Humanos , Mastectomia Segmentar , Estadiamento de Neoplasias , Radioterapia Adjuvante , Estudos Retrospectivos , Programa de SEER
9.
Cancer Res ; 82(18): 3236-3248, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-35852797

RESUMO

Ductal carcinoma in situ (DCIS) is a precursor to invasive breast cancer. The frequency of DCIS is increasing because of routine mammography; however, the biological features and intratumoral heterogeneity of DCIS remain obscure. To address this deficiency, we performed single-cell transcriptomic profiling of DCIS and invasive ductal carcinoma (IDC). DCIS was found to be composed of several transcriptionally distinct subpopulations of cancer cells with specific functions. Several transcripts, including long noncoding RNAs, were highly expressed in IDC compared with DCIS and might be related to the invasive phenotype. Closeness centrality analysis revealed extensive heterogeneity in DCIS, and the prediction model for cell-to-cell interactions implied that the interaction network among luminal cells and immune cells in DCIS was comparable with that in IDC. In addition, transcriptomic profiling of HER2+ luminal DCIS indicated HER2 genomic amplification at the DCIS stage. These data provide novel insight into the intratumoral heterogeneity and molecular features of DCIS, which exhibit properties similar to IDC. SIGNIFICANCE: Investigation of the molecular features of ductal carcinoma in situ at single cell resolution provides new insights into breast cancer biology and identifies candidate therapeutic targets and diagnostic biomarkers.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Intraductal não Infiltrante , Biomarcadores , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Intraductal não Infiltrante/genética , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Perfilação da Expressão Gênica , Humanos
10.
Ann Surg Oncol ; 29(10): 6339-6346, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35789311

RESUMO

BACKGROUND: Primary breast neuroendocrine tumors (BNETs) represent < 1% of breast cancers. Diagnosing BNETs can be challenging, and a limited amount of cohort data currently exists in literature. We aimed to describe primary BNET characteristics, treatment modalities, and survival outcomes through the National Cancer Database (NCDB). METHODS: A retrospective cohort analysis was performed using the NCDB from 2004 to 2017. BNET cases were compared with patients with invasive ductal carcinoma (IDC). A matched IDC cohort was created by matching patient age, race, and disease stage. Kaplan-Meier analysis was performed, and hazard ratios (HR) were calculated through the bootstrap sampling method. RESULTS: A total of 1389 BNET and 1,967,401 IDC cases were identified. When compared with IDC patients, BNET patients were older, had more comorbidities, and were more often male (p < 0.01). BNETs were larger, higher grade, and more frequently hormone receptor negative (p < 0.01). While BNET patients were treated with surgery and radiotherapy (p < 0.01) less often compared with IDC patients, they presented at later disease stage (p < 0.001) and received systemic treatment more frequently (53.5% vs. 40%, p < 0.01). Patients with BNET had increased mortality compared with the matched IDC cohort: stage 1 HR 1.8, stage 2 HR 2.0, stage 3 HR 1.8, and stage 4 HR 1.5 (p < 0.001 for all). CONCLUSION: Patients with BNET tend to present at higher clinical stages, are more frequently hormone receptor negative, and have inferior overall survival compared with patients with IDC. Further treatment strategies and studies are needed to elucidate optimal therapies to maximize patient outcomes.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Tumores Neuroendócrinos , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Hormônios , Humanos , Masculino , Tumores Neuroendócrinos/epidemiologia , Tumores Neuroendócrinos/terapia , Estudos Retrospectivos
11.
Ann Surg Oncol ; 29(10): 6458-6465, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35849283

RESUMO

BACKGROUND: The distinct histologic appearance of invasive lobular carcinoma (ILC) may pose diagnostic challenges for sentinel lymph node (SLN) analysis. We evaluated the impact of cytokeratin immunohistochemistry (IHC) on SLN assessment in ILC and its contribution to pathologic nodal upstaging. METHODS: We identified ILC patients treated with SLN surgery at our institution between September 2008 and August 2021. IHC for SLN assessment was employed at the discretion of the pathologist. Differences between groups evaluated with and without IHC were compared using Chi-square tests. RESULTS: Overall, 608 cases of ILC were identified in patients who underwent SLN surgery. IHC was used in 301 cases (49.5%) and was not associated with cT category, pT category, or tumor grade. Use of IHC increased detection of SLN+ disease when isolated tumor cells (ITCs) were included in the analysis (35.9% with IHC vs. 21.2% without IHC; p < 0.001). There was no effect on nodal upstaging to micrometastatic disease (pN1mi) or greater (21.9% with IHC vs. 21.2% without IHC; p = 0.82). IHC did not increase the number of positive SLNs detected (median 1 with and without IHC) nor did it increase axillary lymph node dissection (ALND) rates (11.6% with IHC vs. 15.3% without IHC; p = 0.18). CONCLUSION: IHC improved detection of pN0(i+) disease among ILC patients undergoing SLN surgery. IHC did not increase upstaging to pN1mi or higher categories of nodal disease, detection of a greater number of positive SLNs, or ALND rates. Our data suggest routine use of IHC for SLN assessment in ILC patients does not add clinical utility.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Lobular , Linfonodo Sentinela , Axila/patologia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/patologia , Feminino , Humanos , Imuno-Histoquímica , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática/patologia , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela
13.
Cancer Rep (Hoboken) ; 5(9): e1646, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35892151

RESUMO

BACKGROUND: Ductal carcinoma in situ (DCIS) is an established precursor to invasive ductal carcinoma (IDC) and its coexistence with IDC appear to favor reduced biological aggressiveness. Its prognostic implication and ability to affect clinical outcome has been understudied in Asia. This study aims to explore if concomitant DCIS affects the clinical behavior and outcomes among Asians. AIM: Stages I to III breast cancer patients with histological proven IDC, diagnosed and treated in a single institution from June 1, 2004 to June 30, 2014 were included in this study. Statistical analyses were conducted using Χ2 test, independent t test, multivariate logistic regression and Kaplan-Meier test. METHODS AND RESULTS: A total of 818 patients were identified, including 224 and 594 patients with isolated IDC (No-DCIS) and IDC with coexisting DCIS (IDC-DCIS) respectively. Patients with IDC-DCIS were found to have smaller tumors (median: 22 mm, p ≤ .01), estrogen receptor positivity (p = .001), progesterone receptor positivity (p < .001) and associated with better pathological stage (p = .001). Patients with No-DCIS were 1.6 times more likely to develop disease progression (95% CI: 1.1-2.3, p = .027) and subsequently associated with distant recurrences (20.5% vs. 13.6%, p = .02). The breast cancer specific 5 year overall survival rate for patients with No-DCIS and those with IDC-DCIS was 90.9% (95% CI: 86.2%-94.5%) and 93.7% (95% CI: 91.4%-95.5%), respectively (p = .202). CONCLUSION: The presence of DCIS component in IDC among Asians is associated with favorable tumor biological profile, thereby indicating reduced disease aggressiveness. Our study is the first to report the clinical significance in terms of disease progression and distant recurrences among Asians.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Intraductal não Infiltrante , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/terapia , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Intraductal não Infiltrante/terapia , Progressão da Doença , Feminino , Humanos , Prognóstico
14.
Ann Surg Oncol ; 29(10): 6133-6139, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35902495

RESUMO

BACKGROUND: In cN1 patients rendered cN0 with neoadjuvant chemotherapy, the false-negative rate of sentinel lymph node biopsy (SLNB) is < 10% when ≥ 3 sentinel lymph nodes (SLNs) are removed. The added value of nodal clipping in this scenario is unknown. Here we determine how often the clipped node is a sentinel node when ≥ 3 SLNs are retrieved. METHODS: We identified cT1-3N1 patients treated between 02/2018 and 10/2021 with a clipped lymph node at presentation. SLNB was performed with a standardized approach of dual-tracer mapping and retrieval of ≥ 3 SLNs. Clipped nodes were not localized; SLNs were X-rayed intraoperatively to determine clip location. Axillary lymph node dissection (ALND) was performed for any residual disease or retrieval of < 3 SLNs. RESULTS: Of 269 patients, 251 (93%) had ≥ 3 SLNs. Median age was 51 years; the majority (92%) had ductal histology; 46% were HR+/HER2-. The median number of SLNs removed was 4 (IQR 3,5). The clipped node was an SLN in 88% (220/251) of cases. Of the 31 where the clipped node was not, 13 had a positive SLN mandating ALND, and the clip was identified in the ALND specimen. In the remaining 18, where ≥ 3 negative SLNs were retrieved and an ALND was not performed, the clip was not retrieved, with no axillary failures in this group (median follow-up: 55 months). CONCLUSION: When the SLNB procedure is optimized with dual tracer and retrieval of ≥ 3 SLNs, the clipped node is an SLN in the majority of cases, suggesting that failure to retrieve the clipped node should not be an indication for ALND.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Lobular , Linfonodo Sentinela , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Lobular/tratamento farmacológico , Carcinoma Lobular/patologia , Carcinoma Lobular/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática/patologia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela/métodos
15.
Ann Surg Oncol ; 29(10): 6288-6296, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35904654

RESUMO

BACKGROUND: Reexcision after breast-conserving surgery (BCS) is costly for patients, but few studies have captured the economic burden to a healthcare system. We quantified operating room (OR) charges as well as OR time and then modeled expected savings of a reexcision reduction initiative. METHODS: We performed a retrospective cohort review of all breast cancer patients with BCS between January 1, 2016 and December 31, 2020. Operating room charges of disposable supplies and implants as well as operative time were calculated. RESULTS: During the 5-year period, the 8804 patients who underwent BCS, 1628 (18.5%) required reexcision. The reexcision cohort was younger (61 vs. 64 years, p < 0.001), more likely to have ductal carcinoma in situ (DCIS) (23.7% vs. 15.2%, p < 0.001), and had larger tumors (T1+T2 73.2% vs. 83.1%, p < 0.001). Reexcision costs represented 39% of total costs, the cost per patient for surgery was fourfold higher for reexcision patients. Reexcision operations comprised 14% of total operating room (OR) time (1848 of 13,030 hours). The reexcision rate for 54 surgeons varied from 7.2-39.0% with 46% (n = 25) having a reexcision rate >20%. A model simulating reducing reexcision rates to 20% or below for all surgeons reduced the reexcision rate to 16.2% overall. Using per procedure data, the model predicted a decrease in reexcision operations by 18% (327 operations), OR costs by 14% ($287,534), and OR time by 11% (204 hours). CONCLUSIONS: Reexcision after BCS represents 39% of direct OR costs and 14% of OR time in our healthcare system. Modest improvements in surgeon reexcision rates may lead to significant economic and OR time savings.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Intraductal não Infiltrante , Prestação Integrada de Cuidados de Saúde , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Intraductal não Infiltrante/cirurgia , Feminino , Humanos , Mastectomia Segmentar , Reoperação , Estudos Retrospectivos
16.
Med Arch ; 76(2): 149-151, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35774046

RESUMO

Background: Ectopic breast tissues (EBT) are developmental abnormality found in 1-6% of normal population. Like an orthotopic breast tissue, ectopic breast may have similar pathological changes including malignancy. Breast cancer as well as ectopic breast tissue in male are extremely rare. We present a case of ectopic breast carcinoma (EBC) in middle aged man mimicking keloid. Case report: A forty-two-year-old Indo-Aryan male referred from primary health care to the dermatology clinic with firm multi-nodular, non-tender, fleshy sessile mass on his right axilla measuring two by three cm in diameter. Excision of this lesion revealed moderately differentiated ductal carcinoma consistent with ectopic breast carcinoma. Conclusion: We report this case to shed light on such a rare condition and to keep in mind that ectopic breast carcinoma should be in differential diagnosis of any suspicious mass in axillae.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Coristoma , Queloide , Adulto , Axila/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/patologia , Coristoma/diagnóstico , Coristoma/patologia , Coristoma/cirurgia , Humanos , Queloide/diagnóstico , Masculino , Pessoa de Meia-Idade
17.
Breast Cancer Res ; 24(1): 54, 2022 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-35906698

RESUMO

BACKGROUND: Invasive lobular breast carcinoma (ILC), the second most prevalent histological subtype of breast cancer, exhibits unique molecular features compared with the more common invasive ductal carcinoma (IDC). While genomic and transcriptomic features of ILC and IDC have been characterized, genome-wide chromatin accessibility pattern differences between ILC and IDC remain largely unexplored. METHODS: Here, we characterized tumor-intrinsic chromatin accessibility differences between ILC and IDC using primary tumors from The Cancer Genome Atlas (TCGA) breast cancer assay for transposase-accessible chromatin with sequencing (ATAC-seq) dataset. RESULTS: We identified distinct patterns of genome-wide chromatin accessibility in ILC and IDC. Inferred patient-specific transcription factor (TF) motif activities revealed regulatory differences between and within ILC and IDC tumors. EGR1, RUNX3, TP63, STAT6, SOX family, and TEAD family TFs were higher in ILC, while ATF4, PBX3, SPDEF, PITX family, and FOX family TFs were higher in IDC. CONCLUSIONS: This study reveals the distinct epigenomic features of ILC and IDC and the active TFs driving cancer progression that may provide valuable information on patient prognosis.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Lobular , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/genética , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/genética , Carcinoma Lobular/patologia , Cromatina/genética , Feminino , Humanos , Fatores de Transcrição/genética
18.
Comput Math Methods Med ; 2022: 7259951, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35872946

RESUMO

The incidence and mortality rates are increasing year by year, and the incidence of the disease is gradually becoming younger. The purpose of this study was to investigate the clinical diagnostic value of PACS in breast tumor patients. Methods. 20 patients with breast tumor diagnosed by PACS were selected for the study, and the diagnosis was confirmed by pathological puncture or surgery. Results. The detection rates of breast tumor by MRI and CT were 94.44% and 96.67%, the sensitivities were 18.82% breast tumor and 96.67%, and the specificities were 53.84% and 54.54%, with no statistically significant difference (P > 0.05). There was no statistically significant difference in the detection rate of invasive lobular carcinoma (LDC) and PACS (P > 0.05). Conclusion. PACS has a greater detection rate for breast tumor and offers some diagnostic usefulness in diagnosing malignant breast tumor. The detection rate of breast tumors can be increased by selecting the most appropriate diagnostic tool for the patient's current circumstances.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Lobular , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/diagnóstico , Carcinoma Lobular/patologia , Carcinoma Lobular/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Estudos Retrospectivos
19.
Balkan Med J ; 39(4): 275-281, 2022 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-35872645

RESUMO

Background: Invasive micropapillary carcinoma (IMPC) is a rare tumor of the breast. IMPC can be classified as a pure or mixed type based on the extent of micropapillary differentiation. Aims: To evaluate the prognostic importance of the IMPC component in breast cancer through retrospective comparison of the clinicopathological characteristics and clinical outcomes of pure and mixed IMPC patients. Study Design: The data of 147 (2.2%) patients with IMPC among 6648 patients histopathologically diagnosed with invasive breast cancer between January 2000-2022 were retrospectively reviewed. The patients were assigned to two groups: pure IMPC and mixed IMPC. Methods: The clinicopathological features such as age at diagnosis, histological type, grade, size, and components of mixed carcinoma, the numbers of metastatic lymph nodes, presence of lymph vascular invasion, hormone receptor, and the Her-2 status of the tumor, T, N, M stages, and the survival rates were reviewed. The clinicopathologic features, patterns of failures, and survival rates were coded and compared between pure and mixed IMPC patients. Results: A total of 45 patients (30.6%) had pure and 102 patients (69.4%) had mixed IMPC. The median follow-up time was 46 months (3-178). The progesterone receptor positivity rate was significantly lower in the pure group than in the mixed group (66.7% vs. 83.3%, p: 0.024). In the pure and mixed groups, respectively, the 5-year overall survival was 90% and 91% (p: 0.839); progression-free survival was 70% and 77% (p: 0.537); locoregional recurrence-free survival was 86% and 95% (p: 0.043); 5-year distant metastasis-free survival was 88% and 83% (p: 0.066), and the locoregional recurrence rate was 10.3% and 2% (p: 0.052). Conclusion: Compared to the mixed IMPC, pure IMPC appears to have a more aggressive behavior with lower locoregional recurrence-free survival and more locoregional recurrences. This may be due to the low progesterone receptor positivity rate.


Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Carcinoma Papilar , Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/patologia , Feminino , Humanos , Recidiva Local de Neoplasia , Receptores de Progesterona , Estudos Retrospectivos
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