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1.
Chirurgia (Bucur) ; 114(5): 664-667, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31670643

RESUMO

Fibromatosis is a benign lesion of the breast that can rarely occur in men, and requires good imaging and biopsy to make a differential diagnosis to breast carcinoma. Primary breast fibromatosis predominately affects females but can rarely affect the male breast (1,2). Due toits rarity, the condition has often been confused with breast carcinoma. Significant variability has been reported regarding imaging characteristics of fibromatosis using ultrasound and MRI. MRI is particularly useful in the evaluation of tumor extent and preoperative planning (3). We report the case of a 66-year old male who presented with a palpable mass within the external quadrant of his right breast. Ultrasound-guided core needle biopsy revealed diagnosis of fibromatosis. Follow-up performed 11 months after resection demonstrated no radiographic evidence of recurrence.


Assuntos
Neoplasias da Mama Masculina/patologia , Mama/patologia , Fibroma/patologia , Idoso , Biópsia com Agulha de Grande Calibre , Mama/diagnóstico por imagem , Neoplasias da Mama Masculina/diagnóstico por imagem , Fibroma/diagnóstico por imagem , Humanos , Biópsia Guiada por Imagem , Masculino , Resultado do Tratamento , Ultrassonografia Mamária
2.
Medicine (Baltimore) ; 98(43): e17577, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651861

RESUMO

RATIONALE: Ovarian cancer often metastasizes, but it is unusual to transfer to the breast as an isolated mass. In particular, it is rare for patients to have breast metastases after 18 years of diagnosis of ovarian cancer. Therefore, accurate identification of ovarian cancer mammary gland metastasis can contribute to the treatment of the disease. PATIENT CONCERNS: This case report shows that an 82-year-old woman was diagnosed with breast metastases from ovarian cancer diagnosed 18 years ago. The patient underwent total uterine attachment, omentum, pelvic lymphadenectomy, pelvic floor tumor reduction, and chemotherapy 18 years ago. DIAGNOSIS: The pathological examination revealed metastatic adenocarcinoma. Immunohistochemical (IHC) staining results were negative for estrogen receptor (ER), progesterone receptor (PR), human epidermal receptor-2 (Her-2), and thyroid transcription factor-1 (TTF-1); and positive for cytokeratin (CK) 5/6, CK7, and CA125. INTERVENTIONS: The patient underwent breast-conserving surgery and sentinel lymph node biopsy because of breast mass in November, 2018. OUTCOMES: Currently, she has been followed for more than 1 month without any signs of recurrence. LESSONS: Breast metastatic tumors should be distinguished from primary breast tumors to avoid any unnecessary surgery. The correct diagnosis is very important: surgical treatment of patients with secondary breast cancer may be diagnostic and palliative.


Assuntos
Adenocarcinoma/secundário , Neoplasias da Mama/secundário , Neoplasias Ovarianas/patologia , Adenocarcinoma/diagnóstico , Idoso de 80 Anos ou mais , Mama/patologia , Neoplasias da Mama/diagnóstico , Feminino , Humanos , Metástase Neoplásica , Fatores de Tempo
3.
Medicine (Baltimore) ; 98(41): e17549, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593136

RESUMO

BACKGROUND: The study aimed to evaluate and compare the dosimetric parameters of incidental irradiation to internal mammary node (IMN) from inverse intensity-modulated radiotherapy (I-IMRT) and field-in-field IMRT (F-IMRT), and 3-dimensional conformal radiotherapy (3D-CRT) in patients after breast-conservation surgery (BCS). METHODS: Eighty-four patients with BCS were selected. The breast, tumor bed, and IMN, including intercostal spaces (ICS) 1 to 3, were contoured. Three plans were generated. The prescription doses for the breast and tumor bed were 50.4 Gy/28 F and 60.2 Gy/28 F, respectively. If there was no tumor bed boost, patient was treated with 50 Gy/25 F for the whole breast only. The IMN was not included in planning target volume. RESULTS: The median mean dose (Dmean) of the IMNtotal (ICS 1-3) was 2740.2 cGy, 2973.9 cGy, and 2951.4 cGy for I-IMRT, F-IMRT, and 3D-CRT, respectively. Differences were not detected between any of the plans. After separating ICS 1 to 3 for further analysis, neither of the Dmean of ICS 1 to 2 was significantly different between the plans. However, for ICS 3, the median Dmean was highest for I-IMRT, and those for 3D-CRT and F-IMRT were not significantly different. After separating the 3 techniques for further analysis, the median Dmean was highest in ICS 3 and lowest in ICS 1 for all the 3 techniques. CONCLUSION: All 3 techniques failed to attain an adequate dose to cure subclinical disease, and there were no significant differences among the 3 techniques. It is risky to avoid IMN irradiation (IMNI) using any of the 3 techniques during whole-breast radiotherapy in women with indications for elective IMNI. However, in era of systematic therapy, whether the incidental dose could meet clinical acquirements needs further follow-up.


Assuntos
Mama/cirurgia , Radiometria/métodos , Radioterapia Conformacional/efeitos adversos , Radioterapia de Intensidade Modulada/efeitos adversos , Adulto , Idoso , Mama/patologia , Mama/efeitos da radiação , Feminino , Humanos , Linfonodos/patologia , Linfonodos/efeitos da radiação , Mastectomia Segmentar/métodos , Mediastino/patologia , Mediastino/efeitos da radiação , Pessoa de Meia-Idade , Radioterapia Conformacional/métodos , Radioterapia de Intensidade Modulada/métodos , Estudos Retrospectivos , Parede Torácica/efeitos da radiação
4.
Medicine (Baltimore) ; 98(39): e17061, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574804

RESUMO

To study the imaging and clinical features of breast sclerosing adenosis (SA), and to enhance the recognition of this disease, as well as to help the clinic to give a correct diagnosis.Imaging findings were retrospectively reviewed in 47 women with SA lesions confirmed by pathology (including 39 cases of mammography, 40 cases of ultrasound [US], and 34 cases magnetic resonance imaging [MRI]).Of 47 patients confirmed with SA, 18 cases were pure SA, and 29 cases coexist with other proliferative lesions and malignancies; the maximum diameter of SA lesions was 0.5 to 3.5 cm with an average of 1.6 cm. On the mammogram of 39 SA cases, the percentage of architectural distortion, calcifications, mass/nodular, asymmetric density, and mass combining with calcifications were 30.8%, 23.1%, 17.9%, 12.8%, and 7.7%, respectively; and 3 cases had no abnormal findings. On the sonogram (excluding 5 normal finding cases), the majority of lesions showed regular shaped (57.1%), well defined margined (60.0%), heterogenous low echoed (71.4%) nodulus. 85.3% lesions showed high signal on T2-weighted images, and all lesions were enhanced markedly, including 82.4% lesions appearing mass-like enhancement (17 star-shaped enhanced masses included); and the percentage of the time-signal intensity curve in type 1, type 2, and type 3 were 52.9%, 41.2%, and 5.9%, respectively. If the category breast imaging-reporting and data system ≥4b was considered to be a suspicious malignant lesion, the misdiagnostic rates of mammography, US, and MRI would be 17.9%, 17.5%, and 35.3%, respectively.The SA lesions are small and can occur with other diseases histologically. The majority of SA lesions showed distortion or calcifications on mammograms, low echo-level nodules with heterogenous echo on US and mass-like lesion with or without star shape on enhanced MRI.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Doenças Mamárias/patologia , Mama/diagnóstico por imagem , Mama/patologia , Adulto , Idoso , Calcinose/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Mamografia , Pessoa de Meia-Idade , Estudos Retrospectivos , Esclerose/diagnóstico por imagem , Ultrassonografia Mamária
5.
Isr Med Assoc J ; 21(10): 666-670, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599508

RESUMO

BACKGROUND: Male breast cancer (MBC) is a rare disease representing less than 1% of breast cancers. In the absence of a screening program, such as for females, the diagnostic workup is critical for early detection of MBC. OBJECTIVES: To summarize our institutional experience in the workup of male patients referred for breast imaging, emphasizing the clinical, imaging, and histopathological characteristics of the MBC cohort. METHODS: All male patients who underwent breast imaging between 2011 and 2016 in our institution were retrospectively reviewed. Clinical, radiological, and histopathological data were collected and statistically evaluated. All images were reviewed using the American College of Radiology Breast Imaging Reporting and Data System. RESULTS: 178 male patients (average age 61 years, median age 64), underwent breast imaging in our institution. The most common indication for referral was palpable mass (49%) followed by gynecomastia (16%). Imaging included mostly mammography or ultrasound. Biopsies were performed on 56 patients, 38 (68%) were benign and 18 (32%) were malignant. In all, 13 patients had primary breast cancer and 5 had metastatic disease to the breast. Palpable mass at presentation was strongly associated with malignancy (P = 0.007). CONCLUSIONS: Mammography and ultrasound remain the leading modalities in breast imaging among males for diagnostic workup of palpable mass, with gynecomastia being the predominant diagnosis. However, presentation with palpable mass was also associated with malignancy. Despite a notable MBC rate in our cohort, the likelihood of cancer is low in young patients and in cases of gynecomastia.


Assuntos
Neoplasias da Mama Masculina/diagnóstico por imagem , Neoplasias da Mama Masculina/patologia , Ginecomastia/diagnóstico por imagem , Ginecomastia/patologia , Mamografia/métodos , Ultrassonografia Mamária/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Mama/diagnóstico por imagem , Mama/patologia , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Medicine (Baltimore) ; 98(37): e17082, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517829

RESUMO

To compare the accuracy of breast lesion size measurement of cone-beam breast-CT (CBBCT), digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM).Patients scheduled for mastectomy due to at least 1 malignant breast lesion were included. Mastectomy specimens were examined by CBBCT, DBT, FFDM, and histopathology.A total of 94 lesions (40 patients) were included. Histopathological analyses revealed 47 malignant, 6 high-risk, and 41 benign lesions. Mean histopathological lesion size was 20.8 mm (range 2-100). Mean absolute size deviation from histopathology was largest for FFDM (5.3 ±â€Š6.7 mm) and smallest for CBBCT 50 mA, high-resolution mode (4.3 ±â€Š6.7 mm). Differences between imaging modalities did not reach statistical significance (P = .85).All imaging methods tend to overestimate breast lesion size compared to histopathological gold standard. No significant differences were found regarding size measurements, although in tendency CBBCT showed better lesion detection and cT classification over FFDM.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Tomografia Computadorizada de Feixe Cônico , Mamografia , Idoso , Mama/diagnóstico por imagem , Mama/patologia , Mama/cirurgia , Neoplasias da Mama/cirurgia , Humanos , Interpretação de Imagem Assistida por Computador , Mamografia/métodos , Mastectomia , Estudos Prospectivos , Estudos Retrospectivos , Carga Tumoral
8.
Magy Seb ; 72(3): 103-106, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31544483

RESUMO

Introduction: Two cases of idiopathic granolomatous mastitis were diagnosed by histological examination in our Surgical Department in 2017. The idiopathic granulomatous mastitis is a rare, benign inflammatory laesion of the breast which can mimic malignancy in it's clinical appearance. We would like to draw attention to this differential diagnostic problem based on the cases of our Surgery Department.


Assuntos
Mastite Granulomatosa/patologia , Adulto , Mama/patologia , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Mastite Granulomatosa/cirurgia , Humanos , Doenças Raras
9.
Anticancer Res ; 39(8): 4031-4041, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366485

RESUMO

BACKGROUND/AIM: Eribulin is currently used to treat advanced and metastatic breast cancer in the clinical setting; however, its efficacy is inhibited by resistance acquisition in many cases. Thus, the present study established two eribulin-resistant breast-cancer cell lines, and used these to investigate the mechanisms that underly eribulin-resistance acquisition. MATERIALS AND METHODS: Eribulin-resistant breast-cancer cell lines were generated by culturing MDA-MB-231 and MCF-7 cells with increasing concentrations of eribulin. RESULTS: The eribulin-resistant cells acquired resistance to eribulin, as well as several other anticancer drugs. After eribulin treatment, the eribulin-resistant cell lines showed no morphological change, no increased expression of epithelial-cadherin, nor any significant alteration in cell-cycle distribution. In contrast, the expression levels of programmed death-ligand 1 were increased in the MCF-7/eribulin-resistant compared to MCF-7 cells. CONCLUSION: The herein developed eribulin-resistant cell lines acquired cross-resistance to various anticancer agents, and displayed resistance to eribulin-induced effects on microtubule function and epithelial-mesenchymal transition (EMT).


Assuntos
Antineoplásicos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Resistencia a Medicamentos Antineoplásicos/genética , Furanos/administração & dosagem , Cetonas/administração & dosagem , Animais , Antineoplásicos/efeitos adversos , Mama/efeitos dos fármacos , Mama/patologia , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Ciclo Celular/efeitos dos fármacos , Ciclo Celular/genética , Transição Epitelial-Mesenquimal/genética , Feminino , Furanos/efeitos adversos , Humanos , Cetonas/efeitos adversos , Células MCF-7 , Camundongos , Microambiente Tumoral/efeitos dos fármacos , Ensaios Antitumorais Modelo de Xenoenxerto
10.
Anticancer Res ; 39(8): 4393-4398, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366535

RESUMO

BACKGROUND/AIM: Metastatic breast cancer (MBC) represents a wide spectrum of heterogeneous conditions with different secondary spread sites, time to relapse and biology. MBC is still considered an incurable disease despite the fact that survival rates have improved in the last years. Cutaneous metastases are a rare site for metastatic spread and indicate advanced disease. The aim of this study is to demonstrate the excellent therapeutic result following endocrine therapy only in MBC with just skin involvement. CASE REPORT: We present a case of an 82-year-old woman with no family history of breast cancer (BC), who was diagnosed with de novo metastatic estrogen/progesterone receptor-positive and HER2-negative invasive lobular BC. The only site of secondary spread was the skin. She was treated with just endocrine therapy for 116 months with which she achieved and maintained long-term complete clinical response (CR). DISCUSSION: To our knowledge this is the only case of lobular BC with de novo metastatic manifestation as multiple skin metastases, which achieved CR following the aromatase inhibitor treatment (anastrozole) with such impressive long-term overall survival.


Assuntos
Anastrozol/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Idoso de 80 Anos ou mais , Anastrozol/efeitos adversos , Inibidores da Aromatase/administração & dosagem , Mama/efeitos dos fármacos , Mama/patologia , Neoplasias da Mama/patologia , Intervalo Livre de Doença , Feminino , Humanos , Recidiva Local de Neoplasia/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/secundário
11.
Life Sci ; 234: 116777, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31465734

RESUMO

This work aimed to characterize normal, benign and malignant excised breast tissues through the analysis of the FTIR spectra of their plasma membrane proteins. Tissue characterization parameters such as peak position, peak intensity, area under the peak, relative peak intensity and relative area under peak were evaluated mainly for protein spectral peaks; 1150 cm-1, Amide I, Amide II, Amide III, and Amide A. The sensitivity, specificity and diagnostic accuracy for each parameter were obtained and Receiver Operating Characteristic (ROC) Curves were plotted. Results showed significant spectral differences between normal and benign tissues compared to malignant tissues at 1536 and 1645 cm-1. The three tissues could be distinguished at 2900 cm-1, where the malignant peak uniquely split into two separate peaks. ROC curves showed that the Amide A peak position yielded a higher accuracy compared to all other investigated characterization parameters. The deconvolution of Amide I revealed the conformational changes in plasma proteins characterizing the transformation to malignancy (a decrease in the percentage of alpha helix accompanied by an increase in the percentage of beta sheets). The use of the present structure-based analysis in conjunction with histopathological examination of excised breast tissues would offer an enhanced characterization that might reduce possible personal diagnostic mistakes.


Assuntos
Neoplasias da Mama/diagnóstico , Mama/patologia , Proteínas de Membrana/análise , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , Mama/química , Neoplasias da Mama/química , Neoplasias da Mama/patologia , Feminino , Humanos , Estrutura Secundária de Proteína
12.
Eur J Radiol ; 117: 199-208, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31307648

RESUMO

PURPOSE: We evaluated the diagnostic value of a high temporal resolution (HTR) dynamic contrast enhanced (DCE) sequence added to a FAST protocol. MATERIALS AND METHODS: 120 women (mean age = 55 years (28-88)) who underwent breast MRI between July 2016 and March 2017 and in whom a biopsy was performed (i.e., gold standard) (n = 179: 69 benign, 7 borderline and 103 malignant lesions) were retrospectively and consecutively included. Two readers classified lesions according to the Breast Imaging-Reporting and Data System (BI-RADS) by reading: a FAST protocol (T1W, T2W, T1W-fat saturated 2 min after injection) and then a FULL standard protocol. Independently they determined if lesions were visible and when (Time To Enhancement (TTE)) on the HTR-DCE sequence. An Abbreviated protocol was then built using data from the HTR-DCE sequence added to the FAST protocol. RESULTS: All lesions were visible with the FAST protocol. 171/179 (95.5%) lesions were detected by reading theHTR-DCE sequence. There were a higher number of cancers rated BI-RADS 3 (PPV of malignancy of 27.6% (8/29) in FAST versus 18.7% (3/16) FULL protocol). An early enhancement on the HTR-DCE sequence (TTE < 31 s) was associated with malignancy with an OR 5.6 (CI 95%: 3.3-20.4) (p < 0.0001). Adding a TTE < 31 s to FAST analysis (AUROC = 0.826) significantly improved lesion characterization with a diagnostic gain of 10.6% (19/179) lesions correctly reclassified (p = 0.0034) compared to FAST protocol; with shorter acquisition time (7 min 48 s versus 13 min 54 s). CONCLUSION: Adding an HTR-DCE sequence to a FAST protocol increases diagnostic performance reaching that of the FULL protocol while reducing acquisition time.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mama/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/patologia , Neoplasias da Mama/patologia , Meios de Contraste , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade
14.
Virchows Arch ; 475(3): 313-323, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31267199

RESUMO

Breast cancer is a highly heterogeneous disease. The efficacy of tailored therapeutic strategies relies on the precise detection of diagnostic biomarkers by immunohistochemistry (IHC). Therefore, considering the increasing incidence of breast cancer cases, a concomitantly time-efficient and accurate diagnosis is clinically highly relevant. Microfluidics is a promising innovative technology in the field of tissue diagnostic, enabling for rapid, reliable, and automated immunostaining. We previously reported the microfluidic-based HER2 (human epidermal growth factor receptor 2) detection in breast carcinomas to greatly correlate with the HER2 gene amplification level. Here, we aimed to develop a panel of microfluidic-based IHC protocols for prognostic and therapeutic markers routinely assessed for breast cancer diagnosis, namely HER2, estrogen/progesterone receptor (ER/PR), and Ki67 proliferation factor. The microfluidic IHC protocol for each marker was optimized to reach high staining quality comparable to the standard procedure, while concomitantly shortening the staining time to 16 min-excluding deparaffinization and antigen retrieval step-with a turnaround time reduction up to 7 folds. Comparison of the diagnostic score on 50 formaldehyde-fixed paraffin-embedded breast tumor resections by microfluidic versus standard staining showed high concordance (overall agreement: HER2 94%, ER 95.9%, PR 93.6%, Ki67 93.7%) and strong correlation (ρ coefficient: ER 0.89, PR 0.88, Ki67 0.87; p < 0.0001) for all the analyzed markers. Importantly, HER2 genetic reflex test for all discordant cases confirmed the scores obtained by the microfluidic technique. Overall, the microfluidic-based IHC represents a clinically validated equivalent approach to the standard chromogenic staining for rapid, accurate, and automated breast cancer diagnosis.


Assuntos
Neoplasias da Mama/diagnóstico , Técnicas Analíticas Microfluídicas/métodos , Microfluídica/métodos , Biomarcadores Tumorais/metabolismo , Mama/patologia , Feminino , Humanos , Imuno-Histoquímica/métodos , Hibridização in Situ Fluorescente , Antígeno Ki-67/metabolismo , Prognóstico , Receptor ErbB-2/metabolismo , Receptores Estrogênicos/metabolismo , Receptores de Progesterona/metabolismo
15.
J Clin Pathol ; 72(12): 800-804, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31350292

RESUMO

AIMS: The clinical significance of radial scar (RS)/complex sclerosing lesion (CSL) with high-risk lesions (epithelial atypia) diagnosed on needle core biopsy is not well defined. We aimed at assessing the upgrade rate to ductal carcinoma in situ (DCIS) and invasive carcinoma on the surgical excision specimen in a large cohort with RS/CSL associated with atypia. METHODS: 157 women with a needle core biopsy diagnosis of a RS/CSL with atypia and follow-up histology were studied. Histological findings, including different forms of the atypical lesions and final histological outcome in the excision specimens, were retrieved and analysed, and the upgrade rates for malignancy and for invasive carcinoma were calculated. RESULTS: 69.43% of the cases were associated with atypical ductal hyperplasia (ADH) or atypia not otherwise classifiable, whereas lobular neoplasia was seen in 21.66%. On final histology, 39 cases were malignant (overall upgrade rate of 24.84%); 12 were invasive and 27 had DCIS. The upgrade differed according to the type of atypia and was highest for ADH (35%). When associated with lobular neoplasia, the upgrade rate was 11.76%. The upgrade rate's variability was also considerably lower when considering the upgrade to invasive carcinoma alone for any associated lesion. CONCLUSIONS: The upgrade rate for ADH diagnosed on needle core biopsy with RS is similar to that of ADH without RS and therefore should be managed similarly. RS associated with lobular neoplasia is less frequently associated with malignant outcome. Most lesions exhibiting some degree of atypia showed a similar upgrade rate to invasive carcinoma. Management of RS should be based on the concurrent atypical lesion.


Assuntos
Neoplasias da Mama/patologia , Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Proliferação de Células , Células Epiteliais/patologia , Doença da Mama Fibrocística/patologia , Adulto , Idoso , Biópsia com Agulha de Grande Calibre , Diagnóstico Diferencial , Inglaterra , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Valor Preditivo dos Testes , Estudos Retrospectivos
16.
Plast Reconstr Surg ; 144(1): 9e-17e, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31246795

RESUMO

BACKGROUND: A closed-suction drain is usually inserted during tissue expander-based breast reconstruction. Prolonged duration of drain retention can disturb patients' daily lives and affect overall sociomedical costs. This study aimed to investigate factors that may influence the drainage and to identify predictors of unusually prolonged drain duration. METHODS: Patients who underwent delayed-immediate, two-stage breast reconstruction using a tissue expander between January of 2013 and July of 2017 were reviewed. Prolonged drain duration was defined as drain duration for longer than the 75th percentile of that for the entire cohort. Effects of patient- and operation-related variables on drainage and prolonged drain duration were evaluated. RESULTS: A total of 1056 cases (1002 patients) were analyzed. The median drain duration was 10 days. Drain placement for more than 12 postoperative days was observed in 256 cases (24.2 percent), classified as prolonged drain duration. Multivariate analyses demonstrated that old age, high body mass index, neoadjuvant chemotherapy, insertion of large Siltex textured tissue expanders, and greater volume of initial inflation were independent risk factors of prolonged drain duration. The size and texture of the tissue expanders and initial inflation volume retained their influence, regardless of mastectomy specimen weight. Use of acellular dermal matrix had contradictory effects according to breast size, being protective against prolonged drain duration in cases with mastectomy specimen weight greater than 400 g, and being a significant predictor for it in cases with mastectomy specimen weight less than or equal to 400 g. CONCLUSION: Several factors, including reconstructive operation-related factors, might influence drain duration following tissue expander-based breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.


Assuntos
Neoplasias da Mama/cirurgia , Drenagem/estatística & dados numéricos , Mamoplastia/efeitos adversos , Expansão de Tecido/efeitos adversos , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Mama/patologia , Neoplasias da Mama/patologia , Remoção de Dispositivo/estatística & dados numéricos , Feminino , Humanos , Mamoplastia/instrumentação , Mamoplastia/métodos , Mastectomia/métodos , Pessoa de Meia-Idade , Tamanho do Órgão , Tratamentos com Preservação do Órgão/métodos , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Fatores de Risco , Expansão de Tecido/instrumentação , Dispositivos para Expansão de Tecidos/efeitos adversos , Adulto Jovem
17.
Microb Pathog ; 135: 103566, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31252065

RESUMO

BACKGROUND: Breast cancer is one of the most common cancers in the world particularly among Iranian women. Bovine leukemia virus (BLV) is an enzootic, exogenous, and oncogenic retrovirus that causes B-cell leukosis in 1-5% of infected cattle. The current study aimed at evaluating the correlation between BLV infection and breast cancer in an Iranian population. MATERIALS AND TECHNIQUES: A total of 400 samples including 200 breast cancer-suspected tissue samples and 200 blood samples of women without breast cancer, were collected from July 2017 to October 2018 from women referred to two general hospitals in Qom Province, Iran. The nested PCR technique was performed to determine the presence of tax and gag gene of BLV in the collected samples. RESULTS: Out of 200 breast cancer-suspected tissue samples, 172 samples were malignant in terms of pathology. Other samples were reported as non-malignant and non-tumor. Based on nested PCR technique, tax and gag genes of BLV were detected in 30% and 8% of breast cancer-suspected tissue samples, respectively. The frequency of BLV in blood samples collected from women without breast cancer was 16.5% (33/200). CONCLUSION: It seems that human breast cancer and BLV infection in cattle could be associated using nested PCR technique.


Assuntos
Sangue/virologia , Mama/virologia , Infecções por Deltaretrovirus/virologia , Vírus da Leucemia Bovina/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/patologia , Neoplasias da Mama/sangue , Neoplasias da Mama/virologia , DNA Viral/análise , Infecções por Deltaretrovirus/epidemiologia , Feminino , Genes gag , Genes pX , Humanos , Irã (Geográfico)/epidemiologia , Vírus da Leucemia Bovina/genética , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase
18.
BMC Womens Health ; 19(1): 73, 2019 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182098

RESUMO

BACKGROUND: Breast angiosarcoma is rare and previous studies only focus on its pathology. This study aimed to summarize its imaging features. METHODS: Overall 17 patients pathologically confirmed with breast angiosarcoma were recruited. Eight patients underwent preoperative mammography, and 13 received preoperative MRI scan. The mammography and MRI findings were classified according to the ACR-BI-RADS-mammography/MR lexicon. RESULTS: Mammography showed that 3 cases developed diffuse asymmetry occupying two or more quadrants of the affected breast and that 5 patients had lobulated or oval masses. The 13 patients' lesions presented as diffuse and slightly/significantly high homogeneous or heterogeneous signals on T1-weighted images, while the necrotic and cystic parts had relatively low signals. The hemorrhagic lesions in 7 cases had high signals on both T1- and T2-weighted images. A hemosiderin ring at the edge of an old hemorrhagic lesion had long and short signals on the T1- and T2-weighted images, respectively. Contrast-enhanced MRI revealed that the 13 patients' lesions had significant heterogeneous enhancement. Significant enhancement was observed in the early phase, and varying degrees of concentric enhancement was seen in the delayed phase. CONCLUSIONS: The mammography findings are nonspecific. MRI scan is helpful in determining the malignancy of the lesions. Breast angiosarcoma usually shows heterogeneous signals on both T1-weighted and T2-weighted images. Due to their incomplete lumens and lack of thrombocytes, patients with angiosarcoma have a higher incidence of bleeding (nearly 50% in this study) than those with other malignant tumors. The pattern of the enhancement curve helps to distinguish this disease from the typical types of breast cancer.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/patologia , Imagem por Ressonância Magnética/métodos , Mamografia/métodos , Adulto , Idoso , Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Medição de Risco
19.
Eur J Radiol ; 116: 21-26, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31153567

RESUMO

PURPOSE: To assess the effect on reducing the out-of-plane artifacts from metal objects in breast tomosynthesis (BT) using a novel artifact-reducing reconstruction algorithm in specimen radiography. METHODS AND MATERIALS: The study was approved by the Regional Ethical Review Board. BT images of 18 partial- and whole mastectomy specimens from women with breast cancer were acquired before and after a needle was inserted close to the lesion. The images were reconstructed using both a standard reconstruction algorithm, and a novel algorithm; the latter uses pre-segmentation to remove highly attenuating artifact-inducing objects from projection images before reconstruction. Images were separately reconstructed with and without segmentation, and combined into an artifact-reduced reconstruction. Standard and artifact-reduced BT-algorithms were compared visually and quantitatively using clinical images of mastectomy specimens and a physical anthropomorphic phantom. Six readers independently assessed the visibility of the lesion with and without artifact-reduction in a side-by-side comparison. A quantitative analysis was performed, comparing the signal-difference to background ratio (SDBR) and artifact spread function (ASF) between the two reconstruction methods. RESULTS: The magnitude of out-of-plane artifacts was clearly reduced with the novel reconstruction compared to BT-images without artifact reduction. Lesion masking by artifacts was largely averted; tumour visibility was comparable to standard BT images without a needle. In 76 ± 8% (standard deviation) of cases overall, readers could confidently state needle location. The same figure was 94 ± 6% for whole mastectomy cases, compared to 62 ± 17% for partial mastectomies. With metal artifact reduction, SDBR increased by 97% in the phantom, and by 69% in the mastectomies. The artifact spread function was substantially narrower. CONCLUSION: Artifact reduction in BT using a novel reconstruction method enables qualitatively and quantitatively improved clinical use of BT when metal artifacts can be a limiting factor such as in tomosynthesis-guided biopsy.


Assuntos
Algoritmos , Artefatos , Neoplasias da Mama/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Mamografia/métodos , Biópsia , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/patologia , Feminino , Humanos , Mastectomia , Metais
20.
Eur J Radiol ; 116: 61-67, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31153575

RESUMO

The MARIA® breast imaging system is a clinical diagnostic tool that uses a hemispherical array of radiowave antennas to generate three-dimensional images of the internal breast. The system utilises the variance of dielectric contrast within the breast volume in order to identify areas of interest for further diagnostic investigation. This multicentre study of 225 patients was conducted at three trial sites and recruited women with both malignant and benign lesions. The MARIA® images from the study were read by both clinicians who had access to the patient's clinical information, as well as by 'blind' reviewers who did not. Results from the study show an overall sensitivity of 76% for the system, which was similar across benign and malignant findings, and in denser breasts. The results from this study are outlined here and discussions on ongoing and future work with MARIA® are deliberated.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Diagnóstico por Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imagem Tridimensional/métodos , Radar , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
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