MedWorm: Breast Needle Aspiration

Huber Needle

About.com Breast Cancer — Sun, 05 Feb 2012 05:00:00 +0100

Huber needles are used for IV chemotherapy. Your chemo nurse will use a Huber needle to access your implanted port. A Huber needle is designed for patient safety and comfort. Learn about Huber needles here. (Source: About.com Breast Cancer)

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Study Suggests Surgical Breast Biopsy Not Overused

Health News from Medical News Today — Fri, 03 Feb 2012 08:00:00 +0100

Contrary to earlier findings, surgical breast biopsies may not be as overused as previously thought, according to a study in the February issue of the Journal of the American College of Radiology. Surgical breast biopsies are more invasive than needle biopsies, requiring an incision and the use of general anesthesia. Results from a previous study in 2011 in a surgical journal suggested that surgery is used for 30 percent of breast biopsies, an excessive number... (Source: Health News from Medical News Today)

Surgical breast biopsy not overused, study suggests

EurekAlert! - Medicine and Health — Wed, 01 Feb 2012 05:00:00 +0100

(American College of Radiology) Contrary to earlier findings, surgical breast biopsies may not be as overused as previously thought, according to a study in the February issue of the Journal of the American College of Radiology. Surgical breast biopsies are more invasive than needle biopsies, requiring an incision and the use of general anesthesia. (Source: EurekAlert! - Medicine and Health)

Percutaneous Needle vs Surgical Breast Biopsy: Previous Allegations of Overuse of Surgery Are in Error

Journal of the American College of Radiology : JACR — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: The previously published statement in the American Journal of Surgery that 30% of breast biopsies are done surgically is erroneous. Medicare data indicate that the true surgical breast biopsy figure is somewhere between 2% and 18%. Given that the recommended rate is 10%, it seems that surgeons and radiologists are collaborating well and that surgical breast biopsy is not being overused. (Source: Journal of the American College of Radiology : JACR)

Comparative evaluation of the modified Scarff-Bloom-Richardson grading system on breast carcinoma aspirates and histopathology

CytoJournal — Tue, 31 Jan 2012 05:00:00 +0100

Conclusion : This prospective study shows that FNA smears from peripheral portion of the lesion are representative of the corresponding histopathological sections and it is possible to score and grade by SBR system on FNA smears. (Source: CytoJournal)

Harms of screening mammography for breast cancer in Japanese women.

Breast Cancer — Fri, 27 Jan 2012 05:00:00 +0100

CONCLUSIONS: The results, although preliminary, indicate the possibility that the harms of screening mammography for Japanese women are less than those for American women. PMID: 22282164 [PubMed - as supplied by publisher] (Source: Breast Cancer)

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Diagnostic value of fine-needle aspiration biopsy for breast mass: a systematic review and meta-analysis

BMC Cancer — Wed, 25 Jan 2012 05:00:00 +0100

Conclusions: FNAB is an accurate biopsy for evaluating breast malignancy if rigorous criteria are used. With regard to unsatisfactory samples, futher invasive procedures are required in order to minimize the chance of a missed diagnosis of breast cancer. (Source: BMC Cancer)

Ipsilateral hemodialysis access after axillary dissection for breast cancer

Breast Cancer Research and Treatment — Tue, 24 Jan 2012 07:35:03 +0100

Abstract Breast cancer survivors who have had axillary lymph node dissection (ALND) and who later develop end-stage renal failure may eventually require hemodialysis access. If veins available for access in the contralateral arm have been exhausted, especially after chemotherapy, the ipsilateral arm will have to be considered for access construction. There are no evidence-based guidelines for lymphedema prevention, but there are sweeping recommendations to avoid physical injury to the ipsilateral limb, including needle puncture, after ALND with or without radiotherapy. Three studies have shown little or no effect of hand surgery in producing or exacerbating lymphedema after ALND. Dialysis access guidelines recommend the use of autogenous accesses over synthetic grafts when...

Multidisciplinary Considerations in the Management of High-Risk Breast Lesions

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. A single uniform approach may not be appropriate for the management of all high-risk breast lesions. A multidisciplinary team may offer individualized treatment options for patients. (Source: American Journal of Roentgenology)

Variations in Physician Recommendations for Surgery After Diagnosis of a High-Risk Lesion on Breast Core Needle Biopsy

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Our opinion is that neither recommendation, surgical excision or follow-up, is well substantiated in the literature and that our ignorance is not serving the needs of women worldwide. The time is now for a prospective trial. (Source: American Journal of Roentgenology)

Nonsurgical Management of High-Risk Lesions Diagnosed at Core Needle Biopsy: Can Malignancy Be Ruled Out Safely With Breast MRI?

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Patients with high-risk lesions associated with the lowest likelihood of malignancy (papilloma and radial scar) and without suspicious MRI findings can safely undergo follow-up instead of surgery. Because of the low negative predictive value, however, MRI is not helpful in cases of lobular neoplasia and atypical ductal hyperplasia, and all these lesions should be excised. (Source: American Journal of Roentgenology)

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Management of Patients Diagnosed With Lobular Carcinoma in Situ at Needle Core Biopsy at a Community-Based Outpatient Facility

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. The diagnosis of LCIS at needle core biopsy, in this small study, revealed that 84% of lesions either were malignant or were atypical or high risk at surgery, of which 33% were found to be carcinoma. Our findings suggest that LCIS should be excised when noted at core biopsy. (Source: American Journal of Roentgenology)

Surgical Outcome of Biopsy-Proven Lobular Neoplasia: Is There Any Difference Between Lobular Carcinoma In Situ and Atypical Lobular Hyperplasia?

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. No statistically significant difference was found between mammographic presentation and postsurgical outcome of LCIS versus ALH lesions. Surgical excision of these lesions is recommended as long as no evident criteria are provided to differentiate those that might be associated with an underlying malignancy. (Source: American Journal of Roentgenology)

Outcome Analysis of 9-Gauge MRI-Guided Vacuum-Assisted Core Needle Breast Biopsies

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Patients with ipsilateral cancer who have additional suspicious lesions identified on MRI require careful evaluation and biopsy to exclude additional sites of cancer that may impact surgical management. (Source: American Journal of Roentgenology)

Myoid Hamartoma of the Breast that Proved Difficult to Diagnose: A case report

World Journal of Surgical Oncology — Mon, 16 Jan 2012 05:00:00 +0100

We describe the case of a 38-year-old premenopausal woman who presenting with a mass in the left breast. Mammography revealed an oval mass that was partly indistinct, and ultrasonography showed a hypoechoic mass with a slightly irregular margin. Bilateral breast dynamic magnetic resonance imaging was performed for a more detailed evaluation. The images showed rapid initial enhancement and a microlobulated margin. Because the suspicion of malignancy was strong at that time, core needle biopsy was performed. Histologically, the tumor was identified as fibroadenoma. A case of myoid hamartoma of the breast that proved difficult to diagnose is reported, and discussed with reference to the literature. (Source: World Journal of Surgical Oncology)

Mucocele-like tumor associated with ductal carcinoma in situ diagnosed as mucinous carcinoma by fine-needle aspiration cytology: report of a case

Surgery Today — Thu, 12 Jan 2012 06:43:01 +0100

We report a case of MLT associated with ductal carcinoma in situ, which was initially diagnosed as fibroadenoma by mammography and ultrasonography, and as mucinous carcinoma by fine-needle aspiration cytology. We discuss the characteristic findings of imaging and the appropriate clinical treatment of this tumor. The characteristic image first signals the possibility of this tumor, following which the diagnosis can be confirmed by pathological examination of a fully excised tumor specimen. Breast-conserving surgery is recommended because of the low risk of high-grade malignancy, even when malignancy is confirmed, and lymph node dissection may be avoided. Content Type Journal ArticleCategory Case ReportPages 1-5DOI 10.1007/s00595-011-0063-yAuthors Shoichi Kikuchi, Department of S...

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Gene expression, molecular class changes and pathway analysis after neoadjuvant systemic therapy for breast cancer.

Clinical Cancer Research — Tue, 10 Jan 2012 05:00:00 +0100

CONCLUSIONS: Our data indicates that energy metabolism related processes are up-regulated and immune related signals are depleted in residual cancers. Targeting these biological processes may represent promising adjuvant treatment strategies for patients with residual cancer. PMID: 22235097 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Fine needle aspiration cytology of nodular fasciitis presenting as a mass in the male breast: report of an unusual case

Cytopathology — Mon, 09 Jan 2012 05:00:00 +0100

(Source: Cytopathology)

Accuracy of HER2 status determination on breast core-needle biopsies (immunohistochemistry, FISH, CISH and SISH vs FISH)

Modern Pathology AOP — Fri, 06 Jan 2012 05:00:00 +0100

Authors: Laurent Arnould, Pascal Roger, Gaëtan MacGrogan, Marie-Pierre Chenard, André Balaton, Sophie Beauclair & Frederique Penault-Llorca (Source: Modern Pathology AOP)

Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast Abscesses: A Ugandan experience

BMC Research Notes — Fri, 06 Jan 2012 05:00:00 +0100

Conclusion: Ultrasound guided needle aspiration is therefore a feasible and cost effective treatment option for both lactating and non lactating breast abscesses with a diameter up to 5 cm by ultrasound in an immune competent patient (Source: BMC Research Notes)

Effects of cold ischemia and inflammatory tumor microenvironment on detection of PI3K/AKT and MAPK pathway activation patterns in clinical cancer samples

International Journal of Cancer — Wed, 04 Jan 2012 17:31:33 +0100

AbstractThe accuracy of common markers for PI3K/AKT and MAPK pathway activation in preclinical and clinical cancer biomarker studies depends on phosphoepitope stability and changes of phosphorylation under ischemia. Herein, we define conditions under which phosphoepitopespecific duplex immunohistochemistry (IHC) on formalin‐fixed, paraffin‐embedded tumor tissues (FFPET) reflects pathway activation in situ as accurately as possible, and identify activation patterns linked to mutational status, pathway dependency and tumor microenvironment in clinical tumor samples, cell culture and xenograft tissues. Systematically assessing robustness of pAKT, pERK1/2, pMEK1/2, and pmTOR detection and related markers in xenograft tissues exposed to ischemia, we show that control of preprocessing and is...

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US follow-up protocol in concordant benign result after US-guided 14-gauge core needle breast biopsy

Breast Cancer Research and Treatment — Wed, 04 Jan 2012 17:02:24 +0100

Abstract To determine the time when follow-up ultrasound (US) should begin for concordant benign lesions after US-guided 14-gauge core needle breast biopsy (CNB). This was an IRB–approved retrospective study, with a waiver of informed consent. Among 3,888 consecutive US-guided CNBs performed between August 2005 and March 2008, 1,492 breast masses in 1,309 women with concordant benign results and follow-up US after CNB were included. Their medical records were reviewed. Statistical comparisons for the result of first follow-up US and malignant rates among 6-month, 12-month, and long-term intervals were performed by using Fisher exact test. Results dichotomized for symptom, lesion size (10 mm), and CNB result (specific or not), were also analyzed. In 1,492 masses, sev...

Fine needle aspirate cell blocks are reliable for detection of hormone receptors and HER‐2 by immunohistochemistry in breast carcinoma

Cytopathology — Tue, 03 Jan 2012 05:00:00 +0100

Conclusion: Cell blocks provide a useful method of assessing ER, PR and HER‐2/neu, mainly for inoperable and recurrent cases, but consideration should be given to carrying out FISH analysis on 1+ as well as 2+ HER‐2/neu results. (Source: Cytopathology)

Pathologic diagnostic correlation with breast imaging findings: a college of american pathologists q-probes study of 48 institutions.

Archives of Pathology and Laboratory Medicine — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions.-Participation in a multidisciplinary breast conference is useful in radiologic-pathologic correlation. Active involvement by pathologists in correlating pathologic and radiologic findings is important. PMID: 22208488 [PubMed - in process] (Source: Archives of Pathology and Laboratory Medicine)

Expanded Role of Cytopathology in Breast Cancer Diagnosis, Therapy and Research: The Impact of Fine Needle Aspiration Biopsy and Imprint Cytology

The Breast Journal — Sun, 01 Jan 2012 05:00:00 +0100

(Source: The Breast Journal)

Diagnostic accuracy of ultrasonography-guided core needle biopsy for breast lesions.

Singapore Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: US-guided CNB is an accurate diagnostic alternative to surgical biopsy in patients with breast lesions detected via US, although the high underestimation rates in DCIS and high-risk lesions are still a concern. PMID: 22252182 [PubMed - in process] (Source: Singapore Medical Journal)

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The radial scar of the breast diagnosed at core needle biopsy.

Baylor University Medical Center Proceedings — Sun, 01 Jan 2012 05:00:00 +0100

In conclusion, RS or CSL diagnosed at core needle biopsy still warrants surgical excision because of the significant percentage (9%) of cases with associated malignancy. PMID: 22275773 [PubMed - in process] (Source: Baylor University Medical Center Proceedings)

The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy

European Radiology — Thu, 29 Dec 2011 06:42:30 +0100

Conclusions Breast MR imaging is potentially useful to predict the presence of occult invasion in biopsy-proven DCIS with NMLE. Key Points • MR mammography permits more precise lesion assessment including ductal carcinoma in situ • A correct diagnosis of occult invasion before treatment is important for clinicians • This study showed the potential of MR mammography to diagnose occult invasion • Treatment and/or aggressive biopsy can be given with greater confidence • MR mammography can lead to more appropriate management of patients Content Type Journal ArticleCategory BreastPages 1-10DOI 10.1007/s00330-011-...

Medullary Cancer of Breast with Atypical Features – A Case Study

Journal of Pakistan Medical Students — Thu, 29 Dec 2011 05:00:00 +0100

DISCUSSION According to the World Health Organization, over 1.2 million women are diagnosed with breast cancer annually worldwide.(1) Infiltrating ductal carcinoma is a broad entity which comprises of tumors that exhibit one or more characteristics of specific types of breast cancers. There is evidence of tubular, papillary, medullary or mucinous differentiation microscopically.(2)The etiology is still unknown. Marcus et al have suggested that BRCA1-associated tumors were more likely to be of medullary or atypical medullary type.(3) For the diagnosis of medullary carcinoma to be made, strict histopathologic criteria should be completed. Traditionally, there has been no clear consensus among pathologists of the best diagnostic parameters for classifying medullary carcinoma. Since th...

Atypical Hyperplasia on Core Biopsy: Is Further Surgery Needed?

The American Journal of the Medical Sciences — Tue, 27 Dec 2011 05:00:00 +0100

CONCLUSION: Upgrade rate to cancer after surgical excision was 11.3% of AH patients diagnosed on CNB. However, none of the variables are significant in determining the presence of malignancy associated with AH diagnosed by CNB. PMID: 22205116 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

Prevalence of the CTNNB1 mutation genotype in surgically resected fibromatosis of the breast

Histopathology — Sun, 25 Dec 2011 17:27:06 +0100

Conclusions: In the majority of cases, clinical presentation and breast imaging are highly suspicious for carcinoma. Definitive pre‐operative pathological diagnosis by core needle biopsy is difficult. CTNNB1 mutation and nuclear β‐catenin expression are frequently detected in sporadic breast fibromatoses, suggesting their potential as a useful tool to distinguish breast fibromatoses from other neoplasms. (Source: Histopathology)

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Hormone receptor and human epidermal growth factor receptor 2 status evaluation on ThinPrep specimens from breast carcinoma

Cancer Cytopathology — Sun, 25 Dec 2011 05:00:00 +0100

CONCLUSIONS:Alcohol‐based fixation seems not to affect the immunocytochemical evaluation of HR and HER2. Considering the high levels of agreement between the evaluation of HR and HER2, on both cytology specimens and on the corresponding FFPE tissue samples, the authors concluded that the TP technique can be routinely used for the biological characterization of IBC. Cancer (Cancer Cytopathol) 2012. © 2012 American Cancer Society. (Source: Cancer Cytopathology)

Med Sci Monit 2012; 18(1):BR60-67 "Apoptosis – associated genes and their role in predicting responses to neoadjuvant breast cancer treatment"

Medical Science Monitor — Thu, 22 Dec 2011 19:17:00 +0100

Conclusions: Gene expression profiling using real-time PCR assay is a valuable research tool for the investigation of molecular markers, which reflect tumor biology and treatment response. (Source: Medical Science Monitor)

Parallel Artery and Vein: Sign of Benign Nature of Breast Masses

American Journal of Roentgenology — Thu, 22 Dec 2011 05:00:00 +0100

CONCLUSION. Although the parallel artery and vein sign is an uncommon finding, it has a significant association with benign pathologic results (96.5%) with a positive likelihood ratio of 24.7. The presence of this color Doppler ultrasound finding in breast masses in BI-RADS ultrasound categories 3 and 4 reinforces the benign nature and may allow follow-up rather than biopsy in the care of some patients. (Source: American Journal of Roentgenology)

Differentiation Between Phyllodes Tumor and Fibroadenoma Using Real-Time Elastography.

Ultraschall in der Medizin — Thu, 22 Dec 2011 05:00:00 +0100

Conclusion: RTE provides a specific elastic pattern, which is sufficient for differentiating between a fibroadenoma and a phyllodes tumor. Therefore, the detection of the most suspicious lesion in women with the coexistence of multiple fibroadenomas and phyllodes tumors seems easier. PMID: 22194044 [PubMed - as supplied by publisher] (Source: Ultraschall in der Medizin)

Molecular pathology of pre-invasive breast disease in the screening setting: application in diagnosis and management

Diagnostic Histopathology — Thu, 22 Dec 2011 05:00:00 +0100

We present a review of the molecular pathology of common pre-invasive lesions of the breast particularly discussing diagnosis on needle core biopsy, their risk of progression, and clinical management following their mammographic detection. (Source: Diagnostic Histopathology)

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Aldehyde dehydrogenase 1‐positive cells in axillary lymph node metastases after chemotherapy as a prognostic factor in patients with lymph node‐positive breast cancer

Cancer — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS:The responsiveness of ALDH1‐positive cells to chemotherapy in primary and metastatic lesions and its prognostic significance were clarified in patients with breast cancer. The authors concluded that ALDH1‐positive status may represent a surrogate marker as a new concept in patients with lymph node‐positive breast cancer. Cancer 2012;. © 2011 American Cancer Society. (Source: Cancer)

Synergy in cancer treatment between liposomal chemotherapeutics and thermal ablation.

Chemistry and Physics of Lipids — Wed, 14 Dec 2011 05:00:00 +0100

Authors: Ahmed M, Moussa M, Goldberg SN Abstract Minimally invasive image-guided tumor ablation using short duration heating via needle-like applicators using energies such as radiofrequency or microwave has seen increasing clinical use to treat focal liver, renal, breast, bone, and lung tumors. Potential benefits of this thermal therapy include reduced morbidity and mortality compared to standard surgical resection and ability to treat non-surgical patients. However, improvements to this technique are required as achieving complete ablation in many cases can be challenging particularly at margins of tumors>3cm in diameter and adjacent to blood vessels. Thus, one very promising strategy has been to combine thermal tumor ablation with adjuvant nanoparticle-based chemotherapy agen...

Gene amplification of ESR1 in breast cancers ‐ Fact or fiction? A fluorescence in situ hybridization and multiplex ligation‐dependent probe amplification study

The Journal of Pathology — Tue, 13 Dec 2011 05:00:00 +0100

AbstractEstrogen receptor‐alpha (ERα), encoded by the ESR1 gene located on 6q25, is a nuclear transcription factor. Since it was reported in 2007 that more than 20% of breast cancers show ESR1 gene amplification, there has been considerable controversy about its frequency and clinical significance. We set out to assess the frequency and levels of ESR1 amplification in breast cancers. In a total of 106 breast needle biopsy specimens examined by immunohistochemistry, 78 tumors contained more than 10% ERα‐positive cancer cells. In fluorescence in situ hybridization (FISH) analysis with an ESR1‐specific probe, variously extended ESR1 signals were found in ERα‐expressing cells. Some of these were indistinguishable from large clustered signals generally accepted to mean high‐level g...

Gene amplification of ESR1 in breast cancers—fact or fiction? A fluorescence in situ hybridization and multiplex ligation‐dependent probe amplification study

The Journal of Pathology — Tue, 13 Dec 2011 05:00:00 +0100

AbstractOestrogen receptor‐alpha (ERα), encoded by the ESR1 gene located on 6q25, is a nuclear transcription factor. Since it was reported in 2007 that more than 20% of breast cancers show ESR1 gene amplification, there has been considerable controversy about its frequency and clinical significance. We set out to assess the frequency and levels of ESR1 amplification in breast cancers. In a total of 106 breast needle biopsy specimens examined by immunohistochemistry, 78 tumours contained more than 10% ERα‐positive cancer cells. In fluorescence in situ hybridization (FISH) analysis with an ESR1‐specific probe, variously extended ESR1 signals were found in ERα‐expressing cells. Some of these were indistinguishable from large clustered signals generally accepted to mean high‐level...

Atypical Ductal Hyperplasia of the Breast Diagnosed by Ultrasonographically Guided Core Needle Biopsy.

Ultraschall in der Medizin — Fri, 09 Dec 2011 05:00:00 +0100

CONCLUSION: US is useful in evaluating ADH lesions and in clarifying the indication for biopsy of these lesions. Familiarity with the frequency associated with malignancy for each feature will improve the utility of US in the work-up of these breast abnormalities. PMID: 22161618 [PubMed - as supplied by publisher] (Source: Ultraschall in der Medizin)

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Psammoma bodies in fine needle aspiration cytology of the breast: A clinicopathological study of 30 cases

Diagnostic Cytopathology — Mon, 05 Dec 2011 05:00:00 +0100

This study has looked in to the diagnostic significance of PBs in fine needle aspiration (FNAC) of breast lesions. Over a 5‐year period, FNACs of the breast were done in 4,563 subjects, of which 1,678 were diagnosed to be malignant. On review of all breast aspirates including non‐neoplastic lesions, 30 cases showed PBs to be associated with breast carcinoma (BC). Cytological features were correlated with clinical, radiological, histological, and immunohistochemical findings. All 30 aspirates and their corresponding histological sections showed varying number of PBs and nonpsammomatous bodies (NPBs). For comparison, 31 cases of age‐matched BC without PBs and NPBs in both aspirates and sections were studied. Statistical analysis using Chi‐square test was done to compare BC with and w...

Breast Cancer Q&A with Lisa Tolnitch, MD

DukeHealth.org: Duke Health Features — Thu, 01 Dec 2011 18:52:59 +0100

Lisa Tolnitch, MD, of Duke Cancer Institute answers questions about breast cancer. Can calcifications in the breast turn into cancer? Calcifications on mammography do not themselves turn into cancer. They can be a marker especially in certain patterns of an evolving cancer. Worrisome features are pleomorphic calcifications (different sizes and shapes in a group), branching forms (following the branches of a milk duct), or casting calcifications. Those features usually require a biopsy under mammogram guidance with a core needle. Is a mastectomy always the best option to treat breast cancer? Mastectomy is an option for surgical treatment. If a tumor is small, less than 4 centimeters, and does not have locally advanced features such as skin involvement, a patient can have a lumpectomy with...

microRNAs as markers of survival and chemoresistance in pancreatic ductal adenocarcinoma.

Clinical Genitourinary Cancer — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Frampton AE, Krell J, Jacob J, Stebbing J, Jiao LR, Castellano L Abstract Evaluation of: Preis M, Gardner TB, Gordon SR et al. microRNA-10b expression correlates with response to neoadjuvant therapy and survival in pancreatic ductal adenocarcinoma. Clin. Cancer Res. 17(17), 5812-5821 (2011). microRNAs (miRs) are a recently recognized class of noncoding short RNAs, 17-25 nucleotides in length, that play a role in post-transcriptional gene regulation by translational repression and/or mRNA degradation. Various miRs have been highlighted in pancreatic cancer development and metastasis, and as potential clinical diagnostic/prognostic biomarkers. Recently, studies have indicated that miRs are responsible for resistance to chemotherapeutic agents. The miR-10b has been identifie...

Performance characteristics of mucinous (colloid) carcinoma of the breast in fine-needle aspirates: observations from the college of american pathologists interlaboratory comparison program in nongynecologic cytopathology.

Archives of Pathology and Laboratory Medicine — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions.-Mucinous carcinoma in FNA was not accurately identified in a glass slide interlaboratory comparison program. We observed better performance with modified Giemsa-stained and ThinPrep slides than with Papanicolaou-stained preparations. The most common response for the benign category of mucinous carcinoma was fibroadenoma. Increased awareness of the cytologic features of mucinous carcinoma may improve accuracy in breast FNA. PMID: 22129179 [PubMed - in process] (Source: Archives of Pathology and Laboratory Medicine)

Nipple discharge in a screening programme: Imaging findings with pathological correlation

Australasian Radiology — Thu, 01 Dec 2011 05:00:00 +0100

SummaryBreastScreen Australia provides free mammographic screening for asymptomatic women over the age of 40, targeting women aged 50–69. Occasionally women will present to screening programmes with a history of nipple discharge, which is uncommonly associated with significant underlying breast disease. Seventy‐six women with a history of nipple discharge were recalled to BreastScreen Western Australia assessment centres from 2004 to 2008, of whom 72 were recalled primarily for their symptoms. Thirty‐six of these patients had pathology investigations, including 18 nipple discharge smears, 17 fine needle aspirations, 11 core biopsies and eight surgical biopsies or therapeutic resections. The biopsies found 11 intraduct papillomas and one invasive ductal carcinoma with ductal carcinoma...

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[Neoadjuvant treatment of breast cancer: Implications for the pathologist].

Annales de Pathologie — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Le Guellec S, Perallon R, Alunni JP, Charitansky H, Leaha C, Gonzalez AM, Chateau MC, Simony-Lafontaine J, Jacot W, Gutowski M, Penault-Llorca F, Dalenc F, Lacroix-Triki M Abstract These past few years, neoadjuvant strategy has taken an increasing place in the management of breast cancer patients. This strategy is mainly indicated to obtain a tumour bulk regression allowing a breast conserving surgery in patients that otherwise would have undergone mastectomy. Of note, development of new chemotherapy agents and targeted therapies has critically helped in the progress of neoadjuvant strategy as it is currently associated with better pathological response rates. In this context, the pathologist is at the crossroad of this multidisciplinary process. First, he provides on the ...

Breast Cancer Q&A with Lisa Tolnitch, MD

DukeHealth.org: Duke Health Features — Fri, 25 Nov 2011 18:19:42 +0100

Surfactant Therapy for Maternal Blood Aspiration: An Unusual Cause of Neonatal Respiratory Distress Syndrome

Indian Journal of Pediatrics — Fri, 25 Nov 2011 17:58:23 +0100

Abstract Surfactant replacement therapy is the main treatment of neonatal respiratory distress syndrome. However, surfactant therapy has been shown to be effective in the treatment of other diseases causing neonatal respiratory diseases such as pulmonary hemorrhage, meconium aspiration syndrome, pneumonia/sepsis, pulmonary edema or acute lung injury resulting a secondary surfactant deficiency (SSD). Rarely, as like as in the present patient, exogenous blood aspiration such as breast milk or formula aspiration may lead to SSD. Blood in alveolus leads to a significant biochemical and functional disturbance of the surfactant system and inhibits surfactant production. Here, the authors report a preterm infant of 33 wk gestational age with secondary surfactant deficiency d...

Successfully treated Mycobacterium abscessus mastitis: A rare cause of breast masses

Indian Journal of Medical Microbiology — Thu, 24 Nov 2011 05:00:00 +0100

We describe a patient with Mycobacterium abscessus mastitis that presented as a mass lesion and haemorrhagical discharge. It was initially diagnosed and treated as fibrocystic disease and non-specific abscess. Full recovery was obtained with combination therapy of clarithromycin, linezolid and amikacin without surgical debridement followed by several abscess aspirations. Atypical mycobacteria should be considered in diagnosis of chronic breast lesions in endemic areas. This is the first reported case of mastitis due to M. abscessus in Turkey. (Source: Indian Journal of Medical Microbiology)

Glypican-3 as a potential differential diagnosis marker for hepatocellular carcinoma: A tissue microarray-based study.

Acta Histochemica — Thu, 24 Nov 2011 05:00:00 +0100

In conclusion, our results show that GPC3 is specifically overexpressed in HCC tissue and may be regarded as a potential marker for differential diagnostic hepatocellular carcinoma. PMID: 22119409 [PubMed - as supplied by publisher] (Source: Acta Histochemica)

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Scoring to predict the possibility of upgrades to malignancy in atypical ductal hyperplasia diagnosed by an 11-gauge vacuum-assisted biopsy device: An external validation study

European Journal of Cancer — Mon, 21 Nov 2011 05:00:00 +0100

Conclusion: The scoring system was not sufficiently accurate to safely define a subset of patients who would be eligible for follow-up only and no additional treatment. These results demonstrate a lack of reproducibility in an external population. A multidisciplinary approach that correlates clinicopathological and mammographic features should be recommended for the management of these patients. (Source: European Journal of Cancer)

Nonimage‐Guided Fine Needle Aspiration Biopsy of Palpable Axillary Lymph Nodes in Breast Cancer Patients

The Breast Journal — Sun, 20 Nov 2011 05:00:00 +0100

We report the utility of office‐based, nonimaged guided fine needle aspiration of palpable axillary lymph nodes in breast cancer patients. We examine the sensitivity and specificity of this procedure, and examine factors associated with a positive fine needle aspiration biopsy result.Abstract: Although the utility of ultrasound‐guided fine needle aspiration biopsy (FNA) of axillary lymph nodes is well established, there is little data on nonimage guided office‐based FNA of palpable axillary lymphadenopathy. We investigated the sensitivity and specificity of nonimage‐guided FNA of axillary lymphadenopathy in patients presenting with breast cancer, and report factors associated with a positive FNA result. Retrospective study of 94 patients who underwent office‐based FNA of palpa...

Prediction of menopausal status from estrogen-related gene expression in benign breast tissue

Breast Cancer Research and Treatment — Fri, 18 Nov 2011 17:33:01 +0100

Abstract The utility of archived paraffin-embedded breast tissue for risk-related research is often limited by missing menopausal status data. We tested the hypothesis that breast tissue gene expression patterns can improve menopausal stratification. Healthy high-risk participants in a clinical trial underwent breast random fine-needle aspiration (rFNA); 100 ng of RNA extracted from rFNA samples was reverse-transcribed; the expression of 28 estrogen-responsive genes was evaluated by real-time PCR. True menopausal status (TMS) was determined by measurement of plasma hormones and age. Differentially expressed genes and age were analyzed by logistic regression. The accuracy of the menopause prediction was assessed using receiver-operator characteristic (ROC) analysis, an...

Evaluation of a hydrogel based breast biopsy marker (HydroMARK®) as an alternative to wire and radioactive seed localization for non‐palpable breast lesions

Journal of Surgical Oncology — Thu, 17 Nov 2011 05:00:00 +0100

ConclusionsWhile intraoperative sonographic visibility was excellent, a large number of excisions were associated with extrusion of the marker. Modifications are needed to improve acceptability of this marker for intra‐operative localization independent of pre‐operative wire or seed localization. J. Surg. Oncol © 2011 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

Ultrasound-guided fine needle aspiration cytology in staging clinically node-negative invasive breast cancer

Gynecological Surgery — Tue, 15 Nov 2011 16:56:48 +0100

Abstract The aim of this study was to evaluate the value of ultrasound (US)-guided axillary lymph node fine needle aspiration cytology (FNAC) in staging clinically node-negative invasive breast cancer. Based on retrospective data, we analyzed sensitivity, specificity, and positive and negative predictive value and efficacy of preoperative axillary US-guided FNAC. A total of 108 consecutive female patients with histological-confirmed invasive breast cancer between January 2006 and December 2010 were included. The management decisions were based on cytological results. Twenty-two patients underwent neoadjuvant chemotherapy and 86 remaining patients benefited of primary surgery. Patients with positive cytology or included in neoadjuvant regimens were scheduled for axillary ly...

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Accuracy of needle biopsy of breast lesions visible on ultrasound: Audit of fine needle versus core needle biopsy in 3233 consecutive samplings with ascertained outcomes.

Breast — Mon, 14 Nov 2011 05:00:00 +0100

CONCLUSION: FNAC and CNB were generally performed in different patients, thus our study reported indirect comparisons of these tests. Although FNAC performed well (except for relatively high inadequacy), CNB had significantly better performance based on measures of sensitivity, but this was associated with lower specificity for CNB relative to FNAC. Overall, CNB is the more reliable biopsy method for sonographically-visible lesions; where FNAC is used as the first-line test, inadequate or inconclusive FNAC can be largely resolved by using repeat sampling with CNB. PMID: 22088803 [PubMed - as supplied by publisher] (Source: Breast)

Granulomatous mastitis: is it an autoimmune disease? Diagnostic and therapeutic dilemmas

Surgery Today — Wed, 09 Nov 2011 07:02:20 +0100

Conclusions The diagnosis of GM should be made carefully to avoid a misdiagnosis. Steroid therapy should be considered based on the idea that this is an autoimmune disease. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00595-011-0046-zAuthors Leyla Özel, Department of 1st General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Istanbul, TurkeyAysun Ünal, Department of Gynecology and Obstetrics, Haydarpasa Numune Training and Research Hospital, Istanbul, TurkeyEthem Ünal, Department of 1st General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Istanbul, TurkeyMelih Kara, Department of 1st General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, ...

Flat Epithelial Atypia of the Breast on Core Needle Biopsy: An Indication for Surgical Excision

Military Medicine — Fri, 04 Nov 2011 09:28:41 +0100

(Source: Military Medicine)

Assessment of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status in the fine needle aspirates of metastatic breast carcinomas

Diagnostic Cytopathology — Tue, 01 Nov 2011 04:00:00 +0100

In this study, expression of ER, PR, and HER2 was assessed by immunohistochemical study in 70 cases of metastatic breast carcinomas and HER2 gene amplification was further evaluated by fluorescence in situ hybridization (FISH) in 38 (54%) cases. Positive expression of ER and PR was seen in 42 (60%) and 16 (23%) cases of metastatic breast carcinomas, respectively. HER2 immunoreactivity was scored as 0/1+ in 39 (56%), 2+ in 10 (14%), and 3+ in 21 (30%) cases. HER2 gene amplification was seen in 20% of HER2 2+ and 64% of HER2 3+ cases. ER, PR, and HER2 status in primary breast cancers were available to comparison in 31 cases (44%). The concordance rates between metastatic and primary breast carcinomas were 81% for ER, 65% for PR and 71% for HER2. Our study demonstrates that ER, PR, and HER2 s...

A plea for the biopsy marker: how, why and why not clipping after breast biopsy?

Breast Cancer Research and Treatment — Mon, 31 Oct 2011 16:52:54 +0100

Abstract In the last decade, percutaneous breast biopsies have become a standard for the management of breast diseases. Biopsy clips allow for precise lesion localization, thus minimizing the volume of breast to be resected at the time of surgery. With the development of many imaging techniques (including mammography, sonography, and breast magnetic resonance imaging), one of the challenges of the multidisciplinary became to synthesize all informations obtained from the various imaging procedures. The use of biopsy markers after percutaneous biopsy is one of the keys for optimal patient management, helping the radiologist to deal with multiple lesions, to insure correlation across different imaging modalities and to follow-up benign lesions, helping the oncologist by marki...

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Rates of upgrade to malignancy for 271 cases of flat epithelial atypia (FEA) diagnosed by breast core biopsy

Breast Cancer Research and Treatment — Mon, 31 Oct 2011 16:52:54 +0100

Abstract Flat epithelial atypia (FEA) is a borderline lesion that might represent an early stage in the development of certain low-grade carcinomas in situ and invasive cancers. There are no guidelines on its management. Our objectives were to determine the upgrade to malignancy rate and identify a subpopulation of patients that might undergo just mammographic surveillance. We retrospectively reviewed the data for 271 FEA cases among 5,555 breast core biopsies obtained over a 7-year period (January 2003–2010). We collated clinical data (age, history of cancer, menopausal status), radiological data (lesion type, size, Bi-Rads category), technical data (number of biopsies, needle gauge, excision quality) and histological data and sought correlations between these factors a...

Measuring β‐Tubulin III, Bcl‐2 and ERCC1 Improves Pathological Complete Remission Predictive Accuracy in Breast Cancer

Cancer Science — Sun, 30 Oct 2011 23:47:55 +0100

SummaryWeekly PCb (Paclitaxel + Carboplatin) in neoadjuvant chemotherapy (NCT) for breast cancer has a high pCR (pathological complete remission) rate. The present study was to identify pCR predictive biomarkers and to test whether integrating candidate molecular biomarkers can improve the pCR predictive accuracy. 91 breast cancer patients treated with weekly PCb NCT were retrospectively analyzed. 11 candidate molecular biomarkers including Tau, β‐Tubulin III, PTEN, MAP4, Thioredoxin, multidrug resistance‐1, Ki67, p53, Bcl‐2, BAX and ERCC1 were detected by immunohistochemistry in pre‐NCT core needle biopsy specimens and analyzed the relationship between these biomarkers and pCR. Univariate analysis showed that estrogen receptor (ER), progesterone receptor (PR), molecular class...

Measuring β‐tubulin III, Bcl‐2, and ERCC1 improves pathological complete remission predictive accuracy in breast cancer

Cancer Science — Sat, 29 Oct 2011 04:00:00 +0100

Weekly PCb (paclitaxel + carboplatin) in neoadjuvant chemotherapy (NCT) for breast cancer has a high pathological complete remission (pCR) rate. The present study was to identify pCR predictive biomarkers and to test whether integrating candidate molecular biomarkers can improve the pCR predictive accuracy. Ninety‐one breast cancer patients treated with weekly PCb NCT were retrospectively analyzed. Eleven candidate molecular biomarkers (Tau, β‐tubulin III, PTEN, MAP4, thioredoxin, multidrug resistance‐1, Ki67, p53, Bcl‐2, BAX, and ERCC1) were detected by immunohistochemistry in pre‐NCT core needle biopsy specimens. We analyzed the relationship between these biomarkers and pCR. Univariate analysis showed that estrogen receptor, progesterone receptor, molecular classificat...

Accuracy of Axillary Ultrasound in the Diagnosis of Nodal Metastasis in Invasive Breast Cancer: A Review

World Journal of Surgery — Fri, 28 Oct 2011 16:58:34 +0100

Abstract Axillary lymph node status is the most important prognostic factor in early-stage breast cancer. Sentinel lymph node biopsy is used to determine the need for axillary node dissection. This technique incurs cost associated with radio-isotope administration and use of the operating room. Accordingly, there is a need to preoperatively identify patients with nodal metastases who can proceed directly to axillary dissection. Axillary ultrasound has increasingly been used to determine nodal status prior to surgery. It has been shown to be a sensitive and specific modality in the detection of nodal metastases. When combined with fine-needle aspiration, the specificity of this modality significantly increases. Here we present a current review of the usefulness of preoperat...

Pregnancy‐induced chromatin remodeling in the breast of postmenopausal women

International Journal of Cancer — Tue, 25 Oct 2011 04:00:00 +0100

AbstractEarly pregnancy and multiparity are known to reduce the risk of women to develop breast cancer at menopause. The knowledge that the differentiation of the breast induced by the hormones of pregnancy plays a major role in this protection, the present work was performed with the purpose of identifying what differentiation‐associated molecular changes persist in the breast until menopause. Core needle biopsies (CNB) obtained from the breast of 42 nulliparous (NP) and 71 parous (P) postmenopausal women were analyzed in morphology, immunocytochemistry and gene expression. Whereas in the NP breast nuclei of epithelial cells were large and euchromatic, in the P breast they were small and hypercromatic, showing strong methylation of histone 3 at lysine 9 and 27. Transcriptomic analysis p...

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An Expert Support System for Breast Cancer Diagnosis using Color Wavelet Features

Journal of Medical Systems — Tue, 18 Oct 2011 05:46:49 +0100

Abstract Breast cancer diagnosis can be done through the pathologic assessments of breast tissue samples such as core needle biopsy technique. The result of analysis on this sample by pathologist is crucial for breast cancer patient. In this paper, nucleus of tissue samples are investigated after decomposition by means of the Log-Gabor wavelet on HSV color domain and an algorithm is developed to compute the color wavelet features. These features are used for breast cancer diagnosis using Support Vector Machine (SVM) classifier algorithm. The ability of properly trained SVM is to correctly classify patterns and make them particularly suitable for use in an expert system that aids in the diagnosis of cancer tissue samples. The results are compared with other multivariate cla...

Rectal carcinoma metastatic to the male breast after 7 years: case report.

Onkologie — Sat, 15 Oct 2011 05:10:02 +0100

Conclusion: The authors highlight the difficulty of making an accurate diagnosis of rectal cancer metastasis to the breast of a male. PMID: 21985854 [PubMed - in process] (Source: Onkologie)

NHS breast screening is leading to needless treatment, say scientists

Guardian Unlimited Science — Tue, 11 Oct 2011 23:01:00 +0100

Evidence from trial used to argue that up to a third of women who go for screening are over-diagnosed and over-treatedThe NHS breast screening programme is picking up many cancers that might just have gone away if they had not been detected, according to an analysis.Scientists from the Nordic Cochrane Collaboration argue that up to a third of women who go for breast screening are over-diagnosed and over-treated.Their evidence comes from a large Swedish trial, the findings of which were the justification for the launch of the NHS screening programme.Per-Henrik Zahl and others, publishing in the Lancet Oncology journal, compare the numbers of cancers found in two similar groups of women, aged 40 to 69, over the course of six years. One group was screened every two years. The other group was ...

Rare Case of Male Breast Cancer and Axillary Lymphoma in the Same Patient: An Unique Case Report

Clinical and Developmental Immunology — Tue, 11 Oct 2011 22:55:26 +0100

Breast cancer in men is uncommon, and even more rare is the simultaneous presentation of two different malignancies. A 39-year-old man was diagnosed with both breast cancer and axillary lymphoma. Familiar history revealed that his mother died because of breast cancer. The patient underwent fine needle aspiration leading to the diagnosis of malignant lesion. Modified radical mastectomy was performed. Histology revealed an infiltrating ductal carcinoma 2.8 cm wide, grade 2, with vascular and lymphatic invasion. Surprisingly, one of the second level nodes was confirmed as a high-grade large B cell non-Hodgkin's lymphoma. No family inheritance or gene mutations (BRCA 1 and 2) were found. The patient underwent local radiotherapy, followed by 6 chemotherapy courses (RCHOP) and treatme...

Artificial neural network in diagnosis of lobular carcinoma of breast in fine‐needle aspiration cytology

Diagnostic Cytopathology — Tue, 11 Oct 2011 04:00:00 +0100

In this study, we applied artificial neural network (ANN) for the diagnosis of lobular carcinoma in fine‐needle aspiration cytology (FNAC) material. We selected a total of 64 cases of histology proven breast lesions consisting of 20 fibroadenomas, 28 infiltrating ductal carcinomas (IDC), and 16 infiltrating lobular carcinomas (ILC). Detailed cytomorphological features were studied on representative Haematoxylin–Eosin (H&E) and May‐Grunwald Giemsa stained slides. Image morphometric analysis was performed on Haematoxylin–Eosin stained smears to study nuclear area, diameter, perimeter, roundness, convex area, and convex perimeter. Both the qualitative cytological features and objective morphometric data were collected and a total of 18 variables were studied. Back propagation ANN ...

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Fine‐needle aspiration cytology of triple‐negative basal‐like breast cancer

Diagnostic Cytopathology — Tue, 11 Oct 2011 04:00:00 +0100

AbstractInvasive breast cancer is divided into luminal A, luminal B, HER2 overexpression, basal‐like (BL) and normal‐like subtypes, among which the BL subtype has the worst prognosis. The purpose of this study was to determine the clinicopathological and cytological characteristics of BL breast cancer (BLBC). Fine‐needle aspiration cytology samples from 17 patients with consecutive BLBC were investigated, and the findings were compared with those of other subtypes (10 cases each) for the following cytomorphological features: necrosis; lymphocyte infiltration; mitotic index; apoptosis; naked nuclei; nuclear/cytoplasmic ratio; nuclear margin, size and pleomorphism; chromatin granularity and density; and nucleolar appearance. Histologically, the BLBCs were heterogeneous, and included me...

Spontaneously Occurring micronuclei in infiltrating ductal carcinoma of breast: A potential biomarker for aggressive phenotype detection?

Diagnostic Cytopathology — Tue, 11 Oct 2011 04:00:00 +0100

In this study, spontaneously occurring MN were counted in epithelial cells on fine needle aspiration cytology (FNAC) smears from 50 patients with benign and malignant breast lesions. Further, the ploidy status and S‐phase fraction (SPF) of the samples was determined by flow cytometry. All these were then correlated with grades of breast cancer at cytology. Most IDC cases showed variable number of MN (n = 16, MN mean = 9.3), in contrast to the benign lesions (n = 26) where they were consistently absent. Aneuploidy and SPF analysis also showed a significant difference between benign (n = 10, mean DNA index [DI] = 0.96 ± 0.04, mean SPF= 8.07% ± 2.93) and malignant (n = 10, mean DI = 1.5 ± 0.41, mean SPF = 25.05% ± 10.35) lesions. On statistical analysis, a positive correlation was obser...

Pre-operative staging of the axilla in breast cancer – An accurate approach that saves time and resources?

International Journal of Surgery — Thu, 06 Oct 2011 22:52:32 +0100

Introduction: Pilot studies have suggested that a combined technique of ultrasonography (US) and fine needle aspiration cytology (FNAC) is useful in detecting axillary lymph node metastasis in breast cancer patients. (Source: International Journal of Surgery)

Clinical utility of routine pre-operative axillary ultrasound and fine needle aspiration cytology in patient selection for sentinel lymph node biopsy.

Breast — Wed, 05 Oct 2011 04:00:00 +0100

This study assessed the clinical utility of US+/-FNAC in patient selection for either axillary node clearance (ANC) or sentinel lymph node biopsy (SLNB) in patients undergoing surgery for operable breast cancer. Over a two-year period, 348 patients with a clinically negative axilla underwent axillary US. 67 patients with suspicious nodes on US also underwent FNAC. The sensitivity and specificity of axillary investigations to determine nodal involvement were 56% (confidence interval: 47-64%) and 90% (84-93%) for US alone, and 76% (61-87%) and 100% (65-100%) for FNAC combined with US, respectively. With a positive US, the post-test probability was 78%. A negative US carried a post-test probability of 25%. When FNAC was positive, the post-test probability was greater than unity. A negative FN...

Surgical treatment of intracystic carcinoma of the breast

World Journal of Surgical Oncology — Tue, 04 Oct 2011 04:00:00 +0100

Conclusion: When it is difficult to diagnose intracystic carcinoma of the breast by fine needle aspiration, active lumpectomy is necessary. Because extramural invasion and lymph node metastasis have been reported, it is necessary to carefully determine the range of excision and rationally perform lymph node dissection, such as sentinel node biopsy. (Source: World Journal of Surgical Oncology)

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MRI findings of cancers preoperatively diagnosed as pure DCIS at core needle biopsy.

Acta Radiologica — Mon, 03 Oct 2011 04:00:00 +0100

ConclusionEnhanced MRI provided informative morphology and size features that might help to predict the underestimation of invasiveness in preoperative biopsy-proven DCIS. PMID: 21969708 [PubMed - as supplied by publisher] (Source: Acta Radiologica)

Improving breast cancer care through a regional quality collaborative

Surgery — Sat, 01 Oct 2011 04:00:00 +0100

We present initial results from our analysis of institutional variation in surgical and core needle biopsy use within a regional breast cancer quality collaborative.Methods: Established in 2006, the Michigan Breast Oncology Quality Initiative (MiBOQI) consists of 18 hospitals collecting data on breast cancer care using the National Comprehensive Cancer Centers Network (NCCN) Oncology Outcomes Database Project platform to analyze and compare breast cancer practices and outcomes amongst member institutions. Institutional review board approval is obtained at each site. Data are submitted electronically to the NCCN and analyzed for concordance with practice guidelines. Aggregate and blinded data are shared with project directors and institutions at collaborative meetings, and ongoing practice ...

Tumor Cell-PMN-EC Binding Kinetics [Cell Biology]

Journal of Biological Chemistry — Fri, 30 Sep 2011 04:00:00 +0100

Interactions between polymorphonuclear neutrophils (PMNs) and tumor cells have been reported to facilitate the adhesion and subsequent extravasation of tumor cells through the endothelium under blood flow, both of which are mediated by binding β2-integrin to intercellular adhesion molecule 1 (ICAM-1). Here the adhesions between human WM9 metastatic melanoma cells, PMNs, and human pulmonary microvascular endothelial cells (HPMECs) were quantified by a gas-driven micropipette aspiration technique (GDMAT). Our data indicated that the cellular binding affinity of PMN-WM9 pair was 3.9-fold higher than that of the PMN-HPMEC pair. However, the effective binding affinities per molecular pair were comparable between the two cell pairs no matter whether WM9 cells or HPMECs were quiescent or cytokin...

Seeding of tumour cells following breast biopsy: a literature review.

The British Journal of Radiology — Mon, 26 Sep 2011 00:38:56 +0100

This article reviews evidence relating to needle biopsy of the breast and the potential for tumour cell migration into adjacent tissues following the procedure. A literature search was undertaken using Medline, Embase and the Cochrane Library. Results are grouped under three categories: histological evidence of spread, clinical evidence of recurrent disease and the likelihood of seeding dependent upon tumour type. There is histological evidence of seeding of tumour cells from the primary neoplastic site into adjacent breast tissue following biopsy. However, as the interval between biopsy and surgery lengthens then the incidence of seeding declines, which suggests that displaced tumour cells are not viable. Clinical recurrence at the site of a needle biopsy is uncommon and the relationship ...

Coexistence of pregnancy-like and cystic hypersecretory hyperplasia with invasive lobular carcinoma.

Onkologie — Sat, 24 Sep 2011 10:36:06 +0100

Conclusions: The present case documents the previously unreported coexistence of PLH/CHH accompanied by multifocal lobular carcinoma. Extensive examination, including an excisional biopsy, is prudent if a needle core biopsy reveals a PLH/CHH lesion. PMID: 21934345 [PubMed - in process] (Source: Onkologie)

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Evaluation of the clinical efficacy of minimally invasive procedures for breast cancer screening at a teaching hospital

Journal of Clinical Pathology — Thu, 22 Sep 2011 04:00:00 +0100

Conclusions Based on an overall analysis, WBN displayed the highest clinical efficacy compared with FNA and imprint, and demonstrated adequate safety for confirming the appropriate diagnosis and management of patients, ensuring the efficacy of the service. (Source: Journal of Clinical Pathology)

A new gene expression signature, the ClinicoMolecular Triad Classification, may improve prediction and prognostication of breast cancer at the time of diagnosis

Breast Cancer Research — Thu, 22 Sep 2011 04:00:00 +0100

Conclusions: CMTC correlates well with current clinical classification of BCs and has the potential to be easily integrated into routine clinical practice readily. Using FNABs, CMTC can be determined at the time of diagnostic needle biopsies for tumors of all sizes. Using the public databases as the validation cohort in our analyses, CMTC appeared to be able to provide treatment guidance more accurately, could be available in preoperative settings and applicable to all BC types independent of size, receptor and nodal status. The unique oncogenic signaling pathway pattern of each CMTC group may provide guidance to new treatment strategies. Further validation of CMTC will required prospective randomized controlled trials. (Source: Breast Cancer Research)

Tumor Markers in Fine-Needle Aspiration Washout for Cervical Lymphadenopathy in Patients With Known Malignancy: Preliminary Study

American Journal of Roentgenology — Wed, 21 Sep 2011 04:00:00 +0100

CONCLUSION. Evaluation of tumor marker concentrations in FNA washout could improve the detection of metastatic LNs in patients with known malignancy. (Source: American Journal of Roentgenology)

Radial scar without associated atypical epithelial proliferation on image-guided 14-gauge needle core biopsy: Analysis of 49 cases from a single-centre and review of the literature.

Breast — Wed, 21 Sep 2011 04:00:00 +0100

Authors: Bianchi S, Giannotti E, Vanzi E, Marziali M, Abdulcadir D, Boeri C, Livi L, Orzalesi L, Sanchez LJ, Susini T, Vezzosi V, Nori J Abstract The purpose of this study was to evaluate the reliability of image-guided 14-gauge needle core biopsy in the diagnosis of radial scar without associated atypical epithelial proliferation, by comparison with definitive histological diagnosis on surgical excision. The records of 8792 consecutive image-guided 14-gauge needle core biopsy of the breast performed from January 1996 to December 2009 were reviewed. Forty-nine cases of radial scar without associated atypical epithelial proliferation were identified and compared with definitive histological diagnosis on surgical excision. The definitive histological diagnosis on surgical excision co...

Diagnostic intervention in breast disease.

Radiologia — Thu, 15 Sep 2011 04:00:00 +0100

Authors: Vega Bolívar A Abstract Imaging-guided percutaneous biopsy techniques have been developed to diagnose the lesions detected in breast cancer screening programs based on mammography. Although traditional fine-needle aspiration cytology continues to be indicated in some cases, in many others it has been supplanted by more modern techniques like core biopsy or vacuum-assisted biopsy guided by ultrasonography, stereotaxy, or magnetic resonance imaging. These highly reliable techniques have minimized the need for surgical biopsy. Radiologists play a key role in the histological diagnosis of breast cancer in the early stages of disease and in the evaluation of its local and regional extension through magnetic resonance imaging and sentinel node biopsy. PMID: 21924750 [PubMed...

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First case of transformation for breast fibroadenoma to high-grade malignant cystosarcoma in an in vitro fertilization patient

Fertility and Sterility — Wed, 14 Sep 2011 04:00:00 +0100

Conclusion(s): Fibroadenoma was transformed into high-grade malignant cystosarcoma after ovarian stimulation in an IVF patient. (Source: Fertility and Sterility)

MR-guided breast biopsy at 3T: diagnostic yield of large core needle biopsy compared with vacuum-assisted biopsy

European Radiology — Tue, 13 Sep 2011 15:43:56 +0100

Conclusion Because of the substantially higher diagnostic yield and certainty of a benign diagnosis, VAB is the optimal biopsy technique at 3 T. LCNB should be considered when VAB is not feasible. Content Type Journal ArticleCategory BreastPages 1-9DOI 10.1007/s00330-011-2272-6Authors Carla Meeuwis, Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525GA Nijmegen, the NetherlandsJeroen Veltman, Department of Radiology, ZGT Almelo, Almelo, the NetherlandsHester N. van Hall, Department of Radiology, Rijnstate Hospital, Alysis Zorggroep, Wagnerlaan 55, 6815 AD Arnhem, the NetherlandsRoel D. M. Mus, Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525GA Nijmegen, the Nethe...

Malignant Seeding Following Percutaneous Breast Biopsy: Documentation With Comprehensive Imaging and Clinical Implications

The Breast Journal — Mon, 12 Sep 2011 04:00:00 +0100

Abstract: The aim of this study was to demonstrate convincing evidence that percutaneous breast biopsy may result in displacement of malignant cells that can initiate tumor growth at a separate anatomic site, other than the index lesion. Two patients with malignancy diagnosed by percutaneous breast biopsy were followed up with subsequent imaging. The observation of displaced cells initiating subsequent malignant growth was compared retrospectively with the previous year’s outcomes following percutaneous breast biopsy. Two cases of displaced malignant cells resulting in malignant growth at a separate site along the biopsy needle track were demonstrated by imaging. During the preceding year, 1644 biopsies with 298 malignant results were compared with the outcomes of these two patients, ...

Histological grade of invasive carcinoma of the breast assessed on needle core biopsy – modifications to mitotic count assessment to improve agreement with surgical specimens

Histopathology — Sat, 10 Sep 2011 04:00:00 +0100

Conclusions: These strategies improve the accuracy of grading on core biopsy and are of particular value in T3 P3 M1 tumours. (Source: Histopathology)

Ask the Expert: Rex Bentley, MD, on Pathology

DukeHealth.org: Duke Health Features — Fri, 09 Sep 2011 17:57:38 +0100

Pathology is the “study and diagnosis of disease through examination of organs, tissues, bodily fluids, and whole bodies” -- a medical discipline that many people have heard of, but most may not clearly understand. Unlike most other doctors, pathologists rarely deal directly with patients. Nonetheless, their work has an enormous impact on patients and their subsequent treatment. We spoke with Duke pathologist Rex Bentley, MD, to learn more about pathology and its impact on cancer. What do pathologists do? In its broadest sense, pathologists study human disease. We examine tissue and body fluid specimens removed from patients and determine the diagnosis. We can also perform autopsies. In smaller hospitals, pathologists may cover a broad range of procedures, while at large medical center...

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Intact Percutaneous Excision (IPEX) for Definitive Diagnosis of High-Risk Breast Lesions

Annals of Surgical Oncology — Fri, 09 Sep 2011 06:00:06 +0100

Conclusions IPEX combined with straightforward histologic and radiologic criteria and imaging surveillance constitutes acceptable management of image-detected HRL, including ADH. Content Type Journal ArticleCategory American Society of Breast SurgeonsPages 1-1DOI 10.1245/s10434-011-1961-3Authors Pat W. Whitworth, Nashville Breast Center, Nashville, TN, USA Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)

Utilizing a PACS-integrated Ultrasound-guided Breast Biopsy Simulation Exercise to Reinforce the ACR Practice Guideline for Ultrasound-Guided Percutaneous Breast Interventional Procedures During Radiology Residency

Academic Radiology — Thu, 08 Sep 2011 09:14:24 +0100

Conclusions: A PACS-integrated USG breast intervention simulation exercise increases residents' procedural confidence and understanding of the ACR practice guideline for the performance of USG percutaneous breast interventional procedures. (Source: Academic Radiology)

Displaced Epithelium After Liposuction for Gynecomastia

International Journal of Surgical Pathology — Mon, 29 Aug 2011 23:00:00 +0100

The authors describe the case of a 36-year-old man with gynecomastia who was previously treated with liposuction of the breast for cosmetic purposes. Histologic examination of a subsequent excisional biopsy revealed nests of displaced epithelial cells in adipose tissue. Epithelial cell displacement is a well-known risk of core needle biopsies and fine-needle aspirations of breast lesions. However, to the authors’ knowledge, epithelial displacement in gynecomastia after liposuction, mimicking invasive ductal carcinoma, has not previously been reported. (Source: International Journal of Surgical Pathology)

Breast Abscess After Nipple Piercing: Sonographic Findings With Clinical Correlation

Journal of Ultrasound in Medicine — Sun, 28 Aug 2011 23:00:00 +0100

The purpose of this series was to review the spectrum of clinical and sonographic features associated with infection after nipple piercing. Between 2002 and 2010, 6 patients presented to our breast center with a breast abscess after nipple piercing. A retrospective analysis of the imaging findings was performed with clinical and pathologic correlation. Patients with breast infections after nipple piercing tend to be young, and the timing since piercing varies from 2 weeks to 17 months. Sonography showed a complex or hypoechoic mass in 5 of 6 patients. Treatment of breast abscesses included surgical incision and drainage, percutaneous drainage, and antibiotic therapy. Surgical evacuation is commonly performed; however, sonographically guided aspiration may be an appropriate management strat...

US-Guided Vacuum-Assisted Percutaneous Excision for Management of Benign Papilloma Without Atypia Diagnosed at US-Guided 14-Gauge Core Needle Biopsy

Annals of Surgical Oncology — Wed, 24 Aug 2011 07:20:13 +0100

Conclusions For the postbiopsy management of benign papilloma without atypia after US-guided CNB, US-guided VAE was accurate and could be alternative to surgery. In cases of diagnosis of atypical lesion at VAE, however, surgery should be performed for a definitive diagnosis. Content Type Journal ArticleCategory Breast OncologyPages 1-7DOI 10.1245/s10434-011-2033-4Authors Ji Hyun Youk, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South KoreaMin Jung Kim, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South KoreaEun Ju Son, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Se...

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Lobular In-Situ Neoplasia on Breast Core Needle Biopsy: Imaging Indication and Pathologic Extent Can Identify Which Patients Require Excisional Biopsy

Annals of Surgical Oncology — Tue, 23 Aug 2011 05:56:10 +0100

Conclusions Women with a CNB diagnosis of LN for calcifications found on routine, normal-risk mammographic screening have a negligible risk of upgrade and may not require excisional biopsy. However, excisional biopsy should be offered to women undergoing imaging for other indications or with >4 foci of LN on CNB. Content Type Journal ArticleCategory Breast OncologyPages 1-8DOI 10.1245/s10434-011-2034-3Authors Mara H. Rendi, Department of Anatomic Pathology, University of Washington Medical Center, Seattle, WA, USASuzanne M. Dintzis, Department of Anatomic Pathology, University of Washington Medical Center, Seattle, WA, USAConstance D. Lehman, Department of Radiology, University of Washington Medical Center, Seattle, WA, USAKristine E. Calhoun, Department of Surge...

Ultrasound-Guided Lumpectomy for Palpable Breast Cancers

Annals of Surgical Oncology — Tue, 23 Aug 2011 05:56:02 +0100

Conclusions Although palpable breast cancers can be excised based on direct palpation or needle localization, we believe that US guidance provides an excellent tool to aid the breast surgeon. Only 10% of patients had a positive margin on final pathology as a result, and the overall re-excision rate was acceptable. Content Type Journal ArticleCategory American Society of Breast SurgeonsPages 1-6DOI 10.1245/s10434-011-1958-yAuthors Carla S. Fisher, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USAFatema Al Mushawah, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USAAmy E. Cyr, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USAFeng Gao, Division of Biostatistics, Washing...

Supplemental Use of Optical Diffusion Breast Imaging for Differentiation Between Benign and Malignant Breast Lesions

American Journal of Roentgenology — Mon, 22 Aug 2011 23:00:00 +0100

CONCLUSION. Optical diffusion imaging might be a good supplemental tool to increase the diagnostic accuracy of conventional ultrasound in differentiating malignant from benign breast lesions. (Source: American Journal of Roentgenology)

Flat Epithelial Atypia of the Breast: Pathological-Radiological Correlation

American Journal of Roentgenology — Mon, 22 Aug 2011 23:00:00 +0100

CONCLUSION. Mammographic and sonographic presentation of flat epithelial atypia is not specific (clustered amorphous microcalcifications and irregular, hypoechoic or complex masses). Given the underestimation rate of malignancy, surgical excision should be considered when imaging-guided biopsy yields flat epithelial atypia. (Source: American Journal of Roentgenology)

MRI Features of Stromal Fibrosis of the Breast With Histopathologic Correlation

American Journal of Roentgenology — Mon, 22 Aug 2011 23:00:00 +0100

CONCLUSION. Stromal fibrosis has widely variable MRI features, often mimicking breast carcinoma. It may represent an acceptable benign concordant diagnosis on vacuum-assisted large-core needle biopsy for the described MRI findings. (Source: American Journal of Roentgenology)

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Imaging-Histologic Discordance After Sonographically Guided Percutaneous Breast Biopsy: A Prospective Observational Study

Ultrasound in Medicine and Biology — Mon, 22 Aug 2011 04:00:00 +0100

The objective of this study was to determine the frequency of imaging-histologic discordance and to compare the frequency of carcinoma between concordant and discordant lesions in sonographically (US)-guided 14-gauge core needle biopsies (CNBs). From January 2005 to December 2006, we performed US-guided 14-gauge automated CNB on 3339 breast lesions and obtained benign results in 2194 cases. Five radiologists prospectively reviewed the pathologic reports in conjunction with the imaging. We included a total of 1588 lesions that were either excised (n = 658) or followed up for at least 2 years (n = 930) after CNB. We evaluated the rate of discordance and the clinical findings for both discordant and concordant lesions. We also analyzed the clinical and imaging differences between the upgrad...

Breast Gangrene

World Journal of Emergency Surgery — Thu, 18 Aug 2011 23:00:00 +0100

Conclusion: Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement. (Source: World Journal of Emergency Surgery)

Iatrogenic displacement of tumor cells to the sentinel node after surgical excision in primary breast cancer

Breast Cancer Research and Treatment — Thu, 18 Aug 2011 05:59:17 +0100

Abstract Isolated tumor cells (ITC) are more common in the sentinel node (SN) after needle biopsy of a breast cancer, indicating iatrogenic displacement of tumor cells. We here investigate whether similar iatrogenic displacement occurs after surgical excision of a breast tumor. We compared the incidence of ITC in the SN of 414 breast cancer patients with recent surgical excision to a group of 16,960 patients without recent surgical procedure in a multivariate analysis by linking data from the Danish Breast Cancer Cooperative Group database and the Danish National Health Register. Moreover, the incidence of spread to non-SNs in patients with ITC in the SN after recent surgical excision was analyzed. We found an adjusted odds ratio on 3.73 (95% CI 2.57–5.43; P <&nb...

HER-2 expression after neoadjuvant chemotherapy of the breast cancers

The Chinese-German Journal of Clinical Oncology — Mon, 08 Aug 2011 19:59:14 +0100

Conclusion Neoadjuvant chemotherapy makes no influence on patients with HER-2 positive expression, while patients with negative expression can be converted to be positive, but without significant difference. Content Type Journal ArticlePages 476-479DOI 10.1007/s10330-011-0825-4Authors Yaojun Feng, Department of Breast Cancer, Hubei Cancer Hospital, Wuhan, 430079 ChinaXinhong Wu, Department of Breast Cancer, Hubei Cancer Hospital, Wuhan, 430079 ChinaCuiping Pan, Department of Breast Cancer, Hubei Cancer Hospital, Wuhan, 430079 ChinaJuan Xu, Department of Breast Cancer, Hubei Cancer Hospital, Wuhan, 430079 ChinaWei Zhong, Department of Breast Cancer, Hubei Cancer Hospital, Wuhan, 430079 ChinaJun Shao, Department of Breast Cancer, Hubei Cancer Hospital, Wuhan, 430079 Ch...

Metastatic breast cancer to anterior chamber of eye: case report and discussion

The Chinese-German Journal of Clinical Oncology — Mon, 08 Aug 2011 19:59:14 +0100

We describe a patient of breast cancer who presented with pain and impaired vision in right eye 8.5 months after metastasis to bone and other viscera were detected and more than 10 years after her primary disease was diagnosed. Multiple yellowish white deposits were noted scattered in anterior chamber giving rise to symptoms of acute narrow angle glaucoma. Metastatic deposits of duct cell carcinoma cells were found by fine needle aspiration cytology. Patient received local external beam radiotherapy to right eye with moderate improvement in her symptoms. The rare features in this case were clinical presentation of acute glaucoma and anterior chamber as the site of metastasis. Content Type Journal ArticlePages 491-493DOI 10.1007/s10330-011-0804-9Authors Vimal Pandita, Departmen...

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Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series

Clinical and Developmental Immunology — Tue, 02 Aug 2011 14:14:14 +0100

Several studies have put to question and evaluated the indication and prognosis of sentinel lymph node biopsy (SNLB) as sole treatment in human breast cancer. We reviewed 1588 patients who underwent axillary surgery. In 239 patients, axillary lymph node dissection (ALND) was performed following positive fine needle aspiration cytology (FNAC), and, in 299 cases, ALND was executed after positive SNLB. The most dramatic result from our data is that patients with either micrometastasis of the sentinel lymph node (SLN) or only metastatic SLN have, respectively, an 84.5% and a 75.0% chance of having no other nodal involvement. We believe a more refined patient selection is neccessary when considering ALND. Where the primary tumor is larger than 5 cm, where radio or adjuvant therapies are ...

Constructing tissue microarrays from core needle biopsies of breast cancers

Histopathology — Mon, 01 Aug 2011 04:00:00 +0100

(Source: Histopathology)

Phyllodes tumours of the breast – differentiating features in core needle biopsy

Histopathology — Mon, 01 Aug 2011 04:00:00 +0100

Conclusions: In the core biopsy assessment of phyllodes tumours, evaluation of selected histological parameters, particularly those pertaining to stromal cellular changes, is helpful. (Source: Histopathology)

Association of Occult Metastases in Sentinel Lymph Nodes and Bone Marrow With Survival Among Women With Early-Stage Invasive Breast Cancer [Original Contribution]

JAMA — Mon, 25 Jul 2011 23:00:00 +0100

Conclusion Among women receiving breast-conserving therapy and SLN dissection, immunohistochemical evidence of SLN metastasis was not associated with overall survival over a median of 6.3 years, whereas occult bone marrow metastasis, although rare, was associated with decreased survival. Trial Registration clinicaltrials.gov Identifier: NCT00003854 (Source: JAMA)

Radiology: Biopsy commonly understages DCIS

Health Imaging News — Fri, 22 Jul 2011 10:36:12 +0100

As many as one-fourth of cases of ductal carcinoma in situ (DCIS) diagnosed using core-needle biopsy are in fact understaged invasive breast cancers, according to a study published in the July issue of Radiology. (Source: Health Imaging News)

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Radiology: Biopsy commonly understages invasive breast cancer

Health Imaging News — Fri, 22 Jul 2011 10:36:12 +0100

Ductal carcinoma in situ of the male breast presenting as adolescent unilateral gynaecomastia

Journal of Plastic, Reconstructive and Aesthetic Surgery — Fri, 22 Jul 2011 04:00:00 +0100

In conclusion this case describes a rare pre-malignant condition of the male breast. Complete histology of such a lump is the only conclusive investigation necessary and the limitations put upon the surgeon by the “rationing” of such treatment must be overcome on clinical grounds. (Source: Journal of Plastic, Reconstructive and Aesthetic Surgery)

Screening and Diagnosis of Breast Cancer in Low-Resource Countries: What Is State of the Art?

Seminars in Ultrasound CT and MRI — Thu, 21 Jul 2011 19:26:56 +0100

Breast cancer is the most common type of cancer in women worldwide; there has been a significant increase in the incidence of breast cancer in low-resource countries, with a disproportionately greater mortality rate compared to high-resource countries attributed to a lack of public awareness of the disease, absence of organized screening programs, and lack of accessible and effective treatment options. Mammography is not a cost-effective or a feasible option for screening and early detection of breast cancer in low-resource countries. A triple test assessment approach of screening clinical breast examination, diagnostic breast ultrasound, and ultrasound-guided fine-needle aspiration cytology may be a feasible option for the early detection of breast cancer. (Source: Seminars in Ultrasound ...

The varied presentation of metastatic melanoma in fine needle aspiration cytology of the breast

Cytopathology — Thu, 21 Jul 2011 17:31:08 +0100

Conclusion: MM should be considered in the differential diagnosis of breast FNA specimens when atypical cells are seen that present as plasmacytoid cells in a dispersed or pseudopapillary pattern, or as spindle, pleomorphic or pigmented cells. These features, combined with clinical history and immunocytochemistry, may assist in correctly identifying MM and directing optimal treatment. (Source: Cytopathology)

Stromal sarcoma of the breast with lung metastases showing a clinical complete response to doxorubicin plus ifosfamide treatment: Report of a case

Surgery Today — Tue, 19 Jul 2011 23:19:43 +0100

Abstract A 29-year-old woman presented with a painful right breast tumor, measuring 15 cm in diameter, which had progressed rapidly over 3 months. Core needle biopsy of the tumor revealed a malignant mesenchymal tumor. A mastectomy was performed, and pathological examination of the tumor showed stromal sarcoma. Solitary pleural dissemination in the right lung was suspected, based on the computed tomography image taken before the operation. Two months after surgery, bilateral multiple lung nodules were demonstrated. Systemic chemotherapy with doxorubicin plus ifosfamide was performed, and 3 months later the lung metastases had disappeared. Moreover, there is still no sign of recurrence at 5 months after the initiation of the chemotherapy. Breast stromal sarcoma is very rare...

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Indication for relumpectomy—a useful scoring system in cases of invasive breast cancer

Journal of Surgical Oncology — Tue, 19 Jul 2011 23:00:00 +0100

ConclusionsFor patients with surgical margins <2 mm and a score of <4, the probability of finding a residual invasive tumor is 0%, while the probability of finding a microfocus of <2 mm of invasive carcinoma is 3.2% and of finding residual DCIS is up to 10%. J. Surg. Oncol. © 2011 Wiley‐Liss, Inc. (Source: Journal of Surgical Oncology)

Rosai‐Dorfman Disease Presenting as a Breast Mass and Enlarged Axillary Lymph Node Mimicking Malignancy: A Case Report and Review of the Literature

The Breast Journal — Thu, 14 Jul 2011 23:00:00 +0100

We present a unique case of a patient presenting with a breast mass and axillary lymphadenopathy, mimicking malignancy clinically and radiographically. Core needle biopsies of the breast and axillary lymph node showed histologic features concerning the lymphoma. However, excisional biopsy specimen demonstrated characteristic features of Rosai‐Dorfman disease. The disease recurred locally 6 months later in the same breast, 1 month later in the contralateral breast, and 11 month later in the subcutaneous tissue of left flank. A review of the literature of Rosai‐Dorfman disease involving the breast is also presented. (Source: The Breast Journal)

An Efficient Technique for Drainage of Seromas after Breast Cancer Surgery

The Breast Journal — Thu, 14 Jul 2011 23:00:00 +0100

We describe a technique that uses a needle attached to a high vacuum wound drainage system. We believe that this technique is aseptic, relatively cheap, and efficient. It can easily and safely be adopted in the outpatient setting. (Source: The Breast Journal)

Breast Lesions with Imaging‐Histologic Discordance During 16‐Gauge Core Needle Biopsy System: would Vacuum‐Assisted Removal get Significantly More Definitive Histologic Diagnosis Than Vacuum‐Assisted Biopsy?

The Breast Journal — Thu, 14 Jul 2011 23:00:00 +0100

Abstract: The aim of this study was to determine the role of vacuum‐assisted biopsy (VAB) in patients with ultrasound imaging‐histologic discordance during 16‐gauge core needle biopsy (CNB) and to compare VAB with vacuum‐assisted removal (VAR) in diagnostic accuracy in patients with ultrasound imaging‐histologic discordance. From January 2006 to October 2008, a consecutive biopsy was performed on 1532 lesions with ultrasound‐guided 16‐gauge CNB. Sixty two lesions were considered to be ultrasound imaging‐histologic discordant. Among the 62 lesions, 55 lesions underwent subsequent VAB or VAR, which made up our study population. Among the 55 cases, 22 underwent subsequent US‐guided VAR, and the other 33 lesions underwent subsequent US‐guided VAB. All malignant lesions a...

A practical approach to grossing breast specimens

Annals of Diagnostic Pathology — Tue, 12 Jul 2011 14:51:42 +0100

Abstract: The grossing of breast specimens has been evolving over the past few decades. As image-guided core-needle biopsy has gradually replaced surgical biopsy in the initial assessment of breast lesions, most patients have a definitive diagnosis at the time of excision. Breast conserving therapy is now well accepted as a definitive treatment. Neoadjuvant therapy is also selected by a large number of patients. In addition, since its introduction in the 1990s, sentinel lymph node biopsy has become a standard procedure performed at the time of excision, as clinically indicated. Based on our institutional experience, practical guidelines for grossing breast excision specimens, as well as sentinel lymph nodes, are provided in this article. (Source: Annals of Diagnostic Pathology)

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Diaforodiagnostic dilemma of a breast tumor in a patient with known history of chest sarcoidosis: a diagnostic approach

Central European Journal of Medicine — Sat, 09 Jul 2011 05:58:51 +0100

We describe the case of a patient with a history of pulmonary sarcoidosis referred to our hospital for a screening mammography. Mammographic findings raised the suspicion for a breast mass. An additional breast ultrasound and fine -needle aspiration biopsy were performed. Finally, patient underwent a excisional biopsy of the left breast and the histopathological report revealed sarcoidosis. Content Type Journal ArticlePages 1-4DOI 10.2478/s11536-011-0068-3Authors Thomai Stavrogianni, Department of Radiology, Theagenion Anticancer Hospital of Thessaloniki, Thessaloniki, GreeceElisavet Psoma, Department of Radiology, Theagenion Anticancer Hospital of Thessaloniki, Thessaloniki, GreeceOlga Nikolaidou, Department of Radiology, Theagenion Anticancer Hospital of Thessaloniki, Thessalon...

Cytological diagnosis of filarial infection in an endemic area where screening and prophylaxis is in place

Cytopathology — Mon, 04 Jul 2011 23:00:00 +0100

Conclusion: FNA cytology is an inexpensive, simple and easy procedure for detecting microfilariae. Detection of microfilariae may not be common even in endemic areas as screening and prophylaxis is routinely performed, and patients may show atypical presentations such as subcutaneous nodules. We believe that careful screening of FNAs, especially those from subcutaneous swellings, as well as serous fluids, is very important in a filariasis‐endemic zone. (Source: Cytopathology)

Needle Biopsy Can Aid in Breast Cancer TriageNeedle Biopsy Can Aid in Breast Cancer Triage

Medscape Medical News Headlines — Fri, 01 Jul 2011 19:38:23 +0100

In newly diagnosed invasive breast cancer, preoperative needle biopsy of the axillary nodes can help triage women directly to axillary node dissection, a new meta-analysis shows. Reuters Health Information (Source: Medscape Medical News Headlines)

Hepatocyte growth factor profile with breast cancer.

Indian Journal of Pathology and Microbiology — Fri, 01 Jul 2011 04:00:00 +0100

Conclusions: Significant increase in serum HGF levels were found in patients with breast cancer as compared with controls. Significant increase was also seen in patients with breast cancer with and without lymph node metastasis when each subgroup was compared with controls. Serum level of HGF is an independent prognostic indicator of breast cancer. Fibrocystic disease of the breast showed weak HGFR expression, while in normal tissue, HGFR was scanty; meanwhile, breast invasive ductal carcinoma showed homogenous strong reaction to HGFR. HGF is only one of a number of key factors involved in breast cancer and preoperative high serum HGF levels and malignancy occur usually together. PMID: 21934211 [PubMed - in process] (Source: Indian Journal of Pathology and Microbiology)

Needle biopsy can aid in breast cancer triage

Modern Medicine — Thu, 30 Jun 2011 23:00:00 +0100

NEW YORK (Reuters Health) - In newly diagnosed invasive breast cancer, preoperative needle biopsy of the axillary nodes can help triage women directly to axillary node dissection, a new meta-analysis shows. (Source: Modern Medicine)

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Indication for sentinel lymph node biopsy for breast cancer when core biopsy shows ductal carcinoma in situ

American Journal of Surgery — Thu, 30 Jun 2011 23:00:00 +0100

Conclusions: Initial SLNB should be considered for patients diagnosed with DCIS by needle biopsy when they have a high risk for harboring invasive ductal cancer preoperatively. (Source: American Journal of Surgery)

Preoperative Diagnosis of Ductal Carcinoma In Situ Arising Within a Mammary Fibroadenoma: A Case Report

Japanese Journal of Clinical Oncology — Wed, 29 Jun 2011 23:00:00 +0100

We present this case to increase awareness of this entity and stress the need for histological evaluation of some breast masses. (Source: Japanese Journal of Clinical Oncology)

Trastuzumab clears HER2/neu-positive isolated tumor cells from bone marrow in primary breast cancer patients

Archives of Gynecology and Obstetrics — Wed, 29 Jun 2011 10:52:48 +0100

Conclusion This is the first evidence that trastuzumab is effective in clearing HER2/neu-positive cells from bone marrow during recurrence-free follow-up in breast cancer patients. It also suggests, thanks to the antigen shift phenomenon, an important prognostic role for HER2/neu expression on marrow ITC as a real-time biopsy. However, treatment was mainly effective in patients with HER2/neu-positive ITC. Given the heterogeneity of minimal residual disease, these patients might benefit from a combination of targeted treatment approaches. Content Type Journal ArticlePages 1-8DOI 10.1007/s00404-011-1954-2Authors Brigitte Rack, Department of Gynecology and Obstetrics, Klinikum Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Maistr. 11, 80337 Munich, GermanyJuli...

Possible use and role of molecular techniques in fine-needle aspiration cytology (FNAC) practice

Diagnostic Histopathology — Sun, 26 Jun 2011 23:00:00 +0100

Abstract: Fine-needle aspiration cytology (FNAC) is a recognized ancillary tool in the diagnosis of tumours and infectious diseases. Throughout decades cytopathologists did tremendous marvels with pure morphologic criteria, diagnosing in shrinking amounts of material. The recent understanding of complex cancer biology reshapes the practice of FNAC. The scientific advance of image techniques gave cytopathologists the possibility to go to deep locations and collecting material from previous unlikely locations. This conjunction of knowledge’s and techniques has increased the role of FNAC in the diagnosis, prognosis and in the establishment of new therapeutic targets. Lately, core needle biopsy is gaining popularity and advantage regarding FNAC. The sample limitation of FNAC regarding immuno...

Computerized Classification of Intraductal Breast Lesions Using Histopathological Images

IEEE Transactions on Biomedical Engineering — Sun, 26 Jun 2011 19:54:12 +0100

In this study, a prototype system for automatically classifying breast microscopic tissues to distinguish between UDH and actionable subtypes (ADH and DCIS) is introduced. This system automatically evaluates digitized slides of tissues for certain cytological criteria and classifies the tissues based on the quantitative features derived from the images. The system is trained using a total of 327 regions of interest (ROIs) collected across 62 patient cases and tested with a sequestered set of 149 ROIs collected across 33 patient cases. An overall accuracy of 87.9% is achieved on the entire test data. The test accuracy of 84.6% is obtained with borderline cases (26 of the 33 test cases) only, when compared against the diagnostic accuracies of nine pathologists on the same set (81.2% average)...

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A review of the utilization of fine needle aspiration in clinical practice and research in Nigeria

CytoJournal — Wed, 22 Jun 2011 23:00:00 +0100

Conclusions: The utilization of FNA is apparently lagging in Nigeria. Given its potential in resource-constrained settings, we are of the opinion that it should be used more often in clinical and translational research. (Source: CytoJournal)

Breast Imaging Training and Attitudes: Update Survey of Senior Radiology Residents

American Journal of Roentgenology — Wed, 22 Jun 2011 23:00:00 +0100

CONCLUSION. Residency programs have devoted more time to breast imaging and made improvements in their curricula, but current residents report decreased opportunities to perform some studies and procedures. Although most residents would not consider a fellowship and did not want to interpret mammograms in future practice, the percentage of residents who would not consider breast imaging as a subspecialty has decreased since 2000. An accurate picture of current breast imaging curricula and variations among residency programs is necessary to identify and correct systemic problems and to improve the training of future breast imagers. (Source: American Journal of Roentgenology)

Biopsy sampling of breast lesions: comparison of core needle- and vacuum-assisted breast biopsies

Breast Cancer Research and Treatment — Wed, 22 Jun 2011 15:56:55 +0100

Abstract Needle biopsy is now the initial investigation of choice for the pre-operative diagnosis of breast lesions. This includes core needle biopsy (CNB) and vacuum-assisted biopsy (VAB) with or without radiologic assistance. The performance indices of both of these biopsy techniques were evaluated. In a large cohort of patients with breast lesions including 464 cases (285 CNB and 179 VAB), with confirmed outcomes, the diagnostic accuracy was compared using parameters including quantitation of the sampling based on the total number of cores taken, cores containing breast parenchyma, and cores with lesion; and non-epithelial changes including necrosis and calcification. CNB showed a 99% PPV, 94% NPV, 96% sensitivity, and 99% specificity, whereas VAB demonstrated a 100% PP...

Non‐Hodgkin's lymphoma presenting as breast masses: A series of 10 cases diagnosed on FNAC

Diagnostic Cytopathology — Tue, 21 Jun 2011 23:00:00 +0100

AbstractPrimary breast lymphoma (PBL) is a rare disease, which comprises 0.04–0.53% of all primary malignant tumors of the breast. The most frequent histological subtype is diffuse large B‐cell type (DLBCL) (40–70%). Differentiation of PBLs from other breast tumors such as poorly differentiated carcinomas and lobular carcinoma may at times be difficult on cytomorphology alone. An audit of breast lymphomas diagnosed on fine needle aspiration cytology (FNAC) over a period of 9 years (2001–2009) was performed. Ten cases were retrieved and the cytomorphology was reviewed along with immunochemistry (IHC), flow cytometry as well as histopathology, wherever available. The age of patients ranged from 17 to 83 years. Eight cases were diagnosed as non‐Hodgkin's lymphoma, high‐grade on FN...

Ductal Carcinoma in Situ at Core-Needle Biopsy: Meta-Analysis of Underestimation and Predictors of Invasive Breast Cancer [Evidence-based Practice]

Radiology — Tue, 21 Jun 2011 23:00:00 +0100

Conclusion: About one in four DCIS diagnoses at CNB represent understaged invasive breast cancer. Preoperative variables significantly associated with understaging include biopsy device and guidance method, size, grade, mammographic features, and palpability. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11102368/-/DC1 (Source: Radiology)

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Lung Cancer: Is “The Blame Game” Hurting our Progress?

DukeHealth.org: Duke Health Features — Tue, 21 Jun 2011 19:58:56 +0100

As a thoracic surgeon, I operate on lung cancer patients every day. We discuss life-and-death issues regarding their surgeries, but we don’t usually talk about how they feel about their disease. At a recent lung cancer advocacy event, I had the opportunity to hear one of my patients tell her story. A former Division I soccer player for East Carolina University, 24-year-old Taylor Bell was diagnosed with lung cancer two weeks after her 21st birthday. She puts a very different face on lung cancer than most people expect. She’s very grateful for her survival, but she says that, even when she’s talking to survivors of other types of cancer -- to anyone, really -- when she tells people she has had lung cancer, inevitably everyone asks the same thing: “Did you smoke?” Her point of view...

Seroma Formation in Two Cohorts after Axillary Lymph Node Dissection in Breast Cancer Surgery: Does Timing of Drain Removal Matter?

The Breast Journal — Thu, 16 Jun 2011 23:00:00 +0100

Abstract: The purpose of this study was to compare short‐term versus long‐term axillary drainage in women treated for lymph node positive breast cancer. A comparative cohort study on differences between short‐term or long‐term axillary drainage was performed. Primary outcome measures were seroma formation demanding aspiration and wound related complications. Secondary outcome measures were type of operation (modified radical mastectomy (MRM) or wide local excision with axillary lymph node dissection (ALND) or completing ALND after positive sentinel node), length of hospital stay, and visits to the emergency department and outpatient clinic. The short‐term drainage group consisted of 37 patients, and the long‐term drainage group of 40 patients. Short‐term drainage was assoc...

Clinical relevance of DNA microarray analyses using archival formalin-fixed paraffin-embedded breast cancer specimens

BMC Cancer — Wed, 15 Jun 2011 23:00:00 +0100

Conclusion: We demonstrated that FFPE specimens retained important prognostic information that could be identified using a recent gene profiling technology. Our study supports the use of FFPE specimens for the development and refinement of prognostic gene signatures for breast cancer. Clinical applications of such prognostic gene profiles await future large-scale validation studies. (Source: BMC Cancer)

Ultrasound-Guided Breast Biopsy

Ultrasound Clinics — Tue, 14 Jun 2011 23:00:00 +0100

Since it was originally described in 1993, ultrasound-guided core needle biopsy has been shown to be a reliable, even preferred, alternative to open surgical biopsy. This technique should be the modality of choice for any breast or axillary sonographic abnormality requiring tissue sampling. The high sensitivity and reproducibility of this technique make this technique a low-cost procedure that minimizes patient morbidity. As ultrasound-guided core needle biopsy gains wider acceptance, its therapeutic uses, such as removal of masses, are becoming more prevalent. (Source: Ultrasound Clinics)

Conservation of the Axilla: An Audit of Sentinel Lymph Node Biopsy After a New Start.

Clinical Genitourinary Cancer — Sat, 11 Jun 2011 23:00:00 +0100

CONCLUSIONS: Sentinel lymph node biopsy in breast cancer allowed conservation of the axilla in 80% (289/360) of patients with negative sentinel lymph nodes in this study. Preoperative ultrasonographically guided core needle biopsy reduced the need for a second operation in 55 patients (13%). PMID: 21715231 [PubMed - as supplied by publisher] (Source: Clinical Genitourinary Cancer)

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Fine-needle Aspiration Cytology of the Breast.

Ultrastructural Pathology — Wed, 08 Jun 2011 23:00:00 +0100

Authors: Berner A, Sauer T Fine-needle aspiration cytology (FNAC) is an established, highly accurate, and cost-effective method for diagnosing lesions in different organs, including the breast. The method is minimally invasive without unwanted side effects. FNAC forms part of the triple assessment of breast lesions. Despite some shortcomings of the reporting categories, FNAC as part of the triple assessment has proved its value in describing the findings most accurately. The diagnostic impact depends on experience of the operator, quality of preparation, and diagnostic skills of the cytopathologist. The highest accuracy is achieved at centers with a multidisciplinary approach. FNAC is often palpation guided from palpable breast masses, whereas ultrasonography guidance is more widely us...

Pilot and feasibility study: prospective proteomic profiling of mammary epithelial cells from high-risk women provides evidence of activation of pro-survival pathways

Breast Cancer Research and Treatment — Mon, 06 Jun 2011 15:00:12 +0100

Abstract Normal mammary gland homeostasis requires the coordinated regulation of protein signaling networks. However, we have little prospective information on whether activation of protein signaling occurs in premalignant mammary epithelial cells, as represented by cells with cytological atypia from women who are at high risk for breast cancer. This information is critical for understanding the role of deregulated signaling pathways in the initiation of breast cancer and for developing targeted prevention and/or treatment strategies for breast cancer in the future. In this pilot and feasibility study, we examined the expression of 52 phosphorylated, total, and cleaved proteins in 31 microdissected Random Periareolar Fine Needle Aspiration (RPFNA) samples by high-throughpu...

Ultrasound-guided thermal radiofrequency ablation (RFA) as an adjunct to systemic chemotherapy for breast cancer liver metastases

La Radiologia Medica — Sat, 04 Jun 2011 06:04:43 +0100

Conclusions RFA appears to be a useful adjunct to systemic chemotherapy and/or hormone therapy in the locoregional treatment of hepatic metastases from breast cancer. RFA may also be a less invasive alternative to surgery in the locoregional treatment of liver metastases from breast cancer Content Type Journal ArticlePages 1-8DOI 10.1007/s11547-011-0697-2Authors G. Carrafiello, Dipartimento di Diagnostica per Immagini, Ospedale di Circolo Fondazione Macchi, Università dell’Insubria, Viale Borri 57, 21100 Varese, ItalyF. Fontana, Dipartimento di Diagnostica per Immagini, Ospedale di Circolo Fondazione Macchi, Università dell’Insubria, Viale Borri 57, 21100 Varese, ItalyE. Cotta, Dipartimento di Diagnostica per Immagini, Ospedale di Circolo Fondazione Macchi, Un...

A Clinical Study of Late Seroma in Breast Implantation Surgery

Aesthetic Plastic Surgery — Fri, 03 Jun 2011 06:01:53 +0100

Conclusion In case of unexpected breast enlargement after prosthesis implantation, the physician should first rule out infection, then investigate possible friction irritation from either a fold in the device or rubbing of a textured implant. According to the authors’ experience and another report, this complication occurs in 1% to 2% of cases. The inclusion of this complication in the informed consent form should be considered. Long-term studies designed to investigate the underlying causes of late seroma are warranted for the prevention and treatment of this complication. Content Type Journal ArticlePages 1-8DOI 10.1007/s00266-011-9755-3Authors Marco Mazzocchi, Department of Plastic and Reconstructive Surgery, University of Perugia, Via G. Dottori, 06100 Perug...

Needle Versus Excisional Biopsy for Noninvasive and Invasive Breast Cancer: Report from the National Cancer Data Base, 2003–2008

Annals of Surgical Oncology — Wed, 01 Jun 2011 05:58:04 +0100

Conclusion The use of needle biopsy is increasing. Tumor stage, hospital volume, and hospital location were the most statistically significant predictors of biopsy type. Rates of needle biopsy at high-volume hospitals suggest that appropriate utilization of this preferred diagnostic method should approach 90%. Content Type Journal ArticlePages 1-9DOI 10.1245/s10434-011-1808-yAuthors Richelle T. Williams, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USAKatharine Yao, Department of Surgery, NorthShore University Health System, Evanston, IL, USAAndrew K. Stewart, Cancer Programs, American College of Surgeons, Chicago, IL, USADavid J. Winchester, Department of Surgery, NorthShore University Health System, Evanston, IL, USAMary Turk, Departme...

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Sentinel Lymph Node Pressure in Breast Cancer

Annals of Surgical Oncology — Mon, 30 May 2011 17:13:28 +0100

Conclusions Breast cancer metastasis in axillary SLNs was associated with significantly higher INP than in tumor-free lymph nodes. When “true” SLNs were replaced by tumor, and the INP levels were very high, lymph flow direction changed; lymphophilic particles (blue dye and radiocolloid) were redirected to the next echelon of nodes, where the pressures were much lower. Mechanical factors may increase the likelihood of metastasis to neighboring lymph nodes with lower INP. Content Type Journal ArticlePages 1-6DOI 10.1245/s10434-011-1796-yAuthors S. David Nathanson, Department of Surgery, Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI, USAMeredith Mahan, Division of Biostatistics, Department of Public Health Sciences, Henry Ford Health System, Det...

A Case of Primary Tubercular Mastitis Masquerading as Carcinoma Breast

Anesthesiology Research and Practice — Mon, 30 May 2011 14:33:01 +0100

Primary extrapulmonary tuberculosis occurring in the breast is extremely rare. In the absence of well-defined clinical features, the true nature of the disease remains obscure and it is often mistaken for carcinoma or pyogenic breast abscess. It also presents a diagnostic problem on radiological and microbiological investigations and thus high index of suspicion acquires an important position. This paper highlights the importance of considering every breast lump as a potential case of tubercular mastitis especially in endemic countries like India that should be subjected to fine needle aspiration cytology or excisional biopsy before considering surgical options like complete mastectomy, without relying only on clinicoradiological findings. (Source: Anesthesiology Research and Practice)

Breast Metastasis Of Primary Colon Cancer With Micrometastasis In The Axillary Sentinel Node: A Metastasis That Metastasized?

BioMed Central — Fri, 27 May 2011 23:00:00 +0100

In conclusion, solid cancers are able to further metastasize, via well-known pathways also recognized in primary cancers such as neoplastic cell invasion of peritumoral lymphatics. (Source: BioMed Central)

Periductal mastitis in a male breast masquerading as lobular carcinoma on fine needle aspiration cytology

Diagnostic Cytopathology — Wed, 25 May 2011 23:00:00 +0100

We present a case of periductal mastitis associated with epithelial hyperplasia, presenting as a subaerolar swelling in a male breast, which was misinterpreted as lobular carcinoma on FNAC. Diagn. Cytopathol. 2011; © 2011 Wiley‐Liss, Inc. (Source: Diagnostic Cytopathology)