The Breast Journal via MedWorm.com

Factors Affecting Nodal Status in Invasive Breast Cancer: A Retrospective Analysis of 623 Patients

The Breast Journal — Tue, 23 Feb 2010 00:00:00 +0100

Abstract: With increasing numbers of early, screen-detected breast cancers and the emergence of sentinel-node biopsy, surgical management of the axilla is evolving. In recent years many authors have searched for favorable subcategories of tumors in which it may be possible to avoid axillary lymph node clearance. The aim of this study is to determine preoperative factors that might predict lymph node negative axillae. A retrospective analysis of 623 patients with invasive breast cancer was performed. A number of clinical and pathological variables were analyzed. Uni- and multivariate analysis was carried out to determine factors predictive for lymph node metastases. Age, tumor size, grade, histology and lymphovascular invasion were found to be independent predictors of nodal positivity but,...

SPARC (Osteonectin) in Breast Tumors of Different Histologic Types and Its Role in the Outcome of Invasive Ductal Carcinoma

The Breast Journal — Tue, 23 Feb 2010 00:00:00 +0100

Abstract: The purpose of this study was to characterize the immunohistochemical distribution of secreted protein acidic and rich in cystein (SPARC) in benign and malignant breast tumors of different histologic types and define its association with the outcome of invasive ductal carcinoma (IDC) patients. A total of 286 samples of benign and malignant breast lesions between 1994 and 2005 were retrieved from National Taiwan University Hospital. Up to 11 years clinical follow-up data were available for 185 patients with IDC. Immunohistochemistry staining with SPARC was performed in tissue microarray or whole section. The association of expression of SPARC and cumulative overall survival of IDC patients were analyzed using Kaplan[ndash]Meier survival analysis and Cox regression analysis. Secret...

A 37-Year-Old Woman With Spindle Cells Metaplastic Breast Carcinoma: A Case Characterized by Very Aggressive Clinical Behavior

The Breast Journal — Tue, 23 Feb 2010 00:00:00 +0100

(Source: The Breast Journal)

The Clinical Characteristics and Prognosis of Chinese Early Stage Breast Cancer Patients: A Retrospective Study

The Breast Journal — Tue, 23 Feb 2010 00:00:00 +0100

(Source: The Breast Journal)

Breast Cancer Following Hodgkin's Disease: The Experience of the University of Florence

The Breast Journal — Tue, 23 Feb 2010 00:00:00 +0100

In this study we considered 1,538 patients on whom a minimum follow up of 6 months had been obtained. Of these, 72 were women. The most represented histological subtype was nodular sclerosis (50.6%). Supradiaphragmatic alone or with subdiaphragmatic complementary extended field radiotherapy was delivered to 83.1% of patients while supradiaphragmatic involved field radiotherapy was delivered to 10.7% of patients. Concerning the characteristics and incidence of BC, we focused our analysis exclusively on the female group. We found that BC occurred in 39, with an overall incidence of 5.4%. The mean interval after Hodgkin treatment was 19.5 years (SD ± 9.0). The median age of BC diagnosis was 50.8 years (SD ± 13.3) while the median age of Hodgkin diagnosis was 31.2 years (SD ± 14.5). Thirty-...

Partial Breast Irradiation or Whole Breast Radiotherapy for Early Breast Cancer: A Meta-Analysis of Randomized Controlled Trials

The Breast Journal — Tue, 23 Feb 2010 00:00:00 +0100

Abstract: The purpose of the study was to compare treatment outcomes in patients with breast cancer treated with partial breast irradiation (PBI) and of those treated with whole breast-radiation therapy (WBRT). We conducted a systematic review and meta-analysis of published randomized clinical trials comparing PBI versus WBRT. Primary outcome was overall survival and secondary outcomes were locally, axillary, supraclavicular, and distant recurrences. A search of the literature identified three trials with pooled total of 1,140 patients. We found no statistically significant difference between partial and whole breast radiation arms associated with death (OR 0.912, 95% CI 0.674[ndash]1.234, p = 0.550), distant metastasis (OR 0.740, 95% CI, 0.506[ndash]1.082, p = 0.120), or supraclavicular r...

Short-Term Quality of Life Following Partial Breast Irradiation with Balloon Brachytherapy- Comparison with Whole Breast Irradiation

The Breast Journal — Tue, 02 Feb 2010 00:00:00 +0100

(Source: The Breast Journal)

Solitary Nasal Cavity Metastasis of Breast Cancer

The Breast Journal — Mon, 01 Feb 2010 00:00:00 +0100

(Source: The Breast Journal)

Breast Cancer in Nigeria: Is Non-Adherence to Chemotherapy Schedules a Major Factor in the Reported Poor Treatment Outcome?

The Breast Journal — Fri, 29 Jan 2010 00:00:00 +0100

(Source: The Breast Journal)

In Newly Diagnosed Breast Cancer, Screening MRI of the Contralateral Breast Detects Mammographically Occult Cancer, Even in Elderly Women: The Mayo Clinic in Florida Experience

The Breast Journal — Fri, 29 Jan 2010 00:00:00 +0100

Abstract: The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution. MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopa...

Predicting Non-Sentinel Lymph Node Status in Breast Cancer Patients with Sentinel Lymph Node Involvement: Evaluation of Two Scoring Systems

The Breast Journal — Fri, 29 Jan 2010 00:00:00 +0100

Abstract: The aim of this study was to validate a nomogram and a scoring system to predict non-sentinel lymph node status in breast cancer patients with sentinel lymph node (SLN) involvement. A total of 516 breast cancer patients underwent sentinel lymph node biopsy at our institution from January 2001 to August 2006. A prospective database was used to identify breast cancer patients with a positive SLN biopsy examination who underwent a completion axillary lymph node dissection. A total of 114 patients were identified. The Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and an axilla scoring system from Paris (Hôpital Tenon) were used to predict the probability of having non-SLN involvement. One hundred fourteen patients were included in the study. The areas under the receiver op...

Routine Breast MRI as a Screening Modality for Occult Contralateral Breast Cancer: Where Do We Draw the Line?

The Breast Journal — Wed, 27 Jan 2010 00:00:00 +0100

(Source: The Breast Journal)

The Use of Oncoplastic Reduction Techniques to Reconstruct Partial Mastectomy Defects in Women with Ductal Carcinoma In Situ

The Breast Journal — Tue, 19 Jan 2010 00:00:00 +0100

This study suggests that although oncoplastic reduction techniques are a reasonable approach for women with DCIS, stricter patient selection and improved confirmation of negative margins will minimize the need for either re-excisions or completion mastectomy and reconstruction. (Source: The Breast Journal)

Evaluation of HER-2 Overexpression of Breast Cancer at a Teaching Hospital in Saudi Arabia

The Breast Journal — Fri, 08 Jan 2010 00:00:00 +0100

(Source: The Breast Journal)

A Pyoderma Gangrenosum Following Breast Reconstruction: A Rare Cause of Skin Necrosis

The Breast Journal — Tue, 29 Dec 2009 00:00:00 +0100

(Source: The Breast Journal)

Axillary Metastatic Disease Secondary to Occult Breast Cancer: A Diagnostic and Therapeutic Dilemma

The Breast Journal — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Breast Journal)

True Recurrences and New Primary Tumors Have Different Clinical Features in Invasive Breast Cancer Patients with Ipsilateral Breast Tumor Relapse After Breast-Conserving Treatment

The Breast Journal — Mon, 21 Dec 2009 00:00:00 +0100

Abstract: Ipsilateral breast tumor relapse (IBTR) after breast-conserving treatment (BCT) may represent two distinct types of lesion, including a true recurrence (TR) or a new primary tumor (NPT). The aim of this study was to ascertain the difference between TRs and NPTs and to show the clinical significance of classifying IBTR into these two types of recurrence. Patients (n = 2,075) with unilateral invasive breast cancer who underwent BCT between 1987 and 2005 at Saitama Cancer Center were analyzed. IBTR was classified into TR and NPT, which was based on all clinical and pathological features of both a primary tumor and IBTR that can be evaluated. IBTR-free survival and the risk factors were analyzed in order to compare the findings for TR and NPT. In addition, the salvage surgical method...

Assessing the Knowledge and Attitudes Regarding Genetic Testing for Breast Cancer Risk in our Region of Southeastern Georgia

The Breast Journal — Thu, 17 Dec 2009 00:00:00 +0100

Abstract: Genetic testing for the breast cancer susceptibility genes, BRCA1 and BRCA2, has been available for over a decade. Positive test results carry significant medical, psychological, and social implications. Knowledge of the public's awareness concerning BRCA testing, and perceived benefits and barriers to testing can help refine educational programs and identify subgroups needing additional support. Patients and their acquaintances with a breast complaint attending a surgical clinic or private office were asked to complete a questionnaire about their knowledge of breast cancer genes and their desire to be tested. Demographic information collected included ethnicity, education background, age, income, and personal and family history of breast cancer, knowledge of BRCA genes and testi...

Granulomatous Mastitis: Clinical, Pathological Features, and Management

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

Abstract: This clinical study was conducted to present clinical, radiologic, and histopathologic features of Granulomatous Mastitis (GM) and evaluate the result of surgical and steroid treatment. Sixteen cases diagnosed histologically as GM were reviewed. Patient characteristics, clinical presentation, radiologic imaging, microbiologic, histopathologic assessment, treatment modalities, recurrence, morbidity, and follow-up data were analyzed. Majority of the patients were child bearing age and all of the patients had a history of breast feeding. Radiologic findings were nonspecific. Histopathology showed the characteristic distribution of granulomatous inflammation in all cases. In 12 cases, surgical excision of the lesion with negative margins was performed. Four cases required quadranecto...

Imaging Features of Bilateral Lupus Mastitis

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

(Source: The Breast Journal)

Comparing the Effect of Diclofenac Gel and Piroxicam Gel on Mastalgia

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

(Source: The Breast Journal)

Does Compliance with Radiation Therapy Differ in African-American Patients with Early-Stage Breast Cancer?1

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

Abstract: The worse outcomes in African-American (AA) breast cancer patients have been attributed to a variety of factors, including compliance/variations with treatment. We evaluated a large cohort of AA patients treated with breast conservation therapy (BCT) in an effort to determine if compliance with radiation or if choice of chemotherapy regimen could be a contributing factor for the worse outcomes reported in AA patients. Our two cohorts consisted of 221 AA and 2170 white patients treated with BCT. Chart reviews were conducted to document dates of treatment, treatment breaks, dose delivered, and chemotherapy delivered. The data were analyzed to detect differences between the two cohorts. The median radiation dose delivered (including cone-down) was 64 Gy in both cohorts (p = 0.9910)....

Adenoid Cystic Carcinoma of the Breast: A Review of a Single Institution's Experience

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

(Source: The Breast Journal)

Racial Differences in Adjuvant Systemic Therapy for Early Breast Cancer among Medicaid Beneficiaries

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

This study, therefore, compared breast cancer treatment, particularly adjuvant systemic therapy and survival in black and white women enrolled in Medicaid. Linked New Jersey Cancer Registry and Medicaid Research files provided diagnostic, prognostic, and treatment information on 237 black and 485 white women aged 20[ndash]64 years diagnosed with early stage breast cancer between January 1997 and December 2001. Racial differences in treatment and survival were examined using logistic regression and Cox proportional hazards models respectively. There were no differences in surgical, radiation, or adjuvant systemic treatment between blacks and whites. Breast cancer specific mortality (Hazard ratio (HR) = 1.37; 95% confidence interval (CI) = 0.94[ndash]1.98) and all-cause mortality (HR = 1.43;...

Hydatid Disease of the Breast

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

(Source: The Breast Journal)

The Role of Radiation Therapy in Locally Advanced Breast Cancer

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

Abstract: The purpose of the study was to evaluate and compare the impact of postoperative radiotherapy, whether it was based on the clinical stage at presentation of the disease or on the pathological downstaged disease after initial chemotherapy for non-inflammatory locally advanced breast cancer (LABC). We retrospectively analyzed locoregional recurrence (LRR), relapse free survival (RFS), overall survival (OS) and disease free survival (DFS) in 55 patients treated for non-inflammatory LABC with neoadjuvant chemotherapy and surgery with or without radiotherapy. The mean follow-up was 55 months. The 3-year OS was 74%, DFS 73% and RFS 87%. The OS and DFS benefit was seen in those receiving radiation, with a mean OS of 89 months versus 68 months (p = 0.029) and mean DFS of 72 months versus...

An Exception to Tumour Neoangiogenesis in a Malignant Breast-Lesion

The Breast Journal — Wed, 16 Dec 2009 00:00:00 +0100

Abstract: Magnetic resonance-mammography is regarded as the most sensitive diagnostic modality in the detection of breast cancer. It uses the tumour neoangiogenesis to depict lesions after intravenous contrast agent injection. It is said, that for tumours exceeding a diameter of three millimetres contrast agent enhancement is mandatory. In our case report we describe a rare tumour growth condition. We observed a large invasive carcinoma (18 millimetres diameter) without contrast enhancement in breast MRI due to an almost missing tumour neoangiogenesis. The cancer had a low cellularity and a strong desmoplastic reaction. (Source: The Breast Journal)

Use of the Harmonic Scalpel for Breast Surgery in Patients with a Cardiac Pacemaker – A Tip

The Breast Journal — Tue, 24 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Impact of a Raised Body Mass Index on Breast Cancer Survival in Relation to Age and Disease Extent at Diagnosis

The Breast Journal — Tue, 24 Nov 2009 00:00:00 +0100

Abstract: The prognostic value of Body Mass Index (BMI) on breast cancer outcome is controversial and previous studies from this unit have not shown any significant relation to survival. The aim of this study was to re-examine any impact of a raised BMI on recurrence and survival related to age and disease stage at the time of diagnosis. Breast cancer patients (2,298) were reviewed and divided in groups by BMI. Recurrence Free Survival (RFS), Breast Cancer Specific Survival (BCSS), and Overall Survival (OS) were compared by Kaplan[ndash]Meier life table analysis. Known prognostic factors including BMI were tested for independent prognostic significance in a Cox's regression model. Obese patients (417) had on average larger tumors (median 2.3 versus 2.1 cm, p < 0.01). A trend to an increase...

Older Breast Cancer Survivors: Factors Associated with Self-reported Symptoms of Persistent Lymphedema Over 7 years of Follow-up

The Breast Journal — Tue, 24 Nov 2009 00:00:00 +0100

Abstract: Lymphedema of the arm is a common complication of breast cancer with symptoms that can persist over long periods of time. For older women (over 50% of breast cancer cases) it means living with the potential for long-term complications of persistent lymphedema in conjunction with the common diseases and disabilities of aging over survivorship. We identified women [ge]65 years diagnosed with primary stage I[ndash]IIIA breast cancer. Data were collected over 7 years of follow-up from consenting patients' medical records and telephone interviews. Data collected included self-reported symptoms of persistent lymphedema, breast cancer characteristics, and selected sociodemographic and health-related characteristics. The overall prevalence of symptoms of persistent lymphedema was 36% ove...

Synchronous Bilateral Breast Carcinoma in a Patient with Cowden Syndrome: A Case Report with Morphologic, Immunohistochemical and Genetic Analysis

The Breast Journal — Mon, 23 Nov 2009 00:00:00 +0100

We reported a 44-year-old woman presenting SBBC and characteristic mucocutaneous lesions of CS, confirmed by PTEN gene mutation analysis. Bilateral modified mastectomy and axillary dissection were performed. Histopathologic examination revealed a moderate-differentiated invasive ductal carcinoma with mixed features of luminal A immunophenotype (Estrogen and/or Progesterone Receptors >50% and/or Ki67 < 30% of positive cells). The skin lesions showed the characteristic findings of tricholemmoma. Lack of PTEN expression was observed in all specimens. Sequencing analysis confirmed the presence of PTEN splice-acceptor site mutation in intron 8 (c.1027-2A>G), a germline mutation which had not been previously reported in CS. The patient received adjuvant chemotherapy and tamoxifen for 5 years. Af...

Wegener's Granulomatosis Presented as Recurrent Breast Abscess

The Breast Journal — Mon, 23 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Dysuria Caused by Pelvic Metastasis from Breast Carcinoma was Alleviated by Multi-Modality Therapy with Zoledronic Acid

The Breast Journal — Mon, 23 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Management of Symptomatic Bone Metastases from Breast Cancer with Concomitant Use of External Radiotherapy and Ibandronate: Results of a Prospective, Pilot Study

The Breast Journal — Fri, 20 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Myoid Hamartoma of the Breast: A Very Rare Entity

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Does the Patient's Opinion Differ From the Clinicians' Regarding Breast Cosmesis after BCT?

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Obesity Increases the Risk of Postmenopausal Breast Cancer and is Associated with More Advanced Stage at Presentation But no Impact on Survival

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Estrogen Deprivation Therapy and Colon Cancer Risk in Breast Cancer Patients

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Clinical Implications of Subcategorizing BI-RADS 4 Breast Lesions associated with Microcalcification: A Radiology–Pathology Correlation Study

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

Abstract: Currently radiologists have the option of subcategorizing BI-RADS 4 breast lesions into 4A (low suspicion for malignancy), 4B (intermediate suspicion of malignancy), and 4C (moderate concern, but not classic for malignancy). To determine the clinical significance of BI-RADS 4 subcategories and the common pathologic changes associated with these mammographic lesions, a retrospective review of 239 consecutive stereotactic-needle core biopsies (SNCB) for microcalcifications was performed. All 239 SNCBs were BI-RADS 4 lesions, and of these, 191 were subcategorized to 4A, 4B or 4C. Ninety-four of 191 (49%) were 4A, 73 (38%) were 4B, and 24 (13%) were 4C. Fibrocystic change was the most common finding (66/239; 28%) followed by ductal carcinoma in situ (DCIS) accounting for 23% of cases...

Early Response to Neo-adjuvant Chemotherapy in Carcinoma of the Breast Predicts Both Successful Breast-Conserving Surgery and Decreased Risk of Ipsilateral Breast Tumor Recurrence

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

In conclusion, the early response to neo-adjuvant chemotherapy may be a useful predictor of both selection of surgical method and IBTR risk. (Source: The Breast Journal)

Discontinuation of Radiation Treatment among Medicaid-Enrolled Women with Local and Regional Stage Breast Cancer

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

Abstract: For women with nonmetastatic breast cancer, radiation therapy is recommended as a necessary component of the breast conserving surgery (BCS) treatment option. The degree to which Medicaid-enrolled women complete recommended radiation therapy protocols is not known. We evaluate radiation treatment completion rates for Medicaid enrollees aged 18[ndash]64 diagnosed with breast cancer. We determine clinical and socio-demographic factors associated with not starting treatment, and with interruptions or not completing radiation treatment. Using data from the Washington State Cancer Registry linked to Medicaid enrollment and claims records, we identified Medicaid enrollees diagnosed with breast cancer from 1997 to 2003 who received BCS. Among the 402 women who met inclusion criteria, 10...

Breast Reconstruction with Implants, Tissue Expanders and AlloDerm: Predicting Volume and Maximizing the Skin Envelope in Skin Sparing Mastectomies

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

Abstract: AlloDerm has been used as a tissue supplement in conjunction with the pectoralis major muscle to provide full coverage over an implant in breast reconstruction. While this method of reconstruction has shown promising results there is little known on the relationship of AlloDerm size and potential immediate expansion volume. A retrospective chart review was completed evaluating all tissue expander or primary implant reconstructions using AlloDerm. Data recorded included: The type/size of implant/expander, dimensions of the AlloDerm used, initial fill volume, number of expansions and time period of expansion. Statistical analysis was completed with a linear regression model. AlloDerm was used on 49 patients (72 reconstructions). Thirty-four patients (50 reconstructions) underwent r...

Breast Cancer: Search of Hidden Culprits

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Progenitor-Enriched Adipose Tissue Transplantation as Rescue for Breast Implant Complications

The Breast Journal — Fri, 13 Nov 2009 00:00:00 +0100

Abstract: Breast enhancement with artificial implants is one of the most frequently performed cosmetic surgeries but is associated with various complications, such as capsular contracture, that lead to implant removal or replacement at a relatively high rate. For replacement, we used transplantation of progenitor-supplemented adipose tissue (cell-assisted lipotransfer; CAL) in 15 patients. The stromal vascular fraction containing adipose tissue progenitor cells obtained from liposuction aspirates was used to enrich for progenitor cells in the graft. Overall, clinical results were very satisfactory, and no major abnormalities were seen on magnetic resonance imaging or mammogram after 12 months. Postoperative atrophy of injected fat was minimal and did not change substantially after 2 months...

Over Expression of RhoA is Associated with Progression in Invasive Breast Duct Carcinoma

The Breast Journal — Thu, 12 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

An Extensive Breast Hematoma Following Stereotactic 9 Gauge Vacuum Assisted Large-Core Biopsy

The Breast Journal — Thu, 12 Nov 2009 00:00:00 +0100

(Source: The Breast Journal)

Patterns of Surgical Treatment for Women with Breast Cancer in Relation to Age

The Breast Journal — Mon, 02 Nov 2009 00:00:00 +0100

Abstract: Although treatment recommendations have been advocated for all women with early breast cancer regardless of age, it is generally accepted that different treatments are preferred based on the age of the patient. The aim of this study was to assess the pattern of breast cancer surgery after adjusting for other major prognostic factors in relation to patient age. Data on cancer characteristics and surgical procedures in 31,298 patients with early breast cancer reported to the National Breast Cancer Audit between 1999 and 2006 were used for the study. There was a close association between age and surgical treatment pattern after adjusting for other prognostic factors, including tumor size, histologic grade, number of tumors, lymph node positivity, lymphovascular invasion (LVI), and e...

Time to First Tumor Progression as Outcome Predictor of a Second Trasuzumab-Based Therapy beyond Progression in HER-2 Positive Metastatic Breast Cancer1

The Breast Journal — Mon, 02 Nov 2009 00:00:00 +0100

Abstract: In a previous analysis performed on a cohort of 37 HER-2 positive metastatic breast cancer (MBC) patients treated with trastuzumab beyond progression, we found that a second trastuzumab-based therapy is associated with a considerable response rate and preserved time to progression as compared with a first trastuzumab-based therapy. In the present study, we extended the analysis to a total of 69 patients treated in four different italian Institutions, also trying to identify clinical predictors of sensitivity to a second trastuzumab-based therapy beyond progression. Efficacy results on the overall population confirmed that a second trastuzumab-based therapy beyond progression is an active regimen (27.5% of responses and 6.5 months of time to progression, respectively). Median time...

Obesity is a Risk Factor for Developing Postoperative Lymphedema in Breast Cancer Patients

The Breast Journal — Mon, 02 Nov 2009 00:00:00 +0100

Abstract: Lymphedema (LE) is a well-known postoperative complication after axillary node dissection (ALND). Although, sentinel lymph node dissection (SLND) involves more focused surgery and less disruption of the axilla, early reports show up to 13% of patients experience some symptoms of LE. The purpose of this study was to determine predictors of arm LE in our patients under going SLND with or without an ALND. One hundred and thirty-seven breast cancer patients were treated at a comprehensive cancer center. Prospective measurement of arm volume was carried every 6 months from date of diagnosis. This data base was retrospectively reviewed for tumor stage, treatment, and subjective complaints of LE. Objective LE was defined as a change greater than 200 mL compared with the control arm. Uni...

Breast Cancer Prevention: Patient Decision Making and Risk Communication in the High Risk Setting

The Breast Journal — Mon, 02 Nov 2009 00:00:00 +0100

This study provides insight into the decision making process of women at high risk for breast cancer and highlights the importance of addressing patient preferences for interventions and risk perception during risk assessment and counseling consultations. (Source: The Breast Journal)

Histiocytoid Variant of Lobular Carcinoma: A Triple Negative Case

The Breast Journal — Mon, 12 Oct 2009 23:00:00 +0100

(Source: The Breast Journal)

Creating Awareness About the Painless Nature of Early Breast Cancer Lump is Important in Low-Income Countries

The Breast Journal — Mon, 12 Oct 2009 23:00:00 +0100

(Source: The Breast Journal)

Flat Epithelial Atypia and Atypical Ductal Hyperplasia: Carcinoma Underestimation Rate

The Breast Journal — Mon, 12 Oct 2009 23:00:00 +0100

This study was carried out to determine the underestimation rate of carcinoma upon surgical biopsy after a diagnosis of flat epithelial atypia and atypical ductal hyperplasia and 11-gauge vacuum-assisted breast biopsy. A retrospective review was conducted of 476 vacuum-assisted breast biopsy performed from May 2005 to January 2007 and a total of 70 cases of atypia were identified. Fifty cases (71%) were categorized as pure atypical ductal hyperplasia, 18 (26%) as pure flat epithelial atypia and two (3%) as concomitant flat epithelial atypia and atypical ductal hyperplasia. Each group were compared with the subsequent open surgical specimens. Surgical biopsy was performed in 44 patients with atypical ductal hyperplasia, 15 patients with flat epithelial atypia, and two patients with flat epi...

Pilomatrixoma Mimicking Breast Cancer in Man

The Breast Journal — Mon, 12 Oct 2009 23:00:00 +0100

(Source: The Breast Journal)

Sentinel Lymph Node Detection in Breast Cancer Patients by Real-Time Virtual Sonography Constructed With Three-Dimensional Computed Tomography-Lymphography

The Breast Journal — Sun, 11 Oct 2009 23:00:00 +0100

Abstract: Ultrasonography (US) is one tool for preoperative diagnosis of lymph node metastases in breast cancer. However, US cannot detect true sentinel lymph nodes (SLNs). We identified SLNs in 60 clinically node-negative breast cancer patients using a real-time virtual sonography (RVS) system to display in real time a virtual multi-planar reconstruction obtained from computed tomography (CT) volume data corresponding to the same cross-sectional image from US. CT volume data were obtained from our original three-dimensional CT lymphography (3DCT-LG), which accurately detects SLNs in breast cancer. SLN metastases were assessed by shape and visibility of the hilum. All patients underwent SLN biopsy and SLN metastases were examined pathologically. In all 60 patients, we were able to detect t...

Interstitial Laser Therapy of Breast Fibroadenomas With 6 and 8 Year Follow-Up

The Breast Journal — Sun, 11 Oct 2009 23:00:00 +0100

Abstract: Fibroadenomas are non-cancerous breast tumors commonly seen in teenagers but also found in women at the time of first mammogram. They have distinct physical findings and imaging features but the definitive diagnosis is made by ultrasound or stereotactic guided needle biopsy. Treatment options are observation or surgical removal. Recently, removal by ultrasound-guided technique has been reported. Alternatively, the tumor may be ablated within the breast by cold (cryotherapy) or by heat (laser, radiofrequency, focused ultrasound and microwave). In this paper the laser treatment in two patients, one with bilateral fibroadenomas, with 6 and 8 year follow-up is presented. (Source: The Breast Journal)

Quantitative Assessment of Radiation-Induced Fibrosis of the Breast with Tissue Compliance Meter, Palpation, and Radiological Imaging: Preliminary Results

The Breast Journal — Sun, 11 Oct 2009 23:00:00 +0100

Abstract: Quantification of radiation (RT)-induced fibrosis (RIF) continues to present a challenge in breast cancer survivors. We compare assessment of RIF by palpation and tissue compliance meter (TCM) to the radiological findings in women treated with RT. Of 300 patients treated with adjuvant RT, 17 women had [ge]2-year follow-up sufficient to document RIF. Palpation and TCM were employed by three radiation oncologists in a blinded fashion. Palpation grades 1, 2, and 3 denoted mild, moderate, and severe RIF. TCM measured degree of compliance (DC) of RIF in irradiated (RTB) and nonirradiated breasts (NRTB). Architectural distortions (AD) on mammograms, ultrasound (US), and MRI were assessed. Median time of follow up was 3.9 years (range 2.1[ndash]6.5 years). Palpation revealed RIF grades ...

Simple Prediction Models for Breast Cancer Patients with Solitary Positive Sentinel Nodes––are they Valid?

The Breast Journal — Sun, 11 Oct 2009 23:00:00 +0100

In this study, we evaluate the performance of two recently published models (Alkhatib et al. and Chagpar et al.) that attempt to predict patients who have isolated sentinel lymph node metastases. Both of these models reported a 5% rate of positive nonsentinel nodes in their respective lowest risk category. From 1997 to 2004, 465 breast cancer patients had a positive sentinel node and underwent axillary lymph node dissection at Mayo Clinic. To evaluate the Alkhatib model, patients were assigned to the following groups: group 1: 1 positive sentinel node and [ge]1 negative sentinel node(s); group 2: >1 positive sentinel node and [ge]1 negative sentinel node(s); group 3: 1 positive sentinel node and no negative sentinel node(s); group 4: >1 positive sentinel node and no negative sentinel node(...

Invasive Breast Carcinoma Arising in Microglandular Adenosis: A Case Report and Review of the Literature

The Breast Journal — Sun, 11 Oct 2009 23:00:00 +0100

We reported a case of invasive carcinoma arising in microglandular adenosis. A lumpectomy was performed on a 42-year-old female because of a mass in the right breast. Grossly, the lesion was ill-defined with thickened areas. Histologically, this case was consistent with carcinoma arising in microglandular adenosis and showed clear transition from microglandular adenosis through atypical microglandular adenosis to in situ and invasive carcinoma. All the epithelial cells were positive for cytokeratin7, S-100 protein, but negative for estrogen receptor, progesterone receptor, and Her2/Neu. No myoepithelial cells were demonstrable with immunohistochemical staining for smooth muscle actin, muscle-specific antigen or P63. Periodic acid-Schiff staining showed the presence of a basement membrane i...

Lymphoepithelioma-like Carcinoma of the Breast: Diagnosis by Core Needle Biopsy

The Breast Journal — Sun, 11 Oct 2009 23:00:00 +0100

(Source: The Breast Journal)

Breast Cancer Subtypes as Defined by the Estrogen Receptor (ER), Progesterone Receptor (PR), and the Human Epidermal Growth Factor Receptor 2 (HER2) among Women with Invasive Breast Cancer in California, 1999–2004

The Breast Journal — Wed, 16 Sep 2009 23:00:00 +0100

This study examines the eight combinations of ER/PR/HER2 in patients with invasive breast cancer. The 5-year relative survival and the distribution among demographic, socioeconomic, and tumor characteristics of each of the subtypes are examined. Using the California Cancer Registry, 61,309 women with primary invasive breast cancer were classified according to ER/PR/HER2 status. Five-year relative survival was computed for the eight subtypes. Bivariate analyses were used to assess the distribution of cases across all subtypes. Multivariate logistic regression was used to compute the adjusted odds of having one of the five subtypes with the best and worst survival. Survival varied from 96% (ER+/PR+/HER2[minus]) to 76% (ER[minus]/PR[minus]/HER2+ and ER[minus]/PR[minus]/HER2[minus]). The four ...

Male Breast Carcinoma With Zosteriform Metastasis

The Breast Journal — Wed, 16 Sep 2009 23:00:00 +0100

(Source: The Breast Journal)

Breast Intracystic Papillary Carcinoma: An Update

The Breast Journal — Mon, 07 Sep 2009 23:00:00 +0100

In this study, surgical pieces of 20 IPCs were reassessed, and markers of myopepithelial layer (p63, CD10 and Smooth Muscle Actin) as well as estrogen receptors (ER) and progesterone receptors (PgR) and C-erb-B2 oncoprotein expression were systematically performed and quantified. In 10 cases, an associated unequivocal invasive component was found. In all 20 cases, no myoepithelial layer was found. Eighteen tumors were ER positive, 14 were PgR positive. Moreover, none of the tumors over-expressed C-erb-B2 oncoprotein. Therefore this study showed that in all cases of IPC there were microscopic features of invasive carcinoma despite good clinical prognostic indicators, and that precise characterization of tumors requires extensive paraffin embedding of surgical pieces. (Source: The Breast Jou...

False Negative Rate of Sentinel Lymph Node Biopsy in Multicentric and Multifocal Breast Cancers May be Higher in Cases with Large Additive Tumor Burden

The Breast Journal — Sun, 06 Sep 2009 23:00:00 +0100

Abstract: We aimed to evaluate the feasibility of sentinel lymph node biopsy (SLNB) in multicentric/ multifocal breast cancer. In this prospective study, 23 women with multicentric/multifocal breast cancer underwent SLNB at our institution from April 2002 to February 2006. Presence of preoperative axillary metastases was confirmed by FNA. Patients underwent sub-areolar radiopharmaceutical injection ± isosulfan blue to perform SLNB, then completion ALND. The false-negative (FN) rate of SLNB was determined based upon final pathology. Twenty women with multicentric and three with multifocal invasive carcinoma were enrolled. The SLN identification rate was 100%. The overall FN rate of SLNB was 15% (95% CI 0.0466, 0.4281). Both cases with FN SLNB had multicentric disease, pathologic stage III ...

An unusual Case of Phyllodes Tumor Presenting as a Trans-Nipple Tumor in a 13-Year-Old Female

The Breast Journal — Sun, 06 Sep 2009 23:00:00 +0100

(Source: The Breast Journal)

Motivations for Breast Surgery: A Qualitative Comparison Study of Breast Reconstruction, Augmentation, and Reduction Patients

The Breast Journal — Sun, 06 Sep 2009 23:00:00 +0100

(Source: The Breast Journal)

Long Standing Accidental Foreign Body (Sewing-Machine Needle) in Breast Tissue

The Breast Journal — Sun, 06 Sep 2009 23:00:00 +0100

(Source: The Breast Journal)

The Significance of Nipple Discharge of the Male Breast

The Breast Journal — Sun, 06 Sep 2009 23:00:00 +0100

Abstract: Although male breast cancer typically presents as a palpable mass, failure to recognize the significance of other symptoms may lead to a delay in diagnosis. Here we present our experience with male patients presenting with a chief complaint of nipple discharge (ND). Using the ICD-9 code for "breast symptoms," we identified 2,319 patients without a current cancer diagnosis who presented to Memorial Sloan-Kettering Cancer Center for evaluation; 24 (1%) patients were male (1995[ndash]2005). Data were collected by retrospective review. Among 24 male patients presenting for evaluation, 14 (58%) presented with a chief complaint of ND, while the remaining 10 (42%) presented for evaluation of a palpable mass in the absence of ND. Among 14 patients presenting with ND, subsequent clinical ...

Dietary Factors and Breast Cancer in Korea: An Ecological Study

The Breast Journal — Mon, 17 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Tamoxifen Induced Severe Hypertriglyceridemia in a Male Patient with Breast Carcinoma

The Breast Journal — Sun, 16 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Influence of Fibrin Glue on Seroma Formation After Modified Radical Mastectomy: A Prospective Randomized Study

The Breast Journal — Sun, 16 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

First Breast Cancer Mammography Screening Program in Mexico: Initial Results 2005–2006

The Breast Journal — Sun, 16 Aug 2009 23:00:00 +0100

This report includes data from the first 96,828 mammographies performed between March 2005 and December 2006. There were 1% of mammographies in Breast Imaging Reporting and Data System 0, 4, or 5 and 208 out of 949 women with abnormal mammographies (27.7%) had breast cancer, a rate of 2.1[permil], most of them in situ or stage I (29.4%) or stage II (42.2%) nevertheless 21% of those women with abnormal mammography did not present for further clinical and radiologic evaluation despite being personally notified at their home addresses. The breast cancer rate of Mexican women submitted to screening mammography is lower than in European or North American women. Family history of breast cancer, nulliparity, absence of breast feeding, and increasing age are factors that increase the risk of breas...

Coping With a Diagnosis of Breast Cancer-Literature Review and Implications for Developing Countries

The Breast Journal — Sun, 16 Aug 2009 23:00:00 +0100

Abstract: Breast cancer is the most common cancer affecting women worldwide. Women are at an increased risk of developing both physical and psychological morbidity after diagnosis; however, many use different strategies to cope with the disease. The aim of this article is to review the available literature on the impact of breast cancer diagnoses and the strategies used by women to cope with this disease. The implications of these emerging findings are extrapolated within the context of health services provided in developing countries. Electronic databases were used to search the relevant literature. The findings showed that women who were diagnosed with breast cancer are at risk of developing several psychological morbidities such as depression, anxiety, fatigue, negative thoughts, suicid...

Benign Inclusion of Axillary Lymph Nodes: Report of Two Cases and Literature Review

The Breast Journal — Sun, 16 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

The Impact of Ethnicity in UK Breast Cancer Screening Programme

The Breast Journal — Sun, 16 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Is Surgical Excision Necessary for Atypical Ductal Hyperplasia Diagnosed with 8 Gauge Stereotactic Biopsy?

The Breast Journal — Sun, 16 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

A Diagnostic Mishap: Solitary Splenic Carcinomatous Metastases from the Breast

The Breast Journal — Sat, 15 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

T1 N0 Triple Negative Breast Cancer: A Bad Actor

The Breast Journal — Tue, 04 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

MR Imaging of Tubular Adenoma of Breast Associated with Lactating Change

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Calcification of Breast Tissue in the Ehlers–Danlos Syndrome

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Metastasis of Breast Carcinoma to Spinal Meningioma

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Non Healing Ulcer of the Breast Due to Calciphylaxis

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Oil Cyst Mimicking Intracystic Neoplasm

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

In Response

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Sentinel Lymph Node Biopsy after Neo-adjuvant Systemic Chemotherapy in Patients with Breast Cancer

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Long-Term Follow-Up of an Anthracycline-Containing Metronomic Chemotherapy Schedule in Advanced Breast Cancer

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

PET–CT Imaging in the Initial Management of High-Risk Breast Cancer Patients: Who Did it Help?

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Shortened Survival and More Metastasis Recurrences among Overweight Breast Cancer Patients

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

The Long-term Impact of Breast Radiotherapy on Dyspnea and Pulmonary Function

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Breastfeeding, Parity, and Reduction of Breast Cancer Risk

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

Elastography: Theory into Clinical Practice

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

(Source: The Breast Journal)

T1N0 Triple Negative Breast Cancer: Risk of Recurrence and Adjuvant Chemotherapy

The Breast Journal — Mon, 03 Aug 2009 23:00:00 +0100

Abstract: Adjuvant treatment of T1N0 breast cancer (BC) has evolved in recent years with chemotherapy options dependent on tumor size and cellular characteristics. Our goal is to describe the difference in outcome between T1N0 triple negative (TriNeg) and estrogen/progesterone receptor positive/her2/neu-negative BC. From our institute's registry, we identified primary BC patients diagnosed from 1998 to 2005, estrogen/progesterone receptor negative (ER[minus]/PR[minus])/her-2/neu negative (her2[minus]) (TriNeg = 110) and ER+/PR+/her2[minus] (HR+/her2[minus] = 919). Clinical diagnosis and treatment variables were chart abstracted. Vital and disease status were updated annually. Pearson chi-squared tests were used for bivariate analysis. Hazard ratios were calculated using the Cox proportiona...

Therapeutic Effects of Vitamin E on Cyclic Mastalgia

The Breast Journal — Tue, 14 Jul 2009 23:00:00 +0100

This study was performed to clarify the therapeutic effects of Vitamin E (Vit E) as a safe treatment for cyclic mastalgia among fertile women. This study was conducted as a double blind clinical trial; 150 women with cyclic mastalgia, referred by three public health centers in Qazvin City in Iran, were enrolled in the trial and randomly divided into two distinct case and control groups; each containing 75 patients. The severity and duration of breast pain were measured according to both the Cardiff Breast Pain Chart and the Visual Analog Scale. Simple, chewable tablets of either Vit E or a placebo were prescribed twice a day for 4 months for case and control participants, respectively. Follow-up was performed at the end of both the second and the fourth months and, at that time, the severi...

Quality of Life after Breast Cancer: Survivorship and Sexuality

The Breast Journal — Mon, 13 Jul 2009 23:00:00 +0100

This report will focus on these four issues highlighting information for the treating oncologist which can assist in the evaluation, counseling, and treatment for their patients. (Source: The Breast Journal)

Βeta-Human Chorionic Gonadotropin Production Associated with Phyllodes Tumor of the Breast: An Unusual Paraneoplastic Phenomenon1

The Breast Journal — Mon, 13 Jul 2009 23:00:00 +0100

Abstract: Phyllodes tumors (PTs) of the breast are uncommon and account for < 1% of all breast tumors. Most patients present with mass lesions; however, there are rare reports of patients presenting with paraneoplastic conditions such as hypoglycemia secondary to insulin-like growth factor II secretion. A 55-year-old woman presented with a rapidly enlarging left breast mass which ulcerated through the skin and invaded the underlying muscle. The serum [beta]-human chorionic gonadotropin ([beta]-hCG) level was found to be 58 mIU/mL preoperatively; this dropped to 2 mIU/mL after surgery. Mastectomy showed a 14.5-cm fibroepithelial neoplasm, the majority of which was composed of a cellular spindle/epithelioid-cell proliferation with the focal presence of elongated epithelial clefts consistent ...

Presentation, Management and Outcome of 32 Patients with Pregnancy-Associated Breast Cancer: A Matched Controlled Study

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

Abstract: Pregnancy-associated breast cancer (PABC) is a rare and challenging problem. We sought to describe epidemiology, management and outcome of women in whom breast cancer was diagnosed during pregnancy or within one year after delivery. Thirty-two women with PABC were referred to two European Union oncology centers between 1995 and 2007, 16 during pregnancy and 16 within 1 year after delivery. Data concerning diagnosis, management, delivery and fetal and maternal outcome were recorded. A group of 32 patients (matched controls) presenting with nonpregnancy-associated breast cancer (non-PABC) was matched for age at diagnosis, tumor size and stage to each PABC patient. Differences in outcome between the PABC and non-PABC groups were then assessed. Histological features were similar in b...

Initial Outcomes Analysis for Large Multicenter Integrated Cancer Network Implementation of Intensity Modulated Radiation Therapy for Breast Cancer

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

Abstract: To analyze the initial clinical outcomes for breast cancer patients treated with intensity-modulated radiation therapy (IMRT) in a large integrated cancer center network. A total of 495 patients with breast cancer received IMRT following breast conserving surgery among nine cancer centers. Seven community cancer centers span a 100-mile radial distance from the two central academic sites. All nine cancer centers followed the same clinical pathway guidelines for the radiotherapeutic management of breast cancer. IMRT planning for all centers was performed at one central location, D3 Advanced Radiation Planning Service. The median IMRT prescription dose was 50 Gy followed by a boost with median dose of 10 Gy. The median breast volume was 918 cm3. The median Dose Homogeneity Index (DH...

Alterations of the Cell Cycle Regulators Cyclin D1, Cyclin A, p27, p21, p16, and pRb in Apocrine Metaplasia of the Breast

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

Abstract: G1/S transition defects have been a proposed requirement for tumor development. Apocrine metaplasia (APM) in the breast has been held as a sign of benignity. Yet, a number of studies have reported the presence of molecular abnormalities in some forms of APM suggesting a possible oncogenic potential for some of these lesions. We currently investigate the role of some of the cell cycle proteins, previously reported to be de-regulated in breast cancer, in an attempt to assess their significance in APM. Using immunohistochemistry, the expression of cyclin D1, cyclin A, p27, p21, p16, pRb and Ki-67 was examined in 93 cases of APM. The cases were divided into nonpapillary (NAPM) (30 cases) and papillary metaplasia (PAPM) (63 cases). PAPM was further subdivided into simple papillary (SP...

Improved Postoperative Pain Control using Thoracic Paravertebral Block for Breast Operations

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

We report our institutional experience with PVB over the initial 8 months of use. All patients undergoing breast operations at the ambulatory care building from September 09, 2005 to June 28, 2005 were reviewed. Comparison was performed between patients receiving PVB and those who did not. Pain scores were assessed immediately, 4 hours, 8 hours and the morning after surgery. 178 patients received PVB and 135 patients did not. Patients were subdivided into three groups: Group A[ndash]segmental mastectomy only (n = 89), Group B[ndash]segmental mastectomy and sentinel node surgery (n = 111) and Group C[ndash]more extensive breast surgery (n = 113). Immediately after surgery there was a statistically significant difference in the number of patients reporting pain between PVB patients and those...

The Role of Smoking in Breast Cancer Development: An Analysis of a Mayo Clinic Cohort

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

Abstract: The purpose of this study was to assess the predictive value of smoking history on breast cancer diagnosis in a referral clinic population. We conducted a case[ndash]control study using clinical data collected on 8,097 female patients (1,225 breast cancer cases and 6,872 controls) seen in the Mayo Clinic Breast Clinic between August 1, 1993 and November 31, 2003. Breast cancer patients and noncancer patients significantly differed with respect to age at time of the index visit (p < 0.001), number of pregnancies (p = 0.006), number of live births (p = 0.002), vital status at last known follow-up (p < 0.001), current menstruation (p < 0.001), age at menopause (p < 0.001), history of hysterectomy (p < 0.001), use of oral contraception (p = 0.05), duration of oral contraception use (...

Intrapulmonary and Cutaneous Siliconomas after Silent Silicone Breast Implant Failure

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

We present six female patients with an average age of 55 (±5) years with bilateral rupture of silicone implants after breast augmentation for aesthetic reasons. The average time after operation was 18 (±6) years. In five patients, we identified peripheral located cutaneous siliconomas and one patient suffered from an intrapulmonal siliconoma. The diagnosis of bilateral rupture of the silicone implants was performed preoperatively by MRI-scans. All five peripheral cutaneous siliconomas and the intrapulmonal siliconoma were validated by histopathologic analysis. Six female patients suffered from bilateral rupture of silicone implants after breast augmentation. In five patients, we identified peripheral located cutaneous siliconomas which were surgically excised. One patient suffered from a...

Current Understanding of Mitochondrial DNA in Breast Cancer

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

Abstract: The recent surge in mitochondrial research has been driven by the identification of mitochondria-associated diseases and the role of mitochondria in apoptosis and aging. Mitochondrial DNA (mtDNA) has been proposed to be involved in carcinogenesis because of its high susceptibility to mutations and limited repair mechanisms in comparison to nuclear DNA. As mtDNA lacks introns, it has been suggested that most mutations will occur in coding sequences. The subsequent accumulation of mutations may lead to tumor formation. By virtue of their clonal nature, high copy number and high frequent mutations may provide a powerful molecular biomarker for the detection of cancer. It has been suggested that the extent of mtDNA mutations might be useful in the prognosis of cancer outcome and/or t...

Breast Hamartomas in Adolescent Females

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

Abstract: Breast hamartomas are uncommon lesions that have not been extensively characterized in the adolescent population. A search of patient records at our institution over a 17-year period identified seven cases of breast hamartomas in patients less than 18 years of age. We examine and report the clinical, radiographic, and pathologic characteristics of these cases. Breast hamartomas present as painless, palpable masses in the adolescent population. Ultrasonography reveals a well-defined, solid, oval mass, similar to the more common fibroadenoma. Two of the patients underwent core needle biopsy for diagnosis as the only intervention with the remainder undergoing surgical excision. None of the patients had any complications from surgery. There was one recurrence 9 months after initial e...

Specimen Radiographs Assist in Identifying and Assessing Resection Margins of Occult Breast Carcinomas

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

The objective of this study was to determine the efficacy of specimen radiographs of mastectomy in identifying occult carcinoma associated with microcalcifications and assessing the resection margins. We reviewed the histology and corresponding specimen radiographs of 16 patients with diffuse and widespread microcalcifications and who underwent skin-sparing mastectomy. After the specimens were serially sectioned, specimen radiographs of each section of the specimens were obtained with digital mammography equipment. Findings in the specimen radiographs were used to direct the histologic sampling of the specimens. On gross examination, two (12.5%) mastectomy specimens had identifiable discreet masses; the lesions were 4 and 7 mm, respectively. Histologic examination revealed the presence of ...

Quality Assessment of Neoadjuvant Therapy Use in Breast Conservation: Barriers to Implementation

The Breast Journal — Sun, 12 Jul 2009 23:00:00 +0100

Abstract: Neoadjuvant systemic therapy (NST) for operable breast cancer can increase the options for conservative surgery in patients with breast cancer. We performed an analysis of a breast cancer outcomes database as a quality assessment of neoadjuvant therapy use in relation to breast conservative rate (BCR). Data were reviewed from a breast cancer database established to monitor outcomes of breast cancer surgery at a tertiary care breast cancer clinic. The frequency of NST-use was correlated to tumor size and BCR. Cause-specific factors for omitting NST in patients undergoing mastectomy for tumors 3 cm or greater were determined. NST was employed in 29 of 241 (12%) cases of invasive breast carcinoma treated surgically from 2003 to 2005. Although a significant decrease in BCR occurred i...

Intraoperative Ultrasound in Excision of Breast Nonpalpable Lesions: The Experience of the Breast Unit of San Giovanni Hospital in Rome

The Breast Journal — Tue, 07 Jul 2009 23:00:00 +0100

(Source: The Breast Journal)

Cross-Trial Comparison of Different AIs

The Breast Journal — Mon, 06 Jul 2009 23:00:00 +0100

(Source: The Breast Journal)

Breast Tumor Resembling the Tall Cell Variant of Papillary Thyroid Carcinoma

The Breast Journal — Sun, 05 Jul 2009 23:00:00 +0100

We describe the case of a 66-year-old woman with a palpable mass in her left breast. Although the diagnosis on core biopsy was an intraductal papilloma, the surgically excised lesion showed it to be an infiltrating carcinoma which appeared to arise in a complex sclerosing lesion and is similar to the recently described breast tumor resembling the tall cell variant of papillary thyroid carcinoma. (Source: The Breast Journal)

Influence of Fibrin Glue on Seroma Formation after Modified Radical Mastectomy: A Prospective Randomized Study

The Breast Journal — Wed, 24 Jun 2009 23:00:00 +0100

(Source: The Breast Journal)

Predictors of Toxicity and Toxicity Profile of Adjuvant Chemotherapy in Elderly Breast Cancer Patients

The Breast Journal — Wed, 10 Jun 2009 04:00:00 +0100

Abstract: Women older than 70 years have been underrepresented in breast cancer adjuvant chemotherapy trials due to concerns about toxicity, safety and tolerance of chemotherapy. The aim of our study was to assess the tolerance of chemotherapy in older women with breast cancer and determine patterns of toxicity including the impact of age, chemotherapy regimen, functional status and comorbid conditions on this toxicity. We retrospectively reviewed the charts of early stage (stages 1 and 2) breast cancer patients older than 70 years from 1998 to 2004. A total of 62 patients, with mean age of 74.3 years, were identified. Chemotherapy was completed in 89% patients. Overall 79% completed chemotherapy without any significant side-effects, dose reductions, or breaks during chemotherapy. Using lo...

Ductoscopy—Increasing Clinical Utility

The Breast Journal — Tue, 09 Jun 2009 04:00:00 +0100

(Source: The Breast Journal)

Use of Ultrasound-Guided Percutaneous Vacuum-Assisted Breast Biopsy for Selected Difficult Indications

The Breast Journal — Sun, 07 Jun 2009 04:00:00 +0100

Abstract: To assess ultrasound-guided vacuum-assisted biopsy (US-VAB) for selected problem cases and to report experiences with two different biopsy systems. Fifty-one lesions have been biopsied using the Mammotome (n = 24) or the Vacora (n = 27) system. Main indications: lesion in scarring (n = 5), complex cystic [ge]8 mm (n = 7), increase in size (n = 10), architectural distortion (n = 4), uncharacteristic palpable abnormality (2), small size (n = 22), regional microcalcifications (n = 1). Results are verified by surgical excision (n = 10) or follow-up (n = 40). One patient was lost to follow-up. In four of the cases preceding core biopsy was inconclusive. four invasive carcinomas, two ductal carcinoma in situ (DCIS), three papillomas, six fibroadenomas, one adenosis tumor, one hamartoma...

Classification of Inflammatory Breast Disorders and Step by Step Diagnosis

The Breast Journal — Fri, 22 May 2009 04:00:00 +0100

In this study, the authors proposed a classification of inflammatory breast disorders based on which a practical systematic scheme in diagnosis was applied aiming to differentiate simple forms of mastitis from more complicated and malignant forms. The study population included 197 female patients who were clinically or pathologically diagnosed as having mastitis. All patients underwent Ultrasound examination. Mammography was performed for 133/197 cases. Cases of simple mastitis and periductal mastitis were followed up to ensure complete resolution. Abscess cavities and postoperative collections were drained. Other cases were biopsied to confirm diagnosis and were managed accordingly by their treating physicians. Statistical analysis was performed by the Statistical Package for Social Scien...

Clinical Criteria as Predictive Factors of Response to Primary Hormone Therapy in Locally Advanced Breast Cancer

The Breast Journal — Fri, 22 May 2009 04:00:00 +0100

This study investigates the efficacy of clinical criteria in selecting patients for primary tamoxifen therapy. A total of 60 breast cancer patients with large primary tumors and unknown hormonal receptor status were subjected to primary hormone therapy. Inclusion criteria were age over 60 years old or menopausal status for at least 10 years and no clinical evidence of inflammatory disease and fast tumor growth. The objective response rate was 55%. There was a positive correlation between the lack of clinical response and axillary lymph node metastasis (p = 0.009). Patients with objective response had significantly improved disease-free (p = 0.045) and overall (p = 0.0002) survival over those who did not have response to hormonal therapy. In multivariate analysis, the clinical response to t...

Randomized Trial Comparing Locoregional Resection of Primary Tumor with No Surgery in Stage IV Breast Cancer at the Presentation (Protocol MF07-01): A Study of Turkish Federation of the National Societies for Breast Diseases

The Breast Journal — Fri, 22 May 2009 04:00:00 +0100

Abstract: The MF07-01 trial is a phase III randomized controlled trial which compares breast cancer patients with distant metastases at presentation who receive locoregional treatment for intact primary tumor with those who do not receive such treatment. The primary objective of the study is to assess whether locoregional treatment of the primary tumor provides a better overall survival. Secondary objectives include progression-free survival, quality-of-life, and morbidity related to locoregional treatment. Locoregional treatments consist of either mastectomy or breast conserving surgery with level I-II axillary clearance in clinically or sentinel lymph node positive patients. Radiation therapy to the whole breast follows breast conserving surgery. Standard systemic therapy is given to all...

Nipple-Sparing Mastectomy: Initial Experience at the Memorial Sloan-Kettering Cancer Center and a Comprehensive Review of Literature

The Breast Journal — Fri, 22 May 2009 04:00:00 +0100

Conclusions about the oncologic safety of this procedure cannot be drawn from our study due to small size series and short follow-up. However, available published data show that NSM can be safely performed for breast cancer treatment in carefully selected cases. Further studies and longer follow-up are necessary to refine selection criteria for NSM. (Source: The Breast Journal)

A Case of Brain Metastases from Breast Cancer that Responded to Anastrozole Monotherapy

The Breast Journal — Fri, 15 May 2009 04:00:00 +0100

(Source: The Breast Journal)

The Value of Breast Ductoscopy in Radiologically Negative Spontaneous/Persistent Nipple Discharge

The Breast Journal — Tue, 12 May 2009 04:00:00 +0100

Abstract: Breast ductoscope is a fiberoptic endoscope used for examining the distal breast ducts under direct vision in order to identify the source of pathologic nipple discharge. The purpose of this study was to investigate the reliability of intra-operative breast ductoscopy in patients with pathologic nipple discharge, which could not be identified by radiologic tests. Between April 2002 and March 2007, breast ductoscopy was performed in 34 patients who had pathologic nipple discharge with no radiologic evidence about the source. The procedures were carried out under general anesthesia and ductoscopic findings were as well as the histopathology of the specimens were recorded and documented. In 88%, (30 of 34) of the patients, endoscope was successfully introduced into the external orif...

Pigmented Mammary Paget's Disease Mimicking Melanoma a Further Case in a Man

The Breast Journal — Tue, 12 May 2009 04:00:00 +0100

(Source: The Breast Journal)

Minimal Breast Cancer in Split Region of Croatia on the Eve of the National Mammographic Screening Program

The Breast Journal — Tue, 12 May 2009 04:00:00 +0100

(Source: The Breast Journal)

Axillary Lymphatic Disruption does not Increase Risk of Breast Carcinoma

The Breast Journal — Tue, 12 May 2009 04:00:00 +0100

(Source: The Breast Journal)

Survival Impact of Integrative Cancer Care in Advanced Metastatic Breast Cancer

The Breast Journal — Tue, 12 May 2009 04:00:00 +0100

We report survival data for a consecutive case series of advanced metastatic breast cancer patients who received a comprehensive clinical program combining conventional treatments with nutrition and supplementation, fitness and mind-spirit instruction at the Block Center for Integrative Cancer Treatment. Treatment outcomes using integrative care for this disease have not previously been documented; survival data will thus contribute to decisions concerning future research directions and design. Ninety consecutive patients with metastatic breast cancer diagnosed during 1984[ndash]1997 who received chemotherapy at the integrative cancer center were included. Prognostic factors, treatments and survival from onset of metastases were determined from analysis of scans, labs, pathology and medica...

Infiltrating Syringomatous Adenoma of the Nipple

The Breast Journal — Tue, 12 May 2009 04:00:00 +0100

Abstract: Infiltrating syringomatous adenoma of the nipple is a rare, benign, locally invasive tumor with recurrence potential, showing sweat duct differentiation. It can clinically, radiologically and pathologically mimic cancer. Histopathologically, it must be distinguished from florid papillomatosis, adenosquamous carcinoma, adenoid cystic carcinoma and sclerosing syringomatous carcinoma. A 44-year-old woman presented with pain on the right nipple for 7 days. On physical exam there was an irregular nodule on nipple area with edema. The skin was intact. The ultrasound showed a hypoechoic irregular nodule measuring 7.5 mm in the nipple area. The mammography was unspecific. The lesion was surgically removed and histopathologically, the tumor was composed of ducts and tubules lined with a d...

Complete Response after Chemotherapy in Metastatic Involvement of the Orbita in Breast Cancer

The Breast Journal — Tue, 12 May 2009 04:00:00 +0100

(Source: The Breast Journal)

Corrigendum