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International Journal of Breast Cancer 2011Breast carcinoma has a complex subgross morphology in the majority of cases. The malignant transformation usually involves a single breast lobe and may demonstrate...
Breast carcinoma has a complex subgross morphology in the majority of cases. The malignant transformation usually involves a single breast lobe and may demonstrate peripheral, segmental, or lobar growth patterns in the in situ phase. During the invasive phase, the tumor may grow beyond the borders of the affected lobe. The dimensions of the involved lobe and the pattern of its involvement determine the extent of the disease in the early phase, with the size, type, and position of the invasive foci being additional determinants in more advanced cases. Breast carcinomas of limited extent (occupying a tissue area <40 mm) are proper candidates for breast-conserving surgery. In other cases, careful individual preoperative assessment of disease extent is necessary in making decisions about the most appropriate surgical approach, taking into account the position of the lesion(s) within the breast, the dimensions of the breast, and patient preference.
PubMed: 22295230
DOI: 10.4061/2011/634021 -
Radiology Nov 2020History A 60-year-old woman was diagnosed with a new right upper lobe stage I lung adenocarcinoma and underwent video-assisted thoracoscopic surgery (VATS) for right...
History A 60-year-old woman was diagnosed with a new right upper lobe stage I lung adenocarcinoma and underwent video-assisted thoracoscopic surgery (VATS) for right upper lobectomy. Her postoperative course was complicated by a large pneumothorax after chest tube removal on postoperative day 3. This was managed with repeat right-sided chest tube placement on the same day. The second chest tube was removed on postoperative day 8 without complications. A 2-week postoperative clinic visit was unremarkable. Postoperative chest radiographs on postoperative days 1, 3, and 8 (Fig 1a-1c) are provided. Subsequently, chest CT scanning was performed as part of routine 6-month postsurgical lung cancer surveillance follow-up (Figs 2, 3). The patient had no clinical complaints at routine follow-up. Physical examination revealed well-healed VATS scars in the chest wall. Laboratory results were within normal limits, including a normal white blood cell count of 6400/μL. Her surgical history included prior left upper lobectomy for remote left upper lobe stage IIIA adenocarcinoma and prior bilateral breast implantation for cosmesis. On the basis of chest CT findings, the patient was transferred from an outside institution.
PubMed: 33074782
DOI: 10.1148/radiol.2020192177 -
Breast Cancer Research and Treatment Jun 2006Information about central and peripheral duct anatomy is a requirement for developing intraductal approaches to human breast cancer, but remains sparse. This study looks...
INTRODUCTION
Information about central and peripheral duct anatomy is a requirement for developing intraductal approaches to human breast cancer, but remains sparse. This study looks at the acquisition and digital modelling of data describing breast duct branching from thick ('subgross') sections using data structures from the neurosciences, and at high-throughput imaging of duct anatomy in the nipple.
METHODS
The branching of a large breast duct system was modelled using data extracted from cleared and stained 2 mm 'subgross' sections of an autopsy breast using a public-domain neuron modelling program (CVAPP), and episcopic fluorescence image capture (EFIC) was used to collect a stack of 1100 autofluorescence images of ducts in a mastectomy nipple.
RESULTS
The duct skeleton was captured in 440 line segments with some pruning of terminal ducts. Extracting this data manually in a usable form was, however, laborious and error prone, emphasising the need for improved morphological informatics. EFIC captured anatomical detail and subsequent 3D reconstruction was consistent with the distinction between 'type A' and 'type B' nipple ducts proposed by Going and Moffat (J Pathol 203: 538-544, 2004).
CONCLUSIONS
Whole-lobe duct modelling and EFIC reveal central and peripheral duct anatomy in human breast. Such knowledge is required for understanding normal breast development, the growth of cancer precursors, and for developing the intraductal approach to breast cancer.
Topics: Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; Imaging, Three-Dimensional; Mammary Glands, Human; Microscopy, Fluorescence; Models, Anatomic; Nipples; Pilot Projects
PubMed: 16791485
DOI: 10.1007/s10549-005-9122-7 -
Journal of Cancer Research and... Dec 2022In this case report, we aimed to present the findings of a follicular thyroid carcinoma patient with breast metastasis, which is rarely reported in the literature. A...
In this case report, we aimed to present the findings of a follicular thyroid carcinoma patient with breast metastasis, which is rarely reported in the literature. A 33-year-old female who had been operated for thyroid cancer 17 years ago, but whose pathology report could not be reached was suspected of recurrence in the left lobe region of the thyroid gland. Fine-needle aspiration biopsy was done in this region, and the biopsy result was reported as thyroid follicular carcinoma. F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) was performed for re-staging before surgery. In the PET/CT, it was found that there was residual thyroid tissue in the right and left lobe region and superior to these lesions in the left side, there were lesions which destruct to the hyoid bone, and there were multiple nodular lesions in both lungs which measured with maximum 15 mm × 12 mm, and all these lesions have increased F-FDG uptake. In addition to these lesions, a nodular lesion with the size of ~11 mm ×10 mm in the upper-middle quadrant of the right breast, and it was showing increased F-FDG uptake (maximum standardized uptake value: 3). Pathology results of the left neck region operation materials were reported as papillary and follicular carcinoma of the thyroid gland. Right lumpectomy was performed for the lesion in the right breast during the same session with thyroid operation. The pathology result of this lesion was also reported as metastasis of thyroid follicular cancer. Posttreatment iodine-131 whole-body scan after surgery was reported as there was abnormal accumulation in residual thyroid tissues on the right side of the neck and lung metastases. In patients with thyroid cancer, the possibility of metastasis of the breasts should be considered when there is a lesion in the breast tissue.
Topics: Female; Humans; Adult; Positron Emission Tomography Computed Tomography; Adenocarcinoma, Follicular; Fluorodeoxyglucose F18; Thyroid Neoplasms; Neoplasms, Second Primary; Positron-Emission Tomography; Radiopharmaceuticals; Melanoma, Cutaneous Malignant
PubMed: 36511011
DOI: 10.4103/jcrt.JCRT_957_20 -
World Journal of Clinical Cases May 2022Metaplastic breast cancer (MBC) is a rare subtype of breast cancer. They constitute less than 1% of breast cancer cases and are much rarer in males. There are few...
BACKGROUND
Metaplastic breast cancer (MBC) is a rare subtype of breast cancer. They constitute less than 1% of breast cancer cases and are much rarer in males. There are few reports of MBC because of its rarity. MBC, an aggressive type of cancer, is refractory to common treatment modalities of breast cancer and has a poor prognosis.
CASE SUMMARY
We report a case of MBC in a 78-year-old man. He visited our clinic with a palpable mass on the left breast with no masses in the axillary areas. He had previously undergone robot-assisted laparoscopic radical prostatectomy for prostate cancer, but there was no family history of malignancy. The breast mass was visible on ultrasonography, mammography, and magnetic resonance imaging, and chest computed tomography revealed a lung mass in the posterior basal segment of the right lower lobe. The patient was diagnosed with metaplastic carcinoma on core needle biopsy with lung metastasis. Total mastectomy with sentinel lymph node biopsy and video-assisted segmentectomy of the right lung was performed. However, multiple metastases appeared 3 mo after surgery in the brain, chest, and abdomen, and the patient died 5 mo after the initial diagnosis.
CONCLUSION
MBC is an aggressive and extremely rare breast cancer type. Further case reports are needed to determine the optimal treatment.
PubMed: 35801042
DOI: 10.12998/wjcc.v10.i15.4964 -
International Journal of Surgical... Oct 2007We hypothesize that carcinoma in situ, and consequently breast carcinoma in general, is a lobar disease because the simultaneously or asynchronously appearing, often...
We hypothesize that carcinoma in situ, and consequently breast carcinoma in general, is a lobar disease because the simultaneously or asynchronously appearing, often multiple tumor foci develop within a single lobe. The sick lobe carries some kind of genetic instability already from its initialization during the early embryonic life and is more sensitive to noxious influences than the other lobes within the same breast. Decades of postnatal life with accumulation of additional genetic alterations are needed for malignant transformation of the cells within the sick lobe. The transformation is often multifocal (involving separate distant lobules of this lobe) or diffuse (involving the larger ducts). This hypothesis offers new perspectives in cancer prevention, because selective visualization, excision, or destruction of the sick lobe before development of malignant lesions would substantially reduce the incidence of breast carcinoma.
Topics: Breast; Breast Neoplasms; Carcinoma in Situ; Carcinoma, Ductal, Breast; Cell Transformation, Neoplastic; Female; Humans; Neoplasm Staging; Precancerous Conditions
PubMed: 17913943
DOI: 10.1177/1066896907302225 -
The Breast Journal Sep 2018
Topics: Amphotericin B; Anti-Bacterial Agents; Antifungal Agents; Breast; Female; Humans; Image-Guided Biopsy; Middle Aged; Occipital Lobe; Paracoccidioidomycosis; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography
PubMed: 30033640
DOI: 10.1111/tbj.13078 -
Virchows Archiv : An International... Jul 2005We postulate that ductal carcinoma in situ (DCIS), and consequently breast carcinoma in general, is a lobar disease, as the simultaneously or asynchronously appearing,... (Review)
Review
We postulate that ductal carcinoma in situ (DCIS), and consequently breast carcinoma in general, is a lobar disease, as the simultaneously or asynchronously appearing, often multiple, in situ tumor foci are localized within a single lobe. Although the whole lobe is sick, carrying some form of genetic instability, the malignant transformation of the epithelial cells may appear localized to a part or different parts of the sick lobe at the same time or with varying time difference. It may be confined to terminal ductal lobular units (TDLUs), to ducts or both. The malignant transformation is often associated with aberrant branching and/or aberrant lobularization within the sick lobe. Involvement of a single individual TDLU or of a group of adjacent TDLUs generates a unifocal lesion. Multifocal lesions appear if distant TDLUs are involved. Diffuse growth pattern in DCIS indicates involvement of the larger ducts. The extent of the involved area in multifocal or diffuse cases varies considerably. Diffuse growth pattern with or without evidence of aberrant arborisation within the sick lobe seems to characterize a subgroup of DCIS with unfavourable prognosis. In this paper, we discuss the anatomical, embryological and pathological background of the theory of the sick lobe and present supporting evidence from modern radiological breast imaging, long-term follow-up studies and from our own series of 108 DCIS cases.
Topics: Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Cell Transformation, Neoplastic; Female; Humans; Keratins; Mammary Glands, Human; Precancerous Conditions
PubMed: 15926070
DOI: 10.1007/s00428-005-1274-7 -
Ceska Gynekologie 2021Analysis of our approach to breast reconstruction after mastectomy in women with breast cancer and/or BRCA mutations. Oncoplastic surgery enables procedures that are...
OBJECTIVE
Analysis of our approach to breast reconstruction after mastectomy in women with breast cancer and/or BRCA mutations. Oncoplastic surgery enables procedures that are sufficiently radical and with a very good cosmetic effect. With the development of genetic testing programs, the need for prophylactic procedures is also increasing. One-sided curative performance and at the same time prophylactic surgery on the other breast can be used.
METHODS
We use the possibility of immediate breast reconstruction simultaneously with subcutaneous and skin-saving mastectomy. We solve the reconstruction either with an expander and in the second time by inserting a silicone implant, or directly by inserting the implant alone or in combination with the use of autologous tissue, depending on further oncological treatment (chemotherapy or radiotherapy).
RESULTS
One-hundred and three reconstructive surgeries were performed on 58 women with breast cancer and/or BRCA mutations from April 2017 to May 2020. Of these, there were 52 immediate reconstructions for untreated tumors. A tissue expander was inserted in 27 women (46.6% of the group) with locally advanced tumors and the need for subsequent radiotherapy (18 immediate and 9 delayed reconstructions). Breast implants were used in 52 women (89.7% of the group) in a total of 80 implants. Breast reconstruction of own tissues was performed in 8 women, of which 5 operations had immediate reconstruction. Postoperative complications occurred in 11 women and 15 corrective procedures were performed (12.7% of operations).
CONCLUSION
Breast reconstruction is a comprehensive set of techniques by which any patient can obtain a breast so that it does not depend on the epithelium. Patients with locally advanced disease who receive neoadjuvant chemotherapy and radiotherapy are at greater risk of complications. With the growing number of breast cancers, the demand for reconstructive procedures, especially immediate reconstructions, is increasing.
Topics: Breast Implants; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Mutation; Postoperative Complications; Retrospective Studies
PubMed: 35038874
DOI: 10.48095/cccg2021374 -
Orvosi Hetilap Feb 2014Due to the development in medical science and industrial technology, minimally invasive procedures have appeared in the surgery of benign and malignant breast diseases....
Due to the development in medical science and industrial technology, minimally invasive procedures have appeared in the surgery of benign and malignant breast diseases. In general , such interventions result in significantly reduced breast and chest wall scars, shorter hospitalization and less pain, but they require specific, expensive devices, longer surgical time compared to open surgery. Furthermore, indications or oncological safety have not been established yet. It is quite likely, that minimally invasive surgical procedures with high-tech devices - similar to other surgical subspecialties -, will gradually become popular and it may form part of routine breast surgery even. Vacuum-assisted core biopsy with a therapeutic indication is suitable for the removal of benign fibroadenomas leaving behind an almost invisible scar, while endoscopically assisted skin-sparing and nipple-sparing mastectomy, axillary staging and reconstruction with latissimus dorsi muscle flap are all feasible through the same short axillary incision. Endoscopic techniques are also suitable for the diagnostics and treatment of intracapsular complications of implant-based breast reconstructions (intracapsular fluid, implant rupture, capsular contracture) and for the biopsy of intracapsular lesions with uncertain pathology. Perception of the role of radiofrequency ablation of breast tumors requires further hands-on experience, but it is likely that it can serve as a replacement of surgical removal in a portion of primary tumors in the future due to the development in functional imaging and anticancer drugs. With the reduction of the price of ductoscopes routine examination of the ductal branch system, guided microdochectomy and targeted surgical removal of terminal ducto-lobular units or a "sick lobe" as an anatomical unit may become feasible. The paper presents the experience of the authors and provides a literature review, for the first time in Hungarian language on the subject. Orv. Hetil., 2014, 155(5), 162-169.
PubMed: 24463161
DOI: 10.1556/OH.2014.29783