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Radiology Case Reports Nov 2023Fibrocystic breast disease is the most common benign condition and is important for differentiating breast cancer. We present the case of a 27-year-old female patient...
Fibrocystic breast disease is the most common benign condition and is important for differentiating breast cancer. We present the case of a 27-year-old female patient with pleomorphic calcifications and segmental distribution on mammography, which was highly suggestive of breast cancer; however, the pathological findings were fibrocystic disease. Although fibrocystic breast disease does not require treatment, appropriate follow-up is necessary after assessing the risk of breast cancer.
PubMed: 37670913
DOI: 10.1016/j.radcr.2023.08.010 -
Breast (Edinburgh, Scotland) Oct 2023Adenosquamous proliferation (ASP) is known to occur in the central nidus of radial sclerosing lesions (RSL) of the breast. However, their significance is debated and...
Adenosquamous proliferation (ASP) is known to occur in the central nidus of radial sclerosing lesions (RSL) of the breast. However, their significance is debated and remains largely unknown. In addition, there is a histologic overlap between ASP and low-grade adenosquamous carcinomas (LGASC). We conducted a large retrospective review of 247 RSLs to evaluate the prevalence of ASP and quantitatively analyze associated histologic features of RSLs including size, stromal cellularity, and presence of chronic inflammation. The central nidus of RSLs were classified as hyalinized in 121 cases (49%), cellular in 37 cases (15%), and equally mixed hyalinized and cellular in 89 (36%). ASP occurred in 92 of 247 RSLs (37.2%). Cases with ASP were significantly associated with a cellular stroma; 78.4% of RSLS with cellular stroma had ASP versus just 11.6% of hyalinized RSLs. In our large cohort, inflammation is commonly found in RSLs with ASP (p= <0.001). In conclusion, we confirm that ASP is statistically more likely to be found in RSLs with a cellular stroma. In addition, ASP is commonly associated with chronic inflammation. The finding challenges the notion that prominent lymphocytes are a diagnostic clue to LGASC on limited biopsy material.
Topics: Female; Humans; Breast Neoplasms; Breast; Fibrocystic Breast Disease; Carcinoma, Adenosquamous; Inflammation; Cell Proliferation
PubMed: 37566996
DOI: 10.1016/j.breast.2023.08.002 -
JPMA. the Journal of the Pakistan... Apr 2023To evaluate the prognostic importance of tumour-infiltrating forkhead box P3 protein + regulatory T cells in breast cancer patients.
OBJECTIVES
To evaluate the prognostic importance of tumour-infiltrating forkhead box P3 protein + regulatory T cells in breast cancer patients.
METHOD
The case-control study was conducted from January 2020 to March 2021 at the Kafrelsheikh University Hospital, Egypt, and comprised individuals with newly-diagnosed breast cancer who underwent conventionalsurgery, and controls who had a fibrocystic change of the breast. The density of tumour-infiltrating forkhead box P3 protein + regulatory T cells was assessed by immunohistochemistry. Overall survival and disease free-survival were assessed. Data was analysed using SPSS 25.
RESULTS
Of the 100 patients having mean age 44.9±9.1 years, 76(76%) had moderate/strong forkhead box P3 protein expression in tumour-infiltrating regulatory T cells, and 24(24%) with no/low expression. On follow-up, Patients with moderate/strong expression had a significantly greater rate of recurrence (p<0.05). Disease-free survival was substantially shorter in patients with moderate/strong expression compared to those with little or low expression (p=0.035). Compared to individuals with no/low expression, patients with moderate/strong expression had a greater rate of mortality, but the difference was not statistically significant (p>0.05).
CONCLUSIONS
High density of forkhead box P3 protein + regulatory T cellsin Egyptian women with breast cancer may serve as a prognostic indicator.
Topics: Humans; Female; Adult; Middle Aged; Prognosis; Breast Neoplasms; Egypt; Case-Control Studies; T-Lymphocytes, Regulatory; Forkhead Transcription Factors
PubMed: 37482848
DOI: 10.47391/JPMA.EGY-S4-30 -
Cureus May 2023Introduction The most common cancer in women is, by far, breast cancer. The incidence and mortality of breast cancer must be reduced by a multidisciplinary strategy that...
Introduction The most common cancer in women is, by far, breast cancer. The incidence and mortality of breast cancer must be reduced by a multidisciplinary strategy that includes education campaigns, preventive measures, screening programmes for early diagnosis, and the availability of treatment facilities. The use of immunohistochemical (IHC) stains with relative specificity for myoepithelial markers has become a mainstay of standard diagnostic breast pathology because the presence and distribution of myoepithelial cells might differ greatly amongst the distinct breast proliferation. Although it has also been reported that DOG1 is expressed in other mesenchymal tumours, DOG1 has been demonstrated to be sensitive and specific for the detection of gastrointestinal stromal tumors (GISTs). Both myoepithelial cells (MECs) and luminal epithelial cells have occasionally displayed DOG1 immunoreactivity in the breast. Materials and methods This prospective cross-sectional study was done in the Department of Pathology at Osmania General Hospital, Hyderabad on 60 cases from June 2017 to June 2019. Female patients with different breast lesions including benign proliferating lesions, ductal carcinoma in-situ (DCIS), and invasive carcinoma breast cases were included in the study. Inflammatory lesions, mesenchymal, and metastatic tumors were excluded. IHC expression of DOG1 as a myoepithelial marker to discriminate invasive from non-invasive breast lesions was evaluated and correlated with clinicopathological features. Results The mean age of the study population was 33.67 ± 8.48 in the benign group and 54.43 ± 12.84 in the malignant group. Fifty percent (15) of the patients with benign lesions belonged to the age group 20-30 years, whereas 26.7% (8) of the patients with malignant lesions belonged to the age group 61-70 years. DOG-1 expression was strongly positive in fibroadenoma, ductal hyperplasia, fibrocystic disease, whereas strongly negative in malignant disease of the breast ( < 0.0001). P63 expression was strongly positive in benign breast diseases and strongly negative in malignant diseases (< 0.0001). Conclusion DOG1 seems to be similar to p63 as a myoepithelial cell marker both in normal breast tissue and in benign lesions. DOG1 is strongly positive in benign breast diseases and strongly negative in malignant breast diseases. Hence, it can be considered as a useful myoepithelial marker in differentiating invasive breast carcinoma and non-invasive breast lesions.
PubMed: 37398743
DOI: 10.7759/cureus.39676 -
Journal of Clinical Imaging Science 2023Microglandular adenosis (MGA) and atypical microglandular adenosis (AMGA) are intensely rare and distinctive forms of adenosis of the breast, usually occurring in...
Microglandular adenosis (MGA) and atypical microglandular adenosis (AMGA) are intensely rare and distinctive forms of adenosis of the breast, usually occurring in middle-aged women. Carcinoma arising in MGA is an extremely rare subtype of breast carcinoma, and most reported cases are of invasive carcinoma. Ultrasound and magnetic resonance imaging are accurate imaging modalities for diagnosing these abnormalities. Our goal in this article was to report a rare instance of ductal carcinoma (DCIS) arising from MGA and AMGA in a very young Vietnamese woman who presented with a palpable mass in her right breast for 1 month. During clinical examination and imaging, suspected lesions were found and categorized as BI-RADS 4a. The final histopathological findings confirmed DCIS arising from MGA/AMGA. In this patient, the disease was detected and managed early when the lesion was localized in the duct and there were no signs of invasive ductal carcinoma.
PubMed: 37292245
DOI: 10.25259/JCIS_32_2023 -
Cureus May 2023Breast cancer is the most common cancer among women and the leading cause of cancer-related deaths globally. Ductal carcinoma of no special type is the most prevalent,...
Breast cancer is the most common cancer among women and the leading cause of cancer-related deaths globally. Ductal carcinoma of no special type is the most prevalent, followed by lobular carcinoma. Finding a triple-negative breast cancer of intermediate grade on core biopsies should raise the possibility of dealing with one of the rare subtypes such as microglandular adenosis (MGA)-associated carcinoma. Here, we present a case of a 40-year-old female, who presented with bilateral breast masses, in which one of them was a high-grade carcinoma and the other turned out to be an MGA-associated carcinoma, which was misdiagnosed initially on the core biopsy as a grade II triple-negative ductal carcinoma of no special type. Such diagnosis is challenging to pathologists, especially on small biopsies where the full morphological spectrum is not evident.
PubMed: 37250605
DOI: 10.7759/cureus.39531 -
Journal of Medical Case Reports May 2023Diabetic mastopathy is a rare breast condition that occurs in women with poorly controlled diabetes and is characterized by hardening of the breast tissue. The purpose...
BACKGROUND
Diabetic mastopathy is a rare breast condition that occurs in women with poorly controlled diabetes and is characterized by hardening of the breast tissue. The purpose of this case report is to provide an overview of the clinical characteristics and therapeutic principles of this rare disease to support front-line physicians in their crucial activity of case identification.
CASE PRESENTATION
A 64-year-old Asian female patient with a history of type II diabetes mellitus was referred to our clinic for an evaluation of a newly discovered breast mass. The patient had been diagnosed with diabetes more than 20 years prior and was being managed with oral hypoglycemic agents. Her past medical history was otherwise unremarkable. Physical examination of the breast revealed a palpable, mobile, and firm mass measuring 6 × 4 cm in the upper quadrant of the right breast. Ultrasound images showed an uneven hypoechoic nodule, BI-RADS 4B. Mammography showed the compact and flaky nature of the two breasts and the heterogeneity of the substantive density increases. The patient's clinical manifestations and imaging findings suggest the possibility of breast cancer. The patient opted for surgical excision of the mass. Through surgery, the mass was completely excised with negative margins. Pathological examination of the mass revealed a proliferation of fibroblastic cells, with an increased nuclear/cytoplasmic ratio, consistent with a diagnosis of diabetic mastopathy.
CONCLUSIONS
This case report serves to highlight the importance of recognizing diabetic mastopathy as a possible differential diagnosis of a breast mass in patients with diabetes mellitus. In our patient, early diagnosis and treatment with lumpectomy resulted in a favorable outcome, emphasizing the importance of prompt medical and surgical management. In addition, more research is needed to mine the diagnostic marker of diabetic mastopathy and provide data related to its prognosis.
Topics: Female; Humans; Middle Aged; Diabetes Mellitus, Type 2; Fibrocystic Breast Disease; Breast Diseases; Breast Neoplasms; Mammography; Breast; Diagnosis, Differential; Autoimmune Diseases
PubMed: 37189170
DOI: 10.1186/s13256-023-03931-z -
Cureus Apr 2023Microglandular adenosis (MGA) is a proliferative breast lesion composed of small, uniform glands lacking a myoepithelial cell layer while still invested by the basement...
Microglandular adenosis (MGA) is a proliferative breast lesion composed of small, uniform glands lacking a myoepithelial cell layer while still invested by the basement membrane. The glands percolate haphazardly through the breast parenchyma rather than maintaining a lobular architecture, typical of other forms of adenosis.MGA is a benign lesion though atypical forms have been well described, often in close association with carcinoma. MGA, atypical MGA (AMGA), and the vast majority of MGA-associated carcinomas (MGACA) are negative for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) by immunohistochemistry. In light of these findings and early molecular studies, MGA is hypothesized to represent a clonal process and nonobligate precursor of basal-type breast carcinomas. We present the case of a 58-year-old woman and the first published molecular comparison of a luminal-type invasive ductal carcinoma with its associated MGA/AMGA. Analysis of small nucleotide variants (SNVs) revealed that 63% of the SNVs identified in the MGA were present in the AMGA while only 10% of them were present in the MGACA, suggesting a direct relationship between MGA and AMGA but not MGA and MGACA.
PubMed: 37159793
DOI: 10.7759/cureus.37198