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Arkhiv Patologii 2023The presented case describes the difficulties of diagnosis of the breast microglandular adenosis (MGA), taken by clinicians for a malignant process due to the nature of...
The presented case describes the difficulties of diagnosis of the breast microglandular adenosis (MGA), taken by clinicians for a malignant process due to the nature of growth and large size. Criteria for histological and immunohistochemical diagnosis and differentiation of MGA with malignant neoplasms, in particular, with tubular breast carcinoma, are presented. Taking into account the rarity of the pathology and the absence of described cases in the Russian-language literature, the observation is of interest to pathologists and clinicians.
Topics: Female; Humans; Fibrocystic Breast Disease; Immunohistochemistry; Carcinoma, Ductal, Breast; Diagnosis, Differential; Breast Neoplasms
PubMed: 37053352
DOI: 10.17116/patol20238502140 -
Annals of Plastic Surgery Jun 2023Routine pathology examination of breast tissue in reduction mammaplasty (RM) is performed with aims of detecting incidental malignancy or risk-increasing lesions. In...
BACKGROUND
Routine pathology examination of breast tissue in reduction mammaplasty (RM) is performed with aims of detecting incidental malignancy or risk-increasing lesions. In adolescent patients, the reported incidence ranges between 0% to 0.01%, and costs of pathology claims range between $23 and $614 per analysis. We aim to investigate the rate of incidental findings and the cost-effectiveness of routine pathology examination in adolescent RM.
METHODS
A single-center retrospective review of the pathology results for 132 breast specimens from 66 consecutive RM patients was performed. Data collected for analysis included breast cancer risk factors, demographic information, and operative variables.
RESULTS
Zero cases of incidental malignant or risk-increasing lesions were found among the 132 breast specimens from 66 patients aged between 10 and 24 years. Of the 132 specimens, 34 (26%) contained benign fibrocystic disease, which was significantly associated a body mass index greater than 30 kg/m 2 and tissue resection weight greater than 1000 g per breast ( P = 0.003, P = 0.007) respectively.
CONCLUSIONS
Based on the available data, the use of routine specimen analysis costs more than US $150 million for one breast cancer diagnosis during RM in this age group. In our study, zero atypical, precancerous, or cancerous lesions were detected in a 7-year analysis. The results of this study support the current literature, which reports no occurrence of incidental findings in young women and may promote a greater understanding of evidence-based healthcare spending while concomitantly decreasing the strain placed on histopathology services.
Topics: Female; Humans; Adolescent; Child; Young Adult; Adult; Mammaplasty; Breast; Breast Neoplasms; Retrospective Studies; Incidental Findings
PubMed: 36975135
DOI: 10.1097/SAP.0000000000003455 -
Journal of Clinical Pathology Apr 2024Cystic neutrophilic granulomatous mastitis (CNGM) is a subtype of granulomatous mastitis (GM) associated with spp infection. We aimed to analyse the prevalence of...
AIMS
Cystic neutrophilic granulomatous mastitis (CNGM) is a subtype of granulomatous mastitis (GM) associated with spp infection. We aimed to analyse the prevalence of Corynebacteria in CNGM and non-CNGM cases.
METHODS
Breast specimens diagnosed as granulomatous inflammation between 2010 and 2020 were reviewed to identify a CNGM cohort and a non-CNGM cohort. Polymerase chain reaction-based identification of Corynebacteria by 16S ribosomal RNA (16S rRNA) primers, followed by confirmatory Sanger sequencing (SS), was performed on all cases. Clinical, radiological and microbiology data were retrieved from the electronic patient records.
RESULTS
Twenty-eight CNGM cases and 19 non-CNGM cases were identified. Compared with the non-CNGM cohort, patients in the CNGM cohort were more likely to be multiparous (p=0.01), breast feeding (p=0.01) and presenting with a larger breast mass (p<0.01), spontaneous drainage (p=0.05) and skin irritation (p<0.01). No significant difference in the prevalence of between the cohorts (7% vs 11%, p=0.68) by microbiological culture was identified. Compared with microbiology culture, the sensitivity and specificity of each Corynebacterial detection method were 50% and 81% for Gram stain, and 25% and 100% for 16S rRNA combined with SS. Regardless of the diagnosis, patients positive for were more likely to have a persistent disease (p<0.01).
CONCLUSION
CNGM presents as a large symptomatic breast mass in multiparous breastfeeding women. The importance of adequate sampling and repeated microbiology culture in conjunction with sequencing on all GM cases with persistent disease is paramount.
Topics: Female; Humans; Granulomatous Mastitis; RNA, Ribosomal, 16S; Breast; Corynebacterium Infections; Corynebacterium; Fibrocystic Breast Disease
PubMed: 36697218
DOI: 10.1136/jcp-2022-208651 -
Cancer Prevention Research... Mar 2023Nonsteroidal anti-inflammatory agents (NSAID) are associated with modest inconsistent reductions in breast cancer risk in population-based cohorts, whereas two focused...
ABSTRACT
Nonsteroidal anti-inflammatory agents (NSAID) are associated with modest inconsistent reductions in breast cancer risk in population-based cohorts, whereas two focused studies of patients with benign breast disease (BBD) have found lower risk with NSAID use. Given that BBD includes fibroinflammatory lesions linked to elevated breast cancer risk, we assessed whether NSAID use was associated with lower breast cancer risk among patients with BBD.Participants were postmenopausal women in the Cancer Prevention Study-II (CPS-II), a prospective study of cancer incidence and mortality, who completed follow-up surveys in 1997 with follow-up through June 30, 2015. History of BBD, NSAID use, and covariate data were updated biennially. This analysis included 23,615 patients with BBD and 36,751 patients with non-BBD, including 3,896 incident breast cancers over an average of 12.72 years of follow-up among participants. NSAID use, overall and by formulation, recency, duration, and pills per month was analyzed versus breast cancer risk overall and by BBD status using multivariable-adjusted Cox models; BBD status and NSAID use were modeled as time-dependent exposures.Patients with BBD who reported using NSAIDs experienced lower breast cancer risk (HR, 0.87; 95% CI, 0.78-0.97), with similar effects for estrogen receptor (ER)-positive breast cancers [HR, 0.85; 95% confidence interval (CI), 0.74-0.97] and ER-negative breast cancers (HR, 0.87; 95% CI, 0.59-1.29); among women without BBD, NSAID use was unrelated to risk (HR, 1.02; 95% CI, 0.92-1.13; Pinteraction = 0.04). Associations stratified by age, obesity, menopausal hormone use, and cardiovascular disease were similar.Among patients with BBD, NSAID use appears linked to lower breast cancer risk. Further studies to assess the value of NSAID use among patients with BBD are warranted.
PREVENTION RELEVANCE
We examined whether NSAID use, a modifiable exposure, is associated with breast cancer risk in postmenopausal women from the Cancer Prevention Study-II with self-reported benign breast disease, an often inflammatory condition associated with higher rates of breast cancer.
Topics: Female; Humans; Breast Neoplasms; Anti-Inflammatory Agents, Non-Steroidal; Prospective Studies; Postmenopause; Risk Factors; Breast Diseases; Fibrocystic Breast Disease
PubMed: 36596665
DOI: 10.1158/1940-6207.CAPR-22-0403 -
Diagnostic Pathology Dec 2022The multistep molecular model of breast carcinogenesis is based on the oestrogen receptor(ER) status of the tumour. Its two main arms comprise ER-positive and...
Proliferative epithelial changes in tumour adjacent tissue in Sri Lankan women with breast carcinoma: do morphological changes support molecular models of breast carcinogenesis?
BACKGROUND
The multistep molecular model of breast carcinogenesis is based on the oestrogen receptor(ER) status of the tumour. Its two main arms comprise ER-positive and ER-negative breast carcinomas(BCa), which are associated with Nottingham grade(NG) of the tumour and different proliferative epithelial changes. According to the model, columnar cell lesions(CCL), lobular carcinoma in-situ(LCIS) and atypical ductal hyperplasia(ADH), low-grade ductal carcinoma in-situ (LG-DCIS) are associated with low grade ER-positive tumours and microglandular adenosis (MGA), pleomorphic LCIS(PLCIS), high-grade DCIS(HG-DCIS) are associated with ER-negative high grade tumours. This study aims to describe the association between proliferative epithelial changes in breast tissue adjacent to tumour, in relation to the ER status and NG of the tumour.
METHODS
This descriptive cross-sectional study included 420, wide local excision and mastectomy specimens of BCa from National Hospital of Sri Lanka, between 2017-2019. The histopathological features of the tumour and proliferative epithelial changes in tumour adjacent tissue within 10 mm distance from the tumour-host interface were evaluated independently by two pathologists. The ER, PR(Progesterone receptor) and HER2 status assessed by immunohistochemistry(IHC) was reviewed. The associations between above epithelial lesions and ER status and NG{categorised as low grade (NG1 and NG2) and high grade (NG3)} of the tumour were analyzed.
RESULTS
ER positive BCa showed significant associations with CCH (p = 0.04), FEA (p = 0.035) and LGDCIS (p < 0.001). Although PLCIS was more frequent in ER positive tumours, the association did not attain statistical significance. ER negative BCa showed a significant association with HGDCIS (p = 0.016). CCLs as a whole (p = 0.005) and also CCC (p = 0.006) and FEA (p = 0.048) and LGDCIS (p < 0.001) showed significant associations with low NG tumours. High NG tumours showed a significant association with HGDCIS (p < 0.001). Microglandular adenosis was not identified in our study population.
CONCLUSION
These morphological findings support the multistep molecular based pathogenetic pathways of breast carcinoma in the studied setting in South Asia. Identification of these proliferative epithelial components in a core biopsy that is negative for BCa, should prompt for close clinicoradiological correlation, and if necessary re-biopsy of women suspected of harbouring a BCa.
Topics: Humans; Female; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Sri Lanka; Cross-Sectional Studies; Mastectomy; Breast Carcinoma In Situ; Carcinogenesis; Carcinoma, Ductal, Breast
PubMed: 36581929
DOI: 10.1186/s13000-022-01281-w -
Pathology International Jan 2023Acinic cell carcinoma (ACC) is an exceptionally rare type of breast carcinoma with a low-grade morphology and a favorable prognosis. It is postulated to be a type of...
Acinic cell carcinoma (ACC) is an exceptionally rare type of breast carcinoma with a low-grade morphology and a favorable prognosis. It is postulated to be a type of invasive carcinoma arising in microglandular adenosis (MGA). We report a case of extensively spreading ACC of the breast with MGA-like features. Macroscopically, yellowish nodules were widely distributed throughout the right breast, up to the axilla, without mass formation. Microscopically, the tumor consisted of two distinct carcinoma components: one was multiple nodular lesions showing invasive carcinoma with fused solid nests, and the other was a widely spreading lesion exhibiting MGA-like features with uniform small single glands. Immunohistochemically, both components were negative for ER, PR, and HER2, and expressed EMA, S100 and lysozyme. The distinct morphology and molecular expression indicated ACC. The single glands in the MGA-like area lacked myoepithelial cells but were linearly surrounded by type IV collagen, a basement membrane component. This case supports the hypothesis that ACC and MGA have the same lineage and indicates that ACC is not necessarily a low-grade malignancy and can be aggressive.
Topics: Female; Humans; Carcinoma, Acinar Cell; Breast; Breast Neoplasms; Fibrocystic Breast Disease; Carcinoma
PubMed: 36579416
DOI: 10.1111/pin.13302 -
Medical Ultrasonography Dec 2022
Topics: Female; Humans; Breast; Fibrocystic Breast Disease; Ultrasonography; Breast Neoplasms; Diagnosis, Differential
PubMed: 36546445
DOI: 10.11152/mu-3903 -
Cureus Nov 2022Introduction The most frequent reason for visiting breast clinics is benign breast disease (BBD), which accounts for 90% of all breast-related presentations globally. It...
Introduction The most frequent reason for visiting breast clinics is benign breast disease (BBD), which accounts for 90% of all breast-related presentations globally. It is widespread among women of childbearing age, peaking between the ages of 30 and 50. However, owing to the lack of studies on BBD compared with breast cancer in Saudi Arabia, this study aimed to assess the common patterns of BBD and factors associated with the frequency of fibroadenoma (FA) occurrence. Methodology A retrospective analytical study was carried out at Al-Noor Specialist Hospital, Makkah, Saudi Arabia, from May to August 2022. The sample was all patients who attended the breast and endocrine unit from January 2015 to December 2020. Results This study included 222 of 367 patients who had BBD. Of them, 42.3% were aged 31-45 years, with a mean age of 36.71 ± 12.48 years. The mean body mass index (BMI) was 26.45 ± 6.69 kg/m, and the mean tumor size was 4.22 ± 4.9 mm. Conclusion Fibroadenoma among BBD types is the most common lesion in the studied population. This study established the baseline pattern of BBD in a specialized hospital in Makkah.
PubMed: 36514593
DOI: 10.7759/cureus.31174 -
Zhonghua Bing Li Xue Za Zhi = Chinese... Dec 2022
Topics: Humans; Female; Fibrocystic Breast Disease; Carcinoma
PubMed: 36480840
DOI: 10.3760/cma.j.cn112151-20220927-00812 -
Journal of the College of Physicians... Nov 2022Granulomatous lobular mastitis (GLM) is an infrequent inflammatory breast disease, which can simulate malignancy on the basis of clinical and imaging features. It is...
Granulomatous lobular mastitis (GLM) is an infrequent inflammatory breast disease, which can simulate malignancy on the basis of clinical and imaging features. It is typically found in parous or lactating women. The differential diagnosis of granulomatous mastitis includes infections caused by bacterial, fungal or mycobacterial agents, and autoimmune disorders like rheumatoid arthritis, sarcoidosis, giant cell vasculitis, and granulomatosis with polyangiitis. Cystic neutrophilic granulomatous mastitis (CNGM) is a sporadic sub-type of GLM that can be linked with infection with Gram-positive bacilli, specifically, Corynebacterium. It is characterised by lipogranulomas that comprise of "cystic" spaces lined by neutrophils which may contain Gram-positive rod-shaped bacteria. The majority of cases of GLM are still "idiopathic" as this pattern of inflammation still remains a mystery. We herein report three cases of CNGM and review the relevant literature. Key Words: Granulomatous mastitis, Corynebacterium, Gram-positive rods, Inflammatory breast disease, Cystic neutrophilic granulomatous mastitis.
Topics: Humans; Female; Granulomatous Mastitis; Corynebacterium Infections; Fibrocystic Breast Disease; Lactation; Corynebacterium; Gram-Positive Bacteria
PubMed: 36377022
DOI: 10.29271/jcpsp.2022.11.1489