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Acta Medica Portuguesa 2002The inflammatory breast cancer corresponds to 1-6% of breast tumors. It is an aggressive clinical entity being characterised by the incidence of local relapse and... (Review)
Review
The inflammatory breast cancer corresponds to 1-6% of breast tumors. It is an aggressive clinical entity being characterised by the incidence of local relapse and distant metastases superior to the other breast malign entities. Changes in its therapy have been observed: progressive innovating therapeutic strategies have been adopted, tendentiously multimodal ones, trying to alter the course of this pathology of such a unfavourable prognosis. Here we show a revision of the most significant facts in the evolution of the inflammatory breast carcinoma diagnosis and treatment, both as to the present development and future perspectives. Aspects of clinical diagnosis are emphasized as well as their corroboration with complementary diagnosis technics and their evolution before different approaching therapies.
Topics: Antineoplastic Agents; Bone Marrow Transplantation; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Inflammation; Neoplasm Metastasis; Recurrence
PubMed: 12680294
DOI: No ID Found -
Cancer Sep 2003The majority of patients with breast carcinoma receive chemotherapy as a component of multimodality treatment. Over the past decade, it has become increasingly more... (Review)
Review
BACKGROUND
The majority of patients with breast carcinoma receive chemotherapy as a component of multimodality treatment. Over the past decade, it has become increasingly more common to deliver chemotherapy first, but this has raised new questions within all disciplines of cancer management.
METHODS
The authors reviewed published studies on the effect of neoadjuvant chemotherapy for breast carcinoma on the practice of medical oncology, surgical oncology, radiation oncology, pathology, and radiology.
RESULTS
Treating breast carcinoma with neoadjuvant chemotherapy has several advantages, such as providing the earliest possible treatment against preexisting micrometastases, offering selected patients breast conservation therapy, and allowing for measurement of disease response, which can then be used to customize subsequent chemotherapy. However, neoadjuvant chemotherapy affects the practice not only of medical oncology, but also has important implications for the specialties of surgery, radiology, pathology, and radiation oncology. The current review addressed the new opportunities and challenges within the multidisciplinary care of breast carcinoma provided by neoadjuvant chemotherapy.
CONCLUSIONS
The complexity of the issues led the authors to conclude that patients who receive neoadjuvant chemotherapy are likely to benefit from a coordinated multidisciplinary approach to their care.
Topics: Breast Neoplasms; Chemotherapy, Adjuvant; Combined Modality Therapy; Female; Humans; Neoadjuvant Therapy; Prospective Studies; Randomized Controlled Trials as Topic; Research
PubMed: 12973838
DOI: 10.1002/cncr.11603 -
Archives of Pathology & Laboratory... Jan 2014Basal-like breast carcinoma (BLBC) is a distinct molecular subtype of breast carcinoma identified through gene expression profiling studies. (Review)
Review
CONTEXT
Basal-like breast carcinoma (BLBC) is a distinct molecular subtype of breast carcinoma identified through gene expression profiling studies.
OBJECTIVE
To provide the clinical background, the histologic profile, and the immunohistochemical profile of these tumors and discuss the current knowledge of their molecular signature and their implications on targeted molecular therapy.
DATA SOURCES
Data were obtained from review of the pertinent peer-reviewed literature.
CONCLUSIONS
Basal-like breast carcinomas are aggressive tumors with poor prognosis. Lack of targeted therapy makes their treatment a challenging task. Traditional chemotherapy is still associated with a high risk of relapse and death in a high percentage of patients. Platinum-based chemotherapy has been considered as a candidate for the treatment of BLBCs owing to their BRCA1 phenotype. Approximately 22% of patients treated with single-agent cisplatin show pathologic complete response, which is a comparable rate to that seen with nonplatinum agents. Antiangiogenic agents have been promising, but their currently demonstrated limited response is considered disappointing. Additionally, epidermal growth factor receptor was not shown to be a helpful target for BLBC. A recent study has shown that BLBC appears to be especially sensitive to MEK inhibitors, making it a promising therapeutic possibility. The list of new targets is still evolving and the "magic" therapeutic target is yet to be discovered.
Topics: Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Humans; Immunohistochemistry; Neoplasms, Basal Cell; Prognosis
PubMed: 24377810
DOI: 10.5858/arpa.2012-0439-RA -
Cancer Medicine Apr 2023We constructed a multicentre cohort in China to analyse the differences in clinical characteristics, treatment strategies and prognoses between breast neuroendocrine...
Differences in clinical characteristics and prognosis between breast neuroendocrine carcinoma and breast invasive ductal carcinoma: A multicentre population-based study from China.
AIM
We constructed a multicentre cohort in China to analyse the differences in clinical characteristics, treatment strategies and prognoses between breast neuroendocrine carcinoma (NEC) and invasive ductal carcinoma (IDC) of the breast.
METHODS
All patients with early-stage breast cancer who attended three hospitals in Beijing from 2000 to 2018 were included in the study. We used propensity score matching to make a 1:3 match between NEC and IDC.
RESULTS
After propensity score matching, 153 patients with IDC and 51 patients with NEC were analysed. Multivariate Cox regression showed that compared to patients with IDC, patients with NEC had a worse disease-free survival (HR = 2.94, 95% CI: 1.69-5.12, p < 0.001).
CONCLUSION
NEC patients have a worse disease-free survival than IDC patients.
Topics: Humans; Female; Carcinoma, Ductal, Breast; Breast Neoplasms; Prognosis; China; Carcinoma, Neuroendocrine
PubMed: 36952359
DOI: 10.1002/cam4.5819 -
Cancer Jun 2004Mastectomy is the current standard of care for in-breast local recurrence of breast carcinoma. The objective of the current study was to critically review the rationale... (Review)
Review
Mastectomy is the current standard of care for in-breast local recurrence of breast carcinoma. The objective of the current study was to critically review the rationale for and the theoretic and actual risks and benefits of repeat breast-conserving surgery followed by partial breast irradiation (PBI) for in-breast local recurrence of breast carcinoma. The main outcomes of interest were local control and survival after in-breast local recurrence and side effects, complications, and cosmesis after reirradiation of the breast. The risk of local recurrence was not found to be eliminated with mastectomy; approximately 2-32% of patients treated with mastectomy develop a chest wall recurrence. The interpretation of local control rates in evaluating repeat breast-conserving surgery studies is difficult because of the lack of information regarding preoperative diagnostic mammography to rule out concurrent multicentric disease and microscopic margin status after surgery. Rates of subsequent local recurrence in these studies appeared to be between 19-50%, similar to reported rates of in-breast local recurrence in patients with a first diagnosis of breast carcinoma who were treated with conservative surgery without irradiation. Early follow-up studies of breast reirradiation suggest that catheter-based interstitial brachytherapy and standard external beam radiation therapy can be delivered to the breast more than once without significant side effects in most patients and with acceptable cosmesis in some patients. Mastectomy may not be necessary in all patients with an in-breast local recurrence of breast carcinoma. Recent advances in conformal radiation delivery and single-center published reports concerning repeat breast-conserving therapy support well designed prospective trials to formally test this hypothesis.
Topics: Breast Neoplasms; Combined Modality Therapy; Female; Humans; Lymph Node Excision; Mastectomy; Neoplasm Recurrence, Local; Reoperation
PubMed: 15160329
DOI: 10.1002/cncr.20257 -
Diagnostic Pathology Oct 2021Secretory breast carcinoma is an uncommon subset of breast cancer that usually has a favorable outcome. Although initially described in children, it also occurs in... (Review)
Review
BACKGROUND
Secretory breast carcinoma is an uncommon subset of breast cancer that usually has a favorable outcome. Although initially described in children, it also occurs in adults where it may metastasize, possibly resulting in death. To date, only 20 cases of secretory breast carcinoma with distant metastases have been described.
CASE PRESENTATION
A 42-year-old female presented with liver metastasis after modified radical mastectomy of the left breast in 2008 at 34 years of age. The liver metastasis was morphologically similar to the primary tumor. Pan-TRK and Fluorescence in situ hybridization showed a rearrangement in the ETV6 gene. She subsequently underwent adjuvant chemotherapy with a fatal outcome.
CONCLUSIONS
Although secretory breast carcinoma is usually associated with favorable outcomes, our study and reviews provide a novel insight into the genetic spectrum and treatment of secretory breast carcinoma showing reduced expression of hormone receptors, abnormal genomic profiles, and possible poor prognosis. Targeted therapy may curb clinically aggressive cases. Additional molecular investigations are needed to determine the links between specific mutations and poor prognosis.
Topics: Adult; Biomarkers, Tumor; Breast Neoplasms; Carcinoma; Chemoradiotherapy, Adjuvant; Fatal Outcome; Female; Gene Rearrangement; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Liver Neoplasms; Mastectomy, Modified Radical; Proto-Oncogene Proteins c-ets; Receptors, Nerve Growth Factor; Repressor Proteins; Treatment Outcome; ETS Translocation Variant 6 Protein
PubMed: 34629079
DOI: 10.1186/s13000-021-01156-6 -
Il Giornale Di Chirurgia 2014To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the...
AIM
To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma.
PATIENTS AND METHODS
67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years' experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture.
RESULTS
20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed.
CONCLUSION
The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated.
Topics: Adult; Breast Implants; Breast Neoplasms; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Prospective Studies; Prosthesis Failure
PubMed: 25644728
DOI: No ID Found -
Asian Pacific Journal of Cancer... Sep 2019Background: The phosphatidylinositol-3 kinase (PI3K) intracellular signaling pathway plays an important role in breast cancer. The current study aimed to evaluate the...
Background: The phosphatidylinositol-3 kinase (PI3K) intracellular signaling pathway plays an important role in breast cancer. The current study aimed to evaluate the expressions of two main regulators of PI3K pathway; phosphatidylinositol-3- kinase catalytic subunit alpha as activator (PIK3CA), and phosphatase and tensin-homolog as inhibitor (PTEN), in breast carcinoma tissue, and compare with their expressions in adjacent normal breast tissue. Methods: A total of fifty female patients with breast carcinoma from surgical oncology unit of Alexandria-Main University Hospital were included in this study. The Quantitative Real Time PCR was used to quantify expressions of PIK3CA and PTEN. Results: PIK3CA mRNA expression was significantly increased in breast cancer tissues compared to normal breast tissues (P<0.001, Z=5.700), also PTEN mRNA expression was significantly higher in breast carcinoma tissue compared to normal breast tissue (P<0.001, Z=5.362). Conclusion: Increased the expressions of PIK3CA and PTEN mRNA in breast cancer tissue compared to normal breast tissue.
Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Lobular; Case-Control Studies; Class I Phosphatidylinositol 3-Kinases; Female; Follow-Up Studies; Gene Expression Regulation, Neoplastic; Humans; Middle Aged; PTEN Phosphohydrolase; Prognosis; Young Adult
PubMed: 31554385
DOI: 10.31557/APJCP.2019.20.9.2841 -
Endocrine Journal Jul 2008It is well-known that estrogens are closely involved in the growth of human breast carcinomas, and that the great majority of breast carcinoma express estrogen... (Review)
Review
It is well-known that estrogens are closely involved in the growth of human breast carcinomas, and that the great majority of breast carcinoma express estrogen receptors. Recent studies have demonstrated that estrogens are locally produced and act on the breast carcinoma tissue. Among these pathways, aromatase is a key enzyme for intratumoral production of estrogens in breast carcinomas, and aromatase inhibitors are currently used in the breast carcinoma in postmenopausal women as an estrogen deprivation therapy. This review summarizes the results of recent studies on the expression and regulation of aromatase in breast carcinoma tissues, and discusses the potential biological and/or clinical significance of aromatase. Aromatase is abundantly expressed in various cell types, such as carcinoma cells, intratumoral stromal cells, and adipocytes adjacent to the carcinoma, in breast carcinoma tissues. Further, a key regulator for aromatase expression differed according to cell type. In addition, aromatase suppressed in situ production of bioactive androgen, 5alpha-dihydrotestosterone (DHT), in breast carcinoma. Aromatase inhibitors may thus have additional antiproliferative effects through increasing local DHT concentration with estrogen deprivation.
Topics: Aromatase; Breast Neoplasms; Carcinoma; Estrogens; Female; Gene Expression Regulation, Enzymologic; Gene Expression Regulation, Neoplastic; Gonadal Steroid Hormones; Humans; Models, Biological; Neoplasms, Hormone-Dependent; Osmolar Concentration; Tissue Distribution
PubMed: 18480557
DOI: 10.1507/endocrj.k07e-053 -
Cancer Oct 2005Estrogen is a well known promoting factor of sporadic breast carcinoma. With regard to hereditary breast carcinoma, such as in BRCA1/BRCA2 syndromes, to date, the... (Review)
Review
Estrogen is a well known promoting factor of sporadic breast carcinoma. With regard to hereditary breast carcinoma, such as in BRCA1/BRCA2 syndromes, to date, the effects of estrogens on risk modification are not clear. Several studies have shown that prophylactic oophorectomy may decrease the risk of breast carcinoma in BRCA1/BRCA2 mutation carriers. Moreover, adjuvant tamoxifen therapy for primary breast carcinoma appears to diminish the risk of a second breast malignancy in BRCA1 mutation carriers. Conversely, exogenous estrogens, such as oral contraceptives, may increase the risk of breast carcinoma in familial breast cancer, as suggested by clinical studies. Paradoxically, the majority of BRCA1-related breast carcinomas are negative for ER. There is some biologic evidence of interactions between estrogens and BRCA proteins. BRCA1 expression could be induced by estradiol in experimental models, whereas recent studies indicate that BRCA1 modifies the regulatory effects of the estrogen receptor (ER) alpha (ERalpha). Prospective studies will be required to estimate the potential benefits of estrogen suppression therapies for the prevention and adjuvant treatment of BRCA1/BRCA2-related breast carcinomas.
Topics: Breast Neoplasms; Estrogen Receptor alpha; Estrogen Receptor beta; Estrogens; Female; Gene Expression Regulation; Genes, BRCA1; Genes, BRCA2; Genetic Predisposition to Disease; Humans; Mutation; Neoplasms, Hormone-Dependent
PubMed: 16155942
DOI: 10.1002/cncr.21367