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Breast Cancer Research : BCR Dec 2017Over 40% of women undergoing breast screening have mammographically dense breasts. Elevated mammographic breast density (MBD) is an established breast cancer risk factor...
BACKGROUND
Over 40% of women undergoing breast screening have mammographically dense breasts. Elevated mammographic breast density (MBD) is an established breast cancer risk factor and is known to mask tumors within the dense tissue. However, the association of MBD with high risk benign breast disease (BBD) is unknown.
METHOD
We analyzed data for 3400 women diagnosed with pathologically confirmed BBD in the Mayo Clinic BBD cohort from 1985-2001, with a clinical MBD measure (either parenchymal pattern (PP) or Breast Imaging Reporting and Data Systems (BI-RADS) density) and expert pathology review. Risk factor information was collected from medical records and questionnaires. MBD was dichotomized as dense (PP classification P2 or DY, or BI-RADS classification c or d) or non-dense (PP classification N1 or P1, or BI-RADS classification a or b). Associations of clinical and histologic characteristics with MBD were examined using logistic regression analysis to estimate odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS
Of 3400 women in the study, 2163 (64%) had dense breasts. Adjusting for age and body mass index (BMI), there were positive associations of dense breasts with use of hormone therapy (HT), lack of lobular involution, presence of atypical lobular hyperplasia (ALH), histologic fibrosis, columnar cell hyperplasia/flat epithelia atypia (CCH/FEA), sclerosing adenosis (SA), cyst, usual ductal hyperplasia, and calcifications. In fully adjusted multivariate models, HT (1.3, 95% CI 1.1-1.5), ALH (1.5, 95% CI 1.0-2.2), lack of lobular involution (OR 1.6, 95% CI 1.2-2.1, compared to complete involution), fibrosis (OR 2.2, 95% CI 1.9-2.6) and CCH/FEA (OR 1.3, 95% CI 1.0-1.6) remained significantly associated with high MBD.
CONCLUSION
Our findings support an association between high risk BBD and high MBD, suggesting that risks associated with the latter may act early in breast carcinogenesis.
Topics: Adult; Aged; Biopsy; Breast Density; Breast Diseases; Cohort Studies; Female; Fibrosis; Humans; Mammography; Middle Aged; Odds Ratio; Population Surveillance; Young Adult
PubMed: 29258587
DOI: 10.1186/s13058-017-0922-6 -
Interdisciplinary Toxicology Oct 2019Aluminium (Al) is frequently accessible to animal and human populations to the extent that intoxications may occur. Intake of Al is by inhalation of aerosols or... (Review)
Review
Aluminium (Al) is frequently accessible to animal and human populations to the extent that intoxications may occur. Intake of Al is by inhalation of aerosols or particles, ingestion of food, water and medicaments, skin contact, vaccination, dialysis and infusions. Toxic actions of Al induce oxidative stress, immunologic alterations, genotoxicity, pro-inflammatory effect, peptide denaturation or transformation, enzymatic dysfunction, metabolic derangement, amyloidogenesis, membrane perturbation, iron dyshomeostasis, apoptosis, necrosis and dysplasia. The pathological conditions associated with Al toxicosis are desquamative interstitial pneumonia, pulmonary alveolar proteinosis, granulomas, granulomatosis and fibrosis, toxic myocarditis, thrombosis and ischemic stroke, granulomatous enteritis, Crohn's disease, inflammatory bowel diseases, anemia, Alzheimer's disease, dementia, sclerosis, autism, macrophagic myofasciitis, osteomalacia, oligospermia and infertility, hepatorenal disease, breast cancer and cyst, pancreatitis, pancreatic necrosis and diabetes mellitus. The review provides a broad overview of Al toxicosis as a background for sustained investigations of the toxicology of Al compounds of public health importance.
PubMed: 32206026
DOI: 10.2478/intox-2019-0007 -
Chirurgia (Bucharest, Romania : 1990) 2017Hydatid cyst is a zoonotic disease seen in endemic areas. It is an important health problem in our country and especially in our Eastern and South-eastern Anatolia...
UNLABELLED
Hydatid cyst is a zoonotic disease seen in endemic areas. It is an important health problem in our country and especially in our Eastern and South-eastern Anatolia Region. Involvement of isolated breast tissue is very rare in hydatid cystdisease. As far as we know, isolated recurrent breast cyst hydatidosis has not been found in the literature.
CASE REPORT
We aimed to present the case of a patient who was diagnosed with recurrent isolated cyst hydatid in the same breast, operated on because of hydatid cyst in the right breast 9 years ago.
CONCLUSION
A hydatid cyst should be considered, particularly in endemic regions, in the differential diagnosis of cystic masses of the breast. If the patient has previously undergone surgery for breast cyst hydatid disease, recurrent cyst hydatid disease should be considered at the differential diagnosis.
Topics: Adult; Albendazole; Animals; Anthelmintics; Breast; Diagnosis, Differential; Echinococcosis; Echinococcus; Female; Humans; Mastectomy; Recurrence; Treatment Outcome
PubMed: 28862127
DOI: 10.21614/chirurgia.112.4.482 -
Frontiers in Immunology 2023is the causative agent of toxoplasmosis, a zoonotic disease that poses a threat to human health and a considerable loss to livestock farming. At present, clinical...
is the causative agent of toxoplasmosis, a zoonotic disease that poses a threat to human health and a considerable loss to livestock farming. At present, clinical therapeutic drugs mainly target tachyzoites and fail to eradicate bradyzoites. Developing a safe and effective vaccine against toxoplasmosis is urgent and important. Breast cancer has become a major public health problem and the therapeutic method needs to be further explored. Many similarities exist between the immune responses caused by infection and the immunotherapy for cancers. dense granule organelles secrete immunogenic dense granule proteins (GRAs). GRA5 is localized to the parasitophorous vacuole membrane in the tachyzoite stage and the cyst wall in the bradyzoite stage. We found that ME49 knockout strain (ME49Δ) was avirulent and failed to form cysts but stimulated antibodies, inflammatory cytokines, and leukocytes infiltration in mice. We next investigated the protective efficacy of ME49Δ vaccination against infection and tumor development. All the immunized mice survived the challenge infection of either wild-type RH, ME49, VEG tachyzoites, or ME49 cysts. Moreover, ME49Δ tachyzoite inoculation attenuated the growth of murine breast tumor (4T1) in mice and prevented 4T1's lung metastasis. ME49Δ inoculation upregulated the levels of Th1 cytokines and tumor-infiltrating T cells in the tumor microenvironment and triggered anti-tumor responses by increasing the number of natural killer, B, and T cells, macrophages, and dendritic cells in the spleen. Collectively, these results suggested that ME49Δ was a potent live attenuated vaccine against infection and breast cancer.
Topics: Animals; Humans; Mice; Female; Toxoplasma; Protozoan Proteins; Toxoplasmosis, Animal; Cytokines; Immunoglobulin G; Mammary Neoplasms, Animal; Breast Neoplasms; Tumor Microenvironment
PubMed: 37426671
DOI: 10.3389/fimmu.2023.1173379 -
Asian Journal of Surgery Jan 2005The clinical presentation, investigation and treatment of women with breast lumps are greatly influenced by geographical factors. These impact disease patterns and their... (Review)
Review
The clinical presentation, investigation and treatment of women with breast lumps are greatly influenced by geographical factors. These impact disease patterns and their presentation (e.g. socioeconomic/educational status and cultural/religious beliefs) and the availability of specialist health care personnel and facilities. The differential diagnoses of a breast lump include breast cancer, benign solid and cystic lumps and inflammatory conditions. The likelihood of a diagnosis relates more to geographical area, age, ethnic origin, family history of breast cancer, presence of high-risk pathology, endemic infection, smoking, pregnancy and lactation history, puerperal care and health education. Investigations and treatments vary more according to the availability of expertise and facilities (e.g. combined diagnostic clinic staffed by breast surgeon and radiologist; breast radiologist to carry out image-guided diagnostic and therapeutic procedures). This article discusses the clinical assessment and investigation of breast lumps and possible treatments from an Asia Pacific perspective.
Topics: Breast Cyst; Breast Neoplasms; Diagnosis, Differential; Female; Health Services Accessibility; Humans; Inflammation; Socioeconomic Factors
PubMed: 15691804
DOI: 10.1016/S1015-9584(09)60264-5 -
Radiology Case Reports Nov 2021Hydatid cyst (cystic echinococcosis) is a chronic parasitic infection by the larval stage of the cestode that is called resulting in the development of cystic lesions...
Hydatid cyst (cystic echinococcosis) is a chronic parasitic infection by the larval stage of the cestode that is called resulting in the development of cystic lesions in animals and humans. In this report, we describe a rare phenotype of hydatid cyst in the breast of a 23-year-old female presented with breast mass in the left upper outer quadrant for 3 months with palpable left axillary lymph nodes. Both US and mammography provided a picture of complex suspicious cystosolid lesion with amorphous micro-calcification (BIRAD-4A). Surgical consultation was performed and Tru-Cut biopsy was recommended. Histopathology results revealed multiple viable protoscolices of and suggested the final diagnosis of breast hydatid cyst. The patient returned with ruptured and infected hydatid cyst of the breast and started treatment with Albendazole 400 mg twice daily in addition to antibiotics. Following-up after two months of Albendazole treatment showed a dramatic shrinkage in the size of the cystic lesion. In conclusion, hydatid cyst should be considered as a differential diagnosis of any cystic or cystosolid lesion in the breast and any organ in the body from head to toe apart from the hair and nails. Radiologists should be aware to the benign lesions that may mimic breast cancer to avoid misdiagnosis and unnecessary invasive procedures and consequent complications.
PubMed: 34484524
DOI: 10.1016/j.radcr.2021.07.055 -
Radiologic Clinics of North America Sep 2010Masses due to cystic lesions of the breast are extremely common findings on mammography, ultrasonography, and magnetic resonance imaging. Although many of these lesions... (Review)
Review
Masses due to cystic lesions of the breast are extremely common findings on mammography, ultrasonography, and magnetic resonance imaging. Although many of these lesions can be dismissed as benign simple cysts, requiring intervention only for symptomatic relief, complex cystic and solid masses require biopsy. Perhaps, the most challenging are complicated cysts, that is, cysts with internal debris. When the debris is mobile or a fluid-debris level is seen, complicated cysts can be dismissed as benign findings. As an isolated finding, homogeneous complicated cysts can be classified as probably benign, with intervention only considered with interval development or enlargement, abscess is suspected, or if suspicious features develop. When multiple and bilateral complicated and simple cysts are present (ie, at least three, with at least one in each breast), a benign, BI-RADS 2, assessment is usually appropriate. Clustered microcysts are common benign findings in pre- and perimenopausal women, though short-interval surveillance may be appropriate for many such lesions in post-menopausal women, particularly if the lesion is new or rather small or deep (ie, diagnostic uncertainty).
Topics: Adult; Age Factors; Aged; Biopsy, Fine-Needle; Breast Cyst; Breast Neoplasms; Diagnosis, Differential; Female; Fibrocystic Breast Disease; Humans; Immunohistochemistry; Mass Screening; Middle Aged; Risk Assessment; Sensitivity and Specificity; Societies, Medical; Ultrasonography, Mammary; United States
PubMed: 20868895
DOI: 10.1016/j.rcl.2010.06.007 -
International Journal of Surgery Case... 2020The hydatid cyst of the breast is a rare pathology even in countries endemic to tuberculosis, however there remains a differential diagnosis evoked in front of any...
INTRODUCTION
The hydatid cyst of the breast is a rare pathology even in countries endemic to tuberculosis, however there remains a differential diagnosis evoked in front of any breast tumor. The clinic, mammography and ultrasound sometimes allow us to suspect the hydatid nature of the lesion. The definitive diagnosis remains histological and the treatment is always surgical. From one case, we recall the important role that cytology can play in preoparatory diagnosis.
CASE PRESENTATION
We report an observation of 59-year-old patient who lives in a tuberculosis endemic area of morocoo. the patient presented to our institute with palpable nodule in the right breast associated with pain of long duration. Clinical examination shows 2 masses occuping the entire upper outer quadrant of the right breast. Radiological explorations (mammography + ultrasound) objectified: A voluminous opacity of the QSE of the right breast corresponding on ultrasound to two cystic with anechoic content. the first classified ACR2 BIRADS. the second has ultimately echogenic content with a sloping portion producing the appearance of pseudo vegetation,classified ACR3 BIRADS. A fine needle aspiration of the cyst only showed the presence of altered polynuclear, without evidence of tumor cells. Treatment consisted of surgical excision such as perikystectomy and pathology examination demonstrated breast hydatidosis.postoperative evolution was favourable. Patient was put on medical treatment based on albendazole immediately.The patient was monitored for one year without local or distant recurrences.
CONCLUSION
Although hydatid disease of the breast remains a rare localization of tuberculosis disease, it should nevertheless be considered as a differential diagnosis of breast tumors. Ultrasound, cytology and MRI play an important preoperative diagnostic role. Treatment is essentially based on surgical pericystectomy associated with medical treatment based on albendazole.
PubMed: 33197778
DOI: 10.1016/j.ijscr.2020.10.109 -
Academic Radiology Jan 2019The purpose of this work is to determine if the speed of sound value of a breast cyst can aid in the clinical management of breast masses. Breast macrocysts are defined...
RATIONALE AND OBJECTIVES
The purpose of this work is to determine if the speed of sound value of a breast cyst can aid in the clinical management of breast masses. Breast macrocysts are defined as fluid-filled tissue masses >1 cm in diameter and are thought to be aberrations of normal development and involution, often associated with apocrine metaplasia. The benign natural history of breast cysts is well known, and it is important to obtain high specificity in breast imaging to avoid unnecessary biopsies in women who have benign diseases, particularly those with dense breast tissue. Transmission ultrasound is a tomographic imaging modality that generates high-resolution, 3D speed of sound maps that could be used to identify breast tissue types and act as a biomarker to differentiate lesions. We performed this study to investigate the microanatomy of macrocysts observed using transmission ultrasound, as well as assess the relationship of speed of sound to the physical and biochemical parameters of cyst fluids.
MATERIALS AND METHODS
Cyst fluid samples were obtained from 37 patients as part of a case-collection study for ultrasound imaging of the breast. The speed of sound of each sample was measured using a quantitative transmission ultrasound scanner in vivo. Electrolytes, protein, cholesterol, viscosity, and specific gravity were also measured (in the aspirated cyst fluid) to assess their relationship to the speed of sound values obtained during breast imaging.
RESULTS
We found positive correlations between viscosity and cholesterol (r = 0.71) and viscosity and total protein × cholesterol (r = 0.78). Additionally, we performed direct cell counts on cyst fluids and confirmed a positive correlation of number of cells with speed of sound (r = 0.74). The speed of sound of breast macrocysts, as observed using transmission ultrasound, correlated with the cytological features of intracystic cell clumps.
CONCLUSION
On the basis of our work with speed as a classifier, we propose a spectrum of breast macrocysts from fluid-filled to highly cellular. Our results suggest high-speed cysts are mature macrocysts with high cell counts and many cellular clumps that correlate with cyst microanatomy as seen by transmission ultrasound. Further studies are needed to confirm our findings and to assess the clinical value of speed of sound measurements in breast imaging using transmission ultrasound.
Topics: Breast Cyst; Cholesterol; Cyst Fluid; Female; Humans; Proteins; Sound; Ultrasonography; Viscosity
PubMed: 29887398
DOI: 10.1016/j.acra.2018.03.027 -
Medicine May 2021The aim of this study was to develop a new breast density classification system for dedicated breast computed tomography (BCT) based on lesion detectability analogous to...
The aim of this study was to develop a new breast density classification system for dedicated breast computed tomography (BCT) based on lesion detectability analogous to the ACR BI-RADS breast density scale for mammography, and to evaluate its interrater reliability.In this retrospective study, 1454 BCT examinations without contrast media were screened for suitability. Excluding datasets without additional ultrasound and exams without any detected lesions resulted in 114 BCT examinations. Based on lesion detectability, an atlas-based BCT density (BCTD) classification system of breast parenchyma was defined using 4 categories. Interrater reliability was examined in 40 BCT datasets between 3 experienced radiologists.Among the included lesions were 63 cysts (55%), 18 fibroadenomas (16%), 7 lesions of fatty necrosis (6%), and 6 breast cancers (5%) with a median diameter of 11 mm. X-ray absorption was identical between lesions and breast tissue; therefore, the lack of fatty septae was identified as the most important criteria for the presence of lesions in glandular tissue. Applying a lesion diameter of 10 mm as desired cut-off for the recommendation of an additional ultrasound, an atlas of 4 BCTD categories was defined resulting in a distribution of 17.5% for density A, 39.5% (B), 31.6% (C), and 11.4% (D) with an intraclass correlation coefficient (ICC) among 3 readers of 0.85 to 0.87.We propose a dedicated atlas-based BCTD classification system, which is calibrated to lesion detectability. The new classification system exhibits a high interrater reliability and may be used for the decision whether additional ultrasound is recommended.
Topics: Adult; Aged; Aged, 80 and over; Breast; Breast Cyst; Breast Density; Breast Neoplasms; Clinical Decision-Making; Datasets as Topic; Decision Support Techniques; Diagnosis, Differential; Fat Necrosis; Female; Humans; Middle Aged; Observer Variation; Reproducibility of Results; Retrospective Studies; Terminology as Topic; Tomography, X-Ray Computed; Ultrasonography, Mammary
PubMed: 33950998
DOI: 10.1097/MD.0000000000025844