Experiences of a Multidisciplinary Elderly Breast Cancer Clinic: Using the Right Specialists, in the Same Place, with Time

Author(s):  
Anne Stotter ◽  
Mohammad Tahir ◽  
Robert S. Pretorius ◽  
Thompson Robinson
2017 ◽  
Vol 24 (10) ◽  
pp. R349-R366 ◽  
Author(s):  
Catherine Zabkiewicz ◽  
Jeyna Resaul ◽  
Rachel Hargest ◽  
Wen Guo Jiang ◽  
Lin Ye

Bone morphogenetic proteins (BMPs) belong to the TGF-β super family, and are essential for the regulation of foetal development, tissue differentiation and homeostasis and a multitude of cellular functions. Naturally, this has led to the exploration of aberrance in this highly regulated system as a key factor in tumourigenesis. Originally identified for their role in osteogenesis and bone turnover, attention has been turned to the potential role of BMPs in tumour metastases to, and progression within, the bone niche. This is particularly pertinent to breast cancer, which commonly metastasises to bone, and in which studies have revealed aberrations of both BMP expression and signalling, which correlate clinically with breast cancer progression. Ultimately a BMP profile could provide new prognostic disease markers. As the evidence suggests a role for BMPs in regulating breast tumour cellular function, in particular interactions with tumour stroma and the bone metastatic microenvironment, there may be novel therapeutic potential in targeting BMP signalling in breast cancer. This review provides an update on the current knowledge of BMP abnormalities and their implication in the development and progression of breast cancer, particularly in the disease-specific bone metastasis.


2021 ◽  
pp. 604-609
Author(s):  
Rika Kouhashi ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Tamami Morisaki ◽  
Sae Ishihara ◽  
...  

Angiosarcoma is a malignant mesenchymal tumor characterized by the presence of vascular endothelial cells. Although rare, angiosarcoma developing in the mammary glands has a poor prognosis. We report a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer. A 78-year-old woman noticed a tumor in her right breast and visited our hospital. The patient had undergone breast-conserving surgery and axillary lymph node dissection from the right breast 12 years before the visit. The tumor was diagnosed as T4bN0M0, stage IIIB. Anastrozole was administered as postoperative adjuvant therapy for 5 years; the patient also received 50-Gy whole-breast radiation therapy after surgery. Physical examination during her visit revealed an elevated lesion with blue purpura around the nipple in the right breast. We performed breast ultrasound and detected a well-defined 19.6 × 16.4 × 10.7 mm hypoechoic tumor in the left subareolar area. The patient underwent core needle biopsy (CNB). Based on the CNB specimen findings, she was suspected to experience late local recurrence after surgery. Therefore, she underwent total mastectomy after breast-conserving surgery. A dark-red tumor sized 18 × 12 mm was found in a specimen from the nipple. The pathological diagnosis of the specimen revealed short spindle-shaped tumor cells with strong nuclear pleomorphism and a significant interstitial fibrosis. Immunohistochemistry using D2-40 and CD31 antibodies showed irregular luminal proliferation at the anastomosis, infiltration into the surrounding tissue, and massive necrosis, thereby leading to the diagnosis of breast angiosarcoma. We have reported a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Masahiro Ohara ◽  
Yumiko Koi ◽  
Tatsunari Sasada ◽  
Keiko Kajitani ◽  
Seishi Mizuno ◽  
...  

Abstract Background Spontaneous regression (SR) is a rare phenomenon in which a cancer disappears or remits without treatment. We report a case of breast cancer that showed spontaneous tumor regression in the surgical specimen after core needle biopsy. Case presentation A 59-year-old woman came to our hospital complaining of a painful lump in the right breast. In the upper-outer quadrant of the right breast, a tumor with an unclear boundary, 30 mm in diameter, was palpable. In pathological findings from needle biopsy, the tumor was diagnosed as solid-type invasive ductal breast carcinoma. Partial coagulation necrosis was generated in estrogen receptor-negative, HER2-negative, and AE1/AE3-positive ductal carcinoma without infiltration of lymphocytes. Surgery for right breast cancer was then performed. Histological examination of the surgical specimen revealed the tumor was invasive ductal carcinoma with lymphocyte infiltration, coagulation necrosis, and fibrous tissue with hemosiderin. The tumor formed a solid nest, 3 mm in diameter, suggesting the possibility of SR. Conclusions Immune responses, infection, hormones, surgical stress, and ischemia have been reported as mechanisms of SR. The findings in this case strongly suggest that SR of breast cancer is associated with anti-tumor immune responses.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12557-e12557
Author(s):  
Zachary Spigelman ◽  
Jo-Ellen Murphy

e12557 Background: Biologic lateralization broadly impacts breast cancer. Malignancies originating in the left breast compared to the right breast tend to be more frequent, larger and of poorer prognosis. Left breast tumors respond differently to HER2-neu signaling and have lateralized Ki67 expression. In a prior study a right-left asymmetry in the neutrophil/lymphocyte ratio (NLR) of breast cancers was identified (ASCO 2018, e13094). As a follow-up, retrospective analysis of results from comprehensive genomic profiling (CGP) of right and left side breast cancer specimens was performed to determine a potential genomic etiology for the observed NLR lateralization. Methods: Tumors from 43 consecutive breast cancer patients underwent analysis for all classes of genomic alterations by hybrid capture-based CGP (Foundation Medicine). The CGP results from the 25 left- and 18 right-sided breast cancer samples were analyzed along with the histologic grade and status of estrogen receptor (ER), progesterone receptor (PR), and HER2 expression. Results: In this cohort of advanced breast cancer patients (stage 3-4), no statistically significant differences in lateralization were identified based on patient age, tumor stage, or frequency of ER or Her2 expression (Table). A predominance of PR positivity (p=0.14 chi square analysis) and amplifications in the ERBB2 (p=0.37) and RAD21 (p=0.08) genes were detected in right side tumors. Conclusions: Together with the prior study, trends in asymmetry based on genomic, pathologic, and immunohistologic differences have been detected in breast cancers, including an increased incidence of ERBB2 and RAD21 amplification in right-side breast tumors in this cohort. The predominance of lower PR positivity in the left breast tumors may be due to preferential hypermethylation, consistent with reports that it mediates biologic lateralization changes, downregulates PR expression, and alters amplification rates. Epigenetic methylation, may contribute to asymmetric breast cancer biology and have implications for therapeutic strategy. Further study is warranted.[Table: see text]


2015 ◽  
Vol 13 (5) ◽  
pp. 1441-1448 ◽  
Author(s):  
Sarah R. Ormseth ◽  
David K. Wellisch ◽  
Adam E. Aréchiga ◽  
Taylor L. Draper

AbstractObjective:The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic.Method:Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES–D score ≥ 16), current level of anxiety (State–Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer).Results:A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted “U” relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels.Significance of Results:Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.


2017 ◽  
Vol 2 (2) ◽  
pp. 20-28
Author(s):  
Bekhal Abdalwahid Amin ◽  
Muhammed Babakir-Mina ◽  
Fadhil Ahmed Mohialdeen ◽  
Mohammed I. M. Gubari

Breast cancer is a devastating affliction, the frequency of which is gradually increasing all over the world. Cancer may be cured if properly intervened at the right time. The correct treatment, aided by professionals and the right technology can provide critical life support to breast cancer patients. This study was conducted to assessment knowledge, attitude and practice of breast cancer among Kurdish females visited Maternity Teaching Hospital in Sulaimani. A face-to-face interview through a question¬naire to assessment of knowledge and practices toward breast cancer of 500 non-breast cancer women visited Maternity Teaching Hospital was done. Data were computerized and analyzed using Statistical Package for the Social Science (SPSS, version 22). P-value of < 0.05 was considered as statistically significant. Out of 500 participants in the current study on knowledge and practices toward breast cancer among non-breast cancer women, consequently were 227 (45.4%) and 201 (40.2%) practiced breast self-examination(BSE) and clinical breast examination respectively. In this study the participants having no symptoms and lack of knowledge about how to do BSE where regarded as the barriers of not practicing BSE (44.7%, 55.3%) respectively. The most common reason for not doing clinical breast examination (CBE) is fear of the outcome and no sign & symptom of breast cancer (28.8%, 61.9%) respectively. The high education level showed significantly more knowledge of breast self-examination and mammography than Illiterate women P≤ 0.001 and P≤ 0.03 respectively. On the other hand, the high education level women showed significantly more practice of breast self-examination P≤ 0.001. In conclusion, the present study found the facts to the inadequate knowledge of female about breast cancer and recognized the negative influence of low knowledge on the practice of BSE, CBE and mammography and the breast cancer incidence. Therefore, more determinations are needed to develop a positive attitude toward BSE, CBE and mammography screening and practice in Sulaimani.


2021 ◽  
Vol 27 (3) ◽  
pp. 201-206
Author(s):  
Özlem Mermut ◽  
Aysun Ozsoy Ata ◽  
Didem Can Trabulus

Abstract Objective: We compared mono-isocenter and dual-isocenter plans in synchronous bilateral breast cancer (SBBC), which is defined as tumours occurring simultaneously in both breasts, and evaluated the effects of these differences in plans on organs-at-risk (OARs). Materials and methods: We evaluated 10 women with early stage, nod negative (Tis-2N0M0) SBBC. The treatment dose was determined to be 50 Gy. We used mean dose and VXGy to evaluate the OARs. To evaluate the effectiveness of treatment plans, Homogeneity index (HI), conformity index (CI) and sigma index (SI) and monitor units (MU) of monoisocenter (MIT) and dual-isocenter (DIT) plans were compared. During bilateral breast planning, for the single-centre plan, the isocenter was placed at the center of both breasts at a depth of 3-4 cm. For the two-center plan, dual-isocenters were placed on the right and left breasts. Results: No significant difference between the techniques in terms of the scope of the target volume was observed. Statistically significant results were not achieved in MIT and DIT plans for OARs. Upon comparing MIT and DIT, the right-side monitor unit (MU) value in DIT (p = 0.011) was statistically significantly lower than that in MIT. Upon comparing right-left side MIT and DIT, the MU value (p = 0.028) was significantly lower in DIT than MIT. Conclusion: SBBC irradiation is more complex than unilateral breast radiotherapy. No significant difference between both techniques and OARs was observed. However, we recommend MIT as a priority technique due to the ability to protect OARs, ease of administration during treatment, and the fact that the patient stays in the treatment unit for a shorter period of time.


2021 ◽  
Author(s):  
Xiaoxiao Zhong ◽  
Fengjiao Ding ◽  
Liyuan Qian ◽  
Wei Wu ◽  
Yanguang Wen ◽  
...  

Abstract Background: Contralateral neck lymph node metastasis is rare for primary breast cancer. Its clinical stage and treatment principles are lack of authoritative guidelines. A 30-year-old breast cancer patient with contralateral neck lymph node metastasis is presented. The clinical treatment is discussed combined with current research.Case presentation: A 30-year-old woman presented with a right breast mass for 5 months and left neck lymph node enlargement for 5 days. The mammography showed a 33mm*14.3mm mass in the inner quadrant of right breast. The ultrasound showed several hypoechoic nodules on the left side of the neck. Rapid intraoperative pathological examination diagnosed right breast malignant tumor and poorly differentiated carcinoma of the left cervical lymph nodes. Then the right mastectomy was performed immediately. The patient was scheduled to administer chemotherapy, molecular targeted therapy, radiotherapy and endocrinotherapy after operation. The long-term efficacy remains to be seen.Conclusion: The infrequent presentation of breast cancer with metastasis to the contralateral neck lymph node can be challenged for standard therapies.


2018 ◽  
Vol 22 (4) ◽  
pp. 45-51
Author(s):  
Alya S. Binmahfouz

Metaplastic breast cancer is rare, representing < 5% of breast cancer (only eight cases have been reported so far). We present here a 42-year-old female complaining of a painless lump in the right breast for the previous two months. Physical examination revealed a palpable mass. Lumpectomy was performed and histopathologic examination revealed metaplastic breast carcinoma with foci of chondrosarcoma. The patient received adjuvant radiation therapy and chemotherapy and is currently following up as an outpatient. We also discuss diff erentimaging diagnostic features of this specifi c type of breast cancer using mammography, ultrasonography, and magnetic resonance imaging.


Data ◽  
2021 ◽  
Vol 6 (11) ◽  
pp. 111
Author(s):  
Asmaa S. Alsolami ◽  
Wafaa Shalash ◽  
Wafaa Alsaggaf ◽  
Sawsan Ashoor ◽  
Haneen Refaat ◽  
...  

The current era is characterized by the rapidly increasing use of computer-aided diagnosis (CAD) systems in the medical field. These systems need a variety of datasets to help develop, evaluate, and compare their performances fairly. Physicians indicated that breast anatomy, especially dense ones, and the probability of breast cancer and tumor development, vary highly depending on race. Researchers reported that breast cancer risk factors are related to culture and society. Thus, there is a massive need for a local dataset representing breast cancer in our region to help develop and evaluate automatic breast cancer CAD systems. This paper presents a public mammogram dataset called King Abdulaziz University Breast Cancer Mammogram Dataset (KAU-BCMD) version 1. To our knowledge, KAU-BCMD is the first dataset in Saudi Arabia that deals with a large number of mammogram scans. The dataset was collected from the Sheikh Mohammed Hussein Al-Amoudi Center of Excellence in Breast Cancer at King Abdulaziz University. It contains 1416 cases. Each case has two views for both the right and left breasts, resulting in 5662 images based on the breast imaging reporting and data system. It also contains 205 ultrasound cases corresponding to a part of the mammogram cases, with 405 images as a total. The dataset was annotated and reviewed by three different radiologists. Our dataset is a promising dataset that contains different imaging modalities for breast cancer with different cancer grades for Saudi women.


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