The conversion of [4-14C]-cortisol to [14C]-11β-hydroxyestradiol in a patient with metastatic breast carcinoma—cortisol metabolism and breast cancer

BackgroundBreast cancer(BC) is the second most common cause after lung cancer of malignant pleural effusions(MPEs),in approximately one third of all MPEs.Although,MPEs are relativity easy to be collated are still not well characterized in their cellular compositions. This opens new avenues to characterize the cellular milieu comprising the MPE, as it has the potential to be highly informative about mutational markers and immune response –ultimately guiding targeted therapy and predicting therapeutic outcomes with their study. The proposed study will characterize immune landscape of the cellular composition of MPE from patients with metastatic breast carcinoma and characterize their relationship with clinicopathologic features in these patients.Abstract 945 Figure 1Comparison between the cell block in H-E and mIF expression CK, CD68 and CD3Abstract 945 Figure 2Composite image in mIF expressing 8 markers. In higher magnification is possible to observe the co expression of CK+Ki67+, CK PDL1, CD3+Foxp3+ and CD3+CD8+Abstract 945 Table 1Results: cell phenotypes in percentage in the six cases analyzedAbstract 945 Table 2Clinical data of the six patients. L: left . R: right , BR : Breast cáncer, CRC: Colorrectal cáncer, NE: No evaluable , IDC : Invasive ductal carcinoma , CT: chemotherapy and BT : biotherapy* Last appointment of the patient.MethodsFive microns thickness paraffin cell pellet blocks from six cases randomly selected of breast carcinoma MPE were stained using a quantitative multiplex immunofluorescence(mIF) panel containing 8 markers against pancytokeratin(CK), PD-L1, PD-1, CD3, CD8, Foxp3, CD68, Ki67, and DAPI (figure 1). Representative regions of interest were scanned using a multispectral scanner (Vectra Polaris) in high magnification (20x) to capture different cell populations. Markers co-expression were processed and analyzed using a quantitative image analysis software (InForm). The final results were obtained as absolute number of cells from each phenotype and were characterized with clinicopathologic features.ResultsWe analyzed and stained six breast cancer MPE cases with previously optimized and validated mIF panel for formalin fixed and paraffin embedded (FFPE) tumor tissues against CK, CD3, CD68, CD8, Foxp3, Ki67, PD1 and PD-L1 (figure 2). The median cellular density was 5870.53 cells. Median for each marker: CK+ was presented in 75.9% (between malignant cells and reactive mesothelial cells) in these cells the expression of Ki67 was 8% and PD-L1+ was present in 0.2%.CD3+ was 0.72% and being the cytotoxic T-cells CD3+CD8+ was 12.13% of these cells and it expression for CD3+PD1+ was in 1.14% without concomitant expression for PD-L1. The median of the macrophages CD68+ was 8.1% of the total cells (table 2).ConclusionsmIF is a promising tool to study diverse corporal effusion from different origin. Although more studies are needed, this new perspective can help us to resolve some clues and possible prognosis in advanced stages of BC.ReferenceNicholas D T, Matthew A. S. Diagnosis and Management of Pleural Metastases and Malignant Effusion in Breast Cancer.En: Kirby I B, Edward M C, V. Suzanne K, William J. G. The Breast (Fifth Edition): Elsevier; 2018. P 934.

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Excision of metastatic breast cancer from sternum and reconstruction in two patients with solitary metastatic spread

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa272 ◽

2020 ◽

Vol 2020 (8) ◽

Author(s):

Saifullah Mohamed ◽

Khurum Mazhar ◽

Ahmed Osman ◽

Akshay Patel ◽

Lakshmi Srinivasan ◽

...

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Previous History ◽

Metastatic Breast ◽

Extent Of Resection ◽

Left Breast ◽

Term Survival ◽

Metastatic Breast Carcinoma ◽

History Of ◽

Treated Breast

Abstract Metastatic breast carcinoma is a relatively common clinical entity. However, the prognosis of oligometastatic and polygometastatic disease differs considerably pertaining to five-year survival. Metastatic breast carcinoma to the sternum has been described as early as 1988. We describe two cases in our institution who presented with solitary sternal metastases with a previous history of treated breast cancer. In both cases, there had been a history of previous left breast cancer treated aggressively with surgical resection and adjuvant oncological therapy and maintenance hormonal therapy. Partial sternectomy or total sternectomy for solitary metastatic sternal deposits is well established with relatively low morbidity and mortality and improvement in quality of life and possible improvement in long-term survival. Furthermore, reconstructive options are inherently dependent on extent of resection performed. These techniques can incorporate the use of sternal plates in order to approximate defects and reinforce the sternum in the setting of partial sternectomy.

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Vinorelbine as first-line chemotherapy for metastatic breast carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.1994.12.2.336 ◽

1994 ◽

Vol 12 (2) ◽

pp. 336-341 ◽

Cited By ~ 128

Author(s):

A Romero ◽

M G Rabinovich ◽

C T Vallejo ◽

J E Perez ◽

R Rodriguez ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Breast Carcinoma ◽

Objective Response ◽

Metastatic Breast ◽

Survival Duration ◽

Severe Toxicity ◽

First Line ◽

Metastatic Breast Carcinoma ◽

Line Chemotherapy

PURPOSE A phase II trial was performed to evaluate the efficacy and toxicity of vinorelbine (VNB) as first-line chemotherapy for metastatic breast carcinoma. PATIENTS AND METHODS Between August 1991 and February 1993, 45 patients with metastatic breast cancer were entered onto the study. Therapy consisted of VNB 30 mg/m2 diluted in 500 mL of normal saline administered as a 1-hour intravenous infusion. Injections were repeated weekly until evidence of progressive disease (PD) or severe toxicity developed. RESULTS One patient was considered not assessable for response. An objective response (OR) was observed in 18 of 44 patients (41%; 95% confidence interval, 26% to 56%). Three patients (7%) had a complete response (CR) and 15 (34%) had a partial response (PR). The median time to treatment failure for the entire group was 6 months (range, 1 to 15), and the median duration of response was 9 months (range, 1 to 15). The median survival duration has not been reached yet. There were no treatment-related deaths. The dose-limiting toxicity was myelosuppression. Leukopenia occurred in 35 patients (78%) and was grade 3 or 4 in 16 (36%). Phlebitis was observed in 19 of 29 patients (66%) who did not have central implantable venous systems. Fifteen patients (33%) developed peripheral neurotoxicity. Myalgia occurred in 20 patients (44%). CONCLUSION VNB is an active drug against metastatic breast cancer with moderate toxicity, which justifies further evaluation in association with other agents.

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B-TREUH: A single-arm phase II pilot study of euthyroid hypothyroxinemia in metastatic breast carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.tps1115 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. TPS1115-TPS1115

Author(s):

Shruti Trehan ◽

Suzan S. Cheng ◽

Aleck Hercbergs

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Breast Carcinoma ◽

Radiation Effects ◽

Metastatic Breast ◽

Progression Free Survival ◽

Free T4 ◽

Metastatic Breast Carcinoma ◽

The Us

TPS1115 Background: It is estimated that there are approximately 155,000 people living with metastatic breast cancer in the US. Studies exploring the connection between hypothyroidism or hyperthyroidism and breast cancer have yielded varying results with up to 33% prevalence of thyroid disease in these patients. L-thyroxine (T4) is the most commonly prescribed agent in the US to manage hypothyroidism. However, there are data suggesting that T4 is a pro-oncogenic agent with proposed mechanisms such as stimulation of mitogenesis, angiogenesis, resistance to apoptosis. In addition, T4 May counter anti-PDL-1 and radiation effects. Triiodothyronine (T3), which is deiodinated form of T4 and also commercially available, is felt to be less oncogenic and less mitogenic. Therefore, exogenous supplementation of T3 would decrease the T4 levels creating the desired state of EUTHYROID HYPOTHYROXINEMIA. The study hypothesizes that replacing L-thyroxine (T4) with Triiodothyronine (T3) in hypothyroid patients with metastatic breast carcinoma, while they simultaneously continue to receive standard systemic therapy, with titrating T3 dose to achieve a state of Euthyroid Hypothyroxinemia would result in improved disease outcomes. Methods: Eligible participants are adults with metastatic breast carcinoma with estimated life expectancy of > 3months, hypothyroidism, and with normal TSH on L-thyroxine (T4). Following consent, participants will discontinue L-thyroixne (T4) and initiate Triiodothyronine (T3) dose based on current T4 dose after an appropriate washout period. Drug titration will be in accordance with thyroid function testing to maintain levels of free T4 at < 50% normal range. The treatment period will continue for 9 months with periodic assessment of disease status, quality of life (FACT-B) and laboratory measures. The primary endpoint is the progression free survival at 12 months while the secondary endpoints are prevalence of hypothyroidism in the cohort, overall survival, quality of life, and duration of time to achieve the Euthyroid Hypothyroxinemia state. Given many uncertainties to calculate power precisely, the sample size is estimated to be approximately 30 patients. Clinical trial information: NCT03787303 .

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Portal Hypertension, Nodular Regenerative Hyperplasia of the Liver, and Obstructive Portal Venopathy due to Metastatic Breast Cancer

Case Reports in Pathology ◽

10.1155/2013/826284 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Andrew T. Turk ◽

Matthias J. Szabolcs ◽

Jay H. Lefkowitch

Keyword(s):

Breast Cancer ◽

Portal Hypertension ◽

Breast Carcinoma ◽

Portal Vein ◽

Metastatic Breast ◽

Nodular Regenerative Hyperplasia ◽

Metastatic Breast Carcinoma ◽

Noncirrhotic Portal Hypertension ◽

Diagnostic Difficulties ◽

Recurrent Breast

Nodular regenerative hyperplasia (NRH) of the liver is associated with noncirrhotic portal hypertension, rheumatologic and hematologic disorders, administration of certain drugs, and other underlying conditions. This report describes a 64-year-old man with clinically presumed cirrhosis who presented to our institution with coffee-ground emesis, esophageal varices, ascites, and encephalopathy. Eleven years earlier he had been treated for breast cancer with mastectomy and chemo-radiotherapy. He died suddenly, and the autopsy showed no evidence of cirrhosis but instead demonstrated NRH with extensive emboli of recurrent breast carcinoma within the portal vein and its intrahepatic branches. Neoplastic occlusion of the portal vein as a cause of presinusoidal noncirrhotic portal hypertension has not previously been reported for metastatic breast carcinoma. This case highlights the importance of obstructive portal venopathy in the pathogenesis of NRH as well as the diagnostic difficulties that may be encountered in determining the cause of portal hypertension.

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Patient with metastatic breast cancer, HER2-positive, trastuzumab- and pertuzumab-resistant responding to lapatinib

ABOUTOPEN ◽

10.19156/abtpn.2018.0044 ◽

2018 ◽

Vol 4 (1) ◽

pp. 66-68

Author(s):

Daniela Cianniello ◽

Roberta Caputo

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Breast Carcinoma ◽

Tyrosine Kinase ◽

Tyrosine Kinase Inhibitor ◽

Kinase Inhibitor ◽

Hepatic Metastases ◽

Metastatic Breast ◽

Her2 Positive ◽

Metastatic Breast Carcinoma

Lapatinib is an intracellular tyrosine kinase inhibitor of EGFR (ErbB1) and HER2 (ErbB2) receptors, approved for the treatment of metastatic breast carcinoma pre-treated with anti-HER2 antibodies. We report the case of a 60-year-old woman diagnosed with metastatic breast neoplasm, HER2-positive, progressing after treatment with trastuzumab, pertuzumab and T-DM1, who obtained a regression of hepatic metastases after treatment with lapatinib-capecitabine (Oncology).

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Detection of metastatic breast carcinoma cells in a bone marrow sample by flow cytometry: case report

Mastology ◽

10.29289/259453942020v30s1030 ◽

2020 ◽

Vol 30 (Suppl 1) ◽

Author(s):

Daniella Serafin Couto Vieira ◽

Manoela Lira Reis ◽

Sandro Wopereis ◽

Maria Claudia Santos Da Silva

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Flow Cytometry ◽

Breast Carcinoma ◽

Metastatic Breast ◽

Lower Limbs ◽

Lumbar Pain ◽

Unknown Primary ◽

Public Health Issue ◽

Metastatic Breast Carcinoma

Introduction: Breast cancer is a global public health issue due to its high mortality. Despite the multidisciplinary approaches and strategies to reduce mortality, many women are diagnosed in advanced stages with metastases, compromising the chances of cure. Objective: To report the case of a 28-year-old woman, G3, with a history of postpartum depression, on treatment for post-breastfeeding mastitis, with lumbar pain radiating to the chest and lower limbs for 5 months, progressing to epistaxis, hair loss, lymphadenopathy, dyspnea, lower limb petechiae, weight loss of 20 kg, and bicytopenia in the prior 2 months. She was admitted to the emergency department with fever and night sweats and was diagnosed with metastatic breast cancer based on bone marrow (BM) analysis by flow cytometry (FC). Method: BM biopsy (BMB) was performed and evaluated by FC immunophenotyping using the antibodies anti-CD3, anti-CD4, anti-CD8, anti-CD19, anti-CD56, anti-CD34, anti-CD45, and anti-HER2. The streptavidin-biotin-peroxidase method was adopted for the phenotypic evaluation by immunohistochemistry (IHC). Results: Clinical findings and her history favored the hypothesis of lymphoproliferative neoplasm. BM samples were collected for immunophenotyping and BMB for histological study and IHC. The initial aspirate analysis by FC identified 0.90% of non-hematological cells, with a positive expression for the antibody anti-HER2, suggesting epithelial neoplasm, which directed the investigation toward solid tumor with unknown primary site. The presence of this cellular component guided the IHC panel of BMB. Cells positive for CKPOOL, CK7, E-cadherin, estrogen receptor, progesterone receptor, HER2, GCDFP15, and mammaglobin were identified, indicating immunophenotype of metastatic breast disease in the BM. Later, a nodule was clinically detected in the right breast, showing a pattern consistent with that found in the BM sample, confirming the metastatic breast carcinoma. Conclusions: FC has proven to be a methodology of great clinical importance. Its routine laboratory application in the diagnosis of solid tumors could become a useful tool, providing agility and increasing diagnostic coverage.

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Initiation of Metastatic Breast Carcinoma by Targeting of the Ductal Epithelium with Adenovirus-Cre: A Novel Transgenic Mouse Model of Breast Cancer

Journal of Visualized Experiments ◽

10.3791/51171 ◽

2014 ◽

Cited By ~ 5

Author(s):

Melanie R. Rutkowski ◽

Michael J. Allegrezza ◽

Nikolaos Svoronos ◽

Amelia J. Tesone ◽

Tom L. Stephen ◽

...

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Mouse Model ◽

Transgenic Mouse ◽

Metastatic Breast ◽

Transgenic Mouse Model ◽

Metastatic Breast Carcinoma ◽

Ductal Epithelium

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Breast Cancer Metastasis Masquerading as the Great Masquerader: Sebaceous Cell Carcinoma

Case Reports in Oncology ◽

10.1159/000477339 ◽

2017 ◽

Vol 10 (2) ◽

pp. 485-488 ◽

Cited By ~ 3

Author(s):

Jonathan Martin ◽

Maxwell A. Fung ◽

Lily Koo Lin

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Cell Carcinoma ◽

Metastatic Disease ◽

Cancer Metastasis ◽

Metastatic Breast ◽

Breast Adenocarcinoma ◽

Eyelid Margin ◽

Upper Eyelid ◽

Metastatic Breast Carcinoma

Objective: We describe the case of a patient with metastatic breast cancer who presented with eyelid margin thickening and madarosis more suggestive of sebaceous cell carcinoma than metastatic disease. Histopathology confirmed metastatic breast adenocarcinoma. Case Report: A 59-year-old woman with a known history of metastatic breast carcinoma actively enrolled in a clinical trial presented with a thickened right upper eyelid margin with madarosis and without ulceration. Although the possibility of metastasis was considered, a biopsy was performed to ensure the patient did not have a primary eyelid malignancy such as sebaceous cell carcinoma given her immunocompromised state. Histopathology revealed metastatic breast adenocarcinoma. Conclusions: To the authors’ best knowledge, metastatic breast carcinoma presenting as eyelid margin thickening without ulceration has not previously been reported. Eyelid metastasis is rare, and this patient’s clinical presentation was found to be unusual as well. It is important to establish metastatic disease even in a small focus such as the eyelid, as it may alter disease management.

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Metastatic Breast Carcinoma Mimicking Urothelial Carcinoma

International Journal of Surgical Pathology ◽

10.1177/10668969211067923 ◽

2021 ◽

pp. 106689692110679

Author(s):

Abdallah TM Shbair ◽

Ayse Irem Yasin ◽

Atakan Topçu ◽

Ganime Coban ◽

Gokce Deniz Uzunoglu ◽

...

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Urothelial Carcinoma ◽

Renal Pelvis ◽

Metastatic Breast ◽

Mass Lesion ◽

Renal Metastasis ◽

Metastatic Breast Carcinoma

Besides being the most frequently diagnosed cancer in women, breast cancer is the main cause of cancer-related deaths in this group of patients. Breast cancer frequently metastasizes to bone, lung, brain, and liver. Renal metastasis from the breast is extremely rare. Here we aimed to report a case of breast cancer with metastasis to bone and left renal pelvis. A 58-year old woman with a mass lesion in the left renal pelvis that mimicked urothelial carcinoma was referred to our clinic. The left nephroureterectomy procedure was performed, and the pathology revealed that a renal pelvis metastasis secondary to breast cancer.

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