Differences of breast tumour localization and size between supine and prone breast MRI for a surgery perspective

SummaryThe plasminogen activation system is a delicately balanced assembly of enzymes which seems to have primary influence on tumour progression. The conversion of plasminogen into serine protease plasmin with fibrinolytic activity depends on the actual balance between plasminogen activators (urokinase type; u-PA and tissue type; t-PA) and their inhibitors (type 1 and 2 plasminogen activator inhibitors; PAI-1 and PAI-2). The purpose of this study was to determine the exact histological localization of all the major factors involved in plasminogen activation, and activation inhibition (plasmin system) in benign and malignant breast tumour samples. Our results show that factors of the plasmin system are present both in benign and malignant tumours. Cancer cells strongly labelled for both u-PA and t-PA, but epithelial cells of fibroadenoma samples were also stained for plasminogen activators at least as intensively as tumour cells in cancerous tissues. In fibroadenomas, all the epithelial cells were labelled for PAM. Staining became sporadic in malignant tumours, cells located at the periphery of tumour cell clusters regularly did not show reaction for PAI-1. In the benign tumour samples the perialveolar connective tissue stroma contained a lot of PAI-1 positive cells, showing characteristics of fibroblasts; but their number was strongly decreased in the stroma of malignant tumours. These findings indicate that the higher level of u-PA antigen, detected in malignant breast tumour samples by biochemical techniques, does not necessarily indicate increased u-PA production by tumour cells but it might be owing to the increased number of cells producing u-PA as well. In malignant tumours PAI-1 seems to be decreased in the frontage of malignant cell invasion; i.e. malignant cells at the host/tumour interface do not express PAI-1 in morphologically detectable quantity and in the peritumoural connective tissue the number of fibroblasts containing PAI-1 is also decreased.

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First experience with MRI-guided vacuum aspirated breast biopsy

Medical alphabet ◽

10.33667/2078-5631-2020-29-25-31 ◽

2020 ◽

pp. 25-31

Author(s):

M. L. Mazo ◽

O. E. Jacobs ◽

O. S. Puchkova ◽

M. V. Feldsherov ◽

E. V. Kondratyev

Keyword(s):

Breast Cancer ◽

Breast Augmentation ◽

Breast Biopsy ◽

Breast Mri ◽

Breast Tumors ◽

High Tech ◽

X Ray ◽

Vacuum Aspiration ◽

Mri Guided ◽

Aesthetic Breast

The rate of detection of breast cancer by MRI, while other methods of radiological diagnosis are not sufficiently informative, ranges from 5.2 to 26.3 per cent. Suspicious breast tumors of category BI-RADS 4, 5 show morphological image-guided biopsy verification, in particular MRI with contrast. Purpose. To show the possibilities and features of carrying out MRI-guided vacuum breast biopsy, including after aesthetic breast augmentation. Material and methods. A comprehensive X-ray, ultrasound and MRI examination of 54 women aged between 28 and 70 years with different breast tumors was conducted. Of these, five were detected only by breast MRI with contrast, and were morphologically verified by MRI-guided vacuum aspiration biopsy. Results. 14 of the 54 patients with breast mass were diagnosed with breast cancer and 26 were diagnosed with benign diseases. The effectiveness of comprehensive examination and low-invasive high-tech MRI-guided procedures in early refined screening for breast cancer, including after aesthetic breast augmentation, has been demonstrated. MRI-guided vacuum-assisted breast biopsy is a fast, safe and accurate diagnostic method of morphological verification of suspicious breast tumors that do not have X-ray and ultrasound.

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