scholarly journals Clinico-radio-pathological Features and Biological Behavior of Breast Cancer in Young Indian Women: A Prospective Study

Author(s):  
Rashmi Sudhir ◽  
Kamala Sannapareddy ◽  
Alekya Potlapalli ◽  
Vidhatri Penmetsa

Abstract Aims The aim of the study is to evaluate the characteristic imaging features of breast cancer on mammogram, ultrasound, and magnetic resonance imaging (MRI) in women less than 40 years of age and to assess the degree of correlation between clinico-radio-pathological features and biological behavior. Methods and Materials A prospective observational study on consecutive women under 40 years of age evaluated with ultrasound of breast, digital mammogram, or contrast-enhanced breast MRI, diagnosed with breast cancer on histopathology and molecular analysis done at our center between January and December 2019 were included. Patient demographics, clinical presentation, family history, BRCA mutation status, imaging, pathological findings, and molecular status were determined. Results Out of 2,470 women diagnosed with breast cancer, 354 (14.3%) were less than 40 years of age who were included in this study. Mammography showed positive findings in 85%, ultrasonography in 94.3%, and MRI in 96.4% of women. Majority of the women (69.6%) presented in the late stage (Stage III and IV) with high-grade carcinoma in 39.5% and triple-negative breast cancer (TNBC) in 45.7%. Tumors with human epidermal growth factor-2neu expression were associated with the presence of microcalcifications (p-value = 0.006), and TNBC with circumscribed margins or BI-RADS 3/4a category on imaging (p-value = 0.007) and high-grade invasive carcinoma compared with others (p-value <0.0001). Conclusion The incidence of breast cancer in Indian women less than 40 years of age is relatively high as compared with the West. The detection of breast cancer in young women remains challenging due to dense breast tissue, lower incidence rate, and lack of regular breast screening. While ultrasound is the recommended imaging method for evaluation of breast under the age of 40 years, we found a better characterization of lesions and higher cancer detection rates when they were also evaluated with mammography and MRI.

2021 ◽  
Author(s):  
Xinglu Zhou ◽  
Yunsong Peng ◽  
Yingci Li ◽  
Jiarui Zhang ◽  
Tianyi Liu ◽  
...  

Abstract Purpose:Positron emission tomography (PET) with integrated computed tomography (PET/CT) is a whole-body imaging method providing information the entire body. When it was used in staging breast cancer patients, quite a few patients were found to have a second primary lung cancer(PLC), which was has few distinguishing features from breast cancer metastasis(MBC). Therefore, based on CT, LDCT and PET images, combined with pathological features, we established radiomics models to distinguish between MBC and PLC.Methods:We retrospectively collected CT, LDCT, and PET images, and pathology features of 100 breast cancer patients, including 60 metastases of breast cancer(MBC) and 40 primary lung cancers(PLC). The two radiologists manually drew a region of interest around the whole visible tumor in consensus. Python 3.8 and Pyradiomics toolkit are used to extract features from CT, LDCT, and PET. The linear discriminant analysis (LDA) classifier was used to build the radiomics model. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to evaluate the classification performance.Results:Total 12, 13, and 9 features were selected from the CT, LDCT, and PET respectively. The model based on the LDCT and PET obtained the same highest AUC (0.9479). The combination with CT and pathology features showed a highest AUC of 0.9583 with a sensitivity of 1.000 and a specificity of 0.8333. Conclusion:Overall, the results are encouraging that radiomics models based on CT, LDCT and PET can differentiate between MBC and PLC pathological features could significantly improve the AUC and ACC of CT model.


2022 ◽  
Author(s):  
Mei-Lin Wang ◽  
Yu-Pin Chang ◽  
Chuan-Han Chen ◽  
Ming-Cheng Liu ◽  
Chen-Hao Wu ◽  
...  

Abstract BackgroundClustered ring enhancement (CRE) of breast MRI is a lexicon of nonmass enhancement (NME) representing tendency of breast cancer and molecular biomarkers are predictors of response to therapy. The purpose of this study was to retrospectively determine the relationship between CRE NME and prognostic molecular biomarkers in breast cancer.MethodsRetrospective analysis of 58 breast lesions in 56 female patients between July 2013 and December 2018 was performed in our institution. Cases with MRI reporting NME in the text were collected via searching the report database. The patterns of enhancement including CRE on breast MRI were reviewed by a radiologist blinded to pathology report. The pathological results and expression of molecular biomarkers were collected. Univariate analysis was applied to evaluate the association between MRI NME imaging features, pathological and IHC stain findings.Results58 Breast lesions were pathologically proven breast carcinoma, and 31 lesions with CRE and 27 lesions without CRE on breast MRI. The expression of estrogen receptor (ER) (P=0.017) and progesterone receptor (PR) (P=0.017) was significantly lower in lesions with CRE compared with those without CRE. The expression of Ki-67 (≥ 25%) was significantly higher in lesions with CRE(P=0.046). The lesions with CRE have a lower expression ratio of ER (50.71 ± 45.39% vs. 74.26 ± 33.59%, p= 0.028).ConclusionOur results indicated that lesions with CRE may possess different features from those without CRE in molecular expression. They tend to bear a more aggressive biological behavior.


2021 ◽  
Vol 11 ◽  
pp. 48
Author(s):  
Gopal R. Vijayaraghavan ◽  
Matthew Kona ◽  
Abiramy Maheswaran ◽  
Dina H. Kandil ◽  
Madhavi K. Toke ◽  
...  

Objectives: Ultrasound (US) is commonly used for diagnostic evaluation of breast lesions. The objective of this study was to investigate the association between US imaging morphology from routine radiologists’ interpretation and biological behavior such as receptor status and tumor grade determined from histopathology in invasive ductal carcinoma (IDC). Material and Methods: This retrospective study included 453 patients with pathology-verified diagnosis of IDC who had undergone US imaging and had surgery over a 5-year period. US and surgical pathology reports were reviewed and compiled. Correlation analyses and age-adjusted multivariable models were used to determine the association between US imaging morphology and receptor status, tumor grade, and germ line mutation of the breast cancer genes (BRCA1 and BRCA2). The odds ratio (OR), area under receiver operating characteristic curve (AUC), and 95% confidence intervals (CI) were obtained. Results: The likelihood for high-grade cancer increased with size (OR: 1.066; CI: 1.042–1.091) and hypo-echogenicity (OR: 2.044; CI: 1.337–3.126), and decreased with angular or spiculated margins (OR: 0.605; CI: 0.393–0.931) and posterior acoustic shadowing (OR: 0.352; CI: 0.238–0.523). These features achieved an AUC of 0.799 (CI: 0.752–0.845) for predicting high-grade tumors. The likelihood for Estrogen Receptor-positive tumors increased with posterior acoustic shadowing (OR: 3.818; CI: 2.206–6.607), angulated or spiculated margins (OR: 2.596; CI: 1.159–5.815) and decreased with US measured tumor size (OR: 0.959; CI: 0.933–0.986) and hypoechoic features (OR: 0.399; CI: 0.198– 0.801), and achieved an AUC of 0.787 (CI: 0.733–0.841). The likelihood for Progesterone Receptor-positive tumors increased with posterior acoustic shadowing (OR: 2.732; CI: 1.744–4.28) and angulated or spiculated margins (OR: 2.618; CI: 1.412–4.852), and decreased with US measured tumor size (OR: 0.961; CI: 0.937–0.985) and hypoechoic features (OR: 0.571; CI: 0.335–0.975), and achieved an AUC of 0.739 (CI: 0.689–0.790). The likelihood for Human epidermal growth factor receptor 2-positive tumors increased with heterogeneous echo texture (OR: 2.141; CI: 1.17– 3.919) and decreased with angulated or spiculated margins (OR: 0.408; CI: 0.177–0.944), and was marginally associated with hypoechoic features (OR: 2.101; CI: 0.98–4.505) and circumscribed margins (OR: 4.225; CI: 0.919–19.4). The model with the aforementioned four US morphological features and achieved an AUC of 0.686 (CI: 0.614–0.758). The likelihood for triple-negative breast cancers increased with hypo-echogenicity (OR: 2.671; CI: 1.249–5.712) and decreased with posterior acoustic shadowing (OR: 0.287; CI: 0.161–0.513), and achieved an AUC of 0.739 (CI: 0.671– 0.806). No statistical association was observed between US imaging morphology and BRCA mutation. Conclusion: In this study of over 450 IDCs, significant statistical associations between tumor grade and receptor status with US imaging morphology were observed and could serve as a surrogate imaging marker for the biological behavior of the tumor.


Author(s):  
R. G. Blanks ◽  
M. G. Wallis ◽  
R. J. Alison ◽  
R. M. Given-Wilson

Abstract Objective Randomised controlled trials have shown a reduction in breast cancer mortality from mammography screening and it is the detection of high-grade invasive cancers that is responsible for much of this effect. We determined the detection rates of invasive cancers by grade, size and type of screen and estimated relative sensitivities with emphasis on grade 3 detection. Methods This observational study analysed data from over 11 million screening episodes (67,681 invasive cancers) from the English NHS breast screening programme over seven screening years 2009/2010 to 2015/2016 for women aged 45–70. Results At prevalent (first) screens (which are unaffected by screening interval), the detection rate of small (< 15 mm) invasive cancers was 0.95 per 1000 for grade 1, but for grade 3 only 0.30 per 1000. The ratio of small (< 15 mm) to large (≥ 15 mm) cancers was 1.8:1 for grade 1 but reversed to 0.5:1 for grade 3. We estimated that the relative sensitivity for grade 3 invasive cancers was 52% of that for grade 1 and the relative sensitivity for small (< 15 mm) grade 3 only 26% of that for small (< 15 mm) grade 1 invasive cancers. Conclusions Sensitivity for small grade 3 invasive cancers is poor compared with that for grade 1 and 2 invasive cancers and larger grade 3 malignancies. This observation is likely a limitation of the current technology related to the absence of identifiable mammographic features for small high-grade cancers. Future work should focus on technologies and strategies to improve detection of these clinically most significant cancers. Key Points • The detection of small high-grade invasive cancers is vital to reduce breast cancer mortality. • We estimate the sensitivity for small grade 3 invasive cancers may be only 26% of that of small grade 1 invasive cancers. This is likely to be associated with the non-specific mammographic features for these cancers. • New technologies and appropriate strategies using current technology are required to maximise the detection of small grade 3 invasive cancers.


2009 ◽  
Vol 27 (5) ◽  
pp. 203-210 ◽  
Author(s):  
Sharawan Yadav ◽  
Naveen Kumar Singhal ◽  
Virendra Singh ◽  
Neeraj Rastogi ◽  
Pramod Kumar Srivastava ◽  
...  

Cytochrome P450 1B1 (CYP1B1) and catechol-$O$-methyltransferase (COMT) enzymes play critical roles in estrogen metabolism. Alterations in the catalytic activity of CYP1B1 and COMT enzymes have been found associated with altered breast cancer risk in postmenopausal women in many populations. The substitution of leucine (Leu) to valine (Val) at codon 432 increases the catalytic activity of CYP1B1, however, substitution of Val to methionine (Met) at codon 158 decreases the catalytic activity of COMT. The present study was performed to evaluate the associations of CYP1B1 Leu432Val and/or COMT Val158Met polymorphisms with total, premenopausal and postmenopausal breast cancer risks in Indian women. COMT and CYP1B1 polymorphisms in controls and breast cancer patients were analyzed employing polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) followed by gel electrophoresis. Although CYP1B1 and COMT genotypes did not exhibit statistically significant association with breast cancer risks when analyzed individually, COMT wild type (Val158Val) in combination with CYP1B1 heterozygous variant (Leu432Val) [OR: 0.21; 95% CI (0.05–0.82), p value; 0.021] and COMT heterozygous variant (Val158Met) in combination with CYP1B1 wild type (Leu432Leu) [OR: 0.29; 95% CI (0.08–0.96), p value; 0.042] showed significant protective association with premenopausal breast cancer risk. The results demonstrate that CYP1B1 wild type in combination with COMT heterozygous or their inverse combination offer protection against breast cancer in premenopausal Indian women.


2021 ◽  
Author(s):  
Taruna Rajagopal ◽  
Arun Seshachalam ◽  
Arunachalam Jothi ◽  
Krishna Kumar Rathnam ◽  
Srikanth Talluri ◽  
...  

Abstract The frequency of triple-negative breast cancer (TNBC) incidence varies among different populations, suggesting the involvement of genetic component towards TNBC development. Previous studies have reported that BRCA1/2 germline mutations confer a lifetime risk of developing TNBC. However, there is hardly any information regarding the common pathogenic variants (PVs) in BRCA1/2 genes that contribute to TNBC in the Indian population. Hence, we screened for PVs in BRCA1/2 and their association with clinico-pathological features in TNBC patients. Among the 59 TNBC genomic DNA samples sequenced, 8 BRCA mutations were detected in 59 TNBC patients (13.6%). Almost 50% pre-menopausal TNBC patients had a BRCA mutation. Of the 8 BRCA mutations, we observed BRCA1 mutations in 6 TNBC patients, and BRCA2 mutations in 2 TNBC patients. Among the 6 BRCA1 mutations, three were c.68_69delAG (185delAG) mutation. Remarkably, all the TNBC patients with BRCA mutations exhibited higher-grade tumors (grade 2 or 3). However, among the BRCA mutation carriers, only one patient with a BRCA2 mutation (p.Glu1879Lys) developed metastasis in the observed cohort. Our data advocates that South Indian women with higher grade TNBC tumors and without hereditary breast and ovarian cancer should be considered for BRCA mutation screening, thereby enabling enhanced decision-making and preventive therapy.


Author(s):  
Sri Burhani Putri

Breast cancer is one of the most common illness that killed woman. One of the therapy to cure breast cancer is chemotherapy. Chemotherapy has side effect either physical and psychology, that caused people who’s in chemo therapy, prone to stress. Stress effected by many factors, such as characteristic and chopping strategy that patient has been using. The aim of this research is to get a perspective about the relation of characteristic and chopping strategy with breast cancer patient stress, whose in chemo therapy. This research using cross sectional study and taking sample by using accidental sampling method. The data analyzed by using bavariat and multivariat with variable result shows that breast cancer patient stress who has chemo therapy realted to age characteristic (p value = 0.00) the time since they diagnosed with cancer (pvalue = 0.03), how long they have chemo therapy (pvalue = 0.00) and chopping strategyby looking social support (pvalue = 0.00) looking for spiritual (pvalue = 0.00) with dominan variable which related to stress is chopping strategy to looking spiritual support (coeffecients B = -1.139).   Key words : Breast cancer, chemotherapy, stress  


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