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

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.

scholarly journals Thyroid gland metastasis from breast cancer: A rare case report and literature overview

2018 ◽  
Vol 146 (7-8) ◽  
pp. 466-469 ◽  
Author(s):  
Zorka Inic ◽  
Aleksandar Martinovic ◽  
Momcilo Inic ◽  
Dijana Pilcevic ◽  
Gordana Pupic
Keyword(s):  
Breast Cancer ◽  
Thyroid Gland ◽  
Rare Case ◽  
Metastatic Breast ◽  
Breast Cancer Case ◽  
Left Breast ◽  
Cancer Case ◽  
Thyroid Lesion ◽  
Metastatic Breast Carcinoma ◽  
History Of

Introduction. The thyroid gland is a rare site for metastatic lesions from non-thyroid cancers. Due to the fact that achieving a diagnosis of thyroid gland metastasis from breast cancer prior to operation is challenging, the diagnosis thereof is mainly based on a pathological biopsy and immunohistochemical staining. The aim of this study was to present a rare case of thyroid gland metastasis from lobular breast cancer. Case outline. The patient was a 33-year-old female who had already had a five-year history of lobular cancer of the right breast and was thereafter found to have two suspicious tumors in the left breast, as well as a thyroid mass diagnosed as metastatic breast carcinoma. Conclusion. Patients who have a thyroid lesion and a history of malignancy are at a higher risk for metastasis and require additional caution during diagnosis and treatment.

scholarly journals Case Report: Metastatic breast cancer to the gallbladder

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 343
Author(s):  
Giulia Missori ◽  
Francesco Serra ◽  
Giorgia Prestigiacomo ◽  
Andrea Aurelio Ricciardolo ◽  
Lucio Brugioni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Hormone Receptors ◽  
Ductal Carcinoma ◽  
Previous History ◽  
Metastatic Breast ◽  
Left Breast ◽  
Surgical Specimen ◽  
Surgical Interventions ◽  
History Of

Cholecystitis is one of the leading causes of emergency surgical interventions; the occurrence of metastases to the gallbladder is rare and has only been reported in the literature exceptionally. Metastatic breast cancer to the gallbladder is even less frequent; in fact, breast cancer usually metastasizes to bone, lung, lymph nodes, liver and brain. We report the case of an 83-year-old female patient with a previous history of breast surgery with axillary dissection in 1997, followed by adjuvant chemotherapy due to invasive ductal carcinoma of the left breast. The patient was admitted at the emergency department for sepsis and an episode of acute kidney failure, anuria and fever. Right-upper quadrant abdominal pain triggered by food intake and abdominal tenderness was also present, placing the diagnostic suspicion of biliary sepsis due to acute cholecystitis. The histological examination of the surgical specimen highlighted the presence of metastasis from an infiltrating ductal breast carcinoma with positive hormone receptors. We also report here the results of a review of the literature looking at articles describing cases of gallbladder metastasis from breast cancer.

scholarly journals 945 Characterization of the immune landscape of malignant pleural effusion composition from patients with metastatic breast carcinoma: a pilot study

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A993-A994
Author(s):  
Caddie Dy Laberiano ◽  
Edwin Parra ◽  
Qiong Gan ◽  
Heladio Ibarguen ◽  
Shanyu Zang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Ductal Carcinoma ◽  
Cytotoxic T Cells ◽  
Metastatic Breast ◽  
Absolute Number ◽  
List Type ◽  
Clinicopathologic Features ◽  
Metastatic Breast Carcinoma ◽  
Promising Tool

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.

Vinorelbine as first-line chemotherapy for metastatic breast carcinoma.

1994 ◽  
Vol 12 (2) ◽  
pp. 336-341 ◽  
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.

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

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 .

Solitary metastatic breast carcinoma in a trigeminal nerve mimicking a trigeminal neurinoma

1996 ◽  
Vol 85 (4) ◽  
pp. 677-680 ◽  
Author(s):  
Ichiro Nakano ◽  
Koichi Iwasaki ◽  
Akinori Kondo
Keyword(s):  
Breast Cancer ◽  
Trigeminal Nerve ◽  
Unusual Case ◽  
Metastatic Breast ◽  
Metastatic Tumor ◽  
Content Type ◽  
Metastatic Breast Carcinoma ◽  
Trigeminal Neurinoma ◽  
History Of ◽  
Histopathological Studies

✓ An unusual case of a metastatic adenocarcinoma located entirely within the trigeminal nerve is reported. The patient, with a history of breast cancer, presented with a pure trigeminal mononeuropathy. The neurological and neuroradiological findings in this patient were quite similar to those of a patient with trigeminal neurinoma. Surgery revealed that the tumor was located within the trigeminal nerve and its appearance was similar to that of a neurinoma. However, histopathological studies proved the tumor to be an adenocarcinoma that was related to the breast cancer treated earlier. A solitary metastatic tumor arising solely in a trigeminal nerve is quite rare; this is the first report of such a case metastasized from breast cancer.

scholarly journals Diabetic Ketoacidosis With Alpelisib

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A376-A377
Author(s):  
Rebecca Jeun ◽  
Victor Ralph Lavis ◽  
Sonali Thosani
Keyword(s):  
Breast Cancer ◽  
Diabetes Mellitus ◽  
Metastatic Breast Cancer ◽  
Diabetic Ketoacidosis ◽  
Hormone Receptor ◽  
Previous History ◽  
Metastatic Breast ◽  
Laboratory Evaluation ◽  
Hormone Receptor Positive ◽  
History Of

Abstract Background: Hyperglycemia is a frequently reported adverse effect of alpelisib, an isoform specific phosphoinositide 3 kinase inhibitor, which is recently approved for use in hormone receptor positive advanced or metastatic breast cancer. Though two patients in clinical trials with alpelisib developed diabetic ketoacidosis (DKA), there have been no case reports to date characterizing this complication after drug approval. We present the first case of DKA in patients on alpelisib therapy. Clinical Case: A 55-year-old woman with a history of hormone-receptor positive metastatic breast cancer was started on treatment with fulvestrant and alpelisib. The patient did not have any previous history of diabetes nor gestational diabetes, though she had evidence of prediabetes prior to starting treatment. Patient was non-obese and had a family history of type 2 diabetes. Baseline hemoglobin A1c was 5.6% (n &lt;5.7%) with impaired fasting glucose of 108 mg/dl (n&lt;105 mg/dL) immediately prior to starting therapy. One week after starting alpelisib, she presented to the emergency center in diabetic ketoacidosis. Initial laboratory evaluation showed serum glucose 690 mg/dl, anion gap metabolic acidosis, with undetectable serum bicarbonate and ketonuria. C-peptide on hospital day 1 was found to be 2.8 ng/ml (n 0.5 - 3.4 ng/ml) with a concurrent glucose of 479 mg/dl. GAD65 and Islet Antigen 2 antibodies were negative. Diabetic ketoacidosis quickly resolved with continuous insulin infusion and stopping alpelisib. The patient was able to come off all insulin therapy prior to discharge and was discharged on metformin with adequate glycemic control. Conclusions: Current manufacturer guidelines for alpelisib recommend screening for diabetes mellitus at baseline and monitoring blood glucose and/or fasting plasma glucose weekly for the first two weeks of treatment and monthly thereafter. However, patients with no pre-existing history of diabetes mellitus may be at risk for life-threatening hyperglycemic crises which may develop within a week of initiation of alpelisib and more frequent monitoring may be indicated. The hyperglycemic effect of alpelisib appears to be reversible upon stopping the drug.

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

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
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.

scholarly journals Malignant adnexal cutaneous tumor of the scalp: a case report of difficult differential diagnosis between metastatic breast cancer and primary sweat gland tumor

2021 ◽  
Vol 31 (1) ◽  
pp. 177-183
Author(s):  
Marcos Alberto Martins ◽  
Cinthia Aparecida Moreira ◽  
Maria Do Carmo Guedes Alcoforado Assunção Queiroz ◽  
Walter Henrique Martins ◽  
Gerson Vilhena Pereira ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Sweat Gland ◽  
Immunohistochemical Study ◽  
Metastatic Breast ◽  
Skin Tumor ◽  
Sweat Gland Tumor ◽  
History Of ◽  
Metastatic Neoplasm ◽  
Primary Focus

The authors describe the case of a 71-year-old female patient who initially went to the dermatologist to assess a scalp skin tumor. This lesion was submitted to an incisional biopsy, performed by dermatologist herself, and the result of the anatomopathological examination and immunohistochemical study showed a preliminary diagnosis of metastasis of breast carcinoma. The patient had no history of breast cancer and, in view of this result, she was referred to consult with the mastologist, who carried out an investigation of breast nodules in search of the possible primary focus of the carcinoma, through imaging exams, biopsies and mammotomy, without finding any possible primary focus on the breasts. Finally, the lesion on the scalp was removed in its entirety by the plastic surgeon and a new exam of pathological anatomy and an immunohistochemical study confirmed the diagnosis of metastasis of breast carcinoma. In view of these results, the authors discuss the difficulty in diagnosing differentiation from primary or metastatic neoplasm of the scalp, with the resources currently available, until the conclusion that it was a primary carcinoma of the sweat gland.

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