scholarly journals Factors that influence ultrasound evaluation of breast tumor size

2019 ◽  
Vol 21 (2) ◽  
pp. 144 ◽  
Author(s):  
Jin Xu ◽  
Ge Ma ◽  
Mengdi Liang ◽  
Yue Wang ◽  
Hong Pan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Breast Tumor ◽  
Core Biopsy ◽  
Molecular Subtype ◽  
Histological Grade ◽  
Breast Ultrasound ◽  
Tumor Type ◽  
Her2 Breast Cancer ◽  
Ultrasound Evaluation

Aims: To determine the factors influencing ultrasound breast tumor size assessment accuracy.Material and methods: Five factors (tumor type, molecular subtype, histological size, histological grade, and breast density) were used to assess the measurement accuracy of breast ultrasound in tumor size. Size underestimation was defined as ultrasound index lesion diameter < histological size by at least 5 mm.Results: Breast ultrasound underestimated tumor size significantly, especially in cases with intraductal components (p=0.002). There was a tendency for higher size underestimation in breast cancer tumors with high–histological grade (p=0.03), human epidermal growth factor receptor type 2 (HER2)-overexpressing breast cancer tumors (p=0.02) and hormone receptor (HR)−/HER2+ breast cancer tumors (p=0.008). Furthermore, core biopsy revealedhigher probability of size underestimation with intraductal components (p=0.002). Size underestimation was more frequent with larger histological size (p<0.001). Masses in non-dense breasts were significantly underestimated (p=0.036) compared to dense breasts.Conclusions: The size underestimation was influenced by pathological type, molecular subtype, and histological size. The pathological results of core biopsy were conducive for predicting tumor size pre-surgery in precise breast cancer diagnosis.

scholarly journals Study characteristics affecting the responses to neoadjuvant chemotherapy and the prognosis of patients with bilateral breast cancer: A retrospective analysis

2019 ◽  
Author(s):  
Zhenrong Tang ◽  
Yihua Wang ◽  
Luo Yang ◽  
Ling Chen ◽  
Yingzi Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Tumor Size ◽  
Breast Tumor ◽  
Molecular Subtype ◽  
Clinical Stage ◽  
Axillary Lymph ◽  
Tumor Type ◽  
Survival Times ◽  
The Right

Abstract BackgroundBilateral breast cancer (BBC) is defined as breast cancer diagnosed in both breasts in the same patient. Neoadjuvant chemotherapy (NAC) is a well-established approach to evaluate the tumor response to chemotherapeutic agents. The consensus is that different responses in characteristics after NAC can affect prognosis in unilateral breast cancer (UBC), but little is known about the responses of the BBC to NAC. This analysis explored the characteristics that can affect the prognosis of patients with BBC.MethodsThe characteristics of patients diagnosed with BBC (n = 126) was collected and the immunohistochemistry staining was used to detect expression levels of estrogen receptor (ER), progesterone receptor (PR), Ki67, and HER2. A statistical analysis of the differences was performed to identify the factors that affect survival times in all patients with BBC.ResultsA logistic regression indicated that the status of sentinel and axillary lymph node, expression of PR of the right breast tumor, and molecular subtype of the right breast tumor might relate to survival times. Tumor size, status of axillary lymph node, clinical stage, tumor type, histological grade, and molecular subtype of the left breast tumor might have a more profound effect on the survival time than the right breast tumor in the synchronous breast cancer (SBBC) patients. A multivariate analysis of overall survival times in patients with metachronous breast cancer (MBBC) showed that age was the only factor affecting survival time. After NAC treatment in SBBC patients, the Kaplan-Meier survival estimate showed that a decrease in tumor size, clinical stage, Ki67 and P53 levels were positive for a prolonged life span. However, a decrease in ER, PR, and HER2 were negative for prolonged life span. Changes in tumor type and molecular subtype also influenced the survival time.ConclusionCharacteristic changes in the left breast tumor were significant factors affecting survival times in patients with SBBC. After NAC treatment, changes in tumor size, Ki67, P53, ER, PR, and HER2 might affect the prognosis of patients with SBBC. For MBBC, only age was a factor affecting survival time. These findings provide clinical insight for the treatment of patients with BBC.

Microcalcification-associated breast cancer: HER2-enriched molecular subtype is associated with mammographic features

2018 ◽  
pp. 20170942 ◽  
Author(s):  
Zhong Nie ◽  
Jian Wang ◽  
Xiao-chun Ji
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Breast Tumor ◽  
Molecular Subtype ◽  
Univariate Analysis ◽  
Breast Cancers ◽  
Tumor Mass ◽  
Tumor Phenotype ◽  
Mass Lesions ◽  
Small Tumor Size

Purpose: To investigate whether the mammographic features were different between breast cancer HER2-enriched molecular subtype and non-HER2-enriched molecular subtype. Methods: 283 microcalcification-associated breast cancers were identified (HER2-enriched: n = 57; non-HER2-enriched: n = 226). Mammographic tumor mass and calcification features in relation to HER2 molecular subtype were analyzed. Results: On univariate analysis, HER2-enriched molecular subtype rates were significantly higher (a) in tumor size <= 2 cm 33 of 57 [57.9%]) than in tumor size >2 cm lesions (22 of 226 [9.7%]) (p = 0.007), (b) in non-spiculated mass 39 of 57 [68.4%]) than in spiculated mass lesions (18 of 226 [7.9%]) (p = 0.034)，(c) in calcifications extent >2 cm (41of 57 [71.9%]) lesions than in calcifications extent <= 2 cm lesions (16 of 226 [7.1%]) (p < 0.001)and (d) in calcification density ＞20/cm2 (44 of 57 [71.2%]) lesions than in calcification density <= 20/cm2 lesions (13 of 226 [5.8%]) (p = 0.034).On multivariate analysis, three mammographic features (tumor size >2 cm vs size⩽2 cm OR: 0.415 95% CI: 0.215 to 0.802, p = 0.009, spiculated mass vs non-spiculated mass OR: 0.226 95% CI: 0.114 to 0.446, p < 0.001 and calcifications extent >2 cm vs calcifications extent <= 2 cm OR: 7.754, 95% CI: 3.100 to 19.339P < 0.001) were independent predictors. Our results indicated that small tumor size, non-spiculated mass and calcification extent >2 cm are more likely to be HER2 molecular subtype. The discrimination of this model, as quantified by the AUC, was 0.751 (95%CI: 0.701 to 0.854). Conclusion: Our study presents a prediction model that incorporates the mammographic features of tumor size, non-spiculated mass and calcification extent, which can potentially be used to preoperative predict breast cancer HER2-enriched subtype. Advancesinknowledge: Mammographic features can noninvasively visualize breast tumor phenotype characteristics.

scholarly journals Luminal Versus Non-luminal Breast Cancer CDH1 Immunohistochemical Expression

2019 ◽  
Vol 70 (2) ◽  
pp. 465-469 ◽  
Author(s):  
Dana Carmen Zaha ◽  
Claudia Maria Jurca ◽  
Simona Bungau ◽  
Gabriela Cioca ◽  
Amorin Popa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Molecular Subtype ◽  
Histological Grade ◽  
Prognostic Index ◽  
Luminal Breast Cancer ◽  
Breast Cancer Patients ◽  
Immunohistochemical Expression ◽  
Luminal A ◽  
E Cadherin

We investigated the immunohistochemical expression of E-cadherin (product of CDH1 gene) and its correlation with clinical-pathological parameters and survival rate in the molecular groups of breast cancer. Our study included female breast cancer patients diagnosed at the Municipal Emergency Clinical Hospital Timisoara followed up five years since diagnosis using formalin fixed paraffin embedded tissue. The traditional prognostic factors (age, tumor size, histological type, histological grade, anatomical status of the lymph nodes) were abstracted from histopathology reports and we set prognostic index (the Nothingham and lymph-node prognosis index). Molecular classification on selected cases was performed in agreement with data from the literature: luminal A, B, HER2+, triple-negative. We noted positive (membranar) expressions in 43 cases (70.49 %). Negative immunoreactions for E-cadherin have been observed in all cases of lobular carcinomas (4 cases), as well as 6 cases of mixed carcinomas. A significant correlation was found between E-cadherin expression and hormonal status, tumor size, histologic type, tumor grade and molecular subtype. Most of the luminal A and B tumors were E-cadherin positive, while more than half of non-luminal tumors were E-cadherin negative. Survival rates are different in the negative and positive E-cadherin tumor groups respectively and between luminal and non-luminal groups. E-cadherin expression may be a useful prognostic marker for classifying other subgroups of breast cancer.

scholarly journals BREAST TUMOR

2018 ◽  
Vol 25 (10) ◽  
pp. 1510-1517
Author(s):  
Rakhshanda Jabbar ◽  
Bushra Riaz ◽  
Fatima Imran
Keyword(s):  
Breast Cancer ◽  
Correlation Coefficient ◽  
Tumor Size ◽  
Gold Standard ◽  
Breast Tumor ◽  
Preoperative Assessment ◽  
Breast Ultrasound ◽  
Radiology Department ◽  
Inclusion Criteria ◽  
Appropriate Treatment

Accurate preoperative assessment of tumor size in breast cancer is important forchoosing appropriate treatment. Mammography & sonography both have been used to predicttumor size but there have been conflicting reports about their accuracy. Some studies havementioned ultrasound to be more accurate than mammography in the preoperative assessmentof breast tumor size. Objectives: The objective of the study was to determine the correlation ofmammography and ultrasound in the preoperative assessment of breast tumor size in patientswith breast cancer taking pathological tumor size as gold standard. Study Design: It was across-sectional survey. Setting: Radiology department SKMCH & RC Lahore. Period: Studywas completed over a period of 6 months from Nov 09, 2008 to May 08, 2009. Subjects andMethods: Eighty cases fulfilling the inclusion criteria were selected. After informed consent,bilateral mammography and breast ultrasound were done in all the patients. Pathologicalmeasurements were done after surgery in the longest diameter of the specimen. Mammographicand ultrasonographic measurements were correlated with pathological measurementsusing Pearson’s correlation coefficient. Results: Ultrasonographic measurements correlatedmore accurately with the pathological measurements as compared to mammographicmeasurements. Correlation coefficient “r” was 0.944 for ultrasound measurements versus 0.898for mammographic measurements. Correlation was higher for lesions of 20 mm or less in therelargest diameter than for larger tumors. Conclusion: Ultasonography is a more accurate toolfor preoperative assessment of breast tumor size especially for small sized tumors of less than20 mm.

ROLE OF SONOMAMMOGRAPHY IN MONITORING THE RESPONSE OF NEOADJUVANT CHEMOTHERAPY IN MALIGNANT BREAST MASSES

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sherine George Moftah ◽  
Essam Mohamed Hafez ◽  
Walid Dahy Zidan
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Size ◽  
Locally Advanced ◽  
Residual Tumor ◽  
High Accuracy ◽  
Breast Ultrasound ◽  
Radiology Department ◽  
Duration Of Symptoms ◽  
Progressive Course

Abstract Background Breast cancer is a leading cause of death and disability between women, particularly young women, in low- and average -income countries (Porter, 2018). Neoadjuvant chemotherapy (NAC) is increasingly used in management patients with locally advanced breast cancer (LABC) (Mougalian et al., 2015). Mammography and breast ultrasound are the most widest diagnostic techniques used to evaluate primary tumor size and character at the time of diagnosis and monitoring the response to NAC (Kald et al., 2015). Aim of the work The purpose of this study is to assess and evaluate the role and the accuracy of Mammography and breast ultrasound modalities in monitoring the response of the breast cancer to the neoadjuvant chemotherapy. Patients and methods Twenty three patients presenting with pathologically proven malignant mass and conducted for neoadjuvant chemotherapy with age above 40 years-old. They were referred to the radiology department (mammography unit, Ultrasound unit and MRI unit) at El Salam oncology center, during the period between December 2018 to June 2019. Once a patient satisfied the inclusion and exclusion criteria for this study, an elaborate history was taken from all the patients which was followed by a thorough clinical evaluation, in which duration of symptoms, affected side, affected breast and family history. Patients were subjected to evaluation before starting neoadjunant chemotherapy by mammography, ultrasound and MRI as well as after finishing the neoadjuvant cycles which usually was ranging 3-4 cycles. Results Total of 23 patients with breast cancer were enrolled in this study. The patients were in the age group of 41-70 years with mean age of 54 years. Majority of patients had infiltrative ductal carcinoma IDC (16 cases -69.56% and the rest of cases were infiltrative lobular carcinoma (9 cases -39.13 %). After monitoring the response of the cases to neoadjuvant chemotherapy the results showed significant regressive course to the majority of cases ( 17 cases ) (73.91%) with the rest non respondent cases divided to cases with stationary ( 3 cases ) (13.04% ) and cases with progressive course ( 3 cases ) (13.04% ). The comparison between the results of Sonomammographic assessment of the breast lesions before and after the neoadjuvant chemotherapy cycles and also to MRI show close results. There were 5 cases that showed non-respondent (including stationary course and progressive course) in both Sonomammography and MRI and only one case that was respondent according to Sonomammography and non-respondent according to MRI breast (false +e). On the other hand there were 16 cases that had showed respondent fashion in both Sonomammography and MRI. Also there was one case that had showed non-respondent course according to Sonomammography and was respondent according to MRI results (false –ve). Sonomammography sensitivity was 94.12 % and specificity was 83.33% compared to MRI results, with high accuracy value reaching to 91.30 %. Conclusion The ability of mammography and breast ultrasound to accurately measure residual tumor size following neoadjuvant chemotherapy compared to Breast MRI measurement of the residual tumor demonstrated sensitivity of 94.12 % and specificity of 83.33% with high accuracy value reaching to 91.30 %. Even that the MRI is proved to be of high accuracy in detecting residual tumor, sonomammographic imaging isa cost-effective imaging modality than the MRI with sensitivity and specificity near to that of MRI.

scholarly journals MAGI1, a New Potential Tumor Suppressor Gene in Estrogen Receptor Positive Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 223 ◽  
Author(s):  
Begoña Alday-Parejo ◽  
François Richard ◽  
Janine Wörthmüller ◽  
Tilman Rau ◽  
José A. Galván ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Tumor Suppressor ◽  
Histological Grade ◽  
Adaptor Protein ◽  
Suppressor Gene ◽  
Her2 Breast Cancer ◽  
Epithelial Junctions ◽  
Tumor Suppressive Function ◽  
Potential Tumor Suppressor

Membrane-associated guanylate kinase (MAGUK) with inverted domain structure-1 (MAGI1) is an intracellular adaptor protein that stabilizes epithelial junctions consistent with a tumor suppressive function in several cancers of epithelial origin. Here we report, based on experimental results and human breast cancer (BC) patients’ gene expression data, that MAGI1 is highly expressed and acts as tumor suppressor in estrogen receptor (ER)+/HER2− but not in HER2+ or triple negative breast cancer (TNBC). Within the ER+/HER2− subset, high MAGI1 expression associates with ESR1 and luminal genes GATA3 and FOXA1 expression and better prognosis, while low MAGI1 levels correlates with higher histological grade, more aggressive phenotype and worse prognosis. Experimentally, MAGI1 downregulation in the ER+ human BC cells MCF7 impairs ER expression and signaling, promotes cell proliferation, and reduces apoptosis and epithelial differentiation. MAGI1 downregulation in the ER+ murine BC cell line 67NR accelerates primary tumor growth and enhances experimental lung metastasis formation. MAGI1 expression is upregulated by estrogen/ER, downregulated by prostaglandin E2/COX-2axis, and negatively correlates with inflammation in ER+/HER2− BC patients. Taken together, we show that MAGI1 is a new potential tumor suppressor in ER+/HER2− breast cancer with possible prognostic value for the identification of patients at high-risk of relapse within this subset.

Characteristics of medullary breast carcinoma compared with invasive ductal carcinoma.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 20-20
Author(s):  
Inhye Park ◽  
Jiyoung Kim ◽  
Se-Kyung Lee ◽  
Min-Young Choi ◽  
Su Yeon Bae ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Invasive Ductal Carcinoma ◽  
Tumor Size ◽  
Ductal Carcinoma ◽  
Histological Grade ◽  
Clinicopathologic Features ◽  
Node Metastasis

20 Background: Medullary carcinoma (MC) represents a rare breast cancer subtype associated with a rather favorable prognosis compared with invasive ductal carcinoma (IDC). It is characterized by the high-grade structure and lymphocytic infiltration, hemorrhagic necrosis. The purpose of this study is to compare the clinicopathologic characteristics and outcome of MC to IDC. Methods: We retrospectively reviewed the medical records of patients with invasive breast cancer managed with operation at Samsung Medical Center in Korea from January 1995 to June 2010 except patients diagnosed with ductal carcinoma in situ, patients with distant metastasis at diagnosis or neoadjuvant chemotherapy. 52 cases were identified with MC; 5,716 patients with IDC. The clinicopathologic features, disease-free survival (DFS) and overall survival (OS) for patients with MC were compared with those of the IDC patients. Results: The medullary group presented at younger age (43.9 ± 8.8 vs 47.7 ± 9.9, p=0.006). Also the medullary group was significantly associated with higher histological grade (poor; 80.0 vs 38.3%, p=0.003) and nuclear grade (grade3; 82.8 vs 41.7%, p<0.001) as well as negative ER (84.8 vs 31.0%, p<0.001) and PR status (91.3 vs 38.8%, p<0.001) regarded as poor prognostic factors. But lymphatic invasion was rare (0.0 vs 29.8%, p<0.001) and N stage was low (N0; 86.5 vs 58.4%, p<0.001). The DFS and OS were not significantly different between the medullary and IDC groups. (5-yr DFS : 88.0 vs 89.2 %, p=0.917, 5-yr OS : 94.4 vs 93.4%, p=0.502) In multivariable analysis, factors associated with DFS and OS included nuclear grade, histological grade, tumor size, lymph node metastasis, ER/PR/C-erbB2 status, chemotherapy and hormone therapy. When adjusting for other factors, histological type itself did not show significant difference from IDC in DFS and OS. Conclusions: Despite MC present specific clinicopathologic features, prognosis is not different from IDC and determined by already known prognostic factors such as tumor size, lymph node metastasis. Therefore, the patients with MC also need aggressive treatment like IDC.

Clinical and pathologic characteristics of patients with breast cancer and a second non-breast primary tumor.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11539-e11539
Author(s):  
Gul Atalay Basaran ◽  
Aziz Yazar ◽  
Cihan Uras ◽  
Evrim Tezcanli ◽  
Devrim Cabuk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Primary Tumor ◽  
Breast Tumor ◽  
Cancer Metastasis ◽  
Histological Grade ◽  
Breast Tumors ◽  
Second Primary ◽  
Primary Tumors ◽  
Second Primary Tumors

e11539 Background: We aimed to investigate the clinical and pathologic characteristics of patients with breast cancer (BC) who had a non-breast primary tumor and treated in our hospital. Methods: We identified BC patients with a second non-breast primary tumor retrospectively in our database. The tumors arising in a sequence by less than 2 months are accepted as synchronous malignancies. We noted clinical and pathological characteristics of breast tumors and analyzed the relapse patterns, the frequency and type of second non-breast primary tumors. Results: A total of 48 patients were identified. Median age was 59 years old. Thirty-four patients were postmenopausal, 41 tumors were IDC, 2 were DCIS only, eight were multiffocal. Two patients had metastatic BC at the time of diagnosis. Ninety-three (n: 26) % patients had breast conserving surgery, 2 had bilateral BC. Twenty-eight patients had node negative disease, 12 had node positive disease and 2 had micrometatatic nodal involvement. Fifty-four % were T1, 31% were T2 tumors. Histological grade was 3 for 14, 2 for 15 and 1 for 7 breast tumors. Forty patients had ER positive disease, 4 had ER/ PR negative disease, 2 tumors were triple negative and 6 tumors were Her-2 positive. Among non-breast second primary tumors; 29 arose after, 11 arose before the diagnosis of BC and 8 arose synchronously with BC. The most common non-breast second primary tumors were as follows: 15% lung cancer, 20% colorectal cancers, 13% ovarian cancer, 10% thyroid cancer, and 8% lymphoma/leukemia. With a median follow up of 76 months, there were 6 relapses; 4 of them were BC relapses. Among these 4 BC relapses, 3 patients had brain metastases and one patient had bone metastasis. There were 4 deaths; 2 were due to BC metastases, one was due to rectal cancer metastasis and the other was due to relapse of sarcoma. Conclusions: Most breast tumors were at early stage and were hormone sensitive. The most common second non-breast primary tumors arising after diagnosis of BC were colorectal, thyroid and lung cancers. The most common second non-breast tumor arising synchronously with BC was lung cancer and the most common second non-breast tumor arising before diagnosis of BC was lymphoma/leukemia.

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