scholarly journals Unusual Occurrence of Rare Lipid-Rich Carcinoma and Conventional Invasive Ductal Carcinoma in the One Breast: Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Katarina Machalekova ◽  
Karol Kajo ◽  
Marian Bencat
Keyword(s):  
Lymph Nodes ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Frozen Section ◽  
Histological Grade ◽  
Resection Margins ◽  
Axillary Lymph Nodes ◽  
Positive Staining ◽  
Axillary Lymph ◽  
Palpable Mass

A 56-year-old woman noticed a palpable mass in her left breast during self-examination. Patient was admitted to our hospital and malignant bifocal tumour was diagnosed by ultrasonography, digital mammography, magnetic resonance, and core-cut biopsy. The patient underwent planned conservative surgery (biquadrantectomy) with a sentinel node examination, but after results of the frozen section with positive resection margins and positive sentinel lymph nodes subsequent mastectomy with axillary lymph node dissection were realized. Histology in the resection specimen revealed two isolated and distinct tumours. One of the lesions represented conventional invasive ductal carcinoma of histological grade 3, and the second tumour was evaluated as invasive lipid-rich carcinoma, containing tumour cells with clear and foamy cytoplasm. Lipids in neoplastic cells were detected by Oil Red O staining and ultrastructural examination. Immunohistochemical analysis of both carcinomas was almost identical with negative steroid receptors, positive staining of HER-2, and p53 and with high proliferation activity (Ki-67). Mastectomy specimen contained residual foci of invasive ductal carcinoma and dissected axillary lymph nodes were free of metastasis. Patient underwent first cycles of chemotherapy with paclitaxel and Herceptin together with local radiotherapy and two month after surgery is without any evidence of the disease.

scholarly journals Synchronous Invasive Breast Carcinoma, Endometrial Cancer and Small Lymphocytic Lymphoma in a 49 Year-old Female Libyan Patient: Case Report and Literature Review

2021 ◽  
pp. 35-39
Author(s):  
Ali Shagan ◽  
Essra Obaid ◽  
Fatma Emaetig ◽  
Youssef Swaisi ◽  
Yassen Topov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endometrial Cancer ◽  
Lymph Nodes ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Resection Margins ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Small Lymphocytic Lymphoma ◽  
Second Cancers

Although breast cancer and endometrial cancer are two frequent female cancers, finding synchronous primary cancers in the same patient is a comparatively uncommon occurrence. We present the case of a Libyan woman who developed synchronous breast cancer, endometrial cancer, and small lymphocytic lymphoma. For the previous six months, a 49-year-old female patient had a right breast mass. An ultrasound scan revealed an uneven doubtful growth in the right breast as well as swollen of the axillary lymph nodes. After a wide local excision, histopathology revealed that the patient had invasive ductal carcinoma of the breast with a positive resection margin, and he was admitted to the Surgery Department. No distal metastasis was seen on a computed tomography (CT) scan of the chest, abdomen, or pelvis, so the patient had a right mastectomy and axillary clearance. Residual invasive ductal carcinoma was found on histopathology and immunohistochemistry with positivity for the estrogen receptor and the progesterone receptor. Small lymphocytic lymphoma (SLL) affected the axillary lymph nodes, affirmed by immunohistochemical staining positive for CD20, CD5, CD23 and BCL-2 while negative for CD3 and Cyclin D1. Resection margins were free. Second cancers are characterized by being linked to SCL, and some researchers have described that the risk of second cancers is elevated in SCL patients. We represent a combined case of synchronous primary SCL with breast cancer and endometrial cancer in a woman which is a rare occurrence.

Invasive Mammary Carcinoma With Paneth Cell–Like Eosinophilic Cytoplasmic Granules: Is It an Entity?

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
Sakshi Sakshi ◽  
Yuri Persidsky ◽  
Kathleen Reilly ◽  
Suad Taraif
Keyword(s):  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Case Reports ◽  
Paneth Cell ◽  
Case Series ◽  
Surgical Excision ◽  
Resection Margins ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Cytoplasmic Granules

Abstract Breast carcinomas with Paneth cell–like eosinophilic cytoplasmic granules are rare and commonly reported in association with acinic cell carcinoma or microglandular adenosis. Paneth cell–like differentiation has been described outside the GI tract, including lung, liver, pancreas, lacrimal glands, and prostate. Very little is known about the significance of these granules and whether they represent a metaplastic or possibly a therapy-related change. There are only 45 reported cases involving the breast, mostly individual case reports or 2 to 3 case series. Although the clinical experience is limited, most of the reported cases seem clinically indolent. Here we present a 74-year-old female with a mammographically detected 1.1-cm left breast retroareolar mass for which she underwent a biopsy and subsequent lumpectomy with axillary dissection. Histology revealed an invasive ductal carcinoma, with Paneth cell–like eosinophilic PAS-positive cytoplasmic granules in the background of extensive ductal carcinoma in situ (DCIS). Similar granules were seen in some ducts involved by DCIS. Invasive carcinoma and DCIS were present throughout the 5.5-cm lumpectomy beyond the grossly measured 4.0-cm mass. There was extensive lymphovascular invasion and tumor was present at all the surgical resection margins. Twelve of the 13 axillary lymph nodes had macrometastases. The tumor was ER and PR positive and HER2 negative. Clinically, there were extensive bony metastases involving the skull, spine, sternum, iliac bones, and femur. There were also multiple lung nodules and mediastinal lymph nodes that were positive for metastasis on biopsy. The patient is still undergoing chemotherapy and radiotherapy 6 months following surgical excision. Our case demonstrates the heterogeneity of this entity as the clinical course in our patient has been very aggressive. A collaborative effort must be established to compile a larger case series to better our understanding of this increasingly reported histological observation and whether it represents a distinct entity.

Sclerosing Adenosis in Sentinel Axillary Lymph Nodes From a Patient With Invasive Ductal Carcinoma: An Unusual Variant of Benign Glandular Inclusions

2008 ◽  
Vol 132 (9) ◽  
pp. 1439-1441 ◽  
Author(s):  
Ying-bei Chen ◽  
John Magpayo ◽  
Paul Peter Rosen
Keyword(s):  
Lymph Nodes ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Correct Diagnosis ◽  
Metastatic Carcinoma ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Unusual Variant ◽  
Immunohistochemical Studies ◽  
Sclerosing Adenosis

Abstract Benign glandular inclusions in axillary lymph nodes are very rare events that have to be distinguished from metastatic carcinoma. We report an exceptional instance in which a patient with invasive ductal carcinoma had benign glandular inclusions in the form of sclerosing adenosis in 2 sentinel lymph nodes. The lymph nodes did not contain metastatic carcinoma. Immunohistochemical studies facilitated the correct diagnosis.

scholarly journals Intra-mammary lymph nodes, an overlooked breast cancer prognostic tool?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tarek Hashem ◽  
Ahmed Abdelmoez ◽  
Ahmed Mohamed Rozeka ◽  
Hazem Abdelazeem
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Percutaneous Biopsy ◽  
Preoperative Imaging ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Pathological Features ◽  
Breast Cancer Patients ◽  
Surgical Data

Abstract Background Due to the high variability of incidence and prevalence of intra-mammary lymph nodes (IMLNs), they might be overlooked during clinical and radiological examinations. Properly characterizing pathological IMLNs and detecting the factors that might influence their prevalence in different stages of breast cancer might aid in proper therapeutic decision-making and could be of possible prognostic value. Methods Medical records were reviewed for all breast cancer patients treated at the National Cancer Institute of Cairo University between 2013 and 2019. Radiological, pathological, and surgical data were studied. Results Intra-mammary lymph nodes were described in the final pathology reports of 100 patients. Five cases had benign breast lesion. Three cases had phyllodes tumors and two cases had ductal carcinoma in situ (DCIS). All ten cases were excluded. The remaining 90 cases all had invasive breast cancer and were divided into two groups: one group for patients with malignant IMLNs (48) and another for patients with benign IMLNs (42). Pathological features of the malignant IMLN group included larger mean tumor size in pathology (4.7 cm), larger mean size of the IMLN in pathology (1.7 cm), higher incidence of lympho-vascular invasion (65.9%), and higher rate of extracapsular extension in axillary lymph nodes (57.4%). In addition, the pathological N stage was significantly higher in the malignant IMLN group. Conclusion Clinicians frequently overlook intra-mammary lymph nodes. More effort should be performed to detect them during preoperative imaging and during pathological processing of specimens. A suspicious IMLN should undergo a percutaneous biopsy. Malignant IMLNs are associated with advanced pathological features and should be removed during surgery.

Minimal Sentinel Node Procedure for Staging Early Breast Cancer

2002 ◽  
Vol 88 (3) ◽  
pp. S45-S47 ◽  
Author(s):  
S Mariotti ◽  
O Buonomo ◽  
F Guadagni ◽  
A Spila ◽  
S Schiaroli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Regional Anesthesia ◽  
Early Breast Cancer ◽  
Frozen Section ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Sentinel Node Procedure ◽  
Time Saving ◽  
Identification Rate

Aims and Background Sentinel lymph node dissection (SLND) has recently been evaluated as a new staging technique for early breast cancer. To minimize the extent of surgery, the feasibility of eradicating primary breast lesions and the relative sentinel lymph nodes (SLN) under regional anesthesia was evaluated in this study. Methods and Study Design A selected population of 76 patients with suspected operable breast cancer and no clinically palpable lymph nodes was enrolled in the study. Intra- and perilesional administration of a radiotracer was performed. Lymphoscintigraphy was carried out to confirm the drainage pathway and locate the SLN. The following day, after inducing a nervous block induction of the ipsilateral intercostal nerves, we performed the surgical procedure with the help of a hand-held gamma-detecting probe. In case the primary lesion was diagnosed as invasive carcinoma by frozen section, the SLN and the remaining axillary lymph nodes (non-SLNs) were removed. The status of SLN and non-SLNs was compared. Results The primary breast lesion was located and excised in all cases (identification rate: 100%). Lymphoscintigraphy positively identified SLNs in 40/45 (89%) patients; in five patients no lymphatic drainage was detected. In 38 cases an average of 1.5 SLNs and 14 non-SLNs per patient were removed and pathologically analyzed; the remaining two patients showed SLNs in the internal mammary chain, which were not excised. Twenty-nine percent of the patients showed metastatic disease in the lymph nodes examined. Of all patients with affected nodes, 55% had cancer cells only in the SLN. No false negatives (skip metastases) were found. No immediate or long-term anesthesia-related complications (eg pleural lesions, intravascular injection) were observed. Conclusions Our data confirm the feasibility of single radiotracer administration for both occult lesion and SLN localization as well as the usefulness of SLND in staging early breast cancer. Regional anesthesia resulted in easy management and good patient compliance. This time-saving procedure allowed the completion of the whole surgical plan, reducing the recovery time without modifying the effectiveness of surgery.

Breast Reconstruction With Postmastectomy Radiation: Choices and Tradeoffs

2017 ◽  
Vol 35 (22) ◽  
pp. 2467-2470 ◽  
Author(s):  
Matthew M. Poppe ◽  
Jayant P. Agarwal
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Treatment Plan ◽  
Multidisciplinary Treatment ◽  
Muscle Flap ◽  
Axillary Node ◽  
Axillary Lymph Nodes ◽  
Autologous Reconstruction ◽  
Axillary Lymph

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 45-year-old premenopausal woman presented with multifocal cancer in the right breast, with lesions at 1:00 and 4:00, the largest measuring approximately 3 cm on exam, and multiple palpable right axillary lymph nodes. A core biopsy confirmed invasive ductal carcinoma, grade 2 of 3, that was estrogen receptor positive, progesterone receptor positive, and HER2 negative. Fine needle aspiration of a right axillary node confirmed metastatic carcinoma. A positron emission tomography (PET)/ computed tomography done before starting chemotherapy demonstrated an absence of metastatic disease with expected avidity in two separate breast masses and multiple conglomerated 1-2 cm level I and II axillary lymph nodes. She received neoadjuvant chemotherapy with doxorubicin plus cyclophosphamide, followed by paclitaxel, and had a complete clinical response with resolution of the breast and axillary masses on exam. A repeat PET/computed tomography demonstrated reduced size of the breast and axillary disease, and no significant residual PET avidity. Her breast surgeon recommended a right mastectomy with axillary node dissection. As part of her multidisciplinary treatment plan, she consulted with two plastic surgeons to discuss reconstruction options. Plastic Surgeon A advised placement of an implant at the time of mastectomy while Surgeon B contrasted the pros and cons of an autologous transverse rectus abdominis muscle flap reconstruction with an implant based reconstruction. Surgeon B believed that autologous reconstruction would yield the best long-term cosmetic outcome. Before making her surgery decision, the patient consulted with a radiation oncologist to discuss the effect radiation may have on her reconstruction outcome.

Epithelium Involving Bilateral Axillary Lymph Nodes: Metastasis, Misplaced, or Mullerian!

2020 ◽  
pp. 106689692095812
Author(s):  
Kamaljeet Singh ◽  
Ruhani Sardana ◽  
M. Ruhul Quddus ◽  
Malini Harigopal
Keyword(s):  
Lymph Nodes ◽  
Frozen Section ◽  
Cancer Staging ◽  
Histological Evaluation ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Staging ◽  
Frozen Section Examination ◽  
First Case

During breast cancer staging, histological evaluation of axillary sentinel lymph nodes (SLN) is usually straightforward. However, the exact characterization of a small epithelial deposit in an SLN can be challenging, especially during the frozen section examination. We report the first case of endosalpingiosis involving bilateral axillary lymph nodes. We review published literature on axillary endosalpingiosis and discuss the differential diagnosis of small epithelial deposits in an axillary SLN. Pathologists should consider benign epithelial rests and displaced epithelium as differential diagnoses for the microscopic epithelial nodal deposit, especially during the frozen section examination.

scholarly journals Male Triple Negative Axillary Accessory Breast Cancer, a Case Report

2021 ◽  
Author(s):  
Chao li ◽  
Biao Qian
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ki 67 ◽  
Breast Invasive Ductal Carcinoma ◽  
Accessory Breast

Abstract Background: Breast cancer is the most common malignancy among women worldwide. In men, cases of breast cancer are few and accounts for less than 1% of all cases of breast cancer. Majority of male breast cancer is hormone receptor-positive. The incidence of male axillary accessory breast cancer derived from axillary accessory breast is very low. Here we report a case of male triple negative axillary accessory breast cancer.Case presentation: We present a case of a male triple negative axillary accessory breast cancer in a 67-year-old man that progressively increased in size through a period of 1 year. We performed right accessory breast resection and right axillary lymph nodes dissection. Postoperative pathological analysis revealed right accessory breast invasive ductal carcinoma with apocrine metaplasia. The tumor size was 3.5 * 3.3cm. In addition, 5 metastatic lymph nodes were seen in 27 axillary lymph nodes. Immunohistochemistry showed ER (-), PR (-), Ki-67 30%, HER2 (2 +), GATA-3 (+), GCDFP-15(+), and AR (+). Fish test obtained a negative result. The patient was treated with adjuvant chemotherapy and radiotherapy.Conclusion: Male triple negative axillary accessory breast cancer is rare. Treatment of male triple negative axillary accessory breast cancer is similar to that of women patients. Most patients undergo surgery and adjuvant chemotherapy.

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