scholarly journals Chronic Lymphocytic Leukemia Involving the Breast Parenchyma, Mimicker of Invasive Breast Cancer: Differentiation on Breast MRI

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Vandana Dialani ◽  
Kalpana Mani ◽  
Nicole B. Johnson
Keyword(s):  
Breast Cancer ◽  
Chronic Lymphocytic Leukemia ◽  
Invasive Ductal Carcinoma ◽  
Invasive Breast Cancer ◽  
Ductal Carcinoma ◽  
Breast Mri ◽  
Collision Tumor ◽  
Lymphocytic Leukemia ◽  
Imaging Features ◽  
Breast Parenchyma

Leukemic involvement of the breast is rare, particularly involvement by chronic lymphocytic leukemia (CLL). While concurrent invasive ductal carcinoma and CLL manifesting as a collision tumor in the breast is extremely rare, this association (CLL and carcinoma) has been described in other organs. We report here a case of a 58-year-old woman with concurrent invasive ductal carcinoma and CLL and describe the imaging features of CLL, particularly the differentiation on MRI.

scholarly journals Invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia manifesting as a collision breast tumor: A case report and literature review

2021 ◽  
Vol 16 (1) ◽  
pp. 867-871
Author(s):  
Xiaowen Chen ◽  
Jianli Chen ◽  
Sihai Liao ◽  
Yuwen Cao
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Invasive Ductal Carcinoma ◽  
Breast Tumor ◽  
Ductal Carcinoma ◽  
Breast Tumors ◽  
Collision Tumor ◽  
Lymphocytic Leukemia ◽  
Epstein Barr Virus Infection ◽  
Small Lymphocytic Lymphoma ◽  
Age Related

Abstract Collision breast tumors, consisting of breast cancer (BC) and non-Hodgkin’s lymphoma (NHL), are extremely rare. Here we report the case of a 64-year-old woman with a collision tumor in her left breast mass that was composed of invasive ductal carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia. In addition, we reviewed the published comparable English-language literature. Collision breast tumor composed of BC and NHL is extremely rare. For that reason, there is a lack of consensus about the underlying mechanism, and diagnosing it without delay remains a complex clinical challenge. We found that post-menopausal, age-related estrogen levels changes and Epstein-Barr virus infection are possible pathogenic factors. However, the symptoms are almost identical, and it is difficult to distinguish a simple breast tumor from a breast collision tumor. In this study, we reviewed the clinical features of all patients with BC and NHL colliding breast tumors; this information might enable early identification and prevention of misdiagnosis.

scholarly journals Efficacy of breast MRI for surgical decision in patients with breast cancer: ductal carcinoma in situ versus invasive ductal carcinoma

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jeeyeon Lee ◽  
Jin Hyang Jung ◽  
Wan Wook Kim ◽  
Chan Sub Park ◽  
Ryu Kyung Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Mri ◽  
Positive Margin ◽  
Breast Conserving Surgery ◽  
Partial Mastectomy

Abstract Background Preoperative breast magnetic resonance imaging (MRI) provides more information than mammography and ultrasonography for determining the surgical plan for patients with breast cancer. This study aimed to determine whether breast MRI is more useful for patients with ductal carcinoma in situ (DCIS) lesions than for those with invasive ductal carcinoma (IDC). Methods A total of 1113 patients with breast cancer underwent mammography, ultrasonography, and additional breast MRI before surgery. The patients were divided into 2 groups: DCIS (n = 199) and IDC (n = 914), and their clinicopathological characteristics and oncological outcomes were compared. Breast surgery was classified as follows: conventional breast-conserving surgery (Group 1), partial mastectomy with volume displacement (Group 2), partial mastectomy with volume replacement (Group 3), and total mastectomy with or without reconstruction (Group 4). The initial surgical plan (based on routine mammography and ultrasonography) and final surgical plan (after additional breast MRI) were compared between the 2 groups. The change in surgical plan was defined as group shifting between the initial and final surgical plans. Results Changes (both increasing and decreasing) in surgical plans were more common in the DCIS group than in the IDC group (P <  0.001). These changes may be attributed to the increased extent of suspicious lesions on breast MRI, detection of additional daughter nodules, multifocality or multicentricity, and suspicious findings on mammography or ultrasonography but benign findings on breast MRI. Furthermore, the positive margin incidence in frozen biopsy was not different (P = 0.138). Conclusions Preoperative breast MRI may provide more information for determining the surgical plan for patients with DCIS than for those with IDC.

Relationship of the breast ductal carcinoma in situ (DCIS) immune microenvironment with clinicopathological features: An institutional experience.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12565-e12565
Author(s):  
Lauren Eisenbud ◽  
Tsering G. Lama Tamang ◽  
Caleb Cheng ◽  
Ibe Ifegwu ◽  
Tianyi Tang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Clinical Outcomes ◽  
Invasive Ductal Carcinoma ◽  
Invasive Breast Cancer ◽  
Ductal Carcinoma ◽  
Recurrent Disease ◽  
Response To Therapy ◽  
Data Set ◽  
Risk Of Recurrence

e12565 Background: DCIS is usually treated with resection followed by 5 years of adjuvant endocrine therapy for hormone receptor (HR) + DCIS. Endocrine therapy is not used in HR- DCIS. Although DCIS is considered a precursor lesion to invasive breast cancer, the different molecular subtypes confer variable clinical outcomes. The host immune response plays a key role in breast cancer progression and response to therapy. However, relative to invasive breast cancer, the immune milieu of DCIS is less understood. This retrospective study compares the clinical outcomes and tumor microenvironment of HR+ and HR- DCIS in order to identify clinical and immunological features in HR- DCIS that may predict an increased risk of recurrence or progression to invasive breast cancer. Methods: A single institution retrospective chart review was performed to identify patients diagnosed with DCIS between 2012 and 2017. A clinico-pathologic data set, as well as the PD-L1 expression of the DCIS and TILs were collected and correlated with various outcomes. Results: Our cohort consisted of 20 cases of HR- DCIS and 50 cases of HR+ DCIS. Overall, 56% were Caucasian, 20% Asian, 18% Hispanic, and 6% African American. Of the HR- patients, 70% were Caucasian, 15% Hispanic, and 15% Asian. Of the 17 HR- patients with available HER2 data, 76% had HER2+, and 24% triple negative (TN) DCIS. 18% of the HR+ patients and 38% of the HR- patients were PD-L1+. 25% of the HR-/HER2+ patients, and 75% of the TN patients were PD-L1+. 6% of the HR+ patients developed recurrent disease, 2 with DCIS and 1 with invasive ductal carcinoma. 20% of the HR- patients had recurrent disease, all of whom were HER2+. Of the HR- patients that recurred, 2 recurred with metastatic disease, 1 with ipsilateral invasive ductal carcinoma, and 1 with DCIS. All 7 patients that recurred had original DCIS pathology showing a high nuclear grade. Our future results at the time of the meeting will expand on this cohort. Conclusions: This retrospective analysis showed that HR- DCIS conferred higher rates of local and distant recurrence. Therefore, there is a need for treatments to reduce the recurrence rates of HR- DCIS. There are ongoing clinical trials for the high risk, HR-/HER2+ DCIS subtype. TN DCIS is also an aggressive phenotype. Given the high rate of PD-L1 positivity we detected in TN DCIS, immune-based therapy may be useful in the adjuvant setting to reduce the risk of recurrence in this cohort of patients.

scholarly journals Review of Metaplastic Carcinoma of the Breast: Imaging Findings and Pathologic Features

2012 ◽  
Vol 2 ◽  
pp. 21 ◽  
Author(s):  
Rebecca Leddy ◽  
Abid Irshad ◽  
Tihana Rumboldt ◽  
Abbie Cluver ◽  
Amy Campbell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Ductal Carcinoma ◽  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Metaplastic Carcinoma ◽  
Imaging Features ◽  
Benign Lesions ◽  
Imaging Characteristics ◽  
Pathology Classification ◽  
Pathologic Features

Metaplastic carcinoma (MPC), an uncommon but often aggressive breast cancer, can be challenging to differentiate from other types of breast cancer and even benign lesions based on the imaging appearance. It has a variable pathology classification system. These types of tumors are generally rapidly growing palpable masses. MPCs on imaging can present with imaging features similar to invasive ductal carcinoma and probably even benign lesions. The purpose of this article is to review MPC of the breast including the pathology subtypes, imaging features, and imaging pathology correlations. By understanding the clinical picture, pathology, and overlap in imaging characteristics of MPC with invasive ductal carcinoma and probably benign lesions can assist in diagnosing these difficult malignancies.

Significance of incidentally detected oval, circumscribed enhancing lesions on preoperative breast MRI.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 12-12
Author(s):  
Jong Yoon Lee ◽  
Mi Jung Jang ◽  
Sun Mi Kim ◽  
Bo La Yun ◽  
Ja Yoon Jang
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Breast Mri ◽  
Imaging Features ◽  
Tubular Carcinoma ◽  
Interval Change ◽  
Mri Features ◽  
Significant Difference ◽  
Preoperative Breast Mri

12 Background: To evaluate the characteristics and malignancy rate of oval, circumscribed enhancing lesions seen on preoperative breast MRI in patients with breast cancer. Methods: From January 2010 through May 2013, a total number of 502 oval, circumscribed mass was incidentally found in 326 patients with breast cancer who had undergone preoperative breast MRI. Seventy-eight lesions were excluded due to the lack of follow-up imaging or total mastectomy. Biopsy was performed when suspicious enhancing kinetics or interval change were detected on MRI. Otherwise, MRI or ultrasound follow up for correlated lesion were performed at least 2 years. Clinical and imaging features were recorded for analysis. Results: Of the 424 oval, circumscribed enhancing lesions detected on MRI, twelve (2.8%) were malignant and 412 (97.2%) were benign. There was no significant difference in size between malignant (0.72±0.26 cm) and benign (0.71±0.34 cm) lesions (p = 0.932). Among 424 lesions, 43 lesions (10.1%) were pathologically confirmed and twelve were malignant. Positive predictive value (PPV) of malignancy for the biopsy was 27.9%. Among 12 malignant lesions, 7 (58.3%) were invasive ductal carcinoma, 4 (33.3%) were ductal carcinoma in situ, and 1 (8.3%) was tubular carcinoma. Of the pathologically confirmed benign lesions, 8 (25.8%) were fibroadenoma, 7 (22.6%) were intraductal papilloma. Interestingly, there were significantly frequent MRI features with early fast enhancement and delayed washout pattern in malignant (11/12) compared to benign (29/412) lesions (p < 0.001). PPV of malignancy for early fast enhancement and delayed washout pattern in MRI was 27.5%. Conclusions: Cancer yield in patients with oval, circumscribed enhancing lesion on preoperative breast MRI was 12 (2.8%) of 424. MRI features with early fast enhancement and delayed washout pattern strongly suggested malignancy.

Chronic Lymphocytic Leukemia and Invasive Ductal Carcinoma Presenting as a Collision Breast Tumor

2015 ◽  
Vol 15 (4) ◽  
pp. e209-e212
Author(s):  
Neda Jafarian ◽  
Kevin Kuppler ◽  
Marilin Rosa ◽  
Susan Hoover ◽  
Bhavika Patel
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Invasive Ductal Carcinoma ◽  
Breast Tumor ◽  
Ductal Carcinoma ◽  
Lymphocytic Leukemia

Expression of Let-7c in invasive ductal carcinoma of breast cancer and its clinical significance

2009 ◽  
Vol 29 (4) ◽  
pp. 400-403
Author(s):  
Shu-rong SHEN ◽  
Jun-yi SHI ◽  
Xian SHEN ◽  
Guan-li HUANG ◽  
Xiang-yang XUE
Keyword(s):  
Breast Cancer ◽  
Clinical Significance ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma

scholarly journals Fat-enlarged axillary lymph nodes are associated with node-positive breast cancer in obese patients

2021 ◽  
Author(s):  
Roberta M. diFlorio-Alexander ◽  
Qingyuan Song ◽  
Dennis Dwan ◽  
Judith A. Austin-Strohbehn ◽  
Kristen E. Muller ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Invasive Breast Cancer ◽  
Breast Mri ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Obese Women ◽  
Axillary Metastases ◽  
Node Positive ◽  
Positive Breast Cancer

Abstract Purpose Obesity associated fat infiltration of organ systems is accompanied by organ dysfunction and poor cancer outcomes. Obese women demonstrate variable degrees of fat infiltration of axillary lymph nodes (LNs), and they are at increased risk for node-positive breast cancer. However, the relationship between enlarged axillary nodes and axillary metastases has not been investigated. The purpose of this study is to evaluate the association between axillary metastases and fat-enlarged axillary nodes visualized on mammograms and breast MRI in obese women with a diagnosis of invasive breast cancer. Methods This retrospective case–control study included 431 patients with histologically confirmed invasive breast cancer. The primary analysis of this study included 306 patients with pre-treatment and pre-operative breast MRI and body mass index (BMI) > 30 (201 node-positive cases and 105 randomly selected node-negative controls) diagnosed with invasive breast cancer between April 1, 2011, and March 1, 2020. The largest visible LN was measured in the axilla contralateral to the known breast cancer on breast MRI. Multivariate logistic regression models were used to assess the association between node-positive status and LN size adjusting for age, BMI, tumor size, tumor grade, tumor subtype, and lymphovascular invasion. Results A strong likelihood of node-positive breast cancer was observed among obese women with fat-expanded lymph nodes (adjusted OR for the 4th vs. 1st quartile for contralateral LN size on MRI: 9.70; 95% CI 4.26, 23.50; p < 0.001). The receiver operating characteristic curve for size of fat-enlarged nodes in the contralateral axilla identified on breast MRI had an area under the curve of 0.72 for predicting axillary metastasis, and this increased to 0.77 when combined with patient and tumor characteristics. Conclusion Fat expansion of axillary lymph nodes was associated with a high likelihood of axillary metastases in obese women with invasive breast cancer independent of BMI and tumor characteristics.

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