scholarly journals Cryoablation of a Symptomatic Chest Wall Desmoid Tumor Underneath a Silicone Breast Implant

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Siddhant S. Kulkarni ◽  
Amy R. Deipolyi ◽  
Yolanda C. D. Bryce ◽  
Joseph P. Erinjeri
Keyword(s):  
Desmoid Tumor ◽  
Ductal Carcinoma ◽  
Breast Implant ◽  
Breast Implants ◽  
Left Breast ◽  
High Rate ◽  
Bilateral Mastectomy ◽  
Desmoid Tumors ◽  
Negative Effects ◽  
Palpable Mass

Desmoid tumors are locally aggressive tumors that have a high rate of reoccurrence, even after resection. Percutaneous cryoablation is an effective alternative treatment with less associated risk. A patient in the fifth decade of life with a history of ductal carcinoma-in-situ, status post bilateral mastectomy and silicone implant placement, presented with a palpable mass in the left breast, core biopsy proven to be a desmoid tumor underneath the implant. The patient underwent two cryoablation procedures in a six-month period. During both procedures part of the implant was included in the ablation zone without any negative effects on the implant. Cryoablation is a feasible treatment option for desmoid tumors adjacent to silicone breast implants.

scholarly journals Breast Cancer Development in a Transgender Male Receiving Testosterone Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Nadia Barghouthi ◽  
Jennifer Turner ◽  
Jessica Perini
Keyword(s):  
Breast Cancer ◽  
Invasive Ductal Carcinoma ◽  
Breast Biopsy ◽  
Ductal Carcinoma ◽  
Growth Factor Receptor ◽  
Premenopausal Women ◽  
Left Breast ◽  
Bilateral Mastectomy ◽  
Testosterone Therapy ◽  
Increased Risk

Context. To describe a case of invasive ductal carcinoma of the breast in a transgender male receiving testosterone therapy for gender-affirming treatment. Case Description. A 28-year-old transgender male receiving intramuscular testosterone was found to have a breast mass on ultrasound after self-exam revealed a palpable breast lump. Ultrasound-guided breast biopsy revealed estrogen receptor/progesterone receptor (ER/PR) negative, human epidermal growth factor receptor-2 (HER-2) positive, invasive ductal carcinoma of the left breast. He underwent neoadjuvant and adjuvant chemotherapy along with bilateral mastectomy. At patient request, his testosterone injections were permanently discontinued. Conclusion. Fewer than 20 cases of breast cancer in transgender male patients have been reported in medical literature. While studies have shown increased risk of breast cancer in postmenopausal women with higher testosterone levels, data regarding premenopausal women is conflicting and little is known about breast cancer risk in transgender individuals receiving gender-affirming hormone therapy (GAHT), with inconclusive results regarding correlation between testosterone therapy and breast cancer. More research is required to evaluate whether a possible increased risk of breast cancer exists for transgender men receiving gender-affirming therapy.

Breast Implant Associated Anaplastic Large Cell Lymphoma Is More Frequent and Lethal Than Previously Reported

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4760-4760
Author(s):  
Matthew Carty ◽  
Christiana E. Toomey ◽  
Evan Farkash ◽  
James W. May ◽  
James S. Michaelson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Registry ◽  
Massachusetts General Hospital ◽  
Medical Center ◽  
Case Reports ◽  
Breast Implant ◽  
Tissue Expander ◽  
Breast Implants ◽  
Large Cell ◽  
Left Breast

Abstract Abstract 4760 Background: Anaplastic large cell lymphoma (ALCL) is a rare disease, comprising 2–3% of all non-Hodgkin lymphomas. Case reports of seroma associated ALCL of the breast in association with silicone breast implants have appeared in the literature since 1997, but no data on the incidence of this complication has been reported. We use three case reports, including two previously published, in conjunction with data derived from three separate entities of Partners HealthCare (Brigham and Women's Hospital; Massachusetts General Hospital; Faulkner Hospital) to establish an incidence estimate for this rare entity. Methods: Individual cases were identified by pathologists, surgeons and medical oncologists. We compared a list of patients from the institutions’ Cancer Registries, with the results of a query we ran on an institution-internal query tool. For MGH patients only, we were also able to compare cancers revealed through a natural language processing search result of institutional pathology reports. Two of the cases were in the overlap of Cancer Registry data, and query results. One case was not contained within these results as it was omitted from the Cancer Registry. Case Presentations: Case 1 was surgically treated for breast cancer and reconstruction at New England Medical Center. At an unknown time relative to her breast cancer and tissue expander placement, she received a McGhan 210 cc textured silicone implant to her left breast. At time of rupture this implant was replaced with a 270 cc McGhan textured silicone implant filled to 295 cc at Newton Wellesley Hospital (NWH). Her surgical course was complicated by recurrent seroma, and she was eventually switched to Mentor smooth implant, with 275 cc implant on the right and 375 filled to 425 cc on the left. However, a biopsy of tissue at the time of this implant revealed ALK-negative ALCL in the left breast. Implants were removed at NWH and she was treated at Massachusetts General Hospital (MGH). After 3 cycles of chemotherapy (CHOP plus radiation) she remains in CR now at 18 months after treatment. Case 2 presented at Brigham and Women's Hospital (BWH) after a surgically treated right breast cancer with recurrence and reconstruction with a McGhan 270 cc textured saline implant. In 2000 the patient presented with erythema at surgical site of her cancer and a biopsy confirmed ALCL. Due to age the patient was treated with radiation alone and this induced a sustained remission of her ALCL. Case 3 originally had bilateral augmentation mammoplasty in 1974 with bilateral McGhan 270cc textured saline implants. She presented at Northwest Medical Center in 2007 with what appeared to be an abscess at her left implant site but was positive for ALCL when biopsied. She was treated with CHOP and radiation at that institution. She recurred in 2008 in the right breast and presented to BWH for treatment. She received ESHAP, then radiation, then gemcitabine, cisplatin, and dexamethasone; despite these treatments, her disease progressed and the patient died this year. Results: A query of the comprehensive electronic health database of the Partners hospitals (RPDR) revealed 9,941 patients at our institutions, who had undergone full or partial reconstruction of the breast, or removal of a breast implant or tissue expander from 1992–2009. Database queries revealed 5778 patients at MGH, 4,968 at BWH, and 4780 at Faulkner Hospital (FH) with non-Hodgkin lymphoma. Cancer Registry data revealed 18 ALCL patients (4 women) at MGH, 73 ALCL patients (24 women) at BWH and 2 ALCL patients at FH (1 woman). Of our three cases one was treated entirely within our core healthcare system, one was referred from another Partners Institution (NWH) and one was referred for tertiary care of her lymphoma. Incidence is established as 2 cases of implant-associated ALCL per 9941 patients or 0.02%. Implant-associated disease comprises 3.2% of all ALCL cases and 10% of ALCLs presenting among women. Conclusions: Incidence of breast implant-associated ALCL may be more common than the rare case reports suggest. Evaluation of late complications of breast implant such as chronic seroma or abscess with consideration of this disease may improve case recognition. The fatality as a result of systemic dissemination of this disease has not previously been reported. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Cavernous hemangioma: A rare tumor in the breast region

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Eimi Nascimento Pacheco ◽  
Amanda Roepke Tiedje ◽  
Érica Elaine Traebert Simezo ◽  
Bráulio Leal Fernandes ◽  
Rebeca Neves Heinzen
Keyword(s):  
Cavernous Hemangioma ◽  
Ductal Carcinoma ◽  
Gynecological Cancer ◽  
Breast Implant ◽  
Hormone Replacement ◽  
Left Breast ◽  
Vascular Tumors ◽  
Intramammary Lymph Node ◽  
Slight Growth ◽  
Mri Characteristics

Introduction: Hemangiomas are benign vascular tumors rarely located in the breast (incidence of 0.4% to 0.8%). They mainly affect post-menopause women on hormone replacement therapy (HRT). These tumors are classified as capillary or cavernous according to the size of vessels involved and can show heterogeneity in imaging tests. Case report: The patient is a woman aged 56 years, G3P3, living in the city of Florianópolis. She has been on HRT, without a family history of gynecological cancer. She reported breast implant and bariatric surgery in 2007. The patient sought medical care due to a tumor in the left breast that she noticed six months before, with slight growth. Physical examination identified a superficial purplish nodule in the left axillary tail, measuring 1.5 cm. Magnetic resonance imaging (MRI) revealed an intramammary lymph node (BI-RADS 2); mammography (MMG) indicated a 2.4 cm nodule in the left axillary tail (BI-RADS 4), suggesting biopsy; ultrasound (US) identified an irregular peripheral nodule at 2 h on the left, with the same classification. Core biopsy revealed cavernous hemangioma. Mammaplasty was performed with excision of the lesion. Commentaries: In hemangiomas, imaging findings can vary. MMG usually shows an oval or lobular mass, isodense or high-density, and circumscribed margins. The heterogeneity in the US may be related to vascular channels histologically seen in cavernous hemangiomas. MRI characteristics vary according to the possibility of internal thrombosis, but they often include an ovoid mass and circumscribed margins. The MRI report showed no hemangioma; however, MMG and US indicated similar characteristics. Although rare and with a heterogeneous presentation, hemangioma should be remembered as a differential diagnosis since, in addition to its similarities to benign lesions, such as bruises and sebaceous cysts, it can also be mistaken for inflammatory carcinoma and ductal carcinoma in situ, mimics that have been described in the literature.

scholarly journals Late hematoma: a rare complication on breast implant

2020 ◽  
Vol 8 (9) ◽  
pp. 3341
Author(s):  
Luis Tamez Pedroza ◽  
Francisco Palacious Luna ◽  
Iram Gonzalez Vargas
Keyword(s):  
Case Reports ◽  
Rare Complication ◽  
Breast Implant ◽  
Breast Implants ◽  
Left Breast ◽  
Ultrasound Guided ◽  
Non Invasive ◽  
Doctor's Office ◽  
First Time ◽  
Invasive Management

Late hematoma is a rare complication on the use of breast implants but on recent year’s case reports become more frequent, there's no data regarding the incidence, authors report multiple theory’s about etiology. In this case report we report a patient who presented a spontaneous late hematoma, patient arrived at doctor’s office complaining about gradual increase over the last 15 days of left breast, we treated the hematoma with guided-ultrasound drainage with total improvement of the symptoms, 1 week later the patient returns for the same symptoms that occurred the first time, an ultrasound-guided drainage is performed again and it is decided to schedule the surgical date in 1 week, as reported on previous cases we tried non-invasive management with ultrasound guided drainage on 2 attempts but patient hematoma recurred and we decided to perform drainage, capsulectomy and implant replacement, we follow the patient through the outpatient clinic 7 months later, and she has not presented a hematoma recurrence.

scholarly journals Asymptomatic Incidental Ductal Carcinoma in situ in a Male Breast Presenting with Contralateral Gynecomastia

2012 ◽  
Vol 2 ◽  
pp. 9 ◽  
Author(s):  
Laura M. Isley ◽  
Rebecca J. Leddy ◽  
Tihana Rumboldt ◽  
Jacqueline M. Bernard
Keyword(s):  
Carcinoma In Situ ◽  
Unusual Case ◽  
Ductal Carcinoma ◽  
Nipple Discharge ◽  
Left Breast ◽  
Palpable Mass ◽  
Bloody Nipple Discharge ◽  
History Of ◽  
Symptomatic Side

Ductal carcinoma in situ (DCIS) in males is rare and usually presents with symptoms on the affected side, such as, palpable mass or bloody nipple discharge. Even as DCIS has been reported in conjunction with gynecomastia in the same breast, we report an unusual case of a 62-year-old Caucasian male, with no family history of breast cancer, who presented with symptomatic side gynecomastia, and was incidentally found to have DCIS in a completely asymptomatic left breast. To the best of our knowledge, this case is the first report in literature of asymptomatic, incidentally discovered DCIS in a male patient.

scholarly journals Desmoid tumor within lesser sac

2006 ◽  
Vol 134 (9-10) ◽  
pp. 438-440 ◽  
Author(s):  
Radoje Colovic ◽  
Nikica Grubor ◽  
Vladimir Radak ◽  
Marijan Micev ◽  
Natasa Colovic
Keyword(s):  
Portal Hypertension ◽  
Histological Examination ◽  
Desmoid Tumor ◽  
Epigastric Pain ◽  
Splenic Vein ◽  
Desmoid Tumors ◽  
Palpable Mass ◽  
Lesser Sac ◽  
Incomplete Excision

Desmoid tumors or fibromatoses comprise a number of benign fibrous proliferative lesions that have local infiltrative growth and tendency to recur after incomplete excision. They never metastasize. The authors present a 31-year old woman who, due to epigastric pain and palpable mass detected on presentation, underwent the excision of firm tumorous mass, 210x140x115mm in diameter, from the lesser sac. Compressing the splenic vein, the tumor caused left-sided portal hypertension which subsided after the mass was removed. The recovery was uneventful. The histological examination verified typical desmoid tumor. Twelve years after surgery, the patient remained symptom-free with no signs of recurrence.

scholarly journals Clinicopathological predictors of postoperative upstaging to invasive ductal carcinoma (IDC) in patients preoperatively diagnosed with ductal carcinoma in situ (DCIS): a multi-institutional retrospective cohort study

Breast Cancer ◽  
2021 ◽  
Author(s):  
Kiyo Tanaka ◽  
Norikazu Masuda ◽  
Naoki Hayashi ◽  
Yasuaki Sagara ◽  
Fumikata Hara ◽  
...  
Keyword(s):  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma In Situ ◽  
Tumor Size ◽  
Medical Records ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Palpable Mass ◽  
Combined Use ◽  
A Prospective Study

Abstract Background We conducted a prospective study with the intention to omit surgery for patients with ductal carcinoma in situ (DCIS) of the breast. We aimed to identify clinicopathological predictors of postoperative upstaging to invasive ductal carcinoma (IDC) in patients preoperatively diagnosed with DCIS. Patients and methods We retrospectively analyzed patients with DCIS diagnosed through biopsy between April 1, 2010 and December 31, 2014, from 16 institutions. Clinical, radiological, and histological variables were collected from medical records. Results We identified 2,293 patients diagnosed with DCIS through biopsy, including 1,663 DCIS (72.5%) cases and 630 IDC (27.5%) cases. In multivariate analysis, the presence of a palpable mass (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.2–2.6), mammography findings (≥ category 4; OR 1.8; 95% CI 1.2–2.6), mass formations on ultrasonography (OR 1.8; 95% CI 1.2–2.5), and tumor size on MRI (> 20 mm; OR 1.7; 95% CI 1.2–2.4) were independent predictors of IDC. Among patients with a tumor size on MRI of ≤ 20 mm, the possibility of postoperative upstaging to IDC was 22.1%. Among the 258 patients with non-palpable mass, nuclear grade 1/2, and positive for estrogen receptor, the possibility was 18.1%, even if the upper limit of the tumor size on MRI was raised to ≤ 40 mm. Conclusion We identified four independent predictive factors of upstaging to IDC after surgery among patients with DCIS diagnosed by biopsy. The combined use of various predictors of IDC reduces the possibility of postoperative upstaging to IDC, even if the tumor size on MRI is larger than 20 mm.

Acinic Cell Carcinoma of the Breast: Report of a Case With Immunohistochemical and Next-Generation Sequencing Studies

2021 ◽  
pp. 106689692110085
Author(s):  
Kaitlin D. Weaver ◽  
James Isom ◽  
Ashwini Esnakula ◽  
Karen Daily ◽  
Jaya R. Asirvatham
Keyword(s):  
Next Generation Sequencing ◽  
Cell Carcinoma ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Left Breast ◽  
Acinic Cell Carcinoma ◽  
Next Generation ◽  
Carcinoma Of The Breast ◽  
Acinic Cell ◽  
Generation Sequencing

Acinic cell carcinoma of the breast is a rare subtype of triple-negative breast cancer that recapitulates the appearance of tumors seen in salivary glands. We present the case of a 42-year-old woman with an irregular, nontender mass above the left nipple during routine obstetric appointment at 24 weeks gestation. She was subsequently diagnosed with triple-negative invasive ductal carcinoma of the left breast, Nottingham grade 3, via core needle biopsy. She was treated with neoadjuvant therapy (doxorubucin and cyclophosphamide) antenatally and paclitaxel in the postpartum period followed by left mastectomy with sentinel node biopsy. The carcinoma in the mastectomy specimen showed a spectrum of morphologic patterns with immunohistochemistry revealing strong positivity for alpha-1-antichymotrypsin, epithelial membrane antigen (EMA), lysozyme, and S100. The histomorphology paired with the immunoprofile led us to the diagnosis of acinic cell carcinoma. We retrospectively performed immunostains in the core biopsy specimen, which demonstrated GATA-3 and DOG-1 positivity. Next-generation sequencing of the postneoadjuvant specimen using a 70-gene panel revealed 2 single-nucleotide variant (SNV) mutations: tumor protein 53 (TP53) (c.747G>T) SNV mutation and rearranged during transfection (RET) (c.2899G>A) SNV mutation.

scholarly journals Granzyme B Is a Biomarker for Suspicion of Malignant Seromas Around Breast Implants

2020 ◽  
Author(s):  
Marshall E Kadin ◽  
John Morgan ◽  
Haiying Xu ◽  
Caroline Glicksman ◽  
David Sieber ◽  
...  
Keyword(s):  
Early Detection ◽  
Tumor Cells ◽  
Breast Implant ◽  
Granzyme B ◽  
Breast Implants ◽  
Large Cell ◽  
Target Cells ◽  
Cytotoxic Lymphocytes ◽  
Tumor Cell Death ◽  
Level Of Evidence

Abstract Background Granzyme B (GrB) is a serine protease secreted, along with pore-forming perforin, by cytotoxic lymphocytes to mediate apoptosis in target cells. GrB has been detected in tumor cells associated with systemic and breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) but its potential use for detection of early BIA-ALCL has not been fully investigated. Objectives Prompted by the increased incidence of BIA-ALCL, the aim of this study was to assess GrB as a new biomarker to detect early disease in malignant seromas and to better understand the nature of the neoplastic cell. Methods A Human XL Cytokine Discovery Magnetic Luminex 45-plex Fixed Panel Performance Assay was used to compare cytokine levels in cell culture supernatants of BIA-ALCL and other T-cell lymphomas, as well as malignant and benign seromas surrounding breast implants. Immunohistochemistry was employed to localize GrB to cells in seromas and capsular infiltrates. Results Differences in GrB concentrations between malignant and benign seromas were significant (P < 0.001). GrB was found in and around apoptotic tumor cells, suggesting that the protease may be involved in tumor cell death. Conclusions GrB is a useful marker for early detection of malignant seromas and to identify tumor cells in seromas and capsular infiltrates. Because there is an overlap between the lowest concentrations of soluble GrB in malignant seromas and the highest concentrations of GrB in benign seromas, it is recommended that GrB be used only as part of a panel of biomarkers for the screening and early detection of BIA-ALCL. Level of Evidence: 5

A patient reported outcomes of treatments for desmoid tumors: An international natural history study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11560-11560
Author(s):  
Danielle Braggio ◽  
Amanda Lucas ◽  
Lynne Hernandez ◽  
Kelly Mercier
Keyword(s):  
Natural History ◽  
Active Surveillance ◽  
Desmoid Tumor ◽  
Patient Reported Outcomes ◽  
The United States ◽  
Desmoid Tumors ◽  
Targeted Agents ◽  
Natural History Study ◽  
Systemic Treatments ◽  
Patient Reported

11560 Background: The Desmoid Tumor Research Foundation (DTRF) launched the natural history study (NHS) in 2017. At this time, there are no standard-of-care options for this rare sarcoma. The treatments, clinical descriptors, and the patient reported outcomes to pharmacologic agents are described here within. Methods: The web-based natural history study launched September 2017 in collaboration with the National Organization of Rare Disorders. It contains 15 surveys covering diagnostics, disease, treatment, care management, and quality of life. Treatment types included in the DTRF NHS were pharmacology, surgery, radiation, high-intensity focused ultrasound (HiFU), and active surveillance (watch and wait). Results: While surgery was once the primary intervention for desmoid tumor patients, the NHS participants reported that 47.6% had received active surveillance or no systemic treatment at diagnosis. This is most common for desmoid tumors located in abdominal wall (54/103; 52.4%). There were 87 reported cases of complete surgical resection, 38 incomplete resections, and 23 bowel resections. 9 amputations were reported; 8 participants reported recurrent disease following the removal of the limb. The non-surgical interventions, such as radiation and HiFU, were mostly described for participants with chest wall tumors (15 pts) and joints/extremities (10 pts). Many options for systemic therapies were described including sorafenib (44/284; 15.5%), sulindac (36/284; 12.7%), and anti-hormonal agents tamoxifen and toremifene (34/285; 10.9%) were described. Targeted agents, such as gamma secretase inhibitor, pazopanib, and sorafenib, were greater in the United States than the non-US country participants (21% vs 9%). Multiple lines of treatments were reported by 81 participants, surgery is greatest as the first intervention for all tumor locations (49/81, 60%), with the exception of those with head/neck tumors who received chemotherapy (6/11, 55%). Analysis has started to evaluate the efficacy of systemic treatments from these NHS data. The table describes the participant reported outcomes of anti-hormonal agents, chemotherapeutics, non-steroidal anti-inflammatories, and targeted agents. Both chemotherapies and targeted agents were reported to have 38.1% response rates from the participants with 34.3% and 23.8% of participants reported progressive disease on therapy, respectively. Conclusions: Desmoid tumor NHS study participants reported the use of many treatment modalities demonstrating a range of frequency of use by tumor location and efficacy. Data collection through the DTRF NHS is ongoing.[Table: see text]

Sign in / Sign up

Export Citation Format

Share Document