scholarly journals Hydronephrosis Caused by Metastatic Breast Cancer

2021 ◽  
pp. 378-385
Author(s):  
Hitoshi Sugimoto ◽  
Goshi Oda ◽  
Minato Yokoyama ◽  
Kumiko Hayashi ◽  
Maho Yoshino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Urinary Tract ◽  
Renal Dysfunction ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Cancer Recurrence ◽  
Metastatic Breast ◽  
Ureteral Stent ◽  
High Care ◽  
Unilateral Case

Breast cancer metastasizes mainly to organs such as bone, lung, and liver, whereas metastases to the peritoneum and urinary tract are rare. Metastasis to the peritoneum or urinary tract may result in renal dysfunction, infection, and painful hydronephrosis. In our hospital, 1,409 breast cancer surgeries were performed between January 2004 and December 2015, and 7 cases of hydronephrosis associated with recurrence were observed. The median age of patients was 69 years (57–79 years). The median time from surgery to diagnosis of hydronephrosis was 47 months (20–70 months). Histology was invasive ductal carcinoma (IDC) in 6 cases and invasive lobular carcinoma (ILC) in 1 case. There were 6 bilateral cases and 1 unilateral case of hydronephrosis. The causes were retroperitoneal metastasis in 5 cases and lymph node metastasis in 2 cases. The hydronephrosis was untreated in 2 cases, and treated with a ureteral stent in 2 cases, nephrostomy in 1 case, and nephrostomy due to ureteral stent failure in 2 cases. The median survival from the onset of hydronephrosis was 12 months (3–57 months). Although the probability of hydronephrosis in breast cancer recurrence was not high, care must be taken to avoid renal dysfunction, infection, or pain, which may require treatment.

scholarly journals Synchronous gastric and colonic metastases of invasive lobular breast carcinoma: case report and review of the literature

2011 ◽  
Vol 93 (5) ◽  
pp. e49-e50 ◽  
Author(s):  
Adam Charles Critchley ◽  
James Harvey ◽  
Michael Carr ◽  
Obi Iwuchukwu
Keyword(s):  
Breast Cancer ◽  
Gastric Carcinoma ◽  
Primary Breast Cancer ◽  
Ductal Carcinoma ◽  
Past History ◽  
Lobular Carcinoma ◽  
Metastatic Breast ◽  
Treatment Modalities ◽  
Gi Tract ◽  
Primary Gastric Carcinoma

Breast cancer is the most common malignancy in women and the main cause of cancer death in the UK. Gastrointestinal (GI) tract metastasis and carcinomatosis from primary breast cancer are rare but breast cancer is the second most common primary malignancy to metastasise to the GI tract after malignant melanoma. The metastatic patterns of invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) have been shown to differ considerably. Liver, lung and brain metastases are more common in IDC. Most series report a greater prediliction for lobular carcinoma to metastasise to the GI tract, gynaecological organs or peritoneum. The presentation of GI metastasis due to breast cancer is typically vague and the clinical, radiological, endoscopic and histopathologic findings are often difficult to distinguish from primary gastric carcinoma. Such a patient is more likely to present to a luminal surgeon or gastroenterologist than a breast surgeon. Therefore a high index of clinical suspicion with early endoscopy in those with non-specific symptoms and a past history of breast cancer, particularly ILC, are recommended. It is imperative to differentiate between metastatic breast cancer and primary gastric carcinoma as treatment strategies differ hugely. Therefore, correlation of endoscopic biopsy histology with the primary breast cancer histology is essential. Treatment modalities are limited to appropriate systemic therapy, which may have a palliative effect in up to 50%. Surgical intervention is nearly always limited to palliative bypass only. Prognosis is consistent with the median survival of all women with metastatic disease secondary to breast cancer.

scholarly journals Distinct Pattern of Metastases in Patients with Invasive Lobular Carcinoma of the Breast

2017 ◽  
Vol 77 (06) ◽  
pp. 660-666 ◽  
Author(s):  
Aju Mathew ◽  
Padma Rajagopal ◽  
Vipin Villgran ◽  
Gurprataap Sandhu ◽  
Rachel Jankowitz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Invasive Lobular Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Metastatic Breast ◽  
Distant Recurrence ◽  
Distinct Pattern ◽  
Breast Cancers ◽  
Gi Tract

Abstract Background Invasive lobular carcinoma (ILC) comprises around 10 – 15% of invasive breast cancers. Few prior studies have demonstrated a unique pattern of metastases between ILC and the more common invasive ductal carcinoma (IDC). To our knowledge, such data is limited to first sites of distant recurrence. We aimed to perform a comparison of the metastatic pattern of ILC and IDC at first distant recurrence as well as over the entire course of metastatic disease. Methods We used a prospectively collated database of patients with metastatic breast cancer. Breast cancer recurrence or metastases were classified into various sites and a descriptive analysis was performed. Results Among 761 patients, 88 (11.6%) were diagnosed with ILC and 673 (88.4%) with IDC. Patients with ILC showed more frequent metastases to the bone (56.8 vs. 37.7%, p = 0.001) and gastrointestinal (GI) tract (5.7 vs. 0.3%, p < 0.001) as first site of distant recurrence, and less to organs such as lung (5.7 vs. 24.2%, p < 0.001) and liver (4.6 vs. 11.4%, p = 0.049). Over the entire course of metastatic disease, more patients with ILC had ovarian (5.7 vs. 2.1%, p = 0.042) and GI tract metastases (8.0 vs. 0.6%, p < 0.001), also demonstrating reduced tendency to metastasize to the liver (20.5 vs. 49.0%, p < 0.001) and lung (23.9 vs. 51.9%, p < 0.001). All associations but bone held after sensitivity analysis on hormonal status. Although patients presenting with ILC were noted to have more advanced stage at presentation, recurrence-free survival in these patients was increased (4.8 years vs. 3.2 years, p = 0.017). However, overall survival was not (2.5 vs. 2.0 years, p = 0.75). Conclusion After accounting for hormone receptor status, patients with IDC had greater lung/pleura and liver involvement, while patients with ILC had a greater propensity to develop ovarian and GI metastases both at first site and overall. Clinicians can use this information to provide more directed screening for metastases; it also adds to the argument that these two variants of breast cancer should be managed as unique diseases.

Financial Toxicity During Breast Cancer Treatment: A Qualitative Analysis to Inform Strategies for Mitigation

2021 ◽  
pp. OP.21.00182
Author(s):  
Laila A. Gharzai ◽  
Kerry A. Ryan ◽  
Lauren Szczygiel ◽  
Susan Goold ◽  
Grace Smith ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Financial Distress ◽  
Ductal Carcinoma ◽  
Financial Burden ◽  
Unmet Need ◽  
Metastatic Breast ◽  
Financial Toxicity ◽  
Knowledge Gaps ◽  
Treatment Expectations

PURPOSE: Financial toxicity from cancer treatment is a growing concern. Its impact on patients requires refining our understanding of this phenomenon. We sought to characterize patients' experiences of financial toxicity in the context of an established framework to identify knowledge gaps and strategies for mitigation. METHODS: Semistructured interviews with patients with breast cancer who received financial aid from a philanthropic organization during treatment were conducted from February to May 2020. Interviews were transcribed and coded until thematic saturation was reached, and findings were contextualized within an existing financial toxicity framework. RESULTS: Thirty-two patients were interviewed, of whom 58% were non-Hispanic White. The mean age was 46 years. Diagnoses ranged from ductal carcinoma in situ to metastatic breast cancer. Concordant with an established framework, we found that direct and indirect costs determined objective financial burden and subjective financial distress stemmed from psychosocial, behavioral, and material impact of diagnosis and treatment. We identified expectations as a novel theme affecting financial toxicity. We identified knowledge gaps in treatment expectations, provider conversations, identification of resources, and support-finding and offer strategies for mitigating financial toxicity on the basis of participant responses, such as leveraging support from decision aids and allied providers. CONCLUSION: This qualitative study confirms an existing framework for understanding financial toxicity and identifies treatment expectations as a novel theme affecting both objective financial burden and subjective financial distress. Four knowledge gaps are identified, and strategies for mitigating financial toxicity are offered. Mitigating patients' financial toxicity is an important unmet need in optimizing cancer treatment.

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.

scholarly journals The Utilization of Physics Parameter to Classify Histopathology Types of Invasive Ductal Carcinoma (IDC) and Invasive Lobular Carcinoma (ILC) by using K-Nearest Neighbourhood (KNN) Method

2018 ◽  
Vol 8 (4) ◽  
pp. 2442
Author(s):  
Anak Agung Ngurah Gunawan ◽  
I Wayan Supardi ◽  
S. Poniman ◽  
Bagus G. Dharmawan
Keyword(s):  
Breast Cancer ◽  
Invasive Ductal Carcinoma ◽  
Invasive Lobular Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Diagnose Breast Cancer ◽  
Object Based ◽  
Computer Aided ◽  
The Mean ◽  
Learning Data

<p>Medical imaging process has evolved since 1996 until now. The forming of Computer Aided Diagnostic (CAD) is very helpful to the radiologists to diagnose breast cancer. KNN method is a method to do classification toward the object based on the learning data which the range is nearest to the object. We analysed two types of cancers IDC dan ILC. 10 parameters were observed in 1-10 pixels distance in 145 IDC dan 7 ILC. We found that the Mean of Hm(yd,d) at 1-5 pixeis the only significant parameters that distingguish IDC and ILC. This parameter at 1-5 pixels should be applied in KNN method. This finding need to be tested in diffrerent areas before it will be applied in cancer diagnostic.</p>

scholarly journals LACTOFERRIN EXPRESSION IN BREAST CANCER IN RELATION TO BIOLOGIC PROPERTIES OF TUMORS AND CLINICAL FEATURES OF DISEASE

2016 ◽  
Vol 38 (3) ◽  
pp. 181-186 ◽  
Author(s):  
L A Naleskina ◽  
N Yu Lukianova ◽  
S O Sobchenko ◽  
D M Storchai ◽  
V F Chekhun
Keyword(s):  
Breast Cancer ◽  
Clinical Features ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Strongly Correlated ◽  
Luminal A ◽  
Clinical Criteria ◽  
Luminal B ◽  
Course Materials ◽  
Er Positive

Aim: To determine the patterns of lactoferrin (LF) expression in breast cancer (BC) in relation to biologic properties of the neoplasms and clinical features of the disease course. Materials and Methods: Clinical specimens of 266 BC patients (115 patients with BC of stages I–II — retrospective study, and 151 BC patients — prospective study) were analyzed. Morphological, immunohistochemical and statistical methods were used. Results: The number of LF-positive tumors in retrospective and prospective groups was similar (52.1 and 52.8%, respectively). Among common clinical criteria for prognosis of the disease outcome in BC patients (patient’s age; stage of the disease; histological type, differentiation grade, receptor status; presence of metastases), a strong correlation was found only between expression indexes of LF and estrogen receptors (ER). In ER-positive tumors expression of LF was significantly higher than in ER-negative tumors (35 vs 18%). 5-Year survival rate of BC patients was higher in LF-positive group (70 vs 52% in LF-negative group). The presence of regional metastasis tended to correlate with an increased number of LF-positive tumors. In the patients with invasive ductal carcinoma, expression level of LF moderately correlated with occurrence of luminal A subtype (r = 0.43), while in the patients with invasive lobular carcinoma this index strongly correlated with occurrence of luminal B subtype (r = 0.71). LF expression correlated positively with low and moderate differentiation grade of luminal B or basal tumors, and negatively with luminal B or basal tumors of high differentiation grade (r = −0.57 and −0.63, respectively). Conclusion: It has been shown that LF expression in breast tumors correlated with life expectancy of BC patients and important physiologic and clinical features of the disease, while the character of such relation strongly depended on molecular phenotype of tumor, i.e. luminal A, luminal B or basal.

Role of Ag NORs in Improve Diagnosis of Breast Cancer with Different grades and Subtypes’ among Sudanese women

2021 ◽  
Vol 1 (4) ◽  
pp. 443-448
Author(s):  
Doaa Ibrahim Ahmed
Keyword(s):  
Breast Cancer ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Age Group ◽  
Lobular Carcinoma In Situ ◽  
Tissue Sections ◽  
In Situ Carcinoma

This study aimed to evaluate the role of Ag NORs in improves diagnosis of Breast cancer with different subtypes’ among Sudanese Patients. This study include tissue sections of breast cancer diagnosed women, they were 30, ductal and lobular invasive carcinoma were 10 for each, while ductal and lobular in-situ carcinoma were 5 each. Found correlation between subtypes of breast cancer and Ag NOR , Invasive ductal carcinoma had more NOR while the lobular carcinoma in situ was less one , Stage III most frequency than the other stage. Silver staining were performed and Ag-NOR were detected in ductal and lobular invasive carcinoma more than ductal and lobular in-situ carcinoma, grade III has more frequency of Ag-NOR than other stages, and no correlation found between Ag-NOR and age group

scholarly journals Difficulty Diagnosing a Brain Tumor during Clinical Maintenance of a Complete Response to anti-HER2 Treatments for Metastatic Breast Cancer: A Case Report

2020 ◽  
Vol 13 (3) ◽  
pp. 1311-1316
Author(s):  
Ryoko Semba ◽  
Yoshiya Horimoto ◽  
Atsushi Arakawa ◽  
Yoko Edahiro ◽  
Tomoiku Takaku ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Tumor ◽  
Ductal Carcinoma ◽  
Metastatic Breast ◽  
Stage Iv ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Her2 Positive ◽  
Stage Iv Breast Cancer ◽  
The Right

A 46-year-old woman with erythema of the right breast presented to our hospital and was diagnosed with stage IV breast cancer (HER2-positive invasive ductal carcinoma). She received 4 courses of anthracycline-based regimens and 4 courses of trastuzumab + pertuzumab + docetaxel (Tmab + Pmab + DTX). Since she responded well to these therapies, only Tmab + Pmab was continued thereafter. Twenty-three months after starting treatment, she developed a headache. A tumor was identified in the right temporal lobe. Craniotomy was performed for definitive diagnosis. Intraoperative pathological assessment suggested the tumor to be brain metastasis of breast cancer. However, the final pathological diagnosis was diffuse large B-cell lymphoma of central nervous system (DLBCL-CNS) based on re-assessment with immunohistochemical examinations. Therefore, the Tmab + Pmab was discontinued, and 6 courses of high-dose methotrexate therapy were administered. This case highlights the importance of considering rare entities, such as DLBCL, when diagnosing a solitary brain tumor in a patient with a primary cancer, based on imaging and pathological findings.

Efficacy and safety of mitoxantrone-based chemotherapy as adjuvant treatment in elderly patients (EP) with node positive and high risk node negative breast cancer (BC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10738-10738
Author(s):  
P. Fedele ◽  
P. Rizzo ◽  
A. Cusmai ◽  
M. D’Amico ◽  
M. C. Chetrì
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Haematological Toxicity ◽  
Combination Regimen ◽  
Older Woman ◽  
Risk Of Recurrence ◽  
Axillary Lymphadenectomy

10738 Background: Breast cancer is a very frequent malignancy among EP. Adjuvant chemotherapy improves survival for patients with early breast cancer, but older woman at high risk of recurrence are frequently not offered adjuvant chemotherapy and few data are available on efficacy, compliance and safety of adjuvant chemotherapy when indicated in EP. Objective: the aim of our study was to determine the efficacy, compliance and safety of adjuvant mitoxantone-based chemotherapy (FNC) in high risk BC patients older than 70. Methods and Results: From July 1994 to July 2005 we treated 30 patients >70 years, who had diagnosed with early BC in our institution. The treatment (mitoxantrone 10 mg/m2, 5-Fluorouracil 600 mg/m2, Cyclophosphamide 600 mg/m2, i.v. on day 1 every 3 weeks for 6 cycles) was indicated if patients had no severe comorbidity and a high risk of recurrence. All the patients had undergone mastectomy (56%) or quadrantectomy plus axillary lymphadenectomy (44%). Patients undergoing conservative surgery were scheduled for radiotherapy that was planned immediately after the end of chemotherapy. Study population age ranged from 70–78 years, mean age of 74 years.PS (ECOG) was 0 in 74% of patients, 1 in 26%. Comorbid conditions were detected in 38% of patients (64% hypertension, 8% arythmia, 10% depression syndrome, 14% arthrosis) Main histologic types were invasive ductal carcinoma (87%) and lobular carcinoma (13%). Stage was IIA in 20%, IIB in 37%, IIIA in 43%. Grading was 2 in 51%, G3 in 49%.Sixty-seven percent of tumors were ER+ PGR+, 20% were ER- PGR-, 8% ER-PGR+, 5% ER+ PGR-. Seventy-five percent of patients received adjuvant endocrine therapy, after the end of chemotherapy. Toxicity was very manageable with grade 3–4 haematological toxicity in 1 patient, nausea and vomiting appeared as grade 0 and 1 severity in 10%, alopecia was extremely mild and appeared as grade 0 and 1 in 12%. Only 1 patient disrupted treatment because of toxicity. The overall and relapse free survival rates were 70% and 73% at the 60-month follow up, respectively. Conclusion: FNC is an effective and well-tolerated combination regimen suitable as adjuvant chemotherapy for high risk breast cancer EP. No significant financial relationships to disclose.

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