Impact of Respiratory Maneuvers on Cardiac Volume Within Left-Breast Radiation Portals

Background: Contrast-enhanced spectral mammogram (CESM) is a modern technique providing additional information to detect or diagnose the breast cancers. Introduction: We present a rare ACC of breast on CESM. Methods: A 49-year-old woman with surgicopathological proved ACC is reported with features on CESM, sonography and contrast-enhanced magnetic resonance imaging (CE-MRI). Results: Sonography revealed a 1.4 cm × 1.2 cm × 1 cm circumscribe round mass in the upper outer quadrant of the left breast that was diagnosed to fibroadenoma. The mammogram did not show any discernible mass, however the recombined subtracted images displayed a circumscribe mass with thin rim enhancement and enhanced internal patches that were resembling to CE-MRI. Finally, the mass was proved to ACC. Conclusion: CESM facilitates detection of an isodense cancer and provides the enhanced features for differential diagnosis. Resembling CE-MRI, CESM displayed rim enhancement and internal enhanced patches as diagnostic clues for this case of ACC.

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Bilateral Phyllodes Giant Tumor. A Case Report Analyzed by Array-CGH

Diagnostics ◽

10.3390/diagnostics10100825 ◽

2020 ◽

Vol 10 (10) ◽

pp. 825

Author(s):

Francesco Fortarezza ◽

Federica Pezzuto ◽

Gerardo Cazzato ◽

Clelia Punzo ◽

Antonio d’Amati ◽

...

Keyword(s):

Array Cgh ◽

Phyllodes Tumor ◽

Molecular Classification ◽

Left Breast ◽

Comparative Genomic ◽

Fish Analysis ◽

Molecular Tests ◽

Giant Tumor ◽

Metastatic Risk ◽

The Right

The breast phyllodes tumor is a biphasic tumor that accounts for less than of 1% of all breast neoplasms. It is classified as benign, borderline, or malignant, and can mimic benign masses. Some recurrent alterations have been identified. However, a precise molecular classification of these tumors has not yet been established. Herein, we describe a case of a 43-year-old woman that was admitted to the emergency room for a significant bleeding from the breast skin. A voluminous ulcerative mass of the left breast and multiple nodules with micro-calcifications on the right side were detected at a physical examination. A left total mastectomy and a nodulectomy of the right breast was performed. The histological diagnosis of the surgical specimens reported a bilateral giant phyllodes tumor, showing malignant features on the left and borderline characteristics associated with a fibroadenoma on the right. A further molecular analysis was carried out by an array-Comparative Genomic Hybridization (CGH) to characterize copy-number alterations. Many losses were detected in the malignant mass, involving several tumor suppressor genes. These findings could explain the malignant growth and the metastatic risk. In our study, genomic profiling by an array-CGH revealed a greater chromosomal instability in the borderline mass (40 total defects) than in the malignant (19 total defects) giant phyllodes tumor, reflecting the tumor heterogeneity. Should our results be confirmed with more sensitive and specific molecular tests (DNA sequencing and FISH analysis), they could allow a better selection of patients with adverse pathological features, thus optimizing and improving patient’s management.

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PO-0836: Impact of Deep Inspiration Breath Hold on Left Anterior Coronary dose in Left Breast irradiation

Radiotherapy and Oncology ◽

10.1016/s0167-8140(17)31273-2 ◽

2017 ◽

Vol 123 ◽

pp. S450-S451

Author(s):

F. Azoury ◽

S. Achkar ◽

N. Farah ◽

D. Nasr ◽

C. El Khoury ◽

...

Keyword(s):

Left Breast ◽

Breath Hold ◽

Deep Inspiration ◽

Breast Irradiation ◽

Deep Inspiration Breath Hold

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Electrical impedance tomography to measure lung ventilation distribution in healthy horses and horses with left‐sided cardiac volume overload

Journal of Veterinary Internal Medicine ◽

10.1111/jvim.16227 ◽

2021 ◽

Author(s):

Muriel Sacks ◽

David P. Byrne ◽

Nicolas Herteman ◽

Cristy J.Cristy Secombe ◽

Andy Adler ◽

...

Keyword(s):

Electrical Impedance Tomography ◽

Electrical Impedance ◽

Volume Overload ◽

Lung Ventilation ◽

Ventilation Distribution ◽

Cardiac Volume ◽

Impedance Tomography

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Deep-inspirational breath-hold (DIBH) technique in left-sided breast cancer: various aspects of clinical utility

Radiation Oncology ◽

10.1186/s13014-021-01816-3 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Szilvia Gaál ◽

Zsuzsanna Kahán ◽

Viktor Paczona ◽

Renáta Kószó ◽

Rita Drencsényi ◽

...

Keyword(s):

Breast Cancer ◽

Side Effects ◽

Clinical Utility ◽

Prospective Trial ◽

Conformal Radiotherapy ◽

Free Breathing ◽

Left Breast ◽

Breath Hold ◽

Ipsilateral Lung ◽

Breast Cancer Radiotherapy

Abstract Background Studying the clinical utility of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and feasibility aspects. Methods In this prospective trial all enrolled patients went through planning CT in supine position under both DIBH and free breathing (FB); in whole breast irradiation (WBI) cases prone CT was also taken. In 3-dimensional conformal radiotherapy (3DCRT) plans heart, left anterior descending coronary artery (LAD), ipsilateral lung and contralateral breast doses were analyzed. The acceptance of DIBH technique as reported by the patients and the staff was analyzed; post-RT side-effects including radiation lung changes (visual scores and lung density measurements) were collected. Results Among 130 enrolled patients 26 were not suitable for the technique while in 16, heart or LAD dose constraints were not met in the DIBH plans. Among 54 and 34 patients receiving WBI and postmastectomy/nodal RT, respectively with DIBH, mean heart dose (MHD) was reduced to < 50%, the heart V25 Gy to < 20%, the LAD mean dose to < 40% and the LAD maximum dose to about 50% as compared to that under FB; the magnitude of benefit was related to the relative increase of the ipsilateral lung volume at DIBH. Nevertheless, heart and LAD dose differences (DIBH vs. FB) individually varied. Among the WBI cases at least one heart/LAD dose parameter was more favorable in the prone or in the supine FB plan in 15 and 4 cases, respectively; differences were numerically small. All DIBH patients completed the RT, inter-fraction repositioning accuracy and radiation side-effects were similar to that of other breast RT techniques. Both the patients and radiographers were satisfied with the technique. Conclusions DIBH is an excellent heart sparing technique in breast RT, but about one-third of the patients do not benefit from that otherwise laborious procedure or benefit less than from an alternative method. Trial registration: retrospectively registered under ISRCTN14360721 (February 12, 2021)

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Cystic Encapsulated Papillary Carcinoma in the Male Breast: An Unusual Feature With a Diagnostic Challenge

International Journal of Surgical Pathology ◽

10.1177/10668969211018754 ◽

2021 ◽

pp. 106689692110187

Author(s):

Rongying Li ◽

Karan Saluja ◽

Brenda Mai ◽

Michael Covinsky ◽

Hongxia Sun

Keyword(s):

Papillary Carcinoma ◽

Cyst Wall ◽

Correct Diagnosis ◽

Nipple Discharge ◽

Left Breast ◽

Male Breast ◽

Unusual Feature ◽

Breast Mass ◽

Repeat Biopsy ◽

Bloody Nipple Discharge

Papillary carcinoma in the male breast is uncommon. Here, we report a case of a large encapsulated papillary carcinoma (EPC) in a 62-year-old male. The patient presented with a left breast mass of 1-year duration and bloody nipple discharge for several days. Mammography and breast ultrasonography showed a large left breast mass. The initial biopsy demonstrated fat necrosis with acute and chronic inflammation only. Due to clinical suspicion, a repeat biopsy was performed and revealed scant fragments of papillary carcinoma in a background of inflammation. The patient underwent left total mastectomy. Grossly, the breast contained a 9.0 cm entirely cystic lesion lined by a hemorrhagic thick fibrotic wall. No solid area was identified in the cyst. The entire cyst wall was examined under microscopy; only a few sections with papillary carcinoma were identified. The lesion was confined to the cyst wall; so, a diagnosis of EPC was made. Compared to the previously reported EPC cases of male breast, the lesion of this case was unusually cystic, which making the diagnosis challenging. Therefore, awareness of this unusual feature, repeat biopsy when the pathology result is discordant, and extensive sampling of the lesion are essential for making the correct diagnosis and guiding patient management.

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