Uncommon Breast Malignancies: Presentation Pattern, Prognostic Issue and Treatment Outcome in an Italian Single Institution Experience

2013 ◽  
Vol 99 (1) ◽  
pp. 39-44
Author(s):  
Claudia Maria Regina Bareggi ◽  
Dario Consonni ◽  
Barbara Galassi ◽  
Donatella Gambini ◽  
Elisa Locatelli ◽  
...  

Aims and background Often neglected by large clinical trials, patients with uncommon breast malignancies have been rarely analyzed in large series. Patients and methods Of 2,052 patients diagnosed with breast cancer and followed in our Institution from January 1985 to December 2009, we retrospectively collected data on those with uncommon histotypes, with the aim of investigating their presentation characteristics and treatment outcome. Results Rare histotypes were identified in 146 patients (7.1% of our total breast cancer population), being classified as follows: tubular carcinoma in 75 (51.4%), mucinous carcinoma in 36 (24.7%), medullary carcinoma in 25 (17.1%) and papillary carcinoma in 10 patients (6.8%). Whereas age at diagnosis was not significantly different among the diverse diagnostic groups, patients with medullary and papillary subtypes had a higher rate of lymph node involvement, similar to that of invasive ductal carcinoma. Early stage diagnosis was frequent, except for medullary carcinoma. Overall, in comparison with our invasive ductal carcinoma patients, those with rare histotypes showed a significantly lower risk of recurrence, with a hazard ratio of 0.28 (95% CI, 0.12–0.62; P = 0.002). Conclusions According to our analysis, patients with uncommon breast malignancies are often diagnosed at an early stage, resulting in a good prognosis with standard treatment.

2021 ◽  
Vol 62 (5) ◽  
Author(s):  
Bui Dang Minh Tri ◽  
Doan Thanh Truc ◽  
Tri Kim Ngoc ◽  
Vo Van Cuong

Objective: Describing the clinical and subclinical characteristics on breast cancer patients treated with Anthracyclines at Thong Nhat hospital.Subjects and methods: a prospective descriptive study on 43 patients with breast cancer was treated with Anthracyclines with 4 to 6 cycles as determined by clinical doctor at Thong Nhat hospital. Results: Average age: 49.2 ± 3.2 years old. The age group accounted for the largest proportion in the study object was the 50-60 age group (48.84%). The percentage of patients who self-examined the tumor was the highest with 79.07%. There were 9.30% of patients with pain symptoms, 11.63% of patients with nipple discharge. Tumor position in the upper-external quadrant accounted for the largest percentage with 55.81%. The average size of tumors was 2.56 ± 1.2 (cm). The main form of lesions detected on ultrasound was the local lesion with over 80% with an unknown boundaryfeature (81.40%) and predominantly invasive (76.74%). The histopathological type accounted for the highest percentage was the invasive tubular carcinoma (79.07%), the medullary carcinoma andmucinous carcinoma body accounted for the lowest rate with 2.33% and 0%, respectively. The histological degree accounted for the highest percentage among the research subjects was degree 2with 50.18%. Stage III accounted for the highest rate with 46.51%.Conclusion: The most common age group for breast cancer was 50-60 years old, the main symptom was self-examination with breast tumors, breast cancer were mainly local tumor at the upper-externalposition. On ultrasound, the lesions were the local, unknown boundary, and invasive lesions. Breast cancer was mainly invasive ductal carcinoma, histologic degree 2.


2020 ◽  
Vol 10 (4) ◽  
pp. 947-953
Author(s):  
Yajuan Wang ◽  
Yuan Fu ◽  
Guangsen Li ◽  
Tianlang Jin

The retrospective analysis of the ultrasonographic features of 108 cases of breast cancer confirmed by surgery and pathology, namely the relationship between mass boundary, posterior echo, calcification and blood flow signal and pathological type, was to explore the features of ultrasound sonography of breast cancer. The link between pathological typing. The results of the study showed that the ultrasound showed that the border of the nvasive ductal carcinoma was mostly burr-like. The ultrasound showed that the border of the invasive lobular carcinoma was mostly strong echo halo. The medullary carcinoma had a clear boundary, while the intraductal carcinoma showed more unclear borders. There was no significant difference in the relationship between the boundary of the mass and the pathological types. Ultrasound of invasive ductal carcinoma and invasive lobular carcinoma showed a posterior echo attenuation, and medullary carcinoma showed more posterior echo enhancement. The relationship between the echo of the posterior mass of the tumor and the pathological types was statistically different. The detection rate of ultrasound calcification in invasive ductal carcinoma and invasive lobular carcinoma was higher. The calcification in medullary carcinoma was less common. The calcification in the pathology of intraductal carcinoma was better. High, but ultrasound can only detect half of it. There was no significant difference in the relationship between calcification and pathological types in the tumor; ultrasound showed that most of the blood flow signals were abundant, suggesting that there was no statistical difference between the blood flow classification and the pathological classification of the tumor. The results of the thesis indicate that the ultrasound characteristics of breast cancer have a high diagnostic value for its pathological classification.


2015 ◽  
Vol 139 (12) ◽  
pp. 1546-1549 ◽  
Author(s):  
Philip E. Bomeisl ◽  
Cheryl L. Thompson ◽  
Lyndsay N. Harris ◽  
Hannah L. Gilmore

ContextOncotype DX (ODX) is a widely used commercial assay that estimates the risk of distant recurrence and may predict the benefit of chemotherapy in a subset of breast cancers. Some studies have shown the ability to predict Oncotype DX recurrence score (ODXRS), based on routinely reported pathologic features; however, there are limited data correlating specific histologic type of breast cancer to ODXRS.ObjectiveTo compare ODXRS to specific histologic types of breast cancer.DesignOne hundred eighty-four cases were sent for ODXRS testing and the results were compared with histologic type and grade.ResultsThe highest average ODXRS was seen in invasive ductal carcinoma with micropapillary features (29) followed by invasive ductal carcinoma not otherwise specified (mean = 19.4, SD = 11.6), invasive mucinous carcinoma (mean = 17.2, SD = 5.9), invasive lobular carcinoma (mean = 15.7, SD = 7.2), mixed ductal and lobular carcinoma (mean = 14.1, SD = 7.7), tubular carcinoma (10.0), and mixed ductal and mucinous carcinoma (mean = 8.0, SD = 4.2). Most tumors that had a high ODXRS were grade 3 invasive ductal carcinoma, representing 13 of a total of 20 cases (65%). Interestingly, 3 of the 4 cases of pure invasive mucinous carcinoma had an intermediate ODXRS.ConclusionsAlthough the numbers are small, our findings raise further awareness of the significance between histologic type and grade, and RS in breast cancer. In some special histologic types of breast cancer, particularly those considered to follow either an excellent or poor clinical course by histology alone, it is unclear whether the ODXRS results are as meaningful as in carcinomas of no special type. Further investigation with higher numbers and outcome data is needed.


2009 ◽  
Vol 29 (4) ◽  
pp. 400-403
Author(s):  
Shu-rong SHEN ◽  
Jun-yi SHI ◽  
Xian SHEN ◽  
Guan-li HUANG ◽  
Xiang-yang XUE

2022 ◽  
pp. 1-12
Author(s):  
Amin Ul Haq ◽  
Jian Ping Li ◽  
Samad Wali ◽  
Sultan Ahmad ◽  
Zafar Ali ◽  
...  

Artificial intelligence (AI) based computer-aided diagnostic (CAD) systems can effectively diagnose critical disease. AI-based detection of breast cancer (BC) through images data is more efficient and accurate than professional radiologists. However, the existing AI-based BC diagnosis methods have complexity in low prediction accuracy and high computation time. Due to these reasons, medical professionals are not employing the current proposed techniques in E-Healthcare to effectively diagnose the BC. To diagnose the breast cancer effectively need to incorporate advanced AI techniques based methods in diagnosis process. In this work, we proposed a deep learning based diagnosis method (StackBC) to detect breast cancer in the early stage for effective treatment and recovery. In particular, we have incorporated deep learning models including Convolutional neural network (CNN), Long short term memory (LSTM), and Gated recurrent unit (GRU) for the classification of Invasive Ductal Carcinoma (IDC). Additionally, data augmentation and transfer learning techniques have been incorporated for data set balancing and for effective training the model. To further improve the predictive performance of model we used stacking technique. Among the three base classifiers (CNN, LSTM, GRU) the predictive performance of GRU are better as compared to individual model. The GRU is selected as a meta classifier to distinguish between Non-IDC and IDC breast images. The method Hold-Out has been incorporated and the data set is split into 90% and 10% for training and testing of the model, respectively. Model evaluation metrics have been computed for model performance evaluation. To analyze the efficacy of the model, we have used breast histology images data set. Our experimental results demonstrated that the proposed StackBC method achieved improved performance by gaining 99.02% accuracy and 100% area under the receiver operating characteristics curve (AUC-ROC) compared to state-of-the-art methods. Due to the high performance of the proposed method, we recommend it for early recognition of breast cancer in E-Healthcare.


Author(s):  
Félix Essiben ◽  
Pascal Foumane ◽  
Esther JNU Meka ◽  
Michèle Tchakounté ◽  
Julius Sama Dohbit ◽  
...  

Background: Breast cancer is today a global health problem. With 1,671,149 new cases diagnosed in 2012, it is the most common female cancer in the world and accounts for 11.9% of all cancers and it affects more people than prostate cancer. In 2008, The United States statistics showed that, for all cancer that affect women before 40 years, more than 40% of them concerned the breast. The aim of this study was to describe the clinical, histopathological and therapeutic aspects of breast cancer in women under 40 years of age in Yaoundé.Methods: This was a retrospective study with data collected from 192 medical case files of women treated over a period of 12 years, from January 2004 to December 2015 at the Yaounde General Hospital and the Yaounde Gyneco-Obstetric and Pediatric Hospital. Microsoft Epi Info version 3.4.5 and SPSS version 20.0 softwares were used for data analysis.Results: From 2004 to 2015, 1489 cases of breast cancer were treated in both hospitals. Of these, 462 women were less than 40 years old, representing a proportion of 31.0%. The mean age at diagnosis was 33.5±5.0 years and 17.7% of women had a family history of breast cancer. The average time before an initial consultation was 6.7±6.6 months.  Most cases were classified as T4 (46.1%). The most common histological type was ductal carcinoma (87.4%). Grades SBR II and SBR III were predominant (76.4%). Axillary dissection (64.4%) and neoadjuvant chemotherapy (43.9%) were the main therapeutic modalities. The overall survival rate at 5 years was 51.2%. Five-year survival rates with no local recurrence and no metastatic occurrence were 35.8% and 43.2% respectively.Conclusions: Breast cancer largely affects women under the age of 40 and is often discovered late, at an advanced stage. The prognosis appears poor. Only screening could facilitate diagnosis at an early stage of the disease for better outcomes.


2009 ◽  
Vol 27 (30) ◽  
pp. 4939-4947 ◽  
Author(s):  
Heather A. Jones ◽  
Ninja Antonini ◽  
Augustinus A.M. Hart ◽  
Johannes L. Peterse ◽  
Jean-Claude Horiot ◽  
...  

Purpose To investigate the long-term impact of pathologic characteristics and an extra boost dose of 16 Gy on local relapse, for stage I and II invasive breast cancer patients treated with breast conserving therapy (BCT). Patients and Methods In the European Organisation for Research and Treatment of Cancer boost versus no boost trial, after whole breast irradiation, patients with microscopically complete excision of invasive tumor, were randomly assigned to receive or not an extra boost dose of 16 Gy. For a subset of 1,616 patients central pathology review was performed. Results The 10-year cumulative risk of local breast cancer relapse as a first event was not significantly influenced if the margin was scored negative, close or positive for invasive tumor or ductal carcinoma in situ according to central pathology review (log-rank P = .45 and P = .57, respectively). In multivariate analysis, high-grade invasive ductal carcinoma was associated with an increased risk of local relapse (P = .026; hazard ratio [HR], 1.67), as was age younger than 50 years (P < .0001; HR, 2.38). The boost dose of 16 Gy significantly reduced the local relapse rate (P = .0006; HR, 0.47). For patients younger than 50 years old and in patients with high grade invasive ductal carcinoma, the boost dose reduced the local relapse from 19.4% to 11.4% (P = .0046; HR, 0.51) and from 18.9% to 8.6% (P = .01; HR, 0.42), respectively. Conclusion Young age and high-grade invasive ductal cancer were the most important risk factors for local relapse, while margin status had no significant influence. A boost dose of 16 Gy significantly reduced the negative effects of both young age and high-grade invasive cancer.


2020 ◽  
Author(s):  
Vahid Zangouri ◽  
Hamid Nasrollahi ◽  
Ali Taheri ◽  
Majid Akrami ◽  
Peyman Arasteh ◽  
...  

Abstract Background and objective Currently no definite guideline exists on the use of intraoperative radiation therapy (IORT) among patients with early stage BC. We report our experiences with IORT among breast cancer (BC) patients in our region.Methods All patient who received radical IORT from April 2014 on to March 2020 were included in the study. Patient selection criteria were as followed: age equal or older than 45 years old; all cases of invasive carcinomas, moreover in lobular carcinomas only after MRI and confirmation, and in cases with ductal carcinoma in-situ (DCIS) only those with low, intermediate grade, tumor size of equal or less than 2.5cm and a margin of 2-3mm; those between 45 and 50 years old with a tumor size of 0-2cm, those between 50 and 55 years old with a tumor size of 2-2.5cm, and those ≥55 years old with a tumor size of 2.5-3cm; those with invasive tumors a negative margin and in cases of DCIS a margin of 3mm; a negative nodal status (exception in patients with micrometastasis); and a positive estrogen receptor status. Results Overall, 252 patients entered the study. Mean (SD) age of patients was 56.43±7.79 years. In total, 32.9% of patients had a family history of BC. Mean tumor size was 1.56±0.55 cm. Median (IQR) follow-up of patients was 24 (13, 36) months. Overall, 6 patients (2.4%) experienced recurrence in follow-up visits, among which three (1.2%) were local recurrence, two (0.8%) were regional recurrence and one patients (0.4%) had metastasis.Median (IQR) time to recurrence was 23 (13, 36) among the six patient who had recurrence. Overall, 11 patients (4.3%) with DCIS in our study received IORT. All these patients had free margins in histopathology examination. None of these patients experience recurrence.Conclusion For the first time, we categorized patients according to age and tumor size and older patients with larger tumor sizes were considered appropriate candidates for IORT. Our series showed a successful experience with the use of IORT in a region where facilities for IORT are limited using our modified criteria for patient selection.


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