Secondary Angiosarcoma With C-MYC Amplification Following Prophylactic Bilateral Mastectomy and Autologous Breast Reconstruction: Report of a Case and Review of the Literature

The germline carrier of the BRCA1 pathogenic mutation has been well proven to confer an increased risk of breast and ovarian cancer. Despite BRCA1 biallelic pathogenic mutations being extremely rare, they have been reported to be embryonically lethal or to cause Fanconi anemia (FA). Here we describe a patient who was a 48-year-old female identified with biallelic pathogenic mutations of the BRCA1 gene, with no or very subtle FA-features. She was diagnosed with ovarian cancer and breast cancer at the ages of 43 and 44 and had a strong family history of breast and gynecological cancers.

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Abstract 16083: Risk of Preserved versus Reduced Ejection Fraction in Women With and Without History of Breast Cancer: The Pathways Heart Study

Circulation ◽

10.1161/circ.142.suppl_3.16083 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Jamal S Rana ◽

Heather Greenlee ◽

Richard Cheng ◽

Cecile A Laurent ◽

Hanjie Shen ◽

...

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Ejection Fraction ◽

Endocrine Therapy ◽

White Women ◽

Cox Regression ◽

Prior History ◽

Reduced Ejection Fraction ◽

Increased Risk ◽

History Of

Introduction: Incidence of heart failure (HF), specifically with preserved ejection fraction (HFpEF), is rising in the general population, yet is understudied. To provide a population-based estimate of HF in breast cancer (BC) survivors, we compared risk of HF in women with and without BC history in the Kaiser Permanente Northern California (KPNC) integrated health system. Methods: Data were extracted from KPNC electronic health records. All invasive BC cases diagnosed from 2005-2013 were identified and matched 1:5 with non-BC controls on birth year, race/ethnicity, and KPNC membership at BC diagnosis. Cox regression models assessed the hazard of HF by EF status: HFpEF (EF ≥ 45%), HF with reduced EF (HFrEF; EF < 45%), and unknown EF. Women with prior history of HF were excluded. Models were adjusted for factors known to affect BC risk or CVD and for prevalent CVD at BC diagnosis. We also examined case subgroups who received cardiotoxic chemotherapy, left-sided radiation therapy, and/or endocrine therapy, versus their controls. Results: A total of 14,804 women diagnosed with invasive BC and with no history of HF were identified and matched to 74,034 women without BC history. Women were on average 61 years at BC diagnosis and 65% white. Women with HFpEF were older and more likely to have hypertension (p<0.05). Among all cases vs. controls, there was increased risk of HFrEF (HR: 1.5, 95% CI: 1.18, 1.98) but not HFpEF or unknown EF (figure). Compared to their controls, women treated with chemotherapy were more than 3-times likely to develop HFrEF (HR: 3.26, 95% CI: 2.2, 4.8) and more than 1.5-times likely to develop HFpEF (HR=1.61, 95% CI: 1.15, 2.24). Women who received left-sided radiation therapy had nearly double the risk of developing HFrEF (HR=1.85, 95% CI: 1.20, 2.84). No associations were found among women who received endocrine therapy. Conclusions: Increased surveillance is warranted for women with BC receiving cardiotoxic chemotherapy for development of both HFrEF and HFpEF.

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A survival comparison between women with uterine serous and/or clear cell carcinoma with and without a history of breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.5580 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 5580-5580

Author(s):

A. Mendivil ◽

T. J. Vogel ◽

V. L. Bae-Jump ◽

P. A. Gehrig

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Cancer Diagnosis ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Uterine Cancer ◽

Breast Cancer Diagnosis ◽

Prior History ◽

Type Ii ◽

History Of

5580 Background: The association between breast and uterine is well known. However, the effect that a prior breast cancer diagnosis may have on women with a new endometrial cancer diagnosis is less well described. The goal of our study was to determine the effect that a prior history of breast cancer would have on the outcome for women with type II uterine cancer. Methods: After obtaining IRB exemption, a retrospective chart review was performed. All women treated for uterine carcinoma between 1994 and 2007 were identified and we identified women with either uterine serous (UPSC) or clear cell carcinoma (UCCC) as the study group. The patients were then divided between those with and those without a prior breast cancer diagnosis. Patient demographics, cancer histologies, and stage of disease data were collected. Fisher's exact test and unpaired t test were used as appropriate. Progression-free (PFS) and overall survival (OS) were calculated using the Kaplan Meier method. Results: Approximately 1,083 patients were treated for uterine carcinoma during the study period of which 74 had pre-existing breast carcinoma (6.9%). One hundred and fifty women had USC and/or UCCC (13.8%) of whom 23 also had pre-existing breast carcinoma (13.3%). The women with breast cancer where older at the time of their uterine cancer diagnosis (77 y.o.) compared to those without breast cancer (68 y.o.) (p = 0.0089); were more likely to develop USC/UCCC (OR 2.56; 95% CI 1.47–4.44); and were more likely to be white compared to black (OR 4.6; 95% CI 1.74–11.99). At five years, there was no significant difference in PFS or OS between those women with and without a prior history of breast cancer. Conclusions: Women with a history of breast cancer have more the twice the likelihood of developing USC and/or UCCC. While having two primary malignancies can be devastating, our study indicated that women who developed a type II uterine cancer and also had a history of a prior breast cancer had the same outcomes as those women without a prior cancer diagnosis. This finding may help to allay patients’ fears about developing another malignancy and its impact on their prognosis. No significant financial relationships to disclose.

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Pleomorphic lobular carcinoma in situ: A distinct entity of controversial significance.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.177 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 177-177

Author(s):

Marina De Brot ◽

Shirin Muhsen ◽

Victor P. Andrade ◽

Starr Koslow Mautner ◽

Melissa Murray ◽

...

Keyword(s):

Breast Cancer ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Lobular Carcinoma ◽

Previous History ◽

Prior History ◽

Lobular Carcinoma In Situ ◽

Pleomorphic Lobular Carcinoma ◽

History Of

177 Background: Pleomorphic lobular carcinoma in situ (PLCIS) is an increasingly diagnosed variant of lobular carcinoma in situ. Histologically, it resembles ductal carcinoma in situ (DCIS), leading to controversy over proper management. Yet, the natural history of PLCIS is unknown. Here we describe our experience with PLCIS. Methods: Review of pathology reports (1995–2012) identified 233 cases of LCIS variants. Patients with synchronous ipsilateral DCIS or invasive cancer (IC) were excluded leaving 25 cases for review. Consensus review by 3 pathologists further excluded 7; leaving 18 cases, 12 of which were classified as PLCIS and 6 as LCIS with pleomorphic features (LCIS-PF). (Table) PLCIS was defined by cellular dyshesion, nuclear pleomorphism with a 2-3 fold size variation, conspicuous nucleoli, mitoses and abundant cytoplasm; lesions not meeting all parameters were classified as LCIS-PF. Loss of e-cadherin was confirmed; clinical data were obtained from medical records. Results: Mean patient age at diagnosis of PLCIS/LCIS-PF was 57 yrs (42-67 yrs). All cases presented with imaging abnormalities. A previous history of breast cancer was present in 7/18 (39%) pts (3/7, ipsilateral; 4/7, contralateral). Following PLCIS/LCIS-PF diagnosis, 6/18 (33%) pts underwent mastectomy and 12/18 had excision alone, with (n=3) or without chemoprevention (n=9). Margin status was negative in 4/12 pts; close in 3/12 pts and positive in 5/12 pts undergoing excision. At a median follow-up of 27 mos (2-148 mos), 2/12 pts treated with excision developed ipsilateral breast cancer (1 DCIS; 1 IC). Both had close margins at initial excision; median time to cancer, 54 mos. Conclusions: Pure PLCIS is an uncommon lesion. Synchronous malignancy or prior history of breast cancer are often present in patients with PLCIS, contributing to the difficulty in determining the actual risk conferred by this lesion and appropriate management. Efforts to systematically characterize LCIS variants and prospective documentation of outcomes are needed to clarify the significance of these lesions. [Table: see text]

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EFFECT OF MANUAL LYMPHATIC DRAINAGE AND EXERCISES IN POST-MASTECTOMY PATIENTS

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.3.1/008 ◽

2014 ◽

Vol 3 (1) ◽

pp. 22-25

Author(s):

Syed Abid Mehdi Kazmi ◽

Nabiha Ahmed ◽

Sangeeta Aujha

Keyword(s):

Breast Cancer ◽

Isometric Exercise ◽

Exercise Program ◽

Lymphatic Drainage ◽

Intermittent Pneumatic Compression ◽

Manual Lymphatic Drainage ◽

Pressure Therapy ◽

Arm Lymphedema ◽

History Of ◽

Fluid Formation

In present world lymphedema is one of the side effects of mastectomy. When we talk about the treatment of lymphedema the standard treatment which comes into our mind is, complex decongestive physiotherapy (CDP). This treatment includes MLD (manual lymphatic drainage), short stretch bandaging, exercises program and also care of skin of the pectoral region and the surroundings as well as pneumatic compression (intermittent). Patient came with unilateral stage l lymphedema with a history of mastectomy. To treat the patient we used MLD, intermittent pneumatic compression and exercises. In the treatment of lymphedema manual lymphatic drainage is performed (MLD). The purpose of performing MLD was to find out the effectiveness in treating breast cancer related lymphedema and also prevent fluid formation in subcutaneous tissues. METHOD We gave the 12-session of manual lymphatic drainage and exercise in every month. RESULT AND CONCLUSION Showing that therapy created has an excellent effect. The lymphedema reduced day by day and It could also be the options to do isometric exercise program instead of performing short stretch bandaging. It is also considered as another option to treat individuals who are contraindicated for pressure therapy. When treating breast cancer you may come across the arm lymphedema. Quality of life may get affected and may also impact long term recovery and survivorship. Early treatment and preventions always plays a significant role in minimizing the complications.

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Age-dependent Characteristics in Women with Breast Cancer: Mastectomy and Reconstructive Trends at an Urban Academic Institution

The American Surgeon ◽

10.1177/000313481608200316 ◽

2016 ◽

Vol 82 (3) ◽

pp. 227-235 ◽

Cited By ~ 5

Author(s):

Katherine A. Rodby ◽

Emilie Robinson ◽

Kirstie K. Danielson ◽

Karina P. Quinn ◽

Anuja K. Antony

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Academic Institution ◽

Bilateral Mastectomy ◽

Autologous Reconstruction ◽

Age Related ◽

Younger Age ◽

Age Dependent ◽

Statistical Trends ◽

Oncologic Treatment

Breast reconstruction is an important aspect of treatment after breast cancer. Postmastectomy reconstruction bears a significant impact on a woman's postsurgical confidence, sexuality, and overall well-being. Previous studies have inferred that women under age 40 years have unique characteristics that distinguish them from an older cohort. Identifying age-dependent trends will assist with counseling women on mastectomy and reconstruction. To identify age-dependent trends, 100 consecutive women were sampled from a prospectively maintained breast reconstruction database at an urban academic institution from June 2010 through June 2013. Women were placed into two cohorts <40 and ≥40 as well cohorts by decade (20s, 30s, 40s, 50s, and 60s). Statistical trends were reported as odds of risk per year of increasing age using logistic regression; linear regression, χ2, and Fischer's exact were used to compare <40 and ≥40 and split cohorts for comparison. Comorbidities, tumor staging, oncologic treatment including chemotherapy and radiation, disease characteristics and genetics, and mastectomy, reconstructive and symmetry procedures were evaluated. Statistical analysis was performed using SAS software. In 100 patients of the sample study cohort, 151 reconstructions were performed. Increasing age was associated with one or more comorbidities [odds ratio (OR) = 1.07, P = 0.005], whereas younger age was associated with metastatic disease (OR = 0.88, P = 0.006), chemotherapy (OR = 0.94, P = 0.01), and radiation (OR = 0.94, P = 0.006); split cohorts demonstrated similar trends ( P < 0.005). Mastectomy and reconstructive characteristics associated with younger age included bilateral mastectomy (OR = 0.94, P = 0.004), tissue expander (versus autologous flap) (OR = 0.94, P = 0.009), extra high implant type (OR = 0.94, P = 0.049), whereas increasing use of autologous flaps and contralateral mastopexy symmetry procedures (OR = 1.09, P = 0.02) were associated with an aging cohort. Increasing age was not associated with an increasing likelihood of complications ( P = 0.75). Age-related factors play a role in the treatment of patients with breast cancer. Younger women typically present with more aggressive features requiring oncologic treatment including chemotherapy and radiation. Mastectomy and reconstructive choices also demonstrate age-dependent characteristics. Women in younger age groups are more likely to pursue risk-reduction procedures and implant-based strategies, whereas older women had a higher propensity for abdominal-based autologous reconstruction. In addition, preferential reconstructive strategies correlate with age-dependent archetypical features of the breast (higher profile implants in younger patients; autologous reconstruction on affected side mimicking natural ptosis, and contralateral mastopexy in older patients). These trends seem to be consistent with each increasing year of age. Age-related preferences and expectations, age-dependent body habitus and breast shape, and lifetime risk play a role in the choices pursued for mastectomy and reconstruction.

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Rapid Response of Breast Cancer Cutaneous Metastasis to Single-Agent Palbociclib: A Case Report

Chemotherapy ◽

10.1159/000512499 ◽

2021 ◽

pp. 1-3

Author(s):

Sami Droubi ◽

Anum Aqsa ◽

Maryam Rehan ◽

Meekoo Dhar

Keyword(s):

Breast Cancer ◽

Cancer Progression ◽

Histopathological Examination ◽

Single Agent ◽

Metastatic Breast ◽

Radical Mastectomy ◽

Cutaneous Metastasis ◽

Breast Adenocarcinoma ◽

Prior History ◽

History Of

Palbociclib is a cyclin-dependent kinase (CDK) 4/6 inhibitor. Palbociclib combined with endocrine therapy has shown promising results in hormone-receptor-positive (HR+) and human epidermal growth factor receptor-negative (HER-2−) breast cancer progression. We present a case of a woman with a history of infiltrating lobular cancer of the left breast, status post modified radical mastectomy 6 years prior, presenting with nodular erythematous lesions on the left arm and back. Histopathological examination confirmed the diagnosis of recurrent metastatic breast adenocarcinoma. She had complete resolution of cutaneous metastasis with 1 cycle of Palbociclib. We believe our case is unique as the resolution of cutaneous metastasis with 1 cycle of single-agent Palbociclib is rare. Furthermore, it highlights the importance of considering cutaneous metastasis as a possibility in patients with prior history of primary internal malignancy.

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BRCA1 gene expression in relation to prognostic parameters of breast cancer

Oncology Reviews ◽

10.4081/oncol.2011.149 ◽

2011 ◽

Vol 5 (3) ◽

pp. 149

Author(s):

Manal Kamal ◽

Yasser H. Shaaban ◽

Mohamed Shehata ◽

Amr T. El-Kashif ◽

Emmad E. Habib ◽

...

Keyword(s):

Breast Cancer ◽

Mrna Expression ◽

Histological Grade ◽

Positive Family History ◽

Rna Extraction ◽

Brca1 Gene ◽

Histological Type ◽

Control Group ◽

Brca1 Mrna ◽

History Of

The tumor suppressor gene, BRCA1 has been conferred to increase the susceptibility to breast cancer in younger women. This work studied the expression of BRCA1 (mRNA) in women with breast cancer in relation to other prognostic parameters such as histological type and grade of cancer, hormone receptor status, human epidermal growth factor receptor 2 (HER2/neu) and CA15-3. Thirty patients with positive family history of breast cancer and a control group of 20 healthy subjects were also included for the study. Ribonucleic acid (RNA) extraction from breast cancer tissues was done (considered suitable for RNA extraction if 70% or more of the tissue section contained tumor) and was followed by real-time reverse transcription polymerase chain reaction. BRCA1 expression was assessed and correlated with age, histological type and grade of breast cancer, estrogen and progesterone receptor (ER, PR) status, HER2/neu expression and CA15-3 levels. The mean age of patients was 54.8 ± 10.49 years. Of the 30 breast cancer cases studied, the majority (77%) was of high histological grade and the most common histological type was infiltrating ductal carcinoma (20 cases). ER expression was positive in 53.3% of breast cancers, while PR expression was positive in 50% of cancers. BRCA1 mRNA was found in 6 patient samples (20% of the breast cancer patients) while the remaining 24 patients (80%) showed negative BRCA1 mRNA expression as well as the control group. A positive significant relationship was demonstrated between BRCA1 (mRNA) expression and high histological grade, negative estrogen and progesterone receptor status, and high levels of serum CA15-3. A significant negative correlation was found between BRCA1 mRNA expression and age (r = −0.683; p < 0.01). The study demonstrated lack of BRCA1 gene expression (mRNA) in the majority of breast cancer cases and confirmed the relationship between BRCA1 expression and parameters that determine poor prognosis in breast cancer. The results suggested that BRCA1 is seen in high-risk women known with positive family history of breast cancer.

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BRCA1 gene expression in relation to prognostic parameters of breast cancer

Oncology Reviews ◽

10.4081/oncol.2011.29 ◽

2011 ◽

pp. 149-155

Author(s):

Manal Kamal ◽

Yasser H. Shaaban ◽

Mohamed Shehata ◽

Amr T. El-Kashif ◽

Emmad E. Habib ◽

...

Keyword(s):

Breast Cancer ◽

Mrna Expression ◽

Histological Grade ◽

Positive Family History ◽

Rna Extraction ◽

Brca1 Gene ◽

Histological Type ◽

Control Group ◽

Brca1 Mrna ◽

History Of

The tumor suppressor gene, BRCA1 has been conferred to increase the susceptibility to breast cancer in younger women. This work studied the expression of BRCA1 (mRNA) in women with breast cancer in relation to other prognostic parameters such as histological type and grade of cancer, hormone receptor status, human epidermal growth factor receptor 2 (HER2/neu) and CA15-3. Thirty patients with positive family history of breast cancer and a control group of 20 healthy subjects were also included for the study. Ribonucleic acid (RNA) extraction from breast cancer tissues was done (considered suitable for RNA extraction if 70% or more of the tissue section contained tumor) and was followed by real-time reverse transcription polymerase chain reaction. BRCA1 expression was assessed and correlated with age, histological type and grade of breast cancer, estrogen and progesterone receptor (ER, PR) status, HER2/neu expression and CA15-3 levels. The mean age of patients was 54.8 ± 10.49 years. Of the 30 breast cancer cases studied, the majority (77%) was of high histological grade and the most common histological type was infiltrating ductal carcinoma (20 cases). ER expression was positive in 53.3% of breast cancers, while PR expression was positive in 50% of cancers. BRCA1 mRNA was found in 6 patient samples (20% of the breast cancer patients) while the remaining 24 patients (80%) showed negative BRCA1 mRNA expression as well as the control group. A positive significant relationship was demonstrated between BRCA1 (mRNA) expression and high histological grade, negative estrogen and progesterone receptor status, and high levels of serum CA15-3. A significant negative correlation was found between BRCA1 mRNA expression and age (r = −0.683; p < 0.01). The study demonstrated lack of BRCA1 gene expression (mRNA) in the majority of breast cancer cases and confirmed the relationship between BRCA1 expression and parameters that determine poor prognosis in breast cancer. The results suggested that BRCA1 is seen in high-risk women known with positive family history of breast cancer.

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