scholarly journals Preoperative Assessment of Small Tumours in Women with Breast Cancer

2005 ◽  
Vol 94 (1) ◽  
pp. 15-20 ◽  
Author(s):  
B. A. Kald ◽  
P. Boiesen ◽  
K. Ronnow ◽  
P. E. Jonsson ◽  
T. Bisgaard
Keyword(s):  
Breast Cancer ◽  
Standard Deviation ◽  
Tumour Size ◽  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
Breast Conserving Surgery ◽  
Surgical Strategy ◽  
Breast Cancers ◽  
Optimal Method ◽  
Small Breast

Background and Objectives: In patients with breast cancer, planning of the surgical strategy may rely on preoperative tumour size. The optimal method for assessment of small tumours has not been established. We compared findings from preoperative mammography and ultrasonography with histopathological tumour size in patients treated with breast-conserving surgery. Material and Methods: The study was retrospective and the setting a single institution clinic with free referral of patients. The patients were examined before the operation with mammography, ultrasonography, and findings were compared with postoperative histopathological tumour size. Results: The study included 131 patients (median age was 59) years with grade I, II, and III cancers in 47, 71 and in 13 patients, respectively. The medium histological tumour size was 14 mm, range 4–45 mm. A wide 95 % confidence interval between histopathological tumour size and preoperative mammography (standard deviation 4.8 mm) and ultrasonography (standard deviation 4.8 mm) was found. The combination of mammography and ultrasonography did not improve the results (standard deviation 4.3 mm). Preoperative mammography tended to over estimate the tumour size compared with histological tumour size whereas preoperative ultrasonography tended to underestimate the tumour size. Conclusion: In this retrospective study with preoperative evaluation of small breast cancers by mammography and ultrasonography, wide 95 % confidence intervals for the methods were found and they should therefore be used with caution in the planning of the surgical strategy.

scholarly journals The Evolving Role of Ultrasound Guided Percutaneous Laser Ablation in Elderly Unresectable Breast Cancer Patients: A Feasibility Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jacopo Nori ◽  
Maninderpal Kaur Gill ◽  
Icro Meattini ◽  
Camilla Delli Paoli ◽  
Dalmar Abdulcadir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Laser Ablation ◽  
Residual Disease ◽  
Performance Status ◽  
Standard Of Care ◽  
Breast Conserving Surgery ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Small Breast

Background and Objectives. Breast-conserving surgery represents the standard of care for the treatment of small breast cancers. However, there is a population of patients who cannot undergo the standard surgical procedures due to several reasons such as age, performance status, or comorbidity. Our aim was to investigate the feasibility and safety of percutaneous US-guided laser ablation for unresectable unifocal breast cancer (BC). Methods. Between December 2012 and March 2017, 12 consecutive patients underwent percutaneous US-guided laser ablation as radical treatment of primary inoperable unifocal BC. Results. At median follow-up of 28.5 months (range 6-51), no residual disease or progression occurred; the overall success rate for complete tumor ablation was therefore 100%. No significant operative side effects were observed, with only 2 (13.3%) experiencing slight to mild pain during the procedure, and all patients complained of a mild dull aching pain in the first week after procedure. Conclusions. Laser ablation promises to be a safe and feasible approach in those patients who are not eligible to the standard surgical approach. However, longer follow-up results and larger studies are strongly needed.

scholarly journals Cancer Grade Model: a multi-gene machine learning-based risk classification for improving prognosis in breast cancer

2021 ◽  
Author(s):  
E. Amiri Souri ◽  
A. Chenoweth ◽  
A. Cheung ◽  
S. N. Karagiannis ◽  
S. Tsoka
Keyword(s):  
Breast Cancer ◽  
Machine Learning ◽  
Clinical Decision Making ◽  
Histological Grade ◽  
Tumour Size ◽  
Clinical Decision ◽  
Gene Signature ◽  
Risk Classification ◽  
Breast Cancers ◽  
Grade 3

Abstract Background Prognostic stratification of breast cancers remains a challenge to improve clinical decision making. We employ machine learning on breast cancer transcriptomics from multiple studies to link the expression of specific genes to histological grade and classify tumours into a more or less aggressive prognostic type. Materials and methods Microarray data of 5031 untreated breast tumours spanning 33 published datasets and corresponding clinical data were integrated. A machine learning model based on gradient boosted trees was trained on histological grade-1 and grade-3 samples. The resulting predictive model (Cancer Grade Model, CGM) was applied on samples of grade-2 and unknown-grade (3029) for prognostic risk classification. Results A 70-gene signature for assessing clinical risk was identified and was shown to be 90% accurate when tested on known histological-grade samples. The predictive framework was validated through survival analysis and showed robust prognostic performance. CGM was cross-referenced with existing genomic tests and demonstrated the competitive predictive power of tumour risk. Conclusions CGM is able to classify tumours into better-defined prognostic categories without employing information on tumour size, stage, or subgroups. The model offers means to improve prognosis and support the clinical decision and precision treatments, thereby potentially contributing to preventing underdiagnosis of high-risk tumours and minimising over-treatment of low-risk disease.

Shear-wave elastography contributes to accurate tumour size estimation when assessing small breast cancers

2014 ◽  
Vol 69 (12) ◽  
pp. 1259-1263 ◽  
Author(s):  
R. Mullen ◽  
J.M. Thompson ◽  
O. Moussa ◽  
S. Vinnicombe ◽  
A. Evans
Keyword(s):  
Shear Wave ◽  
Tumour Size ◽  
Shear Wave Elastography ◽  
Breast Cancers ◽  
Size Estimation ◽  
Small Breast

scholarly journals Expression of CD4, CD8 Biomarkers in Invasive Carcinoma of Breast with Clinicopathological Correlation

2021 ◽  
pp. 65-73
Author(s):  
C. Divyapriya ◽  
Aarthi Kannan ◽  
Vijayashree Raghavan
Keyword(s):  
Breast Cancer ◽  
T Lymphocytes ◽  
Invasive Breast Cancer ◽  
Triple Negative ◽  
Invasive Carcinoma ◽  
Tumour Size ◽  
Breast Cancer Subtype ◽  
Lymph Node Status ◽  
Breast Cancers ◽  
Cd8 T Lymphocytes

Introduction: Tumor infiltrating lymphocytes (TILs) are widely considered a key sign of the immune interaction between host and tumor, and potentially prognostic biomarkers of good or bad outcome in various cancers, including invasive breast cancer (IBC). Aim and Objectives: To correlate the expression of CD4, CD8 T-lymphocytes in invasive carcinoma breast with established markers of prognosis like tumour size, grade, lymph node status and molecular subtypes mainly ER, PR, Her 2Neu, Ki67 status, mainly the triple negative breast cancers(TNBC). Methodology: 58 Invasive breast carcinoma proven tissue blocks were subjected to immunohistochemistry and morphometric analysis for positive CD4, CD8 T-lymphocytes were done. Results:  Triple negative breast cancer subtype shows high TILs than other pathologic subtypes. Tumor interface CD8+ cells very well correlated with the pathological higher nodal stage. Majority CD4, CD8 positive cells were populated more towards the stromal and interface of the tumor microenvironment rather thatintratumoral. Conclusion: CD4+ and CD8+ counts may be a valuable independent prognostic tool in predicting the outcome in invasive breast cancer.

scholarly journals Difficulties of radiological diagnosis оf small breast cancers

2021 ◽  
Vol 20 (2) ◽  
pp. 49-53
Author(s):  
Т. N. Leikht ◽  
G. I. Bratnikova ◽  
Р. S. Gomina ◽  
N. S. Kosolapova ◽  
К. A. Tihaya ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Soft Tissues ◽  
Correct Diagnosis ◽  
Screening Mammography ◽  
Diagnostic Methods ◽  
Benign Tumors ◽  
Breast Cancers ◽  
Vertical Orientation ◽  
Small Breast ◽  
Ultrasound Scanner

Introduction. Breast cancer in the structure of malignancies in women takes the 1st place. There has been an annual increase in morbidity, including due to improvements in diagnostic interventions and screening. Mammography and ultrasound of the breasts is mandatory when diagnosing breast cancer. The difficulties of diagnosis are revealed in small tumors.Methods. Breast ultrasounds were performed on the ultrasound machines of the expert class TOSHIBA APLIO 500, PHILIPS EPIQ 5 and PHILIPS EPIQ 7. Mammography and tomosynthesis were performed on mammogram MAMMOMAT INSPITATION PRIME. Core-biopsia under ultrasound control was carried out on the Logiq9 ultrasound scanner. Eighty women were selected with suspected cancer after breast core-biopsy with the category BI-RADS 3, 4 and 5. The size of the node according to ultrasound data was 6-10 mm.Results. According to core-biopsia has been identified cancer, histologically and immunohystochemically confirmed in 50 cases. In 30 women benign tumors were identified. The most informative mammograms of breast cancer were high tumor density, ray of radiibility and local deformity of soft tissues. Among the characteristic ultrasonic signs of the cancer more often noted vertical orientation, reduced echogenicity, uneven contour, other signs were not so character for the cancer.Conclusion. You can't focus on a separate sign of education! Only a combination of traits, different diagnostic methods contribute to the correct diagnosis.

scholarly journals Association between underestimation of tumour size by imaging and incomplete excision in breast-conserving surgery for breast cancer

2016 ◽  
Vol 103 (7) ◽  
pp. 830-838 ◽  
Author(s):  
J. M. Dixon ◽  
C. Newlands ◽  
C. Dodds ◽  
J. Thomas ◽  
L. J. Williams ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumour Size ◽  
Breast Conserving Surgery ◽  
Incomplete Excision

scholarly journals Surgical considerations for breast-conserving therapy in patients undergoing neoadjuvant chemotherapy for early-stage breast cancer

2005 ◽  
Vol 8 (2) ◽  
Author(s):  
G. V. Babiera
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Systemic Therapy ◽  
Early Stage ◽  
Preoperative Evaluation ◽  
Breast Conserving Surgery ◽  
Breast Conserving Therapy ◽  
Early Stage Breast Cancer ◽  
Optimal Outcomes ◽  
Adjuvant Surgery

According to the National Cancer Comprehensive Network guidelines patients with breast tumours ≤1 cm should be offered systemic therapy. Multiple studies, however, have demonstrated no survival advantage between giving chemotherapy before (neoadjuvant) or after (adjuvant) surgery. There are, however, certain benefits that can be derived from patients who undergo neoadjuvant chemotherapy. Such benefits include better stratification of the patient's prognosis based on tumour and nodal response, and converting patients from mastectomy-only candidates to breast-conserving surgery candidates. Due to these advantages, many patients with early-stage breast cancer will undergo neoadjuvant chemotherapy and the surgical issues must be considered for patients who are treated in such a manner to guarantee optimal outcomes. Issues that will be discussed are the surgical preoperative evaluation, extent and timing of local resection of both the breast and regional nodes and finally, the potential future effects of this multi-modality therapy.

Ten-Year Multi-Institutional Results of Breast-Conserving Surgery and Radiotherapy in BRCA1/2-Associated Stage I/II Breast Cancer

2006 ◽  
Vol 24 (16) ◽  
pp. 2437-2443 ◽  
Author(s):  
Lori J. Pierce ◽  
Albert M. Levin ◽  
Timothy R. Rebbeck ◽  
Merav A. Ben-David ◽  
Eitan Friedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conservation ◽  
Breast Conserving Surgery ◽  
Breast Conservation Surgery ◽  
Breast Cancers ◽  
Mutation Status ◽  
High Risk Women ◽  
Mutation Carriers ◽  
Significant Difference

Purpose We compared the outcome of breast-conserving surgery and radiotherapy in BRCA1/2 mutation carriers with breast cancer versus that of matched sporadic controls. Methods A total of 160 BRCA1/2 mutation carriers with breast cancer were matched with 445 controls with sporadic breast cancer. Primary end points were rates of in-breast tumor recurrence (IBTR) and contralateral breast cancers (CBCs). Median follow-up was 7.9 years for mutation carriers and 6.7 years for controls. Results There was no significant difference in IBTR overall between carriers and controls; 10- and 15-year estimates were 12% and 24% for carriers and 9% and 17% for controls, respectively (hazard ratio [HR], 1.37; P = .19). Multivariate analyses for IBTR found BRCA1/2 mutation status to be an independent predictor of IBTR when carriers who had undergone oophorectomy were removed from analysis (HR, 1.99; P = .04); the incidence of IBTR in carriers who had undergone oophorectomy was not significantly different from that in sporadic controls (P = .37). CBCs were significantly greater in carriers versus controls, with 10- and 15-year estimates of 26% and 39% for carriers and 3% and 7% for controls, respectively (HR, 10.43; P < .0001). Tamoxifen use significantly reduced risk of CBCs in mutation carriers (HR, 0.31; P = .05). Conclusion IBTR risk at 10 years is similar in BRCA1/2 carriers treated with breast conservation surgery who undergo oophorectomy versus sporadic controls. As expected, CBCs are significantly increased in carriers. Although the incidence of CBCs was significantly reduced in mutation carriers who received tamoxifen, this rate remained significantly greater than in controls. Additional strategies are needed to reduce contralateral cancers in these high-risk women.

scholarly journals Prevalence of Breast Cancer Intrinsic Subtypes and Its Association with Clinico-Pathological Feature

2018 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Breast Cancer ◽  
Statistical Significance ◽  
Tumour Size ◽  
Response To Therapy ◽  
Pathological Feature ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Intrinsic Subtypes ◽  
Molecular Features ◽  
Significant Difference

Breast cancer is the commonest cancer in women worldwide and represents a highly heterogeneous group of tumours particularly in terms of molecular features, prognosis and response to therapy. Breast cancer molecular classification can predict the prognosis of breast cancer in terms of recurrence and help and guide us regarding the treatment decision about systemic therapy. Breast carcinomas may be stratified into subtypes similar to those defined by Gene expression profiling using a panel of immune-histochemical (IHC) markers. Routine IHC evaluations of breast cancers may, therefore, provide a reasonable alternative to costly genetic assays especially in under-resourced healthcare systems. The purpose of this study is to investigate the prevalence of molecular subtypes and correlate it to clinic-pathological features. Methods: From 2005 to 2017 total of 4847 Breast cancer patients, in whom complete information was available to classify them into luminal subtypes were retrieved and classified into intrinsic subtypes and patients information in each type was collected about age, tumour size, stage, grade and nodal status. Results: In luminal classification, a highly significant difference was found in mean age (p<0.001) tumour size (p<0.001), grade, metastasis and Ki67. The statistical significance of Her 2 positive and triple negative was found with stage, grade, metastasis and Ki67. Conclusions: IHC assignment into Luminal subtypes is clinically informative in our patients and routinely using this in our practice could identify patients that may need a more aggressive treatment to reduce the likelihood of recurrences.

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