Ductal lavage (DL) of affected and unaffected breasts in women with newly diagnosed breast cancer: Can this technique be used for risk assessment?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 1024-1024
Author(s):  
M. E. Wood ◽  
M. Stanley ◽  
G. Leiman
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Sentinel Node ◽  
Bilateral Breast Cancer ◽  
Ductal Lavage ◽  
Newly Diagnosed ◽  
Nipple Aspiration ◽  
Increased Risk ◽  
Two Samples ◽  
Definitive Surgery

1024 Background: Ductal lavage (DL) is designed to obtain cellular material from breast ducts. The use of DL in risk assessment is under investigation. The aim of this study was to evaluate cytologic findings in DL of affected and unaffected breasts in women undergoing definitive surgery for breast cancer. Methods: Women with newly diagnosed breast cancer participated prior to surgery. Women with prior breast cancer or receiving neoadjuvant therapy were excluded. The study was IRB approved; all women gave written informed consent. Women underwent nipple aspiration followed by ductal lavage of fluid-producing ducts for both the affected and unaffected breast in the operating room prior to surgery. Cytology was interpreted as insufficient cells to make a diagnosis (ICMD), benign, mildly or markedly atypical, or malignant. Results: Twenty-three women aged 32–74 years underwent nipple aspiration of both breasts prior to definitive surgery; 1 had bilateral breast cancer. One woman had DCIS, 1 T1a, 3 T1b, 9 T1c, 6 T2, and 4 T3 lesions. Node status was N0 in 13, N1mic in 3, N1 in 5 and N2 in 3 (15 underwent sentinel node evaluation). Five women produced no NAF and therefore did not undergo DL; 18 underwent DL of at least one breast. Cytology samples were available for 30 breasts, 16 affected and 14 unaffected. Two samples contained malignant cells (one from a patient with pre-existing malignant nipple discharge), 3 moderate atypia, all from affected breasts. Benign cytology was found in 20 samples (8 affected breasts) and ICMD was classified in 5 samples (3 affected breasts). Age (</> 50), tumor size, nodal status, or sentinel node procedure were not associated with NAF production, success or cytology of DL. Conclusion: These findings suggest that DL is not effective in identifying known breast cancer. It brings into question its ability to identify women at increased risk. Future research should focus on molecular markers of risk or other means of tissue retrieval. No significant financial relationships to disclose.

Detection of Malignant lesion in Contralateral Breast in Newly Diagnosed Patients of Unilateral Carcinoma Breast on MRI

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Ghazala Wahid ◽  
Naila Tamkeen ◽  
Anjum Naz ◽  
Maimoona Afsar ◽  
Amina Ashraf ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Examination ◽  
Bilateral Breast Cancer ◽  
Malignant Lesion ◽  
Contralateral Breast ◽  
Radiology Department ◽  
Newly Diagnosed ◽  
Unilateral Breast Cancer ◽  
Carcinoma Breast ◽  
Increased Risk

Background: Women having unilateral breast cancer have added risk of contralateral breast cancer with an incidence of 1-5% synchronous cancer. There is also increased risk of metachronous cancer in contralateral breast . Female patients with bilateral breast cancer have grave prognosis in comparison to those with unilateral breast cancer. MRI breast is used to assess the multifocality and multicentricity of tumour. Objective: To determine the diagnostic performance of MRI in detecting malignant lesion in contralateral breast in newly diagnosed patients of unilateral carcinoma breast.Material and Methods: In this study total 150 newly diagnosed patients of unilateral breast cancer with normal mammographic and clinical examination of other breast were included. Study was conducted in Radiology department, Hayatabad Medical Complex Peshawar from Jan 2017 to March 2020. MRI scan of normal breast was done on a 1.5 Tesla magnet with multi-channel breast coil. For evaluating the breast lesions, administration of IV contrast and high spatial resolution is necessary .The malignant lesions of breast found on MRI were confirmed histo-pathologically. Results: In 5 out of total 150 women included in study, MRI detected occult breast cancer in the opposite breast in whom clinical examination and mammography was normal (3.3%). 18 women (12.5 %) out of total 150 with positive findings on MRI underwent biopsy, and 5 specimens turned out to be carcinoma (27%). Conclusion: MRI is very useful and helpful to detect occult malignancy in opposite breast which are not detected clinically or by mammography at the time of the initial diagnosis of carcinoma breast.

scholarly journals Successful oxytocin-assisted nipple aspiration in women at increased risk for breast cancer

2010 ◽  
Vol 9 (3) ◽  
pp. 321-325 ◽  
Author(s):  
Karijn P. M. Suijkerbuijk ◽  
Elsken van der Wall ◽  
Helen Meijrink ◽  
Xiaojuan Pan ◽  
Inne H. M. Borel Rinkes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nipple Aspiration ◽  
Increased Risk

scholarly journals Cowden Syndrome Diagnosed by Bilateral Breast Cancer with Lhermitte-Duclos Disease: A Case Report

2020 ◽  
Vol 13 (1) ◽  
pp. 419-423
Author(s):  
Tamami Morisaki ◽  
Shinichiro Kashiwagi ◽  
Rika Kouhashi ◽  
Akimichi Yabumoto ◽  
Yuka Asano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Relevant Literature ◽  
Bilateral Breast Cancer ◽  
Cowden Syndrome ◽  
Thyroid Tumor ◽  
Cerebellar Hemisphere ◽  
Bilateral Mastectomy ◽  
Pten Gene ◽  
Early Detection Of Disease ◽  
Increased Risk

Cowden syndrome is extremely rare and is characterized by multiple hamartomas in various tissues, including the skin, mucous membranes, gastrointestinal tract, breast, thyroid, and brain, and has an increased risk of breast, thyroid, and uterine cancers. Here, we report a case of Cowden syndrome diagnosed following presentation with bilateral breast cancer and provide a discussion of the relevant literature. A 47-year-old woman with a tumor in her right breast was referred to our hospital. She was diagnosed with bilateral breast cancer upon imaging and underwent a bilateral mastectomy and sentinel lymph node biopsy. Previously, she had undergone total thyroidectomy to treat a thyroid tumor. Approximately 3 years later, she was diagnosed with Lhermitte-Duclos disease affecting her left cerebellar hemisphere. As her sister and mother had also been diagnosed with breast cancer, we suspected that she might have an inherited disease. Since 80% of individuals with Cowden syndrome have a mutation in the phosphatase and tension homolog (PTEN) gene, we did not perform any genetic testing. Instead, we used the syndrome’s pathognomonic criteria and major criteria (breast cancer, thyroid tumor, and Lhermitte-Duclos disease) to diagnose our patient with Cowden syndrome. While treatment of Cowden syndrome is currently limited to strategies that can manage the symptoms, patients are at an increased risk of certain cancers and require regular screening to allow for early detection of disease.

scholarly journals Detection of Germline Mutations in a Cohort of 139 Patients with Bilateral Breast Cancer by Multi-Gene Panel Testing: Impact of Pathogenic Variants in Other Genes beyond BRCA1/2

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2415 ◽  
Author(s):  
Daniele Fanale ◽  
Lorena Incorvaia ◽  
Clarissa Filorizzo ◽  
Marco Bono ◽  
Alessia Fiorino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Susceptibility ◽  
Bilateral Breast Cancer ◽  
Significant Proportion ◽  
Susceptibility Genes ◽  
Gene Panel ◽  
Panel Testing ◽  
Cancer Susceptibility Genes ◽  
Gene Panel Testing ◽  
Increased Risk

Patients with unilateral breast cancer (UBC) have an increased risk of developing bilateral breast cancer (BBC). The annual risk of contralateral BC is about 0.5%, but increases by up to 3% in BRCA1 or BRCA2 pathogenic variant (PV) carriers. Our study was aimed to evaluate whether all BBC patients should be offered multi-gene panel testing, regardless their cancer family history and age at diagnosis. We retrospectively collected all clinical information of 139 BBC patients genetically tested for germline PVs in different cancer susceptibility genes by NGS-based multi-gene panel testing. Our investigation revealed that 52 (37.4%) out of 139 BBC patients harbored germline PVs in high- and intermediate-penetrance breast cancer (BC) susceptibility genes including BRCA1, BRCA2, PTEN, PALB2, CHEK2, ATM, RAD51C. Nineteen out of 53 positively tested patients harbored a PV in a known BC susceptibility gene (no-BRCA). Interestingly, in the absence of an analysis performed via multi-gene panel, a significant proportion (14.4%) of PVs would have been lost. Therefore, offering a NGS-based multi-gene panel testing to all BBC patients may significantly increase the detection rates of germline PVs in other cancer susceptibility genes beyond BRCA1/2, avoiding underestimation of the number of individuals affected by a hereditary tumor syndrome.

Barriers to breast cancer risk screening

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1505-1505
Author(s):  
A. Zwaagstra ◽  
K. Hoskins
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Practice Nurse ◽  
Assessment Tool ◽  
Advanced Practice ◽  
Advanced Practice Nurse ◽  
Risk Screening ◽  
Increased Risk

1505 Background: The U. S. Preventive Services Task Force has recommended that physicians assess and discuss breast cancer risk with their female patients. With this recommendation comes the need to develop strategies for providing breast cancer risk-screening and a need to identify potential barriers to the successful implementation of a risk-screening strategy. Methods: A personalized breast cancer risk profile was offered to all women presenting for a screening mammogram at a community hospital. The profile included a Gail model estimate and analysis of family cancer history to detect hereditary breast cancer syndromes utilizing a pedigree assessment tool developed by the authors. Women with 5 year Gail estimates ≥ 1.66%, lifetime Gail estimate ≥ 15% or increased score with the pedigree assessment tool were considered at increased breast cancer risk. Women in the increased risk cohort received written notification of their risk status and were advised to undergo formal risk assessment either through a free consultation with an advanced practice nurse with expertise in cancer risk assessment or with their primary physician. We analyzed compliance with this recommendation over the 6 month period of time after subjects received the risk notification letter. Results: For the three month study period, 242 women met criteria for the increased risk cohort. Of these, 201 (83%) failed to follow through with the advanced practice nurse for formal risk assessment. Surveys were mailed to all 201 non-compliant subjects to identify reasons for non-compliance and 80 surveys were returned (40%). Reasons given for failure to follow- through with formal risk assessment included: self-perception of “average” breast cancer risk (75%), recent normal screening mammogram (55%), primary care physician had not referred them (18%), absence of breast symptoms (15%), and time constraints (15%). Only 11 subjects (14%) indicated that they had discussed risk results with their physician. Conclusions: The majority of women in our study who requested breast cancer risk estimates failed to act on that information. These results could have implications for design and implementation of a successful breast cancer risk-screening program, and point to the need for better patient education and involvement of primary care physicians in the risk assessment process. No significant financial relationships to disclose.

Identification of Biomarkers for Breast Cancer in Nipple Aspiration and Ductal Lavage Fluid

2005 ◽  
Vol 11 (23) ◽  
pp. 8312-8320 ◽  
Author(s):  
Jinong Li ◽  
Jing Zhao ◽  
Xiaodong Yu ◽  
Julie Lange ◽  
Henry Kuerer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lavage Fluid ◽  
Ductal Lavage ◽  
Nipple Aspiration
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