scholarly journals Breast cancer abutting the pectoralis major muscle on breast MRI: what are the clinical implications?

2021 ◽  
pp. 20201202
Author(s):  
Kelly S Myers ◽  
Erica Stern ◽  
Emily B Ambinder ◽  
Eniola T Oluyemi
Keyword(s):  
Breast Cancer ◽  
Clinical Outcomes ◽  
Pectoralis Major Muscle ◽  
Pectoralis Major ◽  
Imaging Feature ◽  
Clinical Implications ◽  
Imaging Features ◽  
Pectoralis Muscle ◽  
Breast Cancers ◽  
Muscle Invasion

Objectives: Defining the posterior extent of breast cancer prior to surgery has clinical implications. However, there are limited data available to guide the interpretation of breast cancers seen on MRI that abut the pectoralis muscle but lack associated muscle enhancement. Methods: In this retrospective study of breast MRIs performed between May 2008 and July 2019, 43 female patients demonstrated breast cancers abutting the pectoralis muscle without enhancement of the muscle itself. Imaging features of the cancers as well as pathologic and clinical outcomes were recorded. Statistical analyses of associations between imaging findings and clinical outcomes were performed using Fisher’s exact test, logistic regression, a Mann–Whitney U test and/or Student’s t-test. Results: The pectoralis major muscle was pathologically invaded by carcinoma in 4/43 (9.3%). There was no significant association between pectoralis muscle invasion and any MR imaging feature of the breast cancer. Tumors causing deformation of the muscle contour by MRI, tumors larger in size, tumors with a larger extent abutting the muscle and tumors in which the imaging feature abutting the muscle was a mass or non-mass enhancement (rather than a spicule) were more commonly seen in patients with muscle invasion, although these did not reach statistical significance (p > 0.05). Conclusion: In this study, a lack of pectoralis muscle enhancement by MRI did not exclude pathologic muscle invasion by breast cancers abutting the muscle. Advances in knowledge: Knowledge of the likelihood of pectoralis muscle involvement for breast cancers abutting the pectoralis muscle on MRI may guide accurate interpretation and definition of the posterior extent of disease.

Clinicopathological and Imaging Features Predictive of Clinical Outcome in Metaplastic Breast Cancer

2020 ◽  
Vol 16 (6) ◽  
pp. 729-738
Author(s):  
Ga Young Yoon ◽  
Joo Hee Cha ◽  
Hak Hee Kim ◽  
Hee Jung Shin ◽  
Eun Young Chae ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Tumor Size ◽  
Multivariable Analysis ◽  
Disease Free Survival ◽  
Imaging Features ◽  
Peritumoral Edema ◽  
Imaging Findings ◽  
Metaplastic Breast Cancer

Background: Metaplastic breast cancer (MC) is a rare disease, thus it is difficult to study its clinical outcomes. Objective: To investigate whether any clinicopathological or imaging features were associated with clinical outcome in MC. Methods: We retrospectively evaluated the clinicopathological and imaging findings, and the clinical outcomes of seventy-two pathologically confirmed MCs. We then compared these parameters between triple-negative (TNMC) and non-TNMCs (NTNMC). Results: Oval or round shape, and not-circumscribed margin were the most common findings on mammography, ultrasound (US), and magnetic resonance imaging (MRI). It was mostly a mass without calcification on mammography, and revealed complex or hypoechoic echotexture, and posterior acoustic enhancement on US, and rim enhancement, wash-out kinetics, peritumoral edema, and intratumoral necrosis on MRI. Of all 72, 64 were TNMCs, and eight were NTNMCs. Clinicopathological and imaging findings were similar between the two groups, except that MRI showed peritumoral edema more frequently in TNMCs than NTNMCs (p=0.045). There were 21 recurrences and 13 deaths. Multivariable analysis showed that larger tumor size and co-existing DCIS were significantly predictive of Disease free survival (DFS), and larger tumor size and neoadjuvant chemotherapy were significantly predictive of overall survival (OS). Conclusion: MC showed characteristic imaging findings, and some variables associated with survival outcome may help to predict prognosis.

Subtle signs of breast cancer as an important pitfall in mammographic interpretation. Establishing an accurate diagnosis in an equivocal case

2021 ◽  
pp. 1-6
Author(s):  
Nikolaos S. Salemis ◽  
Eleni Mourtzoukou ◽  
Michail Angelopoulos
Keyword(s):  
Breast Cancer ◽  
Imaging Modality ◽  
Benign Lesion ◽  
Imaging Features ◽  
Breast Cancers ◽  
Breast Clinic ◽  
Delay In Diagnosis ◽  
Delay Of Treatment ◽  
Equivocal Case ◽  
Related Mortality

Mammogram is the standard imaging modality for the early detection of breast cancer, and it has been shown to reduce disease-related mortality by up to 30%. Mammogram, however, has its limitations. It is reported that 10–30% of breast cancers may be missed on a mammogram. Delay in the diagnosis and treatment may adversely affect the prognosis of patients with breast cancer. We present a case of multifocal invasive early breast carcinoma, which was misinterpreted twice as intramammary lymph nodes, thus resulting in a delay in diagnosis for eighteen months. The tumors were detected incidentally after the patient presented to our Breast clinic for symptoms related to a concomitant benign lesion involving the same breast. We describe the tumors’ imaging features and discuss the possible reasons that likely led to repeated misinterpretation. Awareness of possible causes for missed breast cancer is necessary to avoid delay of treatment initiation that may adversely affect prognosis.

scholarly journals A CASE OF NODULAR FASCIITIS OF THE PECTORALIS MAJOR MUSCLE FOLLOWING A LONG-TERM CLINICAL COURSE AND MASQUERADING BREAST CANCER

2009 ◽  
Vol 70 (11) ◽  
pp. 3263-3266 ◽  
Author(s):  
Takeshi YAMAGIWA ◽  
Takayuki TAJIMA ◽  
Masato NAKAMURA ◽  
Masaya MUKAI ◽  
Sadaki INOKUCHI ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Course ◽  
Pectoralis Major Muscle ◽  
Pectoralis Major ◽  
Nodular Fasciitis

scholarly journals Breast Imaging During Pregnancy and Lactation

2019 ◽  
Vol 1 (4) ◽  
pp. 342-351
Author(s):  
Lisa Abramson ◽  
Lindsey Massaro ◽  
J Jaime Alberty-Oller ◽  
Amy Melsaether
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Treatment Options ◽  
Nipple Discharge ◽  
Cancer Staging ◽  
Imaging Features ◽  
Breast Cancers ◽  
Bloody Nipple Discharge ◽  
Breast Cancer Staging ◽  
Pregnancy And Lactation

Abstract Breast imaging during pregnancy and lactation is important in order to avoid delays in the diagnosis and treatment of pregnancy-associated breast cancers. Radiologists have an opportunity to improve breast cancer detection by becoming familiar with appropriate breast imaging and providing recommendations to women and their referring physicians. Importantly, during pregnancy and lactation, both screening and diagnostic breast imaging can be safely performed. Here we describe when and how to screen, how to work up palpable masses, and evaluate bloody nipple discharge. The imaging features of common findings in the breasts of pregnant and lactating women are also reviewed. Finally, we address breast cancer staging and provide a brief primer on treatment options for pregnancy-associated breast cancers.

scholarly journals Alterations in pectoralis muscle cell characteristics after radiation of the human breast in situ

2019 ◽  
Vol 60 (6) ◽  
pp. 825-830 ◽  
Author(s):  
Christoph Wallner ◽  
Marius Drysch ◽  
Stephan A Hahn ◽  
Mustafa Becerikli ◽  
Fleming Puscz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dna Microarray ◽  
Muscle Tissue ◽  
Free Flap ◽  
Muscular Atrophy ◽  
Pectoralis Major Muscle ◽  
Life Time ◽  
Pectoralis Major ◽  
Breast Cancer Patients

ABSTRACT The life-time risk of being diagnosed with breast cancer is ~12%, hence breast cancer is by far the most common cancer among women. The multimodal treatment concept of breast cancer often intends radiation. The utilized ionizing radiation leads changes in the tissue resulting in tissue damage due to an alteration of molecular factors. The goal of this study was to identify the role of muscle-catabolic proteins after radiation of human pectoralis major muscles in situ. Tissue of the pectoralis major muscle was collected in 12 breast cancer patients after radiation (maximum 3 years after radiation) undergoing a deep inferior epigastric perforator free-flap breast reconstruction. At the same time, an intraindividual comparison to rectus abdominis muscle was carried out upon free-flap elevation. Immunological properties, cell proliferation, differentiation as well as the expression profile of the muscle tissue were investigated through immunohistological reactions, a DNA-microarray and histology. We found significantly increased neutrophil immigration in the radiated muscle tissue. At the same time, proteins responsible for muscular atrophy and apoptosis were significantly elevated in immunohistochemistry. A DNA microarray detected immunological upregulation and myo-differentiative disorders in radiated muscle tissue. This novel study investigating catabolism in radiated muscle in situ can serve as a basis for the treatment of radiation-accompanied muscle disorders.

Triple-negative invasive breast cancer (TNBC): Mammographic, US, and MR imaging features according to androgen receptor (AR) expression.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 159-159
Author(s):  
Woo Kyung Moon
Keyword(s):  
Breast Cancer ◽  
Mr Imaging ◽  
Breast Imaging ◽  
Gene Signature ◽  
Irregular Shape ◽  
Consecutive Series ◽  
Imaging Features ◽  
Breast Cancers ◽  
Pathologic Features ◽  
Chi Squared

159 Background: A subset of TNBC is characterized by an androgen gene signature and early clinical trials have demonstrated clinical benefit with the use of the AR antagonist, bicalutamide, for the treatment of patients with AR+, estrogen receptor/progesterone receptor- breast cancer. Methods: AR expression was assessed immunohistochemically in 125 patients (median age; 54 years, range; 26-82 years) with TNBC from a consecutive series of 1,086 operable invasive breast cancers. Two experienced breast imaging radiologists (6 and 24 years of experience, respectively) reviewed the mammograms, US, and MR images without knowledge of clinicopathologic findings. The imaging and pathologic features of 33 AR-positive TNBCs were compared with those of 92 AR-negative TNBCs by using the Fisher’s exact or chi-squared tests. Results: AR expression in TNBC is significantly associated with mammographic findings (P < 0.001), lesion type at MR imaging (P < 0.001), and mass shape or margin at ultrasound (P < 0.001; P= 0.002). The highest PPVs for AR-positive cancer were non-mass enhancement on MR imaging (PPV, 1.00; 95% CI: 0.61, 1.00), calcifications only seen on mammography (PPV, 1.00; 95% CI: 0.37, 1.00), and spiculated masses on US (PPV, 1.00; 95% CI: 0.22, 1.00). Conclusions: AR-positive and AR-negative tumors have distinct imaging features in TNBC. The presence of calcifications or focal asymmetries at mammography, the presence of echogenic halo or non-complex hypoechoic masses at US, masses with irregular shape or indistinct margins at mammography and US, and masses with irregular shape or spiculated margins, or non-mass lesions at MR imaging were associated with AR expression in TNBC. These imaging features may be used to predict AR status, which could assist in treatment planning, prediction of response, and assessment of prognosis for patients with TNBC.

Breast and Pectoralis Muscle Hypoplasia

1996 ◽  
Vol 37 (3P2) ◽  
pp. 759-762 ◽  
Author(s):  
J. M. Perez Aznar ◽  
J. Urbano ◽  
E. Garcia Laborda ◽  
P. Quevedo Moreno ◽  
L. Ferrer Vergara
Keyword(s):  
Upper Extremity ◽  
Male Patient ◽  
Clinical Manifestation ◽  
Pectoralis Major Muscle ◽  
Pectoralis Major ◽  
Breast Size ◽  
Pectoralis Muscle ◽  
Clinical Expression ◽  
Poland’S Syndrome ◽  
Poland's Syndrome

Purpose: Poland's syndrome is a congenital and unilateral aplasia of the pectoralis major muscle (PMM), with other anomalies of the ipsilateral upper extremity. We present 6 cases in which the only clinical expression was asymmetry of the breasts associated with partial absence of the PMM. Material and Methods: We reviewed 95000 mammograms (obtained 1985–1995) to find patients with asymmetrical breast size. Where the asymmetry could not be ascribed to any other cause, the patients were recalled for an examination of the PMM which was conducted at rest and with active contraction of the muscle. Results: Unilateral volume reduction of the PMM was found in 5 women of whom 2 were studied with MR. A 6th case was a fortuitous finding in a male patient. Conclusion: Mild forms of Poland's syndrome are more frequent than severe forms, and may go undiagnosed. Hypoplasia of one breast or a horizontal anterior axillary fold may be the sole clinical manifestation of this syndrome.

scholarly journals A novel immune subtype classification of ER-positive, PR-negative and HER2-negative breast cancer based on the genomic and transcriptomic landscape

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peiling Xie ◽  
Rui An ◽  
Shibo Yu ◽  
Jianjun He ◽  
Huimin Zhang
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Clinical Outcomes ◽  
Immune Escape ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
Molecular Characteristics ◽  
Consensus Clustering ◽  
Breast Cancers ◽  
Her2 Breast Cancer

Abstract Background The diversity and plasticity behind ER+/PR−/HER2− breast cancer have not been widely explored. It is essential to identify heterogeneous microenvironment phenotypes and investigate specific genomic events driving the formation of these phenotypes. Methods Based on the immune-related gene expression profiles of 411 ER+/PR−/HER2− breast cancers in the METABRIC cohort, we used consensus clustering to identify heterogeneous immune subtypes and assessed their reproducibility in an independent meta-cohort including 135 patients collected from GEO database. We further analyzed the differences of cellular and molecular characteristics, and potential immune escape mechanism among immune subtypes. In addition, we constructed a transcriptional trajectory to visualize the distribution of individual patient. Results Our analysis identified and validated five reproducible immune subtypes with distinct cellular and molecular characteristics, potential immune escape mechanisms, genomic drivers, as well as clinical outcomes. An immune-cold subtype, with the least amount of lymphocyte infiltration, had a poorer prognosis. By contrast, an immune-hot subtype, which demonstrated the highest infiltration of CD8+ T cells, DCs and NK cells, and elevated IFN-γ response, had a comparatively favorable prognosis. Other subtypes showed more diverse gene expression and immune infiltration patterns with distinct clinical outcomes. Finally, our analysis revealed a complex immune landscape consisting of both discrete cluster and continuous spectrum. Conclusion Overall, this study revealed five heterogeneous immune subtypes among ER+/PR–/HER2− breast cancer, also provided important implications for clinical translations.

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