Breast papillary lesions: a retrospective analysis from oncology set up of Pakistan

Background: Papillary lesions of the breast are a heterogeneous group of breast lesions that are difficult to diagnose as benign or malignant. These lesions have varied morphologic features that carry differing prognostic implications for affected patients. Accurate diagnosis is required to ensure that effective treatment is achieved. Papillary lesions can have increased risk of carcinoma and recurrence, in these patients even for lesions yielding a benign concordant diagnosis of papilloma at percutaneous biopsy, surgical excision may be warranted. Malignant lesions are usually surgically treated. Depending on stage-adjuvant chemotherapy and/or radiation therapy is given.Methods: A retrospective study was conducted at Shaukat Khanum Memorial hospital and Research Centre Lahore Pakistan. We reviewed the electronic records of diagnostic and registered patients from January 2007 till December 2017 in women imaging section, in age range of 25 to 75 years. Total 150 diagnosed patients with benign or malignant breast papillary lesions were selected and their conventional breast imaging (mammography and ultrasound) and histopathology was retrospectively analyzed on SPSS.Results: Patients were predominantly asymptomatic or on follow-up to an abnormal mammogram. Of the 150 cases most of the patients had intra-ductal papilloma followed by invasive papillary carcinoma and intra cystic papillary carcinoma. Few patients had intra-ductal papillomatosis and invasive micro papillary carcinoma.Conclusions: Conventional breast imaging remains the first main stay and quite sensitive in detecting breast papillary lesions leading to early detection and management.

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Papillary Lesions on Core Breast Biopsy: Excisional Biopsy for All Patients?

The American Surgeon ◽

10.1177/000313481307901212 ◽

2013 ◽

Vol 79 (12) ◽

pp. 1238-1242 ◽

Cited By ~ 9

Author(s):

Lee J. McGhan ◽

Barbara A. Pockaj ◽

Nabil Wasif ◽

Marina E. Giurescu ◽

Ann E. McCullough ◽

...

Keyword(s):

Papillary Carcinoma ◽

Breast Biopsy ◽

Lobular Carcinoma ◽

Significant Proportion ◽

Surgical Excision ◽

Excisional Biopsy ◽

Lesion Size ◽

Papillary Lesions

Excisional biopsy has been recommended for papillary lesions diagnosed on core needle biopsy (CNB) because a significant proportion of cases are upstaged to in situ/invasive cancer after surgical excision. The study goals were to identify patients at lowest risk of upstaging in whom excisional biopsy may potentially be avoided. We retrospectively evaluated 46 patients with a papillary lesion on CNB. Six patients were upstaged overall (13%), to intraductal papillary carcinoma (7%), invasive papillary carcinoma (4%), and mixed invasive ductal/lobular carcinoma (2%). The upstaging rate for patients with atypia on CNB was higher than for patients without atypia (33 vs 3%, P = 0.011). No patient younger than 65 years was upstaged to in situ or invasive carcinoma, and the mean lesion size was also higher among patients who were upstaged ( P > 0.05). Patients younger than 65 years with small papillary lesions lacking atypia on CNB may therefore represent a low-risk group that may be offered close clinical and radiologic follow-up.

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Encapsulated Papillary Carcinoma of the Breast: Imaging Features with Histopathologic Correlation

Journal of Breast Imaging ◽

10.1093/jbi/wbaa068 ◽

2020 ◽

Vol 2 (6) ◽

pp. 590-597

Author(s):

Sarah E Bonnet ◽

Gloria J Carter ◽

Wendie A Berg

Keyword(s):

Papillary Carcinoma ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Breast Imaging ◽

Ductal Carcinoma ◽

Imaging Features ◽

Term Survival ◽

Core Needle ◽

Cystic Component

Abstract Encapsulated papillary carcinoma (EPC) is a rare, clinically indolent breast malignancy most common in postmenopausal women. Absence of myoepithelial cells at the periphery is a characteristic feature. Mammographically, EPC typically presents as a mostly circumscribed, noncalcified, dense mass that can have focally indistinct margins when there is associated frank invasive carcinoma. Ultrasound shows a circumscribed solid or complex cystic and solid mass, and occasional hemorrhage in the cystic component may produce a fluid-debris level; the solid components typically show intense washout enhancement on MRI. Color Doppler may demonstrate a prominent vascular pedicle and blood flow within solid papillary fronds. Encapsulated papillary carcinoma can exist in pure form; however, EPC is often associated with conventional ductal carcinoma in-situ and/or invasive ductal carcinoma, no special type. Adjacent in-situ and invasive disease may be only focally present at the periphery of EPC and potentially unsampled at core-needle biopsy. In order to facilitate diagnosis, the mass wall should be included on core-needle biopsy, which will show absence of myoepithelial markers. Staging and prognosis are determined by any associated frankly invasive component, with usually excellent long-term survival and rare distant metastases.

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Combination of shear wave elastography and BI-RADS in identification of solid breast masses

BMC Medical Imaging ◽

10.1186/s12880-021-00702-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xue Zheng ◽

Fei Li ◽

Zhi-Dong Xuan ◽

Yu Wang ◽

Lei Zhang

Keyword(s):

Shear Wave ◽

Breast Imaging ◽

Color Doppler ◽

Shear Wave Elastography ◽

Definitive Diagnosis ◽

Pathological Examination ◽

Diagnostic Specificity ◽

Breast Masses ◽

Malignant Breast ◽

Grade Ii

Abstract Background To explore the value of quantitative shear wave elastography (SWE) plus the Breast Imaging Reporting and Data System (BI-RADS) in the identification of solid breast masses. Methods A total of 108 patients with 120 solid breast masses admitted to our hospital from January 2019 to January 2020 were enrolled in this study. The pathological examination served as the gold standard for definitive diagnosis. Both SWE and BI-RADS grading were performed. Results Out of the 120 solid breast masses in 108 patients, 75 benign and 45 malignant masses were pathologically confirmed. The size, shape, margin, internal echo, microcalcification, lateral acoustic shadow, and posterior acoustic enhancement of benign and malignant masses were significantly different (all P < 0.05). The E mean, E max, SD, and E ratio of benign and malignant masses were significantly different (all P < 0.05). The E min was similar between benign and malignant masses (P > 0.05). The percentage of Adler grade II-III of the benign masses was lower than that of the malignant masses (P < 0.05). BI-RADS plus SWE yielded higher diagnostic specificity and positive predictive value than either BI-RADS or SWE; BI-RADS plus SWE yielded the highest diagnostic accuracy among the three methods (all P < 0.05). Conclusion SWE plus routine ultrasonography BI-RADS has a higher value in differentiating benign from malignant breast masses than color doppler or SWE alone, which should be further promoted in clinical practice.

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Papillary lesions of the breast: imaging findings and diagnostic challenges

Diagnostic and Interventional Radiology ◽

10.5152/dir.2013.13041 ◽

2013 ◽

Author(s):

Pooja Jagmohan ◽

Felicity Jane Pool ◽

Thomas Choudary Putti ◽

Jill Wong

Keyword(s):

Breast Imaging ◽

Imaging Findings ◽

Papillary Lesions

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P–324 Pregnancy outcome after IVF for endometriosis or male infertility: What differs?

Human Reproduction ◽

10.1093/humrep/deab130.323 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

G Porcu-buisson ◽

V Chaber. Orsini ◽

L Stefan. Morcillo ◽

M Colomban. Barlesi ◽

E Glowaczower ◽

...

Keyword(s):

Male Infertility ◽

Endometrial Thickness ◽

Placenta Previa ◽

Placenta Praevia ◽

Childbearing Age ◽

Number Of Children ◽

Increased Risk ◽

Significant Difference ◽

Set Up ◽

Two Populations

Abstract Study question Are endometriosis women pregnant after IVF at increased risk of preeclampsia or placenta praevia than patients monitored for male infertility? Summary answer Patients with endometriosis are at greater risk than patients monitored for male infertility of developing preeclampsia and placenta previa. What is known already Endometriosis is a chronic estrogen-dependent disease that affects women of childbearing age which represents 10% of the general population[.The main symptoms found are chronic pelvic pain, infertility, dyspareunia and dysmenorrhea. Numerous publications have highlighted the deleterious effect of endometriosis on pregnancy i.e miscarriage, placental abnormalities, preeclampsia, preterm birth, low gestational weight. This complication may be related to the molecular and cellular abnormalities present in the endometrium of these patients and to the inflammatory state that may lead to abnormal contractility of the uterus at the time of the implantation window and trophoblastic invasion. Study design, size, duration This study is a retrospective, non-interventional monocentric cohort study conducted between January 2011 and December 2017 in Institut de Medecine de la Reproduction - Clinique Bouchard in Marseilles, France. Participants/materials, setting, methods The outcome of pregnancies obtained after IVF and/or ICSI in patients with endometriosis (n = 270) was compared with patients,free of endometriosis,monitored for male infertility (n = 366) The statistical study was carried out using GraphPad Version 8 The Student T-test was used to compare means across them. Results were considered significant for p < 0.05. Main results and the role of chance Patients with endometriosis and monitored during this period were older than those managed for male infertility. (33.59 vs 32.78) (p = 0.04). There was no difference between the two populations regarding BMI (p = 0.31) or smoking (p > 0.9). The rate of miscarriage observed in the two populations was comparable (25.37 vs. 25.78%) (p > 0.9), so was the rate of IUGR (5.81% vs. 2.29%) despite the observed percentages (p > 0.9). The rate of premature deliveries did not differ between the two populations (18.37% vs. 14.29%) (p = 0.55) neither did the number of children born with a weight <2500g at term (13.68% vs. 12.5%) (p = 0.83). Although the rate of gestational diabetes was comparable in both groups (4.11% vs 4.56%), the rate of preeclampsia was higher in the group of patients with endometriosis with a statistically significant difference (4.79% vs 0.79%) (p = 0.01). Similarly, the rate of placenta previa was higher in patients with endometriosis (4.11% vs 0.76%) (p = 0.02). All pregnancies complicated by placenta previa resulted from J2/J3 embryo transfer. Estradiol levels on the day of induction (2166 pg/ml vs 2452) (p = 0.67) and endometrial thickness was not different between patients with placenta praevia or no (10.45 vs 10.51) (p = 0.66). Limitations, reasons for caution Our study is retrospective which may introduce several biases despite the size of our sample i;e patients with endometriosis are older, adenomyosis was not included in the criteria. In our study we have not found any additional risk related to the type of embryo transferred. Wider implications of the findings: Patients with endometriosis are at greater risk than patients managed for male infertility of developing preeclampsia and placenta previa. It is advisable to warn patients of this possible complication, to promote e-SET and to set up early monitoring in order to place the appropriate management around these patients. Trial registration number Not applicable

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Role of contrast-enhanced spectral mammography in the post biopsy management of B3 lesions: Preliminary results

Tumori Journal ◽

10.1177/0300891618816212 ◽

2018 ◽

Vol 105 (5) ◽

pp. 378-387 ◽

Cited By ~ 5

Author(s):

Giulia Bicchierai ◽

Jacopo Nori ◽

Diego De Benedetto ◽

Cecilia Boeri ◽

Ermanno Vanzi ◽

...

Keyword(s):

Breast Imaging ◽

Surgical Excision ◽

Surgical Biopsy ◽

Predictive Values ◽

Contrast Enhanced ◽

B3 Lesions ◽

Malignant Lesions ◽

Sensitivity Specificity

PurposeTo evaluate the role of contrast-enhanced spectral mammography (CESM) in the post biopsy management of breast lesions classified as lesions of uncertain malignant potential (B3) by core needle biopsy and vacuum-assisted biopsy (VAB).MethodsThe local ethics committee approved this retrospective study and for this type of study formal consent is not required. A total of 42 B3 lesions in 40 women aged 41–77 years were included in our study. All patients underwent CESM 2–3 weeks after the biopsy procedure and surgical excision was subsequently performed within 60 days of the CESM procedure. Three radiologists reviewed the images independently. The results were then compared with histologic findings.ResultsThe sensitivity, specificity, and positive and negative predictive values for confirmed demonstration of malignancy at CESM were 33.3%, 87.2%, 16.7%, and 94.4% for reader 1; 66.7%, 76.9%, 18.2%, and 96.7% for reader 2; 66.7%, 74.4%, 16.7%, and 96.7% for reader 3. Overall agreement on detection of malignant lesions using CESM among readers ranged from moderate to substantial (κ = .451–.696), for categorization of BPE from moderate to substantial (κ = .562–.711), and for evaluation of lesion intensity enhancement from fair to moderate (κ = .346–.459).ConclusionIn cases of Breast Imaging Reporting and Data System (BI-RADS) 1, BI-RADS 2, or BI-RADS 3 results at CESM, follow-up or VAB rather than surgical biopsy might be performed.

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PEComa of soft tissues can mimick lymph node relapse in patients with history of testicular seminoma

Canadian Urological Association Journal ◽

10.5489/cuaj.413 ◽

2013 ◽

Vol 7 (9-10) ◽

pp. 651 ◽

Cited By ~ 2

Author(s):

Gabriele Guglielmetti ◽

Paolo De Angelis ◽

Paolo Mondino ◽

Carlo Terrone ◽

Alessandro Volpe

Keyword(s):

Lymph Node ◽

Soft Tissue ◽

Soft Tissues ◽

Percutaneous Biopsy ◽

Surgical Excision ◽

Pelvic Lymphadenectomy ◽

Adjuvant Radiation ◽

Soft Tissue Neoplasm ◽

Testicular Seminoma

Perivascular Epithelioid Cell tumour (PEComa) is rare. We describe a 39-year-old man who underwent a left radical orchidectomy and adjuvant radiation therapy for a stage IA classical testicular seminoma. He was diagnosed with a mass lateral to the right common iliac artery that was considered suspicious for late lymph node relapse after 3 years of follow-up. Due to the unusual location of the mass and the equivocal findings of percutaneous biopsy, a laparoscopic pelvic lymphadenectomy was performed. Final pathology revealed PEComa of soft tissue. The patient is disease free after 38 months of follow-up without adjuvant treatment. The presence of rare soft-tissue neoplasm should be considered in differential diagnosis of retroperitoneal masses during follow-up of germ cell tumours. Suspicious isolated recurrences of these neoplasms in unusual locations can require surgical excision to confirm diagnosis and avoid inappropriate treatment.

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Accuracy and Upgrade Rates of Percutaneous Breast Biopsy: The Surgeon's Role

The American Surgeon ◽

10.1177/000313481007601013 ◽

2010 ◽

Vol 76 (10) ◽

pp. 1084-1087 ◽

Cited By ~ 3

Author(s):

Windy Olaya ◽

Won Bae ◽

Jan Wong ◽

Jasmine Wong ◽

Sharmila Roy-Chowdhury ◽

...

Keyword(s):

Needle Biopsy ◽

Breast Imaging ◽

Breast Biopsy ◽

Imaging Study ◽

Surgical Excision ◽

Core Size ◽

Image Guided ◽

Core Samples ◽

Limited Sampling ◽

The Impact

We sought to evaluate the impact of needle core size and number of core samples on diagnostic accuracy and upgrade rates for image-guided core needle biopsies of the breast. A total of 234 patients underwent image-guided percutaneous needle biopsies and subsequent surgical excision. Large-core needles (9 gauge or less) were used in 14.5 per cent of cases and the remainder were performed with smaller core needles. More than four core samples were taken in 78.9 per cent of patients. In 71.8 per cent of cases, needle biopsy pathology matched surgical excision pathology. After surgical excision, upgraded pathology was revealed in 10.7 per cent of cases. Of 11 patients (52.4%) with benign needle core pathology who had upgraded final pathology on surgical excision, 10 had a Breast Imaging Recording and Data System score 4 or 5 imaging study. Lesions smaller than 10 mm were more likely to be misdiagnosed ( P = 0.01) or have upgraded pathology ( P = 0.009). Other predictors of upgraded pathology were patient age 50 years or older ( P = 0.03) and taking four or fewer core samples ( P = 0.003). Needle core size did not impact accuracy or upgrade rates. Surgeons should exercise caution when interpreting needle biopsy results with older patients, smaller lesions, and limited sampling. Discordant pathology and imaging still mandate surgical confirmation.

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The First Women’s Studies Research Centre: A History of Women’s Studies and Its Progenitors

Indian Journal of Gender Studies ◽

10.1177/0971521518763472 ◽

2018 ◽

Vol 25 (2) ◽

pp. 212-233

Author(s):

Maithreyi Krishnaraj

Keyword(s):

Women's Studies ◽

Academic Disciplines ◽

Research Centre ◽

Women's Issues ◽

Women’S Studies ◽

Master's Thesis ◽

History Of ◽

The Government ◽

Set Up ◽

The University

The beginning of Women’s Studies has a special history in India. It owes its origin not only to some stalwarts but also to the historical times in which its birth took place. Its location in the SNDT Women’s University in Mumbai was at the initiative of Dr Neera Desai, a Professor of Sociology at that university. Her own work on women’s issues in her Master’s thesis and her involvement in the women’s movement gave her the background for envisaging that a women’s university should engage with analysis of women’s condition and not just teach women other academic disciplines. It was with this motive, that the Research Centre for Women’s Studies was set up in 1974, a year before the publication of the report Towards Equality of the Government of India. The university - originally begun at the initiative of the educationist Shri Dhondo Kheshav Karve received a handsome grant from the industrialist Shri Damodar Thackersey and got named after his mother Shrimathi Nathibai Damodar Thackersey hereafter SNDT Women’s University. The Centre with the involvement of able and farsighted administrators at this university spearheaded the development of this Centre, which became the torch bearer for raising women’s issues.

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