scholarly journals “A Study of Clinical and Ultrasonographic Findings of Patients Presented With Breast Pain”

2021 ◽  
Vol 8 (08) ◽  
pp. 5574-5577
Author(s):  
Waliur Rahman ◽  
Shireen jabeen Sume ◽  
Shamima Yasmin

Introduction: Breast pain also known as mastalgia is the dull acne in the breast, cause is multifactorial. It can affect any age group. Breast cancer is the most common site-specific cancer in women and is the leading cause of death from cancer for women aged 20-59 years worldwide. In India, breast cancer has ranked number one cancer among females, with age adjusted incidence as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women.  Objective: To find out the Clinical and USG Findings of Patients Presented with Breast Pain.   Settings and Design: Prospective cross-sectional descriptive study.   Materials and Methods: Patients with complaints of breast pain in the age group 15 to 60 years with clinically no palpable mass attending to the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh between January 2020 to December 2020 were included in the study. Detailed history with particular reference to age, duration of symptoms, Size, menstruation, marital status, parity, lactation, Nipple discharge and tenderness are recorded. Pain intensity was evaluated as mild, moderate and severe. Ultrasound of the breast including the axilla was done for all cases and findings recorded to correlate with clinical features. Results: Out of 90 patients studied, majority was in the age group (21-30) years, (43%) followed by (31-40 years) (40%) respectively. 57(63%) were married and 33(43%) were single. 21 patients had 1 child, 18 had 2 children with 6 of them having no children. Out of 90 patients only 3 attained menopause, rest of them have their monthly cycles. 51 patients had cyclical breast pain and 39 had noncyclical breast pain, 39 had pain on right breast, 36 on left side and bilateral in 15 patients. Pain was mild in 15 patients, moderate in 27 patients and severe in 6 patients. Various USG findings of the affected breast were normal study in 48 patients followed by duct ectasia and hetrogenous ectogenicity fibroadenosis, small cystic lesion and enlarged axillary lymph nodes etc. Conclusion: The study results show that majority of patients with breast pain without clinically palpable lump had normal USG study. But it also detects other early changes in the breast tissue. It can be used as a baseline investigation for any breast pain without palpable lump.

2021 ◽  
Vol 2 (2) ◽  
pp. 01-04
Author(s):  
H. N. Ashikur Rahaman ◽  
Shravana Kumar Chinnikatti

Introduction: Breast pain also known as mastalgia is the dull acne in the breast, cause is multifactorial. It can affect any age group. Breast cancer is the most common site-specific cancer in women and is the leading cause of death from cancer for women aged 20-59 years worldwide. In India, breast cancer has ranked number one cancer among females, with age adjusted incidence as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women. Objective: To find out the Clinical and USG Findings of Patients Presented with Breast Pain. Settings and Design: Prospective cross-sectional descriptive study. Materials and Methods: Patients with complaints of breast pain in the age group 15 to 60 years with clinically no palpable mass attending to the Dept. of Clinical Oncology, Enam Medical College & Hospital, Savar, Dhaka, Bangladesh between January 2020 to December 2020 were included in the study. Detailed history with particular reference to age, duration of symptoms, Size, menstruation, marital status, parity, lactation, Nipple discharge and tenderness are recorded. Pain intensity was evaluated as mild, moderate and severe. Ultrasound of the breast including the axilla was done for all cases and findings recorded to correlate with clinical features. Results: Out of 90 patients studied, majority was in the age group (21-30) years, (43%) followed by (31-40 years) (40%) respectively. 57(63%) were married and 33(43%) were single. 21 patients had 1 child, 18 had 2 children with 6 of them having no children. Out of 90 patients only 3 attained menopause, rest of them have their monthly cycles. 51 patients had cyclical breast pain and 39 had noncyclical breast pain, 39 had pain on right breast, 36 on left side and bilateral in 15 patients. Pain was mild in 15 patients, moderate in 27 patients and severe in 6 patients. Various USG findings of the affected breast were normal study in 48 patients followed by duct ectasia and hetrogenous ectogenicity fibroadenosis, small cystic lesion and enlarged axillary lymph nodes etc. Conclusion: The study results show that majority of patients with breast pain without clinically palpable lump had normal USG study. But it also detects other early changes in the breast tissue. It can be used as a baseline investigation for any breast pain without palpable lump.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Emmanuel Kobina Mesi Edzie ◽  
Klenam Dzefi-Tettey ◽  
Philip Narteh Gorleku ◽  
Adu Tutu Amankwa ◽  
Eric Aidoo ◽  
...  

Breast diseases have been one of the major battles the world has been fighting. In winning this fight, the role of medical imaging cannot be overlooked. Breast imaging reveals hidden lesions which aid physicians to give the appropriate diagnosis and definitive treatment, hence this study, to determine the clinical and imaging findings of breast examinations to document the radiologic features in our setting. This cross-sectional retrospective study reviewed the sociodemographics, imaging reports (mammography and ultrasonography with BI-RADS scores and their features), and the clinical data of 425 patients from September 2017 to September 2020 in the Cape Coast Teaching Hospital. 72 solid lesions with their histology reports were also reviewed. Data obtained were organized, coded, and analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0. The results obtained were presented in appropriate tables and charts. A chi-squared test was employed for associations and statistical significance was specified at p ≤ 0.05 . 63.29% of the patients were married, but only 18.59% had a positive family history of breast cancer. BI-RADS scores 1(57.46%) and 2(27.99%) were the most recurrent findings. The most common BI-RADS 2, 3, 4, and 5 imaging features were benign-looking axillary lymph nodes (66.33%), well-defined solid masses (61.54%), ill-defined solid masses (42.86%), and ill-defined solid masses with suspicious-looking axillary lymph nodes (100.00%), respectively. The most frequent indications were routine screening (49.18%), mastalgia (26.59%), and painless breast masses (19.77%). There was significant association between duration of symptoms and breast cancer ( p   value = 0.007 ). In conclusion, routine breast screening and mastalgia were the topmost indications for breast imaging. BI-RADS 1 and 2 were the commonest BI-RADS scores, and benign-looking axillary lymph nodes and simple cysts were the most frequent imaging features for BI-RADS 2 and ill-defined solid masses and suspicious-looking axillary lymph nodes for BI-RADS 4 and 5.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhu-Jun Loh ◽  
Kuo-Ting Lee ◽  
Ya-Ping Chen ◽  
Yao-Lung Kuo ◽  
Wei-Pang Chung ◽  
...  

Abstract Background Sentinel lymph node biopsy (SLNB) is the standard approach for the axillary region in early breast cancer patients with clinically negative nodes. The present study investigated patients with false-negative sentinel nodes in intraoperative frozen sections (FNSN) using real-world data. Methods A case–control study with a 1:3 ratio was conducted. FNSN was determined when sentinel nodes (SNs) were negative in frozen sections but positive for metastasis in formalin-fixed paraffin-embedded (FFPE) sections. The control was defined as having no metastasis of SNs in both frozen and FFPE sections. Results A total of 20 FNSN cases and 60 matched controls from 333 SLNB patients were enrolled between April 1, 2005, and November 31, 2009. The demographics and intrinsic subtypes of breast cancer were similar between the FNSN and control groups. The FNSN patients had larger tumor sizes on preoperative mammography (P = 0.033) and more lymphatic tumor emboli on core biopsy (P < 0.001). Four FNSN patients had metastasis in nonrelevant SNs. Another 16 FNSN patients had benign lymphoid hyperplasia of SNs in frozen sections and metastasis in the same SNs from FFPE sections. Micrometastasis was detected in seven of 16 patients, and metastases in nonrelevant SNs were recognized in two patients. All FNSN patients underwent a second operation with axillary lymph node dissection (ALND). After a median follow-up of 143 months, no FNSN patients developed breast cancer recurrence. The disease-free survival, breast cancer-specific survival, and overall survival in FNSN were not inferior to those in controls. Conclusions Patients with a larger tumor size and more lymphatic tumor emboli have a higher incidence of FNSN. However, the outcomes of FNSN patients after completing ALND were noninferior to those without SN metastasis. ALND provides a correct staging for patients with metastasis in nonsentinel axillary lymph nodes.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tarek Hashem ◽  
Ahmed Abdelmoez ◽  
Ahmed Mohamed Rozeka ◽  
Hazem Abdelazeem

Abstract Background Due to the high variability of incidence and prevalence of intra-mammary lymph nodes (IMLNs), they might be overlooked during clinical and radiological examinations. Properly characterizing pathological IMLNs and detecting the factors that might influence their prevalence in different stages of breast cancer might aid in proper therapeutic decision-making and could be of possible prognostic value. Methods Medical records were reviewed for all breast cancer patients treated at the National Cancer Institute of Cairo University between 2013 and 2019. Radiological, pathological, and surgical data were studied. Results Intra-mammary lymph nodes were described in the final pathology reports of 100 patients. Five cases had benign breast lesion. Three cases had phyllodes tumors and two cases had ductal carcinoma in situ (DCIS). All ten cases were excluded. The remaining 90 cases all had invasive breast cancer and were divided into two groups: one group for patients with malignant IMLNs (48) and another for patients with benign IMLNs (42). Pathological features of the malignant IMLN group included larger mean tumor size in pathology (4.7 cm), larger mean size of the IMLN in pathology (1.7 cm), higher incidence of lympho-vascular invasion (65.9%), and higher rate of extracapsular extension in axillary lymph nodes (57.4%). In addition, the pathological N stage was significantly higher in the malignant IMLN group. Conclusion Clinicians frequently overlook intra-mammary lymph nodes. More effort should be performed to detect them during preoperative imaging and during pathological processing of specimens. A suspicious IMLN should undergo a percutaneous biopsy. Malignant IMLNs are associated with advanced pathological features and should be removed during surgery.


Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 757
Author(s):  
Sanaz Samiei ◽  
Renée W. Y. Granzier ◽  
Abdalla Ibrahim ◽  
Sergey Primakov ◽  
Marc B. I. Lobbes ◽  
...  

Radiomics features may contribute to increased diagnostic performance of MRI in the prediction of axillary lymph node metastasis. The objective of the study was to predict preoperative axillary lymph node metastasis in breast cancer using clinical models and radiomics models based on T2-weighted (T2W) dedicated axillary MRI features with node-by-node analysis. From August 2012 until October 2014, all women who had undergone dedicated axillary 3.0T T2W MRI, followed by axillary surgery, were retrospectively identified, and available clinical data were collected. All axillary lymph nodes were manually delineated on the T2W MR images, and quantitative radiomics features were extracted from the delineated regions. Data were partitioned patient-wise to train 100 models using different splits for the training and validation cohorts to account for multiple lymph nodes per patient and class imbalance. Features were selected in the training cohorts using recursive feature elimination with repeated 5-fold cross-validation, followed by the development of random forest models. The performance of the models was assessed using the area under the curve (AUC). A total of 75 women (median age, 61 years; interquartile range, 51–68 years) with 511 axillary lymph nodes were included. On final pathology, 36 (7%) of the lymph nodes had metastasis. A total of 105 original radiomics features were extracted from the T2W MR images. Each cohort split resulted in a different number of lymph nodes in the training cohorts and a different set of selected features. Performance of the 100 clinical and radiomics models showed a wide range of AUC values between 0.41–0.74 and 0.48–0.89 in the training cohorts, respectively, and between 0.30–0.98 and 0.37–0.99 in the validation cohorts, respectively. With these results, it was not possible to obtain a final prediction model. Clinical characteristics and dedicated axillary MRI-based radiomics with node-by-node analysis did not contribute to the prediction of axillary lymph node metastasis in breast cancer based on data where variations in acquisition and reconstruction parameters were not addressed.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fangfang Liu ◽  
Thomas Hardiman ◽  
Kailiang Wu ◽  
Jelmar Quist ◽  
Patrycja Gazinska ◽  
...  

AbstractThe level of stromal tumor-infiltrating lymphocytes (sTILs) in triple-negative (TNBC) and HER2-positive breast cancers convey prognostic information. The importance of systemic immunity to local immunity is unknown in breast cancer. We previously demonstrated that histological alterations in axillary lymph nodes (LNs) carry clinical relevance. Here, we capture local immune responses by scoring TILs at the primary tumor and systemic immune responses by recording the formation of secondary follicles, also known as germinal centers, in 2,857 cancer-free and involved axillary LNs on haematoxylin and eosin (H&E) stained sections from a retrospective cohort of 161 LN-positive triple-negative and HER2-positive breast cancer patients. Our data demonstrate that the number of germinal center formations across all cancer-free LNs, similar to high levels of TILs, is associated with a good prognosis in low TILs TNBC. This highlights the importance of assessing both primary and LN immune responses for prognostication and for future breast cancer research.


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