scholarly journals Characteristics and Histopathological Grading of Malignant Spiculated Mass in regards to Histopathological Grading of Breast Cancer Based on The Nottingham Grading System

2020 ◽  
Vol 3 (1) ◽  
pp. 33
Author(s):  
Andi Syarti ◽  
Ulinta Pasaribu ◽  
Dyah Fauziah ◽  
Lies Mardiyana ◽  
Tri Wulanhandarini
Keyword(s):  
Breast Cancer ◽  
Mitotic Index ◽  
Proliferation Index ◽  
Grading System ◽  
Nuclear Pleomorphism ◽  
Histopathological Grade ◽  
Grade Ii ◽  
Tubular Formation ◽  
Histopathological Grading ◽  
Grade Iii

Introduction: Spiculation in mammography is a typical finding for invading breast cancer and is an important criterion in diagnosis and in predicting prognostic and plays an important role in management. The purpose of this research is to determine the characteristics of malignant spiculating mass in mammography in regards to histopathological grading using The Nottingham Grading System.Methods: Patients whom had spiculation in mammography was reviewed using medical record data by two breast imaging consultants and then combined with The Nottingham Grading System criteria obtained from histopathological examination results of core biopsy and surgery specimen. There was 29 cases that met the inclusion criteria.Results: Of the 29 patients that met the inclusion, the spiculated masses grade I, II has mitotic index of 0-12, grade III has mitotic index of 13-25. Histopathologic grade II, III has the most tubular formation of <10%, grade I has 10-75%. Grade I, II has moderate nuclear pleomorphism, grade III has severe nuclear pleomorphism. Most were grade III (44.8%), followed by grade II (37.9%), and minimally grade I (17.2%). Most patients are in stage 3 breast cancer.Conclusion: Malignant spiculated mass with grade I, II has low proliferation index (mitotic index 0-12), histopathological grade II, III had worse cellular differentiation (tubular formation <10%), histopathological grade II, III has moderate to severe nuclear pleomorphism.

scholarly journals Applicability of Cytological Grading of Carcinoma Breast

2021 ◽  
Vol 8 (7) ◽  
pp. A174-178
Author(s):  
Saroj Pachori ◽  
Kriti Chaturvedi ◽  
Geeta Pachori ◽  
Tarun Tiwari ◽  
Disha Jain
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Incidence ◽  
Needle Aspiration ◽  
P Value ◽  
Grading System ◽  
Management Options ◽  
Grade Ii ◽  
A Prospective Study ◽  
Grade Iii ◽  
Breast Malignancies

Background: In India breast cancer incidence is on rise and large number of cases occur before 50 years of age. Early diagnosis and proper treatment are known to increase the survival of the patients. As fine needle aspiration cytology is widely used as a preliminary mode for the diagnosis of breast malignancies, adding a reliable grading system in reporting shall aid in planning the management options. Methods: It’s a prospective study done on 100 cases of breast malignancies from June 2018 to May 2020 in department of Pathology JLNMC, Ajmer. Cytology smears were stained with H&E and Geimsa and graded according to Robinson’s cytological grading system while their corresponding histopathological sections were stained with H&E and graded as per Elston and Ellis modification of Scarff Bloom & Richardson grading system and the results were compared. Result: Out of 100 cases of breast cancer evaluated in cytology 29% were grade I, 56% were grade II and 15% were grade III. On histopathological evaluation 25% were grade I, 54% were grade II while 21% were grade III. A highly significant association between the two grading systems was observed with coefficient of correlation 0.831, p value of <0.001 and concordance rate 80%. Conclusion: There is high degree of concordance between the Robinson’s and Elston and Ellis modification of Scarff Bloom & Richardson grading system. Robinson’s method is an easy and quick and reliable method to grade carcinomas of breast, hence it should be included in cytology reporting of breast carcinomas.

scholarly journals Comparative Study of Cytomorphological Robinson’s Grading for Breast Carcinoma with Modified Bloom-Richardson Histopathological Grading

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Neelam Sood ◽  
Jitendra Singh Nigam ◽  
Poonam Yadav ◽  
Shivani Rewri ◽  
Ankit Sharma ◽  
...  
Keyword(s):  
Breast Tumour ◽  
Concordance Rate ◽  
Treatment Modalities ◽  
Grading System ◽  
Breast Cancers ◽  
Multiple Treatment ◽  
Grade Ii ◽  
Breast Lumps ◽  
Histopathological Grading ◽  
Grade Iii

Objective. To study the correlation of cytomorphological Robinson’s grading for breast cancers with a modified Bloom-Richardson histopathological grading. Materials and Methods. One hundred sixteen cytologically malignant breast tumour cases were included in this study and correlated with paraffin embedded sections. Breast lumps were varied from less than 1 cm to 11 cm in greatest dimension. FNA was performed from different sites of the breast lump, and smears were stained with Giemsa and H&E stain and evaluated for cytological grading according to Robinson’s grading system. Paraffin embedded tissue sections were stained with hematoxylin and eosin stain and graded according to modified Bloom-Richardson grading system. Comparison between these two grading systems was done. Results. Cytologically grade I, grade II, and grade III cases were 13.8%, 64.65%, and 21.55%, respectively. Histologically 25%, 54.31%, and 20.69% cases were grade I, grade II, and grade III, respectively. Concordance rate between cytology and histology of grade I, grade II, and grade III tumors was 75%, 70.67%, and 60% respectively. The absolute concordance rate was 68.97%. Conclusion. In the era of multiple treatment modalities and neoadjuvant therapy, cytological grading can be used as a prognostic factor for better management of patients.

scholarly journals Prognostic role of robinson cytological grading system in breast cancer in correlation with the histological grading of modified bloom richardson in Iraq

2018 ◽  
Vol 6 (4) ◽  
pp. 1139
Author(s):  
Noora M. Kareem ◽  
Nihad Salih Rahmatullah
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Concordance Rate ◽  
Grading System ◽  
Histological Grading ◽  
Fine Needle ◽  
Grade Ii ◽  
Grade Iii

Background: The breast cancer is increasing in developing countries and the management options are widened, therefore providing the surgeon with accurate prognostic information on which the mode of therapy will be chosen became so important. Robinson grading system was found to be useful in grading breast carcinoma in fine needle aspirates. The objectives of the study were to estimate the benefits of using Robinson grading system in fine needle aspiration for breast cancer and to estimate the correlation of Robinson grading system in fine needle aspiration with histological grading.Methods: There were Seventy cases of invasive ductal carcinoma was graded on FNA aspirates by Robinson grading system using six cytological parameters (cell dissociation, cell size, cell uniformity, nucleolus, nuclear margin, and nuclear chromatin).Results: The concordance rate between grade I tumors on cytology and histology was 100%, while for grade II tumors it was 62.5% and for grade III tumors it was 100%. The absolute concordance rate was 87.5%, the Spearman rank correlation coefficient (r) was 0.762, p value was (0.00), the sensitivity of Robinson’s cytological grading system in cytological grade I tumors was 73.33% and specificity was 100%. In cytological grade II tumors the sensitivity was 100% and specificity was 76% and in cytological grade III tumors the sensitivity is 100% and specificity was 100%.Conclusions: Robinson’s cytological grading of breast carcinoma correlates well with Bloom-Richardson’s histological grading system and could be a helpful parameter in selecting a neoadjuvant treatment for the breast cancer patients on fine needle aspiration cytology alone.

Histopathological grading affects survival in patients with IDH-mutant grade II and grade III diffuse gliomas

2020 ◽  
Vol 137 ◽  
pp. 10-17
Author(s):  
Enrico Franceschi ◽  
Alicia Tosoni ◽  
Stefania Bartolini ◽  
Santino Minichillo ◽  
Antonella Mura ◽  
...  
Keyword(s):  
Diffuse Gliomas ◽  
Grade Ii ◽  
Histopathological Grading ◽  
Grade Iii

Breast cancer grade and clinical benefit in patients with advanced breast cancer treated with an engineered whole tumor cell-targeted immunotherapy alone or in combination with checkpoint inhibition.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 3033-3033
Author(s):  
William Williams ◽  
Shaker R. Dakhil ◽  
Carmen Julia Calfa ◽  
Jarrod P. Holmes ◽  
Saveri Bhattacharya ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Clinical Benefit ◽  
Cell Activity ◽  
Cancer Cell Line ◽  
Advanced Breast ◽  
Inoculation Site ◽  
Grade Ii ◽  
The Impact ◽  
Grade Iii

3033 Background: SV-BR-1 is a breast cancer cell line derived from a grade II (moderately differentiated) tumor. SV-BR-1 was transfected with the CSF2 gene (encoding GM-CSF) to form SV-BR-1-GM. SV-BR-1-GM expresses HLA class I & II antigens and has functional antigen-presenting cell activity, directly stimulating CD4+ T cells in an HLA-DR restricted fashion. The SV-BR-1-GM regimen consists of low-dose cyclophosphamide (300 mg/m2) to reduce immune suppression, intradermal inoculation with irradiated SV-BR-1-GM (20x106 cells divided into 4 sites) and interferon-α2b (10,000 IU into each inoculation site ~2 & 4 days later) to boost the response. Here, we evaluate the impact of tumor grade on clinical benefit following treatment with the SV-BR-1-GM regimen. Methods: Patients with advanced breast cancer were treated with either the SV-BR-1-GM regimen alone or with the SV-BR-1-GM regimen with pembrolizumab. For the SV-BR-1-GM regimen alone, cycles were administered every 2 weeks x 3 and then monthly, while combination with pembrolizumab (200 mg IV 1-5 days following SV-BR-1-GM inoculation) administered cycles every 3 weeks. Tumor restaging was every 6-12 weeks. Results: 33 patients were enrolled. The treatment was generally safe with inoculation site pruritis, erythema and induration the most common adverse events. 23 patients had grade III (poorly differentiated) tumors, 9 had grade II tumors and one had a grade I (well differentiated) tumor. None of the patients with grade III tumors exhibited clinical benefit. 7 patients with grade I/II tumors received the SV-BR-1-GM regimen alone, 2 received the SV-BR-1-GM regimen with pembrolizumab and 1 received both regimens. As noted in the Table, 7 patients experienced clinical benefit including all 3 patients treated in combination with pembrolizumab. This included 6 patients with stable disease and one with a partial response. Conclusions: The SV-BR-1-GM regimen with or without pembrolizumab appears safe and able to induce clinical benefit even in very heavily pre-treated patients with low or intermediate grade advanced breast cancer. Clinical trial information: NCT03328026 . [Table: see text]

Thoracic pedicle screws: postoperative computerized tomography scanning assessment

2004 ◽  
Vol 100 (4) ◽  
pp. 325-331 ◽  
Author(s):  
Robert F. Heary ◽  
Christopher M. Bono ◽  
Margaret Black
Keyword(s):  
Computerized Tomography ◽  
Pedicle Screws ◽  
Ct Scanning ◽  
Screw Placement ◽  
Grading System ◽  
Content Type ◽  
Thoracic Pedicle Screws ◽  
Grade Ii ◽  
Grade Iii ◽  
Fine Print

Object. The authors evaluated the accuracy of placement of thoracic pedicle screws by performing postoperative computerized tomography (CT) scanning. A grading system is presented by which screw placement is classified in relation to neurological, bone, and intrathoracic landmarks. Methods. One hundred eighty-five thoracic pedicle screws were implanted in 27 patients with the assistance of computer image guidance or fluoroscopy. Postoperative CT scanning was conducted to determine a grade for each screw: Grade I, entirely contained within pedicle; Grade II, violates lateral pedicle but screw tip entirely contained within the vertebral body (VB); Grade III, tip penetrates anterior or lateral VB; Grade IV, breaches medial or inferior pedicle; and Grade V, violates pedicle or VB and endangers spinal cord, nerve root, or great vessels and requires immediate revision. Based on anatomical morphometry, the spine was subdivided into upper (T1–2), middle (T3–6), and lower (T7–12) regions. Statistical analyses were performed to compare regions. The mean follow-up period was 37.6 months. The following postoperative CT scanning—documented grades were determined: Grade I, 160 screws (86.5%); Grade II, 15 (8.1%); Grade III, six (3.2%); Grade IV, three (1.6%); and Grade V, one (0.5%). Among cases involving screw misplacements, Grade II placement was most common, and this occurred most frequently in the middle thoracic region. Conclusions. The authors' grading system has advantages over those previously described; however, further study to determine its reliability, reproducibility, and predictive value of clinical sequelae is warranted. Postoperative CT scanning should be considered the gold standard for evaluating thoracic pedicle screw placement.

scholarly journals A Study of Microvascular Density in Carcinoma of Breast with CD34 Immunostaining

2021 ◽  
pp. 1-12
Author(s):  
Bijoya Debnath ◽  
Mary Lilly
Keyword(s):  
Breast Cancer ◽  
Blood Vessels ◽  
Colon Adenocarcinoma ◽  
Human Colon ◽  
P Value ◽  
Vascular Density ◽  
Breast Cancer Patients ◽  
Sprouting Angiogenesis ◽  
Grade Ii ◽  
Grade Iii

Introduction: Tumor agiogenesis is generally classified in to two types, namely, sprouting and intussusceptive angiogenesis. The formation of new blood vessels from the already existing is termed as sprouting angiogenesis.  Many growth factors including endothelial growth factor (VEGF) contribute the formation of new vessels at the tumor sites. On other hand, the tumor able to split the existing blood vessels, this type is termed as intussuscepted angiogenesis and discovered in human colon adenocarcinoma xenograft.  In intussuscepted angiogenesis, an existing blood vessel splits into two new blood vessels by formation of trans vascular pillars. Objective: The present study aimed to analyse the nicrovascular density on breast cancer patients using CD 34 immunostaining method. Results: This mis-regulation may lead to the development of cancers. Histological grading with Grade II were more with 19 (63.3%) cases followed by Grade I with 4 (13.3%) and Grade III with 3 (10%) cases. There was increase in mean vascular density in Grade II when compared with Grade I and Grade III. However no significant correlation was observed statistically with a P value of 0.176. Using different antibodies such as CD34, CD31, Factor VIII and CD105 to microvessels differentiation was highlighted. Conclusion: The results showed that the anti-CD34 monoclonal antibody is more sensitive than the anti- CD31 antibody in calculation of MVD in breast cancer as mentioned in previous studies.

Syringomyelia Resolution Following Chiari Surgery: A Novel Scale for Communication and Research

Neurosurgery ◽  
2020 ◽  
Vol 88 (1) ◽  
pp. E60-E66
Author(s):  
Jacques Lara-Reyna ◽  
John Chae ◽  
Umberto Tosi ◽  
Mark M Souweidane ◽  
Rafael Uribe-Cardenas ◽  
...  
Keyword(s):  
Chiari Malformation ◽  
Cross Sectional Area ◽  
Percentage Change ◽  
Grading System ◽  
Sectional Area ◽  
Cross Sectional ◽  
Size Grade ◽  
Grade Ii ◽  
The Mean ◽  
Grade Iii

Abstract BACKGROUND The pathophysiological connection between Chiari malformation and syringomyelia is accepted. Debate remains, however, how can we best define changes in syringomyelia following surgery. OBJECTIVE To introduce a grading system focusing on syrinx reduction based on routinely and reproducible radiological information, and provide a suggestion of the application of this scale for prediction of patient's prognoses. METHODS Data from 48 patients with Chiari malformation and syringomyelia were compiled. We calculated syrinx cross-sectional area by approximating an ellipse in the largest axial plane. We compared the percentage of reduction or enlargement following surgery. The percentage change was grouped into four grades: Grade 0 = Increasing size, grade I ≤ 50% reduction, grade II = 50% to 90% reduction, grade III ≥ 90% reduction. RESULTS A total of 89.6% of patients had syrinx improvement after surgery. A total of 5 patients were grade 0, 14 were grade I, 20 patients were grade II, and 9 patients met criteria for grade III. The mean postoperative syrinx area was 24.1 mm2 (0-169 mm2) with a mean syrinx reduction of 62.7%. CONCLUSION Radiological improvement of syringomyelia can be mathematically defined and standardized to assist in communication in outcome-based trials. Radiological resolution is expected most patients.

A clinical phase II study of combination Cisplatinum and Vinorelbine followed by Docetaxel as first-line chemotherapy in metastatic breast cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10683-10683
Author(s):  
N. S. El-Saghir ◽  
Z. Otrock ◽  
Z. Abdel Khalik ◽  
H. Yassine ◽  
M. Khalifeh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Phase Ii ◽  
Metastatic Breast ◽  
Combination Regimen ◽  
First Line ◽  
Grade Ii ◽  
Sequential Combination ◽  
Line Chemotherapy ◽  
Grade Iii

10683 Background: Many chemotherapeutic options exist for metastatic breast cancer (MBC) but there is no standard regimen. We tested a sequential combination regimen using Cisplatinum and Vinorelbine (PVn) followed by Docetaxel as first-line chemotherapy in a phase II clinical trial. This is the first study using a non-anthracycline sequential combination chemotherapy of PVn with Docetaxelin MBC. Methods: Thirty-five patients were enrolled. Cisplatin 80 mg/m2, which was given on day 1 and Vinorelbine 30 mg/m2 on days 1 and 8 q3 weeks for 4 cycles. After the 4th cycle, responding patients received Docetaxel 75 mg/m2 every 21 days for a maximum of 4 cycles. Patients were evaluated every two cycles and those who had no response were offered other therapy. Patients who showed progression after 2 cycles of PVn were offered Docetaxel but were considered off protocol. Three patients were excluded from analysis because of death unrelated to treatment. Results: After a median follow up of 14 months (range 1–36), 32 patients (91.4%) completed the study. Overall response rate was 53.1%. Complete remission was seen in 5 pts (15.6%), partial response in 12 patients (37.5%), stable disease in 6 patients (18.75%), and progressive disease in 9 patients (28.1%). 20 patients (62.5%) were alive at 12 months. Median time to disease progression was 8 months (range 1–24). At 24 months 37.5% (12 patients) were alive. Response rates to PVn were not significantly improved by sequential addition of Docetaxel. A total of 183 cycles were administered with a median of 6 cycles per patient. Delay of chemotherapy because of Grade II neutropenia occurred in 41/183 cycles (22.4%). Febrile neutropenia was observed in 4 patients (2.2%). Grade II anemia was observed in 40/183 cycles (21.8%) and Grade III in 24/183 cycles (13.1%). Grade II nephrotoxicity occurred in 12 cycles (6.5%) and Grade III vomiting was observed in 31/183 cycles (16.9%). No treatment-related mortality has been reported. Conclusions: Sequential PVn-Docetaxel is a feasible and effective non-anthracycline option as first-line chemotherapy in patients with MBC. More effective Docetaxel may be better used upfront and followed by PVn. This regimen has acceptable toxicity as well. No significant financial relationships to disclose.

Vinorelbine is an active antiproliferative agent in pretreated advanced breast cancer patients: a phase II study.

1994 ◽  
Vol 12 (10) ◽  
pp. 2094-2101 ◽  
Author(s):  
G Gasparini ◽  
O Caffo ◽  
S Barni ◽  
L Frontini ◽  
A Testolin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Single Agent ◽  
Objective Response ◽  
Dose Intensity ◽  
Advanced Breast ◽  
World Health ◽  
Cross Resistance ◽  
Grade Ii ◽  
Grade Iii

PURPOSE To evaluate the efficacy and toxicity of single-agent vinorelbine (VNB), a semisynthetic vinca alkaloid, in patients with breast cancer previously treated with other chemotherapeutic regimens for metastatic disease. PATIENTS AND METHODS Sixty-seven of 70 patients with assessable disease entered onto the study were assessable. The main characteristics were as follows: median age, 60 years (range, 41 to 77); median performance status (PS; Karnofsky score), 90 (range, 60 to 100); and number of previous chemotherapeutic regimens given--one in 17, two in 27, three in eight, four in two, and five in one patient. The dominant sites of metastasis were viscera in 40, bone in 16, and soft tissues in 11 patients. VNB was administered beginning with the dose of 20 mg/m2 by 60-minute intravenous (iv) infusion weekly, with a dose escalation up to 25 mg/m2 if the first four courses were well tolerated. The treatment was continued until disease progression. RESULTS Overall, 845 courses of VNB were given (median, 10; range, eight to 33). Objective responses were as follows: complete response (CR) in three (4.5%), partial response (PR) in 21 (31.2%), stable disease (SD) in 20 (30%), and progressive disease (PD) in 23 patients (34.3%). Twenty-four of 67 assessable patients obtained a major objective response (CR or PR, 36%; 95% confidence interval [Cl], 24% to 47%). Thirty-three percent of patients had a > or = 33% reduction of dose-intensity (DI). The median time to progression was 18 weeks. The drug was active in patients pretreated with either cyclophosphamide, methotrexate, and fluorouracil (CMF) or anthracyclines. The most relevant toxicity observed was myelosuppression: 17 (25%) and 19 patients (28%) had World Health Organization grade III, and six (9%) and six patients (9%) had grade IV leukopenia and granulocytopenia, respectively; two (3%) and two patients (3%) had grade III and IV anemia, respectively. Nonhematologic toxicities were phlebitis (grade II or III in 15 patients), alopecia (grade I or II in 16), nausea and vomiting (grade II or III in 15), diarrhea (grade II in two), constipation (grade II or III in 16), stomatitis (grade II or III in 13), peripheral neuropathy (grade II in seven), and asthenia (grade II in five). CONCLUSION This study shows that VNB is an effective and well-tolerated agent in pretreated patients with advanced breast cancer. This drug does not seem to present cross-resistance with previous CMF or anthracycline regimens. Future clinical trials should be designed to prove whether the inclusion of VNB in combination chemotherapy regimens, or whether an enhancement of its dose-intensity using bone marrow growth factors, is able to improve further the efficacy of this drug in breast carcinoma.

Sign in / Sign up

Export Citation Format

Share Document