scholarly journals Study characteristics affecting the responses to neoadjuvant chemotherapy and the prognosis of patients with bilateral breast cancer: A retrospective analysis

2019 ◽  
Author(s):  
Zhenrong Tang ◽  
Yihua Wang ◽  
Luo Yang ◽  
Ling Chen ◽  
Yingzi Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Tumor Size ◽  
Breast Tumor ◽  
Molecular Subtype ◽  
Clinical Stage ◽  
Axillary Lymph ◽  
Tumor Type ◽  
Survival Times ◽  
The Right

Abstract BackgroundBilateral breast cancer (BBC) is defined as breast cancer diagnosed in both breasts in the same patient. Neoadjuvant chemotherapy (NAC) is a well-established approach to evaluate the tumor response to chemotherapeutic agents. The consensus is that different responses in characteristics after NAC can affect prognosis in unilateral breast cancer (UBC), but little is known about the responses of the BBC to NAC. This analysis explored the characteristics that can affect the prognosis of patients with BBC.MethodsThe characteristics of patients diagnosed with BBC (n = 126) was collected and the immunohistochemistry staining was used to detect expression levels of estrogen receptor (ER), progesterone receptor (PR), Ki67, and HER2. A statistical analysis of the differences was performed to identify the factors that affect survival times in all patients with BBC.ResultsA logistic regression indicated that the status of sentinel and axillary lymph node, expression of PR of the right breast tumor, and molecular subtype of the right breast tumor might relate to survival times. Tumor size, status of axillary lymph node, clinical stage, tumor type, histological grade, and molecular subtype of the left breast tumor might have a more profound effect on the survival time than the right breast tumor in the synchronous breast cancer (SBBC) patients. A multivariate analysis of overall survival times in patients with metachronous breast cancer (MBBC) showed that age was the only factor affecting survival time. After NAC treatment in SBBC patients, the Kaplan-Meier survival estimate showed that a decrease in tumor size, clinical stage, Ki67 and P53 levels were positive for a prolonged life span. However, a decrease in ER, PR, and HER2 were negative for prolonged life span. Changes in tumor type and molecular subtype also influenced the survival time.ConclusionCharacteristic changes in the left breast tumor were significant factors affecting survival times in patients with SBBC. After NAC treatment, changes in tumor size, Ki67, P53, ER, PR, and HER2 might affect the prognosis of patients with SBBC. For MBBC, only age was a factor affecting survival time. These findings provide clinical insight for the treatment of patients with BBC.

scholarly journals Factors that influence ultrasound evaluation of breast tumor size

2019 ◽  
Vol 21 (2) ◽  
pp. 144 ◽  
Author(s):  
Jin Xu ◽  
Ge Ma ◽  
Mengdi Liang ◽  
Yue Wang ◽  
Hong Pan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Breast Tumor ◽  
Core Biopsy ◽  
Molecular Subtype ◽  
Histological Grade ◽  
Breast Ultrasound ◽  
Tumor Type ◽  
Her2 Breast Cancer ◽  
Ultrasound Evaluation

Aims: To determine the factors influencing ultrasound breast tumor size assessment accuracy.Material and methods: Five factors (tumor type, molecular subtype, histological size, histological grade, and breast density) were used to assess the measurement accuracy of breast ultrasound in tumor size. Size underestimation was defined as ultrasound index lesion diameter < histological size by at least 5 mm.Results: Breast ultrasound underestimated tumor size significantly, especially in cases with intraductal components (p=0.002). There was a tendency for higher size underestimation in breast cancer tumors with high–histological grade (p=0.03), human epidermal growth factor receptor type 2 (HER2)-overexpressing breast cancer tumors (p=0.02) and hormone receptor (HR)−/HER2+ breast cancer tumors (p=0.008). Furthermore, core biopsy revealedhigher probability of size underestimation with intraductal components (p=0.002). Size underestimation was more frequent with larger histological size (p<0.001). Masses in non-dense breasts were significantly underestimated (p=0.036) compared to dense breasts.Conclusions: The size underestimation was influenced by pathological type, molecular subtype, and histological size. The pathological results of core biopsy were conducive for predicting tumor size pre-surgery in precise breast cancer diagnosis.

scholarly journals Axillary Imaging Following a New Invasive Breast Cancer Diagnosis—A Radiologist’s Dilemma

2021 ◽  
Author(s):  
Vandana Dialani ◽  
Basak Dogan ◽  
Katerina Dodelzon ◽  
Brian N Dontchos ◽  
Neha Modi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Molecular Subtype ◽  
Treatment Plan ◽  
Clinical Stage ◽  
Breast Cancer Diagnosis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Axillary Metastasis ◽  
Image Guided

Abstract Traditionally, patients with newly diagnosed invasive breast cancer underwent axillary US to assess for suspicious axillary lymph nodes (LNs), which were then targeted for image-guided needle biopsy to determine the presence of metastasis. Over the past decade, there has been a shift towards axillary preservation. For patients with palpable lymphadenopathy, the decision to perform axillary imaging with documentation of the number and location of abnormal LNs in preparation for image-guided LN sampling is straightforward. Since LN involvement correlates with cancer size, it is reasonable to image the axilla in patients with tumors larger than 5 cm; however, for tumors smaller than 5 cm, axillary imaging is often deferred until after the tumor molecular subtype and treatment plan are established. Over the last decade, neoadjuvant chemotherapy (NACT) is increasingly used for smaller cancers with more aggressive molecular subtypes. In most cases, detecting axillary metastasis is critical when deciding whether the patient would benefit from NACT. There is increasing evidence that abnormal axillary US findings correlates with LN metastases and reliably establishes a baseline to monitor response to NACT. Depending on hormone receptor status, practices may choose to image the axilla in the setting of clinical stage T1 and T2 cancers to evaluate nodal status and help determine further steps in care. Radiologists should understand the nuances of axillary management and the scope and challenges of LN marking techniques that significantly increase the precision of limited axillary surgery.

Microcalcification-associated breast cancer: HER2-enriched molecular subtype is associated with mammographic features

2018 ◽  
pp. 20170942 ◽  
Author(s):  
Zhong Nie ◽  
Jian Wang ◽  
Xiao-chun Ji
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Breast Tumor ◽  
Molecular Subtype ◽  
Univariate Analysis ◽  
Breast Cancers ◽  
Tumor Mass ◽  
Tumor Phenotype ◽  
Mass Lesions ◽  
Small Tumor Size

Purpose: To investigate whether the mammographic features were different between breast cancer HER2-enriched molecular subtype and non-HER2-enriched molecular subtype. Methods: 283 microcalcification-associated breast cancers were identified (HER2-enriched: n = 57; non-HER2-enriched: n = 226). Mammographic tumor mass and calcification features in relation to HER2 molecular subtype were analyzed. Results: On univariate analysis, HER2-enriched molecular subtype rates were significantly higher (a) in tumor size <= 2 cm 33 of 57 [57.9%]) than in tumor size >2 cm lesions (22 of 226 [9.7%]) (p = 0.007), (b) in non-spiculated mass 39 of 57 [68.4%]) than in spiculated mass lesions (18 of 226 [7.9%]) (p = 0.034)，(c) in calcifications extent >2 cm (41of 57 [71.9%]) lesions than in calcifications extent <= 2 cm lesions (16 of 226 [7.1%]) (p < 0.001)and (d) in calcification density ＞20/cm2 (44 of 57 [71.2%]) lesions than in calcification density <= 20/cm2 lesions (13 of 226 [5.8%]) (p = 0.034).On multivariate analysis, three mammographic features (tumor size >2 cm vs size⩽2 cm OR: 0.415 95% CI: 0.215 to 0.802, p = 0.009, spiculated mass vs non-spiculated mass OR: 0.226 95% CI: 0.114 to 0.446, p < 0.001 and calcifications extent >2 cm vs calcifications extent <= 2 cm OR: 7.754, 95% CI: 3.100 to 19.339P < 0.001) were independent predictors. Our results indicated that small tumor size, non-spiculated mass and calcification extent >2 cm are more likely to be HER2 molecular subtype. The discrimination of this model, as quantified by the AUC, was 0.751 (95%CI: 0.701 to 0.854). Conclusion: Our study presents a prediction model that incorporates the mammographic features of tumor size, non-spiculated mass and calcification extent, which can potentially be used to preoperative predict breast cancer HER2-enriched subtype. Advancesinknowledge: Mammographic features can noninvasively visualize breast tumor phenotype characteristics.

scholarly journals Breast Angiosarcoma with a Preoperative Diagnosis of Late Recurrence of Breast Cancer: A Case Report

2021 ◽  
pp. 604-609
Author(s):  
Rika Kouhashi ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Tamami Morisaki ◽  
Sae Ishihara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Preoperative Diagnosis ◽  
Vascular Endothelial Cells ◽  
Interstitial Fibrosis ◽  
Late Recurrence ◽  
Breast Conserving Surgery ◽  
Surrounding Tissue ◽  
Axillary Lymph ◽  
Elevated Lesion ◽  
The Right

Angiosarcoma is a malignant mesenchymal tumor characterized by the presence of vascular endothelial cells. Although rare, angiosarcoma developing in the mammary glands has a poor prognosis. We report a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer. A 78-year-old woman noticed a tumor in her right breast and visited our hospital. The patient had undergone breast-conserving surgery and axillary lymph node dissection from the right breast 12 years before the visit. The tumor was diagnosed as T4bN0M0, stage IIIB. Anastrozole was administered as postoperative adjuvant therapy for 5 years; the patient also received 50-Gy whole-breast radiation therapy after surgery. Physical examination during her visit revealed an elevated lesion with blue purpura around the nipple in the right breast. We performed breast ultrasound and detected a well-defined 19.6 × 16.4 × 10.7 mm hypoechoic tumor in the left subareolar area. The patient underwent core needle biopsy (CNB). Based on the CNB specimen findings, she was suspected to experience late local recurrence after surgery. Therefore, she underwent total mastectomy after breast-conserving surgery. A dark-red tumor sized 18 × 12 mm was found in a specimen from the nipple. The pathological diagnosis of the specimen revealed short spindle-shaped tumor cells with strong nuclear pleomorphism and a significant interstitial fibrosis. Immunohistochemistry using D2-40 and CD31 antibodies showed irregular luminal proliferation at the anastomosis, infiltration into the surrounding tissue, and massive necrosis, thereby leading to the diagnosis of breast angiosarcoma. We have reported a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer.

Histologic Grade Remains a Prognostic Factor for Breast Cancer Regardless of the Number of Positive Lymph Nodes and Tumor Size: A Study of 161 708 Cases of Breast Cancer From the SEER Program

2014 ◽  
Vol 138 (8) ◽  
pp. 1048-1052 ◽  
Author(s):  
Arnold M. Schwartz ◽  
Donald Earl Henson ◽  
Dechang Chen ◽  
Sivasankari Rajamarthandan
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Nodal Status ◽  
Histologic Grade ◽  
Axillary Lymph Nodes ◽  
Low Grade ◽  
Axillary Lymph ◽  
Data Set

Context.—The appropriate staging of breast cancers includes an evaluation of tumor size and nodal status. Histologic grade in breast cancer, though important and assessed for all tumors, is not integrated within tumor staging. Objective.—To determine whether the histologic grade remains a prognostic factor for breast cancer regardless of tumor size and the number of involved axillary lymph nodes. Design.—By using a new clustering algorithm, the 10-year survival for every combination of T, N, and the histologic grade was determined for cases of breast cancer obtained from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. There were 36 combinations of TN, defined according to the American Joint Committee on Cancer, and grade. Results.—For each combination of T and N, a categorical increase in the histologic grade was associated with a progressive decrease in 10-year survival regardless of the number of involved axillary lymph nodes or size of the primary tumor. Absolute survival differences between high and low grade persisted despite larger tumor sizes and greater nodal involvement, though trends were apparent with increasing breast cancer stage. Statistical significance depended on the number of cases for each combination. Conclusions.—Histologic grade continues to be of prognostic importance for overall survival despite tumor size and nodal status. Furthermore, these results seem to indicate that the assignment of the histologic grade has been consistent among pathologists when evaluated in a large data set of patients with breast cancer. The incorporation of histologic grade in TNM staging for breast cancer provides important prognostic information.

scholarly journals Breast Cancer Combined with Contralateral Neck Lymph Node Metastasis. Case Report

2021 ◽  
Author(s):  
Xiaoxiao Zhong ◽  
Fengjiao Ding ◽  
Liyuan Qian ◽  
Wei Wu ◽  
Yanguang Wen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Clinical Stage ◽  
Pathological Examination ◽  
Cervical Lymph Nodes ◽  
Neck Lymph Node ◽  
Node Metastasis ◽  
Neck Lymph Node Metastasis ◽  
The Right

Abstract Background: Contralateral neck lymph node metastasis is rare for primary breast cancer. Its clinical stage and treatment principles are lack of authoritative guidelines. A 30-year-old breast cancer patient with contralateral neck lymph node metastasis is presented. The clinical treatment is discussed combined with current research.Case presentation: A 30-year-old woman presented with a right breast mass for 5 months and left neck lymph node enlargement for 5 days. The mammography showed a 33mm*14.3mm mass in the inner quadrant of right breast. The ultrasound showed several hypoechoic nodules on the left side of the neck. Rapid intraoperative pathological examination diagnosed right breast malignant tumor and poorly differentiated carcinoma of the left cervical lymph nodes. Then the right mastectomy was performed immediately. The patient was scheduled to administer chemotherapy, molecular targeted therapy, radiotherapy and endocrinotherapy after operation. The long-term efficacy remains to be seen.Conclusion: The infrequent presentation of breast cancer with metastasis to the contralateral neck lymph node can be challenged for standard therapies.

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