scholarly journals Bilateral Primary Breast Cancer: A Case Report and Literature Review

2020 ◽  
Author(s):  
Shuyao Fan ◽  
Xidong Gu ◽  
Zhehao Liang ◽  
Yuping Mao ◽  
Changyu Zhou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Cancer ◽  
Left Lung ◽  
Distant Metastases ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Cancer History ◽  
Diagnosis And Prognosis ◽  
Systemic Treatments ◽  
The Right

Abstract BackgroundInvasive micropapillary carcinoma (IMPC) and secretory carcinoma of the breast (SCB) are relatively rare types of breast cancer. IMPC is usually associated with high incidence of lymphovascular invasion, lymph node metastasis and poor prognosis. While SCB usually carries a relatively favorable prognosis, cases of axillary and distant metastases have been reported. Clinicians generally adopt systemic treatments based on the histopathological findings of the patients to improve the prognosis, but there is currently no consensus on the optimal treatment for these two types of cancer.Case presentationWe treated a 50‐year‐old woman with lung cancer history who presented with a single lump in each breast. Following bilateral breast-conserving surgery, the diagnosis of SCB of the left breast and IMPC of the right breast was confirmed with immunohistochemistry. It is worth noting that the pathological results of left lung adenocarcinoma centered on micropapillary-type was same as the invasive micropapillary component of right breast.ConclusionsWe reported this case of bilateral primary relatively-rare-form breast cancer for its extremely rare occurrence and there are less than 20 cases of SCB reported worldwide till now. It is also significative to distinguish this primary tumor of right breast from metastatic cancer. Our histopathologic diagnosis and synthetical therapy scheme will provide material for SCB and IMPC. To facilitate the diagnosis and prognosis of such relatively rare tumors, more cases will need to be reported.

Left Breast Radiotherapy With Multi Fields Hybrid Intensity Modulated Radiotherapy (IMRT) Versus Volumetric Modulated Arc Therapy (VMAT): Balance Between Left Anterior Descending Artery Sparing and Secondary Cancer Induction Risk

2021 ◽  
Author(s):  
Xiaoyong Xiang ◽  
Zhen Ding ◽  
Kailian Kang ◽  
Zhitao Dai ◽  
Wenjue Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Volumetric Modulated Arc Therapy ◽  
Left Lung ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
High Dose ◽  
Breast Cancer Patients ◽  
Breast Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Arc Therapy

Abstract To explore the feasibility of using Volumetric-Modulated Arc Therapy (VMAT) to protect left anterior descending branch (LAD) after breast-conserving surgery for left breast cancer. 15 left breast cancer patients after breast-conserving surgery were selected. 7F-IMRT and 2A-VMAT treatment plans were designed with Varian Eclipse TPS (13.6version). The prescriptions of PTV and PTV Boost were 43.5Gy and 49.5Gy in 15 fractions. The dosimetric parameters, OARs dose sparing and second cancer risk (SCR) were compared between the two plans using a paired t-test. The VMAT plans obtain better PTV conformity and higher mean dose. VMAT plans show a better dose distribution in high dose areas and better sparing of OARs, including left lung, heart, and LAD. The Dmax and Dmean of LAD decreased significantly in VMAT plans. The SCRs of the contralateral lung and breast significantly increased with a higher mean dose. We recommend that contouring and evaluating the dose of LAD and LAD helping structures in left breast cancer radiotherapy. SCR should be evaluated for younger patients.

scholarly journals Radiation dose to the heart with hypofractionation in patients with left breast cancer

2021 ◽  
Vol 2 ◽  
Author(s):  
Budhi Singh Yadav ◽  
Deepak Kumar Das ◽  
Narendra Kumar ◽  
Manphool Singhal ◽  
Ngangom Robert
Keyword(s):  
Breast Cancer ◽  
Radiation Dose ◽  
Organs At Risk ◽  
Breast Conservation ◽  
Left Lung ◽  
Left Breast ◽  
Breast Conservation Surgery ◽  
Study Planning ◽  
Significant Difference ◽  
The Right

Abstract Introduction In this study we compared radiation dose received by organs at risk (OARs) after breast conservation surgery(BCS) and mastectomy in patients with left breast cancer. Materials and methods Total 30 patients, 15 each of BCS and mastectomy were included in this study. Planning Computerised Tomography (CT) was done for each patient. Chest wall, whole breast, heart, lungs, LAD, proximal and distal LAD, and contra lateral breast was contoured for each patient. Radiotherapy plans were made by standard tangent field. Dose prescribed was 40Gy/16#/3 weeks. Mean heart dose, LAD, proximal and distal LAD, mean and V5 of right lung, and mean, V5, V10 and V20 of left lung, mean dose and V2 of contra lateral breast were calculated for each patient and compared between BCS and mastectomy patients using student’s T test. Results Mean doses to the heart, LAD, proximal LAD and distal LAD were 3.364Gy, 16.06Gy, 2.7Gy, 27.5Gy; and 4.219Gy, 14.653Gy, 4.306Gy, 24.6Gy, respectively for mastectomy and BCS patients. Left lung mean dose, V5, V10 and V20 were 5.96Gy, 16%, 14%, 12.4%; and 7.69Gy, 21%, 18% and 16% in mastectomy and BCS patients, respectively. There was no statistical significant difference in the doses to the heart and left lung between mastectomy and BCS. Mean dose to the right lung was significantly less in mastectomy as compared to BCS, 0.29Gy vs. 0.51Gy, respectively (p = 0.007). Mean dose to the opposite breast was significantly lower in patients with mastectomy than BCS (0.54Gy Vs 0.37Gy, p = 0.007). The dose to the distal LAD was significantly higher than proximal LAD both in BCS (24.6Gy Vs 4.3Gy, p = <0.0001) and mastectomy (27.5Gy Vs 2.7Gy, p = <0.0001) patients. Conclusion There was no difference in doses received by heart and left lung between BCS and mastectomy patients. Mean doses to the right lung and breast were significantly less in mastectomy patients.

scholarly journals Evaluation of DIBH and VMAT in Hypofractionated Radiotherapy for Left-sided Breast Cancers After Breast-conserving Surgery: a Planning Study

2021 ◽  
Author(s):  
Liuwei Tang ◽  
Yojiro Ishikawa ◽  
Kengo Ito ◽  
Takaya Yamamoto ◽  
Rei Umezawa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Organs At Risk ◽  
Left Lung ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Breath Hold ◽  
Breast Cancer Patients ◽  
Lung Dose ◽  
Dose Reductions

Abstract Background This paper aims to compare dosimetric parameters of the organs at risk (OARs) among three different radiotherapy (RT) modalities in left breast cancer patients after breast-conserving surgery (BCS). Methods Eleven patients with left breast cancer after BCS were enrolled and underwent CT simulation in the free breathing (FB) and deep inspiration breath hold (DIBH) position. Three-dimensional radiotherapy (3DCRT) and volumetric modulated arc therapy (VMAT) plans were generated for each patient in the DIBH position. A 3DCRT plan was also created in the FB position. Dose-volume histogram (DVH) was used to analyze each evaluation index of OARs. The principal outcome was heart dose, left anterior descending coronary artery (LADCA) dose and left lung dose.Results For the 3D-CRT plans, significant dose reductions were demonstrated in all evaluation parameters to heart, LADCA and left lung dose in the DIBH position compared with the FB position (p < 0.05). In DIBH position, significant dose reductions were founded in heart and LADCA in VMAT plan compared to 3DCRT plan (p < 0.05). There were no significant differences between 3DCRT and VMAT plan for the left lung dose in DIBH position.Conclusion DIBH and VMAT could reduce dosimetric parameters of the OARs in left breast cancer patients after BCS. RT plans for left breast cancer after BCS can be optimized by DIBH and VMAT techniques to minimize radiation-induced toxicity

scholarly journals Evaluation of DIBH and VMAT in Hypofractionated Radiotherapy for Left-Sided Breast Cancers After Breast-Conserving Surgery: A Planning Study

2021 ◽  
Vol 20 ◽  
pp. 153303382110487
Author(s):  
Liuwei Tang ◽  
Yojiro Ishikawa ◽  
Kengo Ito ◽  
Takaya Yamamoto ◽  
Rei Umezawa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Left Lung ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Breath Hold ◽  
Breast Cancer Patients ◽  
Lung Dose ◽  
Significant Difference ◽  
Dose Reductions

Background: Dosimetric parameters of the planning target volume (PTV) and organs at risk (OARs) were compared among 3 different radiotherapy (RT) modalities in left breast cancer patients after breast-conserving surgery (BCS). Methods: Eleven patients with left breast cancer after BCS were enrolled and underwent CT simulation in the free breathing (FB) and deep inspiration breath-hold (DIBH) position. Three-dimensional conformal RT (3DCRT) and volumetric modulated arc therapy (VMAT) plans were generated for each patient in the DIBH positions. A 3DCRT plan was also created in the FB position. A dose-volume histogram (DVH) was used to analyze each evaluation index of PTV and OARs. The principal outcomes were PTV dose, heart dose, right breast dose, left anterior descending coronary artery (LADCA) dose, and left lung dose. Results: For 3DCRT plans, significant dose reductions were demonstrated in all evaluation parameters of the heart, LADCA, and left lung doses in the DIBH position compared with those in the FB position ( P < 0.05). In the DIBH position, significant dose reductions were found in the heart and LADCA in VMAT plans compared to those in 3DCRT plans ( P < 0.05). For the right breast, VMAT reduced Dmean significantly (0.32 Gy vs 0.08  Gy, P < 0.01). There were no significant differences between 3DCRT and VMAT plans for the left lung dose in the DIBH position. The indicators of PTV had no significant difference between the 3 plans. Conclusion: DIBH and VMAT could reduce dosimetric parameters of the OARs in left breast cancer patients after BCS. RT plans for left breast cancer after BCS can be optimized by DIBH and VMAT techniques to minimize radiation-induced toxicity.

scholarly journals RADIATION DOSE OPTIMIZATION OF BREAST CANCER WITH PROTON THERAPY METHOD USING PARTICLE AND HEAVY ION TRANSPORT CODE SYSTEM

2021 ◽  
Vol 23 (2) ◽  
pp. 79
Author(s):  
Milah Fadhilah Kusuma Fasihu ◽  
Andang Widi Harto ◽  
Isman Mulyadi Triatmoko ◽  
Gede Sutrisna Wijaya ◽  
Yohannes Sardjono
Keyword(s):  
Breast Cancer ◽  
Proton Therapy ◽  
Left Lung ◽  
Optimal Dose ◽  
Heavy Ion ◽  
Left Breast ◽  
High Dose ◽  
Good Precision ◽  
Pencil Beam ◽  
The Right

Radiotherapy is one of the cancer treatments conducted by giving a high dose to the tumor target and minimizing the dose exposed in the healthy organs. One of the methods is proton therapy. Proton therapy is usually used in several breast cancer cases by minimizing the damage in the surrounding tissues due to having good precision. In this study, proton therapy in breast cancer will be simulated. This study aims to identify the optimal dose in breast cancer therapy using proton therapy and to identify the dose exposed in the healthy organs surrounding cancer. This study is PHITS program simulation-based to model the geometry and the components of breast cancer and the surrounding organs. The source of radiation used is proton which is the output of proton therapy with proton/sec firing intensity. The variation in beam modelling towards the dose profile of the tumor used is uniform and pencil beam. The proton energy used is 70 MeV up to 120 MeV. The result of this study shows that the dose from using pencil beam scanning technic of proton therapy for breast cancer is 50.3997 Gy (W) with the total amount of fraction is 25 and the result of dose below the threshold dose in the healthy organs is the skin gets 4.4.0553 Gy per fraction, the left breast gets 0,0011 Gy per fraction, the right breast gets 2.6469 Gy per fractions, the right lung gets 0.0125 Gy per fraction, the left lung gets 0.029 Gy per fraction, the rib gets 0.0179 Gy per fraction, and the heart gets 0.0077 Gy per fraction.

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.

Predominance of RAD21 and ERBB2 amplification and progesterone receptor positivity in tumors of the right breast support breast cancer lateralization.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12557-e12557
Author(s):  
Zachary Spigelman ◽  
Jo-Ellen Murphy
Keyword(s):  
Breast Cancer ◽  
Progesterone Receptor ◽  
Cancer Patients ◽  
Breast Tumors ◽  
Left Breast ◽  
Breast Cancers ◽  
Her2 Expression ◽  
Breast Cancer Patients ◽  
The Right ◽  
Chi Square Analysis

e12557 Background: Biologic lateralization broadly impacts breast cancer. Malignancies originating in the left breast compared to the right breast tend to be more frequent, larger and of poorer prognosis. Left breast tumors respond differently to HER2-neu signaling and have lateralized Ki67 expression. In a prior study a right-left asymmetry in the neutrophil/lymphocyte ratio (NLR) of breast cancers was identified (ASCO 2018, e13094). As a follow-up, retrospective analysis of results from comprehensive genomic profiling (CGP) of right and left side breast cancer specimens was performed to determine a potential genomic etiology for the observed NLR lateralization. Methods: Tumors from 43 consecutive breast cancer patients underwent analysis for all classes of genomic alterations by hybrid capture-based CGP (Foundation Medicine). The CGP results from the 25 left- and 18 right-sided breast cancer samples were analyzed along with the histologic grade and status of estrogen receptor (ER), progesterone receptor (PR), and HER2 expression. Results: In this cohort of advanced breast cancer patients (stage 3-4), no statistically significant differences in lateralization were identified based on patient age, tumor stage, or frequency of ER or Her2 expression (Table). A predominance of PR positivity (p=0.14 chi square analysis) and amplifications in the ERBB2 (p=0.37) and RAD21 (p=0.08) genes were detected in right side tumors. Conclusions: Together with the prior study, trends in asymmetry based on genomic, pathologic, and immunohistologic differences have been detected in breast cancers, including an increased incidence of ERBB2 and RAD21 amplification in right-side breast tumors in this cohort. The predominance of lower PR positivity in the left breast tumors may be due to preferential hypermethylation, consistent with reports that it mediates biologic lateralization changes, downregulates PR expression, and alters amplification rates. Epigenetic methylation, may contribute to asymmetric breast cancer biology and have implications for therapeutic strategy. Further study is warranted.[Table: see text]

scholarly journals Is It Contralateral Axillary Metastasis or Occult Breast Cancer: A Confusing Case Report

2015 ◽  
Vol 8 (3) ◽  
pp. 498-502 ◽  
Author(s):  
Yong Gi Son ◽  
Woon Won Kim ◽  
Ki Hoon Kim ◽  
Jin Soo Kim
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Growth Factor Receptor ◽  
Immunohistochemical Analysis ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Lymph Node Biopsy ◽  
Adjuvant Radiation ◽  
Axillary Lymph ◽  
Axillary Metastasis

We report the case of a 43-year-old woman with primary left breast cancer presenting metastatic lymphadenopathy in the contralateral axilla. This patient represents a diagnostic and therapeutic challenge because primary breast cancer, occult contralateral breast cancer, and extra-mammary primary lesion can all be the source of the contralateral axillary metastasis. Left breast-conserving surgery, left sentinel lymph node biopsy, right breast mass excision, and right axillary lymph node dissection were performed. Immunohistochemical analysis revealed that the left breast cancer specimen was positive for estrogen receptor (ER) and progesterone receptor (PR), but negative for human epidermal growth factor receptor 2 (HER2). In contrast, the right axillary lymphadenopathy specimen was negative for ER and PR, but positive for HER2. Further investigation revealed no evidence of occult primary cancers or extra-mammary tumors. After surgical intervention, the patient was treated with adjuvant chemotherapy, adjuvant radiation therapy, and targeted therapy with trastuzumab. Two years after diagnosis, she is free of disease and presently being treated with tamoxifen.

scholarly journals A Synchronous Diagnosis of Metastatic Male Breast Cancer and Prostate Cancer

2019 ◽  
Vol 7 ◽  
pp. 232470961984723
Author(s):  
Leila Moosavi ◽  
Phyllis Kim ◽  
An Uche ◽  
Everardo Cobos
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Male Breast Cancer ◽  
Breast Cancer Diagnosis ◽  
Male Breast ◽  
Breast Mass ◽  
Medical Attention ◽  
Cancer History ◽  
History Of ◽  
The Right

In this article, we present a patient diagnosed synchronously with metastatic male breast cancer and prostate cancer. This is a 63-year-old male and recent immigrant from Nigeria, who sought medical attention for progressively worsening of shortness of breath and acute progression of a chronic right breast mass. An invasive breast carcinoma was diagnosed by the core biopsy of the right breast mass. Within 2 months of his breast cancer diagnosis, the patient also was diagnosed with prostate adenocarcinoma after being worked up for urinary retention. By presenting this patient with a synchronous diagnosis with metastatic male breast cancer and prostate cancer, history of chronic right breast mass, and gynecomastia, we speculate on possible cancer etiologies and risk factors.

Sign in / Sign up

Export Citation Format

Share Document