scholarly journals Analysis of bilateral breast carcinomas:a profile of patients at a reference service

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Camila Vitola Pasetto ◽  
Bruno Ribeiro Batista ◽  
Lucas Roskamp Budel ◽  
Mariana De Nadai Andreoli ◽  
Vinicius Milani Budel

Objective: To select cases of bilateral breast carcinoma (BBC) of patients seen at Hospital de Clínicas of Paraná, besides recognizing clinical and family characteristics, histological and immunohistochemical pattern, and incidences of synchronic/metachronic tumor in these patients. Method: Observational and analytical study of BBC cases of patients treated at Hospital de Clínicas of Paraná, from 2003 to 2019, developed from the analysis of medical records. Result: A total of 42 patients with BBC were selected. The incidence of BBC was 3.64%. All patients were women, mostly of white skin color and postmenopausal, with an average age of 51.82 years. Half patients showed a positive family history for cancer, with breast cancer present in 46%, ovarian cancer in 16%, and other topographies in 68%. In this sample, the synchronous tumor was present in 55% of patients, and the metachronous tumor, in 45%. Regarding patients’ initial clinical staging, 61% had a locally advanced tumor at diagnosis. Both in the group of synchronic and metachronic tumors, the ductal subtype was the most frequent. Regarding the immunohistochemical subtype, patients in both groups had Luminal B tumors more frequently. In the group of metachronic tumors, the average time between the diagnosis of the first tumor and the second tumor was 5.68 years. Conclusion: In this sample, BBC is associated with a relevant family history, with a synchronic presentation pattern, from histology to ductal and immunohistochemistry to Luminal B as the most frequent.

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Camila Vitola Pasetto ◽  
Lucas Roskamp Budel ◽  
Bruno Ribeiro Batista ◽  
Mariana de Nadai Andreoli ◽  
Vinicius Milani Budel

Introduction: Bilateral breast cancer (BBC) is a rare clinical entity. This pattern of neoplasia can be considered synchronous (simultaneous) or metachronous (1 month to 1 year later). Objective: To select cases of BBC patients seen at HC-UFPR and to recognize in these patients clinical and family characteristics, histological and immunohistochemical patterns, and incidences of synchronous/metachronous occurrences. Method: An observational and analytical study of BBC cases of patients treated at HC-UFPR, from January 2003 to October 2019, based on the analysis of medical records, was developed. Result: 42 patients with BBC were selected and 4 patients were excluded from the study due to incomplete information in the medical record. The incidence of BBC in the surveyed period was 3.64%. All patients are women with a mean age of 51.82 years. White ethnicity is the most prevalent one (82%). With regard to menopausal status, 42% of the subjects are pre-menopausal and 58%, post-menopausal. Regarding parity, only 16% were nulliparous. Half of the patients have a positive family history for neoplasms, with breast cancer present in 46%, ovarian cancer in 16%, and other topography in 68%. In this sample, the synchronous tumor was present in 55% of the patients and the metachronous tumor in 45%. Regarding the patients’ initial clinical staging, 61% presented with locally advanced tumor at the first consultation. In the group of synchronous tumors, the ductal type was the most frequent one (93%), followed by the lobular type (7%). Regarding immunohistochemical subtypes, patients had Luminal B tumors (43%), followed by HER (29%), Triple negative (24%), and Luminal A (5%). Comparing the immunohistochemical profile in both tumors, 62% were in agreement and 48%, in disagreement. In the group of metachronous tumors, the mean time between the diagnosis of the first tumor and that of the second tumor was 5.68 years. The most common histological type was ductal carcinoma (73%), followed by lobular carcinoma (11%), medullary carcinoma (9%), and metaplastics (7%). Regarding the immunohistochemical profile, the most present was Luminal B in 32%, Luminal A in 29%, Triple negative in 24%, and HER 2 in 15%. The immunohistochemical profile was consistent in only 29% of the patients. Conclusion: In this sample, BBC is associated with relevant family history, with a pattern of presentation, synchronous; frequently, ductal is histological and Luminal B is immunohistochemistry.


2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 39-39
Author(s):  
Paula Rosenblatt ◽  
Sukhwant Nikki Singh ◽  
Lindsay Goicochea ◽  
Susan Kesmodel ◽  
Olga B. Ioffe ◽  
...  

39 Background: With the use of highly active antiretroviral therapy, it is postulated the prevalence of breast cancer will increase in the HIV infected population. Few studies have evaluated the presentation and pathological features of breast cancer in this population. Methods: Charts of approximately 5,000 HIV patients seen between 2000-2011 at the University of Maryland were reviewed to identify those diagnosed with breast cancer. Demographics, HIV data, cancer clinical presentation, family history, and pathologic findings were collected. Pathologic findings included receptor status (estrogen [ER], progesterone [PR], and human epidermal growth factor 2 [HER2]), grade, stage, lymphovascular invasion (LVI), multifocality/multicentricity (MF/MC), and presence of carcinoma in-situ. Results: Twenty cases of concomitant HIV and breast cancer were identified. At diagnosis of cancer, the median age, CD4 count, and duration of HIV infection were 48 years, 437 cells/mm3, and 6 years, respectively. 47% had a family history of breast or ovarian cancer. 79% self-palpated a mass. Pathologic findings included 18 invasive ductal carcinoma, 1 invasive lobular carcinoma, and 1 ductal carcinoma in-situ. 70% were ER-positive, 50% were PR-positive, and 47% were HER2-positive. 21% were Grade 1, 21% were Grade 2, and 57% were Grade 3. 21% luminal A (ER/PR+, HER2- and Ki67 ≤14%), 52% luminal B (ER/PR+, HER2+ or Ki67>14% or grade 3), 5% HER2 enriched (ER/PR-, HER2+), and 21% triple-negative/basal (ER/PR-, HER2-). 5% were stage 0, 40% were Stage I, 30% were Stage II, 25% were Stage III, and none were Stage IV. LVI was present in 36%, MF/MC was present in 35%, and carcinoma in-situ was present in 82%. Conclusions: Compared to historical data of non-HIV infected individuals, our population presented at a younger age with a strong family history and a greater number of self-palpated breast masses. HIV-infected patients with breast cancer presented with more HER2 positivity, higher grade, less favorable luminal B subtype, and more MF/MC disease. Despite aggressive pathology, most patients still presented with a relatively early stage. Annual screening mammogram at earlier ages should be considered in HIV-infected patients, particularly in patients with positive family history.


2021 ◽  
Vol 6 (4) ◽  
pp. 457-460
Author(s):  
Richa Verma ◽  
Shankar Lal Jakhar ◽  
Neeti Sharma ◽  
H. S. Kumar ◽  
Surender Beniwal

Background: Breast Cancer is the most common cancer among woman worldwide. In India breast cancer remains the leading cause of both incidence and mortality. Triple negative breast cancer is more difficult to treat as it does not respond to hormone therapy medicines or medicines that target receptor proteins (like HER 2 Neu). It is crucial for the physician to know the status of the disease as the patient can be subjected to a whole new avenue of treatment. The present study was done to assess the epidemiological profile and clinicopathological correlates of patients of triple negative breast cancer. Material and Methods: This retrospective study was carried out in Acharya Tulsi Cancer and Research Institute located in the state of Rajasthan, Bikaner, India, among Ca Breast patients presenting to Medical Oncology, Radiation Oncology and Surgical Oncology outdoor & indoor from April 2016 to March 2017. Out of the total 1017 patients of carcinoma breast 957 were included in this Study. Exclusion criteria was non availability of ER, PR, HER2 neu status reports because of various reasons like affordability. Out of the total 957 patients 249 were found to be triple negative. Statistical analysis was done using IBM SPSS version 21. Results: Mean age of the patients was 46±11.23 years. Out of total 249 patients of triple negative breast carcinoma, 91 (%) were found to have had clinical staging I and II (Early stage) and 158 (%) patients were found to have clinical staging III & IV (Late Stage). Mean size of the tumor was 3.6±1.94cm. 151 (60.6%) were pre-menopausal, 103 (41.4%) and 12 (4.8%) patients had positive family history. All of or patients diagnosed to have Ductal type of carcinoma. Lympho-vascular invasion was seen in 51 (20.5%) patients and High grade Histological Grading was seen in High Grade 169 (67.9%) patients. 172 (69.1%) undergone MRM (Modified Radical Mastectomy) and BCS was done in 74 (29.7%) patients. After comparison of triple Negative Breast Cancer with non-triple Negative Breast Cancer, lower age, later stages (III and IV), pre-menopausal status and high grade (on histology) were significantly more in negative type of Ca breast. Occurrence of early Menarche (< 13 Years) and history of OC pills used was almost equal in both the groups. Conclusion: Triple Negative Breast Cancer was found to present at an earlier age and more in pre – menopausal women. Such patients presented with a higher histological grade of tumor and late stage of presentation. There was no statistically significant association between TNBC and age of menarche, use of OC pill, previous exposure to radiotherapy and positive family history in first degree relative.


2004 ◽  
Vol 171 (4S) ◽  
pp. 172-173
Author(s):  
Kathleen Herkommer ◽  
Juergen E. Gschwend ◽  
Martina Kron ◽  
Richard E. Hautmann ◽  
Thomas Paiss

2016 ◽  
Vol 25 (1) ◽  
pp. 87-94 ◽  
Author(s):  
Kunihiko Izuishi ◽  
Hirohito Mori

Recently, many strategies have been reported for the effective treatment of gastric cancer. However, the strategy for treating stage IV gastric cancer remains controversial. Conducting a prospective phase III study in stage IV cancer patients is difficult because of heterogeneous performance status, age, and degree of cancer metastasis or extension. Due to poor prognosis, the variance in physical status, and severe symptoms, it is important to determine the optimal strategy for treating each individual stage IV patient. In the past decade, many reports have addressed topics related to stage IV gastric cancer: the 7th Union for International Cancer Control (UICC) TNM staging system has altered its stage IV classification; new chemotherapy regimens have been developed through the randomized ECF for advanced and locally advanced esophagogastric cancer (REAL)-II, S-1 plus cisplatin versus S-1 in RCT in the treatment for stomach cancer (SPIRITS), trastuzumab for gastric cancer (ToGA), ramucirumab monotherapy for previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD), and ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW) trials; and the survival efficacy of palliative gastrectomy has been denied by the reductive gastrectomy for advanced tumor in three Asian countries (REGATTA) trial. Current strategies for treating stage IV patients can be roughly divided into the following five categories: palliative gastrectomy, chemotherapy, radiotherapy, gastric stent, or bypass. In this article, we review recent publications and guidelines along with above categories in the light of individual symptoms and prognosis. Abbreviations: APC: argon plasma coagulation; AVAGAST: anti-angiogenic antibody bevacizumab, the avastin in gastric cancer; BSC: best supportive care; CF: cisplatin and fluorouracil; CRP: C-reactive protein; DCF: docetaxel, cisplatin, and 5-FU; FISH: fluorescent in-situ hybridization; GJ: gastrojejunostomy; GPS: Glasgow Prognostic Score; HER: human epidermal growth factor receptor; HR: hazard ratio; NLR: neutrophil-to-lymphocyte ratio; OS: overall survival; PS: performance status; QOL: quality of life; RAINBOW: ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma; RCTs: randomized controlled trials; REAL: randomized ECF for advanced and locally advanced esophagogastric cancer; REGARD: ramucirumab monotherapy for previously-treated advanced gastric or gastro-oesophageal junction adenocarcinoma; REGATTA: reductive gastrectomy for advanced tumor in three Asian countries; SEER: Surveillance Epidemiology and End Results; SEMS: self-expandable metal stents; SPIRITS: S-1 plus cisplatin versus S-1 in RCT in the treatment for stomach cancer; ToGA: trastuzumab for gastric cancer; TTP: time-to-progression; VEGFR: vascular endothelial growth factor receptor.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meng Wang ◽  
Wei-Wei Gong ◽  
Feng Lu ◽  
Ru-Ying Hu ◽  
Qing-Fang He ◽  
...  

Abstract Background Previous studies have indicated inconsistent relationships of diabetes with thyroid cancer risk, yet little is known in China. In this study, we aimed to investigate the associations between diabetes, diabetes duration and the risk of thyroid cancer in Chinese population. Methods A 1:1 matched case-control study was performed between 2015 and 2017 in Zhejiang Province including 2,937 thyroid cancer cases and 2,937 healthy controls. Odds ratios (ORs) with 95 % confidence intervals (CIs) for thyroid cancer were estimated in logistic regression models. Specific effects stratified by age, as well as sex, body mass index (BMI) and family history of diabetes were also examined. Results Overall, neither diabetes (OR = 0.75, 95 % CI: 0.21–2.73) nor diabetes duration (OR = 0.14, 95 % CI: 0.02–1.22 for diabetes duration ≦ 5 years; OR = 2.10, 95 % CI: 0.32–13.94 for diabetes duration > 5 years) was significantly associated with thyroid cancer. In stratified analyses, significant lower risk of thyroid cancer was observed among subjects with diabetes and shorter diabetes duration ( ≦ 5 years), but limited to those who were aged more than 40 years, female, overweight/obese and had positive family history of diabetes. Conclusions Diabetes and shorter diabetes duration were significantly associated with decreased risk of thyroid cancer in individuals characterized by older age, female sex, higher BMI and positive family history of diabetes.


2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Irazú Contreras-Yáñez ◽  
Pilar Lavielle ◽  
Patricia Clark ◽  
Virginia Pascual-Ramos

Abstract Background Assessing risk perception (RP) helps explain how rheumatoid arthritis (RA) patients integrate their ideas concerning the disease and how this understanding affects their self-care management. Compliance with treatment impacts disease-related outcomes and could be associated with RP to variable degrees and at different levels. The primary objective was to determine a potential association between RP and compliance with therapy in RA outpatients and to identify additional factors. The secondary objective was to identify factors associated with judgment bias such as unrealistic RP. Patients and methods Between January 2018 and June 2019, 450 consecutive outpatients who received RA-related treatment were invited to a face-to-face interview to obtain socio-demographic data, RA-related information, comorbidities, and the following outcomes: adherence, persistence, and concordance with medications assessed with a questionnaire locally designed; RP with the RP questionnaire (RPQ); disease activity with the Routine Assessment of Patient Index Data-3 (RAPID-3); disability with the Health Assessment Questionnaire Disability Index (HAQ-DI); quality of life with Medical Outcomes Study Short Form-36 (SF-36) instrument; pain and overall disease with the respective visual analogue scale (VAS); and health literacy assessed with 3 questions. Significant RP was defined according to a cut-off based on the 75th percentile value of the sample in which the RPQ was validated. Unrealistic RP was defined based on the coincidence of the presence/absence of significant RP and less/more than 7 unfavorable medical criteria. Multiple logistic regression analysis was used. Patients provided written informed consent and the study received Internal Review Board approval. Results There were 415 patients included, primarily middle-aged women with long-standing disease and moderate disease activity. Almost half of the patients were receiving corticosteroids and 15.9% intensive RA-related treatment. There were 44.1% of the patients concordant with treatment and 22.6% had significant RP. The patients’ treatment behavior was not retained in the regression analysis; meanwhile, rheumatoid nodes, surgical joint replacement, family history of RA, and higher RAPID-3 score were associated with significant RP. There were 56 patients with unrealistic RP; significant RP and more unfavorable medical criteria were associated with unrealistic RP. Conclusions Compliance with therapy was not associated with significant RP in RA outpatients.


Author(s):  
M. Schoemmel ◽  
◽  
H. Loeser ◽  
M. Kraemer ◽  
S. Wagener-Ryczek ◽  
...  

Abstract Introduction The inflammatory microenvironment has emerged as one of the focuses of cancer research. Little is known about the immune environment in esophageal adenocarcinoma (EAC) and possible tumor-escape mechanisms to avoid immune cell attack. Patients and methods We measured T cell inflammation (CD3, CD8) in the microenvironment using a standardized software-based evaluation algorithm considering different predefined tumor areas as well as expression of MHC class 1 and PD-L1 on 75 analyzable primarily resected and locally advanced (≥ pT2) EACs. We correlated these findings statistically with clinical data. Results Patients with high amounts of T cell infiltration in their tumor center showed a significant survival benefit of 41.4 months compared to 16.3 months in T cell poor tumors (p = 0.025), although CD3 fails to serve as an independent prognostic marker in multivariate analysis. For the invasion zone, a correlation between number of T-cells and overall survival was not detectable. Loss of MHC1 protein expression on tumor cells was seen in 32% and PD-L1 expression using the combined positive score (CPS) in 21.2%. Most likely due to small numbers of cases, both markers are not prognostically relevant, even though PD-L1 expression correlates with advanced tumor stages. Discussion Our analyses reveal an outstanding, though not statistically independent, prognostic relevance of T-cell-rich inflammation in our group of EACs, in particular driven by the tumor center. For the first time, we describe that the inner part of the invasion zone in EACs shows significantly fewer T-cells than other tumor segments and is prognostically irrelevant. We also demonstrate that the loss of antigen presenting ability via MHC1 downregulation by the carcinoma cells is a common escape mechanism in EACs. Future work will need to show whether tumors with MHC class 1 loss respond less well to immunotherapy.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Uzair Abbas ◽  
Bushra Imdad ◽  
Sikander Adil Mughal ◽  
Israr Ahmed Baloch ◽  
Afshan Mehboob Khan ◽  
...  

Abstract Objective MicroRNAs are known to regulate 60% of genes at post translational level. MicroRNAs including Micro RNA-29 family play a vital role in cellular activities and have validate role in numerous metabolic disorders inclusive of diabetes mellitus and its complications. While micro RNA profile changes years before the occurrence of disease. This cross-sectional study was conducted in non-diabetic adults of diabetic and non-diabetic parents to explore the early changes in expression of micro RNA-29 family as it can be served as early biomarker of type 2 diabetes in non-diabetic adults. This study was conducted from January 2019 to January 2021. Micro RNA was extracted from plasma of 50 participants and expression was compared through qPCR. While data was analyzed through SPSS version 21.0. Results 29a and 29b had lower expression in participants with family history of DM compared to those having no family history of DM (P < 0.0001). While micro RNA 29c was found to be significantly higher in participants with positive family history of type 2 diabetes as compared to those without family history of diabetes (P = 0.001).


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