scholarly journals TUMOR FILODES MAMÁRIO COM COMPONENTE DE CARCINOMA DUCTAL INVASOR: UMA RARA ASSOCIAÇÃO

2021 ◽  
Vol 7 (4) ◽  
pp. 1-5
Author(s):  
Welington Lombardi ◽  
◽  
Luciana Borges Lombardi ◽  
Flávia Vicentin Silva ◽  
Narhima Ahdlie Bou Abbas
Keyword(s):  
Core Biopsy

Introdução: O tumor filodes (TF) corresponde a uma neoplasia caracterizada por um maior grau de pleomorfismo das células estromais, além do estroma ser mais abundante e mais celular do que o observado nos fibroadenomas. Trata-se de uma neoplasia fibroepitelial da glândula mamária pouco comum, representando cerca de 0,3% a 0,9% das neoplasias da mama, e 1% a 2,5% dos tumores epiteliais da mama. Pode, raramente, ocorrer em conjunto com carcinomas de mama in situ ou invasivos, sendo o TF na maioria das vezes maligno, e estando presente em 1 a 2% dos casos. A concomitância entre tumor filodes benigno e carcinoma ductal invasivo é ainda mais rara, o que justifica a importância deste estudo. Relato do caso: Assim sendo, relata-se um raro caso de uma paciente feminina, com nodulação palpável em quadrante superior lateral da mama esquerda, cuja punção aspirativa por agulha fina (PAAF), demonstrou quadro citológico hemorrágico intensamente hipocelular com irregularidades nucleares. A core-biopsy evidenciou proliferação bifásica estromatoglandular benigna sugestiva de fibroadenoma. A setorectomia diagnóstica evidenciou carcinoma ductal invasivo e tumor filodes benigno com infarto hemorrágico central, confirmados no anatomopatológico e pela imunohistoquímica. Conclusão: O objetivo, portanto, é descrever um caso pouco frequente de carcinoma ductal invasivo concomitante com tumor filodes benigno na mama, discorrendo sobre suas manifestaçõeses clínicas, diagnóstico e tratamento, auxiliando na abordagem de novos casos semelhantes.

Reflex Estrogen Receptor (ER) and Progesterone Receptor (PR) Analysis of Ductal Carcinoma In Situ (DCIS) in Breast Needle Core Biopsy Specimens

2016 ◽  
Vol 40 (8) ◽  
pp. 1090-1099 ◽  
Author(s):  
Christopher J. VandenBussche ◽  
Ashley Cimino-Mathews ◽  
Ben Ho Park ◽  
Leisha A. Emens ◽  
Theodore N. Tsangaris ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Ductal Carcinoma In Situ ◽  
Core Biopsy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Needle Core Biopsy ◽  
Biopsy Specimens

Advocating Nonsurgical Management of Patients With Small, Incidental Radial Scars at the Time of Needle Core Biopsy: A Study of 77 Cases

2015 ◽  
Vol 139 (9) ◽  
pp. 1137-1142 ◽  
Author(s):  
Cathleen Matrai ◽  
Timothy M. D'Alfonso ◽  
Lindsay Pharmer ◽  
Michele B. Drotman ◽  
Rache M. Simmons ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Core Biopsy ◽  
Carcinoma In Situ ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Radial Scar ◽  
Needle Core Biopsy ◽  
Ductal Hyperplasia

Context Radial scars are benign sclerosing lesions that are routinely excised when diagnosed in a needle core biopsy. Optimal management for patients with incidental and small (≤5 mm) radial scars is uncertain. Objective To assess pathologic upgrade of radial scars diagnosed in needle core biopsy samples and identify a subset of patients who could benefit from conservative management. Design Patients with a diagnosis of radial scar in a needle core biopsy who underwent excision of the biopsied area were identified. Radial scars greater than 5 mm in size and those with coexisting atypia, carcinoma, and papillary lesions were excluded. After histologic-radiographic correlation, rates of pathologic upgrade were assessed. Results Seventy-seven radial scars diagnosed in 66 patients were included. Overall, 9 of 77 (12%) showed upgrade to a high-risk lesion (6 lobular carcinoma in situ, 2 atypical ductal hyperplasia, 1 atypical lobular hyperplasia), while none (0%) showed upgrade to invasive carcinoma or ductal carcinoma in situ. One of 22 incidental radial scars (4.5%) showed upgrade on excision versus 6 of 36 (16.7%) for radial scars considered to be the radiographic target (P = .23). Older age was associated with upgrade (P < .001). Conclusions No incidental or small (≤5 mm) radial scars excised revealed invasive carcinoma or ductal carcinoma in situ on excision. Provided there is good pathologic-radiologic concordance, it appears reasonable for these patients to be managed conservatively.

Do Breast Columnar Cell Lesions with Atypia Need to be Excised?

2007 ◽  
Vol 73 (10) ◽  
pp. 984-986
Author(s):  
Nicole Datrice ◽  
Navneet Narula ◽  
Melinda Maggard ◽  
John Butler ◽  
David Hsiang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Core Biopsy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Excisional Biopsy ◽  
Columnar Cell ◽  
Columnar Cell Lesion ◽  
Simple Mastectomy ◽  
Abnormal Pathology

Columnar cell lesion with atypia (CCLA) is a newly recognized pathologic entity seen in breast specimens. The breast cancer risk associated with this finding is unclear, although CCLA had been found adjacent to both in situ and invasive carcinomas, but the incidence is unknown. Breast specimens from patients with a columnar cell lesion were reviewed by a pathologist for atypia. Twenty-one specimens with CCLA were identified [core biopsy (8), excisional biopsy (11), and simple mastectomy (2)]. Six of eight specimens with CCLA on core had adjacent abnormal pathology: infiltrating ductal carcinoma (IDC)/lobular carcinoma in situ (LCIS) (1), ductal carcinoma in situ (DCIS)/LCIS (1), DCIS (1), LCIS (1), and papillomatosis (2). Five of 11 specimens with CCLA on excisional biopsy had adjacent abnormal pathology: IDC (3), DCIS/LCIS (1), and atypical ductal hyperplasia/papilloma (1). Two of two simple mastectomy specimens had CCLA associated with IDC (1) and DCIS (1). Overall, abnormal pathology was found adjacent to CCLA in 62 per cent of specimens (13/21). Breast pathologic specimens containing a columnar cell lesion should be carefully examined for atypia. Surgical excision is warranted for CCLA found on core biopsy. The future risk of breast cancer based on the finding of CCLA alone requires further investigation.

SP3, a reliable alternative to HercepTest in determining HER-2/neu status in breast cancer patients

2013 ◽  
Vol 66 (5) ◽  
pp. 409-414 ◽  
Author(s):  
Timothy Michael D'Alfonso ◽  
Yi-Fang Liu ◽  
Zhengming Chen ◽  
Ying-Bei Chen ◽  
Ashley Cimino-Mathews ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Core Biopsy ◽  
In Situ Hybridisation ◽  
Excisional Biopsy ◽  
Needle Core Biopsy ◽  
Breast Cancer Patients ◽  
Biopsy Specimens ◽  
Her 2

Accurate assessment of HER-2/neu gene status in breast cancer patients has important prognostic and therapeutic implications. Overexpression/gene amplification of HER-2 is associated with a more aggressive clinical course and eligibility for targeted therapy with trastuzumab. A variety of immunohistochemical (IHC) antibodies and in situ hybridisation (ISH) methods have been employed to assess HER-2 status. SP3 is a rabbit monoclonal antibody that has been shown to have a high level of agreement with other anti-HER-2 antibodies and ISH methods. We assessed HER-2 status by SP3 and HercepTest IHC stains and by fluorescence in situ hybridisation (FISH) on invasive breast carcinomas from paired needle core biopsy and excisional biopsy specimens from 100 patients. We compared the two antibodies with respect to concordance rates with FISH, concordance rates between samples of the same tumour, and sensitivity and specificity using FISH as the reference test. Concordance between SP3 and FISH in needle core biopsy and excisional biopsy specimens was 96% (95% CI 91.9% to 99.7%) (κ=0.89 (95% CI 0.73 to 1.00)) and 97% (95% CI 90.3% to 99.3%) (κ=0.84 (95% CI 0.66 to 1.00)), respectively. Sensitivity and specificity of SP3 for detecting HER-2 overexpression/gene amplification were 78.3% and 100%, respectively, in needle core biopsy and excisional biopsy specimens. Concordance between SP3 results assessed on the needle core biopsy and excisional biopsy was 89% (95% CI 81.2% to 94.4%) (κ=0.62 (95% CI 0.42 to 0.82)). Concordance between SP3 and HercepTest antibodies, after excluding 2+ cases, was 97.6% (95% CI 94.0% to 99.3%) (κ=0.88 (95% CI 0.77 to 1.00)). SP3 is a reliable alternative to HercepTest in evaluating HER-2 status in breast cancer patients. Like other anti-HER-2 antibodies, SP3 may serve as a diagnostic tool in breast pathology and has potential utility as an IHC biomarker in non-mammary malignancies.

scholarly journals A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme

2011 ◽  
Vol 93 (2) ◽  
pp. 123-126 ◽  
Author(s):  
G Osborn ◽  
F Wilton ◽  
G Stevens ◽  
E Vaughan-Williams ◽  
K Gower-Thomas
Keyword(s):  
Core Biopsy ◽  
Breast Screening ◽  
Screening Programme ◽  
Ductal Carcinoma ◽  
Surgical Excision ◽  
Excision Biopsy ◽  
Needle Core Biopsy ◽  
Breast Screening Programme ◽  
Benign Biopsy

INTRODUCTION Radial scars are benign breast lesions; their appearance on mammography may, however, mimic carcinoma. Needle core biopsy is performed for pre-operative diagnosis and, currently in Wales, all lesions with benign biopsy results are surgically excised. We have reviewed all cases of needle core biopsy-diagnosed radial scars from the Welsh breast screening programme, Breast Test Wales (BTW), and investigated the outcome of radial scars based on histology from surgical excision in order to evaluate the appropriateness of the current management of these lesions in Wales. PATIENTS AND METHODS All needle core biopsy diagnosed radial scars were identified from the BTW screening database from the start of screening in 1989 until the end of 2007. RESULTS A total of 118 patients were diagnosed with radial scars on needle core biopsy; two patients had bilateral radial scars. Median patient age was 54 years (range, 49-68 years). Ninety-five lesions (79%) were thought to be pure radial scars on needle core biopsy; however, only 81 pure radial scars were identified on excision biopsy histology. Carcinoma was present in seven patients and ductal carcinoma in situ in nine patients at excision biopsy. In two patients, the cancers occurred in lesions reported as pure radial scars on needle core biopsy. Twenty-two lesions showed atypical ductal or lobular hyperplasia (ADH/ALH) or both on excision biopsy; 14 of these lesions were classed as pure radial scars by needle core biopsy. CONCLUSIONS All core biopsy diagnosed radial scars, presenting as screen detected abnormalities, should be excised due to their association with premalignant and malignant conditions.

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