scholarly journals Diagnostic value of Breast Specific Gamma Imaging with semiquantitative index (T/N) in Breast Cancer Diagnosis

2018 ◽  
Vol 2 (1) ◽  
pp. 32-37
Author(s):  
Dipendra Kumar Mallik ◽  
Wei Zhang Hong ◽  
Wei Zhu ◽  
Ge Yang Wei ◽  
Lei Shen ◽  
...  

Objective: The study in this part was to evaluate the diagnostic value of Breast Specific Gamma Imaging (BSGI) by semi-quantitative method for detection of breast cancer. Methods: 400 patients with indeterminate breast tumors that underwent BSGI were enrolled in this study. All included lesions were confirmed by postoperative pathology. BSGI evaluation was based on the visual interpretation and semi-quantitative parameters of the higher tumor to non-lesion (T/N) value of CC and MLO. Compared with pathological results, the optimal visual analysis and the value of T/N were calculated through ROC curve analysis. Independent t-test and Pearson linear correlation were applied for statistical analysis. Results: Tumor to non-lesion (T/N) ratio was available for 279 out of 400 patients. This population comprised 203 patients with malignant and 74 patients with benign lesion. ROC analysis showed critical value of T/N= 1.91, AUC is 0.83 (standard error=0.014, 95% confidence interval); BSGI sensitivity is 83.71% and specificity is 76%. T/N ratio for invasive and non-invasive cancers are 2.70± 0.88, and 2.09±0.44 respectively; the difference between two have statistical significance (t=3.32, P=0.001). Infiltrating ductal carcinoma (IDC) grade I, grade II, and grade III have T/N ratio of 2.33±0.94, 2.38±0.80, 2.89±0.89 respectively. The T/N differences between grade I and grade II have no statistical significance (t=0.12, P=0.89). The T/N differences between grade I and grade III have no statistical significance (t=1.56, P=0.12). The T/N differences between grade II and grade III have statistical significance (t=3.69, P<0.001). T/N value for tumor size <1cm and >1cm were 1.97±0.79 and 2.46±0.88 respectively; the difference between two have statistical significance (t=3.27, P=0.001). Conclusion: The semi-quantitative index of T/N correlates with clinico-pathological characteristics of tumor like: size, grade, and invasiveness of breast cancer, and at certain level can be helpful to determine patient’s prognosis.

2005 ◽  
Vol 62 (10) ◽  
pp. 745-749 ◽  
Author(s):  
Boris Ajdinovic ◽  
Zoran Krstic ◽  
Marija Dopudja ◽  
Ljiljana Jaukovic

Background/Aim. To determine the incidence of abnormal Technetium Tc 99m Dimercaptosuccinic Acid (Tc99m DMSA) renal scintigraphy findings in the children with urinary tract infection (UTI), and to evaluate the difference between the children with UTI and vesico-ureteral reflux (VUR), and the children with UTI without VUR. Methods. Tc99m DMSA renal scintigraphy was performed in 170 children with UTI, mean age 7.07 years (1 month to 14 years, 137 were girls and 33 were boys). In 88 of the children, VUR was proved by micturating cystouretherography (MCU), while in 82 VUR could not be detected by MCU. VUR was graded in accordance with MCU recommended by the international study of VUR. In 13 of the children the grade of VUR was grade I, in 30 was grade II, in 23 grade III, in 17 grade IV, while the grade V was in 5 of the children. Findings of Tc99m DMSA renal scintigraphy were classified as: 1 - normal, 2 - probably normal, 3 - equivocal, 4 - probably abnormal, and 5 - abnormal. The degree of the significance of the difference of the findings was estimated using ?2, taking p < 0.01 as the limit of statistical significance. Results. Of the total number of 170 studied children, the abnormal findings were detected in 30% (51/170), normal findings in 62% (106/170), and equivocal in 8% (13/170). In the children with UTI and VUR, the incidence of abnormal findings was 49% (43/88), of normal 43% (38/88), and of equivocal findings 8% (7/88). All the children with VUR grade V had the abnormal findings (the incidence of the abnormal findings was 100%). In the children with VUR grade IV, the abnormal findings were 71%. In the children with VUR grade I, 77% of the findings were normal, in the children with VUR grade II, 53% of the findings were normal and in the children with VUR grade III, 30% of the findings of renal scintigraphy were normal. In the children with UTI without VUR, the incidence of abnormal findings was 10% (8/82), of normal findings 83% (68/82), and of equivocal findings 7% (6/82). The incidence of abnormal findings was significantly higher in the children with UTI and VUR than in those with UTI without VUR (p < 0.01). Also, the incidence of the abnormal findings was higher in the children with VUR grades IV and V than in the children with VUR grade I (p < 0.01). Conclusion. DMSA renal scintigraphy in the children with ITU revealed the abnormal findings in 30% of the cases. The incidence of the abnormal findings was significantly higher when VUR was present, as well as if the grade of VUR was higher. Our results confirmed that Tc99m DMSA renal scintigraphy was a very important technique in the evaluation of the children with ITU.


Author(s):  
Yu Wang ◽  
Jiantao Wang ◽  
Haiping Wang ◽  
Xinyu Yang ◽  
Liming Chang ◽  
...  

Objective: Accurate assessment of breast tumor size preoperatively is important for the initial decision-making in surgical approach. Therefore, we aimed to compare efficacy of mammography and ultrasonography in ductal carcinoma in situ (DCIS) of breast cancer. Methods: Preoperative mammography and ultrasonography were performed on 104 women with DCIS of breast cancer. We compared the accuracy of each of the imaging modalities with pathological size by Pearson correlation. For each modality, it was considered concordant if the difference between imaging assessment and pathological measurement is less than 0.5cm. Results: At pathological examination tumor size ranged from 0.4cm to 7.2cm in largest diameter. For mammographically determined size versus pathological size, correlation coefficient of r was 0.786 and for ultrasonography it was 0.651. Grouped by breast composition, in almost entirely fatty and scattered areas of fibroglandular dense breast, correlation coefficient of r was 0.790 for mammography and 0.678 for ultrasonography; in heterogeneously dense and extremely dense breast, correlation coefficient of r was 0.770 for mammography and 0.548 for ultrasonography. In microcalcification positive group, coeffient of r was 0.772 for mammography and 0.570 for ultrasonography. In microcalcification negative group, coeffient of r was 0.806 for mammography and 0.783 for ultrasonography. Conclusion: Mammography was more accurate than ultrasonography in measuring the largest cancer diameter in DCIS of breast cancer. The correlation coefficient improved in the group of almost entirely fatty/ scattered areas of fibroglandular dense breast or in microcalcification negative group.


2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A970-A970
Author(s):  
Danielle Fails ◽  
Michael Spencer

BackgroundEpithelial-mesenchymal transition (EMT) is instrumental during embryonic development—assisting in extensive movement and differentiation of cells. However, during metastasis and tumorigenesis, this process is hijacked. The disruption of this developmental process, and subsequent acquisition of a mesenchymal phenotype, has been shown to increase therapeutic resistance and often leads to poor prognosis in breast cancer.1 Using bioinformatic resources and current clinical data, we designed a panel of biomarkers of value to specifically observe this epithelial/mesenchymal transition.MethodsHuman breast cancer FFPE tissue samples were stained with Bethyl Laboratories IHC-validated primary antibodies, followed by Bethyl HRP-conjugated secondary antibodies, and detected using Akoya Opal™ Polaris 7-color IHC kit fluorophores (Akoya Biosciences [NEL861001KT]). The panel consisted of beta-Catenin, E-Cadherin, Ki67, CD3e, PD-L1, and FOXP3. Antibody staining order was optimized using tissue microarray serial sections, three slides per target, and stained in either the first, third, or sixth position via heat-induced epitope retrieval (HIER) methods. Exposure time was maintained for all three slides/target and cell counts, signal intensity, background, and autofluorescence were analyzed. The final optimized order was then tested on the breast cancer microarray in seven-color mIF. Whole slide scans were generated using the Vectra Polaris® and analyses performed using InForm® and R® Studio.ResultsTwo integral EMT targets, E-Cadherin and beta-Catenin, were used to observe a key occurrence in this transition. Under tumorigenic circumstances, when released from the complex they form together (E-cadherin-B-catenin complex), Beta-catenin can induce EMT. This disjunction/activation of EMT can be seen in the invasive ductal carcinoma below (figure 1).The disorganized E-cadherin cells are in direct contrast to normal, non-cancerous cells in similar tissue. Total CD3e cell counts were down (2%), with 35% cells restricted to the stroma vs. the 1% seen intra-tumorally. Coupled with the elevated presence of Ki67 (10%), a level of rapid cancer growth and potential metastasis (Invasive Ductal Carcinoma Grade II) can be observed.Abstract 925 Figure 1Invasive ductal carcinoma, grade II stained with a 6-plex mIF panel designed to show the epithelial-mesenchymal transitionConclusionsThe presence of EMT in breast cancers is often indicative of a poor prognosis, so the need for reliable markers is imperative. E-Cadherin and beta-Catenin are both up-and-coming clinical targets that can serve to outline this transition within the tumor microenvironment. By utilizing these markers in mIF, closer spatial examination of proteins of interest can be achieved. The application of this mIF panel has the potential to provide invaluable insights into how tumor infiltrating lymphocytes behave in cancers exhibiting the hallmarks of EMT.AcknowledgementsWe would like to acknowledge Clemens Deurrschmid, PhD, Technical Applications Scientist Southeast/South Central, Akoya Biosciences for his assistance with image analysis.ReferencesHorne HN, Oh H, Sherman ME, et al. E-cadherin breast tumor expression, risk factors and survival: pooled analysis of 5,933 cases from 12 studies in the breast cancer association consortium. Sci Rep 2018;8:6574.


2020 ◽  
Vol 3 (1) ◽  
pp. 33
Author(s):  
Andi Syarti ◽  
Ulinta Pasaribu ◽  
Dyah Fauziah ◽  
Lies Mardiyana ◽  
Tri Wulanhandarini

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.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 587-587 ◽  
Author(s):  
Z. Nahleh ◽  
R. Srikantiah ◽  
R. Komrokji ◽  
M. Safa ◽  
J. Pancoast ◽  
...  

587 Background: The incidence of MBC continues to rise. Few studies have addressed the differences between MBC and female breast cancer (FBC). Treatment for MBC has ben extrapolated from FBC regimens. The VA cancer registry (VACCR) provides a unique source to study MBC. This retrospective analysis aims at comparing the characteristics and outcome of MBC and FBC in the VA population. Methods: We reviewed the VACCR database between 1995 and 2005, for 120 VA medical centers. Primary breast cancer site codes were identified (500–508). Data was entered and analyzed using bio-statistical software SPSS. Results: A total of 3025 patients :612 MBC and 2413 FBC were compared. Mean age at diagnosis was 67 for MBC and 57 for FBC (p <0.005). More MBC patients were black. MBC patients presented with a significantly higher stage of disease, more node positive(N+) and larger tumor size. In MBC, ductal histology was more common while lobular and ductal carcinoma in situ were less common than in FBC. ER + and PR + tumors were significantly more common in MBC (60% vs 52% and 53% vs 47%, P< 0.005). MBC patients received less chemotherapy while no statistical difference in hormonal treatment was observed. The median overall survival (OS) was lower for MBC (7 years vs 9.8 years, p<0.005). OS was not significantly different for stage III and IV while OS was inferior for MBC in stage I (7 yr vs not reached, p 0.005) and stage II (6 vs 8.6yr, p 0.001). In N- tumors, OS was inferior in MBC (6.1 vs 14.6 yr, p<0.005) but not statistically different for N+ tumors . In ER + and PR + tumors, OS was inferior in MBC (7yr vs 8yr and 7.3 yr vs 9.8 yr p<0.005); however, no statistical significance was observed in ER - or PR - tumors. Using Cox regression analysis age, sex, clinical stage, nodal status were statistically independent prognostic factors while race, histology and grade were not. Conclusion: This study suggests differences in the biology, pathology, presentation, and survival between male and female VA breast cancer patients. Survival of MBC patients appears inferior in early stage disease and N- tumors suggesting gender differences in the tumor pathogenesis and biology. In hormone receptor + MBC, survival was also inferior despite similar hormonal treatment practices. This observational study calls for different approach and treatment strategies in MBC. No significant financial relationships to disclose.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 580-580 ◽  
Author(s):  
Xavier Pivot ◽  
Mark D. Pegram ◽  
Javier Cortes ◽  
Diana Lüftner ◽  
Gary H. Lyman ◽  
...  

580 Background: SB3 is an approved biosimilar of reference trastuzumab (TRZ). At additional 2-year follow-up after completing neoadjuvant and adjuvant treatment, there was a difference in event-free survival (EFS), but no difference in overall survival (OS) between SB3 and TRZ. Upon monitoring quality attributes of TRZ, a marked downward shift in antibody-dependent cell-mediated cytotoxicity activities (ADCC) was observed in TRZ lots with expiry dates from Aug 2018 to Dec 2019. Some of the lots were used in the Phase III study. This is a post-hoc analysis of EFS and OS by ADCC status from a 3-year follow-up to investigate the difference in EFS between SB3 and TRZ. Methods: After completion of neoadjuvant and adjuvant therapy in patients with HER2 positive early breast cancer, patients from selected countries participated in a 5-year follow-up study (NCT02771795). Within the TRZ group, patients exposed to at least one shifted ADCC lot and those never exposed to shifted ADCC lot during neoadjuvant period were considered as “Exposed” and “Unexposed,” respectively. EFS and OS after 3-year follow-up was analyzed by ADCC status in the long-term follow-up set. Results: 367 patients (SB3, N = 186; TRZ, N = 181) were enrolled in the follow-up study. Within TRZ, 55 patients were Unexposed and 126 patients were Exposed. At a median follow-up duration of 40.8 months in SB3 and 40.5 months in TRZ, 3-year EFS rates were 92.5% in SB3, 94.5% in Unexposed, and 82.5% in Exposed and OS rates were 97.0%, 100%, and 90.6%, respectively. Exposed was associated with decreased EFS compared to Unexposed (HR 0.14, 95% CI 0.04-0.51, p= 0.003). There was a trend of decreased OS in Exposed compared to Unexposed, however, there was no significant difference (HR 0.14, 95% CI 0.02-1.15, p= 0.068). Between SB3 and Unexposed, no difference was observed in EFS (HR 1.06, 95% CI 0.33-3.44, p= 0.923), or OS (HR 0.54, 95% CI 0.05-5.44, p= 0.600). Conclusions: Within the TRZ group, Exposed showed significantly lower EFS compared to Unexposed, and a similar trend was observed in OS with no statistical significance. Between SB3 and Unexposed, no significant difference in EFS or OS was observed. Clinical trial information: NCT02771795.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 3033-3033
Author(s):  
William Williams ◽  
Shaker R. Dakhil ◽  
Carmen Julia Calfa ◽  
Jarrod P. Holmes ◽  
Saveri Bhattacharya ◽  
...  

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]


Author(s):  
Basumitra Das ◽  
Kurimella Vamsya Raj ◽  
Bhagyalakshmi Atla

Background: Astrocytomas form the largest group of gliomas (>75%) and diffusely infiltrating    accounting for more than 60% of all the primary brain tumors. The ki67 proliferative index is a potent biologic marker that estimates the growth of neoplasms quantitatively and thus will aid in identifying the prognosis for patients with neoplasms.  The aim of the research work was to study various histopathological and clinical features of Astrocytomas in detail, to evaluate Ki-67 proliferative index in patients of Astrocytomas and to compare the results of Immunohistochemistry with histological grade of Astrocytomas.Methods: A   total   number   of    40 cases of   Astrocytomas were included in the study.  Ki-67 immunostaining was done on all cases and compared with WHO histological grading of astrocytomas.Results: The mean Ki‑67 LI in Grade I astrocytomas was 4.66, range 4-5 ,  in Grade II astrocytomas mean was 8.07, range 5-12 ,in Grade III astrocytomas mean was 13.5 , range 8-20,  in Grade IV astrocytomas mean was 22.93, range 15-50. There was a highly significant correlation between the histopathological grade of astrocytomas and Ki-67 LI (p<0.05).Conclusions: The monoclonal antibody Ki-67 has proven its prognostic and diagnostic power in astrocytic tumors. Ki-67 LI is the simplest and the most reliable method for evaluating cell proliferation. Ki-67 LI increased with histological grade and the difference between low grade (I and II astrocytomas) and high grade (grade III and IV) is significant. In the present study Ki-67 LI is not dependent on factors like age and sex and is solely dependent on histological grade.


2002 ◽  
Vol 17 (suppl 1) ◽  
pp. 7-10 ◽  
Author(s):  
Carlos Teixeira Brandt ◽  
Ana Lúcia Coutinho Domingues ◽  
Paulo Vilela ◽  
Andréa Sena ◽  
Karina Marques ◽  
...  

The usual histology report of hepatic fibrosis in patients with hepatosplenic schistosomiasis mansoni presents no association with hemodynamic and clinical liver parameters. Histomorphometry is adding a new tool of investigation for measuring density of portal fibrosis in these patients. This investigation was set up for assessing a possible agreement between the well-accepted international classification and the fibrosis density grades measured by histomorphometry. Thirty-five children and equal number of adults were included in this study. All patients underwent splenectomy and ligature of the left gastric vein. Histology findings were assessed in surgical liver biopsy stained with Masson trichrome. The official histology report was used as reference. The histomorphometric studies were done by semi-automatic morphometry. The mean percentage (X) of portal fibrosis plus or minus one standard deviation (SD) was classified as grade II (7.06% up to 34.72%); grade I was up to 7.06%; and grade III above 34.72%. Although, not reaching statistical significance, there is a tendency of the fibrosis to be more intense in children than adults (X±SD - 22.02±13.46% versus 20.63%±15.33% "t" = 0.379 p>0.05). Seven out of nine (77.8%) patients classified as grade I, by morphometry, had the same result on the official report, however, two (22.2%) were described as grade III. Sixteen out of forty-four (36.4%) classified as grade II on morphometry had the same classification as the histology grade, but, twenty seven (61.4%) were classified as grade III and one (2.3%) as grade I. Fifteen (21.4%) out of 70 patients had grade III on both classifications, but, two (11.8%) out of seventeen G III on morphometry were grade II. The kappa (k) measurement of agreement between both classification was k = 0.319, showing a fair strength of association. The histomorphometric measurements of Symmers fibrosis in surgical patients with mansonic schistosomiasis partially support the report from The Department of Pathology - University Hospital, Federal University of Pernambuco - Brazil. However, there is a discrepancy in grade III. While in the official classification, the majority (62.8%) accounts for this grade, on morphometry only 38.6% represent the same grade. On the contrary, on morphometry, similar majority (62.8%) is grade II.


Author(s):  
Bijoya Debnath ◽  
Mary Lilly

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.


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