scholarly journals Frequency of Malignancies in Surgical Subjects and Subjects with Mass in Breast in the Surgical Department of Pumhsw Nawabshah Pakistan

2021 ◽  
pp. 468-474
Author(s):  
Sadia Ayoob Chandio ◽  
Mashoque Ali Khowaja ◽  
Gulshan Ali Memon ◽  
Attiya Ayaz ◽  
Yasir Ayoob Chandio ◽  
...  
Keyword(s):  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Selection Criterion ◽  
Observational Research ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
College Hospital ◽  
Surgical Department ◽  
Total Female ◽  
Breast Lumps

Objective: To conclude frequency for malignancies in subjects with mass in breast at the PUMHSW Nawabshah department of surgery Wards. Design of Study: This is an Observational research. Duration & Location of Study: Current research was carried out in surgery at Nawabshah People's Medical College Hospital (SBA) from November 20, 2018 to November 20, 2020. Methodology: This research comprised of 200 subjects. A comprehensive history was taken from total subjects with special consideration for breast nodules & axillary lymph nodes & recorded proforma to evaluate the affected area was specifically inspected. A systematic review was also conducted to identify comorbidities. Total subjects received baseline & specific tests, especially radiological & histopathological reports. The selection criterion was that total female subjects over the age of 15 associated with mass in breast were included in this research. Exclusion criteria were subjects with breast abscesses & those who were diagnosed & treated for breast cancer with recurrent lesions. Results: the range of age started from 15-65 years, 39+4.11 years was mean age. lesion of Benign nature on biopsy were were Fibroadenoma 22%, intraductal papilloma 9%, Phylloid Tumor Benign 6% & lactating adenoma 5%. Neoplastic nature was observed on biopsy invasive ductal carcinoma 19%, Invasive lobular carcinoma 11% & malignant phylloides tumor 9%. Conclusion: Study determined that frequency of breast malignancy in breast lumps was 58%.

Metastatic “Ductal Carcinoma In Situ–Like” Lobular Carcinoma in a Lymph Node: A Case Report and Review of the Literature

2019 ◽  
Vol 28 (4) ◽  
pp. 436-439
Author(s):  
Sidiq Tijani ◽  
Kirti Sharma ◽  
Henry Yuen ◽  
Abeer Shaaban
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Outer Quadrant

Metastatic breast cancer resembling ductal carcinoma in situ (DCIS) is a rare phenomenon. In this article, we present a unique case of metastatic lobular carcinoma with DCIS-like morphology in the left axillary lymph nodes of a 52-year-old female. She presented with 2 lesions in the left breast on mammography, and a mastectomy with axillary lymph node dissection was performed. Gross examination showed a 3.5 × 2.5 × 1.0 cm indistinct tumor in the lower outer quadrant and a 2.5 × 2.5 × 1.8 cm tumor in the upper outer quadrant. Microscopic assessment revealed a pleomorphic lobular carcinoma in the lower outer quadrant and a grade 2 invasive ductal carcinoma in the upper outer quadrant. Sixteen of the 17 axillary lymph nodes showed metastatic lobular carcinoma with foci of solid and comedo-type DCIS-like features. Immunohistochemical analysis of the primary and metastatic lobular carcinoma showed no expression of E-cadherin and p63 antibodies. To our knowledge, metastatic lobular carcinoma exhibiting this pattern has not been reported. The case suggests that lobular carcinoma can morphologically recreate a primary microenvironment at a distant site and simulate in situ growth. Recognition of this pattern is important to avoid misdiagnosis.

scholarly journals Intra-mammary lymph nodes, an overlooked breast cancer prognostic tool?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tarek Hashem ◽  
Ahmed Abdelmoez ◽  
Ahmed Mohamed Rozeka ◽  
Hazem Abdelazeem
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Percutaneous Biopsy ◽  
Preoperative Imaging ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Pathological Features ◽  
Breast Cancer Patients ◽  
Surgical Data

Abstract Background Due to the high variability of incidence and prevalence of intra-mammary lymph nodes (IMLNs), they might be overlooked during clinical and radiological examinations. Properly characterizing pathological IMLNs and detecting the factors that might influence their prevalence in different stages of breast cancer might aid in proper therapeutic decision-making and could be of possible prognostic value. Methods Medical records were reviewed for all breast cancer patients treated at the National Cancer Institute of Cairo University between 2013 and 2019. Radiological, pathological, and surgical data were studied. Results Intra-mammary lymph nodes were described in the final pathology reports of 100 patients. Five cases had benign breast lesion. Three cases had phyllodes tumors and two cases had ductal carcinoma in situ (DCIS). All ten cases were excluded. The remaining 90 cases all had invasive breast cancer and were divided into two groups: one group for patients with malignant IMLNs (48) and another for patients with benign IMLNs (42). Pathological features of the malignant IMLN group included larger mean tumor size in pathology (4.7 cm), larger mean size of the IMLN in pathology (1.7 cm), higher incidence of lympho-vascular invasion (65.9%), and higher rate of extracapsular extension in axillary lymph nodes (57.4%). In addition, the pathological N stage was significantly higher in the malignant IMLN group. Conclusion Clinicians frequently overlook intra-mammary lymph nodes. More effort should be performed to detect them during preoperative imaging and during pathological processing of specimens. A suspicious IMLN should undergo a percutaneous biopsy. Malignant IMLNs are associated with advanced pathological features and should be removed during surgery.

scholarly journals Unusual Occurrence of Rare Lipid-Rich Carcinoma and Conventional Invasive Ductal Carcinoma in the One Breast: Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Katarina Machalekova ◽  
Karol Kajo ◽  
Marian Bencat
Keyword(s):  
Lymph Nodes ◽  
Invasive Ductal Carcinoma ◽  
Ductal Carcinoma ◽  
Frozen Section ◽  
Histological Grade ◽  
Resection Margins ◽  
Axillary Lymph Nodes ◽  
Positive Staining ◽  
Axillary Lymph ◽  
Palpable Mass

A 56-year-old woman noticed a palpable mass in her left breast during self-examination. Patient was admitted to our hospital and malignant bifocal tumour was diagnosed by ultrasonography, digital mammography, magnetic resonance, and core-cut biopsy. The patient underwent planned conservative surgery (biquadrantectomy) with a sentinel node examination, but after results of the frozen section with positive resection margins and positive sentinel lymph nodes subsequent mastectomy with axillary lymph node dissection were realized. Histology in the resection specimen revealed two isolated and distinct tumours. One of the lesions represented conventional invasive ductal carcinoma of histological grade 3, and the second tumour was evaluated as invasive lipid-rich carcinoma, containing tumour cells with clear and foamy cytoplasm. Lipids in neoplastic cells were detected by Oil Red O staining and ultrastructural examination. Immunohistochemical analysis of both carcinomas was almost identical with negative steroid receptors, positive staining of HER-2, and p53 and with high proliferation activity (Ki-67). Mastectomy specimen contained residual foci of invasive ductal carcinoma and dissected axillary lymph nodes were free of metastasis. Patient underwent first cycles of chemotherapy with paclitaxel and Herceptin together with local radiotherapy and two month after surgery is without any evidence of the disease.

Ductal Carcinoma In Situ Simultaneously Involving the Breast and Epithelial Inclusions in an Ipsilateral Axillary Lymph Node

2018 ◽  
Vol 26 (6) ◽  
pp. 564-568 ◽  
Author(s):  
Leah A. Commander ◽  
David W. Ollila ◽  
Siobhan M. O’Connor ◽  
Johann D. Hertel ◽  
Benjamin C. Calhoun
Keyword(s):  
Lymph Node ◽  
Ductal Carcinoma In Situ ◽  
Axillary Lymph Node ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Disease ◽  
Metastatic Carcinoma ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph

Benign cystic epithelial inclusions with squamous, glandular, or Müllerian phenotypes are known to occur in the axillary lymph nodes of patients with benign and malignant breast disease. Careful evaluation of hematoxylin and eosin–stained slides and correlation with the histologic findings in the ipsilateral breast are paramount in evaluation of suspected benign inclusions. In this case of ductal carcinoma in situ (DCIS) of the breast in a 73-year-old woman, DCIS also involved epithelial inclusions in an ipsilateral axillary lymph node. The recognition of these benign epithelial elements, and awareness that they can be involved by DCIS, is crucial to avoid the overdiagnosis of metastatic carcinoma.

Solitary, Well-Circumscribed, T2 Hyperintense Masses on MRI Have Very Low Malignancy Rates

2019 ◽  
Vol 1 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Lars J Grimm ◽  
Michael Enslow ◽  
Sujata V Ghate
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Mri ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Malignancy Rate ◽  
The Masses

Abstract Objective The purpose of this study was to determine the malignancy rate of solitary MRI masses with benign BI-RADS descriptors. Methods A retrospective review was conducted of all breast MRI reports that described a mass with a final BI-RADS assessment of 3, 4, or 5, from February 1, 2005, through February 28, 2014 (n = 1510). Studies were excluded if the mass was not solitary, did not meet formal criteria for a mass, or had classically suspicious BI-RADS features (e.g., washout kinetics, and spiculated margin). The masses were reviewed by 2 fellowship-trained breast radiologists who reported consensus BI-RADS mass margin, shape, internal-enhancement, and kinetics descriptors. The T2 signal was reported as hyperintense if equal to or greater than the signal intensity of the axillary lymph nodes. Pathology results or 2 years of imaging follow-up were recorded. Comparisons were made between mass descriptors and clinical outcomes. Results There were 127 women with 127 masses available for analysis. There were 76 (60%) masses that underwent biopsy for an overall malignancy rate of 4% (5/127): 2 ductal carcinoma in situ (DCIS) and 3 invasive ductal carcinoma. The malignancy rate was 2% (1/59) for T2 hyperintense solitary masses. The malignancy rate was greater than 2% for all of the following BI-RADS descriptors: oval (3%, 3/88), round (5%, 2/39), circumscribed (4%, 5/127), homogeneous (4%, 3/74), and dark internal septations (4%, 2/44). Conclusion T2 hyperintense solitary masses without associated suspicious features have a low malignancy rate, and they could be considered for a BI-RADS 3 final assessment.

Breast Reconstruction With Postmastectomy Radiation: Choices and Tradeoffs

2017 ◽  
Vol 35 (22) ◽  
pp. 2467-2470 ◽  
Author(s):  
Matthew M. Poppe ◽  
Jayant P. Agarwal
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Ductal Carcinoma ◽  
Treatment Plan ◽  
Multidisciplinary Treatment ◽  
Muscle Flap ◽  
Axillary Node ◽  
Axillary Lymph Nodes ◽  
Autologous Reconstruction ◽  
Axillary Lymph

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 45-year-old premenopausal woman presented with multifocal cancer in the right breast, with lesions at 1:00 and 4:00, the largest measuring approximately 3 cm on exam, and multiple palpable right axillary lymph nodes. A core biopsy confirmed invasive ductal carcinoma, grade 2 of 3, that was estrogen receptor positive, progesterone receptor positive, and HER2 negative. Fine needle aspiration of a right axillary node confirmed metastatic carcinoma. A positron emission tomography (PET)/ computed tomography done before starting chemotherapy demonstrated an absence of metastatic disease with expected avidity in two separate breast masses and multiple conglomerated 1-2 cm level I and II axillary lymph nodes. She received neoadjuvant chemotherapy with doxorubicin plus cyclophosphamide, followed by paclitaxel, and had a complete clinical response with resolution of the breast and axillary masses on exam. A repeat PET/computed tomography demonstrated reduced size of the breast and axillary disease, and no significant residual PET avidity. Her breast surgeon recommended a right mastectomy with axillary node dissection. As part of her multidisciplinary treatment plan, she consulted with two plastic surgeons to discuss reconstruction options. Plastic Surgeon A advised placement of an implant at the time of mastectomy while Surgeon B contrasted the pros and cons of an autologous transverse rectus abdominis muscle flap reconstruction with an implant based reconstruction. Surgeon B believed that autologous reconstruction would yield the best long-term cosmetic outcome. Before making her surgery decision, the patient consulted with a radiation oncologist to discuss the effect radiation may have on her reconstruction outcome.

scholarly journals Tuberculosis axillary lymph node coexistent breast cancer in adjuvant treatment: case report

2015 ◽  
Vol 13 (3) ◽  
pp. 423-425 ◽  
Author(s):  
Silvio Eduardo Bromberg ◽  
Paulo Gustavo Tenório do Amaral
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Treatment ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Lymph Node Biopsy ◽  
Accurate Diagnosis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy

Coexistence of breast cancer and tuberculosis is rare. In most cases, involvement by tuberculosis occurs in axillary lymph nodes. We report a case of a 43-years-old patient who had undergone adenomastectomy and left sentinel lymph node biopsy due to a triple negative ductal carcinoma. At the end of adjuvant treatment, the patient had an atypical lymph node in the left axilla. Lymph node was excised, and after laboratory analysis, the diagnosis was ganglion tuberculosis. The patient underwent treatment for primary tuberculosis. The development of these two pathologies can lead to problems in diagnosis and treatment. An accurate diagnosis is important to avoid unnecessary surgical procedures.

scholarly journals RETROSPECTIVE ANALYSIS OF BREAST CANCER CASES AND SURGICAL TREATMENT IN A PERIOD OF TEN YEARS

2003 ◽  
Vol 40 (139) ◽  
pp. 112-119 ◽  
Author(s):  
Prakash Sayami ◽  
B M Singh ◽  
Y Singh ◽  
R Timila ◽  
U Shrestha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Analysis ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
False Negative ◽  
False Negative Rate ◽  
Axillary Lymph ◽  
Duration Of Symptoms ◽  
Tubular Carcinoma ◽  
Advanced Stages

Retrospective analysis of 321 cases of breast cancer diagnosed in T. U Teaching Hospitalin a period of 10 years, from May, 1991 to April, 2000 was carried out. There were317 cases (98.8%) females and 4 cases males (1.2%). The youngest patient was 22year old female and oldest patient was 92 year old female. The most common agegroup according to frequency was in forties (34.6%) followed by in thirties (25.5 %).Mean duration of symptoms before coming to doctor was 8.3 months and mean size oftumor was 6 cm. Out of 317 females, 310(97.2%) were married and average numberof children was 3. Out of 289 cases diagnosed as malignancy with fine needle aspirationcytology (FNAC) 279 (96.5%) was also diagnosed as malignancy in biopsy and theremaining 10 cases as non malignant diseases were diagnosed as malignancy in biopsywith a false negative rate of 3.5%. The histological types of breast cancer cases wereInfiltrating Ductal Carcinoma 280 cases (87.2%), Medullary Carcinoma 11 cases(3.4%), Infiltrating Lobular Carcinoma 5 cases (1.6%), Mucinous Carcinoma 4 cases(1.2%), Sarcoma 4 cases (1.2%), Squamous Cell Carcinoma 4 cases (1.2%), PapillaryCarcinoma 3 cases (0.9%), Tubular Carcinoma 2 cases, Adenosquamous Carcinoma2 cases (0.6%), Intraductal Carcinoma 2 cases (0.6%) and Non-Hodgkins Lymphoma1 case. Out of 305 operated cases, the types of operation performed was ModifiedRadical Mastectomy in 208 cases (68 %) and palliative mastectomy in 72 cases (23.5%),only lumpectomy in 24 cases (7.9%) and others in 2 cases. Among 246 cases withavailable axillary lymph node biopsy, there was metastatic diseases in 146 cases (60%)of cases. The Breast cancer was diagnosed in advanced stages in 63% of cases. StageIIIA (24%), Stage IIIB (21.5%) and Stage IV (17.4%). Breast cancers were diagnosedin advanced stages in below 40 age group in 65 out of 90 cases (72.2 % ) comparedto137 out of 231 cases ( 59.3 % ) in above 40 age group.Key Words: Breast cancer, Advanced stage, FNAC, Surgery.

Comments on a Series of 88 Invasive Microcarcinomas of the Breast

1983 ◽  
Vol 69 (4) ◽  
pp. 339-342 ◽  
Author(s):  
Bruno Salvadori ◽  
Alberto Luini ◽  
Giuseppe Muscolino ◽  
Marco Greco
Keyword(s):  
Breast Cancer ◽  
Invasive Breast Cancer ◽  
Axillary Dissection ◽  
Lobular Carcinoma ◽  
Minimal Invasive ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Actuarial Survival ◽  
Limited Surgery ◽  
Pathologic Assessment

Eightly-eight women with minimal invasive breast cancer were treated at the Istituto Nazionale Tumori of Milan, in the decade 1970–1980. Their tumors were smaller than 0.5 cm in diameter and were clinically assessed as T1N0M0; surgery, consisting of radical or limited procedures, was performed, always with complete axillary dissection. Pathologic assessment showed that axillary lymph nodes presented with metastases in 21.5% of cases. In 1 of N-positive cases, more than 3 nodes were affected, and in 5 cases extracapsular invasion was observed. Five-year actuarial survival, calculated by the life table method, was as high as 90%, demonstrating that these have a favorable prognosis, even when they are treated by limited surgery followed by radiotherapy on the residual breast, provided that the axilla is completely dissected. Minimal invasive breast cancer should consequently be clearly distinguished from other pathologic entities termed as « minimal », such as lobular carcinoma in situ and intraductal carcinoma, for which complete axillary dissection is not worthwhile.

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