Pancreatic metastasis of invasive ductal breast carcinoma: A potential diagnostic pitfall

The 42-year-old patient, diagnosed with Stage IIA breast cancer, completed the postoperative adjuvant chemotherapy and radiotherapy. At the 11th year of diagnosis, a 3 cm tumor was detected in the pancreas and pancreatectomy was performed. Although the diagnosis of primary pancreatic adenocarcinoma was made at first, then the pancreatic metastasis of breast cancer was discovered. Pancreatic metastasis of breast cancer is extremely rare, and a limited number of patients have been reported in the literature. Here, we report an additional case of this rare tumor and the problems correlating with its diagnosis.

Hematotoxicity and functional impacts related to chemotherapy with doxorubicin and cyclophosphamide for invasive ductal breast carcinoma: a study in clinical records

Objective: To evaluate the occurrence of hematological and functional toxicities during chemotherapy with doxorubicin and cyclophosphamide in women with breast invasive ductal carcinoma. Methods: This was a descriptive, cross-sectional and quantitative study, involving the data collection in clinical records of 119 women undergoing chemotherapy for breast invasive ductal carcinoma in an oncology outpatient clinic, carried out between February 2014 and February 2015. Results: The investigated toxicities and their respectively occurrences in patients exposed to doxorubicin and cyclophosphamide were hemoglobinemia (26,5%), leukopenia (21,6%), neutropenia (10,8%), thrombocytopenia (none) and reduced hematocrit (28,4%), in addition to fatigue (93,1%), fever (20,6%), gain (35,3%) and weight loss (22,5%). In these variables, there were no significant differences between the exposed and not exposed patients. The association with taxanes showed a significant reduction in hematocrit values (p=0.019) and the toxicities distributed by age group were not significant within the exposed group. Conclusions: Exposure to doxorubicin and cyclophosphamide was not associated with an increase in the occurrence of hematotoxicities and functional impacts in women with breast ductal invasive carcinoma, except when associated with taxane agents.

Uterine Metastases in a Diagnosed Case of Invasive Ductal Breast Carcinoma: A Rare Presentation

Breast cancer is the commonest cancer among females and has a high propensity to metastasize, but gynaecological organs are rarely affected. We report a case where invasive ductal carcinoma of the breast metastasized to the uterus after initial management with curative intent. Our patient was on tamoxifen, which can cause endometrial hyperplasia and lead to a challenge in eventual diagnosis.

Is Oncotype DX Testing Necessary For Patients With Node Negative, Low-Grade Invasive Ductal Breast Carcinoma?

Introduction/Objective Oncotype DX (Genomic Health/Exact Sciences, Redwood City, CA) is a 21-gene expression test that is used to predict the risk of recurrence following hormonal therapy and adjuvant chemotherapy (CT) benefit for patients with early-stage, ER-positive and HER2-negative invasive breast carcinoma (IBC). Testing is performed on formalin-fixed, paraffin-embedded tumor tissue from patients that are either lymph node (LN) negative, have micro- metastases, or 1-3 positive LNs. For years pathologists have studied traditional prognostic features of IBC (tumor grade, size, and LN status), as well as biomarker testing results (ER, PR, HER2, and Ki-67), in an effort to identify surrogate equations that could help identify patients that would benefit from CT. The “TAILORx” clinical trial, performed to study CT benefit in patients with midrange recurrence scores (11-25), has shown that the majority of these patients do not derive benefit from CT. Post-TAILORx, we have observed that only a small subset of our node- negative patients who were tested showed a benefit for CT. Following the examination of Oncotype DX results from testing performed on our patients, we hypothesized that overall tumor grade (Nottingham) might predict which patients with invasive ductal breast carcinoma (IDBC) do not require Oncotype DX testing; therefore, eliminating the need for Oncotype DX testing. Methods/Case Report We reviewed the surgical pathology reports and Oncotype DX reports for 251 patients with node-negative disease who underwent surgery at our institution from September 2019 through June 2021. All excisional tumors sent for Oncotype DX testing were ER-positive (Allred score ≥6/8) and HER2-negative by IHC and/or FISH. Results (if a Case Study enter NA) Oncotype DX recurrence scores ranged from 0-65. A benefit for CT was seen in 10.4% (26/251) of the patients with node-negative IDBC. A benefit for CT was seen in 6.1% (7/114) of patients with an overall tumor grade of II and 44.2% (19/43) of patients with an overall grade of III. No patients (0/94) with IDBC and an overall tumor grade of I showed a benefit for CT. Conclusion In the post-TAILORx era, patients with ER-positive (Allred ≥6/8), HER2-negative IDBC, who are node- negative and show an overall tumor grade of I, apparently do not require Oncotype DX testing. Additional studies from other institutions are needed to confirm our observation.

LAPAROSCOPIC METASTASECTOMY OF ADRENAL MASS: A THERAPEUTIC OPTION. CASE REPORT AND LITERATURE REVIEW.

Invasive ductal breast carcinoma (IDC) metastasizes to several organs, but it does not usually affect the adrenal glands. In our knowledge, the cases described in the literature are few. A 60-year-old woman diagnosed with ductal breast carcinoma, was found to have adrenal metachronous metastasis during follow-up. While treatment is unclear, laparoscopic adrenalectomy could be a treatment option with curative intention. In our patient, we decided transperitoneal laparoscopic adrenalectomy, with favourable evolution after surgery.

Integrated Molecular Characterization to Reveal the Association between Kynurenine 3-Monooxygenase Expression and Tumorigenesis in Human Breast Cancers

Kynurenine 3-monooxygenase (KMO) is overexpressed in several tumors and participates in the progression of breast cancer tumorigenesis, including cancer types such as triple-negative breast cancer (TNBC). This malignant gene is an enzyme in the kynurenine pathway, which is involved in the carcinogenesis of cancer through immune function manipulation. However, it remains unclear whether the role of the KMO contributes to tumorigenesis and immune functions in human breast cancer. In this study, we found that KMO was highly expressed in different types of tumors, especially in invasive ductal breast carcinoma. In addition, KMO expression was positively correlated with the malignant clinical features of patients with breast cancer, such as TNBC and a nodal-positive status, along with patients with a higher Nottingham prognostic index (NPI). Furthermore, the top ten KMO-correlated genes were the chemokines and pro-inflammatory cytokines known to be involved in the progression of various cancers, therefore, KMO may facilitate breast cancers via synergistically regulating inflammatory responses in tumors with these hub genes. Taken together, these findings highlight the tumor-promotion role of KMO in breast cancers and suggest that KMO can serve as a biomarker for prognosis prediction in breast cancer patients.