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Fujita K, Kamiya M, Yoshioka T, Ogasawara A, Hino R, Kojima R, Ueo H, Urano Y. Rapid and Accurate Visualization of Breast Tumors with a Fluorescent Probe Targeting α-Mannosidase 2C1. ACS CENTRAL SCIENCE 2020; 6:2217-2227. [PMID: 33376783 PMCID: PMC7760471 DOI: 10.1021/acscentsci.0c01189] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Indexed: 05/21/2023]
Abstract
Accurate detection of breast tumors and discrimination of tumor from normal tissues during breast-conserving surgery are essential to reduce the risk of misdiagnosis or recurrence. However, existing probes show substantial background signals in normal breast tissues. In this study, we focus on glycosidase activities in breast tumors. We synthesized a series of 12 fluorescent probes and performed imaging-based evaluation on surgically resected human breast specimens. Among them, the α-mannosidase-reactive fluorescent probe HMRef-αMan detected breast cancer with 90% sensitivity and 100% specificity. We identified α-mannosidase 2C1 as the target enzyme and confirmed its overexpression in various breast tumors. We found that fibroadenoma, the most common benign breast lesion in young woman, tends to have higher α-mannosidase 2C1 activity than malignant cancer. Combined application of green-emitting HMRef-αMan and a red-emitting γ-glutamyltranspeptidase probe enabled efficient dual-color, dual-target optical discrimination of malignant and benign tumors.
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Affiliation(s)
- Kyohhei Fujita
- Graduate School of Medicine and Graduate School
of Pharmaceutical Sciences, The University
of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Mako Kamiya
- Graduate School of Medicine and Graduate School
of Pharmaceutical Sciences, The University
of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- PRESTO,
Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan
| | - Takafusa Yoshioka
- Graduate School of Medicine and Graduate School
of Pharmaceutical Sciences, The University
of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Akira Ogasawara
- Graduate School of Medicine and Graduate School
of Pharmaceutical Sciences, The University
of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - Rumi Hino
- Daito
Bunka University, Department of Sports and
Health Science, 560 Iwadono, Higashimatsuyama, Saitama 355-8501, Japan
| | - Ryosuke Kojima
- Graduate School of Medicine and Graduate School
of Pharmaceutical Sciences, The University
of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- PRESTO,
Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan
| | - Hiroaki Ueo
- Ueo
Breast Cancer Hospital, 1-3-5 Futamatacho, Oita, Oita 870-0887, Japan
| | - Yasuteru Urano
- Graduate School of Medicine and Graduate School
of Pharmaceutical Sciences, The University
of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
- CREST,
Japan
Agency for Medical Research and Development, 1-7-1 Otemachi, Chiyoda,
Tokyo 100-0004, Japan
- E-mail
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Basara Akin I, Ozgul H, Simsek K, Altay C, Secil M, Balci P. Texture Analysis of Ultrasound Images to Differentiate Simple Fibroadenomas From Complex Fibroadenomas and Benign Phyllodes Tumors. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1993-2003. [PMID: 32329531 DOI: 10.1002/jum.15304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/15/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category 4A lesions can be distinguished from BI-RADS 3 lesions with main ultrasound (US) findings such as a well-defined contour, round/oval shape, and parallel orientation with a homogeneous echo pattern. Breast Imaging Reporting and Data System 4A solid masses might be diagnosed as simple fibroadenomas (SFAs), complex fibroadenomas (CFAs), or benign phyllodes tumors (BPTs). Complex fibroadenomas have an increased risk of invasive cancer development than SFAs, and BPTs have a risk of borderline-malignant phyllodes tumor transformation; both of them are surgically treated, whereas follow-up procedures are applied in SFAs. It is essential to differentiate SFAs from CFAs and BPTs. Grayscale features of these lesions include a prominent overlap. Texture analyses in breast lesions have contributions in benign-malignant lesion differentiation. In this study, we aimed to use texture analysis of US images to differentiate these benign lesions. METHODS Grayscale US features of lesions (32 SFAs, 31 CFAs, and 32 BPTs) were classified according to the BI-RADS. Texture analysis of US images with LIFEx software (http://www.lifexsoft.org) was performed retrospectively. First- and second-order histogram parameters were evaluated. RESULTS In grayscale US, the shape, orientation, and posterior acoustic characteristics had statistical significance (P < .05). In the statistical analysis, skewness, kurtosis, excess kurtosis, gray-level co-occurrence matrix (GLCM)-energy, GLCM-entropy log 2, and GLCM-entropy log 10 revealed significant differences among all 3 groups (P < .05). CONCLUSIONS As grayscale US features show prominent intersections, and treatment options differ, correct diagnosis is essential in SFAs, CFAs, and BPTs. In this study, we concluded that texture analysis of US images can discriminate SFAs from CFAs and BPTs. Texture analyses of US images is a potential candidate diagnostic tool for these lesions, and accurate diagnoses will preclude patients from undergoing unnecessary biopsies.
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Affiliation(s)
- Isil Basara Akin
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Hakan Ozgul
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Kursat Simsek
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Canan Altay
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Mustafa Secil
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Pinar Balci
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Al-Arnawoot B, Scaranelo A, Fleming R, Kulkarni S, Menezes RJ, McCready D, Done S, Freitas V. Cellular fibroepithelial lesions diagnosed on core needle biopsy: Is there any role of clinical-sonography features helping to differentiate fibroadenomas and phyllodes tumor? J Surg Oncol 2020; 122:382-387. [PMID: 32396665 DOI: 10.1002/jso.25977] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/02/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The purpose of this study is to determine the role of clinico-sonographic features of breast cellular fibroepithelial lesions (CFELs) diagnosed on core needle biopsy (CNB) in the differentiation between fibroadenoma (FA) and phyllodes. MATERIALS AND METHODS Results of consecutive women with a CNB showing CFEL from 2005 to 2010 were retrospectively reviewed. Clinical and sonographic findings were compared with surgical outcomes. Chi-square and Fisher's exact tests were used followed by a regression model for statistical analysis. RESULTS A total of 131 women with 134 CFEL were included in the study; 89 (66%) were FAs and 45 (34%) were phyllodes (32 benign; 13 malignant). Significant predictors of increased risk of phyllodes tumor were patient age equal to or greater than 50 years (P = .021) and lesion size less than 2 cm at sonography (P = .043). No other imaging or clinical features were able to differentiate FA from phyllodes tumors. CONCLUSION CFEL with a larger size in older women is associated with the surgical pathological result of phyllodes tumor and management should be tailored accordingly. Younger patients with small size nodules might be approached less aggressively, depending on a personalized discussion with the surgeons, taking into account the results obtained in this study.
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Affiliation(s)
- Basma Al-Arnawoot
- Department of Diagnostic Imaging, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Anabel Scaranelo
- Joint Department of Medical Imaging, Mount Sinai Hospital, Women's College Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada
| | - Rachel Fleming
- Joint Department of Medical Imaging, Mount Sinai Hospital, Women's College Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada
| | - Supriya Kulkarni
- Joint Department of Medical Imaging, Mount Sinai Hospital, Women's College Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada
| | - Ravi J Menezes
- Joint Department of Medical Imaging, Mount Sinai Hospital, Women's College Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada
| | - David McCready
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Susan Done
- Laboratory Medicine Program, University Health Network-Toronto General Hospital Site, University of Toronto, Toronto, Ontario, Canada
| | - Vivianne Freitas
- Joint Department of Medical Imaging, Mount Sinai Hospital, Women's College Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada
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Arora M, Gupta P, Syed A, Aggarwal P, Chowdhury N, Premi V, Mehrotra S, Kapoor A, Pandey D, Sharda P, Ravi B. Mammographic and ultrasonographic concordance in pathologically proven phyllodes tumors: A retrospective study. Breast J 2020; 26:1087-1089. [DOI: 10.1111/tbj.13654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Manali Arora
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
| | - Priyanka Gupta
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
| | - Anjum Syed
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
| | - Pradeep Aggarwal
- Department of Community Medicine AIIMS Rishikesh Rishikesh India
| | | | - Vimugdha Premi
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
| | - Surabhi Mehrotra
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
| | - Aakriti Kapoor
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
| | - Divya Pandey
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
| | - Prateek Sharda
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
| | - Bina Ravi
- Integrated Breast Care Centre (IBCC) AIIMS Rishikesh Rishikesh India
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Md Nasir ND, Ng CCY, Rajasegaran V, Wong SF, Liu W, Ng GXP, Lee JY, Guan P, Lim JQ, Thike AA, Koh VCY, Loke BN, Chang KTE, Gudi MA, Lian DWQ, Madhukumar P, Tan BKT, Tan VKM, Wong CY, Yong WS, Ho GH, Ong KW, Tan P, Teh BT, Tan PH, Rahman NA, Nahar Begum SMK, Cheah PL, Chen CJ, Dela Fuente E, Han A, Harada O, Kanomata N, Lee CS, Han Lee JY, Kamal M, Nishimura R, Ohi Y, Sawyer EJ, Teoh KH, Tsang AKH, Tsang JY, Tse GMK, Yamaguchi R. Genomic characterisation of breast fibroepithelial lesions in an international cohort. J Pathol 2019; 249:447-460. [DOI: 10.1002/path.5333] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 07/11/2019] [Accepted: 08/01/2019] [Indexed: 12/31/2022]
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Papas Y, Asmar AE, Ghandour F, Hajj I. Malignant phyllodes tumors of the breast: A comprehensive literature review. Breast J 2019; 26:240-244. [DOI: 10.1111/tbj.13523] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 01/12/2023]
Affiliation(s)
- Yasmine Papas
- Saint George Hospital University Medical Center University Of Balamand Beirut Lebanon
| | - Antoine El Asmar
- Saint George Hospital University Medical Center University Of Balamand Beirut Lebanon
| | - Fatmeh Ghandour
- Saint George Hospital University Medical Center University Of Balamand Beirut Lebanon
| | - Imad Hajj
- Saint George Hospital University Medical Center University Of Balamand Beirut Lebanon
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Duman L, Gezer NS, Balcı P, Altay C, Başara I, Durak MG, Sevinç AI. Differentiation between Phyllodes Tumors and Fibroadenomas Based on Mammographic Sonographic and MRI Features. Breast Care (Basel) 2016; 11:123-7. [PMID: 27239174 DOI: 10.1159/000444377] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study was performed to compare the mammographic, sonographic, and magnetic resonance imaging (MRI) characteristics of phyllodes tumors and fibroadenomas, which may resemble each other. METHODS Preoperative mammograms, B-mode and Doppler sonograms, and dynamic breast MRIs of 72 patients with pathologically proven fibroadenomas and 70 patients with pathologically proven phyllodes tumor were evaluated in this retrospective study. Statistical significance was evaluated using chi-square and Fisher's exact tests. Correlations in lesion size among radiological methods were examined by Pearson's correlation analysis. RESULTS The features that differed on mammogram were size, shape, and margin of the mass. Sonograms showed significant differences in size, shape, margin, echo pattern, and vascularization of the mass. Pearson's correlation analysis showed strong agreement among radiological methods in terms of assessment of size. Tumor size ≥ 3 cm, irregular shape, microlobulated margins, complex internal echo pattern, and hypervascularity were significant findings of phyllodes tumors. Internal cystic areas on MRI were frequently associated with phyllodes tumors. CONCLUSION Mammographic, sonographic, and MRI findings of fibroadenomas and phyllodes tumors could help radiologists to ascertain imaging-histological concordance and guide clinicians in their decision making regarding adequate follow-up or the necessity of biopsy.
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Affiliation(s)
- Lale Duman
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Naciye S Gezer
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Pınar Balcı
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Canan Altay
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Işıl Başara
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Merih G Durak
- Department of Pathology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ali I Sevinç
- Department of General Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Yoo JL, Woo OH, Kim YK, Cho KR, Yong HS, Seo BK, Kim A, Kang EY. Can MR Imaging Contribute in Characterizing Well-circumscribed Breast Carcinomas? Radiographics 2010; 30:1689-702. [DOI: 10.1148/rg.306105511] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chung EM, Cube R, Hall GJ, González C, Stocker JT, Glassman LM. From the archives of the AFIP: breast masses in children and adolescents: radiologic-pathologic correlation. Radiographics 2009; 29:907-31. [PMID: 19448124 DOI: 10.1148/rg.293095010] [Citation(s) in RCA: 141] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The spectrum of breast lesions in children and adolescents varies markedly from that for adults, with the former lesions being overwhelmingly benign. A breast mass in a young boy or girl may arise from normal and abnormal breast development. Other causes of masses include infection, trauma, and cyst formation. After onset of puberty, most cases of breast enlargement arise from benign fibroadenoma in girls and gynecomastia in boys. These conditions have specific imaging appearances, although juvenile (often giant) fibroadenoma cannot be distinguished from phyllodes tumor, which can be benign or malignant. In children, both conditions usually appear as well-circumscribed, hypoechoic masses at sonography and show diffuse enhancement except for nonenhancing septations at magnetic resonance imaging. A diagnosis of juvenile papillomatosis (a benign lesion) portends later development of breast cancer, and patients with this condition should be closely monitored. Malignant lesions of the breast in children are rare. The most common malignant lesions are metastases and are usually associated with widespread disease. The most common primary breast malignancy is malignant phyllodes tumor. Primary breast carcinoma is exceedingly rare in the pediatric age group, but its imaging appearance in children is the same as seen in adults and is different from that of almost all benign lesions. In girls, diagnostic interventions may injure the developing breast and cause subsequent disfigurement. Given this risk and the low prevalence of malignant disease in this population, a prudent course should be followed in the diagnosis of breast lesions. Imaging findings are very helpful for selecting patients for further diagnostic procedures. Although malignancy is rare, lesions with suspicious imaging findings or progressive growth should be subjected to cytologic or histologic examination.
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Affiliation(s)
- Ellen M Chung
- Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA.
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Role of Breast Sonography in Imaging of Adolescents with Palpable Solid Breast Masses. AJR Am J Roentgenol 2008; 191:659-63. [DOI: 10.2214/ajr.07.3390] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Granić M, Oprić D, Pupić G, Babić D, Ivanović N, Nikolić D, Dikić S, Oprić S. Surgical methods for the treatment of breast phylodes tumors - a report of 319 cases. ACTA ACUST UNITED AC 2006; 53:57-62. [PMID: 16989148 DOI: 10.2298/aci0601057g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Breast phyllodes tumors (FT) belong the fibroapitelial group of breast tumors arising in terminal ductulo-lobular unit (TDLU). Their incidence do not exceed 1% of all breast tumors. Biologicaly they can be divided into benign, borderline and malignant group. Incomplete tumor excision can be the reason for local reccurence. Malignant form of FT metastazise hematogenous most often in the lung. There is no uniform surgical opinion about the treatment FT. Methods: We analyzed histopathology features of 319 FT of the breast surgically removed on Department of surgery Institut of oncology and radiology of Serbia between 1.1.1985.- 31.12.1994 . Retrospective study of surgical treatment 84 patients with FT of the breast (69 benign ,4 borderline and 11 malignant ) and 5 year follow up after surgery we analyzed. Results: local recurrence after surgery was found in 17 (20,2 %) patients(14 benign , 2 borderline and 1 malignant FT ), pulmonary metastases in 6 (7,1%) patients with malignant FT. DFI was 21,3 months for local recurrences and 25,1 months for pulmonary metastases . DFS for al forms of FT was 71 % ( p =0,7104 ) in 5- year follow up . Conclusion: According to biological behavior we propose wide excision for benign and borderline forms and simple mastectomy for malignant FT, and voluminous benign and borderline forms. Axillary disection is not necessary because lymphatic spread of malignant FT is unfrequent.
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