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Pradeep I, Nigam JS, Rathod G, Parmeshwar TM. Cytology of micropapillary mucinous carcinoma: A case report of a clinically and genetically distinct breast carcinoma variant. Diagn Cytopathol 2023; 51:E185-E188. [PMID: 36891770 DOI: 10.1002/dc.25122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/10/2023]
Abstract
Micropapillary mucinous carcinoma (MPMC) is an uncommon histopathological variant of breast cancer accounting for approximately one-fifth of all mucinous breast carcinomas. In contrast to pure mucinous carcinoma, MPMC tends to affect younger women and is associated with decreased progression-free survival, higher nuclear grade, lymphovascular invasion, lymph node metastasis, and positive HER2 status. Typically MPMC histology shows micropapillary architecture with "hobnailing" of cells and reverse polarity. Very few publications document the cytomorphological findings of MPMC. We report a case of MPMC that was suspected in fine needle aspiration cytology (FNAC) and confirmed at histopathology.
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Affiliation(s)
- Immanuel Pradeep
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Jitendra Singh Nigam
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Gunvanti Rathod
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India
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2
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Esmer AC, Tazeoğlu D, Dağ A. Comparison of Clinical, Histopathological, and Survival Outcomes of Pure and Mixed Mucinous Breast Carcinoma. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03573-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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3
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Field AS, Raymond WA, Rickard M, Arnold L, Brachtel EF, Chaiwun B, Chen L, Di Bonito L, Kurtycz DFI, Lee AHS, Lim E, Ljung BM, Michelow P, Osamura RY, Pinamonti M, Sauer T, Segara D, Tse G, Vielh P, Chong PY, Schmitt F. The International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology. Acta Cytol 2019; 63:257-273. [PMID: 31112942 DOI: 10.1159/000499509] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 03/07/2019] [Indexed: 01/29/2023]
Abstract
The International Academy of Cytology (IAC) gathered together a group of cytopathologists expert in breast cytology who, working with clinicians expert in breast diagnostics and management, have developed the IAC Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy (FNAB) Cytology. The project was initiated with the first cytopathology group meeting in Yokohama at the 2016 International Congress of Cytology. This IAC Yokohama System defines five categories for reporting breast cytology, each with a clear descriptive term for the category, a definition, a risk of malignancy (ROM) and a suggested management algorithm. The key diagnostic cytopathology features of each of the lesions within each category will be presented more fully in a subsequent atlas. The System emphasizes that the crucial requirements for diagnostic breast FNAB cytology are a high standard for the performance of the FNAB and for the making of direct smears, and well-trained experienced cytopathologists to interpret the material. The performance indicators of breast FNAB, including specificity and sensitivity, negative predictive value, positive predictive value and ROM stated in this article have been derived from the recent literature. The current practice of breast FNAB has evolved with the increasing use of ultrasound guidance and rapid on-site evaluation. Two recent publications have shown a range of ROM for the insufficient/inadequate category of 2.6-4.8%, benign 1.4-2.3%, atypical 13-15.7%, suspicious of malignancy 84.6-97.1%, and malignant 99.0-100%. The management algorithm in the System provides options because there are variations in the management of breast lesions using FNAB and core-needle biopsy in those countries utilizing the "triple test" of clinical, imaging, and FNAB assessment, and also variations in the availability of CNB and imaging in low- and middle-income countries. The System will stimulate further discussion and research, particularly in the cytological diagnostic features of specific lesions within each category and in management recommendations. This will lead to continuing improvements in the care of patients with breast lesions and possible modifications to the IAC Yokohama System.
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Affiliation(s)
- Andrew S Field
- Department of Pathology, St Vincent's Hospital, and University of NSW and University of Notre Dame Medical Schools, Sydney, New South Wales, Australia,
| | - Wendy A Raymond
- South Australian Pathology, Department of Surgical Pathology, Flinders Medical Centre, Flinders University of South Australia, and Clinpath, Adelaide, South Australia, Australia
| | - Mary Rickard
- BreastScreen NSW and Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Lauren Arnold
- Sydney Breast Clinic, Sydney, New South Wales, Australia
| | - Elena F Brachtel
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Benjaporn Chaiwun
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Lan Chen
- Pathology Department, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Luigi Di Bonito
- Department of Anatomical Pathology, University of Trieste, Trieste, Italy
| | - Daniel F I Kurtycz
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Wisconsin State Laboratory of Hygiene, University of Wisconsin, Madison, Wisconsin, USA
| | - Andrew H S Lee
- Department of Histopathology, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Elgene Lim
- Connie Johnson Breast Cancer Research Laboratory, Garvan Institute of Medical Research, St Vincent's Hospital, UNSW Medical School, Sydney, New South Wales, Australia
| | - Britt-Marie Ljung
- Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Pamela Michelow
- Department of Anatomical Pathology, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Service, Johannesburg, South Africa
| | - Robert Y Osamura
- Nippon Koukan Hospital, Kawasaki, Japan
- Keio University School of Medicine, Tokyo, Japan
| | | | - Torill Sauer
- Institute of Clinical Medicine, Department of Pathology, Faculty of Medicine, Akershus University Hospital, University of Oslo, Oslo, Norway
| | - Davendra Segara
- Breast Surgical Oncologist, St Vincent's Private Hospital, Sydney, New South Wales, Australia
| | - Gary Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Sha Tin, Hong Kong
| | - Philippe Vielh
- Laboratoire National de Santé, Departement de Pathologie Morphologique et Moleculaire, Dudelange, Luxembourg
| | - Phek Y Chong
- Department of Pathology, Sengkang General Hospital, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
| | - Fernando Schmitt
- Institute of Molecular Pathology and Immunology, Instituto de Investigação e Inovação em Saúde and Medical Faculty, University of Porto, Porto, Portugal
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4
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Breast carcinoma with osteoclast-like giant cells: A cytological-pathological correlation with a literature review. Ann Diagn Pathol 2018; 33:1-5. [DOI: 10.1016/j.anndiagpath.2017.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 11/16/2022]
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5
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Sadhasivan SBM, Shafiuzama M, Shammi M, Rao GVS, Souza NJD, Senthilnayagam H, George RS, Prabhakar PM. Studies on reconstruction of large skin defects following mammary tumor excision in dogs. Vet World 2018; 10:1521-1528. [PMID: 29391696 PMCID: PMC5771180 DOI: 10.14202/vetworld.2017.1521-1528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 11/18/2017] [Indexed: 11/30/2022] Open
Abstract
Aim: The main objective of the study was to describe the use of skin fold advancement flaps (SFAFs) and other reconstructive techniques for closure of large skin defects following mammary tumor excision in dogs. Materials and Methods: Twelve dogs underwent reconstruction of large ventral skin defects following mammary tumor excision with wide margins. Skin fold flaps (flank fold flap and elbow fold flap) were elevated from the flank and elbow region, respectively, and transposed and sutured onto the large ventral skin defect following mastectomy in all the dogs. In addition to the skin fold flaps, other reconstructive techniques such as undermining, walking sutures, and tension-relieving suture techniques were followed during surgery in the closure of large skin defects without skin tension and compromising limb mobility. The skin flap viability was assessed subjectively by gross observation of the flap such as color, temperature, capillary perfusion, and cosmetic appearance, and scoring (1-4) was done. Tissue samples were collected from a surgical site on days 3, 6, and 12 post-operatively for histopathological evaluation and healing status of the skin flap. Results: All the surgical wounds healed primarily, without any major complications and the skin flap remained healthy throughout the healing process post-operatively. Distal flap necrosis was noticed in one case and necrosis of skin flap between two suture lines was noticed in another case in which the necrotized distal portion healed by secondary intention after 7 days. The mean survival of subdermal plexus flap in the above cases was 98% which was a subjective evaluation based on surface area of the skin defect measured by Image’ J software and the flap dimensions. The average healing of skin flap in days was 14.91±0.86. Conclusion: The SFAFs along with other reconstructive techniques help in the reconstruction of large ventral skin defects following mastectomy in dogs without much compromising limb mobility.
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Affiliation(s)
- Sabarish Babu Malli Sadhasivan
- Department of Veterinary Surgery and Radiology, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, Chennai-600007, Tamil Nadu, India
| | - Mohamed Shafiuzama
- Department of Veterinary Surgery and Radiology, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, Chennai-600007, Tamil Nadu, India
| | - Mala Shammi
- Department of Veterinary Surgery and Radiology, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, Chennai-600007, Tamil Nadu, India
| | - Ganne Venkata Sudhakar Rao
- Department of Veterinary Pathology, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, Chennai-600007, Tamil Nadu, India
| | - Nitin J D Souza
- Department of Veterinary Surgery and Radiology, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, Chennai-600007, Tamil Nadu, India
| | - Hemalatha Senthilnayagam
- Department of Veterinary Pathology, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, Chennai-600007, Tamil Nadu, India
| | - Ravi Sundar George
- Department of Veterinary Surgery and Radiology, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, Chennai-600007, Tamil Nadu, India
| | - P Manoj Prabhakar
- Department of Veterinary Surgery and Radiology, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, Chennai-600007, Tamil Nadu, India
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6
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Kau S, Miller I, Tichy A, Gabriel C. S100A4 (metastasin) positive mesenchymal canine mammary tumour spheroids reduce Tenascin C synthesis under DMSO exposure in vitro. Vet Comp Oncol 2017; 15:1428-1444. [PMID: 28074628 DOI: 10.1111/vco.12287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/21/2016] [Accepted: 10/16/2016] [Indexed: 12/11/2022]
Abstract
In breast cancer research S100A4-positive tumour-associated stromal cells are assumed as primary source of Tenascin C (TNC) in the metastatic environment. Aim of the present study was to isolate and characterize S100A4/TNC positive stromal canine mammary tumour (CMT) cells. Cells grown as scaffold-free spheroids were investigated for S100A4, TNC, and proliferative activity under 1.8% DMSO stimulation by means of Western blot and immunohistochemistry. DMSO is a commonly used drug solvent despite well-known side effects on cells including TNC expression. DMSO did not affect proliferation, but TNC was significantly reduced under DMSO exposure for 7 and 14 days, whereby for S100A4 a reducing effect was only observed after 14 days. Without DMSO, cells stably expressed TNC and S100A4 which makes them suitable to be used in experimental approaches requiring S100A4/TNC expressing CMT stromal cells. Results show that 1.8% DMSO should not be used as solvent for experiments concerning TNC/S100A4 expression.
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Affiliation(s)
- S Kau
- Institute of Anatomy, Histology and Embryology, Department of Pathobiology, University of Veterinary Medicine, Vienna, Austria
| | - I Miller
- Institute for Medical Biochemistry, Department for Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - A Tichy
- Platform Biostatistics, Department of Biomedical Science, Institute of Population Genetics, University of Veterinary Medicine, Vienna, Austria
| | - C Gabriel
- Institute of Anatomy, Histology and Embryology, Department of Pathobiology, University of Veterinary Medicine, Vienna, Austria
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7
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Ohashi R, Matsubara M, Watarai Y, Yanagihara K, Yamashita K, Tsuchiya SI, Takei H, Naito Z. Pleomorphic lobular carcinoma of the breast: a comparison of cytopathological features with other lobular carcinoma variants. Cytopathology 2016; 28:122-130. [PMID: 27489086 DOI: 10.1111/cyt.12362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Pleomorphic lobular carcinoma (PLC) is a subtype of breast cancer with unique morphological features, but it remains controversial whether PLC should be considered an independent disease entity. The aim of this study was to illustrate cytopathological characteristics of PLC in comparison with other lobular carcinoma variants. METHODS We investigated clinicopathological features of PLC (n = 11) compared with those of other variants of invasive lobular carcinoma (ILC, non-PLC) (n = 32). Histological variants of the non-PLC group consisted of classic (n = 25), solid (n = 2), alveolar (n = 1) and a tubulolobular type (n = 4). A review of cytological reports and fine needle aspiration (FNA) smear samples was performed for the PLC (n = 9) and non-PLC (n = 27) groups. RESULTS Patients with PLC were older, and had a higher nuclear grade and a higher incidence of axillary lymph node metastasis and triple negative phenotype than non-PLC patients (P = 0.007, P < 0.001, P = 0.02 and P < 0.001, respectively). Cytological findings in PLC included medium- to large-sized nuclei, prominent nucleoli, a moderate-to-severe degree of pleomorphism, apocrine change and background necrosis, none of which were evident in the smears of the non-PLC group (P < 0.001, P = 0.002, P < 0.001, P < 0.001, and P = 0.03, respectively). Despite these differences, patients with PLC and non-PLC showed similar clinical outcomes in our follow-up period. CONCLUSIONS Based on our results, a cytological diagnosis of PLC should be proposed if there are moderate- to large-sized nuclei, prominent nucleoli, a moderate-to severe degree of nuclear pleomorphism, apocrine change and necrosis in the background in FNA biopsy samples.
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Affiliation(s)
- R Ohashi
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan
| | - M Matsubara
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan
| | - Y Watarai
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan
| | - K Yanagihara
- Department of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - K Yamashita
- Department of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - S-I Tsuchiya
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan.,Department of Diagnostic Pathology, Iida Hospital, Tokyo, Japan
| | - H Takei
- Department of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Z Naito
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan.,Department of Integrated Diagnostic Pathology, Nippon Medical School, Tokyo, Japan
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8
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Skotnicki P, Sas-Korczynska B, Strzepek L, Jakubowicz J, Blecharz P, Reinfuss M, Walasek T. Pure and Mixed Mucinous Carcinoma of the Breast: A Comparison of Clinical Outcomes and Treatment Results. Breast J 2016; 22:529-34. [DOI: 10.1111/tbj.12621] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Piotr Skotnicki
- Department of Surgical Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Beata Sas-Korczynska
- Department of Clinical Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Lukasz Strzepek
- Department of Surgical Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Jerzy Jakubowicz
- Department of Clinical Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Pawel Blecharz
- Department of Gynaecological Oncology; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Marian Reinfuss
- Department of Radiotherapy; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
| | - Tomasz Walasek
- Department of Radiotherapy; Maria Sklodowska-Curie; Memorial Cancer Centre and Institute of Oncology; Krakow Poland
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9
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Lei L, Yu X, Chen B, Chen Z, Wang X. Clinicopathological Characteristics of Mucinous Breast Cancer: A Retrospective Analysis of a 10-Year Study. PLoS One 2016; 11:e0155132. [PMID: 27232881 PMCID: PMC4883756 DOI: 10.1371/journal.pone.0155132] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 04/25/2016] [Indexed: 12/16/2022] Open
Abstract
Background Mucinous breast carcinoma (MC) is a special type of breast cancer that presents with a large amount of extracellular mucin. MC comprises approximately 4% of all invasive breast cancers. This type of tumor has a better prognosis and higher incidence in peri- and post-menopausal patients. Pathologically, there are two main subtypes of MC: pure and mixed. In this study, we describe 10 years of experience with MC at the Zhejiang Cancer Hospital in China, specifically, clinical data, histological findings and immunohistochemical features. Methods We identified MC patients who were diagnosed as operable and completed clinical treatment from January 2001 to January 2011. The clinicopathological data included the age at diagnosis, tumor size, TNM stage, presence and number of lymph node (LN) metastases, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) status and p53 expression. If the tumor was defined as mixed mucinous carcinoma (MMC), IHC was performed on a non-mucinous part, such as invasive ductal and lobular cancer. We evaluated the clinical characteristics of all MC patients using chi-square, one-way ANOVA and LSD tests. We also studied the correlations between all of the clinical parameters and LN metastasis in a binary logistic regression analysis. We used ten consecutive years of data that were collected at Zhejiang Cancer Hospital. Results We identified 48 cases of pure mucinous carcinoma (PMC) and 77 cases of MMC. The 48 PMC cases consisted of 38 PMC-A and 10 PMC-B subtypes. The MMCs were divided into two groups, those with partial mixed mucinous breast carcinoma (pMMC, 58 cases) and those with main mixed mucinous breast carcinoma (mMMC, 19 cases). pMMC was defined by tumors with less than 50% mucinous components, while mMMC was defined by tumors where the mucinous component accounted for 50% to 90% of the tumor. No significant differences in the clinicopathological characteristics were noted between the patients with PMC-A and those with PMC-B. The tumor size was larger in the mMMC than PMC cases (44.84 mm vs. 30.06 mm, p = 0.021). The number of positive LN metastases was greater in pMMC than PMC patients (p = 0.024). The clinical stages were significantly different among the three groups, with the pMMC group having more stage III-IV patients than the other two groups (p = 0.005). The incidence of LN metastasis was also higher in the pMMC cases (pMMC vs. mMMC and PMC, 50% vs. 31.58% and 18.75%, p = 0.003). The PMC patients had much lower p53 expression than the other two groups (PMC vs. pMMC and mMMC, 27.08% vs. 55.17% and 57.89%, p = 0.007). The tumor size (>30mm), p53 expression and less proportion of the mucinous component are associated with risk of LN metastasis. Conclusion Based on the results of this study, we conclude that the tumor size, status of LN metastasis, clinical stage, and p53 mutation rate may differ between MMC and PMC patients. The tumor size (>30mm), p53 mutation and less proportion of the mucinous component should be considered risk factors of LN metastasis in MC patients.
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Affiliation(s)
- Lei Lei
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
| | - Xingfei Yu
- Department of Breast Tumor Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
| | - Bo Chen
- Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
| | - Zhanhong Chen
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
| | - Xiaojia Wang
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, P. R. China
- * E-mail:
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10
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Ohashi R, Sakatani T, Matsubara M, Watarai Y, Yanagihara K, Yamashita K, Tsuchiya S, Takei H, Naito Z. Mucinous carcinoma of the breast: a comparative study on cytohistological findings associated with neuroendocrine differentiation. Cytopathology 2016; 27:193-200. [PMID: 26804749 DOI: 10.1111/cyt.12298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Mucinous carcinoma (MCA) may show neuroendocrine differentiation (ND), but the cytological features characteristic of ND remains elusive. We compared fine needle aspiration (FNA) findings of MCA between cases with high and low degrees of ND. METHODS Histological sections of 37 MCA cases were immunohistochemically evaluated for expression of chromogranin A and synaptophysin, and were graded as 0 to 3+ degrees of ND. They were divided into low ND (grade 0 and 1+) and high ND (grade 2+ and 3+) groups. Pre-operative FNA samples of each group were assessed for cytological features. RESULTS The mean age of the high ND group (n = 18) was higher than the low ND group (n = 19, P = 0.01). In FNA samples of the high ND group, 17 cases showed moderate to severe degrees of discohesiveness, but low ND cases mainly showed no or only mild discohesiveness (P < 0.001). Nine of the low ND cases displayed overlapped, cohesive cell clusters, whereas, in the high ND cases, the cells were arranged in a loose, flat and monolayered pattern (P = 0.045). Fourteen of the high ND cases had round nuclei, but oval nuclei were predominant in the low ND cases (P = 0.027). The nuclei were eccentrically located in 12 of the high ND cases but were centrally located in 14 of the low ND cases (P = 0.01). CONCLUSIONS Mucinous carcinoma with high ND may be diagnosed by the presence of discohesiveness, a flat, monolayered pattern, and round or eccentrically located nuclei. Features of ND in carcinomas in other organs, such as intracytoplasmic granules and coarse chromatin, may not be reliable cytological features of ND in MCA.
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Affiliation(s)
- R Ohashi
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan
| | - T Sakatani
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan.,Departments of Pathology and Integrative Oncological Pathology, Nippon Medical School, Tokyo, Japan
| | - M Matsubara
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan
| | - Y Watarai
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan
| | - K Yanagihara
- Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - K Yamashita
- Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - S Tsuchiya
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan.,Department of Diagnostic Pathology, Iida Hospital, Nagano, Japan
| | - H Takei
- Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Z Naito
- Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan.,Departments of Pathology and Integrative Oncological Pathology, Nippon Medical School, Tokyo, Japan
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11
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Diagnostic value of fine needle aspiration and core needle biopsy in special types of breast cancer. Breast Cancer 2015; 23:675-83. [DOI: 10.1007/s12282-015-0624-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/21/2015] [Indexed: 10/23/2022]
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12
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Shield PW, Ribu DL, Cominos D. The significance of extracellular mucin in breast fine needle aspiration specimens. Cytopathology 2015; 27:185-92. [PMID: 26104545 DOI: 10.1111/cyt.12257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine if all breast fine needle aspiration (FNA) specimens with abundant extracellular mucin require excisional biopsy. METHODS Fifty cases of breast FNA containing extracellular mucin, reported with a recommendation for biopsy and with histological follow-up were reviewed. Cellular features were noted, and the cases reclassified ignoring the presence of mucin and then correlated with histological outcome. RESULTS Subsequent histology showed benign changes in 20% (10/50), two cases (4%) of atypical ductal hyperplasia (ADH) and 76% (38/50) to be malignant lesions, including three cases of ductal carcinoma in situ (DCIS). When the FNA cases were reviewed disregarding the presence of mucin, 11 cases were reclassified as benign and one case that contained mucin-like material but no epithelial cells reviewed as non-diagnostic. All cases of invasive mixed and mucinous carcinoma (MC) would have been reported with a recommendation for histological examination. In addition, the three cases each of fibroadenoma (FA) and a benign mucocoele-like lesion (MLL) were correctly identified as benign. However, two cases each of DCIS and ADH would have been reported benign with no recommendation for further histology. CONCLUSIONS Breast FNA specimens with mucinous material may arise from sampling of a range of benign and malignant processes; however, a biopsy should be recommended, even in cases of low cellularity, owing to sampling problems and the frequent co-occurrence of significant lesions. FNA is highly accurate at predicting carcinoma with mucinous differentiation although it is not possible to reliably predict if the lesion represents pure MC or a mixed carcinoma.
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Affiliation(s)
- P W Shield
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia.,Cytology Department, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - D L Ribu
- Cytology Department, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
| | - D Cominos
- Cytology Department, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia
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13
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Daily application of low magnitude mechanical stimulus inhibits the growth of MDA-MB-231 breast cancer cells in vitro. Cancer Cell Int 2014; 14:102. [PMID: 25349533 PMCID: PMC4209025 DOI: 10.1186/s12935-014-0102-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 09/29/2014] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Mechanical loads can regulate cell proliferation and differentiation at various stages of development and homeostasis. However, the extension of this regulatory effect of mechanical loads on cancer cells is largely unknown. Increased physical compliance is one of the key features of cancer cells, which may hamper the transmission of mechanical loads to these cells within tumor microenvironment. Here we tested whether brief daily application of an external low magnitude mechanical stimulus (LMMS), would impede the growth of MDA-MB-231 aggressive type breast cancer cells in vitro for 3 wks of growth. METHODS The signal was applied in oscillatory form at 90 Hz and 0.15 g, a regimen that would induce mechanical loads on MDA-MB-231 cells via inertial properties of cells rather than matrix deformations. Experimental cells were exposed to LMMS 15 min/day, 5 days/week in ambient conditions while control cells were sham loaded. Cell proliferation, viability, cycle, apoptosis, morphology and migration were tested via Trypan Blue dye exclusion, MTT, PI, Annexin V, Calcein-AM and phalloidin stains and scratch wound assays. RESULTS Compared to sham controls, daily application of LMMS reduced the number and viability of cancerous MDA-MB-231 cells significantly after first week in the culture, while non-cancerous MCF10A cells were found to be unaffected. Flow cytomety analyses suggested that the observed decrease for the cancer cells in the LMMS group was due to a cell cycle arrest rather than apoptosis. LMMS further reduced cancer cell circularity and increased cytoskeletal actin in MDA-MB-231 cells. CONCLUSION Combined, results suggest that direct application of mechanical loads negatively regulate the proliferation of aggressive type cancer cells. If confirmed, this non-invasive approach may be integrated to the efforts for the prevention and/or treatment of cancer.
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Mucinous breast cancer - clinical characteristics and treatment results in patients treated at the Oncology Centre in Kraków between 1952 and 2002. Contemp Oncol (Pozn) 2014; 18:120-3. [PMID: 24966796 PMCID: PMC4068815 DOI: 10.5114/wo.2014.42727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 07/15/2013] [Accepted: 08/07/2013] [Indexed: 12/25/2022] Open
Abstract
Aim of the study To present the characteristics and clinical outcomes in 94 patients with mucinous breast cancer treated at the Oncology Centre in Krakow between 1952 and 2002. Material and methods Stage I or II carcinomas were found in 66 patients (69.4%) of the presented group and in the remaining 28 patients (29.8%) stage III disease was diagnosed. In 27 cases regional lymph nodes were involved. All patients had been treated with surgery: mastectomy (90 patients) or breast-conserving treatment (4 patients). Radiotherapy was administered in 14 patients, adjuvant chemo-therapy in 14 patients, and endocrine therapy in 39 patients. Results The maximum follow-up was 257 months. Ten-year survival was as follows: 75.7% (overall survival), 82.5% (disease-free survival). During the follow-up, 4 patients developed local recurrence, 5 patients developed metastases. Second primary cancer was found in 8 patients. Conclusions The presented results confirm the good prognosis in patients treated for mucinous breast cancer. The diagnosis of early-stage breast cancer based on mammography can allow breast-conserving treatment.
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Martins D, Beca F, Schmitt F. Metastatic breast cancer: mechanisms and opportunities for cytology. Cytopathology 2014; 25:225-30. [PMID: 24889678 DOI: 10.1111/cyt.12158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2014] [Indexed: 01/15/2023]
Abstract
Despite significant advances in diagnosis, surgical techniques, general patient care, and local and systemic adjuvant therapies, metastatic disease remains the most critical condition limiting the survival of patients with breast cancer. Therefore, the development of effective treatment against late-arising metastasis has become the centre of clinical attention and is one of the current challenges in cancer research. A deeper understanding of the metastatic cascade is fundamental, and the need for repetitive tumour assessments for the evaluation of tumour evolution is a relatively new practice in routine medical care. As such, fine needle aspiration cytology (FNAC) is ideally placed to monitor biological changes in metastasis that may affect treatment and response. As FNAC is a minimally invasive method, it can be performed repeatedly with relatively little trauma, and selective ancillary tests can be applied to FNAC specimens, including for tumour whose primary nature is known. Herein, we review how the linear and parallel models explain metastatic dissemination, thus influencing therapeutic and clinical decisions, and how cytology, together with immunocytochemistry and molecular analysis, can be a tool for routine clinical practice and clinical trials aimed at metastatic disease with a special emphasis on breast cancer.
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Affiliation(s)
- D Martins
- IPATIMUP - Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
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Shafiee R, Javanbakht J, Atyabi N, Bahrami A, Kheradmand D, Safaei R, Khadivar F, Hosseini E. Comparative value of clinical, cytological, and histopathological features in feline mammary gland tumors; an experimental model for the study of human breast cancer. Diagn Pathol 2013; 8:136. [PMID: 23941603 PMCID: PMC3846645 DOI: 10.1186/1746-1596-8-136] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 07/28/2013] [Indexed: 01/26/2023] Open
Abstract
Background The diagnosis of breast lesions is usually confirmed by fine-needle aspiration cytology (FNAC) or histological biopsy. Although there is increasing literature regarding the advantages and limitations of both modalities, there is no literature regarding the accuracy of these modalities for diagnosing breast lesions in high-risk patients, who usually have lesions detected by screening. Moreover, few studies have been published regarding the cytopathology of mammary tumors in cats despite widespread use of the animal model for breast cancer formation and inhibition. The objective of the present study was to evaluate the diagnostic interest of cytological and histopathological analysis in feline mammary tumours (FMTs), in order to evaluate its possible value as an animal model. Methods The study was performed in 3 female cats submitted to surgical resections of mammary tumours. The mammary tumours were excised by simple mastectomy or regional mastectomy, with or without the superficial inguinal lymph nodes. Female cats were of different breeds (1 siamese and 2 persians). Before surgical excision of the tumour, FNA cytology was performed using a 0.4 mm diameter needle attached to a 8 ml syringe held in a standard metal syringe holder. The cytological sample was smeared onto a glass slide and either air-dried for May-Grünwald-stain and masses were surgically removed, the tumours were grossly examined and tissue samples were fixed in 10%-buffered-formalin and embedded in paraffin. Sections 4 μm thick were obtained from each sample and H&E stained. Results Cytologically, atypical epithelial cells coupled to giant nucleus, chromatin anomalies, mitotic figures, spindle shape cells, anisocytosis with anisokaryosis and hyperchromasia were found. Histologically, these tumors are characterized by pleomorphic and polygonal cell population together with mitotic figures, necrotic foci and various numbers inflammatory foci. Also, spindle shaped cells, haemorrhage localized in the different regions, local invasiveness and enlarged nuclei were observed. The samples included 3 tumors of mammary glands mammary tumors were complex carcinomas (n = 2) and adenocarcinoma (n = 1). The histological grades of the 3 cases were as follows: grade II, (1/3); grade III, (2/3) with high mitotic index. The preferential localization of mammary neoplasms was in the inguinal lobe (1/3 case) and abdominal lobes (2/3 cases). Furthermore, 1case of the inguinal mass affected the left caudo-inguinal lobe and 2cases right cranio and caudo abdominal lobes. Conclusion The study concluded that cytology could be used as a quick, rapid, field diagnostic technique in combination with histopathology for the diagnosis of feline mammary tumors (FMTs). Our findings in feline MTs indicate that FMTs could be useful as an animal model of human breast cancer. Moreover, because of the similarity of the cytohistopathological findings in the human and feline mammary gland tumours, it is possible to use the same cytopathological criteria applied in human pathology for the diagnosis of feline mammary gland tumours. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2047361423103295
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Affiliation(s)
- Radmehr Shafiee
- Department of Pathology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran.
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Shafiee R, Javanbakht J, Atyabi N, Kheradmand P, Kheradmand D, Bahrami A, Daraei H, Khadivar F. Diagnosis, classification and grading of canine mammary tumours as a model to study human breast cancer: an Clinico-Cytohistopathological study with environmental factors influencing public health and medicine. Cancer Cell Int 2013; 13:79. [PMID: 23937693 PMCID: PMC3765114 DOI: 10.1186/1475-2867-13-79] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 08/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The human "Elston and Ellis grading method" was utilized in dogs with mammary tumor to examine its relation to prognosis in this species, based on a 2-year follow-up period. Although cytopathology is widely used for early diagnosis of human neoplasms, it is not commonly performed in veterinary medicine. Our objectives in this study were to identify cytopathology criteria of malignancy for canine mammary tumors and the frequency of different types of mammary lesions and their relationship with histologic grade was investigated. Another aim of this study was to differentiate the simple and adenocarcinoma tumors from the complex or mixed tumor described by Elston and Ellis grading method. METHODS The study was performed in 15 pure or mixed-breed female dogs submitted to surgical resections of mammary tumours. The mammary tumours were excised by simple mastectomy or regional mastectomy, with or without the superficial inguinal lymph nodes. Female dogs were mainly terriers (9 dogs) or mixed (3 dogs), the 3 other animals were a German shepherd, Dachshund and Pekingese. Before surgical excision of the tumour, FNAC was performed using a 0.6 mm diameter needle attached to a 10 ml syringe held in a standard metal syringe holder. The cytological sample was smeared onto a glass slide and either air-dried for May-Grünwald-stain, or ethanol-fixed for Papanicolaou stain and masses were surgically removed, the tumours were grossly examined and tissue samples were fixed in 10%-buffered-formalin and embedded in paraffin. Sections 4 μm thick were obtained from each sample and H&E stained. RESULTS We obtained a correct cytohistological correlation in 14/15 cases (93.3%) when all cytopathological examinations were considered. Of the 15 cases examined, 2(13.3%) had well-differentiated (grade I), 6(40%) had moderately differentiated (grade II) and 7(46.7%) had poorly differentiated (grade III) tumours. Classification of all canine mammary gland lesions revealed 13(86.7%) malignant and 2(13.3%) benign tumors. The histological examination showed that the most common tumor types of mammary glands in bitches were: complex carcinoma, adenocarcinoma, malignant mixed tumour, benign mixed tumour, simple carcinoma- (5/15; 33.3%), (3/15; 20%), (3/15; 20%) and (2/15;13.3%), respectively. Simple carcinoma and cystic hyperplasia were less common - (1/15; 6.7%), and (1/15; 6.7%), respectively. Moreover, the most often tumors occur in inguinal mammary (60%) and abdominal (27%) glands. CONCLUSIONS Our results demonstrate that, because of the similarity of the cytohistopathological findings in the human and canine mammary gland tumours, it is possible to use the same cytopathological criteria applied in human pathology for the diagnosis of canine mammary gland tumours. Furthemoer, routine use of this human grading method would help the clinician to make a more accurate prognosis in the interests of post-surgical management in dogs with mammary carcinomas. Furthermore, this research will allow a more discriminating classification of mammary tumors and probably has a bearing on cytohistopathology, epidemiology, pathogenesis and prognosis. The most often tumors occur in inguinal mammary (60%) and abdominal (27%) glands. This interesting regional difference may be due to a) the duration of the growth before the diagnosis; b) the age of the dogs; and c) high prevelance of unspayed animals. Moreover, the most common type of tumor was complex carcinoma - 33.3% (5 cases).
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Affiliation(s)
- Radmehr Shafiee
- Faculty of Veterinary Medicine, Tehran University, Tehran, Iran
| | - Javad Javanbakht
- Department of Pathology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran
| | - Nahid Atyabi
- Department of Pathology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran
| | - Pegah Kheradmand
- Semnan University of Medical Science, Faculty of Medicine, Semnan, Iran
| | - Danial Kheradmand
- MD, Graduate Islamic Azad University of Mashhad, Faculty of Medicine, Mashhad, Iran
| | | | - Hasti Daraei
- Department of Environmental Health Engineering, Alborz University of Medical Sciences, Karaj, Iran
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