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Wen C, Xu W, Qin G, Zeng H, He Z, Wang S, Xu Z, Ma M, Luo Z, Chen W. Pure and Mixed Tubular Carcinoma of the Breast: Mammographic Features, Clinicopathological Characteristics and Prognostic Analysis. Technol Cancer Res Treat 2021; 20:15330338211045198. [PMID: 34918991 PMCID: PMC8761878 DOI: 10.1177/15330338211045198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To evaluate the mammographic features, clinicopathological characteristics, treatments, and prognosis of pure and mixed tubular carcinomas of the breast. Materials and methods: Twenty-five tubular carcinomas were pathologically confirmed at our hospital from January 2011 to May 2019. Twenty-one patients underwent preoperative mammography. A retrospective analysis of mammographic features, clinicopathological characteristics, treatment, and outcomes was performed. Results: Altogether, 95% of the pure tubular carcinomas (PTCs) and mixed tubular carcinomas (MTCs) showed the presence of a mass or structural distortions on mammography and the difference was not statistically significant (P = .373). MTCs exhibited a larger tumor size than PTCs (P = .033). Lymph node metastasis was more common (P = .005) in MTCs. Patients in our study showed high estrogen receptor and progesterone receptor positivity rates, but low human epidermal growth factor receptor 2 positivity rate. The overall survival rate was 100% in both PTC and MTC groups and the 5-year disease-free survival rates were 100% and 75%, respectively with no significant difference between the groups (P = .264). Conclusion: Tubular carcinoma of the breast is potentially malignant and has a favorable prognosis. Digital breast tomosynthesis may improve its detection. For patients with PTC, breast-conserving surgery and sentinel lymph node biopsy are recommended based on the low rate of lymph node metastasis and good prognosis. MTC has a relatively high rate of lymph node metastasis and a particular risk of metastasis. Axillary lymph node dissection should be performed for MTC even if the tumor is smaller than 2 cm.
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Affiliation(s)
- Chanjuan Wen
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Weimin Xu
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Genggeng Qin
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Hui Zeng
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Zilong He
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Sina Wang
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Zeyuan Xu
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Mengwei Ma
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Zhendong Luo
- 444333The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Weiguo Chen
- 198153Southern Medical University Nanfang Hospital, Guangzhou, China
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Durhan G, Demirkazık F. Breast involvement of hematological malignancies: imaging and clinical findings. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00558-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Breast involvement of hematological malignancies is a very rare entity. Accurate diagnosis is essential for appropriate treatment. The aim of this study was to clarify the clinical and radiological findings of hematological malignancy breast involvement and to describe possible pitfalls in diagnosis.
Results
The images of 20 patients with breast involvement of hematological malignancies were retrospectively evaluated on ultrasonography, mammography, and magnetic resonance imaging (MRI) and the findings were reported. Bilaterality was seen only in cases with secondary involvement, and there was no marked difference between primary and secondary breast involvement of hematological malignancies. All patients underwent ultrasonography examination. According to ultrasonography, breast masses were most frequently irregular in shape (11/20, 55%) with non-circumscribed margins (11/20, 55%). Posterior acoustic enhancement was noted in 14 cases (70%). Posterior shadowing was not observed in any of the patients. Mammography was available in 10 patients. Microcalcification was not observed in any patient on mammography. MRI was available in four patients. Hyperintensity in T2-weighted images, type 2 or type 3 dynamic curve, and diffusion restriction were observed in all cases.
Conclusions
Hematological malignancies may mimic both benign breast lesions and breast carcinoma. Familiarity with the radiological features of hematological malignancies can help accurate diagnosis.
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Serhrouchni KI, Kharmoum J, Chraibi M, Karmouni O, Rabhi F, Soussi FZ. Trial of a Rare Diagnosis in a Core Needle Biopsy of Breast. CLINICAL PATHOLOGY 2021; 14:2632010X211049254. [PMID: 34647019 PMCID: PMC8504686 DOI: 10.1177/2632010x211049254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 08/27/2021] [Indexed: 11/20/2022]
Abstract
Objective: Mucinous carcinoma is a rare, special subtype of breast carcinoma associated with a good prognosis. It often presents a confusing appearance with a benign process. For all these reasons, differential diagnosis could be challenging. Case Report: Eighty years-old woman with a soft, lobulated, and well circumscribed mass at the left breast mimicking a benign process. Pathological examination of a core needle biopsy showed pure mucinous carcinoma. Discussion: It is a disease of elderly patient, over 60 years, and usually occurs in postmenopausal women. It accounts for only 2% of total breast carcinomas. On pathologic analysis, to be defined as pure mucinous carcinoma, a carcinoma must be made up of at least 90% intracellular or extracellular mucin. Conclusion: Examination of core biopsy material should be done carefully respecting this criteria to confirm the diagnosis of this rare entity and eliminate differential diagnosis.
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Affiliation(s)
- Karima Idrissi Serhrouchni
- Department of Pathology, University Hospital of Tangier, Faculty of Medicine, Abdel Malek Assadi University Tangier, Tangier, Morocco
| | - Jinane Kharmoum
- Department of Pathology, University Hospital of Tangier, Faculty of Medicine, Abdel Malek Assadi University Tangier, Tangier, Morocco
| | - Mariame Chraibi
- Department of Pathology, University Hospital of Tangier, Faculty of Medicine, Abdel Malek Assadi University Tangier, Tangier, Morocco
| | - Ouafae Karmouni
- Reference Center of Lalla Salma for Reproductive Health and Detection of Breast and Cervical Cancer, Tangier, Morocco
| | - Fayrouz Rabhi
- Reference Center of Lalla Salma for Reproductive Health and Detection of Breast and Cervical Cancer, Tangier, Morocco
| | - Fatima Zahra Soussi
- Reference Center of Lalla Salma for Reproductive Health and Detection of Breast and Cervical Cancer, Tangier, Morocco
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Shi J, Shi J, Yang S. Breast tubular carcinoma at parasternal and retro-nipple area: Two case reports. Medicine (Baltimore) 2021; 100:e24977. [PMID: 33725968 PMCID: PMC7982237 DOI: 10.1097/md.0000000000024977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/11/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Breast tubular carcinoma (TC) is a well-differentiated infiltrating ductal carcinoma, common in postmenopausal women. PATIENT CONCERNS Two patients concerned their abnormality of their breasts, one at deep parasternal higher chest wall in a 74-year-old female and the other behind the nipple in a 39- year-old female. DIAGNOSIS These masses were detected by mammography, ultrasound and magnetic resonance imaging (MRI) examinations. The parasternal mass identified by mammography showed long spicules along the edges of the mass. Ultrasound examination revealed that these masses had solid irregular hypoechoic nodules. The color Doppler ultrasound of the retro-nipple mass presented with increased blood flow resistance index. The dynamic contrast-enhanced MRI examination of the retro-nipple nodule demonstrated an intensely enhancing mass with a plateau-type time-signal intensity curve. INTERVENTIONS Two cases were surgically removed by local resection of foci under ultrasound guidance. OUTCOMES These imaging examinations strongly suggest possible breast tubular carcinoma, which was confirmed by the pathological evaluation of frozen sections from surgically removed masses. CONCLUSION Although uncommon, breast tubular carcinoma may be considered in the differential diagnosis of small solid masses with long spicules at parasternal breast or behind the nipples in adult women.
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Affiliation(s)
- Junhua Shi
- Department of Radiology, Affiliated Hospital of Zunyi Medical University
| | - Junli Shi
- Department of Radiology, Affiliated Hospital of Zunyi Medical University
| | - Shengbo Yang
- Department of Anatomy, Zunyi Medical University, Zunyi, Guizhou, China
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5
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Abdelrahman L, Al Ghamdi M, Collado-Mesa F, Abdel-Mottaleb M. Convolutional neural networks for breast cancer detection in mammography: A survey. Comput Biol Med 2021; 131:104248. [PMID: 33631497 DOI: 10.1016/j.compbiomed.2021.104248] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/08/2021] [Accepted: 01/25/2021] [Indexed: 12/17/2022]
Abstract
Despite its proven record as a breast cancer screening tool, mammography remains labor-intensive and has recognized limitations, including low sensitivity in women with dense breast tissue. In the last ten years, Neural Network advances have been applied to mammography to help radiologists increase their efficiency and accuracy. This survey aims to present, in an organized and structured manner, the current knowledge base of convolutional neural networks (CNNs) in mammography. The survey first discusses traditional Computer Assisted Detection (CAD) and more recently developed CNN-based models for computer vision in mammography. It then presents and discusses the literature on available mammography training datasets. The survey then presents and discusses current literature on CNNs for four distinct mammography tasks: (1) breast density classification, (2) breast asymmetry detection and classification, (3) calcification detection and classification, and (4) mass detection and classification, including presenting and comparing the reported quantitative results for each task and the pros and cons of the different CNN-based approaches. Then, it offers real-world applications of CNN CAD algorithms by discussing current Food and Drug Administration (FDA) approved models. Finally, this survey highlights the potential opportunities for future work in this field. The material presented and discussed in this survey could serve as a road map for developing CNN-based solutions to improve mammographic detection of breast cancer further.
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Affiliation(s)
- Leila Abdelrahman
- University of Miami, Department of Electrical and Computer Engineering, Memorial Dr, Coral Gables, FL, 33146, USA
| | - Manal Al Ghamdi
- Umm Al-Qura University, Department of Computer Science, Alawali, Mecca, 24381, Saudi Arabia
| | - Fernando Collado-Mesa
- University of Miami Miller School of Medicine, Department of Radiology, 1115 NW 14th Street Miami, FL, 33136, USA
| | - Mohamed Abdel-Mottaleb
- University of Miami, Department of Electrical and Computer Engineering, Memorial Dr, Coral Gables, FL, 33146, USA.
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The longitudinal risk of mortality between invasive ductal carcinoma and metaplastic breast carcinoma. Sci Rep 2020; 10:22070. [PMID: 33328559 PMCID: PMC7744577 DOI: 10.1038/s41598-020-79166-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 11/17/2020] [Indexed: 12/14/2022] Open
Abstract
The management of metaplastic breast carcinoma (MBC) has largely paralleled the paradigms used for invasive ductal carcinoma (IDC) in the current National Comprehensive Cancer Network guidelines of breast cancer. However, patients with IDC and MBC have been shown to have a different prognosis, and there are significant differences in risk and failure patterns after treatment. The purpose of this study was to compare breast cancer specific survival (BCSS) and hazard function between IDC and MBC. We included patients from the Surveillance, Epidemiology, and End Results program with stage I-III IDC and MBC between 2000 and 2012. Statistical analyses were including chi-square analysis, life-table methods, multivariate Cox proportional hazards models, and propensity score matching (PSM). We identified 294,719 patients; 293,199 patients with IDC and 1520 patients with MBC. Multivariate analyses showed that the MBC subtype had significantly lower BCSS than the IDC subtype before and after PSM (p < 0.001). There were significant differences in the hazard curve between IDC and MBC. The hazard curve for breast cancer mortality in the IDC cohort peaked at 3 years (2%), and then changed to a slowly decreasing plateau after prolonged follow up. However, the hazard curve for breast cancer mortality in the MBC cohort peaked at 2 years (7%), then declined sharply between 3 and 6 years, and changed to a low death rate after a follow-up time exceeding 6 years. Subgroup analyses revealed that the hazard curves significantly differed between IDC and MBC after stratifying by tumor stage and hormone receptor status. Our study suggests that patients with MBC should receive more effective systemic agents and intensive follow-up because of their significantly augmented risk of death compared to IDC patients.
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Raj SD, Sweetwood K, Kapoor MM, Raj KM, Nagi C, Sepulveda KA, Sedgwick EL. Spindle cell lesions of the breast: Multimodality imaging and clinical differentiation of pathologically similar neoplasms. Eur J Radiol 2017; 90:60-72. [DOI: 10.1016/j.ejrad.2017.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 01/11/2017] [Accepted: 02/13/2017] [Indexed: 01/13/2023]
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8
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Montemezzi S, Cavedon C, Camera L, Meliadò G, Caumo F, Baglio I, Sardanelli F. 1H-MR spectroscopy of suspicious breast mass lesions at 3T: a clinical experience. Radiol Med 2016; 122:161-170. [DOI: 10.1007/s11547-016-0713-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 11/27/2016] [Indexed: 12/24/2022]
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9
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Tubular Carcinoma of the Breast: Advantages and Limitations of Breast Tomosynthesis. Case Rep Radiol 2016; 2016:3906195. [PMID: 28116205 PMCID: PMC5220450 DOI: 10.1155/2016/3906195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 12/04/2016] [Indexed: 11/17/2022] Open
Abstract
Tubular carcinoma of the breast is a rare variant of invasive ductal carcinoma. We report a case of 42-year-old asymptomatic female with a histopathological proven multifocal tubular carcinoma, studied by mammography, Tomosynthesis, Ultrasound, and Magnetic Resonance. Herein, we discuss the advantages and limitations of Tomosynthesis, an emerging imaging technique, in this particular case.
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Kalli S, Lanfranchi M, Alexander A, Makim S, Freer PE. Spectrum of Extramammary Malignant Neoplasms in the Breast With Radiologic-Pathologic Correlation. Curr Probl Diagn Radiol 2015; 45:392-401. [PMID: 26416136 DOI: 10.1067/j.cpradiol.2015.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/13/2015] [Accepted: 07/28/2015] [Indexed: 01/07/2023]
Abstract
Although primary breast cancer is the most common malignancy identified by breast imaging, extramammary malignancies may also rarely be encountered. These uncommon lesions may reflect primary neoplasms of nonmammary origin as well as secondary metastatic lesions, and include lymphoma, melanoma, neuroendocrine tumors, gastrointestinal tract malignancies, and angiosarcoma among other entities. Malignant extramammary breast lesions may be encountered during routine mammographic screening, identified during the diagnostic evaluation of a palpable breast abnormality, or may be detected incidentally during imaging of other organs of interest. As such, the radiologist should have familiarity with the appearance of these lesions. This article focuses on a review of several of the most common extramammary metastases to the breast, as well as a few lesions that may develop as either primary or secondary lesions.
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Affiliation(s)
- Sirishma Kalli
- Department of Radiology, Tufts Medical Center, Boston, MA.
| | | | | | - Shital Makim
- Department of Radiology, Tufts Medical Center, Boston, MA
| | - Phoebe E Freer
- Avon Comprehensive Breast Center, Massachusetts General Hospital, Boston, MA
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11
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Acar T, Tarcan E, Hacıyanlı M, Kamer E, Peşkersoy M, Yiğit S, Gür Ö, Cin N, Sarı AA, Tatar F. How to approach phyllodes tumors of the breast? ULUSAL CERRAHI DERGISI 2015; 31:197-201. [PMID: 26668526 DOI: 10.5152/ucd.2015.2941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 11/24/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Phyllodes tumor of the breast is a rare fibroepithelial breast tumor that comprise 0.3-0.9% of primary breast neoplasms. In this study, we aimed to present clinicopathologic symptoms of our patients along with their treatment modality. MATERIAL AND METHODS Clinicopathologic properties and treatment modality of 20 phyllodes tumor patients who underwent surgery between January 2008 and January 2013 were retrospectively evaluated. RESULTS Median patient age was 47 years (22-75). Fine-needle aspiration biopsy was applied to 19 patients. Biopsy results were reported as suspicious in four, malignant in three, benign in 11, and as non-diagnostic in one patient. Final histopathology reports revealed two benign, one malignant and one borderline tumor out of the four patients with suspicious findings on fine needle aspiration biopsy; all patients with malignant cytology had malignancy. There were two borderline and nine benign lesions within the benign biopsy group. Sixteen patients underwent segmental mastectomy, four patients underwent mastectomy with/without axillary dissection. The median tumor size was 6 (1-13) cm. Histopathologically, 11 (55%) tumors were benign, 5 (25%) were borderline, and 4 (20%) were malignant. Two of the four patients with malignancy underwent radiotherapy and chemotherapy, and one patient only received chemotherapy as adjuvant treatment. CONCLUSION Phyllodes tumors are rare, mix-type breast tumors. Due to high rates of local recurrence and potential for malignancy, preoperative diagnosis and accurate management are important.
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Affiliation(s)
- Turan Acar
- Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Ercüment Tarcan
- Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Mehmet Hacıyanlı
- Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Erdinç Kamer
- Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Mustafa Peşkersoy
- Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Seyran Yiğit
- Clinic of Pathology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Özlem Gür
- Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Necat Cin
- Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Ayşegül Akder Sarı
- Clinic of Pathology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Fatma Tatar
- Clinic of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
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12
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Barquet-Muñoz SA, Villarreal-Colin SP, Herrera-Montalvo LA, Soto-Reyes E, Pérez-Plasencia C, Coronel-Martínez J, Pérez-Montiel D, Vázquez-Romo R, Cantú de León D. Metaplastic breast cancer: a comparison between the most common histologies with poor immunohistochemistry factors. BMC Cancer 2015; 15:75. [PMID: 25881163 PMCID: PMC4340608 DOI: 10.1186/s12885-015-1079-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 02/10/2015] [Indexed: 02/07/2023] Open
Abstract
Background Metaplastic carcinoma of the breast (MCB) is a rare histological type of breast cancer. This study aimed to determine whether MCB exhibits shorter overall survival (OS) and disease-free survival (DFS) compared with other histologies that are considered unfavorable. Methods We retrospectively analyzed 157 clinical file records of the Mexico City-based National Institute of Cancerology and compared the clinical characteristics and treatment of 24 patients with MCB, 37 patients with triple-negative invasive lobular carcinoma (TN-ILC), 48 patients with high-grade invasive ductal carcinoma (HG-IDC), and 48 patients with triple-negative invasive ductal carcinoma (TN-IDC), paired by clinical stage and age. We performed a comparative analysis and analyzed OS and DFS using a log-rank test. Results In patients with MCB, the 5-year DFS was 52.1% (mean, 48.52 months; 95%: 35.32-61.72), and the 5-year OS was 72.2% (mean, 59.77 months; 95% CI: 48.55-71.00). No differences were observed in the DFS of MCB compared with each of the other histologies (MCB vs. HG-IDC, p = 0.865; MCB vs. TN-IDC, p = 0.966, and MCB vs. TN-ILC, p = 0.132). Moreover, no differences were observed when comparing the OS of MCB with that of each of the other histologies (MCB vs. HG-IDC, p = 0.246; MCB vs. TN-IDC, p = 0.255, and MCB vs. TN-ILC, p = 0.387). Conclusions Neither OS nor DFS differ between patients with MCB and those with other histologies with unfavorable immunohistochemical factors.
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Affiliation(s)
| | | | | | - Ernesto Soto-Reyes
- Direction of Research, Instituto Nacional de Cancerología, Mexico City, Mexico.
| | | | | | - Delia Pérez-Montiel
- Department of Surgical Pathology, Instituto Nacional de Cancerología, Mexico City, Mexico.
| | - Rafael Vázquez-Romo
- Department of Breast Tumors, Instituto Nacional de Cancerología, Mexico City, Mexico.
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Al Samaraee A, Angamuthu N, Fasih T. Primary breast osteosarcoma: a case report and review of literature. Scott Med J 2014; 59:e1-4. [PMID: 25210125 DOI: 10.1177/0036933014551674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Primary soft tissue sarcomas are uncommon. We report a case of primary breast osteosarcoma which was treated successfully. This case report is combined with a literature review of this rare breast malignancy. METHODS Electronic literature search of databases: Pubmed/Medline, Ovid and EMBASE, in addition to the search engines Google/Google Scholar and Bing. The keywords used were breast osteosarcoma, soft tissue sarcoma and breast cancer. Searches were screened and those studies thought to be relevant had full text versions retrieved. The references to all retrieved texts were searched for further relevant studies. CONCLUSION Primary breast osteosarcoma is a rare breast malignancy that affects elderly patients. Diagnosis is often challenging and can be debatable due to its rarity, non-specific radiological findings and the complicated histopathological subtypes. Surgery is the treatment of choice.
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Affiliation(s)
- Ahmad Al Samaraee
- Speciality Registrar in General Surgery, Department of General Surgery, Wansbeck General Hospital, UK
| | - Nithia Angamuthu
- SHO in General Surgery, Department of General Surgery, Queen Elizabeth Hospital, UK
| | - Tarannum Fasih
- Consultant Surgeon, Department of General Surgery, Queen Elizabeth Hospital, UK
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14
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Fleury EDFC, Assunção-Queiros MDCGA, Roveda D. Breast carcinomas: variations in sonoelastographic appearance. BREAST CANCER-TARGETS AND THERAPY 2014; 6:135-43. [PMID: 25177152 PMCID: PMC4128690 DOI: 10.2147/bctt.s66110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background This study assessed factors influencing the sonoelastographic presentation of breast carcinoma. Methods A prospective collaborative study was conducted by the Santa Casa de São Paulo and CTC-Center, on 540 breast lesions in women referred for percutaneous breast biopsy. Eighty-four carcinomas showing lesions on ultrasonography were included. These lesions were classified into four sonoelastographic scores, where scores of 1, 2, and 3 were considered false-negative, and a score of 4 was considered true-positive. Scores were compared against histopathologic results, which were divided into two groups, ie, soft lesions (group 1) and hard lesions (group 2). False-negative and true-positive results were also assessed for variation according to patient age and mean lesion diameter. Results Of the 84 lesions studied, nine yielded false-negative results on sonoelastography and 75 yielded true-positive results. In terms of histopathologic classification, eight were assigned to group 1 and 76 to group 2. The chi-squared test showed a correlation between sonoelastographic scores and histopathologic lesion type. No statistically significant differences were observed according to patient age or largest lesion diameter. Conclusion Our results revealed an association between sonoelastographic presentation of breast lesions and histology. False-negative results on sonoelastography were influenced by histologic type of lesion and not by lesion size or patient age.
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Affiliation(s)
| | | | - Decio Roveda
- Faculdade de Cências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
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15
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Patidar AK, Kumar HS, Walke RV, Beniwal S. Primary osteogenic sarcoma of the breast: a case report. Indian J Surg Oncol 2013; 3:255-6. [PMID: 23997518 DOI: 10.1007/s13193-012-0172-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 06/25/2012] [Indexed: 11/25/2022] Open
Affiliation(s)
- Arvind Kumar Patidar
- Acharya Tulsi Regional Cancer Treatment & Research Institute, Bikaner, Rajasthan India ; Karunda, Chhoti-sadri, Pratapgarh, Rajasthan Pin Code 312604 India
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16
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Boisserie-Lacroix M, Hurtevent-Labrot G, Ferron S, Lippa N, Bonnefoi H, Mac Grogan G. Correlation between imaging and molecular classification of breast cancers. Diagn Interv Imaging 2013; 94:1069-80. [PMID: 23867597 DOI: 10.1016/j.diii.2013.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The histological type of tumour according to the WHO: ductal, lobular, rare forms, is correlated with specific aspects of the imaging based on each type. This morphological classification was improved by knowledge of the molecular anomalies of breast cancers, resulting in the definition of cancer sub-groups with distinct prognoses and different responses to treatment: luminal A, luminal B, HER2 positive, basal-like, triple-negative. Studies are beginning to deal with the appearance of each sub-type in the imaging. It is now important for the radiologist to be familiar with them.
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Affiliation(s)
- M Boisserie-Lacroix
- Breast Imaging Unit, Department of Medical Imaging, Institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
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Abstract
Mucinous carcinoma of the breast is one of the rarer forms of intramammary cancer, often presenting as a lobulated, fairly well circumscribed mass on mammography, sonography, and gadolinium-enhanced magnetic resonance imaging. It accounts for 1% to 7% of all breast cancers and generally carries a better prognosis than other types of malignant breast cancers. Metastatic disease occurs at a lower frequency than in other types of invasive carcinoma. We present an atypical case of mucinous carcinoma in a woman who presented with a palpable intramammary lymph node metastasis from an unknown breast primary. Subsequent magnetic resonance imaging and percutaneous biopsy demonstrated histologic findings consistent with a mixed mucinous neoplasm with a micropapillary pattern.
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Affiliation(s)
- Kelli Y Ha
- Department of Radiology, Baylor University Medical Center at Dallas
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Arrigan M, Smyth L, Harmon M, Flynn C, Sheehy N. Imaging findings in recurrent extramedullary leukaemias. Cancer Imaging 2013; 13:26-35. [PMID: 23439108 PMCID: PMC3581869 DOI: 10.1102/1470-7330.2013.0004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acute leukaemias are relatively common malignancies. Treatment has advanced significantly in the recent past and there has been improved patient survival. This improved initial response is leading to an increasing number of cases of relapse. Extramedullary relapse occurs in a wide variety of locations with varying presentations, imaging findings and differentials. The pathophysiology and clinical course of recurrent extramedullary myeloid and lymphocytic leukaemias are reviewed in this article. The wide variety of imaging findings associated with many important sites of recurrence and the associated differential diagnosis are discussed and illustrated.
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Affiliation(s)
- M Arrigan
- Department of Radiology, St James's Hospital, Dublin 8, Ireland.
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19
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Singer A, Tresley J, Velazquez-Vega J, Yepes M. Unusual aggressive breast cancer: metastatic malignant phyllodes tumor. J Radiol Case Rep 2013; 7:24-37. [PMID: 23705037 DOI: 10.3941/jrcr.v7i2.1430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
For the year of 2012, it has been estimated that breast cancer will account for the greatest number of newly diagnosed cancers and the second highest proportion of cancer related deaths among women. Breast cancer, while often lumped together as one disease, represents a diverse group of malignancies with different imaging findings, histological appearances and behavior. While most invasive primary breast cancers are epithelial derived adenocarcinomas, rare neoplasms such as the phyllodes tumor may arise from mesenchymal tissue. Compared to the breast adenocarcinoma, the phyllodes tumor tends to affect a younger population, follows a different clinical course, is associated with different imaging and histological findings and is managed distinctively. There may be difficulty in differentiating the phyllodes tumor from a large fibroadenoma, but the mammographer plays a key role in reviewing the clinical and imaging data in order to arrive at the correct diagnosis. Early diagnosis with proper surgical management can often cure non-metastatic phyllodes tumors. However, in rare cases where metastasis occurs, prognosis tends to be poor. This report describes the presentation, imaging findings and management of a metastatic malignant phyllodes tumor.
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Affiliation(s)
- Adam Singer
- Department of Radiology, Jackson Memorial Hospital, Miami, FL 33136, USA.
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20
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Kaplan SS, Collado-Mesa F, Ekens J, Thurber M. Palpable Solid Breast Masses With Probably Benign Sonographic Features: Can Biopsy Be Avoided? Breast J 2013; 19:212-4. [DOI: 10.1111/tbj.12086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Stuart S. Kaplan
- Breast Imaging Section; Department of Radiology; Mount Sinai Medical Center; Miami; Florida
| | - Fernando Collado-Mesa
- Breast Imaging Section; Department of Radiology; University of Miami Miller School of Medicine Miami; Florida
| | - Julie Ekens
- Women's Diagnostic Center; Louisville; Kentucky
| | - Marzieh Thurber
- Lakes Interventional Radiology and Breast Centers; Miami; Florida
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21
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Gonçalves LLC, Santos SB, Marinho EC, Almeida AMD, Santos AHDS, Barros ÂMMS, Fakhouri R. Câncer de mama feminino: aspectos clínicos e patológicos dos casos cadastrados de 2005 a 2008 num serviço público de oncologia de Sergipe. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2012. [DOI: 10.1590/s1519-38292012000100005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVOS: conhecer os aspectos clínicos e patológicos dos casos de câncer de mama feminino cadastrados num serviço público de oncologia de Sergipe. MÉTODOS: procurou-se fazer uma associação do estadiamento com as características presentes nos tumores. A coleta de dados foi realizada em 165 prontuários de mulheres cadastradas no período de 2005 a 2008 no ambulatório de oncologia do Hospital Cirurgia, localizado em Aracaju-Sergipe, por meio de formulário de coleta de dados, em 2009. RESULTADOS: identificou-se o carcinoma ductal invasivo como o tipo de neoplasia mamária mais frequente com 80,8% dos casos; 76 (46,1%) neoplasias foram diagnosticadas em estádio avançado (IIB, III e IV) e a mastectomia prevaleceu como tipo de cirurgia utilizado no tratamento independente do estadiamento. Quanto aos receptores hormonais todos apresentaram associação com o grau do estádio e, ainda, notou-se que a positividade do estrogênio e progesterona é fator de proteção para um pior prognóstico. CONCLUSÃO: é notável que os casos de câncer de mama estudados apresentam maior agressividade biológica, cursando com pior prognóstico, considerando o estádio clínico. Fazem-se necessárias ações de detecção precoce voltadas ao câncer de mama na atenção básica de Sergipe para redução da morbi-mortalidade, melhora da sobrevida e qualidade de vida entre as mulheres acometidas por essa neoplasia.
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22
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Wessel C, Schnabel JA, Brady M. Towards a more realistic biomechanical modelling of breast malignant tumours. Phys Med Biol 2012; 57:631-48. [DOI: 10.1088/0031-9155/57/3/631] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Surov A, Fiedler E, Holzhausen HJ, Ruschke K, Schmoll HJ, Spielmann RP. Metastases to the breast from non-mammary malignancies: primary tumors, prevalence, clinical signs, and radiological features. Acad Radiol 2011; 18:565-74. [PMID: 21393030 DOI: 10.1016/j.acra.2010.12.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Revised: 12/14/2010] [Accepted: 12/14/2010] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Most secondary intramammary tumors occur as metastatic involvement from the contralateral breast. Breast metastases (BM) from nonmammary malignancies are very rare. The aims of this study were to estimate retrospectively the prevalence of BM from nonmammary malignancies and to describe their radiologic appearance. MATERIALS AND METHODS BM were identified in 51 patients, including 43 women and eight men with a median age of 61 years (range, 24-84 years). Computed tomography of the thoracic region identified 108 lesions in 38 patients. Mammography was available for 37 patients (54 lesions). Ultrasound evaluation was performed in 43 patients (71 lesions). In 24 patients (93 lesions), magnetic resonance imaging of the breast was done. Images were reviewed in consensus by two radiologists according to the Breast Imaging Reporting and Data System lexicon. RESULTS The prevalence of BM in several tumors ranged from 0.12% to 4.92%. On computed tomography, most metastases were round or oval in shape with marked or moderate enhancement. On mammography, solitary or multiple round or oval masses with circumscribed margins were the most common pattern of BM. Ten percent showed microcalcifications. On ultrasound, most BM were hypoechoic, oval or round in shape, with microlobulated or circumscribed margins, and posterior acoustic enhancement. Doppler imaging showed hypervascularity in 39% of BM. On magnetic resonance imaging, most lesions demonstrated marked homogenous contrast enhancement. Type 1 kinetic curve was seen in 18%, type 2 in 52%, and type 3 in 30%. CONCLUSIONS The radiologic features reported in this study should be taken into consideration in the differential diagnosis of breast lesions.
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Germany.
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24
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Roberts-Klein S, Iuanow E, Slanetz PJ. Avoiding pitfalls in mammographic interpretation. Can Assoc Radiol J 2010; 62:50-9. [PMID: 20832240 DOI: 10.1016/j.carj.2010.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 07/14/2010] [Accepted: 07/16/2010] [Indexed: 10/19/2022] Open
Abstract
There is a public misconception that screening mammography detects all breast malignancies. The objective of this pictorial essay is to review classic mammographic features of malignancy that, if missed, could potentially result in malpractice litigation. By identifying radiologic themes, we attempt to improve awareness about the imaging characteristics of a variety of subtle malignancies.
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Affiliation(s)
- Shayna Roberts-Klein
- Division of Breast Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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25
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Linda A, Zuiani C, Girometti R, Londero V, Machin P, Brondani G, Bazzocchi M. Unusual malignant tumors of the breast: MRI features and pathologic correlation. Eur J Radiol 2010; 75:178-84. [DOI: 10.1016/j.ejrad.2009.04.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2009] [Accepted: 04/15/2009] [Indexed: 11/28/2022]
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26
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Typical atypical findings on dynamic MRI of the breast. Eur J Radiol 2009; 76:195-210. [PMID: 19726148 DOI: 10.1016/j.ejrad.2009.07.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 07/28/2009] [Accepted: 07/28/2009] [Indexed: 11/23/2022]
Abstract
Dynamic contrast enhanced magnetic resonance imaging (DCE MRI) of the breast has become an important tool to detect and characterize breast disease. The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS(®)) provides a standardized vocabulary for describing the morphologic features and contrast kinetics of breast lesions. However, some lesions may show morphologic and dynamic MR features not consistent with their histologic nature resulting in incorrect categorization as malignant or benign. Another cause of diagnostic problems is artifacts. Thus correct interpretation of dynamic MRI of the breast demands knowledge of the most common pitfalls encountered in clinical practice. A pictorial overview of these is presented, with particular reference to the differentiation of malignant tumors from benign lesions.
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Matheus VS, Kestelman FP, Canella EDO, Djahjah MCR, Koch HA. Carcinoma medular da mama: correlação anátomo-radiológica. Radiol Bras 2008. [DOI: 10.1590/s0100-39842008000600007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar as características radiológicas do câncer de mama medular em pacientes submetidas a tratamento cirúrgico no Instituto Nacional de Câncer (INCA) - Ministério da Saúde, Rio de Janeiro, RJ, correlacionando os achados com estudo histopatológico. MATERIAIS E MÉTODOS: Foi realizado estudo descritivo retrospectivo de mulheres submetidas a tratamento cirúrgico no INCA, no período de janeiro de 1997 a dezembro de 2006, para identificação das pacientes com carcinoma medular e análise dos achados radiológicos. RESULTADOS: Foram identificadas 21.287 pacientes com diagnóstico de carcinoma neste período, sendo 76 pacientes com diagnóstico de carcinoma medular típico (0,357%). Nessas pacientes selecionadas, a idade média foi de 51,9 anos (32 a 81 anos). Dezenove pacientes apresentavam lesão na mamografia, sendo 17 (89,5%) nódulos e 2 assimetrias focais (10,5%). Entre as pacientes com nódulo, 15 (88,1%) apresentavam alta densidade e 2 eram isodensos (11,9%). Doze pacientes apresentavam achados ultra-sonográficos e, destas, 11 (91,6%) apresentavam nódulos hipoecóicos. Foi observada uma paciente com nódulo anecóico com áreas de degeneração cística. CONCLUSÃO: O nódulo foi o achado radiológico dominante (89,5%), dos quais 88,1% apresentaram nódulos com alta densidade e margens circunscritas. Apesar das características radiológicas de benignidade, um nódulo com alta densidade, sólido, margens circunscritas e crescimento rápido deve ser investigado para confirmar o diagnóstico.
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Affiliation(s)
| | | | | | | | - Hilton Augusto Koch
- Universidade Federal do Rio de Janeiro; Pontifícia Universidade Católica do Rio de Janeiro, Brasil
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Khan S, Griffiths EA, Shah N, Ravi S. Primary osteogenic sarcoma of the breast: A case report. CASES JOURNAL 2008; 1:148. [PMID: 18783623 PMCID: PMC2546375 DOI: 10.1186/1757-1626-1-148] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Accepted: 09/10/2008] [Indexed: 11/10/2022]
Abstract
Introduction Primary osteosarcoma of the breast is a rare malignant tumour. It is typically a poor prognosis tumour, which has some interesting features worthy of discussion. We report a case of primary osteosarcoma of the breast and summarise the previous medical literature to highlight several details of this unusual tumour. Case presentation A 66-year-old Caucasian lady presented with painless lump in her right breast. Mammography showed features of fibroadenoma with calcification and fine needle aspiration cytology was reported as showing malignant cells (C5). Wide local excision was performed and histological features were consistent with primary osteosarcoma with predominance of osteoclastic activity. Subsequent completion mastectomy was performed because of suspicion of incomplete excision. She remains disease free 8 years from her initial surgery.
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Affiliation(s)
- Shabuddin Khan
- Department of General Surgery, Blackpool Victoria Hospital, Blackpool Fylde and Wyre NHS Trust, Blackpool, FY2 8NR, UK.
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29
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Harvey JA, Nicholson BT, Cohen MA. Finding Early Invasive Breast Cancers: A Practical Approach. Radiology 2008; 248:61-76. [DOI: 10.1148/radiol.2481060339] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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