Benign Mastopathy Research Articles

Transcutaneous canine breast cancer detection in Tunisia: a pilot study

BackgroundBreast cancer in Tunisia is often diagnosed at a late stage with long delay in time to consultation and to diagnosis.The aim of this study is to estimate the sensitivity and specificity of the transcutaneous breast cancer detection by canine olfactionin Tunisian women and to identify the potential confounding factors.MethodsThis is a diagnostic case control study that took place from October 2021 to November 2022 in the Department of Medical Oncology at the University Hospital Farhat Hached of Sousse and in the security and training dog center located in Sousse (K9 Dog Center Security & Training). A two-year-old male Belgian Malinois was trained to detect breast cancer on skin secretion samples in compresses that had been worn overnight by women on their breast and then a double-blind testing was performed. There was no contact between women and the dog. From the mentioned responses of the dog, four parameters were calculated: sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV).ResultsTwo hundred women were included in this trial: 100 breast cancer (BC) patients recruited from Farhat Hached University Hospital of Sousse and 100 healthy volunteers (HV).The calculated sensitivity was 84% (95% CI 78–89%) and the calculated specificity was 81% (95% CI 75–86%). The calculated predictive values were: PPV = 83,51% (95% CI 78,37–88,65%) and NPV = 81,55% (95% CI 76.17–86.93%). In the multivariate study, only four confounding factors of test’s sensitivity were retained: age (OR = 1.210 [95% CI = 1.085–1.349]; p = 0.001), history of diabetes(OR = 0.017 [95% CI = 0.001–0.228]; p = 0.002), sampling at hospital (OR = 0.010 [95% CI = 0.003–0.464]; p = 0.010) and testing during chemotherapy courses (OR = 0.034 [95% CI = 0.003–0.404]; p = 0.007).For test’s specificity, we retained the three following confounding factors: age (OR = 1,104 [95% CI = 1.021–1.195]; p = 0.014), history of benign mastopathy (OR = 0.243 [95% CI = 0.074–0.805]; p = 0.021)and history of arterial hypertension (OR = 0.194 [95% CI = 0.053–0.707]; p = 0.013).ConclusionThis is a pilot study that opens new avenues in developing a reliable cancer diagnostic tool that integrates the dog's olfactory ability to detect breast cancer using a transcutaneous sampling method. It could be a pre-test to select patients who are eligible to a screening mammogram, especially in low-income countries where there is no national mammography screening program.Pactr.org identifierPACTR202201864472288, registration date 11/01/2022.

Vitex agnus-castus Ze 440 extract in the therapy of cyclic mastodynia in women with non-tumor breast damage

Cyclic mastalgia of varying intensity occurs every month in at least 70% of women, persistent pain in the mammary glands of moderate and severe degree is occur in about 50% of patients with benign mastopathy. The cause of mastodynia is the morphofunctional rearrangement of the glandular and stromal components of tissues with the expansion of ducts and proliferation of epithelial structures due to a lack of progesterone and an increase in prolactin levels. Therapy for cyclical and chronic mastalgia is empirical and not always effective. Herbal medicine with Vitex agnus-castus is a reasonable alternative to hormonal treatment for women suffering from cyclic mastalgia in combination with other manifestations of premenstrual syndrome. The main effect of such drugs is an increase of luteinizing hormone and progesterone synthesis, effect on the hypothalamic-pituitary system, prolactin and endorphins release, which can increase the level of endogenous opioids.Purpose of the study: to study the effect of the phytopreparation Prefemin (Vitex agnus-castus extract Ze 440) on the intensity of chronic pain syndrome in women with diffuse non-tumor breast lesion. Materials and methods. The study involved 30 women aged 22 to 43 years with various types of benign breast diseases and chest pain lasting at least 3 months. In 12 patients there was diffuse fibroadenoma, in 18 – diffuse cystofibroadenoma (small cystic variant) and duct ectasia.Results. Therapy with Prefemin (Ze 440) allowed to completely eliminate pain syndrome in 93.3% of women and to reduce the frequency of mastodynia in the group with moderate severity in 90.0% of patients with diffuse fibroadenoma and cystofibroadenoma.Conclusions. Phytopreparation Prefemin, which is obtained from the medicinal plant Vitex agnus-castus, has demonstrated high efficacy in the mastalgia treatment in women with diffuse fibrocystic breast disease. This drug was well tolerated and there were no side effects.

The role of E2/P ratio in the etiology benign breast disease and mastopathy

The role of E2/P ratio in the etiology benign breast disease and mastopathy

Awareness and Misconceptions of Breast Cancer Risk Factors Among Laypersons and Physicians

Primary prevention of cancer relies on awareness of and consequent identification of risk factors. We investigated knowledge of breast cancer risk factors not only among laywomen but also among female physicians. The EDIFICE 4 nationwide observational survey was conducted by phone interviews of a representative female population (737 laywomen and 105 female physicians) aged 40-75years, using the quota method. This analysis focuses on spontaneous replies to the question "In your opinion, what are the five main risk factors that increase the risk of breast cancer?". Heredity/Family history of breast cancer was the most widely recognized risk factor in both study populations (98.1% physicians vs. 54.2% laywomen; P ≤ 0.01). Smoking (19.0 and 17.5%) and alcohol consumption (3.8 and 5.5%) were among the lifestyle risk factors that were cited by similar proportions of physicians and laywomen, respectively. Other established risk factors were however very rarely cited by either physicians or laywomen, e.g., Exposure to medical radiation (4.8 vs. 0.4%, respectively; P ≤ 0.05) or not cited at all, i.e., Benign mastopathy and Personal history of breast cancer. This survey highlights a number of misconceptions relating to behavioral risk factors for breast cancer, including the relative impact of alcohol and tobacco consumption and the importance of menopausal status. The limited awareness of the risk related to Exposure to medical radiation, Benign mastopathy, or Personal history raises concern regarding compliance with national screening recommendations.

The Use of Sonography and Mammography in the Evaluation of Eritrean Women with Breast Pain.

Objective: To assess the outcome of sonography and mammography in Eritrean women with breast pain in order to give background information for setting a standard practice of evaluation. Methods: All women with diffuse or focal breast pain referred to the departments of radiology of Orotta national referral hospital and Selam poly clinic between Jan., 2005 and Dec, 2007 were included. Patients with pain and associated palpable abnormality are excluded from the study. All patients underwent sonography and mammography. Finally, a review of all the pathology reports for breast cytology studies or biopsies was done to identify any interval cancer or false interpretations of the imaging of the subjects. Results: 470 patients underwent breast imaging during the study period. Pain alone was mentioned as reason for referral in 105 cases (22%). The mean age at presentation was 32.23. 47 (44.8%) were below the age of 30 year. 16 (15.2%) had family history of breast cancer and 11 (10.5%) had history of hormone use at the time of examinations. The pain was unilateral in 76 patients (72.4%). Most (53.3%) of the referrals were made by surgeons. FNA findings showed that 13 patients (52%) have benign mastopathy, 3 (12%) fibro adenoma, 2(8%) benign fibro epithelial alterations and the rest 6 different cytologic diagnosis, including mastitis ,tuberculous lymphadenitis, and non specific inflammatory changes. FNA cytology examination was suspicious for cancer in one patient but this was not histologically confirmed as the patient was lost to follow up. The negative predictive value for mammography and sonography was 95.7%. Conclusion: The primary use of sonography and mammography in women with breast pain is reassuring to the patients and to the treating clinician.

Hormone replacement therapy in postmenopausal women with benign fibrocystic mastopathy

Objective: To compare the effects of five different hormone replacement regimens on fibrocystic mastopathy in postmenopausal women.Design: This was a randomized, prospective, clinical,case-control study.Methods: Two hundred and twelve women with benign cystic mastopathy were studied. The largest diameters of the breast cysts were measured using ultrasonography at studyentry. Forty-eight women were randomized to the control group and did not take any medication. One hundred and sixty-four women were randomized to the following study groups. Group I (n = 46) weregiven conjugated estrogen (0.625 mg/day) and medroxyprogesterone acetate (5 mg/day) continuously. Group II (n = 22) were given only conjugated estrogens (0.625 mg/day) continuously; these were hysterectomizedwomen. Group III (n = 32) were given transdermal estrogen (50 μg/day) and medroxyprogesterone acetate (5 mg/day) continuously. Group IV (n = 32) were given only transdermal estrogen (50μg/day) continuously; these were also hysterectomized women. Group V (n = 32) were given tibolone (2.5 mg/day) continuously. Hormone therapy was continued for 12 months. Every 3 months the womenwere rescanned using ultrasonography to determine cyst diameters and examine characteristics such as internal echogenicity, and thickness and regularity of the cyst wall. Statistical assessment used Students't test and Friedman analysis.Results: In the control group, there was no statistically significant change in cyst dimensions. However, tibolone was associated with a decrease in cystdimensions which was statistically significant, but none of the other four hormone replacement therapy regimens caused any significant negative effect on the benign cystic mastopathy.

Patient delay and stage of diagnosis among breast cancer patients in Germany – a population based study

Early diagnosis is a tenet in oncology and should enable early treatment with the expectation of improved outcome. Extent and determinants of patient delay of diagnosis in breast cancer patients and its impact on stage of disease were examined in a population based study among female breast cancer patients in Germany. Two hundred and eighty-seven women, aged 18 to 80 years with newly diagnosed invasive symptomatic breast cancer, were interviewed with respect to the diagnostic process. Patient delay was defined as time from onset of first symptoms to first consultation of a doctor. Median patient delay was 16 days among symptomatic patients. Eighteen per cent of all breast cancer patients waited longer than 3 months before consulting a physician. Long patient delay was associated with old age, history of a benign mastopathy, obesity, and indices of health behaviour such as not knowing a gynaecologist for out-patient care and non-participation in general health screening examinations. A strong association between patient delay and stage at diagnosis was observed for poorly differentiated tumours. These results suggest that at risk groups for delaying consultation can be identified and that a substantial proportion of late stage diagnoses of poorly differentiated breast cancer cases could be avoided if all patients with breast cancer symptoms would present to a doctor within 1 month.

Patient delay and stage of diagnosis among breast cancer patients in Germany -- a population based study.

Early diagnosis is a tenet in oncology and should enable early treatment with the expectation of improved outcome. Extent and determinants of patient delay of diagnosis in breast cancer patients and its impact on stage of disease were examined in a population based study among female breast cancer patients in Germany. Two hundred and eighty-seven women, aged 18 to 80 years with newly diagnosed invasive symptomatic breast cancer, were interviewed with respect to the diagnostic process. Patient delay was defined as time from onset of first symptoms to first consultation of a doctor. Median patient delay was 16 days among symptomatic patients. Eighteen per cent of all breast cancer patients waited longer than 3 months before consulting a physician. Long patient delay was associated with old age, history of a benign mastopathy, obesity, and indices of health behaviour such as not knowing a gynaecologist for out-patient care and non-participation in general health screening examinations. A strong association between patient delay and stage at diagnosis was observed for poorly differentiated tumours. These results suggest that at risk groups for delaying consultation can be identified and that a substantial proportion of late stage diagnoses of poorly differentiated breast cancer cases could be avoided if all patients with breast cancer symptoms would present to a doctor within 1 month.British Journal of Cancer (2002) 86, 1034–1040. DOI: 10.1038/sj/bjc/6600209 www.bjcancer.com© 2002 Cancer Research UK

CD44 expression patterns in breast and colon tumors: a PCR-based study of splice variants.

CD44 cell-surface receptor expresses multiple isoforms, some of which are believed to play a role in tumor growth and metastasis. The CD44 gene is composed of 19 exons, of which 9 (exons 6 to 14) are alternatively spliced to form inclusions in the intervening membrane proximal region. Sequences present in the shortest metastatic variant cloned from a rat metastatic cell line have been shown to correspond to human exons 10 and 11, also called exons v6 and v7. Using RT-PCR, we have addressed in detail the CD44 isoforms produced in human breast and colon tumors. We analyzed 53 breast-tumor- and 58 colon-tumor-related samples as well as 1 benign mastopathy, 1 normal breast, 4 non-invaded lymph nodes and 8 normal colon tissues. All tumors analyzed expressed the hemopoietic CD44 (CD44H) isoform (no alternatively spliced exons added), whereas 81% expressed the CD44E form (addition exons 12, 13 and 14). Furthermore, 85% of tumors presented complex patterns of expression, with an average number of 5 to 6 bands detected. In view of their implication in the metastatic process, we investigated in greater detail the isoforms containing exons 10 and 11 (v6 and v7). Exon 10 was more frequently expressed than exon 11, 80% and 57% of the samples respectively. The great majority of cases showed ladder-like patterns starting from the shortest forms (exons 5-10 or 5-10-11) and larger-molecular-weight bands corresponding predominantly to sequential inclusions of exons from 3' to 5'. Exon-10 and exon-11 variants were also found in one benign mastopathy. The majority of normal tissues (1 breast and 6/8 colon) expressed only the CD44H isoform. These data indicate that expression of metastatic variants is common in human breast and colon tumors and can occur early during cancer progression, as testified by their presence in a benign breast tumor. While expression of exon-10 variants were correlated with presence of distal metastases in colon tumors, exon-11 variants were not (metastatic events were too rare in our breast-tumor series to reach significance). This suggest that exon 10 may correspond to the minimal sequences required to favor metastatic events.

Arginase, a new marker of mammary carcinoma

Activities of arginase, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were determined in sera obtained in a group of healthy women, women with verified carcinoma of the breast, benign mastopathy, a group of patients with carcinoma of various organs and a group of patients with acute viral hepatitis. Preoperative values of serum arginase activity in patients with breast carcinoma were up to 4-fold those found in healthy women. Sensitivity of the test was 86%. After the surgery, the activity decreased abruptly during the first week and normalised within 15–30 days. In benign diseases of the breast, the activity of arginase was normal. Serum arginase activity is raised in both benign and malignant liver diseases, however, the quotients alanine aminotransferase/arginase, aspartate aminotransferase/arginase and alkaline phosphatase/arginase differ significantly. Thus, use of alanine aminotransferase/arginase quotient implies a high degree of confidence in differentiating between increased arginase activity in mammary carcinoma (alanine aminotransferase/arginase = 0.572 ± 0.278) and high arginase activity in hepatitis (alanine aminotransferase/arginase = 12.226 ± 1.822).

Surgical Pathology of the Breast.

Normal development - puberty, adolescence, pregnancy, atrophy abnormalities of development - accessory nipples and breast, amazia, hypertrophy, gynaecomastia diagnostic methods - aspiration cytology, trucut biopsy, frozen section, localisation of mammographic abnormalities, steroid receptors, milk fat globulin receptors benign disorders - subcutaneous tissues, nipple areolar complex, nipple retraction and discharge, infections, benign and cystic mastopathy, fibroadenomata, phylloides tumours malignant disease - locoregional recurrent disease, distant metastases.

Triptorelin successfully treats chronic benign mastopathy in premenopausal women

Triptorelin successfully treats chronic benign mastopathy in premenopausal women

Insuline response to glucose tolerance test in female subjects with benign mastopathy (BM)

Insuline response to glucose tolerance test in female subjects with benign mastopathy (BM)

A nationwide study of breast disease.

Records of histopathology from the 3734 Jewish women having breast biopsy and/or operations in all Israeli hospitals during the year from July 1979 to June 1980 were reviewed. Approximately 28.5% of these women were diagnosed as having breast cancer and 71.5% as having benign breast disease: 48.5% had benign proliferative mastopathy (BPM), 16.6% had fibroadenoma (FA) without coexistent BPM, and 6.4% had other benign breast conditions. The age-specific incidence rate was 66 in 100,000 for breast cancer and 165.2 in 100,000 for benign breast disease. Native European or American women and native Israeli women had significantly higher age standardized incidence rates of both breast cancer and BPM, but not of FA, as compared to African/Asian-born women (P less than 0.01). Age-related ratios between invasive to precursor breast lesions were similar in all ethnic groups. The data suggest that breast cancer and benign proliferative mastopathy may have a common etiologic component.

Thyroid disease in patients with benign and malignant mastopathy.

The incidence of thyroid disease was examined prospectively in 97 consecutive patients with breast cancer (Group I) and was compared with that of 61 women with cystic breast disease (Group II) and that of 60 control women (Group III) with no breast problems. Thyroid enlargement was found in 47%, 49%, and 22% of those in Groups I, II, and III, respectively, and treatment with thyroid hormones was taken by 9.3% (I), 8.2% (II), and 5.0% (III) of the cases. The mean thyroid-stimulating hormone (TSH) concentration in those in Group I (5.4 +/- 2.2 microU/ml) was significantly higher than in Groups II (3.9 +/- 1.9, P less than 0.01) and III (4.0 +/- 1.8, P less than 0.001), whereas thyroid microsomal antibodies were detected in 13.4% (I), 9.1% (II), and 1.7% (III); mean triiodothyronine (T3) and thyroxin (T4) concentrations were similar in the three groups. When both TSH and T3 concentrations were taken into account, 24% and 17% of the patients, respectively, from Group I were no longer in the Group III range; the corresponding figures for Group II were 13% and 23%, respectively. These results indicate that breast cancer and thyroid disease are probably related, but not in a specific way, since benign mastopathy also seems to be associated with thyroid disturbances.

Prognostic value of concentration of pregnancy-specific beta 1-glycoprotein (SP1) in serum of patients with breast cancer.

Pregnancy-specific beta 1-glycoprotein (SP1) was assayed by particle counting immunoassay in serum from 46 healthy female blood donors, 33 patients with benign mastopathy and 84 patients with breast cancer before operation and during follow-up. Values greater than 1 micrograms/1 were found more frequently with benign mastopathies (11/33) and in patients with breast cancer at stage 2 (20/48), 3 (4/9), and 4 (7/10) than in healthy female blood donors (3/46). The survival rate after 4 years was significantly lower in patients with SP1 level greater than 1 microgram/1 before tumor resection (52% vs. 87%). The difference remained significant when only patients in stage 2 were taken into account (57% vs. 85%). A highly significant (r = 0.64; N = 46) negative correlation was observed between the concentration of SP1 in serum and the concentration of estrogen receptor in the tumor. The longitudinal study of patients in stage 2 indicated that, of the 15 whose SP1 concentration fell below 1 microgram/1 after operation, 14 survived over 4 years whereas during the same period, 9 of the 10 patients whose SP1 value remained higher than 1 microgram/1 died.

Simultaneous assays of cancer associated antigens in benign and malignant breast diseases.

Five tumor markers can be simultaneously determined in the serum by radioimmunoassay: carcino-embryonal antigen (CEA), α-fetoprotein (αFP), human chorionic gonadotrophin (HCG), β-subunit of HCG (βHCG) and K-Casein. In a series of 935 healthy subjects, these antigens remain undetectable or are detected within very precise limits. At the start of the clinical evolution of breast cancer, the incidence of pathological concentrations (i.e. increased as compared with the highest level observed in normal subjects) of at least one antigen is 69% in stages T1, T2, T3, N0, N1, M0. This high incidence is mainly due to a concomitant determination of CEA, K-casein, HCG and β-HCG. The α-FP test is never positive, while the k-casein concentration is particularly high in the first clinical stages of breast cancer and with metastases. The concomitant determination of these tumor markers may be a biological element contributing to the diagnosis of neoplasia, although it is neither an absolute nor a specific criterion. Indeed, a pathological concentration of at least one antigen was observed in 5.5% of the subjects presenting with benign mastopathy. When metastases occur (25 patients), the incidence of pathological concentrations of at least one antigen increases: at 88%, the absolute values of these levels are increasing simultaneously. The determination of the antigen concentration therefore allows an evaluation of the extension of the disease. Surgical removal reduces the incidence of positivity of these antigens to 34%. Persistance of pathological levels seems to be related to a possibility of relapse or metastatic spreading. Finally, chemotherapy and radiotherapy applied on a tumor which is not excised, do not decrease the incidence of positivity of the tumoral markers, although their levels seem to fluctuate with the clinical evolution.

Ethnic and Constitutional Differences and their Relation to Breast Diseases in Israel: Educational and Socio-Economic Status

An Israeli Jewish population group consisting of 1298 cases of breast cancer and 1816 cases of benign mastopathy hospitalized in 1960-64 and 10,604 properly selected control women was studied with respect to the relationship of breast diseases to ethnic origin, educational background and socio-economic status. It was found that the percentage of Israeli-born and Orientals was higher in the benign mastopathy group than in the cancer group. For the Westerners the opposite was true. Educational level and socio-economic status were considerably higher in patients than in controls, regardless of ethnic origin. They were also higher in Westerners than in Orientals and among the Orientals higher in Iraqis than in Yemenites. The population groups with high breast cancer incidence rate appear to be on a higher educational and socio-economic level than those with a low incidence rate.