Breast Disease Patients Research Articles

Trends and Reasons of Referral of Benign Breast Disease Patients in a Tertiary Hospital in India

Trends and Reasons of Referral of Benign Breast Disease Patients in a Tertiary Hospital in India

Adipocytes promote metastasis of breast cancer by attenuating the FOXO1 effects and regulating copper homeostasis

BackgroundObesity and the forkhead box O1(FOXO1) affect the survival of breast cancer patients, but the underlying mechanism remains unclear. We aimed to investigate the role of FOXO1 in obesity-associated-breast cancer.MethodsWe screened 383 breast disease patients from the first affiliated hospital with Nanjing Medical University in 2020. We performed wound healing, transwell, matrigel assays to assess the metastatic ability of cancer cells. We adopted mRNAs sequencing to select the differentially expressed transcripts in breast cancer. We applied immunohistochemistry, western blot, tissue microarrays to assess the level of FOXO1 and epithelial-mesenchymal transition (EMT) pathways. We conducted bioinformatic analysis to investigate interactions between FOXO1 and miR-135b. We used fluorescence in situ hybridization, RT-qPCR to confirm the characteristics of circCNIH4. We conducted luciferase reporter assay, rescue experiments to investigate interactions between circCNIH4 and miR-135b.ResultsObesity was positively correlated with the incidence and progression of breast cancer. Adipocytes enhanced the migration of breast cancer and attenuated the effects of FOXO1. MiR-135b was a binding gene of FOXO1 and was regulated by circCNIH4. CircCNIH4 exhibited antitumor activity in vitro and in vivo.ConclusionAdipocytes might accelerate the progression of breast cancer by modulating FOXO1/miR-135b/ circCNIH4 /EMT axis and regulating copper homeostasis.

Repository of MRI-derived models of the breast with single and multiple benign and malignant tumors for microwave imaging research.

The diagnosis of breast cancer through MicroWave Imaging (MWI) technology has been extensively researched over the past few decades. However, continuous improvements to systems are needed to achieve clinical viability. To this end, the numerical models employed in simulation studies need to be diversified, anatomically accurate, and also representative of the cases in clinical settings. Hence, we have created the first open-access repository of 3D anatomically accurate numerical models of the breast, derived from 3.0T Magnetic Resonance Images (MRI) of benign breast disease and breast cancer patients. The models include normal breast tissues (fat, fibroglandular, skin, and muscle tissues), and benign and cancerous breast tumors. The repository contains easily reconfigurable models which can be tumor-free or contain single or multiple tumors, allowing complex and realistic test scenarios needed for feasibility and performance assessment of MWI devices prior to experimental and clinical testing. It also includes an executable file which enables researchers to generate models incorporating the dielectric properties of breast tissues at a chosen frequency ranging from 3 to 10 GHz, thereby ensuring compatibility with a wide spectrum of research requirements and stages of development for any breast MWI prototype system. Currently, our dataset comprises MRI scans of 55 patients, but new exams will be continuously added.

Ultrasonographic Evaluation of Fibrocystic Breast Disease in Patients with Polycystic Ovary Syndrome

Ultrasonographic Evaluation of Fibrocystic Breast Disease in Patients with Polycystic Ovary Syndrome

Reviewing the pattern of breast diseases in patients who attended the breast clinic at Alkarkh teaching Hospital, in Baghdad, Iraq

Reviewing the pattern of breast diseases in patients who attended the breast clinic at Alkarkh teaching Hospital, in Baghdad, Iraq

Relationships among breast, gut, and oral microbiota across diverse pathological types of breast cancer, a Chinese cohort study

Background: Recent research has unveiled the association between microbiota and the onset and progression of breast cancer (BC). This study investigates the microbiota in breast tissue, the gut, and the oral cavity in relation to different pathological types of breast diseases, aiming to unveil the microbiota-BC relationship and provide new perspectives for BC diagnosis and treatment.Methods: The study encompassed a total of 98 breast cancer patients, with 52 diagnosed with Luminal A BC, 17 with Luminal B BC, 18 with HER2 BC, and 11 with TNBC. In addition, there were 46 patients with non-malignant breast diseases. The V3-V5 region of the 16S rRNA gene of breast tissue, feces, and the oral cavity was sequenced. Based on Amplicon Sequence Variants (ASV) representative sequences and abundance information, a series of statistical analyses were conducted including community diversity analysis, community composition analysis, species difference analysis, correlation analysis, and functional prediction analysis.Results: Notable divergences in α-diversity and β-diversity were discerned in breast tissue between BC patients and non-malignant breast disease patients. The linear discriminant analysis effect size (LEfSe) and random forest examinations pinpoint Pasteurellaceae as a significant predictor in BC cohorts. Further exploration revealed significant microbial distribution divergences across distinct pathological types of BC, with notable variations in the relative abundance of microbial species such as Streptococcus, Serratia, and Pseudomonas, underscoring the diverse microbial diversity across BC subtypes and sample origins.Conclusion: This venture sheds light on the complex microbiota milieu across varying body sites and pathological types of BC, emphasizing microbiota-BC connectivity. This articulation of a multisite microbiota-BC interrelation significantly advances a holistic grasp of BC pathogenesis.

Clinical characteristics and microbiota analysis of 44 patients with granulomatous mastitis.

Granulomatous mastitis (GM) is a chronic inflammatory breast disease. In recent years, the role of Corynebacterium in GM onset has received more and more attention. This study aims to detect the dominant bacterium in GM patients and analyze the association between clinical characteristics and infectious factors. In this study, 88 samples from 44 GM patients, six acute lactation mastitis (ALM) patients, and 25 non-inflammatory breast disease (NIB) patients were divided into a GM pus group, a GM tissue group, an ALM pus group, and a NIB tissue group; then, 16S ribosomal DNA sequencing was used to explore their microbiota. The clinical data of all 44 GM patients were also retrospectively collected and analyzed to determine their relationship with infection. The median age of the 44 GM patients was 33 years, and 88.6% of patients had primary-onset cases, while 11.4% were recurrences; additionally, 89.5% of patients were postpartum and 10.5% were nulliparous. The serum prolactin level was abnormal in nine patients (24.3%). Samples from 15 GM patients (34.1%) had a Corynebacterium abundance of >1% (1.08-80.08%), with eight (53.3%) displaying an abundance of >10%. Corynebacterium was the only genus with significant differences between the GM pus group and the other three groups (p < 0.05). Corynebacterium kroppenstedtii was the predominant Corynebacterium species. Among clinical characteristics, a statistical difference in breast abscess formation was observed according to Corynebacterium abundance in Corynebacterium-positive and- negative patients (p < 0.05). This study explored the relationship between Corynebacterium infection and GM, compared the clinical characteristics between Corynebacterium-positive and- negative patients, and provided support for the role of Corynebacterium species-in particular, C. kroppenstedtii-in the pathogenesis of GM. The detection of Corynebacterium can predict GM onset, especially in patients with high prolactin levels or a history of recent lactation.

BRCA-1 mediated activation of NF-κβ and its pro-inflammatory network drives tumorigenesis in benign breast disease patients

BackgroundBenign breast disease (BBD) is a broad spectrum of diseases that have been linked to an elevated risk of developing breast cancer to varying degrees. The specific relation between BBD and breast cancer is yet to be resolved. MethodsHence the present study was aimed to investigate the relationship between BRCA-1 mutation and its impact on specific tumor markers and inflammatory cytokines mRNA expression in peripheral blood samples of BBD (n = 25), breast cancer (CAB) subjects (n = 25) and compared with control subjects (n = 25) through RT-qPCR. ResultsResults showed that BRCA-1 gene polymorphism was observed in BBD patients and CAB patients. Further quantitative RT-PCR was performed to detect the relative mRNA expression of NF-κβ, P53, BCL-2, Caspase-3, COX-2, IL-1β, TNF-α, &IL-6 gene transcripts in all the samples. Results showed that the transcript levels of P53 &Caspase-3 were significantly down regulated in BRCA-1 positive CAB (p = 0.0001) followed by BRCA-1 positive BBD subjects (p = 0.0001) when compared to control subjects. Besides, mRNA expression of NF-κβ, BCL-2 COX-2, IL-1β, TNF-α, &IL-6 levels were significantly elevated in BRCA-1 positive breast cancer subjects (2.0-fold, p = 0.0001) followed by BRCA-1 positive BBD subjects (1.2-fold p = 0.001) compared to control subjects. ConclusionBRCA-1 germ line mutation plays a significant role in tumor progression and pathogenesis. Also, the link between BBD and BC are associated with impaired BRCA-1 mutation results in altered expression of tumor markers in peripheral blood leucocytes.

Best Practice Guidelines for Breast Imaging, Breast Imaging Society, India: Part-2

Breast imaging is a prerequisite for providing high quality breast health care. Choosing the appropriate investigation is central to diagnosing breast disease in patients who present to health professionals for treatment. These patients present to doctors of different subspecialties as well as to general practitioners in our country. It is important, therefore, to provide uniform guidance to doctors in different healthcare setups of our country, urban and rural, government and private, for optimal management of breast diseases. These guidelines framed by the task group set up by the Breast Imaging Society, India, have been formulated focusing primarily on the Indian patients and health care infrastructures. They aim to provide a framework for the referring doctors and practicing radiologists to enable them to choose the appropriate investigation for patients with breast symptoms and signs. The aim has been to keep this framework simple and practical so that it can guide not only subspecialists in breast care but also help doctors who do not routinely deal with breast diseases, so that breast cancer is not missed. Overall, the aim of this document is to provide a holistic approach to standardize breast care imaging services in India. Part 2 of these guidelines focuses on the best practice principles for breast interventions and provides algorithms for the investigation of specific common breast symptoms and signs. Ultrasound is the preferred imaging modality for image-guided breast interventions due to real-time needle visualization, easy availability, patient comfort and absence of radiation. Stereotactic mammography guided procedures are performed if the lesion is visualized on mammography but not visualized on ultrasound. 14-gauge automated core biopsy device is preferred for breast biopsies although vacuum assisted biopsy devices are useful for biopsy of certain abnormalities as well as for imaging guided excision of some pathologies. MRI guided biopsy is reserved for suspicious lesions seen only on MRI. Algorithms for investigation of patients presenting with mastalgia, breast lumps, suspicious nipple discharge, infections and inflammation of the breast have been provided. For early breast cancers routine use of investigations to detect occult distant metastasis is not advised. Metastatic work up for advanced breast cancer is required for selection of appropriate treatment options.

Prognostic Evaluation of Metastasis-Related Lymphocyte/Monocyte Ratio in Stage Ⅰ-Ⅲ Breast Cancer Receiving Chemotherapy.

PurposeThis study aims to clarify the prognostic significance of metastasis-related indicators in peripheral blood in stage I-III breast cancer (BC).MethodsThe clinicopathological data of 938 breast cancer patients and 509 benign breast disease patients were retrospectively analyzed, and fasting blood samples were collected before treatment. Univariate and multivariate regression analyses were used to evaluate factors related to metastasis risk and prognosis. The Kaplan-Meier method was used to generate survival curves, and the log-rank test was used to measure differences in survival between groups.ResultsUse the cut-off value (3.433) of LMR, the logistic regression analysis revealed that high carbohydrate antigen 153 (CA153), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), killer T cell level, and low lymphocyte to monocyte ratio (LMR) level were significantly associated with BC distant metastasis. In contrast, LMR>=3.433 (HR: 0.409, 95%CI: 0.193–0.867, P = 0.020), Th/Tc ratio >=1.946 (HR: 0.378, 95% CI: 0.158–0.904, P =0.029) is regarded as a protective factor in the multivariate cox analyses. LMR is an independent prognostic factor for DFS in HER2-negative BC patients.ConclusionPeripheral blood parameters play an important role in predicting distant metastasis and prognosis of BC patients. As a potential marker, LMR can predict the metastasis and prognosis of patients with stage I-III BC.

High serum exosomal long non-coding RNA DANCR expression confers poor prognosis in patients with breast cancer.

BackgroundExosomal long non‐coding RNAs (lncRNAs) serve as excellent candidate biomarkers for clinical applications. The expression of differentiation antagonizing non‐protein coding RNA (DANCR) has been shown to be decreased in breast cancer (BC) tissues and cell lines. However, the clinical value of circulating exosomal DANCR in BC has not been explored.MethodsA total of 120 BC patients, 70 benign breast disease (BBD) patients, and 105 healthy women were recruited in this study. Total RNA was extracted from serum samples, and the level of serum exosomal lncRNA DANCR was evaluated by quantitative real‐time reverse transcription‐polymerase chain reaction (qRT‐PCR).ResultsSerum exosomal lncRNA DANCR levels were significantly higher in BC patients than in BBD patients and normal controls. The diagnostic performance of serum exosomal lncRNA DANCR was good, and the combination of serum exosomal lncRNA DANCR, CA153, and CEA greatly improved the diagnostic accuracy for BC. High serum exosomal lncRNA DANCR level was associated with various clinicopathological variables including lymph node metastasis, ER status, HER2 status, and TNM stage. In addition, the BC patients in the high serum exosomal lncRNA DANCR expression group had significantly shorter 5‐year overall survival time. Multivariate analysis demonstrated that serum exosomal lncRNA DANCR was an independent risk factor for BC.ConclusionSerum exosomal lncRNA DANCR may be a useful non‐invasive biomarker for the clinical diagnosis and prognosis of BC.

Systemic Essential Metal and Metalloid Levels in Patients with Benign Breast Disease and Breast Cancer.

The objective of the present study is evaluation of serum and hair levels of essential metals and metalloids in women with benign breast disease and breast cancer in order to define similar and distinct patterns that may mediate the link between these pathologies. A total of 310 adult women aged 20-80years old were enrolled in the present study. Of those, 103 patients had benign (fibrocystic) breast disease, 107 patients had breast cancer (stage II), and 100 women were healthy and with absence of breast pathology. Trace metal and metalloid levels in hair and serum were evaluated by inductively coupled argon plasma mass-spectrometry (ICP-MS). The data demonstrate that breast cancer patients were characterized by significantly higher hair Cr and V levels, as well as reduced Cu and Mn content as compared to both benign breast disease patients and controls. In contrast, serum Cu levels in women with breast cancer exceeded those in the controls and benign breast disease cases. Patients with both benign and malignant breast tumors were characterized by lower serum Mn levels as compared to the control values. Serum Cu/Zn and especially Cu/Mn were found to be significantly increased in cancer patients. Significantly reduced hair and serum Se levels were noted only in women with fibrocystic disease. Based on the analysis of two biosamples, it is proposed that malignant breast tumor development is associated with the reduction of systemic Mn and Zn levels, and a concomitant elevation of Cu concentrations.

Expression of Poly(Adenosine Diphosphate-Ribose) Polymerase Protein in Breast Cancer.

The use of poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors for breast cancer (BC) therapy is the subject of debate, and there is an urgent need to understand much the expression and prognostic role of the PARP1 protein. In this study, we have compared the expression of PARP between BC and benign breast disease (BBD) patients and also analyzed the association of PARP expression with clinicopathological parameters in BC. The study consists of 30 patients with newly diagnosed operable BC who were planned for surgery without neoadjuvant chemotherapy and 15 patients of BBD as a control between 2019 and 2021. Immunohistochemical analyses were performed prospectively on tissue samples. Anti-human PARP1 rabbit polyclonal antibody gives strong nuclear positivity. Internal control was the adipose tissue and the BBD acted as the external control. PARP1 expression was evaluated using the multiplicative quickscore method. The mean age for BC patients was 51.30 ± 10.694 years (range: 25-75 years) while BBD was below 30 years. Overexpression of PARP was present in 25 (83.3%) and weak expression in 5 (16.7%) of BC patients compared to BBD, only 2 (13.3%) patients demonstrated an overexpression of PARP, and 13 (86.6%) patients showed weak expression which showed significant association (P < 0.001). In BC, nuclear PARP (nPARP) overexpression was seen in 22 (73.3%) patients and weak expression of nPARP in 8 (26.7%), whereas 5 (16.7%) patients showed cytoplasmic overexpression. On comparing expression of PARP with clinicopathological parameters, PARP overexpression was significantly associated with older population (age >50 years) (P = 0.002), postmenopausal women (P = 0.029), higher TNM stage (Stage II and III) (P = 0.014), higher histological grade (grade 2) (P = 0.043), and presence of lymphovascular invasion (P = 0.015). Enhanced PARP1 expression is closely correlated with positive estrogen receptor status (P = 0.001) and PR status (P = 0.001). Overall PARP and nPARP overexpression was significantly associated with ER- (P = 0.006 and P = 0.008) and PR-positive (P = 0.006 and P = 0.008) patients. The PARP and nPARP overexpression was significantly associated with nontriple-negative BC patients (P = 0.001 and P = 0.001). We have not come across any study in the literature to compare PARP expression in BC and BBD patients. On the basis of our observations, we concluded that PARP overexpression is a poor prognostic marker in BC.

High-throughput and multi-phases identification of autoantibodies in diagnosing early-stage breast cancer and subtypes.

Autoantibodies (AAbs) targeted tumor‐associated antigens (TAAs) have the potential for early detection of breast cancer. Here, 574 early‐stage breast cancer (ES‐BC) patients containing 4 subtypes (Luminal A, Luminal B, HER2+, TN), 126 benign breast disease (BBD) patients, and 199 normal healthy controls (NHC) were separated into three‐phases to discover, verify, and validate AAbs. In discovery phase using high‐throughput protein microarray, 37 AAbs with sensitivity of 31.25%‐86.25% and specificity over 73% in ES‐BC, and 40 AAbs with different positive rates between subtypes were identified as candidates. In verification phase, 18 AAbs were significantly increased compared with the Control (BBD and NHC) in focused array. Ten out of 18 AAbs exhibited a significant difference between subtypes (P < .05). In ELISA validation phase, 5 novel AAbs (anti‐KJ901215, ‐FAM49B, ‐HYI, ‐GARS, ‐CRLF3) exhibited significantly higher levels in ES‐BC compared with BBD/NHC (P < .05). The sensitivities of individual AAb and a 5‐AAbs panel were 20.41%‐28.57% and 38.78%, whereas the specificities were over 90% and 85.94%. Simultaneously, 4 AAbs except anti‐GARS differed significantly between TN and non‐TN subtype (P < .05). We constructed 3 random forest classifier models based on AAbs to discriminant ES‐BC from Control or BBD, and to discern TN subtype, which yielded an area under the curve of 0.870, 0.860, and 0.875, respectively. Biological interaction analysis revealed 4 TAAs, except for KJ901215, that were associated with well known proteins of BC. This study discovered and stepwise validated 5 novel AAbs with the potential to diagnose ES‐BC and discern TN subtype, indicating easy‐to‐detect and minimally invasive diagnostic value of serum AAbs ahead of biopsy for future application.

Benign diseases of the breast glands on the background of hyperplastic processes of the endometry (references)

Purpose of the study. To highlight the most substantiated theories that reflect the dependence of benign diseases of the mammary glands in combination with hyperplastic processes of the endometrium.&#x0D; Materials and metods. The sources of literature related to the study of combined benign breast diseases on the background of gynecological pathology and thoroughly reflect the modern views of scientists on this pathology are analyzed.&#x0D; Results. Given the many unexplained patterns of hormonal diseases of the female reproductive system – the search for new options for combining these diseases continues.&#x0D; Conclusion. It is established that in recent years there has been an increase in the number of benign breast diseases in patients with combined gynecological pathology within 60–80%.

Breast Cancer Diagnosis using Machine Learning Approach

Breast cancer is the second most common cancer in women after skin cancer. When cancer care is delayed or inaccessible, there is a lower chance of survival, greater problems associated with treatment and higher costs of care. Early diagnosis improves cancer outcomes and leads to a better prognosis. In third world countries like Nigeria, where state-of-the art breast cancer diagnostic machines and the experts are grossly insufficient, alternative approaches to early diagnosis of breast cancer must be evolved. These preliminary data obtained from images of suspected cases of breast cancer are transformed in profiles of breast diseases, which are used by the local physicians in charge of breast disease patients. Each new case can then be compared by the local treating physician with the profile of all preceded cases with the same diagnosis. Three supervised learning models; Logistic Regression. Random Forest Classifier, and K-Nearest Neighbors were used to train the cancer dataset, and Random Forest Classifier outperformed with accuracy of 96% and an almost perfect sensitivity/Recall index. The dataset could not capture the demographic effects of the breast cancer images on the diagnosis, which now opens up new research areas in this study of breast cancer.

The Importance of Clinical Data for the Diagnosis of Breast Tumours in North Afghanistan.

Background This study was performed in knowledge of the increasing gap between breast disease treatment in countries with restricted resources and developed countries with increasingly sophisticated examination methods. Methods The authors present the analysis of a breast disease register consisting of diagnostic cases from Mazar e Sharif and Herat in 2018 and 2019. The study comprises a total of 567 cases, which were presented to experts via telemedicine for final diagnosis. 62 cases (10.9%) were excluded due to inacceptable data or insufficient image quality. These data provided by daily diagnostic classification were used for the built-up of a profile for each frequent breast disease and a breast cancer register. All images and cases were seen by at least 3 independent experts. The diagnoses were made in 60% of cases by cytology of fine needle aspiration and in 40% by histological images. Results For each entity of breast diseases (e.g., fibroadenoma), a profile of context variables was constructed allowing to assist medical decisions, as “wait and see,” elective surgery or immediate surgical intervention with R0 (complete) resection. These “profiles” could be described for fibroadenoma, mastitis, galactocele, fibrous-cystic disease, and invasive breast cancer. Conclusions The presented preliminary data set could serve as a cost-effective basis for a North Afghan breast cancer registry, with option to extent to a national model. These preliminary data are transformed in profiles of breast diseases, which are used by the local physicians in charge of breast disease patients. Each new case can be compared by the local treating physician with the profile of all preceded cases with the same diagnosis.

Association of hyperlipidemia with breast cancer in Bangladeshi women

BackgroundThe association of circulating lipids with breast cancer is being debated. The objective of this study was to examine the relationship between abnormal plasma lipids and breast cancer risk in Bangladeshi women.MethodsThis was a case-control study designed using a population of 150 women (50 women in each group). The lipid levels of women with breast cancer were compared to the lipid levels of women with benign breast disease (control group 1) and healthy women (control group 2). Study samples were collected from the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, for a period of 1 year. Ethical measures were in compliance with the current Declaration of Helsinki. Statistical analysis was performed with SPSS version 26.ResultsAll of the comparison groups shared similar sociodemographic, anthropometric and obstetric characteristics. The incidence of dyslipidemia was significantly higher in breast cancer patients (96%) than in healthy women (84%) and patients with benign breast disease (82%) (P < 0.05 for both). The levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL) cholesterol among the breast cancer patient group were significantly higher than those among both benign breast disease patients and healthy women (P < 0.05), except for high-density lipoprotein (HDL) cholesterol. Adjusting for other factors, body mass index (BMI) (kg/m2) (> 23) [OR 53.65; 95% CI: 5.70–504.73; P < 0.001] and total cholesterol (mg/dl) (≥ 200) [OR 16.05; 95% CI: 3.13–82.29; P < 0.001] were independently associated with breast cancer.ConclusionsTotal cholesterol and BMI are independent predictors of breast cancer risk among Bangladeshi women.

Immune reactions to clinical carcinogens and steroid hormones in breast pre-cancer and cancer patients

Detection of postmenopausal women at high risk for breast pre-cancer and cancer is a key condition to prevent these diseases. Aim of our research was to study possible usage of immunoassay for antibodies specific to benzo[a]pyrene, estradiol, and progesterone (IgA-Bp, IgA-Es, IgA-Pg) in determination of personal risks for fibrocystic disease and breast cancer at the early stage, with respect to hormone receptor status in tumor tissues. Blood serum IgA-Bp, IgA-Es, IgA-Pg were studied by ELISA in postmenopausal women: healthy controls (n = 401), patients with fibrocystic breast disease (n = 50), and breast cancer (stage I, n = 575, stages II-IV, n = 861). High individual IgA-Bp/IgA-Pg ratios of 1.5 were found in 19.7% of healthy women, and in 50.0% of fibrocystic breast disease patients (p 0.0001; OR = 4.1). IgA-Es/IgA-Pg ratios of 1.0 were revealed in 48.4% healthy women and in 68.0% fibrocystic breast disease patients (p 0.01; OR = 2.3). IgA-Bp/IgAPg values 1.0 were found in 41.9% of healthy women, and, at higher rates, in the patients with breast cancer stage I: 68.3% ER- tumors (p 0.0001; OR = 3.0) and 75.9% ER+ tumors (p 0.0001; OR = 4.4). IgA-Es/ IgA-Pg ratios 1.0 were revealed in 48.4% of healthy women, and in patients with breast cancer stage I: 65.3% ER- tumors (p 0.003; OR = 2.0), and 76.8% ER+ tumors (p 0.0001; OR = 3.5). Some associations of studied antibodies with cancer progression were revealed. Frequency of individual cases with IgA-Bp/IgA-Pg 1.0 in patients with ER- tumors increased from 12.0% at stage I to 19.9% at stage II. Frequency of cases with IgA-Bp/IgA-Pg 1.0 in the patients with ER+ tumors decreased from 62.0% at stage I to 57.3% at stage II (p = 0.002). Frequency of cases with IgA-Es/IgA-Pg 1.0 in the patients with ER- tumors increased from 11.5% at stage I to 21.4% at stage II. Frequency of cases with IgA-Es/IgA-Pg 1.0 in patients with ER+ tumors decreased from 63.3% at stage I to 56.1% at stage II (p 0.001). The cases with individual excessive IgA-Bp and IgA-Es levels are associated with fibrocystic breast disease and ER+ breast cancer at the onset of the disease. Breast cancer progression was associated with the relative decrease of ER in tumor tissues, along with higher individual levels of IgA-Bp and IgА-Es and lower IgA-Pg levels. ELISA testing of IgА-Bp, IgА-Es, IgA-Pg could be recommended for detection of individual risk for fibrocystic breast disease and stage I of breast cancer, as well as for more efficient prevention and therapy by selective modulators of estrogen receptor (raloxifene, arzoxifene and lasofoxifine) and aromatase inhibitors (exemestane, anastrozole).

The Myth of Idiopathic Granulomatous Mastitis

Objectives: Idiopathic granulomatous mastitis (IGM) is a benign rare inflammatory pseudotumor. Final diagnosis is made by biopsy and histopathology. The goals of this study were to present clinical features of IGM and to evaluate the results of treatments. Materials and methods: Ten female cases who fullfield required clinical and histologic criteria of IGM were enrolled in the study. Demographic data, clinical presentation, medication history, and radiologic results are presented. To confirm the difference in clinical course between IGM patients and other inflammatory breast disease patients, a review of the clinical and pathological data was also performed for patients with symptoms similar to these IGM patients. Results: The Median age was 28 years (range 22–42). Nine patients had no recurrence during the follow-up period. Bacterial cultures and pathological tissue diagnosis were performed. After median follow-up of 15 months (range 6–24), one (10%) patient developed disease recurrence, as confirmed by repeat histological examination. Conclusion: According to our findings, histopathology of the disease is fundamental for correct diagnosis. Corticosteroid therapy as a sole therapeutic method (prednisolone) proved to be an applicable and effective choice in the control of idiopathic granulomatous mastitis by decreasing inflammation. Surgical management should be avoided unless all medical treatment options have been exhausted. IGM is a chronic breast inflammatory disease with a recurrence incidence of 10% in the present study, especially if there is history of cigarette smoke exposure and/or isolation of Corynebacterium from tissue/pus sample.