Quadrant Of Breast Research Articles

Cholesterol Granuloma of the Breast Mimicking Cancer: A Case Report and Review of the Literature.

Cholesterol granuloma of the breast is an infrequent benign lesion with clinical and radiological findings suggestive of cancer. Herein, we present the case of a 52-year-old woman with no significant past medical history, who presented to the outpatient department for her routine breast screening. Physical examination revealed a painless palpable nodule in the upper external quadrant of the left breast, measuring 0.7 cm. On imaging, the mass met the criteria for Breast Imaging Reporting and Data System (BI-RADS) category 4B. Subsequently, a core needle biopsy of the mass was performed. Despite the alarming radiologic features, microscopic findings were consistent with breast cholesterol granuloma.

The EMory BrEast imaging Dataset (EMBED): A Racially Diverse, Granular Dataset of 3.4 Million Screening and Diagnostic Mammographic Images.

Supplemental material is available for this article. Keywords: Mammography, Breast, Machine Learning © RSNA, 2023.

Comparative Study Between Pedicled Latissimusdorsi Flap Reconstruction And Traditional Conservative Breast Surgery in Upper Outer Quadrant Breast Cancer

Background:Oncoplastic breast surgery (OPS)has developed as an extension of breast conserving surgery (BCS) in an effort to improve esthetic and functional outcome following surgery for breast cancer (BC). This study evaluatedthe benefits of reconstruction using the latissimusdorsi(LD) flap, as compared with local tissue displacement.Methods: This was a comparative non-randomized control study on patients after excision of the malignant mass from the upper outer quadrant BC. The two groups were classified into Group A: reconstruction by local tissues displacement, and Group B: reconstruction by pedicledLD flap.The two techniques were compared regarding history, examination finding, intraoperative and post-operative complications.Results:there was no significant difference between group A and B regarding their age, BMI, distance between tumor, NACandpostoperative complications. Tumor size was larger in group B,there was a significant longer operative time,increased blood loss and longer time to recoveryin group B than group A.Conclusion: OPS with breast reconstruction using the pedicledLD flap accompanied with better intra and postoperative outcomes.

Clinical Presentation and Management of Breast Lump in Sylhet M.A.G Osmani Medical College and Hospital- A Study of 100 Cases

A breast lump is a growth of tissue that develops within breast. A breast lump is often interchangeably described as a mass, swelling, thickness or fullness. The present cross sectional study was to find the clinical presentation and management of breast lump patient. The study was conducted in the Department of Sylhet MAG Osmani Medical College Hospital between July 2017 to December 2019. The patients who presenting with breast lump were study population and patient with male breast lump and breast abscess were excluded from the study. The mean ages at diagnosis, menarche and menopause were 39.1±15.6, 12.4±1.1, 41.9±10.5 years respectively. The average time lapsed between marriage and 1st child birth was 4.6±2.2 years. Out of 100 patient majorities (84%) patients were married, 8% had family history of breast cancer, 9% had history of taking oral contraceptives. All of the patients complained of swelling in the breast, thirty-four patients complained pain in the breast, twenty-four discharge from the nipple and seven patients complained fever. Half of the patients’ had location of swelling in upper outer quadrant of breast. The mean size of swelling was 4.0±1.5 cm and the lowest and highest size of swelling was 1 cm and 10 cm respectively. Fifty-four percent of patient had firm swelling, forty-one percent had hard and five percent had soft swelling. Two percent had fluctuation in the swelling. Four percent ulceration of breast, two percent peau-d-orange, six percent with fixity of skin and two percent fixity to the underlying structures. Regarding lymph node status twenty-two percent had axillary and four percent had supraclavicular lymphadenopathy. Regarding characteristics of nipple thirteen percent patient had tender nipple followed by eight percent had retracted, four percent had ulcerated and only two percent had protruded nipple. Nearly forty percent patients had blood stained discharge. Out of hundred patients four percent had a history of jaundice, ........

First Case Report of AMPA Receptor Encephalitis Presenting With Features of Parkinsonism

Objective NA. Background Autoimmune Encephalitis is an inflammatory condition of the brain due to antibodies against onconeuronal proteins. Paraneoplastic Parkinsonism is very rare. We report the first case of AMPA receptor encephalitis presenting with symptoms of parkinsonism, an atypical presentation of a rare entity. Design/Methods NA. Results A 71-year-old female with multiple comorbidities presented in a state of stupor with complaints of insidious onset slowly progressive recent memory impairment, progressive slowness in performing daily activities, inability to communicate, and acute onset urinary incontinence. CNS examination initially showed a GCS of E2V1M4 with Grade 2 rigidity in all extremities. MRI Brain showed subtle T2 FLAIR hyperintensities in the peri-ventricular and subcortical white matter. Serum and CSF studies showed AMPA 1 antibody positivity. The FDG PET showed an avid speculated soft tissue density lesion in the upper inner quadrant of the right breast with active right axillary lymph nodes (Histopathology- Infiltrating duct carcinoma Grade 2 NST T2N2aMx). The patient was managed using IVIg and steroids following which her sensorium improved to a GCS of E4M6V5. UPDRS at this point was 29. She subsequently underwent therapy for her tumor following which there was a significant decrease in parkinsonian symptoms and an improvement in memory without the use of any antiparkinsonian medications (UPDRS score-6). During the four years of follow-up, she has remained independent and can perform all her activities of daily living. Hence this autoimmune encephalitis case can be classified as a definite paraneoplastic neurological syndrome (PNS Care score-9). Conclusions We propose that Parkinsonism, in our case, is probably a paraneoplastic neurological syndrome associated with antibodies against the AMPA receptor, as the symptoms and signs recovered with cancer treatment.

Oncoplastic Surgery for Upper Inner Quadrant Breast Cancer: A Comparative Study between Two Oncoplastic Techniques

Oncoplastic Surgery for Upper Inner Quadrant Breast Cancer: A Comparative Study between Two Oncoplastic Techniques

Intraoperative electron radiotherapy in early invasive ductal breast cancer: 6-year median follow-up results of a prospective monocentric registry

BackgroundIntraoperative electron radiotherapy (IOERT) can be used to treat early breast cancer during the conservative surgery thus enabling shorter overall treatment times and reduced irradiation of organs at risk. We report on our first 996 patients enrolled prospectively in a registry trial.MethodsAt Jules Bordet Institute, from February 2010 onwards, patients underwent partial IOERT of the breast. Women with unifocal invasive ductal carcinoma, aged 40 years or older, with a clinical tumour size ≤ 20 mm and tumour-free sentinel lymph node (on frozen section and immunohistochemical analysis). A 21 Gy dose was prescribed on the 90% isodose line in the tumour bed with the energy of 6 to 12 MeV (Mobetron®-IntraOp Medical).ResultsThirty-seven ipsilateral tumour relapses occurred. Sixteen of those were in the same breast quadrant. Sixty patients died, and among those, 12 deaths were due to breast cancer. With 71.9 months of median follow-up, the 5-year Kaplan–Meier estimate of local recurrence was 2.7%.ConclusionsThe rate of breast cancer local recurrence after IOERT is low and comparable to published results for IORT and APBI. IOERT is highly operator-dependent, and appropriate applicator sizing according to tumour size is critical. When used in a selected patient population, IOERT achieves a good balance between tumour control and late radiotherapy-mediated toxicity morbidity and mortality thanks to insignificant irradiation of organs at risk.

Evaluation of Early Cosmetic Outcome and Toxicity after 5-Fraction Stereotactic Partial Breast Irradiation in Early-Stage Breast Cancer: A Prospective Cohort Study

<h3>Purpose/Objective(s)</h3> Partial breast irradiation (PBI) is a promising approach to minimize the patient burden by reducing irradiated volumes with accelerated schedules. Stereotactic-PBI (S-PBI) using a robotic stereotactic radiation system is a less invasive modality. However, prospective data are limited regarding the course of breast fibrosis and cosmesis as objective measures. We prospectively evaluated early toxicity and cosmetic outcome in women undergoing 5-fraction S-PBI. <h3>Materials/Methods</h3> Women undergoing S-PBI for invasive carcinoma and/or carcinoma in situ were prospectively enrolled. S-PBI was delivered with a robotic radiosurgery system with a dose of 30 Gy in 5 fractions. Simultaneously, women who were not a candidate for PBI, but were undergoing whole breast irradiation (WBI) were also enrolled for comparison. Patient-reported and physician-assessed adverse events were noted. Breast fibrosis was measured with a tissue compliance meter. Cosmesis was assessed with automatic computer-based software, BCCT.core. <h3>Results</h3> In total, 204 patients (n = 103, S-PBI; n = 101, WBI) were included, of whom 197 (97%) and 133 (65%) completed a 12-month and 24-month evaluation, respectively. The amount of fibrosis in uninvolved quadrants decreased over time following S-PBI for 12 months. In contrast, this finding peaked at 6 months and further decreased at 12 months in the WBI group. The amount of fibrosis of uninvolved quadrants at 6 months was significantly lower in the S-PBI group than in the WBI group (<i>P = 0.002</i>), while that of involved quadrants or scar sites was not significantly different between groups. In the S-PBI group, patient-reported grade 3–4 events were 3% at 6 months and 0% at 12 months. Physician-assessed grade 3–4 events were 2% at 6 months and 0% at 12 months. Moreover, in the S-PBI group, most cosmetic outcomes were excellent or good (82%) at 24 months, and there was no significant cosmetic detriment from baseline (<i>P = 0.353</i>). <h3>Conclusion</h3> Patients who underwent S-PBI presented with less fibrosis affecting their uninvolved breast quadrants than those who underwent WBI. Patients showed minimal toxicity with no detrimental effect on cosmesis after S-PBI. Longer-term follow-up is ongoing and necessary.

Support vector machine based methodology for classification of thermal images pertaining to breast cancer

Breast cancer has been and continues to be a cause of major health concern for women. It is more prevalent in old age, but its incidence has increased in recent years in groups below 50 years old, as in India. According to the Indian Council of Medical Research (ICMR) 2020, 50% of all the cases are in the age group of 25–50 where the numbers are staggering and constantly rising. The increase in incidence over the years indicates an urging need for innovative approaches to enhance breast cancer detection early. Thermography is non-contact imaging modalities and has potential to detect breast cancer at an early stage. Though thermography has capable of detecting breast cancer early, the challenge lies in the interpretation of the breast thermograms with respect to features and subsequent analysis. The present work discusses image acquisition, image processing related pre-processing, segmentation, and feature extraction. The extracted features were analyzed using ANOVA (Analysis of variance) statistical analysis. Statistical analyses were done in order to find the appropriate feature on the whole and quadrant breast. Statistical analysis results clearly reveal existence of thermal symmetry for the healthy subjects (p value > .05) in both whole and quadrant breast regions. In the case of abnormal subjects, whole breast analyses revealed the significance (p value < .05) for features like mean, variance, standard deviation, kurtosis, skewness, entropy, energy, homogeneity and contrast whereas upper outer quadrant analyses showed significance for all above features except contrast. The well correlated features of upper outer quadrant and whole breast were given as input for the Support Vector Machine – Radial Basis Function (SVM – RBF) classifier with grid search method. The results revealed that whole breast analysis has achieved 92.86% accuracy and upper outer quadrant breast analysis has achieved 85.71% accuracy. The results clearly indicate the involvement of upper outer quadrant and whole breast in early detection of breast cancer using thermal imaging.

Right breast schwannoma in a male: A rare case report

IntroductionSchwannoma are benign neoplasms of peripheral nerve sheath. They usually occur in the head, neck and the extremities. Breast is a rare location of Schwannoma.Case presentationOur case describes the occurrence of Schwannoma in the right breast, in a 60-year-old male, who has had a breast lump since the last 6 years. After ultrasonography (showed 3.4 × 2.3 × 2.0 cm heteroechoic mass in the upper outer quadrant of the right breast), and mammography (showed 2.5 × 3.2 cm sized high density mass in upper outer quadrant of right breast), an excisional biopsy was performed, and on histopathologic examination, the diagnosis of breast schwannoma was confirmed.DiscussionClinical and pathological features resemble that of other benign tumors. On ultrasonography they present a well-defined, solid, hypoechoic mass, with some degree of posterior acoustic enhancement. Diagnosis is usually based on histopathologic examination. Microscopically, it exhibits hypercellular antony A areas along with hypocellular antony B areas. Treatment is usually surgical excision.ConclusionThough Schwannomas in breast are rare, they must be considered as differential diagnoses in patients presenting with breast lumps.

Juvenile fibroadenoma of the breast

Juvenile fibroadenoma is a rare variant of fibroadenoma and is characterized by rapidly enlarging, painless, and unilateral masses. We presents a case of juvenile fibroadenoma of the breast in a 14 year old girl, presented with rapidly growing mass in the right breast of four months duration. On local examination a solitary, firm, mobile, unilateral, non-tender mass was felt in the upper and lower outer quadrant of the right breast, measuring 6.5 x 4.1 x 3.5cm. The overlying skin was normal. There was no axillary lymphadenopathy. The sonomammography of the right breast showed a single, oval, hypoechoic, well circumscribed mass lesion with cleft like spaces features suggestive of complex fibroadenoma BIRADS IV a. On fine niddle aspiration cytology showed sheets of hyperplastic benign ductal epithelial cells with myoepithelial cells and a background of benign bipolar nuclei and blood, without inflammatory cells. It was suggestive of fibroadenoma. She underwent right lumpectomy with breast conservation. We received right breast lumpectomy specimen. On gross showed a well-circumscribed, grey white, firm mass m 6.3 x 4.1 x 3.2 cm. On histologic features reported as juvenile fibroadenoma right breast. The postoperative period was uneventful and she recovered well and advise regular follow up. Juvenile fibroadenomas are rare benign breast tumors that should be distinguished from other masses of breast. Herewith we are presenting case of Juvenile fibroadenoma for its clinical, radio imaging, pathological features and management.

Single-incision for breast-conserving surgery through round block technique

Aims and objectivesThe purpose of this study was to assess the feasibility of using the single-incision round block technique in breast-conserving surgery with sentinel lymph node (SLN) retrieval for breast cancer without compromising oncological safety. Materials and methodsA retrospective observational case-control study was conducted from January 2017 to October 2021. The study population consisted of two groups. In both groups, breast-conserving surgery was carried out through the round-block technique. In group A, SLN retrieval was performed using the round-block incision (study group), while in group B, SLN retrieval was conducted through a second skin incision in the axilla (control group). The study was approved by the local ethics committee Zurich (BASEC-Nr. 2020–02857), and written informed consent was obtained from all participants. ResultsOverall, 134 patients met the inclusion criteria, of whom 86 women underwent breast-conserving surgery and SLN retrieval using the single-incision approach (group A), and 48 women underwent conventional surgery, using two independent incisions for tumour resection and SLN retrieval (group B). The overall success rate in group A regarding SLN retrieval was 97.7%, whereas most tumours were located in the upper outer (47.7%) and upper inner quadrant (27.9%). Although the technique was equally successful in the other quadrants, the share of tumours in the lower outer, and the lower inner quadrant, and the retroareolar region was smaller, representing 17.4%, 3.5% and 3.5%, respectively. The median number of dissected lymph nodes was two, with a positivity rate of 24.4%. The occurrence of axillary neuralgia and axillary skin retraction was significantly higher in group B along with tendentially more axillary seroma formation. There were no significant differences regarding reintervention rates, in terms of complications, resection margins, locoregional recurrences, or deaths with a mean follow-up of 11 months. ConclusionsThe single-incision method through the round block technique is as safe and effective as the standard two-incision approach regarding nodal staging and resection margins, and seems to be applicable for tumours in all breast quadrants.

EP-674 Metastases to the breast from a primary lung adenocarcinoma: A case report and literature review

Abstract Background Primary breast cancer is the commonest malignancy in adult females. However, metastases to the breast is a rare occurrence with a frequency of approximately 0.2% - 1.3%. Lung adenocarcinoma is the most common type of lung cancer and distant metastases to other organs carry a poor prognosis. A wide variety of malignancies can metastasise to the breast, melanoma being most common. On review of the literature there is a paucity of published cases of primary lung adenocarcinoma metastasizing to the breast. Case A 77-year-old lady present to the emergency department (ED) with a 5-day history of presyncope. There were no other associated symptoms and the no findings on clinical exam. Computed tomography (CT) of the thorax, abdomen &amp; pelvis reported diffuse opacities in both lungs and a solitary, 3×2cm mass in the upper inner quadrant of the left breast. A core biopsy of the lesion was carried out. Immunohistochemistry did not support a diagnosis of breast carcinoma but strongly suggested a primary lung adenocarcinoma. After a multidisciplinary meeting (MDM) discussion the plan was to commence a course of chemotherapy. Conclusion Given its atypical presentation it can be challenging to distinguish between a primary breast cancer and metastases. Metastatic disease, although rare, should be considered in the differential diagnosis as the treatment and prognosis differ greatly from primary breast cancer. Immunohistochemistry is essential for identifying the primary origin of the tumour.

Breast cancer combined with contralateral neck lymph node metastasis: a case report

BackgroundContralateral neck lymph node metastasis is rare in primary breast cancer. Its clinical staging and treatment principles lack authoritative guidelines. A case of a 30-year-old breast cancer patient with contralateral neck lymph node metastasis is presented. The clinical treatment is discussed in combination with current research.Case presentationA 30-year-old woman presented with a right breast mass for 5 months and left neck lymph node enlargement for 5 days. Mammography showed a 33 mm*14.3 mm mass in the inner quadrant of the right breast. The ultrasound showed several hypoechoic nodules on the left side of the neck. Rapid intraoperative pathological examination diagnosed a right breast malignant tumor and poorly differentiated carcinoma of the left cervical lymph nodes. Then, right mastectomy was performed immediately. The patient was scheduled to undergo chemotherapy, molecular targeted therapy, radiotherapy and endocrine therapy after the operation. The long-term efficacy remains to be seen.ConclusionThe infrequent presentation of breast cancer with metastasis to the contralateral neck lymph node can be challenging for standard therapies.

Endobronchial ultrasound-guided transbronchial needle aspiration facilitating diagnosis of sarcoidosis in a breast cancer patient with multiple lymphadenopathy: a case report

BackgroundSarcoidosis is a benign systemic granulomatous disorder of unknown etiology. Cell-mediated immunity disorder is often found in sarcoidosis patients, and an association between malignant tumors and sarcoidosis has been suggested. Sarcoidosis and malignant disease can occur simultaneously or sequentially, leading to misdiagnosis and mistreatment. Sarcoidosis is diagnosed clinically, radiologically, and histologically. We report herein a case of sarcoidosis diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration from the mediastinal lymph nodes of a breast cancer patient.Case presentationThe patient was a 70-year-old Asian woman who presented with right breast tumor. A 20-mm movable mass was identified in the inferolateral quadrant of the right breast, and mammography revealed a spiculated mass with calcification. Ultrasonography revealed a mass with internal hypoechogenicity, and biopsy revealed estrogen receptor-positive, human epidermal growth factor receptor 2-positive invasive ductal carcinoma. Positron emission tomography/computed tomography showed multiple lymphadenopathy including mediastinal lymph nodes, with fluorodeoxyglucose accumulation in those nodes suggesting breast cancer metastases. Endobronchial ultrasound-guided transbronchial needle aspiration of a mediastinal lymph node revealed noncaseous epithelioid granuloma. Due to a history of uveitis and elevated soluble interleukin 2 receptor, lymphadenopathy due to sarcoidosis and stage IIA breast cancer were diagnosed. Right partial mastectomy and axillary lymph node dissection were performed after preoperative chemotherapy. No exacerbation of sarcoidosis symptoms has been observed during treatment.ConclusionWe report a case of breast cancer in which sarcoidosis could be diagnosed based on endobronchial ultrasound-guided transbronchial needle aspiration, a history of uveitis, and elevated soluble interleukin 2 receptor despite fluorodeoxyglucose positron emission tomography/computed tomography suggesting multiple lymph node metastases. This report emphasizes the importance of differential diagnosis of lymph node involvements in cancer patients.

Periareolar Incision for Resection of Bilateral Multiple Breast Fibroadenoma in 27-year-old Indonesian Woman – A Case Report

Introduction: A Breast lump is a major health concern amongst women and Fibroadenoma (FA) is the second most common tumor in the breast and is the most common tumor in women younger than 30 years and only surgical resection is curative. The conventional surgical excision is through an overlying incision of the mass and then developed another incision location due to cosmesis concern which is through a periareolar incision.&#x0D; Case Presentation: 27-year-old woman with painless slowly growing bilateral multiple breast lump for 1 year. On physical examination we found bilateral multiple solid masses, with 6 masses on the lateral inferior quadrant, lateral superior quadrant, medial superior quadrant on the right breast, and 4 masses on the same quadrant of the left breast, well-circumscribed, mobile. From the ultrasound, we found well-defined echogenic thin-walled masses suggesting fibroadenoma. We perform multiple excision from the bilateral periareolar incisions.&#x0D; Discussion: Periareolar incision leaves less scar and better cosmetic resulted in higher satisfaction level among women. We found no complications such as nipple paresthesia, the collapse of the nipple-areola area, hematoma, skin necrosis with only 5 ccs of bleeding, and duration of the surgery same as conventional incision.&#x0D; Conclusion: Periareolar incision for removal of the bilateral multiple FA is a favorable technique and recommended.

Idiopathic granulomatous mastitis: a clinical case and a review of the literature

Idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disease of the breast with an unknown etiology, characterized by the presence of sterile non-caseous granulomas and the formation of microabscesses in the lobules of the breast. The exact prevalence of this disease is still unknown. This is mainly due to the relatively small number of the reported cases, as well as the diagnostic difficulties. The aim of the study: to highlight the clinical experience of managing a patient with IGM, to explain the role of pathomorphological examination in diagnostic search, to discuss differential diagnosis and treatment modalities according to the review of English-language literature sources. When the patient visited the clinic, the chief complaint was pain in the right breast. On examination, a painless mass with indistinct border and stone-like density up to 2.5 cm was revealed at the union of the inner quadrants of the right breast. The patient underwent a number of tests: ultrasound, MSCT, mammography, MRI, which were indicative of breast cancer. The final diagnosis was made after the double histopathologically verified examination with differential diagnosis. Considering the young age of the patient, the successful experience of conservative management of patients covered in the world literature, the possible cosmetic effects after surgery, it was decided to treat with cytostatics and glucocorticoids. A 3.5- and 7.0-month follow-up of treatment results by a mammologist showed neither visible pathological changes in the breasts nor palpatory nodular or tumor mass. The state after idiopathic granulomatous mastitis was reconvalescence. The paper also discusses other methods of treatment: surgery, drug therapy such as corticosteroids (topical, oral), immunosuppressants (methotrexate, azathioprine) or a conventional follow-up of patients with mild symptoms. However, considering severe pain and significant aesthetic defects as a result of inadequate therapy, the follow-up is not dominant in the patient management. A delay in the diagnosis can lead to treatment errors, causing chronic changes and increasing the inflammatory size in the breast, influence the severity of the disease and subsequent therapy. Conclusions. The clinical case of the patient with IGM, diagnostic search and effective conservative treatment tactics have been described. The significance and indispensability of pathohistological examination in the diagnostic search have been explained. The most effective treatment regimens for IGM patients have been discussed.

Recurrent bilateral granulomatous mastitis due to Corynebacterium tuberculostearicum with mammary scrofula: A case report

Corynebacterium tuberculostearicum is a Gram positive bacillus from the skin microbiota. Sometimes it can produce recurrent fistulous mastitis associated with granulomas. Its prevalence is very low. The initial therapeutic approach is important to avoid progression. The histopathological and microbiological study is essential for its diagnosis. Differential diagnosis is made with tumor pathology. There is no established therapeutic scheme to which we can adhere. The initial treatment should be antibiotic therapy adjusted by antibiogram and corticosteroids. The evolution can be torpid despite correct treatment. In these cases, surgical treatment with partial or total resections of the breast can be considered.We present the case of a 44-year-old woman who came to the consultation with pain and induration in the lower internal quadrants of the left breast with the formation of fistulous tracts of years of evolution despite antibiotic and corticosteroid treatment.

Prophylactic mastectomy – Correlation between skin flap thickness and residual glandular tissue evaluated postoperatively by imaging

Women with an increased hereditary risk of breast cancer can undergo risk-reducing prophylactic mastectomy. However, there is a balance between how much subcutaneous tissue should be resected to achieve maximal reduction of glandular tissue, while leaving viable skin flaps. Forty-five women previously operated with prophylactic mastectomy underwent magnetic resonance tomography (MRT) and ultrasound (US) to investigate the correlation between skin flap thickness and residual glandular tissue. Residual glandular tissue was documented as being present or not present, but not quantified, as the amount of residual glandular tissue in many cases was considered too small to make reliable volume quantifications with available tools. Since a mastectomy skin flap thickness of 5mm is discussed as an oncologically safe thickness in the literature, this was used as a cut-off. Following prophylactic mastectomy, residual glandular tissue was detected in 39.3% of all breasts and 27.9% of all the breast quadrants examined by MRT, and 44.1% of all breasts and 21.7% of all the breast quadrants examined by US. Residual glandular tissue was detected in 6.9% of the quadrants in skin flaps ≤ 5mm and in 37.5% of the quadrants in skin flaps > 5mm (OR 3.07; CI=1.41-6.67; p=0.005). Furthermore, residual glandular tissue increased significantly already when the skin flap thickness exceeded 7mm. This study highlights that complete removal of glandular breast tissue during a mastectomy is difficult and suggests that this is an unattainable goal. We demonstrate that residual glandular tissue is significantly higher in skin flaps > 5mm in comparison to skin flaps ≤ 5mm, and that residual glandular tissue increases significantly already when the flap thickness exceeds 7mm.

Giant Lactant Adenoma: About a Case

Affecting young women, lactating adenoma is a rare benign tumor of the breast. It is seen mainly in the third trimester of pregnancy and in the postpartum period. Clinically, it is a solid mass, mobile typically benign but its character of rapid evolution is reminiscent of phyllodes tumors, sarcomas and galactoceles. The definitive diagnosis is histological. We report a case of lactating adenoma in a 26-year-old lactating woman, third procedure, second pare, with a history of tumor resection of the outer quadrants of the left breast, 9 months ago, whose histology evoked a fibrotic disease, cystic breast associating non-specific subacute mastitis with suppuration. Received for recurrence of a tumor in the left breast which was the site of a polylobed mass of about 10/5 cm occupying 3/4 of the breast with mobile ipsilateral axillary adenopathies. A micro tru-cut biopsy was performed and the histology was in favor of a lactating breast adenoma with no signs of malignancy. She underwent surgical excision, the consequences of which were simple.