Breast Tumor Size Research Articles

Association of breast cancer reporting delays and care intervals with tumor size in patients with advanced disease

ABSTRACT In Pakistan, breast cancer (BC) is frequently diagnosed with advanced disease. We aimed to examine the association of breast tumor size with reasons of reporting delays, care intervals in patients with advanced disease. This cross-sectional study enrolled 392 BC patients from tertiary care hospitals. Data were collected from August 2018–March 2019. Chi-square for significance and logistic regression for association were used. Patients between 31 and 45 years of age (51%), rural residents (39%), lower-class (88.4%), no family history (17.1%), at stage-IV (36%) and patient interval >90 days (70%, p = .034) presented with large tumor size (>5 cm). Tumor size was significantly associated with area of residence (p = .043), social-class (p = .027), family history (p = .004), smoking (p = .021), nipple discharge (p = .004), recurrence (p = .024), and metastasis (p = .007). Patient-interval was associated with poor knowledge (OR;4.3,p = .0001), influence of traditional healers (OR;2.3,p = .05), religion (OR;3.9,p = .0001), finances (OR;2.4,p = .045), and competing life priorities (OR;2.9,p = .026). In-adjusted linear regression model, area of residences, education, social-class, family-history, recurrence, cancer type, and patient interval (β;0.110,p = .030) were found to be independent predictors of tumor size. In conclusion, education, family history, area of residence, social class, recurrence, cancer stage and patient interval, co-influenced by religion, finances, life priorities, traditional healers, and poor knowledge, were independent predictors of tumor size in BC patients.

A Polysaccharide From the Whole Plant of Plantago asiatica L. Enhances the Antitumor Activity of Dendritic Cell-Based Immunotherapy Against Breast Cancer.

Dendritic cells (DCs) are the most potent professional antigen-presenting cells (APCs) that mediate T-cell immune responses. Breast cancer is one of the most commonly diagnosed diseases and its mortality rate is higher than any other cancer in both humans and canines. Plantain polysaccharide (PLP), extracted from the whole plant of Plantago asiatica L., could promote the maturation of DCs. In this research, we found that PLP could upregulate the maturation of DCs both in vitro and in vivo. PLP-activated DCs could stimulate lymphocytes’ proliferation and differentiate naive T cells into cytotoxic T cells. Tumor antigen-specific lymphocyte responses were enhanced by PLP and CIPp canine breast tumor cells lysate-pulsed DCs, and PLP and CIPp-cell-lysate jointly stimulated DCs cocultured with lymphocytes having the great cytotoxicity on CIPp cells. In the 4T1 murine breast tumor model, PLP could control the size of breast tumors and improve immunity by recruiting DCs, macrophages, and CD4+ and CD8+ T cells in the tumor microenvironment. These results indicated that PLP could achieve immunotherapeutic effects and improve immunity in the breast tumor model.

A Computational Method for the Estimation of the Geometrical and Thermophysical Properties of Tumor Using Contact Thermometry

Abstract Contact thermometry is the measurement of surface temperature using sensors in contact with the medium. These surface temperatures can be potential indicators of any abnormality possibly a tumor. This research work aims to present a computation method that makes use of contact thermometry to estimate the geometric center, size, and thermophysical properties of breast tumor. Wearable thermal sensors captured real-time surface temperature readings from discrete point locations. The continuous heat distribution over the domain was formulated using forward heat transfer analysis. The optimization method estimated tumor parameters of the breast, and a three-dimensional thermal model was developed from the estimated parameters. Laboratory experiments on breast phantoms were done to validate the estimation method. Furthermore, real-time temperature readings of human subjects were recorded, and the estimated location and size were then compared with the mammogram results. It was found that the estimated two-dimensional geometric center and the size in diameter of the tumor closely match with the mammogram results. Further, the thermophysical properties estimated using the proposed method had a higher order in subjects having a tumor making it a tool for breast cancer screening.

A large Phyllodes tumor following fennel consumption: Report of a rare case

Introduction: Phyllodes (PTs) tumors are fibroblastic neoplasms of the breast. PTs are relatively rare and include less than 1% of all breast neoplasms. In this study, a case of large tumor of Phyllodes following fennel consumption was reported. Case presentation: The patient was a 47-year-old MCzabz female who complained of a large mass in the left breast and referred to Peymaniyeh Hospital in Jahrom. The patient had a history of infertility for 8 years. She had a 3 cm mass in the left breast from the past 2 years. During previous 7 months, she has used fennel for 3 months due to menstrual irregularities. Conclusion: It seems that the increasing of the breast tumor size in this patient is due to arbitrary consumption of fennel; because fennel has a lot of estrogen, which affects Endoplasmic Reticulum, and tumor filament cells also have beta ER-estrogen receptors; in this patient, the arbitrary consumption of fennel for 3 months has led to the sudden increase in the volume of this mass in the breast.

P055 - Differences of breast tumour localization and size between supine and prone breast MRI for a surgery perspective

P055 - Differences of breast tumour localization and size between supine and prone breast MRI for a surgery perspective

Assisted computer and imaging system improve accuracy of breast tumor size assessment after neoadjuvant chemotherapy.

BackgroundThe use of neoadjuvant therapy (NAT) in patients with early breast cancer is becoming increasingly common. The purpose of this study was to explore the combined use of breast pathology cabinet X-ray system (CXS) to accurately assess the response to neoadjuvant treatment of breast cancer and establish a standard evaluation system.MethodsA total of 100 patients with breast cancer after neoadjuvant treatment were randomly selected. Preoperative imaging evaluation of tumor masses were significantly degenerated, and they were randomly divided into experimental and control groups of 50 cases each. Compared with the traditional two methods of material extraction, the effective material extraction rate is comparative. Take the two largest diameters of the largest two-dimensional surface of the tumor bed as the measurement object, the macro-description value is D1/D2, the radiographic system description measurement value is the experimental group d1/d2, and the correction under the microscope is worth the true size of the tumor bed H1/H2 as the final test standard, calculate the difference between D1/D2 and d1/d2 with H1 and H2, and compare the difference between d1− H1, d2 − H2 and D1− H1, D2 − H2.ResultsThe average group of tissue samples in the experimental group was 16.4, and the average group of tissue samples in the control group was 16.7, and there was no difference between the two groups; The effective tissue blocks of tumor bed samples in the experimental group were11.8, and the control group was 7.5. There is difference between the two groups. The average effective percentage of tumor bed in the experimental group was 72%, and the average effective percentage of tumor bed in the control group was 44.8%. The difference was also statistically significant; d1− H1, d2 − H2 and D1− H1, D2 − H2 are all different.ConclusionsCXS assists the collection of breast tumor bed, which can significantly improve the efficiency of tumor bed collection and save the cost of collection. Compared with the maximum diameter of the tumor bed by eyes, the CXS mapping value is closer to the value measured under the microscope.

Abstract PS6-29: A new pathological assessment method to assess residual lesions after neoadjuvant chemotherapy for breast cancer: Residual disease in breast and nodes combined with Ki-67 (RDBN-K)

Abstract Purpose The accurate assessment of residual tumor tissue after neoadjuvant chemotherapy (NAC) for breast cancer is closely related to the subsequent treatment and prognosis of patients. Currently commonly used assessment methods, including Miller and Payne system (MPS), Residual Cancer Burden (RCB), and Residual Disease in Breast and Nodes (RDBN) assessment system, etc., have certain limitations in terms of accurate evaluation and determining prognosis. The limitation of MPS lies in the need to review the original tumor biopsy specimen and compare the cell contents of the biopsy specimen and the surgical specimen. The limitation of RCB is that it requires a broader sampling, as well as more time and energy in microscopic examination. Furthermore, determining the number of cells is subjective and differences exist among observers. The limitation of RDBN is its poor correlation with prognosis. Ki-67, as a marker to reflect cell proliferation, is widely used in prognostic judgment of invasive breast cancer and is also an important reference in treatment decision-making. This study aimed to combine the Ki-67 expression status after NAC with RDBN to design a new pathological assessment method, which we called residual disease in breast and nodes combined with Ki-67 (RDBN-K), and to study its significance for the prognosis of patients.Methods RDBN-K = 0.2 (residual breast tumor size in centimeters) + index of involved nodes + tumor histological grade+ index of Ki-67. The residual tumor size, index of involved nodes, and histological grade are the same as RDBN. The index of Ki-67 is scored as 0 for less than 14% and 1 for greater than or equal to 14%. The residual diseases of 723 patients with TNM staging of stage II to stage III who had undergone NAC and surgical treatment were evaluated by RDBN-K. RDBN-K includes 4 risk levels (levels 1-4) according to residual disease magnitude after neoadjuvant chemotherapy. The RDBN-K levels were defined as follows: RDBN-K-1 (equivalent to pCR) is an index of 0, RDBN-K-2 is an index between 0.1 and 3, RDBN-K-3 is an index between 3.1 and 5.3, and RDBN-4 is an index 5.4 or more. At the same time, RDBN was used to evaluate the residual disease of all patients after NAC. This study followed up the survival status of 723 patients. After combining the prognoses, the accuracy and clinical significance of the RDBN and RDBN-K were compared.Results During the follow-up, in the entire cohort, 147 (20.3%) recurrences or metastases were observed; local recurrence was 58 (8.0%), distant metastasis was 103 (14.2%), and 69 (9.5%) patients died. Among the RDBN-2 cases, 40 (5.5%) of 122 cases were reclassified to RDBN-K-3. Among the RDBN-3 cases, 17 (2.4%) of 295 cases were reclassified: 2 cases were reclassified to RDBN-K-4, and 15 cases were reclassified to RDBN-K-2. Among the 220 cases in the RDBN-4 category, 40 (5.5%) were reclassified to the RDBN-K-3 category using the RDBN-K calculation. Over the follow-up period, 13.6% of patients in the RDBN-4 category died, and 15.9% of patients in the RDBN-K-4 category died. RDBN and RDBN-K showed statistically significant differences in the disease-free survival (DFS) and overall survival (OS) of all patients (P values are all less than 0.05). Pairwise stratified analysis showed that the differences in DFS and OS between RDBN-K-3 and RDBN-K-4 (DFS: P = 0.019, OS: P = 0.035) were greater than that between RDBN-3 and RDBN-4 (DFS: P = 0.052, OS: P = 0.214), and the differences in OS between RDBN-K-2 and RDBN-K-3 (P = 0.023) were greater than that between RDBN-2 and RDBN-3 (P = 0.157).Conclusion Compared with RDBN, RDBN-K is more accurate in assessing the residual tumor burden after breast cancer NAC and predicting the prognosis for breast cancer patients, and provides more basis for follow-up intensive treatment of patients. Citation Format: Ruoqi Han, Yueping Liu, Yanqi Ma, Zhikun Liu, Chunxiao Li, Cuizhi Geng. A new pathological assessment method to assess residual lesions after neoadjuvant chemotherapy for breast cancer: Residual disease in breast and nodes combined with Ki-67 (RDBN-K) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-29.

Abstract PS3-12: Prediction of pathological complete response to neoadjuvant chemotherapy in early triple negative breast cancer patients by serial breast ultrasound examination

Abstract Background. Pathological complete response (pCR) following neoadjuvant chemotherapy is associated with a good prognosis and long-term survival in patients with triple negative breast cancer (TNBC). Imaging offers significant information in monitoring response to neoadjuvant chemotherapy as a complement to conventional tumor assessment by physical examination. Methods. This is a single institution, retrospective cohort study. The primary objective was to determine whether volumetric measurement by ultrasound examination, of the pre-treatment breast tumor size, post-cycle two, post-cycle four and at completion of neoadjuvant chemotherapy predicted pCR. Tri-dimensional measurements were used to calculate the volume index. The percentage change between pre-treatment and cycle 2, pre-treatment and cycle 4, and pre-treatment and completion of treatment was calculated. Patients were treated with taxane, anthracycline, and alkylating agents based neoadjuvant chemotherapy. A pCR was defined as the complete disappearance of the invasive cancer in the breast and absence of tumor in the axillary lymph nodes. A radiological complete response (rCR) was defined as no malignant legions detected by ultrasound (0mm). Receiving operating characteristics (ROC) analysis was used to determine the association between pCR and percentage of tumor shrinkage. Specificity was defined as the proportion of patients with a non-pCR that were correctly classified as non-responders by ultrasound measurement. Sensitivity was defined as the proportion of patients with a pCR that were correctly classified as complete responders by ultrasound assessment. Statistical analysis was performed using NCSS version 11 and statistical tests used the significance level of 0.05. Results. Seventy-eight TNBC patients with a median age of 48 years (range 27-85 years). The population’s tumor sizes were classified as T1 = 18 (23%), T2 = 54 (69%), T3 = 6 (8%). Positive glands in 33 (43%) patients and negative glands in 45 (57%) patients. Stage I = 11 (23%) patients, Stage IIA = 40 (51%) patients, stage IIB = 22 (28%) patients and stage III = 5 (6%) patients. The median volume pre-treatment was 18624mm3 (SD = 41284mm3). A pCR rate of 57% was documented. A 80% shrinkage of tumor, following the second cycle of chemotherapy, was associated with a pCR in 74% of responders (specificity 71%, sensitivity 70%). A 93% shrinkage following four cycles of chemotherapy was associated with a pCR in 73% of responders (specificity 62%, sensitivity 81%). A 97% shrinkage upon completion of chemotherapy was associated with a pCR in 70% of responders (specificity 45%, sensitivity 93%). A shrinkage of more than 90% was associated with a pCR in 93% pts (specificity 79%, sensitivity 66%). Radiological CR was associated with a pCR in 84% pts (specificity 70%, sensitivity 68%). Patients attaining a pCR had a mean volume of 877mm compared to patient not attaining a pCR with a mean volume of 833mm (p < 0,97088). Conclusion. The breast ultrasound is a useful, non-expensive, non-invasive test to monitor TNBC pts undergoing neoadjuvant chemotherapy. Measurement of the tumor by serial ultrasound is a useful predictor of pCR in these patients. Percentage shrinkage of more than 90% of the tumor at the completion of treatment, is more accurate in predicting pCR compared to radiological CR. Citation Format: Bernardo Rapoport, Teresa Smit, Liezl Heyman, Farhana Moosa, Carol Ann Benn. Prediction of pathological complete response to neoadjuvant chemotherapy in early triple negative breast cancer patients by serial breast ultrasound examination [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS3-12.

Accurate Estimation of Breast Tumor Size: A Comparison Between Ultrasonography, Mammography, Magnetic Resonance Imaging, and Associated Contributing Factors.

This study aimed to provide further evidence on the accuracy of tumor size estimates and influencing factors. In this cross-sectional study, patients with a biopsy-proven diagnosis of breast cancer referred to our hospital to obtain a preoperative magnetic resonance imaging (MRI) between 2015 and 2016 were included. Data from 76 breast cancer patients with 84 lesions were collected. All participants underwent ultrasonography and MRI, and their mammograms (MGMs) were reevaluated for tumor size estimation. Measurements by the three imaging modalities were compared with the pathologically determined tumor size to assess their accuracy. Influencing factors such as surgical management, molecular and histopathological subtypes, and Breast Imaging Reporting and Data System enhancement types in MRI were also assessed. The rates of concordance with the gold standard were 64.3%, 76.2%, and 82.1% for MGM, ultrasound (US), and MRI measurements, respectively. Therefore, the highest concordance rate was observed in MRI-based estimates. Among the discordant cases, US and MGM underestimation were more prevalent (70%); nevertheless, MRI showed significant overestimation (80%). Tumor size estimates in patients whose MRIs presented with either non-mass enhancement [p=0.030; odds ratio (OR)=17.2; 95% confidence interval (CI): 1.3-225.9] or mass lesion with non-mass enhancement (p=0.001; OR=51.0; 95% CI: 5.0-518.4) were more likely to be discordant with pathological measurements compared with those in cases with only mass lesion on their MRIs. MRI was more accurate than either US or MGM in estimating breast tumor size but had the highest overestimation rate. Therefore, caution should be practiced in interpreting data obtained from subjects whose MRIs present with non-mass enhancement or mass lesion with non-mass enhancement.

Considerations in Oncoplastic Surgery.

The development of oncoplastic surgery (OPS) is one of the greatest achievements for the treatment of breast cancer. OPS combines oncological resection with plastic surgery techniques in a single procedure to allow the excision of tumors without compromising cosmetic outcome. It allows better aesthetic-functional outcomes and consequently an improvement of the psychological aspects of patients with breast cancer.OPS begins with preoperative design considering breast volume, tumor size, and location and distance from nipple of the tumor, with clinical breast examination and image studies. Various techniques of volume replacement and volume displacement methods described here can help the decision-making process so the best results concerning the aesthetic-functional aspects can be achieved.The outcome measurement of the oncoplastic breast surgery consisted of local recurrence, cosmesis, and patients satisfaction. In OPS for breast cancer patients, aesthetic assessment could be performed by various methods. And questionnaires on quality of life can be applied as a scientific method to assess results. In this chapter, we introduced our results of assessment of both aesthetic and QOL outcomes in OPS patients.

The current status of cancer survivorship care and a consideration of appropriate care model in Korea.

Breast cancer patients with a human epidermal growth factor receptor 2 (HER2) enriched subtype are known to have higher rates of brain metastases (BM) than other patients. This study aimed to evaluate treatment options and survival outcomes. A total of 115 breast cancer brain metastases (BCBM) patients with nearly complete medical records were retrospectively analyzed. Additionally, 36 patients were HER2 enriched types according to histological subtypes. The BM was found by brain magnetic resonance imaging in patients who had neurologic symptoms or by regular screening. Age, breast tumor size, number of BM, histological subtypes, first treatment of breast cancer, estrogen receptor, and HER2 status, stage, local treatment of BM were analyzed. Median overall survival, 5-year survival were analyzed from the data. The median survival time after BM was 6 months, the mean survival time was 16.3 months, and the 5-year survival after BM was only 8.0%. Factors that significantly affect the survival of BCBM patients include histological subtype, number of BM, use of lapatinib in multivariate analysis. A total of 19 out of 36 HER2 enriched patients were treated with lapatinib or capecitabine. For the treatment of HER2 enriched patients, additional use of blood-brain barrier (BBB) crossing substances, as well as local treatment for BM, significantly improve the survival rate in the Kaplan-Meier method (P=0.001). A combination of local treatment modality for BCBM and the use of substances that cross the BBB for the HER2 enriched patient improved the survival rate.

Correlation Between Breast Tumor Size and Lymph Node Involvement in Patients Referring to the Pathology Department of Rasoul Akram Hospital in Iran

Background: Breast cancer has the highest mortality rate, second to gastric cancer, among Iranian women and is one of the most common cancers in the world. The incidence of breast cancer in women is increasing gradually. Meanwhile, ductal breast carcinoma experiences more increases than other malignancies and is one of the most important health problems. Objectives: This study aimed at evaluating women with ductal breast carcinoma because of the significance of pathological factors and their association with breast cancer progression. Methods: This retrospective study was conducted using data of ductal breast carcinoma women during the years 2018 and 2019. In this cross-sectional study, demographic data (age, sex, and pathology of breast mass) of 50 patients referring to Rasoul Akram hospital (Tehran, Iran) were gathered. Then, the data were analyzed by SPSS 26 software using the t test and Levene's test. The results were presented using descriptive statistics. Results: Fifty patients with ductal carcinoma were assessed based on their pathological information. The examination of factors including tumor size, involvement/non-involvement of lymph nodes, histological grade, and age of patients revealed a significant direct relationship between tumor size and lymph node involvement (P

Microwave Breast Imaging Using Rotational Bistatic Impulse Radar for the Detection of Breast Cancer: Protocol for a Prospective Diagnostic Study.

BackgroundMammography is the standard examination for breast cancer screening; however, it is associated with pain and exposure to ionizing radiation. Microwave breast imaging is a less invasive method for breast cancer surveillance. A bistatic impulse radar–based breast cancer detector has recently been developed.ObjectiveThis study aims to present a protocol for evaluating the diagnostic accuracy of the novel microwave breast imaging device.MethodsThis is a prospective diagnostic study. A total of 120 participants were recruited before treatment administration and divided into 2 cohorts: 100 patients diagnosed with breast cancer and 20 participants with benign breast tumors. The detector will be directly placed on each breast, while the participant is in supine position, without a coupling medium. Confocal images will be created based on the analyzed data, and the presence of breast tumors will be assessed. The primary endpoint will be the diagnostic accuracy, sensitivity, and specificity of the detector for breast cancer and benign tumors. The secondary endpoint will be the safety and detectability of each molecular subtype of breast cancer. For an exploratory endpoint, the influence of breast density and tumor size on tumor detection will be investigated.ResultsRecruitment began in November 2018 and was completed by March 2020. We anticipate the preliminary results to be available by summer 2021.ConclusionsThis study will provide insights on the diagnostic accuracy of microwave breast imaging using a rotational bistatic impulse radar. The collected data will improve the diagnostic algorithm of microwave imaging and lead to enhanced device performance.Trial RegistrationJapan Registry of Clinical Trials jRCTs062180005; https://jrct.niph.go.jp/en-latest-detail/jRCTs062180005International Registered Report Identifier (IRRID)DERR1-10.2196/17524

A Randomised Clinical Trial to Compare the Efficacy of Hyperbaric Oxygen Therapy with Neoadjuvant Chemotherapy with Neoadjuvant Chemotherapy Alone for Carcinoma Breast: a Pilot Study

Hypoxia plays a major role in cell survival, angiogenesis, glycolytic metabolism and metastasis in breast cancer. Hyperbaric oxygen therapy (HBOT) has a well-established effect for attenuating the effects of hypoxia by enhancing the effects of chemotherapy drugs and increasing oxygen delivery to the tissues. The hypoxic environment encourages cancer cells to acquire stemness and become resistant to chemotherapeutic drugs. We have used HBOT as an adjunct to neoadjuvant chemotherapy in breast cancer patients with the objective of reducing tumour hypoxia and improving the response to chemotherapy. A randomised controlled trial was conducted in patients with breast cancer. The patients were randomly allocated into the study group receiving neoadjuvant chemotherapy (NAC) with HBOT and the control group who received NAC only. The NAC consisted of 3 cycles of intravenous injection of cyclophosphamide, 5-fluorouracil and epirubicin. The HBOT was administered along with the chemotherapy in 3 sessions in each cycle at graded pressures in each sessions. Ultrasound evaluation of patients was carried out and breast tumour size was measured after every cycle of HBOT. All the patients were operated after 3 cycles of chemotherapy and modified radical mastectomy was carried out. The response of therapy was recorded in both the groups. Patients receiving HBOT achieved significantly higher percentage reduction of tumour volume (43.1%) and the largest dimension (80.21%) (p < 0.0001) compared with those receiving chemotherapy alone. Trial registry: CTRI/2019/03/018258

Clinicopathological Features and Outcomes in Individuals with Breast Cancer and ATM, CHEK2, or PALB2 Mutations.

The moderate-penetrance germline mutations ATM, CHEK2, and PALB2 are implicated in an increased risk of the development of breast cancer. Whether these mutations provide clinical utility to guide treatment strategies and prognosis remains unknown. A retrospective case-control study from a tertiary institution compared patients with stage 0-III breast cancer, and positive for ATM, CHEK2, or PALB2 mutations, with a matched cohort selected by randomization and negative for mutations. Data acquisition included demographics, histopathologic, treatment, and clinical outcome variables. A total of 145 patients with breast cancer (144 female and 1 male) were analyzed-74 mutation-positive patients (24 ATM, 26 CHEK2, 24 PALB2) and 71 mutation-negative patients. Mutation-positive patients compared with mutation-negative patients had increased family history of breast cancer (79.7 vs. 52.9%, p < 0.001) and tumor size > 2.0cm (63.1% vs. 42.3%, p = 0.015). Patients with prior knowledge of mutational status were more likely to proceed with total mastectomy and prophylactic mastectomy (74.5% vs. 25.5%, p < 0.02; and 65.5% vs. 34.5%, p < 0.001, respectively). The unadjusted recurrence rate was higher in mutation-positive patients compared with mutation-negative patients (24.3 vs. 8.5%, p = 0.01), although mutation status was not predictive for recurrence in Cox regression analysis. Patients positive for ATM, CHEK2, or PALB2 mutations had increased tumor size and were more likely to undergo extensive surgeries. Mutation status was not predictive of recurrence, although this lack of effect may have been mitigated by lower rates of recurrence in those who pursued total mastectomy. Further studies are needed to confirm these findings.

Comparison of Ultrasound and Mammography With Pathologic Examination in Determining the Size of Malignant Breast Masses

Estimation of breast tumor size is one of the most important diagnostic measures in determining the appropriate treatment. Mammography and ultrasound are the main methods for determining the size of breast tumors. The aim of this study was to compare the correlation between tumor size calculated by breast ultrasound and mammography with the results of pathologic measurements in malignant breast masses. Patients diagnosed with breast cancer by pathologic examination underwent mammography and ultrasound to determine the size of the tumor. The largest observed diameter in ultrasound and mammography was recorded as the tumor size. The mean (SD) tumor size measured by ultrasound (23.58±9.38 mm) was significantly less than the actual size based on histopathologic examination (28.87±11.17 mm) (P=0.008). However, there was no significant difference between the measurements performed between mammography (26.54±10.46 mm) and histopathology (P=0.18). The correlation coefficient between mammography and pathologic examination (r=0.61) was higher than the correlation coefficient between ultrasonography and pathology (r=0.5). Mammography, compared to breast ultrasound, had better accuracy in determining the size of malignant breast masses.

Adipocyte-Derived Exosomes Increase the Growth of Breast Tumors in Obese Mice

Abstract Objectives 1) We assessed whether the secretion and cargos of exosomes are distinct in obese and lean mice. 2) We assessed whether adipocyte-derived exosomes increase the size of tumors of the mammary gland in mice. Methods Female tamoxifen-inducible adipose-specific TSG101 conditional knockout mice (TSG KO) were initiated on an AIN-93G-based 50% high fat (HFD) or 15.8% low fat (LFD) at age 3 weeks and continued on these diets for 10 weeks. At age 4 weeks, mice were injected with tamoxifen or vehicle (TSG+), followed by the injection of 1.8*106 murine breast adenocarcinoma E0771 cells into the mammary gland fat pad 10 days after tamoxifen injection. Loss and gain of TSG101 and Cre, respectively, in inguinal subcutaneous adipose tissue were confirmed by RT-qPCR. Tumors were excised and their size was assessed using a caliper and by weight. H&amp;E staining was used to assess the tumor type. Exosomes were isolated from plasma by an ExoQuick Plasma Prep kit, authenticated by western blot analysis and counted using a Nanosight tracker. The statistical analysis was performed by one-way ANOVA and Least Significant Differences posthoc test using a significance level of P &amp;lt; 0.05. Results HFD led to an increase in breast tumor size, which was diminished in adipose-specific TSG101 KO fed HFD: The size of mammary tumors in TSG+ fed HFD increased by 198% compared to TSG+ fed LFD (P &amp;lt; 0.05), whereas tumor size decreased by 58% TSG101 KO fed HFD compared to TSG+ fed HFD (P &amp;lt; 0.05). HFD led to an increase in adipose-derived exosomes that was reduced by TSG101 KO: The expression of ASC-1, a marker for adipose-derived exosomes in plasma exosomes increased by 58% in TSG+ fed HFD compared to TSG+ fed LFD, and decreased by 29% in TSG KO fed HFD compared to TSG+ fed HFD (P &amp;lt; 0.05). Plasma exosomes tested positive for exosome markers, CD63, CD81 and HSP70 and negative for a non-exosome marker, calnexin. H&amp;E staining suggested that the tumors observed in all mice were adenocarcinomas. Tumor numbers were not affected by TSG101 and diet. Conclusions HFD increases the growth of mammary tumors in mice and the diet effect depends on exosome biogenesis in adipose tissue. We speculate that adipose-derived exosomes promote tumor growth but not metastasis. Funding Sources NIFA, NIH, and USDA. J.Z. is a consultant for PureTech Health.

Oral Vinorelbine or Capecitabine Combined With Trastuzumab as Adjuvant Treatment for Patients With Lymph Node Negative, HER-2 Positive and Small Tumor Size Breast Cancer (ORCHID)

Oral Vinorelbine or Capecitabine Combined With Trastuzumab as Adjuvant Treatment for Patients With Lymph Node Negative, HER-2 Positive and Small Tumor Size Breast Cancer (ORCHID)

Classification of breast tumor models with a prototype microwave imaging system.

The assessment of the size and shape of breast tumors is of utter importance to the correct diagnosis and staging of breast cancer. In this paper, we classify breast tumor models of varying sizes and shapes using signals collected with a monostatic ultra-wideband radar microwave imaging prototype system with machine learning algorithms specifically tailored to the collected data. A database comprising 13 benign and 13 malignant tumor models with sizes between 13 and 40mm was created using dielectrically representative tissue mimicking materials. These tumor models were placed inside two breast phantoms: a homogeneous breast phantom and a breast phantom with clusters of fibroglandular mimicking tissue, accounting for breast heterogeneity. The breast phantoms with tumors were imaged with a monostatic microwave imaging prototype system, over a 1-6GHz frequency range. The classification of benign and malignant tumors embedded in the two breast phantoms was completed, and tumor classification was evaluated with Principal Component Analysis as a feature extraction method, and tuned Naïve Bayes (NB), decision trees (DT), and k-nearest neighbours (kNN) as classifiers. We further study which antenna positions are better placed to classify tumors, discuss the feature extraction method and optimize classification algorithms, by tuning their hyperparameters, to improve sensitivity, specificity and the receiver operating characteristic curve, while ensuring maximum generalization and avoiding overfitting and data contamination. We also added a realistic synthetic skin response to the collected signals and examined its global effect on classification of benign vs malignant tumors. In terms of global classification performance, kNN outperformed DT and NB machine learning classifiers, achieving a classification accuracy of 96.2% when classifying between benign and malignant tumor phantoms in a homogeneous breast phantom (both when the skin artifact is and is not considered). We experimentally classified tumor models as benign or malignant with a microwave imaging system, and we showed a methodology that can potentially assess the shape of breast tumors, which will give further insight into the correct diagnosis and staging of breast cancer.

Breast density does not affect breast cancer tumor size assessment: A comparison of radiologic versus pathologic measurement by different imaging modalities across breast densities

BackgroundTumor size is an important parameter in breast cancer staging. Definitive tumor size is determined by measurement of the pathologic specimen. However, prior to surgery, size must be assessed by imaging with mammography (MMG), ultrasound (US), or magnetic resonance imaging (MRI). Discrepancies between imaging-assessed and pathologic size are not uncommon. Breast density decreases the sensitivity of MMG, and may affect image-based tumor size assessment. AimTo compare tumor size assessed by the different imaging modalities to pathologic size across breast densities. Material & methodsThis was a retrospective analysis of 183 female patients (197 breast cancers) diagnosed and operated for primary breast cancer at a single center. Tumor size measurements were collated for each available imaging modality and compared with measurements from pathologic specimens. Breast density was assessed on MMG using the Breast Imaging Reporting and Data System. ResultsMean pathologic tumor size was 23.0 ± 19.3 mm. Mean tumor size did not differ significantly with MMG (22.3 ± 16.6 mm; P = 0.165) or MRI (23.4 ± 19.2 mm; P = 0.620). However, US significantly underestimated mean tumor size (15.2 ± 8.6 mm; P = 0.0001 vs pathology). Breast density did not affect the accuracy of tumor size assessment by any imaging modality. ConclusionsUS may underestimate breast tumor size. Treatment decisions that take into account tumor size can be made equally reliably in patients with high or low breast density.