Carcinoma In Women Research Articles

Having a first-degree relative with melanoma increases lifetime risk of melanoma, squamous cell carcinoma, and basal cell carcinoma

Previous studies have found familial aggregation of melanoma and keratinocyte cancers (KCs). We sought to determine the risk of melanoma and KCs in those with a positive family history of melanoma while controlling for pigmentary and environmental risk factors. We prospectively followed 216,115 participants from the Nurses' Health Study, Nurse's Health Study 2, and Health Professionals Follow-up Study for more than 20years. Cox proportional hazards regression controlling for known risk factors for skin cancer was used to estimate association between family history of melanoma and melanoma and KCs. Compared with those without a family history of melanoma, individuals with a family history of melanoma had a 74% increased risk of melanoma (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.45-2.09), a 22% increased risk of squamous cell carcinoma (HR, 1.22; 95% CI, 1.06-1.40), and a 27% increased risk of basal cell carcinoma (HR, 1.27; 95% CI, 1.12-1.44). Family history of melanoma increased the risk of development of truncal melanoma in both sexes, extremity melanoma in women, and extremity squamous cell carcinoma in women. Limitations of this study include self-reported family history and detection bias. Individuals with a family history of melanoma are at an increased risk of melanoma and KCs.

Incidence of cervical high-grade squamous intraepithelial lesions and squamous cell carcinoma in women with high-risk human papillomavirus and normal cervical cytology: A retrospective analysis of 1858 cases stratified by age and human papillomavirus genotype.

To retrospectively analyse the incidence of high-grade squamous intraepithelial lesions (HSILs) and squamous cell carcinoma (SCC) in women of different ages with high-risk (HR) human papillomavirus (HPV) but with normal cytology test results stratified by age and HPV genotype. In total, 1858 women with HR-HPV infection but with a normal smear who received a colposcopy and biopsy between 2015 and 2016 at our institution were included. The pathological results were retrospectively analysed after stratifying by age and HPV genotype. Among the 1858 cases, the HSIL% in women aged 21-29years (10.54%) was significantly different from that in women aged 40-49years (19.85%; P<0.05), whereas there was no significant difference in the HSIL% among women aged 21-29years and those in the other age groups (P>0.05). In total, 295 cases had single HPV16 infection. The HSIL% in patients with HPV16/18 infection was >15%, and the 40-49-year age group had the highest percentage at 48.48%. For other HR-HPV infections, the HSIL and SCC incidence rate was 10.41%, and there was no significant difference among the age groups; thus, women with other types of viral infections, regardless of age, should be referred to colposcopy. Although HPV16 is the HPV with the highest risk, other HR-HPV infections can also cause a high percentage of HSILs and SCC in women with normal cytology. Therefore, it is necessary to refer HR-HPV-infected women aged ≥21years for colposcopy in a timely manner to exclude potential cervical intraepithelial neoplasia and cervical cancer.

Thyroid carcinoma in woman. gynecologist view

Over the past decade the incidence of thyroid cancer in Ukraine has increased 1.5 times, and the average age of diagnosis among women is 36 years. Thyroid cancer is the most common endocrine cancer, occurs in 5–10% of patients with thyroid nodules. Papillary carcinoma is 80% of all thyroid malignant neoplasms and is three times more common in women than in men. The peak incidence in women is observed in 40–49 years, while in men the peak is 60–69 years. In addition to established risk factors such as female sex, exposure to ionizing radiation, a history of benign thyroid disease, deficiency or excess of iodine in the diet, somatic mutations BRAFV600E, RET/PTC, NTRK, remain relevant studies of the role of estrogen imbalance and progesterone and progesterone expression of their receptors sensitive in the development of thyroid carcinogenesis. Recent studies devoted to improving the diagnosis of thyroid cancer, surgical intervention techniques, subsequent radioactive iodine therapy and duration of thyroid stimulating hormone suppression. Thanks to this patients with thyroid papillary carcinoma have favorable prognoses, because the 5-year survival rate is more than 98%. According to the American Thyroid Association a modern approach to the treatment of papillary thyroid cancer has several stages and depends on the recurrence risk in a patient. Thus, patients in accordance with the tumor size, the presence of local, distant metastases, BRAF V600E mutations, etc. are divided into three groups: low, medium and high risk of developing a relapse. At the first stage of treatment surgical intervention (thyroidectomy or lobectomy) is performed, followed by histopathological verification of the diagnosis, radioiodine diagnosis of the presence of metastases, evaluation of risk factors for recurrence, and the decision to conduct a course of radioiodine therapy during the second stage of treatment. The further management of these patients also depends on the risk group and includes the long-term suppressive treatment of thyroid stimulating hormone with levothyroxine.

Development of Peritoneal Carcinoma in women diagnosed with Serous Tubal Intraepithelial Carcinoma (STIC) following Risk-Reducing Salpingo-Oophorectomy (RRSO)

IntroductionThe management of Serous Tubal Intraepithelial Carcinoma (STIC) found at the time of Risk-Reducing Salpingo-Oophorectomy (RRSO) remains unclear. We set out to analyse the incidence of peritoneal carcinomas developed after prophylactic surgery and to formulate further guidance for these patients.MethodsThis is a retrospective study of 300 consecutive RRSO performed at the Royal Marsden Hospital between January 2008 and January 2017.ResultsThe median age at RRSO was 47.8 years (range 34 to 60 years) and median BMI was 26.2 kg/m2 (range 16 to 51 kg/m2). A total of 273 patients (91%) were tested for BRCA mutations. Of these, 124 (45.4%) had a BRCA 1 mutation, 118 (43.2%) had a BRCA 2 mutation, 2 (0.7%) had both a BRCA 1 and a BRCA 2 mutation and 29 (10.6%) had no BRCA mutation detected. Isolated STIC lesions were identified in 7 cases (2.3%) and p53 signatures in 75 cases (25%). There were five (1.6%) incidental tubal carcinomas and one (0.3%) ovarian carcinoma at the time of surgery. Two (28.6%) of the 7 patients with STIC identified following RRSO had high grade serous peritoneal carcinoma diagnosed at 53 and 75 months. One (0.3%) patient from the other 287 patients from our series with no STIC diagnosis or incidental carcinomas at RRSO developed high grade serous carcinoma of peritoneal origin after 92 months.ConclusionThis study demonstrates that when a STIC lesion is identified following RRSO there is a significantly higher risk of a subsequent peritoneal cancer. Although there is no published consensus in literature, we recommend that consideration should be given for long term follow-up if a STIC lesion is identified at RRSO.

683 – Distinct Characteristics of Hepatocellular Carcinoma in Women: Results from a Large, Multicenter Study in the United States

683 – Distinct Characteristics of Hepatocellular Carcinoma in Women: Results from a Large, Multicenter Study in the United States

Comparison of oncologic outcomes of unanticipated cervical carcinoma in women undergoing inadvertent simple hysterectomy and those undergoing surgical treatment after preoperative diagnosis

ObjectivesTo determine the proportion of women with undiagnosed cervical carcinoma before simple hysterectomy and its causes and to compare the oncologic outcomes of women diagnosed and treated with standard therapy to those undergoing inadvertent simple hysterectomy with subsequent treatment. MethodsMedical records were reviewed for patients with cervical carcinoma who underwent hysterectomy between 1 January 2004 and 31 December 2014. Demographic data, chemotherapeutic agents, and response rates were analyzed using descriptive statistics. The categorical variables were compared using chi-square or Fisher's exact test. The continuous data were compared using the independent t-test and Mann–Whitney test, as appropriate. The Kaplan–Meier method was used to evaluate the survival outcomes. ResultsOf the 526 patients with cervical carcinoma who underwent hysterectomy, 57 patients (10.8%) were diagnosed with cervical carcinoma after simple hysterectomy. After excluding 121 patients with invasion of <3 mm and without lymphovascular space invasion (LVSI), 353 patients were preoperatively diagnosed with cervical carcinoma stage IA1 with LVSI to IIA and underwent proper surgical treatment. Fifty-two patients were encountered for inadvertent hysterectomy. Forty-four of 52 patients in the inadvertent hysterectomy group consented to subsequent treatment, with 43 patients receiving concurrent chemoradiotherapy and one undergoing additional surgery. The median time before subsequent treatment initiation was 1.6 months [0.5–9.2 months]. The 5-year DFS rates of the standard surgical treatment group and inadvertent hysterectomy group were 88.4% vs. 93.2%, respectively (P = 0.147). The 5-year OS rates of the standard surgical treatment group and the inadvertent hysterectomy group were 98.9% vs. 100%, respectively (P = 0.767). ConclusionsWomen with cervical carcinoma who had small tumors and underwent inadvertent simple hysterectomy with appropriate consequent management had oncologic outcomes comparable to those in the standard surgical treatment group.

Nonmelanoma skin cancer in women.

Men continue to develop nonmelanoma skin cancer (NMSC) at higher rates than women, but the epidemiologic pattern of NMSC development is evolving. We present a selective, narrative review of the literature showing that there is a trend toward a development of basal cell carcinomas in women at younger ages, and highlight potential causes of this trend. We review evidence that indoor tanning is associated with the development of NMSC and show that young women use indoor tanning more than any other age-sex group. We discuss societal factors that relate to the tanning behavior of young women. Finally, we argue that facial NMSCs may have more of a negative impact on quality of life in women than in men.

EP15.14: Endometrial carcinomas in women with polycystic ovary syndrome: sonohysterographic findings

To describe the sonohysterographic features of endometrial carcinomas in women with polycystic ovary syndrome (PCOS) and to determine the diagnostic role of sonohysterography (SH) in the evaluation of these lesions. SH findings of 52 PCOS patients with histologically confirmed endometrial carcinomas were evaluated. The mean age was 33.5 years (range 22-45 years). Histology included endometrioid type in 51 cases and Grade 1 in 46 cases, and 46 patients was stage IA. 23 Patients had high dose progestin treatment and 29 patients undergo surgery. SH demonstrated the endometrial thickening in 39 cases, endometrial mass in 6 cases, and endometrial thickening with mass in 7 cases. The endometrial thickness ranged from 5.5 to 27 mm (mean 9.6 mm) and the mass size ranged from 2 to 4.3 cm. They appeared as a diffuse polypoid endometrial thickening and a sessile endometrial mass with an inhomogeneous hyperechogenicity, an irregular surface, and obliteration of endometrial cavity. The tumour involved only to the endometrium in 35 cases and there were superficial myometrial invasion in 15 cases, deep myometrial invasion in 2 cases, and cervical invasion in 4 cases. The SH features of endometrial carcinomas associated with PCOS included a diffuse polypoid endometrial thickening and a sessile endometrial mass with an inhomogeneous hyperechogenicity, an irregular surface, obliteration of the cavity, and absent myometrial invasion. SH may provide more diagnostic value in the evaluation of endometrial carcinomas in women with PCOS. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Histopathological Analysis of 173 Consecutive Patients with Colorectal Carcinoma: A Pathologist's View.

BackgroundWorldwide, colorectal carcinomas are the third most common carcinomas in men and the second most common carcinomas in women. Pathological examination of rectum specimens requires special attention for correctly evaluating many prognostically important factors. In this study, we present pathological results of 173 lower anterior resection (LAR) and abdominoperineal resection (APR) specimens retrospectively evaluated.Material/MethodsWe included 173 LAR and APR specimens in this study. Patients were evaluated in the Istanbul Ekin Private Pathology Laboratory and underwent surgery at Çanakkale State Hospital, General Surgery Clinic.ResultsOf the 173 specimens, 15 (8.7%) were APR and 158 (91.3%) were LAR specimens. Ninety-four patients (54.3%) were males and 79 patients (45.7%) were females. The mean age of the patients was 63.5 years (range 26–90 years). In the histopathological examination, malignant neoplasm was detected in 172 of the cases (99.4%) and benign endometriosis was detected in 1 of the cases (0.6%). There were 151 (87.2%), 8 (4.6%), 5 (2.9%), 1 (0.6%), 1 (0.6%), 1 (0.6%), 1 (0.6%), 1 (0.6%), and 4 (2.3%) patients with adenocarcinoma, mucinous adenocarcinoma, intramucosal adenocarcinoma in the setting of a high-grade tubulovillous adenoma, synchronous colon/prostate adenocarcinoma, malignant melanoma, signet ring cell carcinoma, gastrointestinal stromal tumor, endometriosis, and adenocarcinoma diagnosed by the examination of colonoscopic biopsy specimens that showed complete regression with neoadjuvant therapy, respectively.ConclusionsWhen evaluating specimens from patients with colorectal carcinoma, pathological evaluation, which is one of the most fundamental pillars in managing patients with cancer, must be performed carefully and meticulously. Each pathological parameter should be evaluated carefully and clinicians and pathologists should evaluate these cases together.

PO-286 Protein kinase D3: a crucial regulator of breast cancer stem cell survival

IntroductionTriple negative breast cancer (TNBC) accounts for 15%–20% of all breast carcinomas in women. TNBC is particularly aggressive, highly metastatic and associated with poor prognosis. We previously identified Protein Kinase D3 (PKD3) to be upregulated in TNBC. PKD3 is a serine-threonine kinase that is best known for its functions in membrane trafficking and actin remodelling. Here we identify a novel role for PKD3 in breast cancer stem cell (CSC) maintenance. CSCs are endowed with tumor-initiating capacity, they possess increased chemoresistance and are known to initiate metastasis, and therefore are responsible for tumour relapse.Material and methodsIn the TNBC cell line MDA-MB-231 with a stable PKD3 knockdown, we performed a flow cytometry based screen of cell surface proteins, revealing the downregulation of several membrane proteins associated with CSCs. The importance of PKD3 for driving a CSC gene expression signature, maintaining CSC numbers and function was tested by qRT-PCR analysis of CSC markers, by measuring aldehyde dehydrogenase (ALDH) activity and performing mammosphere assays, respectively. Paclitaxel sensitivity of TNBC cell lines was assessed in combination with the selective PKD inhibitor CRT0066101. Whether the ectopic expression of PKD3 was sufficient to induce the expansion of the CSC pool was analysed in the non-transformed breast epithelial cell line MCF10A.Results and discussionsIn MDA-MB-231 cells with PKD3 knockdown, the CSC markers (CD184, Notch4, Sox2, Oct3/4) were downregulated. This was associated with reduced CSC numbers based on ALDH positivity and sphere-forming efficiency in mammosphere assays. Pharmacological PKD inhibition in the TNBC cell lines MDA-MB-231, BT549 and MDA-MB-436 verified these results. By contrast, inducible PKD3 expression in MCF10A cells elevated mammosphere formation and stem cell marker expression. Importantly, the combination of paclitaxel with CRT0066101 was superior over the single treatments in suppressing the survival of MDA-MB-231, BT549 and MDA-MB-436 cells in both colony formation and mammosphere assays.ConclusionOur results establish PKD3 as a crucial regulator of CSC maintenance and demonstrate that paclitaxel treatment in combination with PKD inhibition provides a potential novel strategy for future therapeutic applications in TNBC treatment.

Current and Emerging Multianalyte Assays with Algorithmic Analyses-Are Laboratories Ready for Clinical Adoption?

Over the past decade, there have been a rising number of clinically used tests that combine 2 or more biochemical or molecular assays, demographics, and clinical information into an algorithm to generate diagnostic, prognostic, or predictive information for a specific disease. The concept of multianalyte analyses is relatively new in the field of laboratory medicine. Dating back to the 1980s, prenatal screening for fetal abnormalities, such as Down syndrome, by use of maternal biomarkers is among the pioneer tests that use algorithmic analyses for risk assessment. Yet, the number of multianalyte algorithms used clinically remains modest. The American Medical Association provides current procedural terminology (CPT)8 codes for 20 multianalyte assays with algorithmic analyses (MAAAs.) Among these, 9 consist of biochemical markers detected by immunoassay or mass spectrometry, with or without other clinical information; 11 use molecular genetics markers; and 1 is for generic use. In this Q&A, we refer to multivariable tests with risk scores as MAAAs, although not all of them have an associated MAAA CPT code. Generally speaking, MAAAs aim at improving diagnostics for diseases in which single biomarkers have limited clinical validity. The Prostate Health Index (Beckman Coulter) and the 4Kscore® (GenPath) exemplify some of these strategies for prostate cancer detection. Likewise, multianalyte analyses such as the Risk of Ovarian Malignancy Algorithm (ROMA®) and OVA1® and its second-generation OVERATM (Vermillion Inc.) improve upon the suboptimal performance of the tumor marker CA125 in the differential diagnosis and likelihood of ovarian carcinoma in women presenting with a pelvic mass. While both have Food and Drug Administration (FDA) clearance, ROMA is a nonproprietary algorithm cleared on various commercial immunoassays (Fujirebio Diagnostics, Inc.; Abbott Laboratories; Roche Diagnostics). Early identification of acute kidney injury is another area in which an FDA-approved multianalyte test, Nephrocheck® (Astute Medical), …

Three Synchronous Bilateral Solid Papillary Carcinomas of the Breast with Different Radiologic Findings: A Case Report

: Papillary carcinoma of the breast is a rare malignant tumor that is known to account for only approximately 1% - 2% of breast carcinomas in women. Among papillary carcinomas, solid papillary carcinoma (SPC) is a rare breast carcinoma that occurs primarily in elderly women. It is known that approximately 95% of the cases occur in a unilateral breast. The imaging findings for SPCs are not well established, and most of the published articles are about pathological findings. Moreover, there have been no reports of SPCs occurring in both breasts at the same time. We report here a case of three synchronous bilateral breast SPCs in patient with palpable mass, each showing different radiologic findings. Although imaging findings that distinguish between malignant and benign papillary lesions are unclear, familiarity with the features of SPCs may be helpful in establishing imaging findings for these lesions.

Human Papillomavirus - Role in Cervical Carcinogenesis and Methods of Detection

Persistent infection with high-risk human papillomavirus (HPV) strains, especially HPV 16 and HPV 18, is associated with the onset of various malignant diseases, including cervical carcinoma in women. HPV DNA testing is thus being implemented as a complementary method to standard cytological examination, mainly due to its increased sensitivity. This review outlines the role of HPV in cervical carcinogenesis, with a focus on the formation of cervical intraepithelial neoplasias (CIN1-3) and the molecular mechanism underlying cellular transformation. Current biomarkers used to screen premalignant lesions are described, including mRNA transcripts of the E6 and E7 genes, protein p16 (a cyclin-dependent kinase inhibitor that regulates cell cycle progression from G1 to S phase), altered DNA methylation patterns, and actions of specific microRNAs (short (18-22 bp), non-coding, single-stranded RNA molecules that regulate gene expression at the post-transcriptional level). This review also describes the advantages and drawbacks of commercial HPV tests, and depicts novel methods for more cost-effective and faster HPV diagnostics based on optical or electrochemical detection. Although great progress has been made, the incidence and mortality rates of cervical malignancies remain relatively high, especially in developing countries. Incorporation of HPV testing into routine screening programs could help to decrease mortality rates; however, the cost of such testing must be reduced if it is to compete with current cytology-based examinations.Key words: HPV - cervical carcinoma - HPV testing - nucleic acid hybridization - mRNA - DNA methylation - microRNA This work was supported by MEYS-NPS I-LO1413 and GAČR 17-08971S. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 25. 9. 2017Accepted: 26. 1. 2018.

Clinical and histologic characteristics of breast cancers in women with previous pathologic diagnosis of benign breast disease in Spain.

Women with a benign breast disease (BBD) have an increased risk of subsequent breast carcinoma. Information is scarce regarding the characteristics of breast carcinomas diagnosed after a BBD. Our aim was to point out the differences in clinical and histologic characteristics of breast carcinomas diagnosed in women with and without a previous pathologic diagnosis of BBD in the context of population-based mammography screening. Retrospective cohort study of all women aged 50-69years who were screened at least once in a population-based screening program in Spain, between 1994 and 2011 and followed up until December 2012. The mean follow-up was 6.1years. We analyzed 6645 breast carcinomas, of whom 238 had a previous pathologic diagnosis of BBD. Information on clinical and histologic characteristics was collected from pathology reports. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (95%CI) of occurrence of selected histologic characteristics of breast carcinomas in women with and without a previous BBD. Women with a previous BBD had a higher proportion of ductal carcinoma insitu (DCIS) compared with women without a BBD (22.1% and 13.6%, respectively). Among those diagnosed with an invasive breast carcinoma, women with previous BBD were more likely to be diagnosed with carcinomas sized >2cm (OR=1.46; 95%CI=1.03-2.08), metastatic positive (OR=2.66; 95%CI=1.21-5.86), and with a high Ki-67 proliferation rate (OR=1.93; 95%CI=1.24-2.99). No differences were found across histologic subtypes of BBD. Screening participants with a previous pathologic diagnosis of BBD had a higher proportion of DCIS. However, invasive carcinomas detected in women with a BBD were associated with clinical and histologic characteristics conferring a worst prognosis.

BREAST CANCER IN YOUNG WOMEN: PATHOLOGIC AND IMMUNOHISTOCHEMICAL FEATURES.

SUMMARY – A young woman with breast cancer is considered to be a woman younger than 40. According to the literature, breast cancer in the population of young women usually is of a higher histologic grade, unfavorable hormonal status, and overall higher mortality rate when compared with breast cancer occurring in older population. We compared pathologic and immunohistochemical features of breast carcinoma in women under 40 years of age with the respective features in women over 60 years of age. The following parameters were observed in these two groups: tumor size, lymph node status, histologic grade, hormonal receptor status, Ki-67 prognostic index, Her2/neu status, and histologic type of the tumor. Early onset breast carcinoma was found to have a higher frequency of tumor grade 3 (29% vs. 17%) and estrogen receptor negativity (45% vs. 23%). In the group of young women, breast carcinoma was mostly multicentric (23% vs. 5%), triple-negative (32% vs. 10%), and was found to have higher proliferation index Ki-67 (25% vs. 10%). Our results confirmed differences between the young and older groups of patients. In the group of young women, we found predominantly unfavorable prognostic parameters of the disease.

Relationship between clinicopathological features and molecular subtypes of invasive breast ductal carcinoma in young women

Objective To analyze the association between clinicopathological features and molecular subtypes of breast carcinoma in women aged under 35 years old. Methods The clinicopathological data of 385 women aged under 35 years old who had complete data and were diagnosed as breast cancer from July 2009 to May 2016 were retrospectively analyzed. The relationship between clinicopathological features and molecular subtypes was analyzed by using nonparametric Kruskal-Wallis H test. Results In 415 cases, 385 cases were invasive ductal carcinoma, 22 cases were ductal carcinoma in situ, 4 cases were mucinous adenocarcinoma, 3 cases were invasive lobular carcinoma, 1 case was lobular carcinoma in situ. In invasive ductal carcinoma, luminal B type was the most [218 cases (56.6%)], and 60 cases (15.6%) were triple negative breast cancer (TNBC). There were significant differences in tumor mass, N stage, histological grade and clinical stage between the different molecular subtypes (all P < 0.05). Conclusions Tumor size, histological grade, lymph node staging and clinical stage of young female patients with breast carcinoma are closely associated with different molecular subtypes. The ratio of molecular subtypes with poor prognosis, higher histological grade and later clinical stage is high in all cases, which is related to the poor prognosis of young women breast carcinoma and should be paid more attention to the early diagnosis. Key words: Breast neoplasms; Female; Young adult; Molecular typing; Pathological conditions, signs and symptoms

Is there an increased risk of cervical neoplasia in atopic dermatitis patients treated with oral immunosuppressive drugs?

Oral immunosuppressive drugs are frequently prescribed in young women with atopic dermatitis (AD). Immunocompromised patients may have a higher risk of developing high-risk HPV infections, cervical intra-epithelial neoplasia (CIN) and cervical carcinoma. Most literature on patients using oral immunosuppressive drugs is available in organ transplant patients. Literature on the risk of developing cervical carcinoma in AD patients treated with oral immunosuppressive drugs is lacking. At this moment, there is no clear guideline/consensus on this topic, but in daily practice, questions arise concerning whether this risk is increased and whether more intensive screening in women using immunosuppressive drugs should take place. To investigate the occurrence of cervical carcinoma in women with AD treated with oral immunosuppressive drugs. In this retrospective cohort study in two university medical centres in the Netherlands, all female adult AD patients receiving oral immunosuppressive drugs (cyclosporine A, azathioprine, methotrexate, mycophenolate mofetil, enteric-coated mycophenolate sodium and extended release tacrolimus) for more than 2 months between 1989 and 1 January 2014 were included. Patient files in the national histopathology register were screened for PAP3a, CIN I, CIN II, CIN III and cervical carcinoma. A total of 257 female AD patients with one or more treatment episodes from 1989 until 1 January 2014 were identified and included in this study. In 189 patients (73.5%), results of cervical examination were reported in the national histopathology database. Median total duration of treatment in these 189 women was 407.0 days (IQR 243.0-940.0). No cervical carcinoma during or following immunosuppressive therapy was found in our patient group. No intensified screening programme for cervical neoplasia seems necessary for women with AD using oral immunosuppressive drugs.

Risk of Serous Endometrial Carcinoma in Women With Pathogenic BRCA1/2 Variant After Risk-Reducing Salpingo-Oophorectomy.

It has recently been shown that the risk of a rare subtype of endometrial carcinoma (serous type) in women carrying a germline BRCA1/2 pathogenic variant is increased. We assessed the incidence of serous endometrial carcinoma in an independent prospective cohort study of 369 BRCA1/2 women (1779 woman-years of follow-up) who underwent risk-reducing salpingo-oophorectomy by laparoscopy. This occurrence in two BRCA1 carriers led us to estimate that BRCA1/2 carriers present a higher risk than the control population (standardized incidence ratio = 32.2, 95% confidence interval = 11.5 to 116.4, P < .001, two-sided chi-square test, 1 degree of freedom). In addition, in both tumors, the wild-type BRCA1 allele was lost, indicating the inactivation of the BRCA1 gene and arguing for a link with endometrial carcinogenesis. Prophylactic hysterectomy could be discussed with informed women through a shared decision-making process although the estimated 3% life-long risk is moderate. Additional studies are required to establish future prophylactic surgery guidelines.

The performance of 3D ABUS versus HHUS in the visualisation and BI-RADS characterisation of breast lesions in a large cohort of 1,886 women

This study aimed to evaluate automated breast ultrasound (ABUS) compared to hand-held traditional ultrasound (HHUS) in the visualisation and BIRADS characterisation of breast lesions. From January 2016 to January 2017, 1,886 women with breast density category C or D (aged 48.6±10.8 years) were recruited. All participants underwent ABUS and HHUS examination; a subcohort of 1,665 women also underwent a mammography. The overall agreement between HHUS and ABUS was 99.8 %; kappa=0.994, p<0.0001. Two cases were graded as BI-RADS 1 in HHUS, but were graded as BIRADS 4 in ABUS; biopsy revealed a radial scar. Three carcinomas were graded as BI-RADS 2 in mammography but BI-RADS 4 in ABUS; two additional carcinomas were graded as BI-RADS 2 in mammography but BI-RADS 5 in ABUS. Two carcinomas, appearing as a well-circumscribed mass or developing asymmetry in mammography, were graded as BI-RADS 4 in mammography but BI-RADS 5 in ABUS. ABUS could be successfully used in the visualisation and characterisation of breast lesions. ABUS seemed to outperform HHUS in the detection of architectural distortion on the coronal plane and can supplement mammography in the detection of non-calcified carcinomas in women with dense breasts. • The new generation of ABUS yields comparable results to HHUS. • ABUS seems superior to HHUS in detecting architectural distortions. • In dense breasts, supplemental ABUS to mammography detects additional cancers.

Predictive factors of ovarian carcinoma for women with ovarian endometrioma aged 45\xa0years and older in China

BackgroundTo explore the risk factors of endometriosis-associated ovarian cancer (EAOC) in women with ovarian endometriosis (OEM) aged 45 years and above in China.MethodsThis study reviewed the medical records of 1038 women in total who were aged 45 years and above, surgical-pathologically diagnosed with ovarian endometriosis, and were treated at Peking Union Medical College Hospital between December 1996 and December 2016. Histology evaluation was used to determine whether the ovarian endometriosis specimen was with (n = 30) or without (n = 1008) ovarian cancer.Results2.9% (30/1038) of women with the surgical-pathological diagnosis of ovarian endometriosis were found to have EAOC. Those patients with EAOC were prone to be in the postmenopausal status at the time of the diagnosis (OR 5.50, 95%CI 2.54–11.90, P < .001) and larger size of tumor (≥8 cm, OR 7.19, 95% CI 3.34–15.50, P < .001), and higher prevalence of coexisting with endometrial disorders (OR 4.11, 95%CI 1.73–9.73, P = .003). This study showed that patients of an older age when diagnosed with OEM, were at a higher risk of developing EAOC, respectively measuring of 1.7% (13/751) at 45–49 years, 5.6% (12/215) at 50–54 years, and 10.0%(5/50) at 55–59 years (P < 0.001).ConclusionsThis study showed that for women aged 45 years and above who were diagnosed with OEM, the independent risk factors of EAOC were menopausal status, tumor size of 8 cm or greater in diameter, and coexisting endometrial disorders. Therefore, intensive follow-ups or active interventions should be considered for them.