Diagnosis Of Invasive Ductal Carcinoma Research Articles

MiRNAs profile as a signature for cardiovascular disease in long-term breast cancer female survivors: a pilot study

Abstract Background/Introduction Cardiovascular diseases (CVD) is a matter of immediate concern among long term breast cancer (BC) survivors. An early identification of those patients who are at higher risk of developing CVD is warranted to tailor prevention strategies and improve their quality of life. Purpose To identify whether a specific miRNA signature exists in breast cancer female survivors who develop CVD in a long term follow up. Methods We performed cross-sectional comparison of miRNA expression between female BC survivors (i.e. individual with a diagnosis of invasive ductal carcinoma who were free from cancer at 10-year follow up and without known CVD before BC diagnosis) with CVD (n=11) and without CVD (n=11) matched for age, BC grade, treatment received and traditional cardiovascular risk factors. CVD was defined as the incidence of established atherosclerotic cardio- or cerebro-vascular diseases (i.e., ischemic heart disease, carotid endarterectomy, stroke, heart failure), atrial fibrillation or venous thromboembolism. Thirteen miRNAs were selected since they were involved in either BC and CVD. On plasma derived samples, miRNAs expression profile analysis was performed by retro-transcription and real-time PCR assays, using miRNA-specific probes. Results The BC female survivors (mean age 73 years, 70% hypertension, 60% histological grade 2 and 3) were treated with surgery. The majority (76%) received hormone therapy after surgery according to the BC receptor expression. In half of the cohort, radiotherapy was performed. Those female BC survivors developing CVD experienced more commonly cerebral or cardiovascular atherosclerotic events (70%). As reported in Figure 1, some miRNAs analyzed (miR-19a; miR-21; miR-24; miR-125b; miR-195) are upregulated in BC survivors who developed CVD. Of note miR-19a, miR-21 (and miR-195) increase is so significantly relevant to consider these miRNAs as candidate biomarkers. Conclusion(s) In this discovery cohort, a specific miRNA profile signature identified female BC survivors experiencing CVD. Validation of such signatures is needed in a larger cohort as well as mechanistic studies to understand what is the pathophysiological link between the miRNAs identified and vascular health. Nevertheless these miRNAs in both cancer and cardiac diseases are mainly associated with promotion of cell proliferation and inhibition of apoptotic processes. The clinical implications of using a specific miRNA profile as a likely early biomarker of adverse cardiovascular events are indeed of great interest to better preserve BC survivors' health.Figure 1

Sneaky DCIS-looking Invasive Ductal Carcinoma of the Breast in the Extensive DCIS Background

Abstract Introduction/Objective In the most cases, invasive ductal carcinoma (IDC) of the breast is identifiable when they present with classic infiltrative growth pattern. However, subset of IDC can occur in a very sneaky way, significantly mimicking the appearance of ductal carcinoma in situ (DCIS). In this condition, it’s much more easier to miss the invasive component without pulling ancillary staining when morphologic findings are extremely compatible with DCIS, especially the diagnosis of DCIS was made on the previous biopsy. Methods/Case Report Retrospective analysis of the histologic and immunohistochemical findings of pure DCIS and DCIS-looking invasive ductal carcinoma. Results (if a Case Study enter NA) Here, we reported a 55 year-old female who was noted to have microcalcification at the 11:00 o’clock of the right posterior breast on routine mammographic examination in 09/2023. Biopsy of the calcification area in 10/2023 reported high grade DCIS (ER+ PR-). Histologic examination of subsequent mastectomy specimen showed two separate DCIS-looking areas. Immunohistochemical (IHC) staining showed that myoepithelial markers, p63 and smooth muscle myosin heavy chain (SMMHC), were retained at the periphery of all the expanded acini in one area. Unexpectedly and surprisingly, p63 and SMMHC were completely lost at the periphery of part of the DCIS-looking acini in another area, immunohistochemically compatible with the diagnosis of invasive ductal carcinoma admixed with DCIS. Conclusion Knowing that invasive ductal carcinoma of the breast can present as DCIS-looking morphology, especially given the condition that the diagnosis of DCIS was rendered on the previous biopsy, will enhance awareness of pathologists to recognize sneaky DCIS-looking invasive ductal carcinoma in the extensive DCIS background. In turn, this will prevent misdiagnosis and under-treatment of patients with invasive ductal carcinoma of the breast.

The Association of Neuroendocrine Differentiation with MicroRNA 21 and MicroRNA let7f Expression and the Clinicopathological Parameters in Primary Invasive Breast Carcinomas with Neuroendocrine Features.

MiRNAs have been reported as biomarkers with diagnostic, prognostic, and predictive value for many different diseases. Therapeutic agents targeting some miRNAs are currently being developed. We aimed to compare BC-NEFs (carcinoma of the breast with neuroendocrine features) with IDC (invasive ductal carcinoma) cases without neuroendocrine features in terms of the level of miRNA expression known to show the oncogenic (miR-21) and tumor-suppressor effects (miR-let7f) and the clinicopathological features. A total of 29 patients with a diagnosis of BC-NEFs (15 cases with neuroendocrine differentiation >50% of the whole section of tumor and 14 cases with neuroendocrine differentiation 10-50% of the tumor) and 30 patients with a diagnosis of IDC (no neuroendocrine differentiation) were retrospectively re-evaluated. Expression levels of miR-21 and miR-let7f were determined by the qRT-PCR method in paraffin tissue blocks. MiR-21 expression was significantly higher in the IDC group than in the group with BC-NEFs. miR-let7f expression was significantly lower in the group with BC-NEFs compared to the IDC group. A high expression level of miR-21 was found to be associated with progesterone receptor (PR) negativity. Our findings show that the presence of NEFs in breast carcinomas makes a significant difference in the expression levels of the investigated oncogenic (miR-21) and tumor-suppressor (miR-let7f) miRNAs. These findings suggest that miRNAs may be a potential biomarker in BC-NEFs and would benefit from targeted therapy.

Tumor lysis syndrome following letrozole for locally advanced breast cancer: a case report

BackgroundLetrozole, an aromatase inhibitor, is used to treat breast cancer in postmenopausal women. Tumor lysis syndrome (TLS) is a complication that can trigger multiple organ failure caused by the release of intracellular nucleic acids, phosphate, and potassium into the blood due to rapid tumor cell disintegration induced by drug therapy. TLS is uncommon in solid tumors and occurs primarily in patients receiving chemotherapy. Herein, we report a rare occurrence of TLS that developed in a patient with locally advanced breast cancer following treatment with letrozole.Case presentationAn 80-year-old woman with increased bleeding from a fist-sized left-sided breast mass presented to our hospital. Histological examination led to a diagnosis of invasive ductal carcinoma of the luminal type. The patient refused chemotherapy and was administered hormonal therapy with letrozole. Seven days after letrozole initiation, she complained of anorexia and diarrhea. Blood test results revealed elevated blood urea nitrogen (BUN) and creatinine (Cr) levels, and she was admitted to our hospital for intravenous infusions. On the second day after admission, marked elevations of LDH, BUN, Cr, potassium, calcium, and uric acid levels were observed. Furthermore, metabolic acidosis and prolonged coagulation capacity were observed. We suspected TLS and discontinued letrozole, and the patient was treated with hydration, febuxostat, and maintenance hemodialysis. On the third day after admission, her respiratory status worsened because of acute respiratory distress syndrome associated with hypercytokinemia, and she was intubated. On the fourth day after admission, her general condition did not improve, and she died.ConclusionsAlthough TLS typically occurs after chemotherapy initiation, the findings from the present case confirm that this syndrome can also occur after hormonal therapy initiation and should be treated with caution.

Intra and peritumoral PET radiomics analysis to predict the pathological response in breast cancer patients receiving neoadjuvant chemotherapy

ObjectiveThe aim of our study was to evaluate the contribution of 18Fluorine-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) radiomic data obtained from both the tumoral and peritumoral area in predicting pathological complete response (pCR) in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy (NAC). MethodsFemale patients with a diagnosis of invasive ductal carcinoma who received NAC were evaluated retrospectively. The volume of interest (VOI) of the primary tumor (VOI-T) was manually segmented, then a voxel-thick VOI was added around VOI-T to define the peritumoral area (VOI-PT). Morphological, intensity-based, histogram and texture parameters were obtained from VOIs. The patients were divided into two groups as pCR and non-complete pathological response (npCR). A “radiomic model” was created with only radiomic features, and a “patho-radiomic model” was created using radiomic features and immunohistochemical data. ResultsOf the 66 patients included in the study, 21 were in the pCR group. The only statistically significant feature from the primary tumor among patients with pCR and npCR was Morphological_Compacity-T (AUC: 0.666). Between response groups, a significant difference was detected in 2 morphological, 1 intensity, 4 texture features from VOI-PT; no correlation was found between Morphological_Compacity-PT and NGTDM_contrast-PT. The obtained radiomic model’s sensitivity and accuracy values were calculated as 61.9% and 75.8%, respectively (AUC: 0.786). When HER2 status was added, sensitivity and accuracy values of the patho-radiomic model increased to 85.7% and 81.8%, respectively (AUC: 0.903). ConclusionsEvaluation of PET peritumoral radiomic features together with the primary tumor, rather than just the primary tumor, provides a better prediction of the pCR to NAC in patients with breast cancer.

Long-term results of intraoperative multicatheter breast implant (IOMBI) for accelerated partial breast irradiation (APBI) on early breast cancer patients

Background and purposeMulticatheter breast brachytherapy is a standard technique for accelerated partial breast irradiation (APBI) in early breast cancer patients. Intraoperative multicatheter breast implant (IOMBI) followed by perioperative high-dose-rate brachytherapy (PHDRBT) offers a novel and advantageous approach. We present long-term oncological, toxicity, and cosmesis outcomes for a well-experienced single institution. Materials and methodsEligible women aged ≥ 40 years with clinically and radiologically confirmed unifocal invasive or in situ ≤ 3 cm breast tumors underwent IOMBI during breast-conserving surgery. Patients meeting APBI criteria by definitive pathologic results received 3.4 Gy × 10fx with PHDRBT. Patients not suitable for APBI received PHDRBT-boost followed by WBRT. ResultsA total of 171 patients underwent IOMBI during BCS, 120 patients (70.1 %) were suitable for APBI and 51 (29.8 %) for anticipated PHDRBT-boost. The median age was 61 years (range: 40–78), the median tumor size was 1.1 cm (range: 0.2–3.5), with a histological diagnosis of invasive ductal carcinoma in 78.9 % and ductal in situ in 21.1 %. A median of 9 catheters (range: 4–14) were used. For APBI, the median CTV and V100 were 40.8 cc (range: 8.6–99) and 35.4 cc (range: 7.2–94). The median of healthy breast tissue irradiated represents 7.2 % (range: 2.3–28 %) and the median local treatment duration was 10 days (range: 7–16). With a median follow-up of 8.8 years (range: 0.3–16.25), the 8-year local, locoregional, and distant control rates were 99 %, 98.1 %, and 100 %. G1-G2 late-toxicity rate was 53.4 %. Long-term cosmetic evaluation was excellent-good in 90.8 %. ConclusionIOMBI&PHDRBT program reports excellent long-term oncological outcomes, with a reduction from unnecessary irradiation exposure which translates into low long-term toxicity and good cosmesis outcomes, especially on well-selected APBI patients.

Evaluation of Resection Margin by Intraoperative Frozen Section Biopsy in Breast Conservative Surgery for Early Breast Carcinoma

Background: Breast cancer is currently the second leading cause of cancer deaths in women. Early detection and accurate classification of suspicious masses as benign or malignant is important for arriving at an appropriate treatment plan. Aims: To evaluate the resection margin by intra-operative frozen section in breast conserving surgery for early breast carcinoma. Methods: This cross sectional study was carried out in the department of general surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. A total of 20 patients with early stage breast carcinoma underwent surgery were included in this study. Admitted patients with diagnosis of invasive ductal carcinoma of the breast, patient who gave consent for research purpose, patients diagnosed with stage I & II breast cancer, small (up to 4 cm) unifocal tumor and clinically negative axillary nodes were enrolled in this study. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-22). Results: It was observed that more than one third (40.0%) patients belonged to age 41-50 years. The mean age was 45.55±10.94 years with ranged from 28 to 75 years. Half (50.0%) patient’s educational level was primary. Majority (85.0%) patient’s occupational statuses were housewife. Majority (90.0%) patients had lump size >2-≤5 cm. The mean lump size was 2.89±0.66 cm with ranged from 1.5 to 4 cm. Three fourth (75.0%) patients had lump in the right breast. Almost two third (60.0%) patients had lump in the upper outer quadrant of breast. Two (10.0%) patients had Grade I and 18(90.0%) had Grade II tumor. Three fourth (75.0%) patients had resected tumor of T2 >2-≤5 cm size. The mean size of resected toumour was 2.65±0.62 cm with ranged from 1.4 to 3.8 cm. The frequency of positive resection margin on frozen section was 3 (15%). Among them 1 (33.3%) patient had positive superior margin and 2 (66.7%) had positive lateral ....

Optimized Bayesian convolutional neural networks for invasive breast cancer diagnosis system

Deep learning (DL) has depicted unprecedented results in the diagnosis of invasive ductal carcinoma (IDC). However, most DL methods are not able to infer the uncertainty in their predictions, and are often too confident which may cause undesirable consequences. The ability of DL models to express their uncertainty in their predictions is particularly important in diagnosing diseases. Therefore, this paper proposes an uncertainty-aware approach called optimized Bayesian convolutional neural network (OBCNN) for the automated detection of IDC from histopathology images and is capable of estimating and inferring the uncertainty in its predictions. The proposed OBCNN employs an approximate Bayesian version of a pre-trained convolutional neural network (CNN) model named ResNet101V2 that is fine-tuned to the histopathology images of IDC. The Bayesian approximation is performed by adding Monte Carlo dropout (MC-dropout) to ResNet101V2 architecture. Due to the effect of MC-dropout on the obtained posterior predictive distribution (PPD), the value of MC-dropout should be chosen carefully because if the MC-dropout value is too large, the predictive distribution (PD) will be very diverse. Whereas if the MC-dropout value is very small, the PD will be very similar. Therefore, an optimization algorithm known as the slime mould algorithm is utilized to set the optimal value of the MC-dropout. During inference, the proposed OBCNN runs for T forward passes to configure the PPD. The mean, standard deviation (SD) and entropy are then calculated over the obtained PD to estimate the predictive uncertainty (PU) of the OBCNN. The proposed OBCNN achieved an accuracy of 93.83%, a precision of 96.14%, a G-mean of 93.04%, False Negative Rate of 4.72%, and False Positive Rate of 9.96 %. The proposed OBCNN has also been compared with recent related work, the comparison’s results demonstrated that OBCNN performed better in the diagnosis of IDC.

Right Common Femoral Vein Invasion: A Unique Case of Inguinal Ectopic Breast Cancer.

Ectopic breast cancer may present anywhere in the milk line, from the axilla to the groin which is extremely rare in the inguinal region. Despite morphologic differences, ectopic breast tissue presents characteristics related to orthotopic breast tissue in terms of function and pathologic degeneration. The case report describes the treatment of a unique ectopic breast carcinoma which was located in the inguinal region with a common femoral vein invasion. We present a unique case of an ectopic breast carcinoma presenting in an unusual anatomic location along the milk line. The study was approved by the local Ethics Committee (protocol no: 12.01.2023-2023/02) Informed consent was obtained from the patient. The patient is surgically treated and supplemented with neoadjuvant chemotherapy,radiotherapy and endocrine therapy. Histopathological examination revealed the diagnosis of invasive ductal carcinoma. The right common femoral vein was reconstructed with bovine pericardial patch after totally removal of the mass. This report alerts the reader to be cognizant of the unusual location of an ectopic breast cancer which was detected in the inguinal region with a common femoral vein invasion and discusses the treatment, suggesting novel therapeutic advice that could bring considerable clinical advantages. A multidisciplinary approach should be warranted in such cases to confirm a complete remission.

Proteomics-Based Identification of Dysregulated Proteins and Biomarker Discovery in Invasive Ductal Carcinoma, the Most Common Breast Cancer Subtype.

Invasive ductal carcinoma (IDC) is the most common histological subtype of malignant breast cancer (BC), and accounts for 70-80% of all invasive BCs. IDC demonstrates great heterogeneity in clinical and histopathological characteristics, prognoses, treatment strategies, gene expressions, and proteomic profiles. Significant proteomic determinants of the progression from intraductal pre-invasive malignant lesions of the breast, which characterize a ductal carcinoma in situ (DCIS), to IDC, are still poorly identified, validated, and clinically applied. In the era of "6P" medicine, it remains a great challenge to determine which patients should be over-treated versus which need to be actively monitored without aggressive treatment. The major difficulties for designating DCIS to IDC progression may be solved by understanding the integrated genomic, transcriptomic, and proteomic bases of invasion. In this review, we showed that multiple proteomics-based techniques, such as LC-MS/MS, MALDI-ToF MS, SELDI-ToF-MS, MALDI-ToF/ToF MS, MALDI-MSI or MasSpec Pen, applied to in-tissue, off-tissue, BC cell lines and liquid biopsies, improve the diagnosis of IDC, as well as its prognosis and treatment monitoring. Classic proteomics strategies that allow the identification of dysregulated protein expressions, biological processes, and interrelated pathway analyses based on aberrant protein-protein interaction (PPI) networks have been improved to perform non-invasive/minimally invasive biomarker detection of early-stage IDC. Thus, in modern surgical oncology, highly sensitive, rapid, and accurate MS-based detection has been coupled with "proteome point sampling" methods that allow for proteomic profiling by in vivo "proteome point characterization", or by minimal tissue removal, for ex vivo accurate differentiation and delimitation of IDC. For the detection of low-molecular-weight proteins and protein fragments in bodily fluids, LC-MS/MS and MALDI-MS techniques may be coupled to enrich and capture methods which allow for the identification of early-stage IDC protein biomarkers that were previously invisible for MS-based techniques. Moreover, the detection and characterization of protein isoforms, including posttranslational modifications of proteins (PTMs), is also essential to emphasize specific molecular mechanisms, and to assure the early-stage detection of IDC of the breast.

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Overdiagnosis of lobular carcinoma of breast- A review of histomorphological features and immunohistochemistry: A case series

: Invasive lobular carcinoma (ILC) accounts for 5%–15% of all invasive breast cancers (BCs) and is the second most common type of BC behind invasive ductal carcinoma (IDC) of no special type. ILC of the breast is characterized morphologically by small, noncohesive cells that infiltrate the stroma in a single-file pattern(Indian file pattern). ILC tumours display features associated with a good prognosis, being low grade, oestrogen receptor positive and is mainly associated with the complete loss of E-cadherin (E-cad) expression.To review the cases of invasive lobular carcinoma and to immunohistochemically categorize IDC and ILC.This is a retrospective study including all the modified radical mastectomy cases of invasive lobular carcinoma of breast reported in the department of Pathology of a tertiary care centre from January 2021 to January 2022. Histopathological and immunohistochemical analysis of those cases were reviewed.We encountered 10 cases of invasive lobular carcinoma of breast from January 2021 to January 2022. The average age of the patients was 55.9 years old (35–72). The classic presentation was a breast lump found in 100% of the cases. On physical examination, breast carcinoma was suspected in all the patients. The average size of the tumours was 4.5 cm (1.4– 9cm). Out of those 10 cases, 4 cases were right sided lesion and modified radical mastectomy was performed in all the 10 cases. All the 10 cases were diagnosed as invasive lobular carcinoma on histopathology and review of those cases showed 7 out of 10 cases to be IDC. Those cases showed pitfalls in histomorphological analysis which were later confirmed by immunohistochemistry. The findings are presented in the study.Our study found that there was a histomorphological pitfall in the diagnosis of IDC. In ambiguous cases with histologically equivocal features, a strong, complete, membranous E-cadherin expression may help in resolving the problem and in aiding in the subclassification of invasive breast carcinoma.

Diagnostic Value of Ultrasound Elastography in the Differentiation of Breast Invasive Ductal Carcinoma and Ductal Carcinoma In situ.

Ultrasound elastography (US-E) has been shown superior to the conventional US in diagnosing benign and malignant breast lesions. In contrast, the role of US-E in the differentiation of breast invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) has been poorly described. This study was designed to examine the diagnostic value of US-E in the differentiation of IDC and DCIS. Medical records of all patients who underwent preoperative US-E evaluation and were diagnosed with IDC or DCIS at our hospital from April-December 2019 were retrieved and analyzed. Those who had prior surgical treatment, chemotherapy or radiotherapy were excluded. Twenty women with DCIS and 111 women with IDC were included in this study. There were no significant differences in age, maximum lesion diameter and tumor volume between the two groups. While shear wave velocity (SWV) inside the lesion and in the surrounding tissue, strain ratio and tumor area ratio were not substantially different between the two groups, SWV at the edge of the lesion was significantly higher in IDC cases, which had an AUC value of 0.66 with a sensitivity of 65.8% and a specificity of 60.0% for the differential diagnosis of IDC and DCIS. Edge SWV is significantly higher in IDC than that in DCIS, which had a moderate diagnostic value for the differentiation of IDC and DCIS, similar to the performance of diffusion-weighted magnetic resonance imaging as reported in the literature. In terms of cost-effectiveness, US-E could be very useful while waiting for further evaluations to determine whether US-E combined with other diagnostic modalities improves the diagnostic performance.

Artificial intelligence enhanced thermal breast imaging in the diagnosis of invasive breast cancer: a study of 2 case reports

Background: Invasive ductal carcinoma (IDC) of the breast is the most common type of breast cancer in women. Imaging by mammography and/or ultrasonography and histo-pathological examination are collectively used to confirm a diagnosis of IDC. However, the standard imaging modalities are resource intensive and hence, have limited feasibility in resource-limited countries. Thermalytix, an affordable, radiation-free test is a novel Artificial Intelligence (AI)-powered breast cancer detection tool that has shown effectiveness in detecting breast cancer in both symptomatic and asymptomatic women. Case Presentation: We describe two cases of symptomatic women who, on Thermalytix, were identified with a lesion suspicious of malignancy and confirmed as IDC on further evaluation by standard of care imaging and tissue diagnosis. Conclusion: Thermalytix, a new AI-based computer diagnostic solution (Computer diagnostic solution), has the potential to identify breast malignancies such as IDC.

Does the number of cell forming tumor budding alter the prognostic value in invasive ductal carcinoma of breast?

The most commonly used definition for tumor budding (TB) is a single or a cell cluster of tumor cells up to 4 cells. However, there are different opinions regarding the number of cell (NOC) forming TB. It has been proven that TB is associated with poor prognostic factors in most tumors. The current study, it was aimed to investigate the prognostic value of NOC forming TB in invasive ductal carcinoma of the breast. 326 cases with the diagnosis of invasive ductal carcinoma were examined. The NOC forming TB was counted from hematoxylin and eosin stained slide under X200 magnification for each case, and scoring five different TB as 1, ≤2, ≤3, ≤4, ≤5, respectively. Receiver operating characteristic (ROC) analysis based on survival was performed for each TB value separately, and the cut-off was determined. All TB values were associated with poor outcome (p<0.001), presence of distant metastasis (p<0.001), high Ki67 proliferation index (p<0.05), advanced stage (p<0.05), presence of lymphovascular invasion (p<0.001), and metastatic axillary lymph node (p<0.001). According to ROC analysis performed to compare the predictiveness of survival, the area under the curve was similar for all TB values. TB was associated with poor prognostic parameters, and the prognostic value of TB was not affected by NOC forming TB. The NOC up to 4 cells which have been accepted for colon carcinomas, could also provide practicality in breast carcinomas.

Biomarker panel for early screening of trastuzumab -induced cardiotoxicity among breast cancer patients in west virginia.

Cardiotoxicity is a well-known pathophysiological consequence in breast cancer patients receiving trastuzumab. Trastuzumab related cardiotoxicity typically results in an overall decline in cardiac function, primarily characterized by reduction in left ventricular ejection fraction (LVEF) and development of symptoms associated with heart failure. Current strategies for the monitoring of cardiac function, during trastuzumab therapy, includes serial echocardiography, which is cost ineffective as well as offers limited specificity, while offering limited potential in monitoring early onset of cardiotoxicity. However, biomarkers have been shown to be aberrant prior to any detectable functional or clinical deficit in cardiac function. Hence, this study aims to develop a panel of novel biomarkers and circulating miRNAs for the early screening of trastuzumab induced cardiotoxicity. Patients with clinical diagnosis of invasive ductal carcinoma were enrolled in the study, with blood specimen collected and echocardiography performed prior to trastuzumab therapy initiation at baseline, 3- and 6-months post trastuzumab therapy. Following 6-months of trastuzumab therapy, about 18% of the subjects developed cardiotoxicity, as defined by reduction in LVEF. Our results showed significant upregulation of biomarkers and circulating miRNAs, specific to cardiac injury and remodeling, at 3- and 6-months post trastuzumab therapy. These biomarkers and circulating miRNAs significantly correlated with the cardiac injury specific markers, troponin I and T. The findings in the present study demonstrates the translational applicability of the proposed biomarker panel in early preclinical diagnosis of trastuzumab induced cardiotoxicity, further allowing management of cardiac function decline and improved health outcomes for breast cancer patients.

A case report of coexistent carcinoma breast with chronic myeloid leukemia

Multiple primary cancers are gradually becoming a regular condition and frequently result in many diagnostic and therapeutic difficulties. In our case report we present a 68-year female with breast lump who was incidentally diagnosed with chronic myeloid leukemia. The fine needle aspiration biopsy (FNAC) of the breast lump lead to the diagnosis of Invasive ductal carcinoma.

A case of axillary traumatic neuroma mimicking local recurrence following cancer surgery and a review of the literature

Traumatic neuroma (TN) is a non-neoplastic proliferative response developing against neuronal injury. Its pathogenesis is unknown: While its overall incidence is low, the incidence of traumatic neuroma development following mastectomy is even lower. Thirty-eight post-mastectomy traumatic neuromas in 30 patients were reported in the literature. Only two of these were in the axillary region, whereas the others had originated from the mastectomy scar tissue. Even though the ultrasonographic examination reveals the features of a benign mass, performing a histopathological examination is a must for definitive diagnosis of the mass and exclusion of local recurrence, mainly when it has developed following cancer surgery. Here, we aimed to discuss in the light of the literature a patient who had undergone mastectomy and axillary dissection with the diagnosis of invasive ductal carcinoma eight years ago and underwent recurrent axillary dissection with the preliminary diagnosis of axillary metastasis.

A Stacked Ensemble-Based Classifier for Breast Invasive Ductal Carcinoma Detection on Histopathology Images

Breast cancer is one of the main causes of death in women. When body tissues start behaves abnormally and the ratio of tissues growth becomes asymmetrical then this stage is called cancer. Invasive ductal carcinoma (IDC) is the early stage of breast cancer. The early detection and diagnosis of invasive ductal carcinoma is a significant step for the cure of IDC breast cancer. This paper presents a convolutional neural network (CNN) approach to detect and visualize the IDC tissues in breast on histological images dataset. The dataset consists of 90 thousand histopathological images containing two categories: Invasive Ductal Carcinoma positive (IDC+) and Invasive Ductal Carcinoma negative (IDC-). For the detection of this disease, we have proposed an ensemble learning-based deep learning model that consists of the multi-model structure having different internal configuration settings of CNN. As a result, the proposed method has significant progress as per present techniques in terms of accuracy as 92.7%. Therefore, the ensemble approach of multi-model CNN can provide the evolution of IDC at different stages, and this would help the pathologist in the cure of cancer. The experimented results show that the proposed ensemble-based approach of multi-model CNN generated the preeminent results with an accuracy of 92.7% as compared to the already existing techniques.

On the Dynamics and Feasibility of Transferred Inference for Diagnosis of Invasive Ductal Carcinoma: A Perspective

It is generally noticed that increasing the number of convolutional layers in generic image classification procedures proves to be detrimental to model performance in terms of validation accuracy and loss. Apart from vanilla CNNs, we have state-of-the-art (SOTA) architectures such as ResNet50 (and its variants) which show that through the use of skip-connections, higher performance metrics are attainable through deeper architectures. However, most evaluative metrics converge on a log scale as we go deeper with diminishing gradient of the metrics&#x2019; curves. Given these two contrasting speculations, in this paper, we implement various vanilla and SOTA CNNs for the diagnosis of one of the most common forms of breast cancer - invasive ductal carcinoma (IDC) - to examine and understand the feasibility of implementation of SOTA CNNs through transferred weights when juxtaposed with vanilla CNNs (and LeNet-5) of varying configurations in terms of their performance metrics and other parameters. In this paper, we solve the dual-objective of studying behavioural aspects of avant-garde CNN models (more specifically, VGG16, VGG19, ResNet50, ResNet50V2, MobileNetV2, and DenseNet121) and proper diagnosis of IDC through intermediate neural activations to critically evaluate and theorize the performance of different models. We notice that among all the models, only VGG16, VGG19, LeNet-5 and a selected vanilla CNN through an optimization procedure were the ones to attain the best metrics, shared amongst them.