Ductal Breast Research Articles

Expression of epithelial and mesenchymal markers in invasive (ductal) breast carcinoma and nodal metastasis

Introduction The phenomenon, Epithelial-mesenchymal transition (EMT) has been shown to enable epithelial cells to acquire a mesenchymal phenotype facilitating cancer cell mobilization. Evidence in favour has been derived predominantly from cancer cell lines and/or animal model studies. The objectives of this study were to observe E-cadherin and vimentin expression patterns in invasive (ductal) breast carcinoma-no special type (BCa) and corresponding metastatic lymph nodes (mLNs) and to compare the expression of these markers in BCa with and without metastasis using clinical samples. Methodology Tissues of 24 metastatic BCa (mBCa) with mLNs and 17 non metastatic BCa (nmBCa) obtained from the Department of Pathology, Faculty of Medicine, Peradeniya were included. Immunohistochemical expression of E-cadherin (epithelial cell adhesion membrane marker) and vimentin (mesenchymal cytoplasmic marker) was observed on all BCas and mLNs. Ten random high-power fields (10x40) of 100 cells each were assessed to determine the percentage of positive cells . The mean expression of markers was compared between mBCa and nmBCa by independent sample T-test and mBCa and mLN by paired sample T-test. Results The mean E-cadherin expression was 70.54% (27.67%-97.67%) in mBCa, 86.40% (63.33%-96.67%) in nmBCa and 89.95% (46.33%-100%) in mLNs. The mean vimentin expression was 6.54% (2.37%-13.87%) in mBCa, 5.39% (2.12%- 9.77%) in nmBCa and 1.28% (0.13%-8.25%) in mLNs. The E-cadherin expression was significantly lower in mBCa compared to nmBCa (p=0.002) and in mBCa compared to mLNs (p=0.000). Vimentin expression was not significant between mBCA and nmBCa (p=0.176). Higher vimentin expression in mBCa compared to mLNs was statistically significant (p=0.000). Discussion and conclusion The significantly lower expression of E-cadherin in mBCa compared to nmBCa suggests that loss of epithelial cell properties promotes metastasis. Significantly lower E-cadherin and significantly higher vimentin expressions in mBCa compared to mLNs is supportive of EMT in BCa. The reversed pattern is noted in nodal BCa metastasis suggesting the possibility of mesenchymal-epithelial transition of metastatic cancer cells in the lymph node.

Clinical efficacy of fiberoptic ductoscopy in combination with ultrasound-guided minimally invasive surgery in treatment of plasma cell mastitis

Objectives: To analyze clinical efficacy between fiberoptic ductoscopy plus ultrasound-guided minimally invasive irrigation and lesion resection in treating plasma cell mastitis (PCM), aiming to provide clinical evidence for treating PCM. Materials and Methods: 119 patients undergoing fiberoptic ductoscopy plus ultrasound-guided minimally invasive surgery in Ningxia People's Hospital were allocated into the breast duct irrigation group, and 95 counterparts receiving lesion resection in the Affiliated Hospital of Ningxia Medical University into the control group. Clinico-pathological characteristics and therapeutic effect were compared between two groups. Results: The cure rate in the breast duct irrigation group was 98.31% (117/119), significantly higher than 90.53% in the control group (p p Conclusions: Fiberoptic ductoscopy plus with ultrasound-guided minimally invasive drainage is a novel and effective treatment of PCM with high cure rate, low recurrence rate, slight pain, and effectively maintains breast integrity.

Automated breast ultrasound for the detection and reconstruction of the breast ductal pattern

Purpose Automated 3D breast ultrasound (ABUS) has shown several advantages over the conventional handheld systems and promising results in screening women with dense breasts. In addition, ABUS seems to offer a unique opportunity for mapping in vivo the normal ducts thus improving our understanding of normal/malignant relationships in the adult female breast. Preliminary results of such a study are reported here. Materials and methods Six lactating, nursing volunteers were scanned with the Invenia™ ABUS system (GE Healthcare, WI, USA). The women were imaged before and after breastfeeding their infants. Ductal patterns were generated from the manual segmentations of two experts. Results were qualitatively compared to published work. Descriptive statistics and the t -test were applied to characterize the population and variabilities. Results Milk filled ducts in lactating women offered a natural contrast agent but empty ducts may also be observed under light breast compression. Most of the ducts were detected and 3D maps were generated. An increased localized activity of milk filled ducts was observed in the lower outer quadrants of all breasts. Ducts from the upper quadrants show involvement in women breastfeeding the longest (11–18 months). Intra- and inter-volunteer variabilities were significant. Conclusion The ABUS system provided sufficient information to detect and segment most of the breast ducts. The observed localized activity of the ducts agrees with results from prior similar studies and raises new important issues regarding the role of duct involution on cancer development. Further testing is justified as is the development of computer algorithms for automated 3D ductal structure generation.

Easily recognizable sonographic patterns of ductal carcinoma in situ of the breast

BackgroundDuctal carcinoma in situ (DCIS) is a malignant proliferation of ductal epithelium confined by the basement membrane of the involved breast ducts. The aim of this study was to categorize positive findings of DCIS of the breast on sonography. MethodsFrom 2007 to 2011, 100 pathologically proven DCIS lesions were evaluated. Four sonographic patterns used to identify DCIS have been characterized as cumulus-type, coral-type, pipe-type, and miscellaneous lesions. ResultsThe lesion numbers of nonhigh-grade and high-grade DCIS were 44 and 56, respectively. The coral type (42%) was the most commonly found lesion, followed by cumulus-type (38%), pipe-type (17%), and miscellaneous (3%) lesions. There was no significant difference between the sonographic pattern and nuclear grades. However, the coral-type group was composed of significantly more high-grade DCIS cases than the other three types (p < 0.05). ConclusionCoral-, cumulus-, and pipe-type lesions are three easily recognizable sonographic findings of DCIS. Improving the breast ultrasound technique to better demonstrate the sonographic pattern is necessary to facilitate breast lesion interpretation.

The relationship between histologic grades of invasive carcinoma of breast ducts and mast cell infiltration

[This corrects the article on p. 5 in vol. 5, PMID: 27169108.].

Cancer cases attributable to alcohol consumption in Brazil.

This is the first study specifically estimating the proportion of new cancer cases that could be attributable to alcohol consumption in the year 2012 in Brazil. The proportion of exposed cases and the association between alcohol and lip and oral cavity, nasopharynx, other pharynx, larynx, esophagus, colorectum, female breast, liver, and intrahepatic bile ducts cancers was based on data made available by the Integrator System of Hospital Cancer Registries. The cancer incidence was obtained from the estimates produced by GLOBOCAN. In 2012 there were 437,592 new cancer cases in Brazil, excluding non-melanoma skin cancers. Of these, alcohol consumption was responsible for 4.8% of all new cases. The alcohol-attributable fraction was higher for men (7.0%) than for women (2.6%). A total of 21,000 new cancer cases, 15,554 in men and 5,646 in women, could be attributable to alcohol consumption. In Brazil, a significant fraction of cancer cases can be attributed to alcohol consumption, and public health measures to prevent heavy alcohol use should be implemented.

Health care utilization trends in ductal carcinoma in situ admissions.

e18053Background: Ductal carcinoma in situ (DCIS) is a neoplasm confined to breast ducts. The incidence of DCIS has increased since 1970s with acceptance of screening mammography. The treatment of ...

Postaugmentation Galactocele Without Periareolar Incision and 8 Years After Pregnancy.

Sir: Galactocele is a rare breast augmentation complication. Addressing the risk factors involved, Harper et al1 found from previous galactocele reports that 100% of the implants were placed through periareolar incisions and 75% of patients either were on oral contraceptives at the time of their surgery or were lactating after pregnancy, with a remote history of augmentation mammaplasty. A recent retrospective study involving 832 patients and 3 (0.36%) cases of galactocele2 found that the use of a periareolar incision significantly increased the incidence of galactorrhea, but no mention toward increased risk of galactocele. We present a case of postaugmentation galactocele formation without periareolar incision and 8 years after her unique pregnancy. Our patient was a 26-year-old, gravida 1, para 0, abortus 1, without any significant medical or surgical history. She stopped oral contraceptives 30 days before and after surgery. An ultrasound scan showed 1 small (1.1 cm3) benign simple cyst in each breast. She underwent bilateral subglandular augmentation mammaplasty with 285 mL high-profile Silimed (Rio de Janeiro, Brazil) silicone gel implant and vertical, infra-areolar skin excess resection. She developed a painful enlargement of her left breast on postoperative day 17, without signs of inflammation or fever (Fig. ​(Fig.1).1). A postoperative ultrasound scan showed liquid collection around the implant but not suggestive of hematoma. A guided needle aspiration removed 89 mL of creamy fluid; the culture was negative for bacterial growth but biochemistry analyses concluded that it was breast milk. The patient was referred to a mastologist who started dopamine receptor agonist (bromocriptine), despite normal prolactin, for 2 weeks with no recurrence. Due to breast and implant pocket enlargement, the patient underwent revision surgery 6 months later to correct the left ptosis (Fig. ​(Fig.2)2) by skin resection, and the implant was moved to a dual plane pocket. The implant on the other side was also moved to the dual plane pocket due to breast symmetry. Fig. 1. Marked enlargement of the left breast at day 17 postoperatively. Fig. 2. Residual asymmetry due to left breast and implant pocket enlargement after galactocele’s treatment at 6 weeks postoperatively. Galactocele’s pathogenesis is still unknown, but obstruction of breast ducts associated with high levels of prolactin may play a significant role.3 Hyperprolactinemia may be due to intercostal nerve stimulation during surgery, leading to autonomic control over central neurogenic paths diminishing dopamine output into hypophysis’ portal circulation, increasing prolactin levels and milk secretion.4 Because our patient had none of the risk factors previously reported5 (periareolar incision, contraceptives intake, recent pregnancy or lactation, or hyperprolactinemia symptoms), we rely our etiopathogenesis hypothesis on duct obstruction because simple cysts were found preoperatively inside breast parenchyma. The treatment involved ultrasound-guided needle aspiration associated with dopamine agonist (bromocriptine) to halt hyperprolactinemia and milk production, which was successful with no recurrence. Other causes of hyperprolactinemia should be ruled out. Although it is rare, surgeons should be aware of this complication in augmentation mammaplasty. Considering the potential increased risk for galactocele, patients with previous thoracic or breast surgery, breast cysts, or spontaneous breast discharge should be assessed preoperatively for prolactin status to correct eventual disorders.

Abstract P2-12-22: Atypical ductal hyperplasia and breast cancers - A ten year clinical and pathological review on core biopsy, lumpectomy and mastectomy specimens

Abstract Introduction Atypical ductal hyperplasia (ADH) is known to be associated with underlying pre-malignant or malignant breast conditions. Here we report our 10-year data on ADH found in core biopsy, lumpectomy and mastectomy specimens Methods From 1st January 2005 to 31st December 2014, a total of 104 core needle biopsy specimens and 218 lumpectomy / mastectomy specimens were found to contain ADH. Clinical, radiological and pathology data were retrieved and analysed from a prospectively-maintained database. Results Out of the 104 patients with core biopsy showing ADH, 101 patients received excision and 3 refused operation. 34 patients turned out to have ductal carcinoma in-situ (DCIS) on excision, while 6 had invasive ductal carcinoma (IDC), 1 had lobular carcinoma in-situ (LCIS) and 1 had angiosarcoma resulting in an upstaging rate of 40.4% (42/104). The remaining patients had benign lesions including papillary lesions, fibrocystic disease, or ADH alone. Multivariate analysis found that the only correlating factor for the presence of DCIS or IDC was suspicious mammographic features (BIRADS 4 or above) (P = 0.008 and 0.02 respectively) but not other parameters such as extent of micro-calcifications (P = 0.12) or age (P = 0.11). Histopathological diagnosis after excision of lesions containing ADH on core biopsyExcisional Biopsy ResultNumber (%)DCIS34 (32.7%)ADH32 (30.8%)Benign27 (26%)IDC6 (5.8%)LCIS1 (0.9%)Angiosarcoma1 (0.9%)Refuse operation3 (2.9%) 218 lumpectomy or mastectomy specimens were found to harbor ADH. 62 (28.4%) had co-existing pre-malignant or malignant breast diseases. The only determining factor for the presence of malignant or pre-malignant condition was suspicious breast imaging features (BIRADS 4 or above) after multivariate analysis (P = 0.0003). Co-existing conditions in the lumpectomy / mastectomy specimens with ADHCo-existing Patholog(ies)Number (%)Atypical Ductal Hyperplasia alone97 (44.4%)Fibroadenoma / Fibrocystic disease31 (14.2%)Intraductal papilloma22 (10%)Phyllodes tumor6 (2.8%)Ductal carcinoma in-situ36 (16.5%)Invasive ductal carcinoma23 (10.6%)Lobular carcinoma in-situ1 (0.5%)Invasive lobular carcinoma1 (0.5%)Malignant phyllodes tumor1 (0.5%) Conclusion ADH is closely related to the presence of invasive cancer or DCIS especially when suspicious breast imaging features are present. The upstaging rate is still high in patients where initial biopsy was ADH. Citation Format: Co M, Kwong A. Atypical ductal hyperplasia and breast cancers - A ten year clinical and pathological review on core biopsy, lumpectomy and mastectomy specimens. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-12-22.

Abstract P6-10-12: Volumetric breast density better predicts tumour characteristics associated with poor prognosis compared to visual BI-RADS

Abstract Purpose: Early detection of breast cancer through mammography screening reduces breast cancer mortality. To improve outcomes from screening, more than half of invasive cancers and a third of high grade cancers should be small at detection (&amp;lt;15mm), and more than 70% of all cancers should be node negative at diagnosis. Although breast density is associated with reduced mammographic sensitivity, it is unclear whether certain tumor characteristics associated with poorer prognosis are more prevalent in women with denser breasts. The study investigated associations between visually- or volumetrically-assessed breast density and tumor characteristics related to poor prognosis. Methods: Our IRB-approved study included 755 DCIS, invasive ductal or invasive lobular breast cancers diagnosed in women (aged over 40) between January 2009 and December 2012. Information on the patients' tumor characteristics including stage, size, receptor, grade and lymph node status was collected retrospectively. Women were excluded if they had a previous history of breast cancer or breast surgery, or if they were missing tumour size data or raw digital mammograms taken within 24 months of the cancer diagnosis. For women with multiple cancers, only the first diagnosed cancer was included. Breast density was assessed using visual BI-RADS density categories and Volpara Density Grades (VDG; an automated equivalent to 4th Edition BI-RADS, assigned using preset cut-offs of volumetric breast density: 4.5, 7.5, 15.5 and &amp;gt;15.5%). VDG was calculated from both breasts if the prior negative mammogram was available, and the contralateral breast for positive mammograms. Results: Overall, 55% of invasive tumors and 33% of grade 3 tumors were smaller than 15 mm and 83% were node negative. Mean tumor size increased significantly with increasing VDG (VDG 1 = 12.8, 2 = 14.7, 3 = 16.1, 4 = 20.4 mm, p&amp;lt;0.001) and increasing BI-RADS (1 = 12.2, 2 = 13.9, 3 = 16.8, 4 = 18.2 mm, p=0.01). The proportion of node positive tumors also increased significantly with increasing VDG (5.1%, 12.8%, 19.3%, 26.1%, p&amp;lt;0.001) and BI-RADS (0%, 10.6%, 19.5%, 26%, p=0.01). There was a significant increase in grade 3 tumors (11%, 16.1%, 21.7%, 21.7%, p =0.02) and HER-2 positive tumors (5.6%, 10.5%, 13.3%, 14.3%, p=0.02) with increasing VDG that was not seen with visual BI-RADS assessment (p=0.4). Increasing VDG was also significantly associated with increased proportions of larger (i.e. &amp;gt;15mm) node positive cancers (1.7%, 6.3%, 10.5%, 16%, p=0.004) that were not seen with BI-RADS (p=0.2). Conclusion: We found that tumour size and node status differed significantly with breast density as measured by VDG and visual BI-RADS. However, grade 3, HER-2 positive and large/node-positive cancers were all significantly associated with increasing VDG, but not BI-RADS density grade. Further research is needed to investigate whether automated volumetric breast density can be used to predict which women are more likely to be diagnosed with tumours that have poorer prognostic features. Citation Format: Johnston L, Chan A, Arieno A, Morgan R, Highnam R, Destounis S. Volumetric breast density better predicts tumour characteristics associated with poor prognosis compared to visual BI-RADS. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-10-12.

Relationship between erb-B2 mRNA Expression in Blood and Tissue of Invasive Ductal Carcinoma Breast Cancer Patients and Clinicopathological Characteristics of the Tumors.

Molecular detection methods such as RT-PCR for detecting breast cancer-associated gene expression in the peripheral blood have the potential to modify breast cancer (BC) staging and therapy. In this regard, we evaluated the potential of erb-B2 molecular marker in BC detection and analyzed the expression of erb-B2 mRNA in the peripheral blood and fresh tissue samples of 50 pretreated female BC patients and 50 healthy females by reverse transcription-PCR (RT-PCR) method. We also assessed the correlation of erb-B2 mRNA marker positivity in peripheral blood and tumor tissue samples with clinical and pathological factors in BC patients in order to evaluate its prognostic value. It was shown that there is a significant difference between healthy females and BC patients with expression of the erb-B2 molecular marker (p<0.01). A significant difference between the expression of erb-B2 in the peripheral blood and tissue samples of BC patients (p<0.01) and the frequency of circulating erb-B2 mRNA expression in peripheral blood and in tissue was detected by RT-PCR. No correlation was found between erb-B2 mRNA expression in blood or tumor tissue samples and lymph node, tumor grade, tumor stage, tumor size, patient's age, ki67, estrogen receptor (ER), progesterone receptor (PGR), P53, and HER-2 status. However, in a small subset of 31 BC patients we found that expression of erb-B2 in peripheral blood or in both peripheral blood and tumor tissue was directly correlated with lympho-vascular invasion and perineural invasion as poor prognostic features. The highest rates of erb-B2 expression in peripheral blood or tumor tissue were in the ER and PR negative and HER-2 positive group. This study suggests that the application of the RT-PCR and immunohistochemical methods for erb-B2 molecular marker detection would provide a higher detection rate, especially in early stage BC.

New look inside human breast ducts with Raman imaging. Raman candidates as diagnostic markers for breast cancer prognosis: Mammaglobin, palmitic acid and sphingomyelin

Looking inside the human body fascinated mankind for thousands of years. Current diagnostic and therapy methods are often limited by inadequate sensitivity, specificity and spatial resolution. Raman imaging may bring revolution in monitoring of disease and treatment. The main advantage of Raman imaging is that it gives spatial information about various chemical constituents in defined cellular organelles in contrast to conventional methods (liquid chromatography/mass spectrometry, NMR, HPLC) that rely on bulk or fractionated analyses of extracted components. We demonstrated how Raman imaging can drive the progress on breast cancer just unimaginable a few years ago. We looked inside human breast ducts answering fundamental questions about location and distribution of various biochemical components inside the lumen, epithelial cells of the duct and the stroma around the duct during cancer development. We have identified Raman candidates as diagnostic markers for breast cancer prognosis: carotenoids, mammaglobin, palmitic acid and sphingomyelin as key molecular targets in ductal breast cancer in situ, and propose the molecular mechanisms linking oncogenes with lipid programming.

Squamous Papilloma over Lid Margin: An Uncommon Presentation

ABSTRACT Papilloma is a histopathological term describing tumors of a classical finger-like or cauliflower morphology. Though benign, they carry profound malignancy potential and can present at numerous anatomical locations, such as skin, cervix, esophagus, respiratory tract, breast duct, etc. Papillomas over conjunctiva are not frequently encountered and carry special significance. A 60-year-old diabetic female presented with a left upper lid marginal sessile mass of 9 months duration with mild epiphora and foreign body sensation. On examination, a solitary, fleshy, sessile, polypoidal mass measuring 1 × 1 cm was seen, with irregular cauliflower-like surface present over lateral aspect of left upper lid, firm in consistency with raised edges. Visual acuity in right eye was 6/18→6/9 and left eye 6/36→6/9, intraocular pressure (IOP) was 14.6 mm Hg in both eyes by Schiotz tonometry. Complete excision of the lesion employing microsurgical technique with close apposition of lid margin using 6-0 Vicryl sutures was done under local anesthesia (LA). Histopathological examination revealed stratified squamous epithelium forming papillae with variable goblet cells supported by prominent branching fibrovascular cores in the center. A satisfactory cosmetic result was achieved. Follow-up of 6 months did not reveal any recurrence. A satisfactory functional and cosmetic result achieved. Squamous papillomas over lid margin are uncommon presentations. Even though benign they carry morbidity potential in the form of chronic epiphora, corneal erosions, and lid deformities if inadequately managed. How to cite this article Goyal E, Gupta P, Dokania A, Rizvi Y. Squamous Papilloma over Lid Margin: An Uncommon Presentation. Int J Adv Integ Med Sci 2016;1(3):128-130.

Comparison of the influence of human epidermal growth factor receptor 2/neu on the markers of aggression in gastric adenocarcinomas and ductal carcinoma breast

Background: Human epidermal growth factor receptor 2/neu (HER2/neu) assessment is carried out in gastric adenocarcinomas (GAC) and invasive ductal carcinoma (IDC) breast to decide upon of trastuzumab targeted therapy. The study the only of its kind which has compared the influence of HER2/neu expression to markers of tumor aggression in these two malignancies in similar target population. Material and Methods: HER2/neu evaluation was conducted by immunohistochemistry (IHC) using the guidelines of Trastuzumab for Gastric Cancer trial for GAC and ASCO-CAP 2013 for IDC breast. The study correlated HER2/neu expression with markers of tumor aggression. Aims: The present retrospective study compares the disease influence of HER2/neu over expression on markers of disease aggression like age at presentation, grade of tumor and lymph node metastasis in GAC and IDC. Results: We have compared 82 cases of GAC with 113 cases of IDC. HER2/neu expression was seen in 23.2% and 36.3% of GACs and IDCs respectively. The mean age of HER2/neu positive GACs was found to be 3.47 years greater than their negative counterpart but the pattern was reversed in cases of IDC breast where the mean age of HER2/neu positive tumors was 6.09 years less than their negative counterpart. Though no correlation was found between grade of tumor and HER2neu status in GACs (P = 0.2930), however in IDC breast a significant correlation HER2neu positivity was found with higher grade (P = 0.0002). Similarly though we did not find any correlation of HER2neu status with nodal metastasis in GACs (P 0.0511) but in IDCs a significant correlation was found of nodal metastasis with HER2/neu positivity (P = 0.0001). Conclusion: We conclude that HER2/neu expression is more frequent in IDC breast and is significantly associated with markers of aggression in contrast to its influence on the same markers in GACs.

Micro RNA-142-5p Profile as a Predictor of Tumor Markers Regulation in Different Histological Grades of Human Breast Carcinoma

Micro RNA (miRNA) is one of the kinds in non coding RNA class that regulates gene expression by translational repression, mRNA cleavage, mRNA disruption initiated by miRNA-guided rapid de-adenylation. Up- and/or down-regulated expression study of the miRNA is a good approach to study their function in cancer pathogenesis. In our previous study we understood the down regulation of polycomb gene BMI1 and its correlation with histochemical markers like ER, PR and Her2 in different histological grades of breast tumors. To derive on the identification of regulatory factor accountable for this gene regulation pattern, we tried to identify miRNA that could sway on the gene regulation with the consecutive tumor grades. To adequate this perspective we identified miR-142-5p as a regulating marker for the proliferation of human ductal invasive breast carcinoma using microarray hybridization and attempted to demonstrate the expression profile of miR-142-5p in various histological grades of human breast carcinoma using Real time-PCR amplification. The up regulation of miR-142-5p in histological Grades I, II and III predicted variation with the hormone receptor status. The miR-142-5p up regulation was vice versa with the down regulation of BMI1 gene in the tumors from Grade I to Grade III. Hence with the severity in tumor the up regulated miR-142-5p was estimated to show substantial regulatory effect on expression of the histological markers and polycomb gene BMI1. These signatures shall hold on the diagnosis and therapy for human breast carcinoma.

The relationship between histologic grades of invasive carcinoma of breast ducts and mast cell infiltration.

Introduction:Breast carcinoma is the most prevalent tumors among women. Transformation of inflated cells in immune response leads to increase in inflammatory cells such as macrophages, mast cells (MC) and fibroblasts. The aim of this study was to determine the relationship between grades of invasive carcinoma of the breast ducts and MC infiltration around tumoral cells.Methods:During the present study, 75 female patients suffering from invasive ductal carcinoma who underwent surgery or diagnostic biopsy during 2010 and 2013 in Educational-Medical centers of Tabriz University of Medical Sciences, were included in the study. Based on Bloom-Richardson grading system, 25 cases were selected from each grade. To better observe of MCs, samples were stained by Toluidine blue and MCs were counted in 10 40 × 10 fields.Results:The mean age was 47.56 ± 10.84 and the number of MCs was between 6 and 96 and their overall average was 43.01. Average count of MCs in grade 1, 2 and 3 were 15.92 ± 10.07, 45.32 ± 10.47, and 67.8 ± 20.70, respectively. There was a significant relationship between the number of MCs and increase in disease grade (P < 0.001). With increasing grade of malignancy, the number of MCs had grown. No significant relationship was observed between age and grade of disease or age and number of MC.Conclusion:According to obtained results, number of MC around tumoral cells increased significantly with an increase in the grade of disease. In order to treat in the first stages of the disease, recognizing primary changes in the stroma of cells could be helpful.

Granulomatosis with Polyangiitis: an Atypical Presentation

A 45-year-old female came to our attention with a 6-month history of ulcerative mass in her right breast, cough, shortness of breath, nasal obstruction with hematic discharge, and hearing loss. The patient underwent excision biopsy of breast lesion. Definitive pathology (Figure A) documented the presence of a granulomatous mastitis with suppurative necrotic foci (*), giant multinucleated cells (circles), and normal breast ducts trapped by neutrophilic-eosinophilic infiltrate (arrowheads).

Overexpressed genes associated with hormones in terminal ductal lobular units identified by global transcriptome analysis: An insight into the anatomic origin of breast cancer.

Although human breast ducts and terminal ductal lobular units (TDLUs) share the same cell types, ample evidence shows that TDLUs are the predominant site for the origin of breast cancer. Yet, there is still limited information concerning the molecular mechanisms. Analysis of transcriptomic profiles in TDLUs may provide insight into early breast tumorigenesis. We compared genome-wide expression profiles of 8 matched sets of breast main duct and TDLU samples, using significance analysis of microarray (SAM) software to screen differentially expressed genes (DEGs) with fold-change >2.0 and q-value <0.05. Moreover, we used Gene Ontology for functional enrichment analysis. We identified 472 DEGs between the two tissue types, and confirmed 17 randomly chosen DEGs by quantitative reverse transcription-PCR (qRT-PCR). Notably, hormone-related pathways were highly enriched in the TDLU samples, including various hormone-related DEGs that are associated with breast carcinogenesis and tumor progression. Oncogenic upregulation in TDLUs indicates a potential inappropriate or excessive response to successive hormone stimulus during the proliferation, differentiation and lactation cycles of the human mammary gland. Imbalanced hormone reactions may finally result in the early onset of neoplastic transformation that occurs mostly in breast TDLUs.

Multifocal adenoid cystic carcinoma of the breast: not always a quiet course

Adenoid cystic carcinoma (ACC) of breast is a fairly uncommon malignancy, accounting for 0.1% of all cases of breast carcinomas. Though ductal or lobular breast carcinomas can be multifocal/multicentric examples of the multifocal breast ACC is sparse. Hereby we report a case of retro-areolar multifocal ACC of the breast in a 36 year old female with typical grade 1 histomorphology. Characterization is important as ACC breast has an excellent prognosis with little chance of lymph node and distant metastases. However, our case metastasized after undergoing wide local excision. This example reminds both the physician and pathologist to consider ACC in the differential diagnosis of retroareolar multicentric/multifocal breast carcinoma and the importance of mastectomy with axillary clearance in all histological grades. The Sri Lanka Journal of Surgery 2015; 33(3): 18-19

Model predictions for the wide-angle x-ray scatter signals of healthy and malignant breast duct biopsies.

Wide-angle x-ray scatter (WAXS) could potentially be used to diagnose ductal carcinoma in situ (DCIS) in breast biopsies. The regions of interest were assumed to consist of fibroglandular tissue and epithelial cells and the model assumed that biopsies with DCIS would have a higher concentration of the latter. The scattered number of photons from a 2-mm diameter column of tissue was simulated using a 110-kV beam and selectively added in terms of momentum transfer. For a 1-min exposure, specificities and sensitivities of unity were obtained for biopsies 2- to 20-mm thick. The impact of sample and tumor cell layer thicknesses was studied. For example, a biopsy erroneously estimated to be 8mm would be correctly diagnosed if its actual thickness was between 7.3 and 8.7mm. An 8-mm thick malignant biopsy can be correctly diagnosed provided the malignant cell layer thickness is [Formula: see text]. WAXS methods could become a diagnostic tool for DCIS within breast biopsies.