Excised Breast Tissue Research Articles

Cross-Correlation of Confocal Images for Excised Breast Tissues of Total Mastectomy.

The purpose of this study is to develop an image artifact removal method for radar-based microwave breast imaging and demonstrates the detectability on excised breast tissues of total mastectomy. A cross-correlation method was proposed and measurements were conducted. A hand-held radar-based breast cancer detector was utilized to measure a breast at different orientations. Images were generated by multiplying the confocal image data from two scans after cross-correlation. The optimum reconstruction permittivity values were extracted by the local maxima of the confocal image intensity as a function of reconstruction permittivity. With the proposed cross-correlation method, the contrast of the imaging result was enhanced and the clutters were removed. The proposed method was applied to 50 cases of excised breast tissues and the detection sensitivity of 72% was achieved. With the limited number of samples, the dependency of detection sensitivity on the breast size, breast density, and tumor size were examined. The detection sensitivity was strongly influenced by the breast density. The sensitivity was high for fatty breasts, whereas the sensitivity was low for heterogeneously dense breasts. In addition, it was observed that the sensitivity was high for extremely dense breast. This is the first detailed report on the excised breast tissues.

Quantitative measurement of mammographic density in breast-tissue explants using portable NMR: Precision and accuracy.

Single-sided portable NMR (pNMR) has previously been demonstrated to be suitable for quantification of mammographic density (MD) in excised breast tissue samples. Here we investigate the precision and accuracy of pNMR measurements of MD ex vivo as compared with the gold standards. Forty-five breast-tissue explants from 9 prophylactic mastectomy patients were measured. The relative tissue water content was taken as the MD-equivalent quantity. In each sample, the water content was measured using some combination of three pNMR techniques (apparent T2, diffusion, and T1 measurements) and two gold-standard techniques (computed microtomography [μCT] and hematoxylin and eosin [H&E] histology). Pairwise correlation plots and Bland-Altman analysis were used to quantify the degree of agreement between pNMR techniques and the gold standards. Relative water content measured from both apparent T2 relaxation spectra, and diffusion decays exhibited strong correlation with the H&E and μCT results. Bland-Altman analysis yielded average bias values of -0.4, -2.6, 2.6, and 2.8 water percentage points (pp) and 95% confidence intervals of 13.1, 7.5, 11.2, and 11.8 pp for the H&E - T2, μCT - T2, H&E - diffusion, and μCT - diffusion comparison pairs, respectively. T1-based measurements were found to be less reliable, with the Bland-Altman confidence intervals of 27.7 and 33.0 pp when compared with H&E and μCT, respectively. Apparent T2-based and diffusion-based pNMR measurements enable quantification of MD in breast-tissue explants with the precision of approximately 10 pp and accuracy of approximately 3 pp or better, making pNMR a promising measurement modality for radiation-free quantification of MD.

Combined superior and inferior dermoglandular flaps for projection enhancement in giantic breast amputation and free nipple areola graft

Giantomastia has been a pathological condition in which excised breast tissue weighs more than1.5 kg per breast or when breast weight surpasses three percent of body weight. epidermis & Cooper's ligaments, which support breast tissue, expand as a result of breasts becoming heavier & larger, which causes breast ptosis. Numerous methods for correcting gigantomastia have been discovered. amputation for decreased studied cases who complain of gigantomastia & severe ptosis (space among nipple & inframammary fold exceeds twenty-five cm) are only eligible for mammaplasty with free nipple-areola grafting. purpose of that surgery is to achieve breast shape size that is acceptable while also relieving pain & suffering brought on by excessive breast tissue hypertrophy. flat, boxy breasts with poor projection is the main drawback of that treatment. Several flaps, including superior, inferior, medial, superomedial,& lateral-based flaps combined with wise-pattern skin excision, are employed to address this drawback.

Dielectric Characterization of Breast Biopsied Tissues as Pre-Pathological Aid in Early Cancer Detection: A Blinded Feasibility Study.

Dielectric characterization has significant potential in several medical applications, providing valuable insights into the electromagnetic properties of biological tissues for disease diagnosis, treatment planning, and monitoring of therapeutic interventions. This work presents the use of a custom-designed electromagnetic characterization system, based on an open-ended coaxial probe, for discriminating between benign and malignant breast tissues in a clinical setting. The probe's development involved a well-balanced compromise between physical feasibility and its combined use with a reconstruction algorithm known as the virtual transmission line model (VTLM). Immediately following the biopsy procedure, the dielectric properties of the breast tissues were reconstructed, enabling tissue discrimination based on a rule-of-thumb using the obtained dielectric parameters. A comparative analysis was then performed by analyzing the outcomes of the dielectric investigation with respect to conventional histological results. The experimental procedure took place at Complejo Hospitalario Universitario de Toledo-Hospital Virgen de la Salud, Spain, where excised breast tissues were collected and subsequently analyzed using the dielectric characterization system. A comprehensive statistical evaluation of the probe's performance was carried out, obtaining a sensitivity, specificity, and accuracy of 81.6%, 61.5%, and 73.4%, respectively, compared to conventional histological assessment, considered as the gold standard in this investigation.

Breast Cancer Detection by Terahertz UWB Microstrip Patch Antenna Loaded with 6X6 SRR Array

This paper presents cancer tumor detection in the breast phantom and cancer tissue detection in the excised breast tissue phantom by the ultra-wideband terahertz microstrip patch antenna. The proposed antenna structure consists of a silicon dioxide substrate with a dielectric constant of 3.9 and a thickness of 200 µm, a radiating gold patch of length 560 µm, width 700 µm, and thickness 36 µm which is on top of the substrate, and an array of 6 × 6 gold Split Ring Resonator at the ground plane. Each SRR is separated by 28.75 µm. An array of SRR at the antenna's ground plane enhances bandwidth, efficiency, gain, directivity and reduces back radiation. The antenna operates in the frequency range of 0.1-3 THz, with a gain of 19.22 dBi and an efficiency of 98.74%. The antenna setup with the breast phantom and excised breast tissue phantom in between have been designed and analyzed in the CST microwave studio 2019 version. Tumor in the breast phantom and the cancerous tissue in the breast tissue phantom can be detected by placing the phantoms between the two identical antennas. The difference in the dielectrics of the breast and the tumor layers can determine the difference between healthy and malignant tissue. A typical breast phantom model that replicates a real-human breast and a specific excised tissue that replicates the actual breast tissue with and without cancer tissue in terms of dielectric and optical properties has been employed in this study to detect the tumor and cancerous tissue.

Preoperative breast imaging and histopathological findings in chest contouring surgery on transmen

Chest contouring is the most common surgical procedure transmen receive. Only a few articles discuss the importance of preoperative imaging and postoperative histopathological analysis of excised breast tissue. We studied the findings of preoperative breast imaging and the results of postoperative histopathological analysis in a clinical setting. Data from 220 patients were collected retrospectively from 2005 to 2018. Preoperative imaging modalities and their findings were recorded and classified according to the American College of Radiology Breast Imaging Reporting and Data System. The histopathological findings in breast specimens were categorized based on the World Health Organization Classification of Breast Tumors (5th edition). Preoperative imaging was performed in 133 (60.5%) patients. Patients in the ultrasound-only group were younger (mean age 22.8) than the other groups (mammogram (MGR) 37 years and MGR+US 35.5 years). Preoperative imaging results were normal in 131 (98.5%) patients. Two patients needed further evaluation. Histopathological results were available on 206 (93.6%) patients. The most common histopathological findings were fibrosis (67.5%), atrophy (34.3%), and chronic mastopathy (14.5%). There were no high-risk or malignant findings. The need for further examinations based on routine preoperative imaging was low (1.5%). Therefore, more individualized patient selection for preoperative imaging is justified. There were no high-risk or malignant findings in histopathological analysis, and the occurrence of benign findings was similar to that reported in previous studies. Despite our findings, based on current knowledge, histopathological examination of excised breast tissue can still be recommended. Therefore, future studies are needed to define clear guidelines.

Primary Cutaneous Apocrine Adenocarcinoma of the Axilla in Klinefelter’s Syndrome: A Case Report

Background: Primary Cutaneous Apocrine Adenocarcinoma (PCAA) is a rare cutaneous malignancy that arises from areas rich in apocrine glands, particularly the axilla. There are less than 200 cases described in the literature. However, none has been reported in patients with Klinefelter syndrome, who are known to have an increased risk of breast cancer, Case Presentation: We present a 66-year-old man with a significant family history of breast cancer who developed a right axillary mass initially thought to be hidradenitis suppurativa. On physical examination, he had bilateral gynecomastia. Laboratory workup was significant for hyper-gonadotrophic hypogonadism. Mammography showed bilateral gynecomastia with no radiologic evidence of malignancy in the breast, while magnetic resonance imaging of the breast revealed two suspicious masses seen in the right breast. Excision biopsy of the right axillary mass revealed a high-grade invasive adenocarcinoma involving the dermis and subcutis; the cells had prominent nucleoli vesicular chromatin pattern and voluminous eosinophilic cytoplasm consistent with primary cutaneous apocrine adenocarcinoma. Immunohistochemistry was positive for GATA-3, GCDFP-15, E-cadherin, ER Positive, PR negative, HER 2 by IHC 3 +, and androgen receptor-positive 100 %. Positron emission tomography showed mildly hypermetabolic asymmetric gynecomastia, right greater than left, but no abnormal hypermetabolic activity to suggest malignancy. Karyotype confirmed 47 XXY chromosomes which on. The patient underwent bilateral mastectomy due to his preference; excised breast tissue was negative for malignancy. Conclusion: We presented the first case report of PCAA of axillary in Klinefelter syndrome. Awareness of this association and differentiation from breast carcinoma should be undertaken.

Blood Pressure Challenge Reduces Hematomas in Gender-Affirming Mastectomy: A Retrospective Chart Review of 92 Consecutive Patients.

Gender-affirming mastectomy is a common surgery for the treatment of gender incongruence and gender dysphoria and improves quality of life. Hematoma rates for gender-affirming double incision mastectomies are between 2.8% and 8.1%. This study aims to investigate the utility of a blood pressure challenge, whereby the patient's blood pressure is medically increased intraoperatively to reveal bleeding vessels that can be addressed with additional hemostasis before skin closure, to reduce postoperative hematoma. A retrospective chart review of patients who underwent gender-affirming double incision mastectomies over a 6-year period by a single surgeon was conducted. Surgeries were separated into a blood pressure challenge experimental group and a non-blood pressure challenge control group. Demographics, surgical characteristics, and postoperative complications were compared between the 2 cohorts using Pearson χ2, Fisher exact, t tests, univariate logistic regression, and multivariable logistical regression. Significance was established at P < 0.05. A total of 92 patients (184 breasts) were included with 32 patients (64 breasts) in the control group and 60 (120 breasts) in the blood pressure challenge group. In the control group, there were 5 hematomas (7.81%) compared with 1 (0.83%) in the blood pressure challenge group (P = 0.02). On univariate logistical regression analysis, blood pressure challenge was the only variable significantly associated with hematoma (odds ratio, 0.1; 95% confidence interval, 0.01-0.63; P = 0.04). On multivariable logistical regression, after controlling for age, body mass index, smoking status, and mass of excised breast tissue, patients who underwent blood pressure challenge demonstrated lower hematoma rates (odds ratio, 0.08; 95% CI, 0.004-0.59; P = 0.04). Using an intraoperative blood pressure challenge was associated with reduced hematoma rates. Guidelines for blood pressure challenge goals should be established to standardize care and reduce complications in gender-affirming mastectomies.

AI-Powered Biomolecular-Specific and Label-Free Multispectral Imaging Rapidly Detects Malignant Neoplasm in Surgically Excised Breast Tissue Specimens.

Repeated surgery is necessary for 20% to 40% of breast conservation surgeries owing to the unavailability of any adjunctive, accurate, and objective tool in the surgeon's hand for real-time margin assessment to achieve the desired balance of oncologic and cosmetic outcomes. To assess the feasibility of using a multispectral autofluorescence imaging device for discriminating malignant neoplasm from normal breast tissue in pathology as a critical step in the development of a device for intraoperative use, and to demonstrate the device's utility for use in processing and prioritizing specimens during frozen section and in the pathology grossing room. We performed a preliminary assessment of our device, called the TumorMAP system, on 172 fresh tissue blocks from 115 patients obtained from lumpectomy specimens at the time of initial gross examination and compared the device results with gold standard pathology evaluation. The preliminary results demonstrate the potential of our device in detecting breast cancer in fresh tissue samples with a sensitivity of 82%, a specificity of 91%, a positive predictive value of 84%, and a negative predictive value of 89%. Our results suggest that the TumorMAP system is suitable for the detection of malignant neoplasm in freshly excised breast specimens and has the potential to evaluate resection margins in real time.

Reduction Mammoplasty for Macromastia: Our Experience Using the Inferior Pedicle with Inverted-T Skin Resection.

Macromastia is a major reason why women seek for breast reduction especially when there are symptoms. Breast reduction is an uncommon procedure in our environment and this is a report of our experience with inferior pedicle with an inverted-T skin resection. This is a report of breast reductions using the inferior pedicle with an inverted-T skin resection approach that were carried out between 2004 and 2022. The information that was retrieved from the case notes were age, marital status, parity, last child birth, family history of breast enlargement, presenting features, height, weight, the weight of tissue excised, and complications. The data obtained were then entered into the SPSS version 25 (IBM Corp.) software and analysed. Seventeen women were managed with an age range of 16-50 years and a mean of 31.06 ± 9.66 years. The most common features at presentation were heavy weight around the chest, backache, shoulder pain, no appropriate brassiere with low self-esteem and self-confidence. Ten had skin changes and recurrent rashes over the breast, whereas four complained of grooves with skin changes. The weight of excised breast tissue ranged from 0.2 to 5.5 kg with an average of 2.18 ± 1.28 kg for the right and 2.05 ± 1.00 kg for the left breast. All except one patient had blood transfusion. The common complications were delayed wound healing (47%) followed by partial wound dehiscence (17.6%), and flap necrosis (11.8%). Except for those with flap necrosis the wounds healed with some having broad scars. Patients for breast reduction are mainly due to the symptoms and signs with the associated large breast. The inferior pedicle with inverted-T skin resection is a valuable technique with a very good outcome. To improve access to breast reduction, there is the need to enhance awareness through advocacy using women groups and health education.

Biochemical “decoding” of breast ultrasound images with optoacoustic tomography fusion: First-in-human display of lipid and collagen signals on breast ultrasound

To date, studies which utilized ultrasound (US) and optoacoustic tomography (OT) fusion (US-OT) in biochemical differentiation of malignant and benign breast conditions have relied on limited biochemical data such as oxyhaemoglobin (OH) and deoxyhaemoglobin (DH) only. There has been no data of the largest biochemical components of breast fibroglandular tissue: lipid and collagen. Here, the authors believe the ability to image collagen and lipids within the breast tissue could serve as an important milestone in breast US-OT imaging with many potential downstream clinical applications. Hence, we would like to present the first-in-human US-OT demonstration of lipid and collagen differentiation in an excised breast tissue from a 38-year-old female.

Perceptions of patients and medical oncologists toward biospecimen donation in the setting of abnormal breast imaging findings.

We sought to understand the attitudes of individuals with abnormal breast imaging findings prompting a diagnostic breast biopsy toward donation of blood, excised tissue, or percutaneous biospecimens for research, and to understand medical oncologists' attitudes toward research biospecimen collection in this population. We included individuals who presented to a single academic medical center for a clinically indicated, image-guided, percutaneous breast biopsy. We administered a survey prior to knowledge of biopsy results to assess willingness to consider, entirely for research purposes, donating blood or excess excised breast tissue, or having additional biospecimens (AB) obtained during a clinically indicated percutaneous biopsy. We also surveyed breast medical oncologists from National Cancer Institute-designated cancer centers to assess attitudes toward approaching patients for biospecimen research. Overall, 53/63 patients responded to the survey; 70% would consider donating blood, 85% would consider donating excess excised breast tissue, and 32% would consider having AB obtained during a clinically indicated biopsy. Main motivating factors for considering AB included contributing to scientific knowledge and return of study or biopsy results, whereas anxiety and the potential discomfort were the main dissuading factors. Among 191 medical oncologists, most were very comfortable (59.2%), or somewhat comfortable (32.5%) asking patients to have AB obtained during a clinically indicated breast biopsy. Medical oncologists reported hesitancy to refer a patient for AB due to potential pain/discomfort, and other procedure risks. Only one-third of individuals with breast imaging findings would consider consenting to AB during a diagnostic biopsy, whereas most were open to donating blood or excess excised breast tissue. Most medical oncologists would be comfortable asking patients to have AB obtained during the biopsy. Understanding patients' and oncologists' baseline attitudes may inform the design and approach to breast biospecimen-based research.

Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

ObjectivesTo evaluate the clinical value of supine magnetic resonance imaging (MRI) for tumor localization in breast cancer patients with large or multifocal tumors detected by prone MRI, scheduled for oncoplastic breast conserving surgery (OBCS). Outcomes were compared with those of patients who underwent wide local excision (WLE) or OBCS without MRI guidance. MethodsOver a 2-year period, consecutive patients with large or multifocal disease scheduled for OBCS with MRI-only findings were invited to participate (Group-1). Supplementary supine MRI was performed, and tumor margins were marked in the surgical position. Consecutive patients with early, non-palpable breast cancer who underwent WLE (Group-2) or OBCS (Group-3) were included for comparisons. The primary outcome was reoperation due to an insufficient margin. Secondary outcomes included surgical complications and delayed adjuvant treatment. ResultsAltogether, 102 breasts (98 patients) were analyzed. All preoperative demographic data were comparable among the three groups. Multifocality, tumor-to-breast volume ratio, and the volume of excised breast tissue were significantly greater in Group-1 than in Groups-2 and 3. Operation time was longer and the need for axillary clearance or surgery for both breasts was more common in Groups-1 and 3 than in Group-2. Adequate margins were achieved in all patients in Groups-1 and 2, and one patient underwent re-excision in Group-3. ConclusionsSupine MRI in the surgical position is a new, promising method to localize multifocal, large tumors visible on MRI. Its short-term outcomes were comparable with those of conventional WLE and OBCS.

Inferior pedicle with inverted-T procedure for bilateral reduction mammoplasty provided satisfactory surgical and aesthetic outcome

Background: The objective of the study was to evaluate surgical and aesthetic outcomes of bilateral reduction mammoplasty (RM) through the inferior pedicle with inverted-T approach (PO).Methods: 23 women with bilateral symptomatizing macromastia underwent preoperative breast measurements, calculation of breast volume (BV), determination of quality of life (QoL) and self-esteem scorings using the breast reduction assessed severity scale (BRASS) and the Rosenberg self-esteem scale (RSES). RM was performed and intraoperative and PO data were collected. At 3-m PO, aesthetic outcome was evaluated using the ABNSW score, which assesses breasts asymmetry and shape, nipple deformation, skin condition and wound scar, and QoL outcome and overall satisfaction were determined.Results: Mean operative time was 240.4±39.7 min and mean weight of excised breast tissue was 2778.3±307.7 gm. Minor PO complications were managed conservatively and no patient required revision surgery. PO breast measurements were significantly improved with decreased BV and increased breast projection. Median ABNSW score was 10 and PO median BRASS and RSES scores were 9 and 17 with significant change in comparison to preoperative data. Preoperative BRASS score was negatively correlated age and body mass index, while RSES score was positively correlated with age. Nine women were highly satisfied by aesthetic outcome, 10 women were satisfied and 16 women were highly satisfied with overall outcome.Conclusions: RM significantly improved women QoL, aesthetic appearance and psychological status. Inferior pedicle with inverted T-mammoplasty is a safe, and applicable pattern of mammoplasty, allow significant reduction of BV with improved breast measurements and projection and provide satisfactory aesthetic outcome.

Abstract PS9-56: High compliance with choosing wisely breast procedures at a safety net hospital

Abstract The Choosing Wisely campaign has emerged recently in setting guidelines for surgical procedures of low utility and cost-ineffectiveness. Hospitals caring for underserved medical populations represent a unique opportunity to assess for quality of care and adherence to these guidelines. The Choosing Wisely campaign for breast surgery has highlighted: avoiding surgical re-excision for invasive cancer close to margins of excised breast tissue, avoiding double mastectomy in patients who have a single breast with cancer, avoidance of axillary lymph node dissection in women undergoing lumpectomy with limited nodal disease, and avoiding sentinel lymph node biopsy in patients ≥ 70 years of age with early stage breast cancer. Recent studies have shown variable adherence to these recommendations. In order to evaluate cost-effective surgery at our hospital serving a poorer patient population, we retrospectively analyzed patients who underwent surgery for breast cancer from 2015-2020. A total of 231 patients were identified. There were no patients who underwent re-excision for close margins of invasive cancer. Only 0.9% of patients (2/231) received contralateral mastectomy and only 1.6% of eligible patients (3/191) received axillary lymph node dissection instead of sentinel lymph node biopsy. Although 77.7% of patients ≥ 70 years of age with stage 1 hormone positive breast cancer (14/18) received sentinel lymph node biopsy, there was a downward trend during 2015 to 2020 from 100% to 50% of eligible patients receiving sentinel lymph node biopsy. De-implementation of traditional surgical practices, deemed as low-value care, towards newer cost-effective guidelines are achievable even at community hospitals serving a low socioeconomic community while preserving patient outcome and avoiding overtreatment. By avoiding overtreatment, cost savings can be achieved which allow for social distributive justice amongst breast cancer patients by ensuring careful utilization of scarce health economic resources. Citation Format: Annie Tang, Colin Mooney, Shannon Ugarte, Kevin Knopf, Amal Khoury. High compliance with choosing wisely breast procedures at a safety net hospital [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-56.

Utilization of Raman spectroscopy to identify breast cancer from the water content in surgical samples containing blue dye

AbstractBreast conserving surgery (BCS) for breast cancer aims for optimal oncological results with minimal tissue excision. Positive margins due to insufficient resection results in significant numbers of patients requiring re‐excision, which could be resolved with intra‐operative margin analysis (IMA). High wavenumber (HWN) Raman Spectroscopy (RS) examines the difference in protein/lipid environment and water content in tissues. Fluorescence from haemoglobin and blue dye surgical pigments (commonly present in excised breast tissue) can confound HWN RS. We present a Raman system with 785 nm excitation laser and indium gallium arsenide camera capable of quantifying changes in water content in different environments (protein‐rich and lipid‐rich) by measuring the water/total area ratio (W/TAR) of the HWN spectrum. We demonstrate that haemoglobin and blue dye do not adversely affect water content analysis by the W/TAR calculation. Measurement of paired tumour/non‐tumour human breast tissue specimens showed the biochemical differences between tissues, and spectral analysis with W/TAR demonstrated large differences in water content and that our Raman system can accurately differentiate between tumour and non‐tumour tissue, even in the presence of surgical pigments. This provides proof of principle that this Raman system is suitable for further investigation with a view to providing IMA in the clinical environment.image

Immediate Reconstruction of Large Ptotic Breasts following Vertical Reduction Pattern Nipple-Sparing Mastectomy.

PurposeWomen with large and/or ptotic breasts are generally not considered candidates for nipple-sparing mastectomy because of concerns regarding the high incidence of postoperative complications including ischemic complications. Therefore, we adopted a vertical skin resection technique for nipple-sparing mastectomy, and obtained satisfactory results following immediate autologous breast reconstruction. In this study, we aimed to describe our operative technique and review its outcomes.MethodsBetween January 2010 and March 2017, immediate autologous breast reconstructions were performed in 28 patients with moderate or large ptotic breasts after nipple-sparing mastectomy using the vertical reduction pattern. Grade II ptosis was observed in 12 patients, and 16 patients were classified as having grade III ptosis.ResultsOf the 28 patients, 21 received abdominal free flap reconstruction. In the remaining 7 patients, extended latissimus dorsi flaps were used in conjunction with anatomic implants. The mean weight of the excised breast tissue in the 2 groups was 575 g and 482 g, respectively. Satisfactory esthetic outcomes without major complications were achieved in all patients. Similar vertical reductions or mastopexies in the contralateral breast allowed better postoperative adjustment for symmetry. There was only 1 case of complete nipple necrosis; however, the problem was solved with “skin banking.” No local recurrences or distant metastases were detected at follow-up (mean 18 months, range 4 months to 6 years).ConclusionTo enhance cosmetic outcomes in patients with large and/or ptotic breasts, the vertical skin resection pattern for nipple-sparing mastectomy can be used to achieve better breast shape while preserving the nipple-areola complex. Moreover, it can improve the esthetic outcome without compromising oncologic safety.

Rapid assessment of breast tumor margins using deep ultraviolet fluorescence scanning microscopy.

.Significance: Re-excision rates for women with invasive breast cancer undergoing breast conserving surgery (or lumpectomy) have decreased in the past decade but remain substantial. This is mainly due to the inability to assess the entire surface of an excised lumpectomy specimen efficiently and accurately during surgery.Aim: The goal of this study was to develop a deep-ultraviolet scanning fluorescence microscope (DUV-FSM) that can be used to accurately and rapidly detect cancer cells on the surface of excised breast tissue.Approach: A DUV-FSM was used to image the surfaces of 47 (31 malignant and 16 normal/benign) fresh breast tissue samples stained in propidium iodide and eosin Y solutions. A set of fluorescence images were obtained from each sample using low magnification () and fully automated scanning. The images were stitched to form a color image. Three nonmedical evaluators were trained to interpret and assess the fluorescence images. Nuclear–cytoplasm ratio (N/C) was calculated and used for tissue classification.Results: DUV-FSM images a breast sample with subcellular resolution at a speed of . Fluorescence images show excellent visual contrast in color, tissue texture, cell density, and shape between invasive carcinomas and their normal counterparts. Visual interpretation of fluorescence images by nonmedical evaluators was able to distinguish invasive carcinoma from normal samples with high sensitivity (97.62%) and specificity (92.86%). Using N/C alone was able to differentiate patch-level invasive carcinoma from normal breast tissues with reasonable sensitivity (81.5%) and specificity (78.5%).Conclusions: DUV-FSM achieved a good balance between imaging speed and spatial resolution with excellent contrast, which allows either visual or quantitative detection of invasive cancer cells on the surfaces of a breast surgical specimen.

Moonlight human ribosomal protein L13a downregulation is associated with p53 and HER2/neu expression in breast cancer.

Breast cancer is the most common malignancy among females worldwide. Recent studies have shown extra-ribosomal roles of the moonlight ribosomal proteins in the development of human cancers. Accurate quantification of the gene expression level is based on the selection of the reference genes whose expression is independent of cancer properties and patient's characteristics. The aim of this study was the evaluation of the expression level of a previously proposed ribosomal protein as moonlight, L13a (RPL13A), in breast cancer samples and their adjacent tissues. Its association with genes of known roles in developing cancers was also investigated. Traditionally used housekeeping genes were selected and their expression was analyzed in 80 surgically excised breast tissue specimens (40 tumors and 40 tumor-adjacent tissues) by applying three software tools including GeNorm, NormFinder, and BestKeeper to select the most stable reference genes. Then, mRNA expression levels of RPL13A and p53 were evaluated. Additionally, protein expression levels of RPL13A were measured. It was demonstrated that PUM1 and ACTB are the most reliable reference genes and RPL13A is the least stable gene. There was a positive correlation between RPL13A and p53 mRNA expression levels in all the tumor samples. Moreover, significant downregulation of RPL13A expression levels was revealed in HER2+ tumor samples compared to HER2- ones. There was also a marked decrease in p53 mRNA expression levels in HER2+ tumor subtypes. Our results suggest that there is a probable relationship between RPL13A decreased expression with p53 and HER2/neu expression in the breast cancer.

Effect of gigantomastia on School attendance

Introduction. We have been seeing a number of juvenile/teenage girls presenting to our out patient department with gigantomastia/large breasts. These school going girls had not been attending school due to the large breasts and taunting by school mates as well as scrutiny by the public.&#x0D; Aims and Objectives.&#x0D; To do Reduction Mammoplasty.&#x0D; To do histological investigation.&#x0D; To encourage these teenage girls to go back to school.&#x0D; Materials and Methods.&#x0D; Nine juvenile/teenage girls aged between 11 and 16 years were prospectively enrolled for this study from 2016 to 2020. Eight had reduction mammaplasty and one had sub cutaneous mastectomy with free nipple graft. The specimens were weighed and sent for histology.&#x0D; Results. Nine juvenile/teenage girls were included. The age range was 11- 16 years and the weight range was 27-33 Kg. Loss of school attendance time was 3 months to 2 years. Median weight of excised breast tissue was 2.5(1.2 – 5 kg.&#x0D; Histology. Normal breast = 6, Fibroadenosis = 3.&#x0D; Conclusion. &#x0D; Gigantomastia affected school attendance by as much as two years.&#x0D; Reduction mammoplasty was our treatment of choice.&#x0D; Taunting and lack of fitting clothes affected self-esteem of these patients.&#x0D; The juvenile girls have now returned back to school.