Incidence Of Breast Carcinoma Research Articles

Net survival of women diagnosed with breast tumours: a population-based study in Switzerland.

Although the incidence of breast carcinoma in situ has been increasing, the prognosis of breast carcinoma in situ patients has not been extensively investigated. Thus, we aimed to compare the characteristics of invasive breast tumours based on whether or not they were preceded by a breast carcinoma in situ and to estimate the 5-year net survival of patients diagnosed with different breast tumours. Data from women diagnosed with breast tumours between 2003 and 2016 were used in our analyses. Net survival analyses were performed using inverse probability of censoring weights (nonparametric Pohar Perme estimator). Under certain assumptions, differences in survival between the cancer population and the general population can be considered to be attributable to the cancer diagnosis (NS). Descriptive observation of tumour characteristics indicated that invasive breast tumours following a breast carcinoma in situ were more frequently detected at an earlier stage and had less missing information in tumour-specific variables, compared to invasive breast tumours not preceded by a breast carcinoma in situ. Breast carcinoma in situ patients had a 5-year net survival of 1.02 (95% CI: 1.01-1.03), whereas patients diagnosed with invasive breast cancer without a recorded breast carcinoma in situ had a 5-year net survival of 0.89 (95% CI: 0.88-0.90). Patients diagnosed first with breast carcinoma in situ and then with invasive breast cancer had a 5-year net survival of 0.92 (95% CI: 0.85-1.01). Invasive breast tumours that were preceded by a breast carcinoma in situ were detected more frequently at an earlier stage, compared to those that were not. The estimated 5-year net survival of patients with breast tumours was good.

Male breast cancer: a budding and unaddressed issue

Incidence of male breast carcinoma (MBC), although rare, recently has an increasing trend. The increase in incidence is associated with increasing age, and poor clinical outcome seen with MBC is mostly because of illiteracy and lack of health education and shyness in reporting to the clinical physician. In this context, a comprehensive review regarding this forth bursting clinical scenario is important. The present article focus on that aspect encompassing but not limited to different clinical studies. The randomized trials on MBC are sparse and most of the studies are retrospective in nature due to rarity of cases. MBC treatment line is derived from female breast cancer guidelines. MBC has a poorer prognosis than female breast cancer. MBC patients in India present in advanced stage and surgery remains challenging due to paucity of breast tissue. Post mastectomy radiation is indicated on the same lines as of female breast cancer and it decreases locoregional recurrence. Adjuvant hormonal therapy decreases recurrence and improves survival. Further clinical trials are required including large number of patients to study different parameters in respect of prognosis and survival.

Abstract 4212: Comparison of thirty-year population-based incidence rates of invasive lobular vs ductal vs mixed breast carcinoma in Ontario, Canada

Abstract Purpose: We calculated crude, age-adjusted and age-specific incidence rates for invasive lobular, ductal and mixed ductal-lobular breast carcinoma from 1990 to 2020 in the province of Ontario, Canada. We further examined incidence relationships between clinical stage, age at diagnosis and time. Methods: We used population-based administrative healthcare datasets from the Institute of Clinical Evaluative Sciences (ICES Ontario), including the Ontario Cancer Registry, to identify all women diagnosed with breast cancer between 1990 and 2020. We calculated crude, age-adjusted and age-specific incidence rates for invasive lobular (ILC), ductal (IDC) and mixed ductal-lobular (IDC-ILC) breast carcinoma. Incidence rates were adjusted to the 2011 Canadian female standard population. We further examined the incidence relationships between clinical stage and age at diagnosis over time. Results: From 1990 to 2020, the 5-year crude incidence rates of ILC increased from 53.1 to 73.4 per 100,000 (+38%), while IDC increased from 501 to 746.5 per 100,000 (+49%). The crude incidence of mixed IDC-ILC peaked at 45 per 100,000 between 2005 and 2009 and is currently 29 per 100,000. The age-adjusted 5-year incidence rate of ILC has slightly increased from 64 to 70 per 100,000 (+9%) while that of IDC has increased from 598 to 726 per 100,000 (+21%). The age-adjusted 5-year incidence of mixed IDC-ILC peaked at 47 per 100.000 between 2005 and 2009 and has declined to 29 per 100,000. Age-specific 5-year incidence rates for ILC has decreased over time in women < 40 years of age and increased in women over the age of 65. In contrast, age-specific 5-year incidence rates for IDC have remained stable in women over 75. For mixed IDC-ILC, age-specific 5-year incidence rates have increased over time in all age categories. Among women with ILC, there is a greater proportion of women under the age of 50 diagnosed with stage III disease (30%) compared with women diagnosed over the age of 50 (16%). Women between the ages of 50 and 74 have higher rates of being diagnosed at stage I (43%) compared with 35% and 31% for women diagnosed between the ages of 40-49 and over 75, respectively. Conclusions: The incidence of invasive lobular breast carcinoma in increasing, particularly in women over the age 65. Consequently, the burden of lobular breast carcinoma is expected to increase, as the proportion of women over the age of 65 is expected to rise exponentially in the foreseeable future, highlighting a need for further study of this not uncommon breast cancer subtype. While representing a smaller proportion of breast cancer diagnoses, the incidence of mixed invasive ductal-lobular subtype is increasing in all age groups. Citation Format: David Wai Lim, Vasily Giannakeas, Steven Narod, Kelly A. Metcalfe. Comparison of thirty-year population-based incidence rates of invasive lobular vs ductal vs mixed breast carcinoma in Ontario, Canada. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4212.

Abstract P4-03-11: Population-based survival outcomes of pure vs mixed invasive lobular breast carcinoma in Ontario, Canada

Abstract Purpose: We aim to determine incidence and survival rates of pure vs mixed invasive lobular breast carcinoma between 1990 and 2020 in the province of Ontario, Canada. We further evaluated patient and tumour factors that predict survival for invasive lobular carcinoma (ILC). Methods: Using population-based administrative healthcare datasets at Institute of Clinical Evaluative Sciences (ICES) Ontario, we calculated the crude 5-year incidence rates of pure ILC versus invasive ductal carcinoma (IDC) versus mixed ILC-IDC in the province of Ontario, Canada between 1990 and 2020. Kaplan-Meier survival curves were generated to determine the 5-, 10-, 15- and 20-year survival for ILC (and mixed ILC-IDC) as compared with IDC. Survival curves were compared using the log-rank test and stratified by stage. Using a multivariable Cox proportional hazards regression analysis, we identified patient (e.g. demographic, geographic, socioeconomic) and tumour (grade, stage, receptor subtype) factors that predicted survival for patients with ILC. Statistical analysis was performed using SAS® and P values < 0.05 were considered statistically significant. Results: We identified 18,551 (8%) pure ILC, 10,234 (4%) mixed ILC-IDC and 192,371 (81%) IDC cases. The crude incidence of pure ILC increased from 55.7 per 100,000 in 1990 to 80.2 per 100,000 in 2020. The crude incidence of mixed ILC-IDC peaked in the mid-2000s at 48.6 per 100,000 and subsequently declined to 32.1 per 100,000 in 2020. There was a significant difference in overall survival between the three breast cancer subtypes. Over a 30-year follow-up period (mean 9.3 +/- 7.3 years), overall survival of mixed ILC-IDC mirrors the survival of pure IDC, while women with pure ILC have inferior survival compared with IDC beginning after 10 years of follow-up (P < .001). The 20-year overall survival was 40% for ILC and 50% for IDC and mixed ILC-IDC. Older age > 55 years (vs. 50-54 years, P < .0001), lowest neighborhood income quintile (HR 1.1, P = .038), geographic location within Ontario (P < .01) and increasing Elixhauser Comorbidity Index score (P < .0001) predicted worse overall survival for ILC patients. Conversely, the increasing number of mammograms received in the five years prior to diagnosis predicted better overall survival (P < .0001). When stratified by cancer stage, the worse survival in ILC (compared with IDC and mixed ILC-IDC) was only observed for stage III patients (P = .01). Stage III and IV disease, grade 3 histology and ER/PR negativity predicted worse survival (P < .01). Conclusion: The crude incidence of ILC is increasing over time. Over a 30-year follow-up period (mean 9.3 +/- 7.3 years), ILC had worse overall survival compared with IDC and mixed ILC-IDC, particular stage III patients. Patient demographic and tumour factors predict overall survival in ILC. While treatment paradigms for ILC mirror that for IDC, our data demonstrates worse overall survival for ILC and a need for more research and treatments focused on improving long-term survival for ILC patients. Citation Format: David Lim, Vasily Giannakeas, Steven Narod, Kelly Metcalfe. Population-based survival outcomes of pure vs mixed invasive lobular breast carcinoma in Ontario, Canada [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-03-11.

Histological and Clinical Stage Profiles of Young-aged Breast Carcinoma

Background: Breast cancer is the most common type of malignancy in women. Many studies report that the characteristics and prognosis of young-aged breast carcinoma are worse than in old age. Data on young-aged breast carcinoma in Indonesia is relatively lacking and always needs updates.Objective: To determine the incidence and distribution based on histological profiles and clinical stage, as well as the association between molecular subtype with grade and clinical stage of young-aged breast carcinoma (<40 years old) at Dr. Kariadi General Hospital Center in 2018-2020.Methods: This research was an observational descriptive study using medical records of young-aged breast carcinoma patients which were recorded at Dr. Kariadi General Hospital Center from 1st January 2018 until 31st December 2020. The data were processed with Microsoft Excel and SPSS.Results: The results showed that there were 110 patients consisting of 25 people in 2018, 37 people in 2019, and 48 people in 2020. The most common histological and clinical stage was IBC-NST with 75 people (68,18%), Luminal B with 53 people (48,18%). grade II with 71 people (64,65%), and stage IV with 45 people (40,09%). There is a significant association between molecular subtype and grade (p=0.003). There is no significant association between molecular subtype and clinical stage (p=0.704).Conclusion: The incidence of young-aged breast carcinoma at Dr. Kariadi General Hospital Center in 2018-2020 was increasing every year. The most common histological profiles and clinical stage during that period were IBC-NST, Luminal B, grade II, and stage IV. There is a significant association between molecular subtype and grade.Keywords: Breast carcinoma, clinical stage, grade, histological type, molecular subtype, young age

Breast Carcinoma in Young Females: A Prospective Study in Terms of Clinicopathological Presentation at a Tertiary Care Center in India.

Introduction: The incidence of breast carcinoma in young women is on the rise, particularly in developing Asian countries like India. Owing to a unique presentation in terms of genetic background, clinical features, and histological characteristics, the prognosis becomes challenging, which therefore entails a detailed study for better understanding and management of the disease. This study aimed to establish the role of clinical and pathological parameters in breast cancer disease in young women.Methods: This was a prospective comparative study conducted at the Department of Surgery, Hamidia Hospital, Bhopal, India, which spanned a total duration of one year between November 2018 and October 2019, and included a total of 98 consecutive in-house breast carcinoma patients. The patients were categorized into two groups based on age, i.e., the young age group (age < 40 years) and the old age group (age ≥ 40 years).Results: Of the patients, 37 fell in the young age group and 61 in the old age group. There was a significant association between positive family history of breast carcinoma and young age (p = 0.01). Estrogen and progesterone receptor positivity was found to be associated more commonly with old age group patients. The proportion of patients with human epidermal growth factor receptor 2 (HER2)/neu over-expression was higher among the young age group. Triple negativity was more frequently observed amongst young age group patients.Conclusion: Hormone receptor analysis should be an absolute part of the initial work-up of breast carcinoma. Raising awareness among women in society should be of paramount importance. Family history is crucial, particularly in young women, and should not be dismissed. With timely presentation and effective diagnosis, a safer state with a relatively better prognosis can be achieved.

Incidence and laterality of breast carcinoma among patients who attended Aminu Kano Specialist Hospital, Kano State, Nigeria

Breast cancer is the commonest malignancy in females and a major cause of cancer-related mortality worldwide. Previously, histological subtypes of breast carcinoma were determined in Aminu Kano Teaching Hospital, however, the commonest sides of breast carcinoma infection among the patients attending the facility received less attention. The study was retrospective and aimed to evaluate the mean age, incidence and laterality of breast carcinoma cases among patients who attended Aminu Kano Teaching Hospital (AKTH) from 2016 to 2020. A total of five-hundred and seventy-seven (577) data records on breast carcinoma of the patients comprised of histology reports, age, sex, and side of carcinoma were all extracted. The Patients' ages were categorized and mean age was determined. Data were analyzed using Minitab (17) presented in tables, charts and figures using Microsoft word excel, 2019. The results showed the mean age of breast carcinoma as 45.02±12.26, 48.28±13.06, 45.80±13.70, 48.59±13.64 and 46.66±13.35 in 2016, 2017, 2018, 2019 and 2020 respectively. The incidence of breast carcinoma was also dominant in the age group 40-59 and least in the age group 0-19 years. The laterality in breast carcinoma was 54% (226) on the left, 45% (189) affected on the right, and 1.0% (6) on both sides of the breast respectively. In conclusion, although breast carcinoma incidence showed a similar pattern in the five years studied, menopause was the commonest age of risk of breast carcinoma infections and the infections were more on the left breasts than the right among the patients who attended the facility.

THE RELEVANCE AND IMPORTANCE OF TUMOR INFILTRATING LYMPHOCYTES (TILS) IN BREAST CANCER

Tumor infiltrating lymphocytes (TILs) were evaluated in many cancers like ovarian tumors, endometrial tumors, colon cancer and melanoma. Now there is increasing trend in evaluating TILs in breast cancer. Tumor infiltrating lymphocytes gives the patients immune response to the tumor. 100 cases of Modified radical mastectomy specimen were chosen from surgical pathology records. The representative formalin fixed paraffin embedded tissue samples were collected. Detailed history regarding Patients age, sex, side of the breast involved , Grade and neoadjuvant chemotherapy were assessed for 100 cases. Tumor Infiltrating Lymphocytes are evaluated with Immuno HistoChemistry CD45 and CD3 for 100 cases , in which 93% cases were Infiltrating Ductal carcinoma-NOS cases and 07 % cases are of special types like Mucinous, Metaplastic, Apocrine, and Medullary carcinoma. Results: In our study, Highest incidence of breast carcinoma occur in the age group of 41-50 years. Infiltrating Ductal Carcinoma NOS is the most common primary malignant neoplasm of breast constituting 93% of cases. Most of the malignant tumors are left sided. Forty seven percent of cancers are presented in the size range of 2-5cms. Majority of the tumors are of Grade II accounting for 63.5% of all cases. TILs were evaluated with three variables 0- 10 % 20- 40 % and 50- 90 %.Younger the age, more the TILs. Neo adjuvant chemotherapy had significant correlation with TILs (P= 0.05).

Incidental Pathologic Findings in Young Men with Gynecomastia.

Pathologic examination of young adult gynecomastia tissue is controversial given the low incidence of breast carcinoma in this population. The authors examined the pathologic findings in a large cohort of adolescents with gynecomastia to evaluate the need for routine tissue analysis in this population. A retrospective review of men who underwent unilateral or bilateral mastectomy for gynecomastia at a single institution between February of 2007 and November of 2019 identified demographics, medical history, surgical characteristics, and pathologic findings. Descriptive statistics were performed. A total of 268 male patients were included. Mean age was 16.6 years. Mean body mass index was 27.8 kg/m2, and 42.5 percent of the sample was obese. The majority (83.2 percent) underwent bilateral subcutaneous mastectomy. There were no abnormal histopathologic findings in 95.1 percent. Among the 13 patients with abnormalities, eight (3 percent) had nonproliferative changes, two (0.8 percent) had proliferative changes without atypia, two (0.8 percent) had atypical ductal hyperplasia, and one (0.4 percent) had both bilateral atypical ductal hyperplasia and unilateral ductal carcinoma in situ. No patients had invasive carcinoma. The three patients with atypical ductal hyperplasia and/or ductal carcinoma in situ were obese but had no other breast cancer or gynecomastia risk factors. Findings conferring potentially increased risk of developing breast cancer were identified in three male adolescents (1.2 percent). Incidence of these findings is similar between male adolescents and similarly aged female adolescents undergoing breast reduction surgery. Although worrisome pathology results are rare, too little is known about the natural history of atypical proliferation and ductal carcinoma in situ in young men to recommend against routine analysis. Risk, IV.

The Histopathology of Carcinoma Breast with Special Reference to p53 Marker

Introduction: Breast cancer is one of the most common cancers among women in the world. The high incidence of breast carcinoma in women has inspired a thorough investigation of potentially modifiable risk variables (clinical parameters, morphological type, and biochemical indicators) for prognosis, preventative tactics, and treatment options. One of the most important prognostic indicators for breast cancer is p53.&#x0D; Aims and Objectives: The goal of this study was to use immunohistochemistry to assess the prevalence of p53 mutant protein in breast cancer, correlate the results with clinical and histological parameters, and establish its impact on axillary node metastasis.&#x0D; Materials and Methods: A clinicopathological study of 50 cases of infiltrating ductal carcinoma of the breast was performed using immunohistochemistry to examine for p53 mutant protein expression.&#x0D; Results: Percentage of p53 immunohistochemical positivity in this study was 22%, which is similar to other studies' reported statistics. In both the positive and negative cases of lymph node metastases, immunohistochemical data revealed an equivocal p53 status. In compared to p53 negative cases, the carcinomas with p53 positivity showed aggressive characteristics, such as greater size and higher grade. Patients with significant lymphocytic reactions to tumours, patients under 35 years of age, and those with tumours on the left side had a higher chance of receiving a positive p53 status. This study clearly shows that breast cancers with high p53 expression are generally aggressive tumours with a poor prognosis and a poor response to endocrine treatment and chemotherapy.

Rate of Incidental Pathological Lesions ın Reduction Mammoplasty Specimens and Incidence of Invasive Breast Carcinoma Following Breast Reduction Operation.

Reduction mammoplasty (RM) is one of the most frequently performed surgical procedures. The incidental determination of significant pathologic lesions (SPL), that is precursor and malignant lesions, in RM specimens is rare. The aim of this study was to determine the frequency of SPL in RM specimens, to evaluate the relationship between SPL and clinicopathological factors, and to examine the incidence of invasive breast carcinoma forming in the remaining breast tissue during the postoperative follow-up period developing in patients after RM operation. This retrospective study included 874 females who underwent RM operation between January 2012 and January 2021. Demographic, clinicopathological findings, and preoperative radiological findings were recorded. The patients were followed up after the RM operation in respect of the first occurrence of breast cancer. Invasive carcinoma was determined in 0.2% and SPL in 3.5% in RM. The probability of SPL determination was greater in patients aged ≥ 40 years and with ≥ 4 paraffin blocks (p=0.038, p=0.01, respectively). No statistically significant difference was found between patients with and without SPL in respect of radiological findings (p=0.35). The mean postoperative follow-up period was 53.6 months, and invasive carcinoma was diagnosed during follow-up in 0.2% of all patients (6.9% of the patients with SPL). Age over 40 years and an increased number of sampled blocks were found to be factors increasing the possibility of the determination of precursor and malignant lesions in RM specimens. RM could decrease the risk of the development of breast cancer. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Study on Carcinomas of Breast with Special Reference to Expression of Vascular Endothelial Growth Factor and Her 2/neu

Carcinoma is a major health issue worldwide. Breast cancer is by far the most common of all cancers diagnosed in women, in the world. The incidence of breast cancer has risen in India (22.9%). Breast cancer cases in India are expected to increase by 26% by 2020. There be existing 2,088,849 new cases of breast cancer worldwide foremost to 626,679 deaths in 2018. Among the Indian women, cancer cervix and breast carcinoma account for 60% of the total cases, of which the incidence of breast carcinoma is 10.4%. Angiogenesis is nothing but the growth of new vasculature from the pre-existing vasculature. This physiological process is involved in organ and embryonic development, wound healing, and reproductive functions in the adults. However, pathologically, angiogenesis is implicated in macular degeneration, rheumatoid arthritis, psoriasis, and tumour growth. HER2/neu status has recently become clinically very relevant because it has been demonstrated that HER-2/neu positive tumors have worse prognosis than HER2/neu negative tumors. To correlate the expressions of the Immunohistochemical markers HER-2/neu and Vascular Endothelial Growth factor (VEGF) with the various clinicopathological parameters like age, tumour size, histological type, grade, stage and lymph node metastasis status. It concludes an unequivocal association between the expressions of the two immunohistochemical markers, HER-2/neu and VEGF in breast carcinoma cases and its implication in guiding therapy against HER-2/neu over-expressing tumors.

Molecular profiling of breast carcinoma with IHC surrogates in a tertiary care centre in South India

Introduction and Aim: Breast cancer is the most common malignancy in females worldwide. Almost 1.4 million new cases have been diagnosed with breast cancer every year. This aims to study the clinicopathological profile and molecular subtypes of invasive breast carcinoma in resected mastectomy specimens over a period of 5 years.&#x0D; Materials and Methods:A retrospective study of 90 mastectomy and wide local resection specimens received during the period of January 2012 to June 2017 were analyzed. The clinical data of patients including age, gender, and stage of the diseasewere obtained from the medical records section. Immunohistochemical staining for Estrogen Receptor [ER], Progesterone Receptor[PR] and Human Epidermal Growth Factor Receptor 2HER2neu were done.The cases were classified according to the molecular classification based on the ER, PR and HER2 receptor status.&#x0D; Results: The peak incidence of breast carcinoma was in the age group 50 to 60 years. Invasive ductal carcinoma,Not otherwise specified[NOS] accounted for the most common histologic type. There was higher incidence of pT2 tumors in our study. The most common molecular subtype was luminal A, followed by triple negative tumors. These molecular subtypes associated well with Tumor grade and HGDCIS with a statistically significant p value of 0.001 and 0.015 respectively. An increased proportion of Grade 3 tumors were Triple Negative tumors.&#x0D; Conclusion:In breast carcinomas the routine histopathological features provide inexpensive method for understanding tumour biology and prognosis. It`s essential in areas with poor resources. ER, PR and HER2 assessment helps in identifying hormonal status and enables for hormone therapy and anti HER2 therapy.&#x0D;

Incidence of male breast carcinoma in North Uganda: A survey at Lacor Hospital, Gulu, during 2009-2016.

Little information is available on male breast cancer (MBC) incidence from sub-Saharan Africa. This is a retrospective study on MBC in rural North Uganda, based on the pathology records of a private, non-profit, missionary hospital. All male patients that had histological diagnosis of breast carcinoma from January 2009 to December 2016 were included in this study. In time span of 8 years, there were 337 consecutive breast cancer presentations, including 21 MBC (6.2%). The latter patients showed advanced disease (mean symptom duration: 20.3 months; mean tumour size: 5 cm) skin ulceration and ipsilateral lymph node metastasis: 60%). The mean age was 60.52 years (from 30 to 85 yrs). Ductal infiltrating carcinoma was the prevalent histological type in our series (65%), followed by an unusually high rate of papillary carcinomas (15%). There appeared to be a prevalence for left breasts (11 LT versus 6 RT; 64.7%), a finding also observed in the majority of MBC. This study is representative of the scenario in Northern Uganda, where MBC accounts for 6.2% of breast cancers, More information on the occurrence and risk factors of this unusual neoplasm in African countries may prompt prevention of chronic liver disease and early recognition and treatment of MBC.

Occult Breast Carcinoma Is More Common in Women Undergoing Breast Reduction after Contralateral Cancer: A Systematic Review and Meta-Analysis.

Occult breast carcinoma is occasionally found in breast reduction specimens. Although its incidence varies widely, there is a trend toward an increased incidence for women with a history of breast cancer. The authors performed a systematic review and meta-analysis of occult carcinoma incidence in breast reduction specimens. The MEDLINE and Embase databases were searched for peer-reviewed studies with no language restrictions for studies that recorded the incidence of occult carcinoma in breast reduction specimens. Cancer incidence per specimen was pooled for women with and without a history of breast cancer. Forty-two studies were eligible for inclusion, of which 29 were quantitatively analyzed. The pooled incidence of carcinoma was higher within specimens from women with breast cancer (3.4 percent; 95 percent CI, 2.2 to 5.3 percent) than without (0.6 percent; 95 percent CI, 0.4 to 0.8 percent), and this increased likelihood was significant when populations were compared directly (OR, 6.02; 95 percent CI, 3.06 to 11.86; p < 0.0001). Women with a history of breast cancer have an increased incidence of occult breast carcinoma within their breast reduction specimens compared with women with no breast cancer history. There is a need for preoperative radiology screening, counseling, and histopathology guidelines to ensure adequate diagnosis and management of these women.

Clinical and imaging presentation of molecular types of breast cancer

Introduction: Breast cancer is the second most common malignant neoplasm among women in Brazil and worldwide. Its incidence increases with age, especially in individuals older than 50 years. Mammography is the main screening test, has high sensitivity, and is the only method that has made an impact on mortality rate. Breast cancer is classified into molecular subtypes, based on immunohistochemical markers. The luminal A subtype (LA) presents estrogen receptor (ER) and progesterone receptor (PR) positive, HER2 negative, and low Ki-67 index. Luminal B (LB) shows ER and/or PR positive, HER2 negative, high Ki-67 index, or HER2 positive (luminal HER2). HER2 has HER2 overexpression and ER and PR negative. Triple-negative (TN) has ER, PR, and HER2 negative and high histological grade. Objective: To evaluate patient characteristics according to the molecular subtypes of breast carcinoma among individuals treated at the Hospital São Paulo – Universidade Federal de São Paulo. Method: This is a retrospective study based on the analysis of medical records of breast cancer cases from the Hospital São Paulo between 2013 and 2016. During this period, 235 patients were treated. Among them, 40% were classified as LA, 34% as LB, 8% as luminal HER2, 15% as TN, and 3% as HER2. The mean age was 57.6 years. The incidence of breast carcinoma was higher in women over 50 years of age in all subtypes: 75.2% for LA, 65% for LB, 58% for luminal HER2, 100% for HER2 overexpression, and 75.1% for TN. Regarding ethnicity, most women were white in all subtypes, accounting for 66.5% of cases. In all subtypes, the most common clinical complaint was nodule: 86% for LA, 86% for LB, 100% for HER2 overexpression, and 96% for TN. Among the mammographic findings, nodule was the most frequent in all subtypes. Luminal subtypes presented other findings, such as suspicious calcifications (14% for LA and 21% for LB), focal asymmetries (14% for LA and 5% for LB), and distortions (2% for LA and 3% for LB). Conclusion: Breast cancer has a higher incidence among Caucasian individuals and those aged 50 to 60 years. The clinical and imaging presentation of tumors is influenced by their molecular subtype: luminal subtypes have a greater diversity of findings and non-palpable lesions, while TN tumors usually manifest as palpable nodules.

Occult disease in reduction mammoplasties and prophylactic mastectomies.

The aim of this study was to determine the incidence of occult breast carcinoma and significant breast disease in clinically and radiologically unremarkable breast reduction specimens and prophylactic mastectomies. A retrospective search using specimen type codes was performed in the computerized histopathology archive from April 2007 to April 2016. The pathology results of 505 patients were analyzed (782 specimens). A total of 267 patients underwent simple reduction mammoplasties (10 unilateral), 20 had bilateral prophylactic mastectomies and 218 undertook contralateral symmetrizing or prophylactic mastectomy surgery following a history of breast cancer. Overall, normal (unremarkable) breast tissue was found in 42.6% of patients (n=215), benign tissue (nonproliferative/proliferative disease without atypia) in 51.1% (n=258), significant disease (LCIS/proliferative disease with atypia) in 5.5% (n=28), and malignant disease (invasive/ductal carcinoma in situ) in 0.8% (n=4). The incidence of significant breast pathology was statistically higher (P value<.0001) in prophylactic mastectomies (12.4%) compared to reduction mammoplasties (2.3%). There was however no significant increase in the incidence of malignancy between prophylactic mastectomies (1.2%) and reduction mammoplasties (0.6%). Even though the clear majority of resected tissue in reduction mammoplasties and prophylactic mastectomies is benign, our findings support the continued need for histological examination of these specimens for occult carcinoma and precursor lesions.

Risk-reducing medications for primary breast cancer: a network meta-analysis.

Breast cancer is the most frequently occurring malignancy and the second cause of death for cancer in women. Cancer prevention agents (CPAs) are a promising approach to reduce the burden of breast cancer. Currently, two main types of CPAs are available: selective estrogen receptor modulators (SERMs, such as tamoxifen and raloxifene) and aromatase inhibitors (AIs, such as exemestane and anastrozole). To assess the efficacy and acceptability of single CPAs for the prevention of primary breast cancer, in unaffected women, at an above-average risk of developing breast cancer.Using a network meta-analysis, to rank single CPAs, based on their efficacy and acceptability (an endpoint that is defined as the inverse of CPA-related toxicity). We searched the Cochrane Breast Cancer Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP), and ClinicalTrials.gov on 17 August 2018. We handsearched reference lists to identify additional relevant studies. We included randomized controlled trials (RCTs) that enrolled women without a personal history of breast cancer but with an above-average risk of developing a tumor. Women had to be treated with a CPA and followed up to record the occurrence of breast cancer and adverse events. Two review authors independently extracted data and conducted risk of bias assessments of the included studies, and assessed the certainty of the evidence using GRADE. Outcome data included incidence of breast carcinoma (both invasive and in situ carcinoma) and adverse events (both overall and severe toxicity). We performed a conventional meta-analysis (for direct comparisons of a single CPA with placebo or a different CPA) and network meta-analysis (for indirect comparisons). We included six studies enrolling 50,927 women randomized to receive one CPA (SERMs: tamoxifen or raloxifene, or AIs: exemestane or anastrozole) or placebo. Three studies compared tamoxifen and placebo, two studies compared AIs (exemestane or anastrozole) versus placebo, and one study compared tamoxifen versus raloxifene. The risk of bias was low for all RCTs.For the tamoxifen versus placebo comparison, tamoxifen likely resulted in a lower risk of developing breast cancer compared to placebo (risk ratio (RR) 0.68, 95% confidence interval (CI) 0.62 to 0.76; 3 studies, 22,832 women; moderate-certainty evidence). In terms of adverse events, tamoxifen likely increased the risk of severe toxicity compared to placebo (RR 1.28, 95% CI 1.12 to 1.47; 2 studies, 20,361 women; moderate-certainty evidence). In particular, women randomized to receive tamoxifen experienced a higher incidence of both endometrial carcinoma (RR 2.26, 95% CI 1.52 to 3.38; high-certainty evidence) and thromboembolism (RR 2.10, 95% CI 1.14 to 3.89; high-certainty evidence) compared to women who received placebo.For the AIs versus placebo comparison, AIs (exemestane or anastrozole) reduced the risk of breast cancer by 53% (RR 0.47, 95% CI 0.35 to 0.63; 2 studies, 8424 women; high-certainty evidence). In terms of adverse events, AIs increased the risk of severe toxicity by 18% (RR 1.18, 95% CI 1.09 to 1.28; 2 studies, 8352 women; high-certainty evidence). These differences were sustained especially by endocrine (e.g. hot flashes), gastrointestinal (e.g. diarrhea), and musculoskeletal (e.g. arthralgia) adverse events, while there were no differences in endometrial cancer or thromboembolism rates between AIs and placebo.For the tamoxifen versus raloxifene comparison, raloxifene probably performed worse than tamoxifen in terms of breast cancer incidence reduction (RR 1.25, 95% CI 1.09 to 1.43; 1 study, 19,490 women; moderate-certainty evidence), but its use was associated with lower toxicity rates (RR 0.87, 95% CI 0.80 to 0.95; 1 study, 19,490 women; moderate-certainty evidence), particularly relating to incidence of endometrial cancer and thromboembolism.An indirect comparison of treatment effects allowed us to compare the SERMs and AIs in this review. In terms of efficacy, AIs (exemestane or anastrozole) may have reduced breast cancer incidence slightly compared to tamoxifen (RR 0.67, 95% CI 0.46 to 0.98; 5 RCTs, 31,256 women); however, the certainty of evidence was low. A lack of model convergence did not allow us to analyze toxicity data. For women with an above-average risk of developing breast cancer, CPAs can reduce the incidence of this disease. AIs appear to be more effective than SERMs (tamoxifen) in reducing the risk of developing breast cancer. AIs are not associated with an increased risk of endometrial cancer and thromboembolic events. However, long-term data on toxicities from tamoxifen are available while the follow-up toxicity data on unaffected women taking AIs is relatively short. Additional data from direct comparisons are needed to fully address the issues of breast cancer prevention by risk-reducing medications, with special regards to acceptability (i.e. the benefit/harm ratio).

PROFILE OF BREAST CANCER PATIENTS ATTENDING A TERTIARY CARE CENTRE: A CROSS-SECTIONAL STUDY

Background: World-wide breast cancer is the most frequent type of cancer among females with increasing incidence.&#x0D; Methods: This study was retrospective and prospective both. Total 40 Female patients of Breast cancer, from all age group admitted in Department of Surgery, Dr. S.N. Medical College, Jodhpur were included.&#x0D; Results: Lump was presenting feature in all cases 100%. The next most common presenting feature was pain, which was present in 62.5% cases. 10%, 17.5% and 2.5% cases had nipple discharge, nipple retraction and skin ulceration.&#x0D; Conclusion: The highest incidence of breast carcinoma was in 4th, 5th and 6the decades.Majority of the patients was Hindus and of rural areas and all the patients were married female.&#x0D; Keywords: Breast Carcinoma, Histopathologically Positive, Metastasis

Breast carcinoma detected in breast specimens: A fifteen-year single-center experience

Aim:The aim of this study was to determine the incidence of breast carcinomas in our center, to examine their clinicopathological characteristics and to present our experiences.Material and Methods: A total of 4309breast biopsy cases whose histopathological examination was performed in the Pathology Clinic between 2003 and 2018 were retrospectively evaluated. The age, operation procedure, histopathological examination results and postoperative prognostic indices of breast carcinoma cases were presented and analysis results of these parameters were compared with literature data and discussed.Results: Six hundred thirty five (14.7%) of the patients were administered with modified radical mastectomy + lumpectomy. Our cases of 65.2% were grade II, 21.3% of them were grade I, and 13.5% of them were grade III.Lymph node metastasis and recurrence were detected in 53.2% and 9.75% of the cases, respectively, the records of whom were reached. 6.41% of the patients had metastasis at the time of diagnosis. 12.54% of the patients who were followed up until 2019 died.Conclusion: The incidence of breast carcinoma in our center is 37%. It is also quite common at a young age, and lymph node metastasis is common.Keywords: Breast; carcinoma; clinicopathologic characteristics.