Incidence Of Breast Malignancies Research Articles

Doppler Indıces Evaluatıon In Malıgnant Breast Lesıons: A Revıew

The incidence of breast malignancy has displayed a rapid rise in recent times. It is one of the most common malignancies found in women. Women should be educated and made aware about self breast examination in order to detect malignancies at an early stage so that the prognosis can be improved. Breast pathologies can be classified into malignant and benign ones on the basis of signs and symptoms and by ultrasonography but can be confirmed on histopathology which remains the gold standard. Breast ultrasonography is the most common non ionizing radiological investigation used to assess breast lesions especially in women with dense or painful breasts. Breast carcinomas appear irregularly shaped hypoechoic lesions with non-circumscribed margins, but these features can rarely be manifested by benign lesions as well. Recent introduction of doppler ultrasound has led to an increase in the sensitivity of detecting breast carcinoma since most of the breast malignancies are hyper vascular and they show high resistivity index on spectral analysis. Angiogenesis in malignant lesions lead to formation of structurally abnormal and tortuous vessels with increased resistive index. Several studies on doppler analysis of breast malignancies have shown Doppler ultrasound to be a safe and effective modality showing acceptable diagnostic accuracy for non-invasive characterization of malignant breast lesions. Therefore, it can be employed as an alternative to histopathology in patients who present with breast lesions.

English

BACKGROUND Breast diseases have been known to mankind since ancient times. However, earlier it was a matter of taboo and embarrassment that meant detection and diagnosis were rare. But the involvement of more women and actively bringing out the disease into open is a recent phenomenon. Various types of lesions from inflammation to carcinoma can affect the breast. Lump in breast is the commonest complaint which the patient presents to the surgeon. Different aetiologies of breast lump need different lines of management. We wanted to study the clinical profile of patients up to 40 years presenting with a discrete breast lump, diagnose different pathological conditions causing them and also study different investigations used for diagnosis. METHODS The study was done from October 2013 to December 2015 on a total of 305 consenting patients attending surgery outpatient department and those patients admitted in wards at government medical college, Nagpur were up to 40 years of age with a complaint of a breast lump. Clinical profiles of patients up to 40 years of age presenting with breast lumps were studied along with different investigations for diagnosis and different treatment modalities. RESULTS The highest incidence noted was fibroadenoma (178) in 58.36 % of cases and the lowest incidence was of duct ectasia (3) in 0.98 % of cases. The incidence of fibroadenoma in married women was 46.06 % and in unmarried was 53.93 %. The lowest number of breast lump cases was found in the 10-20 yrs (59) age group and a maximum number of breast lump cases was found in the 21-30 yrs age group (140). Total 74 patients diagnosed with malignancy were the most commonly affected patients in the age group of 31 – 40 yrs. Out of 305 patients with a history of self detected lump 87 i.e. 28.52 % had mastalgia and 16 patients presented with nipple discharge. Ultrasound showed only their benign breast disease characteristic and the definitive diagnosis was not possible in them. CONCLUSIONS Rate of benign pathologies is comparatively much higher than malignant ones in young females; however, increasing trends of malignancy in this age group cannot be neglected. With the global trend towards an increase in the incidence of breast malignancy, for every patient with a breast lump, cytological / tissue diagnosis by an expert pathologist must be established, before a further line of treatment can be planned. KEY WORDS Fibroadenoma, Malignancy (CA Breast), OPD (Outpatient Department), Trucut Biopsy.

A CORRELATIONAL STUDY BETWEEN FINE NEEDLE ASPIRATION CYTOLOGY AND HISTOPATHOLOGY OF PALPABLE BREAST LUMPS

Incidence of breast malignancies has been rising. Any breast lump needs to differentiated as surgery may not be required in all cases. The National Health Services Breast Screening Program recommends Fine Needle aspiration cytology (FNAC) as a non-operative diagnostic tool. FNAC is a cheap, readily available, relatively painless, repeatable and patient-friendly investigation with good sensitivity and specificity. FNAC does not yield a tissue diagnosis as opposed to core biopsy, however, a well-performed FNAC and reporting by an expert pathologist help to avoid unnecessary surgeries in benign lesions where only conservative management or elective surgery is needed. Aims: To study the correlation between FNAC and histopathological reports of palpable breast lumps. Materials and method: We conducted an observational study at a tertiary care hospital. The study included 237 patients of palpable breast lumps who had undergone FNAC, excisional biopsy and histopathology in the same institution. The results of FNAC and histopathology reports were correlated into benign and malignant categories. Results: There were 225 women and 12 men in this study. FNAC had reported 20 malignant (C4+C5) cases and 217 benign cases. Histopathology revealed 21 malignant cases and 216 benign cases. We observed a sensitivity of 90.48%, specificity of 99.54%, a positive predictive value of 95%, a negative predictive value of 99.08%, a concordance of 92.41%, a diagnostic accuracy of 98.73% and a negative likelihood ratio of 0.1 for FNAC. Conclusions: Besides other advantages, FNAC of a breast lesion is reliable enough to rule out malignancy.

The Role of Echocardiography in Detection of Chemotherapy-Induced Cardiotoxicity in Breast Cancer Patients

Context: The incidence of breast malignancy is increasing and it became evident that chemotherapy protocols that are based on anthracyclines and trastuzumab, which are being used in these patients, have cardiotoxic effect. Traditional imaging methods could detect the advance stage of chemotherapy-induced cardiomyopathy when cardiac function is significantly impaired. New imaging tools, primarily speckle tracking analysis, could improve detection of cardiotoxicity. Evidence Acquisition: We searched PubMed, Medline, OVID and EMBASE databases for the studies published from January, 1990 up to May, 2016 in the English language using the following keywords: “chemotherapy”, “cardiac toxicity”, “left ventricle”, “anthracyclines”, and “trastuzumab”. Results: Studies show that early signs of chemotherapy-mediated cardiotoxicity in breast cancer patients could be identified even one week after the introduction of anthracycline treatment. Investigations also reported deterioration of the left ventricular mechanics 3, 6 and 12 months after chemotherapy. This suggests that left ventricular strain should be used as an important marker of the left ventricular dysfunction, which might be used simultaneously for detection of cardiotoxicity and for the monitoring of potential improvement of left ventricular function after chemotherapy interruption. Conclusions: New imaging tools provide insight in cardiac function and mechanics, much better than traditional methods. The ability of mechanical changes to predict subsequent cardiotoxicity needs to be evaluated in larger multicenter and longitudinal studies.

Incidence and Prognosis of Breast Malignancies in Young Female (≤ 40 Years of Age)

This study is done to determining the Incidence and Prognostic factors with Histopathological findings and ER & PR status in Young Female (≤ 40 years of age) having breast malignancy. we studied total cases and cases in young female ≤ 40 years of Pathologically diagnosed breast malignancies with family history with observation of Prognostic factors (Age, Tumor size, type, histological grade, invasion, lymph node status and ER & PR status) during one year (from august 2011 to august 2012). We observed total 88 cases of breast malignancies are in 1 year, out of them 22 cases are found in young female ≤ 40 years of age. So incidence of breast malignancies in young female is 25%. In 10 cases (45.45%) size of tumor is ≥ 5 cm, 14 cases (63.63%) shows invasion and lymph node metastasis. 47.36 % cases are ER/PR negative. We conclude that incidence of Breast malignancies in young female (≤ 40 years of age) are increasing, while tumor of young age female found biologically aggressive as per Histopathological findings and ER & PR status.

In Vivo Effect of α-Bisabolol, a Nontoxic Sesquiterpene Alcohol, on the Induction of Spontaneous Mammary Tumors in HER-2/neu Transgenic Mice

Breast cancer represents the most commonly diagnosed invasive malignancy in pre- and postmenopausal women in both developed and underdeveloped countries. Taking into account that treatment options, including surgery, have not been able to deal with the growing incidence of breast malignancy, it is required to develop mechanism-based novel agents for its prevention. Wide interest in some natural compounds as antiinflammatory agents and as alternative to the traditional medicines is increasing because they do not provoke any adverse effects and are effective in multiple organs, alpha-Bisabolol (BISA), a small oily sesquiterpene alcohol, was reported as chemopreventive agent in induced rat mammary carcinogenesis. The aim of the present study is to investigate the role played by two doses of BISA (via intramammary infusion) on the induction and development of mammary tumor in HER-2/neu transgenic mice as well as the BISA effect after tumor surgical resection. The main data show that (a) optimal dosage of BISA is 10 mg/mouse rather than 3.6 mg/mouse with no adverse effects (e.g., alopecia); (b) the number of the palpable tumor masses decreases in mice treated with 10 mg/mouse of BISA; (c) mice after surgical resection of the primary tumor and treatment with BISA (10 mg) are free from tumor for more weeks, after the surgical treatment; (d) using array analysis, some genes implicated in carcinogenesis mechanisms (NF-kappaBia, Map2k, Mapkl4, and HER2/ neu), angiogenesis process (Fgf), and inhibition of apoptosis (Birc5) are differently regulated after BISA treatment, with a downregulation of the HER2/neu as well as of Fgf and Birc5 genes; (e) the NK cell cytotoxicity increases in tumor-treated mice, especially after the removal of the first tumor mass. Such effectiveness could be important to achieve goals for a possible combination of BISA to conventional therapies in breast cancer and to tumor surgical removal (adjuvant therapy), as suggested for other sesquiterpene analogs.

Mammary Gland Dysplasia in Iodine Deficiency

Epidemiological studies suggest that persons living in areas of normal iodine availability show less breast cancer than those living in iodine-deficient areas. 1,2 World Health Organization investigations, recently published, 3 have revealed that a large segment of the population in the United States and other parts of the world lives in areas of limited iodine availability. In addition, there appears to be statistical evidence of an increased incidence of breast malignancy in hypothyroidism. 4-6 Our results imply that iodine deficiency may be involved in these thyroid-breast relationships. The breasts of chronically iodine-deficient female rats treated with testosterone were observed to be considerably larger than their normally fed, testosterone-injected litter-mate controls. No reports directly pertaining to this observation were found in the literature. Therefore, we decided to carry out a systematic investigation of the influence of iodine deficiency on the resting and sex-hormone-treated breasts of female rats. The changes seen were