Invasive Ductal Carcinoma Of Breast Research Articles

From Breast to Sclera: A Silent and Devastating Invasion

Aim: This case report highlights about a silent and devastating invasion of Scleral metastases. Introduction: Ocular metastases remain a rare manifestation of systemic malignancies. Scleral involvement is an exceptionally uncommon presentation, often mimicking inflammatory conditions, which may delay diagnosis and management. Case Presentation: We present the case of a 48-year-old woman with a history of left breast invasive ductal carcinoma diagnosed three years earlier. She underwent conservative treatment, lymph node dissection, chemotherapy, radiotherapy, and was maintained on Tamoxifen. She consulted the emergency department for a painful red left eye evolving over three days. Ophthalmologic examination revealed an 8/10 best-corrected visual acuity, a firm scleral nodule with vascular disorganization, and dilated scleral vessels. Systemic workup showed multiple cutaneous nodules, left pleural effusion, and axillary lymphadenopathy. Histopathological examination confirmed metastatic involvement of the sclera from breast carcinoma. Despite corticosteroid therapy, the lesion progressed. Imaging revealed multiple pulmonary metastases and an intra-auricular thrombus, leading to comprehensive oncologic management. Discussion: Scleral metastases are extremely rare and often masquerade as nodular scleritis. The presence of a treatment-resistant scleral nodule in a neoplastic context should raise suspicion of secondary malignancy. A biopsy is crucial to confirm the diagnosis and initiate timely oncologic care. Conclusion: Although uncommon, scleral metastasis should always be considered in patients with a history of malignancy presenting with atypical ocular symptoms. Early recognition can improve overall prognosis and quality of life.

Bayesian Spatial Analysis of the Incidence Rate of Patients with Breast Cancer in Southern Iran.

In the female population, breast cancer is the most common cancer and a leading cause of cancer death. This study was designed to investigate the geographical pattern of breast cancer risk in different counties of Fars province in the south of Iran from 2001 to 2018. In this historical cohort study, data of Shiraz Population-Based Cancer Registry between 2001 and 2018 was used. The geographical variations of breast cancer incidence rate in 36 counties of Fars province were analyzed using the Bayesian spatiotemporal model. Overall, the averages of relative risk (RR), temporal trend (TT), and δi for breast cancer were 1.59, 1.025, and 0.00 in the total female population; 1.21, 1.002, and 0.00 in the young female population (under 40 years of age); and 1.54, 1.02, and 0.00 in the female population with invasive ductal carcinoma (IDC), respectively. The steady increase in RR of breast cancer and IDC during 2001-2018 was observed in most counties located in the non-central part of the Fars geographic map. Moreover, a steady increase of young breast cancer RR was observed mainly in southern regions and some northern cities of Fars province. Between 2001 and 2018 in Fars province, a steady annual increase of approximately 2% was observed in the total female population for all types of breast cancer, including IDC. High-risk areas, TTs, and changing patterns of breast cancer incidence were determined in this region. Furthermore, areas with a high risk of young breast cancer were identified, which requires special attention.

Immunohistochemical profiling of TNF-α in invasive ductal carcinoma of the breast - A cohort study from Rawalpindi, Pakistan

Breast cancer remains the most prevalent malignancy among women globally, and its incidence increasing, especially in developing countries. In Pakistan, breast cancer poses a significant public health challenge, with a notably high incidence rate among women. Tumor necrosis factor alpha (TNF-α) is a multifunctional cytokine that is commonly up-regulated in various tumors and is considered a tumor promoter element. Reports suggest the involvement of varying levels of TNF-α affecting Breast Cancer susceptibility. Given the diverse genetic, environmental, and lifestyle factors influencing cancer susceptibility, the expression and role of TNF- α in breast cancer may vary across regions. Therefore, it is crucial to explore its expression within specific to understand local disease biology and prognosis. We investigated the expression of TNF-α in 50 different female patients of invasive ductal carcinoma (IDC) of breast using immunohistochemical analysis. Fifty breast tumor biopsy samples and 17 lymph node biopsy specimens were collected. Our findings reveal an elevated expression of TNF-α in most cases analyzed within the local population. Elevated levels of TNF-α were particularly pronounced in metastatic tumors. Additionally, we observed a progressive increase in TNF-α expression in the endothelium as the tumor grade advanced (p-value= 0.044*). This study emphasizes the significant pro-tumor role of TNF in breast cancer within the local population, with elevated expression particularly evident in metastatic and higher-grade tumors.

Arm-Behind-the-Back Position for Breast Cancer Radiotherapy in Patients with Lupus Erythematosus and Shoulder Arthropathy: A Case Report.

BACKGROUND When 3-dimensional conformal radiation therapy (3DCRT) for postoperative breast cancer is performed in the supine position, patients are required to raise their arms to spare the arms from the irradiation field. However, patients with collagen vascular disease can experience severe joint symptoms. CASE REPORT A 43-year-old woman with a history of systemic lupus erythematosus (SLE) 10 years ago received a diagnosis of invasive ductal carcinoma of the left breast. Breast-conserving surgery and sentinel lymph node biopsy were performed. The pathological stage was IA. Physical and immunological examinations indicated that SLE disease activity was stable preoperatively and postoperatively. She had difficulty holding her left arm in a raised position because of arthritis related to SLE and steroid therapy. For postoperative radiation therapy, we developed an arm-behind-the-back position, in which a platform was placed between the patient's body and couch. In this position, the patient's arm was lowered behind the back, such that the arm did not interfere with the irradiation field of 3DCRT. The treatment plan achieved an acceptable homogeneity index, low dose to the lungs and heart, and no problematic hotspots. Although the time required for position matching and irradiation tended to be longer than that in the regular supine position, scheduled irradiation was safely completed. Grade 2 radiation dermatitis was observed. The patient showed no signs of local recurrence or distant metastases after 15 months. No radiation pneumonitis was observed. CONCLUSIONS The ingenuity of positioning can achieve radiotherapy in patients with collagen vascular disease and shoulder joint symptoms.

Melatonin MT1 Receptor Expression in Luminal Invasive Ductal Breast Carcinoma in Postmenopausal Women.

Laboratory and animal studies indicate that melatonin exerts a negative impact on breast cancer progression and metastasis. These actions are both receptor-dependent and -independent. Of the two transmembrane melatonin receptors identified in humans, breast cancer expresses only MT1. The aim of this study was to investigate the expression of MT1 in hormone-receptor-positive, HER2-negative invasive ductal breast carcinoma in postmenopausal women and its possible correlations with clinicopathological parameters and survival. A total of 118 patients with luminal A/B primary breast cancer with or without axillary metastases were identified. The MT1 receptor expression was immunohistochemically assessed as a percentage of stained cells and a weighted index (WI) (percentage multiplied by staining intensity). Most tumor samples (84.7%) and metastasized lymph nodes (96%) stained positive for MT1, with varying intensity. No statistically significant correlations were found between the MT1 expression or the WI in the primary tumor and the patient and tumor characteristics, or the MT1 and WI in the metastasized lymph nodes. The survival analysis did not reveal a significant effect of MT1 expression or the WI on the risk of recurrence or survival.

Metachronous Adrenal Metastasis from Breast Invasive Ductal Carcinoma: A Case Report & Review of Literature

Metachronous Adrenal Metastasis from Breast Invasive Ductal Carcinoma: A Case Report & Review of Literature

The significance of the Ferroptosis Markers (SLC7A11, ACSL4) and Their Relation to M6A Modification Regulators (HNRNPA2B1, YTHDF1) in Breast Invasive Ductal Carcinoma

The significance of the Ferroptosis Markers (SLC7A11, ACSL4) and Their Relation to M6A Modification Regulators (HNRNPA2B1, YTHDF1) in Breast Invasive Ductal Carcinoma

Immunoglobulin A-dominant membranoproliferative glomerulonephritis-like pattern of injury as a possible paraneoplastic nephropathy in a breast cancer patient.

A middle-aged woman was found to have proteinuria during a health check-up. About sixteen months later, she was diagnosed with stage IIA invasive ductal carcinoma of the right breast. Her proteinuria progressed to nephrotic syndrome with significant hematuria. Hormone therapy was initiated for her estrogen and progesterone receptor-positive breast cancer. A kidney biopsy performed 47days after starting the therapy revealed an IgA-dominant membranoproliferative glomerulonephritis-like pattern of injury. Electron microscopy showed subendothelial-dominant electron-dense deposits (EDD), with small amounts of mesangial EDD and a single occurrence of subepithelial hump-like EDD, along with occasional mesangial interpositions. Similar pathology can be caused by IgA vasculitis with nephritis, IgA-dominant infection-associated glomerulonephritis, and liver disease-associated glomerulopathy, but all of these were ruled out. The deposited IgA was found to be galactose-deficient IgA1. Thus, IgA nephropathy with glomerular capillary IgA deposition was considered. She underwent a right partial mastectomy and sentinel lymph node biopsy in the right axilla 75days after starting hormone therapy, followed by adjuvant radiation. Proteinuria and hematuria tended to decrease after the treatment, and this trend continued even after corticosteroid therapy for glomerulonephritis, which was administered 156days after starting hormone therapy. Approximately 15months after starting hormone therapy, her proteinuria had reduced to around 1.0g/g of creatinine, and her hematuria was negative. IgA nephropathy with glomerular capillary IgA deposition is known to be resistant to corticosteroid therapy. The favorable clinical course of the rare glomerulopathy following breast cancer treatment suggested a diagnosis of paraneoplastic glomerulopathy secondary to breast cancer in our patient.

Prognostic Features and Predictive Model for Mixed Invasive Ductal and Lobular Breast Carcinoma in Early-Stage Patients.

Prognostic Features and Predictive Model for Mixed Invasive Ductal and Lobular Breast Carcinoma in Early-Stage Patients.

The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy.

The 2024 Assisi think tank on breast cancer: Focus on the use of a tumour bed boost after breast conserving therapy.

Simultaneous bilateral primary invasive ductal breast carcinoma with apocrine metaplasia detected by 18F-FDG PET/CT

Simultaneous bilateral primary invasive ductal breast carcinoma with apocrine metaplasia detected by 18F-FDG PET/CT

Overlap of high-risk individuals across family history, genetic & non-genetic breast cancer risk models: Analysis of 180,398 women from European & Asian ancestries.

Breast cancer is multifactorial. Focusing on limited risk factors may miss high-risk individuals. We assessed the performance and overlap of various risk factors in identifying high-risk individuals for invasive breast cancer (BrCa) and ductal carcinoma in situ (DCIS) in 161,849 European-ancestry and 18,549 Asian-ancestry women. Discriminatory ability was evaluated using the area under the receiver operating characteristic curve (AUC). High-risk criteria included: 5-year absolute risk ≥1·66% by the Gail model [GAILbinary]; first-degree family history of breast cancer [FHbinary]; 5-year absolute risk ≥1·66% by a 313-variants polygenic risk score [PRSbinary]; and carriers of pathogenic variants in breast cancer predisposition genes [PTVbinary]. The 5-year absolute risk by PRS outperformed the Gail model in predicting BrCa (Europeansvs controls: AUCPRS=0·635 [0·632-0·638] vs AUCGail=0·492 [0·489-0·495]; Asiansvs controls: AUCPRS=0·564 [0·556-0·573] vs AUCGail=0·506 [0·497-0·514]). PRSbinary and GAILbinary identified more high-risk European than Asia individuals. High-risk proportions were higher among BrCa (16-26%) and DCIS (20-33%) compared to controls (9-15%) among young Europeans and all Asians. Fewer than 7% of BrCa, 10% of DCIS, and 3% of controls were classified as high-risk by multiple risk classifiers. Overlap between PRSbinary and PTVbinary was minimal (<0·65% Europeans, <0·15% Asians) compared to the proportion at high risk using PTVbinary alone (Europeans: 4·6%, Asians: 4·4%) and PRSbinary alone (Europeans: 13·9%, Asians: 8·5%). PRSbinary and FHbinary uniquely identified 5-6% and 9-11% of young BrCa, respectively. The incomplete overlap between high-risk individuals identified by PRSbinary, GAILbinary, FHbinary, and PTVbinary highlights the need for a comprehensive approach to breast cancer risk prediction.

Primary squamous cell carcinoma complicated with invasive ductal carcinoma of breast

Primary squamous cell carcinoma complicated with invasive ductal carcinoma of breast

Exploration of crucial stromal risk genes associated with prognostic significance and chemotherapeutic opportunities in invasive ductal breast carcinoma.

Exploration of crucial stromal risk genes associated with prognostic significance and chemotherapeutic opportunities in invasive ductal breast carcinoma.

Mammographic density as a predictor of invasive breast cancer and ductal carcinoma in situ in over six million South Korean women.

Evidence on the associations between categorical mammographic density and breast cancer risk by tumor invasiveness remains limited in Asian women. This large, population-based cohort study investigated the distribution of mammographic density by age and menopausal status, as well as its association with the risks of invasive breast cancer and ductal carcinoma in situ (DCIS) in South Korean women. Mammographic screening was performed on 6,365,522 women between 2009 and 2014 through the Korean National Cancer Screening Program. Mammographic parenchymal composition was classified using the fourth edition of Breast Imaging Reporting and Data System. We computed multivariable-adjusted hazard ratios and 95% confidence intervals (CIs) using Cox proportional hazards regression models for the association between mammographic parenchymal composition and the risk of invasive cancer and DCIS. Overall, 40.6% of women had dense breasts, with the proportion decreasing with increasing age. A total of 44,468 incident breast cancer cases (0.7%) were documented. Compared with almost entirely fatty breasts, increasing mammographic density was associated with a higher risk of breast cancer (HR, 1.55; 95% CI 1.51-1.60 for scattered fibroglandular densities; HR, 2.14; 95% CI 2.08-2.21 for heterogeneously dense breasts; and HR, 2.59; 95% CI 2.50-2.69 for extremely dense breasts). Associations between mammographic density and breast cancer risk were similar for invasive cancer and DCIS, and did not vary significantly by menopausal status. Mammographic density may be a significant risk factor for both invasive cancer and DCIS, regardless of menopausal status. It should be incorporated into breast cancer risk stratification and screening strategies.

Malignant upgrade in lesions of uncertain malignant potential in the breast (B3 lesions) – is open excision always necessary?

PurposeUnclear or suspicious breast findings are typically clarified by interventional breast biopsy. Lesions with uncertain malignant potential are grouped as B3 lesions in histopathology. The B3 group according to the European Working Group for Breast Screening Pathology (EWGBSP) comprises various breast lesions with different upgrade rates to invasive breast cancer (BC) or ductal carcinoma in situ (DCIS) if surgical removal is performed. The objective of this study was to investigate malignant upgrade rates to DCIS and/or invasive breast cancer (BC) after open surgical excision for the different B3 lesions.MethodsA total of 192 patients with histologically verified B3 lesions were followed up retrospectively for this analysis. Patients with the B3 lesions atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), and classical lobular neoplasia (LN1-2) were combined into one group, while cellular fibroepithelial lesions (CFL) and phyllodes tumors without suspicion of malignancy, as well as papillomas and radial scars/complex sclerosing lesions (RS/CSL) were summarized in two other groups. We investigated the association of the different B3 lesions with invasive BC or DCIS after open surgical excision.ResultsHistopathological investigation revealed in 21 (10.9%) of the 192 patients invasive BC or DCIS after open surgical excision. The rate of patients with BC and/or DCIS significantly differed between the patient groups (p < 0.01, Fisher’s exact test): The highest rate was 17.5% (95% confidence interval (CI), 10.7–26.2) in patients within the group of ADH, FEA, and LN1-2. In the other two groups, fewer malignant lesions occurred. In the group with papillomas and RS/CSL the malignant upgrade rate was 4.3% (95% CI, 0.9–12.2), while within the group with CFL and phyllodes tumors without suspicion of malignancy no malignant upgrade was observed (0.0%, 95% CI, 0.0–16.9).ConclusionsB3 lesions harbor the risk of malignant upgrade after surgical excision. In our collective ADH, FEA, and LN1-2 had significant higher upgrade rates than other B3 lesions.

Multispectral photoacoustic imaging of breast cancer tissue with histopathology validation.

Intraoperative multispectral photoacoustic pathology assessment presents a promising approach to guide biopsy resection. In this study, we developed and validated a novel photoacoustic technique to differentiate between healthy and cancerous tissues. Our method consisted of photoacoustic contrast calculations as a function of wavelength, followed by projections of the resulting spectra from training data into a two-dimensional space using principal component analysis to create representative spectra, then calculation of the average cosine similarity between the spectrum of each pixel in test data and the representative spectra. The test healthy tissue region had a 0.967 mean correlation with the representative healthy tissue spectrum and a lower mean correlation (0.801) with the cancer tissue spectrum. The test cancer tissue region had a 0.954 mean correlation with the cancer tissue spectrum and a lower mean correlation (0.762) with the healthy tissue spectrum. Our method was further validated through qualitative comparison with high-resolution hematoxylin and eosin histopathology scans. Healthy tissue was primarily correlated with the optical absorption of blood (i.e., deoxyhemoglobin), while invasive ductal carcinoma breast cancer tissue was primarily correlated with the optical absorption of lipids. Our label-free histopathology approach utilizing multispectral photoacoustic imaging has the potential to enable real-time tumor margin determination during biopsy or surgery.

27 Pancreatic solid pseudopapillary tumor in a patient with newly diagnosed invasive breast ductal carcinoma

27 Pancreatic solid pseudopapillary tumor in a patient with newly diagnosed invasive breast ductal carcinoma

A Regulatory Circuits Analysis Tool, "miRCuit," Helps Reveal Breast Cancer Pathways: Toward Systems Medicine in Oncology.

A systems medicine understanding of the regulatory molecular circuits that underpin breast cancer is essential for early cancer detection and precision/personalized medicine in clinical oncology. Transcription factors (TFs), microRNAs (miRNAs), and long non-coding RNAs (lncRNAs) control gene expression and cell biology, and by extension, serve as pillars of the regulatory circuits that determine human health and disease. We report here the development of a regulatory circuit analysis program, miRCuit, constructing 10 different types of regulatory elements involving messenger RNA, miRNA, lncRNA, and TFs. Using the miRCuit, we analyzed expression profiling data from 179 invasive ductal breast carcinoma and 51 normal tissue samples from the Gene Expression Omnibus database. We identified eight circuit types along with two special types of circuits, one of which highlighted the significant roles of lncRNA CASC15, miR-130b-3p, and TF KLF5 in breast cancer development and progression. These findings advance our understanding of the regulatory molecules associated with breast cancer. Moreover, miRCuit offers a new avenue for users to construct circuits from regulatory molecules for potential applications to decipher disease pathogenesis.

Machine learning-based prognostic modeling and surgical value analysis of de novo metastatic invasive ductal carcinoma of the breast.

Whether primary lesion surgery improves survival in patients with de novo metastatic breast cancer (dnMBC) is inconclusive. We aimed to establish a prognostic prediction model for patients with de novo metastatic breast invasive ductal carcinoma (dnMBIDC) based on machine learning algorithms and to investigate the value of primary site surgery. The data used in our study were obtained from the Surveillance, Epidemiology, and End Results database (SEER, 2010-2021) and the First Affiliated Hospital of Nanchang University (1st-NCUH, June 2013-June 2023). We used COX regression analysis to identify prognostic factors. We divided patients into training and validation groups and constructed Extreme Gradient Boosting (XGBoost) prognostic prediction model. In addition, we used propensity score matching (PSM), K-M survival analysis, and COX regression analysis to explore the survival benefit of patients undergoing primary lesion surgery. A total of 13,383 patients were enrolled, with 13,326 from SEER and 57 from 1st-NCUH. The results showed that XGboost had good predictive ability (training set C-index = 0.726, 1year AUC = 0.788, 3year AUC = 0.774, 5year AUC = 0.774; validation set C-index = 0.723, 1year AUC = 0.785.1, 3year AUC = 0.770, 5year AUC = 0.764), which has better predictive power than the Coxph model. We used Shiny-Web to make our model easily available. Furthermore, we found that surgery was associated with a better prognosis in dnMBIDC patients. Based on the XGboost, we can accurately predict the survival of dnMBIDC patients, which can provide a reference for clinicians to treat patients. In addition, surgery may bring survival benefits to dnMBIDC patients.