Breast Masses Research Articles

A Short Breast Imaging Reporting and Data System-Based Description for Classification of Breast Mass Grade

Identifying breast masses is relevant in early cancer detection. Automatic identification using computational methods helps assist medical experts with this task. Although high values have been reported in breast mass classification from digital mammograms, most results have focused on a general benign/malignant classification. According to the BI-RADS standard, masses are associated with cancer risk by grade depending on their specific shape, margin, and density characteristics. This work presents a methodology of testing several descriptors on the INbreast dataset, finding those better related to clinical assessment. The analysis provides a description based on BI-RADS for mass classification by combining neural networks and image processing. The results show that masses associated with grades BI-RADS-2 to BI-RADS-5 can be identified, reaching a general accuracy and sensitivity of 0.88±0.07. While this initial study is limited to a single dataset, it demonstrates the possibility of generating a description for automatic classification that is directly linked to the information analyzed by medical experts in clinical practice.

A Neglected Case of a Benign Phyllodes Tumor Presenting as a 10.5 kg Breast Mass

A Neglected Case of a Benign Phyllodes Tumor Presenting as a 10.5 kg Breast Mass

Fine Needle Aspiration Cytological Diagnosis of Primary Breast Large-Cell Neuroendocrine Carcinoma/Squamous Cell Carcinoma.

Primary breast large-cell neuroendocrine carcinoma (LCNEC)/squamous cell carcinoma (SCC), also referred to as mixed neuroendocrine/non-neuroendocrine neoplasms of the breast (Br-MiNENs), represents an exceedingly rare malignancy. We report the first case of primary breast LCNEC/SCC diagnosed via ultrasound-guided fine-needle aspiration (FNA) biopsy of the left supraclavicular and left internal mammary lymph nodes. The patient, a 40-year-old female, underwent a lumpectomy followed by breast-conserving surgery and was diagnosed with primary breast LCNEC. Notably, within merely four months following the breast-conserving surgery, PET-CT revealed lymph node enlargement, prompting the performance of FNA. FNA cytology of metastatic lymph nodes revealed two distinct tumor components, allowing for clear differentiation between LCNEC and SCC in the smear. The diagnosis was further corroborated by immunocytochemical (ICC) staining of the cell blocks. Subsequently, histopathological re-examination of the breast mass revealed occult SCC components comprising less than 1% of the tumor cells. Additionally, the case exhibited triple-negative breast cancer, with PIK3CA, TP53, RB1, and BCL2L11 mutations identified through next-generation sequencing (NGS). Br-MiNEN is exceedingly rare, and its cytological diagnosis poses significant challenges. It is recommended that a detailed and objective description of each tumor component and its proportion be provided. This report provides the first detailed description of the FNA cytology of LCNEC/SCC, thereby enhancing cytopathologists' comprehension of this tumor. Auxiliary studies, including ICC staining and molecular biology assays, are crucial for accurate diagnosis, therapy, and prognosis.

PRIMARY CHONDROSARCOMA OF RIB: RARE NEOPLASM WITH ATYPICAL PRESENTATION

Background:Chondrosarcoma is uncommon malignant tumor of rib can have atypical presentation based on age, gender and clinical features. However, Computed Tomography is imaging modality of choice and helps aids in diagnosis and guiding treatment. Case Presentation: This was a case of 84 year old lady, who presented as a breast lump. Core needle biopsy gave the differential diagnosis Malignant phylloides with heterologous cartilaginous component, Primary chondroid sarcoma, Metaplastic carcinoma. However, imaging findings led to diagnosis of chondrosarcoma arising from right 4th rib and hence patient underwent en bloc excision of anterior chest wall with chest wall reconstruction. Final histopathology was suggestive of grade 2 chondrosarcoma with medial margin microscopically positive. Patient was kept on 2 monthly follow up after surgery without giving any adjuvant therapy or additional surgery. She was disease free at 6 months follow up. Conclusion: The incidence of rib Chondrosarcoma is rare and presents a diagnostic challenge. Surgical management with wide local excision and reconstruction remains the treatment of choice.

Ohabm-net: an enhanced attention-driven hybrid network for improved breast mass detection

Ohabm-net: an enhanced attention-driven hybrid network for improved breast mass detection

Evaluation of patients' care pathway before the first consultation in the radiotherapy department of Centre Hospitalier Nganda (Kinshasa) for breast cancer treatment

Introduction: That study assesses the care pathway to detect the reasons why the patients reached the radiotherapy department of Centre Hospitalier Nganda with advanced breast cancer. Material and Methods: We conducted a descriptive and analytical cross-sectional study from March 2024 to June 2024. We included all new breast cancer patients in our center. A p-value ≤ 0.05 was considered statistically significant for all analyses. An average comparison between quantitative variables was performed using the non-parametric Kruskal-Wallis test. Results and discussion: We enrolled 54 patients. The mean age was 53.13 ± 11.94 years and the median age was 51 years. A breast mass dominated the clinical picture in 87.07% of cases. Regarding the first medical contact, 77.78% of patients sought care in a conventional medical center. During the treatment, 31.48% of patients had received traditional pharmacopeia and 16.67% had undergone holistic treatment. Regarding radiotherapy indications, 14.81% of patients had no relevant indication for irradiation. The average time between the first symptoms and the radiotherapy consultation was 12.9 ± 9.2 months. There was a statistically significant positive correlation between the time from first symptoms to radiotherapy consultation and the staging of the disease (P-value=0.023). Patients who sought care at home (OR: 1.1; 95% CI 0.13-6.89) or in a conventional medical center (OR: 1.49; 95% CI 0.35-7.77) were all at risk of reaching radiotherapy with an advanced disease. Conclusion: The care pathway of breast cancer patients has a global impact on the outcome and also on the prognosis.

Two case reports of breast cancer combined with synchronous primary intrahepatic cholangiocarcinoma/mixed liver cancer.

This case report discusses multiple primary malignant tumors, which refer to the occurrence of 2 or more different histological types of malignant tumors simultaneously or successively in the same individual. We present 2 female patients who were admitted to the hospital due to a "left breast mass" and were found to have multiple solid masses in the liver upon imaging. Postoperative pathology revealed that one patient had breast invasive ductal carcinoma was complicated with primary intrahepatic cholangiocarcinoma and mixed hepatocellular carcinoma with intrahepatic cholangiocarcinoma. Both patients underwent extensive resection of the lesion. Regular postoperative checkups and follow-ups have been conducted, and both patient's current conditions are stable. The treatment approach adopted in this case report may serve as a favorable reference for the management of similar cases. However, further extensive biological studies are still needed to investigate the biological mechanisms of multiple primary malignant tumors and to discover specific therapeutic approaches to achieve more clinical benefits for patients.

A 10-year retrospective study of 43 female patients presenting with idiopathic granulomatous mastitis

Background: Idiopathic Granulomatous Mastitis (IGM) is a rare inflammatory breast condition affecting middle aged women. IGM typically presents as a unilateral, painful and challenging-to-treat breast mass, with a high recurrence rate. Common treatments include corticosteroids and antibiotics, with surgical excision reserved for resistant cases. However, the absence of a standardized treatment protocol leads to variability in management across different settings and providers. Methods: We present a case series of 43 patients diagnosed with IGM at a community hospital in New York, aiming to facilitate early recognition and treatment of this rare condition. This study identifies risk factors and reviews best practices in imaging and treatment, emphasizing the importance of considering IGM in the differential diagnosis, particularly in cases of recurrent disease. Results: The sample comprised 43 patients with an average age of 34.65 years, 31 (72%) of whom were Hispanic. The most commonly reported symptoms were pain, mass, erythema, and swelling. In all cases, IGM was confirmed by histopathological examination. Treatment modalities included incision and drainage (I and D), corticosteroids, antibiotics, methotrexate and surgical intervention. Conclusions: IGM is a rare condition often mistaken for breast cellulitis, abscess or carcinoma. Maintaining a high index of suspicion is crucial, particularly in Hispanic women who may be at increased risk. Histopathological diagnosis is essential to prevent unnecessary surgical interventions and antibiotic use, thereby reducing recurrence rates. Early initiation of corticosteroids or alternatives like methotrexate can optimize patient outcomes and reduce healthcare costs.

Cancer incidence and competing mortality risk following 15 presenting symptoms in primary care: a population-based cohort study using electronic healthcare records

·ObjectivesAssessment of age, sex and smoking-specific risk of cancer diagnosis and non-cancer mortality following primary care consultation for 15 new-onset symptoms.Methods and analysisData on patients aged 30–99 in 2007–2017 were...

Giant Phyllodes Sarcoma of the Breast: A Case Report

Breast sarcomas are rare, constituting less than 1% of malignant breast tumors, with phyllodes tumors being the most common. This report details a case of a 50-year-old woman who presented with a rapidly growing right breast mass, initially diagnosed as a low-grade phyllodes tumor two years prior. Upon re-evaluation, the mass had significantly enlarged, exhibiting characteristics of a phyllodes sarcoma.

Breast Neuroendocrine Carcinoma Discovered by Lymph Node and Osteomedullary Metastasis: A Case Report

This case highlights a rare presentation of small cell mammary neuroendocrine carcinoma in a young woman, with metastatic spread to the spinal cord. Such a presentation is exceptionally uncommon, particularly in this demographic, and underscores the diagnostic challenges associated with neuroendocrine tumors outside typical locations. Reporting this case adds to the limited literature on mammary neuroendocrine carcinoma with spinal metastasis and may guide early identification in similar cases. We report A 20-year-old female patient 3 with persistent lower back pain over three months. Clinical examination revealed cervical lymphadenopathy and bilateral breast masses. Magnetic resonance imaging (MRI) identified a spinal tumor infiltration. A biopsy of the cervical lymph nodes, followed by immunohistochemical analysis, confirmed the diagnosis of small cell mammary neuroendocrine carcinoma. Chemotherapy was chosen as the primary therapeutic approach, given the tumor’s aggressiveness and advanced stage at diagnosis. This case underscores the importance of considering neuroendocrine carcinoma as a differential diagnosis for young patients presenting with atypical tumor localizations, such as bilateral breast masses and spinal metastasis. The case highlights the necessity of a multidisciplinary approach in diagnosing and managing rare tumors and demonstrates the potential impact of prompt recognition and treatment to improve outcomes.

Ultrasound S-detect system can improve diagnostic performance of less experienced radiologists in differentiating breast masses. A retrospective dual-center study.

To compare the performance of radiologists when assisted by an S-detect system with that of radiologists or an S-detect system alone in diagnosing breast masses on US images in a dual-center setting. US images were retrospectively identified 296 breast masses (150 benign, 146 malignant) by investigators at two medical centers. Six radiologists from the two centers independently analyzed the US images and classified each mass into categories 2 to 5. The radiologists then re-reviewed the images with the assistance of the S-detect system. The diagnostic value of radiologists alone, S-detect system alone, and S-detect alone, and radiologists + S-detect were analyzed and compared. Radiologists had significantly decreased the average false negative rate (FNR) for diagnosing breast masses using S-detect system (- 10.7%) (P < 0.001) and increased the area under the receiver operating characteristic curve (AUC) from 0.743 to 0.788 (P < 0.001). Seventy-seven out of 888 US images from six radiologists in this study were changed positively (from false negative to true positive or from false positive to true negative) with the S-detect, while 39 out of 888 US images were altered negatively. Radiologists had better performance for the diagnosis of malignant breast masses on US images with an S-detect system than without. The study used a dual-center design and compared the performance of the radiologists alone, the S-detect alone, and the radiologists combined with the S-detect. The study reported an improvement in sensitivity and AUC particularly for low to intermediate-level radiologists, involved cases and radiologists from two different centers, and compared the diagnostic value of using S-detect system for masses of different sizes.

Larger than life: A case of a bleeding giant phyllodes tumor in a COVID-19 positive patient

Introduction: Phyllodes tumor of the breast, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor that accounts for about 0.3–1% of all breast tumors. Unlike most breast tumors that start from the ducts and gland, phyllodes tumor originates from the stroma. The classification of phyllodes tumor is less important on assessing the risk of recurrence as compared to the presence of tumor-free margins after surgical treatment. Case Report: A 54-year-old female presented at the emergency room with a large, bleeding, left breast mass. The patient tested positive for COVID-19 and was admitted previously at the isolation ward. After medical management of her current condition, the patient underwent wide excision (total mastectomy), left with en bloc resection of pectoralis major with delayed reconstruction via split thickness skin graft. This case is one of the few reported giant phyllodes tumor in the English literature, measuring 30 cm widest dimension. Conclusion: Malignant phyllodes tumor is a rare form of breast malignancy behaving like a sarcoma. A diagnostic dilemma may be encountered in patients with such tumors due to the rarity of these cases and the different presentation of the tumor. High suspicion shall be entertained for patients with breast masses which tend to appear like benign lesions but with sudden enlargement. Adequate surgical intervention shall be done ensuring tumor-free margins. Adjuvant therapy for malignant phyllodes tumor is still controversial but shall be entertained according to the patient’s actual case needs.

Reduction Mammaplasty

Background While there is mounting evidence that closed suction drains are not necessary, there is a paucity of literature to demonstrate that drains are harmful after breast reduction. The purpose of this study was to investigate the effect of drains on postoperative seroma, hematoma, and infection, as well as elucidate any risk factors that may be implicated in the development of these complications. Methods A retrospective cohort study was conducted of all reduction mammaplasty procedures at our university medical center between 2010–2020. Pedicle type, skin incision, drain utilization, breast excision mass, sternal notch to nipple distance, and inframammary fold to nipple distance were analyzed with postoperative outcomes including hematoma, seroma, infection, dehiscence, nipple necrosis, and fat necrosis. Results This study included 944 female patients undergoing reduction mammaplasty. Median age was 39.0 years, median body mass index was 31.9 kg/m2, and median breast mass resected was 742 grams per side. Drain utilization did not significantly reduce postoperative hematoma (P = 0.196), seroma (P = 0.185), nipple necrosis (P = 0.511), or fat necrosis (P = 0.113), but drain utilization significantly increased postoperative surgical site infection (P = 0.011). Patients with breast mass removed over 1500 g had significantly higher risk of hematoma (P = 0.002), fat necrosis (P &lt; 0.001), and nipple necrosis (P &lt; 0.001) compared to patients with less than 1500 g removed. In patients with greater than 1500 g resected, drain utilization did not significantly decrease risk of hematoma (P = 0.086) or seroma (P = 0.497). Conclusions Breast reduction greater than 1500 g per side significantly increased risk of hematoma, nipple necrosis, and fat necrosis. Drain utilization did not demonstrate any advantageous effects, rather it increased risk of infection. Future multicenter study will be needed to confirm these findings across different patient referral networks and practice patterns.

Breast metastasis from large cell neuroendocrine carcinoma of the lung: a case report

BackgroundPrimary breast carcinoma is far more common than breast metastases. Common breast metastases usually come from lymphoma, leukemia, melanoma, and ovarian cancers. Breast metastases from neuroendocrine carcinomas are considered an exceeding rare entity. It has been reported in the literature that the pathological presentation of this particular metastatic tumor is very challenging as it shares many morphological characteristics with primary breast carcinoma.Case presentationWe report a case of a patient with large cell neuroendocrine carcinoma of the lung metastasizes to both breasts. The patient was initially presented with brain metastasis of unknown origin. Further radiological imaging workup showed multiple bilateral breast masses and bilateral lymphadenopathy, which raised concern for secondary lymphoma of the breast. The histopathology of this case was challenging, particularly when triple negative invasive ductal carcinoma diagnosis had been made. Multidisciplinary meetings between medical oncologists, radiologists, and pathologists profoundly helped confirming the diagnosis of metastatic large cell neuroendocrine tumor to the breast.ConclusionLarge cell neuroendocrine carcinoma of the lung is a relatively uncommon diagnosis with generally poor prognosis. Large cell neuroendocrine carcinoma that metastasizes to the breast is even scarcer. Correlation between clinical assessment, radiological imaging, and pathological evaluation is the key in making such an unusual and complex diagnosis. Additionally, radiologists should be aware of metastatic presentations of the breast and avoid confusion with mimicking benign entities or primary breast carcinomas.

Artificial Intelligence in Breast Cancer Diagnosis and Treatment: Advances in Imaging, Pathology, and Personalized Care.

Breast cancer is the most prevalent cancer worldwide, affecting both low- and middle-income countries, with a growing number of cases. In 2024, about 310,720 women in the U.S. are projected to receive an invasive breast cancer diagnosis, alongside 56,500 cases of ductal carcinoma in situ (DCIS). Breast cancer occurs in every country of the world in women at any age after puberty but with increasing rates in later life. About 65% of women with the BRCA1 and 45% with the BRCA2 gene variants develop breast cancer by age 70. While these genes account for 5% of breast cancers, their prevalence is higher in certain populations. Advances in early detection, personalised medicine, and AI-driven diagnostics are improving outcomes by enabling a more precise analysis, reducing recurrence, and minimising treatment side effects. Our paper aims to explore the vast applications of artificial intelligence within the diagnosis and treatment of breast cancer and how these advancements can contribute to elevating patient care as well as discussing the potential drawbacks of such integrations into modern medicine. We structured our paper as a non-systematic review and utilised Google Scholar and PubMed databases to review literature regarding the incorporation of AI in the diagnosis and treatment of non-palpable breast masses. AI is revolutionising breast cancer management by enhancing imaging, pathology, and personalised treatment. In imaging, AI can improve the detection of cancer in mammography, MRIs, and ultrasounds, rivalling expert radiologists in accuracy. In pathology, AI enhances biomarker detection, improving HER2 and Ki67 assessments. Personalised medicine benefits from AI's predictive power, aiding risk stratification and treatment response. AI also shows promise in triple-negative breast cancer management, offering better prognosis and subtype classification. However, challenges include data variability, ethical concerns, and real-world validation. Despite limitations, AI integration offers significant potential in improving breast cancer diagnosis, prognosis, and treatment outcomes.

Pseudoangiomatous stromal hyperplasia causing bilateral galactomastia with short-term recurrence after surgery: a case report.

Pseudoangiomatous stromal hyperplasia (PASH) is a rare, benign breast lesion characterized by collagen proliferation, often identified as an incidental microscopic finding. Clinically, it may present as a palpable, well-defined breast mass or, in rare instances, as a diffuse, bilateral process leading to significant breast enlargement. We herein report a case of extensive diffuse PASH with short-term recurrence following lesion resection at another hospital. Because of the severity of symptoms, the patient underwent bilateral mastectomy at our facility. This article reviews the clinical, radiologic, and pathologic features of PASH and emphasizes the importance of an accurate preoperative imaging diagnosis for guiding appropriate treatment.

Lactation Massage and Hypnobreastfeeding Relaxation Techniques in Breastfeeding Mothers

Breast milk is a kind of food that is good for meeting all the physical needs of babies. Breast milk contains most of the nutritional elements, hormones and immunity of a baby. After that the baby will only get breast milk until the baby is six months old, after the baby is six months old the baby will be given complementary food for breast milk until the baby is even two years old. Purpose: this research is to find out the description of nursing care for normal postpartum mothers who experience ineffective breastfeeding at Koja Jakarta Hospital in 2023 with lactation massage and hypnobreastfeeding relaxation techniques. Methodology: the research used is a descriptive researcher with a case study design that will be carried out in June 2023. Results: a study of patients who experienced ineffective breastfeeding by means of lactation massage and hypnobreastfeeding relaxation techniques, could increase milk production, reduce breast swelling and reduce pain. This can happen because of the willingness of the client to follow. Conclusion: lactation massage techniques and hypnobreastfeeding relaxation techniques can be done when complaints of a little milk coming out, anxiety, swelling in the breasts of post partum mothers are normal.

Machine learning-guided synthesis of nanomaterials for breast cancer therapy

Breast cancer is a common malignant tumor, which mostly occurs in female population and is caused by excessive proliferation of breast epithelial cells. Breast cancer can cause nipple discharge, breast lumps and other symptoms, but these symptoms lack certain specificity and are easily confused with other diseases, thus affecting the early treatment of the disease. Once the tumor progresses to the advanced stage, distant metastasis can occur, leading to dysfunction of the affected organs, and even threatening the patients’ lives. In this study, we synthesized high drug-loading gel particles and applied them to control the release of insoluble drugs. This method is simple to prepare, cost-effective, and validates their potential in breast cancer therapy. We first characterized the morphology and physicochemical properties of gel loaded with newly synthesized compound 1 by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FT-IR), and thermal gravimetric analysis (TGA). Using newly synthesized insoluble compound 1 as a model drug, its efficacy in treating breast cancer was investigated. The results showed that hydrogel@compound 1 was able to significantly inhibit the proliferation, migration and invasion of breast cancer cells. Additionally, we utilized machine learning to screen three structurally similar compounds, which showed promising therapeutic effects, providing a new approach for the development of novel small-molecule drugs.

Association between Clinical Features and Risk Factors for Breast Cancer through a Cross-Sectional Study

Introduction: Breast cancer was responsible for 685,000 deaths worldwide in 2020. Approximately half of all breast cancers arise in women who have no identifiable risk factors other than their gender and age. Objectives: The goal of this study was to determine the association between clinical features and breast cancer risk factors. Methods: This cross-sectional study was conducted among 50 histologically confirmed breast cancer patients included by purposive sampling technique in the Surgery Department of Rangpur Medical College, Rangpur. Results: The presence of breast lump was significantly associated with the residence of patients (p value&lt;0.011). The significant association between nipple retraction and family history may indicate a hereditary predisposition that affects the course of the disease (p value&lt;0.031). Conclusion: This research provides insights into vital aspects of breast cancer within a particular demographic, under scoring the necessity for focused approaches to public health to address the discrepancies in breast cancer presentation and outcomes. J Bangladesh Coll Phys Surg 2024; 42: 321-328