Nipple Discharge Research Articles

Clinicopathological profile of mastalgia in females: incidence, types, and pathological correlations. a cross-Sectional study.

Mastalgia was the most common symptom in patients attending a breast clinic. The two most common types of mastalgia were (cyclical and non-cyclical). The common cause of cyclical was Physiological changes due to premenstrual tension syndrome fibrocystic changes or fibroadenosis and (Aberrations in the Normal Development and Involution of the breast ). Non-cyclical diseases are mainly benign rather than malignant. Solid masses (fibroadenomas), cysts, infections, abscesses, trauma, and nipple discharge (hormones) are rare diseases associated with breast cancer. The aim of this study is to study the incidence of mastalgia, types (cyclical and non-cyclical) and pathological types of mastalgia (benign and malignant pathologies). A cross-sectional descriptive study of mastalgia was carried out at the Breast Center Department of Maternity Teaching Hospital located in Erbil, from January 2014 to September 2015. A total of 150 breast pain cases (available clinical data) were studied in detail. There are two types of mastalgia based on triple assessments, these are as follows, cyclical 90 cases (60%) and non-cyclical 60 cases (40%). Fibrocystic breast changes or fibroadenosis 35 cases (23.3%) and thirdly nipple discharges as part of fibrocystic (fibroadenosis) five cases (3.3%). Non-cyclical mastalgia was subdivided into benign breast pathologies, fibroadenoma 30 cases (20%), breast cyst 10 cases (6.7%), nipple discharge (hormonal) five cases (3.3%), mastitis three cases (2%) abscess two cases (1.3%), fat necrosis one case (0.7%), and malignant breast pathologies, cancer three cases (2%). Clinicopathological correlations in the current study were highly significant (P<0.005). Not all discomfort or pain can be diagnosed as mastalgia; occasionally, chest wall, referral pain, and systemic causes can mimic mastalgia. These results highlight the importance of differentiating between cyclical and non-cyclical mastalgia using clinical assessment, sonography, mammography, and blood investigations. Most mastalgia cases are benign, with cyclical mastalgia primarily related to hormonal changes during the menstrual cycle.

Risk Factors for Granulomatous Mastitis and Establishment and Validation of a Clinical Prediction Model (Nomogram).

This study aimed to explore the risk factors and clinical characteristics of granulomatous mastitis (GM) using a case-control study and establish and validate a clinical prediction model (nomogram). This retrospective case-control study was conducted in three hospitals in China from June 2017 to December 2021. A total of 1634 GM patients and 186 healthy women during the same period were included and randomly divided into the modeling and validation groups in a 7:3 ratio. To identify the independent risk factors of GM, univariate and multivariate logistic analyses were conducted and used to develop a nomogram. The prediction model was internally and externally validated using the Bootstrap technique and validation cohort. The receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the discrimination and calibration of the prediction model. Decision curve analysis (DCA) and clinical impact curve (CIC) were used to evaluate the clinical significance of the model. The average age of GM patients was 33.14 years (mainly 20-40). The incidence was high within five years from delivery and mainly occurred in the unilateral breast. The majority of the patients exhibited local skin alterations, while some also presented with systemic symptoms. On multivariate logistic analysis, age, high prolactin level, sex hormone intake, breast trauma, nipple discharge or invagination, and depression were independent risk factors for GM. The mean area under the curve (AUC) in the modeling and validation groups were 0.899 and 0.889. The internal and external validation demonstrated the model's predictive ability and clinical value. Lactation-related factors are the main risk factors of GM, leading to milk stasis or increased ductal secretion. Meanwhile, hormone disorders could affect the secretion and expansion of mammary ducts. All these factors can obstruct or injure the duct, inducing inflammatory reactions and immune responses. Additionally, blunt trauma, depressed mood, and diet preference can accelerate the process. The nomogram can effectively predict the risk of GM.

Problem-solving Breast MRI.

Breast MRI has high sensitivity and negative predictive value, making it well suited to problem solving when other imaging modalities or physical examinations yield results that are inconclusive for the presence of breast cancer. Indications for problem-solving MRI include equivocal or uncertain imaging findings at mammography and/or US; suspicious nipple discharge or skin changes suspected to represent an abnormality when conventional imaging results are negative for cancer; lesions categorized as Breast Imaging Reporting and Data System 4, which are not amenable to biopsy; and discordant radiologic-pathologic findings after biopsy. MRI should not precede or replace careful diagnostic workup with mammography and US and should not be used when a biopsy can be safely performed. The role of MRI in characterizing calcifications is controversial, and management of calcifications should depend on their mammographic appearance because ductal carcinoma in situ may not appear enhancing on MR images. In addition, ductal carcinoma in situ detected solely with MRI is not associated with a higher likelihood of an upgrade to invasive cancer compared with ductal carcinoma in situ detected with other modalities. MRI for triage of high-risk lesions is a subject of ongoing investigation, with a possible future role for MRI in decreasing excisional biopsies. The accuracy of MRI is likely to increase with the use of advanced techniques such as deep learning, which will likely expand the indications for problem-solving MRI. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.

Multi-Institutional Phase II Trial Using Dose Escalated Five Fraction Stereotactic Partial Breast Irradiation (S-PBI) with GammaPodTM for Early-Stage Breast Cancer

We report on our early experience of a multi-institutional phase II study of dose escalated five fraction stereotactic partial breast irradiation (S-PBI) for early-stage breast cancer after partial mastectomy using the GammaPodTM stereotactic radiation system. Patient eligibility included DCIS or invasive epithelial histologies, AJCC clinical stage 0, I, or II with tumor size < 3 cm, and negative margins. Prior safety of Phase I dose escalation has been reported. Dose was 40 Gy delivered in 5 fractions to the CTV, and minimum dose 30 Gy in 5 fractions to the PTV. CTV margin was 1 cm and PTV margin 3 mm. For PTV cavities larger than 100cc, dose was reduced to 35Gy in 5 fractions to the CTV and 30 Gy in 5 fractions to the PTV. Primary endpoint of the study is to determine the 3-year patient global cosmesis score (4-point scale excellent, good, fair, or poor) and adverse cosmesis using a dose escalated approach with smaller PTV margins than conventional methods. Both patients and physicians completed baseline and subsequent cosmesis outcome questionnaires. Treatment related toxicity was graded using the NCI version 4.0 and RTOG/EORTC late radiation scale. From 3/2019-10/2021, 74 patients were treated respectively. Of these, 38 were treated to 40Gy and 36 were treated to 35 Gy. Median follow up (f/u) was 24 months (mo), range (r) 3-39mo. Median age was 63 years (r 43-77). Histology included 28 DCIS, and 46 invasive carcinomas. 45/46 invasive tumors were ER+. 60/74 (81%) patients received endocrine therapy, and 7/74 patient received chemotherapy. There were 221 acute grade 1 toxicities, and 28 Grade 2 toxicities. No grade 3 or higher acute toxicities were reported (< 90 days). The most common Grade 2 toxicities were radiation dermatitis (10), breast pain (8), blister (4), skin infection (2), nipple discharge (2), and fatigue (2). In the late period, there were 54 Grade 1 late toxicities, 4 Grade 2 late toxicities, and no Grade 3 or higher late toxicities. Grade 2 toxicities included fibrosis (2), and pain (2). Two patients developed grade 1 asymptomatic nonpalpable fat necrosis both diagnosed at 12 months after radiation treatments. The most common grade 1 late toxicities were breast pain (14), hyperpigmentation (8), fibrosis (10), and fatigue (5). Physicians scored cosmesis excellent or good 70/73 (95.8%), 58/60 (96.7%), 36/36 (100%),17/17(100%) respectively at baseline, 12 months, 24 months, and 36months post SBRT, while patients scored the same periods 62/71 (83.7%), 53/59 (89.8%), 33/36 (91.6%), 17/18 (94.4%). There have been no reports of disease recurrences. Results at 24-month median follow-up, of our dose escalated stereotactic partial breast 5 fraction regimen, has low acute and late toxicity, while maintaining high proportion of excellent/good cosmetic outcomes. Continued analysis of all cohorts is in progress. gov identifier is NCT03581136.

Clinical presentations and outcomes of young women aged

Ductal carcinoma in situ (DCIS) in young women is rare and not well studied. Since they do not qualify for mammographic screening, they are more likely to present with symptoms. Young women have also been associated with poorer outcomes, but it is unknown whether presentation mode affects outcome. We aimed to compare characteristics of DCIS patients <40 years of age presenting with symptoms versus those without, and determine whether presentation mode affects recurrence. Pure DCIS patients aged <40 years were retrospectively analyzed. Clinical presentation, pathology and recurrence data were collected. Statistical analysis was performed to investigate the correlation of presentation mode with outcomes. 40 patients with 41 cases were included. The mean age at diagnosis was 32.3 years (range 17-39). 73.2% and 26.8% presented with symptoms or abnormal imaging respectively. Of the cases who presented with symptoms, 86.7%, 10.0% and 3.3% had palpable lump, nipple discharge or breast pain, respectively. The average tumor size was 22.0 mm (range 2.0-86.9) and 12.2 mm (range 3-25) for patients who presented with symptoms and non-symptomatic group, respectively. Cases presenting with symptoms were statistically associated with higher grade (p =0.0090). On median follow-up of 85 months, there were 3 (7.3%) recurrences, which were not statistically associated with presentation mode. Young women with DCIS tend to present with symptoms, with breast lump as the commonest symptom. Symptomatic patients tend to be associated with grade III tumours, compared to non-symptomatic patients. On long-term follow-up, mode of presentation was not statistically associated with recurrence.

Expression and clinical significance of CA125, CA153 and CEA in nipple discharge of breast cancer patients.

It is an important clinical means to identify benign and malignant breast diseases caused by nipple discharge through the detection and analysis of components in nipple discharge. This study was aimed to test the expression and clinical significance of carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153) and carcinoembryonic antigen (CEA) in nipple discharge of breast cancer patients. From January 2017 to December 2018, 86 patients with invasive ductal carcinoma of the breast with nipple discharge (breast cancer group) and 50 patients with ordinary breast duct hyperplasia with nipple discharge (benign control group) were selected, and the levels of CA125, CA153 and CEA in nipple discharge and serum were detected by electrochemiluminescence immunoassay.

Clinicopathological profile of breast cancer from Chhattisgarh India: A single-center hospital-based study.

Global breast cancer incidence is increasing at an annual rate of 3·1%. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%). However, the data from different parts of India are still lacking and the study was conducted to assess the burden of disease at tertiary referral centers in central India. Retrospective record analysis (June 2013-June 2017) of data from outdoor clinics and pathology reports. The patients aged <15 yrs, nonresidence of Chhattisgarh, and diagnosed outside the study period were excluded. The triple assessment was used to diagnose all breast lumps (sensitivity 99%). Eighty patients were diagnosed having breast carcinoma. The mean age for breast cancer was 39 ± 3.028 years (ranged 31-50 years). Twenty patients had locally advanced breast carcinoma. The predominant religion was Hindu 55.00%. The referral pathway to seek medical care for breast cancer was via a gynecologist in 40% (32/80). Familial breast cancers were in 0.03% (3/80) of patients. None breast cancer patients have previous histology-proven benign breast disease. The mean size of the breast cancer lump was 3.56 cm (ranged 1.0-11.0 cm). Overlying skin ulceration (n = 2), skin infiltration/peau-d'- orange (n = 2), skin tethering (n = 4), and bloody nipple discharge were found in one patient. Breast cancer was diagnosed during lactation (postnatal period) in one patient. The maximum number of patients have tumor size >5 cm (72.6%). Immunohistochemistry and pathological analysis was done on core biopsy (n = 20) and surgical procedure (n = 60). Modified radical mastectomy was done in 52, breast conservative surgery with Sentinal Lymph node biopsy and axillary lymph node dissection in 6, and toilet mastectomy in two patients. The predominant tumors were solid (n = 79/80), with both solid and cystic types (1/80). The solid and cystic lesion on FNAC was of C3b type, and an excision biopsy revealed medullary carcinoma of the breast. Invasive ductal carcinoma-no special type (IDC-NST) was observed to be the most common histopathologic type (n = 70/80), followed by medullary carcinoma (n = 2), metaplastic carcinoma (n = 1), papillary carcinoma (n = 4), Paget disease with DCIS (n = 1), mucinous carcinoma (n = 1), invasive lobular carcinoma (n = 1). One male patient with breast cancer and two female patient having bilateral breast cancer also have IDC-NST.Scarff Bloom Richardson Grade was predominantly graded 2 in 46.25% (37/80) of breast cancer patients (Grade 1 = 9, Grade 2 = 37, Grade 3 = 34). Lymphovascular (LVI) and perineural invasion (PNI) were predominantly without LVI and PVI. (Lymphovascular present and perineural invasion present = 4, Lymphovascular present and perineural invasion absent = 32, Lymphovascular absent and perineural invasion absent = 42, Lymphovascular absent and perineural invasion present = 2). Histological examination of axillary lymph nodes showed the presence of malignant cells in all. Triple-negative breast carcinoma was 26.58% (21/79). Most breast cancer presented at stage II A = 37.5% (30/80) and II B = 28.7% (23/80) of the AJCC staging system. The clinico-epidemio and histological profile of breast cancer in Chhattisgarh is similar to other parts of India. Scarff Bloom Richardson Grade was predominantly grade 2 in 46.25% (37/80) contrary to Grade III (70%) in other series from India.

259 Avoiding Face-to-Face Appointments Following Benign Breast Biopsies: Improving The Patient Experience Without Compromising Safety

Abstract Aim Minimising face to face (F2F) contact can reduce the costs of outpatient clinics and increase patient satisfaction. Patients undergoing biopsy for suspected benign disease need discussing at an MDT meeting as per national guidelines, however, the majority of these do not need further treatment. We aimed to assess the utility and safety of managing patients without a further F2F appointment following benign MDT discussion. Method A retrospective case-note review was performed on 100 patients discussed at the benign biopsy MDT between June and August 2020. Clinicopathological data was collected on presenting symptoms, histopathology, management, and subsequent requirement for F2F appointment. Results Median age was 43 years (range 25-88). Eighty-one patients (81%) presented with a lump or nipple discharge. The final diagnosis was normal in 22(22%) patients, a diagnosis of fibroadenoma in 35(35%), a B3 lesion in 8 (8%) patients and another benign diagnosis in the remaining 35(35%) patients. Sixteen (16%) patients required surgery or vacuum-assisted-Biopsy, 18(18%) required further clinical or radiology follow up and 66(66%) were reassured and discharged. Forty-three (43%) patients were informed of the MDT plan by letter and 42(42%) by telephone. There were no malignancies identified in any patients. Fourteen (14%) patients required a F2F appointment most commonly because of further clinical review, patient request or interpreter requirements. Conclusions The vast majority of patients undergoing benign biopsy can avoid a further F2F appointment, even if further biopsies or intervention is needed. This can reduce the burden on outpatient clinics whilst improving patient convenience.

907 An Audit of Breast Ultrasonography in Patients Under 35

Abstract Introduction Breast Ultrasonography (USS) is a major part of the triple assessment for breast presentations in those under 35 years. Currently, most institutions are running targeted separate U-35 clinics. The aim of this study is to audit the outcome of breast USS in patients under 35 years. Method Over a 5-month period, December 2021- May 2022, retrospective data was collected across 3 clinics. In total, 300 patients were analyzed. Results The age distribution was as follows: 16-20 years (30), 21-25 years (51), 26-30 years (107), 31-35 years (104). Of the 300 patients, 68% of referrals to clinic were for breast lump (fibroadenoma, cysts and on one occasion papilloma), with the 26-30 age group being the majority at 36%. Half of the patients had USS, with the most common indication being lumps, followed by nodularity at 28%. Other indications for ultrasound included: nipple discharge, palpable nodes, eczema, nipple inversion. The radiological findings were fibroadenoma 21% (32), cysts and abscess with 15% (23) and 2.6% (4) respectively. No cancers identified. Fifty four percent had no identified lesions. Conclusions Our studies showed that of those referred for USS, only 46% had a lesion detected. No cancers diagnosed. Thus, these targeted clinics are effective in meeting demand for services. To increase efficiency, it might be a worthy consideration to have even clearer guidelines on ultrasonography specifically for patients under 35 years.

The "Trunk sign": A novel X-ray sign in galactography of patients with nipple discharge suggesting malignancy.

The etiology of nipple discharge is often unclear, and there are few studies exploring diagnostic approaches of nipple discharge. Galactography is a common method for clinical diagnosis of patients with nipple discharge. Therefore, this study aimed to evaluate the use of galactography in differentiating between benign and malignant lesions in patients with nipple discharge. A retrospective study of 161 patients with nipple discharges, who were evaluated with galactography and underwent surgery in Qilu Hospital of Shangdong University between January 2018 and December 2019, was conducted. Baseline characteristics were obtained from their electronic records including age, menstruation status, physical examination, galactography, cytology, and pathology. There were 110 cases of benign disease, 12 cases of high-risk disease, and 39 cases of malignant disease. With respect to benign diseases there were 26 (23.6%) patients with hyperplasia and ductal ectasia, and 94 (76.4%) with intraductal papilloma. With respect to high risk diseases, there were 2 (16.7%) patients with atypical intraductal papilloma and 10 (83.4%) with atypical hyperplasia. With respect to malignant lesions, 19 (48.7%) patients had intraductal carcinoma, 4 (10.3%) had solid papillary carcinoma, and 16 (41.0%) had invasive carcinoma. The significant findings of our study are as follows: patients with malignant diseases had a higher proportion of concomitant masses (74.4% vs 41.7% vs 22.7%, P < .001), positive spill cytology (51.3% vs 41.7% vs 2.7%, P < .001), and trunk signs (71.8% vs 33.3% vs 10.9%, P < .001). A forest plot revealed that trunk signs were related to an increased risk of malignant diseases in almost all the subgroups. Galactography is important for the differential diagnosis of benign and malignant lesions in nipple discharge, and the "Trunk sign" is an important radiographic sign of malignant lesions. Combining galactography with other methods is advisable to improve the accuracy of diagnosis in patients with nipple discharge.

Disparities in delayed diagnosis and pain management among African American women with breast cancer.

102 Background: Breast Cancer (BC) mortality rates disproportionately affect African American (AA) women over other racial or ethnic group in the United States. Research demonstrates AA women also have disparate rates of an accurate diagnosis and pain management care. Methods: This study addressed barriers to care in diagnosis and pain management care experienced by members of a non-profit organization called the Tigerlily Foundation (TLF), a breast cancer advocacy organization, who design culturally relevant educational materials to support medically underserved populations. This qualitative study interviewed AA women in an IRB-approved study (University of Illinois at Urbana-Champaign). The total duration of each interview lasted a maximum of 1 hour and 45 minutes with participants answering one pre-interview questionnaire for demographic purposes and completing one interview. Results: Among 20 AA women breast cancer survivors, it was discovered participants 90% were delayed, dismissed, and denied screening options to detect their breast cancer diagnosis as early as possible. After several months of displaying anomalies within their breasts (i.e., lump, swelling, pain, nipple discharge), participants had to negotiate with their PCPs to finally get a mammogram, ultrasound, and biopsy. 70% of participants described radiation as excruciating pain. Pain management varied as 10% of participants were offered access to a wound care specialist and received adequate medication to cope with the pain, while 90% of participants received nothing. Those who did not receive assistance tried homeopathic solutions for pain management. Conclusions: Notable differences among AA women breast cancer survivors demonstrated the need for healthcare institutions to review potentially racially bias policies harming this demographic of patients. Future studies among AA populations with disparate breast cancer diagnosis and pain management are needed to improve health outcomes.

Neonatal giant mastauxe: a case report.

A 13-day-term male neonate presented with bilateral breast enlargement and milky nipple discharge, which worsened upon breast massage. The mother had an uneventful pregnancy, and neither the mother nor the baby had a history of drug intake. The examination revealed soft, non-tender, non-erythematous bilateral breast swellings measuring 3.6×3.8cm on the right side and 3.2×3.4cm on the left side. Ultrasonography confirmed their hypoechoic nature with minimum vascularization. The white blood cell count, C-reactive protein levels, and culture of nipple discharge yielded normal results. The baby was discharged, and upon follow-up after 2 weeks, it was observed that breast swellings had spontaneously reduced in size. Neonatal breast enlargement can occur as a result of either the transplacental transfer of maternal estrogens or declining levels of estrogens toward the end of pregnancy, leading to hyperprolactinemia. However, the exact reasons behind the occurrence of giant mastauxe in some newborns remain incompletely understood. It may be due to increased sensitivity of the breast tissue to estrogens. Proper clinical examination, along with the use of ultrasonography and/or laboratory investigations if required, is essential to differentiate giant mastauxe from neonatal mastitis or breast abscess. Treatment primarily involves observation and providing reassurance to parents.

Study of ductal lavage cytology in women at high risk for breast carcinoma

Background: Ductal lavage (DL) involves cannulating the nipple aspirate fluid (NAF)-producing ducts with a microcatheter and lavaging with saline to retrieve cells for cytological and molecular analysis. This method improves upon NAF and fine-needle aspiration and can provide important data on cellular yield and molecular markers in DL fluid. Aims and Objectives: This aimed to study the cytology of DL in women at risk of/clinicoradiological possibility of breast carcinoma and to correlate the cytology of DL with Gail risk score and with histopathology (wherever available). Materials and Methods: The present study, conducted at Hindu Rao Hospital, Delhi, between 2012 and 2014, examined 36 patients with nipple discharge. Nipple aspiration and DL were performed, and the results were analyzed and compared. The present study also looked at the correlation between DL results and the patient’s Gail score and correlated histopathology with DL cytology. Results: The present study enrolled 36 women and studied 50 ducts from 46 breasts. Nipple fluid was aspirated from 34 patients, with inadequate cellular material for diagnosis in 24 breasts, benign in 18, atypia in 2, and no malignancy found. The correlation of DL with Gail score was statistically significant, as was the correlation between epithelial cells in DL and NAF samples. The correlation between DL and histopathological findings was statistically insignificant. Conclusion: DL samples may miss atypical cells, and have higher epithelial cell count than NAF. Higher Gail score correlates with mild atypical cells in DL (P=0.003).

A Randomized Comparison of Excision of 3 cm Versus 1.5 cm Length of Major Mammary Duct in Women Presenting with Non-bloody Nipple Discharge

A Randomized Comparison of Excision of 3 cm Versus 1.5 cm Length of Major Mammary Duct in Women Presenting with Non-bloody Nipple Discharge

Predisposing Factors for Granulomatous Lobular Mastitis: A Case-Control Study.

Despite the rising incidence rate of granulomatous lobular mastitis (GLM), uncertainties persist about its etiologic and predisposing factors to guide clinical treatment and early prevention. The objective of this study is to explore the predisposing factors for GLM. This case-control study was conducted from 2018 to 2021 at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University. Patients with GLM (cases) were matched with healthy examinees (controls) in a 1:1 ratio according to gender and living area. We analyzed their demographic features and investigated 75 factors that may be relevant to GLM using a standard questionnaire. Univariate and multivariable binary conditional logistic regression analyses were used to compare the differences between the two groups and evaluate the predisposing factors that may induce GLM. There were 594 female GLM patients and 594 matched controls included in the study. The average age of the cases was 32.78 years (mainly 20 to 40). The incidence was high within five years after childbirth, and lesions were mainly in the unilateral breast. Univariate and multivariable conditional logistic regression analyses obtained six relevant factors and six high-risk factors. The six relevant factors included age, marriage, emotional abnormality, high prolactin, psychiatric drug intake, and sex hormone intake. Additionally, the independent high-risk factors for GLM included gestation, nipple invagination, blunt trauma, non-iatrogenic massage, lactation disorder, and nipple discharge (odds ratio (OR)=17.378, 8.518, 4.887, 3.116, 2.522, 1.685, P<0.05). Menopause was an independent protective factor (OR=0.249, P<0.05). The factors that increase milk and secretion production in the mammary duct are the main risk factors of GLM, especially when the nipples are invaginated. These factors can obstruct the duct and induce inflammation. Additionally, hormonal disorders, extrinsic trauma, and emotional abnormalities can accelerate the occurrence of GLM.

Breast Cancer Prediction Feature Selection Using ML Algorithms

Breast cancer is a disease that breast epithelial cells uncontrolled hyperplasia under the effects of several different carcinogens. The early symptoms of breast cancer are breast lesions, nipple discharge and axillary fossa lymphadenectasis. Breast cancer can directly threat the life of patient by casing various organ lesions and metastasis of cancer cells in the late stage of suffering from this disease. The method of classifying tumors into malignant or benign is the main challenge that needed to be dealt with to treat patient in a correct way. This paper shows the different classification models to predict the kind of breast cancer. All data used to distinguish the type of breast cancer in the research comes from UCI repository. Some simple classifiers are employed in the research, for instance, Decision Tree Classifier, Extreme Gradient Boosting, Naïve Bayes Classifier, Gradient Boosting, Support Vector Machine. The results show that using Support Vector Machine algorithm the prediction accuracy of breast cancer reaches 99.7%.

The Role of Ultrasound in the Diagnosis of Early Breast Cancer. Clinical Case

Bloody nipple discharge is the main and in most cases the only symptom of the intraductal breast cancer. Detection of this pathology is a rather complex process involving the prescription of extra research methods. Ultrasound is mainly used in addition to such leading diagnostic methods as mammography, breast ductography. However, in the above case report, ultrasound is presented as an independent diagnostic method.

Impact of COVID-19 on Public Interest in Breast Cancer Screening and Related Symptoms: A Google Trends Analysis.

The COVID-19 Pandemic has led to a decrease in cancer screening due to redeployment of healthcare resources and public avoidance of healthcare facilities. Breast Cancer is the most common cancer diagnosed in women, with improved survival rates with early detection. An avoidance of screening, resulting in late detection, greatly affects survival and increases healthcare resource burden and costs. To evaluate if a sustained decrease in public interest in screening occurred, and to evaluate other search terms, and hence interest, associated with that. This study utilized Google Trends to analyze public interest in breast cancer screening and symptoms. We queried search data for four keyword terms ("mammogram", "breast pain", "breast lump", and "nipple discharge") from 2019-01-01 to 2022-01-01. The relative search frequency (RSF) metric was used to assess interest in these terms, and related queries were retrieved for each keyword to evaluate trends in search patterns. Despite an initial drastic drop in interest in mammography from March-April 2020, this quickly recovered by July 2020. After this period, alongside recovery of interest in screening there was a rapid increase in interest for arranging for mammography. Relative search frequencies of perceived Breast Cancer related symptoms such as Breast Lump, Nipple Discharge and Breast Pain remained stable. There was increase public interest in natural and alternative therapy of breast lumps despite recovery of interest in mammography and breast biopsy. There was a significant correlation between search activity and Breast Cancer Awareness Month (BCAM) in October. Online search interest in breast cancer screening experienced a sharp decline at the beginning of the COVID-19 pandemic, with a subsequent return to baseline interest in arranging mammography followed this short period of decreased interest.

Syringomatous adenoma of the nipple: A case series and systematic review

Key Clinical MessageSAN should be considered in the setting of nipple discharge or morphology changes with typical histological findings. There are limited published cases of SAN, and workup of this pathology is still not clear to date.AbstractSyringomatous adenoma of the nipple (SAN) is known to be a rare benign breast neoplasm. With a few cases documented in the literature, preoperatively diagnosing this tumor is a challenge, which often leads to invasive procedure such as mass excision with nipple removal. This study was aimed at presenting a case report of SAN and to conduct a review of published cases. Literature search was conducted through PubMed databases. Articles published from year 1983 to March of 2022 were included. Only histologically confirmed cases of SAN were included. The review was performed according to the PRISMA guidelines. Twenty‐eight cases, including the newly reported case, were included in the review after going through inclusion criteria. The mean age at diagnosis was 44 ± 16 years. 7% were male. The most common presentation was palpable mass. Preoperative biopsy was done for 9 cases, out of which 7 did not indicate typical histopathological characteristic of SAN. Most common treatment was wide local excision with nipple removal. Immunohistochemical staining of the resected tumor was performed in 16 cases postoperatively. 32.1% (9/28) utilized p63 in constellation with histologic findings. Five cases that utilized staining also used Estrogen Receptor (ER) marker, while three used progesterone receptor (PR) marker. SAN should be considered in the setting of nipple discharge or morphology changes with typical histological findings. There are limited published cases of SAN, and workup of this pathology is still not clear to date. The case presented here and our comprehensive literature review suggest that pathohistological findings of SAN can be heterogeneous. Clinicians would also benefit from recognizing these variances. Further research and reported cases are needed to confidently diagnose SAN, which may open doors for less aggressive surgical treatment or surveillance option for asymptomatic patients.

CLINICO PATHOLOGICAL ANALYSIS ON PAPILLARY CARCINOMA BREAST

Background : Papillary carcinoma of breast is rare and account for approximately 1-2% of newly diagnosed cases of breast cancers. The common age group of presentation is 6-7th decade. These tumours usually present with a painless retroareolar swelling associated with bloody nipple discharge in 50% cases. Case 1) 57 year old most Cases : menopausal woman presented with huge ulcerative lump in right breast over a period of 1 year. After confirming diagnosis with incisional biopsy, patient was proceeded with Neoadjuvant Chemotherapy (NACT) followed by Right MRM with SSG. Case 2) 66 year old male patient came with complaints of bloody discharge from nipple for past 1 year. A small subcentimetric lump present in retroareolar region on left breast was present, on which USG guided CNB revealed Invasive Ductal Carcinoma. Patient was proceeded with Left MRM. Case 3) 65 year old male patient presented with painless lump in left breast for 3 months. Clinical examination revealed a 1*2 cm lump in left breast with a single mobile ipsilateral axillary node. Image guided CNB revealed Invasive Papillary carcinoma. Patient was taken up for upfront Left MRM. All 3 patients are on regular follow-up for more than a year, and no recurrence is noted on followup