The Extent and Distribution of Cancer in Breasts with Palpable Primary Tumors (original) (raw)
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Histopathological Profile of Different Breast Lesions: A Single-Center Observational Study
Curēus, 2024
Objective: To describe the histopathological pattern of different breast lesions among tissue specimens sent to our laboratory. Method: A record-based study using a retrospective review of 255 histologically diagnosed breast biopsy reports in the histopathology department of authors from December 2016 to November 2021 was conducted. The specimens were collected from core biopsy, lumpectomy, and mastectomy. All data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) version 28 (IBM SPSS Statistics, Armonk, NY). Then, the findings were presented using text, tables, and charts. Result: A total of 255 breast lesions were analyzed in this study. Most of the cases were benign (58.8%), followed by inflammatory lesions (21.6%), and malignant (19.6%). Fibroadenoma was the most prevalent benign lesion (36.7%), and most of the patients (70.9%) were in the age group of 20-39 years old. The most common inflammatory lesion was granulomatous mastitis (56.4%), and most of the cases were diagnosed in the age group of 30-39 years old. Invasive ductal carcinoma (IDC) was the most encountered histological type of carcinoma (62%). Of the malignant cases, 52% were diagnosed before the age of 50 years. Among these 50 cases, grade 2 was the most prevalent one (46%). Conclusion: Benign breast lesions are more common than malignant breast lesions, and fibroadenoma is the most common benign subtype. Granulomatous mastitis is the most prevalent inflammatory breast lesion. About two-thirds of malignant cases are non-Arab. Invasive ductal carcinoma with no special type (NST) is the most common malignant subtype.
Laboratory Investigation, 2014
Background: Traditional breast conservation therapy consists of partial mastectomy followed by radiotherapy. Thus, previous studies of radiation-induced changes in the breast have focused on residual extratumoral breast tissue that remains after excision, often long after radiotherapy. A current phase 1 trial of single-dose pre-operative radiotherapy followed by partial mastectomy has yielded a novel specimen type-acutely irradiated primary breast tumor and surrounding benign breast tissue. Review of such cases revealed a high rate of atypical squamous metaplasia (ASM). Design: The ongoing trial has recruited 32 women with clinical stage Tis/T1N0M0 breast cancer, predominantly invasive ductal carcinoma and DCIS. Three cohorts of 8, 8, and 16 women received single radiotherapy doses of 15 Gy, 18 Gy, and 21 Gy, respectively, followed by partial mastectomy. Excisions were submitted entirely for histologic review. HE stained slides for each case were evaluated for 1) presence or absence of ASM and 2) if present, spatial relationship to the tumor/biopsy site. Results: This series included 31 cases of postmenopausal women treated with preoperative radiotherapy. Average interval between radiotherapy and excision was 5.9 days (range 3-10.) ASM was identifi ed in 18 cases (58%), both within the tumor area and away from it. It was more frequent in the highest radiation dose group (13/15) compared to the two lower dose groups (5/16). ASM ranged from focal to diffuse, involving terminal ducts as well as lobules. It typically affected the myoepithelial layer, but a subset of cases demonstrated involvement of luminal epithelium. Importantly, in several cases, ASM mimicked ADH or even DCIS. No ASM was identifi ed in 30 control cases of non-irradiated partial mastectomies. Conclusions: Atypical squamous metaplasia in the breast is commonly observed in excisions following neoadjuvant radiotherapy. The variable appearance of ASM and its regular presence beyond the tumor bed location creates a diagnostic challenge which may be associated with overestimation of tumor size and incorrect margin assessment, possibly leading to inappropriate additional treatment. Awareness of this phenomenon is important since pre-and peri-operative radiotherapy continue to take on an increased role in treating early breast cancers given the practical appeal of an intact tumor target and the opportunity to improve our understanding of the effect of radiation on breast cancer cells.
Histomorphological study of various patterns in breast lesions, including carcinoma breast
IP Innovative Publication Pvt.Ltd, 2017
Aims and Objectives: 1) To study the prevalence of breast diseases, and 2) To study the histological patterns in inflammatory breast diseases, benign and malignant lesions of breast. Materials and Method: The present study includes 70 cases from January 2012 to June 2016. The specimens were received in different forms such as excision biopsies, modified radical mastectomies and simple mastectomies. Samples were received from KBN Hospital Gulbarga, to department of Pathology KBNIMS Gulbarga. Detailed gross and microscopic examination was done for each specimen. Results: During four and a half year study period, out of 70 cases, 51 were benign lesions (constituting 72.85%of total breast lesions). The mean age for benign diseases of breast was 22.5 years and the age range 10 – 50 years and 19 were malignant lesions. Eight cases (42.10%) were below the age of 40 years, with an age range of 20-80 years. Most common benign breast disease of breast was fibroadenoma (45.71%) (Most common histologic change is that of intracanalicular pattern), followed by lactating adenoma (histologic change related to the stage of pregnancy). Other major lesions encountered were, benign phyllodes (a leaf-like growth pattern of stroma), fibrocystic disease of breast (fibrosis, cyst formation), sclerosing adenosis (increased number of distorted lobules, associated with stromal fibrosis), granulomatous mastitis (composed of non-caseating granulomas, giant cells, and foamy histiocytes) and duct ectasia (dilated duct and lymphoplasmacytic infiltrate). Malignant breast lesions were 27.15% of all breast lesions. The most common type of malignancy was infiltrating duct carcinoma-not otherwise specified (84.2%), followed by medullary carcinoma (5.26%), invasive lobular carcinoma (5.26%), and intra-ductal carcinoma (5.26%). Conclusion: Although benign breast diseases constituted 72.85% of all breast diseases and were mostly fibroadenomas, however, the incidence of malignancy was 27.15%. All breast lesions should be seriously examined because identification of benign lesions like duct ectasia, sclerosing adenosis and granulomatous mastitis is important as they simulate malignancy.
Prospective Study of Histological Proliferative Changes in Adjacent Areas of Breast Cancer
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Breast cancer remains a global health problem with an increasing incidence. Proliferative breast diseases are recognised as one of the risk factors in the development of carcinoma. This study was undertaken to know the frequency of proliferative lesions and other lesions in association with breast carcinomas in mastectomy specimens. MATERIALS AND METHODS 100 cases of excised carcinoma breast sent to the Department of Pathology for a three-year period at tertiary care centre was thoroughly examined and changes adjacent to the tumour was recorded and tissue was subjected for histopathological examination and results tabulated. RESULTS Infiltrating duct cell carcinoma, Not Otherwise Specified (NOS) type was present in 89% of cases. Among the associated lesions, nonproliferative lesions constituted 16%, proliferative breast disease without atypia 29%, proliferative breast disease with atypia 10% and others 45%. Fibrocystic disease constituted 14% of cases, epithelial hyperplasia 15%, sclerosing adenosis 12% and atypical ductal hyperplasia in 10% of cases. Other types of associated lesions were duct carcinoma in situ in 4 cases. CONCLUSION Proliferative lesions adjacent to carcinoma breast were seen in 39% of cases. Fibrocystic disease, epithelial hyperplasia, sclerosing adenosis and atypical ductal hyperplasia being the commonest lesions adjacent to carcinoma breast in the present study.
Histopathological study of breast lesions
International Journal of Medical Research and Review, 2017
Objectives: To study the histopathological features of neoplastic and non neoplastic lesions of breast. To correlate the pathological findings with clinical parameters. Design and methods: We have studied total 161 cases of breast lesions over a period of two years in our institute. The specimens were received in histopathology section of our department. Detailed gross examination of specimens was done followed by fixation, thorough sampling, and tissue processing. The different lesions were studied by histopathological examination and analysed. Neoplastic lesions were classified according to the WHO classification (2012). Results: Out of the 161 cases, 128 cases had neoplastic lesions and 32 cases had non-neoplastic lesions, and one case had coexistent neoplastic and nonneoplastic lesions. Two cases had dual neoplastic lesions. Out of the total 129 cases with neoplastic lesions, 76 cases had benign breast tumors, 53 cases had malignant breast tumors, and 2 cases had precursor lesions. Fibroadenoma was the most common benign tumour with 60 cases. Invasive carcinoma no special type was the most common malignant tumour with 43 cases. Special subtypes of invasive carcinoma found in our study were metaplastic carcinoma (3 cases) and mucinous carcinoma (1 case). The most common nonneoplastic lesion was mastitis with 12 cases, followed by duct ectasia and fibrocystic change. There were 4 cases of gynaecomastia. All the tumors involved upper outer quadrant most frequently. The benign tumors were most frequent in second, third and fourth decades, malignant tumours were seen beyond 4 th decade. The nonneoplastic lesions were common in 4 th decade. Conclusion: Histopathological study is important in the management of breast lumps
World journal of clinical oncology, 2012
To evaluate any differences between the percentages of involved breast volume, pathologic attributes, and tumor marker expression of T3 and T4a-c tumors in locally advanced breast cancers (BC). All patients with T3N > 0 and T4a-c BC without evidence of distant metastasis (M0), presenting to the Breast Clinic from 1980 to 2010, were examined to determine whether their BC's involved ≥ 50% of their breast volumes, defined by gross replacement of at least one hemisphere. Core needle biopsy or post-mastectomy specimens from tumors involving a known percent of breast volume were evaluated for: (1) pathological grades and lympho-vascular invasion (LVI); (2) hormone receptor (ER/PR) expression > 0; and (3) epidermoid growth factor 2 (her2) over-expression (3+) by immune-histochemical staining or fluorescent in situ hybridization. The data base included 98 patients with T3N> 0 M0 and 120 with T4a-c, any N disease, M0 disease. T3 tumor masses involved 50% or more of the breast in...
Precancerous lesions of the breast
Nature Clinical Practice Oncology, 2008
The management of precancerous lesions of the breast has become a considerable clinical problem in the past 20 years, mostly as a consequence of increased detection due to the introduction of mammographic screening. It is not possible to identify with absolute certainty which of these lesions will progress to invasive carcinoma, and tailoring the treatment according to each individual case remains a challenge. There is a particular dilemma for surgeons, who must balance the risk of resecting too much and causing unnecessary cosmetic damage, or resecting too little and leaving an increased risk of recurrence. Further knowledge in the field of predictive and prognostic factors together with the development of gene-profiling techniques will, hopefully, provide answers to these questions. Among precancerous lesions of the breast, particular attention should be paid to ductal carcinoma in situ or intraductal carcinoma, appropriate treatment of which is crucial to prevent invasive breast cancer. Nearly all possible combinations of surgery, radiotherapy and medical treatments (anti-estrogens) have been tested in different clinical trials, but the situation is far from satisfactory. We believe that an important contribution can come from oncoplastic surgery, which is the application of plastic and reconstructive surgical techniques to ensure both radical excision of the disease and acceptable cosmetic outcomes.