DigitalUM :: Browsing by Subject "Breast"

Browsing by Subject "Breast"

Now showing 1 - 20 of 20

Open Access
A new management technique for symptomatic haematomas following therapeutic vacuum-assisted biopsy.
(MDPI, 2019-09-19) Guzman Aroca, Florentina; Berná Serna, Juan de Dios; Garcia Ortega, Ana Azahara; Hernández Gómez, Dolores; Berná Mestre, Juan de Dios; Dermatología, Estomatología, Radiología y Medicina Física
The aim of this study was to investigate the efficacy of the vacuum-assisted biopsy (VAB) system in evacuating symptomatic haematomas after VAB excision of benign breast lesions. We retrospectively analysed the data of eight patients with symptomatic and large haematomas who were treated with VAB evacuation between 10 and 14 days after VAB excision. Only one case underwent the procedure 24 h after VAB excision, due to the patient reporting intense pain, which was relieved after application of the technique, even though it had to be done twice. This new clinical application of the VAB system for evacuating symptomatic breast haematomas was successful in all the cases in the present study. No technique-related complications were observed. Conclusions: To the best of our knowledge, this is the first study to reveal that VAB evacuation of symptomatic haematomas is safe, effective, quick and well-tolerated by patients.
Open Access
A new treatment for mammillary fistulas using ultrasound-guided percutaneous needle electrolysis
(MDPI, 2020-02-28) Berná Serna, Juan de Dios; García Vidal, José Antonio; Escolar Reina, María P.; Medina Mirapeix, Francesc; Guzmán Aroca, Florentina; Piñero Madrona, Antonio; Berná Mestre, Juan de Dios; Fisioterapia
The aim of this study was to investigate the efficacy of ultrasound-guided percutaneous needle electrolysis (PNE) in mammillary fistulas (MFs). A prospective study was performed in 18 patients with MF who were treated with the PNE technique. The technique was repeated in the case of no response or recurrence. The results obtained show that MFs revealing an elongated appearance with the ultrasound (US) are generally resolved with two sessions of PNE, whereas ovoid MFs require several sessions of PNE for complete resolution and they tend to recur. Success of the treatment with PNE was observed in 88.8% of the patients (16/18), and failure, after five or six sessions in two cases (11.2%), which were referred for surgery. Conclusions: To the best of our knowledge this is the first study to reveal that the PNE technique is safe, effective, quick, and well-tolerated by patients.
Open Access
ATM gene expression is associated with differentiation and angiogenesis in infiltrating breast carcinomas
(Murcia : F. Hernández, 2006) Cuatrecasas, M.; Santamaria, G.; Velasco, M.; Camacho, E.; Hernandez, L.; Sanchez, M.; Orrit, C.; Murcia, C.; Cardesa, Antonio; Campo, Elías; Fernandez, P.L.
The product of the ATM gene, mutated in the human genetic disorder ataxia-telangiectasia (A-T) plays a key role in the detection and repair of DNA doublestrand breaks. A-T is defined by progressive cerebellar ataxia, telangiectasia, sensitivity to ionising radiation and genomic instability with cancer predisposition. On the other hand, increased angiogenesis is essential for tumor growth and metastasis. The aim of this study was to investigate ATM expression in breast carcinomas and its relationship to neoangiogenesis. Methods and Results: Fifty-two breast tumors from 51 patients, 38 of them with concomitant in situ component (CIS), were analyzed by immunohistochemistry for the expression of ATM. CD34 expression was used for the morphometric evaluation of vasculature. ATM was positive in 1 to 10% of normal epithelial cells. ATM expression was reduced in 55.8% of infiltrating carcinomas, non-reduced in 34.6%, and increased in 9.6%. Expression of ATM in CIS was similar to the infiltrating component in 71% of cases and reduced in 23.7% of them. High-grade ductal infiltrating carcinomas showed lower ATM expression than lowgrade ones. Reduced ATM expression also correlated with increased microvascular area. Conclusions: Reduced ATM expression in breast carcinomas correlated with tumor differentiation and increased microvascular parameters, supporting its role in neoangiogenesis and tumor progression in breast carcinogenesis.
Open Access
Breast carcinoma vascularity, A comparison of manual microvessel count and Chalkley count
(Murcia : F. Hernández, 2009) Dhakal, Hari Prasad; Bassarova, A.V.; Naume, Bjørn; Synnestvedt, Marit; Borgen, Elin; Kaaresen, Rolf; Schlichting, Ellen; Wiedswang, Gro; Giercksky, Karl- Erik; Nesland, Jahn M.
. Manual counting of microvessels as intratumoral microvessel density (MVD) and Chalkley counting have been used in several studies to assess the prognostic impact of vascularity in invasive breast carcinomas. In our present study, the aim was to evaluate the prognostic value of angiogenesis in invasive breast carcinoma assessed by MVD and Chalkley techniques in the same series of patients. A total of 498 breast carcinoma patients with median follow up time 85 months were evaluated. The tumour vascularity was quantified by both manual microvessel count (MVD) and Chalkley count in CD34 stained breast carcinoma slides by a single investigator blinded to clinical information. Other relevant clinicopathological parameters were noted, including breast cancer related death and both loco-regional and systemic relapse. The patients were stratified by converting MVD and Chalkley counts to categorical variables to assess prognostic impact, and results were compared. High vascular grades using MVD count did not demonstrate any prognostic significance for breast cancer specific survival (BCSS) or distant disease free survival (DDFS) either in whole patient group (BCSS, p=0.517, DDFS, p=0.301) or in non-treated node negative patients (p>0.05). Chalkley count showed prognostic significance for both DDFS and BCSS in whole patient group (p<0.001) and also in untreated node negative patient group (p<0.05). In multivariate analysis, Chalkley count, but not MVD, retained the prognostic value for BCSS (p=0.007) and DDFS (p=0.014). The Chalkley count for assessing angiogenesis in invasive breast carcinomas demonstrated prognostic value. The Chalkley method appears to be the better method in estimating the prognostic impact of vascularity in invasive breast carcinomas.
Open Access
Eccrine spiradenoma of the nipple: Case report, differential diagnosis and literature review
(Universidad de Murcia. Departamento de Biología Celular e Histología, 2019) Metovic, Jasna; Gallino, Chiara; Zanon, Eugenio; Bussone, Riccardo; Russo, Roberto; Vissio, Elena; Annaratone, Laura; Conti, Luca; Papotti, Mauro; Cassoni, Paola; Castellano, Isabella
Eccrine spiradenoma is a rare lesion originating from eccrine sweat glands, with only few cases reported in breast tissue: we here describe for the first time, an eccrine spiradenoma arising in the nipple. An 84 year-old woman with a lesion enlarging her right nipple, showing ulcerations and eczema-like changes of the covering skin, was admitted to our hospital. Surgical excision of the central quadrant with nipple-areola complex was performed, followed by histopathological evaluation which revealed an adenoma with predominantly basaloid epithelial cells. The lesion was composed of tightly packed small and large groups of cells, arranged in diffuse alveolar/pseudorosette formations. The small cells expressed p63 and calponin, while a positive expression of CK7 and CD117 was detected in large cells. After careful and detailed examination, excluding various similar entities, a diagnosis of eccrine spiradenoma has been rendered. Although extremely rare, eccrine spiradenoma should be taken into account in the differential diagnosis of subcutaneous primary breast tumors.
Open Access
Electron microscopy and immunostaining of the normal breast and its benign lesions. A search for neuroendocrine cells.
(Murcia : F. Hernández, 1987) Nesland, Jahn M.; Sigurd, Lunde; Holm, Ruth; Johannessen, Jan Vicents
Specimens from 7 patients with normal breast tissue 26 patients with benign breast lesions (6 fibroadenomas, and 4 intraductal papillomas, 2 mammae lactantes, 10 cases of cystic disease and 4 fibrotic lesions) were studied by immunocytochemistry and electron microscopy. Excretory epithelial cells in 2 of the 4 papillomas were immunostained for NSE. Myoepithelial cells were frequently stained as well. All the breast specimens were nonreactive to the antichromogranin antibody we used. The 2 NSE positive intraductal papillomas were tested for presence of hormone immunoreactivity, but no positively stained cells were observed. No cells with neuroendocrine features were observed by electron microscopy. The present study did not reveal neuroendocrine cells in the normal breast specimens and undisputed proof of neuroendocrine differentiation in benign breast lesions was not established. We conclude that if neuroendocrine cells are present in the normal breast, they are very rare, and probably not the cellular origin of all breast carcinomas with neuroendocrine features.
Open Access
Expression of amine oxidase-related proteins in breast phyllodes tumor
(Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2025) Kim, Hye Min; Koo, Ja Seung
Background. Breast phyllodes tumors (BPTs) are difficult to differentiate from other tumor types. In-depth research is needed due to the insufficient description of the amine oxidase protein family, particularly in BPTs. Objective. This study investigated the expression and clinical implications of amine oxidase-related proteins in BPTs. METHODS: Tissue microarrays were constructed (n=181), and amine oxidase-related proteins of monoamine oxidase (MAO) A, MAOB, lysyl oxidase (LOX), and primary-amine oxidase 3 (AOC3) were assessed using immunohistochemical staining. Staining patterns of these proteins were compared and analyzed with clinicopathologic parameters. Results. In all, 149, 27, and 5 cases were classified as benign, borderline, and malignant, respectively. A higher grade of BPT was associated with increased MAOB (P<0.001), LOX (P=0.035), and AOC3 (P<0.001) expression. BPT cases with tumor recurrence and distant metastasis had higher proportions of MAOB positivity in stromal components (P=0.002 and 0.018, respectively). During follow-up, there was a significant association between MAOB positivity in the stromal component and shorter disease-free survival (DFS) (P=0.001) as well as overall survival (P=0.003). Moreover, MAOB positivity emerged as an independent factor for shorter DFS (hazard ratio: 4.253, 95% confidence interval: 1.034–17.49, P=0.045). Conclusions. Higher MAOB, LOX, and AOC3 expression were observed in higher-grade BPTs, and MAOB expression was identified as a significant prognostic factor.
Open Access
Expression of checkpoint kinase 2 in breast carcinomas, correlation with key regulators of tumor cell proliferation, angiogenesis, and survival
(Murcia : F. Hernández, 2006) Ribeiro-Silva, A.; Koyota Moutinho, M.A.; Becker de Moura, H.; Ribeiro do Vale, F.; Zucoloto, S.
Checkpoint kinase 2 (Chk2) is a cell-cyclecheckpoint kinase that may act as a tumor suppressor gene due to its important role in DNA damage signaling and cell cycle regulation. The role of Chk2 expression in mammary tumorigenesis, however, is still poorly understood. This study was designed to assess the relationship between the expression of Chk2 and wellestablished prognostic factors, including disease-freesurvival and overall survival; and several regulators of cell proliferation and invasiveness in breast carcinomas, including oncogenes, tumor suppressor genes, apoptosisrelated proteins, and angiogenesis-related markers. Immunohistochemistry with 27 primary antibodies was performed in 100 formalin-fixed paraffin-embedded samples of not otherwise specified invasive ductal carcinomas. Clinical data were retrieved from medical files. In normal mammary parenchyma adjacent to the tumors Chk2 stained the nuclei of epithelial cells. Downexpression of Chk2 protein was observed in 23 carcinomas and correlated with advanced disease. Among the regulators of tumor cell proliferation and invasiveness analyzed, the downexpression of Chk2 correlated only with reduced expression of p27 and telomerase. There was no difference between the overall survival and disease-free survival rates according to Chk2 status. In conclusion, Chk2 correlated with reduced expression of h-TERT and p27, but not with angiogenic factors. Chk2 expression also did not interfere in the outcome of the patients.
Open Access
Expression of T cell-related proteins in breast ductal carcinoma in situ
(Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2025) Shin, Eunah; Kim, Hye Min; Koo, Ja Seung
This study aims to explore the expression of T cell subtype markers within the immune cells constituting the tumor microenvironment of ductal carcinoma in situ (DCIS) and to assess its implications. A tissue microarray comprising 191 cases of breast DCIS was created, and immunohistochemistry staining for T cell subtype markers (STAT3, STAT4, STAT-6, and FOXP3) was conducted. The DCIS cases were categorized into luminal, HER-2, and TNBC (Triple-negative breast cancer) types based on ER, PR, HER-2, and Ki-67 results. Additionally, they were classified as low-TIL (tumor-infiltrating lymphocytes) (<10%) or high-TIL (≥10%) types according to stromal TIL. Results revealed that 54.6% were luminal, 39.5% HER-2, and 5.9% TNBC. STAT3 exhibited a high positivity rate in luminal-type tumor cells, while STAT3, STAT4, STAT6, and FOXP3 showed elevated positivity rates in TNBC immune cells (p<0.05). Furthermore, a higher positivity rate was observed in high-TIL immune cells compared with low-TIL (p<0.001). The strongest agreement between T cell subtype markers in immune cells was found between STAT3 and STAT4 (OA=83.7%, κ=0.658), whereas the lowest was between STAT4 and FOXP3 (OA=71.7%, κ=0.370). In immune cells, STAT3 and STAT4 positivity correlated with necrosis (p<0.001), and the absence of positivity in all immune cell-related proteins in DCIS with necrosis was associated with poor prognosis (p=0.013). In conclusion, the immune cells in DCIS exhibit positivity for diverse T cell subtype markers, with TNBC and high-TIL DCIS displaying heightened positivity.
Open Access
Immunolocalization of thymidylate synthase as a favorable prognostic marker in estrogen receptor-positive breast carcinoma
(F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología, 2015) Takagi, Kiyoshi; Miki, Yasuhiro; Nakamura, Yasuhiro; Hirakawa, Hisashi; Kakugawa, Yoichiro; Amano, Goro; Watanabe, Mika; Ishida, Takanori; Sasano, Hironobu; Suzuki, Takashi
Background: Thymidylate synthase (TS) is an enzyme involved in DNA synthesis, and it is a target for 5-fluorouracil. Previous studies have demonstrated that TS is a potent estrogen-induced gene in breast carcinoma cells, suggesting the importance of TS in estrogen-receptor (ER)-positive breast carcinoma. TS immunolocalization has been reported previously, but the clinicopathological significance of TS in ER-positive breast carcinoma still remains unclear. Patients and methods: We immunolocalized TS in 178 breast carcinoma tissues in total, and examined its significance according to the ER-status. Results: TS status was positive in 58% of ERpositive ductal carcinoma in situ (DCIS) cases, and it was significantly associated with the Ki-67 and progesterone receptor (PR). Moreover, in ER-positive DCIS patients who received aromatase inhibitor (AI) before surgery, TS immunoreactivity was significantly decreased after AI treatment. In ER-positive invasive ductal carcinoma (IDC) cases, TS status was significantly associated with PR, and it turned out an independent favorable prognostic factor for recurrence of the patients by multivariate analysis. On the other hand, TS status was positively correlated with pathological T factor in ER-negative IDC cases, and tended to have a worse prognosis for disease-free survival of the patients. Conclusion: These results suggest that TS expression is mainly regulated by estrogen in ERpositive breast carcinoma and is associated with estrogen-mediated proliferation. TS status is a favorable prognostic factor in ER-positive IDC patients, which is different from the ER-negative cases.
Open Access
Mammary myofibroblastoma: an update with emphasis on the most diagnostically challenging variants
(Universidad de Murcia. Departamento de Biología Celular e Histología, 2016) Magro, Gaetano
Myofibroblastoma (MFB) is a rare benign mesenchymal tumor which usually occurs in the breast parenchyma of both females and males. Although this tumor is typically composed of bland-looking spindleshaped cells arranged in short fascicles interrupted by keloidal-like collagen fibers, several variations on this basic morphological theme do exist. With the advent of mammographic screening, an increased number of mammary MFBs are being detected and pathologists should be aware of the wide morphological and immunohistochemical spectrum exhibited by this unusual tumor. This review focuses on the most diagnostically challenging variants of mammary MFB, which could represent potential diagnostic pitfalls of malignancy, especially when evaluating needle core biopsies. In this regard the following variants of MFB, including the most recently recognized, will be presented: myxoid MFB, lipomatous MFB, epithelioid cell MFB, deciduoid cell MFB, epithelioid cell MFB with multinodular growth pattern, palisaded/ schwannian-like MFB and MFB with extensive myxoedematous stromal changes. Histological illustrations along with differential diagnostic problems for each single variant of MFB will be provided to offer helpful suggestions for a correct diagnostic approach in daily practice.
Embargo
Mixoma de mama. Estudio citopatológico de un caso
(Elsevier, 1985) Pérez Guillermo, M.; Pastor Quirante, F.; Martínez Díaz, F.; Hernández Barceló, E.; Ortuño Pacheco, G.; Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica
A rapidly growing tumor of one month evolution in the right mammary gland of a 12 year old girl was diagnosed by fine needle P.A.B. and interpreted as probable myxoma. An enuc/eation was suggested. The later histopathologic and electronomicroscopic study confirmed that within an abundan/ mould of acid mucopolysaccharides there existed a fibroblastic proliferation. A cytological differential diagnosis against different entities with myxoid stromas was established and the histopathologic similarity with the so called myxoma of nervous sheaths is underlined. We stress the uti/ity of the fine needle P.A. B. for the diagnosis and the therapeutic planning of mammary pathology. -----------
Open Access
p63 expression in benign and malignant breast lesions
(Murcia : F. Hernández, 2004) Stefanou, D.; Batistatou, Anna; Nonni, A.; Arkoumani, E.; Agnantis, N.J.
The p63 gene encodes six protein isoforms. The transactivating isoforms have similar actions with p53, while the N-isoforms inhibit transcription activation by p53 and transactivating isoforms. p63 is expressed in stratified epithelia and in basal cells of the prostate and salivary glands. In mammary epithelium p63 has been shown to be expressed only in the myoepithelial layer. In the present study we investigated the immunohistochemical expression of p63, in benign and malignant breast lesions, and compared it with known myoepithelial cell markers. Our material consisted of 140 benign and 126 malignant breast lesions. We used the antibodies anti-p63, anti-a-smooth muscle actin, anti-S-100 protein and anti-cytokeratin 14. In all benign lesions, p63 immunoreactivity was noted in the myoepithelial cell layer surrounding the luminal epithelial cells. A less continuous peripheral rim of myoepithelial cells was also highlighted with p63- staining in all situ carcinomas. All invasive breast carcinomas were devoided of peripheral p63 staining. Interestingly, strong nuclear p63 immunoreactivity was noted in a small fraction (5-15%) of epithelial cells in all cases of papillomatosis, in 62.5% of in situ ductal papillary-type carcinomas and in 33.3% of invasive papillary carcinomas. Comparable staining was observed with S-100. The stromal cells were unreactive to p63. Our findings suggest that p63 is a sensitive and specific myoepithelial marker, and may be included in immunohistochemical panels aiming to identify myoepithelial cells in problematic breast lesions. Regarding papillary neoplasms, it is possible that tumor cells acquire and exhibit at least in part a myoepithelial differentiation program.
Embargo
Percutaneous management of breast abscesses. An experience of 39 cases
(Elsevier Science Ltd., 2004-01-01) Berná Serna, Juan de Dios; Madrigal, Manuel; Berná Mestre, Juan de Dios; Dermatología, Estomatología, Radiología y Medicina Física
This is a review of our experience with percutaneous drainage by means of needle aspiration or catheter drainage of breast abscesses under ultrasound (US) guidance, and a suggested management algorithm. A retrospective study of the 39 patients (36 women, 3 men; mean age: 28.9 years) with breast abscesses who were treated by percutaneous US-guided procedures over a period of 13 years (1989 to 2002) was carried out. Of the 36 women, 34 were nonlactating and two lactating. Needle aspiration was used in the cases of fluid collections < 3 cm and catheter drainage in fluid collections of > 3 cm. Postdrainage care and US evolutive controls were carried out on an outpatient basis. Fine-needle aspiration cytology was performed in masses unresolved after postdrainage. Mammography was performed in patients over 30 years old. In all cases, US examination revealed images of fluid collection. A single needle aspiration was sufficient in 19 cases; 3 patients needed a second aspiration to resolve the breast abscess. A total of 15 cases were resolved by means of percutaneous catheter drainage. In 2 of the 17 patients who underwent catheter drainage, the mass persisted postdrainage; histologic findings showed a chronic abscess requiring surgical intervention in one and a breast carcinoma in the second. Mean follow-up was 8.4 months. Recurrence of breast abscess occurred in 4 patients, and these were resolved by surgical excision. Percutaneous drainage procedures in breast abscesses are a safe and effective alternative to incision and drainage. Needle aspiration is employed in cases of small abscesses and catheter drainage in abscesses larger than 3 cm. Although, in chronic abscesses, the treatment of choice is surgical excision, percutaneous drainage remains as an intermediate therapeutic option.
Open Access
Primary malignant fibrous histiocytoma of the breast.
(Murcia : F. Hernández, 1986) Sigurd, Lunde; Nesland, Jahn M.; Holm, Ruth; Johannessen, Jan Vicents
Clinical, light microscopic, electron microscopic and immunocytochemical features of 4 cases (3 women and 1 man) of primary malignant fibrous histiocytoma (MFH) of the breast are presented. The literature is reviewed and the diagnosis and treatment discussed. The good outcome is stressed and local excisioo or simple mastectomy recommended as appropriate treatment .
Open Access
Prognostic factors of breast phyllodes tumors
(Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2023) Shin, Eunah; Koo, Ja Seung
Background. Phyllodes tumor (PT) is a relatively rare breast tumor, accounting for <1% of all breast tumors. Main body. Adjuvant therapy with chemotherapy or radiation therapy, other than surgical excision, has not been established yet. PT, similar to other breast tumors, is classified as benign, borderline, and malignant according to the World Health Organization classification system, depending on stromal cellularity, stromal atypia, mitotic activity, stromal overgrowth, and tumor border. However, this histological grading system cannot effectively or fully reflect the clinical prognosis of PT. Several studies have investigated prognostic factors for PT as some PTs recur or metastasize to distant sites, and thus, prediction of prognosis is clinically imperative. Conclusion. This review discusses clinicopathological factors, immunohistochemical markers, and molecular factors that have been investigated in previous studies to have an impact on the clinical prognosis of PT.
Embargo
La reconstrucción posmastectomía y su relación con la radioterapia adyuvante en el tratamiento del cáncer invasivo de mama: ¿asunto cerrado?
(Elsevier, 2024-10) Císcar García, Irene; Fuente Muñoz, Isabel de la; Sánchez Henarejos, Pilar; Marín Rodríguez, Pedro; Marín Hernández, Caridad; Servet Pérez de Lema, Carmen María; Alonso Romero, José Luis; Piñero Madrona, Antonio; Medicina
Introducción la radioterapia posmastectomía es crucial en el tratamiento del cáncer de mama, mejorando la supervivencia. La reconstrucción mamaria posmastectomía influye en la calidad de vida, pero la radioterapia adyuvante es controvertida por las complicaciones que genera sobre la misma. Se examina la relación entre la radioterapia y las complicaciones en la reconstrucción, considerando el momento y la técnica empleadas. Métodos se realizó un estudio retrospectivo en un solo centro con 273 pacientes tratadas con mastectomía y reconstrucción. La radioterapia fue evaluada como variable independiente en relación con las complicaciones. Se analizaron variables demográficas, anatomopatológicas, quirúrgicas y de tratamiento. Resultados la incidencia general de complicaciones fue del 42,2%, siendo la necrosis grasa y la contractura capsular las más comunes. No hubo asociación significativa entre la radioterapia y las complicaciones en general, pero hubo una tendencia a más complicaciones con las reconstrucciones inmediatas. La reconstrucción autóloga se asoció con menos complicaciones que la heteróloga, especialmente con radioterapia. Discusión aunque estudios previos sugieren una asociación entre la radioterapia y la morbilidad en la reconstrucción posmastectomía, este estudio no encontró una conexión directa. Se destacó la importancia de distinguir entre las complicaciones en el sitio donante y receptor. La reconstrucción inmediata mostró más complicaciones con radioterapia, apoyando la recomendación de posponerla. La reconstrucción autóloga se destacó como la opción preferida. Conclusiones el estudio no encontró una asociación directa entre la radioterapia en pacientes reconstruidas posmastectomía y las complicaciones en general. Sin embargo, reveló una correlación entre las complicaciones y las técnicas heterólogas, subrayando la preferencia por reconstrucciones autólogas.
Open Access
Risk perception of patients with ductal carcinoma in situ (DCIS) of the breast and their healthcare practitioners: The importance of histopathological terminology, and the gaps in our knowledge
(Universidad de Murcia, Departamento de Biologia Celular e Histiologia, 2025) Riggi, Julia; Galant, Christine; Vernaeve, Hilde; Vassilieff, Maud; Berlière, Martine; Van Bockstal, Mieke R.
Despite ductal carcinoma in situ (DCIS) being a non-obligatory precursor of invasive breast carcinoma, its diagnosis generates substantial psychological distress. The limited knowledge about the natural history of DCIS contributes to the insufficient transmission of information about DCIS to patients and the general population. The uncertainty about the progression risk to invasive carcinoma hampers adequate communication by clinicians. Breast cancer-related mortality after a DCIS diagnosis is low. However, several studies have demonstrated that DCIS patients generally overestimate the risk of developing loco-regional recurrence or dying from breast cancer. Various factors contribute to this perceived risk. Despite the lack of infiltrative growth, DCIS is treated similarly to invasive breast cancer, with surgery, radiotherapy, and hormonal therapy. Additionally, the term ‘carcinoma’ in DCIS provokes anxiety. Incorrect risk perception by physicians may result in overtreatment. Here, we provide an overview of epidemiologic data on mortality after DCIS. We discuss the impact of the term “ductal carcinoma in situ” on patients’ and physicians’ perceptions of risk. The available evidence is mostly limited to patients within the Anglosphere. Recent studies, and European studies in particular, are scarce. We identify this as an area of interest for future large-scale European studies. We discuss the potential value of the “ductal intraepithelial neoplasia” (DIN) terminology, introduced in 1998. Although replacing the concept of “DCIS” with the DIN terminology is unlikely to solve the entire problem of risk overestimation, it could be the first step to optimize doctor-patient communication and alter the current risk perception.
Embargo
Sonographically guided percutaneous intralesional triamcinolone injection: a new treatment for mammillary fistulas. Preliminary results
(Wiley, 2012-04-01) Berná Serna, Juan de Dios; Berná Mestre, Juan de Dios; Piñero, Antonio; Carrascosa, Maria C.; Dermatología, Estomatología, Radiología y Medicina Física
We describe a new procedure, sonographically guided intralesional triamcinolone injection, for the treatment of mammillary fistulas. Six patients with mammillary fistulas were enrolled in this prospective study. Clinical improvement was rapid after the first triamcinolone injection. The initial response to treatment was assessed as complete in 4 cases, and the remaining 2 cases resolved successfully with additional injections. On the basis of the excellent results obtained in this study, it is thought that intralesional triamcinolone injection may be a good alternative to surgery.
Open Access
The expression of succinate dehydrogenase in breast phyllodes tumor
(F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología, 2014) Choi, Junjeong; Kim, Do Hee; Jung, WooHee; Koo, Ja Seung
The purpose of this study is to investigate the expression of succinate dehydrogenase (SDH)A, SDHB, and HIF-1α in phyllodes tumors and the association with clinic-pathologic factors. Using tissue microarray (TMA) for 206 phyllodes tumor cases, we performed immunohistochemical stains for SDHA, SDHB, and HIF-1α and analyzed their expression in regard to clinicopathologic parameters of each case. The cases were comprised of 156 benign, 34 borderline, and 16 malignant phyllodes tumors. The expression of stromal SDHA and epithelial- and stromal- SDHB increased as the tumor progressed from benign to malignant (P<0.001). There were five stromal SDHA-negative cases and 31 stromal SDHB-negative cases. SDHB negativity was associated with a lower histologic grade (P=0.054) and lower stromal atypia (P=0.048). Univariate analysis revealed that a shorter disease free survival (DFS) was associated with stromal SDHB highpositivity (P=0.013) and a shorter overall survival (OS) was associated with high-positivity of stromal SDHA and SDHB (P<0.001 and P<0.001, respectively). The multivariate Cox analysis with the variables stromal cellularity, stromal atypia, stromal mitosis, stromal overgrowth, tumor margin, stromal SDHA expression, and stromal SDHB expression revealed that stromal overgrowth was associated with a shorter DFS (hazard ratio: 24.78, 95% CI: 3.126-196.5, P=0.002) and a shorter OS (hazard ratio: 176.7, 95% CI: 8.466-3691, P=0.001). In conclusion, Tumor grade is positively correlated with SDHA and SDHB expression in the tumor stroma in phyllodes tumors of the breast. This result may be attributed to the increased metabolic demand in high grade tumors.