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Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Breast cancers most commonly develop from epithelial tumors. Carcinoma in situ is diagnosed when there is cancer cell proliferation in the ducts or lobules. The majority of breast cancers are ductal carcinomas. A small or wide breast area may be affected. If the area is wide, microscopic invasive foci may eventually develop. Metastatic carcinoma is usually adenocarcinoma. The mucinous subtype usually develops in older women, and grows slowly with a much better prognosis. Inflammatory breast cancer grows quickly and is often fatal. Breast cancer may spread via the regional lymph nodes, bloodstream, or both. Metastatic breast cancer may spread to the lungs, bones, brain, liver, or skin. The pathophysiological link between diabetes and breast cancer is a bit complicated. When there is increased abdominal fat, there is decreased production of adiponectin and increased production of estrogen – all of which lead to increased insulin levels. Increased insulin also increases estrogen and increases the blood supply to cancer cells. Increased estrogen decreases sex hormone binding globulin, further increasing estrogen, and the increased estrogen contributes to breast cancer cell growth.
General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
A 70-year-old woman presents with a hot, red, painful breast. What is the likely cause and how will you treat her?Consider inflammatory breast cancer until proven otherwise. Rare (1%–5% of all breast cancers), aggressive, locally advanced breast cancer that spreads through dermal lymphatic vessels, giving erythematous/discoloured, swollen/oedematous appearance to whole breast.Take a history and perform a triple assessment. Clinical examination may reveal breast mass, peau d'orange, palpable axillary nodesMammography, ultrasound and core biopsyReview results in MDT, arrange staging CT/bone scan and give neoadjuvant chemotherapy prior to surgery.
Conditions
Published in Sarah Bekaert, Women's Health, 2018
Inflammatory breast cancer is so called because the overlying skin of the breast has a reddened appearance. In patients with inflammatory breast cancer, the reddened appearance is caused by breast cancer cells blocking tiny channels in the breast tissue known as lymph channels. The latter are part of the lymphatic system that is involved in the body’s defence against infections. Inflammatory breast cancer is a rare type of breast cancer.
Diagnosis and Treatment of 75 Patients with Idiopathic Lobular Granulomatous Mastitis
Published in Journal of Investigative Surgery, 2019
IGLM mammography is often not specific, and is not easy to distinguish from breast cancer, leading to misdiagnosis.3,10,17 Forty-one (54.0%) patients were diagnosed as inflammation by mammography. The accuracy of breast ultrasound diagnosis was 45.0% (34/75), and mammography X-ray was only 14.5% (11/75). The echo area of breast lumps was as low as having no echo, and breast lobular formation of the “false kidney sign,” combined with history and signs, can provide a preliminary diagnosis of IGLM. Moreover, the breast ultrasonography can also help to distinguish mastitis related swelling lymph nodes from cancer related ones as the former have more regular shape, clearer echogenicity of hilar and boundary between cortex and medulla. Besides, in color Doppler flow image (CDFI), the blood supply type of mastitis related lymph nodes is often hilar (central) pattern, compared with the peripheral parenchymal pattern blood flow of metastatic lymph node. Mammography showed diverse findings, which are especially difficult to identify inflammatory breast cancer. It can also cause pain in patients, with little help for the diagnosis of IGLM. Breast MRI is consider to be sensitive to malignant disease18 and efficient to solve the problem when ultrasound and mammography cannot make a decision.19 Some researches tried to figure out pathognomonic signs of IGLM20,21, but in general, the specificity of MRI is still not sufficient (37–86%) 22. Our patients did not receive breast MRI scan.
Vinorelbine’s anti-tumor actions may depend on the mitotic apoptosis, autophagy and inflammation: hypotheses with implications for chemo-immunotherapy of advanced cancers and pediatric gliomas
Published in Journal of Chemotherapy, 2018
Meric A. Altinoz, Aysel Ozpinar, Ebru Emekli Alturfan, Ilhan Elmaci
Inflammatory breast cancer is a rare form of breast cancer, and according to the data of the National Cancer Institute (USA), it accounts for 1–5% of all breast cancers. Nonetheless, inflammatory breast cancer is very aggressive, often hormon receptor negative (tamoxifen resistant) and progresses very rapidly often in matter of months or even weeks. Inflammatory breast cancer increases volume, temperature and induration of the breast, causes tenderness or pain, peau d’orange or cutaneous edema with redness of the skin of at least one-third of the breast.41 Paradoxically, despite the existence of the very prominent clinical signs of inflammation, there exist very few studies which compared the molecular cascades of inflammation between inflammatory breast cancer and the other frequent types of breast cancer. The cause of this neglect may be the early pathological observations which showed that tumor cells block lymphatic vessels in inflammatory breast cancer. Hence, people may have assumed that clinical signs of inflammation may be more due to anatomical reasons (lymphatic tumor microemboli) than the molecular pathways in these tumors. However, recent studies in canine inflammatory breast cancer showed that they expressed significantly more COX enzymes than the other frequent types of breast cancer.42,43
Idiopathic Granulomatous Mastitis: Etiology, Clinical Manifestation, Diagnosis and Treatment
Published in Journal of Investigative Surgery, 2022
Yulong Yin, Xianghua Liu, Qingjie Meng, Xiaogang Han, Haomeng Zhang, Yonggang Lv
Because of the breast mass and skin changes of IGM, the differential diagnosis with inflammatory breast cancer may be difficult even with the use of mammography, ultrasound, magnetic resonance imaging (MRI) and other imaging methods. Furthermore, although rare, mammary tuberculosis needs to be considered, but it is more prone to changes in lymph nodes and lungs, as well as caseous necrosis and involvement of breast ducts by histology [49]. Therefore, because IGM is rare and the clinical manifestations are not specific, imaging and histopathology are required for definitive diagnosis.