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Breast
Published in Anna Kowalewski, SBAs and EMQs in Surgery for Medical Students, 2021
Q13 A 62- year- old woman presents with a lump in her breast. On examination you note the lump is almost 3 cm in diameter. Biopsy reveals the patient is suffering from invasive ductal carcinoma. The following are all first- line investigations for the staging of breast carcinoma except?
Pathology of Breast Cancer
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
If the clinical management of DCIS is similar to that of an invasive ductal carcinoma, the distinction between the two entities may not be critical. Otherwise, it is essential to recommend confirmatory surgical biopsy to precisely assess the presence or absence of tumor invasion. This is particularly important for patients selected for preoperative chemotherapy or radiotherapy.
Breast cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sarah J Vinnicombe, Alexandra Athanasiou
Most breast cancers arise in the terminal duct lobular unit (TDLU) (23). Malignancy initially develops in situ, becoming invasive once the basement membrane is breached. Ductal carcinoma in situ (DCIS) is regarded as a non-obligate precursor of invasive ductal carcinoma, but it is very heterogeneous with variable malignant potential. The frequency with which it progresses to invasive disease depends on histological (cytonuclear) grade and disease extent. By contrast, lobular intraepithelial neoplasia (including classical lobular carcinoma in situ, LCIS) is now regarded as a generalized marker of risk.
Tumour budding is a novel marker in breast cancer: the clinical application and future prospects
Published in Annals of Medicine, 2022
Ting Huang, Hui Bao, Yu-hua Meng, Jian-lin Zhu, Xiao-dong Chu, Xiao-li Chu, Jing-hua Pan
In 474 patients with invasive ductal carcinoma of the breast, TB was associated with poor clinicopathological features, including larger tumour size, LVI, lymphovascular invasion, LNM, high tumour stroma content, low inflammatory infiltration, and higher buds were also associated with lower five-year overall survival (OS) and shorter cancer-specific survival (CSS) [17,18]. Budding is significantly correlated with known adverse histological features (mainly LVI) and lymph node positivity [54]. Therefore, in the total specimen sections, the level of TB can be used to predict lymphatic invasion and lymph node involvement. Salhia et al. investigated intratumoral (ITB) and peripheral tumour buds (PTB) can be used as predictors of lymph node involvement by comparing 148 resected specimens of invasive ductal carcinomas with 99 matched preoperative biopsy specimens [15]. Thus, it is possible to predict further whether patients' lymph nodes are involved and the subsequent surgical approach is based on their ITB biopsy level.
Clinic-Pathological Features of Breast Ductal Carcinoma in Situ with Micro-Invasion
Published in Cancer Investigation, 2020
Jie Zheng, Tao Zhou, Fang Li, Jiajie Shi, Lina Zhang
At present, the incidence and mortality of breast cancer in female cancer ranks first, because the sensitivity, specificity of diagnostic cancer in early breast cancer is increasing with the update and improvement of technology gradually. According to the estimates in 185 countries from the International Agency for Research on Cancer in 2018, the incidence of breast cancer is approximately 24.2% and mortality is about 15.0% (1). In Eastern Asia, the incidence is higher than the average level worldwide, near 39.2%, but mortality is the lowest in world-wide, belike 8.6% % (1). It has been reported that the incidence of ductal carcinoma in situ (DCIS) accounts for 20–30% of newly diagnosed breast cancer, and ductal carcinoma in situ with micro-invasive (DCIS-MI) accounts for approximately 1% among all types of breast cancer (2). DCIS-MI is intermediate pathological status between DCIS and invasive ductal carcinoma (IDC), and DCIS-MI will eventually develop into IDC if patients does not receive any treatment (3).
Hypofractionated whole breast irradiation after conservative surgery for patients aged less than 60 years: a multi-centre comparative study
Published in Acta Oncologica, 2020
Icro Meattini, Philip Poortmans, Youlia Kirova, Calogero Saieva, Luca Visani, Viola Salvestrini, Jiyoung Kim, Wonguen Jung, Emanuela Olmetto, Matteo Mariotti, Isacco Desideri, Alain Fourquet, Lorenzo Livi, Kyubo Kim
All patients had histologically confirmed invasive breast cancer (invasive ductal carcinoma, invasive lobular carcinoma, or other) or ductal carcinoma in situ (DCIS). Oestrogen receptor (ER) status, progesterone receptor (PgR) status, and Ki-67 labelling index were assessed. For ER and PgR status, two categories (negative and positive) were considered according to the 10% cut-off values for both ER and PgR [11]. Human epidermal growth receptor factor 2 (HER2) immunohistochemistry (IHC) expression was scored as follows: scores of 0 and 1+ were considered negative. HER2 IHC 3+ and fluorescent in situ hybridisation amplified tumours were considered positive. HER2 testing followed the recommendations of the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) [12]. Tumours were classified according to the histologic type and the 7th edition of TNM Classification of Malignant Tumours. Histologic tumour grading was assessed according to Elston and Ellis [13]; to distinguish Ki-67 high from Ki-67 low we used the cut-off value of 20% [14].