Clinical analysis of 276 cases of non-palpable TO breast cancer
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Keywords:
Nipple discharge
Axillary lymph nodes
Breast carcinoma
Objective To preliminarily study the correlation between manifestations of breast carcinoma on the color Doppler ultrasound and the expression of immunohistochemical factors ER, PR, C-erbB-2, and to provide more information and scientific evidence for the preoperative adjuvant therapy and for the evaluation of the prognosis. Methods Forty-four patients with breast carcinoma on firmed by histopathology were involved in this study. The color Doppler ultrasound was performed in every case before therapy, and ER, PR, C-erbB-2 were performed after operation. The correlation of the color Doppler ultrasonographic manifestations of breast carcinoma and the expressions of the three factors were analyzed. Results ①There was not a correlation between the size of breast carcinoma and the expression of ER, PR, C-erbB-2 respectively (P0.05). ②The positive expression rate of ER in spiculated breast carcinoma was higher than non-spiculated (P0.01). ③The positive expression rate of C-erbB-2 was higher in patients with axillary lymph nodes metastasis (P0.05), the positive expression rate of ER was lower (P0.01). ④The positive expression rate of C-erbB-2 was higher in breast carcinoma tissue of plentiful blood stream than lacking of blood stream (P0.01). Conclusion The manifestations of breast carcinoma on the ultrasound have some kind of correlation with expressions of immunohitochemical factors. The breast carcinoma with spiculated and axillary lymph nodes nonmetastasis are less malignant and more suitable for endocrine therapy; the breast carcinoma with plentiful blood flow and axillary lymph nodes metastasis have more possibility about the positive expression of C-erbB-2, indicating more malignant and prognosis badness.
Breast carcinoma
Axillary lymph nodes
Color doppler
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Objective To explore the relationship between the expressions of cell proliferation markers(PCNA and Ki 67) and prognosis of breast carcinoma. Methods The expression of proliferating cell nuclear antigen(PCNA)(monoclonal antibody PC10) in 112 cases of primary breast carcinoma was detected by immunohistochemical method(EnVision staining). MIB1 labelling index(MIB1 LI) in the breast carcinoma was detected. Histological classification, typing, grading and staging of 112 cases of breast carcinoma were conducted on the basis of the reported diagnostic criteria. The clinical data were collected and a follow up was conducted. Results Expressions of MIB1 LI and PCNA in patients with tumor larger than 2 cm in size, at Ⅲ-Ⅳ, with metastasis in axillary lymph nodes, or with more than four axillary lymph nodes involved were significantly higher than those in patients with tumor less than 2 cm in size, at Ⅰ-Ⅱ, without metastasis in axillary lymph nodes, or with no more than 3 axillary lymph nodes involved( P 0 05). The cumulative 10 year survival rate of the former was lower than that of the latter. Ages and menstrual conditions were not significantly related with expression levels of MIB1 LI and PCNA and cumulative 10 year survival rate( P 0 05). Conclusion Expression intensity of MIB1 LI and PCNA, closely associated with many clinical and pathological factors, may be the reliable and important factor for judging the prognosis of breast carcinoma.
Breast carcinoma
Axillary lymph nodes
Grading (engineering)
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BACKGROUND:
The aim of this study is to identify and analyse patients presenting to the general surgical outpatient department with breast related complaints such as breast pain and nipple discharge without the presence of history of breast lump to aid in the identifying the incidence of carcinoma breast in these patients.
PATIENTS AND METHODS:
Our study includes 50 patients who present to the general surgical out patient department with the history of complaints of breast related complaints such as breast pain and nipple discharge without the presence of breast lump.
RESULTS:
In our study, we have identified that the most common diagnosis to be made in patients who present to the general surgical out patient department with breast related complaints was found to be Aberrations in Normal Development and Involution (ANDI) which consisted of diseases such as fibrocystic disease of breast and fibroadenoma. It was found that carcinoma breast was diagnosed with a frequency of much less than benign breast diseases and the incidence of carcinoma breast was found to be very minimal in comparing to benign breast diseases.
CONCLUSION:
The most common disease in the female population with breast related complaints such as breast pain and nipple discharge without the presence of breast lump is found to be Aberrations in Normal Development and Involution (ANDI). Carcinoma breast is diagnosed with very less frequency than benign breast diseases in patients presenting with these type of complaints. But, the clinical suspicion of carcinoma breast should always be kept in mind and further evaluation of female patients should always be done who present to the out patient department with breast related complaints.
Nipple discharge
Breast carcinoma
Breast pain
Breast disease
Outpatient clinic
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The aim of this study is to report our experience with ductoscopic evaluation for screening patients with nipple discharge and evaluate any potential indications and benefits of ductoscopy. From January 2010 to December 2012, 419 female patients with nipple discharge were enrolled in this study. All patients involved in this study showed no mass in ultrasound and mammography. Data concerning age, clinical characteristics of nipple discharge, nipple discharge cytology, ductoscopic and postsurgical diagnosis, and complications were statistically analyzed. Ductoscopy examinations were completed in 405 patients (96.66%). For these 405 patients, there were 519 ductoscopic investigations. 112 (27.65%) patients were found to have intraductal papillary lesions of which 62 were operated in our hospital. Postsurgical diagnosis showed 8 (12.9%) malignancy including 6 DCIS and 2 invasive ductal carcinomas. All of the 8 patients meet at least two criteria of pathologic nipple discharge (single duct, spontaneous, bloody nipple discharge). The other patients with nonpapillary lesions are still under surveillance. By univariate analysis, patients with unilateral, single duct, spontaneous and bloody nipple discharge were more likely to have intraductal papillary lesions. By multivariate analysis, unilateral, spontaneous, and bloody nipple discharge showed statistically significant correlations with intraductal papillary lesions revealed by ductoscopy. Ductoscopy is a safe and efficient investigation in preoperative screening of the patients with nipple discharge. Clinical characteristics have predictive value in selection of patients for ductoscopical investigation. Patients with clinical characteristics of unilateral, spontaneous, and bloody nipple discharge were more likely to have intraductal papillary lesions revealed by ductoscopy.
Nipple discharge
Bloody
Intraductal papilloma
Univariate analysis
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Abstract Background Nipple discharge is one of the commonest encountered complaints in the field of breast imaging. Excluding malignancy as a cause of pathological nipple discharge is of utmost importance. Our aim in this study was to assess the role of contrast-enhanced spectral mammography (CESM) in the diagnostic workup of patients with pathological nipple discharge (PND). Results In the current prospective study, 59/140 lesions were benign and 81/140 lesions were malignant. Analysis of CESM had achieved a higher sensitivity of 97.5% and a similar specificity of 54.2% as compared to sono-mammography, which achieved a sensitivity of 92.6% and specificity of 54.2%. The diagnostic accuracy of CESM was higher (79.3%) than sono-mammography (76.3%). CESM performed better than sono-mammography in the assessment of disease extent, as it was able to detect multifocality, multicentricity, and diffuse abnormalities, which were found in 24.1%, 43.0% and 8.9% of cases, respectively, as compared to 20.5%, 37.2%, and 3.8% of cases by sono-mammography. Conclusion CESM can be a valuable diagnostic imaging tool in the detection of malignancy associated with PND if sono-mammographic findings are equivocal. Its greater impact is on the delineation of disease extent, which will alter the treatment strategy.
Nipple discharge
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The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma, this can mimic or complicate the staging of a malignant disease. Dual organ pathology can lead to interpretation difficulties and inappropriate treatment of tuberculosis as well as breast carcinoma. We report an observation of infiltrating carcinoma of the non-specific type of the breast in woman aged 39, where tuberculosis was found in the axillary lymph nodes in addition to metastases. The possible and simultaneous occurrence of breast carcinoma and tuberculosis should be mentioned in order to avoid difficulties of interpretation and allow adequate management of axillary tuberculous lymphadenitis and breast carcinoma.
Breast carcinoma
Axillary lymph nodes
Metastatic carcinoma
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Objective:To assess the value of fiberoptic ductoscopy in the diagnosis and treatment of nipple discharge.Methods:Fiberoptic ductoscopy was used to check 150 cases with nipple discharge from July 2009 to October 2010 in our hospital,and then to compare the preoperative clinical diagnosis with pathologic diagnosis in patients with nipple discharge.Results:150 cases were checked successfully.3 cases were diagnosed with breast cancer and 62 cases wer papilloma.The coincidence rate of clinical diagnosis and pathological diagnosis is about 66.7% and 88.7% respectively;85 cases wre diagnosed with mammary ductectasia with duct inflammation.After ductal lavagedrugs,the nipple discharge have significantly improved or curde.Conclusion: Fiberoptic ductoscopy was the preferred method in diagnosis of nipple discharge.It could clear the cause of nipple discharge in a more intuitionistic and accurate way and define the position and size of the nipple discharge;it could make the duct inflammation and duct ectasia patients free from operation.Also Fiberoptic ductoscopy was an effective technique in diagnosis of breast intraductal papilloma and intraductal carcinoma with nipple discharge as the main performance.
Nipple discharge
Intraductal papilloma
Ectasia
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Abstract Thirty‐seven axillary status of patients with breast carcinoma was studied with preoperative and peroperative palpation before mastectomy and total axillary dissection. Special attention was paid to the clinical supiciousness and size of axillary nodes. The preoperative axillary palpation gave false diagnosis of axillary content 27% of the time and peroperative, 19%. Of all 249 nodes studied, 54 were found to contain malignant growth in routine histological examination. Mean diameter of malignant nodes was 12.4 mm and of benign nodes, 6.3 mm. The most clinically suspect axillary lymph node gave correct diagnosis of axillary status in 72 % of the cases. The 2 most suspect lymph nodes together were positive in 89%. There was no case with histologically positive axilla where none of the 3 most suspect lymph nodes was malignant. We conclude that at least the 3 most suspect axillary lymph nodes must be removed for histological examination to be sure that axillary metastasizing of breast carcinoma can be found by routine histological examination.
Breast carcinoma
Axilla
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Objective To evaluate the diagnostic value of high frequency ultrasonography in axillary lymph nodes metastasis of breast carcinoma. Methods Seventy-nine patients with breast carcinomas were examined for axillary lymph nodes by high frequency ultrasonography before operation. The shape size,echogenicity and blood supply on high frequency ultrasonography were recorded and compared with that of pathology after operation. Results Among 79 patients, 51 patients showed turgid axillary lymph nodes on high frequency ultrasonography and the sensitivity was 64.5% (51/79).There were 27 patients with susputive axillary lymph nodes metastasis of breast carcinoma,and 25 of them were confirmed by pathology after operation with a sensitivity of 92.6% (25/27). Conclusion High Frequency ultrasonography is a simple and valuable method to show axillary lymph nodes metastasis of breast cancinomas.An important index for axillary lymph nodes metastasis of breast carcinoma is the transverse of axillariy node (T)5mm and longitude/transverse (S/L) ratio2. The shape echogenicity and blood supply of axillary lymph nodes are references for metastasis of breast carcinoma.
Axillary lymph nodes
Echogenicity
Breast carcinoma
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Well-differentiated carcinoma is a specific type of mammary carcinoma easily mistaken for sclerosing adenosis because of its deceptively innocent histologic appearance. A study of 33 patients with well-differentiated carcinoma of the breast was carried out to determine the clinical behavior of the lesion. The clinical findings in these patients were similar to those of women with other types of mammary carcinoma. The tumors tended to be small (median diameter, 1.6 cm), but metastasis to axillary lymph nodes was nonetheless present in 10 patients (30%). The prognosis is quite favorable, even when there are positive axillary lymph nodes, as only one patient in this series died of metastatic carcinoma. Because axillary involvement is almost always limited to 1 or 2 lymph nodes in the lower axillary region, modified mastectomy (Auchincloss) is advocated for this type of carcinoma of the breast.
Axillary lymph nodes
Breast carcinoma
Mammary carcinoma
Metastatic carcinoma
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