Mammographic Appearances of Breast Medullary Carcinoma: Comparison with Pathology and Differentiation with Fibroadenoma
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Objective To evaluate mammography in distinguishing medullary carcinoma from fibroadenoma and in distinguishing true from atypical medullary carcinoma.Materials and Methods Mammographic findings of 27 medullary carcinomas and 34 fibroadenomas were retrospectively analyzed. The findings were compared with pathologic results.Results The most common finding was non-calcified mass for both medullary carcinoma (78%) and fibroadenoma (74%). Usually, the mass was of high-density for medullary carcinoma (19/25) and of iso-density for fibroadenoma (19/28), with significant difference between two tumors (P=0.001). Most medullary carcinomas showed an infiltrating or lobulated border (23/25), while most fibroadenomas had a clear border or could be demonstrated only on a certain direction exposure (25/28), with significant difference between two tumors (P0.001). Of 27 medullary carcinomas, 9 were atypical. No obvious difference in tumor's shape (P=0.670), margin (P=0.394) and density (P=0.637) existed between the true and the atypical medullary carcinomas. Conclusion Breast medullary carcinoma has certain mammographic features, which are well correlated with its pathology and based on which differentiation from fibroadenoma can be made. Pathologically, medullary carcinoma can be further divided into true type and atypical type. Nevertheless, it is almost impossible to make a correct differentiation of the two types on the mammogram.Keywords:
Medullary carcinoma
Breast Fibroadenoma
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Objective To describle mammographic features of breast architectural distortion in order to improve its diagnostic accuracy.Methods Mammographic manifestations of 33 breasts with histropathologic proved breast structure deformation, which occurred in 18 benign diseases and 15 malignant diseases, were retrospectively analyzed. Density, margin and structure of lesion were assessed. The underling entities included post-operation change (n=5), fat necrosis companied with stromal fibrosis(n=1), versicle hyperplasia (n=6) and inflammation (n=4), invasive ductal carcinoma(n=6), DCIS(n=2), infiltrating lobular carcinoma(n=3), mucinous carcinoma(n=2) and Paget (n=2). Results On mammogram, breast architectural distortion was high in 17 cases and iso-density in 16 cases. The margin of the lesions was infiltrating in 10 cases, poor defined in 12 cases, spiculatted changes in 11 cases. Structure of the lesions was disappeared in 17 cases, and was discriminable in 16 cases. They were hard in 14 cases, pliable in 11 cases and of patch thickness in 8 cases on palpate. Statistically significant mammographic findings favoring a diagnosis of companied with malignant lesion included infiltrating margin and structure disappearance with a P value of 0.01 and 0.025 respectively, while the other signs showed no statistic significant difference between benign and malignant lesions. Conclusion Although mammographic manifestations of breast architectural distortion can be variety, analysis of its margin and structure can be helpful for the differentiate diagnosis for benign and malignance of its underlying diseases.
Margin (machine learning)
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This paper deals with the clinicopathologic features exhibited in 7 cases of carcinoma of the breast arising in fibroadenomas. The average age of the patients was 44, a figure similar to that reported in the only other comparable study, approximately 20 years older than the peak incidence of fibroadenomas in the general female population. Lesions were uniformly asymptomatic and varied in known duration from 10 days to 10 years. Clinical and gross pathologic examinations were characteristic of fibroadenoma. The predominant pathologic expression of the carcinoma developing within a fibroadenoma appears to be lobular rather than ductal and is primarily one of lobular carcinoma in situ, an occurrence which supports the concept that a portion of the mammary epithelium within some fibroadenomas is of terminal duct and lobular derivation. The clinical and pathologic features of lobular carcinoma are reviewed, and recommendations for appropriate management of both lobular and ductal neoplasms are offered.
Lobular carcinoma
Invasive lobular carcinoma
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Background: Fibroadenoma of the breast is a relatively frequently occurring tumor. Although often considered a benign tumour, several reports describe a higher risk of subsequent breast carcinoma in patients diagnosed with fibroadenoma. Increased risk depends on presence of complex changes within fibroadenoma, presence of hyperplasia and positive family history for breast cancer. But surprisingly not much literature is available on the variations within the fibroadenoma of the breast. Aims and Objectives: Our main aim was to study the histological variations within the fibroadenoma of the breast. We also tried to identify those lesions with the possible risk of malignancy. Materials and Methods: A total of 100 specimens of fibroadenoma of breast between May 2013 and April 2015 were studied at our institute. Slides were stained with hematoxylin and Eosin (H & E) and were thoroughly reviewed. Slides were screened for proliferative epithelial changes, fibrocystic epithelial changes, stromal changes and various other changes such as foci of tubular adenoma and phyllodes tumour. Slides with invasive malignancies were excluded from the study. Results: Mild hyperplasia was the commonest variation within the fibroadenoma. Complex hyperplasia was seen in older age groups. Conclusion: Fibroadenoma is a common tumour of breast, more frequently occurring in 2 nd and 3 rd decade. Since malignant transformation is not seen or is extremely rare under 35yrs of age, only fibroadenomas in women above this age should be considered for excision biopsy.
Phyllodes tumor
Breast Fibroadenoma
Atypical Hyperplasia
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To evaluate the mammographic features of medullary carcinoma, to determine the frequency of pathologic overdiagnosis of this neoplasm, and to assess whether mammography can distinguish true from atypical medullary carcinomas, since this distinction has important prognostic implications.Retrospective review revealed 25 patients with an initial pathologic diagnosis of medullary carcinoma. Histopathologic slides and mammograms were reviewed.After review of histopathologic slides, 14 (56%) lesions were classified as medullary carcinomas and 11 (44%) as atypical medullary carcinomas. At mammography, a circumscribed mass was present in four of the 14 (28%) medullary carcinomas and in one of the 11 (9%) atypical medullary carcinomas (P = .34), an indistinct mass was present in seven of the 14 (50%) medullary carcinomas and in five of the 11 (45%) atypical medullary carcinomas (P = .86), and an obscured mass was present in two of the 14 (14%) medullary carcinomas and in three of the 11 (27%) atypical medullary carcinomas (P = .62). Calcification, which was present in one of the 11 (9%) atypical medullary carcinomas, and s spiculated border, which was present in one of the 11 (9%) atypical medullary carcinomas, were not observed in medullary carcinomas (P = .44).At mammography, medullary carcinoma was usually an uncalcified mass with indistinct or circumscribed borders. Atypical medullary carcinoma may be misdiagnosed as medullary carcinoma. Mammography could not reliably help distinguish true medullary carcinomas from atypical medullary carcinomas.
Medullary carcinoma
Overdiagnosis
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Objective To investigate the relationship between the sonographic and histologic appearances of breast medullary carcinoma, and to determine the value of sonography in the differentiation of typical and atypical breast medullary carcinoma. Methods We retrospectively reviewed ultrasonographic appearances of 19 cases of breast medullary carcinoma which were confirmed by pathology. Results Eight of 19 medullary carcinomas were classified as typical and 11 were atypical. On sonography,a smooth outline was visualized in 6 of the 8 typical medullary carcinomas but in none of 11 atypical carcinomas. A jagged margin was sonographically visualized in 10 of 11 atypical carcinomas, and a focal irregularity in the margin was visualized in 1 of the 11 atypical carcinomas. Four of the typical medullary carcinomas had posterior enhancement, and 8 of the atypical medullary carcinomas showed retrotumoral shadowing. The difference of tumor margin regularity between typical and atypical medullary carcinomas was statistically significant. Conclusions Treatment and prognosis of typical and atypical medullary carcinomas are different. Ultrasonography is useful in the differential diagnosis of typical and atypical medullary carcinomas.
Medullary carcinoma
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Objective:To explore sign of clustered calcification found by mammography and evaluate its clinical values in the diagnosis of early breast cancer.Methods:To analyze the density,number,size,morphology and to compare with breast masses of the clustered calcification from 97cases breast with benign and malignant.All cases were confirmed by operation and pathology.Results:①Among 97 patients,the breast type of Ⅲ(cords-duct type) and Ⅳ(inter mixed type) were 86.6%,the breast cancer is mostly;②In 94 cases breast cancer,39 cases(41.5%) with noninvasive carcinoma,there are intraductal carcinoma and lobular carcinoma in situ;55 cases(58.5%) with invasive carcinoma,there are invasive ductal carcinoma,invasive lobular carcinoma,scirrhous carcinoma,carcinoma simplex,mucinous carcinoma and medullary carcinoma.In 3 cases benign papillomatosis,2 cases with mezzo atypical intraductal epithelial cell hyperplasia intraductal,1 cases carcinoma,invasive lobular carcinoma,scirrhoma carcinoma,carcinoma simplex,mucinous carcinoma,medullary carcinoma.In 3 cases benign papillomatosis,2 cases with mezzo atypical intraductal epithelial cell hyperplasia intraductal,1 cases cystic hyperplasia;③In 94 cases breast cancer,clustered rod-shaped,minute or sand-shaped and multiform calcified foci were the main kinds,the calcify number20 grains/ cm2.In 77 cases of benign and malignant breast tumors,there are 20(20.4%) singles mass,calcifications in mass appeared in 34(79.6%) cases.Conclusion:The modality of calcifications was seen both in malignant and benign breast tumors.Their features of calcification are very valuable in the diagnosis of breast tumors,specifically of breast cancer in early stage.
Intraductal papilloma
Lobular carcinoma
Medullary carcinoma
Mucinous carcinoma
Carcinoma in situ
Atypical Hyperplasia
Breast carcinoma
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Objective: To study the mammographic features of breast carcinoma which showed no distinct mass or calcification. Methods: The clinical data, ultrasonographic and momographic features of 26 cases of breast carcer comfirmed by surgery and histopathology but without distinct mass or calcification by mammography were retrospectively analyzed. Results: All 26 patients were palpated to have mass or nodule. Among them, 25 were classfied small or massine mammary gland type. There was no distinct interface between disease foci and mammary glands. In histopathology 24 cases were infiltrative ductal carcinoma and were infiltrative lobular carcinoma of the breast. Conclusion: Breast carcinoma without distinct mass or calcification by mammography but with clinical palpated mass should be carefully study and compared with the other breast.
Histopathology
Breast carcinoma
Nodule (geology)
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Morphological and mammographic study of small (less than 1 cm) focal mammary gland lesions of 170 women revealed foci of typical epithelium proliferation of the ducts and lobules, fibrosing adenosis, small duct papillomas and fibroadenoma, intraductal and ductal carcinoma in situ, sometimes with small invasion foci, infiltrating carcinoma, infiltrating lobular carcinoma. Peculiarities of small focal lesion morphology determine the mammographic picture. Analysis of nodular shadows on the mammogram gives as a rule a possibility to differentiate between benign conditions (focal proliferation of the epithelium, fibroadenoma), early carcinoma (intraductal and lobular in situ, sometimes with small foci of invasion) and infiltrating carcinoma. Calcareous deposits in both benign lesions and carcinomas do not differ mammographically. Morphogenetic link was revealed between foci of epithelium proliferation (benign displasia), intraductal and lobular carcinoma in situ and infiltrating carcinoma. Among 65 cases of non-palpable carcinoma, 31 (47.7%) were classified as early carcinoma and 34 (52.3%) as infiltrating carcinoma with a relatively low histological degree of malignancy. In both groups a good postoperative survival was observed.
Lobular carcinoma
Intraductal papilloma
Carcinoma in situ
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Breast ultrasound
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Metaplastic carcinoma accounts for less than %1 of all malignant breast lesions. It has a more aggressive behaviour and worse prognosis than other breast carcinomas. Clinically metaplastic carcinomas are more common in women more than 50 years old and usually present as palpable masses. The purpose of this study was to investigate the mammographic, sonographic and magnetic resonance imaging findings of metaplastic carcinoma of the breast and to correlate the radiologic features with clinical and histopathologic findings. We present the clinical and radiological findings of 35 year old woman whose histopathologic diagnosis is metaplastic carcinoma.
Metaplastic Carcinoma
Breast carcinoma
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