Surgical margins factors determining the extent of tumor resection in breast cancer patients treated by conservative surgery

A total of 102 female patients proven to have breast carcinoma was treated by modified radical mastectomy. Risk factors of local recurrence [tumor size, histological type and grade, presence of extensive intraductal component [EIC], vascular invasion and lymph node status] in addition to resection margins were examined. Immunohistochemical expression of adhesion molecule CD44 and prognostic marker C-erb B-2 were evaluated and correlated to the extent of tumor spread beyond the primary site. Tumor bed biopsies from the modified radical mastectomy specimens were taken at distances from 1-6 cm at six positions [anterior, posterior, lateral, medial, upper and lower] and examined for tumor extension. Risk factors of local recurrence in breast carcinoma [histological type, grade, EIC and lymph node status], in addition to adhesion molecule CD44 and prognostic marker C-erb B-2 should be considered in the selection of patients for conservative lumpectomy treatment and in determining the extent of surgical resection. A safety margin of 3 cm is considered to be sufficient in cases of invasive duct carcinoma without intraductal component

Histopathological, immuno-histochemical and electronmicroscopic study [EM] of soft tissue sarcoma

Sixty eight cases of soft tissue sarcoma [STS] selected from the files of Pathology Departments, Benha Faculty of Medicine-Zagazig University and National Cairo Institute- Cairo University, during the period from 1993 to 1997, were examined by light microscopy and class Wed into 44 differentiated cases [64.7%] and 24 undifferentiated cases [35.3%]. The differentiated cases were studied by histochemical and immunohistochemical stains using a panel of Antibodies. We applied the results of histological, histochemical and immunohistochemical reactivity of classified cases -on the 24 undifferentiated cases in trial to classify them. Histochemical and immunohistochemical stains were of most value in classification of 18 [75%] out of 24 undifferentiated cases as: 4 cases liposarcoma, 4 malignant fibrous histiocytoma [MFH], 4 leiomyosarcoma, 2 angiosarcoma, one case of monophasic synovial sarcoma and 3 cases of rhabdomyosarcoma. Combination of electron microscopic [E.M.] with light microscopic examination, [L.M], histochemical and immunohistochemical stains resulted in a specific diagnosis in 4 out of 6 unclassified cases [66.7%], This work supports the view that L.M. readily discriminate between differentiated tumor types. Special histochemical stains could be supportive and confirmation. Immunohistochemical markers together with appropriate clinical and histological features can minimize the number of undifferentiated sarcomas. In problematic cases, immunohistochemical and E.M. have complementary role