validity of MRI in evaluation of tumor response to neoadjuvant chemotherapy in locally advanced breast cancer

Physical Examination [PE] and breast MRI are two of the current methods which have usually used in diagnosis of primary breast cancer. Their accuracy in detection of: either complete response or presence of residual tumor, however, has not yet been established in patients who have been received Neoadjuvant Chemotherapy [NAC]. The purpose of this study was to evaluate the diagnostic accuracy of breast MRI in assessment of residual neoplastic tissue after NAC in patients with Locally Advanced Breast Cancer [LABC]. Twenty patients with LABC have undergone contrast-enhanced MRI before and after the NAC. Considering histology as the gold standard, the tumor sizes in MRI and PE have compared with the histology results. We have calculated for all below: the accuracy, sensitivity, specificity, Positive Predictive Value [PPV] and Negative Predictive Value [NPV] for each of MRI and physical examination, as well as Pearson's correlation coefficients between the results of MRI and PE, and their histology results. We have found an accuracy of 85% for MRI with a sensitivity of 100%, a specificity of 50%, a PPV of 83.3%, and an NPV of 100%. In addition, the accuracy for PE was 70% with a sensitivity of 71.4%, a specificity of 66.6%, a PPV of 83.3%, and an NPV of 50%. In this study, the calculated Pearson's correlation coefficient for MRI and histology was 0.817 [p<0.0001] versus 0.26 [p=0.26] for correlation between PE and histology. MRI has higher sensitivity but less specificity than PE for detection of residual tumor after NAC in locally advanced breast carcinoma. Also, the tumor size that has measured by MRI had highly correlation with the histology

Lactating breast abscess: a rare presentation of adenosquamous breast carcinoma

We report the case of a 33-year-old lactating woman who presented with a 10-cm breast abscess. Biopsy of the abscess wall revealed a poorly differentiated invasive ductal carcinoma. The patient had no family history of breast cancer or other risk factors for breast cancer. The disease was considered to be a large noninflammatory invasive breast cancer, for which the patient received neoadjuvant chemotherapy, breast-conserving surgery using axillary dissection (the patient did not consent to a mastectomy), and postoperative radiotherapy. Final histologic examination revealed a 4-cm, triple negative, high-grade adenosquamous carcinoma. At follow-up four years after surgery, the patient was doing well with no signs of recurrence. Adenosquamous carcinoma is an extremely rare disease that mainly presents in low-grade forms. High-grade forms are aggressive and frequently present with axillary involvement. To the best of our knowledge, there has been no report of adenosquamous carcinoma presenting as a breast abscess in the literature. The case we report highlights that, although rare, cancer should be considered in lactating breast abscesses.

Crude and age-specific incidence rate patterns for histopathologic subtypes of ovarian cancer in Iran

The purpose of this study was to report age-specific incidence rates of histopathological subtypes of ovarian cancer in Iran. Data published by the pathology-based Cancer Registry, Iranian Ministry of Health and Medical Education for the year 2004, was utilized. This study included 793 new ovarian cancer cases which were analyzed by SPSS software [version 13]. There were 45 different histologies reported in 793 new cases which were categorized into ten major groups. Epithelial tumors displayed the highest age specific incidence rate, followed by germ cell tumors. Serous epithelial tumors were the most common in the epithelial group. The age-specific incidence rate of ovarian cancer varies based on histolo