Intraductal papilloma of the breast in association with preoncogenic gene of breast cancer

We reported a case of an African American woman who went to the hospital with palpable right breast lump with bloody nipple discharge at University of Texas Medical Branch at Galveston. The modalities of breast imagings included mammography and ultrasonography. The method used for viral identification was Linear Array HPV genotyping test. Intraductal papilloma revealed as high density tubular or rounded lobular masses with partially circumscribed, obscured margins and clustered punctate microcalcifications on mammograms. Ultrasound showed as intraductal masses with dilated ducts. The core biopsy demonstrated duct filled with papillary lesion and post excision revealed intraductal papilloma. HPV DNA types 16, 33, 58 and 71 were detected after use of Linear Array HPV genotyping test.

Margin determination of two-view specimen radiography in breast cancer

Background: Specimen radiography (SR) is most useful for confirming complete excision of a lesion in the breast conservation therapy. The radiologist is expected to evaluate the margin status for possible additional tissue removal by the surgeon. Objective: To develop the technique of specimen radiography to obtain the accurate marginal assessment in breast cancer. Materials and methods: A retrospective review was performed on 12 patients who underwent wire-localized partial mastectomy for malignant breast lesions at the University of Texas Medical Branch at Galveston between May and September 2007. The specimen was oriented to obtain the correct margin using different color stitches. Based on two-view specimen radiography on anteroposterior and lateral planes, the margin status was assessed and compared with final histopathology. Results: Eighty-three percent cases had discordance by the one-view SR, and 67.0% by the two-view SR with pathological findings. One-view SR has a sensitivity of 25.0%, specificity of 25.0%, positive predictive value (PPV) of 40.0%, and negative predictive value (NPV) of 14.3%. Two-view SR has a sensitivity of 37.5%, specificity of 25.0%, PPV of 50.0%, and NPV of 16.7%. The false negative rate is 50.0% for one-view specimen and 42.0% for two-view. The false positive rate is 25.0% for one-view specimen and 25.0% for two-view. The concordance rate between SR and HP in two-view SR was higher compared with one view SR. Conclusion: Specimen radiography could aid in the intraoperative assessment of margin status in patients undergoing excision of a breast mass.