Patología benigna mamaria en pacientes del Servicio de Ginecología Oncológica del Hospital Nacional Arzobispo Loayza

Objetivos: Determinar la patología mamaria benigna más frecuente según diagnóstico histopatológico y sus características. Diseño: Estudio observacional, retrospectivo. Institución: Hospital Nacional Arzobispo Loayza, Lima, Perú. Participantes: Mujeres con patología mamaria benigna. Intervenciones: Entre enero y diciembre de 2012, en pacientes con patología mamaria benigna según diagnóstico histopatológico, se relacionó la patología con localización, tamaño e intervalo de edad más frecuente. Principales medidas de resultados: Características de la patología mamaria benigna. Resultados: En 175 pacientes, la patología tumoral benigna más frecuente fue el fibroadenoma en 61 casos, con más presencia entre los 10 y 39 años. El tumor fue único en 158 casos (90%), siendo la mama izquierda la más afectada en 84 pacientes (48%), con tumoraciones que oscilaron entre 1 y 3 cm (60% del total), y los radios de localización 2, 3 y 10 los más comprometidos. Conclusiones: La patología tumoral benigna mamaria más frecuente fue el fibroadenoma, siendo necesario su hallazgo y un examen anatomopatológico, para poder establecer diagnóstico diferencial con carcinoma.

Objectives: To determine the most common benign breast disease by histopathology diagnosis and its characteristics. Design: Observational, retrospective study. Setting: Hospital Nacional Arzobispo Loayza, Lima, Peru. Participants: Women with benign breast disease. Interventions: Between January and December 2012, benign breast disease with pathology diagnosis was related to localization, size and most frequent age interval. Main outcome measures: Benign breast disease pathology characteristics. Results: In 175 women fibroadenoma was the most frequent benign breast tumor, present in 61 cases, mainly in women 10-39 year-old. The tumor was single in 158 (90%) patients (158), the left breast was the most affected in 84 (48%) patients, with tumors ranging from 1 to 3 cm (60% of patients), the radius of location at 2, 3 and 10. Conclusions: The most common breast benign tumor was fibroadenoma. Its finding is necessary for pathologic examination to exclude carcinoma.

Serum Phospholipid Fatty Acids in Benign Breast Tumor and Breast Cancer

Studies on the relationship between blood fatty acids and the risk of breast cancer have not yielded definite conclusions. The role of fatty acids in the development and progression of breast cancer is unclear. We conducted a case-control study to determine serum phospholipid fatty acid composition in benign breast tumor and breast cancer. Subjects consisted of 27 benign breast tumor and 68 breast cancer patients, and 28 matched controls. The levels of fatty acids were measured by gas chromatography. Higher arachidonic and palmitic acids were observed in breast cancer patients as compared with control and benign breast tumor patients. The percentage of total saturated fatty acids in breast cancer was higher than in control and benign breast tumor patients. The level of stearic acid was lower in benign breast tumor and breast cancer patients. Saturation index, the ratio of stearic to oleic acid, was lower in benign breast tumor and breast cancer patients compared to the control. Moreover, stearic acid was negatively and arachidonic acid was positively correlated with the cancer stage. In conclusion, our results support that serum phospholipid compositions of specific fatty acids are associated with the risk of benign breast tumor as well as breast cancer. Further studies are necessary to investigate mechanisms linked to the breast cancer etiology.

Is Mammotome Excision Feasible for Benign Breast Mass Bigger than 3 cm in Greatest Dimension?

PURPOSE: The aim of this study was to evaluate that a surgeon can safely remove all sonographic evidence of masses in the breast grater than 3.0 cm in greatest dimension using the 8 g hand held Mammotome (MT). METHODS: From Jan. 2003 to Mar. 2005, a total of 1,368 US-guided MT excision were performed in 1,112 patients at Kangnam Cha hospital. Of these 1,368 lesions 28 lesions with BI-RADS category 3 features by ultrasonography were included in this study. Ultrasonographic follow-up were performed on 3~6 months later to assess residual tissue and scarring. RESULTS: Mean patient age was 32.0 years (range 20~55 years). The average size of lesion was 3.5 cm (SD+-0.43 cm). All of the lesions were palpable and all of the specimens were benign. Most common pathologic features were fibroadenoma (75.0%) and breast abscess (14.3%). Mean time required to perform mammotome procedures was 12.2+/-8.2 minutes and mean number of cores removed were 35.1+/-30.2 pieces. No bleeding or infections occurred postoperatively and most complications were mild and anticipated. CONCLUSION: This study demonstrates that percutaneous removal of big breast benign mass above 3 cm in diameter using The MT system is feasible, effective and safe method for the therapeutic management with minimal morbidity without any additional procedures.

Excision of benign breast tumor by an Ultrasound-Guided hand held Mammotome biopsy device / 한국유방암학회지

PURPOSE: The mammotome (MMT) biopsy is a new surgical technique that is a minimally invasive, image guided procedure, and it requires just one small incision and there is no need for multiple insertions in the breast. The aim of this study was to evaluate the efficacy and the safety of the MMT biopsy device for percutaneous removal of breast masses with using ultrasound guidance. METHODS: From Jan. 2003 to Mar. 2005, a total of 1368 US-guided excisional MMT biopsies were performed in 1112 patients at Kangnam Cha Hospital. Those lesions with BI-RADS category 3 and 4a features by USG examination were included in this study. Lesions below 1.0 cm were removed by an 11 G probe, and lesions above 1.0cm were removed by an 8 G probe. Ultrasonographic follow-ups were performed 3-6 months later to assess the residual tissue and scarring. RESULTS: The mean patient age was 36 (range: 14-76) years. The average size of lesion was 1.14 cm (SD = 0.63 cm). Among the patients, 67.3% had nonpalpable lesion and 32.7% had palpable tumor. The majority of the specimens (98.3%) were benign. Most of benign specimens (77.7%) consisted of fibroadenoma and fibrocystic changes, although 23 lesions (1.7%) were malignant. The mean MMT procedure time was 6.2+/-3.9 minutes and the mean number of cores removed was 14.8+/-9.8. No serious bleeding or infection occurred postoperatively. CONCLUSION: This study demonstrates that percutaneous breast biopsy using the MMT system may be feasible and effective method for the diagnostic and therapeutic management of benign breast lesions with minimal morbidity. Complete MMT excision may be safely performed for the lesions those are less than 3 cm in size. A breast surgeon can use MMT instead of open or core needle biopsy for the initial biopsy of breast lesions.

Analysis of Chromosome-specific Aneusomy in Breast Tumor by Using Fluorescence in Situ Hybridization

PURPOSE: Several studies have used FISH (fluorescence in situ hybridization) to analyze aneuploids in various solid tumors. FISH, using chromosome-specific, alpha-stellite DNA probes, can be used to detect aneusomy in interphase and/or metaphase cells. The aims of this study were to compare the FISH cen tromere signals from benign breast tumors and to those from breast cancers and to evaluate the clinico pathologic parameters and the aneusomic patterns involving chromosomes 1, 11, and 17 in breast cancers. METHODS: FISH was performed on touch preparations from 15 benign breast-tumor and 29 breast-cancer specimens. The frequency of aneusomy, measured by nondisomy, was determined for chromosomes 1, 11, and 17 through the use of chromosome-specific alpha-stellite DNA probes. The frequency of chromosome- specific aneusomy was then correlated with clinicopathologic parameters, including tumor size, lymph- node involvement, estrogen receptor, and nuclear grade. RESULTS: Only one of the 15 benign breast tumors was shown to be aneusomic for chromosome 1. The other 14 cases of the benign breast tumors showed no evidence of aneusomy for any of the 3 chromosomes. In breast cancers, however, 26 of the 29 cases (90%) were exhibited aneusomy of at least 1 of the 3 chromosomes evaluated and chromosome 1 was most frequently aneusomic (26 of 29 cases (90%)). The present study also suggested a possible correlation between the numeric abnormality of chromosome 1 and estrogen receptor levels. No significant correlations with tumor size, regional lymph-node metastasis, and nuclear grade were observed. CONCLUSION: These findings suggest that chromosome-specific aneusomy is more frequently observed in breast cancers than in benign breast tumors and that aneusomy of chromosome 1 correlates with estrogen receptor levels.