Construction of a predictive model based on columnar maps for factors influencing lesion residuals after minimally invasive rotary mastectomy for breast masses / 中华内分泌外科杂志

Objective:To investigate the influencing factors associated with lesion residual after minimally invasive rotary mastectomy for breast masses and to construct a predictive model using columnar plots.Methods:Two hundred and twenty-eight patients with Breast lumps in Linyi People’s Hospital from Jun. 2018 to Jun. 2020 were selected as study subjects, all of whom underwent minimally invasive rotational resection, and the influencing factors of postoperative lesion residual were analyzed using univariate and multifactorial analysis, and a column line graph risk warning model was constructed and given for evaluation and validation.Results:228 patients were followed up for 6 months after surgery, 3 cases were lost, 225 cases completed postoperative follow-up, among which 185 cases (82.22%) had successfully resected lesions; 40 cases (17.78%) had residual lesions. Univariate, logistic regression analysis showed that tumor diameter ( t=15.52, P<0.001) , lesion morphology ( t=15.52, P<0.001) , lesion boundary ( χ2=7.71, P=0.006) , ultrasound guidance ( χ2=12.69, P<0.001) , and minimally invasive spinotomy system ( χ2=10.64, P=0.001) were the factors influencing lesion residual after minimally invasive spinotomy of breast masses. Based on the above factors to construct a column line graph model of lesion residual after minimally invasive rotational mastectomy for breast lumps, the area under the working characteristic curve (ROC) for model subjects was 0.974 (95% CI: 0.954-0.994) , indicating that the calibration curve basically matched the actual curve; external validation of the model showed that the area under the obtained ROC was 0.962 (95% CI: 0.933-0.991) , indicating that the model has a high degree of calibration. Conclusion:Tumor diameter, lesion morphology, lesion boundary, ultrasound guidance, and minimally invasive spinotomy system are the influencing factors of lesion residual after minimally invasive spinotomy for Breast lumps, and the column line graph model prediction of lesion residual occurring after surgery constructed based on the above factors has good confidence.

Study of clinical, imaging and pathological assessment of breast lumps: an observational study

Background: A palpable lump in a woman’s breast could be benign or malignant and it requires prompt evaluation to confirm or exclude cancer. This study aims to establish the correlation between clinical and radiological parameters for provisional diagnosis of breast lumps and the role of histopathology for final diagnosis of these breast lumps.Methods: Total 275 female patients with palpable breast lumps were included in the study, where a detailed history was recorded and clinical examination was done. All patients underwent ultrasonography of the breast along with fine needle aspiration cytology or histopathology, wherever indicated.Results: Benign breast lumps were found more commonly in 18-30 years of age group whereas malignant breast lumps were seen more commonly in the 41-60 years age group and the incidence increased with age. Fixity to skin was present in 5.1% and fixity to chest wall was present in 5.8% respectively, and all of these cases turned out to be malignant.Conclusions: Attributing factors for suspicion of malignant lumps are advanced age, fixity to surrounding structures, presence of ulceration and peau’d orange breast skin appearance. Although for confirmation of malignancy from a suspected breast lump requires either cytology or histopathology of the excised specimen.

Evaluation of Role of Tru-Cut Biopsy in the Diagnosis of Clinically Palpable Breast Lumps

Many diseases affect the breast that range from inflammatory conditions, benign lesions to malignant lesions, most of which present as lumps in the breast. Breast lumps are one of the frequent complaints that we come across in surgical OPDs. Breast lumps not only create apprehension but also can cause unacceptable pain and impairment if they are found to be malignant. Fine Needle Aspiration Cytology (FNAC), Tru-Cut biopsy, incision biopsy and excision biopsy are the pathological investigations available for the diagnosis of breast lesions. This study is done to evaluate the role of Tru-Cut biopsy in diagnosing the breast lesions and compare it with FNAC and histopathology.METHODSThis prospective study is conducted in the Department of General Surgery at a tertiary care centre from September 2015 to November 2016 among patients attending surgical OPD and admitted in general surgical wards with clinically palpable breast lumps.RESULTSThe sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC were 86.36%, 93.75%, 90.47%, 90.90% and 90.74 % respectively. For Tru-Cut biopsy the values were 95.45%, 100%, 100%, 96.96 % and 98.14 % respectively.CONCLUSIONSTru-Cut biopsy has better efficacy over FNAC in our study. The superiority of Tru-Cut biopsy is particularly seen in Sclerosing, papillary, fibro-epithelial lesions and malignancies with inconclusive and suspicious FNAC results.

Incidence of Breast Lumps Encountered in the Department of Surgery: A Hospital Based Study

Introduction:- World Health Organization reported that there were 14.1 million new cancer cases, 8.2 million cancer deaths and 32.6 million people living with cancer within 5 years of diagnosis worldwide. Methodology:- Data were collected on the bases of findings of history and clinical examination. Fine needle aspiration cytology (FNAC) was done in patients with palpable lump in breast and suspicious lesions. Suspected cases were sent for histo pathological examination. Result:- Most of the cancer patients were found in the 51-55 year age group. In this study, cyto-pathological features were occur, Fibroadenoma (54%), fibroadenosis(8%), Fibrocystic disease(4%), seb. Cyst breast (2%), gynaecomastia(0%), breast abscess(12%), mastitis(0%), ductal carcinoma(18%), paget disease of nipple(2%). Conclusion:- benign breast lesions are more common among female population than malignant lesion, the frequency of breast cancer is increasing rapidly across the global.

Cyto-Histopathological Correlation of Breast Lump as a Part of Internal Quality Control

Background: Breast malignancy is the most widely recognized tumor in females around the world. With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lesions has been revolutionized. Its accuracy in many situations can approach that of histopathology in providing an unequivocal diagnosis. Hence a review was undertaken with the following objectives. To correlate cytological and histopathological diagnosis of breast lesions as a part of internal quality control. To know the incidence of false positive and false negative cases. To find out the sensitivity and specificity of FNAC of breast lesions. Methods: This study was conducted for a period of 2 year and 102 aspirations of breast lumps studied. Out of which 82 cases were followed- up by histopathological correlation. Results: Cytological diagnosis in general was divided into four categories, benign (76.29%), malignant (18.29%), suspicious (2.44%), and unsatisfactory (00). Age of the patient was range from 16 - 62 years with mean age of 32 years. There were 76 female patients and 06 male patients. Fibroadenoma (54.87%) was most common benign neoplasm. The two cases which were categorized as “Epithelial Hyperplasia, Suspicious” by cytology turned out to be malignant lesions on histopathology. Sensitivity and specificity of FNAC in breast lesions were reported to be 88.24 % and 100% respectively, with 100% positive predictive value and 97.01% negative predictive value. Conclusion: Considering the high specificity and sensitivity of aspiration cytology in the cases of breast lesion, it can be established as an internal quality control at tertiary centre to minimize economical stress demanded for EQAS (External Quality Assessment Scheme).

Cytological study of palpable breast lumps with their histological correlation in a tertiary care hospital

Background: Breast lump have varied pathology and different techniques are available to diagnose it. But fine needle aspiration cytology (FNAC) is highly accurate, rapid, and reliable tool for diagnosing breast lump. It helps the clinician to plan correct management. Aim: Aim of this study was to evaluate role of FNAC in diagnosis of palpable breast lesions in term of sensitivity, specificity, accuracy, positive predictive value, negative predictive value and to compare cytopathological findings of breast lesions with histopathology wherever possible. Materials and methods: This study was carried out on 234 patients, all presented with breast lump in pathology Department, GMERS medical college, Valsad over a period of January 2015 to May 2017. Out of 234 patients 2 were male. Cytological diagnoses were correlated with histopathological findings. Results: Cytopathologically lesions were categorized as non-neoplastic 16(6.83%), benign 122(52.13%), malignant 30(31.19%) suspicious 12(5.12%) and unsatisfactory aspirates 11(4.70%). Of these 234 cases 69(29.48%) cases were available for histopathological examination, of which 39 benign cases and 24 malignant cases were similarly diagnosed on histopathology. 5 suspicious cases and 1 unsatisfactory aspirate on FNAC were turned out to be malignant on histopathology. So sensitivity was 80%, specificity 100%, positive predictive value 100%, negative predictive value 86.6% and diagnostic accuracy 91.30%. Conclusion: FNAC is a simple and reliable method for diagnosis of breast lump with quite accuracy and avoiding unnecessary surgery. The results of FNAC show high degree of correlation with Sunita Mistry, Jignasha Patel, Kamlesh Shah, Ajit Patel. Cytological study of palpable breast lumps with their histological correlation in a tertiary care hospital. IAIM, 2018; 5(1): 11-16. Page 12 histopathology reports and that proves that the procedure has high sensitivity, specificity and diagnostic accuracy.

Cytomorphological Study of Palpable Breast Lumps: Spectrum of Lesions and Diagnostic Utility of FNAC.

Background: Palpable breast lumps are quite common which can be benign or malignant. Carcinoma breast is the second most common cancer after cervical cancer. Fine needle aspiration cytology (FNAC) is a minimally invasive, rapid, reliable and cost-effective outdoor procedure to provide effective diagnosis and way to further planning of treatment without need for biopsy. The objective of the study is to study the spectrum of various breast lesions on cytomorphology and its histopathological correlation. Methods: This was a two years retrospective study from June 2014 to May 2016 including 280 cases aspirated from palpable breast lumps. Physical examination of breast lumps by palpation was done. Cytological diagnosis was made and histopathological correlation was done, wherever available. Results: On cytomorphological study of 280 breast lump aspirates 32 (11.43%) were inflammatory lesions, 180 (64.29%) benign, 6 (2.14%) atypical/probably benign, 8 (2.86%) suspicious of malignancy, 46 (16.43%) malignant and 8 (2.86%) were unsatisfactory for evaluation, of these 280 cases, 70 (25%) were available for histopathological examination. The most common benign lesion in the present study was fibroadenoma 115 (41.07%) and the most common malignant lesion was ductal carcinoma 43 (15.36%). Conclusion: Fine needle aspiration cytology is a rapid and reliable tool to provide effective diagnosis in palpable breast lumps. It should be used as routine diagnostic procedure to provide the effective health care to the patients with breast lesions.

Ultrasonographic Discrimination of Benign and Malignant Breast Lumps with Histopathological Correlation.

Background: A lump in the breast is a cause of great concern. High frequency high resolution ultrasonogram helps in its evaluation. With major advances in ultrasonographic technology during the past 20 years, ultrasonogram can now distinguish benign and malignant solid breast lumps. Knowledge of the specific benign and malignant ultrasonographic characteristics of breast lumps is imperative for accurate diagnosis and optimal patient management. Objective: To determine the validity of ultrasound in the assessment of palpable breast lump by detecting the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ultrasonogram in distinguishing benign and malignant breast lumps. Materials and Methods: This cross sectional study was done in the department of Radiology and Imaging of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka in collaboration with the department of Pathology of BSMMU for histopathological correlation during July 2008 to June 2009. A total of 100 patients who were clinically suspected of having breast lump were included in this study. Data on clinical presentation, ultrasonographic findings including histopathological reports were collected and documented in structured forms. Analysis was done using SPSS 13.0 version. Results: The study was done in 100 women of 18–70 years of age with mean age 41.46 ± 11.62 years. Breast lumps were found with associated clinical presentation of pain in 26 (26%) cases, discharge in 12 (12%) cases, skin changes in 28 (28%) cases, nipple retraction in 10 (10%) cases, and palpable lymph nodes in 10 (10%) cases. On ultrasonogram, lesions were diagnosed as benign in 62% cases and malignant in 38% cases. Out of sonographically diagnosed 62 benign lesions 58 (93.5%) were also proved benign histopathologically and 4 (6.5%) as malignant. Out of 38 sonographically malignant lesions, 34 (89.5%) were also proved as malignant histopathologically and 4 (10.5%) as benign. Conclusion: Ultrasonographic findings of benign and malignant breast lumps correlated well in most of the cases with the histopathological results. Therefore, it can be concluded that ultrasonogram is a useful imaging tool to discriminate benign and malignant breast lumps and thus we can reduce unnecessary breast biopsies, patient discomfort and anxiety in addition to increase in cost of the patient.

The value of hardness rating and area ratio method of ultrasound elastography in differential diagnosis of benign and malignant lesions / 中国基层医药

Objective To compare the value of hardness rating and area ratio method of ultrasound elastog-raphy in differential diagnosis of benign and malignant lesions.Methods ultrasound imaging data of 120 cases with breast lesions(130 breast)who were pathologically confirmed during the period from January 201 1 to June 2013 were retrospectively analyzed,there were 62 malignant tumors,68 benign tumors,the sensitivity,specificity,accuracy of hardness rating and area ratio method of ultrasound elastography in differential diagnosis of benign and malignant lesions were assessed.Results (1 )The ultrasound elastography of 52 cases with benign tumor were 0 -2point, 16 cases were 3-4point,10 cases with malignant tumors were 0 -2point,52 cases were 3 -4point,the difference between two groups were statistically significant(χ2 =11.55,P<0.05);(2)The average area ratio of benign tumor was (1.09 ±0.37),malignant tumors was (2.28 ±1.68),the difference between two groups were statistically signifi-cant(t =6.22,P=0.01);(3)the sensitivity,specificity,accuracy of elastography hardness rating in diagnosis of malignant breast tumors were 83.87%,6.47%,80.00%,the area ratio method were 80.65%,75.00%,77.68%, joint inspection of two groups were 93.10%,93.55%,93.09%,joint inspection had obvious advantages,the differ-ence was statistically significant(all P<0.05 ).Conclusion Hardness rating and area ratio method of ultrasound elastography in differential diagnosis of benign and malignant lesions had higher value and higher diagnostic accuracy of combined.

Applied research on the ultrasonic light scattering imaging technology in the diagnosis of early breast lumps / 中国医学装备

Objective:To discuss the applied value of the ultrasonic light scattering imaging DOT technology in the diagnosis of early breast lumps. Methods: The data of 114 patients that were experted ultrasound imaging of light scattering and were with clear pathological diagnosis results were analyzed retrospectively in our department in three years. Diagnostic indicators (SDI), the mass of the total amount of hemoglobin (HBT), oxygen saturation (SO2), mass direction (Orien) form factor (Forml) and the posterior echo (Pecho) were recorded, and the diagnostic sensitivity, specificity, positive predictive value, negative predictive value, false negative rate and false positive rate were analyzed. The results were proceed and analyzed through SPSS 17.0. Results:There were significant differences in the SDI, HBT, Orien, Forml(t=-4.122,t=-2.275,t=-2.206,t=-2.927,P<0.05)The diagnostic sensitivity was 95.7%, specificity was 95.5%, positive predictive value was 93.8%, negative predictive value was 97.0%,false negative rate was 4.3%and false positive rate was 4.5%. Conclusion: Light scattering of ultrasound imaging use SDI, HBT, Orien, the Forml four quantitative indicators, qualitative evaluation can reach the masses, has a higher value in the differential diagnosis.

Hepatocyte growth factor profile with breast cancer.

Background: The multifunctional hepatocyte growth factor (HGF) is the ligand of c-Met receptor; it plays important role in mammary differentiation. HGF-Met signaling is a critical downstream function of c-Src-Stat3 pathway in mammalian tumorigenesis. Aim: Evaluation of tissue c-Met receptor hepatocyte growth factor receptor (HGFR) and serum level of HGF in female breast ductal carcinoma. Materials and Methods: Sixty-eight premenopausal females were divided as 30 control females subdivided into: [Group 1] 15 healthy volunteer females and [Group 2] five with fibrocystic disease and 10 having fibroadenoma of the breast and patients group [Group 3] consisted of 38 female patients with breast ductal carcinoma. Thorough clinical examination, preoperative fine needle aspiration cytology, estimation of fasting serum glucose, urea, creatinine, and uric acid levels, alanine aminotransferase activities, C-reactive protein, HGF level, before surgery and histopathological examination of the breast masses, and immunohistochemical detection of HGFR were done. Results and Conclusions: Significant increase in serum HGF levels were found in patients with breast cancer as compared with controls. Significant increase was also seen in patients with breast cancer with and without lymph node metastasis when each subgroup was compared with controls. Serum level of HGF is an independent prognostic indicator of breast cancer. Fibrocystic disease of the breast showed weak HGFR expression, while in normal tissue, HGFR was scanty; meanwhile, breast invasive ductal carcinoma showed homogenous strong reaction to HGFR. HGF is only one of a number of key factors involved in breast cancer and preoperative high serum HGF levels and malignancy occur usually together.