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Objective: To investigate the clinicopathological factors and prognostic status of young Mammary Paget's disease (MPD) patients with invasive ductal carcinoma (IDC). Methods: In this study, we defined the age at diagnosis below 40 years old as young patients, and retrospectively analyzed data from 123 MPD-IDC patients who were admitted at the Cancer Hospital Chinese Academy of Medical Sciences from June 2002 to February 2019. Patients were divided into the young group (≤40 years old, 15 cases) and the old group (>40 years old, 108 cases) according to the age of onset, and the clinicopathological characteristics and prognosis of the two groups were compared. Cox regression model analysis was used to analyze the prognosis influencing factors. Results: The proportions of patients in the young group with non-menopausal, axillary lymph node metastasis, and Ki-67 index ≥15% were 93.3% (14/15), 73.3% (11/15), and 86.7% (13/15), respectively, which were higher than those in the old group [45.4% (49/108), 39.8%(43/108), and 60.2% (65/108), respectively] , with statistically significant differences (P<0.05). At an average follow-up of 63.2 months, patients in the young group had a significantly shorter disease-free survival (DFS) compared with that of the old group (P=0.012), while the difference in overall survival (OS) between the two groups was not statistically significant (P=0.161). Multifactorial Cox regression analysis showed that axillary lymph node status was an independent influencing factor on OS (HR=3.339, 95% CI: 1.121-9.943) in patients with MPD-IDC, while age was not. Conclusion: Compared with the old group, young patients with MPD-IDC have a higher incidence of axillary lymph node metastasis, high Ki-67 expression, and a shorter DFS, but age is not an independent influencing factor on DFS or OS in patients with MPD-IDC.
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Adult , Female , Humans , Breast Neoplasms , Carcinoma, Ductal, Breast/surgery , Ki-67 Antigen , Lymphatic Metastasis , Paget's Disease, Mammary/metabolism , Prognosis , Retrospective StudiesABSTRACT
Objective@#To analyze the clinicopathological features and prognosis of breast invasive ductal carcinoma patients receiving radical mastectomy according to the primary tumor location.@*Methods@#From January 2008 to December 2008, 993 patients with breast invasive ductal carcinoma received radical mastectomy in Tianjin Medical University Cancer Institute and Hospital. Patients were grouped according to the primary tumor location when breast cancer was diagnosed. The clinicopathological characteristics and follow-up information of them was collected and analyzed retrospectively.@*Results@#Of the 993 patients, primary tumor located in the upper-outer quadrant (UOQ) in 556 patients (56.0%), the lower-outer quadrant (LOQ) in 97 (9.8%), the central portion in 99 (10.0%), the upper-inner quadrant (UIQ) in 186 (18.7%), and the lower-inner quadrant (LIQ) in 55 (5.5%). Patients in the central portion tended to have larger tumors, and more patients in the upper-inner quadrant received endocrine therapy. The estimated 5-year disease-free survival (DFS) rates of patients with primary lesion in the UOQ, LOQ, central portion, UIQ and LIQ were 90.3%, 88.7%, 79.8%, 86.0% and 72.7%, respectively, with significant differences (P<0.001). The 5-year overall survival (OS) rates were 97.5%, 96.9%, 90.9%, 94.1% and 87.3%, respectively, with significant differences (P<0.001). Multivariate analysis showed that 5-year recurrence and metastasis risks were significantly increased in patients with primary lesion in the central portion, UIQ and LIQ compared to other groups (P<0.001), and 5-year mortality risks were increased in these three groups (P=0.002).@*Conclusion@#Primary lesion located in central portion and inner quadrant is an independent adverse prognostic factor for patients with breast invasive ductal carcinoma patients receiving radical mastectomy.
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Objective The histological grade of breast cancer is closely related with the treatment and prognosis of the malignancy, and radiomics plays a valuable role in the identification of its grade. This article aimed to investigate the values of the conventional parameters of breast MRI and breast MRI-based imaging features in the histological grading of breast invasive ductal carcinoma (IDC).Methods This retrospective study included 71 cases of breast cancer treated in our hospital from June 2015 to June 2016. We obtained the traditional quantitative parameters of MRI, including the apparent diffusion coefficient (ADC) and initial enhancement rate (IER), performed manual segmentation of the ADC and DCE maps, extracted the radiomic features and analyzed the differences in the radiomic signatures between low- and high-grade IDC. Using logistic regression analysis, we assessed the values of ADC and IER and the radiomic signatures of the ADC and DCE images in differentiating low-grade from high-grade IDC.Results The values of ADC, B_sum_variance, L_SRE and R_RP were significantly lower (P0.05). In differentiating high-grade from low-grade IDC, the ADC image-based radiomic signature model achieved a significantly higher AUC (0.858 [0.774-0.924]) than the ADC (0.709 [0.588-0.830]) and DCE model (0.691 [0.565-0.818]), and the former also manifested markedly higher accuracy, specificity, and rates of positive and negative prediction than the latter two.Conclusion ADC- and MRI-based radiomic features play a valuable role in differentiating high-grade from low-grade IDC, particularly the former, which could provide even more clinical information, while IER is of little value in this aspect.
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Objective The article was to discuss the correlation between three?dimensional volume ultrasound VOCAL parame?ters and pathological grading of mass type breast invasive ductal carcinoma. Methods 106 breast nodule patients admitted in our hospi?tal who were pathologically confirmed with histological grading from March 2014 to February 2016 were included in the study. The patients underwent three?dimensional volume ultrasound preoperatively. Vocal system in GE LOGIQ E9 was used in lesion analysis to obtain energy histograms:average gray scale (MG), average energy (MP), vascular index ( R) , blood flow index ( VFI) . Analysis was made in the differ?ence among MG, MP, R and VFI of ductal carcinoma in situ, invasive ductal carcinoma grade I, invasive ductal carcinoma grade II, invasive ductal carcinoma grade III and fibroadenoma. Results No sig?nificant difference was found in MG of ductal carcinoma in situ and IDC I, fibroadenoma and ductal carcinoma in situ, fibroadenoma and IDC I(P>0.05), but the difference was statistically significant between other pathological levels (P0.05) , but the difference was statistically significant between other pathological levels ( P<0.05) . Conclusion Three?dimensional volume ultrasonic VOCAL parameters of MG、MP、R、VFI can reflect gray?scale levels and blood flow perfusion in mass type breast nodules of different pathological level, and predict the pathological grading before operation, which provides objective evidence for the evaluation of mass type breast invasive ductal carcinoma and the development of individualized treatment plan.
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Background and purpose:Breast invasive ductal carcinoma (IDC) is the most common breast carci-noma, and the ultrasonographic features of its molecular subtypes has great clinical value. The purpose of this study was to discuss the correlation between ultrasonographic features of IDC and its molecular subtypes.Methods:Ultrasonographic features of 112 patients with preoperative integrated ultrasonographic information and pathologically confirmed IDC from Sep. 2012 to Feb. 2015 were retrospectively analyzed. Based on the immunohistochemistry results of ER (estrogen receptor), PR (progesterone receptor), HER-2 (human epidermal growth factor receptor-2) and Ki-67, these cases were categorized into 4 molecular subtypes: Luminal A group, Luminal B group, ERBB2 positive group and Basal-like group. Results:There were 14 cases (12.5%) in Luminal A group, 62 cases (55.4%) in Luminal B group, 21 cases (18.7%) in ERBB2 positive group and 15 cases (13.4%) in Basal-like group. The 4 molecular subtypes differed in tumor length, lymph node involvement, tumor boundary, tumor shape and internal blood flow on ultrasonography (P0.05).Luminal A group and Luminal B group had less lymph node involvement, more obscure boundary and irregular shape. More internal blood flow, bigger tumor size and lymph node involvement were observed in ERBB2 positive group of this study. Patients in Basal-like group were more likely to have clear tumor boundary, regular tumor shape, bigger tumor size and lymph node involvement on ultrasonogram.Conclusion:Correlation exists between ultrasonographic features and molec-ular subtypes of IDC. This has tremendous clinical significance in the early diagnosis of IDC, preoperative, intraoperative and prognosis evaluation of IDC patients.
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Objective To investigate the distribution of breast invasive ductal carcinoma with different molecular subtypes ,and to study the relationship between molecular subtypes and clinical pathological features in Xinjiang area .Methods A total of 621 patients with IDC from January 2013 to January 2014 was classified into Luminal A type,Luminal B type,HER-2 overexpression type and Basal -like type,different molecular subtypes according to the estrogen receptor(ER),progesterone receptor(PR),epidermal growth factor receptor -2(HER-2) and Ki-67,and compared the statistics combining with the clinical pathological characteristics of IDC .Re-sults The result showed that Luminal B type accounted for 53.1%,Luminal A type,HER-2 overexpression type and Basal-like type accounted for 14.5%,15.9%,16.4%,respectively.There were significant differences between the molecular subtypes and tumor size ,histological grade ,tumor pathological stage ,the expression of ER , PR and HER-2(P0.05).Conclusion There is a close relationship between invasive ductal carcino-ma of different molecular subtypes and clinical pathological characteristics .The molecular subtypes are beneficial to treatment guidelines for clinical individual .
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Objective:To investigate the expression of sphingosine kinase 1 (SphK1) and its clinical significance in breast invasive ductal carcinoma ( BIDC).Methods: We detected SphK1 expression in 58 samples of surgically resected paired BIDC and normal tumor-adjacent tissues samples by using immunohistochemistry.The correlation between SphK 1 expression and clinicopathologic features was analyzed.Results: The positive expression rate of SphK 1 in BIDC tissues was 69.0% ( 40/58 ) , while its positive expression rate in normal tumor-adjacent was 17.2% (10/58),the difference was statistical significance (χ2=31.636,P=0.000). Clinicopathological evaluation suggested that SphK 1 positive expression was associated with ER negative (χ2=4.392,P=0.036),PR negative (χ2=7.920 , P=0.005 ) , lymph node metastasis (χ2 =5.033 , P=0.025 ) and tumor stage (χ2 =7.117 , P=0.008 ) . Conclusion:The high-expression of SphK1 is correlated with the poor clinicopathological features in BIDC ,suggesting SphK1 may play a key role in development and progression of BIDC.
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Purpose To detect the HER2 gene amplification by fluorescence in-situ hybridization(FISH) and to explore its clinicopathologic relationship with the breast cancer.Methods A prospective study was conducted in 50 cases of breast invasive ductal carcinoma from Beijing Toren Hospital. Clinicopathologic data were summarized and FISH was performed in the paraffin-embedded sections for HER2 gene amplificayion using DNA probe, and immunohistochemical stain for ER, PR and HER2.Results The average age of the patients was 55.5 years. The pathologic grading showed that 11 cases were in grade Ⅰ, 30 cases in grade Ⅱ, and 9 cases in grade Ⅲ. The TNM staging showed that 13 cases were in stage Ⅰ,15 cases in ⅡA,13 cases in ⅡB,6 cases in ⅢA,2 cases in ⅢB,and 1 case in ⅢC.The median metastasis rate of lymph node was 6.91%.33 cases were positive for ER,and 32 cases positive for PR.For HER2 detection, 40 cases were positive by IHC and 33 positive by FISH. HER2 gene amplification by FISH was closely related with the expression of HER2 protein by immunohistochemistry, but not significantly related with pathologic grading, The TNM staging, median lymph node metastasis rate, ER and PR status (P>0.05). FISH test was positive in 3 cases of tumor embolus and 3 cases of multiple primary tumors. Conclusions FISH and immunohistochemistry for detecting HER2 have a good conformance, HER2 gene amplification may be related with tumor embolus and multiple primary tumors, but it can not be used as an indirect marker to predict the prognosis.
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To evaluate the potential value of 1H Magnetic resonance spectroscopy (MRS) for detecting and characterizing invasive ductal carcinoma of breast. We conducted 1H Magnetic resonance spectroscopy (MRS), using a 3.0T MR scanner, on 40 patients who were histologically diagnosed to have invasive ductal carcinoma (IDC); tumor areas of the patients were designated as experimental samples, and non-tumor areas as control samples. The peak at 3.2 ppm is characteristically intense and observed in 34 cases of the total 40 invasive ductal carcinoma (sensitivity 86.2%; specificity 100%; positive predictive value 100%; negative predictive value 60%). In constrast peak at 1.3 ppm is characteristically intense and observed in normal breast (sensitivity 86.2%; specificity 100%; positive predictive value 100%; negative predictive value 60%). The study shows that 1H MRS can effectively discriminate invasive ductal carcinoma from normal breast in most cases. It also demonstrates the feasibility of localized in vivo 1H MRS technique as a new diagnostic modality in the detection of breast tumor.
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Humans , Breast , Carcinoma, Ductal , Magnetic Resonance Spectroscopy , Magnetics , Magnets , Sensitivity and SpecificityABSTRACT
Objective: To determinate whether human primary breast invasive ductal carcinoma((HPBIDC)) express somatostatin receptor(SSTR). Methods: SSTR expression in 82 patients with invasive duct carcinoma of breast was determined by immunohistochemistry and its correlation with clinical and pathological facts was analysed. Results: IHC analyses revealed that SSTR was expressed in HPBIDC (61/82, 74.4%). A significant correlation was found between SSTR expression and tumor stage (P
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Objective: To investigate the relationship of the expression of the somatostatin receptor(SSTR) with tumor stages,tumor differentiation and the survival time in patients with human primary breast invasive ductal carcinoma(HPBIDC) and to provide theoretical evidence for the diagnosis,prognosis and treatment of the disease based on the SSTR expression.Methods: We detected the SSTR expression in the tumor tissues of 82 HPBIDC patients,and analyzed the relationship of the SSTR expression with the prognosis and survival time of the patients.Results: In the HPBIDC patients,the 5-year overall survival(OS) rates of the negative,weakly positive,moderately positive and strongly positive SSTR expression groups were 59.1,76.2,85.2 and 100.0%,those of the well,moderately and poorly differentiated groups were 94.1,90.6 and 60.0%,and those of the TNM Ⅰ,TNM Ⅱ,TNM Ⅲ and TNM Ⅳ groups were 100.0,86.0,56.3 and 25.0%,respectively.Conclusion: The expression of SSTR is significantly correlated with the prognosis of human primary breast invasive ductal carcinoma.
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Objective To investigate the correlation of the expression of p27 and Ki-67 with the clinicopathologic features in breast invasive ductal carcinoma. Methods S-P immunohistochemical staining was performed to examine the expression of p27 and Ki-67 in 60 specimens of breast invasive ductal carcinoma. Results The low p27 expression rate was 45.0 %(27/60), low expression in breast cancer was associated with larger tumor, nerve/vessel invasion, lymph node metastasis and histological grade(P
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Objective:To study the expression of Ets-1 and VEGF in breast invasive ductal carcinoma (IDC) tissues,and to analyze its correlation with clinicopathologic characteristics of IDC. Methods:Forty breast IDC tissues and their adjacent normal tissue samples were obtained from clinical diagnosed breast IDC patients after surgery. Expression of Ets-1 and VEGF protein and mRNA was examined by immunohistochemistry and RT-PCR. Results:(1)Expression of Ets-1 and VEGF protein in breast IDC tissues was significantly higher than that in adjacent normal tissues (P