ABSTRACT
Objective To evaluate the diagnostic value of MRI for the mammographic sign of focal asymmetry of the breast (FAB) .Methods The morphological features of MRI and Time‐signal intensity curve (TIC) types of 46 cases of mammographic signs of FAB were analyzed retrospectively .Results In all 46 patients ,MRI detected 46 lesions in the corresponding areas of FAB on mammography ,in which 35 cases of benign lesions and 11 cases of malignant lesions were confirmed by pathology .The accuracy , positive predictive value and negative predictive value of the sub‐leaf shape and edge burr of the breast lesions were 82 .61% ,66 .67% , 86 .49% and 86 .96% ,85 .71% ,87 .18% respectively .TIC showed:in type Ⅰ ,all 17 cases were benign;In type Ⅱ ,4 cases were be‐nign and 2 cases were malignant ;In type Ⅲ ,9 cases were all malignant .The diagnostic accuracy of MRI for the benign and malignant breast lesions was 86 .96% .The positive predictive value and negative predictive values were 81 .82% and 96 .88% respectively .Con‐clusion MRI can definitely estimate the potential character of lesion in FAB ,and more accurately discriminate malignant and benign breast lesions .
ABSTRACT
Aim and objectives: To show the incidence of triple negative breast carcinomas in the younger age group (20-40 years) in the study sample and to establish a correlation between expression patterns of estrogen receptor (ER), progesterone receptor (PR) and HER2 /neu with tumour histopathology of breast carcinoma. Material and methods: A 5 years study, 2 years restopective and 3 years prospective was conducted in Mahatama Gandhi Memorial hospital, Warangal, from 2009 to 2014 on triple negative breast carcinomas. All the mastectomy specimens, received in the pathology Department during this period were considered. Results: Total of 28 cases of carcinoma breast in females diagnosed histopathologically, were included in the study. In the present study, the patients were in the age group of 20-40 years Since most carcinomaS in this age group are triple negative. most of the tumours werte of size > 5 cm, 12 cases (43%), followed by 10 cases (36%) of size 2-5 cm. Total 20 (71.4%) were IDC (NOS), followed by 4 (14.2%) were Medullary carcinomas and 2 (7.1%) cases of ILC and each 1 (3.6%) case of tubular and Mucinous carcinomas. Histopathological grading was done according to Modified Bloom Richardson grading and found that 11 (39.3%) were of grade II followed by 5 (17.9%) cases were grede lll,4 cases were of grade I and 8 cases were inassessible. ER and PR were positive in 61% and 47% of tumors respectively. HER-2 over expression was seen in 36% of tumors and was negative in 64% of tumours. Triple negative carcinomas were 4 out of 28 cases, of which 3 were IDC (NOS) and 1 was medullary carcinoma. Triple negative carcinomas are associated with poor prognosis. Conclusion: ER, PR and HER-2 status correlates well with histopathological grading and other clinico-pathological parameters. Higher grade is associated with HER-2 positivity and ER/PR negativity,larger tumor size, lympho-vascular invasion, lymph node metastasis, and higher clinical stage.
ABSTRACT
Metaplastic breast carcinomas (MBCs) are rare primary breast malignancies characterized histologically by carcinoma of two epithelial types or co-existence of carcinoma with non-epithelial cellular elements. They are aggressive tumours that carry poor prognosis. We reviewed the pathologic features and clinical outcomes of MBCs seen in our institution between the years 2000 to 2007. Out of 471 breast cancer patients, six female patients were histologically-proven to have MBCs giving an incidence rate of 1.3%. The patients comprised four Malays and two Indians and their mean age was 51 years old. Five patients underwent mastectomy (four with axillary clearance and one without) and one had wide local excision with axillary clearance. Axillary lymph node involvement was seen in four patients (three with epithelial only type tumour and one with the biphasic tumour). In all the cases, the tumours were bigger than 5 cm in diameter (T3), grade 3 and estrogen receptor negative. Five patients received chemotherapy while one refused. All of the patients had tumour recurrence with a mean time of recurrence of 9 months. In conclusion, metaplastic breast carcinomas are rare and aggressive tumours usually affect the post menopausal age group. They present as aggressive, large sized, high grade tumours that are estrogen receptor negative. Tumour size and axillary lymph node involvement indicate poor prognosis. Despite treatment with chemotherapy and radiotherapy, these patients have high risk of local recurrence and distant metastases which are potentially fatal.