The immunohistochemical Galectin-3 expression in tumor and cancer-associated fibroblasts in invasive ductal carcinomas of breast and their relationship with clinicopathological parameters

Background: Galectin-3 has an important role in metastasis, therefore, Galectin-3-focused therapies have attracted attention for various cancers. Aim: We aimed to reveal the relationship between the expression of Galectin-3 within the tumor/cancer-associated fibroblasts (CAF) and clinicopathological parameters in patients with invasive ductal carcinomas. Materials and Methods: Hematoxylin and eosin-stained slides of breast excision materials diagnosed between 2010 and 2016 were re-examined retrospectively. Accordingly, 118 cases (luminal group = 58, Human epidermal growth factor receptor 2 (HER2) group = 27, and triple-negative breast carcinoma group [TNBC] =33 cases) were included. Galectin-3 levels were evaluated with a calculated H-score in tumor and semiquantitatively in CAFs. Statistical Analysis: Data was analyzed with t-tests and Chi-square tests. Kaplan–Meier and Log-rank tests were used for survival analysis. Results: The presence of Galectin-3 expression in CAFs but not in the tumor was associated with the greater number of axillary metastatic nodes and advanced pN stage. The loss of Galectin-3 expression in CAFs was more frequent in TNBC. There was no significant relationship between the expression level of Galectin-3 and survival status. However, in most of the cases with distant metastasis or patients who died, Galectin-3 was negative in the tumor, whereas it was positive in CAFs. Conclusions: The expression of Galectin-3 in tumors and CAFs may have a role in metastasis to axillary lymph nodes and distant sites. In terms of molecular subtype, TNBCs show a relationship with Galectin-3 negativity in CAFs.

Hoof beats could mean zebras: A rare late metastasis of breast carcinoma in the rectum

Breast cancer metastasis is most commonly observed in bone, lung, liver, and brain and is rarely observed in the gastrointestinal tract (GI). In rarer cases, GI metastasis reaches the rectum and generally presents as late metastasis. The type of breast cancer usually associated with GI metastasis is invasive lobular carcinoma; however, few case reports also show their association with invasive ductal carcinoma (IDC). Here, we report a case that unfortunately is a coalescence of all these atypical events, with metastatic rectal linitis plastica (RLP) of the breast, 15 years after the treatment of the primary tumor, originating from IDC. This is the first case report from India, reporting the late metastatic presentation of breast cancer as RLP. The report emphasizes the need to correlate persistent GI symptoms to breast cancer history; however, late the presentation may be.

Effect of neoadjuvant chemotherapy on breast invasive ductal carcinoma and changes of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 and Ki67 in tissues / 中国综合临床

Objective:To observe the clinical effect on patients of invasive ductal carcinoma of the breast by neoadjuvant chemotherapy, and to analyze the changes of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2) and Ki67 in neoplasm.Methods:A total of 83 patients which were treated by neoadjuvant chemotherapy in breast invasive ductal carcinoma diagnosed were selected in North China University of Science and Technology Affiliated Hopital from January 2014 to December 2020. There were 30 cases of Luminal type A, 31 cases of Luminal type B, 10 cases of HER-2 positive type and 12 cases of triple negative type. To observe the clinical effect of different molecular subtypes, detect the expression of Er, PR, HER-2 and Ki67 in pathological tissues before and after neoadjuvant chemotherapy, and conduct a retrospective case-control study. Comparison between the two groups use χ2 test, matched χ2 and accurate probability method. Results:Fifty-eight cases were clinically effective, the total effective rate was 69.8% (58/83), and 9 cases were pathological complete response (pCR), accounting for 10.8% (9/83). After neoadjuvant chemotherapy, the highest clinical efficacy was luminal type B in 26 cases, and the highest PCR was triple negative type in 3 cases. The pathological results showed that the expression of ER (6 cases of positive expression were increased, χ2=1.03, P=0.310), PR (8 cases of positive expression were increased, χ2=1.56, P=0.210) and HER-2 (2 cases of positive expression were decreased, χ2=0.10, P=0.748) was not different before and after neoadjuvant chemotherapy. The expression of Ki67 was decreased in 25 cases (30.1%) after chemotherapy compared with 59 cases (71.1%) before chemotherapy (34 cases of positive expression were decreased, χ2=27.85, P<0.001). Five cases were added among Luminal type A after chemotherapy, all of which were transformed from Luminal type B, but the kappa value was 0.919 (>0.75), the consistency rate was 91.9%. The consistency was idea before and after chemotherapy. Five cases were added after Luminal type A chemotherapy, all of which were transformed from Luminal type B, but the kappa value was 0.919 ( P>0.75), and the consistency rate was 91.9%,The consistency before and after chemotherapy was good. After chemotherapy, HER-2 expression remained unchanged in 59 cases (clinically effective in 48 cases), up-regulated in 9 cases (clinically effective in 4 cases) and down regulated in 15 cases (clinically effective in 6 cases)( χ2=12.82, P=0.002). Ki67 expression remained unchanged in 35 cases (20 cases were clinically effective), up-regulated in 7 cases (2 cases were clinically effective) and down regulated in 41 cases (36 cases were clinically effective)( χ2=14.63, P=0.001). Conclusion:The clinical effect of neoadjuvant chemotherapy in the treatment of breast invasive ductal carcinoma is ideal. The clinical effective rate of Luminal B type is the highest, and the pCR rate of triple negative type is the highest.And it can significantly reduce the expression of Ki67. The down-regulation of HER-2 and Ki67 is significant for clinical efficiency.

Estrogen and progesterone hormone receptor status in pre-menopausal and postmenopausal women with invasive ductal carcinoma in a private tertiary hospital in Cebu City, Philippines: A retrospective study

OBJECTIVE@#This study was conducted to determine the difference of hormone receptor status between pre-menopausal and postmenopausal women diagnosed with invasive ductal carcinoma in the local setting. @*METHODS@#This retrospective descriptive study used data gathered from chart review of premenopausal and postmenopausal female patients diagnosed with invasive ductal carcinoma by tissue biopsy and underwent determination of hormone receptor status (estrogen and progesterone receptor) by immunohistochemical staining (ICA) using biopsy samples taken from June 2016 to December 2019 at Cebu Velez General Hospital, Cebu City. The significance of the difference in the hormone receptor status with menopausal status was analyzed using Fisher’s exact test.@*RESULTS@#Comparing the two groups, 25 (60%) of the pre-menopausal women and 37 (73%) of the post-menopausal women were determined as hormone sensitive, while 17 (40%) pre-menopausal women and 14 (27%) post-menopausal women were hormone resistant. The Fisher’s exact test did not detect a statistically significant difference in the hormone receptor status of pre-menopausal and post-menopausal breast cancer patients.@*CONCLUSION@#There is no significant difference on the hormonal receptor status among pre-menopausal and post-menopausal women diagnosed with invasive ductal carcinoma. Thus, the need for hormone receptor status determination in these patients should be emphasized to aid in proper diagnosis, prognostication, and treatment planning.

Hemoglobin patterns and anemia in forward‐planned intensity‐modulated radiotherapy versus three‐dimensional conformal radiotherapy among patients with breast cancer

BACKGROUND@#Radiotherapy (RT) to the chest or other large areas of the body may cause bone marrow suppression, resulting in anemia and other changes in blood cell counts.@*OBJECTIVE@#To compare the post­RT hemoglobin levels between patients who underwent forward­ planned intensitymodulated radiotherapy (FPIMRT) and those who underwent three­dimensional conformal radiotherapy (3D­CRT).@*DESIGN@#Retrospective cohort study@*SETTING@#Department of Radiological and Imaging Sciences, Southern Philippines Medical Center, Davao City, from October 2018 to March 2019.@*PARTICIPANTS@#94 women with invasive ductal carcinoma, aged 29 to 75 years, who received at least 28 fractions (with or without boost dose) of either 3D­CRT or FPIMRT.@*MAIN OUTCOME MEASURES@#Mean hemoglobin counts and anemia within 4 weeks post­RT.@*MAIN RESULTS@#Of the 94 women, 62 (65.96%) underwent 3D­CRT, and 32 (34.04%) underwent FPIMRT. The proportion of patients with left­sided tumors was significantly higher in the FPIMRT group than in the 3D­CRT group. The baseline hemoglobin levels (12.60 ± 1.04 g/dL for 3D­CRT vs 12.49 ± 0.80 g/dL for FPIMRT; p=0.5994) and the mean changes in hemoglobin count from baseline (­0.11 ± 0.72 g/dL for 3D­CRT vs ­0.18 ± 0.67 g/dL for FPIMRT; p=0.6707) were both comparable between the two groups. The proportions of patients with anemia within four weeks post­RT were also comparable between the two groups (13/62, 20.97% for 3D­CRT vs 8/32, 25.00% for FPIMRT; p=0.6565). Left­sided tumors were significantly associated with post­RT anemia (unadjusted OR 2.87; 95% CI 1.00 to 8.22; p=0.0498), even after controlling for type of RT technique (adjusted OR 3.15; 95% CI 1.01 to 9.87; p=0.0484).@*CONCLUSION@#After RT, the mean hemoglobin levels of patients with breast cancer who underwent 3D­CRT were comparable with those of patients who underwent IMRT. The type of RT technique was not significantly associated with the occurrence of post­RT anemia in these patients.

Invasive ductal carcinoma of the breast in a pregnant woman: case report

Gestational breast cancer is the most common cause of cancer in pregnant women. It is a challenging condition for the medical team, since the physiological changes in the breast during this period increase the density of the breast parenchyma, which makes it difficult to detect the nodule on physical and imaging examination, causing delay in diagnosis. We present here a case report of a woman with breast cancer diagnosed during pregnancy. This was a 28-year-old female patient who arrived at the service at 14 weeks' gestation, diagnosed with invasive ductal carcinoma in the left breast, with T4dN2M0 staging. Neoadjuvant chemotherapy treatment was started with a pause for the cesarean section at 36 weeks' gestation. After delivery, chemotherapy was restarted, followed by radical mastectomy, radiotherapy and hormone therapy. Two years after the initial diagnosis and still being treated with hormone therapy, the patient presented with musculoskeletal pain, detected on magnetic resonance imaging and bone scintigraphy, as well as several points of metastasis in the spine with pathological fracture of L2-L3, where she was then submitted to decompressive laminectomy. After surgery, radiotherapy of the thoracic and lumbar spine was started, in addition to chemotherapy. Currently, the patient is asymptomatic, being on paclitaxel and transtuzumab, with stable bone scintigraphy and radiography and ultrasound showing no metastases, and the child is healthy after three years of follow-up.

Immunohistochemical Survey of Invasive Ductal Carcinoma of the Breast, using ER, PR, HER2 and KI-67 biomarkers, in Uyo, Nigeria

Background: Breast's Invasive Ductal Carcinoma (IDC), which is the commonest type of malignancy in females worldwide, can be characterized using immunohistochemistry in view of personalized cancer therapy. In this study, we aimed to determine the pattern of immunohistochemical profiles of IDC using oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 receptor (HER2) and proliferative index (Ki-67) biomarkers in our tertiary healthcare facility in Uyo, Akwa Ibom State, Nigeria given the dearth of its data in our environment. Materials and methods: We carried out a retrospective hospital-based immunohistochemical study of archival IDC tissue blocks over a four- and half-year period. Using systematic random sampling method, 64 formalin fixed paraffin embedded (FFPE) IDC tissue blocks were selected for this study. We carried out immunohistochemical evaluation using ER, PR, HER2 and Ki-67 biomarkers. Subsequently, we presented the results and classification schemes as text, tables, graphs, and photomicrographs. Results: We found that the proportion of expressions were ER-negative (88.7%), PR-negative (87.3%), HER2-negative (68.3%) and Ki-67 (<20%) being 83.6% respectively. The immunohistochemical-based classification which was done using combined immunohistochemical profiles of ER/PR/HER2 and ER/PR/HER2/Ki-67 biomarkers respectively, revealed five immunohistochemical-based subtypes. These subtypes were ER-positive luminal A (ER+/±PR+/HER2-) [5.56%], ER-positive luminal B (ER+/±PR+/HER2+) [5.56%], HER2-overexpression (ER-/±PR+/HER2+) [16.66%], Triple negative (ER-/PR-/HER2-) [66.67%] and Unclassified subtypes (ER-/PR+/HER2-) [5.56%]. Furthermore, these five subtypes were further subcategorized into low (Ki-67 <20%) and high (Ki-67 ≥20%) proliferation subtypes accordingly. Conclusion: The commonest pattern of immunohistochemical profile expression of IDC in Uyo was found to be the Triple negative subtype.

Young mammary Paget's disease patients with underlying breast invasive ductal carcinoma: clinicopathological features and prognosis / 中华肿瘤杂志

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.

Ultrasound evaluation of biopsy proven malignant breast mass

Background: Breast cancer is the most common malignancy in female worldwide. Ultrasound (US) is a safe and easily available modality for evaluation of breasts in females of all age groups. It can detect characteristic features of breast malignancy with high degree of accuracy. This study was undertaken with the aims to evaluate the ultrasonographic features of malignant breast mass, to identify the most commonly encountered gray scale ultrasound findings and to study the role of Doppler ultrasound in those cases.Methods: The study was conducted in Dr B. Borooah Cancer Institute, Guwahati from January 2018 to January 2019. Gray scale ultrasound including Doppler study was done in all the female patients coming with palpable breast lump or with nipple discharge and images were archived. The archived images of a total number of 108 patients with biopsy report positive for malignancy were retrospectively studied and the ultrasound findings were evaluated.Results: Most common gray scale ultrasound features for malignant breast masses were hypoechoic mass, taller than wide, irregular shape, having spiculated margins, neither posterior acoustic enhancement nor shadowing, presence of intralesional microcalcifications and surrounding echogenic halo. Hypervascularity, noticeable difference in waveform pattern between central and peripheral vessels, high resistance flow pattern with absent or reversal of diastolic flow were the common Doppler findings.Conclusions: Combination of Doppler with gray scale ultrasound has emerged as a very important technique in diagnosing malignant breast mass with high accuracy.

A case report of 29 year old male patient with breast carcinoma: diagnosed on fine needle aspiration cytology

Breast cancer has been considered a female dominated disease. Carcinoma of male breast is a rare disease representing 1% of all breast cancers and less than 1 % of all cancers in men. The mean age at presentation is mainly in sixties. We here present a case of male breast cancer presented at very young age of 29 years, diagnosed on fine needle aspiration which was confirmed later on histopathological examination.

Association of JMJD3, MMP-2 and VEGF expressions with clinicopathological features of invasive ductal breast carcinoma / 南方医科大学学报

OBJECTIVE@#To examine the expressions of JMJD3, matrix metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) in invasive ductal breast carcinoma, their association with the clinicopathological features of the patients and the effect of JMJD3 overexpression on proliferation and MMP-2 and VEGF expressions in breast cancer cells.@*METHODS@#The protein and mRNA expressions of JMJD3, MMP-2, and VEGF in invasive ductal breast carcinoma and paired adjacent tissues were detected by immunohistochemistry and RT-PCR, respectively, and their correlation with the clinicopathological characteristics of the patients was analyzed. Kaplan-Meier survival analysis was used to evaluate the correlation of JMJD3, MMP-2 and VEGF expression levels with the survival of the patients. In breast cancer MDA-MB-231 cells transfected with a JMJD3-expression plasmid, the expression of Ki67 was examined immunohistochemically, the cell proliferation was assessed with CCK8 assay, and the mRNA expressions of MMP-2 and VEGF were detected with RT-PCR.@*RESULTS@#Breast cancer tissues had significantly lower JMJD3 expression and higher MMP-2 and VEGF expressions at both the mRNA and protein levels than the adjacent tissue (@*CONCLUSIONS@#The expressions of JMJD3, MMP-2 and VEGF in invasive ductal breast carcinoma are closely correlated to tumor proliferation, invasion, metastasis and prognosis and can be used for prognostic evaluation of breast cancer.

Carcinoma of breast with medullary features: a case report in 27 year old female

Medullary carcinoma of breast is a rare variant of invasive ductal carcinoma of breast and its incidence is less than 5% of invasive breast carcinomas. These tumours tend to occur in younger women, with the average age reported to range from 42 to 52 years. Authors are presenting this case in a 27 years old female having single, large, well circumscribed mass in right breast for 6 months. Fine needle aspiration cytology report was proliferative lesion with atypia Histopathology report was given as carcinoma with medullary features. Immunohistochemistry showed Estrogen Receptor (ER), Progesterone Receptor (PR) and Her-2 neu negative. Authors are presenting this case of Medullary carcinoma of breast for being a specific histopathological subtype.

Reverse Warburg Effect-Related Mitochondrial Activity and ¹⁸F-FDG Uptake in Invasive Ductal Carcinoma / 대한핵의학회잡지

PURPOSE: We evaluated the relationship between fluorine-18 fluoro-2-deoxy-glucose (¹⁸F-FDG) uptake and mitochondrial activity in cancer cells and investigated the prognostic implications of this relationship in patients with invasive ductal carcinoma of the breast (IDCB).METHODS: One hundred forty-six patients with primary IDCB who underwent preoperative ¹⁸F-FDG PET/CT followed by curative surgical resection were enrolled in the current study. Mitochondrial activity of cancer cells was assessed based on translocase of outer mitochondrial membrane 20 (TOMM20) expression and cytochrome C oxidase (COX) activity. A Pearson's correlation analysis was used to assess the relationship between the maximum standardized uptake value of the primary tumour (pSUVmax) and mitochondrial activity. Clinicopathological factors, including pSUVmax, histological grade, oestrogen receptor (ER), progesterone receptor (PR), and TOMM20 expression; and COX activity, were assessed for the prediction of disease-free survival (DFS) using the Kaplan–Meier method and Cox proportional hazards model.RESULTS: Fourteen of the 146 subjects (9.6%) showed tumour recurrence. There was a significant positive correlation between ¹⁸F-FDG uptake and the mitochondrial activity of cancer cells in patients with IDCB, and increased ¹⁸F-FDG uptake and mitochondrial activity were significantly associated with a shorter DFS. Additionally, results from the receiver-operating curve analysis demonstrated that the cut-off values of pSUVmax, TOMM20 expression, and COX activity for the prediction of DFS were 7.76, 4, and 5, respectively. Further, results from the univariate analysis revealed that pSUVmax, TOMM20 expression, PR status, and histologic grade were significantly associated with DFS; however, the multivariate analysis revealed that only pSUVmax was associated with DFS (HR, 6.51; 95% CI, 1.91, 22.20; P = 0.003).CONCLUSIONS: The assessment of preoperative ¹⁸F-FDG uptake and post-surgical mitochondrial activity may be used for the prediction of DFS in patients with IDCB.

Effect of the primary tumor location on the prognosis of breast invasive ductal carcinoma patients treated with radical mastectomy / 中华肿瘤杂志

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.

The ultrasonographic characteristics of fibrocystic breast change / 中华超声影像学杂志

Objective@#To investigate the ultrasonographic features of fibrocystic breast change (FBC) and improve the ultrasonographic diagnosis and differential diagnosis of FBC.@*Methods@#Fifty-five patients of FBC with 60 lesions and 39 patients of invasive ductal carcinoma (IDC) with 42 lesions, which were confirmed by pathology after operation in the Affiliated Union Hospital of Fujian Medical University from January 2014 to February 2019 were enrolled. The preoperative sonographic findings of FBC and IDC were retrospectively analyzed and compared.@*Results@#There was no significant difference between the two groups in the rates of showing irregular shape, which were 86.7% in FBC group and 88.1% in IDC group, respectively (P>0.05), but the rate of showing crab feet or burrs on the edge of lesions in FBC group was lower than that in IDC group(P<0.05). The occurrence rates of posterior echo enhancement and cystic degeneration in FBC group were 81.7% and 71.7% respectively, which were significantly higher than those in IDC group (38.1% and 16.7%)(P<0.001). In addition, the FBC group showed fewer features such as hyperechoic halo and more features such as hypovascular supply than that of IDC group (all P<0.001).@*Conclusions@#In terms of ultrasonic features, including irregular shape or even crab feet and burrs, FBC can be easily misdiagnosed as malignant tumors. However, posterior echo enhancement, interior scattered small cysts, lack of blood supply and rare hyperechoic halo may be the characteristics of FBC, which can be differentiated from malignant tumors.

The ultrasonographic characteristics of fibrocystic breast change / 中华超声影像学杂志

Objective To investigate the ultrasonographic features of fibrocystic breast change ( FBC) and improve the ultrasonographic diagnosis and differential diagnosis of FBC . Methods Fifty‐five patients of FBC with 60 lesions and 39 patients of invasive ductal carcinoma ( IDC ) with 42 lesions ,which were confirmed by pathology after operation in the Affiliated Union Hospital of Fujian M edical University from January 2014 to February 2019 were enrolled . T he preoperative sonographic findings of FBC and IDC were retrospectively analyzed and compared . Results T here was no significant difference between the two groups in the rates of showing irregular shape ,which were 86 .7% in FBC group and 88 .1% in IDC group , respectively ( P ＞0 .05) ,but the rate of showing crab feet or burrs on the edge of lesions in FBC group was lower than that in IDC group( P ＜0 .05 ) . T he occurrence rates of posterior echo enhancement and cystic degeneration in FBC group were 81 .7% and 71 .7% respectively ,w hich were significantly higher than those in IDC group ( 38 .1% and 16 .7% ) ( P ＜0 .001) . In addition ,the FBC group showed fewer features such as hyperechoic halo and more features such as hypovascular supply than that of IDC group ( all P ＜0 .001 ) . Conclusions In terms of ultrasonic features ,including irregular shape or even crab feet and burrs ,FBC can be easily misdiagnosed as malignant tumors . However ,posterior echo enhancement ,interior scattered small cysts ,lack of blood supply and rare hyperechoic halo may be the characteristics of FBC ,w hich can be differentiated from malignant tumors .

The value of MRI in the differential diagnosis of intraductal papilloma and invasive ductal carcinoma / 实用放射学杂志

Objective To investigate the MRI features and characteristics of irregular intraductal papilloma (IDP)and invasive ductal carcinoma (IDC),and to improve the diagnostic accuracy of MRI.Methods This study retrospectively included 3 3 patients with IDP and IDC confirmed by surgery and pathology,and analyzed MRI findings including lesion size,boundary,internal components,plain signal intensity,enhancement mode,ADC value and TIC curve χ.2 test,t test and rank-sum test were performed.Results Compared with the two groups,lesion boundary (P＜0.001),size (P＜0.001 ),ADC value (P＜0.001 ),enhancement mode (P＝0.001 ),TIC curve peak time (P＜0.001),slope (P＜0.001)and peak enhancement rate (P＜0.001)were statistically significant (P＜0.05);lesion (P＝0.159), internal components (P＝0.778),T2 WI signal (P＝0.438)and curve type (P＝0.406)were no statistically difference.Conclusion The irregular mass type IDP and IDC have similar MRI findings,the edge of the lesion,the ADC value,the enhancement mode,and the peak time,slope and peak enhancement rate of the curve are important for the identification of the two diseases.

Comparison of lymphangiogenesis, lymphatic invasion, and axillary lymph node metastasis in breast carcinoma

Context: Lymphangiogenesis correlates with poor prognosis in Invasive Ductal Carcinoma (IDC) breast. D2-40 antibody, a specific marker for lymphatic endothelium, differentiates lymphatic from vascular endothelium. Therefore, the aims of this study were to estimate lymphangiogenesis using D2-40 antibody and correlate with lymphatic invasion (LI) and axillary lymph node (LN) status and compare lymphatic mean vessel density (LMVD) with Tumor (T) and Node (N) stages and grade of tumor. Methods and Material: The study was conducted on fifty consecutive cases of IDC breast who underwent modified radical mastectomy (MRM) from Jan 2009 to March 2011. Hematoxylin-eosin sections and Immunohistochemistry (IHC) slides were studied along with their LN status. LMVD was counted after D2-40 immunostaining (100x magnification) in three hot spots in peritumoral areas and averaged. LI as opposed to vascular invasion (BVI), and LN status for all cases were assessed. Statistical Analysis: Statistical analysis was done using SPSS software (version 14.0 for Windows). Pearson's correlations, χ2 tests and Mann-Whitney U test were used. Results: Lymphangiogenesis varied from 0 to 58 with mean LMVD of 11. Of 50 cases, five showed no lymphatic vessels in peritumoral areas; of these five, three had positive LNs. 21/50 cases had LI. No statistical significant association was seen between lymphangiogenesis and LI. 34/50 cases had positive LNs. Mean LMVD was higher in patients with N2/N3 stage as compared to N0/N1 stage and was statistically significant (P = 0.013). Conclusions: D2-40 is specific marker for lymphatic endothelium. LI and lymphangiogenesis, as opposed to BVI, are better prognostic indicators in IDC breast.

Multi-variated analysis of differential diagnosis in ultrasonography of idiopathic granulomatous mastitis and invasive ductal carcinoma / 中华肿瘤杂志

Objective@#To evaluate the differential diagnosis of idiopathic granulomatous mastitis (IGM) and invasive ductal carcinoma.@*Methods@#The ultrasonographic data of 37 IGM patients and 50 cases of IDC were analyzed retrospectively. The shape, growth direction, margin, internal echo, posterior echo, calcification, Adler blood flow classification, PSV(peak sestolic velocity), RI (resistance index)and elasticity scores were analyzed by χ2 test and independent sample t test. The optimal cutoff values of age, PSV and RI were calculated by receiver operating characteristic (ROC) curve. Logistic regression analysis was used to calculate the odds ratio (OR) of ultrasonic variates in the diagnosis of both diseases.@*Results@#There were no significant differences in the shape, margin, internal echo and blood flow grading between the two groups. The age, lesion growth direction, posterior echo, calcification, PSV, RI and elasticity were statistically different. The cut-of value of Age, PSV and RI were 38.5 years old, 13.20 cm/s, and 0.655. Logistic regression multi-variated analysis revealed that elastic score (OR=9.806) had the best value of the differential diagnosis, as well as calcification (OR=6.937), posterior echo decay (OR=4.613), RI (OR=3.257), lesion growth orientation (OR=3.198), and PSV (OR=1.202). Lesion shape, margin, internal echo, and Adler blood flow classification did not help in differential diagnosis.@*Conclusion@#Ultrasound multi-parameter analysis has high value in IGM and IDC differential diagnosis.

MRI-based radiomic features in histological grading of breast invasive ductal carcinoma / 医学研究生学报

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.