Nodal status, C-ERBB-2 expression combined with lymphovascular invasion creates a more powerful tool for predicting outcome in breast cancer

To evaluate the prognostic role of peritumoral vascular invasion [PVI] and its association with axillary nodal status and c-erbB-2 expression. Seventy five patients with stage I and II breast carcinoma who underwent conservative breast surgery or modified radical mastectomy were assessed clinically and pathologically for tumor size, grade, axillary lymph node status and peritumoral vascular invasion [PVI]. The immunophenotype of the tumor was determined as: the expression of oestrogen [ER] and progesterone [PgR] receptors, and c-erbB2. Thirty eight patients [50.7%] showed PVI. It was found that extensive PVI was significantly more likely to be associated with nodal positivity, higher tumor grade and c-erbB-2 over-expression. - 52/75 [69.3%] patients showed positive nodal status. The analysis showed that nodal positivity was significantly associated with tumor size, higher grade, presence of PVI and c-erbB-2 overexpression. - PVI and nodal positivity showed no significant association with receptor status. These data suggest that assessment of PVI together with axillary nodal status and c-erbB-2 expression creates a more powerful tool for predicting outcome in patients with breast cancer

Guided wire localization of non-palpable breast lesions

The wide use of screening mammography had resulted in the discovery of an increasing number of suspicious non-palpable breast lesions for which surgical excision after guided wire localization is the diagnostic gold standard. This study had included 32 patients with non-palpable breast lesions, wire localization was done guided by U.S in 22 patients and by mammography in the remaining ten. This was followed by operative excision of the lesion around the guide wire tip. Specimen radiography was done for 25 of excised specimens. Complete excision was achieved in 22 patients [88%]. Histopathological examination yielded the final pathological diagnosis, malignant lesions were found in 7 occasions [21.87%]. U.S proved to be a simple technique allowing guidance in different sites of the breast through the shortest possible route thus obviating excessive breast dissection