Relationship between Arterial Calcifications on Mammograms and Cardiovascular Events: A Twenty-Three Year Follow-Up Retrospective Cohort Study.

PURPOSE: Breast arterial calcifications (BAC) have been associated with cardiovascular diseases. We aimed to examine whether the presence of BAC could predict the development of cardiovascular events in the very long term, as evidence has suggested. PATIENTS AND METHODS: We conducted a 23-year follow-up retrospective cohort study considering women specifically studied for breast cancer. After reviewing the mammograms of 1759 women, we selected 128 patients with BAC and an equal number of women without BAC. RESULTS: Women with BAC had higher relative risk (RR) for cardiovascular events, globally 1.66 (95% CI): 1.31-2.10 vs. 0.53 (0.39-0.72), and individually for ischemic heart disease 3.25 (1.53-6.90) vs. 0.85 (0.77-0.94), hypertensive heart disease 2.85 (1.59-5.09) vs. 0.79 (0.69-0.89), valvular heart disease 2.19 (1.28-3.75) vs. 0.83 (0.73-0.94), congestive heart failure 2.06 (1.19-3.56) vs. 0.85 (0.75-0.96), peripheral vascular disease 2.8 (1.42-5.52) vs. 0.85 (0.76-0.94), atrial fibrillation 1.83 (1.09-3.08) vs. 0.86 (0.76-0.98), and lacunar infarction 2.23 (1.21-4.09) vs. 0.86 (0.77-0.96). Cox's multivariate analysis, also considering classical risk factors, indicated that this BAC was significantly and independently associated with survival (both cardiovascular event-free and specific survival; 1.94 (1.38-2.73) and 6.6 (2.4-18.4)). CONCLUSIONS: Our data confirm the strong association of BAC on mammograms and the development cardiovascular events, but also evidence the association of BAC with cardiovascular event-free and specific survival.

Partial Thrombosis of Corpus Cavernosum.

Thrombosis of the corpus cavernosum is a rare disease of unknown cause that usually affects young men. We present the case of a 25-year-old man with an unilateral, painful perineal mass and ultrasound scan compatible with this entity. The magnetic resonance and tomography computarised scan images corroborate the diagnosis. Anticoagulants were prescribed which solved the clinical picture.

Partial Thrombosis of Corpus Cavernosum

Thrombosis of the corpus cavernosum is a rare disease of unknown cause that usually affects young men. We present the case of a 25-year-old man with an unilateral, painful perineal mass and ultrasound scan compatible with this entity. The magnetic resonance and tomography computarised scan images corroborate the diagnosis. Anticoagulants were prescribed which solved the clinical picture (AU)

Relationship between morphological features and kinetic patterns of enhancement of the dynamic breast magnetic resonance imaging and tumor expression of metalloproteases and their inhibitors in invasive breast cancer.

AIM: Matrix metalloproteases (MMPs) expression and their inhibitors (TIMPs) play an important role in tumor physiopathology, so we investigated the relationship between the magnetic resonance (MR) and MMPs/TIMPs expression by breast carcinomas. MATERIALS AND METHODS: MRI parameters of 64 breast carcinomas were investigated. An immunohistochemical study was also performed in these cases using tissue microarrays and specific antibodies against MMP-1, MMP-2, MMP-7, MMP-9, MMP-11, MMP-13, MMP-14, TIMP-1, TIMP-2 and TIMP-3. RESULTS: Tumors with spiculated margins had a high global (score) values of MMP-1 or MMP-7, and high expression of TIMP-3 by tumor cells. Heterogeneous tumors had a higher score values of MMP-1, MMP-13, TIMP-2 or TIMP-3, and frequent expression of TIMP-3 by tumor cells. Tumors showing fast enhancement, had higher score values of MMP-1 or MMP-11. Associations between washout curve (type III) and MMP-1, MMP-11, MMP-13 and TIMP-1 expression by tumor cells, were found. CONCLUSIONS: MRI features may predict in some grade the expressions of MMPs/TIMPs in breast tumors, which might to contribute to a better biological characterization of breast cancer.

Low microvascular density at the tumor center is related to the expression of metalloproteases and their inhibitors and with the occurrence of distant metastasis in breast carcinomas.

BACKGROUND: The aims of this study were to evaluate the microvascular density (MVD) at the center of breast carcinomas, its relationship with the expression of metalloproteases (MMPs) and their inhibitors (TIMPs), and its connection with the distant metastasis rate. METHODS: An immunohistochemical study of four MMPs and two TIMPs was performed on cancer specimens from 97 women with a histological confirmed diagnosis of early invasive breast cancer. RESULTS: Expressions of MMP-9 by cancerous cells, or MMP-11 and TIMP-2 by stromal cells, were all negative and significantly associated with MVD, whereas MMP-7 score values were positive and also significantly associated with MVD. However, positive expression of MMP-1 by mononuclear inflammatory cells was significantly associated with MVD. Multivariate analysis demonstrated a significant and inverse relationship between MVD and the occurrence of distant metastasis. CONCLUSIONS: Our data point out the clinical importance of low MVD at the tumor center as an independent prognostic factor of distant metastasis development in breast cancer.

Relationship between morphological features and kinetic patterns of enhancement of the dynamic breast magnetic resonance imaging and clinico-pathological and biological factors in invasive breast cancer.

BACKGROUND: To investigate the relationship between the magnetic resonance imaging (MRI) features of breast cancer and its clinicopathological and biological factors. METHODS: Dynamic MRI parameters of 68 invasive breast carcinomas were investigated. We also analyzed microvessel density (MVD), estrogen and progesterone receptor status, and expression of p53, HER2, ki67, VEGFR-1 and 2. RESULTS: Homogeneous enhancement was significantly associated with smaller tumor size (T1: < 2 cm) (p = 0.015). Tumors with irregular or spiculated margins had a significantly higher MVD than tumors with smooth margins (p = 0.038). Tumors showing a maximum enhancement peak at two minutes, or longer, after injecting the contrast, had a significantly higher MVD count than those which reached this point sooner (p = 0.012). The percentage of tumors with vascular invasion or high mitotic index was significantly higher among those showing a low percentage (150%) of enhancement rate (p = 0.016 and p = 0.03, respectively). However, there was a significant and positive association between the mitotic index and the peak of maximum intensity (p = 0.036). Peritumor inflammation was significantly associated with washout curve type III (p = 0.042). CONCLUSIONS: Variations in the early phase of dynamic MRI seem to be associated with parameters indicatives of tumor aggressiveness in breast cancer.