ABSTRACT
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.
ABSTRACT
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.
Subject(s)
Penile Diseases , Thrombosis , Adult , Anticoagulants/therapeutic use , Humans , Male , Penis/diagnostic imaging , Penis/pathology , Thrombosis/diagnostic imaging , UltrasonographyABSTRACT
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)
Subject(s)
Humans , Male , Adult , Penile Diseases/diagnostic imaging , Thrombosis/diagnostic imaging , Penis/blood supplyABSTRACT
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.
Subject(s)
Breast Neoplasms/diagnostic imaging , Mammography/methods , Matrix Metalloproteinases/metabolism , Tissue Inhibitor of Metalloproteinases/metabolism , Adult , Aged , Aged, 80 and over , Breast/diagnostic imaging , Breast/metabolism , Breast Neoplasms/genetics , Breast Neoplasms/metabolism , Female , Humans , Matrix Metalloproteinases/genetics , Middle Aged , Tissue Inhibitor of Metalloproteinases/geneticsSubject(s)
Arteriosclerosis/diagnostic imaging , Breast Diseases/diagnostic imaging , Breast/blood supply , Calcinosis/diagnostic imaging , Macular Degeneration/diagnosis , Mammography , Aged , C-Reactive Protein/metabolism , Female , Homocysteine/blood , Humans , Middle Aged , Tomography, Optical CoherenceABSTRACT
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.
Subject(s)
Breast Neoplasms/blood supply , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/blood supply , Carcinoma, Ductal, Breast/metabolism , Carcinoma, Ductal, Breast/pathology , Metalloproteases/metabolism , Tissue Inhibitor of Metalloproteinases/metabolism , Biomarkers, Tumor/analysis , Breast Neoplasms/surgery , Female , Humans , Matrix Metalloproteinase 11/metabolism , Matrix Metalloproteinase 9/metabolism , Microvessels/metabolism , Middle Aged , Multivariate Analysis , Predictive Value of Tests , Prognosis , Stromal Cells/metabolism , Stromal Cells/pathology , Tissue Inhibitor of Metalloproteinase-2/metabolismABSTRACT
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 (
Subject(s)
Breast Neoplasms/pathology , Gene Expression Regulation, Neoplastic , Magnetic Resonance Imaging/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Ki-67 Antigen/biosynthesis , Kinetics , Microcirculation , Middle Aged , Neoplasm Invasiveness , Receptor, ErbB-2/biosynthesis , Receptors, Estrogen/biosynthesis , Receptors, Progesterone/biosynthesis , Tumor Suppressor Protein p53/biosynthesis , Vascular Endothelial Growth Factor Receptor-1/biosynthesis , Vascular Endothelial Growth Factor Receptor-2/biosynthesisABSTRACT
To assess whether breast arterial calcifications (BAC) are associated with altered serum markers of cardiovascular risk, mammograms and records from 1759 women (age range: 45-65 years) screened for breast cancer were revised. One hundred and forty seven (8.36%) women showed BAC. A total of 136 women with BAC and controls (mean age: 57 and 55 years, respectively) accepted entering the study. There were no significant differences in serum levels of urea, glucose, uric acid, creatinine, total cholesterol, HDL-C, LDL-C, folic acid, vitamin B(12), TSH or cysteine, between both groups of patients. However, women with BAC showed higher serum levels of triglycerides (p=0.006), homocysteine (p=0.002) and hs-CRP (p=0.003) than women without BAC. Likewise, we found a significantly higher percentage of cases with an elevated LDL-C/HDL-C ratio (coronary risk index >2) amongst women with BAC than in women without BAC (56.7 and 38.2%, respectively; p=0.04). Our results indicate that the finding of BAC identify women showing altered serum markers of cardiovascular risk.
Subject(s)
Breast Neoplasms/blood , Breast Neoplasms/diagnostic imaging , Calcinosis/blood , Calcinosis/diagnostic imaging , Mass Screening/statistics & numerical data , Peripheral Vascular Diseases/blood , Peripheral Vascular Diseases/diagnostic imaging , Aged , Breast Neoplasms/epidemiology , C-Reactive Protein/analysis , Calcinosis/epidemiology , Cholesterol/blood , Comorbidity , Female , Homocysteine/blood , Humans , Incidence , Middle Aged , Peripheral Vascular Diseases/epidemiology , Radiography , Risk Assessment/methods , Risk Factors , Spain/epidemiology , Statistics as Topic , Triglycerides/bloodABSTRACT
OBJECTIVES: To evaluate the clinical significance of the mammographic appearance of tumors in 411 patients with infiltrating ductal carcinoma of the breast. STUDY DESIGN: Tumors were classified into five radiographic subgroups: spiculated mass (A-type), diffuse changes with or without suspicious microcalcifications (B-type), microcalcifications with a mass (C-type), circumscribed (D-type), and not visible (E-type). Intratumoral levels of estrogen (ER) and progesterone (PR) receptors, c-erbB-2, EGFR, pS2, cathepsin D and tPA, ploidy and S-phase fraction, were analysed in a significant number of cases. RESULTS: A-type A radiographic pattern was detected in 234 patients (57%), B-type in 46 (11%), C-type in 46 (11%), D-type in 68 (17%), and E-type in 17 patients (4%). On the other hand, a total of 155 tumors (37.8%) showed microcalcifications. The percentage of tumors showing A-type pattern was more frequent in postmenopausal women, in well-differentiated tumors, and in those showing higher levels of ER, pS2 of tPA. However, B-type pattern was detected in a high percentage of premenopausal women and in those showing larger tumors, positive nodes, poor differentiation or high S-phase fraction. Cox multivariate analysis showed that B-type pattern and the absence of microcalcifications were factors significantly associated to high risk for relapse. CONCLUSIONS: Our results suggest that the mammographic appearance of tumor may to provide useful clinical information in addition to classical prognostic factor in infiltrating ductal carcinoma of the breast.