E-cadherin expression in estrogen receptor-positive and negative breast carcinomas of postmenopausal women.

BACKGROUND: Preservation of E-cadherin expression is usually related to non-invasive and well differentiated breast carcinomas. PURPOSE: The aim of this study was to evaluate E-cadherin immunohistochemical expression in estrogen receptor (ER) positive and negative infiltrating ductal breast carcinomas. METHODS: Twenty-three postmenopausal patients with Stage II, operable, infiltrating ductal breast carcinomas were divided into groups A (ER+; n = 13) and B (ER-; n = 10). E-cadherin immunohistochemical expression was assessed semiquantitatively according to membrane staining intensity and classified as negative (< 10% of cells with stained membranes), positive + (10-50% of cells stained) or positive ++ (> 50% of cells stained). Fisher's exact test was used to compare the distribution of staining intensity in the two groups (p < 0.05). RESULTS: In group A (ER+), E-cadherin staining was positive in all cases: + (n = 3; 23%) and ++ (n = 10; 77%) compared to three cases (30%) in group B (ER-), + (n = 2; 20%) and ++ (n = 1; 10%). This difference was statistically significant (p < 0.0005). CONCLUSIONS: The present results indicate that E-cadherin expression loss is significantly associated with ER-negative tumors and therefore with a more aggressive phenotype of invasive ductal breast carcinoma.

Tuberculosis of the breast: analysis of 20 cases and a literature review.

Tuberculosis (TB) of the breast is a very rare pathology. The clinical presentations of this disease are manifold, often mimicking carcinoma of the breast. We conducted a retrospective analysis of 20 women with TB of the breast receiving care at the mastology clinic at Getúlio Vargas Hospital, PI, Brazil, between 1994 and 2007. The clinical presentation of the disease, the diagnosis and the response to specific treatment were analyzed. Most of the patients were of reproductive age, with the disease affecting the right breast in eleven patients (55%) and the left breast in nine patients (45%). Palpable nodules were present in five patients (25%) and fistulae in 15 (75%). The mean time between onset of symptoms and diagnosis was 7.7 months (range 3-12 months). Skin testing with purified protein derivative of tuberculin was strongly reactive in all patients, six (30%) of whom were breastfeeding. Diagnosis was confirmed by histopathology and all patients were satisfactorily treated with a combination of rifampicin, isoniazid and pyrazinamide. In the present study, TB of the breast presented predominantly as breast abscesses and fistulae and responded satisfactorily to treatment with anti-TB drugs.

Myiasis in the uterine cavity of an elderly woman with a complete uterine prolapse.

Myiasis is the infestation of the tissues of vertebrate animals by the larvae of flies (maggots). As the condition generally occurs in exposed areas of the body, genital myiasis is a rare condition, and myiasis of the uterine cavity is even rarer, only one case having been previously described in the literature. The case reported here describes myiasis of the uterine cavity and ulcerated vaginal mucosa of an 89-year-old woman with a severe (third-degree) genital prolapse. This case describes an extremely rare situation, and emphasizes the need for good hygiene and surgical correction in patients with a genital prolapse.