When Does Atypical Ductal Hyperplasia Require Surgical Excision?

When Does Atypical Ductal Hyperplasia Require Surgical Excision? Surg Oncol Clin N Am. 2018 Jan;27(1):23-32 Authors: Racz JM, Degnim AC Abstract Atypical ductal hyperplasia (ADH) is a proliferative, nonobligate precursor breast lesion and a marker of increased risk for breast carcinoma. Surgical excision remains the standard recommendation following a core needle biopsy result consistent with ADH. Recent research suggests that women with no mass lesion or discordance, removal of greater than or equal to 90% of calcifications at the time of core needle biopsy, involvement of less than or equal to 2 terminal duct lobular units, and absence of cytologic atypia or necrosis are likely to have a less than 5% chance of a missed cancer. PMID: 29132563 [PubMed - in process]
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Tags: Surg Oncol Clin N Am Source Type: research

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The distinction between benign and malignant papilloma of the breast through percutaneous needle biopsy can be difficult because of limited samples; the underestimation rate can be up to 25%. The aim of this study is to identify clinical and histological factors associated with underestimation, invasive ductal carcinoma, or ductal in-situ carcinoma (DCIS) of the breast found in surgical specimens from papillary lesions. This may contribute toward selection of patients for a follow-up strategy without the need for surgical excision. From a database of 3563 patients, we identified 85 with intraductal papilloma between 2007 a...
Source: European Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Research Papers: Breast Cancer Source Type: research
ConclusionsWe found a very low upgrade rate to breast cancer when RS was found on CNB with or without associated HRL. Our results are consistent with other reported series. Our data do not support surgical excision for RS but rather close clinical follow-up for patients with RS on CNB.
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
Abstract AIMS: To fully elucidate the clinicopathological features of breast carcinoma in sclerosing adenosis (SA-BC). METHODS: Clinical and histological characteristics of 206 SA-BCs from 180 patients were retrospectively evaluated. Immunohistochemical phenotype was examined. The clinicopathological relevance of the topographical pattern of SA-BCs was analysed. RESULTS: Overall, up to 46 patients (25.6%) had contralateral cancer, either SA associated or not. Of 99 cases who underwent core needle biopsy (CNB), 36 were underestimated as adenosis or atypical ductal hyperplasia at CNB, 5 invasive cases were...
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Tags: J Clin Pathol Source Type: research
We present a case of a G-CSF-producing metaplastic breast carcinoma (MpBC) accompanied by systemic elevation of IL-17 and VEGF levels. A 56-year-old woman presented with a rapidly growing tumor measuring  >  10 cm in her left breast. Core needle biopsy confirmed the diagnosis as MpBC with triple-negative features. Diffuse fluorodeoxyglucose uptake in the long bones and marked leukocytosis suggested that the G-CSF was produced by the primary tumor, which showed upregulated G-CSF mRNA and protein leve ls. Multiplex cytokine assessment identified increased serum IL-17, VEGF, and G-CSF levels. After radic...
Source: International Cancer Conference Journal - Category: Cancer & Oncology Source Type: research
Intramammary metastasis of renal cell carcinoma (RCC) is extremely rare, accounting for only 1.5% of all intramammary metastases. Distinguishing intramammary metastases from benign tumors and breast cancer is clinically problematic. Some patients undergo excessive surgery after a misdiagnosis of breast cancer instead of a mammary tumor. We performed a core needle biopsy (CNB) of a breast mass that developed in a 71-year-old woman after surgeries for bilateral RCC and breast cancer, leading to a diagnosis of intramammary metastasis of RCC. In this case, the CNB and immunohistochemical examination were critical for reaching ...
Source: Case Reports in Oncology - Category: Cancer & Oncology Source Type: research
Conclusion: BSGI is a useful imaging modality to predict upstaging to invasive breast cancer in cases of DCIS on CNB in conjunction with US tumor size and Ki67 expression. This research was supported by grants from the National Research Foundation (2015R1C1A1A02037051) of South Korea. Multivariate analysis for predicting upstaging to invasive breast cancerVariablesCutoffOR95% CIp-valueTumor size (cm)> 2.03.051.39-6.700.005Ki-67 (%)> 84.401.87-10.34 30.442.541.14-5.620.022
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Breast Cancer Posters Source Type: research
CONCLUSIONS: Routinely performing SLN biopsy for patients undergoing mastectomy for a preoperative diagnosis of DCIS is overtreatment, because the prevalence of SLN metastasis was low. SLN biopsy can be omitted for most patients. In particular, we suggest omitting SLN biopsy for patients who have lesions of ultrasound category 0-3, who have neither a mass nor NMA detected by ultrasound, or whose initial diagnosis was made based on a specimen obtained by methods other than CNB. PMID: 29786772 [PubMed - as supplied by publisher]
Source: Breast Cancer - Category: Cancer & Oncology Authors: Tags: Breast Cancer Source Type: research
We report a case of 64-year-old man who presented with the history of lower urinary tract symptoms. The digital rectal examination revealed hard and nodular prostate, and serum prostate-specific antigen level was 23.4 ng/mL. 68Ga-labeled prostate-specific membrane antigen PET/CT revealed prostate-specific membrane antigen–expressing lesions in the prostate, axillary tail of the right breast, and axillary lymph nodes. Histology from prostate revealed prostate carcinoma, whereas fine-needle aspiration from the breast revealed invasive ductal carcinoma of the breast.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Conclusions: After NST, image-guided FNA/VACB can accurately identify patients with a breast pCR. Based on these results, a prospective clinical trial has commenced in which breast surgery is omitted in patients with a breast pCR after NST according to image-guided biopsy.
Source: Annals of Surgery - Category: Surgery Tags: Original Articles Source Type: research
AbstractMembranous Ki-67 staining with the MIB-1 antibody has been described in hyalinising trabecular adenomas of the thyroid and sclerosing haemangiomas of the lung. Its relatively rare occurrence in breast tumours has also been documented. The aim of the present study was to assess the rate of any membranous MIB-1 staining in breast specimens. The staining was performed at room temperature with 1:100 dilution of the antibody. One hundred four core needle biopsies and 41 operative specimens were analysed. Membranous staining was noted in 36/144 invasive carcinomas, 20/42 in situ carcinomas and 46/99 cases of peritumoural...
Source: Virchows Archiv - Category: Pathology Source Type: research
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