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PubMedDate not supplied

Diagnostic significance of coexpression of intermediate filaments in fine needle aspirates of human tumors.

A study was undertaken of the diagnostic significance of the coexpression of intermediate filaments in fine needle aspirates of human tumors. Three types of coexpression were found: (1) true coexpression, in which tumor cells simultaneously express more than one intermediate filament protein; (2) pseudocoexpression, in which various tumor cell types from histogenetically different parts of a complex tumor show different results; and (3) false coexpression, in which tumor cells with one or two types of intermediate filaments are present together with benign cells expressing a different filament type. True coexpression of vimentin and keratin was documented in renal cell carcinomas, endometrial carcinomas, certain thyroid carcinomas and Hürthle cell adenomas. Coexpression of keratin and neurofilaments was seen in Merkel cell carcinomas, and coexpression of desmin and vimentin was found in leiomyosarcomas. Keratin, vimentin and neurofilament expression was seen in medullary thyroid carcinomas, and keratin, vimentin and glial fibrillary acidic protein expression was observed in pleomorphic adenomas of the salivary gland. Pseudocoexpression was noted in synovial sarcoma, epithelioid sarcoma, benign cystosarcoma phyllodes of the breast, teratocarcinoma, malignant granular cell tumor, progonoma, Wilms' tumor and triton tumor. Sources of false coexpression are also discussed.

Biopsy, Needle↗
PubMed1989

[Breast repair using a silicone gel-filled prosthesis. Report of 21 cases].

From March 1985 to May 1988, a total of 32 breast repairs in 21 patients following mastectomy were performed in our hospital. The operative procedures included: immediate prosthesis insertion following subcutaneous mastectomy in 16 patients; subsequent prosthesis implantation following simple mastectomy in 4 patients; a transfer of latissimus dorsi skin-muscle flap with submuscular placement of prosthesis subsequent to the radical mastectomy in 1 patient. The chief indications for mastectomy are: multiple fibroadenomas, giant fibroadenoma, severe fibrocystic mastopathy and cystosarcoma phyllodes and so on. After a period of 1-38 months follow-up postoperatively, the results were satisfactory with no significant complications. It is believed that the breast repair by utilizing silicone gel-filled implant following mastectomy is a safe, reliable and more effective procedure, and is reasonable to extend its indication in latter clinical application.

Adenofibroma↗
PubMed1985

[Percutaneous injection of a contrast medium in isolated lesions of the breast].

The percutaneous injection of contrast medium was performed into 44 breast fibroadenomas, 13 tumors of fibrocystic disease and 5 cancers. The radiological aspect does not to assure some discrimination between peri- or intracanalicular fibroadenomas, nor between giant fibroadenomas and cystosarcoma phyllodes. The opacification of the intratumoral galactophoric channels is achieved in 34,1% of fibroadenomas. It can be observed in fibrocystic disease but nor in cancer. A pattern of fibrous tissue and/or opacification of large peripheric extratumoral channels will appear in 34,1% of fibroadenomas. They are be observed in fibrocystic diseases and cancers. It is the same thing for spot figure. For diagnosis, the technic is not recommended to be generalized since the accuracy seems to be less serious than the cytological analysis of the puncture.

Adenofibroma↗
PubMed1985

[Mesenchymal breast sarcomas. Apropos of 25 cases].

Breast sarcoma are rare, representing 1% of all malignant breast tumours. This is a retrospective study of 25 patients with a breast sarcoma, treated at Institut Gustave Roussy from 1954 to 1981. Thirty six per cent of these arose in a cystosarcoma phyllodes. A variety of histologies were found, the main one being malignant fibrohistiocytoma (44%). Nodal involvement was rare (4%) and, as in other sarcoma, hematogenous spread of metastases was more usual. Local recurrence occurred in 44% of cases and distant metastases (usually pulmonary) in 24%. The 3 year disease-free survival was 60% and the major prognostic factor was the mitotic index. Surgery is the treatment of choice of these tumours, supplemented by local irradiation in those cases where only a tumorectomy has been performed. The role of adjuvant chemotherapy remains undefined.

Adolescent↗
PubMed1986

Pleomorphic adenoma in the breast of a human female. Aspiration biopsy findings and receptor determinations. Case report.

A case of multiple pleomorphic adenomas ("mixed" tumour of salivary gland type) of the breast is reported. This rare benign tumour can be misinterpreted as a malignant tumour both clinically and radiologically. The aspiration biopsy findings suggested cystosarcoma phyllodes. Oestrogen and progesterone receptor determinations revealed medium high levels, comparable to carcinoma of the breast.

Adenoma, Pleomorphic↗
PubMed1988

Haemangiomatous lesions of lymph nodes. Report of two cases and review of literature.

Two cases of haemangiomatous lesions in lymph nodes are described in this paper. They were recorded from a pelvic lymph node of a gravid woman. 42 years old, with adenocarcinoma of the uterine cervix, and from an axillary lymph node of a woman, aged 57 years, with malignant cystosarcoma phyllodes of the breast with chondro-osteoid and osteoblastic differentiation. The haemangiomatous lesions were situated cortically or paracortically and composed of round, densely arranged, dilated capillary blood vessels with walls lined by one single endothelial layer. Comparison with the few cases so far published supports the assumption that the differences described may have been caused by development phases of the lesions, but are in fact one nosological entity.

Adult↗
PubMed1987

Mammary masses in the adolescent female.

Disease of the breast is uncommon in the adolescent female. Of 25,650 surgical specimens examined at The Children's Memorial Hospital in Chicago from 1974 through 1985, only 40 lesions were of adolescent breast origin in females. The ages of the patients ranged from 12 to 22 years. The most common lesion was fibroadenoma (19) followed by gigantomastia and cystosarcoma phyllodes. A malignant lesion is rare in this age group and both instances in this series had predisposing factors (for example, prior regional radiation in childhood). The findings of this study, plus that of the literature reviewed, emphasize conservative treatment with observation followed by simple excision when the patient nears completion of the development of the breast in most instances.

Adenofibroma↗
PubMed1980

[Pathology of benign tumorous diseases of the mammary glands (author's transl)].

Among the large number of mammary biopsies undertaken today, benign diseases and marginally normal types occupy a considerable place. Of these, those which are considered prestages of malignant tumors, simulate malignant tumors and cause difficulties in differential diagnosis (intraoperative section) are of great importance. In childhood, infantile hypertrophies must be thought of macromastia in precocious puberty, puberal macromastia in puberty; in women, of forms of chronic mastitis in the presence of retention of secretion and periductal inflammation. The best known is the fibroadenoma in the region of which Cystosarcoma phyllodes and even a lobular carcinoma in situ may develop. Undoubtedly chronic cystic mastopathy is of particular prognostic significance. Less than 5% of all forms of mastopathy are premalignant diseases.

Adenofibroma↗
PubMed1982

[Adriamycin, cardiotoxicity--a case report].

In 1976, a 61-year-old female was diagnosed as malignant cystosarcoma phyllodes, and she was admitted to the hospital for chemotherapy. She was started receiving the combination chemotherapy consisting of adriamycin. 60 mg/3-week, mitomycin C, 1 mg/week, 5-Fluorouracil, 175 mg/week, and citosine arabinoside, 10 mg/week. The initial ECG revealed incomplete right bundle branch block pattern. After the first 60 mg administration of adriamycin, the ECG showed non-specific ST-T changes in addition to I.R.B.B.B. pattern. At the second 60 mg administration of adriamycin, the ECG returned to normal. After the administration of adriamycin, the ECG showed the same ST-T changes again which were seen at the first adriamycin treatment. The same phenomenon was observed at the third adriamycin treatment. In this case, there was a reproducible coincidence between the administration of adriamycin and the occurrence of non-specific changes on ECG; the fore a possibility of adriamycin cardiotoxicity was strongly suggested.

Breast Neoplasms↗
PubMed1983

[Management of a lump in the breast?].

Cancer is the primary concern in a patient with a nodule of the breast. Diagnosis is based on clinical, radiological and pathological data. After the preoperative workup, tumorectomy with intraoperative pathological examination is the first step of the surgical procedure. Resection can be extended to radical mastectomy when malignancy is demonstrated. Additional radio, chemo, hormono or immunotherapy may be given according to tumor staging. In non-malignant disorders, isolated nodules must be distinguished from multiple ones. A single nodule may be either a fibroadenoma, if it is solid, or a cyst accompanying a mastopathy. Multiple nodules rise the difficult problem of the management of Reclus disease. Other nodules are uncommon, such as cystosarcoma phyllodes, gigantic fibroadenoma, scirhus, and tumor of the galactophorus duct.

Breast Neoplasms↗
PubMed1994

Sarcoma of the breast: implications for extent of therapy. The M. D. Anderson experience.

BACKGROUND: Sarcoma of the breast is a rare clinical entity for which there are no prospective data about extent of surgery indicated or role of multimodality therapy. The purpose of this study was to examine one of the largest single institutional experiences to shed light on these clinical issues. METHODS: This study retrospectively reviewed 60 cases of sarcoma of the breast (cystosarcoma phyllodes excluded). RESULTS: For the entire series there was a median overall survival time (OS) of 67 months and a disease-free survival period (DFS) of 18 months. Tumors smaller than 5 cm were associated with a better DFS (p < 0.04) and OS (p < 0.009). Patients with tumors less than 5 cm in diameter did equally well whether treated by wide local excision or mastectomy. Angiosarcoma histologic characteristics were associated with longer OS than stromal sarcoma (p = 0.017), malignant fibrous histiocytoma (p = 0.075), or fibrosarcoma (p = 0.08). Axillary dissections did not recover any nodal metastasis; moreover, treatment in 75% of the patients with negative nodes subsequently failed. Regional lymph node metastases were always and only in the context of disseminated disease. Adjuvant chemotherapy and/or radiotherapy was associated with prolonged DFS (p = 0.015). There was a trend toward improved local control with adjuvant radiotherapy (p = 0.14). CONCLUSIONS: Lesions less than 5 cm should be treated by breast-preserving wide local excision, and adjuvant radiotherapy should be considered for selected subgroups. For tumors 5 cm or larger, a more aggressive approach seems appropriate; consideration should be given to neoadjuvant chemoradiation followed by margin-negative surgery (if possible). There is no demonstrable staging or therapeutic role for routine axillary dissection.

Adolescent↗
PubMed1993

The impact of resection margins in the treatment of primary sarcomas of the breast. A clinicopathological study of 8 cases with review of literature.

We reviewed the clinical and pathological features of eight patients (seven females, one male), who underwent surgery for sarcomas of the breast, to evaluate the effect of the margins of resection and histological tumor type on survival. Patients with carcinosarcoma, cystosarcoma phyllodes or dermatofibrosarcoma protuberans were excluded. Tumor size ranged between 4.5 and 26 cm (median 12.8 cm); there were three grade 3, four grade 2 and one grade 1 lesions. Of the five patients treated by radical resection margins, two with large grade 3 sarcomas died of distant metastasis 3 and 10 months later. One patient out of the five radical resected patients developed a local recurrence 96 months later. The recurrence was resected radically, radiotherapy was administered, and the patient is still alive at 168 months. The remaining four radical resected patients are free of disease until now. One of three patients, treated by wide or marginal resection, received adjuvant radiotherapy. This patient developed local recurrence and solitary distant metastasis at 26 and 49 months, respectively, and died of multiple distant metastasis at 54 months. Regional axillary lymph node metastasis was not observed in five patients in whom lymph node dissection was performed, with a median of 14.2 dissected lymph nodes. Two of eight patients received preoperative chemo- or radiotherapy because of large tumor size; five of eight received postoperative radiotherapy. Local tumor control was achieved in six of eight patients. The median follow-up time was 53.9 months (3-168 months), of all survivors median 72.2 months. Recurrence and disease-free survival rates were analysed according to histologic grade, tumor size, stage, surgical and adjuvant treatment.

Adult↗
PubMedDate not supplied

The value of fine needle aspiration cytology in the diagnosis of breast proliferative lesions.

In order to further characterize fine needle aspiration cytology of breast proliferative lesions, we analyzed 723 FNA of patients with palpable breast abnormalities who underwent physical, mammographic and/or echographic examination. In 28 biopsies (3.9%), the final cytologic diagnosis was a proliferative lesion, a group of uncommon breast proliferative diseases not yet explored, in which cytology is sufficiently cellular with plenty of atypical elements but not suspicious of carcinoma. Histologic material was available in 22 cases and represented the basis of this retrospective evaluation. Among the positive proliferative lesions (PPL), 10 cases were infiltrating ductal carcinomas and 1 was a microinvasive carcinoma; whereas for the negative proliferative lesions (NPL), in 8 cases the histologic findings demonstrated fibrocystic changes, in 1 a fibroadenoma and in 1 a cystosarcoma phyllodes. The cytologic criteria utilized to define breast proliferative lesions were the following: increased cellularity, occasional single atypical cells, decreased cellular cohesion, crowded, enlarged and overlapping nuclei with three dimensional groupings with prominent nucleoli and chromatic changes. The cytologic characteristics examined demonstrated that the PPL are characterized by single atypical cells with nuclear alterations such as coarsely granular chromatin with a thick nuclear membrane and numerous prominent nucleoli. These features are common to many malignancies, therefore surgical biopsy confirmation is suggested.

Adult↗
PubMed1997

[Measurement of aspecific alkaline phosphatase in the intraoperative histological examination of the breast].

One hundred seventy two consecutive cases of female breast pathology have been intraoperatively processed by frozen sections (FS) in combination with aspecific alkaline phosphatase (AAF) histochemical evaluation. The corresponding histology on permanent embedded tissues (ET) was compared with both these techniques. The related theoretical and practical methodological aspects are presented and discussed. The consultations concerned the following histopathological types (WHO terminology): 136 malignant epithelial tumours(intraductal carcinoma: 11; invasive ductal carcinoma: 100; invasive lobular carcinoma: 8; medullary carcinoma: 3; mucinous carcinoma: 8; papillary carcinoma: 3; tubular carcinoma: 2); one cystosarcoma phyllodes; 19 benign tumours; 15 mammary dysplasias (fibrocystic disease); one tumour-like lesion(hamartoma); one fibromatous lesion. In terms of concordance/discordance between FS and ET diagnoses no false positive cases and only one false negative resulted. The diagnosis was deferred in 18 circumstances (10,5%). The AAF reaction in 64/153 (41,8%) cases (correctly interpreted on FS) displayed more histological evidence with special reference to the detection of the myoepithelial cells. The morphological implementation was particularly relevant as far as the differentiation between intraductal and microinvasive carcinoma, carcinomatous and papillomatous papillary proliferation, carcinomatous and non carcinomatous tubular structures, pseudocarcinomatous (florid and/or sclerosing) dysplasia and carcinoma is concerned. Analogously in 12/17 (70,6%) comparable deferred diagnoses as well as in the single false negative case the interpretation could have been correctly stated intraoperatively. The normal and pathological features as disclosed by the AAF reaction have been analytically examined. The AAF procedure seems to be a possible relevant tool in order to improve the classical FS performance also in respect to the increasingly systematic, precocious and conservative approach of the modern breast surgery.

Alkaline Phosphatase↗
PubMedDate not supplied

Breast preserving surgery decision making.

Mammography, and in special cases MRT, allow the detection of DCIS and microcarcinomas. Breast preserving surgery needs intraoperative care for tumor free margins. Decision making under favourable and unfavourable conditions is discussed. Tumor grading is important with respect to locoregional recurrences. Improvements in breast cancer diagnosis are discussed in a separate paper in the same volume. The significance of c-erbB2 in pT1N0M0 stage has been determined in 472 cases. Within the c-erbB family, c-erbB2 has highest significance. p53 should also be evaluated with respect to tumor progress. In a few cases of malignant cystosarcoma phyllodes, p53 reaction was found in epithelial and mesenchymal cell systems. These results correspond to the results of Domagala et al (90) which show that vimentin positivity correlates with high proliferation, a high degree of malignancy and c-erbB2 positivity. Finally, the significance of angiogenesis with respect to the ineffective knot-formation for tumor cell transport and detachment of epithelia with apoptosis are discussed. The significance of proteolytic activity of cancer according to the results of Schmitt et al (89) is included in the discussion. Biochemical analysis seems to be much more effective for prediction of metastatic process as compared with immunohistochemical evaluations.

Breast Neoplasms↗
PubMed1961

[Giant fibroma].

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Breast Neoplasms↗