乳腺浸润性导管癌微卫星不稳定性

目的 探讨乳腺浸润性导管癌的微卫星不稳定(MSI)性及其与临床病理资料的关系。方法 选取10个微卫星位点，从石蜡包埋的存档标本中选取34例肿瘤组织和其对应的自身正常对照组织，提取DNA后用PCR扩增，6％聚丙稀酰胺凝胶电泳，银染显色后进行微卫星不稳定性分析。用免疫组化S-P法观察p53、c-erbB-2、PR、ER在乳腺癌中表达情况。结果 在34例乳腺浸润性导管癌中有9例(26．47％)至少1个位点出现MSI。MSI和病人年龄、肿瘤大小、病理分级、淋巴结转移、p53、c-erbB-2之间没有明显的相关性。但ER和PR阴性的病例出现MSI的比例远远高于ER和PR阳性病例。结论在乳腺癌的发生、发展过程中出现MSI,并可能和ER、PR的表达降低有关。     

乳腺浸润性导管癌与小叶癌的超声诊断分析

目的探讨乳腺浸润性导管癌和浸润性小叶癌的超声声像图特征。方法对2006年1月至2008年6月经手术、病理证实为乳腺浸润性导管癌（IDC）136例和浸润性小叶癌61例的超声声像图、彩色多普勒表现进行对比分析。结果两种病理类型的肿瘤的超声声像图在肿块形状、内部与后方回声以及血流图上差异有统计学意义（P〈0．05）。在侧方回声与内部钙化情况上差异无统计学意义（P〉0．05）。结论乳腺浸润性导管癌和浸润性小叶癌可以根据各自超声声像的特点进行诊断，组织学的不同影响乳腺癌的超声影像表现。     

乳腺浸润性导管癌伴导管原位癌

<正>1临床资料本例读片资料由山西省肿瘤医院病理科提供,通讯读片编号BB19-8。患者女性,35岁,于2017年6月入院,发现右侧乳腺肿物5个月,无明显触痛,局部皮肤红肿。外院影像超声:低回声结节,大小2 cm×1. 7 cm,形态欠规则,周界不清。当地医院局部术后病理诊断:乳腺癌;会诊:浸润性癌,不除外化生性癌。患者无既往史,入院行根治术:右侧乳腺改良根治术,     

锰超氧化物歧化酶在乳腺浸润性导管癌中的表达及临床意义

目的检测锰超氧化物歧化酶(manganese superoxide dismutase,MnSOD)在乳腺浸润性导管癌组织及癌旁正常组织中的表达,探讨MnSOD在肿瘤的发生及肿瘤侵袭过程中的作用。方法采用RT-PCR和Western blot法分别对20例乳腺浸润性导管癌组织样本和20例癌旁正常组织样本的MnSOD mRNA及蛋白表达进行检测,以β-actin作为定量参考物,比较其在乳腺癌组织和癌旁正常组织中的表达差异,并结合临床特征淋巴结转移和TNM分期,分析MnSOD在肿瘤不同阶段表达的差异。结果乳腺浸润性导管癌组织MnSOD mRNA的表达值为0.61±0.15,癌旁组织为1.24±0.14,两者比较差异具有统计学意义(P<0.01);MnSOD蛋白在癌组织中表达值为0.40±0.04,癌旁组织为0.75±0.06,两者比较差异具有统计学意义(P<0.01)。乳腺浸润性导管癌中淋巴结转移与非淋巴结转移MnSOD mRNA及蛋白表达无统计学意义(P>0.05)。TNM分期:Ⅰ期4例MnSOD mRNA表达值为0.45±0.15,Ⅱ期9例MnSOD mRNA表达值为0.44±0.15,Ⅲ期7例MnSOD mRNA表达值为0.36±0.07,Ⅱ期与Ⅲ期及Ⅰ期与Ⅲ期的比较差异均有统计学意义(P<0.05);Ⅰ期与Ⅱ期比较差异无统计学意义(P>0.05);Ⅰ～Ⅲ期MnSOD蛋白表达三者相互间比较差异均无统计学意义(P>0.05)。结论乳腺浸润性导管癌组织中Mn-SOD mRNA和蛋白表达明显下降,检测MnSOD的表达可作为临床诊治及判定乳腺浸润性导管癌预后的指标。     

上皮钙依赖粘附素相关分子在乳腺浸润性小叶癌和导管癌中的表达及意义

目的 探讨上皮钙依赖粘附素相关分子α-、β-、γ-catenin在乳腺浸润性小叶癌（ILC）和浸润性导管癌（IDC）中的表达及其意义。方法 采用免疫组织化学LSAB法检测了19例ILC和32例IDC组织中α-、β-、γ-catenin的表达,并根据阳性癌细胞占肿瘤细胞的比例进行半定量化分析和统计学x^2检验。结果 α-、β-、γ-catenin在19例ILC中表达缺失和明显减少的分别为15例（78.9%),10例（52.6%)和16例（84.2%),而在32例IDC癌组织中的表达缺失和明显减少为24例（75.0%),14例（43.8%)和26例(81.3%)例。另外,这3种蛋白在浸润性癌组织中表达强度弱于原位癌灶的表达强度。α-catenin和β-catenin在乳腺浸润性癌中的表达具有明显的正相关性,未发现α-、β-、γ-catenin在乳腺浸润性癌中的表达与有无伴有淋巴结转移病例之间的关系有统计学意义。结论 α-、β-、γ-catenin在乳腺ILC和IDC中表达均为明显缺失和减少,说明这些粘附分子在乳腺浸润性癌发生中确实丧失了其正常的细胞粘附功能。     

间皮素(mesothelin)在乳腺浸润性导管癌中的表达及临床意义

目的:研究间皮素(mesothelin)的表达与乳腺浸润性导管癌的关系.方法:采用免疫组化测定46例乳腺浸润性导管癌组织中mesothelin的表达情况.结果:mesothelin在乳腺浸润性导管癌组织中的阳性表达率为19.6% (9/46).在手术病理分期Ⅰ期、Ⅱ期和Ⅲ期中阳性率分别为5.56%、12.5%和50%....     

乳腺浸润性微乳头状癌:淋巴结转移和结外浸润的高发生率及其与浸润性导管癌的免疫组化比较

浸润性微乳头状癌(Invasivemicropapillarycarcinoma,IMC)是一种少见而独特的乳腺癌类型,其组织学特征是:缺乏纤维血管轴心的微乳头或管泡状细胞簇在由纤细的网状或胶原纤维性间质分隔形成的透明间隙中浸润,不伴有促纤维增生。作者总结了5 3例IMC的组织学特点和免疫组化染色结果,并与6 0例浸润性导管癌进行比较。此组IMC的发病率占浸润性乳腺癌的2 6 %。患者均为女性,年龄33～78岁(平均5 2 5岁)。查体均触及X片可见的乳腺肿块,大小5～90mm(平均2 7mm)。所有病例针吸活检均诊断恶性肿瘤并行乳腺改良根治术,4 8例患者附加腋窝淋巴结清…     

乳腺浸润性导管癌中HPV18、HPV16感染的研究

目的 :了解乳腺浸润性导管癌中HPV18、HPV16的感染情况 ,分析其是否是乳腺癌发生的危险因素及与临床病理的相关性。方法 :根据HPV16、HPV18的DNA序列 ,合成相应特异的寡核苷酸片段 ,用加尾标记法制备地高辛标记探针 ,用原位杂交法检测 5 1例乳腺浸润性导管癌、10例相应正常乳腺上皮及 15例良性乳腺病变中HPV18、HPV16的感染 ,并分析其与患者发病年龄、肿块大小及淋巴结转移的相关性。结果 :浸润性导管癌中HPV18或 16的总阳性率达 70 6 % ,其中HPV18与HPV16的阳性率分别为 5 8 8%、4 5 1% ,均明显高于正常乳腺上皮的感染率 (30 0 %、10 0 % ;P <0 0 5 ) ;乳腺良性病变的HPV18、16阳性率分别是 6 0 0 %、6 0 % ,其中HPV18的阳性率亦显著高于正常乳腺上皮 (P <0 0 5 )。结论 :(1)HPV16和18可能是乳腺浸润性导管癌发生的致病因子 ,HPV18尚可能与乳腺良性病变的发生有关。 (2 )HPV的感染与患者年龄、肿块大小及淋巴结转移无相关性。     

乳腺浸润性导管癌中MT1-MMP的表达及临床意义

目的 探讨MT1-MMP的表达与乳腺浸润性导管癌临床病理特征的关系.方法 采用免疫组化EnVision法检测43例乳腺癌组织及正常癌旁组织中MT1-MMP的表达,并分析MT1-MMP的表达与临床病理参数之间的关系.结果 MT1-MMP在正常乳腺组织中不表达,在乳腺导管癌细胞、癌旁间质中均有表达,乳腺癌细胞质、细胞膜表达MT1-MMP.结论 MT1-MMP的表达与乳腺癌肿块直径、淋巴结转移、临床分期呈正相关,与ER、PR无相关性,可作为判断乳腺癌侵袭转移能力的一个指标.     

Dextroscope系统对乳腺浸润性导管癌的三维重建及术前应用

目的:研究Dextroscope系统对乳腺浸润性导管癌的三维重建方法,探讨其临床应用价值.方法:对浸润性导管癌10例患者采用Dextroscope系统软件生成虚拟图像,从任意角度观察肿瘤与乳腺的解剖关系,确定保乳手术方案并进行模拟操作.10例均行乳腺癌保乳手术.结果:Dextroscope系统对乳腺浸润性导管癌的三维重建图像清晰,可以精确定位肿瘤.10例患者病理切缘均为阴性.术后病理大体标本与术前模拟图像测量数值,差异无统计学意义(P＞0.05).结论:通过Dextroscope系统,术者提前预演手术,为精确手术创造了条件,对乳腺癌保乳手术的实施有指导意义.     

Clinical Significance of Microcalcifications Detection in Invasive Breast Carcinoma

Background

Recently, a lot of cases with microcalcifications of the breast are pointed by the images of mammography (MG), because breast screening using MG become common. Although MG is a gold standard modality for detecting microcalcifications, images of ultrasonography (US) are now feasible to detect microcalcifications with recent improvements to ultrasound diagnostic devices. In this report, we analyzed clinical significance of microcalcifications detected with US images in invasive breast carcinoma.

Methods

Eighty-eight patients with invasive breast carcinoma who underwent MG and US before surgery at the Division of Breast and Endocrine Surgery of Tottori University Hospital between January 2012 and August 2013. After reviewing US images, the association between the presence of echogenic spots that indicate microcalcifications and images of MG or pathological findings was assessed.

Results

Patients without microcalcifications on US images were significantly more likely to have the Luminal A subtype and a lower nuclear grading. Conversely, patients with microcalcifications on US images were significantly more likely to have higher level of MIB-1 index, lymphovascular invasion, comedonecrosis and lymph node metastasis. The rate of detecting microcalcifications on US images was relatively good, with 81.8% of sensitivity, 94.5% of specificity and 89.8% of diagnostic accuracy. Among the calcifications detected by MG images, detected rate of calcifications with US images was higher in necrotic type (92.6%) than secretory type (33.3%).

Conclusion

This study suggest that microcalcifications of tumors detected by US images could serve as an useful prediction to evaluate the degree of malignancy for patients with invasive breast carcinoma.     

The First Case of HER2+ Invasive Ductal Carcinoma Arising From a Breast Hamartoma and Literature Review

Carcinomas arising from breast hamartomas are exceedingly rare. We present the first reported case of an African-American female presenting with a right breast lump and a subsequent mammogram suggestive of a hamartoma. She later underwent lumpectomy and was found to have HER2+ invasive ductal carcinoma (IDC) arising from a hamartoma. She was amenable to HER2-targeted trastuzumab, hormone therapy and adjuvant radiation but declined chemotherapy. In a review of the literature, IDC is the predominant neoplastic type found in hamartomas. The average hamartoma size at time of neoplasm diagnosis is 6.0 cm. Patients with hamartomas greater than 6.0 cm, with changes in calcification pattern; new nodules or asymmetry should be considered for additional evaluation with ultrasound, MRI and/or biopsy. HER2 status is under-reported among cases and should be evaluated in any malignancy found within hamartomas as HER-2 therapy has improved overall survival and recurrence free survival in HER2+breast cancer patients.     

Alveolar Variant of Invasive Lobular Carcinoma of the Breast: An Electron Microscopic Study

Four cases of alveolar variant of invasive lobular carcinoma of the breast were examined by electron microscopy, and their appearance compared with those of in situ and classical invasive lobular carcinoma. The individual tumor cells in the alveolar variant were basically similar to those described in the other two lobular tumors. The neoplastic alveoli consisted mostly of light cells, although a few dark cells were sometimes seen at the periphery. The nuclei were large, rounded and rich in euchromatin. The cytoplasm contained a variable amount of mitochondria and endoplasmic reticulum, and a few cells had intracytoplasmic filaments. Numerous tumor cells with membrane-bound electron-dense granules were occasionally seen. A few cells also had intracytoplasmic lumina. Tumor cells were usually seen in close contact with each other. Interdigitating processes and desmosomes were present. In general the tumor cells were not surrounded by basal lamina, but most alveoli were surrounded by elongated fibroblasts or myofibroblasts. These findings confirm both the lobular and the invasive nature of this distinct variant of breast carcinoma.     

Invasive lobular carcinoma of the breast: incidence and variants

The criteria for the separation of invasive lobular and ductal carcinomas are analysed. Lobular tumours account for 14% of invasive cancers in our material. The widely differing figures given in the literature are mainly attributable to intrinsic difficulties of classification. In addition to the classical dissociated-cell patterns with single filing, a tragetoid appearance and related features, variants with trabecular, loose alveolar and tubular features are recognized; a 'solid' variant requires further investigation. The variants either represent better differentiated forms, or in some cases, an 'earlier' phase in the production of the more traditional Indian file formations and dartboard patterns. Focal signet-ring cell differentiation is another newly-recognized feature. The theoretical and practical implications of these variants are considered. The division into invasive lobular and ductal carcinomas is not as easy as most of the literature implies. Five per cent of cases could not be so classified and, in some of these unclassified cases, both ductal and lobular differentiation may be present. In the diagnosis of problem cases, no single parameter proved reliable but a combination of several parameters enables one to make an objective diagnosis in about 95% of cases.     

Microcalcification of Tumor is a Predictor of Response to Neoadjuvant Chemotherapy for Invasive Breast Carcinoma

Background

In recent years, neoadjuvant chemotherapy (NAC) is often performed for patients with unresectable breast carcinoma or without indication of breast conserving therapy. However, it is currently difficult to predict response to NAC with diagnostic imaging of breast carcinoma. In this study, we investigated imaging findings that could serve as a predictor of the response to NAC for patients with invasive breast carcinoma.

Methods

Twenty-six patients with invasive breast carcinoma who received NAC at the Division of Breast and Endocrine Surgery of Tottori University Hospital between January 2010 and May 2014 were retrospectively investigated. Their imaging findings from mammograms and ultrasonograms were reviewed. The association between findings on mammograms and ultrasonograms captured before NAC and response to treatment after NAC was examined.

Results

Of the 26 patients with invasive breast carcinoma, 19 (73%) responded well to treatment and 7 (27%) did not. Most notably, all 10 patients who had microcalcifications on mammogram responded well to treatment (53% of responders), and all patients who did not respond to treatment had no microcalcifications (P < 0.05). Of these 10 patients, 9 (90%) had microcalcifications of comedo type and one (10%) had non comedo type. As a distribution, 8 of the 10 (80%) had a clustered type of microcalcifications and the remaining 2 (20%) had a segmental type of them.

Conclusion

Microcalcifications of tumor observed in mammogram (particularly comedo type) could be a predictor of response to NAC for patients with invasive breast carcinoma.     

Invasive cribriform carcinoma of the breast†

A histological review of 1003 invasive breast carcinomas identified 51 tumours in which the invasive component showed a predominantly cribriform pattern. These separated into two groups; 35 which showed exclusively cribriform or cribriform with a limited extent of tubular invasive elements only, designated ‘classical’ invasive cribriform carcinoma and 16 which also contained areas of less well differentiated invasive carcinoma, designated ‘mixed’ invasive cribriform carcinoma. At follow-up, 10 to 21 years after diagnosis, none of the 35 patients with classical invasive cribriform carcinoma had died as a result of this initial carcinoma and 30 remained alive. Of the 16 remaining patients, whose tumours showed areas of less well differentiated carcinoma, only six remained alive. However, the adjusted 10 year survival rate of these patients in this mixed group was significantly better than that of invasive carcinoma in Edinburgh. Invasive cribriform carcinoma in its classical form, is a histological subgroup of invasive carcinoma with the same excellent prognosis as that of invasive tubular carcinoma.     

Angiopoietin-Like Protein 4 and Insulin-Like Growth Factor-1 Expression in Invasive Breast Carcinoma in Young Women

Simple SummaryBreast cancers arising before the age of 45 years, also known as early-onset breast cancers, have a more aggressive behavior and worse prognosis than late-onset breast cancers. Therefore, there is an urgent need to identify potential therapeutic targets for this group of tumors. In the last decade, angiopoietin-like protein 4 and insulin-like growth factor-1 have attracted attention in clinical research as independent markers of the progression and prognosis of malignancies. In this study, we investigated the expression of both proteins in breast carcinoma tissue from young patients and examined whether their expression can be predicted by clinicopathological parameters.AbstractBiomarker identification is imperative for invasive breast carcinoma, which is more aggressive and associated with higher mortality and worse prognosis in younger patients (<45 years) than in older patients (>50 years). The current study aimed to investigate angiopoietin-like protein 4 (ANGPTL4) and insulin-like growth factor-1 (IGF-1) protein expression in breast tissue from young patients with breast carcinoma. Immunohistochemical staining was applied in formalin-fixed, paraffin-embedded samples of breast carcinoma tissue from young patients aged <45 years at the time of diagnosis. Both proteins were expressed in the majority of cases. The highest frequency of positive ANGPTL4 and IGF-1 expression was observed in the luminal A subtype, whereas the HER2-overexpression subtype exhibited the lowest expression frequency for both proteins. There was no significant association between ANGPTL4 (p = 0.897) and IGF-1 (p = 0.091) expression and molecular subtypes of breast carcinoma. The histological grade was a significant predictor of ANGPTL4 expression (grade 1 vs. grade 3, adjusted odds ratio = 12.39, p = 0.040). Therefore, ANGPTL-4 and IGF-1 expressions are common in young breast carcinoma tissue. There is a potential use of them as biomarkers in breast carcinoma.     

Light and Electron Microscopic Study of an Invasive Cribriform Carcinoma with Extensive Microcalcification Developing in a Breast with Silicone Augmentation

Although recent epidemiologic studies suggest that silicone augmentation of the breast is not associated with an increased risk of mammary carcinoma, cases of breast carcinoma arising in augmented breasts are being increasingly encountered as a large number of patients who had augmentation are getting older. A case of a 51-year-old woman with a 20-year history of breast augmentation who developed an invasive cribriform carcinoma associated with extensive microcalcification is presented. The patient had submammary silicone implants 20 years ago that were replaced, because of local complications, in subpectoral positions 10 years later. Dispersive X-ray microanalysis failed to demonstrate silicone in sections of the tumor and adjacent breast tissue. Appropriately fixed tumor tissue was available for electron microscopic examination. The tumor cells were rich in mitochondria, and their luminal surfaces were endowed with abundant microvilli, but the cell surfaces that came closest to the calcified microspheriols were devoid of microvilli and had cellular buddings between the microspheriols. It is suggested that the tumor cells might have been actively involved in the process of microcalcification.     

Ultrastructural Analysis of Apocrine Carcinoma of the Human Breast

A case report with ultrastructural analysis of an apocrine carcinoma of the breast is presented. The key finding with electron microscopy is numerous large mitochondria with abundant incomplete cristae. The ultrastructure of this tumor is compared to the ultrastructure of apocrine cells in the skin, oncocytes, and apocrine metaplastic cells of the breast. The apocrine carcinoma cells have some of the features of typical metaplastic breast epithelium and some features of oncocytes. Their exact origin remains open to speculation.     

Ultrastructural Analysis of Apocrine Carcinoma of the Human Breast

A case report with ultrastructural analysis of an apocrine carcinoma of the breast is presented. The key finding with electron microscopy is numerous large mitochondria with abundant incomplete cristae. The ultrastructure of this tumor is compared to the ultrastructure of apocrine cells in the skin, oncocytes, and apocrine metaplastic cells of the breast. The apocrine carcinoma cells have some of the features of typical metaplastic breast epithelium and some features of oncocytes. Their exact origin remains open to speculation.