Association of breast cysts and breast cancer

A review of 915 consecutive patients with breast cancer and 812 with breast cysts showed that an association between the two is uncommon--5% of breast cancers were associated with cysts and 4% of cysts were associated with breast cancer. Four types of association were identified: (a) cystic cancers--easily diagnosed because of the characteristic features of the aspirate, failure of the mass to disappear and early recurrence in a patient whose age and menstrual status were not usually associated with cysts; (b) cancers occurring simultaneously with breast cysts--recognized because they did not contain cyst fluid; (c) cysts occurring after breast cancer--diagnosed by aspiration of the mass in premenopausal women; (d) cancers in patients who have had breast cysts--usually occurring many years after the cyst aspiration when menses had ceased. These associations were not sufficiently frequent to justify specific follow-up, but all suspected cysts should be successfully aspirated to confirm the clinical diagnosis.     

乳腺癌与载脂蛋白B基因多态性关系

目的 探讨载脂蛋白B(ApoB)基因-516位基因多态性与女性乳腺癌发生的关系.方法 运用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法检测200例乳腺癌患者(实验组)和200例正常女性(对照组)的ApoB 基因-516位C/T 基因型和等位基因的分布,并进行对比分析及相关性研究.结果 乳腺癌患者中CC、CT基因型的频率分别是78.00％、22.00％,而对照组中则分别为91.50％、8.50％;乳腺癌患者中C、T等位基因的频率分别为89.00％、11.00％,对照组中则分别为95.75％、4.25％,差异均有统计学意义(P＜0.05).CT型个体罹患乳腺癌的风险显著高于CC 型个体(P＜0.05).调整年龄、体质量指数后,携带CT 型的个体较CC 型罹患乳腺癌的风险增加(P＜0.05).结论 ApoB 基因-516位基因多态性与乳腺癌的易感性相关.     

Association of breast cancer with papillary lesions identified at percutaneous image-guided breast biopsy

BACKGROUND: The management of papillary lesions identified on image-guided breast biopsy remains controversial. In the literature, data regarding papillary lesions are limited because of small sample sizes. The purpose of this study was to identify the prevalence of atypical ductal hyperplasia and malignancy associated with papillary lesions identified on image-guided breast biopsy. METHODS: This study is a retrospective review of 9,310 consecutive image-guided biopsies performed at our institution between January 1996 and November 2003. Patients were included if they underwent an excisional biopsy after a papillary lesion was diagnosed on image-guided biopsy. RESULTS: Papillary lesions were identified in 153 (2%) of the 9,310 image-guided biopsies performed, and 87 of these patients underwent subsequent excisional biopsy at our institution. Breast cancer (in situ or invasive) was identified in 15 patients (17%), and 16 patients (18%) had atypical ductal hyperplasia identified at excisional biopsy. CONCLUSIONS: These data suggest that excisional biopsy should be considered when a papillary lesion is identified at percutaneous image-guided breast biopsy. The final surgical pathology may impact the treatment plan, risk reduction, and/or surveillance for more than a third of patients diagnosed with a papillary lesion on image-guided biopsy.     

甲状腺疾病和乳腺癌相关性研究的进展

内分泌功能的变化和相关疾病的发生有着密切的关系.甲状腺与乳腺同属激素依赖性器官,甲状腺疾病与乳腺癌之间存在着一些共同的致病危险因素,乳腺癌患者多并发甲状腺形态学、病理学及功能改变.尽管甲状腺疾病与乳腺癌之间相关性的研究已有一定深入,但其结果却不甚一致,相关机制仍不十分明确.     

乳腺癌与甲状腺疾病相关性研究进展

乳腺癌与甲状腺疾病均是现代女性的常见病,乳腺与甲状腺均受到下丘脑-垂体内分泌轴的作用,提示乳腺癌与甲状腺疾病之间存在着一些共同的致病危险因素。笔者通过复习文献,对乳腺癌与甲状腺疾病相关性的研究进展进行综述。     

Association of comprehensive thyroid cancer molecular profiling with tumor phenotype and cancer-specific outcomes

BackgroundMolecular testing improves the diagnostic accuracy of thyroid cancer. Whether specific molecular testing results are associated with tumor phenotype or provide prognostic information needs further delineation.MethodsConsecutive thyroid cancer patients after index thyroidectomy with ThyroSeq version 3 (Rye Brook, NY) molecular testing obtained on preoperative fine-needle aspiration or thyroidectomy specimens from patients with thyroid cancer were categorized into 3 molecular risk groups based on detected mutations, fusions, copy number alterations, and/or gene expression alterations and correlated with histopathology and recurrence, defined as biochemical or structural.ResultsOf 578 patients, 49.9%, 37.5%, and 12.6% had molecular risk group–low, molecular risk group–intermediate, and molecular risk group–high cancers, respectively. With a median 19-month follow-up, 9.1% patients recurred. Compared with molecular risk group–low, molecular risk group–intermediate cancers were diagnosed in younger patients and more often had microscopic extrathyroidal extension, involved margins, and nodal disease. Compared with molecular risk group–intermediate, molecular risk group–high cancers were diagnosed in older patients and more often had gross extrathyroidal extension and vascular invasion. In multivariable analysis, recurrence was more likely in molecular risk group–high cancers than in molecular risk group–intermediate (hazard ratio = 4.0; 95% confidence interval, 1.9–8.6; P < .001) and more likely in molecular risk group–intermediate than in molecular risk group–low (hazard ratio = 5.0; 95% confidence interval, 2.0–12.5; P < .001).ConclusionUsing modern comprehensive genotyping, the genetic profile of thyroid cancers can be categorized into 3 novel molecular risk groups that were associated with histopathologic phenotype and recurrence in short-term follow-up.     

Association of breast cancer with the finding of atypical ductal hyperplasia at core breast biopsy.

OBJECTIVE: The purpose of the study is to evaluate the prevalence of occult breast carcinoma in surgical breast biopsies performed on nonpalpable breast lesions diagnosed initially as atypical ductal hyperplasia (ADH) by core needle biopsy. BACKGROUND: Atypical ductal hyperplasia is a lesion with significant malignant potential. Some authors note that ADH and ductal carcinoma in situ (DCIS) frequently coexist in the same lesion. The criterion for the diagnosis of DCIS requires involvement of at least two ducts; otherwise, a lesion that is qualitatively consistent with DCIS but quantitatively insufficient is described as atypical ductal hyperplasia. Thus, the finding of ADH in a core needle breast biopsy specimen actually may represent a sample of a true in situ carcinoma. METHODS: Between May 3, 1994, and June 12, 1996, image-guided core biopsies of 510 mammographically identified lesions were performed using a 14-gauge automated device with an average of 7.5 cores obtained per lesion. Atypical ductal hyperplasia was found in 23 (4.5%) of 510 lesions, and surgical excision subsequently was performed in 21 of these cases. In these 21 cases, histopathologic results from core needle and surgical biopsies were reviewed and correlated. RESULTS: Histopathologic study of the 21 surgically excised lesions having ADH in their core needle specimens showed seven (33.3%) with DCIS. CONCLUSIONS: In the authors' patient population, one third of patients with ADH at core biopsy have an occult carcinoma. A core needle breast biopsy finding of ADH for nonpalpable lesions therefore warrants a recommendation for excisional biopsy.     

Association of tumor differentiation with caffeine and coffee intake in women with breast cancer

Caffeine, which has been linked to benign breast disease, has an antineoplastic effect in experimental animals, whereas in tissue cultures it inhibits mitoses and induces cell differentiation. We examined caffeine and coffee intake in 101 women with breast cancer to determine whether either or both influence cell differentiation in tumors as well. Nutrient analysis was performed by the Nutrition Coding Center of the University of Minnesota with the Nutrition Data system from the National Heart, Lung, and Blood Institute. Stepwise logistic regression, with tumor differentiation (well and moderate versus poor) as the dependent variable, was used. The analysis indicates that caffeine and/or coffee intake has a significant association with tumor differentiation as women with moderately to well-differentiated tumors had higher caffeine and coffee intake. This raises the question whether caffeine or coffee consumption may help induce cell differentiation and slow tumor growth.     

Clinical profile of long-term survivors of breast or thyroid cancer with metastatic spinal tumours

Patients with breast or thyroid cancer with metastatic spinal tumours are expected to survive relatively longer than patients with other cancers with metastatic spinal tumours. The purpose of this study was to determine the clinical characteristics of long-term survivors of breast or thyroid cancer with metastatic spinal tumours. We studied the clinical profile of long-term survivors by comparing the characteristics of nine patients who had survived for at least 5 years after a spinal operation with the characteristics of 16 patients who had not. Our results showed that the longer the time from the diagnosis of the primary cancer to the spinal operation, the longer patients with breast or thyroid cancer and metastatic spinal tumours would survive. Six of the eight patients (75.0%) who had undergone the spinal operation at least 5 years after the diagnosis of the primary cancer survived especially long. In conclusion, the duration from the diagnosis of the primary cancer to the spinal operation is very useful for predicting a prognosis in patients with breast or thyroid cancer and metastatic spinal tumours.     

人乳腺癌患者外周血循环肿瘤细胞与Sipal基因多态性的关系

目的 探讨Sipal基因rs931127和rs746429多态性与乳腺癌外周血循环肿瘤细胞的关系.方法 采用基因测序的方法,对124例原发性乳腺癌患者以及120例健康人进行Sipal基因rs931127和rs746429多态性分析.实时荧光定量聚合酶链反应(RT-qPCR)检测其中92例患者外周血循环肿瘤细胞,比较Sipal基因rs931127和rs746429多态性与外周血循环肿瘤细胞之间的关系.采用Fisher精确检验及非条件Logisitic同归法计算各组P值及相对危险度比(OR)及95％可信区间(95％ CI).结果 Sipal基因rs931127和rs746429多态性与乳腺癌患者外周血循环肿瘤细胞无明显相关(P＞0.05).Sipal基因rs931127和rs746429多态性与乳腺癌患者的年龄、肿块大小、雌激素受体(ER)、孕激素受体(PR)、C-erb-B2蛋白的表达以及乳腺癌分子分型均无明显相关(P＞0.05).但Sipal rs931127野生型GG淋巴转移率22.6％,低于杂合型GA 48.3％和突变型AA71.0％(P＜0.01),Sipal rs746429野生型CC的淋巴结转移率为31.4％,也低于杂合型CT 64.2％及突变型TT44.4％(P＜0.01).结论 Sipal基因rs931127多态性和rs746429多态性与乳腺癌患者外周血循环肿瘤细胞无明显相关,但与淋巴结转移有关.提示rs931127 GA或AA以及rs746429 CT或TT基因型可能与乳腺癌淋巴转移有关.     

Association of sonographically detected calcification with thyroid carcinoma

BACKGROUND: Calcification can be detected in both benign and malignant nodules and is often neglected by clinical physicians. The purpose of this study was to investigate the association of thyroid nodule calcification detected on ultrasound with thyroid carcinoma. METHODS: One hundred seven cases of thyroid carcinoma and 215 cases of benign thyroid nodules were selected from the records of inpatients of our hospital who had high-resolution ultrasonography preoperatively and pathologic diagnosis postoperatively between 2001 and 2004. The case numbers and percentage of calcification, fine stippled psammomatous (FSP), and non-FSP calcification in benign nodules and thyroid carcinoma, sex, and age groups (<45 years and >or=45 years) were retrospectively reviewed. Statistical analysis was performed using chi-square test and odds ratio. Sensitivity and specificity of calcification and FSP calcification on ultrasonography were also calculated. RESULTS: The incidence of calcification, non-FSP calcification, and FSP calcification were significantly higher in thyroid carcinoma than in the benign group (p < .001, p = .03, and p < .001, respectively). However, FSP calcification was more significant than the non-FSP calcification (p = .001) for predicting thyroid cancer. The incidence of non-FSP calcification and FSP calcification did not differ significantly between the sexes (p = .50 and p = .83, respectively). The relative risk of malignancy incidence was significantly higher in those younger than 45 years old with FSP calcification (p < .001). The incidence of non-FSP calcification was significantly higher in the older group (p = .03). The sensitivity of calcification and FSP calcification for the detection of malignancy was 63.55% and 24.30%, respectively; the specificity was 69.77% and 96.77%, respectively. CONCLUSIONS: The detection of calcification on ultrasonography should increase the clinical index of suspicion for thyroid carcinoma and alert the physician. FSP calcification is valuable and has a very high specificity for predicting thyroid carcinoma, particularly for those younger than 45 years old or with calcified regional lymph nodes. To increase the sensitivity for the diagnosis of thyroid carcinoma, tests such as fine-needle aspiration cytology should also be performed. The use of these modalities could result in earlier detection of thyroid carcinoma. The use of ultrasound to detect calcification and FSP calcification is as efficient as thyroid papillary macrocarcinoma in predicting microcarcinoma.