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Ductal carcinoma in situ

Tomohiro Hirano, Shuhei Suzuki, Keita Adachi, Hitomi Kubota, Yukiko Hara, Katsuhisa Enomoto, Ryouichi Tomita, Shigeru Fujisaki, Kenichi Sakurai
We report a case of a non-invasive ductal carcinoma revealed on long-term follow-up of spontaneous nipple discharge. The patient, a 36-year-old woman, had noticed spontaneous nipple discharge from both breasts over a 3-year period. Mammography and ultrasonography did not reveal any lesions in the breasts. The nipple discharge from her left breast stopped 36 months after initial clinical assessment. However, the nipple discharges from her right breast transformed into a bloody discharge from a single duct. Ultrasonography showed a tumor, 6mm in diameter, in the upper-outer quadrant of her right breast...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Bonny Parkinson, Kerry A Sherman, Paul Brown, Laura-Kate E Shaw, John Boyages, Linda D Cameron, Elisabeth Elder, Thomas Lam
OBJECTIVE: To report on the cost-effectiveness of BRECONDA (Breast RECONstruction Decision Aid), a web-based decision aid to facilitate decisions regarding breast reconstruction surgery, with usual care for women with breast cancer. METHODS: The economic evaluation was conducted alongside a randomized controlled trial. Women diagnosed with breast cancer or ductal carcinoma in situ and eligible for breast reconstruction following mastectomy were randomized to access BRECONDA for 6 months + usual care (n = 106) or usual care (n = 116) and were assessed at baseline preintervention, and then 1-month and 6-months post-randomization...
April 5, 2018: Psycho-oncology
Adam R Brentnall, Jack Cuzick, Diana S M Buist, Erin J Aiello Bowles
Importance: Accurate long-term breast cancer risk assessment for women attending routine screening could help reduce the disease burden and intervention-associated harms by personalizing screening recommendations and preventive interventions. Objective: To report the accuracy of risk assessment for breast cancer during a period of 19 years. Design, Setting, and Participants: This cohort study of the Kaiser Permanente Washington breast imaging registry included women without previous breast cancer, aged 40 to 73 years, who attended screening from January 1, 1996, through December 31, 2013...
April 5, 2018: JAMA Oncology
Madoka Iwase, Masataka Sawaki, Masaya Hattori, Akiyo Yoshimura, Junko Ishiguro, Haruru Kotani, Naomi Gondo, Yayoi Adachi, Ayumi Kataoka, Sakura Onishi, Kayoko Sugino, Hiroji Iwata
BACKGROUND: Enhanced magnetic resonance imaging (MRI) and ultrasonography (US) are used to assess residual lesions after preoperative chemotherapy before surgery. However, residual lesion assessments based on preoperative imaging often differ from postoperative pathologic diagnoses. We retrospectively reviewed the accuracy of preoperative residual lesion assessments, including ductal carcinoma in situ (DCIS) cases to find criteria for cases in which surgery can be omitted. METHODS: We reviewed 201 patients who received preoperative chemotherapy and surgery in our hospital from January 2013 to November 2016...
April 4, 2018: Breast Cancer: the Journal of the Japanese Breast Cancer Society
Javier Anchuelo Latorre, Piedad Galdós, Lucía Alonso Buznego, Ana García Blanco, Juan Cardenal, María Ferri, Iván Díaz de Cerio, Elisabet Arrojo, Nicolás Sierrasesúmaga, Mónica González Noriega, Ana De Juan Ferré, Rosa Fabregat, Samuel Ruíz, Pedro J Prada
Purpose: To evaluate the feasibility of acute and chronic toxicity in patients suitable for accelerated partial breast irradiation (APBI) in a single 18 Gy fraction with multicatheter high-dose-rate (HDR) brachytherapy, as well as cosmetic and oncological outcomes. Material and methods: Between September 2014 and March 2016, twenty consecutive patients with low-risk invasive and ductal carcinoma in situ were treated with interstitial multicatheter HDR brachytherapy in a single 18 Gy fraction...
February 2018: Journal of Contemporary Brachytherapy
Filip E F Thiessen, Wiebren A A Tjalma, Thierry Tondu
Conservative breast surgery followed by irradiation, often referred to as Breast conserving therapy (BCT), has replaced modified radical mastectomy for the treatment of early stage invasive breast cancer and ductal carcinoma in situ (DCIS). About 10% to 40% of the patients treated with BCT have poor cosmetic outcome results. Small tumours in large breasts can be successfully treated by lumpectomy and radiotherapy, with good cosmetic outcome. However when the tumour breast ratio is higher, the cosmetic outcome can be very disappointing...
March 27, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Lars J Grimm, Ashirbani Saha, Sujata V Ghate, Connie Kim, Mary Scott Soo, Sora C Yoon, Maciej A Mazurowski
RATIONALE AND OBJECTIVES: To determine if background parenchymal enhancement (BPE) on screening breast magnetic resonance imaging (MRI) in high-risk women correlates with future cancer. MATERIALS AND METHODS: All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013, were identified. Sixty-one patients who subsequently developed breast cancer were matched 1:2 by age and high-risk indication with patients who did not develop breast cancer (n = 122)...
March 27, 2018: Academic Radiology
Chenming Guo, Minggang Fu, Yilamu Dilimina, Sha Liu, Liying Guo
The present study aimed to determine whether the expression of microRNA (miR)-10b was correlated with the molecular subtypes of early invasive ductal carcinoma of the breast. In situ hybridization was used to detect the expression of miR-10b in 193 patients diagnosed with early invasive ductal carcinoma. Immunohistochemistry was performed to evaluate the expression of estrogen receptor (ER)-α, progesterone receptor (PR) and human epidermal growth factor receptor-2 (Her-2). The positive expression rate of miR-10b in patients with early invasive ductal carcinoma with ER-α (+) or PR (+) was decreased compared with ER-α (-) or PR (-) patients (P<0...
March 2018: Experimental and Therapeutic Medicine
San-Gang Wu, Wen-Wen Zhang, Jia-Yuan Sun, Zhen-Yu He
Background: The prognostic implication of concomitant ductal carcinoma in situ (DCIS) in invasive ductal carcinoma (IDC) remains controversial. Our objective was to investigate whether concomitant DCIS affects survival outcomes in patients with IDC. Materials and methods: Patients with nonmetastatic breast cancer who underwent surgery in 2010-2014 were included from the Surveillance, Epidemiology, and End Results program. Statistical analyses were conducted using χ 2 test, linear-by-linear association, one-way analysis of variance, Kaplan-Meier method, Cox proportional hazards regression model, and propensity score matching (PSM)...
2018: Cancer Management and Research
Ayesha Khan, Dorin Dumitru, Giuseppe Catanuto, Nicola Rocco, Maurizio B Nava, John Benson
Ductal carcinoma in situ (DCIS) has been the subject of much controversy since the advent of population based breast screening programmes. An increasing number of asymptomatic women are being diagnosed with this condition and there is uncertainty over the best treatment algorithm for this condition if treatment is to be considered at all. Different subtypes of DCIS show innate differences in developmental pathways and biological behaviour. This is not only determined by pathological subtypes but there is increasing understanding of molecular biomarkers related to DCIS progression...
March 28, 2018: Minerva Chirurgica
Mirna B Podoll, Emily S Reisenbichler, Lania Roland, Andrew Bruner, Sarah Mizuguchi, Mary Ann G Sanders
CONTEXT: - Ductal carcinoma in situ (DCIS) represents 20% of screen-detected breast cancers. The likelihood that certain types of DCIS are slow growing and may never progress to invasion suggests that our current standards of treating DCIS could result in overtreatment. The LORIS (LOw RISk DCIS) and LORD (LOw Risk DCIS) trials address these concerns by randomizing patients with low-risk DCIS to either active surveillance or conventional treatment. OBJECTIVE: - To determine the upgrade rate of DCIS diagnosed on core needle biopsy to invasive carcinoma at surgery and to evaluate the safety of managing low-risk DCIS with surveillance alone, by characterizing the pathologic and clinical features of upgraded cases and applying criteria of the LORD and LORIS trials to these cases...
March 27, 2018: Archives of Pathology & Laboratory Medicine
Hisashi Yoshimura, Yoko Matsuda, Masami Yamamoto, Masaki Michishita, Kimimasa Takahashi, Norihiko Sasaki, Naoshi Ishikawa, Junko Aida, Kaiyo Takubo, Tomio Arai, Toshiyuki Ishiwata
H19 is an oncofetal RNA expressed in the developing embryo as well as in bladder, breast, gastric, pancreatic, hepatocellular, and prostate cancers. Recent studies have shown that H19 enhances cancer invasion and metastasis; however, its roles in cancer remain controversial. In the current study, H19 exhibited the second largest increase (82.4-fold) and represented the only non-protein coding gene among 11 genes identified that were elevated over 10-fold in lung-metastasis-derived pancreatic cancer cells compared with their parental cells using a mouse metastatic model...
March 26, 2018: Laboratory Investigation; a Journal of Technical Methods and Pathology
Florin-Andrei Taran, Andreas Schneeweiss, Michael P Lux, Wolfgang Janni, Andreas D Hartkopf, Naiba Nabieva, Friedrich Overkamp, Hans-Christian Kolberg, Peyman Hadji, Hans Tesch, Achim Wöckel, Johannes Ettl, Diana Lüftner, Markus Wallwiener, Volkmar Müller, Matthias W Beckmann, Erik Belleville, Diethelm Wallwiener, Sara Y Brucker, Peter A Fasching, Tanja N Fehm, Florian Schütz
This summary provides an overview of how new therapies or new aspects of established therapies relate to the latest findings. Neoadjuvant therapy, local therapy, new aspects of systemic therapy, and prognostic and predictive factors are presented. In the neoadjuvant setting, the association between pathological complete response (pCR) and prognosis is still of interest as is the identification of new molecular predictors for new therapies such as CDK4/6 inhibitors. As regards surgical treatment, the target is still to reduce the aggressiveness of surgery...
March 2018: Geburtshilfe und Frauenheilkunde
Marzana Chowdhury, David Euhus, Banu Arun, Chris Umbricht, Swati Biswas, Pankaj Choudhary
PURPOSE: Women diagnosed with unilateral breast cancer are increasingly choosing to remove their other unaffected breast through contralateral prophylactic mastectomy (CPM) to reduce the risk of contralateral breast cancer (CBC). Yet a large proportion of CPMs are believed to be medically unnecessary. Thus, there is a pressing need to educate patients effectively on their CBC risk. We had earlier developed a CBC risk prediction model called CBCRisk based on eight personal risk factors...
March 24, 2018: Breast Cancer Research and Treatment
Faina Nakhlis
PURPOSE OF REVIEW: The aim of this review is to summarize recently published literature addressing atypical ductal hyperplasia (ADH), lobular neoplasia (atypical lobular hyperplasia [ALH] and classic lobular carcinoma in situ [C-LCIS]), non-classic lobular carcinoma in situ (NC-LCIS), papillary lesions, and flat epithelial atypia (FEA). RECENT FINDINGS: While ADH, ALN, and C-LCIS are well-established markers of an increased risk of future breast cancers, the risk implications are less clear for papillary lesions and FEA...
March 23, 2018: Current Oncology Reports
Bhavika K Patel, Matthew Covington, Victor J Pizzitola, Roxanne Lorans, Marina Giurescu, William Eversman, John Lewin
OBJECTIVE: As experience and aptitude in digital breast tomosynthesis (DBT) have increased, radiologists are seeing more areas of architectural distortion (AD) on DBT images compared with standard 2D mammograms. The purpose of this study is to report our experience using tomosynthesis-guided vacuum-assisted biopsies (VABs) for ADs that were occult at 2D mammography and ultrasound and to analyze the positive predictive value for malignancy. MATERIALS AND METHODS: We performed a retrospective review of 34 DBT-detected ADs that were occult at mammography and ultrasound...
March 23, 2018: AJR. American Journal of Roentgenology
Matthias Waldner, Holger J Klein, Walter Künzi, Merlin Guggenheim, Jan A Plock, Pietro Giovanoli
Objectives: Patients undergoing reduction mammoplasty (RM) bear the risk of having occult breast cancer nests. The detection rate of malignant neoplasms in the resected specimens, varies greatly in the literature. The aim of our present study was to analyze risk factors and evaluate histopathological findings in our cohort of patients who underwent RM towards our center. Material and methods: In this retrospective single center study we analyzed 559 female patients [median age 35...
2018: Frontiers in Surgery
Fawz Kazzazi, Rosanna C Ching, Charles M Malata
Introduction: Thin women have fewer autologous tissue breast reconstructive options than their higher body mass index counterparts-due to a lack of adequate donor sites. They are therefore usually offered expander/implant techniques. The total autologous latissimus dorsi flap is generally used in "well-padded" individuals, as they have enough fat on their back on which a completely autologous reconstruction could be based. When implant-based reconstruction is contraindicated (for instance due to planned adjuvant radiotherapy) or unacceptable to the patient, the total autologous latissimus dorsi flap can provide adequate tissue volume by utilizing the additional back fat deposits even in the thin, small-breasted patient...
2018: Eplasty
Leah A Commander, David W Ollila, Siobhan M O'Connor, Johann D Hertel, Benjamin C Calhoun
Benign cystic epithelial inclusions with squamous, glandular, or Müllerian phenotypes are known to occur in the axillary lymph nodes of patients with benign and malignant breast disease. Careful evaluation of hematoxylin and eosin-stained slides and correlation with the histologic findings in the ipsilateral breast are paramount in evaluation of suspected benign inclusions. In this case of ductal carcinoma in situ (DCIS) of the breast in a 73-year-old woman, DCIS also involved epithelial inclusions in an ipsilateral axillary lymph node...
March 1, 2018: International Journal of Surgical Pathology
Michael S Toss, I Miligy, Abdubaqi Al-Kawaz, Mansour Alsleem, Hazem Khout, Padmashree C Rida, Ritu Aneja, Andrew R Green, Ian O Ellis, Emad A Rakha
Tumor-infiltrating lymphocytes (TILs) provide prognostic value in invasive breast cancer and guidelines for their assessment have been published. This study aims to evaluate: (a) methods of TILs assessment, and (b) their prognostic significance in breast ductal carcinoma in situ (DCIS). Hematoxylin and eosin sections from two clinically annotated DCIS cohorts; a training set (n = 150 pure DCIS) and a validation set (n = 666 comprising 534 pure DCIS and 132 cases wherein DCIS and invasive breast carcinoma were co-existent) were assessed...
March 20, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
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