scholarly journals Prognostic Significance of Ki-67 and p53 Immunoexpression in Breast Carcinoma Patients with Positive Axillary Lymph Nodes

2019 ◽  
Vol 6 (10) ◽  
pp. A487-495
Author(s):  
Lalit Sharma ◽  
◽  
Kafil Akhtar ◽  
Syed Shamshad Ahmad ◽  
Atia Zakaur Rab ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Prognostic Significance ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ki 67

scholarly journals Atypical axillary lymphadenopathy mimicking an occult breast carcinoma in a patient diagnosed with sarcoidosis: case report

Mastology ◽  
2020 ◽  
Vol 30 (Suppl 1) ◽  
Author(s):  
Paula Clarke ◽  
Carolina Nazareth Valadares ◽  
Douglas de Miranda Pires ◽  
Nayara Carvalho de Sá
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Breast Lesions ◽  
Axillary Lymph ◽  
Axillary Lymphadenopathy ◽  
Granulomatous Lymphadenitis ◽  
Occult Breast Carcinoma

Introduction: Occult breast carcinoma is a rare presentation of breast cancer, with histological evidence of axillary lymph node involvement and clinical and radiological absence of malignant breast lesions. Its survival is similar to that of the usual presentation. The treatment consists of modified radical mastectomy or axillary drainage with breast irradiation, resulting in similar survival, associated with systemic therapy according to the staging. Neoadjuvant therapy should be considered in N2-3 axillary cases. Differential diagnoses of axillary lymphadenopathies include: non-granulomatous causes (reactive, lymphoma, metastatic carcinoma) and granulomatous causes (infectious – toxoplasmosis, tuberculosis, sarcoidosis, atypical mycobacteria). Objectives: To report the case of a patient who needed a differential diagnosis among the various causes of axillary lymphadenopathy. Methods: This is a literature review conducted in the PubMed database, using the keywords "granulomatous lymphadenitis", "breast sarcoidosis", "occult breast cancer". Inclusion and exclusion criteria were applied. Case report: V.F.S., female, 51 years old, was referred to an evaluation of axillary lymphadenopathy in May 2019. She was followed by the department of pulmonology due to mediastinal sarcoidosis since 2017. Physical examination indicated breasts without changes. Axillary lymph nodes had increased volume and were mobile and fibroelastic. Mammography revealed only axillary lymph nodes with bilaterally increased density, and the ultrasound showed the presence of atypical bilateral lymph nodes. Neither presented breast lesions. Axillary lymph node core biopsy was compatible with granulomatous lymphadenitis. This result corroborates the diagnosis of sarcoidosis affecting peripheral lymph nodes. The patient was referred back to the department of pulmonology, with no specific treatment since she is oligosymptomatic. Discussion: Despite the context of benign granulomatous disease, malignancy overlying the condition of sarcoidosis must be ruled out. The biopsy provided a safe and definitive diagnosis, excluding the possibility of occult breast carcinoma. The patient will continue to undergo breast cancer screening as indicated for her age and usual risk. Conclusion: In the presentation of axillary lymphadenopathy, the mastologist must know the various diagnoses to be considered. The most feared include lymphoma and carcinoma metastasis with occult primary site. A proper workup can determine the diagnosis and guide the appropriate treatment.

Prognostic significance of occult lymph node metastases in breast cancer: a meta-analysis

2021 ◽  
Author(s):  
Guixin Wang ◽  
Shuhao Zhang ◽  
Meiling Wang ◽  
Lin Liu ◽  
Yaqian Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Nodes ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Occult Metastases ◽  
Node Metastases ◽  
Disease Free

Abstract Background: Occult metastases in axillary lymph nodes have been reported to be associated with poor prognosis in patients with breast cancer. However, studies on the prognostic value of occult metastases remain controversial. This meta-analysis aimed to evaluate the prognostic significance of occult lymph node metastases in breast cancer.Methods: Studies published published until May, 2020, which retrospectively examined negative lymph nodes by step sectioning and/or immunohistochemistry, were retrieved from MEDLINE, EMBASE, CNKI, and Cochrane Library. The pooled Relative risk (RR) with 95% confidence interval (95% CI) for overall survival (OS) and disease-free survival (DFS) were calculated to appraise the associations between occult metastases and prognosis.Results: The results showed patients with occult metastases in axillary lymph nodes had poorer five-year DFS (RR = 0.930; 95% CI = 0.907–0.954) and OS (RR = 0.972; 95% CI = 0.954–0.990). Furthermore, the DFS (RR = 0.887; 95% CI = 0.810–0.972) and OS (RR = 0.896; 95% CI = 0.856–0.939) of patients with occult metastases were much lower after a ten-year follow-up.Conclusions: Occult metastases in the axillary lymph nodes of patients with breast cancer are associated with poorer disease-free and overall survival. Occult metastases might serve as a predictive factor of survival outcomes in patients with breast cancer.

The axillary lymph nodes in breast carcinoma

2014 ◽  
Vol 34 (2) ◽  
pp. 125-129
Author(s):  
Tarek N. El-Bolkainy ◽  
Omnia M. Badawy ◽  
Samir A. Shawky ◽  
Mohamed N. El- Bolkainy ◽  
Medhat M. Khafagy
Keyword(s):  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph

Role of Contrast-Enhanced Sonography in the Evaluation of Axillary Lymph Nodes in Breast Carcinoma: A Monocentric Study

2017 ◽  
Vol 36 (3) ◽  
pp. 505-511 ◽  
Author(s):  
Giacomo Agliata ◽  
Gianluca Valeri ◽  
Giulio Argalia ◽  
Elisa Tarabelli ◽  
Gian Marco Giuseppetti
Keyword(s):  
Breast Carcinoma ◽  
Lymph Nodes ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Contrast Enhanced

Positron emission tomography/computed tomography (PET/CT) as a biomarker of pathologic response to neoadjuvant chemotherapy in breast carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21147-e21147
Author(s):  
Catherine M. Kelly ◽  
Clare Smith ◽  
Susan Conlon ◽  
Reem Salman ◽  
John McCaffrey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Breast Cancer Subtype ◽  
Standardized Uptake Value ◽  
Predictive Biomarkers ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Pet Ct

e21147 Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast carcinoma is prognostic. Predictive biomarkers for pCR include early response to NAC, estrogen receptor (ER) negativity, HER2 positivity, and high Ki67. We assessed whether absence of fluoro-deoxy glucose (FDG) uptake measured by standardized uptake value (SUV) after NAC would predict pCR. Methods: We identified 23 patients (pts) who had PET/CT scanning pre and post NAC. We examined breast cancer subtype, chemotherapy (CT) regimen, number of cycles of CT given, clinical and pathological staging data and changes in SUV in the breasts and lymph nodes pre and post NAC. pCR was defined as no residual cancer in the breast or axillary lymph nodes. Results: Median age at diagnosis was 46 years (IQR; 37 to 56). Median tumor size at diagnosis was 30mm (IQR; 25 to 43) and 19 pts (83%) had node positive breast cancer. Most tumors were ductal (n=22) with 1 lobular cancer. Preoperatively 95% received all CT. All HER2+ pts received Trastuzumab. Anthracycline/taxane based regimens were most frequently given in 22 cases, 1 received lapatinib/trastuzumab. Five tumors (21.7%) were ER+/HER2+; 14 (60.9%) ER+/HER2-; 2 (8.7%) ER-/HER2+ and 2 (8.7%) were ER-/HER2-. All tumors were high (n=9, 39.1%) or intermediate grade (n=14, 61%). SUV was significantly lower post NAC (p=0.035). We observed no SUV uptake in breast or lymph nodes in 15 cases (65.2%) post NAC, these corresponded to; ER+HER2+ 4/5 (80%); ER+HER2- 7/15 (46.7%); ER-HER2- 2/2(100%), ER-HER2+ 2/2(100%). Absent SUV uptake post NAC was associated with a pCR (breast and lymph nodes) in 5/15 (33%) of pts (ER+HER2+ n=1, ER+HER2- n=1, ER-HER2- n=2, ER-HER2+ n=1). Ten of 15 tumors (67%) had no SUV uptake in the breast post NAC and 7 (47%) were associated with a pCR. There was a trend toward increased odds of pCR with no SUV uptake post NAC (OR 2.76; 95% CI 0.85 to 8.94: P= 0.09). Overall rate of pCR was 21.7% (n=5). Conclusions: A non-statistically significant trend toward increased odds of pCR with no SUV uptake post NAC was observed. Larger subtype-specific breast cancer cohorts will be required to determine the value of PET/CT as a predictive biomarker for pCR.

scholarly journals The Simian Immunodeficiency Virus Δnef Vaccine, after Application to the Tonsils of Rhesus Macaques, Replicates Primarily within CD4+ T Cells and Elicits a Local Perforin-Positive CD8+ T-Cell Response

2002 ◽  
Vol 76 (2) ◽  
pp. 688-696 ◽  
Author(s):  
Christiane Stahl-Hennig ◽  
Ralph M. Steinman ◽  
Peter Ten Haaft ◽  
Klaus Überla ◽  
Nicole Stolte ◽  
...  
Keyword(s):  
Cell Cycle ◽  
T Cells ◽  
Lymph Nodes ◽  
Cell Response ◽  
Rhesus Macaques ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Ki 67 ◽  
Immunodeficiency Virus ◽  
Infected Cells

ABSTRACT Deletion of the nef gene from simian immunodeficiency virus (SIV) strain SIVmac239 yields a virus that undergoes attenuated growth in rhesus macaques and offers substantial protection against a subsequent challenge with some SIV wild-type viruses. We used a recently described model to identify sites in which the SIVΔnef vaccine strain replicates and elicits immunity in vivo. A high dose of SIVΔnef was applied to the palatine and lingual tonsils, where it replicated vigorously in this portal of entry at 7 days. Within 2 weeks, the virus had spread and was replicating actively in axillary lymph nodes, primarily in extrafollicular T-cell-rich regions but also in germinal centers. At this time, large numbers of perforin-positive cells, both CD8+ T cells and CD3-negative presumptive natural killer cells, were found in the tonsil and axillary lymph nodes. The number of infected cells and perforin-positive cells then fell. When autopsy studies were carried out at 26 weeks, only 1 to 3 cells hybridized for viral RNA per section of lymphoid tissue. Nevertheless, infected cells were detected chronically in most lymphoid organs, where the titers of infectious virus could exceed by a log or more the titers in blood. Immunocytochemical labeling at the early active stages of infection showed that cells expressing SIVΔnef RNA were CD4+ T lymphocytes. A majority of infected cells were not in the active cell cycle, since 60 to 70% of the RNA-positive cells in tissue sections lacked the Ki-67 cell cycle antigen, and both Ki-67-positive and -negative cells had similar grain counts for viral RNA. Macrophages and dendritic cells, identified with a panel of monoclonal antibodies to these cells, were rarely infected. We conclude that the attenuated growth and protection observed with the SIVΔnef vaccine strain does not require that the virus shift its characteristic site of replication, the CD4+ T lymphocyte. In fact, this immunodeficiency virus can replicate actively in CD4+ T cells prior to being contained by the host, at least in part by a strong killer cell response that is generated acutely in the infected lymph nodes.

Sign in / Sign up

Export Citation Format

Share Document