scholarly journals Papillary Neoplasm of Breast-Changing Trends in Diagnosis and Management

2021 ◽  
Author(s):  
Amrit Pal Singh Rana ◽  
Manjit Kaur Rana
Keyword(s):  
Invasive Carcinoma ◽  
Treatment Guidelines ◽  
Nipple Discharge ◽  
Diagnostic Technique ◽  
Surgical Excision ◽  
Bloody Nipple Discharge ◽  
Non Invasive ◽  
In Situ Carcinoma ◽  
Papillary Neoplasm

Papillary neoplasm of breast comprises of seven separate heterogeneous entities ranging from benign, atypical and malignancy including non-invasive and invasive carcinoma. Papillary carcinoma (PC) is seen more commonly in older postmenopausal women with favorable prognosis. PC breast typically presents with bloody nipple discharge and an abnormal mass with radiologic features of intraductal mass. Encapsulated PC and solid PC is to be treated as in situ carcinoma, but distinction of invasive PC from non invasive carcinoma is critical both at microscopic and molecular level. So, surgical excision should be the choice of definitive diagnostic technique in papillary neoplasm instead of core needle biopsy. Furthermore, treatment guidelines for invasive PC also have been framed, but incidence of recurrence and death attributable to various subtypes of carcinoma remained same. So, this is important topic to be addressed to understand the need for further management and outcome of the disease.

Solid Papillary Carcinoma of the Breast: A Pathologically and Clinically Distinct Breast Tumor

2012 ◽  
Vol 136 (10) ◽  
pp. 1308-1311 ◽  
Author(s):  
Jinous Saremian ◽  
Marilin Rosa
Keyword(s):  
Invasive Carcinoma ◽  
Nipple Discharge ◽  
Surgical Excision ◽  
Myoepithelial Cells ◽  
Low Grade ◽  
True Nature ◽  
Bloody Nipple Discharge ◽  
Ductal Cells ◽  
Malignant Lesions

Solid papillary carcinomas are tumors morphologically characterized by round, well-defined nodules composed of low-grade ductal cells separated by fibrovascular cores. These tumors are rare and affect predominantly older women. Although they are considered in situ carcinomas, debate and uncertainty still exist regarding their true nature, because immunohistochemistry for myoepithelial cells has shown absence of myoepithelial cell layer along the epithelial-stromal interface of the tumor in many cases. Clinically, these tumors present as a palpable, centrally located mass or as bloody nipple discharge. Pathologically, solid papillary carcinomas exhibit low-grade features, and often the tumors display neuroendocrine and mucinous differentiation. In the majority of cases an associated invasive carcinoma is present, with colloid and neuroendocrine carcinomas being the most common. The pathologic differential diagnosis is broad and ranges from benign to malignant lesions. The treatment for solid papillary carcinomas is surgical excision. When invasive carcinoma is not present, the prognosis is excellent.

Role of Ag NORs in Improve Diagnosis of Breast Cancer with Different grades and Subtypes’ among Sudanese women

2021 ◽  
Vol 1 (4) ◽  
pp. 443-448
Author(s):  
Doaa Ibrahim Ahmed
Keyword(s):  
Breast Cancer ◽  
Invasive Carcinoma ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Age Group ◽  
Lobular Carcinoma In Situ ◽  
Tissue Sections ◽  
In Situ Carcinoma

This study aimed to evaluate the role of Ag NORs in improves diagnosis of Breast cancer with different subtypes’ among Sudanese Patients. This study include tissue sections of breast cancer diagnosed women, they were 30, ductal and lobular invasive carcinoma were 10 for each, while ductal and lobular in-situ carcinoma were 5 each. Found correlation between subtypes of breast cancer and Ag NOR , Invasive ductal carcinoma had more NOR while the lobular carcinoma in situ was less one , Stage III most frequency than the other stage. Silver staining were performed and Ag-NOR were detected in ductal and lobular invasive carcinoma more than ductal and lobular in-situ carcinoma, grade III has more frequency of Ag-NOR than other stages, and no correlation found between Ag-NOR and age group

scholarly journals Breast MRI in Patients with Unilateral Bloody and Serous-Bloody Nipple Discharge: A Comparison with Galactography

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Lucia Manganaro ◽  
Ilaria D’Ambrosio ◽  
Silvia Gigli ◽  
Francesca Di Pastena ◽  
Guglielmo Giraldi ◽  
...  
Keyword(s):  
Nipple Discharge ◽  
Breast Mri ◽  
Bloody Nipple Discharge ◽  
Ductal Cancer ◽  
Malignant Lesions ◽  
Mass Enhancement ◽  
Higher Sensitivity

Purpose. Assessing the role of breast MRI compared to galactography in patients with unilateral bloody or serous-bloody nipple discharge.Materials and Methods. Retrospective study including 53 unilateral discharge patients who performed galactography and MRI. We evaluated the capability of both techniques in identifying pathology and distinguishing between nonmalignant and malignant lesions. Lesions BIRADS 1/2 underwent follow-up, while the histological examination after surgery has been the gold standard to assess pathology in lesions BIRADS 3/4/5. The ROC analysis was used to test diagnostic MRI and galactography ability.Results. After surgery and follow-up, 8 patients had no disease (15%), 23 papilloma (43%), 11 papillomatosis (21%), 5 ductal cancer in situ (10%), and 6 papillary carcinoma (11%) diagnoses. Both techniques presented 100% specificity; MRI sensitivity was 98% versus 49% of galactography. Considering MRI, we found a statistical association between mass enhancement and papilloma (P<0.001; AUC 0.957; CI 0.888–1.025), ductal enhancement and papillomatosis (P<0.001; AUC 0.790; CI 0.623–0.958), segmental enhancement and ductal cancer in situ (P=0.007; AUC 0.750; CI 0.429–1.071), and linear enhancement and papillary cancer (P=0.011).Conclusions. MRI is a valid tool to detect ductal pathologies in patients with suspicious bloody or serous-bloody discharge showing higher sensitivity and specificity compared to galactography.

The Role of Galactography in the Detection of Breast Cancer

1988 ◽  
Vol 74 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Stefano Ciatto ◽  
Patrizia Bravetti ◽  
Daniela Berni ◽  
Sandra Catarzi ◽  
Simonetta Bianchi
Keyword(s):  
Breast Cancer ◽  
Physical Examination ◽  
Benign Lesion ◽  
Nipple Discharge ◽  
Surgical Excision ◽  
Histologic Examination ◽  
Breast Cancers ◽  
Bloody Nipple Discharge ◽  
Low Incidence

The authors report on a series of 529 consecutive patients examined on physical examination, mammography, nipple discharge cytology and galactography. The criterion for galactography was essentially bloody nipple discharge (73% of cases). Serous nipple discharge was not considered worthy of routine galactography since it is associated with an extremely low incidence of breast cancer. Surgical excision and histologic examination of the discharging duct was performed in 200 cases. Eighteen cases of breast cancer were detected (10 infiltrating, 8 intraductal) of which 9, 6, 7 or 7 were suspected on physical examination, mammography, cytology or galactography, respectively. All combined tests suspected 13 of 18 breast cancers; 3 intraductal breast cancers were biopsied because of evidence of multiple papillomas on galactography, and 2 infiltrating breast cancers were operated because of persistent bloody nipple discharge in the absence of any other sign. No breast cancer was suspected on galactography alone. Galactography is indicated in the presence of bloody nipple discharge, and a biopsy should be performed when breast cancer or multiple papillomas are suspected. The diagnosis and excision of a single papilloma (breast cancer was never misdiagnosed as a single papilloma on galactography) is not worthwhile since a single papilloma is a benign lesion, and the benefit of its excision is still unclear.

Microglandular Adenosis: A Possible Non-Obligate Precursor to Breast Carcinoma With Potential to Either Luminal-Type or Basal-Type Differentiation

2019 ◽  
Vol 27 (7) ◽  
pp. 781-787 ◽  
Author(s):  
Alexander T. Damron ◽  
Katrina Korhonen ◽  
Samantha Zuckerman ◽  
Julia Tchou ◽  
Kimberly L. Dumoff ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Invasive Carcinoma ◽  
Case Reports ◽  
Unique Case ◽  
Diagnostic Pitfall ◽  
In Situ Carcinoma ◽  
Luminal Type ◽  
Basal Type ◽  
Microglandular Adenosis

Microglandular adenosis (MGA) of the breast is exceedingly rare, with only a few case reports and series published to date. Previous studies have elegantly demonstrated the progression of benign MGA to atypical MGA to MGA-in situ carcinoma to invasive carcinoma and therefore suggest MGA as a possible non-obligate precursor lesion to a subset of breast carcinomas. Immunohistochemically, MGA is negative for estrogen receptor (ER), progesterone receptor (PR), and HER2-neu oncoprotein expression, and carcinomas arising in the setting of MGA are often reported to be triple negative. In this article, we present a unique case of an ER+/PR+/HER2− invasive carcinoma associated with MGA and atypical MGA. Our case highlights the diagnostic pitfall of MGA and suggests that MGA is a heterogeneous group of lesions with potential for either luminal-type or basal-type differentiation during progression to breast carcinoma.

scholarly journals Therapeutic mammotome excisions: radial scars

2008 ◽  
Vol 11 (3) ◽  
Author(s):  
J. Morel ◽  
M. J. Michell
Keyword(s):  
Core Biopsy ◽  
Invasive Carcinoma ◽  
Surgical Excision ◽  
Tissue Sampling ◽  
Non Invasive ◽  
Associated Lesions ◽  
Risk Of Malignancy ◽  
Associated Malignancy

AbstractBenign radial scars, lesions characterised histologically by a fibroelastic core surrounded by stellate duct proliferation, cannot be differentiated from lesions with associated invasive or non-invasive carcinoma on imaging, and histological sampling is therefore mandatory. There is also extensive evidence of the frequency with which radial scars are associated with malignancy and with other lesions that have an associated risk of malignancy. The traditionally accepted management has been the surgical excision of all suspected radial scars because insufficient tissue was removed by standard biopsy techniques to exclude associated lesions. In more recent series, it has been shown that with extensive tissue sampling of such lesions with core biopsy and modern vacuum-assisted sampling devices, the presence of associated malignancy can be excluded, thus negating the need for surgical excision.

Radiation-Associated Primary Osteosarcoma of the Breast

Pathobiology ◽  
2020 ◽  
Vol 87 (5) ◽  
pp. 322-326
Author(s):  
Helen Bartlett ◽  
Maiar Elghobashy ◽  
Nayneeta Deshmukh ◽  
Rashmi Rao ◽  
Abeer M. Shaaban
Keyword(s):  
Ductal Carcinoma ◽  
Surgical Excision ◽  
Metaplastic Carcinoma ◽  
Post Irradiation ◽  
In Situ Carcinoma ◽  
Complete Surgical Excision ◽  
Spindle Cell Lesion ◽  
Phyllodes Tumour

<b><i>Introduction:</i></b> Non-epithelial primary mammary osteosarcomas are extremely rare. The differentials include metaplastic carcinoma and malignant phyllodes tumour. This is the first published case of primary breast osteosarcoma arising after local radiotherapy. <b><i>Case Presentation:</i></b> A 73-year-old female presented with a right-sided breast lump. The same breast had been irradiated 11 years previously for invasive ductal carcinoma. Diagnostic excision revealed a highly cellular, malignant spindle-cell lesion merged with an osteoid matrix and foci of calcification and bone formation. Immunohistochemistry and molecular studies showed no lines of differentiation. Due to the lack of epithelial/glandular differentiation, in situ carcinoma or leaf-like pattern, the diagnosis of post-irradiation osteosarcoma was made. She underwent mastectomy and is disease-free at 8 months of follow-up. <b><i>Conclusion:</i></b> Post-irradiation osteosarcoma should be considered in the differential diagnosis of breast lesions showing malignant osteoid. Extensive sampling and careful search for epithelial differentiation is required to guide management. Complete surgical excision is recommended.

scholarly journals In situ carcinoma of the conjunctiva: surgical excision associated with cryotherapy

2013 ◽  
pp. 1889
Author(s):  
Julio Urrets-Zavalía ◽  
María Elena Forniés Paz ◽  
Rodolfo Monti ◽  
Evangelina Espósito ◽  
Juan Pablo Maccio ◽  
...  
Keyword(s):  
Surgical Excision ◽  
In Situ Carcinoma
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