fibrocystic breast disease

UNLABELLED Frozen section examination is aimed at making a preoperative diagnosis, determining the benign or malignant nature of a breast lesion, but also the most suitable surgical procedure. The sensitivity and specificity of this method and the causes of discrepancies were analyzed in a retrospective study of 2 177 breast lesions. METHOD 1,150 frozen sections from 2,177 breast lesions were performed in the interval 1999-2005. The sections made at the open door cryostat and measuring 5 microm were stained with rapid Hematoxylin-Eosin. The following terms were used for describing the intraoperative diagnosis: negative, positive, and await paraffin section. After the frozen section diagnosis was made, the frozen tissue was thawed to room temperature and fixed in formalin overnight for further paraffin processing. The remaining unfrozen tissue was processed into a paraffin section. RESULTS The number of cases and the number of frozen sections increased from 1999 (341 cases, 87 frozen...

As part of an IACUC-approved study on therapeutic modalities for intervertebral disc degeneration, a principal investigator acquired 24 adult female New Zealand white rabbits from a commercial vendor in May 2008. We housed the rabbits in an AAALAC-accredited animal facility following the recommendations of the Guide for the Care and Use of Laboratory Animals1 and the Animal Welfare Act2. An automated monitoring system controlled ventilation and maintained temperature at 19 ± 3 °C, humidity at 35–55% and air change rate at 15 air changes per h. Illumination was also automatically controlled, and the rabbits were maintained on a light:dark cycle of 12 h:12 h. We limit-fed the rabbits 150 g of Global Hi Fiber Rabbit Diet per day and provided them with reverse osmosis drinking water ad libitum using an automatic watering and valve system. The intervertebral disc degeneration study required each rabbit to undergo an initial surgical procedure to create disc degeneration in two noncontiguous discs using a lateral retroperitoneal approach. Twelve weeks later, a second surgery was done to provide the experimental treatments. Lateral radiographs of the spine were taken before and immediately after surgery and then at 2-week intervals until completion of the study at 24 weeks. Radiography was done on rabbits sedated with ketamine and acepromazine. At the end of the study, the rabbits were to be euthanized. During one of the post-operative radiography sessions (week 12), one female rabbit was observed to have diffusely swollen mammary glands, particularly the left second mammary gland. Upon palpation, we could express a milky yellow fluid. The mammary glands were not painful, and there were no other clinical signs—the animal was eating, drinking and behaving normally. We monitored the rabbit for any changes that would signal systemic illness. Our primary differential diagnosis at the time was mammary gland development due to false pregnancy. Because false pregnancy typically resolves uneventfully after 16–18 days, we did not treat the rabbit with any medications. About one month later (week 16), the left second mammary gland was flat but nodular and a brownish-red discharge could be expressed from the nipple. The rabbit was still clinically unremarkable: attitude, appetite and activity level were normal, and on palpation of the affected mammary gland, there was no evidence of pain. Cytologic examination of the discharge showed low cellularity. Two weeks later (week 18), the nipple was enlarged and dark purple (Fig. 1). A discharge could be elicited upon palpation. We gave the rabbit a trimethoprim-sulfa antibiotic and meloxicam for pain. The nipple returned to its normal color and size within two weeks, and we discontinued treatment. One month later (week 20), the nipple was again enlarged and discolored. There had been no change in the animal’s attitude, appetite or activity level, and there were no signs of pain associated with palpation of the mammary glands. We continued to observe the rabbit but did not administer any medications. Euthanasia as per protocol was carried out one month later (week 24). Before euthanizing the rabbit, we drew blood for a complete blood count and

PURPOSE To investigate the general applicability and interobserver variability of ultrasonographic (US) features in differentiating benign from malignant solid breast masses. MATERIALS AND METHODS One hundred sixty-two consecutive solid masses with a tissue diagnosis were reviewed. Three radiologists reviewed the masses without knowledge of clinical history or histologic examination results. RESULTS US features that most reliably characterize masses as benign were a round or oval shape (67 of 71 [94%] were benign), circumscribed margins (95 of 104 [91%] were benign), and a width-to-anteroposterior (AP) dimension ratio greater than 1.4 (82 of 92 [89%] were benign). Features that characterize masses as malignant included irregular shape (19 of 31 [61%] were malignant), microlobulated (four of six [67%] were malignant) or spiculated (two of three [67%] were malignant) margins, and width-to-AP dimension ratio of 1.4 or less (28 of 70 [40%] were malignant). If the three most reliable cri...

A multiwavelength, high bandwidth (1 GHz) frequency–domain photon migration (FDPM) instrument has been developed for quantitative, non–invasive measurements of tissue optical and physiological properties. The instrument produces 300 kHz to 1 GHz photon density waves (PDWs) in optically turbid media using a network analyser, an avalanche photodiode detector and four amplitude–modulated diode lasers (674 nm, 811 nm, 849 nm and 956 nm). The frequency–dependence of PDW phase and amplitude is measured and compared to analytically derived model functions in order to calculate absorption, μ a , and reduced scattering, μ ′ s , parameters. The wavelength–dependence of absorption is used to determine tissue haemoglobin concentration (total, oxy– and deoxy– forms), oxygen saturation and water concentration. We present preliminary results of non–invasive FDPM measurements obtained from normal and tumour–containing human breast tissue. Our data clearly demonstrate that physiological changes caus...

Some fibroepithelial lesions (FEL) of the breast are difficult to classify as cellular fibroadenoma (CFA) or benign phyllodes tumor (BPT) due to overlapping histologic features. This indeterminate group is histologically characterized by prominent stromal cellularity, mild atypia, and mitotic activity. The local recurrence potential of cellular FEL (CFEL) has been insufficiently studied. The objective of this study was to evaluate the histologic features, characterize the long-term follow-up and recurrence rate of CFEL, and compare this data with the recurrence rate of definitive BPT. Ninety CFEL that were <4 cm were recovered from the benign breast disease cohort. The control group comprised of 10 randomly selected patients with BPT. Cases were classified based on a combination of mitotic activity, intracanalicular growth, stromal atypia, stromal prominence, and fat infiltration. None of the CFEL was widely excised. Of the 90 CFEL cases, there were 22 BPT-like, 35 CFA, and 33 in...

Background/Aim. Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant. The aim of this study was to assess the role of sonography in the diagnosis of palpable breast masses according to the American College of Radiology Ultrasonographic Breast Imaging Reporting and Data System (BI-RADS) and to correlate the BI-RADS 4 and BI-RADS 5 category with pathohistological findings. Methods. A retrospective study was conducted with the breast sonograms of 30 women presented with palpable breast masses found to be mammography category BI-RADS 0 and ultrasonographic BI-RADS categories 4 and 5. The sonographic categories were correlated with pathohistological findings. Results. Surgical biopsy in 30 masses revealed: malignancy (56.7%), fibroadenoma (26.7%), fibrocystic dysplasia with/without atypia (10%), lipoma (3.3%) and intramammar...

The National Public Health Program has established the organized mammography screening in Hungary. The aim of this study was to conduct an audit of “gray zone” smears of the organized mammography screening in comparison with histopathological diagnoses. Methods: Cytology results were rated to C3 atypia probably benign and C4 suspicious of malignancy. Results: 1361 women had aspiration cytology performed from a total of 47,718 mammography non-negative lesions. 105 (7.8%) were diagnosed as C3, whereas 78 (5.7) as C4. Of the 105 patients with C3 diagnosis 61 (58%) patients underwent surgical biopsy. Histology proved malignancy in 20 (32.8%) cases, and benign lesion in 41 (67.2%) cases. All (100%) of the 78 patients with C4 diagnosis had open biopsies; 69 (88.4%) cases were histologically malignant and 9 (11.6%) cases were benign lesions. Conclusion: The auditing results of fine needle aspiration cytology of “gray zone” in organized mammography screening meet the proposed threshold valu...

Iodine deficiency is generally recognized as the most commonly preventable cause of mental retardation and the most common cause of endocrinopathy (goiter and primary hypothyroidism). Iodine deficiency becomes particularly critical in pregnancy due to the consequences for neurological damage during fetal development as well as during lactation. The safety of therapeutic doses of iodine above the established safe upper limit of 1 mg is evident in the lack of toxicity in the Japanese population that consumes 25 times the median intake of iodine consumption in the United States. Japan's population suffers no demonstrable increased incidence of autoimmune thyroiditis or hypothyroidism. Studies using 3.0- to 6.0-mg doses to effectively treat fibrocystic breast disease may reveal an important role for iodine in maintaining normal breast tissue architecture and function. Iodine may also have important antioxidant functions in breast tissue and other tissues that concentrate iodine via ...

After literature reports linking fibrocystic breast disease (FBD) to methylxanthine ingestion, a pilot study was undertaken to investigate the possible contribution of theophylline to this effect. The major goal of this project was to measure the effect of theophylline therapy on FBD in asthmatic women. All women attending an allergy clinic or an obstetrics/gynecology clinic over a 9-month period were examined to clinically assess FBD and were asked to complete a detailed questionnaire covering health history, other risk factors, and drug and dietary methylxanthines. The sample included 62 asthmatic women, 66 allergic but not asthmatic women, and 72 nonallergic and nonasthmatic women. By use of the FBD clinical taxonomy with its 19-point scale going from 0 to 18 that was developed for this study, the three groups did not differ significantly in terms of mean severity of FBD. On analyzing the effect of each of the methylxanthines on FBD severity, there is clear evidence that total methylxanthines was a contributing factor in FBD severity with or without adjustment for relevant variables, such as age, menopause, pregnancies, and groups. Theophylline was significant only when adjustments were made for age, pregnancy, and menopause in contrast to caffeine that was only significant with no adjustments.

The hedgehog signaling network regulates pattern formation, proliferation,cell fate and stem/progenitor cell self-renewal in many organs. Altered hedgehog signaling is implicated in 20-25% of all cancers, including breast cancer. We demonstrated previously that heterozygous disruption of the gene encoding the patched-1 (PTCH1) hedgehog receptor, a negative regulator of smoothened (Smo) in the absence of ligand, led to mammary ductal dysplasia in virgin mice. We now show that expression of activated human SMO(SmoM2) under the mouse mammary tumor virus (MMTV) promoter in transgenic mice leads to increased proliferation, altered differentiation, and ductal dysplasias distinct from those caused by Ptch1 heterozygosity. SMO activation also increased the mammosphere-forming efficiency of primary mammary epithelial cells. However, limiting-dilution transplantation showed a decrease in the frequency of regenerative stem cells in MMTV-SmoM2epithelium relative to wild type, suggesting enhance...

Carcinoma of the breast is the second most frequent tumour in African females. Breast carcinomas in African females appear about a decade earlier and follow a more aggressive clinical course than those in developed countries. To elucidate this difference we investigated 63 ...

On the past decade a plethora of investigations were directed on identification of molecules involved in breast tumorogenesis, which could represent a powerful tool for monitoring, diagnostics and treatment of this disease. In current study we analyzed six previously identified medullary breast carcinoma autoantigens including LGALS3BP, RAD50, FAM50A, RBPJ, PABPC4, LRRFIP1 with cancer restricted serological profile in different histological types of breast cancer. Semi-quantitative immunohistochemical analysis of 20 tissue samples including medullary breast carcinoma, invasive ductal carcinoma, invasive lobular carcinoma and non-cancerous tissues obtained from patients with fibrocystic disease (each of five) was performed using specifically generated polyclonal antibodies. Differences in expression patterns were evaluated considering percent of positively stained cells, insensitivity of staining and subcellular localization in cells of all tissue samples. All 6 antigens predominantl...

Wnts control a number of processes during limb development—from initiating outgrowth and con-trolling patterning, to regulating cell differentiation in a number of tissues. We analyzed the expression pattern of various Wnts (4, 5a, 5b, 6, 11, and 14) in whole mount in situ ...

Diabetic mastopathy is a little known entity and can easily be mistaken for breast carcinoma. This entity has mainly been described in patients with diabetes type 1 and, to a much lesser extent, in those with other endocrine disorders. We describe a case of diabetic mastopathy associated with diabetes mellitus type 2, which showed a rapid clinical course. Lack of awareness of this entity can lead to inappropriate management. Because there are no specific histological or clinical features for diabetic mastopathy, patients may receive an incorrect diagnosis or undergo unnecessary investigations. A high index of suspicion is required to reach a correct diagnosis and provide appropriate treatment. The results of diagnostic tests are non-specific and the key to diagnosis is core needle biopsy.

Background The glycoprotein MUC1 is overexpressed and underglycosylated in cancer cells. MUC1 is translated as a single polypeptide that undergoes autocleavage into 2 subunits (the extracellular domain and the cytoplasmic tail), and forms a stable heterodimer at the apical membrane of normal epithelial cells. The MUC1 cytoplasmic tail localizes to the cytoplasm of transformed cells and is targeted to the nucleus. Aims To study the expression of the MUC1 extracellular subunit in cell nuclei of neoplastic breast, head and neck, and colon samples. Materials and Methods 330 primary tumor samples were analyzed: 166 invasive breast carcinomas, 127 head and neck tumors, and 47 colon tumors; 10 benign breast disease (BBD) and 40 normal specimens were also included. A standard immunohistochemical method with antigen retrieval was performed. Nuclear fractions from tissue homogenates and breast cancer cell lines (ZR-75, MDA-MB-231, MCF7, and T47D) were obtained and analyzed by Western blotting...

Background The glycoprotein MUC1 is overexpressed and underglycosylated in cancer cells. MUC1 is translated as a single polypeptide that undergoes autocleavage into 2 subunits (the extracellular domain and the cytoplasmic tail), and forms a stable heterodimer at the apical membrane of normal epithelial cells. The MUC1 cytoplasmic tail localizes to the cytoplasm of transformed cells and is targeted to the nucleus. Aims To study the expression of the MUC1 extracellular subunit in cell nuclei of neoplastic breast, head and neck, and colon samples. Materials and Methods 330 primary tumor samples were analyzed: 166 invasive breast carcinomas, 127 head and neck tumors, and 47 colon tumors; 10 benign breast disease (BBD) and 40 normal specimens were also included. A standard immunohistochemical method with antigen retrieval was performed. Nuclear fractions from tissue homogenates and breast cancer cell lines (ZR-75, MDA-MB-231, MCF7, and T47D) were obtained and analyzed by Western blotting...