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Sample records for carcinoma ductal infiltrante

  1. Isolated Uterine Metastasis of Invasive Ductal Carcinoma

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    Deniz Arslan

    2013-01-01

    Full Text Available Introduction. Most common metastasis sites of breast cancer are the lungs, bones, liver, and brain, whereas uterine involvement by metastatic breast disease is rare. Metastatic carcinoma of the uterus usually originates from other genital sites, most commonly being from the ovaries. Invasive lobular carcinoma spreads to gynecologic organs more frequently than invasive ductal carcinoma. Case Report. A 57-year-old postmenopausal woman was diagnosed with breast carcinoma 2 years ago and modified radical mastectomy was performed. Pathological examination of tumor revealed invasive ductal carcinoma, stage IIIc. She presented with abdominal pain and distension. Diagnostic workup and gynecologic examination revealed lesions that caused diffuse thickening of the uterus wall. Endometrial sampling was performed for confirmation of the diagnosis. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Breast carcinoma metastases in endometrium and myometrium were confirmed histopathologically and immunohistochemically. Conclusion. We herein report the first case of isolated uterine patient who had invasive ductal carcinoma of breast.

  2. DUCTAL CARCINOMA IN SITU OF THE BREAST

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To investigate the clinical characteristics, treatment and prognosis of ductal carcinoma in situ (DCIS) of the breast. Methods: Clinicopathological and follow-up data were collected in 52 patients with DCIS. Results: The clinic data showed that 50 patients had signs of breast lumps or/and nipple discharges, 2 patients presented abnormal mammography; 2 patients had lymph node involved; and 14 patients were accompanied with intraductal papillomatosis. All patients were Received surgical therapy. The follow-up data showed 1 patient locally recurred after lumpectomy, and was underwent mastectomy again, then cured. There were no patients died of DCIS. Conclusion: Mastectomy should be a standard surgical mode, and the prognosis of DCIS was favorable, but mammography for screening of asymptomatic women should be strengthened to find DCIS.

  3. Optical diagnosis of mammary ductal carcinoma using advanced optical technology

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    Wu, Yan; Fu, Fangmeng; Lian, Yuane; Nie, Yuting; Zhuo, Shuangmu; Wang, Chuan; Chen, Jianxin

    2015-02-01

    Clinical imaging techniques for diagnosing breast cancer mainly include X-ray mammography, ultrasound, and magnetic resonance imaging (MRI), which have respective drawbacks. Multiphoton microscopy (MPM) has become a potentially attractive optical technique to bridge the current gap in clinical utility. In this paper, MPM was used to image normal and ductal cancerous breast tissues, based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG). Our results showed that MPM has the ability to exhibit the microstructure of normal breast tissue, ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) lesions at the molecular level comparable to histopathology. These findings indicate that, with integration of MPM into currently accepted clinical imaging system, it has the potential to make a real-time histological diagnosis of mammary ductal carcinoma in vivo.

  4. Ductal carcinoma in situ: a challenging disease

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    Sevilay Altintas

    2011-12-01

    Full Text Available Ductal carcinoma in situ (DCIS represents a heterogenous group of lesions with variable malignant potential. Although it is clearly pre-invasive, not all lesions progress to an invasive malignant disease. The significant increase in the frequency of diagnosis is the result of both widespread use of screening mammography and better recognition among pathologists. Treatment is controversial, but for several decades total mastectomy has been considered as the appropriate treatment. The tendency to be less aggressive in terms of surgery has followed the pattern of events observed in the treatment of invasive breast carcinomas. More recently, it has become clear that breastconserving procedures could be applied and selected on the basis of diagnostics and risk factors. When all patients with DCIS are considered, the overall mortality is extremely low, only about 1–2%. On the other hand, breast-conserving surgery is only curative in 75–85%; 50% of the local recurrences have proven to be invasive with a mortality rate of 12–15%. There is no place for axillary node dissection, adjuvant hormonal treatment or chemotherapy in the treatment. Important factors in predicting local recurrence are age, family history, nuclear grade, comedo-type necrosis, tumor size and margin width. With the addition of radiation therapy to excisional surgery, there is a 50% reduction in the overall local recurrence rate. The Van Nuys Prognostic Index (VNPI, recently updated, is a tool that quantifies measurable prognostic factors that can be used in the decision-making process of treatment. Recent data from large cohort studies and randomized trials have emerged to guide treatment. DCIS is now understood to have diverse malignant potential and it is unlikely that there will be a single treatment for this wide range of lesions. Advances in molecular biology and gene expression profiling of human breast tumors have been providing important insights into the relationship

  5. Case Report: Ductal Carcinoma In Situ in the Male Breast

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    Joshua Chern

    2012-01-01

    Full Text Available High-grade ductal carcinoma in situ is incredibly rare in male patients. The prognosis for ductal carcinoma in situ (DCIS in a male patient is the same as it would be for a female with the same stage disease; therefore, early recognition and diagnosis are of the utmost importance. We present a case of a male with unilateral invasive ductal carcinoma who was diagnosed with DCIS in the contralateral breast. The DCIS presented as microcalcifications on mammography and was found to be biopsy proven grade 3 papillary DCIS. This case also illustrates the importance of family history and risk factors, all of which need to be evaluated in any male presenting with a breast mass or nipple discharge.

  6. Regression of Ductal Carcinoma In Situ After Treatment with Acupuncture

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    Dehen, Regina

    2013-01-01

    This report describes a case of ductal carcinoma in situ (DCIS) that regressed after treatment with acupuncture, Chinese herbs, and other complementary and alternative medicine (CAM). The natural history of DCIS remains to be elucidated, and it is unclear whether all DCIS cases progress to invasive breast cancer. Surgery plus radiation therapy or mastectomy is recommended for women in whom this potentially nonprogressive cancer is detected. This case supports the developing trend toward activ...

  7. Histological Grading in Ductal Carcinoma in Situ of the Breast

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To study the significance of histological grading as a prognostic factor in ductal carcinoma in situ of the breast. Methods: According to the Van Nuy's classification, 32 cases of ductal carcinoma in situ (DCIS) of the breast were divided into three groups. Results: Low grade (well differentiated, low grade DCIS) 12 patients (37.5%); Intermediate grade, 9 patients (28.1%); High grade (poorly differentiated DCIS) 11 patients (34.4%). Among the high grade DCIS, the histologic subtypes were comedo (9 patients), micropapillary (1 patient) and solid (1 patient). The positive expression of c-erbB-2, p53 and MIB-1 in high grade DCIS was higher than that in intermediate and low grade DCIS. The difference between high grade and low grade DCIS was significant (p<0.05). The expression of ER in high grade DCIS was lower than that in intermediate and low grade DCIS. Conclusions: Histological grading of breast ductal carcinoma in situ may be a good prognostic factor.

  8. PROGNOSTIC SIGNIFICANCE OF MIB1 PROLIFERATIONMARKER EXPRESSION ON DUCTAL CARCINOMA IN SITU ANDINVASIVE DUCTAL CARCINOMA OF THE BREAST

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To determine the prognostic significance of MIB1 proliferation marker expression on ductal carci noma in situ (DCIS) and invasive ductal carcinoma (IDC) of the breast. Methods By means of histological and immunohis tochemical techniques, MIB1 labelling index (LI) was determined in 31 pathologic specimens (DICS 6, IDC 22 and 3 benign breast lesions as control). Results Significantly higher (P<0.05) MIB1 expression was noted in breast carcinomas in con trast with benign breast lesions. MIB1 LI increased with increasing tumor invasion from DCIS to IDC (P<0.05). Increased tendency of MIB1 LI had been also noted in according with the increased nuclear grading (NG) of IDC. Conclusion MIB1 ex pression can faithfully reflect the proliferative activity of the breast lesions, where the breast cancers with both high MIB1 LI and NG seem to have a poor prognosis.

  9. Invasive ductal carcinoma of the pancreas showing exophytic growth

    Institute of Scientific and Technical Information of China (English)

    Yuichi Sanada; Kazuhiro Yoshida; Masaoki Itoh; Riki Okita; Morihito Okada

    2009-01-01

    BACKGROUND: Invasive pancreatic carcinoma generally appears as poorly deifned mass relfecting the inifltrative growth. We aimed to identify the histological and immunohistochemical features in a rare case of pancreatic carcinoma showing exophytic growth. METHODS: A 67-year-old woman presented with a mass of 5.0 cm in diameter in the pancreatic head. Preoperative computed tomography revealed a well-demarcated, primarily solid mass with a central low-density area. Magnetic resonance cholangiopancreatography revealed neither encasement nor dilation of the main pancreatic duct. An incorrect preoperative diagnosis was made of solid pseudopapillary tumor of the pancreas. Elevated serum carcinoembryonic antigen (CEA) levels and abnormal FDG positron emmission tomography accumulation suggested that the tumor had malignant potential requiring a pancreatoduodenectomy. RESULTS: The head of the pancreas contained a well-circumscribed encapsulated mass of 5.0 cm in diameter, comprising 50% adenocarcinoma, with mucinous carci-noma in the center and anaplastic carcinoma at the periphery. The anaplastic carcinoma comprised pleo-morphic cells (PCs) and pleomorphic giant cells (PGCs). The PGCs phagocytozed mononuclear PCs and lymphocytes adjacent to the capsule without inifltrating the capsule itself. Immunohistochemistry revealed that the anaplastic carcinoma cells including PGCs were positive for the tumor antigen Mucin 1 and CEA but negative for vimentin. CONCLUSION: Our observations suggest anaplastic carcinoma components in the present tumor have a ductal origin and that the exophytic tumor growth is associated with the phagocytotic activity of PGCs.

  10. Genetic predisposition to ductal carcinoma in situ of the breast

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    Petridis, Christos; Brook, Mark N; Shah, Vandna;

    2016-01-01

    BACKGROUND: Ductal carcinoma in situ (DCIS) is a non-invasive form of breast cancer. It is often associated with invasive ductal carcinoma (IDC), and is considered to be a non-obligate precursor of IDC. It is not clear to what extent these two forms of cancer share low-risk susceptibility loci, o...

  11. Molecular Insights on the Transition of Non-invasive DCIS to Invasive ductal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Dihua YU

    2009-01-01

    @@ More than 90% of breast cancer-related deaths are caused by metastasis not primary tumor. To effectively reduce cancer mortality, it is extremely im-portant to predict the risk of, and to intervene in, the critical transition from non-invasive ductal carcinoma in situ (DCIS) to life-threatening invasive ductal carcinoma (IDC).

  12. Carcinoma ductal de la mama simulando linitis plástica.

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    Herrera L. Sandra

    2011-09-01

    Full Text Available CASO CLÍNICO: paciente de 54 años con diagnóstico de carcinoma ductal de la mama infiltrante, con metástasis a hueso y cerebrodetectadas de forma sincrónica. Consulta por dolor abdominal y ausencia de deposiciones. Al examen físico se encontró una masapobremente definida en epigastrio. Esofagogastroduodenoscopia reporta estómago de aspecto infiltrativo (mucosa irregular,dura, no distensible sugestivos de neoplasia gástrica (linitis?, por lo que se toma biopsia, la cual fue informada: mucosa gástricainfiltrada por de células grandes de núcleos hipercromáticos, algunos con morfología de células en anillo de sello. No sereconocieron glándulas gástricas neoplásicas. A la tinción de PAS resultó negativa en células problemas. Por lo anterior serealizaron marcadores de inmunohistoquímica tipo CD20, AE1AE3, receptor de estrógeno y progesterona, ante la búsqueda deltumor primario. Los resultados de las stinciones fueron: AE1AE3: intensamente positiva en células problemas. CD20: negativa,excluye estirpe linfoide, receptores de estrógeno, progesterona y Her-2/neu: positivos para células tumorales. Finalmente seconcluyó que la presencia de marcación para receptores de estrógeno, en células de tipo anillo de sello hace sospechar el origenmamario de este tumor y se confirma con Her-2/neu. El resultado definitivo: tumor maligno mal diferenciado, carcinoma de origenmamario metastásico.COMENTARIOS: la prevalencia de metástasis en general al tracto gastrointestinal (TGI es muy variable, la mayoría de casosreportados son en autopsias, siendo el TGI superior el más frecuentemente afectado. La incidencia de metástasis gástrica postmortem se ha demostrado que varía del 7.4% al 18%, mientras que la frecuencia de detección de metástasis gástrica durante todala vida se ha determinado en un 6%. Las metástasis gástricas del cáncer de mama son eventos raros, en su mayoría detectadas enautopsia y constituyen muy ocasionalmente el

  13. Ductal carcinoma in situ and atypical ductal hyperplasia of the breast diagnosed at stereotactic core biopsy.

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    Méndez, I; Andreu, F J; Sáez, E; Sentís, M; Jurado, I; Cabezuelo, M A; Castañer, E; Gallardo, X; Díaz-Ruiz, M J; López, E; Marco, V

    2001-01-01

    Stereotactic core needle biopsy (SCNB) allows specific histopathologic diagnoses to be made without surgery and has been demonstrated to be an accurate, cost-effective method of diagnosing breast disease, particularly nonpalpable lesions. However, recent studies have concluded that the diagnosis of atypical ductal hyperplasia (ADH) by means of SCNB has resulted in nearly equal odds that a coexisting malignant lesion will be missed. Furthermore, others have concluded that SCNB diagnosed as DCIS cannot reliably indicate the absence of tumor invasion in surgical excision. Between 1993 and 1998, 1,221 consecutive SCNB of mammographically identified lesions were performed using a 14-gauge automated device with an average of 5.3 cores obtained per lesion. ADH was identified in 19 (1.6%) lesions and DCIS in 89 (7.3%). Surgical biopsy was performed in 89 of these patients and histopathologic results from SCNB and surgical biopsies were reviewed and correlated. In 12 cases of ADH diagnosed by SCNB, surgical biopsy showed ADH in 8 (67%) cases and DCIS in the other 4 (33%) cases. In 77 cases of DCIS diagnosed by SCNB, a surgical biopsy showed DCIS in 55 (71%) cases, 6 more cases (8%) had DCIS with focal microinvasion, and 15 (19%) had invasive ductal carcinoma. In one case no residual tumor was found at surgery. In the author's patient population, the diagnosis of ADH at SCNB indicates high probability of DCIS or residual ADH in the surgical biopsy. The diagnosis of DCIS at SCNB is confirmed in the majority of surgical biopsies; however, a significant number of cases may show microinvasion or invasive carcinoma.

  14. Ductal Carcinoma In Situ of the Breast: A Surgical Perspective

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    Mohammed Badruddoja

    2012-01-01

    Full Text Available Ductal carcinoma in situ (DCIS of the breast is a heterogeneous neoplasm with invasive potential. Risk factors include age, family history, hormone replacement therapy, genetic mutation, and patient lifestyle. The incidence of DCIS has increased due to more widespread use of screening and diagnostic mammography; almost 80% of cases are diagnosed with imaging with final diagnosis established by biopsy and histological examination. There are various classification systems used for DCIS, the most recent of which is based on the presence of intraepithelial neoplasia of the ductal epithelium (DIN. A number of molecular assays are now available that can identify high-risk patients as well as help establish the prognosis of patients with diagnosed DCIS. Current surgical treatment options include total mastectomy, simple lumpectomy in very low-risk patients, and lumpectomy with radiation. Adjuvant therapy is tailored based on the molecular profile of the neoplasm and can include aromatase inhibitors, anti-estrogen, anti-progesterone (or a combination of antiestrogen and antiprogesterone, and HER2 neu suppression therapy. Chemopreventive therapies are under investigation for DCIS, as are various molecular-targeted drugs. It is anticipated that new biologic agents, when combined with hormonal agents such as SERMs and aromatase inhibitors, may one day prevent all forms of breast cancer.

  15. Invasive ductal carcinoma of the breast in a 14-year-old girl

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    Breast cancer is rare in children and adolescents. In particular, there are very few cases of invasive ductal carcinoma in childhood. We report a case of invasive ductal carcinoma of the breast in a 14-year-old girl presenting as a palpable mass. While the tumor demonstrated a relatively benign appearance on ultrasound, magnetic resonance imaging revealed typical malignant features. Several polymorphisms of single nucleotide variation were observed on gene analysis. The patient underwent breast conserving surgery and received subsequent concurrent chemo-radiation therapy. An awareness that ductal carcinoma of the breast rarely occurs in children is important to detect early stage breast cancer. (orig.)

  16. Invasive ductal carcinoma of the breast in a 14-year-old girl

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    Kim, Joo Yeon; Kim, Yun Ju; Kim, Sung Hun; Kang, Bong Joo [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology, Seoul (Korea, Republic of); Song, Byung Joo [The Catholic University of Korea, Department of General Surgery, Seoul St. Mary' s Hospital, College of Medicine, Seoul (Korea, Republic of)

    2014-11-15

    Breast cancer is rare in children and adolescents. In particular, there are very few cases of invasive ductal carcinoma in childhood. We report a case of invasive ductal carcinoma of the breast in a 14-year-old girl presenting as a palpable mass. While the tumor demonstrated a relatively benign appearance on ultrasound, magnetic resonance imaging revealed typical malignant features. Several polymorphisms of single nucleotide variation were observed on gene analysis. The patient underwent breast conserving surgery and received subsequent concurrent chemo-radiation therapy. An awareness that ductal carcinoma of the breast rarely occurs in children is important to detect early stage breast cancer. (orig.)

  17. Basal cytokeratin as a potential marker of low risk of invasion in ductal carcinoma in situ

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    Fernando N. Aguiar

    2013-05-01

    Full Text Available OBJECTIVES: Biological markers that predict the development of invasive breast cancer are needed to improve personalized therapy for patients diagnosed with ductal carcinoma in situ. We investigated the role of basal cytokeratin 5/6 in the risk of invasion in breast ductal carcinoma in situ. METHODS: We constructed tissue microarrays using 236 ductal carcinoma in situ samples: 90 pure samples (group 1 and 146 samples associated with invasive carcinoma (group 2. Both groups had similar nuclear grades and were obtained from patients of similar ages. The groups were compared in terms of estrogen (ER and progesterone receptor (PR status, human epidermal growth factor receptor 2 (HER2 expression, cytokeratin 5/6 immunostaining, human epidermal growth factor receptor 1 (EGFR membrane staining and molecular subtype, as indicated by their immunohistochemistry profiles. RESULTS: ER/PR-negative status was predictive of invasion, whereas HER2 superexpression and cytokeratin 5/6-positive status were negatively associated with invasion. Among the high-grade ductal carcinoma in situ cases, a triple-positive profile (positive for estrogen receptor, progesterone receptor, and HER2 and cytokeratin 5/6 expression by neoplastic cells were negatively associated with invasion. In the low-grade ductal carcinoma in situ subgroup, only cytokeratin 5/6 expression exhibited a negative association with the probability of invasion. CONCLUSION: The immunohistochemical expression of cytokeratin 5/6 by ductal carcinoma in situ epithelial cells may provide clinically useful information regarding the risk of progression to invasive disease.

  18. Carcinoma espinocelular infiltrante de base de cráneo en paciente de 16 años con albinismo óculo-cutáneo

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    J.M. Lasso-Vázquez

    2013-12-01

    Full Text Available Presentamos el caso de una adolescente africana de 16 años de edad afectada por albinismo óculo-cutáneo, que desarrolló un carcinoma epidermoide en pabellón auricular derecho que requirió escisión radical y reconstrucción con colgajo TRAM libre. El albinismo es un trastorno metabólico genético que consiste en la incapacidad hereditaria para sintetizar melanina. Tiene dos variantes clínicas: el albinismo ocular y el albinismo óculo-cutáneo. En determinados países africanos, los pacientes afectos por esta enfermedad son socialmente rechazados y por ello no se les presta un control sanitario adecuado. Por esta razón el tumor llevaba varios años de evolución y cuando la paciente fue vista en nuestro centro, existía una infiltración profunda con afectación severa de la base del cráneo. La compleja anatomía de las estructuras vitales en esta región hace que la resección quirúrgica de los tumores sea complicada. Comentamos las peculiaridades en la reconstrucción de casos complejos en la base lateral del cráneo con proyección a la zona temporal.

  19. Contemporary management of ductal carcinoma in situ and lobular carcinoma in situ.

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    Obeng-Gyasi, Samilia; Ong, Cecilia; Hwang, E Shelley

    2016-06-01

    The management of in situ lesions ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) continues to evolve. These diagnoses now comprise a large burden of mammographically diagnosed cancers, and with a global trend towards more population-based screening, the incidence of these lesions will continue to rise. Because outcomes following treatment for DCIS and LCIS are excellent, there is emerging controversy about what extent of treatment is optimal for both diseases. Here we review the current approaches to the diagnosis and treatment of both DCIS and LCIS. In addition, we will consider potential directions for future management of these lesions. PMID:27197512

  20. Hsp90 in the continuum of breast ductal carcinogenesis: Evaluation in precursors, preinvasive and ductal carcinoma lesions

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    Patsouris Effstratios

    2010-07-01

    Full Text Available Abstract Background Hsp90 (heat shock protein90 is a chaperone protein essential for preserving and regulating the function of various cellular proteins. Elevated Hsp90 expression seems to be a trait of breast cancer and may be an integral part of the coping mechanisms that cancer cells exhibit vis-à-vis stress. This manuscript tries to examine the immunohistochemical expression of Hsp90 all along the continuum of breast ductal lesions encompassing ductal hyperplasia without atypia (DHWithoutA, atypical ductal hyperplasia (ADH, ductal carcinoma in situ (DCIS and invasive ductal carcinoma (IDC. Methods Tissue specimens were taken from 30 patients with DHWithoutA, 31 patients with ADH, 51 with DCIS and 51 with IDC. Immunohistochemical assessment of Hsp90 was performed both in the lesion and the adjacent normal breast ducts and lobules; the latter serving as control. Concerning Hsp90 assessment the percentage of positive cells and the intensity were separately analyzed. Subsequently, the Allred score was calculated. Post hoc analysis on the correlations between Hsp90 Allred score and possible predictors (grade, nodal status, tumor size, ER Allred score, PR Allred score, c-erbB-2 status and triple negative status was conducted in IDC. Results Hsp90 exhibited mainly cytoplasmic immunoreactivity. Hsp90 Allred score exhibited an increasing trend along the continuum of breast ductal lesions (Spearman's rho = 0.169, p = 0.031. Compared to the adjacent normal ducts and lobules, no statistically significant differences were noted in DHwithoutA, ADH and DCIS. Hsp90 expression (intensity, positive cells, Allred score was higher in IDC, compared to the adjacent normal tissue. Higher Hsp90 expression was observed in grade 2/3 IDCs (borderline association and tumors of larger size. At the univariable analysis, higher Hsp90 expression was associated with higher ER Allred score, PR Allred score and c-erbB-2 positivity in IDC. Triple-negative IDCs exhibited

  1. Hypofractionated Radiation Therapy for Breast Ductal Carcinoma In Situ

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    Hathout, Lara [Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Centre affilié à l' Université de Montréal, Montreal, Quebec (Canada); Hijal, Tarek [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Théberge, Valérie [Department of Radiation Oncology, Centre hospitalier universitaire de Québec, L' Hôtel-Dieu de Québec, Quebec (Canada); Centre des maladies du sein Deschênes-Fabia, Quebec (Canada); Fortin, Bernard [Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Centre affilié à l' Université de Montréal, Montreal, Quebec (Canada); Vulpe, Horia [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Hogue, Jean-Charles [Centre des maladies du sein Deschênes-Fabia, Quebec (Canada); Centre hospitalier universitaire de Québec, Hôpital St-Sacrement, Quebec (Canada); Lambert, Christine [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Bahig, Houda [Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Centre affilié à l' Université de Montréal, Montreal, Quebec (Canada); and others

    2013-12-01

    Purpose: Conventional radiation therapy (RT) administered in 25 fractions after breast-conserving surgery (BCS) is the standard treatment for ductal carcinoma in situ (DCIS) of the breast. Although accelerated hypofractionated regimens in 16 fractions have been shown to be equivalent to conventional RT for invasive breast cancer, few studies have reported results of using hypofractionated RT in DCIS. Methods and Materials: In this multicenter collaborative effort, we retrospectively reviewed the records of all women with DCIS at 3 institutions treated with BCS followed by hypofractionated whole-breast RT (WBRT) delivered in 16 fractions. Results: Between 2003 and 2010, 440 patients with DCIS underwent BCS followed by hypofractionated WBRT in 16 fractions for a total dose of 42.5 Gy (2.66 Gy per fraction). Boost RT to the surgical bed was given to 125 patients (28%) at a median dose of 10 Gy in 4 fractions (2.5 Gy per fraction). After a median follow-up time of 4.4 years, 14 patients had an ipsilateral local relapse, resulting in a local recurrence-free survival of 97% at 5 years. Positive surgical margins, high nuclear grade, age less than 50 years, and a premenopausal status were all statistically associated with an increased occurrence of local recurrence. Tumor hormone receptor status, use of adjuvant hormonal therapy, and administration of additional boost RT did not have an impact on local control in our cohort. On multivariate analysis, positive margins, premenopausal status, and nuclear grade 3 tumors had a statistically significant worse local control rate. Conclusions: Hypofractionated RT using 42.5 Gy in 16 fractions provides excellent local control for patients with DCIS undergoing BCS.

  2. Quantitative histopathological variables in in situ and invasive ductal and lobular carcinomas of the breast

    DEFF Research Database (Denmark)

    Ladekarl, M; Sørensen, Flemming Brandt

    1993-01-01

    This study was carried out to compare quantitative histopathological estimates obtained in normal breast epithelium (N = 15), lobular carcinoma in situ (N = 29), ductal carcinoma in situ (N = 24), invasive lobular carcinoma (N = 39), and invasive ductal carcinoma (N = 71) of the female breast......) with those obtained in tumors of pure lobular carcinoma in situ (N = 7), only the difference in mean NI reached statistical significance (2p = 0.001). Several significant differences were found between means of quantitative histopathological estimates obtained in normal breast epithelium, pure in situ...... value of the investigated variables in the diagnostic separation of normal breast epithelium, in situ lesions, and invasive carcinomas. The quantitative variables obtained in the situ lesions did not indicate whether an accompanying invasive tumor was present or not....

  3. Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast.

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    de Deus Moura, Rafael; Wludarski, Sheila C L; Carvalho, Filomena M; Bacchi, Carlos E

    2013-01-01

    The distinction between classic lobular and ductal carcinoma, both in situ and invasive, has important therapeutic and management implications. Most ductal and lobular carcinomas are distinguished readily on hematoxylin-eosin-stained sections because of distinct histomorphologic features. In cases with ambiguous morphologic features, however, categorization in one or another type can be a challenge. Several immunohistochemical markers, including epithelial cadherin, p120, β-catenin, and low-molecular-weight and high-molecular-weight cytokeratins among others, have been introduced to help better discriminate between lobular neoplasia and ductal carcinoma. In this critical review of the literature, we comment about the usefulness and the limitations of these markers to improve the accuracy in the differential diagnosis of breast pathology.

  4. Current controversies in the treatment of ductal carcinoma in situ of the breast.

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    Franceschini, Gianluca; Terribile, Daniela; Magno, Stefano; Fabbri, Cristina; D'Alba, Pierfrancesco; Chiesa, Federica; Di Leone, Alba; Scafetta, Ilaria; Masetti, Riccardo

    2008-01-01

    The incidence of ductal carcinoma in situ (DCIS), a noninvasive form of breast cancer, has increased markedly in recent decades, and DCIS now accounts for approximately 20% of breast cancers diagnosed by mammography. Laboratory and patient data suggest that DCIS is a precursor lesion for invasive cancer. Controversy exists with regard to the optimal management of DCIS patients. In the past, mastectomy was the primary treatment for patients with DCIS, but as with invasive cancer, breast-conserving surgery has become the standard approach. A mini-review of the management of ductal carcinoma in situ is presented, and the roles and dilemmas of surgery, radiotherapy and endocrine therapy are discussed. PMID:18958961

  5. Mucinous carcinoma of the breast is genomically distinct from invasive ductal carcinomas of no special type.

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    Lacroix-Triki, Magali; Suarez, Paula H; MacKay, Alan; Lambros, Maryou B; Natrajan, Rachael; Savage, Kay; Geyer, Felipe C; Weigelt, Britta; Ashworth, Alan; Reis-Filho, Jorge S

    2010-11-01

    Mucinous carcinomas are a rare entity accounting for up to 2% of all breast cancers, which have been shown to display a gene expression profile distinct from that of invasive ductal carcinomas of no special type (IDC-NSTs). Here, we have defined the genomic aberrations that are characteristic of this special type of breast cancer and have investigated whether mucinous carcinomas might constitute a genomic entity distinct from IDC-NSTs. Thirty-five pure and 11 mixed mucinous breast carcinomas were assessed by immunohistochemistry using antibodies against oestrogen receptor (ER), progesterone receptor, HER2, Ki67, cyclin D1, cortactin, Bcl-2, p53, E-cadherin, basal markers, neuroendocrine markers, and WT1. Fifteen pure mucinous carcinomas and 30 grade- and ER-matched IDC-NSTs were microdissected and subjected to high-resolution microarray-based comparative genomic hybridization (aCGH). In addition, the distinct components of seven mixed mucinous carcinomas were microdissected separately and subjected to aCGH. Pure mucinous carcinomas consistently expressed ER (100%), lacked HER2 expression (97.1%), and showed a relatively low level of genetic instability. Unsupervised hierarchical cluster analysis revealed that pure mucinous carcinomas were homogeneous and preferentially clustered together, separately from IDC-NSTs. They less frequently harboured gains of 1q and 16p and losses of 16q and 22q than grade- and ER-matched IDC-NSTs, and no pure mucinous carcinoma displayed concurrent 1q gain and 16q loss, a hallmark genetic feature of low-grade IDC-NSTs. Finally, both components of all but one mixed mucinous carcinoma displayed similar patterns of genetic aberrations and preferentially clustered together with pure mucinous carcinomas on unsupervised clustering analysis. Our results demonstrate that mucinous carcinomas are more homogeneous between themselves at the genetic level than IDC-NSTs. Both components of mixed mucinous tumours are remarkably similar at the

  6. Determination of infiltrative ductal breast carcinoma differentiation grade in biopsy imprints

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    Vukašinović-Bokun Zorana

    2009-01-01

    Full Text Available Background/Aim. In patients with breast carcinoma there are many risk factors for assessment of breast carcinoma maturity and prognosis. Besides histological type of differentiation, cytologic criteria for the evaluation grade of the differentiation of infiltrative ductal breast carcinomas are very important for prognosis. The aim of this study was to define cytologic criteria for grading of infiltrative ductal carcinomas of the breast. Methods. The imprints of intraoperative biopsies from 124 patients were studied. They were air-dried and stained by May-Grünwald Giemsa method. The features assessed were: the degree and type of cell clustering, nuclear diameter and pleomorphism, chromatin structure, number and features of nucleoli, the aspect of cytoplasm, noncellular background and the variability of cells and nuclei. According to these morphologic features the infiltrative ductal carcinomas of the breast could be classified into three grades of differentiation. Results. Cytologic and histologic differentation grade revealed disagreement among 34.6% of the imprints. In 9 of total 23 histologicaly well differentiated carcinomas, cytological differentation grade was moderately differentiated. In 63 carcinomas with histologic differentiation grade II, cytologic differentiation grade was good in 12 and poor in 16 carcinomas. Conclusion. Cytologic and histologic grading were not identical in 34.6% of the imprints what points out the need to further definition of diagnostic criteria, especially for grade II of differentiation.

  7. Diagnosis and management of ductal carcinoma in situ.

    Science.gov (United States)

    Khan, Amina; Newman, Lisa A

    2004-04-01

    Ductal carcinoma in situ (DCIS) is a preinvasive form of breast cancer that has increased in incidence over the past 25 years, primarily as a result of mammographically detected microcalcifications. Inadequately treated DCIS carries a risk for evolving into the malignant phenotype; however, the magnitude and timeline for this risk are poorly defined. Treatment options include lumpectomy with or without breast irradiation and mastectomy. The overall survival rate is 96% to 98% with any of these strategies, but the risk of local recurrence (LR) is highest after lumpectomy alone. Breast irradiation can reduce this risk from levels in excess of 40% to 10% over a 10-year follow-up period. Approximately 50% of all LR from DCIS are invasive lesions. Therefore, the occurrence of a LR after breast-conserving therapy is a potentially greater threat to the patient with DCIS compared to the patient diagnosed with invasive cancer. In patients diagnosed with invasive cancer, the risk of micrometastatic disease is present from the time of initial diagnosis. In patients with DCIS, the expectation is that a potentially 100% cure rate should be achieved with local therapy alone. Although most DCIS cases complicated by LR will be successfully salvaged with prolonged overall survival, it is critically important to take every precaution that will minimize the risk of locally recurrent disease. Therefore, radiation therapy as an adjunct to lumpectomy is essential. A subset of patients with DCIS with low-volume low-grade disease who can be safely treated by lumpectomy alone has not yet been clearly defined. Prospective studies designed to identify this category are ongoing. Inadequate margin control is the most consistent risk factor for LR that has been reported thus far, but there is no universally accepted definition for what constitutes an optimal negative margin distance. Young age at diagnosis, high nuclear grade, and comedonecrosis are other factors that have been implicated as

  8. A rare case of isolated adrenal metastasis of invasive ductal breast carcinoma

    Directory of Open Access Journals (Sweden)

    Anđelić-Dekić Nataša

    2014-01-01

    Full Text Available Introduction. Isolated adrenal metastases of invasive ductal breast carcinoma are extremely rare. We report a case with isolated left adrenal metastases, verified three years after diagnosed breast carcinoma. Case Outline. A 58-year-old female patient with a right breast tumor, clinically staged as IIIA (T2N2M0 started neoadjuvant anthracycline chemotherapy after biopsy which revealed invasive ductal breast carcinoma. Immunohistochemical findings of tumor biopsy showed hormonal steroid receptors for estrogen and progesterone negative, and human epidermal growth factor receptor 2 (HER2 positive. After 4 cycles of chemotherapy and partial tumor regression the patient underwent radical mastectomy. Definite histopathological analysis confirmed the diagnosis of invasive ductal carcinoma. The patient continued treatment with adjuvant chemotherapy to cumulative dose of anthracyclines, postoperative radiotherapy and adjuvant trastuzumab for one year. Three years later abdominal computerized tomography showed tumor in the left adrenal gland as the only metastatic site. Left adrenalectomy was performed and histopathological finding confirmed breast cancer metastases. Postoperatively, the patient received 6 cycles of docetaxel with trastuzumab and continued trastuzumab until disease progression. One year after left adrenalectomy control abdominal computerized tomography showed a right adrenal tumor with retroperitoneal lymphadenopathy. Treatment with capecitabine was continued for one year, but eventually she developed brain metastasis causing lethal outcome. Conclusion. In order to better understand metastatic pathways of invasive ductal breast carcinoma, publications of individual patient cases diagnosed with rare metastatic sites should be encouraged. This might improve our understanding of metastatic behavior of breast cancer and stimulate further clinical research.

  9. Five-year survival following a medial pancreatectomy for an invasive ductal carcinoma from the body of the pancreas

    Institute of Scientific and Technical Information of China (English)

    Hideki Abe; Kouichi Tsuneyama; Kazuhiro Tsukada; Masatoshi Makuuchi

    2006-01-01

    We report a rare case of a patient who survived for 5years after undergoing a medial pancreatectomy for invasive ductal carcinoma originating from the body of the pancreas. A 63-year-old woman was diagnosed as a small cancer of the pancreatic body, and surgery was performed. Even though the tumor was a carcinoma, its small size prompted us to perform a medial pancreatectomy with regional lymph nodes dissection. Additional chemoradiation was performed and, five years after surgery, the patient is well with no signs of recurrence.Medial pancreatectomy for invasive ductal carcinoma has not ever been reported. Furthermore, long-term survival after a lumpectomy for invasive ductal carcinoma has never been reported in the literatures. The current case suggests that long-term survival in patients with invasive ductal carcinoma of the pancreas may be associated with the pathological or biological features of pancreatic carcinoma.

  10. Analysis of EGFR and HER-2 expressions in ductal carcinomas in situ in canine mammary glands

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    I.L.D. Silva

    2014-06-01

    Full Text Available Biomolecular evidence has shown that ductal carcinoma in situ (DCIS may develop into invasive carcinoma of the canine mammary gland, and mutations in proto-oncogenes HER2 and EGFR; two members of the family of epidermal growth factor receptors, may be involved in this process. The purpose of this study was the characterization of the immunohistochemical expression of the EGFR and HER2 proteins in the process of neoplastic transformation, supposedly present in ductal carcinomas in situ in canine mammary glands. Fifteen cases of DCIS were evaluated, with a higher expression of HER2 and EGFR being observed in low-grade carcinomas when compared with high-grade neoplasms, and with a high positive statistical correlation in the latter. Results suggest that aggressive tumors tend to lose the expression of EGFR and HER2 simultaneously. The loss of the expression of these markers may be related to the process of neoplastic progression in canine mammary tumors.

  11. Variation in detection of ductal carcinoma in situ during screening mammography

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Ponti, Antonio; James, Ted;

    2014-01-01

    BACKGROUND: There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative ...

  12. Synchronous unilateral triple breast cancers composed of invasive ductal carcinoma, invasive lobular carcinoma, and Paget's disease.

    Science.gov (United States)

    Onoe, Shunsuke; Tsuda, Hitoshi; Akashi-Tanaka, Sadako; Hasebe, Takahiro; Iwamoto, Eriko; Hojo, Takashi; Kinoshita, Takayuki

    2014-03-01

    We report a case of synchronous unilateral triple breast cancers comprising invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and Paget's disease. A 57-year-old woman with a left breast mass was referred to our hospital. Mammography revealed only an isodense area with foci of microcalcification in the lateral area of the left breast. Ultrasonography revealed 2 hypoechoic masses in the outer lower and inner upper areas, and these 2 lesions were diagnosed by core needle biopsy as ILC and IDC, respectively. Left total mastectomy with sentinel lymph node biopsies was performed. In addition to the ILC and IDC, histological examination also identified Paget's disease. Breast cancer often manifests as multiple unilateral lesions; however, it is sometimes difficult to determine whether these tumors have developed multicentrically or have multifocally invaded from an intraductal carcinoma. This case was clearly diagnosed to have occurred multicentrically because of the absence of continuity among the 3 tumors, the presence of a non-invasive component in all 3 tumors, and different histopathological findings. The synchronous unilateral development of ILCs is well known. Cases of synchronous unilateral triple or more breast cancers were reviewed, and their histopathological characteristics, including the incidence of Paget's disease, is discussed. PMID:21140247

  13. Confocal fluorescence microscopy to evaluate changes in adipocytes in the tumor microenvironment associated with invasive ductal carcinoma and ductal carcinoma in situ.

    Science.gov (United States)

    Dobbs, Jessica L; Shin, Dongsuk; Krishnamurthy, Savitri; Kuerer, Henry; Yang, Wei; Richards-Kortum, Rebecca

    2016-09-01

    Adipose tissue is a dynamic organ that provides endocrine, inflammatory and angiogenic factors, which can assist breast carcinoma cells with invasion and metastasis. Previous studies have shown that adipocytes adjacent to carcinoma, known as cancer-associated adipocytes, undergo extensive changes that correspond to an "activated phenotype," such as reduced size relative to adipocytes in non-neoplastic breast tissue. Optical imaging provides a tool that can be used to characterize adipocyte morphology and other features of the tumor microenvironment. In this study, we used confocal fluorescence microscopy to acquire images of freshly excised breast tissue stained topically with proflavine. We developed a computerized algorithm to identify and quantitatively measure phenotypic properties of adipocytes located adjacent to and far from normal collagen, ductal carcinoma in situ and invasive ductal carcinoma. Adipocytes were measured in confocal fluorescence images of fresh breast tissue collected from 22 patients. Results show that adipocytes adjacent to neoplastic tissue margins have significantly smaller area compared to adipocytes far from the margins of neoplastic lesions and compared to adipocytes adjacent to non-neoplastic collagenous stroma. These findings suggest that confocal microscopic images can be utilized to evaluate phenotypic properties of adipocytes in breast stroma which may be useful in defining alterations in microenvironment that may aid in the development and progression of neoplastic lesions. PMID:27116366

  14. Infiltrating ductal carcinoma of the breast associated with primary breast lymphoma.

    Science.gov (United States)

    Arlen, Myron; Freiman, Jacob J; Ionescu, Marina

    2011-01-01

    We report on the development of an uncommon association of pathologic processes, where an invasive adenocarcinoma of the breast developed concomitantly with a primary lymphoma arising in the same breast. The patient, a 78 year old female, presented with two palpable breast lesions in her left breast and an additional lesion in the right breast. Core needle biopsies of the lesions revealed both ductal carcinoma and lymphoma existing adjacent to each other in the left breast and a second primary lymphoma in her right breast. The mammogram, which also defined the lesions, illustrated collision tumors of the left breast and a separate pathologic process in the right breast. Excision of the lesions confirmed the two independent lesions on the left side, one an infiltrating ductal carcinoma and the second a large B-cell lymphoma. Biopsy of the right breast also demonstrated existence of a large B-cell lymphoma. Left axillary biopsy using sentinel node technology indicated that there was no evidence of nodal metastasis. The question arose as to possible etiologic factors related to viral transfection at the DNA level, that could cause transformation within the ductal epithelium of the breast with similar transfection of the lymphocytes of an adjacent intramammary node, that led to the development of the simultaneous pathologic processes of ductal carcinoma and B-cell lymphoma, defined on biopsy. PMID:21475637

  15. Infiltrating Ductal Carcinoma of the Breast Associated with Primary Breast Lymphoma

    Directory of Open Access Journals (Sweden)

    Myron Arlen, Jacob J. Freiman, Marina Ionescu

    2011-01-01

    Full Text Available We report on the development of an uncommon association of pathologic processes, where an invasive adenocarcinoma of the breast developed concomitantly with a primary lymphoma arising in the same breast. The patient, a 78 year old female, presented with two palpable breast lesions in her left breast and an additional lesion in the right breast. Core needle biopsies of the lesions revealed both ductal carcinoma and lymphoma existing adjacent to each other in the left breast and a second primary lymphoma in her right breast. The mammogram, which also defined the lesions, illustrated collision tumors of the left breast and a separate pathologic process in the right breast. Excision of the lesions confirmed the two independent lesions on the left side, one an infiltrating ductal carcinoma and the second a large B-cell lymphoma. Biopsy of the right breast also demonstrated existence of a large B-cell lymphoma. Left axillary biopsy using sentinel node technology indicated that there was no evidence of nodal metastasis. The question arose as to possible etiologic factors related to viral transfection at the DNA level, that could cause transformation within the ductal epithelium of the breast with similar transfection of the lymphocytes of an adjacent intramammary node, that led to the development of the simultaneous pathologic processes of ductal carcinoma and B-cell lymphoma, defined on biopsy.

  16. Ductal carcinoma in situ within fibroadenoma: Microcalcifications identified on mammography play a crucial role in diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    You, Jai Kyung; Kim, Yee Jeong; Kim, Bo Mi [NHIS Ilsan Hospital, Goyang (Korea, Republic of); Kim, Eun Kyung [Dept. of Diagnostic Radiology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    Fibroadenoma is a common, benign tumor of the breast, which is rarely associated with an increased risk of carcinoma. We report a case of ductal carcinoma in situ within a fibroadenoma in a 38-year-old woman. The lesion was a 1 cm, circumscribed, ovoid mass with internal calcifications evident on mammography and ultrasound, which is commonly found in fibroadenoma, but the calcifications were fine and linear, which is uncommon. This type of calcification is classified as suspicious by the American College of Radiology Breast Imaging-Reporting And Data System, and it is often correlated with comedo necrosis of ductal carcinoma, and, so, requires immediate pathologic confirmation. In our case, careful analysis of the unusual calcifications led to appropriate intervention and diagnosis. Radiologists should be aware that fibroadenomas can be malignant, and they should look for suspicious microcalcifications within a fibroadenoma.

  17. Synchronous infiltrating ductal carcinoma and primary extramedullary plasmacytoma of the breast

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    Liu Yan-Xue

    2009-04-01

    Full Text Available Abstract Background Extramedullary plasmacytomas are seldom solitary and usually progress to diffuse myelomatosis. Plasmacytomas of the breast are rare, especially when not associated multiple myeloma. Synchronous infiltrating ductal carcinoma and primary extramedullary plasmacytoma of the breast have not previously reported. Case presentation A 27-years-old woman with an untreated upper outer quadrant breast mass for 1-year was referred to our cancer hospital for surgical evaluation of increasing breast pain. Postoperatively, microscopic examination revealed an infiltrating ductal carcinoma complicated by an extramedullary plasmacytoma divided by fibrous tissue in one section. Following surgery, the patient received chemotherapy for the carcinoma and radiotherapy for the plasmacytoma. Conclusion In this case, careful histopathology examination was essential to make the correct diagnosis and therapy for these synchronous lesions. The patient finished chemotherapy and radiotherapy without significant adverse effects.

  18. 63 Patients and cytokeratin 8/18 expression in breast, atypical ductal hyperplasia, ductal carcinoma in situ and invasive Duct Carcinoma

    International Nuclear Information System (INIS)

    Background and Purpose: The pattern and distribution of 63 Patients expression as a myoepithelia/basal stem cell marker can be different between atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) and may denote basal phenotype of breast ductal carcinoma. CK8/18 is a luminal marker and may indicate a luminal phenotype of IDC and its expression in ADH and DCIS may refer to a possible precursor lesion to IDC. This work was designed to study and compare the expression of 63 Patients and cytokeratin 8/18 (CK8/l8) in some cases of ADH, DC IS and IDC. Materials and Methods: Histopathological evaluation and immunohistochemical study of anti- 63 Patients and anti-CK8/l8 was performed on selected archival cases of 7 ADH, 12 DCIS, 30 IDC of known clinico pathological data and previous estrogen receptor status (ER) for IDe. Confirmatory anti-smooth muscle actin (ASMA) expression for positive 63 Patients cases was performed. Results: 63 Patients was expressed in the peripheral rim of the myoepithelial cell layer in ADH and DCIS with occasional gabs in DCrS. It was positive and stained occasional malignant cells in 3/30 (10%) of IDC cases. Confirmatory ASMA staining decorated the same peripheral rim of cells in ADH and DCIS, but was negative in 63 Patients positive IDC cases. CK8/l8 was positive in 100% of ADH, 8/12 (66.7%) of DC IS and 22/30 (73%) of IDC cases. Combined 63 Patients and CK8/ 18 expression was noticed in 3/30 (10%) of IDe. Conclusion: It is concluded from this study that 63 Patients is specific and valuable in differentiating myoepithelial cells and is more specific and valuable than other myoepithelial markers, as ASMA and can differentiate between ADH, DCIS, IDC as it stains peripheral myoepithelial cells in ADH and DCIS with gabs in the latter and does not stain any neoplastic cells. In IDC, it is positive in malignant cells in a minority of cases which may indicate basal/stem cell/myoepithelial cell origin

  19. In situ quantitation of inflammatory mononuclear cells in ductal infiltrating breast carcinoma. Relation to prognostic parameters.

    OpenAIRE

    An, T.; Sood, U.; Pietruk, T.; Cummings, G.; Hashimoto, K; Crissman, J. D.

    1987-01-01

    The authors examined inflammatory mononuclear cells in 10 fibroadenomas and 56 ductal infiltrating type carcinomas of the breast to see whether the distribution of various subpopulations of the mononuclear cells were correlated with known histologic, biochemical, and clinical parameters of the cancers. T cells, B cells, natural killer cells, and macrophages were quantitated on frozen tissue sections, which were stained with monoclonal antibodies, as demonstrated by the immunoperoxidase techni...

  20. Reproductive and Hormonal Risk Factors for Ductal Carcinoma in situ of the Breast

    OpenAIRE

    Millikan, Robert C.; Schroeder, Jane C; Barnholtz-Sloan, Jill S.; Levine, Beverly J.

    2009-01-01

    One-fifth of all newly diagnosed breast cancer cases are ductal carcinoma in situ (DCIS), but little is known about DCIS risk factors. Recent studies suggest that some subtypes of DCIS (high grade, or comedo) share histopathologic and epidemiologic characteristics with invasive disease, while others (medium or low grade, or non-comedo) show different patterns. To investigate whether reproductive and hormonal risk factors differ among comedo and non-comedo types of DCIS and invasive breast can...

  1. An Intraductal Human-in-mouse Transplantation Model Mimics the Subtypes of Ductal Carcinoma In Situ

    OpenAIRE

    Behbod, Fariba; Kittrell, Frances S; LaMarca, Heather; Kerbawy, Sofia; Heestand, Jessica C; Young, Evelin; Mukhopadhyay, Purna; Yeh, Hung-Wen; Allred, D. Craig; Medina, Daniel; Edwards, David; Hu, Min; Polyak, Kornelia; Rosen, Jeffrey M.

    2009-01-01

    Introduction: Human models of noninvasive breast tumors are limited, and the existing in vivo models do not mimic inter- and intratumoral heterogeneity. Ductal carcinoma in situ (DCIS) is the most common type (80%) of noninvasive breast lesions. The aim of this study was to develop an in vivo model whereby the natural progression of human DCIS might be reproduced and studied. To accomplish this goal, the intraductal human-in-mouse (HIM) transplantation model was developed. The resulting model...

  2. Ductal Carcinoma In Situ Detected by Shear Wave Elastography within a Fibroadenoma

    OpenAIRE

    Kılıç, Fahrettin; Ustabaşıoğlu, Fethi Emre; Samancı, Cesur; Baş, Ahmet; Velidedeoglu, Mehmet; Kılıçaslan, Tülin; Aydogan, Fatih; Yılmaz, Mehmet Halit

    2014-01-01

    Fibroadenoma is the most common breast tumor in women. Malignant transformation occurs rarely within fibroadenoma at older ages. Clinicians, radiologists, and pathologists need to be aware of malignant transformation within fibroadenomas. Radiologic studies play an important role in the diagnosis of fibroadenoma; however, radiologic findings are often nonspecific for malignancy and may appear completely benign. We detected an occult ductal carcinoma in situ that originated inside a fibroadeno...

  3. Infiltrating Ductal Carcinoma of the Breast Associated with Primary Breast Lymphoma

    OpenAIRE

    Arlen, Myron; Freiman, Jacob J.; Ionescu, Marina

    2011-01-01

    We report on the development of an uncommon association of pathologic processes, where an invasive adenocarcinoma of the breast developed concomitantly with a primary lymphoma arising in the same breast. The patient, a 78 year old female, presented with two palpable breast lesions in her left breast and an additional lesion in the right breast. Core needle biopsies of the lesions revealed both ductal carcinoma and lymphoma existing adjacent to each other in the left breast and a second primar...

  4. Histopathological Features of Invasion of Breast Invasive Ductal Carcinoma and Safety of Breast-conserving Surgery

    Institute of Scientific and Technical Information of China (English)

    Chunping LIU; Huaxiong PAN; Zhi LI; Lan SHI; Tao HUANG

    2009-01-01

    In order to investigate the relationship between the extent of tumor invasion and the tu-mor size,axillary lymph nodes metastasis,Her-2 gene overexpression,and histologic grading in breast invasive ductal carcinoma as well as the optimal extent of excision during the breast-serving surgery,the clinical data of 104 patients with breast invasive ductal carcinoma who had received modified radical mastectomy were analyzed.The correlation analysis on invasive extent,which was evaluated by serial sections at an interval of 0.5 cm from 4 different directions taking the focus as the centre,and the tumor size,axillary lymph nodes metastasis,Her-2 gene overexpression,and his-tologic grading was processed.There was a significant correlation between invasive extent and tumor size (r=0.766,P0.05),and histologic grading (r=0.228,P>0.05).The 100% negative rate of infiltration in patients without nipple discharge with tumor size 3 cm was obtained at 1.5,2.0 and 2.5 cm away from the tumor respectively.It is concluded that the performance of breast-serving surgery in patients with breast invasive ductal carcinoma should be evaluated by tumor size in combination with axillary lymph nodes involvement to decide the possibility of breast-serving and the secure excision extent.

  5. Coexistence of lobular granulomatous mastitis and ductal carcinoma: a fortuitous association?

    Science.gov (United States)

    Limaiem, F; Khadhar, A; Hassan, F; Bouraoui, S; Lahmar, A; Mzabi, S

    2013-12-01

    A 77-year-old female patient with a medical history significant for hypertension and epilepsy presented with right breast pain of 6-months duration. Examination revealed a hard sub-areola tender mass with irregular borders associated with mild right nipple retraction. Mammography showed a 2.2 x 2.4 cm stellate mass of the right breast. Ultrasound-guided core biopsies of the tumour were performed. Pathological examination revealed a grade II infiltrating ductal carcinoma. The patient underwent right radical mastectomy with homolateral axillary lymphadenectomy. Histological examination of the surgical specimen revealed grade II infiltrating ductal carcinoma concomitant with granulomatous lobular mastitis. To the best of our knowledge, the coexistence of granulomatous lobular mastitis and ductal carcinoma has been described only twice in the English language literature. The theory that chronic inflammation leads to cancer is well documented. Whether our patient had developed cancer from granulomatous lobular mastitis or otherwise is a matter of debate until more cases are encountered and more research is done in the area of breast cancer pathogenesis with regards to it arising from granulomatous lobular mastitis.

  6. Expression of CD133, PAX2, ESA, and GPR30 in invasive ductal breast carcinomas

    Institute of Scientific and Technical Information of China (English)

    LIU Qun; LI Ji-guang; ZHENG Xin-yu; JIN Feng; DONG Hui-ting

    2009-01-01

    Background Biomarkers in breast neoplasms provide invaluable information regarding prognosis and help determining the optimal treatment. We have examined the possible correlation between cancer stem cell (CSC)-Iike markers (CD133,paired box gene 2 protein (PAX2), epithelial specific antigen (ESA)), and a new membrane estrogen receptor (G-protein coupled receptor 30 (GPR30)) in invasive ductal breast carcinomas with known clinicopathological parameters, tumor recurrence, and expression of some known biomarkers.Methods In 74 invasive ductal breast carcinomas, we investigated the protein expression of these molecular markers by immunohistochemistry, and their associations with known clinicopathological parameters, tumor recurrence, and expression of some known biomarkers. We studied the interrelationship between the expressions of these proteins.Results CD133, a putative CSC marker, was positively related to tumor size, tumor stage, and lymph node metastasis.PAX2 was negatively correlated with tumor recurrence. ESA, one of the breast CSC markers, was an indicator of tumor recurrence. GPR30 was associated with hormone receptors. Despite the correlation between GPR30 and the nuclear estrogen receptor, the expression was dependent. Positive staining of GPR30 in tumors displayed a significant association with high C-erbB2 expression and a tendency for tumor recurrence. A positive relationship between GPR30 and CD133 existed.Conclusion Detecting the expression of CD133, PAX2, ESA, and GPR30 in invasive ductal breast carcinomas may be of help in more accurately predicting the aggressive properties of breast cancer and determining the optimal treatment.

  7. ASPN and GJB2 Are Implicated in the Mechanisms of Invasion of Ductal Breast Carcinomas

    Directory of Open Access Journals (Sweden)

    Bàrbara Castellana, Daniel Escuin, Gloria Peiró, Bárbara Garcia-Valdecasas, Tania Vázquez, Cristina Pons, Maitane Pérez-Olabarria, Agustí Barnadas, Enrique Lerma

    2012-01-01

    Full Text Available The mechanism of progression from ductal carcinoma in situ (DCIS to invasive ductal carcinoma (IDC remains largely unknown. We compared gene expression in tumors with simultaneous DCIS and IDC to decipher how diverse proteins participate in the local invasive process.Twenty frozen tumor specimens with concurrent, but separated, DCIS and IDC were microdissected and evaluated. Total RNA was extracted and microarray analysis was performed using Affymetrix GeneChip® Human Gene 1.0 ST Arrays. Microarray data were validated by quantitative real time reverse transcription-PCR (qRT-PCR and immunohistochemistry. Controls included seven pure in situ carcinomas, eight fragments from normal breast tissue, and a series of mouse breast carcinomas (MMTV-PyMT.Fifty-six genes were differentially expressed between DCIS and IDC samples. The genes upregulated in IDC samples, and probably associated with invasion, were related to the epithelial-mesenchymal transition (ASPN, THBS2, FN1, SPARC, and COL11A1, cellular adhesion (GJB2, cell motility and progression (PLAUR, PLAU, BGN, ADAMTS16, and ENPP2, extracellular matrix degradation (MMP11, MMP13, and MMP14, and growth/proliferation (ST6GAL2. qRT-PCR confirmed the expression patterns of ASPN, GJB2, ENPP2, ST6GAL2, and TMBS10. Expression of the ASPN and GJB2 gene products was detected by immunohistochemistry in invasive carcinoma foci. The association of GJB2 protein expression with invasion was confirmed by qRT-PCR in mouse tumors (P < 0.05.Conclusions: The upregulation of ASPN and GJB2 may play important roles in local invasion of breast ductal carcinomas.

  8. A candidate metastasis-associated DNA marker for ductal mammary carcinoma

    International Nuclear Information System (INIS)

    Molecular genetic markers to identify the 13% lymph node-negative mammary carcinomas that are prone to develop metastases would clearly be of considerable value in indicating those cases in need of early aggressive therapy. Representational difference analysis was used in an attempt to identify genetic alterations related to breast cancer metastasis by comparing genomic DNA from microdissected normal cells and from metastatic cells of ductal breast carcinoma patients. Representational difference analysis products yielded 10 unique metastasis-associated DNA sequences (MADS), i.e. products apparently lost in metastatic cell DNA. Of these sequences, MADS-IX was found to be lost in the transition from primary to metastasis in two out of five ductal breast carcinoma cases. This sequence was localized on chromosome 10q21 by radiation hybrid mapping and fluorescence in situ hybridization. The PTEN gene, which is also located on chromosome 10q, was detected to be present by PCR in all five cases. On the contrary, a breast carcinoma cell line, HCC-1937, which has homozygous loss of a region encompassing the PTEN gene, showed the presence of MADS-IX. PCR screening of three additional breast carcinoma cell lines with known losses in specific chromosomal regions also showed the presence of MADS-IX. These data suggest that MADS-IX possibly is part of a novel candidate metastasis-associated gene located close to the PTEN gene on chromosome 10q. The first set of PCR screening in five patient samples indicates that it could be used as a molecular marker for ductal mammary metastasis

  9. Characterization of ductal and lobular breast carcinomas using novel prolactin receptor isoform specific antibodies

    Directory of Open Access Journals (Sweden)

    Heger Christopher D

    2010-12-01

    Full Text Available Abstract Background Prolactin is a polypeptide hormone responsible for proliferation and differentiation of the mammary gland. More recently, prolactin's role in mammary carcinogenesis has been studied with greater interest. Studies from our laboratory and from others have demonstrated that three specific isoforms of the prolactin receptor (PRLR are expressed in both normal and cancerous breast cells and tissues. Until now, reliable isoform specific antibodies have been lacking. We have prepared and characterized polyclonal antibodies against each of the human PRLR isoforms that can effectively be used to characterize human breast cancers. Methods Rabbits were immunized with synthetic peptides of isoform unique regions and immune sera affinity purified prior to validation by Western blot and immunohistochemical analyses. Sections of ductal and lobular carcinomas were stained with each affinity purified isoform specific antibody to determine expression patterns in breast cancer subclasses. Results We show that the rabbit antibodies have high titer and could specifically recognize each isoform of PRLR. Differences in PRLR isoform expression levels were observed and quantified using histosections from xenografts of established human breast cancer cells lines, and ductal and lobular carcinoma human biopsy specimens. In addition, these results were verified by real-time PCR with isoform specific primers. While nearly all tumors contained LF and SF1b, the majority (76% of ductal carcinoma biopsies expressed SF1a while the majority of lobular carcinomas lacked SF1a staining (72% and 27% had only low levels of expression. Conclusions Differences in the receptor isoform expression profiles may be critical to understanding the role of PRL in mammary tumorigenesis. Since these antibodies are specifically directed against each PRLR isoform, they are valuable tools for the evaluation of breast cancer PRLR content and have potential clinical importance in

  10. Intercalated duct cell is starting point in development of pancreatic ductal carcinoma?

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    Yamaguchi Toshikazu

    2005-01-01

    Full Text Available Abstract Background Although it is well known that the pancreatic ductal carcinoma may develop having a relationship to the mucous gland hyperplasia (MGH with atypia (PanIN-1B by PanIN system, the starting point of this atypical MGH is unclear. To know it, we examined the pancreas tissue using many methods described below. Methods 1. Twenty-seven surgically resected pancreas tissue specimens, including pancreatic ductal carcinomas (PDC, chronic pancreatitis and normal pancreas, were investigated using immunohistochemical stainings for MUC1, MUC6, 45M1, Ki67 and p53. 2. DNA extraction and analysis of K-ras mutation at codon 12 using microdissection method: The paraffin blocks with 16 regions including the intercalated duct cell (IC adjacant to the atypical MGH were prepared for DNA extraction. Mutation of K-ras codon 12 was analized and compared in enriched polymerase chain reaction-enzyme-linked minisequence assay (PCR-ELMA. Results 1. In the normal pancreas, although no positive cell was seen in 45M1, p53, Ki67, the cytoplasm of IC were always positive for MUC1 and sometimes positive for MUC6. In the pancreas with fibrosis or inflammation, MGH was positive for MUC6 and 45M1. And atypical MGH was positive for MUC1, MUC6 and 45M1. Some IC adjacent to the atypical MGH was positive for Ki67 as well as atypical MGH. The carcinoma cells in all cases of PDC were diffusely positive for MUC1, 45M1, p53 and Ki67, and focally positive for MUC6. 2. In K-ras mutation, we examined the regions including IC adjacent to the atypical MGH, because the immunohistochemical apomucin stainings of these regions resembled those of PDC as decribed above. And K-ras mutation was confirmed in 12 of 16 regions (75%. All mutations were a single mutation, in 6 regions GTT was detected, in 4 regions GAT was detected and in 2 region AGT was detected. Conclusion Some intercalated duct cell may be the starting point of the pancreatic ductal carcinoma, because the exhibitions of

  11. ALDH1在乳腺UDH、ADH、IDC中的表达及意义%The Expression and Significance of ALDH1 in Usual Ductal Hyperplasia (UDH), Atypical Ductal Hyperplasia (ADH) and Infiltrative Ductal Carcino-ma (IDC)

    Institute of Scientific and Technical Information of China (English)

    郭钰; 卫建平

    2014-01-01

    Objective To investigate the expression of ALDH1 in usual ductal hyperplasia, atypical ductal hyperplasia and infiltra-tive ductal carcinoma and its clinical significance. Methods Immunohistochemistry method was used to detect the expression of ALDH1 in the normal mammary gland of 30 cases and mammary gland ductal disease of 90 cases of patients. Results The positive expression rate of ALDH1 in normal mammary gland, usual ductal hyperplasia, atypical ductal hyperplasia and infiltrative ductal carcinoma was 0%, 23.3%, 23.3%, 60%, respectively. Conclusion The positive rate of ALDH1 in patients with infiltrative ductal carcinoma was significantly higher than that in normal mammary gland and other mammary gland diseases, which suggests that the positive expression of ALDH1 has a certain relationship with the evolution of the mammary gland hyperplasia to mammary gland cancer and the prognosis of the disease.%目的:探讨ALDH1在乳腺普通导管增生、非典型导管上皮增生以及浸润性导管癌中表达及其临床意义。方法采用免疫组织化学方法对30例正常乳腺及90例乳腺导管疾病患者的ALDH1的表达进行测定。结果 ALDH1在正常、乳腺普通导管增生、不典型导管上皮增生以及浸润性导管癌中的阳性表达率为:0%、23.3%、23.3%、60%。结论乳腺浸润性导管癌患者的ALDH1的阳性率明显高于正常乳腺及其它乳腺导管疾病,提示ALDH1的阳性表达与乳腺增生至乳腺癌变的演进,且与疾病的预后有一定的关系。

  12. A rare case of male breast ductal carcinoma in-situ associated with prolactinoma

    OpenAIRE

    Mallawaarachchi, Chandike Maithri; Ivanova, Snezana; Shorthouse, Alice; Shousha, Sami; Sinnett, Dudley

    2011-01-01

    A case of ductal carcinoma in-situ (DCIS) associated with prolactinoma in a male patient is described. A 56-year-old gentleman presented with lethargy and loss of libido. His prolactin at presentation was 3680 mU/l and an MRI scan of the head revealed a pituitary tumour suggestive of prolactinoma. Following 18 months of treatment with cabergoline, the prolactin level reduced to 914 mU/l. However, 3 years later he presented with blood stained nipple discharge, the cytology of which was negativ...

  13. Metastasis of Ductal Breast Carcinoma to the Vagina – A Case Report

    OpenAIRE

    Leila Cristina Soares; Anna Candida Andrade de Camaret

    2013-01-01

    Primary cancers of the vagina are rare, and so vaginal tumours are likely to represent metastasis from another site. Although breast cancer is a common malignancy, it rarely gives rise to vaginal metastases. In this study, we report a case of vaginal cancer diagnosed in a 65-year-old woman. Clinical examination showed the presence of a breast tumour, and ductal breast carcinoma was diagnosed by biopsy. Analysis of the vaginal tumour suggested that it was a metastasis. It was through the detec...

  14. p53 overexpression is a predictor of local recurrence after treatment for both in situ and invasive ductal carcinoma of the breast

    NARCIS (Netherlands)

    de Roos, M.A.; de Bock, G.H.; de Vries, J; van der Vegt, Bert; Wesseling, J.

    2007-01-01

    Background. Several biological markers have been related to prognosis in mammary ductal carcinoma. The aim of the study was to determine biological markers that could predict local recurrence following treatment for all stages of primary operable ductal carcinoma of the breast. Materials and methods

  15. Basal cytokeratin phenotypes of myoepithelial cells indicates the origin of ductal carcinomas in situ of the breast.

    Science.gov (United States)

    Chen, Ling; Yin, Xiaona; Lu, Shanshan; Chen, Guorong; Dong, Lei

    2015-09-01

    Terminal duct lobular unit (TDLU) is widely accepted as the origin of ductal carcinoma in situ of breast. The differentiation states of myoepithelial cells of breast ductal system hint the development of breast hyperplastic lesions. Basal cytokeratin (CK) phenotypes indicate the differentiation of myoepithelial cells. Using antibodies of CK5/6, CK14, and CK17, this study reports the basal CK phenotypes of myoepithelial cells in 20 foci of normal breast, 20 usual ductal hyperplasias, 36 ductal carcinomas in situ (DCIS), and 28 sclerosing adenosis (SA). The results showed that the positive staining of basal CKs of myoepithelial cells in normal ducts were significantly higher than those in normal lobules. The basal CK expression of myoepithelial cells of DCIS and usual ductal hyperplasia was similar to that of normal duct, whereas that of SA was similar to that of normal lobule. We propose a modified model of TDLU origin of intraductal carcinoma that most of DCIS originate from terminal ducts of TDLU, whereas most SA originate from lobules.

  16. Ductal carcinoma in situ presenting as microcalcifications : the effect of stereotactic large-core needle biopsy on surgical therapy

    NARCIS (Netherlands)

    Pijnappel, RM; Groote, AD; de Vries, J; Post, WJ; Baas, PC; de Roos, M.A.J.

    2004-01-01

    The aim of this investigation was to study the efficacy of surgical therapy in patients with non-palpable ductal carcinoma in situ (DCIS) presenting as microcalcifications diagnosed by means of stereotactic large-core needle biopsy (SCNB). This is a retrospective study with a historical control grou

  17. Mammographycally occult high grade ductal carcinoma in situ (DCIS) as second primary breast cancer, detected with MRI: a case report:

    OpenAIRE

    Zebic-Sinkovec, Marta; Kadivec, Maksimiljan; Podobnik, Gasper; Skof, Erik; Snoj, Marko

    2010-01-01

    Background Contralateral breast cancer (CLB) is the most common second primary breast cancer in patients diagnosed with breast cancer. The majority of patients harbouring CLB tumours develop the invasive disease. Almost all invasive carcinomas are believed to begin as ductal carcinoma in situ (DCIS) lesions. The sensitivity of MRI for DCIS is much higher than that of mammography. Case report We report the case of a woman who was treated with breast conserving therapy 10 years ago. At that tim...

  18. A Self-Folding Hydrogel In Vitro Model for Ductal Carcinoma.

    Science.gov (United States)

    Kwag, Hye Rin; Serbo, Janna V; Korangath, Preethi; Sukumar, Saraswati; Romer, Lewis H; Gracias, David H

    2016-04-01

    A significant challenge in oncology is the need to develop in vitro models that accurately mimic the complex microenvironment within and around normal and diseased tissues. Here, we describe a self-folding approach to create curved hydrogel microstructures that more accurately mimic the geometry of ducts and acini within the mammary glands, as compared to existing three-dimensional block-like models or flat dishes. The microstructures are composed of photopatterned bilayers of poly (ethylene glycol) diacrylate (PEGDA), a hydrogel widely used in tissue engineering. The PEGDA bilayers of dissimilar molecular weights spontaneously curve when released from the underlying substrate due to differential swelling ratios. The photopatterns can be altered via AutoCAD-designed photomasks so that a variety of ductal and acinar mimetic structures can be mass-produced. In addition, by co-polymerizing methacrylated gelatin (methagel) with PEGDA, microstructures with increased cell adherence are synthesized. Biocompatibility and versatility of our approach is highlighted by culturing either SUM159 cells, which were seeded postfabrication, or MDA-MB-231 cells, which were encapsulated in hydrogels; cell viability is verified over 9 and 15 days, respectively. We believe that self-folding processes and associated tubular, curved, and folded constructs like the ones demonstrated here can facilitate the design of more accurate in vitro models for investigating ductal carcinoma.

  19. Neuroendocrine carcinoma of the pancreas with similar genetic alterations to invasive ductal adenocarcinoma.

    Science.gov (United States)

    Kimura, Tetsuo; Miyamoto, Hiroshi; Fukuya, Akira; Kitamura, Shinji; Okamoto, Koichi; Kimura, Masako; Muguruma, Naoki; Ikemoto, Tetsuya; Shimada, Mitsuo; Yoneda, Akiko; Bando, Yoshimi; Takishita, Makoto; Takayama, Tetsuji

    2016-08-01

    Neuroendocrine carcinoma (NEC) of the pancreas is very rare, and its origin is not fully elucidated. Here, we present a case of a small-size NEC of the pancreas that is genetically similar to invasive ductal adenocarcinoma (IDA). A 65-year-old man was referred to our hospital due to obstructive jaundice and found to have a 12-mm solid tumor in the pancreas head. The tumor exhibited low vascularity on enhanced computed tomography, and endoscopic retrograde pancreatographic imaging revealed an irregular obstruction in a branch duct of the pancreas. The patient was thereby diagnosed with a pancreatic ductal cancer, and stomach-preserving pancreaticoduodenectomy with regional lymph node resection was performed. Histochemical analysis of the resected tumor showed that the neoplastic cells with scanty cytoplasm and hyperchromatic nuclei strongly expressed chromogranin A and synaptophysin. The Ki-67 index was 40 % in the most proliferative tumor regions, and the tumor was diagnosed as a NEC of the pancreas. However, in the analysis of genetic alterations of the tumor tissue, the neoplastic cells showed altered KRAS, TP53, and SMAD4/DPC4, suggesting that the NEC in our case is genetically related to IDA. Our data suggest that poorly differentiated IDAs may transform into NECs. PMID:27262570

  20. Symmetrical ethmoidal metastases from ductal carcinoma of the breast, suggesting transcribrosal spread.

    Science.gov (United States)

    Monserez, D; Vlaminck, S; Kuhweide, R; Casselman, J

    2001-01-01

    Symmetrical ethmoidal metastases from ductal carcinoma of the breast, suggesting transcribrosal spread. While half of breast cancers develop metastases, the appearance of metastatic disease in paranasal sinuses from this origin is very rare. Eighteen other cases were found in the literature, dating from 1939 till now. A case of metastatic breastcancer presenting as a subacute therapy-resistant pansinusitis is described. The perfect symmetry was misleading. Bilateral ethmoidal biopsies were compatible with metastases from a ductal adenocarcinoma. Further investigation revealed meningeal carcinomatosis in the supra-orbital region and locoregional recurrence in the mastectomy scar and axilla. Comparing these 19 cases in chronological order, it was noticed that symptoms at time of diagnosis shift from those of space occupying lesions to those suggestive for sinusitis. This shift could be explained by earlier diagnosis. High index of suspicion is the key to diagnosis. Earlier diagnosis does not result in longer survival since in most cases patients have already widespread disease and die within one year. Most authors mention the role of the vertebral venous plexus in hematogeneous spreading of tumor cells. Another pathway of hematogenous spread is via (occult) lung metastases. This case prompts the hypothesis of transcribrosal spread from meningeal involvement.

  1. Ductal Carcinoma In Situ: What Can We Learn from Clinical Trials?

    Directory of Open Access Journals (Sweden)

    Lucio Fortunato

    2012-01-01

    Full Text Available Ductal Carcinoma in situ has been diagnosed more frequently in the last few years and now accounts for approximately one-fourth of all treated breast cancers. Traditionally, this disease has been treated with total mastectomy, but conservative surgery has become increasingly used in the absence of unfavourable clinical conditions, if a negative excision margin can be achieved. It is controversial whether subgroups of patients with favourable in situ tumors could be managed by conservative surgery alone, without radiation. As the disease is diagnosed more frequently in younger patients, these issues are very relevant, and much research has focused on this topic in the last two decades. We reviewed randomized trials regarding adjuvant radiation after breast-conservative surgery and compared data with available retrospective studies.

  2. Penurunan Imunoekspresi P63 Pada Mioepitel Ductal Carcinoma In Situ (DCIS Payudara Sebagai Prediktor Infiltrasi Tumor

    Directory of Open Access Journals (Sweden)

    Teresa Liliana Wargasetia

    2009-03-01

    Full Text Available The occurrence of breast carcinoma is common in women. Ductal carcinoma in situ (DCIS of the breast is breast carcinoma with tumor cells which exist in the breast glandular duct and have not infiltrated into stroma. Retrospective study has been made on 23 paraffin blocks of morphological breast DCIS variants, namely kribriform, solid, and komedo. One way to find out DCIS aggressiveness is by detecting myoepithelial cells surrounding the breast duct indicating the integrity of the basal membrane. Detection of myoepithelial cells by means of immunohistochemical technique is done by using a selective marker for breast myoepithelial cells, namely p63. The aim of this research was predict tumor infiltration through decrease of immunoexpression of p63 in myoepithelial cells of morphological variants: cibriform, solid, and komedo of breast DCIS. This research was performed at Pathology Anatomy Laboratory of Medical Faculty of Padjadjaran University/RSUP Hasan Sadikin Bandung from Juli 2005 to September 2006. The result of the research indicated that immunoexpression of p63 in myoepithelial cells of morphological breast DCIS variants - cibriform, solid and komedo - did not show any significant difference (p<: 0,05. This indicated that tumor infiltration can occur in every breast DCIS morphological variant being studied, namely cribriform, solid, and comedo. The conclusion of this research is that decrease of immunoexpression of p63 in myoepithelial cells of morphological variants: cibriform, solid, and comedo of breast DCIS predict the presence of tumor infiltration.

  3. Pituitary Tumor-Transforming Gene 1 Is Expressed in Primary Ductal Breast Carcinoma, Lymph Node Infiltration, and Distant Metastases

    Directory of Open Access Journals (Sweden)

    Fabio Grizzi

    2013-01-01

    Full Text Available Despite the advances that have been made in the fields of molecular and cell biology, there is still considerable debate explaining how the breast cancer cells progress through carcinogenesis and acquire their metastatic ability. The lack of preventive methods and effective therapies underlines the pressing need to identify new biomarkers that can aid early diagnosis and may be targets for effective therapeutic strategies. In this study we explore the pituitary tumor-transforming gene 1 (PTTG1 expression in primary ductal breast carcinoma, lymph node infiltration, and distant metastases. Three human cell lines, 184B5 derived from normal mammary epithelium, HCC70 from a primary ductal carcinoma, and MDA-MB-361 from a breast metastasis, were used for quantifying PTTG1 mRNA expression. The PTTG1 immunohistochemical expression was carried out on specimens taken from eight patients with invasive ductal breast cancer who underwent surgical treatment and followup for five years retrospectively selected. The study demonstrated that PTTG1 is expressed gradually in primary ductal breast carcinoma, lymph node infiltration, and distant metastases. Our findings suggest that the immunohistochemical evaluation of PTTG1 expression might be a powerful biomarker of recognition and quantification of the breast cancer cells in routine pathological specimens and a potential target for developing an effective immunotherapeutic strategy for primary and metastatic breast cancer.

  4. Ductal carcinoma In-Situ in turner syndrome patient undergoing hormone replacement therapy: A case report

    Directory of Open Access Journals (Sweden)

    Rashmi Bawa

    2016-03-01

    Full Text Available Turner’s syndrome is a rare congenital disease which affects about 1 in every 2500-3000 live-born females. This happens due to chromosomal abnormalities in a phenotypic female, causing increased gonadotropin concentrations and low concentrations of estrogens from infancy. As a result, hormone replacement therapy is started in most adolescent Turner syndrome patients to initiate and sustain sexual maturation. Accordingly, most Turner’s syndrome patients undergo several decades of estrogen replacement therapy, from puberty to post-menopausal age. The highly publicized findings of the Women’s Health Initiative have called into question the appropriateness of hormone replacement therapy in adolescents with Turner’s syndrome. Those concerns were mostly theoretical extrapolations, as few prospective studies of cancer occurrence in women with Turner syndrome have been reported. Consequently, several recent publications have challenged those extrapolations, based on the assertion that the levels of hormone replacement in Turner syndrome patients are well below the physiologic levels observed in normal menstruating women, as well as the fact that these women are significantly younger than those studied by the Women’s Health Initiative. In discord to those reports, we present a case of ductal carcinoma in-situ in a 40-year-old Turner patient, who had undergone over two decades of combined hormone replacement therapy. The patient underwent an elective excisional biopsy for a palpable mass, with histopathology revealing a complex fibroadenoma with a nidus of ductal carcinoma in-situ. The lesion was noted to be estrogen receptor positive and progesterone receptor negative, with heavy staining for HER-2/Neu receptor. The patient was treated with tamoxifen. While a rare case, it is imperative for the astute clinician to keep in mind the consequences of long-term hormone replacement therapy in Turner’s syndrome patients in order to avoid missed

  5. Intratumoral metabolic heterogeneity predicts invasive components in breast ductal carcinoma in situ

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hai-Jeon [Ewha Womans University School of Medicine, Department of Nuclear Medicine, Yangchun-Ku, Seoul (Korea, Republic of); Kim, Yemi [Ewha Womans University, Clinical Research Institute, Seoul (Korea, Republic of); Kim, Bom Sahn [Ewha Womans University School of Medicine, Department of Nuclear Medicine, Yangchun-Ku, Seoul (Korea, Republic of); Ewha Womans University, Clinical Research Institute, Seoul (Korea, Republic of)

    2015-12-15

    This study investigated whether texture-based imaging parameters could identify invasive components of ductal carcinoma in situ (DCIS). We enrolled 65 biopsy-confirmed DCIS patients (62 unilateral, 3 bilateral) who underwent {sup 18}F-FDG PET, diffusion-weighted imaging (DWI), or breast-specific gamma imaging (BSGI). We measured SUV{sub max} and intratumoral metabolic heterogeneity by the area under the curve (AUC) of cumulative SUV histograms (CSH) on PET, tumour-to-normal ratio (TNR) and coefficient of variation (COV) as an index of heterogeneity on BSGI, minimum ADC (ADC{sub min}) and ADC difference (ADC{sub diff}) as an index of heterogeneity on DWI. After surgery, final pathology was categorized as pure-DCIS (DCIS-P), DCIS with microinvasion (DCIS-MI), or invasive ductal carcinoma (IDC). Clinicopathologic features of DCIS were correlated with final classification. Final pathology confirmed 44 DCIS-P, 14 DCIS-MI, and 10 IDC. The invasive component of DCIS was significantly correlated with higher SUV{sub max} (p = 0.017) and lower AUC-CSH (p < 0.001) on PET, higher TNR (p = 0.008) and COV (p = 0.035) on BSGI, lower ADC{sub min} (p = 0.016) and higher ADC{sub diff} (p = 0.009) on DWI, and larger pathologic size (p = 0.018). On multiple regression analysis, AUC-CSH was the only significant predictor of invasive components (p = 0.044). The intratumoral metabolic heterogeneity of {sup 18}F-FDG PET was the most important predictor of invasive components of DCIS. (orig.)

  6. Ductal carcinoma of the breast: morphological aspects according to the age

    Directory of Open Access Journals (Sweden)

    Ranniere G. F. Aquino

    2015-08-01

    Full Text Available ABSTRACTIntroduction:Breast cancer is the most common cancer in women worldwide, and its morphological characteristics, despite the current molecular classification, also provide important information about the pattern of this disease.Objective:To analyze the morphological characteristics of invasive ductal breast carcinoma among women older and younger than 50 years.Method:302 cases of invasive ductal carcinoma patients treated at the Division of Mastology of the Universidade Federal do Ceará, in the period 2005-2014, aged ≤ 50 years and older. The following morphological characteristics were analyzed: larger tumor diameter (TD, lymph node metastasis (MX, and histological grade (HG.Results:The mean age of patients was 55.6 years. The average tumor size was 3.4 cm, 40% of tumors have diameter ≤ 2 cm and 60% > 2 cm. As for the histological grade, 23.7% were grade 1, 32.1% grade 2, and 42% grade 3. Axillary metastasis were present in 66% of the cases and 34% did not. Women aged ≤ 50 years had fewer tumors grade 1 (p = 0.002, compared with grades 2 and 3. Women older than 50 years had more grade 3 tumors (p = 0.002, and more tumors larger than 2 cm diameter (p < 0.001. The presence of metastasis predominated in both age groups when analyzed separately (p < 0.001.Conclusion:Women older than 50 years had larger and more morphologically undifferentiated tumors. Women aged ≤ 50 years had less well-differentiated tumors. There were no differences in morphology between these two age groups when compared each other.

  7. Monoclonal antibody BrE-3 participation in a multivariate prognostic model for infiltrating ductal carcinoma of the breast.

    Science.gov (United States)

    Chan, C M; Baratta, F S; Ozzello, L; Ceriani, R L

    1994-01-01

    Monoclonal antibody (MoAb) BrE-3, an anti-human milk fat globule (HMFG) MoAb, is used here as a novel prognostic indicator for survival and relapse time in patients with infiltrating ductal carcinoma of the breast. A scoring system (4-Score method) was developed to this effect that measured, in a statistically reliable fashion, the level of expression of the epitope for MoAb BrE-3 in the cytoplasm and membranes of breast carcinoma cells in paraffin-embedded sections. In univariate analysis, data obtained by the 4-Score Method as well as data from traditional prognostic indicators (tumor size, axillary node status, and grade of differentiation) were found to be associated with patient survival and relapse. In multivariate analysis, using a Cox proportional hazards regression model, levels of expression of BrE-3 epitope plus tumor size and axillary node status were weighted and combined in an Individual Linear Composite Prognostic Score (ILCPS) that had a high level of association with survival and relapse time in this sample model of patients with infiltrating ductal carcinoma of the breast. This level of association was found to be higher than the level of association for any other combination of traditional or 4-Score method variables. The level of expression of BrE-3 significantly adds to the prognostic capacity of traditional prognostic markers for infiltrating ductal carcinoma of the breast. PMID:7981443

  8. Mixed acinar-neuroendocrine-ductal carcinoma of the pancreas: a tale of three lineages.

    Science.gov (United States)

    Anderson, Mark J; Kwong, Christina A; Atieh, Mohammed; Pappas, Sam G

    2016-01-01

    Most pancreatic cancers arise from a single cell type, although mixed pancreatic carcinomas represent a rare exception. The rarity of these aggressive malignancies and the limitations of fine-needle aspiration (FNA) pose significant barriers to diagnosis and appropriate management. We report a case of a 54-year-old man presenting with abdominal pain, jaundice and a hypodense lesion within the uncinate process on CT. FNA suggested poorly differentiated adenocarcinoma, which was subsequently resected via pancreaticoduodenectomy. Pathological analysis yielded diagnosis of invasive mixed acinar-neuroendocrine-ductal pancreatic carcinoma. Given the rare and deadly nature of these tumours, clinicians must be aware of their pathophysiology and do practice with a high degree of clinical suspicion, when appropriate. Surgical resection and thorough pathological analysis with immunohistochemical staining and electron microscopy remain the standards of care for mixed pancreatic tumours without gross evidence of metastasis. Diligent characterisation of the presentation and histological findings associated with these neoplasms should continue in order to promote optimal diagnostic and therapeutic strategies. PMID:27257019

  9. Development and Evaluation of a Prediction Model for Underestimated Invasive Breast Cancer in Women with Ductal Carcinoma In Situ at Stereotactic Large Core Needle Biopsy

    OpenAIRE

    Suzanne C E Diepstraten; van de Ven, Stephanie M. W. Y.; Pijnappel, Ruud M; Peeters, Petra H. M.; van den Bosch, Maurice A. A. J.; Helena M Verkooijen; Elias, Sjoerd G

    2013-01-01

    BACKGROUND: We aimed to develop a multivariable model for prediction of underestimated invasiveness in women with ductal carcinoma in situ at stereotactic large core needle biopsy, that can be used to select patients for sentinel node biopsy at primary surgery. METHODS: From the literature, we selected potential preoperative predictors of underestimated invasive breast cancer. Data of patients with nonpalpable breast lesions who were diagnosed with ductal carcinoma in situ at stereotactic lar...

  10. Effect of Metformin on Breast Ductal Carcinoma In Situ Proliferation in a Randomized Presurgical Trial.

    Science.gov (United States)

    DeCensi, Andrea; Puntoni, Matteo; Guerrieri-Gonzaga, Aliana; Cazzaniga, Massimiliano; Serrano, Davide; Lazzeroni, Matteo; Vingiani, Andrea; Gentilini, Oreste; Petrera, Marilena; Viale, Giuseppe; Cuzick, Jack; Bonanni, Bernardo; Pruneri, Giancarlo

    2015-10-01

    Metformin is associated with lower breast cancer risk in epidemiologic studies and showed decreased proliferation in HER2-positive breast cancer in a presurgical trial. To provide insight into its preventive potential, we measured proliferation by Ki-67 labeling index (LI) of intraepithelial lesions surrounding breast cancer. We randomly assigned 200 nondiabetic patients diagnosed with invasive breast cancer in core biopsies to metformin, 1,700 mg or placebo once daily for 28 days before surgery. Upon surgery, five to seven specimens of cancer adjacent (≤1 cm) and distant (>1 cm) tissue were screened for LCIS, ductal carcinoma in situ (DCIS), and ductal hyperplasia (DH). The prevalence of LCIS, DCIS, and DH was 4.5% (9/200), 67% (133/200), and 35% (69/200), respectively. Overall, metformin did not affect Ki-67 LI in premalignant disorders. The median posttreatment Ki-67 LI (IQR) in the metformin and placebo arm was, respectively, 15% (5-15) versus 5% (4-6) in LCIS (P = 0.1), 12% (8-20) versus 10% (7-24) in DCIS (P = 0.9), and 3% (1-4) versus 3% (1-4) in DH (P = 0.5). However, posttreatment Ki-67 in HER2-positive DCIS lesions was significantly lower in women randomized to metformin especially when ER was coexpressed: 22% (11-32) versus 35% (30-40) in HER2-positive DCIS (n = 22, P = .06); 12% (7-18) versus 32% (27-42) in ER-positive/HER2-positive DCIS (n = 15, P = .004). Eight of 22 (36%) HER2-positive DCIS were adjacent to HER2-negative invasive breast cancer. In tissue samples obtained following 4 weeks of study drug, proliferation was lower in HER2-positive DCIS for women randomized to metformin versus placebo. An adjuvant trial incorporating metformin in HER2-positive DCIS is warranted. PMID:26276754

  11. Estrogen receptor-negative breast ductal carcinoma: clinicopathological features and MIB-1 (Ki-67 proliferative index association.

    Directory of Open Access Journals (Sweden)

    Noorasmaliza Mdpaiman

    Full Text Available Breast cancer estrogen receptor (ER status is one of the strong additional factors in predicting response of patients towards hormonal treatment. The main aim of this study was to assess the morphological characteristics and proliferative activity using MIB-1(Ki-67 of estrogen receptor negative invasive breast ductal carcinoma (NOS type as well as to correlate these features with clinicopathological data. We also aim to study the expression of c-erbB2 in ER negative breast tumors. High proliferative rate (MIB-1 above 20% was observed in 63 (63.6% of 99 ER negative tumors and that these tumors were associated with high expression of c-erbB2 (57.6%. We observed that MIB-1 is a reliable independent prognostic indicator for ER negative infiltrating ductal carcinoma in this study.

  12. Estrogen Receptor-Negative Breast Ductal Carcinoma: Clinicopathological Features and Mib-1 (Ki-67) Proliferative Index Association

    OpenAIRE

    Noorasmaliza Mdpaiman; Siti Aishah Md Ali; Reena Mdzin; Meor Zamari Meor Kamal; Wan Anna Md Amin; Mohan Nallusamy; Pavitratha Puspanathan; Rohaizak Muhammad; Sharifa Ezat Wan Puteh; Srijit Das

    2014-01-01

    Breast cancer estrogen receptor (ER) status is one of the strong additional factors in predicting response of patients towards hormonal treatment. The main aim of this study was to assess the morphological characteristics and proliferative activity using MIB-1(Ki-67) of estrogen receptor negative invasive breast ductal carcinoma (NOS type) as well as to correlate these features with clinicopathological data. We also aim to study the expression of c-erbB2 in ER negative breast tumors. High pro...

  13. Correlations in survivin expression with the expression of p53 and bcl-2 in invasive ductal carcinoma of the breast.

    Science.gov (United States)

    Al-Joudi, F S; Iskandar, Z A; Imran, A K

    2007-09-01

    This work studied the correlations between survivin, bcl-2 and p53 in infiltrating ductal carcinoma of the breast. A total number of 382 cases were collected from 3 hospitals in northeastern Malaysia. Survivin, bcl-2 and p53 were detected by immunohistochemistry on samples prepared from tissue blocks. Significant correlations were found between tumor histological grades and tumor size and lymph node involvement. Highly significant statistical correlations (pfashion, implying that many of these cases may share common abnormalities. PMID:18041310

  14. Conservative treatment of breast ductal carcinoma in situ: results of an Italian multi-institutional retrospective study

    OpenAIRE

    Vidali Cristiana; Caffo Orazio; Aristei Cynthia; Bertoni Filippo; Bonetta Alberto; Guenzi Marina; Iotti Cinzia; Leonardi Maria; Mussari Salvatore; Neri Stefano; Pietta Nicoletta

    2012-01-01

    Abstract Background The incidence of ductal carcinoma in situ (DCIS) has increased markedly in recent decades. In the past, mastectomy was the primary treatment for patients with DCIS, but as with invasive cancer, breast-conserving surgery followed by radiation therapy (RT) has become the standard approach. We present the final results of a multi-institutional retrospective study of an Italian Radiation Oncology Group for the study of conservative treatment of DCIS, characterized by a very lo...

  15. Expression of Presenilin-2 and Glutathione S Transferase π and Their Clinical Significance in Breast Infiltrating Ductal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    FANWei; WUXiaoting; ZHOUYejiang; ZHOUTong; HUANGXiong

    2005-01-01

    Objective: To investigate the expressions of presenilin-2 (PS2) and glutathione S transferase π (GSTπ) and their roles in prognosis and therapy of breast infiltrating ductal carcinoma. Methods:The paraffin-embedded specimens of 210 patients with breast infiltrating ductal carcinoma were examined by using LSAB immunohistochemistry for the expression of PS2 and GSTπ. Results: The expression rate of PS2 and GSTπ was 49.5% (104/210) and 48.1% (101/210) respectively. The 5-year and 10-year postoperative survival rates in 4 groups, from high to low, were group 1 (PS2 positive expression/GSTπ negative expression), group 2 (PS2 positive expression/GSTπ positive expression), group 3 (PS2 negative expression/GSTπ negative expression) and group 4 (PS2 negative expression/GSTπ positive expression) in turn. Conclusion: The prognosis of the group 1 was the best, followed by the group 2, group 3 and group 4 in turn. These results suggested that the reasonable use of endocrinotherapy and chemotherapy for patients with breast infiltrating ductal carcinoma is necessary.

  16. Nuclear Morphometry in Ductal Breast Carcinoma with Correlation to Cell Proliferative Activity and Prognosis

    International Nuclear Information System (INIS)

    Morphometry is the quantitative description of biologic structures. This study was designed to evaluate the efficiency of morphometric measurements in diagnosis and prognosis of patients with breast carcinoma. Methods: Histological samples from 61 patients of invasive duct carcinoma (IDC) of no special type (NST), 12 cases of ductal carcinoma in situ (DCIS) and 14 control breast samples taken from fibrocystic change disease were retrospectively analyzed by computerized nuclear morphometry. All IDC patients underwent modified radical mastectomy without preoperative chemotherapy. The mean follow up was 28±19 months (range] -71). In each case, 25-50 nuclei were measured and the mean nuclear area (MNA), mean nuclear perimeter (MNP), mean maximum nuclear diameter (MMNO) and mean minimal nuclear diameter (Mmnd) were measured. The mean axis ratio (MAR), mean nuclear compactness (MNC), mean nuclear size (MNS) and mean shape factor (MSHF), were calculated mathematically. To measure the nuclear diameters, a new method was employed using the AutoCAD program. Morphometric parameters were compared with different clinico pathologic features, patient's survival and cell proliferative activity as determined by Ki-67 immunostaining which was evaluated quantitatively. Most of the morphometric parameters were significantly higher in DCIS and IDC groups than benign one. In IDC group morphometric features related to nuclear size (MNA, MNP, MMNO, Mmnd and MNS) were significantly correlated to most clinico pathologic features and cell proliferative activity assessed by Ki-67 immunostaining. However, the shape factor failed to achieve this correlation. The univariate analysis using Kaplan Meier curves indicated that short survival time was correlated with high nuclear morphometric values (MNA. MNP, MMND, Mmnd, MNS and MSHF). Moreover, the Spear man correlation analysis showed that Mmnd has the highest converse correlation with survival (r= -0.75, (ρ < 0.0001). In multivariate analysis

  17. Diagnosis of Ductal Carcinoma in situ: Role of Additional Breast Sonography

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Sae Rom; Moon, Hee Jung; Kim, Min Jung; Kim, Eun Kyung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    To verify the role of additional sonography on routine mammograms in the diagnosis of ductal carcinoma in situ (DCIS). Between 2005 and 2008, a total of 105 breasts belonging to 102 patients were diagnosed with DCIS by surgery. Preoperative ultrasound and mammographic findings and reports using BI-RADS were retrospectively reviewed and analyzed. In both mammogram and ultrasound, BI-RADS categories 1, 2, and 3 were regarded as negative results and categories 4 and 5 as positive results. We analyzed the frequency in which additional ultrasound examinations aided in the diagnosis in each mammographic finding. Out of the 105 cases, 96 showed positive results on a mammogram and 9 cases showed negative results. Clustered microcalcifications, positive mammographic findings, were found most often (64/96, 66.67%). In those cases, ultrasound examinations gave no additional information, but did enablesonographically-guided biopsies in 38. In the 32 cases with other positive mammographic findings, ultrasound examinations were helpful in 15 cases. Of the 9 cases showing negative results on a mammogram, 8 cases were correctly diagnosed with DCIS because of the additionally-performed ultrasound examination, but 1 case returned a false negative on both the mammogram and ultrasound examination. Additional sonography contributes to a diagnosis of DCIS in patients with negative mammographic findings, nonspecific mammographic findings, or multifocal lesions

  18. Identifying three different architectural subtypes of mammary ductal carcinoma in situ using multiphoton microscopy

    Science.gov (United States)

    Wu, Yan; Fu, Fangmeng; Lian, Yuane; Nie, Yuting; Zhuo, shuangmu; Wang, Chuan; Chen, Jianxin

    2015-10-01

    Ductal carcinoma in situ (DCIS) is often considered as the precursor of invasive breast cancer, and the risk of DCIS progression to IBC has been estimated based on the evaluation of pathological features, among which the architectural subtype is the most common one. In this study, multiphoton microscopy (MPM) is applied to identify three different architectural subtypes of DCIS (solid, cribriform and comedo). It is found that MPM has the capability to visualize the proliferating pattern of tumor cells, the presence of intraluminal necrosis and the morphology of basement membrane, which are all taken into account in subtyping DCIS. In addition, MPM also can be used to quantify the cellular metabolism, for quantitatively identifying tumor staging during tumor progression. This result highlights the potential of MPM as an advanced technique to assess the pathological characters of the breast tumor in real-time and reflect the degree of tumor progression in vivo, by integrating into the intra-fiberoptic ductoscopy or transdermal biopsy needle.

  19. Treatment outcome of ductal carcinoma in situ patients treated with postoperative radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Yu Jin; Kim, Kyu Bo; Choi, Eui Kyu; Han, Won Shik; Noh, Dong Young; Ha, Sung W. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or ≥1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.

  20. Long-term Survival after Resection of HER2+ Infiltrating Ductal Carcinoma Metastasis to the Brainstem.

    Science.gov (United States)

    Awad, Al-Wala; Zaidi, Hasan A; Awad, Al-Homam; Spetzler, Robert

    2016-01-01

    The central nervous system is a common site of metastatic spread from neoplasms in distant organs, including breast, bone, and lung. The decision to surgically treat these metastatic lesions is often challenging, especially in the setting of systemic disease or when eloquent brain regions are involved. Treating metastatic disease in the brainstem can be technically difficult, and in many institutions, considered a contraindication to surgical intervention, given the relatively high risk of new postoperative neurological deficits. Herein, we report a case of metastatic ductal carcinoma of the breast with spread to the pontine-medullary junction that was treated with aggressive surgical resection and chronic hormonal therapy. After surgical excision of the brainstem lesion, the patient remained asymptomatic and was maintained on trastuzumab therapy over a 10-year follow-up period, with no radiographic or clinical evidence of recurrent disease. To our knowledge, this is the first report of a patient treated for a solitary metastasis to the brainstem with long-term survival. PMID:26929889

  1. Modeling ductal carcinoma in situ: a HER2-Notch3 collaboration enables luminal filling.

    LENUS (Irish Health Repository)

    Pradeep, C-R

    2012-02-16

    A large fraction of ductal carcinoma in situ (DCIS), a non-invasive precursor lesion of invasive breast cancer, overexpresses the HER2\\/neu oncogene. The ducts of DCIS are abnormally filled with cells that evade apoptosis, but the underlying mechanisms remain incompletely understood. We overexpressed HER2 in mammary epithelial cells and observed growth factor-independent proliferation. When grown in extracellular matrix as three-dimensional spheroids, control cells developed a hollow lumen, but HER2-overexpressing cells populated the lumen by evading apoptosis. We demonstrate that HER2 overexpression in this cellular model of DCIS drives transcriptional upregulation of multiple components of the Notch survival pathway. Importantly, luminal filling required upregulation of a signaling pathway comprising Notch3, its cleaved intracellular domain and the transcriptional regulator HES1, resulting in elevated levels of c-MYC and cyclin D1. In line with HER2-Notch3 collaboration, drugs intercepting either arm reverted the DCIS-like phenotype. In addition, we report upregulation of Notch3 in hyperplastic lesions of HER2 transgenic animals, as well as an association between HER2 levels and expression levels of components of the Notch pathway in tumor specimens of breast cancer patients. Therefore, it is conceivable that the integration of the Notch and HER2 signaling pathways contributes to the pathophysiology of DCIS.

  2. The Problems of Radiofrequency Ablation as an Approach for Advanced Unresectable Ductal Pancreatic Carcinoma

    International Nuclear Information System (INIS)

    Advanced ductal pancreatic carcinoma (PC) remains a challenge for current surgical and medical approaches. It has recently been claimed that radiofrequency ablation (RFA) may be beneficial for patients with locally advanced or metastatic PC. Using the MEDLINE database, we found seven studies involving 106 patients in which PC was treated using RFA. The PC was mainly located in the pancreatic head (66.9%) with a median size of 4.6 cm. RFA was carried out in 85 patients (80.1%) with locally advanced PC and in 21 (19.9%) with metastatic disease. Palliative surgical procedures were carried out in 41.5% of the patients. The average temperature used was 90 °C (with a temperature range of 30–105 °C) and the ratio between the number of passes of the probe and the size of the tumor in centimeters was 0.5 (range of 0.36–1). The median postoperative morbidity and mortality were 28.3% and 7.5%, respectively; the median survival was 6.5 months (range of 1–33 months). In conclusion, RFA is a feasible technique: however, its safety and long-term results are disappointing; Thus, the RFA procedure should not be recommended in clinical practice for a PC patient

  3. Is Radiation Indicated in Patients With Ductal Carcinoma In Situ and Close or Positive Mastectomy Margins?

    International Nuclear Information System (INIS)

    Purpose: Resection margin status is one of the most significant factors for local recurrence in patients with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery with or without radiation. However, its impact on chest wall recurrence in patients treated with mastectomy is unknown. The purpose of this study was to determine chest wall recurrence rates in women with DCIS and close (5 cm or diffuse disease. Median width of the close final margin was 2 mm. Nineteen patients had margins of <1 mm. One of these 59 patients experienced a chest wall recurrence with regional adenopathy, followed by distant metastases 2 years following skin-sparing mastectomy. The DCIS was high-grade, 4 cm, with a 5-mm deep margin. A second patient developed an invasive cancer in the chest wall 20 years after her mastectomy for DCIS. This cancer was considered a new primary site arising in residual breast tissue. Conclusions: The risk of chest wall recurrence in this series of patients is 1.7% for all patients and 3.3% for high-grade DCIS. One out of 20 (5%) patients undergoing skin sparing or total skin-sparing mastectomy experienced a chest wall recurrence. This risk of a chest wall recurrence appears sufficiently low not to warrant a recommendation for postmastectomy radiation therapy for patients with margins of <5 mm. There were too few patients with positive margins to draw any firm conclusions.

  4. The Problems of Radiofrequency Ablation as an Approach for Advanced Unresectable Ductal Pancreatic Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pezzilli, Raffaele, E-mail: raffaele.pezzilli@aosp.bo.it [Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna (Italy); Ricci, Claudio [Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna (Italy); Serra, Carla [Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna (Italy); Casadei, Riccardo; Monari, Francesco; D’Ambra, Marielda [Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna (Italy); Corinaldesi, Roberto [Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna (Italy); Minni, Francesco [Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna (Italy)

    2010-07-01

    Advanced ductal pancreatic carcinoma (PC) remains a challenge for current surgical and medical approaches. It has recently been claimed that radiofrequency ablation (RFA) may be beneficial for patients with locally advanced or metastatic PC. Using the MEDLINE database, we found seven studies involving 106 patients in which PC was treated using RFA. The PC was mainly located in the pancreatic head (66.9%) with a median size of 4.6 cm. RFA was carried out in 85 patients (80.1%) with locally advanced PC and in 21 (19.9%) with metastatic disease. Palliative surgical procedures were carried out in 41.5% of the patients. The average temperature used was 90 °C (with a temperature range of 30–105 °C) and the ratio between the number of passes of the probe and the size of the tumor in centimeters was 0.5 (range of 0.36–1). The median postoperative morbidity and mortality were 28.3% and 7.5%, respectively; the median survival was 6.5 months (range of 1–33 months). In conclusion, RFA is a feasible technique: however, its safety and long-term results are disappointing; Thus, the RFA procedure should not be recommended in clinical practice for a PC patient.

  5. Proteomic profiling of 13 paired ductal infiltrating breast carcinomas and non-tumoral adjacent counterparts.

    Science.gov (United States)

    Pucci-Minafra, Ida; Cancemi, Patrizia; Marabeti, Maria Rita; Albanese, Nadia Ninfa; Di Cara, Gianluca; Taormina, Pietra; Marrazzo, Antonio

    2007-01-01

    According to recent statistics, breast cancer remains one of the leading causes of death among women in Western countries. Breast cancer is a complex and heterogeneous disease, presently classified into several subtypes according to their cellular origin. Among breast cancer histotypes, infiltrating ductal carcinoma represents the most common and potentially aggressive form. Despite the current progress achieved in early cancer detection and treatment, including the new generation of molecular therapies, there is still need for identification of multiparametric biomarkers capable of discriminating between cancer subtypes and predicting cancer progression for personalized therapies. One established step in this direction is the proteomic strategy, expected to provide enough information on breast cancer profiling. To this aim, in the present study we analyzed 13 breast cancer tissues and their matched non-tumoral tissues by 2-DE. Collectively, we identified 51 protein spots, corresponding to 34 differentially expressed proteins, which may represent promising candidate biomarkers for molecular-based diagnosis of breast cancer and for pattern discovery. The relevance of these proteins as factors contributing to breast carcinogenesis is discussed. PMID:21136615

  6. Correlation between imaging and pathology in ductal carcinoma in situ of the breast

    Directory of Open Access Journals (Sweden)

    de Vries Jaap

    2004-03-01

    Full Text Available Abstract Background It is helpful in planning treatment for patients with ductal carcinoma in situ (DCIS if the size and grade could be reliably predicted from the mammography. The aims of this study were to determine if the type of calcification can be best used to predict histopathological grade from the mammograms, to examine the association of mammographic appearance of DCIS with grade and to assess the correlation between mammographic size and pathological size. Methods Mammographic films and pathological slides of 115 patients treated for DCIS between 1986 and 2000 were reviewed and reclassified by a single radiologist and a single pathologist respectively. Prediction models for the European Pathologist Working Group (EPWG and Van Nuys classifications were generated by ordinal regression. The association between mammographic appearance and grade was tested with the χ2-test. Relation of mammographic size with pathological size was established using linear regression. The relation was expressed by the correlation coefficient (r. Results The EPWG classification was correctly predicted in 68%, and the Van Nuys classification in 70% if DCIS was presented as microcalcifications. High grade was associated with presence of linear calcifications (p Conclusions Prediction of histopathological grade of DCIS presenting as microcalcifications is comparable using the Van Nuys and EPWG classification. There is no strict association of mammographic appearance with histopathological grade. There is a better linear relation between mammographic- and pathological size of DCIS presented as microcalcifications than as a density, although both relations are statistically significant.

  7. A comparison study of pancreatic acinar cell carcinoma with ductal adenocarcinoma using computed tomography in Chinese patients

    Directory of Open Access Journals (Sweden)

    Wang Q

    2016-09-01

    Full Text Available Qingbing Wang,1,2 Xiaolin Wang,1,2 Rongfang Guo,2,3 Guoping Li1,2 1Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 2Shanghai Institute of Medical Imaging, 3Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China Abstract: Pancreatic acinar cell carcinoma (ACC is a rare tumor that is difficult to diagnose preoperatively. The aim of this study was to evaluate and describe the computed tomography (CT features of ACC and compare the results with pancreatic ductal adenocarcinoma (DAC for improving preoperative diagnosis. The control group consisted of 34 patients with DAC collected from the pathology electronic database. The CT imaging from nine patients with pathologically confirmed ACC was retrospectively reviewed. Two radiologists independently assessed the tumor location, size, texture, and enhancement patterns. We found that 64.3% (9/14 of ACC tumors were homogeneous and 35.7% (5/14 had necrosis. The percentage of common bile duct and pancreatic ductal dilation was 14.3% (2/14 and 7.1% (1/14, respectively. The mean size of ACC was 50.1±24.2 mm. The mean attenuation of ACC was 35.4±3.9 Hounsfield unit (HU before enhancement, 73.1±42.9 HU in arterial phase, and 71.8±15.6 HU in port venous phase. It is difficult to distinguish ACC from DAC preoperatively only based on CT findings. However, compared with DAC, we found that ACC tumors are likely to be larger and contain more heterogeneous intratumoral necrotic hypovascular regions, and less pancreatic ductal and common biliary dilation. Keywords: acinar cell carcinoma, computed tomography, pancreatic ductal carcinoma, pancreas

  8. Chromosomal aberrations detected by comparative genomic hybridization technique (CGH in invasive ductal carcinoma of breast

    Directory of Open Access Journals (Sweden)

    Nooshiravanpour P

    2007-10-01

    Full Text Available Background: Nonlethal genetic damage is the basis for carcinogenesis. As various gene aberrations accumulate, malignant tumors are formed, regardless of whether the genetic damage is subtle or large enough to be distinguished in a karyotype. The study of chromosomal changes in tumor cells is important in the identification of oncogenes and tumor suppressor genes by molecular cloning of genes in the vicinity of chromosomal aberrations. Furthermore, some specific aberrations can be of great diagnostic and prognostic value. Comparative genomic hybridization (CGH is used to screen the entire genome for the detection and/or location chromosomal copy number changes.Methods: In this study, frozen sections of 20 primary breast tumors diagnosed as invasive ductal carcinoma from the Cancer Institute of Imam Khomeini Hospital, Tehran, Iran, were studied by CGH to detect chromosomal aberrations. We compared histopathological and immunohistochemical findings.Results: Hybridization in four of the cases was not optimal for CGH analysis and they were excluded from the study. DNA copy number changes were detected in 12 (75% of the remaining 16 cases. Twenty-one instances of chromosomal aberrations were detected in total, including: +1q, +17q, +8q, +20q, -13q, -11q, -22q, -1p, -16q, -8p. The most frequent were +1q, +17q, +8q, -13q, similar to other studies. In three cases, we detected -13q, which is associated with axillary lymph node metastasis and was reported in one previous study. The mean numbers of chromosomal aberrations per tumor in metastatic and nonmetastatic tumors was 1.5 and 1, respectively. No other association between detected chromosomal aberrations and histopathological and immunohistochemical findings were seen.Conclusion: Since intermediately to widely invasive carcinomas are more likely to have chromosomal aberrations, CGH can be a valuable prognostic tool. Furthermore, CGH can be used to detect targeting molecules within novel amplifications

  9. Expression of miR-21 and its targets (PTEN, PDCD4, TM1) in flat epithelial atypia of the breast in relation to ductal carcinoma in situ and invasive carcinoma

    NARCIS (Netherlands)

    Qi, Liqiang; Bart, Joost; Tan, Lu Ping; Platteel, Inge; van der Sluis, Tineke; Huitema, Sippie; Harms, Geert; Fu, Li; Hollema, Harry; van den Berg, Anke

    2009-01-01

    Background: Flat epithelial atypia (FEA) of the breast is characterised by a few layers of mildly atypical luminal epithelial cells. Genetic changes found in ductal carcinoma in situ (DCIS) and invasive ductal breast cancer (IDC) are also found in FEA, albeit at a lower concentration. So far, miRNA

  10. Elevated expression of LSD1 (Lysine-specific demethylase 1 during tumour progression from pre-invasive to invasive ductal carcinoma of the breast

    Directory of Open Access Journals (Sweden)

    Serce Nuran

    2012-08-01

    Full Text Available Abstract Background Lysine-specific demethylase1 (LSD1 is a nuclear protein which belongs to the aminooxidase-enzymes playing an important role in controlling gene expression. It has also been found highly expressed in several human malignancies including breast carcinoma. Our aim was to detect LSD1 expression also in pre-invasive neoplasias of the breast. In the current study we therefore analysed LSD1 protein expression in ductal carcinoma in situ (DCIS in comparison to invasive ductal breast cancer (IDC. Methods Using immunohistochemistry we systematically analysed LSD1 expression in low grade DCIS (n = 27, intermediate grade DCIS (n = 30, high grade DCIS (n = 31 and in invasive ductal breast cancer (n = 32. SPSS version 18.0 was used for statistical analysis. Results LSD1 was differentially expressed in DCIS and invasive ductal breast cancer. Interestingly, LSD1 was significantly overexpressed in high grade DCIS versus low grade DCIS. Differences in LSD1 expression levels were also statistically significant between low/intermediate DCIS and invasive ductal breast carcinoma. Conclusions LSD1 is also expressed in pre-invasive neoplasias of the breast. Additionally, there is a gradual increase of LSD1 expression within tumour progression from pre-invasive DCIS to invasive ductal breast carcinoma. Therefore upregulation of LSD1 may be an early tumour promoting event.

  11. Tumor characteristics and the clinical outcome of invasive lobular carcinoma compared to infiltrating ductal carcinoma in a Chinese population

    Directory of Open Access Journals (Sweden)

    Cao A-Yong

    2012-07-01

    Full Text Available Abstract Background We sought to compare the baseline demographics, standard pathologic factors and long-term clinical outcomes between ILC and infiltrating ductal carcinoma (IDC using a large database. Methods Clinicopathologic features, overall survival (OS, and recurrence/metastasis-free survival (RFS were compared between 2,202 patients with IDC and 215 patients with ILC. Results ILC was significantly more likely to be associated with a favorable phenotype, but the incidence of contralateral breast cancer was higher for ILC patients than for IDC patients (8.4% vs. 3.9%; P =0.001. The frequencies of recurrence/metastasis (P = 0.980 and death (P = 0.064 were similar among patients with IDC and patients with ILC after adjustment for tumor size and nodal status. The median follow-up was 42.8 months. Conclusions Chinese women with ILCs do not have better clinical outcomes than their counterparts with IDC. Management decisions should be based on individual patient and tumor biologic characteristics, and not on lobular histology.

  12. Axillary evaluation and lymphedema in women with ductal carcinoma in situ.

    Science.gov (United States)

    Coromilas, Ellie J; Wright, Jason D; Huang, Yongmei; Feldman, Sheldon; Neugut, Alfred I; Hillyer, Grace Clarke; Chen, Ling; Hershman, Dawn L

    2016-07-01

    Axillary evaluation in women with ductal carcinoma in situ (DCIS) is increasing; however, this may introduce additional morbidity with unclear benefit. Our objective was to examine the morbidity and mortality associated with axillary evaluation in DCIS. We conducted a retrospective cohort study of 10,504 women aged 65-90 years with DCIS who underwent breast conserving surgery between 2002 and 2012 using SEER-Medicare database. Patients were categorized by receipt of axillary evaluation with either sentinel lymph node biopsy (SLNB) or axillary node dissection (ALND). We determined the incidence of lymphedema treatment as defined by diagnostic and procedural codes, as well as 10-year breast cancer-specific and all-cause mortality. 18.3 % of those treated with BCS and 69.4 % of those treated with mastectomy had an axillary evaluation. One year after treatment, 8.2 % of women who had an axillary evaluation developed lymphedema, compared to 5.9 % of those who did not. In a multivariable Cox proportional hazard model, the incidence of lymphedema was higher among those who underwent axillary evaluation (HR 1.22, 95 % CI 1.04-1.45). Overall 10-year breast cancer-specific survival was similar between both groups (HR 0.83, 95 % CI 0.40-1.74). Only 44 (0.40 %) women died of breast cancer; receipt of axillary evaluation did not alter overall survival. Axillary evaluation is commonly performed in women with DCIS, especially those undergoing mastectomy. However, women who receive an axillary evaluation have higher rates of lymphedema, without breast cancer-specific or overall survival benefit. Efforts should be made to determine the population of women with DCIS who benefit from this procedure. PMID:27365080

  13. Micro-PIXE analysis in invasive ductal carcinoma tissues after treatment of astaxanthin

    International Nuclear Information System (INIS)

    Trace elements play an important role in a number of biological processes. Astaxanthin, a carotoid pigment found in certain marine plant and animals, has shown anti cancer and anti free radical properties. This work intended to understand the effect of Astaxanthin in breast cancer (invasive ductal carcinoma) by using micro-PIXE method. For this aim the concentration of trace elements were compared in healthy, cancerous and cancer treated with astaxanthin in the breast and liver tissues of breast cancer bearing mice, using proton induced X-ray emission. Materials and Methods: Proton induced X-ray emission was used In a study intending to compare the concentration of trace elements in breast and liver tissues of mice bearing tumor, three groups of mice: healthy, cancerous, and cancerous treated by astaxanthin, were considered. Astaxanthin was supplied from Research Institute of women, Alzahra University. Results: Comparing the untreated tumor tissue, treatment with Astaxanthm significantly decreased the amount Fe, P, S, and Ca elements level in tumor tissue of the breast cancer. It is also found that the concentrations of those elements in liver of the untreated mice and the liver of treated mice with astaxanthin were fairly equal. Astaxanthln significantly decrease the accumulation of elements in the site of tumor, and caused the breast cancer cell membrane to lose their desire to collect the elements from healthy tissues. Conclusion: The micro -PIXE technique could calculate elemental concentrations in tissues. Changes in metallic elements may affect microenvironment and cell functions, which might led lead to cell degeneration or death, the results shows that astaxanthin reduces vital element concentration in tumor site, thus it could be used as an anti tumor agent.

  14. Expression analysis of carbohydrate antigens in ductal carcinoma in situ of the breast by lectin histochemistry

    Directory of Open Access Journals (Sweden)

    Kieber-Emmons Thomas

    2008-05-01

    Full Text Available Abstract Background The number of breast cancer patients diagnosed with ductal carcinoma in situ (DCIS continues to grow. Laboratory and clinical data indicate that DCIS can progress to invasive disease. Carbohydrate-mediated cell-cell adhesion and tumor-stroma interaction play crucial roles in tumorigenesis and tumor aggressive behavior. Breast carcinogenesis may reflect quantitative as well as qualitative changes in oligosaccharide expression, which may provide a useful tool for early detection of breast cancer. Because tumor-associated carbohydrate antigens (TACA are implicated in tumor invasion and metastasis, the purpose of this study was to assess the expression of selected TACA by lectin histochemistry on DCIS specimens from the archival breast cancer tissue array bank of the University of Arkansas for Medical Sciences. Methods For detection of TACA expression, specimens were stained with Griffonia simplicifolia lectin-I (GS-I and Vicia vilosa agglutinin (VVA. We studied associations of lectin reactivity with established prognostic factors, such as tumor size, tumor nuclear grade, and expression of Her-2/neu, p53 mutant and estrogen and progesterone receptors. Results We observed that both lectins showed significant associations with nuclear grade of DCIS. DCIS specimens with nuclear grades II and III showed significantly more intense reactivity than DCIS cases with nuclear grade I to GS-1 (Mean-score chi-square = 17.60, DF = 2; P = 0.0002 and VVA (Mean-score chi-square = 15.72, DF = 2; P = 0.0004. Conclusion The results suggest that the expression of VVA- and GS-I-reactive carbohydrate antigens may contribute to forming higher grade DCIS and increase the recurrence risk.

  15. Outcomes in Patients Treated With Mastectomy for Ductal Carcinoma In Situ

    International Nuclear Information System (INIS)

    Purpose: To examine, in a large, population-based cohort of women, the risk factors for recurrence after mastectomy for pure ductal carcinoma in situ (DCIS) and to identify which patients may benefit from postmastectomy radiation therapy. Methods and Materials: Data were analyzed for 637 subjects with pure DCIS, diagnosed between January 1990 and December 1999, treated initially with mastectomy. Locoregional relapse (LRR), breast cancer-specific survival, and overall survival were described using the Kaplan-Meier method. Reported risk factors for LRR (age, margins, size, Van Nuys Prognostic Index, grade, necrosis, and histologic subtype) were analyzed by univariate (log-rank) and multivariate (Cox modeling) methods. Results: Median follow-up was 12.0 years. Characteristics of the cohort were median age 55 years, 8.6% aged ≤40 years, 30.5% tumors >4 cm, 42.5% grade 3 histology, 37.7% multifocal disease, and 4.9% positive margins. At 10 years, LRR was 1.0%, breast cancer-specific survival was 98.0%, and overall survival was 90.3%. All recurrences (n=12) involved ipsilateral chest wall disease, with the majority being invasive disease (11 of 12). None of the 12 patients with recurrence died of breast cancer; all were successfully salvaged (median follow-up of 4.4 years). Ten-year LRR was higher with age ≤40 years (7.5% vs 1.5%; P=.003). Conclusion: Mastectomy provides excellent locoregional control for DCIS. Routine use of postmastectomy radiation therapy is not justified. Young age (≤40 years) predicts slightly higher LRR, but possibly owing to the small number of cases with multiple risk factors for relapse, a subgroup with a high risk of LRR (ie, approximately 15%) was not identified

  16. Zinc presence in invasive ductal carcinoma of the breast and its correlation with oestrogen receptor status

    Science.gov (United States)

    Farquharson, M. J.; Al-Ebraheem, A.; Geraki, K.; Leek, R.; Jubb, A.; Harris, A. L.

    2009-07-01

    Zinc is known to play an important role in many cellular processes, and the levels of zinc are controlled by specific transporters from the ZIP (SLC39A) influx transporter group and the ZnT (SLC30A) efflux transporter group. The distribution of zinc was measured in 59 samples of invasive ductal carcinoma of breast using synchrotron radiation micro probe x-ray fluorescence facilities. The samples were formalin fixed paraffin embedded tissue micro arrays (TMAs) enabling a high throughput of samples and allowing us to correlate the distribution of trace metals with tumour cell distribution and, for the first time, important biological variables. The samples were divided into two classes, 34 oestrogen receptor positive (ER+ve) and 25 oestrogen receptor negative (ER-ve) based on quantitative immunohistochemistry assessment. The overall levels of zinc (i.e. in tumour and surrounding tissue) in the ER+ve samples were on average 60% higher than those in the ER-ve samples. The zinc levels were higher in the ER+ve tumour areas compared to the ER-ve tumour areas with the mean levels in the ER+ve samples being approximately 80% higher than the mean ER-ve levels. However, the non-tumour tissue regions of the samples contained on average the same levels of zinc in both types of breast cancers. The relative levels of zinc in tumour areas of the tissue were compared with levels in areas of non-tumour surrounding tissue. There was a significant increase in zinc in the tumour regions of the ER+ve samples compared to the surrounding regions (P tissue zinc level in the same sample, a significant difference between the ER+ve and ER-ve samples was found (P < 0.01).

  17. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Abbott, Andrea M.; Portschy, Pamela R. [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Lee, Chung [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota (United States); Le, Chap T. [Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota (United States); Han, Linda K. [Department of Surgery, Indiana University, Indianapolis, Indiana (United States); Washington, Tara [Vantage Oncology, Redhawk and Wildomar Centers California, Wildomar, California (United States); Kinney, Michael [Center for Advanced Breast Care, Arlington Heights, Illinois (United States); Bretzke, Margit [Surgical Specialists of Minnesota, Minneapolis, Minnesota (United States); Tuttle, Todd M., E-mail: tuttl006@umn.edu [Division of Surgical Oncology, University of Minnesota, Minneapolis, Minnesota (United States)

    2013-11-01

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended.

  18. No-Touch Pancreatectomy for Invasive Ductal Carcinoma of the Pancreas

    Directory of Open Access Journals (Sweden)

    Masahiko Hirota

    2014-05-01

    Full Text Available Background Pancreatectomy is the only effective treatment for cancers of the pancreas. Surgeons usually grasp tumors duringpancreatectomy, however, this procedure may increase the risk of squeezing and shedding of the cancer cells into the portal vein, retroperitoneum, and/or peritoneal cavity. In an effort to overcome these problems, we have developed surgical techniques for no-touch pancreatectomy. Methods From April 2008 through September 2013, 52 patients have been operated on no-touch pancreatectomy for invasive ductal carcinoma of the pancreas by a single operator (M.H.. Among them, 40 received pancreatoduodenectomy (PD, and 12 did distal pancreatectomy (DP. Twenty two cases (42% required SMV-PV resection. This is a study to see if pancreatectomy can be technically done using a no-touch surgical technique without deteriorating the post-operative prognosis. During the procedure, the pancreatic tumor is neither grasped nor squeezed by the surgeon. Furthermore, for improved dissection of the retroperitoneal tissue (leftward and posterior margins for PD and rightward and posterior margins for DP, we use a hanging and clamping maneuver and dissection behind Gerota fascia. Results Overall 2- and 5-year survival rates were 64 and 42% with mean follow-up periods of 34.4 months (range: 6-68 months. Recurrence free 2- and 5-year survival rates were 49 and 31%, respectively. The 5-year survival rates of patients with JPS-stage ? andthose with JPS-stage ? were 57 and 20%, respectively. The 5-year survival rates of patients with UICC-stage ?A and those with UICCstage ?B were 49 and 39%, respectively. Patients with UICC-stage ? or ? did not survive for more than 2 years. Conclusions No-touch pancreatectomy has many theoretic advantages that merit further investigation in future randomized controlled trials.

  19. Increased serum carbohydrate antigen 19-9 in relapsed ductal breast carcinoma.

    Science.gov (United States)

    Papantoniou, Vassilios; Tsiouris, Spyridon; Koutsikos, John; Ptohis, Nikolaos; Lazaris, Dimitrios; Zerva, Cherry

    2006-01-01

    Increased serum carbohydrate antigen (CA) 19-9 is a quite uncommon manifestation of breast cancer both on early disease and on relapse. A 53-year-old woman with invasive ductal breast carcinoma underwent left-sided mastectomy. Two years later she palpated a subcutaneous mass at the mastectomy scar, arousing suspicion of local relapse. Surgery and histopathology revealed infiltration by breast adenocarcinoma and she was treated with chemotherapy. At that time serum tumor markers, carcinoembryonic antigen (CEA) and CA 15-3 were within normal range. Over the next six months she displayed an increase of serum CEA while serum CA 15-3 remained within normal range. In an attempt to search for a second neoplasm possibly of gastrointestinal (GI) origin, abdominal computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangio-pancreatography (MRCP), endoscopy of the upper GI tract and colonoscopy were performed, as well as measurement of serum CA 19-9. While no indication of a GI neoplasm was detected, she displayed an over 10-fold increase of serum CA 19-9. The patient had also an X-ray mammography and technetium-99m hexakis-2-methoxyisobutylisonitrile ((99m)Tc-MIBI) scintimammography (SM). Whilst mammography was negative for contralateral disease recurrence, SM was suggestive of axillary lymph node involvement. Axillary lymph node dissection confirmed an extensive metastatic infiltration of these nodes by breast adenocarcinoma. Three months later serum CA 19-9 and CEA became normal. The interest of this case lies on the unexpected high serum CA 19-9 values found in a breast relapsed adenocarcinoma and in the important contribution of SM in diagnosing the axillary lymph node metastatic infiltration. PMID:16617392

  20. Prospective Multicenter Trial Evaluating Balloon-Catheter Partial-Breast Irradiation for Ductal Carcinoma in Situ

    International Nuclear Information System (INIS)

    Purpose: To determine outcomes of accelerated partial-breast irradiation (APBI) with MammoSite in the treatment of ductal carcinoma in situ (DCIS) after breast-conserving surgery. Methods and Materials: We conducted a prospective, multicenter trial between 2003 and 2009. Inclusion criteria included age >18 years, core needle biopsy diagnosis of DCIS, and no prior breast cancer history. Patients underwent breast-conserving surgery plus MammoSite placement. Radiation was given twice daily for 5 days for a total of 34 Gy. Patients were evaluated for development of toxicities, cosmetic outcome, and ipsilateral breast tumor recurrence (IBTR). Results: A total of 41 patients (42 breasts) completed treatment in the study, with a median follow up of 5.3 years. Overall, 28 patients (68.3%) experienced an adverse event. Skin changes and pain were the most common adverse events. Cosmetic outcome at 6 months was judged excellent/good by 100% of physicians and by 96.8% of patients. At 12 months, 86.7% of physicians and 92.3% of patients rated the cosmetic outcome as excellent/good. Overall, 4 patients (9.8%) developed an IBTR (all DCIS), with a 5-year actuarial rate of 11.3%. All IBTRs were outside the treatment field. Among patients with IBTRs, the mean time to recurrence was 3.2 years. Conclusions: Accelerated partial-breast irradiation using MammoSite seems to provide a safe and cosmetically acceptable outcome; however, the 9.8% IBTR rate with median follow-up of 5.3 years is concerning. Prospective randomized trials are necessary before routine use of APBI for DCIS can be recommended

  1. Five Year Outcome of 145 Patients With Ductal Carcinoma In Situ (DCIS) After Accelerated Breast Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ciervide, Raquel [Department of Radiation Oncology, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States); Dhage, Shubhada; Guth, Amber; Shapiro, Richard L.; Axelrod, Deborah M.; Roses, Daniel F. [Department of Surgery, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States); Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States)

    2012-06-01

    Background: Accelerated whole-breast radiotherapy (RT) with tumor bed boost in the treatment of early invasive breast cancer has demonstrated equivalent local control and cosmesis when compared with standard RT. Its efficacy in the treatment of ductal carcinoma in situ (DCIS) remains unknown. Methods and Materials: Patients treated for DCIS with lumpectomy and negative margins were eligible for 2 consecutive hypofractionated whole-breast RT clinical trials. The first trial (New York University [NYU] 01-51) prescribed to the whole breast 42 Gy (2.8 Gy in 15 fractions) and the second trial (NYU 05-181) 40.5 Gy (2.7 Gy in 15 fractions) with an additional daily boost of 0.5 Gy to the surgical cavity. Results: Between 2002 and 2009, 145 DCIS patients accrued, 59 to the first protocol and 86 to the second trial. Median age was 56 years and 65% were postmenopausal at the time of treatment. Based on optimal sparing of normal tissue, 79% of the patients were planned and treated prone and 21% supine. At 5 years' median follow-up (60 months; range 2.6-105.5 months), 6 patients (4.1%) experienced an ipsilateral breast recurrence in all cases of DCIS histology. In 3/6 patients, recurrence occurred at the original site of DCIS and in the remaining 3 cases outside the original tumor bed. New contralateral breast cancers arose in 3 cases (1 DCIS and 2 invasive carcinomas). Cosmetic self-assessment at least 2 years after treatment is available in 125 patients: 91% reported good-to-excellent and 9% reported fair-to-poor outcomes. Conclusions: With a median follow-up of 5 years, the ipsilateral local recurrence rate is 4.1%, comparable to that reported from the NSABP (National Surgical Adjuvant Breast and Bowel Project) trials that employed 50 Gy in 25 fractions of radiotherapy for DCIS. There were no invasive recurrences. These results provide preliminary evidence that accelerated hypofractionated external beam radiotherapy is a viable option for DCIS.

  2. A Case Report: Lobular Carcinoma In Situ in a Male Patient with Subsequent Invasive Ductal Carcinoma Identified on Screening Breast MRI

    Directory of Open Access Journals (Sweden)

    Linda Kao, Yekaterina Bulkin, Susan Fineberg, Leslie Montgomery, Tova Koenigsberg

    2012-01-01

    Full Text Available Lobular carcinoma in situ is a form of in situ neoplasia that develops within the terminal lobules of the breast. It is an extremely rare finding in males due to the lack of lobular development in the male breast. The authors herein report an unusual case of incidentally discovered lobular carcinoma in situ in a male patient with recurrent bilateral gynecomastia who was subsequently diagnosed with invasive ductal carcinoma of the left breast. The pathology of lobular carcinoma in situ in a male as well as screening MRI surveillance of male patients at high risk for breast cancer are discussed, emphasizing the importance of screening and imaging follow up in men who are at high risk for breast cancer.

  3. BOLD-MRI of breast invasive ductal carcinoma: correlation of R2* value and the expression of HIF-1α

    International Nuclear Information System (INIS)

    To explore the reliability and feasibility of blood oxygenation level-dependent-based functional magnetic resonance imaging (BOLD-fMRI) to depict hypoxia in breast invasive ductal carcinoma. A total of 103 women with 104 invasive ductal carcinomas (IDCs) underwent breast BOLD-fMRI at 3.0 T. Histological specimens were analysed for tumour size, grade, axillary lymph nodes and expression of oestrogen receptors, progesterone receptors, human epidermal growth factor receptor 2, p53, Ki-67 and hypoxia inducible factor 1α (HIF-1α). The distribution and reliability of R2* were analysed. Correlations of the R2* value with the prognostic factors and HIF-1α were respectively analysed. The R2* map of IDC demonstrated a relatively heterogeneous signal. The mean R2* value was (53.4 ± 18.2) Hz. The Shapiro-Wilk test (W = 0.971, P = 0.020) suggested that the sample did not follow a normal distribution. The inter-rater and intrarater correlation coefficient was 0.967 and 0.959, respectively. The R2* values of IDCs were significantly lower in patients without axillary lymph nodes metastasis. The R2* value had a weak correlation with Ki67 expression (r = 0.208, P = 0.038). The mean R2* value correlated moderately with the level of HIF-1α (r = 0.516, P = 0.000). BOLD-fMRI is a simple and non-invasive technique that yields hypoxia information on breast invasive ductal carcinomas. (orig.)

  4. BOLD-MRI of breast invasive ductal carcinoma: correlation of R2* value and the expression of HIF-1{alpha}

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Min; Guo, Xiaojuan; Wang, Shuangkun [Capital Medical University, Department of Radiology, Beijing Chao Yang Hospital, Beijing (China); Jin, Mulan; Wang, Ying [Capital Medical University Beijing, Department of Pathology, Beijing Chaoyang Hospital, Beijing (China); Li, Jie; Liu, Jun [Capital Medical University Beijing, Department of Breast Surgery, Beijing Chaoyang Hospital, Beijing (China)

    2013-12-15

    To explore the reliability and feasibility of blood oxygenation level-dependent-based functional magnetic resonance imaging (BOLD-fMRI) to depict hypoxia in breast invasive ductal carcinoma. A total of 103 women with 104 invasive ductal carcinomas (IDCs) underwent breast BOLD-fMRI at 3.0 T. Histological specimens were analysed for tumour size, grade, axillary lymph nodes and expression of oestrogen receptors, progesterone receptors, human epidermal growth factor receptor 2, p53, Ki-67 and hypoxia inducible factor 1{alpha} (HIF-1{alpha}). The distribution and reliability of R2* were analysed. Correlations of the R2* value with the prognostic factors and HIF-1{alpha} were respectively analysed. The R2* map of IDC demonstrated a relatively heterogeneous signal. The mean R2* value was (53.4 {+-} 18.2) Hz. The Shapiro-Wilk test (W = 0.971, P = 0.020) suggested that the sample did not follow a normal distribution. The inter-rater and intrarater correlation coefficient was 0.967 and 0.959, respectively. The R2* values of IDCs were significantly lower in patients without axillary lymph nodes metastasis. The R2* value had a weak correlation with Ki67 expression (r = 0.208, P = 0.038). The mean R2* value correlated moderately with the level of HIF-1{alpha} (r = 0.516, P = 0.000). BOLD-fMRI is a simple and non-invasive technique that yields hypoxia information on breast invasive ductal carcinomas. (orig.)

  5. 18F-Fluorodeoxyglucose Positron Emission Tomography/CT Scan Findings for Ductal Carcinomas of Breast: Association of Standardized Uptake Value and Histological Findings

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Lee, Eun Hye [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Park, Jung Mi [Dept. of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Kwak, Jeong Ja [Dept. of Pathology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2012-02-15

    To evaluate the factors associated with variations in 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) uptake in ductal carcinomas of the breast. We enrolled 216 ductal carcinoma cases that underwent 18F-FDG PET/CT. We evaluated the positivity and measured peak standardized uptake value (pSUV) of lesions that underwent 18F-FDG PET/CT. We analyzed the correlation between pSUV and invasiveness, lesion size, and the histologic factors of invasive ductal carcinoma (IDC). In the 18F-FDG PET/CT of ductal carcinomas, sensitivity was 90.2%, positive and negative predictive values were 99.5% and 25.0%, respectively. In ductal carcinoma in situ (DCIS) and IDC, the sensitivities were 68.8% and 92.0%, respectively. The mean pSUV of true positive (TP) DCIS and IDC were 2.6 and 5.1 (p < 0.05), respectively, whereas the false negative (FN) were 1.3 and 1.2 (p > 0.05), respectively, and that of false positive (FP) and true negative (TN) lesions were 2.2 and 0.9, respectively. The mean size of TP DCIS and IDC were 4.5 cm and 2.7 cm (p < 0.05), respectively, whereas the mean size of FN DCIS and IDC were 1.5 cm and 1.4 cm (p > 0.05), respectively, and that of FP and TN lesions were 1.8 cm and 1.2 cm respectively. Among the histological factors affecting IDC, mitosis showed the best correlation with pSUV (rho = 0.5). For 18F-FDG PET/CT of ductal carcinomas, the positive predictive value was 99.5% and the FN rate was 9.7%. False negative factors included DCIS and an IDC < 1.5 cm, whereas mitosis was the TP factor.

  6. Integration of transcript expression, copy number and LOH analysis of infiltrating ductal carcinoma of the breast

    Directory of Open Access Journals (Sweden)

    Hawthorn Lesleyann

    2010-08-01

    Full Text Available Abstract Background A major challenge in the interpretation of genomic profiling data generated from breast cancer samples is the identification of driver genes as distinct from bystander genes which do not impact tumorigenesis. One way to assess the relative importance of alterations in the transcriptome profile is to combine parallel analyses that assess changes in the copy number alterations (CNAs. This integrated analysis permits the identification of genes with altered expression that map within specific chromosomal regions which demonstrate copy number alterations, providing a mechanistic approach to identify the 'driver genes'. Methods We have performed whole genome analysis of CNAs using the Affymetrix 250K Mapping array on 22 infiltrating ductal carcinoma samples (IDCs. Analysis of transcript expression alterations was performed using the Affymetrix U133 Plus2.0 array on 16 IDC samples. Fourteen IDC samples were analyzed using both platforms and the data integrated. We also incorporated data from loss of heterozygosity (LOH analysis to identify genes showing altered expression in LOH regions. Results Common chromosome gains and amplifications were identified at 1q21.3, 6p21.3, 7p11.2-p12.1, 8q21.11 and 8q24.3. A novel amplicon was identified at 5p15.33. Frequent losses were found at 1p36.22, 8q23.3, 11p13, 11q23, and 22q13. Over 130 genes were identified with concurrent increases or decreases in expression that mapped to these regions of copy number alterations. LOH analysis revealed three tumors with whole chromosome or p arm allelic loss of chromosome 17. Genes were identified that mapped to copy neutral LOH regions. LOH with accompanying copy loss was detected on Xp24 and Xp25 and genes mapping to these regions with decreased expression were identified. Gene expression data highlighted the PPARα/RXRα Activation Pathway as down-regulated in the tumor samples. Conclusion We have demonstrated the utility of the application of

  7. Automatic detection of invasive ductal carcinoma in whole slide images with convolutional neural networks

    Science.gov (United States)

    Cruz-Roa, Angel; Basavanhally, Ajay; González, Fabio; Gilmore, Hannah; Feldman, Michael; Ganesan, Shridar; Shih, Natalie; Tomaszewski, John; Madabhushi, Anant

    2014-03-01

    This paper presents a deep learning approach for automatic detection and visual analysis of invasive ductal carcinoma (IDC) tissue regions in whole slide images (WSI) of breast cancer (BCa). Deep learning approaches are learn-from-data methods involving computational modeling of the learning process. This approach is similar to how human brain works using different interpretation levels or layers of most representative and useful features resulting into a hierarchical learned representation. These methods have been shown to outpace traditional approaches of most challenging problems in several areas such as speech recognition and object detection. Invasive breast cancer detection is a time consuming and challenging task primarily because it involves a pathologist scanning large swathes of benign regions to ultimately identify the areas of malignancy. Precise delineation of IDC in WSI is crucial to the subsequent estimation of grading tumor aggressiveness and predicting patient outcome. DL approaches are particularly adept at handling these types of problems, especially if a large number of samples are available for training, which would also ensure the generalizability of the learned features and classifier. The DL framework in this paper extends a number of convolutional neural networks (CNN) for visual semantic analysis of tumor regions for diagnosis support. The CNN is trained over a large amount of image patches (tissue regions) from WSI to learn a hierarchical part-based representation. The method was evaluated over a WSI dataset from 162 patients diagnosed with IDC. 113 slides were selected for training and 49 slides were held out for independent testing. Ground truth for quantitative evaluation was provided via expert delineation of the region of cancer by an expert pathologist on the digitized slides. The experimental evaluation was designed to measure classifier accuracy in detecting IDC tissue regions in WSI. Our method yielded the best quantitative

  8. Results of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS)

    International Nuclear Information System (INIS)

    Purpose: The role of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS) is controversial. In particular, there is little data for outcome with radiation in a group of patients comparable to those treated with local excision and surveillance (mammographic calcifications ≤2.5cm, negative resection margins, negative post biopsy mammogram). This study reports outcome of conservative surgery and radiation for mammographically detected DCIS with an emphasis on results in patients considered candidates for excision alone. Methods and Materials: >From 1983 to 1992, 110 women with mammographically detected DCIS (77% calcifications ± mass) and no prior history of breast cancer underwent needle localization and biopsy with (55%) or without a re excision and radiation. Final margins of resection were negative in 62%, positive 7%, close 11%, and unknown 20%. The median patient age was 56 years. The most common histologic subtype was comedo (54%), followed by cribriform (22%). The median pathologic tumor size was 8 mm (range 2 mm to 5 cm). Forty-seven percent of patients with calcifications only had a negative post biopsy mammogram prior to radiation. Radiation consisted of treatment to the entire breast (median 50.00 Gy) and a boost to the primary site (97%) for a median total dose of 60.40 Gy. Results: With a median follow-up of 5.3 years, three patients developed a recurrence in the treated breast. The median interval to recurrence was 8.8 years and all were invasive cancers. Two (67%) occurred outside the initial quadrant. The 5- and 10-year actuarial rates of recurrence were 1 and 15%. Cause-specific survival was 100% at 5 and 10 years. Contralateral breast cancer developed in two patients. There were too few failures for statistical significance to be achieved with any of the following factors: patient age, family history, race, mammographic findings, location primary, pathologic size, histologic subtype, re excision, or

  9. Zinc presence in invasive ductal carcinoma of the breast and its correlation with oestrogen receptor status

    Energy Technology Data Exchange (ETDEWEB)

    Farquharson, M J [Department of Medical Physics and Applied Radiation Sciences, McMaster University, 1280 Main St W Hamilton, Ontario, L8S 4L8 (Canada); Al-Ebraheem, A [Department of Radiography, City Community and Health Sciences, City University, London, EC1V 0HB (United Kingdom); Geraki, K [Diamond Light Source, Harwell Science and Innovation Campus, Didcot, Oxon, OX11 0DE (United Kingdom); Leek, R; Jubb, A; Harris, A L [Cancer Research UK, Oxford Cancer Centre, Molecular Oncology Laboratories, University of Oxford, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, 0X3 9DS (United Kingdom)], E-mail: farquhm@mcmaster.ca

    2009-07-07

    Zinc is known to play an important role in many cellular processes, and the levels of zinc are controlled by specific transporters from the ZIP (SLC39A) influx transporter group and the ZnT (SLC30A) efflux transporter group. The distribution of zinc was measured in 59 samples of invasive ductal carcinoma of breast using synchrotron radiation micro probe x-ray fluorescence facilities. The samples were formalin fixed paraffin embedded tissue micro arrays (TMAs) enabling a high throughput of samples and allowing us to correlate the distribution of trace metals with tumour cell distribution and, for the first time, important biological variables. The samples were divided into two classes, 34 oestrogen receptor positive (ER+ve) and 25 oestrogen receptor negative (ER-ve) based on quantitative immunohistochemistry assessment. The overall levels of zinc (i.e. in tumour and surrounding tissue) in the ER+ve samples were on average 60% higher than those in the ER-ve samples. The zinc levels were higher in the ER+ve tumour areas compared to the ER-ve tumour areas with the mean levels in the ER+ve samples being approximately 80% higher than the mean ER-ve levels. However, the non-tumour tissue regions of the samples contained on average the same levels of zinc in both types of breast cancers. The relative levels of zinc in tumour areas of the tissue were compared with levels in areas of non-tumour surrounding tissue. There was a significant increase in zinc in the tumour regions of the ER+ve samples compared to the surrounding regions (P < 0.001) and a non-significant increase in the ER-ve samples. When comparing the increase in zinc in the tumour regions expressed as a percentage of the surrounding non-tumour tissue zinc level in the same sample, a significant difference between the ER+ve and ER-ve samples was found (P < 0.01)

  10. Inter- and intra-individual variability in somatic allele loss in ductal carcinoma of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Rebbeck, T.; Godwin, A.; Rosvold, E. [Fox Chase Cancer Center, Philadelphia, PA (United States)] [and others

    1994-09-01

    The etiology of most cancers involves both inherited genetic susceptibility and somatic genetic changes. We studied 28 ductal carcinomas of the breast to evaluate variability in loss of constitutional heterozygosity (LOH) across loci and across individuals and to assess the relationship of candidate genes with LOH. LOH was measured on 33 chromosome arms using the most telomeric, highly heterozygous tetranucleotide repeat markers from the Cooperative Human Linkage Center (CHLC). The overall mean proportion of LOH was 11%. The proportion of LOH ranged from 0% to 37% across loci. LOH > 20% was observed at chromosomes 1p, 7q, 10q, 11p, 17p, and 18q. Of these, simultaneous losses at the following locus pairs occurred more often than expected: 1p & 11p; 1p & 17p; 7q & 18q; 11p & 17p. An elevated proportion of LOH was not observed for the marker on chromosome 17q. The proportion of LOH ranged from 0% to 67% across individuals. 20 tumors showed less than 10% LOH, and 6 showed more than 20% LOH. There was no correlation between LOH and tumor stage. To examine whether variability in candidate genes was associated with LOH, allelic variability was measured at CYP1A1, CYP2D6, epoxide hydrolase (EH), HADP(H):quinone oxidoreductase (NQO1), and glutathione-S-transferase-{mu} (GST-{mu}). An elevated proportion of LOH was observed for genotypes at CYP2D6 (17% for 1/1, 1/2`s vs. 8% for 2/2`s), NQO1 (13% for 1/2, 2/2`s vs. 8% for 1/1`s), and GST-{mu} (15% for {open_quotes}null{close_quotes} genotypes vs. 7% for wild types), but not at CYP1A1 (12% for 1/2`s vs. 10% for 1/1`s) or EH (11% for 1/1`s vs. 10% for 1/2`s). Our results suggest that LOH is not randomly distributed across the genome, and that there is substantial interindividual variability in LOH. This interindividual variability may be explained by genes that metabolize environmental carcinogens or steroid hormones.

  11. Improved Outcomes of Breast-Conserving Therapy for Patients With Ductal Carcinoma in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Halasz, Lia M. [Harvard Radiation Oncology Program, Boston, MA (United States); Sreedhara, Meera [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, MA (United States); Chen, Yu-Hui [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA (United States); Bellon, Jennifer R.; Punglia, Rinaa S.; Wong, Julia S.; Harris, Jay R. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, MA (United States); Brock, Jane E., E-mail: jebrock@partners.org [Department of Pathology, Brigham and Women' s Hospital, Boston, MA (United States)

    2012-03-15

    Purpose: Patients treated for ductal carcinoma in situ (DCIS) with breast-conserving surgery (BCS) and radiation therapy (RT) at our center from 1976 to 1990 had a 15% actuarial 10-year local recurrence (LR) rate. Since then, improved mammographic and pathologic evaluation and greater attention to achieving negative margins may have resulted in a lower risk of LR. In addition, clinical implications of hormone receptor and HER-2 status in DCIS remain unclear. We sought to determine the following: LR rates with this more modern approach; the relation between LR and HER-2 status; and clinical and pathologic factors associated with HER-2{sup +} DCIS. Methods and Materials: We studied 246 consecutive patients who underwent BCS and RT for DCIS from 2001 to 2007. Of the patients, 96 (39%) were Grade III and the median number of involved tissue blocks was 3. Half underwent re-excision and 222 (90%) had negative margins (>2 mm). All received whole-breast RT (40-52 Gy) and 99% (244) received a tumor bed boost (8-18 Gy). Routine estrogen receptor (ER), progesterone receptor (PR), and HER-2 immunohistochemistry was instituted in 2003. Results: With median follow-up of 58 months, there were no LRs. Seven patients (3%) developed contralateral breast cancer (4 invasive and 3 in situ). Among 163 patients with immunohistochemistry, 124 were ER/PR{sup +}HER-2{sup -}, 27 were ER/PR{sup +}HER-2{sup +}, 6 were ER{sup -}/PR{sup -}HER-2{sup +}, and 6 were ER{sup -}/PR{sup -}HER-2{sup -}. On univariable analysis, HER-2{sup +}was significantly associated with Grade III, ER{sup -}/PR{sup -}, central necrosis, comedo subtype, more extensive DCIS, and postmenopausal status. On multivariable analysis, Grade III and postmenopausal status remained significantly associated with HER-2{sup +}. Conclusions: In an era of mammographically identified DCIS, larger excisions, widely negative margins and the use of a tumor bed boost, we observed no LR regardless of ER/PR/HER-2 status. Factors associated

  12. Expression of e-cadherin, n-cadherin and snail and their correlation with clinicopathological variants: an immunohistochemical study of 132 invasive ductal breast carcinomas in Egypt

    Directory of Open Access Journals (Sweden)

    Hanan Mohamed Abd ElMoneim

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate the expression of the cell adhesion molecules E-cadherin and N-cadherin and the transcription factor Snail in invasive ductal breast carcinomas and to determine their relationships with clinicopathological features. METHODS: Immunohistochemistry was used to examine E-cadherin, N-cadherin, and Snail protein expression in 132 invasive breast carcinomas. RESULTS: The expression of E-cadherin was decreased (negative or weak in 37.1% of invasive carcinomas, while N-cadherin and Snail overexpression were detected in 51.9% and 40.9% of carcinomas, respectively. Low E-cadherin expression was significantly correlated with poorly differentiated carcinoma (53.1%, positive node status (80.9%, poor Nottingham Prognostic Index (64.7%, and the presence of estrogen and progesterone receptors. Overexpression of N-cadherin and Snail were also significantly correlated with poorly differentiated carcinoma, positive node status, and poor Nottingham Prognostic Index but were correlated with the absence of hormone receptors. Loss of E-cadherin immunoexpression was strongly associated with the presence of membranous N-cadherin (87.8% and nuclear Snail (69.4%. CONCLUSION: Loss of E-cadherin and overexpression of N-cadherin and Snail in breast carcinomas may play a central role in the development of invasive ductal breast carcinoma. These biomarkers may provide a valuable reference for the study of invasive ductal carcinoma progression and to characterize the biological behavior of the tumor. In the future, increased N-cadherin and decreased E-cadherin expression may be used as indicators of the progression and prognosis of invasive ductal carcinoma.

  13. Caracterización biológica del adenocarcinoma lobulillar infiltrante de mama

    OpenAIRE

    Abellán Rosique, Beatriz

    2016-01-01

    El cáncer de mama constituye actualmente, la causa más frecuente de muerte por cáncer de los países desarrollados, en las mujeres entre 40 y 45 años. Actualmente presenta un aumento de la incidencia anual del 2%. El carcinoma lobulillar de mama (CL) es la segunda neoplasia más frecuente entre los carcinomas mamarios. Tradicionalmente se ha asociado a los mismos factores de riesgo que el carcinoma ductal y la misma etiopatogenia. Sin embargo se conocen la existencia de diferenci...

  14. Identification of the boundary between normal breast tissue and invasive ductal carcinoma during breast-conserving surgery using multiphoton microscopy

    Science.gov (United States)

    Deng, Tongxin; Nie, Yuting; Lian, Yuane; Wu, Yan; Fu, Fangmeng; Wang, Chuan; Zhuo, Shuangmu; Chen, Jianxin

    2014-11-01

    Breast-conserving surgery has become an important way of surgical treatment for breast cancer worldwide nowadays. Multiphoton microscopy (MPM) has the ability to noninvasively visualize tissue architectures at the cellular level using intrinsic fluorescent molecules in biological tissues without the need for fluorescent dye. In this study, MPM is used to image the microstructures of terminal duct lobular unit (TDLU), invasive ductal carcinoma and the boundary region between normal and cancerous breast tissues. Our study demonstrates that MPM has the ability to not only reveal the morphological changes of the cuboidal epithelium, basement membrane and interlobular stroma but also identify the boundary between normal breast tissue and invasive ductal carcinoma, which correspond well to the Hematoxylin and Eosin (H and E) images. Predictably, MPM can monitor surgical margins in real time and provide considerable accuracy for resection of breast cancerous tissues intraoperatively. With the development of miniature, real-time MPM imaging technology, MPM should have great application prospects during breast-conserving surgery.

  15. Sentinel lymph node biopsy in patients with a needle core biopsy diagnosis of ductal carcinoma in situ: is it justified?

    LENUS (Irish Health Repository)

    Doyle, B

    2012-02-01

    BACKGROUND: The incidence of ductal carcinoma in situ (DCIS) has increased markedly with the introduction of population-based mammographic screening. DCIS is usually diagnosed non-operatively. Although sentinel lymph node biopsy (SNB) has become the standard of care for patients with invasive breast carcinoma, its use in patients with DCIS is controversial. AIM: To examine the justification for offering SNB at the time of primary surgery to patients with a needle core biopsy (NCB) diagnosis of DCIS. METHODS: A retrospective analysis was performed of 145 patients with an NCB diagnosis of DCIS who had SNB performed at the time of primary surgery. The study focused on rates of SNB positivity and underestimation of invasive carcinoma by NCB, and sought to identify factors that might predict the presence of invasive carcinoma in the excision specimen. RESULTS: 7\\/145 patients (4.8%) had a positive sentinel lymph node, four macrometastases and three micrometastases. 6\\/7 patients had invasive carcinoma in the final excision specimen. 55\\/145 patients (37.9%) with an NCB diagnosis of DCIS had invasive carcinoma in the excision specimen. The median invasive tumour size was 6 mm. A radiological mass and areas of invasion <1 mm, amounting to "at least microinvasion" on NCB were predictive of invasive carcinoma in the excision specimen. CONCLUSIONS: SNB positivity in pure DCIS is rare. In view of the high rate of underestimation of invasive carcinoma in patients with an NCB diagnosis of DCIS in this study, SNB appears justified in this group of patients.

  16. Correlation of HER2 overexpression with gene amplification and its relation to chromosome 17 aneuploidy: a 5-year experience with invasive ductal and lobular carcinomas.

    Science.gov (United States)

    Nassar, Aziza; Khoor, Andras; Radhakrishnan, Reshmitha; Radhakrishnan, Anu; Cohen, Cynthia

    2014-01-01

    The HER2 oncogene shows expression or amplification, or both, in approximately 15% to 20% of breast cancers and has been associated with poor prognosis and a response to trastuzumab therapy. HER2 gene status determines the eligibility of breast cancer patients for trastuzumab therapy and a large fraction (41-56%) of these patients respond to targeted therapy. Several studies have related the increased expression of HER2 to an increased copy number of chromosome 17, rather than amplification of the HER2 gene. We compared the results of immunohistochemistry and fluorescence in situ hybridization in both invasive ductal and invasive lobular carcinomas, to determine the frequency of chromosome 17 aneuploidy associated with discordant results. In total, 390 invasive ductal carcinomas and 180 invasive lobular carcinomas diagnosed from January 2000 to December 2005 were included in the study only if results were available for immunohistochemistry (HercepTest; DAKO, Carpinteria, California) and fluorescence in situ hybridization (PathVysion HER2 DNA Probe Kit; Abbott Laboratories, Des Plaines, Illinois). Tumors classified as invasive ductal carcinomas were graded according to the Bloom-Richardson grading system. Correlation between the results of immunohistochemistry and fluorescence in situ hybridization was performed for all categories. Among invasive ductal carcinomas, 29% (115/390) showed chromosome 17 aneuploidy, mostly associated with grade 3/HER2 2+ (45%) or grade 2/HER2 3+ (55%) that were not amplified. Also, 34% (12/35) of invasive lobular carcinomas showed chromosome 17 aneuploidy; approximately one-third of these cases were HER2 2+ (33%) and HER2 3+ (37%) that were not amplified. Discordance between the results of immunohistochemistry and fluorescence in situ hybridization in both ductal and lobular carcinomas is largely associated with chromosome 17 aneuploidy.

  17. Invasive ductal carcinomas of the breast showing partial reversed cell polarity are associated with lymphatic tumor spread and may represent part of a spectrum of invasive micropapillary carcinoma.

    Science.gov (United States)

    Acs, Geza; Esposito, Nicole N; Rakosy, Zsuzsa; Laronga, Christine; Zhang, Paul J

    2010-11-01

    Invasive micropapillary carcinomas (IMPC) of the breast are aggressive tumors frequently associated with lymphatic invasion and nodal metastasis even when micropapillary (MP) differentiation is very focal within the tumors. We have noticed that some breast carcinomas showing lymphatic spread but lacking histologic features of IMPC have occasional tumor cell clusters reminiscent of those of IMPC without the characteristic prominent retraction artifact. To study the clinicopathologic significance of such features, we prospectively selected 1323 invasive ductal carcinomas and determined the presence and extent of MP differentiation and retraction artifact in the tumors. One representative tumor block per case was used for immunostaining for epithelial membrane antigen (EMA). Partial reverse cell polarity (PRCP) was defined as prominent linear EMA reactivity on at least part of the periphery of tumor cell clusters usually associated with decreased cytoplasmic staining. The clinicopathologic features of carcinomas with PRCP were compared with IMPC and invasive ductal (no special type) carcinomas without this feature. Of the 1323 cases, 96 (7.3%) and 92 (7.0%) showed MP features and the presence of PRCP, respectively. We found that the presence of both PRCP and MP features were strongly associated with decreased cytoplasmic EMA immunoreactivity and the presence of lymphatic invasion and nodal metastasis, even if such features were present only very focally. Our results suggest that breast carcinomas with PRCP may have the same implication as MP differentiation and these tumors may represent part of a spectrum of IMPC. Complete or partial reversal of cell polarity may play a significant role in lymphatic tumor spread.

  18. Eliminating "ductal carcinoma in situ" and "lobular carcinoma in situ" (DCIS and LCIS) terminology in clinical breast practice: The cognitive psychology point of view.

    Science.gov (United States)

    Pravettoni, Gabriella; Yoder, Whitney R; Riva, Silvia; Mazzocco, Ketti; Arnaboldi, Paola; Galimberti, Viviana

    2016-02-01

    There is evidence from the literature that the terms "ductal carcinoma in situ" and "lobular carcinoma in situ" (DCIS and LCIS) should be eliminated in clinical breast cancer practice and replaced with the new "ductal intraepithelial neoplasia" (DIN) and "lobular intraepithelial neoplasia" (LIN) terminology. The main purpose of the present article is to expand on this argument from a cognitive psychology perspective and offer suggestions for further research, emphasizing how the elimination of the term "carcinoma" in "in situ" breast cancer diagnoses has the potential to reduce both patient and health care professional confusion and misperceptions that are often associated with the DCIS and LCIS diagnoses, as well as limit the adverse psychological effects of women receiving a DCIS or LCIS diagnosis. We comment on the recent peer-reviewed literature on the clinical implications and psychological consequences for breast cancer patients receiving a DCIS or LCIS diagnosis and we use a cognitive perspective to offer new insight into the benefits of embracing the new DIN and LIN terminology. Using cognitive psychology and cognitive science in general, as a foundation, further research is advocated in order to yield data in support of changing the terminology and therefore, offer a chance to significantly improve the lives and psychological sequelae of women facing such a diagnosis. Typology: Controversies/Short Commentary.

  19. Aberrant methylation of Glutathione S-transferase P1 and E-cadherin in invasive ductal breast carcinoma and fibroadenoma

    Institute of Scientific and Technical Information of China (English)

    Wings Tjing Yung Loo; Mary Ngan Bing Cheung; Louis Wing Cheong Chow

    2010-01-01

    Objective To investigate the hypermethylation status of glutathione transferase P1(GSTP1) and E cadherin (ECAD), TSGs (tumor suppressor genes) in our breast cancer samples and explore their correlation with clinicopathological features of corresponding cancer patients. Methods One hundred and thirty six IDC (invasive ductal carcinoma) patients were recruited for analysis and 16 fibroadenoma patients acted as control. DNA extraction and methylation specific PCR (MSP) were subsequently performed preceded by pathological examination. Results The percentage of hypermethylated GSTP1 in carcinoma and fibroadenoma groups was 34.92% and 15.79% respectively and the percentage of hypermethylated ECAD in carcinomas and fibroadenomas was 18.00% and 0.00% respectively. Carcinoma had the highest percentage of c erbB2 overexpression being 54.55% among the clinicopathological parameters. Conclusion Hypermethylation patterns are frequent in IDC and seem to relate to c erbB2 overexpression, and such epigenetic change should not be neglected in fibroadenoma. Tumor methylation status in cancer patients can be determined at early stage and it may be a reference for better treatment planning.

  20. Screen-detected ductal carcinoma in situ found on stereotactic vacuum-assisted biopsy of suspicious microcalcifications without mass: radiological-histological correlation

    Directory of Open Access Journals (Sweden)

    Szynglarewicz Bartlomiej

    2016-06-01

    Full Text Available Commonly identified on screening mammography breast microcalcifications are the predominant manifestation of ductal carcinoma in situ (DCIS. The aim of this study was to investigate the association between clinico-radiological features and histological findings in patients with screen-detected DCIS.

  1. Local recurrences after different treatment strategies for ductal carcinoma in situ of the breast: a population-based study in the East Netherlands.

    NARCIS (Netherlands)

    Schouten van de Velden, A.P.; Vugt, R. van; Dijck, J.A.A.M. van; Leer, J.W.H.; Wobbes, Th.

    2007-01-01

    PURPOSE: Outcomes after different treatment strategies for ductal carcinoma in situ (DCIS) of the breast were analyzed for a geographically defined population in the East Netherlands. METHODS AND MATERIALS: A total of 798 patients with a first diagnosis of DCIS between January 1989 and December 2003

  2. Radiologic Findings of Ductal Carcinoma in Situ Arising Within a Juvenile Fibroadenoma: Mammographic, Sonographic and Dynamic Contrast-Enhanced Breast MRI Features

    OpenAIRE

    Park, Eun Kyung; Cho, Kyu Ran; Seo, Bo Kyoung; Woo, Ok Hee; Lee, Jeong Hyeon; Song, Sung Eun; Bae, Jeong Won

    2015-01-01

    Juvenile fibroadenoma is an uncommon histologic variant of fibroadenoma that frequently shows a remarkable and rapid growth. The development of a carcinoma within a fibroadenoma, either in situ or invasive, is a rare condition. We encountered a 36-year-old woman with a palpable mass in the right breast. The radiologic findings were indicative of a fibroadenoma in the breast. Sonographic guided biopsy using a 14G core needle revealed the presence of ductal carcinoma in situ (DCIS) within the j...

  3. Cyclin D1 expression in ductal carcinoma of the breast and its correlation with other prognostic parameters

    Directory of Open Access Journals (Sweden)

    Gayatri Ravikumar

    2014-01-01

    Full Text Available Purpose: Cyclin D1 is a cell cycle regulatory gene emerging as a potentially significant oncogene in invasive breast cancers. In this study, we attempted to see the expression of Cyclin D1 in invasive ductal carcinomas of the breast in our population and correlate its expression with other known prognostic parameters. Materials and Methods: A total of 39 cases were selected from our case files from January 2011. Immunohistochemistry for Cyclin D1 was performed and interpreted as positive when >10% of the tumor cells expressed the marker with a moderate to strong intensity of staining. Clinicopathological parameters such as laterality, focality, tumor size, grade, ductal carcinoma in situ (DCIS, axillary lymph node (ALN metastasis, hormone receptor status and human epidermal growth factor receptor 2 status were analyzed and correlated with Cyclin D1 expression. Results: The patients′ age ranged from 30 to 76 years (mean = 53.18. The tumors were unilateral and unifocal in 38 cases; one patient had bilateral synchronous tumors. The majority were grade2 (67.5% and tumor size T2 (57.5%. Nearly 35% were associated with DCIS and 57.5% had ALN metastasis. Estrogen receptors (ER and progesterone receptor (PgR positivity was seen in 65% of the cases and 25% was triple negative. Cyclin D1 expression was seen in 67.5% of the cases in our study. Among the ER, PgR positive and Her-2 negative tumors, Cyclin D1 expression was seen in the majority of cases (92% cases, whereas none of the triple negative tumors showed Cyclin D1 expression. The other prognostic parameters such as tumor size, grade and lymph node status did not show any association with Cyclin D 1 positivity. Conclusions: Cyclin D1 expression was seen in 67.5% of ductal carcinoma and it showed a significant correlation with ER, PgR expression (92% in this study, which is in concordance with other similar studies in literature.

  4. Pathologic Complete Response of HER-2 Neu-Positive Invasive Ductal Carcinoma and Ductal Carcinoma In Situ following Neoadjuvant Chemotherapy plus Trastuzumab: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Sommer R. Gunia

    2012-01-01

    Full Text Available Pathologic complete response (pCR after NC has been consistently associated with improved outcomes. Residual DCIS after NC does not portray worse prognosis compared to complete eradication of all disease but has clinical implications regarding surgical management. We report a case of pCR of DCIS associated with invasive carcinoma in an HER-2 + tumor after NC plus trastuzumab despite persistence of malignant-appearing microcalcifications mammographically. A 41-year-old Caucasian female presented with a 4×4 cm mass in the right breast and a 2.5 cm right axillary node. Mammogram showed a 2.5 cm mass and a 12 cm area of linear pleomorphic, suspicious calcifications in the upper part of the breast. Core biopsy revealed invasive ductal carcinoma and DCIS associated with calcifications (ER 85%, PR 6%, Her2neu 3+ by IHC. Axillary node FNA was positive for malignancy. The patient received doxorubicin/cyclophosphamide (AC → paclitaxel plus T with complete clinical and radiologic response but no significant change in the microcalcifications. Final pathology showed no residual invasive carcinoma or DCIS despite the presence of numerous ducts with microcalcifications. Documented eradication of DCIS has not been reported following NC when malignant-appearing calcifications persist and this observation may have important clinical implications regarding surgical management.

  5. Correlation of primary tumor FDG uptake with clinicopathologic prognostic factors in invasive ductal carcinoma of the breast

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the correlation of primary tumor FDG uptake to clinicopathological prognostic factors in invasive ductal carcinoma of the breast. We retrospectively reviewed 136 of 215 female patients with pathologically proven invasive ductal breast cancer from January 2008 to December 2011 who underwent F-18 FDG PET/CT for initial staging and follow-up after curative treatment with analysis of estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor 2 (HER2). The maximum standardized uptake value (SUVmax) of the primary breast tumor was measured and compared with hormonal receptor and HER2 overexpression status. The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: tumor size, histologic grade, TNM stage, negativity of ER, negativity of PR, HER2 overexpression and triple negativity. The recurrent group with non-triple negative cancer had a higher SUVmax compared with the non-recurrent group, though no significant difference in FDG uptake was noted between the recurrence and non-recurrent groups in subjects with triple-negative cancer. Lymph node involvement was the independent risk factor for cancer recurrence in the multivariate analysis. In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer

  6. Aggressiveness of 'true' interval invasive ductal carcinomas of the breast in postmenopausal women

    NARCIS (Netherlands)

    van der Vegt, Bert; Wesseling, J.; Pijnappel, R.M.; Dorrius, M.D.; den Heeten, G.J.; de Roos, M.A.J.; de Bock, G.H.

    2010-01-01

    There is debate whether interval carcinomas differ from screen-detected tumours biologically. In this study, clinico-pathological parameters and the expression of well-validated biological markers were compared between 'true' interval carcinomas and screen-detected/missed carcinomas hypothesising th

  7. Development and evaluation of a prediction model for underestimated invasive breast cancer in women with ductal carcinoma in situ at stereotactic large core needle biopsy.

    Directory of Open Access Journals (Sweden)

    Suzanne C E Diepstraten

    Full Text Available BACKGROUND: We aimed to develop a multivariable model for prediction of underestimated invasiveness in women with ductal carcinoma in situ at stereotactic large core needle biopsy, that can be used to select patients for sentinel node biopsy at primary surgery. METHODS: From the literature, we selected potential preoperative predictors of underestimated invasive breast cancer. Data of patients with nonpalpable breast lesions who were diagnosed with ductal carcinoma in situ at stereotactic large core needle biopsy, drawn from the prospective COBRA (Core Biopsy after RAdiological localization and COBRA2000 cohort studies, were used to fit the multivariable model and assess its overall performance, discrimination, and calibration. RESULTS: 348 women with large core needle biopsy-proven ductal carcinoma in situ were available for analysis. In 100 (28.7% patients invasive carcinoma was found at subsequent surgery. Nine predictors were included in the model. In the multivariable analysis, the predictors with the strongest association were lesion size (OR 1.12 per cm, 95% CI 0.98-1.28, number of cores retrieved at biopsy (OR per core 0.87, 95% CI 0.75-1.01, presence of lobular cancerization (OR 5.29, 95% CI 1.25-26.77, and microinvasion (OR 3.75, 95% CI 1.42-9.87. The overall performance of the multivariable model was poor with an explained variation of 9% (Nagelkerke's R(2, mediocre discrimination with area under the receiver operating characteristic curve of 0.66 (95% confidence interval 0.58-0.73, and fairly good calibration. CONCLUSION: The evaluation of our multivariable prediction model in a large, clinically representative study population proves that routine clinical and pathological variables are not suitable to select patients with large core needle biopsy-proven ductal carcinoma in situ for sentinel node biopsy during primary surgery.

  8. MRI of ductal carcinoma in situ of the breast. Patterns of findings and evaluation of disease extent

    Energy Technology Data Exchange (ETDEWEB)

    Hiramatsu, Hideko; Ikeda, Tadashi; Mukai, Makio; Masamura, Shigeru; Hiramatsu, Kyoichi [Keio Univ., Tokyo (Japan). School of Medicine; Kikuchi, Kiyoshi

    2000-03-01

    Ten cases of ductal carcinoma in situ (DCIS) or DCIS with microinvasion were reviewed in order to evaluate the characteristic findings of DCIS and to evaluate the extent of disease on MRI. A 1.5 Tesla Signa or Horizon (GE Medical Systems) unit was used with a dedicated receive-only breast coil. The pulse sequence based on RARE was used with the fat suppression technique. After examining both breasts with a large FOV (30 cm), the affected breast alone was examined with a smaller FOV (18 cm) and larger matrix (512 x 384) with and without Gd-enhancement. DCIS showed several types of findings on MRI: linear, spotty enhancement; gathering of linear enhancement; enhanced area or mass without distortion of the surrounding tissue; and well-circumscribed mass mimicking intraductal papilloma. Compared with typical findings of invasive carcinoma, DCIS tended to be enhanced slowly. After performing MR examination in addition to mammography and ultrasonography, a more accurate diagnosis of disease extent was possible in 6 of 10 patients. MRI was useful in providing more precise information on the disease extent of DCIS, and it is considered useful in planning the type of surgery. Further study using larger series and precise pathological correlations are necessary. (author)

  9. Metastatic ductal carcinoma of the breast to the thyroid gland diagnosed with fine needle aspiration: A case report with emphasis on morphologic and immunophenotypic features.

    Science.gov (United States)

    Magers, Martin J; Dueber, Julie C; Lew, Madelyn; Pang, Judy C; Davenport, Robertson D

    2016-06-01

    Metastases to the thyroid are uncommon [thyroid fine needle aspirations (FNA)]. Of metastases to the thyroid, breast carcinoma is relatively common. The diagnosis of metastasis to the thyroid has important therapeutic and prognostic implications. To our knowledge, a morphologic and immunophenotypic comparison of metastatic ductal carcinoma of the breast and primary thyroid carcinomas has not been reported. Here, we report the case of a 37-year-old female with a history of metastatic ductal carcinoma of the breast (modified Bloom-Richardson grade 2; ER+, PgR+, HER2+) diagnosed 6 years prior. She developed hoarseness, prompting a CT scan. Multiple thyroid nodules were found, including a 1.5 cm hypoechoic, solid, irregularly-shaped nodule. On FNA, cells were arranged singly and in crowded groups, varied in size and degree of pleomorphism, and exhibited rare nuclear grooves, inconspicuous nucleoli, and rare intracytoplasmic lumina with no nuclear pseudoinclusions or colloid (Figs. 1A and B). These findings raised the differential of papillary thyroid carcinoma (Fig. 1C), follicular neoplasm (Fig. 1D), medullary carcinoma (Fig. 1E), parathyroid (Fig. 1F), and metastatic breast carcinoma. Immunostaining for GATA-3 (+), ER (+), PAX-8 (-), and TTF-1 (-) was consistent with metastatic breast carcinoma (Fig. 2). We conclude that metastatic breast carcinoma to the thyroid may morphologically mimic primary thyroid carcinoma on FNA; a panel of immunomarkers, such as GATA-3, hormonal marker(s), PAX-8, and TTF-1, may be useful in some cases. GATA-3 immunostaining for metastatic breast carcinoma was helpful in our case and has not been previously reported in a thyroid metastasis sampled by FNA. Diagn. Cytopathol. 2016;44:530-534. © 2016 Wiley Periodicals, Inc.

  10. Correlation of primary tumor FDG uptake with clinicopathologic prognostic factors in invasive ductal carcinoma of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Jo, I; Kim, Sung Hoon; Kim, Hae Won; Kang, Sung Hee [Keimyung University, School of Medicine, Daegu (Korea, Republic of); Zeon, Seok Kil [Dept. of Nuclear Medicine, Bundang Jesaeng General Hospital, Sungnam (Korea, Republic of); Kim, Su Jin [Dept. of Anesthesiology and Pain Medicine, Dongguk University, School of Medicine, Gyeongju (Korea, Republic of)

    2015-03-15

    The purpose of this study was to investigate the correlation of primary tumor FDG uptake to clinicopathological prognostic factors in invasive ductal carcinoma of the breast. We retrospectively reviewed 136 of 215 female patients with pathologically proven invasive ductal breast cancer from January 2008 to December 2011 who underwent F-18 FDG PET/CT for initial staging and follow-up after curative treatment with analysis of estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor 2 (HER2). The maximum standardized uptake value (SUV{sub max}) of the primary breast tumor was measured and compared with hormonal receptor and HER2 overexpression status. The high SUV{sub max} of primary breast tumors is significantly correlated with the clinicopathological factors: tumor size, histologic grade, TNM stage, negativity of ER, negativity of PR, HER2 overexpression and triple negativity. The recurrent group with non-triple negative cancer had a higher SUV{sub max} compared with the non-recurrent group, though no significant difference in FDG uptake was noted between the recurrence and non-recurrent groups in subjects with triple-negative cancer. Lymph node involvement was the independent risk factor for cancer recurrence in the multivariate analysis. In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer.

  11. Novel markers for differentiation of lobular and ductal invasive breast carcinomas by laser microdissection and microarray analysis

    Directory of Open Access Journals (Sweden)

    Srovnal Josef

    2007-03-01

    Full Text Available Abstract Background Invasive ductal and lobular carcinomas (IDC and ILC are the most common histological types of breast cancer. Clinical follow-up data and metastatic patterns suggest that the development and progression of these tumors are different. The aim of our study was to identify gene expression profiles of IDC and ILC in relation to normal breast epithelial cells. Methods We examined 30 samples (normal ductal and lobular cells from 10 patients, IDC cells from 5 patients, ILC cells from 5 patients microdissected from cryosections of ten mastectomy specimens from postmenopausal patients. Fifty nanograms of total RNA were amplified and labeled by PCR and in vitro transcription. Samples were analysed upon Affymetrix U133 Plus 2.0 Arrays. The expression of seven differentially expressed genes (CDH1, EMP1, DDR1, DVL1, KRT5, KRT6, KRT17 was verified by immunohistochemistry on tissue microarrays. Expression of ASPN mRNA was validated by in situ hybridization on frozen sections, and CTHRC1, ASPN and COL3A1 were tested by PCR. Results Using GCOS pairwise comparison algorithm and rank products we have identified 84 named genes common to ILC versus normal cell types, 74 named genes common to IDC versus normal cell types, 78 named genes differentially expressed between normal ductal and lobular cells, and 28 named genes between IDC and ILC. Genes distinguishing between IDC and ILC are involved in epithelial-mesenchymal transition, TGF-beta and Wnt signaling. These changes were present in both tumor types but appeared to be more prominent in ILC. Immunohistochemistry for several novel markers (EMP1, DVL1, DDR1 distinguished large sets of IDC from ILC. Conclusion IDC and ILC can be differentiated both at the gene and protein levels. In this study we report two candidate genes, asporin (ASPN and collagen triple helix repeat containing 1 (CTHRC1 which might be significant in breast carcinogenesis. Besides E-cadherin, the proteins validated on tissue

  12. Development and Validation of Web-Based Nomograms to Predict Postoperative Invasive Component in Ductal Carcinoma in Situ at Needle Breast Biopsy

    OpenAIRE

    Lee, Seong Cheol; Chang, Myung-Chul

    2014-01-01

    Objectives Although sonography-guided core needle biopsy is a highly targeted method, there is a possibility of an invasive component after surgical excision of ductal carcinoma in situ (DCIS) of the breast. This study was performed to develop and validate nomograms to predict the postoperative invasive component in DCIS at core needle biopsy. Methods Two nomograms were developed using the data of previous meta-analysis and multivariate analysis. Nomograms were validated externally using the ...

  13. Successful Salvage Chemotherapy with FOLFIRINOX for Recurrent Mixed Acinar Cell Carcinoma and Ductal Adenocarcinoma of the Pancreas in an Adolescent Patient.

    Science.gov (United States)

    Pfrommer, Sarah; Weber, Achim; Dutkowski, Philipp; Schäfer, Niklaus G; Müllhaupt, Beat; Bourquin, Jean-Pierre; Breitenstein, Stefan; Pestalozzi, Bernhard C; Stenner, Frank; Renner, Christoph; D'Addario, Giannicola; Graf, Hans-Jörg; Knuth, Alexander; Clavien, Pierre-Alain; Samaras, Panagiotis

    2013-01-01

    Pancreatic tumors are rare in children and adolescents. Here, we report the case of a 15-year-old boy who presented with a mixed acinar cell carcinoma/ductal adenocarcinoma with blastomatous components. He received multimodal treatment including various chemotherapy regimens and multistep surgery including liver transplantation. Introduction of FOLFIRINOX after relapse repeatedly achieved a durable metabolic and clinical response with good quality of life. PMID:24163668

  14. Successful Salvage Chemotherapy with FOLFIRINOX for Recurrent Mixed Acinar Cell Carcinoma and Ductal Adenocarcinoma of the Pancreas in an Adolescent Patient

    Directory of Open Access Journals (Sweden)

    Sarah Pfrommer

    2013-09-01

    Full Text Available Pancreatic tumors are rare in children and adolescents. Here, we report the case of a 15-year-old boy who presented with a mixed acinar cell carcinoma/ductal adenocarcinoma with blastomatous components. He received multimodal treatment including various chemotherapy regimens and multistep surgery including liver transplantation. Introduction of FOLFIRINOX after relapse repeatedly achieved a durable metabolic and clinical response with good quality of life.

  15. Relationship of family history and outcome after breast conservation therapy in women with ductal carcinoma in situ of the breast

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to evaluate the relationship between a family history of breast or ovarian cancer and outcome after breast-conserving surgery and radiation in women presenting with an initial diagnosis of ductal carcinoma in situ (DCIS) of the breast. Methods and Materials: A total of 146 consecutive women with a pathologic diagnosis of ductal carcinoma in situ as their first diagnosis of any breast cancer were identified; 28 (19%) had a positive family history of breast or ovarian cancer in a first-degree relative, 27 (19%) had a positive family history in a second-degree relative, and 91 (62%) had no family history. Pathologic, clinical, and treatment factors, and clinical outcomes for each family history group were compared. Cosmesis and complications were recorded at each follow-up. Patients were treated between 1978 and 1995, and the median follow-up was 7.1 years. Results: Patients with a positive family history in a first- or second-degree relative each had an 8% incidence of local failure at 10 years, while the negative family history group demonstrated a 16% local failure rate (p = 0.33). Overall survival at 10 years for patients with a positive family history in a first- or second-degree relative was 100% and for those with a negative family history was 91% (p = 0.08). The negative family history group had a higher median age that may account for the difference in overall survival. Cause-specific survival (CSS) was 97%, 100%, and 99%, respectively, at 10 years (p = 0.25). There were no differences in the cosmetic results or complication rates between women with a positive or negative family history. Conclusion: We have shown that a family history of breast and/or ovarian cancer is not associated with an adverse outcome for women treated with breast conservation therapy for DCIS. Local recurrence, cause-specific survival, overall survival, cosmesis, and complication rates were comparable to that of similarly treated women with

  16. Radiologic Findings of Ductal Carcinoma in Situ Arising Within a Juvenile Fibroadenoma: Mammographic, Sonographic and Dynamic Contrast-Enhanced Breast MRI Features.

    Science.gov (United States)

    Park, Eun Kyung; Cho, Kyu Ran; Seo, Bo Kyoung; Woo, Ok Hee; Lee, Jeong Hyeon; Song, Sung Eun; Bae, Jeong Won

    2015-04-01

    Juvenile fibroadenoma is an uncommon histologic variant of fibroadenoma that frequently shows a remarkable and rapid growth. The development of a carcinoma within a fibroadenoma, either in situ or invasive, is a rare condition. We encountered a 36-year-old woman with a palpable mass in the right breast. The radiologic findings were indicative of a fibroadenoma in the breast. Sonographic guided biopsy using a 14G core needle revealed the presence of ductal carcinoma in situ (DCIS) within the juvenile fibroadenoma. Focal excision was performed and the patient underwent radiation therapy in the right breast after surgery. PMID:26060554

  17. Radiologic Findings of Ductal Carcinoma in Situ Arising Within a Juvenile Fibroadenoma: Mammographic, Sonographic and Dynamic Contrast-Enhanced Breast MRI Features

    International Nuclear Information System (INIS)

    Juvenile fibroadenoma is an uncommon histologic variant of fibroadenoma that frequently shows a remarkable and rapid growth. The development of a carcinoma within a fibroadenoma, either in situ or invasive, is a rare condition. We encountered a 36-year-old woman with a palpable mass in the right breast. The radiologic findings were indicative of a fibroadenoma in the breast. Sonographic guided biopsy using a 14G core needle revealed the presence of ductal carcinoma in situ (DCIS) within the juvenile fibroadenoma. Focal excision was performed and the patient underwent radiation therapy in the right breast after surgery

  18. Synchronous presentation of invasive ductal carcinoma and mantle cell lymphoma: a diagnostic challenge in menopausal patients

    OpenAIRE

    Woo, Edward J.; Baugh, Aaron D.; Ching, Karen

    2016-01-01

    Synchronous presentation of breast carcinoma and non-Hodgkin lymphoma (NHL) is a rare occurrence (Bradford PT, Freedman DM, Goldstein AM, Tucker MA. Increased risk of second primary cancers after a diagnosis of melanoma. Arch Dermatol 2010;146:265–72; Dutta Roy S, Stafford JA, Scally J, Selvachandran SN. A rare case of breast carcinoma co-existing with axillary mantle cell lymphoma. World J Surg Oncol 2003;1:27; Suresh Attili VS, Dadhich HK, Rao CR, Bapsy PP, Batra U, Anupama G et al. A case ...

  19. Preoperative breast magnetic resonance imaging and contralateral breast cancer occurrence among older women with ductal carcinoma in situ.

    Science.gov (United States)

    Wang, Shi-Yi; Long, Jessica B; Killelea, Brigid K; Evans, Suzanne B; Roberts, Kenneth B; Silber, Andrea; Gross, Cary P

    2016-07-01

    Although preoperative magnetic resonance imaging (MRI) can detect mammographically occult contralateral breast cancers (CBCs) among women with ductal carcinoma in situ (DCIS), the impact of MRI on the incidence of subsequent CBC events is unclear. We examined whether MRI use decreases CBC occurrences and detection of invasive disease among women who develop a CBC. Utilizing the Surveillance, Epidemiology, and End Results-Medicare dataset, we assessed overall, synchronous (cancer diagnosis), and subsequent (≥6 months after diagnosis, i.e., metachronous) CBC occurrence in women aged 67-94 years diagnosed with DCIS during 2004-2009, with follow-up through 2011. We applied a matched propensity score approach to compare the stage-specific incidence rate of CBC according to MRI use. Our sample consisted of 9166 beneficiaries, 1258 (13.7 %) of whom received preoperative MRI. After propensity score matching, preoperative MRI use was significantly associated with a higher synchronous CBC detection rate (108.6 vs. 29.7 per 1000 person-years; hazard ratio [HR] = 3.65; p lesions may not become clinically evident. PMID:27287780

  20. Impact of Boost Radiation in the Treatment of Ductal Carcinoma In Situ: A Population-Based Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rakovitch, Eileen, E-mail: Eileen.rakovitch@sunnybrook.ca [Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario (Canada); Institute for Clinical Evaluative Sciences, Toronto, Ontario (Canada); University of Toronto, Toronto, Ontario (Canada); Narod, Steven A. [University of Toronto, Toronto, Ontario (Canada); Women’s College Research Institute, Toronto, Ontario (Canada); Nofech-Moses, Sharon; Hanna, Wedad [Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario (Canada); University of Toronto, Toronto, Ontario (Canada); Thiruchelvam, Deva; Saskin, Refik; Taylor, Carole [Institute for Clinical Evaluative Sciences, Toronto, Ontario (Canada); Tuck, Alan [London Health Sciences Center, London, Ontario (Canada); Youngson, Bruce; Miller, Naomi; Done, Susan J. [University Health Network, Toronto, Ontario (Canada); Sengupta, Sandip [Kingston General Hospital, Kingston, Ontario (Canada); Elavathil, Leela [University of Toronto, Toronto, Ontario (Canada); Henderson General Hospital, 711 Concession Street, Hamilton, Ontario (Canada); Jani, Prashant A. [University of Toronto, Toronto, Ontario (Canada); Regional Health Sciences Centre, Thunder Bay, Ontario (Canada); Bonin, Michel [Sudbury Regional Hospital, Sudbury, Ontario (Canada); Metcalfe, Stephanie [Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario (Canada); Paszat, Lawrence [Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario (Canada); Institute for Clinical Evaluative Sciences, Toronto, Ontario (Canada); University of Toronto, Toronto, Ontario (Canada)

    2013-07-01

    Purpose: To report the outcomes of a population of women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery and radiation and to evaluate the independent effect of boost radiation on the development of local recurrence. Methods and Materials: All women diagnosed with DCIS and treated with breast-conserving surgery and radiation therapy in Ontario from 1994 to 2003 were identified. Treatments and outcomes were identified through administrative databases and validated by chart review. The impact of boost radiation on the development of local recurrence was determined using survival analyses. Results: We identified 1895 cases of DCIS that were treated by breast-conserving surgery and radiation therapy; 561 patients received boost radiation. The cumulative 10-year rate of local recurrence was 13% for women who received boost radiation and 12% for those who did not (P=.3). The 10-year local recurrence-free survival (LRFS) rate among women who did and who did not receive boost radiation was 88% and 87%, respectively (P=.27), 94% and 93% for invasive LRFS (P=.58), and was 95% and 93% for DCIS LRFS (P=.31). On multivariable analyses, boost radiation was not associated with a lower risk of local recurrence (hazard ratio = 0.82, 95% confidence interval 0.59-1.15) (P=.25). Conclusions: Among a population of women treated with breast-conserving surgery and radiation for DCIS, additional (boost) radiation was not associated with a lower risk of local or invasive recurrence.

  1. Extent of ductal carcinoma in situ according to breast cancer subtypes: a population-based cohort study.

    Science.gov (United States)

    Doebar, Shusma C; van den Broek, Esther C; Koppert, Linetta B; Jager, Agnes; Baaijens, Margreet H A; Obdeijn, Inge-Marie A M; van Deurzen, Carolien H M

    2016-07-01

    Ductal carcinoma in situ (DCIS) is a precursor of invasive breast carcinoma (IBC). The DCIS component is often more extensive than the invasive component, which affects local control. The aim of our study was to analyze features of DCIS within different IBC subtypes, which may contribute to the optimization of personalized approaches for patients with IBC. Patients with IBC reported according to the synoptic reporting module in the Netherlands between 2009 and 2015 were included. Data extraction included characteristics of the invasive component and, if present, several features of the DCIS component. Resection margin status analyses were restricted to patients undergoing breast-conserving surgery (BCS). Differences between subtypes were tested by a Chi-square test, spearman's Rho test or a one-way ANOVA test. Overall, 36.937 cases of IBC were included. About half of the IBCs (n = 16.014; 43.4 %) were associated with DCIS. Her2+ IBC (irrespective of ER status) was associated with a higher prevalence of adjacent DCIS, a larger extent of DCIS and a higher rate of irradicality of the DCIS component as compared to ER+/Her2- and triple-negative subtypes (P IBC on the other hand was lowest. In this large population-based cohort study, we showed significant differences between the prevalence and extent of DCIS according to IBC subtypes, which is also reflected in the resection margin status in patients treated with BCS. Our data provide important information regarding the optimization of local therapy according to IBC subtypes. PMID:27318854

  2. Ductal carcinoma in situ of the breast (DCIS with heterogeneity of nuclear grade: prognostic effects of quantitative nuclear assessment

    Directory of Open Access Journals (Sweden)

    Fu Yuejiao

    2007-09-01

    Full Text Available Abstract Background Previously, 50% of patients with breast ductal carcinoma in situ (DCIS had more than one nuclear grade, and neither worst nor predominant nuclear grade was significantly associated with development of invasive carcinoma. Here, we used image analysis in addition to histologic evaluation to determine if quantification of nuclear features could provide additional prognostic information and hence impact prognostic assessments. Methods Nuclear image features were extracted from about 200 nuclei of each of 80 patients with DCIS who underwent lumpectomy alone, and received no adjuvant systemic therapy. Nuclear images were obtained from 20 representative nuclei per duct, from each of a group of 5 ducts, in two separate fields, for 10 ducts. Reproducibility of image analysis features was determined, as was the ability of features to discriminate between nuclear grades. Patient information was available about clinical factors (age and method of DCIS detection, pathologic factors (DCIS size, nuclear grade, margin size, and amount of parenchymal involvement, and 39 image features (morphology, densitometry, and texture. The prognostic effects of these factors and features on the development of invasive breast cancer were examined with Cox step-wise multivariate regression. Results Duplicate measurements were similar for 89.7% to 97.4% of assessed image features. For the pooled assessment with ~200 nuclei per patient, a discriminant function with one densitometric and two texture features was significantly (p Conclusion Image analysis provided reproducible assessments of nuclear features which quantitated differences in nuclear grading for patients. Quantitative nuclear image features indicated prognostically significant differences in DCIS, and may contribute additional information to prognostic assessments of which patients are likely to develop invasive disease.

  3. Comparison of nuclear grade and immunohistochemical features in situ and invasive components of ductal carcinoma of breast Comparação do grau nuclear e perfil imunoistoquímico nos componentes in situ e invasivo de carcinoma mamário

    OpenAIRE

    Fernando Nalesso Aguiar; Henrique Nogueira Mendes; Bacchi, Carlos E.; Filomena Marino Carvalho

    2013-01-01

    PURPOSE:To compare the prognostic and predictive features between in situ and invasive components of ductal breast carcinomas. METHODS:We selected 146 consecutive breast samples with ductal carcinoma in situ (DCIS) associated with adjacent invasive breast carcinoma (IBC). We evaluated nuclear grade and immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), cytokeratin 5/6 (CK5/6), and epidermal growth factor recep...

  4. Unusual mammography findings of patients with ductal carcinoma in situ (DCIS of the breast.

    Directory of Open Access Journals (Sweden)

    F Ismail

    2008-12-01

    Full Text Available Abstract The early detection of carcinoma is the highlight of mammography. We present two patients with pathological diagnosis of DCIS with unusual mammographic findings for which one needs to have a higher index of suspicion. The first patient presented with multifocal disease requiring biopsy of all visible lesions and the second patient (twenty four years old presented with segmental distribution of calcifications, which may have been missed had a single-view baseline mammogram not been done.

  5. MRI for the size assessment of pure ductal carcinoma in situ (DCIS): A prospective study of 33 patients

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    Marcotte-Bloch, C., E-mail: marcotte.c@free.fr [Department of Medical Imaging, Centre Antoine Lacassagne, 33 route de Valombrose, 06100 Nice (France); Balu-Maestro, C. [Department of Medical Imaging, Centre Antoine Lacassagne, 33 route de Valombrose, 06100 Nice (France); Chamorey, E. [Department of Medical Statistics, Centre Antoine Lacassagne, 33 route de Valombrose, 06100 Nice (France); Ettore, F. [Department of Pathology, Centre Antoine Lacassagne, 33 route de Valombrose, 06100 Nice (France); Raoust, I.; Flipo, B. [Department of Surgery, Centre Antoine Lacassagne, 33 route de Valombrose, 06100 Nice (France); Chapellier, C. [Department of Medical Imaging, Centre Antoine Lacassagne, 33 route de Valombrose, 06100 Nice (France)

    2011-03-15

    Objective: To determine whether MRI assesses the size of ductal carcinomas in situ (DCIS) more accurately than mammography, using the histopathological dimension of the surgical specimen as the reference measurement. Materials and methods: This single-center prospective study conducted from March 2007 to July 2008 at the Antoine-Lacassagne Cancer Treatment Center (Nice, France) included 33 patients with a histologically proven DCIS by needle biopsy, who all underwent clinical examination, mammography, and MRI interpreted by an experienced radiologist. All patients underwent surgery at our institution. The greatest dimensions of the DCIS determined by the two imaging modalities were compared with the histopathological dimension ascertained on the surgical specimen. The study was approved by the local Ethical Research Committee and was authorized by the French National Health Agency (AFSSAPS). Results: The mean age of the 33 patients was 59.7 years ({+-}10.3). Three patients had a palpable mass at clinical breast examination; 82% underwent conservative surgical therapy rather than radical breast surgery (mastectomy); 6% required repeat surgery. MRI detected 97% of the lesions. Non-mass-like enhancement was noted for 78% of the patients. In over 50% of the cases, distribution of the DCIS was ductal or segmental and the kinetic enhancement curve was persistent. Lesion size was correctly estimated ({+-}5 mm), under-estimated (<5 mm), or over-estimated (>5 mm), respectively, by MRI in 60%, 19% and 21% of cases and by mammography in 38%, 31% and 31% (p = 0.05). Mean lesion size was 25.6 mm at histopathology, 28.1 mm at MRI, and 27.2 mm on mammography (nonsignificant difference). The correlation coefficient between histopathological measurement and MRI was 0.831 versus 0.674 between histopathology and mammography. The correlation coefficient increased with the nuclear grade of the DCIS on mammography; this coefficient also increased as the mammographic breast density

  6. Breast-conserving therapy for ductal carcinoma in situ of the breast: the French Cancer Centers' experience

    International Nuclear Information System (INIS)

    Purpose: To assess the long-term outcome for women with ductal carcinoma in situ of the breast treated in current clinical practice by conservative surgery with or without definitive breast irradiation. Methods and Materials: We analyzed 705 cases of ductal carcinoma in situ treated between 1985 and 1995 in nine French regional cancer centers; 515 underwent conservative surgery and radiotherapy (CS+RT) and 190 CS alone. The median follow-up was 7 years. Results: The 7-year crude local recurrence (LR) rate was 12.6% (95% confidence interval [CI] 9.4-15.8) and 32.4% (95% CI 25-39.7) for the CS+RT and CS groups, respectively (p<0.0001). The respective 10-year results were 18.2% (95% CI 13.3-23) and 43.8% (95% CI 30-57.7). A total of 125 LRs occurred, 66 and 59 in the CS+RT and CS groups, respectively. Invasive or microinvasive LRs occurred in 60.6% and 52% of the cases in the same respective groups. The median time to LR development was 55 and 41 months. Nine (1.7%) and 6 (3.1%) nodal recurrences occurred in the CS+RT and CS groups, respectively. Distant metastases occurred in 1.4% and 3% of the respective groups. Patient age and excision quality (final margin status) were both significantly associated with LR risk in the CS+RT group: the LR rate was 29%, 13%, and 8% among women aged ≤40, 41-60, and ≥61 years (p<0.001). Even in the case of complete excision, we observed a 24% rate of LR (6 of 25) in women <40 years. Patients with negative, positive, or uncertain margins had a 7-year crude LR rate of 9.7%, 25.2%, and 12.2%, respectively (p=0.008). RT reduced the LR rate in all subgroups, especially in those with comedocarcinoma (17% vs. 59% in the CS+RT and CS groups, respectively, p<0.0001) and mixed cribriform/papillary tumors (9% vs. 31%, p<0.0001). In the multivariate Cox regression model, young age and positive margins remained significant in the CS+RT group (p=0.00012 and p=0.016). Finally, the relative LR risk in the CS+RT group compared with the CS group

  7. Fine-needle aspiration of gray zone lesions of the breast: fibroadenoma versus ductal carcinoma.

    Science.gov (United States)

    Jing, Xin; Normolle, Daniel; Michael, Claire W

    2013-09-01

    While breast lesions have characteristic cytological features, some lesions, particularly adenocarcinoma and fibroadenoma, may present with overlapping features causing erroneous diagnoses. The current study aimed to define significant cytomorphologic features predictive of fibroadenoma and adenocarcinoma, respectively. Further, we intended to evaluate the predictive characteristics for differentiation between gray zone lesions and to identify root causes contributing to misdiagnoses. First, direct smears prepared from 14 histology-confirmed fibroadenomas and 14 adenocarcinomas were reviewed and characteristics of commonly encountered morphologic features were assessed. We then retrospectively and blindly reviewed nine cytohistologic discrepant cases using the significant characteristic as a guideline, in order to assess whether these discrepant cases could be correctly categorized. Morphologic characteristics predictive of fibroadenoma included moderate cellularity, large, folded cellular sheets/aggregates, staghorn projections, smooth and round borders, monolayers, honeycomb arrangement, smaller nuclear size, and background bipolar cells. Predictive characteristics of adenocarcinoma included high cellularity, loose cohesive sheets/aggregates, pointed projections, irregular borders, larger nuclear size, irregular nuclear membrane, prominent nucleoli, and single atypical epithelial cells. Retrospective, blind review correctly re-classified seven out of nine cytohistologic discrepant cases, including five false negative cases and two false positive cases. Root causes contributing to the misdiagnoses were large branching sheets of carcinoma mimicking folded sheets of fibroadenoma; fibroblasts mimicking myoepithelial cells; apocrine cells mimicking carcinoma cells; and not recognizing the loose myxoid matrix presenting as soap bubbles in fibroadenoma. In conclusion, this study identified significant characteristics that can assist in achieving accurate diagnosis in a

  8. Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast

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    Capitanio Giovanni

    2005-03-01

    Full Text Available Abstract Background Sentinel lymph node (SLN biopsy is an effective tool for axillary staging in patients with invasive breast cancer. This procedure has been recently proposed as part of the treatment for patients with ductal carcinoma in situ (DCIS, because cases of undetected invasive foci and nodal metastases occasionally occur. However, the indications for SLN biopsy in DCIS patients are controversial. The aim of the present study was therefore to assess the incidence of SLN metastases in a series of patients with a diagnosis of pure DCIS. Methods A retrospective evaluation was made of a series of 102 patients who underwent SLN biopsy, and had a final histologic diagnosis of pure DCIS. Patients with microinvasion were excluded from the analysis. The patients were operated on in five Institutions between 1999 and 2004. Subdermal or subareolar injection of 30–50 MBq of 99 m-Tc colloidal albumin was used for SLN identification. All sentinel nodes were evaluated with serial sectioning, haematoxylin and eosin staining, and immunohistochemical analysis for cytocheratin. Results Only one patient (0.98% was SLN positive. The primary tumour was a small micropapillary intermediate-grade DCIS and the SLN harboured a micrometastasis. At pathologic revision of the specimen, no detectable focus of microinvasion was found. Conclusion Our findings indicate that SLN metastases in pure DCIS are a very rare occurrence. SLN biopsy should not therefore be routinely performed in patients who undergo resection for DCIS. SLN mapping can be performed, as a second operation, in cases in which an invasive component is identified in the specimen. Only DCIS patients who require a mastectomy should have SLN biopsy performed at the time of breast operation, since in these cases subsequent node mapping is not feasible.

  9. Expression analysis of E-cadherin, Slug and GSK3β in invasive ductal carcinoma of breast

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    Bhatnagar Dinesh

    2009-09-01

    Full Text Available Abstract Background Cancer progression is linked to a partially dedifferentiated epithelial cell phenotype. The signaling pathways Wnt, Hedgehog, TGF-β and Notch have been implicated in experimental and developmental epithelial mesenchymal transition (EMT. Recent findings from our laboratory confirm that active Wnt/β-catenin signaling is critically involved in invasive ductal carcinomas (IDCs of breast. Methods In the current study, we analyzed the expression patterns and relationships between the key Wnt/β-catenin signaling components- E-cadherin, Slug and GSK3β in IDCs of breast. Results Of the 98 IDCs analyzed, 53 (54% showed loss/or reduced membranous staining of E-cadherin in tumor cells. Nuclear accumulation of Slug was observed in 33 (34% IDCs examined. Loss or reduced level of cytoplasmic GSK3β expression was observed in 52/98 (53% cases; while 34/98 (35% tumors showed nuclear accumulation of GSK3β. Statistical analysis revealed associations of nuclear Slug expression with loss of membranous E-cadherin (p = 0.001; nuclear β-catenin (p = 0.001, and cytoplasmic β-catenin (p = 0.005, suggesting Slug mediated E-cadherin suppression via the activation of Wnt/β-catenin signaling pathway in IDCs. Our study also demonstrated significant correlation between GSK3β nuclear localization and tumor grade (p = 0.02, suggesting its association with tumor progression. Conclusion The present study for the first time provided the clinical evidence in support of Wnt/β-catenin signaling upregulation in IDCs and key components of this pathway - E-cadherin, Slug and GSK3β with β-catenin in implementing EMT in these cells.

  10. Outcomes of Low-Risk Ductal Carcinoma In Situ in Southeast Asian Women Treated With Breast Conservation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Fuh Yong, E-mail: fuhyong@yahoo.com [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Wang, Fuqiang [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Chen, John Ju [Department of Cancer Informatics, National Cancer Centre Singapore (Singapore); Tan, Chiew Har [Department of Radiation Oncology, National Cancer Centre Singapore (Singapore); Tan, Puay Hoon [Department of Pathology, Singapore General Hospital (Singapore)

    2014-04-01

    Purpose: To examine the outcomes of Southeast Asian (SEA) women with low-risk ductal carcinoma in situ (DCIS) treated with breast-conserving surgery (BCS) and adjuvant radiation therapy. Methods and Materials: Retrospective chart reviews of patients treated with BCS for DCIS from 1995 to 2011 were performed. Patients meeting the selection criteria from Eastern Cooperative Oncology Group 5194 were included. Most patients received adjuvant radiation therapy (RT) consisting of whole-breast RT delivered to 50 Gy followed by a 10-Gy boost to the tumor bed. Results: Of 744 patients with pathologic diagnosis of pure DCIS identified, 273 met the selection criteria: low-intermediate grade (LIG), n=219; high grade (HG), n=54. Median follow-up for these patients was 60 months. There were 8 ipsilateral breast tumor recurrences (IBTRs) in total, 7 of which were DCIS. The estimated actuarial IBTR rates at 5 and 10 years for the entire cohort are 1.8% and 4.3%, respectively. Of the 219 patients with LIG DCIS, 210 received RT and 9 did not. There were 7 IBTRs in LIG DCIS, 2 among the 9 patients who did not receive RT. The IBTR rates in LIG DCIS at 5 and 10 years are 2.3% and 4.2%, respectively. All patients with HG DCIS received RT. There was only 1 IBTR occurring beyond 5 years, giving an estimated IBTR rate of 4.5% at 10 years. Conclusions: SEA women with screen-detected DCIS have exceedingly low rates of IBTR after BCS, comparable to that observed in reports of similar patients with low-risk DCIS treated with adjuvant radiation.

  11. Glucose Uptake and Intracellular pH in a Mouse Model of Ductal Carcinoma In situ (DCIS) Suggests Metabolic Heterogeneity.

    Science.gov (United States)

    Lobo, Rebecca C; Hubbard, Neil E; Damonte, Patrizia; Mori, Hidetoshi; Pénzváltó, Zsófia; Pham, Cindy; Koehne, Amanda L; Go, Aiza C; Anderson, Steve E; Cala, Peter M; Borowsky, Alexander D

    2016-01-01

    Mechanisms for the progression of ductal carcinoma in situ (DCIS) to invasive breast carcinoma remain unclear. Previously we showed that the transition to invasiveness in the mammary intraepithelial neoplastic outgrowth (MINO) model of DCIS does not correlate with its serial acquisition of genetic mutations. We hypothesized instead that progression to invasiveness depends on a change in the microenvironment and that precancer cells might create a more tumor-permissive microenvironment secondary to changes in glucose uptake and metabolism. Immunostaining for glucose transporter 1 (GLUT1) and the hypoxia marker carbonic anhydrase 9 (CAIX) in tumor, normal mammary gland and MINO (precancer) tissue showed differences in expression. The uptake of the fluorescent glucose analog dye, 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl) amino]-2-deoxy-D-glucose (2-NBDG), reflected differences in the cellular distributions of glucose uptake in normal mammary epithelial cells (nMEC), MINO, and Met1 cancer cells, with a broad distribution in the MINO population. The intracellular pH (pHi) measured using the fluorescent ratio dye 2',7'-bis(2-carboxyethyl)-5(6)-155 carboxyfluorescein (BCECF) revealed expected differences between normal and cancer cells (low and high, respectively), and a mixed distribution in the MINO cells, with a subset of cells in the MINO having an increased rate of acidification when proton efflux was inhibited. Invasive tumor cells had a more alkaline baseline pHi with high rates of proton production coupled with higher rates of proton export, compared with nMEC. MINO cells displayed considerable variation in baseline pHi that separated into two distinct populations: MINO high and MINO low. MINO high had a noticeably higher mean acidification rate compared with nMEC, but relatively high baseline pHi similar to tumor cells. MINO low cells also had an increased acidification rate compared with nMEC, but with a more acidic pHi similar to nMEC. These findings demonstrate

  12. Results of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS)

    International Nuclear Information System (INIS)

    Purpose: The role of conservative surgery and radiation for mammographically detected DCIS is controversial. In particular, there is a paucity of data for outcome with radiation in a group of patients comparable to those treated with local excision and surveillance (mammographically detected DCIS ≤2.5 cm, negative resection margins, negative post-biopsy mammogram). The purpose of this study is to report long term outcome of conservative surgery and radiation for mammographically detected DCIS with emphasis on the results in patients (pts.) considered candidates for excision alone. Materials and Methods: From 1983 to 1992, 110 women with mammographically detected DCIS (calcifications 72%, mass ± calcifications 27%) and no prior history of breast cancer underwent needle localization biopsy followed by radiation. The median age of the patient population was 56 yrs. (range 37-81). The median followup was 5.3 yrs. (range .5-12). Re-excision was performed in 55%. Final margins of resection were negative in 62%, positive 7%, close 11%, and unknown 20%. Axillary dissection was performed in 31 pts. and all had negative nodes. 31% had a positive family history of breast cancer (1 affected relative-25 pts., two-7 pts., three-2 pts.). The most common predominant histologic subtype was comedo (54%) followed by cribriform (22%). The median pathologic tumor size was 8 mm (range 2 mm to 5 cm). A post-biopsy mammogram prior to radiation was performed in 46% of the patients. Radiation consisted of treatment to the entire breast (median 5000 cGy) with a boost to the primary site (97%) of an additional 1000 cGy. The median total dose to the primary site was 6040 cGy (range 5000 to 6660). Results: Three patients developed a recurrence in the treated breast at 52, 106, and 107 months. All 3 recurrences were invasive ductal cancers and all were treated with mastectomy. The location of the recurrence was in the same quadrant as the primary in 1 pt. and in a separate quadrant in 2 pts

  13. Ductal carcinoma in situ of the breast - a review of diagnosis, treatment and outcome in a hospital-based Norwegian series

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    Wang, H.; Jebsen, P.W.; Kaaresen, R.; Thoresen, S.O. [Cancer Registry of Norway, Oslo (Norway)

    2000-07-01

    Between 1980 and 1994, 71 women with histologically proven ductal carcinoma in situ (DCIS) were diagnosed at Ullevaal Hospital; bilateral tumours were found in two patients. Surgical treatment was mastectomy (42 lesions) or local excision (31 lesions). Median follow-up time was 7.2 years. Ten patients experienced a local recurrence, seven of which were invasive carcinomas. The actuarial 5-year local recurrence rate was 22% after local excision. A multivariate analysis found that tumour size was the only factor that predicted local recurrence after local excision. An analysis of relative survival in a nation-wide material of 832 DCIS patients in the period 1980 to 1994 demonstrates that relative survival after a DCIS diagnosis is almost 100%, irrespective of surgical treatment of the initial lesion.

  14. Conservative treatment of breast ductal carcinoma in situ: results of an Italian multi-institutional retrospective study

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    Vidali Cristiana

    2012-10-01

    Full Text Available Abstract Background The incidence of ductal carcinoma in situ (DCIS has increased markedly in recent decades. In the past, mastectomy was the primary treatment for patients with DCIS, but as with invasive cancer, breast-conserving surgery followed by radiation therapy (RT has become the standard approach. We present the final results of a multi-institutional retrospective study of an Italian Radiation Oncology Group for the study of conservative treatment of DCIS, characterized by a very long period of accrual, from February 1985 to March 2000, and a median follow-up longer than 11 years. Methods A collaborative multi-institutional study was conducted in Italy in 10 Radiation Oncology Departments. A consecutive series of 586 women with DCIS histologically confirmed, treated between February 1985 and March 2000, was retrospectively evaluated. Median age at diagnosis was 55 years (range: 29–84; 32 patients were 40 years old or younger. All women underwent conservative surgery followed by whole breast RT. Irradiation was delivered to the entire breast, for a median total dose of 50 Gy; the tumour bed was boosted in 295 cases (50% at a median dose of 10 Gy. Results After a median follow-up of 136 months (range: 16–292 months, 59/586 patients (10% experienced a local recurrence: invasive in 37 cases, intraductal in 20 and not specified in two. Salvage mastectomy was the treatment of choice in 46 recurrent patients; conservative surgery in 10 and it was unknown in three patients. The incidence of local recurrence was significantly higher in women younger than 40 years (31.3% (p= 0.0009. Five patients developed distant metastases. Furthermore 40 patients developed a contralateral breast cancer and 31 a second primary tumour in a different site. The 10-year actuarial overall survival (OS was 95.5% and the 10-year actuarial disease-specific survival (DSS was 99%. Conclusions Our results are consistent with those reported in the literature. In

  15. Preservation of cosmesis with low complication risk after conservative surgery and radiotherapy for ductal carcinoma in situ of the breast

    International Nuclear Information System (INIS)

    Purpose: Although the clinical outcome after treatment of ductal carcinoma in situ (DCIS) using breast-conservation surgery and radiation therapy has been well documented, little data has been reported on cosmetic outcome or treatment complications. Therefore, the present study was performed to evaluate cosmesis and complications after breast-conservation treatment for DCIS and to analyze various factors that might affect cosmesis and predispose to complications. Methods and Materials: The records of 90 patients who were alive without evidence of disease with a 3-year minimum follow-up were evaluated for cosmetic results and treatment complications following breast-conservation surgery and radiation therapy for DCIS. Complete gross excision of the primary tumor had been performed in all patients. Additionally, 24 patients had undergone an axillary lymph node dissection in the earlier years of the study. The majority of the patients had received 50-50.4 Gy to the whole breast followed by an electron boost for a total dose of 60-66 Gy. Results: The cosmetic results of 90 evaluable patients at 3 years were: excellent in 69 (77%), good in 19 (21%), and fair in 2 (2%). The cosmetic results of 64 evaluable patients at 5 years were: excellent in 46 (72%), good in 16 (25%), and fair in 2 (3%). Factors associated with worse cosmetic results were an increased volume of tissue excised (>70 cm3) and a negative ipsilateral breast biopsy after radiotherapy. Complications in the 24 patients with an axillary dissection were: arm edema (n = 6), cellulitis of the arm (n = 5), and axillary vein thrombosis (n = 1). Complications in the 66 patients without an axillary dissection were: cellulitis of the arm (n = 1) and cellulitis of the breast (n = 1). Discussion: Breast-conservation surgery followed by radiation therapy achieved excellent or good cosmetic results in 98 and 97% of patients at 3 years and 5 years, respectively. Complications were associated primarily with axillary

  16. Conservative treatment of breast ductal carcinoma in situ: results of an Italian multi-institutional retrospective study

    International Nuclear Information System (INIS)

    The incidence of ductal carcinoma in situ (DCIS) has increased markedly in recent decades. In the past, mastectomy was the primary treatment for patients with DCIS, but as with invasive cancer, breast-conserving surgery followed by radiation therapy (RT) has become the standard approach. We present the final results of a multi-institutional retrospective study of an Italian Radiation Oncology Group for the study of conservative treatment of DCIS, characterized by a very long period of accrual, from February 1985 to March 2000, and a median follow-up longer than 11 years. A collaborative multi-institutional study was conducted in Italy in 10 Radiation Oncology Departments. A consecutive series of 586 women with DCIS histologically confirmed, treated between February 1985 and March 2000, was retrospectively evaluated. Median age at diagnosis was 55 years (range: 29–84); 32 patients were 40 years old or younger. All women underwent conservative surgery followed by whole breast RT. Irradiation was delivered to the entire breast, for a median total dose of 50 Gy; the tumour bed was boosted in 295 cases (50%) at a median dose of 10 Gy. After a median follow-up of 136 months (range: 16–292 months), 59/586 patients (10%) experienced a local recurrence: invasive in 37 cases, intraductal in 20 and not specified in two. Salvage mastectomy was the treatment of choice in 46 recurrent patients; conservative surgery in 10 and it was unknown in three patients. The incidence of local recurrence was significantly higher in women younger than 40 years (31.3%) (p= 0.0009). Five patients developed distant metastases. Furthermore 40 patients developed a contralateral breast cancer and 31 a second primary tumour in a different site. The 10-year actuarial overall survival (OS) was 95.5% and the 10-year actuarial disease-specific survival (DSS) was 99%. Our results are consistent with those reported in the literature. In particular it has been defined the importance of young age (40

  17. The impact of sentinel lymph node biopsy and magnetic resonance imaging on important outcomes among patients with ductal carcinoma in situ.

    Science.gov (United States)

    Tuttle, Todd M; Shamliyan, Tatyana; Virnig, Beth A; Kane, Robert L

    2010-01-01

    The objective of this systematic review was to determine the impact of sentinel lymph node (SLN) biopsy and breast magnetic resonance imaging (MRI) on important outcomes for patients with ductal carcinoma in situ. We identified no study that directly evaluated important outcomes for SLN biopsy. So, we determined the incidence of SLN metastases among patients with ductal carcinoma in situ. Using American Joint Committee on Cancer criteria, the incidence of pN1 and pN1(mic) SLN metastases were 0.9% and 1.5%, respectively. Because the incidence of SLN metastasis is very low, SLN biopsy is not likely to affect important outcomes. We identified one study that directly evaluated important outcomes after breast MRI. In this study, the use of MRI did not affect local recurrence rates after breast-conserving surgery and radiation. Although MRI may identify occult multicentric or contralateral breast cancer in some patients, it may also lead to unnecessary biopsies and overtreatment. PMID:20956814

  18. S100A7 (psoriasin) expression is associated with aggressive features and alteration of Jab1 in ductal carcinoma in situ of the breast

    International Nuclear Information System (INIS)

    The S100A7 (psoriasin) gene is highly expressed in ductal carcinoma in situ (DCIS) of the breast and can be downregulated in invasive carcinoma. Persistent S100A7 expression in invasive carcinoma is associated with a worse prognosis, and this effect may be mediated in part through interaction with the multifunctional cell signaling protein Jab1. In order to investigate the relationship between S100A7 and progression from DCIS to invasive carcinoma, we studied S100A7 expression in 136 patients with DCIS (including 46 patients with associated invasive carcinoma) by immunohistochemistry. S100A7 expression was present in 63 out of 136 (46%) of DCIS lesions and was associated with estrogen receptor negative status (P = 0.0002), higher nuclear grade (P < 0.0001), necrosis (P < 0.0001) and inflammation (P < 0.0001). S100A7 status was no different between DCIS with and DCIS without an invasive component, but higher levels of S100A7 were present in DCIS associated with invasive carcinoma (P < 0.004). Analysis of a subset of cases showed that S100A7 expression was also associated with an increase in nuclear Jab1 (n = 43; P = 0.0019) and reduced p27kip1 (n = 47; P = 0.0168). In cases of DCIS associated with invasive carcinoma, there was also a significant reduction in S100A7 between in situ and invasive components (n = 46; P < 0.0001). In pure DCIS cases treated by local excision, there was no difference in frequency of S100A7 expression between patients with recurrence of DCIS (n = 9) and those without (n = 36). The findings reported here suggest that, although S100A7 may not be a marker for recurrence of DCIS, it is associated with poor prognostic markers in DCIS and may influence progression of breast carcinoma through its interaction with and influence on Jab1

  19. Comparison of intraoperative frozen section analysis for sentinel lymph node biopsy during breast cancer surgery for invasive lobular carcinoma and invasive ductal carcinoma

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    Povoski Stephen P

    2009-03-01

    Full Text Available Abstract Background Sentinel lymph node (SLN biopsy is the standard of care for the surgical assessment of the axilla during breast cancer surgery. However, the diagnostic accuracy of intraoperative frozen section analysis for confirming metastatic involvement of SLNs in cases of invasive lobular carcinoma (ILC versus that of invasive ductal carcinoma (IDC has generated controversy secondary to a frequently low-grade cytologic appearance and an often discohesive pattern displayed by metastatic lymph nodes in ILC. In the current report, we present a comparison of intraoperative frozen section analysis for confirming the presence of metastatic disease within SLNs during breast cancer surgery for ILC and IDC. Methods We evaluated the results of 131 consecutive cases of ILC from 1997 to 2008 and 133 cases of IDC (selected by a random sequence generator program from amongst 1163 consecutive cases of IDC from the same time period. All cases had at least one SLN that had both intraoperative frozen section analysis and confirmatory permanent section analysis performed. Results No statistically significant difference was found in the sensitivity (67% vs. 75%, P = 0.385, specificity (100% vs. 100%, accuracy (86% vs. 92%, P = 0.172, false negative rate (33% vs. 25%, P = 0.385, negative predictive value (81% vs. 89%, P = 0.158, and positive predictive value (100% vs. 100% for frozen section analysis for confirming the presence of metastatic disease within SLNs during breast cancer surgery for ILC and IDC. Conclusion Since there was no statistically significant difference in sensitivity, specificity, accuracy, false negative rate, negative predictive value, and positive predictive value between frozen section analysis of SLNs for patients with ILC and IDC, the clinical accuracy of confirming metastatic involvement of SLNs on frozen section analysis for ILC should not be considered inferior to the clinical accuracy for IDC. Therefore, frozen section analysis

  20. Lack of correlation between Tc-99m-sestaMIBI uptake and cadherin expression in infiltrating ductal breast carcinoma as prognostic indicators

    International Nuclear Information System (INIS)

    Despite using various kinds of prognostic indicators, it is still not possible to predict the biological behavior of breast cancer in all patients. Tc-99m-sestaMIBI (MIBI) uptake determined by breast scintigraphy and cadherin expression of tumor tissue revealed by immunohistochemistry are suggested as potential agents for this purpose. We hypothesize that there can be a correlation between MIBI whose cellular mitochondrial content is claimed to play a significant role in its tumor uptake and cadherin whose downregulation causes an increase in mitochondrial activity in human mammary carcinoma cell lines. The aim of this study was to assess the relationship between the degree of MIBI tumor uptake and cadherin expression in infiltrating ductal breast carcinoma. Correlation with response to chemotherapy and some known prognostic factors of breast cancer such as tumor size, number of metastatic axillary lymph nodes and microscopic grading was also done. Fourteen patients who underwent scintimammography and subsequent surgical excisional biopsy that revealed infiltrating ductal carcinoma were enrolled in this study. Statistical analysis did not show any correlation between MIBI uptake and cadherin expression (p>0.05). Also, no statistically significant correlation was noted between MIBI uptake and tumor size, number of metastatic lymph nodes, microscopic grade, stage of the disease or response to chemotherapy. Similarly, there was no statistically significant correlation between cadherin expression and tumor size, number of metastatic lymph nodes, microscopic grade, stage of the disease or chemotherapy response. The results of this study imply that there is no correlation between MIBI tumor uptake and cadherin expression with neither of them good enough to be used as prognostic indicators for breast cancer. (author)

  1. Expression of E2F-1, Rb and ER in Peripheral Papilloma and Ductal Carcinoma in Situ of the Breast and its Significance

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To investigate the correlation of E2F-1, Rb and ER expression with peripheral papilloma (Peri-PM) and ductal carcinoma in situ of the breast (DCIS), and further explore some molecular mechanisms of the canceration of Peri-PM.METHODS Imunohistochemistry was used to examine the expression of E2F-1, Rb and ER in 60 Peri-PM, 60 Peri-PM with atypical ductal hyperplasia (Peri-PM with ADH) and 60 DCIS. Normal breast tissues were selected as a control group.RESULTS Based on immunohistochemical staining, the positive rate of E2F-1 expression in Peri-PM, Peri-PM with ADH and DCIS was 21.7%,46.7% and 78.3% respectively. The positive rate of Rb expression was 83.3 %, 53.9% and 21.7% and the ER expression was 86.7%,61.7% and 55.0%.Significant differences were found among the 3 groups (Peri-PM, Peri-PM with ADH and DCIS) (P<0.05). Significant differences existed between any 2 groups (P<0.05) except for the rate of ER positive expression comparing Peri-PM with ADH verus DCIS (P>0.05). The expression of E2F-1 was negatively correlated with ER and Rb, and at the same time the expression of ER was positively correlated with Rb. Following the degree of breast epithelial hyperplasia involved and its development into carcinoma, the positive rate of E2F-1 expression displayed an elevating tendency, but that of Rb and ER expression showed a tendency to decline.CONCLUSION The interaction of the 3 indexes studied may play an important role in the conversion of precancerous lesions to early in situ breast carcinoma, and the evaluation of these indexes might provide a valuable basis for screening high-risk cases of Peri-PM.

  2. Feasibility of a prospective, randomised, open-label, international multicentre, phase III, non-inferiority trial to assess the safety of active surveillance for low risk ductal carcinoma in situ - The LORD study

    NARCIS (Netherlands)

    Elshof, Lotte E.; Tryfonidis, Konstantinos; Slaets, Leen; van Leeuwen-Stok, A. Elise; Skinner, Victoria P.; Dif, Nicolas; Pijnappel, Ruud M.; Bijker, Nina; Rutgers, Emiel J. Th.; Wesseling, Jelle

    2015-01-01

    Background: The current debate on overdiagnosis and overtreatment of screen-detected ductal carcinoma in situ (DCIS) urges the need for prospective studies to address this issue. A substantial number of DCIS lesions will never form a health hazard, particularly if it concerns non-to slow-growing low

  3. Immunohistochemical and Proteomic Evaluation of Nuclear Ubiquitous Casein and Cyclin-Dependent Kinases Substrate in Invasive Ductal Carcinoma of the Breast

    Directory of Open Access Journals (Sweden)

    Piotr Ziółkowski

    2009-01-01

    Full Text Available Nuclear ubiquitous casein and cyclin-dependent kinases substrate (NUCKS is 27 kDa chromosomal protein of unknown function. Its amino acid composition as well as structure of its DNA binding domain resembles that of high-mobility group A, HMGA proteins. HMGA proteins are associated with various malignancies. Since changes in expression of HMGA are considered as marker of tumor progression, it is possible that similar changes in expression of NUCKS could be useful tool in diagnosis and prognosis of breast cancer. For identification and analysis of NUCKS we used proteomic and histochemical methods. Analysis of patient-matched samples of normal and breast cancer by mass spectrometry revealed elevated levels of NUCKS in protein extracts from ductal breast cancers. We elicited specific antibodies against NUCKS and used them for immunohistochemistry in invasive ductal carcinoma of breast. We found high expression of NUCKS in 84.3% of cancer cells. We suggest that such overexpression of NUCKS can play significant role in breast cancer biology.

  4. Long-Term Outcome in Patients With Ductal Carcinoma In Situ Treated With Breast-Conserving Therapy: Implications for Optimal Follow-up Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wilkinson, J. Ben [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Kestin, Larry L. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ye Hong [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Goldstein, Neal S. [Advanced Diagnostics Laboratory, Redford, Michigan (United States); Martinez, Alvaro A. [Michigan HealthCare Professionals, Pontiac, Michigan (United States); Vicini, Frank A., E-mail: fvicini@pol.net [Michigan HealthCare Professionals, Pontiac, Michigan (United States)

    2012-07-01

    Purpose: To determine 20-year rates of local control and outcome-associated factors for ductal carcinoma in situ (DCIS) after breast-conserving therapy (BCT). Methods and Materials: All DCIS cases receiving BCT between 1980 and 1993 were reviewed. Patient demographics and pathologic factors were analyzed for effect on outcomes, including ipsilateral breast tumor recurrence (IBTR) and survival. Results: One hundred forty-five cases were evaluated; the median follow-up time was 19.3 years. IBTR developed in 25 patients, for 5-, 10-, 15-, and 20-year actuarial rates of 9.9%, 12.2%, 13.7%, and 17.5%, respectively. One third of IBTRs were elsewhere failures, and 68% of IBTRs occurred <10 years after diagnosis. Young age and cancerization of lobules predicted for IBTR at <10 years, and increased slide involvement and atypical ductal hyperplasia were associated with IBTR at later time points. Conclusions: Patients with DCIS treated with BCT have excellent long-term rates of local control. Predictors of IBTR vary over time, and the risk of recurrence seems highest within 10 to 12 years after diagnosis.

  5. A Comparison of the Proteomic Expression in Pooled Saliva Specimens from Individuals Diagnosed with Ductal Carcinoma of the Breast with and without Lymph Node Involvement

    Directory of Open Access Journals (Sweden)

    Charles F. Streckfus

    2009-01-01

    Full Text Available Purpose. The objective was to compare the salivary protein profiles of saliva specimens from individuals diagnosed with invasive ductal carcinoma of the breast (IDC with and without lymph node involvement. Methods. Three pooled saliva specimens from women were analyzed. One pooled specimen was from healthy women; another was from women diagnosed with Stage IIa IDC and a specimen from women diagnosed with Stage IIb. The pooled samples were trypsinized and the peptide digests labeled with the appropriate iTRAQ reagent. Labeled peptides from each of the digests were combined and analyzed by reverse phase capillary chromatography on an LC-MS/MS mass spectrometer. Results. The results yielded approximately 174 differentially expressed proteins in the saliva specimens. There were 55 proteins that were common to both cancer stages in comparison to each other and healthy controls while there were 20 proteins unique to Stage IIa and 28 proteins that were unique to Stage IIb.

  6. Role of preoperative breast MRI in ductal carcinoma in situ for prediction of the presence and assessment of the extent of occult invasive component.

    Science.gov (United States)

    Nori, Jacopo; Meattini, Icro; Giannotti, Elisabetta; Abdulcadir, Dalmar; Mariscotti, Giovanna; Calabrese, Massimo; Angelino, Francesca; Chiesa, Fabio; Saieva, Calogero; Vanzi, Ermanno; Boeri, Cecilia; Bianchi, Simonetta; Sanchez, Luis; Orzalesi, Lorenzo; Casella, Donato; Susini, Tommaso; Livi, Lorenzo

    2014-01-01

    Ductal carcinoma in situ (DCIS) is a common neoplasm that may be associated with focal invasive breast cancer lesions. The aim of our study was to evaluate the role of preoperative magnetic resonance imaging (MRI) in determining occult invasive presence and disease extent in patients with preoperative diagnosis of pure DCIS. We analyzed 125 patients with postoperative pure DCIS (n = 91) and DCIS plus invasive component (n = 34). Diagnostic mammography (MRX) showed a size underestimation rate of 30.4% while MRI showed an overestimation rate of 28.6%. Comparing the mean absolute error between preoperative MRI and MRX evaluations and final disease extent, MRI showed an improved accuracy of 51.2%. In our analysis preoperative breast MRI showed a better accuracy in predicting postoperative pathologic extent of disease, adding strength to the growing evidences that preoperative MRI can lead to a more appropriate management of DCIS patients. PMID:24750509

  7. The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy

    International Nuclear Information System (INIS)

    To evaluate whether magnetic resonance (MR) imaging features can predict the presence of occult invasion in cases of biopsy-proven pure ductal carcinoma in situ (DCIS). We retrospectively reviewed 92 biopsy-proven pure DCIS in 92 women who underwent MR imaging. The following MR imaging findings were compared between confirmed DCIS and invasive breast cancer (IBC): lesion size, type, morphological and kinetic assessments by ACR BI-RADS MRI, and findings of fat-suppressed T2-weighted (FS-T2W) imaging. Sixty-eight of 92 (74%) were non-mass-like enhancements (NMLE) and 24 were mass lesions on MR imaging. Twenty-one of 68 (31%) NMLE and 13 of 24 (54%) mass lesions were confirmed as IBC. In NMLE lesions, large lesions (P = 0.007) and higher signal intensities (SI) on FS-T2W images (P = 0.032) were significantly associated with IBC. Lesion size remained a significant independent predictor of invasion in multivariate analysis (P = 0.032), and combined with FS-T2W SIs showed slightly higher observer performances (area under the curve, AUC, 0.71) than lesion size alone (AUC 0.68). There were no useful findings that enabled the differentiation of mass-type lesions. Breast MR imaging is potentially useful to predict the presence of occult invasion in biopsy-proven DCIS with NMLE. MR mammography permits more precise lesion assessment including ductal carcinoma in situ A correct diagnosis of occult invasion before treatment is important for clinicians This study showed the potential of MR mammography to diagnose occult invasion Treatment and/or aggressive biopsy can be given with greater confidence MR mammography can lead to more appropriate management of patients. (orig.)

  8. Genomic and mutational profiling of ductal carcinomas in situ and matched adjacent invasive breast cancers reveals intra-tumour genetic heterogeneity and clonal selection

    Science.gov (United States)

    Lambros, Maryou B; Campion-Flora, Adriana; Rodrigues, Daniel Nava; Gauthier, Arnaud; Cabral, Cecilia; Pawar, Vidya; Mackay, Alan; A’Hern, Roger; Marchiò, Caterina; Palacios, Jose; Natrajan, Rachael; Weigelt, Britta; Reis-Filho, Jorge S

    2016-01-01

    The mechanisms underlying the progression from ductal carcinoma in situ (DCIS) to invasive ductal carcinoma (IDC) of the breast are yet to be fully elucidated. Several hypotheses have been put forward to explain the progression from DCIS to IDC, including the selection of a subpopulation of cancer cells with specific genetic aberrations, the acquisition of new genetic aberrations or non-genetic mechanisms mediated by the tumour microenvironment. To determine whether synchronously diagnosed ipsilateral DCIS and IDCs have modal populations with distinct repertoires of gene copy number aberrations and mutations in common oncogenes, matched frozen samples of DCIS and IDCs were retrieved from 13 patients and subjected to microarray-based comparative genomic hybridisation (aCGH), and Sequenom MassARRAY (Oncocarta v1.0 panel). Fluorescence in situ hybridisation and Sanger sequencing were employed to validate the aCGH and Sequenom findings, respectively. Although the genomic profiles of matched DCIS and IDCs were similar, in three of 13 matched pairs amplification of distinct loci (i.e. 1q41, 2q24.2, 6q22.31, 7q11.21, 8q21.2 and 9p13.3) was either restricted to, or more prevalent in, the modal population of cancer cells of one of the components. Sequenom MassARRAY identified PIK3CA mutations restricted to the DCIS component in two cases, and in a third case, the frequency of the PIK3CA mutant allele reduced from 49% in the DCIS to 25% in the IDC component. Despite the genomic similarities between synchronous DCIS and IDC, our data provide strong circumstantial evidence to suggest that in some cases the progression from DCIS to IDC is driven by the selection of non-modal clones that harbour a specific repertoire of genetic aberrations. PMID:22252965

  9. The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Mariko; Yuen, Sachiko; Akazawa, Kentaro; Nishida, Kaori; Yamada, Kei [Kyoto Prefectural University of Medicine, Departments of Radiology, Graduate School of Medical Science, Kyoto (Japan); Konishi, Eiichi [Kyoto Prefectural University of Medicine, Departments of Pathology, Graduate School of Medical Science, Kyoto (Japan); Kajihara, Mariko [Kyoto Breast Center Sawai Memorial Clinic, Departments of Radiology, Kyoto (Japan); Shinkura, Nobuhiko [Kyoto Breast Center Sawai Memorial Clinic, Departments of Surgery, Kyoto (Japan)

    2012-06-15

    To evaluate whether magnetic resonance (MR) imaging features can predict the presence of occult invasion in cases of biopsy-proven pure ductal carcinoma in situ (DCIS). We retrospectively reviewed 92 biopsy-proven pure DCIS in 92 women who underwent MR imaging. The following MR imaging findings were compared between confirmed DCIS and invasive breast cancer (IBC): lesion size, type, morphological and kinetic assessments by ACR BI-RADS MRI, and findings of fat-suppressed T2-weighted (FS-T2W) imaging. Sixty-eight of 92 (74%) were non-mass-like enhancements (NMLE) and 24 were mass lesions on MR imaging. Twenty-one of 68 (31%) NMLE and 13 of 24 (54%) mass lesions were confirmed as IBC. In NMLE lesions, large lesions (P = 0.007) and higher signal intensities (SI) on FS-T2W images (P = 0.032) were significantly associated with IBC. Lesion size remained a significant independent predictor of invasion in multivariate analysis (P = 0.032), and combined with FS-T2W SIs showed slightly higher observer performances (area under the curve, AUC, 0.71) than lesion size alone (AUC 0.68). There were no useful findings that enabled the differentiation of mass-type lesions. Breast MR imaging is potentially useful to predict the presence of occult invasion in biopsy-proven DCIS with NMLE. MR mammography permits more precise lesion assessment including ductal carcinoma in situ A correct diagnosis of occult invasion before treatment is important for clinicians This study showed the potential of MR mammography to diagnose occult invasion Treatment and/or aggressive biopsy can be given with greater confidence MR mammography can lead to more appropriate management of patients. (orig.)

  10. Hypoxia-inducible factor-2a is associated with ABCG2 expression, histology-grade and Ki67 expression in breast invasive ductal carcinoma

    Directory of Open Access Journals (Sweden)

    Xiang Lei

    2012-03-01

    Full Text Available Abstract Background Breast cancer is the most common cancer and the leading cause of cancer mortality in women worldwide. Hypoxia is an important factor involved in the progression of solid tumors and has been associated with various indicators of tumor metabolism, angiogenesis and metastasis. But little is known about the contribution of Hypoxia-Inducible Factor-2a (HIF-2a to the drug resistance and the clinicopathological characteristics in breast cancer. Methods Immunohistochemistry was employed on the tissue microarray paraffin sections of surgically removed samples from 196 invasive breast cancer patients with clinicopathological data. The correlations between the expression of HIF-2a and ABCG2 as well as other patients' clinicopathological data were investigated. Results The results showed that HIF-2a was expressed in different intensities and distributions in the tumor cells of the breast invasive ductal carcinoma. A positive staining for HIF-2a was defined as a brown staining observed mainly in the nucleus. A statistically significant correlation was demonstrated between HIF-2a expression and ABCG2 expression (p = 0.001, histology-grade (p = 0.029, and Ki67 (p = 0. 043 respectively. Conclusion HIF-2a was correlated with ABCG2 expression, histology-grade and Ki67 expression in breast invasive ductal carcinoma. HIF-2a could regulate ABCG2 in breast cancer cells, and could be a novel potential bio-marker to predict chemotherapy effectiveness. The hypoxia/HIF-2a/ABCG2 pathway could be a new mechanism of breast cancer multidrug-resistance. Virtual slides http://www.diagnosticpathology.diagnomx.eu/vs/2965948166714795

  11. Carcinomas invasores triples negativosde la glándula mamaria: incidencia y características clínico-patológicas

    Directory of Open Access Journals (Sweden)

    José L Quirós-Alpízar

    2010-06-01

    Full Text Available Justificación y objetivo: El comportamiento epidemiológico de los tumores malignos del país ha presentado un cambio en los últimos años; el cáncer de mama ha aumentado su incidencia hasta colocarse como el segundo tumor maligno más frecuente en la mujer y el primero en mortalidad. Este tipo de tumor tiene características que se pueden estudiar con las técnicas de inmunohistoquímica, como son la expresión de receptores en las células neoplásicas (estrógenos, progesterona y el HER2 o receptor 2 del factor de crecimiento epidérmico humano. Los carcinomas que no expresan ninguno de estos tres receptores tienen un peor pronóstico. El estudio tiene como objetivos conocer las principales características de este grupo de tumores denominados triples negativos, y determinar su relevancia dentro del grupo total del carcinoma de mama. Materiales y métodos: Se recolectaron los casos diagnosticados de cáncer de mama en mujeres, en el periodo comprendido entre el 1 de enero y el 31 de diciembre de 2006, en el Hospital San Juan de Dios, en el Servicio de Patología, que dispusieran de estudios inmunohistoquímicos. Se consideró la información acerca de la edad de las pacientes, así como el tipo histológico y grado de diferenciación de cada uno de los tumores. Se separó el grupo correspondiente a los tumores triple negativo y se realizaron los análisis estadísticos por medio del programa Epi Info 3.3.4. Resultados: De una población de 221 pacientes diagnosticadas con cáncer de mama en el periodo mencionado, se presentaron 40 pacientes con cáncer de mama triple negativo, resultando en una incidencia de un 18% (I.C. 95%, 12,79 - 23,40 y una edad promedio de 54 años (I.C. 95%, 50 - 59, con una mediana de 52 y una moda de 48. El cáncer de mama triple negativo tuvo una relación mayor con el tipo histológico ductal infiltrante, con un 67,5% (I.C. 95%, 51,7383,26; seguido por el lobulillar infiltrante, con un 12,5% (I.C.95%, 4,18 - 26

  12. The Polycomb group protein RING1B is overexpressed in ductal breast carcinoma and is required to sustain FAK steady state levels in breast cancer epithelial cells

    Science.gov (United States)

    Bosch, Almudena; Panoutsopoulou, Konstantina; Corominas, Josep Maria; Gimeno, Ramón; Moreno-Bueno, Gema; Martín-Caballero, Juan; Morales, Saleta; Lobato, Tania; Martínez-Romero, Carles; Farias, Eduardo F.; Mayol, Xavier; Cano, Amparo; Hernández-Muáoz, Inmaculada

    2014-01-01

    In early stages of metastasis malignant cells must acquire phenotypic changes to enhance their migratory behavior and their ability to breach the matrix surrounding tumors and blood vessel walls. Epigenetic regulation of gene expression allows the acquisition of these features that, once tumoral cells have escape from the primary tumor, can be reverted. Here we report that the expression of the Polycomb epigenetic repressor Ring1B is enhanced in tumoral cells that invade the stroma in human ductal breast carcinoma and its expression is coincident with that of Fak in these tumors. Ring1B knockdown in breast cancer cell lines revealed that Ring1B is required to sustain Fak expression in basal conditions as well as in Tgfβ-treated cells. Functionally, endogenous Ring1B is required for cell migration and invasion in vitro and for in vivo invasion of the mammary fat pad by tumoral cells. Finally we identify p63 as a target of Ring1B to regulate Fak expression: Ring1B depletion results in enhanced p63 expression, which in turns represses Fak expression. Importantly, Fak downregulation upon Ring1B depletion is dependent on p63 expression. Our findings provide new insights in the biology of the breast carcinoma and open new avenues for breast cancer prognosis and therapy. PMID:24742605

  13. Effect of radiotherapy on survival of women with locally excised ductal carcinoma in situ of the breast: a Surveillance, Epidemiology, and End Results population-based analysis

    Directory of Open Access Journals (Sweden)

    Qian GW

    2015-06-01

    Full Text Available Guo-Wei Qian,1,* Xiao-Jian Ni,1,* Zheng Wang,2 Yi-Zhou Jiang,1 Ke-Da Yu,1 Zhi-Ming Shao1 1Department of Breast Surgery, 2Department of Radiation Oncology, Shanghai Cancer Center and Cancer Institute, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Although it has been previously reported that radiotherapy (RT effectively reduced the incidence of local recurrence of ductal carcinoma in situ (DCIS following breast-conserving surgery (BCS, little is known about the effect of RT on survival of patients with locally excised DCIS. Patients and methods: Using Surveillance, Epidemiology, and End Results registry data, we selected 56,968 female DCIS patients treated with BCS between 1998 and 2007. Overall survival (OS and breast cancer-specific survival (BCSS were compared among patients who received RT or no RT using the Kaplan–Meier methods and Cox proportional hazards regression models. Results: Median follow-up was 91 months. In the multivariable model, patients receiving postoperative RT had better OS than those undergoing BCS alone (hazard ratio [HR] 0.59, 95% confidence interval [CI] 0.53–0.67, P<0.001. This pattern remained after stratification by estrogen receptor (ER status and age. In contrast, RT delivery was not significantly associated with improved BCSS (HR 0.71, 95% CI 0.48–1.03, P=0.073. However, after stratifying by the above two variables, RT contributed to better BCSS in ER-negative/borderline patients (HR 0.41, 95% CI 0.19–0.88, P=0.023 and younger patients (≤50 years old; HR 0.37, 95% CI 0.15–0.91, P=0.030. Conclusion: Our analysis confirms the beneficial effect of RT on OS in women with locally excised DCIS and reveals the specific protective effect of RT on BCSS in ER-negative/borderline and younger patients. Keywords: ductal carcinoma in situ, breast cancer, breast-conserving surgery, radiotherapy, survival

  14. Protein Alterations in Infiltrating Ductal Carcinomas of the Breast as Detected by Nonequilibrium pH Gradient Electrophoresis and Mass Spectrometry

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    Maria Kabbage

    2008-01-01

    Full Text Available Improvement of breast-cancer detection through the identification of potential cancer biomarkers is considered as a promising strategy for effective assessment of the disease. The current study has used nonequilibrium pH gradient electrophoresis with subsequent analysis by mass spectrometry to identify protein alterations in invasive ductal carcinomas of the breast from Tunisian women. We have identified multiple protein alterations in tumor tissues that were picked, processed, and unambiguously assigned identities by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF. The proteins identified span a wide range of functions and are believed to have potential clinical applications as cancer biomarkers. They include glycolytic enzymes, molecular chaperones, cytoskeletal-related proteins, antioxydant enzymes, and immunologic related proteins. Among these proteins, enolase 1, phosphoglycerate kinase 1, deoxyhemoglobin, Mn-superoxyde dismutase, α-B-crystallin, HSP27, Raf kinase inhibitor protein, heterogeneous nuclear ribonucleoprotein A2/B1, cofilin 1, and peptidylprolyl isomerase A were overexpressed in tumors compared with normal tissues. In contrast, the IGHG1 protein, the complement C3 component C3c, which are two newly identified protein markers, were downregulated in IDCA tissues.

  15. Impact of Nonosseous Findings on {sup 18}F-NaF PET/CT in a Patient with Ductal Breast Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kuyumcu, Serkan; Adalet, Isik; Isik, Emine Goknur; Unal, Seher Nilgun [Intanbul Univ., Istanbul (Turkmenistan)

    2014-03-15

    {sup 18}F-NaF was used as a bone-seeking PET tracer for skeletal imaging until the introduction of the widely available {sup 99m}Tc-labeled bone agents. However, there is renewed clinical interest in {sup 18}F-NaF since prior technical and logistic limitations to its routine use are no longer present, and, as a consequence, it is likely that uptake unrelated to bone and non-osseous findings will be encountered more frequently. As a result of tumoral necrosis, soft tissue metastases may demonstrate {sup 18}F-NaF avidity due to dystrophic calcification. On the other hand, all non-osseous findings, whether {sup 18}F-NaF avid or not, may provide important diagnostic information that may alter the course of the disease, including treatment options. Herein we present a patient with ductal carcinoma of the breast in whom findings unrelated to the skeletal system in {sup 18}F-NaF PET/CT altered the treatment strategy.

  16. The Role of Preoperative Bilateral Breast Magnetic Resonance Imaging in Patient Selection for Partial Breast Irradiation in Ductal Carcinoma In Situ

    Directory of Open Access Journals (Sweden)

    Kristin V. Kowalchik

    2012-01-01

    Full Text Available Purpose. Women with ductal carcinoma in situ (DCIS are often candidates for breast-conserving therapy, and one option for radiation treatment is partial breast irradiation (PBI. This study evaluates the use of preoperative breast magnetic resonance imaging (MRI for PBI selection in DCIS patients. Methods. Between 2002 and 2009, 136 women with newly diagnosed DCIS underwent a preoperative bilateral breast MRI at Mayo Clinic in Florida. One hundred seventeen women were deemed eligible for PBI by the NSABP B-39 (National Surgical Adjuvant Breast and Bowel Project, Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. MRIs were reviewed for their impact on patient eligibility, and findings were pathologically confirmed. Results. Of the 117 patients, 23 (20% were found ineligible because of pathologically proven MRI findings. MRI detected additional ipsilateral breast cancer in 21 (18% patients. Of these women, 15 (13% had more extensive disease than originally noted before MRI, and 6 (5% had multicentric disease in the ipsilateral breast. In addition, contralateral breast cancer was detected in 4 (4%. Conclusions. Preoperative breast MRI altered the PBI recommendations for 20% of women. Bilateral breast MRI should be an integral part of the preoperative evaluation of all patients with DCIS being considered for PBI.

  17. Initiation of Metastatic Breast Carcinoma by Targeting of the Ductal Epithelium with Adenovirus-Cre: A Novel Transgenic Mouse Model of Breast Cancer

    Science.gov (United States)

    Svoronos, Nikolaos; Tesone, Amelia J.; Stephen, Tom L.; Perales-Puchalt, Alfredo; Nguyen, Jenny; Zhang, Paul J.; Fiering, Steven N.; Tchou, Julia; Conejo-Garcia, Jose R.

    2014-01-01

    Breast cancer is a heterogeneous disease involving complex cellular interactions between the developing tumor and immune system, eventually resulting in exponential tumor growth and metastasis to distal tissues and the collapse of anti-tumor immunity. Many useful animal models exist to study breast cancer, but none completely recapitulate the disease progression that occurs in humans. In order to gain a better understanding of the cellular interactions that result in the formation of latent metastasis and decreased survival, we have generated an inducible transgenic mouse model of YFP-expressing ductal carcinoma that develops after sexual maturity in immune-competent mice and is driven by consistent, endocrine-independent oncogene expression. Activation of YFP, ablation of p53, and expression of an oncogenic form of K-ras was achieved by the delivery of an adenovirus expressing Cre-recombinase into the mammary duct of sexually mature, virgin female mice. Tumors begin to appear 6 weeks after the initiation of oncogenic events. After tumors become apparent, they progress slowly for approximately two weeks before they begin to grow exponentially. After 7-8 weeks post-adenovirus injection, vasculature is observed connecting the tumor mass to distal lymph nodes, with eventual lymphovascular invasion of YFP+ tumor cells to the distal axillary lymph nodes. Infiltrating leukocyte populations are similar to those found in human breast carcinomas, including the presence of αβ and γδ T cells, macrophages and MDSCs. This unique model will facilitate the study of cellular and immunological mechanisms involved in latent metastasis and dormancy in addition to being useful for designing novel immunotherapeutic interventions to treat invasive breast cancer. PMID:24748051

  18. Surgical Excision Without Radiation for Ductal Carcinoma in Situ of the Breast: 12-Year Results From the ECOG-ACRIN E5194 Study

    Science.gov (United States)

    Solin, Lawrence J.; Gray, Robert; Hughes, Lorie L.; Wood, William C.; Lowen, Mary Ann; Badve, Sunil S.; Baehner, Frederick L.; Ingle, James N.; Perez, Edith A.; Recht, Abram; Sparano, Joseph A.; Davidson, Nancy E.

    2015-01-01

    Purpose To determine the 12-year risk of developing an ipsilateral breast event (IBE) for women with ductal carcinoma in situ (DCIS) of the breast treated with surgical excision (lumpectomy) without radiation. Patients and Methods A prospective clinical trial was performed for women with DCIS who were selected for low-risk clinical and pathologic characteristics. Patients were enrolled onto one of two study cohorts (not randomly assigned): cohort 1: low- or intermediate-grade DCIS, tumor size 2.5 cm or smaller (n = 561); or cohort 2: high-grade DCIS, tumor size 1 cm or smaller (n = 104). Protocol specifications included excision of the DCIS tumor with a minimum negative margin width of at least 3 mm. Tamoxifen (not randomly assigned) was given to 30% of the patients. An IBE was defined as local recurrence of DCIS or invasive carcinoma in the treated breast. Median follow-up time was 12.3 years. Results There were 99 IBEs, of which 51 (52%) were invasive. The IBE and invasive IBE rates increased over time in both cohorts. The 12-year rates of developing an IBE were 14.4% for cohort 1 and 24.6% for cohort 2 (P = .003). The 12-year rates of developing an invasive IBE were 7.5% and 13.4%, respectively (P = .08). On multivariable analysis, study cohort and tumor size were both significantly associated with developing an IBE (P = .009 and P = .03, respectively). Conclusion For patients with DCIS selected for favorable clinical and pathologic characteristics and treated with excision without radiation, the risks of developing an IBE and an invasive IBE increased through 12 years of follow-up, without plateau. These data help inform the treatment decision-making process for patients and their physicians. PMID:26371148

  19. Immunohistochemical expression of insulin-like growth factor binding protein-3 in invasive breast cancers and ductal carcinoma in situ: implications for clinicopathology and patient outcome

    International Nuclear Information System (INIS)

    Insulin-like growth factor binding protein-3 (IGFBP-3) differentially modulates breast epithelial cell growth through insulin-like growth factor (IGF)-dependent and IGF-independent pathways and is a direct (IGF-independent) growth inhibitor as well as a mitogen that potentiates EGF (epidermal growth factor) and interacts with HER-2. Previously, high IGFBP-3 levels in breast cancers have been determined by enzyme-linked immunosorbent assay and immunoradiometric assay methods. In vitro, IGFBP-3's mechanisms of action may involve cell membrane binding and nuclear translocation. To evaluate tumour-specific IGFBP-3 expression and its subcellular localisation, this study examined immunohistochemical IGFBP-3 expression in a series of invasive ductal breast cancers (IDCs) with synchronous ductal carcinomas in situ (DCIS) in relation to clinicopathological variables and patient outcome. Immunohistochemical expression of IGFBP-3 was evaluated with the sheep polyclonal antiserum (developed in house) with staining performed as described previously. IGFBP-3 was evaluable in 101 patients with a variable pattern of cytoplasmic expression (positivity of 1+/2+ score) in 85% of invasive and 90% of DCIS components. Strong (2+) IGFBP-3 expression was evident in 32 IDCs and 40 cases of DCIS. A minority of invasive tumours (15%) and DCIS (10%) lacked IGFBP-3 expression. Nuclear IGFBP-3 expression was not detectable in either invasive cancers or DCIS, with a consistent similarity in IGFBP-3 immunoreactivity in IDCs and DCIS. Positive IGFBP-3 expression showed a possible trend in association with increased proliferation (P = 0.096), oestrogen receptor (ER) negativity (P = 0.06) and HER-2 overexpression (P = 0.065) in invasive tumours and a strong association with ER negativity (P = 0.037) in DCIS. Although IGFBP-3 expression was not an independent prognosticator, IGFBP-3-positive breast cancers may have shorter disease-free and overall survivals, although these did not reach

  20. The lipid-reactive oxygen species phenotype of breast cancer. Raman spectroscopy and mapping, PCA and PLSDA for invasive ductal carcinoma and invasive lobular carcinoma. Molecular tumorigenic mechanisms beyond Warburg effect.

    Science.gov (United States)

    Surmacki, Jakub; Brozek-Pluska, Beata; Kordek, Radzislaw; Abramczyk, Halina

    2015-04-01

    Vibrational signatures of human breast tissue (invasive ductal carcinoma and invasive lobular carcinoma) were used to identify, characterize and discriminate structures in normal (noncancerous) and cancerous tissues by confocal Raman imaging, Raman spectroscopy and IR spectroscopy. The most important differences between normal and cancerous tissues were found in regions characteristic for vibrations of carotenoids, fatty acids, proteins, and interfacial water. Particular attention was paid to the role played by unsaturated fatty acids and their derivatives. K-means clustering and basis analysis followed by PCA and PLSDA is employed to analyze Raman spectroscopic maps of human breast tissue and for a statistical analysis of the samples (82 patients, 164 samples). Raman maps successfully identify regions of carotenoids, fatty acids, and proteins. The intensities, frequencies and profiles of the average Raman spectra differentiate the biochemical composition of normal and cancerous tissues. The paper demonstrates that Raman imaging has reached a clinically relevant level in regard to breast cancer diagnosis applications. The sensitivity and specificity obtained directly from PLSLD and cross validation are equal to 90.5% and 84.8% for calibration and 84.7% and 71.9% for cross-validation respectively.

  1. Long-term survival of women with basal-like ductal carcinoma in situ of the breast: a population-based cohort study

    International Nuclear Information System (INIS)

    Microarray gene-profiling of invasive breast cancer has identified different subtypes including luminal A, luminal B, HER2-overexpressing and basal-like groups. Basal-like invasive breast cancer is associated with a worse prognosis. However, the prognosis of basal-like ductal carcinoma in situ (DCIS) is still unknown. Our aim was to study the prognosis of basal-like DCIS in a large population-based cohort. All 458 women with a primary DCIS diagnosed between 1986 and 2004, in Uppland and Västmanland, Sweden were included. TMA blocks were constructed. To classify the DCIS tumors, we used immunohistochemical (IHC) markers (estrogen-, progesterone-, HER2, cytokeratin 5/6 and epidermal growth factor receptor) as a surrogate for the gene expression profiling. The association with prognosis was examined for basal-like DCIS and other subtypes using Kaplan-Meier survival analyses and Cox proportional hazards regression models. IHC data were complete for 392 women. Thirty-two were basal-like (8.2%), 351 were luminal or HER2-positive (89.5%) and 9 unclassified (2.3%). Seventy-six women had a local recurrence of which 34 were invasive. Another 3 women had general metastases as first event. Basal-like DCIS showed a higher risk of local recurrence and invasive recurrence 1.8 (Confidence interval (CI) 95%, 0.8-4.2) and 1.9 (0.7-5.1), respectively. However, the difference was not statistically significant. Also, no statistically significant increased risk was seen for triple-negative or high grade DCIS. Basal-like DCIS showed about a doubled, however not statistically significant risk for local recurrence and developing invasive cancer compared with the other molecular subtypes. Molecular subtyping was a better prognostic parameter than histopathological grade

  2. Breast-conserving surgery with or without radiotherapy in women with ductal carcinoma in situ: a meta-analysis of randomized trials

    Directory of Open Access Journals (Sweden)

    Leon Paola G

    2007-08-01

    Full Text Available Abstract Background To investigate whether Radiation therapy (RT should follow breast conserving surgery in women with ductal carcinoma in situ from breast cancer (DCIS with objective of decreased mortality, invasive or non invasive recurrence, distant metastases and contralateral breast cancer rates. We have done a meta-analysis of these results to give a more balanced view of the total evidence and to increase statistical precision. Methods A meta-analysis of randomized controlled trials (RCT was performed comparing RT treatment for DCIS of breast cancer to observation. The MEDLINE, EMBASE, CANCERLIT, Cochrane Library databases, Trial registers, bibliographic databases, and recent issues of relevant journals were searched. Relevant reports were reviewed by two reviewers independently and the references from these reports were searched for additional trials, using guidelines set by QUOROM statement criteria. Results The reviewers identified four large RCTs, yielding 3665 patients. Pooled results from this four randomized trials of adjuvant radiotherapy showed a significant reduction of invasive and DCIS ipsilateral breast cancer with odds ratio (OR of 0.40 (95% CI 0.33 – 0.60, p Conclusion The conclusion from our meta-analysis is that the addition of radiation therapy to lumpectomy results in an approximately 60% reduction in breast cancer recurrence, no benefit for survival or distant metastases compared to excision alone. Patients with high-grade DCIS lesions and positive margins benefited most from the addition of radiation therapy. It is not yet clear which patients can be successfully treated with lumpectomy alone; until further prospective studies answer this question, radiation should be recommended after lumpectomy for all patients without contraindications.

  3. Multi-Institutional Experience of Ductal Carcinoma In Situ in Black vs White Patients Treated With Breast-Conserving Surgery and Whole Breast Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Carl [Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Bai, Harrison [Yale University School of Medicine, New Haven, Connecticut (United States); Neboori, Hanmanth [Drexel Medical College, Philadelphia, Pennsylvania (United States); Takita, Cristiane [University of Miami, Miami, Florida (United States); Motwani, Sabin [Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Wright, Jean L.; Hobeika, Georges [University of Miami, Miami, Florida (United States); Haffty, Bruce G. [Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Jones, Tiffanie [Yale University School of Medicine, New Haven, Connecticut (United States); Goyal, Sharad [Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Moran, Meena S., E-mail: meena.moran@yale.edu [Yale University School of Medicine, New Haven, Connecticut (United States)

    2012-11-01

    Purpose: Given the paucity of data on racial disparities in ductal carcinoma in situ (DCIS), the data from a multi-institutional cohort of DCIS patients treated with breast-conserving surgery and whole breast radiation therapy (RT) were analyzed to determine whether racial disparities or differences exist. Methods and Materials: A total of 533 white and 76 black DCIS patients from 3 university-based cancer centers were uniformly treated with breast-conserving surgery and RT. All patient data were collected and analyzed as a function of race. Results: The median follow-up was 5.2 years. No significant racial differences were seen in tumor size, age at diagnosis, estrogen receptor status, necrosis, or grade (all P>.05). Of the treatment parameters, the RT dose delivered, boost, positive margin rates, frequency of hormone receptor status assessment, and receipt of hormonal therapy for the 2 cohorts did not significantly differ (all P>.05). The local relapse-free survival was similar at 5 years (96.1% and 98.1%, P=.399) and 10 years (92.8% vs 95.8%, P=.360), with no significant overall survival difference at 10 years (94.0% vs 88.9%, P=.290) between the white and black patients, respectively. On multivariate analysis, race was not an independent predictor of local relapse-free survival or overall survival when accounting for age, grade, and margin status. Conclusion: In our large cohort of DCIS patients uniformly treated at 3 institutions with breast conservation without any apparent differences in treatment delivery parameters, we demonstrated that the clinical and pathologic features and local survival outcomes did not differ as a function of race. Our results suggest that when black patients with DCIS are appropriately selected for breast conservation and receive adjuvant RT without racial disparities in the treatment parameters, differences in the outcomes as a function of race do not exist.

  4. Multi-Institutional Experience of Ductal Carcinoma In Situ in Black vs White Patients Treated With Breast-Conserving Surgery and Whole Breast Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: Given the paucity of data on racial disparities in ductal carcinoma in situ (DCIS), the data from a multi-institutional cohort of DCIS patients treated with breast-conserving surgery and whole breast radiation therapy (RT) were analyzed to determine whether racial disparities or differences exist. Methods and Materials: A total of 533 white and 76 black DCIS patients from 3 university-based cancer centers were uniformly treated with breast-conserving surgery and RT. All patient data were collected and analyzed as a function of race. Results: The median follow-up was 5.2 years. No significant racial differences were seen in tumor size, age at diagnosis, estrogen receptor status, necrosis, or grade (all P>.05). Of the treatment parameters, the RT dose delivered, boost, positive margin rates, frequency of hormone receptor status assessment, and receipt of hormonal therapy for the 2 cohorts did not significantly differ (all P>.05). The local relapse-free survival was similar at 5 years (96.1% and 98.1%, P=.399) and 10 years (92.8% vs 95.8%, P=.360), with no significant overall survival difference at 10 years (94.0% vs 88.9%, P=.290) between the white and black patients, respectively. On multivariate analysis, race was not an independent predictor of local relapse-free survival or overall survival when accounting for age, grade, and margin status. Conclusion: In our large cohort of DCIS patients uniformly treated at 3 institutions with breast conservation without any apparent differences in treatment delivery parameters, we demonstrated that the clinical and pathologic features and local survival outcomes did not differ as a function of race. Our results suggest that when black patients with DCIS are appropriately selected for breast conservation and receive adjuvant RT without racial disparities in the treatment parameters, differences in the outcomes as a function of race do not exist.

  5. 乳腺导管内原位癌的诊疗%The diagnosis and treatment of breast ductal carcinoma in situ

    Institute of Scientific and Technical Information of China (English)

    陈传志; 马瑞民; 郭贵龙

    2016-01-01

    Accurate knowledge,diagnosis and treatment of breast ductal carcinoma in situ(DCIS),are crucial in controlling the development of breast cancer.In the diagnosis phase,breast ultrasound is commonly used as a screening tool,and a clear diagnosis can be made by mammography.Meanwhile,serological tests contribute to the detection of DCIS in early stages.In the treatment,the optimal surgical operation method remains debatable.It is widely acknowledged that the radiotherapy of postoperative patients should become more individualized.In addition,corresponding endocrine therapy helps those ER positive patients to reduce the recurrence.In the development of DCIS to invasive cancer,there are changes in gene and protein expressions,which may be a potential direction for further research.%正确认识和诊治乳腺导管内原位癌(DCIS)对控制乳腺癌的发生发展有着重要作用.检查方面,乳腺超声一般作为筛查工具而被广泛应用,再通过乳腺钼靶进一步明确诊断,而血清免疫学检查也有助于早期发现DCIS.治疗方面,最恰当的手术治疗方式仍不明确,普遍认同的是术后辅助个体化的放疗,ER阳性患者进行相应的内分泌治疗以减少复发.DCIS进展成为浸润性癌中有许多基因蛋白的表达改变,有待深入研究.

  6. Ductal carcinoma in situ diagnosed at US-guided 14-gauge core-needle biopsy for breast mass: Preoperative predictors of invasive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ah Young; Gweon, Hye Mi; Son, Eun Ju; Yoo, Miri; Kim, Jeong-Ah; Youk, Ji Hyun, E-mail: jhyouk@yuhs.ac

    2014-04-15

    Objectives: To identify preoperative features that could be used to predict invasive breast cancer in women with a diagnosis of ductal carcinoma in situ (DCIS) at ultrasound (US)-guided 14-gauge core needle biopsy (CNB). Methods: A total of 86 DCIS lesions that were diagnosed at US-guided 14-gauge CNB and excised surgically in 84 women were assessed. We retrospectively reviewed the patients’ medical records, mammography, US, and MR imaging. We compared underestimation rates of DCIS for the collected clinical and radiologic variables and determined the preoperative predictive factors for upstaging to invasive cancer. Results: Twenty-seven (31.4%) of 86 DCIS lesions were upgraded to invasive cancer. Preoperative features that showed a significantly higher underestimation of DCIS were palpability or nipple discharge (p = 0.040), number of core specimens less than 5 (p = 0.011), mammographic maximum lesion size of 25 mm or larger (p = 0.022), mammographic mass size of 40 mm or larger (p = 0.046), sonographic mass size of 32 mm or larger (p = 0.009), lesion size of 30 mm on MR (p = 0.004), lower signal intensity (SI) on fat-saturated T2-weighted MR images (FS-T2WI) (p = 0.005), heterogeneous or rim enhancement on MR images (p = 0.009), and apparent diffusion coefficient (ADC) values lower than 1.04 × 10{sup −3} mm{sup 2}/s on diffusion-weighted MR imaging (DWI) (p < 0.001). Conclusion: Clinical symptom of palpability or nipple discharge, number of core specimen, mammographic maximum lesion or mass size, SI on FS-T2WI, heterogeneous or rim enhancement on MR, and ADC value may be helpful in predicting the upgrade to invasive breast cancer for DCIS diagnosed at US-guided 14-gauge CNB.

  7. Breast Cancer Heterogeneity Examined by High-Sensitivity Quantification of PIK3CA, KRAS, HRAS, and BRAF Mutations in Normal Breast and Ductal Carcinomas.

    Science.gov (United States)

    Myers, Meagan B; Banda, Malathi; McKim, Karen L; Wang, Yiying; Powell, Michael J; Parsons, Barbara L

    2016-04-01

    Mutant cancer subpopulations have the potential to derail durable patient responses to molecularly targeted cancer therapeutics, yet the prevalence and size of such subpopulations are largely unexplored. We employed the sensitive and quantitative Allele-specific Competitive Blocker PCR approach to characterize mutant cancer subpopulations in ductal carcinomas (DCs), examining five specific hotspot point mutations (PIK3CA H1047R, KRAS G12D, KRAS G12V, HRAS G12D, and BRAF V600E). As an approach to aid interpretation of the DC results, the mutations were also quantified in normal breast tissue. Overall, the mutations were prevalent in normal breast and DCs, with 9/9 DCs having measureable levels of at least three of the five mutations. HRAS G12D was significantly increased in DCs as compared to normal breast. The most frequent point mutation reported in DC by DNA sequencing, PIK3CA H1047R, was detected in all normal breast tissue and DC samples and was present at remarkably high levels (mutant fractions of 1.1 × 10(-3) to 4.6 × 10(-2)) in 4/10 normal breast samples. In normal breast tissue samples, PIK3CA mutation levels were positively correlated with age. However, the PIK3CA H1047R mutant fraction distributions for normal breast tissues and DCs were similar. The results suggest PIK3CA H1047R mutant cells have a selective advantage in breast, contribute to breast cancer susceptibility, and drive tumor progression during breast carcinogenesis, even when present as only a subpopulation of tumor cells. PMID:27108388

  8. S100A7 (Psoriasin), highly expressed in Ductal Carcinoma In Situ (DCIS), is regulated by IFN-gamma in mammary epithelial cells

    International Nuclear Information System (INIS)

    The aim of the present work was to explore signal transduction pathways used in the regulation of S100A7 (psoriasin). Members of the S100 gene family participate in many important cellular functions. Psoriasin, S100A8 (calgranulin A) and S100A9 (calgranulin B) are expressed in ductal carcinoma in situ (DCIS), as well as in the hyperproliferative skin disease, psoriasis. In the latter condition, a disturbance in the STAT pathway has recently been reported. This pathway is implicated in the regulation of IFN-gamma, widely recognized as a key cytokine in psoriasis. IFN-gamma also exerts anti-tumor action in a number of tumor cell types, including breast cancer. We therefore examined the effect of IFN-gamma and STAT-signaling on the psoriasin expression. We established a TAC2 mouse mammary epithelial cell line with tetracycline-inducible psoriasin expression (Tet-Off). Viability in cell culture was estimated using MTS assay. Protein and gene expression were evaluated by Western blotting and quantitative real-time PCR. Statistical analyses were assessed using a one-tailed, paired t-test. We report the downregulation of psoriasin by IFN-gamma in the MDA-MB-468 breast cancer cell line, as well as the downregulation of psoriasin induced by anoikis in cell lines derived from different epithelial tissues. In contrast, IFN-gamma had no suppressive effect on calgranulin A or calgranulin B. IFN-gamma is an important activator of the STAT1 pathway and we confirmed an active signaling pathway in the cell lines that responded to IFN-gamma treatment. In contrast, in the SUM190 breast carcinoma cell line, IFN-gamma did not suppress the expression of endogenous psoriasin. Moreover, a reduced phosphorylation of the STAT1 protein was observed. We showed that IFN-gamma treatment and the inhibition of the transcription factor NFkappaB had a synergistic effect on psoriasin levels. Finally, in TAC2 cells with tetracycline-induced psoriasin expression, we observed the increased viability of

  9. Study on micro calcification pathological classification of invasive ductal carcinoma in 50 cases%浸润性导管癌50例的微钙化病理归类研究

    Institute of Scientific and Technical Information of China (English)

    黄雅萍

    2014-01-01

    Objective:To study the micro calcification pathological classification of invasive ductal carcinoma.Methods:50 cases of invasive ductal cancer microcalcifications in breast cancer patients were selected from April 2011 to April 2014.We analyzed the relationship between in ductal carcinoma in situ.Results:In 50 cases,according to the calcification in or without the lumen,45 cases(90%) were in the lumen;5 cases(10%) were not present in the lumen.The lumen with necrosis was in 35 cases(70%);the lumen without necrosis was in 10 cases(20%);5 cases were lumen calcification type(10%) (P<0.05).Calcification was located outside the lumen:5 cases were lumen outside calcification type;there was significant differences in the calcification pathological typing(P<0.05).Conclusion:In invasive ductal carcinoma microcalcification,intraluminal form is the main,and accompanies by coagulation necrosis.It provides the reference for the mechanism study of micro calcifications in breast cancer,and invasive ductal carcinoma microcalcification will as an important sign of ductal carcinoma in situ.%目的:对浸润性导管癌病例的微钙化病理归类进行研究。方法:2011年4月-2014年4月收治浸润性导管癌微钙化乳腺癌患者50例,并对其同导管原位癌之间的关系进行分析。结果:在50例患者中,按照钙化灶是否存在于管腔,存在于管腔中45例(90.00%),不存在于管腔中5例(10.00%)。管腔内伴坏死型35例(70.00%),管腔内无坏死10例(20.00%),管腔外钙化型5例(10.00%)(P<0.05)。钙化灶位于管腔外:管腔外钙化型5例(10.00%),在钙化灶病理分型方面差异有统计学意义(P<0.05)。结论:浸润性导管癌微钙化以管腔内形式存在为主,并且伴有凝固性坏死,为乳腺癌微钙化发生机制研究提供参考依据,浸润性导管癌中微钙化将作为导管原位癌重要标志。

  10. Long-term Outcomes of Hypofractionation Versus Conventional Radiation Therapy After Breast-Conserving Surgery for Ductal Carcinoma In Situ of the Breast

    Energy Technology Data Exchange (ETDEWEB)

    Lalani, Nafisha; Paszat, Lawrence [University of Toronto, Toronto, Ontario (Canada); Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Institute for Clinical Evaluative Sciences, Toronto, Ontario (Canada); Sutradhar, Rinku; Thiruchelvam, Deva [Institute for Clinical Evaluative Sciences, Toronto, Ontario (Canada); Nofech-Mozes, Sharon; Hanna, Wedad; Slodkowska, Elzbieta [University of Toronto, Toronto, Ontario (Canada); Department of Anatomic Pathology, Sunnybrook Health Sciences Centre and Department of Laboratory Medicine and Pathobiology, Toronto, Ontario (Canada); Done, Susan J. [University of Toronto, Toronto, Ontario (Canada); Laboratory Medicine Program, University Health Network and Department of Laboratory Medicine and Pathobiology, Campbell Family Institute for Breast Cancer Research, Toronto, Ontario (Canada); Miller, Naomi; Youngson, Bruce [University of Toronto, Toronto, Ontario (Canada); Laboratory Medicine Program, University Health Network and Department of Laboratory Medicine and Pathobiology, Toronto, Ontario (Canada); Tuck, Alan [Pathology and Laboratory Medicine, London Health Sciences Centre and Saint Joseph' s Health Care, London, Ontario (Canada); Sengupta, Sandip [Department of Pathology and Molecular Medicine, Kingston General Hospital, Kingston, Ontario (Canada); Elavathil, Leela [Department of Anatomical Pathology, Juravinski Hospital, Hamilton Health Sciences, Hamilton, Ontario (Canada); Chang, Martin C. [Department of Pathology and Laboratory Medicine, Mount Sinai Hospital and Department of Laboratory Medicine and Pathobiology, Toronto, Ontario (Canada); Jani, Prashant A. [Department of Anatomical Pathology, Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario (Canada); Bonin, Michel [Pathology and Laboratory Medicine, Sudbury Regional Hospital, Sudbury, Ontario (Canada); and others

    2014-12-01

    Purpose: Whole-breast radiation therapy (XRT) after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) may decrease the risk of local recurrence, but the optimal dose regimen remains unclear. Past studies administered 50 Gy in 25 fractions (conventional); however, treatment pattern studies report that hypofractionated (HF) regimens (42.4 Gy in 16 fractions) are frequently used. We report the impact of HF (vs conventional) on the risk of local recurrence after BCS for DCIS. Methods and Materials: All women with DCIS treated with BCS and XRT in Ontario, Canada from 1994 to 2003 were identified. Treatment and outcomes were assessed through administrative databases and validated by chart review. Survival analyses were performed. To account for systematic differences between women treated with alternate regimens, we used a propensity score adjustment approach. Results: We identified 1609 women, of whom 971 (60%) received conventional regimens and 638 (40%) received HF. A total of 489 patients (30%) received a boost dose, of whom 143 (15%) received conventional radiation therapy and 346 (54%) received HF. The median follow-up time was 9.2 years. The median age at diagnosis was 56 years (interquartile range [IQR], 49-65 years). On univariate analyses, the 10-year actuarial local recurrence–free survival was 86% for conventional radiation therapy and 89% for HF (P=.03). On multivariable analyses, age <45 years (hazard ratio [HR] = 2.4; 95% CI: 1.6-3.4; P<.0001), high (HR=2.9; 95% CI: 1.2-7.3; P=.02) or intermediate nuclear grade (HR=2.7; 95% CI: 1.1-6.6; P=.04), and positive resection margins (HR=1.4; 95% CI: 1.0-2.1; P=.05) were associated with an increased risk of local recurrence. HF was not significantly associated with an increased risk of local recurrence compared with conventional radiation therapy on multivariate analysis (HR=0.8; 95% CI: 0.5-1.2; P=.34). Conclusions: The risk of local recurrence among individuals treated with HF regimens

  11. A Comparative Study on Digital Mammography and Ultrasonography in Diagnosis of Breast Ductal Carcinoma%乳腺导管内癌数字化摄影与超声诊断的对比研究

    Institute of Scientific and Technical Information of China (English)

    徐向红; 赵玉年; 王慧华

    2012-01-01

    Objective To investigate the value of digital mammography and ultrasonography in diagnosis of breast ductal carcinoma. Methods 53 cases of ductal carcinoma were retrospectively analyzed. The digital mammography and ultrasonography were performed in all cases. The diagnosis of digital mammography and ultrasonography was divided into probably malignant, indeterminate , probably benign, and negative. According to surgical and histopathological outcomes, a comparative study on the value of digital mammo-graphy and ultrasonography was performed. Results There are 36 cases and 33 cases of probably malignant ,4 cases and 5 cases of indeterminate,7 cases and 10 cases of of probably benign,6 cases and 5 cases of negative diagnosed by digital mammography and ultrasonography respectively. The accuracy of digital mammography and ultrasonography were 67. 9%( 36/53 ) and 62. 3% ( 33/53 ) respectively. The accuracy of digital mammography associated with ultrasonography was 88. 7%( 47/53 ). Conclusion Digital mammography and ultrasonography are valuable in the diagnosis of breast ductal carcinoma. The diagnostic accuracycan be improved by the combination of the two methods.%目的 探讨数字化摄影与超声检查对乳腺导管内癌的诊断价值.方法 回顾性分析53例乳腺导管内癌病例,所有病例都接受了数字化摄影及超声检查.数字化摄影和超声诊断分为可能恶性、性质待定、可能良性和阴性.对照手术和病理组织学检查结果,比较数字化摄影和超声检查的价值.结果 数字化摄影和超声分别诊断可能恶性36例和33例,性质待定4例和5例,可能良性7例和10例,阴性6例和5例.数字化摄影和超声诊断的准确性分别是67.9%(36/53)和62.3%(33/53).数字化摄影结合超声诊断的准确性是88.7%(47/53).结论 数字化摄影和超声诊断可用于乳腺导管内癌的诊断,联合应用可提高诊断的准确性.

  12. MRI Diagnosis of Breast Ductal Carcinoma in Situ%乳腺MRI对导管原位癌及其微浸润的诊断

    Institute of Scientific and Technical Information of China (English)

    梅昂; 华佳

    2011-01-01

    Objective To assess diagnostic value of MRI for breast ductal carcinoma in situ( DCIS). Methods MRI and mammography data in 13 women with breast DCIS and DCIS with microinvasion (DCIS-Mi) confirmed by pathology were retrospectively and comparativcly analyzed with pathologic examination. Results In 13 cases underwent contrast-enhanced dynamic MR imaging,11 lesions showed non-mass-like enhancement. In 10 patients underwent mammography, one case showed negative result. Regarding the BI-RADS Ⅳ or Ⅴ as the positive standard , there was not significant difference in accurate diagnostic rate between MRI and mammography(P=O. 353). Regarding the extent of the lesions measured on pathologic examination as gold standard, 10 cases in MRI and 6 cases in mammography were corresponded,2 lesions overestimated extent by MRI and mammography , respectively, and one lesion underestimated by mammography. The difference was not significant ( P = 0. 277). Conclusion MR imaging features of DCIS and DCIS-Mi were characteristic certainly. MR imaging combined with mammography can improve the detecting rate and diagnostic accuracy of DCIS.%目的 探讨乳腺MRI对导管原位癌及其微浸润的诊断价值.方法 回顾性分析经手术病理证实的乳腺导管原位癌及导管原位癌伴微浸润病例 13例,所有病例均于术前行动态增强MRI检查,其中 10例同时行钼靶X线检查.结果 MR检查13例病灶中11例表现为非肿块样强化,10例行钼靶X线检查,1例阴性,以BIRADS分级中的4、5级为MR和X线检查的阳性指标,其正确诊断率差异无统计学意义(P=0.353).以病理结果为金标准,MRI界定病灶范围符合10例,高估2例,钼靶X线符合6例,高估2例,低估1例,差异无统计学意义(P=0.277).结论 乳腺MRI对导管原位癌及导管原位癌伴微浸润有其特征性表现,钼靶X线和MR检查相结合能提高早期导管原位癌的检出率及正确诊断率.

  13. Magnetic Resonance Imaging after Completion of Neoadjuvant Chemotherapy Can Accurately Discriminate between No Residual Carcinoma and Residual Ductal Carcinoma In Situ in Patients with Triple-Negative Breast Cancer.

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    Seho Park

    Full Text Available The accurate evaluation of favorable response to neoadjuvant chemotherapy (NCT is critical to determine the extent of surgery. We investigated independent clinicopathological and radiological predictors to discriminate no residual carcinoma (ypT0 from residual ductal carcinoma in situ (ypTis in breast cancer patients who received NCT.Parameters of 117 patients attaining pathological complete response (CR in the breast after NCT between January 2010 and December 2013 were retrospectively evaluated by univariate and multivariate analyses. All patients underwent mammography, ultrasound, and magnetic resonance imaging (MRI before and after NCT.There were 67 (57.3% patients with ypT0. These patients were associated with hormone receptor-negative status, human epidermal growth factor receptor-2 (HER2-negative tumors, and a higher likelihood of breast-conservation surgery. Baseline mammographic and MRI presentation of the main lesion, absence of associated microcalcifications, shape, posterior features, and absence of calcifications on ultrasound were significantly associated with ypT0. CR in mammography, ultrasound, or MRI after NCT was also related to ypT0. By multivariate analysis, independent predictors of ypT0 were the triple-negative subtype [Odds ratio (OR, 4.23; 95% confidence interval (CI, 1.11-16.09] and CR in MRI after NCT (OR, 5.23; 95% CI, 1.53-17.85. Stratified analysis by breast cancer subtype demonstrated that MRI well predicted ypT0 in all subtypes except the HER2-positive subtype. In particular, of 40 triple-negative subtypes, 22 showed CR in MRI and 21 (95.5% were ypT0 after NCT.Among imaging modalities, breast MRI can potentially distinguish between ypT0 and ypTis after NCT, especially in patients with triple-negative breast cancer. This information can help clinicians evaluate tumor response to NCT and plan surgery for breast cancer patients of all subtypes except for those with HER2-enriched tumors after NCT.

  14. Diagnostic value comparison of ultrasonography and mammography in breast infiltrating ductal carcinoma%超声与钼靶X线对浸润性导管癌临床诊断价值的比较

    Institute of Scientific and Technical Information of China (English)

    胡波; 周碧华; 庞彩霞; 章瑜

    2013-01-01

    目的:对比超声与钼靶X线检查在乳腺浸润性导管癌中的诊断价值.方法:对420例乳腺肿块患者按绝经前后分两组比较超声及钼靶X线检查对乳腺浸润性导管癌的诊断准确性,并对病理证实122例乳腺浸润性导管癌的超声及钼靶X线征象进行对比分析.结果:绝经前组超声符合率89.7%,钼靶X线诊断符合率74.8%;绝经后组超声的诊断符合率为89.7%,钼靶X线诊断符合率为89.1%.绝经前超声诊断乳腺浸润性导管癌比钼靶X线的诊断符合率高 (P<0.05),绝经后两者诊断符合率差异无统计学意义(P>0.05).绝经前乳腺浸润性导管癌患者中的超声检查对乳腺肿块影、钙化灶检出率均高于钼靶X线(P<0.05).结论:超声与钼靶X线对绝经前、后浸润性导管癌均有较高诊断价值,乳腺超声成像对绝经前浸润性导管癌患者的诊断价值更大.%Objective:To evaluate the value of ultrasonography and mammography in diagnosis of breast infiltrating ductal cancer.Methods:420 cases of mammary tumor patients were analyzed retrospectively.They were divided into premenopausal group and postmenopausal group.Pathologic result were chosen to be gold standard.The diagnostic accuracy of mammography and ultrasound was compared and then mammography and ultrasound signs were comparative analysis in the pathology confirmed premenopausal sixty cases of infiltrating ductal carcinoma patients.Results:In the group of premenopausal:the diagnosis coincidence rate of ultrasonography was 89.7%,the diagnosis coincidence rate of mammography was 74.8%.In the group of postmenopausal:the diagnosis coincidence rate of ultrasonography was 89.7%,the diagnosis coincidence rate of mammography was 89.1%.The diagnosis coincidence rates of ultrasonograph were higher than those of mammography in the group of premenopausal (P < 0.05).The diagnosis coincidence rate was no significant difference in the group of postmenopausal

  15. Tratamiento de lesiones de caries interproximales mediante el uso de infiltrantes Treatment of approximal caries lesions using infiltrants

    Directory of Open Access Journals (Sweden)

    ML Marró Freitte

    2011-12-01

    Full Text Available Basados en el respeto por la estructura dentaria junto a un adecuado tratamiento y detención de las lesiones de caries, se ha desarrollado ICON®, un sistema que penetra los tejidos afectados con una resina de baja viscosidad fotopolimerizable (infiltrante sin necesidad de la apertura mecánica de una cavidad. De este modo se introducen los “infiltrantes” como herramientas para el tratamiento de las lesiones proximales. El “infiltrante” actúa bloqueando la progresión de la lesión de caries y estabilizando la estructura dentaria. En este reporte se muestra la técnica de infiltración con el uso del kit ICON®, mediante la presentación de un caso clínico de lesión proximal extendida al tercio externo de la dentina.Based on the respect for the tooth structure with adequate treatment and arrest of carious lesions, ICON ® has been developed. This system enters the affected tissue with a low-viscosity light-curing resin (infiltrant with no need for mechanical opening of a cavity. This will introduce the infiltrants as tools for the treatment of proximal lesions. The “infiltrant” works by blocking the progression of caries lesion and stabilizing tooth structure. This report shows the technique with the use of the ICON ® kit, by presenting a case of proximal carious lesion extended to the outer third of dentin.

  16. Carcinoma ductal in situ da mama: critérios para diagnóstico e abordagem em hospitais públicos de Belo Horizonte Approach of ductal carcinoma in situ of the breast in three public hospitals in Belo Horizonte

    Directory of Open Access Journals (Sweden)

    Marcio de Almeida Salles

    2006-12-01

    Full Text Available OBJETIVOS: avaliar os aspectos clínicos, radiológicos, anátomo-patológicos e terapêuticos de uma série de casos de carcinoma ductal in situ (CDIS da mama de pacientes atendidos em três hospitais públicos de Belo Horizonte (MG. MÉTODOS: foram selecionados dos arquivos médicos todos os casos de câncer de mama diagnosticados entre os anos de 1985 e 2000, encontrando-se 179 casos com diagnóstico de CDIS. Fez-se revisão anátomo-patológica das lâminas e obtiveram-se dados clínicos completos, mamografias e informações sobre tratamento em 85 casos. RESULTADOS: a maioria dos casos eram assintomáticos e os diagnósticos foram feitos pela mamografia (68,2%, sendo as microcalcificações a alteração radiológica mais freqüente. Houve aumento progressivo no diagnóstico de CDIS ao longo dos anos simultâneo à introdução do exame periódico mamográfico. Houve concordância entre o diagnóstico inicial e após a revisão histopatológica em 72,9% dos casos. Em três casos, o diagnóstico original de CDIS não foi confirmado pela revisão, tratando-se de hiperplasias com atipias. O achado de microcalcificações radiológicas foi confirmado no estudo histopatológico em 95,6%. A metade dos pacientes foi submetida à mastectomia. Nos casos submetidos à linfadenectomia axilar, todos os linfonodos dissecados foram negativos para metástases. CONCLUSÕES: os dados encontrados estão de acordo com a literatura, que mostra um aumento do diagnóstico do CDIS a partir de 1990. Houve importante variação interobservador entre os diagnósticos anátomo-patológicos iniciais e os da revisão, sendo que os diagnósticos iniciais tendiam para malignidade. Houve grande número de tratamentos mais radicais como a mastectomia e esvaziamentos axilares, que provavelmente, com os conhecimentos atuais, seriam substituídos por tratamentos conservadores e biópsia do linfonodo sentinela.PURPOSE: to evaluate the clinical, radiological therapeutic and

  17. Carcinomas invasores triples negativosde la glándula mamaria: incidencia y características clínico-patológicas Triple-Negative Invasive Breast Carcinoma: Incidence and Clinical - Pathological Characteristics

    Directory of Open Access Journals (Sweden)

    José L Quirós-Alpízar

    2010-06-01

    Full Text Available Justificación y objetivo: El comportamiento epidemiológico de los tumores malignos del país ha presentado un cambio en los últimos años; el cáncer de mama ha aumentado su incidencia hasta colocarse como el segundo tumor maligno más frecuente en la mujer y el primero en mortalidad. Este tipo de tumor tiene características que se pueden estudiar con las técnicas de inmunohistoquímica, como son la expresión de receptores en las células neoplásicas (estrógenos, progesterona y el HER2 o receptor 2 del factor de crecimiento epidérmico humano. Los carcinomas que no expresan ninguno de estos tres receptores tienen un peor pronóstico. El estudio tiene como objetivos conocer las principales características de este grupo de tumores denominados triples negativos, y determinar su relevancia dentro del grupo total del carcinoma de mama. Materiales y métodos: Se recolectaron los casos diagnosticados de cáncer de mama en mujeres, en el periodo comprendido entre el 1 de enero y el 31 de diciembre de 2006, en el Hospital San Juan de Dios, en el Servicio de Patología, que dispusieran de estudios inmunohistoquímicos. Se consideró la información acerca de la edad de las pacientes, así como el tipo histológico y grado de diferenciación de cada uno de los tumores. Se separó el grupo correspondiente a los tumores triple negativo y se realizaron los análisis estadísticos por medio del programa Epi Info 3.3.4. Resultados: De una población de 221 pacientes diagnosticadas con cáncer de mama en el periodo mencionado, se presentaron 40 pacientes con cáncer de mama triple negativo, resultando en una incidencia de un 18% (I.C. 95%, 12,79 - 23,40 y una edad promedio de 54 años (I.C. 95%, 50 - 59, con una mediana de 52 y una moda de 48. El cáncer de mama triple negativo tuvo una relación mayor con el tipo histológico ductal infiltrante, con un 67,5% (I.C. 95%, 51,7383,26; seguido por el lobulillar infiltrante, con un 12,5% (I.C.95%, 4,18 - 26

  18. Structural imaging of the pancreas in rat using micro-CT: application to a non-invasivelongitudinal evaluation of pancreatic ductal carcinoma monitoring

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    Akladios CY

    2013-04-01

    Full Text Available The aim of the study was to evaluate the feasibility of a longitudinal non-invasive monitoring of rat pancreatic ductal adenocarcinoma (PDAC using microCTscans (μCT. The identification of the pancreatic gland on (μCT was performed at first using contrast products (Fenestra LC and VC, v/v at a dosage of 0.5 ml/Kg of body weight. Then orthotopic PDAC developed in adult Lewis rat was detected and monitored. In vivo μCT measurement of tumor was compared to actual size ex vivo in 12 rats. Gemcitabine treatment of PDAC was monitored at two week intervals until defined endpoints (liver metastasis or ascitis in 10 rats versus 10 controls. μCT had a 100% positive predictive value in the detection of orthotropic PDAC. Regression analysis showed a linear correlation between ex vivo and in vivo μCT tumor measurements. Longitudinal evaluation of tumor progression showed a reduction in tumor growth (P<0.05 at 8 weeks and a slightly prolonged survival (P=0.15 under gemcitabine treatment. In conclusion μCT appears to be a cost-effective mean for preclinical study of PDAC saving time, animals, while respecting animal welfare. It could be considered as an efficient tool in anticancer drug research and development.

  19. Underestimation of invasive lesions in patients with ductal carcinoma in situ of the breast diagnosed by ultrasound-guided biopsy: A comparison between patients with and without HER2/neu overexpression

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Wei-Chou [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Hsu, Hsian-He, E-mail: hsianhe@yahoo.com.tw [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Yu, Jyh-Cherng [Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Ko, Kai-Hsiung [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Peng, Yi-Jen [Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China); Tung, Ho-Jui [Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC (China); Chang, Tsun-Hou; Hsu, Giu-Cheng [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC (China)

    2014-06-15

    Purpose: To determine the rate of underestimation of ductal carcinoma in situ (DCIS) diagnosed at imaging-guided biopsy and to analyze its association with HER2/neu oncogene, an important biomarker in assessing the tumour aggressiveness and guiding hormone therapy for breast cancer. Methods: We retrospectively reviewed 162 patients with DCIS diagnosed by imaging-guided core needle biopsy between January 2008 and March 2013. All of these patients received surgical excision, and in 25, the diagnosis was upgraded to invasive breast cancer. In this study, we examined the ultrasound, mammographic features and histopathological results for each patient, and compared these parameters between those with and without HER2/neu overexpression. Results: Of the 162 DCIS lesions, 110 (67.9%) overexpressed HER2/neu. Nineteen patients with HER2/neu overexpressing DCIS (n = 19/110, 17.3%) were upgraded after surgery to a diagnosis of invasive breast cancer. In this group, the upgrade rate was highest in patients with a dilated mammary duct pattern (42.1%, n = 8/19, p = 0.02) and the presence of abnormal axillary nodes (40.0%, n = 12/30, p < 0.01) at ultrasound and was significantly associated with comedo tumour type on pathology. Conclusions: Biopsy may underestimate the invasive component in DCIS patients. Sonographic findings of dilated mammary ducts and presence of abnormal axillary lymph nodes may help predicting the invasive components and possibly driving more targeted biopsy procedures.

  20. Is sentinel lymph node biopsy necessary for the patients diagnosed with breast ductal carcinoma in situ using core needle biopsy or vacuum-assisted biopsy as the initial diagnostic method?

    Institute of Scientific and Technical Information of China (English)

    Xiaoyi Zhang; Rui Wang; Zhiyong Wu; Xueqing Jiang

    2014-01-01

    Objective:Axil ary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especial y in ductal carcinoma in situ (DCIS). The purpose of this study was to investigate whether sentinel lymph node biopsy (SLNB) should be performed in patients with an initial diagnosis of DCIS. Methods:A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axil ary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results:Eighty-two patients (66.1%) had pure DCIS and 25 (20.2%) had DCIS with microinvasion (DCISM), 17 (13.7%) updated to invasive breast cancer (IBC). 115 patients (92.7%) underwent SLNB, among them, 70 patients (56.5%) underwent axil ary node dissection. 3 of 115 patients (2.6%) had a positive sentinel lymph node, only 1 (1.4%) of 70 patients had axil ary lymph node metastasis, in 84 patients (66.7%) who were diagnosed DCIS by core needle biopsy (CNB) and vacuum-assisted biopsy (VAB). 26 patients (31.0%) were upstaged into IBC or DCISM in the final histological diagnosis. The statistical y significant factors predictive of underestimation were large tumor size, microcalci-fications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion:The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especial y in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.

  1. Three Dimensional Reconstruction of Breast Invasive Ductal Carcinoma Based on Dextroscope System and Its Preoperative Application%Dextroscope系统对乳腺浸润性导管癌的三维重建及术前应用

    Institute of Scientific and Technical Information of China (English)

    刘宝胤; 骆成玉; 张键; 罗雯; 韩春姿; 张宇

    2011-01-01

    Objective: To investigate the methods of 3D reconstruction of breast invasive ductal carcionma and discuss its value in preoperative application. Methods : 10 cases underwent MRI examination before operation were diagnosed with invasive ductal carcinoma by biopsy cores. Dextroscope virtual reality system generated virtual images which could be used to observe the relationship between tumor and breast from different directions. The surgical plan were carried out and operation were simulated. All the cases were performed breast conserving operation. Results: The image of 3D reconstruction conducted hy Dextroscope system was clear,which could contribute to the precise allocation of tumor. The pathological cut margins were all negative. There was no significant difference between preoperative simulating image with intraoperative and pathological observation. Conclusions :The image of 3D reconstruction can practice the surgery in advance and create conditions for precise operation. It has a guiding significance for implementation of breast conserving surgery.%目的:研究Dextroscope系统对乳腺浸润性导管癌的三维重建方法,探讨其临床应用价值.方法:对浸润性导管癌10例患者采用Dextroscope系统软件生成虚拟图像,从任意角度观察肿瘤与乳腺的解剖关系,确定保乳手术方案并进行模拟操作.10例均行乳腺癌保乳手术.结果:Dextroscope系统对乳腺浸润性导管癌的三维重建图像清晰,可以精确定位肿瘤.10例患者病理切缘均为阴性.术后病理大体标本与术前模拟图像测量数值,差异无统计学意义(P>0.05).结论:通过Dextroscope系统,术者提前预演手术,为精确手术创造了条件,对乳腺癌保乳手术的实施有指导意义.

  2. Comparison of nuclear grade and immunohistochemical features in situ and invasive components of ductal carcinoma of breast Comparação do grau nuclear e perfil imunoistoquímico nos componentes in situ e invasivo de carcinoma mamário

    Directory of Open Access Journals (Sweden)

    Fernando Nalesso Aguiar

    2013-03-01

    Full Text Available PURPOSE:To compare the prognostic and predictive features between in situ and invasive components of ductal breast carcinomas. METHODS:We selected 146 consecutive breast samples with ductal carcinoma in situ (DCIS associated with adjacent invasive breast carcinoma (IBC. We evaluated nuclear grade and immunohistochemical expression of estrogen receptor (ER, progesterone receptor (PR, human epidermal growth factor receptor 2 (HER2, cytokeratin 5/6 (CK5/6, and epidermal growth factor receptor (EGFR in both components, in situ and invasive, and the Ki-67 percentage of cells in the invasive part. The DCIS and IBC were classified in molecular surrogate types determined by the immunohistochemical profile as luminal (RE/PR-positive/ HER2-negative, triple-positive (RE/RP/HER2-positive, HER2-enriched (ER/PR-negative/HER2-positive, and triple-negative (RE/RP/HER2-negative. Discrimination between luminal A and luminal B was not performed due to statistical purposes. Correlations between the categories in the two groups were made using the Spearman correlation method. RESULTS:There was a significant correlation between nuclear grade (pOBJETIVO: Comparar características prognósticas e preditivas entre os componentes in situ e invasivo de carcinomas ductais da mama. MÉTODOS: Selecionamos 146 amostras mamárias consecutivas com carcinoma ductal in situ (CDIS associado com carcinoma invasivo (CI adjacente. Avaliamos grau nuclear e a expressão imunoistoquímica de receptor de estrogênio (RE, receptor de progesterona (RP, receptor do fator de crescimento epidérmico humano 2 (HER2, citoqueratina 5/6 (CK5/6 e o receptor do fator de crescimento epidérmico (EGFR em ambos componentes, in situ e invasor, e a porcentagem de células marcadas pelo Ki-67 no componente invasivo. CDIS e CI foram classificados nos tipos moleculares, determinados pelo perfil imunoistoquímico, como luminal (RE/RP-positivo/HER2-negativo, triplo-positivo (RE/RP/HER2-positivo, HER2-puro

  3. Does ductal lavage assert its role as a noninvasive diagnostic modality to identify women at low risk of breast cancer development?

    OpenAIRE

    Konstandiadou, Ioanna; Mastoraki, Aikaterini; Kotsilianou, Olympia; Karakitsos, Petros; Athanasas, George; Smyrniotis, Vasilios; Arkadopoulos, Nikolaos

    2012-01-01

    Objective Ductal lavage (DL) involves evaluation of the ductal system of the breast for detection of intra-ductal carcinomas and precursor lesions by collecting breast epithelial cells using a small-gauge catheter inserted into a ductal orifice on the nipple. The aim of this survey was to analyze cytologic features of samples obtained from low-risk women with DL and to elucidate the efficacy of this diagnostic modality in evaluating fluid production, cannulating and determining atypical breas...

  4. Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 11-gauge vacuum-assisted biopsy

    Institute of Scientific and Technical Information of China (English)

    Lei Ye; Liping Wang; Youbin Deng

    2013-01-01

    Objective: The objective of this study was to compare the underestimation rate of invasive carcinoma caseswith ductal carcinoma in situ (DCIS) at percutaneous ultrasound-guided core biopsies of breast lesions between 14-gaugeautomated core needle biopsy (ACNB) and 11-gauge vacuum-assisted biopsy (VAB), and analyze the diagnostic advantagesand insufficiencies in DCIS between this two methods, and to determine the relationship between the lesion type (masses ormicrocalcifications on radiological findings ) and DCIS underestimation rate. Methods: We collected 152 breast lesions whichwere diagnosed as DCIS by retrospectively reviewing data about ultrasound-guided biopsies of breast lesions (from February2003 to July 2010). There were 98 lesions in 95 patients by 14-gauge ACNB, and 54 lesions in 52 patients by 11-gauge VAB(The system used in this study called Mammatome, MMT). The clinical and radiological findings were reviewed; meanwhileall the selected patients had histological results of the biopsies and follow-up surgeries which also achieved the reliablepathological results to compare with the biopsy results. The differences between two correlated histological results defined asunderestimation, and the histological DCIS underestimation rates were compared between the two groups. According to theradiological characteristics, each group was classified into two subgroups (masses or microcalcifications group), and the differencesbetween subgroups were also analyzed. Results: The DCIS underestimation rate was 45.9% (45/98) for 14-gaugeACNB and 16.6% (9/54) for MMT. According to the lesion type on ultrasonography, DCIS underestimation was 31.0% (26/84)in masses (43.1% using ACNB and 12.1% using MMT; P = 0.003) and 42.6% (29/68) in microcalcifications (48.9% usingACNB and 23.8% using MMT; P = 0.036). Conclusion: The underestimation rate of invasive carcinoma in cases with DCISat ultrasound-guided core biopsies is significantly higher for ACNB than for MMT. Furthermore

  5. A Catalogue of Altered Salivary Proteins Secondary to Invasive Ductal Carcinoma: A Novel In Vivo Paradigm to Assess Breast Cancer Progression.

    Science.gov (United States)

    Streckfus, Charles F; Bigler, Lenora

    2016-08-01

    The objective of this manuscript is to introduce a catalogue of salivary proteins that are altered secondary to carcinoma of the breast. The catalogue of salivary proteins is a compilation of twenty years of research by the authors and consists of 233 high and low abundant proteins which have been identified by LC-MS/MS mass spectrometry, 2D-gel analysis and by enzyme-linked immunosorbent assay. The body of research suggests that saliva is a fluid suffused with solubilized by-products of oncogenic expression and that these proteins may be useful in the study of breast cancer progress, treatment efficacy and the tailoring of individualized patient care.

  6. Presentación de un modelo de decisión Bayesiano para el tratamiento del Carcinoma Ductal In Situ (CDIS) de mama.

    OpenAIRE

    Belda Ibáñez, Tatiana

    2015-01-01

    El Carcinoma de Mama (CM) es el tumor maligno más frecuente en mujeres y su incidencia aumenta un 2% anual, por ello es uno de los problemas sanitarios más importantes de los países industrializados. Los sistemas nacionales de salud se centran en su diagnóstico precoz para minimizar las consecuencias fatales de la enfermedad, con la realización de mamografías periódicas en las mujeres entre los 40 y 70 años. El desarrollo de estos programas de cribado han demostrado adelantar el diagnóstico ...

  7. 乳腺浸润性导管癌腋窝淋巴结转移的相关因素分析%Analysis of related factors of axillary lymph node metastasis in breast invasive ductal carcinoma

    Institute of Scientific and Technical Information of China (English)

    王丰; 宋苏云; 张锐

    2011-01-01

    Objective To study related factors of axillary lymph node metastasis in breast invasive ductal carcinoma and using ultrasound and pathology exams to predict axillary lymph node metastasis status. Methods One hundred and seventy-five breast invasive ductal carcinoma patients confirmed pathologically were retrospectively analyzed. All patients were examined by color Doppler ultrasound to estimate breast tumor position, tumor diameter. tumor Adler grade of blood flow. number of axillary lymph node. axillary lymph node diameter.longitudinal-transverse axis ratio of axillary lymph node. cortical thickness and blood flow grade of axillary lymph node. Pathology examinations after surgery was performed to observe tumor histological grade and expression of estrogen receptor (ER) , progesterone receptor ( PR) . Ki67 antibody and c-erbB-2. Chi-square test and univariate and multivariate logistic regression analysis were used. ROC curve was drawn and the area under the ROC curves was calculated. Results Of the 175 patients, 107 were proved with axillary lymph node metastasis. Breast tumor diameter. tumor Adler grade of blood flow. number of axillary lymph node. axillary lymph node diameter, longitudinal-transverse axis ratio of axillary lymph node. cortical thickness of axillary lymph node. blood flow grade of axillary lymph node. tumor histological grade, the expression of Ki67 antibody, and c-erbB-2 positive expression were correlated with axillary lymph node metastasis ( P < 0. 050) . Five factors finally entered the multivariate logistic regression model. including breast tumor diameter,cortical thickness of axillary lymph node, longitudinal-transverse axis ratio of axillary lymph node. tumor histological grades Ⅱ and Ⅲ and Ki67 antibody positive expression. The area under the ROC curve was 0.964. Conclusions Low longitudinal-transverse axis ratio of axillary lymph node. the cortical thickness of axillary lymph node ≥ mm. breast tumor diameter≥ cm. tumor

  8. Expression and significance of E-cadherin and Ki-67 in non-special type of invasive ductal carcinoma of breast%E-钙黏蛋白和Ki-67在非特殊型乳腺浸润性导管癌中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    李玉红; 贾爱华; 鲁庆阳; 任玉波

    2011-01-01

    Objective To investigate the role of E-cadherin and antigen identified by monoclonal antibody Ki-67 in the occurrence and development of non-special type of invasive ductal carcinoma of breast. Methods The expression of E-cadherin and Ki-67 in 100 non-special type of invasive ductal carcinoma ( breast cancer group) and 20 breast fibroadenoma tissues ( fibroadenoma group) were detected by immunohistochemistry, and the relationship between these two antibodies and the clinicopathological features of non-special type of invasive ductal carcinoma were analyzed. Results The breast cancer group (67%) was lower than than the fibroadenoma group ( 100% ) in E-csdherin positive expression rate, and was ( 59% ) higher than the fibroadenoma group( 25% ) in Ki-67 positive expression rate, both P < 0.05; the expression of E-cadherin and Ki-67 were closely related to non-special type of invasive ductal carcinoma of breast in it's lymph node metastasis, TNM stage and histological grade, but not in patients' age and tumor diameter. Conclusions Reduced expression of E-cadherin and elevated expression of Ki-67 were closely related to non-special type of invasive ductal carcinoma of breast in it's occurrence and development, and detection of these two antibodies is helpful for determining the degree of malignancy and prognosis of non-special type of invasive ductal carcinoma of breast.%目的 探讨E-钙黏蛋白和增殖指数抗原Ki-67在非特殊型乳腺浸润性导管癌发生、发展中的作用.方法 采用免疫组化法检测E-钙黏蛋白和Ki-67在100份非特殊型乳腺浸润性导管癌组织(乳腺癌组)及20份乳腺纤维腺瘤组织(纤维腺瘤组)中的表达,并分析两者与非特殊型乳腺浸润性导管癌临床病理特征的关系.结果 乳腺癌组E-钙黏蛋白的阳性率(67%)明显低于纤维腺瘤组(100%),Ki-67的阳性率(59%)高于纤维腺瘤组(25%),P均<0.05;E-钙黏蛋白和Ki-67表达与非特殊型乳腺浸润性导管癌

  9. Comparison of Color Doppler Ultrasound and X-ray Mammography Photography in the Diagnostic Value of Breast Invasive Ductal Carcinoma%彩色多普勒超声对比钼靶X线摄影诊断乳腺浸润性导管癌的价值评价

    Institute of Scientific and Technical Information of China (English)

    张苗苗

    2016-01-01

    Objective To analyze the diagnosis value of color Doppler ultrasound in breast invasive ductal carcinoma.MethodsAnalysis of 50 cases of breast invasive ductal carcinoma with color Doppler ultrasound diagnosis and X-ray mammography photography,the diagnostic accuracy,the rate of misdiagnosis and missed diagnosis rate in the two methods were compared.Results The accuracy of ultrasound group was significantly higher than X-ray mammography,while the misdiagnosis rate was significantly lower,the difference was statisticaly significant(P<0.05).Conclusion Color Doppler ultrasound and X-ray mammography can effectively diagnose breast invasive ductal carcinoma. Ultrasound diagnosis can greatly improve the accuracy and reduce the rate of misdiagnosis and missed diagnosis rate.%目的:分析乳腺浸润性导管癌使用彩色多普勒超声进行诊断的价值。方法观察分析50例乳腺浸润性导管癌患者的彩色多普勒超声诊断结果和钼靶X线影摄的诊断结果,对比两组方法的诊断准确率、漏误诊率。结果超声组的准确率比钼靶组高,其漏诊率较低,组间差异具有统计学意义(P<0.05)。结论彩色多普勒超声和钼靶X线都能够有效诊断乳腺浸润性导管癌,超声诊断大大提高了准确率,降低了漏诊率。

  10. The expression of Twist in invasive ductal carcinoma of breast and its relationship with cell proliferation and angiogenesis%乳腺浸润性导管癌中Twist的表达与细胞增殖和血管生成的关系

    Institute of Scientific and Technical Information of China (English)

    蔡凤林; 何春兰; 章佳新; 周士福; 时伟锋

    2012-01-01

    目的 探讨Twist在乳腺浸润性导管癌中的表达及其与细胞增殖和血管生成的关系.方法 应用免疫组织化学法检测60例乳腺浸润性导管癌组织中Twist和Ki-67的表达情况,计算Ki-67指数和微血管密度(MVD).结果 乳腺浸润性导管癌组织中Twist阳性表达率为56.7%(34/60),Twist阳性患者Ki-67指数、MVD显著高于Twist阴性患者[(57.05±16.37)%比(25.32±16.16)%、(34.30±12.25)%比(23.04±10.45)%,P< 0.05].结论 乳腺浸润性导管癌组织中Twist高表达,Twist可促进肿瘤细胞增殖和肿瘤血管生成,从而成为其促进乳腺癌浸润、转移的途径之一.%Objective To study the expression of Twist in invasive ductal carcinoma of breast and its relationship with cell proliferation and angiogenesis.Methods The expression of Twist and Ki-67 was detected in 60 cases with invasive ductal carcinoma of breast by immunohistochemistry.Ki-67 index and microvascular density (MVD) were calculated.Results The positive expression rate of Twist was 56.7% (34/60) in invasive ductal carcinoma of breast.Ki-67 index and MVD in the patients with positive expression of Twist was higher than those in the patients with negative expression of Twist [(57.05 ± 16.37)% vs.(25.32 ± 16.16)%,(34.30 ± 12.25)% vs.(23.04 ± 10.45)%,P< 0.05 ].Conclusions The overexpression of Twist is found in invasive ductal carcinoma of breast.To stimulate cell proliferation and angiogenesis may be one of the pathways of Twist to contribute to the invasion and metastasis of breast cancer.

  11. 乳腺浸润性导管癌连接蛋白43和上皮性钙黏蛋白相关性研究%Expressions of Connexin43 and E-cadherin and their significance in invasive ductal carcinoma

    Institute of Scientific and Technical Information of China (English)

    涂永久; 高一菁; 陈战; 李锐

    2014-01-01

    目的:探讨乳腺浸润性导管癌组织中间隙连接蛋白43(Cx43)及上皮性钙黏蛋白(E-cad)表达中的相关性。方法采用Elivision免疫组织化学法对89例乳腺侵润性导管癌组织及48例分区组织的Cx43与E-cad检测。结果乳腺浸润性导管癌的肿瘤区、交界区和远癌区的Cx43和E-cad蛋白表达具有较好的一致性(γ=0.460,P<0.01);在肿瘤区两者同时为阴性表达时,淋巴结转移率最高。结论 Cx43和E-cad在乳腺浸润性导管癌发生和发展过程中具有一定的协同作用,与其发生浸润转移有关。%Objective To explore the correlation of Connexion43(Cx43),E-cadherin(E-cad)in breast infiltrating ductal carcinoma tis-sue. Methods The expressions of Cx43 and E-cad proteins were detected in 89 cases breast infiltrating ductal carcinoma tissue,48 cases partition groups. by immunohistochemistry Elivision method. Results The expressions of Cx43 and E-cad has a better consistency in the tumor area,the border area and far cancer area of breast infiltrating ductal carcinoma. For both the negative expression in tumor area same time,the rate of lymph node metastasis was highest. Conclusion Cx43 and E-cad in breast invasive ductal carcinoma has a certain synergy in the process of the occurrence and development,which related to its metastasis occurred.

  12. Diagnoses of breast ductal carcinoma in situ by combination of ultrasound and mammography%超声与钼靶联合诊断乳腺导管内癌

    Institute of Scientific and Technical Information of China (English)

    王建伟; 林僖; 赵静; 李安华; 韩峰; 郑玮; 裴小青

    2011-01-01

    目的 分析乳腺导管内癌(DCIS)的超声及钼靶特征,对二者进行对比分析,并探讨二者联合对诊断DCIS的准确性.方法 分析经病理证实的30例DCIS的超声和钼靶特征,并利用BI-RADS第4版分别进行评估.结果 超声表现为Ⅰ型结节肿块型9例,Ⅱ型导管扩张填充型15例,Ⅲ型结构紊乱型3例,Ⅳ型囊实性混合回声型1例,V型无占位的单纯钙化点型2例.钼靶表现为钙化者23例,表现为局部密度增高或等密度肿块者11例,表现为结构紊乱者13例,未见明确占位病变1例.超声对乳腺导管内癌的诊断符合率为66.6%,钼靶对乳腺导管内癌的诊断符合率80.0%,二者差异无统计学意义(χ2=0.900χ20.05,1,P<0.05).结论 超声和钼靶对乳腺导管内癌的诊断均有重要价值,二者联合可明显提高对乳腺导管内癌的诊断符合率.%Objective To analyze the features of ductal carcinoma in situ (DCIS) by ultrasound and mammography and estimate the accuracy of ultrasound,mammography and combination of both methods in diagnosis of DCIS.Methods To analyze the mammographic and sonographic images of breast DCIS in 35 patients confirmed by pathology and assessed by BI-RADS ( 4th ).Results The solid lesion in 9 cases, and ductal ectasia filled with stuff cases in 15 cases, and architecture disorder cases in 3 cases, and mass contains both anechoic and echogenic components in 1 case, and calcification only in 2 cases were observed by ultrasound.By mammography, calcifications were found in 23 cases, nodular lesion or local increased density in 11 cases, architecture disorder cases in 13 cases, and no lesion in 1 case.The coincidence rates of ultrasound and mammography of DCIS were 66.6% and 80.0%,respectively.The accuracy of ultrasound and mammography was not statistically different( x2 = 0.900 < x20.05,1, P > 0.05 )and the coincidence rate of combination of both methods was 90.0% , higher than that of ultrasound( x2 = 5.142 > x20

  13. An Adequate Margin of Breast Conserving Surgery for Ductal Carcinoma in Situ: A Meta Analysis%乳腺导管原位癌保乳手术最佳切缘距离的系统评价

    Institute of Scientific and Technical Information of China (English)

    叶长生; 姚广裕; 李学瑞; 陈睿婷

    2011-01-01

    much higher in ac - celerated phase/blast crisis. Conventional cytogenetic analysis is helpful to the diagnosis of CML and analysis of the pro -gress. On the basis of conventional cytogenetic analysis , FISH analysis technology can significantly promote the diagnosis rate and the accuracy in detection of chromosomal ahnormalities , and is effective in the detection of der (9) deletions.%@@ 1 文献来源 Dunne C, Burke JP, Morrow M, et al.Effect of margin status on local recurrence after breast conser-vation and radiation therapy for ductal carcinoma in situ[J].J Clin Oncol, 2009, 28 (10) : 1615-1620.

  14. 乳腺MRI与乳腺X线检查诊断导管原立癌的敏感度研究%MRI outstands mammogram in sensitivity of breast ductal carcinoma in situ : an analysis of 122 cases

    Institute of Scientific and Technical Information of China (English)

    郁骐襄; 陈小松; 吴佳毅; 韩宝三; 何建蓉; 朱丽; 陈伟国; 李亚芬; 谭令

    2013-01-01

    Objectives To compare the sensitivity of mammogram and breast dedicated MRI in detecting ductal carcinoma in situ with microinvaion (DCIS-MI) and ductal carcinoma in situ (DCIS) lesions,and to further investigate the independent predictive factors of mammogram and MRI sensitivity.Methods From August 2009 to November 2011,122 consecutive confirmed breast cancer patients who had received operations were recruited for this clinical research.These patients were divided into two groups including DCIS (72 cases) and DCIS-MI (50 cases) based on pathologic reports.All the patients were female,with mean ages of 52.6 years and 54.4 years.Preoperative bilateral breast mammogram,breast dedicated MRI depictions and reports as well as histopathological reports were collected.Results Sensitivity of MRI outstood mammogram in each subgroups:84.7% vs.42.4% in DCIS (x2 =27.028,P =0.000),94.0% vs.80.0% in DCIS-MI group (x2 =4.540,P =0.040).And further analysis showed that MRI was more sensitive to high nuclear grade DCIS and DCIS-MI lesions than low nuclear grade ones (OR =3.471,P =0.031).Results of logistic regression analysis proved microcalcification was an independent predictive factor of mammogram sensitivity (OR =1 1.287,P =0.001).Conclusions Sensitivity of breast dedicated MRI is superior to mammogram in detecting DCIS and DCIS-MI groups.Lesions with microcalcifiation is an independent predictive marker which meant that mammogram would achieve high detection rate in cancers presented calcification on mammogram image when compared with non-calcification.Diagnostic performance of breast MRI is less affected by clinical and pathological characteristics of the early stage breast cancer patients but further increased detection rate is observed in DCIS and DCIS-MI with high nuclear grade lesions which indicated that MRI could detect more early stage cancers with relative more aggression biological behaviour and provide these patients with early surgical interventions before

  15. 乳腺浸润性导管癌患者癌组织c-Met蛋白的表达及病理探讨%C-Met protein expression of cancer tissue of patients with breast inifltrating ductal carcinoma and its pathological study

    Institute of Scientific and Technical Information of China (English)

    王晓娟

    2016-01-01

    Objective to analyze and investigate c-Met protein expression of cancer tissue of patients with breast infiltrating ductal carcinoma and its pathological significance.Methods randomly choose clinical pathological specimens of 140 patients with breast infiltrating ductal carcinoma in our hospital from January 2015 to December 2015 as research objects, detect c-met protein expression of breast cancer tissue, and analyze relations between c-Met protein expression and TNM staging, tumor pathological grading, lymph node metastasis and tumor size.Results there were 60 cases positive c-Met protein, accounting for 42.86%; 80 cases negative c-Met protein, accounting for 57.14%. C-met protein expression positive rate in pathological grade I, II, and III and different tumor sizes showed no significant difference (P> 0.05); expression positive rate at TNM stage III to IV and breast cancer tissue with lymph node metastasis was significantly higher than that in TNM stage I-II and breast cancer tissue without lymph node metastasis, and data difference showed statistical significance (P0.05);在TNM分期III~IV期及有淋巴结转移的乳腺癌组织中表达阳性率明显高于TNM分期I~II期无淋巴转移的乳腺癌组织,且数据均差异有统计学意义(P<0.05)。结论 c-Met蛋白的表达在乳腺癌的转移以及侵袭中具有不可忽视的作用,可以采用干预手段或者是检测c-Met蛋白表达来进行对乳腺癌其发生、发展情况和患者的预后做判断。

  16. Synchronous gastric adenocarcinoma and pancreatic ductal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Mirko Muroni; Francesco D'Angelo; Massimo Pezzatini; Simone Sebastiani; Samantha Noto; Emanuela Pilozzi; Giovanni Ramacciato

    2010-01-01

    BACKGROUND: The association between gastric and pancreatic carcinoma is a relatively rare condition. In gastric carcinoma patients, the prevalence of second tumors varies 2.8% to 6.8% according to the reported statistics. Gastric cancer associated with pancreatic cancer is uncommon. METHODS: We report a case of a 73-year-old patient hospitalized for vomiting and weight loss. Esophagogastro-duodenoscopy demonstrated an ulcerative lesion of the gastric antrum. Computed tomography and magnetic resonance showed a gastric thickening in the antral and pyloric portion and a nodular mass (3×1.7 cm) in the uncinate portion of the pancreas. RESULTS: The patient underwent pancreaticoduoden-ectomy according to Whipple regional typeⅠFortner. Histological examination of the specimen demonstrated a moderately differentiated adenocarcinoma of the stomach and a poorly differentiated ductal adenocarcinoma of the pancreas. CONCLUSIONS: Long survival is rare in patients with associated gastric and pancreatic cancer. Surgical resection remains the only potentially curative treatment.

  17. Ductal adenocarcinoma of the prostate: immunohistochemical findings and clinical significance

    Directory of Open Access Journals (Sweden)

    Sha JJ

    2013-10-01

    not detected on MRI and bone scan. Conclusion: Ductal adenocarcinoma of the prostate is a rare subtype of prostate carcinoma, the diagnosis of which could be based on pathological and immunohistochemical examination. Earlier management promises better prognosis. Keywords: ductal adenocarcinoma, immunohistochemistry, pathology, prognosis, prostate

  18. The latest molecular typing of infiltrating ductal carcinoma of the breast and the analysis of clinical and pathological characteristics%乳腺浸润性导管癌最新分子分型及其临床病理特征分析

    Institute of Scientific and Technical Information of China (English)

    王盛; 李娜

    2015-01-01

    目的:探讨乳腺浸润性导管癌(Invasive Ductal Carcinoma of Breast)最新分子分型与其临床病理特征的关系。方法:通过免疫组化及临床病理资料回顾性分析119例乳腺浸润性导管癌患者,并结合文献探讨分子亚型与临床特征的关系。结果:①119例乳腺浸润性导管癌中,年龄23~81岁,平均53岁。以Luminal B型最多见[70例(58.8%)],Lu-minal A 型较以往分型方法比例降低[11例(9.2%)]。②各分子亚型在不同年龄组的分布上差异无明显统计学意义(P=0.95,>0.05);42例维族、56例汉族与各分子亚型间差异有统计学意义(P=0.026,<0.05)。③临床病理特征中肿瘤大小(P=0.003)、组织学分级(P<0.01)与分子各亚型组间差异具有显著统计学意义,年龄及淋巴结转移与分子各亚型组间差异无统计学意义(P>0.05);进一步分析显示,Luminal B型中HER-2(-)和HER-2(+)亚型之间与各临床病理特征差异均无统计学意义(P>0.05)。结论:乳腺浸润性导管癌分子亚型与肿瘤大小、组织学分级分布差异具有统计学意义,各分子亚型与其临床特征关系密切。Luminal B(HER-2阴性型)因Ki-67高表达,提示预后较差。%Objective:To explore the latest molecular typing of infiltrating ductal carcinoma of the breast and the analysis of clinical and pathological characteristics.Methods:Through immunohistochemical technique and clinicopathologic data,we retrospectively analyzed 119 cases of invasive ductal breast carcinoma,combining with the literature to discuss the related molecular subtype and clinical features.Results:①Among 119 cases of invasive ductal breast carcinoma,with age ranging from 23 to 81 years,and the mean was 53 years.Luminal B type[70 cases(58.8%)] was the most common,and Luminal A classification method of proportion was reduced relatively[11 cases(9.2%)].②On the distribution of various molecular subtypes in different age groups was no

  19. 中下段胆管癌切除后切缘阳性的意义及预后因素分析%Significance of positive ductal margin and prognostic factors of surgical resection in middle and distal bile duct carcinoma

    Institute of Scientific and Technical Information of China (English)

    梁建伟; 赵平; 周志祥; 田艳涛; 赵东兵; 王成锋

    2009-01-01

    目的 分析中下段胆管癌切除术后切缘阳性的意义,研究影响中下段胆管癌切除术后的预后因素.方法 回顾性分析1990年1月至2006年12月收治的79例中下段且日管癌切除患者的临床病理资料.其中男性53例、女性26例,年龄30~79岁,平均61岁.中段胆管癌34例,下段胆管癌45例.行胰十二指肠切除术46例,行根治性胆总管癌切除术25例,行根治性胆总管癌切除联合肝部分切除术6例,行根治性胆总管癌切除联合门静脉部分切除术2例.5例于术后1个月内死亡,对其余74例患者的15项临床病理特征进行单因素及多因素分析.结果 74例患者总的5年生存率为30.7%,中位生存期为36个月.术后病理榆查为镜下切缘阳性(R1切除)16例(20.3%),其中肝脏端胍管切缘阳性6例,远端胆管切缘阳性3例,双侧胆管切缘阳性2例,环周切缘阳性5例.接受R0和Rl切除的患者的5年生存率分别为34.4%和15.5%.10例(17.2%)R0切除的胆管癌出现局部复发,10例(62.5%)R1切除出现复发,差异有统计学意义(X2=13.024,P<0.01).单因素分析显示术前血红蛋白水平、分化程度、肿瘤浸润深度、淋巴结转移、TNM分期及手术切缘为影响预后的因素.多因素分析显示淋巴结转移状况和切缘癌残留是影响预后的独立因素.结论 中下段胆管癌根治术中冰冻病理检查切缘达R0切除是提高长期生存的重要策略,辅助治疗的效果尚待进一步研究.%Objective To discuss the significance of a positive ductal margin and evaluate the prognostic factors related to surgical resection for middle and distal bile duct carcinoma. Methods A retrospective clinicopathological analysis of 79 patients who had undergone surgical resection for middle or distal bile ductal cancer between January 1990 and December 2006 was conducted. The surgical procedures consisted of pancreatoduodenectomy in 46 patients, bile duct resection in 25 patients, bile duct resection

  20. Breast ductal endoscopy: how many procedures qualify?

    Directory of Open Access Journals (Sweden)

    Papalabros Alexandros

    2009-06-01

    Full Text Available Abstract Background Breast ductal endoscopy is a relatively new diagnostic method with ever growing importance in the work-up of patients with bloody nipple discharge. The ability to perform ductal endoscopy is very important and useful for breast fellows. Learning curve in breast ductal endoscopy remains a terra incognita, since no systematic studies have addressed this topic. The purpose of this study is to determine the point (number of procedures during training beyond which ductal endoscopy is successfully performed. Findings Ten breast fellows received training in our Breast Unit. For the training process, an ex vivo model was adopted. Fellows were trained on 20 surgical specimens derived from modified radical mastectomy for breast cancer. The target of the education program was to acquire proficiency in performing ductoscopy. The achievement of four consecutively successful ductal endoscopies was determined as the point beyond which proficiency had been achieved. The number of procedures needed for the achievement of proficiency as defined above ranged between 9 and 17 procedures. The median value was 13 procedures; i.e. 50% of trainees had achieved proficiency at the 13th procedure or earlier. Conclusion These pilot findings point to approximately 13 procedures as a point beyond which ductal endoscopy is successfully performed; studies on a larger number of fellows are nevertheless needed. Further research, focusing on the learning curves of different training models of ductal endoscopy, seems desirable.

  1. 乳腺浸润性导管癌钼靶X线表现与腋窝淋巴结转移及p53蛋白表达的关系%Relationship of mammography, lymph node metastasis, and p53 protein expression in infiltrating ductal breast carcinoma

    Institute of Scientific and Technical Information of China (English)

    林黎娟; 曹中良; 林贞花; 张晓燕; 张锦辉; 王研

    2011-01-01

    Objective To investigate the relationship among the mammography signs, the axillary lymph node ( LN) metastasis, and the p53 expression of infiltrating ductal breast carcinoma. Methods Mammography signs and axillary LN metastasis were analyzed in 72 cases of infiltrating ductal carcinoma. Immunohistochemistry was used to detect p53 expression in tumor specimens. The relationship among the mammography signs, the axillary LN metastasis and the p53 expression was assessed. Results The positive rate of p53 expression was 56. 7% in the patients with axillary LN metastasis, which was higher than 31.4% in the patients without axillary LN metastasis ( P < 0. 05 ). The rate of axillary LN metastasis and p53 expression were 66. 7% and 70. 0% in the tumors larger than 2 cm, 56. 4% and 66. 7% in the tumors with more vascular signs, 28. 6% and 38. 1% in the tumors less than 2 cm, 30. 3% and 33. 3% in the tumors with normal vascular signs (P <0. 01) , respectively. The rate of axillary LN metastasis in the patients with spinulation was 70. 8% , which was higher than 41.1% of patients without spinulation (P <0.05). Conclusion Mammography signs of breast cancer can evaluate the axillary LN metastasis and p53 expression, and also can provide objective reference for clinical diagnosis, treatment and prognosis of breast carcinoma.%目的 探讨乳腺浸润性导管癌X线征象与腋窝淋巴结转移、p53蛋白表达的关系.方法 观察72例浸润性导管癌的X线征象及腋窝淋巴结转移状况,应用免疫组织化学检测p53表达,分析乳腺癌X线征象与腋窝淋巴结转移、p53表达的关系.结果 淋巴结转移组p53阳性表达率56.7%,较未转移组31.4%高(P<0.05);≥2 cm组和血管增粗组p53阳性表达率、淋巴结转移率分别为66.7%、70.0%和56.4%、66.7%,均较<2 cm组28.6%、38.1%和血管正常组30.3%、33.3%高(P均<0.01);毛刺组淋巴结转移率70.8%高于无毛刺组41.7%(P<0.05).结论 乳腺癌X线征象可评

  2. Risk factor analysis of axillary lymph node metastasis in patients with breast ductal carcinoma in situ with microinvasion%乳腺导管原位癌伴微浸润发生腋窝淋巴结转移的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张琴琴; 唐军; 邱超学; 范平; 黄毓珍; 冯乐平; 杨名添

    2012-01-01

    目的探讨乳腺导管原位癌伴微浸润(breast ductal carcinoma in situ with microinvasion,DCIS-Mi)患者发生腋窝淋巴结转移的危险因素.方法 应用回顾性调查方法收集2000年1月至2008年10月可手术乳腺DCIS-Mi病例共174例,分析有无腋窝淋巴结转移患者的不同分子病理特征,并通过χ2检验、Spearman检验以及Logistic回归分析筛选腋窝淋巴结转移的危险因素.结果 174例DCIS-Mi患者中,有腋窝淋巴结转移者9例(5.17%).DCIS-Mi病灶中,DCIS级别与腋窝淋巴结转移呈正相关(r=0.262,P=0.000),激素受体状态与腋窝淋巴结转移呈负相关(r=-0.192,P=0.011).经Logistic回归分析各因素相互调整后,DCIS高级别(OR=37.191,P=0.005)和肿瘤直径≥4.0 cm(OR=29.634,P=0.023)是DCIS-Mi病灶发生转移的高危因素.结论在DCIS-Mi患者中,DCIS级别高和肿瘤直径≥4.0 cm者容易发生腋窝淋巴结转移,对此类患者进行个体化治疗是必要的.%Objective To study the risk factors of axillary lymph node metastasis in patients with breast ductal carcinoma in situ with microinvasion ( DCIS-Mi). Methods Totally 174 cases of DCIS-Mi from January 2000 to December 2008 were involved for retrospective survey. The molecular pathologic features were compared between the patients with axillary lymph node metastasis and the patients without. The risk factors of axillary lymph node metastasis were screened out by Chi-square test, Spearman test and Logistic regression analysis. Results In 174 cases of DCIS-Mi,9 (5. 17% ) cases were observed with axillary lymph node metastasis. The tumor grade of DCIS was found to be positively correlated with the risk of axillary lymph node metastasis ( r = 0. 262 , P = 0. 000 ). Patients with hormone receptor positive had decreased risk of axillary lymph node metastasis ( r = -0. 192 ,P = 0. 011). After adjusted by various factors in Logistic regression analysis, high grade and tumor diameter ≥ 4. 0 cm were the high risk factors of

  3. The Value of p63 and CK5/6 Expression in the Differential Diagnosis of Ductal Lesions of Breast

    Institute of Scientific and Technical Information of China (English)

    DING Yanping; RUAN Qiurong

    2006-01-01

    In order to explore the value of p63, smooth muscle actin (α-SMA) and cytokeratin 5/6(CK5/6) in the differential diagnosis of ductal lesions of breast, 88 tissue specimens of ductal lesions of breast were collected and examined histologically by HE staining. By using immunohistochemistry,the expression of p63, α-SMA and CK5/6 was detected. The results showed that in 38 cases of benign breast lesions, the proliferating cells were all positive for p63 and α-SMA. In 19 cases of ductal carcinoma in situ (DCIS) and 7 cases of intraductal papillary carcinoma, α-SMA positive cells formed a layer of continuous embroider-shaped structure and the p63 positive cells formed a layer of evenly separated embroider-shaped structure around the ducts. There was no cross-reaction between p63 and interstitial myofibroblasts and vascular smooth muscle cells. In 38 cases of benign breast lesions, the positive rate of CK5/6 expression was 100 %. In 5 cases of atypical ductal hyperplasia, there were few positive cells in the ducts. In 19 cases of CDIS, no tumor cells expressed CK5/6. In 19 cases of invasive ductal carcinoma, almost no CK5/6 was detectable. It was suggested that p63 could serve as a novel specific marker for the identification of breast myoepithelial cells. CK5/6 is of value in differentiating ductal proliferation of varying degrees, especially in the differentiation between cancerous and non-cancerous changes. Simultaneous detection of p63, CK5/6 and α-SMA can help increase the diagnostic accuracy of breast diseases.

  4. Squamous cell carcinoma of the pancreas with liver metastasis: a case report

    Institute of Scientific and Technical Information of China (English)

    CHEN Qiang-pu; OU Kun; GUAN Qing-hai; ZHANG Fan

    2008-01-01

    @@ Squamous cell carcinoma of the pancreas is an unusual cancer of ductal cell origin. In a review of 6668 cases of exocrine pancreatic cancer from various registries reported from 1950 through 1985, the incidence of squamous carcinoma and adenosquamous carcinoma was 0.005% and 0.01%, respectively.1 We report a case of squamous cell carcinoma of the pancreas with liver metastasis.

  5. The useful signs to differentiate ductal carcinoma in situ from papilloma showing non-mass like lesions in breast MRI%MRI非肿块样强化对乳腺导管原位癌与导管内乳头状瘤的鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    王丽君; 汪登斌; 李志; 阮玫; 柴维敏; 严福华

    2013-01-01

    目的 探讨乳腺MRI增强扫描对乳腺导管原位癌(DCIS)与导管内乳头状瘤的鉴别诊断价值.方法 回顾性分析经病理证实的MRI表现为非肿块样强化的DCIS 32例和导管内乳头状瘤33例,所有入选病例术前均行乳腺X线检查.分析2种病变的MRI和X线表现.结果 (1) 在MRI上,15例(46.9%)DCIS和 30例(90.9% )导管内乳头状瘤病例出现结节样强化(P=0.000).其中成簇分布结节多见于 DCIS (73.3%),散在分布结节多见于导管内乳头状瘤(93.3%).导管内乳头状瘤组伴导管扩张者占84.8%,高于DCIS组(34.4%)(P=0.000).DCIS组多出现成簇小环状强化(68.8%,P=0.000),节段性分布(46.9%,P=0.000),而导管内乳头状瘤组多表现为导管样强化(84.8%,P=0.000).(2)在X线上,78.1% 的 DCIS病例和24.2%的导管内乳头状瘤病例可见阳性表现.DCIS组伴微小钙化多于导管内乳头状瘤组,2组分别占92.0%和 12.5%.结论 DCIS与导管内乳头状瘤在MRI强化上各具有一定的特征性表现,有助于两者的鉴别诊断.%Objective To investigate the value of contrast-enhanced MR imaging in differential diagnosis of ductal carcinoma in si-tu(DCIS) and papilloma of the breast. Methods In total,32 cases of DCIS and 33 cases of papilloma showing non-mass like enhancement at contrast-enhanced MR imaging(CE MRI) confirmed by surgicopathology, were retrospectively reviewed. All cases underwent X-ray examination of the breast prcopcration. Both MR imaging and mammographical findings were assessed. Results ( 1 )At CK MRI, nodule-like enhancement in 15 cascs(46. 9%) of DCIS and 30 cases (90. 9%) of papilloma was found (P = 0. 000). Of which, clustered nodules were mostly found in DCIS (73.3%) while scattered nodules were mostly found in papilloma( 93. 3 % ). The presence of dilated duct was found in 84. 8% of papilloma and in only 34. 4 % of DCIS (P = 0. 000). DCIS showed clustered ring enhancement (68.8%, P = 0.000) and scgmcntal enhancement (46.9%, P = 0.000) more

  6. Peroral cholangioscopy for non-invasive papillary cholangiocarcinoma with extensive superficial ductal spread

    Institute of Scientific and Technical Information of China (English)

    Toshifumi Wakai; Yoshio Shirai; Katsuyoshi Hatakeyama

    2005-01-01

    Papillary carcinoma arising from the extrahepatic bile duct often shows superficial ductal spread. We report herein the case of a patient with extensive superficial spread of non-invasive papillary cholangiocarcinoma,which was depicted with peroral cholangioscopy. A 65-year-old woman presented with the sudden-onset of severe epigastric pain. Ultrasonography revealed acute acalculous cholecystitis. Endoscopic retrograde cholangiography found small protruding lesions around the confluence of the cystic duct, suggestive of a cholangiocarcinoma. As the contour of the middle and upper bile ducts it was slightly irregular on the cholangiogram, the presence of superficial ductal spread was suspected. Peroral cholangioscopy revealed small papillary lesions around the confluence of the cystic duct and fine granular mucosal lesions in the middle and upper bile ducts and the right hepatic duct, suggesting a superficially spreading tumor. A right hepatectomy with bile duct resection was performed and no residual tumor was found. Histological examination revealed a non-invasive papillary carcinoma arising from the cystic duct with extensive superficial spread. Our experience of this case and a review of the literature suggest that a fine granular or fine papillary appearance of the ductal mucosae on cholangioscopy indicates superficial spread of papillary cholangiocarcinoma, for which peroral cholangioscopy is an efficient diagnostic option.

  7. Ductal adenoma of the breast: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Oh, Ki Keun; Lee, Kyong Sik; Lee, Hyun Hee [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-11-01

    Ductal adenoma of the breast is an uncommon benign tumor consisting of an adenomatous nodule within the ductal lumen; on both clinical and histologic examination, it may simulate malignancy. We report a case of ductal adenoma of the breast, and the related mammographic and sonographic findings.

  8. Solitary breast papilloma: Comparison of galactographic and ductal echographic features

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Nariya; Oh, Ki Keun; Nam, Ji Eun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2001-12-15

    To compare the galactographic and ductal echographic features of solitary breast papilloma and to determine the role of the ductal echography. Twenty patients with pathologically proven solitary intraductal papilloma were included, and galactography and ductal echography were available in all patients. Galactograms were assessed for the presence of filling defect, obstructed duct and location of lesion. Ductal echograms were assessed for the presence of mass, dilated duct, location of the mass and Kamio type. All ductal echograms and galactograms were reviewed, and the detectability of lesion was evaluated. The detectability of lesion on galactography was 18/20 (90%) and 17/20 (85%) on ductal echography, respectively. There were three cases of Kamio type Ia, fourteen cases of Ib, two cases of Ic and one case of IIb. In four cases with multiple filling defects detected on galactograms, three cases showed single or no lesion on ductal echograms. Two cases without a definite filling defect on galactograms showed a small mass on ductal echograms. In addition, when the proximal duct was completely obstructed, the distal ductal system could be visualized on ductal echogram. Ductal echography showed a similar detectability of intraductal papilloma as galactography, but ductal echography can be complementary to galactography for the diagnosis of the papilloma.

  9. Acinar-to-ductal metaplasia accompanies c-myc-induced exocrine pancreatic cancer progression in transgenic rodents.

    Science.gov (United States)

    Grippo, Paul J; Sandgren, Eric P

    2012-09-01

    Several important characteristics of exocrine pancreatic tumor pathogenesis remain incompletely defined, including identification of the cell of origin. Most human pancreatic neoplasms are ductal adenocarcinomas. However, acinar cells have been proposed as the source of some ductal neoplasms through a process of acinar-to-ductal metaplasia. The oncogenic transcription factor c-myc is associated with human pancreatic neoplasms. Transgenic mice overexpressing c-myc under control of acinar cell-specific elastase (Ela) gene regulatory elements not only develop acinar cell carcinomas but also mixed neoplasms that display both acinar-like neoplastic cells and duct-like neoplastic cells. In this report, we demonstrate that, first, c-myc is sufficient to induce acinar hyperplasia, though neoplastic lesions develop focally. Second, cell proliferation remains elevated in the neoplastic duct cell compartment of mixed neoplasms. Third, the proliferation/apoptosis ratio in cells from all lesion types remains constant, suggesting that differential regulation of these processes is not a feature of cancer progression in this model. Fourth, before the development of mixed neoplasms, there is transcriptional activation of the duct cell-specific cytokeratin-19 gene promoter in multicellular foci of amylase-positive acinar neoplasms. This observation provides direct evidence for metaplasia as the mechanism underlying development of ductal neoplastic cells within the context of an acinar neoplasm and suggests that the stimulus for this transformation acts over a multicellular domain or field within a neoplasm. Finally, focal ductal elements develop in some acinar cell carcinomas in Ela-c-myc transgenic rats, indicating that myc-associated acinar-to-ductal metaplasia is not restricted to the mouse.

  10. 钙化与非钙化乳腺导管原位癌的影像表现及病理特点%Imaging and Histopathological Characteristics of Calcified and Non-calcified Ductal Carcinoma in Situ of Mam-mary Glands

    Institute of Scientific and Technical Information of China (English)

    吴朋; 郭宏兵; 李勇; 许克宁

    2015-01-01

    Objective To compare histopathological characteristics of calcified and non-calcified ductal carcino-ma in situ ( DCIS) of mammary glands by mammography, ultrasound and magnetic resonance imaging ( MRI) . Methods The study involved 212 DCIS patients (217 sites) admitted during April 2009 and December 2013. The patients were divided into calcified and non-calcified DCIS groups according to the calcifications by mammography. The imagings were observed by two physicians using each method to carefully record tumorous shape, size, density/echo/signal features, borderline, boundary, calcified shape, surrounding tissue formation and so on. The histopathological features of the le-sions were obtained from medical records. Results Mammography showed 49. 3% of non-calcified DCIS patients with a false-negative finding, and 100% of calcified patients with DCIS, in which 68. 5% of calcified lesions were calcification alone. Ultrasound showed that all non-calcified DCIS were massive with 100% incidence rate, while the incidence rate of calcified DCIS was 61. 6%. The MRI showed that incidence rates of non-calcified and calcified DCIS were 65. 0% and 51. 7% respectively, but there were no significant differences in MRI features between the two groups (P>0. 05). His-topathology showed that high nuclear grade, necrosis, positive progesterone receptor and HER-2 were more common in the calcified DCIS patients compared with those in the non-calcified DCIS patients (P=0. 017, P0. 05). 病理组织学显示高级别、坏死、孕酮受体阳性、HER-2在钙化DCIS比非钙化DCIS更为常见(分别为P=0. 017、P<0. 001,P=0. 027,P<0. 001). 乳腺X线摄影、超声、MRI表现测量钙化与非钙化 DCIS直径大小与病理测定直径大小的 ICC值分别为:0. 625,0. 705;0. 801,0. 552;0. 760, 0. 767. 结论 钙化与非钙化DCIS在乳腺X线摄影、超声、MRI呈不同表现,乳腺X线摄影对钙化DCIS敏感性较高,超声对非钙化敏感性较高,MRI对检出钙化与非钙化DCIS均有较高敏感性.

  11. Tumor antigens as proteogenomic biomarkers in invasive ductal carcinomas

    DEFF Research Database (Denmark)

    Olsen, Lars Rønn; Campos, Benito; Winther, Ole;

    2014-01-01

    found to be perturbed. Conclusion: Tumor antigens are a group of proteins recognized by the cells of the immune system. Specifically, they are recognized in tumor cells where they are present in larger than usual amounts, or are physiochemically altered to a degree at which they no longer resemble...

  12. Treatment Options for Ductal Carcinoma In Situ (DCIS)

    Science.gov (United States)

    ... trials is available from the NCI website . Locally Advanced or Inflammatory Breast Cancer Treatment of locally advanced ... NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an ...

  13. Tumor antigens as proteogenomic biomarkers in invasive ductal carcinomas

    DEFF Research Database (Denmark)

    Olsen, Lars Rønn; Campos, Benito; Winther, Ole;

    2014-01-01

    Background: The majority of genetic biomarkers for human cancers are defined by statistical screening of high-throughput genomics data. While a large number of genetic biomarkers have been proposed for diagnostic and prognostic applications, only a small number have been applied in the clinic. Si...

  14. 乳腺浸润性导管癌中 SATB1和 BRMS1的表达及与淋巴转移的相关性%The expression of SATB1 and BRMS1 in breast invasive ductal carcinoma and their correlations with lymphatic ;metastasis

    Institute of Scientific and Technical Information of China (English)

    张英; 陈丽娟; 刘永源

    2015-01-01

    Objective To investigate the expression of SATB 1 and BRMS1 in the tissue of the primary breast in-vasive ductal carcinoma ( IDC) , axillary nodes metastases and the normal breast tissues adjacent to carcinoma ;thus to an-alyze the correlation between SATB1 and clinicopathologic parameters , and the correlation between SATB1 and BRMS1. Methods The mRNA and proteins levees of SATB1 and BRMS1 in 51 samples of IDC tissues,17 samples of axillary nodes metastases tissues and 32 samples of the normal breast tissues adjacent to carcinoma tissues were detected by quanti -tative reverse transcription-polymerase chain reaction ( qRT-PCR) and immunohistochemical SP .Results The positive rates of SATB1 in IDC tissues and axillary nodes metastases tissues were 76.47%and 82.35%, respectively;significantly higher than that (28.12%) in the normal breast tissues adjacent to carcinoma (P0.05) .There were significant differences in SATB 1 protein and mRNA and BRMS1 mRNA between the group of IDC with lymph node metastasis and the group of IDC without lymph node metastasis ( P0.05).Conclusion The altered ex-pression of SATB1 and BRMS1 in IDC is correlated with the pathogenesis and lymph node metastasis , suggesting potential value in predicting lymph node metastasis of IDC .%目的:探讨核基质结合区结合蛋白-1(SATB1)及乳腺癌转移抑制基因1(BRMS1)在乳腺浸润性导管癌( IDC)原发灶、腋窝淋巴结转移灶中的表达,分析SATB1与临床病理参数的关系及两者表达的相关性。方法采用免疫组化SP法及qRT-PCR检测51例乳腺IDC组织、17例对应腋窝淋巴结转移灶组织、32例配对癌旁乳腺组织中SATB1、BRMS1蛋白及mRNA的表达情况。结果在原发灶组织、腋窝淋巴结转移灶组织SATB1阳性表达率分别是76.47%、82.35%,均高于癌旁组织的28.12%( P <0.05);BRMS1蛋白的表达率分别是25.49%、23.53%,均低于于癌旁组织的87.50%( P<0.05);在原

  15. Molecular pathology of breast apocrine carcinomas

    DEFF Research Database (Denmark)

    Celis, J.E.; Gromova, I.; Gromov, P.;

    2006-01-01

    Breast cancer is a heterogeneous disease that encompasses a wide range of histopathological types including: invasive ductal carcinoma, lobular carcinoma, medullary carcinoma, mucinous carcinoma, tubular carcinoma, and apocrine carcinoma among others. Pure apocrine carcinomas represent about 0...... benign apocrine changes and breast carcinoma is unclear and has been a matter of discussion for many years. Recent proteome expression profiling studies of breast apocrine macrocysts, normal breast tissue, and breast tumours have identified specific apocrine biomarkers [15-hydroxyprostaglandin...... dehydrogenase (15-PGDH) and hydroxymethylglutaryl coenzyme A reductase (HMG-CoA reductase)] present in early and advanced apocrine lesions. These biomarkers in combination with proteins found to be characteristically upregulated in pure apocrine carcinomas (psoriasin, S100A9, and p53) provide a protein...

  16. Geometric Hysteresis of Alveolated Ductal Architecture

    OpenAIRE

    Kojic, M.; Butler, J. P.; Vlastelica, I.; B. Stojanovic; Rankovic, V.; Tsuda, A.

    2011-01-01

    Low Reynolds number airflow in the pulmonary acinus and aerosol particle kinetics therein are significantly conditioned by the nature of the tidal motion of alveolar duct geometry. At least two components of the ductal structure are known to exhibit stress-strain hysteresis: smooth muscle within the alveolar entrance rings, and surfactant at the air-tissue interface. We hypothesize that the geometric hysteresis of the alveolar duct is largely determined by the interaction of th...

  17. Invasive lobular carcinoma of the breast with extracellular mucin: A case report

    Directory of Open Access Journals (Sweden)

    G.S. Gómez Macías

    2016-01-01

    Conclusion: It is important to know that extracellular mucin production is not exclusive of ductal lesions and keep in mind the lobular carcinomas with extracellular mucin as a differential diagnosis.

  18. Tumor-infiltrating CD4+ T lymphocytes in early breast cancer reflect lymph node involvement Linfócitos T CD4+ tumor infiltrantes no câncer de mama inicial refletem envolvimento linfonodal

    Directory of Open Access Journals (Sweden)

    Alexandre Henrique Macchetti

    2006-06-01

    Full Text Available BACKGROUND: The role of immune system in the pathogenesis and progression of breast cancer is a subject of controversy, and this stimulated us to investigate the association of the immunophenotype of tumor-infiltrating lymphocytes in early breast cancer with the spread of tumor cells to axillary lymph nodes. METHODS: Tumor samples from 23 patients with early breast cancer from the Department of Gynecology and Obstetrics of Ribeirão Preto Medical School (USP were obtained at the time of biopsy and submitted to an enzyme-digestion procedure for the extraction of tumor-infiltrating lymphocytes. The lymphocytes extracted were analyzed by dual-color flow cytometry with monoclonal antibodies in these combinations: CD3 FITC/CD19 PE, CD3 FITC/CD4 PE, CD3 FITC/CD8 PE, and CD16/56 PerCP, which are specific for immunophenotyping of T and B lymphocytes, helper and cytotoxic T lymphocytes, and natural killer (NK cells. The mean percentage of these cells was used for comparing groups of patients with or without lymph node metastasis. RESULTS: The mean value for T-lymphocyte infiltration was 24.72 ± 17.37%; for B-lymphocyte infiltration, 4.22 ± 6.27%; for NK-cell infiltration, 4.41 ± 5.22%, and for CD4+ and CD8+ T-lymphocyte infiltration, 12.43 ± 10.12% and 11.30 ± 15.09%, respectively. Only mean values of T- and CD4+ T-lymphocyte infiltration were higher in the group of patients with lymph node metastasis, while no differences were noted in the other lymphocyte subpopulations. CONCLUSION: The association of tumor-infiltrating CD4+ T lymphocytes with lymph node metastasis suggests a role for these cells in the spread of neoplasia to lymph nodes in patients with early breast cancer.INTRODUÇÃO: O papel do sistema imunológico na patogênese e progressão do câncer de mama ainda é controverso, e isto nos estimulou a verificar a associação do imunofenótipo dos linfócitos tumor infiltrantes do câncer de mama inicial com a disseminação de c

  19. Diffuse pancreatic ductal adenocarcinoma: Characteristic imaging features

    International Nuclear Information System (INIS)

    Purpose: To evaluate imaging findings of diffuse pancreatic ductal adenocarcinoma. Materials and methods: We included 14 patients (4 men and 10 women; mean age, 64.5 years) with diffuse pancreatic ductal adenocarcinoma on the basis of retrospective radiological review. Two radiologists retrospectively reviewed 14 CT scans in consensus with respect to the following: tumor site, peripheral capsule-like structure, dilatation of intratumoral pancreatic duct, parenchymal atrophy, and ancillary findings. Eight magnetic resonance (MR) examinations with MR cholangiopancreatography (MRCP) and seven endoscopic retrograde cholangiopancreatography (ERCP) were also reviewed, focusing on peripheral capsule-like structure and dilatation of intratumoral pancreatic duct. Results: CT revealed tumor localization to the body and tail in 11 (79%) patients and peripheral capsule-like structure in 13 (93%). The intratumoral pancreatic duct was not visible in 13 (93%). Pancreatic parenchymal atrophy was not present in all 14 patients. Tumor invasion of vessels was observed in all 14 patients and of neighbor organs in 8 (57%). On contrast-enhanced T1-weighted MR images, peripheral capsule-like structure showed higher signal intensity in five patients (71%). In all 11 patients with MRCP and/or ERCP, the intratumoral pancreatic duct was not dilated. Conclusion: Diffuse pancreatic ductal adenocarcinoma has characteristic imaging findings, including peripheral capsule-like structure, local invasiveness, and absence of both dilatation of intratumoral pancreatic duct and parenchymal atrophy

  20. Antidiabetic thiazolidinediones induce ductal differentiation but not apoptosis in pancreatic cancer cells

    Institute of Scientific and Technical Information of China (English)

    Elisabetta Ceni; Tommaso Mello; Mirko Tarocchi; David W Crabb; Anna Caldini; Pietro Invernizzi; Calogero Surrenti; Stefano Milani; Andrea Galli

    2005-01-01

    AIM: Thiazolidinediones (TZD) are a new class of oral antidiabetic drugs that have been shown to inhibit growth of same epithelial cancer cells. Although TZD were found to be ligands for peroxisome proliferator-activated receptor γ (PPARγ), the mechanism by which TZD exert their anticancer effect is presently unclear. In this study,we analyzed the mechanism by which TZD inhibit growth of human pancreatic carcinoma cell lines in order to evaluate the potential therapeutic use of these drugs in pancreatic adenocarcinoma.METHODS: The effects of TZD in pancreatic cancer cells were assessed in anchorage-independent growth assay.Expression of PPARγ was measured by reverse-transcription polymerase chain reaction and confirmed by Western blot analysis. PPARγ activity was evaluated by transient reporter gene assay. Flow cytometry and DNA fragmentationassay were used to determine the effect of TZD on cell cycle progression and apoptosis respectively. The effect of TZD on ductal differentiation markers was performed by Western blot.RESULTS: Exposure to TZD inhibited colony formation in a PPARγ-dependent manner. Growth inhibition was linked to G1 phase cell cycle arrest through induction of the ductal differentiation program without any increase of the apoptotic rate.CONCLUSION: TZD treatment in pancreatic cancer cells has potent inhibitory effects on growth by a PPAR-dependent induction of pacreatic ductal differentiation.

  1. PROGNOSTIC SIGNIFICANCE OF MIBl PROLIFERATION MARKER EXPRESSION ON DUCTAL CARCINOMA IN SITU AND INVASIVE DUCTAL CARCINOMA OF THE BREAST

    Institute of Scientific and Technical Information of China (English)

    张伟; 于颖彦

    2000-01-01

    feSUm6 Objectif Pour dsterminer la signification Prormtique de i' exprendon de Proliferation refor MIBI sur carcinome canaliculaire in situ (DCIS) et corcinome conaliculaire inwisif (IDC) du akin. met~ A l' aids de techniques histologique et immunohistochimique, l' indice etiquettaire MIBI (MIBI LI), a ate ddtennirk sur 31 tissus potholedques (DCIS 6et lie 22 et des 3 mastopothies benignes comma control). Anultats L' expression dlevde (P< 0. 05) a ate trouvde dans destissus canCdreux dont MIBI LI a eu un ra...

  2. p-ezrin和p-p38在乳腺浸润性导管癌中的表达及临床意义%The expressions and significant of p-ezrin and p-p38 in breast invasive ductal carcinoma

    Institute of Scientific and Technical Information of China (English)

    刘树立; 刘楠; 曹红一; 宋敏

    2011-01-01

    Objective To examine the expressions of p-ezrin and p-p38 in breast invasive ductal carcinomas (IDC), and analyze its relationship and significant with the metastasis of breast cancer. Methods The expressions of p-ezrin and p-p38 were examined using immunohistochemistry S-P method in 80 IDC tissues. Results The abnormal high expression of p-ezrin was found in 7 cases of 33 IDC tissues without metastasis (21.2% ) and in 27 cases of 47 IDC tissues with metastasis (57.4%). The abnormal high expression of p-p38 was found in 15 cases of IDC without metastasis (45.5%) and in 34 cases of IDC with metastasis (72.3%). The abnormal expressions of p-ezrin and p-p38 were positively correlated with each other (r= 0.269, P = 0.016).Conclusion p-ezrin and p-p38 are correlate with the invasion and metastasis of IDCs and might be important markers of lymph node metastasis of IDCs.%目的 Ezrin是细胞膜与细胞骨架连接蛋白,参与肿瘤细胞的侵袭和转移.本研究通过检测p-ezrin和p-p38在乳腺浸润性导管癌中的表达情况,探讨其与乳腺癌转移的关系和意义.方法 采用免疫组织化学SP法检测80例乳腺浸润性导管癌组织切片中p-ezrin和p-p38的表达.结果 p-ezrin在33例无转移的癌组织中7例异常高表达(21.2%),47例有转移的癌组织中27例异常高表达(57.4%).p-p38在无转移的癌组织中15例异常高表达(45.5%),而在有转移的癌组织中34例异常高表达(72.3%).p-ezrin异常表达与p-p38异常表达正相关性(r = 0.269,P = 0.016).结论 p-ezrin和p-p38与乳腺导管癌的浸润和转移密切相关,可以作为预测浸润性乳腺导管癌淋巴结转移的重要肿瘤标志物.

  3. Ductal adenocarcinoma of the prostate: histogenesis, biology and clinicopathological features.

    Science.gov (United States)

    Seipel, Amanda H; Delahunt, Brett; Samaratunga, Hemamali; Egevad, Lars

    2016-08-01

    Ductal adenocarcinoma of the prostate (DAC) is recognised as a subtype of prostatic adenocarcinoma, but its diagnostic criteria and biology remain controversial. DAC was first thought to stem from Müllerian duct remnants, but further studies suggest a prostatic origin. DAC is composed of tall, columnar, pseudostratified epithelium with a papillary, cribriform, glandular or solid architecture. The diagnosis is based on morphology alone with papillary architecture being the most helpful diagnostic feature. The tumour is rare in a pure form and most cases are combined with acinar adenocarcinoma. The most common differential diagnoses of DAC are intraductal carcinoma of the prostate and high-grade prostatic intraepithelial neoplasia. Patients often present at an advanced clinicopathological stage. High rates of extra-prostatic extension, seminal vesicle invasion, local and regional metastases, and positive surgical margins are seen after radical prostatectomy. DAC metastasises to sites that are less commonly seen for prostate cancer such as lung, brain, testis and penis. The morphology and the unusual metastatic locations make the accurate diagnosis of metastases challenging, but a positive immunostain for prostate specific markers may be helpful. The correct identification of DAC has implications for treatment as well as outcome. PMID:27321992

  4. Imaging features of ductal plate malformations in adults

    Energy Technology Data Exchange (ETDEWEB)

    Venkatanarasimha, N., E-mail: nandashettykv@yahoo.com [Department of Radiology, Derriford Hospital, Plymouth (United Kingdom); Thomas, R.; Armstrong, E.M.; Shirley, J.F.; Fox, B.M.; Jackson, S.A. [Department of Radiology, Derriford Hospital, Plymouth (United Kingdom)

    2011-11-15

    Ductal plate malformations, also known as fibrocystic liver diseases, are a group of congenital disorders resulting from abnormal embryogenesis of the biliary ductal system. The abnormalities include choledochal cyst, Caroli's disease and Caroli's syndrome, adult autosomal dominant polycystic liver disease, and biliary hamartoma. The hepatic lesions can be associated with renal anomalies such as autosomal recessive polycystic kidney disease (ARPKD), medullary sponge kidney, and nephronophthisis. A clear knowledge of the embryology and pathogenesis of the ductal plate is central to the understanding of the characteristic imaging appearances of these complex disorders. Accurate diagnosis of ductal plate malformations is important to direct appropriate clinical management and prevent misdiagnosis.

  5. Pancreatic ductal bicarbonate secretion: challenge of the acinar acid load

    Directory of Open Access Journals (Sweden)

    Peter eHegyi

    2011-07-01

    Full Text Available Acinar and ductal cells of the exocrine pancreas form a close functional unit. Although most studies contain data either on acinar or ductal cells, an increasing number of evidence highlights the importance of the pancreatic acinar-ductal functional unit. One of the best examples for this functional unit is the regulation of luminal pH by both cell types. Protons co-released during exocytosis from acini cause significant acidosis, whereas, bicarbonate secreted by ductal cells cause alkalization in the lumen. This suggests that the first and probably one of the most important role of bicarbonate secretion by pancreatic ductal cells is not only to neutralize the acid chyme entering into the duodenum from the stomach, but to neutralize acidic content secreted by acinar cells. To accomplish this role, it is more than likely that ductal cells have physiological sensing mechanisms which would allow them to regulate luminal pH. To date, four different classes of acid-sensing ion channels have been identified in the gastrointestinal tract (transient receptor potential ion channels, two-pore domain potassium channel, ionotropic purinoceptor and acid-sensing ion channel, however, none of these have been studied in pancreatic ductal cells. In this mini-review, we summarize our current knowledge of these channels and urge scientists to characterize ductal acid-sensing mechanisms and also to investigate the challenge of the acinar acid load on ductal cells.

  6. Pancreatic mucinous noncystic (colloid) carcinomas and intraductal papillary mucinous carcinomas are usually microsatellite stable.

    Science.gov (United States)

    Lüttges, Jutta; Beyser, Kurt; Pust, Susanne; Paulus, Anja; Rüschoff, Josef; Klöppel, Günter

    2003-06-01

    Pancreatic mucinous noncystic (colloid) carcinomas (MNCC) differ from the usual ductal adenocarcinomas in their mucin expression profile and share with many extrapancreatic mucinous carcinomas the expression of MUC2. Because mucinous carcinomas are frequently associated with mutations of the DNA mismatch repair genes, causing them to exhibit the so-called mutator phenotype, we decided to investigate whether MNCCs of the pancreas are characterized by microsatellite instability (MSI). Twelve carcinomas with a mucinous phenotype (8 mucinous noncystic carcinomas, 3 intraductal papillary-mucinous carcinomas with an invasive muconodular component, and 1 ductal adenocarcinoma with an extensive mucinous noncystic component) and 11 ductal adenocarcinomas were immunostained with monoclonal antibodies to the mismatch repair gene products hMLH1, hMSH2, and hMSH6. For MSI analysis, DNA was isolated from microdissected tissue, and five primary microsatellites (BAT 25, BAT 26, D5S346, D17S250, and D2S123) were analyzed. MSI was diagnosed in case a novel allele was found, compared with the normal tissue. The criterion for LOH was a 75% signal reduction. All carcinomas tested exhibited nuclear expression of mismatch repair gene products, except for one MNCC that also showed MSI at the molecular level. The data suggest that pancreatic carcinomas with a mucinous phenotype (MUC2+/MUC1-) do not appear to normally exhibit mutations in the mismatch repair genes and therefore differ in their carcinogenesis from those in other organs.

  7. Geometric hysteresis of alveolated ductal architecture.

    Science.gov (United States)

    Kojic, M; Butler, J P; Vlastelica, I; Stojanovic, B; Rankovic, V; Tsuda, A

    2011-11-01

    Low Reynolds number airflow in the pulmonary acinus and aerosol particle kinetics therein are significantly conditioned by the nature of the tidal motion of alveolar duct geometry. At least two components of the ductal structure are known to exhibit stress-strain hysteresis: smooth muscle within the alveolar entrance rings, and surfactant at the air-tissue interface. We hypothesize that the geometric hysteresis of the alveolar duct is largely determined by the interaction of the amount of smooth muscle and connective tissue in ductal rings, septal tissue properties, and surface tension-surface area characteristics of surfactant. To test this hypothesis, we have extended the well-known structural model of the alveolar duct by Wilson and Bachofen (1982, "A Model for Mechanical Structure of the Alveolar Duct," J. Appl. Physiol. 52(4), pp. 1064-1070) by adding realistic elastic and hysteretic properties of (1) the alveolar entrance ring, (2) septal tissue, and (3) surfactant. With realistic values for tissue and surface properties, we conclude that: (1) there is a significant, and underappreciated, amount of geometric hysteresis in alveolar ductal architecture; and (2) the contribution of smooth muscle and surfactant to geometric hysteresis are of opposite senses, tending toward cancellation. Quantitatively, the geometric hysteresis found experimentally by Miki et al. (1993, "Geometric Hysteresis in Pulmonary Surface-to-Volume Ratio during Tidal Breathing," J. Appl. Physiol. 75(4), pp. 1630-1636) is consistent with little or no smooth muscle tone in anesthetized rabbits in control conditions, and with substantial smooth muscle activation following methacholine challenge. The observed local hysteretic boundary motion of the acinar duct would result in irreversible acinar flow fields, which might be important mechanistic contributors to aerosol mixing and deposition deep in the lung. PMID:22168737

  8. PANCREATIC CARCINOMA: REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Veena Kumari

    2015-05-01

    Full Text Available It is well known that the prognosis of pancreatic cancer is extremely poor, even when treated with radical surgery. The overall 5 year survival rate following surgical intervention is around 10%.With the increasing use of CT scans for other reasons not related to pancreas, a variety of neoplastic and non - neoplastic lesions are increasingly encountered in clinical practice. The distinction of these lesions has significant therapeutic and prognostic implications. Regarding ductal carcinoma, key distinguishing features from chronic pancreatitis and a discussion of the concept of pancreatic intraepithelial neoplasia ( PanIN are included. Precursors, mo lecular carcinogenesis, risk factors and different morphological patterns of tumors arising from exocrine pancreas are discussed. Research on early detection is ongoing. Screening of people with a family history of hereditary pancreatitis plays an importan t role in the early detection of ductal carcinoma of pancreas.

  9. Intracystic papillary carcinoma in a male as a rare presentation of breast cancer: a case report and literature review.

    LENUS (Irish Health Repository)

    Romics, Laszlo

    2009-01-01

    The term "intracystic papillary ductal carcinoma in situ" has recently changed and is now more appropriately referred to "intracystic papillary carcinoma". Intracystic papillary carcinoma in men is an extremely rare disease with only a few case presentations published in the literature so far.

  10. Identification of genes with altered expression in medullary breast cancer vs. ductal breast cancer and normal breast epithelia

    DEFF Research Database (Denmark)

    Gjerstorff, Morten; Benoit, Vivian; Laenkholm, Anne-Vibeke;

    2006-01-01

    Medullary breast cancer (MCB) is a morphologically and biologically distinct subtype that, despite cytologically highly malignant characteristics, has a favorable prognosis compared to the more common infiltrating ductal breast carcinoma. MCB metastasizes less frequently, which has been attributed...... to both immunological and endogenous cellular factors, although little is known about the distinct biology of MCB that may contribute to the improved outcome of MCB patients. To identify candidate genes, we performed gene array expression analysis of cell lines of MCB, ductal breast cancer and normal...... breast epithelia, and the differential expression of a panel of candidate genes was further validated by quantitative PCR and immunohistochemical analysis of cell lines and tumor biopsies. A limited number of genes, including several members of the GAGE and insulin growth factor binding protein (IGFBP...

  11. Identification of genes with altered expression in medullary breast cancer vs. ductal breast cancer and normal breast epithelia

    DEFF Research Database (Denmark)

    Gjerstorff, Morten F; Benoit, Vivian M; Laenkholm, Anne-Vibeke;

    2006-01-01

    to both immunological and endogenous cellular factors, although little is known about the distinct biology of MCB that may contribute to the improved outcome of MCB patients. To identify candidate genes, we performed gene array expression analysis of cell lines of MCB, ductal breast cancer and normal......Medullary breast cancer (MCB) is a morphologically and biologically distinct subtype that, despite cytologically highly malignant characteristics, has a favorable prognosis compared to the more common infiltrating ductal breast carcinoma. MCB metastasizes less frequently, which has been attributed...... breast epithelia, and the differential expression of a panel of candidate genes was further validated by quantitative PCR and immunohistochemical analysis of cell lines and tumor biopsies. A limited number of genes, including several members of the GAGE and insulin growth factor binding protein (IGFBP...

  12. Expression of Ki-67, p53, and K-ras in chronic pancreatitis and pancreatic ductal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Seok Jeong; Young Bae Kim; Don Haeng Lee; Jung Il Lee; Jin-Woo Lee; Kye Sook Kwon; Pum-Soo Kim; Hyung Gil Kim; Yong Woon Shin; Young Soo Kim

    2005-01-01

    AIM: To examine surgical specimens of pancreas with either chronic pancreatitis or pancreatic cancer in order to study whether ductal hyperplasia and dysplasia in pancreas represent precursor lesions for pancreatic cancer.METHODS: We examined expression of Ki-67, CEA,p53, and K-ras, in the surgical specimens of pancreas with adenocarcinomas (n = 11) and chronic pancreatitis (n = 12). Cellular proliferation was assessed by Ki-67proliferation index using the proliferation marker Ki-67.In specimens with pancreas cancer, we divided pancreas epithelium into normal (n=7), ductal hyperplasia (n=3), dysplasia (n=4), and cancerous lesion (n=11) after hematoxylin and eosin staining, Ki-67, and CEA immunohistochemical staining. In cases with chronic pancreatitis, the specimen was pathologically examined as in cases with pancreas cancer, and they were also determined as normal (n=10), ductal hyperplasia (n=4), or dysplasia (n= 5). p53 and K-ras expression were also studied by immunohistochemical staining.RESULTS: In pancreatic cancer, the Ki-67 index was 3.73±3.58 in normal site, 6.62±4.39 in ductalhyperplasia, 13.47±4.02 in dysplasia and 37.03±10.05in cancer tissue, respectively. Overall, p53 was positive in normal ducts, ductal hyperplasia, dysplasia, and carcinoma cells in 0 of 14 (0%), 0 of 7 (0%), 7 of 9 (78%),and 10 of 11 (91%), respectively, and K-ras was positive in 0 of 8 (0%), 1 of 3 (33%), 4 of 6 (67%), 4 of 5 (80%),respectively.CONCLUSION: Our results favorably support the hypothesis that ductal hyperplasia and dysplasia of the pancreas might be precursor lesions for pancreas cancer.Further evaluation of oncogenes by the molecular study is needed.

  13. 乳腺导管原位癌患者生活质量调查及相关因素分析%Survey of quality of life for patients with breast ductal carcinoma in situ and analysis of related factors

    Institute of Scientific and Technical Information of China (English)

    蒋蓓琦; 傅韵; 武弈; 成小林; 李正东; 庄志刚

    2013-01-01

    Objective To study the quality of life (QOL) of patients with ductal carcinoma in situ (DCIS) and to analyze the relevant factors affecting their QOL.Methods A total of 84 patients with DCIS and 125 patients with invasive breast cancer were surveyed.Researchers used SF-36 to assess the QOL of participants at one year after operation.The relationships between some information of patients and SF-36 score were analyzed,such as age,the type of surgery,endocrine therapy,education,marital status,working status and health insurance.Results Compared to normal women,patients with DCIS had lower QOL in physical function (t =2.468,P =0.029),bodily pain (t =2.076,P =0.039),general health (t =2.153,P =0.033) and mental health (t =3.396,P =0.003).Patients with invasive breast cancer also had poorer QOL in physical function (t =5.638,P =0.002),bodily pain (t =5.417,P =0.002),vitality (t =4.438,P =0.002),general health (t =3.960,P =0.002) and mental health (t =6.020,P =0.001).QOL of DCIS patients was similar to that of invasive breast cancer patients,except that scores of physical function (t =2.714,P =0.032) and vitality (t =2.134,P =0.040) were better in DCIS patients.Endocrine therapy significantly affected the score of QOL of DCIS patients.DCIS patients with endocrine therapy had poorer score in physical function (t =2.082,P < 0.05),bodily pain (t =2.003,P < 0.05),general health (t =2.751,P <0.05),vitality (t =2.048,P < 0.05) and mental health (t =4.162,P < 0.05).Conclusion Patients with DCIS have poor QOL at one year after operation.Endocrine therapy significantly reduces their QOL.%目的 调查乳腺导管原位癌(DCIS)患者生活质量(QOL),分析其相关影响因素.方法 采用36条目简明量表(SF-36),对术后1年的84例DCIS患者、125例浸润性乳腺癌患者进行QOL评估,分析年龄、手术方式、内分泌治疗、学历、婚姻状况、工作状态、医疗保险对患者QOL的影响.结果 与正常女性相比,术后1

  14. Targeting Pancreatic Ductal Adenocarcinoma Acidic Microenvironment

    Science.gov (United States)

    Cruz-Monserrate, Zobeida; Roland, Christina L.; Deng, Defeng; Arumugam, Thiruvengadam; Moshnikova, Anna; Andreev, Oleg A.; Reshetnyak, Yana K.; Logsdon, Craig D.

    2014-03-01

    Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death in the USA, accounting for ~40,000 deaths annually. The dismal prognosis for PDAC is largely due to its late diagnosis. Currently, the most sensitive diagnosis of PDAC requires invasive procedures, such as endoscopic ultrasonography, which has inherent risks and accuracy that is highly operator dependent. Here we took advantage of a general characteristic of solid tumors, the acidic microenvironment that is generated as a by-product of metabolism, to develop a novel approach of using pH (Low) Insertion Peptides (pHLIPs) for imaging of PDAC. We show that fluorescently labeled pHLIPs can localize and specifically detect PDAC in human xenografts as well as PDAC and PanIN lesions in genetically engineered mouse models. This novel approach may improve detection, differential diagnosis and staging of PDAC.

  15. Abiraterone Acetate and Castration Resistant Ductal Adenocarcinoma of the Prostate

    Directory of Open Access Journals (Sweden)

    Edgar Linden-Castro

    2014-01-01

    Full Text Available Ductal adenocarcinoma of the prostate is a rare histological variant that only represents <1% of prostate tumors. This histological variant has several important clinical implications with respect to their evolution, clinical prognosis, and treatment. We report the case of a 64-year-old patient with ductal adenocarcinoma of the prostate, which progresses to castration-resistant prostate cancer, that was treated with abiraterone acetate with good clinical response, to our knowledge, the first case of ductal adenocarcinoma of the prostate in treatment with abiraterone acetate.

  16. Diagnostic imaging of lobular carcinoma of the breast. Mammographic, US and MR findings; La diagnostica per immagini del carcinoma lobulare della mammella. Aspetti mammografici, ecografici e con Risonanza Magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Bazzocchi, M.; Facecchia, I.; Zuiani, C.; Smania, S. [Udine Univ., Udine (Italy). Ist. di Radiologia; Puglisi, F. [Udine Univ., Udine (Italy). Reparto di Oncologia; Di Loreto, C. [Udine Univ., Udine (Italy). Ist. di Anatomia Patologica

    2000-12-01

    Purpose of this article is to evaluate the most frequent mammographic, US and MR findings of invasive lobular carcinoma and the role of MRI in defining multifocality and/or multicentricity of this tumor histotype. 45 lobular carcinomas in 39 patients were studied and selected from 421 breast cancers. Core biopsy with a 14G needle was performed in 39 cases, under US guidance in 36/39 and under mammographic guidance in 3/39 cases. Surgical biopsy was performed in 2 cases and the diagnosis could be made only after mastectomy in 5 cases. All patients were examined with mammography and US and (10-13 MHz) and 8 also with MRI. 28/46 palpable lesions (60.9%). Core biopsy correctly diagnosed 38/39 lesions (97.4%). The most frequent mammographic findings was that of a nodular opacity without microcalcifications (34.8%), followed by a mass with spiculated borders (30.4%). Microcalcifications were seen in one case only (2.2%). Mammography detected no abnormalities in 15.2% of cases, but US showed a lesion in 2 of these cases. The most frequent US pattern was that of a hypoechoic lesion (43.5%), followed by posterior US beam attenuation. No US signs of abnormality were seen 15.2%. MRI correctly detected 13 lesions. Contrast enhancement was greater than 70% at one minute in 10 cases and greater than 40% in one case; two lesions exhibited atypical slow contrast enhancement, peaking at 5 minutes. MRI detected 5 lesions missed both mammography and US and showed multifocal (3 and 2) lesions where the other techniques had detected one lesion only. At mammography and US invasive lobular carcinoma exhibits no different features than ductal carcinoma but is difficult to identify especially in its early stages. US is a useful tool especially to characterize mammography-detected lesions but in the experience it also demonstrated 2 lesions missed at mammography. MRI is a precious examination to define the multifocal, multi centric or bilateral character of invasive lobular carcinoma

  17. Denture hyperplasia with areas simulating oral inverted ductal papilloma.

    Science.gov (United States)

    Vargas, Pablo Agustin; Perez, Danyel Elias da Cruz; Jorge, Jacks; Rangel, Ana Lúcia Carrinho Ayrosa; León, Jorge Esquiche; Almeida, Oslei Paes de

    2005-07-01

    Denture hyperplasia is a reactive lesion of the oral mucosa, usually associated to an ill-fitting denture. This lesion is easily diagnosed and in some cases distinct microscopic variations such as osseous, oncocytic and squamous metaplasia may be found. These metaplastic alterations probably are associated with the lymphocytic infiltrate usually present in denture hyperplasia. We present a case of denture hyperplasia containing salivary gland tissue with ductal alterations mimicking an oral inverted ductal papilloma.

  18. Enhancing area surrounding breast carcinoma on MR mammography: comparison with pathological examination

    International Nuclear Information System (INIS)

    The enhancing area surrounding breast carcinoma on MR mammography is correlated with findings from pathological examination. We studied 194 patients with breast cancer who underwent preoperative MR mammography. Of all malignant lesions presenting with an enhancing surrounding area on MR mammography, morphologic features including long spicules, a ductal pattern, diffuse enhancement or nodules were evaluated and compared with histopathological examination. A double breast coil was used; we performed a 3D FLASH sequence with contiguous coronal slices of 2 mm, before and after injection of 0.2 mmol/kg GD-DTPA, and subtraction images were obtained. In total, 297 malignant lesions were detected at MR mammography and 101 of them had one or more types of enhancing surrounding area. In 49 of the 53 cancers with long spicules and in 49 of the 55 cancers with surrounding ductal pattern of enhancement, pathological examination showed in situ and/or invasive carcinoma. Multiple nodules adjacent to the carcinoma were seen in 20 patients and corresponded with six cases of invasive and ten cases of ductal in situ carcinoma. A diffuse enhancing area next to a mass was seen in ten patients and consisted of carcinoma in all cases: seven in situ and three invasive carcinomas. Enhancing areas including long spicules, a ductal pattern, noduli, or diffuse enhancement surrounding a carcinoma corresponded with in situ or invasive extension of the carcinoma in 92.5, 89, 80 and 100% of cases, respectively. (orig.)

  19. Low expression of nucleus accumbens-associated protein 1 predicts poor prognosis for patients with pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    Nishi, Takeshi; Maruyama, Riruke; Urano, Takeshi; Nakayama, Naomi; Kawabata, Yasunari; Yano, Seiji; Yoshida, Manabu; Nakayama, Kentaro; Miyazaki, Kohji; Takenaga, Keizo; Tanaka, Tsuneo; Tajima, Yoshitsugu

    2012-12-01

    Nucleus accumbens-associated protein 1 (NAC1) is overexpressed in various carcinomas including ovarian, cervical, breast, and pancreatic carcinomas. High expression of NAC1 is considered to have adverse effects on prognosis through negative regulation of growth arrest and DNA-damage-inducible 45-γ interacting protein 1 (GADD45GIP1) in ovarian and cervical carcinomas. In the present study, the expression of NAC1 in pancreatic ductal adenocarcinoma (PDA) was measured using immunohistochemistry and computer-assisted image analysis in order to investigate its correlation with various clinicopathological parameters and prognosis. Patients with low-NAC1 PDA had worse overall survival (P = 0.0010) and a shorter disease-free survival (P = 0.0036) than patients with high-NAC1 PDA. This was a clinical effect opposite to that reported in ovarian and cervical carcinomas. Furthermore, knockdown of NAC1 in pancreatic carcinoma cell lines did not increase expression of the GADD45GIP1 protein. These results indicate that the gene(s) regulated by NAC1 vary depending on the types of carcinoma or originating tissue, and that low expression of NAC1 predicts poor prognosis for patients with PDA.

  20. Interventional Nanotheranostics of Pancreatic Ductal Adenocarcinoma.

    Science.gov (United States)

    Li, Junjie; Liu, Fengyong; Gupta, Sanjay; Li, Chun

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) accounts for over 90% of all pancreatic cancer. Nanoparticles (NPs) offer new opportunities for image-guided therapy owing to the unique physicochemical properties of the nanoscale effect and the multifunctional capabilities of NPs. However, major obstacles exist for NP-mediated cancer theranostics, especially in PDAC. The hypovascular nature of PDAC may impede the deposition of NPs into the tumor after systemic administration, and most NPs localize predominantly in the mononuclear phagocytic system, leading to a relatively poor tumor-to-surrounding-organ uptake ratio. Image guidance combined with minimally invasive interventional procedures may help circumvent these barriers to poor drug delivery of NPs in PDAC. Interventional treatments allow regional drug delivery, targeted vascular embolization, direct tumor ablation, and the possibility of disrupting the stromal barrier of PDAC. Interventional treatments also have potentially fewer complications, faster recovery, and lower cost compared with conventional therapies. This work is an overview of current image-guided interventional cancer nanotheranostics with specific attention given to their applications for the management of PDAC. PMID:27375787

  1. MicroRNAs in pancreatic ductal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Jong Y Park; James Helm; Domenico Coppola; Donghwa Kim; Mokenge Malafa; Seung Joon Kim

    2011-01-01

    Ductal adenocarcinoma of the pancreas is a lethal cancer for which the only chance of long-term survival belongs to the patient with localized disease in whom a potentially curative resection can be done.Therefore,biomarkers for early detection and new therapeutic strategies are urgently needed.miRNAs are a recently discovered class of small endogenous non-coding RNAs of about 22 nucleotides that have gained attention for their role in downregulation of mRNA expression at the posttranscriptional level.miRNAs regulate proteins involved in critical cellular processes such as differentiation,proliferation,and apoptosis.Evidence suggests that deregulated miRNA expression is involved in carcinogenesis at many sites,including the pancreas.Aberrant expression of miRNAs may upregulate the expression of oncogenes or downregulate the expression of tumor suppressor genes,as well as play a role in other mechanisms of carcinogenesis.The purpose of this review is to summarize our knowledge of deregulated miRNA expression in pancreatic cancer and discuss the implication for potential translation of this knowledge into clinical practice.

  2. 彩色多普勒超声联合数字钼靶X线对不同级别乳腺导管原位癌的应用价值%TheInvestigationoftheUltrasoundCombinedwithDigitalMammographyX-rayofDifferentGradeDuctalCarcinomainSitu (DuctalCarcinomainSitu,DCIS)ApplicationValue

    Institute of Scientific and Technical Information of China (English)

    程志坚; 危成波; 周芳

    2013-01-01

    目的探讨超声联合数字钼靶X线对不同级别乳腺导管原位癌(DCIS)的应用价值。方法经病理学证实的48例女性乳腺导管原位癌,均采用彩色多普勒超声检查和钼靶X线检查对不同级别导管原位癌进行诊断与鉴别诊断。结果钼靶对低、中、高级别导管原位癌诊断为BI-RADS4或5级(中度或高度怀疑恶性病变)分别为7例、8例、20例;彩色多普勒超声对低、中、高级别导管原位癌诊断为BI-RADS4或5级分别为8例、9例、17例;同时两种方法联合对低、中、高级别导管原位癌诊断为BI-RADS4或5级分别为9例、10例、21例。结论彩色多普勒超声与钼靶X线摄影联合应用可提高对不同级别导管原位癌诊断率,值得临床推广。%Objective To investigate the ultrasound combined with digital mammography X-ray of different grade Ductal carcinoma in situ (Ductal carcinoma in situ, DCIS) application value. Method Conifrmed by pathology of 48 cases of female breast ductal carcinoma in situ, all use of color doppler ultrasound and molybdenum target X-ray on different levels for diagnosis and differential diagnosis of ductal carcinoma in situ. Results Mammography for low, medium and high grade ductal carcinoma in situ diagnosis of BI-RADS4 or level 5 (moderately or highly suspected malignant lesions) of 7 cases respectively, 8 cases, 20 cases;color doppler lfow imaging (cdif) in low, medium and high grade ductal carcinoma in situ diagnosis of BI-RADS4 or level 5 of 8 cases, 9 cases, 17 cases respectively;the combination of the two methods at the same time low, medium and high grade ductal carcinoma in situ diagnosis of BI-RADS4 or level 5 of 9 cases, 10 cases, 21 cases respectively. Conclusion Color doppler ultrasonography and molybdenum target X-ray photography combined use of ductal carcinoma in situ with different grades can be improved diagnostic rate, worthy of clinical promotion.

  3. Biliary manometry in choledochal cyst with abnormal choledochopancreatico ductal junction.

    Science.gov (United States)

    Iwai, N; Tokiwa, K; Tsuto, T; Yanagihara, J; Takahashi, T

    1986-10-01

    Intraoperative manometry of the biliary tract and measurement of amylase levels in choledochal cysts were performed in seven patients, aged 14 months to 5 years, with choledochal cysts, in an investigation of the pathophysiology of the biliary tract. An abnormal choledochopancreatico ductal junction was observed in these seven patients by preoperative endoscopic retrograde cholangiopancreaticography (ERCP) or intraoperative cholangiograms. All six patients examined showed a high amylase level in the choledochal cyst (5,450 to 46,500 Somogyi Units). The intraoperative manometry of the biliary tract showed that a remarkable high pressure zone as was found in the area of sphincter of Oddi was not found in the area of abnormal choledochopancreatico ductal junction. The pressure recordings also demonstrated that the sphincter of Oddi pressure in the patient with choledochal cyst was increased by gastrin stimulation. On the contrary, no pressure reaction to gastrin or secretin was found in the area of abnormal choledochopancreatic ductal junction. From these results it seems that free reflux of pancreatic juice into the biliary system occurs, and the reflux stream depends upon the pressure gradient between pancreatic ductal pressure and common bile duct pressure because of the lack of a sphincter function at the choledochopancreatico ductal junction.

  4. MEDULLARY CARCINOMA OF THE BREAST: ROENTGENOLOGIC AND ULTRASOUND SEMIOTICS

    OpenAIRE

    A. B. Abduraimov; K. A. Lesko; V. Yu. Pletneva; I. A. Blokhin

    2015-01-01

    Breast cancer (BC) is the most common female cancer type and the leading cause of female cancer mortality in Russia and in majority countries of the world. Along with the most common type of BC – ductal carcinoma, there are a lot of histological types, distinguished by structure features, which lead to a variable clinical and instrumental semiotics.These histological types of BC in the group marked out special types of BC, including medullary carcinoma. The concept of medullary cancer include...

  5. MSX2 in pancreatic tumor development and its clinical application for the diagnosis of pancreatic ductal adenocarcinoma

    Science.gov (United States)

    Satoh, Kennichi; Hamada, Shin; Shimosegawa, Tooru

    2012-01-01

    MSX2, a member of the homeobox genes family, is demonstrated to be the downstream target for ras signaling pathway and is expressed in a variety of carcinoma cells, suggesting its relevance to the development of ductal pancreatic tumors since pancreatic ductal adenocarcinoma (PDAC) and intraductal papillary-mucinous neoplasia (IPMN) harbor frequent K-ras gene mutations. Recent studies revealed the roles of MSX2 in the development of carcinoma of various origins including pancreas. Among gastrointestinal tumors, PDAC is one of the most malignant. PDAC progresses rapidly to develop metastatic lesions, frequently by the time of diagnosis, and these tumors are usually resistant to conventional chemotherapy and radiation therapy. The molecular mechanisms regulating the aggressive behavior of PDAC still remain to be clarified. On the other hand, IPMN of the pancreas is distinct from PDAC because of its intraductal growth in the main pancreatic duct or secondary branches with rare invasion and metastasis to distant organs. However, recent evidence indicated that once IPMN showed stromal invasion, it progresses like PDAC. Therefore, it is important to determin how IPMN progresses to malignant phenotype. In this review, we focus on the involvement of MSX2 in the enhancement of malignant behavior in PDAC and IPMN, and further highlight the clinical approach to differentiate PDAC from chronic pancreatitis by evaluating MSX2 expression level. PMID:23162473

  6. Coanda effect on ductal flow in the pulmonary artery.

    Science.gov (United States)

    Guntheroth, W; Miyaki-Hull, C

    1999-03-01

    The Coanda effect (the tendency of a jet stream to adhere to a boundary wall), and the relevant anatomy, may explain the location of ductal jets within the main pulmonary artery. With the usual insertion of the duct close to the left pulmonary artery, during right ventricular ejection, the ductal jet adheres to the left wall of the main pulmonary artery. When right ventricular ejection is absent in pulmonary atresia, the ductal jet streams down the right wall of the pulmonary artery to the pulmonary valve, reverses, and maintains a parallel column back toward the bifurcation. If the reversed flow is mistaken for ejection from the right ventricle, the diagnosis of pulmonary atresia may be missed. PMID:10082354

  7. Breast carcinoma metastasis to the lacrimal gland

    DEFF Research Database (Denmark)

    Nickelsen, Marie N.; Von Holstein, Sarah; Hansen, Alastair B.;

    2015-01-01

    tomography scans revealed irregular lacrimal gland tumours in the two patients. The two patients had history of breast cancer. The first breast cancer metastasis in the lacrimal gland demonstrated a cribriform growth pattern containing ductal elements. The epithelial tumour cells stained positive...... study aimed to describe two such cases and draw attention to breast carcinomas as a differential diagnosis and the most frequent cause of lacrimal gland metastasis....

  8. GATA3 expression in breast carcinoma: utility in triple-negative, sarcomatoid, and metastatic carcinomas.

    Science.gov (United States)

    Cimino-Mathews, Ashley; Subhawong, Andrea P; Illei, Peter B; Sharma, Rajni; Halushka, Marc K; Vang, Russell; Fetting, John H; Park, Ben Ho; Argani, Pedram

    2013-07-01

    GATA3 plays an integral role in breast luminal cell differentiation and is implicated in breast cancer progression. GATA3 immunohistochemistry is a useful marker of breast cancer; however, its use in specific subtypes is unclear. Here, we evaluate GATA3 expression in 86 invasive ductal carcinomas including triple-negative, Her-2, and luminal subtypes, in addition to 13 metaplastic carcinomas and in 34 fibroepithelial neoplasms. In addition, we report GATA3 expression in matched primary and metastatic breast carcinomas in 30 patients with known estrogen receptor (ER), progesterone receptor (PR), and Her-2 status, including 5 with ER and/or PR loss from primary to metastasis. Tissue microarrays containing 5 to 10 cores per tumor were stained for GATA3, scored as follows: 0 (0-5%), 1+ (6%-25%), 2+ (26%-50%), 3+ (51%-75%), and 4+ (>75%). GATA3 labeling was seen in 67% (66/99) of primary ductal carcinomas including 43% of triple-negative and 54% of metaplastic carcinomas. In contrast, stromal GATA3 labeling was seen in only 1 fibroepithelial neoplasm. GATA3 labeling was seen in 90% (27/30) of primary breast carcinomas in the paired cohort, including 67% of triple-negative carcinomas. GATA3 labeling was overwhelmingly maintained in paired metastases. Notably, GATA3 was maintained in all "luminal loss" metastases, which showed ER and/or PR loss. In conclusion, GATA3 expression is maintained between matched primary and metastatic carcinomas including ER-negative cases. GATA3 can be particularly useful as a marker for metastatic breast carcinoma, especially triple-negative and metaplastic carcinomas, which lack specific markers of mammary origin. Finally, GATA3 labeling may help distinguish metaplastic carcinoma from malignant phyllodes tumors.

  9. Pancreatic ductal system obstruction and acute recurrent pancreatitis

    Institute of Scientific and Technical Information of China (English)

    M Delhaye; C Matos; M Arvanitakis; J Devière

    2008-01-01

    Acute recurrent pancreatitis is a clinical entity largely associated with pancreatic ductal obstruction.This latter includes congenital variants,of which pancreas divisum is the most frequent but also controversial,chronic pancreatitis,tumors of the pancreaticobiliary junction and sphincter of Oddi dysfunction.This review summarizes current knowledge about diagnostic work-up and therapy of these conditions.

  10. The diagnostic utility of the minimal carcinoma triple stain in breast carcinomas.

    Science.gov (United States)

    Ross, Dara S; Liu, Yi-Fang; Pipa, Jennifer; Shin, Sandra J

    2013-01-01

    Pathologists are expected to accurately diagnose increasingly smaller breast carcinomas. Correct classification (ie, lobular vs ductal or in situ vs invasive) directly affects subsequent management, especially when the focus is near a surgical margin or present in a needle core biopsy and is further challenging if the lesion is morphologically ambiguous. We assessed the diagnostic utility of a multiplex, trichromogen immunostain of 3 commonly employed antibodies (CK7, p63, and E-cadherin) developed in our laboratory to evaluate these small lesions. Of the 147 specimens containing minimal (defined as ≤3 mm in size) invasive carcinoma, 81 also contained in situ carcinoma. In each case, the Minimal Carcinoma Triple Stain was prepared with a parallel H&E-stained slide. Observations of staining characteristics in the focus of interest were recorded. The Minimal Carcinoma Triple Stain was diagnostically useful in all but 1 case. In a case of invasive lobular carcinoma in an excisional biopsy, the Minimal Carcinoma Triple Stain stained only the surrounding breast tissue (appropriately) and not the focus of interest. Also, a subset of 29 of 81 excisional biopsies had minimal invasive carcinoma located 2 mm or less from the inked surgical margin, in which in all cases the Minimal Carcinoma Triple Stain was fully interpretable despite morphologic distortion due to concomitant cautery artifact and tissue disruption in some cases. The Minimal Carcinoma Triple Stain offers an accurate and tissue-conserving method to diagnose small, morphologically problematic foci of breast carcinoma while ideally leaving more tissue for additional adjunctive studies.

  11. Carcinoma primario intraóseo

    Directory of Open Access Journals (Sweden)

    Susana Szlabi

    2013-12-01

    Full Text Available El carcinoma primario intraóseo (PIOC es un tumor poco frecuente, definido como carcinoma escamoso que se desarrolla en huesos maxilares, no teniendo conexión inicial con mucosa ni piel adyacente. Es localmente agresivo, con una incidencia de metástasis en ganglios regionales del 28% y en pulmón del 5%, en el momento del diagnóstico. Su origen puede ser de novo o a partir de otros tumores odontogénicos. Los huesos maxilares son los únicos que tienen en su interior tejidos epiteliales, por lo cual esta neoplasia se localiza exclusivamente en este sitio, predominantemente en la mandíbula. Los criterios diagnósticos del PIOC incluyen: histopatología de carcinoma escamocelular, ausencia de compromiso de mucosa oral y senos paranasales, descartando metástasis de un sitio distante en base a estudios clínicos y métodos complementarios. El tratamiento de elección consiste, siempre que sea posible, en la exéresis con criterios oncológicos, y radio y/o quimioterapia adicional. Se requiere además, cirugía reconstructiva con injerto y/o prótesis con fines estéticos y funcionales. Presentamos el caso de un varón de 72 años, que consultó por molestias en maxilar inferior tres meses después de la extracción de un molar. Se efectuó biopsia por curetaje y luego se resecó el maxilar inferior con vaciamiento ganglionar. El estudio histopatológico mostró un carcinoma escamoso pobremente diferenciado, infiltrante en hueso maxilar, con hallazgos morfológicos que lo vinculaban a quiste odontogénico residual, y metástasis en 15 de 48 ganglios aislados. Se realizó radioterapia postquirúrgica, falleciendo a los 30 meses del diagnóstico por deterioro progresivo.

  12. KL-6 mucin expression in pancreatic ductal carcinoma and its clinical significance%肺泡Ⅱ型上皮细胞抗原黏蛋白在胰腺导管癌中的表达及其临床意义

    Institute of Scientific and Technical Information of China (English)

    孔晔宏; 刘三光; 穆宏凌; 王文斌; 刘建华

    2014-01-01

    目的 检测肺泡Ⅱ型上皮细胞抗原(KL-6)黏蛋白(Mucin)在胰腺导管癌中的表达水平,探讨其在胰腺癌诊断和预后评估中的临床意义.方法 38例胰腺癌患者标本采用免疫组织化学染色的方法检测胰腺癌组织标本KL-6 Mucin的表达.结果 38例胰腺导管癌标本的免疫组织化学结果显示,KL-6 Mucin均呈阳性表达(100%),78.9%表达为强阳性,72.3%的癌周胰腺组织未见KL-6 Mucin的强阳性表达.KL-6 Mucin的阳性表达与肿瘤的发展与分化呈正相关.结论 胰腺导管癌中KL-6 Mucin多呈强阳性表达,而癌周胰腺组织内表达不明显,这表明KL-6 Mucin和胰腺癌的浸润行为相关.%Objective To investigate the expression of KL-6 mucin in pancreatic ducatal tissue,and to explore its clinical significance.Methods All specimens form 38 patients who were diagnosed as pancreatic ductal adenocarcinoma were subjected to immunohistochemical analysis using KL-6 monoclonal antibody.Results 100% specimens of pancreatic adenocarcinoma were found positive staining,and marked positive staining was 78.9%,remarkable positive staining was not found in the surrounding noncancer regions of the pancreatic tissues (72.3%).KL-6 mucin expression was statistical significance with the tumor development and differentiation.Conclusion Most of all pancreatic adenocarcinoma cases showed remarkable positive staining for KL-6 mucin,while the majority of surrounding non-cancer regions did not.The aberrant expression of KL-6 mucin is significantly related to aggressive tumor behaviors of pancreatic adenocarcinoma.KL-6 mucin may be a specific target to detect the pancreatic adenocarcinoma in molecular imaging study.

  13. Squamous Cell Carcinoma of the Pancreas

    Directory of Open Access Journals (Sweden)

    Andre Luiz De Souza

    2014-11-01

    Full Text Available We previously published our and Johns Hopkins data titled: "Platinum-based therapy in adenosquamous pancreatic cancer: experience at two institutions” [1]. We will here like to submit a related case report as a letter to the editor to JOP in reference to the above paper. Squamous cell carcinoma of the pancreas has various reported incidence rates, ranging from 0.5% to as high as 5% of pancreatic ductal carcinomas [2, 3]. Of the 1300 cases of pancreatic cancers observed at autopsy in a survey in Japan in 1992, 0.7% were squamous cell carcinoma [4]. A Mayo clinic review of very rare exocrine tumors showed an even rarer incidence of squamous cell carcinoma when compared to acinar and small cell carcinoma of the pancreas [5]. This discrepancy in the reported incidence rates related to the fact that some of the cases represent adenosquamous carcinoma rather than pure squamous cell carcinoma of pancreas. In an analysis of 25 patients, mean age at diagnosis of pancreatic squamous cell carcinoma was 62 years (range: 33–80 years and there was no gender difference [6]. There is no study about the molecular profile of squamous carcinoma of the pancreas. There are no retrospective or prospective studies about the best therapy for these tumors

  14. Invasive breast carcinoma arising in microglandular adenosis: two case reports.

    Science.gov (United States)

    Choi, Jung Eun; Bae, Young Kyung

    2013-12-01

    Microglandular adenosis (MGA) is a rare benign disease that shows an infiltrative growth pattern of small glands, and it may progress to include atypia and carcinoma. Here we report two cases of breast carcinoma arising in MGA. Case 1 was a 44-year-old woman with a previous history of ductal carcinoma in situ in her right breast. During a follow-up, a 1.8 cm mass-like lesion was found in her left breast. An excisional biopsy suggested that the lesion was breast carcinoma. Case 2 was a 57-year-old woman with a 2.9 cm mass in her right breast. A core needle biopsy of the lesion suggested invasive carcinoma. Both patients underwent modified radical mastectomy with sentinel lymph node biopsy. Both tumors lacked a myoepithelial cell layer and stained positively for S-100, lysozyme, and α1-antitrypsin, which is typical of MGA. Both cases showed invasive carcinoma arising in MGA. PMID:24454466

  15. Hybrid Palliation for Ductal-Dependent Systemic Circulation.

    Science.gov (United States)

    Evans, William N; Galindo, Alvaro; Rothman, Abraham; Ciccolo, Michael L; Carrillo, Sergio A; Acherman, Ruben J; Mayman, Gary A; Cass, Kathleen A; Kip, Katrinka T; Luna, Carlos F; Ludwick, Joseph M; Rollins, Robert C; Castillo, William J; Alexander, John A; Restrepo, Humberto

    2016-06-01

    We reviewed our hybrid palliation experience for 91 neonates, with ductal-dependent systemic circulation, born between August 2007 and October 2015. For analysis, we stratified the 91 patients by a risk factor (RF) score and divided them into three groups: (1) high-risk two-functional ventricles (2V) median RF score of 3 (N = 20); (2) low-risk one-functional ventricle (1V) RF score 0-1 (N = 32); and (3) high-risk 1V RF score ≥2 (N = 39). Midterm survival (median 4 years) by group was: (1) 95 %, (2) 91 %, and (3) 15 %, (p = 0.001). In conclusion, hybrid palliation was associated with excellent midterm results for high-risk 2V and low-risk 1V patients with ductal-dependent systemic circulation. In contrast, high-risk 1V patients had significantly worse outcomes.

  16. Ductal aneurysm masquerading as nonresolving pneumonia: A challenging differential!

    Directory of Open Access Journals (Sweden)

    Chodhary Maitri

    2010-01-01

    Full Text Available We report here, the case of a six-and-a-half-month-old boy investigated for persistent respiratory distress and homogeneous opacity in the left upper lobe. Echocardiography revealed a giant ductal aneurysm compressing the left pulmonary artery and upper lobe division of the left bronchus. Computerized tomography angiogram delineated the exact anatomy and prompt surgical resection provided a successful cure to this lesser known entity.

  17. Targeting mTOR in Pancreatic Ductal Adenocarcinoma

    OpenAIRE

    Iriana, Sentia; Ahmed, Shahzad; Gong, Jun; Annamalai, Alagappan Anand; Tuli, Richard; Hendifar, Andrew Eugene

    2016-01-01

    Treatment options for advanced pancreatic ductal adenocarcinoma (PDAC) are limited; however, new therapies targeting specific tumor-related molecular characteristics may help certain patient cohorts. Emerging preclinical data have shown that inhibition of mammalian target of rapamycin (mTOR) in specific KRAS-dependent PDAC subtypes leads to inhibition of tumorigenesis in vitro and in vivo. Early phase II studies of mono-mTOR inhibition have not shown promise. However, studies have shown that ...

  18. Aberrant E-cadherin staining patterns in invasive mammary carcinoma

    Directory of Open Access Journals (Sweden)

    Brogi Edi

    2005-11-01

    Full Text Available Abstract Background E-cadherin, a cell surface protein involved in cell adhesion, is present in normal breast epithelium, benign breast lesions, and in breast carcinoma. Alterations in the gene CDH1 on chromosome 16q22 are associated with changes in E-cadherin protein expression and function. Inactivation of E-cadherin in lobular carcinomas and certain diffuse gastric carcinomas may play a role in the dispersed, discohesive "single cell" growth patterns seen in these tumors. The molecular "signature" of mammary lobular carcinomas is the loss of E-cadherin protein expression as evidenced by immunohistochemistry, whereas ductal carcinomas are typically E-cadherin positive. Patients and methods We report on E-cadherin immunostaining patterns in five cases of invasive mammary carcinoma Results These were five exceptional instances in which the E-cadherin immunophenotype did not correspond to the apparent histologic classification of the lesion. These cases which are exceedingly rare in our experience are the subject of this report. Conclusion Findings such as those illustrated in this study occur in virtually all biologic phenomena and they do not invalidate the very high degree of correlation between the expression of E-cadherin and the classification of breast carcinomas as ductal or lobular type on the basis of conventional histologic criteria.

  19. [Neuroendocrine carcinoma of the urinary bladder. A case report].

    Science.gov (United States)

    Aragón-Tovar, Anel Rogelio; Pineda-Rodríguez, Marco Elí; Puente-Gallegos, Francisco Edgardo; Zavala-Pompa, Angel

    2014-01-01

    Antecedentes: el carcinoma neuroendocrino de células pequeñas primario de vejiga es una lesión maligna muy poco frecuente. Caso clínico: paciente masculino de 68 años de edad, que tuvo hematuria macroscópica de 24 horas de evolución. Estudios de imagen mostraron tumoración vesical de 218 cc, que en 20 días alcanzó un volumen de 426 cc. A la tinción con hematoxilina-eosina, histológicamente se apreció: placa sólida infiltrante de bordes irregulares, compuesta por células neoplásicas con claro predominio de núcleo y escaso citoplasma (células pequeñas). A la tinción inmunohistoquímica con cromogranina parecía difusamente positivo en células neoplásicas, en un patrón granular citoplasmático. A la tinción con citoqueratina de alto peso molecular se observó patrón negativo en células neoplásicas con control interno positivo en el urotelio acompañante en espécimen. De igual manera, la tumoración fue positiva para sinaptofisina y CD-56 y negativa para CK-7 y CK-20. El paciente recibió tratamiento a base de radioterapia y quimioterapia. Conclusión: el carcinoma neuroendocrino de células pequeñas primario de vejiga representa de 0.35 a 0.70% de los tumores vesicales primarios. Su diagnóstico se basa en el reconocimiento histológico e inmunohistoquímico. El tratamiento se fundamenta en quimioterapia con cisplatino más cistectomía radical, excepto cuando existe enfermedad metastásica.

  20. Invasive Micropapillary Carcinoma in Breast Presented as Hyperechoic Mass with Coarse Macrocalcifications: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hee Sun; Seo, Bo Kyung; Song, Sung Eun; Kim, Young Sik [Dept. of Radiology, Korea University Ansan Hospital, Ansan (Korea, Republic of); Cho, Kyu Ran [Dept. of Radiology, Korea University Anam Hospital, Seoul (Korea, Republic of); Woo, Ok Hee [Dept. of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Invasive micropapillary carcinoma is a rare, clinically aggressive variant of invasive ductal carcinoma. Imaging findings of invasive micropapillary carcinoma are not specific, and associated microcalcifications are frequent. Our case presented with unique radiological features: a mass with coarse macrocalcifications on mammography and breast computed tomography and a hyperechoic mass on breast ultrasound. Macrocalcifications and hyperechogenicity are not usual malignant characteristics. We report here on our experience with a 55-year-old woman who had invasive micropapillary carcinoma in the breast with unique radiological and pathological findings.

  1. Squamous Cell Carcinoma of the Pancreas: A Case Report and Review of Literature

    Science.gov (United States)

    Brijbassie, Alan; Stelow, Edward; Shami, Vanessa M

    2014-01-01

    Primary squamous cell carcinoma (SCC) of the pancreas is an extremely rare tumor with the normal pancreas being entirely devoid of squamous cells. It, however, has been noted that during inflammatory episodes, squamous metaplasia of ductal columnar cells has been observed; however, transformation to SCC is rare. We herein describe a case of pancreatic SCC and provide a review of existing literature.

  2. Does ductal lavage assert its role as a noninvasive diagnostic modality to identify women at low risk of breast cancer development?

    Science.gov (United States)

    Konstandiadou, Ioanna; Kotsilianou, Olympia; Karakitsos, Petros; Athanasas, George; Smyrniotis, Vasilios; Arkadopoulos, Nikolaos

    2012-01-01

    Objective Ductal lavage (DL) involves evaluation of the ductal system of the breast for detection of intra-ductal carcinomas and precursor lesions by collecting breast epithelial cells using a small-gauge catheter inserted into a ductal orifice on the nipple. The aim of this survey was to analyze cytologic features of samples obtained from low-risk women with DL and to elucidate the efficacy of this diagnostic modality in evaluating fluid production, cannulating and determining atypical breast epithelial cells. Methods Into this prospective study were consecutively registered 80 women between ages 28 to 67. Nipple aspiration was performed to identify all fluid-yielding ducts. According to the grading of specific features the interpretation of the sample included: normal/benign (category, 0), mild atypical (category, I), markedly atypical (category, II) or malignant (category, III) disorders. Results Ninety five percent (316/334) of the nipple aspirate fluid samples were classified as category 0, 4.8% (16/334) as category I and 0.2% (2/334) as category II changes. Category III disorders were not detected. Therefore, in 80% of the women examined results were within normal limits while 17.5% of the participants presented mild atypical and 2.5% markedly atypical rates. Conclusion DL collection procedure proved to be rapid as well as acceptable by the women studied. It retains the advantage over other methods of nipple aspirate fluid in that it is easy to perform, thereby removing most clinician variability. It also helped low risk women to discriminate those with breast disorders that require additional investigation, further follow-up or administration of preventive medication. PMID:22523627

  3. Breast carcinoma with choriocarcinomatous features: a case report and review of the literature

    OpenAIRE

    Zhu, Yanyun; Liu, Mei; Li, Jinyu; Jing, Fangfang; Linghu, Ruixia; Guo, Xiaoqin; JIAO, SHUNCHANG; Yang, Junlan

    2014-01-01

    Background Breast carcinoma with choriocarcinomatous features (BCCF) is a rare variant of breast cancer, characterized by high expression of human chorionic gonadotropin (HCG) in cancer cells such as multinucleated syncytiotrophoblast-like giant cells. The first case of BCCF was reported in 1981 by Saigo and Rosen. Only one case of BCCF was reported to show no component of breast ductal carcinoma, and only partially cancer cells, such as multinucleated syncytiotrophoblast-like giant cells, ex...

  4. Invasive ductal breast cancer metastatic to the sigmoid colon

    Directory of Open Access Journals (Sweden)

    Zhou Xiao-cong

    2012-11-01

    Full Text Available Abstract The most common sites of breast cancer metastasis are the bone, lung, liver and brain. However, colonic metastases from breast cancer are very rare in the clinic. We describe an unusual case of sigmoid colonic metastasis from invasive ductal breast cancer. With this report, we should increase the clinical awareness that any patient with a colorectal lesion and a history of malignancy should be considered to have a metastasis until proven otherwise. Early diagnosis is very important, which enables prompt initiation of systemic treatment, such as chemotherapy, endocrine therapy or both, thus avoiding unnecessary radical surgical resection and improving the prognosis.

  5. CT features of nonfunctioning islet cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Eelkema, E.A.; Stephens, D.H.; Ward, E.M.; Sheedy, P.F. II

    1984-11-01

    To determine the computed tomographic (CT) characteristics of nonfunctioning islet cell carcinoma of the pancreas, the CT scans of 27 patients with that disease were reviewed. The pancreatic tumor was identified as a mass in 26 patients (96%) Of the 25 tumors evaluated with contrast enhancement, 20 became partially diffusely hyperdense relative to nearby normal pancreatic tissue. Hepatic metastases were identified in 15 patients (56%), regional lymphadenopathy in 10 (37%), atrophy of the gland proximal to the tumor in six (22%), dilatation of the biliary ducts in five (19%), and dilatation of the pancreatic duct in four (15%). The CT appearances of the nonfunctioning islet cell tumors were compared with those of 100 ordinary (ductal) pancreatic adenocarcinomas. Although the two types of tumors were sometimes indistinguishable, features found to be more characteristic of islet cell carcinoma included a pancreatic mass of unusually large size, calcification within the tumor, and contrast enhancement of either the primary tumor or hepatic metastases. Involvement of the celiac axis or proximal superior mesenteric artery was limited to ductal carcinoma.

  6. Pathomorphological characteristics of the restructuring of pancreatic ductal system in chronic pancreatitis

    Directory of Open Access Journals (Sweden)

    Kovalenko I.S.

    2013-01-01

    Full Text Available Background. Processes that could precede the development of pancreatic ductal adenocarcinoma are not well understood. Objective. Pathomorphological characteristics of the structural remodeling of the ductal apparatus of pancreas in patients with chronic pancreatitis, considering features of the ductal hypertension, proliferative and apoptotic activity of ductal epithelium. Methods. Complex pathomorphological study of pancreatic biopsies of 16 patients with severe pancreatic fibrosis at a chronic pancreatitis was performed. 10 patients had signs of pancreatic duct dilation, confirmed by ultrasound diagnostic, while in other patients ductal hypertension was not accompanied with the duct dilation. Immunohistochemical markers Ki-67 and Caspase-3 were used to detect proliferative and apoptotic activity, respectively. Results. Main morphological changes were manifested as: the concentric periductal fibrosis and local stenosis, the dysplastic changes of ductal epithelium with low level of proliferative activity and caspase -3 expression (in patients with pancreatic duct dilation; the cystic dilation of small and medium-sized intralobular ducts with low levels of Ki-67 and caspase-3 expression (in patients with ductal hypertension, but without pancreatic duct dilation; pancreatic intraepithelial neoplasia (PanIN is accompanied with the excessive nuclear Ki-67 expression and the low cytoplasmic caspase-3 levels. Conclusion. Structural remodeling of the pancreatic ductal system during chronic pancreatitis were not associated with rising of Ki-67 or Caspase-3 expression levels, unless in case of pancreatic intraepithelial neoplasia.

  7. 3-D CT angiographic demonstration of a neonatal ductus arteriosus aneurysm with development of ductal calcification: are the ''ductus bump'', ductus arteriosus aneurysm, and ductal calcification related?

    International Nuclear Information System (INIS)

    A ''ductus bump'' was noted as an incidental finding on a chest radiograph in a newborn infant with congenital cystic adenomatoid malformation. A chest CT performed on the first day of life demonstrated this to be a ductus arteriosus aneurysm (DAA), which subsequently thrombosed. Ductal calcification was noted on follow-up imaging. We propose that the ''ductus bump'' may actually be a DAA, which resolves presumably by thrombus formation. Ductal calcification may also be related to the regression of the thrombus. (orig.)

  8. Salivary duct carcinoma of the parotid gland

    Directory of Open Access Journals (Sweden)

    Mona Mlika

    2012-01-01

    Full Text Available Salivary duct carcinoma of the parotid gland is an uncommon tumor, highly aggressive. About 200 cases have been reported in the English literature. Pathomorphologically, these tumors showed great similarities to ductal carcinoma of the female breast, which is why they described this tumor as "salivary duct carcinoma." The authors describe a new case of salivary duct carcinoma of the parotid gland. We present the case of a 50-year-old patient with progressive facial paralysis. The MRI examination of the head showed two ill-defined formations. A malignant tumor was strongly suspected, so that a total left parotidectomy with excision of the adjacent facial nerve and left lymph node dissection was performed. Microscopic examination concluded to a salivary duct carcinoma of the left parotid gland negative with Her2/neu antibody with lymph node metastasis. There were no recurrences or metastases within 3 years of follow-up. Salivary duct carcinoma of the parotid gland is a rare tumor with an aggressive behavior. This is due to its propensity to infiltrate distant organs. The diagnosis is based on microscopic examination. Treatment modalities are non-consensual, but some authors advocate the necessity of aggressive approach, especially in tumors negative with Heur2/neu antibody. This is due to the fact that the overexpression of this antigen was reported to be associated with a poor prognosis.

  9. Review of Metaplastic Carcinoma of the Breast: Imaging Findings and Pathologic Features

    Directory of Open Access Journals (Sweden)

    Rebecca Leddy

    2012-01-01

    Full Text Available Metaplastic carcinoma (MPC, an uncommon but often aggressive breast cancer, can be challenging to differentiate from other types of breast cancer and even benign lesions based on the imaging appearance. It has a variable pathology classification system. These types of tumors are generally rapidly growing palpable masses. MPCs on imaging can present with imaging features similar to invasive ductal carcinoma and probably even benign lesions. The purpose of this article is to review MPC of the breast including the pathology subtypes, imaging features, and imaging pathology correlations. By understanding the clinical picture, pathology, and overlap in imaging characteristics of MPC with invasive ductal carcinoma and probably benign lesions can assist in diagnosing these difficult malignancies.

  10. E-cadherin expression in primary carcinomas of the breast and its distant metastases

    International Nuclear Information System (INIS)

    Aberrant expression of E-cadherin has been associated with the development of metastases in patients with breast cancer. Even though the expression of E-cadherin has been studied in primary breast tumors, little is known about its expression at the distant metastatic sites. We investigate the relationship between E-cadherin expression in primary breast carcinoma and their distant, non-nodal metastases. Immunohistochemical analysis of E-cadherin was performed in tissues from 30 patients with primary invasive breast carcinoma and their distant metastases. E-cadherin expression was evaluated as normal or aberrant (decreased when compared with normal internal positive controls, or absent). Twenty-two (73%) invasive carcinomas were ductal, and eight (27%) were lobular. Of the primary invasive ductal carcinomas, 55% (12/22) had normal E-cadherin expression and 45% (10/22) had aberrant expression. All of the metastases expressed E-cadherin with the same intensity as (12 tumors) or with stronger intensity than (10 tumors) the corresponding primaries. Of the invasive lobular carcinomas, one of eight (12%) primary carcinomas and none of the metastases expressed E-cadherin in the cell membranes, but they accumulated the protein in the cytoplasm. Aberrant E-cadherin expression is frequent in invasive ductal carcinomas that progress to develop distant metastases. Distant metastases consistently express E-cadherin, often more strongly than the primary tumor. Invasive lobular carcinomas have a different pattern of E-cadherin expression, suggesting a different role for E-cadherin in this form of breast carcinoma

  11. Congestive heart failure from suspected ductal closure in utero.

    Science.gov (United States)

    Arcilla, R A; Thilenius, O G; Ranniger, K

    1969-07-01

    This is the 1st case report of a ductal closure occurring during fetal growth. The case was a spontaneous delivery in cephalic presentation from a 31-year-old gravida 3, para 3 Black woman who had been treated with isoniazid and spreptomycin up to 2 months before her delivery. Gestational age was 37 weeks when the fetus was delivered weighing 3.15 kgm. The cord had been wrapped around the fetus's neck, and breathing was delayed 2 minutes. In the nursery, the baby's general condition was poor, and congestive heart failure was diagnosed. The newborn had trieuspid insufficiency, severe heart failure, and acidosis at birth. These disappeared the next day. Hemodynamic studies when the baby was 4 hours old showed a large cone-shaped ductus arteriousus extending from the pulmonary artery but ending blindly at the aortic end.

  12. Targeting hyaluronan for the treatment of pancreatic ductal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Norihiro Sato

    2016-03-01

    Full Text Available Progression of cancer is often associated with interactions between cancer cells and extracellular matrix (ECM surrounding them. Increasing evidence has suggested that accumulation of hyaluronan (HA, a major component of ECM, provides a favorable microenvironment for cancer progression. Pancreatic ductal adenocarcinoma (PDAC is characterized typically by a dense desmoplastic stroma with a large amount of HA, making this molecule as an attractive target for therapy. Several studies have shown efficacy of inhibitors of HA synthesis or signaling for the treatment of PDAC. Recent studies have also demonstrated substantial improvements in the effects of chemotherapy by a targeted depletion of stromal HA in PDAC using an enzymatic agent. Thus, targeting HA has been recognized as a promising therapeutic strategy to treat this highly aggressive neoplasm. In this review article, we summarize our current understanding of the role of HA in the progression of PDAC and discuss possible therapeutic approaches targeting HA.

  13. Metastatic ductal adenocarcinoma in a Western Hognose snake (Heterodon nasicus).

    Science.gov (United States)

    Stern, Adam W; Velguth, Karen E; D'Agostino, Jennifer

    2010-06-01

    A 17-yr-old Western Hognose snake (Heterodon nasicus) presented with a prominent midcoelomic swelling. Surgical exploration revealed a large, multicystic, irregular, tan, and firm mass grossly effacing the splenopancreas. The mass was subsequently removed. Histologically, the mass was composed of tubules of columnar to flattened neoplastic cells with an abundant stroma and moderate cellular atypia consistent with a scirrhous adenocarcinoma, likely ductal in origin, given the location of the neoplastic mass. Bloodwork revealed anemia, monocytosis, marked hypercalcemia, and, postoperatively, persistent hyperglycemia. After postoperative recovery, the snake was diagnosed with iatrogenically induced diabetes mellitus and exocrine pancreatic insufficiency. Due to the inability to clinically control the diabetes mellitus and exocrine pancreatic insufficiency and when additional palpable masses were noted, the snake was euthanatized. Necropsy and histopathologic examination confirmed metastasis of the previously removed adenocarcinoma to the liver, right kidney, and large intestine. PMID:20597225

  14. High SIRT1 expression is a negative prognosticator in pancreatic ductal adenocarcinoma

    International Nuclear Information System (INIS)

    Several lines of evidence indicate that Sirt1, a class III histone deacetylase (HDAC) is implicated in the initiation and progression of malignancies and thus gained attraction as druggable target. Since data on the role of Sirt1 in pancreatic ductal adenocarcinoma (PDAC) are sparse, we investigated the expression profile and prognostic significance of Sirt1 in vivo as well as cellular effects of Sirt1 inhibition in vitro. Sirt1 expression was analyzed by immunohistochemistry in a large cohort of PDACs and correlated with clinicopathological and survival data. Furthermore, we investigated the impact of overexpression and small molecule inhibition on Sirt1 in pancreatic cancer cell culture models including combinatorial treatment with chemotherapy and EGFR-inhibition. Cellular events were measured quantitatively in real time and corroborated by conventional readouts including FACS analysis and MTT assays. We detected nuclear Sirt1 expression in 36 (27.9%) of 129 PDACs. SIRT1 expression was significantly higher in poorly differentiated carcinomas. Strong SIRT1 expression was a significant predictor of poor survival both in univariate (p = 0.002) and multivariate (HR 1.65, p = 0.045) analysis. Accordingly, overexpression of Sirt1 led to increased cell viability, while small molecule inhibition led to a growth arrest in pancreatic cancer cells and impaired cell survival. This effect was even more pronounced in combinatorial regimens with gefitinib, but not in combination with gemcitabine. Sirt1 is an independent prognosticator in PDACs and plays an important role in pancreatic cancer cell growth, which can be levered out by small molecule inhibition. Our data warrant further studies on SIRT1 as a novel chemotherapeutic target in PDAC

  15. Genome and transcriptome delineation of two major oncogenic pathways governing invasive ductal breast cancer development

    Science.gov (United States)

    Aswad, Luay; Yenamandra, Surya Pavan; Ow, Ghim Siong; Grinchuk, Oleg; Ivshina, Anna V.; Kuznetsov, Vladimir A.

    2015-01-01

    Invasive ductal carcinoma (IDC) is a major histo-morphologic type of breast cancer. Histological grading (HG) of IDC is widely adopted by oncologists as a prognostic factor. However, HG evaluation is highly subjective with only 50%–85% inter-observer agreements. Specifically, the subjectivity in the assignment of the intermediate grade (histologic grade 2, HG2) breast cancers (comprising ~50% of IDC cases) results in uncertain disease outcome prediction and sub-optimal systemic therapy. Despite several attempts to identify the mechanisms underlying the HG classification, their molecular bases are poorly understood. We performed integrative bioinformatics analysis of TCGA and several other cohorts (total 1246 patients). We identified a 22-gene tumor aggressiveness grading classifier (22g-TAG) that reflects global bifurcation in the IDC transcriptomes and reclassified patients with HG2 tumors into two genetically and clinically distinct subclasses: histological grade 1-like (HG1-like) and histological grade 3-like (HG3-like). The expression profiles and clinical outcomes of these subclasses were similar to the HG1 and HG3 tumors, respectively. We further reclassified IDC into low genetic grade (LGG = HG1+HG1-like) and high genetic grade (HGG = HG3-like+HG3) subclasses. For the HG1-like and HG3-like IDCs we found subclass-specific DNA alterations, somatic mutations, oncogenic pathways, cell cycle/mitosis and stem cell-like expression signatures that discriminate between these tumors. We found similar molecular patterns in the LGG and HGG tumor classes respectively. Our results suggest the existence of two genetically-predefined IDC classes, LGG and HGG, driven by distinct oncogenic pathways. They provide novel prognostic and therapeutic biomarkers and could open unique opportunities for personalized systemic therapies of IDC patients. PMID:26474389

  16. Expression and signifi cance of TLR4 and HIF-1α in pancreatic ductal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the expression of toll-like receptor(TLR) 4,nuclear factor-κB(NF-κB) p65 and hypoxiainducible transcription factor 1α(HIF-1α) in pancreatic ductal adenocarcinoma and their clinical significance.METHODS:The mRNA of TLR4 and HIF-1α were investigated by real-time polymerase chain reaction in 30 cases of pancreatic ductal adenocarcinoma and its adjacent tissues,and expression of TLR4,NF-κB p65 and HIF-1α protein were detected by immunohistochemistry in 65 cases of pancreatic ductal adenocarci...

  17. Estimation of Immunohistochemical Expression of VEGF in Ductal Carcinomas of the Breast

    DEFF Research Database (Denmark)

    Maae, Else; Nielsen, Martin; Dahl Steffensen, Karina;

    2012-01-01

    Introduction: Vascular endothelial growth factor A (VEGF-A) is a very important growth factor in angiogenesis and holds the potential as both a predictive marker for anti-angiogenic cancer treatment and as a prognostic variable. Consequently, reliable estimation of VEGF expression is crucial...... at 5x magnifications was the most efficient considering data load and time consumption. Discussion and conclusion: The need for biomarkers is obvious and reliable measurements are crucial to enable application in clinical trials and routine settings. We described a method to gain reproducible...

  18. Estimation of Immunohistochemical Expression of VEGF in Ductal Carcinomas of the Breast

    DEFF Research Database (Denmark)

    Maae, Else; Nielsen, Martin; Dahl Steffensen, Karina;

    2011-01-01

    Vascular endothelial growth factor A (VEGF-A) is a very important growth factor in angiogenesis and holds the potential as both a predictive marker for anti-angiogenic cancer treatment and as a prognostic variable. Consequently, reliable estimation of VEGF expression is crucial. We immunostained...... delineation of the tumor area. We found that the AI scores were correlated to the manual scoring of VEGF intensity, but reproducibility of manual IHC scores was rather poor. The AI scores were reproducible and the restricted analysis of 25% of the tumor area at 5x magnifications was the most efficient...

  19. International variation in management of screen-detected ductal carcinoma in situ of the breast

    NARCIS (Netherlands)

    A. Ponti (Antonio); E. Lynge (Elsebeth); T. James (Ted); O. Májek (Ondřej); M. Von Euler-Chelpin (My); A. Anttila (Ahti); P. Fitzpatrick (Patricia); M.P. Mano (Maria Piera); M. Kawai (Masaaki); A. Scharpantgen (A.); J. Fracheboud (Jacques); S. Hofvind (Solveig); C. Vidal (Carmen); N. Ascunce (Nieves); D. Salas (Dolores); J.L. Bulliard; N. Segnan (N.); K. Kerlikowske (Karla); S. Taplin (Stephen)

    2014-01-01

    textabstractResults Twelve countries contributed data from a total of 15 screening programmes, all from Europe except the United States of America and Japan. Among women aged 50-69 years, 7,176,050 screening tests and 5324 screen-detected DCIS were reported. From 21% to 93% of DCIS had a pre-operati

  20. International variation in management of screen-detected ductal carcinoma in situ of the breast

    DEFF Research Database (Denmark)

    Ponti, Antonio; Lynge, Elsebeth; James, Ted;

    2014-01-01

    node positive. Among BCS patients 35% received SLNB only and 4.8% received ALND. Starting in 2006, PO and SLNB use increased while ALND remained stable. SLNB and ALND were associated with larger size and higher grade DCIS lesions. CONCLUSIONS: Variation in DCIS management among screened women is wide...

  1. CA15.3 Serum Concentrations in Older Women with Infiltrating Ductal Carcinomas of the Breast

    Directory of Open Access Journals (Sweden)

    Álvaro Ruibal

    2014-10-01

    Full Text Available Breast cancer is currently becoming a disease of the elderly. We have studied the relation between CA 15.3 serum concentrations and clinical-pathological parameters in 69 women with IDC aged over 70 years (76.3 ± 4.2; range: 71–88; median 76. A group of 205 women with the same tumor but aged <70 years (62.8 ± 4.0; range: 55–70; median 63 was also considered for comparison. Tumor size, axillary lymph node involvement, distant metastasis and histological grade were taken account. Serum CA 15.3 was determined by luminescence assay. CA 15.3 serum concentrations ranged between 6 and 85 U/mL (median 22.9 U/mL, and were higher only in patients with greater (qualitative and quantitative; p: 0.041 tumor size. Our results show that in women with IDCs, and aged over 70 years, serum CA 15.3 serum concentrations are associated exclusively with a greater tumor size, being these findings different to those described in women with the same subtype of tumor considered as a whole or with lower age.

  2. Is There a Role for Postmastectomy Radiation Therapy in Ductal Carcinoma In Situ?

    Directory of Open Access Journals (Sweden)

    Manjeet Chadha

    2012-01-01

    Full Text Available Background. DCIS treated by mastectomy ensures high local control rates. There is limited data on risk for relapse and lack of clear indication for adjuvant radiation therapy (RT. We report a retrospective review on a population of DCIS patients treated with mastectomy. The objective was to identify the overall incidence of relapse, risk factors for local recurrence, and accordingly for whom adjuvant postmastectomy RT may be considered. Methods. This is an IRB-approved retrospective study on a prospective breast cancer database. From 1997 to 2007, we identified 969 patients with diagnoses of DCIS, among them 211 breasts in 207 patients were treated with mastectomy and comprise the study group. Results. With a median followup of 55 months (4.6 years the 10-year relapse-free survival is 97%. Two of 211 breasts (0.9% treated with mastectomy developed a local-regional recurrence. Both the relapses were among patients defined as having <1 mm final mastectomy margin. Conclusions. The rare local relapse after mastectomy limits our ability to reliably identify risk factors for relapse. The consideration for postmastectomy RT should be based on an individualized risk evaluating surgical technique used, presence of BRCA mutation, grade and extent of tumor, and proximity of lesion to the margin of resection.

  3. Preliminary results of centralized HER2 testing in ductal carcinoma in situ (DCIS): NSABP B-43

    Science.gov (United States)

    Siziopikou, Kalliopi P.; Anderson, Stewart J.; Cobleigh, Melody A.; Arthur, Douglas W.; Zheng, Ping; Mamounas, Eleftherios P.; Pajon, Eduardo R.; Behrens, Robert J.; Eakle, Janice F.; Leasure, Nick C.; Atkins, James N.; Polikoff, Jonathan A.; Seay, Thomas E.; McCaskill-Stevens, Worta J.; Rabinovitch, Rachel; Costantino, Joseph P.; Wolmark, Norman

    2016-01-01

    NSABP B-43 is the first prospective, randomized phase III multi-institution clinical trial targeting high-risk, HER2-positive DCIS. It compares whole breast irradiation alone with WBI given concurrently with trastuzumab in women with HER2-positive DCIS treated by lumpectomy. The primary aim is to determine if trastuzumab plus radiation will reduce in-breast tumor recurrence. HER2-positive DCIS was previously estimated at >50 %, occurring primarily in ER-negative, comedo-type DCIS of high nuclear grade. There has been no documented centralized multi-institutional HER2 analysis of DCIS. NSABP B-43 provides a unique opportunity to evaluate this in a large cohort of DCIS patients. Patients undergoing lumpectomy for DCIS without evidence of an invasive component are eligible. A central review of each patient’s pure DCIS lesion is carried out by immunohistochemistry analysis. If the lesion is 2+, FISH analysis is performed. Patients whose tumors are HER2 3+ or FISH-positive are randomly assigned to receive two doses of trastuzumab during WBI or WBI alone. NSABP B-43 opened 11/9/08. As of 7/31/2013, 5,861 patients have had specimens received centrally, and 5,645 of those had analyzable blocks; 1,969 (34.9 %) were HER2 positive. A total of 1,428 patients have been accrued, 1,137 (79.6 %) of whom have follow-up information. The average follow-up time for the 1,137 patients is 23.3 months. No grade 4 or 5 toxicity has been observed. In NSABP B-43 the HER2-positive rate for pure DCIS among patients undergoing breast-preserving surgery is 34.9 %, lower than the previously reported rate. No trastuzumab-related safety signals have been observed. Interest in this trial has been robust. PMID:24202240

  4. The Major Prognostic Features of Nuclear Receptor NR5A2 in Infiltrating Ductal Breast Carcinomas

    Directory of Open Access Journals (Sweden)

    Li-Yun Chang

    2015-01-01

    Full Text Available Background. Gene expression profiles of 181 breast cancer samples were analyzed to identify prognostic features of nuclear receptors NR5A1 and NR5A2 based upon their associated transcriptional networks. Methods. A supervised network analysis approach was used to build the NR5A-mediated transcriptional regulatory network. Other bioinformatic tools and statistical methods were utilized to confirm and extend results from the network analysis methodology. Results. NR5A2 expression is a negative factor in breast cancer prognosis in both ER(− and ER(−/ER(+ mixed cohorts. The clinical and cohort significance of NR5A2-mediated transcriptional activities indicates that it may have a significant role in attenuating grade development and cancer related signal transduction pathways. NR5A2 signature that conditions poor prognosis was identified based upon results from 15 distinct probes. Alternatively, the expression of NR5A1 predicts favorable prognosis when concurrent NR5A2 expression is low. A favorable signature of eight transcription factors mediated by NR5A1 was also identified. Conclusions. Correlation of poor prognosis and NR5A2 activity is identified by NR5A2-mediated 15-gene signature. NR5A2 may be a potential drug target for treating a subset of breast cancer tumors across breast cancer subtypes, especially ER(− breast tumors. The favorable prognostic feature of NR5A1 is predicted by NR5A1-mediated 8-gene signature.

  5. MicroRNA Expression Analyses in Preoperative Pancreatic Juice Samples of Pancreatic Ductal Adenocarcinoma

    OpenAIRE

    Yoshihiko Sadakari; Takao Ohtsuka; Kenoki Ohuchida; Kosuke Tsutsumi; Shunichi Takahata; Masafumi Nakamura; Kazuhiro Mizumoto; Masao Tanaka

    1999-01-01

    Context Cytological assessment of pancreatic juice is commonly used to diagnose pancreatic ductal adenocarcinoma; however, the sensitivity of cytological assessment has been reported to be low. MicroRNAs are small RNAs regulating various cellular processes and have recently been identified as possible markers of malignant diseases including pancreatic ductal adenocarcinoma. Objective The purposes of this study were to prove the existence of microRNAs in pancreatic juice and to determine wheth...

  6. Parotid carcinoma

    DEFF Research Database (Denmark)

    Sørensen, Kristine Bjørndal; Godballe, Christian; de Stricker, Karin;

    2006-01-01

    OBJECTIVES: Our aim is to investigate the expression of kit protein (KIT) and epidermal growth factor receptor (EGFR) in parotid carcinomas in order to correlate the expression to histology and prognosis. Further we want to perform mutation analysis of KIT-positive adenoid cystic carcinomas....... PATIENTS AND METHODS: Formalin-fixed paraffin-embedded sections from 73 patients with parotid gland carcinomas were used for the study. The sections were stained with both KIT and EGFR polyclonal antibodies. Twelve KIT-positive adenoid cystic carcinomas were examined for c-kit mutation in codon 816....... RESULTS: Of all carcinomas 25% were KIT-positive and 79% were EGFR-positive. Ninety-two percentage of the adenoid cystic carcinomas were KIT-positive. None of the adenoid cystic carcinomas had mutations in codon 816 of the c-kit gene. CONCLUSION: Neither KIT- nor EGFR-expression seem to harbour...

  7. Adnexal germ cell carcinoma with bone metastases in pregnant women: case report and review

    Directory of Open Access Journals (Sweden)

    María Del Rosario Tenorio -Guadalupe

    2016-08-01

    Full Text Available Resumen El carcinoma de células germinales durante el embarazo es una entidad poco frecuente, a pesar de que su detección ha aumentado debido al posicionamiento de la ecografía de control fetal dentro del programa de control prenatal. En este artículo se reporta el caso de una gestante de 27 años de edad, diagnosticada de carcinoma anexial de células germinales a las seis semanas de gestación, cuyo abordaje inicial fue la resección local (citorreducción subóptima. Cuatro semanas después de la cirugía, la paciente debutó con neuropatía periférica grado IV en miembros inferiores, cuyo hallazgo por imagenología (resonancia magnética nuclear indicó lesión infiltrante paravertebral a nivel de D5. En junta médica se decidió que reciba tratamiento de quimioterapia a partir de la semana 19 de la gestación. El embarazo cursó sin complicaciones y la paciente fue sometida a cesárea a las 34 semanas de gestación teniendo como producto un recién nacido vivo sin complicaciones. Desafortunadamente, cuatro días luego de la cesárea, la paciente falleció a consecuencia de un shock séptico de foco respiratorio.

  8. Circulating IL-35 in pancreatic ductal adenocarcinoma patients.

    Science.gov (United States)

    Jin, Peng; Ren, He; Sun, Wei; Xin, Wen; Zhang, Huan; Hao, Jihui

    2014-01-01

    IL-35 is a novel inhibitory cytokine that is mainly produced by regulatory T-cells (Tregs) and is required for Treg-mediated immunosuppression. However, the plasma levels of IL-35 in patients with pancreatic ductal adenocarcinoma (PDAC) have never been investigated. In this study, we found that plasma IL-35 levels more significantly increased in PDAC patients than in normal controls (134.53 ± 92.45 pg/mL vs. 14.26 ± 6.56 pg/mL). IL-35 mRNA levels were positively correlated with plasma IL-35 levels (EBI3, R = 0.925, pIL-35 expression levels were associated with lymph node metastasis (p = 0.001) and late tumor stage (p = 0.002). For the resected patients, high IL-35 expression levels were associated with large tumor size (pIL-35 in PDAC patients significantly increased, suggesting that regulating the expression of IL-35 may provide a new possible target for the treatment of PDAC patients, especially for the resectable ones.

  9. Stem cells as the root of pancreatic ductal adenocarcinoma

    International Nuclear Information System (INIS)

    Emerging evidence suggests that stem cells play a crucial role not only in the generation and maintenance of different tissues, but also in the development and progression of malignancies. For the many solid cancers, it has now been shown that they harbor a distinct subpopulation of cancer cells that bear stem cell features and therefore, these cells are termed cancer stem cells (CSC) or tumor-propagating cells. CSC are exclusively tumorigenic and essential drivers for tumor progression and metastasis. Moreover, it has been shown that pancreatic ductal adenocarcinoma does not only contain one homogeneous population of CSC rather than diverse subpopulations that may have evolved during tumor progression. One of these populations is called migrating CSC and can be characterized by CXCR4 co-expression. Only these cells are capable of evading the primary tumor and traveling to distant sites such as the liver as the preferred site of metastatic spread. Clinically even more important, however, is the observation that CSC are highly resistant to chemo- and radiotherapy resulting in their relative enrichment during treatment and rapid relapse of disease. Many laboratories are now working on the further in-depth characterization of these cells, which may eventually allow for the identification of their Achilles heal and lead to novel treatment modalities for fighting this deadly disease.

  10. Impaired Pancreatic Ductal Bicarbonate Secretion in Cystic Fibrosis

    Directory of Open Access Journals (Sweden)

    Soleimani M

    2001-07-01

    Full Text Available Patients with cystic fibrosis demonstrate a defect in HCO(3(- secretion by their pancreatic duct cells. However, attempts toward understanding or correcting this defect have been hampered by a lack of knowledge regarding the cellular and molecular mechanisms mediating HCO(3(- transport in these cells. Recent functional and molecular studies indicate a major role for a basolateral electrogenically-driven Na(+:HCO(3(- cotransporter (NBC1 in mediating the transport of HCO(3(- into the duct cells. The HCO(3(- exits at the lumen predominantly via two recently discovered apical HCO(3(- transporters. cAMP, which mediates the stimulatory effect of secretin on pancreatic ductal HCO(3(- secretion, potentiates the basolateral Na(+:HCO(3(- cotransporter due to generation of a favorable electrogenic gradient as a result of membrane depolarization by Cl(--secreting cystic fibrosis transmembrane conductance regulator (CFTR. Two apical HCO(3(- transporters drive the secretion of bicarbonate into the pancreatic duct lumen. Molecular and functional studies indicate that CFTR upregulates the expression of these two apical HCO(3(- transporters. In addition, CFTR may also upregulate the expression of certain water channels and facilitate the secretion of fluid into the duct lumen. In brief, current research suggests that the defect in pancreatic HCO(3(- secretion in patients with cystic fibrosis is multifactorial and involves the alteration in the function/expression of transporters at the basolateral and luminal membrane domains of the duct cells.

  11. Breast Carcinoma With Unrecognized Neuroendocrine Differentiation Metastasizing to the Pancreas: A Potential Diagnostic Pitfall.

    Science.gov (United States)

    Christensen, Lene; Mortensen, Michael Bau; Detlefsen, Sönke

    2016-08-01

    The current World Health Organization classification recognizes 3 subtypes of breast carcinomas with neuroendocrine features. Their reported prevalence is highly variable, ranging from breast carcinomas. We report the case of a 73-year-old woman who underwent lumpectomy with a postoperative diagnosis of invasive ductal breast carcinoma. Six weeks after lumpectomy, pancreatic biopsies showed tumor cells with neuroendocrine features. The first immunohistochemical panel showed positivity for synaptophysin and cytokeratins, raising suspicion of a pancreatic neuroendocrine tumor. However, a second panel revealed positivity for estrogen receptors and GATA3. On review of the lumpectomy specimen, a significant neuroendocrine component was found, leading to the final diagnosis of breast carcinoma with neuroendocrine features metastasizing to the pancreas. Neuroendocrine markers are not routinely analyzed in breast tumors. Hence, metastases from breast carcinomas with unrecognized neuroendocrine features may lead to false diagnoses of primary neuroendocrine tumors at different metastatic sites, such as the pancreas. PMID:26912472

  12. Gastric carcinoma in a South American sea lion (Otaria flavescens)

    Science.gov (United States)

    YAMAZAKI, Mutsumi; KOUTAKA, Mitsuru; UNE, Yumi

    2016-01-01

    A 22-year-old captive male South American sea lion (Otaria flavescens) developed an undifferentiated carcinoma originating in the cardiac region of the stomach. Clinical symptoms included vomiting, anorexia and weight loss. Ultrasonography and endoscopy showed gastric wall thickness. At necropsy, the gastric wall had significant thickening around the cardiac region, and metastases were found in some organs. Histologically, samples from the stomach wall and metastases showed the same tumor tissue. Immunohistochemistry was positive for epithelium markers. Ductal growth, keratinocytes or signet ring cells were absent. The tumor was classified as an undifferentiated carcinoma using the World Health Organization’s (WHO) guide to international classification of tumors in domestic animals. This is the first report of a primary gastric carcinoma in a pinniped. PMID:27052463

  13. Proinflammatory Cytokines Induce Endocrine Differentiation in Pancreatic Ductal Cells via STAT3-Dependent NGN3 Activation

    Directory of Open Access Journals (Sweden)

    Ivan Achel Valdez

    2016-04-01

    Full Text Available A major goal of diabetes research is to develop strategies that replenish pancreatic insulin-producing beta cells. One emerging strategy is to harness pancreatic plasticity—the ability of pancreatic cells to undergo cellular interconversions—a phenomenon implicated in physiological stress and pancreatic injury. Here, we investigate the effects of inflammatory cytokine stress on the differentiation potential of ductal cells in a human cell line, in mouse ductal cells by pancreatic intraductal injection, and during the progression of autoimmune diabetes in the non-obese diabetic (NOD mouse model. We find that inflammatory cytokine insults stimulate epithelial-to-mesenchymal transition (EMT as well as the endocrine program in human pancreatic ductal cells via STAT3-dependent NGN3 activation. Furthermore, we show that inflammatory cytokines activate ductal-to-endocrine cell reprogramming in vivo independent of hyperglycemic stress. Together, our findings provide evidence that inflammatory cytokines direct ductal-to-endocrine cell differentiation, with implications for beta cell regeneration.

  14. p53 mutations cooperate with oncogenic Kras to promote adenocarcinoma from pancreatic ductal cells.

    Science.gov (United States)

    Bailey, J M; Hendley, A M; Lafaro, K J; Pruski, M A; Jones, N C; Alsina, J; Younes, M; Maitra, A; McAllister, F; Iacobuzio-Donahue, C A; Leach, S D

    2016-08-11

    Pancreatic cancer is one of the most lethal malignancies, with virtually all patients eventually succumbing to their disease. Mutations in p53 have been documented in >50% of pancreatic cancers. Owing to the high incidence of p53 mutations in PanIN 3 lesions and pancreatic tumors, we interrogated the comparative ability of adult pancreatic acinar and ductal cells to respond to oncogenic Kras and mutant Tp53(R172H) using Hnf1b:CreER(T2) and Mist1:CreER(T2) mice. These studies involved co-activation of a membrane-tethered GFP lineage label, allowing for direct visualization and isolation of cells undergoing Kras and mutant p53 activation. Kras activation in Mist1(+) adult acinar cells resulted in brisk PanIN formation, whereas no evidence of pancreatic neoplasia was observed for up to 6 months following Kras activation in Hnf1beta(+) adult ductal cells. In contrast to the lack of response to oncogenic Kras alone, simultaneous activation of Kras and mutant p53 in adult ductal epithelium generated invasive PDAC in 75% of mice as early as 2.5 months after tamoxifen administration. These data demonstrate that pancreatic ductal cells, whereas exhibiting relative resistance to oncogenic Kras alone, can serve as an effective cell of origin for pancreatic ductal adenocarcinoma in the setting of gain-of-function mutations in p53. PMID:26592447

  15. Redefining Lumpectomy Using a Modification of the Sick Lobe Hypothesis and Ductal Anatomy

    International Nuclear Information System (INIS)

    Objectives. The Sick Lobe hypothesis states that breast cancers evolve from entire lobes or portions of lobes of the breast where initiation events have occurred early in development. The implication is that some cancers are isolated events and others are truly multi-focal but limited to single lobar-ductal units. Methods. This is a single surgeon retrospective review of early stage breast cancer lumpectomy patients treated from 1/2000 to 2/2005. Ductal endoscopy was used direct lumpectomy surgical margins by defining ductal anatomy and mapping proliferative changes within the sick lobe for complete excision. Results. Breast conservation surgery for stage 02 breast cancer with an attempt to perform endoscopy in association with therapeutic lumpectomy was performed in 554 patients (successful endoscopy in 465 cases). With an average followup of >5 years for the entire group, annual hazard rate for local failure in traditional lumpectomy without ductal mapping was 0.97%/yr. and for lumpectomy with ductal mapping and excision of entire sick lobe was 0.18%/yr. With endoscopy, 42% of patients were found to have extensive disease within their sick lobe. Conclusions. Targeting breast cancer lumpectomy using endoscopy and excision of regional associated proliferation seems associated with lower recurrence in this non-randomized series

  16. Redefining Lumpectomy Using a Modification of the “Sick Lobe” Hypothesis and Ductal Anatomy

    Directory of Open Access Journals (Sweden)

    W. Dooley

    2011-01-01

    Full Text Available Objectives. The “Sick Lobe” hypothesis states that breast cancers evolve from entire lobes or portions of lobes of the breast where initiation events have occurred early in development. The implication is that some cancers are isolated events and others are truly multi-focal but limited to single lobar-ductal units. Methods. This is a single surgeon retrospective review of early stage breast cancer lumpectomy patients treated from 1/2000 to 2/2005. Ductal endoscopy was used direct lumpectomy surgical margins by defining ductal anatomy and mapping proliferative changes within the sick lobe for complete excision. Results. Breast conservation surgery for stage 0–2 breast cancer with an attempt to perform endoscopy in association with therapeutic lumpectomy was performed in 554 patients (successful endoscopy in 465 cases. With an average followup of >5 years for the entire group, annual hazard rate for local failure in traditional lumpectomy without ductal mapping was 0.97%/yr. and for lumpectomy with ductal mapping and excision of entire sick lobe was 0.18%/yr. With endoscopy, 42% of patients were found to have extensive disease within their “sick lobe.” Conclusions. Targeting breast cancer lumpectomy using endoscopy and excision of regional associated proliferation seems associated with lower recurrence in this non-randomized series.

  17. Basisquamous Carcinoma

    Directory of Open Access Journals (Sweden)

    Yesudian Devakar P

    1997-01-01

    Full Text Available A 50 year old woman presented with an ulceroproliferative mass in the value of 4 month duration. Biopsy of the lesion showed features of a basisquamous cell carcinoma. This is a rare tumour showing histopathological features of both basal cell and squamous cell carcinomas. The clinical, histopathological and histogenetic status of this tumour are discussed.

  18. H3K4 dimethylation in hepatocellular carcinoma is rare compared with other hepatobiliary and gastrointestinal carcinomas and correlates with expression of the methylase Ash2 and the demethylase LSD1.

    Science.gov (United States)

    Magerl, Christian; Ellinger, Jörg; Braunschweig, Till; Kremmer, Elisabeth; Koch, Lin Kristin; Höller, Tobias; Büttner, Reinhard; Lüscher, Bernhard; Gütgemann, Ines

    2010-02-01

    Methylation of core histones regulates chromatin structure and gene expression. Recent studies have demonstrated that these methylation patterns have prognostic value for some tumors. Therefore, we investigated dimethylation of histone H3 at lysine 4 (H3K4diMe) and H3K4 methylating (Ash2 complex) and demethylating enzymes (LSD1) in carcinomas of the hepatic and gastrointestinal tract. High levels of H3K4diMe were rarely observed in 15.7% of hepatocellular carcinoma (8/51) unlike other carcinomas including, in ascending order, cholangiocellular carcinoma/adenocarcinoma of the extrahepatic biliary tract, gastric carcinoma, pancreatic ductal adenocarcinoma, and neuroendocrine carcinoma (P carcinomas (38/45) and correlated directly with H3K4diMe modification (correlation coefficient r = 0.53) and LSD1 expression (r = 0.35). In contrast to other carcinomas, 65.9% (29/44) of hepatocellular carcinomas analyzed showed no LSD1 expression (P carcinomas without LSD1 expression appeared to be frequently Ash2 and H3K4diMe weak or negative (P = .004). In summary, high H3K4diMe expression is rare in hepatocellular carcinoma compared with other carcinomas (negative predictive value 92.3%), which may aid in the differential diagnosis. Lack of H3K4diMe is possibly due to complex epigenetic regulation involving Ash2 and LSD1.

  19. A rapid in vivo screen for pancreatic ductal adenocarcinoma therapeutics.

    Science.gov (United States)

    Ocal, Ozhan; Pashkov, Victor; Kollipara, Rahul K; Zolghadri, Yalda; Cruz, Victoria H; Hale, Michael A; Heath, Blake R; Artyukhin, Alex B; Christie, Alana L; Tsoulfas, Pantelis; Lorens, James B; Swift, Galvin H; Brekken, Rolf A; Wilkie, Thomas M

    2015-10-01

    Pancreatic ductal adenocarcinoma (PDA) is the fourth leading cause of cancer-related deaths in the United States, and is projected to be second by 2025. It has the worst survival rate among all major cancers. Two pressing needs for extending life expectancy of affected individuals are the development of new approaches to identify improved therapeutics, addressed herein, and the identification of early markers. PDA advances through a complex series of intercellular and physiological interactions that drive cancer progression in response to organ stress, organ failure, malnutrition, and infiltrating immune and stromal cells. Candidate drugs identified in organ culture or cell-based screens must be validated in preclinical models such as KIC (p48(Cre);LSL-Kras(G12D);Cdkn2a(f/f)) mice, a genetically engineered model of PDA in which large aggressive tumors develop by 4 weeks of age. We report a rapid, systematic and robust in vivo screen for effective drug combinations to treat Kras-dependent PDA. Kras mutations occur early in tumor progression in over 90% of human PDA cases. Protein kinase and G-protein coupled receptor (GPCR) signaling activates Kras. Regulators of G-protein signaling (RGS) proteins are coincidence detectors that can be induced by multiple inputs to feedback-regulate GPCR signaling. We crossed Rgs16::GFP bacterial artificial chromosome (BAC) transgenic mice with KIC mice and show that the Rgs16::GFP transgene is a Kras(G12D)-dependent marker of all stages of PDA, and increases proportionally to tumor burden in KIC mice. RNA sequencing (RNA-Seq) analysis of cultured primary PDA cells reveals characteristics of embryonic progenitors of pancreatic ducts and endocrine cells, and extraordinarily high expression of the receptor tyrosine kinase Axl, an emerging cancer drug target. In proof-of-principle drug screens, we find that weanling KIC mice with PDA treated for 2 weeks with gemcitabine (with or without Abraxane) plus inhibitors of Axl signaling

  20. A rapid in vivo screen for pancreatic ductal adenocarcinoma therapeutics

    Directory of Open Access Journals (Sweden)

    Ozhan Ocal

    2015-10-01

    Full Text Available Pancreatic ductal adenocarcinoma (PDA is the fourth leading cause of cancer-related deaths in the United States, and is projected to be second by 2025. It has the worst survival rate among all major cancers. Two pressing needs for extending life expectancy of affected individuals are the development of new approaches to identify improved therapeutics, addressed herein, and the identification of early markers. PDA advances through a complex series of intercellular and physiological interactions that drive cancer progression in response to organ stress, organ failure, malnutrition, and infiltrating immune and stromal cells. Candidate drugs identified in organ culture or cell-based screens must be validated in preclinical models such as KIC (p48Cre;LSL-KrasG12D;Cdkn2af/f mice, a genetically engineered model of PDA in which large aggressive tumors develop by 4 weeks of age. We report a rapid, systematic and robust in vivo screen for effective drug combinations to treat Kras-dependent PDA. Kras mutations occur early in tumor progression in over 90% of human PDA cases. Protein kinase and G-protein coupled receptor (GPCR signaling activates Kras. Regulators of G-protein signaling (RGS proteins are coincidence detectors that can be induced by multiple inputs to feedback-regulate GPCR signaling. We crossed Rgs16::GFP bacterial artificial chromosome (BAC transgenic mice with KIC mice and show that the Rgs16::GFP transgene is a KrasG12D-dependent marker of all stages of PDA, and increases proportionally to tumor burden in KIC mice. RNA sequencing (RNA-Seq analysis of cultured primary PDA cells reveals characteristics of embryonic progenitors of pancreatic ducts and endocrine cells, and extraordinarily high expression of the receptor tyrosine kinase Axl, an emerging cancer drug target. In proof-of-principle drug screens, we find that weanling KIC mice with PDA treated for 2 weeks with gemcitabine (with or without Abraxane plus inhibitors of Axl signaling

  1. Cáncer injertado en tejido mamario aberrante

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    Lidia Torres Ajá

    2012-02-01

    Full Text Available Entre las anomalías del desarrollo embrionario de las mamas se encuentran las mamas supernumerarias y el tejido ectópico aberrante. Ambas pueden ser asiento de tumores malignos de la mama, en mayor número  el tejido aberrante. Se presenta el caso de una paciente femenina de 73 años, que refiere tiene desde siempre una “mamita pequeña en el surco submamario izquierdo la cual nunca le ocasiono molestias hasta hace 2 meses en que aumentó de volumen y se le retrajo la piel". Mediante biopsia escisional se le diagnostica un carcinoma ductal infiltrante, siendo así  el primer caso de carcinoma injertado en tejido mamario aberrante diagnosticado en nuestra provincia.

  2. Epithelial myoepithelial carcinoma in nasal cavity with bony destruction: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Ho Jin; Lee, Byung Hoon; Hwang, Yoon Joon; Kim, Su Young [Dept. of Radiology, Ilsan Paik Hospital, Inje University School of Medicine, Goyang , (Korea, Republic of)

    2013-10-15

    Epithelial-myoepithelial carcinoma (EMC) is a rare tumor that commonly involves the salivary glands. EMC arising from the nasal cavity is one of the most unusual cases. We describe a case of a 48-year-old patient who is presented with bilateral nasal obstruction for several months. Multidetector computed tomography reveals expansile, well-defined, heterogeneous enhancing soft tissue masses filling the nasal cavity with bony destruction of hard palate and maxillary alveolar ridge. The carcinoma was histologically characterized by a mixture of trabecular structure with myoepithelial cells and ductal cells, which are confirmed by electron microscopy and immunohistochemistry.

  3. A subset of prostatic basal cell carcinomas harbor the MYB rearrangement of adenoid cystic carcinoma.

    Science.gov (United States)

    Bishop, Justin A; Yonescu, Raluca; Epstein, Jonathan I; Westra, William H

    2015-08-01

    Adenoid cystic carcinoma (ACC) is a basaloid tumor consisting of myoepithelial and ductal cells typically arranged in a cribriform pattern. Adenoid cystic carcinoma is generally regarded as a form of salivary gland carcinoma, but it can arise from sites unassociated with salivary tissue. A rare form of prostate carcinoma exhibits ACC-like features; it is no longer regarded as a true ACC but rather as prostatic basal cell carcinoma (PBCC) and within the spectrum of basaloid prostatic proliferations. True ACCs often harbor MYB translocations resulting in the MYB-NFIB fusion protein. MYB analysis could clarify the true nature of prostatic carcinomas that exhibit ACC features and thus help refine the classification of prostatic basaloid proliferations. Twelve PBCCs were identified from the pathology consultation files of Johns Hopkins Hospital. The histopathologic features were reviewed, and break-apart fluorescence in situ hybridization for MYB was performed. All 12 cases exhibited prominent basaloid histology. Four were purely solid, 7 exhibited a cribriform pattern reminiscent of salivary ACC, and 1 had a mixed pattern. The MYB rearrangement was detected in 2 (29%) of 7 ACC-like carcinomas but in none (0%) of the 5 PBCCs with a prominent solid pattern. True ACCs can arise in the prostate as is evidenced by the presence of the characteristic MYB rearrangement. When dealing with malignant basaloid proliferations in the prostate, recommendations to consolidate ACCs with other tumor types may need to be reassessed, particularly in light of the rapidly advancing field of biologic therapy where the identification of tumor-specific genetic alterations presents novel therapeutic targets.

  4. Von Meyenburg complex and complete ductal plate malformation along with Klatskin tumour: a rare association.

    Science.gov (United States)

    Gupta, Ashish; Pattnaik, Bramhadatta; Das, Ashim; Kaman, Lileswar

    2016-01-01

    Von Meyenburg complexes (VMCs), or bile duct microhamartomas, are among the constellation of defects of ductal plate malformation. These present as multiple small intrahepatic cysts and are diagnosed incidentally. Association of intrahepatic VMCs with a bile duct cancer has rarely been reported. We describe a case of a 53-year-old man presenting with obstructive jaundice. Biochemistry and radiology gave a provisional diagnosis of a resectable Klatskin tumour. The patient underwent right hepatectomy with common bile duct and caudate lobe excision. The histopathological examination demonstrated intrahepatic VMCs with complete ductal malformation and malignancy at the hilum. PMID:27090552

  5. Sebaceous Carcinoma

    Science.gov (United States)

    ... of the Year Award Arnold P. Gold Foundation Humanism in Medicine Award Diversity Mentorship Program Eugene Van ... What causes sebaceous carcinoma? SC is rare, so scientists still have much to learn, including what causes ...

  6. Breast magnetic resonance imaging in patients with occult breast carcinoma: evaluation on feasibility and correlation with histopathological findings

    Institute of Scientific and Technical Information of China (English)

    LU Hong; XU Yi-lin; ZHANG Shu-ping; LANG Rong-gang; Chi S.Zee; LIU Pei-fang; FU Li

    2011-01-01

    Background As an uncommon presentation, occult primary breast cancer remains a diagnostic and therapeutic challenge in clinical practice. This study aimed to retrospectively assess the feasibility of breast magnetic resonance imaging (MRI) in patients with malignant axillary lymphadenopathy and unknown primary malignancy, and correlation with histopathological characteristics.Methods A total of 35 women with occult breast carcinoma were evaluated with dynamic contrast-enhanced breast MRI. Whole seriate section was used in all cases. MRI performance was assessed and correlated with histopathological findings.Results Twenty-one of 35 patients were found to have primary breast carcinoma histologically. Twenty of the 21 patients had abnormal MR findings and 1 patient had a normal MRI study. Of the remaining 14 patients, 10 were negative on both MRI and surgery. Four had suspicious enhancement on MRI and no corresponding tumor was found. Lesions with mass enhancement were found in 55% (11/20) and ductual and segmental enhancement in 45%. The average diameter of the primary tumors was 15 mm. Invasive ductal carcinomas were found in 81% (17/21). One of 17 invasive ductual carcinomas was too small to be graded. Fourteen of the remaining 16 were classified as grade II and 2 as grade I. Thirty-two of the 35 patients had received estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 examinations and the 12 of 32 were triple-negative breast carcinoma.Conclusions Mass lesions with small size and lesions with ductal or segment enhancement are common MRI features in patients with occult breast cancer. The dominant types of primary tumors are invasive ductal carcinoma with moderate histopathological grade. The rate of triple-negative breast carcinoma may be higher in occult breast cancer.

  7. Mucinous carcinoma with axillary lymph node metastasis in a male breast: A case report

    Directory of Open Access Journals (Sweden)

    Faten Hammedi

    2010-01-01

    Full Text Available Context : Pure mucinous carcinoma of the male breast is an extremely rare neoplasm. It is characterized by a lower incidence of metastatic nodal involvement and a higher survival rate than invasive ductal carcinomas. Case Report : We report the case of a 75-year-old male who presented with a retroareolar mass of the right breast. The patient underwent radical mastectomy including right axillary lymph node dissection. The tumor was well demarcated and had a friable consistency with a gelatinous appearance. Histologically, the diagnostic of pure mucinous carcinoma with lymph node metastasis was performed. After surgery, the patient received chemotherapy, radiotherapy, and hormonotherapy (Tamoxifen. The patient remained free of disease for 36 months after surgery. Conclusion : Pure mucinous carcinoma of the male breast is a very rare tumor; in which axillary nodal disease is exceptional.

  8. Ansa Pancreatica Type of Ductal Anatomy in a Patient with Idiopathic Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Deepak K Bhasin

    2006-05-01

    Full Text Available Context :Ansa pancreatica is a type of pancreatic ductal variation. The exact clinical significance of this ductal variation is not clear. Case report :We report the case of a 21-yearold male with acute idiopathic severe pancreatitis and extensive parenchymal necrosis who later developed a large pancreatic abscess. Subsequently, transpapillary drainage of the pancreatic abscess was attempted and on endoscopic retrograde pancreatography, disruption in the mid-body of the pancreas and the ansa pancreatica type of ductal anatomy was noted. A 7 Fr nasopancreatic catheter was placed across the disruption. However, due to the development of a new abscess, surgical drainage was performed. The patient has since been asymptomatic over a one-year follow up period. Conclusion :A pancreatic ductal variation such as ansa pancreatica may be a finding in severe acute pancreatitis; it is not clear if the presence of these two conditions is coincidental or if ansa pancreatica causes acute pancreatitis. Further studies are needed to clarify these points.

  9. Ductal recanalization and stenting for late presenters with TGA intact ventricular septum

    Directory of Open Access Journals (Sweden)

    Shyam S Kothari

    2011-01-01

    Full Text Available Introduction: The ideal management strategy for patients presenting late with transposition of great arteries (TGA, intact ventricular septum (IVS, and regressed left ventricle (LV is not clear. Primary switch, two-stage switch, and Senning operation are the options. Left ventricular retraining prior to arterial switch by ductal stenting may be effective, but the experience is very limited. Methods: Five of six children aged 3-6 months with TGA-IVS and regressed LV underwent recanalization and transcatheter stenting of ductus arteriosus. The ductal stent was removed during arterial switch surgery. Results: The procedure was successful in 5/6 patients. All the patients had totally occluded ductus and needed recanalization with coronary total occlusion hardware. The ductus was dilated and stented with coronary stents. In all the patients, there was significant luminal narrowing despite adequate stent placement and deployment. Two patients needed reintervention for abrupt closure of the stent. Ductal stenting resulted in left ventricular preparedness within 7-14 days. One patient died of progressive sepsis after 14 days of stenting, even though the LV was prepared. Four patients underwent successful uneventful arterial switch surgery. During surgery, it was observed that the mucosal folds of duct were protruding through the struts of the stent in one patient. Conclusions: Ductal stenting is a good alternative strategy for left ventricular retraining in TGA with regressed LV even in patients with occluded ducts.

  10. Treatment of patent ductus arteriosus by the use of an Amplatz canine ductal occluder device.

    Science.gov (United States)

    White, Pam

    2009-04-01

    A 7-month-old female, spayed border collie was referred to the Ontario Veterinary College due to a continuous murmur noted by the referring veterinarian prior to ovariohysterectomy. Auscultation confirmed a grade VI/VI continuous murmur. An echocardiogram confirmed patent ductus arteriosus (PDA). An Amplatz canine ductal occluder device was successfully placed for occlusion of blood flow though the ductus. PMID:19436449

  11. PDX-1 Expression in Pancreatic Ductal Cells after Partial Pancreatectomy in Adult Rats

    Institute of Scientific and Technical Information of China (English)

    刘涛; 王春友; 万赤丹; 熊炯忻; 许逸卿; 周峰

    2004-01-01

    To investigate the protein and mRNA expression of pancreas/duodenal homeobox-1(PDX-1), a transcription factor as a marker for pancreatic stem cells, in pancreatic ductal cells of rats after partial (90 %) pancreatectomy and evaluated the significance of the PDX-1 expression.Western blot and Reverse transcriptase-polymerase chain reaction (RT-PCR) were used to detect the expression of PDX-1 protein and mRNA respectively. PDX-1 protein was only faintly detected in pancreatic ductal cells on the day 1 after partial pancreatectomy. On the day 2 and 3 after operation in operation group, a 2-3 fold increased PDX-1 protein was observed, corresponding to the characteristic 42-kD protein in Western blot. There was significant difference between operation group and sham-operation group (P<0.05). PDX-1 protein expression on the day 5 and 7 after operation had already been no difference from control group (P>0.05). RT-PCR revealed the PDX-1mRNA expression showed no significant difference between operation group at various time points and sham-operation group (P>0.05). These results indicate that there was overexpression of PDX-1 in the cells of pancreatic epithelium during the regeneration of remnant pancreas after partial pancreatectomy in adult rats, suggesting the pancreatic stem cells in pancreatic ductal epithelial cells are involved in the regeneration of remnant pancreas and the expression of PDX-1 in ductal cells was regulated posttranscription.

  12. Cell-free plasma microRNA in pancreatic ductal adenocarcinoma and disease controls

    DEFF Research Database (Denmark)

    Carlsen, Anting Liu; Joergensen, Maiken Thyregod; Knudsen, Steen;

    2013-01-01

    There are no tumor-specific biochemical markers for pancreatic ductal adenocarcinoma (PDAC). Tissue-specific gene expression including microRNA (miRNA) profiling, however, identifies specific PDAC signatures. This study evaluates associations between circulating, cell-free plasma-miRNA profiles a...... and PDAC in a disease and disease-control cohort....

  13. A Notch-dependent molecular circuitry initiates pancreatic endocrine and ductal cell differentiation

    DEFF Research Database (Denmark)

    Shih, Hung Ping; Kopp, Janel L; Sandhu, Manbir;

    2012-01-01

    differentiation necessitates subsequent Sox9 downregulation and evasion from Notch activity via cell-autonomous repression of Sox9 by Ngn3. If high Notch levels are maintained, endocrine progenitors retain Sox9 and undergo ductal fate conversion. Taken together, our findings establish a novel role for Notch in...

  14. Interfacing polymeric scaffolds with primary pancreatic ductal adenocarcinoma cells to develop 3D cancer models

    NARCIS (Netherlands)

    Ricci, C.; Mota, C.M.; Moscato, S.; Alessandro, D' D.; Ugel, S.; Sartoris, S.; Bronte, V.; Boggi, U.; Campani, D.; Funel, N.; Moroni, L.; Danti, S.

    2014-01-01

    We analyzed the interactions between human primary cells from pancreatic ductal adenocarcinoma (PDAC) and polymeric scaffolds to develop 3D cancer models useful for mimicking the biology of this tumor. Three scaffold types based on two biocompatible polymeric formulations, such as poly(vinyl alcohol

  15. A novel approach to ductal spasm during percutaneous device occlusion of patent ductus arteriosus.

    Science.gov (United States)

    De Decker, Rik; Comitis, George; Thomas, Jenny; van der Merwe, Elmarie; Lawrenson, John

    2016-10-01

    Ductal spasm is a rare yet important complication of device occlusions of patent ductus arteriosus. Spasm may result in failure of the procedure, under-sizing of the device, or embolisation of the implanted device as the spasm resolves after the procedure. We describe a novel protocol that rapidly and completely reversed the spasm in eight prematurely born infants who experienced ductal spasm during cardiac catheterisations for patent ductus arteriosus occlusion. In total, eight infants born between 25 and 34 weeks of gestation presented for transcatheter patent ductus arteriosus occlusion between 13 and 87 months of age. All eight patients experienced ductal spasm either immediately before, during, or soon after induction of anaesthesia or only after entering the ductus arteriosus with a catheter. After detection of the spasm, the anaesthetist, in each case, changed the mode of anaesthesia from inhaled sevoflurane to total intravenous anaesthesia with propofol, reduced the inhaled oxygen fraction to 21%, and initiated a continuous intravenous infusion of prostaglandin E1. The first two steps (total intravenous anaesthesia and FiO2 0.21) resulted in only partial relaxation of the spasm. Complete relaxation was attained after intravenous prostaglandin E1 infusions of only 10-15 minutes' duration. While maintaining this protocol, six ducti were successfully occluded and two were considered to be unsuitable for device occlusion and were referred for surgery. Ductal spasm during transcatheter occlusion may be reliably resolved and the procedure safely completed by a simple anaesthetic protocol, including the continuous infusion of intravenous prostaglandin E1.

  16. Apoptosis and hormonal milieu in ductal system of normal prostate and benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    Shu-Jie XIA; Chun-Xiao XU; Xiao-Da TANG; Wan-Zhong WANG; De-Li DU

    2001-01-01

    Aim: To study theapoptotic rate (AR) and the androgen and estrogen milieu in the proximal and distal ductal sys tems of prostate, in order to help exploring the effects of these factors on prostatic growth and the pathogenesis of be nign prostatic hypertrophy (BPH). Methods: The proximal and distal ends of the ductal system were incised from 20 normal prostate as well as the hypertrophic prostate tissue from 20 patients with BPH. The AR was determined by the DNA end-labeling method and dihydrotestosterone (DHT) and estrodiol (E2), by radioimmunoassay. Results:There was no significant difference in DHT and E2 density between the proximal and distal ends of the ductal systems in normal prostate. E2 appeared to be higher in BPH than in normal prostatic tissues, but the difference was statistically in significant. In normal prostatic tissue, the AR was significantly higher in the distal than in the proximal ends of the ductal system ( P < 0.05), while the AR of the proximal ends was significantly higher ( P < 0.01) than that in the BPH tissue. No significant correlation was noted between the DHT and E2 density and the AR both in the normal prostate and BPH tissues. Conclusion: The paper is the first time describing a difference in AR in different regions of the ductal system of normal prostate, while the hormonal milieu is similar, indicating a functional inhomogeneity of these regions. A low AR in the proximal duct, where BPH originates, and an even lower AR in the BPH tissue, sug gesting the participation of apoptosis in the BPH pathogenesis.

  17. Nitric oxide alterations following acute ductal constriction in the fetal lamb: a role for superoxide.

    Science.gov (United States)

    Hsu, Jong-Hau; Oishi, Peter; Wiseman, Dean A; Hou, Yali; Chikovani, Omar; Datar, Sanjeev; Sajti, Eniko; Johengen, Michael J; Harmon, Cynthia; Black, Stephen M; Fineman, Jeffrey R

    2010-06-01

    Acute partial compression of the fetal ductus arteriosus (DA) results in an initial abrupt increase in pulmonary blood flow (PBF), which is followed by a significant reduction in PBF to baseline values over the ensuing 2-4 h. We have previously demonstrated that this potent vasoconstricting response is due, in part, to an endothelin-1 (ET-1)-mediated decrease in nitric oxide synthase (NOS) activity. In addition, in vitro data demonstrate that ET-1 increases superoxide levels in pulmonary arterial smooth muscle cells and that oxidative stress alters NOS activity. Therefore, the objectives of this study were to determine the potential role of superoxide in the alterations of hemodynamics and NOS activity following acute ductal constriction in the late-gestation fetal lamb. Eighteen anesthetized near-term fetal lambs were instrumented, and a lung biopsy was performed. After a 48-h recovery, acute constriction of the DA was performed by inflating a vascular occluder. Polyethylene glycol-superoxide dismutase (PEG-SOD; 1,000-1,500 units/kg, n = 7) or PEG-alone (vehicle control group, n = 5) was injected into the pulmonary artery before ductal constriction. Six animals had a sham operation. In PEG-alone-treated lambs, acute ductal constriction rapidly decreased pulmonary vascular resistance (PVR) by 88%. However, by 4 h, PVR returned to preconstriction baseline. This vasoconstriction was associated with an increase in lung superoxide levels (82%), a decrease in total NOS activity (50%), and an increase in P-eNOS-Thr495 (52%) (P < 0.05). PEG-SOD prevented the increase of superoxide after ductal constriction, attenuated the vasoconstriction, preserved NOS activity, and increased P-eNOS Ser1177 (307%, P < 0.05). Sham procedure induced no changes. These data suggest that an acute decrease in NOS activity that is mediated, in part, by increased superoxide levels, and alterations in the phosphorylation status of the endothelial NOS isoform, underlie the pulmonary vascular

  18. Carcinoma primário do pulmão Primary carcinoma of the lung

    Directory of Open Access Journals (Sweden)

    A. Penna de Azevedo

    1943-01-01

    Full Text Available Em um período de 23 anos, de 1919 a 1941, observaram-se 25 casos de carcinoma primário do pulmão entre o total de 6.458 necrópsias, registadas na Secção de Anatomia Patológica do Instituto Osvaldo Cruz e realizadas nos vários hospitais do Rio de Janeiro. Os indivíduos eram de procedência variada, não só de diferentes regiões do Brasil, como também de alguns países estrangeiros. A incidência do carcinoma primário do pulmão, considerado como causa mortis, entre o total das necrópsias e de 0,38 % e, entre os casos de cancer, 4,5 %. Em referência ao sexo, 21 casos eram de indivíduos masculinos (84 % e 4 femininos (16 %, fornecendo a relação de 5:1. Dos 25 casos, 13 (52 % eram de nacionalidade estrangeira e 12 (48 % brasileira; 18, em indivíduos de cor branca, 6 pretos e 1 pardo. Em relação à idade, a maior incidência ocorreu entre 41 e 70 anos, com o máximo entre 51 a 60, existindo casos extremos de 21 e 93 anos. A forma anatômica mais freqüente, no mesmo material, e a infiltrante hilar, 16 casos (64 %, seguindo-se a nodular, com 7 casos (28 % e a difusa, 2 casos (8 . O carcinoma de células indiferenciadas é o tipo histológico mais comum, existindo em 13 casos (52 %, seguindo-se o tipo de células cilíndricas, em 8 casos (32 % e o de células pavimentosas em 4 casos (16 %. A incidência das metastases foi observada em 22 casos (88 %, sendo, para o carcinoma de células indiferenciadas, de 76,9 %, e, tanto para o carcinoma de células cilíndricas como para o de células pavimentosas, de l00%. Em três casos (12 %, não foram observadas metástases. Entre os orgãos sede frequente das metástases, foi observada a seguinte relação: gênglios linfáticos, 72 %; fígado, 56 %; pleura, 12 %; peritônio, pericárdio, rins e suprarrenal, 8 %; cérebro e osso, 4 %. Nos últimos 10 anos (1932 a 1941, ocorreram 16 casos (64 % do total dos 25 encontrados, demostrando senão o aumento do cancer pulmonar, certamente o maior n

  19. MEDULLARY CARCINOMA OF THE BREAST: ROENTGENOLOGIC AND ULTRASOUND SEMIOTICS

    Directory of Open Access Journals (Sweden)

    A. B. Abduraimov

    2015-01-01

    Full Text Available Breast cancer (BC is the most common female cancer type and the leading cause of female cancer mortality in Russia and in majority countries of the world. Along with the most common type of BC – ductal carcinoma, there are a lot of histological types, distinguished by structure features, which lead to a variable clinical and instrumental semiotics.These histological types of BC in the group marked out special types of BC, including medullary carcinoma. The concept of medullary cancer includes typical medullary BC, atypical medullary BC and invasive ductal BC with evidence of medullary morphology.Based on the current literature data, the authors discuss the main epidemiological, clinical and morphological diagnostic features of medullary BC. The authors pay special influence pathological picture, forming the characteristic diagnostic features of medullary cancer detected using X-ray mammography and ultrasound of the breast – the basic techniques of BC and other breast diseases detection.In 2003–2013 diagnosed 19 medullary BC cases in women aged 18–56 years, with 18 of them were recorded in patients aged 34–56 years. The authors describe in detail the features of clinical, mammographic and ultrasound semiotics of medullary BC. Article is focused on the main X-ray and ultrasound characteristics, such as mass shape and margin features, as well as its internal structure, and also the results of power Doppler. One of the main features of this article is description of ultrasound elastography pattern of medullary BC, which could be find in only a small number of scientific articles.Typical medullary BC, atypical medullary cancer and ductal carcinoma with medullary signs have different prognosis. This problem leads to necessity find reliable distinguishing features in mammograpic and ultrasound semiotics. It is seems important to reveal sites with indistinct margin. We have found the indistinct margin detection is not statistically significant

  20. FDG PET imaging of Ela1-myc mice reveals major biological differences between pancreatic acinar and ductal tumours

    Energy Technology Data Exchange (ETDEWEB)

    Abasolo, Ibane [Institut Municipal d' Investigacio Medica-Hospital del Mar, Parc de Recerca Biomedica de Barcelona, Barcelona (Spain); Universitat Pompeu Fabra, Parc de Recerca Biomedica de Barcelona, Departament de Ciencies Experimentals i de la Salut, Barcelona (Spain); Institut d' Alta Tecnologia - CRC, Parc de Recerca Biomedica de Barcelona, Barcelona (Spain); Pujal, Judit; Navarro, Pilar [Institut Municipal d' Investigacio Medica-Hospital del Mar, Parc de Recerca Biomedica de Barcelona, Barcelona (Spain); Rabanal, Rosa M.; Serafin, Anna [Universitat Autonoma de Barcelona, Departament de Medicina i Cirurgia Animals, Barcelona (Spain); Millan, Olga [Institut d' Alta Tecnologia - CRC, Parc de Recerca Biomedica de Barcelona, Barcelona (Spain); Real, Francisco X. [Institut Municipal d' Investigacio Medica-Hospital del Mar, Parc de Recerca Biomedica de Barcelona, Barcelona (Spain); Universitat Pompeu Fabra, Parc de Recerca Biomedica de Barcelona, Departament de Ciencies Experimentals i de la Salut, Barcelona (Spain); Programa de Patologia Molecular, Centro Nacional de Investigaciones Oncologicas, Madrid (Spain)

    2009-07-15

    The aim was to evaluate FDG PET imaging in Ela1-myc mice, a pancreatic cancer model resulting in the development of tumours with either acinar or mixed acinar-ductal phenotype. Transversal and longitudinal FDG PET studies were conducted; selected tissue samples were subjected to autoradiography and ex vivo organ counting. Glucose transporter and hexokinase mRNA expression was analysed by quantitative reverse transcription polymerase chain reaction (RT-PCR); Glut2 expression was analysed by immunohistochemistry. Transversal studies showed that mixed acinar-ductal tumours could be identified by FDG PET several weeks before they could be detected by hand palpation. Longitudinal studies revealed that ductal - but not acinar - tumours could be detected by FDG PET. Autoradiographic analysis confirmed that tumour areas with ductal differentiation incorporated more FDG than areas displaying acinar differentiation. Ex vivo radioactivity measurements showed that tumours of solely acinar phenotype incorporated more FDG than pancreata of non-transgenic littermates despite the fact that they did not yield positive PET images. To gain insight into the biological basis of the differential FDG uptake, glucose transporter and hexokinase transcript expression was studied in microdissected tumour areas enriched for acinar or ductal cells and validated using cell-specific markers. Glut2 and hexokinase I and II mRNA levels were up to 20-fold higher in ductal than in acinar tumours. Besides, Glut2 protein overexpression was found in ductal neoplastic cells but not in the surrounding stroma. In Ela1-myc mice, ductal tumours incorporate significantly more FDG than acinar tumours. This difference likely results from differential expression of Glut2 and hexokinases. These findings reveal previously unreported biological differences between acinar and ductal pancreatic tumours. (orig.)

  1. KRAS Mutations in Canine and Feline Pancreatic Acinar Cell Carcinoma.

    Science.gov (United States)

    Crozier, C; Wood, G A; Foster, R A; Stasi, S; Liu, J H W; Bartlett, J M S; Coomber, B L; Sabine, V S

    2016-07-01

    Companion animals may serve as valuable models for studying human cancers. Although KRAS is the most commonly mutated gene in human ductal pancreatic cancers (57%), with mutations frequently occurring at codons 12, 13 and 61, human pancreatic acinar cell carcinomas (ACCs) lack activating KRAS mutations. In the present study, 32 pancreatic ACC samples obtained from 14 dogs and 18 cats, including seven metastases, were analyzed for six common activating KRAS mutations located in codons 12 (n = 5) and 13 (n = 1) using Sequenom MassARRAY. No KRAS mutations were found, suggesting that, similar to human pancreatic ACC, KRAS mutations do not play a critical role in feline or canine pancreatic ACC. Due to the similarity of the clinical disease in dogs and cats to that of man, this study confirms that companion animals offer potential as a suitable model for investigating this rare subtype of pancreatic carcinoma. PMID:27290644

  2. CT features of colloid carcinomas of the pancreas

    Institute of Scientific and Technical Information of China (English)

    REN Fang-yuan; SHAO Cheng-wei; ZUO Chang-jing; LU Jian-ping

    2010-01-01

    Background Colloid carcinomas of the pancreas have better prognosis than ordinary ductal adenocarcinoma, and preoperative distinction of colloid carcinoma from other pancreatic tumors is valuable for patient therapeutic planning and prognosis assessment.However, data about CT features of colloid carcinoma are very limited.This study aimed to investigate the CT features of this tumor.Methods Institutional review board approval was obtained for this study.Seven patients with pathologically proven colloid carcinoma of the pancreas were included.Unenhanced and dynamic enhanced CT was performed in all the patients.CT features were analyzed retrospectively and correlations with pathological findings were evaluated.Results Mean age of the patients was 59.8 years (41-76 years).Five tumors were located in the pancreatic head, and the other two in body and tail respectively.The maximum mean diameter of the tumors on axial scanning was 3.9 cm (3.0-6.7 cm).Tumors were round (n=5) and Iobular (n=2).Tumors appeared slight hyp-attenuation on unenhanced CT, and peripheral and internal meshlike progressive delayed enhancement with great percent of cystic areas on enhanced CT.Calcification and gas in the tumor was seen in one patient whose duodenum was invaded by the tumor.Conclusions Colloid carcinomas of the pancreas appear as round or labular masses with great percent of cystic areas and slight hyp-attenuation on unenhanced CT and peripheral and internal meshlike progressive delayed enhancement on enhanced CT.

  3. Telomere length alterations unique to invasive lobular carcinoma.

    Science.gov (United States)

    Heaphy, Christopher M; Asch-Kendrick, Rebecca; Argani, Pedram; Meeker, Alan K; Cimino-Mathews, Ashley

    2015-08-01

    Telomeres are nucleoprotein complexes located at the extreme ends of eukaryotic chromosomes and protect chromosomal ends from degradation and recombination. Dysfunctional telomeres contribute to genomic instability, promote tumorigenesis, and, in breast cancer, have been associated with increased cancer risk and poor prognosis. Short telomere lengths have been previously associated with triple-negative and human epidermal growth factor receptor (Her2)--positive ductal carcinomas. However, these investigations have not specifically assessed invasive lobular carcinomas (ILCs), which accounts for 5% to 15% of all invasive breast cancers. Here, we evaluate telomere lengths within 48 primary ILCs with complete characterization of estrogen receptor (ER), progesterone receptor (PR), and Her2 status, including 32 luminal/Her2- (ER+/PR+/Her2-), 8 luminal/Her2+ (ER+/PR+/Her2+), 3 Her2+ (ER-/PR-/Her2+), and 5 triple-negative (ER-/PR-/Her2-) carcinomas. A telomere-specific fluorescence in situ hybridization assay, which provides single-cell telomere length resolution, was used to evaluate telomere lengths and compare with standard clinicopathological markers. In contrast to breast ductal carcinoma, in which more than 85% of cases display abnormally short telomeres, approximately half (52%) of the ILCs displayed either normal or long telomeres. Short telomere length was associated with older patient age. Interestingly, 3 cases (6%) displayed a unique telomere pattern consisting of 1 or 2 bright telomere spots among the normal telomere signals within each individual cancer cell, a phenotype that has not been previously described. Additional studies are needed to further evaluate the significance of the unique bright telomere spot phenotype and the potential utility of telomere length as a prognostic marker in ILC.

  4. Acinic cell carcinoma of breast: morphologic and immunohistochemical review of a rare breast cancer subtype☆

    Science.gov (United States)

    Conlon, Niamh; Sadri, Navid; Corben, Adriana D.; Tan, Lee K.

    2016-01-01

    Summary Acinic cell carcinoma of breast is a rare subtype of triple-negative breast carcinoma and demonstrates extensive morphologic overlap with acinic cell carcinoma of the salivary gland. In this study, we perform a detailed morphologic and immunohistochemical description of 2 cases of this rare entity and undertake a comprehensive review of all reported cases of breast acinic cell carcinoma in the English language literature to date. One-third of reported cases of breast acinic cell carcinoma have been associated with the presence of a ductal carcinoma not otherwise specified component, which is frequently poorly differentiated. Breast acinic cell carcinoma can demonstrate focal morphologic features similar to microglandular adenosis; these areas are frequently negative for collagen IV and laminin on immunohistochemistry. The true relationship between these 2 entities remains unclear, but we advocate that microglandular adenosis–like areas at the periphery of a breast acinic cell carcinoma should be considered part of the carcinomatous process and re-excised if this process extends to the initial surgical margins. PMID:27067778

  5. Acinic cell carcinoma of breast: morphologic and immunohistochemical review of a rare breast cancer subtype.

    Science.gov (United States)

    Conlon, Niamh; Sadri, Navid; Corben, Adriana D; Tan, Lee K

    2016-05-01

    Acinic cell carcinoma of breast is a rare subtype of triple-negative breast carcinoma and demonstrates extensive morphologic overlap with acinic cell carcinoma of the salivary gland. In this study, we perform a detailed morphologic and immunohistochemical description of 2 cases of this rare entity and undertake a comprehensive review of all reported cases of breast acinic cell carcinoma in the English language literature to date. One-third of reported cases of breast acinic cell carcinoma have been associated with the presence of a ductal carcinoma not otherwise specified component, which is frequently poorly differentiated. Breast acinic cell carcinoma can demonstrate focal morphologic features similar to microglandular adenosis; these areas are frequently negative for collagen IV and laminin on immunohistochemistry. The true relationship between these 2 entities remains unclear, but we advocate that microglandular adenosis-like areas at the periphery of a breast acinic cell carcinoma should be considered part of the carcinomatous process and re-excised if this process extends to the initial surgical margins. PMID:27067778

  6. Expression of the "stem cell marker" CD133 in pancreas and pancreatic ductal adenocarcinomas

    Directory of Open Access Journals (Sweden)

    Sakariassen Per

    2008-02-01

    Full Text Available Abstract Background It has been suggested that a small population of cells with unique self-renewal properties and malignant potential exists in solid tumors. Such "cancer stem cells" have been isolated by flow cytometry, followed by xenograft studies of their tumor-initiating properties. A frequently used sorting marker in these experiments is the cell surface protein CD133 (prominin-1. The aim of this work was to examine the distribution of CD133 in pancreatic exocrine cancer. Methods Fifty-one cases of pancreatic ductal adenocarcinomas were clinically and histopathologically evaluated, and immunohistochemically investigated for expression of CD133, cytokeratin 19 and chromogranin A. The results were interpreted on the background of CD133 expression in normal pancreas and other normal and malignant human tissues. Results CD133 positivity could not be related to a specific embryonic layer of organ origin and was seen mainly at the apical/endoluminal surface of non-squamous, glandular epithelia and of malignant cells in ductal arrangement. Cytoplasmic CD133 staining was observed in some non-epithelial malignancies. In the pancreas, we found CD133 expressed on the apical membrane of ductal cells. In a small subset of ductal cells and in cells in centroacinar position, we also observed expression in the cytoplasm. Pancreatic ductal adenocarcinomas showed a varying degree of apical cell surface CD133 expression, and cytoplasmic staining in a few tumor cells was noted. There was no correlation between the level of CD133 expression and patient survival. Conclusion Neither in the pancreas nor in the other investigated organs can CD133 membrane expression alone be a criterion for "stemness". However, there was an interesting difference in subcellular localization with a minor cell population in normal and malignant pancreatic tissue showing cytoplasmic expression. Moreover, since CD133 was expressed in shed ductal cells of pancreatic tumors and was

  7. Whole exome sequencing reveals recurrent mutations in BRCA2 and FAT genes in acinar cell carcinomas of the pancreas

    OpenAIRE

    Toru Furukawa; Hitomi Sakamoto; Shoko Takeuchi; Mitra Ameri; Yuko Kuboki; Toshiyuki Yamamoto; Takashi Hatori; Masakazu Yamamoto; Masanori Sugiyama; Nobuyuki Ohike; Hiroshi Yamaguchi; Michio Shimizu; Noriyuki Shibata; Kyoko Shimizu; Keiko Shiratori

    2015-01-01

    Acinar cell carcinoma of the pancreas is a rare tumor with a poor prognosis. Compared to pancreatic ductal adenocarcinoma, its molecular features are poorly known. We studied a total of 11 acinar cell carcinomas, including 3 by exome and 4 by target sequencing. Exome sequencing revealed 65 nonsynonymous mutations and 22 indels with a mutation rate of 3.4 mutations/Mb per tumor, on average. By accounting for not only somatic but also germline mutations with loss of the wild-type allele, we ide...

  8. KLF4 Is Essential for Induction of Cellular Identity Change and Acinar-to-Ductal Reprogramming during Early Pancreatic Carcinogenesis.

    Science.gov (United States)

    Wei, Daoyan; Wang, Liang; Yan, Yongmin; Jia, Zhiliang; Gagea, Mihai; Li, Zhiwei; Zuo, Xiangsheng; Kong, Xiangyu; Huang, Suyun; Xie, Keping

    2016-03-14

    Understanding the molecular mechanisms of tumor initiation has significant impact on early cancer detection and intervention. To define the role of KLF4 in pancreatic ductal adenocarcinoma (PDA) initiation, we used molecular biological analyses and mouse models of klf4 gain- and loss-of-function and mutant Kras. KLF4 is upregulated in and required for acinar-to-ductal metaplasia. Klf4 ablation drastically attenuates the formation of pancreatic intraepithelial neoplasia induced by mutant Kras(G12D), whereas upregulation of KLF4 does the opposite. Mutant KRAS and cellular injuries induce KLF4 expression, and ectopic expression of KLF4 in acinar cells reduces acinar lineage- and induces ductal lineage-related marker expression. These results demonstrate that KLF4 induces ductal identity in PanIN initiation and may be a potential target for prevention of PDA initiation.

  9. Is there different correlation with prognostic factors between “non-mass” and “mass” type invasive ductal breast cancers?

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Lei, E-mail: jiang_belinder@sina.com [Radiology Department, Beijing Hospital, Peking University, The Ministry of Health, Dahua Road 1#, East District, Beijing 100730 (China); Zhou, Yiming, E-mail: zhou_belly@sina.com [Radiology Department, Chaoyang Hospital, Capital University, Baijiazhuang Road 8#, Chaoyang District, Beijing 100020 (China); Wang, Zheng, E-mail: wangzhengmay@163.com [Pathology Department, Beijing Hospital, Peking University, The Ministry of Health, Dahua Road 1#, East District, Beijing 100730 (China); Lu, Xu, E-mail: luxu01@sina.cn [Surgery Department, Beijing Hospital, Peking University, The Ministry of Health, Dahua Road 1#, East District, Beijing 100730 (China); Chen, Min, E-mail: chenmin62@yahoo.com [Radiology Department, Beijing Hospital, Peking University, The Ministry of Health, Dahua Road 1#, East District, Beijing 100730 (China); Zhou, Cheng, E-mail: Chengzhou2000@yahoo.com [Radiology Department, Beijing Hospital, Peking University, The Ministry of Health, Dahua Road 1#, East District, Beijing 100730 (China)

    2013-09-15

    Purpose: To investigate the association between non-mass type breast cancer and common clinical–pathological prognostic factors, compared with mass type breast cancer. Materials and methods: After institutional review board approval, retrospective blind review of contrast-enhanced breast MRI was carried out for 88 histologically proven breast invasive ductal carcinoma (IDC) patients, presenting from January 2008 to December 2011. Two radiologists assessed the images of each lesion for the morphologic enhancement type [mass enhancement or non-mass-like enhancement (NMLE)] and the distribution/internal enhancement of NMLE. Two pathologists evaluated the histological grade of IDC, presence or absence of ductal carcinoma in situ (DCIS), lymph node status, presence or absence of vascular invasion, and expression status of estrogen receptor (ER)/progesterone receptor (PR)/HER-2/p53 tumor suppressor gene (p53)/Ki-67. Inter-observer agreement was assessed with kappa test. Chi-square test and Spearman rank correlation were performed to explore the associations of morphologic enhancement type with the age, lesion size and the above pathological prognostic factors Results: Inter-observer agreement was excellent, with kappa > 0.75. Morphologic enhancement type was significantly correlated with age (P = 0.02), with NMLE more commonly seen in women less than 50 y/o. The size of NMLE was larger than that of mass and, with the increase of lesion size, proportion of NMLE among the cases increased (P = 0.001). NMLE was also significantly correlated with low histologic grade of IDC (P = 0.003) and presence of DCIS (P < 0.001). There was no significant correlation between morphologic enhancement type and lymph node status, vascular invasion, ER/PR/HER-2/p53/Ki-67 status. The histological grade was higher in clumped enhancement than non-clumped (P = 0.011). There was no correlation between enhancement distribution and prognostic factors Conclusions: Non-mass type breast cancer may

  10. Carcinoma vulvar

    Directory of Open Access Journals (Sweden)

    Yamit Peñas Zayas

    2015-11-01

    Full Text Available El carcinoma de la vulva tiene una incidencia de aproximadamente un 3-5% dentro de todas las enfermedades ginecológicas malignas. El 90% de los tumores malignos de la vulva está constituido por carcinoma epidermoide, el resto son adenocarcinomas, carcinomas de células basales y melanomas. Se realiza la presentación de un caso de una paciente femenina de 25 años de edad con antecedentes  de Diabetes Mellitus tipo II y trombopatia, que ingresa en el servicio de ginecología con un cuadro cutáneo polimorfo, localizado en labios mayores y menores, dado por lesiones eritematoerosivas y vegetante, sospechándose clínicamente el diagnóstico  de un carcinoma epidermoide, corroborándose el mismo histológicamente al realizarse biopsia de piel. Se indicó tratamiento con quimioterapia. Por la edad de la paciente y ser menos frecuente en mucosa que en la piel,  motivo la presentación del caso.

  11. Parathyroid carcinoma

    DEFF Research Database (Denmark)

    Qvist, N; Krøll, L; Ladefoged, C;

    1986-01-01

    Parathyroid carcinoma is a slow growing tumor, and the patients most often die from complications to the hypercalcemia. Therefore, any attempt should be made to remove local recurrence and metastasis surgically, as medical treatment is disappointing. A case treated with extensive vascular surgery...

  12. Inverted ductal papilloma of the oral cavity secondary to lower lip trauma. A case report and literature review

    OpenAIRE

    Sala Pérez, Sergi; España Tost, Antonio Jesús; Vidal Bel, A.; Gay Escoda, Cosme

    2013-01-01

    Inverted ductal papilloma of the oral cavity is an infrequent benign neoplasm of papillary appearance that originates in the secretory duct of a salivary gland. The etiology is unknown, though some authors have related it to human papillomavirus (HPV) infection. We present the case of a 40-year-old woman with a tumor of the lower lip mucosa. Histopathological study of the lesion diagnosed inverted ductal papilloma of the oral cavity. Human papillomavirus DNA detection and typing based on tumo...

  13. Increased SGLT1 expression in salivary gland ductal cells correlates with hyposalivation in diabetic and hypertensive rats

    OpenAIRE

    Sabino-Silva, Robinson; Okamoto, Maristela Mitiko; David-Silva, Aline; Mori, Rosana Cristina; Freitas, Helayne Soares; Machado, Ubiratan Fabres

    2013-01-01

    Background Oral health complications in diabetes and hypertension include decreased salivary secretion. The sodium-glucose cotransporter 1 (SGLT1) protein, which transports 1 glucose/2 Na+/264 H2O molecules, is described in salivary glands. We hypothesized that changes in SGLT1 expression in the luminal membrane of ductal cell may be related to an altered salivary flow. Findings By immunohistochemistry, we investigated SGLT1 expression in ductal cells of parotid and submandibular glands from ...

  14. Development of a panel of DNA Aptamers with High Affinity for Pancreatic Ductal Adenocarcinoma

    Science.gov (United States)

    Champanhac, Carole; Teng, I.-Ting; Cansiz, Sena; Zhang, Liqin; Wu, Xiaoqiu; Zhoa, Zilong; Fu, Ting; Tan, Weihong

    2015-11-01

    Pancreatic cancer costs nearly 40,000 lives in the U.S. each year and has one of the lowest survival rates among cancers. Effective treatment of pancreatic ductal adenocarcinoma is hindered by lack of a reliable biomarker. To address this challenge, aptamers were selected by cell-SELEX (Systematic Evolution of Ligands by EXponential enrichment) targeting human pancreatic ductal adenocarcinoma (PL45). Five promising aptamers presenting low Kd values and good specificity were generated. Among these five aptamers, one was tailored into a nanostructure carrying a high drug payload for specific drug delivery. The results show a viability of almost 80% for negative cells while only 50% of the target cells remained alive after 48 h incubation. These results lead to the conclusion that further research could reveal protein biomarkers specific to pancreatic adenocarcinoma, with probes available for early detection.

  15. Apocrine Sweat Gland Ductal Adenoma with Sebaceous Differentiation in a Dog

    Directory of Open Access Journals (Sweden)

    Masaki Michishita

    2013-01-01

    Full Text Available A 7-year-old male, Border Collie, developed a firm mass, measuring approximately 1 cm in diameter, in the left buccal skin. Histologically, the mass was composed of ductal structures lined by bilayered luminal epithelial and basaloid tumor cells along with a few nests of sebaceous cells. Immunohistochemical staining revealed that the luminal epithelial tumor cells were positive for cytokeratin (CK, CAM5.2 and CK19 but not for CK14 or p63. In contrast, the basaloid tumor cells were positive for CK14, p63, and αSMA but not for CK19 or CAM5.2. CK8 expression was observed in both luminal epithelial and basaloid tumor cells. The tumor cells with sebaceous differentiation were positive for CK14 but not for the other markers. This is the first case of an apocrine sweat gland ductal adenoma with sebaceous differentiation occurring in the buccal skin of a dog.

  16. Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation): A Review

    OpenAIRE

    Salvatore Paiella; Roberto Salvia; Marco Ramera; Roberto Girelli; Isabella Frigerio; Alessandro Giardino; Valentina Allegrini; Claudio Bassi

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) has still a dismal prognosis. Locally advanced pancreatic cancer (LAPC) accounts for the 40% of the new diagnoses. Current treatment options are based on chemo- and radiotherapy regimens. Local ablative techniques seem to be the future therapeutic option for stage-III patients with PDAC. Radiofrequency Ablation (RFA) and Irreversible Electroporation (IRE) are actually the most emerging local ablative techniques used on LAPC. Initial clinical studies on ...

  17. ERP in chronic pancreatitis - ductal morphology, relation to exocrine function and pain - clinical value

    International Nuclear Information System (INIS)

    ERP was analyzed in 87 patients with chronic pancreatitis with special reference to its clinical value in management of pain, the dominating symptom in uncomplicated chronic pancreatitis. A significant correlation was found between ductal changes due to pancreatitis and decrease in pancreatic function. However, no association was found between severe pancreatic pain and pancreatic function or pancreatic morphology. The significance of ERP in management of patients with persistent severe pancreatic pain is discussed. (orig.)

  18. Bicaudal C1 promotes pancreatic NEUROG3+ endocrine progenitor differentiation and ductal morphogenesis

    DEFF Research Database (Denmark)

    Lemaire, Laurence A; Goulley, Joan; Kim, Yung Hae;

    2015-01-01

    that line the ducts during development, and in the ducts after birth, but not in differentiated endocrine or acinar cells. Genetic inactivation of Bicc1 leads to ductal cell over-proliferation and cyst formation. Transcriptome comparison between WT and Bicc1 KO pancreata, before the phenotype onset, reveals......, and suggest a new candidate gene for syndromes associating kidney dysplasia with pancreatic disorders, including diabetes....

  19. Slug inhibits pancreatic cancer initiation by blocking Kras-induced acinar-ductal metaplasia

    OpenAIRE

    Kazumi Ebine; Chow, Christina R.; DeCant, Brian T.; Hattaway, Holly Z.; Grippo, Paul J.; Krishan Kumar; Munshi, Hidayatullah G.

    2016-01-01

    Cells in the pancreas that have undergone acinar-ductal metaplasia (ADM) can transform into premalignant cells that can eventually become cancerous. Although the epithelial-mesenchymal transition regulator Snail (Snai1) can cooperate with Kras in acinar cells to enhance ADM development, the contribution of Snail-related protein Slug (Snai2) to ADM development is not known. Thus, transgenic mice expressing Slug and Kras in acinar cells were generated. Surprisingly, Slug attenuated Kras-induced...

  20. SCF, Regulated by HIF-1α, Promotes Pancreatic Ductal Adenocarcinoma Cell Progression

    OpenAIRE

    Gao, Chuntao; Li, Shasha; Zhao, Tiansuo; Chen, Jing; Ren, He; Zhang, Huan; Wang, Xiuchao; Lang, Mingxiao; Liu, Jingcheng; Gao, Song; Zhao, Xiao; Sheng, Jun; Yuan, Zhanna; Hao, Jihui

    2015-01-01

    Stem cell factor (SCF) and hypoxia-inducible factor-1α (HIF-1α) both have important functions in pancreatic ductal adenocarcinoma (PDAC). This study aims to analyze the expression and clinicopathological significance of SCF and HIF-1α in PDAC specimens and explore the molecular mechanism at PDAC cells in vitro and in vivo. We showed that the expression of SCF was significantly correlated with HIF-1α expression via Western blot, PCR, chromatin immunoprecipitation (ChIP) assay, and luciferase a...

  1. β-cell replacement sources for type 1 diabetes: a focus on pancreatic ductal cells.

    Science.gov (United States)

    Corritore, Elisa; Lee, Yong-Syu; Sokal, Etienne M; Lysy, Philippe A

    2016-08-01

    Thorough research on the capacity of human islet transplantation to cure type 1 diabetes led to the achievement of 3- to 5-year-long insulin independence in nearly half of transplanted patients. Yet, translation of this technique to clinical routine is limited by organ shortage and the need for long-term immunosuppression, restricting its use to adults with unstable disease. The production of new bona fide β cells in vitro was thus investigated and finally achieved with human pluripotent stem cells (PSCs). Besides ethical concerns about the use of human embryos, studies are now evaluating the possibility of circumventing the spontaneous tumor formation associated with transplantation of PSCs. These issues fueled the search for cell candidates for β-cell engineering with safe profiles for clinical translation. In vivo studies revealed the regeneration capacity of the exocrine pancreas after injury that depends at least partially on facultative progenitors in the ductal compartment. These stimulated subpopulations of pancreatic ductal cells (PDCs) underwent β-cell transdifferentiation through reactivation of embryonic signaling pathways. In vitro models for expansion and differentiation of purified PDCs toward insulin-producing cells were described using cocktails of growth factors, extracellular-matrix proteins and transcription factor overexpression. In this review, we will describe the latest findings in pancreatic β-cell mass regeneration due to adult ductal progenitor cells. We will further describe recent advances in human PDC transdifferentiation to insulin-producing cells with potential for clinical translational studies.

  2. β-cell replacement sources for type 1 diabetes: a focus on pancreatic ductal cells.

    Science.gov (United States)

    Corritore, Elisa; Lee, Yong-Syu; Sokal, Etienne M; Lysy, Philippe A

    2016-08-01

    Thorough research on the capacity of human islet transplantation to cure type 1 diabetes led to the achievement of 3- to 5-year-long insulin independence in nearly half of transplanted patients. Yet, translation of this technique to clinical routine is limited by organ shortage and the need for long-term immunosuppression, restricting its use to adults with unstable disease. The production of new bona fide β cells in vitro was thus investigated and finally achieved with human pluripotent stem cells (PSCs). Besides ethical concerns about the use of human embryos, studies are now evaluating the possibility of circumventing the spontaneous tumor formation associated with transplantation of PSCs. These issues fueled the search for cell candidates for β-cell engineering with safe profiles for clinical translation. In vivo studies revealed the regeneration capacity of the exocrine pancreas after injury that depends at least partially on facultative progenitors in the ductal compartment. These stimulated subpopulations of pancreatic ductal cells (PDCs) underwent β-cell transdifferentiation through reactivation of embryonic signaling pathways. In vitro models for expansion and differentiation of purified PDCs toward insulin-producing cells were described using cocktails of growth factors, extracellular-matrix proteins and transcription factor overexpression. In this review, we will describe the latest findings in pancreatic β-cell mass regeneration due to adult ductal progenitor cells. We will further describe recent advances in human PDC transdifferentiation to insulin-producing cells with potential for clinical translational studies. PMID:27540464

  3. Does pancreatic ductal anatomy play a role in determining outcomes of pancreatic anastomoses?

    Science.gov (United States)

    Shukla, P J; Sakpal, S V; Maharaj, R

    2011-02-01

    Pancreatoduodenectomy (PD) is the surgical procedure performed for cancers of the head of the pancreas. Despite a substantial reduction in mortality rates following PD, morbidity remains high secondary to major post-operative complications. Post-operative pancreatic fistula (POPF), the commonest major complication following PD, results from the failure of the pancreato-enteric anastomosis. There appears to be a correlation between intrinsic pancreatic features like the texture of the gland and duct size and the outcome of the pancreatic anastomosis. Based on current clinical research data, we propose a new hypothesis called the "pancreatic ductal anatomy" concept. We hypothesize that morphological variations, anomalies or aberrations of the main pancreatic duct play a role in the outcome of the pancreatic anastomosis, irrespective of its type. The consequence of aberrant ductal anatomy is that certain areas of the remnant pancreas remain either undrained or partially drained, or have blocked ductules/ducts. This results in localized obstructive pancreatitis causing an inflammatory reaction which jeopardizes the anastomosis. We also propose two maneuvers which could possibly play a role in predicting potential problems and also planning the surgical resection and reconstruction in order to reduce the incidence of POPF. The first modality is the use of pre-operative magnetic resonance imaging (MRI) of the pancreatic duct, and the second maneuver is the gentle cannulation test of the pancreatic duct with a soft, narrow tube following transection of the pancreatic neck. These factors would alert the surgeon about potential ductal variations and could facilitate the surgical approach.

  4. Thyroid cancer - medullary carcinoma

    Science.gov (United States)

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary ... The cause of medullary carcinoma of the thyroid (MTC) is unknown. MTC is very rare. It can occur in children and adults. Unlike other types ...

  5. Basal Cell Carcinoma (BCC)

    Science.gov (United States)

    ... epithelioma, is the most common form of skin cancer. Basal cell carcinoma usually occurs on sun-damaged skin, especially ... other health issues. Infiltrating or morpheaform basal cell carcinomas: Infiltrating basal cell carcinomas can be more aggressive and locally destructive ...

  6. Metaplastic carcinoma of the breast: multimodality imaging and histopathologic assessment

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Bae (Department of Radiology, Chungnam National University Hospital, Daejeon (Korea, Republic of)), Email: med20@hanmail.net; Shu, Kwang Sun (Department of Pathology, Chungnam National University Hospital, Daejeon (Korea, Republic of))

    2012-02-15

    Background Metaplastic carcinomas are ductal carcinomas that display metaplastic transformation of the glandular epithelium to non-glandular mesenchymal tissue. Metaplastic carcinoma has a poorer prognosis than most other breast cancers, so the differential diagnosis is important. Although many clinical and pathologic findings have been reported, to our knowledge, few imaging findings related to metaplastic carcinoma have been reported. Purpose To investigate whole-breast imaging findings, including mammography, sonography, MRI, and pathologic findings, including immunohistochemical studies of metaplastic carcinomas of the breast. Material and Methods We analyzed 33 cases of metaplastic carcinoma between January 2001 and January 2011. Mammography, ultrasonography, and MRI were recorded retrospectively using the American College of Radiology (ACR) breast imaging reporting and data system (BI-RADS) lexicon. Immunohistochemical studies of estrogen receptor (ER), progesterone receptor (PR), p53, and C-erbB-2 were performed. Results The most common mammographic findings were oval shape (37%), circumscribed margin (59%), and high density (74%). The most common sonogfindings were irregular shape (59.4%), microlobulated margin (41%), complex echogenicity (81%), parallel orientation (97%), and posterior acoustic enhancement (50%). Axillary lymph node metastases were noted for 25% of the sonographic examinations. On MRI, the most common findings of margin and shape were irregularity (57% and 52.4%, respectively). High signal intensity was the most common finding on T2-weighted images (57%). Immunohistochemical profile was negative for ER (91%, 29/32) and PR (81%, 26/32). Conclusion Metaplastic carcinomas might display more benign features and less axillary lymph node metastasis than IDC. High signal intensity on T2 MRI images and hormone receptor negativity would be helpful in differentiating this tumor from other breast cancers

  7. Carcinoma verrugoso

    Directory of Open Access Journals (Sweden)

    Esteban Quesada Jiménez

    2004-09-01

    Full Text Available Se presenta el caso de un paciente masculino de 76 años, vecino de Turrialba, agricultor, que consultó por una lesión de 3 años de evolución, localizada en la palma de la mano derecha a nivel palmar y compromiso de los dedos de la misma mano, caracterizada como una neoformación exofítica verrugosa de 5 por 11 cm. aproximadamente, con material caseoso entre sus crestas. La lesión ha estado creciendo de forma acelerada en los últimos 3 meses, causándole dolor y que le imposibilita ellaborar. Se le realizaron exámenes y se descartaron varias causas infecciosas, y concluyendo luego de varias biopsias con el diagnóstico de un carcinoma verrugoso. El paciente fue tratado mediante una amputación parcial de la mano. Este tumor es una variante del carcinoma epidermoide y presentamos su clasificación, patogénesis, histopatología, manifestaciones clínicas más frecuentes y diagnóstico diferencial.A 76 year old farmer from Turrialba (Cartago, presented with a 3 year old lesion of his right pal and proximal fingers. It was exophitic, wart like, and it measured 5x11 cm, draining caseous material from its crests. The lesion had grows quickly for the last 3 months and it became tender to the point of making impossible for him to work. A series of tests were done to rule out other possible infections causes, after several biopsies the diagnosis of verrocous carcinoma was made. The patient underwent a partial amputation of his hand. This tumor is considered a from of squamous cell carcinoma, we present here its classification, pathogenesis, histopathology, clinical manifestations and diferential diagnosis.

  8. Salivary Duct Carcinoma of the Minor Salivary Gland: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Shalini Gupta

    2013-08-01

    Full Text Available Salivary duct carcinoma is a rare invasive malignancy arising in the ductal epithelium of the salivary glands. Nearly 85% of the cases occur in the parotid gland followed by submandibular gland. Rarely is it described in the hard palate. Salivary duct carcinomas affecting the minor salivary glands have been reported in only 4% of the SDC cases and constitute 2% of all the salivary gland malignant neoplasms. It is characterized by aggressive behavior with early metastasis, local recurrence and significant mortality. The tumor has predilection for older men in the 6th to 7th decades of life. In this article; we report a case of a salivary gland carcinoma which was present in the right posterior region of the maxilla of a 50 year old female patient. [J Interdiscipl Histopathol 2013; 1(4.000: 222-226

  9. Cancer Grafted in Aberrant Breast Tissue Cáncer injertado en tejido mamario aberrante

    Directory of Open Access Journals (Sweden)

    Lidia Torres Ajá

    2012-03-01

    Full Text Available Among the anomalies during embryonic development of the breasts we may find supernumerary breasts and aberrant ectopic tissue. In both of them, malignant tumors of the breast can proliferate, mostly in aberrant tissue. We present the case of a female patient aged 73, who refers to have always had a "little mammary gland in the left submammary that never caused discomfort to the last two months when its volume increased and the skin retracted". Excisional biopsy allowed diagnosing an infiltrating ductal carcinoma, the first case of carcinoma grafted in aberrant breast tissue diagnosed in the province.

    Entre las anomalías del desarrollo embrionario de las mamas se encuentran las mamas supernumerarias y el tejido ectópico aberrante. Ambas pueden ser asiento de tumores malignos de la mama, en mayor número  el tejido aberrante. Se presenta el caso de una paciente femenina de 73 años, que refiere tiene desde siempre una “mamita pequeña en el surco submamario izquierdo la cual nunca le ocasiono molestias hasta hace 2 meses en que aumentó de volumen y se le retrajo la piel". Mediante biopsia escisional se le diagnostica un carcinoma ductal infiltrante, siendo así  el primer caso de carcinoma injertado en tejido mamario aberrante diagnosticado en nuestra provincia.

  10. Synchronous Bilateral Solid Papillary Carcinomas of the Breast

    Directory of Open Access Journals (Sweden)

    Noriko Yoshimura

    2013-01-01

    Full Text Available We herein report a case of synchronous bilateral solid papillary carcinoma of the breast. A 73-year-old female had a mass that was detected in the right breast on mammography. An ultrasound examination revealed one intracystic tumor in the right breast and two tumors in the left breast. A fine-needle aspiration biopsy of these three tumors was performed, which revealed a diagnosis of malignancy. A magnetic resonance imaging examination of the breasts showed diffuse small nodules surrounding these tumors bilaterally. Bilateral partial mastectomy and a sentinel lymph node biopsy were performed. Lymph node metastasis was detected in the right axilla, and additional lymph node dissection was performed. The pathological diagnosis was synchronous bilateral breast cancer, invasive ductal carcinoma NOS of the right breast, mucinous carcinomas of the left breast, and bilateral SPCs. A wide range of surgical margins were positive for SPCs, and additional bilateral total mastectomy was then performed. To the best of our knowledge, little is known about synchronous bilateral SPCs. Our case indicates that some SPCs can be widely scattered and make up a variety of invasive carcinomas. It is difficult to make a correct preoperative evaluation in such cases.

  11. Decreased Hsp90 expression in infiltrative lobular carcinoma: an immunohistochemical study

    Directory of Open Access Journals (Sweden)

    Zagouri Flora

    2010-08-01

    Full Text Available Abstract Background Elevated Hsp90 expression has been documented in breast ductal carcinomas, whereas decreased Hsp90 expression has been reported in precursor lobular lesions. This study aims to assess Hsp90 expression in infiltrative lobular carcinomas of the breast. Methods Tissue specimens were taken from 32 patients with infiltrative lobular carcinoma. Immunohistochemical assessment of Hsp90 was performed both in the lesion and the adjacent normal breast ducts and lobules; the latter serving as control. Concerning Hsp90 assessment: i the percentage of positive cells and ii the intensity were separately analyzed. Subsequently, the Allred score was adopted and calculated. The intensity was treated as an ordinal variable-score (0: negative, low: 1, moderate: 2, high: 3. Statistical analysis followed. Results All infiltrative lobular carcinoma foci mainly presented with a positive cytoplasmic immunoreaction for Hsp90. Compared to the adjacent normal ducts and lobules, infiltrative lobular carcinoma exhibited a statistically significant decrease in Hsp90 expression, both in terms of Hsp90 positive cells (% and Allred score (74.2 ± 11.2 vs. 59.1 ± 14.2 p = 0.0001; 7.00 ± 0.95 vs. 6.22 ± 1.01, p = 0.007, Wilcoxon matched-pairs signed-ranks test. Concerning the intensity of Hsp90 immunostaining only a marginal decrease was noted (2.16 ± 0.68 vs. 1.84 ± 0.63, p = 0.087, Wilcoxon matched-pairs signed-ranks test. Conclusion ILC lesions seem to exhibit decreased Hsp90 expression, a finding contrary to what might have been expected, given that high Hsp90 expression is a trait of invasive ductal carcinomas.

  12. Uptake and metabolism of D-glucose in isolated acinar and ductal cells from rat submandibular glands.

    Science.gov (United States)

    Cetik, Sibel; Rzajeva, Aigun; Hupkens, Emeline; Malaisse, Willy J; Sener, Abdullah

    2014-07-01

    The present study deals with the possible effects of selected environmental agents upon the uptake and metabolism of d-glucose in isolated acinar and ductal cells from the rat submandibular salivary gland. In acinar cells, the uptake of d-[U-(14) C]glucose and its non-metabolised analogue 3-O-[(14) C-methyl]-d-glucose was not affected significantly by phloridzin (0.1 mM) or substitution of extracellular NaCl (115 mM) by an equimolar amount of CsCl, whilst cytochalasin B (20 μM) decreased significantly such an uptake. In ductal cells, both phloridzin and cytochalasin B decreased the uptake of d-glucose and 3-O-methyl-d-glucose. Although the intracellular space was comparable in acinar and ductal cells, the catabolism of d-glucose (2.8 or 8.3 mM) was two to four times higher in ductal cells than in acinar cells. Phloridzin (0.1 mM), ouabain (1.0 mM) and cytochalasin B (20 μM) all impaired d-glucose catabolism in ductal cells. Such was also the case in ductal cells incubated in the absence of extracellular Ca(2+) or in media in which NaCl was substituted by CsCl. It is proposed that the ductal cells in the rat submandibular gland are equipped with several systems mediating the insulin-sensitive, cytochalasin B-sensitive and phloridzin-sensitive transport of d-glucose across the plasma membrane.

  13. Comparison of sensitivity of screening mammography with that of screening ultrasonography for detection of noninvasive ductal breast cancer at our institution

    International Nuclear Information System (INIS)

    From January 2005 to October 2007, 53 women were diagnosed as ductal carcinoma in situ (DCIS) from our program. We examined the sensitivity of mammography (MMG) and ultrasonography (US) using individual initial report written independently on the same day. Category 3 or higher judgement was considered as a true positive. The sensitivities of MMG and US were 71.7% (38/53) and 81.1% (43/53), respectively, and the difference was not statistically significant. When the results were analyzed in terms of patient age, women who were 49 or younger had a MMG sensitivity of 75.0% (21/28) and a US sensitivity of 82.1% (23/28), whereas women who were 50 or older had a MMG sensitivity of 68.0% (17/25) and a US sensitivity of 80% (20/25), none of these differences being statistically significant. Thus US was proved to have a DCIS detection rate similar to that of MMG. Among the 53 patients with proven DCIS, 29 (54.7%) presented positive findings on both MMG and US, 9 (17.0%) only on MMG, and 14 (26.4%) only on US. Five of the 14 US-positive patients showed punctate high echoes, suggesting the usefulness of US for detection of calcification. In 52 (98%) of the patients, either MMG, US, or both gave positive results for detection of DCIS. Therefore we conclude that MMG and US compensate each other for breast cancer screening. (author)

  14. Intensity Modulated Accelerated Partial Breast Irradiation Before Surgery in Treating Older Patients With Hormone Responsive Stage 0-I Breast Cancer

    Science.gov (United States)

    2016-05-04

    Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Ductal Breast Carcinoma With Predominant Intraductal Component; Lobular Breast Carcinoma in Situ; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-positive Breast Cancer; Stage IA Breast Cancer; Stage IB Breast Cancer; Tubular Ductal Breast Carcinoma

  15. Association between genetic subgroups of pancreatic ductal adenocarcinoma defined by high density 500 K SNP-arrays and tumor histopathology.

    Directory of Open Access Journals (Sweden)

    María Laura Gutiérrez

    Full Text Available The specific genes and genetic pathways associated with pancreatic ductal adenocarcinoma are still largely unknown partially due to the low resolution of the techniques applied so far to their study. Here we used high-density 500 K single nucleotide polymorphism (SNP-arrays to define those chromosomal regions which most commonly harbour copy number (CN alterations and loss of heterozygozity (LOH in a series of 20 PDAC tumors and we correlated the corresponding genetic profiles with the most relevant clinical and histopathological features of the disease. Overall our results showed that primary PDAC frequently display (>70% extensive gains of chromosomes 1q, 7q, 8q and 20q, together with losses of chromosomes 1p, 9p, 12q, 17p and 18q, such chromosomal regions harboring multiple cancer- and PDAC-associated genes. Interestingly, these alterations clustered into two distinct genetic profiles characterized by gains of the 2q14.2, 3q22.1, 5q32, 10q26.13, 10q26.3, 11q13.1, 11q13.3, 11q13.4, 16q24.1, 16q24.3, 22q13.1, 22q13.31 and 22q13.32 chromosomal regions (group 1; n = 9 versus gains at 1q21.1 and losses of the 1p36.11, 6q25.2, 9p22.1, 9p24.3, 17p13.3 and Xp22.33 chromosomal regions (group 2; n = 11. From the clinical and histopathological point of view, group 1 cases were associated with smaller and well/moderately-differentiated grade I/II PDAC tumors, whereas and group 2 PDAC displayed a larger size and they mainly consisted of poorly-differentiated grade III carcinomas. These findings confirm the cytogenetic complexity and heterozygozity of PDAC and provide evidence for the association between tumor cytogenetics and its histopathological features. In addition, we also show that the altered regions identified harbor multiple cancer associate genes that deserve further investigation to determine their relevance in the pathogenesis of PDAC.

  16. Oleic acid and glucose regulate glucagon-like peptide 1 receptor expression in a rat pancreatic ductal cell line

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Leshuai W.; McMahon Tobin, Grainne A.; Rouse, Rodney L., E-mail: rodney.rouse@fda.hhs.gov

    2012-10-15

    The glucagon-like peptide 1 receptor (GLP1R) plays a critical role in glucose metabolism and has become an important target for a growing class of drugs designed to treat type 2 diabetes. In vitro studies were designed to investigate the effect of the GLP1R agonist, exenatide (Ex4), in “on-target” RIN-5mF (islet) cells as well as in “off-target” AR42J (acinar) and DSL-6A/C1 (ductal) cells in a diabetic environment. Ex4 increased islet cell proliferation but did not affect acinar cells or ductal cells at relevant concentrations. A high caloric, high fat diet is a risk factor for impaired glucose tolerance and type-2 diabetes. An in vitro Oleic acid (OA) model was used to investigate the effect of Ex4 in a high calorie, high fat environment. At 0.1 and 0.4 mM, OA mildly decreased the proliferation of all pancreatic cell types. Ex4 did not potentiate the inhibitory effect of OA on cell proliferation. Akt phosphorylation in response to Ex4 was diminished in OA-treated ductal cells. GLP1R protein detected by western blot was time and concentration dependently decreased after glucose stimulation in OA-treated ductal cells. In ductal cells, OA treatment altered the intracellular localization of GLP1R and its co-localization with early endosome and recycling endosomes. Chloroquine (lysosomal inhibitor), N-acetyl-L-cysteine (reactive oxygen species scavenger) and wortmannin (a phosphatidylinositol-3-kinase inhibitor), fully or partially, rescued GLP1R protein in OA-pretreated, glucose-stimulated ductal cells. The impact of altered regulation on phenotype/function is presently unknown. However, these data suggest that GLP1R regulation in ductal cells can be altered by a high fat, high calorie environment. -- Highlights: ► Exenatide did not inhibit islet, acinar or ductal cell proliferation. ► GLP1R protein decreased after glucose stimulation in oleic acid-treated ductal cells. ► Oleic acid treatment altered localization of GLP1R with early and recycling

  17. Chemoradiation for Ductal Pancreatic Carcinoma: Principles of Combining Chemotherapy with Radiation, Definition of Target Volume and Radiation Dose

    Directory of Open Access Journals (Sweden)

    Heinemann V

    2005-05-01

    Full Text Available Review of the role of chemoradiotherapy in the treatment of locally advanced pancreatic cancer with a specific focus on the technical feasibility and the integration of chemoradiotherapy into multimodal treatment concepts. Combined chemoradiotherapy of pancreatic cancer is a safe treatment with an acceptable profile of side effects when applied with modern planning and radiation techniques as well as considering tissue tolerance. Conventionally fractionated radiation regimens with total doses of 45-50 Gy and small-volume boost radiation with 5.4 Gy have found the greatest acceptance. Locoregional lymphatic drainage should be included in the planning of target volumes because the risk of tumor involvement and local or loco-regional recurrence is high. Up to now, 5-fluorouracil has been considered the "standard" agent for concurrent chemoradiotherapy. The role of gemcitabine given concurrently with radiation has not yet been defined, since high local efficacy may also be accompanied by enhanced toxicities. In addition, no dose or administration form has been determined to be "standard" up to now. The focus of presently ongoing research is to define an effective and feasible regimen of concurrent chemoradiotherapy. While preliminary results indicate promising results using gemcitabine-based chemoradiotherapy, reliable data derived from mature phase III trials are greatly needed. Intensity-modulated radiotherapy has been developed to improve target-specific radiation and to reduce organ toxicity. Its clinical relevance still needs to be defined.

  18. Evaluation of BRCAPRO Risk Assessment Model in Patients with Ductal Carcinoma In situ Who Underwent Clinical BRCA Genetic Testing.

    Science.gov (United States)

    Elsayegh, Nisreen; Barrera, Angelica M Gutierrez; Muse, Kimberly I; Lin, Heather; Kuerer, Henry M; Helm, Monica; Litton, Jennifer K; Arun, Banu K

    2016-01-01

    The authors retrospectively aimed to determine which of the following three scenarios, related to DCIS entry into BRCAPRO, predicted BRCA mutation status more accurately: (1) DCIS as an invasive breast cancer (IBC) entered using the actual age of diagnosis, (2) DCIS as IBC entered with 10 years added to the actual age of diagnosis, and (3) DCIS entered as no cancer. Of the 85 DCIS patients included in the study, 19% (n = 16) tested positive for a BRCA mutation, and 81% (n = 69) tested negative. DCIS patients who tested positive for a BRCA mutation had a higher BRCAPRO risk estimation (34.61%) than patients who tested negative (11.4%) when DCIS was entered at the actual age of diagnosis. When DCIS was entered with 10 years added to the actual age at diagnosis, the BRCAPRO estimate was still higher amongst BRCA positive patients (25.4%) than BRCA negative patients (7.1%). When DCIS was entered as no cancer, the BRCAPRO estimate remained higher among BRCA positive patients (2.56%) than BRCA negative patents (1.98%). In terms of accuracy of BRCA positivity, there was no statistically significant difference between DCIS at age at diagnosis, DCIS at 10 years later than age at diagnosis, and DCIS entered as no cancer (AUC = 0.77, 0.784, 0.75, respectively: p = 0.60). Our results indicate that regardless of entry approach into BRCAPRO, there were no significant differences in predicting BRCA mutation in patients with DCIS. PMID:27200080

  19. HIF-1 alpha Overexpression in Ductal Carcinoma In Situ of the Breast in BRCA1 and BRCA2 Mutation Carriers

    NARCIS (Netherlands)

    van der Groep, Petra; van Diest, Paul J.; Smolders, Yvonne H. C. M.; Ausems, Margreet G. E. M.; van der Luijt, Rob B.; Menko, Fred H.; Bart, Joost; de Vries, Elisabeth G. E.; van der Wall, Elsken

    2013-01-01

    Recent studies have revealed that BRCA1 and BRCA2 germline mutation-related breast cancers show frequent overexpression of hypoxia inducible factor-1 alpha (HIF-1 alpha), the key regulator of the hypoxia response. However, the question remained whether hypoxia is a late stage bystander or a true car

  20. HDAC1 Expression in Invasive Ductal Carcinoma of the Breast and Its Value as a Good Prognostic Factor

    OpenAIRE

    Eom, Minseob; Oh, Sung Soo; Lkhagvadorj, Sayamaa; Han, Airi; Park, Kwang Hwa

    2012-01-01

    Background Histone deacetylase 1 (HDAC1) is associated with the expression and function of estrogen receptors and the proliferation of tumor cells, and has been considered a very important factor in breast tumor progression and prognosis. Several studies have reported an association between HDAC1 expression and poorer prognosis in cancers including breast cancer, with a few exceptions. However, because of the dearth of studies on HDAC1 expression in breast cancer, its significance for breast ...

  1. SMAD4 regulates cell motility through transcription of N-cadherin in human pancreatic ductal epithelium.

    Directory of Open Access Journals (Sweden)

    Ya'an Kang

    Full Text Available Expression of the cellular adhesion protein N-cadherin is a critical event during epithelial-mesenchymal transition (EMT. The SMAD4 protein has been identified as a mediator of transforming growth factor-β (TGF-β superfamily signaling, which regulates EMT, but the mechanisms linking TGF-β signaling to N-cadherin expression remain unclear. When the TGF-β pathway is activated, SMAD proteins, including the common mediator SMAD4, are subsequently translocated into the nucleus, where they influence gene transcription via SMAD binding elements (SBEs. Here we describe a mechanism for control of CDH2, the gene encoding N-cadherin, through the canonical TGFβ-SMAD4 pathway. We first identified four previously undescribed SBEs within the CDH2 promoter. Using telomerase immortalized human pancreatic ductal epithelium, we found that TGF-β stimulation prompted specific SMAD4 binding to all four SBEs. Luciferase reporter and SMAD4-knockdown experiments demonstrated that specific SMAD4 binding to the SBE located at -3790 bp to -3795 bp within the promoter region of CDH2 was necessary for TGF-β-stimulated transcription. Expression of N-cadherin on the surface of epithelial cells facilitates motility and invasion, and we demonstrated that knockdown of SMAD4 causes decreased N-cadherin expression, which results in diminished migration and invasion of human pancreatic ductal epithelial cells. Similar reduction of cell motility was produced after CDH2 knockdown. Together, these findings suggest that SMAD4 is critical for the TGF-β-driven upregulation of N-cadherin and the resultant invasive phenotype of human pancreatic ductal epithelial cells during EMT.

  2. Carcinoma verrugoso

    Directory of Open Access Journals (Sweden)

    Esteban Quesada Jiménez

    2004-09-01

    Full Text Available Se presenta el caso de un paciente masculino de 76 años, vecino de Turrialba, agricultor, que consultó por una lesión de 3 años de evolución, localizada en la palma de la mano derecha a nivel palmar y compromiso de los dedos de la misma mano, caracterizada como una neoformación exofítica verrugosa de 5 por 11 cm. aproximadamente, con material caseoso entre sus crestas. La lesión ha estado creciendo de forma acelerada en los últimos 3 meses, causándole dolor y que le imposibilita ellaborar. Se le realizaron exámenes y se descartaron varias causas infecciosas, y concluyendo luego de varias biopsias con el diagnóstico de un carcinoma verrugoso. El paciente fue tratado mediante una amputación parcial de la mano. Este tumor es una variante del carcinoma epidermoide y presentamos su clasificación, patogénesis, histopatología, manifestaciones clínicas más frecuentes y diagnóstico diferencial.

  3. FEATURES OF ISLET-LIKE CLUSTERS GENERATION IN PANCREATIC DUCTAL CELL MOLOLAYER CULTURING

    Directory of Open Access Journals (Sweden)

    L. A. Kirsanova

    2012-01-01

    Full Text Available Newborn rabbit pancreatic cell monolayer was obtained as we described earlier.The cultivated epithelial cells were shown by immunofluorescence to express special ductal marker CK19 and were insulin-and glucagon- negative for 10–15 days. A few fusiforms of nestin-positive cells were found in monolayer. Over 2 weeks in serum-free medium the plaques of epithelial cells became crowded and formed 3-dimentional structures – islet- like clusters. Islet-like clusters contain some insulin- and glucagon-positive cells recognized by immunohysto- chemistry staining. Pancreatic endocrine cell generation in 3-dimentional structures is discussed. 

  4. A benign presentation of primary ductal adenocarcinoma of lacrimal gland: A rare malignancy

    Directory of Open Access Journals (Sweden)

    Lindfay Laura Lau

    2015-01-01

    Full Text Available A 34-year-old patient with a swelling over the upper eyelid for nearly 1 year was seen in our clinic. The history, examination and investigations were suggestive of a benign lacrimal gland tumor. The tumor and lacrimal gland were resected. Subsequent histopathological examination revealed the tumor was a primary ductal adenocarcinoma of the lacrimal gland. This is a very rare tumor with less than half a dozen cases reported so far. This case report is being presented to highlight an unusual presentation of this rare malignancy.

  5. Re-evaluation of classical prognostic factors in resectable ductal adenocarcinoma of the pancreas.

    Science.gov (United States)

    Åkerberg, Daniel; Ansari, Daniel; Andersson, Roland

    2016-07-28

    Pancreatic ductal adenocarcinoma carries a poor prognosis with annual deaths almost matching the reported incidence rates. Surgical resection offers the only potential cure. Yet, even among patients that undergo tumor resection, recurrence rates are high and long-term survival is scarce. Various tumor-related factors have been identified as predictors of survival after potentially curative resection. These factors include tumor size, lymph node disease, tumor grade, vascular invasion, perineural invasion and surgical resection margin. This article will re-evaluate the importance of these factors based on recent publications on the topic, with potential implications for treatment and outcome in patients with pancreatic cancer. PMID:27605878

  6. A benign presentation of primary ductal adenocarcinoma of lacrimal gland: A rare malignancy.

    Science.gov (United States)

    Lau, Lindfay Laura; Lung, Chong Ka; Ahmad, Syed Shoeb

    2015-11-01

    A 34-year-old patient with a swelling over the upper eyelid for nearly 1 year was seen in our clinic. The history, examination and investigations were suggestive of a benign lacrimal gland tumor. The tumor and lacrimal gland were resected. Subsequent histopathological examination revealed the tumor was a primary ductal adenocarcinoma of the lacrimal gland. This is a very rare tumor with less than half a dozen cases reported so far. This case report is being presented to highlight an unusual presentation of this rare malignancy.

  7. p53 alteration in morphologically normal/benign breast tissue in patients with triple-negative high-grade breast carcinomas: breast p53 signature?

    Science.gov (United States)

    Wang, Xi; Stolla, Moritz; Ring, Brian Z; Yang, Qi; Laughlin, Todd S; Rothberg, Paul G; Skinner, Kristin; Hicks, David G

    2016-09-01

    p53 alterations have been identified in approximately 23% of breast carcinomas, particularly in hormone receptor-negative high-grade carcinomas. It is considered to be an early event in breast carcinogenesis. Nevertheless, the putative precursor lesion of high-grade breast carcinoma remains elusive. Breast excision specimens from 93 triple-negative high-grade invasive ductal carcinomas, 48 estrogen receptor (ER)-positive/progesterone receptor-positive/Her2-negative non-high-grade invasive ductal carcinomas, and 50 mammoplasty breasts were selected. At least 2 tissue blocks with tumor and adjacent benign tissue were sectioned and subjected to immunohistochemistry staining for p53. TP53 gene sequencing was performed on select tumors. Further immunohistochemistry staining for ER and Ki-67 was performed on consecutive sections of tissue with p53-positive normal/benign cells. Of the 93 high-grade carcinomas, 51 (55%) were positive for p53 alteration, whereas only 3 (6.25%) of the 48 non-high-grade carcinomas were p53 altered. Focal p53 positivity in adjacent normal/benign breast tissue was identified in 19 cases, and 18 of them also had p53 alteration in their carcinomas. Only 1 case had focal p53 staining in normal/benign tissue, but the tumor was negative for p53 alteration. No p53 staining positivity was identified in the mammoplasty specimens. The p53-stained normal/benign cells were ER negative and did not show an increase in the Ki-67 labeling index. These findings indicate that the p53 staining positivity in normal/benign breast tissue is not a random event. It could be considered as the "p53 signature" in breast and serve as an indicator for future potential risk of p53-positive high-grade breast carcinoma. PMID:27246177

  8. Inverted ductal papilloma of the oral cavity secondary to lower lip trauma. A case report and literature review.

    Science.gov (United States)

    Sala-Pérez, Sergi; España-Tost, Antoni; Vidal-Bel, August; Gay-Escoda, Cosme

    2013-04-01

    Inverted ductal papilloma of the oral cavity is an infrequent benign neoplasm of papillary appearance that originates in the secretory duct of a salivary gland. The etiology is unknown, though some authors have related it to human papillomavirus (HPV) infection. We present the case of a 40-year-old woman with a tumor of the lower lip mucosa. Histopathological study of the lesion diagnosed inverted ductal papilloma of the oral cavity. Human papillomavirus DNA detection and typing based on tumor lesion DNA amplification and posterior hybridization, revealed no presence of viral DNA. The antecedents of trauma reported by the patient could have played an important role in the development of this tumor. Key words:Inverted ductal papilloma, intraductal papilloma, oral papilloma, papillary epidermoid adenoma. PMID:24455058

  9. A Geometrically-Constrained Mathematical Model of Mammary Gland Ductal Elongation Reveals Novel Cellular Dynamics within the Terminal End Bud.

    Directory of Open Access Journals (Sweden)

    Ingrid Paine

    2016-04-01

    Full Text Available Mathematics is often used to model biological systems. In mammary gland development, mathematical modeling has been limited to acinar and branching morphogenesis and breast cancer, without reference to normal duct formation. We present a model of ductal elongation that exploits the geometrically-constrained shape of the terminal end bud (TEB, the growing tip of the duct, and incorporates morphometrics, region-specific proliferation and apoptosis rates. Iterative model refinement and behavior analysis, compared with biological data, indicated that the traditional metric of nipple to the ductal front distance, or percent fat pad filled to evaluate ductal elongation rate can be misleading, as it disregards branching events that can reduce its magnitude. Further, model driven investigations of the fates of specific TEB cell types confirmed migration of cap cells into the body cell layer, but showed their subsequent preferential elimination by apoptosis, thus minimizing their contribution to the luminal lineage and the mature duct.

  10. Vulvar carcinoma

    International Nuclear Information System (INIS)

    Purpose: Controversies exist regarding the use of radiation therapy in the treatment of vulvar carcinoma. A retrospective review was performed to evaluate our institution's experience with surgery and radiation for this disease. Methods and Materials: The medical records of 47 patients treated for squamous cell carcinoma of the vulva at our institution (1974-1992) were reviewed for TNM stage (AJCC criteria), treatment modality, and associated 5-year local control and survival based on Kaplan-Meier analysis. Results: Twenty-eight patients (60%) presented with Stage I and II disease and their 5-year survival was 69%. Stage III patients accounted for 12 (25%) of the patients and their 5-year survival was 73%. Seven patients presented with Stage IV disease and five died within 13 months of diagnosis after predominantly palliative therapy. The 40 patients with Stages I, II, and III disease were treated aggressively and were further evaluated for treatment-modality-associated survival and local control. Radiation therapy was used as primary treatment in nine patients, of whom seven were treated with radiation alone and two were treated postoperatively after wide excision. Surgery alone was performed in 31 patients consisting of either radical vulvectomy (20 patients) or wide excision (11 patients). When comparing outcomes of radical vulvectomy vs. radiation therapy, we noted that the 5-year actuarial survivals were comparable (74% for either modality), despite the presence of more favorable prognostic factors in the group treated with radical vulvectomy. Patients treated with wide excision alone had a trend for a poorer 5-year actuarial survival (51%) and local control (50%). Conclusions: Radical vulvectomy offers good locoregional control and survival. This retrospective review further supports the use of radiation therapy with conservative surgery as an alternative treatment option for patients with vulvar carcinoma treated with curative intent. In contrast, the use of

  11. Locoregional Treatment for Breast Carcinoma After Hodgkin's Lymphoma: The Breast Conservation Option

    International Nuclear Information System (INIS)

    Purpose: To report clinical and pathologic characteristics and outcome of breast cancer (BC) after irradiation for Hodgkin’s lymphoma (HL) in women treated at the Institut Curie, with a special focus on the breast-conserving option. Methods and Materials: Medical records of 72 women who developed either ductal carcinoma in situ or Stage I–III invasive carcinoma of the breast after HL between 1978 and 2009 were retrospectively reviewed. Results: Median age at HL diagnosis was 23 years (range, 14–53 years). Median total dose received by the mediastinum was 40 Gy, mostly by a mantle-field technique. Breast cancers occurred after a median interval of 21 years (range, 5–40 years). Ductal invasive carcinoma and ductal carcinoma in situ represented, respectively, 51 cases (71%) and 14 cases (19%). Invasive BCs consisted of 47 cT0–2 tumors (82%), 5 cN1–3 tumors (9%), and 20 Grade 3 tumors (35%). Locoregional treatment for BCs consisted of mastectomy with (3) or without (36) radiotherapy in 39 patients and lumpectomy with (30) or without (2) adjuvant radiotherapy in 32 patients. The isocentric lateral decubitus radiation technique was used in 17 patients after breast-conserving surgery (57%). With a median follow-up of 7 years, 5-year overall survival rate and locoregional control rate were, respectively, 74.5% (95% confidence interval [CI], 64–88%) and 82% (95% CI, 72–93%) for invasive carcinoma and 100% (95% CI, 100 –100%) and 92% (95% CI, 79–100%) for in situ carcinoma. In patients with invasive tumors, the 5-year distant disease-free survival rate was 79% (95% CI, 69–91%), and 13 patients died of progressive BC. Contralateral BC was diagnosed in 10 patients (14%). Conclusions: Breast-conserving treatment can be an option for BCs that occur after HL, despite prior thoracic irradiation. It should consist of lumpectomy and adjuvant breast radiotherapy with use of adequate techniques, such as the lateral decubitus isocentric position, to protect the

  12. Locoregional Treatment for Breast Carcinoma After Hodgkin's Lymphoma: The Breast Conservation Option

    Energy Technology Data Exchange (ETDEWEB)

    Haberer, Sophie, E-mail: sophie.haberer@wanadoo.fr [Department of Radiation Oncology, Institut Curie, Paris (France); Belin, Lisa [Department of Biostatistics, Institut Curie, Paris (France); Le Scodan, Romuald; Kirova, Youlia M. [Department of Radiation Oncology, Institut Curie, Paris (France); Savignoni, Alexia; Stevens, Denise [Department of Biostatistics, Institut Curie, Paris (France); Moisson, Patricia [Department of Radiation Oncology, Institut Curie, Paris (France); Decaudin, Didier; Pierga, Jean-Yves [Department of Medical Oncology, Institut Curie, Paris (France); Reyal, Fabien [Department of Surgery, Institut Curie, Paris (France); Campana, Francois; Fourquet, Alain; Bollet, Marc A. [Department of Radiation Oncology, Institut Curie, Paris (France)

    2012-02-01

    Purpose: To report clinical and pathologic characteristics and outcome of breast cancer (BC) after irradiation for Hodgkin's lymphoma (HL) in women treated at the Institut Curie, with a special focus on the breast-conserving option. Methods and Materials: Medical records of 72 women who developed either ductal carcinoma in situ or Stage I-III invasive carcinoma of the breast after HL between 1978 and 2009 were retrospectively reviewed. Results: Median age at HL diagnosis was 23 years (range, 14-53 years). Median total dose received by the mediastinum was 40 Gy, mostly by a mantle-field technique. Breast cancers occurred after a median interval of 21 years (range, 5-40 years). Ductal invasive carcinoma and ductal carcinoma in situ represented, respectively, 51 cases (71%) and 14 cases (19%). Invasive BCs consisted of 47 cT0-2 tumors (82%), 5 cN1-3 tumors (9%), and 20 Grade 3 tumors (35%). Locoregional treatment for BCs consisted of mastectomy with (3) or without (36) radiotherapy in 39 patients and lumpectomy with (30) or without (2) adjuvant radiotherapy in 32 patients. The isocentric lateral decubitus radiation technique was used in 17 patients after breast-conserving surgery (57%). With a median follow-up of 7 years, 5-year overall survival rate and locoregional control rate were, respectively, 74.5% (95% confidence interval [CI], 64-88%) and 82% (95% CI, 72-93%) for invasive carcinoma and 100% (95% CI, 100 -100%) and 92% (95% CI, 79-100%) for in situ carcinoma. In patients with invasive tumors, the 5-year distant disease-free survival rate was 79% (95% CI, 69-91%), and 13 patients died of progressive BC. Contralateral BC was diagnosed in 10 patients (14%). Conclusions: Breast-conserving treatment can be an option for BCs that occur after HL, despite prior thoracic irradiation. It should consist of lumpectomy and adjuvant breast radiotherapy with use of adequate techniques, such as the lateral decubitus isocentric position, to protect the underlying heart

  13. Assessment of Pathological Response of Breast Carcinoma in Modified Radical Mastectomy Specimens after Neoadjuvant Chemotherapy

    Directory of Open Access Journals (Sweden)

    Dhanya Vasudevan

    2015-01-01

    Full Text Available Aim. Paclitaxel based neoadjuvant chemotherapy regimen (NAT in the setting of locally advanced breast cancer (LABC can render inoperable tumor (T4, N2/N3 resectable. The aim of this study was to assess the status of carcinoma in the breast and lymph nodes after paclitaxel based NAT in order to find out the patient and the tumor characteristics that correspond to the pathological responses which could be used as a surrogate biomarker to assess the treatment response. Materials and Methods. Clinical and tumor characteristics of patients with breast carcinoma (n=48 were assessed preoperatively. These patients were subjected to modified radical mastectomy after 3 courses of paclitaxel based NAT regimen. The pathological responses of the tumor in the breast and the lymph nodes were studied by using Chevallier’s system which graded the responses into pathological complete response (pCR, pathological partial response (pPR, and pathological no response (pNR. Results. Our studies showed a pCR of 27.1% and a pPR of 70.9% . Clinically small sized tumors (2–5 cms and Bloom Richardson’s grade 1 tumors showed a pCR. Mean age at presentation was 50.58 yrs. 79.2% of cases were invasive ductal carcinoma NOS; only 2.1% were invasive lobular carcinoma, their response to NAT being the same. There was no downgrading of the tumor grades after NAT. Ductal carcinoma in situ and lymphovascular invasion were found to be resistant to chemotherapy. The histopathological changes noted in the lymph nodes were similar to that found in the tumor bed. Discussion and Conclusion. From our study we conclude that histopathological examination of the tumor bed is the gold standard for assessing the chemotherapeutic tumor response. As previous studies have shown pCR can be used as a surrogate biomarker to assess the tumor response.

  14. Intraductal carcinoma of the prostate: interobserver reproducibility survey of 39 urologic pathologists.

    Science.gov (United States)

    Iczkowski, Kenneth A; Egevad, Lars; Ma, Jun; Harding-Jackson, Nicholas; Algaba, Ferran; Billis, Athanase; Camparo, Philippe; Cheng, Liang; Clouston, David; Comperat, Eva M; Datta, Milton W; Evans, Andrew G; Griffiths, David F; Guo, Charles C; Hailemariam, Seife; Huang, Wei; Humphrey, Peter A; Jiang, Zhong; Kahane, Hillel; Kristiansen, Glen; La Rosa, Francisco G; Lopez-Beltran, Antonio; MacLennan, Gregory T; Magi-Galluzzi, Cristina; Merrimen, Jennifer; Montironi, Rodolfo; Osunkoya, Adeboye O; Picken, Maria M; Rao, Nagarjun; Shah, Rajal B; Shanks, Jonathan H; Shen, Steven S; Tawfik, Ossama W; True, Lawrence D; Van der Kwast, Theodorus; Varma, Murali; Wheeler, Thomas M; Zynger, Debra L; Sahr, Natasha; Bostwick, David G

    2014-12-01

    The diagnosis of intraductal carcinoma (IDC) of the prostate remains subjective because 3 sets of diagnostic criteria are in use. An internet survey was compiled from 38 photomicrographs showing duct proliferations: 14 signed out as high-grade prostatic intraepithelial neoplasia (HGPIN), 17 IDC, and 7 invasive cribriform/ductal carcinoma. Each image was assessed for the presence of 9 histologic criteria ascribed to IDC. Thirty-nine respondents were asked to rate images as (1) benign/reactive, (2) HGPIN, (3) borderline between HGPIN and IDC, (4) IDC, or (5) invasive cribriform/ductal carcinoma. Intraclass correlation coefficient was 0.68. There was 70% overall agreement with HGPIN, 43% with IDC, and 73% with invasive carcinoma (P borderline or IDC was reached in 9 (47%). Two-thirds consensus other than IDC was reached in the remaining 19 of 38 cases, with 15 supporting HGPIN and 4 supporting invasive carcinoma. Findings that differed across diagnostic categories were lumen-spanning neoplastic cells (P sufficient criteria for IDC. Finally, 20.5% of respondents agreed that an isolated diagnosis of IDC on needle biopsy warrants definitive therapy, 20.5% disagreed, and 59.0% considered the decision to depend upon clinicopathologic variables. Although IDC diagnosis remains challenging, we propose these criteria: a lumen-spanning proliferation of neoplastic cells in preexisting ducts with a dense cribriform or partial solid growth pattern. Solid growth, in any part of the duct space, emerges as the most reproducible finding to rule in a diagnosis of IDC. Comedonecrosis is a rarer finding, but in most cases, it should rule in IDC. Duct space enlargement to greater than 2× the diameter of the largest, adjacent benign spaces is usually present in IDC, although there may be rare exceptions. PMID:25263387

  15. Prostata carcinomas

    International Nuclear Information System (INIS)

    Pre-operative staging, using transrectal prostatic sonography and CT, was carried out in 30 patients with cytologically confirmed carcinomas of the prostate and the results compared with the clinical findings. All patients underwent radical prostatectomy and the pre-operative findings could be verified histologically. Transrectal prostatic sonography is better than CT or clinical examination for determining local tumour spread or penetration of the capsule. A high proportion of enlarged pelvic lymphnodes shown by CT had non-specific changes; failure to demonstrate enlarged nodes excludes lymph node metastases with considerable certainty. Transrectal prostatic sonography provides a higher degree of information regarding local tumour spread, whereas CT indicates the presence or absence of lymph node metastases. (orig.)

  16. Atypical Ductal Hyperplasia (ADH): Can the Sonoelastography Predict the Upgrade of ADH to Malignancy?

    Energy Technology Data Exchange (ETDEWEB)

    An, Yeong Yi; Kim, Sung Hun; Kang, Bong Joo [Dept. of Radiology, Seoul St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of); Lee, Ah Won [Dept. of Pathology, Seoul St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of); Song, Byung Joo [Dept. of Surgery, Seoul St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of)

    2011-04-15

    To evaluate whether the sonoelastographic features of atypical ductal hyperplasia (ADH) can be used to predict an upgrade to malignancy. Conventional US and sonoelastographic images were available in 17 women with 18 ADH lesions diagnosed by sonographically guided core needle biopsy. Conventional US findings were analyzed according to the Breast Imaging Reporting and Data System classification. Elastographic images were classified into 5 elasticity scores according to the ITOH classification. In addition, the strain ratio between the mass and surrounding fat tissue as well as the mammographic features were reviewed. All lesions underwent subsequent surgical excision and a correlation was found for sonoelastographic and conventional US findings with pathologic results. Of the 18 ADH lesions that underwent surgical excision, four were found to be malignant (underestimation rate of 22.2%). Moreover, there was no significant difference in elasticity score (p=0.054) and strain ratio (p=0.375) between atypical ductal hyperplasia and lesions upgraded to malignancy on elastography. A mass with microcalcifications on mammography had a significantly higher association with malignancy and microcalcifications, as opposed to the absence of a mass, which was in all cases, benign (p=0.036).

  17. Preadipocyte factor 1 induces pancreatic ductal cell differentiation into insulin-producing cells.

    Science.gov (United States)

    Rhee, Marie; Lee, Seung-Hwan; Kim, Ji-Won; Ham, Dong-Sik; Park, Heon-Seok; Yang, Hae Kyung; Shin, Ju-Young; Cho, Jae-Hyoung; Kim, Young-Bum; Youn, Byung-Soo; Sul, Hei Sook; Yoon, Kun-Ho

    2016-01-01

    The preadipocyte factor 1 (Pref-1) is involved in the proliferation and differentiation of various precursor cells. However, the intracellular signaling pathways that control these processes and the role of Pref-1 in the pancreas remain poorly understood. Here, we showed that Pref-1 induces insulin synthesis and secretion via two independent pathways. The overexpression of Pref-1 activated MAPK signaling, which induced nucleocytoplasmic translocation of FOXO1 and PDX1 and led to the differentiation of human pancreatic ductal cells into β-like cells and an increase in insulin synthesis. Concurrently, Pref-1 activated Akt signaling and facilitated insulin secretion. A proteomics analysis identified the Rab43 GTPase-activating protein as a downstream target of Akt. A serial activation of both proteins induced various granular protein syntheses which led to enhanced glucose-stimulated insulin secretion. In a pancreatectomised diabetic animal model, exogenous Pref-1 improved glucose homeostasis by accelerating pancreatic ductal and β-cell regeneration after injury. These data establish a novel role for Pref-1, opening the possibility of applying this molecule to the treatment of diabetes. PMID:27044861

  18. [A case of ductal adenocarcinoma of prostate associated with retroperitoneal multiple cysts].

    Science.gov (United States)

    Soda, Tetsuji; Fukumoto, Ryo; Hayashi, Tetsuya; Oka, Daizo; Fujimoto, Nobumasa; Koide, Takuo; Akamaru, Yusuke; Kasugai, Tsutomu

    2012-10-01

    A 61-year-old man came to our hospital with a complaint of lower abdominal pain. Computed tomography (CT) and magnetic resonance imaging (MRI) around his abdominal area showed large multiple cysts in the pelvis suggesting a malignant tumor. He showed high levels of serum carbohydrate antigen 19- 9 (CA19-9) and carcinoembryonic antigen (CEA). The complete diagnostic studies, including upper gastrointestinal endoscopy and colonoscopy examinations, failed to demonstrate the presence of alimentary primary tumors. With the diagnosis of cystic tumor in the pelvis, the operation was performed. The cysts adhered firmly to the surrounding organs including bladder and peritonium, which could not be resected completely. A histopathological diagnosis was papillary adenocarcinoma positive for prostate specific antigen (PSA). Because the level of serum PSA was 9.39 ng/ml, prostate biopsy was performed and ductal adenocarcinoma of prostate was revealed. After the operation, the levels of serum CA19-9 and CEA decreased to a normal level. Androgen deprivation therapy (ADT) was started, and the level of PSA was normalized one month later. Ductal adenocarcinoma forming cysts is rare. We reviewed 15 cases reported in the Japanese literature.

  19. TGF-β1 promotes acinar to ductal metaplasia of human pancreatic acinar cells.

    Science.gov (United States)

    Liu, Jun; Akanuma, Naoki; Liu, Chengyang; Naji, Ali; Halff, Glenn A; Washburn, William K; Sun, Luzhe; Wang, Pei

    2016-01-01

    Animal studies suggest that pancreatitis-induced acinar-to-ductal metaplasia (ADM) is a key event for pancreatic ductal adenocarcinoma (PDAC) initiation. However, there has not been an adequate system to explore the mechanisms of human ADM induction. We have developed a flow cytometry-based, high resolution lineage tracing method and 3D culture system to analyse ADM in human cells. In this system, well-known mouse ADM inducers did not promote ADM in human cells. In contrast, TGF-β1 efficiently converted human acinar cells to duct-like cells (AD) in a SMAD-dependent manner, highlighting fundamental differences between the species. Functionally, AD cells gained transient proliferative capacity. Furthermore, oncogenic KRAS did not induce acinar cell proliferation, but did sustain the proliferation of AD cells, suggesting that oncogenic KRAS requires ADM-associated-changes to promote PDAC initiation. This ADM model provides a novel platform to explore the mechanisms involved in the development of human pancreatic diseases. PMID:27485764

  20. Nevoid Basal Cell Carcinoma Syndrome

    Science.gov (United States)

    ... Nevoid Basal Cell Carcinoma Syndrome Request Permissions Nevoid Basal Cell Carcinoma Syndrome Approved by the Cancer.Net Editorial Board , 04/2016 What is Nevoid Basal Cell Carcinoma Syndrome? Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is ...

  1. CORRELATION BETWEEN LAMININ AND CATHEPSIN D EXPRESSIONS IN BREAST CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    CHEN Feng; CHEN Wei-hong; ZHENG Jian-ming; HUANG Ling

    2006-01-01

    Objective: Laminin is a major glycoprotein component of basement membrance which is an important barrier to tumor cells which must be breeched before metastatic spread can occur. Proteolytic enzymes play an important role in mediating the passage of cancer cells through the basement membrane (BM) and extracellular matrix. We compared the patterns of laminin and cathepsin D (CD) expressions in a range of benign and malignant breast lesions to better understand the process of tumor progression. Methods: One hundred and sixty-two cases of breast samples comprising 18 fibroadeomas, 22 cases of fibrocystic disease, 96 cases of invasive ductal carcinoma and 26 carcinomas with intraductal components were evaluated for laminin and cathepsin D expressions by immunohistochemical staining. Results: The prevalence of CD positivity in both neoplastic and stromal cell components were significantly higher in higher histological grade tumors compared to lower grades (P<0.001). Various severity of BM disruption correlated with histological grade of the carcinomas (P<0.001). There was a negative correlation between the laminin expression and CD presence. Conclusion: In the process of cancer cell invasion and metastasis, the basement membrane is disrupted by proteinase secreted by cancer cells, especially by stroma cells of cancer.

  2. Regulation of In Situ to Invasive Breast CarcinomaTransition

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Min; Carroll, Danielle K.; Weremowicz, Stanislawa; Chen,Haiyan; Carrasco, Daniel; Richardson, Andrea; Bissell, Mina; Violette,Shelia; Gelman, Rebecca S.; Schnitt, Stuart; Polyak, Kornelia

    2007-03-13

    The transition of ductal carcinoma in situ (DCIS) to invasive carcinoma is a key event in breast tumor progression that is poorly understood. Comparative molecular analysis of tumor epithelial cells from in situ and invasive tumors has failed to identify consistent tumor stage-specific differences. However, the myoepithelial cell layer, present only in DCIS, is a key distinguishing and diagnostic feature. To determine the contribution of non-epithelial cells to tumor progression, we analyzed the role of myoepithelial cells and fibroblasts in the progression of in situ carcinomas using a xenograft model of human DCIS. Progression to invasion was promoted by fibroblasts, but inhibited by normal myoepithelial cells. The invasive tumor cells from these progressed lesions formed DCIS rather than invasive cancers when re-injected into naive mice. Molecular profiles of myoepithelial and epithelial cells isolated from primary normal and cancerous human breast tissue samples corroborated findings obtained in the xenograft model. These results provide the proof of principle that breast tumor progression could occur in the absence of additional genetic alterations and that tumor growth and progression could be controlled by replacement of normal myoepithelial inhibitory signals.

  3. Regulation of in situ to invasive breast carcinoma transition

    Energy Technology Data Exchange (ETDEWEB)

    Polyak, Kornelia; Hu, Min; Yao, Jun; Carroll, Danielle K.; Weremowicz, Stanislawa; Chen, Haiyan; Carrasco, Daniel; Richardson, Andrea; Violette, Shelia; Gelman, Rebecca S.; Bissell, Mina J.; Schnitt, Stuart; Polyak, Kornelia

    2008-05-07

    The transition of ductal carcinoma in situ (DCIS) to invasive carcinoma is a key event in breast tumor progression that is poorly understood. Comparative molecular analysis of tumor epithelial cells from in situ and invasive tumors has failed to identify consistent tumor stage-specific differences. However, the myoepithelial cell layer, present only in DCIS, is a key distinguishing and diagnostic feature. To determine the contribution of non-epithelial cells to tumor progression, we analyzed the role of myoepithelial cells and fibroblasts in the progression of in situ carcinomas using a xenograft model of human DCIS. Progression to invasion was promoted by fibroblasts, but inhibited by normal myoepithelial cells. The invasive tumor cells from these progressed lesions formed DCIS rather than invasive cancers when re-injected into naive mice. Molecular profiles of myoepithelial and epithelial cells isolated from primary normal and cancerous human breast tissue samples corroborated findings obtained in the xenograft model. These results provide the proof of principle that breast tumor progression could occur in the absence of additional genetic alterations and that tumor growth and progression could be controlled by replacement of normal myoepithelial inhibitory signals.

  4. Invasive micropapillary carcinoma of the breast: MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyo Soon; Jeong, Seo In; Choi, You Ri; Kim, Jin Woong; Lee, Ji Shin; Park, Min Ho [Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Kuzmiak, Cherie M. [Department of Radiology, University of North Carolina, Chapel Hill (Korea, Republic of)

    2013-08-15

    To analyze the magnetic resonance (MR) imaging findings of invasive micropapillary carcinoma of the breast. MR images were retrospectively evaluated in 14 patients (age range: 37-67, mean age: 49 years) with pathologically confirmed invasive micropapillary carcinoma of the breast. The enhancement type (mass/non-mass), shape, margin, contrast enhancement, and time-intensity curve pattern on the dynamic study were correlated with the histopathologic features. Associated findings, such as edema, nipple change, skin change and enlarged axillary lymph nodes were also studied. The most common features of the masses were irregular shape (12 of 14 patients, 85.8%) and irregular or spiculated margin (11 of 14 patients, 78.7%). The contrast enhancement was heterogeneous in 11 patients (78.7%), rim enhancement in 2 cases (14.2%), and homogeneous in one patient (7.1%). The predominant kinetic pattern was rapid increase (14 of 14, 100%) in the initial phase and washout (11 of 14, 78.7%) in the delayed phase. Associated non-mass like enhancement was shown in 4 patients, representing ductal carcinoma in situ. MR imaging helped detect additional sites of cancer other than the index lesion in 3 patients (21.4%). Enlarged axillary lymphadenopathy was identified in 7 of the 14 patients (50%). Invasive micropapillary carcinoma appears as a mass with an irregular shape, irregular or spiculated margin and heterogeneous enhancement on MR imaging. Though these findings are not specific and are also observed with other breast malignancies, invasive micropapillary carcinoma frequently showed multiple lesions, accompanying non-mass enhancement and axillary lymph node enlargement.

  5. Liver cancer - hepatocellular carcinoma

    Science.gov (United States)

    Primary liver cell carcinoma; Tumor - liver; Cancer - liver; Hepatoma ... Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually diagnosed in people age 50 or older. ...

  6. Thyroid cancer - papillary carcinoma

    Science.gov (United States)

    Papillary carcinoma of the thyroid ... About 80% of all thyroid cancers diagnosed in the United States are the papillary carcinoma type. It is more common in women than in men. It may occur in childhood, but is most often seen ...

  7. Undifferentiated salivary gland carcinomas

    DEFF Research Database (Denmark)

    Herbst, H.; Hamilton-Dutoit, S.; Jakel, K.T.;

    2004-01-01

    Undifferentiated salivary gland carcinomas may be divided into small cell and large cell types. Among large cell undifferentiated carcinomas, lymphoepithelial carcinomas have to be distinguished, the latter of which are endemic in the Arctic regions and southern China where virtually all cases...... of these tumors are associated with the Epstein-Barr virus (EBV). Association with EBV may also be observed in sporadic cases, and detection of EBV gene products may aid their diagnosis. Immunohistology may be employed to resolve the differential diagnosis of undifferentiated salivary gland carcinomas, comprising...... malignant lymphomas, amelanotic melanomas, Merkel cell carcinomas, and adenoid cystic carcinomas, in particular in small biopsy materials. Because of the rarity of undifferentiated salivary gland carcinomas, the differential diagnosis should always include metastases of undifferentiated carcinomas arising...

  8. Ansa Pancreatica: A Case Report of a Type of Ductal Variation in a Patient with Idiopathic Acute Recurrent Pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hye Mi; Park, Jung Yup; Kim, Myeong Jin [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    Ansa pancreatica is a rare type of pancreatic ductal variation. Recently, ansa pancreatic has been considered as a predisposing factor in patients with idiopathic acute pancreatitis. To the best of our knowledge, no previously published report in Korea has described ansa pancreatica. We report a case of acute recurrent pancreatitis with ansa pancreatica, which was revealed on magnetic resonance cholangiopancreatography (MRCP)

  9. High resolution 3D MRI of mouse mammary glands with intra-ductal injection of contrast media.

    Science.gov (United States)

    Markiewicz, Erica; Fan, Xiaobing; Mustafi, Devkumar; Zamora, Marta; Roman, Brian B; Jansen, Sanaz A; Macleod, Kay; Conzen, Suzanne D; Karczmar, Gregory S

    2015-01-01

    The purpose of this study was to use high resolution three-dimensional (3D) magnetic resonance imaging (MRI) to study mouse mammary gland ductal architecture based on intra-ductal injection of contrast agents. Female FVB/N mice age 12-20 weeks (n=12), were used in this study. A 34G, 45° tip Hamilton needle with a 25μL Hamilton syringe was inserted into the tip of the nipple. Approximately 20-25μL of a Gadodiamide/Trypan blue/saline solution was injected slowly over one minute into the nipple and duct. To prevent washout of contrast media from ducts due to perfusion, and maximize the conspicuity of ducts on MRI, mice were sacrificed one minute after injection. High resolution 3D T1-weighted images were acquired on a 9.4T Bruker scanner after sacrifice to eliminate motion artifacts and reduce contrast media leakage from ducts. Trypan blue staining was well distributed throughout the ductal tree. MRI showed the mammary gland ductal structure clearly. In spoiled gradient echo T1-weighted images, the signal-to-noise ratio of regions identified as enhancing mammary ducts following contrast injection was significantly higher than that of muscle (pcontrast media (pcontrast agents to measure metabolism or target receptors in normal ducts and ducts with in situ cancers.

  10. Diagnosis and interventional therapy for ductal gallstones; Diagnostik und interventionelle Therapie von Gallengangssteinen

    Energy Technology Data Exchange (ETDEWEB)

    Brambs, H.-J.; Hoffmann, M.; Pauls, S. [Universitaetsklinikum Ulm (Germany). Abteilung Diagnostische Radiologie

    2005-11-01

    Different imaging modalities recently underwent considerable improvements for the visualization of ductal gallstones. The declining significance of endoscopic retrograde cholangiopancreatography (ERCP) has been accepted unanimously. This paradigm shift is mostly due to improvements in transabdominal ultrasound, the increased availability of endoscopic ultrasound, and the use of magnetic resonance cholangiopancreatography (MRCP). In particular, MRCP is limited only in visualizing very small intraductal gallstones due to spatial resolution restrictions, whereas the detection rate of larger concretions is comparable to that with ERCP and endoscopic ultrasound. Patients with biliary pancreatitis benefit greatly from noninvasive MRCP visualization, establishing it as the preferred imaging modality. Particularly if ductal gallstones requiring further intervention are highly suspected, ERCP is preferable to other imaging modalities. If that suspicion is moderate, MRCP would be the imaging modality of choice, and transabdominal ultrasound would be performed if ductal gallstones are considered improbable. In up to 90% of cases, removal can be achieved endoscopically. Using a percutaneous approach smaller concretions can be extracted directly. However, larger gallstones need to be broken down into smaller fragments. For lithotripsy, either cholangioscopically-guided laser or electrohydraulic procedures are easy and effective. In case of strictures due to biliodigestive anastomoses, additional papillary balloon dilatation may be required. (orig.) [German] Um die Diagnostik von Gallengangssteinen konkurrieren mehrere Verfahren. Die Bedeutung der endoskopischen retrograden Cholangiopankreatographie (ERCP) ist ruecklaeufig, was im Wesentlichen durch die Verbesserung des transabdominellen Ultraschalls, durch die zunehmende Verbreitung des endoskopischen Ultraschalls und durch die Magnetresonanzcholangiopankreatographie (MRCP) bedingt ist. Die MRCP ist wegen der begrenzten

  11. Mucinous breast carcinoma showing as a cluster of suspicious microcalcifications on mammography

    Energy Technology Data Exchange (ETDEWEB)

    Pina Insausti, L.J. [Department of Radiology, Instituto Oncologico, San Sebastian (Spain); Soga Garcia, E. [Department of Pathology, Instituto Oncologico, San Sebastian (Spain)

    1998-12-01

    We report a case of mucinous breast carcinoma whose mammographic features consisted of a suspicious cluster of microcalcifications as the unique sign of malignancy. The lesion was non-palpable and measured approximately 2 cm at the greatest diameter. The microcalcifications showed several morphologies: round, pleomorphic, and fine shapes were identified. The total number of microcalcifications was > 30 and the number per square centimeter varied from 10 to 20. The histological calcifications showed good correlation with the mammographic ones and were localized predominantly at the periphery of the tumor inside ducts with ductal carcinoma in situ or in the acellular mucin. Two types were observed: psammomatous and gross-irregular calcifications. To our knowledge, only one case with similar findings has been reported previously. (orig.) With 4 figs., 12 refs.

  12. Expression of GLUT1 in stratified squamous epithelia and oral carcinoma from humans and rats

    DEFF Research Database (Denmark)

    Voldstedlund, M; Dabelsteen, Erik

    1997-01-01

    such as the blood-brain barrier, and this isoform has been suggested as an indicator of such barriers. GLUT1 has been found in basal layers of human epidermis where no such tissue barrier is present. To further clarify these issues, we examined the distribution of GLUT1 and GLUT4 in skin, different types of oral...... mucosa from rat and man, and a human oral carcinoma by indirect immunofluorescence microscopy. The results showed that GLUT1 was expressed in the basal and parabasal layers of the different stratified squamous epithelia, with some variations between keratinized and non-keratinized subtypes. GLUT1...... was also expressed in ductal- and myoepithelial cells of minor salivary glands and perineural sheath located in the lamina propra, and furthermore in the cells of an oral carcinoma. GLUT4 was not expressed in any of the tissues examined. This distribution of GLUT1 does not fit with the idea of GLUT1...

  13. In vitro pancreas duodenal homeobox-1 enhances the differentiation of pancreatic ductal epithelial cells into insulin-producing cells

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To observe whether pancreatic and duodenal homeobox factor-1 enhances the differentiation of pancreatic ductal epithelial cells into insulin-producing cells in vitro.METHODS: Rat pancreatic tissue was submitted to digestion by collegenase, ductal epithelial cells were separated by density gradient centrifugation and then cultured in RPMI1640 medium with 10% fetal bovine serum. After 3-5 passages, the cells were incubated in a six-well plate for 24 h before transfection of recombination plasmid XIHbox8VP16. Lightcycler quantitative real-time RT-PCR was used to detect the expression of PDX-1 and insulin mRNA in pancreatic epithelial cells. The expression of PDX-1 and insulin protein was analyzed by Western blotting. Insulin secretion was detected by radioimmunoassay. Insulinproducing cells were detected by dithizone-staining.RESULTS: XIHbox8 mRNA was expressed in pancreatic ductal epithelial cells. PDX-1 and insulin mRNA as well as PDX-1 and insulin protein were significantly increased in the transfected group. The production and insulin secretion of insulin-producing cells differentiated from pancreatic ductal epithelial cells were higher than those of the untransfected cells in vitro with a significant difference (1.32 ± 0.43 vs 3.48 ± 0.81, P < 0.01 at 5.6 mmol/L; 4.86 ± 1.15 vs 10.25 ± 1.32, P < 0.01 at 16.7 mmol/L).CONCLUSION: PDX-1 can differentiate rat pancreatic ductal epithelial cells into insulin-producing cells in vitro.In vitro PDX-1 transfection is a valuable strategy for increasing the source of insulin-producing cells.

  14. Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation): A Review.

    Science.gov (United States)

    Paiella, Salvatore; Salvia, Roberto; Ramera, Marco; Girelli, Roberto; Frigerio, Isabella; Giardino, Alessandro; Allegrini, Valentina; Bassi, Claudio

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) has still a dismal prognosis. Locally advanced pancreatic cancer (LAPC) accounts for the 40% of the new diagnoses. Current treatment options are based on chemo- and radiotherapy regimens. Local ablative techniques seem to be the future therapeutic option for stage-III patients with PDAC. Radiofrequency Ablation (RFA) and Irreversible Electroporation (IRE) are actually the most emerging local ablative techniques used on LAPC. Initial clinical studies on the use of these techniques have already demonstrated encouraging results in terms of safety and feasibility. Unfortunately, few studies on their efficacy are currently available. Even though some reports on the overall survival are encouraging, randomized studies are still required to corroborate these findings. This study provides an up-to-date overview and a thematic summary of the current available evidence on the application of RFA and IRE on PDAC, together with a comparison of the two procedures. PMID:26981115

  15. Local Ablative Strategies for Ductal Pancreatic Cancer (Radiofrequency Ablation, Irreversible Electroporation: A Review

    Directory of Open Access Journals (Sweden)

    Salvatore Paiella

    2016-01-01

    Full Text Available Pancreatic ductal adenocarcinoma (PDAC has still a dismal prognosis. Locally advanced pancreatic cancer (LAPC accounts for the 40% of the new diagnoses. Current treatment options are based on chemo- and radiotherapy regimens. Local ablative techniques seem to be the future therapeutic option for stage-III patients with PDAC. Radiofrequency Ablation (RFA and Irreversible Electroporation (IRE are actually the most emerging local ablative techniques used on LAPC. Initial clinical studies on the use of these techniques have already demonstrated encouraging results in terms of safety and feasibility. Unfortunately, few studies on their efficacy are currently available. Even though some reports on the overall survival are encouraging, randomized studies are still required to corroborate these findings. This study provides an up-to-date overview and a thematic summary of the current available evidence on the application of RFA and IRE on PDAC, together with a comparison of the two procedures.

  16. Genetic Diversity of Pancreatic Ductal Adenocarcinoma and Opportunities for Precision Medicine.

    Science.gov (United States)

    Knudsen, Erik S; O'Reilly, Eileen M; Brody, Jonathan R; Witkiewicz, Agnieszka K

    2016-01-01

    Patients with pancreatic ductal adenocarcinoma (PDA) have a poor prognosis despite new treatments; approximately 7% survive for 5 years. Although there have been advances in systemic, primarily cytotoxic, therapies, it has been a challenge to treat patients with PDA using targeted therapies. Sequence analyses have provided a wealth of information about the genetic features of PDA and have identified potential therapeutic targets. Preclinical and early-phase clinical studies have found specific pathways could be rationally targeted; it might also be possible to take advantage of the genetic diversity of PDAs to develop therapeutic agents. The genetic diversity and instability of PDA cells have long been thought of as obstacles to treatment, but are now considered exploitable features. We review the latest findings in pancreatic cancer genetics and the promise of targeted approaches in PDA therapy.

  17. Clinical importance of histologic grading of lobular carcinoma in situ in breast core needle biopsy specimens: current issues and controversies.

    Science.gov (United States)

    Gao, Faye; Carter, Gloria; Tseng, George; Chivukula, Mamatha

    2010-05-01

    Lobular carcinoma in situ (LCIS) is considered a risk factor for development of invasive carcinoma (IC). Many variants of LCIS have been described based on pathologic features such as nuclear grade, pleomorphism, and necrosis, but little is known about the biology of these variants. The proposed 3-tier grading system for LCIS has not been validated or endorsed across laboratories. We found significant upstaging of pure pleomorphic LCIS (LCIS with nuclear grade [NG] 3), up to 25% in core needle biopsy (CNB) specimens, in an earlier study. The aim of the current study was to address the importance of pure classical LCIS (NGs 1 and 2) in CNB specimens along with clinicopathologic follow-up. In follow-up resection specimens, IC or ductal carcinoma in situ was seen in 18% (7/39), a high incidence of residual LCIS was seen in 69% (27/39), and other high-risk lesions, such as atypical ductal hyperplasia, were seen in 36% (14/39) of LCIS NG 2 cases. Our study illustrates the importance of grading LCIS; we recommend follow-up excision in LCIS NG 2 cases owing to a high incidence of residual LCIS and the likelihood of identifying other high-risk lesions. PMID:20395524

  18. Expressions of Matrix Metalloproteinases 2, 7, and 9 in Carcinogenesis of Pancreatic Ductal Adenocarcinoma

    Science.gov (United States)

    Januszewska, Joanna; Sidorkiewicz, Iwona; Niewiński, Andrzej; Lewczuk, Łukasz; Kędra, Bogusław; Guzińska-Ustymowicz, Katarzyna

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) is a highly fatal disease, usually diagnosed in an advanced stage which gives a slight chance of recovery. Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases that participate in tissue remodeling and stimulate neovascularization and inflammatory response. The aim of the study was to evaluate the expression of MMP-2, MMP-7, and MMP-9 in normal ducts, tumor pancreatic adenocarcinoma cells, and peritumoral stroma in correlation with clinicohistopathological parameters. The study material was obtained from 29 patients with pancreatic ductal adenocarcinoma. The expressions of MMP-2, MMP-7, and MMP-9 were performed by immunohistochemical technique. Microvessel density (MVD) was visualized by special immunostaining. The expressions of MMP-2, MMP-7, and MMP-9 were mainly observed in tumor cells and peritumoral stroma. MMP-2 expression in cancer cells was correlated with female gender, stronger inflammation, and histopathological type of cancer (R = 0.460, p = 0.013; R = 0.690, p = 0.0001; R = −0.440, p = 0.005, resp.). The expression of MMP-7 in tumor cells was found to positively correlate with the presence of necrosis and negatively correlate with MVD (R = 0.402, p = 0.031; R = −0.682, p = 0.000). We also showed that positive MMP-9 expression in tumor cells was associated with MVD (R = 0.368, p = 0.084); however, it was not statistically significant. Our results demonstrate that MMP-2, MMP-7, and MMP-9 expressions correlate with various morphological features of the PDAC tumor such as inflammation, necrosis, and formation of the new blood vessels.

  19. Role of anti-stromal polypharmacy in increasing survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Samuel; J; Tingle; John; A; Moir; Steven; A; White

    2015-01-01

    AIM: To investigate the survival impact of common pharmaceuticals, which target stromal interactions, following a pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. METHODS: Data was collected retrospectively for 164 patients who underwent a pancreaticoduodenectomy for pancreatic ductal adenocarcinoma(PDAC). Survival analysis was performed on patients receiving the following medications: angiotensin-converting enzyme inhibitors(ACEI)/angiotensin Ⅱ receptor blockers(ARB), calcium channel blockers(CCB), aspirin, and statins. Statistical analysis included Kaplan-meier survival estimates and cox multivariate regression; the latter of which allowed for any differences in a range of prognostic indicators between groups. Medications showing a significant survival benefit were investigated in combination with other medications to evaluate synergistic effects.RESULTS: No survival benefit was observed with respect to ACEI/ARB(n = 41), aspirin or statins on individual drug analysis(n = 39). However, the entire CCB group(n = 26) showed a significant survival benefit on multivariate cox regression; hazard ratio(HR) of 0.475(CI = 0.250-0.902, P = 0.023). Further analysis revealed that this was influenced by a group of patients who were taking aspirin in combination with CCB; median survival was significantly higher in the CCB + aspirin group(n = 15) compared with the group taking neither drug(n = 98); 1414 d vs 601 d(P = 0.029, logrank test). Multivariate cox regression revealed neither aspirin nor CCB had a statistically significant impact on survival when given alone, however in combination the survival benefit was significant; HR = 0.332(CI = 0.126-0.870, P = 0.025). None of the other medications showed a survival benefit in any combination.CONCLUSION: Aspirin + CCB in combination appears to increase survival in patients with PDAC, highlighting the potential clinical use of combination therapy to target stromal interactions in pancreatic cancer.

  20. Hepatocellular carcinoma.

    Science.gov (United States)

    Edwards, J T; Macdonald, G A

    2000-05-01

    The incidence of hepatocellular carcinoma (HCC) appears to be declining in Taiwan and potentially in other high-prevalence areas as a consequence of vaccination for hepatitis B virus (HBV). However, there is evidence that the incidence of HCC is increasing in North America and Europe. This appears to be related to the increasing prevalence and duration of hepatitis C virus (HCV) infection in these countries. There is also growing evidence to support an increase in the risk of HCC in patients with HCV who are coinfected with occult HBV (patients who have lost HBV surface antigen but still have detectable HBV DNA either in blood or liver). Occult HBV infection in patients with HCV may be more common than previously thought, and HCC that occurs in this setting appears to have a worse prognosis. There is continuing interest in the effect of interferon therapy on the incidence of HCC in patients with HCV. Several studies from Japan have shown a benefit in patients without cirrhosis, although there are a number of potentially confounding variables that may partly explain these results. Prospective randomized studies are needed to investigate this important question. The molecular biology of HCC and the events of malignant transformation in the liver continue to be areas of intense study. Recently, there has been considerable interest in telomeres, the repeat units on the ends of chromosomes, and the enzyme that maintains these, telomerase. Telomeres shorten with each cell division and can be used to determine the number of divisions a cell has undergone. Eventually they reach a critical length, with further loss resulting in cellular senescence. Telomerase restores telomere length and may help malignant cells escape senescence. Nearly all HCCs have telomerase activity and assessments of telomeres and telomerase may be clinically useful. PMID:17023886

  1. NUCLEAR BRACHYURY EXPRESSION IS CONSISTENT IN CHORDOMA, COMMON IN GERM CELL TUMORS AND SMALL CELL CARCINOMAS AND RARE IN OTHER CARCINOMAS AND SARCOMAS. AN IMMUNOHISTOCHEMICAL STUDY OF 5229 CASES

    Science.gov (United States)

    Miettinen, Markku; Wang, Zengfeng; Lasota, Jerzy; Heery, Christopher; Schlom, Jeffrey; Palena, Claudia

    2015-01-01

    Brachyury is a transcription factor of the T-box family typically expressed in notochord and chordoma. Some studies report brachyury as highly specific for chordoma, whereas others have concluded that brachyury is expressed in many types of common carcinomas by RT-PCR and immunohistochemistry and could be involved in the epithelial-mesenchymal transition and metastatic process. In this study, we immunohistochemically evaluated 5229 different tumors for nuclear brachyury expression using a new rabbit monoclonal antibody and automated immunostaining (Leica Bond Max). Only nuclear labeling was scored, and antibody dilution of 1:2000 was used. In normal tissues, only rare cells in seminiferous tubules were labeled; all other organs were negative. All chordomas (75/76), except a sarcomatous one, were positive, whereas chondrosarcomas were negative. Among epithelial tumors, positivity was often detected in embryonal carcinoma (74%) and seminoma (45%). Pulmonary small cell carcinoma was often positive (41%), whereas pulmonary and pancreatic adenocarcinomas only rarely showed nuclear brachyury-positivity (3–4%). Common carcinomas such as ductal carcinomas of breast, or adenocarcinomas of the prostate only exceptionally showed nuclear positivity (< 1%). No colorectal, hepatocellular, renal cell, squamous cell, thyroid or urothelial carcinoma, or mesothelioma showed nuclear brachyury-positivity. Among mesenchymal and neuroectodermal tumors, only isolated cases of melanoma, malignant peripheral nerve sheath tumor, rhabdomyosarcoma, synovial sarcoma, and follicular lymphoma showed nuclear expression. However, as shown previously with lung carcinoma, experiments with lower antibody dilutions (1:200–1:500) showed weak cytoplasmic and nuclear labeling in breast cancers. In addition to chordoma, we show here for the first time that nuclear brachyury expression is prevalent in embryonal carcinoma, seminoma, and small cell carcinoma of the lung but very rare in common carcinomas

  2. Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Somi

    2005-09-01

    Full Text Available IntroductionHepatocellular carcinoma (HCC is one of the most common malignant tumors worldwide(1, with over four hundred thousand new cases and almost as many deaths each year(2. The incidence ranges from <10 cases per 100,000 population in North America and Western Europe to 50-150 cases per 100,000 population in parts of Africa and Asia where HCC is responsible for a large proportion of cancer deaths. Studies from the USA, UK, mainland Europe and Australia have shown a rising incidence of HCC(3-6, which probably relates to the increasing prevalence of hepatitis B and C due to immigration(7. Improved care for individuals with cirrhosis has resulted in prolonged and a relatively greater opportunity for malignant changes to develop. HCC is a disease of multifactorial etiology; the development of a carcinoma in a given individual is a multi-step process and the result of an accumulation of risks. It is estimated that persistent infection with hepatotrophic viruses account for well over 80% of the world's liver cancer(8. Hepatocellular carcinoma is the major cause of death in cirrhotic patients in Europe(9,10,11. Once cirrhosis is present, up to 20% of patients will develop HCC over 10 years(12. Genetic alterations are fundamental to the development of HCC by resulting in uncontrolled cellular proliferation and de-differentiation. Without treatment, the prognosis is dismal, with only a few months survival(13. Several surgical and non-surgical therapeutic modalities have been used for the treatment of HCC. Surgical resection, liver transplantation and local ablation therapies demonstrate potentially curative treatment options that should always be considered when the tumor is restricted to liver.EpidemiologyThe incidence of HCC varies widely by geographic location. The distribution of HCC also differs among ethnic groups and regions within the same country(14. High incidence regions (more than 15 cases per 100,000 populations per year include sub

  3. Significance of β-tubulin Expression in Breast Premalignant Lesions and Carcinomas

    Institute of Scientific and Technical Information of China (English)

    Yuxia Gao; Yun Niu; Xiumin Ding; Yong Yu

    2008-01-01

    OBJECTIVE To explore the expression of β-tubulin in premalignant lesions and carcinomas of the breast, and to observe the relationship of its expression with breast cancer pathological features.METHODS The expression of β-tubulin was detected immunohistochemically in 50 specimens of premalignant lesions of the breast (ADH and Peri-PM with ADH), 50 specimens of breast in situ ductal carcinomas (DCIS), and 50 specimens of invasive ductal carcinomas (IDC). Thirty specimens of normal breast tissues served as a control group.RESULTS Immunohistochemical analysis showed that: the differences among the 4 groups (normal breast tissues, breast premalignant lesions, DCIS and IDC, P < 0.05) were significant,and there were also statistically significant differences between any 2 groups (P < 0.05) except for the β-tubulin positive expression comparing DCIS versus IDC (P > 0.05). In addition, β-tubulin was expressed at a higher level in Peri-PM with ADH compared to ADH (P < 0.05). Following the degree of breast epithelial hyperplasia involved, and its development into carcinoma, the β-tubulin positive expression displayed an elevating tendency.We also found a significant positive relationship of β-tubulin expression with lymph node metastasis (P < 0.05), but no significant correlation with histological grading and nuclear grade.CONCLUSION Centrosome defects may be an early event in the development of breast cancer and they can also promote tumor progression. Studies of aberrations of centrosomal proteins provide a new way to explore the mechanism of breast tumorigenesis.

  4. Expression of tight junction molecules in breast carcinomas analysed by array PCR and immunohistochemistry.

    Science.gov (United States)

    Tőkés, Anna-Mária; Szász, Attila Marcell; Juhász, Eva; Schaff, Zsuzsa; Harsányi, László; Molnár, István Arthur; Baranyai, Zsolt; Besznyák, István; Zaránd, Attila; Salamon, Ferenc; Kulka, Janina

    2012-07-01

    In the past few decades an enormous amount of data became known to clarify the molecular composition and architecture of tight junctions (TJs). Despite the efforts, the expression and function of several TJ genes and proteins in breast carcinoma are still not known and some of the data are contradictory. The expression of forty-four TJ associated genes was examined at mRNA level in eighteen invasive ductal breast carcinoma samples and corresponding normal breast tissues by using low density array PCR. Expressions of claudins (CLDNs) 5, 10, 16, 17, and 18, and ZO-1, ZO-2 were evaluated by immunohistochemistry as well. Using immunohistochemical phenotype as a surrogate for the genetic subtype, 11 luminal A, 3 luminal B, 3 triple negative and one HER2+ cases were included. Ten genes were significantly downregulated in tumors compared with normal breast tissues (CLDNs 5, 10, 16, 18, 19, CTNNAL1, JAM-B, ZO-1, ZO-2 and PARD3), whereas one gene (CLDN17) was significantly up-regulated in tumors when compared with normal breast. At protein level CLDNs 5, 10, 16, 18, ZO-1 and ZO-2 were downregulated in tumors as compared with normal breast tissue. CLDN17 showed variable expression in tumor tissues in comparison to normal breast. In the single HER2+ tumor when compared with the other subtypes CLDNs 5, 16, 17, 18, CTNNAL1, JAM-B, ZO-1, ZO-2 and PARD3 genes were found to be upregulated. We found altered TJ genes and proteins whose expression has not yet been associated with breast carcinoma. Our findings show a tendency of TJ genes and proteins to be downregulated in breast cancer. Further studies are necessary to examine whether the downregulation of the above mentioned TJ associated genes and proteins may contribute to the malignant progression of invasive ductal breast carcinomas.

  5. Cryotherapy for hepatocellular carcinoma

    DEFF Research Database (Denmark)

    Awad, Tahany; Thorlund, Kristian; Gluud, Christian

    2009-01-01

    BACKGROUND: Hepatocellular carcinoma is the most common primary malignant cancer of the liver. Evidence for the role of cryotherapy in the treatment of hepatocellular carcinoma is controversial. OBJECTIVES: The aim of this review is to evaluate the potential benefits and harms of cryotherapy for...... the treatment of hepatocellular carcinoma. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and LILACS until June 2009. We identified further studies by...... hepatocellular carcinoma. Randomised clinical trials with low-risk of bias may help in defining the role of cryotherapy in the treatment of hepatocellular carcinoma....

  6. [Functional distinction of secreting pools of the pancreas and participation of the pancreatic ductal system in the development of the pancreatic secret properties].

    Science.gov (United States)

    Korot'ko, G F; Voskanian, S E; Gladkiĭ, E Iu; Makarova, T M; Bulgakov, V A

    2002-08-01

    Acute experiments on dogs with separate secretion of the pancreatic enzymes, either stimulated or inhibited, from two lobes of pancreas, and investigation into the character of kinetics of the secretion from 5-7 ductal pools of the pancreas showed the functional specifics, with the device of ductal valves and microdepot of a secret of the pancreas ductal system playing an important role. The conclusion is made that the final secret of pancreas removed to the duodenum is a product of a secret-motor activation of non-equipotentional microregions of the gland, being the components of an intervisceral dynamical mosaic.

  7. Basal cell carcinoma of the skin with areas of squamous cell carcinoma: a basosquamous cell carcinoma?

    OpenAIRE

    Faria, J.

    1985-01-01

    The diagnosis of basosquamous cell carcinoma is controversial. A review of cases of basal cell carcinoma showed 23 cases that had conspicuous areas of squamous cell carcinoma. This was distinguished from squamous differentiation and keratotic basal cell carcinoma by a comparative study of 40 cases of compact lobular and 40 cases of keratotic basal cell carcinoma. Areas of intermediate tumour differentiation between basal cell and squamous cell carcinoma were found. Basal cell carcinomas with ...

  8. Hepatocellular carcinoma.

    Science.gov (United States)

    Okuda, K

    2000-01-01

    Hepatocellular carcinoma (HCC) is increasing in many countries as a result of an increase in hepatitis C virus (HCV) infection since World War II. The epidemiology of HCC varies with the global region. There have been conflicting observations from different parts of the world concerning the frequency of HCC in patients who in the distant past had post-transfusion non-A, non-B hepatitis. The genetic basis of hepatocarcinogenesis is still poorly understood. In hepatitis B virus (HVB) associated HCC, codon 249 mutation in the p 53 gene seems more related to exposure to aflatoxin B1 than to hepatocarcinogenesis itself. HCC that occurs in children in high HBV endemic regions could be associated with germ-line mutations, but little information is available; not much is known about chemical hepatocarcinogens in the environment other than aflatoxins. The X gene of HBV seems to play an important role in HBV-associated hepatocarcinogenesis. There are preliminary observations on the molecular mechanism of HCV-associated HCC, such as HCV core protein inducing HCC in transgenic mice and the NS3 genome transforming NIH 3T3 cells. Pathological distinction between preneoplastic and very early transformed lesions still depends on classical morphology, and a more genetically oriented differential diagnosis is required. Clinical diagnosis based on modern imaging has improved greatly, but is still unsatisfactory in the differential diagnosis of preneoplastic and early transformed nodules, because the vasculature changes that occur within the nodule are not accurately discerned with the current imaging. Use of sensitive des-gamma-carboxy prothrombin (PIVKA II) assay, and lectin affinity chromatography separating HCC specific subspecies of AFP molecules with a more practical biochemical technique will further improve diagnosis. Early diagnosis and transplantation are the best treatment at the moment, but transplantation is not widely available because of the donor shortage. Despite

  9. First description of an acinic cell carcinoma of the breast in a BRCA1 mutation carrier: a case report

    International Nuclear Information System (INIS)

    Acinic cell carcinoma (ACC) is a rare malignant epithelial neoplasm characterized by the presence of malignant tubular acinar exocrine gland structures. Diagnosis is generally made in salivary glands and in the pancreas. ACC of the breast has been reported in few cases only. Carriers of inherited mutations in the BRCA1 gene are prone to the development of breast cancer, mainly invasive ductal or medullary type carcinomas. We describe for the first time a BRCA1 mutation carrier with a diagnosis of ACC of the breast. The patient developed an invasive ductal carcinoma (IDC) at the age of 40 years and an ACC in the contralateral breast at 44 years. Immunohistochemical examination of the ACC revealed a triple negative status (i.e., negativity for estrogen receptor, progesterone receptor and HER2 protein) and positivity for p53. Using a combination of loss of heterozygosity (LOH) and sequencing analyses, the loss of the wild-type BRCA1 allele was detected in both the ACC and the IDC. In addition, two different somatic TP53 mutations, one in the ACC only and another one in the IDC only, were observed. Both the immunohistochemical and molecular features observed in the ACC are typical of BRCA1-associated breast cancers and suggest an involvement of the patient’s germline mutation in the disease. The occurrence of rare histological types of breast cancers, including malignant phyllodes tumor, atypical medullary carcinoma and metaplastic carcinoma, in BRCA1 mutation carriers has been already reported. Our findings further broaden the spectrum of BRCA1-associated breast malignancies

  10. [Morphologic, morphometric and immunohistochemical studies on pancreatic intraductal hyperplasia and infiltrating carcinoma].

    Science.gov (United States)

    Tomaszewska, R

    1999-01-01

    Pancreatic cancer belongs to the neoplasms which are characterised by increasing morbidity and mortality. Five-year survival rates of about 0.4% are the norm, and little has changed in the last 70 years. Important etiological factors are age, sex, diet, tobacco smoking, alcohol abuse, occupation and chemical exposure, hereditary chronic pancreatitis, and previous surgery (cholecystectomy and gastrectomy). The majority of exocrine tumours of the pancreas are malignant and 80-90% of them comprise ductal adenocarcinomas. The development and growth of pancreatic carcinoma appears to be caused by a progressive accumulation of multiple genetic abnormalities. This includes oncogene (K-ras) activation, loss of tumour-suppressor p53 gene function and overexpression of growth factors and their ligands. The morphological background for the development of pancreatic carcinoma is ductal epithelial hyperplasia. Current molecular studies have resulted in the identification of cell clones exhibiting the same genetic alterations (K-ras and p53 mutations) as in infiltrating pancreatic carcinoma. Pancreatic intraepithelial neoplasia is only partially defined. The purpose of our study was to evaluate Ki-67 proliferative index and HER-2/neu gene expression in pancreatic intraepithelial proliferative lesions as a sign of increasing epithelial proliferation and dysplasia. Additionally we made an attempt to apply morphometry in demarcating between intraepithelial proliferations of "reactive" type and proliferations with tendency towards progression to cancer. Another aim of the study was to evaluate the expression of bcl-2 and p53 genes in various types of pancreatic intraepithelial proliferations and in pancreatic cancer and to answer the question whether they interact in the process of pancreatic intraepithelial neoplasia. We have also undertaken investigations aiming at determination of the CD44s gene and its v6 isoform expression in intraductal and invasive pancreatic carcinoma

  11. Synchronous gastric neuroendocrine carcinoma and hepatocellular carcinoma

    DEFF Research Database (Denmark)

    Ewertsen, Caroline; Henriksen, Birthe Merete; Hansen, Carsten Palnæs;

    2009-01-01

    UNLABELLED: Gastric neuroendocrine carcinomas (NECs) are rare tumours that are divided into four subtypes depending on tumour characteristics. Patients with NECs are known to have an increased risk of synchronous and metachronous cancers mainly located in the gastrointestinal tract. A case...... of synchronous gastric NEC and hepatocellular carcinoma in a patient with several other precancerous lesions is presented. The patient had anaemia, and a gastric tumour and two duodenal polyps were identified on upper endoscopy. A CT scan of the abdomen revealed several lesions in the liver. The lesions were...... invisible on B-mode sonography and real-time sonography fused with CT was used to identify and biopsy one of the lesions. Histology showed hepatocellular carcinoma. A literature search showed that only one case of a hepatocellular carcinoma synchronous with a gastric NEC has been reported previously. TRIAL...

  12. Expression of glucosylceramide synthase in invasive ductal breast cancer may be correlated with high estrogen receptor status and low HER-2 status

    OpenAIRE

    Liu, Jiannan; Sun, Ping; Sun, Yuan; Liu, Aina; You, Dong; Jiang, Fenge; Sun, Yuping

    2014-01-01

    Abstract Background and objectives Breast cancer is one of the most common causes of cancer-related deaths in women worldwide. Studies on glucosylceramide synthase (GCS) activity suggest that this enzyme has a role in the development of multidrug resistance in many cancer cells. However, few studies have shown the expression of GCS in invasive ductal breast cancer and breast intraductal proliferative lesions. Methods In total, 196 samples from patients with invasive ductal breast cancer and 6...

  13. Ductal adenocarcinoma and unusual differential diagnosis; Duktales Adenokarzinom und ungewoehnliche Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Haage, P.; Schwartz, C.A.; Scharwaechter, C. [Universitaet Witten/Herdecke, Zentrum fuer Radiologie HELIOS Universitaetsklinikum Wuppertal, Wuppertal (Germany)

    2016-04-15

    Ductal pancreatic adenocarcinoma is by far the most common solid tumor of the pancreas. It has a very poor prognosis, especially in the more advanced stages which are no longer locally confined. Due to mostly unspecific symptoms, imaging is key in the diagnostic process. Because of the widespread use of imaging techniques, incidental findings are to a greater extent discovered in the pancreas, which subsequently entail further work-up. Ductal pancreatic adenocarcinoma can be mimicked by a large number of different lesions, such as anatomical variants, peripancreatic structures and tumors, rarer primary solid pancreatic tumors, cystic tumors, metastases or different variants of pancreatitis. Additionally, a number of precursor lesions can be differentiated. The correct classification is thus important as an early diagnosis of ductal pancreatic adenocarcinoma is relevant for the prognosis and because the possibly avoidable treatment is very invasive. All major imaging techniques are principally suitable for pancreatic imaging. In addition to sonography of the abdomen, usually the baseline diagnostic tool, computed tomography (CT) with its superior spatial resolution, magnetic resonance imaging (MRI) with its good soft tissue differentiation capabilities, possibly in combination with MR cholangiopancreatography (MRCP), endosonography with its extraordinary spatial resolution, conceivably with additional endoscopic retrograde CP or the option of direct biopsy and finally positron emission tomography CT (PET-CT) as a molecular imaging tool are all particularly useful modalities. The various techniques all have its advantages and disadvantages; depending on the individual situation they may need to be combined. (orig.) [German] Das duktale Adenokarzinom ist der weitaus haeufigste solide Tumor des Pankreas. Die Prognose ist sehr schlecht, insbesondere bei fortgeschrittenen, nicht mehr lokal begrenzten Tumoren. Bei meist unspezifischen geringen Beschwerden kommt der

  14. Metachronous colorectal carcinoma

    DEFF Research Database (Denmark)

    Bülow, Steffen; Svendsen, L B; Mellemgaard, A

    1990-01-01

    During the period 1943-67, 903 Danish patients aged less than 40 years had colorectal carcinoma. The patients were followed up for up to 41 years and during this period 44 of 501 (9 per cent) operated on for cure developed a metachronous colorectal carcinoma. The cumulative risk of a metachronous...... colorectal carcinoma was 30 per cent after up to 41 years of observation. The occurrence of a metachronous colorectal carcinoma was evenly distributed in the observation period. The cumulative survival rate after operation for a metachronous colorectal carcinoma was 41 per cent after 20 years of observation....... We propose a lifelong follow-up programme after resection of colorectal carcinoma for cure in this age group, including annual Hemoccult test and colonoscopy at 3-year intervals....

  15. URACHAL CARCINOMA IN BLADDER

    Institute of Scientific and Technical Information of China (English)

    薛丽燕; 吕宁; 何祖根; 林冬梅; 刘秀云

    2004-01-01

    Objective: To investigate the clinicopathologic features and diagnostic criteria of urachal carcinoma in the bladder.Methods: Seven cases of urachal carcinoma in the bladder were analyzed retrospectively. Results: All the tumors were found locating in the dome of bladder. Of them, 4 were mucinous adenocarcinoma, one was well differentiated papillary enteric adenocarcinoma, one was well differentiated squamous carcinoma, and one was neuroendocrine carcinoma. Cystomorphous urachal remnants were found in 4 cases. The main complaint was hematuria and all patients underwent partial excision of bladder and urachus. Conclusion: Mucinous adenocarcinoma is the main histo-pathological type, and cystomorphous urachal remnants are often accompanied with urachal carcinoma in the bladder. The key diagnostic criteria of urachal carcinoma in bladder are site and histopathology. And to examine the specimens carefully to find the urachal remnants is important.

  16. Assessment and optimization of electroporation-assisted tumoral nanoparticle uptake in a nude mouse model of pancreatic ductal adenocarcinoma

    OpenAIRE

    West DL; White SB; Zhang Z; Larson AC; Omary RA

    2014-01-01

    Derek Lamont West,1,2 Sarah B White,3 Zhouli Zhang,4 Andrew C Larson,4 Reed A Omary5 1Department of Diagnostic and Interventional Radiology, 2Department of Bioengineering and Nanomedicine, University of Texas Health Sciences Center at Houston, Houston, TX, 3Department of Radiology, Medical College of Wisconsin, Milwaukee, WI; 4Department of Radiology, Northwestern University, Chicago, IL; 5Department of Radiology, Vanderbilt University, Nashville, TN, USA Abstract: Pancreatic ductal adenoca...

  17. Validation of a prognostic nomogram in patients undergoing resection for pancreatic ductal adenocarcinoma in a UK tertiary referral centre

    OpenAIRE

    Clark, E.J.; Taylor, M. A.; Connor, S.; O'Neill, R.; Brennan, M. F.; Garden, O J; Parks, R.W.

    2008-01-01

    Introduction. Survival following resection for pancreatic ductal adenocarcinoma (PDAC) remains poor. The aim of this study was to validate a survival nomogram designed at the Memorial Sloan-Kettering Cancer Centre (MSKCC) in a UK tertiary referral centre. Methods. Patients who underwent resection for PDAC between 1995 and 2005 were analysed retrospectively. Standard prognostic factors and nomogram-specific data were collected. Continuous data are presented as median (inter-quartile range). Re...

  18. Pancreatic Duct Glands are Distinct Ductal Compartments that React to Chronic Injury and Mediate Shh-induced Metaplasia

    OpenAIRE

    STROBEL, OLIVER; Rosow, David E.; Rakhlin, Elena Y.; Lauwers, Gregory Y; Trainor, Amanda G.; Alsina, Janivette; Fernández–Del Castillo, Carlos; Warshaw, Andrew Louis; Thayer, Sarah P.

    2009-01-01

    BACKGROUND & AIMS: Pancreatic intraepithelial neoplasia (PanIN) are pancreatic cancer precursor lesions of unclear origin and significance. PanIN aberrantly express sonic hedgehog (Shh), an initiator of pancreatic cancer, and gastrointestinal mucins. A majority of PanIN are thought to arise from ducts. We identified a novel ductal compartment that is gathered in gland-like outpouches (pancreatic duct glands [PDG]) of major ducts and characterized its role in injury and metaplasia. METHODS: Th...

  19. TNF-like weak inducer of apoptosis (TWEAK promotes beta cell neogenesis from pancreatic ductal epithelium in adult mice.

    Directory of Open Access Journals (Sweden)

    Fei Wu

    Full Text Available AIM/HYPOTHESIS: The adult mammalian pancreas has limited ability to regenerate in order to restore adequate insulin production from multipotent progenitors, the identity and function of which remain poorly understood. Here we test whether the TNF family member TWEAK (TNF-like weak inducer of apoptosis promotes β-cell neogenesis from proliferating pancreatic ductal epithelium in adult mice. METHODS: C57Bl/6J mice were treated with Fc-TWEAK and pancreas harvested at different time points for analysis by histology and immunohistochemistry. For lineage tracing, 4 week old double transgenic mice CAII-CreER(TM: R26R-eYFP were implanted with tamoxifen pellet, injected with Fc-TWEAK or control Ig twice weekly and analyzed at day 18 for TWEAK-induced duct cell progeny by costaining for insulin and YFP. The effect of TWEAK on pancreatic regeneration was determined by pancytokeratin immunostaining of paraffin embedded sections from wildtype and TWEAK receptor (Fn14 deficient mice after Px. RESULTS: TWEAK stimulates proliferation of ductal epithelial cells through its receptor Fn14, while it has no mitogenic effect on pancreatic α- or β-cells or acinar cells. Importantly, TWEAK induces transient expression of endogenous Ngn3, a master regulator of endocrine cell development, and induces focal ductal structures with characteristics of regeneration foci. In addition, we identify by lineage tracing TWEAK-induced pancreatic β-cells derived from pancreatic duct epithelial cells. Conversely, we show that Fn14 deficiency delays formation of regenerating foci after Px and limits their expansion. CONCLUSIONS/INTERPRETATION: We conclude that TWEAK is a novel factor mediating pancreatic β-cell neogenesis from ductal epithelium in normal adult mice.

  20. Solid Variant of Adenoid Cystic Carcinoma: Difficulties in Diagnostic Recognition.

    Science.gov (United States)

    Ben Salha, Imen; Bhide, Shree; Mourtzoukou, Despoina; Fisher, Cyril; Thway, Khin

    2016-08-01

    Adenoid cystic carcinoma (ACC) is a malignant neoplasm that mainly affects the salivary glands but has been described in many other anatomical sites. It is composed of basaloid cells with myoepithelial/basal cell differentiation and ductal epithelial cells that proliferate in a fibrous stroma, with variable amounts of myxohyaline material. Three patterns (cribriform, tubular, and solid) occur, and the solid variant is characterized by a predominant compact sheet-like and nested pattern of rounded basaloid cells lacking obvious cribriform or tubular architecture. The solid variant has significant morphological and immunohistochemical overlap with a large range of neoplasms of different lineages, including other carcinomas and sarcomas. We describe a case of solid variant ACC of the paranasal sinuses, which showed an almost entirely solid pattern of growth (in >95% of cells) and which on initial biopsy showed no features of classical ACC. This highlights the potential for diagnostic misinterpretation with a variety of other neoplasms, which is particularly important because of the significant difference in treatment for ACC and tumors in its differential diagnosis. PMID:27069025

  1. Solid Variant of Adenoid Cystic Carcinoma: Difficulties in Diagnostic Recognition.

    Science.gov (United States)

    Ben Salha, Imen; Bhide, Shree; Mourtzoukou, Despoina; Fisher, Cyril; Thway, Khin

    2016-08-01

    Adenoid cystic carcinoma (ACC) is a malignant neoplasm that mainly affects the salivary glands but has been described in many other anatomical sites. It is composed of basaloid cells with myoepithelial/basal cell differentiation and ductal epithelial cells that proliferate in a fibrous stroma, with variable amounts of myxohyaline material. Three patterns (cribriform, tubular, and solid) occur, and the solid variant is characterized by a predominant compact sheet-like and nested pattern of rounded basaloid cells lacking obvious cribriform or tubular architecture. The solid variant has significant morphological and immunohistochemical overlap with a large range of neoplasms of different lineages, including other carcinomas and sarcomas. We describe a case of solid variant ACC of the paranasal sinuses, which showed an almost entirely solid pattern of growth (in >95% of cells) and which on initial biopsy showed no features of classical ACC. This highlights the potential for diagnostic misinterpretation with a variety of other neoplasms, which is particularly important because of the significant difference in treatment for ACC and tumors in its differential diagnosis.

  2. Myoepithelial cells in lobular carcinoma in situ: distribution and immunophenotype.

    Science.gov (United States)

    Wang, Ying; Jindal, Sonali; Martel, Maritza; Wu, Yaping; Schedin, Pepper; Troxell, Megan

    2016-09-01

    Myoepithelial cells have important physical and paracrine roles in breast tissue development, maintenance, and tumor suppression. Recent molecular and immunohistochemical studies have demonstrated phenotypic alterations in ductal carcinoma in situ-associated myoepithelial cells. Although the relationship of lobular carcinoma in situ (LCIS) and myoepithelial cells was described in 1980, further characterization of LCIS-associated myoepithelial cells is lacking. We stained 27 breast specimens harboring abundant LCIS with antibodies to smooth muscle myosin heavy chain, smooth muscle actin, and calponin. Dual stains for E-cadherin/smooth muscle myosin heavy chain and CK7/p63 were also performed. In each case, the intensity and distribution of staining in LCIS-associated myoepithelial cells were compared with normal breast tissue on the same slide. In 78% of the cases, LCIS-associated myoepithelial cells demonstrated decreased staining intensity for one or more myoepithelial markers. The normal localization of myoepithelial cells (flat against the basement membrane, pattern N) was seen in 96% of LCIS, yet 85% of cases had areas with myoepithelial cell cytoplasm oriented perpendicular to the basement membrane (pattern P), and in 30% of cases, myoepithelial cells appeared focally admixed with LCIS cells (pattern C). This study characterizes detailed architectural and immunophenotypic alterations of LCIS-associated myoepithelial cells. The finding of variably diminished staining favors application of several myoepithelial immunostains in clinical practice. The interaction of LCIS with myoepithelial cells, especially in light of the perpendicular and central architectural arrangements, deserves further mechanistic investigation. PMID:27195907

  3. Role of YAP and TAZ in pancreatic ductal adenocarcinoma and in stellate cells associated with cancer and chronic pancreatitis.

    Science.gov (United States)

    Morvaridi, Susan; Dhall, Deepti; Greene, Mark I; Pandol, Stephen J; Wang, Qiang

    2015-01-01

    Pancreatic ductal adenocarcinoma (PDAC) is characterized by a fibrotic and inflammatory microenvironment that is formed primarily by activated, myofibroblast-like, stellate cells. Although the stellate cells are thought to contribute to tumorigenesis, metastasis and drug resistance of PDAC, the signaling events involved in activation of the stellate cells are not well defined. Functioning as transcription co-factors, Yes-associated protein (YAP) and its homolog transcriptional co-activator with PDZ-binding motif (TAZ) modulate the expression of genes involved in various aspects of cellular functions, such as proliferation and mobility. Using human tissues we show that YAP and TAZ expression is restricted to the centroacinar and ductal cells of normal pancreas, but is elevated in cancer cells. In particular, YAP and TAZ are expressed at high levels in the activated stellate cells of both chronic pancreatitis and PDAC patients as well as in the islets of Langerhans in chronic pancreatitis tissues. Of note, YAP is up regulated in both acinar and ductal cells following induction of acute and chronic pancreatitis in mice. These findings indicate that YAP and TAZ may play a critical role in modulating pancreatic tissue regeneration, neoplastic transformation, and stellate cell functions in both PDAC and pancreatitis. PMID:26567630

  4. Identification of a novel subpopulation of tumor-initiating cells from gemcitabine-resistant pancreatic ductal adenocarcinoma patients.

    Directory of Open Access Journals (Sweden)

    Kazuya Shimizu

    Full Text Available Pancreatic ductal adenocarcinoma is highly resistant to systemic chemotherapy. Although there are many reports using pancreatic cancer cells derived from patients who did not receive chemotherapy, characteristics of pancreatic cancer cells from chemotherapy-resistant patients remain unclear. In this study, we set out to establish a cancer cell line in disseminated cancer cells derived from gemcitabine-resistant pancreatic ductal adenocarcinoma patients. By use of in vitro co-culture system with stromal cells, we established a novel pancreatic tumor-initiating cell line. The cell line required its direct interaction with stromal cells for its in vitro clonogenic growth and passaging. Their direct interaction induced basal lamina-like extracellular matrix formation that maintained colony formation. The cell line expressed CD133 protein, which expression level changed autonomously and by culture conditions. These results demonstrated that there were novel pancreatic tumor-initiating cells that required direct interactions with stromal cells for their in vitro cultivation in gemcitabine-resistant pancreatic ductal adenocarcinoma. This cell line would help to develop novel therapies that enhance effects of gemcitabine or novel anti-cancer drugs.

  5. Primary clear cell ductal adenocarcinoma of the pancreas: A case report and clinicopathologic literature review

    Directory of Open Access Journals (Sweden)

    Yashpal Modi

    2014-01-01

    Full Text Available We present a very rare, interesting case of a carcinoma of the pancreas with predominantly abundant clear cell morphology. According to the WHO classification, primary clear cell carcinoma of the pancreas is classified as a rare "miscellaneous" carcinoma. The tumor was observed in the distal body and tail of the pancreas of a 74-year-old woman. The histopathology of tumor cells showed well-defined cell membranes, clear cytoplasm, and prominent cell boundaries. Immunohistochemical (IHC staining showed positive reactions to antibodies against vimentin, cytokeratin 7 (CK-7, mucicarmine (MUC-1, periodic acid-Schiff (PAS, periodic acid-Schiff with diastase (PASD, carcinoembryonic antigen (CEA, and Carbohydrate Antigen 19-9 (CA 19-9. On the other hand, IHC staining was negative for alpha-fetoprotein (AFP, cytokeratin 20 (CK-20, HMB45, chromogranin, and synaptophysin. The patient was subsequently diagnosed with a primary solid-type pancreatic clear cell carcinoma with hepatic metastasis. Herein, we report this rare case and include a review of the current literature of this tumor.

  6. Synchronous bilateral medullary carcinoma of breast: Is it metastasis or second primary?

    Directory of Open Access Journals (Sweden)

    Chandrika

    2012-01-01

    Full Text Available Bilateral breast cancer is a rare event accounting for 2-5% of all breast malignancies. A second tumor in contralateral breast may be either synchronous or metachronous lesion. Synchronous bilateral invasive ductal carcinoma is known but medullary carcinoma is rare. The etiology of bilateral breast cancer is uncertain and prognosis in these cases once thought to be poor but recent data suggest a similar survival compared to unilateral disease. We report a case of triple negative synchronous bilateral medullary carcinoma in a 38-year-old female who presented with lump in both the breasts for three months. Multidetector computed tomography breast scan revealed bilateral heterogeneously enhancing well-defined lesion in both the breasts. Fine needle aspiration cytology from both the breast lump was suggestive of malignancy. Patient underwent bilateral modified radical mastectomy with axillary clearance in a single sitting. Histopathology showed synchronous bilateral medullary carcinoma of breast with ER, PR and HER- 2/ neu negativity. Patient was treated with chemoradiation and she is on regular follow up for one year without any recurrence or metastasis.

  7. Bilateral synchronous breast carcinomas followed by a metastasis to the gallbladder: a case report

    Directory of Open Access Journals (Sweden)

    Dardamanis Dimitrios

    2007-09-01

    Full Text Available Abstract Background Breast cancer is usually associated with metastases to lungs, bones and liver. Breast carcinoma metastasizing to the gallbladder is very rare. Case presentation A 59-year-old woman presented with bilateral synchronous breast lesions. A palpable, retroareolar solid lesion of diameter equal to 5 cm was present in the right breast, and a newly developed, non-palpable lesion with microcalcifications (diameter equal to 0.7 cm was present in the upper outer quadrant of the left breast. Modified radical mastectomy was performed on the right breast and lumpectomy after hook-wire localization was performed on the left breast, combined with lymph node dissection in both sides. The pathological examination revealed invasive lobular carcinoma grade II in the right breast and invasive ductal carcinoma grade I in the left breast. Chemotherapy, radiation therapy, trastuzumab and letrozole were appropriately administered. At her 18-month follow-up, the patient was free of symptoms; the imaging tests (chest CT, abdominal U/S, bone scan, biochemical tests, blood cell count and tumor markers were also normal. At the 20th month after surgery however, the patient developed symptoms of cholecystitis and underwent cholecystectomy. The histopathological examination revealed metastasis of the lobular carcinoma to the gallbladder. Conclusion This extremely rare case confirms on a single patient the results of large series having demonstrated the preferential metastasis of lobular breast cancer to the gallbladder. Symptoms of cholecystitis should not be neglected in such patients, as they might indicate metastasis to the gallbladder.

  8. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas

    Directory of Open Access Journals (Sweden)

    Almir Galvão Vieira Bitencourt

    2014-04-01

    Full Text Available Objective To correlate the results of 18F-fluoro-2-deoxy-D-glucose (18F-FDG positron emission tomography/computed tomography (PET/CT performed with a specific protocol for assessment of breasts with histological/immunohistochemical findings in breast carcinoma patients. Materials and Methods Cross-sectional study with prospective data collection, where patients with biopsy-confirmed breast carcinomas were studied. The patients underwent PET/CT examination in prone position, with a specific protocol for assessment of breasts. PET/CT findings were compared with histological and immunohistochemical data. Results The authors identified 59 malignant breast lesions in 50 patients. The maximum diameter of the lesions ranged from 6 to 80 mm (mean: 32.2 mm. Invasive ductal carcinoma was the most common histological type (n = 47; 79.7%. At PET/CT, 53 (89.8% of the lesions demonstrated anomalous concentrations of 18F-FDG, with maximum SUV ranging from 0.8 to 23.1 (mean: 5.5. A statistically significant association was observed between higher values of maximum SUV and histological type, histological grade, molecular subtype, tumor diameter, mitotic index and Ki-67 expression. Conclusion PET/CT performed with specific protocol for assessment of breasts has demonstrated good sensitivity and was associated with relevant histological/immunohistochemical factors related to aggressiveness and prognosis of breast carcinomas.

  9. 乳腺癌病理学诊断研究%Pathological analysis of breast carcinoma

    Institute of Scientific and Technical Information of China (English)

    杨槐

    2011-01-01

    目的 探讨乳腺癌的临床病理诊断的特点及其方法.方法 对243例乳腺癌患者进行组织病理学检查以及针吸细胞学检查.结果 乳腺癌的病理类型以浸润性导管癌为主;出现淋巴道转移概率最高的为浸润性小叶癌;40~60岁为乳腺癌高发年龄段.结论 乳腺癌的诊断应注意术前针吸细胞学检查与术中和术后的组织病理学检查结合,保证患者在术后有良好的预后.%Objective To investigate the pathological characteristics of breast cancer and its treatment method.Methods Totally 243 patients with breast cancer were underwent histopathological examination and fine needle aspiration cytodiagnosis.Results The main histological type of breast carcinoma was invasive ductal carcinoma;lymphatic metastasis was most frequently occurred in invasive lobular carcinoma;40 ~60 years old was the high incidence age period.Conclusion It should be noted that preoperative fine needle aspiration cytology and intraoperative and postoperative histopathological examination should be combined in diagnosing breast carcinoma to ensure a good prognosis.

  10. Anomalous arrangement of the pancreatobiliary ductal system in patients with a choledochal cyst.

    Science.gov (United States)

    Todani, T; Watanabe, Y; Fujii, T; Uemura, S

    1984-05-01

    An anomalous arrangement of the pancreatobiliary ductal system is usually observed in patients with a congenital choledochal cyst and is represented by a long common channel distal to the pancreatobiliary junction. According to the angle of the pancreatobiliary junction, anomalous junctions can be classified into four groups: right angle, acute angle, complex union, and normal union (presented here in the order of their incidence). The right-angle type tends to have cystic dilatation of the choledochus, whereas the acute-angle type generally has cylindrical dilatation. However, the grade and length of the stenosis on the distal part of the choledochus tend to determine the type of choledochal cyst. Cystic dilatation is usually observed in patients with high-grade and long stenosis, whereas cylindrical dilatation is seen in those with low-grade and short stenosis. Patients with an acute angle junction seem to only suffer from abdominal pain, and those in the complex union group tend to have jaundice and an abdominal tumor. A high amylase level in the bile within the cyst is observed frequently. In patients with obstructive jaundice, however, the amylase level is usually not elevated, because pancreatic juice cannot enter the choledochus.

  11. Ballistic penetration test results for Ductal and ultra-high performance concrete samples.

    Energy Technology Data Exchange (ETDEWEB)

    Reinhart, William Dodd; Thornhill, Tom Finley, III (KTech)

    2010-03-01

    This document provides detailed test results of ballistic impact experiments performed on several types of high performance concrete. These tests were performed at the Sandia National Laboratories Shock Thermodynamic Applied Research Facility using a 50 caliber powder gun to study penetration resistance of concrete samples. This document provides test results for ballistic impact experiments performed on two types of concrete samples, (1) Ductal{reg_sign} concrete is a fiber reinforced high performance concrete patented by Lafarge Group and (2) ultra-high performance concrete (UHPC) produced in-house by DoD. These tests were performed as part of a research demonstration project overseen by USACE and ERDC, at the Sandia National Laboratories Shock Thermodynamic Applied Research (STAR) facility. Ballistic penetration tests were performed on a single stage research powder gun of 50 caliber bore using a full metal jacket M33 ball projectile with a nominal velocity of 914 m/s (3000 ft/s). Testing was observed by Beverly DiPaolo from ERDC-GSL. In all, 31 tests were performed to achieve the test objectives which were: (1) recovery of concrete test specimens for post mortem analysis and characterization at outside labs, (2) measurement of projectile impact velocity and post-penetration residual velocity from electronic and radiographic techniques and, (3) high-speed photography of the projectile prior to impact, impact and exit of the rear surface of the concrete construct, and (4) summarize the results.

  12. Identification of novel vascular projections with cellular trafficking abilities on the microvasculature of pancreatic ductal adenocarcinoma

    Science.gov (United States)

    Wu, Yanhua; Wei, Youheng; Fang, Yuan; Han, Xu; Li, Jianang; Zhou, Ping; Yi, Qing; Maitra, Anirban; Liu, Jun O; Tuveson, David A.; Lou, Wenhui; Yu, Long

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) is a nearly lethal neoplasm. It is a remarkably stroma-rich, vascular-poor, hypoperfused tumor, which prevents efficient drug delivery. Paradoxically, the neoplastic cells have robust glucose uptake, suggesting the microvasculature has adopted an alternative method for nutrient uptake and cellular trafficking. Using an adapted thick tumor section immunostaining and 3-dimensional (3D) construction imaging method in human tissue samples, we identified an undiscovered feature of the mature and angiostatic microvasculature in advanced PDAC tumors; long, “hairy”-like projections on the basal surface of microvessels that we refer to as “basal microvilli”. Functionally, these basal microvilli have an actin-rich cytoskeleton, endocytic and exocytic properties, and they contain glucose transporter-1 (GLUT-1) positive vesicles. Clinically, as was demonstrated by PET-CT, the tumor microvasculature with the longest and the most abundant basal microvilli positively correlated with the high glucose uptake of the PDAC tumor itself. In addition, these basal microvilli were found in regions of the tumor with low GLUT-1 expression, suggesting their presence could be dependent upon the glucose concentrations in the tumor milieu. Altogether, these basal microvilli mark a novel, pathological feature of the PDAC tumor microvasculature. Because these basal microvilli are pathological features with endo- and exocytic properties, they may provide a non-conventional method for cellular trafficking in PDAC tumors. PMID:25561062

  13. Procathepsin E is highly abundant but minimally active in pancreatic ductal adenocarcinoma tumors.

    Science.gov (United States)

    O'Donoghue, Anthony J; Ivry, Sam L; Chaudhury, Chaity; Hostetter, Daniel R; Hanahan, Douglas; Craik, Charles S

    2016-09-01

    The cathepsin family of lysosomal proteases is increasingly being recognized for their altered expression in cancer and role in facilitating tumor progression. The aspartyl protease cathepsin E is overexpressed in several cancers and has been investigated as a biomarker for pancreatic ductal adenocarcinoma (PDAC). Here we show that cathepsin E expression in mouse PDAC tumors is increased by more than 400-fold when compared to healthy pancreatic tissue. Cathepsin E accumulates over the course of disease progression and accounts for more than 3% of the tumor protein in mice with end-stage disease. Through immunoblot analysis we determined that only procathepsin E exists in mouse PDAC tumors and cell lines derived from these tumors. By decreasing the pH, this procathepsion E is converted to the mature form, resulting in an increase in proteolytic activity. Although active site inhibitors can bind procathepsin E, treatment of PDAC mice with the aspartyl protease inhibitor ritonavir did not decrease tumor burden. Lastly, we used multiplex substrate profiling by mass spectrometry to identify two synthetic peptides that are hydrolyzed by procathepsin E near neutral pH. This work represents a comprehensive analysis of procathepsin E in PDAC and could facilitate the development of improved biomarkers for disease detection. PMID:27149201

  14. African Americans with pancreatic ductal adenocarcinoma exhibit gender differences in Kaiso expression.

    Science.gov (United States)

    Jones, Jacqueline; Mukherjee, Angana; Karanam, Balasubramanyam; Davis, Melissa; Jaynes, Jesse; Reams, R Renee; Dean-Colomb, Windy; Yates, Clayton

    2016-10-01

    Kaiso, a bi-modal transcription factor, regulates gene expression, and is elevated in breast, prostate, and colon cancers. Depletion of Kaiso in other cancer types leads to a reduction in markers for the epithelial-mesenchymal transition (EMT) (Jones et al., 2014), however its clinical implications in pancreatic ductal adenocarcinoma (PDCA) have not been widely explored. PDCA is rarely detected at an early stage but is characterized by rapid progression and invasiveness. We now report the significance of the subcellular localization of Kaiso in PDCAs from African Americans. Kaiso expression is higher in the cytoplasm of invasive and metastatic pancreatic cancers. In males, cytoplasmic expression of Kaiso correlates with cancer grade and lymph node positivity. In male and female patients, cytoplasmic Kaiso expression correlates with invasiveness. Also, nuclear expression of Kaiso increases with increased invasiveness and lymph node positivity. Further, analysis of the largest PDCA dataset available on ONCOMINE shows that as Kaiso increases, there is an overall increase in Zeb1, which is the inverse for E-cadherin. Hence, these findings suggest a role for Kaiso in the progression of PDCAs, involving the EMT markers, E-cadherin and Zeb1. PMID:27424525

  15. An angiopoietin-like protein 2 autocrine signaling promotes EMT during pancreatic ductal carcinogenesis

    Science.gov (United States)

    Carbone, Carmine; Piro, Geny; Fassan, Matteo; Tamburrino, Anna; Mina, Maria Mihaela; Zanotto, Marco; Chiao, Paul J; Bassi, Claudio; Scarpa, Aldo; Tortora, Giampaolo; Melisi, Davide

    2015-01-01

    The identification of the earliest molecular events responsible for the metastatic dissemination of pancreatic ductal adenocarcinoma (PDAC) remains critical for early detection, prevention, and treatment interventions. In this study, we hypothesized that an autocrine signaling between Angiopoietin-like Protein (ANGPTL)2 and its receptor leukocyte immunoglobulin-like receptor B2 (LILRB2) might be responsible for the epithelial-to-mesenchymal transition (EMT) and, the early metastatic behavior of cells in pancreatic preneoplastic lesions. We demonstrated that the sequential activation of KRAS, expression of HER2 and silencing of p16/p14 are sufficient to progressively and significantly increase the secretion of ANGPTL2, and the expression of LILRB2. Silencing the expression of ANGPTL2 reverted EMT and reduced migration in these cell lines. Blocking ANGPTL2 receptor LILRB2 in KRAS, and KRAS/HER2/p16p14shRNA LILRB2- expressing cells reduced ANGPTL2-induced cell proliferation and invasion. An increasingly significant overexpression of ANGPTL2 was observed in in a series of 68 different human PanIN and 27 PDAC lesions if compared with normal pancreatic parenchyma. These findings showed that the autocrine signaling of ANGPTL2 and its receptor LILRB2 plays key roles in sustaining EMT and the early metastatic behavior of cells in pancreatic preneoplastic lesions supporting the potential role of ANGPTL2 for early detection, metastasis prevention, and treatment in PDAC. PMID:25360865

  16. Comparative evaluation of cancer stem cell markers in normal pancreas and pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    Vizio, Barbara; Mauri, Francesco A; Prati, Adriana; Trivedi, Pritesh; Giacobino, Alice; Novarino, Anna; Satolli, Maria Antonietta; Ciuffreda, Libero; Camandona, Michele; Gasparri, Guido; Bellone, Graziella

    2012-01-01

    Chemoresistance and self-renewal of cancer stem cells (CSC), found in many tumors including pancreatic ductal adenocarcinoma (PDAC), are believed to underlie tumor mass regrowth. The distribution of cells carrying the putative stem-cell markers CD133, Nestin, Notch1-4, Jagged1 and 2, ABCG2 and aldehyde dehydrogenase (ALDH1) was assessed immunohistochemically using PDAC and normal pancreas tissue microarrays. The immunoreactivity was semi-quantitatively graded against the normal pancreas and was correlated with the differentiation grade and disease stage. No statistical significant differences were found between normal pancreas and PDAC in the expression of Nestin, Notch1, 3 and 4, ABCG2 or ALDH1. Notch2 and Jagged1 and 2 expression were increased in PDAC. CD133-positive cells were above-normal in PDAC, but the difference was not statistically significant. Nestin, Notch1-4, Jagged1, ABCG2 and ALDH1 immunostaining scores were not correlated with tumor grade or disease stage. CD133 and Notch2 expression was significantly inversely correlated with tumor grade, but not disease stage. Notch3 immunostaining positively correlated with tumor stage, but not with differentiation grade. Jagged2 protein expression correlated inversely with disease stage, but not with tumor grade. From the clinical standpoint, improved delineation of the tumor CSC signature, putatively responsible for tumor initiation and recurrence after initial response to chemotherapy, may offer novel therapeutic targets for this highly lethal cancer.

  17. Metabonomic changes from pancreatic intraepithelial neoplasia to pancreatic ductal adenocarcinoma in tissues from rats.

    Science.gov (United States)

    Wen, Shi; Li, Zhishui; Feng, Jianghua; Bai, Jianxi; Lin, Xianchao; Huang, Heguang

    2016-06-01

    Pancreatic ductal adenocarcinoma (PDAC) is one of the most malignant tumors and is difficult to diagnose in the early phase. This study was aimed at obtaining the metabolic profiles and characteristic metabolites of pancreatic intraepithelial neoplasia (PanIN) and PDAC tissues from Sprague-Dawley (SD) rats to establish metabonomic methods used in the early diagnosis of PDAC. In the present study, the animal models were established by embedding 7,12-dimethylbenzanthracene (DMBA) in the pancreas of SD rats to obtain PanIN and PDAC tissues. After the preprocessing of tissues, (1) H nuclear magnetic resonance (NMR) spectroscopy combined with multivariate and univariate statistical analysis was applied to identify the potential metabolic signatures and the corresponding metabolic pathways. Pattern recognition models were successfully established and differential metabolites, including glucose, amino acids, carboxylic acids and coenzymes, were screened out. Compared with the control, the trends in the variation of several metabolites were similar in both PanIN and PDAC. Kynurenate and methionine levels were elevated in PanIN but decreased in PDAC, thus, could served as biomarkers to distinguish PanIN from PDAC. Our results suggest that NMR-based techniques combined with multivariate statistical analysis can distinguish the metabolic differences among PanIN, PDAC and normal tissues, and, therefore, present a promising approach for physiopathologic metabolism investigations and early diagnoses of PDAC. PMID:27019331

  18. Analysis of long non-coding RNA expression profiles in pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    Fu, Xue-Liang; Liu, De-Jun; Yan, Ting-Ting; Yang, Jian-Yu; Yang, Min-Wei; Li, Jiao; Huo, Yan-Miao; Liu, Wei; Zhang, Jun-Feng; Hong, Jie; Hua, Rong; Chen, Hao-Yan; Sun, Yong-Wei

    2016-01-01

    Pancreatic ductal adenocarcinoma (PDAC) remains one of the most aggressive and lethal malignancies. Long non-coding RNAs (lncRNAs) are a novel class of non-protein-coding transcripts that have been implicated in cancer biogenesis and prognosis. By repurposing microarray probes, we herein analysed the lncRNA expression profiles in two public PDAC microarray datasets and identified 34 dysregulated lncRNAs in PDAC. In addition, the expression of 6 selected lncRNAs was confirmed in Ren Ji cohort and pancreatic cell lines, and their association with 80 PDAC patients' clinicopathological features and prognosis was investigated. Results indicated that AFAP1-AS1, UCA1 and ENSG00000218510 might be involved in PDAC progression and significantly associated with overall survival of PDAC. UCA1 and ENSG00000218510 expression status may serve as independent prognostic biomarkers for overall survival of PDAC. Gene set enrichment analysis (GSEA) analysis suggested that high AFAP1-AS1, UCA1 and low ENSG00000218510 expression were correlated with several tumorigenesis related pathways. Functional experiments demonstrated that AFAP1-AS1 and UCA1 were required for efficient invasion and/or proliferation promotion in PDAC cell lines, while ENSG00000218510 acted the opposite. Our findings provide novel information on lncRNAs expression profiles which might be beneficial to the precise diagnosis, subcategorization and ultimately, the individualized therapy of PDAC. PMID:27628540

  19. Hepatocyte growth factor signaling in intrapancreatic ductal cells drives pancreatic morphogenesis.

    Directory of Open Access Journals (Sweden)

    Ryan M Anderson

    Full Text Available In a forward genetic screen for regulators of pancreas development in zebrafish, we identified donut(s908 , a mutant which exhibits failed outgrowth of the exocrine pancreas. The s908 mutation leads to a leucine to arginine substitution in the ectodomain of the hepatocyte growth factor (HGF tyrosine kinase receptor, Met. This missense mutation impedes the proteolytic maturation of the receptor, its trafficking to the plasma membrane, and diminishes the phospho-activation of its kinase domain. Interestingly, during pancreatogenesis, met and its hgf ligands are expressed in pancreatic epithelia and mesenchyme, respectively. Although Met signaling elicits mitogenic and migratory responses in varied contexts, normal proliferation rates in donut mutant pancreata together with dysmorphic, mislocalized ductal cells suggest that met primarily functions motogenically in pancreatic tail formation. Treatment with PI3K and STAT3 inhibitors, but not with MAPK inhibitors, phenocopies the donut pancreatic defect, further indicating that Met signals through migratory pathways during pancreas development. Chimera analyses showed that Met-deficient cells were excluded from the duct, but not acinar, compartment in the pancreatic tail. Conversely, wild-type intrapancreatic duct and "tip cells" at the leading edge of the growing pancreas rescued the donut phenotype. Altogether, these results reveal a novel and essential role for HGF signaling in the intrapancreatic ducts during exocrine morphogenesis.

  20. Arsenic trioxide plus PX-478 achieves effective treatment in pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    Lang, Mingxiao; Wang, Xiuchao; Wang, Hongwei; Dong, Jie; Lan, Chungen; Hao, Jihui; Huang, Chongbiao; Li, Xin; Yu, Ming; Yang, Yanhui; Yang, Shengyu; Ren, He

    2016-08-10

    Arsenic trioxide (ATO) has been selected as a promising treatment not only in leukemia but also in solid tumors. Previous studies showed that the cytotoxicity of ATO mainly depends on the induction of reactive oxygen species. However, ATO has only achieved a modest effect in pancreatic ductal adenocarcinoma, suggesting that the existing radical scavenging proteins, such as hypoxia inducible factor-1, attenuate the effect. The goal of this study is to investigate the effect of combination treatment of ATO plus PX-478 (hypoxia-inducible factor-1 inhibitor) and its underlying mechanism. Here, we showed that PX-478 robustly strengthened the anti-growth and pro-apoptosis effect of ATO on Panc-1 and BxPC-3 pancreatic cancer cells in vitro. Meanwhile, in vivo mouse xenograft models also showed the synergistic effect of ATO plus PX-478 compared with any single agent. Further studies showed that the anti-tumor effect of ATO plus PX-478 was derived from the reactive oxygen species-induced apoptosis. We next confirmed that Hypoxia-inducible factor-1 cleared reactive oxygen species by its downstream target, forkhead box O transcription factors, and this effect may justify the strategy of ATO plus PX-478 in the treatment of pancreatic cancer. PMID:27212442

  1. Novel Drug Targets Based on Association between Inflammation and Pancreatic Ductal Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Muhammad Wasif Saif

    2010-07-01

    Full Text Available Dear Sir We read with great interest the editorial published by Uomo et al. in the 2010 May issue of JOP. J Pancreas (Online titled: “Inflammation and Pancreatic Ductal Adenocarcinoma: A Potential Scenario for Novel Drug Targets” [1]. There is a growing amount of evidence that inflammation plays a contributory role in the pathogenesis of cancer, including pancreatic carcinogenesis. Inflammatory states are characterized by the formation of reactive oxygen species and the induction of cell cycling for tissue growth and repair [1, 2, 3]. The initiation, promotion and expansion of tumors may be influenced by numerous components that also function in the inflammatory response. Recognized risk factors for pancreatic cancer include cigarette smoking, chronic/hereditary pancreatitis, obesity and type II diabetes. Each risk factor is linked by the fact that the inflammatory state significantly drives its pathology. We agree with the authors that multiple links between inflammation and pancreatic adenocarcinoma has led to development of novel targeted therapy which is under evaluation both in vivo and in vitro studies to fight against pancreatic adenocarcinoma. Pancreatic cancer is one of the leading causes of cancer mortality in the United States. Current therapy for pancreatic cancer involves surgery, chemotherapy, and radiation therapy; however, the 5-year survival rate remains less than 5%. Therefore, developments of novel agents, in particular based on the pathogenesis of pancreatic adenocarcinoma are urgently indicated.

  2. A Multicenter Trial Defining a Serum Protein Signature Associated with Pancreatic Ductal Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Anna S. Gerdtsson

    2015-01-01

    Full Text Available Background. Pancreatic ductal adenocarcinoma (PDAC is an aggressive disease with rapid tumor progression and poor prognosis. This study was motivated by the lack of sensitive and specific PDAC biomarkers and aimed to identify a diagnostic, serum protein signature for PDAC. Methods. To mimic a real life test situation, a multicenter trial comprising a serum sample cohort, including 338 patients with either PDAC or other pancreatic diseases (OPD and controls with nonpancreatic conditions (NPC, was analyzed on 293-plex recombinant antibody microarrays targeting immunoregulatory and cancer-associated antigens. Results. Serum samples collected from different hospitals were analyzed and showed that (i sampling from five different hospitals could not be identified as a preanalytical variable and (ii a multiplexed biomarker signature could be identified, utilizing up to 10 serum markers that could discriminate PDAC from controls, with sensitivities and specificities in the 91–100% range. The first protein profiles associated with the location of the primary tumor in the pancreas could also be identified. Conclusions. The results demonstrate that robust enough serum signatures could be identified in a multicenter trial, potentially contributing to the development of a multiplexed biomarker immunoassay for improved PDAC diagnosis.

  3. Low Expression of TBX4 Predicts Poor Prognosis in Patients with Stage II Pancreatic Ductal Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Meijuan Zong

    2011-08-01

    Full Text Available This study was designed to investigate the expression of the T-box transcription factor 4 (TBX4, a tumor biomarker that was previously identified by proteomics, in pancreatic ductal adenocarcinoma (PDAC and evaluate its clinical utility as a potential prognostic biomarkers for PDAC. The expression of TBX4 was detected in 77 stage II PDAC tumors by immunohistochemistry, and the results were analyzed with regard to clinicopathological characteristics and overall survival. Moreover, Tbx4 promoter methylation status in primary PDAC tumors and normal adjacent pancreas tissues was measured by bisulfite sequencing. Among 77 stage II PDAC tumors, 48 cases (62.3% expressed TBX4 at a high level. No significant correlation between TBX4 expression and other clinicopathological parameters, except tumor grade and liver metastasis recurrence, was found. The survival of patients with TBX4-high expression was significantly longer than those with TBX4-low expression (P = 0.010. In multivariate analysis, low TBX4 expression was an independent prognostic factor for overall survival in patients with stage II PDAC. TBX4 promoter methylation status was frequently observed in both PDAC and normal adjacent pancreas. We conclude that a low level of TBX4 expression suggests a worse prognosis for patients with stage II PDAC. Down-regulation of the TBX4 gene in pancreas is less likely to be regulated by DNA methylation.

  4. CD95 promotes metastatic spread via Sck in pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    Teodorczyk, M; Kleber, S; Wollny, D; Sefrin, J P; Aykut, B; Mateos, A; Herhaus, P; Sancho-Martinez, I; Hill, O; Gieffers, C; Sykora, J; Weichert, W; Eisen, C; Trumpp, A; Sprick, M R; Bergmann, F; Welsch, T; Martin-Villalba, A

    2015-07-01

    Cancer stem cells (CSCs) have been implicated in the initiation and maintenance of tumour growth as well as metastasis. Recent reports link stemness to epithelial-mesenchymal transition (EMT) in cancer. However, there is still little knowledge about the molecular markers of those events. In silico analysis of RNA profiles of 36 pancreatic ductal adenocarcinomas (PDAC) reveals an association of the expression of CD95 with EMT and stemness that was validated in CSCs isolated from PDAC surgical specimens. CD95 expression was also higher in metastatic pancreatic cells than in primary PDAC. Pharmacological inhibition of CD95 activity reduced PDAC growth and metastasis in CSC-derived xenografts and in a murine syngeneic model. On the mechanistic level, Sck was identified as a novel molecule indispensable for CD95's induction of cell cycle progression. This study uncovers CD95 as a marker of EMT and stemness in PDAC. It also addresses the molecular mechanism by which CD95 drives tumour growth and opens tantalizing therapeutic possibilities in PDAC. PMID:25613377

  5. The proteomes of human parotid and submandibular/sublingual gland salivas collected as the ductal secretions.

    Science.gov (United States)

    Denny, Paul; Hagen, Fred K; Hardt, Markus; Liao, Lujian; Yan, Weihong; Arellanno, Martha; Bassilian, Sara; Bedi, Gurrinder S; Boontheung, Pinmannee; Cociorva, Daniel; Delahunty, Claire M; Denny, Trish; Dunsmore, Jason; Faull, Kym F; Gilligan, Joyce; Gonzalez-Begne, Mireya; Halgand, Frédéric; Hall, Steven C; Han, Xuemei; Henson, Bradley; Hewel, Johannes; Hu, Shen; Jeffrey, Sherry; Jiang, Jiang; Loo, Joseph A; Ogorzalek Loo, Rachel R; Malamud, Daniel; Melvin, James E; Miroshnychenko, Olga; Navazesh, Mahvash; Niles, Richard; Park, Sung Kyu; Prakobphol, Akraporn; Ramachandran, Prasanna; Richert, Megan; Robinson, Sarah; Sondej, Melissa; Souda, Puneet; Sullivan, Mark A; Takashima, Jona; Than, Shawn; Wang, Jianghua; Whitelegge, Julian P; Witkowska, H Ewa; Wolinsky, Lawrence; Xie, Yongming; Xu, Tao; Yu, Weixia; Ytterberg, Jimmy; Wong, David T; Yates, John R; Fisher, Susan J

    2008-05-01

    Saliva is a body fluid with important functions in oral and general health. A consortium of three research groups catalogued the proteins in human saliva collected as the ductal secretions: 1166 identifications--914 in parotid and 917 in submandibular/sublingual saliva--were made. The results showed that a high proportion of proteins that are found in plasma and/or tears are also present in saliva along with unique components. The proteins identified are involved in numerous molecular processes ranging from structural functions to enzymatic/catalytic activities. As expected, the majority mapped to the extracellular and secretory compartments. An immunoblot approach was used to validate the presence in saliva of a subset of the proteins identified by mass spectrometric approaches. These experiments focused on novel constituents and proteins for which the peptide evidence was relatively weak. Ultimately, information derived from the work reported here and related published studies can be used to translate blood-based clinical laboratory tests into a format that utilizes saliva. Additionally, a catalogue of the salivary proteome of healthy individuals allows future analyses of salivary samples from individuals with oral and systemic diseases, with the goal of identifying biomarkers with diagnostic and/or prognostic value for these conditions; another possibility is the discovery of therapeutic targets.

  6. Neurotensin is a Versatile Modulator of In Vitro Human Pancreatic Ductal Adenocarcinoma Cell (PDAC Migration

    Directory of Open Access Journals (Sweden)

    Tatjana Mijatovic

    2007-01-01

    Full Text Available Background: While the neurotensin (NT roles in pancreatic cancer growth are well documented, its effects on pancreatic cancer cell migration have not been described. Methods: The NT-induced effects on the migration process of human pancreatic ductal adenocarcinoma cells (PDACs were characterized by means of various assays including computer-assisted video-microscopy, fluorescence microscopy, ELISA-based, small GTPase pull-down and phosphorylation assays. Results: The NT-induced modifications on in vitro PDACs migration largely depended on the extra-cellular matrix environment and cell propensity to migrate collectively or individually. While NT significantly reduced the level of migration of collectively migrating PDACs on vitronectin, it significantly increased the level of individually migrating PDACs. These effects were mainly mediated through the sortilin/NTR3 receptor. Neurotensin both induced altered expression of αV and β5 integrin subunits in PDACs cultured on vitronectin resulting in modified adhesion abilities, and caused modifications to the organization of the actin cytoskeleton through the NT-mediated activation of small Rho GTPases. While the NT effects on individually migrating PDACs were mediated at least through the EGFR/ERK signaling pathways, those on collectively migrating PDACs appeared highly dependent on the PI 3-kinase pathway. Conclusion: This study strongly suggests the involvement of neurotensin in the modulation of human PDAC migration.

  7. Genetic ablation of Smoothened in pancreatic fibroblasts increases acinar-ductal metaplasia.

    Science.gov (United States)

    Liu, Xin; Pitarresi, Jason R; Cuitiño, Maria C; Kladney, Raleigh D; Woelke, Sarah A; Sizemore, Gina M; Nayak, Sunayana G; Egriboz, Onur; Schweickert, Patrick G; Yu, Lianbo; Trela, Stefan; Schilling, Daniel J; Halloran, Shannon K; Li, Maokun; Dutta, Shourik; Fernandez, Soledad A; Rosol, Thomas J; Lesinski, Gregory B; Shakya, Reena; Ludwig, Thomas; Konieczny, Stephen F; Leone, Gustavo; Wu, Jinghai; Ostrowski, Michael C

    2016-09-01

    The contribution of the microenvironment to pancreatic acinar-to-ductal metaplasia (ADM), a preneoplastic transition in oncogenic Kras-driven pancreatic cancer progression, is currently unclear. Here we show that disruption of paracrine Hedgehog signaling via genetic ablation of Smoothened (Smo) in stromal fibroblasts in a Kras(G12D) mouse model increased ADM. Smo-deleted fibroblasts had higher expression of transforming growth factor-α (Tgfa) mRNA and secreted higher levels of TGFα, leading to activation of EGFR signaling in acinar cells and increased ADM. The mechanism involved activation of AKT and noncanonical activation of the GLI family transcription factor GLI2. GLI2 was phosphorylated at Ser230 in an AKT-dependent fashion and directly regulated Tgfa expression in fibroblasts lacking Smo Additionally, Smo-deleted fibroblasts stimulated the growth of Kras(G12D)/Tp53(R172H) pancreatic tumor cells in vivo and in vitro. These results define a non-cell-autonomous mechanism modulating Kras(G12D)-driven ADM that is balanced by cross-talk between Hedgehog/SMO and AKT/GLI2 pathways in stromal fibroblasts. PMID:27633013

  8. The use of Multidimensional Data to Identify the Molecular Biomarker for Pancreatic Ductal Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Liwei Zhuang

    2013-01-01

    Full Text Available Pancreatic ductal adenocarcinoma (PDAC is a lethal disease, and the patient has an extremely poor overall survival with a less than 5% 5-year survival rate. Development of potential biomarkers provides a critical foundation for the diagnosis of PDAC. In this project, we have adopted an integrative approach to simultaneously identify biomarker and generate testable hypothesis from multidimensional omics data. We first examine genes for which expression levels are correlated with survival data. The gene list was screened with TF regulation, predicted miRNA targets information, and KEGG pathways. We identified that 273 candidate genes are correlated with patient survival data. 12 TF regulation gene sets, 11 miRNAs targets gene sets, and 15 KEGG pathways are enriched with these survival genes. Notably, CEBPA/miRNA32/PER2 signaling to the clock rhythm qualifies this pathway as a suitable target for therapeutic intervention in PDAC. PER2 expression was highly associated with survival data, thus representing a novel biomarker for earlier detection of PDAC.

  9. Optical coherence tomography in detection of dysplasia and cancer of the gastrointestinal tract and bilio-pancreatic ductal system

    Institute of Scientific and Technical Information of China (English)

    Pier Alberto Testoni; Benedetto Mangiavillano

    2008-01-01

    Optical coherence tomography (OCT) is an optical imaging modality that performs high-resolution, cross-sectional, subsurface tomographic imaging of the microstructure of tissues. The physical principle of OCT is similar to that of B-mode ultrasound imaging, except that it uses infrared light waves rather than acoustic waves. The in vivo resolution is 10-25 times better (about 10 μm) than with high-frequency ultrasound imaging, but the depth of penetration is limited to 1-3 mm, depending upon tissue structure, depth of focus of the probe used, and pressure applied to the tissue surface. In the last decade, OCT technology has evolved from an experimental laboratory tool to a new diagnostic imaging modality with a wide spectrum of clinical applications in medical practice, including the gastrointestinal (GI) tract and pancreatic-biliary ductal system. OCT imaging from the GI tract can be done in humans by using narrow-diameter, catheter-based probes that can be inserted through the accessory channel of either a conventional front-view endoscope, for investigating the epithelial structure of the GI tract, or a side-view endoscope, inside a standard transparent ERCP catheter, for investigating the pancreatico-biliary ductal system. Esophagus and the esophago-gastric junction has been the most widely investigated organ so far; more recently, also duodenum, colon and pancreatico-biliary ductal system have been extensively investigated. OCT imaging of the gastro-intestinal wall structure is characterized by a multiple-layer architecture that permits an accurate evaluation of the mucosa, lamina propria, muscularis mucosae, and part of the submucosa. The technique may be, therefore, used to identify pre-neoplastic conditions of the GI tract, such as Barrett's epithelium and dysplasia, and evaluate the depth of penetration of early-stage neoplastic lesions. OCT imaging of the pancreatic and biliary ductal system could improve the diagnostic accuracy for ductal epithelial

  10. Cdk4 regulates recruitment of quiescent beta-cells and ductal epithelial progenitors to reconstitute beta-cell mass.

    Directory of Open Access Journals (Sweden)

    Ji-Hyeon Lee

    Full Text Available Insulin-producing pancreatic islet beta cells (beta-cells are destroyed, severely depleted or functionally impaired in diabetes. Therefore, replacing functional beta-cell mass would advance clinical diabetes management. We have previously demonstrated the importance of Cdk4 in regulating beta-cell mass. Cdk4-deficient mice display beta-cell hypoplasia and develop diabetes, whereas beta-cell hyperplasia is observed in mice expressing an active Cdk4R24C kinase. While beta-cell replication appears to be the primary mechanism responsible for beta-cell mass increase, considerable evidence also supports a contribution from the pancreatic ductal epithelium in generation of new beta-cells. Further, while it is believed that majority of beta-cells are in a state of 'dormancy', it is unclear if and to what extent the quiescent cells can be coaxed to participate in the beta-cell regenerative response. Here, we address these queries using a model of partial pancreatectomy (PX in Cdk4 mutant mice. To investigate the kinetics of the regeneration process precisely, we performed DNA analog-based lineage-tracing studies followed by mathematical modeling. Within a week after PX, we observed considerable proliferation of islet beta-cells and ductal epithelial cells. Interestingly, the mathematical model showed that recruitment of quiescent cells into the active cell cycle promotes beta-cell mass reconstitution in the Cdk4R24C pancreas. Moreover, within 24-48 hours post-PX, ductal epithelial cells expressing the transcription factor Pdx-1 dramatically increased. We also detected insulin-positive cells in the ductal epithelium along with a significant increase of islet-like cell clusters in the Cdk4R24C pancreas. We conclude that Cdk4 not only promotes beta-cell replication, but also facilitates the activation of beta-cell progenitors in the ductal epithelium. In addition, we show that Cdk4 controls beta-cell mass by recruiting quiescent cells to enter the cell

  11. Endoscopic diagnosis and treatment of anomalous pancreaticobiliary ductal junction%先天性胆胰管合流异常的内镜诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    周玉保; 潘亚敏; 王田田; 胡冰

    2009-01-01

    Objective To evaluate application of endoscopic retrograde cholangiopancreatography (ERCP)in diagnosis and managements of anomalous pancreaticobiliary ductal junction(APBDJ).Methods Data of APBDJ patients,including occurrence,sub-type characteristics,relationship with concurrent pancreaticobiliary diseases and endoscopic treatment,who underwent ERCP in the past 5 years,were retrospectively reviewed.Results APBDJ was diagnosed in 49 patients.which accounted for 0.74% of all ERCP cases(6639)in the salne period,among whom,there were 27 cases of P-B sub-type,19 B-P type,and 3 complex type.Gallbladder carcinoma Was accompanied in 16 patients,choledochal cyst in 19,chronic pancreatitis in 7,and pancreas divisum in 2,with morbidity rates signitlcandy higher than those in non-APBDJ population(P<0.01).The gallbladder carcinoma Was most commonly seen in P-B patients(14/16),and choledochal cyst most frequently occurred in B-P type(15/19).The endoscopic managements applied in APBDJ patients included sphincterotomy in 10 cases,naso-biliary drainage in 16,plastic stenting in 15,metal stenting in 6,and pancreatic stent placement in 2.Conclusion ERCP is a direct and reliable method for the diagnosis of APBDJ,which is commonly complicated with gallbladder carcinoma,choledochal cyst,and chronic pancreatitia.Endoscopic therapy can be considered in accordance with complications.%目的 探讨ERCP对胆胰管合流异常(APBDJ)的诊断价值与临床处理原则.方法 回顾分析近5年来接受ERCP诊疗的患者中,APBDJ的发生情况、分型特点、与合并胆胰疾病的关系,以及内镜下处理的情况.结果 探讨ERCP对胆胰管合流异常(APBDJ)的诊断价值与临床处理原则.方法 回顾分析近5年来接受ERCP诊疗的患者中,APBDJ的发生情况、分型特点、与合并胆胰疾病的关系,以及内镜下处理的情况.结论 ERCP是APBDJ一种直接、可靠的诊断手段;APBDJ与胆囊癌、胆总管囊肿及慢性胰腺炎等症有非常密

  12. Multiple primary bronchogenic carcinomas.

    Science.gov (United States)

    Yang, X; Ji, H; Paljarvi, L; Soimakallio, S

    1996-07-01

    Multiple primary bronchogenic carcinomas (MPBCa) are extremely rare. The differentiation of a MPBCa from a pulmonary metastasis due to an extrathoracic neoplasm is sometimes difficult. We reviewed 324 pathologically proved primary pulmonary carcinomas and found six cases of MPBCa (1.9%). We herewith present the series and discuss the diagnosis of MPBCa. PMID:21594435

  13. Primary cutaneous myoepithelial carcinoma

    DEFF Research Database (Denmark)

    Frost, Markus Winther; Steiniche, Torben; Damsgaard, Tine Engberg;

    2013-01-01

    This study describes a case of primary myoepithelial carcinoma of the skin and reviews the available literature on this topic. Myoepitheliomas and carcinomas arise most frequently from myoepithelial cells within the salivary glands but are found in many anatomical locations. We documented a case...

  14. Radiologic-pathologic correlation of microcalcifications in intraductal breast carcinomas; Correlacion radipatologica de microcalcificaciones en el carcinoma intraductal de mama

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Revillo, J.; Perez-Seoane, C. [Hospital Universitario Reina Sofia. Cordoba (Spain)

    2002-07-01

    To contribute our experience in the study of ductal carcinoma in situ of the breast (DCis), correlating the radiological and pathological features of the calcifications detected by mammography with their histological location within the tumor. Out of 24 cases of DCis, 20 diagnosed on the basis of calcifications detected on mammography (81%) were reviewed retrospectively. The authors assessed the radiological features of the calcifications such as cluster formation, number, distribution, size, shape and density. They were classified into three pathological subtypes, and the location of calcium within the tumor was studied. The histological data were correlated with the mammographic findings. Mammography showed that non segmented focal clusters were the most common type (13 of 20 cases) and that 45% of the tumors (9 of 20) presented 5 to 10 microcalcifications. Heterogeneity of size and shape predominated (80% and 75%, respectively) while 65% of the lesions had a round morphology. The histological findings showed that 95% of the microcalcifications were located in the interior of the tumor, and consisted of calcium with a necrotic component in grade III lesions, and calcium in the cribriform cells or micro papillae of the tumors in grades I and II. Microfocality and micro infiltration were detected in all three subtypes. There is a good radiologic-pathologic correlation of micro calcification in DCis. The calcifications observed in mammograms from grade I and II lesions are predominantly round-shaped and small in size. Histological analysis identifies them as laminated or psammomatous calcific depots in the cribriform cells or micropapillae of the tumor. In grade III lesions, the calcifications are rounded or elongated, and correspond to amorphous calcifications compressed of intra ductal necrotic tissue. (Author) 17 refs.

  15. Strong adverse effect of epidermal growth factor receptor 2 overexpression on prognosis of patients with invasive lobular breast cancer: a comparative study with invasive ductal breast cancer in Chinese population.

    Science.gov (United States)

    Wang, Tong; Ma, Yuanyuan; Wang, Liang; Liu, Hong; Chen, Meixuan; Niu, Ruifang

    2015-08-01

    The data on the outcome of breast invasive lobular carcinoma (ILC) are conflicting. In addition, the prognostic effect of molecular subtypes on ILC remains unclear. In this study, the clinicopathological and prognostic data between 269 ILC and 816 invasive ductal carcinoma (IDC) cases in a Chinese population were extensively compared, with a median follow-up time of 7.8 years. Compared with the IDC group, ILC tumors had more lymph node invasion, hormonal receptor positivity, and human epidermal growth factor receptor 2 (HER2) negativity. ILC patients showed overall survival (OS) and recurrence/metastasis-free survival (RFS) rates similar to those of IDC patients but exhibited worse disease-free survival (DFS) rate because of the higher rate of contralateral breast cancer (BC). Further analysis showed that OS, RFS, and DFS were similar between ILC and IDC patients in the subgroups of luminal A and triple-negative BC with HER2 negativity but were worse in ILC patients than those in IDC patients in the subgroups of luminal B and HER2 overexpression with positive HER2 expression. Multivariate analysis indicated HER2 positivity as an independent risk factor for OS, RFS, and DFS of ILC patients, which increased the risk in the ILC group than that in IDC group. The interaction of HER2 and ILC was also defined as an independent risk factor for OS, RFS, and DFS of the entire population. In conclusion, overexpression of HER2 exhibited stronger negative effect on the prognosis of ILC patients than that in IDC patients, suggesting that treatment targeting HER2 is crucial for this BC subgroup. PMID:25804795

  16. Pancreatic Stellate Cells and Pancreatic Carcinoma: An Unholy Alliance

    Directory of Open Access Journals (Sweden)

    Johannes-Matthias Löhr

    2009-07-01

    Full Text Available The importance of the stromal compartment in the development, proliferation, invasion, metastasis and resistance of epithelial cancers has increasingly been recognized in recent decades [1, 2]. This stromal reaction is found in many carcinomas, e.g. in breast, prostate, colon, ovarian and pancreatic cancer. It is made up of stromal cells, endothelial cells, immune cells and extracellular matrix proteins. Moreover, the ECM proteins in the stroma act as a reservoir for growth factors released either by tumor or stromal cells, thus enabling autocrine and paracrine stimulation of the cells within the tumor mass. In this respect, groundbreaking work in solid tumors was done by Mina Bissell with breast carcinoma as her model system [3]. Recently, Vonlaufen et al. have contributed a review on the relationship between activated pancreatic stellate cells (PSCs and pancreatic ductal adenocarcinoma cells which is worth reading [4]. Vonlaufen et al., with their own study [5] and those of some other groups (see their review, convincingly demonstrate a reciprocal influence of both nonepithelial and epithelial constituents of pancreatic carcinoma which works to their mutual benefit. Thus, the coinjection of PSC and pancreatic tumor cells enhances tumor growth and metastasis. In In vitro and animal models, PSCs increase tumor cell proliferation and decrease basal and induced apoptosis of pancreatic tumor cells. On the other hand, pancreatic tumor cells activate PSCs, recruit them to their vicinity and stimulate their proliferation. This review clearly exemplifies the specialized milieu in which both cell types grow to their mutual benefit, thus forming one of the deadliest tumors we know.

  17. Human carcinomas variably express the complement inhibitory proteins CD46 (membrane cofactor protein), CD55 (decay-accelerating factor), and CD59 (protectin).

    Science.gov (United States)

    Niehans, G A; Cherwitz, D L; Staley, N A; Knapp, D J; Dalmasso, A P

    1996-07-01

    Normal human tissues express membrane-associated complement inhibitory proteins that protect these tissues from damage by autologous complement. To determine whether neoplasms also express these proteins, we examined the distribution of the complement inhibitors decay-accelerating factor (DAF), CD59 (protectin), and membrane cofactor protein in frozen samples of human breast, colon, kidney, and lung carcinomas and in adjacent non-neoplastic tissues, using immunohistochemistry. All samples were also studied for deposition of C3 fragments and activated C5b-9. Differences between normal tissues and the corresponding neoplasms were often observed, with loss or gain of expression of one or more inhibitors. Ductal carcinomas of the breast showed the most variation in phenotype; some tumors expressed only one inhibitor while others expressed different combinations of two or three inhibitors. Colon carcinomas, by contrast, stained intensely for all inhibitors. Renal cell carcinomas had weak to moderate expression of one to three inhibitors, generally DAF and CD59, whereas non-small cell carcinomas of the lung usually expressed CD59 and membrane cofactor protein with variable DAF immunoreactivity. The two small cell carcinomas of the lung showed little or no staining for any inhibitor. Activated C5b-9 deposition was seen adjacent to tumor nests in a minority of carcinomas and showed no correlation with complement inhibitor expression. C3 fragment deposition was minimal. Our results demonstrate that most carcinomas, with the exception of small cell carcinomas of the lung, do express one or more complement inhibitors at a level likely to inhibit complement-mediated cellular damage. Unexpectedly, large quantities of DAF and CD59 were often observed in tumor stroma, with only limited deposition in normal connective tissue. This suggests that carcinomas may supplement the activity of membrane-associated complement inhibitors by release of soluble forms of DAF and CD59 into the

  18. Bioelectric impedance phase angle in breast carcinoma

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    Ruchi Tyagi

    2014-01-01

    Full Text Available Context: Worldwide breast cancer is the most frequently diagnosed life threatening cancer and the leading cause of death in women. Bioelectric impedance analysis (BIA affords an emerging opportunity to assess prognosis because of its ability to non invasively assess cell and plasma membrane structure and function by means of phase angle. Aims: To compare the phase angle between patients of breast cancer and their matched control with the help of BIA. Settings and Design: After taking clearance from ethical committee, a total of 34 female cases of histologically proven infiltrating ductal breast carcinoma were included from the surgery IPD, department of surgery. Equal numbers of the matched controls were recruited from the friends and relatives of cases. Materials and Methods: Bio Electrical Impedance Analyzer (BIA BODY STAT QUAD SCAN 4000 was used to measure resistance (R and reactance (Xc by recording a voltage drop in applied current. Phase angle is the ratio of reactance to resistance and is a measure of cell vitality. Statistical analysis used: Unpaired "t" test was applied. Results: In control group, the phase angle showed a mean of 5.479 whereas in test group, it showed a mean value of 4.726. The P value showed a significant difference (P < 0.0001. The smaller the phase angle values were higher was the tumor, nodes, metastases (TNM staging. The phase angles differed significantly from the healthy age matched control values. Conclusions: This study demonstrated that phase angle is a strong predictor of severity of breast cancer and differed significantly between the two groups.

  19. Missed pancreatic ductal adenocarcinoma: Assessment of early imaging findings on prediagnostic magnetic resonance imaging

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    Jang, Kyung Mi; Kim, Seong Hyun, E-mail: sh6453.kim@samsung.com; Kim, Young Kon; Song, Kyoung Doo; Lee, Soon Jin; Choi, Dongil

    2015-08-15

    Highlights: • MR imaging was superior to CT for the detection of early PDAC. • A focal lesion with no MPD interruption is common MR finding of early PDAC. • A mean volume doubling time of early PDAC was about five months. - Abstract: Objective: To investigate the early imaging findings and growth rate of pancreatic ductal adenocarcinoma (PDAC), and to assess whether MR imaging detects early PDAC better than CT. Materials and methods: The institutional review board approved this retrospective study and waived the requirement for informed consent. Twenty-two patients were included, and two radiologists, by consensus, assessed the presence of focal lesions, interruption of the main pancreatic duct (MPD), MPD dilatation, and pancreatitis, volume doubling time (VDT) of PDAC on prediagnostic MR imaging. Two other observers independently reviewed three image sets (CT images, unenhanced MR images, and unenhanced and contrast-enhanced MR images) for the detection of early PDAC. Paired Wilcoxon signed rank test and receiver operating characteristic (ROC) curve analysis were used for statistical analyses. Results: In 20 (90.9%) patients, prediagnostic MR exams showed abnormality, and all of them showed focal lesions on the first abnormal prediagnostic MR exams. Thirteen lesions (65%) showed no MPD interruption and one lesion (5%) was accompanied by pancreatitis. The mean VDT of PDAC was 151.7 days (range, 18.3–417.8 days). Diagnostic performance of unenhanced MR images (Az, 0.971–0.989) and combined unenhanced and contrast-enhanced MR images (Az, 0.956–0.963) was significantly better than that of CT images (Az, 0.565–0.583; p < 0.01) for both observers, Conclusion: The most common early imaging finding of PDAC on prediagnostic MR exams was a focal lesion with no MPD interruption with a mean volume doubling time of five months. MR imaging was superior to CT for the detection of early PDAC.