OBJECTIVETo assess the diagnostic value of core needle biopsy (CNB) before neoadjuvant chemotherapy for breast cancer.

METHODSOne hundred and nineteen breast cancer cases underwent neoadjuvant chemotherapy in our hospital during the period from June, 2005 to January, 2007 were analyzed. CNB was carried out before starting chemotherapy. The hematoxylin and eosin-stained slides of CNB taken before and after neoadjuvant chemotherapy were reviewed independently by two pathologists, and the rate of consistency was verified.

RESULTSAmongst the 119 cases studied, 110 cases were confirmed to be carcinoma, including 105 cases of invasive carcinoma and 5 cases of ductal carcinoma-in-situ. The rate of consistency was 97.22% (105/108).

CONCLUSIONCNB has important value in distinguishing benign from malignant lesions, as well as in confirming the diagnosis of invasive carcinoma before starting neoadjuvant chemotherapy.

Biopsy, Needle ; methods ; utilization ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; drug therapy ; Carcinoma, Ductal, Breast ; diagnosis ; pathology ; Female ; Humans ; Neoadjuvant Therapy ; methods

OBJECTIVETo study the clinicopathological features of primary squamous cell carcinoma (SCC) of breast and the diagnosis and treatment of the disease.

METHODSThe clinical, operative and pathological data from 7 cases of SCC of breast were retrospectively analysed.

RESULTSFive patients complained of painless mass and two of them were accompanied with local pain. All patients were diagnosed as having SCC by fine-needle aspiration before operation. Two patients underwent modified radical mastectomy, and the others received radical mastectomy. Pathological examination showed primary squamous cell carcinoma of the breast with metastasis to axlliary lymph nodes in one patient. Follow-up of four patients revealed that two patients are living well and two patients died. Three patients lost to follow up.

CONCLUSIONThe diagnosis of primary squamous cell carcinoma of the breast is dependent on pathological results. Radical mastectomy including modified radical mastectomy is most effective in the treatment of mammary SCC. Postoperative chemotherapy and radiation are necessary auxiliary therapy.

Adult ; Aged ; Breast Neoplasms ; diagnosis ; pathology ; therapy ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; therapy ; Female ; Humans ; Middle Aged ; Prognosis ; Retrospective Studies

Biopsy, Needle ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; pathology ; therapy ; Chemotherapy, Adjuvant ; Female ; Humans ; Mastectomy ; methods ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Risk Factors ; Sentinel Lymph Node Biopsy

Axilla ; Breast Neoplasms ; diagnosis ; pathology ; therapy ; Female ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; diagnosis ; Sentinel Lymph Node Biopsy

OBJECTIVETo investigate the clinical value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing pathologic responses in breast cancer treated with neoadjuvant chemotherapy.

METHODSForty-five patients with pathologically confirmed breast carcinoma who finished last course of neoadjuvant chemotherapy underwent preoperative breast MRI. All the specimen slices were blindly reviewed by one pathologist. Pathologic response was assessed according Miller & Payne five-point classification, of which grade 5 defined as pathological complete response (pCR) , and grade 5 or 4 defined as major histological response (MHR). DCE-MRI images were blindly reviewed by two radiologists retrospectively on workstation with Functool software. Any non-vessel enhancement in previous tumor bed in any phase of postcontrast acquisition was defined as residual disease. The diagnostic results of two radiologists were correlated to pathological gold standard. Inter-observer consistency was analyzed by Kappa statistics.

RESULTSDCE-MRI for pathological invasive (pINV) residual disease detection in two radiologists had sensitivities of 94.7% and 97.4%, specificities of 42.8% and 57.1%, and accuracy of 86.6% and 91.1%, respectively, while MHR evaluation had sensitivities of 95.5% and 81.8%, specificities of 73.9% and 82.6%, and accuracies of 84.4% and 82.2%, respectively. K values in determine pINV and MHR were 0.728 and 0.778, respectively, showing good inter-observer consistency.

CONCLUSIONDCE-MRI is sensitive in detecting residual breast cancer after neoadjuvant chemotherapy, and can be used to predict the postoperative pathologic response.

Breast Neoplasms ; diagnosis ; drug therapy ; pathology ; Contrast Media ; Female ; Humans ; Magnetic Resonance Imaging ; Neoadjuvant Therapy ; Neoplasm, Residual ; Sensitivity and Specificity

OBJECTIVETo investigate the clinicopathological manifestation, immunophenotypic features and prognostic factors of patients with primary breast DLBCL (PB-DLBCL).

METHODSTwelve cases of PB-DLBCL, diagnosed according to the 2008 World Health Organization classification of tumors of hematopoietic and lymphoid tissues, were retrospectively studied.

RESULTSMost patients were admitted to hospital because of painless unilateral breast mass. Out of 12 cases, 5 were in Ann Arbor stage I (41.7%), 7 case were in stage II (58.3%). Most (89.9%) were assigned to non-GCB subtypes, 11.1% were classified as GCB subtype. The patients who recepted treatment were sensitive to chemotherapy and they were all alive following 12 to 92 months.

CONCLUSIONPrimary breast DLBCL is extremely rare without specific clinical features. They all respond well to chemotherapy and show good prognosis.

Breast Neoplasms ; diagnosis ; pathology ; therapy ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; therapy ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVETo explore the morbidity, clinical characteristics, diagnosis, metastasis, treatment and prognosis of primary breast lymphoma (PBL).

METHODSFrom January 1960 to August 2007, 49 cases with PBL were treated among 22811 cases of breast malignancy and 7337 cases of malignant lymphoma. The clinical data of these 49 patients, included gender, age, pathologic type, breast X ray and B ultrasound examination results, involved lymph nodes and organs, treatment, survival time, were retrospectively analyzed.

RESULTSFrom 1960 to 2007, the incidence rate of PBL in Tianjin Municipality was 59/10 millions; in details, the incidence rate of PBL for every 10 years was 2/10 millions, 3/10 millions, 0, 13/10 millions and 32/10 millions, respectively. According to circle graph of age, PBL occurred frequently in female aged 30 to 59 years. Most of this group of PBL was non-Hodgkin lymphoma (48 cases). No typical characteristics was found with the examination of breast X ray, B ultrasound and frozen section pathology. Bone marrow (9 cases), lung (7 cases), meninges (4 cases) and ovary (4 cases) were frequently involved organs. The overall 5-year survival rate was 6.1% for the group. The prognosis in patients with radical mastectomy combined chemotherapy was much better than that in patient received super to local mastectomy plus chemotherapy or simple tumor resection plus chemotherapy (5-year survival rates were 21.4%, 0, 0, respectively).

CONCLUSIONSPBL is a kind of rare lymphoma with incidence increasing sharply in the past few decades. The clinical manifestation is atypical. Diagnosis of PBL should adopt histological examination. Radical mastectomy combined chemotherapy could bring better prognosis, but the prognosis is still poor.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; diagnosis ; pathology ; therapy ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; therapy ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo investigate general and clinicopathological characteristics of male breast cancer and analyzed the factors affecting the outcomes of the patients based on the data from a single institution.

METHODSTwenty-five male breast cancer patients treated at Sun Yet-sen University Cancer Center between January 1, 2000 and April 30, 2011 were included into the study. The patients were followed up for 1 to 90 months with a median follow-up of 51 months. The general and clinicopathological characteristics including family history, age, smoking, alcohol drinking, site of tumor, location of tumor, histological type, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), Ki-67, vascular endothelial growth factor (VEGF), P53 expression, neoadjuvant chemotherapy, surgery, adjuvant chemotherapy, adjuvant radiotherapy, adjuvant endocrine therapy, tumor size, lymph node status, distant metastasis and TNM stage were investigated by univariate analysis to evaluate the impact of these factors on patient survival.

RESULTSThe 5-year survival rate was 66.5% in these patients. Neoadjuvant chemotherapy, tumor size, lymph node status, distant metastasis and TNM stage were significant predictors for the overall survival. Patients receiving adjuvant endocrine therapy tended to have a better overall survival, though this was not supported statistically (P=0.086). However, patients with neoadjuvant chemotherapy had a poorer overall survival than those without it (P=0.000). Patients in stages I and II had better overall survival than those in stages III and IV (P=0.000).

CONCLUSIONThe 5-year survival rate was 66.5% in these male breast cancer patients. Neoadjuvant chemotherapy, tumor size, lymph node status, distant metastasis and TNM stage are significant predictors of the overall patient survival.

Breast Neoplasms, Male ; diagnosis ; drug therapy ; pathology ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Survival Rate

Pseudomyxoma peritonei is a very rare condition, and even rarer in patients with history of cancer. A 70-year old woman with a history of breast cancer was admitted with abdominal pain and distention. Abdominal computed tomography revealed ascites collection, diffuse engorgement and infiltration of the mesenteric vessel, suggesting peritonitis or peritoneal carcinomatosis. Diagnostic paracentesis was attempted several times, but a sufficient specimen could not be collected due to the thick and gelatinous nature of the ascites. Therefore, the patient underwent diagnostic laparoscopy for tissue biopsy of the peritoneum, which indicated pseudomyxoma peritonei. However, the origin of the pseudomyxoma peritonei could not be identified intraoperatively due to adhesions and large amount of mucoceles. Systemic chemotherapy was performed using Fluorouracil, producing some symptomatic relief. After discharge, abdominal pain and distention gradually worsened, so at 18 months after initial diagnosis the patient received palliative surgery based on massive mucinous ascites and palpable mass at the omentum. The patient expired after surgery due to massive bleeding.
Abdomen/diagnostic imaging ; Aged ; Antimetabolites, Antineoplastic/therapeutic use ; Ascites ; Breast Neoplasms/pathology ; Colonoscopy ; Female ; Fluorouracil/therapeutic use ; Humans ; Laparoscopy ; Peritoneal Neoplasms/*diagnosis/drug therapy/pathology ; Peritoneum/pathology ; Pseudomyxoma Peritonei/*diagnosis/drug therapy/pathology ; Tomography, X-Ray Computed

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast ; pathology ; Breast Neoplasms ; drug therapy ; pathology ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell ; drug therapy ; pathology ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Sarcoma ; pathology ; Spleen ; pathology ; Splenic Neoplasms ; drug therapy ; pathology ; Vincristine ; therapeutic use