Breast cancer developing from a surgical scar is rare; this type of malignancy has been reported in only 12 cases to date. Herein, we report on a 52-year-old female who developed infiltrating ductal carcinoma in a surgical scar following excision of a benign mass. Two years previously, the patient underwent surgery and radiotherapy for invasive ductal carcinoma of the contralateral breast. The initial appearance of the scar was similar to fat necrosis; it was observed to be progressively shrinking on follow-up sonography. On the two year follow-up ultrasound, the appearance changed, an angular margin and vascularity at the periphery of the scar were noted. A biopsy and subsequent excision of the scar were performed; the diagnosis of infiltrating ductal carcinoma of the scar was confirmed.
Breast Neoplasms/*etiology/pathology/surgery ; Carcinoma, Ductal, Breast/*etiology ; Cicatrix/*complications ; Female ; Foreign-Body Reaction/pathology ; Giant Cells/pathology ; Humans ; Middle Aged ; Papilloma, Intraductal/pathology/surgery

INTRODUCTIONPathological pulmonary hernia is a rare clinical entity which can be caused by malignancies.

CLINICAL PICTUREA 72-year-old female presented with a painful bulge in the left 4th intercostal space. Chest radiography and computed tomography demonstrated a left pulmonary hernia, pleural effusion and destruction of ribs.

TREATMENTThe hernia sac was excised and a part of the chest wall was resected with reconstruction of residual defect.

OUTCOMEThe patient died 2 years after the treatment.

CONCLUSIONSA multidisciplinary approach involving various medical specialists may offer patients with pathological pulmonary hernia remarkable palliation and better quality of life.

Aged ; Breast Neoplasms ; complications ; pathology ; surgery ; Carcinoma, Ductal, Breast ; complications ; secondary ; Female ; Hernia ; etiology ; Herniorrhaphy ; Humans ; Lung Diseases ; etiology ; surgery ; Mastectomy ; Neoplasm Recurrence, Local ; Thoracic Neoplasms ; complications ; secondary

Breast Neoplasms ; pathology ; radiotherapy ; surgery ; Diagnosis, Differential ; Female ; Hemangiosarcoma ; etiology ; pathology ; surgery ; Humans ; Iatrogenic Disease ; Neoplasm Recurrence, Local ; Neoplasms, Radiation-Induced ; etiology ; pathology ; surgery ; Vascular Diseases ; etiology ; pathology ; surgery

OBJECTIVETo evaluate the biological behavior and treatment method for the breast atypical lobular hyperplasia (ALH) and breast lobular carcinoma in situ (LCIS).

METHODSSeventeen cases of ALH and thirty-five cases of LCIS were reviewed from July 1982 to January 1996. All cases were followed by physical examination, mammography and B-ultrasound for an average of 146.6 months (range, 3 - 257 months).

RESULTSMost cases of ALH and LCIS occurred before menopause (about 69.2%). Fifty-two cases of ALH and LCIS were occasionally verified pathologically after surgery for benign diseases. The microcalcification with ALH and LCIS had been detected in 25 cases, accounted for 48.1%. Eight cases of ALH/LCIS became invasive carcinoma. There were 5 cases in the same breast, 3 cases in the contralateral breast; The subsequent breast cancer occurred longer than nine years after ALH/LCIS was diagnosed. The family history of breast carcinoma and ovary carcinoma occurred in 4 cases of breast carcinoma, accounted for 50%, but it was no significant (P > 0.05). Also, there was no difference between LCIS and ALH, which occurred the breast carcinoma (P > 0.05).

CONCLUSIONThe excisional biopsy might be necessary to ALH and LCIS.

Adult ; Aged ; Breast Neoplasms ; etiology ; pathology ; surgery ; Carcinoma in Situ ; etiology ; pathology ; surgery ; Female ; Fibrocystic Breast Disease ; etiology ; pathology ; surgery ; Follow-Up Studies ; Humans ; Middle Aged ; Retrospective Studies ; Risk Factors

OBJECTIVETo evaluate and compare localization by ductoscopy-guided wire with localization by conventional methods in the terminal duct excision for women with pathological nipple discharge.

METHODSBreast terminal duct excision were performed in 174 consecutive patients with intraductal lesions diagnosed by mammary ductoscopy. Sixty-eight of those underwent ductoscopy-guided wire localization for more accurate ductal excision. The patients received mammary ductoscopy and a hooked wire was anchored at the intraductal lesions under endoscopic surveillance just before the operation. Then a biopsy resection of wire-guided terminal duct and frozen section were done. Tbe other 106 patients received terminal duct excision under localization with conventional methods without ductoscopy either by puncturing a needle or injection of blue dye through the duct with pathological discharge.

RESULTSOf the 68 patients with ductoscopy-guided duct excision, 64 had intraductal papillomas and 4 duct carcinoma in situ proved by pathology. All the lesions in these 68 patients were completely resected during biopsy without extra extended resection, and the concordance rate of the pathological result with ductoscopic diagnosis was 100.0%. None of them developed a postoperative breast distortion. In the conventional method localization group, there were 96 intraductal papilloma, 6 duct carcinoma in situ and 4 adenosis. Only 77.4% of the lesions were excised in the primary biopsy, and 22.6% needed extended resection. The concordance rate of the pathological diagnosis with ductoscopic diagnosis was 96.2%. Twenty-six patients had a deformed breast postoperatively.

CONCLUSIONDuctoscopy-guided wire localization is superior to the conventional localization method in the surgical terminal duct excision for women with spontaneous nipple discharge. It is not only helpful for more accurate localization and resection as well as pathologic sampling, but also is minimally invasive. Further studies are still required and this method may deserve to be popularized.

Adult ; Aged ; Breast Diseases ; etiology ; pathology ; surgery ; Breast Neoplasms ; complications ; pathology ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; complications ; pathology ; surgery ; Endoscopy ; methods ; Exudates and Transudates ; secretion ; Female ; Humans ; Microsurgery ; methods ; Middle Aged ; Nipples ; pathology ; secretion ; Papilloma, Intraductal ; complications ; pathology ; surgery ; Young Adult

Several months after left radical mastectomy without irradiation therapy for breast cancer, a 74-year-old woman developed severe edema on the homolateral arm extending to the axilla. Ten years later, purplish to brownish blotch and nodules accompanied with heating sensation and pain appeared and increased in size gradually on the left forearm. The patient was treated by irradiation therapy under the clinical and histopathologic diagnosis of Stewart-Treves syndrome and almost all of the skin lesions and symptoms disappeared after irradiation of 6450 rads.
Aged ; Arm ; Breast Neoplasms/*surgery ; Female ; Hemangiosarcoma/*etiology/pathology/radiotherapy ; Humans ; Lymphedema/*complications ; Mastectomy, Radical/*adverse effects ; Skin Neoplasms/*etiology/pathology/radiotherapy

OBJECTIVETo explore the correlation between breast carcinoma and silicone gel injection for breast augmentation.

METHODSFour cases of breast cancer after silicone gel injection were studied by means of clinical pathological analysis.

RESULTSIn the four women, breast lump of over 5 cm in diameter was found half year to 2 years after silicone injection. The tumor was misdiagnosed to inflammatory reaction of silicone gel injection. Definite diagnosis was made by histological examinations, which showed there was mucoid, light blue and well-distributed silicone gel among the nests of neoplasm cells. Lymph node metastasis of cancer cells was observed.

CONCLUSIONSSilicone gel injection to the breast may be a reason for evoking or accelerating breast cancer. Breast cancer that occurred after breast augmentation with silicone gel injection could be misdiagnosed. Final diagnosis depends on biopsy. Silicone gel injection for breast augmentation should be abandoned.

Adult ; Breast ; pathology ; surgery ; Breast Neoplasms ; diagnosis ; etiology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; adverse effects ; Middle Aged ; Silicone Gels ; adverse effects ; therapeutic use

Aged ; Axilla ; Axillary Vein ; surgery ; Blood Vessel Prosthesis ; Breast Neoplasms ; complications ; pathology ; surgery ; Female ; Histiocytoma, Malignant Fibrous ; complications ; pathology ; surgery ; Humans ; Jugular Veins ; surgery ; Male ; Neoplasm Recurrence, Local ; Upper Extremity Deep Vein Thrombosis ; etiology ; surgery ; Vascular Grafting ; methods

Conventional pedicled-flap based surgeries in treating breast cancer have their limitations. New surgical regimens are yet to be explored, which will follow the oncological principle of being "total tumor free", whilst fit into the unique characteristics of China's own medical system as well as patients' demand. From 2007 to 2013, 143 patients with early stage breast cancer were included in the study, with the average age of 46.1 years. Fifty-three patients were subjected to modified breast conserving surgery (MBCS)+latissimus dorsi (LD) flap reconstruction, 41 to skin sparing mastectomy (SSM)+implant+LD flap reconstruction, 29 to MBCS+distal transverse rectus abdominis myocutaneous (DTRAM) flap reconstruction, and 20 to SSM+DTRAM flap reconstruction. The results showed that out of the 143 patients, there was no graft loss. Minor complications included 4 cases of fat liquefaction, and 6 cases of seratoma, which all resolved after conservative treatment. Five patients had visible protuberance in the abdomen, but not leading to any gastrointestinal symptoms. The reconstructed breasts all presented good shape. 96.7% of the patients were satisfied with the outcome. The follow-up period varied from 6 months to 60 months, and only one patient died from tumor metastasis in the brain. No local recurrence occurred. It was concluded that these two modified pedicled-flap surgeries are readily practical, and aesthetically satisfactory, with high applicability in China. They do not compromise the oncological outcomes, but also are well-accepted by Chinese patients.
Adult ; Breast Neoplasms ; pathology ; surgery ; China ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Segmental ; adverse effects ; methods ; Middle Aged ; Neoplasm Staging ; Postoperative Complications ; etiology ; pathology

OBJECTIVETo investigate the efficacy, indication and complication of radiofrequency ablation (RFA) with cool-tip needle in patients with hepatic malignancies.

METHODS421 patients with hepatic malignancies underwent ultrasound-guided RFA with cool-tip needle under local anaesthesia. The tumor size was from 1.0 to 15 cm in diameter with an average diameter of 4.3 cm.

RESULTSThe complete ablation (CA) rate was 91.4% (382/418) in the patients with a tumor < 3 cm, 78.9% (97/123) in those with a tumor of 3 to 5 cm and 37.6% (35/93) in the patients with a tumor > 5 cm. No patient died or changed to celiotomy during the 1121 times of RFA for 634 lesions in 421 patients. No hemorrhage occurred in any of these patients after the RFA treatment. The complications included abdominal pain in 32.3% (136/421), nausea in 9.0% (38/421), fever in 34.9% (147/421) and biliary leakage in 0.2% (1/421) of the patients.

CONCLUSIONUltrasound-guided percutaneous radiofrequency ablation with cool-tip needle is effective and safe in the treatment of liver tumors.

Abdominal Pain ; etiology ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; secondary ; Catheter Ablation ; adverse effects ; methods ; Female ; Fever ; etiology ; Gastrointestinal Neoplasms ; secondary ; Humans ; Liver Neoplasms ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Nausea ; etiology ; Ultrasonography, Interventional