OBJECTIVE: The aim of this study is to investigate the effect of tamoxifen on endometrial thickness in postmenopausal women taking adjuvant tamoxifen therapy for breast cancer after chemotherapy. METHODS: Fifty-eight tamoxifen-treated postmenopausal breast cancer patients underwent periodically transvaginal ultrasonography twice a year for 2 years and then once a year. We analyzed the correlation between the sonographic endometrial thickness and the duration of tamoxifen therapy. RESULTS: The mean endometrial thickness of breast cancer patients before tamoxifen therapy was 4.68 mm. But the mean endometrial thickness increased to 5.03 mm at 6 months, 5.21 mm at 12 months, after which it slightly declined to 5.13 mm at 18 months. And then it increased to 5.15 mm at 24 months, and 5.24 mm at 36 months. There was a significant increase in endometrial thickness after tamoxifen therapy compared with before tamoxifen therapy (p<0.05). Overall, proliferative endometrium was the most common histopathologic finding (5/14) in tamoxifen-treated postmenopausal women who had endometrial thickness >or=5 mm. No cases of endometrial cancer were detected. CONCLUSION: Significant increase in endometrial thickness with the duration of tamoxifen therapy in postmenopausal tamoxifen-treated patients may be associated with a high risk of endometrial pathologies in these patients.
Breast Neoplasms* ; Breast* ; Drug Therapy ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Pathology ; Tamoxifen ; Ultrasonography

A malignant tumor is generally believed to be very unlikely to metastasize to the thymus. Only three cases of thymic metastases have been reported so far in the medical literature. We report here a rare case of metastatic breast cancer to the thymus, which was detected by CT and PET scanning, and the metastasis was also confirmed by video-assisted thoracic surgery biopsy. Recognition of an unusual breast cancer metastasis, such as to the thymus, as well as the usual patterns of breast cancer metastasis will facilitate an accurate, prompt diagnosis and its appropriate treatment.
Adult ; Antineoplastic Agents, Phytogenic/therapeutic use ; Breast Neoplasms/drug therapy/*pathology ; Carcinoma, Ductal, Breast/drug therapy/*pathology/secondary ; Female ; Humans ; Paclitaxel/therapeutic use ; Thymus Neoplasms/drug therapy/*secondary

We have studied the patterns of P-glycoprotein expression before and after 3 cycles of induction chemotherapy (5-fluorouracil, adriamycin and cyclophosphamide) using immunohistochemically stained paraffin-embedded specimen of 28 patients with locally advanced breast cancer. The frequency of P-glycoprotein expression in untreated breast cancer turned out to be very low: only one out of 28 untreated, biopsy specimen at the time of diagnosis was positive. The frequency of P-glycoprotein expression was markedly increased from 9.1% before chemotherapy to 63.6% after induction chemotherapy (p = 0.006). After 3 cycles of induction chemotherapy, 25 patients had obtained clinical response to chemotherapy (4, CR; 21, PR). Eleven out of 25 tumors (44%) showing clinical response and all three tumors (100%) with minimal response have expressed P-glycoprotein. One out of 6 patients (16.7%) with microscopic residual tumor seen in mastectomy specimen expressed P-glycoprotein, whereas 13 of 22 patients (59.1%) with gross residual tumor showed the presence of P-glycoprotein (p = 0.08). The frequency of intrinsic P-glycoprotein expression in untreated breast cancer was quite low, but approximately half of the patients do acquire P-glycoprotein expression during the cycles of induction chemotherapy. Therefore, the results suggest that the immunohistochemical detection of P-glycoprotein on residual tumor cells after induction chemotherapy can predict acquired drug resistance in breast cancer.
Adult ; Aged ; Breast Neoplasms/chemistry/*drug therapy/pathology ; Breast Neoplasms/chemistry/*drug therapy/pathology ; Drug Resistance ; Drug Resistance ; Female ; Human ; Immunohistochemistry ; Membrane Glycoproteins/*analysis ; Middle Age ; P-Glycoprotein

Antineoplastic Agents ; therapeutic use ; Breast ; pathology ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Female ; Humans ; Lymphatic Metastasis ; Neoadjuvant Therapy ; Neoplasm, Residual

breast cancer, as it can provide timely and individualized chemo-sensitivity information and is beneficial for custom-designing subsequent treatment strategies. To accurately select candidates for neoadjuvant chemotherapy, the association between various immunohistochemical biomarkers of primary disease and tumor response to neoadjuvant chemotherapy has been investigated, and results have shown that certain pathological indicators evaluated after neoadjuvant chemotherapy are associated with long-term prognosis. The Food and Drug Administration (FDA) has recommended that complete pathological response can be used as a surrogate endpoint for neoadjuvant chemotherapy, which is related to better prognosis. Considering that residual tumor persists in the majority of patients after neoadjuvant chemotherapy, the value of various pathological indicators of residual disease in predicting the long-term outcomes is being extensively investigated. This review summarizes and compares various predictive and prognostic indicators for patients who have received neoadjuvant chemotherapy, and analyzes their efficacy in different breast cancer subtypes.]]>
Biomarkers ; Breast Neoplasms ; Breast ; Drug Therapy ; Humans ; Neoadjuvant Therapy ; Neoplasm, Residual ; Pathology ; Prognosis ; United States Food and Drug Administration

Contrast-enhanced magnetic resonance imaging (MRI) of the breast is probably the most sensitive method for the detection of the pathology of the breast. It is an emerging technology that may revolutionize the management of women with known or suspected breast cancer. Recently, breast MRI has proven most useful in patients with proven breast cancer for the assessment of a multifocal/multicentric disease, chest wall involvement, chemotherapy response, or tumor recurrence or to identify the primary site in patients with occult breast cancer. False positive findings can pose a significance problem in the interpretation of a breast MRI. MRI examinations should be interpreted with an awareness of the pitfalls, false positive breast lesions, and artifacts that can affect on the image evaluation.
Artifacts ; Breast Diseases* ; Breast Neoplasms ; Breast* ; Drug Therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Pathology ; Recurrence ; Thoracic Wall

This paper aims to investigate the value of diffusiion weighted imaging (DWI) and different apparent diffusion coefficient (ADC) methods to predict the curative effects of neoadjuvant chempotherapy (NAC) for breast cancer. From March 2010 to December 2012, seventy-one patients were pathologically confirmed invasive breast cancer by needle puncture biopsy received before surgery, and underwent magnetic resonance before and after NAC, the ADC were measured by mean ADC method and lower ADC method. The pathologic response after NAC was divided to major histological response (MHR) group and non-major histological response (NMHR) group according to Miller & Payne system. Results displayed that ADC values obtained before NAC, at the end of the second cycle of NAC, and after whole course of treatment, had good correlations between mean and lower ADC methods (the Pearson's correlation=0.699, 0.749 and 0.895, respectively). Significant difference in ADC obtained both with mean and lower ADC methods could be found between MHR and NMHR groups after the second cycle of NAC (P< 0.05). After the second cycle of NAC, significant difference in the change rate of ADC could be found between MHR and NMHR groups by using lower ADC method (P<0.05), but not be found by using mean ADC method (P >0.05). In conclusion, DWI could monitor the pathologic changes of breast cancer after NAC, and the lower ADC method might be used to evaluate the curative effect of NAC with the change rate of ADC.
Breast Neoplasms ; drug therapy ; pathology ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Neoadjuvant Therapy

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

Breast Neoplasms ; drug therapy ; genetics ; pathology ; Carcinoma, Ductal, Breast ; drug therapy ; genetics ; pathology ; Carcinoma, Lobular ; drug therapy ; genetics ; pathology ; Cell Nucleus ; pathology ; Female ; Gene Expression Profiling ; Humans ; Immunophenotyping ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Neoadjuvant Therapy ; Tumor Burden

AIMTo investigate the effects of tamoxifen on proliferation of human breast cancer Bcap-37 cells and cervical carcinoma HeLa cells and to explore it's possible mechanism.

METHODSThe techniques of cell culture, growth curves, flow cytometry and laser scanning confocal microscope were used.

RESULTSTamoxifen (10(-6) mol/L) shifted the growth curve of Bcap-37 cells downward, and shifted the growth curve of HeLa cells upward. Tamoxifen (10(-8) - 10(-6) mol/L) inhibited the proliferation of Bcap-37 cells in a dose-dependent manner, but stimulated the proliferation of HeLa cells in a dose-dependent manner. Bcap-37 cells appeared apoptosis when treated with tamoxifen (10(-6) mol/L), and the same dose stimulated the proliferation of HeLa cells at GI/S phases. The apoptotic rate of Bcap-37 cells was 97.5%. It blocked G1 phase of HeLa cells from 55.5% to 32.8%, and increased the S phase from 29.0% to 49.4%. Tamoxifen (10(-6) mol/L) also increased the releasing of calcium in Bcap-37 and HeLa cells.

CONCLUSIONTamoxifen can significantly influence the proliferation of breast cancer and cervical carcinoma cells possibly by affecting cell cycle and stimulating the releasing of Ca2+ in the cells.

Breast Neoplasms ; drug therapy ; pathology ; Cell Proliferation ; drug effects ; Female ; HeLa Cells ; Humans ; Tamoxifen ; pharmacology ; therapeutic use ; Tumor Cells, Cultured ; Uterine Cervical Neoplasms ; drug therapy ; pathology