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

Breast Neoplasms ; pathology ; surgery ; Carcinoma, Ductal, Breast ; pathology ; surgery ; Carcinoma, Papillary ; pathology ; surgery ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Humans ; Mastectomy, Segmental ; Neoplasm Invasiveness

OBJECTIVETo investigate the histological criteria of breast cancer response to neoadjuvant therapy.

METHODSOne hundred and fifty-four cases of breast cancer receiving neoadjuvant therapy were collected from June, 2005 to June, 2007 and the clinical data were analyzed. All patients were operated on within 4 weeks after neoadjuvant therapy. All specimens were assessed by the standard method of Miller and Payne (MP) grading system. The response to neoadjuvant therapy were assessed by two pathologists independently, using MP grading system and common grading system separately.

RESULTSThe response rate using the MP grading system were grade 1 in 12 cases (7.8%), grade 2 in 33 cases (21.4%), grade 3 in 64 cases (41.6%), grade 4 in 31 cases (20.1%) and grade 5 in 14 cases (9.1%). Using the common grading system, the response were mild in 51 cases (33.1%), moderate in 71 cases (46.1%) and severe in 32 cases (20.8%). MP grading system may be related to common grading system (chi2 = 186.660, P < 0.01). Follow up information were available in 147 cases, with 14 cases showing recurrence, metastasis or death from the disease. The MP grading system may be related to the outcome (chi2 = 11.612, P = 0.020), but not the common grading system (chi2 = 0.881, P = 0.644).

CONCLUSIONMP grading system may be one of the prognostic factors in the neoadjuvant therapy of breast cancer.

Biopsy, Needle ; Breast ; pathology ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Preoperative Period

OBJECTIVETo evaluate the clinical characteristics and prognosis of adrenal metastasis from breast cancer, and to explore methods to improve prognosis.

METHODSThirty-four breast cancer patients with adrenal metastasis were diagnosed and treated in our hospital from Jan. 1999 to Dec. 2010. SPSS 17.0 was used for survival analysis.

RESULTSDuring the Jan. 1999 to Dec. 2010 period, 13 595 patients with breast cancer were treated in our hospital. Among them, 34 cases had adrenal metastasis from breast cancer, with an incidence of 0.25%. The median time to progression (TTP) and overall survival of the 34 patients was 6.2 months (95%CI 3.1-9.3 months) and 21.4 months (95%CI 0-44.0 months), respectively. Eleven patients (34.4%) achieved partial response among 32 patients who received chemotherapy, and 10 (31.2%) achieved stable disease. Patients who achieved best response of PR or SD were superior in TTP and OS than patients with disease progression after chemotherapy (TTP: 18.1 months vs. 2.3 months, P < 0.001; OS: 35.2 months vs. 10.3 months, P = 0.003). Patients who received 1st or 2nd line chemotherapy were superior in TTP than patients who received over 2nd line chemotherapy (TTP: 15.7 months vs. 4.2 months, P = 0.005).

CONCLUSIONSThe incidence of adrenal metastasis from breast cancer is low. Chemotherapy-based systemic therapy should be recommended to improve the prognosis for these patients.

Adrenal Gland Neoplasms ; drug therapy ; secondary ; surgery ; Adrenalectomy ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; pathology ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; surgery ; Disease Progression ; Female ; Humans ; Middle Aged ; Remission Induction ; Retrospective Studies ; Survival Rate

Breast ; surgery ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Node Excision ; Mastectomy, Segmental ; Neoplasm Recurrence, Local ; Treatment Outcome

OBJECTIVETo explore the frequency of the involvement of level III and interpectoral lymph nodes in patients with node-positive breast cancer, and discuss the necessity of completely axillary dissection in this subgroup of patients.

METHODSConsecutive 291 cases underwent completely axillary dissections (level I/II/III and interpectoral node) according to identical procedure. Level I/II, Level III and interpectoral lymph nodes were sent separately for routine pathological examination.

RESULTSEighty-seven cases (29.9%) were proved to be node-positive. Among them, metastases were detected at level III lymph nodes in 18 cases (20.7%) and at interpectoral lymph nodes in 16 cases (18.3%), respectively. Twenty-five cases involved in level III and/or interpectoral lymph nodes. In a subgroup of 52 cases with primary tumor smaller than 5 cm and involved Level I/II lymph nodes less than 4, 6 cases (11.5%) were found metastases at level III and/or interpectoral lymph nodes.

CONCLUSIONSIt is reasonable to perform completely axillary nodes dissection including level III and interpectoral lymph nodes for patients with node-positive breast cancer.

Adult ; Aged ; Axilla ; Breast Neoplasms ; pathology ; therapy ; Combined Modality Therapy ; Female ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Pectoralis Muscles ; pathology ; surgery

We describe here a female patient who presented with a breast mass and giant abdominal mass. Fine needle aspiration cytology of the breast mass and histological examination after modified radical mastectomy confirmed metaplastic carcinoma of the breast. The epithelial components were formed by infiltrating ductal carcinoma with poor differentiation, and the sarcomatous components were formed by fibrosarcoma and osteosarcoma. Histological examination of the abdominal mass confirmed ovarian teratoma. The patient underwent modified radical mastectomy of the right breast and laparoscopic excision of the abdominal mass in the lower right quadrant. Having underwent six courses of chemotherapy, the patient is now in her tenth month after surgery and under follow-up, and she has no relapsed disease. These two diseases have never seen in one patient before. The case we report here provides some new data for research and clinical experience and it may also provide a new insight into the relationship between metaplastic breast carcinoma and ovarian teratoma.
Biopsy, Fine-Needle ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Middle Aged ; Neoplasms, Multiple Primary ; drug therapy ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; drug therapy ; pathology ; surgery ; Receptor, ErbB-2 ; metabolism ; Sarcoma, Myeloid ; drug therapy ; metabolism ; pathology ; surgery ; Teratoma ; drug therapy ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo investigate the effect of activated charcoal-epirubicin suspension (Epi-CH) for treatment of breast cancer and clearance of axillary lymph node metastasis.

METHODSSixty patients with breast cancer of stages II-III were randomized into Epi-CH group (n=40) receiving injection with 10 mg Epi-CH in the tissue around the primary tumor 72 h before modified radical resection and control group (n=20) with 10 mg of aqueous epirubicin injection in the same region. The dissected axillary lymph nodes and the staining lymph nodes were counted. The concentration of epirubicin in the lymph nodes was detected by high-performance liquid chorography, and the specimens of lymph nodes were observed microscopically.

RESULTSIn comparison with the control group, Epi-CH injection allowed dissection of 4.04 more lymph nodes (P<0.01) and resulted in the staining rate of the axillary lymph nodes of 86.9% (565/650). The proportion of the staining lymph nodes with diameter>1.0 cm was significantly lower than that with diameter 0.05). In Epi-CH group, the concentration of epirubicin in the stained lymph nodes was significantly higher than that in non-stained ones (443.0-/+123.1 vs 31.8-/+11.9 ng/g, P<0.01). Remarkable degeneration and necrosis could be observed microscopically in the stained lymph nodes.

CONCLUSIONEpi-CH allows more effective treatment of breast cancer and clearance of axiliary metastasis by increasing the dissected lymph nodes and raising the concentration of epirubicin in the axillary lymph nodes.

Adult ; Aged ; Antibiotics, Antineoplastic ; administration & dosage ; Axilla ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; surgery ; Charcoal ; administration & dosage ; Epirubicin ; administration & dosage ; Female ; Humans ; Injections, Intralymphatic ; Lymph Nodes ; drug effects ; pathology ; Lymphatic Metastasis ; Middle Aged

OBJECTIVETo investigate the pathological manifestation of the lesion as well as the feasibility of conservative breast surgery after neoadjuvant chemotherapy of patients with locally advanced breast cancer.

METHODSClinic data of the 46 patients treated by neoadjuvant chemotherapy effectively and surgical procedures from June 2003 to August 2007 were analyzed. All the patients were female, aged from 28 to 65 years old with a mean of 46.3 years old. The diameter of neoplasm was 7 to 13 cm. All the patients had been treated by neoadjuvant chemotherapy effectively and received modified radical mastectomy or Halsted radical mastectomy. The specimen slices were cut from 6 different directions taking the residual cancerous lesion as the center.

RESULTSNineteen patients (41.3%) were concentrating contracted, with complete remission in 6 patients (31.6%) and residual focus in peripheral zone in 13 patients (68.4%). Twenty-seven patients (58.7%) responded in a sifter-like pattern.

CONCLUSIONFor most patients with locally advanced breast cancer treated by neoadjuvant chemotherapy effectively, their pathologic features are not up to the conservative breast surgery criterion, conservative breast surgery should be cautiously considered.

Adult ; Aged ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Feasibility Studies ; Female ; Humans ; Mastectomy, Segmental ; Middle Aged ; Retrospective Studies

OBJECTIVETo explore different therapies and affecting factors in breast cancer patients ≥ 65 years old.

METHODSTo retrospectively analyze the clinical characteristics, treatments, comorbidity and survival rate of 126 female breast cancer patients over 65 years old who underwent surgical operation in our hospital from January 2009 to December 2010. To compare and analyze the differences in the treatment patterns, and find out the affecting factors.

RESULTSOne hundred and twenty-six cases were included in this retrospective study, and they were divided into two groups according to age: 65-74 years old group (71 cases) and >74 years group (55 cases). Most patients in the two groups received modified radical mastectomy (84.5% and 89.1%); 73.2% and 54.5% of patients received adjuvant chemotherapy in the two groups, respectively. 67.6% and 61.8% of the patients had adjuvant endocrine therapy respectively. 19.7% and 7.3% of the patients received radiotherapy, respectively. Chemotherapy in elderly breast cancer patients was correlated with age, pathological types, progesterone receptor (PR) status and comorbidity. Radiotherapy in elderly breast cancer patients was related to age, surgical patterns, TNM stage and lymph node status. Multivariate analysis showed that age, pathological types, PR expression and comorbidity were independent factors affecting choice of chemotherapy in elderly breast cancer patients (P < 0.05 for all). Age and surgical patterns were independent factors affecting choice of radiotherapy (P < 0.05 for all). The 3-year disease-free survival (DFS) rate and overall survival (OS) rate in these patients were 91.3% and 92.0%, respectively. Furthermore, endocrine therapy was related to 3-year DFS rate (P = 0.038) and age was correlated with 3-year OS rate (P = 0.037) in these elderly patients.

CONCLUSIONSBreast cancer in the elderly patients receive similar surgery and endocrine therapy, but the elderly patients are less likely to have chemotherapy and radiotherapy, due to age, PR expression, pathological types, surgical patterns and comorbidity. Only age contributes to the lower 3-year overall survival rate in >74-year old patients.

Adenocarcinoma, Mucinous ; pathology ; surgery ; therapy ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; pathology ; surgery ; therapy ; Carcinoma, Ductal, Breast ; pathology ; surgery ; therapy ; Carcinoma, Intraductal, Noninfiltrating ; pathology ; surgery ; therapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Lymphatic Metastasis ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Neoadjuvant Therapy ; Neoplasm Staging ; Radiotherapy, Adjuvant ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Survival Rate