To make the objective standard of nuclear size in grading nuclear pleomorphism of invasive ductal carcinoma of the breast, we measured maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections from 65 cases by using computer-based image analysis system (Optimas 6.0). The maximal diameter of red blood cells were also measured to evaluate the ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells. The mean values of maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections were 7.56microgram, 7.53microgram in nuclear grade 1, 8.92+/-0.98microgram, 9.02+/-0.74microgram in nuclear grade 2, and 12.90+/-1.47prn, 12.44+/-1.41microgram in nuclear grade 3, respectively. There were no significant differences between values of imprint cytology and histologic section. The ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells were 1.3-1.4:1 in nuclear grade 1, 1.6-1.7:1 in nuclear grade 2, and 2.2-2.3:1 in nuclear grade 3. Ths would be guidelines for grading nuclear pleomorphism of invasive ductal carcinoma of the breast on routine surgical pathology work.
Breast ; Carcinoma, Ductal ; Erythrocytes ; Pathology, Surgical ; Purpura*

To make the objective standard of nuclear size in grading nuclear pleomorphism of invasive ductal carcinoma of the breast, we measured maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections from 65 cases by using computer-based image analysis system(Optimas 6.0). The maximal diameter of red blood cells were also measured to evaluate the ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells. The mean values of maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections were 7.56 micrometer, 7.53 micrometer in nuclear grade 1, 8.92+/-0.98 micrometer, 9.02+/-0.74 micrometer in nuclear grade 2, and 12.90+/-1.47 micrometer, 12.44+/-1.41 micrometer in nuclear grade 3, respectively. There were no significant differences between values of imprint cytology and histologic section. The ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells were 1.3-1.4:1 in nuclear grade 1, 1.6-1.7:1 in nuclear grade 2, and 2.2-2.3:1 in nuclear grade 3. These values would be guidelines for grading nuclear pleomorphism of invasive ductal carcinoma of the breast on routine surgical pathology work.
Breast* ; Carcinoma, Ductal* ; Erythrocytes ; Pathology, Surgical

Breast/pathology* ; Breast Neoplasms/pathology* ; Carcinoma, Ductal, Breast/pathology* ; Carcinoma, Intraductal, Noninfiltrating/pathology* ; Consensus ; Female ; Humans

PURPOSE: The purpose of this study was to assess the mammographic features and pathologic outcome of category 4 lesions using the Breast Imaging Reporting and Data System(BI-RADS), and to evaluate the significance of final assessment categories. MATERIALS AND METHODS: Using BI-RADS, the interpretations of 8,134 mammograms acquired between January 1997 and May 1998 were categorized. From among 161 lesions categorized as "4"("suspicious abnormality") and pathologically confirmed by surgery or biopsy, we analysed 113, found in 66 patients. RESULTS: The pathologic outcome of these 113 lesions was as follows: infiltrating ductal carcinoma, 17.7%(20/113); DCIS(ductal carcinoma in sitv), 8.0 %(9/113); ADH(atypical ductal hyperplasia), 5.3 % (6/113); DEH(ductal epithelial hyperplasia), 1.8 %(2/113); ductectasia, 0.9 %(1/113), FCD(fibrocystic change), 27 .4 %(31/113); fibroadenoma, 7.1 %(8/113); stromal fibrosis, 9.7%(11/113); normal parenchyma, 7.1 % (8/113); other pathology, 15.0 %(17/113). The most frequent mammographic features of BI-RADS category 4 lesions were irregular mass shape(41.2 %), spiculated mass margin(52.3%), amorphous calcification(47.3%) and clustered calcification distribution(37.1% ). CONCLUSION: Because category 4 lesions account for about 25.7 % of all breast malignancies, mammographic lesions in this category ("suspicious abnormality")should be considered for supplementary study and breast biopsy rather than short-term follow-up. Initial pathologic findings can thus be confirmed.
Biopsy ; Breast* ; Carcinoma, Ductal ; Fibroadenoma ; Fibrosis ; Humans ; Pathology

PURPOSE: The purpose of this study was to assess the mammographic features and pathologic outcome of category 4 lesions using the Breast Imaging Reporting and Data System(BI-RADS), and to evaluate the significance of final assessment categories. MATERIALS AND METHODS: Using BI-RADS, the interpretations of 8,134 mammograms acquired between January 1997 and May 1998 were categorized. From among 161 lesions categorized as "4"("suspicious abnormality") and pathologically confirmed by surgery or biopsy, we analysed 113, found in 66 patients. RESULTS: The pathologic outcome of these 113 lesions was as follows: infiltrating ductal carcinoma, 17.7%(20/113); DCIS(ductal carcinoma in sitv), 8.0 %(9/113); ADH(atypical ductal hyperplasia), 5.3 % (6/113); DEH(ductal epithelial hyperplasia), 1.8 %(2/113); ductectasia, 0.9 %(1/113), FCD(fibrocystic change), 27 .4 %(31/113); fibroadenoma, 7.1 %(8/113); stromal fibrosis, 9.7%(11/113); normal parenchyma, 7.1 % (8/113); other pathology, 15.0 %(17/113). The most frequent mammographic features of BI-RADS category 4 lesions were irregular mass shape(41.2 %), spiculated mass margin(52.3%), amorphous calcification(47.3%) and clustered calcification distribution(37.1% ). CONCLUSION: Because category 4 lesions account for about 25.7 % of all breast malignancies, mammographic lesions in this category ("suspicious abnormality")should be considered for supplementary study and breast biopsy rather than short-term follow-up. Initial pathologic findings can thus be confirmed.
Biopsy ; Breast* ; Carcinoma, Ductal ; Fibroadenoma ; Fibrosis ; Humans ; Pathology

OBJECTIVE: We have developed breast tumor image retrieval system using content-based retrieval method. It compares the breast tumor image with Fibrocystic Change images, Ductal Carcinoma in Situ images and Invasive Ductal Carcinoma images and find most similar one. Since the final diagnosis for breast tumor image is done only by pathologist manually, this system can provide the objectivity and the reproducibility for determining and diagnosing the breast tumor. METHODS: The breast tumor image features used in the content-based image retrieval are color feature, texture feature and texture features of wavelet transformed images. And the system can be accessed through the internet. We used Windows 2003 as an operating system, Internet Information Server 6.0 as Web a server and ms-sql server 2000 as a database server. Also we use ActiveX Data Object to connect database easily. RESULT: We evaluated the recall and precision performance of the system according to the combinations of feature types and usage of partial or whole image. Results showed that the use of multiple features and whole image gave consistently higher rates compared to the use of single feature and partial image. CONCLUSION: This retrieval system can help pathologist determine the type of breast tumor more efficiently. Also it is working based on the internet, we can use it for researching and teaching in pathology later.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Internet* ; Pathology ; Wavelet Analysis

Breast Neoplasms ; pathology ; Carcinoma, Ductal, Breast ; pathology ; Humans ; Medical Records ; standards

Pancreatic metastases from primary breast cancer are very rare. We report a case of pancreatic metastasis from invasive ductal carcinoma 13 years after the initial diagnosis of breast cancer. When the pancreatic mass was discovered, it was believed to be a primary pancreatic cancer due to the long interval from the initial diagnosis of breast cancer to metastasis. However, it was confirmed as metastatic breast cancer based on the pathology after surgical removal. Follow-up imaging has shown no recurrence.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Diagnosis ; Follow-Up Studies ; Neoplasm Metastasis* ; Pancreatic Neoplasms ; Pathology ; Recurrence

PURPOSE: Increased technologic capabilities have allowed for the expanded use of ultrasound beyond simple differentiation of a lesion as solid versus cystic nature, allowing us to classify lesions into various categories based on a number of descriptive features. The purpose of this study was to investigate whether to predict the preoperative prognosis of breast cancer through the correlation between ultrasonographic images and the grade of malignancy. MATERIALS AND METHODS: The patient population for this study consisted of 107 patients with infiltrative ductal carcinoma who were evaluated using ultrasound technology. Ultrasonographic findings were divided as follows: Type I, round or oval shape and regular border; Type II, partially round or oval shape and partially irregular border; and Type III, irregular shape and irregular border. RESULTS: 1. The frequency of grade 1 (G1) was significantly higher in the Type I group than the othergroups. 2. In the 2.0 cm sized mass, the lymph node metastasis rate was significantly lower in the Type I group than the other groups. 3. In all the groups, Estrogen receptor (ER) positivity was insignificant regardless of tumor size and type. 4. In the 2.0 cm sized mass, c-erbB-2 positivity was significantly lower in the Type I than the other groups. There was no clear difference among the three groups in tumors greater than 2.0 cm in size. CONCLUSION: These results show that our classification of ultrasonographic images reflect the grade of malignancy in terms of clinicopathological features in breast cancers less than 2.0 cm in size. Therefore, ultrasonographic findings may help predict the preoperative prognosis in T1 size breast cancer, although further study is required.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Classification ; Diagnosis ; Estrogens ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Pathology ; Prognosis ; Ultrasonography

PURPOSE: In breast cancer, Her-2/neu amplification/overexpression predicts a poor clinical outcome, and enhanced survival benefits have been reported with Her-2/neu targeted therapy. Currently, there are several methods for assessing the amplification/overexpression of Her-2/neu, each having advantages and disadvantages. The aim of this work was to establish a reproducible, sensitive and specific method of testing for Her-2/neu, which could be used in diagnostic pathology laboratories. MATERIALS AND METHODS: We compared the immunohistochemistry (IHC) detection of Her-2/neu overexpression, with differential polymerase chain reaction (PCR) to assess the gene amplification of the Her-2/ neu, in 163 cases of invasive ductal carcinoma of the breast using paraffin-embedded tissue. In addition, assessment of the appropriate cut off points was established. RESULTS: The overexpression of the Her-2/neu was detected in 39 (23.9%) cases, and its amplification in 37 (22.7%) cases. The methods were positive in 21.5% of cases and negative in 74.8%. There was a 96.3% concordance between the two methods. The sensitivity and specificity of IHC, compared with PCR, were 94.6 and 96.8%, respectively. CONCLUSION: We conclude that the automation of PCR-based Her-2/neu testing approaches is expected to play an increasing role in the future of Her-2/neu testing. Also, we have demonstrated that IHC is a sensitive and specific method for assessing Her-2/neu stati in breast cancer, compared to PCR. The current study indicates that moderate, or strong, complete membrane staining in> or =10% of tumor cells provides an appropriate cut off point compared with PCR.
Automation ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Gene Amplification ; Immunohistochemistry* ; Membranes ; Pathology ; Polymerase Chain Reaction* ; Sensitivity and Specificity