Humans ; Female ; Fibrocystic Breast Disease/surgery* ; Carcinoma

Microglandular adenosis (MGA) of the breast is a very rare and benign proliferative lesion. Most patients complain of a palpable breast mass that may arouse a clinical suspicion of breast cancer. Histopathologically, it is hard to distinguish MGA from breast cancer because of the lack of a myoepithelial layer and infiltrative proliferation. Several studies have reported a strong relationship between MGA and carcinoma arising in MGA, so the mass should be excised completely in cases of MGA determined from a core needle biopsy rather than observation. A 72-years-old woman presented with a palpable breast mass. On physical examination, a mass was palpable in the right upper outer quadrant area and somewhat fixed to the surrounding tissues and pectoralis major muscle. We could not detect any mass or dense lesion on mammography because of a grade 4 dense breast. Ultrasonographic findings revealed a low echoic lesion with indistinct margins. The result of a core needle biopsy was MGA, which was confirmed by excision. We report one case of MGA, which was believed to breast cancer clinically.
Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Female ; Fibrocystic Breast Disease ; Humans ; Mammography ; Muscles ; Physical Examination

The objective of the study was to describe the incorporation of breast cancer screening program in the medical curriculum of a medical school and determine its feasibility in finding breast cancer.

METHODS: From school year 2011 - 2012, a 3-hour module that assesses third year medical students' proficiency in clinical breast examination (CBE) was incorporated into the pre-clinical clerkship program at the Cebu Institute of Medicine. The students who have satisfactorily completed the module were invited to participate in the Breast Cancer Control Outreach Program (BCAcop). Pertinent data included: number of participating consultants and students,number of patients seen as well as their demographic and clinical profile, breast cancer cases found.

RESULTS: Four BCAcop were conducted and 6 consultants supervised the medical students in the CBE modules and BCAcop. Seventy seven medical students passed the CBE module and participated in BCAcop. A total of 254 patients with age range of 8 to 80 (mean32 years) attended the lay forum while 246 patients (96.9%) consulted at the on-site breast clinic. Among those examined, 146 patients (59.3%) had essentially normal breasts. Fibrocystic change was the most frequent diagnosis with 49 patients (19.9%), followed by fibroadenoma with 34 patients (13.8%). Six patients (2.4%) were suspected to have breast cancer. Four patients (66.7%) proceeded to have a biopsy and were confirmed. Two patients availed of treatment.

CONCLUSION: Incorporating breast cancer screening program in the medical school curriculum encourages medical students to participate in breast cancer control outreaches where their basic knowledge and skills on clinical breast exam are reinforced with actual patient contact. Furthermore, women with breast cancer are found and offered treatment through this program.

OBJECTICE: To compare the use of conventional, real-time compound, and pulse-inversion harmonic imaging in the evaluation of breast nodules. MATERIALS AND METHODS: Fifty-two breast nodules were included in this study, conducted between May and December 2000, in which conventional, real-time compound, and pulse-inversion harmonic images were obtained in the same plane. Three radiologists, each blinded to the interpretations of the other two, evaluated the findings, characterizing the lesions and ranking the three techniques from grade 1, the worst, to grade 3, the best. Lesion conspicuity was assessed, and lesions were also characterized in terms of their margin, clarity of internal echotexture, and clarity of posterior echo pattern. The three techniques were compared using Friedman's test, and interobserver agreement in image interpretation was assessed by means of the intraclass correlation coefficient. RESULTS: With regard to lesion conspicuity, margin, and internal echotexture of the nodules, real-time compound imaging was the best technique (p < 0.05); in terms of posterior echo pattern, the best was pulse-inversion harmonic imaging (p < 0.05). Real-time compound and pulse inversion harmonic imaging were better than conventional sonography in all evaluative aspects. Interobserver agreement was greater than moderate. CONCLUSION: Real-time compound and pulse-inversion harmonic imaging procedures are superior to conventional sonography in terms of both lesion conspicuity and the further characterization of breast nodules. Real-time compound imaging is the best technique for evaluation of the margin and internal echotexture of nodules, while pulse-inversion harmonic imaging is very effective for the evaluation of the posterior echo patterns.
Breast Neoplasms/*ultrasonography ; Comparative Study ; Female ; Fibrocystic Disease of Breast/*ultrasonography ; Human ; Middle Age ; Ultrasonography, Mammary/*methods

PURPOSE: Adenosis lesions of the breast, including sclerosing adenosis and adenosis tumors, are a group of benign proliferative disorders that may mimic the features of malignancy on imaging. In this study, we aim to describe the features of breast adenosis lesions with suspicious or borderline findings on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). METHODS: In our database, we identified 49 pathologically proven breast adenosis lesions for which the final assessment of the breast MRI report was classified as either category 4 (n=45) or category 5 (n=4), according to the Breast Imaging Reporting and Data System (BI-RADS) published by the American College of Radiology (ACR). The lesions had a final diagnosis of either pure adenosis (n=33, 67.3%) or mixed adenosis associated with other benign pathologies (n=16, 32.7%). RESULTS: Of the 49 adenosis lesions detected on DCE-MRI, 32 (65.3%) appeared as enhancing masses, 16 (32.7%) as nonmass enhancements, and one (2.1%) as a tiny enhancing focus. Analysis of the enhancing masses based on the ACR BI-RADS lexicon revealed that among the mass descriptors, the most common features were irregular shape in 12 (37.5%), noncircumscribed margin in 20 (62.5%), heterogeneous internal pattern in 16 (50.0%), rapid initial enhancement in 32 (100.0%), and wash-out delayed en-hancement pattern in 21 (65.6%). Of the 16 nonmass enhancing lesions, the most common descriptors included focal distribution in seven (43.8%), segmental distribution in six (37.5%), clumped internal pattern in nine (56.3%), rapid initial enhancement in 16 (100.0%), and wash-out delayed enhancement pattern in eight (50.0%). CONCLUSION: Adenosis lesions of the breast may appear suspicious on breast MRI. Awareness of these suspi-cious-appearing features would be helpful in obviating unnecessary breast biopsies.
Biopsy ; Breast* ; Diagnosis ; Fibrocystic Breast Disease ; Information Systems ; Magnetic Resonance Imaging* ; Pathology ; Subject Headings

BACKGROUND: Columnar cell lesions (CCLs) are characterized by the presence of columnar epithelial cells lining the terminal duct lobular units of the breast and frequently found in biopsies for microcalcifications. Their incidence and relationship with other lesions and the locations of microcalcifications have not been established. METHODS: We reviewed 1,038 cases of fibrocystic change (FCC) for the degrees of CCLs and ductal proliferative change (PC) and the locations of microcalcifications. RESULTS: Among 1,038 FCC cases, CCLs were found in 18.9%, columnar cell change (CCC) in 12.5%, columnar cell hyperplasia (CCH) in 5.3% and flat epithelial atypia (FEA) in 1.1%. CCLs were found in 14.2%, 28.8%, and 40.0% of non-PC (NPC), proliferative disease (PD) without atypia and PD with atypia, respectively. Microcalcifications were found in 33.5%, 56.2%, 61.8%, and 81.8% of caese without CCLs, with CCC, CCH and FEA, respectively. Their locations were in NPC in 66.3% of the cases, PD in 14.8% of the cases or both areas in 18.8% of FCC. CONCLUSIONS: The incidence of CCLs increased according to the degree of PD without positive correlation between the degree of CCLs and PD. The frequency of microcalcifications increased according to the degree of CCLs but was statistically insignificant. There is a possibility that a needle biopsy targeting a microcalcification area might leave additional PD around the targeted area because microcalcifications were found more frequently in NPC than PD area.
Biopsy ; Biopsy, Needle ; Breast ; Chlormequat ; Epithelial Cells ; Fibrocystic Breast Disease ; Hyperplasia ; Incidence

BACKGROUND : A discussion of the chronologic trends of operative indications of breast masses for proper management of breast masses is desirable. METHODS : A retrospective analysis of 882 patients with breast masses who underwent operations at Kangnam General Hospital from January 1986 to December 1997 was done. All the lesions were classified according to for age, size of the mass, and the pathologic result. Concurrently, the distributions of the different masses were retrospectively analyzed for each one-year time period. RESULTS : The most prevalent age group was the third decade (28.6%) followed by the fourth decade (25.3%) and the fifth decade (24.4%). The most common lesion was fibroadenoma (38.7%), followed by mammary dysplasia (22.6%) and malignancy (18.3%). In fibroadenoma, the most common pathologic type was intracanalicular (34.9%), and the juvenile type occurred in significantly younger patients compared to other types (19.2 vs 29.2 years of age). In mammary dysplasia, the most common pathologic type was fibrous (74.4%), and the epithelial hyperplasia and adenosis types were occurred in older patients compared to the other types (39.1 and 41.0 vs 33.5 and 35.4 years of age). As the chronologically changing pattern of the pathologic types, the number of mammary dysplasia had a decreasing tendency and fibroadenoma had a relatively increasing one, and the reason may be the effect of fine-needle aspiration cytology. CONCLUSIONS : The result of this study shows that the distribution of the disease in terms of age and frequency is almost the same as that of other reported results. The trend of the disease types in terms of the time period shows that the operation rate for fibroadenomas is increasing while the rate for mammary dysplasia is decreasing. This tendency might come from the decreasing use of surgical biopsy for mammary dysplasia.
Biopsy* ; Biopsy, Fine-Needle ; Breast* ; Fibroadenoma ; Fibrocystic Breast Disease ; Hospitals, General ; Humans ; Hyperplasia ; Retrospective Studies

OBJECTIVETo compare therapeutic effects of red-hot needle therapy and filiform needle therapy on nodules of breast of the type of stagnation of liver-qi and phlegm coagulation.

METHODSSix hundred cases were randomly divided into a treatment group and a control group, 300 cases in each group. The treatment group were treated with red-hot needle pricking at the proliferative parts and Ashi points as main, and the control group with filiform needle therapy.

RESULTSIn the treatment group, 240 cases were cured, 58 cases improved and 2 cases were not cured with an effective rate of 99.3%; and in the control group, 113 cases were cured, 165 cases improved and 22 were not cured with an effective rate of 92.7%, with a significant difference between the two groups (P = 0.001).

CONCLUSIONThe therapeutic effect of red-hot needle therapy is better than that of filiform needle therapy on nodules of breast of the type of stagnation of liver-qi and phlegm coagulation.

Mammary carcinoma arising in microglandular adenosis (MGA) is extremely rare, and MGA is regarded as a non-obligate precursor of triple-negative breast cancer. We report five cases of carcinoma arising in MGA of the breast. All cases showed a spectrum of proliferative lesions ranging from MGA to atypical MGA, ductal carcinoma in situ or invasive carcinoma. Immunohistochemically, all cases were triple-negative and expression of S-100 protein gradually decreased as the lesions progressed from MGA to atypical MGA and carcinoma. Three cases showed acinic cell differentiation with reactivity to α1-antitrypsin, and one case was metaplastic carcinoma. During clinical follow-up, one patient developed local recurrence. Carcinoma arising in MGA is a rare but distinct subset of triple-negative breast cancer with characteristic histologic and immunohistochemical findings.
Acinar Cells ; Breast ; Carcinoma, Intraductal, Noninfiltrating ; Fibrocystic Breast Disease* ; Follow-Up Studies ; Humans ; Recurrence ; S100 Proteins ; Triple Negative Breast Neoplasms

The initial presentation of breast malignancy as noninvasive carcinoma in an area of sclerosing adenosis is unusual. Especially, lobular carcinoma in situ in sclerosing adenosis sometimes can be a potential source of confusion with invasive lobular carcinoma. We report a case of lobular carcinoma in situ presenting in adenosis exhibiting patterns akin to invasive lobular carcinoma, thus leading to potential misdiagnosis. Overall architecture of the lesion as seen at lower power and immunohistochemistry can be useful to distinguish between sclerosing adenosis with lobular carcinoma in situ and infiltrating lobular carcinoma.
Breast Neoplasms/pathology* ; Carcinoma in Situ/pathology* ; Carcinoma, Lobular/pathology* ; Case Report ; Female ; Fibrocystic Disease of Breast/pathology* ; Human ; Immunohistochemistry ; Middle Age