Objective: To investigate the histopathological and immunohistochemical characteristics of benign apocrine cystic papillary hyperplasia of the breast with loss of myoepithelial cell layer. Methods: The clinical data, histopathological features and immunohistochemical profile of patients with benign apocrine cystic papillary hyperplasia of breast with loss of myoepithelial cell layer from January 2016 to December 2021 were examined, in which six patients were identified. Results: All six patients were female, aged 36-61 years (median 46 years), who presented with a breast mass; three cases were from the left breast and three cases were from the right breast. Microscopic examination of all cases showed breast hyperplasia with apocrine cysts, accompanied by different degrees of micropapillary and papillary hyperplasia of apocrine cells. One case was associated with lobular carcinoma in situ, and one case was associated with apocrine ductal carcinoma in situ with intraductal dissemination in adenosis. Immunohistochemical staining of CK5/6, p63, SMA, SMMHC, Calponin and CD10 showed complete absence of myoepithelial cell layer surrounding ducts in apocrine cystic papillary hyperplasia. Conclusions: The myoepithelial cells of apocrine cystic papillary hyperplasia of the breast may undergo abnormal changes and may even be completely lost. The diagnosis should be comprehensively considered along with cytomorphological and histological features to avoid overdiagnosis.
Female ; Humans ; Epithelial Cells/pathology* ; Hyperplasia/pathology* ; Papilloma/pathology* ; Adult ; Middle Aged ; Mammary Glands, Human/pathology* ; Breast Neoplasms/pathology* ; Carcinoma, Lobular/complications* ; Carcinoma, Ductal/complications*

Breast/pathology* ; Breast Neoplasms/pathology* ; Carcinoma in Situ/pathology* ; Carcinoma, Lobular/pathology* ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia/pathology*

PURPOSE: We investigated the prognostic significance of CD9 expression in tumor cells of patients with invasive lobular carcinoma (ILC). METHODS: CD9 expression was evaluated by immunohistochemistry in 113 ILC tissue samples. Correlation of CD9 expression with the patients' clinicopathological parameters and overall survival was assessed. RESULTS: CD9 expression was detected in 48 (42.5%) ILC patients. However, no significant relation could be determined between CD9 expression and the clinicopathological parameters of the patient including tumor size, lymph node metastasis, lymphovascular invasion, histologic grade, expression of hormone receptors, human epidermal growth factor receptor 2 status, and Ki-67 labeling index. Patients with CD9 expression had worse overall survival (p = 0.051) and disease-free survival (DFS, p = 0.014) compared to patients without CD9 expression. Multivariate analysis revealed that CD9 expression was an independent prognostic factor for DFS (p = 0.049). CONCLUSION: CD9 expression in tumor cells could be a significant prognostic marker in patients with ILC.
Breast Neoplasms ; Carcinoma, Lobular ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Receptor, Epidermal Growth Factor

OBJECTIVES: We aimed to compare the diagnostic performances of digital mammography (DM), digital breast tomosynthesis (DBT), ultrasound (US), magnetic resonance imaging (MRI), breast specific gamma imaging (BSGI) and/or positron emission tomography/computed tomography (PET/CT) for the detection of invasive lobular carcinoma (ILC). METHODS: Index ILCs and multifocal/multicentric (multiple) ILCs were analyzed using various imaging modalities. The final surgical pathology was regarded as the reference standard. The detection rate for index cancers and the diagnostic performance for multiple ILCs per breast were evaluated. RESULTS: Seventy-eight ILCs in 76 women were enrolled. Twenty-six breasts had multiple ILCs. DM (n=72), DBT (n=15), US (n=77), MRI (n=76), BSGI (n=50), and /or PET/CT (n=74) were performed. For index cancer, the detection rate was 100% for DBT, US, and MRI. For multiple ILCs, the sensitivity was 100% for DBT and MRI (P<0.001). The diagnostic accuracy for multiple ILCs were 73.3% for DBT and 73.0% for PET/CT (P=0.460). CONCLUSION: DBT was the most accurate imaging modality for both index and multiple ILCs. PET/CT was also valuable for multiple ILCs, whereas DM and BSGI showed relatively low diagnostic performances. DBT and PET/CT have promising roles in the diagnosis of multiple ILCs.
Breast ; Carcinoma, Lobular* ; Diagnosis ; Electrons ; Female ; Humans ; Magnetic Resonance Imaging ; Mammography ; Pathology, Surgical ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Ultrasonography

PURPOSE: The American Joint Committee on Cancer (AJCC) recently released the breast cancer staging system, 8th edition, which included additional four biologic factors. However, there has been no external validation of the prognostic value of the new stages with different population-based databases. METHODS: To validate the prognostic value of the new staging system in the Asian population, with a focus on Korean patients with breast cancer, we performed a retrospective study with data from the Korean Breast Cancer Society that included 24,014 patients with invasive ductal or lobular carcinoma who underwent surgery between January 2009 and January 2012 in Korea. The proportional differences were evaluated between the anatomic staging system (AJCC 7th edition) and the prognostic staging system (AJCC 8th edition, December 2017 published version). Comparisons of overall survival (OS) and disease-free survival (DFS) with Kaplan-Meier graphs and hazard ratios were also performed. RESULTS: Our analysis included 24,014 patients (median age, 50 years; range, 20–91 years). Stage I, II, and III disease accounted for 47.6%, 43.5%, and 8.9%, respectively, of anatomic stages and 61.8%, 27.6%, and 10.8%, respectively, of clinical prognostic stages. A total of 6,272 cases (26.1%) were upstaged, 4,656 (19.4%) were downstaged, and 13,086 (54.5%) remained unchanged. OS and DFS decreased in the order from prognostic stages IA to IIIC but did not change among the anatomic stage groups. CONCLUSION: Our data suggests that the prognostic staging system provides superior prognostic value to the anatomic staging system in Korean patients with breast cancer.
Asian Continental Ancestry Group ; Biological Factors ; Breast Neoplasms* ; Breast* ; Carcinoma, Lobular ; Disease-Free Survival ; Humans ; Joints* ; Korea ; Neoplasm Staging ; Prognosis ; Retrospective Studies

No abstract available.
Breast ; Carcinoma, Lobular ; Collagen

Metastasis from primary cancer to the thyroid is uncommon in breast cancer. Here we present a case of lobular breast carcinoma that metastasized to the thyroid. A 54-year-old woman without symptoms was admitted to our institution for staging of the lymph node above the left clavicle. An ¹⁸F-fluoro-deoxy-D-glucose positron emission tomography scan was performed for staging, and low uptakes were observed in the left supraclavicular and cervical lymph nodes. High uptake was seen in the posterior and lower left lobe of the thyroid. Histologic findings indicated lobular breast carcinoma (positive GATA3, loss of E-cadherin expression) metastatic to the thyroid with a luminal profile. Immunohistochemical analysis was negative for primary thyroid or parathyroid carcinoma. To our knowledge, this is the first report of a patient presenting a metastatic invasive lobular carcinoma in the thyroid and lymph nodes without a prior diagnosis of breast cancer.
Breast Neoplasms* ; Breast* ; Cadherins ; Carcinoma, Lobular ; Clavicle ; Diagnosis ; Female ; Humans ; Immunohistochemistry ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis* ; Parathyroid Neoplasms ; Phenobarbital ; Positron-Emission Tomography ; Thyroid Gland*

Invasive lobular carcinoma (ILC) is the second most common kind of breast cancer. Diffusion weighted imaging (DWI) and positron emission tomography/computed tomography (PET/CT) are functional modalities for presenting the biological characteristics of breast cancer. The purpose of this article is to study the relationship between DWI or PET/CT and ILC's prognostic factors. The relationship between the apparent diffusion coefficient (ADC) values, standard uptake value (SUV)max and prognostic factors of ILC were statistically evaluated. The ADC values were lower in mass types of ILC. SUVmax was statistically higher in grade 3 and 4 background parenchymal enhancement and positive lymph node metastasis. ADC values of DWI and SUVmax of PET/CT can be helpful in the prediction of the prognosis of ILC.
Breast ; Breast Neoplasms ; Carcinoma, Lobular ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Electrons ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Population Characteristics ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Prognosis

Gastric metastasis from invasive lobular breast carcinoma is rare. Mostly gastrointestinal metastasis presents as one among multiple metastases, several years after primary diagnosis of breast carcinoma. Herein, we report a synchronously diagnosed gastric metastasis from invasive lobular carcinoma, mimicking primary gastric linitis plastica with pyloric obstruction. We reviewed clinical and pathological findings of gastric carcinoma metastatic from the breast. In particular, we focused on immunohistochemical studies of selected antibodies, including those for estrogen receptors, gross cystic disease fluid protein-15, and caudal-type homeobox transcription factor 2, for accurate differential diagnosis. Clinical suspicion, repeat endoscopic biopsy, and detailed histological analysis including immunohistochemistry are necessary for diagnosis of gastric carcinoma metastatic from the breast.
Antibodies ; Biopsy ; Breast Neoplasms* ; Breast* ; Carcinoma, Lobular ; Diagnosis ; Diagnosis, Differential ; Genes, Homeobox ; Immunohistochemistry ; Linitis Plastica ; Neoplasm Metastasis* ; Receptors, Estrogen ; Stomach ; Transcription Factors

PURPOSE: This study aimed to evaluate the clinicopathological characteristics of pregnancy-associated breast cancer (PABC) in comparison with non-pregnancy associated breast cancer (non-PABC). METHODS: A total of 344 eligible patients with PABC were identified in the Korean Breast Cancer Society Registry database. PABC was defined as ductal carcinoma in situ, invasive ductal carcinoma, or invasive lobular carcinoma diagnosed during pregnancy or within 1 year after the birth of a child. Patients with non-PABC were selected from the same database using a 1:2 matching method. The matching variables were operation, age, and initial stage. RESULTS: Patients with PABC had significantly lower survival rates than patient with non-PABC (10-year survival rate: PABC, 76.4%; non-PABC, 85.1%; p=0.011). PABC patients had higher histologic grade and were more frequently hormone receptor negative than non-PABC patients. Being overweight (body mass index [BMI], ≥23 kg/m²), early menarche (≤13 years), late age at first childbirth (≥30 years), and a family history of breast cancer were more common in the PABC group than in the non-PABC group. Multivariate analysis showed the following factors to be significantly associated with PABC (vs. non-PABC): early menarche (odds ratio [OR], 2.165; 95% confidence interval [CI], 1.566–2.994; p<0.001), late age at first childbirth (OR, 2.446; 95% CI, 1.722–3.473; p<0.001), and being overweight (OR, 1.389; 95% CI, 1.007–1.917; p=0.045). CONCLUSION: Early menarche, late age at first childbirth, and BMI ≥23 kg/m² were more associated with PABC than non-PABC.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Child ; Female ; Humans ; Menarche ; Methods ; Multivariate Analysis ; Overweight ; Parturition ; Pregnancy ; Survival Rate