PURPOSE: This study aimed to evaluate the effects of sentinel lymph node biopsy (SLNB) on recurrence and survival after neoadjuvant chemotherapy (NAC) in breast cancer patients with cytology-proven axillary node metastasis. METHODS: We selected patients who were diagnosed with invasive breast cancer and axillary lymph node metastasis and were treated with NAC followed by curative surgery between January 2007 and December 2014. We classified patients into three groups: group A, negative sentinel lymph node (SLN) status and no further dissection; group B, negative SLN status with backup axillary lymph node dissection (ALND); and group C, no residual axillary metastasis on pathology with standard ALND. RESULTS: The median follow-up time was 51 months (range, 3–122 months) and the median number of retrieved SLNs was 5 (range, 2–9). The SLN identification rate was 98.3% (234/238 patients), and the false negative rate of SLNB after NAC was 7.5%. There was no significant difference in axillary recurrence-free survival (p=0.118), disease-free survival (DFS; p=0.578) or overall survival (OS; p=0.149) among groups A, B, and C. In the subgroup analysis of breast pathologic complete response (pCR) status, there was no significant difference in DFS (p=0.271, p=0.892) or OS (p=0.207, p=0.300) in the breast pCR and non-pCR patients. CONCLUSION: These results suggest that SLNB can be feasible and oncologically safe after NAC for cytology-determined axillary node metastasis patients and could help reduce arm morbidity and lymphedema by avoiding ALND in SLN-negative patients.
Arm ; Breast Neoplasms* ; Breast* ; Diagnosis* ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphedema ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Pathology ; Polymerase Chain Reaction ; Recurrence ; Sentinel Lymph Node Biopsy*

OBJECTIVETo investigate the clinicopathological manifestation, immunophenotypic features and prognostic factors of patients with primary breast DLBCL (PB-DLBCL).

METHODSTwelve cases of PB-DLBCL, diagnosed according to the 2008 World Health Organization classification of tumors of hematopoietic and lymphoid tissues, were retrospectively studied.

RESULTSMost patients were admitted to hospital because of painless unilateral breast mass. Out of 12 cases, 5 were in Ann Arbor stage I (41.7%), 7 case were in stage II (58.3%). Most (89.9%) were assigned to non-GCB subtypes, 11.1% were classified as GCB subtype. The patients who recepted treatment were sensitive to chemotherapy and they were all alive following 12 to 92 months.

CONCLUSIONPrimary breast DLBCL is extremely rare without specific clinical features. They all respond well to chemotherapy and show good prognosis.

Breast Neoplasms ; diagnosis ; pathology ; therapy ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; therapy ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate

Pseudomyxoma peritonei is a very rare condition, and even rarer in patients with history of cancer. A 70-year old woman with a history of breast cancer was admitted with abdominal pain and distention. Abdominal computed tomography revealed ascites collection, diffuse engorgement and infiltration of the mesenteric vessel, suggesting peritonitis or peritoneal carcinomatosis. Diagnostic paracentesis was attempted several times, but a sufficient specimen could not be collected due to the thick and gelatinous nature of the ascites. Therefore, the patient underwent diagnostic laparoscopy for tissue biopsy of the peritoneum, which indicated pseudomyxoma peritonei. However, the origin of the pseudomyxoma peritonei could not be identified intraoperatively due to adhesions and large amount of mucoceles. Systemic chemotherapy was performed using Fluorouracil, producing some symptomatic relief. After discharge, abdominal pain and distention gradually worsened, so at 18 months after initial diagnosis the patient received palliative surgery based on massive mucinous ascites and palpable mass at the omentum. The patient expired after surgery due to massive bleeding.
Abdomen/diagnostic imaging ; Aged ; Antimetabolites, Antineoplastic/therapeutic use ; Ascites ; Breast Neoplasms/pathology ; Colonoscopy ; Female ; Fluorouracil/therapeutic use ; Humans ; Laparoscopy ; Peritoneal Neoplasms/*diagnosis/drug therapy/pathology ; Peritoneum/pathology ; Pseudomyxoma Peritonei/*diagnosis/drug therapy/pathology ; Tomography, X-Ray Computed

OBJECTIVE: To explore the factors affecting the successful rate of nano-carbon in sentinel lymph node biopsy.
 METHODS: A total of 270 patients with breast cancer, who were treated in First Affilitated Hospital of Henan University of Science and Technology from January 2013 to March 2015, were chosen and given sentinel lymph node biopsy (SLN) with nano-carbon, and the influencial factors were examined by logistic analysis.
 RESULTS: Successful rate of biopsy, accuracy, sensitivity and false negative rate was 92.2%, 97.6%, 93.1% and 6.8%, respectively. Age, primary tumor lesions, body mass index, axillary lymph node status, number of SLN and pathological grade were the factors affetcing successful biopsy (all P<0.05), and body mass index, age, and number of SLN were three independent factors affecting the successful rate of biopsy (all P<0.05). The history of biopsy, tumor location, affected sides, injection sites and chemotherapy showed little effect on the successful rate of biopsy (all P> 0.05).
 CONCLUSION Nano-carbon tracer method is a reliable method in sentinel lymph node biopsy. The body mass index, age, and number of lymph node metastasis greatly impact the successful rate of biopsy.
Axilla ; Breast Neoplasms ; diagnosis ; Carbon ; chemistry ; Female ; Humans ; Logistic Models ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Nanoparticles ; chemistry ; Neoadjuvant Therapy ; Neoplasm Grading ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy

OBJECTIVETo evaluateclinical features, treatment and outcomes of patients diagnosed with primary breast diffuse large B-cell lymphoma（DLBCL）.

METHODSClinical data were analyzed for all patients diagnosed with primary breast DLBCL（n=21）. Kaplan-Meier method was used to estimate 5- year overall survival（OS）rate, and the difference was compared by Log- rank test.

RESULTSThe 21 cases of patients with primary breast DLBCL were all female with median age at diagnosis as 48 years （range 21-64 years）. 13 patients had International Prognostic Index（IPI）of 0, 6 IPI 1, and 2 IPI 2. The 5- year OS rates of CHOP/R- CHOP and R±DICE after R±EPOCH groups were 40.0% and 72.2% , respectively（P=0.035）. The central nervous system relapse rate of CHOP/R-CHOP and R±DICE after R± EPOCH groups were 16.7% and 6.7%（P=0.500）, respectively. The 5- year OS rates of patients with primary breast DLBCL staging Ⅱ E-Ⅲ E and Ⅰ E were 21.4% and 83.3% , respectively（P=0.025）.

CONCLUSIONPrimary breast DLBCL was rare. The patients of primary breast DLBCL with chemotherapy regimen of R±DICE after R±EPOCH might have a better prognosis and lower relapse rate of central nervous system; the primary breast DLBCL patients staging ⅡE-ⅢE might have a poor prognosis.

Antibodies, Monoclonal, Murine-Derived ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; diagnosis ; drug therapy ; pathology ; China ; Cisplatin ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Etoposide ; Female ; Humans ; Ifosfamide ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; drug therapy ; pathology ; Neoplasm Recurrence, Local ; Prednisone ; Prognosis ; Retrospective Studies ; Vincristine

Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast.
Breast Neoplasms/pathology/surgery/therapy ; Carcinoma/*pathology/surgery/therapy ; Cervix Uteri/pathology/ultrasonography ; Charcoal/toxicity ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Granuloma/*diagnosis/pathology ; Humans ; Lymph Nodes/*surgery/ultrasonography ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed

We herein report the case of a 50-year-old woman who presented with persistent fever and a large mass in her right breast. Haematology, liver function, and other blood test results were abnormal. Computed tomography and positron emission tomography indicated that the lesion had spread to multiple organs. Immunohistochemical staining confirmed that the patient had plasmablastic lymphoma, an invasive and rare form of diffuse large B-cell lymphoma, and an underlying infection by the Epstein-Barr virus. After three rounds of CHOPE chemotherapy, followed by hyperCVAD and ESHAP, the patient achieved rapid and complete remission. This case is unusual in that the patient presented with a large breast mass and her recovery was extremely rapid.
Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; diagnosis ; pathology ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; Epstein-Barr Virus Infections ; diagnosis ; Female ; Glucocorticoids ; administration & dosage ; Herpesvirus 4, Human ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; drug therapy ; Middle Aged ; Remission Induction ; Tomography, X-Ray Computed

No abstract available.
Adenocarcinoma/*diagnosis/radiography/secondary ; Adult ; Antineoplastic Agents/therapeutic use ; Breast Neoplasms/*diagnosis/drug therapy/pathology ; Carrier Proteins/metabolism ; Doxorubicin/therapeutic use ; Drug Therapy, Combination ; Endoscopy, Digestive System ; Female ; Glycoproteins/metabolism ; Humans ; Mastectomy, Modified Radical ; Positron-Emission Tomography and Computed Tomography ; Stomach Neoplasms/*diagnosis/radiography/secondary ; Taxoids/therapeutic use ; Tomography, X-Ray Computed

BACKGROUND: Therapy-related myeloid neoplasms (t-MN) occur as late complications of cytotoxic therapy. This study reviewed clinical and cytogenetic characteristics of patients with t-MN at a single institution in Korea. METHODS: The study subjects included 39 consecutive patients diagnosed with t-MN. Each subject's clinical history of previous diseases, treatments, and laboratory data was reviewed, including cytogenetics. The primary diagnosis was hematologic malignancy in 14 patients and solid tumor in 25 patients. RESULTS: Therapy-related acute myeloid leukemia (t-AML, 66.7%) was found to be more common than therapy-related myelodysplastic syndrome (t-MDS). Primary hematologic malignancies that were commonly implicated included mature B-cell neoplasm and acute leukemia. Breast cancer was the most common primary solid tumor. The mean time interval from cytotoxic therapy initiation to t-MN detection was 49 months. Chromosomal aberrations were observed in 35 patients, and loss of chromosome 5, 7, or both accounted for 41% of all cases. Balanced rearrangements occurred in 13 patients; these patients showed shorter latency intervals (mean, 38 months) than patients with loss of chromosome 5 or 7 (mean, 61 months). CONCLUSIONS: In this study, we determined the clinical and cytogenetic characteristics of Korean patients with t-MN. Although our results were generally consistent with those of previous reports, we found that t-MN resulting from de novo leukemia was common and that t-AML was more common than t-MDS at presentation. Multi-institutional studies involving a larger number of patients and additional parameters are required to investigate the epidemiology, genetic predisposition, and survival rate of t-MN in Korea.
Adolescent ; Adult ; Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Asian Continental Ancestry Group ; Bone Marrow/pathology ; Breast Neoplasms/drug therapy/pathology/radiotherapy ; Child ; Child, Preschool ; Chromosome Aberrations ; Chromosomes, Human, Pair 5 ; Chromosomes, Human, Pair 7 ; Female ; Hematologic Neoplasms/drug therapy/pathology/radiotherapy ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute/*diagnosis/etiology/genetics ; Male ; Middle Aged ; Myelodysplastic Syndromes/*diagnosis/etiology/genetics ; Neoplasms, Second Primary/*diagnosis/etiology/genetics ; Republic of Korea ; Young Adult

OBJECTIVETo assess and compare the prognostic role of tumor-infiltrating T lymphocytes in stage 1-3 breast cancer.

METHODSParaffin sections were retrospectively collected from 130 cases of stage 1-3 breast cancer patients who received surgery between January 2000 and December 2002 in General Hospital of the People's Liberation Army. Immunohistochemistry was used to assess the density of tumor-infiltrating lymphocytes(TILs) that were positive of CD4 and CD8. These variables were evaluated for their association with histopathologic features along with overall survival(OS) , distant disease-free survival(DDFS) and disease-free survival(DFS) .

RESULTSIntraepithelial CD4+lymphocytes infiltration was an independent prognostic factor for DFS(HR=0.248, 95%CI=0.113-0.543, P=0.000) , DDFS(HR=0.361, 95%CI=0.157-0.830, P=0.017) , and OS(HR=0.297, 95%CI=0.119-0.741, P=0.009) in multifactor COX regression model. In hormone receptor negative group, mesenchymal CD8+lymphocytes and intraepithelial CD8+lymphocytes were independent prognostic factors for OS(HR=0.286, 95%CI=0.101-0.807, P=0.018) and DDFS(HR=0.293, 95%CI=0.104-0.825, P=0.020) , respectively. In hormone receptor positive group, mesenchymal CD8+lymphocytes and intraepithelial CD8+lymphocytes were independent prognostic factors for OS(HR=4.854, 95%CI=1.435-16.415, P=0.011) and DDFS(HR=10.493, 95%CI=1.226-89.795, P=0.032) respectively. Further analysis found that OS of hormone receptor positive patients with lower mesenchymal CD8+TILs was significantly proved by adjuvant endocrine therapy.

CONCLUSIONSIn the current investigation, intraepithelial CD4+TILs demonstrated independent prognostic significance for survival. CD8+TILs were associated with better survival in hormone receptor negative patients but associated with worse survival in hormone receptor positive patients. The long-term clinical effects of adjuvant endocrine therapy is related with density of mesenchymal CD8+TILs and in turn affected prognostic value of mesenchymal CD8+TILs.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; diagnosis ; pathology ; therapy ; CD4-Positive T-Lymphocytes ; pathology ; CD8-Positive T-Lymphocytes ; pathology ; Disease-Free Survival ; Female ; Humans ; Immunohistochemistry ; Lymphocytes, Tumor-Infiltrating ; pathology ; Middle Aged ; Prognosis ; Retrospective Studies