Latest Research News on Breast Carcinoma : Dec 2020

Invasive micropapillary carcinoma of the breast.

Nine examples of a rare variant of invasive breast carcinoma characterized by the formation of micropapillae within clear spaces separated by a fibrocollagenous or delicate fibrovascular stroma are presented. Designated as invasive micropapillary carcinoma, the unusual morphology of this tumor requires its distinction from metastatic ovarian serous papillary carcinoma and extensive vascular/lymphatic invasion by either a primary or metastatic breast carcinoma. The micropapillary pattern is retained in metastatic foci and areas of recurrence. This pattern also occurs admixed with regular infiltrating duct carcinoma either in the primary mammary tumor or when it recurs. [1]

 

Breast Carcinoma in Children

CARCINOMA of the breast in children is infrequently reported. In 1917, Levings1 published a case in a 12-year-old girl; in 1940, Sears and Schlesinger2 reported one in a 10-year-old girl. Other single case reports include that of Puente and Ramirez,3 Simmons,4 and the unique instance of a 6-year-old boy with a single axillary metastasis published by Hartman and Margish5 in 1955. To our knowledge a series of such cases giving comparative morphology and natural history as modified by various forms of therapy has not been reported. The present paper is based on the study of seven cases of breast carcinoma in young children that have come to our attention by way of consultation material sent to the Pathology Department at Memorial Hospital during the past 15 years. Because of the nature of this consultation practice, it is impossible to ascertain from how large a group. [2]

Breast carcinoma in men

BACKGROUND

Male breast carcinoma is an uncommon disease, and most previous studies have been single‐institution series that were limited by extremely small sample sizes. The goals of the current study were to fill in the major gaps in knowledge regarding the incidence, presenting characteristics, prognostic factors, and survival rates of male breast carcinoma and to determine how breast carcinoma differs between men and women.

METHODS

Data from the National Cancer Institute Surveillance, Epidemiology, and End Results 1973–1998 database were used. Age‐adjusted incidence rates were calculated. Characteristics of the patients and presenting tumors were compared between men and women. Univariate and multivariate analyses were performed to determine the effect of each variable on overall survival. Survival rates by disease stage were compared for men and women.

RESULTS

Over the years of the study, the incidence of male breast carcinoma increased significantly from 0.86 to 1.08 per 100,000 population (P < 0.001). Men had a higher median age at diagnosis (P < 0.001) and were more likely to have lymph node involvement (P < 0.001), a more advanced stage at diagnosis (P < 0.001), and tumors that were positive for estrogen receptor (ER) (P < 0.001) and progesterone receptor (PR) (P < 0.001). In multivariate analysis, larger tumor size and lymph node involvement were associated with shortened survival. Tumor grade and ER/PR status did not appear to independently influence survival. Relative survival rates by stage of disease for men and women were similar.

CONCLUSIONS

Although it remains a rare disease, the incidence of male breast carcinoma is increasing. Breast carcinoma in men has some epidemiologic and biologic differences from breast carcinoma in women. Cancer 2004. © 2004 American Cancer Society. [3]

Antiproliferative Activity by Ethanolic Extract of Red Alpinia galanga (L) Willd in Inoculated Breast Carcinoma Cells of C3H Mice

Background: The objective of this study is to investigate the anticancer activity of ethanolic extract of Alpinia galanga Willd (galangal) on breast adenocarcinoma cells transplanted in C3H mice. In some previous studies ethanolic extract of galangal containing active substance i.e 1’-acetoxychavicol acetate (ACA), is used as anticancer by various mechanisms such as induction of apoptosis, inhibiting cell proliferation, antiinflammation and antioxidant.

Methods: This experimental study was designed by post test only controlled design group, using 32 C3H mice. The C3H mice  were inoculated with tumor cells and then divided into 4 groups: control group (K) and three treatment groups (T1, T2 and T3) given graded doses of ethanolic extract of galangal (225 mg/kobo/day, 450 mg/kobo/day and 675 mg/kobo/day) for 2 weeks. After all mice were terminated, we count the tumor volume of each mice. Ki-67 immunostaining was performed to analyse cell proliferative activity. All the data were analyzed with Pearson Chi Square and OneWay Anova.

Results: This study found that there is marked differences of tumor volume between groups, with control group has the highest tumor volume and treatment group 3 is the lowest. The immunoexpression of Ki-67 has highest mean score at control group  and the lowest at T3 group. There were statistically significant correlation between tumor volume and dose of galangal extract, and significant differences among groups of Ki-67 immunoexpression.

Conclusion: Oral administration of ethanolic extract of Alpinia galanga Willd at the graded doses  has anticancer activity on C3H breast adenocarcinoma by inhibition of cell proliferative activity and growth of tumor volume. The best result of anticancer activity is found in group with the highest dose of galangal extract (675 mg/kgBW). [4]

Sentinel Lymph Node Biopsy in Breast Carcinoma: A Tertiary Center Experience

Objectives: To evaluate feasibility, accuracy and technique of sentinel lymph node biopsy in the management of early breast cancer.

Methods: A retrospective study of sentinel lymph node biopsy was done at King Abdulaziz University Hospital from June 2007– to –June 2013. Total of 110 patients were studied, these patients underwent lumpectomy + Sentinel lymph node biopsy. Patients records were studied by looking file, electronic records, OPD records and data was collected regarding previous surgery, location of mass in breast, size of mass, site of breast, pre or postmenopausal, previous axillary surgery, radiological evaluation, radiotherapy, type of surgery done, adjuvant or neo-adjuvant chemotherapy, gross margins, frozen section margins, new frozen section margins, permanent margins, reoperation, intra-operative radiotherapy[IOR], tumor type, lympho-vascular invasion, estrogen receptor[ER], progesterone receptor[PR], HER2, metastasis, stage of disease, tumor size, no. of lymph nodes, sentinel lymphnode dissection [SLD] done, number of sentinel lymph node, sentinel lymph node [SLN] frozen section, SLN permanent, completion axillary lymph node dissection [ALND], skin necrosis, numbness, wound infection.

Results: Majority of patients were Saudis (64.5%). 9.1% had previous surgery. Pre menopausal were 43.6% and post menopausal 56.4%. Left breast was involved in 60% and right breast in 40% of cases. Upper outer quadrant was involved in 51.9%9%. Size of mass was less than 1 cm in 14.8% cases, 1-2.9 cm in 43.5%, 3-4 cm in 13%, more than 4 cm in 10.2%. Previous axillary surgery was done in 3.7% cases. Radiological evaluation of axilla was done in 68.2%. Lumpectomy plus sentinel lymph node biopsy was done in 96.4% and lumpectomy and axillary lymph node dissection was done in 1.8% cases, and unspecified BCS in 1.8%. Neo-adjuvant chemotherapy was given in 3.6% and adjuvant chemotherapy in 80% of cases Intra-operative radiotherapy was done in 29.1%. Invasive ductal carcinoma was found in 77.3%, DCIS in 10%, invasive lobular carcinoma in 7.3%, mucinus on 2.7%, medullary in 0.9%, LCIS in 0.9% cases. Lympho-vascular margins were positive in 20.9%. ER were positive in 69.1%, PR were positive in 60%. HER-2 was positive in 26.4% cases. Tumor size was T1 42.7%, T2-42.7%, T3-5.5%, T4-0.9% and carcinoma in situ in 6.4% cases. Lymph nodes were N1-33.6%, N2-4.5%, N0-60.9%. MI-0.9% and MO -98.2%. Sentinel Lymph node biopsy was done in 98.2% of cases. Number of Sentinel lymph nodes retrieved was assessed, two LN in 21.8%, three in 18.2%, one in 17.3%, four in 16.4%, five in 13.6%, six in 6.4%, seven in 1.8%. SLN on frozen section had positive for malignancy in 25.5%, while on permanent section they were positive in 38.2%. Completion axillary dissection was done in 34.5%. Skin necrosis was found in 2.2%, numbness was found in 4.4%, wound infection was in 2.2%.

Conclusion: Methylene blue is effective and safe in the detection of sentinel lymph node in patients with breast cancer and it has low cost and readily available. [5]

Reference

[1] Siriaunkgul, S. and Tavassoli, F.A., 1993. Invasive micropapillary carcinoma of the breast. Modern pathology: an official journal of the United States and Canadian Academy of Pathology, Inc, 6(6), pp.660-662.

[2] McDivitt, R.W. and Stewart, F.W., 1966. Breast carcinoma in children. Jama, 195(5), pp.388-390.

[3] Giordano, S.H., Cohen, D.S., Buzdar, A.U., Perkins, G. and Hortobagyi, G.N., 2004. Breast carcinoma in men: a population‐based study. Cancer: Interdisciplinary International Journal of the American Cancer Society, 101(1), pp.51-57.

[4] Asri, A. and Winarko, S. (2015) “Antiproliferative Activity by Ethanolic Extract of Red Alpinia galanga (L) Willd in Inoculated Breast Carcinoma Cells of C3H Mice”, Journal of Advances in Medical and Pharmaceutical Sciences, 5(4), pp. 1-9. doi: 10.9734/JAMPS/2016/22301.

[5] Zaidi, N., Merdad, A., Althoubaity, F., Akeel, N. and Sultan, A. (2017) “Sentinel Lymph Node Biopsy in Breast Carcinoma: A Tertiary Center Experience”, Journal of Advances in Medicine and Medical Research, 19(10), pp. 1-8. doi: 10.9734/BJMMR/2017/30919.

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