The journal of breast health最新文献

A woman aged 50 years was diagnosed as having an invasive ductal carcinoma in the right breast and ductal carcinoma in situ in the left breast and underwent bilateral mastectomy eight years ago. A mass was identified during follow-up in positron-emission tomography (PET) image in the left infraclavicular region, indicating metastasis. Histopathologic examination showed a mass of 1.9 × 1 × 0.7 cm in dimensions characterized by spindle or round nuclei cells that formed island or cords in hyaline and myxoid ground and intracytoplasmic vacuoles containing erythrocytes. In the immunohistochemical analysis, tumor cells were widespread with diffuse positivity with CD34 and vimentin. These findings redirected us from a diagnosis of metastatic carcinoma to epithelioid hemangioendothelioma, a rare tumor of intermediate vascular tumor groups. In this respect, confirmation through biopsy from considered cases of metastasis is important in making a definite pathologic differential diagnosis.

Gestational gigantomastia is a rare condition characterized by fast, disproportionate and excessive breast growth, decreased quality of life in pregnancy, and presence of psychologic as well as physical complications. The etiology is not fully understood, although hormonal changes in pregnancy are considered responsible. Prolactin is the most important hormone. To date, 125 cases of gigantomastia have been reported in the literature. In this case presentation, we report a pregnant woman aged 26 years with a 22-week gestational age with gestational gigantomastia and review the diagnosis and treatment of this rare disease in relation with the literature.

Objective: Breast cancer is the most common type of cancer in women both in developed and developing countries. It has a higher mortality rate in low and middle income countries due to the late-stage diagnosis. The principal aim of this study was to investigate what patients with breast cancer did before presenting to Turgut Özal Medical Center and its relationship with late stage diagnosis. The study also aimed to identify the level of patients' perceived social support.

Materials and methods: The study included 200 patients with breast cancer who were treated at the chemotherapy unit during 2013 and 2014.

Results: The mean age of the patients was 51.16±1.10 years and 60% of the women were graduates of elemantary school. The majority of patients (69.5%) noticed breast mass as the first symptom and 56.5% were diagnosed at later stages. Thirty-four percent of the patients delayed their visit to a health care centers after realizing the first symptom. No statistically significant relationship was determined between women's education level, residential area, age, the first symptom noticed, stages of tumor, and patients and system-related delay (p>0.05). In terms of family history of breast cancer, there was a significant difference between patient-related and system-related delays (p<0.05). The family support score (24.8±4.6) was higher than those of friends and husbands (23.8±5.5, 21.3±6.4, respectively). The husband support score was statistically different in terms of intimacy between women and their husbands after disease (p<0.001).

Conclusion: It can be concluded that overcoming barriers related to patients and the system will lead to early-stage diagnosis, which in turn will result in higher survival rates of patients with breast cancer. As awareness and knowledge level of women about cancer increases, they will visit health care centers earlier where they can receive more comprehensive treatment.

Mastitis is inflammation of breast tissue that may or may not originate from an infection. Two different forms of mastitis have been described, lactational and non-lactational. Lactational mastitis is the most common type and generally conservative therapy that includes milk removal and physical therapy provides symptomatic relief, but antibiotic therapy is also needed. Common types of non-lactational mastitis are periductal mastitis and idiopathic granulomatous mastitis. Treatment includes antibiotics, drainage, and surgery, but usually this is a chronic process and a therapeutic management algorithm for chronic breast inflammation is unclear and has no consensus. Negative-pressure wound therapy is commonly used for various types of wounds but is limited for breast wounds. In this report, we present and discuss two patients with chronic breast inflammation who underwent surgery and were successfully treated using negative-pressure wound therapy to minimize wide tissue defects and cosmetic problems after surgery. Use of negative-pressure wound therapy for breast wounds might be benefical as it is with other wounds but there is scarce information in the literature.

Objective: Breast cancer is the most common type of cancer in women worldwide. It is indicated that increased body mass index elevates the risk of developing breast cancer, worsens prognosis, and decreases survival. Several polymorphisms of adiponectin have been shown to affect serum levels of adiponectin and their association with breast cancer. The aim of this study was to investigate the relationship between the adiponectin 45T/G and 276 G/T gene polymorphism and breast cancer in the East Marmara region.

Materials and methods: A case-control study was performed in 97 patients with breast cancer and 101 controls in East Marmara in order to evaluate the prevalence of adiponectin gene polymorphism at positions 45 and 276. Patients with familial breast cancer and those who had received chemotherapy or radiotherapy were excluded from the study. Adiponectin gene polymorphisms were investigated using polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP).

Results: Adiponectin 45T/G gene genotype frequencies of TT, TG, and GG were 61.9%, 37.1%, and 1% in patients with breast cancer, and 67.3%, 30.7%, and 2% in the control group, respectively. Adiponectin 276G/T gene genotype frequencies of GG, GT, and TT were 45.4%, 45.4%, and 9.3% in patients with breast cancer and 55.4%, 39.6%, and 5.0% in the control group, respectively.

Conclusion: Our study showed that adiponectin 45T/G and 276 G/T gene polymorphism is not associated with breast cancer risk in patients from the East Marmara region.

Objective: To assess the feasibility of sentinel node biopsy (SNB) in ductal and lobular invasive breast cancer, a group of tumors known as special histologic type (SHT) of breast cancer.

Materials and methods: Between January 1997 and July 2008, 2253 patients from 6 affiliated hospitals underwent SNB who had early breast cancer and clinically negative axilla. The patients' data were collected in a multicenter database. For lymphatic mapping, all patients received an intralesional dose of radiocolloid Tc-99m (4mCi in 0.4 mL saline), at least two hours before the surgical procedure. SNB was performed by physicians from the same nuclear medicine department in all cases.

Results: Of the 2253 patients in the database, the SN identification rate was 94.5% (no radiotracer migration in 123 patients), and positive sentinel node prevalence was 22%. SHT was reported in 144 patients (6.4%) of the whole series. In this subgroup, migration of radiotracer was unsuccessful in 8 patients (identification rate was 94.4%) and SNs were positive in 7.4%. SN positivity prevalence in these tumors was variable across the subtypes. Higher probability of lymphatic spread seemed to be related to tumor invasiveness (20% of positivity in micropapillary, 15% in cribriform subtypes, and 0% in adenoid-cystic).

Conclusion: Sentinel node biopsy is feasible in special histologic subtypes of breast carcinoma with a good identification rate. Lower migration rates, however, might be associated with special histologic features (colloid subtype). Complete axillary dissection after a positive sentinel node cannot be omitted in patients with SHT breast cancer because they can be associated with further axillary disease; the reported very low incidence of axillary metastases would justify avoiding axillary dissection only in the adenoid-cystic subtype.

Objective: Mammography-screening (MS) rates remain low in underdeveloped populations. We aimed to find the barriers against MS in a low socioeconomic population.

Materials and methods: Women aged 40-69 years who lived in the least developed city in Turkey (Mus), were targeted. A survey was used to question breast cancer (BC) knowledge and health practices.

Results: In total, 2054 women were surveyed (participation rate: 85%). The MS rate was 35%. Women aged 50-59 years (42%, p<0.001), having annual Obstetric-Gynecology (OB-GYN) visits (42%, p<0.001), reading daily newspaper (44%, p=0.003), having Social Security (39%, p=0.006) had increased MS rates. The most common source of information about BC was TV/radio (36%). Having doctors as main source of information (42%, p<0.001), knowing BC as the most common cancer in females (36%, p=0.024), knowing that BC is curable if detected early (36%, p=0.016), knowing that MS is free (42%, p<0.001) and agreeing to the phrase "I would get mammography (MG), if my doctor referred me" (36%, p=0.015) increased MS rates. Agreeing that MG exposes women to unnecessary radiation decreased MS rate (32%, p=0.002).

Conclusion: To increase the MS rate in low socioeconomic populations, clear messages about BC being the most common cancer in women, MS after 40 years of age not causing unnecessary radiation but saving lives through enabling early detection, and MS being free of charge should be given frequently on audiovisual media. Uninsured women and women aged 40-49 years should be especially targeted. Physicians from all specialties should inform their patients about BC.