The journal of breast health最新文献

英文中文

Three Cases of Breast Metastases from Lung Cancer and Systematic Review of the Literature. 肺癌乳腺转移3例及文献系统复习。

The journal of breast health

Pub Date : 2020-05-22 DOI: 10.5152/ejbh.2020.5703

N. Güldoğan, G. E. İçten, F. Tokat, B. Tutar, H. Kara, T. Korkmaz, B. Oyan Uluç, G. Demir

Despite the high prevalence of lung cancer among other primary tumors, metastasis of this particular malignancy in the breast is very rare. We report three new cases of lung cancer with breast metastases and discuss radiological and clinical findings. Radiologically, each case displayed different characteristics. First, one of them had bilateral superficially and deeply located irregular lesions. Second, the patient presented with findings similar to inflammatory breast cancer. The third case had a circumscribed mass, resembling a benign complicated cyst. To guide clinicians for proper patient management, radiologists should be aware of the scope of typical and atypical imaging findings of metastatic involvement of the breast.

尽管肺癌在其他原发肿瘤中发病率很高，但这种特殊的恶性肿瘤在乳房的转移是非常罕见的。我们报告三例新的肺癌伴乳腺癌转移，并讨论放射学和临床表现。放射学上，每个病例表现出不同的特征。首先，其中一人有双侧浅深部不规则病变。第二，患者表现出与炎性乳腺癌相似的症状。第三例有边界肿块，类似良性复杂囊肿。为了指导临床医生对患者进行适当的管理，放射科医生应该了解乳腺转移性病变的典型和非典型影像学发现的范围。

引用次数: 2

Desmoid Type Fibromatosis of the Breast Masquerading as Breast Carcinoma: Value of Dynamic Magnetic Resonance Imaging and Its Correlation. 伪装成乳腺癌的乳腺硬纤维瘤病:动态磁共振成像的价值及其相关性。

The journal of breast health

Pub Date : 2020-05-20 DOI: 10.5152/ejbh.2020.5482

Wei Lin Ng, Sze Yong Teoh, M. See, K. Rahmat, P. Jayalakshmi, M. T. Ramli, M. Teh, A. Vijayananthan

Desmoid type fibromatosis of the breast is a rare stromal tumor that accounts for <0.2% of all breast tumors. Bilateral and multicentric lesions are extremely rare, with only less than ten cases reported in the literature. Although benign, it is locally aggressive with frequent recurrence in up to almost one-third of the cases. We experienced our first case of bilateral multicentric breast fibromatosis in a 19-year-old woman, with a paternal aunt diagnosed with breast cancer at age 30, who presented to our institution with the chief complaint of retracted nipples for 1 year. The patient denied any history of trauma to her chest. Sonography showed suspicious bilateral hypoechoic masses. Magnetic resonance imaging (MRI) was performed for further evaluation because of the extensive involvement of both the breasts. This report aimed to illustrate the main clinical, radiological, and histopathological characteristics of this rare disease to increase awareness of this entity and discuss the role of MRI.

乳腺筛状纤维瘤病是一种罕见的间质瘤，占所有乳腺肿瘤的＜0.2%。双侧和多中心病变极为罕见，文献中仅报道了不到10例。虽然是良性的，但它具有局部侵袭性，几乎三分之一的病例经常复发。我们经历了第一例双侧多中心乳腺纤维瘤病，患者为一名19岁的女性，其姑姑在30岁时被诊断为乳腺癌症，她在我们的机构就诊1年，主要症状是乳头退缩。病人否认胸部有任何外伤史。声像图显示可疑的双侧低回声肿块。由于双侧乳房广泛受累，因此进行了核磁共振成像（MRI）以进行进一步评估。本报告旨在说明这种罕见疾病的主要临床、放射学和组织病理学特征，以提高对这种疾病的认识，并讨论MRI的作用。

引用次数: 2

15th. National Breast Diseases Congress Abstract Book 第十五国家乳腺疾病大会摘要书

The journal of breast health

Pub Date : 2020-01-10 DOI: 10.5152/ejbh.2019.929092

引用次数: 0

Erratum. 勘误表。

The journal of breast health

Pub Date : 2020-01-01 DOI: 10.5152/ejbh.2019.231219

[This corrects the article on p. 105 in vol. 14, PMID: 29774319.].

[这更正了第14卷第105页的文章，PMID: 29774319.]

引用次数: 0

Erratum. 勘误表。

The journal of breast health

Pub Date : 2020-01-01 DOI: 10.5152/ejbh.2019.2312019

[This corrects the article on p. 173 in vol. 14, PMID: 30123884.].

[这是对第14卷第173页的文章的更正，PMID: 30123884]。

引用次数: 0

Diffusion-Weighted Imaging of Breast Cancer: Correlation of the Apparent Diffusion Coefficient Value with Pathologic Prognostic Factors. 癌症扩散加权成像：表观扩散系数和病理预后因素的相关性。

The journal of breast health

Pub Date : 2019-10-01 DOI: 10.5152/ejbh.2019.4860

Şehnaz Tezcan, N. Uslu, F. Öztürk, E. Akçay, T. Tezcaner

ObjectiveThe aim was to evaluate relationship between apparent diffusion coefficient (ADC) values with pathologic prognostic factors in breast carcinoma (BC).Materials and Methods83 patients were enrolled in this study. Prognostic factors included age, tumor size, expression of estrogen receptor (ER) and progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), nuclear grade (NG), lymph node involvement and histologic type. The relationship between ADC and prognostic factors was determined using Independent sample t-test, ANOVA, Pearson correlation and relative operating characteristics (ROC) analysis.ResultsThere was no significant difference between ADC and prognostic factors, including age, tumor size, ER, HER2 and histologic type. The PR-positive tumors (p=0.03) and axillary lymph node involvement (p=0.000) showed a significant association with lower ADC values. The ADC values were significantly lower in high-grade tumors than low-grade tumors (p=0.000). ROC analysis showed an optimal ADC threshold of 0.66 (×10-3 mm2/s) for differentiating low-grade tumors from high-grade tumors (sensitivity, 85.5%; specificity, 81%; area under curve, 0.90).ConclusionThe lower ADC values of BC were significantly associated with positive expression of PR, LN positivity and high-grade tumor. Especially, ADC values were valuable in predicting NG subgroups.

目的探讨表观扩散系数（ADC）值与乳腺癌病理预后因素的关系。材料与方法83例患者参加本研究。预后因素包括年龄、肿瘤大小、雌激素受体（ER）和孕激素受体（PR）的表达、人表皮生长因子受体2（HER2）、细胞核分级（NG）、淋巴结受累和组织学类型。ADC与预后因素之间的关系使用独立样本t检验、ANOVA、Pearson相关性和相对操作特征（ROC）分析来确定。结果ADC与年龄、肿瘤大小、ER、HER2和组织学类型等预后因素无显著差异。PR阳性肿瘤（p=0.03）和腋窝淋巴结受累（p=0.000）与ADC值降低显著相关。高级别肿瘤的ADC值显著低于低级别肿瘤（p=0.000）。ROC分析显示，区分低级别肿瘤和高级别肿瘤最佳ADC阈值为0.66（×10-3 mm2/s）（敏感性85.5%；特异性81%；曲线下面积0.90），LN阳性和高级别肿瘤。特别是ADC值在预测NG亚组方面有价值。

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引用次数: 6

Correlation between the Expression of PD-L1 and Clinicopathological Parameters in Triple Negative Breast Cancer Patients. 三阴性乳腺癌患者PD-L1表达与临床病理参数的关系

The journal of breast health

Pub Date : 2019-10-01 DOI: 10.5152/ejbh.2019.4912

Rabia Doğukan, R. Uçak, F. M. Doğukan, C. Tanık, B. Citgez, F. Kabukçuoğlu

ObjectiveTriple-negative breast cancer (TNBC) is a heterogenous group of tumors with no estrogen receptor (ER), progesterone receptor (PR) and Cerb-B2/HER2 expression. Programmed death ligand-1 (PD-L1) is a transmembrane protein located on both non-tumor and tumor cells and it has been shown to be associated with the escape of tumor cells from the immune system. PD-L1-targeted therapy alone or in combination is now an alternative strategy in several aggressive tumor types. In this respect, TNBC is a potential candidate having limited treatment options and poor outcome.Material and MethodsSixty-one breast cancers with no expression of ER, PR and Cerb-B2/HER2 were chosen to study PD-L1 immunohistochemistry. PD-L1 staining and its correlation with main clinicopathological parameters were evaluated.ResultsThe percentage of PD-L1 positivity was 37.7% and 47.5% in tumor and tumor microenvironment, respectively. The positivity rate was higher in breast carcinomas with medullary features (83.3%) and metaplastic carcinoma (66.6%) subgroups. PD-L1 expression of tumors was positively correlated with their Ki-67 score and PD-L1 positivity of the tumor microenvironment. No significant relationship was found between the other variables.ConclusionPD-L1 expression rate was remarkable both in the tumor and the tumor microenvironment of TNBCs. Larger cohorts of TNBC are required to further describe their PD-L1 expression characteristics and help standardize PD-L1 immunohistochemistry assays in these tumors.

目的:三阴性乳腺癌(triple -negative breast cancer, TNBC)是一种异质性肿瘤，无雌激素受体(ER)、孕激素受体(PR)和Cerb-B2/HER2表达。程序性死亡配体-1 (PD-L1)是一种位于非肿瘤细胞和肿瘤细胞上的跨膜蛋白，已被证明与肿瘤细胞逃离免疫系统有关。单独或联合pd - l1靶向治疗现在是几种侵袭性肿瘤类型的替代策略。在这方面，TNBC是一种潜在的候选者，治疗选择有限，结果不佳。材料与方法选择61例无ER、PR和Cerb-B2/HER2表达的乳腺癌患者进行PD-L1免疫组化研究。评价PD-L1染色与主要临床病理参数的相关性。结果PD-L1在肿瘤和肿瘤微环境中的阳性率分别为37.7%和47.5%。具有髓样特征的乳腺癌(83.3%)和化脓性癌(66.6%)亚组阳性率较高。肿瘤PD-L1表达与Ki-67评分及肿瘤微环境PD-L1阳性呈正相关。其他变量之间无显著关系。结论pd - l1在tnbc肿瘤及肿瘤微环境中的表达率均显著。需要更大的TNBC队列来进一步描述其PD-L1表达特征，并有助于标准化这些肿瘤中的PD-L1免疫组织化学分析。

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引用次数: 20

Comparison of Clinical Features and Treatment Results of Mix Mucinous Carcinomas and Other Atypical Carcinomas of the Breast. 乳腺混合粘液癌和其他不典型癌的临床特点及治疗效果比较。

The journal of breast health

Pub Date : 2019-10-01 DOI: 10.5152/ejbh.2019.5032

Mustafa Gök, Uğur Topal, Bahadır Öz, Hülya Akgün, Alper Celal Akcan, Erdoğan Mütevelli Sözüer

Objective: There are multiple subtypes of breast cancer with different biological and pathological features and accordingly exhibit different clinical behaviors. The aim of this study was to compare the treatment modalities, clinical features and prognostic characteristics of Mix Mucinous Carcinomas (MMBC) and other rare tumors of the breast.

Materials and method: A total of 2152 patients who were operated on for breast cancer in our clinic between 2010-2019, with pathological diagnoses of tubular, pure mucinous, mix mucinous or papillary carcinoma were enrolled in the study. Patients were divided into two groups as mix mucinous patients (Group1) and other rare tumors (Group2). The demographic, clinical and prognostic characteristics and treatment approaches were compared between Groups, and additionally between the subtypes of Group 2.

Results: 42 patients participated in our study. Group 1 consisted of 7 patients, and Group2 consisted of 35 patients. The subtypes in Group2 were papillary (n=21), pure mucinous (n=10) and tubular (n=4). Progesterone Receptor Positivity was found to be significantly higher in Group 2 patients than in Group1 patients (p=0.005, p<0.05). Multicentricity rates in the tumors of the patients in Group1 were found to be statistically significantly higher than the patients in Group 2 (p=0.024, p<0.05). In subtype analysis in Group2, there were no statistically significant differences parameters in the subgroups (p>0.05). Mean survival was 19.5+5.6 (8.5-30.5) months in Group 1 and 46.3+5.2 (36.1-56.6) months, in Group2 when evaluated separately (p:0.002).

Conclusion: The prognosis of pure mucinosis (PMBC) and other atypical cancers of the breast compared to the (MMBC) is quite good. Rare pathological types of breast cancer can have favorable outcomes when treated with necessary oncological principles.

目的癌症有多种亚型，具有不同的生物学和病理学特征，并表现出不同的临床行为。本研究的目的是比较混合粘液癌（MMBC）和其他罕见乳腺肿瘤的治疗方式、临床特征和预后特征。材料与方法2010-2019年间，我院共有2152例癌症患者接受了乳腺癌手术，病理诊断为管状癌、纯黏液癌、混合黏液癌或乳头状癌。将患者分为两组：混合粘液性患者（第1组）和其他罕见肿瘤（第2组）。比较两组之间以及2组亚型之间的人口统计学、临床和预后特征以及治疗方法。结果42名患者参与了我们的研究。第1组由7名患者组成，第2组由35名患者组成。第2组的亚型为乳头状（n=21）、纯粘液性（n=10）和管状（n=4）。第2组患者的孕酮受体阳性率显著高于第1组患者（p=0.005，p0.05）。单独评估时，第1组的平均生存期为19.5+5.6（8.5-30.5）个月，第2组的平均存活期为46.3+5.2（36.1-56.6）个月（p=0.002）。罕见的病理类型的癌症可以有良好的结果，当治疗必要的肿瘤学原则。

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引用次数: 0

Prognostic Importance of Ki-67 in Breast Cancer and Its Relationship with Other Prognostic Factors. Ki-67在乳腺癌预后中的重要性及其与其他预后因素的关系。

The journal of breast health

Pub Date : 2019-10-01 DOI: 10.5152/ejbh.2019.4778

G. Kanyilmaz, B. Yavuz, M. Aktan, M. Karaağaç, M. Uyar, S. Fındık

ObjectiveThe clinical feature of breast cancer is very heterogeneous because of the variable prognostic factors impact its behaviour. The aim of study is to find the prognostic importance of Ki-67 and to analyse the correlation between Ki-67 index and the other conventional prognostic factors in breast cancer patients.Materials and MethodsBetween 2010 and 2017, patients with invasive ductal carcinoma who received radiotherapy after surgery were included in study. A single pathologist re-defined of all cases retrospectively. Ki-67 were established three categories based on Ki-67 levels: low (<10%), intermediate (10-25%) and high (>25%).ResultsA total of 258 patients were included. 46 of 258 (18%) patients were in low, 82 of 258 (32%) patients were in intermediate and 130 of 258 (50%) patients were in high Ki-67 group. There were no correlations between menopausal status, age, and Ki-67 level. Low-pT stages tended to have low Ki-67 expression (p=0.07). Low-pN stages correlated with low Ki-67 values (p=0.007). Patients with ECE (+) were prone to have higher Ki-67 values (p=0.02). The significant correlation was seen between Ki-67 and tumour grading (p=<0.0001). Patients with LVI (+) had higher Ki-67 expression (p=0.007). Luminal A tumours were correlated with low Ki-67 group (p=<0.0001). Ki-67 values had significant effect on DFS (p=0.03) but not OS (p=0.09).ConclusionThis study showed that high Ki-67 expression is associated with higher pT-stage, higher pN-stage, higher grade, ER/PR negativity, HER2/neu positivity, ECE and LVI positivity. The prognostic impact of Ki-67 was only demonstrated for DFS.

目的乳腺癌的临床特征具有异质性，影响其预后的因素多种多样。本研究旨在发现Ki-67在乳腺癌患者预后中的重要性，并分析Ki-67指数与其他常规预后因素的相关性。材料与方法2010 - 2017年浸润性导管癌术后放疗患者纳入研究。一位病理学家对所有病例进行回顾性重新定义。Ki-67根据Ki-67水平分为低(25%)三类。结果共纳入258例患者。258例患者中46例(18%)为低Ki-67组，82例(32%)为中Ki-67组，130例(50%)为高Ki-67组。绝经状态、年龄与Ki-67水平无相关性。低pt期Ki-67表达较低(p=0.07)。低pn分期与低Ki-67值相关(p=0.007)。ECE(+)患者Ki-67值较高(p=0.02)。Ki-67与肿瘤分级有显著相关性(p=<0.0001)。LVI(+)患者Ki-67表达较高(p=0.007)。腔内A肿瘤与低Ki-67组相关(p=<0.0001)。Ki-67值对DFS有显著影响(p=0.03)，对OS无显著影响(p=0.09)。结论Ki-67高表达与高pt分期、高pn分期、高分级、ER/PR阴性、HER2/neu阳性、ECE和LVI阳性相关。Ki-67仅对DFS有预后影响。

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引用次数: 42

Determining Breast Cancer Treatment Costs Using the Top Down Cost Approach. 使用自顶向下成本法确定乳腺癌治疗费用。

The journal of breast health

Pub Date : 2019-10-01 DOI: 10.5152/ejbh.2019.4909

R. Tekin, Meltem Saygılı

ObjectiveBreast cancer is the most common type of cancer among women in Turkey, with approximately 15.000 breast cancer diagnoses each year. In this study, our goal was to determine annual direct medical costs of all breast cancer patients in Turkey with top down cost approach.Materials and MethodsData regarding patients who have been diagnosed with breast cancer and received health services from any hospital in Turkey in 2014 were used for the purpose of the study. Data were obtained from the MEDULA System for a total of 126.664 patient. Treatment of costs of patients were calculated based on types of patient admissions (inpatient/outpatient/intensive care) and costs of drugs and medical equipment. Indirect costs and out of pocket costs were not included.ResultsTotal medical costs of 126,664 patients was calculated as $116.792.107,9, with an average treatment cost per patient of $922,1. Based on types of patient admission, intensive care treatment had the highest average cost with $2.916.5. In metastatic breast cancer patients, average annual treatment cost per patient is $2.326,6, which is 2.8 times higher compared to non-metastatic breast cancer patients.ConclusionIn order to ensure effective resource allocation at micro and macro level, healthcare administrators have to learn costs of diseases with high incidence such as breast cancer. Results obtained from studies on disease costs calculated using the top down cost approach provide data on actual health services use and therefore are seen as important tools for healthcare administrators in terms of effective resource allocation.

目的乳腺癌是土耳其妇女中最常见的癌症类型，每年约有15,000例乳腺癌诊断。在这项研究中，我们的目标是用自上而下的成本法确定土耳其所有乳腺癌患者的年度直接医疗成本。材料和方法本研究使用了2014年在土耳其任何一家医院接受过乳腺癌诊断和医疗服务的患者的数据。数据来自MEDULA系统，共126.664例患者。患者的治疗费用是根据患者入院类型(住院/门诊/重症监护)以及药物和医疗设备的费用计算的。间接费用和自付费用不包括在内。结果126664例患者的总医疗费用为116.792.107,9美元，平均治疗费用为922.1美元。按入院病人类型划分，重症监护治疗的平均费用最高，为2916.5美元。在转移性乳腺癌患者中，每位患者的平均年治疗费用为2.326,6美元，是非转移性乳腺癌患者的2.8倍。结论为了保证微观和宏观资源的有效配置，医疗卫生管理者必须了解乳腺癌等高发疾病的成本。使用自顶向下成本方法计算疾病成本的研究结果提供了实际卫生服务使用情况的数据，因此被视为卫生保健管理人员有效分配资源的重要工具。

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