1/132. Fine-needle aspiration cytology of cystic hypersecretory ductal carcinoma in situ of the breast: a case report.Cystic hypersecretory intraductal carcinoma is an unusual, cystic form of intraductal breast carcinoma affecting middle-aged women. Cytopathologists have rarely encountered this lesion, with only 2 other cases having been previously reported (Colandrea et al., Arch Pathol Lab Med 1988:112:560-563; Kim et al., Acta Cytol 1997;41:892-896). In our cases, the cytologic findings of both air-dried, Diff-Quick-stained and ethanol-fixed, Papanicolaou-stained smears are presented. The cytologic hallmarks of this entity include the presence of a few scattered epithelial cells with bland nuclear morphology in a background of extensive, amorphous, pink-staining material. Cytomorphologically, the differential diagnosis includes other entities containing pink-staining material such as colloid carcinoma, mucocele-like lesion of the breast, and benign fibrocystic change.- - - - - - - - - - ranking = 1keywords = breast (Clic here for more details about this article) |
2/132. carcinosarcoma, endometrial intraepithelial carcinoma and endometriosis after tamoxifen therapy in breast cancer.The fourth case of heterologous mesodermal tumour of the uterine corpus, that developed, years following tamoxifen therapy for breast cancer in a postmenopausal woman with no previous pelvic irradiation, is presented with coincidental endometriosis and endometrial intraepithelial carcinoma. This coincidence after tamoxifen treatment appears to be an indication for the possible carcinogenic potency of tamoxifen.- - - - - - - - - - ranking = 0.83333333333333keywords = breast (Clic here for more details about this article) |
3/132. The potential oncogenic effect of tamoxifen on the endometrium.We report the case of an in-situ endometrial adenocarcinoma with severe atypical hyperplasia which developed while the patient was on tamoxifen only 1 year after endometrial resection for benign pathology. A 55-year-old woman received tamoxifen as adjuvant therapy for breast cancer treated in 1994. At that time, a benign endometrial polyp was also removed before initiating tamoxifen treatment. In 1997, endometrial resection was performed for benign pathology (atrophic cystic endometrium). In 1998, an endometrial adenocarcinoma was diagnosed. This case illustrates that endometrial resection does not protect women taking tamoxifen against subsequent development of severe atypical lesions.- - - - - - - - - - ranking = 0.16666666666667keywords = breast (Clic here for more details about this article) |
4/132. Observations on the histopathologic diagnosis of microinvasive carcinoma of the breast.Our histopathologic criteria for diagnosing microinvasive carcinoma of the breast may be enunciated as follows: (1) cytologically malignant cells in the stroma associated with in situ carcinoma, (2) absence of basement membrane and myoepithelial cells around the invasive cells, (3) frequent accompanying stromal alterations in the form of myxomatous change and loosening of connective tissue, and (4) the frequent presence of an inflammatory cell infiltrate composed of lymphocytes and plasma cells. Most or all of these four features are present in cases of ductal microinvasive carcinoma of the breast, but the lobular type is not likely to be accompanied by stromal changes or a lymphoplasmacytic cell infiltrate. The minimum information regarding microinvasive carcinoma of the breast that should be conveyed in the final pathology report includes size as measured by the ocular micrometer or a statement that microinvasion refers to a lesion smaller than 1 mm, the number of foci of invasion, and the spatial distribution of the invasive foci. The nuclear grade of the invasive cells and the size, type, and nuclear grade of the accompanying DCIS should be specified. The status of margins, presence of vascular channel involvement (a rarity in microinvasive carcinoma of the breast), and degree of proliferative changes in adjacent nonneoplastic breast tissue should be reported. Immunostains for basement membrane and myoepithelial cells may be helpful in the diagnosis of microinvasive carcinoma of the breast. Sclerosing lesions such as radial scar and sclerosing adenosis can simulate microinvasive carcinoma of the breast, especially when the latter is associated with in situ carcinoma. Caution should be exercised in cases wherein in situ malignant cells may be dislodged by needling procedures or during dissection of the excised specimen. cautery-induced artifacts also hinder optimal histologic assessment. In some cases, it is virtually impossible to determine if true invasion is present, and the statement "microinvasive carcinoma of the breast cannot be entirely excluded" may be employed as a last resort. We consider the latter diagnosis to be the last refuge of the diligent pathologist and do not recommend it unless all diagnostic measures, including examination of deeper levels and supplemental stains, have been exhausted. It may be necessary to seek an expert opinion in "difficult" cases, particularly in the event that therapeutic decisions are to be based on the determination of invasion. From a clinical perspective, the management of microinvasive carcinoma of the breast ought to be dictated by the individual circumstances in each case. Based on currently available data, which admittedly suffer from lack of diagnostic uniformity, the vast majority of patients with microinvasive carcinoma of the breast will be node-negative and can look forward to an excellent prognosis. It is hoped that since the UICC has adopted a previously recommended definition of microinvasive carcinoma of the breast, prospective or retrospective studies with uniform diagnostic criteria will be conducted that will enable more definitive conclusions regarding the treatment and prognosis of microinvasive carcinoma of the breast.- - - - - - - - - - ranking = 2.6666666666667keywords = breast (Clic here for more details about this article) |
5/132. calcium oxalate crystals (Weddellite) within the secretions of ductal carcinoma in situ--a rare phenomenon.A case is described in which calcium oxalate (Weddellite) crystals were identified in an area of ductal carcinoma in situ of the breast. Seventy other cases were examined but no evidence of Weddellite was detected. This is evidently a rare phenomenon in carcinoma in situ.- - - - - - - - - - ranking = 0.16666666666667keywords = breast (Clic here for more details about this article) |
6/132. Lobular carcinoma-in-situ within a fibroadenoma of the breast.We present a case of an in-situ lobular carcinoma within an otherwise benign fibroadenoma in a 45-year-old woman.- - - - - - - - - - ranking = 0.66666666666667keywords = breast (Clic here for more details about this article) |
7/132. Microinvasive carcinoma of the breast: can it be diagnosed reliably and is it clinically significant?Deciding whether in-situ breast carcinoma is associated with microinvasion is a common problem. Histological features resembling invasion can be simulated by in-situ carcinoma distorted by inflammatory and reparative changes. Having expended the effort to diagnose genuine microinvasion, just how useful is this diagnosis in planning further treatment and follow-up? In the following articles, Hoda et al. comment on the utility of immunohistochemistry in resolving uncertainty about the presence of microinvasion, and Ellis et al. critically appraise the definition of microinvasion and its clinical significance.- - - - - - - - - - ranking = 0.83333333333333keywords = breast (Clic here for more details about this article) |
8/132. Sebaceous carcinoma of the breast.We report on a rare distinctive variant of infiltrating ductal carcinoma characterized by sebaceous differentiation of tumor cells. The neoplasm was identified in a lumpectomy specimen from a 45-year-old woman with extensive metastatic disease. In addition to conventional in situ and invasive ductal components, approximately half of the tumor cells exhibited a phenotype resembling tumors of the sebaceous skin appendage with coarsely vacuolated cytoplasm and peripherally displaced nuclei. The sebaceous moiety was also present in the distant metastatic deposits. There was no evidence of mucin production by tumor cells. Ultrastructurally, empty-appearing non-membrane bound vacuoles attested to the sebaceous cells' lipid content. The immunoprofile of the lesion included positivity for cytokeratin and epithelial membrane antigen. vimentin, S100 protein and carcinoembryonic antigen were not expressed. Most tumor cell nuclei reacted with antibodies to oestrogen and progesterone receptors but failed to show overexpression of the HER2/neu protein. The MIB-1 labeling index averaged 16%. At variance with sebaceous breast carcinomas on record, the present case is notable for its prolonged clinical course.- - - - - - - - - - ranking = 0.83333333333333keywords = breast (Clic here for more details about this article) |
9/132. Signet-ring cell carcinoma of the breast.Primary signet-ring cell carcinoma of the breast is a very rare tumor and is not recognized as an independent entity of the world health organization classification of breast tumor. Primary signet-ring cell carcinoma of the breast is usually considered as a variant of mucinous carcinoma or lobular carcinoma and usually originates from the lobular epithelium. A case of primary signet-ring cell carcinoma of the breast in a 68-year-old woman is presented. Histologically, the majority of neoplastic cells had an intracytoplasmic mucin collection. The histological presence of ductal carcinoma in situ, absence of lobular lesion and immunoreactivity for estrogen and progesterone receptors implicated the tumor cells arising from ductal epithelium. The papillary or organoid growth pattern is characteristic in this case. The patient underwent a modified radical mastectomy and was subsequently followed up for 6 months.- - - - - - - - - - ranking = 1.3333333333333keywords = breast (Clic here for more details about this article) |
10/132. Carcinoma in a fibroadenoma.A carcinoma arising within a fibroadenoma is an unusual occurrence, with only a little over 100 reported cases. The purpose of this report is to increase the awareness of this entity and to discourage the practice of rendering a diagnosis on gross examination of the tumor. We are reporting a case with two distinct primary tumors within the same breast, one of which was arising within the fibroadenoma. Only two such cases have been previously reported.- - - - - - - - - - ranking = 0.16666666666667keywords = breast (Clic here for more details about this article) |
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