1/106. Gastric cancer in pregnancy: do pregnancy, age or female sex alter the prognosis? case reports and review.The coincidence of gastric cancer and pregnancy is a rare event. By literature research of the last three decades only 31 cases from outside japan were identified including two own patients. The analysis of these and another 61 cases from japan revealed the same predominance of poorly differentiated diffuse carcinomas with peritoneal and lymphatic metastases as in other young patients (<40 years). The survival rate is not obviously affected by pregnancy, young age or female sex. Experimental and epidemiological data suggest a protective effect of oestrogen against the induction of (intestinal) gastric cancer, while the cancer growth itself seems to be enhanced. Oestrogen receptors (ER) are found in about 22% of gastric cancer cells, especially in the poorly differentiated type. In contrast to target organs like the breast, ER in gastric cancer seem to be a sign of tumour adaptation involving e.g. the pathway of the epidermal growth factor. The results of treatment with anti-oestrogen are controversial in experimental and clinical settings. Due to the very common epigastric complaints early diagnosis of gastric cancer is even more difficult in pregnancy, so that early gastroscopy is advisable in patients on risk. Main effort should be given, however, to primary prevention.- - - - - - - - - - ranking = 1keywords = breast (Clic here for more details about this article) |
2/106. cardiac tamponade as an unusual presentation of advanced breast cancer in pregnancy.BACKGROUND: breast cancer is the most commonly diagnosed cancer in pregnancy. Though the prognosis by stage is not different from that in nonpregnant women, it is more likely to present at an advanced stage in pregnancy. CASE: A 28-year-old primigravida presented with dyspnea and pleuritic chest pain. The workup revealed cardiac tamponade. pericardiocentesis and subsequent pericardial window were performed. Cytology of the pericardial fluid revealed poorly differentiated adenocarcinoma. ultrasonography displayed a right breast mass, and biopsy identified it as the primary source of the cancer. CONCLUSION: cardiac tamponade is an unusual presentation of advanced breast cancer. To the best of our knowledge, it has not previously been described as occurring in pregnancy.- - - - - - - - - - ranking = 6keywords = breast (Clic here for more details about this article) |
3/106. Multimodal cancer chemotherapy during the first and second trimester of pregnancy: a case report.This paper reports treatment with combined chemotherapy during pregnancy. A 39-year-old woman with breast cancer was given adjuvant chemotherapy including cyclophosphamide, methotrexate and 6-fluorouracil from the 6th to the 24th week of gestation. The possibility of teratogenic effects on the fetus was explained to the patient however she refused to terminate the pregnancy. A 30-week male infant with only a minor malformation was delivered. The authors reviewed the literature regarding chemotherapeutic agents given during the first trimester of pregnancy. Most cytotoxic drugs have teratogenic effects on experimental animal subjects. However, actual data on human fetuses are sparse because of the variety of therapeutic regimens and the rarity of administering chemotherapy during pregnancy. The long-term effects of exposure to cytotoxic drugs in utero, needs further research.- - - - - - - - - - ranking = 1keywords = breast (Clic here for more details about this article) |
4/106. breast metastases from cutaneous melanoma: a report of three cases.In this report we describe three female patients with breast metastases from cutaneous melanoma (CM) who were treated in slovenia in the period from 1988 to 1991. We found that in 476 Slovenian patents with this disease diagnosed in the given period CM disseminated to the breast less frequently than in other series. In one pregnant and one perimenopausal patient breast involvement by CM was confirmed at the time of widespread dissemination of the disease. Treatment was not effective and the survival of these patients was four months and two weeks and six months, respectively. A slightly better outcome was observed in a normally menstruating patient referred from another country with an isolated solitary breast metastasis from CM. In this patient quadrantectomy seemed to have been sufficient to achieve a disease-free interval of more than eight months. Special attention should therefore be given to a small subset of patients with isolated solitary breast metastases from CM, since their prognosis may be less dismal than in patients with massively infiltrated breasts and disseminated disease.- - - - - - - - - - ranking = 6keywords = breast (Clic here for more details about this article) |
5/106. Angiosarcoma of the breast complicating pregnancy.A 32-year-old pregnant lady presented with a rapidly enlarging right breast mass. A fine needle aspiration was suggestive of a malignant phylloides tumour. However histopathological examination after mastectomy revealed a moderately differentiated angiosarcoma. The histopathological and cytological features of this rare tumour together with the diagnostic pitfalls are discussed.- - - - - - - - - - ranking = 5keywords = breast (Clic here for more details about this article) |
6/106. Giant-sized condyloma of the breast with focal acantholytic changes.BACKGROUND: A healthy 26-year-old pregnant woman presented with a 6.0-cm exophytic mass in her left inframammary fold. The lesion was surgically excised. methods: Histopathologic sections of the skin lesion were reviewed in hematoxylin and eosin-stained slides. Additional sections were studied by an in situ hybridization method for human papillomavirus dna (HPV) types 6 and 11. RESULTS: The histopathologic examination demonstrated a benign exophytic, verrucous and papillary epidermal proliferation with features of condyloma acuminatum. Reactivity to HPV dna types 6 and 11 was demonstrated by in situ hybridization method. The epidermis adjacent to, and focally within, the neoplasm showed multiple areas of suprabasilar and intraepidermal acantholysis without dyskeratosis. CONCLUSIONS: Condylomas related to HPV 6 and 11 may be found in extragenital locations including conjunctiva, oral and nasal mucosa. To our knowledge, however, the extragenital condylomas described in the literature have not included the giant-sized variant. We describe an example of a benign, giant-sized condyloma acuminatum of the breast with nearby acantholytic alterations similar to Hailey-Hailey disease.- - - - - - - - - - ranking = 5keywords = breast (Clic here for more details about this article) |
7/106. breast carcinoma presenting during or shortly after pregnancy and lactation.CONTEXT: Much has been written about the clinical management and prognosis of breast carcinomas presenting during pregnancy and lactation, yet little is known about the detailed histopathology of these tumors. OBJECTIVE: To determine whether these carcinomas have any specific diagnostic features. DESIGN: A detailed histologic and immunohistochemical study of 14 cases of breast carcinoma presenting during or shortly after pregnancy or lactation was conducted. The findings were compared with a control group of 13 tumors developing in age-matched women with no recent history of pregnancy or lactation. SETTING: The histopathology department of a tertiary referral teaching hospital. RESULTS: Tumors in the pregnancy/lactation group had a significantly higher incidence of cancerization of lobules (79% vs 15%) and of grade III invasive ductal carcinomas (80% vs 33%). Tumors occurring during lactation were either totally or partly mucinous and were MUC2 positive. Tumors occurring during pregnancy, but not during lactation, were mostly estrogen and progesterone receptor negative (4/5 and 5/5, respectively). All tumors occurring during pregnancy and lactation that were tested for c-erbB-2 overexpression were negative, whereas all 4 tumors tested that occurred shortly after delivery or cessation of lactation were positive for c-erbB-2 overexpression. The incidence of axillary lymph node metastasis was high in both the study and control groups, although it was slightly higher in the control group (78% and 90%, respectively). CONCLUSIONS: Although breast carcinomas diagnosed during or shortly after pregnancy and lactation have features in common with those developing in women of similar ages, particularly with respect to a high incidence of lymph node metastasis, the findings of this study suggest that they may also have distinct morphologic and immunohistochemical features of their own. Such features may vary according to whether the patient was pregnant, lactating, or had recently terminated her pregnancy or lactation at the time of surgical excision. Examination of more cases would help confirm these findings.- - - - - - - - - - ranking = 3keywords = breast (Clic here for more details about this article) |
8/106. Postoperative tailored radiotherapy for locally advanced breast carcinoma during pregnancy: a therapeutic dilemma.A 45-year-old woman with breast carcinoma was found to be pregnant during postoperative radiotherapy. The pregnancy was desired. We performed in vivo and phantom radiation dosimetry. No effects on the embryo or treatment disadvantages for the patient were expected. Thirty-six months post partum the baby is healthy and the mother is free of disease.- - - - - - - - - - ranking = 5keywords = breast (Clic here for more details about this article) |
9/106. Disseminated Burkitt's-like lymphoma during pregnancy.The occurrence of Burkitt's-like lymphoma (BL) during pregnancy is rarely diagnosed and its outcome is poor. A case of BL localized in the uterus, ovaries and breast during the course of pregnancy is presented. The patient was treated with a combination of surgery and chemotherapy and was disease-free for 6 months after the diagnosis.- - - - - - - - - - ranking = 1keywords = breast (Clic here for more details about this article) |
10/106. Bilateral cystosarcoma phyllodes of the breast: a case report of malignant form with contralateral benign form.Bilateral cystosarcoma phyllode is uncommon; bilateral tumors, either synchronous or metachronous, are generally either benign or malignant. We report one case of bilateral synchronous cystosarcoma phyllode in a 32-year-old pregnant woman. The left breast mass, measuring 21 x 17 x 10 cm, was classified as malignant cystosarcoma phyllode (high cellularity, stromal overgrowth, marked nuclear atypia, necrosis, mitotic rate = 4 mitoses/10 high power field, infiltrative margin). The right 9 x 9 cm mass was a benign cystosarcoma phyllode tumor (low to moderate cellularity, discrete nuclear atypia, mitotic rate = 1 mitoses/10 high power field, no necrosis, pushing margin). The patient had a left-sided mastectomy and a complete local excision with clear margin of the right breast mass. The patient is free of disease with a 17-month follow-up.- - - - - - - - - - ranking = 6keywords = breast (Clic here for more details about this article) |
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