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Overexpression of HER2/neu and estrogen receptors (ER) and/or progesterone receptors (PR) are reported to be inversely associated with breast cancer (BC). The relationship between hormone receptors and HER2/neu is attenuated by age and numerous other clinical factors. Here, we examined the link between hormone receptors and HER-2/neu in terms of an additional variable, such as the histological grades of breast tumors in women. A total of 240 breast cancer samples were obtained from the Department of Histopathology at the University of Lahore Teaching Hospital in Lahore, Punjab. Immunohistochemistry (IHC) was used to examine the expression of hormone receptors and HER-2/neu. Using the χ2 and fisher exact test, the association between hormone receptors and HER-2/neu in various age groups and histological grades was investigated. Patients that were included in this study had ages between 30 and 90 years, with a mean age of 51.89 ± 12.01 years, and were mostly having grade 1 tumors. The most prevalent type of breast cancer was invasive ductal carcinoma (95.83%). It was found that the ER, PR, and HER-2/neu were more expressive in older (above 45) and grade 1 tumors as compared to younger (≤45) and higher-grade tumor patients. HER-2 was negatively correlated with hormonal receptors in women aged >45 years old with grade-1 tumors. Hormonal receptor (ER/PR) expression is asso)ciated with HER-2/neu expression not only in older age (>45) but also in grade 1 tumors. This correlation between HER2/neu and hormone receptors that improves with age and tumor grade is useful for predicting outcomes and, likely, for guiding therapy choices. [ABSTRACT FROM AUTHOR]

Granulomatous response associated with breast cancer and within the draining lymph nodes is an extremely rare phenomenon. In this study, we are presenting a series of 4 cases of invasive ductal carcinoma showing both caseating and noncaseating granulomas within the ipsilateral draining axillary lymph nodes. We also discussed the pathogenesis of granulomatous response and its clinicopathologic significance. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Male breast cancer is rare and accounts for less than 1% of all breast cancer cases worldwide.This retrospective cohort study included all patients of invasive male breast cancer treated with curative intent by a trimodality approach via a multidisciplinary team at an academic university hospital in India between 2009 and 2023. Records were identified from a prospectively maintained database. Clinicopathological parameters, treatment details and survival were recorded and analysed.Thirty‐four patients were included. The median (IQR) age was 55(44–63) years. Most patients were overall stage III (74%) and node positive (79%) with Scarff‐Bloom‐Richardson grade II (50%). Twenty‐five patients (73%) were oestrogen receptor (ER) positive. Lymphovascular space invasion (LVSI) and perineural invasion (PNI) were present in 62% and 21% of patients, respectively. The most common chemotherapy timing was adjuvant (53%) followed by neoadjuvant (41%), and the most commonly used regimen consisted of a combination of doxorubicin‐cyclophosphamide followed by a taxane (53%). Most (85%) patients underwent a mastectomy, five patients underwent breast conservation. All patients received radiotherapy to a dose of 42.6 Gy in 16 fractions, followed by a tumour bed boost for those undergoing breast conservation. At a median follow‐up of 70 months (range 10–159 months), the five and ten‐year overall survival was 91% and 58%, and the five‐year disease‐free survival (DFS) was 67%. The median DFS was 72 months. On univariate analysis, the tumour sub‐type (Luminal versus TNBC) significantly predicted DFS (P = 0.03 log‐rank).Breast cancer in males has a high incidence of node positivity, ER positivity and LVSI. Even with advanced stages at presentation, trimodality therapy in a multidisciplinary setting offers good long‐term outcomes. [ABSTRACT FROM AUTHOR]

Breast cancer risk factors include lifestyle, genetic–hormonal influences, and viral infections. Human papillomavirus (HPV), known primarily as the etiological agent of cervical cancer, also appears active in breast carcinogenesis, as evidenced in our study of 56 patients from northeastern Brazil. We assessed the clinical and sociodemographic characteristics, correlating them with various breast cancer tumor types. HPV detection involved amplifying the L1 region, with viral load measured using the E2/E6 ratio and viral activity indicated by E5 oncogene expression. Predominantly, patients over 56 years of age with healthy lifestyles showed a high incidence of invasive ductal carcinoma and triple-negative breast cancer. HPV was detected in 35.7% of cases, mostly HPV16, which is associated with high viral loads (80 copies per cell) and significant E5 expression. These results hint at a possible link between HPV and breast carcinogenesis, necessitating further studies to explore this association and the underlying viral mechanisms. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is considered an important public health topic owing to its high incidence, occurrence, and death rate. It is a multi-faceted disease with both environmental and genetic causal factors. It is the first of the 10 most popular tumors triggering public concern in Iraq, compensating for 20% of all cancers and approximately 33 % of the total female cancers. This study aimed to study the demographic characteristics of female individuals identified recently as having breast cancer with the clinical features as tumor characteristics, and stage at time of diagnosis. Methods: A descriptive cross-sectional study was accomplished in the early detection of breast cancer clinic. Seventy women recently diagnosed as having breast cancer were included in the study. Purposive sampling was done, all women attending the clinic and recently identified with breast cancer based on clinical examination, imaging findings, and confirmed by histopathological assessment were included. The data was collected for those patients including; demographical, clinical, and histopathological findings, and were statistically analyzed. Results: The mean age of females who participated in the study was 52.2±10.5 years. A positive family member's history of carcinoma of the breast was reported in (21.4%) of patients. Most patients presented with a painless palpable mass (74.3%). Stage II breast carcinoma was the predominance stage while invasive ductal carcinoma was the most common histological type (74.3%). Conclusions: At the time of diagnosis, a considerable majority of female breast cancer patients have locally progressed disease, with the most common complaint being a painless breast lump. [ABSTRACT FROM AUTHOR]

Breast cancer, a prominent contributor to global cancer-related deaths, is a substantial health obstacle for women. Of all the several types of breast cancers, invasive ductal carcinoma is the most prevalent histological subtype, which includes ductal carcinoma, inflammatory breast cancer, invasive lobular carcinoma, and breast carcinoma. Although there have been improvements in traditional treatment methods, it is still crucial to develop more accurate and efficient therapies. CRISPR technology, which stands for clustered, regularly interspaced short palindromic repeats, has become a ground-breaking tool in the fight against breast cancer. This article provides an overview on the prospective application of CRISPR technology to explore breast cancer and its capacity to transform the identification and therapy of breast carcinoma. Presently, the research community is actively exploring targeted approaches to utilize CRISPR for the purpose of selectively modifying crucial genes linked to breast cancer, surmounting resistance to therapy, and improving the precision of diagnostic methods. Researchers are utilizing the accuracy and CRISPR technology's adaptability to create new tactics & strategies for addressing breast cancer and triple negative breast carcinoma (TNBC), providing renewed optimism for patients and healthcare practitioners. [ABSTRACT FROM AUTHOR]

Abstract Background Invasive ductal carcinoma (IDC) is the most common form of breast cancer which accounts for 85% of all breast cancer diagnoses. Non-invasive and early stages have a better prognosis than late-stage invasive cancer that has spread to lymph nodes. The involvement of microRNAs (miRNAs) in the initiation and progression of breast cancer holds great promise for the development of molecular tools for early diagnosis and prognosis. Therefore, developing a cost effective, quick and robust early detection protocol using miRNAs for breast cancer diagnosis is an imminent need that could strengthen the health care system to tackle this disease around the world. Methods We have analyzed putative miRNAs signatures in 100 breast cancer samples using two independent high fidelity array systems. Unique and common miRNA signatures from both array systems were validated using stringent double-blind individual TaqMan assays and their expression pattern was confirmed with tissue microarrays and northern analysis. In silico analysis were carried out to find miRNA targets and were validated with q-PCR and immunoblotting. In addition, functional validation using antibody arrays was also carried out to confirm the oncotargets and their networking in different pathways. Similar profiling was carried out in Brca2/p53 double knock out mice models using rodent miRNA microarrays that revealed common signatures with human arrays which could be used for future in vivo functional validation. Results Expression profile revealed 85% downregulated and 15% upregulated microRNAs in the patient samples of IDC. Among them, 439 miRNAs were associated with breast cancer, out of which 107 miRNAs qualified to be potential biomarkers for the stratification of different types, grades and stages of IDC after stringent validation. Functional validation of their putative targets revealed extensive miRNA network in different oncogenic pathways thus contributing to epithelial-mesenchymal transition (EMT) and cellular plasticity. Conclusion This study revealed potential biomarkers for the robust classification as well as rapid, cost effective and early detection of IDC of breast cancer. It not only confirmed the role of these miRNAs in cancer development but also revealed the oncogenic pathways involved in different progressive grades and stages thus suggesting a role in EMT and cellular plasticity during breast tumorigenesis per se and IDC in particular. Thus, our findings have provided newer insights into the miRNA signatures for the classification and early detection of IDC.

Ectopic breast tissue (EBT) is breast tissue located outside the normal anatomic boundaries of the breasts, developing due to incomplete embryological regression of the mammary ridges. EBT can develop anywhere along the milk line, with the axilla being the most common site. While generally benign, EBT can undergo malignant transformation. This case report discusses a 24-year-old female with locally advanced invasive ductal carcinoma in the axillary EBT, highlighting its clinical presentation, diagnostic process, and management in a resource-limited setting. The patient underwent wide local excision and axillary lymph node dissection followed by adjuvant chemotherapy and radiotherapy, achieving a favorable short-term outcome. This case underscores the importance of considering EBT in differential diagnosis of axillary masses and the need for tailored treatment strategies in such settings. [ABSTRACT FROM AUTHOR]

Background: Invasive ductal carcinoma (IDC) is the most common form of breast cancer which accounts for 85% of all breast cancer diagnoses. Non-invasive and early stages have a better prognosis than late-stage invasive cancer that has spread to lymph nodes. The involvement of microRNAs (miRNAs) in the initiation and progression of breast cancer holds great promise for the development of molecular tools for early diagnosis and prognosis. Therefore, developing a cost effective, quick and robust early detection protocol using miRNAs for breast cancer diagnosis is an imminent need that could strengthen the health care system to tackle this disease around the world. Methods: We have analyzed putative miRNAs signatures in 100 breast cancer samples using two independent high fidelity array systems. Unique and common miRNA signatures from both array systems were validated using stringent double-blind individual TaqMan assays and their expression pattern was confirmed with tissue microarrays and northern analysis. In silico analysis were carried out to find miRNA targets and were validated with q-PCR and immunoblotting. In addition, functional validation using antibody arrays was also carried out to confirm the oncotargets and their networking in different pathways. Similar profiling was carried out in Brca2/p53 double knock out mice models using rodent miRNA microarrays that revealed common signatures with human arrays which could be used for future in vivo functional validation. Results: Expression profile revealed 85% downregulated and 15% upregulated microRNAs in the patient samples of IDC. Among them, 439 miRNAs were associated with breast cancer, out of which 107 miRNAs qualified to be potential biomarkers for the stratification of different types, grades and stages of IDC after stringent validation. Functional validation of their putative targets revealed extensive miRNA network in different oncogenic pathways thus contributing to epithelial-mesenchymal transition (EMT) and cellular plasticity. Conclusion: This study revealed potential biomarkers for the robust classification as well as rapid, cost effective and early detection of IDC of breast cancer. It not only confirmed the role of these miRNAs in cancer development but also revealed the oncogenic pathways involved in different progressive grades and stages thus suggesting a role in EMT and cellular plasticity during breast tumorigenesis per se and IDC in particular. Thus, our findings have provided newer insights into the miRNA signatures for the classification and early detection of IDC. [ABSTRACT FROM AUTHOR]

Purpose: To explore the value of ultrasound (US) characteristics in diagnosing breast fibromatosis (BF) and evaluate their differences from breast carcinoma. Methods: A total of 121 patients with BF (n = 24, 29 lesions) or invasive ductal carcinoma (IDC) (n = 97, 102 lesions) of the breast were included. Their clinical and US findings were recorded and analyzed. Results: The mean age of BF was younger than that of IDC (28.75 ± 5.55 vs. 50.19 ± 9.87, p < 0.001). The mean size of the BF was smaller than that of IDC (2.09 ± 0.91 vs. 2.71 ± 1.20, p = 0.011). Compared to IDC, BF had more frequency of posterior echo attenuation (p < 0.001), less frequency of peripheral hyperechoic halo (p = 0.002), calcification (p = 0.001), US reported axillary lymph node positive (p = 0.025), and grade 2–3 vascularity (p < 0.001). The Breast Imaging Reporting and Data System categorized BF at a lower level than IDC (p < 0.001). After adjusting for age, the peripheral hyperechoic halo, posterior echo feature, and vascularity could independently identify the differences between these two entities. Conclusion: Some differences were observed between BF and IDC in terms of patient age, lesion size, and US characteristics. [ABSTRACT FROM AUTHOR]

Background: Breast cancer in males is a rare disease with an estimated incidence of 0.5-1% of all breast cancer cases. However recent data show that incidence is slowly rising but epidemiological data regarding Male Breast Cancer is little as compared to Female Breast Cancer due to the rarity of this disease. It is mostly seen in elderly men in the 6th or 7th decade of life. They usually present at an advanced stage with a poor prognosis as compared to FBC. This study is aimed to analyze the epidemiologic, and clinicopathological behavior of male breast cancer patients. Methods: This work is the prospective work of 11 male breast cancer patients who were presented in department of General Surgery Rims, Ranchi during a period of 1 year. Data regarding clinical history, examination findings, family history, stage of the disease, histopathological examination and hormonal status were evaluated. Results: Results showed that male breast cancer occurs later in life with median age being 58.5 years. The average diagnosis delay was 6.6 months. Out of eleven patients, eight of them had involvement of the left breast while the other three had involvement of right side of breast. Invasive ductal carcinoma was the histological type found in nine cases. Ten patients presented an advanced stage of T4 while one patient presented at T3. Hormone receptors were positive in 81.8% cases. Conclusion: To conclude male breast cancer is a rare disease with multiple and varied risk factors. It is similar in clinical, histological and prognostic characteristic to breast cancer in women but also has varied characteristics. We suggest that for early diagnosis and enhanced prognosis, teaching self-breast examination in males, screening mammography and testing for familial predisposition shall be helpful in high risk groups. Therefore, there is a requirement for more free awareness public programmes to educate males about breast cancer and promote its early detection. [ABSTRACT FROM AUTHOR]

Breast cancer, particularly Invasive Ductal Carcinoma (IDC), is a primary global health concern predominantly affecting women. Early and precise diagnosis is crucial for effective treatment planning. Several AI-based techniques for IDC-level classification have been proposed in recent years. Processing speed,memory size, and accuracy can still be improved for better performance. Our study presents ECAM, an Enhanced Channel-Wise Attention Mechanism, using deep learning to analyze histopathological images of Breast Invasive Ductal Carcinoma (BIDC). The main objectives of our study are to enhance computational efficiency using a Separable CNN architecture, improve data representation through hierarchical feature aggregation, and increase accuracy and interpretability with channel-wise attention mechanisms. Utilizing publicly available datasets, DataBioX IDC and the BreakHis, we benchmarked the proposed ECAM model against existing state-of-the-art models: DenseNet121, VGG16, and AlexNet. In the IDC dataset, the model based on AlexNet achieved an accuracy rate of 86.81% and an F1 score of 86.94%. On the other hand, DenseNet121 outperformed with an accuracy of 95.60% and an F1 score of 95.75%. Meanwhile, the VGG16 model achieved an accuracy rate of 91.20% and an F1 score of 90%. Our proposed ECAM model outperformed the state-of-the-art, achieving an impressive F1 score of 96.65% and an accuracy rate of 96.70%. The BreakHis dataset, the AlexNet-based model, achieved an accuracy rate of 90.82% and an F1 score of 90.77%. DenseNet121 achieved a higher accuracy rate of 92.66% with an F1 score of 92.72%, while the VGG16 model achieved an accuracy of 92.60% and an F1 score of 91.31%. The proposedECAMmodel again outperformed, achieving an F1 score of 96.37% and an accuracy rate of 96.33%. Our model is a significant advancement in breast cancer diagnosis, with high accuracy and potential as an automated grading, especially for IDC. [ABSTRACT FROM AUTHOR]

Background: The most common malignancy and second most common cause of death is breast cancer among women. About 2.09 million fatalities from breast cancer happened in 2018. The objective was to evaluate the elevated CA15-3 in breast cancer patients with visceral metastases presenting at the tertiary care hospital of Karachi. Methods: It was a cross-sectional study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from 15th December 2018 to 15th November 2019. Female patients aged 26-80 years diagnosed with visceral metastatic (defined as metastasis to lung, liver, brain and adrenal glands) breast cancer were included in the study. The diagnosis of breast cancer was confirmed on histopathology whereas the metastatic sites were evaluated using physical examination and imaging. The serum CA15-3 concentration was assessed using assay kits. The serum CA15-3 level of 0-32 U/ml was taken as normal range for all the patients whereas CA15-3 level greater than 32 U/L was considered as elevated CA15-3. SPSS version 23 was used to enter and analyze data. Results: A total of 139 females were included in the study. The mean age & BMI of the patients were reported as 46.5 years & 26.69 kg/m². In the majority of the patients' metastases were detected in the liver (n=54), 92 in the lungs+ parenchymal disease, 20 in adrenal glands, 12 in pleural effusion and 10 in the brain. Out of 139 patients with visceral metastases, 52(37.4%) had normal CA15-3 level whereas 87 (62.6%) had elevated serum CA15-3 levels (>32 U/L). Conclusion: The serum CA15-3 tumour marker is elevated significantly in visceral metastases and can be used as a prognostic marker in metastatic breast cancer patients. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common type of cancer in women, with one to eight women developing breast cancer in their lifetime. This study aims to investigate the effect of invasive ductal carcinoma on some physiological and immunological parameters in women with breast cancer. The methods: The current study at the National Cancer Centre in Al-Najaf province for the period between 8/15/2022 to 1/20/2023. this study included 60 women with breast cancer considered as the patients and 30 healthy women free of diseases considered a control group, both groups, their ages ranged between (30-68) years old, body mass index, erythrocyte sedimentation rate, C-reactive protein, iron stores (ferritin) and fetal carcinoembryonic antigen were estimated. Results: The results showed that invasive ductal carcinoma is the most prevalent type of breast cancer with a rate of 68.7% within the studied sample. As for metastasis, it was noted that stage 0 was the highest with a rate of 96.7%. The results of the disease stage also showed that stage 2 was the highest with a rate of 73.3%. The results showed an increase in body mass index (BMI) in the control group compared to the patients' group. A significant increase in the erythrocyte sedimentation rate (ESR) was also observed in women with breast cancer compared with the group of healthy women. The results of the statistical analysis also showed a significant increase in iron stores (Ferritin), CRP and CEA among the affected women compared with the healthy women. The results showed that there were no significant differences in the type of invasive ductal carcinoma compared to the invasive lobular carcinoma for the criteria represented by body mass index, and erythrocyte sedimentation rate. As for the levels of ferritin, C-reactive protein and CEA, the results of the statistical analysis showed that there was a significant increase in their levels in patients with invasive lobular carcinoma compared with the other group with invasive ductal carcinoma. The results also showed that there is an effect of the type of disease ((invasive ductal carcinoma)) on each of the erythrocyte sedimentation rate and CEA. Conclusions: the results obtained through the current study, we conclude that invasive ductal carcinoma is the most common type of breast cancer with an increase of ESR, CRP, ferritin and CEA in women with breast cancer. The effect of invasive ductal carcinoma on CEA and ESR criteria was more than invasive lobular carcinoma. [ABSTRACT FROM AUTHOR]

Background: Two‐dimensional synthetic MRI of the breast has limited spatial coverage. Three‐dimensional (3D) synthetic MRI could provide volumetric quantitative parameters that may reflect the immunohistochemical (IHC) status in invasive ductal carcinoma (IDC) of the breast. Purpose: To evaluate the feasibility of 3D synthetic MRI using an interleaved Look–Locker acquisition sequence with a T2 preparation pulse (QALAS) for discriminating the IHC status, including hormone receptor (HR), human epidermal growth factor receptor 2 (HER 2), and Ki‐67 expression in IDC. Study Type: Prospective observational study. Population: A total of 33 females with IDC of the breast (mean, 52.3 years). Field Strength/Sequence: A 3‐T, 3D‐QALAS gradient‐echo and fat‐suppressed T1‐weighted 3D fast spoiled gradient‐echo sequences. Assessment: Two radiologists semiautomatically delineated 3D regions of interest (ROIs) of the whole tumors on the dynamic MRI that was registered to the synthetic T1‐weighted images acquired from 3D‐QALAS. The mean T1 and T2 were measured for each IDC. Statistical Tests: Intraclass correlation coefficient for assessing interobserver agreement. Mann–Whitney U test to determine the relationship between the mean T1 or T2 and the IHC status. Multivariate logistic regression analysis followed by receiver operating characteristics (ROC) analysis for discriminating IHC status. A P value <0.05 was considered statistically significant. Results: The interobserver agreement was good to excellent. There was a significant difference in the mean T1 between HR‐positive and HR‐negative lesions, while the mean T2 value differed between HR‐positive and HR‐negative lesions, between the triple‐negative and HR‐positive or HER2‐positive lesions, and between the Ki‐67 level > 14% and ≤ 14%. Multivariate analysis showed that the mean T2 was higher in HR‐negative IDC than in HR‐positive IDC. ROC analysis revealed that the mean T2 was predictive for discriminating HR status, triple‐negative status, and Ki‐67 level. Data Conclusion: 3D synthetic MRI using QALAS may be useful for discriminating IHC status in IDC of the breast. Evidence Level: 1. Technical Efficacy: Stage 2. [ABSTRACT FROM AUTHOR]

Breast cancer is the most prevalent cancer in women worldwide, and its prevalence has increased since the introduction of screening programs. Most cases are discovered at an early stage; however, despite effective treatment, some cases progress to metastasis. The most common breast cancer metastatic locations are the bone, liver, and lungs. Ascites malignant due to peritoneal involvement is a rare manifestation of metastatic breast cancer. After 8 years of well-controlled breast cancer, we report a 54-year-old woman who presents with malignant ascites and is known to have cirrhosis of the liver.

On the global level, Invasive Ductal Carcinoma (IDC) is one of the leading malignancies among women undergoing breast cancer screening. A slight delay in detecting and diagnosing this disease may result in irreversible complications. Histopathological images obtained from a biopsy examination present enormous structural information, which helps significantly in improving the prognosis of the disease. Pathological analysis involving microscopic examination of the histopathological slides is a highly challenging task due to the limited abilities of conventional computer-aided detection (CAD) methods to reach a precise diagnosis. The problem has become more accentuated due to the less availability of medical data in the public domain. Lately, deep learning methods using artificial neural networks are being used consistently to improve the performance of these CAD methods. Despite less medical data availability, transfer learning has recently been commonly practised to facilitate a deep neural network to train on a specific dataset in resolving the problem. However, the performance of this method is not remarkably appreciable on small and low-resolution medical image datasets compared to those comprising whole slide images of higher resolutions. In this direction, this study proposes a domain-specific learning strategy, Histo-Fusion, with the objective of detecting the IDC more precisely. In the proposed method, the deep CNN model is initially trained on higher-resolution histopathological images of breast tissue which presents ample information for a model to learn the significant features for better discrimination between normal and malignant tissues. Subsequently, through a positive transfer of domain features, the model is further trained on the small and low-resolution images, enabling it to classify these histology images into IDC - and IDC + categories. Moreover, shallow and deep neural network architectures are utilized in the study to compare their performance across the two learning approaches: transfer learning and Histo-Fusion on the IDC dataset. As revealed by the present study results, the proposed Histo-Fusion learning approach has improved each deep CNN's discriminating abilities by yielding better accuracy scores of around 5% over and above those obtained by the commonly used transfer learning strategy. Therefore, the procedure is expected to reduce false-positive rates and help expert pathologists reach accurate diagnoses. [ABSTRACT FROM AUTHOR]

Background: LRIG1 belongs to the family of transmembrane proteins containing leucine-rich repeats. LRIGs are considered as tumor suppressors as they negatively regulate receptor tyrosine kinases. The role of LRIG1 as an EGFR regulator makes it an important marker to be studied in various epithelial-derived cancers. Methods: LRIG1 expression was determined in Erbb2 + cell lines by western blotting, and cell motility was examined by cell migration assay. The AKT/GSK3-β/β-catenin pathway was determined in the presence of LRIG1 and Erbb2 by using western blotting. Results: So far, no study has reported the expression of LRIG1 in benign forms of tumor such as fibroadenoma. The current study aims to analyze LRIG1 expression in fibroadenoma and invasive ductal carcinoma (IDC) tissues. In this study, we compared the LRIG1 expression with different clinicopathological parameters of patients having IDC or fibroadenoma. LRIG1 expression was low in Erbb2+ cell lines, and more cell motility was observed. The AKT/GSK3-β/β-catenin pathway was activated when LRIG1 was downregulated; consequently, Erbb2 was upregulated. Our results indicated that LRIG1 expression can be significantly correlated with age, Nottingham index, and Her2/neu status of cancer. The expression of LRIG1 in IDC and fibroadenoma were found to be significantly different. Conclusion: The fibroadenoma tissue sections were found to express LRIG1 more intensely as compared to the IDC sections, which are in line with the studies reporting reduced copy number of the gene either due to gene deletion or transcriptional inhibition. This further supports that the downregulation of LRIG1 may lead to malignant tumor acting as a tumor suppressor. [ABSTRACT FROM AUTHOR]

Purpose: Invasive lobular cancer (ILC) is the second most common histology type of breast cancer followed by invasive ductal carcinoma (IDC). This study aimed to investigate the characteristic, treatment strategies, and clinical outcomes of ILC based on a national population-based cancer registry. Methods: This study recruited 2671 ILC and 52,215 IDC patients diagnosed between 2011 and 2017 using the Taiwan Cancer Registry (TCR). Correlations between ILC and IDC subgroups were assessed using 1:4 propensity score matching and compared using the χ2 test. Disease free survival(DFS) and overall survival(OS) were estimated using the Kaplan–Meier method with the log-rank test. The risk of disease relapse and mortality were assessed using Cox proportional hazards model. Results: ILC patients had larger tumor sizes, more positive axillary lymph node involvement, lower tumor grade, and higher cancer stage than IDC patients. After matching, ILC patients had a significantly higher rate of receiving mastectomy (58.93% and 53.85%) and positive surgical margin regardless of surgery type. ILC exhibited a significantly higher rate of distant metastasis than IDC(3.67% and 2.93%), but no difference in local recurrence rate, DFS or OS between the two groups. Higher cancer stage, higher grade, and mastectomy were risk factors for disease relapse and cancer-specific mortality. The hormone receptor-positive and HER2 over-expression subtypes were found to be associated with a reduced risk of disease relapse, while only PR positivity was associated with a decreased risk of mortality. (all P-values < 0.05). Conclusion: ILC patients had a higher mastectomy rate, higher surgical margin rate and distant metastasis rate than IDC patients. There is no significant difference in DFS or OS between ILC and IDC patients. Mastectomy was associated with poor outcomes regardless of ILC or IDC. [ABSTRACT FROM AUTHOR]

Background: Breast cancer, a prevalent malignancy in women, and sickle cell disease (SCD), a genetic disorder affecting red blood cells, are both well-understood individually. However, their coexistence is rare and presents unique challenges in diagnosis, treatment, and management. The complex interplay between these two conditions necessitates a tailored approach to care. The report focuses on a case of coexistence of breast cancer and sickle cell disease in a 40 - year-old female. Case Presentation: A 40-year-old female patient, diagnosed with SCD and managed with 20 mg/kg hydroxyurea, experiencing 1-2 mild painful crises annually and requiring 1-2 units of transfusion yearly, presented with swelling in the right breast in October 2022.Initial MRI revealed widespread edematous changes in the right breast parenchyma and multiple lymph nodes in the right axilla. Follow-up ultrasound in December 2022 detected an ill-defined hypoechoic area in the right breast and lymphadenopathies. A tru-cut biopsy confirmed invasive ductal carcinoma. PET scan showed no metastatic focus, but cranial imaging revealed an aneurysmatic dilation in the left ICA cavernous segment. The patient's biopsy material was re-examined, showing 90% positive estrogen receptor, 60% positive progesterone receptor, Cerb2:1 positive, E-cadherin positive, and a Ki-67 proliferation index of 10%. The patient underwent neoadjuvant chemotherapy followed by modified radical mastectomy surgery, and adjuvant RT was planned with radiation oncology. Comments: The coexistence of breast cancer and SCD in this case underscores the importance of an integrated approach to diagnosis and treatment. The rarity of this coexistence in the literature highlights the need for further research to understand the specific interactions between these diseases. The case also emphasizes the necessity of collaboration between oncology, hematology, and other specialties to develop effective therapeutic strategies tailored to the unique needs of patients affected by both conditions.

Rationale and Objectives: Lymphovascular invasion (LVI) plays an important role in the prediction of metastasis and prognosis in breast cancer (BC) patients. The present study assessed correlations between preoperative breast MRI, clinical features, and LVI in patients with invasive ductal carcinoma (IDC) and identified risk factors based on these correlation factors.Materials and Methods: Patients confirmed with IDC between 01/2012 and 12/2021 were retrospectively reviewed at our hospital. A total of 5 clinical and 14 MRI features to characterize tumours were extracted. LVI evaluated in hematoxylin and eosin sections. T-test and chi-square tests were used to compare the differences in clinical and MRI features between the LVI positive and negative groups. The associations between individual features and LVI were analysed by univariable logistic regression analysis, and risk factors for LVI were identified by multivariable logistic regression analysis based on these correlation factors.Results: This study included 353 patients with IDC, including 130 with positive LVI. Age, CEA, CA-153, amount of fibroglandular tissue (FGT), background parenchymal enhancement, tumour size, shape, skin thickening, nipple retraction, adjacent vessel sign, and axillary lymph node (ALN) size in the LVI positive group were significantly different from the LVI negative group (all p<0.05). Multivariate logistic regression analysis revealed that age (odds ratio OR = 1.030), CA-153 (OR = 1.018), heterogeneous FGT (OR = 2.484), shape (OR = 2.157), and ALN size (OR = 1.051) were risk factors for LVI (all p<0.05).Conclusion: Preoperative breast MRI and clinical features correlated with LVI, age, CA-153, heterogeneous FGT, shape, and ALN size are risk factors for LVI in patients with IDC. [ABSTRACT FROM AUTHOR]

Invasive ductal carcinoma of no special type is the most common type of breast cancer. In light of the above, many authors have reported the histological and electron microscopic characteristics of these tumors. On the other hand, a limited number of works exist where the authors have concentrated on investigating the extracellular matrix. This article presents data received as the results of light and electron microscopic examination of the extracellular matrix, angiogenesis, and cellular microenvironment of invasive breast ductal carcinoma of no special type. The authors have shown that the processes of stroma formation in the IDC NOS type are associated with the presence of fibroblasts, macrophages, dendritic cells, lymphocytes, and other cells. It was also shown the detailed interaction of the above cells with each other, as well as with vessels and fibrillar proteins such as collagen and elastin. The microcirculatory component is characterized by histophysiological heterogeneity, which manifests as the activation of angiogenesis, relative vascular differentiation, and regression of individual microcirculation components. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study is to investigate the impact of 18F-FDG PET/CT on prognosis of stage II invasive ductal carcinoma (IDC) of the breast primarily treated with surgery. Methods The clinical records of 297 consecutive IDC with preoperative PET/CT and pathologically staged II in surgery from 2013 to 2017 were retrospectively reviewed. The maximum standardized uptake value (SUVmax), peak standardized uptake value (SUVpeak), tumor-to-liver ratio (TLR), and metabolic tumor volume (MTV) were measured. Association of clinicopathologic factors (age, T stage, N stage, AJCC pathologic stage of IIA or IIB, pathologic prognostic stage, grade, hormonal receptor status, HER2 status, Ki-67, and adjuvant therapy) and PET parameters with DFS was assessed using the Cox proportional hazards model. Results There were 35 recurrences and 10 deaths at a median follow-up of 49 months (range 0.8 ~ 87.3). All PET parameters were significantly associated with DFS in univariate analysis but in multivariate analysis, SUVpeak was the only factor significantly associated with DFS (hazard ratio 2.58, 95% confidence interval 1.29–5.15, P = 0.007). In cohorts with higher values of SUVpeak or TLR, patients who received adjuvant chemotherapy had significantly superior DFS. Conclusion Metabolic parameters derived from preoperative PET/CT was significantly associated with recurrence in stage II IDC primarily treated with surgery. PET/CT can be a powerful prognostic tool in conjunction with novel staging systems and current biomarkers for patients undergoing contemporary therapy. Our results urge to reconsider the currently underestimated value of PET/CT confined to diagnostic aspect and to newly recognize its prognostic impact in these intermediate-risk breast cancer.

Autoamputation is the spontaneous detachment from the body and elimination of an appendage or abnormal growth. Autoamputation of an organ due to malignancy has been reported in various organs, although its aetiopathogenesis has not been fully explained. Autoamputation of the breast is associated with late presentation and slow desmoplastic reaction in breast cancer. The patient was a 43- year- old Nigerian woman who presented with a one-year history of left breast mass diagnosed as triple negative invasive ductal carcinoma. She defaulted from hospital care but represented after autoamputation of the left breast. The case is reported to showcase the variations in the clinical course of breast cancers.

Background: Breast cancer (BC) is the most common type of cancer in Ethiopia. The incidence of BC is also rising, but the exact figure is still poorly known. Therefore, this study was conducted to address the gap in epidemiological data on BC in southern and southwestern Ethiopia. Materials and Methods: This is a five-year (2015–2019) retrospective study. The demographic and clinicopathological data were collected from biopsy reports of different kinds of breast carcinomas in the pathology department of Jimma University Specialized Hospital and Hawassa University Specialized Referral Hospital. Histopathological grades and stages were conducted using Nottingham grading and TNM staging system, respectively. Collected data were entered and analyzed using SPSS Version-20 software. Results: The mean age of patients at diagnosis was 42.27 (SD = 13.57) years. The pathological stage of most BC patients was stage III, and most of them had tumor sizes greater than 5 cm. Most patients had moderately differentiated tumor grade, and mastectomy was the most common type of surgery at the time of diagnosis. Invasive ductal carcinoma was the most common histological type of BC, followed by invasive lobular carcinoma. Lymph node involvement was seen in 60.5% of cases. Lymph node involvement was associated with tumor size (χ2 = 8.55, p = 0.033) and type of surgery (χ2 = 39.69, p < 0.001). Conclusions: This study showed that BC patients in southern and southwestern Ethiopia displayed advanced pathological stages, relatively young age at diagnosis, and predominant invasive ductal carcinoma histological patterns. [ABSTRACT FROM AUTHOR]

Background/IntroductionAs the most common form of pre-invasive breast cancer, ductal carcinoma in situ (DCIS) affects over 50,000 women in the US annually. Despite standardized treatment involving lumpectomy and radiation therapy, up to 25% of patients with DCIS experience disease recurrence often with invasive ductal carcinoma (IDC), indicating that a subset of patients may be under-treated. As most DCIS cases will not progress to invasion, many patients may experience over-treatment. By understanding the underlying processes associated with DCIS to IDC progression, we can identify new biomarkers to determine which DCIS cases may become invasive and improve treatment for patients. Accumulation of fibroblasts in IDC is associated with disease progression and reduced survival. While fibroblasts have been detected in DCIS, little is understood about their role in DCIS progression.GoalsWe sought to determine 1) whether DCIS fibroblasts were similar or distinct from normal and IDC fibroblasts at the transcriptome level, and 2) the contributions of DCIS fibroblasts to breast cancer progression.MethodsFibroblasts underwent transcriptome profiling and pathway analysis. Significant DCIS fibroblast-associated genes were further analyzed in existing breast cancer mRNA databases and through tissue array immunostaining. Using the sub-renal capsule graft model, fibroblasts from normal breast, DCIS and IDC tissues were co-transplanted with DCIS.com breast cancer cells.ResultsThrough transcriptome profiling, we found that DCIS fibroblasts were characterized by unique alterations in cell cycle and motility related genes such as PKMYT1, TGF-α, SFRP1 and SFRP2, which predicted increased cell growth and invasion by Ingenuity Pathway Analysis. Immunostaining analysis revealed corresponding increases in expression of stromal derived PKMYT1, TGF-α and corresponding decreases in expression of SFRP1 and SFRP2 in DCIS and IDC tissues. Grafting studies in mice revealed that DCIS fibroblasts enhanced breast cancer growth and invasion associated with arginase-1+ cell recruitment.ConclusionDCIS fibroblasts are phenotypically distinct from normal breast and IDC fibroblasts, and play an important role in breast cancer growth, invasion, and recruitment of myeloid cells. These studies provide novel insight into the role of DCIS fibroblasts in breast cancer progression and identify some key biomarkers associated with DCIS progression to IDC, with important clinical implications.

Background: Chronic inflammation is a hallmark of cancer, and it can be stimulated by many factors. Substance P (SP), through binding to neurokinin 1 receptor (NK1R), and pyruvate kinase M2 (PKM2) play critical roles in cancer development and progression via modulating the tumor microenvironment. This study aimed to investigate the prognostic significance of SP and PKM2 in combination with NK1R and Ki-67 in hormone receptor negative (HR-ve) breast cancer. Methods: Immunohistochemical expression levels of SP, NK1R, PKM2, and Ki-67 were measured in 144 paraffin-embedded breast cancer tissues (77 h -ve and 67 h + ve). SP, NK1R, and PKM2 were scored semiquantitatively, while Ki-67 was obtained by the percentage of total number of tumor cells with nuclear staining. The optimal cutoff value for SP, NK1R, PKM2, and Ki-67 were assessed by Cutoff Finder. Results: High SP expression in HR -ve breast cancer was associated with TNM stage (p = 0.020), pT stage (p = 0.035), pN stage (p = 0.002), axillary lymph node metastasis (p = 0.003), and NK1R expression level (p = 0.010). In HR + ve breast cancer, SP expression was associated with HER2 status (p = 0.001) and PKM2 expression level (p = 0.012). Regarding PKM2 expression level, it significantly associated with HER2 status (p = 0.001) and history of DCIS (p = 0.046) in HR-ve tumors, and with HER2 status (p < 0.001) and SP expression level (p = 0.012) in HR + ve tumors. Survival analysis revealed that high SP level negatively impacted overall survival in HR-ve tumors that had low NK1R level (p = 0.021). Moreover, high SP negatively impacted overall survival in HR-ve tumors that had low Ki-67 level (p = 0.005). High PKM2 negatively impacted overall survival in HR-ve cases with low SP (p = 0.047). Conclusion: Combined expression levels of SP with NK1R or Ki-67, and PKM2 with SP could be used to predict survival in breast cancer patients with HR-ve tumors. Our findings suggest a role of SP/NK1R pathway and PKM2 in HR-ve breast cancer pathogenesis which should be further investigated to unveil the underlying molecular mechanisms. [ABSTRACT FROM AUTHOR]

Background: Presurgical Magnetic Resonance Imaging (MRI) is increasingly used for staging patients with breast cancer. If breast-conserving surgery (BCS) is required, MRI evaluation has to be carried out to cases with suspected breast cancer, in particular those with dense breast parenchyma, in which the sensitivity of ultrasonography and mammography is low. Objective: The aim of the current study is to evaluate the validity of MRI in surgical decision making in women with dense breast who are provisionally diagnosed to have breast cancer by sono-mammography and are considered suitable for BCS with pathological correlation of MRI findings. Patients and Methods: A prospective case series was conducted on females with dense breast admitted at Mansoura Oncology Center, during the period of 2 years. The study included patients with dense breast (mammography ACR C & D) who are provisionally diagnosed to have breast cancer by sono-mammography and are considered suitable for BCS. All cases underwent breast sonography and MRI. Results: The study was carried out on a total of 30 female cases, with mean age 43 years old. All cases show abnormal sono-mammographic findings. MRI displayed additional suspicious findings in the form of non-mass enhancement in 50%, multifocal lesions in 10%, multicentric lesions with non-mass enhancement and deep fascia infiltration in 3.33%. Concordance and discordancy between MRI additional findings and pathology displayed true positive in 95.2%. Only 1 (4.8%) non-mass enhancement was false positive (4.8%). Conclusion: Regarding BCS for cases with dense breast, preoperative breast MRI provides more information in detecting multifocal, multicentric, and extension of lesions which is necessary for determining the management plan. [ABSTRACT FROM AUTHOR]

Breast cancer is the most prevalent cancer in women worldwide, and its prevalence has increased since the introduction of screening programs. Most cases are discovered at an early stage; however, despite effective treatment, some cases progress to metastasis. The most common breast cancer metastatic locations are the bone, liver, and lungs. Ascites malignant due to peritoneal involvement is a rare manifestation of metastatic breast cancer. After 8 years of well-controlled breast cancer, we report a 54-year-old woman who presents with malignant ascites and is known to have cirrhosis of the liver. [ABSTRACT FROM AUTHOR]

Background: Sex-determining region Y-box 3 (SOX3) protein, a SOX transcriptions factors group, has been identified as a key regulator in several diseases, including cancer. Downregulation of transcriptions factors in invasive ductal carcinoma (IDC) can interfere in neoplasia development, increasing its aggressiveness. We investigated SOX3 protein expression and its correlation with apoptosis in the MDA-MB-231 cell line, as SOX3 and Pro-Caspase-3 immunoexpression in paraffin-embedded invasive ductal carcinoma tissue samples from patients (n = 27). Breast cancer cell line MDA-MD-231 transfected with pEF1-SOX3 + and pEF1-Empty vector followed by cytotoxicity assay (MTT), Annexin-V FITC PI for apoptosis percentage assessment by flow cytometry, qPCR for apoptotic-related gene expression, immunofluorescence, and immunohistochemistry to SOX3 immunolocalization in culture cells, and paraffin-embedded invasive ductal carcinoma tissue samples.Results: Apoptotic rate was higher in cells transfected with pEF1-SOX3 + (56%) than controls (10%). MDA-MB-231 transfected with pEF1-SOX3 + presented upregulation of pro-apoptotic mRNA from CASP3, CASP8, CASP9, and BAX genes, contrasting with downregulation antiapoptotic mRNA from BCL2, compared to non-transfected cells and cells transfected with pEF1-empty vector (p < 0.005). SOX3 protein nuclear expression was detected in 14% (4/27 cases) of ductal carcinoma cases, and pro-Caspase-3 expression was positive in 50% of the cases.Conclusion: Data suggest that SOX3 transcription factor upregulates apoptosis in breast cancer cell line MDA-MB-231, and has a down nuclear expression in ductal carcinoma cases, and need to be investigated as a tumor suppressor protein, and its loss of expression and non-nuclear action turn the cells resistant to apoptosis. Further studies are necessary to understand how SOX3 protein regulates the promoter regions of genes involved in apoptosis. [ABSTRACT FROM AUTHOR]

Introduction: Coexistence of malignant phyllodes tumor and invasive ductal carcinoma in a breast lesion is a very rare medical condition. In this study, a case of coexistence of invasive ductal carcinoma and malignant phyllodes tumor in a single breast mass was reported. Case presentation: The patient was a 39-year-old woman with a mass in left breast. On the requested ultrasound, the image of a heterogeneous hypovaco mass with an irregular margin with size of 30 × 17 × 24 mm was seen. The patient was candidate for complete removal of the breast and axillary lymph nodes. In the histologic evaluation, an invasive ductal carcinoma with malignant phyllodes component was diagnosed which was confirmed by immunohistochemistry. In immunohistochemical study, ER, PR, HER2 were negative in carcinomatous component and CK was negative in phyllodes stromal component, also KI67 index was 35%. In the evaluation of axillary lymph nodes, one out of 7 lymph nodes involved by invasive ductal carcinoma. The patient was referred for adjuvant chemotherapy using four cycles of doxorubicin, cyclophosphamide every two weeks, and four cycles of paclitaxel every two weeks and then adjuvant radiotherapy. In 20 month follow-up, she was alive with no evidence of disease recurrence. Conclusion: Although coexistence of malignant phyllodes and invasive ductal carcinoma of the breast is very rare, but in breast carcinoma with abnormal microscopic findings, due to the diagnostic and therapeutic importance, the concurrent presence of other breast neoplasms such as phyllodes tumor should be considered. Keywords:

Background: The prognostic relevance of the PIK3CA mutation together with PD-L1, c-Met, and mismatch repair deficiency (dMMR) have not been fully investigated in Asian women with breast cancer (BC) who have undergone postoperative adjuvant chemotherapy. Methods: We analyzed PIK3CA mutations via peptide nucleic acid (PNA)-mediated real-time PCR assay, PD-L1/c-Met expression via immunohistochemistry (IHC), and microsatellite instability (MSI) status using PCR and IHC, in 191 resected BCs from 2008 to 2011. The Cancer Genome Atlas (TCGA) dataset for the involvement of the PIK3CA mutation with PD-L1/c-Met/MMR was explored. Results: The PNA clamp-mediated assay was able to detect the PIK3CA mutation in 1% of the mutant population in the cell line validation. Using this method, the PIK3CA mutation was found in 78 (49.4%) of 158 samples. c-Met and PD-L1 positivity were identified in 31.4 and 21.8% of samples, respectively, which commonly correlated with high histologic grade and triple-negative subtype. MSI/dMMR was observed in 8.4% of patients, with inconsistency between MMR IHC and the MSI PCR. The PIK3CA mutation exhibited a poor prognostic association regarding recurrence-free survival (RFS) in both overall and triple-negative BCs. In subgroup analyses, the PIK3CA-mutated tumors showed poorer RFS than the PIK3CA-wildtype within the c-Met-positive, MSS, triple-negative, or age onset PIK3CA mutation together with c-Met or dMMR/MSI status might be relevant to poor prognosis in BC subsets, especially in Asian women.

Phyllodes tumors (PTs) are rare breast neoplasms, with an incidence rate of <1 %. Further, the coexistence of PTs and carcinoma is also uncommon. In this report, we describe a rare case of the synchronous coexistence of a benign PT and invasive ductal carcinoma (IDC) of the ipsilateral breast. A 42-year-old woman presented with a 6-month history of a tumor in her right breast. Mammography and ultrasonography revealed a 9.0 cm breast lump, and core biopsy revealed a benign PT. A simple mastectomy of the right breast revealed IDC foci in the mammary area, close to the benign PT. Right axillary lymph node staging was performed by surgery. However, no lymph node metastasis was observed. Subsequently, appropriate adjuvant therapy was initiated. Currently, the patient is doing well. Breast cancer may be located close to the PT of the ipsilateral breast and is difficult to detect preoperatively, especially in cases of large PTs. Early detection of the presence of a coexisting carcinoma is clinically important because it can alter patient management. Careful assessment of the PT using additional breast imaging tools might help identify their coexistence with breast cancer in cases of difficult diagnosis of coexistent tumors using standard breast imaging tools such as mammography or ultrasound. • We describe a rare case of coexistence of a benign PT and IDC. • Early detection of the presence of a coexisting carcinoma is clinically important. • Imaging tools other than standard breast imaging tools should be used in such cases. [ABSTRACT FROM AUTHOR]

It is generally noticed that increasing the number of convolutional layers in generic image classification procedures proves to be detrimental to model performance in terms of validation accuracy and loss. Apart from vanilla CNNs, we have state-of-the-art (SOTA) architectures such as ResNet50 (and its variants) which show that through the use of skip-connections, higher performance metrics are attainable through deeper architectures. However, most evaluative metrics converge on a log scale as we go deeper with diminishing gradient of the metrics’ curves. Given these two contrasting speculations, in this paper, we implement various vanilla and SOTA CNNs for the diagnosis of one of the most common forms of breast cancer - invasive ductal carcinoma (IDC) - to examine and understand the feasibility of implementation of SOTA CNNs through transferred weights when juxtaposed with vanilla CNNs (and LeNet-5) of varying configurations in terms of their performance metrics and other parameters. In this paper, we solve the dual-objective of studying behavioural aspects of avant-garde CNN models (more specifically, VGG16, VGG19, ResNet50, ResNet50V2, MobileNetV2, and DenseNet121) and proper diagnosis of IDC through intermediate neural activations to critically evaluate and theorize the performance of different models. We notice that among all the models, only VGG16, VGG19, LeNet-5 and a selected vanilla CNN through an optimization procedure were the ones to attain the best metrics, shared amongst them.

One challenge in the surgical management of breast cancer is maximizing the preservation of healthy tissue while achieving acceptable negative margins. Tools capable of assessing disease-margin involvement intraoperatively and in real-time could provide clinically useful guidance regarding the adequacy of margin resection before the surgery is over. Here we report the intraoperative use of optical coherence tomography (OCT) in 3 patients with DCIS. In all 3 cases, additional lesions identified by OCT during surgery were also noted in histopathology reports 3 to 5 days post-surgery, suggesting that intraoperative use of OCT is a valuable tool for margin determination in real-time. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) is a type of tumor that develops in the breast cells and is one of the most common cancers in women. Women are also at risk from BC, the second most life-threatening disease after lung cancer. The early diagnosis and classification of BC are very important. Furthermore, manual detection is time-consuming, laborious work, and, possibility of pathologist errors, and incorrect classification. To address the above highlighted issues, this paper presents a hybrid deep learning (CNN-GRU) model for the automatic detection of BC-IDC (+,−) using whole slide images (WSIs) of the well-known PCam Kaggle dataset. In this research, the proposed model used different layers of architectures of CNNs and GRU to detect breast IDC (+,−) cancer. The validation tests for quantitative results were carried out using each performance measure (accuracy (Acc), precision (Prec), sensitivity (Sens), specificity (Spec), AUC and F1-Score. The proposed model shows the best performance measures (accuracy 86.21%, precision 85.50%, sensitivity 85.60%, specificity 84.71%, F1-score 88%, while AUC 0.89 which overcomes the pathologist's error and miss classification problem. Additionally, the efficiency of the proposed hybrid model was tested and compared with CNN-BiLSTM, CNN-LSTM, and current machine learning and deep learning (ML/DL) models, which indicated that the proposed hybrid model is more robust than recent ML/DL approaches. [ABSTRACT FROM AUTHOR]

Invasive micropapillary carcinoma is a rare variant of invasive ductal carcinoma of the breast. This variant has been described as clinically aggressive due to its high frequency of lymphovascular invasion, axillary nodal metastases, and a greater degree of loco-regional recurrence. Invasive micropapillary carcinoma can have a variety of imaging presentations, typically presenting as an irregular mass. This case report describes a unique presentation of invasive micropapillary carcinoma and illustrates the propensity of invasive micropapillary carcinoma to secrete fluid and have a lack of regional lymphadenopathy. The challenges of the accompanying diagnostic imaging-work up are discussed.

Objectives: Breast cancers are classified as invasive or noninvasive based on histopathological findings. Although time-intensity curve (TIC) analysis using magnetic resonance imaging (MRI) can differentiate benign from malignant disease, its diagnostic ability to quantitatively distinguish between invasive and noninvasive breast cancers has not been determined. In this study, we evaluated the ability of TIC analysis of dynamic MRI data (MRI-TIC) to distinguish between invasive and noninvasive breast cancers. Material and Methods: We collected and analyzed data for 429 cases of epithelial invasive and noninvasive breast carcinomas. TIC features were extracted in washout areas suggestive of malignancy. Results: The graph determining the positive diagnosis rate for invasive and noninvasive cases revealed that the cut-off i/ni value was 21.6° (invasive: w > 21.6°, noninvasive: w = 21.6°). Tissues were classified as invasive or noninvasive using this cut-off value, and each result was compared with the histopathological diagnosis. Using this method, the accuracy of tissue classification by MRI-TIC was 88.6% (380/429), which was higher than that using ultrasound (73.4%, 315/429). Conclusion: MRI-TIC is effective for the classification of invasive vs. noninvasive breast cancer. [ABSTRACT FROM AUTHOR]

Objective: The incidence of female breast cancer in the world is 11.7% with a mortality rate of 6.9%. According to Globocon 2020, breast cancer is the most commonly diagnosed cancer (24.5%) and the leading cause of cancer-related death amongst women worldwide. The purpose of this study was to analyze the impact of Body Mass Index (BMI) on pathological complete response (pCR) rates for operable breast cancer after neoadjuvant chemotherapy (NACT). The primary endpoint was to assess histopathological features of the surgical specimen in response to NACT and to investigate the relationship with pre-chemotherapy BMI taking into account the various molecular subtypes of breast cancer. Materials and Methods: Patients with biopsy-proven breast carcinoma who underwent surgery after NACT between January 2017 and May 2021 were included. All patients were initially divided into three groups depending on their pre-chemotherapy BMI. With BMI <22.9 as normal or underweight category, BMI of 23-27.4, was taken as overweight category and BMI =27.5 as obese category. Results: The study included 184 patients. Normal weight patients had the highest rate of pCR (75%) and the lowest was seen in the obese category (33.75%). Furthermore, the subtype most likely to achieve pCR was HER2+/ER negative followed by triple negative BC with odds ratios of 3.46 and 2.21, respectively. Conclusion: This retrospective study established that overweight and obese patients suffering from breast carcinoma had a lessened pCR rate following NACT in comparison with those who were under-/normal weight. [ABSTRACT FROM AUTHOR]

Background: This retrospective observational study validated nuclear grading criteria developed to identify a high-risk group with recurrence rate ≥20–30% and local pathology diagnosis used in a previous multi-institutional randomized N·SAS-BC 01 trial, where the efficacy of adjuvant chemotherapy regimens was evaluated in 733 high-risk node-negative invasive breast cancer patients. Methods: Of 545 patients with long-term follow-up data (median 12.1 years), pathology slides, and local pathology diagnosis, 530 eligible patients were subjected to central pathology review (CPR) for histological type and nuclear grade (NG). Concordance in NGs was compared with local diagnosis. The 10/15-year recurrence-free survival (RFS) and overall survival (OS) rates stratified by NG and histological type were calculated. Results: Local diagnoses were invasive ductal carcinoma (IDC)-NG2, IDC-NG3, invasive lobular carcinoma (ILC), and metaplastic carcinoma (MC) in 158/327/38/7 patients, respectively. The 10/15-year RFS rates were 87.2/82.6% for IDC-NG2 and 81.8/75.0% for IDC-NG3 (p = 0.061), and OS rates were 95.0/92.8% for IDC-NG2 and 90.8/85.7% for IDC-NG3 (p = 0.042). CPR graded 485 locally diagnosed IDCs as IDC-NG1/NG2/NG3/unknown in 98/116/267/4 patients, respectively. No significant difference was found among survival curves for the three NG groups. Although the agreement level between local and CPR diagnoses was low (κ = 0.311), both diagnoses identified a patient group with a 15-year recurrence rate ≥ 20%. The 10/15-year RFS rates were 79.4/63.5% for ILC and 68.6%/unknown for MC. Conclusions: The N·SAS grading system identified a patient group with high-risk node-negative invasive breast cancer, suggesting that local diagnosis was performed efficiently in the N·SAS-BC 01 trial. Trial registration number: UMIN000022571. Date of registration: June 1, 2016. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common malignancy affecting women's health, with an increasing incidence worldwide. This study aimed to measure the intracellular concentration of the hypoxia-inducible factor 1 a (HIF-1a), tumor suppression protein p53, and estradiol (E2) in tumor tissues of adult females with breast cancer and their relation to tumor grade, tumor size, and lymph node metastases (LNM). The study was conducted on 65 adult female participants with breast mass admitted to the operating theater in Al-Hussein Teaching Hospital and Al-Habboby Teaching Hospital in Nasiriyah, Iraq, from January to November 2021. Fresh breast tumor tissues were collated and homogenized for intracellular biochemical analysis using the enzyme-linked immunosorbent assay method. In total, 44 (58%) out of 65 patients, in the age range of 18-42 years and the mean±SD age of 32.55±6.40 years, had fibroadenomas, and other 21 (42%) cases, in the age range of 32-80 years and the mean±SD age of 56±14.4 years had invasive ductal carcinoma (IDC) breast cancer. Intracellular levels of HIF-1a, p53, and E2 were elevated significantly (P<0.001) in IDC cases compared to the benign group. The most malignant tumors of IDC cases were in grade III and sizes T2 and T3. The tissue concentrations of HIF-1a, P53, and E2 were significantly elevated in patients with tumor stage T3 compared to T2 and T1. A significant elevation was found in the levels of HIF-1a, p53, and E2 in the positive LNM subgroup compared to the negative LNM group. Based on the obtained results, the prognostic value of the intracellular HIF-1a is considered to be a useful prognostic factor in Iraqi women with ICD and the combination of a HIF-1a protein with the nonfunctional p53 and E2 tends to indicate the proliferation, invasiveness, and metastases of the breast tumors. [ABSTRACT FROM AUTHOR]

Dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) is performed to distinguish between benign and malignant lesions by evaluating the changes in signal intensity of the acquired image (kinetic curve). This study aimed to verify whether the existing breast DCE‐MRI analyzed by the sigmoid model can accurately distinguish between benign and invasive ductal carcinoma (IDC) and predict the subtype. A total of 154 patients who underwent breast MRI for detailed breast mass examinations were included in this study (38 with benign masses and 116 with IDC. The sigmoid model involved the acquisition of images at seven timepoints in 1‐min intervals to determine the change in signal intensity before and after contrast injection. From this curve, the magnitude of the increase in signal intensity in the early phase, the time to reach the maximum increase, and the slopes in the early and late phases were calculated. The Mann–Whitney U‐test was used for the statistical analysis. The IDC group exhibited a significantly larger and faster signal increase in the early phase and a significantly smaller rate of increase in the late phase than the benign group (P < 0.001). The luminal A‐like group demonstrated a significantly longer time to reach the maximum signal increase rate than other IDC subtypes (P < 0.05). The sigmoid model analysis of breast DCE‐MRI can distinguish between benign lesions and IDC and may also help in predicting luminal A‐like breast cancer. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a heterogeneous disease and differences in the expression levels of the ER, PR, and HER2 the triplet of established biomarkers used for clinical decision-making have been reported among breast cancer patients. Furthermore, resistance to anti-estrogen and anti-HER2 therapies emerges in a considerable rate of breast cancer patients, and novel drug therapies are required. Several anomalous signaling pathways have been known in breast cancer have been known; heat shock protein 90 (HSP90) is one of the most plenty proteins in breast cells. The family of ubiquitin ligases such as SIAH1 and SIAH2 is known to specifically target misfolded proteins to the proteasome; also, they have been illustrated to play a role in RAS signaling and as an essential downstream signaling component required for EGFR/HER2 in breast cancer. Methods: The expression of SIAH2, HSP90, and HER2 was assessed by quantitative Real-Time PCR in 85 invasive ductal carcinoma breast tumor samples at Uludag University Hospital in Turkey during the years 2018–2019, and its association with the clinicopathologic variables of patients was evaluated. Results: HSP90, SIAH1, and SIAH2 were significantly (P=0.0271, P=0.022, and P=0.0311) upregulated tumor tissue of patients with breast cancer. Moreover, this study observed a significant association between the high expression of SIAH2/ HSP90 with ER status, high expression of HSP90 with Recurrence/ Metastasis, and high expression of SIAH2 with Ki-67 proliferation index. Conclusion: The HSP90 and SIAH2 expressions play a significant role in breast cancer development by combining the experimental and clinical data obtained from the literature.

Abstract Persistent thrombocytosis in patients with cancer needs workup because it can be linked to essential thrombocytosis. The management should be individualized to start treatment for low‐risk essential thrombocytosis due to the combined risk of thrombosis.

Background: Breast cancer (BC) is the most common type of cancer in Ethiopia. The incidence of BC is also rising, but the exact figure is still poorly known. Therefore, this study was conducted to address the gap in epidemiological data on BC in southern and southwestern Ethiopia. Materials and Methods: This is a five-year (2015–2019) retrospective study. The demographic and clinicopathological data were collected from biopsy reports of different kinds of breast carcinomas in the pathology department of Jimma University Specialized Hospital and Hawassa University Specialized Referral Hospital. Histopathological grades and stages were conducted using Nottingham grading and TNM staging system, respectively. Collected data were entered and analyzed using SPSS Version-20 software. Results: The mean age of patients at diagnosis was 42.27 (SD = 13.57) years. The pathological stage of most BC patients was stage III, and most of them had tumor sizes greater than 5 cm. Most patients had moderately differentiated tumor grade, and mastectomy was the most common type of surgery at the time of diagnosis. Invasive ductal carcinoma was the most common histological type of BC, followed by invasive lobular carcinoma. Lymph node involvement was seen in 60.5% of cases. Lymph node involvement was associated with tumor size (χ2 = 8.55, p = 0.033) and type of surgery (χ2 = 39.69, p < 0.001). Conclusions: This study showed that BC patients in southern and southwestern Ethiopia displayed advanced pathological stages, relatively young age at diagnosis, and predominant invasive ductal carcinoma histological patterns.