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Com a crescente urbanização e individualidade social há o aumento da criação com guarda responsável de animais de estimação, com principais exemplares os cães e gatos, este último como preferencial pelos tutores de forma ascendente nos últimos anos. Naturalmente os felinos podem ter até três gestações no período de um ano, com variação de um a nove filhotes em cada uma delas. Desta forma, a superpopulação destes animais ocorre de maneira exponencial. Esta característica, leva os proprietários a procurar por formas de contracepção para os animais. Dentre as formas existentes, destacam-se a ovariosalpingohisterectomia (OSH) e a contracepção hormonal. Os fármacos anticoncepcionais de maior utilização são os análogos sintéticos da progesterona, como, Acetato de Medroxiprogesterona (AMP), o Acetato de Megestrol e a proligestona. Porém, estes provocam efeitos negativos como hiperplasia endometrial cística, levando à piometra, hiperplasia mamária, resultando em tumores mamários, aborto, diabetes mellitus, dermatopatias e distúrbios comportamentais, portanto não é recomendado o seu uso nesta espécie. Foi realizado um levantamento de dados por meio de questionários, com proprietários de gatas levadas para atendimento clínico do Hospital Veterinário Universitário Jeremias Pereira da Silva da Universidade Federal do Piauí, com o objetivo de analisar quantitativamente os casos de animais com efeitos colaterais, de acordo com a raça e a idade, correlacionado ao uso de fármacos contraceptivos. Os dados obtidos se referem aos meses de março a maio de 2015. Todos os animais descritos neste estudo que apresentaram características patológicas fizeram a utilização de fármacos contraceptivos. Nos 2 casos de piometra encontrados a faixa etária de 4 anos (50%) e 8 anos (50%) foi observada, e todos (100%) os casos ocorreram em gatas Sem Raça definida (SRD). Dos 3 casos de neoplasia mamária, animais com 9 meses correspondem a 33,3%, 1 ano (33,33%) e 2 anos (33,33%) de idade, e todos (100%) eram SRD. Dos 2 casos de abortos, a faixa etária observada foi de 2 anos (50%) e de 3 anos (50%) de idade, e as raças afetadas foram SRD (50%) e siamesa (50%). Dos 2 casos de hiperplasia mamária observados. em gatas com 6 meses (50%) e 8 meses (50%) de idade, e a única raça acometida foi a SRD (100%). Conclui-se que o uso indiscriminado de fármacos contraceptivos ainda é frequente, assim como, é elevada a quantidade de animais que apresentam efeitos negativos ao seu uso.

Pseudoangiomatous stromal hyperplasia (PASH) is a benign hyperplastic condition of the breast that can lead to macromastia. The standard treatment for PASH is focal excision or rarely reduction mammoplasty. We present a rare case of postpartum bilateral rapid breast enlargement and axillary growth that was refractory to reduction mammoplasty. Ultimately, the patient required bilateral mastectomy and two-stage implant-based breast reconstruction. This more extensive form along with its management represents one of the few reported cases in the literature. The decision to pursue bilateral mastectomy was undertaken after exhausting more conservative options. Excellent aesthetic outcome and pain relief was obtained following definitive extirpative and reconstructive surgery.

A hiperplasia mamária felina, também conhecida como hiperplasia fibroepitelial, é caracterizada microscopicamente pelo rápido crescimento do estroma e epitélio ductal das glândulas mamárias em resposta a estímulo hormonal. O objetivo deste trabalho foi relatar um caso que teve um andamento inesperado pela formação de edema após a ovário-salpingo-histerectomia. Uma gata, sem raça definida, com sete meses de idade, nulípara, foi encaminhada ao Departamento de Medicina Veterinária da Universidade Federal de Sergipe, com histórico de aumento de volume de todas as cadeias mamárias há um mês, desenvolvendo os sintomas mencionados dias após a administração de um contraceptivo. Como tratamento, foi proposta a realização da ovário-salpingo-histerectomia com abordagem pelo flanco devido as mamas se apresentarem muito grandes. Após duas semanas houve redução do tecido mamário, porém grande acúmulo de líquido, corroborando para a realização de mastectomia radical no felino. Este relato chama a atenção para considerar a ocorrência deste edema nas mamas após tratamento conservador por meio de ovário-salpingo-histerectomia ou fármacos, já que pode haver uma falsa interpretação de que a mama não esteja reduzindo ou até mesmo aumentando.

The aim of this article is to present briefly new pathological entities which are recently increasingly commonly used in pathology reports, as well as to discuss their clinical consequences. The new WHO classification of breast diseases includes, inter alia , invasive carcinoma of no special type: this is not a specific entity, but rather a group of malignancies without specific features. The lobular hyperplasia group includes a classical variant and a pleomorphic variant of lobular carcinoma in situ, as well as atypical lobular hyperplasia. The ductal hyperplasia group, according to the current revision of the WHO classification of breast diseases, encompasses: typical (i.e. non-atypical) ductal hyperplasia, columnar cell change, columnar cell hyperplasia, atypical ductal hyperplasia. The mesenchymal breast hyperplasia group includes pseudoangiomatous stromal hyperplasia. We briefly discuss the above mentioned entities together with their respective clinical and therapeutic consequences.

A Hiperplasia mamária felina (HMF) é uma alteração não neoplásica, caracteriza pela proliferação celular do estroma do ducto das glândulas mamárias, comumente diagnosticada no Brasil. Tal alteração muitas vezes é causada pelo uso inadequado de progestágenos exógenos em gatos, que podem ser armazenados no organismo do animal, e sensibilizam as glândulas à proliferação exacerbada por estímulo hormonal. Um dos fatores associados aos casos recorrentes da HMF é a venda desses medicamentos em lojas que prestam serviço de venda de produtos veterinários, aplicados sem restrições e sem conhecimento da fisiologia felina, na tentativa de controle gestacional. A conscientização de tutores sobre os malefícios da aplicação sem critério de progestágenos e a estimulação dos mesmos para que optem por esterilização cirúrgica dos seus animais deve ser feita pelos médicos veterinários, a fim de que se evitem maiores complicações como neoplasia mamária, garantindo, portanto, maior bem estar da população felina. O objetivo dessa revisão é abordar aspectos epidemiológicos, fisiológicos e clínicos, e promover alusão ao uso indiscriminado de anticoncepcionais nessa espécie.

Introduction: Bilateral breast reduction surgery is the surgical treatment of bilateral breast hypertrophy. This is one of the most common breast surgery requested by women, and performed by plastic surgeons. The reasons that patients want this surgery are to re-size sagging breasts aesthetically, and to get rid of somatic symptoms such as shoulder, chest, back, and neck pain. We believe that the objective positive effects of breast reduction surgery exist beside aesthetic. In our study, our aim is to elicit positive effects of surgery on lungs, if there are, by making pulmonary function test and carbon monoxide diffusion test before surgery and after 6 months of surgery. Materials and Methods: Thirty patients agreed to participate in the study. Study is completed with 19 patients. Pulmonary function test and carbon monoxide diffusion test were made to all patients in preoperative and 6 months of postoperative period. Lung roentgenogram of all patients was performed and height, weight, body mass index were measured. Saturation level was measured. Results: There was a meaningful increase in FEV1 and FVC values in the postoperative period in comparison with pulmonary function test performed in preoperative period. DLCO in postoperative period decreased meaningfully as compared to the preoperative period. Conclusion: Breast reduction surgery seems to have positive effects on pulmonary function test values and relaxes patients clinically. Patients with big breasts should be evaluated from this perspective if they apply chest diseases clinic with shortness of breath. © 2017, Ankara University. All rights reserved.

Breast cancer is estimated to be the leading cancer type among new cases in American women. Core biopsy data have shown a close association between breast hyperplasia and breast cancer. The early diagnosis and treatment of breast hyperplasia are extremely important to prevent breast cancer. The Mongolian medicine RuXian-I is a traditional drug that has achieved a high level of efficacy and a low incidence of side effects in its clinical use. However, for detecting the efficacy of RuXian-I, a rapid and accurate evaluation method based on metabolomic data is still lacking. Therefore, we proposed a framework, named the metabolomics deep belief network (MDBN), to analyze breast hyperplasia metabolomic data. We obtained 168 samples of metabolomic data from an animal model experiment of RuXian-I, which were averaged from control groups, treatment groups, and model groups. In the process of training, unlabelled data were used to pretrain the Deep Belief Networks models, and then labelled data were used to complete fine-tuning based on a limited-memory Broyden Fletcher Goldfarb Shanno (L-BFGS) algorithm. To prevent overfitting, a dropout method was added to the pretraining and fine-tuning procedures. The experimental results showed that the proposed model is superior to other classical classification methods that are based on positive and negative spectra data. Further, the proposed model can be used as an extension of the classification method for metabolomic data. For the high accuracy of classification of the three groups, the model indicates obvious differences and boundaries between the three groups. It can be inferred that the animal model of RuXian-I is well established, which can lay a foundation for subsequent related experiments. This also shows that metabolomic data can be used as a means to verify the effectiveness of RuXian-I in the treatment of breast hyperplasia.

Background In recent years, with the accelerated pace of life, diet, environmental problems occur frequently. External factors are easily to cause endocrine disorders and hormone sensitivity of breast tissue, which can lead to mammary hyperplasia. The incidence rate of hyperplasia of mammary glands is increasing year by year, and the age of onset is also getting lower and lower. If not treated in time, there is a crisis of breast cancer.Clinical studies have found that auricular point pressing therapy is widely used in clinical treatment of mammary hyperplasia recently, but the efficacy of massage in the treatment of mammary hyperplasia has not been systematically reviewed. The purpose of this study is to explore the efficacy, safety and effectiveness of auricular point pressing therapy in the treatment of hyperplasia of mammary glands. Methods We will search PubMed, Web of Science, Cochrane Library, EMBASE, Wan fang Database, Chinese Scientific Journal Database, CNKI, VIP, and Chinese Biomedical Literature Database. The retrieval date was January 10, 2021. RevMan 5.3 software was used to evaluate the quality and risk of included studies. The efficacy, recurrence rate, and symptom score of breast hyperplasia were analyzed, and the results were observed and measured. Results This study will be from the clinical efficiency, improvement rate, pain symptoms disappear rate, tumor size improvement rate, and other aspects of the existing evidence for a high quality synthesis, as well as auricular point pressing therapy adverse events. Conclusion the conclusion of this review will provide the basis for judging whether auricular point pressing therapy is safe and effective in the treatment of hyperplasia of mammary glands. Ethics and dissemination This systematic will evaluate the effectiveness and safety of auricular point pressing therapy in the treatment of hyperplasia of mammary glands. As all data used in this systematic review and meta-analysis have been published, ethical approval is not required for this review. Protocol registration number INPLASY202110028.

Background With the accelerated pace of life, the problems of residence, diet, and environment have occurred frequently in recent years. External factors are easily to cause endocrine disorders and hormone sensitivity of breast tissue, which can lead to mammary hyperplasia. The incidence rate of hyperplasia of mammary glands is increasing year by year, and the age of onset is also getting lower and lower. If not treated in time, there is a crisis of breast cancer.Clinical studies have found that massage is widely used in clinical treatment of mammary hyperplasia recently, but the efficacy of massage in the treatment of mammary hyperplasia has not been systematically reviewed. The purpose of this study is to explore the efficacy, safety and effectiveness of massage in the treatment of hyperplasia of mammary glands. Methods We will search PubMed, Cochrane Central Register of controlled trials (central), ScienceNet, EMBASE, CBM, CNKI, VIP and Wanfang databases. The retrieval date was October 20, 2020. RevMan 5.3 software was used to evaluate the quality and risk of included studies. The efficacy, recurrence rate, and symptom score of breast hyperplasia were analyzed, and the results were observed and measured. Results This study will be from the clinical efficiency, improvement rate, pain symptoms disappear rate, tumor size improvement rate and other aspects of the existing evidence for a high quality synthesis, as well as massage adverse events. Conclusion the conclusion of this review will provide the basis for judging whether massage is safe and effective in the treatment of hyperplasia of mammary glands. Ethics and dissemination This systematic will evaluate the effectiveness and safety of massage in the treatment of hyperplasia of mammary glands. As all data used in this systematic review and meta-analysis have been published, ethical approval is not required for this review. Protocol registration number INPLASY2020100066.

The aim of the present study was to examine Ki-67 expression in tissue of luminal type breast cancer and to investigate the association between the Ki-67 expression level and clinicopathology of breast cancer. A total of 62 patients with breast cancer were included in the study group, whereas 30 patients undergoing a health check-up who were diagnosed with breast hyperplasia were included in the control group. Levels of Ki-67 expression in patients of the two groups were assessed using fluorescent quantitative polymerase chain reaction. The association between Ki-67 and the clinicopathology of the cancer was investigated by analyzing cancer cell proliferation and migration by reducing Ki-67 expression in the human MCF-7 cancer cell line. Compared with the controls, Ki-67 expression was significantly increased in the serum and cancer tissue of breast cancer patients (P

Introduction: Abnormal proliferation in the breast is clinically seen ranging from hyperplasia to atypia to in situ carcinomas (DCIS) to invasive cancers. Whether these states comprise points along an evolutionary continuum is a subject of debate, but has significant implications for prevention, prognosis, and treatment. Due to the length of time involved, tumor evolution is difficult to study in vivo and in vitro models. We hypothesize a continuum from hyperplasia to cancer can be demonstrated by examining patterns of accumulated mutations in tumors. We employ a previously developed computational model of ductal epithelial dynamics, the DEABM (1), to simulate and track accumulated mutations during the progression from a normal epithelial population through hyperplastic states to the development of invasive tumors Methods: Simulation experiments were performed using an expanded DEABM, which incorporates the functions of luminal and myoepithelial cells, their progenitors and fibroblasts. DNA damage can potentially disrupt 12 functional pathways regulated by oncogenes and tumor suppressors implicated in breast cancer (BRCA1, P53, E-cadherin, RUNX3, Myc, ER, TGF-b, MMP-3, EGFR, HER-2 and Telomerase). The expanded DEABM allows for sequential tracking of genetic lesions in each cell. 3,000 simulations in both wild-type (WT) and BRCA1-mutated states were run over 40 years of simulated menses. Cell populations were characterized as normal, hyperplastic or malignant based on quantitative cell expansion from baseline, as well as by mutational profiles, sequential order of mutations and ER status. Results: Tumor profiles approximated epidemiologic rates of cancer incidence and ER/HER2 status. 2.6 % of WT developed malignancy vs. 45.9% of BRCA1. WT tumors were 54% ER+/HER2-, 17% ER+/HER2+, 6% ER-/HER2+ and 22% ER-/HER2-. BRCA1 tumors were 29% ER+/HER2-, 7% ER+/HER2+, 13% ER-/HER2+ and 50% ER-/HER2-. Hyperplastic populations carried more mutations than non-hyperplastic populations (p>.01) and were more likely to carry mutations in telomerase, E-cadherin and genes related to ER expression (TGFB, RUNX3, p Conclusion: The DEABM generates diverse tumors that express tumor markers consistent with epidemiologic data. The DEABM also generates non-invasive, hyperplastic populations, analogous to atypia and/or DCIS, via mutations to genes known to be present in hyperplastic lesions and early mutations in breast cancers. The results demonstrate that agent-based models are well-suited to studying tumor evolution through stages of carcinogenesis and have the potential to be used to develop prevention and treatment strategies. Ref: Chapa J, et al. "Examining the Pathogenesis of Breast Cancer Using a Novel Agent-Based Model of Mammary Ductal Epithelium Dynamics." PloS one 8.5 (2013). Citation Format: Joaquin Chapa, Gary An, Swati A Kulkarni. Demonstration of the evolutionary dynamics of the progression from breast hyperplasia to cancer using the duct epithelial agent based model (DEABM) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-08-03.

To explore the efficacy of psychological interventions (PI) in patients with breast hyperplasia (BH). In total 120 BH patients who were treated in the Third Affiliated Hospital of the Third Military Medical University were randomly divided into PI group (n = 40; treated with oral XiaoYao Pill and psychological interventions), anti-anxiety/depression medication (AADM) group (n = 40; treated with oral XiaoYao Pill and paroxetine), and control group (n = 40; treated with oral XiaoYao Pill) and the treatment lasted for 1 year. Before the treatment and 4, 8, and 12 months after the initiation of treatment, the changes in the psychological indicators were measured using Toronto Alexithymia Scale (TAS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Ways of Coping Questionnaire (WCQ), as well as the physiological indicators including estradiol, prolactin, and progesterone were determined. The overall response rates were evaluated at the end of the treatment, and the relapse rates were calculated during the 1-year follow-up. The HAMD and HAMA scores were declined in all three groups. The scores of TAS and WCQ negative coping subscales showed a declining trend after treatment for the AADM and PI groups. Compared to the control and PI groups, the HAMA and HAMD scores were significantly lower in the AADM group 4, 8, and 12 months after the initiation of treatment (P P P P P P > 0.05), while the relapse rate was significantly lower in the PI group than the control and AADM groups (P P > 0.05). PI can effectively improve the psychological status of BH patients and restore the disordered endocrine system. The efficacy lasts for long and the relapse rate is lower. Therefore, it could be an effective method for treating BH.

Pseudo Angiomatous Stromal Hyperplasia (PASH), a benign disease with extremely low incidence, is manifested as giant breasts, frequent relapse after surgery, or endocrine disorder. Cases with unilateral breast and undetailed endocrine condition have been reported in African and American. In this case, a 19-year-old Asian girl suffered from bilateral breast PASH after the human placenta and progesterone treatment for 3-month delayed menstruation. Her breasts enlarged remarkably 1 month after the treatment, with extensive inflammatory swell in bilateral mammary glands and subcutaneous edema in retro mammary space. The patient received the bilateral quadrantectomy plus breast reduction and suspension surgery to terminate the progressive hyperplasia of breast. During the whole treatment period, the patient was given tamoxifen treatment for 4 months, and endocrine levels were intensively recorded. The follow-up after 4 months showed recovered breast with normal shape and size, and there was no distending pain, a tendency toward breast hyperplasia, or menstrual disorder. Level of Evidence: Level IV, case study. Keywords: Pseudo angiomatous stromal hyperplasia; 19-year-old Asian girl; Tamoxifen

The objective of the present study was to investigate a comparative estimation screening method of prostate specific antigen levels in serum samples with immunohistochemistry results for analysis expression of prostate specific antigen in female breast tissues at benign breast hyperplasia and breast cancer. This study was applied on 65 women suffering from breast cancer, 31 of them have benign breast hyperplasia and 34 have malignant breast cancer. Each group was divided into 2 subgroups, pre and postmenopause, both subgroups were compared with 15 normal cases to assess serum and tissue PSA in benign and malignant patients in pre and post menopause state by immunoradiometric assay in blood and immunohistochemistry in tissue. No significant difference in serum Total PSA concentration between any of the studied cases. However, there were different variations in the distribution of PSA in the breast tumor tissue, with complete absence of PSA in the tissue samples of the malignant in postmenopausal patients. In conclusion, PSA presence in benign breast hyperplasia in either serum or tissue may show clinical value regarding the diagnosis and prognosis of the disease.

The main reason for waist and back pain in patients with gigantomasty is increased thoracic kyphosis and lumber lordosis. These symptoms and abnormal spinal angulations regress after reduction mammoplasty operations. However, the effect of chronic mechanical stress caused by gigantomasty on the spinal degenerative process is not clear yet. In this study with computed tomography it is shown that degenerative spondylosis is more widespread and severe in patients with large breasts. © 2017 - IOS Press and the authors. All rights reserved.

Objective To observe the clinical efficacy of acupuncture combined with medication in treating breast hyperplasia.

Aromatase is essential for estrogen production and is the target of aromatase inhibitors, the most effective endocrine treatment for postmenopausal breast cancer. Peripheral tissues in women, including the breast, express aromatase via alternative promoters. Female mice lack the promoters that drive aromatase expression in peripheral tissues; thus, we generated a transgenic humanized aromatase (Aromhum) mouse line containing a single copy of the human aromatase gene to study the link between aromatase expression in mammary adipose tissue and breast pathology. Aromhum mice expressed human aromatase, driven by the proximal human promoters II and I.3 and the distal promoter I.4, in breast adipose fibroblasts and myoepithelial cells. Estrogen levels in the breast tissue of Aromhum mice were higher than in wild-type mice, whereas circulating levels were similar. Aromhum mice exhibited accelerated mammary duct elongation at puberty and an increased incidence of lobuloalveolar breast hyperplasia associated with increased signal transducer and activator of transcription-5 phosphorylation at 24 and 64 wk. Hyperplastic epithelial cells showed remarkably increased proliferative activity. Thus, we demonstrated that the human aromatase gene can be expressed via its native promoters in a wide variety of mouse tissues and in a distribution pattern nearly identical to that of humans. Locally increased tissue levels, but not circulating levels, of estrogen appeared to exert hyperplastic effects on the mammary gland. This novel mouse model will be valuable for developing tissue-specific aromatase inhibition strategies.

Uncontrolled proliferation is one of the hallmarks of breast cancer. We have previously identified the human Ecd protein (human ortholog of Drosophila Ecdysoneless, hereafter called Ecd) as a novel promoter of mammalian cell cycle progression, a function related to its ability to remove the repressive effects of Rb-family tumor suppressors on E2F transcription factors. Given the frequent dysregulation of cell cycle regulatory components in human cancer, we used immunohistochemistry of paraffin-embedded tissues to examine Ecd expression in normal breast tissue versus tissues representing increasing breast cancer progression. Initial studies of a smaller cohort without outcomes information showed that Ecd expression was barely detectable in normal breast tissue and in hyperplasia of breast, but high levels of Ecd were detected in benign breast hyperplasia, ductal carcinoma in situ (DCIS) and infiltrating ductal carcinoma (IDCs) of the breast. In this cohort of 104 IDC patients, Ecd expression levels showed a positive correlation with higher grade (P = 0.04). Further analyses of Ecd expression using a larger, independent cohort (954) confirmed these results, with a strong positive correlation of elevated Ecd expression with higher histological grade (P = 0.013), mitotic index (P = 0.032), and Nottingham Prognostic Index score (P = 0.014). Ecd expression was positively associated with HER2/neu (P = 0.002) overexpression, a known marker of poor prognosis in breast cancer. Significantly, increased Ecd expression showed a strong positive association with shorter breast cancer specific survival (BCSS) (P = 0.008) and disease-free survival (DFS) (P = 0.003) in HER2/neu overexpressing patients. Taken together, our results reveal Ecd as a novel marker for breast cancer progression and show that levels of Ecd expression predict poorer survival in Her2/neu overexpressing breast cancer patients. Electronic supplementary material The online version of this article (doi:10.1007/s10549-011-1946-8) contains supplementary material, which is available to authorized users.

Pectus excavatum deformity is the most frequent congenital anomaly of the thoracic wall. If the invasive surgical procedures of thoracoplasty are not indicated or the patient refuses them, alternative treatment options should be considered. In such cases, local or distant transposition of autologous tissue could be appropriate. This report presents a selected case of funnel chest deformity and concomitant unilateral breast hyperplasia. Both deformities were corrected simultaneously using a pedicled internal mammary artery perforator (IMAP) flap dissected from the hyperplastic breast. This is a safe, reliable, low-morbidity, one-stage option for adult women that uses an easy-to-harvest flap for simultaneous correction of mild funnel chest deformity and concomitant breast hyperplasia with a single resulting scar.

RuXian-I has traditionally been used as a remedy for breast hyperplasia in the Inner Mongolia Autonomous Region of China. As a first step toward the investigation of biomarkers associated with RuXian-I treatment, a proteome-wide analysis of rat breast tissue was conducted. First, rat breast hyperplasia was induced by injection of estradiol and progesterone. After treatment with RuXian-I, there is a marked decrease in the hyperplasia, as can be shown by decreases in the nipple diameter and the pathological changes in breast. Subsequently, we used an approach that integrates size-based 2D-DIGE, MALDI-TOF/TOF-MS, and bioinformatics to analyze data from the control group, the model group and the RuXian-I treatment group. Using this approach, seventeen affected proteins were identified. Among these, 15 (including annexin A1, annexin A2, superoxide dismutase [Mn], peroxiredoxin-1, translationally-controlled tumor protein and a B-crystallin) were significantly up-regulated in the model group and down-regulated upon treatment with RuXian-I, and two (Tpil protein and myosin-4) have the opposite change trend. The expression of annexin A1 was confirmed using immunohistochemistry. The expression of superoxide dismutase (SOD) activity was confirmed biochemically. These results indicated that RuXian-I treats rat breast hyperplasia through regulation of cell cycle, immune system, metabolic, signal transduction, etc. The differential expressions of these proteins (annexin A1, superoxide dismutase [Mn], alpha B-crystallins and translationally controlled tumor protein, among others) were associated with occurrence and metastasis of breast cancer. These findings might provide not only far-reaching valuable insights into the mechanism of RuXian-I action, but also leads for prognosis and diagnosis of breast hyperplasia and breast cancer.

BACKGROUND: The precise timing of the angiogenic switch and the role of angiogenesis in the development of breast malignancy is currently unknown. METHODS: Therefore, the expression of CD31 (pan endothelial cells (ECs)), endoglin (actively proliferating ECs), hypoxia-inducible factor-1 (HIF-1alpha), vascular endothelial growth factor-A (VEGF) and tissue factor (TF) were quantified in 140 surgical specimens comprising normal human breast, benign and pre-malignant hyperplastic tissue, in situ and invasive breast cancer specimens. RESULTS: Significant increases in angiogenesis (microvessel density) were observed between normal and benign hyperplastic breast tissue (P

The cyclooxygenase-2 (COX-2) enzyme, which is induced by inflammatory and mitogenic stimuli, plays a protumorigenic role in several human cancers. COX-2 is overexpressed in invasive and in situ breast cancers. Atypical hyperplasia in breast tissue, although benign, is associated with a high risk of breast cancer. We investigated whether COX-2 overexpression in atypical hyperplasia is associated with the risk of subsequent breast cancer.COX-2 expression was assessed immunohistochemically in archival sections from 235 women with atypia whose biopsy specimens were obtained at the Mayo Clinic from January 1, 1967, through December 31, 1991. COX-2 expression was scored as 0 (negative), 1+ (weak), 2+ (moderate), or 3+ (strong). Risk factor information and follow-up for breast cancer events were obtained via a study questionnaire and the medical records. All statistical tests were two-sided.Forty-one (17%) of the 235 women developed breast cancer during a median follow-up of 15 years. Moderate (category 2+) or strong (category 3+) COX-2 expression was identified in 71 (30%) and 34 (14%) of the 235 samples, respectively. The risk for developing breast cancer, relative to a control population (the Iowa Surveillance, Epidemiology, and End Results registry), increased with increasing COX-2 expression (relative risk [RR] = 2.63, 95% confidence interval [CI] = 1.56 to 4.15, for those with negative or weak COX-2 expression; RR = 3.56, 95% CI = 1.94 to 5.97, for those with moderate expression; and RR = 5.66, 95% CI = 2.59 to 10.75, for those with strong expression; P = .07). Overexpression of COX-2 was statistically significantly associated with the type of atypia (lobular vs ductal, P.001), number of foci of atypia in the biopsy (P = .02), and older age at time of biopsy (45 years, P = .01).COX-2 appears to be a biomarker that further stratifies breast cancer risk among women with atypia and may be a relevant target for chemoprevention strategies.

The main disadvantage of Vacuum Assisted Breast Biopsy (VABB) is the probability of underestimating atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). This study evaluates a modified way of performing VABB.266 women with microcalcifications graded BI-RADS 34 underwent VABB (11G) on the Fischer's table. 133 women were allocated to the "standard" protocol and 24 cores were obtained (1 offset-main target and one additional offset). 133 women were randomly allocated to the "extended" protocol and 96 cores were excised (one offset- main target and 7 peripheral offsets). A preoperative diagnosis was established, and the removed volume was calculated. When precursor or malignant lesions were diagnosed, open surgery was performed. A second pathologist, blind to the preoperative results and to the protocol made the postoperative diagnosis. The discrepancy between preoperative and postoperative diagnoses was evaluated.When the standard protocol was applied, the underestimation rate for preoperative ADH, lobular neoplasia (LN), DCIS was 16.7%, 50% and 14.3% correspondingly. In the extended protocol, no underestimation was present in LN, ADH, but the underestimation rate for DCIS was 6.3%. In the extended protocol, no precursor/malignant tissue was left after VABB in all ADH cases, in 87.5% of LN cases, in 73.3% of DCIS, and in 50% of invasive carcinomas. The volume excised was 2.33 +/- 0.60 cc and 6.14 +/- 1.30 cc for the standard and the extended protocol, respectively. The rate of hematoma formation did not differ between the two protocols.This recently introduced, "extended" way of performing VABB in microcalcifications safely minimizes the underestimation rate, which may lead to a modified management of ADH lesions.

To detect the expressions of E-cadherin, α-catenin and β-catenin and analyze the relationship between E-cadherin-catenin adhesion complex and clinicopathological features in breast cancer. The expressions of E-cadherin, α-cadherin and β-catenin in specimens of 54 breast cancer, 21 normal breast tissues around tumor, 15 breast hyperplasia of usual type and 15 breast atypical hyperplasia were detected by immunohistochemical method. In 21 normal breast tissues, E-cadherin and α-catenin were expressed on cell membrane of ductal and acinic cells, showing cellular contour and border among cells. The staining character of the three proteins in breast hyperplasia of usual type was the same as that in normal breast tissue. In breast atypical hyperplasia, the abnormal expression rates of E-cadherin, α-catenin and β-catenin were 6.7%, 13.3% and 26.7%, respectively. The total abnormal expression rate of E-cadherin-catenin complex was 33.3%. In breast cancer, the abnormal expression rates of E-cadherin, α-catenin and β-catenin were 51.9%, 63.0% and 61.1%, respectively. The total abnormal expression rate of E-cadherin-catenin complex was 88.9%. Abnormal expression of E-cadherin and α-catenin were significantly correlated with histological grade. Abnormal expressions of α-catenin and β-catenin were significantly correlated with TNM staging, axillary lymph nodes metastasis and postoperative distant metastasis. Abnormal expression of E-cadherin-catenin complex was correlated with TNM staging, histological grade and axillary lymph nodes. Abnormal expression of β-catenin was negatively correlated with expression of HER-2. COX multiple factor analysis showed that E-cadherin or α-catenin or β-catenin was not independent prognostic indicator. Abnormal expressions of E-cadherin, α-catenin and β-catenin frequently occur in breast cancer. Abnormal expression of E-cadherin-catenin complex is correlated with differentiation disturbance and metastasis. Combined measurement of E-caherin, α-catenin and β-catenin may improve accuracy and sensitivity of predicting metastasis and prognosis of breast cancer.

It remains unclear whether hyperplastic breast lesions, especially with atypia, are cancer precursors or markers of increased cancer risk. Quantified comparisons of genomic alterations in coexisting lesions could address this question. Therefore, we examined allele imbalance (AI), also known as loss of heterozygosity (LOH), at 20 microsatellite markers on nine chromosome arms, in DNA from 106 samples microdissected from 17 randomly selected cancer-containing breast specimens: 13 simple (DH) and 45 atypical ductal hyperplastic (ADH) lesions, 30 in situ (DCIS) and 18 invasive ductal carcinomas (IDC). Data were analysed using regression models and generalized estimating equations. We found that AI increased as histology became more aberrant and varied with histology across the chromosome arms (p

Although a variety of studies exists, the silicone controversy is still going on. In the present study we investigated the expression of the activation markers CD44-v6, intracellular adhesion molecule 1 (ICAM-1), and HLA class II molecules on breast epithelia adjacent to a silicone gel-filled breast implants (SGBI). Using an indirect immunoperoxidase procedure 12 tissue samples from implant recipients were investigated and 6 tissue samples from patients with slight breast hyperplasia were used as controls. Expression of CD44-v6 was found on ductal epithelia in all specimens from implant recipients, HLA-DR was expressed in all specimens, HLA-DQ in 3 of 10, and ICAM-1 in 8 of 12. In contrast, neither CD44-v6 nor HLA-DQ nor ICAM-1 were expressed on ductal epithelia from patients with slight breast hyperplasia, and HLA-DR was only weakly expressed in 2 of 6 patients. These data show that CD44-v6 can be expressed by benign cells under certain conditions, which may indicate an abnormal state of activation in breast tissue adjacent to an SGBI.

Cowden's disease is a rare entity accompanied with caracteristic mucocutaneous lesions, gastrointes-tinal polyposis, thyroid hyperplasia and breast hyperplasia. We describe a case of Cowden's disease in a 55-year-old woman accompanied with bilateral breast cancers, colon cancer and gastrointestinal polyposis. There were previous histories of undergoing operations for a goiter, left breast cancer, and right breast cancer when she was 40, 50, and 52 years old, respectively. Physical findings showed small popule on the face and extremities and papillomatous oral lesion. X-ray and endoscopic examinations revealed multiple polyps in the esophagus, stomach, duodenum and colon and a cancer of the sigmoid colon. Sigmoidectomy was performed. Histological findings of the cancer was well differenticated adenocarcinoma invaded the propria muscle and those of polyps indicated hyperplastic polyp. It has been reported that Cowden's disease is accompanied with malignant tumor in a high frequency and based on a review of the Japanese literature, malignant lesion have been reported in 18 out of 49 cases. When adiagnosis of Cowden's disease is made, we should screen probable maliganant lesions.

Benign breast hyperplasia is a diseases of civilization associated in women with hormonal disorders, estrogen dominance syndrome. Risk of developing breast cancer for women with proliferative forms of benign breast disease increased tenfold. Absolutely all patients seek medical attention, regardless of pathology, must undergo breast examination and obtain recommendations for the prevention and the multiplicity of diagnostic tests. An important role in the pathogenesis of benign breast hyperplasia plays an increase prolactin levels. Hyperprolactinemia is a frequent cause of menstrual and generative dysfunctions, as well as benign breast hyperplasia, which negatively affects the quality of women life. Quite often there is not a permanent but temporary (latent or hidden) increase prolactin secretion. Occasional bursts of prolactin levels, combined with hyperestrogenemia cause bloating, breast tenderness (mastalgia). Hyperprolactinemia induced menstrual dysfunction causes abnormal steroidogenesis in the ovaries, which also exacerbates the morphological and functional abnormalities in the mammary glands, promotes dishormonal breast diseases and increases the risk of breast cancer. Due to the increase of cancer incidence in all countries is increased emphasis on early tumors diagnosis and prevention. Special nutrition and various diets are considered as one of the variants of the anti-tumor protection. Numerous studies in recent years devoted phytonutrients – substances of plant origin. Phytopreparation that can be used in these disorders is Epigalin Brest® that contained indole-3-carbinol, epigallocatechin-3-gallate and Vitex agnus castus extract. Indole-3-carbinol and epigallocatechin-3-gallate are biologically active substances with a well-deserved popularity among clinicians in Europe and the United States. Herbal drug Epigalin Brest® regulates the metabolism of estrogen by blocking the synthesis of its “aggressive” forms, reduces the level of prolactin, inhibits the abnormal proliferation in hormone-dependent organs (mammary gland) and tissues of the reproductive system. Also Epigalin Brest® has antiproliferative effects.

Estrogens play a key role in the genesis and progression of breast cancer, activating two estrogen receptors, alpha and beta (ERα and ERβ). We have previously observed that ERα methylation occurs in high frequency and may be one of the mechanisms of ERα expression silence in a subset of Chinese sporadic breast cancers. However, the ERβ promoter methylation status and the relationship between clinicopathological characteristics and ERβ methylation in sporadic breast cancer are still unknown, especially in Chinese women. This study acted to determine the methylation status of the ERβ promoter and its correlation with clinicopathological features of sporadic breast cancers in Chinese women, and lay a foundation for the management of breast cancer. In total, 178 cases with sporadic breast cancers were enrolled in the study. ERβ methylation was determined using a methylation-specific polymerase chain reaction (MSP). In general, ERβ promoter methylation was found in 44.9% (80/178) of breast tumor samples, significantly higher than the benign breast hyperplasia (44.9% vs. 14.3%, X(2) = 4.986, P = 0.026). A total of 58% (40/69) of ERβ-negative tumors got methylation compared with 36.7% (40/109) of ERβ-positive cases being methylated (X(2) = 7.728, P = 0.005). The levels of ERβ protein expression diminished with the frequency of ERβ methylation (r = -0.249, P < 0.0001). In addition, we observed a strong correlation between ERα promoter and ERβ promoter methylation (odds ratio 2.054, 95% confidence interval 1.086-3.886, P = 0.026), and the triple-negative tumors showed a significantly higher methylation rate of ERβ. This study presents, for what we believe to be the first time, that ERβ methylation is also a frequent event in breast cancer and maybe also one of the mechanisms of ERβ expression silence in a subset of Chinese sporadic breast cancers. Epigenetic alteration of the ERβ gene may play an important role in the pathogenesis of breast cancer.

Obesity has been associated with abnormally high expression of the enzyme aromatase in the breast, increased local estrogen production, and predisposition to breast hyperplasia and cancer. Increased adiposity in postmenopausal women may trigger signaling pathways that induce aromatase expression. In breast adipose fibroblasts, increased TNF production may induce the distal aromatase promoter, whereas increased local PGE(2) production may induce the proximal promoter region. We review here the mechanisms that control aromatase gene expression in breast adipose tissue, and the paracrine interactions between malignant breast epithelial cells and the surrounding adipose fibroblasts. Systematic characterization of these signaling pathways will facilitate the identification of potential drug targets to selectively reduce aromatase expression and excessive estrogen production, with therapeutic benefit.

Expressions of Notch1 and Cyclin D1 were analysed by immunohistochemical method in the specimens of normal mammary tissue, usual hyperplasia, atypical hyperplasia, cancer in situ, and invasive cancer tissue, which were obtained from the patients operated due to some kind of breast disease. We observed an evidently decreased Notch1 and increased cyclin D1 expression respectively from normal tissue to invasive cancer, and a negative correlation was drawn between Notch1 and Cyclin D1. No correlation was found between Notch1 expression and any clinicopathologic parameter, but there was positive correlation between the Cyclin D1 expression and ER. This indicated the inhibiting function of Notch1 and promoting function of Cyclin D1 in proliferating process of mammary ductal tissue. From hyperplasia to cancer, there is a continus and sequential process, which suggest an intimate relationship between mammary hyperplasia and breast cancer. Key words-mammary ductal hyperplasia; invasive mammary cancer; Notch1; Cyclin D1; immunohistochemistry

Previous studies have shown the chromosomal alterations in usual ductal hyperplasia (UDH), atypical ductal hyperplasia (ADH), and ductal carcinoma in situ (DCIS) in the breast with bilateral ductal hyperplasia or adjacent to invasive ductal carcinoma (IDC). However, the role of UDH as a putative precursor of breast IDC is not clear and has not been fully addressed. The aim of this study was to clarify the role of UDH in breast carcinoma pathogenesis. To investigate chromosomal imbalances and commonality, samples of pure unilateral UDH (n=20) were obtained by laser capture microdissection and analyzed by comparative genomic hybridization. Other ductal lesions, including ADH (n=2), high-grade DCIS (n=3), and grade III IDC (n=5), were assessed at the same time for comparison. The mean values of alteration were 1.95 (39/20) in UDH, 9.5 (19/2) in ADH, 11.0 (33/3) in DCIS and 18.2 (89/5) in IDC, respectively. Some common predisposition regions for the deletions were at chromosomes 1p36-pter, 13q11-14, and 16q11-23, while the high frequency amplification regions were 1q31-qter, 3p21-pter, 6p21-pter, 11q11-14, 12q11-qter, 13q21-qter, 16p12-pter, 17q12-22, and 20q. The genetic abnormalities in the spectrum of breast ductal hyperplasia revealed that the deletion of DNA copy in UDH was the lowest, and gradually increased in the lineages of ADH, DCIS and IDC. Results showed that a significant portion of UDH shares common genetic alterations with ADH, DCIS and IDC, indicating UDH as a precursor of invasive breast ductal carcinoma.

Leprechaunism was first recognized in 1954 and is characterized by severe intrauterine and postnatal growth retardation, failure to thrive, lipoatrophy, dysmorphic features (globular eyes, large ears, and micrognathia), hirsutism and acanthosis nigricans. The presented infant, a 30 day-old boy, had multiple phenotypic anomalies, including low-set ears, prominent eyes, decreased subcutaneous fat, hirsutism, breast hyperplasia, and penile enlargement. We found persistent hyperglycemia with remarkably high immunoreactive insulin levels. His phenotypic and laboratory features were consistent with a diagnosis of leprechaunism. We observed some effect of treatment with metformin but not with insulin glargine.

To estimate whether breast uptake of (99m)Tc-(V)DMSA and (99m)Tc-sestamibi in usual ductal epithelial breast hyperplasia (UDH) and apocrine metaplasia is related to cell proliferation rate (Ki-67) and oestrogen receptor (ER) expression, both of which are associated with the potential risk of evolving to malignancy.Among patients referred for suspicious breast findings on palpation and/or mammography and evaluated preoperatively with both radiopharmaceuticals, we retrospectively studied 17 (10 with UDH: group I; and seven with apocrine metaplasia: group II). Lesion-to-background (L/B) ratios in early and late acquisitions were calculated for both radiotracers in both groups, as well as their retention ratios. Ki-67 and oestrogen receptor expression were determined immunohistochemically. The late L/B ratios between the two tracers were compared, as were the late ratios for each tracer between Ki-67or = 3% and3%, and between ERor = 15% and15%. Linear regression analysis was also performed between L/B and retention ratios and Ki-67 expression.There was a significant increase of the (99m)Tc-(V)DMSA L/B ratio in late images as compared to the early images in group I (P0.05), while in group II it was not significantly increased (P=0.084). (99m)Tc-sestamibi ratios did not demonstrate variability over time in either group (P=0.156 and 0.274, respectively). Significant coefficient correlation was found between the (99m)Tc-(V)DMSA L/B(late) ratios and retention ratios and Ki-67 levels only for group I (r=0.889, P0.001 and r=0.802, P0.01, respectively). The (99m)Tc-(V)DMSA L/B(late) ratios in group I were significantly higher when Ki-673% than when Ki-67or = 3% (P=0.016) but did not differ considerably between ER15% andor = 15% (P=0.732).(99m)Tc-(V)DMSA uptake in UDH correlates with Ki-67 expression. This could prove useful in identifying women with benign but high-risk breast pathologies who might benefit from chemoprophylaxis.

BACKGROUND. Atypical lobular hyperplasia (ALH) is associated with a 10% to 20% risk of subsequent invasive carcinoma, primarily in the ipsilateral breast. Nottingham grading, special tumor types, and survival after invasive cancer diagnosis were analyzed consistently for the first time. METHODS. A longitudinal follow-up study of 252 women who underwent 261 benign surgical biopsies between 1950 and 1985 with a diagnosis of ALH was undertaken. Subsequent invasive breast cancers were graded and subtyped based on histologic features and the cohort assessed for cancer survival. RESULTS. Forty-eight (19%) women developed invasive breast cancer at an average of 15.1 years. Twenty (42%) of the tumors were special subtype tumors with good prognosis. By an average of 13 years after invasive cancer diagnosis, 2 (10%) of 20 women with special type and variant tumors had died of breast cancer, compared with 9 (32%) of 28 women with tumors of no special type (24 tumors) or an unknown type (4 tumors). Only 1 patient with a tumor of low Nottingham grade died of breast cancer. CONCLUSIONS. ALH is a nonobligate cancer precursor associated with a moderate risk of breast cancer and predicts that later cancers are associated with overall excellent survival. Nearly half of the subsequent cancers show classic or variant patterns of special types with a good prognosis and the majority are of low or intermediate combined histologic grade. Treatment of women with ALH should be influenced by their modest elevation in breast cancer risk and the good prognosis and low mortality of many of these cancers. Cancer 2006. © 2006 American Cancer Society.

A diagnosis of atypical ductal hyperplasia (ADH) after breast core biopsy usually is followed by an excisional biopsy to exclude the presence of a more significant lesion. To determine whether the immunohistochemical expression of cyclin D1 (CyD1) and Ki-67 can aid in case stratification for the likelihood of finding ductal carcinoma in situ (DCIS) on subsequent excision, we immunohistochemically stained 21 consecutive ADH cases diagnosed by core biopsy, and proliferation indices (PIs) were calculated for each case. Fluorescence in situ hybridization to detect CCND1 amplification was performed in 10 cases. In 5 cases, DCIS (with or without invasive carcinoma) was identified in the subsequent excision. The mean PI CyD1 and PI Ki-67 for these cases were significantly higher than in the remainder (P = .03 and P = .05, respectively). The sensitivities of PI CyD1 and PI Ki-67 for the presence of DCIS on subsequent excision were 100%, and the specificities were 75% and 69%, respectively. The specificity of the 2 markers combined was 88%. The number of cells with CCND1 amplification was higher in cases with DCIS or ADH on subsequent excision. Immunostaining for CyD1 and Ki-67 might help stratify cases of ADH on core biopsy and identify patients unlikely to have DCIS found on excision.

Angiogenesis (as microvascular density—MVD) and vascular endothelial growth factor (VEGF) expression were evaluated by immunohistochemistry in all types of human pre-invasive breast lesion, un-associated with invasive carcinoma, including florid ductal hyperplasia of usual type (FDHUT, 40 cases), atypical ductal hyperplasia (ADH, 10), well-differentiated intraductal carcinoma (WDIC, 16), intermediately differentiated intraductal carcinoma (IDIC, 25), poorly differentiated intraductal carcinoma (PDIC, 20), atypical lobular hyperplasia (ALH, 13), and lobular carcinoma in situ (LCIS, 12). Both parameters were also studied in normal glandular structures obtained from normal breasts or from breasts containing pre-invasive lesions. Increased vascularization was present in all lesion types (MVD mean values (expressed as vessel number/mm2): 115 ± 8 in normal lobules, 146 ± 26 in lesions; p < 0.05) and increased with lesion severity. In ductal lesions, MVDs were significantly higher in PDIC (190 ± 65) and IDIC (167 ± 61) than in FDHUT (123 ± 40) and ADH (122 ± 47); MVD was much higher in PDIC than in WDIC (p < 0.001). WDIC showed peculiar features, with a degree of vascularization closer to hyperplasia than to the other histological types of in situ ductal cancer; this observation is in line with the hypothesis that IDIC and PDIC may originate ‘de novo’, without a mandatory transition through WDIC. LCIS was more vascularized than ALH (168 ± 50 and 125 ± 40, respectively; p < 0.05), showing MVD values similar to those of PDIC and IDIC. The vascularization of normal lobules was constant, regardless of their association with lesions. VEGF expression in normal glandular structures was lower than in lesions, with the highest levels found in ductal lesions when compared with lobular lesions. No correlation was found between VEGF expression and the degree and/or type of vascularization. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

To test directly the role of breast-tissue estrogen in initiation of breast cancer, we have developed the aromatase-transgenic mouse model and demonstrated for the first time that increased mammary estrogens resulting from the overexpression of aromatase in mammary glands lead to the induction of various preneoplastic and neoplastic changes that are similar to early breast cancer. Continued overexpression of aromatase that leads to increased breast-tissue estrogen contributes to a number of epigenetic changes in mammary tissue such as alteration in the regulation of genes involved in apoptosis, activation of genes involved in cell cycle and cell proliferation, and activation of a number of growth factors. Our current studies show aromatase overexpression is sufficient to induce and maintain early preneoplastic and neoplastic changes in female mice without circulating ovarian estrogen. Preneoplastic and neoplastic changes induced in mammary glands as a result of aromatase overexpression can be completely abrogated with the administration of the aromatase inhibitor, letrozole. Consistent with complete reduction in hyperplasia, we have also seen downregulation of estrogen receptor and a decrease in cell proliferation markers, suggesting aromatase-induced hyperplasia can be treated with aromatase inhibitors. Our studies demonstrate that aromatase overexpression alone, without circulating estrogen, is responsible for the induction of breast hyperplasia and these changes can be abrogated using aromatase inhibitors.

Laminin is a glycoprotein of the basement membrane (BM), involved in a variety of normal and pathological cellular events including tumour invasion and metastasis. Cells bind laminin through different types of receptor. The 67-kD laminin receptor (67LR) is a cell-surface protein which binds laminin with high affinity. 67LR expression has been shown to increase in neoplastic cells, compared with normal tissues, and 67LR seems to play an important role during the first steps of neoplastic progression. In this study, 67LR expression was analysed during the morphological phases of breast cancer progression from normal tissue to invasive carcinoma. A total of 506 formalin-fixed, paraffin-embedded normal breast structures and lesions were stained by immunohistochemistry using the MLuC5 monoclonal antibody, which is specific for 67LR. The results show that in normal breast and in any kind of breast lesion, myoepithelial and endothelial cells express 67LR. While 67LR is not seen in the epithelium of normal breast, cysts, adenosis, and benign tumours, it is expressed in the epithelial cells of several hyperplasias and carcinomas in situ, both ductal and lobular, as well as in all invasive carcinomas. The 67LR-positive cell subpopulation expands from hyperplastic lesions to invasive carcinoma, suggesting that 67LR could be related to the induction and progression of breast cancer. © 1997 John Wiley & Sons, Ltd.

The cytogenetic analysis of five mammary epithelial hyperplasias is reported. Only two cases had clonal chromosome alterations. Structural alterations involved chromosomes 1 and 5. Numerical alterations involved chromosomes X, 1, 6, 9, and 19. In four cases, the modal number was in the diploid range, and one case was tetraploid. The study of benign proliferations and their comparison with the chomosome alterations of their malignant counterparts could lead to a better understanding of the genes acting solely in cell proliferation and those that cause these cells to undergo malignant transformation and to become invasive.

A). No correlation (p =NS) was found between hormone receptors and CEA, CA 15−3, and MIB-1 in both groups. Conclusions: Our results suggests that (1) baseline STM CEA and CA 15−3 are not useful for prognostic purposes, (2) age, size, and ER are week isolated prognostic factors, and (3) the cumulative risk of relapse increases in the presence of multiple factors such younger age associated with highest levels of STMs and MIB-1, and low ER rate, together.

Purpose: The need for surgical excision in patients with ultrasound-guided core needle biopsy (CNB)-diagnosed atypical ductal hyperplasia (ADH) remains an issue of debate. The present study sought to validate a scoring system (the U score, for underestimation) that we have previously developed for predicting malignancy in CNB-diagnosed ADH. Methods: The study prospectively enrolled 85 female patients with CNB-diagnosed ADH who underwent subsequent surgical excision. Underestimation was defined as a surgical specimen having malignant foci. Results: The overall underestimation rate was 37% (31/85). Multivariate analysis showed that a clinically palpable mass, microcalcification on imaging, size > 15 mm and a patient age of ≥ 50 years were independently associated with underestimation. When applied to the scoring system, the validation score was significant (p< 0.001; area under the curve, 0.852). No patient with a U score < 3.5 had an underestimated lesion. Conclusion: The present study successfully validated the efficacy of our scoring system for predicting malignancy in CNB-diagnosed ADH. A U score of ≤ 3.5 indicates that surgical excision may not be necessary.

The purpose of this study was to investigate if ibuprofen intake can influence mammary uptake of the proliferation-seeking radiotracer technetium 99m-pentavalent dimercaptosuccinic acid (99mTc-(V)DMSA) in women with severe epithelial and atypical epithelial breast hyperplasia. Eight patients with histologically confirmed severe epithelial breast hyperplasia with (n = 4) and without atypia (n = 4) were submitted prospectively to 99mTc-(V)DMSA scintimammography before and after a 4-week course of 400 mg ibuprofen daily oral intake. Lesion to background ratios 60 minutes postinjection were calculated and compared (t-test) before and after ibuprofen administration. Prior to ibuprofen, the patients with severe epithelial hyperplasia displayed a significantly higher 99mTc-(V)DMSA uptake ratio compared to those with atypical epithelial hyperplasia (2.40 ± 0.32 vs 1.67 ± 0.09, respectively; p = .003). They also exhibited a more substantial percent decline in tracer uptake postibuprofen compared to women with atypical epithelial hyperplasia (62.0 ± 7.1 vs 15.0 ± 0.2, respectively; p = .001). Ibuprofen induces significant uptake reduction of the proliferation-seeking radiotracer 99mTc-(V)DMSA in severe epithelial breast hyperplasia without atypia. This agent could therefore constitute a potential imaging tool for monitoring chemoprophylaxis effectiveness in women at the early stages of malignant transformation.

Breast core needle biopsy (CNB) is an established method for diagnosing benign and malignant breast disease and CNB is widely used in daily practice. However, CNB samples only part of a lesion, and this can be the reason for an inaccurate diagnosis.(1) This size limitation of CNB gives rise to important diagnostic problems because one of the important factors for making the differential diagnosis between atypical ductal hyperplasia (ADH) and lowgrade ductal carcinoma in situ (DCIS) is the size of the lesion.(2,3) Previous studies have reported that ADH in a CNB showed significant discordance in the subsequent surgical excision specimens for which 33-87% demonstrated ductal carcinoma such as DCIS and invasive ductal carcinoma (IDC).(4-11) Therefore, surgical excision is presently recommended when ADH is diagnosed in a CNB. Investigations to determine the factors that are predictive of more advanced lesions in surgical excision specimens when ADH was diagnosed in the CNB have suggested cytologic atypia,(11) more than 4 foci (7) and micropapillary architecture (7), yet consistent results were not demonstrated. The purpose of this study was to identify the predictive factors that suggest the diagnosis of ductal carcinoma in the subsequent surgical excision specimens when ADH is diagnosed in a CNB.

A 24-year-old woman, para 2, who was 36 weeks pregnant, presented with massive diffuse enlargement of both breasts, which had progressed since conception (Panel A). There had been no such enlargement during her earlier pregnancies. Multiple cutaneous ulcerations occurred as a result of the rapid enlargement of the breasts over a period of 4 to 5 months. The breasts were normal on ultrasonography. Fine-needle aspiration revealed hyperplasia of the mammary glands that was consistent with pregnancy (Panel B), with no evidence of fibrosis or cancer. Supportive treatment was given until delivery at 38 weeks of gestation. The patient did not . . .

In a previous communication (1) dealing with benign fibro-adenomata of the rat's breast, morphologic changes appearing in the transplanted tumors were described. From time to time there occurred variations in the rate of growth, and in the size and consistency of the growing transplants. Differences in the proliferative ratio of stroma and glandular substance also appeared. These changes seemed to be associated with factors relating to sex, to the age of the animal at the time of inoculation, and to pregnancy. The relationship of age, sex, and other factors to the origin and growth of spontaneous and transplanted malignant tumors in mice is discussed by Woglom (2). He quotes Gierke (3) to the effect that young mice (before puberty had supervened) were as suitable as older animals for transplanting tumors, and mentions Loeb (4), Ehrlich (5), Gierke (3), and Lewin (6) as finding no difference in susceptibility between males and females. The influence of gestation and lactation is also mentioned, but here the observations are contradictory. No reference is made to the role of the above factors in benign tumor growth. The present report attempts, in the first place, to determine whether endogenous hormonal factors play a role in experimentally produced benign fibro-adenomata of the rat's breast, growing in animals of different age groups, different sexes, and during pregnancy and lactation. A further study deals with results in male and female castrates, while other series of experiments were undertaken to determine the effect on transplanted tumors and on normal breast tissue of exogenous hormones injected subcutaneously in white rats. I. Endogenous Hormonal Factors The Age Factor: As previously mentioned, the age of the animal at the time of tumor inoculation influences the morphology of the implanted benign fibro-adenoma. The age of the animal from which the tumor is derived and the age of the tumor must also be taken into consideration.

The results of a series of 305 consecutive office curettages are presented. The patients were subjected to the procedure because of either menometrorrhagia functional sterility amenorrhea premenstrual tension or abnormal breast hyperplasia. 5 early cases of adenocarcinoma were discovered. Only 2 patients had untoward reactions to the procedure which were temporary. Curettage provided valuable information regarding the etiology of the symptoms. Office curettage when performed by a trained gynecologist is a safe and useful procedure.

A GREAT deal of clinical and experimental investigation of the relationship of the ovarian hormones to benign breast neoplasms is being conducted and reported. With these facts in mind, it was decided to analyze our clinical data, with the hope that these relationships would hold for the human breast. Benign hyperplasia of the breast is a multiform and complex disease, the life history of which may last from several months to more than the entire active life span of the ovaries. The normal breast originates from a group of cells which are, beside other factors, apparently under ovarian hormonal influence. The development of the ducts is influenced by estrin, which is normally present throughout the menstrual cycle in varying amounts (1). The growth of the acini is said to occur under the influence of progestin which is normally present in the latter part of the cycle (2, 3, 4). In animal experimentation it has been shown that progestin probably influences acinar development, but in the human breast eviden...