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Breast cancer typically arises from the terminal duct-lobular unit of the mammary gland and rarely from the ducts inside the nipple. The present paper reports a rare case of primary invasive ductal carcinoma of the papilla, which was a locally advanced triple-negative breast cancer that was treated with 6 cycles of neoadjuvant chemotherapy with a nab-paclitaxel, epirubicin and cyclophosphamide regimen. Surgical pathology confirmed that a pathological complete response was achieved and adjuvant radiotherapy was performed postoperatively. No recurrence or metastasis occurred as of April 2024. A review of previous similar cases revealed that primary invasive breast cancer of the nipple has several manifestations. Changes in the nipple should be treated cautiously and a pathological biopsy should be performed in a timely manner. Breast cancer occurring in the nipple can be treated with reference to the same type of common breast cancer, and neoadjuvant chemotherapy can also be performed first if neoadjuvant chemotherapy is indicated. [ABSTRACT FROM AUTHOR]

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]

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.

Objectives: To explore the utility of gray-scale ultrasound (GSUS) and mammography (MG) for radiomic analysis in distinguishing between breast adenosis and invasive ductal carcinoma (IDC). Methods: Data from 147 female patients with pathologically confirmed breast lesions (breast adenosis: 61 patients; IDC: 86 patients) between January 2018 and December 2022 were retrospectively collected. A training cohort of 113 patients (breast adenosis: 50 patients; IDC: 63 patients) diagnosed from January 2018 to December 2021 and a time-independent test cohort of 34 patients (breast adenosis: 11 patients; IDC: 23 patients) diagnosed from January 2022 to December 2022 were included. Radiomic features of lesions were extracted from MG and GSUS images. The least absolute shrinkage and selection operator (LASSO) regression was applied to select the most discriminant features, followed by logistic regression (LR) to construct clinical and radiomic models, as well as a combined model merging radiomic and clinical features. Model performance was assessed using receiver operating characteristic (ROC) analysis. Results: In the training cohort, the area under the curve (AUC) for radiomic models based on MG features, GSUS features, and their combination were 0.974, 0.936, and 0.991, respectively. In the test cohort, the AUCs were 0.885, 0.876, and 0.949, respectively. The combined model, incorporating clinical and all radiomic features, and the MG plus GSUS radiomics model were found to exhibit significantly higher AUCs than the clinical model in both the training cohort and test cohort (p<0.05). No significant differences were observed between the combined model and the MG plus GSUS radiomics model in the training cohort and test cohort (p>0.05). Conclusion: The effectiveness of radiomic features derived from GSUS and MG in distinguishing between breast adenosis and IDC is demonstrated. Superior discriminatory efficacy is shown by the combined model, integrating both modalities. [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]

Clinical and pathologic characteristics of the invasive ductal carcinoma (IDC) presenting as a thick-walled breast cyst are little known. Three female patients were included in this report. A palpable, nontender breast lump was found in all cases. While mammography showed a hyperdense mass, ultrasonography demonstrated a thick-walled cystic mass. Magnetic resonance imaging clearly showed the cystic breast lesions with ring-like or irregular rim enhancement. A grade III IDC was confirmed in all cases. All IDCs but one were estrogen receptor negative, progesterone receptor negative, and human epidermal growth factor receptor 2 negative, with merely weak progesterone receptor positivity (5%) in one case. All cases underwent surgical management first and postoperative chemotherapy. Breast malignancy presenting as a thick-walled cystic mass could be a highly aggressive IDC, even triple-negative breast cancer. It is imperative for breast cancer-related practitioners to identify the potentially malignant cystic lesions timely and adopt appropriate management. [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]

A 54-year-old female presented with a recurrent mass in the right breast for eight months, associated with pain and discolouration of the skin for two weeks. Past history revealed a wide local excision of a tumour in the same breast 10 months ago, which was reported as a benign phyllodes tumour. Local examination revealed a bosselated mass of size 20×20×10 cm occupying all four quadrants of the right breast, along with another firm lump of size 3×3 cm in the lower inner quadrant. Magnetic Resonance Imaging (MRI) of the breast showed two separate lumps: the large lump involved all four quadrants of the right breast and was suggestive of malignant transformation of a recurrent phyllodes tumour-BIRADS V (Breast Imaging-Reporting and Data System), and another smaller lump was noted in the lower inner quadrant. A Tru-cut biopsy of the larger lesion was reported as a possibility of a phyllodes tumour with mild nuclear atypia. The total mastectomy specimen showed both solid and cystic areas with necrotic material, haemorrhagic fluid, and blood clots in the larger lump. A separate lump from the lower inner quadrant of the ipsilateral breast showed a firm, solid lesion. Microscopic examination of both lesions revealed the simultaneous presentation of a malignant phyllodes tumour with chondrosarcomatous differentiation and infiltrating ductal carcinoma. This case highlights the unpredictable co-existence of two separate malignant lumps in the ipsilateral breast, which is an extremely rare event.

BACKGROUND: Breast cancer has the second highest mortality rate of all cancers and occurs mainly in women. OBJECTIVE: To investigate the relationship between magnetic resonance imaging (MRI) radiomics features and histological grade of invasive ductal carcinoma (IDC) of the breast and to evaluate its diagnostic efficacy. METHODS: The two conventional MRI quantitative indicators, i.e. the apparent diffusion coefficient (ADC) and the initial enhancement rate, were collected from 112 patients with breast cancer. The breast cancer lesions were manually segmented in dynamic contrast-enhanced MRI (DCE-MRI) and ADC images, the differences in radiomics features between Grades I, II and III IDCs were compared and the diagnostic efficacy was evaluated. RESULTS: The ADC values (0.77 ± 0.22 vs 0.91 ± 0.22 vs 0.92 ± 0.20, F = 4.204, p < 0.01), as well as the B_sum_variance (188.51 ± 67.803 vs 265.37 ± 77.86 vs 263.74 ± 82.58, F = 6.040, p < 0.01), L_energy (0.03 ± 0.02 vs 0.13 ± 0.11 vs 0.12 ± 0.14, F = 7.118, p < 0.01) and L_sum_average (0.78 ± 0.32 vs 16.34 ± 4.23 vs 015.45 ± 3.74, F = 21.860, p < 0.001) values of patients with Grade III IDC were significantly lower than those of patients with Grades I and II IDC. The B_uniform (0.15 ± 0.12 vs 0.11 ± 0.04 vs 0.12 ± 0.03, F = 3.797, p < 0.01) and L_SRE (0.85 ± 0.07 vs 0.78 ± 0.03 vs 0.79 ± 0.32, F = 3.024, p < 0.01) values of patients with Grade III IDC were significantly higher than those of patients with Grades I and II IDC. All differences were statistically significant (p < 0.05). The ADC radiomics signature model had a higher area-under-the-curve value in identifying different grades of IDC than the ADC value model and the DCE radiomics signature model (0.869 vs 0.711 vs 0.682). The accuracy (0.812 vs 0.647 vs 0.710), specificity (0.731 vs 0.435 vs 0.342), positive predictive value (0.815 vs 0.663 vs 0.669) and negative predictive value (0.753 vs 0.570 vs 0.718) of the ADC radiomics signature model were all significantly better than the ADC value model and the DCE radiomics signature model. CONCLUSION: ADC values and breast MRI radiomics signatures are significant in identifying the histological grades of IDC, with the ADC radiomics signatures having greater value. [ABSTRACT FROM AUTHOR]

Introduction: Breast carcinoma is leading cause of cancer death in women. Breast lesions constitute heterogeneous group of diseases with wide variety of etiologies ranging from inflammatory-benign- malignant lesions. There are several reported markers for immunohistochemical detection of myoepithelial cells. Smooth muscle specific proteins, such as smooth muscle actin, smooth muscle myosin heavy chain, calponin and h-caldesmon are used to highlight myoepithelium. p63 antibody is myoepithelial cell marker that selectively stains nuclei. It is negative in stromal, myofibroblastic and adipocytic cells. Aims and Objectives: The aim of this study was to establish role of p63 expression in distinguishing benign breast lesions, premalignant lesions and malignant tumors of breast. Materials and Methods: 30 cases were selected from core biopsy, lumpectomy and mastectomy specimens of breast received at department of Pathology, Chalmeda Anand Rao Institute of Medical Sciences during the period of January 2021 to December 2021 and were studied prospectively. All specimens were processed according to CAP protocol and reported . Immunohistochemistry was performed to determine p63 expression in those specimens. p63expression was evaluated as continuous positive/discontinuous positive/negative. Ethical Approval: This study was reviewed and approved by institute ethics committee, CAIMS, Karimnagar. Results: Among total 30 cases, 18 cases (60%) were benign lesions and all were positive for p63 expression. 3 cases (9.99%) were premalignant and were least positive for p63 expression. All malignant cases 9 cases (29.99%) were negative for p63 expression. Conclusion: The Positive correlation was seen between histomorphological features and p63 scoring in all the lesions, So p63 is good Immunohistochemical marker for evaluating breast lesions. [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]

OBJECTIVE: To explore the discriminatory diagnostic value of multimodal ultrasound(US) combined with blood cell analysis (BCA) for Granulomatous Lobular Mastitis (GLM) and Invasive Ductal Carcinoma (IDC) of the breast. METHODS: A total of 157 breast disease patients were collected and divided into two groups based on postoperative pathological results: the GLM group (57 cases with 57 lesions) and the IDC group (100 cases with 100 lesions). Differences in multimodal ultrasound features and the presence of BCA were compared between the two groups. The receiver operating characteristic (ROC) curve was used to calculate the optimal cutoff values, sensitivity, specificity, 95% confidence interval (CI), and the area under the curve (AUC) for patient age, lesion size, lesion resistive index (RI), and white blood cell (WBC) count in BCA. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and AUC were calculated for different diagnostic methods. RESULTS: There were statistically significant differences (P < 0.05) observed between GLM and IDC patients in terms of age, breast pain, the factors in Conventional US (lesion size, RI, nipple delineation, solitary/multiple lesions, margin, liquefaction area, growth direction, microcalcifications, posterior echogenicity and abnormal axillary lymph nodes), the factors in CEUS (contrast agent enhancement intensity, enhancement pattern, enhancement range, and crab-like enhancement) and the factors in BCA (white blood cells, neutrophils, lymphocytes and monocytes). ROC curve analysis results showed that the optimal cutoff values for distinguishing GLM from IDC were 40.5 years for age, 7.15 cm for lesion size, 0.655 for lesion RI, and 10.525*109/L for white blood cells. The diagnostic accuracy of conventional US combined with CEUS (US-CEUS) was the highest (97.45%). The diagnostic performance AUCs for US-CEUS, CEUS, and US were 0.965, 0.921 and 0.832, respectively. CONCLUSION: Multifactorial analysis of multimodal ultrasound features and BCA had high clinical application value in the differential diagnosis of GLM and IDC. [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.

A 54-year-old female presented with a recurrent mass in the right breast for eight months, associated with pain and discolouration of the skin for two weeks. Past history revealed a wide local excision of a tumour in the same breast 10 months ago, which was reported as a benign phyllodes tumour. Local examination revealed a bosselated mass of size 20x20x10 cm occupying all four quadrants of the right breast, along with another firm lump of size 3x3 cm in the lower inner quadrant. Magnetic Resonance Imaging (MRI) of the breast showed two separate lumps: the large lump involved all four quadrants of the right breast and was suggestive of malignant transformation of a recurrent phyllodes tumour-BIRADS V (Breast Imaging-Reporting and Data System), and another smaller lump was noted in the lower inner quadrant. A Tru-cut biopsy of the larger lesion was reported as a possibility of a phyllodes tumour with mild nuclear atypia. The total mastectomy specimen showed both solid and cystic areas with necrotic material, haemorrhagic fluid, and blood clots in the larger lump. A separate lump from the lower inner quadrant of the ipsilateral breast showed a firm, solid lesion. Microscopic examination of both lesions revealed the simultaneous presentation of a malignant phyllodes tumour with chondrosarcomatous differentiation and infiltrating ductal carcinoma. This case highlights the unpredictable co-existence of two separate malignant lumps in the ipsilateral breast, which is an extremely rare event. [ABSTRACT FROM AUTHOR]

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]

Metaplastic breast carcinoma is rare and may present as a highly aggressive subtype of breast cancer. In this case report of metastatic metaplastic breast carcinoma with osteosarcomatous differentiation in a female patient previously treated for invasive ductal carcinoma, we describe the new presentation of a palpable mass with associated calcifications on imaging near the site of prior partial mastectomy. This article will detail the clinical presentation, imaging findings, histopathology, and clinical course following treatment of our case. Knowledge of the clinical and imaging presentation of this rare subtype, which can present with benign features on mammography and ultrasound, can facilitate timely diagnosis as treatment paradigms evolve.

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]

We report 2 rare cases of male breast cancer with bloody nipple discharge. Patient 1, a 32-year-old male, presented with a bloody nipple discharge from the left breast. Diagnostic workup revealed papillary ductal carcinoma in situ. Patient 1 underwent bilateral mastectomy with left axillary sentinel lymph node biopsy and has been doing well ever since. Patient 2, a 70-year-old male with concomitant metastatic prostate cancer, presented with a palpable right breast mass and with initially serous, then bloody nipple discharge. Diagnostic workup revealed invasive ductal carcinoma with ductal carcinoma in situ of the right breast. Patient 2 received aromatase inhibitor therapy prior to right total mastectomy with SLN biopsy followed by adjuvant tamoxifen therapy. Patient 2 recovered without complication for 2 years until metastatic disease recurrence was detected. This case report's purpose is to increase awareness and enhance understanding of the presentation, diagnosis, treatment, and outcomes of rare malignant pathologies.

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.

PurposeNon-puerperal mastitis (NPM) accounts for approximately 4-5% of all benign breast lesions. Ultrasound is the preferred method for screening breast diseases; however, similarities in imaging results can make it challenging to distinguish NPM from invasive ductal carcinoma (IDC). Our objective was to identify convenient and objective hematological markers to distinguish NPM from IDC.MethodsWe recruited 89 patients with NPM, 88 with IDC, and 86 with fibroadenoma (FA), and compared their laboratory data at the time of admission. LASSO regression, univariate logistic regression, and multivariate logistic regression were used to screen the parameters for construction of diagnostic models. Receiver operating characteristic curves, calibration curves, and decision curves were constructed to evaluate the accuracy of this model.ResultsWe found significant differences in routine laboratory data between patients with NPM and IDC, and these indicators were candidate biomarkers for distinguishing between the two diseases. Additionally, we evaluated the ability of some classic hematological markers reported in previous studies to differentiate between NPM and IDC, and the results showed that these indicators are not ideal biomarkers. Furthermore, through rigorous LASSO and logistic regression, we selected age, white blood cell count, and thrombin time to construct a differential diagnostic model that exhibited a high level of discrimination, with an area under the curve of 0.912 in the training set and with 0.851 in the validation set. Furthermore, using the same selection method, we constructed a differential diagnostic model for NPM and FA, which also demonstrated good performance with an area under the curve of 0.862 in the training set and with 0.854 in the validation set. Both of these two models achieved AUCs higher than the AUCs of models built using machine learning methods such as random forest, decision tree, and SVM in both the training and validation sets.ConclusionCertain laboratory parameters on admission differed significantly between the NPM and IDC groups, and the constructed model was designated as a differential diagnostic marker. Our analysis showed that it has acceptable efficiency in distinguishing NPM from IDC and may be employed as an auxiliary diagnostic tool.

Objective: To analyze the clinical and ultrasonic characteristics of breast sclerosing adenosis (SA) and invasive ductal carcinoma (IDC), and construct a predictive nomogram for SA. Materials and methods: A total of 865 patients were recruited at the Second Hospital of Shandong University from January 2016 to November 2022. All patients underwent routine breast ultrasound examinations before surgery, and the diagnosis was confirmed by histopathological examination following the operation. Ultrasonic features were recorded using the Breast Imaging Data and Reporting System (BI-RADS). Of the 865 patients, 203 (252 nodules) were diagnosed as SA and 662 (731 nodules) as IDC. They were randomly divided into a training set and a validation set at a ratio of 6:4. Lastly, the difference in clinical characteristics and ultrasonic features were comparatively analyzed. Result: There was a statistically significant difference in multiple clinical and ultrasonic features between SA and IDC (P<0.05). As age and lesion size increased, the probability of SA significantly decreased, with a cut-off value of 36 years old and 10 mm, respectively. In the logistic regression analysis of the training set, age, nodule size, menopausal status, clinical symptoms, palpability of lesions, margins, internal echo, color Doppler flow imaging (CDFI) grading, and resistance index (RI) were statistically significant (P<0.05). These indicators were included in the static and dynamic nomogram model, which showed high predictive performance, calibration and clinical value in both the training and validation sets. Conclusion: SA should be suspected in asymptomatic young women, especially those younger than 36 years of age, who present with small-size lesions (especially less than 10 mm) with distinct margins, homogeneous internal echo, and lack of blood supply. The nomogram model can provide a more convenient tool for clinicians. [ABSTRACT FROM AUTHOR]

Prediction of the stage of cancer plays an important role in planning the course of treatment and has been largely reliant on imaging tools which do not capture molecular events that cause cancer progression. Gene-expression data–based analyses are able to identify these events, allowing RNA-sequence and microarray cancer data to be used for cancer analyses. Breast cancer is the most common cancer worldwide, and is classified into four stages — stages 1, 2, 3, and 4 [2]. While machine learning models have previously been explored to perform stage classification with limited success, multi-class stage classification has not had significant progress. There is a need for improved multi-class classification models, such as by investigating deep learning models. Gene-expression-based cancer data is characterised by the small size of available datasets, class imbalance, and high dimensionality. Class balancing methods must be applied to the dataset. Since all the genes are not necessary for stage prediction, retaining only the necessary genes can improve classification accuracy. The breast cancer samples are to be classified into 4 classes of stages 1 to 4. Invasive ductal carcinoma breast cancer samples are obtained from The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) datasets and combined. Two class balancing techniques are explored, synthetic minority oversampling technique (SMOTE) and SMOTE followed by random undersampling. A hybrid feature selection pipeline is proposed, with three pipelines explored involving combinations of filter and embedded feature selection methods: Pipeline 1 — minimum-redundancy maximum-relevancy (mRMR) and correlation feature selection (CFS), Pipeline 2 — mRMR, mutual information (MI) and CFS, and Pipeline 3 — mRMR and support vector machine–recursive feature elimination (SVM-RFE). The classification is done using deep learning models, namely deep neural network, convolutional neural network, recurrent neural network, a modified deep neural network, and an AutoKeras generated model. Classification performance post class-balancing and various feature selection techniques show marked improvement over classification prior to feature selection. The best multiclass classification was found to be by a deep neural network post SMOTE and random undersampling, and feature selection using mRMR and recursive feature elimination, with a Cohen-Kappa score of 0.303 and a classification accuracy of 53.1%. For binary classification into early and late-stage cancer, the best performance is obtained by a modified deep neural network (DNN) post SMOTE and random undersampling, and feature selection using mRMR and recursive feature elimination, with an accuracy of 81.0% and a Cohen-Kappa score (CKS) of 0.280. This pipeline also showed improved multiclass classification performance on neuroblastoma cancer data, with a best area under the receiver operating characteristic (auROC) curve score of 0.872, as compared to 0.71 obtained in previous work, an improvement of 22.81%. The results and analysis reveal that feature selection techniques play a vital role in gene-expression data-based classification, and the proposed hybrid feature selection pipeline improves classification performance. Multi-class classification is possible using deep learning models, though further improvement particularly in late-stage classification is necessary and should be explored further. [ABSTRACT FROM AUTHOR]

Keywords: Cutaneous metastases; Metastatic breast carcinoma; Invasive ductal carcinoma; Invasive lobular carcinoma EN Cutaneous metastases Metastatic breast carcinoma Invasive ductal carcinoma Invasive lobular carcinoma 2725 2728 4 09/25/23 20231101 NES 231101 To the Editor, Cutaneous metastases of primary breast carcinoma (CMBC) occur in nearly 30% of patients with breast cancer [[1]]. Lymph-node metastases in invasive lobular carcinoma are different from those in ductal carcinoma of the breast. Cutaneous metastases, Metastatic breast carcinoma, Invasive ductal carcinoma, Invasive lobular carcinoma. [Extracted from the article]

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]

Due to limited biopsy samples, ~20% of DCIS lesions confirmed by biopsy are upgraded to invasive ductal carcinoma (IDC) upon surgical resection. Avoiding underestimation of IDC when diagnosing DCIS has become an urgent challenge in an era discouraging overtreatment of DCIS. In this study, the metabolic profiles of 284 fresh frozen breast samples, including tumor tissues and adjacent benign tissues (ABTs) and distant surrounding tissues (DSTs), were analyzed using desorption electrospray ionization‐mass spectrometry (DESI‐MS) imaging. Metabolomics analysis using DESI‐MS data revealed significant differences in metabolite levels, including small‐molecule antioxidants, long‐chain polyunsaturated fatty acids (PUFAs) and phospholipids between pure DCIS and IDC. However, the metabolic profile in DCIS with invasive carcinoma components clearly shifts to be closer to adjacent IDC components. For instance, DCIS with invasive carcinoma components showed lower levels of antioxidants and higher levels of free fatty acids compared to pure DCIS. Furthermore, the accumulation of long‐chain PUFAs and the phosphatidylinositols (PIs) containing PUFA residues may also be associated with the progression of DCIS. These distinctive metabolic characteristics may offer valuable indications for investigating the malignant potential of DCIS. By combining DESI‐MS data with machine learning (ML) methods, various breast lesions were discriminated. Importantly, the pure DCIS components were successfully distinguished from the DCIS components in samples with invasion in postoperative specimens by a Lasso prediction model, achieving an AUC value of 0.851. In addition, pixel‐level prediction based on DESI‐MS data enabled automatic visualization of tissue properties across whole tissue sections. Summarily, DESI‐MS imaging on histopathological sections can provide abundant metabolic information about breast lesions. By analyzing the spatial metabolic characteristics in tissue sections, this technology has the potential to facilitate accurate diagnosis and individualized treatment of DCIS by inferring the presence of IDC components surrounding DCIS lesions. © 2023 The Pathological Society of Great Britain and Ireland. [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]

Summary: Background: Invasive lobular carcinoma (ILC) represents the second most common type of invasive breast cancer (BC). Although ILC generally have good prognostic properties (positive estrogen receptor, ER, low tumor grade), they are generally diagnosed at a more advanced stage. The data on the axillary lymph node status in ILC compared to invasive ductal carcinoma (IDC) are considered controversial. Therefore, the aim of this study was to compare the pathological node stage (pN) between ILC and IDC in an Austria-wide register. Methods: Data of the Clinical Tumor Register (Klinisches TumorRegister, KTR) of the Austrian Association for Gynecological Oncology (AGO) were retrospectively analyzed. Patients with primary early BC, invasive lobular or ductal, diagnosed between January 2014 and December 2018, and primary surgery were included. A total of 2127 tumors were evaluated and compared in 2 groups, ILC n = 303, IDC n = 1824. Results: A total of 2095 patients were analyzed in the study. In the multivariate analysis, pN2 and pN3 were observed significantly more frequently in ILC compared with IDC (odds ratio, OR 1.93; 95% confidence interval, CI 1.19–3.14; p = 0.008 and OR 3.22; 95% CI: 1.47–7.03; p = 0.003; respectively). Other factors associated with ILC were tumor grades 2 and 3, positive ER, and pathological tumor stage (pT) 2 and pT3. In contrast, concomitant ductal carcinoma in situ, overexpression of the human epidermal growth factor receptor 2 (HER2), and a moderate and high proliferation rate (Ki67) were found less frequently in ILC. Conclusion: The data show an increased risk of extensive axillary lymph node metastasis (pN2/3) in ILC. [ABSTRACT FROM AUTHOR]

Abstract Aim We constructed a multicentre cohort in China to analyse the differences in clinical characteristics, treatment strategies and prognoses between breast neuroendocrine carcinoma (NEC) and invasive ductal carcinoma (IDC) of the breast. Methods All patients with early‐stage breast cancer who attended three hospitals in Beijing from 2000 to 2018 were included in the study. We used propensity score matching to make a 1:3 match between NEC and IDC. Results After propensity score matching, 153 patients with IDC and 51 patients with NEC were analysed. Multivariate Cox regression showed that compared to patients with IDC, patients with NEC had a worse disease‐free survival (HR = 2.94, 95% CI: 1.69–5.12, p

Background: Invasive ductal carcinoma (IDC) is the most common type of breast cancer (BC) worldwide. Nowadays, due to its heterogeneity and high capacity for metastasis, it is necessary to discover novel diagnostic and prognostic biomarkers. Therefore, this study aimed to identify novel candidate prognostic genes for IDC using an integrated bioinformatics approach. Methods: Three expression profile data sets were obtained from GEO (GSE29044, GSE3229, and GSE21422), from which differentially expressed genes (DEGs) were extracted for comparative transcriptome analysis of experimental groups (IDC versus control). Next, STRING was utilized to construct a protein interaction network with the shared DEGs, and MCODE and cytoHubba were used to identify the hub genes, which were then characterized using functional enrichment analysis in DAVID and KEGG. Finally, using the Kaplan-Meier tracer database, we determined the correlation between the expression of hub genes and overall survival in BC. Results: We identified seven hub genes (Kinesin-like protein KIF23 [KIF23], abnormal spindle-like microcephaly [ASPM]-associated protein [ASPMAP], Aurora kinase A [AURKA], Rac GTPase-activating protein 1 [RACGAP1], centromere protein F [CENPF], hyaluronan-mediated motility receptor [HMMR], and protein regulator of cytokinesis 1 [PRC1]), which were abundant in microtubule binding and tubulin binding, pathways linked to fundamental cellular structures including the mitotic spindle, spindle, microtubule, and spindle pole. The role of these genes in the pathophysiology of IDC is not yet well characterized; however, they have been associated with other common types of BC, modulating pathways such as Wnt/β-catenin, the epithelial-to-mesenchymal transition (EMT) process, chromosomal instability (CIN), PI3K/AKT/mTOR, and BRCA1 and BRCA2, playing an important role in its progression and being associated with a poor prognosis, thus representing a way to improve our understanding of the process of tumorigenesis and the underlying molecular events of IDC. Conclusions: Genes identified may lead to the discovery of new prognostic targets for IDC.

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.

Objectives: We aimed to study the immunohistochemical and clinicopathological characteristics of invasive breast carcinoma among Nigerian women. Methods: We conducted a retrospective assessment of female patients diagnosed with breast carcinoma at a tertiary hospital in Nigeria between 2012 and 2019. Archived pathology request forms and processed specimens (tissue blocks and slides) were used as source data in addition to the patients’ demographic and other relevant data. Results: Reports pertaining to 113 patients were assessed. Their age range was 30 to 80 years (mean = 52.1±12.1 years). Breast carcinoma was most common in patients aged 40 to 49 years (32.7%), closely followed by those aged 50 to 59 years (30.1%). Invasive ductal carcinoma was the most common histopathological subtype (94.7%). Nottingham grade III and grade II breast carcinoma accounted for 41.6% and 40.7% of the cases, respectively. Mastectomy specimens formed 68.1% of the samples. The most common tumor size (75.9%) was > 5cm (mean = 6.8±3.2cm), consistent with the most common staging of T3 (46.0%). The most common lymph node involvement was N1 (56.6%). Immunohistochemical assessment of these tumors with estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 (HER-2) biomarkers expressed positivity of 36.3%, 28.3%, and 41.6%, respectively. These tumors were immunohistochemically classified into luminal A (16.8%), luminal B (20.4%), HER-2 enriched (20.4%), and triple-negative (42.5%) subtypes. Conclusions: The most common immunohistochemical subtype of invasive breast carcinoma among this sample of Nigerian women was the triple-negative subtype, similar to the finding among African Americans.

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]

Atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) are relatively common breast lesions on the same spectrum of disease. Atypical ductal hyperblasia is a nonmalignant, high-risk lesion, and DCIS is a noninvasive malignancy. While a benefit of screening mammography is early cancer detection, it also leads to increased biopsy diagnosis of noninvasive lesions. Previously, treatment guidelines for both entities included surgical excision because of the risk of upgrade to invasive cancer after surgery and risk of progression to invasive cancer for DCIS. However, this universal management approach is not optimal for all patients because most lesions are not upgraded after surgery. Furthermore, some DCIS lesions do not progress to clinically significant invasive cancer. Overtreatment of high-risk lesions and DCIS is considered a burden on patients and clinicians and is a strain on the health care system. Extensive research has identified many potential histologic, clinical, and imaging factors that may predict ADH and DCIS upgrade and thereby help clinicians select which patients should undergo surgery and which may be appropriate for active surveillance (AS) with imaging. Additionally, multiple clinical trials are currently underway to evaluate whether AS for DCIS is feasible for a select group of patients. Recent advances in MRI, artificial intelligence, and molecular markers may also have an important role to play in stratifying patients and delineating best management guidelines. This review article discusses the available evidence regarding the feasibility and limitations of AS for ADH and DCIS, as well as recent advances in patient risk stratification. [ABSTRACT FROM AUTHOR]

Purpose of Review: Many processes in the male breast are similar to those encountered in female patients, with a few notable differences. While the majority of male breast pathology is benign, a working knowledge of varying imaging presentations of both benign and malignant pathology is necessary to guide appropriate management. The focus of this review is to highlight the classic mammographic and sonographic appearances of benign and malignant pathologies in the male breast. Recent findings: Mammography is the initial modality of choice for symptomatic male patients who are 25 years of age or older. In patients younger than 25, however, ultrasound should be performed first. Screening mammography for the general male population is not currently widely recommended due to the low prevalence of breast cancer in men. Additionally, although no current guidelines exist regarding the utilization of breast magnetic resonance imaging (MRI) in men, it can be used as an adjunct imaging modality for treatment planning in patients with breast cancer. Summary: Mammography and ultrasound are the mainstay imaging modalities for evaluating the symptomatic male breast. Core needle biopsy can be performed in cases of suspicious findings. [ABSTRACT FROM AUTHOR]

Abstract Background Inadequate immunity caused by poor immune surveillance leads to tumorigenesis, while excessive immunity due to breakdown of immune tolerance causes autoimmune genesis. Although the function of immunity during the onset of these two processes appears to be distinct, the underlying mechanism is shared. To date, gene expression data for large bodies of clinical samples are available, but the resemblances of tumorigenesis and autoimmune genesis in terms of immune responses remains to be summed up. Methods Considering the high disease prevalence, we chose invasive ductal carcinoma (IDC) and systemic lupus erythematosus (SLE) to study the potential commonalities of immune responses. We obtained gene expression data of IDC/SLE patients and normal controls from five IDC databases (GSE29044, GSE21422, GSE22840, GSE15852, and GSE9309) and five SLE databases (GSE154851, GSE99967, GSE61635, GSE50635, and GSE17755). We intended to identify genes differentially expressed in both IDC and SLE by using three bioinformatics tools including GEO2R, the limma R package, and Weighted Gene Co-expression Network Analysis (WGCNA) to perform function enrichment, protein-protein network, and signaling pathway analyses. Results The mRNA levels of signal transducer and activator of transcription 1 (STAT1), 2'-5'-oligoadenylate synthetase 1 (OAS1), 2'-5'-oligoadenylate synthetase like (OASL), and PML nuclear body scaffold (PML) were found to be differentially expressed in both IDC and SLE by using three different bioinformatics tools of GEO2R, the limma R package and WGCNA. From the combined databases in this study, the mRNA levels of STAT1 and OAS1 were increased in IDC while reduced in SLE. And the mRNA levels of OASL and PML were elevated in both IDC and SLE. Based on Kyoto Encyclopedia of Genes and Genomes pathway analysis and QIAGEN Ingenuity Pathway Analysis, both IDC and SLE were correlated with the changes of multiple components involved in the Interferon (IFN)-Janus kinase (JAK)-signal transducer and activator of transcription (STAT) signaling pathway. Conclusion The expression levels of STAT1 and OAS1 manifest the opposite expression tendency across cancer and autoimmune disease. They are components in the IFN-JAK-STAT signaling pathway related to both tumorigenesis and autoimmune genesis. STAT1 and OAS1-associated IFN-JAK-STAT signaling could explain the commonalities during tumorigenesis and autoimmune genesis and render significant information for more precise treatment from the point of immune homeostasis.

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.