• Investigative Magnetic Resonance Imaging
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• v.21 no.4
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• pp.269-272
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• 2017

Periductal stromal sarcoma (PSS) is a type of rare malignant fibroepithelial tumor. PSS is a recently introduced diagnostic entity and there are few reports about radiological features of this tumor. Pre-operative diagnosis is difficult because it reveals similar symptoms with other benign and malignant tumors with absence of specific radiologic findings. We present a woman age 30 that underwent mammotome biopsy for a BI-RADS 4 lesion on her left breast and received histopathology diagnosis of a phyllodes tumor. Additionally, she underwent a wide excision depending on her histopathology diagnosis. Her final diagnosis was PSS. Six months later, no recurrence was detected. However, frequent follow-up is needed because PSS can develop into phyllodes tumor or entity of breast cancer.

• The Korean Journal of Cytopathology
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• v.4 no.2
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• pp.160-165
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• 1993

Phyllodes tumor of the breast, especially malignant, is a rare tumor which has characteristic cytologic features. We recently experienced a case of fine needle aspiration cytology of malignant phyllodes tumor of the breast metastatic to the lung. The aspirate showed cellular smear with biphasic population of epithelial and stromal cells. Many individual large cells with round hyperchromatic nuclei were found in the necrotic background and stromal cell atypia was also present. Chondrosarcomatous fragments were also seen in cytologic specimens.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.52-56
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• 1994

We experienced a case of fine-needle aspiration (FNA) cytology of breast which showed atypical proliferative lesion. It was very difficult to differentiate this case from malignancy, because of hypercellular smear and many clusters composed of large, atypical ductal cells. However, it showed other features favoring benignancy, such as tendency of cellular cohesiveness, only slightly increased nucleus/cytoplasm ratio and most importantly presence of myoepithelial cells. It's histologic diagnosis was intraductal hyperplasia with atypia. This case indicates that all atypical breast FNA specimen should lead to the suggestion of surgical biopsy for avoiding over- or under-diagnosis.

• The Korean Journal of Cytopathology
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• v.5 no.2
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• pp.106-112
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• 1994

Fine needle aspiration biopsy has been proved as a safe, accurate and cost-effective diagnostic modality in palpable breast lesions. Cytologically, fibrocystic disease can be classified into 3 categories as nonproliferative breast disease, proliferative breast disease without atypia, and proliferative breast disease with atypia. This terminology for fine needle aspirates is compatible with that of diagnostic histopathology. Cytologic differentiation of nonproliferative disease from proliferative breast disease is important, since the risk of cancer development in cases of atypical hyperplasia is 4-5 times higher than that of general population. Twenty five fine needle aspirates of fibrocystic disease confirmed by subsequent histopathology were re-evaluated and classified into 3 categories depending on their architectural and nuclear features. In addition, these aspirates were scored according to the cytologic grading system, devised by Masood et al. and based on six cytologic criteria. Concordance rates between cytomorpholgic diagnosis and cytologic diagnosis using the cytologic criteria grading system and histologic diagnosis were 88% and 92%, respectively.

• Journal of Yeungnam Medical Science
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• v.38 no.3
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• pp.175-182
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• 2021

Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare T-cell non-Hodgkin lymphoma characterized as CD30 positive and anaplastic lymphoma kinase (ALK) negative. In 2016, the World Health Organization declared BIA-ALCL as a new disease entity. The first case of BIA-ALCL was reported in 1997, and as of July 2019, the United States Food and Drug Administration had cited a total of 573 United States and global medical device reports of BIA-ALCL, including 33 deaths. In all clinical case reports, except for those with unknown clinical history, the patient had received at least one textured surface breast implant. Although the etiology is not yet clear, chronic inflammation has been proposed as a potential precursor to tumorigenesis. The most common presentation of BIA-ALCL is peri-implant fluid collection following aesthetic or reconstructive implantation with textured surface breast implants. It can be accompanied by breast swelling, asymmetry, pain, skin lesions, lymphadenopathy, and B-type symptoms. Most cases are detected on average 7 to 10 years after implantation. Diagnostic specimens can be obtained with fine-needle aspiration or biopsy. BIA-ALCL is CD30 positive, epithelial membrane antigen positive, and ALK negative. It can be cured with complete surgical excision at the T1-T3 stage.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1929-1934
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• 2015

Purpose: To determine the diagnostic yield of primary circulating tumor cells in women with suspicion of breast cancer, detected as a result of an abnormal mammography. Materials and Methods: Consecutive women presenting for breast biopsy as a result of a mammogram BiRADs of 3 or more, had an 8ml blood sample taken for primary circulating tumor cell (CTC) detection. Mononuclear cells were obtained using differential gel centrifugation and CTCs identified using standard immunocytochemistry using anti-mammoglobin. A test was determined to be positive if 1 CTC was detected. Results: A total of 144 women with a mean age of $54.7{\pm}15.6$ years participated, 78/144 (53.0%) had breast cancer on biopsy, 65/140 (46.3%) benign pathologies and 1(0.7%) non-Hogkins lymphoma. Increasing BiRADs scores were associated with increased cancer detection (p=0.004, RR 1.00, 4.24, 8.50). CTC mammoglobin positive had a sensitivity of 81.1% and specificity of 90.9%, with positive and negative predictive values of 90.9% and 81.1% respectively. Mammoglobin positive CTCs detected 87% of invasive cancers, while poorly differentiated cancers were negative for mammoglobin. Only 50% of in situ cancers and none of the intraductal cancers had CTCs detected. Menopausal status did not affect the diagnostic yield of the CTC test, which was higher in women with BiRADS 4 mammograms. There was a significant trend (p<0.0001 Chi squared for trends) in CTC detection frequency from intraductal, in situ and invasive (OR 1.00, 8.00, 472.00). Conclusions: The use of primary CTC detection in women suspected of breast cancer has potential uses, especially with invasive cancer, but it failed to detect intra-ductal cancer and 50% of in situ cancer. There was no difference in the diagnostic yield between pre and post menopausal women. To confirm its use in reducing biopsies in women with BIRADs 4a mammagrams and in the detection of interval invasive breast cancer, larger studies are needed.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6067-6072
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• 2012

Background: Breast cancer in developing countries is on the rise. There are currently no guidelines to screen women at risk in India. Since mammography in the western world is a well-accepted screening tool to prevent late presentation of breast cancer and improve mortality, it is intuitive to adopt mammography as a screening tool of choice. However, it is expensive and fraught with logistical issues in developing countries like India. Materials and Methods: Our breast cancer screening camp was done at a local district hospital in India after approval from the director and administrators. After initial training of local health care workers, a one-day camp was held. Clinical breast examination, mammograms, as well as diagnostic evaluation with ultrasound and fine needle aspiration biopsy were utilized. Results: Out of total 68 women screened only 2 women with previous history of breast cancer were diagnosed with breast cancer recurrence. None of the women in other groups were diagnosed with breast cancer despite suspicious lesions either on clinical exam, mammogram or ultrasound. Most suspicious lesions were fibroadenomas. The average cost of screening women who underwent mammography, ultrasound and fine needle aspiration was $30 dollars, whereas it was $16 in women who had simple clinical breast examination. Conclusions: Local camps act as catalysts for women to seek medical attention or discuss with local health care workers concerns of discovering new lumps or developing breast symptoms. Our camp did diagnose recurrence of breast cancer in two previously treated breast cancer patients, who were promptly referred to a regional cancer hospital. Further studies are needed in countries like India to identify the best screening tool to decrease the presentation of breast cancer in advanced stages and to reduce mortality.

• Investigative Magnetic Resonance Imaging
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• v.19 no.1
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• pp.37-46
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• 2015

Purpose: This report compared the diagnostic effectiveness between ultrasmall superparamagnetic iron oxide (USPIO) and gadolinium (Gd) based magnetic resonance imaging (MRI) for differentiation of axillary status in breast cancer patients. Materials and Methods: The present authors performed a meta-analysis of previous studies that compared USPIO or Gd based MRI with histological diagnosis after surgery or biopsy. We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, Ovid databases and references of articles to identify studies reporting data until December 2013. Pooled sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analysis was done. Analyses of study quality and heterogeneity were also assessed. Results: There were 14 publications that met the criteria for inclusion in our meta-analysis. USPIO based MRI showed 0.83 (95% CI: 0.75-0.89) and 0.97 (95% CI: 0.94-0.98) for pooled sensitivity and specificity, respectively. Gd based MRI represented pooled sensitivity and specificity of 0.61 (95% CI: 0.55-0.67) and 0.90 (95% CI: 0.87-0.92) for each. Overall weighted area under the curve for USPIO and Gd based MRI were 0.9563 and 0.9051, respectively. Conclusion: USPIO based MRI had a tendency toward high pooled sensitivity and specificity in detection of axillary metastases for breast cancer. This result may mean that USPIO based MRI could be used as complementary modality to differentiate axillary status more precisely, and assist in the decision-making process regarding possible invasive procedures, such as sentinel node biopsy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10739-10743
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• 2015

The present study aimed at evaluating and comparing the diagnostic performance of B-mode ultrasound (US), elastography score (ES), and strain ratio (SR) for the differentiation of breast lesions. This retrospective study enrolled 431 lesions from 417 in-hospital patients. All patients were examined with both conventional ultrasound and elastography. Two experienced radiologists reviewed ultrasound and elasticity images. The histopathologic result obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard. Pathologic examination revealed 276 malignant lesions (64%) and 155 benign lesions (36%). A cut-off point of 4.15 (area under the curve, 0.891) allowed significant differentiation of malignant and benign lesions. ROC (receiver-operating characteristic) curves showed a higher value for combination of B-mode ultrasound and elastography for the diagnosis of breast lesions. Conventional ultrasound combined elastography showed high sensitivity, specificity, and accuracy for group II lesions (10mm${\leq}20mm$). Elastography combined with conventional ultrasound show high specificity and accuracy for differentiation of benign and malignant breast lesions. Elastography is particularly important for the diagnosis of BI-RADS 4 and small breast lesions.

• Asian Oncology Nursing
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• v.9 no.2
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• pp.145-154
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• 2009

Purpose: The purpose of this study was to obtain information about the experiences of sensations after breast cancer surgery characterized by prevalence, frequency, and severity, distresses, and disturbances in ADL using the BSAS (Breast Sensation Assessment Scale) and to develop the standardized Korean BSAS. Methods: Thirty two women from 3 to 100 days after breast cancer surgery (BCS) completed Roberta's BSAS. The 18 sensations of BSAS were translated using the references of Lee's Korean Pain Rating Scale and English-English, English-Korean dictionaries and the consultation from two native Americans, one bilingual permanent resident of the States, and one nursing professor. The Korean-translated BSAS has high reliability in test-retest. Likert type 4-point scale and 100 mm VAS were used for assessment. Results: Certain sensations remained prevalent (tender, pull, pain), frequent (numb, nag, throb), severe (throb, shoot, numb), causing distress (throb, penetrate, shoot), and influencing on ADL (throb, penetrate, nag). The most frequently experienced sensation other than BSAS was itching. There was little difference in the prevalence of symptom experiences between sentinel lymph node biopsy and axillary lymph node dissection. Conclusion: The women after BCS are suffering from neuropathic sensations. The Korean- translated BSAS could be used in effectively assessing breast sensations after BCS in Korean women.