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1
Nasrazadani, Azadeh, Yujia Li, George Tseng, et al. "Mixed invasive ductal-lobular carcinoma: Clinicopathological characterization and clinical outcomes." Journal of Clinical Oncology 37, no. 15_suppl (2019): e12531-e12531. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e12531.
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e12531 Background: Mixed Invasive Ductal-Lobular Carcinoma (IDC-L) is a histological subtype of invasive breast carcinoma comprised of both ductal and lobular morphologies. There is limited information on the relative proportions of the individual components in IDC-L and on outcomes compared to invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC). Methods: Clinical information was abstracted from 16,308 patients with invasive breast cancer seen at UPMC Magee Women’s Hospital from 1990-2017 using the UPMC Network Cancer Registry. A systematic chart review was performed on a subset of patients annotated with IDC-L (n=806); however, a thorough review of pathology reports led to the exclusion of all but 408 patients for further analysis, due to the lack of a standardized definition of IDC-L. Of the 408 cases, 92% were estrogen receptor (ER)+. Survival of patients with ER+ IDC-L (n=376) was compared to ER+ IDC (n=9,716) and ER+ ILC (1,465). For a subset of IDC-L cases (n=54), distributions of individual subtype components were abstracted from pathology reports. Results: IDC-L made up 2.5% of the total cases (408/16,308). IDC-L tumors were on average 31% ductal and 69% lobular (p =0.001). Survival analysis showed worse disease free survival (DFS) (p=0.05) and overall survival (OS) (p=0.002) in patients with ER+ ILC compared to ER+ IDC, with ER+ IDC-L patients showing a median OS superior to ILC yet inferior to IDC counterparts (ns). Conclusions: Identification of patients with IDC-L through cancer registry protocols representative of standard practices by national cancer registries revealed a lack of a standardized definition of mixed IDC-L. Reliance on accuracy of these diagnoses calls in to question the reliability of prior clinico-pathologic analyses reported on this topic. DFS and OS of IDC-L patients falls between that of IDC and ILC patients while ILC patients showed significantly worse outcome. The predominant distribution of lobular morphology in IDC-L tumors suggests this subtype may have additional characteristics similar to lobular rather than ductal carcinomas. Comprehensive clinical and molecular characterization of a carefully identified IDC-L cohort is underway.
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Tsai, Wen-Chiuan, Chi-Hong Chu, Cheng-Pin Yu, et al. "Matriptase and Survivin Expression Associated with Tumor Progression and Malignant Potential in Breast Cancer of Chinese Women: Tissue Microarray Analysis of Immunostaining Scores with Clinicopathological Parameters." Disease Markers 24, no. 2 (2008): 89–99. http://dx.doi.org/10.1155/2008/945197.
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Objective: The aim of this study was to examine the expression of matriptase and survivin in breast carcinoma and correlate with clinicopathological parameters.Methods: Immunohistochemical analysis of matriptase and survivin were performed in tissue microarray slides of 290 cases, including 11 normal breast tissue; 27 fibrocystic disease; 17 fibroadenoma; 6 atypical ductal hyperplasia; 39 ductal carcinoma in situ, low grade (DCIS, low grade); 39 ductal carcinoma in situ, high grade (DCIS, high grade); 27 invasive ductal carcinoma, grade I (IDC, grade I); 78 invasive ductal carcinoma, grade II (IDC, grade II); and 46 invasive ductal carcinoma, grade III (IDC, grade III).Results: The average immunostaining scores of matriptase were 44.1 in normal breast tissue, 52.7 in fibrocystic disease, 76.5 in fibroadenoma, 81.7 in atypical ductal hyperplasia, 133.7 in low-grade DCIS, and 155.8 in high-grade DCIS. Among 151 breast IDC cases, the average immunostaining scores of matriptase were 172.7 in grade I, 211.7 in grade II, and 221.2 in grade III. Additionally, the average immunostaining scores of surviving also correlate with tumor grades and stages.Conclusions: Higher expressions of matriptase and survivin correlate significantly with clinicopathological parameters in breast cancer and the malignant potential in premalignant lesions. In addition, higher survivin expression had poorer prognosis of breast IDC cases.
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Ebata, Akiko, Takashi Suzuki, Kiyoshi Takagi, et al. "Oestrogen-induced genes in ductal carcinoma in situ: their comparison with invasive ductal carcinoma." Endocrine-Related Cancer 19, no. 4 (2012): 485–96. http://dx.doi.org/10.1530/erc-11-0345.
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It is well known that oestrogens play important roles in both the pathogenesis and development of invasive ductal carcinoma (IDC) of human breast. However, molecular features of oestrogen actions have remained largely unclear in pure ductal carcinoma in situ (pDCIS), regarded as a precursor lesion of many IDCs. This is partly due to the fact that gene expression profiles of oestrogen-responsive genes have not been examined in pDCIS. Therefore, we first examined the profiles of oestrogen-induced genes in oestrogen receptor (ER)-positive pDCIS and DCIS (DCIS component (DCIS-c)) and IDC (IDC component (IDC-c)) components of IDC cases (n=4 respectively) by microarray analysis. Oestrogen-induced genes identified in this study were tentatively classified into three different groups in the hierarchical clustering analysis, and 33% of the genes were predominantly expressed in pDCIS rather than DCIS-c or IDC-c cases. Among these genes, the status of MYB (C-MYB), RBBP7 (RBAP46) and BIRC5 (survivin) expressions in carcinoma cells was significantly higher in ER-positive pDCIS (n=53) than that in ER-positive DCIS-c (n=27) or IDC-c (n=27) by subsequent immunohistochemical analysis of the corresponding genes (P<0.0001, P=0.03 and P=0.0003 respectively). In particular, the status of C-MYB immunoreactivity was inversely (P=0.006) correlated with Ki67 in the pDCIS cases. These results suggest that expression profiles of oestrogen-induced genes in pDCIS may be different from those in IDC; and C-MYB, RBAP46 and survivin may play important roles particularly among oestrogen-induced genes in ER-positive pDCIS.
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Srebnijs, Andrejs, Sergejs Isajevs, Jānis Eglītis, Viesturs Krūmiņš, Juris Bērziņš, and Uldis Vikmanis. "Distribution And Clinicopathological Features Of Breast Cancer Histological Subtypes In Latvia." Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. 69, no. 1-2 (2015): 14–19. http://dx.doi.org/10.1515/prolas-2015-0001.
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Abstract Breast cancer is a heterogenous disease. It consists of several histological subtypes that can be separated by morphology and immunohistochemistry. The aim of our study was to determine the distribution of breast cancer histological and molecular subtypes, and their relationship with clinical and pathological characteristics. A total of 561 patients who underwent breast carcinoma surgical treatment from January 2003 till December 2012 were enrolled in the study. In total, invasive ductal carcinomas not otherwise specified (IDC-NOS) plus invasive ductal carcinomas no special type (IDC-NST) were observed in 430 patients (76.65% of cases), medullar carcinoma in 14 patients (2.45%), other rare ductal carcinoma subtypes in 13 patients (2.31%), lobular carcinoma in 81 patients (14.4%) and tubulolobular carcinoma in 23 patients (4.19%). Ductal carcinoma, lobular and tubulolobular carcinoma had predominantly luminal A and B subtype, whereas medullar carcinoma had HER2-positive and triple-negative (TN) subtype. Tubular, cribriform, mucinous, papillary, and apocrine carcinomas had predominantly luminal A subtype. Significant differences between breast cancer histological subtypes and clinicopathological characteristics were observed. Our study for the first time reported the distribution and characteristics of breast cancer histological subtypes in Latvian women and relationship to clinical and tumour histopathological characteristics.
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Peres, Raquel Mary Rodrigues, Kátia Piton Serra, Sophie F. M. Derchain, et al. "Comparative evaluation of the erbB2 and hormone receptor status of neighboring invasive and in situ components of ductal carcinomas of the breast." International Journal of Biological Markers 24, no. 4 (2009): 238–44. http://dx.doi.org/10.1177/172460080902400404.
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Background It remains unknown whether erbB2 expression and hormone receptor status predict the invasive potential of ductal carcinoma in situ (DCIS) of the breast. Objectives To examine erbB2 and estrogen/progesterone receptor (ER/PR) status in the precise areas where DCIS turns into invasive ductal carcinoma (IDC). Subjects and methods Eighty-seven cases of breast malignancies harboring contiguous regions of DCIS and IDC were selected. Separate histological samples from the DCIS and the neighboring IDC were obtained using tissue microarrays. The erbB2 and ER/PR statuses were assessed using immunohistochemistry (erbB2 and ER/PR) and fluorescence in situ hybridization (FISH – only erbB2). Results The expression of erbB2 did not differ in the DCIS and IDC components of the breast tumors (p=0.35). There was good agreement in sample-by-sample comparisons of erbB2 (intraclass correlation coefficient [ICC]=0.78), PR (ICC=0.61) and ER (ICC=0.70) expression in the DCIS and IDC components. Conclusion Our findings suggest that the expressions of erbB2 and ER/PR do not differ in the contiguous regions from DCIS to IDC.
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Timbres, Jasmine, Charlotte Moss, Anca Mera, et al. "Survival Outcomes in Invasive Lobular Carcinoma Compared to Oestrogen Receptor-Positive Invasive Ductal Carcinoma." Cancers 13, no. 12 (2021): 3036. http://dx.doi.org/10.3390/cancers13123036.
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Invasive lobular breast cancer (ILC) accounts for 10–15% of breast cancers and has distinct characteristics compared with the more common invasive ductal carcinoma (IDC). Studies have shown that ILC may be less sensitive to chemotherapy than IDC, with lower rates of complete pathological response after neo-adjuvant chemotherapy, but it is not clear how this affects long-term survival. Patients at Guy’s and St Thomas’ NHS Foundation Trust between 1975 and 2016 diagnosed with ER+ IDC or ER+ ILC were eligible for inclusion. Kaplan–Meier plots and Cox proportional-hazards regression models were used for analysis. There was no difference in overall survival comparing ER+ ILC to ER+ IDC (OR: 0.94, 95% CI: 0.83, 1.04) with a median follow-up time of 8.3 years compared to 8.4 years in IDC. However, ER+HER2− ILC had worse survival compared to ER+HER2− IDC in those that received chemotherapy (OR: 1.46, 95% CI: 1.06, 2.01). Here, median follow-up time was 7.0 years in ILC compared to 8.1 years in IDC. These results indicate worse overall survival after chemotherapy (neo-adjuvant and adjuvant) in ILC compared to ER+HER2− IDC even when correcting for tumour grade, age, size, and nodal involvement, but validation is needed in a larger study population.
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Park, Inhye, Jiyoung Kim, Se-Kyung Lee, et al. "Characteristics of medullary breast carcinoma compared with invasive ductal carcinoma." Journal of Clinical Oncology 30, no. 27_suppl (2012): 20. http://dx.doi.org/10.1200/jco.2012.30.27_suppl.20.
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20 Background: Medullary carcinoma (MC) represents a rare breast cancer subtype associated with a rather favorable prognosis compared with invasive ductal carcinoma (IDC). It is characterized by the high-grade structure and lymphocytic infiltration, hemorrhagic necrosis. The purpose of this study is to compare the clinicopathologic characteristics and outcome of MC to IDC. Methods: We retrospectively reviewed the medical records of patients with invasive breast cancer managed with operation at Samsung Medical Center in Korea from January 1995 to June 2010 except patients diagnosed with ductal carcinoma in situ, patients with distant metastasis at diagnosis or neoadjuvant chemotherapy. 52 cases were identified with MC; 5,716 patients with IDC. The clinicopathologic features, disease-free survival (DFS) and overall survival (OS) for patients with MC were compared with those of the IDC patients. Results: The medullary group presented at younger age (43.9 ± 8.8 vs 47.7 ± 9.9, p=0.006). Also the medullary group was significantly associated with higher histological grade (poor; 80.0 vs 38.3%, p=0.003) and nuclear grade (grade3; 82.8 vs 41.7%, p<0.001) as well as negative ER (84.8 vs 31.0%, p<0.001) and PR status (91.3 vs 38.8%, p<0.001) regarded as poor prognostic factors. But lymphatic invasion was rare (0.0 vs 29.8%, p<0.001) and N stage was low (N0; 86.5 vs 58.4%, p<0.001). The DFS and OS were not significantly different between the medullary and IDC groups. (5-yr DFS : 88.0 vs 89.2 %, p=0.917, 5-yr OS : 94.4 vs 93.4%, p=0.502) In multivariable analysis, factors associated with DFS and OS included nuclear grade, histological grade, tumor size, lymph node metastasis, ER/PR/C-erbB2 status, chemotherapy and hormone therapy. When adjusting for other factors, histological type itself did not show significant difference from IDC in DFS and OS. Conclusions: Despite MC present specific clinicopathologic features, prognosis is not different from IDC and determined by already known prognostic factors such as tumor size, lymph node metastasis. Therefore, the patients with MC also need aggressive treatment like IDC.
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Anak, Agung Ngurah Gunawan, Wayan Supardi I, Poniman S., and G. Dharmawan Bagus. "The Utilization of Physics Parameter to Classify Histopathology Types of Invasive Ductal Carcinoma (IDC) and Invasive Lobular Carcinoma (ILC) by using K-Nearest Neighbourhood (KNN) Method." International Journal of Electrical and Computer Engineering (IJECE) 8, no. 4 (2018): 2442–50. https://doi.org/10.11591/ijece.v8i4.pp2442-2450.
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Medical imaging process has evolved since 1996 until now. The forming of Computer Aided Diagnostic (CAD) is very helpful to the radiologists to diagnose breast cancer. KNN method is a method to do classification toward the object based on the learning data which the range is nearest to the object. We analysed two types of cancers IDC dan ILC. 10 parameters were observed in 1-10 pixels distance in 145 IDC dan 7 ILC. We found that the Mean of Hm(yd,d) at 1-5 pixeis the only significant parameters that distingguish IDC and ILC. This parameter at 1-5 pixels should be applied in KNN method. This finding need to be tested in diffrerent areas before it will be applied in cancer diagnostic.
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Pilika, Kliti, Aldo Shpuza, Anita Pilika, and Xhesika Xhetani. "Invasive Ductal Carcinoma Arising within a Fibroadenoma: A Case Report and Literature Review." International Journal of Medical Science and Dental Health 10, no. 05 (2024): 71–75. http://dx.doi.org/10.55640/ijmsdh-10-05-06.
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Background: Invasive ductal carcinoma (IDC) is the most common form of breast cancer, frequently presenting independently. Rarely, IDC arises within a fibroadenoma, a benign breast tumor typically associated with younger women. This case report and literature review aim to highlight the diagnostic challenges and clinical implications of finding IDC within a fibroadenoma. Case Presentation: A 36-year-old female patient presented with a dolent palpable mass in the right breast. Initial mammography described normal fibroglandular structures without significant findings. However, subsequent imaging ultrasound identified an 18x14 mm oval formation at the 9 o'clock position in the right breast, categorized as BI-RADS 3. Further histopathological evaluation after a biopsy confirmed the presence of a fibroadenoma with invasive ductal carcinoma, classified as Grade III with perivascular and neural infiltration. Discussion: The coexistence of IDC within a fibroadenoma poses significant diagnostic challenges due to the benign appearance of fibroadenomas on standard imaging modalities. This case emphasizes the need for a thorough evaluation and possible biopsy of fibroadenomas that exhibit atypical features or changes over time. Conclusion: This report underscores the importance of vigilance and comprehensive diagnostic strategies in cases of fibroadenomas, especially in patients with unusual or evolving lesions. The review of literature confirms that although rare, the occurrence of IDC within fibroadenomas can have significant implications for treatment and prognosis.
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Bernhardt, Sarah M., Elizabeth Mitchell, Stephanie Stamnes, et al. "Isogenic Mammary Models of Intraductal Carcinoma Reveal Progression to Invasiveness in the Absence of a Non-Obligatory In Situ Stage." Cancers 15, no. 8 (2023): 2257. http://dx.doi.org/10.3390/cancers15082257.
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In breast cancer, progression to invasive ductal carcinoma (IDC) involves interactions between immune, myoepithelial, and tumor cells. Development of IDC can proceed through ductal carcinoma in situ (DCIS), a non-obligate, non-invasive stage, or IDC can develop without evidence of DCIS and these cases associate with poorer prognosis. Tractable, immune-competent mouse models are needed to help delineate distinct mechanisms of local tumor cell invasion and prognostic implications. To address these gaps, we delivered murine mammary carcinoma cell lines directly into the main mammary lactiferous duct of immune-competent mice. Using two strains of immune-competent mice (BALB/c, C57BL/6), one immune-compromised (severe combined immunodeficiency; SCID) C57BL/6 strain, and six different murine mammary cancer cell lines (D2.OR, D2A1, 4T1, EMT6, EO771, Py230), we found early loss of ductal myoepithelial cell differentiation markers p63, α-smooth muscle actin, and calponin, and rapid formation of IDC in the absence of DCIS. Rapid IDC formation also occurred in the absence of adaptive immunity. Combined, these studies demonstrate that loss of myoepithelial barrier function does not require an intact immune system, and suggest that these isogenic murine models may prove a useful tool to study IDC in the absence of a non-obligatory DCIS stage—an under-investigated subset of poor prognostic human breast cancer.
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Petrovic, Nina, Snezana Jovanovic-Cupic, Goran Brajuskovic, et al. "Micro RNA-21 expression levels in invasive breast carcinoma with a non-invasive component." Archives of Biological Sciences 67, no. 4 (2015): 1285–95. http://dx.doi.org/10.2298/abs150327105p.
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Invasive ductal carcinomas with a non-invasive component (IDC-DCIS) are classified as a group of invasive breast carcinomas, together with pure invasive ductal carcinomas of the breast (IDC). MicroRNA-21 (miR-21) has been characterized as a factor of breast cancer invasiveness, however the difference in miR-21 expression levels between IDC-DCIS and pure IDC tumors and the correlations with standard diagnostic and prognostic parameters inside the IDC-DCIS group are unknown. Our aim was to determine if miR-21 had the ability to distinguish these two invasive breast cancer groups. Levels of miR-21 expression were measured by a stem-loop quantitative Real-Time PCR (RT-qPCR) method. Expression levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (Her-2) and proliferative index Ki-67 were evaluated by immunohistochemistry. IDC-DCIS tumors had significantly lower levels of miR-21 expression in grade 2 (P=0.003, Mann-Whitney U test), ER positive (P=0.025, Mann-Whitney U test) and PR positive tumors (P=0.024, Mann-Whitney U test) than pure IDCs. miR-21 levels showed a different pattern of expression in IDC-DCIS compared to IDC tumors, which is based on the difference in miR-21 expression between Her-2 negative and Her-2 positive IDC-DCIS tumors (P=0.030, Mann-Whitney U test) and high negative correlation of miR-21 levels with PR levels (?=-0.886, P=0.006, Spearman correlation). According to our results, IDC-DCIS breast carcinomas act in a different manner in pure IDC tumors with regard to the relations between miR-21 expression levels and the standard diagnostic and prognostic parameters, such as Her-2 status, ER and PR status and protein levels.
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Zangouri, Vahid, Negin Nourinejad, Souzan Soufizadeh Balaneji, et al. "Comparison of clinicopathologic characteristics of Invasive Papillary Carcinoma with Invasive Ductal Carcinoma and their survival outcome." Polish Journal of Surgery 95, no. 6 (2023): 1–5. http://dx.doi.org/10.5604/01.3001.0053.7691.
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Background: Invasive Papillary Carcinoma (IPC) of the breast is a rare breast cancer subtype. This study aimed to evaluate the clinicopathologic characteristics of IPC of the breast, its differences from Invasive Ductal Carcinoma (IDC), and their survival outcomes.Materials and Methods: The medical records of 6599 patients were retrospectively reviewed at the Breast Disease Research Center from December 1993 to December 2021. The patients were divided into two groups: IPC and IDC. The tumor size, lymph node metastasis, pathologic stage, nuclear and histological grade, hormonal receptor status, and survival were reviewed and compared between the IPC and IDC groups.Results: Of the 6599 patients, 27 had IPC, and 6572 had IDC. The mean age of patients with IPC and IDC was 58.5 and 49 years, respectively (P=0.02). Patients with IPC were more likely to have a positive node status and had a significantly higher incidence of lymphovascular invasion (14.9% for IPCs and 53.3% for IDCs, P<0.001). ER status was positive in 66.6% of IPCs and 78.1% of IDCs (P=0.23). Additionally, 62.5% of patients with IPC and 94.9% of those with IDC received adjuvant chemotherapy (P<0.001). Disease-free survival (DFS) and overall survival (OS) were better in IPC patients for stage I (5-year DFS: 69% vs. 81%, P=0.008; 5-year OS: 75% vs. 85%, P=0.001).Conclusion: IPC is a rare tumor type that presents unique clinicopathological characteristics and is associated with a higher rate of breast-conserving surgery and a favorable prognosis than IDC
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Von Minckwitz, G., S. Darb-Esfahani, S. Loibl, et al. "Responsiveness of adjacent ductal carcinoma in situ and changes in HER2 status after neoadjuvant chemotherapy/trastuzumab treatment in early breast cancer: Results from the GeparQuattro study (GBG 40)." Journal of Clinical Oncology 29, no. 27_suppl (2011): 6. http://dx.doi.org/10.1200/jco.2011.29.27_suppl.6.
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6 Background: Adjacent ductal carcinoma in situ (DCIS) is in found in approximately 45% of invasive ductal carcinomas (IDC) of the breast. Pure DCIS overexpresses HER2 in approximately 45%. There is uncertainty whether adjacent DCIS impacts on the response to neoadjuvant chemotherapy and trastuzumab as well as whether HER2 expression in IDC component or adjacent DCIS changes throughout treatment. Methods: Core biopsies and surgical tissue from participants of the GeparQuattro study with HER2-positive IDC were centrally examined for the area of invasive ductal component and adjacent DCIS before and after receiving neoadjuvant anthracycline-taxane-trastuzumab containing chemotherapy. HER2 overexpression in IDC and adjacent DCIS was quantified separately by immunohistochemistry using the Ventana automated staining system. Pathological complete response (pCR) was defined as no residual invasive or non-invasive tumor tissue. Results: Fifty nine (37.3%) of 158 IDCs presented with adjacent DCIS at diagnosis. These tumors showed lower regression grades than pure IDC (p=0.033). Presence of adjacent DCIS was an independent negative predictor of pCR (odds ratio 0.42 [95% CI 0.2-0.9], p=0.027). Adjacent DCIS area decreased from pre-treatment to surgery (r=0.205) with 30 (50.8%) IDCs with adjacent DCIS showing complete eradication of adjacent DCIS. HER2 status of adjacent DCIS was highly correlated with HER2 status of IDC component before (r=0.892) and after treatment (r=0.676). Degree of HER2 overexpression of the IDC component decreased in 16 (33.3%) out of 49 patients without a pCR. These 16 IDCs showed lower RGs compared to the 33 IDCs with unchanged HER2 expression (p=0.055). Conclusions: HER2-positive IDCs with adjacent DCIS is less responsive to neoadjuvant chemotherapy and trastuzumab compared to pure IDC. However, complete eradication of adjacent DCIS is frequently observed. HER2-overexpression of the invasive ductal component decreases in a subset of tumors, which showed less tumor regression.
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Kothari, Charu, Alisson Clemenceau, Geneviève Ouellette, et al. "Is Carboxypeptidase B1 a Prognostic Marker for Ductal Carcinoma In Situ?" Cancers 13, no. 7 (2021): 1726. http://dx.doi.org/10.3390/cancers13071726.
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Ductal carcinoma in situ (DCIS) is considered a non-obligatory precursor for invasive ductal carcinoma (IDC). Around 70% of women with atypical ductal hyperplasia (ADH) undergo unnecessary surgery due to the difficulty in differentiating ADH from low-grade DCIS. If untreated, 14–60% of DCIS progress to IDC, highlighting the importance of identifying a DCIS gene signature. Human transcriptome data of breast tissue samples representing each step of BC progression were analyzed and high expression of carboxypeptidase B1 (CPB1) expression strongly correlated with DCIS. This was confirmed by quantitative PCR in breast tissue samples and cell lines model. High CPB1 expression correlated with better survival outcome, and mRNA level was highest in DCIS than DCIS adjacent to IDC and IDC. Moreover, loss of CPB1 in a DCIS cell line led to invasive properties associated with activation of HIF1α, FN1, STAT3 and SPP1 and downregulation of SFRP1 and OS9. The expression of CPB1 could predict 90.1% of DCIS in a cohort consisting of DCIS and IDC. We identified CPB1, a biomarker that helps differentiate DCIS from ADH or IDC and in predicting if a DCIS is likely to progress to IDC, thereby helping clinicians in their decisions.
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Karla, Itzel Sánchez Gutiérrez, Castro Cortés Samantha, Arlin Gómez Arteaga Brisa, Lemus Bedolla Emilio, and Raul Castillo Guzmán Alberto. "Cutaneous Metastasis as the First Manifestation of Infiltrating Ductal Carcinoma: A Case Report." International Journal of Medical Science and Clinical Research Studies 04, no. 08 (2024): 1517–20. https://doi.org/10.5281/zenodo.13358181.
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Cutaneous metastasis as an initial presentation of invasive ductal carcinoma (IDC) is an exceedingly rare clinical scenario, often leading to significant diagnostic challenges. This case study elucidates the clinical presentation, diagnostic process, histopathological findings, and therapeutic strategies employed in a patient presenting with cutaneous metastasis as the first sign of IDC. By emphasizing the dermatological manifestations of IDC and their implications for early detection and management, this article aims to contribute to the existing literature on atypical presentations of breast cancer. Our findings underscore the importance of a multidisciplinary approach in the evaluation of unusual cutaneous lesions, particularly in patients with no prior oncological history, to ensure timely and accurate diagnosis and treatment.
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Lee, JungSun, Minkyung Oh, SeungSang Ko, et al. "Parity Differently Affects the Breast Cancer Specific Survival from Ductal Carcinoma In Situ to Invasive Cancer: A Registry-Based Retrospective Study from Korea." Breast Cancer: Basic and Clinical Research 13 (January 2019): 117822341882513. http://dx.doi.org/10.1177/1178223418825134.
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Purpose: Multiparity might increase general mortality for women, but has inconclusive in patients with breast cancer. Here, we aim to discover their effect in terms of the breast cancer development hypothesis: from ductal carcinoma in situ to invasive carcinoma. Methods: We included 37 947 patients from the web-based breast cancer registration program of the Korean Breast Cancer Society and analyzed survivals using multivariate Cox regression analysis and whether the associations of these factors displayed linear trends. They were divided into the following groups: (1) pure ductal carcinoma in situ (DCIS), (2) invasive ductal carcinoma (IDC) mixed with intraductal component (DCIS-IDC), and (3) node negative pure IDC. Results: The mean age was 48.9 ± 9.9 years including premenopausal women was 61.8%. Although patients with parities of 1-3 had better prognosis compared with patients with nulliparous women, high parity (⩾4) increased the hazard ratio (HR) of overall survival (OS) (DCIS: HR, 1.52; 95% confidence interval [CI] 0.62-3.78; IDC: HR, 1.43, 95% CI 0.89-2.31; and DCIS-IDC: HR, 1.44, 95% CI 0.45-4.59) during 84.2 (±10.7) months. For breast cancer specific survival (BCSS), the HR of the IDC group ( P-value for trend = .04) increased along with increasing parity and was worse than nulliparous patients, and the HR of the DCIS-IDC group increased but was better than nulliparous patients ( P-value for trend = .02). Compared with nulliparous patients, any age at first birth (AFB) decreased HR of OS in the DCIS and IDC groups (DCIS: P = .01; IDC: P = .04). Conclusions: Parity show dual effects on OS of women with all ductal typed breast cancer but show different effects on BCSS in Korea.
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Nasrazadani, Azadeh, Yujia Li, George Tseng, et al. "Metastatic behavior of mixed invasive ductal lobular carcinoma (mIDC/ILC)." Journal of Clinical Oncology 38, no. 15_suppl (2020): 1085. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.1085.
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1085 Background: Mixed invasive ductal lobular carcinoma (mIDC/ILC) is a poorly described subtype of invasive breast cancer, characterized by its composition of both ductal and lobular histopathology. It is unclear if individual or both components drive metastasis. Literature is sparse regarding sites of metastatic spread of this elusive subtype of invasive breast cancer. Methods: Cohorts of patients with mIDC/ILC, invasive ductal carcinoma (IDC), and invasive lobular carcinoma (ILC) were identified from the UPMC Network Cancer Registry. Among these, 46 patients with mIDC/ILC, 1,131 patients with IDC, and 145 patients with ILC seen at UPMC Magee Women’s Hospital from 1990 – 2017 were found to have developed distant metastasis during the course of their disease. The metastatic pattern of spread was compared between the cohorts. Formalin-fixed, paraffin-embedded patient samples from the metastatic sites of a portion of the mIDC/ILC cases (n = 19) was acquired and evaluated by H&E staining. Results: Patients with IDC were more likely than patients with ILC to have metastasis to the liver (p = 0.001) and lung (p < 0.001), and less likely to have metastasis to the peritoneum (p < 0.001). Patients with mIDC/ILC were more likely than patients with IDC to have peritoneal metastasis (p = 0.01), similar to patients with ILC. Compared to patients with ILC, patients with mIDC/ILC were more likely to have liver metastasis (p = 0.001), similar to patients with IDC. Evaluation of the metastatic lesions originating from mIDC/ILC displayed a spectrum of histopathology including mixed histology (n = 3), pure IDC (n = 3), pure ILC (n = 5), and indeterminate lesions with features of both IDC and ILC (n = 6). Two cases were uninterpretable due to significant crush artifact. Metastatic mIDC/ILC lesions with retained mIDC/ILC histology were found in vertebral, pleural, and skin tissues. Metastatic mIDC/ILC lesions with IDC histology were found in a cerebellar, liver, and chest wall lesion; whereas, those with ILC histology were found in bowel, omental fat, ovary, bone, and sacrum. Indeterminate histology metastatic lesions were found at liver, chest wall, cerebellar, and bone sites. Conclusions: mIDC/ILC metastasizes to a range of distant sites with a higher preference to the liver and peritoneum as compared to ILC and IDC, respectively. Metastatic lesions arising from mIDC/ILC tumors showed a spectrum of histologies, including mIDC/ILC, IDC, ILC and indeterminate lesions with features of both IDC and ILC. Ongoing genomics studies will provide further insight into development of metastases from mIDC/ILC tumors.
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Namugenyi, Kakia Anne Faith, Kelechi Elizabeth Oladimeji, Alungile Mthimba, Chris Mzileni, and Olanrewaju Oladimeji. "Case Report: Invasive micropapillary ductal breast carcinoma." F1000Research 11 (November 18, 2022): 1342. http://dx.doi.org/10.12688/f1000research.122339.1.
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Background: Invasive micropapillary carcinoma (IMPC) of the breast is a rare variant of invasive ductal breast carcinoma (IDC), with most cases characterized by lymph node metastasis and lymphatic vascular invasion. It is a ductal breast cancer subtype with a very high risk of recurrence and therefore requires special attention from breast cancer physicians and radiologists. Case: We present a case of an IMPC that has been followed up for two years since diagnosis and management. Based on clinical breast examination, ultrasound, and mammography, the initial diagnosis was a suspicious mass that required further investigation. Radiological and histological findings informed the diagnosis of a highly suspicious lesion, which turned out to be IMPC. The patient underwent surgery, left mastectomy with nodal dissection. During the 24-month follow-up, ultrasound and mammography revealed no evidence of local recurrence or involvement of the contralateral breast. Conclusions: This case reveals that invasive micropapillary carcinoma is a distinct but poorly recognized variant and subtype of invasive ductal carcinoma.
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Shi, W., D. Ren, I. Ifegwu, and C. Niu. "Sneaky DCIS-looking Invasive Ductal Carcinoma of the Breast in the Extensive DCIS Background." American Journal of Clinical Pathology 162, Supplement_1 (2024): S13. http://dx.doi.org/10.1093/ajcp/aqae129.028.
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Abstract Introduction/Objective In the most cases, invasive ductal carcinoma (IDC) of the breast is identifiable when they present with classic infiltrative growth pattern. However, subset of IDC can occur in a very sneaky way, significantly mimicking the appearance of ductal carcinoma in situ (DCIS). In this condition, it’s much more easier to miss the invasive component without pulling ancillary staining when morphologic findings are extremely compatible with DCIS, especially the diagnosis of DCIS was made on the previous biopsy. Methods/Case Report Retrospective analysis of the histologic and immunohistochemical findings of pure DCIS and DCIS-looking invasive ductal carcinoma. Results (if a Case Study enter NA) Here, we reported a 55 year-old female who was noted to have microcalcification at the 11:00 o’clock of the right posterior breast on routine mammographic examination in 09/2023. Biopsy of the calcification area in 10/2023 reported high grade DCIS (ER+ PR-). Histologic examination of subsequent mastectomy specimen showed two separate DCIS-looking areas. Immunohistochemical (IHC) staining showed that myoepithelial markers, p63 and smooth muscle myosin heavy chain (SMMHC), were retained at the periphery of all the expanded acini in one area. Unexpectedly and surprisingly, p63 and SMMHC were completely lost at the periphery of part of the DCIS-looking acini in another area, immunohistochemically compatible with the diagnosis of invasive ductal carcinoma admixed with DCIS. Conclusion Knowing that invasive ductal carcinoma of the breast can present as DCIS-looking morphology, especially given the condition that the diagnosis of DCIS was rendered on the previous biopsy, will enhance awareness of pathologists to recognize sneaky DCIS-looking invasive ductal carcinoma in the extensive DCIS background. In turn, this will prevent misdiagnosis and under-treatment of patients with invasive ductal carcinoma of the breast.
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Timbres, Jasmine, Kelly Kohut, Michele Caneppele, et al. "DCIS and LCIS: Are the Risk Factors for Developing In Situ Breast Cancer Different?" Cancers 15, no. 17 (2023): 4397. http://dx.doi.org/10.3390/cancers15174397.
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Ductal carcinoma in situ (DCIS) is widely accepted as a precursor of invasive ductal carcinoma (IDC). Lobular carcinoma in situ (LCIS) is considered a risk factor for invasive lobular carcinoma (ILC), and it is unclear whether LCIS is also a precursor. Therefore, it would be expected that similar risk factors predispose to both DCIS and IDC, but not necessarily LCIS and ILC. This study examined associations with risk factors using data from 3075 DCIS cases, 338 LCIS cases, and 1584 controls aged 35–60, recruited from the UK-based GLACIER and ICICLE case-control studies between 2007 and 2012. Analysis showed that breastfeeding in parous women was protective against DCIS and LCIS, which is consistent with research on invasive breast cancer (IBC). Additionally, long-term use of HRT in post-menopausal women increased the risk of DCIS and LCIS, with a stronger association in LCIS, similar to the association with ILC. Contrary to findings with IBC, parity and the number of births were not protective against DCIS or LCIS, while oral contraceptives showed an unexpected protective effect. These findings suggest both similarities and differences in risk factors for DCIS and LCIS compared to IBC and that there may be justification for increased breast surveillance in post-menopausal women taking long-term HRT.
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Chen, Siying, Yang Liu, Jin Yang, et al. "Comparison of survival outcomes in medullary carcinoma and invasive ductal carcinoma of the breast." Future Oncology 15, no. 27 (2019): 3111–23. http://dx.doi.org/10.2217/fon-2018-0776.
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Aim: To compare clinicopathological characteristics and prognoses of medullary carcinoma (MC) and invasive ductal carcinoma (IDC) of the breast. Patients & methods: We screened patients from the SEER database. Kaplan–Meier analysis and Cox proportional hazards models were used to investigate influence on survival. Propensity score matching analysis was performed to reduce possible bias. Results: Compared with IDC, MC tended to be younger patients, poor differentiation, negative estrogen receptor and progesterone receptor and chemotherapy. Better overall survival and disease-specific survival were observed in MC patients than in IDC patients. It shared several prognostic factors. Worse disease-specific survival was observed in IDC patients than in MC patients (HR: 1.590; 95% CI: 1.475–1.714; p < 0.001). Conclusion: The clinical features and outcomes had evident differences between MC and IDC patients. These findings will provide more information for the prognosis of MC and IDC.
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Yaman, Mehmet Emrah, Haci Mehmet Kayili, Mevlut Albayrak, Yucel Kadioglu, and Bekir Salih. "Differential N-glycosylation profiling of formalin-fixed paraffin-embedded (FFPE) invasive ductal carcinoma tissues using MALDI-TOF-MS." Molecular Omics 17, no. 3 (2021): 394–404. http://dx.doi.org/10.1039/d0mo00150c.
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Invasive ductal carcinoma (IDC) is the most common type of breast cancer. In this study, matrix assisted laser desorption ionization-mass spectrometry (MALDI-MS)-based analyses were conducted for determining differential N-glycosylation patterns of IDC.
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Petridis, Christos, Mark N. Brook, Vandna Shah, et al. "Genetic predisposition to ductal carcinoma in situ of the breast." Breast Cancer Research 18, no. 1 (2016): 22. https://doi.org/10.1186/s13058-016-0675-7.
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<strong>Background: </strong>Ductal carcinoma <i>in situ</i> (DCIS) is a non-invasive form of breast cancer. It is often associated with invasive ductal carcinoma (IDC), and is considered to be a non-obligate precursor of IDC. It is not clear to what extent these two forms of cancer share low-risk susceptibility loci, or whether there are differences in the strength of association for shared loci.<strong>Methods: </strong>To identify genetic polymorphisms that predispose to DCIS, we pooled data from 38 studies comprising 5,067 cases of DCIS, 24,584 cases of IDC and 37,467 controls, all genotyped using the iCOGS chip.<strong>Results: </strong>Most (67 %) of the 76 known breast cancer predisposition loci showed an association with DCIS in the same direction as previously reported for invasive breast cancer. Case-only analysis showed no evidence for differences between associations for IDC and DCIS after considering multiple testing.Analysis by estrogen receptor (ER) status confirmed that loci associated with ER positive IDC were also associated with ER positive DCIS. Analysis of DCIS by grade suggested that two independent SNPs at 11q13.3 near <i>CCND1</i> were specific to low/intermediate grade DCIS (rs75915166, rs554219). These associations with grade remained after adjusting for ER status and were also found in IDC.We found no novel DCIS-specific loci at a genome wide significance level of <i>P</i> < 5.0x10<sup>-8</sup>.<strong>Conclusion: </strong>In conclusion, this study provides the strongest evidence to date of a shared genetic susceptibility for IDC and DCIS. Studies with larger numbers of DCIS are needed to determine if IDC or DCIS specific loci exist.
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Zhang, Lei, Sabahattin Comertpay, David Shimizu, et al. "Axillary Metaplastic Breast Carcinoma with Ipsilateral Pectoral Invasive Ductal Carcinoma: An Unusual Presentation." Case Reports in Oncological Medicine 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/938509.
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We report a case of axillary metaplastic breast carcinoma (MBC) with triple negative (ER−/PR−/Her2−) phenotype, concurrent with multifocal invasive ductal carcinoma (IDC) of ipsilateral pectoral breast (ER+/PR+/Her2−) in a 60-year-old woman. The two tumors demonstrate different morphology, immunophenotype, and opposite response to neoadjuvant chemotherapy of paclitaxol, adriamycin, and cyclophosphamide. Methylation analysis of human androgen receptor (HUMARA) on X-chromosome identified monoclonal pattern of X-chromosome inactivation in MBC and mosaic pattern in the IDC. Stem cell origin of MBC is suggested in this case. Clinicopathological features, imaging findings, biological markers, chemoradiation management, and prognosis of MBC are reviewed in comparison to invasive ductal carcinoma. Our case and literature review suggest that traditional chemotherapy applicable to IDC is less effective towards MBC. However, new chemotherapy protocols targeting stem cell and multimodality management of MBC are promising. Recognition of unusual presentation of MBC will help tailor therapy towards tumor with worse prognosis.
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Metzger Filho, Otto, Anita Giobbie-Hurder, Elizabeth Mallon, et al. "Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial." Journal of Clinical Oncology 33, no. 25 (2015): 2772–79. http://dx.doi.org/10.1200/jco.2015.60.8133.
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Purpose To evaluate the relative effectiveness of letrozole compared with tamoxifen for patients with invasive ductal or lobular carcinoma. Patients and Methods Patients diagnosed with early-stage invasive ductal carcinoma (IDC) or classic invasive lobular carcinoma (ILC) who were randomly assigned onto the Breast International Group (BIG) 1-98 trial and who had centrally reviewed pathology data were included (N = 2,923). HER2-negative IDC and ILC were additionally classified as hormone receptor–positive with high (luminal B [LB] –like) or low (luminal A [LA] –like) proliferative activity by Ki-67 labeling index. Survival analyses were performed with weighted Cox models that used inverse probability of censoring weighted modeling. Results The median follow-up time was 8.1 years. In multivariable models for disease-free survival (DFS), significant interactions between treatment and histology (ILC or IDC; P = .006) and treatment and subgroup (LB like or LA like; P = .01) were observed. In the ILC subset, there was a 66% reduction in the hazard of a DFS event with letrozole for LB (hazard ratio [HR], 0.34; 95% CI, 0.21 to 0.55) and a 50% reduction for LA subtypes (HR, 0.50; 95% CI, 0.32 to 0.78). In the IDC subset, there was a significant 35% reduction in the hazard of a DFS event with letrozole for the LB subtype (HR, 0.65; 95% CI, 0.53 to 0.79), but no difference between treatments was noted for IDC and the LA subtype (HR, 0.95; 95% CI, 0.76 to 1.20). Conclusion The magnitude of benefit of adjuvant letrozole is greater for patients diagnosed with lobular carcinoma versus ductal carcinoma.
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Olukayode, Ekundina Victor, Awopetu Ayodele Victoria, Oladoye Olawalepelumi Olayinka, Alabi Gloria Oluwagbenro, and Iyiola Sina. "BAX and BCL-2 Gene Mutation Signature in Benign and Malignant Lesions of the Breast." Annals of Medical and Health Sciences Research 13, no. 2 (2023): 7. https://doi.org/10.5281/zenodo.14523818.
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Background: Apoptosis regulator BAX, also known as bcl-2-like protein 4, is a protein that in humans is encoded by the BAX gene. BAX, a central cell death regulator, is an indispensable gateway to mitochondrial dysfunction and a major pro-apoptotic member of the BCL-2 family proteins that control apoptosis in normal and cancer cells. Dysfunction of apoptosis renders the cancer cell resistant to treatment as well as promotes tumorigenesis. The aim was to study BAX and BCL-2 gene mutations in benign and malignant lesions of the breast. Materials and methods: A case controlled retrospective study was done with a total of 10 formalin ę¡ed and paraffin wax embedded tissue blocks retrieved from pathology archives, amongst these were 5 benign ębroadenoma and 5 m alignant invasive ductal carcinoma conęrmed cases of the breast analyzed using Nucleic acid amplęcaton techniques, the cells was lysed, separated from cellular debris, precipitated, washed with 70% ethanol and eluted, results were presented in SNPs and functional mutation. Results: This study showed that Bax mutation In Fibroadenoma SNPs observed, 100% transversion, 0% indel and transition. Functional mutation in Fibroadenoma observed, 100% missense, 0% silent and nonsense. In Invasive ductal adenocarcinoma SNPs observed, 58% indel, 29% transversion and 14% transition. Functional mutation in Invasive ductal adenocarcinoma observed, 100% missense and 0% nonsense and silent. BCL-2 mutation in ębroadenoma SNPs observed, 100% transition, 0% indel and 0% transversion. Functional mutation in ębroadenoma observed 67% missense, 0% nonsense and 33% silent. In invasive ductal carcinoma SNPs observed, 30% transversion, 0% insertion and 70% transition. Funcional mutation in invasive ductal carcinoma observed, 40% missense, 60% silent and 0% nonsense. Comparison between BAX and BCL-2 gene in ębroadenoma S NPs observed, 6 0% t ransition, 4 0% transversion a nd 0% indel. Functional mutation in ębroadenoma observed 8 0% Missense, 20%Silent and 0% Nonsense. In invasive ductal carcinoma SNPs observed, 47% transversion, transition 29% and 24% indel. Functional mutation in invasive ductal carcinoma observed, 50% missense and 50%Silent and 0% nonsense. Conclusion: After carrying out this investigation, BAX gene mutation is more defenseless against invasive ductal adenocarcinoma than Fibroadenoma. As a result, mutation in invasive ductal adenocarcinoma in most cases cannot be rectify. In this study, BAX and BCL-2 gene mutation seems to lead to development of breast cancer and affects the disease progression.
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Lien, C. Gilbert J. Velazquez C* and Margheim B. "Breast Cancer Tumoral Heterogeneity: A Case Report of the Discovery of Multiple Heterogeneous Foci of Invasive Carcinoma Arising Within the Right Breast." Mega Journal of Case Reports 8, no. 3 (2025): 2001–11. https://doi.org/10.5281/zenodo.14970070.
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<strong>Abstract</strong> We report the case of a 50-year-old female with bilateral breast implants who presented with indeterminate, pleomorphic, linear, branching ductal calcifications in the right breast. Following unsuccessful stereotactic biopsy, the patient underwent a right breast excisional biopsy with wireless localization. The biopsy identified ER positive, PR positive, invasive ductal carcinoma (IDC) with mucinous features and ductal carcinoma in situ (DCIS). In order to obtain adequate margins, the decision was made to proceed with bilateral mastectomy with reconstruction and right sentinel lymph node biopsy. Final pathology revealed multiple, heterogeneous foci of invasive carcinoma arising within the right breast including invasive tubular carcinoma (ER and PR positive, HER2 negative), high-grade DCIS and moderately differentiated invasive ductal carcinoma (ER and PR negative, HER2 positive). Ultimately, adjuvant hormonal therapy, HER2 targeted therapy and chemoradiotherapy were recommended.
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Rahamath, Kashifa, Bhawna Dev, and Venkata Sai P.M. "Determining the Unique Radiological Features of Lobular Breast Cancer on Imaging in Histopathologically Proven Cases – Our Institutional Experience." Journal of Evolution of Medical and Dental Sciences 10, no. 18 (2021): 1296–301. http://dx.doi.org/10.14260/jemds/2021/274.
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BACKGROUND Lobular breast carcinomas have always been a diagnostic challenge, over the years, to the radiologist. They are one of the most commonly missed lesions on breast cancer screening checks, due to their varied presentation. We wanted to provide a concise and practical approach to characterise their morphology and presentation on mammography and ultrasound. METHODS A retrospective study was done for four years and a total of 699 patients with histopathologically proven breast cancer were chosen. Those patients with invasive lobular carcinoma (N = 56) and invasive ductal carcinoma (N = 538) were segregated and 50 cases from each group were selected randomly. RESULTS On mammography, an irregular, high-density mass was the most common presentation of both lobular (68 %) and ductal (86 %) carcinomas. Presentation as focal asymmetry (28 %) was significantly more prevalent in lobular breast carcinomas. Sonographically, an architectural distortion (30 %) and non-parallel orientation (28 %) was predominantly seen in invasive lobular carcinomas (ILCs). Mass (88 %) with micro lobulated (34 %) or angular (22 %) margins was more in favour of ductal carcinoma. Other general parameters like age at presentation, positive family history, multifocality, bilaterality, tumour size and lymph nodal involvement were not significantly different between both the groups. CONCLUSIONS A careful analysis of digital breast tomosynthesis and ultrasonography, keeping in mind all the clear differentiating features, along with experience in the field, will dramatically increase the early detection of lobular breast cancers. KEY WORDS Invasive Lobular Carcinoma (ILC), Invasive Ductal Carcinoma (IDC), X-Ray Mammography, Sono-Mammography
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Liu, Yanbiao, Zining Jin, Xinmiao Yu, Ang Zheng, Feng Jin, and Xu Wang. "An insight into the invasion of breast ductal carcinoma in situ based on clinical, pathological and hematological data." PeerJ 10 (August 31, 2022): e13966. http://dx.doi.org/10.7717/peerj.13966.
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Background Ductal carcinoma in situ (DCIS) has become a non-negligible part of breast cancers owing to the greatly increased incidence. While its natural history was not fully elucidated, which is the reason for current controversies in clinical treatment. Exploration of this issue from a clinical perspective is meaningful. Methods Medical records of 389 patients diagnosed with DCIS or DCIS with invasive ductal carcinoma (IDC) were reviewed. All of them received appropriate medical care in our center. All 324 patients in training cohort were divided into invasion and non-invasion groups based on pathology. Differences in DCIS immunohistochemical markers and hematological indicators between them were analyzed. In the invasion group, differences between DCIS and matched IDC were compared to explore changes in the tumor heterogeneity during invasion. Conclusions are validated in the validation cohort of 65 patients. Results Patients in invasion and non-invasion groups were balanced in baseline characteristics and no statistically significant differences were noticed for DCIS immunohistochemical markers. For hematological indicators, high expression of platelet >291.50) (odds ratio, 2.46; CI [1.35–4.46]; p = 0.003) and SII (>347.20) (odds ratio, 2.54; CI [1.56–4.12]; p < 0.001) were established as independent predictors for invasion by logistic analysis and were validated in the validation cohort. Ki-67 of IDC was significantly higher than that of matched DCIS (p < 0.001). HER2 expression and histological grade of DCIS were separately linearly related to those of IDC. Conclusion The change in hematological indicators is an independent predictor for invasion and can be incorporated into the treatment decision-making process for DCIS. Invasion tumor cells exhibit a stronger proliferative capacity compared with the in-situ ones. There are linear relationships in HER2 expression and histological grades between DCIS and matched IDC. DCIS subclones with different histological grades will develop into invasive carcinomas separately.
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Can, Nhu Thuy, Cynthia A. Flannery, Jess Hoag, Alekhya Akkunuri, Helen Bailey, and Frederick Baehner. "Abstract P2-23-11: Quantitative gene expression by RT-PCR in histologic subtypes of invasive breast carcinoma: an update in nearly one million cases." Cancer Research 83, no. 5_Supplement (2023): P2–23–11—P2–23–11. http://dx.doi.org/10.1158/1538-7445.sabcs22-p2-23-11.
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Abstract Background: Invasive ductal carcinoma (IDC) accounts for ~80% of all invasive breast carcinomas (IBC) with several histologic subtypes comprising the remainder of cases. Some histologic subtypes of IDC (such as tubular carcinoma) have been associated with better prognosis, while other subtypes (such as metaplastic and micropapillary) have been associated with poorer prognosis. Prior studies have shown patients with early stage, hormone-receptor positive IBC that have low Recurrence Score® (RS), as measured by the 21-gene Oncotype DX® (ODX) assay, have little benefit from chemotherapy. Here, we report our experience with the histologic subtypes of IDC and associated patterns of observed gene expression using ODX. Methods: All US samples submitted for IBC ODX between 2005 to 2021 were reviewed. Ductal carcinoma NOS (DC), tubular carcinoma (TC), cribriform carcinoma (CC), mucinous carcinoma (MUC), lobular carcinoma classic, solid or alveolar type (ILC), pleomorphic lobular carcinoma (PL), medullary/medullary-like carcinoma (MED), metaplastic carcinoma (MET), micropapillary carcinoma (MP), papillary carcinoma (PC) and solid papillary carcinoma (SPC) were included. Quantitative expression of 16 cancer-related genes was measured on a scale from 2 to 15 (relative to reference genes) where 1 unit increment is associated with ~2-fold change in expression. RS was calculated as published. Descriptive statistics for the RS, individual genes (ER, PR, HER2), and gene groups [invasion gene group (IGG) and proliferation gene group (PGG)] were obtained. Results: A total of 957,624 samples were included in this analysis with 85.4% DC, 9.7% ILC, 2.8% MUC, 0.5% TC, 0.4% PL, 0.4% PC, 0.3% MP, 0.2% CC, 0.2% MED, 0.1% SPC, and 0.02% MET. For all types, a wide continuous range of RS was noted. MET had the highest median RS, followed in decreasing order by MED, PL, DC & ILC, TC, MUC, MP, CC, SPC, and PC. ER and PR were highest among PC and SPC. ER and PR were lowest among MED and MET. HER2 was highest among PC and TC and lowest among MED and MET. IGG was highest in MET and lowest in SPC. PGG was lowest for TC and highest for MED and MET. ER+/PR-/HER2- phenotype occurred more often in MED and PL. ER-/PR+/HER2- phenotype rarely occurred, but was most frequent in MED and MET. ER+/PR+/HER2+ accounted for 0.4% of our total sample. Conclusions: Here, we demonstrate histologic subtypes of IDC have a wide continuous range of RS. ODX assay may be used to further stratify patients with IDC and its histologic subtypes; however, further studies are needed to better understand the predictive capability of ODX in the histologic subtypes. Table 1. Quantitative gene expression by RT-PCR in histologic subtypes of invasive breast carcinoma Table 2. Biomarker profile in histologic subtypes of invasive breast carcinoma Citation Format: Nhu Thuy Can, Cynthia A. Flannery, Jess Hoag, Alekhya Akkunuri, Helen Bailey, Frederick Baehner. Quantitative gene expression by RT-PCR in histologic subtypes of invasive breast carcinoma: an update in nearly one million cases [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-23-11.
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Danzinger, Sabine, Nora Hielscher, Miriam Izsó, et al. "Invasive lobular carcinoma: clinicopathological features and subtypes." Journal of International Medical Research 49, no. 6 (2021): 030006052110170. http://dx.doi.org/10.1177/03000605211017039.
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Objective To analyze the characteristics of invasive lobular carcinoma (ILC) compared with invasive ductal carcinoma (IDC) and to investigate the impact of histology on axillary lymph node (ALN) involvement in luminal A subtype tumors. Methods We retrospectively analyzed patients diagnosed with ILC or IDC from 2012 to 2016 who underwent surgery. Patients constituted 493 primary early breast cancer cases (82 ILC; 411 IDC). Results Compared with IDC, ILC tumors were significantly more likely to be grade 2, estrogen receptor- (ER) positive (+), have a lower proliferation rate (Ki67 <14%), and a higher pathological T stage (pT2–4). The luminal A subtype was significantly more common in ILC compared with IDC. In a multivariate regression model, grade 2, ER+, progesterone receptor-positive, pT2, and pT3 were significantly associated with ILC. Additionally, with the luminal A subtype, ALN involvement (pathological node stage (pN)1–3) was significantly more frequent with ILC versus IDC. Conclusions Our data suggest that grade 2, positive hormone receptor status, and higher pathological T stage are associated with ILC. With the luminal A subtype, ALN involvement was more frequent with ILC versus IDC.
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Bharti, Kumari, Kumari Mamta, Haldar Debaditya, Singh Shashi, and Kumar Amresh. "Significance of CK 8 and E-Cadherin in Differentiating Lobular From Ductal Breast Carcinoma and its Correlation with Clinicopathological Parameters." International Journal of Pharmaceutical and Clinical Research 16, no. 2 (2024): 1830–35. https://doi.org/10.5281/zenodo.11087464.
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<strong>Introduction:</strong> Differentiating the cases of invasive ductal carcinoma (IDC) from invasive lobular carcinoma (ILC) is difficult in equivocal cases due to some overlapping features. In such cases E-cadherin and Cytokeratin 8 (CK 8) immunohistochemical markers can be useful in confirming the results. <strong>Aim & Objectives:</strong> To explore E-cadherin and CK 8 expression in breast carcinoma cases having ductal and lobular morphology, and to determine the role of these two immunohistochemical markers in distinguishing between IDC and ILC and their in-situ components, and to correlate with clinicopathological parameters. <strong>Methods:</strong> We conducted a prospective observational study on 80 breast carcinoma cases in the Pathology Department of IGIMS, Patna over a period of one year, from 2022 to 2023. Haematoxylin & Eosin stained slides of tissue samples of breast carcinoma cases were studied for histomorphological parameters and manual immunohistochemistry was performed with E-cadherin and CK 8 to evaluate its expression and correlate it with histomorphological findings. <strong>Results:</strong> There were 65 IDC and 15 ILC cases. We found Ductal carcinoma in situ (DCIS) in 40 cases and Lobular carcinoma in situ (LCIS) in 10 patients. There was significant statistical correlation of E-cadherin score and CK 8 expression pattern in IDC, ILC, DCIS and LCIS. <strong>Conclusion: </strong>The combination of CK 8 and E-cadherin immunohistochemical markers could be used as diagnostic utility markers in cases of IDC, ILC, DCIS and LCIS.
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Han, Bing, Ye Du, Ton Fu, et al. "Differences and Relationships Between Normal and Atypical Ductal Hyperplasia, Ductal Carcinoma In Situ, and Invasive Ductal Carcinoma Tissues in the Breast Based on Raman Spectroscopy." Applied Spectroscopy 71, no. 2 (2016): 300–307. http://dx.doi.org/10.1177/0003702816681009.
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The aim of this study was to find the differences and relationships between normal, atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS), and invasive ductal carcinoma (IDC) lesions of the breast based on biochemical characteristics determined by Raman spectroscopy (RS). After collecting 39 frozen sections from patients who underwent surgical resection or mammotome biopsy, nine normal tissues, seven ADH, eight DCIS, and 15 IDC lesions were detected using confocal RS. We then used leave-one-out cross-validation (LOOCV) and radial basis function (RBF) to build a support vector machine (SVM) diagnosis model. Pronounced mean Raman spectra differences were observed between normal tissues, ADH, DCIS, and IDC tissues. Most noticeable was the increased protein and reduced lipid levels of ADH tissues compared to normal tissues. The major spectra differences in ADH, DCIS, and IDC spectrograms were evidenced by a red shift with a broad peak of CH2 (1301 cm−1), the intensity of the stretching vibration peak of carotenoids (1526 cm−1), a relatively strong band of amide-I (1656 cm−1), and the nuclear (882 cm−1) acid peak. Atypical ductal hyperplasia tissues had the largest constituent variations between subjects. During the disease progression, IDC tissues have smaller inter-subject constituent variations than DCIS and ADH tissues. The overall accuracy of SVM model is 74.39%. The sensitivities of normal tissue, ADH, DCIS, and IDC are 62.5%, 50%, 90%, and 66.7%, respectively. The specificities of normal tissue, ADH, DCIS, and IDC are 100%, 100%, 66.7%, and 89.06%, respectively. Atypical ductal hyperplasia shows significant differences and the relationship between normal tissue and malignant disease. Further study to explain the biochemical relationships between these differences will shed more light into a better understanding of the mechanism by which ADH converts to DCIS and to IDC.
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Kanavati, Fahdi, and Masayuki Tsuneki. "Breast Invasive Ductal Carcinoma Classification on Whole Slide Images with Weakly-Supervised and Transfer Learning." Cancers 13, no. 21 (2021): 5368. http://dx.doi.org/10.3390/cancers13215368.
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Invasive ductal carcinoma (IDC) is the most common form of breast cancer. For the non-operative diagnosis of breast carcinoma, core needle biopsy has been widely used in recent years for the evaluation of histopathological features, as it can provide a definitive diagnosis between IDC and benign lesion (e.g., fibroadenoma), and it is cost effective. Due to its widespread use, it could potentially benefit from the use of AI-based tools to aid pathologists in their pathological diagnosis workflows. In this paper, we trained invasive ductal carcinoma (IDC) whole slide image (WSI) classification models using transfer learning and weakly-supervised learning. We evaluated the models on a core needle biopsy (n = 522) test set as well as three surgical test sets (n = 1129) obtaining ROC AUCs in the range of 0.95–0.98. The promising results demonstrate the potential of applying such models as diagnostic aid tools for pathologists in clinical practice.
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Goh, Chih Wan, Jiayi Wu, Shuning Ding, et al. "Invasive ductal carcinoma with coexisting ductal carcinoma in situ (IDC/DCIS) versus pure invasive ductal carcinoma (IDC): a comparison of clinicopathological characteristics, molecular subtypes, and clinical outcomes." Journal of Cancer Research and Clinical Oncology 145, no. 7 (2019): 1877–86. http://dx.doi.org/10.1007/s00432-019-02930-2.
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., Malashree, Gowda Kavita Umapathy, and Shashikala P. "Study of Cytomorphological Patterns of Neoplastic Breast Lesions along with Robinson’s Cytological Grading of Invasive Ductal Carcinoma." Annals of Pathology and Laboratory Medicine 11, no. 6 (2024): A95–103. https://doi.org/10.21276/apalm.3321.
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Background Fine Needle Aspiration Cytology (FNAC) plays an important role as it is a simple, minimally invasive, cost-effective, outpatient-based, and rapid diagnostic method. Grading of breast carcinoma is ideal as it helps in the selection of patients for appropriate therapy. The study was undertaken to observe the cytomorphological patterns of neoplastic lesions, assess the grade of invasive ductal carcinoma by Robinson’s cytological grading, and to correlate with Modified Bloom Richardson’s histopathological grading wherever possible. Material and Methods A descriptive cross-sectional study was conducted over a period of 2 years (July 2015-June 2017). FNAC of neoplastic breast lesions was studied. Invasive ductal carcinomas were graded according to Robinson’s cytological grading system and compared with Modified Nottingham Bloom-Richardson’s histological grading in instances where resected specimens were available. Results In the present study, fibroadenoma (31/33; 94.0%) was the most common benign neoplasm and invasive ductal carcinoma (40/41; 97.6%) was the most common malignant neoplasm. According to Robinson’s cytological grading done on IDC breast, the majority of the cases were grade II [24 (60.0%)]. Histopathological correlation was done by Modified Bloom Richardson’s grading on 13 cases of IDC in which 6 (42.8%) cases were in grade II followed by grade III and I. There was a significant concordance of 71.4% (p=0.015) between Robinson’s cytological grading system and Modified Nottingham Bloom Richardson’s histopathological grading system. Conclusion Robinson’s cytological grading on invasive ductal carcinoma of the breast has good concordance with Modified Bloom Richardson’s histopathological grading.
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Yu, Bao-Hua, Shao-Xian Tang, Xiao-Li Xu, et al. "Breast carcinoma in sclerosing adenosis: a clinicopathological and immunophenotypical analysis on 206 lesions." Journal of Clinical Pathology 71, no. 6 (2018): 546–53. http://dx.doi.org/10.1136/jclinpath-2017-204751.
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AimsTo fully elucidate the clinicopathological features of breast carcinoma in sclerosing adenosis (SA-BC).MethodsClinical and histological characteristics of 206 SA-BCs from 180 patients were retrospectively evaluated. Immunohistochemical phenotype was examined. The clinicopathological relevance of the topographical pattern of SA-BCs was analysed.ResultsOverall, up to 46 patients (25.6%) had contralateral cancer, either SA associated or not. Of 99 cases who underwent core needle biopsy (CNB), 36 were underestimated as adenosis or atypical ductal hyperplasia at CNB, 5 invasive cases were misinterpreted as in situ carcinomas, whereas 4 ductal carcinoma in situ (DCIS) cases were overdiagnosed as invasive carcinoma. Microscopically, 163 tumours were in situ, including 136 DCIS, 19 lobular carcinomas in situ (LCIS) and 8 mixed DCIS/LCIS; of these carcinomas in situ (CIS), 37 had microinvasion. The DCIS group exhibited low, intermediate and high grades in 53.7%, 34.6% and 11.8% of cases, respectively, mostly with solid (43.4%) or cribriform (41.9%) pattern. Forty out of 43 invasive cases were invasive ductal carcinoma (IDC), mostly DCIS predominant. Immunophenotypically, luminal A phenotype was identified in 55.1%, 63.2% and 45.0% of DCIS, LCIS and IDC cases, respectively. Topographical type A group (carcinoma being entirely confined to SA, n=176) was characterised by smaller size, less invasiveness, lower grade and more frequency of luminal A immunophenotype compared with type B group (≥ 50% but not all of the carcinomatous lesion being located in SA, n=30) (all P<0.05).ConclusionsCIS, especially non-high-grade DCIS, represents the most common variant of SA-BC, and luminal A is the most predominant immunophenotype. CNB assessment might be challenging in some SA-BCs. The topographical pattern has great clinicopathological relevance. Careful evaluation of the contralateral breast and long-term follow-up for patients with SA-BC is necessary given its high prevalence of bilaterality.
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Cohen, Ronald J., Beverly A. Shannon, and Sydney L. Weinstein. "Intraductal Carcinoma of the Prostate Gland With Transmucosal Spread to the Seminal Vesicle: A Lesion Distinct From High-Grade Prostatic Intraepithelial Neoplasia." Archives of Pathology & Laboratory Medicine 131, no. 7 (2007): 1122–25. http://dx.doi.org/10.5858/2007-131-1122-icotpg.
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Abstract Intraductal carcinoma of the prostate (IDC-P) gland represents an intraluminal neoplastic proliferation that is distinct from high-grade prostatic intraepithelial neoplasia (HG-PIN) and almost always coexists with large-volume, high-stage, and high-grade invasive carcinoma. We document an unusual presentation of apparently “early” IDC-P without an aggressive invasive element that, despite being confined to the acinar-ductal system, has gained access to the ejaculatory duct and seminal vesicle by transmucosal spread. This finding confirms that IDC-P, in contrast to HG-PIN, is inherently aggressive and has the ability to spread beyond the prostate gland. In this case, the absence of an aggressive invasive element suggests that IDC-P has most likely evolved within the lumens directly from HG-PIN.
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Yeong, Joe, Aye Aye Thike, Puay Hoon Tan, and Jabed Iqbal. "Identifying progression predictors of breast ductal carcinoma in situ." Journal of Clinical Pathology 70, no. 2 (2016): 102–8. http://dx.doi.org/10.1136/jclinpath-2016-204154.
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Ductal carcinoma in situ (DCIS) refers to neoplastic epithelial cells proliferating within the mammary ducts of the breast, which have not breached the basement membrane nor invaded surrounding tissues. Traditional thinking holds that DCIS represents an early step in a linear progression towards invasive ductal carcinoma (IDC). However, as only approximately half of DCIS cases progress to IDC, important questions around the key determinants of malignant progression need to be answered. Recent studies have revealed that molecular differences between DCIS and IDC cells are not found at the genomic level; instead, altered patterns of gene expression and post-translational regulation lead to distinct transcriptomic and proteomic profiles. Therefore, understanding malignant progression will require a different approach that takes into account the diverse tumour cell extrinsic factors driving changes in tumour cell gene expression necessary for the invasive phenotype. Here, we review the roles of the tumour stroma (including mesenchymal cells, immune cells and the extracellular matrix) and myoepithelial cells in malignant progression and make a case for a more integrated approach to the study and assessment of DCIS and its progression, or lack thereof, to invasive disease.
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Aditi, Raj, Jaysing Rajput Jyoti, and Raut Sonal. "Study of Histomorphological Spectrum of Malignant Breast Diseases- in a Tertiary Care Centre of Mumbai." International Journal of Pharmaceutical and Clinical Research 16, no. 6 (2024): 2422–25. https://doi.org/10.5281/zenodo.13763685.
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<strong>Background</strong><strong>:</strong> Worldwide, breast cancer is the most frequent cancer among women and the primary cause of cancer related deaths. It is now the most common cancer among women in India, surpassing even cervical cancer. Accurate diagnosis, prognosis, and treatment planning of breast cancer depend on an understanding of its histomorphological features. The purpose of this study is to look at the histomorphological range of breast cancers. <strong>Methods</strong><strong>:</strong> Ninety female patients diagnosed with malignant breast diseases were included. Data on patient demographics, clinical presentation, and histopathological findings were collected. Tumor types, grades, and lymphovascular invasion were analyzed. Statistical analysis was performed using SPSS version 23.0, with significance set at p<0.05. <strong>Results</strong><strong>:</strong> Ninety patients, whose mean age was 53.4 years, were enrolled in the study. The most prevalent tumour type (80%) was invasive ductal carcinoma (IDC), which was followed by invasive lobular carcinoma (11.1%), mucinous carcinoma (4.4%) and other tumour types. The majority of tumours (55.6%) were Grade 2, followed by Grade 3 (33.3%) and Grade 1 (11.1%). Lymphovascular invasion was seen in 38.9% of patients which was substantially correlated with IDC (p=0.025). <strong>Conclusion</strong><strong>:</strong> IDC is the predominant type of malignant breast disease in this cohort, with a significant association between IDC and lymphovascular invasion, indicating a higher metastatic potential. The findings highlight the importance of histopathological examination in diagnosing and prognosticating breast cancer. <strong>Recommendations:</strong> Early detection and tailored treatment strategies are essential, especially for patients with IDC and lymphovascular invasion. Further studies with larger sample sizes are recommended to validate these findings and explore additional histomorphological parameters.
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Chen, Xuan, Xinji Li, Jingyao Wang, et al. "Breast invasive ductal carcinoma diagnosis with a three-miRNA panel in serum." Biomarkers in Medicine 15, no. 12 (2021): 951–63. http://dx.doi.org/10.2217/bmm-2020-0785.
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Aim: Breast cancer, especially invasive ductal carcinoma (IDC), is the cause of a great clinical burden. miRNA could be considered as a noninvasive biomarkers for IDC diagnosis. Materials & methods: Two hundred and sixty participants (135 IDC patients and 125 healthy controls) were enrolled in a three-cohort study. The expression of 28 miRNAs in serum were detected with quantitative reverse transcription-PCR. Bioinformatic analysis was used for predicting the target genes of three selected miRNAs. Results: The expression level of seven miRNAs (miR-9-5p, miR-34b-3p, miR-1-3p, miR-146a-5p, miR-20a-5p, miR-34a-5p, miR-125b-5p) was discrepant at the validation cohort. Through statistical test, a three-miRNA panel (miR-9-5p, miR-34b-3p, miR-146a-5p) was significant for IDC diagnosis (AUC = 0.880, sensitivity = 86.25%, specificity = 81.25%). Conclusion: The three-miRNA panel in serum could be used as a noninvasive biomarker in the diagnosis of IDC.
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A, Ruibal, Aguiar P, Arias JI, and Herranz M. "Size In Breast Invasive Ductal Carcinoma Leads Changes in Important Biological Parameters." JSM Surgical Oncology and Research 1, no. 2 (2016): 1–4. http://dx.doi.org/10.47739/2578-3688.surgicaloncology.1006.
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Lin, Shuwen, and Jesus Del Santo Anampa Mesias. "Short-term and long-term survival outcomes in patients with invasive lobular carcinoma vs. invasive ductal carcinoma of the breast." Journal of Clinical Oncology 42, no. 16_suppl (2024): e12564-e12564. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.e12564.
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e12564 Background: Invasive lobular carcinoma (ILC) accounts for 10% of all invasive breast cancer and has distinct histological and biological features compared to the most common breast cancer histological subtype, invasive ductal carcinoma (IDC). ILC is more endocrine sensitive and chemotherapy resistant than IDC and has a different metastatic pattern. There is lack of conclusive data on the differences in survival outcomes between ILC and IDC. We aimed to assess the short-term and long-term survival outcomes in patients with ILC and IDC in a large population database. Methods: This is a retrospective, population-based study using data from the Surveillance, Epidemiology, and End Results database. We included women > 18 years with stage I-III ILC or IDC diagnosed from 1992-2020. Multivariable logistic regression was used to assess factors associated with different treatment modalities in patients with IDC vs. ILC. We estimated breast cancer-specific survival (BCSS) using Kaplan-Meier methods and their survival rates were compared using the log-rank test. We analyzed BCSS at different time points using a cox regression model with time-varying coefficients. Results: 343,397 patients with IDC and 39,859 patients with ILC were included in this study. Patients with ILC were older (63.0 ± 12.5 years vs. 59.2 ± 13.5 years, p<0.001). There were more non-Hispanic white patients with ILC vs. IDC (76% vs. 67%, p<0.001). Patients with ILC had more advanced disease: more stage III disease (16% vs. 11%, p<0.001), more T3-T4 disease (15% vs. 6%, p<0.001), and more N2-N3 disease (12% vs. 9%, p<0.001). Patients with ILC also had a higher frequency of hormone receptor positive disease (97% vs. 81%, p<0.001). Fewer patients with ILC had grade 3-4 tumors (9% vs. 36%, p<0.001). Our multivariate analysis showed that compared to patients with IDC, patients with ILC were more likely to undergo mastectomy (OR=1.85, p < 0.001) and radiation (OR=1.20, p<0.001), but less likely to receive chemotherapy (OR= 0.92, p<0.001). After adjusting for clinicopathological features, treatment modalities, and socioeconomic variables; compared to patients with IDC, patients with ILC had better BCSS in the first five years (HR=0.71, p <0.001), but worse BCSS in later years (HR=1.30, p<0.001 in year 6-10; HR=1.75, p<0.001 in year 11-15; HR=2.17, p<0.001 in year 16-20). Annual hazard models show that IDC peaked at recurrence in the first 5 years after diagnoses, and the hazard rate declines gradually after that. ILC peaked at recurrence in the first 5 years after diagnosis with minimal decrease in hazard rates after that. Conclusions: BCSS of patients with ILC is better in early years but worse in later years compared to patients with IDC. Future studies are needed to identify predictors of late relapses in ILC, and novel therapeutic strategies are required for these patients.
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Yoon, Kwang Hyun, Jee Hyun Ahn, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, and Seho Park. "Impact of Axillary Burden on Survival: A Comparative Study of Invasive Lobular Carcinoma and Invasive Ductal Carcinoma in Early-Stage Breast Cancer." Cancers 17, no. 6 (2025): 1002. https://doi.org/10.3390/cancers17061002.
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Purpose: Invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) are the most common breast cancer types. While they differ biologically and pathologically, their association with axillary lymph node (ALN) metastasis and survival remains unclear. This study compares the clinical features of ILC and IDC to evaluate ALN surgery considerations for ILC patients. Materials and Methods: We retrospectively analyzed 3543 patients who underwent upfront surgery for early breast cancer at Yonsei University Severance Hospital between January 2015 and December 2019. Multivariate logistic regression assessed factors linked to ALN metastasis, while Cox regression identified predictors of recurrence and survival. Results: Among the patients, 92.1% had IDC and 7.9% had ILC. T2-stage tumors were more prevalent in ILC (31.4% vs. 18.1%, p < 0.001). The rates of ALN metastasis were similar between the groups (IDC: 21.1%, ILC: 24.6%, p = 0.655); however, the presence of more than two metastatic ALNs was more frequent in ILC (9.6% vs. 5.0%, p = 0.004). Factors associated with having >2 metastatic ALNs included histology, suspicious axillary ultrasound, T stage, and lymphovascular invasion. The median follow-up period was 65 months, with no significant differences observed in 8-year recurrence-free survival (ILC: 95.2%, IDC: 94.1%, p = 0.134) or 5-year overall survival (ILC: 97.1%, IDC: 97.4%, p = 0.289). Conclusions: ILC features larger tumors and a higher nodal burden but has similar survival rates to IDC with proper treatment. Caution is essential in axillary surgery to avoid underestimating the nodal burden.
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Gupta, Isha, Sheifali Gupta, and Swati Singh. "Architectures Based on Deep Learning for the Detection of Invasive Ductal Carcinoma." ECS Transactions 107, no. 1 (2022): 5469–79. http://dx.doi.org/10.1149/10701.5469ecst.
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Image processing techniques have improved dramatically in recent years to help pathologists identify cancer cells. Like convolutional neural networks (CNNs), deep learning methods are increasingly used for imaging processes and analysis in histopathology images. This research aims to demonstrate the detection of histopathological pictures linked with the prediction of invasive ductal carcinomas (IDC) and non-IDC in the breasts. A complex problem is the detection of IDC in histopathological images, as cancer includes minor entities with a variety of shapes that can readily be confused with other objects or facts in the picture. As a result, the suggested research recommends three distinct CNN architectures for identifying IDC using histopathological images, referred to as 10-layer, 19-layer, and 20-layer convolutional neural networks, respectively. Excellent values of sensitivity, precision, and low classification error rate have been achieved to detect IDC in histopathology images using deep layer-convolutional neural networks. Using 19 layer-convolutional neural networks, the efficiency obtained was 87%, revealing improved results for deep layer convolutional neural network architecture.
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Datrice, Nicole, Navneet Narula, Melinda Maggard, et al. "Do Breast Columnar Cell Lesions with Atypia Need to be Excised?" American Surgeon 73, no. 10 (2007): 984–86. http://dx.doi.org/10.1177/000313480707301012.
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Columnar cell lesion with atypia (CCLA) is a newly recognized pathologic entity seen in breast specimens. The breast cancer risk associated with this finding is unclear, although CCLA had been found adjacent to both in situ and invasive carcinomas, but the incidence is unknown. Breast specimens from patients with a columnar cell lesion were reviewed by a pathologist for atypia. Twenty-one specimens with CCLA were identified [core biopsy (8), excisional biopsy (11), and simple mastectomy (2)]. Six of eight specimens with CCLA on core had adjacent abnormal pathology: infiltrating ductal carcinoma (IDC)/lobular carcinoma in situ (LCIS) (1), ductal carcinoma in situ (DCIS)/LCIS (1), DCIS (1), LCIS (1), and papillomatosis (2). Five of 11 specimens with CCLA on excisional biopsy had adjacent abnormal pathology: IDC (3), DCIS/LCIS (1), and atypical ductal hyperplasia/papilloma (1). Two of two simple mastectomy specimens had CCLA associated with IDC (1) and DCIS (1). Overall, abnormal pathology was found adjacent to CCLA in 62 per cent of specimens (13/21). Breast pathologic specimens containing a columnar cell lesion should be carefully examined for atypia. Surgical excision is warranted for CCLA found on core biopsy. The future risk of breast cancer based on the finding of CCLA alone requires further investigation.
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Lim, David Wai, Vasily Giannakeas, Steven Narod, and Kelly A. Metcalfe. "Abstract 4212: Comparison of thirty-year population-based incidence rates of invasive lobular vs ductal vs mixed breast carcinoma in Ontario, Canada." Cancer Research 83, no. 7_Supplement (2023): 4212. http://dx.doi.org/10.1158/1538-7445.am2023-4212.
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Abstract Purpose: We calculated crude, age-adjusted and age-specific incidence rates for invasive lobular, ductal and mixed ductal-lobular breast carcinoma from 1990 to 2020 in the province of Ontario, Canada. We further examined incidence relationships between clinical stage, age at diagnosis and time. Methods: We used population-based administrative healthcare datasets from the Institute of Clinical Evaluative Sciences (ICES Ontario), including the Ontario Cancer Registry, to identify all women diagnosed with breast cancer between 1990 and 2020. We calculated crude, age-adjusted and age-specific incidence rates for invasive lobular (ILC), ductal (IDC) and mixed ductal-lobular (IDC-ILC) breast carcinoma. Incidence rates were adjusted to the 2011 Canadian female standard population. We further examined the incidence relationships between clinical stage and age at diagnosis over time. Results: From 1990 to 2020, the 5-year crude incidence rates of ILC increased from 53.1 to 73.4 per 100,000 (+38%), while IDC increased from 501 to 746.5 per 100,000 (+49%). The crude incidence of mixed IDC-ILC peaked at 45 per 100,000 between 2005 and 2009 and is currently 29 per 100,000. The age-adjusted 5-year incidence rate of ILC has slightly increased from 64 to 70 per 100,000 (+9%) while that of IDC has increased from 598 to 726 per 100,000 (+21%). The age-adjusted 5-year incidence of mixed IDC-ILC peaked at 47 per 100.000 between 2005 and 2009 and has declined to 29 per 100,000. Age-specific 5-year incidence rates for ILC has decreased over time in women &lt; 40 years of age and increased in women over the age of 65. In contrast, age-specific 5-year incidence rates for IDC have remained stable in women over 75. For mixed IDC-ILC, age-specific 5-year incidence rates have increased over time in all age categories. Among women with ILC, there is a greater proportion of women under the age of 50 diagnosed with stage III disease (30%) compared with women diagnosed over the age of 50 (16%). Women between the ages of 50 and 74 have higher rates of being diagnosed at stage I (43%) compared with 35% and 31% for women diagnosed between the ages of 40-49 and over 75, respectively. Conclusions: The incidence of invasive lobular breast carcinoma in increasing, particularly in women over the age 65. Consequently, the burden of lobular breast carcinoma is expected to increase, as the proportion of women over the age of 65 is expected to rise exponentially in the foreseeable future, highlighting a need for further study of this not uncommon breast cancer subtype. While representing a smaller proportion of breast cancer diagnoses, the incidence of mixed invasive ductal-lobular subtype is increasing in all age groups. Citation Format: David Wai Lim, Vasily Giannakeas, Steven Narod, Kelly A. Metcalfe. Comparison of thirty-year population-based incidence rates of invasive lobular vs ductal vs mixed breast carcinoma in Ontario, Canada. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4212.
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Elzubair, Qubaa Ahmed, Mohamed Alfaki, Musaab Ahmed Ahmed, et al. "Evaluation of Ki67 Biomarker as a Prognostic Marker in Breast Invasive Ductal Carcinoma in Khartoum State in Sudan." Biomedical and Pharmacology Journal 17, no. 3 (2024): 1931–36. http://dx.doi.org/10.13005/bpj/2995.
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Introduction: Worldwide, breast cancer is the most prevalent cancer among women to be diagnosed, and it is the primary cause of cancer-related mortality, coming in second only to lung cancer. High levels of Ki67, a nuclear marker of cell proliferation, in breast cancer are linked to worse outcomes. Methods and materials: This retrospective cross-sectional laboratory investigation aimed to examine Ki67 expression as a prognostic predictor in invasive ductal carcinoma (IDC) utilizing manual tissue microarrays (MTMAs) technology. The study was done from June 2018 to July 2019 at the Elrahman Health Centre in Khartoum, Sudan, using thirty-five paraffin block samples collected from patients previously diagnosed with invasive ductal carcinoma (IDC). The study population ranged in age from 31 to 71 years. Results: The study found that 94.3% (n=33/35) of the tissues were positive for the Ki67 antigen, while 5.7% (n=2/35) were negative. Age and score correlation is (P=0.047), and a favorable prognosis could be the cause of the two unfavorable results. Conclusion: This study highlights the importance of the Ki67 biomarker as a prognostic indicator in invasive ductal carcinoma (IDC) of the breast. High levels of Ki67 expression (94.3%) were associated with more aggressive tumors and poorer prognostic outcomes. However, there was no significant correlation between Ki67 scores and patient age, indicating age does not influence the prognostic value of Ki67 in this cohort.
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T, Shruthi, Dr Ramesh Chavan, and Dr Naresh Jaikumar Kulkarni. "Aberrant expression of E-cadherin in infiltrating ductal and lobular breast carcinomas and its correlation with clinicopathological parameters – A hospital-based study." Tropical Journal of Pathology and Microbiology 7, no. 3 (2021): 99–109. http://dx.doi.org/10.17511/jopm.2021.i03.02.
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Introduction: Breast carcinoma is one of the commonest malignant tumours in women, leading topremature deaths and morbidity. E-cadherin is a 120kDa calcium-dependent transmembraneglycoprotein encoded by the CDH1 gene located on chromosome 16q21 and is expressed in mostepithelial cells. Loss of E Cadherin expression implies cell discohesion and favours metastasis.Materials and Methods: A total of 30 cases of breast carcinomas were studied, over two years.Histological grade and type were assessed by staining the paraffin-embedded sections with H & E.Using IHC technique, E-cadherin antigen was retrieved by Heat-Induced Epitome Retrieval method,and immunostaining was scored semiquantitatively. Cases were grouped as ‘preserved,’ whenpositivity was strong membranous, and occurred in more than 75% of the neoplastic epithelial cellsand ‘aberrant’ in all the remaining cases. Results: E-cadherin was found to be preserved in 46.7%of all the breast carcinomas and aberrant in 51.7% of invasive ductal carcinomas (IDC) alone, while100% of invasive lobular carcinomas showed aberrant expression. No significant correlation wasfound with E-cadherin grading and histological type of carcinoma, histopathological grade orinvolvement of deep surgical margin. Conclusion: Differentiation between invasive ductal andinvasive lobular carcinoma based on the loss of E-cadherin has to be done cautiously given itsaberrant expression in ductal carcinomas as well.
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Majer, Martin, Elizabeth Fauchier Little, Sarah Jones, et al. "Similar decrease of proliferation employing Ki-67 after brief neoadjuvant hormonal treatment on invasive ductal carcinoma versus invasive lobular carcinoma." Journal of Clinical Oncology 39, no. 15_suppl (2021): e12606-e12606. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e12606.
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e12606 Background: Invasive lobular carcinoma (ILC) differs from the more prevalent invasive ductal carcinoma (IDC) in histology, molecular underpinning, and biological responsiveness to cytotoxics. Patients diagnosed with IDC or ILC were evaluated in the clinical setting to determine if they differ in responsiveness to neoadjuvant hormone treatment. Methods: This is a retrospective observational study of an underserved, low income, rural population in Oroville, California. The data for this study was collected over ten years (2011-2021) from 58 estrogen receptor positive (ER+) breast cancer patients. The majority of these patients (48/58) were diagnosed with IDC with ages ranging from 35 to 91 (mean age is 66) and the remaining 10 were diagnosed with ILC with ages ranging from 58 to 85 (mean age is 64). Patients were given neoadjuvant hormone treatment starting after their initial biopsy confirming ER+ status until scheduled surgical removal by lumpectomy or mastectomy. Ki-67 was measured prior to treatment and then measured again after a minimum of 14 days on hormone therapy. The initial Ki-67 range for patients with IDC was 2%-75% (median of 15%). Ki-67 initial range for patients with ILC was 2%-30% (median of 11%). Positive response to treatment was set at > 50% reduction in Ki-67, with no response set at < 50% reduction in Ki-67. We compared the response rates of ILC and IDC patients using a chi-square test. Results: Chi-square analysis found no statistically significant difference between IDC and ILC response to hormone therapy. 34/48 (71%) patients with IDC responded to treatment, and 8/10 (80%) of ILC patients showed response. Incidentally, we noticed a higher prevalence of ILC in our community compared to expected numbers. Conclusions: When evaluating hormone therapy responsiveness in the neoadjuvant setting, there is no observable statistical difference in response rates between IDC and ILC. Neoadjuvant hormone testing employing Ki-67 response identifies subgroups of patients who benefit from the addition of new biologics (-ciclibs, mTOR inhibitors) in addition to hormone treatment. Our experience supports testing in this way to further individualize the care of patients unable to participate in clinical trials.