Peritoneal dissemination of breast cancer diagnosed by laparoscopy

AbstractThe accuracy of modern imaging techniques for the diagnosis of peritoneal carcinomatosis is poor. A breast cancer patient with a high serum CA15-3 level did not receive a definitive diagnosis of peritoneal dissemination by imaging examination and then underwent laparoscopy. Pathological examination showed peritoneal dissemination of breast cancer, but the biological markers were different from the primary lesion: ER(−), PgR(−), and Her2:3 +. T-DM1 therapy was very effective, and her systemic symptoms disappeared. Since biomarkers of metastatic lesions may sometimes change, laparoscopic biopsy is very important and useful.

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Urachal Carcinoma with Peritoneal Dissemination Treated with Chemotherapy and Surgical Resection Leading to Prolonged Survival with No Recurrence

Case Reports in Urology ◽

10.1155/2018/9836154 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Masato Yasui ◽

Ryosuke Jikuya ◽

Tomoyuki Tatenuma ◽

Kentaro Muraoka ◽

Susumu Umemoto ◽

...

Keyword(s):

Multimodal Therapy ◽

Peritoneal Dissemination ◽

Tumor Resection ◽

Rectus Muscle ◽

Vermiform Appendix ◽

Pathological Examination ◽

Urachal Carcinoma ◽

Metastatic Lesions ◽

Abdominal Rectus Muscle ◽

Complete Tumor

A 56-year-old man was admitted to our hospital for urachal carcinoma with peritoneal dissemination. He received first-line chemotherapy with gemcitabine and cisplatin. After the fifth cycle, a computed tomography (CT) scan revealed abdominal fluid, and his serum tumor marker levels were increased. The patient was started on second-line therapy with FOLFIRI. After 11 cycles, his tumor decreased in size and no new metastatic lesions were detected. The patient underwent complete tumor resection with partial cystectomy and pelvic lymph node dissection. The tumor was removed, along with adhering surrounding organs, including the omentum, peritoneum, abdominal rectus muscle, and vermiform appendix. Although pathological examination confirmed peritoneal dissemination, his tumor markers normalized soon after surgery. The patient has survived 62 months after surgery without any adjuvant therapy and with no evidence of recurrence. To our knowledge, this is the longest duration of survival without recurrence of a patient with urachal carcinoma with peritoneal dissemination who received multimodal therapy.

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Comparison of Mammography and Ultrasonography for Tumor Size of DCIS of Breast Cancer

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666180131163321 ◽

2019 ◽

Vol 15 (2) ◽

pp. 209-213

Author(s):

Yu Wang ◽

Jiantao Wang ◽

Haiping Wang ◽

Xinyu Yang ◽

Liming Chang ◽

...

Keyword(s):

Breast Cancer ◽

Correlation Coefficient ◽

Tumor Size ◽

Ductal Carcinoma ◽

Pearson Correlation ◽

Dense Breast ◽

Pathological Examination ◽

Negative Group ◽

The Difference

Objective: Accurate assessment of breast tumor size preoperatively is important for the initial decision-making in surgical approach. Therefore, we aimed to compare efficacy of mammography and ultrasonography in ductal carcinoma in situ (DCIS) of breast cancer. Methods: Preoperative mammography and ultrasonography were performed on 104 women with DCIS of breast cancer. We compared the accuracy of each of the imaging modalities with pathological size by Pearson correlation. For each modality, it was considered concordant if the difference between imaging assessment and pathological measurement is less than 0.5cm. Results: At pathological examination tumor size ranged from 0.4cm to 7.2cm in largest diameter. For mammographically determined size versus pathological size, correlation coefficient of r was 0.786 and for ultrasonography it was 0.651. Grouped by breast composition, in almost entirely fatty and scattered areas of fibroglandular dense breast, correlation coefficient of r was 0.790 for mammography and 0.678 for ultrasonography; in heterogeneously dense and extremely dense breast, correlation coefficient of r was 0.770 for mammography and 0.548 for ultrasonography. In microcalcification positive group, coeffient of r was 0.772 for mammography and 0.570 for ultrasonography. In microcalcification negative group, coeffient of r was 0.806 for mammography and 0.783 for ultrasonography. Conclusion: Mammography was more accurate than ultrasonography in measuring the largest cancer diameter in DCIS of breast cancer. The correlation coefficient improved in the group of almost entirely fatty/ scattered areas of fibroglandular dense breast or in microcalcification negative group.

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Mesenteric Cysts: A Retrospective Review. Its Not All That Simple

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.257 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S117-S118

Author(s):

M Bourgeau ◽

V Avadhani

Keyword(s):

Cyst Wall ◽

Imaging Techniques ◽

Case Reports ◽

Lymphatic Vessels ◽

Mucinous Cystadenoma ◽

Final Diagnosis ◽

Cystic Mass ◽

Pathological Examination ◽

Urachal Cyst ◽

Mesenteric Cysts

Abstract Introduction/Objective Mesenteric cysts are rare intra-abdominal lesions in adults. However, with the advanced imaging techniques and laparoscopic techniques, they are more often being identified and resected when clinically significant. There is a lack of detailed information in histopathology (except as case reports) since mesentery is generally neglected in our organ-based textbooks. The aim of our study is to highlight the importance of identifying and classifying mesenteric cystic lesions; they are not all that simple. Methods We performed a retrospective search on all mesenteric cysts submitted as excisions in our electronic database from 2013-2019. We classified them as per the de Perrot (PMID: 11053936) classification with modification. Results Our search showed: A. Lymphatic origin-11 (lymphangioma-10, Lymphangioma hamartomatous-1, associated with LAM-0), B. Mesothelial origin-68 (Benign mesothelial cysts-57, multilocular mesothelial cyst-11), C. Enteric origin- 3, D. Urogenital origin (Urachal cyst, mullerian inclusion cyst)-9, E. Mature cystic teratom-2, F. Pseudocyst-12, G. Epithelial cyst (not urogenital)- 11 (a/w LAMN-3, MCN-4, Mucinous cystadenoma-4), H. Associated with carcinoma-2. Case illustration: A 61-year-old male presented with worsening dysphagia, emesis and hiccups. A CT scan showed a 21.2 cm cystic mass with at least one septation (Fig 1). The cyst was resected. On gross pathological examination, the cyst measured 18 cm in greatest dimension with a thick, rough, tan-brown capsule. Microscopic examination showed a fibrous capsule, and cyst wall composed of numerous lymphatic vessels (CD31 positive) and prominent smooth muscle proliferation (Desmin positive). Scattered lymphoid aggregates were also present throughout the cyst wall. No definite epithelial lining was identified and was suspected to have been denuded. HMB-45 immunostain was negative, ruling out association with LAM. The final diagnosis of a Lymphangiomyoma, hamartomatous was rendered. Conclusion Though most of the mesenteric cysts are benign, some of them are significantly important such as Lymphangiomyoma (esp secondary to LAM), MCN, those associated with LAMN etc. and identifying and differentiating from their mimics has distinct clinical implications.

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Clinical relevance of a degree of extracapsular extension in a sentinel lymph node in breast cancer patients: a single-centre study

Scientific Reports ◽

10.1038/s41598-021-88351-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tomasz Nowikiewicz ◽

Andrzej Kurylcio ◽

Iwona Głowacka-Mrotek ◽

Maria Szymankiewicz ◽

Magdalena Nowikiewicz ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Term Treatment ◽

Extracapsular Extension ◽

Group Iii ◽

Metastatic Lesions ◽

Cancer Metastases ◽

Group I ◽

Long Term Treatment

AbstractIn some breast cancer (BC) patients, an examination of lymph nodes dissected during sentinel lymph node biopsy (SLNB) demonstrates a presence of metastatic lesions and extracapsular extension (ECE) in a SLN. This study aimed to evaluate clinical relevance of ECE in BC patients. This is a retrospective analysis of 891 patients with cancer metastases to SLN, referred to supplementary axillary lymph node dissection (ALND), hospitalized between Jan 2007 and Dec 2017. Clinical and epidemiological data was evaluated. Long-term treatment outcomes were analysed. In 433 (48.6%) patients, cancer metastases were limited to the SLN (group I), in 61 (6.8%) patients the SLN capsule was exceeded focally (≤ 1 mm—group II). In 397 (44.6%) patients, a more extensive ECE was found (> 1 mm—group III). Metastases to non-sentinel lymph nodes (nSLNs) were diagnosed in 27.0% patients from group I, 44.3% patients from group II and in 49.6% patients from group III. No statistically significant differences were observed in long-term treatment outcomes for compared groups. The presence of ECE is accompanied by a higher stage of metastatic lesions in the lymphatic system. The differences in this respect were statistically significant, when compared to the group of ECE(−) patients. ECE, regardless of its extent, did not impact the long-term treatment results. ECE remains an indication for supplementary ALND and for other equivalent cancer treatment procedures, regardless of ECE size.

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Assessment and Prediction of Response to Neoadjuvant Chemotherapy in Breast Cancer: A Comparison of Imaging Modalities and Future Perspectives

Cancers ◽

10.3390/cancers13143521 ◽

2021 ◽

Vol 13 (14) ◽

pp. 3521

Author(s):

Valeria Romeo ◽

Giuseppe Accardo ◽

Teresa Perillo ◽

Luca Basso ◽

Nunzia Garbino ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Tumor Response ◽

Imaging Techniques ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Complete Response ◽

Mri Imaging ◽

Future Perspectives ◽

Advanced Imaging

Neoadjuvant chemotherapy (NAC) is becoming the standard of care for locally advanced breast cancer, aiming to reduce tumor size before surgery. Unfortunately, less than 30% of patients generally achieve a pathological complete response and approximately 5% of patients show disease progression while receiving NAC. Accurate assessment of the response to NAC is crucial for subsequent surgical planning. Furthermore, early prediction of tumor response could avoid patients being overtreated with useless chemotherapy sections, which are not free from side effects and psychological implications. In this review, we first analyze and compare the accuracy of conventional and advanced imaging techniques as well as discuss the application of artificial intelligence tools in the assessment of tumor response after NAC. Thereafter, the role of advanced imaging techniques, such as MRI, nuclear medicine, and new hybrid PET/MRI imaging in the prediction of the response to NAC is described in the second part of the review. Finally, future perspectives in NAC response prediction, represented by AI applications, are discussed.

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Imaging techniques in breast cancer. What is new? What is useful? — a review

European Journal of Cancer and Clinical Oncology ◽

10.1016/0277-5379(88)90177-0 ◽

1988 ◽

Vol 24 (1) ◽

pp. 61-68 ◽

Cited By ~ 1

Author(s):

Michael N. Maisey

Keyword(s):

Breast Cancer ◽

Imaging Techniques

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Foreword: Imaging Techniques Alternative to Mammography for Early Detection of Breast Cancer

Technology in Cancer Research & Treatment ◽

10.1177/153303460500400101 ◽

2005 ◽

Vol 4 (1) ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Radhika Sivaramakrishna

Keyword(s):

Breast Cancer ◽

Early Detection ◽

Imaging Techniques

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Definitive Diagnosis and Location of Peanuts in the Airways Using Magnetic Resonance Imaging Techniques

Annals of Emergency Medicine ◽

10.1016/s0196-0644(94)70366-3 ◽

1994 ◽

Vol 23 (6) ◽

pp. 1379-1382 ◽

Cited By ~ 15

Author(s):

Hitoshi Imaizumi ◽

Masamitsu Kaneko ◽

Satoshi Nara ◽

Hiroko Saito ◽

Koji Asakura ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Imaging Techniques ◽

Definitive Diagnosis ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Techniques

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Diabetes, Obesity, and Inflammation: Impact on Clinical and Radiographic Features of Breast Cancer

International Journal of Molecular Sciences ◽

10.3390/ijms22052757 ◽

2021 ◽

Vol 22 (5) ◽

pp. 2757

Author(s):

Braden Miller ◽

Hunter Chalfant ◽

Alexandra Thomas ◽

Elizabeth Wellberg ◽

Christina Henson ◽

...

Keyword(s):

Breast Cancer ◽

Imaging Techniques ◽

Growth Factor Receptor ◽

Breast Cancer Diagnosis ◽

Screening Mammography ◽

Imaging Modalities ◽

Conventional Imaging ◽

Obese Women ◽

Detection Rates ◽

Therapeutic Decision Making

Obesity, diabetes, and inflammation increase the risk of breast cancer, the most common malignancy in women. One of the mainstays of breast cancer treatment and improving outcomes is early detection through imaging-based screening. There may be a role for individualized imaging strategies for patients with certain co-morbidities. Herein, we review the literature regarding the accuracy of conventional imaging modalities in obese and diabetic women, the potential role of anti-inflammatory agents to improve detection, and the novel molecular imaging techniques that may have a role for breast cancer screening in these patients. We demonstrate that with conventional imaging modalities, increased sensitivity often comes with a loss of specificity, resulting in unnecessary biopsies and overtreatment. Obese women have body size limitations that impair image quality, and diabetes increases the risk for dense breast tis-sue. Increased density is known to obscure the diagnosis of cancer on routine screening mammography. Novel molecu-lar imaging agents with targets such as estrogen receptor, human epidermal growth factor receptor 2 (HER2), pyrimi-dine analogues, and ligand-targeted receptor probes, among others, have potential to reduce false positive results. They can also improve detection rates with increased resolution and inform therapeutic decision making. These emerg-ing imaging techniques promise to improve breast cancer diagnosis in obese patients with diabetes who have dense breasts, but more work is needed to validate their clinical application.

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