Possible cancerous change of intraductal papillomas of the breast. A 3-D reconstruction study of 25 cases

Ohuchi, Noriaki; Abe, Rikiya; Kasai, Morio

doi:10.1002/1097-0142(1984)54:4<605::aid-cncr2820540402>3.0.co;2-6

Cited by 115 publications

(50 citation statements)

References 6 publications

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“…The frequent localization within small ducts and/or lobules and the morphologic similarities between microfocal DCIS and LCIS fit well with the hypothesis of Welling & Jensen (1973) that both lesions arise in the lobular-terminal unit. The registered association of malignancy with papillomas confirms the results of other studies (Haagensen et al, 1981;Ohuchi et al, 1984), but the number of cases were too small to evaluate the effect of these lesions independent of age ( Table III). The same was true for the association with adenosis and duct ectasia (Table III).…”

Section: Resultsmentioning

confidence: 99%

Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies

Nielsen

Thomsen²,

Primdahl³

et al. 1987

Br J Cancer

377

162

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(Andersen, 1981;Moskowitz, 1981; Tabiar et al., 1985), and from clinically based series of self-selected women (Betsill et al., 1978;Fisher et al., 1986;Moskowitz, 1983;Page et al., 1978;Page et al., 1982). However, as in situ breast carcinoma (in situ BC) is rarely symptomatic and the sensitivity of mammography in detecting malignancy is limited despite improved techniques (Holland et al., 1983), much uncertainty exists concerning these lesions.Histopathologic examination of the breast is a reliable method for detection of clinically and radiologically occult malignant and atypical lesions but extensive sampling is mandatory to detect these small lesions. The few autopsy studies using this technique have been carried out mainly on elderly women (Alpers & Wellings, 1985;Kramer & Rush, 1973;Nielsen et al., 1984).To obtain an estimate of the frequency and characteristics of clinically occult malignant and atypical lesions in younger Danish women, a series of medicolegal cases seemed to be a suitable sample. The results of an extensive histopathologic breast tissue examination and correlative specimen radiography in such a group of women are presented in this paper. Materials and methodsThe study group consisted of a series of 110 consecutive medicolegal autopsies on (Danmarks Statistik, 1985). During the sampling period about 10% of all deaths within the area underwent medicolegal examination and of these about 25% were subjected to autopsy.During the medicolegal autopsy, bilateral total mastectomy with partial axillary dissection (Cady, 1973) was performed in all cases, except for one woman who had undergone previous mastectomy for IBC and consequently only had a contralateral mastectomy.Each fresh breast specimen was weighed and radiographed intact in a single frontal projection in a Faxitron (model 43805N) using Kodak industrial M film. With the nipple as the center point, the specimen was then divided into the four quadrants and cut systematically from the deep fascia to the outer surface in 5 mm-thick slices. Each of these were radiographed and thereafter fixed in formalin. The slices were examined grossly after fixation and the relative proportion of glandular and fatty breast tissue was evaluated in 10% estimates. All tissue including fatty tissue was processed routinely for paraffin embedding. Axillary lymph nodes were also radiographed and processed for microscopic examination.The total number of paraffin blocks was 60,335 with each block containing -1.3 g of breast tissue. The average number of paraffin blocks from each breast specimen was 275 (range 57-683). The average number of lymph nodes from each woman was 21 (range 0-50). Sections for microscopic examination were cut from each paraffin block and stained with hematoxylin and eosin. In cases with suspicion of or with manifest in situ BC and atypical ductal hyperplasia (ADH), additional serial sections were prepared. The PAS-alcian stain was used to support the differentiation between LCIS and DCIS, based on the presence of intracytoplasmic lumi...

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Section: Resultsmentioning

confidence: 99%

Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies

Nielsen

Thomsen²,

Primdahl³

et al. 1987

Br J Cancer

377

162

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“…In this context it should be addressed that two of the three most common falsely positive histopathologies have been papillomas as well as radial scars. These histologies are associated with an increased degeneration rate [28,29,30] and are therefore recommended for surgical extraction. This aspect should be taken into account when discussing specificity.…”

Section: Discussionmentioning

confidence: 99%

Is the ?blooming sign? a promising additional tool to determine malignancy in MR mammography?

et al. 2004

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The aim of this study was to evaluate potential diagnostic relevance of blooming effect for verification of suspicious breast lesions in MR mammography (MRM). The MRM examinations of 1035 patients, all following the same imaging protocol (from 1994 to 2001) were retrospectively evaluated by two experienced radiologists in consensus. A total of 817 lesions showed a focal enhancement; of these, 793 were histologically verified after surgical intervention so that 514 malignant and 279 benign lesions could be evaluated. Using a 1.5-T Gyroscan ACS II-imager (Philips, Hamburg, Germany) and a double breast coil with the patient lying in a prone position, 0.1 mmol/kgbw Magnevist (Schering, Berlin, Germany) were injected into the cubital vein to obtain dynamic axial and coronal T1-weighted fast-field-echo images every minute up to 7 min after bolus injection. Blooming sign describes a progradient unsharpness of lesion borders initially sharply shaped and fast enhancing 7 min after bolus injection; 324 of 514 (63.0%) malignant lesions and 41 of 279 (14.7%) benign lesions revealed a blooming sign (sensitivity 63.0%, specificity 85.3%, accuracy 70.9%, positive predictive value 88.8%, negative predictive value 56.0%). Forty-one of 279 benign lesions showed a blooming sign; of these, there were 4 of 86 (4.7%) fibroadenomas, 2 of 21 (9.5%) phylloides tumours, 11 of 38 (28.9%) papillomas, 3 of 9 (33.3%) radial scars, 2 of 19 (10.5%) mastitis, 1 of 4 (25%) galactophoritis, 1 of 3 (33.3%) ADH and 19 of 99 (17.2%) mastopathic proliferations, respectively. Blooming sign is a phenomenon which should be taken into account when diagnosing MR mammographies because it might increase the ability to discriminate uncertain breast lesions; however, this effect can only be used as an additional item to other well-known effects such as plateau, washout and cancer corner.

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“…8,9 These lesions are designated as papilloma with ADH and papilloma with DCIS, respectively. 2 The atypical features include the presence of evenly spaced, small, regular cells with round, monotonous nuclei characteristic of those in ADH and low-grade DCIS, and complex architecture patterns (ie, solid, cribriform, or micropapillary) ( Figure 5, A through C).…”

Section: Papilloma With Adh and Papilloma With Dcismentioning

confidence: 99%

Papillary Lesions of the Breast: An Update

Wei

2016

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Papillary lesions of the breast, characterized by the presence of arborescent fibrovascular cores that support epithelial proliferation, constitute a heterogeneous group of neoplasms with overlapping clinical manifestation and histomorphologic features, but may have divergent biological behavior. These lesions are exclusively intraductal neoplasms, although an invasive carcinoma may rarely have a predominantly papillary architecture. Although recognition of a papillary architecture is typically not challenging, the histologic distinction of these entities is not always straightforward. Historically, different terminologies and variable criteria have been proposed for a given entity by various authorities. The difficulty in classifying these lesions has been further confounded by the scarcity of data and the heterogeneity across different studies with regard to the molecular genetic characteristics of this group of lesions. Objective.—To provide an overview focusing on the current concepts in the diagnosis and classification of papillary lesions of the breast incorporating recent molecular genetic advances. Data Sources.—Data were obtained from pertinent peer-reviewed English-language literature. Conclusions.—The recent evolution of molecular techniques has enhanced our knowledge of the pathogenesis of papillary carcinomas of the breast. This, along with emerging outcome studies, has led to prognosis-based reclassification of some of these entities. Additional studies focusing on the molecular signatures are needed to identify potential decision tools to further stratify these lesions with respect to prognostic significance.

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Possible cancerous change of intraductal papillomas of the breast. A 3-D reconstruction study of 25 cases

Cited by 115 publications

References 6 publications

Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies

Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies

Is the ?blooming sign? a promising additional tool to determine malignancy in MR mammography?

Papillary Lesions of the Breast: An Update

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