The role of skin ulceration in breast carcinoma staging and outcome

Khoury, Thaer; Gaudioso, Carmelo; Fang, Yisheng; Sanati, Souzan; Opyrchal, Mateusz; Desouki, Mohamed Mokhtar; Karabakhtsian, Rouzan G.; Wang, Dan; Yan, Li; Jacobson, Rebecca

doi:10.1111/tbj.12830

Cited by 7 publications

(7 citation statements)

References 16 publications

(41 reference statements)

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“…Consistent with our results, skin ulceration over a malignant CMT has been proposed as a prognostic value of CMT-SS 27 , 93 . In HBC studies, skin involvement (referred to as ulceration, oedema, peau d'orange, and satellite skin nodules) is included in the TNM classification despite some discrepancies regarding its prognostic value 94 . In light of our findings, we believe that this feature should be considered for CMT evaluation and in the future revision of TNM staging system.…”

Section: Discussionmentioning

confidence: 99%

Risk factor analysis and clinicopathological characteristics of female dogs with mammary tumours from a single-center retrospective study in Poland

Dolka,

Czopowicz,

Stopka

et al. 2024

Sci Rep

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This is a comprehensive retrospective study to characterize female dogs with canine mammary tumors (CMTs) using a dataset retrieved from the archives of the Division of Animal Pathology, Institute of Veterinary Medicine in Warsaw, and to identify prognostic factors. Clinical and histopathological data of 1447 dogs with CMTs were included. Malignant tumours were found in 83.3% (n = 1206), benign tumours in 11.7% (n = 169), and non-neoplastic lesions in 5.0% (n = 72) of dogs. Dogs most often had grade II carcinomas (38.2%, 215/562) of a single histological subtype (88.5%, 1281/1447), mostly simple carcinoma (35.3%, 510/1447). Dogs with a median age of 10 years significantly often had larger (≥ 3 cm) and malignant CMTs, whereas intact females had smaller tumours (median size 2.0 cm). However, the threshold value for the age of the dog in the differentiation of malignant and non-neoplastic/benign masses could not be determined. Most females were hormonally active (76.4%, 372/487). Hormonally active dogs significantly more often had multiple tumours. Multiple tumours were significantly smaller (median 2.5 cm) than single ones. Among pedigree dogs, small-breed dogs were mostly recorded (43%, 428/1006). Twelve breeds had an increased risk of CMTs, regardless of tumour behaviour, compared with the theoretical distribution of pedigree dogs in Poland. Four breeds were often affected only by malignant and other four breeds only by non-neoplastic/benign CMT. Large-breed dogs were significantly younger and affected by larger CMT (median 4 cm) compared with small- and medium-breed dogs. Ninety dogs with a malignant CMT and complete records were included in the full analysis of CMT-specific survival (CMT-SS) with a median follow-up time of 20.0 months. We showed that the timing of ovariohysterectomy in relation to mastectomy was significantly associated with grade, CMT-SS, and CMT-related death. We indicated the low diagnostic accuracy of palpation of regional lymph nodes (RLN) in the prediction of their metastatic involvement. By multivariable analysis, dogs with neoplastic emboli, tumour ulceration, and simple or complex carcinoma had a significantly higher risk of local recurrence. Tumour size > 3 cm was as a strong independent predictor of lung metastases. Compared with dogs with an easily separated localized tumour, dogs with a multiple/diffuse malignant CMT pattern had a fivefold higher risk of death. The risk of death was significantly higher in the presence of neoplastic emboli (~ fivefold) and tumour ulceration (~ fourfold). Furthermore, the presence of neoplastic emboli and large tumour size were independent predictors of CMT-related death.

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Section: Discussionmentioning

confidence: 99%

Risk factor analysis and clinicopathological characteristics of female dogs with mammary tumours from a single-center retrospective study in Poland

Dolka,

Czopowicz,

Stopka

et al. 2024

Sci Rep

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“…Each institution performed a system search for intra‐MLN using specific keywords including “breast,” “cancer,” “carcinoma,” “lymph node,” “intramammary” and “intra‐mammary” at various time frames. The text information extraction system (TIES), which is natural language processing system, was used to retrieve cases from four institutions that are members of the TIES Cancer Research Network including Roswell Park Comprehensive Cancer Center, Buffalo, NY; Magee Women's Hospital of the University Of Pittsburg Medical Center, Pittsburgh, PA; University of Pennsylvania, Philadelphia, PA; and Augusta University, Augusta, GA . Portable document format files of pathology reports from the Women Circle of Health Study were manually reviewed to retrieve candidate cases using key words (intramammary and intra‐mammary).…”

Section: Methodsmentioning

confidence: 99%

The clinical significance of metastatic breast carcinoma to intramammary lymph node

Khoury

Fang²,

Karabakhtsian

et al. 2019

Breast J

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The incidence of involved intramammary lymph node (intra‐MLN) with breast carcinoma (BC) is rare. Its clinical significance and impact on the clinical decision making is unclear. A total of 113 BC cases with at least one positive intra‐MLN were collected from 11 academic institutions. The inclusion criteria were subsequent axillary lymph node dissection, and the availability of information on T‐stage, size of node metastasis, extranodal extension status, biomarkers status, and clinical follow‐up. Stage 4 cases and/or neo‐adjuvant treated patients were excluded. AJCC TN‐stage was calculated twice, with and without intra‐MLN. Five‐year overall survival (OS) and relapse (local and/or distant)‐free survival (RFS) were calculated and correlated with the clinicopathologic variables. Excluding intra‐MLN, TN‐stage correlated with OS (P = .016) but not with RFS (P = .19). However, when intra‐MLN was included, TN‐stage correlated with both OS (P < .001) and RFS (P = .016). In the multivariate analysis, when intra‐MLN was excluded, only radiation therapy (RT) correlated with RFS (HR = 0.19, 95% CI: 0.054‐0.66, P = .009). However, when intra‐MLN was included in the TN‐stage both RT (HR = 0.13, 95% CI: 0.04‐0.45, P = .001) and TN‐stage 3 (HR = 8.92, 95% CI: 1.47‐54, P = .017) correlated with RFS. Tumor multifocality was the only variable correlated with OS when the intra‐MLN involvement was excluded. When intra‐MLN was included, multifocality became insignificant but TN‐stage 3 correlated with OS (HR = 8.59, 95% CI: 1.06‐69.71, P = .044). Positive intra‐MLN is an independent factor in predicting both RFS and OS.

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“…The presence of ulceration adds another layer of complexity to the patient’s condition. This typically refers to an open sore or break in the skin, a phenomenon that is relatively rare in breast cancer but can occur, particularly in advanced cases 2 .…”

Section: Introductionmentioning

confidence: 99%

The management of locally advanced, ulcerated breast cancer in a menopausal woman: a case report

Izzo,

Polistena

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: This case report presents the clinical details of a 46-year-old postmenopausal woman who was diagnosed with a locally advanced, ulcerated, hormone receptor-positive, HER2-negative Stage 2B lobular carcinoma of the breast. The complexity of the case necessitated a multi-disciplinary, personalized approach. Case presentation: The patient, a postmenopausal woman, presented with a locally advanced lobular carcinoma of the breast. The tumor was of a significant size and exhibited ulceration. Given the hormone receptor-positive status of the tumor, a comprehensive treatment plan was formulated, taking into account the patient’s overall health and potential tolerance to treatment. Surgical removal of the tumor was performed, followed by adjuvant therapy with aromatase inhibitors. Clinical discussion: The complexity of this case highlights the importance of a personalized and patient-centered strategy in managing breast cancer. The patient’s menopausal status, tumor characteristics, and potential tolerance to treatment were crucial factors that influenced the treatment plan. The successful outcome of the treatment and the patient’s ability to tolerate the therapy underscore the significance of individualized treatment planning. Conclusion: This case report emphasizes the necessity for a comprehensive and patient-centered approach in managing complex cases of breast cancer. The findings support the development of personalized therapeutic strategies aimed at improving patient outcomes and quality of life. The successful treatment of the locally advanced, ulcerated lobular carcinoma of the breast in this postmenopausal patient further highlights the importance of considering individual factors and tailoring treatment plans accordingly.

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The role of skin ulceration in breast carcinoma staging and outcome

Cited by 7 publications

References 16 publications

Risk factor analysis and clinicopathological characteristics of female dogs with mammary tumours from a single-center retrospective study in Poland

Risk factor analysis and clinicopathological characteristics of female dogs with mammary tumours from a single-center retrospective study in Poland

The clinical significance of metastatic breast carcinoma to intramammary lymph node

The management of locally advanced, ulcerated breast cancer in a menopausal woman: a case report

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