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A morphologic and morphometric study of cells from colloid carcinoma of the breast obtained by fine needle aspiration. Distinction from other breast lesions.

Morphologic and morphometric studies were carried out on eight cases of pure and mixed colloid carcinoma of the breast initially diagnosed by fine needle aspiration (FNA). Key morphologic features included (1) cellular smears, (2) single cells, loose aggregates and cohesive groups of cells bathed in a mucinous background, (3) single cells displaying nuclear eccentricity and (4) little variation in nuclear size or shape, with bland-to-accentuated chromatin and rare nucleoli. These morphologic features are compared with those observed in pregnancy adenoma, lobular carcinoma, fibroadenoma, ductal carcinoma and medullary carcinoma. A morphometric study employing the major and minor axes of the nucleus, its axis product and axis ratio was also performed. Statistical treatment confirmed that the nuclear axis product (a size factor) distinguished colloid carcinoma from the other breast lesions, except the small-cell type of ductal carcinoma. Furthermore, the nuclear axis ratio (a shape factor) discriminates pregnancy adenoma and small-cell ductal carcinoma from the other breast lesions studied. By combining morphologic and morphometric criteria, one can specifically separate colloid carcinoma from the other breast lesions when examining smears obtained by FNA. Since colloid carcinoma is usually composed of cells with a relatively benign-appearing cytomorphology, the importance of recognizing this entity in fine needle aspirates is emphasized.

Adenocarcinoma, Mucinous↗

Benign lesions of the breast other than fibrocystic change.

Benign diseases of the breast other than those labeled as "fibrocystic" in nature can be divided into congenital, developmental, inflammatory, neoplastic, and miscellaneous categories. Several of the most common breast lesions in these categories are discussed in this article.

Acute Disease↗

Normal serum proteins in female breast carcinomas and fibroadenomas. An immunohistochemical study.

Several serum proteins were immunohistochemically studied in benign and malignant breast lesions in 13 patients. The majority of infiltrating duct and lobular carcinomas showed albumin and IgG abundant immune reactive cells. Fewer cells contained immune reactive alpha-1-antitrypsin and transferrin. Staining was diffuse and limited to the cell cytoplasm. Immune reactive cells alternated with non reactive ones in a characteristic heterogeneous pattern. The parenchymal cells in carcinomas were non reactive to ceruloplasmin, fibrinogen and alphafetoprotein. Myoepithelial and epithelial cells in fibroadenomas were also positive for albumin and IgG, but less frequently for alpha-1-antitrypsin and transferrin. Normal breast tissue surrounding fibroadenomas as well as a lactational adenoma showed no immune reactive cells. Mechanisms that may be involved with the presence of plasma proteins in the cytoplasm of parenchymal cells in breast lesions are discussed.

Adenofibroma↗

Contextual analysis complements single-cell analysis in the diagnosis of breast cancer in fine needle aspirates.

Image analysis techniques were used to characterize individual nuclei of cells and entire clusters of cells in hematoxylin-and-eosin-stained smears of fine needle aspirates of the breast to determine the ability of these techniques to distinguish benign from malignant cases. Analysis of the individual nuclear features showed significant differences in nuclear area, shape (bending energy), texture and integrated darkness between benign and malignant samples. Analysis of the clusters demonstrated that the benign clusters were fewer in number, more cellular (average gray level) and larger than malignant clusters. A statistical classifier was constructed to test the discriminatory accuracy for benign and malignant cases. Good discrimination was found for both the individual nuclei and the clusters when analyzed separately, although a few cases were misclassified by each type of analysis. When combined, the two classifiers achieved a completely accurate classification. This suggests the complementary nature of high-resolution single-cell analysis and the more global cluster analysis techniques.

Adenofibroma↗

[The immunohistochemical localization of CA 15-3 in human breasts and their tumors].

The tissue distribution of CA 15-3, a breast carcinoma associated antigenic determinant, has been investigated by an avidin-biotin immunoperoxidase technique in the human breasts and in their tumors. In cases of scirrhous carcinoma, positive stainings for CA 15-3 were observed in almost all carcinoma cells. In cases of solid-tubular carcinomas and papillotubular carcinomas, the reaction was various and there was no correlation between the distribution of CA 15-3 and the clinical stage. Apical staining was recognized in both solid-tubular and papillotubular carcinomas, in benign breast tumors, and in normal breast tissues. CA 15-3 appears to be related to the degree of differentiation of the breast tissue.

Adenocarcinoma↗

[In vivo measurements of electrical bio-impedance of breast tumors].

The electrical bio-impedance of 17 breast tumors including 12 breast cancers and 5 fibroadenomas, were measured in vivo with three-electrode method in the frequency range of 0 to 200 KHZ. The three-electrode consists of a coaxial needle electrode inserted into the tumor and a large reference electrode on upper abdominal wall. The tissue can be regarded electrically as a equivalent consisted of extracellular resistance (R1), intracellular resistance (R2), and electric capacitance of the cell membrane (C). These three parameters were calculated from the measured values of electrical bioimpedance. It was found that R1, and R2 of breast cancers were significantly higher than those of fibroadenomas (p less than 0.001), and that C of breast cancers was significantly lower than that of fibroadenomas (p less than 0.001). The measurement of the electrical impedance of breast tumor in vivo may be useful for the differential diagnosis of breast lesions.

Adenocarcinoma, Scirrhous↗

Magnetic resonance imaging of the human female breast. Current status and pathologic correlations.

Over the past decade, research in MR of the female breast has focused on in vitro studies of excised breast tissue samples or mastectomy specimens and on in vivo clinical imaging of patients, usually with biopsy correlation. The results of in vitro measurement of T1 and T2 times of excised benign and malignant breast tissue do not conclusively demonstrate a clear separation based on these values alone. In particular, benign tumors (fibroadenomas) cannot be distinguished from carcinomas and there is considerable overlap in values for cancer and fibrocystic disease. MR images produced from mastectomy specimens allow detailed correlation with mammographic and histologic findings but are incompletely applicable to in vivo images because of numerous factors including tissue changes associated with disruption of blood supply. In vivo studies have shown that benign tumors (fibroadenomas), fibrocystic changes, and cancers can be imaged successfully by MR. To date the best images show a resolution of about 2 mm. Small cancers and cysts have been imaged successfully but proliferative patterns of fibrocystic disease cannot be differentiated at this time. Carcinomas occurring in dense fibroglandular breasts which are a problem to image mammographically have not been successfully imaged by MR in vivo and in only one instance in vitro in a mastectomy specimen. Since MR cannot image microcalcifications, it does not appear likely to replace mammography as the imaging modality of choice at the present time. Newer magnets of increased strength, specialized surface coils specifically for breast imaging, and the use of contrast enhancing agents all may increase the usefulness of MR as an imaging modality for the detection of breast disease. In particular, increased resolution and contrast enhancing agents which may aid in tissue differentiation should be studied for their ability to detect carcinomas in dense fibroglandular breast tissue and to identify lesions of carcinoma in situ and proliferative patterns of fibrocystic disease. The need for careful collaborative studies between radiologists and pathologists will be essential for the success of these research efforts.

Adenofibroma↗

[Magnetic resonance of the breast. Clinical experience with a dedicated coil].

MR Imaging was performed on 10 healthy volunteers and 86 patients, using a 0.5 T superconducting magnet and a dedicated coil to image both breasts simultaneously. The patients were selected by the presence of nodules at clinical examination. Final diagnoses were made either at histology--in the patients who underwent surgery--or at cytology, with fine needle biopsy. The MR findings of the different breast diseases are discussed. In spite of an improved spatial resolution and of a very good natural contrast between different tissues, MR Imaging does not allow a satisfactory characterization of the lesions; its use is thus limited to the staging of cancers which need a better therapeutic planning.

Adenofibroma↗

Pathologic considerations in the high-risk breast patient.

An understanding of the spectrum of benign breast changes is necessary to optimize diagnosis and treatment. To evaluate the relative risk for developing cancer with benign breast lesions, each of the entities included in the category of benign breast conditions is discussed individually.

Adenofibroma↗