수질성유방암의 임상병리학적 특성과 예후

오재원,박세호,김주희,구자승,허호,양우익,박병우,이경식 한국유방암학회 2009 Journal of breast cancer Vol.12 No.1

Purpose: Medullary carcinoma of the breast is a variant of breast cancer characterized by the histologic appearance of poorly differentiated cells surrounded by a prominent lymphoid stroma. Medullary carcinoma has been reported to carry a prognosis better than other invasive breast carcinomas, but it is frequently overdiagnosed due to the difficulty in diagnosis. The aim of this study was to assess the clinical manifestations and outcome of medullary carcinoma of the breast. Methods: We reviewed the data of 91 patients diagnosed with medullary carcinoma and 3,743 patients with invasive ductal carcinoma, not otherwise specified (NOS) from January 1980 to December 2005 at Yonsei University Severance Hospital. The clinicopathologic features, disease free survival (DFS) and overall survival (OS) for patients with medullary carcinoma were compared with those of the NOS patients. Results: With reviewing the pathologic slides, 69 (75.8%) patients had findings compatible with typical medullary carcinoma (TMC) and the remaining 22 (24.2%) patients were reclassified as atypical medullary carcinoma (AMC). Early stage cancer was more frequent at medullary carcinoma and lymph node positive cancer was less frequent at medullary carcinoma. The expression of ER/PR was positive in either the TMC (18.9%/16.2%) and AMC (15.0%/20.0%) as compared to the NOS (63.2%/57.2%), and the difference was significant (p<0.001). In contrast, the HER-2/neu expression rate was significantly higher in the TMC (47.4%) and AMC (45.5%) than in the NOS (28.3%, p=0.001). The 10-year disease free survival and 10-year overall survival of the atypical medullary carcinoma patients (67.8%, 77.8%) were in fact similar to the NOS carcinoma patients (68.3%, 74.7%). There was significant difference in 10-year disease free survival and 10-year overall survival between the TMC (77.8%, 86.0%) and NOS carcinoma (68.3%, 74.7%) patients (p=0.002, p=0.006). Conclusion: The clinical outcome of typical medullary carcinoma is favorable in spite of its aggressive pathologic features and it differs from atypical medullary carcinoma. For precise prediction of prognosis of medullary cancer, we should apply strict criteria for the diagnosis of subtype with medullary features.

[P351] Invasive ductal carcinoma with direct skin invasion on breast of male patient

( Chang Min Kim ),( Sook In Ryu ),( Bo Young Kim ),( Jung Jin Shin ),( Hye-rim Moon ),( Il-hwan Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.1

Male breast cancer accounts for less than 1% of all breast cancers. Most common type of male breast cancer is the invasive ductal carcinoma(IDC), which cancer cells of ductal origin break through the wall of the milk duct and invade the tissues of the breast. A 59-year-old male patient presented with a painful protruding erosive nodule with oozing on right nipple, which was found 15 years prior to the visit. Under the impression of malignant melanoma, partial excisional biopsy was done. Pathologist reported that the tissue was confirmed as invasive carcinoma, probably ductal type. The patient was transferred to department of breast surgery, and radical mastectomy of right breast with sentinel lymph node biopsy was done. There was no lymph node metastasis and carcinoma was removed with clear resection margin. The post-operational chemotherapy with docetaxel, cyclophosphamide and tamoxifen has been done to patient and no sign of recurrence showed till now. In this case there was retro-areolar mass on breast of male patient and direct skin invasion of mass was seen. We easily underestimate the possibility of male breast cancer because of its rare incidence and delayed diagnosis of it would increase the chance of metastasis. We should not exclude the possibility of male breast cancer when there`s an abnormal eczematous lesion in nipple. Herein we report a rare case of IDC with direct skin invasion on male breast.

Mast Cell and Macrophage Counts and Microvessel Density in Invasive Breast Carcinoma-Comparison Analysis with Clinicopathological Parameters

Gui Young Kwon,Sang Dae Lee,박언섭 대한암학회 2005 Cancer Research and Treatment Vol.37 No.2

Purpose: The purpose of this study was to evaluate the clinicopathological significance of the microvessel density and macrophage and mast cell counts in invasive breast carcinomas.Materials and Methods: 45 invasive breast carcinomas were immunohistochemically stained with the endothelial antigen, CD34, and macrophage marker, CD68. 0.1% toluidine blue was used to highlight mast cells. The microvessel and mast cell counts were performed at ×200 magnification and the macrophages at ×400 magnification.Results: With the 45 invasive breast carcinomas, there were no statistically significant associations between the mast cell, macrophage and microvessel counts and the tumor size and lymph node status. ER and PR negative mast cells infiltrated more than in cases of positive stati,with statistical significance (p-value=0.010 and 0.005,respectively). The macrophage counts were negatively correlated with the PR status (p-value=0.030). With respect to the c-erbB-2 status, there was no significance correlation with the mast cell, macrophage and microves-selcounts. The mast cell counts showed significantly positive correlation with the microvessel counts in the invasive breast carcinomas (p-value=0.015). In a comparisonof the macrophage counts with the microvessel counts, a positive tendency for both parameters, but without statistical significance (p-value=0.310).Conclusion: Increasing numbers of mast cells and macrophages were recruited in invasive breast carcinomas, which contribute to angiogenesis. The microvesseldensity in invasive breast carcinomas had no statistically significant association with the tumor size, lymph node status, and histological grade, presence of DCIS component, estrogen/progesterone receptor status and cerbB-2 status. The evaluation of angiogenesis using these methods is not thought to provide an independent clinicopathological factor in invasive breast carcinomas.

The Glycolytic Phenotype is Correlated with Aggressiveness and Poor Prognosis in Invasive Ductal Carcinomas

장세민,Hulin Han,장기석,전영진,장시형,민경환,정민성,백승삼 한국유방암학회 2012 Journal of breast cancer Vol.15 No.2

Purpose: Glucose uptake and glycolytic metabolism are enhanced in cancer cells, and increased expression of glucose transporter 1 (GLUT1) has also been reported. The aim of this study was to investigate GLUT1 expression in human breast tissues and invasive ductal carcinomas. Methods: We used tissue microarrays consisting of normal breast tissue, ductal hyperplasia, ductal carcinoma in situ, invasive ductal carcinoma, and lymph node metastases. We examined GLUT1 expression in the microarrays by immunohistochemistry, reviewed the medical records and performed a clinicopathological analysis. Results: Membranous GLUT1 expression was observed in normal and tumor cells. GLUT1 expression was higher in ductal carcinoma in situ, invasive ductal carcinoma, and lymph node metastasis than in normal tissue and ductal hyperplasia (p=0.002). Of 276 invasive ductal carcinomas, 106 (38.4%) showed GLUT1 expression. GLUT1 expression was correlated with higher histologic grade (p<0.001), larger tumor size (p=0.025), absence of estrogen receptor (p<0.001), absence of progesterone receptor (p<0.001), and triple-negative phenotype (p<0.001). In univariate survival analysis, patients with GLUT1 expression had poorer overall survival and disease-free survival (p=0.017 and p=0.021, respectively, log-rank test). In multivariate survival analysis with the Cox proportional hazards model, GLUT1 expression was an independent prognostic factor of poorer overall survival and disease-free survival (p=0.017 and p=0.019, respectively). Conclusion: GLUT1 expression seems to play an important role in malignant transformation, and the glycolytic phenotype in invasive ductal carcinoma may indicate aggressive biological behavior and a worse prognosis.

유방의 관상피증식, 관상피내암종 및 침윤성 암종에서의 Maspin단백 발현

주영채,박인서,김윤주,김준미,한혜승,한지영,김영배 대한병리학회 1999 Journal of Pathology and Translational Medicine Vol.33 No.8

사람의 침윤성 유방암종에서 Heregulia mRNA 및 Her-2/neu단백의 발현과 림프절 전이, DNA 배수성의 관계

이광길,정우희,이희대,김의정,이성공,문인걸 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.8

한쪽 유방에서 동시에 발견된 피낭 유두상 암종과 관내 유두종에서 기원한 침윤성 관상피암: 증례 보고

김정규,김신영,이현주,이상미,김성용,이득영 대한영상의학회 2014 대한영상의학회지 Vol.71 No.3

Encapsulated papillary carcinoma of the breast is rare, accounting for just 0.5% to 2% of all breast cancers. A histological upgrade from papillary lesion can also possibly occur, however, an upgrade to invasive ductal carcinoma has uncommonly been reported. Furthermore, to the best of our knowledge, there is no reported case of encapsulated papillary carcinoma and invasive ductal carcinoma arising from intraductal papilloma in the same breast. We report an extremely rare case of synchronous encapsulated papillary carcinoma and invasive ductal carcinoma arising from intraductal papilloma on the same breast with radiologic—pathologic correlation. 유방의 피낭 유두상 암종은 매우 드문 종양으로 전체 유방암의 약 0.5~2%를 차지한다. 또한 관내 유두종은 조직학적 상향화가 가능하지만 침윤성 관상피암으로의 상향화는 흔하지 않게 보고되었고 더욱이 저자들이 알기에 한쪽 유방에서 동시에 발견된 피낭 유두상 암종과 관내 유두종에서 기원한 침윤성 관상피암은 보고된 적이 없었기에 이들의 영상학적 소견과 병리소견을 보고하고자 한다.

유방암의 종양 신생혈관형성과 전이의 연관성에 대한 연구

김남훈,박문향 대한병리학회 1995 Journal of Pathology and Translational Medicine Vol.29 No.6

Invasive Cribriform Carcinoma Arising in Malignant Phyllodes Tumor of Breast: A Case Report

최유미,박소연,이경율,장민혜,설혜실,김성원 대한병리학회 2012 Journal of Pathology and Translational Medicine Vol.46 No.2

Phyllodes tumor is an uncommon fibroepithelial neoplasm of the breast. And it is characterized by expanded stroma with increased cellularity and elongated epithelium-lined clefts. Mammary carcinomas within phyllodes tumors have been rarely reported. To date, however, no reports have described the invasive cribriform carcinoma arising in malignant phyllodes tumor. Here, we report a 62-year-old woman who presented with a large breast mass. Microscopically, the mass was a typical malignant phyllodes tumor showing well developed leaf-like architecture and stromal overgrowth with high cellularity and nuclear pleomorphism. In a portion of the tumor, however, the epithelial component showed a cribriform pattern of proliferation in the absence of myoepithelial cells, suggestive of the invasive cribriform carcinoma. To our knowledge, this is rare and it is difficult to make a differential diagnosis of it. Here, we report our case with a review of literatures.

Sonography of Invasive Apocrine Carcinoma of the Breast in Five Cases

서경진,안영이,황인용,장은덕,강봉주,김성헌,박창숙,김정수,홍현주 대한영상의학회 2015 Korean Journal of Radiology Vol.16 No.5

To evaluate the sonographic features of invasive apocrine carcinoma (IAC) of the breast. This study included five pathologically proven cases of IAC, and their sonographic features were retrospectively analyzed according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon. All five lesions involved the left breast and were seen as irregularly shaped masses. All lesions, except one, had a parallel orientation to the chest wall. All five lesions showed noncircumscribed margins and heterogeneous echotexture; however, they showed various posterior features. One lesion had edema as an associated feature. Sonographic assessments were classified as BI-RADS category 4 in all five cases. Invasive apocrine carcinoma sonographic findings are difficult to differentiate from those of invasive ductal carcinoma of no special type.