Benign Breast Disease

En el presente estudio se determinaron por espectometría de absorción atómica con llama (FAAS) los niveles séricos sanguíneos de cobre (Cu) y zinc (Zn) de 100 individuos (n=100), 50 de ellos con síndrome metabólico (SM) y 50 como controles (C) de ambos géneros residenciados en la ciudad de Maracaibo. Las muestras de sangre completa para ambos grupos se recolectaron del antebrazo derecho, en tubos de polipropileno no heparinizados en el Centro de

Dichlorodiphenyldichloroethane (DDE) adipose tissue level has been regarded as a preferred indicator of accumulated human exposure to DDT; however, blood sera are more feasible to obtain and analyze than adipose tissue samples. Inconsistent and scarce information exists in relation to the adipose tissue/serum DDE ratio. As a part of a hospital-based case±control study performed in Mexico City from 1994 to 1996, 198 paired serum and adipose tissue samples were obtained from 72 women with histologically con¢rmed breast cancer and 126 women with benign breast disease. Both adipose tissue and serum DDE levels were determined by gas±liquid chromatography and reported as ppb lipid weight (ng/g) as well as wet basis (ng/ml). Results showed that the adipose tissue/serum DDE ratio (ADSE) varies according to the type of information (lipid vs wet basis, arithmetic vs geometric means) used for its estimation. ADSE gets a value near 1 (1.1) only when the geometric DDE levels in lipid basis are used for its estimation.The correlation between DDE serum and adipose tissue levels was found (r = 0.364, P 5 5 0.001). The ADSE did not vary by disease status, nor was it altered by parity, history of breast-feeding, and other reproductive characteristics. We endorse the use of venipuncture instead of biopsy as a way to estimate DDT body burden levels in further research.

Patients & Methods. : Ten months data of 2011 consisted of 829 cases of breast diseases, which were obtained from the histopathology department of DDRL, OJHA campus located in Karachi .The diseases were grouped into malignant, benign and inflammatory types. There was no limitation of age and both genders were considered. Cancers other than breast diseases were excluded from the study. Reports of missing information were not analyzed. Normal breast tissue was as well excluded. Results : Analysis revealed 413 as malignant lesions, 322 benign and 80 inflammatory .Most numerous malignant tumours were invasive ductal carcinoma grade 2 (23.7%).Fibroadenoma (28.0%) was highest among all benign and inflammatory breast diseases. Fibrocystic change (6.1%), benign phylloides (2.4%) was the next in incidence ranking, lipoma was 1.2% and no record of lactating adenoma was found. Among inflammatory lesion breast abscess (4.0%) scored the maximum, chronic mastitis (1.7%) and granulomatous mastitis (1.7%) both presented equally, duct ectasia (1.3%) followed and fat necrosis was least diagnosed. Conclusion : Breast diseases trend in the women of Karachi are changing. Malignant breast lesions are presenting at younger age and its occurrence is more than benign and inflammatory lesion altogether in this study.

Background: Data from the Shanghai Breast Cancer Study were analyzed to evaluate the relationship between benign breast disease (BBD) and breast cancer among Chinese women with a self-report of physician-diagnosed BBD. Methods: Study participants consisted of 3,452 breast cancer cases and 3,474 population controls recruited by the Shanghai Breast Cancer Study. In-person interviews were conducted to collect information on demographics and suspected risk factors for breast cancer, including a detailed history of BBD. Unconditional logistic regression was used to derive adjusted odds ratios (OR adj ) and 95% confidence intervals (CI) for the association between self-reported BBD and breast cancer. Results: Women with breast cancer were significantly more likely to have a self-reported history of BBD including lobular proliferation (OR adj =1.6; 95% CI 1.4-1.8), fibroadenoma (OR adj =1.9; 95% CI 1.5-2.3), and other BBD (OR adj =1.6; 95% CI 1.3-2.1). Breast cancer risk was lower for surgically treated fibroadenoma as compared to non-surgically treated and higher for other BBDs that were surgically treated versus non-surgically treated. Our results suggest that personal history of BBD is associated with an increased risk of future breast cancer among women in China. Surgical intervention for fibroadenoma may reduce the risk.

The cytochrome P450 superfamily of enzymes is important in the metabolism of many drugs and in the activation of chemical carcinogens. The activities of two cytochromes P450 (CYP2D6 and CYP2C19) are under independent monogenic control and exhibit marked genetic polymorphisms. Three to eight per cent of white Caucasians are termed poor metabolisers (PMs) because of an inability to metabolize debrisoquine or mephenytoin, the prototype substrates of CYP2D6 and CYP2C19, respectively. Some previous studies have suggested that PMs of debrisoquine are at lower risk of developing lung cancer. The aim of the present study was to investigate the relationship between breast cancer and drug oxidation phenotype and genotype. One hundred and five women with histologically proven breast cancer and a control group of 223 women with benign breast disease were recruited. Each subject was given 10 mg debrisoquine hemisulphate and 100 mg mephenytoin p.o. and urine was collected for 8 h. A blood sample was taken for CYP2D6 genotyping. There was no significant difference in the median debrisoquine/4-hydroxydebrisoquine ratio between the breast cancer patients (0.73) and the controls (0.59). Similarly, the prevalence of the PM phenotype did not differ significantly between the malignant (11%) and control (12%) groups. There was no significant difference in the frequency of the CYP2D6B mutant allele between the two groups (malignant = 0.22, n = 30; benign = 0.18, n = 93). A marginally significant difference was observed between the median S-/R-mephenytoin ratios for the breast cancer (0.37) and control (0.27) groups (P = 0.048) but not between the median mephenytoin/4'-hydroxymephenytoin ratios (malignant = 0.00243; benign = 0.00163). The distributions of the log,, mephenytoin/4'-hydroxymephenytoin ratios appeared bimodal unlike those of the S-/R-mephenytoin ratios. The prevalence of the PM phenotype for mephenytoin did not differ significantly between the patients with breast cancer (5%) and the control group (4%). In conclusion, neither the debrisoquine nor the mephenytoin oxidation polymorphism appears to be related to susceptibility to breast cancer.

Background: Breast carcinoma is the common malignant lesion in women. Fine needle aspiration cytology has high sensitivity and specificity and is simple, rapid and safe method to diagnose breast lesions. Materials and methods: A retrospective study was done in department of pathology of C.U.SHAH medical college and hospital of Surendranagar from January 2010 to July 2012. Total 120 FNAC of palpable breast lump was done in pathology department of C.U. SHAH medical college and hospital and correlate it with histopathological findings. All cases are categorized according to risk for cancer into unsatisfactory sample, benign proliferative breast disease without atypia, Benign proliferative disease with atypia, Inflammatory breast disease, suspicious for malignancy and malignant lesions. Results: Out of 120 cases, 65 cases were benign, 32 malignant, 2 suspicious and 16 were inflammatory breast and 4 were unsatisfactory lesions. Cytological and histopathological correlation found in 114 c...

Novel strategies for early detection of breast cancer, the most common and second most lethal cancer in women, are urgently needed. Silencing tumor suppressor genes via DNA methylation has established hypermethylation as one of the most frequent molecular alterations that may initiate and drive many types of human neoplasia including breast cancer. Detecting such epigenetic changes in DNA derived not only from tumor tissue, but also from bodily fluids, may be a promising target for the molecular analysis of cancer. In this study we examined serum, a readily accessible bodily fluid known to contain neoplastic DNA, from individuals with breast carcinoma. Using sensitive methylation-specific polymerase chain reaction, we searched for aberrant promoter hypermethylation of two normally nonmethylated genes: RAS association domain family member 1A (RASSF1A) and death-associated protein kinase 1 (DAPK1) in 26 patients with breast cancer, 16 patients with benign breast diseases, and 12 age-matched healthy controls. Hypermethylation of at least one gene was detected in 25/26 (96%) cancer patients, in 7/16 (43%) cases with benign breast diseases, and only 1/12 (8%) control subjects. Furthermore, methylation of both genes was found to be associated with ductal type of breast carcinoma. RASSF1A was hypermethylated in 18/26 cases (69%) and DAPK1 in 23/26 (88%). However, DAPK1 promoter methylation was more pronounced, as 12/23 DAPK1 methylated cases (52%) were strongly methylated (O75%) compared to the weaker methylation of RASSF1A (none of the cases with methylation at the level of O75%). These findings, if confirmed in studies of extended cohorts, may lead to useful clinical application in early diagnosis of breast cancer and better management of the neoplastic disease.

Background: Microfilaria is a major public health problem in tropical countries like India. It is most commonly diagnosed in peripheral blood smears, but detection of microfilaria in FNAC of breast is a rare finding. Case presentation: We are reporting a case of 35 year old female who presented with a painless nodule in left breast. Fine-needle aspiration cytology from the nodule was done, aspiration showed many sheathed motile microfilaria likely Wuchereria bancrofti and the patient was put on anti-filarial treatment with Diethyl carbamazine citrate. Conclusion: In endemic areas, it should be considered as one of the differential diagnoses of a superficial swelling. Despite its high prevalence, filariasis in female breast is a rare finding and careful screening of nodules help in detecting microfilaria even in asymptomatic patients and thus plays a significant role in recognition of the disease and institution of specific treatment. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Gigantomastia during pregnancy is a rare disorder that is characterized by diffuse, extreme, and incapacitating breast hypertrophy. Ectopic breast tissue is defined as glands of breast tissue located outside of the normal anatomic breasts. The factors controlling breast growth are complex and not completely understood. Breast tissue including ectopic displays all of the characteristics of normal breast tissue including growth during puberty, pregnancy and lactation. Cases of ectopic vulvar lactating breast with gigantomastia have been described in only few cases in the literature. Hence, we present this rare case of a gravid patient with recurrent lactating vulvar breast and gigantomastia. This was managed conservatively with postpartum resolution of gigantomastia and excision of the vulvar mass.

Background: Breast lump is the most common reason for presenting to surgery department. It is a source of great anxiety to a female when it is discovered. This study aims at a clinico-pathologic review of breast lump as a present- ing complaint.

Material and Methods: A 5-year retrospective analysis of 550 patients presenting with a complaint of breast lump to the surgery department of a Teaching Hospital in Western India from January 2008 December 2012.

Results: Breast lump was the presenting complaint in 550(82.8%) of 664 patients, the lump was painless in 458 (83.3%), associated with pain and breast ulcer in 59(10.7%) and 33(6.0%) patients respectively; no palpable lump in 23 patients (4.2%) and only 54 patients (9.7%) had >1 lump.

The clinical diagnosis were breast cancer in 260 patients (47.3%), fibroadenoma in 175 (31.8%), fibrocystic changes in 67 (12.2%) patients; the others were benign diseases. Histopathology, done in 294 patients, revealed 161(54.8%), 56(19.0%) and 46(15.6%) patients having invasive cancer, fibroadenoma, and fibrocystic changes respectively.

Conclusion: Breast lump was the most common presenting complaint with most patients not presenting early. Fewer lumps are discovered by breast self examination. The finding of fibroadenoma as the most common of the benign lesions is similar to that reported by other researchers in India and other parts of the world.

We present findings on the associations between DNA adduct levels in breast tissue, risk of breast cancer, and polymorphisms in the DNA repair enzyme XPD. Breast cancer cases, benign breast disease (BBD) controls, and healthy controls were enrolled. Polycyclic aromatic hydrocarbons (PAH)-DNA adduct levels were measured by immunohistochemistry in breast tissue samples from cases and BBD controls. XPD polymorphisms at codons 312 and 751 was determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis using white blood cell DNA. Neither of the polymorphisms were associated with case-control status, both in comparisons of cases and BBD controls, and cases and healthy controls. XPD polymorphisms at codons 312 and 751 were associated with higher levels of PAH-DNA in tumor tissue from breast cancer cases. Subjects with an Asp/Asn or Asn/Asn polymorphic genotype in codon 312 of XPD had elevated levels of PAH-DNA adducts compared to subjects with the Asp/Asp genotype (0.55 optical density (OD) v.s. 0.33 OD, p < 0.01). PAH-DNA adducts were associated with increasing copy number of the Gln allele for the codon 751 polymorphism (p for trend <0.01). Among subjects with the Asp/Asn or Asn/Asn genotype at codon 312, adduct levels were higher in tumor tissue compared to tissue from BBD controls (0.55 OD v.s. 0.36 OD, p = 0.003). Among subjects with the Gln/Gln genotype at codon 751 adduct levels were higher in tumor tissue compared to tissue from BBD controls (0.68 OD v.s. 0.40 OD, p = 0.01). The trend of increasing PAH-DNA adduct levels with either the Asn/Asn or Gln/Gln genotype was greater in tumor tissue than the trend in BBD control tissue.

Pseudoangiomatous Stromal Hyperplasia (PASH) is a rare, benign proliferative condition of the breast stroma that can mimic more serious vascular lesions. Accurate diagnosis is critical to avoid unnecessary aggressive treatments. This case report highlights the clinical presentation, differential diagnosis, and the importance of detailed immunohistochemistry (IHC) studies in differentiating PASH from vascular lesions.

Background: The number of male patients imaged in the breast imaging center at our hospital has increased more than three times over the last decade from 0.8% of all diagnostic patients in 1998 to 2.7% of all diagnostic patients in 2008. We hypothesize that the increasing incidence of benign breast disease, mostly gynecomastia, accounts for the increasing numbers. Based on our experience, the rising incidence of gynecomastia may be partly due to the increasing use of medications, as well as the growing prevalence of obesity. We reviewed various patient demographics to understand benign breast diseases in men and indications for male breast imaging.

Background: The number of male patients imaged in the breast imaging center at our hospital has increased more than three times over the last decade from 0.8% of all diagnostic patients in 1998 to 2.7% of all diagnostic patients in 2008. We hypothesize that the increasing incidence of benign breast disease, mostly gynecomastia, accounts for the increasing numbers. Based on our experience, the rising incidence of gynecomastia may be partly due to the increasing use of medications, as well as the growing prevalence of obesity. We reviewed various patient demographics to understand benign breast diseases in men and indications for male breast imaging.

Objective: To investigate etiological role of Epstein-Barr virus (EBV) DNA in breast cancer. Materials and Methods: The presence of EBV DNA in 57 breast cancer tissues was investigated with a sensitive PCR assay. The breast cancer tissues were from invasive ductular (n = 28), lobular (n = 20) and other miscellaneous carcinomas (n = 9). Tissues from normal breasts and patients with various benign breast diseases (n = 55): fibrocystic disease (n = 34), fibroadenoma (n = 16), hyperplasia, and granulomatous mastitis (n = 5), were used as control samples. Results: EBV DNA was detected in 13 (23%) cancerous tissues (7 ductular, 4 lobular, 2 other carcinoma) and 19 (35%) in the control tissues. The difference between EBV presence in malignant and benign tissues was not statistically significant (p &gt; 0.05). Conclusion: The presence of EBV DNA was detected almost equally in both breast cancer and normal tissues, which indicates no etiological role for EBV in breast cancer. We suggest furt...

Microglandular adenosis (MGA) is a benign breast tumor, but it is considered a non-obligate precursor to invasive breast carcinoma. MGA has a few different morphological variations, including microglandular adenosis (MGA), atypical microglandular adenosis (AMGA), and breast carcinoma-associated microglandular adenosis (BCMGA). Initially, with the identification of MGA, it was classified as a benign lesion; however, recent molecular studies have demonstrated an association between MGA, AMGA, and BCMGA. As a precancerous tumor, a definitive diagnosis of MGA is essential, including reporting the degree of atypia if present. We present the case of a 39-year-old woman whose routine mammogram revealed an irregular density, leading to her diagnosis of AMGA. We provide a brief review of the pertinent literature, including diagnosis, differential diagnosis, molecular studies, management, and outcome of MGA.

BACKGROUND Cancer of the breast is the second most common cause of cancer in women. Benign or malignant lesions presenting as mass in the breast causes anxiety to the patients and the family members. AIMS AND OBJECTIVES OF THE STUDY 1. To classify different types of lesions of breast, both benign and malignant. 2. Histomorphological study of various types of benign and malignant breast lesions. 3. To study spectrum of lesions associated with benign and malignant breast diseases. SETTING AND DESIGN All the breast biopsies, lumpectomies, and mastectomy specimens presenting to Department of Pathology of our institution between June 2012 to June 2014. MATERIALS AND METHODS A sample size of 100 cases are included in this study. Clinical details are taken from records. The specimens of breast sent to the Department of Pathology are processed by routine histopathological techniques. Histopathological features are studied on haematoxylin and eosin-stained sections. STATISTICAL ANALYSIS Statistically, the test of proportion is used to obtain the frequency of all lesions. Chi-square test, which is used to find the association between the spectrum of lesions showed a p value of 0.0438 and hence the study was considered significant. RESULTS In our study, out of 100 cases, malignant breast lesions constituted the majority of the lesions comprising of 49 cases (49%), followed by benign lesions comprising 46 cases (46%) and the inflammatory lesions comprising 5 cases (5%). Among benign lesions, fibrocystic disease was the predominant lesion comprising of 39 cases (41%), followed by fibroadenoma comprising 26 cases (28%), which is followed by 13 cases (14%) of fibrocystic disease with columnar cell change and 8 cases (9%) of sclerosing adenosis. Among malignant lesions, invasive ductal carcinoma (NST) type was the most common lesion comprising 31 cases (61%) followed by 11 cases (21%) of invasive lobular carcinoma. Invasive papillary carcinoma and medullary carcinoma comprising of 3 cases (6%) each and 1 case (2%) of metaplastic carcinoma. CONCLUSION In the present study, we conclude that the benign breast lesions associated with intermediate and high risk epithelial proliferative lesions, which forms the matter of concern since most of them occurring commonly in young females who are in the reproductive age group. Hence, diagnosing these lesions in small breast biopsies, lumpectomies, and excised specimens is of utmost importance and in this regard these must be carefully evaluated.

Serum concentrations of antigenic keratan sulphate determined by an enzyme linked immunosorbent assay (ELISA) with a monoclonal antibody were studied in patients with rheumatoid arthritis (RA), osteoarthritis, ankylosing spondylitis, other inflammatory diseases, and a large control group of women without arthritis. Mean keratan sulphate concentrations were low in 117 women with RA compared with 227 female control subjects matched for age drawn from a community survey. There were significant correlations between serum keratan sulphate concentrations in patients with RA and serum C reactive protein and the erythrocyte sedimentation rate. Serum keratan sulphate concentrations were also low in 29 men and women with ankylosing spondylitis and 29 patients with arthritis and high concentrations of C reactive protein. In 98 women undergoing an operation for benign breast disease there were decreases in serum keratan sulphate concentrations after the operation which correlated with doses in serum C reactive protein. No differences were found in keratan sulphate concentrations in 137 women with osteoarthritis compared with controls. Within the group with osteoarthritis there were no differences for the various joint groups and there was no obvious correlation with radiographic severity or progression. These findings suggest serum keratan sulphate is unlikely to be usefil as a diagnostic marker in osteoarthritis or RA but indicate a role for inflammation in the regulation of cartilage loss.

Background: Benign breast diseases are the most common cause of breast problems. The most common symptoms are breast pain, lumpiness or a lump and nipple discharge. Triple assessment that includes clinical examination, imaging like ultrasonography (USG) or mammography and a pathological examination-FNAC or core needle biopsy has a very high accuracy rate in diagnosing, discrete benign breast diseases and this can be used for reassurance. Objective: The purpose of the present study was to determine the frequency of different types of benign neoplasm of breast lump in different age and sex. Methodology: The present study was carried out at the Department of Pathology, Chittagong Medical College, Bangladesh one year period from May 2005 to June 2006. This study was cross sectional which included 48 cases of breast neoplasm. The specimens were received from indoor patient Department of Surgery, Chittagong Medical College, Bangladesh. Histopathological examination was done. Results: This study shows the mean age of the patients was 32.91 years with age range 11 to 70 years. Most of the patients were in 31 to 50 years (45.8%) age group and female predominance than male. Fibroadenoma accounted for 76.2%. Sclerosing adenosine the second most common benign breast disease in this study accounted for 9.5% of cases. Conclusion: This study showed that among the benign breast diseases in females there were preponderance of fibroadenoma followed by sclerosing adenosine.

Periostin (POSTN), a secreted homodimeric protein that binds integrins αvβ3, αvβ5 and α6β4, was originally found to be expressed in fetal tissues and in the adult upon injury particularly bone fractures due to its role in remodelling and repair. Recently it was found to be over-expressed in human breast cancer and a variety of other tumour types including head and neck squamous cell carcinoma, where its overexpression correlates with increased tumour invasion. Progress in studying its functional role in tumour pathogenesis has been hampered by the paucity of antibodies for its specific and sensitive detection. It has proven very difficult to obtain monoclonal antibodies (mAbs) against this highly conserved protein but we report here that combining infection of mice with lactate dehydrogenase elevating virus (LDV), a B cell activating arterivirus, with conjugation of human POSTN to ovalbumin as an immunogenic carrier, enabled us to develop 6 mAbs recognizing both human and mouse POST...

Breast cysts (galactocele) form in the mammary gland from ductal obstruction. Multiple pathologic entities may produce complex cystic breast lesions. Ultrasound is presently the first primary modality in breast evaluation after physical palpitation. We report a progressive case of multiple cysts in a 32-year-old woman, ranging from 28 mm to 20 mm. Though in-situ milk (sono-penic) appears sterile, the superficial presentation (externally) is that of a firm mass. Due to the known hazards of radioactive mammography, this case report proves the usefulness of sonar to image, map, measure, identify and diagnose breast pathology. In women with dense-heavy breast, ultrasound examination will play an important role in screening palpable and non-palpable masses.

Aims: Estimation of prevalence of autoimmune thyroid disorders in Greek breast cancer patients (prospective study). Methods: The prevalence of autoimmune thyroiditis was estimated in 310 Greek breast cancer patients, in 100 women with benign breast disease and in 190 women without any breast disease, by submitting them to clinical examination, ultrasound thyroid evaluation, serum thyroid antibody determination and fine needle aspiration (FNA) of the thyroid gland. Results: Autoimmune thyroiditis was found in 136/310 (43.9%) breast cancer women: 95 were diagnosed by positive autoantibodies, 19 had positive FNA findings and 22 had both positive autoantibodies and positive FNA findings. In 117 cases, thyroid autoantibodies were positive (37.7% whereas the control groups had respective rates of 19% and 18.4% autoantibody positivity). Conclusions: There is evidence of high incidence of autoimmune thyroiditis in Greek breast cancer patients, increasing in relation to cancer stage.

Insulin-like growth factor II is a growth factor important in fetal development. Several cancer tissues and cell lines have been reported to express IGF-II and rat IGF-II is mitogenic for breast cancer cell lines. Using Northern analysis and ribonuclease protection assays, IGF-II mRNA was detected in normal fibroblasts and in the established breast cancer cell line, T47D. In this cell line, steady state levels of IGF-II message were increased by treatment with estradiol. 10 nM IGF-II, purified from human serum, was mitogenic for breast cancer cell lines. In vitro, IGF-II may act as an autocrine growth factor for some cell lines. RNA derived from breast cancer, pathologically normal breast tissue, and benign breast disease also contained IGF-II mRNA. When paired samples of normal and cancer tissue were obtained from the breast of the same patient, the level of IGF-II mRNA expression in the normal tissue was at least that found in the cancer. This is consistent with previous observati...

Malignant papillary neoplasms of the breast comprise a number of microscopically distinct lesions, where apocrine metaplasia is commonly found in papillomas compared to other papillary lesions including papillary carcinomas. However, association of apocrine metaplasia in papilloma with Ductal Carcinoma in Situ (DCIS) is not very well defined. The lesions with apocrine metaplasia are not only difficult to categories, but also there is controversy regarding their relative risk of subsequent carcinoma development. A case of extensive apocrine differentiation in duct papilloma with DCIS developing in the background of papillomatosis, posing a diagnostic dilemma for the pathologist and a therapeutic challenge for the surgeon, is hereby reported for its uniqueness and rarity. Awareness of this association should be kept in mind by both the pathologist as well as clinician for optimal therapeutic intervention.

In this study, copper (Cu) and zinc (Zn) levels were determined by flame atomic absorption spectrometry (FAAS) in the blood serum of patients with metabolic syndrome (MS) and controls (C) from the city of Maracaibo. Whole blood samples (N = 100; 50 for MS and 50 for C) were collected in polypropylene containers at the Endocrine Metabolic Research Center (CIEM), Faculty of Medicine at the University of Zulia. After separating the clot, each sample was centrifuged to obtain serum and stored at 4°C. Quantification of copper and zinc was performed by calibration curves prepared with concentrated aqueous standards of 0.10, 0.50, 1.00, 2.00, 4.00 and 6.00 mg Cu L-1 ; and 0.05, 0.10, 0.20, 0.30, 0.40, 0.50, 0.60, 0.80, and 1.00 mg Zn L-1. Serum concentrations of copper and zinc in patients with MS (ca. 0.76 ± 0.24 and 1.31 ± 0.42 mg L-1 , respectively) were below those obtained for subjects in the control group (ca. 0.96 ± 0.21 and 1.04 ± 0.14 mg L-1 , respectively), demonstrating the involvement of Cu and Zn in disorders of carbohydrate and lipid metabolism in the experimental population studied.

To the Editor: Mastalgia is a common and enigmatic condition. It may be severe enough to interfere with usual daily activities, and its effect on quality of life is often underestimated (1). Pain can be severe enough to interfere with usual daily activities, but the etiology and optimal treatment remain undefined. Approximately 60-70% of women experience some type of breast pain at some stage of their lives, and in 10-20% of cases, it is severe (2). The two most common concerns of patients presenting with mastalgia are the fear that breast pain is a symptom of breast cancer and the presence of severe pain that affects a woman's quality of life. Different drugs have been used with varied response. The most commonly prescribed nonsteroidal drug is evening primrose oil. Other drugs used at present are danazol, bromocriptine, tamoxifen, and luteinizing hormone releasing hormone analogs. Most of them are steroid-based drugs with significant side effects. Dhar and Srivastava (3) reported 100% regression in mastalgia, nodularity, and tenderness by centchroman. Centchroman is a novel nonsteroidal, selective anti-estrogen oral contraceptive, synthesized by the Central Drug Research Institute, Lucknow,

Background. Duct excision for pathologic nipple discharge (PND) often requires "blind" surgical resection. Intraoperative mammary ductoscopy can allow for direct visualization of intraductal abnormalities during surgical resection. Methods. We reviewed our experience with 119 patients with PND undergoing ductoscopy-directed duct excision. The variables that could interfere with a successful procedure were analyzed. Results. Cannulation of the discharging duct was successful in 105 of 119 (88%) of patients, and ductoscopy-directed duct excision could be performed in 104 of 119 (87%). A preoperative ductogram was obtained in 70 patients and was positive in 53 of 70 (76%). In this same group, ductoscopy was positive in 63 of 70 (90%). The pathologic diagnoses were as follows: cancer (5), papilloma (84), and hyperplasia (16), for an abnormal pathology yield of 88%. Hyperplasia and cancer were significant predictors of unsuccessful cannulation. In 22 patients, ductoscopy visualized multiple lesions or abnormalities beyond 4 cm. Conclusions. Mammary ductoscopy for PND is a safe, effective procedure that offers advantages of a high lesion localization rate and intraoperative guidance, therefore negating the need for a preoperative ductogram. Lesions deep within the ductal system can be identified and removed, which would likely have been missed by blind duct excision.

This paper focused on 3 rare lesions of breast an exceedingly rare case of fibrocystic disease of breast with predominantly chondroid metaplasia. Giant lipoma of breast which is infrequently observed because of rarity in size and location, with only very few case reports available in literature and fibroadenoma with atypical ductal hyperplasia(ADH) of breast which is an unusual finding in the adolescent or young adult female.

Background The importance of analyzing tissue removed during reduction mammoplasty in healthy and asymptomatic patients has been emphasized in many publications. Pathological analysis can reveal many important findings that may be used to determine the patient's risk of breast cancer. Methods The pathology findings of patients who underwent reduction mammoplasty and mastopexy due to breast asymmetry and/or breast hypertrophy between January 1995 and May 2018 were analyzed retrospectively. Results A total of 283 women underwent breast reduction during the study period (560 breasts). Of all of the specimens, 273 had histopathological findings, most of which were fibrocystic breast tissue pattern (85.71%). In 11 specimens, 16 lesions considered proliferative in nature were detected. The mean follow-up period of the proliferative lesions was 6.1 years. No malignancy was observed during the follow-up period. Conclusions Age is not the only significant factor affecting pathology results. Risk factors should be determined and imaging findings should be considered as well. Every reduction mammoplasty procedure should be regarded as an opportunity for screening the breast tissue of the candidates. Level of evidence: Level IV, risk/prognostic study.

INTRODUCTION: Maffucci's syndrome is a rare congenital, non-hereditary mesodermal dysplasia characterised by multiple enchondromas and vascular lesions. To our knowledge this is the first report of tubular adenoma of the breast in association with Maffucci's syndrome. PRESENTATION OF CASE: We report a 31-year-old female who presented with a large, ulcerated slowgrowing painless breast mass. She had also sustained two pathological fractures during childhood as well as progressive deformity and limb shortening on the right side of the body. Skeletal survey revealed enchondromas exclusively on the right side in association with phleboliths. Excision of the breast mass was performed. Histological examination of the breast lesion revealed a diagnosis of tubular adenoma, core biopsy of the bony lesions confirmed enchondromas and a cutaneous haemangioma was excised from the abdominal wall. DISCUSSION: Tubular adenoma of the breast is a rare benign tumour. When large they may cause ulceration leading to diagnostic and management dilemmas. Patients with Maffucci's Syndrome require lifelong surveillance for the development of malignancy. CONCLUSION: Tubular adenomas of the breast carry no risk of malignancy. However, malignancy remains high on the differential list when the skin is ulcerated. Ulceration can also be caused by pressure necrosis in benign tumours. This diagnostic dilemma can lead to unnecessarily radical surgery.

INTRODUCTION: Maffucci's syndrome is a rare congenital, non-hereditary mesodermal dysplasia characterised by multiple enchondromas and vascular lesions. To our knowledge this is the first report of tubular adenoma of the breast in association with Maffucci's syndrome. PRESENTATION OF CASE: We report a 31-year-old female who presented with a large, ulcerated slowgrowing painless breast mass. She had also sustained two pathological fractures during childhood as well as progressive deformity and limb shortening on the right side of the body. Skeletal survey revealed enchondromas exclusively on the right side in association with phleboliths. Excision of the breast mass was performed. Histological examination of the breast lesion revealed a diagnosis of tubular adenoma, core biopsy of the bony lesions confirmed enchondromas and a cutaneous haemangioma was excised from the abdominal wall. DISCUSSION: Tubular adenoma of the breast is a rare benign tumour. When large they may cause ulceration leading to diagnostic and management dilemmas. Patients with Maffucci's Syndrome require lifelong surveillance for the development of malignancy. CONCLUSION: Tubular adenomas of the breast carry no risk of malignancy. However, malignancy remains high on the differential list when the skin is ulcerated. Ulceration can also be caused by pressure necrosis in benign tumours. This diagnostic dilemma can lead to unnecessarily radical surgery.

90 ovarian cystectomies performed at a single children's hospital by the pediatric gynecology service between the years of 2010 to 2014 on the basis of procedure codes (Table 1). For each patient, total operative time, number of ovarian cysts, cyst size, BMI, cyst pathology, blood loss, and concurrent operative diagnoses/procedures were recorded. Charts with incomplete documentation were excluded from the study. Cyst size was categorized into 3 groups: small (< 6 cm), medium (6 e 10 cm) and large (>10 cm) and the mean operative time was compared between groups. Patient's BMI, cyst pathology, blood loss, and concurrent surgical procedures were also correlated to cyst size to assess for confounding (Table 2). Finally, a multivariate analysis was performed to compare mean surgery time between the three cyst size groups after adjustment for BMI. Results: A total of 73 patients met inclusion criteria. The mean age was 11+/-3 years. The mean age of menarche was 14+/-1.3 years, with 13 of the subjects premenarchal. Both the operative time and BMI varied as a function of cyst size, with differences significant between small/large cyst size and medium/large groups (p<.01). The difference between the mean operating time between medium and large ovarian cysts was 57 minutes. In multivariate analysis after control for BMI, mean operative time for small cyst (79.2 minutes), and medium cyst (85.2 minutes) groups continued to be lower as compared to large size group (132.4 minutes) (p ¼ .002). Conclusion: When scheduling operating rooms for ovarian cystectomies, cyst size is a factor that should be considered in order to more efficiently schedule cases and maximize the use of OR time.

Abstract

Background: Benign Breast Diseases, though more frequently responsible for bringing the patient to the doctor, have not found many places in good recent researches. Benign lesions of the breast have assumed increasing importance in recent years because of the public awareness of breast cancer. These benign lumps are a recognized important risk factor for later breast cancer.
Objective: To study the surgical profile of patient with benign breast disease
Materials and Methods: This retrospective study was conducted at ESIC medical college and Hospital Gulbarga, India. Study conducted after approval of Scientific committee and Ethical committee. Records of all patients undergoing breast surgery from the period March 2016 to March 2021 were analysed, and age, sex, laterality, diagnosis and surgery performed were noted.
Results: The most common type of benign breast disease was fibroadenoma in 58.4% of the cases. The most common age group affected was 21-30 years seen in 60.3% of the cases. Right side was most commonly affected in 57.3% of the cases. Benign breast disease as expected is more common in females (98.7%) compared to males who had only eight cases. Most common type of surgery performed was excision in all cases except for duct ectasia in which case microdochtecomy was performed. Circumareolar type of incision was most commonly used in all cases.
Conclusion: Fibroadenoma was most common type of benign breast disease affecting 21-30 years of age commonly and right side. Excision remains the most commonly performed surgery for benign breast disease. Most of benign breast lumps surgery was done using circumareolar incision.

Keywords: Breast disease, Benign, Cyst, Mastectomy, Incision

The discussion of abnormal results of breast imaging and abnormal pathologic findings can be challenging for health care professionals and often is stressful for patients. Although most imaging findings and biopsy results are negative and do not infer a substantial increase in breast cancer risk, the subsequent conversation between the patient and her practitioner is more effective and informative with a thorough review of the pathologic results and an appreciation of the importance of radiologic-histologic concordance. This article provides insight into and understanding of breast imaging and biopsy techniques and of histologic findings as a means to timely and appropriate decision making and action by the patient and her health care professional.

Apocrine hidrocystomas (AHC) are uncommon cystic lesions of apocrine glands and are most often solitary. They are usually found in the head and neck region. Multiple AHC have been rarely reported in the literature usually in the eyelids and face. On extensive search of literature, we came across only a single case report of multiple axillary AHC. We report a case of a 31-year-old female who presented with fullness and discomfort in bilateral axillae, so a clinical diagnosis of bilateral accessory breast was made. However on histopathological examination, it turned out to be bilateral multiple AHC associated with apocrine hyperplasia.

Adenolipoma of the breast is an uncommon mammary lesion classified as a hamartomatous lesion, presenting as a soft, mobile and well-defined mass. The typical mammographic findings is of a well-circumscribed lesion containing both fat and soft tissue surrounded by a capsule. Microscopically, adenolipoma exhibits a hamartomatous mixture of ducts and lobules intermingled with adipose and fibroconnective tissue. Enucleation is the standard treatment and recurrences are rare. We report a 29-year-old woman with a mobile, tender and firm mass, 6x5 cm, in the upper inner quadrant of the right breast of 1 month duration. Mediolateral mammography images demonstrated a well-defined mass with mixed granular and fat density. Histopathology of the excised mass revealed well-circumscribed lobules of ducts and glandular structures haphazardly embedded in mature fatty tissue. Breast hamartoma should be differentiated from other benign lesions of the breast. Awareness among radiologists and pathologists of this benign lesion would help avoid an incorrect diagnosis and unnecessary intervention.

The aetiology of Idiopathic Granulomatous Mastitis is uncertain. But our study noted CD 3 positive lymphocyte infiltration of the lesion. Aerobic and anaerobic culture did not did not grow bacteria in 86.8% patients with Idiopathic Granulomatous Mastitis. Special stains to identify presence of Mycobacterium species and Fungus were non-contributory. Limited operative procedure and systemic prednisolone were effective in preventing recurrence.

OBJECTIVE: Recent studies have demonstrated the presence of the IGF-binding proteins (IGFBPs) and prostate specific antigen (PSA), an IGFBP protease. in human breast tissue. We sought to investigate the differences in serum IGFs, IGFBP-1, -3 and -6, and PSA between patients with surgically proven breast cancer and patients with benign breast disease. DESIGN AND METHODS: Concentrations of IGFs, IGFBP-1, -3 and -6, and PSA were determined in the sera from 57 patients with breast cancer (CA), and 46 women with benign breast disease (BBD) using immunoassays for IGFs and IGFBPs and an ultrasensitive ELISA for PSA. RESULTS: The mean (+/- S.E.M.) serum IGFBP-6 level in the CA group, 127 (16) ng/ml, was statistically significantly lower than in the BBD group, 157 (10) ng/ml (P = 0.016). Patients with CA had an elevated geometric mean serum PSA level of 0.018 (range: 0.0015-0.107) ng/ml, compared with 0.007 (range: 0.0015-0.019) ng/ml in women with BBD (P = 0.025). Mean serum IGFBP-1 concent...

A case of a 45 year-old woman who presented with a perianal fistula was reported. Histologically, the excised lesion showed features of apocrine fibroadenoma. In addition, the lesion had both glandular and stromal growth patterns and active chronic inflammation in the background. Malignant or benign counterparts of these types of lesions are widely described in literature. However fistula does not usually accompany and is very rare. Therefore, it is crucial for the pathologists and clinicians to be aware of such lesions. The relationship between apocrine fibroadenoma and perianal region was also discussed. Apocrin fibroadenoma; Perianal region; Fistula.

Mammary fibroepithelial lesions encompass a wide spectrum of tumours ranging from an indolent fibroadenoma to potentially fatal malignant phyllodes tumour. Here, we report a case of 22 -year -old unmarried girl with bilateral breast lump for one month who underwent wide local excision which on histopathological examination revealed borderline phyllodes tumour and tubular adenoma in a background of fibrocystic disease with adenosis, marked epithelial hyperplasia, fibro adenomatoid change and apocrine metaplasia a rare occurrence which can be confused with benign and malignant lesions of the breast.

Keywords: Fibroepithelial lesion, Phyllodes tumour, Tubular adenoma.

Mammary hamartoma (MH) is an infrequent form of breast tumor that accounts for approximately 4.8% of all benign breast lesions. Myoid (muscular) hamartomas are uncommon benign breast lesions that are considered to be a variant of mammary hamartomas. Since the pathogenesis of MH is poorly understood, its true incidence is under-reported by clinicians and as well as pathologists.Thus, we report this case of MH in a middle-aged female, who presented with a large breast mass mimicking phyllodes tumor and giant fibroadenoma, however, histopathology and immunohistochemical examination aided its diagnosis as Myoid Hamartoma. We present this case to highlight this rare benign breast lesion.

Keywords: Breast, Hamartoma, Myoid, Muscular, Smooth muscle actin.

Mammographers occasionally are surprised by the diagnosis of a rare lesion at breast biopsy. The imaging features of some breast lesions are unfamiliar because they are rarely seen in routine mammographic practice and they are not well described or well documented in the radiologic literature. Moreover, there may be wide variation in the appearances of rare breast lesions at mammography and ultrasonography (US). In addition, although a few rare breast lesions have a typical imaging appearance, most have mammographic and US features similar to those of breast carcinomas, and a needle biopsy is almost always necessary to obtain a diagnosis. However, even when a rare breast lesion is diagnosed on the basis of a needle biopsy, knowledge of the imaging features of such lesions may help the radiologist decide whether the results of pathologic analysis concur with the imaging findings and whether surgical excision is necessary. It is therefore important that radiologists be familiar with the broad spectrum of imaging features of rare breast lesions as well as with the correlation between their histopathologic features and their current classification according to the World Health Organization classification system. ©