Predictive factors for breast cancer in patients diagnosed atypical ductal hyperplasia at core needle biopsy

<p>Abstract</p> <p>Background</p> <p>Percutaneous core needle biopsy (CNB) is considered to be the standard technique for histological diagnosis of breast lesions. But, it is less reliable for diagnosing atypical ductal hyperplasia (ADH). The purpose of the present study was to predict, based on clinical and radiological findings, which cases of ADH diagnosed by CNB would be more likely to be associated with a more advanced lesion on subsequent surgical excision.</p> <p>Methods</p> <p>Between February 2002 and December 2007, consecutive ultrasound-guided CNBs were performed on suspicious breast lesions at Seoul St. Mary's Hospital. A total of 69 CNBs led to a diagnosis of ADH, and 45 patients underwent follow-up surgical excision. We reviewed the medical records and analyses retrospectively.</p> <p>Results</p> <p>Sixty-nine patients were diagnosed with ADH at CNB. Of these patients, 45 underwent surgical excision and 10 (22.2%) were subsequently diagnosed with a malignancy (ductal carcinoma <it>in situ</it>, n = 8; invasive cancer, n = 2). Univariate analysis revealed age (≥ 50-years) at the time of core needle biopsy (p = 0.006), size (> 10 mm) on imaging (p = 0.033), and combined mass with microcalcification on sonography (p = 0.029) to be associated with underestimation. When those three factors were included in multivariate analysis, only age (p = 0.035, HR 6.201, 95% CI 1.135-33.891) was an independent predictor of malignancy.</p> <p>Conclusion</p> <p>Age (≥ 50) at the time of biopsy is an independent predictive factor for breast cancer at surgical excision in patients with diagnosed ADH at CNB. For patients diagnosed with ADH at CNB, only complete surgical excision is the suitable treatment option, because we could not find any combination of factors that can safely predict the absence of DCIS or invasive cancer in a case of ADH.</p

Incidental thyroid lesions detected by FDG-PET/CT: prevalence and risk of thyroid cancer

<p>Abstract</p> <p>Background</p> <p>Incidentally found thyroid lesions are frequently detected in patients undergoing FDG-PET/CT. The aim of this study was to investigate the prevalence of incidentally found thyroid lesions in patients undergoing FDG-PET/CT and determine the risk for thyroid cancer.</p> <p>Methods</p> <p>FDG-PET/CT was performed on 3,379 patients for evaluation of suspected or known cancer or cancer screening without any history of thyroid cancer between November 2003 and December 2005. Medical records related to the FDG-PET/CT findings including maximum SUV(SUV_max) and pattern of FDG uptake, US findings, FNA, histopathology received by operation were reviewed retrospectively.</p> <p>Results</p> <p>Two hundred eighty five patients (8.4%) were identified to have FDG uptake on FDG-PET/CT. 99 patients with focal or diffuse FDG uptake underwent further evaluation. The cancer risk of incidentally found thyroid lesions on FDG-PET/CT was 23.2% (22/99) and the cancer risks associated with focal and diffuse FDG uptake were 30.9% and 6.4%. There was a significant difference in the SUV_maxbetween the benign and malignant nodules (3.35 ± 1.69 vs. 6.64 ± 4.12; P < 0.001). There was a significant correlation between the SUV_maxand the size of the cancer.</p> <p>Conclusion</p> <p>The results of this study suggest that incidentally found thyroid lesions by FDG-PET/CT, especially a focal FDG uptake and a high SUV, have a high risk of thyroid malignancy. Further diagnostic work-up is needed in these cases.</p

Pattern of distant recurrence according to the molecular subtypes in Korean women with breast cancer

<p>Abstract</p> <p>Background</p> <p>Distant recurrence is one of the most important risk factors in overall survival, and distant recurrence is related to a complex biologic interaction of seed and soil factors. The aim of the study was to investigate the association between the molecular subtypes and patterns of distant recurrence in patients with breast cancer.</p> <p>Methods</p> <p>In an investigation of 313 women with breast cancer who underwent surgery from 1994 and 2000, the expressions of estrogen and progestrone receptor (ER/PR), and human epithelial receptor-2 (HER2) were evaluated. The subtypes were defined as luminal-A, luminal-HER2, HER2-enriched, and triple negative breast cancer (TNBC) according to ER, PR, and HER2 status.</p> <p>Results</p> <p>Bone was the most common site of distant recurrence. The incidence of first distant recurrence site was significantly different among the subtypes. Brain metastasis was more frequent in the luminal-HER2 and TNBC subtypes. In subgroup analysis, overall survival in patients with distant recurrence after 24 months after surgery was significantly different among the subtypes.</p> <p>Conclusions</p> <p>Organ-specific metastasis may depend on the molecular subtype of breast cancer. Tailored strategies against distant metastasis concerning the molecular subtypes in breast cancer may be considered.</p

Genomic alterations of primary tumor and blood in invasive ductal carcinoma of breast

<p>Abstract</p> <p>Background</p> <p>Genomic alterations are important events in the origin and progression of various cancers, with DNA copy number changes associated with progression and treatment response in cancer. Array CGH is potentially useful in the identification of genomic alterations from primary tumor and blood in breast cancer patients. The aim of our study was to compare differences of DNA copy number changes in blood and tumor tissue in breast cancer.</p> <p>Methods</p> <p>DNA copy number changes in blood were compared to those in tumor tissue using array-comparative genomic hybridization in samples obtained from 30 breast cancer patients. The relative degree of chromosomal changes was analyzed using log2 ratios and data was validated by real-time polymerase chain reaction.</p> <p>Results</p> <p>Forty-six regions of gains present in more than 30% of the tissues and 70 regions of gains present in more than 30% of blood were identified. The most frequently gained region was chromosome 8q24. In total, agreement of DNA copy numbers between primary tumor and blood was minimal (Kappa = 0.138, p < 0.001).</p> <p>Conclusion</p> <p>Although there was only a slight agreement of DNA copy number alterations between the primary tumor and the blood samples, the blood cell copy number variation may have some clinical significance as compared to the primary tumor in IDC breast cancer patients.</p

Effects of an internal medicine floor interdisciplinary team on hospital and clinical outcomes of seniors with acute medical illness

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100310/1/ggi12035.pd

A hydro/oxo-phobic top hole-selective layer for efficient and stable colloidal quantum dot solar cells

In this report, we explore the underlying mechanisms by which doped organic thin films as a top hole-selective layer (HSL) improve the performance and stability of colloidal quantum dot (CQD)-based solar cells. Molecular dynamics-based theoretical studies prove that the hydro/oxo-phobic properties of the HSL serve to efficiently passivate the CQD solid. Furthermore, the robust and outstanding electrical properties of the HSL, simultaneously ensure a high power conversion efficiency (PCE) and increase the stability performance of CQD-based solar cells. As a result, a best PCE of 11.7% in a lead sulfide (PbS)-based CQD solar cell is achieved and over 90% of the initial performance is retained after 1 year storage under ambient conditions

A hydro/oxo-phobic top hole-selective layer for efficient and stable colloidal quantum dot solar cells

In this report, we explore the underlying mechanisms by which doped organic thin films as a top hole-selective layer (HSL) improve the performance and stability of colloidal quantum dot (CQD)-based solar cells. Molecular dynamics-based theoretical studies prove that the hydro/oxo-phobic properties of the HSL serve to efficiently passivate the CQD solid. Furthermore, the robust and outstanding electrical properties of the HSL, simultaneously ensure a high power conversion efficiency (PCE) and increase the stability performance of CQD-based solar cells. As a result, a best PCE of 11.7% in a lead sulfide (PbS)-based CQD solar cell is achieved and over 90% of the initial performance is retained after 1 year storage under ambient conditions

Endoscopic Treatment of Duodenal Bleeding Caused by Direct Hepatocellular Carcinoma Invasion with an Ethanol Injection

We report a case of a man who developed duodenal bleeding caused by direct hepatocellular carcinoma (HCC) invasion, which was successfully treated with endoscopic ethanol injection. A 57-year-old man with known HCC was admitted for melena and exertional dyspnea. He had been diagnosed with inoperable HCC a year ago. Urgent esophagogastroduodenoscopy (EGD) showed two widely eroded mucosal lesions with irregularly shaped luminal protruding hard mass on the duodenal bulb. Argon plasma coagulation and Epinephrine injection failed to control bleeding. We injected ethanol via endoscopy to control bleeding two times with 14 cc and 15 cc separately without complication. Follow-up EGD catched a large ulcer with necrotic and sclerotic base but no bleeding evidence was present. He was discharged and he did relatively well during the following periods. In conclusion, Endoscopic ethanol injection can be used as a significantly effective and safe therapeutic tool in gastrointestinal tract bleeding caused by HCC invasion