Pregnancy-associated breast cancer: A review of imaging modalities

Context: The most common cancer and cause of cancer-related death in pregnant and breastfeeding patients is breast cancer. In the world, the incidence of pregnancy-associated breast cancer (P.A.B.C) is increasing, which is due to the fact that women delay their pregnancy up to the middle ages. According to the definition of P.A.B.C, a pregnancy-associated breast cancer is a case of breast cancer that occurs during pregnancy or up to 1 year after delivery. The aim of this paper is to review the clinical findings and novel imaging methods and findings, which help to diagnose pregnancy-associated breast cancer early. Evidence Acquisition: We reviewed the papers with subjects of PABC and imaging modalities in PABC by searching the medical and health databases such as PubMed, Google Scholar, as well as clinical trials. Results: The most frequent manifestation is a painless mass sensation. The most prevalent pathology of PABC is high-grade ductal carcinoma. The first diagnostic tool and most sensitive modality of imaging in this disease is ultrasound. Mammography during pregnancy and lactation is a safe method, which performs in symptomatic patients or in patients with positive ultrasound findings. MRI is not recommended during pregnancy, but it is completely harmless in breastfeeding patients and it is usually used as the complementary modality. Conclusions: Timely diagnosis of PABC requires complete knowledge of clinical symptoms and accurate interpreting of the images in different diagnostic modalities including mammography, ultrasound, and MRI. It should be noted that delay in diagnosis of PABC is the most common cause of low survival rate and bad prognosis. © 2018, Author(s)

Assessment of ultrasound features and BI-RADS categories of malignant breast masses in Women � 40

Background: To evaluate ultrasound (US) characteristics and BI-RADS (Breast imaging-reporting and data system) of malignant breast masses in women <40 years and to compare with older patients. Methods: In a retrospective, descriptive-analytical study, we assessed the US images and BI-RADS category of 78 malignant masses with a final pathology of invasive ductal carcinoma (IDC, NOS type). Results: Overall, the most frequent US descriptors of IDC were indistinct margin (45), irregular shaped (63.5), posterior shadowing (38.8), heterogeneous internal echogenicity (56.3) and non-parallel orientation (76.3). In this study, most malignant masses of young patients were categorized as BI-RADS 4a while in the older patients (over 40), they were mostly BI-RADS 4b and 5 with P=0.03 and odds ratio (OR) of 2.57 (95 confidence interval (CI), 0.74-8.8). In addition, the mean dimension of the mass in young cases was greater (18.3 mm) compared with older patients (13.2 mm) with P value of 0.04 and OR of 3.8 (95 CI, 1.1-13.4). Conclusion: Similar to previous studies, malignant masses were diagnosed in greater dimensions in younger cases which may be due to the delay in diagnosis, the rapid growth of the tumor and the absence of routine screening guidelines. Radiologists should be aware of the possibility of malignancy in palpable slightly suspicious masses (BI-RADS 4A) in young cases. © 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

A micropillar array-based microfluidic chip for label-free separation of circulating tumor cells: The best micropillar geometry?

Introduction The information derived from the number and characteristics of circulating tumor cells (CTCs), is crucial to ensure appropriate cancer treatment monitoring. Currently, diverse microfluidic platforms have been developed for isolating CTCs from blood, but it remains a challenge to develop a low-cost, practical, and efficient strategy. Objectives This study aimed to isolate CTCs from the blood of cancer patients via introducing a new and efficient micropillar array-based microfluidic chip (MPA-Chip), as well as providing prognostic information and monitoring the treatment efficacy in cancer patients. Methods We fabricated a microfluidic chip (MPA-Chip) containing arrays of micropillars with different geometries (lozenge, rectangle, circle, and triangle). We conducted numerical simulations to compare velocity and pressure profiles inside the micropillar arrays. Also, we experimentally evaluated the capture efficiency and purity of the geometries using breast and prostate cancer cell lines as well as a blood sample. Moreover, the device’s performance was validated on 12 patients with breast cancer (BC) in different states. Results The lozenge geometry was selected as the most effective and optimized micropillar design for CTCs isolation, providing high capture efficiency (>85 %), purity (>90 %), and viability (97 %). Furthermore, the lozenge MPA-chip was successfully validated by the detection of CTCs from 12 breast cancer (BC) patients, with non-metastatic (median number of 6 CTCs) and metastatic (median number of 25 CTCs) diseases, showing different prognoses. Also, increasing the chemotherapy period resulted in a decrease in the number of captured CTCs from 23 to 7 for the metastatic patient. The MPA-Chip size was only 0.25 cm2 and the throughput of a single chip was 0.5 ml/h, which can be increased by multiple MPA-Chips in parallel. Conclusion The lozenge MPA-Chip presented a novel micropillar geometry for on-chip CTC isolation, detection, and staining, and in the future, the possibilities can be extended to the culture of the CTCs

The Effect of Vitagnus on Cyclic Breast Pain in Women of Reproductive Age

BACKGROUND AND OBJECTIVE: One of the most common complaints in women is breast pain associated with reduced women quality of life and a lot of problems and costs. This study aimed to investigate the effect of vitagnus on severity of cyclic mastalgia in women of reproductive age. METHODS: This study is a triple blind controlled clinical trial performed on 67 women with cyclic mastalgia. Women randomly entered to an intervention group (34 patients) or a placebo (n=33) groups and training and proper nutrition were done. Vitagnus daily was given for three months in the intervention group (8 ml) and eatable paraffin (1 ml) mixed with water and honey (a total of 10 ml) was given to the placebo group. The pain from two months before to three months after treatment with VAS and McGill measuring instruments were compared. FINDINGS: The mean score of McGill in Vitagnus group decreased from 16.94±3.94 before the intervention to 9.50±5.32 in fifth month and in the placebo group decreased from 15.08±3.62 before the intervention to 13.08±4.29 in fifth month (p<0.0001). Mean VAS score in Vitagnus Group decreased from 6.59±3.35 before the intervention to 3.27±2.20 in fifth month and in the placebo group from 5.94±1.32 before the intervention to 4.94±1.81 in the fifth month (p<0.0001). CONCLUSION: The results showed that Vitagnus can be used as an effective and low-cost treatment in the treatment of mastalgia

Application of canonical correlation analysis for detecting risk factors leading to recurrence of breast cancer

Background: Advances in treatment options of breast cancer and development of cancer research centers have necessitated the collection of many variables about breast cancer patients. Detection of important variables as predictors and outcomes among them, without applying an appropriate statistical method is a very challenging task. Because of recurrent nature of breast cancer occurring in different time intervals, there are usually more than one variable in the outcome set. For the prevention of this problem that causes multicollinearity, a statistical method named canonical correlation analysis (CCA) is a good solution. Objectives: The purpose of this study was to analyze the data related to breast cancer recurrence of Iranian females using the CCA method to determine important risk factors. Patients and Methods: In this cross-sectional study, data of 584 female patients (mean age of 45.9 years) referred to Breast Cancer Research Center (Tehran, Iran) were analyzed anonymously. SPSS and NORM softwares (2.03) were used for data transformation, running and interpretation of CCA and replacing missing values, respectively. Data were obtained from Breast Cancer Research Center, Tehran, Iran. Results: Analysis showed seven important predictors resulting in breast cancer recurrence in different time periods. Family history and loco-regional recurrence more than 5 years after diagnosis were the most important variables among predictors and outcomes sets, respectively. Conclusions: Canonical correlation analysis can be used as a useful tool for management and preparing of medical data for discovering of knowledge hidden in them. © 2016, Iranian Red Crescent Medical Journal

Radiation exposure of the surgeons in sentinel lymph node biopsy

Background: Sentinel node biopsy (SLNB) is the standard of care for breast cancer treatment and it is getting wide acceptance in Iran. The radiation safety of the procedure has been investigated under controlled conditions, but the standard dose of radiotracer and techniques are not always observed in the community setting. The aim of this study was to assess the magnitude of the absorbed doses of radiation to the hands of operating surgeons. Materials and Methods: Twenty consecutive SLNB procedures were studied. Radiation dose to the hands of the surgeons was measured by placing lithium fluoride thermoluminescent dosimeters (TLDs) in the surgeons' glove. The radiation dose to the abdomen and thyroid area was measured by placing TLDs at these areas. The injected dose of radiotracer, the time interval to the surgery and the duration of the surgery were recorded. Results: The injected dose of radiotracer ranged from 0.1 to 5 mCi. The highest absorbed dose was recorded by TLD, placed on the non-dominant hand third finger (189.1 μSv). Mean recorded doses were higher for non-dominant hand second finger (53.49 ± 24.60 μSv). The measured absorbed doses for the abdominal and thyroid area were lower than those for the fingers. Conclusion: This study has confirmed the procedure safety, even with high dose of radiotracer. Nevertheless, it is advisable to use the lowest dose of the radiotracer to avoid the waste of resources

A micropillar array-based microfluidic chip for label-free separation of circulating tumor cells: The best micropillar geometry?

Introduction: The information derived from the number and characteristics of circulating tumor cells (CTCs), is crucial to ensure appropriate cancer treatment monitoring. Currently, diverse microfluidic platforms have been developed for isolating CTCs from blood, but it remains a challenge to develop a low-cost, practical, and efficient strategy. Objectives: This study aimed to isolate CTCs from the blood of cancer patients via introducing a new and efficient micropillar array-based microfluidic chip (MPA-Chip), as well as providing prognostic information and monitoring the treatment efficacy in cancer patients. Methods: We fabricated a microfluidic chip (MPA-Chip) containing arrays of micropillars with different geometries (lozenge, rectangle, circle, and triangle). We conducted numerical simulations to compare velocity and pressure profiles inside the micropillar arrays. Also, we experimentally evaluated the capture efficiency and purity of the geometries using breast and prostate cancer cell lines as well as a blood sample. Moreover, the device’s performance was validated on 12 patients with breast cancer (BC) in different states. Results: The lozenge geometry was selected as the most effective and optimized micropillar design for CTCs isolation, providing high capture efficiency (>85 %), purity (>90 %), and viability (97 %). Furthermore, the lozenge MPA-chip was successfully validated by the detection of CTCs from 12 breast cancer (BC) patients, with non-metastatic (median number of 6 CTCs) and metastatic (median number of 25 CTCs) diseases, showing different prognoses. Also, increasing the chemotherapy period resulted in a decrease in the number of captured CTCs from 23 to 7 for the metastatic patient. The MPA-Chip size was only 0.25 cm2 and the throughput of a single chip was 0.5 ml/h, which can be increased by multiple MPA-Chips in parallel. Conclusion: The lozenge MPA-Chip presented a novel micropillar geometry for on-chip CTC isolation, detection, and staining, and in the future, the possibilities can be extended to the culture of the CTCs

Corticosteroid treatment in the management of idiopathic granulomatous mastitis to avoid unnecessary surgery

Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast. It can mimic breast carcinoma clinically and radiologically, and usually affects females of childbearing age. There is no commonly accepted optimal treatment for IGM. In this study, we present the clinical and histopathological features and outcomes of the therapeutic management of IGM, as well as the clinical course of the disease when patients were treated with oral corticosteroids