The Experts below are selected from a list of 1281 Experts worldwide ranked by ideXlab platform
Anders Lindgren - One of the best experts on this subject based on the ideXlab platform.
-
Fine needle aspiration cytology of tubular breast carcinoma and Radial Scar.
Acta cytologica, 1994Co-Authors: M. De La Torre, K. Lindholm, Anders LindgrenAbstract:Fine needle aspiration cytology (FNAC) findings in 33 tubular breast carcinomas (TC) and 10 Radial Scars (RS) were reviewed. In 19 (57%) cases of TC, a categorical diagnosis of malignancy could be made. Four (12%) TC, all containing myoepithelial cells, were misdiagnosed as benign. None of the RS was misinterpreted as malignant on FNAC. All RS smears contained myoepithelial cells. Although RS shared some of the cytologic features of TC, the lack of conspicuous nucleoli and pleomorphism prevented a false-positive diagnosis. Tubular angular structures, considered to be a characteristic feature of TC, may also occur in RS. Cellularity was poorer in RS than TC. The FNA yield obtained when attempting to aspirate small TC and RS lesions may originate in adjacent breast lesions and give a misleading cytologic picture. The occurrence of myoepithelial cells and/or lack of dissociation are not unequivocal benign signs in FNA smears; such findings do occur in TC. Finally, the difficulties that may be encountered in the diagnosis of TC and RS by frozen section are briefly discussed. Radiology often helped in establishing a diagnosis of malignancy in TC but did not help in ruling out malignancy in RS. A teamwork approach to the diagnosis and management of these lesions is recommended.
-
Localization of hyaluronan in normal breast tissue, Radial Scar, and tubular breast carcinoma.
Human pathology, 1993Co-Authors: Manuel De La Torre, Alvin F. Wells, Jonas Bergh, Anders LindgrenAbstract:Hyaluronan (hyaluronic acid [HYA]) is one of the extracellular matrix components involved in normal cell physiology and is localized mainly in bodily fluids and connective tissues. Increased amounts of HYA in serum have been demonstrated in a number of neoplastic and inflammatory conditions, among them breast cancer. Tubular breast carcinoma (TC) and Radial Scar (RS) are two breast lesions that microscopically display characteristic stromal alterations and possess gross and microscopic similarities. Due to the importance of HYA as a component of the extracellular matrix, we investigated its presence in these lesions and in normal breast tissue. Using a biotinylated HYA-binding region for the in situ detection of HYA, we noted an increased amount of HYA in both TC and RS as compared with that in normal breast tissue specimens. A strong reactivity was observed predominantly around glandular structures and in the interlobular stroma of both TC and RS. Perivascular HYA staining also was distinctly observed in these lesions (TC and RS). Some HYA was observed in the connective tissue of the intralobular regions, around small blood vessels, and in the perivascular connective tissue of the normal breast. The distribution of HYA adjacent to the epithelium in the normal breast suggests a role for HYA in the interaction between epithelium and stroma of the normal breast. Its increase in the connective tissue of both TC and RS reflects the derangement of the stroma commonly observed in these conditions and supports the notion that these lesions may be associated.
Sophia K Apple - One of the best experts on this subject based on the ideXlab platform.
-
Upgrade rates of high-risk breast lesions diagnosed on core needle biopsy: a single-institution experience and literature review
Modern Pathology, 2016Co-Authors: Kelly L Mooney, Lawrence W Bassett, Sophia K AppleAbstract:Optimal management of high-risk breast lesions detected by mammogram yielding atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia, lobular carcinoma in situ , and Radial Scar without atypia on core needle biopsy is controversial. This is a single-institution retrospective review of 5750 core needle biopsy cases seen over 14.5 years, including 249 (4.3%), 72 (1.3%), 50 (0.9%), 37 (0.6%), and 54 (0.9%) cases of atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia, lobular carcinoma in situ , and Radial Scar without atypia, respectively. Patient age, radiologic characteristics, needle gauge, and excision diagnoses were recorded. Of 462 high-risk cases analyzed, 333 (72%) underwent excision. Upgrade rate to ductal carcinoma in situ , pleomorphic carcinoma in situ , or invasive mammary carcinoma was 18% for atypical ductal hyperplasia, 11% for flat epithelial atypia, 9% for atypical lobular hyperplasia, 28% for lobular carcinoma in situ , and 16% for Radial Scar. Carcinoma diagnosed on excision was more likely to be in situ than invasive, and if invasive, more likely to be low grade than high grade. Overall, cases that were benign ( vs high risk or carcinoma) on excision were less likely to have residual calcifications after biopsy (17% vs 27%, P =0.013), and more likely to have a smaller mass size (
-
upgrade rates of high risk breast lesions diagnosed on core needle biopsy a single institution experience and literature review
Modern Pathology, 2016Co-Authors: Kelly L Mooney, Lawrence W Bassett, Sophia K AppleAbstract:Optimal management of high-risk breast lesions detected by mammogram yielding atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia, lobular carcinoma in situ, and Radial Scar without atypia on core needle biopsy is controversial. This is a single-institution retrospective review of 5750 core needle biopsy cases seen over 14.5 years, including 249 (4.3%), 72 (1.3%), 50 (0.9%), 37 (0.6%), and 54 (0.9%) cases of atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia, lobular carcinoma in situ, and Radial Scar without atypia, respectively. Patient age, radiologic characteristics, needle gauge, and excision diagnoses were recorded. Of 462 high-risk cases analyzed, 333 (72%) underwent excision. Upgrade rate to ductal carcinoma in situ, pleomorphic carcinoma in situ, or invasive mammary carcinoma was 18% for atypical ductal hyperplasia, 11% for flat epithelial atypia, 9% for atypical lobular hyperplasia, 28% for lobular carcinoma in situ, and 16% for Radial Scar. Carcinoma diagnosed on excision was more likely to be in situ than invasive, and if invasive, more likely to be low grade than high grade. Overall, cases that were benign (vs high risk or carcinoma) on excision were less likely to have residual calcifications after biopsy (17% vs 27%, P=0.013), and more likely to have a smaller mass size (<1 cm) (82% vs 50%, P=0.001). On subgroup analysis, atypical ductal hyperplasia cases that were benign (vs high risk or carcinoma) on excision were more likely to have smaller mass size (<1 cm) (P=0.025). Lobular neoplasia diagnosed incidentally (vs targeted) on core needle biopsy was less likely to upgrade on excision (5% vs 39%, P=0.002). A comprehensive literature review was performed, identifying 116 studies reporting high-risk lesion upgrade rates, and our upgrade rates were similar to those of more recent larger studies. Careful radiological-pathological correlation is needed to identify high-risk lesion subgroups that may not need excision.
Rachel Q. Liu - One of the best experts on this subject based on the ideXlab platform.
-
Upstage rate of Radial Scar/complex sclerosing lesion identified on core needle biopsy.
American journal of surgery, 2021Co-Authors: Rachel Q. Liu, Leo Chen, Amie Padilla-thornton, Jin-si Pao, Rebecca Warburton, Carol Dingee, Amy Bazzarelli, Elaine MckevittAbstract:Abstract Background We assessed the cancer upstage rate of Radial Scars (RS), and Complex Sclerosing Lesions (CSL), and risk-stratified lesions based on radiological and pathological features. Methods Characteristics of RS/CSL treated from 2013 to 2018 were examined for features associated with cancer. Results 78 RS/CSL were found on core needle biopsy (CNB) and surgically excised. 9 (11.5%) lesions were upstaged. Upstaged patients were older (66 vs 51, p = 0.033). More upstaged lesions were accompanied by a mass on both mammography (87.5% vs. 30.0%, p = 0.005) and ultrasound (100.0% vs. 62.8%, p = 0.043). 20.5% of lesions biopsied under ultrasound guidance with small needles (14-18G) were upstaged, but no lesions biopsied under stereotactic guidance with large needles (9–12 G) with vacuum assistance were upstaged (p = 0.009). Conclusions Excision of RS/CSL seen on CNB is warranted, especially if the patient is older, the CNB is performed under ultrasound guidance with small needles, or if a mass is present on imaging.
-
upstage rate of Radial Scar complex sclerosing lesion identified on core needle biopsy
American Journal of Surgery, 2021Co-Authors: Rachel Q. Liu, Leo Chen, Jin-si Pao, Rebecca Warburton, Amie Padillathornton, Carol DingeeAbstract:Abstract Background We assessed the cancer upstage rate of Radial Scars (RS), and Complex Sclerosing Lesions (CSL), and risk-stratified lesions based on radiological and pathological features. Methods Characteristics of RS/CSL treated from 2013 to 2018 were examined for features associated with cancer. Results 78 RS/CSL were found on core needle biopsy (CNB) and surgically excised. 9 (11.5%) lesions were upstaged. Upstaged patients were older (66 vs 51, p = 0.033). More upstaged lesions were accompanied by a mass on both mammography (87.5% vs. 30.0%, p = 0.005) and ultrasound (100.0% vs. 62.8%, p = 0.043). 20.5% of lesions biopsied under ultrasound guidance with small needles (14-18G) were upstaged, but no lesions biopsied under stereotactic guidance with large needles (9–12 G) with vacuum assistance were upstaged (p = 0.009). Conclusions Excision of RS/CSL seen on CNB is warranted, especially if the patient is older, the CNB is performed under ultrasound guidance with small needles, or if a mass is present on imaging.
Kelly L Mooney - One of the best experts on this subject based on the ideXlab platform.
-
Upgrade rates of high-risk breast lesions diagnosed on core needle biopsy: a single-institution experience and literature review
Modern Pathology, 2016Co-Authors: Kelly L Mooney, Lawrence W Bassett, Sophia K AppleAbstract:Optimal management of high-risk breast lesions detected by mammogram yielding atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia, lobular carcinoma in situ , and Radial Scar without atypia on core needle biopsy is controversial. This is a single-institution retrospective review of 5750 core needle biopsy cases seen over 14.5 years, including 249 (4.3%), 72 (1.3%), 50 (0.9%), 37 (0.6%), and 54 (0.9%) cases of atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia, lobular carcinoma in situ , and Radial Scar without atypia, respectively. Patient age, radiologic characteristics, needle gauge, and excision diagnoses were recorded. Of 462 high-risk cases analyzed, 333 (72%) underwent excision. Upgrade rate to ductal carcinoma in situ , pleomorphic carcinoma in situ , or invasive mammary carcinoma was 18% for atypical ductal hyperplasia, 11% for flat epithelial atypia, 9% for atypical lobular hyperplasia, 28% for lobular carcinoma in situ , and 16% for Radial Scar. Carcinoma diagnosed on excision was more likely to be in situ than invasive, and if invasive, more likely to be low grade than high grade. Overall, cases that were benign ( vs high risk or carcinoma) on excision were less likely to have residual calcifications after biopsy (17% vs 27%, P =0.013), and more likely to have a smaller mass size (
-
upgrade rates of high risk breast lesions diagnosed on core needle biopsy a single institution experience and literature review
Modern Pathology, 2016Co-Authors: Kelly L Mooney, Lawrence W Bassett, Sophia K AppleAbstract:Optimal management of high-risk breast lesions detected by mammogram yielding atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia, lobular carcinoma in situ, and Radial Scar without atypia on core needle biopsy is controversial. This is a single-institution retrospective review of 5750 core needle biopsy cases seen over 14.5 years, including 249 (4.3%), 72 (1.3%), 50 (0.9%), 37 (0.6%), and 54 (0.9%) cases of atypical ductal hyperplasia, flat epithelial atypia, atypical lobular hyperplasia, lobular carcinoma in situ, and Radial Scar without atypia, respectively. Patient age, radiologic characteristics, needle gauge, and excision diagnoses were recorded. Of 462 high-risk cases analyzed, 333 (72%) underwent excision. Upgrade rate to ductal carcinoma in situ, pleomorphic carcinoma in situ, or invasive mammary carcinoma was 18% for atypical ductal hyperplasia, 11% for flat epithelial atypia, 9% for atypical lobular hyperplasia, 28% for lobular carcinoma in situ, and 16% for Radial Scar. Carcinoma diagnosed on excision was more likely to be in situ than invasive, and if invasive, more likely to be low grade than high grade. Overall, cases that were benign (vs high risk or carcinoma) on excision were less likely to have residual calcifications after biopsy (17% vs 27%, P=0.013), and more likely to have a smaller mass size (<1 cm) (82% vs 50%, P=0.001). On subgroup analysis, atypical ductal hyperplasia cases that were benign (vs high risk or carcinoma) on excision were more likely to have smaller mass size (<1 cm) (P=0.025). Lobular neoplasia diagnosed incidentally (vs targeted) on core needle biopsy was less likely to upgrade on excision (5% vs 39%, P=0.002). A comprehensive literature review was performed, identifying 116 studies reporting high-risk lesion upgrade rates, and our upgrade rates were similar to those of more recent larger studies. Careful radiological-pathological correlation is needed to identify high-risk lesion subgroups that may not need excision.
Steven J. Sferlazza - One of the best experts on this subject based on the ideXlab platform.
-
Role of Sonography in Evaluation of Radial Scars of the Breast
AJR. American journal of roentgenology, 2000Co-Authors: Michael A. Cohen, Steven J. SferlazzaAbstract:OBJECTIVE. We investigated the usefulness of sonography in revealing Radial Scars suspected on mammography.CONCLUSION. Many Radial Scars are visible on sonography and, when visible, may present features virtually identical to those of carcinoma of the breast. Findings indicative of a Radial Scar are often more conspicuous on sonography than on mammography; thus, sonography may have a definitive role when evaluating subtle findings suggestive of a Radial Scar or when features of a Radial Scar are evident on only one mammographic view and cannot be localized with certainty.
