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Nio Y.,Nio Breast Surgery Clinic | Iguchi C.,Nio Breast Surgery Clinic | Tsuboi K.,Nio Breast Surgery Clinic | Maruyama R.,The University of Shimane
Oncology Letters | Year: 2011

Phyllodes tumor (PT) is a rare type of breast tumor that rarely occurs with breast carcinoma. This study evaluated a 53-year-old female patient with a benign PT with ductal carcinoma in situ (DCIS) within the tumor. A firm, painless, well-demarcated tumor measuring 4-5 cm was noted in the left breast. Over the course of the previous 14 years, the patient underwent excision of a breast tumor four times at the same site in the left breast. The pathological diagnosis of the first tumor was a fibroadenoma (FA), and those of the following three were benign PTs. The tumor was the 5th one noted over the course of the previous 14 years, following the previously recorded surgeries. A firm tumor with a diameter of 3.5 cm was located beneath the scar from the previous surgery, just above the nipple of the left breast. Mammography revealed a high-density irregularly shaped mass with a clear margin. An ultrasound showed low but heterogeneous echogenicity. A computed tomography scan revealed a well-defined enhanced tumor. These image examinations were compatible with recurrent PT. Fine-needle aspiration cytology revealed that the tumor was likely a benign FA. The patient underwent a partial mastectomy with a 1.0 cm margin from the tumor edge, and the firm, attached scar tissue was also resected. Macroscopic examination showed a hard elastic mass, which was encapsu- lated by thin fibrous tissue and which adhered firmly to the adjacent scar tissue. Microscopic examination showed a 5 mm in diameter DCIS of the cribiform type in a section of the PT epithelial component with an apparently benign stroma. The DCIS cells were strongly positive for estrogen and proges- terone receptors, but HER2 expression was negative (score 0). The patient received local irradiation following surgery and no evidence of recurrence or metastasis was detected in the 2 years following surgery. This was a noteworthy case of a DCIS arising in benign PT. To the best of our knowledge, a total of 28 breast carcinomas were previously reported to arise in PT. In this case report, a female patient who presented with a PT was evaluated. A review of the literature is also discussed. Source


Nio Y.,Nio Breast Surgery Clinic | Tsuboi K.,Nio Breast Surgery Clinic | Tamaoki M.,Nio Breast Surgery Clinic | Maruyama R.,The University of Shimane
Anticancer Research | Year: 2012

Lymphoepithelioma-like carcinoma (LELC) of the breast is a very rare tumor, and fewer than 20 cases have been reported. A recent report suggested the implication of human papilloma virus (HPV) in the pathogenesis of breast LELC. We report a case of LELC of the breast with a review of its relevance to an association with HPV. A 45-year-old female patient presented with a solid mass in the outer-upper part of her left breast, which was diagnosed as malignant (ductal carcinoma) by fine-needle aspiration cytology. The patient underwent a quadrantectomy of the breast and axillary sentinel node biopsy. Pathological examination revealed cohesive sheets or nests of malignant epithelial cells, with unclear circumscription in a background of diffuse lymphoid infiltration; the postsurgical clinical stage was pT1pNOMO, stage 1. Immunohistochemistry demonstrated that the tumor was triple negative and basal-like breast cancer. In the present case in situ hybridization demonstrated positive HPV signals in a few tumor cells; however, polymerase chain reaction study failed to detect HPV in tumor cells. Conclusion: To the best of our knowledge, this is the second report on HPV infection associated with breast LELC. Source


Tamaoki M.,Nio Breast Surgery Clinic | Nio Y.,Nio Breast Surgery Clinic | Tsuboi K.,Nio Breast Surgery Clinic | Nio M.,Nio Breast Surgery Clinic | Maruyama R.,The University of Shimane
Oncology Letters | Year: 2014

The double presentation of breast cancer and follicular lymphoma is extremely rare, and only six cases have previously been reported in the literature. In the present study, a case of synchronous ductal carcinoma in situ (DCIS) of the breast and follicular lymphoma is reported. During an annual breast screening procedure, a 49-year-old female presented with a hard induration under the nipple of the right breast and swelling of a soft lymph node (LN) in the right axilla. Mammography and ultrasonography revealed two lesions in the right breast: One was a tumor with microcalcification, 1.0 cm in diameter, and the other was a large, crude calcification, 2.5 cm in diameter. In addition, computed tomography and positron emission tomography revealed swellings of the bilateral axillary (Ax) LN and intra-abdominal para-aortic LN. The patient underwent excisions of the large calcified mass, a micro-calcified tumor and the right AxLN. The pathological and immunohistochemical studies revealed fat necrosis and DCIS of the breast, which was positive for the estrogen receptor and the progesterone receptor, while human epidermal growth factor receptor II protein expression was evaluated as 2+ and stage was classified as pTis pN0 M0, stage 0. Furthermore, the Ax node was diagnosed as follicular lymphoma, which was positive for cluster of differentiation (CD)20, CD79a, CD10 and B-cell lymphoma (Bcl)-2 protein, but negative for Bcl-6 protein. The clinical stage was classified as stage III. The patient was administered chemotherapy followed by radiotherapy to the conserved breast. Two years have passed since the surgery, and the patient is disease-free. Source

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