Atypia Involving Fibroadenomas: Outcomes and Upgrade Rates.

Objective: Fibroadenomas (FAs) involved by atypia are rare. Consensus guidelines for management of FAs involved by atypia when diagnosed on image-guided biopsy do not exist because of limited data reporting surgical upgrade rates to ductal carcinoma in situ (DCIS) or invasive malignancy. Therefore, these lesions commonly undergo surgical excision.

Use of Ultrasound and Ki-67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy.

Background: Prediction of tumor shrinkage and pattern of treatment response following neoadjuvant endocrine therapy (NET) for estrogen receptor positive (ER+), Her2 negative (Her2-) breast cancers have had limited assessment. We examined if ultrasound (US) and Ki-67 could predict the pathologic response to treatment with NET and how the pattern of response may impact surgical planning.

Methods: A total of 103 postmenopausal women with ER+, HER2- breast cancer enrolled on the FELINE trial had Ki-67 obtained at baseline, day 14, and surgical pathology.

Intraoperative sentinel lymph node evaluation in patients with node-positive breast cancer status post neoadjuvant systemic therapy - An institutional experience.

Recent studies have shown the feasibility and utility of sentinel lymph node (SLN) biopsy in patients with biopsy proven node-positive breast cancer after neoadjuvant chemotherapy. We reviewed our experience in intraoperative SLN evaluation in such cases and its effect on axillary management. A retrospective analysis of breast cancer patients (2015-2018) with a biopsy-proven positive axillary lymph node, who received neoadjuvant systemic therapy and underwent intraoperative SLN assessment was performed.

Malignancy-associated acquired vulvar lymphangioma circumscriptum: A clinicopathologic study of 71 cases.

Background: Acquired lymphangioma circumscriptum of the vulva is rare and can occur subsequent to malignancies of the anogenital and pelvic region. We sought to investigate the clinicopathologic characteristics of malignancy-associated acquired vulvar lymphangioma circumscriptum (AVLC).

Methods: We identified all cases of AVLC within our institution with history of prior malignancy between 2005 and 2021.

A rare case of group A streptococcal toxic-shock syndrome in a postpartum adolescent leading to multi-organ failure.

Teenage pregnancy is not uncommon, but given the age of the patient, experience, and competency among medical providers varies. While toxic-shock syndrome from group A streptococcus is rare in teenage pregnancy, observed is a gap in care of bridging.

Bariatric surgery-induced weight loss changes immune markers in the endometrium of morbidly obese women.

Background: Obesity has been linked to abnormal estrogen regulation, endometrial hyperplasia, and endometrial cancer (EC). Our group has shown that hormone receptor expression profiles in the endometria of morbidly obese women change with weight loss, in some cases concordantly with resolving hyperplasia; however other potential drivers of neoplasia, including altered immunologic tolerance exist. The objective of this study was to evaluate the effect of bariatric surgery induced weight loss on the expression patterns of nonhormone receptor biomarkers associated with cancer and immunity.

Immunohistochemical profile of breast cancer with respect to estrogen receptor and HER2 status.

There are a few studies that have evaluated a panel of stains on a single large data set of breast cancers, which is required for direct comparison between antibodies. The immunohistochemical panel in this study was chosen to include breast-specific markers and markers that are expressed in tumors resembling breast cancer. The individual marker positivity in decreasing order was 95% (177/186) for GATA-3, 92% (172/186) for cytokeratin (CK)7, 80% (151/189) for AR, 80% for estrogen receptor (158/198), 69% for progesterone receptor (137/198), 55% (105/190) for NY-BR-1, 52% (99/189) for mammaglobin, 31% (59/191) for vimentin, 26% (51/195) for GCDFP-15, 0.

Low ER+ breast cancer: Is this a distinct group?

Objectives: Estrogen receptor (ER) level can be semiquantified by immunohistochemistry (IHC) using the H-score. The score, given as the sum of the percent staining multiplied by the intensity level, ranges from 0 to 300.

Methods: Forty-nine ER+/HER2- invasive tumors with low ER expression (H-scores of 1-100, representing approximately 5% of all tumors) were studied for various morphologic parameters, progesterone receptor (PR), and Ki-67 IHC.

Hormone receptor expression patterns in the endometrium of asymptomatic morbidly obese women before and after bariatric surgery.

Objective: Obesity increases risk for endometrial neoplasia, but neither the pathophysiology nor the effects of weight loss on the risk are well established. We attempted to characterize the molecular profile of the endometrium of asymptomatic women with morbid obesity before and following bariatric surgery-induced weight loss.

Methods: 59 asymptomatic, morbidly obese women underwent endometrial sampling before bariatric surgery; 46 (78%) of these returned one year later for re-biopsy (median weight loss of 41kg).

Microinvasive breast carcinoma carries an excellent prognosis regardless of the tumor characteristics.

The clinical implication of microinvasive breast carcinoma (MIBC), especially when multiple foci are identified, is still not clearly defined. This study is designed to collect clinicopathologic and follow up data on patients with MIBC. Histologic data including invasive breast cancer type, nuclear grade, number of microinvasive foci and lymph node status, as well as associated in situ component histologic and biomarkers parameters were recorded.

Outcomes of breast cancer patients with micrometastases and isolated tumor cells in sentinel lymph nodes.

Background: The prognostic value and clinical implication of micrometastases and isolated tumor cells (ITCs) in sentinel lymph nodes are still not clearly defined. This study was designed to collect clinical pathological data in our Institution.

Patients And Methods: Twenty-five cases of micrometastases and nine cases of ITCs were identified among 1,000 sentinel lymph node biopsies performed at our institution in the last 10 years.