Our results suggest that COX-2 is highly expressed in DCIS and takes part in the molecular pathway implicated in progression of breast cancer and may provide a rationale for targeting COX-2 in preinvasive breast cancer therapy.
This simple, inexpensive, and minimally invasive technique makes it possible to avoid the additional cost of a sentinel lymph node biopsy while also sparing the patient the stress of undergoing a second surgery.
During the last 20 years an ever increasing number of nonpalpable breast lesions (NPBL) have been identified. A cytohistological definition is required to establish the correct diagnostic classification of these lesions and the suitable therapy to be used. The Fine-Needle Aspiration Cytology (FNAC), the Advanced Breast Biopsy Instrumentation (ABBI) system or the Vacuum Assisted Core Biopsy (VACB) represent valid alternatives to the surgical excision with needle localisation. 591 NPBL have been included in the present study. The suspected grade of each lesion was then assigned according to the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. All the BI-RADS 4 and 5, and all the BI-RADS 3 lesions, which after 6-month follow-up showed altered morphology, were sampled for cytological and/or histological examinations by FNAC, VACB or biopsy by ABBI system. The diagnostic algorithm used in this study obviated a surgical procedure in 574 women (97.1%), yielding a 73.9% decrease in the cost of diagnosis compared with surgical biopsy, and a 48.1% decrease in cost if all lesions had been histologically tested using ABBI or VACB procedure. Compared to surgical biopsy, VACB and ABBI system are less expensive, and have smaller emotional and aesthetical impact on patients; however they retain the same sensitivity and specificity.
Abstract.Gastrointestinal stromal tumors (GISTs) represent 0.1-1% of gastrointestinal malignancies. They are commonly asymptomatic and found incidentally during laparoscopy, surgical procedures or radiological studies. Diagnosis is based on histology and immunohistochemistry, while the role of imaging studies is not diagnosis-specific. We present the case of a 38-year-old patient complaining of an increase in her abdominal circumference. Consequently, a vaginal examination, a transvaginal ultrasound and an MRI of the abdomen and pelvis were carried out. It should be noted that a preoperative diagnosis of GISTs is uncommon, due to the rarity and many presentations of the disease. Ultrasound and MRI are not able to differentiate a GIST from ovarian cancer. However, if a pelvic mass is detected, the possibility of a nongynaecological tumor has to be considered. IntroductionGastrointestinal stromal tumors (GISTs) represent 0.1-1% of gastrointestinal malignancies (1). They are the most common mesenchymal tumors of the gastrointestinal tract. Generally, they are asymptomatic and found incidentally during surgical procedures or radiological studies. When symptomatic, these tumors tend to present as GI bleeding, abdominal mass or abdominal pain (2).GIST may arise anywhere in the tubular gastrointestinal tract from the oesophagus to the rectum (3,4). Identical lesions may occur in extra-intestinal locations such as the mesentery, omentum and retroperitoneum, while exceptional sites are include the gallbladder or bladder (5). In terms of distribution, 50-60% of lesions arise in the stomach, 20-30% in the small bowel, 10% in the large bowel, 5% in the oesophagus and 5% elsewhere in the abdominal cavity (5-7).Diagnosis is based on histology and immunohistochemistry. In the past, GISTs were considered to be part of GI leiomyomas, leiomyosarcomas, leiomyoblastomas and the schwannomas group (Table I) as a result of their histological findings and apparent origin in the muscolaris propria layer of the intestinal wall. With the advent of immunohistochemical staining techniques and ultrastructural evaluation, GISTs are now recognized as a distinct group of mesenchymal tumors. They originate from the interstitial cell of Cajal, a cell type which shares immunophenotypical and ultrastructural features of muscle and neuronal cells. Moreover, 95% of GISTs show KIT (CID117) immunopositivity, which is a specific marker for the tumor. Aside from consistent positivity for KIT, 60-70% of GISTs show immunopositivity for CD34, 30-40% for smooth-muscle actin (SMA) and 5% for the S-100 protein.As regards their development, ~20-30% of GISTs show malignant behaviour. A large size and high mitotic activity have been strongly associated with malignancy, while very low risk is characterised by tumors <2 cm and <5 mitosis/50 high power fields. Nevertheless, a small size and the absence of mitotic activity do not preclude malignant behaviour (8).GISTs do not generally metastasize to the regional lymph node but spread hematogenously to the liver or me...
Cyclooxygenase-2 (COX-2) is highly expressed in human intraepithelial neoplasia of the breast and takes part in the molecular pathway implicated in progression of breast cancer. Recently, we demonstrated that COX-2 protein is mainly located in plasma membrane of lobular intraepithelial neoplasia (LIN) cells suggesting a localization in caveolae-like structures. The aim of the present study is to establish subcellular locations of COX-2 and its colocalization with caveolin-1 (CAV-1) to caveolae structures in LIN. To establish a relationship between COX-2 and CAV-1, 39 LINs were studied by immunohistochemistry and confocal microscopy analysis. COX-2 and CAV-1 expression was observed respectively in 79.5 and in 94.9% of LIN studied. A positive correlation was found between membrane COX-2 staining pattern and CAV-1 expression, while no correlation was found between cytoplasm COX-2 staining pattern and CAV-1. Confocal analysis showed that COX-2 localized to plasma membrane was strictly associated to CAV-1 suggesting that an amount of COX-2 protein is placed in caveolae-like structures. Our results show that COX-2 is localized within caveolae compartment and colocalized with CAV-1 protein in LIN lesions. Because caveolae are rich in signaling molecules, this COX-2 compartment may play an important role in diverse breast cancer carcinogenesis processes.
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