No abstract

Breast neoplasms are becoming more common in the last few years. Among these masses, metastasis to the breast is rare. Extra-gestational choriocarcinoma is extremely rare among breast neoplasms. We intend to present a case of a 30-year-old female with complaints of breast and axillary lumps. She had a history of a previously treated uterine trophoblastic tumor. Subsequently, she underwent a trucut biopsy of the breast mass and the axillary node, revealing metastatic choriocarcinoma.

Persistent left superior vena cava (SVC) is a rare but vital congenital anomaly of the thoracic venous system. It is the persistence of vessel that normally regresses during early foetal life. It has utmost importance in intervention radiology, cardiothoracic procedures and insertion of the central venous line as well as in trauma. The vessel can drain into the right atrium through the coronary sinus, directly into left atrium or through pulmonary veins. It is usually detected during routine investigations and requires surgical treatment. In our case, SVC persists on both right and left sides with enlarged coronary sinus incidentally detected during follow-up for breast cancer.Key words: Persistent left superior vena cava, superior vena cava, vascular variant

Objectives: To determine false negative rate, negative predictive value and the factors predicting false negativity of pre-treatment axillary ultrasound. Method: The retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, and comprised data from January 2019 to December 2020 of patients with normal lymph nodes on ultrasound, tumour stages T1, T2 or T3 having invasive cancer who underwent sentinel lymph node biopsy. Ultrasound findings were compared with the biopsy results, dividing the sample into false negative group A and true negative group B. Clinical, radiological, histopathological parameters and therapeutic strategies were compared between the two groups. Data was analysed using SPSS 20. Results: Of the 781 patients with mean age 49.39±11.51 years, 154(19.7%) were in group A and 627(80.2%) were in group B, with negative predictive value of 80.2%. Initial tumour size, histopathology, tumour grade, receptors, timing of chemotherapy, and type of surgery has significant difference between the groups (p<0.05). Multivariate analysis showed larger, high-grade, progesterone receptor negative and human epidermal growth factor receptor 2 positive tumours were significantly associated with lower false negative rate on axillary ultrasound (p<0.05). Conclusion: Axillary ultrasound was found to be effective in ruling out axillary nodal disease, especially in patients with high-burden axillary disease, aggressive tumour biology, larger tumour size and higher timour grade. Key Words: Axillary ultrasound, Sentinel lymph node biopsy, Early breast cancer, False negativity.

Aim To analyze the histopathological outcome of stereotactic biopsies of newly developed suspicious calcifications at lumpectomy scar site in patients with breast conservation surgery (BCS) to determine the incidence of malignancy and the association of mammographic appearance of recurrent microcalcification and their distribution. We also determined the association of disease recurrence with the presence of calcifications in original tumor and lumpectomy resection margins with the risk of recurrence. Materials and methods This study is a retrospective review of mammograms of patients with breast cancer from 2010 to 2021 who underwent stereotactic biopsy of newly developed suspicious calcifications at scar site appreciated on annual follow-up mammogram after breast conservation surgery (BCS) with no mass on correlative ultrasound. The radiological and pathological features of the patients' primary tumor and new calcifications were obtained from the hospital's electronic patient record system. Results A total of 84 patients with breast cancer developed suspicious microcalcifications at the lumpectomy scar site detected on follow-up mammograms after BCS, and 28.6% showed malignant histopathological outcomes. All malignant cases demonstrated pleomorphic morphology. All amorphous (9.5%) and coarse heterogeneous (54.8%) calcifications were benign. The distribution pattern of recurrent malignant calcifications was grouped in 9.5%, regional in 2.4%, linear in 9.5%, and segmental in 7.1%. Calcifications in primary tumors were found in 20.2% of cases. Positive margins were found in 7.1% of these malignant cases. Statistically, there was a strong association between calcification morphology, calcification distribution, presence of calcifications on baseline mammogram, and tumor resection margins. The presence of calcifications in primary tumors and positive resection margins were identified as significant independent risk factors of malignant recurrent calcifications in the logistic regression model and marginal statistical significance in the multivariable logistic regression (MLR) model. Conclusion The interval development of pleomorphic calcifications after BCS with either linear or segmental pattern, positive resection margins, and associated calcifications in primary tumors was related to the increase in the risk of recurrence. Although amorphous and coarse heterogeneous morphology with grouped distribution showed benign outcomes, stereotactic biopsy is recommended to exclude disease recurrence in this high-risk patient population.