Breast Diseases

乳腺疾病
  • 文章类型: Review
    浆细胞性乳腺炎(PCM)是一种慢性乳腺炎症性疾病。它是一种良性实体,主要见于非孕妇和非哺乳期妇女。PCM表现出炎症症状,乳房红斑,群众,和坚持。我们在此描述了一名26岁的女性,在怀孕和哺乳期间有2年的右乳房肿胀史和1年的左乳房肿胀史。她被临床诊断为双侧乳腺癌,但活检标本显示PCM.在怀孕和哺乳期间,PCM可表现为双侧病变。早期表现和诊断至关重要,因为PCM,良性疾病,如果允许进展到晚期,可能会导致显著的发病率。
    Plasma cell mastitis (PCM) is a chronic inflammatory disease of the breast. It is a benign entity mainly found in nonpregnant and nonlactating women. PCM presents with symptoms of inflammation, breast erythema, masses, and indurations. We herein describe a 26-year-old woman with a 2-year history of right breast swelling and a 1-year history of left breast swelling during pregnancy and lactation. She was clinically diagnosed with bilateral breast cancer, but a biopsy specimen revealed PCM. During pregnancy and lactation, PCM can present as bilateral lesions. Early presentation and diagnosis are crucial because PCM, a benign disease, can lead to remarkable morbidity if allowed to progress to an advanced stage.
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  • 文章类型: Journal Article
    对比增强乳房X线照相术(CEM)是一种相对较新的诊断技术,在临床实践中越来越多地使用。直到最近,CEM结果缺乏标准化报告。然而,随着乳腺影像学报告和数据系统(BI-RADS)的增刊的发布,这种情况发生了变化.全面了解CEM对于进一步增强其在筛查和管理乳腺恶性肿瘤患者中的作用至关重要。CEM也可以有利于解决问题,改善不确定的乳房发现的管理。该领域的从业者应该更加了解如何以及何时采用这种技术并解释各种CEM发现。本文旨在概述专门针对CEM的BI-RADS更新版本中的关键发现。此外,它将介绍一些临床实践中经常遇到的临床病例。关键相关性声明标准化报告和对CEM结果的透彻理解对于提高CEM在筛查和管理乳腺癌患者中的作用至关重要。这种标准化显著有助于将CEM整合为日常临床实践的重要组成部分。关键点•全面了解和理解新的BI-RADSCEM中概述的发现对于准确报告是必要的。•BI-RADSCEM补充是直观和实用的使用。•CEM发现的标准化能够实现更准确的患者管理。
    Contrast-enhanced mammography (CEM) is a relatively recent diagnostic technique increasingly being utilized in clinical practice. Until recently, there was a lack of standardized reporting for CEM findings. However, this has changed with the publication of a supplement in the Breast Imaging Reporting and Data System (BI-RADS). A comprehensive understanding of CEM is essential for further enhancing its role in both screening and managing patients with breast malignancies. CEM can also be beneficial for problem-solving, improving the management of uncertain breast findings. Practitioners in this field should become more cognizant of how and when to employ this technique and interpret the various CEM findings. This paper aims to outline the key findings in the updated version of the BI-RADS specifically dedicated to CEM. Additionally, it will present some clinical cases commonly encountered in clinical practice.Critical relevance statement Standardized reporting and a thorough understanding of CEM findings are pivotal for advancing the role of CEM in screening and managing breast cancer patients. This standardization contributes significantly to integrating CEM as an essential component of daily clinical practice.Key points • A complete knowledge and understanding of the findings outlined in the new BI-RADS CEM are necessary for accurate reporting.• BI-RADS CEM supplement is intuitive and practical to use.• Standardization of the CEM findings enables more accurate patient management.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    目的:研究非洲女性异质性人群中良性乳腺疾病(BBD)与乳腺癌(BC)的相关性。
    方法:在三个撒哈拉以南非洲国家登记了BC病例和对照,尼日利亚,喀麦隆,乌干达,1998年至2018年。采用多变量logistic回归分析BBD与BC的相关性。选择与BBD和BC双重相关的危险因素。使用参数中介分析模型,我们评估了选定的BC危险因素是否由BBD介导。
    结果:在6,274名参与者中,55.6%(3,478例)为乳腺癌。360(5.7%)自我报告BBD。纤维腺瘤(46.8%)是最常见的BBD。自我报告有BBD病史的女性比没有BBD病史的女性发生BC的几率更大(调整后的比值比[aOR]1.47,95%CI1.13-1.91)。活检证实的BBD与BC相关(aOR2.25,95%CI1.26-4.02)。BBD没有显著介导任何选定的BC危险因素的作用。
    结论:在这项研究中,BBD与BC相关,并不显著介导选定BC危险因素的影响。
    OBJECTIVE: To examine the association between benign breast disease (BBD) and breast cancer (BC) in a heterogeneous population of African women.
    METHODS: BC cases and controls were enrolled in three sub-Saharan African countries, Nigeria, Cameroon, and Uganda, between 1998 and 2018. Multivariable logistic regression was used to test the association between BBD and BC. Risk factors dually associated with BBD and BC were selected. Using a parametric mediation analysis model, we assessed if selected BC risk factors were mediated by BBD.
    RESULTS: Of 6,274 participants, 55.6% (3,478) were breast cancer cases. 360 (5.7%) self-reported BBD. Fibroadenoma (46.8%) was the most commonly reported BBD. Women with a self-reported history of BBD had greater odds of developing BC than those without (adjusted odds ratio [aOR] 1.47, 95% CI 1.13-1.91). Biopsy-confirmed BBD was associated with BC (aOR 2.25, 95% CI 1.26-4.02). BBD did not significantly mediate the effects of any of the selected BC risk factors.
    CONCLUSIONS: In this study, BBD was associated with BC and did not significantly mediate the effects of selected BC risk factors.
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  • 文章类型: Review
    乳腺胆固醇肉芽肿是罕见的良性病变,临床和放射学发现提示癌症。在这里,我们介绍了一个52岁的女性,没有明显的既往病史,她去门诊部做例行乳房检查。体格检查发现左乳房外上象限有一个无痛的可触及结节,测量0.7厘米。在成像方面,肿块符合乳腺影像报告和数据系统(BI-RADS)4B类标准.随后,对肿块进行了芯针活检.尽管有令人震惊的放射学特征,镜检结果与乳腺胆固醇肉芽肿一致.
    Cholesterol granuloma of the breast is an infrequent benign lesion with clinical and radiological findings suggestive of cancer. Herein, we present the case of a 52-year-old woman with no significant past medical history, who presented to the outpatient department for her routine breast screening. Physical examination revealed a painless palpable nodule in the upper external quadrant of the left breast, measuring 0.7 cm. On imaging, the mass met the criteria for Breast Imaging Reporting and Data System (BI-RADS) category 4B. Subsequently, a core needle biopsy of the mass was performed. Despite the alarming radiologic features, microscopic findings were consistent with breast cholesterol granuloma.
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  • 文章类型: Review
    异位乳腺肿瘤的发展并不常见,而腋窝异位乳腺叶状肿瘤的发展更为罕见。我们报告了一例罕见的51岁女性病例,该女性在右腋下出现肿胀和疼痛的抱怨,在其他器官中没有相关的抱怨。磁共振成像提示转移性淋巴结病的可能性。对右腋窝肿块进行了完全切除,并进行了组织病理学检查,对其进行了彻底检查并进行了切片。在显微镜检查中,可见叶样模式的基质增殖,具有轻度的基质异型性和边界的局灶性渗透,并诊断为腋窝异位交界叶状肿瘤,这是非常罕见的,需要从其紧密的区别,如纤维腺瘤和导管周围间质肉瘤。
    Development of a neoplasm in an ectopic breast is uncommon, while the development of phyllodes tumor in an ectopic breast in the axilla is even rarer. We report a rare case of a 51-year-old female who presented with a complain of swelling and pain in the right axilla with no associated complaints in other organs. Magnetic resonance imaging suggested a possibility of metastatic lymphadenopathy. Complete excision of the right axillary mass was performed and sent for histopathological examination which was examined thoroughly and sections were given. On microscopic examination, stromal proliferation in a leaf-like pattern with mild stromal atypia and focal permeation of borders were seen, and a diagnosis of Ectopic borderline phyllodes tumor in axilla was made, which is extremely rare and needs to be differentiated from its close differentials like fibroadenoma and periductal stromal sarcoma.
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  • 文章类型: Case Reports
    这项研究描述了一例罕见的男性肉芽肿性小叶性乳腺炎(GLM),在同侧不同部位复发。一名48岁男性患者,既往无乳腺相关疾病史,体格检查显示右乳房有肿块。超声检查显示右侧乳房有囊肿和感染。实验室分析未见明显异常。芯针活检显示GLM。右侧病灶切开引流,症状在几周内缓解。在这一初步陈述后的两年里,患者报告饮酒后,右乳肿块再次出现在不同位置。相关检查和芯针活检再次提示右乳GLM。患者拒绝激素治疗,随后失去随访。在审查了这个案子之后,这个病人的病程,以及男性乳房发育症和GLM之间的联系,伴随着同侧复发,正在调查中。
    This study describes a rare case of male granulomatous lobular mastitis (GLM) with recurrence in different sites on the ipsilateral side. A 48-year-old male patient presented with no previous history of breast-related disease, and physical examination suggested a mass in the right breast. Ultrasonography revealed a cyst and infection in the right breast. No obvious abnormality was found in laboratory analysis, and a core needle biopsy revealed GLM. Incision and drainage were applied to the right lesion, and symptoms resolved within a few weeks. At 2 years following this initial presentation, the patient reported that the right breast mass reappeared in different locations after the consumption of alcohol. Relevant examination and a core needle biopsy again suggested GLM of the right breast. The patient declined hormone therapy and was subsequently lost to follow-up. After reviewing this case, the course of the disease in this patient, and the connection between gynecomastia and GLM, along with ipsilateral recurrence, are under investigation.
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  • 文章类型: Case Reports
    背景:糖尿病性乳腺病是一种罕见的乳房疾病,发生在糖尿病控制不佳的女性中,其特征是乳房组织硬化。本病例报告的目的是概述这种罕见疾病的临床特征和治疗原则,以支持一线医师进行病例识别的关键活动。
    方法:一名有II型糖尿病病史的64岁亚洲女性患者被转诊到我们的诊所评估新发现的乳腺肿块。该患者在20多年前被诊断患有糖尿病,并正在接受口服降糖药的治疗。她过去的病史在其他方面并不引人注目。乳房的体格检查显示,mobile,右乳上腹6×4cm实性肿块。超声图像显示不均匀的低回声结节,BI-RADS4B.乳房X线照相术显示两个乳房的紧凑和片状性质,并且实质性密度的异质性增加。患者的临床表现和影像学表现提示乳腺癌的可能性。患者选择手术切除肿块。通过手术,肿块完全切除,切缘阴性.肿块的病理检查显示成纤维细胞增殖,随着核/细胞质比率的增加,与糖尿病性乳腺病变的诊断一致.
    结论:本病例报告强调了认识糖尿病性乳腺病作为糖尿病患者乳腺肿块的可能鉴别诊断的重要性。在我们的病人身上,乳房肿瘤切除术的早期诊断和治疗结果良好,强调及时医疗和手术管理的重要性。此外,需要更多的研究来挖掘糖尿病性乳腺病的诊断标记物,并提供与其预后相关的数据.
    BACKGROUND: Diabetic mastopathy is a rare breast condition that occurs in women with poorly controlled diabetes and is characterized by hardening of the breast tissue. The purpose of this case report is to provide an overview of the clinical characteristics and therapeutic principles of this rare disease to support front-line physicians in their crucial activity of case identification.
    METHODS: A 64-year-old Asian female patient with a history of type II diabetes mellitus was referred to our clinic for an evaluation of a newly discovered breast mass. The patient had been diagnosed with diabetes more than 20 years prior and was being managed with oral hypoglycemic agents. Her past medical history was otherwise unremarkable. Physical examination of the breast revealed a palpable, mobile, and firm mass measuring 6 × 4 cm in the upper quadrant of the right breast. Ultrasound images showed an uneven hypoechoic nodule, BI-RADS 4B. Mammography showed the compact and flaky nature of the two breasts and the heterogeneity of the substantive density increases. The patient\'s clinical manifestations and imaging findings suggest the possibility of breast cancer. The patient opted for surgical excision of the mass. Through surgery, the mass was completely excised with negative margins. Pathological examination of the mass revealed a proliferation of fibroblastic cells, with an increased nuclear/cytoplasmic ratio, consistent with a diagnosis of diabetic mastopathy.
    CONCLUSIONS: This case report serves to highlight the importance of recognizing diabetic mastopathy as a possible differential diagnosis of a breast mass in patients with diabetes mellitus. In our patient, early diagnosis and treatment with lumpectomy resulted in a favorable outcome, emphasizing the importance of prompt medical and surgical management. In addition, more research is needed to mine the diagnostic marker of diabetic mastopathy and provide data related to its prognosis.
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  • 文章类型: Case Reports
    特发性肉芽肿性乳腺炎(IMD)是一种慢性良性乳腺炎症性疾病,可以模仿乳腺癌。它在育龄的年轻女性中更为常见,并且对炎症性乳腺肿瘤的诊断提出了挑战。我们报告了一名26岁女性患者的情况,该患者患有炎症性乳房。临床检查显示,脱口症患者的左乳房有水肿和无痛的不规则光滑肿块,大小为4厘米,上面有结皮和多发的疤痕,通过施加压力排出脓液,伴有同侧移动腋窝腺病。其余的体格检查显示两条腿上有炎性红斑。进行乳房X线照片加乳房超声检查,然后进行活检,以客观地诊断纤维性乳腺病。由于症状的持续进行了肿块切除术。解剖病理学检查客观化肉芽肿性乳腺炎。病因研究没有确定明确的原因。与抗生素治疗相关的皮质治疗开始,两个月后症状完全消退。
    Idiopathic granulomatous mastitis (IMD) is a chronic benign inflammatory disease of the breast which can mimic breast cancer. It is more common in young women of childbearing age and poses a challenge in diagnosis of inflammatory breast tumor. We report the case of a 26-year-old female patient who presented with inflammatory breast. Clinical examination showed apyretic patient with edematized and painless irregular smooth mass in the left breast measuring 4 cm surmounted by crusts and multiples fistulizing scars discharging pus by applying pressure, with mobile ipsilateral axillary adenopathy. The remainder of the physical examination showed inflammatory erythematous patches on both legs. A mammogram plus breast ultrasound was performed followed by biopsy that objectified fibrous mastopathy. Lumpectomy was performed due to the persistence of symptoms. Anatomopathological examination objectified granulomatous mastitis. Etiological research didn\'t identify a clear cause. Corticotherapy associated with antibiotic therapy was started with complete regression of symptoms after two months.
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  • 文章类型: Journal Article
    目的:动脉粥样硬化性心血管疾病(ASCVD)是发病和死亡的主要原因。乳房X线照片上的乳腺动脉钙化(BAC)与乳腺癌风险无关。然而,越来越多的证据支持其与心血管疾病(CVD)的相关性.这项研究在一项基于澳大利亚人群的乳腺癌研究中检查了BAC和ASCVD之间的关联及其危险因素。
    方法:将参与乳腺癌环境和就业研究(BCEES)的对照组的数据与西澳大利亚州卫生部医院发病率数据库和死亡率登记相关联,以获得ASCVD结果和相关危险因素数据。放射科医生评估了没有ASCVD病史的参与者的乳房X线照片的BAC。Cox比例风险回归用于检查BAC与ASCVD事件后期发生之间的关联。采用Logistic回归分析探讨BAC的相关因素。
    结果:共纳入了1020名平均年龄为60岁(sd=7.0岁)的女性,纳入了184名(18.0%)的BAC。1020名参与者中有80名(7.8%)患有ASCVD,事件发生的平均时间为距基线6.2年(sd=4.6)。在单变量分析中,BAC患者更有可能发生ASCVD事件(HR=1.9695%CI1.29~2.99).然而,在调整了其他风险因素后,这种关联减弱(HR=1.3795%CI0.88-2.14).年龄(OR=1.15,95%CI1.12-1.19)和产次(pLRT<0.001)与BAC相关。
    结论:BAC与ASCVD风险增加相关,但这并非独立于心血管危险因素。
    OBJECTIVE: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality. Breast arterial calcification (BAC) on mammograms is not associated with breast cancer risk. However, there is increasing evidence supporting its association with cardiovascular disease (CVD). This study examines the association between BAC and ASCVD and their risk factors within an Australian population-based breast cancer study.
    METHODS: Data from the controls who participated in the breast cancer environment and employment study (BCEES) were linked with the Western Australian Department of Health Hospital Morbidity database and Mortality Registry to obtain ASCVD outcomes and related risk factor data. Mammograms from participants with no prior history of ASCVD were assessed for BAC by a radiologist. Cox proportional hazards regression was used to examine the association between BAC and later occurrence of an ASCVD event. Logistic regression was used to investigate the factors associated with BAC.
    RESULTS: A total of 1020 women with a mean age of 60 (sd = 7.0 years) were included and BAC found in 184 (18.0%). Eighty (7.8%) of the 1020 participants developed ASCVD, with an average time to event of 6.2 years (sd = 4.6) from baseline. In univariate analysis, participants with BAC were more likely to have an ASCVD event (HR = 1.96 95% CI 1.29-2.99). However, after adjusting for other risk factors, this association attenuated (HR = 1.37 95% CI 0.88-2.14). Increasing age (OR = 1.15, 95% CI 1.12-1.19) and parity (pLRT < 0.001) were associated with BAC.
    CONCLUSIONS: BAC is associated with increased ASCVD risk, but this is not independent of cardiovascular risk factors.
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