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7th International Conference on Breast Pathology and Cancer Diagnosis, will be organized around the theme “Modern Innovation to Breast Cancer Research”
Breast Pathology 2019 is comprised of keynote and speakers sessions on latest cutting edge research designed to offer comprehensive global discussions that address current issues in Breast Pathology 2019
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There are trillions of cells in the body. These cells have regulated cell cycle that controls their growth, maturity, division, and death. During childhood, normal cells replicate faster to allow the person to grow. Once adulthood is reached the cells divide to replace worn-out cells and to repair injuries. This cell division and growth is controlled by the cellular blueprint or DNA and genes that lie within the cell’s nucleus. Cancer initiate when cells in a part of the body start to grow out of control. All types of cancer, irrespective of their origin, occur due to this uncontrollable growth of cells that leads to the formation of tumors and lesions. These cells have longer lifespans and instead of dying to continue to grow and form new, abnormal cells. Cancer cells can also invade other tissues. This property is called metastasis. Cancer cells grow into tumors that are supplied to blood vessels. This is called angiogenesis. Damage to the DNA and genetic mutations can also lead to breast cancer have been experimentally linked to estrogenic exposure. Some individuals inherit defects in the DNA and genes like the BRCA1, BRCA2, and P53 among others. Those with a family history of ovarian or breast cancer thus are at an increased risk of breast cancer.
In Grading of Breast Cancer, Histological grade provides important prognostic and management information. The internationally accepted system is that defined by Elston and Ellis1. Grading is Assess by evaluating acinar formation, nuclear size/pleomorphism and mitotic activity. The Nuclear evaluation is the most subjective and can lead to inconsistency. Although originally designed for grading NST tumours it is recommended that it is applied to all cancers. An attempt should be made to grade the pre-operative core biopsy as there is acceptable concordance with excision grade. Staging: Stage is usually expressed as a number on a scale of 0 through IV - with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body.
In Breast cancer Diagnosis, if tests show that you have breast cancer you will need to have further tests. The tests check the size of cancer and whether there is any spread to nearby. These may be done as part of standard preparation before surgery.
The involvement of pathologists in the management of breast disease divided into four main areas: Diagnosis, Assessment of adequacy of treatment and prognosis, effective communication and research. Biopsy is the removal of breast tissue for examination by a pathologist. Mammography is useful for finding early changes in the breast. Breast ultrasound scans Ultrasound scans use sound waves to make a picture of the inside of the body.
"Cancer" is used as a generic term to cover the whole range of malignant disease of the breast. This area inevitably constitutes the main focus of the study of breast disease as from a clinical point of view. Malignant tumors are cancerous and aggressive because they invade and damage the surrounding tissue. When a tumor is suspected to be malignant, the doctor will perform a biopsy to determine the severity or aggressiveness of the tumor. CARCINOMA IN SITU is a type of malignant cancer and also known as pre-invasive carcinoma.it is confined with ducts or lobules this is Immunostains very helpful in diagnosis.
\ \\ In cancer care, doctors specializing in different areas of cancer treatment—such as surgery, radiation oncology, and medical oncology. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counsellors, nutritionists, and others. The biology and behaviour of a breast cancer affects the treatment plan. Some tumours are small but grow fast, while others are large and grow slowly. Treatment options and recommendations are very personalized and depend on several factors, including: stage of tumour, tumour subtypes, genomic maker, patient age, and patient menopausal status, mutations in inherited breast cancer genes, such as BRCA1 or BRCA2. For both DCIS and early-stage invasive breast cancer, doctors generally perform surgery to remove the tumour. For larger cancers, or those that are growing more quickly, doctors may recommend systemic treatment with chemotherapy or hormonal therapy before surgery, called neo adjuvant therapy.\
\ Breast cancer is found in about 1 in every 3,000 pregnant women. Breast cancer is the most common type of cancer found pregnancy, while breastfeeding, or within the first year of delivery. You may hear this called gestational breast cancer or pregnancy-associated breast cancer (PABC). When a pregnant woman develops breast cancer, it’s often diagnosed at a later stage than it would be if the woman were not pregnant. It’s also more likely to have spread to the lymph nodes. This is partly because of hormone changes during pregnancy. Another reason it may be hard to find breast cancers early during pregnancy is that screening for breast cancer is often delayed until after the pregnancy is over. Pregnancy and breastfeeding can also make breast tissue denser.\
\ The Separation of epithelial proliferative lesions and differentiation between usual epithelial hyperplasia. And atypical ductal hyperplasia (ADH) is the most common problems encountered. Intra duct benign epithelial proliferation, Epithelial and myoepithelial cells proliferate together. Therefore mixed pattern seen on CK 5/6 or P63 immunostaining. In this condition Streaming pattern usually seen and Peripheral slit-like spaces within ducts is present, Cells are smaller in size, more crowded and overlapping than in atypical proliferations or carcinoma in Situ . Atypical hyperplasia is of three types Atypical Ductal Hyperplasia (ADH): Columnar Cell Change with atypical, Atypical Lobular Hyperplasia (ALH). ADH is important because it carries a 4-5 times relative risk of breast cancer at 10-15 yrs. post biopsy. It causes difficulty to diagnostic pathologists - inconsistency in diagnosis is common. It lies closest morphologically to low grade DCIS - it is not a high grade lesion.\
\ Women may prevent their risk of breast cancer by maintaining a healthy weight, drinking less alcohol, being physically active and breastfeeding their children. Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer: Older age, A personal history of breast cancer or benign (not cancer) breast disease, A family history of breast cancer, Inherited gene changes, Dense breasts, Exposure of breast tissue to oestrogen, made in the body, Taking hormone, therapy for symptoms of menopause, Radiation therapy to the breast or chest, Obesity, Drinking alcohol, Being white.\
\ The cancer does return after treatment for early-stage disease, it is called recurrent cancer. When breast cancer recurs, it may come back in the following parts of the body, same place as the original cancer, chest wall, lymph node, bones, lungs, liver and brain. A local or regional recurrence is manageable and may be curable for women with a local recurrence in the breast after initial treatment with lumpectomy and adjuvant radiation therapy, the recommended treatment is mastectomy. Usually the cancer is completely removed with this treatment. For women with a local or regional recurrence in the chest wall after an initial mastectomy, surgical removal of the recurrence followed by radiation therapy to the chest wall and lymph nodes is the recommended treatment. However, if radiation therapy has already been given for the initial cancer, this may not be an option. Radiation therapy cannot usually be given at full dose to the same area more than once. For women with a local or regional recurrence in the chest wall after an initial mastectomy, surgical removal of the recurrence followed by radiation therapy to the chest wall and lymph nodes is the recommended treatment.\
\ The two most common genetic risk factors for breast cancer are the BRCA1 & 2 genes.BRCA1 & BRCA2 Approximately 5% of all breast cancers are caused by a recognised specific genetic predisposition due to germ line mutations of one of two different genes: BRCA1 located on Chromosome 17q, BRCA2 located on Chromosome 13q. BRCA1 mutations also predispose to carcinoma of the ovary and possibly carcinoma of the Fallopian tube. Mutations of this gene are particularly common in Ashkenazy Jews (2%). The risk of developing breast cancer among carriers is around 55% by age 70. BRCA2: The product of BRCA2 is involved in controlling gene function and DNA repair. Gene function involves in transcriptional activation and completion of cell division by cytokinesis. Majority of BRCA2-associated tumours are invasive ductal, no special-type tumours.\
\ Immunohistochemistry has an important role in the pathology of breast disease, as well as in other benign or malignant tumours. Overall, immunotherapy holds several key advantages over conventional chemotherapeutic and targeted treatments directed at the tumour itself. First, immunotherapy generally results in fewer side effects, enabling it to be administered for longer periods of time and/or in combination with other agents without added toxicity. The principal function of immunohistochemistry of breast pathology is: Solving common diagnostic dilemmas e.g., Benign/malignant, Epithelial proliferations, in situ v micro invasion. Tumour typing and confirming diagnoses, such as: Tumour typing, subtle foci of invasion, Status of margins, Lymph node metastases, demonstrating epithelial cells in necrotic material. For confirmation of this diagnosis most frequently used immunostains in breast pathology are: Myoepithelial markers - CK 5/6; P63, Lobular v Ductal - E Cadherin, Receptors - ER; PGR and Her2.\
\ In medicine, a case report contains detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case report usually describes an unusual or novel occurrence. Case reports are an unexpected association between diseases or symptoms. It may results in finding the shed new light on the possible pathogenesis of a disease or an adverse effect.it may contour Unique or rare features of a disease, unique therapeutic approaches.\
\ Research has developed ways of grouping breast cancers into different types. They sometimes call rarer breast cancers special type and the more common breast cancers no special type. More than 90% of breast cancers are invasive carcinoma and 10% are rare types of cancers. The rare types of breast cancers are, medullary breast cancer About 5 out of 100 breast cancers (5%) are medullary breast cancers. The cancer cells tend to be bigger than other breast cancer cells. Mucinous (mucoid or colloid) breast cancers about 2 in 100 breast cancers (2%) are mucinous breast cancers. This type of cancer tends to be slower growing than other types of breast cancers and is less likely to spread to the lymph nodes. Tubular breast cancer is called tubular because the cells look like tubes when seen under a microscope. Only about 1 in 100 breast cancers (1%) are tubular cancers.\