Hiroko Tsunoda-Shimizu

Neuroendocrine ductal carcinoma in situ (NE‐DCIS) of the breast – comparative clinicopathological study of 20 NE‐DCIS cases and 274 non‐NE‐DCIS cases

Aims:  To clarify the clinicopathological significance of breast neuroendocrine ductal carcinoma in situ (NE‐DCIS), i.e. DCIS in which >50% of cells immunohistochemically express NE markers (chromogranin A and/or synaptophysin), 20 NE‐DCIS were studied and the findings compared with those of 274 non‐NE‐DCIS.

Neuroendocrine ductal carcinoma in situ of the breast: cytological features in 32 cases

T. Kawasaki, S. Nakamura, G. Sakamoto, T. Kondo, H. Tsunoda‐Shimizu, Y. Ishii, T. Nakazawa, K. Mochizuki, T. Yamane, M. Inoue, S. Inoue and R. Katoh 
Neuroendocrine ductal carcinoma in situ of the breast: cytological features in 32 cases

Determining the morphological features of breast cancer and predicting the effects of neoadjuvant chemotherapy via diagnostic breast imaging

BackgroundNeoadjuvant chemotherapy has recently become common therapy for breast cancer. This work studied whether or not the effects of neoadjuvant chemotherapy can be predicted from morphological features of breast cancer in initial diagnostic imaging.Materials and methodsA total of 186 cases who underwent neoadjuvant chemotherapy at this hospital in 2006 were studied. Morphological features were classified into four categories. One is a type of invasive carcinoma that tends to grow along the mammary ducts (type A1), another is a type of expansively growing invasive carcinoma that is relatively well-defined (type A2), a third is a type of irregularly shaped mass that retracts surrounding tissue (type A3), and the fourth is a mixed type. Thus, the effects of neoadjuvant chemotherapy on carcinomas of the four types were compared on the basis of image and pathological findings. Effects of neoadjuvant chemotherapy were classified into three categories of enlarged mass, pCR, and other, with the latter indicating no change or shrinkage.ResultsOf the 186 total cases, 72 were classified as type A1, 31 as type A2, 52 as type A3, and 31 as a mixed type. Seven of 31 cases of type A2 (22.6%) were cases of an enlarged mass, revealing a high percentage of such cases. Dividing cases into type A2 and other types and looking at the proportion of cases of an enlarged mass thus indicated a significantly higher tendency. pCR was achieved in 6 of 31 cases with type A2 (19.4%). Here, also, the proportion of type A2 cases was significantly higher.ConclusionMorphological features prior to neoadjuvant chemotherapy can contribute to determining the effects of the therapy. Expansively growing well-defined masses contain lesions at both extremes, tending to enlarge in some instances or instead allowing pCR, so the course of therapy must be carefully followed when performing neoadjuvant chemotherapy.

A Tool for Temporal Comparison of Mammograms: Image Toggling and Dense-Tissue-Preserving Registration

Temporal comparison is indispensable for mammography reading. In this paper, we propose a new method to perform temporal comparison of digital mammograms using persistence of vision and propose a dense-tissue-preserving registration method for the temporal alignment. In this method, we use non-rigid registration to deform a prior mammogram to align with its corresponding current mammogram. We apply a dense-tissue-preserving constraint to the registration to preserve the shape and size of the dense tissue areas. Once aligned, we toggle the display back and forth between the current mammogram and its corresponding registered prior mammogram. The proposed method was applied to 11 temporal mammogram cases and evaluated by two experienced radiologists.

Breast schistosomiasis japonica – a report of four Japanese cases

a history of locally advanced invasive ductal carcinoma of the left breast treated with neoadjuvant chemotherapy and excisional biopsy. There was a complete pathological response with absence of invasive carcinoma, changes consistent with chemotherapy effect, focal atypical ductal hyperplasia, radial scar and microcalcifications. Incidentally, a lobule with salivary gland-like acinar differentiation was noted in a background of benign breast tissue (Figure 1). The cells had slightly granular, amphophilic cytoplasm with zymogen-like secretory granules, a characteristic feature of serous acinar cells. These granules were readily highlighted by periodic acid–Schiff reaction (Figure 1). Breast neoplasms which exhibit eosinophilic and granular cytoplasm are varied, and acinic cell-like breast carcinoma can be included in this category. However, these tumours exhibit the features of malignancy with invasive growth, necrosis and cytological atypia, features absent in our case. Furthermore, the pretreatment core biopsy was invasive mammary carcinoma, no special type, without salivary acinar-like features. Changes of the breast resembling salivary gland have been reported in two cases, one associated with invasive ductal papillary carcinoma and the other with usual intraductal hyperplasia. Its identification raises the question of whether breast tumours with salivary gland differentiation originate from malignant transformation of terminal duct-lobular units with metaplastic changes. Alternatively, this type of salivary gland-like metaplasia might be part of the spectrum of histological changes seen in the breast after chemotherapy, or may merely be another form of metaplasia that has not been described in benign breast tissue. Finally, there is a possibility that this case represents a heterotopic salivary gland, as has been described in the neck, pituitary, parathyroid, mediastinum and rectum. Documenting these types of changes in various settings may be helpful in further defining the circumstances under which they occur and determining their significance, if any.