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Objectives: The aim of this study was to investigate the role of superb microvascular imaging (SMI) and shear wave elastography (SWE) in the prediction of malignancy and invasiveness of isolated microcalcifications (MC) that can be visualized by ultrasonography (US). Material and Methods: Sixty‐seven women with MC, who were considered suspicious on mammography were evaluated. Only those lesions that could be visualized by US and presented as non‐mass lesion were included. They were evaluated by B‐mode US, SMI, and SWE before US‐guided core‐needle biopsy. B‐mode US, SMI (vascular index (SMIvi)), and SWE (E‐mean, E‐ratio) findings were compared with histopathologic features. Results: Pathology confirmed 45 malignant (21 invasive and 24 in situ carcinomas) and 22 benign lesions. There was a statistically significant difference between malignant and benign groups in terms of size (P =.015), distortion (P =.028), cystic component (P <.001), E‐mean (P <.001), E‐ratio (P <.001), and SMIvi (P =.006). For differentiation of invasiveness E‐mean (P =.002), E‐ratio (P =.002), and SMIvi (P =.030) were statistically significant. According to ROC analysis E‐mean (cut‐off point at 38 kPa) was the most sensitive (78%) and the most specific (95%) value among four numeric parameters (size, SMI, E‐mean, and E‐ratio) with AUC = 0.895, PPV = 97%, and NPV = 68% in detecting malignancy. In the evaluation of invasiveness, the most sensitive (71.4%) method was SMI (cut‐off point at 3.4) and the most specific (72%) method was E‐mean (cut‐off point at 91.5 kPa). Conclusion: Our study shows that adding SWE and SMI to the sonographic evaluation of MC would be an advantage for US‐guided biopsy. Including suspicious areas according to SMI and SWE in the sampling area can help target the invasive part of the lesion and avoid underestimation of core biopsy. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: To investigate the efficacy of the advanced imaging methods, superb microvascular imaging (SMI) and shear wave elastography (SWE) in predicting molecular subtypes in invasive breast carcinomas.Materials and Methods: A total of 210 biopsy-proven breast carcinomas in 200 patients who underwent ultrasound (US) imaging with SMI and SWE were included in this study. Quantitative analyses were performed using mean elasticity (Emean) score by SWE and vascular index (VI) by SMI. For qualitative assessment of microvascularity, first, lesions were graded according to Adler's classification in four types. Then, a new morphological model was used to classify the microvascular architecture into six patterns: type one, no signal; type two, penetrant; type three, rim-like; type four, dot-like/linear/regional; type five, wheel-like and type six, irregular signals. The correlation between these variables and molecular subtypes, nuclear grade, the Ki-67 levels and axillary status was investigated.Results: The average VI and Emean values were relatively higher in non-luminal subtypes (VI, p = 0.002; Emean, p > 0.05). The two microvascularisation models were significantly able to differentiate the molecular subtypes according to the Kruskal Wallis test (p < 0.05). Rim-like, penetrant and regional patterns were primarily observed in luminal subtypes. The dominant pattern in non-luminal subtypes was wheel-like pattern. VI, Emean, Adler's classification and morphological vascularisation model were not significantly correlated with the nuclear grade, Ki-67 index or axillary status.Conclusion: The proposed microvascular categorization model may be more valuable in predicting molecular subtypes of breast carcinomas compared to VI and Emean and may contribute to the management of breast carcinomas as a non-invasive variable. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of the different imaging modalities in detecting recurrence in breast cancer follow-up. Materials and Methods: Sixty-four women with recurrent breast cancer were examined between January 2020 and July 2022. Recurrency was divided into four categories: local; regional; second primary; and distant metastasis. The detectability of recurrent lesions with mammography (MG), ultrasound (US) and magnetic resonance imaging (MRI), was evaluated. In addition, recurrences that firstly appeared by positron emission tomography (PET) scan were recorded. Results: Twenty-seven (42.2%) recurrences were local, 10 (15.6%) were regional and 27 (42.2%) were second primary. Forty-six (71.9%) of them were determined to have invasive carcinoma, 8 (12.5%) were ductal carcinoma in situ, and 10 (15.6%) were axillary metastases. Eight (12.5%) of them were first diagnosed by PET-computed tomography/MRI. Among the available images performed, 78.7% could be detected pathologically by MG, 95.2% by US, and 100% by MRI. Distant metastasis associated with other types of recurrence was detected in 6 (9.4%) cases. Conclusion: MRI is the most powerful imaging modality in detecting recurrent breast cancer. With the addition of US to routine MG follow-up, a higher rate and early detection of recurrent cancers can be achieved. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the strength of quantitative imaging and metabolic parameters in differentiating invasive breast carcinomas with elevated Ki‐67 levels. Materials and Methods: A total of 123 patients with 129 breast lesions confirmed as invasive breast carcinoma underwent shear wave elastography (SWE), superb microvascular imaging (SMI) and positron emission tomography (PET)/CT or MRI. Adler's grade (classifying the microvascularity into four types) and Vascular Index (VI) was obtained by SMI as microvascular parameters. In addition, the stiffness value (Emean) was evaluated in kilopascal by SWE. The average of consecutive measurements was recorded as mean VI and mean Emean. PET scan parameters were obtained as SUVmax and SULpeak. Lesions were divided into two groups according to the Ki‐67 expression, low as ≤14 and high as >14. Results: Adler's grading was the most correlated imaging parameter with high Ki‐67 expression (p < 0.05), while VI and Emean had poor correlation (p > 0.05). SUVmax and SULpeak indicated a significant linear correlation with Ki‐67 but a moderate correlation with the high levels of Ki‐67 (p < 0,001). The sensitivity of VI, Emean, SUVmax and SULpeak was 64.6%, 66.7%, 65.7%, and 66.7% when the cut‐off point was set to 5.25, 102.5, 6.59, and 2.63, respectively. SUVmax had the highest AUC value of 0.740, according to the ROC curve analysis. Conclusions: Our results suggest that the quantitative parameters obtained by advanced imaging methods may be useful in predicting the high proliferation in invasive breast carcinomas. But none of them is eligible to be used as an independent biomarker in distinguishing aggressive behavior. Nevertheless, as a noninvasive method, visual assessment of microvascular morphology using SMI increases the prognostic efficiency in invasive breast carcinomas. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to investigate the contribution of mass CT density values to the diagnosis in the evaluation of the response of the local disease to the treatment during the treatment of breast cancer. Methods: 40 female patients histopathologically proven to have breast cancer, had routine Thorax CT at diagnosis and the treatment stage, and whose metabolic activity was known by PET CT were included.The mean mass densities were measured from malignant breast lesions at the time of diagnosis and after treatment through the Thorax CT examinations. Results: In our study, we found the mean mass density measurement values of breast cancer before treatment as 38.21 HU, and the average density measurement values after treatment as 20.54 HU. We showed that malignant mass densities were significantly reduced in the non-metabolic period after treatment. We found that thorax CT density values can be a guide in evaluating the response of malignant breast lesions to local treatment. Conclusion: In conclusion, adding a quantitative CT attenuation value to breast lesions examinations increases the diagnostic accuracy of malignant lesions. We have shown that malignant lesions show significantly higher attenuation on Thorax CT and attenuation values decrease in response to treatment. [ABSTRACT FROM AUTHOR]

Thyroid gland blood supply is rich but it is not an open area for metastasis. Only 1%–3% of the neoplastic lesions seen in the thyroid are of extrathyroidal origin. Thyroid, lung, bone, lymph node metastasis were detected at the time of diagnosis in a 78-year-old woman with metastatic breast cancer. Control imaging was performed 3 months after hormone therapy was started. All lesions were regressed except thyroid lesion and neck lymph. Tru-cut biopsy was performed to the lesion in the thyroid. The result is consistent with breast cancer metastasis. With this breast cancer metastasis to thyroid case, we want to emphasize the differential diagnosis of neoplastic lesions in the thyroid is important in those diagnosed with malignancy. If there is clinical suspicion after a nondiagnostic thyroid sampling, repeated biopsies should be performed. [ABSTRACT FROM AUTHOR]

Background: Expression of kallikrein-11 (KLK11) has been found to be related to the prognosis of various human cancer types but its physiological functions in the steps of breast cancer (BC) progression are still unknown. Materials and Methods: BC and adjacent normal breast tissue samples were collected from 28 patients. KLK11 expression levels were determined by real-time polymerase chain reaction for each sample and associations with known prognostic features were statistically analyzed. Results: Although there was slight up-regulation in tumor tissues overall, significant down-regulation of KLK11 expression in tumor tissue was observed in the elderly and in patients with perineural invasion. Furthermore, tumor size, grade, mitotic score, necrosis, calcification, lymphatic invasion, hormone receptor status and Ki67 expression were associated with altered KLK11 level. Conclusion: Changes in expression levels of KLK11, associated with patient characteristics, might be used as complementary data in order to predict clinical outcome and prognosis in BC. [ABSTRACT FROM AUTHOR]

Leukocyte diapedesis is an important process in breast cancer etiopathogenesis. Therefore, Junctional adhesion molecule-A (JAMA) and lymphocyte function-associated antigen-1 (LFA-1) genes are among potential candidate genes involved in breast cancer development. In the present study, JAM-A rs790056 (T>C), LFA-1 rs8058823 (A>G) and LFA-1 rs2230433 (C>G) gene variations and their associations with breast cancer risk were investigated in breast cancer patients and healthy subjects. The JAM-A and LFA-1 genotypes were determined in 108 breast cancer patients and 63 healthy controls with Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) assay. LFA-1 rs8058823 common AA genotype (χ2= 6.062, p= 0.014) and A allele frequency (p= 0.001) and LFA-1 rs2230433 rare GG genotype frequency (p= 0.048) was higher in the patient group compared with controls. The TA haplotype (JAM-A rs790056-T, LFA-1 rs8058823-A alleles) frequency was significantly increased in the patient group compared with controls (p= 0.0173), while the TG haplotype (JAM-A rs790056-T, LFA-1 rs8058823-G alleles) and CG haplotype (LFA-1 rs2230433-C, LFA-1 rs8058823-G alleles) frequencies were significantly lower in the patient group compared with controls (p= 0.0051 and p= 0.002, respectively). In addition, the TCG haplotype (JAM-A rs790056-T, LFA-1 rs2230433-C, LFA-1 rs8058823-G alleles) frequency was significantly lower in the patient group compared with controls (p= 0.0096). Haplotype analysis confirmed that the LFA-1 rs8058823 is more effective in breast cancer risk than LFA-1 rs2230433 and JAM-A rs790056. LFA-1 rs8058823 A allele may be related to breast cancer risk, influencing leukocyte diapedesis. Our findings indicate that functional gene variations associated with leukocyte diapedesis may affect breast cancer risk. [ABSTRACT FROM AUTHOR]

It is becoming evident that local estrogen exposure is important in postmenopausal breast cancer patients. The microenvironment is established by breast stromal cells based on communication with tumor cells that is essential to cancer development, invasion, and metastasis. Here we investigated aromatase activity levels in both tumor and matched stromal tissues by showing their impact on the manufacturing of local estrogen and tumor progression in cases of invasive ductal carcinoma (IDC). Tumor (T) and tumor-associated stroma (TAS) neighboring tissues were acquired from each postmenopausal patient, diagnosed with IDC, and categorized as luminal A (n = 20). The control group was formed from tumor-free breast tissue samples (N, n = 12). A microsomal-based technique was created to compare breast tissue aromatase activities using liquid chromatography – mass spectrometry. We observed that the TAS tissues have the highest aromatase activities (p < 0.05). High progesterone receptor (PR) intensity levels were found to be decreasing the activity level in these tissues significantly (p < 0.05). Tumor tissue specific aromatase activity levels of postmenopausal patients' were tend to be lower compared to healthy premenopausal subjects' (3 fold, p < 0.001). In addition low activity in tumor tissues were associated with low grade and late stage cancers. Early detection and personalized therapy is essential for postmenopausal breast cancer patients. Together, our in-house tandem mass spectrometry technique has the potential for further development and standardization for the measurement of aromatase activity and may assist clinicians decide on therapy policies for postmenopausal IDC patients which could be an invaluable asset for precise and specific evaluation. • Local production of estrogen is used in favor for the tumor progression in postmenopausal IDC cases. • Stromal aromatase activity is associated with grade, stage and progesterone receptor intensity of the tumor tissue. • The developed method have a potential to assist clinicians for personalized therapy. [ABSTRACT FROM AUTHOR]

Natural products have been focused by researchers due to their important anticarcinogenic characteristics in the treatment of cancer with the slightest side effects possible. Propolis is one of the most prominent candidates among these natural products in terms of its anticancer features. In this study we aim to research the effects of Anatolian propolis on ER/PR-, HER-2/neu+ human breast cancer cell line SK-BR-3 with intent to clarify the molecular mechanism propolis in HER+ breast cancers in overview of whole genomic expression for the first time via a microarray experiment. Afterwards, microarray data was validated via real time PCR with the selected genes. After performing bioinformatic analysis via GeneSpring Software and String analysis, a 50 ^g/mL dose of propolis affected several pathways of HER-2 positive breast cancer cells including cell cycle, DNA repair and apoptosis especially at 48th hour exposure. In contrast, after exposure to 50 ^g/mL dose of propolis, up-regulated genes were detected at diverse pathways such as immune response, cell migration regulation, organization of cell-cell adhesion, etc. For this reason, we proposed that polyphenol-rich propolis can be used in the treatment of HER-2 positive breast cancer with characteristics of less toxic than the current treatment methods. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study wasto investigate whole-breast imaging findings (mammography, ultrasonography (US), magnetic resonance imaging (MRI),clinical, and histopathological findings of primary neuroendocrine carcinomas of the breast (NEC) and neuroendocrine differentiated breast cancers (NEBC).Methods: Patients withadiagnosis of breast cancer with histopathological neuroendocrine features between the years 2010 and 2021 were retrospectively screened.The lesions were divided into two main groups depending on staining with neuroendocrine markers (synaptophysin and chromogranin A). Those showing focal staining were categorized as NEBC while those with diffuse staining as NEC.The mammography, US, and MRI of the lesionswere reviewed in consensus by two breast radiologists in order to assess imaging featuresretrospectively according to the Breast Imaging Reporting and Data System (BI-RADS) 5th lexicon.The findings were compared with breast cancers without neuroendocrine features (BC-WNE) which were randomly selected from the same database.Results: A total of 105 lesions [NEBC (n = 44), NEC(n = 11), BC-WNE (n = 50)] were evaluated.Patients with neuroendocrine tumors were older (p < 0.001) than those with BC-WNE. Compared with BC-WNE tumors, radiological findings typical of malignancy such as irregular shape [NEBC (7/20); NEC(3/7) vs BC-WNE (35/43); p < 0.001], spiculation [NEBC (2/20); NEC(0/7) vs BC-WNE (21/43); p < 0.001], architectural distortion [(NEBC (3/24); NEC(0/9) vs BC-WNE (31/50); p < 0.001)], calcification [(NEBC (6/24), NEC(0/9) vs BC-WNE (n = 27/50); p = 0.001)] on mamography, non-parallel orientation to skin [(NEBC (n = 17/29), NEC(n = 4/9), BC-WNE (n = 35/42); p = 0.008)], acoustic shadowing [(NEBC (n = 12/29), NEC(1/9), BC-WNE (n = 29/42); p = 0.009)], axillary lymphadenopathy [(NEBC(n = 3/30), NEC(n = 1/9), BC-WNE (21/50); p < 0.001)]on US were less common features of the neuroendocrine carcinomas of breast. Aside from shape features, there was no significant difference in contrast pattern (p = 0.866), kinetic curve (p = 0.454) and diffusion restriction (p = 0.242) on MRI.Conclusion: Characteristic malignant imaging features, including irregular shape, spiculated margins, suspicious calcifications, and posterior acoustic shadowing, are uncommon in neuroendocrine carcinomas of breast. These carcinomas tend to show more benign imaging features when compared with BC-WNE. [ABSTRACT FROM AUTHOR]