exudates and Carcinoma--Intraductal--Noninfiltrating

GLOBOCAN12 recently reported high cancer mortality in Malaysia suggesting its cancer health services are under-performing. Cancer survival is a key index of the overall effectiveness of health services in the management of patients. This report focuses on Subang Jaya Medical Centre (SJMC) care performance as measured by patient survival outcome for up to 5 years.. All women with breast cancer treated at SJMC between 2008 and 2012 were enrolled for this observational cohort study. Mortality outcome was ascertained through record linkage with national death register, linkage with hospital registration system and finally through direct contact by phone or home visits.. A total of 675 patients treated between 2008 and 2012 were included in the present survival analysis, 65% with early breast cancer, 20% with locally advanced breast cancer (LABC) and 4% with metastatic breast cancer (MBC). The overall relative survival (RS) at 5 years was 88%. RS for stage I was 100% and for stage II, III and IV disease was 95%, 69% and 36% respectively.. SJMC is among the first hospitals in Malaysia to embark on routine measurement of the performance of its cancer care services and its results are comparable to any leading centers in developed countries.

Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Cancer Care Facilities; Carcinoma, Intraductal, Noninfiltrating; Cohort Studies; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Malaysia; Middle Aged; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Survival Rate; Young Adult

To document the pathological features of breast carcinoma diagnosed in women aged 35 years or less.. The files of the Department of Pathology, Singapore General Hospital, were searched for cases of breast cancer diagnosed in individuals aged 35 years or less between January 1993 and December 2004. Histological slides and pathology reports were retrieved and reviewed. Pathologic parameters of tumour size, histological grade, accompanying ductal carcinoma in situ (DCIS), lymphovascular invasion, nodal status, hormone receptor and c-erbB-2 profiles, were documented.. Of 112 cases of breast cancer, 91 (81.3%) were invasive carcinomas, 17 (15.2%) pure DCIS, three (2.7%) were diagnosed on needle aspirates. No residual tumour was available for microscopic assessment in one (0.9%) patient who underwent bilateral mastectomy in our institution but had her initial surgery elsewhere. Invasive tumour size ranged from 0.3 to 11.5 cm (mean 2.7 cm, median 2.1 cm), with 84 (92.3%) infiltrative ductal, two (2.2%) lobular, two (2.2%) mucinous, two (2.2%) atypical medullary, and one (1.1%) mixed ductal-lobular. The majority were grade 3 (54 cases, 59.3%), with 24 (26.4%) grade 2 and 7 (7.7%) grade 1, while grading was not accomplished in six (6.6%) cases. Nodal status was positive in 39 (42.9%), negative in 25 (27.4%), unknown in the rest (27 cases, 29.7%). Oestrogen and progesterone receptors (ER, PR) were positive in 51 (61.4%) and 43 (51.8%) cases, respectively, out of 83 (91.2%) cases in which they were evaluated. c-erbB-2 immunostaining, carried out in 54 (59.3%) invasive cancers, showed positivity in 16 (29.6%) cases.DCIS cases ranged from 0.25 to 6.2 cm (mean 2.2 cm, median 2 cm) in size. Nuclear grade was low in seven (41.2%), intermediate in four (23.5%), and high in six (35.3%).. The majority of breast carcinomas in young women are invasive, with T2 disease at presentation, and of poor histological grade. The recent rise in numbers suggests increased detection, plausibly due to improved awareness of breast disease among the younger female population. Pathogenetic causes that differ from breast carcinogenesis in older women have to be further clarified.

Topics: Adult; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Cell Nucleus; China; Female; Humans; India; Lymph Nodes; Malaysia; Receptor, ErbB-2; Receptors, Estrogen; Receptors, Progesterone; Retrospective Studies; Singapore

Breast ductal carcinoma in-situ (DCIS) is increasingly being diagnosed as a result of screening mammography and better pathological recognition. With this and the rising breast cancer incidence in Singapore, DCIS is poised to become a bigger part of surgical practice. Principles of screening, diagnosis and management of DCIS have also been rapidly evolving. Against this background, a clinicopathological audit of recent cases of DCIS in our centre was performed.. Thirty-eight cases of DCIS diagnosed in the period 1997-2000 were retrospectively analysed. Histological examination and immunohistochemical studies for oestrogen and progesterone receptor expression were performed.. In the present study, DCIS was most common in the group of patients who were <50 years (58%) as compared to an American series' where the corresponding group were > or =60 years (36%). Compared to a previous local study a decade ago, the present series showed that: (i) DCIS constituted a higher proportion of all breast cancers (6.4% vs 3.7%); (ii) a larger proportion of patients had disease detected by mammography (47% vs 10%); (iii) conservative breast excision was the only definitive surgery in 39% of cases (vs approximately 30%); and (iv) the mean size of lesions is smaller (13.5 mm vs 24.4 mm). Histologically, 26% of tumours were high grade, 71% had necrosis while 32% were oestrogen receptor (ER) and progesterone receptor (PR) negative. High grade tumours were associated with the presence of necrosis (P = 0.018), ER negativity (P = 0.015) and PR negativity (P = 0.001).. This study reveals interesting trends of DCIS in Singapore. The sizeable proportion of hormone receptor-negative tumours may have implications for the hormonal adjuvant therapy of DCIS.

Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; Malaysia; Mammography; Mastectomy, Segmental; Middle Aged