European Journal of Molecular & Clinical Medicine

Background: Leptomeningeal metastasis (LM) is a condition that develops when malignant cells from an extrameningeal primary tumor invade the leptomeninges. Patients with solid tumors (5-8%) and patients with lymphohematopoietic neoplasms (5-15%) are both diagnosed with it. Among solid tumors, leptomeningeal metastases are most frequently caused by metastases to the breast and lungs. The management of the patient depends on the early detection of LM. Cerebrospinal fluid (CSF) cytological analysis is still essential for LM diagnosis. The molecular subtypes of breast cancer should affect LM propensity because they are correlated with tumor behavior and prognosis.
Methodology: Records of patients who underwent CSF examination and had meningeal involvement with clinical symptoms were kept for seven years at an oncology facility in North India. The data was analyzed for CSF involvement in the tumor subtypes after the cases were divided into molecular subtypes by hormone receptor profiling, HER2, and the proliferation index of the breast tumors.
Results: Of the 1332 patients at our hospital who were diagnosed with breast cancer during the study period, 41 patients (3%) had CNS symptoms, and 22 patients (53% of them) had LM confirmed by CSF cytology. The majority of these (40.9%) belonged to the molecular subtype of triple-negative breast cancer, which was followed by HER2 (36.36%), Luminal A (13.63%), and Luminal B (9.09%).
Conclusion: The results show that triple-negative breast cancer is more likely than other subtypes to metastasize to the CNS, which is consistent with its more aggressive behavior. As a result, complications like leptomeningeal metastasis may be predicted by the molecular subtyping of breast carcinoma.

Introduction: As it has to aware that the breast cancer is the commonest cancer among women around the globe. Diffusion Weighted Imaging (DWI) helps to evaluate the physiological and functional environment of the lesion by observing the random motion of water molecules, tissue cellularity, fluid viscosity, membrane permeability and blood flow pattern that could be measured quantitatively by Apparent Diffusion Coefficient (ADC) values.
Materials and Methodology: A total of 70 patients with histo-pathologically proven breast carcinoma form the study sample in the study (3 patients had bilateral malignancy). MRI examinations were performed within 2 weeks before surgery. All the 70 participants who had done breast MRI underwent surgery. Statistical analysis was performed using SPSS (Statistical package for social science version16.0 for windows). Students T test and Analysis of Variance (ANOVA) were used to study the difference in ADC between two groups.
Results: Out of all the total 70 breast lesions, 53 lesions were (76%) single, while 9(13%) were multifocal carcinoma and 8 (11%) were multicentric multifocal breast carcinoma. Histological types included invasive ductal carcinoma no special type (65) invasive lobular carcinoma (1) mucinous carcinoma (2) papillary carcinoma (1) medullary carcinoma (1). The ADC value was correlated with pathological grading of the tumour (r = ‑0.497, P < 0.001).
Conclusion: DWI usually takes short acquisition time and post‑processing time and does not require any administration of contrast dyes and provides a real-time quantitative functional parameter for evaluating the tumour aggressiveness.

Background: To study breast carcinoma based on the expression patterns of ER, PgR, HER2/neu and its Histomorphology.
Materials and Methods: The present study is a 4 years study, 1 year retrospective and 3 year prospective study from 1^st November 2017 to 31^st October 2021, done in the Department of Pathology Kamineni Institute of Medical Sciences, Narketpally. Specimens received with a clinical diagnosis of carcinoma of breast were processed according to standard protocol. The specimen received following neoadjuvant chemotherapy was excluded from the study. Histomorphology of tumor, Nottinghams modification of Scarff Bloom Richardson grading was studied by H&E stained section and the ER, PgR and HER2/neu expression studied by IHC stains.
Results: A total of 86 cases of breast carcinomas were analysed. Most of the cases occurred in perimenopausal age group. Lump in the breast was the most common presenting symptom. Majority of tumor were within the size of >2-5cm, frequently in upper outer quadrant. Invasive breast carcinoma no special type was most common type, accounting to 81.40%, followed by invasive lobular carcinoma of breast in 5.81%. Majority of tumor were of Grade II. ER, PgR and HER2/neu were expressed in 53.48%, 43.03% and 39.54% of cases. The most common molecular subtype was ER /PgR+/HER2neu. Hormonal receptor expression was less in women with age above 40 years, with increase in size and grade of tumor and with increase in number of metastatic lymphnode. Expression of HER2/neu increased with increase in grade of tumor. HER2/neu expression decrease in women more than 40 years. No relation was observed between HER2/neu expression and number of metastatic lymph nodes.
Conclusion: As the scenario of breast carcinoma in India is changing, the knowledge regarding histological parameters like type, grading and staging along with hormone receptor expression and HER2/neu amplification are important as it will guide the clinician to choose the most appropriate modality of treatment for the best possible outcome in a patient with breast carcinoma.

Breast cancer is the most common cancer in women worldwide and the second most common cause of cancer related deaths in women. Incidence of breast cancer is increasing with age as there is improvement in survival rate. It has attracted considerable interest in the study of carcinoma breast in elderly. Study was conducted on all the clinically diagnosed cases of breast cancer in the elderly women aged above 60years. Data was collected from the patient after obtaining a written informed consent. Detailed history, clinical examination and relevant laboratory investigations were done and clinical diagnosis confirmed perioperatively and postoperatively based on histopathological examination in the elderly patients. 4(8%) patients presented with clinical T1 stage, 22 (44%) patients presented with T2 Stage, 15 (30%) patients with T3, 5(10%) patients with T4a and 4 (8%) patients with T4b tumor status. 25 (50%) patients had clinically N0 Status at presentation. 20 (40%) patients were N1 at presentation, 5(10%) patients presented with N2 nodal status and 1 (2%) patients with N3 status. Infiltrating ductal carcinoma was the most common histological variant constituting 22 (44%) of the population. Clinico pathological features and treatment vary in elderly compared to young patients, Infiltrating ductal carcinoma is the most common histological variant of breast cancer seen.

Background: The most frequent type of cancer among women is breast cancer. In terms of total cancers, it is ranked second. Many risk factors are linked to it. Breast cancer can manifest itself in a variety of ways, ranging from invasive carcinoma to non-invasive carcinoma.
Aim and objective: To explore the risk factors, clinical presentation, and management of breast cancer, 100 patients with diagnosed breast cancer were evaluated in a tertiary care centre. Data was gathered using a pre-tested questionnaire. Demographic characteristics, clinical presentation, risk factors, and breast cancer management were all collected. Data was evaluated using statistical tests.
Results and discussion: All of the patients had a lump in their breast (100 percent). A lump with pain was detected in 21% of the patients. The most prevalent histopathological type was infiltrating duct carcinoma (97 percent). The majority of the patients (56 percent) were in stage II, followed by stage I. (23 percent). The patient's average age was 52.21±4.6 years. Menarche occurred at an average age of 13.86±1.8 years. The average age of menopause was 46.3±4.31. The average number of months spent breastfeeding was 36.41±5.62. A modified radical mastectomy was provided to 51% of patients, while total mastectomy was offered to 23%.

Introduction: For nonpalpable breast lesions, imaging-guided breast tissue biopsy has become a viable alternative to open surgical biopsy. It can be difficult to talk about abnormal results of the connection between imaging and pathology findings because they can help with decision-making about additional treatment options by arriving at a full diagnosis.
Materials and Methods: This was a retrospective study. A specialist radiologist collected and classified radiological data from 500 patients' imaging-guided breast biopsies over a 6-year period using the BIRADS format. The discordance between histopathology reports was investigated.
Results: A total of 500 cases were reviewed. Approximately 4.6% (23) of cases fell into BIRADS 2 category, 33.6% (168) of cases fell into the BIRADS 3 category, 24.4% (122) into the BIRADS 4, 36.6% (183) into BIRADS 5 categories and 0.8% (4) into BIRADS 6 categories. Approximately 49.2% (n = 246) cases were benign, 3.4% (17) belonged to the high‑risk category, and 47.4% (237) were malignant. The number of discordant cases was 12 (2.4%), mostly due to technical factors. The sensitivity of biopsies to detect malignancy was 85%, specificity was 96%, and accuracy of biopsy in diagnosing cancer was 90%.
Discussion: The most sensitive way for detecting early breast cancer is the "triple assessment." Because of the high occurrence of carcinoma in these lesions, an effective communication line between a physician, radiologist, and pathologist is required for surgical excision in discordance.
Conclusion: In discordant cases, the ultimate choice is based on two concordant findings out of the three parameters, either due to abnormal imaging results or abnormal pathology findings. A multidisciplinary breast conference is held, with the pathologist taking an active role.

In India breast cancer is the 2nd most common cancer in women after cervical
cancer and is associated with high mortality and morbidity. Role of IL-10 in cancer though, well
accepted, is vaguely understood. IL-10 is known to exhibit both pro and anti-tumour activities.
Polymorphism in interleukin genes are thought to influence the expression or function of these
proteins. Hence our study was designed to evaluate the role of low penetrant interleukin-10 (IL-
10) gene and its influence on tumorigenesis.

Background:Mammography is a widely used screening approach in the detecting of breast
cancer and proved to help reduce the mortality effectively. D-dimer (or D dimer) is a fibrin
degradation product (or FDP), a small protein fragment present in the blood after a blood
clot is degraded by fibrinolysis. Hence; the present study was undertaken for assessing the
d-dimer levels in carcinoma breast.Materials & methods:A total of 25 breast carcinoma
patients were enrolled.Data was collected using self-structured Performa which consisted
of detailed history, thorough examination, investigations and results. Blood venous
samples (3 ml) were collected from all patients before any surgical intervention, and
clinical staging was done. All the results were recorded and analysed using SPSS software.
Results:Mean D Dimer levels were found to be 2.458 μg/mL.Mean D-Dimer levels among
patients with and without lymph node involvement was 2.896 μg/mL and 1.354 μg/mL
respectively. Significant results were obtained while comparing the mean D-Dimer levels
among patients with and without lymph node involvement.Conclusion:D-dimer was found
to be an independent predictive factor for lymph node metastasis. However; further studies
are recommended.