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1.  An Interesting Pathological Diagnosis – Adenoid Cystic Carcinoma in an Adolescent Girl 
Adenoid cystic carcinomas (ACCs) constitute 0.1–1 % of all malignant breast tumors. They have better prognosis than other breast malignancies. To date, there have been about 933 cases reported as per English literature. To the best of our knowledge, this case may be the second well-documented case of ACC of breast at younger age.
PMCID: PMC4294633
ACC; young age; core biopsy
2.  Diagnosis of a Nonpalpable Intraductal Papilloma without Radiological Abnormality by Nipple Discharge Smear Examination: A Case Report 
Nipple discharge is the third most common breast complaint after breast pain and breast mass, most commonly associated with endocrine alterations and/or medications, pregnancy, lactation, post lactation, fibrocystic disease, intraductal papilloma, duct ectasia, nipple adenoma, infection, chronic mastitis, subareolar abscess, and least frequently, breast carcinoma. Cytological examination of nipple discharge (ND) is a noninvasive method of diagnosing the underlying breast pathology. We report a 46 year old female, who presented with pain and blood-mixed ND from the right breast with an impalpable mass. Cytological examination of the discharge was done and diagnosis of papillary neoplasm with degeneration, metaplasia, and atypia was given, which was further confirmed on histology and positive IHC for HMWCK and p63. Final diagnosis was intraductal papilloma of the lactiferous duct with squamous metaplasia and infarction. Differentiating benign papilloma from a carcinoma is challenging to the cytopathologist and requires clinicopathological correlation and a good knowledge of cytology.
PMCID: PMC3981477  PMID: 24737934
nipple discharge; papillary neoplasms; infarction; HMWCK; p63
3.  Successful Remission of Hemolytic-Uremic Syndrome During the Third-line Weekly Gemcitabine for Metastatic Breast Cancer 
Sequential palliative chemotherapy for metastatic breast cancer incorporating weekly gemcitabine administered as three-weeks-on, one-week-off schedule is widely adopted throughout the East Asia region. Hemolytic-uremic syndrome (HUS) associated with weekly gemcitabine for a breast cancer patient is extremely rare. We report here a case of 43-year-old woman with metastatic breast cancer who received weekly gemcitabine as a third-line palliative chemotherapy for her disease. She developed HUS after a cumulative dose of 11,000 mg/m2 gemcitabine, evidenced by microangiopathic hemolytic anemia (MAHA) with schistocytes seen in peripheral blood smear, decreased haptoglobin level (<0.29 mmol/L), thrombocytopenia, negative direct Coombs test, and acute kidney injury. Owing to the ease of administration of weekly gemcitabine, gemcitabine-induced thrombocytopenia, multifactorial anemia in metastatic breast cancer, and possibility of cancer progression, HUS could have gone unnoticed. Breast cancer oncologist should be cognizant of this rare HUS even during weekly gemcitabine treatment.
PMCID: PMC3972075  PMID: 24701120
breast neoplasms; gemcitabine; hemolytic-uremic syndrome
4.  Adjuvant Chemotherapy for Breast Cancer in a Patient with Primary Autoimmune Neutropenia 
We report an extremely rare and complex case of a 44-year-old woman diagnosed with an early stage triple negative breast cancer in the setting of primary autoimmune neutropenia with a pre-existing severe neutropenia. This case-report demonstrates that adjuvant chemotherapy for breast cancer can be administered in a patient with severe neutropenia. The management is however complicated and requires careful monitoring of side-effects related to both chemotherapy and treatment of autoimmune neutropenia. The role of chemotherapy in the treatment of triple negative breast cancer, the approach to autoimmune neutropenia and potential interactions are reviewed. To our knowledge, this is the first case reporting on the use of chemotherapy in a patient with severe pre-existing primary autoimmune neutropenia.
PMCID: PMC3572877  PMID: 23440399
breast cancer; autoimmune neutropenia; chemotherapy
5.  Orbital Metastasis of Breast Carcinoma 
We report a case of orbital metastasis in a previously diagnosed metastatic breast cancer in a 46-year old woman presenting with diplopia and proptosis of her left eye bulb. An orbital computed-tomography (CT) and a magnetic resonance imaging (MRI) both revealed an intra-orbital extra-bulbar mass of 1.5 × 3 cm in size, in the left orbit. The patient had been diagnosed with stage IV breast cancer 4 years before. She had received chemotherapy with docetaxel and was on hormone therapy at the time of presentation of her eye symptoms. Current treatment included systemic combination therapy with docetaxel and capecitabine as well as local irradiation with stereotactic radiosurgery (cyberknife). There was a gradual improvement of local symptoms and signs. The metastatic involvement of the orbit in malignant tumors is a rarely diagnosed condition. Breast cancer accounts for the majority of these cases. The appearance of eye symptoms in patients with a history of cancer should always be investigated with a consideration of ocular metastatic disease.
PMCID: PMC3086305  PMID: 21556252
orbital metastases; breast cancer; orbit

Results 1-5 (5)