Fig 1 - uploaded by Ayad Ahmad Mohammed
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Showing the supernumerary nipple behind the anterior border of latissimus dorsi muscle, the costal margin is marked anteriorly with the normal right nipple shown.
Source publication
Introduction: Accessory or supernumerary nipples can be applied when more than 2 breasts present in human beings. Usually they are seen in the embryonic milk line; however, their presence outside this line is extremely rare. A 14-year-old boy presented to the surgical consultation room complaining from a round brown skin lesion over the right shoul...
Contexts in source publication
Context 1
... examination the lesion was a round, brown, and slightly elevated from the skin surface. The size was about 1 cm in diameter with central projection. The location of the mass was in the region of the right shoulder, Fig. ...
Citations
... The accessory nipple may be found along the mammary line as in our patient. However, it could be located as ectopic lesion beyond such line overlying scapula [21]. ...
Polythelia is a congenital anomaly in which there is a third or more nipples. Although it is a relatively rare condition, it is frequently associated with other congenital malformations including the cardiovascular, urogenital, and skeletal systems. It may occur sporadically or with a familial tendency with some genetic factors. We report an association of polythelia with congenital hypogonadotropic hypogonadism (CHH) in a young male. The patient was complaining of delayed puberty. He was short in stature and had hypogonadism. On physical examination, a third nipple was found below the normal left nipple along the left mammary line. The case was carefully evaluated to exclude other disorders. It has been suggested that every newborn can be checked for the presence of accessory nipples which could indicate another internal problem in its body. We report the association of accessory nipple and right-sided hydronephrosis in a female term newborn.
... The accessory nipple may be found along the mammary line as in our patient. However, it could be located as ectopic lesion beyond such line overlying scapula [21]. ...
Polythelia is a congenital anomaly in which there is a third or more nipples. Although it is a relatively rare condition, it is frequently associated with other congenital malformations including the cardiovascular, urogenital, and skeletal systems. It may occur sporadically or with a familial tendency with some genetic factors. We report an association of polythelia with congenital hypogonadotropic hypogonadism (CHH) in a young male. The patient was complaining of delayed puberty. He was short in stature and had hypogonadism. On physical examination, a third nipple was found below the normally located nipple along the left mammary line. The case was carefully evaluated to exclude other disorders. It has been suggested that every newborn can be checked for the presence of accessory nipples which could indicate another internal problem in its body.
... Most cases are diagnosed adopting the triple assessment which include the history and clinical examination, imaging and the histopathological examination. The choice of the treatment whether surgical, adjuvant or neoadjuvant one depend on the age of patient, the clinical stage of the tumor, the hormone recerprot status, and HER2 status [15][16][17]. ...
Introduction
The prognosis of breast cancer depends on several clinical and pathological parameters most importantly the clinical stage, other factors predicting the outcome are hormone receptors like estrogen and progesterone receptors. Expression of Ki67 also have been shown to affect the outcome.
Patients and methods
This retrospective study included 278 female patients diagnosed and operated for breast cancer. Patients were grouped into 2 groups according to the expression of Ki67 to those with positive and those with negative expression. Both groups were compared for differences.
Results
The mean age was 48.61 years and the right breast was the commonest affected side, the mean tumor size was 34 mm, 70% had axillary LN involvement, 50% had intermediate tumor grade, and 85.6% had no recurrence. Most patients had stage IIA, IIB, and IIIA, 67.6% had positive expression of Ki67 and had a significant correlation with the tumor grade, tumor necrosis, and ER expression (P values 0.001, 0.047, and 0.002) respectively, while the correlation was negative with recurrence, axillary LN involvement, TNM stage, site of the tumor, age, tumor size, PR and HER-2 receptor (P values 0.476, 0.971, 0.509, 0.405, 0.122, 0.994, 0.892, and 0.418) respectively.
Conclusion
Most patients with breast cancer have positive expression of Ki67 which has a positive correlation with tumor grade, the presense of necrosis inside the tumor and estrogene receptor status. This marker is directly related with higher degrees of tumor agressiveness and may be useful in modulating different treatment modalities.
Background
The breast is affected by a variety of benign disorders with a wide range of imaging and histopathological characteristics. Epidemiological investigations indicate that more than 50% of women will have one of the benign breast disorders beyond the age of 20 years.
Objectives
The objective of this study is to evaluate females with benign breast disorders attending the breast clinic in Duhok city by the triple assessment method.
Patients and methods
This is a prospective study conducted in Duhok Breast Clinic at Azadi Teaching Hospital from May 2017 to July 2018 which included 445 female patients with benign breast diseases. The patients were assessed by the triple assessment method (clinical examination, imaging and histopathological evaluation), females from all age groups were included. Patients with malignant disease and male patients were excluded from the study.
Results
The mean age of the patients was 34.65 years; breast pain was reported in 403 patients 73 patients presented with breast lump or lumps, 42 patients presented with nipple discharge, 36 patients were presented with nipple retraction.
From these the total number of the patients 55 of them were reassured and no further work up was done, 235 sent for ultrasound examination,36 sent for mammography, 22 sent for both ultrasound and mammography and 4 patients were sent for MRI of the breast.
Excisional biopsy done for 37 patients, FNAC in 28 patients, tru cut biopsy in 10 patients and cytological examination for the fluid discharge in 18 patients.
Mastalgia was the commonest disorder seen in 376 patients, Ductectasia in 60 cases, Fibrocystic disease in 36cases, fibroadenoma in 33cases, breast cysts in 28 cases.
Conclusions
Benign breast diseases is a common problem in women, in this study mastalgia is the commonest followed by benign and inflammatory lesions. The use of the triple assessment to approach breast pathologies increase the diagnostic yield. Surgeons evaluating breast pain should have more rational criteria in using further sophisticated, expensive and invasive tests.
