Hyperplasia Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):233-240
DOI 10.1590/SO100-720320150005333
To assess the effect of tibolone on mammary tissue of castrated rats over 3
different periods of time.
Sixty virgin female Wistar rats were submitted to oophorectomy. Twenty-one days
after surgery, with hypoestrogenism confirmed, the experimental rats were randomly
assigned to six groups: Tibolone 1 (n=10) received tibolone 1 mg/day for 23 days,
tibolone 2 (n=10) for 59 days and tibolone 3 (n=10) for 118 days. The groups
control 1 (n=8), control 2 (n=7) and control 2 (n=10) received distilled water for
23, 59 and 118 days, respectively. After treatment, all six pairs of mammary
glands were removed and stained with hematoxylin and eosin (HE) for histological
analysis after euthanasia. The histological parameters evaluated were: epithelial
cell proliferation and secretory activity. The variables were analyzed
statistically, with the level of significance set at 0.05.
Histological changes were observed in 20/55 rats, mild epithelial hyperplasia in
7/55, moderate epithelial hyperplasia in 5/55, alveolar-nodular hyperplasia in
7/55, atypia without epithelial proliferation in 1/55, and no cases of severe
epithelial hyperplasia were found. Secretory activity was observed in 31/55 rats.
The secretory activity was significantly higher in the tibolone groups compared to
control at all the time points assessed (p=0,001). The histological changes were
did not show significance when the control and tibolone groups were compared. The
time of exposure to tibolone did not show significance when the three different
periods of evaluation were compared.
No relation between histological modification and tibolone treatment was verified
after short-, medium- and long-term treatment.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):233-240
DOI 10.1590/SO100-720320150005333
To assess the effect of tibolone on mammary tissue of castrated rats over 3
different periods of time.
Sixty virgin female Wistar rats were submitted to oophorectomy. Twenty-one days
after surgery, with hypoestrogenism confirmed, the experimental rats were randomly
assigned to six groups: Tibolone 1 (n=10) received tibolone 1 mg/day for 23 days,
tibolone 2 (n=10) for 59 days and tibolone 3 (n=10) for 118 days. The groups
control 1 (n=8), control 2 (n=7) and control 2 (n=10) received distilled water for
23, 59 and 118 days, respectively. After treatment, all six pairs of mammary
glands were removed and stained with hematoxylin and eosin (HE) for histological
analysis after euthanasia. The histological parameters evaluated were: epithelial
cell proliferation and secretory activity. The variables were analyzed
statistically, with the level of significance set at 0.05.
Histological changes were observed in 20/55 rats, mild epithelial hyperplasia in
7/55, moderate epithelial hyperplasia in 5/55, alveolar-nodular hyperplasia in
7/55, atypia without epithelial proliferation in 1/55, and no cases of severe
epithelial hyperplasia were found. Secretory activity was observed in 31/55 rats.
The secretory activity was significantly higher in the tibolone groups compared to
control at all the time points assessed (p=0,001). The histological changes were
did not show significance when the control and tibolone groups were compared. The
time of exposure to tibolone did not show significance when the three different
periods of evaluation were compared.
No relation between histological modification and tibolone treatment was verified
after short-, medium- and long-term treatment.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):164-170
DOI 10.1590/S0100-72032013000400006
PURPOSE: To evaluate the agreement about the histopathological diagnosis of intraductal proliferative breast lesions between general pathologists and a specialist in breast pathology. METHODS: This was an observational, cross-sectional study of 209 lesions received in consultation at the Breast Pathology Laboratory of the School of Medicine, Federal University of Minas Gerais, from 2007 to 2011, comparing the original diagnosis and the review. We included only cases with a formal request for review and cases in which the original diagnosis or reviewer's diagnosis showed proliferative lesions, pure ductal carcinoma in situ, ductal carcinoma in situ associated with microinvasion or associated with invasive carcinoma. The kappa index and percent concordance were used in the statistical analyses. RESULTS: A moderate agreement was observed between the original histopathological diagnosis and the second opinion (kappa=0.5; percentual concordance=83%). After the review, the diagnosis of malignancy was confirmed in 140/163 cases (86%) and the diagnosis of benign lesions was confirmed in 34/46 cases (74%). Regarding specific diagnosis, we observed moderate agreement between the original diagnosis and the reviewer's diagnosis (136/209 cases; kappa=0.5; percent concordance=65%). The highest disagreement was observed in cases of ductal carcinoma in situ with microinvasion (6/6 cases; 100%). Important discordance was observed in cases of atypical ductal hyperplasia (16/30 cases; 53%) and ductal carcinoma in situ (25/75 cases; 33%). Regarding the histological grade of ductal carcinoma in situ, we observed good agreement between the original diagnosis and the review (29/39 cases; kappa=0.6, percent agreement=74%). CONCLUSION: Our data confirm that intraductal proliferative breast lesions, especially atypical ductal hyperplasia, ductal carcinoma in situ and ductal carcinoma in situ with microinvasion show relevant discrepancies in the histopathological diagnoses, which may induce errors in therapeutic decisions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):164-170
DOI 10.1590/S0100-72032013000400006
PURPOSE: To evaluate the agreement about the histopathological diagnosis of intraductal proliferative breast lesions between general pathologists and a specialist in breast pathology. METHODS: This was an observational, cross-sectional study of 209 lesions received in consultation at the Breast Pathology Laboratory of the School of Medicine, Federal University of Minas Gerais, from 2007 to 2011, comparing the original diagnosis and the review. We included only cases with a formal request for review and cases in which the original diagnosis or reviewer's diagnosis showed proliferative lesions, pure ductal carcinoma in situ, ductal carcinoma in situ associated with microinvasion or associated with invasive carcinoma. The kappa index and percent concordance were used in the statistical analyses. RESULTS: A moderate agreement was observed between the original histopathological diagnosis and the second opinion (kappa=0.5; percentual concordance=83%). After the review, the diagnosis of malignancy was confirmed in 140/163 cases (86%) and the diagnosis of benign lesions was confirmed in 34/46 cases (74%). Regarding specific diagnosis, we observed moderate agreement between the original diagnosis and the reviewer's diagnosis (136/209 cases; kappa=0.5; percent concordance=65%). The highest disagreement was observed in cases of ductal carcinoma in situ with microinvasion (6/6 cases; 100%). Important discordance was observed in cases of atypical ductal hyperplasia (16/30 cases; 53%) and ductal carcinoma in situ (25/75 cases; 33%). Regarding the histological grade of ductal carcinoma in situ, we observed good agreement between the original diagnosis and the review (29/39 cases; kappa=0.6, percent agreement=74%). CONCLUSION: Our data confirm that intraductal proliferative breast lesions, especially atypical ductal hyperplasia, ductal carcinoma in situ and ductal carcinoma in situ with microinvasion show relevant discrepancies in the histopathological diagnoses, which may induce errors in therapeutic decisions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):550-555
DOI 10.1590/S0100-72032008001100004
PURPOSE: to analyze interobserver variability in the histopathological diagnosis of premalignant breast lesions before and after training with diagnostic standardized criteria. METHODS: Slides containing histological sections representative of three kinds of breast lesions (atypical ductal hyperplasia, ductal carcinoma in situ and ductal carcinoma in situ with microinvasion), revised by an international specialist in breast pathology whose diagnoses were considered as golden standard, have been used. The same slides have been evaluated at two different times by five pathologists from the community according to a specific protocol for classifying the lesions. In the first evaluation, the cases were analyzed and classified according to the specific criteria adopted in each service. At the second time, the pathologists were given a tutorial containing diagnostic criteria and representative images, and the lesions were classified again, employing the standardized criteria. Interobserver analysis using percent agreement and weighted Kappa index has been performed. RESULTS: There has been a large diagnostic variation among the pathologists in the initial analysis without the use of standardized diagnostic criteria concerning the diagnostic, nuclear grade and histological grade (weighted Kappa indexes related to diagnosis varied from 0.15 to 0.40). In the second evaluation using standardized criteria, there has been a significant improvement in the diagnostic concordance among the five pathologists concerning the diagnosis, nuclear grade and histological grade (weighted Kappa indexes related to diagnosis have varied from 0.42 to 0.80). CONCLUSIONS: interobserver concordance related to diagnosis and classification of breast premalignant lesions may be improved with specific training and the use of standardized histopathological criteria.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):550-555
DOI 10.1590/S0100-72032008001100004
PURPOSE: to analyze interobserver variability in the histopathological diagnosis of premalignant breast lesions before and after training with diagnostic standardized criteria. METHODS: Slides containing histological sections representative of three kinds of breast lesions (atypical ductal hyperplasia, ductal carcinoma in situ and ductal carcinoma in situ with microinvasion), revised by an international specialist in breast pathology whose diagnoses were considered as golden standard, have been used. The same slides have been evaluated at two different times by five pathologists from the community according to a specific protocol for classifying the lesions. In the first evaluation, the cases were analyzed and classified according to the specific criteria adopted in each service. At the second time, the pathologists were given a tutorial containing diagnostic criteria and representative images, and the lesions were classified again, employing the standardized criteria. Interobserver analysis using percent agreement and weighted Kappa index has been performed. RESULTS: There has been a large diagnostic variation among the pathologists in the initial analysis without the use of standardized diagnostic criteria concerning the diagnostic, nuclear grade and histological grade (weighted Kappa indexes related to diagnosis varied from 0.15 to 0.40). In the second evaluation using standardized criteria, there has been a significant improvement in the diagnostic concordance among the five pathologists concerning the diagnosis, nuclear grade and histological grade (weighted Kappa indexes related to diagnosis have varied from 0.42 to 0.80). CONCLUSIONS: interobserver concordance related to diagnosis and classification of breast premalignant lesions may be improved with specific training and the use of standardized histopathological criteria.
