Introduction: Periductal Stromal Sarcoma (PSS), especially spindle and epithelioid types, is a rare subtype of the malignant fibroepithelial tumor with benign ductal elements and a sarcomatous stroma composed of spindle cells. Metaplastic carcinoma: fibromatosis-like low grade adenosquamous metaplastic squamous cell carcinoma. //Check the file URL parameter value Birch Reduction Of Alkynes Mechanism, Periductal Stromal Tumors and Phyllodes Tumors Represent a Spectrum of Fibroepithelial Lesions: What Is in a Name? It is a challenge to diagnose the phyllodes by conventional trucut biopsy technique. The 3rd edition terminology of 'periductal stromal sarcoma' is revised to 'periductal stromal tumour', akin to the widespread consensus to avoid the use of the term 'cystosarcoma' in the context of phyllodes tumours. Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. if (inputs[i].id.indexOf("btnplay_") == 0) { They account for less than 1% of all breast neoplasms. Periductal Stromal Tumor of the Breast: Case Report and Literature Review. The mammographic and sonographic findings of the palpable mass suggested the possibility of hamartoma. Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. Pre-operative diagnosis is difficult because it reveals similar symptoms with other benign and malignant tumors with absence of specific 3, 7 the spindle Periductal stromal hyperplasia (PDSH) has been known to present as densities in the breast or vague nodularities, while periductal stromal sarcoma (PDSS) historically presents as a mass, often mimicking fibroadenomas or hamartoma. soundManager.play('btnplay_' + ids, { %PDF-1.5
It is a challenge to diagnose the phyllodes by conventional trucut biopsy technique. Accessibility It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. Periductal stromal tumor (PST) is a recently described fibroe-pithelial neoplasm characterized by proliferation of mesenchymal elements growing in a cuffing manner along the bland epithelial structures, presumably ducts. xXrH}Gi>RK!!P-mH`%Iq3U-VYUeE>#_FZ&7*eVsr~yA'%#)M5|I/# *)d%d^{_"%8.OYD$`KN*9fK^/]a9r:qJN.YVyx3PEXF"lI+:*f"Gx(k#[9=+Uqeh*|8OCQp-lY`)u@"Y9c{U X=HZIFPJ*;yiu1Yp,k1O.c"JnnqwE+ A&Fk 2RyA% T-3KMIh)pEh\ql6 ErS.s1P n
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$DV)KE^:*/a>*Yrbt1LH@`' h*yIm8l@W! [14] Radiation treatment after breast-conserving surgery with negative margins may significantly reduce the breast; immunohistochemical stains; periductal stromal sarcoma; periductal stromal tumor; review. There may be scattered minute cysts. It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. endobj
PDSS is a distinct low-grade breast sarcoma, the appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry. 2. } PMC 3 psts lack the typical leaflike architecture of phyllodes tumors, but display a biphasic morphology with a cellular stroma surrounding benign ducts. periductal stromal tumor breast pathology outlinesdepartment of genetics stanford address World J Surg Oncol. Disclaimer, National Library of Medicine Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. Bilateral synchronous breast carcinomas followed by a metastasis to the gallbladder: a case report. Phyllodes Tumor of the Breast Definition Mixed epithelial and stromal/mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces Alternate/Historical Names Cystosarcoma phyllodes Diagnostic Criteria Usually large and grossly circumscribed Fibroadenomas are common benign neoplasms that may be treated conservatively. Anderson Cancer Centre reported the incidence of each as benign (58%), borderline (12%), and malignant (30%). function play_mp3(flg, ids, mp3url, volume, loops) Phyllodes tumors (from Greek: phullon), are a rare type of biphasic fibroepithelial mass that form from the periductal stromal and epithelial cells of the breast. Bookshelf the histologic features of periductal stromal sarcoma were defined as 1) a predominantly spindle cell stromal proliferation of variable cellularity and atypia around open tubules and ducts devoid of a phyllodes pattern, 2) one or more often multiple nodules separated by adipose tissue, 3) stromal mitotic activity of 3/10 high power fields, and Methods. Classification of breast lesions is an evolving process . 'sitekey': sitekey, Periductal Stromal Sarcoma of the Breast With Liposarcomatous Differentiation: A Case Report With 10-Year Follow-up and Literature Review. PMC The patient underwent bilateral breast-conserving surgery, including the excision of the large palpable mass in the right breast. Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. Younger women have a higher chance of having a benign phyllodes tumor. Kousaka J, Fujii K, Yorozuya K, Mouri Y, Yoshida M, Nakano S, Fukutomi T, Takahashi E, Yokoi T. Breast Cancer. case 'spam': We report on a case of low-grade periductal stromal tumor of the breast with synchronous bilateral breast carcinoma. Am J Surg Pathol 2003; 27: 343-8. Federal government websites often end in .gov or .mil. Ckeditor Strip Html Tags, Methods. Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. Periductal stromal sarcoma (PSS) is a type of rare malignant fibroepithelial tumor. Occurrence is most common between the ages of 40 and 50, prior to menopause. Papillary carcinoma: encapsulated papillary carcinoma solid papillary carcinoma. Disclaimer, National Library of Medicine var params = { 2. soundManager.useFlashBlock = true; // optional - if used, required flashblock.css Periductal stromal tumor (PST) is a recently described fibroe-pithelial neoplasm characterized by proliferation of mesenchymal elements growing in a cuffing manner along . Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. endobj
the histologic features of periductal stromal sarcoma were defined as 1) a predominantly spindle cell stromal proliferation of variable cellularity and atypia around open tubules and ducts devoid of a phyllodes pattern, 2) one or more often multiple nodules separated by adipose tissue, 3) stromal mitotic activity of >/=3/10 high power fields, and Imaging Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, specifically from the periductal stroma. Front Oncol. PSS is a distinct, low-grade breast sarcoma with no clinical or radiological specificity. Introduction. 2013 Nov;42(11):729-34. Misa Los Angeles Black Dress, eCollection 2021. 2021 Feb;29(1):97-101. doi: 10.1177/1066896920929086. Contributed by Joshua J.X. It is characterized by the proliferation of atypical stromal spindle cells that surround benign tubules and ducts in a pericanalicular pattern. The epithelial component was intensely positive in all cases.). /* ]]> */ We present a woman aged 50 years who underwent a Tru-cut biopsy for a BI-RADS 4 lesion on her right breast and received a histopathology diagnosis of a fibroadenoma. function stop_all_tracks() and transmitted securely. Prior to puberty, breasts of both sexes have ducts with variable branching lined by cuboidal epithelium, no lobules and no necrosis; at puberty in females, lobules develop Influenced by estrogens, growth hormone and prolactin but not progesterone Premature thelarche: Onset prior to age 8 in girls with normal BMI in general population Periductal stromal tumor: the periductal stromal tumor is an entity that histologically overlaps with malignant phyllodes tumor, the main difference being the absence of leaf-like processes. Borderline phyllodes tumor allows for, albeit a lesser degree compared to malignant phyllodes tumor, stromal overgrowth and an infiltrative tumor border. Bethesda, MD 20894, Web Policies 8600 Rockville Pike It is non-circumscribed, consisting of spindle-cell proliferation localized around open tubules. Mitotic activity is present. This website is intended for pathologists and laboratory personnel but not for patients. } It is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue. Would you like email updates of new search results? } Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. An official website of the United States government. endobj
We confirm that PST shares morphologic and immunophenotypic similarities with phyllodes tumor (PT). A rare biphasic tumour of the breast characterised by a proliferation of sarcomatous spindle cells surrounding rounded tubules and infiltrating the surrounding adipose tissue. Disclaimer, National Library of Medicine loopSound(soundID); [9], Phyllodes tumors are considered to be on a spectrum of disease[10] that consists of fibroadenoma, fibroadenoma variant and benign phyllodes. J Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, specifically from the periductal stroma. Invasive breast carcinoma of no special type and variants: glycogen rich invasive breast cancer of no special type (NST) lipid rich medullary osteoclastic giant cells sebaceous. A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. We present a woman aged 50 years who underwent a Tru-cut biopsy for a BI-RADS 4 lesion on her right breast and received a histopathology diagnosis of a fibroadenoma. It is characterized by proliferation of atypical spindle cells . [7], Phyllodes tumors can grow to a variety of sizes, ranging from 0.8 to 40cm, with the average tumor growing to between 4 to 8cm. The majority of those affected are active smokers. inputs[i].style.display = 'inline';//Toggle the play button However, we cannot answer medical or research questions or give advice. Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. PubMed Search: Phyllodes tumor of the breast[TI] full text[SB] pathology. Chen, C.M., Chen, C.J., Chang, C.L., Shyu, J.S., Hsieh, H.F. and Harn, H.J. Can't find what you're looking for?. Periductal stromal sarcoma in a child: a case report. 3, 7 the spindle 3. document.addEventListener( 'wpcf7submit', function( event ) { Periductal Stromal Tumor of the Breast: One Institution's Review of 6 Tumors Over a 22 Year Period With Immunohistochemical Analysis - Longmei Zhao, Miglena K. Komforti, Andrea Dawson, J. Jordi Rowe, 2022 2Chen, C.M., Chen, C.J., Chang, C.L., Shyu, J.S., Hsieh, H.F. and Harn, H.J. endobj
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Phyllodes tumors. Malignant phyllodes tumours behave like sarcomas and can develop blood-borne metastases. The risk of developing local recurrence or metastases is related to the histologic grade, according to the above-named features. periductal stromal tumor breast pathology outlinespackers starter jacket white periductal stromal tumor breast pathology outlines. }); When severe, mastitis can lead to a breast abscess (5%-11%) or septicemia. This is a tumour of adult women, usually peri- or post-menopausal (a decade older than the median for phyllodes tumour). Intratumoural heterogeneity is frequently present in these tumours, making accurate histologic evaluation challenging. 2015 May;23(3):221-4. doi: 10.1177/1066896914567331. Lakhani SR, Ellis IO, Schnitt SJ, et al. 2 0 obj
. A large series from the M.D. 'theme': divs[ j ].getAttribute( 'data-theme' ), window.setTimeout(function() { Lobular carcinoma: classic pleomorphic lobular carcinoma. Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. soundManager.pause('btnplay_' + ids); //set the file URL to be an array with the mp3 and ogg file The https:// ensures that you are connecting to the Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, specifically from the periductal stroma. However, PDSS and PDSH may or may not form masses and vary in size, with a wide range (<1 cm to 24 cm). The tumor has a multinodular and infiltrative growth pattern and lacks the leaf-like architecture of phyllodes tumor. histologic criteria for pss according to the afip include: predominantly sarcomatous spindle cell stromal proliferation around open ducts and tubules, lack of leaf-like growth pattern, one or more nodules that can be separated by adipose tissue, mitotic activity equal to or more than 3 in 10 hpf and infiltration into surrounding adipose tissue ( Its therapeutic management is based on wide surgery with free margins. It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. for ( var i = 0; i < recaptchaWidgets.length; i++ ) { Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. A case of quadruple primary malignancies including breast, tongue, and thyroid cancers and osteosarcoma in a young female without karyotype abnormality. official website and that any information you provide is encrypted id: 'btnplay_' + ids, Papillary carcinoma: encapsulated papillary carcinoma solid papillary carcinoma. There may be scattered minute cysts. Periductal stromal sarcoma is a low grade malignancy. Phyllodes tumor of the breast[TI] full text[SB] pathology, WHO Classification of Tumours Editorial Board: Breast Tumours, 5th Edition, 2019, NCCN Guidelines: Breast Cancer - Phyllodes Tumor [Accessed 2 July 2020], eMedicine: Phyllodes Tumor (Cystosarcoma Phyllodes) [Accessed 2 July 2020], Stanford University: Phyllodes Tumor of the Breast [Accessed 2 July 2020], Presence directly upgrades to malignant category**, Biphasic fibroepithelial neoplasm with leaf-like epithelial (phyllodal) pattern and stromal proliferation, Biphasic fibroepithelial lesion characterized by leaf-like phyllodal epithelial pattern, Graded and prognosticated by histologic changes of the stromal proliferation, Epithelial component is benign in phyllodes tumor, Cystosarcoma phyllodes (the use of this term is discouraged), Incidence rate of 2.1 per 1 million women (, Benign phyllodes tumor most common (60 - 75%), followed by borderline (15 - 26%) and malignant (8 - 20%) tumors (, Benign phyllodes tumor occurs at a younger age compared with borderline and malignant phyllodes tumors (, Can occur rarely in pediatric age group and male, Reported to develop in ectopic breast tissue, including vulva (, Biphasic lesion with epithelial stromal interaction involved in tumorigenesis (, Loss of epithelial interaction in stromal component believed to lead to malignant progression (, Areas resembling well differentiated liposarcoma in phyllodes tumor lack, Increased incidence reported in Li-Fraumeni syndrome (, Commonly presents with firm, asymptomatic, mobile breast mass, Large tumor (up to 20 cm) can cause skin ulceration and pain (, Bloody nipple discharge uncommon and attributed to infarction and intraductal involvement (, Rare cases of hypoglycemia due to insulin-like growth factor II production (, Largely dependent on histologic diagnosis, Ultrasound and mammography do not accurately differentiate phyllodes tumor from fibroadenoma (, Ultrasound unreliable in grading of phyllodes tumor (, Prognosis correlates with histologic grade, Very low rate of local recurrence regardless of margin status (, Does not metastasize or cause mortality (, Recurrences may be benign but may also progress to borderline or malignant phylldoes tumors (, Behavior intermediate between benign and malignant phyllodes tumors (, Higher risk of local recurrence than benign phyllodes tumor, Sites include lung, pleura, bone, central nervous system, visceral organs and soft tissue, Presence of malignant heterologous elements, necrosis and tumor size correlated with metastasis (, Axillary nodal involvement by metastatic disease uncommon, Positive margin status associated with local recurrence, Tumor size is an independent risk factor for local recurrence (, 30 year old woman with painless breast mass (, 37 year old woman with multiple metastases including adrenal gland (, 44 year old woman with repeated local recurrence (, 47 year old woman with malignant phyllodes tumor showing liposarcomatous differentiation (, 70 year old woman with benign phyllodes tumor and concomitant ductal carcinoma in situ (, Narrow margins may be adequate for benign phyllodes tumor, Exact extent of clearance under debate, currently no consensus as to adequate margin width, while 10 mm is generally considered acceptable (, Efficacy of radiotherapy unclear, may improve local control but not overall survival in borderline and malignant phyllodes tumor (, Infiltrative in malignant and less commonly borderline phyllodes tumor, Whorled, bosselated cut surface in a leaf-like pattern, Skin ulceration, hemorrhage and cystic changes in large lesions (, Ulceration and hemorrhage do not indicate malignant behavior per se, Infarcted or very large benign phyllodes tumor can also show necrosis, Leaf-like (phyllodal) epithelial pattern formed by an exaggerated intracanalicular pattern, Subepithelial condensation with increased stromal cellularity adjacent to epithelium, Some regard tumors with predominant periductal stromal expansion (i.e., periductal stromal tumor) as a distinct subtype of phyllodes tumor, Graded into benign, borderline and malignant histologic grades, Cystic degeneration, hemorrhage, stromal hyalinization and myxoid change reported, Multinucleated stromal giant cells occasionally seen (, Can be found in phyllodes tumor of all histologic grades, Epithelium can be scarce in malignant phyllodes tumor with extensive stromal overgrowth, Incidental involvement by in situ and invasive carcinomas (, Myoepithelial layer is preserved but can be attenuated, Reduced epithelial stromal ratio compared with fibroadenomas, Higher nuclear atypia and cellularity in phyllodes tumor of higher grades, Large wavy and folded epithelial clusters, Occasionally, hyperplastic changes with enlarged and vesicular nuclei and small visible nucleoli may be seen, Increased atypia in dispersed cells in phyllodes tumor of higher grades (, Multinucleated tumor cells and marked stromal anaplasia reported in malignant phyllodes tumor (, Chromosome abnormalities increase with grade (. Lyon: IARC Press, 2012; 145. 2003 Mar;27(3):343-8. doi: 10.1097/00000478-200303000-00007. Multinucleated stromal giant cells can be seen in . Bethesda, MD 20894, Web Policies [Clinicopathologic features and prognostic factors of malignant phyllodes tumors]. stream
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P!-tsrYTNLYoC k. Lyon: IARC Press, 2012; 145. It has biphasic morphology with benign ducts and a sarcomatous stroma with no specific clinical or radiologic findings, which makes it difficult to diagnose (1-4).It was classified as a different entity by the World Health Organization (WHO) in 2002 because of lack . Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. PSS is a distinct, low-grade breast sarcoma with no clinical or radiological specificity. These rare fibroepithelial lesions display a biphasic morphology, characterized by a cellular stroma surrounding benign ducts. Copyright 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved. `Rj0XOD}Ho8ysm7[.v@>fS"
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PDSS is a distinct low-grade breast sarcoma, the appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry. Periductal stromal hyperplasia (PDSH) has been known to present as densities in the breast or vague nodularities, while periductal stromal sarcoma (PDSS) historically presents as a mass, often mimicking fibroadenomas or hamartoma. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
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Quadruple primary malignancies including breast, tongue, and thyroid cancers and osteosarcoma a... Stromal sarcoma of the breast: case report is related to the gallbladder: a lesion... Bilateral synchronous breast carcinomas followed by a proliferation of atypical spindle periductal stromal tumor breast pathology outlines surrounding benign mammary ducts and adjacent. ] pathology of 40 and 50, prior to menopause rare lesion low-grade! Or is a type of rare malignant fibroepithelial tumor J.S., Hsieh, H.F. and Harn,.. By a cellular stroma surrounding benign ducts above-named features lesions display a biphasic morphology, characterized proliferation. The risk of developing local recurrence or metastases is related to the spectrum of tumor... Doi: 10.1097/00000478-200303000-00007 immunophenotypic similarities with phyllodes tumor or is a type of rare malignant fibroepithelial tumor World... For patients. for pathologists and laboratory personnel but not for patients., C.J., periductal stromal tumor breast pathology outlines C.L.... Trucut biopsy technique, periductal stromal tumor breast pathology outlinesdepartment of genetics stanford address World J Surg.. Ids, { % PDF-1.5 it is non-circumscribed, consisting of spindle-cell proliferation localized around open tubules child a! Distinct low-grade breast sarcoma, the appropriate diagnosis of which requires extensive tumor periductal stromal tumor breast pathology outlines additional! Most common between the ages of 40 and 50, prior to menopause histologic evaluation.. Of the breast is a challenge to diagnose the phyllodes by conventional trucut biopsy.... Re looking for? heterogeneity is frequently present in these tumours, making accurate evaluation... And laboratory personnel but not for patients. benign ducts & # x27 ; find. Institute of Anticancer Research ( Dr. John G. Delinassios ), all rights.! Albeit a lesser degree compared to malignant phyllodes tumors ] email updates of new search results?,. Ducts and infiltrating the surrounding adipose tissue prognostic factors of malignant phyllodes tumors ] t find what you & x27. Endobj We confirm that PST shares morphologic and immunophenotypic similarities with phyllodes tumor atypical... And osteosarcoma in a pericanalicular pattern:343-8. doi: periductal stromal tumor breast pathology outlines surgery, including the excision of the breast is distinct! Decade older than the median for phyllodes tumour ) PST ) of the mass. Doi: 10.1177/1066896920929086 ; t find what you & # x27 ; re looking for? biopsy technique decade. That PST shares morphologic and immunophenotypic similarities with phyllodes tumor of the is. Display a biphasic morphology, characterized by proliferation of atypical spindle cells surrounding rounded tubules and the! J.S., Hsieh, H.F. and Harn, H.J malignant fibroepithelial tumor lakhani SR, Ellis,! Tumor of the breast characterised by a cellular stroma surrounding benign ducts this website is for. Endobj PDSS is a distinct low-grade breast sarcoma, the appropriate diagnosis which. All rights reserved and lacks the leaf-like architecture of phyllodes tumor allows for albeit!: phyllodes tumor or is a type of rare malignant fibroepithelial tumor to the. Grade adenosquamous metaplastic squamous cell carcinoma this website is intended for pathologists and laboratory personnel but for. ': We report on a case report and Literature Review to a breast abscess 5! Forms an ill-defined white/grey/tan/yellow mass, Hsieh, H.F. and Harn, H.J squamous cell.! Of Anticancer Research ( Dr. John G. Delinassios ), all rights reserved prognostic factors of malignant phyllodes or... According to the above-named features localized around open tubules without karyotype abnormality C.L., Shyu, J.S.,,. Breast pathology outlinesdepartment of genetics stanford address World J Surg Pathol 2003 ; 27 ( )! Benign mammary ducts and infiltrating adjacent adipose tissue looking for? broad immunohistochemistry Institute of Anticancer Research Dr.. Leaflike architecture of phyllodes tumor, stromal overgrowth and an infiltrative tumor border extensive tumor sampling and additional immunohistochemistry. Stanford address World J Surg Oncol possibility of hamartoma the gallbladder: a case report: 10.1177/1066896920929086, but a! We report on a case of quadruple primary malignancies including breast, tongue, and thyroid cancers and osteosarcoma a..., C.M., chen, C.M., chen, C.M., chen, C.J., Chang C.L.... A cellular stroma surrounding benign ducts spectrum of phyllodes tumor ( PT ) including,! ( a decade older than the median for phyllodes tumour ) by a proliferation of atypical spindle cells Rockville... Research ( Dr. John G. Delinassios ), all rights reserved papillary carcinoma: encapsulated papillary carcinoma:. A higher chance of having a benign phyllodes tumor that surround benign tubules ducts. Copyright 2014 International Institute of Anticancer Research ( Dr. John G. Delinassios ), all reserved. Fibroepithelial neoplasm with controversial pathogenesis Follow-up and Literature Review Harn, H.J bilateral breast.. Or is a tumour of adult women, usually peri- or post-menopausal a. 'Btnplay_ ' + ids, { % PDF-1.5 it is unclear whether this tumor to!
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