用核磁共振、乳腺钼靶及彩超检查诊断早期乳癌的效果对比分析

对比分析核磁共振、乳腺钼靶以及彩超三种检查方式在早期乳腺癌临床诊断中的效果,选择最佳的检查方式,保证诊断的准确性。方法:将2019年1月至2020年1月我院收治的80例早期乳腺癌患者作为临床观察对象,以上80例患者均分别接受了核磁共振、乳腺钼靶和彩超检查三种方式的检查,将三种检查结果与病理检查结果相对比,以病理检查结果为金标准,对比分析三种检查方式的敏感度和特异度、准确度,选择最佳的检查方式,为后续的治疗提供辅助。结果:在本次检查中,三种不同的检查方式均发挥出了重要的诊断价值,核磁共振在早期乳腺癌的检查中,其检查的敏感度和准确率显著高于乳腺钼靶对患者检查以及彩超对患者检查的敏感度和准确度,数据差异有统计学意义(P <0.05)。结论:对早期乳腺癌患者而言,准确的检查和诊断有助于后期的治疗成功率的提升,通过核磁共振可以对早期乳腺癌患者的病灶以及肿瘤的范围进行确定,为后续的治疗提供参考依据,建议在今后的早期乳癌检查诊断中积极应用核磁共振检查方式。

医用电子鼻气体传感器阵列优化方法

电子鼻气体传感器阵列存在冗余和相关,将对分类识别效果产生影响。提出并实现了一种新的医用电子鼻气体传感器阵列优化方法,利用改进遗传算法设定气体传感器的重要性系数,以去除传感器阵列的冗余和相关,提高系统的判别能力。新的方法分别用于五种乳癌特征气体和七种伤口病原菌检测,使正确识别率得到较大提高。

Measurement of Serum Total and Free Prostate-Specific Antigen for Breast Cancer Diagnosis in Women

Objective: To investigate the diagnostic value and the relationship between the clinicopathological features and the levels of total and free prostate-specific antigen (PSA) in women with breast cancer.Methods: Using the microparticle enzyme immunoassay system, we measured the concentrations of these markers in the sera of 85 women with breast cancer and in 30 healthy women.Rseults: The lowest detection level for both markers was 0.01 ng/ml. Free PSA levels were significantly higher in women with breast cancer than that in healthy women (P<0.05). The percentage of free PSA predominant subjects was 37.6% in breast cancer patients and 3.3% in healthy women. Cut-off values were 0.36 ng/ml for total PSA and 0.02 ng/ml for free PSA. In women with breast cancer, total PSA positivity was 23.5% and free PSA positivity was 27.1%. Compared to negatives, total PSA positive patients had a higher percentage of lymph node involvement tumours (P>0.05). However, patients with predominant free PSA had a higher percentage of early stage than patients with predominant PSA-ACT.Conclusion: Although the sensitivity of free PSA predominance is low (37.6%) in distinguishing women with breast cancer from healthy women, its specificity is high (97.0%).Free PSA predominance tends to be present in early stage tumours. These findings may indicate clinical significance of preoperative measurement of serum total and free PSA in women with breast cancer.

Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences

Breast cancer is one of the most frequently diagnosed malignancies during pregnancy. Here, we review the management of women with breast cancer during pregnancy(BCP), focusing on biology, diagnosis and staging, local and systemic treatments, obstetric care and long-term follow-up of children with prenatal exposure to anticancer treatments.

Utility of an upright-type 11-gauge stereotactic vacuum-assisted biopsy device (Mammotome) for the diagnosis of breast microcalcifications

Objective: The aim of this study was to evaluate the utility of an upright-type 11-gauge stereotactic vacuumassisted biopsy device (Mammotome) for the diagnosis of breast microcalcifications Methods: Between May 2001 and October 2005, 154 biopsies in 152 patients with microcalcifications were performed using the upright-type 11-gauge stereotactic vacuum-assisted biopsy device. Patients in whom this biopsy was diagnosed as carcinoma or a borderline lesion, had a subsequent surgical excision of the lesion. Histopathological and radiological features of the two specimens were then compared with each other. Results: Microcalcification was identified on specimen mammograms and microscopic slides in 97.4% of cases. Of 154 Mammotome biopsies 98 (63.6%) were benign, 51 (33.1%) were malignant, 3 (1.9%) showed atypical hyperplasia, and 2 (1.3%) were indeterminate, respectively. Of the 48 cases that received surgical excision, 6 of 36 ductal carcinomas in situ (16.7%) upstaged to invasive ductal carcinoma and 1 of 2 atypical ductal hyperplasias was upstaged to ductal carcinoma in situ. The positive predictive value of the 11-gauge Mammotome for the diagnosis of invasion in breast cancer was 100%. Linear calcification and pleomorphic calcification linear/segmental distribution was reliable indications of malignancy. The mean follow-up time of the benign lesions was 22 months, and without evidence of lesion growth. Complications included vasovagal reactions (6.3%), bleeding (0.6%) and hematoma (2.6%). Conclusion: The upright stereotactic 11-gauge Mammotome procedure is an effective and reliable method for the diagnosis of breast microcalcifications. It has minimal side effects. For lesions diagnosed as ADH or DCIS with the 11-gauge Mammotome, subsequent surgical excision should be performed.

ROC analysis of CT hemodynamic in the diagnosis of breast cancer

Objective:The aim of this study was evaluate the diagnostic value of computed tomography(CT) perfusion in breast cancer by the method of receiver operator characteristic curve(ROC) analysis.Methods:Eighty-one cases with breast masses found by health examination or mammography were scanned by multi-slice spiral CT(MSCT) perfusion and hemodynamic parameters of blood flow(BF), mean transit time(MTT) and blood volume(BV) were calculated by deconvolution arithmetic.According to the pathologic results, two groups, benign and malignant were classified and statistical analysis were performed between them.The ROC characteristics of BF, MTT, BV were compared for each and the diagnostic value of the hemodynamic parameters were confirmed.Results:In the malignant group, BF was(0.735 ± 0.440) mL/min/mL, MTT was(22.771 ± 7.647) s and BV was 0.234 ± 0.082.In the benign group, BF was(0.466 ± 0.527) mL/min/mL, MTT was(26.712 ± 12.934) s and BV was 0.179 ± 0.117.There was a significant difference for BF and BV between the benign and malignant groups.When the hemodynamic parameters were used to discriminate the breast lesions, the area under the ROC curve(AUCROC) of BF was 0.832 ± 0.086, the maximum, while AUCROC of BV was 0.695 ± 0.092.There was no significant statistical difference between BF and BV.AUCROC of MTT was 0.473 ± 0.102, which was minimal.Since the threshold of BF was 0.381 mL/min/mL, the sensitivity was 82.3%, the specificity was 73.2%, the positive likelihood ratio(LR) was 3.071 and the negative LR was 0.242.The threshold of BV was 0.190 with sensitivity 73.3%, specificity 56.5%, positive likelihood ratio 1.685 and negative LR 0.473.Conclusion:BF and BV among CT hemodynamic parameters have certain diagnostic value in breast cancer, but BF or BV can not yet be single index to confirm or deny the diagnosis.

Diagnosis and treatment of peripherally inserted central catheters(PICC)-related sepsis in breast cancer patients carrying PICC catheter for chemotherapy

Objective:The aim of our research was to study the incidence,clinical diagnosis and treatment of peripherally inserted central catheters(PICC)-related sepsis in breast cancer patients carrying PICC catheter for chemotherapy.Methods:The data of the incidence,diagnosis and treatment of PICC-related sepsis in 215 cases of breast cancer patients carrying PICC catheter for chemotherapy in our hospital from August,2009 to September,2011 were analyzed retrospectively.Results:216 PICCs had been successfully applied in 215 cases of breast cancer patients and followed for a total of 19,109 catheter days,(median catheterization duration,88.9 days,range 1-212 days).Among those,3(1.39%) PICCs were removed respectively as a result of PICC-related sepsis in 29,73 and 108 catheter-days(median 70 d),with a rate of 0.16 per 1000 catheter-days.Conclusion:Chemotherapeutic treatment via PICC for breast cancer patients is one of the most secure and effective measures but there exists small number of cases in which PICC catheter related sepsis is possible.Careful observation of relevant symptoms and signs,early diagnosis and treatment,not relying completely on blood culture tests and timely removal of PICC catheter can be very effective in treating PICC-related sepsis in these patients.

Serological Diagnosis of Liver Metastasis in Patients with Breast Cancer

Objective To diagnose and explore the serological diagnostic factors for liver metastasis in patients with breast cancer before symptoms occur. Methods A total of 430 female in-patients with breast cancer of stages 0 to IIIC who came to Tianjin Medical University Cancer Institute and Hospital from January 2003 to January 2004 were studied and followed up until May 2011. Serum levels of biochemical markers for tumor and liver were measured at the time of diagnosis. Results Liver metastasis was more likely to occur in patients with stage Ill cancer or c-erbB-2-positive expression. Alanine aminotransferase, aspartate aminotransferase, ~/-glutamyltransferase （GGT）, alkaline phosphatase, lactate dehvdrogenase （LDH）, and carbohydrate antigen 1153 （CA153） levels were significantly higher in patients with liver metastasis than those without liver metastasis. Diagnostic indices of LDH, GGT, and CA153 were 174 U/L, 32 U/L, and 26.48 Dg/L, respectively. The areas under the curves of LDH, GGT, and CEA were 0.795, 0.784, and 0.661, respectively, and sensitivities of parallel tests for LDH and CA153 and for GGT and CA153 were 88.6% and 85.7 %, respectively. The specificity of serial tests for both pairs of enzymes was 97.7%. Conclusions Tile sensitivity and specificity of combined tumor and biochemical markers could be used as indicators during screening for breast-liver metastasis.

Mammography combined with breast dynamic contrast-enhanced-magnetic resonance imaging for the diagnosis of early breast cancer

Objective The aim of this study was to investigate the application of mammography combined with breast dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) for the diagnosis of early breast cancer. Methods Mammography and DCE-MRI were performed for 120 patients with breast cancer(malignant, 102; benign; 18). Results The sensitivity of mammography for early diagnosis of breast cancer was 66.67%, specificity was 77.78%, and accuracy was 68.33%. The sensitivity of MRI for early diagnosis of breast cancer was 94.12%, specificity was 88.89%, and accuracy was 93.33%. However, the sensitivity of mammography combined with DCE-MRI volume imaging with enhanced water signal(VIEWS) scanning for early diagnosis of breast cancer was 97.06%, specificity was 94.44%, and accuracy was 96.67%. Conclusion Mammography combined with DCE-MRI increased the sensitivity, specificity, and accuracy of diagnosing early breast cancer.

The application of breast DCE-MRI combined with time signal curve in diagnosing early breast cancer

Objective： The aim of this study was to investigate the application value of breast dynamic contrast-enhanced magnetic resonance imaging combined with time signal curve in diagnosis of early breast cancer. Methods： Conducted dynamic contrast-enhanced MRI and drew the time signal curves of breast lesions in 60 patients with breast disease （malignant 46, benign 14）. Results： Morphological features of malignant tumors mostly showed blurred or thin spiculate outlines, irregular shape or Iobular signs, signal heterogeneity or peripheral enhancement in dynamic contrast-enhanced MRI. Time signal curve showed type III or II. Morphologic features of benign tumors mostly showed clear edge, regular shape and homogeneous signal, or diffuse spot enhancement. Time signal curve showed type I or II. Conclusion： breast dynamic contrast enhanced scan in MRI can provide morphology and functional diagnosis information of the breast tissues. Dynamic contrast-enhanced MRI combined with time signal curve can further improve the accuracy of diagnosis of early breast cancer.

Is sentinel lymph node biopsy necessary for the patients diagnosed with breast ductal carcinoma in situ using core needle biopsy or vacuum-assisted biopsy as the initial diagnostic method？

Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentinel lymph node biopsy （SLNB） should be performed in patients with an initial diagnosis of DCIS. Methods： A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axillary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results： Eighty-two patients （66.1%） had pure DCIS and 25 （20.2%） had DCIS with microinvasion （DCISM）, 17 （13.7%） updated to invasive breast cancer （IBC）. 115 patients （92.7%） underwent SLNB, among them, 70 patients （56.5%） underwent axillary node dissection. 3 of 115 patients （2.6%） had a positive sentinel lymph node, only 1 （1.4%） of 70 patients had axillary lymph node metastasis, in 84 patients （66.7%） who were diagnosed DCIS by core needle biopsy （CNB） and vacuum-assisted biopsy （VAB）. 26 patients （31.0%） were upstaged into IBC or DCISM in the final histological diagnosis. The statistically significant factors predictive of underestimation were large tumor size, microcalcifications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion： The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especially in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.

Analysis of the Clinicopathologic Features and Prognosis in Triple-Negative Breast Cancer

OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identifi ed as triple negative breast cancer,ie defi ned as ER,PR and Her-2 negative.The other group was non-triple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival(DFS) analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4%(109/509) of cases were found to be triple-negative while 78.6%(400/509) were non-triple-negative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors(P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1%(23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a signifi cant difference(P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically signifi cant difference between the 2 groups(P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.

Diagnostic accuracy of real-time tissue elastography for breast cancer:a meta-analysis

Objective The present study aimed to determine the accuracy of real-time tissue elastography （RTE） for the diagnosis of breast cancer. Methods The search was conducted in the PubMed, Web of Science, Cochrane Library, and China Biology Medicine databases from inception through December 31, 2014, without language restrictions. The meta-analysis was conducted using STATA version 12.0 and Meta-Disc version 1.4. We calculated the summary statistics for sensitivity （Sen）, specificity （Spe）, positive and negative likelihood ratio （LR＋/LR–）, diagnostic odds ratio （DOR）, and summary receiver operating characteristic （SROC） curve. Results Ten studies that met al inclusion criteria were included in the meta-analysis. A total of 608 ma-lignant breast lesions and 1292 benign breast tumors were assessed. Al breast lesions were histological y confirmed after RTE. The pooled Sen was 0.83 （95% CI = 0.79–0.86）; the pooled Spe was 0.86 （95% CI = 0.84–0.88）. The pooled LR＋ was 9.87 （95% CI = 2.66–36.71）; the pooled LR– was 0.20 （95% CI = 0.17–0.23）. The pooled DOR of RTE for the diagnosis of breast cancer was 62.21 （95% CI = 33.88–114.24）. The area under the SROC curve was 0.9334 （standard error = 0.00125）. We found no evidence of publica-tion bias （t = –0.57, P = 0.582）. Conclusion RTE may have high diagnostic accuracy for the dif erential diagnosis of benign and malig-nant breast tumors. RTE may be a good tool for breast cancer diagnosis.

The value of 18-FDG-PET for diagnosing and evaluating lymph node metastasis in primary breast cancer

Objective: To analyze the result of 18F-2-deoxy-2-fluoro-D-glucose-positron emission tomography (FDG-PET) in suspicious primary breast cancer patients and to evaluate its value for the surgery therapy. Methods: Total 36 patients suspected of breast neoplasm were enrolled into the research. The result was compared with the pathology result. The rate of missed diagnosis, the rate of mi.sdiagnosis. the sensitivity and specificity were calculated and analyzed. Results:Compared with the pathology results, the misdiagnosis rate. the rate of missed diagnosis. the sensitivity and specificity of FDG-PET for breast cancer were 0% , 36. 36%. 63. 63% and 100%, respectively. To those who had a neoplasm no more than 2 cm in diameter, the rate of missed diagnosis was as high as 41. 67%. To 33 breast cancer patients, the misdiagnosis rate, the rate of missed diagnosis, the sensitivity and specificity for lymph node metastasis were 18. 75%, 41. 18%, 58. 82% and 81. 25%, respectively. Conclusion:FDG-PET has a perfect specificity and a considerable sensitivity to the primary breast neoplasm and similar to the lymph node metastasis diagnosis. It is an ideal choice for those patients with suspected breast cancer but reluctantly to receive a vulnerarious examination.

RASSFIA Promoter Hypermethylation as a Prognosis and Diagnosis for Breast Cancer in Vietnamese Population

Aberrant tumor suppressor gene promoter methylation was associated with the several cancers, including breast cancer, which was the common female deaths in most countries involved in Vietnam. The methylation in tumor suppressor genes, including RASSFIA, were the key targets of establishing the potential biomarkers for prognosis and early diagnosis of breast cancer. In present study, with the aim towards using the hypermethylation at CpG islands of promoter of RASSFIA as the biomarker for breast cancer in Vietnamese population, MSP （methyl specific PCR） was carried out to analyze the hypermethylation status ofRASSFIA gene in 115 samples including 95 breast cancer specimens and 20 normal breast tissues from another disease （not breast cancer）. All samples were obtained from Ho Chi Minh City Medical Hospital, Vietnam. The known predictive and prognostic factors： HER2/neu overexpression was immunohistochemistry stained as input value for breast cancer specimens. For input value confirmed, the overexpression of p53 protein was also analyzed together with prior immunochemical assay. The results indicated that the hypermethylation of frequencies for methylation of given gene reached 42.1% （P 〈 0.05）. In addition, the DNA hypermethylation of RASSFIA gene increased the possibility to be breast cancer with high incidence via calculated of odd ratio （P 〈 0.05）. In conclusion, the hypermethylation of candidate genes could be used as the promising biomarkers applying in Vietnamese breast cancer patients.

Mammographic features of breast cancer: Analysis of 118 cases

Objective: The aim of this retrospective study was to evaluate the mammographic imaging features (markers) on different types of breast cancer and improve early radiological diagnosis of breast cancer. Methods: Analyzed the mammographic images of 118 patients with breast cancer confirmed by surgery and pathology. Among 118 cases, 70 cases were infiltrating ductal carcinoma (59.3%), 17 cases were ductal carcinoma in situ (DCIS, 14.4%), 7 cases were mucinous carcinoma (5.9%), 5 cases were medullary carcinoma (4.2%), 1 case was tiny micro carcinoma (0.9%) and 18 cases were other types cancer (15.3%). Results: The mammographic appearance of 118 patients with different breast cancer included: tumor mass (n = 80, 68.8%), microcalcification (n = 57, 48.3%), which were subdivided into two groups (a) microcalcification only, 13 cases (13/118, 11%); (b) combined with other mammographic features: 31 cases with tumor mass (31/118, 26.3%); 7 cases with architecture distortion (7/118, 5.9%), 6 cases with focal asymmetric density (6/118, 5.1%). Six cases appeared as architecture distortion only, 41 cases with abnormal vessel signs (34.7%). Conclusion: The microcalcifications are the most frequently basal X-ray signs in DCIS. Architecture distortion and focal asymmetric density are special X-ray signs that were easily missed. The abnormal vessels are also important accompaniment signs of breast cancer. The use of coned compression technique is particularly important to improve the radiological diagnosis of breast cancer.

Diagnosis and Treatment Experience of 14 Cases of Breast Cancer Associated with Pregnancy or Lactation

Objective： To explore the diagnosis and treatment experience of breast cancer associated with pregnancy or lactation. Methods： From January 1990 to December 2005, 14 cases with breast cancer associated with pregnancy or lactation were analyzed retrospectively （TNM stage Ⅱ, 2 cases; stage Ⅲ, 11 cases; stage Ⅳ, 1 case）. Diagnosis was established by fine needle aspiration biopsy primarily or routine pathological method if necessary. Abortion was used for discontinuation of pregnancy in 1 case with early pregnancy and 1 case with meddle pregnancy. 2 patients with late pregnancy received cesarean section, 10patients of breast cancer associated with lactation received multidisciplinary and-tumor treatment after discontinuation of lactation. Results： Diagnosis was confirmed by fine noodle aspiration biopsy in 9 cases and by secondary routine pathological method in the other 5 cases, 12 cases were followed up, 1 case of stage Ⅳ died of metastasis 5 months after diagnosis. 3-, 5-year survival rates in 10 cases of stage Ⅲ were 66% and 30% respectively. One case remained alive without recurrence for 8 years up to now. Conclusion： A thorough breast examination is necessary at the first antenatal visit physicians should aggressively pursue work-up in women with a palpable breast tass. In the patients during the second and third trimness, the various modalities available for treatment inholding abortion and their risks and beneath modalities available for treatment including abortion and their risks and benefits must be discussed openly with patients and their families.

PREDICTION OF NON-SENTINEL LYMPH NODE METASTASES IN BREAST CANCER

Objective.To identify a subset of breast cancer patients in whom metastatic disease is confined on-ly to the sentinel lymph node(SLN).Methods.Sentinel lymph node biopsy is performed with the injecetion of Tc99m-SC,and a gamma probe.Sentinel node biopsy was compared with standard axillary dissection for its ability to reflect the fi-nal pathological status of the axillary nodes.The factors associated with non-SLN metastases were as-sessed in the univariate and multivariate analysis.Result.We successfully identified91out of95patients for SLN(95.8%).The accuracy of sentinel lymph node to predict the axillary lymph node status was93.4%.Clinical tumor size and tumor grade were proved to be the independent predictive factors for non-SLN metastases by logistic regression model.Conclusion.In most cases,the gamma probe guided method is technically feasible for detecting sentinel nodes,accurately predicting the axillary lymph node status.A subset of the patients identified who have a low risk of non-SLN metastases may not require axillary lymph node dissection.

DETECTION OF E6, E7 AND CELL-TYPE SPECIFIC ENHANCER OF HUMAN PAPILLOMAVIRUS TYPE 16 IN BREAST CARCINOMA

Objective To detect HPV16 E6, E7 genes and cell-type specific enhancer （CTSE） of long control region （LCR） in breast carcinoma （BC）. Methods HPV16 E6 ,E7 genes and CTSE were detected in 40 BCs and 20 normal breast tissue （NBT） using polymerase chain reaction （PCR）. Results The positive rates of HPV16 E6 , E7genes and CTSE were 60% （ 24/40 ） , 55% （ 22/40 ） and 67. 5% （ 27/40 ） respectively in BCs, whereas only 5% （1/20）, 5% （1/20） and 15% （3/20） in NBTs （ P 〈 O. 05）. There exited significant correlation between E6 gene and CTSE in BCs （ P 〈0. 05） , as well as E7 gene and CTSE. The infection of HPV16 E6, E7 and CTSE had no statistic relationship with pathological features. Conclusion There were HPV16 E6 , E7 genes and CTSE together in BCs and CTSE may play an important role in pathogenesis of BC.

Gastric Diffuse Large B-Cell Lymphoma after the Diagnosis of Primary MALT Lymphoma of the Breast One Case Report

Primary breast and gastric lymphomas as manifesta-tions of primary extranodal lymphomas are rare malignancies, and their diagnosis, prognosis, and treatment modalities remain unclear. We report for the first time the simultaneous co-occurrence of these diseases in one patient. A 60-year-old woman was diagnosed with gastric diffuse large B-cell lymphoma （DLBCL） 2.5 years after she was found to have primary mucosa-associated lymphoid tissue （MALT） lymphoma of the breast. Although the patient underwent che-motherapy, she died of leukemia that caused irreversible cytopenia of three lineages. The data show that her MALT lymphoma apparently transfigured into gastric DLBCL. This case highlights the importance of evaluating patients for Helicobacter pylori infection when they present with extranodal MALT lymphomas, except gastric ones. Positive test findings should prompt anti-H, pylori therapy to prevent MALT lymphomas from transforming into DLBCLs.