Background. Encapsulated papillary carcinoma (EPC) is a rare entity of breast cancer accounting for approximately 1–2% of all breast tumours. There are no evidence-based guidelines for the treatment of EPC. Materials and methods. From the database of the National Centre of Pathology (NCP), we obtained pathology reports of 19 patients with histologically confirmed EPC, who were treated at the National Cancer Institute (NCI) in Vilnius, Lithuania, between July 2009 and July 2015. Demographic, diagnostic and treatment data were collected from medical records retrospectively. Results. During the indicated period, 19 patients with EPC were treated at the NCI. Three of them had pure EPC, they were 74 to 81 years of age at the time of diagnosis (mean 76.7 years, median 75 years); all of them are still alive and no disease progression has been observed. Seven patients had EPC associated with carcinoma in situ. Nine patients had EPC associated with invasive breast ductal carcinoma. All patients underwent surgery, in most cases – wide local excision. Only one patient died. Conclusions. EPC is a rare form of breast cancer and usually presents with an invasive breast carcinoma or carcinoma in situ in postmenopausal women. Tumours have an excellent prognosis in the cases of pure EPC and in both EPC associated with carcinoma in situ (CIS) and invasive carcinoma.
The aim of this study was to examine the association between type 2 diabetes (T2DM), use of glucose-lowering medications and endometrial cancer (EC) risk. Methods: The risk of EC incidence among women with T2DM in Lithuania was assessed using a retrospective cohort study design. Female patients who were registered with T2DM between 1 January 2000 and 31 December 2012 were identified in the National Health Insurance Fund database. EC cases (ICD-10 code C54) were identified from the Lithuanian Cancer Registry. Standardized incidence ratios (SIRs) were calculated by dividing the observed numbers of EC among patients with T2DM by the expected number of EC, calculated using national rates. Results: A total of 77,708 diabetic women were included in the analysis, and 995 cases of EC were identified. A significantly increased EC risk in diabetic women was found as compared to the general population (SIR = 1.69, 95% CI 1.59–1.80). The greatest EC risk was found among younger patients at T2DM diagnosis, and the risk declined gradually with increasing age but persisted in being significantly increased among all age groups. The risk for EC increased with increasing duration of diabetes, and the highest EC risk was observed more than 10 years after T2DM diagnosis. A significantly higher EC risk than expected from the general population was found in all patient groups by glucose-lowering medication combinations. The lowest EC risk was observed in diabetic women who were users of “oral only” (without metformin) (SIR = 1.42, 95% CI 1.10–1.83) and “metformin only” (SIR = 1.69, 95% CI 1.49–1.92) medications. A two times greater EC risk was observed among the remaining glucose-lowering medication categories. In contrast, use of insulin only was not related to a higher EC incidence risk (SIR = 0.45, 95% CI 0.23–0.86); however, the risk estimation was based on nine cases. Conclusions: Our study shows a significantly increased EC risk in diabetic women as compared to the general population. In this study, a significantly higher EC risk was found in all patient groups by glucose-lowering medication combinations, except for insulin only users.
Background: The aim of this study was to analyze the incidence trends of localized and advanced breast cancer (BC) before and during the implementation of the mammography screening program (MSP) in Lithuania. Methods: The study period was divided into 2 intervals: the prescreening period (1998-2005) and implementation period (2006-2012). Analysis was performed for 3 age-groups: 0 to 49 years, 50 to 69 (target population), and older than 70. Results: In all age-groups, the incidence of localized BC has shown a steady increase, while the incidence of advanced stage BC has decreased. In the target population, during the study period, the stage I BC incidence increased statistically significantly by 10.3% per year (from 3.3 per 100 000 in 1998 to 12.2 per 100 000 in 2012). The increase in localized BC was faster in the period before the implementation of the MSP than during the implementation in 2006 to 2012 (10.3% and 5.7%). A slightly statistically significant decrease was observed for advanced BC during the study period (−1.1% per year), while during the implementation of the MSP, significant changes were not seen. Conclusions: The results of our study indicate that the implementation of the MSP in Lithuania did not significantly influence trends of localized and advanced BC. Changes observed during the study period, including the prescreening and screening introduction periods, may reflect the general trends in the awareness of BC and improvements in diagnostics.
BackgroundBreast cancer is the most frequent oncological disease as well as the leading cause of cancer death among women worldwide. Decline in mortality in economically strong countries is observed. This decline is mostly related to early diagnosis (improvement in breast cancer awareness and mammography screening program (MSP)) and more effective treatment. In the end of 2005, the MSP started in Lithuania. The main aim of this article was to evaluate breast cancer mortality during 22 years in Lithuania, as well as changes before the start of the MSP and during its implementation, in order to assess the influence of the MSP on mortality. Materials and MethodsAnalysis was based on data from the population-based Lithuanian Cancer Registry. Analysis of changes in mortality included the period from 1998 to 2019. Age standardized mortality rates were calculated for assessment of changes. Join-point regression analysis was used. ResultsApplying the segmental regression model, it was found that during the study period mortality was statistically significantly decreasing by -1.1% each year. Mortality among women under the age of 50 decreased both before and during the implementation of MSP. Mortality in the target population also was already decreasing until the implementation of the program, but since 2006 significant reduction in mortality was observed in this group. ConclusionsOverall breast cancer mortality is decreasing in Lithuania. After the implementation of MSP the largest reduction in mortality was observed among the target population, however, it is not as pronounced as it could be with the well-organized MSP.