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Importance of literature review

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Learning how to effectively write a literature review is a critical tool for success for an academic, and perhaps even professional career. Being able to summarize and synthesize prior research pertaining to a certain topic not only demonstrates having a good grasp on available information for a topic, but it also assists in the learning process. Although literature reviews are important for one's academic career, they are often misunderstood and underdeveloped. This article is intended to provide both undergraduate and graduate students in the criminal justice field specifically, and social sciences more generally, skills and perspectives on how to develop and/or strengthen their skills in writing a literature review. Included in this discussion are foci on the structure , process, and art of writing a literature review. What is a Literature Review? In essence, a literature review is a comprehensive overview of prior research regarding a specific topic. The overview both shows the reader what is known about a topic, and what is not yet known, thereby setting up the rationale or need for a new investigation, which is what the actual study to which the literature review is attached seeks to do. Stated a bit differently (Creswell 1994, pp. 20, 21) explains: The literature in a research study accomplishes several purposes: (a) It shares with the reader the results of other studies that are closely related to the study being reported (Fraenkel & Wallen, 1990. (b) It relates a study to the larger, ongoing dialog in the literature about a topic, filling in gaps and extending prior studies (Marshall & Rossman, 1989). (c) It provides a framework for establishing the importance of the study. As an overview, a well done literature review includes all of the main themes and subthemes found within the general topic chosen for the study. These themes and subthemes are usually interwoven with the methods or findings of the prior research. Also, a literature review sets the stage for and JOURNAL

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A literature review is a critical consideration of the work by authors and researchers who have written on a particular topic. IT involves synthesising these writings so that a 'picture' of the issue under review forms. Therefore, it requires you to use summarising, analytical and evaluative skills. The effectiveness of these will, to a large extent, depend on your ability to link the work of various authors highlighting similarities, differences, strengths and weaknesses. A Literature Review is not a list describing or summarising one piece of literature after another, so avoid beginning each paragraph with the name of the researcher.

Amanda Bolderston

A literature review can be an informative, critical, and useful synthesis of a particular topic. It can identify what is known (and unknown) in the subject area, identify areas of controversy or debate, and help formulate questions that need further research. There are several commonly used formats for literature reviews, including systematic reviews conducted as primary research projects; reviews written as an introduction and foundation for a research study, such as a thesis or dissertation; and reviews as secondary data analysis research projects. Regardless of the type, a good review is characterized by the author’s efforts to evaluate and critically analyze the relevant work in the field. Published reviews can be invaluable, because they collect and disseminate evidence from diverse sources and disciplines to inform professional practice on a particular topic. This directed reading will introduce the learner to the process of conducting and writing their own literature review.

Andrew Johnson

This chapter describes the process of writing a literature review and what the product should look like

HUMANUS DISCOURSE

Humanus Discourse

The importance of literature review in academic writing of different categories, levels, and purposes cannot be overemphasized. The literature review establishes both the relevance and justifies why new research is relevant. It is through a literature review that a gap would be established, and which the new research would fix. Once the literature review sits properly in the research work, the objectives/research questions naturally fall into their proper perspective. Invariably, other chapters of the research work would be impacted as well. In most instances, scanning through literature also provides you with the need and justification for your research and may also well leave a hint for further research. Literature review in most instances exposes a researcher to the right methodology to use. The literature review is the nucleus of a research work that might when gotten right spotlights a work and can as well derail a research work when done wrongly. This paper seeks to unveil the practical guides to writing a literature review, from purpose, and components to tips. It follows through the exposition of secondary literature. It exposes the challenges in writing a literature review and at the same time recommended tips that when followed will impact the writing of the literature review.

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LITERATURE REVIEW

Jul 22, 2014

2.14k likes | 6.18k Views

LITERATURE REVIEW. 2.1What is a “Literature Review”?. A literature review is an overview of research on a given topic and answers to related research questions Literature reviews are an important part of research and should be treated as such A well-written literature review:

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• distinguish
• related research questions
• relevant journal articles
• selective use
• low priority
• bibliographic data

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2.1What is a “Literature Review”? • A literature review is an overview of research on a given topic and answers to related research questions • Literature reviews are an important part of research and should be treated as such • A well-written literature review: • Organizes literature • Evaluates literature • Identifies patterns and trends in literature • Synthesizes literature

‘the literature’ means the works you consulted in order to understand and investigate your research problem. • A literature review involves providing a rationale for your selection of literature related to the subject studied.

The literature review familiarizes the reader with the subject and the scope of the research topic. • It helps the reader to define key concepts • Finally it establishes the body of knowledge which will be able to contribute towards the research.

2.2 Writing the Literature Review • Firstly decide what you need to read from a broad spectrum of literature available • Refer to books, periodicals, journals, and websites which will be relevant to your study.

Determine what exactly are your objectives • Provide a current and complete overview of your related topic. • Show that you have read extensively and formed a body of knowledge on the subject of field of study

Purpose of writing a literature Review Your review should be in a form of • critical decision, • showing awareness of differing arguments, theories, approaches and methodologies. It should be a synthesis and analysis of the relevant published work, linked at all times to your objective and rationale of your study.

There are several purposes on why we write a literature review: • it reviews knowledge of previous studies on the subject of research • it identifies a conceptual framework for own research • it provides directions for future research • it provides resources previously unknown to the reader • it identifies gaps in past studies

To sum up, a good literature review is: • critical of what has been written, • identifies areas of controversy, • raises questions and identifies areas which need further research.

2.3 Process of Writing a Literature Review • There are several stages in developing a literature review(Biddlek, 1997). The stages are : • Identify • Record • Relevance • Retrieve • Review • Write

Stage 1 – Identify • Compile a list of references. • Use a kind of index system either a hard copy or a software referencing system. • i)work through key catalogues, databases, indexes, bibliographies and websites for relevant resources • ii)check the references and in the articles you have read • iii)locate and use research reviews

Stage 2-Record • Make a record of any literature that relates to your topic. • You should have citation details, where it is located, and should also write a few sentences that help you remember what the article is about

Stage 3 –Relevance • i)Prioritize the literature, after having read the abstract, rank them if it should be high, medium or low priority • ii)On the website scan through the literature for relevance before you decide to download or print it out • iii) You need to focus on the literature and sources you have identified and ranked as most important, the most recent development from the periodicals. • iv) Distinguish between textbooks and research articles from journals and books. They contain different kinds of information that will be more or less relevant to your research

Stage 4 -Retrieve • i) Make hard copies of the most important literature. Print relevant journal articles from databases and photocopy articles from journals

Stage 5 –Review • Use the reading log which allows you to record different kinds of information: the bibliographic details, a description, and relationship to other readings. • Also record where the literature is located so that you can easily refer to the quotes or ideas paraphrased when you are editing. • As you are taking notes, ensure you are clear about what you are quoting and paraphrasing. You cannot risk unintentionally plagiarizing ideas.

Stage 6 -Write • Start with an introductory paragraph • Discuss the literature on the subject in a logical and coherent way • Conclude with a paragraph that is relevant to the literature of the research

2.4 Five Phases of Writing a Literature Review • Phase 1 – Specify the scope of your review • i)Ensure you have a precise topic • you must be precise about having a topic. It should not be too broad or unspecific. Look at the following topic which is too broad • Example: ‘Life and Times of Sigmund Freud” • The title below seems to be limited, but still considered too broad • Example: “Psychological Theories of Sigmund Freud • However, a more manageable and appropriate topic would be • ‘Freud’s Theory of Personality Applied to Mental Health” • If your research question is too broad or defined vaguely or abstractly, you may end up reading and compiling too much information for your literature review. However if your research question is specified too narrowly or defined concisely, you may miss out more general information

ii)Scope of the Literature Review You have to determine the precise scope of the literature review. Questions which need to be answered are as follows :- • What will I cover in my review? • How comprehensive will it be? • How current are my materials? • What type of materials/documents will be needed?

Phase 2: Locating and Accessing Information • Obtain all the necessary materials for your literature review by searching relevant bibliographies, print indexes and online databases i)Using Existing Literature Reviews • Many journals on different subject areas publish review articles. In these journals you may find commentaries on research articles. You may find these reviews relevant to your literature review.

Phase 3 Recording the Information • You can develop a systematic way of recording information through: note cards with citations • Photocopied articles with points highlighted or underlined with notes in the margins • Traditional taking down notes or in laptops

i)Tips on Recording Information • A quick skimming and scanning through the introduction and the conclusion of an article, would give you an idea of the article and general points. • a)Start with the most recent studies and work backwards. Refer to the list of references on a recent article;   • b)Read, first the report or article’s abstract - this will give you some clues about the article • c)When taking down notes, remember to write out the complete bibliographic citation for each work. It is essential you note down the page numbers as these will be necessary later for footnotes and bibliography. For internet citations note the URL • d)Write all direct quotations precisely when taking down notes. You should use quotations marks, so it can recognize as a directly quoted text and not a paraphrase. If you fail to put a direct text in quotation marks or to credit the authors, it amounts to plagiarism.

Phase 4 Evaluating the Information • After having read all the articles, you must now decide and evaluate what should be included in the review. • Be selective - you have to consider issues and themes that link different articles.

Phase 5 Organizing and Writing the Literature Review • After accessing, reading and evaluating the material, these materials need to be organized. • You may organize the selected readings by theoretical approaches, by specific concepts or issues, and by methodologies

Some tips on writing After you have located, read, analyzed and evaluated the literature, the next stage is actual writing. Here are some tips: • Keep your paragraphs short • Subheadings are essential, as it clarifies the structure. They break up the materials into more readable units • Avoid too many long direct quotations from the studies. Paraphrase other writers’ works rather than quote lengthy passages • Don’t cite references that you haven’t read

Some traps to avoid • Trying to read everything! • not to provide a summary of all the published work that relates to your research, but a survey of the most relevant and significant work. • Reading but not writing! • Writing can help you understand and find relationships between the work you’ve read, so don’t put writing off until you’ve “finished” reading. • Not keeping bibliographic information! - Source: http://www.clpd.bbk.ac.uk/students/litreview web.pdx.edu/~bertini/literature_review.pdf

Final Checklist Here is a checklist from University of Melbourne: (http://www.lib.unimelb.eduau/postgrad/litreview/finalchecklist.html) • Have you indicated the purpose of the review? • Have you ascertained the parameters of the review and are they reasonable? • Have you emphasized on recent development of the research? • Have you focused on primary sources with only selective use of secondary sources? • Is the literature selected relevant to your study? • Is your bibliographic data complete?

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10 Best Literature Review Templates for Scholars and Researchers [Free PDF Attached]

Imagine being in a new country and taking a road trip without GPS. You would be so lost. Right? Similarly, think about delving into a topic without having a clue or proper understanding of the reason behind studying it. 

That’s when a well-written literature review comes to the rescue. It provides a proper direction to the topic being studied. 

The literature review furnishes a descriptive overview of the existing knowledge relevant to the research statement. It is a crucial step in the research process as it enables you to establish the theoretical roots of your field of interest, elucidate your ideas, and develop a suitable methodology. A literature review can include information from various sources, such as journals, books, documents, and other academic materials. This promotes in-depth understanding and analytical thinking, thereby helping in critical evaluation.

Regardless of the type of literature review — evaluative, exploratory, instrumental, systematic, and meta-analysis, a well-written article consists of three basic elements: introduction, body, and conclusion. Also its essence blooms in creating new knowledge through the process of review, critique, and synthesis.

But writing a literature review can be difficult. Right?

Relax, our collection of professionally designed templates will leave no room for mistakes or anxious feelings as they will help you present background information concisely. 

10 Designs to Rethink Your Literature Reviews

These designs are fully customizable to help you establish links between your proposition and already existing literature. Our PowerPoint infographics are of the highest quality and contain relevant content. Whether you want to write a short summary or review consisting of several pages, these exclusive layouts will serve the purpose. 

Let’s get started.

Template 1: Literature Review PPT Template

This literature review design is a perfect tool for any student looking to present a summary and critique of knowledge on their research statement. Using this layout, you can discuss theoretical and methodological contributions in the related field. You can also talk about past works, books, study materials, etc. The given PPT design is concise, easy to use, and will help develop a strong framework for problem-solving. Download it today.

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Template 2: Literature Review PowerPoint Slide

Looking to synthesize your latest findings and present them in a persuasive manner? Our literature review theme will help you narrow relevant information and design a framework for rational investigation. The given PPT design will enable you to present your ideas concisely. From summary details to strengths and shortcomings, this template covers it all. Grab it now.

Template 3: Literature Review Template

Craft a literature review that is both informative and persuasive with this amazing PPT slide. This predesigned layout will help you in presenting the summary of information in an engaging manner. Our themes are specifically designed to aid you in demonstrating your critical thinking and objective evaluation. So don't wait any longer – download our literature review template today.

Template 4: Comprehensive Literature Review PPT Slide

Download this tried-and-true literature review template to present a descriptive summary of your research topic statement. The given PPT layout is replete with relevant content to help you strike a balance between supporting and opposing aspects of an argument. This predesigned slide covers components such as strengths, defects, and methodology. It will assist you in cutting the clutter and focus on what's important. Grab it today.

Template 5: Literature Review for Research Project Proposal PPT

Writing a literature review can be overwhelming and time-consuming, but our project proposal PPT slides make the process much easier. This exclusive graphic will help you gather all the information you need by depicting strengths and weaknesses. It will also assist you in identifying and analyzing the most important aspects of your knowledge sources. With our helpful design, writing a literature review is easy and done. Download it now.

Template 6: Literature Review for Research Project Proposal Template

Present a comprehensive and cohesive overview of the information related to your topic with this stunning PPT slide. The given layout will enable you to put forward the facts and logic to develop a new hypothesis for testing. With this high-quality design, you can enumerate different books and study materials taken into consideration. You can also analyze and emphasize the technique opted for inquiry. Get this literature review PowerPoint presentation template now.

Template 7: Literature Review for Research Paper Proposal PowerPoint Slide

Lay a strong foundation for your research topic with this impressive PowerPoint presentation layout. It is easy to use and fully customizable. This design will help you describe the previous research done. Moreover, you can enlist the strengths and weaknesses of the study clearly. Therefore, grab it now.

Template 8: Literature Review for Research Paper Proposal PPT

Download this high-quality PPT template and write a well-formatted literature review. The given layout is professionally designed and easy to follow. It will enable you to emphasize various elements, such as materials referred to, past work, the list of books, approach for analysis, and more. So why wait? Download this PowerPoint design immediately.

Template 9: Literature Review for Academic Student Research Proposal PPT

With this exclusive graphic, you'll have everything you need to create a well-structured and convincing literature review. The given design is well-suited for students and researchers who wish to mention reliable information sources, such as books and journals, and draw inferences from them. You can even focus on the strong points of your study, thereby making an impactful research statement. Therefore, grab this PPT slide today.

Template 10: Literature Review Overview for Research Process PPT

Demonstrate your analytical skills and understanding of the topic with this predesigned PowerPoint graphic. The given research overview PPT theme is perfect for explaining what has been done in the area of your topic of interest. Using this impressive design, you can provide an accurate comparison showcasing the connections between the different works being reviewed. Get it right away.  

Creating an effective literature review requires discipline, study, and patience. Our collection of templates will assist you in presenting an extensive and cohesive summary of the relevant works. These PPT layouts are professionally designed, fully editable, and visually appealing. You can modify them and create perfect presentations according to your needs. So download them now!

P.S. Are you looking for a way to communicate your individual story? Save your time with these predesigned book report templates featured in this guide . 

Download the free Literature Review Template PDF .

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 “A substantive, thorough, sophisticated literature review is a precondition for doing substantive, thorough, sophisticated research”. Boote and Baile 2005

Authors of manuscripts treat writing a literature review as a routine work or a mere formality. But a seasoned one knows the purpose and importance of a well-written literature review.  Since it is one of the basic needs for researches at any level, they have to be done vigilantly. Only then the reader will know that the basics of research have not been neglected.

The aim of any literature review is to summarize and synthesize the arguments and ideas of existing knowledge in a particular field without adding any new contributions.   Being built on existing knowledge they help the researcher to even turn the wheels of the topic of research.  It is possible only with profound knowledge of what is wrong in the existing findings in detail to overpower them.  For other researches, the literature review gives the direction to be headed for its success. 

The common perception of literature review and reality:

As per the common belief, literature reviews are only a summary of the sources related to the research. And many authors of scientific manuscripts believe that they are only surveys of what are the researches are done on the chosen topic.  But on the contrary, it uses published information from pertinent and relevant sources like

• Scholarly books
• Scientific papers
• Latest studies in the field
• Established school of thoughts
• Relevant articles from renowned scientific journals

and many more for a field of study or theory or a particular problem to do the following:

• Summarize into a brief account of all information
• Synthesize the information by restructuring and reorganizing
• Critical evaluation of a concept or a school of thought or ideas
• Familiarize the authors to the extent of knowledge in the particular field
• Encapsulate
• Compare & contrast

By doing the above on the relevant information, it provides the reader of the scientific manuscript with the following for a better understanding of it:

• It establishes the authors’  in-depth understanding and knowledge of their field subject
• It gives the background of the research
• Portrays the scientific manuscript plan of examining the research result
• Illuminates on how the knowledge has changed within the field
• Highlights what has already been done in a particular field
• Information of the generally accepted facts, emerging and current state of the topic of research
• Identifies the research gap that is still unexplored or under-researched fields
• Demonstrates how the research fits within a larger field of study
• Provides an overview of the sources explored during the research of a particular topic

Importance of literature review in research:

The importance of literature review in scientific manuscripts can be condensed into an analytical feature to enable the multifold reach of its significance.  It adds value to the legitimacy of the research in many ways:

• Provides the interpretation of existing literature in light of updated developments in the field to help in establishing the consistency in knowledge and relevancy of existing materials
• It helps in calculating the impact of the latest information in the field by mapping their progress of knowledge.
• It brings out the dialects of contradictions between various thoughts within the field to establish facts
• The research gaps scrutinized initially are further explored to establish the latest facts of theories to add value to the field
• Indicates the current research place in the schema of a particular field
• Provides information for relevancy and coherency to check the research
• Apart from elucidating the continuance of knowledge, it also points out areas that require further investigation and thus aid as a starting point of any future research
• Justifies the research and sets up the research question
• Sets up a theoretical framework comprising the concepts and theories of the research upon which its success can be judged
• Helps to adopt a more appropriate methodology for the research by examining the strengths and weaknesses of existing research in the same field
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Case report article, untypical bilateral breast cancer with peritoneal fibrosis on 18 f-fdg pet/ct: case report and literature review.

• Department of Nuclear Medicine, Peking University First Hospital, Beijing, China

Background: Retroperitoneal fibrosis, a condition of uncertain origin, is rarely linked to 8% of malignant cases, including breast, lung, gastrointestinal, genitourinary, thyroid, and carcinoid. The mechanism leading to peritoneal fibrosis induced by tumors is not well understood, possibly encompassing direct infiltration of neoplastic cells or the initiation of inflammatory responses prompted by cytokines released by tumor cells. We report a case of breast cancer with renal metastasis and retroperitoneal fibrosis detected using 18 F-FDG PET/CT, providing help for clinical diagnosis and treatment.

Case report: A 49-year-old woman was referred to the hospital with elevated creatinine and oliguria for over a month. Abdominal computer tomography (CT) and magnetic resonance imaging (MRI) showed a retroperitoneal fibrosis-induced acute kidney injury (AKI) was suspected. However, a percutaneous biopsy of the kidney lesion confirmed metastasis from breast cancer. The physical examination revealed inverted nipples and an orange peel appearance on the skin of both breasts. Ultrasonography revealed bilateral hyperplasia (BIRADS 4a) of the mammary glands and bilateral neck and axillary lymphadenopathy. Subsequently, 18 F-deoxyglucose positron emission tomography/computer tomography ( 18 F-FDG PET/CT) detected abnormally high uptake (SUVmax) in the bilateral mammary glands and axillary lymph nodes, suggesting bilateral breast cancer. Furthermore, abnormal 18 F-FDG uptake was detected in the kidney, suggesting renal metastasis. In addition, abnormal 18 F-FDG uptake was observed in the vertebrae, accompanied by an elevation in inhomogeneous bone mineral density, raising suspicion of bone metastases. However, the possibility of myelodysplasia cannot be dismissed, and further investigations will be conducted during close follow-ups. There was significant 18 F-FDG uptake in the retroperitoneal position indicating a potential association between retroperitoneal fibrosis and breast cancer. The final pathological diagnosis of the breast tissue confirmed bilateral invasive ductal carcinoma. The patient had been treated with 11 cycles of albumin-bound (nab)-paclitaxel (0.3 mg) and had no significant adverse reaction.

Conclusion: In this case, neither the bilateral breast cancer nor the kidney metastatic lesion showed typical nodules or masses, so breast ultrasound, abdominal CT, and MRI did not suggest malignant lesions. PET/CT played an important role in detecting occult metastases and primary lesions, thereby contributing to more accurate staging, monitoring treatment responses, and prediction of prognosis in breast cancer.

Introduction

Retroperitoneal fibrosis is an uncommon disorder of unclear etiology, with 8% of cases associated with malignancies, among which breast cancer is a relatively common cause. The pathogenesis of peritoneal fibrosis caused by tumors remains unclear, potentially involving direct neoplastic cell infiltration or inflammatory reactions triggered by cytokines secreted by tumor cells. Retroperitoneal fibrosis is characterized by increased fibrotic deposition in the retroperitoneum, frequently leading to ureteral obstruction [1]. Herein, we report a case of breast cancer with retroperitoneal fibrosis and renal insufficiency as the first symptoms. Conventional imaging did not reveal any evidence of breast cancer or distant metastases. However, 18 F-deoxyglucose positron emission tomography/computer tomography ( 18 F-FDG PET/CT) images demonstrated increased 18 F-FDG uptake in the breast and kidney, which was suspicious of bilateral breast cancer (BBC) with diffuse renal metastatic lesions. PET/CT plays a crucial role in detecting primary lesions and metastatic lesions, monitoring relapses, managing treatment, and improving patient prognosis. In addition, we summarized the basic information and clinical details of some cases with tumor-associated retroperitoneal fibrosis in Table 1 .

Table 1 . Literature review of tumor-related retroperitoneal fibrosis.

Case presentation

A 49-year-old woman was referred to the hospital with elevated creatinine and oliguria for over a month. The patient experienced abdominal pain and lower back pain with noticeable pitting edema in both lower extremities, along with decreased urine, without an apparent trigger over a month ago. The patient has no family history of the disease. Laboratory results revealed a serum creatinine level of 1,054 μmol/L and a hemoglobin level of 76 g/L, suggestive of acute kidney injury (AKI). Ultrasonography demonstrated bilateral hydronephrosis with widening of the proximal ureters and moderately low echogenicity around the abdominal aorta, suggesting that retroperitoneal fibrosis might be present. Abdominal CT and magnetic resonance imaging (MRI) ( Figure 1 ) revealed bilateral kidney swelling, dilation of the bilateral kidneys, renal calyces, and upper ureters, accompanied by multiple retroperitoneal and bilateral perirenal exudations, suggestive of retroperitoneal fibrosis. No focal lesions were found in either kidney.

Figure 1 . Computed tomography images and magnetic resonance images. The coronal image shows bilateral hydronephrosis and enlarged kidneys (A,E) . The axial images show diffuse lesions in the renal parenchyma, with no obvious masses detected (B,C,F,G) . The axial image shows retroperitoneal multiple exudation (D,H) .

AKI is likely attributed to post-renal obstruction secondary to retroperitoneal fibrosis. To further define the histological features of renal lesions and exclude the probability of primary kidney disease, a biopsy was performed of the lower pole of the right kidney. The biopsy of the lower pole of the right kidney demonstrated acute renal tubular necrosis and heterotypic cells in the renal tissue. The tumor cells have moderate dysplasia, form adenoid arrangements, and show an invasive growth pattern. Immunohistochemical results showed that P120-, HER2-, PR 90%, ER 90%, E-Cadherin-, GATA (3+), CKpan (3+), and Vimentin-. Combined with the results of immunohistochemistry, it was consistent with breast cancer metastasis. Therefore, the mammary gland of the patient was further examined. A physical examination of the patient revealed an orange peel change on the skin of both breasts and a bilateral inverted nipple. Breast ultrasound showed bilateral hyperplasia (BIRADS 4a) of the mammary glands with a reduced echo. Contrast-enhanced breast MRI was precluded by the patient’s compromised renal function and aimed at averting potential adverse reactions to the gadolinium contrast agent, including those associated with nephrogenic systemic fibrosis. Consequently, whole-body 18 F-deoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) imaging was conducted to pinpoint the most reliable clinical biopsy site. Moreover, 18 F-FDG PET/CT proves valuable in distinguishing between benign and malignant lesions, as well as in determining breast cancer staging, grading, and locating primary and metastatic tumor foci. The anteroposterior 3-dimensional maximum intensity projection (MIP) image demonstrated patchy metabolic elevation on both sides of the mammary glands, along with diffusely uneven metabolic foci in both kidneys ( Figure 2A ). Bilaterally dense mammary glands with a diffuse, mild 18 F-FDG uptake were seen, with a maximum standardized uptake value (SUVmax) of 4.7. Bilateral local thickening of the breast skin with an SUVmax of 2.3 was found, which was higher on the right side. BBC was considered ( Figure 2B ). Enlargement of both kidneys with various degrees of 18 F-FDG uptake is found, with an SUVmax at approximately 8.2 ( Figure 2C ). A patchy soft tissue density lesion is visible around the renal fascia and adjacent to the abdominal aorta, with mild 18 F-FDG uptake, and the SUVmax is approximately 3.3 ( Figure 2D ). Furthermore, diffuse inhomogeneous 18 F-FDG uptake was observed in bone lesions, characterized by an SUVmax of approximately 2.9. Additionally, inhomogeneous hyperintensities in bone mineral density were identified in the cones ( Figures 2E , F ), prompting suspicion of potential bone metastasis. Nevertheless, we cannot definitively exclude the possibility of myelodysplasia, and we will vigilantly monitor this concern during subsequent follow-up assessments. The lesions in the kidneys, bones, and retroperitoneal area were associated with the metastasis of breast cancer.

Figure 2 . 18 F-FDG PET/CT images. The MIP demonstrated patchy metabolic elevation on both sides of the mammary glands, as well as increased volume in both kidneys, accompanied by a diffusely uneven elevated metabolic lesion (A) . The bilateral dense breast tissue shows diffuse mild 18 F-FDG uptake, with an SUVmax of approximately 4.7. There is a local thickening of the skin in both breasts, with an SUVmax of 2.3, more prominent on the right side (B) . The transverse images show inhomogeneous 18 F-FDG uptake in the bilaterally enlarged kidneys, with an SUVmax of approximately 8.2 (C) . The transverse images show right perirenal fascia thickening with a significantly higher uptake of an SUVmax of approximately 3.3 (D) . The sagittal images show the heterogeneous bone density elevation with radioactive distribution, SUVmax of approximately 2.9 (E,F) .

Subsequently, the bilateral mammary glands were examined histologically and immunohistochemically. Pathological examination ( Figure 3 ) revealed grade II invasive lobular carcinoma with ER 90%, PgR 50%, P40-, E-cadherin-, P120++, GATA (3+), Ki67 15%, HER2-, and PD-L1- in both breasts. The clinician diagnosed stage IV invasive breast cancer. The presence of the BRCA1 gene mutation was identified in the germline of the BBC. Renal metastases due to breast cancer were diagnosed on the basis of immunohistochemistry. The patient was ultimately identified as having BBC accompanied by metastases to the bones, kidneys, and retroperitoneal location. Additionally, AKI was observed due to retroperitoneal fibrosis. A week later, after the contraindication of chemotherapy was excluded, the patient was treated with albumin-bound (nab)-paclitaxel (0.3 mg). At present, the chemotherapy has been 11 cycles, and the patient has had no obvious adverse reactions during the course of the chemotherapy. We are still following up.

Figure 3 . Histologic and immunohistochemical features of breast cancer. (A) Hematoxylin–eosin (HE) staining (×400). In immunohistochemical staining, the tumor cells were positive for ER (B) and GATA3 (C) . Moreover, 15% of them were positive for Ki-67 (D) [magnification (B–D)  × 200].

Breast cancer represents 24.5% of all cancer cases in women. In 2022, breast cancer will have the highest incidence and mortality in most countries ( 10 ). BBC is uncommon and accounts for 1.4–12% of all breast cancers ( 11 ). Based on the time interval between the diagnosis of bilateral malignant tumors, BBC can manifest synchronously or asynchronously ( 12 ). The primary risk factors associated with BRCA1-related breast cancer include a family history of breast cancer, younger age (under 40 years old), multifocal cancer, a history of lobular carcinoma, inherited genetic mutations such as those in the BRCA1 and BRCA2 genes, and exposure to radiation ( 13 – 16 ). For BRCA1 mutation carriers, the risk of breast cancer increases substantially between the ages of 30 and 50, while for women with a BRCA2 mutation, the risks are highest between ages 40 and 60 ( 16 ). BRCA-related breast cancer is characterized by a more aggressive phenotype than sporadic breast cancer, with BRCA1-related breast cancer being more frequently high grade and triple negative, and BRCA2-related breast cancer being on average a higher histological grade than sporadic cases ( 17 ). The systematic review and meta-analysis conducted by Baretta et al. ( 17 ) showed that mutation carriers have worse overall survival than BRCA-negative/sporadic cases (hazard ratio, HR 1.30, 95% CI: 1.11–1.52) and worse breast cancer-specific survival than sporadic/BRCA-negative cases among patients with stage I–III breast cancer (HR 1.45, 95% CI: 1.01–2.07). In this particular case, the patient had no other risk factors, and genetic testing revealed a mutation in the BRCA1 gene. BRCA1 mutation carriers with breast cancer may benefit from treatment with cisplatinum ( 18 ) or olaparib ( 19 ) compared to those without a mutation. These data collectively indicate the important role of BRCA mutation status with respect to treatment decisions that may impact outcomes. Genetic mutation detection plays an essential role in the clinical management of breast cancer, as it enables physicians to more accurately identify the molecular characteristics of the disease, formulate personalized treatment plans, and predict the efficacy of therapy and patient prognosis ( 20 , 21 ). Family members can understand their genetic risks through genetic counseling and undergo appropriate screening and management based on the recommendations of healthcare professionals. Moreover, studies have found that the infiltrating ductal type is the most common histology in BBC ( 22 – 24 ). Some studies indicate that the survival rates of patients with unilateral and BBC are comparable ( 25 , 26 ). While routine radiological assessments, including mammography and ultrasonography, are conducted for women presenting with suspicious breast symptoms, these methods have certain limitations in diagnosing BBC ( 27 ). In addition, contrast-enhanced MRI is forbidden for patients with renal failure. In such a situation, PET/CT, in particular, is instrumental in detecting axillary extra-nodal disease and occult metastasis in patients with locally advanced breast cancer. Its role in assessing responses to neoadjuvant or adjuvant chemotherapy is continually evolving. In the detection of suspected recurrences, it proves more effective than traditional imaging modalities ( 28 ).

Retroperitoneal fibrosis is a rare condition of diverse etiology, associated with radiotherapy, aortic aneurysms, infections, and malignancy ( 29 ). Eight percent of cases are associated with malignancies ( 30 ). Common tumors leading to retroperitoneal fibrosis include breast, lung, gastrointestinal, genitourinary, thyroid, lymphoma, sarcoma, and carcinoid ( 31 ). The pathogenic mechanism of peritoneal fibrosis induced by tumors is unknown. It may result from a desmoplastic reaction of the retroperitoneum to malignant cells, an inflammatory reaction, or cytokines secreted by the tumor ( 30 ). We have compiled a subset of cases presenting with tumor-associated retroperitoneal fibrosis, and the basic information and clinical details are summarized in Table 1 . In the literature, several cases of malignant retroperitoneal fibrosis associated with breast cancer have been documented, with the majority of reported cases featuring a history of breast cancer in the patients ( 1 , 2 , 4 ). Obstructive uropathy is typical of retroperitoneal fibrosis, and bilateral flank pain is the most frequent clinical presentation ( 1 , 2 , 4 ). Our patient presented classic symptoms of bilateral flank pain and hydronephrosis. CT reveals a diffusely infiltrative soft tissue mass enveloping retroperitoneal structures, which is a typical radiological manifestation of retroperitoneal fibrosis ( 32 ). 18 F-FDG PET/CT can be a valuable tool in evaluating the disease activity and lesion range of retroperitoneal fibrosis and monitoring the treatment of retroperitoneal fibrosis. Furthermore, as illustrated by our cases, in some patients with malignant tumors present with peritoneal fibrosis as the initial manifestation, PET/CT can assist in identifying the primary lesion and accurately staging and grading the condition.

Breast cancer metastasis to the kidneys is rarely seen ( 33 ). In one study, the incidence of metastasis of breast cancer to the kidneys was 12% ( 34 ). The mechanism of breast cancer metastasis to the kidneys can be attributed to the physiological characteristics of the kidneys. Specifically, the substantial proportion of cardiac output dedicated to renal blood flow makes it likely for circulating tumor cells to enter the renal capillaries ( 35 ). Common symptoms of renal metastasis are flank pain and hematuria ( 36 , 37 ). The most common form of metastatic renal carcinomas is multiple bilaterally circumscribed, rounded masses ( 35 ). In patients with known primary tumors, diffuse enlargement of the kidney without a clear mass may suggest renal metastatic disease ( 38 ). In this case, the imaging findings were bilaterally enlarged kidneys without focal lesions. However, PET findings indicated various degrees of 18 F-FDG uptake in the bilateral kidneys with suspicions of breast cancer metastasis to the kidney, which was agreeable with the pathological diagnosis. In PET/CT imaging, renal metastasis may manifest as small, multiple, bilateral, circular lesions with high 18 F-FDG uptake and a diffusely invasive, large, single mass with high 18 F-FDG uptake. By the time the primary lesion was detected by PET/CT at some sites, especially tumors prone to renal metastasis (lymphomas and carcinomas of the lung, breast, stomach, pancreas, and colon), there was a high probability of renal involvement. A biopsy for histological analysis was performed if necessary. Conducting a thorough examination of the renal cortex through 18 F-FDG PET, coupled with a review of anatomical images such as CT and MRI results, plays a pivotal role in the identification of renal tumors.

In conclusion, we present a case study detailing the 18 F-FDG PET/CT imaging manifestations in a BBC patient with retroperitoneal fibrosis and renal metastasis. Compared with conventional imaging, PET can find systemic metastases based on the detection of primary foci, which can be used for disease staging and the evaluation of treatment efficacy.

Data availability statement

The original contributions presented in the study are included in the article/ Supplementary material , further inquiries can be directed to the corresponding author.

Ethics statement

Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article. Written informed consent was obtained from the participant/patient(s) for the publication of this case report.

Author contributions

LS: Writing – original draft, Writing – review & editing. YQ: Conceptualization, Writing – original draft. WH: Data curation, Writing – original draft. XS: Investigation, Writing – original draft. QY: Methodology, Writing – original draft. YP: Project administration, Writing – review & editing. LK: Conceptualization, Funding acquisition, Investigation, Project administration, Supervision, Writing – review & editing.

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Natural Science Foundation of China (82171970), the Beijing Science Foundation for Distinguished Young Scholars (JQ21025), the Beijing Municipal Science and Technology Commission (Z221100007422027), and the National High-Level Hospital Clinical Research Funding (Interdisciplinary Research Project of Peking University First Hospital, 2023IR17).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fmed.2024.1353822/full#supplementary-material

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Keywords: bilateral breast cancer , peritoneal fibrosis , renal metastasis , 18 F-FDG PET/CT , case report

Citation: Song L, Qiu Y, Huang W, Sun X, Yang Q, Peng Y and Kang L (2024) Untypical bilateral breast cancer with peritoneal fibrosis on 18 F-FDG PET/CT: case report and literature review. Front. Med . 11:1353822. doi: 10.3389/fmed.2024.1353822

Received: 11 December 2023; Accepted: 08 April 2024; Published: 29 April 2024.

Reviewed by:

Copyright © 2024 Song, Qiu, Huang, Sun, Yang, Peng and Kang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Lei Kang, [email protected]

This article is part of the Research Topic

Case Reports in PET Imaging 2023