Primary Screening for Breast Diseases among 17618 Women in Wufeng Area, a Region with High Incidence of Cervical Cancer in China

In this study, the current status for breast diseases in a region with high-incidence of cervical cancer were epidemiologically investigated. From March to August, 2009, 17618 women, from Wufeng area of Hubei province, China, were recruited to screen breast diseases by using breast infrared diagnostic apparatus. Other diagnostic methods, such as B-mode ultrasound, X-ray mammography, needle biopsy and pathological examination were, if necessary, used to further confirm the diagnosis. The screening showed that 5990 of 17618 cases (34.00%) had breast diseases, 5843 (33.16%) had mammary gland hyperplasia, 48 (0.27%) had breast fibroadenoma, 11 (0.06%) had breast carcinoma, and 88 (0.50%) had other breast diseases. The peak morbidity of breast cancer was found in the women aged 50–60 ages. The morbidity of breast cancer was significantly increased in women elder than or equal to 50 years old (n=8, 0.157%) in comparison with that in the subjects younger than 50 years old (n=3, 0.024%) (u=2.327, P<0.05). It was shown that the occurrence of breast diseases was concentrated in women aged 20–40 years, while the total morbidity reached its peak at the age of 30 years and then decreased sharply after age of 40. Compared with the patients elder than or equal to 40 years old (n=3289, 27.46%), the morbidity rate of breast diseases was significantly increased in women less than 40 years old (2648 cases, 47.18%; P<0.001). However, there was no significant difference in the morbidity of breast diseases between the age group of 20–29 years and that of 30–39 years (P=0.453), and both of them were high. There was no significant association between the morbidity of breast diseases and cervical cancer. Since the morbidity of breast diseases was higher among young women, more attention should be paid to the screening of breast diseases among young women for early diagnosis.

The Influence of Progesterone Gel Therapy in the Treatment of Fibrocystic Breast Disease

The effect of progesterone therapy on E2/P ratio changes during the luteal phase, and its consequences are on mastalgia and cyst, within a fibrocystic breast disease (FBD). Fifty women with FBD were included. Information for mastalgia and mastodynia were checked with a questionnaire. All women had (E2) and (P) concentration checked before and during the therapy on the 21st and 24th day of a cycle, ultrasound measured size and number of cysts before and during the therapy. T-test, X2-test, McNemar test, Wilcoxon test and Friedman test were used for statistics. There was a decrease E2/P relation during the therapy vs. before the treatment p < 0.01, as well as the decrease of E2 level on the 24th day during the therapy vs. same day of E2 level, before the therapy (p = 0.164). There was an increase of p level on the 24th day vs. on 24th day before the therapy (p < 0.001). During the therapy, it was found decrease in pain and tension (p < 0.001), and the number and size of the cysts (p < 0.001). Mastalgia and mastodynia significantly decreased during the local p gel therapy, and there was a significantly lower number and size of the cysts in patients with FBD.

Prospective Study of Color Doppler Ultrasonography in the Diagnosis of Breast Disease.

One hundred and four cases of breast disease were examined by color Doppler ultrasonography (CDUS). Malignant lesions were rich in blood blow signal and 56% of +++-++++grade while benign lesions had little blood flow signal

STUDIES ON THE HISTOLOGICAL CLASSIFICATION OF PROLIFERATIVE DISEASE OF BREAST AND ITS RELATION WITH BREAST CARCINOMA

Objective: Proliferative disease of breast (PDB)always exists compositely, it is difficult to be classifiedduring pathologic diagnosis. For probe into therelationship between PDB and breast carcinoma in thecyto-biologic level, a new classification method wasstudied.Matcrials and methods: Specimen slices of 439 PDBin females and 176 breast carcinomas were studied incontrast. The degree of fibroplastic proliferation wastaken as the classifying index of the consecutive progressof PDB. Then the PDB cases were divided into three types:the lobular hyperplastic type (LHT), the fibroadenosistype (FAT) and the fibrosclerosis type (FST). Each typewas once again separated into simple and compoundgroups- A part of these slices were stained withmonoclonal immunohistochemical stain to demonstratethe hyperplastic activities of PDB cells as well as theencirclement of periductal myoepithelial cells and basemembrane.Results: PCNA express level was increasedsuccessively along with the progress of pathologic changesin all the three types of PDB. And especially, it was almostparallel with the cancerous express in FST. ASMAstaining showed afrophy and rupture of periductalmyoepithelial cells and base membrane in FST andserious untypical hyperplastic PDB cases.Conclusions: In FST and serious untypicalhyperplastic PDB cases, the ductal epithelial cellsproliferated vigorously, it is closely related with thegrowth of carcinomas. The imcomplete encirclement ofperiductal myoepithelial cells and base membrane arealso a sort of dangerous factor.

Comparative Study of the Effect of Shugan Shuru Granule (疏肝舒乳颗粒) on Pathology and p53 Gene Expression in Patients with Hyperplastic Disease of Breast

Objective: To study the effect of Shugan Shuru Granule (疏肝舒乳颗粒,SSG) on the p53 gene expression in patients with hyperplastic disease of breast (HDB) to indirectly explore the mechanism of SSG’s effect on HDB on the molecular pathological level. Methods: Sixty-six patients with HDB were allocated in the treated group and the control group,with the former treated with SSG and the latter not. All patients underwent breast operation and their diseased mammary tissues were cut out, sectioned, and observed under microscopy with HE staining and immunohistochemical staining, with ABC method adopted to estimate the degree of hyperplasia and p53 gene expression. The severity of HDB was classified into normal, mild, moderate and severe grades (marked as 0 to Ⅲ), according to the degree of hyperplasia in the mammary gland. Results: Hyperplasia in the control group mostly belonged to grade Ⅰ-Ⅲ before treatment, showing overgrowth of gland and proliferation of glandular epithelial cells, which were high columnar shaped, more stratified, with papillary or substantive dysplasia. While in the treated group, most belonged to grade 0-Ⅰ after SSG treatment, with proliferated gland and dysplasia recovered to normal or disappeared. The positive rate of p53 gene expression in the treated group was 9.09%, and in the control group 39.39%, comparison between the two groups showing significant difference (P<0.01), the intensity in the former was significantly weaker than that in the latter.Conclusion: SSG could not only inhibit the proliferation of mammary duct epithelia and lobuli, but also inhibit the over-expression of P53. Therefore, it could be regarded as an effective remedy for treatment of HDB and prevention of mammary cancer genesis.

The Therapeutic Ways for Chronic Liver Diseases Accompanied by Diseases of the Endocrine and Mammary Glands

It is discovered by the authors of this article thatchronic hepatitis and hepatocirrhosis (hereinafterchronic hepatopathy for short) are often accompaniedby some diseases of endocrine and mammary glands.The authors have studied the pathogenesis andtreatment of the complications as presented in thefollowing.

Breast adenoid cystic carcinoma arising in microglandular adenosis:A case report and review of literature

BACKGROUND Breast adenoid cystic carcinoma(AdCC)is a rare invasive carcinoma composed of epithelial and myoepithelial cells.Microglandular adenosis(MGA)is a rare benign proliferative lesion consisting of small,uniform,and round glands formed by a single layer of epithelial cells and basement membrane without a myoepithelial cell layer.MGA may progress to atypical MGA and carcinoma arising in MGA.Among various invasive carcinomas from MGA,AdCC has been rarely reported.Here,we report a case of AdCC arising in MGA.CASE SUMMARY A 59-year-old woman was diagnosed with a newly developed density on a routine mammogram.The density was similar to or slightly lower than that of the breast parenchyma.Sonography showed an irregular mass with a slightly higher echo than that of fat.Magnetic resonance imaging showed an irregular mass with a similar T1 signal intensity and a slightly higher T2 signal intensity compared to muscles or the breast parenchyma.The lesion showed heterogeneous internal enhancement with an initially slow and delayed persistent enhancing pattern.Microscopically,the tumor was composed of invasive AdCC,in situ AdCC,and MGA.AdCC is composed of basaloid and ductal epithelial cells forming cribriform or solid sheets,or haphazardly scattered small cribriform or tubular glands.MGA showed small glands with a single epithelial lining and retained lumen.S-100 staining was strongly positive in MGA area.The patient underwent breast-conserving surgery with sentinel lymph node biopsy.CONCLUSION Breast AdCC arising in MGA showed unique imaging findings that was different from usual invasive cancer.

Value of magnetic resonance diffusion combined with perfusion imaging techniques for diagnosing potentially malignant breast lesions

BACKGROUND Lesions of breast imaging reporting and data system(BI-RADS)4 at mammography vary from benign to malignant,leading to difficulties for clinicians to distinguish between them.The specificity of magnetic resonance imaging(MRI)in detecting breast is relatively low,leading to many false-positive results and high rates of re-examination or biopsy.Diffusion-weighted imaging(DWI),combined with perfusion-weighted imaging(PWI),might help to distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.AIM To evaluate the value of DWI and PWI in diagnosing BI-RADS 4 breast lesions.METHODS This is a retrospective study which included patients who underwent breast MRI between May 2017 and May 2019 in the hospital.The lesions were divided into benign and malignant groups according to the classification of histopathological results.The diagnostic efficacy of DWI and PWI were analyzed respectively and combinedly.The 95 lesions were divided according to histopathological diagnosis,with 46 benign and 49 malignant.The main statistical methods used included the Student t-test,the Mann-Whitney U-test,the chi-square test or Fisher’s exact test.RESULTS The mean apparent diffusion coefficient(ADC)values in the parenchyma and lesion area of the normal mammary gland were 1.82±0.22×10^(-3)mm^(2)/s and 1.24±0.16×10^(-3)mm^(2)/s,respectively(P=0.021).The mean ADC value of the malignant group was 1.09±0.23×10^(-3)mm^(2)/s,which was lower than that of the benign group(1.42±0.68×10^(-3)mm^(2)/s)(P=0.016).The volume transfer constant(Ktrans)and rate constant(Kep)values were higher in malignant lesions than in benign ones(all P<0.001),but there were no significant statistical differences regarding volume fraction(V_(e))(P=0.866).The sensitivity and specificity of PWI combined with DWI(91.7%and 89.3%,respectively)were higher than that of PWI or DWI alone.The accuracy of PWI combined with DWI in predicting pathological results was significantly higher than that predicted by PWI or DWI alone.CONCLUSION DWI,combined with PWI,might possibly distinguish between benign and malignant BI-RADS 4 breast lesions at mammography.

Primary Breast Tuberculosis Mimicking Carcinomatous Mastitis: A Case Report

The breast is a rare localization of extra-pulmonary tuberculosis, even in highly endemic countries. It is most often primitive. The clinical and radiological features are sometimes misleading. It poses diagnostic problems especially with cancer. We report a case of breast tuberculosis having clinical and radiological presentations as a breast carcinoma. Through this observation and a review of the literature, we provide an update on the epidemiological characteristics and the means of diagnosis of this lesion. It was a 52-year-old woman with inflammatory lump of the left breast, adherent to the skin. Ultrasonography and mammography revealed a homogeneous, poorly demarcated nodule of approximately 4 cm of diameter, classified ACR4. Surgical excision was performed. The histological diagnosis was breast tuberculosis. The diagnosis of tuberculous mastitis is made on bacteriological and pathological examinations. Histological examination helps for diagnostic confirmation while excluding a malignant lesion of the breast.

Expression and Clinical Significance of Vascular Endothelial Growth Factor in Benign and Malignant Tissues of Breast

Objective： To detect the expression of vascular endothelial growth factor （VEGF） and microvessel density （MVD） count in breast benign affection, breast atypical hyperplasia and breast carcinoma in situ, and to clarify the relationship between VEGF expression, MVD and the clinicopathological features of these diseases. Methods： The expression of VEGF and MVD count in 115 cases breast benign diseases （including 40 breast fibroid tumor, 40 breast cystic hyperplasia and 35 intraductal papilloma, 19 breast atypical hyperplasias and 32 breast carcinomas in situ were examined by immunohistochemistry staining （SP-method）. Results： The positive rate of VEGF in breast benign diseases, breast atypical hyperplasia and breast carcinoma in situ were 21.74%（25/115）, 31.58.% （6/19）and 53.13%（17/32） respectively. It was the lowest in breast benign affection group, and was the highest breast carcinoma in situ group. The expression of VEGF increased gradually in the three groups （P〈0.05）. The MVD count of the three groups were 14.41 ± 2.59, 18.89± 4.47 and 21.13 ± 4.12 respectively, It was the lowest in breast benign affection group, and was the highest breast carcinoma in situ group. The MVD count of the three groups increased gradually （P〈0.05）. In VEGF positive group, MVD count was 19.41 ±4.78; In VEGF negative group, MVD count was 14.91±3.15. The MVD count was higher in VEGF positive group than that in VEGF negative group （P〈0.05）. Conclusion： The results of this study suggested that VEGF could promote microvessel growth in breast tumors. The occurrence and progression of breast cancer might be related with the expression of VEGF.

Metastatic Lobular Carcinoma of the Breast Presenting with Small Bowel Metastases:Case Report and Literature Review

Introduction: Invasive lobular carcinoma (ILC) is the second most common histologic type of breast cancer, representing 5% to 15% of invasive tumors. ILC tends to spread to bones, lungs, central nervous system, reproductive organs, and the gastrointestinal tract (GI tract). The most commonly affected organs in the GI tract are the stomach, small intestine, followed by colon and rectum. Case presentation: A 78-year-old woman who was referred to our institution after having a bowel obstruction that required a diagnostic laparoscopy where they identified an obstructing ulcerative lesion in the distal ileum that was managed with a segmental bowel resection. Pathology report showed an invasive lobular breast carcinoma that occluded 90% of the bowel lumen. A PET/CT scan revealed a left breast tumor with increased metabolism. The patient was staged as a clinical cT4b, cN0, cM1 left breast invasive lobular carcinoma (ER/PgR positive, HER-2 negative). She was managed with endocrine therapy with Letrozole (an eight-week course). A follow-up PET/CT showed a peritoneal hypermetabolic nodule adjacent to the previous ileal anastomosis. The lesion decreased in size and metabolic activity. In a multidisciplinary fashion, the endocrine therapy was extended for another three months. Another follow-up PET/CT scan was performed three months after the identification of the peritoneal implant that showed that the nodule increased in size and in metabolism. The lesion continued to decrease significantly in size and became metabolically inactivity. Due to the good breast response and the possibility that the ileal nodule could be a granuloma, she underwent an exploratory laparoscopy with excision of the peritoneal nodule, and a modified left radical mastectomy with immediate breast reconstruction (complex wound closure). The final pathology report of the nodule was negative for malignancy. She continued on endocrine therapy and underwent whole breast irradiation four weeks after the operation. Currently, she is free of disease with no evidence of local, regional, or distant recurrence, and she is still on endocrine therapy. Discussion: The time interval between primary breast cancer and gastrointestinal involvement may range from synchronous presentation to as long as 30 years. The clinical manifestations in GI lobular breast cancer metastasis may range from non-specific complaints to acute GI symptoms, such as a bowel obstruction. There are multiple controversies in the management of ILC. Systemic treatment should be initiated as soon as possible. Indications for postmastectomy radiotherapy are also controversial, given the propensity for multifocal/multicentric tumors and late recurrences, sometimes in atypical locations. Five years of postoperative adjuvant hormonal therapy is an option for women with poor prognosis. Remissions are observed in 32% to 53% of patients. Conclusion: Metastatic lobular carcinoma of the breast has a wide range of clinical presentations. Patients with a history of breast cancer who present with new GI tumors should have these lesions evaluated for evidence of metastasis through histopathologic and immunohistochemical analysis, this will allow for appropriate management. Currently, breast cancer management involves a multidisciplinary approach including surgery, radiotherapy, and systemic medical therapy, and the treatment must be tailored to the patient’s needs.

New Exploration of Needling Manipulations at Point Tianzong

In present clinical practice, point Tianzong (SI 11) is often used to treat pain and numbness in the scapular region and the upper limbs. The authors have tried various needling manipulations at this point and obtained extraordinarily good therapeutic result, as is reported in the following. ……

上海市妇科疾病及乳腺疾病筛查服务成本核算

目的调查上海市2家筛查机构提供妇科疾病及乳腺疾病(以下简称“两病”)筛查服务的方式、流程和内容,构建两病筛查服务成本核算体系,分别对2家样本机构的两病筛查旧包(筛查项目包括妇科三合诊检查、阴道分泌物常规检查、阴道超声检查、宫颈脱落细胞学检查、乳腺红外线检查和乳房手诊检查)和上海市60家筛查机构的两病筛查新包(筛查项目包括妇科三合诊检查、阴道分泌物常规检查、阴道超声检查、乳房手诊检查、宫颈液基薄层细胞学检查、乳腺彩色多普勒超声检查)进行成本核算。方法采用文献研究、关键知情人访谈等方法构建两病筛查服务成本核算体系,设计成本数据调查表,组织承担两病筛查的医疗机构根据实际情况逐一填报调查表。结果上海市妇女两病筛查旧包和新包的实际成本均比上海市现行收费高。剔除各筛查机构收到的财政补偿后,两病筛查旧包和新包的剩余成本均比上海市现行收费低。结论政府可结合现有补偿渠道综合考虑筛查的间接成本,合理确定筛查经费的投入标准,并通过改进筛查技术和项目来提高退休妇女和生活困难妇女的获得感。

Genetic counseling in post-genomic era: Don't pretend to know the meaning of a gene mutation if you don't know

In this post-genomic era, more and more susceptibility loci of many possible genetic diseases are published. As our knowledge about these susceptibility loci is limited and partial, we should be very careful and responsible when patients seek genetic counseling about these possible genetic diseases. We should apply Confucius' s principle about knowledge and information to genetic conseling, and tell the truth to our patients about what we know and what we do not know. Like many other cancers, breast cancer is a very complicated, multifactorial disease; genetic factors, lifestyles and eating habits, environmental factors, and viral infections might be involved in breast cancer; hence, it is difficult to figure out the real etiology of breast cancer. It is not crystal clear that a person who carries mutations of the breast cancer 1, early onset and/or breast cancer 2, early onset genes would eventually get breast cancer in her/his lifetime. No person should undergo a preventive double mastectomy, unless we know the etiology of breast cancer someday.

Deep learning applied to two-dimensional color Doppler flow imaging ultrasound images significantly improves diagnostic performance in the classification of breast masses:a multicenter study

Background:The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions.In China,breast masses are divided into four categories according to the treatment method:inflammatory masses,adenosis,benign tumors,and malignant tumors.These categorizations are important for guiding clinical treatment.In this study,we aimed to develop a convolutional neural network(CNN)for classification of these four breast mass types using ultrasound(US)images.Methods:Taking breast biopsy or pathological examinations as the reference standard,CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers.The patients were randomly divided into training and test groups(n=1810 vs.n=1813).Separate models were created for two-dimensional(2D)images only,2D and color Doppler flow imaging(2D-CDFI),and 2D-CDFI and pulsed wave Doppler(2D-CDFI-PW)images.The performance of these three models was compared using sensitivity,specificity,area under receiver operating characteristic curve(AUC),positive(PPV)and negative predictive values(NPV),positive(LR+)and negative likelihood ratios(LR-),and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators,between images from different hospitals with AUC,and with the performance of 37 radiologists.Results:The accuracies of the 2D,2D-CDFI,and 2D-CDFI-PW models on the test set were 87.9%,89.2%,and 88.7%,respectively.The AUCs for classification of benign tumors,malignant tumors,inflammatory masses,and adenosis were 0.90,0.91,0.90,and 0.89,respectively(95%confidence intervals[CIs],0.87-0.91,0.89-0.92,0.87-0.91,and 0.86-0.90).The 2D-CDFI model showed better accuracy(89.2%)on the test set than the 2D(87.9%)and 2D-CDFI-PW(88.7%)models.The 2D model showed accuracy of 81.7%on breast masses≤1 cm and 82.3%on breast masses>1 cm;there was a significant difference between the two groups(P<0.001).The accuracy of the CNN classifications for the test set(89.2%)was significantly higher than that of all the radiologists(30%).Conclusions:The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.Trial registration:Chictr.org,ChiCTR1900021375;http://www.chictr.org.cn/showproj.aspx?proj=33139.

Modulation of expression of P16 and Her2 in rat breast tissues of mammary hyperplasia model by external use of Rupifang Extract

tract in external use on expression of proto-onco- genes her2 and tumor suppression genes p16 in rat breast tissues of mammary hyperplasia model. To explore the mechanisms of Rupifang Extract in external use for preventing and treating mammary hyperplasia. METHODS Thirty virginal female Wistar rats were randomized into 5 groups, 6 in each, A： blank con- trol group; B： model group; C： the low dose group of Rupifang; D： the middle dose group of Rupifang; and E： The high dose group of Rupifang. The mam- mary hyperplasia rat models were produced by in- jecting estradiol benzoate and progesterone and ir- ritating by tail nipping. Drug intervention was also launched during the model formation. After 30 days, the expression of her2 and p16 in breast tis- sues of rats in each group were detected by the SP immunohistochemical method. RESULTS： Compared with Blank control group, the expression of her2 in breast tissues in Model group was higher, and the expression of p16 was lower （P〈O.05 or P〈O.01）. After intervention with Rupi- fang Extract, compared with Model group, the ex- pression of her2 in breast tissues in Rupifang groups was lower, and the expression of p16 higher （P〈O.05 or P〈O.01）. CONCLUSION： The mechanisms of Rupifang Ex- tract in external application for preventing and treating mammary hyperplasia may be reducing the expression of proto-oncogenes her2 and in- creasing the expression of tumor suppression genes p16.

Clinical Observation on Combination of Acupuncture and Medication in Treating Breast Hyperplasia

Objective: To observe the clinical efficacy of acupuncture combined with medication in treating breast hyperplasia. Methods: One hundred patients with breast hyperplasia who met the inclusion criteria were randomly divided into an acupuncture combined with traditional Chinese medicine(A&TCM) group and a traditional Chinese medicine(TCM) group, 50 cases in each group. The A&TCM group received acupuncture combined with oral TCM; the TCM group only received oral TCM. After two courses of treatment, the efficacy was observed. Results: During the two treatment courses, the recovery rates had been increasing in both groups. The recovery rate of the A&TCM group was 40.0% and the total effective rate was 98.0%. While the recovery rate of the TCM group was 18.0% and the total effective rate was 80.0%. According to statistical analysis, the differences of recovery rate and total effective rate between the two groups were statistically significant(P<0.01). Conclusion: Combination of acupuncture and TCM is more effective than simple oral TCM.

Observation on Efficacy of Acupuncture for Hyperplasia of Mammary Glands

Objective： To observe the effect of acupuncture on hyperplasia of mammary glands. Methods： Sixty patients with hyperplasia of mammary glands were randomly divided into 2 groups, the treatment group and the control group, 30 cases in each group. The patients in the treatment group were treated by acupuncture combined with electromagnetic therapy, while the patients in the control group were treated by Tamoxifen. After treatment, the serum estradiol （E2） and progesterone （P） levels were detected during luteal phase. Results： The total effective rate of the treatment group was 90.3%, while it was 93.3% in the control group, there was no statistical difference （P〉0.05）. The E2 levels decreased, and the P levels increased in the two groups. After treatment, the E2 and P levels were significantly different from those before in the two groups （P 〈 0.05）. And there was no statistical difference of the E2 and P levels between the two groups both before and after the treatments. Conclusion： Acupuncture combined with electromagnetic therapy can regulate the hypothalamic- pituitary-ovarian axis＇ function, and can repair normal process from hyperplasia to involution of the mammary glands. According to our study, the effect of acupuncture combine with electromagnetic therapy was almost the same with the western medicine.

Infrared Radiation Temperature Comparison on Body Surface of Points Between Healthy People and Patients with Hyperplasia of Mammary Glands

Objective： To compare the difference of infrared radiation temperature on body surface of points between healthy people and patients with hyperplasia of mammary glands. Method： The thermaCATMT P30 infrared thermal imaging system was selected to measure the infrared radiation temperature on body surface of eight points in four meridians in 74 patients with hyperplasia of mammary glands and 63 healthy people. Results： The infrared radiation temperatures on body surface of right Youmen （KI 21） in cases with hyperplasia of mammary glands were significantly higher than the healthy people （P=-0.009）, and the infrared radiation temperatures on left Youmen （KI 21） and other points had no significant difference with healthy people （P〉0.05）. Conclusion： The infrared radiation temperatures on body surface of right Youmen （KI 21） have significant differences with healthy people. This might occur because of the pathogenesis of hyperplasia of mammary glands and of the specificity of the point Youmen （KI 21）.

Observation on lower-reinforcing and upper- reducing acupuncture method for hyperplasia of mammary gland and its influence on estradiol and progesterone

Objective： To observe the clinical effect of lower-reinforcing and upper-reducing acupuncture method for hyperplasia of mammary gland （HMG） and its influence on estradiol （E2） and progesterone （P）. Methods： A randomized, single-blinded and controlled trial was conducted. A total of 124 cases conforming to the inclusion criteria were randomized by random number table into a treatment group and a control group, with 62 cases in each group. Patients in both groups received acupuncture therapy at the same acupoints, while patients in the treatment group received lower-reinforcing and upper-reducing method, and patients in the control group received even reinforcing-reducing manipulation. The treatment started around 10 d before menstruation and was conducted every other day. Patients received 5 treatments in each menstruation cycle for consecutive 3 cycles. The levels of E2, P and E2/P and clinical efficacy were measured before and after treatment. Results： After treatment, the breast lump size, pain intensity and concomitant symptoms score in both groups were substantially lower than those before treatment, showing statistical significances （all P〈0.01）, and the improvement in the treatment group was higher than that in the control group, and the between-group comparisons showed statistical significances （all P〈0.01）. After treatment, the overall effective rate was 91.9% in the treatment group, higher than 72.6% in the control group, and the between-group comparison showed a statistical significance （P〈0.01）. After treatment, levels of E2, P and E2/P value showed no statistical significance when compared with those before treatment in the two groups （all P〉0.05）. Conclusion： Lower-reinforcing and upper-reducing acupuncture method can effectively alleviate clinical symptoms and signs in HMG patients, and produce a better effect than even reinforcing-reducing manipulation. The majority of HMG patients＇ E2, P level and E2/P value were not beyond the normal ranges; therefore, acupuncture showed no substantial influence on E2 and P levels and E2/P value.