Breast cancer remains a significant global health challenge, necessitating effective early detection and prognosis to enhance patient outcomes. Current diagnostic methods, including mammography and MRI, suffer from li...Breast cancer remains a significant global health challenge, necessitating effective early detection and prognosis to enhance patient outcomes. Current diagnostic methods, including mammography and MRI, suffer from limitations such as uncertainty and imprecise data, leading to late-stage diagnoses. To address this, various expert systems have been developed, but many rely on type-1 fuzzy logic and lack mobile-based applications for data collection and feedback to healthcare practitioners. This research investigates the development of an Enhanced Mobile-based Fuzzy Expert system (EMFES) for breast cancer pre-growth prognosis. The study explores the use of type-2 fuzzy logic to enhance accuracy and model uncertainty effectively. Additionally, it evaluates the advantages of employing the python programming language over java for implementation and considers specific risk factors for data collection. The research aims to dynamically generate fuzzy rules, adapting to evolving breast cancer research and patient data. Key research questions focus on the comparative effectiveness of type-2 fuzzy logic, the handling of uncertainty and imprecise data, the integration of mobile-based features, the choice of programming language, and the creation of dynamic fuzzy rules. Furthermore, the study examines the differences between the Mamdani Inference System and the Sugeno Fuzzy Inference method and explores challenges and opportunities in deploying the EMFES on mobile devices. The research identifies a critical gap in existing breast cancer diagnostic systems, emphasizing the need for a comprehensive, mobile-enabled, and adaptable solution by developing an EMFES that leverages Type-2 fuzzy logic, the Sugeno Inference Algorithm, Python Programming, and dynamic fuzzy rule generation. This study seeks to enhance early breast cancer detection and ultimately reduce breast cancer-related mortality.展开更多
Background:?Male breast cancer is rare, accounting for approximately 0.5% - 1.0% of all breast cancer cases;hormone-dependent luminal type male breast cancer is the most common. The proportion of hormone receptor-nega...Background:?Male breast cancer is rare, accounting for approximately 0.5% - 1.0% of all breast cancer cases;hormone-dependent luminal type male breast cancer is the most common. The proportion of hormone receptor-negative and human epithelial growth factor Receptor type 2-positive breast cancer is?extremely low among male breast cancer.?A patient with advanced HER2 type breast cancer, a rare male breast cancer, was successfully treated with pertuzumab, trastuzumab, and eribulin therapy. Case Presentation:?A 75-?year-old man presented to our hospital with induration of the right anterior chest and lymphoedema of the right upper limb. Based on the results of core needle biopsy, he was diagnosed with HER2 type invasive ductal carcinoma associated with bone metastasis (stage IV). Chemotherapy with pertuzumab, trastuzumab, and eribulin was started. The drugs were remarkably effective, and his lymphoedema tended to improve.?Conclusion:?We reported a successful case of chemotherapy and targeted therapy for a rare male breast cancer of HER2 positive and hormone negative type.展开更多
Background: Triple-negative breast cancer (TNBC) is defined by the absence of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor 2 (HER2) expression. Patients with TNBC derive no ben...Background: Triple-negative breast cancer (TNBC) is defined by the absence of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor 2 (HER2) expression. Patients with TNBC derive no benefit from molecularly targeted treatments, such as endocrine therapy or trastuzumab, as they lack the appropriate targets for these drugs. TNBC is characterized by its biological aggressiveness and poor prognosis, and consists of two subtypes, basal and nonbasal. The purpose of our study is to differentiate the clinicopathological characteristics of the two subtypes. Methods: 367 patients with primary breast cancer were recruited from April 2004 to December 2010 at 1st Department of Surgery, Sapporo Medical University. ER, PgR, and HER2 status were evaluated in all cases. Moreover, we classified TNBC into basal, nonbasal subtypes on the basis of immunohistochemical staining of epidermal growth factor receptor (EGFR), cytokeratin (CK) 5/6. Basal type was defined as CK5/6-positive and/or EGFR-positive, and nonbasal type was defined as no expression of these two markers. Results: Breast cancer subtypes by molecular classification were Hormone receptor (HR)-positive/HER2-negative (61%), HR-positive/HER2-positive (10%), HR-negative/HER2-positive (14%), and HR-negative/HER2-negative (15%). There was no difference between the basal type and the nonbasal type in clinicopathological factors. But, the basal type was significantly associated with Ki67 labeling index (p=0.0002), p53 expression (p=0.047), and BRCA1 expression (p=0.03). Further, patients with the basal type TNBC showed a shorter overall survival (p=0.032) than did patients with the nonbasal type. Conclusion: Classification of TNBC subtypes by EGFR, CK5/6 is a very useful prognostic factor, and highlights the need for the development of an adequate new strategy for the basal type TNBC.展开更多
Objective: To study the expression and clinical significance of urokinase-type plasminogen activator (uPA) in breast cancer. Methods: Applying streptavidin-biotin complex (SABC) immunohistochemical technique, expressi...Objective: To study the expression and clinical significance of urokinase-type plasminogen activator (uPA) in breast cancer. Methods: Applying streptavidin-biotin complex (SABC) immunohistochemical technique, expression of uPA was studied in 100 patients with primary breast cancer. Results: There were 55 patients with high uPA expression, and 45 with lower expression. There was significant correlation between uPA expression and TNM stage, lymph node status, and the tumor size. Neither age, menopausal status, nor ER status was significantly related with level of uPA expression. The patients with high expression of uPA had significantly shorter disease-free survival (DFS) and overall survival (OS) than did those with low expression of uPA. Univariate analysis showed that uPA as a prognostic factor was of similar magnitude to lymph node status and TNM stage, but stronger than that of ER status and tumor size. UPA was an independent prognostic factor affecting disease-free survival and overall survival. Conclusion: uPA appears to be a strong and independent biologic marker for predicting prognosis of breast cancer.展开更多
Objective:To investigate the expressions of plasminogen activator inhibitor type 1 (PAI-1), C-erbB-2, VEGF and Ki-67 by immunohistostaining and then to evaluate the prognostic value of PAI-1 in node-negative breast ca...Objective:To investigate the expressions of plasminogen activator inhibitor type 1 (PAI-1), C-erbB-2, VEGF and Ki-67 by immunohistostaining and then to evaluate the prognostic value of PAI-1 in node-negative breast cancer. Methods:The study included a retrospective series of 62 female patients with axillary lymph node-negative breast cancer. Expressions of PAI-1, C-erbB-2, VEGF and Ki-67 were determined by immunohistostaining on formalin-fixed paraffin-embedded tissue sections from these patients after a median follow-up of 69 months (range 22–117 months). Correlations with well known clinicopathologic factors were assessed and multivariate survival analyses were performed. Results: High PAI-1 level was positively associated with high histologic grade of the tumors. Disease-free survival (DFS) was significantly shorter for the patients with moderate to intensive expression of PAI-1 than for those with negative (χ2 = 25.46, P < 0.001; χ2 = 23.07, P < 0.001) to mild expression (χ2 = 19.75, P < 0.001; χ2 = 17.40, P < 0.001). Although on univariate analysis of the prognostic factors, tumor size, location of primary tumor and age as well as expressions of PAI-1, VEGF and Ki-67 were all significantly prognostic factors for DFS (P < 0.05), PAI-1 was the only independent prognostic factor on multivariate analysis (P<0.0001; hazard ratio [HR], 4.041; 95% confidence interval [CI], 1.928–8.468). Conclusion: These results of the current study indicate that intermediate or high expression of PAI-1 represents a strong and independent unfavorable prognostic factor for the de-velopment of recurrence or metastases in axillary node-negative breast cancer.展开更多
目的分析基于超声乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类对不同病理类型乳腺肿块诊断的结果。方法方便选取2022年3月—2023年8月在枣庄市台儿庄区人民医院和济南市平阴县中医医院进行检查的74...目的分析基于超声乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类对不同病理类型乳腺肿块诊断的结果。方法方便选取2022年3月—2023年8月在枣庄市台儿庄区人民医院和济南市平阴县中医医院进行检查的74例女性患者为研究对象。以病理检查为金标准,经病理证实乳腺肿块共80个,采用kappa检验分析超声检查与病理结果的一致性。结果病理结果显示,良性肿块61个,恶性肿块19个(kappa值为0.710,P<0.01)。超声BI-RADS分类诊断的灵敏度、特异度、准确度分别为96.72%、84.21%、93.75%。超声BI-RADS对良性肿瘤的诊断符合率均≥85.71%,而对恶性肿瘤诊断中,符合率最低时为75.00%。结论虽然不同病理类型乳腺肿块的超声诊断符合率较高,但在实际操作过程中仍然存在漏诊误诊等情况,故需要临床医师了解超声检查的不足,对超声诊断质量做好把控。展开更多
文摘Breast cancer remains a significant global health challenge, necessitating effective early detection and prognosis to enhance patient outcomes. Current diagnostic methods, including mammography and MRI, suffer from limitations such as uncertainty and imprecise data, leading to late-stage diagnoses. To address this, various expert systems have been developed, but many rely on type-1 fuzzy logic and lack mobile-based applications for data collection and feedback to healthcare practitioners. This research investigates the development of an Enhanced Mobile-based Fuzzy Expert system (EMFES) for breast cancer pre-growth prognosis. The study explores the use of type-2 fuzzy logic to enhance accuracy and model uncertainty effectively. Additionally, it evaluates the advantages of employing the python programming language over java for implementation and considers specific risk factors for data collection. The research aims to dynamically generate fuzzy rules, adapting to evolving breast cancer research and patient data. Key research questions focus on the comparative effectiveness of type-2 fuzzy logic, the handling of uncertainty and imprecise data, the integration of mobile-based features, the choice of programming language, and the creation of dynamic fuzzy rules. Furthermore, the study examines the differences between the Mamdani Inference System and the Sugeno Fuzzy Inference method and explores challenges and opportunities in deploying the EMFES on mobile devices. The research identifies a critical gap in existing breast cancer diagnostic systems, emphasizing the need for a comprehensive, mobile-enabled, and adaptable solution by developing an EMFES that leverages Type-2 fuzzy logic, the Sugeno Inference Algorithm, Python Programming, and dynamic fuzzy rule generation. This study seeks to enhance early breast cancer detection and ultimately reduce breast cancer-related mortality.
文摘Background:?Male breast cancer is rare, accounting for approximately 0.5% - 1.0% of all breast cancer cases;hormone-dependent luminal type male breast cancer is the most common. The proportion of hormone receptor-negative and human epithelial growth factor Receptor type 2-positive breast cancer is?extremely low among male breast cancer.?A patient with advanced HER2 type breast cancer, a rare male breast cancer, was successfully treated with pertuzumab, trastuzumab, and eribulin therapy. Case Presentation:?A 75-?year-old man presented to our hospital with induration of the right anterior chest and lymphoedema of the right upper limb. Based on the results of core needle biopsy, he was diagnosed with HER2 type invasive ductal carcinoma associated with bone metastasis (stage IV). Chemotherapy with pertuzumab, trastuzumab, and eribulin was started. The drugs were remarkably effective, and his lymphoedema tended to improve.?Conclusion:?We reported a successful case of chemotherapy and targeted therapy for a rare male breast cancer of HER2 positive and hormone negative type.
文摘Background: Triple-negative breast cancer (TNBC) is defined by the absence of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor 2 (HER2) expression. Patients with TNBC derive no benefit from molecularly targeted treatments, such as endocrine therapy or trastuzumab, as they lack the appropriate targets for these drugs. TNBC is characterized by its biological aggressiveness and poor prognosis, and consists of two subtypes, basal and nonbasal. The purpose of our study is to differentiate the clinicopathological characteristics of the two subtypes. Methods: 367 patients with primary breast cancer were recruited from April 2004 to December 2010 at 1st Department of Surgery, Sapporo Medical University. ER, PgR, and HER2 status were evaluated in all cases. Moreover, we classified TNBC into basal, nonbasal subtypes on the basis of immunohistochemical staining of epidermal growth factor receptor (EGFR), cytokeratin (CK) 5/6. Basal type was defined as CK5/6-positive and/or EGFR-positive, and nonbasal type was defined as no expression of these two markers. Results: Breast cancer subtypes by molecular classification were Hormone receptor (HR)-positive/HER2-negative (61%), HR-positive/HER2-positive (10%), HR-negative/HER2-positive (14%), and HR-negative/HER2-negative (15%). There was no difference between the basal type and the nonbasal type in clinicopathological factors. But, the basal type was significantly associated with Ki67 labeling index (p=0.0002), p53 expression (p=0.047), and BRCA1 expression (p=0.03). Further, patients with the basal type TNBC showed a shorter overall survival (p=0.032) than did patients with the nonbasal type. Conclusion: Classification of TNBC subtypes by EGFR, CK5/6 is a very useful prognostic factor, and highlights the need for the development of an adequate new strategy for the basal type TNBC.
文摘Objective: To study the expression and clinical significance of urokinase-type plasminogen activator (uPA) in breast cancer. Methods: Applying streptavidin-biotin complex (SABC) immunohistochemical technique, expression of uPA was studied in 100 patients with primary breast cancer. Results: There were 55 patients with high uPA expression, and 45 with lower expression. There was significant correlation between uPA expression and TNM stage, lymph node status, and the tumor size. Neither age, menopausal status, nor ER status was significantly related with level of uPA expression. The patients with high expression of uPA had significantly shorter disease-free survival (DFS) and overall survival (OS) than did those with low expression of uPA. Univariate analysis showed that uPA as a prognostic factor was of similar magnitude to lymph node status and TNM stage, but stronger than that of ER status and tumor size. UPA was an independent prognostic factor affecting disease-free survival and overall survival. Conclusion: uPA appears to be a strong and independent biologic marker for predicting prognosis of breast cancer.
基金Research Programme of the Shanghai Municipal Science and Technology Commission(No.06DZ19505)
文摘Objective:To investigate the expressions of plasminogen activator inhibitor type 1 (PAI-1), C-erbB-2, VEGF and Ki-67 by immunohistostaining and then to evaluate the prognostic value of PAI-1 in node-negative breast cancer. Methods:The study included a retrospective series of 62 female patients with axillary lymph node-negative breast cancer. Expressions of PAI-1, C-erbB-2, VEGF and Ki-67 were determined by immunohistostaining on formalin-fixed paraffin-embedded tissue sections from these patients after a median follow-up of 69 months (range 22–117 months). Correlations with well known clinicopathologic factors were assessed and multivariate survival analyses were performed. Results: High PAI-1 level was positively associated with high histologic grade of the tumors. Disease-free survival (DFS) was significantly shorter for the patients with moderate to intensive expression of PAI-1 than for those with negative (χ2 = 25.46, P < 0.001; χ2 = 23.07, P < 0.001) to mild expression (χ2 = 19.75, P < 0.001; χ2 = 17.40, P < 0.001). Although on univariate analysis of the prognostic factors, tumor size, location of primary tumor and age as well as expressions of PAI-1, VEGF and Ki-67 were all significantly prognostic factors for DFS (P < 0.05), PAI-1 was the only independent prognostic factor on multivariate analysis (P<0.0001; hazard ratio [HR], 4.041; 95% confidence interval [CI], 1.928–8.468). Conclusion: These results of the current study indicate that intermediate or high expression of PAI-1 represents a strong and independent unfavorable prognostic factor for the de-velopment of recurrence or metastases in axillary node-negative breast cancer.
文摘目的分析基于超声乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类对不同病理类型乳腺肿块诊断的结果。方法方便选取2022年3月—2023年8月在枣庄市台儿庄区人民医院和济南市平阴县中医医院进行检查的74例女性患者为研究对象。以病理检查为金标准,经病理证实乳腺肿块共80个,采用kappa检验分析超声检查与病理结果的一致性。结果病理结果显示,良性肿块61个,恶性肿块19个(kappa值为0.710,P<0.01)。超声BI-RADS分类诊断的灵敏度、特异度、准确度分别为96.72%、84.21%、93.75%。超声BI-RADS对良性肿瘤的诊断符合率均≥85.71%,而对恶性肿瘤诊断中,符合率最低时为75.00%。结论虽然不同病理类型乳腺肿块的超声诊断符合率较高,但在实际操作过程中仍然存在漏诊误诊等情况,故需要临床医师了解超声检查的不足,对超声诊断质量做好把控。
