Non-retroareolar male mucinous breast cancer without gynecomastia development in an elderly man:A case report

BACKGROUND Male breast cancer(MBC)is an extremely rare condition and accounts for less than 1%of all breast cancers,and malignant tumors occur in less than 1%of the affected men.Mucinous breast cancer is extremely rare and accounts for 2%of all invasive breast cancers.Generally,MBC is accompanied by a retroareolar mass.CASE SUMMARY Herein,we report a case of male mucinous breast carcinoma(MMBC)without gynecomastia development and with mass localization outside the common retroareolar region,wherein the mass was a painless nodule in the right breast of a 64-year-old man.We also discuss the clinical and pathological characteristics of this unusual tumor.The excised breast specimen showed pure mucinous carcinoma.The patient had strong expression of estrogen and progesterone receptors,a low Ki-67 proliferation index of the tumor cells,and negative pathological axillary lymph nodes.The patient underwent modified radical mastectomy and axillary lymph node dissection,followed by tamoxifen hormone therapy.CONCLUSION To the best of our knowledge,this is the first case report of MMBC in the nonretroareolar region of the nipple without gynecomastia development.Mucinous tumors are easily missed during diagnosis,and the incidence of axillary lymph node metastases of chest mucinous tumors has increased.

Violence against Women with Breast Neoplasms

The aim of this study is to assess the occurrence and type of violence suffered by women with breast cancer in the High Complexity Care Unit of a municipality in the South of Minas and patients in a support group of the University of the South of Minas Gerais. For that aim, a descriptive-exploratory methodology was applied through the quantitative method. Data were collected through a semi-structured form applied in individual interviews over a period of three months. We interviewed 57 patients and among those, 20 women （35.08%） reported having experienced some form of violence at some stage of their life, and the most frequently mentioned was the psychological violence followed by physical aggression. Although it was possible to identify that violence against affected these women, complaints against the aggressor were not affected.

HER2 Type Male Breast Cancer Successfully Treated with Pertuzumab, Trastuzumab, and Eribulin Therapy: A Case Report

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.

The 5-year incidence of male breast cancer in Southwest of China from 2007 to 2011

Objective: Male breast cancer is a rare disease with an incidence of about 1% of breast cancers in USA, but relatively lack of the information of male breast cancer in China, especially in Southwest of China, led us to study its incidence trends. Methods: Chongqing is one of the biggest and the most important areas that is located in Southwest of China. There are around 31.4 million people who live in approximate 82 402.95 km2area of Chongqing. Data about breast cancer patients registered in the Center for Disease Prevention and Control of Chongqing(China) were statistically collected from 187 hospitals, about 58 hospitals in city and 129 hospitals in country, and over 6.2 million people were studied every year. It was tried to represent all the people in villages and cities in Chongqing, China. Results: The incidence of male breast cancer in Southwest of China ranged from 0.34/100 000 to 1.45/100 000 between 2007 and 2011, while the incidence of female breast cancer ranged from 15.40/100000 to 21.66/100000 at the same time. The rate of male breast cancer to female breast cancer ranged from 0.02:1 to 0.07:1, male breast cancer accounted for 1.96% to 6.5%(with the mean value of 2.9%) of breast cancers in Southwest of China from 2007 to 2010. Conclusion: In Southwest of China male breast cancer accounts for about 2.9% of breast cancers which is higher than that in United States. It is important for policy makers and health manager to seriously consider breast cancer in future plan in Southwest of China.

A meta-analysis based on case-control studies shows the similar prognosis between male and female patients with breast cancer

Objective： Male breast cancer （MBC） is a rare disease, and studies to compare the prognosis between the MBC and female breast cancer （FBC） available now were case-control studies and population-based studies, however, with controversial outcomes. To further investigate whether sex affects the prognosis of breast cancer, we performed a meta-analysis based on all the peered papers. Methods： The PubMed database was screened. Subsequently, the hazard ratios （HRs） for overall survival （OS） and disease special survival （DSS）, were pooled using the Review Manager 5.0 package. Results： This study comprised of 254 MBC and 733 FBC patients enrolled in six case-control studies. There was no statistically significant heterogeneity among the trials for either outcome variable. The pooled HR showed that there was no significant difference in 5-year or 10-year DSS （HR： 1.25, 95% CI： 0.76-2.08; HR： 1.04, 95% CI： 0.68-1.5g） and 5-year or 10-year OS （HR： 0.76, 95% CI： 0.51-1.14; HR： 0.74, 95% CI： 0.54-1.02） between MBCs and FBCs. Conclusion： MBC and FBC with similar prognosis are found in this meta-analysis based on only case-control studies which matched main potential prognostic factors such as age, clinical stage, and time at diagnosis.

Characteristics of Chinese male patients with breast cancer:summary of the published papers

Objective:The extremely low incidence of male breast cancer (MBC) leads to lack of prospective randomized phase III studies worldwide. Especially in China,all studies on Chinese patients with MBC were based on small sample size and single institute experience. The aim of this study was to provide overall view of characteristics of Chinese patients with MBC by means of summarizing all related papers published in Chinese journals. Methods: An online search was made in CBM,VIP,CNKI,and CBA databases to find all published articles of interest on Chinese patients with MBC. And eight subjects including the proportion of MBC in all breast cancer,age,tumor location,clinical stages,pathological subtypes,treatment modalities,ER/PR expression,and 5-year survival rate were selected to calculate the proportion and their 95% interval confidence. Results: There were 122 papers with 2584 patients enrolled. The basic features of Chinese patients with MBC included:(1) MBC only with a proportion of 1.06% of all the breast cancer; (2) The mean age at diagnosis was 57.6 years old; (3) Tumor mainly located in the areolar region (74.83%) with obvious nipple and/or skin involvement; (4) Nearly 62.62% patients were in early stage before accepting treatment; (5) Infiltrating ductal carcinoma accounted for 79.05% of all pathological subtypes; (6) ER/PR expression rate was 65.86%; (7) Radical resection was up to 86.06% in all surgical modalities; (8) The 5-year survival rate was 57.33%. Conclusion: The results showed in this study were an overall view of Chinese patients with MBC whose characteristics were similar to that reported in the West. Though this study provided a little bit stronger confidence than a single study collected in this paper,studies with more powerful evidence are urgently demanding in China.

EXPRESSION OF ONCOGENE AND ANTI-ONCOGENE IN MALE BREAST CARCINOMA

Expression of oncogene and anti-oncogene products in 12 cases of male breast carcinoma was studied.Positive staining was seen in 6 cases for c-myc,6 cases for EGFR.4 cases for c-erbB-2 cases for N-ras,5 cases for Rb and 3 cases for P53.One case was positive and 4 cases were negative for all above mentioned oncogene and antioncogene products.In addition,Cathepsin D(Cath-D),ER.PR,AR.PCNA and AgNOR were also assayed.In all the cases showed c-erbB-2 or P53 positive were Cath-D positive.The significance of expression of c-erbB-2,c-myc,Cath-D,ER and PR in male breast carcinoma was emphatically discussed.

Echo-Mammographic and Anatomo-Pathological Aspects of Male Breast Cancer in Togo

Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of this study is to report cases of male breast cancer in Togo by describing the main epidemiological, mammo-echographic and pathological aspects. This was a retrospective, descriptive and analytical study of 10 cases of male patients presenting with breast cancer confirmed by the pathologic examination on the echo-guided samples over a period of 6 years in University Teaching Hospital in Lomé. A total of ten patients were retained. The mean age of patients was 55 years with extremes of 39 years and 65 years. All patients had a palpable breast mass. The lesions were classified in 60% American College of Radiology (ACR) 5 and 40% ACR 4. The axillary lymph node invasion rate was 40%. Infiltrating ductal carcinoma was the histologic type diagnosed in all patients. Any breast mass in an elderly male subject is suspected with high predictive value. Mammography ultrasound plays an important role in the diagnosis alongside pathology.

A biomarker study in Peruvian males with breast cancer

BACKGROUND Breast cancer(BC)frequency in males is extremely low and tumor features vary from its female counterpart.Breast cancer clinical and pathological features differ by race in women.Tumor infiltrating lymphocyte(TIL)levels,mismatch repair(MMR)protein loss,androgen receptor(AR)expression,and PIK3CA gene mutations are predictive biomarkers of response to biological therapy in female BC.There is limited information about clinical and pathological features as well as predictive biomarkers in males of non-Caucasian races with BC.AIM To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population.METHODS This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018.Standard pathological features,TIL levels,MMR proteins,AR immunohistochemistry staining,and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material.Percentage of AR and estrogen receptor(ER)positive cells was additionally calculated by software after slide scanning.Statistical analyses included association tests,intraclass correlation test and Kaplan Meier overall survival curves.RESULTS The median age was 63 years and most cases were ER-positive(85.7%),HER2 negative(87.2%),Luminal-A phenotype(60%)and clinical stage II(41.5%)among our male breast tumors.Median TIL was 10%and higher levels tended to be associated with Luminal-B phenotype and higher grade.AR-positive was found in 85.3%and was correlated with ER(intraclass index of 0.835,P<0.001).Loss of MMR proteins was found in 15.4%and PIK3CA mutation(H1047R)in 14.3%(belonged to the Luminal-A phenotype).Loss of MMR proteins was associated with AR-negative(P=0.018)but not with ER(P=0.43)or TIL(P=0.84).Early stages(P<0.001)and lower grade(P=0.006)were associated with longer overall survival.ER status,phenotype,AR status,TIL level,MMR protein loss nor PIK3CA mutation was not associated with survival(P>0.05).CONCLUSION Male BC is usually ER and AR positive,and Luminal-A.MMR loss and PIK3CA mutations are infrequent.Stage and grade predicted overall survival in our South American country population.

Egyptian male breast carcinoma:patients' hormonal profile,management and outcome

Objective:Male breast cancer(MBC) represents < 1% of all breast cancers.Hormone receptors and Her-2/neu status are established prognostic factors in female breast cancer but not yet studied enough in male breast cancer.The aim of the study was to verify the clinico-pathologic profile of male patients with breast cancer including analysis of hormone receptors and Her-2/neu state and its impact on survival rate.Methods:This is a retrospective study carried on a total of 123 male patients presented to the National Cancer Institute(NCI),Cairo University,Egypt-with breast carcinoma from January 1999 to December 2009.Results:The patients had a median age of 58(ranged from 29-92) years.About 39.8% of the patients presented with T4 lesion.At presentation,12.2% of the cases had metastasis with bone represented 86.7% of metastatic sites.About 92.7% of patients were subjected to modified radical mastectomy and radical mastectomy.Invasive duct carcinoma reported in 91.1%,and 76.4% of the patients had grade II pathology.Hormone profile was reported in 74% of the patients with 71.4% positive ER and 69.2% positive PR.Among 57 cases tested for Her-2/neu,10.5% were positive.Luminal A was the most common subtype detected in male breast carcinoma patients constituting 66.7%.Comparison with female patients with breast carcinoma revealed some differences regarding stage,hormone profile,Her-2/neu status and breast cancer subtypes.Chemotherapy as adjuvant,neo-adjuvant and metastatic was given for 73.1%,17.3% and 9.6% of the cases,with 83% of them had an anthracyclin-containing regimen.Sixty-nine patients received radiation treatment,65.2% and 34.8% of them with adjuvant and palliative aim,respectively.Dose of adjuvant radiotherapy had a median value of 4410(3400-5000) cGy.Adjuvant hormonal treatment(Tamoxafin) was given for 47 patients all of them with ER and/or PR positive for a median period of 33.5(4-60) months.The 5-year overall survival(OS),loco-regional control(LRC),metastasis-free survival(MFS) rates were 63%,68%,and 62%,respectively.Axillary lymph node metastasis and advanced tumor stage significantly worsen all survival rates.While,higher grade was associated with a poor overall survival,this was not reflected on LRC and MFS rates.Adjuvant radiotherapy and chemotherapy had significantly improved all survival rates.Conclusion:Some gender differences were detected regarding stage,hormone profile,Her-2 state,and tumor subtypes.

Study of the Expression of ALDH1 and CD44 Stem Cell Markers in Male Breast Cancers

Aims: Male breast cancer represents - mor aggressiveness and drug resistance. CSCs are characterized by CD44 and/or ALDH1 expression. In this study, we investigated their expression in male breast cancer. Method: Two in situ ductal carcinoma (DCIS) and 18 invasive duc- tal carcinoma (IDC) male breast cancer cases were studied with Jefferson IRB approval. Membrane staining of CD44 was scored by the percentage of positivity. Cytoplasmic expression of ALDH1 was considered positive. Results: Ten cases had high CD44 expression, which were all IDC. Both DCIS and in situ component of IDC were CD44 low. ALDH1 was only positive in 15 IDCs. ALDH1+ cells were mostly in the invasive component. Both DCIS cases were negative for ALDH1. Among the 15 ALDH1+ IDCs, five with only invasive component had a higher percentage (aver- age 4.4%) of positive cells compared to the other eight with in situ components (average 2.0%). Metastatic cells in sen- tinel lymph nodes had a similar expression pattern of CD44 and ALDH1 as their primary tumor. Conclusion: CD44 and ALDH1 are expressed in male breast cancers and they are overexpressed in invasive cancer compared to carcinoma in situ. These findings suggest that CSCs play an important role in the progression to invasive carcinoma.

Breast Cancer in Males (BCM), Does It Really Differ? National Cancer Institute Experience (NCI), Cairo University, Egypt

Background: Carcinoma of the male breast is relatively a rare disease accounting for about 1% of all cancer in men. Its treatments are based mainly on those of Female Breast Cancer (BCF). Materials and Methods: This is a single institution retrospective study including all presenting to the NCI, Cairo University with Breast Cancer in a Male (BCM) in the last 11 years between Jan. 2005 until Jan. 2016. Data were collected from patient’s files from the statistical department then analyzed. Aims: To study the clinico-pathological characteristics, the presentation, workup, surgical approaches and postoperative complications and outcome of management, with addressing similarities and difference from BCF. Results: 64 patients were included in this cohort. The mean age was 58.6 & the median age was 59 years (range: 31 - 87 years). The main presenting symptomatology was retroareolar breast lump (50 cases, 78.1%). Most of our cases were advanced;22 cases (34.3%) were stage III & 16 cases (25%) were stage IV. Surgery was performed for 50 patients;MRM for 26 cases (40.6%), RM for 18 cases (28.1%) & toilet mastectomy for 6 cases (9.3%). Primary closure was feasible in 34 patients (68%) while 16 cases (32%) required reconstruction by local or pedicled flaps. Tamoxifen is the most important non-surgical treatment. It was given to all our cases (64 cases, 100%) either postoperatively as adjuvant management (36 cases, 56.2%) or as palliation for metastatic disease (28 cases, 43.8%). Chemotherapy was given to 32 patients (100%) as an adjuvant for 24 cases (75%) and as a palliation for 8 cases (25%). Radiotherapy was given to 26 patients (100%) as adjuvant therapy for 20 cases (76.9%) and as a palliation for 6 cases (23.1%). The only significant factor determining the overall 5 years survival was the stage of the disease. LN status & surgery type were of border line significance (better survival with negative LN & with MRM). The 5-year Overall Survival (OS) & Disease Free Survival (DFS) for the whole group were 66% & 52% respectively. Within the DFS there was no significant variable;however, the stage and type of surgery were of borderline significance, with better survival with early stage disease (I & II) and with MRM (both were 61%). Conclusion: BCM has many similarities to BCF, but it harbours many different genetic and pathologic features. They obtain similar prognostic factors and similar stage-for-stage survival. They are always advanced to T4 stage rapidly due to the lack of breast parenchyma with higher ER expression in BCM than BCF patients.

The accuracy of magnetic resonance imaging and ultrasound in evaluating the size of early-stage breast neoplasms

Objective Breast cancer is the most frequently diagnosed cancer in women. Accurate evaluation of the size and extent of the tumor is crucial in selecting a suitable surgical method for patients with breast cancer. Both overestimation and underestimation have important adverse effects on patient care. This study aimed to evaluate the accuracy of breast magnetic resonance imaging(MRI) and ultrasound(US) examination for measuring the size and extent of early-stage breast neoplasms.Methods The longest diameter of breast tumors in patients with T_(1–2)N_(0–1)M_0 invasive breast cancer preparing for breast-conserving surgery(BCS) was measured preoperatively by using both MRI and US and their accuracy was compared with that of postoperative pathologic examination. If the diameter difference was within 2 mm, it was considered to be consistent with pathologic examination.Results A total of 36 patients were imaged using both MRI and US. The mean longest diameter of the tumors on MRI, US, and postoperative pathologic examination was 20.86 mm ± 4.09 mm(range: 11–27 mm), 16.14 mm ± 4.91 mm(range: 6–26 mm), and 18.36 mm ± 3.88 mm(range: 9–24 mm). US examination underestimated the size of the tumor compared to that determined using pathologic examination(t = 3.49, P < 0.01), while MRI overestimated it(t =-6.35, P < 0.01). The linear correlation coefficients between the image measurements and pathologic tumor size were r = 0.826(P < 0.01) for MRI and r = 0.645(P < 0.01) for US. The rate of consistency of MRI and US compared to that with pathologic examination was 88.89% and 80.65%, respectively, and there was no statistically significant difference between them(χ~2 = 0.80, P > 0.05).Conclusion MRI and US are both effective methods to assess the size of breast tumors, and they maintain good consistency with pathologic examination. MRI has a better correlation with pathology. However, we should be careful about the risk of inaccurate size estimation.

Solid pseudopapillary neoplasm of the pancreas in a young male with main pancreatic duct dilatation: A case report

BACKGROUND Solid pseudopapillary neoplasms(SPNs)are rare tumors of the pancreas.Typically,they occur in young females,often have characteristic imaging features,such as cystic components and calcification,and have few effects on the pancreatic duct.CASE SUMMARY A 31-year-old man was admitted to our hospital with the chief complaint of epigastric pain.There was only mild tenderness in his upper abdomen,and blood tests showed only a slight increase in alkaline phosphatase.Contrast-enhanced computed tomography showed a 40-mm-diameter,hypovascular mass in the head of the pancreas,and the main pancreatic duct upstream of the mass was severely dilated.Magnetic resonance imaging showed low intensity on T1-weighted images,with high intensity on T2-weighted image in some parts.Pancreatic ductal adenocarcinoma was the primary differential diagnosis.Portal vein infiltration could not be ruled out,so this case was a candidate for neoadjuvant chemotherapy.Subsequently,endoscopic ultrasound-guided fine needle aspiration was performed,and pathological evaluation and immunostaining suggested a diagnosis of SPN.Thus,pancreatoduodenectomy was performed.One year after the operation,the patient is alive with no recurrence.CONCLUSION Main pancreatic duct dilatation is usually a finding of suspected pancreatic cancer.However,pancreatic duct dilatation can occur in SPN depending on the location and growth speed.Therefore,SPN should be considered in the differential diagnosis of tumors with pancreatic duct dilatation,and pathological evaluation by endoscopic ultrasound-guided fine needle aspiration should be actively performed.

Synchronous multiple primary malignant neoplasms in breast,kidney,and bilateral thyroid:A case report

BACKGROUND Multiple primary malignant neoplasms(MPMNs)are rare,while synchronous MPMNs(SMPMNs)are even less common.Owing to the progression of medical technology and the extension of life expectancy,its incidence is gradually increasing.CASE SUMMARY Although reports of breast and thyroid dual cancers are common,cases of an additional diagnosis of kidney primary cancer within the same individual are rare.CONCLUSION We present a case of simultaneous MPMN of three endocrine organs,reviewing the relevant literature to enhance our understanding of SMPMNs while emphasizing the increasingly important need for accurate diagnosis and multidisciplinary management whenever this challenging situation arises.

The prognostic value of clinical and pathologic features in nonmetastatic operable male breast cancer

Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed a retrospective analysis using clinical and pathologic data from 109 nonmetastatic operable male breast cancer patients treated from January 1996 to December 2011 at Tianjin Medical University Cancer Institute and Hospital. Log-rank test showed that lower tumor stage, no lymph node involvement, and positive estrogen/progesterone receptor status were good predictors of both disease-free survival and overall survival on univariate analysis. However, hormonotherapy is only a good predictive factor of disease-free survival, and not of overall survival. In addition, based on a Cox proportional hazard regression model, only lymph node involvement, and estrogen/progesterone receptor status were statistically significant predictive factors on multivariate analysis. Our results demonstrated that although adjuvant systemic therapy is used extensively in male breast cancer patients and prognosis has improved over the last few decades, lymph node involvement, and estrogen/progesterone receptor status are still the most important prognostic factors. A prospective multi-center study with a larger sample size is urgently needed to further understand male breast cancer.

Male Breast Cancer:10-Year Experience at Mansoura University Hospital in Egypt

Objective Male breast cancer （MBC） is a rare disease representing less than 1% of all malignancies. The objective of the study is to report clinicopathological characteristics, treatment patterns, and outcomes of MBC in Mansoura University Hospital, Egypt. Methods This retrospective study focused on male breast cancer patients during 10 years （2000-2009）. The studied variables were data regarding general characteristics of patients, treatment modalities and survival. Results The series included 37 patients （0.8% of all breast cancer）. The median age was 57.7 years （range： 26-86 years）. The main clinical complaint was a mass beneath the areola ill 94.5% of the cases. Most patients had a locally advanced disease. 94.5% of tumors were invasive duct carcinomas. The treatment was essentially surgery in 91.8%, followed by adjuvant radiotherapy （in 89.2%）, hormonal therapy （in 56.7%） and chemotherapy （in 91.8%）. Follow-up period ranged from 6-115 months. Local recurrence occurred in 4 cases and metastasis in 11 cases. The 2-year and 5-year overall survival （OS） rates were 81.6% and 60.5%, respectively. The 2-year and 5-year disease-free survival （DFS） rates were 68.4%, and 52.6%, respectively. OS was not significantly affected by any of the studied parameters. Factors influencing DFS were： T stage （P=0.05）, positive lymph nodes （P=0.043）, metastasis （P=0.004）, and chemotherapy （1＇=0.046）. Conclusions MBC is a rare disease and often diagnosed at a locally advanced stage. The management of male and female breast carcinoma is identical. Future research for better understanding of this disease is needed to improve the management and prognosis of male breast cancer patients.

Breast cancer: Epidemiology, risk factors and screening

Breast cancer is a global health concern with a significant impact on the well-being of women. Worldwide, the past several decades have witnessed changes in the incidence and mortality of breast cancer. Additionally,epidemiological data reveal distinct geographic and demographic disparities globally. A range of modifiable and non-modifiable risk factors are established as being associated with an increased risk of developing breast cancer.This review discusses genetic, hormonal, behavioral, environmental, and breast-related risk factors. Screening plays a critical role in the effective management of breast cancer. Various screening modalities, including mammography,ultrasound, magnetic resonance imaging(MRI), and physical examination, have different applications, and a combination of these modalities is applied in practice. Current screening recommendations are based on factors including age and risk, with a significant emphasis on minimizing potential harms to achieve an optimal benefits-to-harms ratio. This review provides a comprehensive insight into the epidemiology, risk factors, and screening of breast cancer. Understanding these elements is crucial for improving breast cancer management and reducing its burden on affected individuals and healthcare systems.

Breast reconstruction:Review of current autologous and implantbased techniques and long-term oncologic outcome

Implant-based reconstruction is the most common method of breast reconstruction.Autologous breast reconstruction is an indispensable option for breast reconstruction demanding keen microsurgical skills and robust anatomical understanding.The reconstructive choice is made by the patient after a discussion with the plastic surgeon covering all the available options.Advantages and disadvantages of each technique along with long-term oncologic outcome are reviewed.

Analysis of the Indicence and Survival of Female Breast Cancer Patients in Beijing Over a 20-Year Period

OBJECTIVE To provide evidence for breast cancer prevention and control through epidemiological analysis of the incidence, mortality and survival rate of female breast cancer patients in Beijing. METHODS The female registration data in the Beijing urban area from 1982 to 2001 were retrospectively reviewed. The incidence, mortality and survival rate of female breast cancer patients were analyzed using routine and life-table statistical methods. RESULTS During the period of 1982 to 2001, there was a trend of an average annual increase of female breast cancer incidence of 4.6% in urban Beijing, and of 4,9% in the world-population standardized incidence. The epidemiological features of urban Beijing female breast cancer showed：（1）The incidence distribution of different age groups from 25 to 80 years elevated with two peaks at ages of 45- and 70- years; （2）There was an elevation in each age group over the last 20 years; （3）The incidence rate at ages of 35 to 64 reached 95.3/10^5, causing breast cancer to become the number one cancer in females. The changes in the survival rate showed the following： the 5-year observed survival rate （OSR） increased from 62.0% in 1982～1983 to 68.7% in 1987-1988, and the relative-survival rate （RSR） increased from 6613% to 74.2%. The 10-year OSR and RSR in 1987～1988 were 60.3% and 65.1%, and at 15 years 57.5% and 61.3%, respectively. The mortality rate of breast cancer patients fluctuated from 8 to 10 per 105 population over the 20 years of study. CONCLUSION There is a trend of an annual increase in female breast cancer in Beijing. The 5-year survival is being improved gradually while the mortality remains stable. The results demonstrate that the principles of ＂early prevention, diagnosis and treatment＂ for breast cancer are effective in Beijing.