222例双侧原发性乳癌的预后因素

目的探讨双侧原发性乳癌（Bilateral Primary Breast Cancer，BPBC）的预后及其影响因素。方法对天津市医科大学附属肿瘤医院1972年3月-2003年12月收治的222名BPBC患者的临床资料进行预后因素分析。结果BPBC的5、10年累计生存率分别为78．73％、69．09％。sBPBC的生存率总体较mBPBC的差，但无统计学意义。第一侧淋巴结阳性结果、第二侧淋巴结阳性结果、第二侧肿瘤大小、第二侧组织学分级对生存的作用有统计学意义。结论同时性和异时性BPBC的生存率相似。第二侧肿瘤≥5cm，双侧淋巴结阳性的预后差。多因素分析表明第二侧肿瘤大小和第一侧、第二侧淋巴结阳性同是影响预后的因素。

原发性乳癌新辅助化疗效果评价

目的：观察原发性乳癌新辅助化疗的临床效果及价值。方法：将自2009年8月～2012年8月在我院就诊的62例乳癌患者的临床资料进行回顾性分析，患者采用新辅助化疗后均采用Miller及Payhe方法再次进行评价。将评价结果与超声影像结果进行比较观察。结果：本组患者治疗有效且肿瘤残留≤1em患者43例，其中显著有~t521例，有效22例。经Miller及Payhe方法评价，病理显效20例；最大直径〉1cm的19例患者中，显效6例，有效9例，病理显效8例，2组数据比较有显著差异，P〈0．05，有统计学意义。结论：原发性乳腺癌患者行新辅助化疗后，残留病灶明显减小，且病理反应较好。

异时性原发双侧乳癌患者的护理

对 10例异时性原发双侧乳癌手术治疗患者进行针对性的护理 ,效果满意。做好心理支持、患肢功能锻炼指导、生活护理、静脉化疗护理、健康教育等是其主要内容。

卵巢癌误诊3例分析

目的探讨非原发性卵巢癌的临床特点、诊断、鉴别诊断和治疗。方法回顾性分析3例非原发性卵巢癌患者的临床病理资料。结果3例非原发性卵巢癌患者的临床表现为盆腔包块伴腹水、CA125升高,术前均腹水穿刺找到腺癌细胞,均诊断为卵巢癌。术中冰冻切片及术后病理、结合免疫组化均表明非原发性卵巢癌。结论转移性卵巢癌与腹膜原发性浆乳癌与原发性卵巢癌都有相似的临床表现,需通过术后病理及免疫组化染色确诊。两者在治疗原则上有根本区别,转移途径和预后截然不同。

Correlation of pretreatment serum tissue polypeptide specific antigen (TPS) with prognosis in primary breast cancer

Objective: The aim of this study was to explore the correlation of pretreatment serum tissue polypeptide specific antigen (TPS) with prognosis in primary breast cancer. Methods: A total of 361 patients with grades I-III breast cancer had been followed up from January 2001 to February 2011. Serumal TPS level was measured by enzyme-linked immunosorbent assays (ELISA). Univariate and multivariate analyses were used to investigate associations between pretreatment TPS level and clinicopathological parameters and patient outcomes. Results: First, at the univariate analysis, the expression of TPS was related with some clinicopathological traditional prognostic factors such as tumor size (P = 0.030), histologic grade (P = 0.001) and lymph node status (P = 0.008). Second, overall survival were significantly shorter among patients with elevated pretreatment serum TPS (P = 0.038). However, finally, multivariate Cox regression indicated that the level of pretreatment serum TPS was not an independent prognostic parameter for overall survival in primarily breast cancer patients (P > 0.05). Conclusion: The expression of pretreatment serum TPS is closely correlated with clinicopathology parameters and overall survival of patients with primarily breast cancer, but its level has no independent prognostic value.

Accessory Breast Cancer Occurring Concurrently with Bilateral Primary Invasive Breast Carcinomas:A Report of Two Cases and Literature Review

The development of accessory breast tissue,which is found anywhere along the milk line,is attributed to the failure of milk line remnants to regress during embryogenesis.Primary tumors may arise from any ectopic breast tissue.Accessory breast cancer occurring concurrently with primary invasive breast cancer is extremely rare.Two such cases were reported in this article.One was a 43-year-old Chinese female who exhibited bilateral breast cancer(invasive ductal carcinoma,not otherwise specified,IDC-NOS) and an accessory breast carcinoma(IDC-NOS) incidentally identified in her left axilla.The ectopic breast tissue in her right axilla presented with adenosis.The patient was surgically treated,followed by postoperative docetaxel epirubicin(TE) chemotherapy.The second case was a 53-year-old Chinese female with bilateral breast cancer(apocrine carcinoma) accompanied by an accessory breast carcinoma(IDC-NOS) in her right axilla that was also incidentally identified.The patient was surgically treated after three doses of cyclophosphamide epirubicin docetaxel(CET) neoadjuvant chemotherapy,followed by adjuvant chemotherapy of the same regimen.

The value of 18-FDG-PET for diagnosing and evaluating lymph node metastasis in primary breast cancer

Objective: To analyze the result of 18F-2-deoxy-2-fluoro-D-glucose-positron emission tomography (FDG-PET) in suspicious primary breast cancer patients and to evaluate its value for the surgery therapy. Methods: Total 36 patients suspected of breast neoplasm were enrolled into the research. The result was compared with the pathology result. The rate of missed diagnosis, the rate of mi.sdiagnosis. the sensitivity and specificity were calculated and analyzed. Results:Compared with the pathology results, the misdiagnosis rate. the rate of missed diagnosis. the sensitivity and specificity of FDG-PET for breast cancer were 0% , 36. 36%. 63. 63% and 100%, respectively. To those who had a neoplasm no more than 2 cm in diameter, the rate of missed diagnosis was as high as 41. 67%. To 33 breast cancer patients, the misdiagnosis rate, the rate of missed diagnosis, the sensitivity and specificity for lymph node metastasis were 18. 75%, 41. 18%, 58. 82% and 81. 25%, respectively. Conclusion:FDG-PET has a perfect specificity and a considerable sensitivity to the primary breast neoplasm and similar to the lymph node metastasis diagnosis. It is an ideal choice for those patients with suspected breast cancer but reluctantly to receive a vulnerarious examination.

Primary Osteosarcoma of the Breast in Young Women: One Case Report and Literature Review

Case Report A 21-year-old female with a breast tumor for over a month came to our hospital. The physical examinations on her breast showed a mammary neoplasm of about 4 cm, with a good range of motion and no abnormality seen in the skin. The patient remained single, and had no family history of breast cancer or ovarian carcinoma. CT and X-ray examinations on the osseous tissue of the whole body showed that no lesions were found. A glabrous tumor with peplos was seen during the surgery, and was completely excised.