Breast cancer(BC) is the most common cancer among women worldwide. The aetiology and carcinogenesis of BC are not clearly defined, although genetic, hormonal, lifestyle and environmental risk factors have been establi...Breast cancer(BC) is the most common cancer among women worldwide. The aetiology and carcinogenesis of BC are not clearly defined, although genetic, hormonal, lifestyle and environmental risk factors have been established. The most common treatment for BC includes breast-conserving surgery followed by a standard radiotherapy(RT) regimen. However, radiation hypersensitivity and the occurrence of RT-induced toxicity in normal tissue may affect patients' treatment. The role of DNA repair in cancer has been extensively investigated, and an impaired DNA damage response may increase the risk of BC and individual radiosensitivity. Single nucleotide polymorphisms(SNPs) in DNA repair genes may alter protein function and modulate DNA repair efficiency, influencing the development of various cancers, including BC. SNPs in DNA repair genes have also been studied as potential predictive factors for the risk of RT-induced side effects. Here, we review the literature on the association between SNPs in base excision repair(BER) genes and BC risk. We focusedon X-ray repair cross complementing group 1(XRCC1), which plays a key role in BER, and on 8-oxoguanine DNA glycosylase 1, apurinic/apyrimidinic endonuclease 1 and poly(ADP-ribose) polymerase-1, which encode three important BER enzymes that interact with XRCC1. Although no association between SNPs and radiation toxicity has been validated thus far, we also report published studies on XRCC1 SNPs and variants in other BER genes and RT-induced side effects in BC patients, emphasising that large well-designed studies are needed to determine the genetic components of individual radiosensitivity.展开更多
Introduction: This study describes an intra-operative scoring system to advise the surgeon of the?centricity of the tumour in the excised specimen. Methods: Spatial estimations were prospectively made in 10 consecutiv...Introduction: This study describes an intra-operative scoring system to advise the surgeon of the?centricity of the tumour in the excised specimen. Methods: Spatial estimations were prospectively made in 10 consecutive patients undergoing wide local excision (WLE) using Bioptics intra-operative digital specimen imaging. The centricity score was defined as 100 – (ICD/SD?×?100), where ICD is the inter-centre distance between the specimen’s centre and the tumour’s centre. Results: 10 patients with invasive breast cancer (T1b to T4a), mean age 56 years (range 44 - 71) were studied. The mean tumour and specimen diameter was 24 mm ± 10 (range 12 - 48) and 101 mm ± 22 (range 64 - 140). The mean centricity score was 86 ± 9 (range 65 - 95). Conclusion:?This study successfully?describes an intraoperative radiological spatial scoring system for patients undergoing WLE. Tumours were well centered in specimens with an overall score of 86/100. The centricity score could?be used to guide excision and potentially set benchmarks for conservative breast surgery.展开更多
The clinical significance of pleomorphic lobular carcinoma in situ(PLCIS) is a subject of controversy. As a consequence, there is a risk of providing inconsistent management to patients presenting with PLCIS. This rev...The clinical significance of pleomorphic lobular carcinoma in situ(PLCIS) is a subject of controversy. As a consequence, there is a risk of providing inconsistent management to patients presenting with PLCIS. This review aims to establish whether the current guidelines for the management of PLCIS are consistent with current evidence. A systematic electronic search was performed to identify all English language articles regarding PLCIS management. The data was analysed, specifically looking at: incidence of concurrent disease, recurrence rates, long-term prognosis and PLCIS management. A search was also performed for PLCIS management guidelines for the United Kingdom, United States, Canada, Australia, Germany and pan-European. The results of the evidence analyses were compared to the guidelines in order to establish whether the recommended management is consistent with the published evidence. Nine studies(level 3-4 evidence), involving a total of 176 patients and five management guidelines(from United Kingdom, United States, Australia and pan-European) were included in the review. From the evidence, 46 of 93(49%) patients were found to have PLCIS with concurrent invasive disease on excision specimen analysis. Regarding recurrence rates, 11 of 117(9.4%) patients developed a recurrence of PLCIS. There were no instances of invasive disease or ductal carcinoma in situ(DCIS) on recurrence histology. There were no studies assessing long-term outcomes in PLCIS cases. With regards to the management guidelines, the Association of Breast Surgery(United Kingdom) and the National Breast and Ovarian Cancer Care(Australia) do not mention PLCIS. The National Comprehensive Cancer Network(United States) suggest considering excision of PLCIS with negative margins. The NHS Breast Screening Programme(United Kingdom) and the European Society of Medical Oncology(pan-European) recommend PLCIS should be treated as with DCIS. We conclude that high quality evidence to inform guidance is lacking, thus recommendations are relatively vague. However, based on the available evidence, it would seem prudent to treat PLCIS in a similar manner to DCIS.展开更多
Background: About 25% - 35% of breast cancers are non-palpable at the time of diagnosis. Wire guided localization (WGL) had been considered as the standard technique for many years for excision of theses breast lesion...Background: About 25% - 35% of breast cancers are non-palpable at the time of diagnosis. Wire guided localization (WGL) had been considered as the standard technique for many years for excision of theses breast lesions. The aim of this study is to assess the efficacy of WGL biopsy in the management of non-palpable suspicious breast masses. Patients & Methods: This retrospective study concerned thirty female patients who were presented by non-palpable breast lesions as proved by mammography and complimentary ultrasonography between February 2013 and September 2014. According to BIRADS classification system, all the lesions were BIRADS III, IV and V. However, BIRADS I and II lesions and lesions proved to be benign were excluded from this study. The patients were submitted to WGL under local anesthesia. Then, they were shifted to the operating theatre, where they underwent WGL biopsy. The removed specimens were sent for radiological confirmation of complete excision. Then, it was sent for histopathological examination. Results: The mean age was 52.63 years. Eighteen patients (60%) were asymptomatic, 7 (23.3%) patients were with breast pain, and 5 patients (16.7%) had nipple discharge. Ten lesions (33.3%) were BIRADS III, 17 lesions (56.7%) were BIRADS IV, and 3 lesions (10%) were BIRADS V. The WGL was done by mammography in 19 patients (63.3%) and under ultrasonographic guidance in 11 patients (36.7%). No post-operative complications were reported. The mean tumor size was 11.23 mm and the mean safety margin of excision was 6.7 mm. IDC was found in 56.7% or cases, DCIS in 30%, and ILC in 13.3% of cases. 40% of the lesions were of grade I, 30% were of grade II, and 30% were of grade III. There were positive resection margins in 11 patients (36.7%). Conclusion: WGL biopsy is a safe and reliable surgical technique for management of non-palpable suspicious breast lesions. Special care should be paid for proper margin excision. However, WGL biopsy is technically demanding and needs learning curve for both the surgeon and the radiologist.展开更多
目的研究乳腺癌易感基因1(BRCA1)和切除修复交叉互补基因1(ERCC1)在乳腺癌发生、发展中的作用及临床意义。方法采用原位杂交技术(ISH)检测BRCA1和ERCC1 m RNA在乳腺癌癌前病变和乳腺癌组织芯片中的表达,以及与乳腺癌临床病理因素的关系...目的研究乳腺癌易感基因1(BRCA1)和切除修复交叉互补基因1(ERCC1)在乳腺癌发生、发展中的作用及临床意义。方法采用原位杂交技术(ISH)检测BRCA1和ERCC1 m RNA在乳腺癌癌前病变和乳腺癌组织芯片中的表达,以及与乳腺癌临床病理因素的关系。结果 1BRCA1和ERCC1 m RNA在乳腺癌旁正常组织、乳腺癌癌前病变及乳腺癌组织中的阳性表达率呈递减趋势,差异有统计学意义(P<0.05)。2BRCA1和ERCC1 m RNA在乳腺癌的表达差异显著并具有相关性(P<0.01)。3BRCA1 m RNA的阳性表达与乳腺癌组织学分级、肿瘤大小呈负相关(P<0.05),与发病年龄、临床分期和淋巴结转移无关(P>0.05),ERCC1m RNA的表达与肿瘤大小和淋巴结转移相关(P<0.05),与患者发病年龄、组织学分级及临床分期无关(P>0.05)。结论 BRCAl与ERCC1 m RNA表达的减少可能与乳腺癌的发生发展有关,两基因的联合检测有利于乳腺癌的早期诊断与治疗。展开更多
文摘Breast cancer(BC) is the most common cancer among women worldwide. The aetiology and carcinogenesis of BC are not clearly defined, although genetic, hormonal, lifestyle and environmental risk factors have been established. The most common treatment for BC includes breast-conserving surgery followed by a standard radiotherapy(RT) regimen. However, radiation hypersensitivity and the occurrence of RT-induced toxicity in normal tissue may affect patients' treatment. The role of DNA repair in cancer has been extensively investigated, and an impaired DNA damage response may increase the risk of BC and individual radiosensitivity. Single nucleotide polymorphisms(SNPs) in DNA repair genes may alter protein function and modulate DNA repair efficiency, influencing the development of various cancers, including BC. SNPs in DNA repair genes have also been studied as potential predictive factors for the risk of RT-induced side effects. Here, we review the literature on the association between SNPs in base excision repair(BER) genes and BC risk. We focusedon X-ray repair cross complementing group 1(XRCC1), which plays a key role in BER, and on 8-oxoguanine DNA glycosylase 1, apurinic/apyrimidinic endonuclease 1 and poly(ADP-ribose) polymerase-1, which encode three important BER enzymes that interact with XRCC1. Although no association between SNPs and radiation toxicity has been validated thus far, we also report published studies on XRCC1 SNPs and variants in other BER genes and RT-induced side effects in BC patients, emphasising that large well-designed studies are needed to determine the genetic components of individual radiosensitivity.
文摘Introduction: This study describes an intra-operative scoring system to advise the surgeon of the?centricity of the tumour in the excised specimen. Methods: Spatial estimations were prospectively made in 10 consecutive patients undergoing wide local excision (WLE) using Bioptics intra-operative digital specimen imaging. The centricity score was defined as 100 – (ICD/SD?×?100), where ICD is the inter-centre distance between the specimen’s centre and the tumour’s centre. Results: 10 patients with invasive breast cancer (T1b to T4a), mean age 56 years (range 44 - 71) were studied. The mean tumour and specimen diameter was 24 mm ± 10 (range 12 - 48) and 101 mm ± 22 (range 64 - 140). The mean centricity score was 86 ± 9 (range 65 - 95). Conclusion:?This study successfully?describes an intraoperative radiological spatial scoring system for patients undergoing WLE. Tumours were well centered in specimens with an overall score of 86/100. The centricity score could?be used to guide excision and potentially set benchmarks for conservative breast surgery.
文摘The clinical significance of pleomorphic lobular carcinoma in situ(PLCIS) is a subject of controversy. As a consequence, there is a risk of providing inconsistent management to patients presenting with PLCIS. This review aims to establish whether the current guidelines for the management of PLCIS are consistent with current evidence. A systematic electronic search was performed to identify all English language articles regarding PLCIS management. The data was analysed, specifically looking at: incidence of concurrent disease, recurrence rates, long-term prognosis and PLCIS management. A search was also performed for PLCIS management guidelines for the United Kingdom, United States, Canada, Australia, Germany and pan-European. The results of the evidence analyses were compared to the guidelines in order to establish whether the recommended management is consistent with the published evidence. Nine studies(level 3-4 evidence), involving a total of 176 patients and five management guidelines(from United Kingdom, United States, Australia and pan-European) were included in the review. From the evidence, 46 of 93(49%) patients were found to have PLCIS with concurrent invasive disease on excision specimen analysis. Regarding recurrence rates, 11 of 117(9.4%) patients developed a recurrence of PLCIS. There were no instances of invasive disease or ductal carcinoma in situ(DCIS) on recurrence histology. There were no studies assessing long-term outcomes in PLCIS cases. With regards to the management guidelines, the Association of Breast Surgery(United Kingdom) and the National Breast and Ovarian Cancer Care(Australia) do not mention PLCIS. The National Comprehensive Cancer Network(United States) suggest considering excision of PLCIS with negative margins. The NHS Breast Screening Programme(United Kingdom) and the European Society of Medical Oncology(pan-European) recommend PLCIS should be treated as with DCIS. We conclude that high quality evidence to inform guidance is lacking, thus recommendations are relatively vague. However, based on the available evidence, it would seem prudent to treat PLCIS in a similar manner to DCIS.
文摘Background: About 25% - 35% of breast cancers are non-palpable at the time of diagnosis. Wire guided localization (WGL) had been considered as the standard technique for many years for excision of theses breast lesions. The aim of this study is to assess the efficacy of WGL biopsy in the management of non-palpable suspicious breast masses. Patients & Methods: This retrospective study concerned thirty female patients who were presented by non-palpable breast lesions as proved by mammography and complimentary ultrasonography between February 2013 and September 2014. According to BIRADS classification system, all the lesions were BIRADS III, IV and V. However, BIRADS I and II lesions and lesions proved to be benign were excluded from this study. The patients were submitted to WGL under local anesthesia. Then, they were shifted to the operating theatre, where they underwent WGL biopsy. The removed specimens were sent for radiological confirmation of complete excision. Then, it was sent for histopathological examination. Results: The mean age was 52.63 years. Eighteen patients (60%) were asymptomatic, 7 (23.3%) patients were with breast pain, and 5 patients (16.7%) had nipple discharge. Ten lesions (33.3%) were BIRADS III, 17 lesions (56.7%) were BIRADS IV, and 3 lesions (10%) were BIRADS V. The WGL was done by mammography in 19 patients (63.3%) and under ultrasonographic guidance in 11 patients (36.7%). No post-operative complications were reported. The mean tumor size was 11.23 mm and the mean safety margin of excision was 6.7 mm. IDC was found in 56.7% or cases, DCIS in 30%, and ILC in 13.3% of cases. 40% of the lesions were of grade I, 30% were of grade II, and 30% were of grade III. There were positive resection margins in 11 patients (36.7%). Conclusion: WGL biopsy is a safe and reliable surgical technique for management of non-palpable suspicious breast lesions. Special care should be paid for proper margin excision. However, WGL biopsy is technically demanding and needs learning curve for both the surgeon and the radiologist.
文摘目的研究乳腺癌易感基因1(BRCA1)和切除修复交叉互补基因1(ERCC1)在乳腺癌发生、发展中的作用及临床意义。方法采用原位杂交技术(ISH)检测BRCA1和ERCC1 m RNA在乳腺癌癌前病变和乳腺癌组织芯片中的表达,以及与乳腺癌临床病理因素的关系。结果 1BRCA1和ERCC1 m RNA在乳腺癌旁正常组织、乳腺癌癌前病变及乳腺癌组织中的阳性表达率呈递减趋势,差异有统计学意义(P<0.05)。2BRCA1和ERCC1 m RNA在乳腺癌的表达差异显著并具有相关性(P<0.01)。3BRCA1 m RNA的阳性表达与乳腺癌组织学分级、肿瘤大小呈负相关(P<0.05),与发病年龄、临床分期和淋巴结转移无关(P>0.05),ERCC1m RNA的表达与肿瘤大小和淋巴结转移相关(P<0.05),与患者发病年龄、组织学分级及临床分期无关(P>0.05)。结论 BRCAl与ERCC1 m RNA表达的减少可能与乳腺癌的发生发展有关,两基因的联合检测有利于乳腺癌的早期诊断与治疗。
