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 g...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.展开更多
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 t...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.展开更多
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. Bot...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.展开更多
Objective: Early assessment of response to neoadjuvant chemotherapy (NAC) for breast cancer allows therapy to be individualized. The optimal assessment method has not been established. We investigated the accuracy ...Objective: Early assessment of response to neoadjuvant chemotherapy (NAC) for breast cancer allows therapy to be individualized. The optimal assessment method has not been established. We investigated the accuracy of automated breast ultrasound (ABUS) to predict pathological outcomes after NAC. Methods: A total of 290 breast cancer patients were eligible for this study. Tumor response after 2 cycles of chemotherapy was assessed using the product change of two largest perpendicular diameters (PC) or the longest diameter change (LDC). PC and LDC were analyzed on the axial and the coronal planes respectively. Receiver operating characteristic (ROC) curves were used to evaluate overall performance of the prediction methods. Youden's indexes were calculated to select the optimal cut-off value for each method. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) and the area under the ROC curve (AUC) were calculated accordingly.Results: ypT0/is was achieved in 42 patients (14.5%) while ypT0 was achieved in 30 patients (10.3%) after NAC. All four prediction methods (PC on axial planes, LDC on axial planes, PC on coronal planes and LDC on coronal planes) displayed high AUCs (all〉0.82), with the highest of 0.89 [95% confidence interval (95% CI), 0.83-0.95] when mid-treatment &BUS was used to predict final pathological complete remission (pCR). High sensitivities (85.7%-88.1%) were observed across all four prediction methods while high specificities (81.5%-85.1%) were observed in two methods used PC. The optimal cut-off values defined by our data replicate the WHO and the RECIST criteria. Lower AUCs were observed when mid-treatment ABUS was used to predict poor pathological outcomes. Conclusions:ABUS is a useful tool in early evaluation of pCR after NAC while less reliable when predicting poor pathological outcomes.展开更多
In order to investigate the relationship between the extent of tumor invasion and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and histologic grading in breast invasive ductal carcinoma ...In order to investigate the relationship between the extent of tumor invasion and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and histologic grading in breast invasive ductal carcinoma as well as the optimal extent of excision during the breast-serving surgery, the clinical data of 104 patients with breast invasive ductal carcinoma who had received modified radical mastectomy were analyzed. The correlation analysis on invasive extent, which was evaluated by serial sections at an interval of 0.5 cm from 4 different directions taking the focus as the centre, and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and his- tologic grading was processed. There was a significant correlation between invasive extent and tumor size (r=-0.766, P〈0.01), and lymph nodes metastases 0=0.574, P〈0.01), but there was no significant correlation between invasive extent and Her-2 expression (r=-0.106, P〉0.05), and histologic grading (r=-0.228, P〉0.05). The 100% negative rate of infiltration in patients without nipple discharge with tumor size 〈2, 2-3 and 〉3 cm was obtained at 1.5, 2.0 and 2.5 cm away from the tumor respectively. It is concluded that the performance of breast-serving surgery in patients with breast invasive ductal carcinoma should be evaluated by tumor size in combination with axillary lymph nodes involvement to decide the possibility of breast-serving and the secure excision extent.展开更多
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,e...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.展开更多
OBJECTIVE To investigate the inhibitory effects of Spatholobus Suberectus Column Extract(SSCE)on estrogen receptor positive(ER+)breast cancer cel MCF-7and its possible molecular mechanism.METHODS MCF-7cells were cultu...OBJECTIVE To investigate the inhibitory effects of Spatholobus Suberectus Column Extract(SSCE)on estrogen receptor positive(ER+)breast cancer cel MCF-7and its possible molecular mechanism.METHODS MCF-7cells were cultured without estrogen and with 17-β-estrogen(10-8mol·L-1),respectively,then treated with SSCE(0,40,80,160,320μg·m L-1).MTT assay was employed to evaluate cell viability.Flow cytometry assays were performed to underlying apoptosis and detecting cel cycle of MCF-7 cells treated with SSCE(0,80,160,320μg·mL-1).Wound healing assays was conducted to detect the migration ability.Dual luciferase reporter system was used to detect the activity of p-ERα,p-ERβpresented in intra-nuclear estrogen response element(ERE).Western blotting assay was employed to identify the expression of protein such as Bax,Bcl-2,p-ERα,p-ERβ,ERK1/2,p-ERK1/2,AKT,p-AKT,m TOR,p-m TOR,PI3K,p-PI3K.RESULTS It showed that SSCE(80,160and 320μg·mL-1)significantly decreased the viability of MCF-7.SSCE also triggered apoptosis,arrested cell cycle at G0/G1phase,inhibited migration.Dual luciferase reporter system showed that SSCE suppressed intra-nuclear p-ER activity,Western blotting analysis confirmed that SSCE did repress the expression of phosphorylated-ER alpha(p-ERα),ERK1/2,p-ERK1/2,AKT,p-AKT,pmT OR,PI3K,p-PI3K,which indicate that SSCE suppress MAPK PI3K/AKT signal pathway.CONCLUSION Our result showed that SSCE cause ER+MCF-7 cells apoptosis,G0/G1phase arresting,migration decreasing,via hypo-active of ER,suppress MAPK PI3K/AKT pathway.展开更多
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 anat...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.展开更多
Objective: To explore the clinicopathologic features of secretory carcinoma of breast (SCB). Methods: Four cases of SCB were analyzed by light microscopy, histochemistry, immunohistochemistry and electron microscopy. ...Objective: To explore the clinicopathologic features of secretory carcinoma of breast (SCB). Methods: Four cases of SCB were analyzed by light microscopy, histochemistry, immunohistochemistry and electron microscopy. The clinical data were also analyzed. Special staining of periodic acid-Schiff reaction with diastase pretreatment, immunohistochemical staining of ER, PR, HER-2, p53, MIB-1, S-100, p63, CK8/18 and EMA by En Vision method were performed. Results: Solid, cribriform, tubular, or papillary architecture may be seen. Tumor forms cystic spaces filled with abundant pale pink secretory material, positive with diastase resistant periodic acid-Schiff (PAS-DR) stains. Tumor cells were small with bland nuclei and abundant pale, eosinophilic cytoplasm, rare mitotic activity and necrosis. Immunohistochemically, tumor cells were positive for CK8/18, EMA, negative for S-100, p63 and variable partially positive for p53, ER, PR, HER-2 and MIB-1. Under electron microscopy, the tumor cells possessed numerous membrane-bound secretory vacuoles in cytoplasm lined by microvilli. Conclusion: SCB is a rare, low-malignant neoplasm. SCB have pathology, clinical picture, treatment, follow-up, immunohistochemical and genetic features that distinguish them from invasive ductal carcinomas of the usual type.展开更多
BACKGROUND Granular cell tumor(GCT)of the breast(GCTB)is a rare neoplasm that can exhibit malignant characteristics both clinically and radiologically.This tumor can also coexist and colocalize with breast carcinoma.C...BACKGROUND Granular cell tumor(GCT)of the breast(GCTB)is a rare neoplasm that can exhibit malignant characteristics both clinically and radiologically.This tumor can also coexist and colocalize with breast carcinoma.CASE SUMMARY We present a patient with this uncommon tumor and discuss the diagnostic and therapeutic approaches in order to further the knowledge of GCTB and prevent misdiagnosis and overtreatment.The characteristics of the tumor,methods of diagnosis,therapy and postoperative pathological outcomes were analyzed,and relevant literatures of GCTs were reviewed.The patient underwent surgery after core needle biopsy,and the excised neoplasm was sent for pathological examination.Histological analysis revealed nests of cells with abundant pink granular cytoplasm,confirming the diagnosis of GCTB.CONCLUSION As manifestations of GCT and malignancy can mimic each other,a careful histological examination is essential before major surgery.Treatment consisting of complete excision with close clinical follow-up is recommended.展开更多
OBJECTIVE Different mammographic features are probably predictive of different prognosis. However, ambiguity still exists in understanding the relationship between them. In resent years, digital mammography has been a...OBJECTIVE Different mammographic features are probably predictive of different prognosis. However, ambiguity still exists in understanding the relationship between them. In resent years, digital mammography has been available for clinical use which has led to a revolution in the resolving of images and an increase in early-stage breast cancer detection. Based on the above knowledge, this study was performed to evaluate the relationship between full-field digital mammographic features and clinicopathologic characteristics in breast cancer. METHODS Digital mammograms of 176 patients with pathologically proven breast cancer were reviewed. Also, clinical and pathologic records (histological types and axillary lymph nodes status) were retrospectively examined. RESULTS Most of the patients with a solitary microcalcification were young women under the age of 50(84.4%), but the majority of the patients with microcalcifications complicated by a mass were elderly women. Microcalcifications detected by mammography occurred frequently in ductal carcinoma in situ (28.1%) and in early invasive carcinoma (15.6%). Breast cancers with expression of microcalcifications combined with a spiculate mass had a high metastatic rate of axillary lymph nodes (69.4%). A high metastatic rate of axillary lymph nodes was also found in the patients with solitary worm-like microcalcifications (57.1%), solitary spiculate mass (53.7%) and solitary non-worm-like microcalcifications (44.4%). Simple worm-like microcalcifications accompanied with metastasis of 4 to 9 axillary lymph nodes occurred in 42.9% of the(6/14) cases. The patients with microcalcifications combined by a spiculate mass and with metastasis of 4 to 9 axillary lymph nodes accounted for 27.8% (10/36) of the cases, and those with metastases of 10 and over accounted for 16.7% (6/36). CONCLUSION Solitary microcalcifications occur frequently in young women and are usually associated with early breast cancer. There is a close relationship between worm-like microcalcifications, a spiculate mass and positive metastases of axillary lymph nodes, which are an index of poor prognosis.展开更多
Objective:To compare the differences in surgical procedures,pathological features and prognosis between young and elderly women with breast cancer in China.Methods:A retrospective study compared the data of surgical p...Objective:To compare the differences in surgical procedures,pathological features and prognosis between young and elderly women with breast cancer in China.Methods:A retrospective study compared the data of surgical procedures,pathological features and prognosis of 61 cases of young females(≤40 years)and 507 cases of elderly females(>40 years),treated in our department from August 2011 to July 2018.This data was analyzed using SPSS 23.0 program.Results:10.74% of total cases,in this period of time,involve young females.In terms of surgical procedures,24.59%of young patients underwent breast conserving surgery(8.48% elderly,respectively),and 13.11%underwent reconstruction surgery(1.18% elderly,respectively),with statistically significant differences existing between the two groups(P<0.05).Progesterone receptor(PR)expression in young women was significantly higher than in elderly females(P<0.05).There were no significant differences between the two groups in the proportion of invasive ductal carcinoma(IDC),axillary lymph node metastasis(ALNM),expression of estrogen receptor(ER),human epidermal growth factor receptor-2(HER-2)and Ki-67,but the lymphatic metastasis stage showed an increasing rate with younger age.No significant difference was found in 3-year disease-free survival(DFS)and overall survival(OS).Conclusion:The selection rate of breast conserving and reconstructive surgery in young women with breast cancer is significantly higher than that in elderly women.The younger the patient,the more frequently the PR positive expression,and the more likely ALNM to occur.The 3-year prognosis of the young and elderly patients is similar.展开更多
<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">In patients with breast cancer after Neoadjuvant Chemotherapy...<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">In patients with breast cancer after Neoadjuvant Chemotherapy (NAC), pathological Complete Response (pCR) was associated with better </span><span style="font-family:Verdana;">long-term outcome</span></span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;">. We here attempted to predict pCR using machine</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> learning. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> From 2008 to 2017, 1308 breast cancer patients underwent NAC before surgery, of whom 377 patients underwent Cancer</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">SCAN</span><sup><span style="font-family:Verdana;">TM</span></sup><span style="font-family:Verdana;"> for gene data. Of 377, 238 were analyzed here, with 139 excluded due to incomplete medical data. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The pCR (-</span></span><span style="font-family:;" "=""><span><span style="font-family:Verdana;">) vs. (+) group had 200 vs. 38 patients. In our predictive model with gene data, the Area Under the </span><span style="font-family:Verdana;">Curve (AUC) of the Receiver Operating Characteristic (ROC) curve was</span><span style="font-family:Verdana;"> 0.909 and accuracy was 0.875. In another model without gene data, the AUC of ROC curve was 0.743 and accuracy was 0.800. We also conducted internal validation with 72 patients undergoing NAC and Cancer</span></span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">SCAN</span><sup><span style="font-family:Verdana;">TM</span></sup><span style="font-family:Verdana;"> during July 2017 and April 2018. When we applied a 0.4 threshold value, accuracy was </span><span style="font-family:Verdana;">0.806 and 0.778 in </span></span><span style="font-family:Verdana;">the </span><span style="font-family:Verdana;">predictive model with vs. without gene profiles, </span><span style="font-family:;" "=""><span style="font-family:Verdana;">respec</span><span><span style="font-family:Verdana;">tively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The present predictive model may be a useful an</span></span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> easy-to-access tool for pCR-prediction in breast cancer patients treated with NAC.</span></span>展开更多
A cross-sectional online survey was conducted.A high proportion of the Chinese breast cancer(BC)physician respondents(n=77)would prescribe extended adjuvant endocrine therapy(AET)with aromatase inhibitors(AI)beyond 5 ...A cross-sectional online survey was conducted.A high proportion of the Chinese breast cancer(BC)physician respondents(n=77)would prescribe extended adjuvant endocrine therapy(AET)with aromatase inhibitors(AI)beyond 5 years for postmenopausal females with BC,especially those with higher risk.Respondents with≥15 years of clinical experience were more likely to prescribe a longer duration of AET for low-risk patients.Half of the respondents considered intermittent letrozole as an acceptable option.Most respondents would prescribe adjuvant chemotherapy to genomic high-intermediate risk[Oncotype DX recurrence score(RS)21-25]females aged≤50 years regardless of the clinical risk classification.展开更多
目的探讨基于组织学、免疫组化的三阴型乳腺癌(triple-negative breast cancer,TNBC)分型标准,为完善TNBC分型治疗提供理论依据。方法根据组织学特点和免疫组化标志物AR、CD8、FOXC1的表达对TNBC进行分型,比较TNBC亚型的临床病理特征、...目的探讨基于组织学、免疫组化的三阴型乳腺癌(triple-negative breast cancer,TNBC)分型标准,为完善TNBC分型治疗提供理论依据。方法根据组织学特点和免疫组化标志物AR、CD8、FOXC1的表达对TNBC进行分型,比较TNBC亚型的临床病理特征、预后差异。结果93例TNBC中腔面雄激素受体型23例(24.7%),免疫调节型24例(25.8%),基底样免疫抑制型39例(42.0%),间充质型7例(7.5%)。TNBC亚型的临床病理特征:pT分期(P=0.030)、组织学分级(P<0.001)、肿瘤间质淋巴细胞浸润模式(P<0.001)、PD-L1(P<0.001)、HER2低表达(P=0.024)差异均有统计学意义;各亚型间的无瘤生存率差异无统计学意义(P>0.05)。单因素分层生存分析:亚型间pT1分期的无瘤生存率差异有统计学意义(P=0.011),其余临床病理特征均为非独立预后因素。结论TNBC基于组织学、免疫组化分型的临床病理特征有差异,有望替代复杂基因表达谱分型,为TNBC分型和靶向治疗提供理论依据。展开更多
基金Shanxi Soft Science General Program,No.2018041032-2.
文摘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.
文摘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.
文摘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.
文摘Objective: Early assessment of response to neoadjuvant chemotherapy (NAC) for breast cancer allows therapy to be individualized. The optimal assessment method has not been established. We investigated the accuracy of automated breast ultrasound (ABUS) to predict pathological outcomes after NAC. Methods: A total of 290 breast cancer patients were eligible for this study. Tumor response after 2 cycles of chemotherapy was assessed using the product change of two largest perpendicular diameters (PC) or the longest diameter change (LDC). PC and LDC were analyzed on the axial and the coronal planes respectively. Receiver operating characteristic (ROC) curves were used to evaluate overall performance of the prediction methods. Youden's indexes were calculated to select the optimal cut-off value for each method. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) and the area under the ROC curve (AUC) were calculated accordingly.Results: ypT0/is was achieved in 42 patients (14.5%) while ypT0 was achieved in 30 patients (10.3%) after NAC. All four prediction methods (PC on axial planes, LDC on axial planes, PC on coronal planes and LDC on coronal planes) displayed high AUCs (all〉0.82), with the highest of 0.89 [95% confidence interval (95% CI), 0.83-0.95] when mid-treatment &BUS was used to predict final pathological complete remission (pCR). High sensitivities (85.7%-88.1%) were observed across all four prediction methods while high specificities (81.5%-85.1%) were observed in two methods used PC. The optimal cut-off values defined by our data replicate the WHO and the RECIST criteria. Lower AUCs were observed when mid-treatment ABUS was used to predict poor pathological outcomes. Conclusions:ABUS is a useful tool in early evaluation of pCR after NAC while less reliable when predicting poor pathological outcomes.
文摘In order to investigate the relationship between the extent of tumor invasion and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and histologic grading in breast invasive ductal carcinoma as well as the optimal extent of excision during the breast-serving surgery, the clinical data of 104 patients with breast invasive ductal carcinoma who had received modified radical mastectomy were analyzed. The correlation analysis on invasive extent, which was evaluated by serial sections at an interval of 0.5 cm from 4 different directions taking the focus as the centre, and the tumor size, axillary lymph nodes metastasis, Her-2 gene overexpression, and his- tologic grading was processed. There was a significant correlation between invasive extent and tumor size (r=-0.766, P〈0.01), and lymph nodes metastases 0=0.574, P〈0.01), but there was no significant correlation between invasive extent and Her-2 expression (r=-0.106, P〉0.05), and histologic grading (r=-0.228, P〉0.05). The 100% negative rate of infiltration in patients without nipple discharge with tumor size 〈2, 2-3 and 〉3 cm was obtained at 1.5, 2.0 and 2.5 cm away from the tumor respectively. It is concluded that the performance of breast-serving surgery in patients with breast invasive ductal carcinoma should be evaluated by tumor size in combination with axillary lymph nodes involvement to decide the possibility of breast-serving and the secure excision extent.
基金supported by the CAMS Innovation Fund for Medical Sciences (No. 2021-I2M-1-014 and No. 2022-I2M-2-002)。
文摘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.
基金The project supported by Beijing Natural Science Foundation(7122083)Beijing Science and Technology Projec(tD161100005116005)
文摘OBJECTIVE To investigate the inhibitory effects of Spatholobus Suberectus Column Extract(SSCE)on estrogen receptor positive(ER+)breast cancer cel MCF-7and its possible molecular mechanism.METHODS MCF-7cells were cultured without estrogen and with 17-β-estrogen(10-8mol·L-1),respectively,then treated with SSCE(0,40,80,160,320μg·m L-1).MTT assay was employed to evaluate cell viability.Flow cytometry assays were performed to underlying apoptosis and detecting cel cycle of MCF-7 cells treated with SSCE(0,80,160,320μg·mL-1).Wound healing assays was conducted to detect the migration ability.Dual luciferase reporter system was used to detect the activity of p-ERα,p-ERβpresented in intra-nuclear estrogen response element(ERE).Western blotting assay was employed to identify the expression of protein such as Bax,Bcl-2,p-ERα,p-ERβ,ERK1/2,p-ERK1/2,AKT,p-AKT,m TOR,p-m TOR,PI3K,p-PI3K.RESULTS It showed that SSCE(80,160and 320μg·mL-1)significantly decreased the viability of MCF-7.SSCE also triggered apoptosis,arrested cell cycle at G0/G1phase,inhibited migration.Dual luciferase reporter system showed that SSCE suppressed intra-nuclear p-ER activity,Western blotting analysis confirmed that SSCE did repress the expression of phosphorylated-ER alpha(p-ERα),ERK1/2,p-ERK1/2,AKT,p-AKT,pmT OR,PI3K,p-PI3K,which indicate that SSCE suppress MAPK PI3K/AKT signal pathway.CONCLUSION Our result showed that SSCE cause ER+MCF-7 cells apoptosis,G0/G1phase arresting,migration decreasing,via hypo-active of ER,suppress MAPK PI3K/AKT pathway.
文摘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.
文摘Objective: To explore the clinicopathologic features of secretory carcinoma of breast (SCB). Methods: Four cases of SCB were analyzed by light microscopy, histochemistry, immunohistochemistry and electron microscopy. The clinical data were also analyzed. Special staining of periodic acid-Schiff reaction with diastase pretreatment, immunohistochemical staining of ER, PR, HER-2, p53, MIB-1, S-100, p63, CK8/18 and EMA by En Vision method were performed. Results: Solid, cribriform, tubular, or papillary architecture may be seen. Tumor forms cystic spaces filled with abundant pale pink secretory material, positive with diastase resistant periodic acid-Schiff (PAS-DR) stains. Tumor cells were small with bland nuclei and abundant pale, eosinophilic cytoplasm, rare mitotic activity and necrosis. Immunohistochemically, tumor cells were positive for CK8/18, EMA, negative for S-100, p63 and variable partially positive for p53, ER, PR, HER-2 and MIB-1. Under electron microscopy, the tumor cells possessed numerous membrane-bound secretory vacuoles in cytoplasm lined by microvilli. Conclusion: SCB is a rare, low-malignant neoplasm. SCB have pathology, clinical picture, treatment, follow-up, immunohistochemical and genetic features that distinguish them from invasive ductal carcinomas of the usual type.
文摘BACKGROUND Granular cell tumor(GCT)of the breast(GCTB)is a rare neoplasm that can exhibit malignant characteristics both clinically and radiologically.This tumor can also coexist and colocalize with breast carcinoma.CASE SUMMARY We present a patient with this uncommon tumor and discuss the diagnostic and therapeutic approaches in order to further the knowledge of GCTB and prevent misdiagnosis and overtreatment.The characteristics of the tumor,methods of diagnosis,therapy and postoperative pathological outcomes were analyzed,and relevant literatures of GCTs were reviewed.The patient underwent surgery after core needle biopsy,and the excised neoplasm was sent for pathological examination.Histological analysis revealed nests of cells with abundant pink granular cytoplasm,confirming the diagnosis of GCTB.CONCLUSION As manifestations of GCT and malignancy can mimic each other,a careful histological examination is essential before major surgery.Treatment consisting of complete excision with close clinical follow-up is recommended.
文摘OBJECTIVE Different mammographic features are probably predictive of different prognosis. However, ambiguity still exists in understanding the relationship between them. In resent years, digital mammography has been available for clinical use which has led to a revolution in the resolving of images and an increase in early-stage breast cancer detection. Based on the above knowledge, this study was performed to evaluate the relationship between full-field digital mammographic features and clinicopathologic characteristics in breast cancer. METHODS Digital mammograms of 176 patients with pathologically proven breast cancer were reviewed. Also, clinical and pathologic records (histological types and axillary lymph nodes status) were retrospectively examined. RESULTS Most of the patients with a solitary microcalcification were young women under the age of 50(84.4%), but the majority of the patients with microcalcifications complicated by a mass were elderly women. Microcalcifications detected by mammography occurred frequently in ductal carcinoma in situ (28.1%) and in early invasive carcinoma (15.6%). Breast cancers with expression of microcalcifications combined with a spiculate mass had a high metastatic rate of axillary lymph nodes (69.4%). A high metastatic rate of axillary lymph nodes was also found in the patients with solitary worm-like microcalcifications (57.1%), solitary spiculate mass (53.7%) and solitary non-worm-like microcalcifications (44.4%). Simple worm-like microcalcifications accompanied with metastasis of 4 to 9 axillary lymph nodes occurred in 42.9% of the(6/14) cases. The patients with microcalcifications combined by a spiculate mass and with metastasis of 4 to 9 axillary lymph nodes accounted for 27.8% (10/36) of the cases, and those with metastases of 10 and over accounted for 16.7% (6/36). CONCLUSION Solitary microcalcifications occur frequently in young women and are usually associated with early breast cancer. There is a close relationship between worm-like microcalcifications, a spiculate mass and positive metastases of axillary lymph nodes, which are an index of poor prognosis.
文摘Objective:To compare the differences in surgical procedures,pathological features and prognosis between young and elderly women with breast cancer in China.Methods:A retrospective study compared the data of surgical procedures,pathological features and prognosis of 61 cases of young females(≤40 years)and 507 cases of elderly females(>40 years),treated in our department from August 2011 to July 2018.This data was analyzed using SPSS 23.0 program.Results:10.74% of total cases,in this period of time,involve young females.In terms of surgical procedures,24.59%of young patients underwent breast conserving surgery(8.48% elderly,respectively),and 13.11%underwent reconstruction surgery(1.18% elderly,respectively),with statistically significant differences existing between the two groups(P<0.05).Progesterone receptor(PR)expression in young women was significantly higher than in elderly females(P<0.05).There were no significant differences between the two groups in the proportion of invasive ductal carcinoma(IDC),axillary lymph node metastasis(ALNM),expression of estrogen receptor(ER),human epidermal growth factor receptor-2(HER-2)and Ki-67,but the lymphatic metastasis stage showed an increasing rate with younger age.No significant difference was found in 3-year disease-free survival(DFS)and overall survival(OS).Conclusion:The selection rate of breast conserving and reconstructive surgery in young women with breast cancer is significantly higher than that in elderly women.The younger the patient,the more frequently the PR positive expression,and the more likely ALNM to occur.The 3-year prognosis of the young and elderly patients is similar.
文摘<strong>Background:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">In patients with breast cancer after Neoadjuvant Chemotherapy (NAC), pathological Complete Response (pCR) was associated with better </span><span style="font-family:Verdana;">long-term outcome</span></span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;">. We here attempted to predict pCR using machine</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> learning. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> From 2008 to 2017, 1308 breast cancer patients underwent NAC before surgery, of whom 377 patients underwent Cancer</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">SCAN</span><sup><span style="font-family:Verdana;">TM</span></sup><span style="font-family:Verdana;"> for gene data. Of 377, 238 were analyzed here, with 139 excluded due to incomplete medical data. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The pCR (-</span></span><span style="font-family:;" "=""><span><span style="font-family:Verdana;">) vs. (+) group had 200 vs. 38 patients. In our predictive model with gene data, the Area Under the </span><span style="font-family:Verdana;">Curve (AUC) of the Receiver Operating Characteristic (ROC) curve was</span><span style="font-family:Verdana;"> 0.909 and accuracy was 0.875. In another model without gene data, the AUC of ROC curve was 0.743 and accuracy was 0.800. We also conducted internal validation with 72 patients undergoing NAC and Cancer</span></span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">SCAN</span><sup><span style="font-family:Verdana;">TM</span></sup><span style="font-family:Verdana;"> during July 2017 and April 2018. When we applied a 0.4 threshold value, accuracy was </span><span style="font-family:Verdana;">0.806 and 0.778 in </span></span><span style="font-family:Verdana;">the </span><span style="font-family:Verdana;">predictive model with vs. without gene profiles, </span><span style="font-family:;" "=""><span style="font-family:Verdana;">respec</span><span><span style="font-family:Verdana;">tively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The present predictive model may be a useful an</span></span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> easy-to-access tool for pCR-prediction in breast cancer patients treated with NAC.</span></span>
文摘A cross-sectional online survey was conducted.A high proportion of the Chinese breast cancer(BC)physician respondents(n=77)would prescribe extended adjuvant endocrine therapy(AET)with aromatase inhibitors(AI)beyond 5 years for postmenopausal females with BC,especially those with higher risk.Respondents with≥15 years of clinical experience were more likely to prescribe a longer duration of AET for low-risk patients.Half of the respondents considered intermittent letrozole as an acceptable option.Most respondents would prescribe adjuvant chemotherapy to genomic high-intermediate risk[Oncotype DX recurrence score(RS)21-25]females aged≤50 years regardless of the clinical risk classification.
文摘目的探讨基于组织学、免疫组化的三阴型乳腺癌(triple-negative breast cancer,TNBC)分型标准,为完善TNBC分型治疗提供理论依据。方法根据组织学特点和免疫组化标志物AR、CD8、FOXC1的表达对TNBC进行分型,比较TNBC亚型的临床病理特征、预后差异。结果93例TNBC中腔面雄激素受体型23例(24.7%),免疫调节型24例(25.8%),基底样免疫抑制型39例(42.0%),间充质型7例(7.5%)。TNBC亚型的临床病理特征:pT分期(P=0.030)、组织学分级(P<0.001)、肿瘤间质淋巴细胞浸润模式(P<0.001)、PD-L1(P<0.001)、HER2低表达(P=0.024)差异均有统计学意义;各亚型间的无瘤生存率差异无统计学意义(P>0.05)。单因素分层生存分析:亚型间pT1分期的无瘤生存率差异有统计学意义(P=0.011),其余临床病理特征均为非独立预后因素。结论TNBC基于组织学、免疫组化分型的临床病理特征有差异,有望替代复杂基因表达谱分型,为TNBC分型和靶向治疗提供理论依据。