Management of lymphedema is really a matter in patients with breast cancer

Lymphedema is a prevalent complication affecting patients with breast cancer,greatly impacting their quality of life.This editorial describes diagnostic methods and therapeutic interventions for managing lymphedema in patients with breast cancer.Diagnosis relies on clinical evaluation and objective measures,including arm circumference and volumetric assessments,along with lymphoscintigraphy and ultrasonic measurements.Treatment primarily involves complex decongestive physical therapy,comprising manual lymphatic drainage,compression therapy,exercise,and meticulous skin care.These interventions aim to reduce swelling,alleviate discomfort,and prevent further complications.Additionally,lifestyle modifications such as avoiding extreme temperatures and maintaining proper hygiene are essential.Flavonoids can be used for drug therapy.Despite its prevalence,lymphedema often receives inadequate attention in clinical practice,emphasizing the importance of raising awareness and enhancing medical services for affected individuals.Clinicians play a pivotal role in educating patients about preventive measures and ensuring timely intervention.Overall,a comprehensive approach encompassing early diagnosis,multidisciplinary management,and patient education is essential to mitigate the burden of lymphedema in patients with breast cancer and improve their overall well-being.

Identifying barriers to early diagnosis of breast cancer and perception of women in Malwa region of Punjab,India

Objective:The aim of present study is to identify the breast cancer screening barriers among the women with breast cancer of Malwa region of Punjab,India.The study was conducted at three government hospitals representing almost all districts of Malwa region.Methods:The quantitative research design was followed using empirical research methods.Study was carried out by one-to-one interview by the field investigator and research assistant.Total of 363 breast cancer patient has been interviewed through the scheduled questionnaire and results has been recorded for further analysis.In this study,five barriers are described namely as personal barriers,socio-cultural barriers,economic barriers,health­system barriers,and treatment barriers which contains various questions regarding barriers to breast cancer screening.Univariate analysis methods have been used for the analysis to access the socio-demographic profile of women.Data has been obtained with the help of 5-point liker scale.Binary logistic model was chosen.Results:Majority of participants were in the age groups 50-<60 years(3&6%,140/363)and>60 years(31.1%,112/363).Majority of these women(47.4%,171/363)were illiterate and most of them were housewives.The major barriers to breast cancer screening faced by most of the women were having no knowledge about screening services(90.9%,329/363),the importance of early diagnosis(90.9%,329/363),different screening methods(95.5%,347/363)and place of availing screening services(91.2%,330/363)misguided belief in God and fate(81.5%,295/363)and preferring duties than taking care of health(70.2%,254/363).Education qualification(odds ratio[OR]0.74,β'=-0.309,t=-5.357,P=0.000)and socioeconomic class(OR 1.43,β’=0.354,t=3.399,P=0.001)were found to be significant determinant of the barriers among women.Conclusion:The survey was conducted in the women between the age 40-60 years and as an outcome,the unawareness about screening services,fatalistic attitude,fear of being diagnosed with the cancer,low per capita income was found out significant factors that restricted the women for early check-up for the breast cancer.

Scoping review: obese elderly women with breast cancer and physical activity/exercise

Objective:Obesity and breast cancer(BC)are diseases of concern,especially within the context of an aging population.This scoping review is aimed at mapping out the literature on the subject of elderly women(EW)with breast cancer,obesity and physical activity/exercise(PAE)to identify gaps in the present extant literature,and to suggest directions for future research.Data sources:A total of four articles were finalized from an initial 2905 articles found via searches on the Annals of Internal Medicine by American College of Physicians(ACP)^(TM),BioMed Central(BMC)^(TM),BMJ Journals^(TM),Journal of the American Medical Association(JAMA)^(TM),PubMed^(TM),SAGE^(TM),ScienceDirect^(TM),SpringerLink(e-journals)^(TM),Taylor and Francis Online^(TM),and Wiley Online Library^(TM) databases.Methods:Recognized structural frameworks for scoping reviews were utilized to guide the methodology and technical aspects of this paper.Data extraction was conducted via a charting table.Results:Research gaps identified include a paucity in research on the subject of obesity and breast cancer among elderly women;there is a limitation of the types of methodologies used in the research on this subject indicating vast opportunities for future studies using different methodologies;lack of use of the alternative types of physical activity and exercise such as Tai Chi,Qigong and Yoga;lack of focus on the older elderly population;and areas of social support from family and friends for obese elderly with breast cancer to engage in physical activity and exercise.Conclusion:Future research would address the urgent need within academia to address the research gap of PAE and EWBC.Such research should use a diverse range of both quantitative and qualitative research methodologies,while including eastern exercise regimens such as Tai Chi,Qigong and Yoga as a means of studying PAE among EWBC.Additionally,future research may focus on the“old elderly”as a demographic group of study as well as how social support may encourage PAE among EWBC.

Exercise in patients coping with breast cancer: An overview

Breast cancer is the most common type of cancer in women, but fortunately has high survival rates. Many studies have been performed to investigate the effects of exercise in patients diagnosed with breast cancer. There is evidence that exercise after the diagnosis of breast cancer improves mortality, morbidity, health related quality of life, fatigue, physical functioning, muscle strength, and emotional wellbeing. Based on scientific data, breast cancer patients should be recommended to participate in rehabilitation programs including aerobic and strength training. The aim of this article is to review the recently published data on the effect of exercise in patients with breast cancer in order to present the current perspective on the topic.

Physical activity engagement after breast cancer: Advancing the health of survivors

Background: Physical inactivity is identified as the fourth leading risk factor for global mortality and associated with increased breast cancer diagnosis and risks of recurrence. Objectives: To investigate the level of physical activity engagement after breast cancer in survivors and healthy controls. Design: A descriptive casecontrol study on survivors and matched (ethnic, gender, age) healthy controls was surveyed using a pre-post questionnaire and a 1-minute cancer control media. The socio- and medical demographic data, physical activity status information were obtained from self report questionnaires. Results: Breast cancer survivors (n = 51) were found to participate in low-moderate level of physical activity while healthy controls (n = 45) participated in moderate-vigorous level of physical activity. Healthy adults reported more barriers and excuses but all participants (90% survivors and control) were unaware of the strong inverse relationship between level of physical activity and risks of cancer recurrence. The post test on video showed an increased awareness and intention to re-engagement in physical activity for cancer control (M = 7.1 ± 1.53, p < 0.01). Conclusion: The finding suggests that simple public health message within the Model of cancer survivorship care must be disseminated. The “teachable moments” after a cancer diagnosis should be optimised to promote rehabilitation for physically active lifestyle.

Correlation between breast cancer and lifestyle within the Gulf Cooperation Council countries:A systematic review

BACKGROUND In the six Gulf Cooperation Council countries(GCCCs),Bahrain,Saudi Arabia,Kuwait,Oman,Qatar and the United Arab Emirates,breast cancer(BC)is the greatest cause of cancer incidence and mortality.Obesity and physical inactivity are established risk factors for BC globally and appear to be more of a problem in high income countries like the GCCCs.AIM To determine whether obesity and physical inactivity are associated with BC incidence in the GCCCs using the United Kingdom as a comparator.METHODS This systematic review was carried out according to PRISMA guidelines.A cancer registry and a statistical data search was done to identify the BC incidence over the past two decades and the prevalence of obesity and physical inactivity in the GCCCs.Additionally,a systematic search of the databases,MEDLINE,Web of Science,and PubMed between 1999 and 2019 was performed to determine whether obesity and physical inactivity are risk factors for BC in the GCCCs.All papers were critically appraised according to their research methods and were assessed for quality and risk of bias.RESULTS BC was the top malignancy in each GCC country.Women tended to be diagnosed with BC at a younger age than women in the United Kingdom.The greatest 10-year increase in BC incidence was seen in Saudi Arabia(54.2%),,approximately seven times the rate of increase seen in the United Kingdom(7.6%).The prevalence of obesity and physical inactivity was greater in all the GCCCs in comparison to the United Kingdom.A total of 155 full studies were reviewed of which 17 were included.Of those,eight looked at the prevalence of obesity and physical inactivity in the Gulf States and nine looked at these as risk factors for BC.Only one study found an association between BC and obesity(odds ratio=2.29).No studies looked solely at the link between physical inactivity and BC.CONCLUSION The prevalence of obesity and physical inactivity was high within the GCCCs,but the majority of the included studies found no positive correlation between obesity or physical inactivity and BC.A high proportion of women in this study were pre-menopausal which could contribute to the negative findings.

Impact of community-based exercise program participation on aerobic capacity in women with and without breast cancer

BACKGROUND Evidence for exercise as an efficacious strategy to improve aerobic capacity of breast cancer survivors(BCS)has come largely from intervention studies conducted in laboratory settings.There is an increasing need to translate to community-type settings,but the efficacy of those interventions using gold standard evaluation is not well-established.AIM To investigate whether similar improvement in aerobic capacity(maximal oxygen consumption[VO2])measured with gold standard testing can be achieved through a community-based setting in BCS.METHODS A peak cardiopulmonary exercise test(VO2peak),6-min walk test(6MWT),and timed up and go test(TUG)were assessed pre-and post-16 wk of progressive intensity aerobic and strength training exercise at a community center.RESULTS The sample consisted of 31 early BCS(<1 year since treatment completion)and 15 controls(CTLs).Both groups significantly improved VO2peak(+1.2 mL/kg/min;P=0.030),6MWT(+35 meters;P<0.001),and TUG(-0.44 s;P<0.01)following training.Both groups improved peak cycling power during the cardiopulmonary exercise test with BCS improving by+10 watts more than the CTLs(P=0.020).Average exercise attendance was 71%(34 of 48 possible days),but compliant days averaged only 60%of total days for aerobic,and<40%for strength in both groups.CONCLUSION Community-based exercise programs can be an effective strategy to improve aerobic capacity and physical function for early-stage BCS but potentially not to the same extent observed in laboratory-based randomized controlled trials.Further research is needed to explore barriers and facilitators of exercise engagement in community-based centers to maximize training benefits for adults with cancer.

A review of home-based physical activity interventions for breast cancer survivors

As breast cancer relative survival continues to increase, many breast cancer patients face many issues, including recurrence of cancer and cancer-related side effects that impact several aspects of their quality of life. With breast cancer patients living longer, there is more of a concern for negative breast cancer outcomes. Although physical activity is an affordable and relatively convenient way to improve breast cancer outcomes, only about one-third of breast cancer survivors engage in the recommended level of physical activity. This article reviews articles published to date to examine whether home-based physical activity interventions are effective in improving physical activity and other outcomes among breast cancer survivors who have completed primary therapy for the disease. The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from 1980 through February 28, 2019 were identified. A total of 360 article citations were identified in PubMed and non-duplicates in CINAHL. After screening the abstracts or full texts of these articles and reviewing the references of previous review articles, 20 studies that met the eligibility criteria. Three of the studies were pre-/post-test trials and 17 were randomized controlled trials. Home-based exercise programs are effective in improving physical activity among breast cancer survivors who have completed primary therapy for the disease. Home-based exercise programs such as walking programs offer a convenient and affordable option for women who wish to increase their physical activity and maintain a healthy lifestyle.

Kinesio tape in the treatment of postoperative lymphedema of breast cancer

The Kinesio tape was originally developed by Dr. Kenzo Kase, a Japanese chiropractor, which was used for pain of joint and muscle, the elastic tape is capable of stretching up to 130-140% of its resting static length ensuring free mobility of the applied muscle or joint. It is claimed that Kinesio tape supports injured muscles and joints and helps relieve pain by lifting the skin and allowing improved blood and lymph flow. Therefore, Kinesio Taping has become a very popular treatment for several health conditions over the last decade. Nowadays, lymphatic drainage is a new function of Kinesio taping in the field of physical therapy. This article explores the application of Kinesio tape in breast cancer-related lymphedema in order to provide a new treatment for patients with lymphedema after breast cancer surgery.

Investigating the Physiological Mechanisms between Resistance Training and Pain Relief in the Cancer Population: A Literature Review

This literature review examines the mechanisms of how exercise, specifically in the form of resistance training, may lead to pain relief in the cancer population. Primary data from three different cancer populations: breast, prostate, and lung, will be examined. A number of experimental studies have been conducted to confirm the effectiveness of resistance training on pain relief as well as the biochemical pathways that relate to this process. In this review, we will examine 5 randomized controlled trials. For the purposes of this review, pain is defined as physical suffering or discomfort associated with illness. Pain is the body’s natural signal, bringing attention to damage that has been sustained by tissues. However, chronic pain is common in the cancer population, and often serves no good purpose but instead will negatively impact both physical and mental health. The three types of pain: nociceptive, neuropathic, and inflammatory pathways have been investigated, and the knowledge of pain mechanisms allows for the understanding of how it is associated with pain. The purpose of this exploratory literature review is to give insight on how to maximize pain-relieving effects of resistance training. Research has indicated that resistance training modulates pain pathways by upregulating the release of pain-relieving substances including beta-endorphins, anti-inflammatory cytokines, and endocannabinoids. Understanding of the benefits of resistance training may be useful in relieving cancer pain, and reproducing effects of pain-relieving strategies while minimizing the symptoms related to cancer and its treatment.

Effectiveness of a theory-based tailored mHealth physical activity intervention for women undergoing chemotherapy for breast cancer:A quasi-experimental study

Objectives:This study aimed to explore the effectiveness of the theory-based tailored mHealth physical activity(PA)intervention among patients with breast cancer undergoing chemotherapy.Methods:A quasi-experimental study design was adopted.A total of 60 breast cancer patients were selected from two tertiary hospitals in Shanghai and Hangzhou City from September 2019 to August 2021.According to the admission order,30 patients werefirst included in the control group,followed by 30 patients in the intervention group.A smartphone application(app)named“Breast Care”was developed based on social cognitive theory,self-efficacy theory,and the theory of planned behavior.The app integrated various functions,including information browsing,PA monitoring and feedback,symptom reporting,and social interaction.Patients in the intervention group received three months of personalized online PA guidance in addition to routine care.The control group received routine care.Baseline and post-intervention investigations after three months were conducted in two groups using the Short Form of International Physical Activity Questionnaire,the Hospital Anxiety and Depression Scale,and the Functional Assessment of Cancer TherapydBreast cancer.Results:After three months of intervention,compared to the control group,breast cancer patients in the intervention group showed significant improvements in walking,moderate PA,and overall PA(P<0.05).Compared to the baseline data,breast cancer patients in the intervention group had significant improvements in walking and overall PA after three months(P<0.05),whereas the control group experienced significant declines in walking,moderate PA,and overall PA after three months(P<0.05).There were statistically differences between the two groups in scores for anxiety,overall quality of life,and its dimensions,such as physical well-being,emotional well-being,and additional breast cancer well-being(P<0.05).Conclusions:The theory-based tailored mHealth PA intervention has demonstrated a positive impact on promoting PA behavior change and emotional management among breast cancer patients.The‘Breast Care’app integrated various practical behavior change strategies,offering valuable guidance for personalized remote rehabilitation support for cancer patients.

乳腺癌miR-4500、NGF表达与术前磁共振征象的相关性研究

目的分析乳腺癌患者中miR-4500、神经生长因子(NGF)表达与术前磁共振(MR)征象的相关性。方法选取我院收治的乳腺癌患者105例,通过qRT-PCR法检测患者乳腺癌组织及癌旁组织中miR-4500、NGF mRNA表达水平,免疫组化法测定乳腺癌组织及癌旁组织中NGF的阳性表达率。分析乳腺癌组织中miR-4500、NGF表达与患者临床病理特征及MR征象的相关性。生物信息网站预测miR-4500与NGF的靶向关系,并分析二者表达的相关性。结果与癌旁组织相比,乳腺癌组织中miR-4500表达水平降低(P<0.05),NGF mRNA水平、NGF阳性表达率升高(P<0.05)。年龄、病理类型、肿瘤分型、实质背景、表观弥散系数、强化曲线在不同miR-4500表达及NGF表达间差异无统计学意义(P>0.05),组织学分级、淋巴结转移、肿瘤直径、肿瘤形态、环形强化、瘤周水肿与miR-4500表达及NGF表达有关(P<0.05)。生物信息网站预测显示,miR-4500与NGF存在结合位点,乳腺癌组织中miR-4500表达与NGF mRNA表达呈负相关(r=-0.576,P<0.05)。结论乳腺癌组织miR-4500低表达,NGF高表达,二者与患者术前MR征象具有相关性,为MR征象提供了分子学依据。

乳腺癌病人院外团体视觉艺术活动真实体验的质性研究

目的:探讨乳腺癌病人对院外团体视觉艺术活动的真实体验。方法:采用目的抽样法选取2021年4月-8月某三级甲等医院乳腺肿瘤科15例乳腺癌病人作为研究对象,病人住院期间体验院外团体视觉艺术活动,采用面对面一对一半结构化访谈形式收集资料,运用Colaizzi 7步分析法对访谈资料进行分析。结果:提炼出心理体验和身体体验两大主题,包括积极心理体验(关爱获得感、表达欣赏与喜悦、建立人际亲密联系、提升住院满意度、坚定人生信念)、消极心理体验(与社会隔离、复发担忧)、身体体验(增加运动锻炼和改善睡眠状态)。结论:院外团体视觉艺术活动对乳腺癌病人身心均有一定影响,积极影响较为突出,医护人员应建立个体化的身心体验方案和反馈机制,帮助乳腺癌病人早日康复。

乳腺癌DBT毛刺征象与Ki-67增殖指数的相关性分析

目的:利用数字乳腺断层摄影(digital breast tomosynthesis,DBT)评估病变边缘方面的优势,探讨DBT图像的毛刺征象与Ki-67增殖指数的关系。方法:回顾并纳入2022年3月—2023年4月于郑州大学第一附属医院就诊的99例浸润性乳腺癌患者的DBT影像学资料,所有患者在DBT图像中均表现为毛刺型肿块。对99例乳腺毛刺型肿块的肿块大小、毛刺的长度和宽度、肿瘤边缘毛刺的覆盖情况及毛刺的数量进行分析,并收集患者的一般临床资料,比较各参数在Ki-67增殖指数之间的差异。采用多因素logistic回归分析Ki-67增殖指数的独立预测因素,并采用受试者工作特征曲线评价其诊断效能。结果:Ki-67增殖指数高低患者之间DBT图像毛刺特征,包括毛刺长度与毛刺宽度比较差异均有统计学意义(P<0.05),而毛刺数量、患者年龄、绝经状态及肿块大小差异无统计学意义(P=0.060,P=0.175,P=0.507,P=0.050)。多因素logistic回归模型分析显示,毛刺长度(OR=0.036,P<0.001)、毛刺宽度(OR=8.829,P<0.001)为Ki-67增殖指数的独立预测因素。将毛刺长度与毛刺宽度联合后,诊断效能最好,AUC为0.897。结论:乳腺癌DBT图像中的毛刺征分析可作为一种无创预测恶性肿瘤增殖活性的方法,从而判断患者的预后。

乳腺癌患者超声征象与病理组织学类型的相关性分析

目的:研究乳腺癌患者超声征象与其病理组织学类型之间的相关性。方法:以回顾性研究纳入2020年1月—2022年1月南通市第一人民医院收治的70例乳腺癌患者的临床资料,均于治疗前行彩色多普勒超声检查,于治疗后行组织病理学检测。统计患者的一般资料,对不同病理组织学类型[乳腺浸润性小叶癌(ILC)、乳腺浸润性导管癌(IDC)]、分级(低分化、中高分化)患者的超声征象(肿块形态、毛刺征、高回声晕、后方回声、微小钙化、血流)进行比较分析。结果:70例患者组织学分类为IDC 45例、ILC 25例。组织学分化等级为低分化者32例、中高分化者38例。IDC患者中的肿块形态不规则比例低于ILC患者,微小钙化比例高于ILC患者,差异均有统计学意义(P<0.05);低分化乳腺癌患者的肿块形态不规则比例、微小钙化比例、血流丰富比例均高于中高分化乳腺癌患者,差异均有统计学意义(P<0.05)。结论:乳腺癌患者超声检查中的肿块形态不规则、微小钙化征象与其病理组织学类型和分级均有一定关系,血流丰富征象对判断乳腺癌患者的病理组织学分类亦有积极作用。

Accuracy of physical examination, ultrasonography, and magnetic resonance imaging in predicting response to neo-adjuvant chemotherapy for breast cancer

Background Accurate evaluation of response following chemotherapy treatment is essential for surgical decision making in patients with breast cancer. Modalities that have been used to monitor response to neo-adjuvant chemotherapy （NAC） include physical examination （PE）, ultrasound （US）, and magnetic resonance imaging （MRI）. The purpose of this study was to evaluate the accuracy of PE, US, and MRI in predicting the response to NAC in patients with breast cancer. Methods According to the response evaluation criteria in solid tumors guidelines, the largest unidimensional measurement of the tumor diameter evaluated by PE, US, and MRI before and after NAC was classified into four grades, including clinical complete response, clinical partial response, clinical progressive disease, clinical stable disease, and compared with the final histopathological examination. Results Of the 64 patients who received NAC, the pathologic complete response （pCR） was shown in 13 of 64 patients （20%）. The sensitivity of PE, US, and MRI in predicting the major pathologic response was 73%, 75%, and 80%, respectively, and the specificity was 45%, 50%, and 50% respectively. For predicting a pCR, the sensitivity of PE, US, and MRI was 46%, 46%, and 39%, respectively, and the specificity was 65%, 98%, and 92% respectively. Conclusions Compared with final pathologic findings, all these three clinical and imaging modalities tended to obviously underestimate the pCR rate. A more appropriate, universal, and practical standard by clinical and imaging modalities in predicting the response to neo-adjuvant chemotherapy in vivo is essential.

Physiotherapy,Yoga and Educational Project for Patients Suffering from Pain Due to Hormone Therapy after Breast Cancer:The SKYPE Feasibility Study

Approximately 50%of breast cancer patients under hormone therapy experience osteoarticular pain,which increases the risk of treatment discontinuation and relapse.The aim of the study was to assess the feasibility of yoga practice associated with patient education(PE)for at-home practice in breast cancer patients under hormone therapy.We also evaluated osteoarticular pain,flexibility and patients’satisfaction.In this study,intervention was split into two 6-week periods(P):P1 consisting of a supervised yoga-PE session of 90 minutes/week and 15-minutes of daily at-home yoga,and P2,involving daily autonomous athome yoga sessions.Feasibility was evaluated by patient adherence defined as completion of at least 4 out of the 6 supervised yoga-PE sessions and 70%or more of the at-home yoga sessions.Evaluations(at inclusion and at the end of each period)consisted in assessment of osteoarticular pain,forward flexibility and patient satisfaction.Twenty-four women with a median age of 53 years[36–72]were included.Feasibility was validated with a successful adherence rate reaching 83%,combined with a mean satisfaction score of 10/10[8–10].In addition,58%of patients reported reduced osteoarticular pain,with a 2-point reduction on the numerical rating scale.The forward flexibility also improved,with a median gain of 8 cm.Combined physiotherapy-yoga-PE intervention is a feasible strategy,increasing at-home yoga practice with potential benefit on pain,flexibility,and patient satisfaction.Evaluation of this innovative program is ongoing in a larger randomized multicenter trial.

多普勒超声成像与非特殊型浸润性乳腺癌病理分级及ER、PR、P53、HER-2的关系

目的探讨多普勒超声成像与非特殊型浸润性乳腺癌(NSIBCs)病理分级及雌激素受体(ER)、孕激素受体(PR)、P53基因、人类表皮生长因子受体-2(HER-2)的关系。方法选取江苏省无锡市中医医院2018-02—2021-12收治的102例NSIBCs患者,术前均给予多普勒超声成像检查,采用免疫组化法检测癌组织中ER、PR、P53、HER-2表达情况。比较不同病理组织分级NSIBCs患者的多普勒超声征象,对比不同多普勒超声征象NSIBCs患者中的ER、PR、P53、HER-2表达情况。结果Ⅱ级、Ⅲ级病理组织分级患者的病灶>2 cm、后方回声增强占比高于Ⅰ级患者(P<0.05),Ⅲ级病理组织分级患者的病灶>2 cm、后方回声增强占比高于Ⅱ级患者(P<0.05);Ⅲ级病理组织分级患者有边缘毛刺征占比低于Ⅱ级、Ⅰ级患者(P<0.05);Ⅲ级病理组织分级患者有周边高回声晕征者占比、富血供型血流分布占比均高于Ⅱ级、Ⅰ级患者Z(P<0.05);Ⅱ级、Ⅲ级病理组织分级患者有腋窝淋巴结转移占比高于Ⅰ级患者(P<0.05)。有微钙化患者的P53、HER-2阳性表达率高于无微钙化患者(P<0.05);有腋窝淋巴结转移患者癌组织中ER、PR阳性表达率低于无腋窝淋巴结转移患者(P<0.05),有腋窝淋巴结转移患者癌组织中P53、HER-2阳性表达率高于无腋窝淋巴结转移患者(P<0.05);富血供型血流分布患者癌组织中P53、HER-2阳性表达率高于乏血供型患者(P<0.05)。结论多普勒超声成像特征与NSIBCs病理分级及ER、PR、P53、HER-2表达关系密切,对临床具有一定指导价值。

雄激素受体、细胞周期蛋白D1在非特殊型浸润性乳腺癌中的表达及与患者超声征象的关系

目的 探讨雄激素受体(AR)、细胞周期蛋白D1(cyclin D1)在非特殊型浸润性乳腺癌中的表达及与患者超声征象的关系。方法 收集105例非特殊型浸润性乳腺癌患者的非特殊型浸润性乳腺癌组织和癌旁正常组织,采用免疫组织化学染色法检测AR、cyclin D1表达情况。比较非特殊型浸润性乳腺癌组织和癌旁正常组织中AR、cyclin D1表达情况,比较不同组织学分级、AR表达情况、cyclin D1表达情况非特殊型浸润性乳腺癌患者的超声征象。采用Pearson相关分析法分析AR、cyclin D表达情况与非特殊型浸润性乳腺癌患者超声征象的相关性。结果 非特殊型浸润性乳腺癌组织中AR、cyclin D1阳性表达率均明显高于癌旁正常组织,差异均有统计学意义(P﹤0.01)。不同组织学分级非特殊型浸润性乳腺癌患者的肿瘤直径、边缘毛刺征、后方回声、周边高回声晕征、腋窝淋巴结转移情况比较,差异均有统计学意义(P﹤0.05)。不同AR、cyclin D1表达情况非特殊型浸润性乳腺癌患者的肿瘤直径、病灶内微钙化情况、病灶内血流情况比较,差异均有统计学意义(P﹤0.05)。AR、cyclin D1表达与非特殊型浸润性乳腺癌患者的肿瘤直径、病灶内微钙化及病灶内血流均呈正相关(P﹤0.01)。结论非特殊型浸润性乳腺癌组织中AR、cyclin D1阳性表达率均较高,且其表达与患者的超声征象有关。

乳腺癌动态增强MRI征象特征及病灶周围血管征与诺丁汉预后指数的相关性

目的探讨乳腺癌动态增强MRI征象特征及病灶周围血管征(adjacent vessel sign,AVS)与诺丁汉预后指数(Nottingham prognostic index,NPI)的相关性。方法选取本院2019年3月至2020年10月经术后病理证实的105例乳腺癌患者。统计分析患者动态增强MRI征象特征及病灶AVS。根据NPI评分高低将患者分为<3.4组22例、3.4~5.4组36例和>5.4组47例。应用χ2检验分析患者MRI征象及AVS与NPI评分之间的关系,采用列联Cramer's V系数分析病灶MRI征象及AVS与NPI评分之间的相关性。结果NPI评分与患者病灶形态特征(Cramer's V=0.036,P=0.935)和时间-信号强度曲线(time-signal intensity curve,TIC)类型(Cramer's V=0.096,P=0.750)均无相关。NPI评分与患者病灶MRI信号特点(Cramer's V=0.623,P<0.01)、病灶边缘情况(Cramer's V=0.319,P=0.005)、病灶早期强化特点(Cramer's V=0.422,P<0.01)、病灶强化方式(Cramer's V=0.304,P=0.008)、强化顺序(Cramer's V=0.345,P<0.01)、早期强化率(early enhancement rate,EER)情况(Cramer's V=0.452,P<0.01)和AVS级别(Cramer's V=0.542,P<0.01)存在相关性。结论乳腺癌动态增强MRI征象特征与NPI评分呈现一定的相关性,对患者的预后具有一定提示作用。