Study on the Anti-Inflammatory and Analgesic Mechanisms of Breast Lump Resolution Detergent in a Rat Model of Breast Hyperplasia

Objective: This study aimed to investigate the anti-inflammatory and analgesic mechanisms of a breast lump resolution detergent in a rat model of breast hyperplasia. Methods: A rat model of breast hyperplasia was established using injections of estradiol benzoate combined with progesterone. The effects of the breast lump resolution detergent on nipple height and diameter in the rat model were observed, along with its impact on serum levels of estradiol (E2), prolactin (PRL), and progesterone (P). Additionally, the study examined the morphological changes in breast tissue. The impact of the breast nodule detergent on blood rheology parameters was also observed. Furthermore, the anti-inflammatory effect of the breast nodule detergent was assessed using the cotton ball granuloma experiment, and the analgesic effect was observed using the writhing test. Results: The breast lump resolution detergent reduced nipple height and diameter in the rat model, decreased serum levels of E2, PRL, and P, and alleviated pathological changes in breast tissue. It also lowered hemorheological parameters including whole blood high, medium, and low shear viscosity, plasma viscosity, red blood cell hematocrit, red blood cell aggregation index, red blood cell deformability index, red blood cell electrophoresis time, and erythrocyte sedimentation rate in the acute “blood stasis” rat model. The detergent reduced the weight of cotton ball granulomas in mice and decreased the number of writhing episodes caused by acetic acid. Conclusion: The breast lump resolution detergent demonstrates favorable therapeutic effects in treating breast hyperplasia, promoting blood circulation and removing blood stasis, exerting anti-inflammatory properties, and providing analgesic effects. The downregulation of serum E2 and PRL levels and the upregulation of P levels may be critical mechanisms underlying its efficacy.

Histopathological and Ultrasound Correlation in Women Presenting with Breast Lumps in Yaoundé, Cameroon

Context: Breast cancer is very deadly among women with higher rates in the developing world. Imaging tools such as ultrasound, can be used to differentiate between the types of breast lumps. This study aimed to determine the value of ultrasound as a first-line examination in the diagnosis of breast masses. Methods: This was a retrospective cross-sectional study of women presenting with breast lumps from November 2022 to June 2023 at the Yaounde General Hospital, which lasted seven months, from November 2022 to June 2023. The sampling was exhaustive and consecutive. Association between variables was studied using the x2 test and concordance between ultrasound and histopathological findings was assessed using the Kappa correlation coefficient. Results: 234 women were included in the study. Their mean age was 46.3 ± 11.4 years. Overall, 15 (6.4%) lumps were benign while 219 (93.6%) were malignant. Triple negative (5.6%) was the most recurrent genomic classification. The correlation between the ultrasound and histopathological findings was significant, with an observed concordance rate at 85.1%, kappa = 0.322 and a p-value Conclusion: The performance of ultrasound in differentiating benign and malignant lesion was high. However, the discordant cases highlight the need for a diagnosis system which blends histopathological and radiological findings for an improved management of patients with breast lumps.

Breast Lump Recognition Algorithms Based on Ultrasound Radio-Frequency Signals

A method for evaluating the benign and malignant breast tumors based on radio?frequency(RF)data was explored by extracting the characteristic parameters of breast ultrasound RF signals.The breast biopsy data were used as the reference data for judging the lump benign or malignant.The extracted ultrasound RF data were reconstructed and segmented by computer aided method to obtain the breast tumor region of interest(ROI)and its characteristic parameters(entropy and standard deviation).The characteristic parameters were statistically analyzed to evaluate the relationship between characteristic parameters and benign or malignant breast tumors.The results indicate the entropy and standard deviation of normal region is much higher than that of lump region,which shows that the standard deviation and entropy characteristic parameters of ultrasonic RF signals are meaningful in the diagnosis of breast tumors.The proposed method provides a new direction for computer?aided diagnosis of benign and malignant breast tumors.

Frozen Section Analysis of Breast Lumpectomy Margins

Objectives: To evaluate breast lumpectomy margins by frozen section in breast conservation surgery. Methods: A retrospective study of frozen section of lumpectomy margins of one hundred ten patients was done at King Abdulaziz University Hospital from June 2007 to June 2013. All patients underwent lumpectomy + Sentinel lymph node biopsy. Patient records were studied for location of mass in breast, size of mass, site of breast, pre or postmenopausal, frozen section margins, new frozen section margins, permanent margins, reoperation. Complications like skin necrosis, numbness, and wound infection were studied. Result: Majority were Saudis (64.5%). Left breast was involved in 60%. Upper outer quadrant was involved in majority (51.9%). Size of mass was less than 1 cm in 14.8% cases, 1 - 2.9 cm in 43.5%, 3 - 4 cm in 13%, more than 4 cm in 10.2%. Lumpectomy plus sentinel lymph node biopsy was done in 96.4% and lumpectomy and axillary lymph node dissection was done in 1.8% cases. Gross margins were positive in 17.3% and frozen margins were positive in 28.2%. New margin on frozen section were positive in 3.6% and negative in 79.1%. Permanent section histology showed positive margins in 5.5% and negative in 94.5% cases. Re-operation was done in 7.3%. Lympho-vascular margins were positive in 20.9%. Skin necrosis was found in 2.2%, numbness was found in 4.4%, wound infection was in 2.2%. Conclusion: Lumpectomy margins with frozen section reduce re-operation and recurrence.

Awareness that early cancer lump is painless could decrease breast cancer mortality in developing countries

There are several factors which contribute to patients' reporting late to healthcare facility even after detecting the breast lump(patient delay). Amongst these, one of the important factors in low- and middle-income countries is lack of awareness that early cancer lump is painless(ECLIPs). Pain is often taken as a danger sign and absence of pain is often not taken seriously. The studies have shown that up to 98% of women in lowincome countries are unaware that a painless lump could be a warning sign of early breast cancer. This fact is significant because this could be one of the prime reasons for the women having discovered a painless lump in the breast, accidentally or by breast self-examination, presume it to be harmless and don't report early to health care facility. Therefore, creating awareness about ECLIPs could be an effective strategy to reduce mortality due to breast cancer in low- and middle-income countries. Moreover, unlike modifying risk factors which requires long term behavior modification, creating awareness about ECLIPs is easy and cost effective.

Repeated lumps and infections: A case report on breast augmentation complications

BACKGROUND Polyacrylamide hydrogel(PAAG)injections were once common in breast augmentation and have been prohibited for augmentation mammaplasty in China since a large number of patients who underwent breast augmentation with PAAG injections have continued to seek medical advice as a result of related complications.Among all these complications,distant migration is relatively rare.CASE SUMMARY A 49-year-old female presented at the hospital with a one-year history of a vulvar lump.The sonography of the lump showed several subcutaneous fluid-filled regions from the left vulva to the pubic symphysis,which suggested possible fat liquefaction.An enhanced magnetic resonance imaging(MRI)revealed a cystic area,which was considered a benign lesion.Intraoperative observations showed that the mass did not have an obvious capsule,the subcutaneous tissue presented as a cavity,and some yellow material came out of this cavity.A culture of the drainage did not show bacterial contamination.Histopathology revealed a foreign body granuloma.After resection and closed drainage,lumps were successively observed in the left lower abdomen and the bilateral hypochondriac region with infections.Sonography found that the hypoechoic areas in the bilateral hypochondriac region seemed continuous with deep in the breasts.The patient reported that she had undergone surgery with PAAG injections 20 years ago after she was repeatedly asked about her past history.Finally,a diagnosis of distant migration of PAAG was made.CONCLUSION PAAG gel can migrate after long periods of time.A diagnosis should not be limited to the area where the symptom develops.

近五年针刺治疗乳腺增生症的临床概况

乳腺增生症是乳腺疾病中的常见病、多发病,属于中医“乳癖”范畴,是以乳房疼痛、肿块、乳房溢液为主要特征。临床上针刺治疗该病具有疗效快、复发率低的优势,文章针对近5年单纯针刺疗法、针刺联合其他疗法以及电针、火针、浮针、穴位埋线多种方法治疗乳腺增生症的相关文献进行全面整理与研究,以期为临床针刺治疗乳腺增生症提供新思路,减轻患者痛苦。

乳癖汤联合情绪疏导法对周期性乳痛症伴焦虑患者远期疗效观察

目的观察乳癖汤联合情绪疏导法对周期性乳痛症伴焦虑情绪患者的临床疗效。方法选取温岭市中医院2020年1月—2021年12月收治的视觉模拟量表(VAS)评分≥6分,焦虑自评量表(SAS)评分≥53分的周期性乳痛症患者,随机分为单用乳癖汤的乳癖汤组(50例)和乳癖汤联合情绪疏导的乳癖情绪组(50例),分别在治疗前、治疗后评估两组VAS评分及雌二醇(E_(2))、孕酮(P)、E_(2)/P值,并在停药后6个月进行VAS远期疗效评估。结果与治疗前比较,两组治疗后与停药6个月后VAS评分差异有统计学意义(P<0.05);治疗后E_(2)差异均无统计学意义(P>0.05),P差异有统计学意义(P<0.05),E_(2)/P值差异有统计学意义(P<0.05)。结论对于周期性乳痛症伴焦虑情绪患者,中药疗效确切,中药联合情绪疏导法远期疗效优于纯中药治疗。

Primary Malignant Peripheral Nerve Sheath Tumor of the Breast—A Case Report

Malignant peripheral nerve sheath tumor is a rare soft tissue sarcoma. Breast is an extremely rare location of this lesion and presentation as a breast lump in the absence of pain or previous benign neural tumor is even rarer. We report such a lesion in a 60 year-old female who presented with hard and painless breast lump for 2 years. Histopathology revealed a malignant spindle cell tumor of low grade potential. It was subsequently confirmed to be malignant peripheral nerve sheath tumor (MPNST) on the basis of immunopositivity for vimentin, neurone specific enolase and S-100.

The Value of Clinical Breast Examination, Imaging, and Fine Needle Aspiration and the Challenge of Diagnosing Breast Cancer in a Low Resource Setting: A Hospital-Based Analytical Study in Yaounde

Background: Breast cancer is the most common cancer in the world, as well as in Cameroon, where it represents about 20.1% of all cancers recorded in 2020. The number of pathologists in the country is as few as seven for a population of about 26 million. The diagnostic performances of diagnostic modalities other than histology—clinical breast examination (CBE), imaging and fine needle aspiration and cytology (FNA)—in our context are not known. Study Objectives: Our objectives were to estimate the proportions of cases managed with mammography, breast ultrasound and FNA and to estimate the sensitivity, specificity, positive and negative predictive values, and accuracy of CBE, mammography, breast ultrasound and FNA;using histology as reference. Study Methodology: The study was cross-sectional and analytical, and was carried out at the Yaoundé General Hospital. It lasted twelve months, April 2015 through March 2016 and covered the period January 2010 to February 2016. Using histology as reference, we calculated measures of diagnostic accuracy for all four modalities using the statistical methods of Galen and Gambino. Results: We recruited 107 cases, 105 females (98.1%) and 02 males. We had 112 breast lumps, 106 malignant (94.6%) and 6 benign. The mean lump size was 61.1 mm. The most frequently used diagnostic tool after CBE was FNA (49.1%), while the diagnostic accuracies were 76.8%, 79.1%, 82.9%, and 82.0% for CBE, breast US, mammography and FNA. Conclusion: The four baseline diagnostic modalities for breast cancer are used sub-optimally and FNA appears to be the most commonly used in our setting after CBE. We recommend that FNA should be considered for diagnosis as appropriate but a negative result should not stop the quest for histological elimination of presence of malignancy.

Clinicopathological Profile of Breast Cancer Patients at a Tertiary Care Hospital in Kashmir Valley

Introduction: Breast cancer is the commonest malignancy in women worldwide. There are considerable variations in risk factors and presentation of the disease region wise. The present study aimed to describe clinical and pathological profile of breast cancer patients attending tertiary care hospital. Method: All consenting patients attending to surgical out-patient department (OPD) with complaints pertaining to breast disease were enrolled from 16th June 2015 to 15th June 2016. The patients were followed and demographic, clinical and pathologic information was recorded and analysed. Results: Total Of 180 patients with breast disease were enrolled. 34/100 were diagnosed of malignancy and formed the cases of the present study. Age of the patients ranged from 22 to 60 years with mean age of 42.06 ± 10.7 years. All the patients presented as breast lump variably associated with pain or discharge. Infiltrating Ductal Carcinoma Not Otherwise Specified (IDC NOS) was common histologic diagnosis (76.47%). Conclusion: Breast carcinoma presents with painless lump and patients are usually diagnosed in our setup at locally advanced stage. Implementation of the simple and effective screening programs for early detection is urgent need in our population.

乳腺良性肿块切除后预防性应用乳癖散结胶囊临床观察

目的:观察乳癖散结胶囊预防性用于乳腺良性肿块切除的疗效。方法:400例随机分为两组,观察组200例预防性应用乳癖散结胶囊,对照组200例未行预防性用药。结果:肿块复发率观察组低于对照组(P<0.05),乳房疼痛比率观察组低于对照组(P<0.05)。结论:乳癖散结胶囊预防良性肿块切除术后肿块复发效果较好,缓解疼痛、改善腺体厚度效果明显。

剪切波弹性成像联合超声加权评分法对乳腺肿块诊断的应用价值

目的:探讨剪切波弹性成像(SWE)联合超声加权评分法对乳腺肿块诊断的应用价值。方法:回顾性选取2018年5月至2020年5月本院收治的120例乳腺肿块患者作为研究对象,其中良性组62例,恶性组58例。两组均行乳腺常规超声和SWE检查,比较两组SWE最大值、SWE最小值、平均值和超声加权评分,并采用ROC曲线分析剪切波弹性成像评分联合超声加权评分法对乳腺肿块的诊断效能。结果:乳腺超声加权评分恶性组为(7.97±4.01)分,明显高于良性组(4.48±2.34)分(t=5.771,P<0.05);超声加权评分和SWE联合超声加权评分对乳腺肿块分级的诊断两组结果比较,差异无统计学意义(P>0.05)。SWE最大值、SWE平均值良性组低于恶性组(P<0.05);两组SWE最小值比较,差异无统计学意义(P>0.05);二元Logistic回归分析结果提示,SWE最大值、SWE平均值及超声加权评分均为乳腺良恶性肿块的影响因素(P<0.05);ROC曲线分析显示,联合SWE最大值、SWE平均值和超声加权评分法诊断乳腺肿块的AUC为0.931,高于超声加权评分法的0.763,SWE最大值的0.799,SWE平均值的0.769(Z分别为4.188;3.241;3.938,P<0.05)。结论:剪切波弹性成像评分联合超声加权评分法可提高乳腺肿块诊断的准确度,有助于乳腺癌的早期筛查诊断。

重构本草——夏枯草

通过古籍文献调研、中药现代研究进展及其研究成果的梳理,结合中医临床及中药学等学科领域内的专家学者的认识及应用经验,经讨论认为夏枯草:功效主要为清肝泻火,明目,散结消肿;症靶为甲状腺肿大、乳腺肿块、目赤肿痛;标靶为甲状腺功能、高血压;现代药理发现夏枯草及其有效成分具有抗炎、抗肿瘤、调节免疫、降血糖、降血压、抗病毒的功能;本品无毒,脾胃寒弱者慎用;临床使用剂量为9~60 g。内服时当根据不同疾病,或同一疾病的不同阶段进行辨证使用,并积极探索夏枯草用量与症靶、标靶的量效关系构建。

剪切波弹性成像联合BI-RADS评分标准对乳腺肿块良恶性的诊断研究

目的:分析超声剪切波弹性成像(shear wave elastography,SWE)联合乳腺影像报告数据系统(breast imaging-reporting and data system,BI-RADS)对乳腺肿块良恶性的评估价值。方法:选取2020年6月—2023年1月在苏州市吴中区第二人民医院超声科就诊的经常规超声诊断为BI-RADS 4类的乳腺肿块患者58例(共72个肿块),肿块直径均≤20 mm,患者均进行SWE检查,并分别对每个肿块进行SWE评分、联合BI-RADS分类评估肿块的良恶性。以病理结果为金标准,评价SWE单独及联合BI-RADS分类对乳腺肿块良恶性的诊断效能。结果:58例乳腺肿块患者中良性病灶31个、恶性病灶41个。以病理结果为“金标准”,诊断BI-RADS 4类乳腺肿块的灵敏度为75.61%、特异度为83.87%。SWE与常规二维超声联合诊断BI-RADS 4类乳腺肿块的灵敏度为82.93%、特异度为90.32%。SWE+BI-RADS评分较单一BI-RADS的灵敏度高,差异有统计学意义(P<0.05)。结论:综合运用SWE+BI-RADS评分可提高乳腺疾病患者恶性肿块的检出率。对直径≤20 mm的乳腺肿块患者行SWE+BI-RADS评分检查的恶性诊出率高于单一BI-RADS检查。

超声光散射成像技术在乳腺肿块中的诊断价值

目的:评价超声光散射成像技术在乳腺肿块诊断中的临床价值。方法:选取2012年10月—2018年6月期间在滨州医学院附属医院进行手术治疗的女性乳腺肿块患者52例(共73个结节)纳入研究,应用超声光散射成像技术对73个乳腺肿块进行检查,评价其超声检查结果与病理诊断的一致性,判断超声光散射成像技术的准确性。结果:术后病理诊断恶性乳腺肿块18个,良性55个。光散射乳腺成像(diffused optical tomography,DOT)诊断恶性乳腺肿块33个、良性40个,超声联合DOT诊断恶性乳腺肿块25个、良性48个。恶性肿块患者的血红蛋白总量高于良性肿块患者,差异有统计学意义(P<0.05)。DOT诊断乳腺肿块的灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为88.89%(16/18)、69.09%(38/55)、48.48%(16/33)、95.00%(38/40)、73.97%(54/73),超声联合DOT诊断效能分别为94.44%(17/18)、87.27%(48/55)、70.83%(17/24)、97.96%(48/49)、89.04%(65/73)。结论:超声光散射成像检查对乳腺肿块性质判断的准确性及敏感性较高,提供了乳腺肿块的代谢信息,为临床诊断提供了新的依据。

肝郁气滞证研究现状及热点可视化分析

目的 探索肝郁气滞证的研究现况和热点。方法 从中国知网、维普网、万方等中文数据库检索近20年肝郁气滞证相关文献;借助CiteSpace可视化功能生成年发文趋势图、机构合作图、作者联系图、关键词共现、聚类、突现图。结果 最终纳入文献10 016篇,年发文量总体呈上升趋势;北京中医药大学发文量最多且中心度最高;王玉来是发文量最多且中心度最高的作者;肝郁气滞、辨证论治、临床经验、抑郁症、失眠等关键词出现频率高且中心度也较高;聚类分析生成13个标签;突现词25个。结论 本领域研究者通过综述、经验介绍、临床观察和研究等方法,从相关疾病、理法方药等研究热点深入探索,取得显著成果;但研究机构和作者尚未形成大规模合作交流。

真空辅助乳腺微创旋切系统在自体脂肪移植隆胸术后乳房肿块治疗中的疗效分析

目的 探讨真空辅助乳腺微创旋切系统在自体脂肪移植隆胸术后乳房肿块治疗中的疗效及应用价值。方法 回顾性分析我科2018年12月至2022年12月收治的34例自体脂肪移植隆胸术后乳房肿块患者的临床资料,根据超声表现将乳房肿块分为囊性、实性、混合性和钙化灶四种类型,比较超声引导下EnCor微创旋切系统对四种类型乳房肿块患者的治疗效果、并发症和满意度。结果 34例患者中有囊性肿块12例(35%),实性肿块5例(15%),混合性肿块10例(29%),钙化灶7例(21%)。四种类型的乳房肿块均能被微创旋切系统完整准确地切除,所有患者未出现乳房感染等严重并发症,仅有2例患者出现术后皮肤瘀斑。术后随访12~24个月,均未发现复发。所有患者恢复良好,31例(91%)对治疗效果和切口外观表示满意。结论 真空辅助乳腺微创旋切系统在自体脂肪移植隆胸术后乳房肿块治疗中具有安全、有效、微创和美观等优势,是一种值得推广的治疗方法。

乳腺1号方口服联合外敷治疗肝郁气滞型乳腺增生的有效性及安全性分析

目的探讨与分析乳腺1号方口服联合外敷治疗肝郁气滞型乳腺增生的有效性及安全性。方法选取2021年5月—2022年5月在北京市密云区中医医院诊治的肝郁气滞型乳腺增生患者70例作为研究对象,根据随机数表法把患者分为联合组与对照组,各35例。对照组给予乳腺1号方口服治疗,联合组给予乳腺1号方口服联合外敷治疗,两组都治疗观察4周,记录治疗的有效性与安全性情况,判定乳房肿块与乳房疼痛评分变化情况,测量乳房直径变化情况,检测血清催乳素与雌二醇含量变化情况。结果所有患者都完成治疗,治疗期间无严重不良反应。治疗后联合组的总有效率高于对照组,但差异无统计学意义(P>0.05)。两组治疗后的乳房肿块硬度评分与乳房疼痛评分、乳房肿块直径都明显低于治疗前(P<0.05),治疗后联合组各项评分及乳房肿块直径明显低于对照组(P<0.05)。两组治疗后的血清催乳素与雌二醇含量都明显低于治疗前(P<0.05),治疗后联合组也明显低于对照组(P<0.05)。结论乳腺1号方口服联合外敷治疗肝郁气滞型乳腺增生能抑制催乳素与雌二醇的释放,促进缩小乳房肿块直径,缓解患者的乳房肿块硬度与乳房疼痛症状,提高总体治疗效果。

非哺乳期复发性乳腺炎的诊断和治疗探讨（附68例分析）

非哺乳期复发性乳腺炎临床表现可分为三种类型：急性乳房脓肿、乳房肿块和慢性瘘管。Ｂ超、细针穿刺细胞学检查和病理检查最具诊断价值。作者认为对乳房脓肿作单纯切开引流常致复发及瘘管形成。有复发者应争取于静止期将所有病变组织及导管广泛切除。表现为炎性肿块者，单用药物治疗常导致复发。只要炎症局限良好，即使有中央脓肿形成，仍应作肿块及周围病变组织和导管切除术。慢性瘘管者，可作瘘管切开、扩大引流，或搔刮术。若能同时切除周围的炎症肉芽和扩张的导管，效果更好。久治不愈的瘘管、严重变形的乳房，才考虑作单纯乳房切除术。部分年轻患者可同期或分期行乳房整形术。