Objective:To investigate the clinical characteristics and clinicopathological correlations of bilateral breast cancer(BBC)in China.Methods:Data of 440 patients diagnosed with BBC in 2018 were collected from 33 centers...Objective:To investigate the clinical characteristics and clinicopathological correlations of bilateral breast cancer(BBC)in China.Methods:Data of 440 patients diagnosed with BBC in 2018 were collected from 33 centers of the Chinese Society of Breast Surgery.Demographic characteristics,bilateral tumor characteristics,and comprehensive treatment data were obtained.Correlations between the clinicopathological characteristics of bilateral tumors were analyzed.Results:The proportion of BBC was 0.22%-3.08%.A total of 33(7.5%)patients had a family history of malignant tumors,304(69.1%)patients had synchronous BBC.Only 1(0.2%)patient was male.More than half of all patients received concurrent or asynchronous endocrine/chemotherapy,32.5%of all human epidermal growth factor receptor 2(HER2)-positive patients received HER2-targeted therapy,and approximately 21.6%of all patients received radiotherapy.The most common pathological cancer type was invasive ductal cancer(>60%).Approximately 70%of all patients had bilateral hormone receptor(HR)-positive tumors and presented with a single breast mass.Significant correlations were found with pathological type,histological grade,locations of tumor,molecular subtype,Ki-67 index,tumor site and size of bilateral tumors.Results of the subgroup analysis showed more clinicopathological characteristics when synchronous BBC was compared with metachronous BBC.Conclusions:In China,the clinicopathological characteristics of bilateral tumors showed significant correlations,and more significant clinicopathological correlations were observed when synchronous BBC was compared with metachronous BBC.展开更多
BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically ...BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.展开更多
<strong>Purpose:</strong><span style="font-family:""><span style="font-family:Verdana;"> The study was performed comparing dosimetric characteristics of volumetric modu...<strong>Purpose:</strong><span style="font-family:""><span style="font-family:Verdana;"> The study was performed comparing dosimetric characteristics of volumetric modulated arc therapy (VMAT) and field-in-field (FiF) techniques on a patient with synchronous bilateral breast carcinoma. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> The patients with bilateral breast cancer treatment were included in this study. A total dose of 40.05 Gy in 15 fractions was prescribed to the Planning Target Volume (PTV) of the whole bilateral breast cancer with the supraclavicular and infraclavicular nodes, with a complementary boost of 10 Gy in 4 fractions to the surgical bed (PTV</span><sub><span style="font-family:Verdana;">boost</span></sub><span style="font-family:Verdana;">). For both radiotherapy techniques, several V</span><sub><span style="font-family:Verdana;">xGy</span></sub><span style="font-family:Verdana;"> parameters were analyzed for the PTVs, together with the Conformity index (CI), the Homogeneity index (HI) and the critical organs at risk (OARs), lungs and heart. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The patient was treated by the VMAT technique and the daily treatment time was less than 20 minutes with daily CBCT imaging. In the VMAT plan, the PTV 95% dose covered 38.89 ± 0.81 Gy, compared to 37.26 ± 1.02 Gy in the FiF technique. The VMAT plan improved the dose homogeneity index and lower dose in lung towards high dose region. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The study demonstrates the viability of the VMAT technique in the treatment of bilateral breast cancer. The introduced single isocentric VMAT technique is fast to deliver and it increases the dose homogeneity of the target volume with some limitations. The treatment was well tolerated, without interruption of the treatment courses caused by treatment</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">related toxicities.</span>展开更多
<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer is the most common cancer diagnosed worldwide, synchronous bil...<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer is the most common cancer diagnosed worldwide, synchronous bilateral breast cancer accounts for </span><span style="font-family:Verdana;">unique</span><span style="font-family:Verdana;"> entity of the disease, particularly post-operative radiotherapy for Synchronous Bilateral Breast Cancer (SBBC) is challenging with </span><span style="font-family:Verdana;">lack</span><span style="font-family:Verdana;"> of evidence about the best irradiation technique. In this </span><span style="font-family:Verdana;">study</span></span><span style="font-family:Verdana;">,</span><span style="font-family:""><span style="font-family:Verdana;"> we tried to explore the optimum radiotherapy technique regarding the dosimetric parameters. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We recruited 15 SBBC patients in whom </span><span style="font-family:Verdana;">post-operative</span><span style="font-family:Verdana;"> radiotherapy was indicated and we established three plans for each patient using 3DCRT, IMRT </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> VMAT, and then we compared the three plans as regard target volume coverage parameters and organs at risk (OAR) doses. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We found that PTV coverage parameter was superior with IMRT compared with 3DCRT and VMAT in terms of Dmean (p = 0.001), D95% (p = 0.001), D</span><sub><span style="font-family:Verdana;">max</span></sub><span style="font-family:Verdana;"> (p = 0.0001), conformity index (p = 0.0001) and HI (p = 0.0001). Doses to OAR w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> not significantly different between the three techniques in </span><span style="font-family:Verdana;">cardiac</span><span style="font-family:Verdana;"> dose and LAD maximum dose, but 3DCRT was superior in LAD mean dose (p = 0.03) and lung volume receiving 20 Gy (V20) and 10 Gy (V10) (p = 0.0001), but this difference was non-significant between 3DCRT and IMRT (p = 0.4 and 0.06 respectively), while VMAT led to the highest doses to LAD and lung. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">IMRT showed the best target coverage parameters in post-operative radiotherapy for SBBC compared with 3DCRT and VMAT. For OAR doses IMRT showed comparable results with 3DCRT</span></span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">while</span><span style="font-family:""><span style="font-family:Verdana;"> VMAT delivered </span><span style="font-family:Verdana;">a significantly higher dose</span><span style="font-family:Verdana;"> to OAR.</span></span>展开更多
基金supported by the National Natural Science Foundation of China(No.81673762)Provincial Foundation of Liaoning(No.2019-BS-072,No.2019-ZD0780)Innovation Foundation of Dalian(No.2018J11CY026)。
文摘Objective:To investigate the clinical characteristics and clinicopathological correlations of bilateral breast cancer(BBC)in China.Methods:Data of 440 patients diagnosed with BBC in 2018 were collected from 33 centers of the Chinese Society of Breast Surgery.Demographic characteristics,bilateral tumor characteristics,and comprehensive treatment data were obtained.Correlations between the clinicopathological characteristics of bilateral tumors were analyzed.Results:The proportion of BBC was 0.22%-3.08%.A total of 33(7.5%)patients had a family history of malignant tumors,304(69.1%)patients had synchronous BBC.Only 1(0.2%)patient was male.More than half of all patients received concurrent or asynchronous endocrine/chemotherapy,32.5%of all human epidermal growth factor receptor 2(HER2)-positive patients received HER2-targeted therapy,and approximately 21.6%of all patients received radiotherapy.The most common pathological cancer type was invasive ductal cancer(>60%).Approximately 70%of all patients had bilateral hormone receptor(HR)-positive tumors and presented with a single breast mass.Significant correlations were found with pathological type,histological grade,locations of tumor,molecular subtype,Ki-67 index,tumor site and size of bilateral tumors.Results of the subgroup analysis showed more clinicopathological characteristics when synchronous BBC was compared with metachronous BBC.Conclusions:In China,the clinicopathological characteristics of bilateral tumors showed significant correlations,and more significant clinicopathological correlations were observed when synchronous BBC was compared with metachronous BBC.
文摘BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.
文摘<strong>Purpose:</strong><span style="font-family:""><span style="font-family:Verdana;"> The study was performed comparing dosimetric characteristics of volumetric modulated arc therapy (VMAT) and field-in-field (FiF) techniques on a patient with synchronous bilateral breast carcinoma. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> The patients with bilateral breast cancer treatment were included in this study. A total dose of 40.05 Gy in 15 fractions was prescribed to the Planning Target Volume (PTV) of the whole bilateral breast cancer with the supraclavicular and infraclavicular nodes, with a complementary boost of 10 Gy in 4 fractions to the surgical bed (PTV</span><sub><span style="font-family:Verdana;">boost</span></sub><span style="font-family:Verdana;">). For both radiotherapy techniques, several V</span><sub><span style="font-family:Verdana;">xGy</span></sub><span style="font-family:Verdana;"> parameters were analyzed for the PTVs, together with the Conformity index (CI), the Homogeneity index (HI) and the critical organs at risk (OARs), lungs and heart. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The patient was treated by the VMAT technique and the daily treatment time was less than 20 minutes with daily CBCT imaging. In the VMAT plan, the PTV 95% dose covered 38.89 ± 0.81 Gy, compared to 37.26 ± 1.02 Gy in the FiF technique. The VMAT plan improved the dose homogeneity index and lower dose in lung towards high dose region. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The study demonstrates the viability of the VMAT technique in the treatment of bilateral breast cancer. The introduced single isocentric VMAT technique is fast to deliver and it increases the dose homogeneity of the target volume with some limitations. The treatment was well tolerated, without interruption of the treatment courses caused by treatment</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">related toxicities.</span>
文摘<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer is the most common cancer diagnosed worldwide, synchronous bilateral breast cancer accounts for </span><span style="font-family:Verdana;">unique</span><span style="font-family:Verdana;"> entity of the disease, particularly post-operative radiotherapy for Synchronous Bilateral Breast Cancer (SBBC) is challenging with </span><span style="font-family:Verdana;">lack</span><span style="font-family:Verdana;"> of evidence about the best irradiation technique. In this </span><span style="font-family:Verdana;">study</span></span><span style="font-family:Verdana;">,</span><span style="font-family:""><span style="font-family:Verdana;"> we tried to explore the optimum radiotherapy technique regarding the dosimetric parameters. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We recruited 15 SBBC patients in whom </span><span style="font-family:Verdana;">post-operative</span><span style="font-family:Verdana;"> radiotherapy was indicated and we established three plans for each patient using 3DCRT, IMRT </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> VMAT, and then we compared the three plans as regard target volume coverage parameters and organs at risk (OAR) doses. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We found that PTV coverage parameter was superior with IMRT compared with 3DCRT and VMAT in terms of Dmean (p = 0.001), D95% (p = 0.001), D</span><sub><span style="font-family:Verdana;">max</span></sub><span style="font-family:Verdana;"> (p = 0.0001), conformity index (p = 0.0001) and HI (p = 0.0001). Doses to OAR w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> not significantly different between the three techniques in </span><span style="font-family:Verdana;">cardiac</span><span style="font-family:Verdana;"> dose and LAD maximum dose, but 3DCRT was superior in LAD mean dose (p = 0.03) and lung volume receiving 20 Gy (V20) and 10 Gy (V10) (p = 0.0001), but this difference was non-significant between 3DCRT and IMRT (p = 0.4 and 0.06 respectively), while VMAT led to the highest doses to LAD and lung. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">IMRT showed the best target coverage parameters in post-operative radiotherapy for SBBC compared with 3DCRT and VMAT. For OAR doses IMRT showed comparable results with 3DCRT</span></span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">while</span><span style="font-family:""><span style="font-family:Verdana;"> VMAT delivered </span><span style="font-family:Verdana;">a significantly higher dose</span><span style="font-family:Verdana;"> to OAR.</span></span>