Clinical, Prognostic and Socio-Economic Aspects of T4 Breast Cancers in Ouagadougou, Burkina Faso: A Retrospective Study

Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this study to present the clinical and prognostic aspects of T4 breast cancer in Ouagadougou. It was a descriptive retrospective study based on the medical record of patients received from January 1, 2017 to December 31, 2021 in the cancer department of Yalgado Ouedraogo University Hospital. Patients followed for histologically confirmed breast cancer who were classified in the cT4 category of the TNM code 8e edition were included. We collected a total of 286 patients. Non-salaried patients accounted for 90.56%. In this study, 53.3% of patients lived in urban area and 36.7% in rural area. Menopausal patients accounted for 56.8% of cases. One hundred and thirty-three (46.5%) patients were overweight or obese and 121 (42.3%) patients had a normal weight. The average consultation time, which is the time between the first signs and consultation in a specialized center, was 12 months, with a median of 11 months. According to category T of the TNM code, 19 patients (6.6%) were classified T4d, 176 (61.5%) were classified T4c, 69 (24.1%) were classified T4b and 22 (7.7%) T4a. One hundred and twenty patients (42%) were metastatic. The median overall survival of all patients in our sample was 20 months. In univariate analysis, metastatic status was risk factor for death, while obesity and surgery were protective factors. In multivariate analysis, obesity, surgery and metastatic status were independently associated with survival;obesity and surgery were protective factors. Survival is poor due to advanced stages and difficulties in the management of these cancers. Measures to facilitate access to care would improve the prognosis of these cancers.

Clinical characteristics and prognosis of triple-negative breast cancer

客观我们调查了临床的特征，和三元组否定的乳癌的预示的因素。130 个三元组否定的乳癌病人在临床的特征和预后上被考察的方法。所有情况是免疫组织化学决定的雌激素受体，孕酮受体，和 HER2/neu 的表示的缺乏。结果 17.1% 所有乳癌病人(774 个案例) 是三元组否定的乳癌，并且 68.9% 三元组否定的乳癌病人(91 个案例) 是绝经前的。53.8% 病人(71 个案例) 与 T2 尺寸有肿瘤，并且(52 个病人) 他们中的 39.4% 个有淋巴节点转移。没有淋巴节点转移，在有淋巴节点转移的病人的恶化的率在病人显然比那高(P = 0.001 ) 。后续的中部的时间是 63 个月。33 案例 relapsed 和 20 个病人死了。23 个病人有至少二机关转移。5 年的没有疾病、全面的幸存率是 73.8% 和 85.7% 。结论三元组否定的乳癌病人通常在治疗以后在 2 3 年里有多重远转移的高率。淋巴节点的地位是最重要的预示的因素。有淋巴节点转移的三元组否定的胸 caner 病人有差的预后。

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.

Breast Cancer: Epidemiological, Clinical, and Therapeutic Aspects in Pointe Noire (Congo Brazzaville)

Introduction: Breast cancer is the leading cancer and the leading cause of cancer death in women worldwide. The objective of our study was to describe the epidemiological, clinical and therapeutic aspects of breast cancer at the General Hospital of Loandjili in Pointe Noire. Patients and Methods: This was a descriptive and cross-sectional study that took place in the Cancer Department of the General Hospital of Loandjili in Pointe Noire during the period from January 1st, 2012 to December 31st, 2016 for duration of 5 years. 54 records of patients over 18 years of age with histological evidence were collected. The variables studied were: age, level of education, time to presentation, telltale sign, stage of extension, histological type, and histological grade. Chi-square test was used to compare variables and groups. Results: At the end of this study, we collected 54 files of breast cancer patients from 150 patients hospitalized in the Cancer Department. The frequency of breast cancer was 36%. The average age was 50 ± 13.6 years;the extremes were 27 years and 79 years. The most represented age group was from 37 to 40 years old with a percentage of 28%. The patient’s level of study was primary in the majority of cases (57%). The most represented histological type was invasive ductal carcinoma, (100%). The majority of patients arrived at advanced stages 44.4% and metastatic stages 26%. Patients were treated in most of cases by chemotherapy (82%), surgery (42%) and radiotherapy (10%). There was a correlation between time of presentation and stage of extension. Conclusion: Breast cancer is the first cancer of the woman in Pointe Noire. Patients arrive at advanced stages;the most common histological type is invasive ductal carcinoma. The presentation time is correlated with the extension stage. These results suggest the establishment of a cancer control program in developing countries.

Epidemiological and Clinical Profile of Breast Cancer at Bamako Radiotherapy Center

Breast cancer is a major public health problem because of its incidence and mortality. Purpose: To establish the epidemiological and clinical characteristics of breast cancer seen at the radiotherapy center at the Mali Hospital of Bamako. Patients and methods: It was a retrospective, descriptive study of data from patients seen for breast cancer at the Center of Radiotherapy of Mali Hospital between April 2014 and December 2016. The parameters studied were: age, sex, family history of breast cancer, menopausal status, parity, breast tumor location, histological type, histological grade, cancer classification stage. Results: 134 cases of breast cancer were collected, with a frequency of 15%. The sex ratio (H/F) of 0.007. The patient’s mean age was 47 ± 11 years old. The most represented age groups were 33 - 47 years old with 45.5% and 48 - 62 years old with 39%. Three percent (3%) of patients had a family history of breast cancer. Fifty (50%) of the patients were menopausal. The main clinical signs found were : mammary nodules (98%), mastodynia (65%), nodes (67%). Invasive ductal carcinomas were found in 94% of patients, followed by infiltrating lobular carcinomas with 3.7% and metaplastic carcinomas with 1.7%. SBR Grades II and III were mostly found with 37% and 23%. The average tumor size was 87 mm ± 43. Stage III was predominantly represented with 72%, followed by Stage II with 24% and Stages I and IV with 2% each. Conclusion: Breast cancer is common and reaches both before and after 50 years;the diagnosis is usually late;hence it is the importance of raising awareness and screening before the age of 50 and popularizing some complementary tests to better understand the prognosis of this disease and promote more targeted and conservative treatments that will improve survival.

Clinical and Histological Profile of Breast Cancer at University Clinics of Kinshasa, Democratic Republic of Congo

Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced cancers and inflammatory forms. Objectives: To describe the socio-demographic, clinical and histological characteristics of breast cancer at the University Clinics of Kinshasa. Methods: A descriptive and retrospective study was completed at University Clinics of Kinshasa from 1 January 2003 to 30 July 2018, including 300 cases of breast cancer diagnosed and treated. Results: The mean age of women at diagnosis was 47.5 ± 10.8 years. Most of the patients were married, multipara with an average parity of 3.7 ± 2.5 and non-menopausal. Breast mass was the main reason for medical visit (47.5%) and the majority of patients consulted 12 months after the onset of the disease (36.3%) at stage 3 (56%) and node extension was observed in 61.3%. The average size of the breast mass was 8.02 ± 3.7 cm. The infiltrating ductal carcinoma was the most common histological type in 82.5% of cases;the majority of tumors were histo-pronostic II in 47.5% of cases. 83% of the tumors were hormonal-dependent. Only 35.9% of the tumors over-expressed the HER 2/Neu receptor. Conclusion: Most patients consulted more than 12 months after the onset of the disease and the diagnosis was made at advanced stages. The tumor was large at diagnosis. The left breast was the most affected. The majority of tumors are of high histopronostic grade and are hormonal-dependent.

Epidemiological Clinical and Histological Aspects of Gynecological and Breast Cancer in Pointe Noire (Congo Brazzaville)

INTRODUCTION: The objective of our study was to determine the epidemiological clinical and histological aspects of gynecological and breast cancers in Pointe-Noire. PATIENTS AND METHODS: This was a retrospective descriptive study that took place in the cancerology and internal medicine department during the period from January 1, 2012 to December 31, 2021, i.e. a period of 10 years. Women with histological diagnosis of gynecological and breast cancers were included in our study. The variables studied were: frequency, age, alcohol and tobacco consumption, histological type, stage of extension, location of cancer. Bivariate analysis was done between age and location of the tumour. The statistical test used was the KHI2 test. The results were statistically significant for a value of p RESULTS: We collected 400 files from women with cancer. Among the 400 files, 265 were represented by gynecological and breast cancers, that is a frequency of 65.43%. Among the 265 cases of gynecological and breast cancer identified during this study period, breast cancer represented the first rank with 52% frequency. Cervical cancer accounted for 41% followed by ovarian cancer (5%) and endometrial (2%). Cancer of vulva was represented by a single case. The average age of patients with gynecological and breast cancers during our study was 52 ± 12 years. The average age of patients with cancer of the breast, cervix, ovarian, endometrial was respectively 49 ± 11.97 years, 54.73 ± 12.91 years old, 50 ± 14 years, 67 ± 14.24 years, the age of the vulva cancer patient was 51 years old. The histological type of breast cancer was represented by infiltrating ductal adenocarcinoma in 91% of cases, invasive lobular carcinoma in 7% and sarcoma in 2%. Cervical cancers were represented by squamous cell carcinomas in 95% of cases and adenocarcinomas in 5% of cases. Vulva cancer was represented by squamous cell carcinoma, ovarian cancer was represented by epithelial tumors (adenocarcinoma) in 100% of cases. Endometrial cancers were represented by endometrial adenocarcinoma. All cancers were diagnosed at advanced stages (locoregional and metastatic stage). Patients over the age of 50 had more gynecological and breast cancers;but this result was not significant. CONCLUSION: Gynecological and breast cancers are frequent and constitute the first cancer of Congolese women in Pointe-Noire. Breast cancer is the first cancer followed by cancer of the cervix and ovaries. The histological types are those of the literature. Patients with gynecological and breast cancers consult at very advanced stages.

Analysis of the Clinicopathologic Features and Prognosis in Triple-Negative Breast Cancer

OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identifi ed as triple negative breast cancer,ie defi ned as ER,PR and Her-2 negative.The other group was non-triple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival(DFS) analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4%(109/509) of cases were found to be triple-negative while 78.6%(400/509) were non-triple-negative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors(P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1%(23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a signifi cant difference(P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically signifi cant difference between the 2 groups(P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.

New generation of breast cancer clinical trials implementing molecular profiling

The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnerabilities. In particular, there is an increasing list of molecularly targeted anticancer agents undergoing clinical development that aim to block specific molecular aberrations. This leads to a paradigm shift, with an increasing list of specific aberrations dictating the treatment of patients with cancer. This paradigm shift impacts the field of clinical trials, since the classical approach of having clinico-pathological disease characteristics dictating the patients' enrolment in oncology trials shifts towards the implementation of molecular profiling as prescreening step. In order to facilitate the successful clinical development of these new anticancer drugs within specific molecular niches of cancer diagnoses, there have been developed new, innovative trial designs that could be classified as follows: i)longitudinal cohort studies that implement(or not) "nested" downstream trials, 2) studies that assess the clinical utility of molecular profiling, 3) "master" protocol trials, iv) "basket" trials, v) trials following an adaptive design. In the present article, we review these innovative study designs, providing representative examples from each category and we discuss the challenges that still need to be addressed in this era of new generation oncology trials implementing molecular profiling. Emphasis is put on the field of breast cancer clinical trials.

Prediction of Nipple and Areola Complex Invasion in Breast Cancer Patients. Clinical and Pathological Study of Surgical Specimens

Breast conservation surgery (BCS) and nipple-areola-sparing (NAS) mastectomy have been recognized as two milestones in this period. This study included 60 Egyptian female patients with breast cancer, all of them were subjected to modified radical mastectomy operation. Methods: This study included female patients > 18 years old who have breast cancer with healthy looking non invaded skin of nipple and areola and excluded patients < 18 years old, patients unfit for surger, patients previously subjected to chemo or radiotherapy for breast cancer. We peformed clinical examination of 60 patients with breast cancer. We studied the relevant factors that affect NAC invasion such as patient’s age, menstrual state, family history, tumor size, tumor location (central vs peripheral), tumor to nipple distance, lymphovascular invasion of NAC, lymph node metastasis, histological tumor type, tumor stage, multifocal/multicentric tumors and (ER, PR, HER2) status. Result: In our study, we have shown that NAC invasion is strongly associated with: 1) Nipple retraction as a patient’s complaint;2) Tumor site;3) Tumor-nipple-distance ≤ 4 cm;4) Multifocal/multicentric tumor;5) Tumor grade (grade III tumors);6) Positive lymph node invasion;7) ER and PR receptors negativity;8) HER2 positivity. This helps in preoperative planning for selecting patients for NAS mastectomy. Conclusion: The ideal patients for NAS mastectomy are with these criteria: 1) Clinically normal nipple areola complex;2) Distance from the tumor to the nipple is >4 cm;3) No multifocal/multicentric tumor;4) Absence of lymph node invasion;5) Tumor grade (grade I, II);6) Peripheral not central tumor;7) No sub-areolar lymphovascular invasion (LVI);8) ER receptor positive;9) PR receptor positive;10) HER2 negative.

乳腺肿瘤整形保乳手术治疗乳腺癌的临床效果研究

目的探究在乳腺癌患者的治疗中乳腺肿瘤整形保乳手术的临床应用效果。方法106例乳腺癌患者,按入院顺序编号分组,奇数者划至对照组,偶数者划至研究组,各53例。对照组以改良根治术治疗,研究组以整形保乳手术治疗。比较两组临床手术指标、术后并发症发生情况、手术前后血清肿瘤标志物水平、乳房美观满意度。结果研究组患者手术时间(129.74±10.65)min、术中失血量(64.29±9.31)ml、切口长度(4.64±1.19)cm、住院时间(4.88±1.10)d均优于对照组的(150.07±10.53)min、(86.71±10.29)ml、(10.48±3.74)cm、(5.92±1.21)d,组间比较统计学差异明显(P<0.05)。研究组并发症发生率5.66%低于对照组的22.64%,组间比较统计学差异明显(P<0.05)。两组术后癌抗原153(CA153)和癌胚抗原(CEA)均低于术前,统计学差异明显(P<0.05)。研究组患者对乳房美观的总满意度为96.23%,高于对照组的81.13%,组间比较统计学差异明显(P<0.05)。结论对于乳腺癌患者的手术治疗来说,乳腺肿瘤整形保乳手术的实施,可以在保证原有治疗效果的基础上,改善临床手术指标,减少术后并发症风险,同时满足患者在乳房美观度方面的要求,由此可见其良好的临床应用价值,因此可以于临床展开大力推广。

自制乳腺肿物模型训练法在超声导丝定位穿刺实践教学中的效果评价

目的探究自制乳腺肿物穿刺模型在临床超声介入教学中的应用效果。方法选取2021年1月—2022年12月黑龙江中医药大学附属第二医院超声影像学专业及康复医学专业的50名规培生为研究对象,按照不同规培时间将其分为研究组和对照组,每组25名,其中对照组规培时间为2021年1—12月,研究组规培时间为2022年1—12月。对照组规培生予传统教学法,即课堂理论教学结合高强度琼脂乳腺教学模型进行训练;研究组规培生在课堂理论教学的基础上再结合自制乳腺肿物模型实操训练;待学习结束后统一对两组规培生进行理论及实践考核以及学习满意度调查,比较对照组及研究组的学习结果。结果两组规培生的理论考核成绩差异比较,差异无统计学意义(P>0.05)。研究组规培生的操作考核成绩明显高于对照组学生,差异有统计学意义(P<0.05)。研究组规培生在增强操作技能、激发理论兴趣、丰富教学内容等各个方面评分均有较高的满意度,且显著高于对照组,差异有统计学意义(P均<0.05)。结论自制乳腺肿物穿刺模型能使学生更好地将超声介入技术应用于今后的临床操作中,有效提高教师的临床教学质量及学生的超声穿刺水平。

乳腺癌合并间质性肺疾病患者的临床特征及治疗情况

目的分析乳腺癌合并间质性肺疾病(ILD)患者的临床特征及治疗情况。方法收集76例乳腺癌患者的病历资料,分析其临床特征、检查结果、抗肿瘤药物的使用、ILD的发生及治疗情况。结果76例乳腺癌合并ILD患者中,9例患者无明显症状,其余67例均存在呼吸道等方面的症状;胸部CT检查均呈现不同程度的间质改变,其中52例患者表现为不同程度的低氧血症和呼吸衰竭;患者接受系统性化疗46例,靶向药物27例,恩美曲妥珠单抗2例,内分泌药物氟维司群1例;紫杉类药物ILD发生情况最多,靶向药物中依维莫司ILD发生情况最多,内分泌药物ILD发生情况最少;9例患者不良事件通用术语标准(CTCAE)分级为1级,59例CTCAE分级为2级,8例患者CTCAE分级为3级;所有患者经过治疗后ILD情况均明显好转。结论引起ILD的抗肿瘤药物主要以紫杉类及吉西他滨等细胞毒性药物和雷帕霉素靶蛋白(MTOR)抑制剂靶向药物为主。掌握ILD患者的临床特征及治疗方法,并有针对性地为乳腺癌合并ILD患者选择适宜的治疗方案,既可以增加药物疗效,也可以减少药物的不良反应,改善患者预后。

Clinical experience in treating 78 cases of upper limb edema after breast cancer operation by WenYang HuoXue Washing Prescription

观察中药温阳活血泡洗法治疗乳腺癌术后上肢水肿的临床疗效及安全性.方法给予符合入组标准的 78例阴证乳腺癌术后上肢水肿患者温阳活血泡洗方患臂湿敷及护理指导,观察治疗前、治疗后 14d患肢症状评分,最终评价临床总有效率.结果：显效23例,有效 41例,无效14例,总有效率为 82.1%,而根据水肿分期Ⅰ期与Ⅱ期比较,两组无显著性差异（P〉0.05）;研究期间未发生任何不良事件.结论：中药温阳活血泡洗方能有效改善乳腺癌术后上肢水肿寒症患肢不适症状,值得临床推广应用.

乳腺癌组织中bFGF、Ki-67及ADAM15表达情况及与其临床病理特征的相关性分析

目的 探讨乳腺癌组织中碱性成纤维细胞生长因子(bFGF)、Ki-67及去整合素金属蛋白酶15(ADAM15)表达情况及其与临床病理特征的关系。方法 选取87例乳腺癌患者作为研究对象,均行手术治疗,采集肿瘤标本及癌旁标本行免疫组化染色检查,比较肿瘤组织及癌旁组织内bFGF、Ki-67及ADAM15表达情况,并分析bFGF、Ki-67及ADAM15表达与其临床病理特征的关系。结果 肿瘤组织内bFGF、Ki-67及ADAM15阳性率高于癌旁组织,差异有统计学意义(P<0.05);bFGF阳性组肿瘤Ⅲ~Ⅳ期、有淋巴结转移、肿瘤直径≥3 cm占比高于bFGF阴性组,差异有统计学意义(P<0.05);Ki-67阳性组肿瘤Ⅲ~Ⅳ期、有淋巴结转移、肿瘤直径≥3 cm占比高于Ki-67阴性组,差异有统计学意义(P<0.05);ADAM15阳性组肿瘤Ⅲ~Ⅳ期、有淋巴结转移、肿瘤直径≥3 cm占比高于ADAM15阴性组,差异有统计学意义(P<0.05)。结论 bFGF、Ki-67及ADAM15在乳腺癌组织内存在较高阳性表达,且与肿瘤分期、淋巴结转移及肿瘤直径存在密切关系,或可作为完善乳腺癌治疗方案的新靶点。

愈灵液对乳腺癌术后皮瓣恢复影响的临床疗效观察

目的:观察愈灵液对乳腺癌术后皮瓣恢复的临床效果。方法:将2018年1月—2022年1月,安徽中医药大学附属滁州中西医结合医院普外科行乳腺癌改良根治术40例患者,随机分为对照组和观察组,每组20例。两组患者均予以相同的改良根治手术以及术后相同的护理方式,对照组采用常规碘伏消毒,观察组在对照组基础上加用愈灵液外敷换药,每三天换药一次,观察15天内住院期间患者皮瓣愈合情况。结果:观察组20例患者皮瓣均无坏死,总有效率100%,对照组无坏死15例,轻度坏死4例,中度坏死1例,总有效率75%,两组比较差异具有统计学意义(P=0.047)。结论:愈灵液能有效减少皮瓣坏死的发生,促进皮瓣恢复,值得临床推广。

乳腺浸润性癌中CD147和PHH3的表达与临床病理特征的关系

目的观察浸润性乳腺癌中CD147蛋白的定量表达和PHH3阳性细胞数目,分析二者与多个临床病理特征的关系及相关性。方法选取80例乳腺原发浸润性癌手术切除标本为研究对象,29例正常乳腺组织作为对照组,采用免疫组织化学SP法检测CD147和PHH3的表达,用IPP6.0图像分析软件对CD147蛋白表达进行定量测试,计数PHH3阳性个数和有丝分裂指数,分析浸润性乳腺癌中CD147和PHH3的表达与临床病理特征的关系,用Spearman法分析二者之间的相关性。结果CD147主要定位于乳腺癌细胞胞膜或膜浆,PHH3主要定位于浸润性乳腺癌有丝分裂的细胞核内,二者在浸润性乳腺癌组织中的定量表达和阳性数目均显著高于正常乳腺组织(P=0.000)。80例浸润性乳腺癌中,CD147蛋白定量表达在肿瘤直径较大、WHO分级较高、淋巴结有转移、TNMⅢ-Ⅳ期、雌激素受体(estrogen receptor,ER)阴性、Her-2基因无扩增阳性强度较高(P均<0.05);PHH3阳性数目和有丝分裂指数在肿瘤直径较大、WHO分级较高、淋巴结有转移状况及TNM分期Ⅲ-Ⅳ期(P_(均)<0.05)。CD147蛋白表达越高,PHH3阳性数目相应越多,有丝分裂指数越高,Spearman分析显示CD147分别与PHH3阳性数目和有丝分裂指数呈显著正相关(r=0.950,r=0.706,P=0.000)。结论浸润性乳腺癌中CD147和PHH3高表达,与肿瘤的发生发展有关,二者呈正相关,检测乳腺癌中CD147蛋白定量表达、PHH3阳性数目和有丝分裂指数有助于侵袭和转移的判断,为乳腺癌临床病理诊断提供了参考价值。

达尔西利在乳腺癌治疗中的研究进展

达尔西利是首个国产原研的细胞周期蛋白依赖性激酶4/6抑制剂,国家药品监督管理局已批准其联合氟维司群或芳香化酶抑制剂治疗激素受体阳性/人表皮生长因子受体2阴性的晚期或转移性乳腺癌。本文主要介绍了达尔西利在乳腺癌中的研究进展,总结药物的作用机制、Ⅰ-Ⅲ期临床试验、以及药物安全性等问题。

2023年改变早期乳腺癌临床实践的重要研究成果及进展

乳腺癌发病率逐年升高,随着肿瘤筛查的普及和人民健康意识的增强,早期乳腺癌的诊断率也明显提高。早期乳腺癌广义上指无远处器官转移的乳腺癌,是相较于晚期乳腺癌的概念。治愈是早期乳腺癌的治疗目标。临床实践的开展应依据循证医学证据,参考指南与共识,给予患者个体化的精准治疗。临床研究作为指南及共识的证据基础,为乳腺癌患者带来更加优化的治疗方案。本文根据2022—2023年国内外重要指南及共识更新,对改变早期乳腺癌临床实践的多项重要临床研究进行归纳和分类,这些研究以分子分型为基础,可分为乳腺癌新辅助治疗和辅助治疗的优化、辅助治疗的升阶梯和降阶梯、局部治疗的优化:人表皮生长因子受体-2(human epidermal growth factor receptor 2,HER2)阳性乳腺癌新辅助治疗和辅助优化治疗的相关研究包括国产原研小分子酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKI)吡咯替尼应用于新辅助治疗的PHEDRA研究;奈拉替尼辅助强化治疗的ExteNET研究;曲妥珠单抗和帕妥珠单抗皮下注射制剂(pertuzumab trastuzumab fixed dose combination subcutaneous injection,PHFDCSC)药代动力学、疗效及安全性的FDChina研究;三阴性乳腺癌(triple-negative breast cancer,TNBC)新辅助治疗和辅助优化治疗的相关研究主要为KEYNOTE-522研究。在辅助治疗的升阶梯方面:高危HER2阳性乳腺癌中曲妥珠单抗(trastuzumab,H)加入帕妥珠单抗(pertuzumab,P)疗效的APHINITY研究;阿贝西利及瑞波西利在早期高危激素受体阳性乳腺癌患者中应用的MonarchE和NATALEE研究;高危绝经前乳腺癌应用卵巢功能抑制剂(ovarian function suppression,OFS)及联合依西美坦或他莫昔芬的SOFT TEXT研究。辅助治疗的降阶梯相关研究为HER2阴性早期中高危乳腺癌6个周期多西他赛联合环磷酰胺辅助化疗的PLAN B研究。在乳腺癌局部治疗相关研究中,包括多中心病灶乳腺癌保乳可行性的ACOSOG Z11102研究,低危乳腺癌豁免腋窝手术的SOUND研究,老年低危乳腺癌患者保乳术后是否可豁免放疗的PRIMEⅡ研究,对比保乳术后全乳放疗后不同加强放疗方案的IMPORT HIGH研究,超大分割放疗的FAST-Forward研究。这些研究为临床实践、诊疗指南和共识的制定提供了扎实的循证医学依据。本文将围绕国内外各项乳腺癌诊疗指南、共识的更新展开,重点就以上重要临床研究对早期乳腺癌临床实践的影响进行讨论。

乳腺佩吉特病患者的临床特征及预后分析

目的探讨乳腺佩吉特病患者的临床特征及预后。方法收集71例乳腺佩吉特病患者的临床资料,分析患者的临床特征及预后,采用多因素Cox回归分析方法对乳腺佩吉特病患者预后的影响因素进行分析。结果71例乳腺佩吉特病患者,诊断时平均年龄56.42岁(32~89岁)。7例患者为单纯佩吉特病,36例患者伴有浸润癌,28例患者伴有原位癌。71例乳腺佩吉特病患者,中位随访时间为108个月(24~245个月),2、5年无病生存率分别为91.5%(65/71)和62.0%(44/71)。T分期晚、N分期晚及孕激素受体(PR)阳性均为乳腺佩吉特病合并浸润癌患者预后的危险因素(P﹤0.05)。N分期晚为乳腺佩吉特病患者预后的危险因素(P﹤0.05)。结论N分期是乳腺佩吉特病患者预后的影响因素,T、N分期及PR状态是乳腺佩吉特病合并浸润癌患者预后的影响因素。