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Objective To investigate ultrasonographic (US) features of mucinous breast carcinoma with pathological correlation and to improve the early diagnosis for the mucinous breast carcinoma.Methods Twenty-two patients with 23 focuses mucinous carcinoma of the breast confirmed by pathology were included in this study,retrospectively evaluate sonographic features according to the American College of Radiology(ACR) Breast Imaging Reporting and Data System(BI-RADS) Lexicon,all cases were classified by BI-RADS before operation.Histological type of mucinous breast carcinoma included mixed and pure two forms,the latter was classified into cellular variants and hypocellular variants.The correlation between the ultrasonographic findings of mucinous carcinoma and histologic features in different types were analysed.Results On US examination,all 22 cases presented as solid mass.In pure form,they showed well-defined margins with no pseudocapsule and isoechogenic or hypoechoic internal echo pattern relative to that of subcutaneous fat in 86.7％ (13/15) focuses which histological type were pure type.93.3％ (14/15) of pure type focuses had posterior enhancement.All pure type focuses demonstrated that the orientation of the mass is parallel to the skin line.75.0％ (6/8) of mixed type focuses and 13.3％ (2/15) of pure type focuses,however,demonstrated ill-defined and or spiculated margins with more hypoechogenic structure (P ＜0.01).Mixed type focuses have more aggressive malignant features.65.2％ (15/23) of cases being classified as BI-RADS 4 or 5 were suspected as malignancy,which included 6 mixed type focuses and 9 pure type respectively accounting for 75.0％ (6/8) and 60.0％ (6/15) of each type focuses.Conclusions Mucinous breast carcinoma especial pure type did not have the typical malignant breast masses sonographic features,which showed some benign masses sonographic features except no pseudocapsule benign feature.Mixed type mucinous carcinomas tumors have more aggressive margin imaging characteristics.It is suggested that mucinous breast carcinoma should be classified category 4 by BI-RADS to avoid diagnosis delay.
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Objective:To explore the clinical value of stereotactic wire-localized biopsy(SWLB)in digital mammography in the detection of microcalcification of the breast.Methods:A total of 45 patients with nonpalpable breast lesions which were positive for microcalcification by mammography but could not be detected clinically underwent SWLB.Their mammography fndings were analyzed in detail with pathology.Results:Among the 45 cases,13 cases(28.9%)had malignant lesions including ductal carcinoma in situ in 3 cases (20.1%),ductal carcinoma in situ with microinvasion in 4 cases(30.8%),invasive ductal carcinoma in 5 cases (38.5%)and intraductal papillary carcinoma in 1 case(7.7%).Thirty-two cases(71.1%)had benign lesions,2 cases(6.3%)of which were severe atypical hyperplasia.Conclusion:SWLB can accurately guide the surgical excision of nonpalpable breast microcalcification lesions and diagnose microcalcifications exactly,which is helpful for increasing the detection rate of eady-stage breast cancer.
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Objective To observe the iffectiveness of comprehensive rehabilitationinterventions on stroke patients with unilateral spatial neglect (USN). Methods A total of 245 cases if strijd were examined to diagnose USN. Of the 245 patients,86 cases were diagnosed as being with USN, and divided into a control group(n=43 cases) and a treatment group (n=43 cases) randomly. The control group was treated with Bobath and Rood techniques in addition to routine clinical medical interventions, while the treatment group was treated with a comprehensive rehabilitation protocol for USN in addition to the same interventions for the control group. Both groups were assessed with regard to motor, balance function, walking performance, and USN severity as well as the activities of daily living (ADL) performance. Results After 8 weeks of treatment,both groups improved, but there showed a significantly statistical difference between the 2 groups in terms of Fugl-Meyer motor function scores (P＜0.01), balance function scores (P＜0.01) Holden walding function classifications (P＜0.01), Barthel index(P＜0.001) and USN severity scores(P＜0.01). Conclusion Comprehensive USN rehabilitation intervention could improve motor, balance, walking functions and ADL performance and alleviate the USN severity in stroke patients with USN.
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BACKGROUND: Recently the prevalence rate of mass in mammary gland increases significantly than before. To use which kind of technology is not only related with the post-operation recurrence, but also related with the reconstruction of their confidence. Therefore, how to reduce the trauma physically and psychologically in patients to the maximal degree has become the chief factor to choose technology by surgeons.OBJECTIVE: To observe the effects of transverse rectus abdominis musculocutaneous (TRAM) flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis after skin-sparing mastectomy with immediate breast reconstruction.DESIGN: Case analysis.SETTING: Department of Plastic Surgery, Shenzhen People's Hospital,Second Clinical Medical College of Jinan University.PARTICIPANTS: A total of 15 ductal carcinoma in situ (DCIS) and huge breast benign tumor patients were enrolled into Shenzhen People's Hospital between October 1997 and May 2004, aged from 20 to 46 years. They all got disease in single breast, and 8 of them had preoperative diagnosis of DCIS, T1N0M0 and 7 of them had huge breast benign tumor. Operation program was informed to the patients before operation so as to gain their agreement.METHODS: Skin-sparing mastectomy was performed with circular shape incision at areola and using TRAM flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis to fill breast. Slight skin of musculo-cutaneous flap could compensate the nipple and areola when performing reconstruction. At the reoperation, nipple was made at the transferred flap.MAIN OUTCOME MEASURES: To observe the patients with or without recurrence or transfer after operation and local healing of wound.RESULTS: With the cooperation of general surgeons the operation was done in 15 cases and 14 cases of them were followed up for more than 1 year. The reconstructed breasts were with good symmetry with the opposite one, normal skin sensation, natural shape and inconspicuous scar.CONCLUSION: This is an excellent alternative method for mastectomy and breast reconstruction based on the avoidance of recurrence of breast cancer in severe operation.
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Objective To study the method of biological dye injection for detecting sentinel lymph node(SLN) in breast cancer, and explore the accuracy of evaluating axillary lymph node status by SLN biopsy(SLNB). Methods Intro-dermal methylthionium injection during operation was applied to identify SLN in 71 breast cancer patients, and the detection results were compared with the metastasis status of dissected axillary lymph nodes. Results SLN was identified in 70 of 71 patients(97%) using methylthionium injection. Total 188 SLNs were detected in all patients, each patient having 1～4 SLNs(average 2 7). The false negative rate of methylthionium injection for detecting SLN was 2%(1/42). The sensitivity, specificity and accurate rate of SLN to predict axillary lymph node metastasis status were 96%, 100% and 97% respectively. Conclusion Intro-dermal methylthionium injection can identify SLN and accurately predict the axillary lymph node status . This method is cheap and can be widely used.
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Objective To explore the effect of breast-conserving operation for the treatment of early-stage breast cancer. Methods From November 1999 to Octorber 2001, the patients with early-stage breast cancer were treated with breast-conserving surgery followed by radical irradiation according to the patients' will. The cosmetic results and quality of life were analyzed after surgery and radiation. Results In all the patients received operation treatment from 1999 to 2001, eighteen patients were treated with breast-conserving surgery with breast conservation rate of 10.2%, of which 7 cases with quadrantetomy plus axillary lymph node dissection (ALND), 8 cases with lumpectomy plus ALND and 3 cases with lumpectomy. Pathological staging was as follow: 4 cases in stage 0, 12 cases in stage Ⅰ, and 2 cases in stage Ⅱ. All cases were followed-up. The cosmetic results were good in 94%(17/18) and fair in 6%(1/18). All the patients had not local recurrence and distant metastasis. Conclusions Breast-conserving surgery followed by radiation therapy is superior to mastectomy in terms of improving breast cosmesis and quality of life. Postoperative radiation therapy does not affect the cosmetic result.