ABSTRACT
Objective Less than a decade ago, ER-positive and PgR-positive diagnostic criteria decrease from 10%to 1%. Up to 20%of current immunohistochemical determinations of ER and PgR worldwide may be inaccu-rate. It is necessary to study patients whose tumors are between luminal A (LABC) and triple-negative (TNBC) breast cancer. Methods Survival analysis grouping by the level of positive hormone receptor, CK5/6 and EGFR, and en-docrine therapy was carried out in 206 patients whose tumors were junction zone between LABC and TNBC. Re-sults There were no significant differences between the low-positive (1%-9%) HR group and positive HR (10%-19%) group in overall survival (OS) and disease-free survival (DFS). There was an apparent difference between the nor-mal-like group and basal-like group in OS and DFS, and between the patients with and without endocrine therapy. There were significant differences between death and tumor progression for EGFR and CK5/6, chemotherapy, and endocrine therapy. Conclusions We conclude that EGFR and CK5/6 are better prognostic indicators than the lev-el of positive HR in patients whose tumors are junction zone at the junction zone between LABC and TNBC. En-docrine therapy can be highly beneficial to these patients regardless of the positive HR level.
ABSTRACT
Objective To investigate the extent of axillary lymph node dissection which can not only ef-fectively evaluate the axillary status but also reduce the complications to the minimum in early stage breast can-cer. Methods 331 patients with early breast cancer surgically treated from Jan. 2011 to Dec. 2013 were retro-spectively analyzed. Their preoperative axillary state was evaluated. They undertook sentinel lymph node biopsy (SLNB) by pure methylene blue dye method and frozen section examination during surgery. According to the ex-tent of axillary lymph nodes dissection, patients were divided into SLNB group (98 cases) and intercostobrachial nerve level lymph node dissection (ILND) group (233 cases). The pros and cons of the operation were compared. Results The sentinel lymph nodes (SLN) labeled by methylene blue were located under the intercostobrachial nerve level. The average number of SLN and intercostobrachial nerve level lymph nodes were 5.64+1.68 and 13.34+3.61 respectively. The detection rate and the false negative rate of SLNB was 97.42% and 2.58% respec-tively. The medium follow-up was 27.5 months. There was no significant difference in postoperative complications including upper limb paresthesia, swelling or limitation of shoulder activity between the two groups. Conclusion ILND is an effective and suitable surgical method in early breast cancer patients with failed intraoperative SLN labeling or with one SLN metastasis.
ABSTRACT
Objective To evaluate diagnostic value of the combined examination of ultrasound , contrast-enhanced CT and physical examination in axillary lymph node status in breast cancer .Methods 316 cases of breast cancer were studied from Jan .2012 to Dec.2013.The axillary lymph nodes were divided into negative group, suspicious negative group , suspicious positive group and positive group by physical examination , axillary ultrasound , and contrast-enhanced breast CT imaging .ROC curve was used to evaluate diagnostic value and the sensitivity,specificity,and accuracy were analyzed .Results The evaluation model presented the AUC of 0.859. The accuracy, sensitivity, specificity, positive and negative predictive value was 91.3%, 93.8%, 92.5%, 94.0%and 90.9%in negative group and positive group .Conclusion This evaluation method can accurately predict the axillary lymph node status and may be instructive to clinical operation mode selection .