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Objective:To make the early clinical antibiotic regimen by finding out the infection of corynebacterium in the pus of patients with granulomatous mastitis in the early stage.Methods:A total of 42 patients who were diagnosed and treated in the Breast Center of Guangdong Maternal and Child Health Hospital from Jun. 2016 to Mar. 2017 with complete follow-up data were retrospectively analyzed. PCR method was used to detect corynebacterium in the patients’ pus. Patients in the positive group were treated with antibiotics alone, antibiotics + hormones and hormones alone, while patients in the negative group were treated with antibiotics + hormones and hormones alone. The postoperative recurrence rate and cure rate of different groups of patients were observed.Results:The antibiotic regimen for granulomatous mastitis in patients with corynebacterium infection included a combination of short-acting levofloxacin and azithromycin and long-acting anti-mycobacterium drugs. Among the 42 patients in the subgroup, 21 patients were confirmed positive for corynebacterium by PCR detection of pus, and the postoperative recurrence rate was 23.5%. There was a statistically significant difference between the antibiotic group, the antibiotic + hormone group and the hormone group in treatment of granulomatous mastitis infected with corynebacterium ( χ2=5.494, P=0.036) . PCR detection shouwed corynebacterium negative in 21 cases, and postoperative recurrence rate of 16.7%. No statistically significant difference in efficacy was found between antibiotic + hormone group and hormone only group for GM patients without bacterial infection ( χ2=1.129, P=0.719) . Conclusion:Early detection of corynebacterium infection in GM patients is significant for clinical guidance of the application of lipophilic antibiotics.
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Objectives@#To examine the effect of VAE and open surgery on the postoperativelocal recurrence of benign phyllodes tumors of breast and to investigate the clinical efficacy of VAE in the treatment of benign phyllodes tumors.@*Methods@#The clinical data of 128 patients with benign phyllodes tumors of breast admitted to the Guangdong Women and Children Hospital from January 2013 to January 2018 were retrospectively analyzed. All patients were female, aged (37.7±9.1) years (range: 16 to 56 years). Eighty patients underwent ultrasound-guided VAE (minimally invasive group) and 48 patients underwent open surgery (open group). The t-test, χ2 test or Fisher exact probability method were used to compare the clinical characteristics of the two groups of patients. Logistic regression was used to analyze the prognostic factors of postoperative local recurrence.@*Results@#The maximum diameter of tumor in the minimally invasive group was smaller than that in the open group ((20.6±7.4) mm vs. (42.0±2.0) mm, t=-7.173, P=0.000). The follow-up time was (36.4±1.8) months (range: 12 to 71 months). There were 7 cases of local recurrences during the follow-up period. The local recurrence rates in the minimally invasive and open groups were 5.0% (4/80) and 6.3% (3/48). The results of multivariate analysis showed that the maximum tumor diameter of 25 mm was an independent prognosis factor for postoperativelocal recurrence (OR=0.122, 95%CI: 0.016 to 0.901, P=0.039). While surgical procedure, age, menopausal status and history of fibroadenomas in the ipsilateral breast is not an independent prognostic factor for postoperative local recurrence. In the minimally invasive surgery group, the local recurrence rates were 2.9% (2/69) and 2/11 in patients with tumor maximum diameters<25 mm and ≥25 mm, respectively.@*Conclusions@#Local recurrence of breast benign phyllodes tumors is closely related to the tumor size. For patients with tumor diameter<25 mm, the postoperative local recurrence rate of VAE is low, which can be used in clinical practice. Intraoperative complete resection to achieve a negative surgical margin should be guaranteed to avoid local recurrence.
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Objective To evaluate the hemostasis effect of balloon urinary catheter after vacuum-assisted breast biopsy (VABB).Methods From May.2016 to May.2017,270 patients undergoing VABB were randomized into study group (135 cases) and control group (135cases).Patients in the study group received VABB postoperative indwelling catheter balloon hemostasis,while patients in the control group received VABB postoperative conventional thoracic pressure bandage to stop bleeding.Postoperative bleeding and hematoma were recorded and compared between the two groups.Results The rates of postoperative bleeding and hematoma in the study group were significantly lower than that in the control group (6.7％ vs 16.3％,P＜0.05;8.9％ vs 24.4％,P＜0.05).Among patients with lesions ≤ 1.5 cm,the rates of postoperative bleeding and hematoma were 1.6％ and 4.7％ in the study group,and 6.5％ and 8.1％ in the control group.There was no significant difference between the two group (P＞0.05).Among patients with lesions ＞1.5 cm,the rates of postoperative bleeding and hematoma in the study group were significantly lower than those in the control group (11.3％ vs 24.7％,P＜0.05;12.7％ vs 32.9％,P＜0.05).Conclusion Hemostasis with balloon urinary catheter is a safe and effective method for postoperative bleeding and hematoma control after VABB.
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Objective To investigate the role of the predictive prognostic value of BRCA1 screened by whole genome expression profiling in ductal carcinoma in situ.Methods Collected 4 cases of breast ductal carcinoma and 4 cases of breast invasive ductal carcinoma fresh samples from January 2014 to June 2014,and the difference of BRCA1 expression on whole genone expression profiling was analyzed by microarray comparative genomic hybridization.The expression of BRCA1 was detected by immunohistochemistry in 70 cases of ductal carcinoma in situ of the breast,and the prognosis of intraductal carcinoma was evaluated.Results BRCA1 gene differentially expressed in invasive ductal carcinoma and ductal carcinoma in situ by screening.The positive rate of BRCA1 protein in breast ductal carcinoma in 14.3％ (10/70),its expression had no significant relationship with age (P =0.959),menopause (P =0.959),tumor size (P =0.627),axillary lymph node status (P =1.000),HR status (P =0.958),HER-2 status (P =1.000),P53 expression (P =0.460).ductal carcinoma with micro-infiltration ratio in BRCA1 negative group was higher than BRCA1-positive group (P =0.043).The median follow-up of 47 months,Disease-free survival rate of all was 97.1％.Disease-free survival of BRCA1 negative group and BRCA1-positive group had no significant difference (96.7％ vs 100％,P =0.569),over all survival of BRCA1 negative and positive groups was 100％.Conclusions BRCA1 expression may not predict the prognosis of intraductal carcinoma,but ductal carcinoma in situ with microinvasion group ratio in BRCA1 negative was higher than ductal carcinoma in situ group,BRCA1 may take affect within ductal carcinoma infiltration process work.
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Objective To compare the sensitivity and diagnostic features of mammogram (MG) and magnetic resonance imaging (MRI) on diagnosis of breast ductal carcinoma in situ (DCIS) with or without microinvasion (DCIS-MI).Methods From Jan 2012 to Nov 2013,results of MG and MRI from 72 cases of DCIS or DCIS-MI were retrospectively analyzed.Results The sensitivity of MG was 52.8％ (38/72).The sensitivity of MRI was 87.5％ (63/72),among those 76.2％ (48/63)lesions presented as non-mass-like enhancement.Sensitivity of MRI was significantly higher in DCIS-MI than DCIS (84.6％ vs 100％,P =0.027).Logistic regression analysis showed calcifications was an independent factor influencing the sensitivity of MG (OR =23.785,P ＜ 0.001).Conclusions The sensitivity of MRI is higher than MG for the diagnosis of DCIS and DCIS-MI.
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With the development of screening and early diagnosis for breast cancer, the detected rote of ductal carcinoma in situ (DCIS) has increase markedly in recent decades. However, we know little about the biological potential of DCIS and its natural history. Controversy also exists with regard to the optimal management of DCIS.