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Objective:To analyze the differences of clinicopathological features and prognosis between secretory breast carcinoma (SBC) and invasive ductal carcinoma (IDC), and to explore the influence of SBC on the prognosis of breast cancer.Methods:We retrieved data of patients diagnosed with SBC and IDC from The National Cancer Institute′s Surveillance, Epidemiology, and End Results (SEER) database between 1990 and 2016. 109 cases of SBC (SBC group) and 558 814 cases of IDC (IDC group) were collected. The clinicopathological features were compared between SBC and IDC groups. The tendency score matching method was used to match the balance confounding factors according to 1∶4 proportion. The breast cancer-specific survival time (BCSS) and overall survival time (OS) of the two histological types of breast cancer before and after matching were analyzed. The survival curve was drawn using the Kaplan-Meier method and compared with the log-rank test. Univariate and multivariate Cox regression analysis was used to determine the independent prognostic factors of breast cancer.Results:There were significant difference in diagnostic age, marital status, sex, histological grade, American Joint Committee on Cancer (AJCC) N stage, estrogen receptor (ER) and progesterone receptor (PR) expression between SBC and IDC group (all P<0.05). The BCSS of SBC group was similar to IDC group, and OS was better than IDC ( P<0.05). Univariate and multivariate regression analysis showed that diagnostic age, race, marriage, sex, location, histological grade, AJCC stage, treatment mode and ER, PR expression were all related factors affecting BCSS and OS (all P<0.05). SBC was an independent prognostic factor for OS ( P<0.05). After propensity score matching according to 1∶4, there was no significant difference in BCSS and OS between the two groups ( P<0.05). Cox regression analysis showed that AJCC T stage and PR negative expression were the influencing factors of BCSS (all P<0.05), and diagnostic age and AJCC T stage were the influencing factors of OS (all P<0.05). SBC was no longer an influencing factor of OS in breast cancer. Conclusions:There was no significant difference in prognosis between SBC and IDC. SBC was not an independent risk factor for breast cancer.
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Objective To investigate the clinical significance of early diagnosis and treatment of impal-pable breast tumor.Methods From Jan.2007 to Dec.2014, 570 patients with impalpable breast tumor were treated.Among them, 107 patients were found with breast nodules by ultrasound scan , 340 patients were found with nodules , calcification or distort gland structure and 123 patients were found with nipple discharge by mam-mography .They were biopsied with various methods such as wire localization guided by ultrasound , X-ray mam-mography and fiberoptic ductoscopy .All patients were treated routinely and followed up .Results The his-topathological examination results were as follows:134 cases of breast cancer (23.51%) and 436 cases of benign lesions.44 breast cancer patients were localized by ultrasound , 78 cases were localized by X-ray mammography, and 12 cases were localized by fiberoptic ductoscopy .All lesions were accurately localized and excised .During the two-year follow up, no recurrence or metastasis occurred .Conclusion Early diagnosis and treatment of im-palpable breast tumor can improve early diagnosis level of breast cancer .
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Objective To investigate the clinical correlated problems of immediate breast reconstruction with silicagel prosthesis after modified radical mastectomy.Methods From Jun.2007 to Dec.2011,30 patients were treated with skin sparing modified mastectomy and immediate reconstruction by placing silicone implants into submuscle.15 cases were reserved the nipple-areola complexes.All patients were treated routinely after operation.Results Objective evaluation after operation showed that the excellent rate reached to 90.0％,and subjective evaluation showed that the excellent rate reached to 93.3％.Two cases suffered under-flap hydrops,one case suffered capsular contraction,one case suffered flap ischemia and superficial necrosis of nipple-areola complex,one case suffered gel metastasis,and one cases suffered obvious asymmetry.All the cases were followed up for 12 to 54 months,among whom one case had hepatic and bone metastasis,and the others had no recurrence or metastasis.Conclusions Immediate breast reconstruction with silicagel prosthesis after modified radical mastectomy was proven to be an effective and safe method,with no increase of local recurrence.The modification of operation may avoid the risk of complications.
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The HER-2/neu gene, also named c-erbB-2 or erbB-2, is proto-oncogene of v-erbB-2 which was firstly discovered in 1985. Many studies have been reported since that amplification of the HER-2 gene in breast tumors is associated with poor prognosis was recognized. The relevant knowledge of HER-2/neu gene is summarized in this article.