A retrospective clinical study of patients with pregnancy-associated breast cancer among multiple centers in China (CSBrS-008) / 中华医学杂志(英文版)

BACKGROUND@#Pregnancy-associated breast cancer (PABC) is a special type of breast cancer that occurs during pregnancy and within 1 year after childbirth. With the rapid social development and the adjustment of reproductive policies in China, the average age of females at first childbirth is increasing, which is expected to lead to an increase in the incidence of PABC. This study aimed to accumulate clinical experience and to investigate and summarize the prevalence, diagnosis, and treatment of PABC based on large multicenter samples in China.@*METHODS@#According to the Chinese Society of Breast Surgery, a total of 164 patients with PABC in 27 hospitals from January 2016 to December 2018 were identified. The pregnancy status, clinicopathological features, comprehensive treatment methods, and outcomes were retrospectively analyzed. Survival curves were plotted using the Kaplan-Meier method.@*RESULTS@#A total of 164 patients of PABC accounted for 0.30% of the total number of cases in the same period; of which, 83 patients were diagnosed during pregnancy and 81 patients during lactation. The median age of PABC was 33 years (24-47 years). Stage I patients accounted for 9.1% (15/164), stage II 54.9% (90/164), stage III 24.4% (40/164), and stage IV 2.4% (4/164). About 9.1% (15/164) of patients were luminal A. Luminal B patients accounted the most (43.3% [71/164]). About 15.2% (25/164) of patients were human epidermal growth factor receptor 2 (Her-2) overexpression and 18.9% (31/164) of patients were triple-negative breast cancer. For pregnancy breast cancer, 36.1% (30/83) of patients received direct surgery and 20.5% (17/83) received chemotherapy during pregnancy. About 31.3% (26/83) chose abortion or induction of labor. The median follow-up time was 36 months (3-59 months); 11.0% (18/164) patients had local recurrence or distant metastasis and 3.0% (5/164) died.@*CONCLUSIONS@#It is safe and feasible to standardize surgery and chemotherapy for PABC.

Multidisciplinary cooperation strengthens individualized management of breast cancer in pregnancy / 中华外科杂志

As the pregnant patient with breast cancer is in a special physiological period, both the efficacy of mother and the safety of developing fetus should be considered during the whole process of diagnosis and treatment. It is particularly important for multidisciplinary teams including breast, obstetrics and nursing departments to make a secure and effective individualized plan for those in different gestational week and different stages of breast cancer development. Pregnancy risk assessment and whole-process multidisciplinary case management mode for breast cancer during pregnancy are helpful for the early detection of abnormal health status of pregnant women and fetuses, enabling rapid and efficient treatment, reducing the occurrence of adverse medical events, and maximizing the safety of pregnant women and fetuses. Obstetricians should pay attention to the chief complaints of pregnant women and conduct regular breast ultrasound examinations. Once anything suspicious is found, breast surgeons need to take charge of a multidisciplinary discussion. Not only should the multidisciplinary collaborative outpatient clinic determine the treatment plan for breast cancer during pregnancy, but also the concept of multidisciplinary collaboration should be incorporated into the follow-up treatment process, including active surgical treatment, selection of neoadjuvant chemotherapy and adjuvant chemotherapy, avoidance of endocrine therapy, targeted therapy and radiotherapy, and adherence to multidisciplinary follow-up, etc. Multidisciplinary case management of breast cancer during pregnancy is necessary and feasible, and more prospective clinical studies need to be carried out to help improve clinical diagnosis and treatment strategies.

The correlation of synuclein-γ and matrix metalloproteinase 9 in breast cancer / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the expression of synuclein-γ (SNCG) and metalloproteinase 9 (MMP-9) both in the invasive ductal breast cancer samples and T47D and T47D(SNCG)- cell lines, to investigate the correlation between SNCG and MMP-9.</p><p><b>METHODS</b>Totally 96 invasive ductal breast cancer samples (female, mean age of (56 ± 8) years) were collected between June 2009 and June 2012. The expressions of SNCG and MMP-9 were investigated by immunohistochemistry. T47D and SNCG knock down T47D(SNCG)- cell lines were established and SNCG and MMP-9 protein expression were investigated by Western blot and gene expression by real-time PCR.</p><p><b>RESULTS</b>Among 96 samples, 26 (27.1%) of them co-expressed SNCG and MMP-9, 30(31.2%) of them expressed neither SNCG nor MMP-9. The expression of SNCG was correlated with the expression of MMP-9 (r = 0.655, P = 0.000).SNCG mRNA level of T47D cell line was 13.5 fold of T47D(SNCG)- cell line and SNCG protein expression was 2.1 fold. While MMP-9 mRNA level of T47D cell line was 7.3 fold of T47D(SNCG)- cell line and MMP-9 protien expression was 1.6 fold.When SNCG was knocked down, the expression of MMP-9 decreased.</p><p><b>CONCLUSIONS</b>SNCG and MMP-9 are significantly correlated with each other in breast cancer. SNCG may promote the invasion and metastasis of breast cancer mediated by up-regulating the expression of MMP-9.</p>

The effect of breast cancer specific gene 1 in the prognosis of breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To detect breast cancer specific gene 1 (BCSG1) expression in different breast tissue, analysis its correlation with clinical parameters and evaluate the prognosis of breast cancer.</p><p><b>METHODS</b>The expression of BCSG1 was detected by reverse transcription-polymerase chain reaction (RT-PCR) in surgical specimens from 84 cases of breast disease patients selected randomly at XinHua Hospital affiliated with Shanghai Second Medical University from September 1999 to December 2002. Of 84 cases, 72 case were breast cancer. Statistic analysis BCSG1 gene expression correlation with clinical parameters of breast cancer. 72 breast cancers were followed up (4 - 43 months) to set up independent prognosis factor by survival analysis.</p><p><b>RESULTS</b>BCSG1 was undetectable in all benign breast lesions, while was detectable in 36.1% of all breast cancer samples (26/72), in which 79.2% of stage III/IV cases were positive (19/24). The expression of BCSG1 was tightly correlated with the stage (P = 0.000) and the size of tumor (P = 0.007). Both ER (P = 0.027) and BCSG1 (P = 0.001) were the independent prognosis factor of breast cancer.</p><p><b>CONCLUSION</b>BCSG1 is one of independent tumor marker of breast cancer, the expression of BCSG1 is closely correlated to the stage of breast cancer and the tumor size. Maybe, BCSG1 is a new prognosis factor of breast cancer.</p>