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Objective To explore the diagnostic and therapeutic methods for male breast cancer. Methods Clinical data of 11 cases of male breast cancer treated in our hospital from 1992 were analyzed (retrospectively). Results 2 patients were diagnosed at advanced stage and survived 6 and 8 months (respectively) after biopsy. The other 9 patients received radical mastectomy. 3 were lost to follow-up, 1 was found to have pulmonary metastasis after 5 years and combined treatment of traditional Chinese medicine and western medicine was given. Nodules were found under the axillary fossa in another patient at five years after surgery and the nodules were recurrent carcinoma as confirmed by biopsy. The patient has survived for 7 years with radiotherapy and chemotherapy. The other 4 cases have survived 0.5 to 7 years respectively, and are undergoing treatment. Conclusions Early diagnosis of male breast cancer should be emphasized. Aggressive surgery combined with other auxiliary treatments are effective.
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Objective To explore the therapeutic effects of radical mastectomy(RM) and extended radical mastectomy(ERM) for stage II, III breast cancer. Methods The 5 year and 10 year survival rates in 691 patients with stage II, III breast cancer treated either by extended radical mastectomy or radical mastectomy were retrospectively analyzed . Out of the 691 patients, 206 stage II cases and 193 stage III cases underwent RM, and 142 stage II and 150 stage III cases received ERM. Results In patients with stage II, III breast cancer located in the central portion or medial portion of mammary, the 5 year survival rates and in stage III patients 10 year survival rate after ERM were significantly higher than those after RM (P
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Objective To study the clinical outcome of breast conserving treatment of breast ductal carcinoma in situ(DCIS).Methods The data of 62 patients with pathologically proven DCIS who underwent breast conserving operation and adjuvant radiotherapy were retrospectively compared with 62 concurrent cases of stageⅠ or Ⅱ infiltrating ducatl carcinoma who received breast conserving operation and adjuvant readotherapy.Results The recurrence rate in DCIS cases was 6.4%(4/62),among them,3 cases belonged to comedo type;the recurrence rate in early infiltrating type of ductal breast carcinoma was 19.3%(11/62)(P
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Objective To evaluate the effect of preserving the intercostobrachial nerve(ICBN) during modified radical mastectomy for breast cancer.Methods Preservation of ICBN during modified radical mastectomy was performed in 100 patients with stage Ⅰ or stage Ⅱ breast carcinoma.All patients were followed up after operation.Results Ninty-one patients had normal sensation of the skin of upper arm on operated side,while medial side paresthesia of the upper arm occurred in 9 cases within the postoperative follow up period.Conclusions Preserving the intercostobrachial nerve in modified radical mastectomy for patients with breast cancer can decrease the incidence of abnormal sensation of the skin of affected upper arm,and improve the quality of life of patients after operation.
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Objective To explore the cause and prevention of skin flap necrosis after radical operation for breast cancer and reduce the incidence of skin flap necrosis.Methods The data of 158 patients with breast cancer who had surgical treatment were analysed.The data included the thickness of the skin flap,tension of the skin flap,and the mode of the operation and their relation with necrosis of the skin flap.Results Among the 158 operated cases,32 cases(20.25%) had skin flap necrosis.The incidence of the flap necrosis in the thick skin flap group was lower than in the thin skin flap group(10.87%vs28.95%,P
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0.05). Conclusions The therapeatic effect of breast-conserving therapy of stage I,and IIa breast cancer located ≥3cm of the nipple is similar to that of modified radical mastectomy. Breast-conserving therapy can gradually become the operation of first choice for stage I and IIa breast cancer.
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Objective To evaluate the results of breast conservation surgery combined with radiotherapy for early stage breast cancer.Methods The cinical data of 76 breast cancer patients who underwent breast(conservation) operation plus radiotherapy at Changzheng Hospital in the recent 6 years were retrospectively(analyzed).Results The 3-,and 5-year survival rate was 96.05% and 94.8%,respectively,the 3-,and 5-year local recurrence rate was 5.3% and 6.6% respectively,and the 3-,and 5-year breast conservation rate was 96.05% and 93.3%,respectively.Only one case had chest wall recurrence and there was no mortality.The case with recurrence was a 25-year old unmarried woman,who had an intense desire for breast conservation.After tumor recurrence,mastectomy was performed again and chemotherapy was(administered).The patient is presently alive and in good health.Postoperative cosmetic physical results were(satisfactory) in 80.5% of cases.Conclusions Breast conservation surgery plus radiotherapy can get(satisfactory) results.The important aspects for success of breast conservation treatment are standardization of(resection) and postoperative radiotherapy and integrated systemic therapy.
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(0.05)).There were 5 cases(4.7%) of upper limb edema and functional handicap in PAL group,and 12 cases(11.7%) of upper limb edema and functional handicap in TAL group,there was a statistical difference between PAL group and TAL group(P
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Objective To investigate the possibility and accuracy of idenfication of the sentinel lymph node(SLN) in breast cancer(BC) by using methylene blue intra operatively.Methods 4～6ml methylene blue dye was injected around the breast mass intra operatively. 5～10 minutes after injection,the operation for BC was performed. All blue stained lymph nodes found during operation were considered as SLN, and removed for pathological examination. All patients had axillary lymphadenectomy(ALDN),and the acquired nonsentinel lymph nodes(NSLN)from them were also examined. Results The SLN were identified in 45 of 50 patients(90.0%).There were all 117 SLNs in this series. Of 117 SLNs,111 were located in stage I lymph nodes in axilla(95.0%),and 6 SLNs in stage II(5.0%). Of the 5 cases of the unidentified SLN,the primary tumor was located in the inferior quadrant in 4 cases,and in the uper quadrant in 1 case (P0.05). Histologic status of the SLNs accurately predicted axillary nodes status with an accuracy rate of 91.0%. 4 cases or SLN examination were negative while their NSLN were positive with false negative rate 8.9%. Conclusions This technique can identify SLN accurately;the histology of SLN can predict axillary status correctly. Sentinel lymph node has correlation with the location of the primary tumor but has no correlation with the size of the tumor or breast operation before.
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Objective To study the clinical diagnosis,treatment and prognosis of and the factors influencing prognosis of breast cancer(BC) in young women. Methods A restrospective analysis of the clinical data of 59 cases treated from Jan .1990 to Dec. 1998was carried out in the Second Xiangya Hospital. Results All patients underwent operation, including 31 radical mastectomy , 25 modified radical mastectomy and 3 simple mastectomy. 34 cases had axillary lymph node metastasis. The overall 3,5 and 7 year survival rates were 67.2% , 61.0% and 57.1%respectively. The 3,5 year survival rates in patients with axillary-lymph node metastasis were lower than those in patients without axillary lymph node metastasis (61.8%,45.5%vs 86.4% ,83.3%). The 3,5 year survival rates in patients with negative C erbB 2 expression were 84.6%,82.4% and in patients with positive C erbB 2 expression were 54.6%,45.8%,respectively(all P
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Objective To explore the strategy of surgical therapy for breast carcinoma . Methods The clinical data of 258 patients with breast carcinoma were analysed retrospectively. Results (1)136 patients with stage Ⅰ～Ⅱ breast carcinoma were subjected to modified radical mastectomy, overall survival(OS) was 100%, and relapse free survival(RFS)92.6%.(2)Partial mastectomy and axillary dissection were performed on two patients with stage Ⅱbreast carcinoma,one relapsed in 5 months after operation. (3)In patients with stage Ⅲ breast carcinoma,there was no statistical difference in OS and RFS between 88 patients subjected to modified radical mastectomy and 20 radical mastectomy.(4)The radical operation showed a better efficacy in 5 patients with stage Ⅳ breast carcinoma.(5)Using special breast cutter and electrotome,the rate of surgical blood transfusion was 3.5%,postoperative hematocele 2.7%,flap necrosis 7.4%, effusion under skin 18.6%,and edema of affected limb 4.3%. Conclusions (1)The modified radical mastectomy is the major operation for stage Ⅰ～Ⅲ breast carcinoma patients. (2)Using special breast cutter and electrotome could cut down surgical blood transfusion and operation time.(3)Rational axillary lymph node dissective could reduce postoperative complications.
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Objective In order to deeper understand DCIS,improve the rate of diagnosis and therapeutic efficacy.Methods The clinical data of 123 DCIS treated at the First Affiliated Hospital of China Medical University were retrospectively analyzed in regards to age at onset of disease,clinical features,breast ultrasound examination,mammography examination,pathology,immunohistochemistry examination,and surgical methods.Results(1) The average age at onset was(47.7?9.3) years.(2)The major features on physical examination were breast lump in 79cases,nipple discharge in 19cases,and breast pain with glandular thickening in 30 cases.(3)Among 45 cases that underwent both ultrasound and mammography examination,in 17cases(60%) and 30 cases(66.7%) respectively,might be positive for malignancy,but the difference between the 2 melhods was not significant.With the use of both methods togather,diagmosis of possible malignant lesion was made in 37 cases(82.2%).(4) Sixty-five cases underwent breast ultrasound examination,substantive mass was found in 43 cases(66%),blood flow signals in 41 cases(63%),ductal dilatation in 52 cases(80%) and intraductal spotty strong light beam in 33 cases(50.7%).(5) Fifty-two cases underwent breast mammography examination,which showed sand-like calcification,mass with calcification clusters,localized gland density and breast tumor.(6)The immunohistochemistry examination included estrogen receptor(ER),progesterone receptor(PR),p53 and c-erbB-2,but the rate of positive expressios of those indices showed no significance difference between DCIS and DIS with microvasion(DCIS-MI).(7)Six cases underwent radical mastectomy(of which there were 3 cases of DCIS-MI).Modified radical mastectomy was done in 86 cases,including 59 cases of DCIS,27 cases of DCIS-MI.Lymph node metastasis was found in 2 cases of DCIS,and 5 cases of DCIS-MI.ConclusionsCombined breast ultrasound and mammography can increase the rate of DCIS diagnosis.
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Objective To study the clinical features and treatment of unilateral multicentric breast cancer.Methods The clinical data of 14 cases of unilateral multicentric breast cancer,which were found from July,2004 to December,2007 were analyzed retrospectively.ResultsSix cases(42.9%) had infiltrating lobular carcinoma,and the other 8 cases(57.1%) were invasive ductal carcinoma.The number of cancer focus was 2 to 9,and with a diameter of 0.5-4.3 cm.The focus in 12 cases were located in upper lateral quadrant;1 case was located in the upper medial and lateral quadrant;1 case was located in the upper lateral quadrants,the junction area of upper medial and upper lateral quadrants,and between upper lateral quadrant and lower lateral quadrants.One patient was treated by breast conservation operation,with no recurrence at 3-5 years follow-up;while the other 13 cases received modified radical operation,and with no recurrence at 2-37 months of follow-up.ConclusionsUnilateral multicentric breast cancer are often distributed in the same quadrant or adjacent quadrants of breast,and the majority cases are with invasive ductal carcinoma.For treatment of these lesions were a modified radical operation combine with comprehensive treatment.
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Objective To explore the clinico-pathological characteristics of primary breast lymphoma(PBL).Methods The clinical data of 36 cases of PBL were analyzed retrospectively.Results Among the 36 cases of PBL,16 patients presented with stage Ⅰa disease,14 patients with stage IIa disease,2 patients with stageⅡb disease,and 4 patients with stage Ⅳ.All of the patients underwent surgery and chemotherapy,and 20 cases had radiotherapy.Thirty three patients(91.7%) were followed up for 3-193 months,during which time,12 patients died,including 2 patients died of brain metastases,five patients died of bone metastasis,and five patients died of diffuse hepatic and pulmonary metastasis.In the 21 surviving patients,the survival time was 3～192 months,and the median survival time was 43.5 months.The overall 3-and 5-year survival rate was 70.1% and 49.0%,respectively.Conclusions Most PBL are NHL.PBL is diagnosed basically by methods of pathology and immunohistochemistry,and operation combined with chemotherapy and/or radiotherapy is the best treatment method.
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Objective To study the treatment and prognosis factor of male breast cancer(MBC). Methods The clinical data of 37 male cases of breast cancer were analyzed retrospectively.All the patrents underwent operation , including radical mastectomy(10cases), modified radical mastectomy(19cases),simple mastectomy plus axillary lymph node extirpation(4cases) and mastectomy (4cases).Results the 5-year survival rate of operation mentioned above were 80.0% ,78.9%,25.0%,25.0%, respectively. The 5 years survival rate in patients with axillary lymph node metastasis and without metastasis were 50.0% and 93.3%( P
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Objective To study the feasibility and effect of endoscopic breast conserving surgery in the treatment of early stage of breast cancer(EBC) via transaxillary small concealing incision. Methods Twenty -one cases of EBC were treated by endoscopic breast conserving surgery,combined with the lipolysis and suction of the fat in axilla, via transaxillary small incision. Results There was no cancer residue in all the resected margins of all samples confirmed by the frozen sections. The lymph nodes metastasis was found in 3 cases. The average operation time was 81.6 minutes. Subcutaneous liquid collection occurred in one case postoperatively,the liquid disappeared quickly after treatment. All patient′s had a good breast configuration. All patients were followed-up for 3.1 months to 15.6 months after operation. There were no recurrence and distant metastasis in this series. Conclusions Breast conserving surgery can be smoothly performed by a small concealing incision with endoscope. This operation has many advantages, such as the incision is small and concealing, so it can improve the patients′ quality of life. The suction of the fat in axilla makes axillary dissection easier.
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0.05) . Conclusions The effect of early-stage of breast cancer treatment by breast-conserving therapy plus other adjunct therapies is satisfactory . It can be as the first choice for the treatment of patients with early-stage of breast cancer.
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Objective To study the effective therapy of breast intraductal papilloma . Method One hundred and thirty-two patients with breast intraductal papilloma (four patients with cancerization)were treated by resection of the tissue stained by methylene blue. The effect was evaluated. Results The pathological diagnosis were 91 patients with breast intraductal papilloma and 41 breast intraductal papillomatosis, and 4 of them were cancerization. One hundred and ninteen patients(90.1%) were followed up for 3～46 months, all patients were cured without recurrence after operation. Conclusions Resection of the tissue stained by methylene blue in treating breast intraductal papilloma is a reliable and effective method.
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0.05).Conclusions Neoadjuvant chemotherapy followed by breast-conserving surgery for stage Ⅱ and Ⅲ breast cancer is safe and can achieve the results of radical operation.Neoadjuvant chemotherapy,strict adherence to standerdize surgical technique and use of postoperative radiotherapy and chemotherapy are crucial to breast-conserving therapy for these patients.
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Objective To study the method and significance of preserving anterior thoracic nerve(ATN) and intercostobrachial nerve(ICBN) during breast-conserving operation for breast cancer.Methods A total of 382 cases with breast-conserving operation for breast cancer in recent 5 years were reviewed.In 312 cases the opeeration was performed by preserving ATN and ICBN,and in 70 cases the ATN and ICBN were not preserved.The patients were followed-up postoperatively.Results Among the patients whose operation was performed by preserving ATN and ICBN,skin sensation of armpit and upper arm was normal in 80.4%(251/312) and abnormal in 19.6%(61/312) of patients,but in most of them,it recovered in 2-3 months.Among the patients with out preservation of ATN and ICBN,skin sensation was normal in only 16 cases(22.9%),and had varying degrees of abnormal sensation in 54 cases(77.1%).Conclusions Preservation of ATN and ICBN during breast-conserving surgery for breast cancer is feasible,can decrease the incidence of hypoesthesia of axilla and upper arm and atrophy of pectoralis muscles,and the quality of life of patients after operation is improved.