ABSTRACT
Objective:To compare the therapeutic effects between immediate breast reconstruction (IBR) after skin-sparing mastecto-my and modified radical mastectomy (MRM) in young breast cancer patients (≤35 years), as well as to analyze the prognostic factors of IBR in these patients. Methods:The clinicopathological data of young breast cancer patients who had undergone IBR after skin-spar-ing mastectomy (60 cases) and MRM (68 cases) in Liuzhou People's Hospital from July 2008 to June 2014 were retrospectively ana-lyzed. Local recurrence, disease-free survival, and overall survival of the patients between the two groups were compared. The influ-encing factors for survival of the IBR group patients, such as age, tumor size, and nipple-areolar complex preservation, were analyzed. Results:All patients were followed-up for a period ranging from 15 to 88 months with a median of 51. In the IBR group, local recur-rence, distant metastasis, and death occurred in 3, 8, and 5 cases, respectively. The 3-and 5-year disease-free survival rates (DFSR) were 91.7%and 81.7%, respectively, whereas the overall survival rate (OSR) was 91.7%. In the MRM group, local recurrence, distant metastasis, and death occurred in 2, 9, and 5 cases, respectively. The 3-and 5-year DFSRs were 94.1%and 83.8%, respectively, where-as the OSR was 92.6%. No statistical difference was noted between the two groups (P>0.05). The analysis of prognostic correlation fac-tors in the IBR group patients shows that lymph node metastasis and estrogen and progesterone receptor-negative correlated with the tumor-free survival and overall survival rates (P<0.05). Conclusion:No apparent statistical difference in the comparison of the local re-currence and long-term survival rate was observed between the two groups' young breast cancer patients who underwent IBR after skin-sparing mastectomy and MRM. IBR after skin-sparing mastectomy is safe for young breast cancer patients with early-stage, and nipple-areolar complex preservation does not increase the risk of recurrence in the IBR group patients. Lymph node metastasis and es-trogen and progesterone receptor-negative are the major prognostic factors of IBR after skin-sparing mastectomy in young breast can-cer patients.
ABSTRACT
Background and purpose:The young breast cancer patients were treated with goserelin without individualized regimen, and lack of available clinical marker. The aim of this study was to investigate the role of anti-Müllerian hormone (AMH) in evaluation of individualized treatment of ovarian function suppression in the young breast cancer patients.Methods:Forty-one young patients with estrogen receptor (ER) and progesterone receptor (PR) positive breast cancer from May 2012 to Jan. 2014 were randomly divided into 2 groups to undergo radical resection of breast cancer. According to postoperative treatment, one group was treated with goserelin + chemotherapy (n=20), and the other group received chemotherapy alone (n=21). Thirty female patients in the same age group were selected as normal control group. The time of menopause and menstrual recovery after the goserelin + chemotherapy or chemotherapy alone were observed in 2 groups. In early follicular phase (day 3-5) of the cycle preceding the operation and 3, 6 courses after the goserelin + chemotherapy treatment or chemotherapy treatment, serum levels of AMH, FSH and E2 were measured in 2 groups. Accordingly, serum levels of AMH, FSH and E2 were evaluated as well in normal control group.Results:There were no signiifcant differences in preoperative general conditions and preoperative serum FSH and E2 levels among the 3 groups (P>0.05). Compared with normal control group, the preoperative serum AMH levels of young breast cancer patients were decreased signiifcantly (P=0.04). The menopause time and menstrual recovery time in 2 chemotherapy groups were signiifcantly shorter than that in normal control group (P=0.00). Compared with normal control group and preoperative measurement, the differences in serum FSH and E2 levels were not statistically significant in goserelin + chemotherapy group or chemotherapy alone group (P<0.05). The serum AMH levels measured at different time points of the goserelin + chemotherapy group and chemotherapy alone group were decreased signiifcantly (P<0.05). Compared with the chemotherapy group, the serum AMH levels of the goserelin + chemotherapy group after 6 courses were signiifcantly decreased, and then signiifcantly increased 6 months after menstrual recovery (P<0.05).Conclusion:This study demonstrated that the serum AMH levels were obviously decreased after the ovarian function suppression treatment and increased after the menstrual recovery compared with evaluation of other ovarian reserve index. The serum AMH level could suggest ovarian reserve damage even after ovarian function has recovered to the noticeable level. Thus, AMH could be used clinically to evaluate the ovarian reserve of breast cancer patients as a potential marker for the individualized ovarian function suppression treatment in young breast cancer patients.