Clinical analysis of 382 immediately breast reconstruction after mastectomy in Beijing City, Tianjin City and Hebei Province from 2012 to 2016 / 中华外科杂志

Objective@#To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province.@*Methods@#A retrospective analysis was made on the data of 382 cases with breast cancer who were treated and followed up successfully with immediate breast reconstruction after mastectomy from January 2012 to December 2016 in Beijing City, Tianjin City and Hebei Province. Clinic data of the followed-up 382 cases (all female, age (38.5±4.2) years (range: 24 to 70 years)), including general information, tumor information, sugery methods, and treatments after surgery were collected. The survival status, metastasis,complications and prognosis were followed up. Cosmetic effcet was evalated by Harris method, and life quality by Functional Assessment of Cancer Therapy-Breast scale (FACT-B). χ2 test was used to compare the difference between year 2012 and year 2013 to 2016. Bonferroni method was used to correct the inspection level, which was 0.05/10=0.005. The trend of IBR rate (ratio of IBR to modified radical mastectomy) from 2013 to 2016 was analyzed by trend χ2 test.@*Results@#There was 46 cases in stage 0, 152 cases in stage Ⅰ, 165 cases in stage Ⅱ, 19 cases in stage Ⅲ. Twenty-five cases was treated by neoadjuvant chemotherapy, 231 by chemotherapy and 35 by radiotherapy. The proportion of implant reconstruction was 48.7% (186/382), more than expanded of 21.5% (82/382), with latissimus dorsi of 12.0% (46/382), TRAM of 8.9% (34/382), DIEP of 2.1% (8/382), and latissimus plus implant of 6.8% (26/382). According to the Harris standard, the excellent and good rate of the cosmetic effect of the reconstructed breast was 93.7%. The score of FACT-B was 108.20±16.9 (range: 67 to 144) 1 year postoperatively. Compared with 2012, the IBR rate was significant increased, till 2015, the IBR rate was 153/10 000 cases (χ2=47.028, P=0.000).@*Conclusions@#There is a significant increase on IBR rate in Beijing City, Tianjin City and Hebei province by year. Most of cases received IBR is stage Ⅰ to Ⅱ. Implant reconstruction is the main reconstructive method. Postoperative cosmetic effects and quality of life are both meet patients′ demon.

Clinical analysis of 382 immediately breast reconstruction after mastectomy in Beijing City, Tianjin City and Hebei Province from 2012 to 2016 / 中华外科杂志

Objective@#To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province.@*Methods@#A retrospective analysis was made on the data of 382 cases with breast cancer who were treated and followed up successfully with immediate breast reconstruction after mastectomy from January 2012 to December 2016 in Beijing City, Tianjin City and Hebei Province. Clinic data of the followed-up 382 cases (all female, age (38.5±4.2) years (range: 24 to 70 years)), including general information, tumor information, sugery methods, and treatments after surgery were collected. The survival status, metastasis,complications and prognosis were followed up. Cosmetic effcet was evalated by Harris method, and life quality by Functional Assessment of Cancer Therapy-Breast scale (FACT-B). χ2 test was used to compare the difference between year 2012 and year 2013 to 2016. Bonferroni method was used to correct the inspection level, which was 0.05/10=0.005. The trend of IBR rate (ratio of IBR to modified radical mastectomy) from 2013 to 2016 was analyzed by trend χ2 test.@*Results@#There was 46 cases in stage 0, 152 cases in stage Ⅰ, 165 cases in stage Ⅱ, 19 cases in stage Ⅲ. Twenty-five cases was treated by neoadjuvant chemotherapy, 231 by chemotherapy and 35 by radiotherapy. The proportion of implant reconstruction was 48.7% (186/382), more than expanded of 21.5% (82/382), with latissimus dorsi of 12.0% (46/382), TRAM of 8.9% (34/382), DIEP of 2.1% (8/382), and latissimus plus implant of 6.8% (26/382). According to the Harris standard, the excellent and good rate of the cosmetic effect of the reconstructed breast was 93.7%. The score of FACT-B was 108.20±16.9 (range: 67 to 144) 1 year postoperatively. Compared with 2012, the IBR rate was significant increased, till 2015, the IBR rate was 153/10 000 cases (χ2=47.028, P=0.000).@*Conclusions@#There is a significant increase on IBR rate in Beijing City, Tianjin City and Hebei province by year. Most of cases received IBR is stage Ⅰ to Ⅱ. Implant reconstruction is the main reconstructive method. Postoperative cosmetic effects and quality of life are both meet patients′ demon.

Clinicopathological characteristics and risk factors of female breast hyperplasia in different age groups / 中华普通外科杂志

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (＜ 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3％ vs.42.7％,P ＜ 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9％ vs.61.7％,P ＜0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4％ vs.4.2％,P ＜ 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.

A multicenter, randomized, controlled, phase Ⅲ clinical study of PEG-rhG-CSF for preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.</p><p><b>METHODS</b>According to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.</p><p><b>RESULTS</b>The duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).</p><p><b>CONCLUSIONS</b>In patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.</p>

Verification of a molecular pathology detection method of sentinel lymph node in breast cancer patients:a comparison between RT-LAMP and GeneSearch / 军事医学

Objective To verify the reliability of our previously established reverse-transcription loop-mediated isother-mal amplification ( RT-LAMP) method for the detection of sentinel lymph nodes metastasis in breast cancer patients .Meth-ods Sentinel lymph nodes of breast cancer patients were analyzed by RT-LAMP and FDA-approved GeneSearch methods respectively, and the consistency of the two methods was assessed with a kappa concordance test.Results One hundred and thirty-four cases of sentinel lymph node samples were collected from seven hospitals in Beijing .Using the GeneSearch assay as the gold standard, the sensitivity, specificity and consistentcy of RT-LAMP were 96.2%(25/26),96.3%(104/108) and 96.3%(129/134), respectively.Statistical analysis showed that the two methods were consistent (Kappa=0.8857, P<0.001).Conclusion RT-LAMP is highly consistent with GeneSearch ,efficient,simple and inexpensive, promising a good prospect of application to intra-operative detection of sentinel lymph nodes metastasis for breast cancer patients.

Multicenter prospective study of magnetic resonance imaging prior to breast-conserving surgery for breast cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging (MRI) prior to breast-conserving surgery for breast cancer.</p><p><b>METHODS</b>The research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012. The participants were allocated to a breast-conserving surgery group (breast-conserving group) or a total mastectomy group (total mastectomy group). Enhanced MRI was used to measure breast volume, longest diameter of tumor and tumor volume. The correlations between these measurements and those derived from histopathologic findings were assessed. The relationships between the success rate of breast-conserving surgery and MRI- and pathology-based measurement results were statistically analyzed in the breast-conserving group.</p><p><b>RESULTS</b>The study included 461 cases in the total mastectomy group and 195 in the breast-conserving group. Allocation to these groups was based on clinical indications and patient preferences. The cut-off for concurrence between MRI- and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm. In the total mastectomy group, the confidence interval for 95% concurrence of these measurements was 35.41%-44.63%. Correlation coefficients for MRI and histopathology-based measurements of breast volume, tumor volume and tumor volume/breast volume ratio were r = 0.861, 0.569, and 0.600, respectively (all P < 0.001). In the breast-conserving group, with 0.30 cm taken as the cut-off for concurrence, the 95% confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98%-44.01%. The subjective and objective success rates for breast-conserving surgery were 100% and 88.54%, respectively.</p><p><b>CONCLUSIONS</b>There were significant correlations between dynamic enhanced MRI- and histopathology-based measurements of the longest diameter of breast lesions, breast and tumor volumes, and breast volume/tumor volume ratios. Preoperative MRI examination improves the success rate of breast-conserving surgery.</p>

Immediate breast reconstruction after radical mastectomy / 肿瘤研究与临床

Breast reconstruction after radical mastectomy significantly improves the patient' s quality of life and has become an important part of comprehensive treatments. However, there are a number of reconstruction problems. The choice of breast reconstruction after breast cancer should be considered in general. Immediate reconstruction is not superior to breast-conserving surgery, while immediate reconstruction is superior to delayed reconstruction, and choices vary between implant reconstruction and autologous reconstruction. In short, breast reconstruction should be based on the radical principle with balance of beauty.

The Value of Mammary Ductoscopy in Diagnosis and Treatment of Nipple Discharge: A Report of 206 cases / 中国微创外科杂志

Objective To explore efficacy of mammary ductoscopy in diagnosis and treatment of nipple discharge.Methods 206 cases of nipple discharge underwent 211 examinations of mammary ductoscopy from May 2001 to October 2006.Results Fifty-eight patients diagnosed as non-protrusion lesions under mammary ductoscopy were treated by irrigation therapy and followed up for 3-18 months(mean,12 months) without recurrence.One hundred and forty-eight cases were diagnosed as protrusion lesions,in which 125 cases received operation.115 cases of single mammary intraductal papilloma,7 cases of papillomatosis,and 3 cases of intraductal carcinoma were diagnosed under mammary ductoscopy,while 112 case of intraductal papilloma,10 cases of papillomatosis and 3 cases of ductal carcinoma were confirmed by postoperative pathology.Of the 125 cases,mammary ducts resection was carried out in 120 cases guided by locating needle,segment mammectomy in 1 case,"mammary gland displacement" in 1 case,quadrant resection with nipple-conserving combined with axillary lymph node dissection in 1 case,quadrant resection without nipple-conserving combined with axillary lymph node dissection in 2 cases.Follow-up for 4 to 20 months(mean,10 months) showed no recurrence.3 cases of ductal carcinoma in situ were followed up for 12-18 months,and survived with tumor-free.Conclusions Mammary ductoscopy examination makes accurate diagnosis of nipple discharge induced by intraductal carcinoma before operation,and has important clinical value to choose procedures.Locating needles to locate lesions in mammary ducts may be taken as a guide during operation.

A report of 15 cases of intraductal papillomatosis / 中国微创外科杂志

Objective To discuss the diagnosis and treatment of intraductal papillomatosis. Methods Fifteen cases of intraductal papillomatosis were analyzed retrospectively. Results Of the 15 cases,preoperative diagnosis of intraductal papillomatosis was made in 8 cases who had received fiberoptic ductoscopy,while the rest of 7 cases who had not undergone ductoscopy were wrongly diagnosed.Postoperative pathological findings revealed 2 cases of partial malignant change and 1 case of contralateral infiltrating lobular carcinoma.Reoperation was required in 3 cases because of relapse,the relapse rate being 20%. Conclusions Intraductal papillomatosis is absolutely different from intraductal papilloma.It presents the potentiality of malignancy,and is subject to relapse after local resection.Fiberoptic ductoscopy may improve the diagnosis rate for this disease.