Conservative treatment for patients with plasma cell mastitis / 中华内分泌外科杂志

Objective To investigate the etiology and novel treatment of plasma cell mastitis (PCM).Methods 145 cases of PCM undergoing massage dredge,ductal lavage and local amalgesic injection from Jan.2011 to Dec.2012 were retrospectively analyzed.Results 145 cases of PCM underwent conservative treatment for 2 to 8 weeks,among whom 128 cases were cured and the other 17 cases underwent surgical treatment for poor outcome.Among the 128 cases undergoing conservative treatment,9 cases had relapse during the follow-up of 12 to 36 months.Conclusions The combined treatment of massage dredge,ductal lavage and partial closed treatment is effective for patients with PCM,and it can keep patients from having mastectomy and reduce the recurrent rate.

Does ductal lavage assert its role as a noninvasive diagnostic modality to identify women at low risk of breast cancer development? / 부인종양

OBJECTIVE: Ductal lavage (DL) involves evaluation of the ductal system of the breast for detection of intra-ductal carcinomas and precursor lesions by collecting breast epithelial cells using a small-gauge catheter inserted into a ductal orifice on the nipple. The aim of this survey was to analyze cytologic features of samples obtained from low-risk women with DL and to elucidate the efficacy of this diagnostic modality in evaluating fluid production, cannulating and determining atypical breast epithelial cells. METHODS: Into this prospective study were consecutively registered 80 women between ages 28 to 67. Nipple aspiration was performed to identify all fluid-yielding ducts. According to the grading of specific features the interpretation of the sample included: normal/benign (category, 0), mild atypical (category, I), markedly atypical (category, II) or malignant (category, III) disorders. RESULTS: Ninety five percent (316/334) of the nipple aspirate fluid samples were classified as category 0, 4.8% (16/334) as category I and 0.2% (2/334) as category II changes. Category III disorders were not detected. Therefore, in 80% of the women examined results were within normal limits while 17.5% of the participants presented mild atypical and 2.5% markedly atypical rates. CONCLUSION: DL collection procedure proved to be rapid as well as acceptable by the women studied. It retains the advantage over other methods of nipple aspirate fluid in that it is easy to perform, thereby removing most clinician variability. It also helped low risk women to discriminate those with breast disorders that require additional investigation, further follow-up or administration of preventive medication.

Actualización sobre prevención del cáncer de mama / Breast cancer prevention: An update

The combined results from the four tamoxifen prevention trials showed a 38% reduction in breast cancer incidence. The largest risk-reduction trial, the Breast Cancer Prevention Trial conducted by the National Surgical Adjuvant Breast and Bowel Project, revealed that tamoxifen reduced the risk of invasive breast cancer by 49%. Tamoxifen is currently approved for breast cancer risk reduction. However, because of side effects associated with tamoxifen, other agents are being investigated. The Study of Tamoxifen and Raloxifene is designed to compare the efficacy of tamoxifen and raloxifene in reducing breast cancer risk. Aromatase inhibitors are also being evaluated in the prevention setting. Other agents are being investigated for chemoprevention. Novel agents are especially required for estrogen receptornegative breast cancer. Ductal lavage is a non-invasive method utilized for individualized risk assessment. Future utility of ductal lavage may be as an adjunct to screening as well a way to evaluate intermediate biochemical markers for chemopreventive agents.

Los resultados combinados de los cuatro estudios sobre la prevención con tamoxifeno demostraron una disminución del 38% en la incidencia de cáncer de mama. El estudio más amplio acerca de la disminución del riesgo, el Breast Cancer Prevention Trial, realizado por el National Surgical Adjuvant Breast and Bowel Project, reveló que el tamoxifeno disminuía el riesgo de cáncer de mama invasor en un 49%. El tamoxifeno actualmente está aprobado para disminuir el riesgo de cáncer de mama. Sin embargo, debido a los efectos colaterales asociados, otros agentes están siendo investigados. El ensayo Study of Tamoxifen and Raloxifene fue diseñado para comparar su eficacia para disminuir el riesgo de cáncer de mama. Los inhibidores de la aromatasa también están siendo evaluados en el marco de la prevención. Otros agentes están siendo investigados para la quimioprevención. Se requieren especialmente nuevos agentes para el cáncer de mama con receptores de estrógeno negativos. El lavado ductal es un método no invasivo que se utiliza para una valoración del riesgo individualizada. Su utilidad futura puede ser tanto para auxiliar de la pesquisa como para evaluar los marcadores bioquímicos intermedios para agentes quimiopreventivos

Advances in Clinical Application of Fiberoptic Ductoscopy / 中国普外基础与临床杂志

Objective To introduce the current status of clinical application, value and perspective of fiberoptic ductoscopy.Methods The related literatures on advances in clinical application of fiberoptic ductoscopy were reviewed.Results Fiberoptic ductoscopy is now widely used in breast diseases, especially complicated with nipple discharge, and it has a higher accuracy rate than routine examinations. With ductoscopy, ductal lavage,location, biopsy and treatment can be carried out.Conclusion Fiberoptic ductoscopy has a greater value in diagnosis and treatment, we believe it will be better applied and further developed.