Résumé
Objective To explore the effect of preserving intercostobrachial nerve (ICBN) in axillary lymph node dissection on sensory disturbance for breast cancer.Methods Clinical data of 146 cases of stage Ⅰ,Ⅱ and Ⅲa breast cancer patients treated by modified radical mastectomy was analyzed.The patients were randomly divided into two groups.Retention group included 67 patients who were performed axillary lymph node dissection preserving ICBN,and 79 cases undergoing axillary lymph node dissection were taken as control group.Data of the two groups were assessed to compare the operation time,nunber of lymph nodes dissection and sensory abnormalities of upper arms.Results In the follow-up of 1,3 and 6 months,the incidence rate of the lateral upper ann sensory disturbance were 17.9％ and 74.9％,11.9％ and 60.7％,7.4％ and 59.5％ respectively in the retention and control group,and the difference was statistically significant (x2=46.78,P＜0.001;x2=36.54,P＜0.001;x2=42.80,P＜0.001).Meanwhile,there was no obvious difference between the retention and control group in operation time and number of lymph nodes(P＞0.05).No local recurrence after operation occurred in the follow-up of 8 months to 5 years.Conclusions For stage Ⅰ,Ⅱ and Ⅲ a breast cancer patients undergoing axillary lymph node dissection,retaining ICBN can significantly reduce the chance of the postoperative medial upper arm sensory disturbance,improve the quality of life with no increase of local recurrence rate.
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Objective To investigate the relationship among the expression of miR-340 protein, occurrence, development and metastasis in triple-negative breast cancer (TNBC). Method 60 patients with breast cancer, from January 2006 to December 2012, according to the immunohistochemistry expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER-2), were divided into TNBC (33 patients) and non-TNBC (27 patients), and the breast cancer tissues (15 patients) were also selected at the same period, and the expression of miR-340 protein were detected by the immunohistochemistry. Results The positive expression of miR-340 protein was 73.33%in adjacent tissues of breast cancer, 51.52%in TNBC, 29.63%non-TNBC, the expression differences of each group were statistically significant(χ2=7.671,P<0.05). The expression of miR-340 protein in TNBC and non-TNBC patients were no significant difference in age, menopausal status and tumor size;while there were obvious correlation among clinical stage, lymph node metastasis and protein expression of miR-340 in TNBC(P<0.05). Conclusion The gene of miR-340 involves in the occurrence, development and metastasis of TNBC, they would be one of the purposes gene therapy in TNBC.
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Objective To evaluate the effect of ultrasound-guided vacuum-assisted minimal invasive resection(Mammotome procedure)of breast lumps through the retromammary space. Methods Seven hundred and eighty-seven patients in Obstetrics and Gynecology Hospital Affiliated to Fudan University from Jan. 2011 to May 2012 were underwent ultrasound-guided Mammotome operation through the retromammary space (retromammary space group,385 cases),or adjacent the lumps,and followed by post-operation visits regularly (Mammotome operation adjacent the lumps group,402 cases). The operation effects were compared between the two groups. Results All cases were followed up for 12 months. The period of Mmmotome operation through the retromam mary space and the rate of resection were(48 ± 6)min and(52 ± 4)min,99. 48%(383 / 385), 99. 25%(399 / 402),perspectively,in group of Mammotome operation through the retromammary space and Mammotome operation adjacent lumpsand. There was no significant difference between the two groups( P> 0. 05). The amount of procedural bleeding,the incidence of ecchymosis,local hematoma and the number of incision in group of Mammotome operation through the retromammary space were(8 ± 3)ml,2. 34%(9 / 385), 0. 52%(2 / 385),(1. 3 ± 0. 6)respectively,which were significantly lower than those in Mammotome operation adjacent the lumps group((14 ± 6)ml,8. 71%(35 / 402),2. 74%(11 / 402),(2. 4 ± 0. 3)respectively). There were statistical difference between two groups( P = 0. 003,P < 0. 001,P = 0. 001,P = 0. 006). The rate of satisfaction in group of Mammotome operation through the retro-mammary space was 98. 70%(380 / 385),which is significantly higher than in group of Mammotome operation adjacent the lumps(89. 30%(359 / 402),P< 0. 01). Conclusion The therapy approach of ultrasound-guided Mammotome operation through the retromammary space has lower hemorrhagic complication,as well as the better effect with special advantages. Therefore it has prospective clinical application.
Résumé
Objective To explore the surgery methods for multiple fibroadenoma of breast,provide a ref erence for the surgical treatment of breast multiple fibroadenoma.Methods The clinical data of 152 cases of breast multiple fibmadenoma admitted from January 2008 to October 2012 in Department of Breast Surgery,Obstetrics and Gynecology Hospital of Fudan University were analyzed retrospectively.All the cases were applied intraoperative B-ultrasound guided,taken the areola incision through breast subcutaneous layer approach for resection of multiple breast fibroadenoma.The surgical incision design,surgical procedures and results of operations were analyzed.Results All 152 cases fibroadenoma were resected which were guided by B-ultrasound with areola incision.One month and three months after operation,the assessment of physician-patient for the scars were different.There was no significance in the Pearson Correlations which were 0.894 (P =0.106) and 0.905 (P =0.065),respectively.But twelve months later,it satisfied with the appearance of scar,either the patients or the doctors (P ＜ 0.05).The Pearson Correlation was 0.946 (P ＜0.001).Conclusions B-ultrasound guided areola incision through the breast subcutaneous layer approach could removal multiple breast fibroadenoma at one time,patients were satisfacted with the good cosmetic results,we believe this operation method has short operation time and good clinical value.