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.

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

To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province. 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). χ(2) 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 χ(2) test. 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 (χ(2)=47.028, 0.000). 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.

Impact of adjuvant chemotherapy on the survival of patients with estrogen receptor ≥50 ％, human epidermal growth factor receptor-2 negative, lymph node negative breast cancer / 中华普通外科杂志

Objective To study the effect of adjuvant chemotherapy on the survival of patients with ER ≥ 50％,HER2 negative,lymph node negative breast cancer.Methods 428 patients from Jan 1,2004 to Dec 31,2010 were enrolled.All patients received operation plus chemoendocrine therapy (CET,n =239) or endocrine therapy (ET,n =189).Result The median follow-up time was 76.5 months,with 8.2％ loss to follow-up.The recurrence-free survival (RFS) was 93.7％ in CET group and 95.2％ in ET group,the distant disease-free survival (DDFS) was 94.6％ and 97.4％ in CET and ET group respectively.Multivariate regression indicated that the risk of tumor size ＞ 2 cm was higher than that of tumor size ≤2 cm in recurrence (HR=2.31,95％ CI 1.07-5.29,P =0.047) and metastasis (HR=4.71,95％ CI 1.47-11.85,P =0.01).Compared with CET group,however,no statistical significance was found on RFS (HR =1.08,95 ％ CI 0.46-2.57,P =0.86) and DDFS (HR =0.72,95 ％ CI 0.17-1.37,P =0.55) in ET group.Conclusions Adjuvant chemotherapy cannot improve the RFS and DDFS of ER≥50％,HER2 negative,lymph node negative breast cancer.Tumor size ＞ 2 cm was the risk factor of recurrence and distant metastasis.

Breast-conserving surgery with immediate partial breast reconstruction using pedicled thoracodorsal artery perforator flap: a clinical analysis of 33 patients / 中华外科杂志

Objective@#To explore the application value of pedicled thoracodorsal artery perforator flap in immediate partial breast reconstruction for breast cancer.@*Methods@#This study is a prospective case series studies. Totally 128 cases of primary breast cancer patients who prepared to receive the breast-conserving surgery combine with immediate partial breast reconstruction of pedicled thoracodorsalartery perforator flap were enrolled in Breast Cancer Prevention and Treatment Center of Peking University Cancer Hospital from June 2013 to March 2016. Finally, the operations had been completed successfully in 33 eligible cases. All patients were female with a median age of 40 years (ranging from 22 to 52 years). The perforator vessel location, the donor area design, the post-operative complications, the influence of radiation and chemotherapy had been evaluated.@*Results@#The average diameter of thoracic dorsal artery perforators measured by Doppler ultrasound before the operation was (1.5±0.4) mm (ranging from 0.6 to 2.7 mm). The average size of flaps was 15 cm×6 cm. The average time of operations was (271±72) minutes (ranging from 120 to 245 minutes). Drainage tube removed on (4.7±2.1) days after operation (ranging from 3 to 12 days). All patients received follow-up, and there was no local recurrence and distant metastasis during a median follow-up of 17(12) months (M(QR)) (ranging from 5 to 38 months). All TDAP flaps were survival, the wound complication rates was 6% (2/33).@*Conclusions@#The breast reconstruction of pedicled thoracodorsal artery perforator flap is a good choice of repairing local breast defect of breast conserving surgery.Its advantages are no-influence of latissimus dorsi function and little complications in donor area.

Ultrasound-guided minimally invasive biopsy in the diagnosis of minor breast lesions: the contrast between core needle biopsy and vacuum-assisted biopsy / 中华普通外科杂志

Objective To explore the diagnostic value of ultrasound guided core needle biopsy (CNB) and vacuum assisted biopsy (VAB) in minor breast lesions with diameter 0.6 to 1.0 cm.Methods Totally 7 730 cases of breast lesions examined by ultrasound guided minimally invasive biopsy were enrolled in Breast Cancer Prevention and Treatment Center of Peking University Cancer Hospital from April 2014 to May 2016.254 lesions with maximum diameter 0.6 to 1.0 cm in 243 cases were analysed retrospectively (232 unilateral &11 bilateral) and divided into group CNB(152 lesions) and group VAB (102 lesions).The accuracy of pathological diagnosis and the rate of breast conserving surgery were compared between the two groups.Results There were 94 non-malignant and 58 malignant breast lesions as initially diagnosed by CNB.Among those 94 tentative non-malignant lesions,33 underwent open surgical biopsy and 4 malignancies were finally established by pathology.In group CNB,the sensitivity was 93.4％,the specific was 100％,the accuracy was 97.4％.There were 91 non-malignant and 11 malignant lesions as initially diagnosed by VAB.In those with established malignant disease,the rate of breast conserving surgery between group CNB and group VAB was statistically different (62.9％ vs.27.3％,P =0.045).Conclusions Ultrasound guided core needle biopsy and vacuum assisted biopsy are with high accuracy for small breast lesions.The rate of breast conserving surgery for breast cancer is higher in group CNB patients by the different type of minimally invasive biopsy.

Safety of breast-conserving treatment for triple-negative breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of risk factors on ipsilateral breast tumor recurrence (IBTR) and distant disease-free survival (DDFS) for patients with triple-negative breast cancer (TNBC) who underwent breast-conserving treatment (BCT).</p><p><b>METHODS</b>A series of 1 835 patients with primary breast cancer treated with BCT in a single institute between December 1999 and August 2010 were analyzed retrospectively. Totally 1 614 patients, whose characteristics were intact, were analyzed to compare their outcomes with respect to the incidence of IBTR, DDFS and disease-free survival (DFS). All of patients were female. Median age was 47 years (ranging 21 to 92 years, interquartile range 14 years). According to the immunohistochemical results of the patients, 1 614 cases were divided into TNBC group (n=308) and non-TNBC group (n=1 306). The risk factors of relapse after breast-conserving treatment (age at diagnosis, spread to axillary lymph nodes, hormone receptor status, neoadjuvant chemotherapy, and maximal tumor diameter, human epidermal growth factor receptor 2 (HER-2) status, preoperative MRI, the location and extent of the tumor bed defined by CT scans for electron boost planning as part of breast radiotherapy) were studied.χ(2) test was used to compare the distribution of baseline characteristics among subtypes. The probability of survival (or relapse occurrence), and DDFS were calculated using the Kaplan-Meier method. Cumulative incidence functions were used to describe the cumulative hazard from LR, IBTR and DDFS in the presence of competing risks.</p><p><b>RESULTS</b>A total of 1 614 women with primary breast cancer underwent a breast-conserving surgery followed by radiotherapy. The median follow-up period was 77 months (interquartile range 36 months). One hundred and forty patients (8.6%) were lost to follow-up. Overall 5-year IBTR rate was 3.1% (95% CI: 2.2% to 4.0%), 5-year DDFS rate was 95.8% (95% CI: 94.9% to 96.7%) and 5-year DFS rate was 93.8% (95% CI: 92.7% to 94.9%). Lymph nodal involvement (HR=3.03, 95% CI: 1.66 to 5.51, P=0.000) and use of CT information in boost field planning (HR=0.40, 95% CI: 0.20 to 0.80, P=0.010) were associated significantly with IBTR in Cox multivariable analysis. Multivariable analysis showed that TNBC doesn't have a significantly increased risk of IBTR compared with the non-TNBC subtype (HR=0.90, 95% CI: 0.50 to 1.76, P=0.78). TNBC was not an independent risk factor for DDFS or DFS. The multivariable model showed significant effect of nodal status and age at diagnosis on 5-year DDFS rate and 5-year DFS rate.</p><p><b>CONCLUSIONS</b>Breast-conserving treatment for TNBC is not associated with increased IBTR compared with non-TNBC subtype. Use of CT information in boost field planning can reduce the risk of ipsilateral breast tumor recurrence for patients undergoing BCT.</p>

Neoadjuvant chemotherapy using epirubicin, cyclophosphamide and fluorouracil: neutropenia and elevation of transaminase, and their management / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To retrospectively investigate the incidence of severe neutropenia and elevation of transaminase during neoadjuvant chemotherapy using epirubicin, cyclophosphamide and fluorouracil in breast cancer patients.</p><p><b>METHODS</b>From January 2011 to December 2012, 303 consecutive breast cancer patients with complete treatment data treated in our department were included in this analysis. All patients received neoadjuvant chemotherapy with equal dose of EPI (100 mg/m(2)) administered every 3 weeks for 4 cycles before surgery.</p><p><b>RESULTS</b>200 patients (66.0%) experienced at least one episode of grade 3/4 neutropenia/leukopenia, among them 176 patients experienced their first episode after the first cycle. Febrile neutropenia (FN) occurred in 13 patients for 14 episodes. Elevation of transaminase occurred in a total of 46 patients (15.2%), among them, grade 2 or higher elevation occurred in 15 patients (5.0%). Three blood test plans were adopted to monitor the patients during chemotherapy: (1) Routine blood count repeated every week; (2) Routine blood count before and on day 10 of each chemotherapy episode; (3) Routine blood count before and on day 7, 10 and 14 of each chemotherapy episode. The number of patients whose chemotherapy was delayed due to 3/4 neutropenia/leucopenia in each blood test plan was 3 (5.0%), 7 (3.9%) and 2 (3.2%), respectively. The number of patients with febrile neutropenia (FN) in each blood test plan was 2 (3.3%), 8 (4.4%) and 3 (4.8%), respectively. No statistically significant difference in treatment delay or the incidence of FN was observed among different blood test plans. No statistically significant difference in the incidence of grade 3/4 neutropenia/leukopenia or grade 2 or higher transaminase elevation was observed among different 5-Fu regimens.</p><p><b>CONCLUSIONS</b>During neoadjuvant chemotherapy using FE100 C, Fci E100 C or E100 C for breast cancer patients without routine prophylactic G-CSF, the incidence of grade 3/4 neutropenia/leukopenia is 66.0%. With the patient management plan we adopted, 4.3% of patients developed febrile neutropenia. Prophylactic medication may not be necessary for patients without evident liver dysfunction.</p>

Ultrasonic features of triple-negative breast cancer / 中国医师杂志

Objective To investigate the ultrasonic features of triple-negative breast cancer (TN-BC).Methods Ultrasonographic findings of 299 patients with pathologically confirmed breast cancer were analyzed retrospectively.Patients were divided into TNBC group (46 cases) and non-triple-negative breast cancer(NTNBC) group (253 cases) according to the expression of estrogen receptor (ER),progesterone receptor (PR),and human epidermal growth factor receptor 2 (HER2) that were determined with immunohistochemical staining.Each patient was ultrasonically analyzed.Results The ultrasonic images showed that TNBC group had a greater proportion in the mass with regular shape,clear boundary,or microlobulated relative to NTNBC group (P ＜ 0.01).Calcification was significantly less in TNBC than NTNBC (P ＜0.01).Eight (17.3％)of 46 Cases of TNBC had BI-RADS sonographic features that favored the diagnosis of a benign condition.Conclusions Some of sonographic criteria for TNBC are more likely to be associated with benign lesions,ultrasound-guided biopsy should be recommended for such lesions.

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.

The study of associations between circulating tumor cells and clinicopathologic characteristics in axillary lymph node positive primary breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the correlations between circulating tumor cell (CTC) and clinicopathologic characteristics of tumors obtained by core needle biopsy in axillary lymph node positive primary breast cancer patients.</p><p><b>METHODS</b>The peripheral venous blood samples were collected from 126 patients with axillary lymph node positive primary breast cancer and were detected to found CTCs using the CellSearch automatic detection system. The associations between CTCs and clinicopathologic characteristics of tumors were analyzed in axillary lymph node positive primary breast cancer patients. All patients were female, age ranging from 27 to 65 years (median, 49 years).</p><p><b>RESULTS</b>One or more CTCs were detected from the peripheral blood in 25.4% (32/126) patients. The positive rate of CTCs was 36.2% (17/47) in the human epidermal growth factor receptor 2 (HER-2) (+) patients, 19.0% (15/79) in the HER-2 (-) patients. In univariate analysis, there were significant differences about the positive rate of CTCs between the two groups (χ² = 4.592, P < 0.05). In multivariate analysis, the risk of circulating tumor cells positive in HER-2 (+) patients was 2.712 times higher than in HER-2 (-) patients (OR = 2.712, 95% CI: 1.117-6.584, P = 0.027), whereas the positive rate of CTCs in axillary lymph node positive primary breast cancer patients showed no significant differences among the different subgroups with regards to age, menopausal status, the T staging of the tumor, histological type, histological grade, hormone receptor status and Ki-67 expression level (P > 0.05).</p><p><b>CONCLUSIONS</b>There are significant correlations between the presence of CTCs and the HER-2 status of the tumor in axillary lymph node positive primary breast cancer patients. No significant correlations are found between the presence of CTCs and the age, menopausal status, T staging of the tumor, histological type, histological grade, hormone receptor status and Ki-67 expression level.</p>

Time distribution of postoperative recurrence for breast cancer patients with different hormone receptor status / 中华普通外科杂志

Objective To study the time distribution of recurrence for postoperative breast cancer patients by hormone receptor status.Methods The characteristics of recurrence in 1099 breast cancer patients with different hormone receptor status undergoing surgery between December 1999 and April 2006 were analyzed retrospectively.Results For those 1099 patients the median follow-up time was 60.6 months.Recurrence was found in 171 patients.For hormone receptor-negative (HRN) patients the first peak of recurrence appeared at the 12th month and the second at about the 54th month.For hormone receptor-positive (HRP) patients the peak of recurrence appeared at the 36th month and a second peak at about the 54th month,and beyond 54 months the hazard was higher for hormone receptor-positive patients.The risk of recurrence was higher with more nodes involved.Node-positive HRP patients suffered two to three times higher risk of recurrence than node-negative HRP patients.Node-positive HRN patients had three to four times higher risk of recurrence than node-negative HRN patients.The recurrence-free survival in HRP patients was higher than that in HRN patients,also the recurrence-free survival in node-negative HRP patients was higher than that in node-positive patients (all P ＜ 0.01).Conclusions The recurrence risk for HRP breast cancer patients was higher than that in HRN patients after 54 months postoperatively.The risk of recurrence for node-positive breast cancer patients was higher than that for HRP node-negatives.

Efficacy analysis of THP-containing regimens as neoadjuvant and adjuvant chemotherapy for primary breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the effect of anthracycline pirarubicin-based regimen in association with different ways of fluorouracil (5-Fu) as neoadjuvant and adjuvant chemotherapy for primary breast cancer.</p><p><b>METHODS</b>Two hundred and eighty-nine primary breast cancer patients who were to be operated, two to eight cycles of pirarubicin in association with cyclophosphamide and 5-Fu (CTF or CTFci regimen) were given before operation. The pathological response rate, effect and its relation with the infusion routes of 5-Fu were analyzed.</p><p><b>RESULTS</b>The overall pathological complete remission (pCR) rate was 28.4%. The median follow-up period was 39 months. The 5-year DFS was 87.6% (95% CI:82.1% to 92.7%), 5-year DDFS was 89.9% (95% CI:84.0% to 95.8%), and overall survival was 99.6%. CTFci (5-Fu, continuous infusion) regimen was superior to CTF regimen in pCR rates (32.3% vs. 20.2%, P = 0.037), and 5-year DDFS were 92.9% and 80.1%, respectively (P = 0.015). The pCR group was superior to non-pCR group in 5-year DDFS (92.4% vs. 85.6%, P = 0. 033). The pCR rate of patients with ER/PR-positive tumor was significantly lower than those of ER/PR-negative (P = 0.004). The 5-year DDFS rates of HER-2 (+) and HER-2(-) groups were 75.0% and 91.9%, respectively (P = 0.043). In the ER/PR-positve group, the 5-year DDFS of CTFci regimen was superior to those of CTF regimen, 91.4% vs. 81.4% (P = 0.047).</p><p><b>CONCLUSIONS</b>CTF/CTFci regimen as neoadjuvant and adjuvant chemotherapy is effective for primary breast cancer. CTFci regimen is superior to CTF regimen in pathological complete response rate and 5-year DDFS. CTFci regimen may do better to ER/PR (+) patients' benefits compared with CTF regimen.</p>

Comparison of other cancers in Chinese han women with familial and sporadic breast cancer / 国际外科学杂志

ObjectiveTo investigate the family history of other cancers in Chinese han women with familial or sporadic breast cancer.Methodswe analyzed the clinical date of 4 847 primary breast cancer patients cancer patients were treated at the Breast Cancer,Peking University Cancer Hospital between October 2003 and February 2011,among them,465 were familial and4 382 were sporadic breast cancer patients.The differences of family history of cancers other than breast or ovarian cancers were compared between the patients with familial breast cancer and sporadic breast cancer.Results The proportion of cancers other than breast or ovarian cancers in familial breast cancer patients was significantly higher than that in sporadic breast cancer patients(29.7％ vs 20.8％,odds ratio 1.61,P＜ 0.001).Furthermore,the proportion in pancreatic cancer,prostate cancer,and renal cancer in familial breast cancer patients was significantly higher than that of sporadic breast cancer patients ( pancreatic cancer:2.2％ vs 0.8％,P =0.002 ; prostate cancer:1.5％ vs 0.3％,P ＜ 0.001 ; renal cancer:1.1％ vs 0.4％,P =0.03,respectively).And the relative risks of pancreatic cancer,prostate cancer,and renal cancer in the familial breast cancer patients were 2.90-fold,6.07-fold,and 2.97-fold higher than that of sporadic breast cancerpatients,respectively.ConclusionsOur results suggest that the relative risk of cancer other than breast or ovarian in familial breast cancer patients is significantly higher than that in sporadic breast cancer patients,especially pancreatic cancer,prostate cancer,and renal cancer.

The oncologic safety of breast-conserving surgery for breast ductal carcinoma in situ / 中华普通外科杂志

ObjectiveTo evaluate the safety of breast-conserving surgery for ductal carcrnoma in situ (DCIS).MethodsOne hundred and nineteen patients with pathologically confirmed DCIS were analyzed retrospectively. The relationship among local recurrence and distant metastasis with relevant factors including surgical procedure, age, tumor size, estrogen/progesterone status and human epithelial receptor 2 (HER-2) status were analyzed by univariate and multivariate methods.ResultsIn this study 48 patients received breast conserving surgery,71 patients received mastectomy. All patients were followed up for 7-132 months (median 35 months). Chest wall recurrence was found in mastectomy group in one case and none in ipsilateral breast tumor recurrence (IBTR) in breast conservation group (P =0. 384). Two patients had distant metastasis in mastectomy group, and one patient in breast conserving group ( P =0. 383 ). The three year disease-free survival (DFS) were 100％ and 94. 4％ in breast conserving and mastectomy groups respectively(P =0. 225). Univariate analysis showed that age( ＜40 years)was the risk factor for distant metastasis(P =0. 035) ,a factor not confirmed by multivariate analysis (P =0. 086).ConclusionsThere is no significant difference on local recurrence and distant metastasis between breast conserving surgery and mastectomy for DCIS of the breast.

The clinical research of local recurrence after breast-conserving therapy for breast cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To compare and analyze the data of breast cancer recurrence after breast-conserving therapy (BCT), and to find high risk factors that can affect local recurrence.</p><p><b>METHODS</b>A total of 1034 patients in the data base between January 2000 and June 2008 were analyzed retrospectively. The patients aged 23 to 94 years when diagnosed (median age, 48 years). The data was investigated to compare of two different groups in local recurrence rate and survival rate. The high risk factors of recurrence after BCT [estrogen receptor (ER)/progesterone receptor (PR), human epidermal growth factor receptor (HER-2), age, lymph node involvement, tumor diameter, neoadjuvant chemotherapy, pathological status] were studied.</p><p><b>RESULTS</b>The patients were followed-up to June 2010, and the median period was 42 months (range, 3-126 months). During the period, 35 patients developed ipsilateral breast tumor recurrence (3.3%), 47 patients had metastasis to distant organs (4.5%). The 5-year disease-free survival was 87.7%, 5-year distant disease-free survival was 94.0%. The lymph node status, HER-2 status and age were significant risk factors for ipsilateral breast tumor recurrence on univariate analysis. One peak recurrence period was from the 2nd to 3rd year, and the other was from the 5th to 6th year after the operation. The HER-2 status was independent factors of ipsilateral breast tumor recurrence on multivariate analysis.</p><p><b>CONCLUSIONS</b>The recurrence happens primarily in the 2nd to 3rd and the 5th to 6th year after the breast-conserving therapy. HER-2 status is an independent factor of ipsilateral breast tumor recurrence. The patients with high risk factors of recurrence should be treated more aggressively.</p>

Association between MDM2 SNP309 Polymorphism and Breast Cancer Risk in Chinese Women / 中国肿瘤临床

Objective: To investigate the correlation of MDM2 SNP309 polymorphism with breast cancer risk in Chinese women. Methods: The polymorphism of MDM2 SNP309 was detected by PCR-restriction frag-ment length polymorphisms assay (PCR-RFLP) in 698 women with primary breast cancer and 525 healthy controls. Results: Compared with the T/T genotype, the G allele (T/G or G/G) was not associated with an in-creased risk of breast cancer in the entire population studied (T/G, adjusted OR=1.2, 95% CI: 0.8-1.6, P=0.30; G/G, adjusted OR=1.0, 95% CI: 0.7 ～ 1.5, P=0.88). Among postmenopausal women, the G allele (T/G or G/G) was significantly associated with an increased risk of breast cancer (T/G, adjusted OR=1.8, 95% CI:1.2～3.0, P=0.011; G/G, adjusted OR=1.9, 95% CI: 1.2～3.3, P=0.014). But this association was not ob-served among premenopausal women. Conclusion: MDM2 SNP309 heterozygous T/G genotype and homozy-gous mutant GIG genotype increase breast cancer risk in postmenopausal Chinese women.

Correlation between elastography score and strain rate ratio in breast small tumor / 中南大学学报(医学版)

Objective To explore the value of elastography score and strain rate ratio in the diagnosis of small breast malignant focus. Methods We retrospectively analyzed 22 patients with breast small malignant foci less than 10 mm. Ultrasound characteristics were summed up in breast small cancer. Results On elastogram, 2 patients scored 3, 14 scored 4 and 6 scored 5.The average strain rate ratio of all foci was 4.76, and there was correlation between it and elastography scores. Conclusion Ultrasonic elastography has important value in the diagnosis of breast small cancer.

Prognostic role of apoptosis-related gene Fas-1377 and -670 polymorphisms in breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the correlations between Fas-1377 and -670 polymorphisms and survival in Chinese women with breast cancer.</p><p><b>METHODS</b>Polymerase chain reaction-restriction fragment length polymorphism assay (PCR-RFLP) was used to detect the polymorphism of Fas gene in 310 breast cancer patients with a long-term follow-up (median 10.5 years, range 0.2 - 16.1 years). Survival curves were analyzed by Kaplan-Meier method.</p><p><b>RESULTS</b>The polymorphism of neither Fas-1377 nor Fas-670 was significantly correlated with the overall survival in this series of 310 cases (P > 0.05). However, among 146 patients without lymph node metastasis, the 5-year overall survival (OS) rate was significantly lower in the patients with Fas-1377 AA genotype than that in the patients with Fas-1377 GA or GG genotype (OS: 66.7% vs. 95.4%, P = 0.03). Among 117 patients with lymph node metastasis, both the Fas-1377 and Fas-670 polymorphisms were not significantly correlated with OS (P = 0.42).</p><p><b>CONCLUSION</b>Among breast cancer patients without lymph node metastasis, patients with Fas-1377 AA genotype may have a worse survival, while patients with Fas-1377 GA or GG genotype may not be so.</p>

Correlation of BRCA1 and APC aberrant methylation with the response to anthracycline-based neoadjuvant chemotherapy in primary breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the correlation of hypermethylation of BRCA1 and APC gene promoters with the response to anthracycline-based neoadjuvant chemotherapy in primary breast cancer.</p><p><b>METHODS</b>One hundred and forty patients with primary breast cancer received anthracycline-based neoadjuvant chemotherapy, and pretreatment hypermethylation status of BRCA1 and APC genes promoters was detected by methylation-specific PCR.</p><p><b>RESULTS</b>Of the 140 patients, 30 (21.4%) achieved pathological complete response (pCR), and methylation rates of BRCA1 and APC gene promoters were 21.4% (30/140) and 18.3% (24/131), respectively. Among the 110 patients with unmethylated BRCA1 gene, 28 (25.5%) achieved pCR, while in the 30 patients with methylated BRCA1 gene, only 2 (6.7%) had a pCR, with a significant difference between the two groups (chi(2) = 4.94, P = 0.026). However, no statistically significant correlation was found between the methylation of APC gene and pCR to neoadjuvant chemotherapy in this cohort of patients (P > 0.05).</p><p><b>CONCLUSION</b>Primary breast cancer with an unmethylated BRCA1 gene is prone to achieve a pathological complete response to anthracycline-based neoadjuvant chemotherapy than those with a methylated BRCA1 gene. BRCA1 methylation status may be a useful predictor for anthracycline-based neoadjuvant chemotherapy in primary breast cancer patients.</p>