Effect of mammary ductoscope in treatment of lactational mastitis induced by galactostasis / 中华内分泌外科杂志

Objective To investigate the effect of mammary ductoscope in treatment of lactational masti-tis induced by galactostasis ( nonbacterial mastitis ) .Methods This study included 200 patients with galactosta-sis-induced lactational mastitis in Department of Breast Surgery , Puyang Maternal and Child Health Care Hospital of Henan Province, from Jul.2010 to Jun.2014.The affected lactiferous ducts were unblocked and flushed un-der mammary ductoscope.The treatment outcomes were analyzed .Results Of all patients, 85%(170/200)were cured after being treated once, 7.5%(15/200)were cured after being treated twice, 2.0%(4/200)were cured af-ter being treated three times, and 5.5%(11/200)were converted to other therapies;97.0%(194/200)continued lactation after treatment .Conclusions The mammary ductoscope is effective in identifying the blockade of lactifer-ous ducts and draining the lactiferous ducts with galactostasis .It provides an effective diagnostic and therapeutic means for patients with galactostasis-induced lactational mastitis and can increase the accuracy of etiological diagno -sis and the cure rate.In addition, the space-occupying lesions in lactiferous ducts can be identified and located in time with the mammary ductoscope , thus reducing the length of operation .

A clinical study on upper limb lymph-node-conserving surgery in axillary lymph node dissection for early breast cancer / 中华内分泌外科杂志

Objective To evaluate the feasibility of upper limb lymph node conservation in axillary lymph node dissection(ALND)for early breast cancer patients.Methods This study involved 52 patients.Before ALND,they were,injected 5 ml of methylene blue subcutaneouly in ipsilateral upper limb for upper limb lymphatic mapping.Level II lymph nodes and upper limb lymph nodes were respectively separated from axillary lymph nodes during operation.Level II lymph nodes were given intraoperative imprint cytology and frozen section.All lymph nodes were given routine pathological examination after operation.Results Of the 52 patients,50 cases showed blue stained lymphatic vessels or lymph nodes in the axillary region.The rate of blue dye under naked eyes was 96.2%(50/52).The postoperative pathological examination showed there were 31 cases of axillary lymph nodes metastasis in patients with blue stained lymph nodes.There was 1 case with metastasis to level II lymph nodes only(2.0%)and 30 cases with metastasis to level I lymph nodes(60.0%).There were 10 cases with metastasis to both level II and level I lymph nodes(22.0%).There were 3 cases with metastasis to both level II and upper limb lymph nodes.3 patients with metastasis to upper limb lymph nodes all had metastasis to level II lymph nodes.For cases with metastasis to level I lymph nodes only,pathological examination showed there was no metastasis to the blue stained lymph nodes removed from the axillary region.For the ll cases with metastasis to level II lymph nodes,8 cases were successfully detected by intraoperative imprint cytology,9 cases were detected by frozen section and 10 were detected by the combination of imprint cytology and frozen section.Comparing the combining method(intraoperative imprint cytology and frozen section)and postoperative routine pathological examination,the concordant rate was 98.0%(49/50).Conclusions Subcutaneous methylene blue injection in ipsilateral upper limb call effectively map lymph nodes of upper limb in the axillary region.The upper limb lymph-node-conserving surgery in ALND can be performed if the patients don't have level II lymph node metastasis identified by intraop erative rapid pathological examination.

Diagnosis and treatment of 17 cases male breast cancer / 中华内分泌外科杂志

Objective To investigate the clinical features and treatment of male breast cancer. Methods Retrospective analysis was made on 17 cases of male breast cancer treated in our hospital and the City Peoples Hospital from 1995 to 2009. Results The number of male breast cancer accounted for 0.7% of the total breast cancer admitted in the same period. All the 17 cases were diagnosed by pathology, including 10 cases infiltrating ductal carcinoma, 3 cases Paget disease, 2 cases adenocarcinoma, 1 case medullary carcinoma and 1 case mucinous adenocarcinoma. Conclusions The common symptom of male breast cancer is a painless lump under the areola, sometimes with nipple retraction, nipple discharge, and pain. Prognosis of male breast cancer is related to treatment timing and whether the treatment is standard or not. Surgical approaches are mainly based on modified radical mastectomy and radical mastectomy. Autologus skin graft is often needed. Postoperative chemotherapy, radiotherapy, endocrine therapy and traditional Chinese medicine therapy depend on clinical and pathological features.