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Objective:To explore clinical application value of immediate breast reconstruction with silicone prosthesis after nipple areolar sparing mastectomy for breast cancer.Methods:The clinical data of 30 breast cancer patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy from January 2016 to January 2018 were collected. In the observation group, 15 patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy. In the control group, 15 patients underwent conventional modified radical mastectomy only. The differences of operation indicator and postoperative complications between the two groups were compared, and the postoperative cosmetic effects were evaluated.Results:The patients successfully completed prosthetic breast reconstruction in the observation group. The surgical time and indwelling time of the drainage tube in the observation group were both increased compared with the control group, and the difference was statistically significant ( t=118.8 and t=23.9, P<0.05). There were no statistically significant differences between the two groups in the complications of postoperative flap necrosis, subcutaneous hematoma, intraoperative infection and incision dehiscence ( P>0.05). The total complications rate of the observation group was 40%, compared with the control group (20%), there were not statistically significant differences ( P>0.05). The postoperative aesthetic effect evaluation showed that the reconstructed breast was full in shape and basically symmetrical to the contralateral side, with an excellent and good rate of 83.3%. The patients were satisfied with the appearance of the breast. All patients were followed up for 12 to 36 months with the average time of 24 months, and local recurrence and distant metastasis were not observed. Conclusions:In the modified radical mastectomy for breast cancer with preserved nipple and areola, the immediate application of silicone prosthesis for breast reconstruction has the advantages of less trauma, faster postoperative recovery and better cosmetic effect, which is worthy of clinical application.
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Objective To investigate the clinical significance of peripheral blood metastasis in breast cancer and its relationship with the metastasis suppressor gene BRMS1.Methods Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of micrometastatic marker hMAM-RNA in the peripheral blood of 149 cases of invasive breast carcinoma.Immunohistochemical method was used to detect the expression of BRMS1 protein in breast cancer tissues after surgery.The recurrence was followed up.SPSS19.0 statistics software was used to analyze the data.Results Among the 149 cases of invasive breast carcinoma patients with preoperative peripheral blood,expression of hMAM-RNA was found in 71 cases,and the micrometastasis rate was 47.65％.Peripheral blood micrometastasis rate in breast cancer was closely related to tumor TMN stage,lymph node metastasis and postoperative recurrence (P＜0.05);while it had nothing to do with patients' age,tumor size,pathological types or tumor tissue typing (P＞0.05).The expression of BRMS1 in postoperative breast cancer tissue was detected in 56 cases,and the positive rate was 37.58％.For BRMS1 positive cases,16 cases had peripheral blood micrometastasis (the positive rate was 28.57％);For BRMS1 negative cases,55 cases had peripheral blood micrometastasis (the positive rate was 51.93％).The difference had statistical significance and the two showed a significant negative correlation(r=-0.296,P＜0.01).With the gradual increase of positive staining intensity of BRMS1 protein,the micrometastasis rate of peripheral blood of breast cancer showed a significant decrease (P＜0.05).At the same time,among patients with positive peripheral blood micrometastasis,the recurrence rate of patients with positive BRMS1 (12.5％) was significantly lower than that of patients with negative BRMS1 (43.64％),and the difference was statistically significant(P＜0.05).Conclusions BRMS 1 expression and breast cancer micrometastasis in peripheral blood is closely related.BRMS1 can also be used as an important molecular marker for determining micrometastasis in peripheral blood of breast cancer.Routine detection of BRMS1 expression in breast cancer tissue is helpful for clinical understanding of breast cancer patients,peripheral blood micrometastasis and postoperative recurrence,thus guiding clinical individualized treatment and prognosis.
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Objective To investigate the expression and clinical significance of RhoC protein in breast cancer.Methods Expression of RhoC protein was detected by immunohistochemlstry in 112 cases of breast cancer,20 cases of adjscent non-cancerous normal tissues and 15 cases of normal mammary gland tissues.The relation between expression of RhoC protein and clinicopathological characteristics was analyzed.Expression of CD34 in breast cancer tissues was detected.Microvessel density(MVD)was calculated and its correlation with RhoC protein Was analyzed.Results RhoC had a positive expression rate of 40.2%(45/112)in breast cancer,while it was not expressed in adjacent non-cancerous tissues or normal mammary gland tissues.Rhoc expression in breast tissues was related to lymph node metastasis and pathological stages(P<0.05).MVD value in patients with positive RhoC expression was significantly higher than that in patients with negative RhoC expression(P<0.05).Conclusions The expression of RhoC protein is related to lymphatic metastasis,pathological stages and MVD value.The upregulation of RhoC protein expression may promote the metastasis and invasion of breast cancer.