[Diagnosis and treatment of occult breast cancer: report of 23 cases].

OBJECTIVE: To explore the presenting clinical features, management approach and treatment outcomes for occult breast cancer. METHODS: Twenty-three patients with occult breast cancer presenting with axillary nodal metastases treated in our department between 1986 and 2007 were included in this study. The clinicopathological, imaging and follow-up data of the 23 cases were retrospectively analyzed. RESULTS: All patients were female. The mean age of diagnosis was 57.7 years with a range of 27 - 73 years. The mean follow-up was 15.70 months (range 1 - 62 months). Eight cases in 17 patients were positive by breast ultrasound, three cases in 9 patients were positive by mammography, one case in 2 patients was positive by breast MRI. 20 patients underwent modified radical mastectomy and three patients did not receive the mastectomy treatment. 16 patients had chemotherapy, four patients had radiotherapy, two patients had both chemotherapy and radiotherapy. Two patients had pulmonary metastasis, one patient had recurrence of axillary nodes, pulmonary metastasis and bone metastasis during follow-up. CONCLUSIONS: A normal check before operation to exclude a cancer of other origin can help to diagnose occult breast cancer. The breast must be treated. Axillary nodal dissection and mastectomy, or breast conservation with radiation therapy alone can be considered as a management option.

[Application of breast conservative therapy in breast cancer patients with nipple discharge].

OBJECTIVE: To study the feasibility of breast conserving treatment in breast cancer patients with nipple discharge. METHODS: Retrospective analysis were carried out in 7 cases of breast cancer patients with nipple discharge who were treated by central segmental resection with latissimus dorsi myocutaneous transfer. RESULTS: No flap necrosis is happened, and cosmetic outcome was excellent in all 7 patients. Average follow-up was 7 months, there was no local recurrence and distant metastasis. CONCLUSION: Central segmental resection with latissimus dorsi myocutaneous transfer as the local treatment strategy for breast cancer patients with nipple discharge is feasible and safe.

[Treatment of premenopausal patients with advanced or recurrent breast cancer by chemical ablation].

OBJECTIVE: To evaluate the clinical efficacy and safety of luteinizing hormone releasing hormone (LH-RH) analog in premenopausal patients with advanced or recurrent breast cancer. METHODS: LH-RH analog (enantone 3.75 mg/2 ml) were administered to 28 premenopausal patients with advanced recurrent breast cancer and its efficacy and side effect were observed. RESULTS: The response rate (complete response and partial response) was 42.9%, and after 8 weeks of treatment, the plasma estrogen in all patients decreased to the level of postmenopause. No major adverse events were observed. CONCLUSIONS: LH-RH analog is effective and safe for premenopausal breast cancer with low adverse reaction and its administration method is easy.

[Diagnosis and treatment of Paget's disease of the breast: report of 33 cases].

OBJECTIVE: To study the clinical features and histologic criteria of Paget's disease of breast, and evaluate the potential prognostic factors for better appropriate treatment strategies. METHODS: Thirty-three patients treated for Paget's disease of breast were reviewed retrospectively. RESULTS: The median age of diagnosis was 57 years. Twenty-nine patients were treated by modified radical mastectomy, 4 cases by mastectomy. Twenty-three (69.7%) patients had underlying carcinoma. Twenty-six (78.8%) patients did not have a palpable breast mass, 10 of them was simple Paget's disease, eight had ductal carcinoma in situ, eight had invasive ductal carcinoma. Seven patients had a palpable breast mass, and none of them was simple Paget's disease, except one of them had ductal carcinoma in situ, six had invasive ductal carcinoma. CONCLUSIONS: Most patients with Paget's disease had associated breast carcinoma. Paget's disease of the breast with a palpable breast mass is more likely to be accompanied by an invasive ductal carcinoma and had a poor prognosis. Patients with any nipple complaints deserve a serious investigation.