Endoscopic technique is one of the important development directions of modern surgical techniques. Compared with the laparoscopic and thoracoscopic surgery, the development of endoscopic technology in breast surgery is generally slow due to the limitation of the physiological structure of this organ. The characteristics of endoscopic technology such as micro-incision trauma and remote operation are especially suitable for breast (cancer) surgery, which desires flawless skin surface and perfect remodeling. In the meantime, however, the obstacles of breast (cancer) endoscopic surgery include the establishment and maintenance of a satisfactory surgical field, the endoscopic exposure of large and heavy glands, the obstruction by the slope of the skeletal thorax, the remote operation that is difficult to accomplish with conventional endoscopic instruments, and the complete removal of large and tough glands and so on. By studying and pondering the experience of the pioneers of endoscopy, the endoscopic team of West China Hospital took five years to develop this novel one axillary-incision, single-port and liposuction-free endoscopic surgical approach which is low costing and only requires one-port operation platform. The original “inverse sequence method”, “Huaxi hole no. 1, 2, 3” and other endoscopy-assisted approach overcome the aforesaid obstacles. It has significantly reduced the technical threshold and operational difficulty of breast (cancer) endoscopic surgery and contributed our own wisdom to the vigorous development of breast endoscopic technology in China. The author shared her observations and thoughts on the technical details of breast endoscopic surgery based on her nearly 20 years of experience in endoscopic operation.
Malignant melanoma is a kind of highly malignant tumor, which mainly occurs in the skin, mucous membrane, and rarely in the breast. Here we reported a case of malignant melanoma in the chest wall skin with mammary metastasis. A sizable pigment spot on the skin of the thoracic region was found at the patient’s birth, existing for 50 years with quite atypical clinical manifestation. A nodule at 12 o’clock of the left breast was found by ultrasound four months ago, who was mistaken for a fibroadenoma. As a result, the patient received a minimally invasive excision of the breast lesion, after which the pathological report suggested malignant melanoma. By sharing this case, we aimed to discuss the diagnosis and treatment of this kind of atypical malignant melanoma in detail and provide some clinical experience.
Objective To introduce the current studies on bone biochemical markers in breast cancer with bone metastasis. Methods The papers in recent 8 years about the application of bone biochemical markers in the diagnosis and treatment of breast cancer with bone metastasis were reviewed. Results NTX had the best relation with bone metastasis. ICTP was much more worthy than NTX in diagnosis of breast cancer with bone metastasis. Osteogenesis markers were little worthy in diagnosis of breast cancer with bone metastasis. Conclusion Bone biochemical markers can not replace the image exams and biopsy in diagnosing the bone metastasis of breast cancer,but may be one of the factors to get the early diagnosis.
ObjectiveTo summarize the isolation procedures, molecular characterization, and differentiation and vascularization capacity of adipose-derived stem cells (ADSCs), in order to discuss the potential value of ADSCs for the repairment and regeneration of adipose tissues. MethodsRelated literatures about ADSCs were retrieved to summarize the potential value of ADSCs for the repairment and regeneration of adipose tissues. ResultsAs mesenchymal stem cells, ADSCs was rich in human adipose tissues. ADSCs possessed the potential to differentiate toward a variety of cell lineages, such as adipogenic, chondrogenic, osteogenic, cardiomyogenic, myogenic, and angiogenic. Besides, its capacity of adipogenic differentiation could maintain several passages. The most importantly, ADSCs could secrete significant amounts of angiogenesis-related cytokines, such as vascular endothelial growth factor (VEGF) and fibroblast growth factor-2 (FGF-2), which increased the angiogenesis of adipose tissue. ConclusionsADSCs play a key role in adipose tissue engineering, autologous adipose tissue grafting, and soft tissue wound repairing, which have important application prospect for breast reconstruction.
ObjectiveTo review the properties of bio-derived hydrogels and their application and research progress in tissue engineering. MethodsThe literature concerning the biol-derived hydrogels was extensively reviewed and analyzed. ResultsBio-derived hydrogels can be divided into single-component hydrogels (collagen,hyaluronic acid,chitosan,alginate,silk fibroin,etc.) and multi-component hydrogels[Matrigel,the extract of extracellular matrix (ECM),and decellularized ECM].They have favorable biocompatibility and bioactivity because they are mostly extracted from the ECM of biological tissue.Among them,hydrogels derived from decellularized ECM,whose composition and structure are more in line with the requirements of bionics,have incomparable advantages and prospects.This kind of scaffold is the closest to the natural environment of the cell growth. ConclusionBio-derived hydrogels have been widely used in tissue engineering research.Although there still exist many problems,such as the poor mechanical properties,rapid degradation,the immunogenicity or safety,vascularization,sterilization methods,and so on,with the deep-going study of optimization mechanism,desirable bio-derived hydrogels could be obtained,and thus be applied to clinical application.
ObjectiveTo summarize the burden and epidemiological trends of global breast cancer and China’s breast cancer according to the 2018, 2020 and 2022 versions of the global cancer statistics report jointly prepared by the International Cancer Research Institute of the World Health Organization and the American Cancer Society. MethodThe data of global and Chinese breast cancer in the 2018, 2020, 2022 edition of the Global Cancer Statistical Report were analyzed. ResultsIn 2022, the global new breast cancer was estimated to be about 2.309 million, ranking the second. The crude incidence rate of breast cancer was 54.1 per 100 000, and the age standardized incidence rate (ASIR) was 46.8 per 100 000. In 2022, the global breast cancer death would be about 666 000, ranking the fourth, with the crude mortality rate of 11.3 per 100 000, age standardized mortality rate (ASMR) was 12.6 per 100 000. The incidence rate and mortality rate of breast cancer vary greatly between regions/countries, and were related to the human development index; the crude incidence rate was high in economically developed regions, and the crude mortality rate was relatively increasing, but the ASMR was low. In economically underdeveloped areas, the crude incidence rate was relatively low, and the crude mortality rate was relatively decreasing, but ASMR was high. In 2022, the number of breast cancer patients in China would be 357 000, ranking the fourth, with a crude incidence rate of 51.7 per 100 000 and an ASIR of 33.0 per 100 000. In 2022, there would be about 75 000 deaths from breast cancer in China, ranking the seventh, with a crude mortality rate of 10.9 per 100 000 and an ASMR of 6.1 per 100 000. From 2018 to 2022, the incidence rate and mortality rate of breast cancer in China show a downward trend. ConclusionsBoth the world and China are facing a severe burden of breast cancer, and breast cancer prevention and treatment has a long way to go.
Breast cancer, the most common malignancy in the world, also causes the most death cases of women among malignancies. Breast cancer risk reduction guidelines (version 2023) was updated by National Comprehensive Cancer Network (NCCN). Based on high-level evidences from evidence-based medicine and the latest research progress, the guidelines provided standardized guidance for breast cancer risk assessment and risk reduction strategies for individuals without a history of invasive breast cancer or ductal carcinoma in situ, which has attracted widespread attention from clinicians worldwide. Breast cancer is also the most common malignancy in Chinese women, and the number of newly diagnosed breast cancer cases each year in China ranks first in the world due to the large population, so the breast cancer prevention has become a major public health challenge in China. Aimed to provide reference for breast cancer prevention in China, this article interpreted the guidelines (the new version) based on the characteristics of breast structure in Asian women and the epidemiological characteristics of breast cancer in China.