ObjectiveTo evaluate the clinical value of multi-slice CT in the diagnosis of complications due to breast augmentation. MethodsWe collected the imaging data of 32 female patients who accepted multi-slice CT examination in the second People's Hospital of Chengdu after breast augmentation between February 2010 and February 2015. The position, shape, edge, internal density, leakage, rupture and hard nodules of the prosthesis were observed and analyzed carefully. ResultsIn the 32 patients with breast augmentation, 12 were normal with bilateral symmetry and without abnormal shape or density. Among the other 20 patients, 11 had capsular contracture, 5 had prosthesis leakage, rupture and hard nodules, 4 had breast infection, 1 had fibroadenoma, 1 had cystoma, and 5 had little calcified nodules in the breast tissue. ConclusionThe multi-slice CT scan can clearly and accurately show the position, shape and size of the breast prosthesis as well as the existence of leakage, rupture and hard nodules in the prosthesis. It plays a very important role in the diagnosis of the complications due to breast augmentation and can be effective guidance for clinical operation.
Objective To study the relationship between metalloproteinases (MMPs) and breast cancer. Methods The literature in recent years on the relationship between the expression of MMPs and breast cancer was reviewed. Results The balance between MMPs and tissue inhibitors of metalloproteinases (TIMPs) is keeping normally kept in human body. Many of the studies showed that the expression of MMPs is increased in breast cancer. Conclusion The growth, invasion and metastasis of breast cancer is closely related with the increased expression of MMPs. This suggests that MMPs is a valuable prognostic marker and TIMPs would be a novel drug against cancer.
To investigate the relationship between metallothionein (MT) and prognosis in breast cancer MT expression was determined with immunohistochemical method (SABC). Results: There was a statistically significant association between expression of MT in breast benign and malignant disease (Ｐ＜0.005). The positive rate was 73.8%(62/84) and 15.0%(3/20) in breast cancer and mastofibroma respectively. The positivity of MT was ber in advanced clinical stages than in early clinical stages. There was no association between MT expression and lymph node metastasis. The mortality of the cancer cases with lymph node metastasis having positive MT expression was higher than those with negative MT expression. Conclusion: MT can be taken as a prognostic index of breast cancer.
ObjectiveTo explore the clinical application of combined transverse upper gracilis flap and adductor magnus perforator flap in breast reconstruction of breast cancer patients after mastectomy.MethodsBetween August 2016 and February 2017, the combined transverse upper gracilis flap and adductor magnus perforator flap was used in 12 cases of breast cancer patients who received modified radical surgery for breast reconstruction. All patients were females with the age of 32 to 59 years (mean, 41.5 years). There were 7 cases in left side and 5 cases in right side. Eight cases were received breast reconstruction by one-stage operation and 4 cases by two-stage operation. In one-stage operation cases, pathological diagnosis includes invasive ductal carcinoma in 4 cases and invasive lobular carcinoma in 4 cases. The disease duration ranged from 2 to 9 months (mean, 4.5 months). In two-stage operation cases, the time interval between mastectomy and breast reconstruction ranged from 12 to 70 months (mean, 37.4 months). The length of flap was 20-28 cm, the width of flap was 5.5-7.5 cm, the thickness of flap was 2.5-4.5 cm. The length of gracilis flap pedicle was 6.5-9.2 cm, the length of adductor magnus perforator flap pedicle was 7.5-10.4 cm. The weight of flap was 295-615 g.ResultsThe ischemia time of flap ranged from 95 to 230 minutes (mean, 135 minutes). All flaps were successfully survived. All incisions of recipient donor sites healed by first intention. All patients were followed up 7-14 months (mean, 9.5 months). The reconstructed breasts’ shape, texture, and elasticity were good and no flap contracture deformation happened. Only linear scar left in the donor sites, but the function of thighs was not affected. No local recurrence happened during follow-up.ConclusionWith appropriate patient selection and surgical technique, the combined transverse upper gracilis flap and adductor magnus perforator flap can be a valuable option as an alternative method for autologous breast reconstruction.
【Abstract】 Objective To research the significance on expression of vascular endothelial growth factor-C (VEGF-C) in human breast carcinoma, benign diseases and normal mammary gland by self-constructed tissue chips and research its relationship to regional lymph node metastasis. Methods The tissue chips containing specimens of breast carcinoma, breast benign disease and normal mammary gland were designed and constructed. The expression of VEGF-C in the specimens was detected by the tissue chips and immunohistochemical method, and researched the relationship of the expression of VEGF-C in breast cancer with regional lymph node metastasis. Results The positive rates of VEGF-C in the centre and borderline of carcinoma and distant mammary gland （the distance from the tumor’s bouncary ＞3 cm） were 69.4%（68 /98）, 69.1%（67 /97） and 52.9%（36 /68）, respectively， but not in benign disease and normal mammary gland specimens. The positive rates of VEGF-C in the centre and borderline of carcinoma in lymph node metastasis group 〔75.0%（51/68）， 76.1%(51/67)〕 were significantly higher than that of no metastasis group 〔25.0%（17/68），23.9%(16/67)〕, P＜0.05. The positive rates of VEGF-C in the centre and borderline of carcinoma and distant mammary gland were no correlation with size, type and clinical stage of tumor. Conclusion The tissue chips is high efficiency and well quality control in multiple factor investigation. There are overexpression of VEGF-C in primary breast cancer, and that may play an important role in lymph node metastasis.
Objective To summarize the progress of clinical research on triple-negative breast cancer (TNBC). Methods Domestic and international publications on the study of TNBC in recent years were collected and reviewed. Results The patients with TNBC were younger, and their prognosis was poorer. Besides operation, chemotherapy was the major therapeutic tool for them. Currently the targeted therapy for epidermal growth factor receptor and its signal conducting system was applied to clinical therapy gradually， and it might benefit the patients with TNBC. Conclusion The study on TNBC may bring a new way for therapy.
ObjectiveTo explore the effects of exogenous estrogen receptor β1 (ERβ1) gene on the expression of human telomerase reverse transcriptase (hTERT) as well as the changes of proliferation ability in MDA-MB-231 cell line by transfecting recombinant eukaryotic expressing vector containing ERβ1 cDNA into human breast cancer MDA-MB-231 cell. MethodsRecombinant eukaryotic expressing vector containing ERβ1 cDNA was transfected into human breast cancer MDA-MB-231 cell by using cationic liposome as transfecting agent (acted as pcDNA3.1ERβ1 transfection group), empty vector group and non-transfection group acted as controls. The expression levels in both the mRNA and protein of both the ERβ1 and hTERT were tested by real-time PCR and Western blot, respectively. The change of proliferation ability in MDA-MB-231 cell was displayed by cell growth curve, and the change of cell apoptosis was detected by flow cytometry. ResultsThe expression level of ERβ1 mRNA in the pcDNA3.1-ERβ1 transfection group (0.449±0.077) significantly increased as compared with the nontransfection group (0.153±0.035) or the empty vector group (0.160±0.020), P=0.001 or P=0.000. The expression level of ERβ1 protein in the pcDNA3.1-ERβ1 transfection group (0.847±0.065) significantly increased as compared with the non-transfection group (0.356±0.050) or the empty vector group (0.390±0.030), P=0.001 or P=0.000. The expression level of hTERT mRNA in the pcDNA3.1-ERβ1 transfection group (0.127±0.020) significantly decreased as compared with the non-transfection group (0.283±0.025) or the empty vector group (0.283±0.049), P=0.001 or P=0.002. The expression level of hTERT protein in the pcDNA3.1-ERβ1 transfection group (0.147±0.023) significantly decreased as compared with the non-transfection group (0.783±0.025) or the empty vector group (0.802±0.019), P=0.001 or P=0.002. The rate of cell apoptosis in the pcDNA3.1-ERβ1 transfection group 〔(6.15±0.94)%〕 was higher than that in the non-transfection group 〔(1.41±0.42)%〕， P=0.001. Cell proliferation curve showed that proliferation ability significantly decreased in the pcDNA3.1-ERβ1 transfected groups as compared with the non-transfection group (Plt;0.05). ConclusionERβ1 could inhibit cell growth of human breast cancer MDA-MB-231 cell by down-regulating the expression of hTERT.
Objective To investigate the effect of steroid receptor coactivator family in initiation, development, treatment and prognosis of breast cancer. Methods The literatures in recent years which have related to the effect of steroid receptor coactivators in breast cancer are reviewed. Results Steroid receptor coactivators are essential for several kinds of steroid hormones binding to steroid receptors, so they are important accessory factors that induce the initiation, development and recurrence of breast cancer, and predictive factors that estimate the prognosis of breast cancer. Conclusion Inhibition of the expression and signaling pathway of steroid receptor coactivators may be effective for breast cancer prevention and treatment.
【Abstract】Objective To study the surgical therapy and staging investigation about stage Ⅳ breast carcinoma. Methods The clinical data of 38 patients with stage Ⅳ breast carcinoma were summarized, and the patients were followed up. Results The stage Ⅳ patients who had isolated metastasis and removable primary tumor were treated by radical surgery with good effect. On the other hand, the stage Ⅳ patients who had extensive metastasis and primary tumor unresectable were treated by palliative operation with the living quality of patients becoming better and chemotherapy load cutting down. Conclusion The stage Ⅳ patients should be divided into stage Ⅳa and stage Ⅳb. And the stage Ⅳa patients should be treated by radical operation, and the stage Ⅳb by palliative operation.
【Abstract】 Objective To discuss the aesthetic effect and appl ication of refined incisions in breast reconstructionfor breast cancer patients by the transverse rectus abdominis myocutaneous (TRAM) flap. Methods From January 2001 toOctober 2006, 77 cases with breast cancer were treated with TRAM flap to immediate breast recontruction. The patients were all femals, with an average age of 45 years (ranging from 26 years to 53 years). There were 39 cases of left breast and 38 cases of right breast. The disease course was from 1 day to 180 days. There were 11 cases of stage I , 60 cases of stage II and 6 cases of stage III, among which 34 cases were located in the upper outer quadrant, 15 in the lower outer quadrant, 22 in the upper inner quadrant and 6 in the lower inner quadrant. The size of tumors varied from 1 cm to 4 cm. As to the pathologic type, 60 cases were invasive ductal cancers, 12 ductal cancers in situ, 5 invasive lobular cancers; positive lymph node (number: 1-7) happened in 29 cases, while negative lymph node happened in 48 cases. Among the 77 cases, regular shuttle incisions were performed in 35 cases, and refined circle incisions were performed in 42 cases, which were 2 cm away from the breast tumor border. Axillary incision was necessary for the breast tumors located in upper inner, lower inner and upper outer quadrants in order to perform axillary mastectomy. Ten cases were ni pple-areola sparing. The shape, symmetry and incision scar of the reconstructed breast were evaluated and graded. Results There were 6 cases out of 77 cases of breast reconstruction in which partial necrosis happened and the necrosis rate was 7.79%. The time of follow-up was from 13 months to72 months, with an average of 39 months. No recurrence or matastasis happened in 76 cases, and distant metastasis happened only in 1 case. There were 40 cases out of 42 cases with refined incisions which were scored more than 3, and the satisfaction rate was 95.24%. There were 31 cases out of 35 cases with regular incisions which were scored more than 3, and the satisfaction rate was 88.57%. Conclusion The reasonable refined incision based on the location of the tumor is effective to improve the satisfaction rate for the shape of the reconstructed breast.