早在1757年法国LeDran即说过有希望“治愈”乳腺癌，历经三个多世纪，乳腺癌的诊治虽已发生很大的变化，但依然是危害女性的重要疾病之一，至今尚未能解释乳腺癌的全部生物行为，也无统一的理想治疗方案。现将乳腺癌诊治进展介绍如下。
目的 探讨乳腺叶状囊肉瘤和巨纤维腺瘤的诊断和治疗。方法 回顾分析我院1985～2002年期间外科收治的9例乳腺叶状囊肉瘤和8例乳腺巨纤维腺瘤的临床资料。结果 9例乳腺叶状囊肉瘤中行单纯乳房切除术4例，保留乳头皮下乳房切除术1例，保留乳头和部分压缩腺体＋肿块切除术1例，改良根治术3例; 术后恢复良好，仅1例复发。8例乳腺巨纤维腺瘤中行单纯乳房切除术2例，保留乳头皮下乳房切除术1例，保留乳头和部分压缩腺体＋肿块切除术2例，单纯乳腺肿块切除术3例； 术后恢复良好，术后2例复发。结论 乳腺叶状囊肉瘤和巨纤维腺瘤临床上均表现为无痛性包块，除乳腺叶状囊肉瘤发病年龄较大、肿块范围大及易恶变外，二者主要依据病理检查结果相鉴别； 均以手术治疗为主，根据患者年龄、肿块大小以及病理检查结果选择不同的手术方式。
The expressions and significance of c-met oncoprotein and transforming growth factor-α (TGF-α) were studied by immunohistochemical method in 50 cases of breast cancer (BC) and 12 cases of benign lesions of breast (BL). The positive rate of c-met, TGF-α in BC was 26.0% and 25.0% respectively, in BL was 8.3% and 25.0% respectively. The positive rate of c-met oncoprotein was lower in the cases of histologic Grade Ⅰ, positive of ER and PR or CEA than that of histologic Grade Ⅲ, negative of ER and PR or CEA. The positive rate of TGF-α was lower in the cases of histologic Grade Ⅰ, negative of ER and PR or CEA than that of histologic Grade Ⅲ, positive of ER and PR or CEA. These results suggest the expression of c-met and TGF-α might be related to the carcinogenesis and development or endocrine state of BC.
Objective To determine the investigation progression on exemestane in the treatment of breast cancer. Methods The literatures of recent years on the studies of exemestane were reviewed. Results Exemestane is an effective steroidal aromatase inactivator with superior tolerability, safety and efficacy in the adjuvant, neo-adjuvant and metastatic therapy of breast cancer. Conclusion With the progression of clinical trial with exmestane, exemestane will be regarded as an important drug in comprehensive therapy of breast cancer.
ObjectiveTo explore the surgical technique and clinical effect of endoscopic assisted transaxillary breast tumor resection in the treatment of benign and malignant breast tumors. MethodsThe clinical data of 18 patients received endoscopic breast tumor resection from September 2020 to December 2021 in the Department of Breast Surgery, West China Hospital, Sichuan University, were retrospectively analyzed to evaluate the feasibility, tumor safety and postoperative cosmetic effect. There were 7 patients with benign breast tumors (a benign breast tumor group) and 11 patients with early breast cancer (a malignant breast tumor group). Breast-Q and Scar-Q questionnaires were used to evaluate postoperative quality of life and satisfaction of patients. ResultsEndoscopic breast tumor resection was performed successfully in 18 female patients, among whom 12 patients received day surgery. The mean age of benign and malignant breast tumor groups was 29.6±11.6 years and 46.7±14.3 years, the mean tumor size in pathological examination was 3.3±2.1 cm and 2.0±0.8 cm, and the operative time was 138.9±57.0 min and 177.3±46.3 min, respectively. One patient had positive resection margin and underwent intraoperative extended resection in the malignant breast tumor group. All the patients were successfully followed up, and the mean follow-up time of benign and malignant breast tumor groups was 6.8±4.0 months and 8.7±4.9 months, respectively. No complications or tumor recurrence occurred. The scores of psychosocial status, sexual well-being, chest wall status and breast satisfaction decreased one month after surgery and basically recovered to the preoperative level in one year, and the score of scar appearance increased to 64.6±5.9 points one year postoperatively. ConclusionEndoscopic assisted transaxillary breast tumor resection can effectively improve postoperative cosmetic effect and patient satisfaction on the premise of safety.
ObjectiveTo investigate the expression and distribution of CD15s antigen in breast cancer and its relationship with carcinogenesis, progression and metastatic proclivity. MethodsCatalyzed signal amplification(CSA) immunohistochemical technique was used to detect the expression of CD15s antigen in breast cancer and in adjacent normal mucosa. Immunoelectromicroscopic ultrastructural localization of CD15s antigen labelled by colloidal gold was also bserved.ResultsThe positive rate of CD15s antigen expression in primary breast cancer was 79.8%(75/94). In adjacent normal mucosa (n=10) CD15s antigen showed weaker staining. The positive rate of CD15s antigen expression in grade Ⅱ-Ⅲ (87.3%) was notably higher than that in grade Ⅰ (69.2%, P＜0.05). In patients with lymph node metastasis, the positive rate of CD15s antigen expression was 90.2%, which was significantly higher than 67.4% in nodes with no metastasis (P＜0.05). CD15s antigen immunoreactivity was mainly localized in the border membrane of cytoplasm, endoplasmic reticulum, golgi complex and surrounding nuclear membrane in tumor tissue, and in the border membrane of cytoplasm in adjacent normal tissue. Conclusion CD15s antigen is a practical parameter for evaluating the degree of malignancy and lymphatic metastatic proclivity of breast cancer. It can provide a new pathway to investigate the carcinogenesis and progression of breast cancer.
【Abstract】ObjectiveTo evaluate the localized biopsy of nonpalpable breast lesions (NPBLs) and its role in the early diagnosis and treatment of breast cancer. MethodsOne hundred and fifty-eight NPBLs from a series of 141 women detected by mammography were resected with wire localization technique. ResultsForty-two lesions (26.6%, 42/158) in 42 patients were diagnosed with malignant result, including 12(28.6%) patients with stage 0 breast cancer, 24(57.1%) with stageⅠ, 2(4.8%) with stage Ⅱ and 4(9.5%) with stage Ⅲ disease according to American Joint Committee on Cancer (AJCC) staging system（the 6th edition）. The contralateral axillary lymph nodes metastasis were found in only one (2.4%) patient with stage Ⅲ disease and the other fortyone patients remained free of recurrent disease at a median follow-up of 31 months.ConclusionThe results showed that the most nonpalpable breast cancers detected by mammography were earlystage breast cancers and had good prognosis. The NPBLs should get a localized biopsy in order to facilitate the early diagnosis and treatment of nonpalpable breast cancers.
Objective To investigate the role of β-catenin gene in breast tumorigenesis by detecting mutation and expression of β-catenin gene in breast hyperplasia and breast cancer. Methods Mutation and expression of β-catenin gene in 42 breast cancer, 15 simple hyperplasia and 15 atypical hyperplasia were detected by polymerase chain reaction-single strand conformation polymorphism and immunohistochemistry. Results Normal expression of β-catenin occurred in tissue of breast simple hyperplasia. The rate of abnormal expression of β-catenin in tissue of breast atypical hyperplasia and breast cancer were 26.7% （4/15） and 59.5% （25/42）, respectively, which were higher than that of simple hyherplasia tissue (P＜0.05). And there was a markedly difference between the atypical hyperplasia tissue and breast cancer tissue (P＜0.05). Mutation of β-catenin gene wasn’t detected in this three kinds of tissues. Conclusion Abnormal expression of β-catenin plays an important role in human breast tumorigenesis, reason of abnormal expression of β-catenin isn’t mutation of β-catenin gene. Expression of β-catenin can be regulated by other mechanisms.
Objective To review the recent studies on the multidrug resistance of breast cancer. Methods The literatures of recent years on the studies of multidrug resistance, multidrug resistance protein and breast cancer resistance protein were reviewed. Results Multidrug resistance resulted from multiple factors. How to identify the sensibility of chemotherapy drugs and select individual therapeutic regime early were important to improve the survival rate and life quality of breast cancer patients. Conclusion These studies on multidrug resistance of breast cancer are helpful to predicting the effect and outcome of chemotherapy and overcoming the barrier of drug resistance.
The expression of C-erb B-2 oncogene protein in the tissues of normal breast, atypical cystic hyperplasia of breast and breast carcinoma were determined in order to analyse the significance of the changes of C-erb B-2 oncogene in the course from atypical hyperplasia to carcinoma of breast. Results: there were no expression of C-erb B-2 protein in the tissues of normal breast and cystic hyperplasia of breast with epithelia proliferation grade Ⅰ. The positive rates of the expressions of C-erb B-2 protein in the tissues of atypical hyperplasia grades Ⅱ, Ⅲ and carcinoma of breast were 20.0%, 40.0% and 54.2% respectively. The results indicated that the abnormal changes of C-erb B-2 nocogene might occured in the carcinomatous transformation phase along with the changes from normal breast epithelial cell through atypical hyperplasia to breast cancer, those changes could be the result or promotion factor of abnormal proliferation of atypical hyperplasia of breast and was one of the markers of malignant transformation of epithelia of breast.