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.
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.
ObjectiveTo study the application of artificial intelligence based on neural network in breast cancer screening and diagnosis, and to summarize its current situation and clinical application value.MethodThe combined studies of neural network and artificial intelligence in the directions of breast mammography, breast ultrasound, breast magnetic resonance, and breast pathology diagnosis in CNKI and PubMed database were reviewed.ResultsPublic databases of mammography, such as Digital Database for Screening Mammography (DDSM), provided raw materials for the research of neural network in the field of mammography. Mammography was the most widely used data for screening and diagnosis of breast diseases by neural network. In the field of mammography and color doppler ultrasound, neural network could segment, measure, and analyze the characteristics, judge the benign or malignant, and issue a structured report. The application of neural network in the field of breast ultrasound focused on the diagnosis and treatment of benign and malignant breast diseases. Samsung Madison Group taken the lead in grafting research results into ultrasound instruments. Breast MRI had a lot of high-throughput information, which had became the breakthrough point for the joint study of artificial neural network and imaging omics. Pathological images had more data information to be measured, and quantitative analysis of data was the advantage of neural network. The combination of the two kinds of methods could significantly improve the diagnosis time of pathologists.ConclusionsTo study the application of artificial intelligence in breast cancer screening and diagnosis is to analyze the application of neural network in breast imaging and pathology. At present, artificial intelligence screening can be used as a physician assistant and an objective diagnostic reference assistant, to improve the diagnosis of breast disease. With the development of medical image histology and neural network, the application of artificial intelligence in medical field can be extended to surgical method design, efficacy evaluation, prognosis analysis, and so on.
Objective To review the latest progress in the major biological properties of adipose-derived stem cells (ADSCs) and ADSCs assisted autologous lipotransfer in breast repair and reconstruction. Methods Recent literature about ADSCs assisted autologous lipotransfer in breast repair and reconstruction was reviewed. Results ADSCs have multipotential differentiation capacity, and they could promote angiogenesis and regulate immune reactions. ADSCs assisted autologous lipotransfer can obtain satisfactory effectiveness in breast repair and reconstruction with few complications, but more studies are needed to confirm the long-term safety. Conclusion ADSCs assisted autologous lipotransfer has good effectiveness in breast repaired and reconstruction. But further clinical trials are needed to confirm the long-term safety.
Recently, the National Cancer Center analyzed the disease burden and epidemiological trend of breast cancer based on the global population registration data, providing important reference for the prevention and control of breast cancer and health decision-making. Based on the current situation of prevention and control of breast cancer in China, this paper briefly interpreted the key points of the disease burden and trend of breast cancer.