The report of brachial plexus injuries following radical mastectomy in patients with breast cancer was rare even though the operation was a main measure in treating with breast cancer. Nine patients treated from Oct. 1989 to Feb.1991 were summarized. The results were not ideal.
ObjectiveThyroid nodules are an exceptionally common thyroid disorder. Past studies suggested a possible link between thyroid diseases and breast neoplasms. However, few studies have delved into the causal relationship between thyroid nodules and breast neoplasms. This study conducted a Mendelian randomization (MR) analysis to further investigate the causal relationship between them. MethodsThis study was conducted using data sourced from genome-wide association study (GWAS) summary datasets. The study focused on thyroid nodules, benign breast tumors, and malignant breast cancers as the research objects, and relevant single nucleotide polymorphisms (SNPs) were selected as instrumental variables (IVs). The inverse-variance weighted (IVW) was primarily used to assess the causal relationship between thyroid nodules and breast neoplasms. Cochran’s Q test was employed to detect heterogeneity, while MR-Egger intercept and MR-PRESSO were used to test for pleiotropy. Sensitivity analysis was conducted using the leave-one-out method. ResultsThere was a significant causal relationship between thyroid nodules and malignant neoplasm of breast (OR=0.88, 95%CI 0.83 to 0.95, P<0.01), with no evidence of reverse causality between them (OR=1.01, 95%CI 0.99 to 1.03, P=0.16). No causal relationship was found between thyroid nodules and benign neoplasm of breast, as indicated by both forward MR analysis (OR=0.97, 95%CI 0.89 to 1.06, P=0.51) and reverse MR analysis (OR=0.97, 95%CI 0.92 to 1.04, P=0.40). Sensitivity analyses suggested that the study findings were accurate and reliable. ConclusionThe present study identifies thyroid nodules as a potential protective factor for malignant neoplasm of breast.
ObjectiveTo explore the method of preventing heat steam induced skin damage in robotic nipple-sparing mastectomy and immediate breast reconstruction (R-NSM-IBR) using Da Vinci Robots. Methods A clinical data of 128 female patients with breast cancer, who were treated with R-NSM-IBR between September 2022 and December 2023 and met the selection criteria, was retrospectively analyzed. During robotic nipple-sparing mastectomy, the breasts were covered with gauze cooled by ice water to reduce skin temperature in 99 cases (group A) and were not treated in 29 cases (group B). There was no significant difference in the age, affected side, body mass index, pathological type of breast cancer, and constituent ratios of adjuvant chemotherapy and neoadjuvant chemotherapy between the two groups (P>0.05). Intraoperative breast skin temperature, unilateral robotic nipple-sparing mastectomy time, and the incidence of complications of breast heat steam induced skin damage were recorded. Results The time for unilateral robotic nipple-sparing mastectomy was (77.18±9.23) minutes in group A and (76.38±12.88) minutes in group B, with significant difference between the two groups (P<0.05). The intraoperative breast skin temperature was significantly lower in group A than in group B [(25.61±0.91)℃ vs (33.38±1.14)℃; P<0.05]. Seven cases of heat steam skin damage occurred during operation, including 2 cases (2.0%) in group A and 5 cases (17.2%) in group B, with a significant difference in incidence between the two groups (P<0.05). Among them, 1 patient in group B had a vesication rupture and infection, which eventually led to the removal of the implant; the rest of the patients were treated with postoperative interventions for skin recovery. Conclusion The use of breast covered with gauze cooled by ice water during R-NSM-IBR can effectively reduce the risk of heat steam induced skin damage.
ObjectiveTo investigate the anatomy and function of pectoralis fascia in breast cancer operation, and the choice of resection and preservation of pectoralis fascia in different operation methods.MethodWe searched the articles related to pectoralis fascia and breast cancer through PubMed, Web of Science, EBSCO, WanFang Medical Network, SinoMed, and other databases, and then selected the Chinese and foreign articles that met the objective of this paper, and made an review after reading the articles.ResultsIn the immediate breast reconstruction of breast prosthesis after breast cancer operation, the preservation of pectoralis fascia was beneficial to the complete coverage of breast prosthesis and improved the cosmetic effect after operation. The purpose of preserving pectoralis fascia adipose tissue in breast-conserving surgery was to reduce the loss of breast volume and to pursue the cosmetic effect after operation. At present, there had been reports on the safety of pectoralis fascia oncology, but there was no final conclusion on the safe distance between tumor and pectoralis fascia, and the current research could not provide sufficient evidence for the preservation of pectoralis fascia.ConclusionsThe question of whether the pectoralis fascia needs to be removed in breast cancer surgery is still controversial. The preservation of pectoralis fascia is more for better immediate breast reconstruction after operation. However, the current evidence of evidence-based medicine is not sufficient. Clinicians need to conduct multicenter, randomized controlled clinical trials to improve the evidence.
ObjectiveTo explore advances in clinical applications of circulating tumor DNA (ctDNA) for early diagnosis of breast cancer.MethodReviewed on the latest literatures about studies of advances in clinical applications of ctDNA for early diagnosis of breast cancer.ResultsctDNA was a cell-free DNA generated by tumor cells that contained tumor-associated mutations and could dynamically reflect the entire picture of the tumor genome. It was a very important potential tumor biomarker. ctDNA had been widely used in a variety of tumors for early diagnosis, curative effect assessment, and prognosis evaluation due to its advantages such as small trauma and real-time monitoring, and its role in breast cancer had attracted more and more attention.ConclusionEarly diagnosis is critical to improve the breast cancer patients’ overall survival rate and ctDNA plays an important role in early diagnosis and early detection of recurrence and metastasis of breast cancer.
Objective To analyze the relationship between the expression of carbonic anhydrase 3 (CA3) in breast cancer tissues, its prognostic potential and the number of immune cells by a variety of online databases. Methods GEPIA2.0 and TIMER databases were used to analyze the difference of CA3 mRNA expression in breast cancer tissues. Bc-GenExMinerv4.7 database was used to analyze the difference of CA3 mRNA expression in breast cancer subcategories. Kaplan-Meier plotter, Bc-GenExMinerv4.7 and PrognoScan databases were used to analyze the effect of CA3 mRNA expression levels on prognosis of patient. LinkedOmics database was used to analyze of the biological behavior involved in CA3 co-expressed genes. TIMER database was used to analyze the relationship between CA3 mRNA expression and immune cells infiltration in breast cancer tissues. Results The expression of CA3 mRNA in breast cancer tissues was lower than that in normal breast tissues (P<0.05), and the expression levels of CA3 mRNA were higher in ER negative (P<0.05), PR negative (P<0.05), HER2 negative (P<0.05) and no lymphatic metastasis (P<0.05). In addition, the expression level of CA3 in breast cancer patients with high Ki67 expression was lower (P<0.05) and closely related to SBR and NPI grade (P<0.05). Breast cancer patients with low expression of CA3 mRNA had lower overall survivall, recurrence free survival, and disease free survival ( P<0.05). Ten of the top 50 positively correlated co-expressed genes screened out had low risk ratio (P<0.05), and 11 of the top 50 negatively correlated co-expressed genes screened out had high risk ratio (P<0.05). The expression of CA3 mRNA was positively correlated with CD4+ T cells and CD8+ T cells in breast cancer tissues (rs=0.175, P<0.001; rs=0.137, P<0.001), and negatively correlated with T cell failure markers LAG3, TIM-3 and PVRL2 (rs=–0.100, P<0.01; rs=–0.143, P<0.001; rs=–0.082, P<0.05). Conclusions The low expression of CA3 mRNA in breast cancer tissues is correlated with the occurrence, development and prognosis of breast cancer. CA3 can be used as a potential independent prognostic marker for breast cancer and may be related to immune infiltration.
ObjectiveTo explore advantages and feasibility of a new prosthesis implantation method after breast cancer surgery by reacquaint breast anatomy. MethodsThe clinicopathologic data of patients with breast cancer were retrospectively collected. The patients underwent the breast cancer surgery and prosthesis implantation with cricoid breast ligament in the Xuzhou Cancer Hospital from January 1, 2021 to May 30, 2023. ResultsA total of 10 patients were collected, with age ranging from 31 to 59 years old. Three patients received postoperative analgesia, 2 patients occurred infection, 1 patient occurred fat liquefaction. All patients did not experience capsular contracture, flap necrosis, or removal of the prosthesis. Two patients had sentinel lymph node metastasis. All patients followed-up 3 to 24 months after surgery. The BREAST-Q questionnaire was used to assess the quality of life and satisfaction after surgery, 3 patients were very satisfied, 5 were satisfied, and 2 were basically satisfied. ConclusionFrom the results of limited cases analysis in this study, it is safe and feasible to implant the prosthesis with cricoid breast ligament in selected patients after breast cancer surgery.
ObjectiveTo compare the clinicopathological characteristics of breast invasive micropapillary carcinoma (IMPC) with different composition ratios, and analyze the relationship between proportion of micropapillary carcinoma components and the prognosis of IMPC. Methods The related data of 121 patients with invasive ductal carcinoma (IDC) complicated with IMPC who were treated in the Department of Breast Surgery, Affiliated Hospital of Southwest Medical University from August 2016 to August 2020 were collected. With micropapillary carcinoma accounting for 50%, the patients were divided into IMPC <50% group and IMPC ≥50% group. The correlation between related clinicopathological features and prognosis of patients was analyzed. Results There were 85 patients in the IMPC <50% group and 36 patients in the IMPC ≥50% group. The analysis results showed that there was no significant differences between the two groups in menstrual status, histological grade, molecular typing, TNM stage, age, immunohistochemical expression, neoadjuvant therapy, nerve invasion, nipple invasion, and skin invasion (P>0.05). The rate of lymphatic vessel invasion (LVI) in the IMPC ≥50% group was 83.33% (30/36), which was significantly higher than 61.18% (52/85) in the IMPC <50% group, and the difference between the two groups was statistically significant (χ2=5.684, P=0.017). Kaplan-Meier survival curve was drawn, and the analysis results showed that the 3-year cumulative disease-free survival (DFS) of IMPC patients was correlated with the number of lymph node metastasis and LVI (P<0.05). And with the estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular typing, proportion of micropapillary carcinoma components and histological grade were unrelated (P>0.05). The results of multivariate Cox risk regression analysis showed that the number of lymph node metastases and LVI were independent prognostic factors affecting DFS in patients. Conclusions When the proportion of IMPC component is ≥50%, the LVI rate of tumor is higher than that of IMPC component <50%. The number of lymph node metastasis and LVI are independent prognostic factors affecting DFS in IMPC patients.
Atrial fibrillation (AF) and breast cancer are common diseases with high incidence, which can be promoted and maintained by a wide range of regulatory factors (changes of hormone secretion, chronic inflammation, dysfunctions in autonomic nervous system, coagulation system and endothelia). There may be a consistent pathophysiological link between the increased incidence of breast cancer and AF, which is currently seldomly reported. The development process of these two diseases are complex, and the occurrence of breast cancer may increase the incidence of AF. In this paper, we reviewed the relationship between breast cancer and AF based on the latest reports.
Objective To explore the clinicopathological features of bilateral primary breast cancer (BPBC) at different ages. Methods Clinical data of 105 BPBC patients admitted to the Department of Breast Surgery in The First Affiliated Hospital of Zhengzhou University from January 2017 to January 2020 were collected and divided into young group (≤40 years old) and middle-old group (>40 years old) according to age. The characteristics and differences of bilateral tumor lesions in pathological type, molecular type, tumor diameter, histological grade, clinical stage, lymph node metastasis, recurrence or distant metastasis, immunohistochemical indexes expression characteristics, consistency and difference, and overall prognosis between the two groups were retrospectively analyzed. Results There were statistically significant differences between the two groups in the size of the first primary cancer, lymph node metastasis, the high expression rate of Ki-67 in the second primary cancer, clinical stage of double primary cancer and recurrence or distant metastasis (P<0.05). In the young group, the proportion of the first primary cancer with T3–T4 stage was higher, the incidence of lymph node metastasis was higher, the proportion of high expression of Ki-67 in the second primary cancer was higher, and the proportion of patients with double primary cancer at first diagnosed as stage Ⅳ were higher than those in the middle-old group, and were prone to recurrence or distant metastasis. The expression of immunohistochemical indexes in bilateral cancer foci was consistent between the two groups (P<0.05). The expression consistency of ER and Ki-67 in the young group was better, and the expression consistency of PR and HER-2 in the middle-old group was better. The histological grade of the first primary cancer, TNM stage of bilateral primary cancer and recurrence or metastasis were independent factors affecting the prognosis of patients (P<0.05). Conclusions The BPBC patients of different ages have different clinicopathological features, and the expression of immunohistochemical indexes in bilateral cancer foci is consistent. Tumor histological grade of the first primary cancer may affect the prognosis of patients with BPBC, and the prognosis of patients with early bilateral TNM stage is better.