【摘要】 目的 探讨选择性乳腺导管造影对溢液性乳腺肿瘤的鉴别诊断价值。 方法 回顾性分析2005年1月-2009年7月50例溢液性乳腺肿瘤资料，所有患者均行钼靶X线平片摄影、选择性乳腺导管造影检查及手术病理确诊。 结果 17例乳腺癌主要表现为分支导管内不规则的充盈缺损伴导管壁破坏，导管阻塞中断、断续征、潭湖状充盈等征象；33例乳腺导管内乳头状瘤主要表现为大导管内光整的充盈缺损，导管壁多无破坏，并伴有导管扩张以及扭曲。 结论 选择性乳腺导管造影对溢液性乳腺肿瘤诊断和鉴别诊断具有重要价值。【Abstract】 Objective To evaluate the value of selective mammary ductography in the diagnosis of breast tumours with nipple discharge. Methods The clinical data of 50 patients with breast tumours with nipple discharge diagnosed in our department form January 2005 to July 2009 were analyzed retrospectively. All patients were proved by molybdenum target mammography, selective mammary ductography and pathology. Results Seventeen patients with breast cancer’s galactographic features were mostly irregular intraductal defect with ductal wall breakage and ductal obstruction in the peripheral ducts; 33 patients with intraductal papilloma’s galactographic features were smooth intraductal filling defect with ductal wall integrity and ductal dilatation and torsion in the main ducts. Conclusions Selective mammary ductography is useful in diagnosis and differentiation of the breast tumours with nipple discharge.
【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 detect the expressions of osteopontin （OPN）， breast tumor kinase （Brk）， and vascular endothelial growth factor （VEGF） in the breast cancer tissue， the adjacent （2cm） normal breast tissue， and the distal（＞5cm） normal breast tissue， and analyze their clinical significances. Method The immunohistochemical method was used to detect the expressions of OPN， Brk， and VEGF in the breast cancer tissue， the adjacent （2cm） normal breast tissue， and the distal （＞5cm） normal breast tissue from 40 cases of breast cancer. Results ① The expressions of OPN，Brk， and VEGF in the breast cancer tissue were significantly higher than those of the adjacent （2cm） normal breast tissue and the distal （＞5cm） normal breast tissue （P＜0.01）， the expression of Brk in the adjacent （2cm） normal breast tissue was significantly higher than that of the distal （＞5 cm） normal breast tissue （P＜0.05）. ② In the breast cancer tissue， the OPN and Brk protein expressions were not associated with age， tumor diameter， and histological grade （P＞0.05），were associated with lymph node metastasis and TNM stage （P＜0.05）. The VEGF protein expression was not associated with age and tumor diameter （P＞0.05）， but was associated with histological grade， lymph node metastasis， and TNM staging （P＜0.05）. ③ In the breast cancer tissue， OPN， Brk， and VEGF had positive correlation with each other （P＜0.05）， but not in the adjacent （2cm） normal breast tissue and the distal （＞5 cm） normal breast tissue （P＞0.05）. Conclusions The expressions of OPN and Brk from the same signal pathway increase by turns in the distal （＞5 cm） normal breast tissue， adjacent （2cm） normal breast tissue， and breast cancer tissue. OPN induced the adhesion and migration of endothelial cells to accelerate vascular repair through VEGF and Brk has correlation with the progress of tumor invasion and metastasis through participating in tumor vascularization.
目的 探讨乳腺癌患者术后行化学疗法（化疗）期间采用集体操锻炼方式对促进术后康复的影响及效果。 方法 2010年4月－2011年4月，将90例乳腺癌术后行化疗患者，随机分为试验组和对照组（n=45），分别采用不同形式的康复训练方法锻炼患侧上肢功能，在第6个周期化疗结束时，测量比较两组患者患侧肩关节活动度及肺功能。 结果 试验组患肢肩关节活动度及肺功能明显优于对照组，差异有统计学意义（P＜0.05）。 结论 集体操运动方式结合瑜伽功，可有效提高患者的整体康复效果。
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。
【Abstract】ObjectiveTo observe the effect of nimesulide (NIM) on DMBA-induced mammary tumors and to investigate possible mechanisms of inhibiting tumors. MethodsThe Wistar rats were randomly divided into four groups: DMBA group, NIM+DMBA group, NIM+diet group and diet group. The incidence and mean latent phase of mammary tumors were observed. The number and volume of tumors in every rat were measured. The apoptosis index and proliferation index were evaluated by TUNEL assay and PCNA immunohistochemical staining respectively.Results The latent phases of mammary tumors in NIM+DMBA group were strikingly longer than those in DBMA group 〔(115±14.8) d vs (84±15.6) d,P＜0.01〕. The incidence of mammary tumors was 69.2% in DMBA group, 46.4% in NIM+DMBA group. There was obviously decreased incidence in NIM+DMBA group (P＜0.05）. The number and the mean volume of mammary tumors in every rat in NIM+DMBA group were markedly less than DBMA group 〔（0.82±0.31） vs （1.52±0.43），（3.24±1.21） cm3 vs （6.03±1.84） cm3，P＜0.05〕. The apoptosis index was obviously higher and the proliferation index was markedly lower in NIM+DMBA group compared with DMBA group〔(42.54±13.24)% vs (18.14±6.66)%, (20.25±4.97)% vs (36.36±5.02)%, P＜0.05〕. ConclusionNIM can inhibit the development of DMBA-induced mammary tumors by inhibiting proliferation and inducing apoptosis.
【Abstract】ObjectiveTo detect expressions of E-cadherin and α-catenin in breast cancer and analyze the relationship between those expressions and biological behaviors of breast cancer. MethodsFifty-four female patients with breast cancer received modified -radical -mastectomy or radical mastectomy in our department from August 1998 to March 1999. Their ages ranged from 30 years to 76 years and the postoperative follow-up time ranged from 6 to 67 months. Sixteen patients died during their follow-up time. The expressions of E-cadherin and α-catenin in specimens of 54 breast carcinomas and 21 normal breast tissues around tumor were measured by immunohistochemical method. Results In normal breast tissues, E-cadherin and α-catenin were expressed on cell membrance of ductal and acinic cells. No abnormal expressions were found in normal breast tissues. The abnormal expression rates of E-cadherin and α-catenin in breast cancer were 51.9% and 63.0% respectively. Abnormal expressions of E-cadherin and α-catenin were significantly correlated with histological grade and proliferative grade. Abnormal expression of α-catenin was significantly correlated with TNM staging, axillary lymph node metastasis and postoperative distant metastasis. Abnormal expression of Ecadherin was positively correlated with expression of HER-2. COX multiple factor analysis suggested that neither E-cadherin nor α-catenin expression was an independent prognostic indicator of breast cancer. ConclusionAbnormal expressions of E-cadherin and α-catenin frequently occur in breast cancer. Abnormal expressions of E-cadherin and α-catenin are correlated with disturbance of proliferation and differentiation of breast cancer and its metastasis.
ObjectiveTo study the relationship between clinical features of patients with phyllodes tumor of breast (PTB) and reccurence, distant metastasis, and prognosis.MethodsThe clinical data of 96 patients with PTB treated in this hospital from March 2011 to December 2018 were retrospectively analyzed. The correlation of clinical features with local recurrence and distant metastasis were analyzed by the Chi-square test and logistic regression. The Kaplan-Meier method was used to compute disease-free survival (DFS). The correlation of clinical features with prognosis was analyzed by the log-rank test and Cox regression.ResultsNinety-four patients with PTB showed the unilateral single nodule, 2 patients showed the bilateral nodule. The benign tumor had 36 patients, borderline tumor had 34 patients, malignant tumor had 26 patients. A total of 27 patients had local recurrence, 4 patients had distant metastasis, 4 patients died during the follow-up period. The 1-, 3-, and 5-year accumulate DFS rate was 81.2%, 64.9%, and 64.9%, respectively. The accumulate 5-year overall survival rate was 92.3%. The multivariate analysis showed that the age, types of tumor, and surgical method were related to the local recurrence (P<0.050), and no clinicopathological factors were found to be related to the distant metastasis (P>0.050). It was found that type of tumor was the independent factor affecting prognosis (P<0.050).ConclusionsFor PTB, the recurrence rate is higher, the age and tumor types are the independent recurrent factors. Surgical treatment is the primary management, extend resection and mastectomy are alternative operation.