Objective To study the expression and significance of CCR chemokine receptor-7 (CCR7) protein and vascular endothelial growth factor-D (VEGF-D) protein in the progression of breast cancer, including normal breast tissue, slight and moderate atypical hyperplasia, severe atypical hyperplasia and intraductal carcinoma in situ, as well as invasive ductal carcinoma. Methods Immunohistochemistry was used to detect the expression of CCR7 and VEGF-D protein in the nomal breast tissue (n=20), slight and moderate ductal atypical hyperplasia tissue (n=20), severe atypical hyperplasia and intraductal carcinoma in situ tissue, as well as invasive ductal breast carcinoma tissue (n=73). In addition, the D2-40 staining was also used to determine lymphatic microvessel density (LMVD). Meanwhile, the relationship between the expression of the two kinds of protein and clinicopathological factors/LMVD was analyzed by statistical analysis in breast cancer, and the correlation between expression of CCR7 protein and expression of VEGF-D protein was analyzed too. Results ①The positive rates of CCR7 protein (χ 2 =23.905，P<0.050) and VEGF-D protein (χ 2 =22.349，P<0.050) were gradually increased in the normal breast tissue group 〔CCR7 protein: 0 (0/20), VEGF-D protein: 5.0% (1/20)〕, slight and moderate atypical hyperplasia group 〔CCR7 protein: 5.0% (1/20), VEGF-D protein: 20.0% (4/20)〕, severe atypical hyperplasia and intraductal carcinoma in situ group 〔CCR7 protein: 30.0% (6/20), VEGF-D protein: 40.0% (8/20)〕, and invasive ductal carcinoma group 〔CCR7 protein: 47.9% (35/73), VEGF-D protein: 57.5% (42/73)〕. ②The LMVD value gradually increased in normal breast tissue group (2.00±1.02), slight and moderate atypical hyperplasia group (6.70± 3.48), severe atypical hyperplasia and intraductal carcinoma in situ group (9.01±2.13), as well as invasive ductal carcinoma group (16.32±4.07), there was significant difference between any 2 groups (P<0.050). ③The expressions of CCR7 protein and VEGF-D protein were correlated with clinical staging, histological grading, lymph node metastasis, and expression of human epidermal growth factor receptor-2 (HER-2) protein in patients with breast cancer (P<0.050), the higher positive rates of CCR7 and VEGF-D protein occurred in patients with higher histological grading, later clinical staging of Ⅲ+Ⅳ (compared with staging of Ⅰ+Ⅱ), lymph node metastasis (compared with no lymph node metastasis), and positive expression of HER-2 protein (compared with negative expression of HER-2 protein). The result indicated that LMVD value was related with expression of VEGF-D protein (r=0.623, P<0.010) in patients with breast cancer, but there was no correlation with expression of CCR7 protein (r=-0.303, P>0.050). Furthermore, there was weak positive correlation between expression of CCR7 protein and expression of VEGF-D protein in breast cancer (r=0.112, P<0.050). Conclusion The results strongly suggest that the expression levels of the VEGF-D protein and CCR7 protein indicate the potential of translation some extent, and they play an important role in the progression of breast 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 review the progress of treatment and prevention of breast cancer related lymphedema. MethodsThe recent literature concerning treatment and prevention of breast cancer related lymphedema was extensively consulted and reviewed. ResultsThe treatment of lymphedema is now based on complete decongestive therapy, supplemented with medicine and surgery. Those procedures have been proved to be safe and effective. Sentinel lymph node biopsy, axillary reverse mapping, and lymphaticovenous anastomoses have been used to decrease the incidence of lymphedema. They show promising effectiveness in short term, but the long-term effectiveness needs further tests. ConclusionIn clinical practice, many treatment methods are used to decrease lymphedema, and lymphedema prevention is playing an increasingly important role. Lymphaticovenous anastomoses shows a promising effectiveness in reducing lymphedema.
ObjectiveTo evaluate the diagnostic value of contrast enhanced ultrasound (CEUS) to the sentinel lymph node (SLN) of breast cancer. MethodsSeventy-two operable breast cancer patients with clinically negative axillary lymph node were enrolled.Sulphur hexafluoride microbubbles for injection (SonoVue) was used alone as the tracer agent for the sentinel lymph node biopsy (SLNB), and axillary dissection was performed after the methylene blue location.All SLNs were examined pathologically with HE staining.The SLN diagnosis result of contrast enhanced ultrasound and postoperative pathological examination result were comparative analyzed. ResultsAfter the injection of SonoVue can obtain a clear image of the lymphatic vessels and SLN.The success rate of CEUS imaging was 84.72% (61/72) in this group of 72 patients, and the false negative rate was 12.12% (4/33).The sensitivity and specificity of diagnosis by CEUS was 92.50% (37/40) and 92.59% (50/54), respectively, the diagnostic odds ratio (DOR) was 154.17.By the pathology results as the gold standard, the internal consistency of these two methods was good (Kappa value=0.848, P < 0.01). ConclusionCEUS may be a useful orientation and determination method for SLNs.
ObjectiveTo systematically review the correlation between the birth number and the risk of breast cancer of Chinese female. MethodsWe electronically searched databases including the CNKI, WanFang Data and VIP databases from inception to September 1st 2015, to collect case-control studies about the correlation between the number of births and the risk of breast cancer among Chinese female. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Then meta-analysis was performed by using Stata software. ResultsA total of 14 case-control studies involving 3 428 patients and 3 906 controls were included. The results of meta-analysis showed that:the females who had term birth had significant lower incidence of breast cancer than those without childbirth history (OR=0.429, 95%CI 0.322 to 0.571). Subgroup analysis based on the number of term birth showed that:Compared with the female without childbirth history, those who had term birth of one time (OR=0.464, 95%CI 0.321 to 0.670), two times (OR=0.394, 95%CI 0.269 to 0.576) and≥3 times (OR=0.340, 95%CI 0.232 to 0.499) had significant lower incidence of breast cancer. ConclusionTerm birth is a protective factor for breast cancer of Chinese female, and more times of term birth will decrease the risk of breast cancer.
Objective To analyze the factors associated with the adoption of targeted therapy in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer and to generate evidence to inform decision-making on public security policy regarding innovative anticancer medicines for the benefit of patients. Methods The study population comprised female patients diagnosed with HER2-positive breast cancer and treated at Fujian Cancer Hospital from 2014 to 2020. The patients were eligible for targeted therapy. The demographic and sociological characteristics and clinical information of patients were extracted from the hospital information system. We performed binary logistic regression analysis of factors associated with the adoption of targeted therapy in patients with HER2-positive breast cancer. We also divided the participants into two groups according to their tumor stage for subgroup analysis. Results A total of 1 041 female patients with HER2-positive breast cancer were included, among them, 803 received targeted therapy. In September 2017, molecular-targeted medicines for HER2-positive breast cancer began to be included in the local basic health insurance program. Only 282 (35.1%) patients adopted targeted therapy before September 2017, after which this number increased to 521 (64.9%). Among the patients who adopted targeted therapy, most were formally employed (45.8%) and enrollees of the urban employee health insurance program (66.0%). Among those who did not adopt targeted therapy, most were unemployed (42.4%) and enrollees of the resident health insurance program (50.0%). Binary logistic regression analysis revealed that patient occupation, gene expression of estrogen receptor, tumor stage, surgery or not, radiotherapy or not, and undergoing treatment before or after September 2017 were correlated with the adoption of targeted therapy (P<0.05). Conclusions Inclusion of targeted medicines for HER2-positive breast cancer in the health insurance program substantially increased the overall administration of these therapies. Individual affordability is a critical factor associated with the application of targeted therapy in eligible patients. Future policies should enhance the public security of patients with a relatively weak ability to pay and provide insurance coverage for innovative anti-cancer medicines.
Objective To review the recent studies on the suppressing function of breast cancer metastasis suppressor 1 (BRMS1) in breast cancer metastasis. Methods The recent literatures on the mechanisms of BRMS1 in the breast cancer that were published in and abroad were reviewed and summarized. Results BRMS1, similar to the other anti-metastasis genes, only suppresses the metastasis of breast cancer cells but has nothing to do with the growth of tumor. BRMS1 could suppress metastasis of tumor cells by reestablishing both the homospecific and the heterospecific gap junctional intercellular comminications (GJIC) and by altering the expressions of relevant metastasis genes in the breast cancer. Conclusion Further studies on BRMS1 may be helpful to understand the metastasis of breast cancer, which may provide a new way for the diagnosis and treatment of breast cancer.
ObjectiveTo explore the role of toremifene in postmenopausal operable patients with luminal subtype of breast cancer in China. MethodsA total of 618 eligible patients diagnosed with luminal subtype of breast cancer from January 2000 to December 2009 in the Cancer Center of Sun Yat-sen University were analyzed. One hundred and fifteen patients were treated with toremifene(toremifene group) and 503 patients were treated with tamoxifen(tamoxifen group) as adjuvant endocrine therapy. Survival was compared by Kaplan-Meier with log-rank test in two groups. Cox analysis was used to compare different prognostic factors. ResultsThe general clinical data had no significant differences between the toremifene group and tamoxifen group (P > 0.05). After a median follow-up of 76 months, there was no statistical difference in the 5-year disease free survival rate and 5-year overall survival rate between the toremifene group and the tamoxifen group (5-year disease free survival rate:78.5% versus 85.5%, P=0.083;5-year overall survival rate:86.4% versus 92.0%, P=0.334). Univariated analysis showed that the histological grade, tumor size, lymph node status, TNM stage, HER-2 positive expression were associated with the disease free survival rate and overall survival rate(P < 0.05). Multivariated analysis showed that the tumor size and lymph node status were the independent risk factors of disease free survival rate and overall survival rate for postmenopausal operable patients with luminal subtype of breast cancer(P < 0.05). HER-2 positive expression was the independent risk factor in predicting disease free survival rate for patients with tamoxifen or toremifene. There was no grade 3 or 4 toxicity for all the patients according to CTC AE 4.0 grade. ConclusionsSimilar benefit is found in disease free survival rate and overall survival rate in Chinese postmenopausal patients with operable luminal subtype of breast cancer between patients receiving toremifene and tamoxifen with tolerable adverse effects. HER-2 status is associated with disease free survival rate.
ObjectiveTo summarize the relationship of microRNA (miRNA) to metastasis and invasion of breast cancer. MethodDomestic and international publications involving the relationship of miRNA to breast cancer were screened and reviewed. ResultsmiRNA played a key role in the process of breast cancer metastasis. According to its function, it could be distinguished from cancer-promoting gene (such as miR-21, miR-10b, etc.) to suppressor gene (such as miR-31, let-7, etc.). ConclusionThe more detailed experimental studies about the relationship of miRNA to metastasis and invasion of breast cancer need to be researched in order to provide a new method for the diagnosis and treatment of breast cancer metastasis and invasion.
Objective To assess the diagnostic value of MRI and Bone Scan (BS) for osseous metastases in patients with breast cancer. Methods The trials were searched from PubMed, EMBASE, Cochrane Library, CBM, CNKI and VIP; the Criteria for inclusion and exclusion were based on the standard for diagnosis tests. Meta-Disc software (Version 1.4) was used for data analysis; and the area under curve (AUC) of SROC was calculated. Results A total of 5 researches involving 329 patients were included. The sensitivity of MRI and BS were 0.99 (0.97, 1.00) and 0.93 (0.88, 0.97) respectively; the specificity for MRI and BS were 0.99 (0.95, 1.00) and 0.86 (0.79, 0.92) respectively; and the AUC of SROC curve for MRI and BS were 0.993 6 and 0.967 5 respectively. Conclusion MRI can be regarded as an effective and feasible method for osseous metastases in breast cancer.