Dense breast is an independent risk factor for females with breast cancer, and also one of the important reasons for decreased sensitivity of mammography and increased risk of missed diagnosis. Females with dense breast in China account for a high proportion, making the breast cancer screening a key and difficult point in the prevention and control targeting breast cancer in such population. The formulation of specialized screening expert consensus for dense breast populations is conducive to achieving more accurate early detection, improving screening efficiency, and reasonably allocating medical resources. Committee for Integrative Prevention and Screening of Breast Cancer, China Anti-Cancer Association takes the lead and organizes multi-disciplinary experts to systematically review relevant evidence-based medical evidence domestically and internationally, integrate the actual situation, and clinical experience of China, and conform to setting norms of international guidelines to complete evidence integration and form recommendations, thereby formulating “Expert Consensus on Breast Cancer Screening in Chinese Female with Dense Breast (2025 edition)”. This expert consensus puts forward recommendations on the risk stratification, screening age, screening interval, screening methods, joint screening strategies, and other key issues of females with dense breast, aiming to promote the standardized screening practice of such population, improve the level of early diagnosis and treatment of breast cancer, and provide technical support and implementation basis for the prevention and control of Chinese females with breast cancer.
ObjectiveBy comparing the epidemiological characteristics of the incidence and death of female breast cancer in China and the United States, the differences in prevention and screening strategies between China and the United States were analyzed to explore the prevention and control measures of female breast cancer in China. MethodsBased on the relevant data released by the Global Burden of Disease in 2020, the National Cancer Center of China, and the China Health Statistical Yearbook, the new cases and deaths of breast cancer in Chinese and American women in 2023 were estimated respectively, and the incidence, mortality and time trend of breast cancer in Chinese and American women were analyzed. ResultsIn China, 376 789 new cases of female breast cancer and 116 791 deaths were expected in 2023. In the United States, approximately 297 790 women were expected to be newly diagnosed with breast cancer in 2023, representing approximately 15.2% of new cancer cases. About 43 170 women died from breast cancer, accounting for about 7.1% of all cancer deaths. The incidence of breast cancer in women in the United States during the period 1975–2020 gradually increased and then stabilized; In contrast, the incidence of breast cancer among Chinese women increased year by year during the period 1990–2020. In recent years, the incidence and mortality rates of breast cancer in Chinese women had increased more than those in the United States, and there was a large difference between urban and rural areas in China. ConclusionsBoth China and the United States face a large burden of female breast cancer, and the characteristics of female breast cancer in China are similar to those in the United States. To reduce the burden of breast cancer in Chinese women, further efforts should be made in various aspects, such as strengthening breast cancer education, raising public health awareness, improving diet structure, cultivating healthy lifestyle, increasing screening efforts, and improving medical level.
ObjectiveTo preliminarily explore the effect of Osteoporosis Self-assessment Tool for Asians (OSTA) and Fracture Risk Assessment Tool (FRAX) on predicting osteoporosis and osteoporosis fracture in postmenopausal patients with maintenance hemodialysis (MHD).MethodsThirty-six postmenopausal patients undergoing MHD from August 2017 to October 2018 in Hemodialysis Center of Nephrology Department, West China Hospital of Sichuan University were selected. Relevant data such as age, height, and weight were collected. OSTA index and the 10-year probability of major osteoporotic fractures and 10-year probability of hip fractures of FRAX score were calculated. Bone mineral densities (BMD) of the hip and lumbar spine were measured by dual energy X-ray absorptiometry (DXA) at the same time. The value of OSTA index and FRAX scale in evaluating the risk of osteoporosis predicated on T value ≤?2.5 determined by DXA BMD and fracture in postmenopausal patients with MHD were analyzed.ResultsThe DXA BMD of the 36 patients showed that 50.0% (18/36) had a T value≤?2.5, and 30.6% (11/36) had a fracture history. BMD in postmenopausal patients with MHD was negatively correlated with FRAX score (model without BMD values), and positively correlated with OSTA index. The sensitivity and specificity of OSTA in the prediction of osteoporosis were 94.4% and 61.1%, respectively; and the sensitivity and specificity of FRAX (the model without BMD values) in the prediction of osteoporosis were 88.9% and 50.0%, respectively. The FRAX score with or without BMD had the same clinical value in predicting osteoporosis.ConclusionsPostmenopausal MHD patients have a higher risk of osteoporosis and fracture. Both OSTA index and FRAX scale can predict osteoporosis risk among postmenopausal MHD patients, and the FRAX scale with or without BMD has the same clinical value in predicting osteoporosis risk. In clinical work, for primary hospitals and dialysis centers lacking DXA, preliminary screening of osteoporosis in MHD patients can be performed with OSTA and FRAX scales.
Objective To explore the feasibility and safety of tension-free vaginal tape-obturator for female stress urinary incontinence under the daytime surgical mode based on the concept of enhanced recovery after surgery. Methods The clinical data of female patients with stress urinary incontinence at the First Affiliated Hospital of Kunming Medical University between June 2019 and June 2023 were retrospectively analyzed. According to the perioperative management mode of patients, they were divided into daytime surgery group and routine surgery group. The basic, intraoperative, and postoperative conditions of two groups of patients were compared. Results Finally, 183 patients were included, including 91 in the routine surgery group and 92 in the daytime surgery group. All patients successfully completed the surgery. There was no statistically significant difference in age, preoperative comorbidities, surgeon in chief, or operation duration between the two groups of patients (P>0.05). The preoperative waiting time after hospitalization [(0.00±0.00) vs. (2.42±0.58) d], hospitalization expenses [(13815.10±2906.01) vs. (18095.21±3586.67) yuan], total surgical expenses [(3961.36±707.35) vs. (4440.19±1016.31) yuan], anesthesia expenses [(718.53±61.06) vs. (755.30±74.65) yuan], western medicine expenses [(818.07±259.30) vs. (1282.14±460.75) yuan], total hospitalization duration [(1.11±0.31) vs. (5.77±1.30) d], and postoperative hospitalization duration [(1.11±0.31) vs. (3.35±1.42) d] in the daytime surgery group were lower than those in the routine surgery group (P<0.05). There was no significant difference between the two groups in postoperative complications (respiratory complications, fever, nausea and vomiting, vaginal bleeding, urinary retention, peritonitis), satisfaction, postoperative pain or self perception of symptom improvement (P>0.05). Conclusion The daytime surgery for female stress urinary incontinence based on the concept of enhanced recovery after surgery is safe and feasible, which can shorten hospitalization duration and reduce hospitalization costs.
ObjectiveTo compare the outcomes after self-gripping mesh repair to ordinary polypropylene mesh secured with sutures in women’s Lichtenstein hernioplasty.MethodsThe clinical data of 116 female patients with primary unilateral inguinal hernia who were admitted to The First Affiliated Hospital of Zhengzhou University from January 2014 to January 2017 were prospectively analyzed. A randomized controlled trial was performed based on a random number table. All patients were allocated into self-gripping mesh group (PG group) and ordinary polypropylene mesh group (PL group). The outcomes included operative time, post-operative pain score, analgesic used, hospital stay, urinary retention, wound infection, and seroma were recorded. Patients were followed-up after 1 week, 1 months, 3 months, 1 year, and 2 years after operation. Follow-up data included chronic pain, foreign body feeling, affect daily activities, and recurrence.ResultsNinety-nine participants completed follow-up. There were 48 patients in the PG group and 51 participants in the PL group. The operative time of the PG group was significantly shorter than that of the PL group (P=0.045), but there was no significant difference in analgesic used, hospital stay, incidence of urinary retention and wound infection, visual analogue scale (VAS) of wound pain at rest at 1 week postoperatively, VAS of wound pain on coughing at 1 week postoperatively between the two groups (P>0.05). At 1 month after operation, the incidence of foreign body feeling in the PG group was significantly higher than that of the PL group (P=0.031), while there was no significant difference in ratio of VAS≥3 and incidence of affect daily activities (P>0.05). At 3 months, 1 year, and 2 years after operation, there was no significant difference in incidences of foreign body feeling, chronic pain, and affect daily activities between the two groups (P>0.05). There was one recurrence in the PL group and none in the PG group, without a significant difference (P=0.248).ConclusionThe surgical outcomes of self-gripping mesh are comparable to the ordinary polypropylene mesh with a reduced operation time in women’s Lichtenstein hernioplasty.
Objective To examine the influence of hormonal fluctuations on the perioperative outcomes of patients undergoing congenital heart surgery. Methods We conducted a retrospective analysis of clinical data from fertile women diagnosed with congenital heart disease at the Guangdong Provincial People's Hospital, between January 1, 2015, and July 30, 2019. Initially, patients were categorized into groups based on serum progesterone levels: a low progesterone group (n=31) and a high progesterone group (n=153). Furthermore, based on serum estrogen levels, they were divided into a low estrogen group (n=10), a medium estrogen group (n=32), and a high estrogen group (n=118) for comparative analysis. A control group (n=24) consisted of patients who received progesterone injections before their menstrual period. Results We finally included 184 patients. The patients’ average age was 27.6±5.7 years, with 142 (77.17%) presenting with complex congenital heart conditions. There were statistically significant differences in total postoperative standard thoracic drainage volume and postoperative albumin level between the high and low progesterone groups (P<0.05), while other perioperative outcome indicators showed no statistical differences (P>0.05). Among the different serum estrogen level groups, there were statistically significant differences in postoperative blood urea nitrogen levels, total postoperative standard thoracic drainage volume, and hospital stay (P<0.05), while other perioperative outcome indicators showed no statistical differences (P>0.05). ConclusionConsidering the overall clinical significance, the physiological changes in sex hormone levels appear to have a negligible effect on the perioperative outcomes of fertile women with congenital heart disease.
ObjectiveTo investigate the effectiveness of clitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate for genital virilization in girls with congenital adrenal hyperplasia (CAH).
MethodsBetween June 2000 and October 2015, 27 girls with genital virilization were treated with clitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate. The chromosomal karyotype was 46, XX in all patients, whose age ranged from 3 to 11 years (mean, 3.9 years). According to Parder's virilization scale, 5 cases were classified as stage Ⅱ, 18 cases as stage Ⅲ, and 4 cases as stage Ⅳ. The hormone tests showed decreased cortisol level and increased testosterone and 17-hydroxyprogesterone levels. They were diagnosed with non-salt-wasting CAH.
ResultsAll of the patients underwent clitoroplasty successfully. The mean operation time was 74 minutes (range, 58-95 minutes). Incision healed primarily. The patients were followed up 6 months to 10 years (median, 19 months). The external genitalia had good appearance, without necrosis of flap and the glans clitoris, abnormal sensation of the glans clitoris, or clitorism recurrence. Five girls had breast development and normal menstrual cycle during adolescence, and 1 patient who was followed up for 10 years gave birth to a son.
ConclusionClitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate is a relatively ideal method for treating genital virilization in girls. It has less complications, good aesthetic and functional results. There are satisfactory outcomes when combining with the endocrine treatment.
Objective To systematically review the prevalence of osteoporosis (OP) in Chinese postmenopausal females. Methods The CNKI, VIP, CBM, WanFang Data, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect studies on the prevalence of OP in Chinese postmenopausal females from inception to March 17th, 2022. Two reviewers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed using Stata 14.0 software. Results A total of 54 studies involving 96 391 cases and 41 651 confirmed OP patients were included. The meta-analysis results showed that the prevalence of OP in Chinese postmenopausal females was 38.8% (95%CI 34.1% to 43.5%). Subgroup analysis showed that the prevalence of OP was 31.7% (95%CI 16.6% to 48.6%) in females who had been menopausal for less than 5 years, 47.4% (95%CI 32.2% to 62.5%) for 5-9 years, 52.7% (95%CI 37.1% to 68.3%) for 10-14 years, 77.5% (95%CI 69.5% to 85.4%) for 15-19 years, and 78.3% (95%CI 56.3% to 100.0%) for more than 20 years. The rate was 16.2% (95%CI 28.8% to 37.2%) in under 50 years age group, 28.8% (95%CI 34.4% to 47.9%) for 50- years group, 41.1% (95%CI 34.4% to 47.9%) for 60- years group, 55.3% (95%CI 45.8% to 64.8%) for 70- years group, 82.0% (95%CI 76.1% to 87.9%) for 80- years group. The prevalence in different regions was between 31.0% and 43.5%, which was lowest in the northeast (31.0%, 95%CI 26.3% to 51.4%) and highest in the northwest (43.5%, 95%CI 22.3% to 64.7%). According to the year of publication, the rate was 43.9% (95%CI 15.7% to 72.0%) from 1997 to 2009 and 38.2% (95%CI 33.8% to 42.5%) from 2010 to 2021. The prevalence of OP was 24.9% (95%CI 20.5% to 29.3%) in postmenopausal females with no birth or 1 birth, and 45.0% (95%CI 37.0% to 53.0%) in females with 2 or more births. Conclusion The prevalence of OP in Chinese postmenopausal females is relatively high. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
