Objective To investigate the differences in clinicopathological characteristics and prognostic survival of human epidermal growth factor receptor 2 (HER2) high expression, HER2 low expression and HER2 negative breast cancer. MethodWe retrospectively collected 1 560 female breast cancer patients who underwent surgical treatment at the Department of Breast and Thyroid Surgery in Renmin Hospital of Wuhan University between January 8, 2010 and December 31, 2015, and divided them into high expression group, low expression group and negative group according to HER2 expression, to compare the differences in clinicopathological characteristics among the three groups of breast cancer patients and to explore the factors influencing prognosis. Results The proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, TNM stage Ⅲ, Ki67 high expression, and hormone receptor negative expression were higher in the high expression group than those in the low expression group and negative group (P<0.050); the proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, and TNM stage Ⅲ were higher in the low expression group than those in the negative group (P<0.050). However, the proportions of Ki67 high expression and hormone receptor negative expression were lower than those of the negative group (P<0.050). The 5-year disease-free survival rate were 85.6%, 80.3% and 74.5% for the high expression, low expression and negative group, respectively, and the 5-year overall survival rate were 90.4%, 86.0% and 80.7%, respectively. The results of multivariate Cox proportional hazard model showed that patients with high histological grade, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year disease-free survival (P<0.050); patients with older age, high histological grade, lymph node metastasis, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year overall survival (P<0.050). Conclusions The intensity of HER2 expression affects the 5-year disease-free survival and overall survival of breast cancer patients, and the higher the intensity of HER2 expression, the better the 5-year disease-free survival and overall survival, while the weaker the HER2 expression, the worse the 5-year disease-free survival and overall survival.
Primary breast angiosarcoma (PBA) is a rare malignant tumor, and few clinical cases have been reported. In this case, the mammographic and contrast-enhanced magnetic resonance imaging of PBA were reported, and the relevant pathologic basis was also briefly introduced in order to enhance the clinicians’ understanding of the imaging manifestations of this rare disease.
ObjectiveTo explore the immune biomarkers for prognosis of breast cancer and to construct a risk assessment model.MethodsThe gene expression of breast cancer samples was retrieved from The Cancer Genome Map (TCGA) database and immune related genes (IRGs) were retrieved from the ImmPort database. Cox proportional hazards regression and least absolute shrinkage and selection operator (LASSO) regression were used for prognostic analysis. Gene set enrichment analysis ( GSEA) was used to explore biological signaling pathways. ESTIMATE and CIBERSORT algorithms were used to explore the relationship between risk score and tumor immune microenvironment.ResultsNine kinds of immune-related differentially expressed genes independently related to prognosis were identified: adrenoceptor beta 1 (ADRB1), interleukin 12B (IL12B), syndecan 1 (SDC1), thymic stromal lymphopoietin (TSLP), fibroblast growth factor 19 (FGF19), fatty acid binding protein 7 (FABP7), interferon epsilon (IFNE), tumor necrosis factor receptor superfamily member 18 (TNFRSF18) and interleukin 27 (IL27). The risk assessment equation constructed by these nine kinds of genes had powerful predictive ability. The “neurotrophin signaling pathway” and “adipocyte factor signaling pathway” were activated in patients of high-risk group, and “leukocyte transendothelial migration” “WNT signaling pathway” “FcεRI signaling pathway” “valine, leucine and isoleucine biosynthesis” and “protein export pathway” were activated in patients of low-risk group. A variety of tumor-killing immune cells were significantly enriched in the tumor-infiltrating immune cells of patients in the low-risk group. The immunosuppressive immune cells were significantly enriched in tumor infiltrating immune cells of patients in high-risk group.ConclusionIRGs prognostic signatures are an effective potential predictive classifier in breast cancer treatment.
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.
Objective
To summarize current research status of sperm protein 17 (SP17) in breast cancer.
Method
Bysearching PubMed, Web of Science, CNKI, and Wanfang databases, the studies about expression and function of SP17 in the breast cancer were summarized.
Results
SP17 only expressed in the breast cancer tissue but not in the normal breast tissue. The result of the study showed that SP17 was only detected in the metastatic stage of tumor cells. The preclinical trails found that the breast cancer cells with SP17 positive expression could be killed by the specific T lymphocyte.
Conclusions
SP17 might be a potential target of immunotherapy of breast cancer, it might promote metastasis of cancer. More studies are needed to further explore its function in tumor development, thus accelerate its application in clinical practice.
ObjectiveTo discuss the role of primary tumor resection in breast cancer of stage Ⅳ.MethodsTo search and review retrospective and prospective clinical trials about primary tumor resection in breast cancer of stage Ⅳ in recent years at home and abroad.ResultsThe results of most retrospective clinical trials were that primary tumor resection in breast cancer of stage Ⅳ was beneficial. But there were some obvious bias: younger patients, smaller tumors, non-randomized design, and so on. The results of several prospective studies abroad were inconsistent. In the MF07-01, hazard of death was lower in the surgery group and subgroup analysis showed that the risk of death was lower in the surgery group with respect to positive-hormone receptor, negative-human epidermal growth factor 2, patients younger than 55 years, and patients with solitary bone-only metastases when other prospective studies come to the different conclusions. Several Chinese retrospective studies also had similar results that primary tumor resection was beneficial.ConclusionPrimary tumor resection in breast cancer of stage Ⅳ can benefit some patients, whom need more prospective studies to choose.
ObjectiveTo compare the surgical data, safety, cosmetic outcomes, and quality of life of patients underwent single axillary incision endoscopic nipple-sparing mastectomy and immediate breast reconstruction with endoscopic harvesting of latissimus dorsi muscle flap (abbreviation as the “endoscopic group”) and traditional open surgery of latissimus dorsi muscle flap harvesting for breast reconstruction after mastectomy (abbreviation as the “open group”). MethodsThe patients were collected, who underwent latissimus dorsi breast reconstruction at the West China Hospital of Sichuan University and the Fourth People’s Hospital of Sichuan Province from January 2021 to June 2024 from a prospective maintenance database, and then were assigned into an endoscopic group and open group according to the surgical method. Their basic information, information relevant operation, postoperative complications, and patient reported outcomes (BREAST-Q scale) score were compared between the two groups. ResultsA total of 73 patients were enrolled, including 23 patients in the endoscopic group and 50 patients in the open group. There were no statistically significant differences in the age, body mass index, breast sagging, tumor location, tumor N stage, pathological type, adjuvant therapy, etc. between the patients of two groups, except for a higher proportion of T4 stage patients in the open group as compared with the endoscopic group (P＜0.001). A longer size of latissimus dorsi muscle flap was harvested in the endoscopic group as compared with the open group (P=0.002). There were no statistically significant differences in the total surgical complications, major complications, minor complications, and implant-related complications between the patients of two groups (P>0.05). The most common complication in the patients of both groups was back seroma, 21.7% (5/23) in the endoscopic group and 22.0% (11/50) in the open group. The total length of incisions in the endoscopic group was significantly shorter than that in the open group (P<0.001), and the points of the breast satisfaction (P=0.045), back satisfaction (P<0.001), and sexual well-being (P=0.028) of the patients in the endoscopic group were significantly higher than those in the open group. The major complications did not happen in the endoscopic group, but happened in 2 cases in the open group (1 patient due to ischemic necrosis of the latissimus dorsi muscle and 1 patient due to breast infection resulting in implant removal). During the follow-up period, 3 (6.0%) patients had distant metastasis (all were lung metastasis) in the open group, and there was no local or regional recurrence, distant metastasis, and specific death of breast cancer in the endoscopic group. ConclusionsThe results of this study suggest that, for patients who have skin invasion but who desire breast reconstruction or have failed by prosthetic breast reconstruction (such as skin flap necrosis), traditional open surgery of latissimusdorsi flap harvesting for breast reconstruction is worth choosing. However, for breast cancer patients who do not need additional skin breast reconstruction, endoscopic latissimus dorsi breast reconstruction has greater advantages in cosmetic effect, and it is safe and effective.
Objective
To summarize the progress of biological indexes which could predict the efficiency of neoadjuvant chemotherapy for breast cancer.
Methods
Various related researches were collected to make a review.
Results
Many indexes linked to the efficiency of neoadjuvant chemotherapy for breast cancer according to several studies. According to many studies, indexes such as human epidermal growth factor receptor-2 (HER-2) gene, estrogen receptor (ER), progesterone receptor (PR), Ki-67, P53 gene, neutrophil to lymphocyte ratio (NLR), platelet level, and mean platelet volume (MPV) may have association with the outcome of neoadjuvant chemotherapy in treatment of breast cancer, and these factors maybe individual biomarkers to predict the efficiency of the treatment, but no coincident conclusion has been reached for these indexes.
Conclusion
The value of these indexes that predict the efficiency of neoadjuvant chemotherapy is not sure, further study need to be done to solve this topic.
The expression of C-erb B-2 oncogene protein in the tissues of normal breast, atypical cystic hyperplasia of breast and breast carcinoma were determined in order to analyse the significance of the changes of C-erb B-2 oncogene in the course from atypical hyperplasia to carcinoma of breast. Results: there were no expression of C-erb B-2 protein in the tissues of normal breast and cystic hyperplasia of breast with epithelia proliferation grade Ⅰ. The positive rates of the expressions of C-erb B-2 protein in the tissues of atypical hyperplasia grades Ⅱ, Ⅲ and carcinoma of breast were 20.0%, 40.0% and 54.2% respectively. The results indicated that the abnormal changes of C-erb B-2 nocogene might occured in the carcinomatous transformation phase along with the changes from normal breast epithelial cell through atypical hyperplasia to breast cancer, those changes could be the result or promotion factor of abnormal proliferation of atypical hyperplasia of breast and was one of the markers of malignant transformation of epithelia of breast.
Objective
To systematically review the correlation between polymorphism of DNA methyltransferase 1(DNMT1) rs16999593 and the susceptibility of breast cancer.
Methods
Databases such as PubMed, EMbase, Web of Science, Chinese Biomedical Literature Database, CNKI, WanFang, and VIP database were searched from inception to Mar. 2017 to collect case-control studies on the correlation between DNMT1 rs16999593 C/T polymorphism and the susceptibility of breast cancer. Two reviewers independently identified the literatures according to inclusion and exclusion criterias, extracted data, and assessed the quality of the included studies. The meta-analysis was performed by using RevMan 5.3 software.
Results
A total of 5 studies involving 1 741 cases and 1 917 control subjects were included. The results of meta-analysis showed that, dominate model ［TT+TC vs. CC: OR=0.63, 95% CI was (0.30, 1.30), P=0.21］, homozygous model ［TT vs. CC: OR=1.01, 95% CI was (0.70, 1.47), P=0.95］, heterozygous model ［TC vs. CC: OR=0.44, 95% CI was (0.18, 1.04), P=0.06］, and additive model ［T vs. C: OR=1.29, 95% CI was (0.90, 1.86), P=0.16］ were not significantly related to breast cancer, but recessive gene model was related to breast cancer ［TT vs. TC+CC: OR=1.74, 95% CI was (1.01, 3.00), P=0.04］.
Conclusion
The current studies showed that, DNMT1 rs16999593 TT genotype decreases the susceptibility of breast cancer.
