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Flat Aesthetic Mastectomy Closure with the Angel Wing Technique to Address Lateral Adiposity: Technique and Outcome Analysis 用天使翼技术进行平整美观的乳房切除术闭合,解决外侧脂肪问题:技术与结果分析
IF 2.1 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-25 DOI: 10.1155/2024/7349633
E. Klenotic, D. Ochoa, K. Stephenson, C. Croswell, S. Sullivan, A. C. Sherman, R. Henry-Tillman

Introduction. Oncologic mastectomy in the setting of obesity poses challenges in achieving a flat closure that includes the lateral adiposity. The angel wing (AW) technique was developed to address this issue. We aim to demonstrate the safety of AW by evaluating incidence of arm lymphedema (AL) and decreased range of motion (dROM) in patients postmastectomy with and without the AW closure. Methods. We performed a single-center retrospective cohort study at an academic referral center of patients who underwent mastectomy with and without the AW technique from May 2014 to October 2022. Those who received breast reconstruction (immediate or delayed), partial mastectomy, and male patients were excluded. The presence of postoperative AL and dROM was evaluated. Subgroup analysis was performed for patient factors including BMI, extent of axillary surgery, PMRT, and pathologic stage. Results. A total of 390 patients met inclusion criteria. Of those, 173 (44.4%) underwent AW and 217 (55.6%) had non-AW mastectomy. Expectedly, the average BMI was significantly higher in the AW cohort (p < 0.0001). The overall rate of AL was 51/390 (13.1%), seen in 27 (15.6%) undergoing AW and 24 (11.1%) non-AW (p value = 0.18). While the rate of dROM within the cohort was 52/390 (13.1%), 27 (15.6%) underwent AW vs. 24 (11.1%) non-AW (p value = 0.22), resulting in no statistical significance between AW and non-AW mastectomy upon subsequent development of AL or dROM. Conclusion. Our study demonstrates the AW technique does not convey an increased risk of overall AL or dROM, even when considering known risk factors such as obesity, PMRT, and extent of axillary surgery. As we strive to provide our patients with improved surgical techniques for oncologic resection, we submit that this technique is a viable and safe option for achieving the goals of cosmesis with oncologic safety.

导言。肥胖情况下的肿瘤乳房切除术在实现包括侧脂肪的平整闭合方面存在挑战。天使之翼(AW)技术就是为解决这一问题而开发的。我们旨在通过评估使用和未使用天使翼闭合术的乳房切除术后患者的手臂淋巴水肿(AL)发生率和活动范围缩小(dROM)来证明天使翼的安全性。方法。我们在一家学术转诊中心开展了一项单中心回顾性队列研究,研究对象是在2014年5月至2022年10月期间接受乳房切除术并使用或未使用AW技术的患者。排除了接受乳房重建(即刻或延迟)、乳房部分切除术的患者和男性患者。对术后AL和dROM的存在情况进行了评估。针对患者因素(包括体重指数、腋窝手术范围、PMRT 和病理分期)进行了分组分析。结果。共有 390 名患者符合纳入标准。其中,173 人(44.4%)接受了腋窝切除术,217 人(55.6%)接受了非腋窝切除术。预计AW组患者的平均体重指数(BMI)明显更高()。AL的总体比率为51/390(13.1%),其中27人(15.6%)接受了AW,24人(11.1%)未接受AW(值=0.18)。而队列中的 dROM 发生率为 52/390(13.1%),其中 27 例(15.6%)接受了乳房下切除术,24 例(11.1%)未接受乳房下切除术(数值 = 0.22),因此乳房下切除术和未乳房下切除术在随后发生 AL 或 dROM 方面没有统计学意义。结论。我们的研究表明,即使考虑到肥胖、PMRT 和腋窝手术范围等已知风险因素,AW 技术也不会增加 AL 或 dROM 的总体风险。当我们努力为患者提供更好的肿瘤切除手术技术时,我们认为这种技术是一种可行且安全的选择,既能达到美观的目的,又能保证肿瘤安全。
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引用次数: 0
The Prognostic Quality of Risk Prediction Models to Assess the Individual Breast Cancer Risk in Women: An Overview of Reviews 评估女性个人乳腺癌风险的风险预测模型的预后质量:综述
IF 2.1 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-21 DOI: 10.1155/2024/1711696
Sarah Wolf, Ingrid Zechmeister-Koss, Irmgard Fruehwirth

Purpose. Breast cancer is the most common cancer among women globally, with an incidence of approximately two million cases in 2018. Organised age-based breast cancer screening programs were established worldwide to detect breast cancer earlier and to reduce mortality. Currently, there is substantial anticipation regarding risk-adjusted screening programs, considering various risk factors in addition to age. The present study investigated the discriminatory accuracy of breast cancer risk prediction models and whether they suit risk-based screening programs. Methods. Following the PICO scheme, we conducted an overview of reviews and systematically searched four databases. All methodological steps, including the literature selection, data extraction and synthesis, and the quality appraisal were conducted following the 4-eyes principle. For the quality assessment, the AMSTAR 2 tool was used. Results. We included eight systematic reviews out of 833 hits based on the prespecified inclusion criteria. The eight systematic reviews comprised ninety-nine primary studies that were also considered for the data analysis. Three systematic reviews were assessed as having a high risk of bias, while the others were rated with a moderate or low risk of bias. Most identified breast cancer risk prediction models showed a low prognostic quality. Adding breast density and genetic information as risk factors only moderately improved the models’ discriminatory accuracy. Conclusion. All breast cancer risk prediction models published to date show a limited ability to predict the individual breast cancer risk in women. Hence, it is too early to implement them in national breast cancer screening programs. Relevant randomised controlled trials about the benefit-harm ratio of risk-adjusted breast cancer screening programs compared to conventional age-based programs need to be awaited.

目的。乳腺癌是全球妇女最常见的癌症,2018 年的发病率约为 200 万例。为了更早地发现乳腺癌并降低死亡率,全世界都制定了基于年龄的有组织乳腺癌筛查计划。目前,人们对除年龄外还考虑各种风险因素的风险调整筛查计划充满期待。本研究调查了乳腺癌风险预测模型的判别准确性,以及这些模型是否适合基于风险的筛查计划。研究方法。按照 PICO 计划,我们对综述进行了概述,并系统地检索了四个数据库。所有方法步骤,包括文献选择、数据提取和综合以及质量评估,均按照四眼原则进行。质量评估采用了 AMSTAR 2 工具。结果根据预先确定的纳入标准,我们从 833 篇文献中纳入了 8 篇系统综述。这八篇系统综述包括 99 项主要研究,这些研究也被纳入了数据分析。三篇系统综述被评估为存在高偏倚风险,其他综述被评估为存在中度或低度偏倚风险。大多数已确定的乳腺癌风险预测模型的预后质量较低。加入乳房密度和遗传信息作为风险因素只能适度提高模型的判别准确性。结论迄今为止发表的所有乳腺癌风险预测模型在预测女性个体乳腺癌风险方面的能力都很有限。因此,在国家乳腺癌筛查计划中实施这些模型还为时尚早。有关风险调整乳腺癌筛查计划与传统的基于年龄的计划相比的利弊比,还需要等待相关的随机对照试验。
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引用次数: 0
Selective Capsulotomies and Partial Capsulectomy in Implant-Based Breast Reconstruction Revision Surgery 假体乳房再造翻修手术中的选择性帽状切除术和部分帽状切除术
IF 2.1 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-02-27 DOI: 10.1155/2024/9097040
Pietro Susini, Gianluca Marcaccini, Francesco Ruben Giardino, Mirco Pozzi, Francesco Volanti, Giuseppe Nisi, Roberto Cuomo, Luca Grimaldi

Background. Breast cancer with about 2.3 million diagnoses and 685,000 deaths globally is the most frequent malignancy in the female population. Continuous research has led to oncological and reconstructive advances in the management of breast cancer, thus improving outcomes and decreasing patient morbidity. Nowadays, the submuscular expander and prosthesis (E/P) implant-based breast reconstruction (IBR) accounts for 73% of all reconstructions. Despite its widely accepted efficacy, the technique is not free from complications and up to 28% of cases require revision surgery for mechanical complications such as capsular contracture, implant displacement/rotation, and implant rupture. With this study, the authors report their experience in the management of E/P IBR revision surgery through the technique of Selective Capsulotomies (SCs) and Partial Capsulectomy (PC). Methods. A retrospective study was conducted on patients who had previously undergone E/P IBR and presented for revision reconstruction between January 2013 and May 2023 at the Department of Plastic Surgery of the University of Siena, Italy. Reasons for revision included capsular contracture, implant displacement/rotation, and implant rupture. Revision reconstructions involved SC and PC with implant replacement. Fat grafting was also considered. The complication rate was evaluated by analysis of patients’ medical records. Patients’ satisfaction with the treatment was assessed through a specific questionnaire. Results. 32 patients underwent revision surgeries. No early complication occurred. Recurrence rate was assessed at 19% with average follow-up of 59 months (range: 13–114 months). The average time between revision surgery and recurrence was 3 years (range: 1–6 years). 23 patients answered the questionnaire and were overall satisfied with the treatments (8.29/10). Conclusions. SC possibly associated to PC is a valuable option for E/P IBR revision surgery with minimal complications, reduced surgical trauma, short operating time, and relatively low recurrence risk. In addition, treated patients are overall satisfied with the results over time.

背景。乳腺癌是女性最常见的恶性肿瘤,全球约有 230 万人确诊乳腺癌,685,000 人死于乳腺癌。不断的研究使乳腺癌的治疗在肿瘤学和整形方面取得了进步,从而改善了治疗效果,降低了患者的发病率。目前,肌肉下扩张器和假体(E/P)植入式乳房重建术(IBR)占所有重建术的 73%。尽管该技术的疗效得到了广泛认可,但也并非没有并发症,高达 28% 的病例需要因包膜挛缩、假体移位/旋转和假体破裂等机械并发症进行翻修手术。在本研究中,作者报告了他们通过选择性囊袋切开术(SC)和部分囊袋切除术(PC)处理 E/P IBR 翻修手术的经验。方法。对曾接受过 E/P IBR 手术,并于 2013 年 1 月至 2023 年 5 月期间在意大利锡耶纳大学整形外科接受翻修重建手术的患者进行了回顾性研究。翻修的原因包括囊性挛缩、假体移位/旋转和假体破裂。翻修重建包括SC和PC以及假体置换。此外,还考虑了脂肪移植。通过分析患者的医疗记录评估了并发症发生率。患者对治疗的满意度通过特定的问卷进行评估。结果32 名患者接受了翻修手术。无早期并发症发生。复发率为 19%,平均随访时间为 59 个月(13-114 个月)。翻修手术与复发之间的平均间隔时间为 3 年(范围:1-6 年)。23 名患者回答了调查问卷,并对治疗总体表示满意(8.29/10)。结论。可能与 PC 相关的 SC 是 E/P IBR 翻修手术的重要选择,并发症少,手术创伤小,手术时间短,复发风险相对较低。此外,接受治疗的患者对长期疗效总体满意。
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引用次数: 0
Mammoplasty Using Modified Superomedial Pedicle Technique in Severely Macromastia and Ptotic Breasts 在严重巨乳症和乳房下垂中使用改良的上内侧乳房柄技术进行乳房整形术
IF 2.1 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-02-15 DOI: 10.1155/2024/7635485
Engin Selamioğlu, Özgür Agdoğan

Mammoplasty is a surgery commonly used for macromastia. Many mammoplasty techniques are described, all with their specific pros and cons. However, the concern to avoid serious complications sometimes takes precedence, and the ideal result cannot be. For macromastia and severely ptotic breasts, usually the free nipple-areolar complex (NAC) mammoplasty technique is implemented. The results, however, may only be completely satisfactory regarding cosmetics. Loss of NAC, poor appearance, flabbiness, flattening, and ptosis are among the disadvantages of this technique. This study aimed to present the results of mammoplasty employing the superomedial pedicle technique without interrupting a macromastia central base with a pedicle length of 8 to 18 cm. According to the literature, many plastic surgeons recommend the free NAC rather than the pedicle technique because of the high complication rates in mammoplasties planned for highly ptotic breasts and macromastia. On the other hand, many free NAC techniques and their modifications with pedicle mammoplasty are described. The general conviction is that a standard method, protocol, or technique good for all patients does not exist. Our results are more acceptable both cosmetically and physiologically. Therefore, the superomedial pedicle technique can be modified to achieve ideal results where free NAC mammoplasty is considered for severe macromastia and ptotic patients. This combined method contributes to the viability of NAC by increasing blood supply to breast tissue and providing an ideal breast appearance.

乳房成形术是一种常用于治疗巨乳症的手术。乳房整形术有多种技术,各有利弊。然而,有时为了避免严重的并发症,理想的效果并不能实现。对于巨乳症和严重下垂的乳房,通常采用游离乳头乳晕复合体(NAC)乳房整形术。然而,其结果可能只是在美容方面完全令人满意。乳头乳晕复合体缺失、外观不佳、松弛、扁平和下垂是这种技术的缺点。本研究旨在介绍采用上内侧基底技术进行乳房整形术的结果,该技术不中断大乳房中央基底,基底长度为 8 至 18 厘米。根据文献,许多整形外科医生建议采用游离乳房下垂矫正术,而不建议采用乳房下垂矫正术,因为乳房高度下垂和巨乳症患者的乳房整形手术并发症发生率较高。另一方面,许多游离 NAC 技术及其与有蒂乳房成形术的改良方法都有描述。人们普遍认为,并不存在适合所有患者的标准方法、方案或技术。我们的结果在外观和生理上都更容易被接受。因此,在考虑对严重的巨乳症和上睑下垂患者进行游离 NAC 乳房整形术时,可对上内侧椎弓技术进行修改,以达到理想的效果。这种联合方法增加了乳房组织的血液供应,提供了理想的乳房外观,从而提高了 NAC 的成活率。
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引用次数: 0
Idiopathic Granulomatous Mastitis 特发性肉芽肿性乳腺炎
IF 2.1 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-01-25 DOI: 10.1155/2024/6693720
Christina Dilaveri, Amy Degnim, Christine Lee, Daniel DeSimone, Dan Moldoveanu, Karthik Ghosh

Idiopathic granulomatous mastitis (IGM) is a rare, benign inflammatory disorder of the breast that is often underrecognized. The exact etiology and pathophysiology are unknown, but milk stasis is felt to play a role. Classically, this condition is noninfectious, but many cases are noted to be associated with Corynebacterium species. Most patients affected are parous women with a mean age of 35, and many have breastfed within five years of diagnosis. Patients typically present with a painful mass and symptoms of inflammation, and these features can sometimes mimic breast cancer. Biopsy is needed to make a definitive diagnosis, and noncaseating granulomas are found on core biopsy. Many patients have a waxing and waning course over a period of six months to two years. Goal of treatment is to avoid surgery given poor wound healing, high risk of recurrence, and poor cosmetic outcomes. Medical treatment is preferred and includes observation, antibiotics, steroids, and immune modulators such as methotrexate. In more recent years, topical and intralesional steroids have become the treatment of choice, with similar outcomes to oral steroids.

特发性肉芽肿性乳腺炎(IGM)是一种罕见的乳腺良性炎症性疾病,通常未被充分认识。确切的病因和病理生理学尚不清楚,但乳汁淤积被认为是其中的一个原因。一般来说,这种疾病是非感染性的,但很多病例都与棒状杆菌有关。大多数患者是平均年龄为 35 岁的准妈妈,许多患者在确诊后五年内哺乳过。患者通常表现为肿块疼痛和炎症症状,这些特征有时会与乳腺癌相似。需要进行活检才能明确诊断,核心活检可发现非溃疡性肉芽肿。许多患者的病程会在 6 个月到 2 年间时长时短。由于伤口愈合差、复发风险高、美容效果差,治疗目标是避免手术。药物治疗是首选,包括观察、抗生素、类固醇和免疫调节剂(如甲氨蝶呤)。近年来,局部和鞘内类固醇激素已成为首选治疗方法,其疗效与口服类固醇激素相似。
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引用次数: 0
A Single-Center 18-Year Series of 73 Cases of Metaplastic Carcinoma of the Breast 单中心 18 年 73 例乳腺间变性癌系列研究
IF 2.1 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-01-04 DOI: 10.1155/2024/5920505
Kassandra Thériault, Mariem Ben Moussa, Marjorie Perron, Christine Desbiens, Brigitte Poirier, Éric Poirier, Dominique Leblanc, Claudya Morin, Julie Lemieux, Jean-Charles Hogue, Dominique Boudreau

Aim. To examine the clinical management of metaplastic breast cancer (MeBC), particularly the role of chemotherapy. Methods. This retrospective study included patients with MeBC (n = 73) from a tertiary breast cancer center: the “Centre des Maladies du Sein of the CHU de Québec–Université Laval.” The specimens were reviewed by two pathologists. Patient and tumor characteristics, systemic therapy (neoadjuvant and adjuvant), disease-free survival (DFS), and overall survival (OS) were recorded. Results. The median follow-up was 57.2 months. The mean tumor size was 39.5 ± 32.1 (range, 1–200) mm. Most were in grade 3 (75.3%), without evidence of clinical nodal involvement (75.3%), and triple-negative (79.5%). Chemotherapy was given to 49 (67.1%) patients. Thirty-seven patients (50.7%) underwent a mastectomy, and 22/37 (59.5%) received radiotherapy. Adjuvant chemotherapy was given to 36 patients (49.3%), and nine (12.3%) patients were treated with neoadjuvant chemotherapy. The 5-year OS and DFS rates were 60.2% and 66.8%. Among the nine patients who received neoadjuvant chemotherapy, three (33.3%) achieved a partial response, three (33.3%) had stable disease, and three (33.3%) had disease progression. The use of chemotherapy, especially in the adjuvant setting, had a significant positive effect on 5-year OS (P = 0.003) and 5-year DFS (P = 0.004). Nodal involvement was associated with worse OS (P = 0.049) but similar DFS (P = 0.157). Lumpectomy was associated with better 5-year OS (P < 0.0001) and DFS (P = 0.0002) compared with mastectomy. Conclusion. MeBC represents a rare heterogeneous group of malignancies with poor prognosis. Adjuvant chemotherapy was associated with improved OS and DFS. Patients should be carefully selected for neoadjuvant chemotherapy.

目的研究变性乳腺癌(MeBC)的临床治疗,尤其是化疗的作用。研究方法这项回顾性研究包括来自一家三级乳腺癌中心--"魁北克大学拉瓦尔分校恶性肿瘤中心 "的 MeBC 患者(n = 73)。标本由两名病理学家审查。记录了患者和肿瘤特征、系统治疗(新辅助治疗和辅助治疗)、无病生存期(DFS)和总生存期(OS)。结果显示中位随访时间为 57.2 个月。肿瘤平均大小为 39.5 ± 32.1(1-200)毫米。大多数肿瘤为3级(75.3%),无临床结节受累证据(75.3%),三阴性(79.5%)。49名患者(67.1%)接受了化疗。37名患者(50.7%)接受了乳房切除术,22/37(59.5%)接受了放射治疗。36名患者(49.3%)接受了辅助化疗,9名患者(12.3%)接受了新辅助化疗。5年的OS和DFS率分别为60.2%和66.8%。在接受新辅助化疗的9名患者中,3人(33.3%)获得部分应答,3人(33.3%)病情稳定,3人(33.3%)病情进展。化疗的使用,尤其是辅助化疗,对5年生存期()和5年生存率()有显著的积极影响。结节受累与较差的 OS()相关,但与相似的 DFS()相关。与乳房切除术相比,肿块切除术与较好的 5 年 OS()和 DFS()相关。结论。MeBC是一种罕见的异质性恶性肿瘤,预后较差。辅助化疗可改善OS和DFS。应谨慎选择患者进行新辅助化疗。
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引用次数: 0
Multi-MicroRNA Analysis Can Improve the Diagnostic Performance of Mammography in Determining Breast Cancer Risk 多重微量核糖核酸分析可提高乳腺 X 射线摄影在确定乳腺癌风险方面的诊断性能
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-27 DOI: 10.1155/2023/9117047
Ji-Eun Song, Ji Young Jang, Kyung Nam Kang, Ji Soo Jung, Chul Woo Kim, Ah Sol Kim

The objective of this study was to determine whether multi-microRNA analysis using a combination of four microRNA biomarkers (miR-1246, 202, 21, and 219B) could improve the diagnostic performance of mammography in determining breast cancer risk by age group (under 50 vs. over 50) and distinguish breast cancer from benign breast diseases and other cancers (thyroid, colon, stomach, lung, liver, and cervix cancers). To verify breast cancer classification performance of the four miRNA biomarkers and whether the model providing breast cancer risk score could distinguish between benign breast disease and other cancers, the model was verified using nonlinear support vector machine (SVM) and generalized linear model (GLM) and age and four miRNA qRT-PCR analysis values (dCt) were input to these models. Breast cancer risk scores for each Breast Imaging-Reporting and Data System (BI-RADS) category in multi-microRNA analysis were analyzed to examine the correlation between breast cancer risk scores and mammography categories. We generated two models using two classification algorithms, SVM and GLM, with a combination of four miRNA biomarkers showing high performance and sensitivities of 84.5% and 82.1%, a specificity of 85%, and areas under the curve (AUCs) of 0.967 and 0.965, respectively, which showed consistent performance across all stages of breast cancer and patient ages. The results of this study showed that this multi-microRNA analysis using the four miRNA biomarkers was effective in classifying breast cancer in patients under the age of 50, which is challenging to accurately diagnose. In addition, breast cancer and benign breast diseases can be classified, showing the possibility of helping with diagnosis by mammography. Verification of the performance of the four miRNA biomarkers confirmed that multi-microRNA analysis could be used as a new breast cancer screening aid to improve the accuracy of mammography. However, many factors must be considered for clinical use. Further validation with an appropriate screening population in large clinical trials is required. This trial is registered with (KNUCH 2022-04-036).

这项研究的目的是确定利用四种microRNA生物标记物(miR-1246、202、21和219B)组合进行的多microRNA分析是否能提高乳腺X光造影术在按年龄组(50岁以下与50岁以上)确定乳腺癌风险方面的诊断性能,并区分乳腺癌与良性乳腺疾病和其他癌症(甲状腺癌、结肠癌、胃癌、肺癌、肝癌和宫颈癌)。为了验证四种 miRNA 生物标记物的乳腺癌分类性能,以及提供乳腺癌风险评分的模型能否区分良性乳腺疾病和其他癌症,我们使用非线性支持向量机(SVM)和广义线性模型(GLM)对模型进行了验证,并向这些模型输入了年龄和四种 miRNA qRT-PCR 分析值(dCt)。我们分析了多miRNA分析中每个乳腺影像报告和数据系统(BI-RADS)类别的乳腺癌风险评分,以研究乳腺癌风险评分与乳腺X光检查类别之间的相关性。我们使用 SVM 和 GLM 两种分类算法生成了两个模型,四个 miRNA 生物标记物的组合表现出很高的性能,灵敏度分别为 84.5% 和 82.1%,特异性为 85%,曲线下面积(AUC)分别为 0.967 和 0.965,在乳腺癌的各个阶段和患者年龄段都表现出一致的性能。研究结果表明,这种利用四种 miRNA 生物标记物进行的多 miRNA 分析能有效地对 50 岁以下的乳腺癌患者进行分类,而准确诊断 50 岁以下的乳腺癌具有一定的难度。此外,乳腺癌和良性乳腺疾病也能被分类,这显示了通过乳房 X 射线照相术帮助诊断的可能性。对四种 miRNA 生物标记物性能的验证证实,多重 miRNA 分析可作为一种新的乳腺癌筛查辅助手段,以提高乳房 X 线照相术的准确性。然而,临床应用必须考虑许多因素。需要在大型临床试验中对适当的筛查人群进行进一步验证。该试验已在(KNUCH 2022-04-036)注册。
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引用次数: 0
Evaluation of a Surgical Navigation System for Localization and Excision of Nonpalpable Lesions in Breast and Axillary Surgery 评估手术导航系统在乳房和腋窝手术中对无法触及的病灶进行定位和切除的效果
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-23 DOI: 10.1155/2023/9993852
Kjirsten A. Carlson, Cristina Checka, Kelly K. Hunt, Jennifer Jung, Christian Bridges, Puneet Singh, Ana Refinetti, Tanya Moseley, Frances Perez, Cody Mayo, Nina Tamirisa

Introduction. Elucent Medical has introduced a novel EnVisio™ Surgical Navigation system which uses SmartClips™ that generate a unique electromagnetic signal triangulated in 3 dimensions for real-time navigation. The purpose of this study was to evaluate the efficacy and feasibility of the EnVisio Surgical Navigation system in localizing and excising nonpalpable lesions in breast and axillary surgery. Methods. This pilot study prospectively examined patients undergoing breast and nodal localization using the EnVisio Surgical Navigation system. SmartClips were placed by designated radiologists using ultrasound (US) or mammographic (MMG) guidance. The technical evaluation focused on successful deployment and subsequent excision of all localized lesions including SmartClips and biopsy clips. Results. Eleven patients underwent localization using 27 SmartClips which included bracketed multifocal disease (n = 4) and clipped lymph node (n = 1). The bracketed cases were each localized with 2 SmartClips. Mammography and ultrasound were used (n = 8 and n = 19, respectively) to place the SmartClips. All 27 devices were successfully deployed within 5 mm of the targeted lesion or biopsy clip. All SmartClip devices were identified and retrieved intraoperatively. No patients required a second operation for margin excision. Conclusion. In a limited sample, the EnVisio Surgical Navigation system was a reliable technology for the localization of breast and axillary lesions planned for surgical excision. Further comparative studies are required to evaluate its efficacy in relation to the other existing localization modalities.

简介。Elucent Medical 公司推出了新颖的 EnVisio™ 手术导航系统,该系统使用 SmartClips™,可产生独特的电磁信号,在三维空间进行三角测量,从而实现实时导航。本研究旨在评估 EnVisio 手术导航系统在乳腺和腋窝手术中定位和切除非肉眼可见病灶的有效性和可行性。方法。这项试验性研究对使用EnVisio手术导航系统进行乳腺和结节定位的患者进行了前瞻性检查。智能夹由指定的放射科医生使用超声(US)或乳腺X线摄影(MMG)引导放置。技术评估的重点是所有定位病灶(包括 SmartClips 和活检夹)的成功部署和后续切除。结果。11 名患者使用 27 个 SmartClips 进行了定位,其中包括括号内的多灶性疾病(4 例)和剪切的淋巴结(1 例)。括号内的病例各使用 2 个 SmartClips 进行定位。使用乳房 X 线照相术和超声检查(分别为 8 例和 19 例)来放置 SmartClips。所有 27 个装置都成功部署在目标病灶或活检夹 5 毫米范围内。所有 SmartClip 装置都在术中被识别并取回。没有患者需要二次手术进行边缘切除。结论。在有限的样本中,EnVisio手术导航系统是对计划进行手术切除的乳腺和腋窝病灶进行定位的可靠技术。需要进一步进行比较研究,以评估其与其他现有定位方式的功效。
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引用次数: 0
MLLT11 siRNA Inhibits the Migration and Promotes the Apoptosis of MDA-MB-231 Breast Cancer Cells MLLT11 siRNA抑制MDA-MB-231乳腺癌细胞迁移并促进细胞凋亡
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-12-01 DOI: 10.1155/2023/6282654
Xiangrong Liu, Wenqi Bai, Jianrong Li, Jinfeng Ma, Yan Liu, Zhixiang Wang, Linjie Hu, Zheng Li, Dimitri Papukashvili, Nino Rcheulishvili, Fusheng Wang, Xiaoqing Lu

Breast cancer is considered the most prevalent malignancy due to its high incidence rate, recurrence, and metastasis in women that makes it one of the deadliest cancers. The current study aimed to predict the genes associated with the recurrence and metastasis of breast cancer and to validate their effect on MDA-MB-231 cells. Through the bioinformatics analysis, the transcription factor 7 cofactor (MLLT11) as the target gene was obtained. MLLT11-specific siRNA was synthesized and transfected into MDA-MB-231 cells. The results demonstrated that the siRNA significantly reduced the MLLT11 mRNA levels. Moreover, cell migration and invasion, as well as the protein levels of phosphatidylinositol 3-kinase (PI3K), AKT, matrix metalloproteinase (MMP) 2, and MMP9, were significantly lower in the groups treated with siRNA while the apoptosis was augmented. Collectively, MLLT11 siRNA elicited ameliorative properties on breast cancer cells, possibly via the inhibition of the PI3K/AKT signaling pathway.

乳腺癌被认为是最普遍的恶性肿瘤,因为它在女性中发病率高,复发和转移,使其成为最致命的癌症之一。目前的研究旨在预测与乳腺癌复发和转移相关的基因,并验证它们对MDA-MB-231细胞的影响。通过生物信息学分析,获得转录因子7辅因子(MLLT11)作为靶基因。合成mllt11特异性siRNA并转染到MDA-MB-231细胞中。结果表明,siRNA显著降低了MLLT11 mRNA水平。此外,siRNA处理组细胞迁移和侵袭,以及磷脂酰肌醇3-激酶(PI3K)、AKT、基质金属蛋白酶(MMP) 2和MMP9蛋白水平显著降低,细胞凋亡增加。总的来说,MLLT11 siRNA可能通过抑制PI3K/AKT信号通路,引发乳腺癌细胞的改善特性。
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引用次数: 0
The Clinicopathological Features and Prognostic Significance of HER2-Low in Early Breast Tumors Patients Prognostic Comparison of HER-Low and HER2-Negative Breast Cancer Stratified by Hormone Receptor Status 早期乳腺肿瘤患者her2 -低水平的临床病理特征及预后意义her2 -低水平与her2 -阴性乳腺癌激素受体分层预后比较
IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2023-11-30 DOI: 10.1155/2023/6621409
Sanaa Gamrani, Laila Akhouayri, Sara Boukansa, Mehdi Karkouri, Hinde El Fatemi

Introduction. There has been increased interest in HER2-low breast tumors recently, as these tumors may have distinct clinical and molecular characteristics compared to HER2-negative and HER2-positive tumors. A new nomenclature has been proposed for HER2 1+ and HER2 2+ tumors that are confirmed negative according to fluorescence in situ hybridization (FISH). These tumors are now referred to as HER2-low, and it is thought that they may represent a distinct subtype of breast cancer that warrants further investigation. In this study, we aimed to evaluate the clinicopathological characteristics and prognostic impact of this particular subtype in a North-African context where HER2-low breast cancer is a relatively understudied subtype, particularly in non-Western populations. Methods. We conducted a retrospective cohort study on 1955 breast tumors in Moroccan patients over 10 years, collected at the Pathology Department of Ibn Rochd University Hospital in Casablanca and at the pathology department of Hassan II University Hospital in Fes. We elaborated on their complete immunohistochemical profile based on the main breast cancer biomarkers: Ki-67, HER2, estrogen, and progesterone receptors. Their overall survival and disease free survival data were also retrieved from their respective records. Results. Out of 1955 BC patients, 49.3% were classified as HER2-low; of which 80.7% and 19.2% were hormone receptors positive and negative, respectively. The clinicopathologic features indicate that HER2-low subtype tumors behave much more like HER2-positive than HER2-negative tumors. The survival analysis showed that the HER2-low subtype-belonging patients present significantly the poorest prognosis in disease-free survival (p = 0.003) in comparison with HER2-negative ones. When considering the hormonal status, hormonal-dependent tumors show a significant difference according to HER2 subtypes in disease-free survival (p < 0.001). Yet no significant difference was shown among hormonal negative tumors. Moreover, patients with hormonal positive tumors and simultaneously belonging to the HER2-low subgroup present a significantly good prognosis in overall survival compared to the ones with hormonal negative tumors (p = 0.008). Conclusion. Our study has shown that the HER2-low phenotype is common among hormone-positive patients. The clinicopathological features and prognostic data indicate that the hormonal receptors effect and HER2 heterogeneity are crucial factors to consider. It is important to note that this particular subgroup is different from the HER2-negative one and should not be treated in the same way. Therefore, this study offers a new perspective in the management of HER2-low patients and can serve as a basis for future prospective analyses.

介绍。由于与her2阴性和her2阳性肿瘤相比,这些肿瘤可能具有不同的临床和分子特征,最近人们对her2低乳腺癌的兴趣越来越大。根据荧光原位杂交(FISH)证实为阴性的HER2 +和HER2 +肿瘤提出了一个新的命名法。这些肿瘤现在被称为her2低,人们认为它们可能代表了一种独特的乳腺癌亚型,值得进一步研究。在这项研究中,我们的目的是在北非地区评估这种特殊亚型的临床病理特征和预后影响,在北非地区,her2低乳腺癌是一种研究相对不足的亚型,特别是在非西方人群中。方法。我们在卡萨布兰卡伊本罗得德大学医院病理部门和费斯哈桑二世大学医院病理部门收集了摩洛哥患者10年来的1955例乳腺肿瘤进行了回顾性队列研究。基于主要的乳腺癌生物标志物:Ki-67, HER2,雌激素和孕激素受体,我们详细阐述了他们完整的免疫组织化学谱。他们的总生存期和无病生存期数据也从各自的记录中检索。结果。在1955例BC患者中,49.3%归为her2低;激素受体阳性和阴性分别占80.7%和19.2%。临床病理特征表明her2低亚型肿瘤比her2阴性肿瘤表现得更像her2阳性肿瘤。生存分析显示,与her2阴性患者相比,her2低亚型患者的无病生存预后明显较差()。在考虑激素状态时,激素依赖性肿瘤根据HER2亚型在无病生存中表现出显著差异()。然而在激素阴性肿瘤中没有明显差异。此外,与激素阴性肿瘤相比,激素阳性肿瘤同时属于her2低亚组的患者的总生存预后明显较好()。结论。我们的研究表明her2低表型在激素阳性患者中很常见。临床病理特征和预后数据表明,激素受体的作用和HER2异质性是考虑的关键因素。值得注意的是,这个特殊的亚组不同于her2阴性的亚组,不应该用同样的方法治疗。因此,本研究为HER2-low患者的管理提供了一个新的视角,可以作为未来前瞻性分析的基础。
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Breast Journal
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