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Assessment of Stromal Elastin Fibers in Breast Cancer and Fibroadenomas: Is There a Correlation With Ultrasound Elastography Findings? 乳腺癌和纤维腺瘤间质弹性蛋白纤维的评估:是否与超声弹性成像结果相关?
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2022.2021-8-3
N. Toprak, İ. Aras, O. Toktaş, Adem Yokuş, Ali Mahir Gündüz
ObjectiveThe stiffness of a breast lesion provides information on the likelihood of malignancy. The most important factor affecting this stiffness is the composition of the extracellular matrix (ECM). The aim of this study was to assess the elastin fiber contents of malignant breast lesions and fibroadenomas and investigate any relationship between the shear wave velocity (SWV) measured by ultrasonography, and the elastin fiber content of lesions.Materials and MethodsConsecutive patients with breast lesions were enrolled. The SWV values of the lesions were analyzed. Histopathological analysis of elastin in excised lesions was performed by the method of Shivas and Douglas. Breast cancer patients were reviewed according to their lymph node status and tumor diameter. The relationship between SWV value and tissue elastin fiber score was analyzed. The correlation between breast cancer grade and elastin fiber score in malignant lesions was investigated.ResultsA total of 167 consecutive breast lesions in 167 patients were included in this study (75 invasive cancer, 92 fibroadenomas). High elastic fiber score was significantly more common (p = 0.001) in malignant lesions (n = 61; 81.3%) than fibroadenomas (n = 13; 14.1%). There was a negative correlation between the mean SWV and the elastin fiber score of fibroadenomas (p = 0.001). A low grade in breast cancer was associated with high elastin fiber score (p = 0.01).ConclusionMalignant lesions tend to have higher elastin fiber scores than fibroadenomas. Elastin fiber assessment may provide additional prognostic information in malignant lesions. Changes in elastin fiber content may account for the variation in elasticity in fibroadenomas.
目的乳腺病变的硬度提供了恶性肿瘤可能性的信息。影响这种硬度的最重要因素是细胞外基质(ECM)的组成。本研究的目的是评估乳腺恶性病变和纤维腺瘤的弹性蛋白纤维含量,并研究超声测量的剪切波速(SWV)与病变的弹性蛋白光纤含量之间的任何关系。材料和方法选择连续的乳腺病变患者。分析病变的SWV值。采用Shivas和Douglas方法对切除病灶中的弹性蛋白进行组织病理学分析。根据癌症患者的淋巴结状况和肿瘤直径对其进行回顾。分析SWV值与组织弹性蛋白纤维评分的关系。探讨了乳腺癌癌症分级与恶性病变中弹性蛋白纤维评分的相关性。结果本研究共纳入167例患者的167个连续乳腺病变(75个侵袭性癌症,92个纤维腺瘤)。高弹性纤维评分在恶性病变(n=61;81.3%)中明显高于纤维腺瘤(n=13;14.1%)。纤维腺瘤的平均SWV与弹性纤维评分呈负相关(p=0.001)。癌症分级低与高弹性纤维分相关(p=0.01)评分高于纤维腺瘤。弹性蛋白纤维评估可以为恶性病变提供额外的预后信息。弹性蛋白纤维含量的变化可能是纤维腺瘤弹性变化的原因。
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引用次数: 0
The Comparative Frequency of Breast Cancer-Related Lymphedema Determined by Bioimpedance Spectroscopy and Circumferential Measurements. 通过生物阻抗谱和周向测量测定乳腺癌相关淋巴水肿的比较频率。
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2022.2021-9-2
P. Borman, A. Yaman, L. Doğan, Ayşe Arıkan Dönmez, E. Koyuncu, Ayşegül Balcan, S. Aksoy, C. Özaslan, Rabiye Akın, Kaniye Üneş
ObjectiveThe survival of patients with breast cancer has prolonged due to early diagnosis and modern methods of treatment and lymphedema has become the most important morbidity secondary to the treatment of the disease. Early detection and timely intervention have potential to reduce advanced breast cancer-related lymphedema. The aims of this study were to comparatively determine the frequency of subclinical/clinical lymphedema by using prospective monitoring with bioimpedance spectroscopy (BIS) and circumferential measurements in a group of patients who underwent breast cancer surgery.Materials and MethodsPatients having breast cancer surgery were recruited between October 2018 and December 2019. Demographical and surgical properties were recorded. Extremity volumes by circumferential and BIS measurements were performed after surgery (baseline) and monitorizations were carried out at third and sixth months, in order to determine the frequency of subclinical/clinical lymphedema. L-Dex value of >6.5 was recently taken attention as subclinical lymphedema and values >7 were considered as clinical lymphedema. The presence of subclinical and clinic lymphedema was assessed by inter-limb volume difference (>5% and >10 respectively) based on the serial circumferential measurements in both affected and non-affected extremities. The functional status and quality of Life (QoL) were determined by quick-DASH and LYMQOL-Arm questionnaires respectively. The relationship between volume measurements, functional status and QoL scores were determined.ResultsEighty-two female patients with a mean age of 49.6 years were included to the study. 30 (36.5%) and 21 (25.6%) of patients were determined as having subclinical/clinical lymphedema by BIS, while 18 (21.9%) and 19 (23.1%) of patients had subclinical/clinical lymphedema by circumferentialmeasurements at third-and-sixth months respectively. The functional and QoL scores were not correlated with circumferential volume measurements and BIS scores. There was a moderate-high correlation with BIS and circumferential measurements.ConclusionIn conclusion 36.5% and 25.6% of our study group had subclinical and clinical lymphedema by BIS respectively during the 6 months surveillance period. Periodic monitoring of women with BIS allows early detection for lymphedema in more patients than in circumferential volume measurements, which may have implications for timely and necessary management.
目的早期诊断和现代治疗方法使癌症患者的生存期延长,淋巴水肿已成为仅次于治疗的最重要的并发症。早期发现和及时干预有可能减少晚期乳腺癌相关的淋巴水肿。本研究的目的是通过使用生物阻抗谱(BIS)和周向测量的前瞻性监测,在一组接受癌症手术的患者中,比较确定亚临床/临床淋巴水肿的频率。材料和方法招募2018年10月至2019年12月期间接受癌症手术的患者。记录了人口统计学和外科特性。术后(基线)通过周向和BIS测量四肢体积,并在第三个月和第六个月进行监测,以确定亚临床/临床淋巴水肿的频率。L-Dex值>6.5最近被认为是亚临床淋巴水肿,值>7被认为是临床淋巴水肿。亚临床和临床淋巴水肿的存在是根据受影响和未受影响四肢的一系列圆周测量,通过肢体间体积差异(分别>5%和>10)来评估的。功能状态和生活质量(QoL)分别通过快速DASH和LYMQOL臂问卷进行测定。确定容积测量、功能状态和生活质量评分之间的关系。结果82例女性患者,平均年龄49.6岁。BIS确定30例(36.5%)和21例(25.6%)患者具有亚临床/临床淋巴水肿,而在第三个月和第六个月时分别有18例(21.9%)和19例(23.1%)患者具有临床/亚临床淋巴水肿。功能和生活质量评分与周向容积测量和BIS评分无关。BIS和周向测量值之间存在中度-高度相关性。结论在6个月的BIS监测期内,本研究组分别有36.5%和25.6%的患者出现亚临床和临床淋巴水肿。对患有BIS的女性进行定期监测,可以比周向体积测量更早地发现更多患者的淋巴水肿,这可能对及时和必要的管理有意义。
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引用次数: 0
Prognostic Value of Receptor Change After Neoadjuvant Chemotherapy in Breast Cancer Patients. 癌症患者新辅助化疗后受体变化的预后价值。
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2022.2022-1-4
Özlem Özdemir, B. Zengel, Demet Kocatepe Çavdar, C. Yılmaz, R. Durusoy
ObjectiveThe aim of this study was to investigate the relationship between hormone receptors (HR) and human epidermal growth factor receptor 2 (HER-2) discordance with prognosis, before and after neoadjuvant chemotherapy (NAC) in breast cancer patients.Materials and MethodsHistopathological data of 142 breast cancer patients attending a single center between 2001 and 2018 and were operated after NAC were evaluated retrospectively.ResultsThe median (range) age of patients was 58 (32-69) years. In patients who underwent Tru-cut biopsy before NAC, 77 patients were ER+, 30 were ER (-), 73 were PR (+), 33 were PR-, 14 were HER-2 (+), and 94 patients were HER-2 (-). In terms of ER change, five patients were found to have changed status and 85 had no receptor change. The mean overall survival of patients with receptor changes was 31 months against 60 months in patients with no receptor changes, which was not significant (p = 0.351). In sub-group analysis of patients undergoing receptor change, the ER (+) → (-) group had significantly shorter survival (p = 0.003). For PR change, mean survival was 38 months in seven patients with a receptor change and 59 months in 87 patients without a receptor change, which was not significant (p = 0.603). Sub-group analysis of PR status change showed that survival was significantly shorter in the PR (+) → (-) group (p = 0.012).ConclusionThese results suggest there is a need for reassessment of HR and HER-2 status in surgical samples from patients following NAC, and that NAC-induced changes in the HR state may be used as a prognostic factor.
目的探讨癌症患者新辅助化疗(NAC)前后激素受体(HR)和人表皮生长因子受体2(HER-2)与预后的关系。材料与方法回顾性评估2001年至2018年在一个中心就诊的142例癌症患者NAC术后的组织病理学数据。结果患者的中位(范围)年龄为58岁(32-69岁)。在NAC前接受Tru切割活检的患者中,77例为ER+,30例为ER(-),73例为PR(+),33例为PR-,14例为HER-2(+)和94例为HER2(-)。在ER变化方面,发现5名患者的状态发生了变化,85名患者的受体没有变化。受体发生变化的患者的平均总生存期为31个月,而受体无变化的患者为60个月,这并不显著(p=0.351)。在受体发生变化患者的亚组分析中,ER(+)→ (-)组的生存期明显较短(p=0.003)。对于PR变化,7名受体发生变化的患者的平均生存期为38个月,87名受体未发生变化的病例的平均生存率为59个月,这并不显著(p=0.063)。PR状态变化的亚组分析显示,PR(+)组的存活期明显较低→ (-)组(p=0.012)。结论这些结果表明,有必要重新评估NAC患者手术样本中的HR和HER-2状态,NAC诱导的HR状态变化可能被用作预后因素。
{"title":"Prognostic Value of Receptor Change After Neoadjuvant Chemotherapy in Breast Cancer Patients.","authors":"Özlem Özdemir, B. Zengel, Demet Kocatepe Çavdar, C. Yılmaz, R. Durusoy","doi":"10.4274/ejbh.galenos.2022.2022-1-4","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2022.2022-1-4","url":null,"abstract":"Objective\u0000The aim of this study was to investigate the relationship between hormone receptors (HR) and human epidermal growth factor receptor 2 (HER-2) discordance with prognosis, before and after neoadjuvant chemotherapy (NAC) in breast cancer patients.\u0000\u0000\u0000Materials and Methods\u0000Histopathological data of 142 breast cancer patients attending a single center between 2001 and 2018 and were operated after NAC were evaluated retrospectively.\u0000\u0000\u0000Results\u0000The median (range) age of patients was 58 (32-69) years. In patients who underwent Tru-cut biopsy before NAC, 77 patients were ER+, 30 were ER (-), 73 were PR (+), 33 were PR-, 14 were HER-2 (+), and 94 patients were HER-2 (-). In terms of ER change, five patients were found to have changed status and 85 had no receptor change. The mean overall survival of patients with receptor changes was 31 months against 60 months in patients with no receptor changes, which was not significant (p = 0.351). In sub-group analysis of patients undergoing receptor change, the ER (+) → (-) group had significantly shorter survival (p = 0.003). For PR change, mean survival was 38 months in seven patients with a receptor change and 59 months in 87 patients without a receptor change, which was not significant (p = 0.603). Sub-group analysis of PR status change showed that survival was significantly shorter in the PR (+) → (-) group (p = 0.012).\u0000\u0000\u0000Conclusion\u0000These results suggest there is a need for reassessment of HR and HER-2 status in surgical samples from patients following NAC, and that NAC-induced changes in the HR state may be used as a prognostic factor.","PeriodicalId":91975,"journal":{"name":"The journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46503857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Overexpression of miR-490-5p/miR-490-3p Potentially Induces IL-17-Producing T Cells in Patients With Breast Cancer. 过表达miR-490-5p/miR-490-3p可能诱导乳腺癌患者产生il -17的T细胞
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2022.2021-10-4
F. Seif, H. Vaseghi, M. Ariana, S. M. Ganji, Mohammad Nazari, Kowsar Kiani Rad, M. Pornour
ObjectiveBreast cancer (BC) is the most prevalent female cancer globally and this is also true in Iranian women. Alteration in circulating microRNAs affects the fate of immune cells, affecting immunological response to neoplasia.Materials and MethodsWe investigated the expression of miR-490-5p and miR-490-3p in peripheral blood mononuclear cells (PBMCs) and plasma of patients with BC. Moreover, the correlation of these microRNAs with the expression levels of CD3d, interleukin 2 (IL-2), IL-2 receptor chain alpha (IL-2RA), forkhead box O1 (FOXO1) and nuclear factor of activated T cells 5 (NFAT5) were investigated.ResultsTwo groups, including 42 patients with BC, aged 22-75 years with stage I, II, III disease without administration of immunosuppressive chemotherapy regimens/radiotherapy and 40 healthy controls aged 27-70 years, participated. Overexpression and higher circulation levels of miR-490-5p and miR-490-3p were found in the patients with consequent down-regulation of all targets investigated in PBMCs. Furthermore, there was a significant negative correlation between the overexpression of these microRNAs and a reduction in levels of CD3d, IL-2, and IL-2RA in patients with BC.ConclusionThese results suggest that down-regulation of the target genes by miR-490 may predispose and facilitate the production of Th17 lymphocytes and IL-17-producing Tregs. The variation in miR-490-5p/-3p and the investigated targets in the PBMCs of BC patients may be used as non-invasive diagnostic markers.
目的乳腺癌(BC)是全球最常见的女性癌症,在伊朗女性中也是如此。循环microrna的改变影响免疫细胞的命运,影响对肿瘤的免疫反应。材料与方法我们研究了miR-490-5p和miR-490-3p在BC患者外周血单核细胞(PBMCs)和血浆中的表达。此外,我们还研究了这些microrna与CD3d、白细胞介素2 (IL-2)、IL-2受体链α (IL-2RA)、forkhead box O1 (FOXO1)和活化T细胞核因子5 (NFAT5)表达水平的相关性。结果两组共42例BC患者,年龄22 ~ 75岁,均为未行免疫抑制化疗/放疗的I、II、III期患者;对照组40例,年龄27 ~ 70岁。在患者中发现miR-490-5p和miR-490-3p的过表达和更高的循环水平,从而导致pbmc中所研究的所有靶标下调。此外,在BC患者中,这些microrna的过表达与CD3d、IL-2和IL-2RA水平的降低之间存在显著的负相关。结论miR-490下调靶基因可诱发和促进Th17淋巴细胞和产生il -17的Tregs的产生。BC患者PBMCs中miR-490-5p/-3p的变化和所研究的靶标可作为非侵入性诊断标志物。
{"title":"Overexpression of miR-490-5p/miR-490-3p Potentially Induces IL-17-Producing T Cells in Patients With Breast Cancer.","authors":"F. Seif, H. Vaseghi, M. Ariana, S. M. Ganji, Mohammad Nazari, Kowsar Kiani Rad, M. Pornour","doi":"10.4274/ejbh.galenos.2022.2021-10-4","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2022.2021-10-4","url":null,"abstract":"Objective\u0000Breast cancer (BC) is the most prevalent female cancer globally and this is also true in Iranian women. Alteration in circulating microRNAs affects the fate of immune cells, affecting immunological response to neoplasia.\u0000\u0000\u0000Materials and Methods\u0000We investigated the expression of miR-490-5p and miR-490-3p in peripheral blood mononuclear cells (PBMCs) and plasma of patients with BC. Moreover, the correlation of these microRNAs with the expression levels of CD3d, interleukin 2 (IL-2), IL-2 receptor chain alpha (IL-2RA), forkhead box O1 (FOXO1) and nuclear factor of activated T cells 5 (NFAT5) were investigated.\u0000\u0000\u0000Results\u0000Two groups, including 42 patients with BC, aged 22-75 years with stage I, II, III disease without administration of immunosuppressive chemotherapy regimens/radiotherapy and 40 healthy controls aged 27-70 years, participated. Overexpression and higher circulation levels of miR-490-5p and miR-490-3p were found in the patients with consequent down-regulation of all targets investigated in PBMCs. Furthermore, there was a significant negative correlation between the overexpression of these microRNAs and a reduction in levels of CD3d, IL-2, and IL-2RA in patients with BC.\u0000\u0000\u0000Conclusion\u0000These results suggest that down-regulation of the target genes by miR-490 may predispose and facilitate the production of Th17 lymphocytes and IL-17-producing Tregs. The variation in miR-490-5p/-3p and the investigated targets in the PBMCs of BC patients may be used as non-invasive diagnostic markers.","PeriodicalId":91975,"journal":{"name":"The journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43294981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
A Rare Case of Granulomatous Mastitis in the Accessory Axillary Breast of a Pregnant Woman Successfully Treated by Surgery. 一例罕见的孕妇副腋窝乳房肉芽肿性乳腺炎成功手术治疗。
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2021.2021-10-5
Jun Nakamura, Futoshi Tanaka, K. Ohtaka, Ken Sato, A. Iyama
Granulomatous mastitis (GM) is a chronic inflammatory disease of the breast that usually occurs in women of reproductive age. However, GM during pregnancy is unusual and only one case of GM in the accessory breast has been reported so far. Here, we report an extremely rare case of GM in the accessory axillary breast of a pregnant woman. A 24-year-old pregnant woman had persistent pain and swelling in the right axilla that did not improve with antibiotic administration. Despite incision and drainage for subcutaneous abscess, the incised skin gradually became ulcerated, exposing the subcutaneous granulomatous tissue. Corynebacterium species were isolated in the bacterial culture of drained pus. Lower back pain, pain in several joints, and erythema nodosum on the lower legs appeared later. Based on the result of bacterial culture and the above disease course, the patient was clinically suspected of having GM. The axillary mass was surgically removed after childbirth, and the excised mass was histopathologically confirmed as GM. Treatment for GM should be considered individually and carefully in accordance with the patients' condition. Unnecessary surgery should be avoided. However, early addition of surgical interventions may yield good outcomes, especially for pregnant women because of limited treatment options.
肉芽肿性乳腺炎(GM)是一种常见于育龄妇女的乳腺慢性炎性疾病。然而,妊娠期发生GM并不常见,目前仅报道一例副乳发生GM。在这里,我们报告一个极其罕见的GM病例在副腋窝乳房的孕妇。一名24岁的孕妇右腋窝持续疼痛和肿胀,抗生素治疗没有改善。尽管对皮下脓肿进行了切开引流,但切开的皮肤逐渐溃烂,暴露出皮下肉芽肿组织。从排脓的细菌培养中分离出棒状杆菌。后出现腰痛,多处关节疼痛,下肢结节性红斑。根据细菌培养结果和上述病程,临床怀疑患者患有GM。分娩后手术切除腋窝肿块,组织病理学证实为GM。GM的治疗应根据患者的情况单独考虑。应避免不必要的手术。然而,早期增加手术干预可能会产生良好的结果,特别是对孕妇,因为有限的治疗选择。
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引用次数: 3
The Benefit of Routine Axillary Sonographic Assessment in cN0 Breast Cancer Patients. cN0乳腺癌症患者常规腋窝超声检查的益处。
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2022.2021-11-6
Marian Khatib, Panagiotis Sgardelis, Schlomo Schneebaum, Ortal Schaffer, Richard Sutton

Objective: Axillary ultrasound (US) is often part of the routine assessment of the clinically negative axilla in primary breast cancer, which determines the extent of axillary surgery to be performed. This study aims to ascertain the burden of disease in the axilla of patients with a normal clinical examination (cN0) but with US detected metastatic axillary lymph nodes.

Materials and methods: We retrospectively identified 345 female patients who underwent axillary lymph node dissection, following a positive lymph node biopsy, between January 2015 and August 2019.Eighty-nine of those had a positive biopsy prior to surgery. They were divided into two groups: Those with clinically palpable axillary disease preoperatively, cN1 (n = 41), and those with a normal clinical axillary examination, cN0 (n = 48). We assessed the number of positive axillary lymph nodes dissected in the two groups.

Results: In the cN0 group the mean value of excised disease-positive axillary lymph nodes was 3.6, while in the cN1 group it was 8.0 (p<0.01). However, further analysis showed that 25 patients of the cN0 who had T1/T2 tumors had ≥3 positive lymph nodes.

Conclusion: Our study suggests that the presence of clinically palpable axillary lymph nodes appears to be correlated to a higher number of positive lymph nodes. However, in cases of non-palpable sonographically positive lymph nodes there might still be significant axillary disease, even in T1 and T2 tumors. Therefore we still support the routine use of preoperative sonographic assessment of the axilla for early breast cancer.

目的腋窝超声(US)通常是原发性癌症临床阴性腋窝常规评估的一部分,它决定了腋窝手术的范围。本研究旨在确定临床检查正常(cN0)但US检测到转移性腋窝淋巴结的患者腋窝的疾病负担。材料和方法我们回顾性地确定了345名女性患者,她们在2015年1月至2019年8月期间接受了腋窝淋巴结清扫,淋巴结活检呈阳性。其中89人在手术前进行了阳性活检。他们被分为两组:术前有临床可触及腋窝疾病的患者,cN1(n=41),和临床腋窝检查正常的患者,c N0(n=48)。我们评估了两组腋窝淋巴结的阳性解剖数量。结果cN0组腋窝淋巴结检出率为3.6,cN1组为8.0(p<0.01),但进一步分析发现,25例T1/T2肿瘤cN0患者腋窝淋巴结阳性率≥3。结论我们的研究表明,临床上可触及的腋窝淋巴结的存在似乎与较高的阳性淋巴结数量相关。然而,在未触及的声像图阳性淋巴结的病例中,即使在T1和T2肿瘤中,也可能存在显著的腋窝疾病。因此,我们仍然支持术前常规使用腋窝超声评估早期乳腺癌症。
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引用次数: 0
Lipid Intake and Breast Cancer Risk: Is There a Link? A New Focus and Meta-Analysis. 脂质摄入与乳腺癌风险:有联系吗?一个新的焦点和元分析。
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2021.2021-11-2
M. Lodi, A. Kiehl, Fei Qu, V. Gabriele, C. Tomasetto, C. Mathelin
ObjectiveTo determine if there is an association between total lipid intake, saturated fatty acid (SFA), Poly- and Mono-Unsaturated Fatty Acid (PUFA and MUFA) and cholesterol intake and breast cancer risk.Materials and MethodsWe conducted a systematic review of the literature and a meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included all cohort and case-control studies published up to December 2020 with subgroup analysis according to menopausal status.ResultsWe included 44 articles for analysis. There was no association between total fat, SFA, MUFA, PUFA and cholesterol intake and breast cancer in the general population and in pre-menopausal women. In postmenopausal women, high SFA consumption was associated with increased breast cancer risk in case-control studies [relative risk (RR): 1.12; confidence interval (CI) 95%: 1.03-1.21; p = 0.006 but not in cohort studies (RR: 1.01; CI 95%: 0.85-1.19; p = 0.93).ConclusionThere was a weak association between high SFA consumption and breast cancer risk in post-menopausal women, however there was high heterogeneity for this analysis. As lipids can have different actions in the same family, studies should rather focus on specific lipid consumption.
目的确定总脂质摄入量、饱和脂肪酸(SFA)、多不饱和脂肪酸和单不饱和脂肪酸酯(PUFA和MUFA)与胆固醇摄入量和癌症风险之间是否存在关联。材料和方法我们对文献进行了系统综述,并根据系统综述和荟萃分析(PRISMA)指南的首选报告项目进行了荟萃分析。我们纳入了截至2020年12月发表的所有队列和病例对照研究,并根据更年期状况进行了亚组分析。结果纳入44篇文献进行分析。在一般人群和绝经前妇女中,总脂肪、SFA、MUFA、PUFA和胆固醇摄入量与乳腺癌症之间没有关联。在绝经后妇女中,在病例对照研究中,高SFA消耗与癌症风险增加相关[相对风险(RR):1.12;置信区间(CI):1.03-1.21;p=0.006,但在队列研究中不相关(RR:1.01;CI 95%:0.85-1.19;p=0.93)结论在绝经后妇女中,高SFA消耗量与乳腺癌症风险之间的相关性较弱,但该分析具有高度的异质性。由于脂质在同一家族中可能具有不同的作用,因此研究应侧重于特定的脂质消耗。
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引用次数: 3
Patient Satisfaction and Surgical Outcome After Oncoplastic Reconstruction following Radical Lumpectomy Versus Standard Lumpectomy: A Retrospective Cohort Study. 肿瘤整形重建术后患者满意度和手术结果:一项回顾性队列研究。
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2022.2021-12-1
Eyal Barkai, Yossi Namir, Orit Golan, Yoav Barnea, Ehud Arad, Tehillah S Menes

Objective: Oncoplastic reconstruction (OR) enables widening of the indications for breast conserving therapy (BCT) and is redefining the limits of breast conservation. We examined the outcome and satisfaction of patients undergoing OR after radical lumpectomy (excision of more than 25% of the breast volume) and compared it to the outcome of women undergoing OR after standard lumpectomy.

Materials and methods: A retrospective, cohort study, including all patients undergoing OR after BCT between 2009 and 2018, was conducted. The ratio of volume of excision to breast volume was calculated using imaging studies. The study group included women that had more than 25% of their breast volume removed. The remainder formed the control group. Demographic characteristics, oncological treatment, and operation properties were collected. We compared post-operative complications, margin status and need for further surgery, as well as patient satisfaction, evaluated using the BREAST-Q Questionnaire.

Results: One hundred and fifty women were included, of whom 24 (16%) comprised the study group with a mean breast volume reduction of 39%, while the remainder (mean volume reduction 8%) served as controls. Patient, tumor characteristics and treatment were comparable. There was a non-significant higher proportion of women in the radical group that underwent a second operation due to complications or positive margins [4/24 (16.7%) vs. 14/126 (11%), p = 0.4). Physical well-being was similar but satisfaction with breasts and with outcome was slightly lower for the study group. These differences did not reach statistical significance.

Conclusion: Surgical outcome and patient satisfaction in women undergoing very extensive breast resections with OR are comparable to standard resections.

肿瘤整形重建(OR)拓宽了保乳治疗(BCT)的适应证,重新定义了保乳的界限。我们检查了根治性肿块切除术(切除超过25%的乳房体积)后接受OR的患者的结果和满意度,并将其与标准肿块切除术后接受OR手术的女性的结果进行了比较。材料和方法进行了一项回顾性队列研究,包括2009年至2018年间接受BCT手术的所有患者。切除体积与乳房体积的比值是通过影像学研究计算出来的。研究组包括切除了25%以上乳房体积的女性。其余组成对照组。收集人口统计学特征、肿瘤学治疗和手术特点。我们比较了术后并发症、边缘状态和进一步手术的需要,以及患者满意度,并使用BREAT-Q问卷进行了评估。结果150名女性被纳入研究,其中24名(16%)为研究组,平均乳房体积减少39%,其余(平均体积减少8%)为对照组。患者、肿瘤特征和治疗具有可比性。在根治性组中,由于并发症或阳性边缘而接受第二次手术的女性比例并不显著较高[4/24(16.7%),而14/126(11%),p=0.4)。研究组的身体健康状况相似,但对乳房和结果的满意度略低。这些差异没有达到统计学意义。结论接受OR乳腺大面积切除的妇女的手术结果和患者满意度与标准切除相当。
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引用次数: 0
Digital Mammography, Ultrasound and Magnetic Resonance Imaging Characteristics in Differential Diagnosis of Papillary Carcinoma Subtypes of the Breast and Diagnostic Challenges. 数字乳房x线摄影、超声和磁共振成像在乳腺乳头状癌亚型鉴别诊断中的特点和诊断挑战。
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2022.2021-9-4
Tuğba İlkem Kurtoğlu Özçağlayan, M. Öznur
ObjectiveWe aimed to investigate mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) findings of papillary breast carcinoma subtypes and to compare the diagnostic features and performance of the imaging method in distinguishing subtypes.Materials and MethodsForty-two patients presenting with pathological diagnosis of 45 papillary carcinoma lesions, between 2014 and 2019, were included. Cases were assigned to five subgroups according to the latest World Health Organization (WHO) classification. The clinical characteristics (n = 45) and imaging features of each pathological subgroup were retrospectively related to imaging findings from US (n = 45), MG (n = 37), and breast MRI (n = 23), and further compared.ResultsThe finding of a palpable mass in all subgroups was more common than nipple discharge on clinical breast evaluation, and no significant difference was found between the subgroups. Irregular shape on MG (10/12, 83.3%, p = 0.039) and US (11/12, 91.7%, p = 0.039) was found more frequently in invasive micropapillary carcinoma (IMPC) compared to other subgroups. Circumscribed margins (4/5, 80%, p = 0.002) occurred more frequently in papillary ductal carcinoma in situ (pDCIS) and encapsulated papillary carcinoma (EPC) than in other subgroups (6/8, 75%, p = 0.002). Lower apparent diffusion coefficient (ADC) values were found in solid papillary cancer (SPC) than in other subgroups (ADC = 0.35 x 10-3, p = 0.017).ConclusionRadiological findings of papillary carcinomas overlap with each other. US and MRI are complementary when revealing specific morphological characteristics.
目的研究乳腺乳头状癌亚型的钼靶x线(MG)、超声(US)和磁共振成像(MRI)表现,并比较影像学方法在区分亚型方面的诊断特征和性能。材料和方法纳入2014年至2019年间42例病理诊断为45个乳头状癌病变的患者。根据世界卫生组织(世界卫生组织)的最新分类,病例被分为五个亚组。将每个病理亚组的临床特征(n=45)和影像学特征与US(n=45、MG(n=37)和乳腺MRI(n=23)的影像学表现进行回顾性关联,并进行进一步比较。结果在临床乳腺评估中,所有亚组的可触及肿块的发现都比乳头溢液更常见,并且亚组之间没有显著差异。与其他亚组相比,侵袭性微乳头状癌(IMPC)中MG(10/12,83.3%,p=0.039)和US(11/12,91.7%,p=0.039)的不规则形状更常见。原位乳头状导管癌(pDCIS)和包膜乳头状癌(EPC)的切缘发生率(4/5,80%,p=0.002)高于其他亚组(6/8,75%,p=002)癌彼此重叠。US和MRI在揭示特定形态特征时是互补的。
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引用次数: 4
Will Radiomics Replace Sentinel Lymph Node Biopsy? 放射组学会取代前哨淋巴结活检吗?
Pub Date : 2022-04-01 DOI: 10.4274/ejbh.galenos.2022.2022-2-3
A. Eldaly, Ayman R. Fath, Sarah M. Mashaly
Axillary lymph node metastasis is by far the most vital determinant of survival for breast cancer patients (1). Sentinel lymph node biopsy (SLNB) is the gold standard for axillary lymph node staging in clinically node-negative patients. However, despite the reported high sensitivity (44%–100%) and specificity (100%) of SLNB (2), it is associated with multiple morbidities, including sensory impairment, motor dysfunction, and lymphedema (3). to predict axillary lymph node status in breast cancer patients. Magnetic resonance imaging, computed tomography, and mammography are usually used as the image sources to build the predictive model. The results of radiomics are promising, with an accuracy, sensitivity, and specificity as high as 98% (5). Although radiomics shows high accuracy in predicting axillary lymph node metastasis, it is not expected to replace SLNB in the near future. This is because the evidence from current radiomics studies is of modest quality. To date, almost all radiomics studies are retrospective in design and lack comparison with the gold standard. Moreover, most of the studies lack external validation and cost-effectiveness analysis. We believe that replacing SLNB with radiomics in axillary lymph node staging in breast cancer is possible and will spare millions of patients unnecessary surgical interventions. However, implementing radiomics in breast cancer care requires robust evidence from randomized controlled trials. Whether or not the current evidence from the retrospective studies justifies clinical trials is yet to be determined. The answer to this question may be solved by conducting a meta-analysis of the existing literature.
腋窝淋巴结转移是迄今为止乳腺癌患者生存最重要的决定因素(1)。前哨淋巴结活检(SLNB)是临床淋巴结阴性患者腋窝淋巴结分期的金标准。然而,尽管有报道称SLNB具有高敏感性(44%-100%)和特异性(100%)(2),但在预测乳腺癌患者腋窝淋巴结状态时,它与多种发病率相关,包括感觉障碍、运动功能障碍和淋巴水肿(3)。磁共振成像、计算机断层扫描和乳房x线摄影通常作为图像源来建立预测模型。放射组学的结果是有希望的,其准确性、敏感性和特异性高达98%(5)。尽管放射组学在预测腋窝淋巴结转移方面显示出很高的准确性,但在不久的将来,它预计不会取代SLNB。这是因为目前放射组学研究的证据质量一般。迄今为止,几乎所有的放射组学研究在设计上都是回顾性的,缺乏与金标准的比较。此外,大多数研究缺乏外部验证和成本-效果分析。我们相信用放射组学代替SLNB在乳腺癌腋窝淋巴结分期中是可能的,并且将使数百万患者免于不必要的手术干预。然而,在乳腺癌治疗中实施放射组学需要来自随机对照试验的有力证据。目前来自回顾性研究的证据是否证明临床试验是合理的还有待确定。这个问题的答案可以通过对现有文献进行荟萃分析来解决。
{"title":"Will Radiomics Replace Sentinel Lymph Node Biopsy?","authors":"A. Eldaly, Ayman R. Fath, Sarah M. Mashaly","doi":"10.4274/ejbh.galenos.2022.2022-2-3","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2022.2022-2-3","url":null,"abstract":"Axillary lymph node metastasis is by far the most vital determinant of survival for breast cancer patients (1). Sentinel lymph node biopsy (SLNB) is the gold standard for axillary lymph node staging in clinically node-negative patients. However, despite the reported high sensitivity (44%–100%) and specificity (100%) of SLNB (2), it is associated with multiple morbidities, including sensory impairment, motor dysfunction, and lymphedema (3). to predict axillary lymph node status in breast cancer patients. Magnetic resonance imaging, computed tomography, and mammography are usually used as the image sources to build the predictive model. The results of radiomics are promising, with an accuracy, sensitivity, and specificity as high as 98% (5). Although radiomics shows high accuracy in predicting axillary lymph node metastasis, it is not expected to replace SLNB in the near future. This is because the evidence from current radiomics studies is of modest quality. To date, almost all radiomics studies are retrospective in design and lack comparison with the gold standard. Moreover, most of the studies lack external validation and cost-effectiveness analysis. We believe that replacing SLNB with radiomics in axillary lymph node staging in breast cancer is possible and will spare millions of patients unnecessary surgical interventions. However, implementing radiomics in breast cancer care requires robust evidence from randomized controlled trials. Whether or not the current evidence from the retrospective studies justifies clinical trials is yet to be determined. The answer to this question may be solved by conducting a meta-analysis of the existing literature.","PeriodicalId":91975,"journal":{"name":"The journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44859937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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The journal of breast health
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