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Sentinel node in breast cancer as an indicator of quality in medical care: Evaluation of statistics in Colombia. 作为医疗质量指标的乳腺癌前哨结节:评估哥伦比亚的统计数据。
Pub Date : 2024-04-08 DOI: 10.3233/bd-230059
Mario Arturo González Mariño
BACKGROUNDSentinel lymph node biopsy in breast cancer is considered the standard of staging in cases of clinically negative lymph nodes. Its omission in favor of axillary dissection generates significant morbidity.OBJECTIVETo determine the total number of sentinel node biopsy procedures in breast cancer in Colombia from 2017 through 2020, model and analyze them as if they were performed only in stage I breast cancer patients, and integrate their results into the concepts of quality of medical care.METHODSSearch in a database of the Ministry of Health and Social Protection of Colombia with sentinel lymph node biopsy codes, and filters of breast cancer and year. Their results are contrasted with the number of cases in stage I of breast cancer.RESULTSBreast cancer TNM staging was reported in 22154 cases, 3648 stage I. In the same time frame, the number of sentinel lymph node biopsies for breast cancer in Colombia was 1045, 28.64% of the total cases reported in stage I.CONCLUSIONSColombia is far from complying with the standard indicator of sentinel lymph node biopsy. It is recommended to concentrate breast cancer cases in hospitals that provide the conditions for its performance.
背景乳腺癌前哨淋巴结活检被认为是临床淋巴结阴性病例的分期标准。目的确定 2017 年至 2020 年哥伦比亚乳腺癌前哨淋巴结活检的总数量,建立模型并进行分析,将其视为仅在 I 期乳腺癌患者中进行,并将其结果纳入医疗质量的概念中。方法在哥伦比亚卫生和社会保障部的数据库中搜索前哨淋巴结活检代码、乳腺癌过滤器和年份。结果哥伦比亚报告的乳腺癌 TNM 分期病例为 22154 例,I 期病例为 3648 例。同一时期,哥伦比亚乳腺癌前哨淋巴结活检病例为 1045 例,占 I 期病例总数的 28.64%。建议将乳腺癌病例集中到有条件进行前哨淋巴结活检的医院。
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引用次数: 0
Telangiectasias induced by combination tucatinib and ado-trastuzumab emtansine in a patient with metastatic breast cancer. 一名转移性乳腺癌患者因联合使用图卡替尼和ado-trastuzumab emtansine而诱发远端血管瘤。
Pub Date : 2024-04-01 DOI: 10.3233/bd-230053
Gabriella F Rodriguez, Anuj Shah, A. Maderal
BACKGROUNDTucatinib is a tyrosine kinase inhibitor currently used in salvage therapy for human epidermal growth factor receptor 2 (HER2)-positive breast and colorectal cancer. The use of tucatinib alone or in combination with ado-trastuzumab emtansine (T-DM1) in the treatment of advanced HER2-positive cancers is rapidly expanding.OBJECTIVE/METHODSWe report the case of a 66-year-old female who presented to the dermatology clinic with a one-year history of widespread telangiectasias that began after initiation of combination chemotherapy with tucatinib and T-DM1 for metastatic HER2-positive invasive ductal carcinoma.RESULTSThe patient's lesions regressed upon cessation of combination therapy and reappeared in the setting of tucatinib re-initiation, with gradual improvement over the following four months following electrocautery to the affected regions.CONCLUSIONSWe postulate that telangiectasias may be a previously unreported dermatologic side effect of combination treatment with tucatinib and T-DM1. Electrocautery is a safe and effective procedure to reduce the appearance of telangiectasias and improve patient satisfaction during chemotherapy.
背景图卡替尼是一种酪氨酸激酶抑制剂,目前用于人类表皮生长因子受体2(HER2)阳性乳腺癌和结直肠癌的挽救性治疗。我们报告了一例 66 岁女性的病例,她在皮肤科门诊就诊,一年前开始出现广泛的毛细血管扩张,在开始使用图卡替尼和 T-DM1 联合化疗治疗转移性 HER2 阳性浸润性导管癌后开始发病。结果患者的皮损在停止联合治疗后消退,在重新开始使用图卡替尼治疗时再次出现,在对受影响区域进行电灼治疗后,皮损在随后的四个月中逐渐好转。电灼是一种安全有效的方法,可以减少毛细血管扩张的出现,提高化疗期间患者的满意度。
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引用次数: 0
The role of platelet rich plasma enriched fat graft for correction of deformities after conservative breast surgery. 富血小板血浆脂肪移植对乳房保守手术后畸形矫正的作用。
Pub Date : 2024-01-01 DOI: 10.3233/BD-230057
Ahmed Shaaban, Medhat Anwar, Rabie Ramadan

Background: Fat transfer has been widely used after breast conservative surgery (BCS) where it aims to recover shapes as a simple, inexpensive, biocompatible method but the technique is not without complications. Platelet Rich Plasma (PRP) is a promising approach to enhance fat graft survival and subsequently improve the outcome. The aim of this study was to evaluate the effect of enriching fat graft with PRP for delayed correction of deformities after conservative surgery for breast cancer regarding esthetic outcome and incidence of complications.

Methods: The current study included 50 female patients who were scheduled for delayed lipofilling for correction of deformities after conservative surgery for breast cancer. The studied patients were randomly allocated into 2 groups: Group I (G I) included 25 patients scheduled for PRP enriched lipoinjection and Group II (G II) included 25 patients scheduled for lipoinjection without PRP as a control group.

Results: Number of sessions of lipoinjection was significantly less in G I in comparison to G II (P = 0.024). During the 2nd session; the amounts of fat injected and harvested were significantly less in G I in comparison to G II (P = 0.049 and 0.001 respectively). Recipient site complications were significantly more evident in G II in comparison to G I (P = 0.01). Surgeon and patient satisfactions were significantly more evident in GI in comparison to G II (P = 0.005 and 0.029 respectively).

Conclusion: The addition of PRP to fat grafts is a simple, cost-effective and safe method to improve esthetic outcome and decrease complications.

背景:脂肪移植作为一种简单、廉价、生物相容性好的方法,在乳房保守手术(BCS)后被广泛用于恢复外形,但该技术并非没有并发症。富血小板血浆(PRP)是一种很有前景的方法,可提高脂肪移植的存活率,从而改善手术效果。本研究的目的是评估在乳腺癌保守手术后延迟矫正畸形时使用富血小板血浆进行脂肪移植对美学效果和并发症发生率的影响:本研究包括50名女性患者,她们在乳腺癌保守手术后被安排进行延迟脂肪填充以矫正畸形。研究对象被随机分为两组:第一组(G I)包括25名计划接受富含PRP脂肪注射的患者,第二组(G II)包括25名计划接受不含PRP脂肪注射的患者作为对照组:结果:与 G II 相比,G I 组的脂肪注射次数明显较少(P = 0.024)。在第 2 次注射中,G I 组注射和抽取的脂肪量明显少于 G II 组(P = 0.049 和 0.001)。G II 与 G I 相比,受体部位并发症明显增多(P = 0.01)。GI 与 G II 相比,外科医生和患者的满意度明显更高(P = 0.005 和 0.029):结论:在脂肪移植中添加 PRP 是一种简单、经济、安全的方法,可改善美学效果并减少并发症。
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引用次数: 0
Primary breast sarcomas: A 13 case-series study treated in university hospital in central Tunisia over a 25-year period. 原发性乳腺肉瘤:突尼斯中部大学医院 25 年间治疗的 13 个病例系列研究。
Pub Date : 2024-01-01 DOI: 10.3233/BD-230037
Fadoua Bouguerra, Samia Kanoun Belajouza, Emna Mziou, Rym Zanzouri, Hayfa Chahdoura, Sabrine Tbessi, Nadia Bouzid, Sameh Tebra Mrad

Aim: To retrospectively study the therapeutic modalities of primary breast sarcomas in view of the data of a local Tunisian experience.

Methods: It is a monocentric, descriptive, retrospective study including 13 cases of primary breast sarcoma treated over a period of 25 years (1995-2020) in the oncological radiotherapy department of a university hospital in Sousse, Tunisia.

Results: In our study, 13 cases of non-metastatic breast sarcomas that has been identified, divided into ten cases of phyllodes sarcomas and three cases of non-phyllodes sarcomas.Surgically, all our patients had a mastectomy. Among them, seven underwent a lymph node procedure: five underwent axillary lymph node dissection, and two others had primary axillary lymph node biopsy. For the adjuvant treatment, all the patients included in our study received radiotherapy and seven received chemotherapy. Local recurrence occurred on the operative scar in one patient after completion of radiation therapy. Metastatic relapse was described in five patients. The time to onset of metastases varied between two months and five years. Nevertheless, a complete remission was noted in 6 patients with a follow-up varying from four years to 20 years. Two patients were lost to follow-up.

Conclusion: Breast sarcomas remain a very rare entity of aggressive tumors.The therapeutic approach is poorly codified. For this reason, the therapeutic decision should always be discussed in a multidisciplinary assessment.

目的:根据突尼斯当地的经验数据,对原发性乳腺肉瘤的治疗方法进行回顾性研究:这是一项单中心、描述性、回顾性研究,包括突尼斯苏塞一所大学医院肿瘤放疗科在 25 年内(1995-2020 年)治疗的 13 例原发性乳腺肉瘤病例:在我们的研究中,共发现了 13 例非转移性乳腺肉瘤,其中 10 例为鳞状肉瘤,3 例为非鳞状肉瘤。在手术方面,我们所有的患者都接受了乳房切除术,其中 7 人接受了淋巴结清扫术:5 人接受了腋窝淋巴结清扫术,另外 2 人接受了原发腋窝淋巴结活检术。在辅助治疗方面,我们研究的所有患者都接受了放疗,7 人接受了化疗。一名患者在完成放疗后在手术疤痕上出现局部复发。五名患者出现了转移性复发。出现转移的时间从两个月到五年不等。不过,6 名患者的病情完全缓解,随访时间从 4 年到 20 年不等。有两名患者失去了随访机会:乳腺肉瘤仍然是一种非常罕见的侵袭性肿瘤。因此,治疗决定应始终在多学科评估的基础上进行讨论。
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引用次数: 0
Physical activity and quality of life in breast cancer survivors. 乳腺癌幸存者的体育锻炼和生活质量。
Pub Date : 2024-01-01 DOI: 10.3233/BD-249005
Nurul Qisti Agussalim, Mardiana Ahmad, Prihantono Prihantono, Andi Nilawati Usman, Sitti Rafiah, Dinah Inrawati Agustin

Objectives: We reviewed the literature on breast cancer patients' physical activity and quality of life. This paper should urge health services and breast cancer survivors to continue appropriate physical activity and assess its advantages.

Design: A systematic review was conducted.

Data sources: This systematic review used online databases: PubMed, Web of Science, Scopus, and Google Scholar. A search from the beginning of 2018-2024 was conducted.

Review method: Medical Subject Headings (MESH) were used for keyword selection along with other target keywords, such as "Quality of life", "Breast cancer", "Chemotherapy", "Treatment side effects", "Patient experience", "Psychosocial well-being", "Physical functioning", "Emotional distress", and "Supportive care". We reviewed and included all English-language publications. A narrative synthesis was conducted to present the results of the studies.

Results: The search using the keywords yielded a total of 135 studies. Each result was filtered again according to the inclusion and exclusion criteria, resulting in a final total of 15 studies to be included in the systematic review.

Conclusion: The evidence supports the benefits of physical activity in enhancing the quality of life for breast cancer survivors, indicating that further prospective and intervention studies are needed.

目的:我们回顾了有关乳腺癌患者体育锻炼和生活质量的文献。本文应敦促医疗服务机构和乳腺癌幸存者继续进行适当的体育锻炼,并评估其优势:设计:我们进行了一项系统性综述:本系统综述使用了在线数据库:PubMed、Web of Science、Scopus 和 Google Scholar。检索时间为 2018 年初至 2024 年.综述方法:在选择关键词时使用了医学主题词表(MESH)以及其他目标关键词,如 "生活质量"、"乳腺癌"、"化疗"、"治疗副作用"、"患者体验"、"社会心理健康"、"身体功能"、"情绪困扰 "和 "支持性护理"。我们审查并收录了所有英文出版物。我们对研究结果进行了叙述性综合:使用关键词进行搜索后,共获得 135 项研究结果。根据纳入和排除标准对每项结果再次进行筛选,最终共有 15 项研究被纳入系统综述:证据支持体育锻炼对提高乳腺癌幸存者生活质量的益处,这表明需要进一步开展前瞻性和干预性研究。
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引用次数: 0
Parametric optimization and comparative study of machine learning and deep learning algorithms for breast cancer diagnosis. 用于乳腺癌诊断的机器学习和深度学习算法的参数优化和比较研究。
Pub Date : 2024-01-01 DOI: 10.3233/BD-240018
Parul Jain, Shalini Aggarwal, Sufiyan Adam, Mohsin Imam

Breast Cancer is the leading form of cancer found in women and a major cause of increased mortality rates among them. However, manual diagnosis of the disease is time-consuming and often limited by the availability of screening systems. Thus, there is a pressing need for an automatic diagnosis system that can quickly detect cancer in its early stages. Data mining and machine learning techniques have emerged as valuable tools in developing such a system. In this study we investigated the performance of several machine learning models on the Wisconsin Breast Cancer (original) dataset with a particular emphasis on finding which models perform the best for breast cancer diagnosis. The study also explores the contrast between the proposed ANN methodology and conventional machine learning techniques. The comparison between the methods employed in the current study and those utilized in earlier research on the Wisconsin Breast Cancer dataset is also compared. The findings of this study are in line with those of previous studies which also highlighted the efficacy of SVM, Decision Tree, CART, ANN, and ELM ANN for breast cancer detection. Several classifiers achieved high accuracy, precision and F1 scores for benign and malignant tumours, respectively. It is also found that models with hyperparameter adjustment performed better than those without and boosting methods like as XGBoost, Adaboost, and Gradient Boost consistently performed well across benign and malignant tumours. The study emphasizes the significance of hyperparameter tuning and the efficacy of boosting algorithms in addressing the complexity and nonlinearity of data. Using the Wisconsin Breast Cancer (original) dataset, a detailed summary of the current status of research on breast cancer diagnosis is provided.

乳腺癌是女性最常见的癌症,也是导致女性死亡率上升的主要原因。然而,人工诊断这种疾病非常耗时,而且往往受到筛查系统的限制。因此,迫切需要一种能够在癌症早期阶段快速检测出癌症的自动诊断系统。数据挖掘和机器学习技术已成为开发此类系统的重要工具。在这项研究中,我们对威斯康星乳腺癌(原始)数据集上的几种机器学习模型的性能进行了调查,重点是找出哪些模型在乳腺癌诊断中表现最佳。这项研究还探讨了拟议的 ANN 方法与传统机器学习技术之间的对比。本研究中采用的方法与早期研究中在威斯康星乳腺癌数据集上采用的方法也进行了比较。本研究的结果与之前的研究结果一致,之前的研究也强调了 SVM、决策树、CART、ANN 和 ELM ANN 在乳腺癌检测方面的功效。几种分类器对良性和恶性肿瘤分别达到了较高的准确度、精确度和 F1 分数。研究还发现,有超参数调整的模型比没有超参数调整的模型表现更好,而 XGBoost、Adaboost 和 Gradient Boost 等增强方法在良性肿瘤和恶性肿瘤中的表现也一直很好。这项研究强调了超参数调整的重要性以及提升算法在解决数据的复杂性和非线性方面的功效。利用威斯康星乳腺癌(原始)数据集,详细总结了乳腺癌诊断的研究现状。
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引用次数: 0
Chemotherapy induced alopecia in breast cancer patients: A monocentric prospective study. 乳腺癌患者化疗诱发的脱发:单中心前瞻性研究
Pub Date : 2024-01-01 DOI: 10.3233/BD-240019
Wala Ben Kridis, Olfa Boudawara, Afef Khanfir

Introduction: Alopecia is one of the main adverse events of chemotherapy in breast cancer. However, its impact is often ignored and underestimated by clinicians. Our aim was to evaluate the quality of life of breast cancer patients with chemotherapy induced alopecia.

Methods: We conducted a prospective study including 72 breast cancer patients who developed alopecia on or after stopping chemotherapy in the last 6 months. Clinical information and characteristics of alopecia were assessed using a self-prepared questionnaire. DLQI score was used to evaluate patients' quality of life.

Results: We interviewed a total of 72 women with a mean age of 53.5 ± 6 years. Alopecia appeared soon after the first course in 62.5%. All patients actively tried to hide induced hair fall (either by a hat in 6.9% or by a headscarf in 93.1%). Quality of life was impacted in 97.2% of patients with a median DLQI score of 6.5. Women who did not underwent mastectomy were significantly more bothered by hair loss than those who had radical surgery (78.1% vs 55%, p = 0.04). Working status was a significant predictor factor of a bad quality of life due to alopecia (100% in working women vs 58.3% in homemaker or retired patients, p = 0.006).

Conclusion: Chemotherapy induced alopecia had a negative impact on quality of life of patients with breast cancer, especially in working women and those who did not have radical surgery. Prior wearing of headscarves did not impact significantly the DLQI score.

简介脱发是乳腺癌化疗的主要不良反应之一。然而,临床医生往往忽视或低估其影响。我们的目的是评估化疗引起脱发的乳腺癌患者的生活质量:我们开展了一项前瞻性研究,纳入了 72 名在过去 6 个月中停止化疗或化疗后出现脱发的乳腺癌患者。我们使用自拟的问卷对脱发的临床信息和特征进行了评估。DLQI评分用于评估患者的生活质量:我们共访问了 72 名女性患者,她们的平均年龄为 53.5 ± 6 岁。62.5%的患者在首次治疗后不久出现脱发。所有患者都试图掩盖引起的脱发(6.9%的患者戴帽子,93.1%的患者戴头巾)。97.2%的患者生活质量受到影响,DLQI中位数为6.5分。未接受乳房切除术的女性受脱发困扰的比例明显高于接受根治性手术的女性(78.1% 对 55%,P = 0.04)。工作状况是脱发导致生活质量下降的一个重要预测因素(职业女性为100%,家庭主妇或退休患者为58.3%,P = 0.006):化疗引起的脱发对乳腺癌患者的生活质量有负面影响,尤其是职业女性和未接受根治性手术的患者。曾戴头巾对 DLQI 评分没有明显影响。
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引用次数: 0
Clinicopathological analysis of 38 male patients diagnosed with breast cancer. 对 38 名确诊为乳腺癌的男性患者进行临床病理分析。
Pub Date : 2024-01-01 DOI: 10.3233/BD-230050
Seniha Irem Sahin, Serdar Balci, Gulnur Guler, Kadri Altundag

Background: Male breast cancer (MBC) accounts for one percent of all breast cancers. Due to the lack of awareness and routine screening programs, most patients present with systemic disease at the time of diagnosis with low overall survival.

Objectives: This study aims to investigate the prognostic factors of male breast cancer and its correlation with established prognostic parameters and patient outcomes.

Methods: Thirty-eight male breast cancer patients are identified from the MKA Breast Cancer Clinic database, and their corresponding clinical and pathological characteristics are obtained. Cut-off values of 1% and 10% are applied to further classify ER and PR results.

Results: Older men are more likely to develop MBC than younger men and are more likely to have spread to axillary lymph nodes. Invasive ductal carcinoma is a more common histologic type in MBC. All the tested patients have ER and PR positivity. Distant metastasis developed in 17/38 (44.7%) patients. Bone metastasis is seen commonly in metastatic MBC.

Conclusions: According to our cohort, MBC is seen in older males, presents in later stages, and shows hormone receptor positivity and a tendency to bone involvement. MBC is a heterogenous but distinct biological entity requiring a specific clinical and pathological approach.

背景:男性乳腺癌(MBC)占所有乳腺癌的百分之一。由于缺乏认识和常规筛查计划,大多数患者在确诊时已出现全身性疾病,总体生存率较低:本研究旨在调查男性乳腺癌的预后因素及其与既定预后参数和患者预后的相关性:方法:从 MKA 乳腺癌诊所数据库中找出 38 例男性乳腺癌患者,并获得其相应的临床和病理特征。结果:年龄较大的男性更容易罹患MMR:结果:老年男性比年轻男性更容易罹患乳腺导管癌,而且更容易扩散到腋窝淋巴结。浸润性导管癌是 MBC 更常见的组织学类型。所有受检患者的ER和PR均呈阳性。17/38(44.7%)例患者出现远处转移。骨转移常见于转移性MBC:根据我们的队列,MBC 多见于老年男性,出现于晚期,表现为激素受体阳性和骨受累倾向。MBC是一种异质但独特的生物实体,需要采用特定的临床和病理方法。
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引用次数: 0
Impact of the COVID-19 pandemic on breast cancer pathological stage at diagnosis in Tunisian patients. COVID-19 大流行对突尼斯患者诊断时乳腺癌病理阶段的影响。
Pub Date : 2024-01-01 DOI: 10.3233/BD-230051
Meriam Triki, Mouna Zghal, Houda Ben Ayed, Saadia Makni, Maroua Bouhamed, Semi Fendri, Slim Charfi, Tahya Boudawara, Manel Mellouli

Background: Breast cancer (BC) patients' diagnosis and management was affected by a global reorganization after the Coronavirus disease 2019 (COVID-19). Our study aimed to assess the impact of the pandemic on the pathological stage of newly diagnosed patients with BC compared to pre-pandemic and to identify predictive factors of tumor advanced stage.

Methods: Pathological records of all consecutive newly operated BC patients between March 2020 and December 2021 were reviewed retrospectively. Clinical and pathological prognostic factors of BC were collected and compared between pre-pandemic and pandemic periods. Then, predictive factors of tumor advanced stage were identified.

Results: Of the 225 cases included in the analysis, 98.7% were females and 1.3% were males. The median time from first histological diagnosis to first surgical treatment was enlarged by 42 days with a significant difference between the two periods (p = 0.002). Newly diagnosed BC patients during the COVID-19 pandemic were operated at a more advanced stage (54.1% vs 36.2%, p = 0.007), had a greater lymphovascular invasion (p = 0.002), lymph node metastasis (p = 0.015) and are more commonly of IBC NST histological type (p = 0.005). Moreover, multivariate analyses showed that the pandemic period (AOR = 2.28; p = 0.016) and the lympho-vascular invasion (p < 0.001) were independently associated with advanced stage of tumors.

Conclusion: Our findings proved an increase in alarming rates of advanced stage BC associated with the COVID-19 crisis. These findings support recommendations for a quick restoration of BC screening at full capacity, with adequate prioritization strategies to mitigate harm.

背景:2019年冠状病毒病(COVID-19)发生后,乳腺癌(BC)患者的诊断和管理受到全球重组的影响。我们的研究旨在评估与大流行前相比,大流行对新诊断的 BC 患者病理分期的影响,并确定肿瘤晚期的预测因素:方法:回顾性审查2020年3月至2021年12月期间所有连续新手术的BC患者的病理记录。方法:回顾性审查 2020 年 3 月至 2021 年 12 月期间所有新近手术的 BC 患者的病理记录,收集 BC 的临床和病理预后因素,并将其与大流行前和大流行期间进行比较。然后,确定了肿瘤晚期的预测因素:在纳入分析的 225 例病例中,98.7% 为女性,1.3% 为男性。从首次组织学诊断到首次手术治疗的中位时间延长了42天,两个时期之间存在显著差异(P = 0.002)。在 COVID-19 大流行期间新确诊的 BC 患者手术时处于更晚期(54.1% 对 36.2%,p = 0.007),淋巴管侵犯更严重(p = 0.002),淋巴结转移更严重(p = 0.015),更常见的组织学类型为 IBC NST(p = 0.005)。此外,多变量分析显示,大流行期(AOR = 2.28;p = 0.016)和淋巴管侵犯(p < 0.001)与肿瘤晚期独立相关:我们的研究结果表明,与COVID-19危机相关的晚期BC的惊人发病率有所增加。这些研究结果支持有关迅速恢复 BC 筛查能力的建议,并建议采取适当的优先策略以减轻危害。
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引用次数: 0
Erratum to: Clinical significance of Notch receptors in triple negative breast cancer. 勘误:三阴性乳腺癌中 Notch 受体的临床意义。
Pub Date : 2024-01-01 DOI: 10.3233/BD-229041
Heer Shah, Mittal Mistry, Nupur Patel, Hemangini Vora
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引用次数: 0
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Breast disease
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