Objective To explore the correlation between homocysteine （Hcy） level and the risk of breast cancer，and try to find a new method to reduce the risk factors and benefit for treatment of breast cancer. Methods From January2010 to December 2012， 245 cases of breast cancer （breast cancer group）， 109 cases of benign breast tumor （benign breast tumor group）， and 78 cases of healthy women （healthy control group） in the Sichuan Provincial People’s Hospital， who were in accordance with the inclusion criteria， were analyzed retrospectively. The difference of Hcy level was compared among three groups. Meanwhile the relation between Hcy level and patients’s age， blood glucose， serum creatinine， estrogen receptor （ER）， progesterone receptor （PR）， Ki-67 （%）， tumor diameter， or axillary lymph node status was analyzed.Results ① The Hcy level was significantly different among the breast cancer group， benign breast tumor group， and healthy control group （P＜0.001）. The Hcy level of the breast cancer group was significantly higher than those of the benignbreast tumor group （P＜0.001） or healthy control group （P＜0.001）， but the Hcy level was not significantly different bet-ween the benign breast tumor group and healthy control group （P=0.082） . ② The Hcy levels of different types of the breastcancer （type of Luminal A， Luminal B， Her-2， and triple negative） were significantly higher than those of the benign breast tumor group （except for Her-2 type， P＜0.05） or healthy control group （P＜0.05）. ③Plasma Hcy level of the patients with benign and malignant breast tumor was positively correlated with age （r=0.197， P=0.004） or serum creatinine level （r=0.381， P＜0.001）， but not correlated with blood glucose （r=0.023， P=0.668）. ④Plasma Hcy level of the patients with malignant breast tumor was positively correlated with age （r=0.267， P=0.007） or serum creatinine level （r=0.341， P＜0.001）， but not correlated with blood glucose （r=-0.005， P=0.935）， tumor diameter （r=-0.049， P=0.443）， axillary lymph node status （r=-0.006， P=0.921）， or Ki-67 （%） （rs=-0.029， P=0.650）. Conclusions Plasma Hcy level of breast cancer patient is abnormally elevated， and it may have some relation with the occurrence of breast cancer.
Objective To explore the value of the application of latissimus dorsi myocutaneous flap in the breast reconstruction. Methods The clinical data of the 36 patients with breast tumor who had undergone breast reconstruction with latissimus dorsi myocutaneous flap from January 2012 to December 2016 were collected retrospectively. The postoperative complications and cosmetic results were analyzed. Results Thirty-six patients with breast tumor who underwent breast reconstruction with latissmus dorsi myocutaneous flap, including 32 patients with immediate breast reconstruction and 4 patients with delayed breast reconstruction respectively. The operative time of the patients who undertwent immediate breast reconstruction was 235–490 min (mean of 325 min), the intraoperative blood loss was 200–260 mL (mean of 220 mL), and the hospitalization time was 18–33 d (mean of 23.6 d). The total operative time of patients who underwent delayed breast reconstruction was 325–550 min (mean of 355 min), the total intraoperative blood loss was 200–250 mL (mean of 220 mL), and the total hospitalization time was 27–45 d (mean of 32.5 d). The cosmetic results was excellent in 22 patients, good in 8 patients, fair in 6 patients, respectively, and fine rate was 83.3% (30/36). There was no flap loss, but donor site seroma occurred in 21 patients, partial necrosis of the surgical margin of back skin occurred in 1 patient, partial necrosis of the nipple and areola skin occurred in 2 patients. All the patients were followed-up for 3–60 months, and the mean follow-up time was 37 months. During the follow-up period, no patient occurred metastasis or recurrence. After undergoing radiotherapy, reconstructive breast volume of 2 patients significantly contracted. None of the patients had significant limb function. Conclusion The breast reconstruction with the latissimus dorsi myocutaneous flap is a simple, easy, and effective surgical procedure.
Objective To evaluate the feasibility of immediate breast reconstruction with silicone prosthesis for breast tumor. Methods The clinical data of the 42 patients with breast tumor who had undergone breast reconstruction with silicone prosthesis from January 2012 to June 2017 were collected retrospectively. The postoperative complications and cosmetic results were analyzed. Results All patients underwent operation successfully. The surgical time was 230–435 min (mean of 325 min), the intraoperative blood loss was 100–160 mL (mean of 130 mL), and the hospitalization time was 18–33 d (mean of 24 d). The cosmetic results was excellent in 26 patients, good in 8 patients, bad in 8 patients, and fine rate was 81.0% (34/42). Rate of patients’ overall satisfaction with breast reconstruction was 73.8% (31/42) and rate of aesthetic satisfaction was 78.6% (33/42). After operation, seroma occurred in 2 patients, and the ischemic necrosis in nipple and areola occurred in 3 patients. All the patients were followed-up for 4–70 months, and the median follow-up time was 37 months. During the follow-up period, no patient had metastasis or recurrence. Six patients received radiotherapy, among them 2 patients appeared Ⅱ-grade capsular contracture. Conclusion The breast reconstruction with silicone prosthesis is a simple, easy, and effective surgical procedure.
ObjectiveTo investigate the strategy adjustment of breast cancer surgery management process during the outbreak of novel coronavirus pneumonia (NCP), and to summarize the experience.MethodsBased on "Pneumonitis Diagnosis and Treatment Plan for Novel Coronavirus Infection (Fifth Trial Version)" and "Surgery Work System During the Prevention and Control of Novel Coronavirus Infection in Mianyang Central Hospital (Second Edition)", the breast surgery department adjusted strategies and plans for breast cancer surgery during the epidemic.ResultsFrom January 25, 2020 to February 11, 2020, 8 cases of breast cancer surgery were performed in our hospital. They were all females, with an average age of 45 years. Five patients underwent modified radical mastectomy, 2 patients underwent breast-conserving surgery plus sentinel lymph nodes biopsy, and 1 case underwent breast-conserving surgery plus axillary lymph node dissection. All 8 patients were diagnosed as invasive ductal carcinoma of breast by hollow needle biopsy. All patients recovered smoothly after surgery, no complications occurred, and they were discharged as planned. No patients or medical staff showed NCP exposure and infection.ConclusionDuring the NCP epidemic, breast cancer surgery can be performed and the epidemic can be effectively prevented and controlled by adjusting the work flow and strategy.
ObjectiveTo explore the surgical technique and clinical effect of endoscopic assisted transaxillary breast tumor resection in the treatment of benign and malignant breast tumors. MethodsThe clinical data of 18 patients received endoscopic breast tumor resection from September 2020 to December 2021 in the Department of Breast Surgery, West China Hospital, Sichuan University, were retrospectively analyzed to evaluate the feasibility, tumor safety and postoperative cosmetic effect. There were 7 patients with benign breast tumors (a benign breast tumor group) and 11 patients with early breast cancer (a malignant breast tumor group). Breast-Q and Scar-Q questionnaires were used to evaluate postoperative quality of life and satisfaction of patients. ResultsEndoscopic breast tumor resection was performed successfully in 18 female patients, among whom 12 patients received day surgery. The mean age of benign and malignant breast tumor groups was 29.6±11.6 years and 46.7±14.3 years, the mean tumor size in pathological examination was 3.3±2.1 cm and 2.0±0.8 cm, and the operative time was 138.9±57.0 min and 177.3±46.3 min, respectively. One patient had positive resection margin and underwent intraoperative extended resection in the malignant breast tumor group. All the patients were successfully followed up, and the mean follow-up time of benign and malignant breast tumor groups was 6.8±4.0 months and 8.7±4.9 months, respectively. No complications or tumor recurrence occurred. The scores of psychosocial status, sexual well-being, chest wall status and breast satisfaction decreased one month after surgery and basically recovered to the preoperative level in one year, and the score of scar appearance increased to 64.6±5.9 points one year postoperatively. ConclusionEndoscopic assisted transaxillary breast tumor resection can effectively improve postoperative cosmetic effect and patient satisfaction on the premise of safety.