Objective To summarize the relation between tumor location and lymph node metastasis in early stage of breast cancer, which is aimed at providing a more individualized treatment for breast cancer patients. Method The literatures about breast cancer location and lymph node metastasis in recent years were extracted, through the literatures study we made a thematic review of the relation between them. Results There were two main classification methods for the location of breast tumors at present: tumor in the different quadrants and tumor to skin distance. In the quadrant classification method, the tumor in the upper inner quadrant (UIQ) had the lowest lymph node metastasis rate, while the lower inner quadrant (LIQ) tumor recurrence-free survival rate and overall survival rate were significantly lower than other quadrants. When measuring tumor to skin distance, the closer the tumor was to the skin, the more likely lymph node metastasis occurred. In combination with the distribution, histology, and anatomical differences of lymphatic and lymphatic networks, our study group proposed to classify tumors according to different anatomical levels of the breast, thus the anatomic location of the tumor was divided into four types: constricted in the gland, break the anterior gland, break the posterior gland, and break both anterior and posterior gland. Conclusions Regardless of the way the location is classified, the location of breast tumors is closely related to lymphatic and lymph node metastasis. The new classification according to the distribution of tumors at different anatomical levels of the breast accords with the law of lymphatic metastasis is scientific and reasonable. Therefore, during clinical practices, we recommend to use the new method to classify tumor location, and we should consider the differences in the location of the patients’ tumor to assess the status of axillary lymph node, which may provide a more individualized treatment for breast cancer patients.
ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on September 26, 2019. The data items included: date of surgery, precancerous lesions, cancer family, tumor site, distance to the dentate line, morphology of tumor, size, position, happening and origination, differentiation, pathology of tumor, Ki-67 of protein, complications (included obstruction, intussusception, perforation, pain, edema, and hemorrhage) were analyzed for the characteristics of each selected data item.ResultsA total of 11 898 analyzable data rows were obtained by screening the DACCA database. Among the 11 898 pieces of data, the effective data of precancerous lesions was 1 275, including 541 (42.4%) with precancerous lesions, and 734 (57.6%) without precancerous lesions. There were 1 116 valid data on cancer families, and 761 (6.4%) had a family history of cancer. The Ki-67 index had a total of 1 893 valid data, which ranged form 0 to 95% [(59.0±20.1) %]. According to the classification of tumor occurrence, the primary colorectal cancer accounted for the vast majority (92.8%), and the metastatic colorectal cancer was the least (0.3%). According to the primary and multiple primary, respectively analysis of tumor site, distance to the dentate line, morphology of tumor, size, position, differentiation, and pathology of tumor showed that, most tumor’s position were in the rectum (76.9%, 41.9%), the most common morphology was ulcers (42.4%, 51.5%), the most tumors were located around the wall of intestine (44.6%, 35.0%), the degree of differentiation was mostly moderate (65.4%, 61.3%), most of the tumor pathologies were adenocarcinoma (77.8%, 64.0%).ConclusionA more accurate and detailed analysis of colorectal cancer tumor characteristics by the DACCA database is helpful for determining the diagnosis and treatment plan in clinical work, judging the prognosis, and so on.
Whether anatomical segmentectomy can replace lobectomy in the treatment of early-stage lung cancer remains controversial. A large number of studies have been conducted for decades to explore whether pulmonary segmentectomy can treat early-stage lung cancer, which is actually to explore the indications of intentional segmentectomy. With the development of scientific researches, it is found that many characteristics affect the malignancy of lung cancer, and the different grades of each characteristic affect the prognosis of patients. It is worth exploring whether different surgical approaches can be used for early-stage lung cancer with different characteristics and different grades. This article reviews the literature and studies to discuss the advances in indications of segmentectomy for early-stage lung in terms of tumor size, consolidation-to-tumor ratio, pathological classification and tumor location, respectively. The objective of this review is to help thoracic surgeons to objectively and scientifically select the surgical method according to the clinical characteristics of early-stage lung cancer.
ObjectiveTo compare the effectiveness of sequential method pure single-port lumpectomy-breast conserving surgery (SMPSL-BCS) in treating early-stage breast cancer patients with tumors in different quadrants. Methods A retrospective analysis was conducted on 200 early-stage breast cancer female patients admitted between January 2023 and December 2023. According to the quadrant where the tumor was located, the patients were allocated into the upper outer quadrant group (UO group), lower outer quadrant group (LO group), upper inner quadrant group (UI group), and lower inner quadrant group (LI group), with 50 cases in each group. There was no significant difference (P>0.05) in the baseline data, including age, body mass index, smoking history, marital status, comorbidities, affected breast side, maximum tumor diameter on ultrasound, maximum pathological tumor diameter, clinical tumor stage, molecular subtype, and disease duration. The operation time, intraoperative blood loss, postoperative drainage volume, and extubation time were recorded and compared between groups. Additionally, the occurrence of early-stage complications (1-3 months after operation; including subcutaneous fluid accumulation, incision infection, superficial skin burns) and late-stage complications (>3 months after operation; including pectoralis major muscle adhesion, changes in breast appearance and shape, sensory discomfort) were assessed. At 6 months after operation, the cosmetic outcome of breast-conserving surgery was rated for all groups. Results The UO group had the shortest operation time, followed by the UI group, LO group, and LI group, showing significant differences between groups (P<0.05). The UO group had the least intraoperative blood loss, followed by the LO group, UI group, and LI group; except for the difference between UO group and LO group, which was not significant (P>0.05), the differences between the other groups were significant (P<0.05). The UO group had the least postoperative drainage volume, followed by the LO group, UI group, and LI group; except for the difference between LO group and UI group, which was not significant (P>0.05), the differences between the other groups were significant (P<0.05). The extubation time of the LI group was significantly longer than that of the other groups (P<0.05). All patients were followed up 4-12 months, with an average of 8 months. And 193 patients were followed up more than 6 months, including 48 patients in UO group, 47 in LO group, 49 in UI group, and 49 in LI group. In the early-stage period, the LI group had a higher incidence of subcutaneous fluid accumulation after tube removal compared to the UO group and LO group (P<0.05), while there was no significant difference in the incidences of other early complications between groups (P>0.05). In the late-stage period, the LI group had significantly higher incidences of pectoralis major muscle adhesion and changes in breast appearance and shape than UO group and LO group (P<0.05), and a significantly higher incidence of sensory discomfort than UO group (P<0.05). There was no significant difference in the incidences of other late-stage complications between groups (P>0.05). At 6 months after operation, the cosmetic outcomes of breast-conserving surgery were significantly better in UO group, LO group, and UI group than in LI group (P<0.05); there was no significant difference between the other groups (P>0.05). Conclusion In the treatment of early-stage breast cancer using SMPSL-BCS, patients with tumors located in the upper outer quadrant show the best effectiveness. The effectivenesses are similar for patients with tumors in the lower outer and upper inner quadrants. However, patients with tumors in the lower inner quadrant do not experience significant advantages. Therefore, it is recommended that SMPSL-BCS should not be the first-choice surgical method for patients with tumors in the lower inner quadrant.