Skin-Sparing Mastectomy (SSM) is a method of removing a minimum amount of the skin and a mammary gland under the skin and conserving the native skin. Therty-eight patients (39-73 years old) with breast cancer underwent SSM and immediate breast reconstruction by the use of silicon natrium solution bags. Before cancer operation, none of them said they hoped for immediate breast reconstruction by autogenous tissue. Two patients were considering the reconstruction with autogenous tissue after silicon natrium solution bag reconstruction. By the reconstruction of an implant insertion, it was difficult to achieve a good result by one operation. About half of the reconstructed breast was asymmetry. But, nobody hoped for a revision operation or re-implant operation. There patients said they were not afraid of going to a hot spring but two patients said they were hesitant to do so. The Hokushin district is an agricultural area. So, there was no one who wanted to take time off from to undergo a revision operation to preserve a cosmetic appearance. We should advise secondary reconstruction in the Hokushin district.
Solutions ; Neoplasm of uncertain or unknown behavior of skin ; Integumentary system ; Simple mastectomy ; Lower case dee

OBJECTIVETo assess the clinicopathological features of atypical cystic duct (ACD) as a precancerous lesion of the breast.

METHODSWhole mammary gland serial sections were performed on 200 cases of breast cancer without pre-operative biopsy (prior operation, fine needle aspiration or needle biopsy were routinely performed in each case). The clinicopathological findings and immunohistochemical features of ACD were investigated.

RESULTSForty-four (22%) of the 200 breast cancer patients had ACD breast lesions. The frequency of patients with ACD increased in premenopausal women (P=0.001). A number of ACD lesions displayed a histological transition to adjacent ductal carcinoma in-situ. In 16 of 44 (36%) patients with ACD, carcinoma cells stained positive for p53. In 12 of these 16 cases (75%), ACD cells also stained positive for p53 protein (P=0.001). Myoepithelial cells of ACD appeared attenuated and stained strongly for alpha-smooth muscle actin. There was no correlation between the ACD-present group and the ACD-absent group in tumor size, nodal metastasis, and immunostaining patterns of estrogen receptor (ER), progesterone receptor (PR), p53, c-erbB-2 and Ki-67 labeling index of cancerous tissues. All 44 ACD lesions showed a negative staining of c-erbB-2, regardless of the staining result in their corresponding carcinomas. The mean Ki-67 labeling index of ACD lesions was low.

CONCLUSIONSACD is frequently associated with breast cancer. It may represent a precancerous mammary lesion, supported by the frequent histological continuum between ACD and malignancy, and simultaneous p53 over-expression present in both ACD and its corresponding breast carcinoma.

Biomarkers, Tumor ; analysis ; Breast Neoplasms ; chemistry ; pathology ; surgery ; Carcinoma in Situ ; chemistry ; pathology ; surgery ; Carcinoma, Ductal, Breast ; chemistry ; pathology ; surgery ; Female ; Humans ; Precancerous Conditions ; chemistry ; pathology ; surgery ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis