The technique of nipple-areola complex (NAC)-sparing mastectomy (NSM) facilitates the breast reconstruction due to preserving the skin and NAC of breast in the treatment of breast cancer. Key issues still remain controversial in NSM, in terms of the role of radiotherapy combined with NSM and sequence of radiotherapy and NSM, which arise from the consideration of the oncology safety. Some investigations addressed that post-NSM external beam irradiation and intra-operative radiotherapy (IORT) combined with NSM could reduce the local recurrence rate. Based on the appropriate patient selection and good quality of surgery, radiotherapy would be applied in different strategies of combination with NSM according to the risk of local recurrence of the cancer.

Immunity is the basic defense barrier for body, and also closely related to the development, progression, treatment and prognosis of breast cancer. Adjuvant radiotherapy plays an important role in the multidisciplinary treatment of breast cancer. It has long been believed that radiotherapy was immunosuppressive because it could destroy the body’s immune cells directly. While recent studies have shown that radiotherapy can stimulate the host immune system in the antitumor process, including antigen processing, presentation, recognition, and eventually tumor-cell killing. In the clinical aspect, a variety of immune targeted therapies, combined with radiotherapy, have entered clinical trials. The article reviewed research progress and status of the inlfuence of breast cancer adjuvant radiotherapy on antitumor immunity.

The liver is one of the most common metastatic sites in patients with breast cancer. Systemic therapy is the standard treatment for breast cancer with liver metastasis, but the results are far from satisfaction. A distinctive subset of metastatic breast cancer is oligometastatic disease. Local therapy including metastasectomy, radiofrequency ablation and radiation therapy combined with systemic therapy can provide survival beneift. This review introduced the latest research results of local therapy in liver oligometastases of breast cancer.

Radiotherapy plays an important role in breast cancer management after mastectomy, breast reconstruction was much more accepted by patients after mastectomy. The impact of radiotherapy on breast reconstruction are commonly concerns by radiation oncologist, breast surgeon and plastic surgeon. This article reviewed the timing and method of reconstruction in patents who underwent breast reconstruction after mastectomy,and the negative impact of radiotherapy on cosmetic result. We also analysed the impact of reconstruction on radiation design and the most appropriate timing and method of reconstruction in different settings of radiotherapy.

Radiation therapy (RT) plays an important role in the multimodality management of patients with breast cancer. Traditional RT techniques increase risk of death from cardiovascular diseases. With the development of new techniques, cardiac injury after RT has already been reduced. This article summarizes the studies on reducing cardiac injury by the development of RT techniques, as well as analyzes of risk factors for cardiac injury.Possible causes will also be discussed.

Sentinel lymph node biopsy has been the standard axillary intervention for breast cancer patients with clinical negative axillary lymph nodes.Complete axillary dissection could be omitted for patients with negative sentinel lymph nodes.While, the optimal axillary intervention for patients with 1-2 positive sentinel lymph nodes remained controversial.This review introduced the latest research results of the axillary management for early stage breast cancer patients with 1-2 positive sentinel lymph nodes.

Bone remains the predominant site of metastasis in advanced breast cancer. Bone metastases dramatically decrease the quality of life. Moreover, pathologic fractures and other skeletal-related events (SREs) caused by bone metastases could result in higher mortality risk in patients with breast cancer. Palliative radiotherapy is a crucial element in bone metastases treatment. The present review discusses the emerging evidence in bone metastases of breast cancer, focusing on optimized radiotherapy strategies and multidisciplinary management.

Purpose:To obtain the optimum irradiation technique in different plans of conventional radiotherapy(2DRT)and conformal radiotherapy(3DCRT)and between different conformal radiotherapy techniques for esophageal carcinoma as compared by 3D-TPS.Methods:10 patients with esophageal carcinoma were enrolled in this study.The conventional treatment plan and four conformal technique plans were created for each patient.Plan 1 was the same as the 2DRT,plan 2 consisted of anterior and two posterior oblique fields,plan 3 consisted of posterior and two anterior oblique fields,plan 4 consisted of 2 dynamic arc fields.Different plans were compared using DVH.Results:①On average,PTV of 2DRT was the same as that of 3DCRT in DVH.The difference in maximum dose to spinal cord was obvious.The left lung dose in D_(mean)?D_(min)?V_(30) in 2DRT was significantly increased as compared to 3DCRT(P

Neoadjuvant chemotherapy combined with surgery and/or radiotherapy is the common method in treating locally advanced breast cancer.This article reviewed the progress on the rationales for neoadjuvant chemotherapy,regimens and courses of chemotherapy,the factors relative to the outcome of the treatment and prognoses,advantage and disadvantage of neoadjuvant chemotherapy.The progress in diagnosis,surgery,radiotherapy and endocrine therapy for locally advanced breast cancer are also summarized.

OBJECTIVE To investigate current status of ventilator-associated pneumonia(VAP) and to provide prevention measures associated with nursing.METHODS Clinical data,such as incidence,categories of pathogenic bacteria and prevention measures associated with nursing,were retrospectively analyzed in 106 patients who received ventilator treatment in our hospital during 2004-2006.RESULTS The positive rate of microorganism culture in these patients was 95.3%.Totally 178 strains of microorganisms were cultured,including 63 strains of fungi,48 strains of nonfermanters,34 strains of Staphylococcus,33 strains of Enterobacteriaceae.There were many risk factors contributed to pathogenesis of VAP.Among these factors,underlying disease was one of the important internal causes and invasive medical procedure was one of the important external causes.The incidence of VAP was reducing yearly as improving of prevention measures associated with nursing.CONCLUSIONS Nurse acts an important role in prevention of VAP.Enhancing nursing management,improving nursing procedure and adopting appropriate intensive care measurement will reduce incidence of VAP.