Breast ; pathology ; Breast Neoplasms ; blood supply ; pathology ; Carcinoma, Ductal, Breast ; blood supply ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; blood supply ; parasitology ; Female ; Humans ; Hyperplasia ; Microcirculation ; pathology ; Neovascularization, Pathologic ; pathology

OBJECTIVETo study the thymidine phosphorylase (TP) expression in different types of cancer and its correlation with tumor microvessel density (MVD).

METHODSThe expression of TP and MVD was detected by immunohistochemistry method. In a series of 251 cancer patients there were 48 patients with gastric cancer, 53 with colorectal cancer, 47 with breast cancer, 56 with cervical cancer, 47 with lung cancer. Normal gastric (n = 25), colorectal (n = 25), cervical (n = 17) and lung (n = 25) tissues around the cancer were also examined.

RESULTSThe TP expression rate was 64.6% in gastric cancer, 67.9% in colorectal cancer, 80.9% in breast cancer, 82.1% in cervical cancer, and 63.8% in lung cancer, which was significantly higher than that in normal tissues (P = 0.0000). TP expression was positively correlated with MVD in gastric, colorectal, breast, and cervical cancers. The correlation was not statistically significant in lung cancer.

CONCLUSIONThis study indicates that TP overexpression in cancer may be associated with tumor angiogenesis.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; blood supply ; enzymology ; Colorectal Neoplasms ; blood supply ; enzymology ; Female ; Humans ; Male ; Middle Aged ; Neovascularization, Pathologic ; pathology ; Stomach Neoplasms ; blood supply ; enzymology ; Thymidine Phosphorylase ; metabolism ; Uterine Cervical Neoplasms ; blood supply ; enzymology

OBJECTIVETo investigate the blood supply patterns of the anteriorlateral thigh adipofascial flap for clinical applications.

METHODSTo investigate the blood supply patterns of the anteriorlateral thigh (ALT) adipofascial flap, 16 fresh cadavers were anatomically examined by intraarterial injection of colored latex. Three-dimensional analysis of the vasculature of the subcutaneous adipofascial tissue was performed. Sixteen patients underwent microsurgical correction with the ALT adipofascial flap. Among them, there were fifteen with hemifacial atrophy, one with micromastia.

RESULTSThe three-dimensional arterial structures of the ALT adipofascial flap were the same in all the cadaver specimens. Each layer of the adipofascial tissue was supplied by several blood vessels of the axial pattern, especially in the deep layer. Sixteen patients were successfully treated with this flap. The postoperative follow-up ranged from six months to eleven years. There was not postoperative flap necrosis or absorption of the fatty tissue. Stable restoration of the facial contour or the breast was achieved. The donor-site morbidity was minimal.

CONCLUSIONThe blood supply of the ALT adipofascial flap is reliable. A considerable amount of the fatty layer of the flap can be removed primarily. It is a preferable procedure for reconstructing soft tissue defects.

Adipose Tissue ; Adolescent ; Adult ; Breast ; surgery ; Female ; Humans ; Male ; Mammaplasty ; methods ; Surgical Flaps ; blood supply ; Thigh

Deposition of basement membrane extracellular matrix is influenced by adjacent tumor cells, and in some cases, the pattern of type IV collagen deposit is characteristic in malignant tumors. In this report, we analyzed the difference in type IV collagen deposition patterns between benign and malignant phyllodes tumors (PTs) of the breast. Of the 15 cases of PTs, 8 cases were benign PTs and 7 cases were malignant PTs. Three cases of other primary sarcomas of the breast (stromal sarcoma, angiosarcoma and osteosarcoma) and 2 cases of fibroadenomas were studied for comparison. The malignant PTs were distinguished from benign ones by increased mitotic figures, cellular atypism, and a higher proliferation index of stromal cells. Immunohistochemical staining against type IV collagen in malignant PTs revealed extensive to moderate deposition of type IV collagen around the small blood vessels in duplicate or multilayering pattern, while benign PTs showed minimal deposition in a single linear pattern. All of the three cases of other sarcomas revealed multilayering or meshwork pattern of type IV collagen around the blood vessels. The deposition of type IV collagen around the blood vessels may reflect the malignant behavior of the stromal tumors of the breast.
Adult ; Breast Neoplasms/blood supply/*metabolism ; Collagen/*metabolism ; Female ; Humans ; Middle Aged ; Retrospective Studies

On May 14, 2020, a 37 year old female patient with unilateral breast cancer was admitted to Hunan Cancer Hospital. She underwent modified radical mastectomy for right breast cancer and free transplantation of bilateral superficial inferior epigastric artery perforator flap (weighed 305 g) for breast reconstruction. During the operation, the right inferior epigastric vascular pedicle was anastomosed with the proximal end of the right internal mammary vessel, and the left inferior epigastric vascular pedicle was anastomosed with the distal end of the right internal mammary vessel; the blood flow of the flap was good; the wound in the donor site of the abdominal flap was closed directly. The operation lasted for 9 hours. In the first 48 hours post operation, the flap showed mild elevation in perfusion over drainage, but no obvious edema or blister was observed, flap temperature was consistent with the surrounding skin, and the drainage volume out of drainage tube was only 40 mL. The blood supply of the flap was completely restored to normal 3 days post operation, the flap survived well, the donor site incision had no obvious tension, and the healing was smooth. After 2 months of follow-up, the donor site incision of abdomen healed completely, only linear scar was left, and the reconstructed breast had a natural appearance; the patient planned to perform further nipple reconstruction and contralateral breast mastopexy. This case suggests that autologous breast reconstruction can be performed using bilateral superficial inferior epigastric artery perforator flaps under certain circumstances to minimize donor site injury to the greatest extent.
Female ; Humans ; Adult ; Epigastric Arteries/surgery* ; Perforator Flap/blood supply* ; Breast Neoplasms/surgery* ; Mastectomy ; Unilateral Breast Neoplasms/surgery* ; Mammaplasty

OBJECTIVETo clarify the relationship between biologic behavior and morphologic features of invasive micropapillary carcinoma (IMPC) of the breast.

METHODSTwo thousand and eighty-eight cases of clinically defined monocentric breast cancer without pre-operative biopsy (except fine needle aspiration procedure) were examined by whole mammary gland serial sectioning. The clinicopathologic and morphologic features (including microscopic and ultrastructural) of IMPC were analyzed.

RESULTSOne hundred and seventeen cases of IMPC (6.2%, 117/1 880) were diagnosed during the period of study. The incidence of lymphovascular invasion (54.7%, 58/106) and nodal metastases (76.4%, 81/106) was significantly higher in IMPC, as well as the number of metastatic node (on average 9.6) was significantly more in IMPC, as compared with that of the invasive ductal carcinoma. Microscopically, the tumor was characterized by morula-like clusters and small papillae of malignant cells floating within irregular interstitial spaces and separated by fibrous septa. Ultrastructurally, microvilli were observed on the neoplastic cell surface at the periphery of the micropapillae. There were also numerous fine intermediate filaments in the cytoplasm. Newly formed capillaries were noted in the interstitium and some tumor cells were directly in contact with endothelial cells.

CONCLUSIONSA predominant component of IMPC in breast carcinoma is associated with a higher risk of lymphovascular invasion and nodal metastasis. The aggressive behavior of IMPC can be attributed to the proliferative activity of the tumor cells, and its associated angiogenesis.

Adult ; Aged ; Breast Neoplasms ; blood supply ; pathology ; ultrastructure ; Carcinoma, Papillary ; blood supply ; pathology ; ultrastructure ; Female ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Invasiveness

OBJECTIVETo investigate the relation between angiogensis, fibrinolysis and invasion/metastasis in breast cancer.

METHODSThe expression of urokinase-type plasminogen activator (uPA) and microvascular density (MVD) was immunohistochemically studied in 110 patients with primary breast cancer.

RESULTSHigh uPA expression was found in 59 patients (53.6%), and weak expression in 51 patients (46.4%). Strong MVD expression was found in 53 patients (48.2%), and weak expression in 57 patients (51.8%). The correlation between uPA expression and tumor size, lymph node status, TNM stage was statistically significant. Expression of MVD was also significantly associated with tumor size and TNM stage. Neither age related to GDDP, menopausal status nor PR ER status was significantly with uPA and MVD expression. Patients with strong expression of uPA and/or MVD had a significantly shorter relapse-free survival than those with weak expression of uPA and/or MVD. Especially, patients with strong expression of both uPA and MVD were likely to develop recurrence and metastasis. Multivariate analysis showed that uPA and MVD were two independent prognostic factors affecting the relapse-free survival.

CONCLUSIONAngiogensis and fibrinolysis were closely associated with invasion and metastasis of breast cancer. uPA and MVD may be two strong and independent biologic markers in predicting postoperative relapse and metastasis of breast cancer.

Adult ; Aged ; Breast Neoplasms ; blood ; blood supply ; pathology ; Female ; Fibrinolysis ; physiology ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Invasiveness ; Neovascularization, Pathologic

OBJECTIVETo explore the differences between the angioarchitecture, hemodynamics, ultrastructure of neovasculr endothelial cells, and vascular distribution in different perfusion regions in benign and malignant breast tumors.

METHODS30 cases of breast carcinoma (33 lesions) and 30 cases of breast fibroadenoma (34 lesions) were examined by contrast enhanced microvascular imaging (MVI), and perfusion indexes were collected both inside and at the margin of each focus according to time-intensity quantitative analysis, including peak intensity (PI), area under the curve (AUC), time to peak (TTP) and wash-out time (WOT). The ultrastructure of neovascular endothelial cells was examined by transmission electron microscopy. The expression of CD34, VEGF, Flk-1/KDR in both two groups were detected by immuhistochemistry.

RESULTSSignificant differences were found between the two groups characterized with filling defect, vascular distortion, dilatation and uneven enhancement. Most of the curves of malignant group (87.9%, 29/33) ascended rapidly and dropped slowly while those of the benign group (79.4%, 27/34) ascended slowly and dropped rapidly. The AUC and WOT of malignant tumor group were significantly higher than those of benign group, while the PI and TTP had statistically no significant difference. In the malignant tumor group, PI, AUC and WOT collected from the margin of foci were significantly different from those collected inside the foci, however, there was no significant difference in the benign group. The margin of foci was characterized with dilated and distorted vessels, and the center of the foci was occupied by narrow or occluded blood vessels, sometimes with contracted endothelial cells and pericytes. Abundant microvascular areas located at the margin of foci. The ultrastructure of endothelial cells in the newly formed blood vessels of malignant group showed strong ability to divide, which was different from normal endothelium cells.

CONCLUSIONThe perfusion pattern, mode of time-intensity curve, mean perfusion parameter and variation of regional perfusion parameters provide a valuable diagnostic basis in distinguishing benign and malignant breast tumors. The density, morphology, distribution, structure and function of newly formed microvessels in tumor foci are also crucial factors when tumors are assessed by imaging examination.

Antigens, CD34 ; metabolism ; Area Under Curve ; Breast Neoplasms ; blood supply ; diagnostic imaging ; pathology ; ultrastructure ; Carcinoma in Situ ; blood supply ; diagnostic imaging ; pathology ; ultrastructure ; Carcinoma, Ductal, Breast ; blood supply ; diagnostic imaging ; pathology ; ultrastructure ; Contrast Media ; Female ; Fibroadenoma ; blood supply ; diagnostic imaging ; pathology ; ultrastructure ; Hemodynamics ; Humans ; Microscopy, Electron, Transmission ; Microvessels ; diagnostic imaging ; pathology ; ultrastructure ; Neovascularization, Pathologic ; diagnostic imaging ; pathology ; Radiography

OBJECTIVETo investigate the relationship between serum VEGF (sVEGF) level and VEGF, COX-2 and MVD expression in breast cancer, and to discuss their role in angiogensis of breast cancer.

METHODSsVEGF level was detected by ELISA in 68 preoperative breast cancer, 35 benign breast disease and 20 healthy women. The expression of VEGF, COX-2 and MVD was detected by immunohistochemical method in tissues of breast cancer and breast benign diseases, and to analyze the relationship of sVEGF, VEGF, COX-2 and MVD.

RESULTS(1) sVEGF level in preoperative breast cancers was 306.51 pg/ml (interquartile range from 190.44 to 442.04 pg/ml), in benign diseases was 150.82 pg/ml (interquartile range from 82.36 to 212.34 pg/ml), and in healthy control was 105.93 pg/ml (interquartile range from 78.54 to 157.77 pg/ml). The sVEGF level of preoperative breast cancer group was significantly higher than that of breast benign disease group and healthy women (P = 0.001). (2) The VEGF expression positive rate in breast cancer (67.65%) was significantly higher than that in breast benign disease (44.12%) (P = 0.015). The COX-2 expression positive rate in breast cancer (42.86%) was significantly higher than that in breast benign disease (11.43%) (P = 0.002). (3) the COX-2 expression positive rate in sVEGF high level patients (56.00%) was significantly higher than that in sVEGF normal level patients (11.11%) (P = 0.024), and MVD in sVEGF high level patients (27.32 +/- 3.40) was also higher than that in sVEGF normal level patients (15.31 +/- 6.16) (P = 0.011). (4) The sVEGF level (322.09 +/- 79.31) of 68 breast cancer patients whose VEGF was positive in breast cancer tissues was significantly higher than that in VEGF negative group (222.47 +/- 73.53) (P = 0.017). (5) The COX-2 expression positive rate in VEGF positive expression group (65.21%) was significantly higher than that in VEGF negative expression group (18.18%) (P = 0.017). The MVD expression in COX-2 positive expression group (22.94 +/- 5.51) was significantly higher than that in COX-2 negative expression group (10.30 +/- 4.42) (P = 0.027).

CONCLUSIONsVEGF level in breast cancer is significantly higher than that in breast benign disease and healthy women, and is correlated with the expression of COX-2 and MVD in breast cancer tissues.

Adult ; Aged ; Antigens, CD34 ; metabolism ; Breast Neoplasms ; blood ; blood supply ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; blood ; blood supply ; metabolism ; pathology ; Cyclooxygenase 2 ; metabolism ; Female ; Fibroadenoma ; blood ; blood supply ; metabolism ; Humans ; Lymphatic Metastasis ; Microvessels ; pathology ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; Prognosis ; Vascular Endothelial Growth Factor A ; blood ; metabolism

OBJECTIVETo investigate the differences in the expression of angiogenesis-related molecules between benign and malignant breast neoplasms.

METHODSThirty breast cancer patients (33 foci) and 30 with benign breast neoplasms (34 foci) were examined for CD34, vascular endothelial growth factor (VEGF) and Flk-1/KDR expressions using immunohistochemistry.

RESULTSIn patients with breast cancer, the microvessels densely distributed around the cancer nest. The microvessel density (MVD) in the cancer patients was significantly higher than that in patients with benign tumors (34.48+/-8.34 vs 18.65+/-4.69, P<0.05). In the breast cancer patients, strong VEGF expression was found in the epithelial cells and vascular endothelial cells around the breast carcinoma, and Flk-1/KDR was also strongly expressed in the vascular endothelial cells. The expressions of VEGF and Flk-1/KDR were hardly detectable in the benign tumors.

CONCLUSIONVEGF is an important regulatory factor in promoting breast tumor angiogenesis.

Breast Neoplasms ; blood supply ; metabolism ; Carcinoma, Ductal, Breast ; blood supply ; metabolism ; Female ; Humans ; Neovascularization, Pathologic ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism