1.Microvascular perfusion characteristics of breast cancer by contrast-enhanced ultrasound and its comparison with pathology
Jinqiu MA ; Yang WANG ; Deshun YAO
Chinese Journal of Postgraduates of Medicine 2023;46(2):172-175
Objective:To study the characteristics of tumor microvascular perfusion by contrast-enhanced ultrasound (CEUS) in patients with breast cancer, and to analyze its relationship with pathology.Methods:The clinical data of 180 breast cancer patients admitted to Tangshan People′s Hospital from February 2019 to March 2021 were retrospectively analyzed. They were examined by contrast-enhanced ultrasound before surgery, and the specimens were sent for pathological biopsy after surgery. The characteristics of tumor microvascular perfusion under CEUS were observed, and the correlation between the characteristics and pathological classification and grade were analyzed.Results:The results of the CEUS showed that the contrast agentrapid infusion was 47.78%(86/180), slowly filled was 60.00%(108/180), the mass showed hyperenhancement when the contrast agent reached its peak was 42.78%(77/180), the contrast agent slowly withdrew was 42.78% (77/180), and the contrast agent retention in clearance was 65.56% (118/180). Pathological biopsy revealed that among 180 patients, 16 patients (8.89%) were non-invasive carcinoma, 41 patients (22.78%) were invasive lobular carcinoma, 88 patients (48.89%) were invasive ductal carcinoma, 10 patients (5.56%) were mucinous adenocarcinoma, 11 patients (6.11%) were medullary carcinoma, 8 patients (4.44%) were squamous carcinoma, 6 patients (3.33%) were hard carcinoma (3.33%). There was no correlation between tumor microvascular perfusion characteristics and pathological classification under CEUS ( P>0.05). Pathological biopsy showed that 95 patients (52.78%) were grade Ⅰ, 49 patients (27.22%) were gradeⅡand 36 patients (20.00%) were grad Ⅲ. There was a certain correlation between tumor microvascular perfusion characteristics and pathological grade under CEUS ( P<0.05). Conclusions:There is a certain relationship between tumor microvascular perfusion characteristics detected by CEUS and pathological grading in patients with breast cancer. Analysis of the microvascular perfusion characteristics can provide an important basis for pathological grading.
2.Significance of endoscopic exposure of circummammary ligament under endoscopy and the effect of membrane anatomy in breast reconstruction
Zihan WANG ; Bin BAI ; Guoqian DING ; Wei XU ; Yang WANG ; Xiaobao YANG ; Shuai ZHENG ; Deshun YAO ; Guoxuan GAO ; Xiang QU
International Journal of Surgery 2022;49(10):694-698,C5
Objective:To explore the significance of exposing the circummammary ligament under endoscopy and the effect of membrane anatomy in breast reconstruction.Methods:The case data of 49 breast cancer patients who underwent endoscopic nipple-sparing mastectomy combined with one-stage breast reconstruction with prosthesis implantation in Beijing Friendship Hospital, Capital Medical University from February 2014 to December 2021 were retrospectively analyzed, there were 44 cases of posterior pectoralis prosthesis implantation, 5 cases of anterior pectoralis prosthesis implantation. The anatomical structure of the circummammary ligament was observed under endoscopy during operation, and the annular mammary ligament was used as an anatomical marker to complete subcutaneous glandectomy and prosthesis implantation for breast reconstruction, the BREAST-Q scales were used to evaluate the postoperative effect.Results:The medial sternal ligament, sub clavicular ligament, lateral confluence ligament and triangular ligament condensation could be clearly exposed in all 49 cases. Breast reconstruction module of BREAST-Q were used to evaluate the surgery effect after breast cancer surgery, the scores of postoperative breast satisfaction, chest wall status, psychosocial status and sexual health status were 81.43±12.57, 88.39±10.61, 88.04±13.70, 74.82±15.93.Conclusion:The endoscopic technique is beneficial to expose the circummammary ligament during operation, and surgical resection and reconstruction can better restore the appearance of the breast and improve postoperative satisfaction according to the principle of membrane anatomy.