Purpose:To explore the possibility of non-sent inel lymph node (NSN) metastases in early breast carcinoma patients with positi ve sentinel lymph node (SLN) and its clinical significance. Methods:The incidence and related clinical factors of NSN metas tases were analyzed in 84 early breast carcinoma patients with positive sentinel lymph node, who underwent radical mastectomy. Results:The metastatic NSN was identified in 41 of the 84 pati ents with positive sentinel lymph node (48.8%), the incidence of NSN metastases was related to primary tumor size, SLN metastatic focus size and HER-2 expressi on status, the incidence rate of NSN metastases is proportional to the size of t he primary tumor and metastatic SLN focus, patients with positive HER-2 expres sion have a high NSN metastases rate. Conclusions:The early breast carcinoma patients with

Objective To investigate the combining anticancer effect of tamoxifen(TAM) and ?-interferon on breast cancer cells in vitro and its mechanism.Methods MCF-7 ER-positive breast cancer cell lines were treated with tamoxifen alone,or in combination with ?-interferon and/or estrogen in vitro.Cell proliferation was evaluated by MTT assay;FCM was used to determine the distribution of cell cycle,cell apoptosis and protein expression of Bcl-2,Bax,Fas,FasL,Caspase-8,and the activity of Caspase-3.Results TAM inhibited the proliferation of ER-postive breast cancer cells with cell cycle arrest in G0/G1 phase and with induction of apoptosis,and the proliferation-promoting effect of estrogen on MCF-7 was blocked by TAM.Anticancer effect of TAM was enhanced when cells were pretreated with ?-interferon for 24 hours.Bcl-2 protein expression was down-regulated and Caspase-8 was up-regulated by TAM and/or ?-interferon,but these drugs did not affect Bax,Fas,FasL protein expression and the activity of Caspase-3.Conclusions TAM has anticancer effect by inhibiting proliferation and inducing apoptosis in ER-positive breast cancer cells in vitro,and ?-interferon can enhance anticancer effect of TAM on breast cancer cells.The mechanism of these effects may be related with the down-regulation of Bcl-2 expression and up-regulation of Caspase-8 by TAM and ?-interferon.

Objective: To investigate the enhancing effect of ?-interferon on anticancer effect of tamoxifen against breast cancer cells in vitro. Methods: ER-positive MCF-7 and ER-negative MDA-MB-231 breast cancer cell lines were treated with tamoxifen alone, or in combination with ?-interferon or estrogen in vitro. Cell proliferation was evaluated by MTT assay; distribution of cell cycle was determined by flow cytometry( FCM) and cell apoptosis was determined by DNA gel electrophoresis and FCM. Results: Tamoxifen inhibited the growth of ER-negtive and-positive brest cancer cells, induced G0/G1 phase arrest and induced cell apoptosis. Tamoxifen at same concentration had stronger inhibitory effect on ER-positive cells than ER-negative ones. Promoting effect of estrogen on MCF-7 growth was blocked by TAM, but inhibition of MDA-MB-231 by TAM was not related to estrogen. Anticancer effect of TAM was enhanced when cells were pre-treated with ?-interferon for 24 h. Conclusion: TAM exerts its anti-cancer effect through inhibiting proliferation and inducing apoptosis of ER-positive/negative breast cancer cells in vitro, and ?-interferon can enhance this manticancer effect of TAM on breast cancer cells.

Objective To explore the role of Bcl-2 and Caspase-3 in modulating apoptosis of ER-negative breast cancer cells induced by tamoxifen. Methods ER-negative breast cancer cell lines MDA-MB-231 were treated with 10.0?M tamoxifen for 12, 24, 36,48, 60 hours. The rate of cell apoptosis with or without caspase-3 inhibitor Ac-DEVD-CHO, and protein expression of Bcl-2,Bax were determined by flow cytometry, and the activity of Caspase-3 was examined with fluorophotometry. Results The expression of Bcl-2 was down-regulated, the activity of Caspase-3 and the rate of cell apoptosis were increased by TAM time-dependently, and the rate of apoptosis reached its peak at 48 hours. The expression of Bcl-2 was (negatively) correlated with activity of caspase-3. Tamoxifen, however, did not affect Bax protein expression. Ac-DEVD-CHO, a caspase-3 inhibitor, blocked the activation of caspase-3 and inhibited cell apoptosis (induced) by tamoxifen. Conclusions TAM could induce apoptosis in ER-negative breast cancer cells via (mitochondria) pathway by down-regulating Bcl-2 expression, and the activation of Caspase-3 might play an (important) role in the process of tamoxifen-induced apoptosis of ER-negative breast cancer cells.

Objective To study the arterial blood supply of nipple-areola and provide the anatomical basis for avoiding nipple-areola necrosis in breast operation. Methods The vascular structure of nipple-areola of 26 female breasts in 13 cadavers were studied. Results The nipple-areola mainly accepted arterial blood supply from branches of the lateral thoracic artery and the internal thoracic artery. The 2nd~4th intercostal ~perforating branches of the internal thoracic artery and branches of the lateral thoracic artery reach the base of nipple-areola from a superior,medial and upper lateral direction by passing between lobules of mammary gland, then ascend between the lacteal ducts to supply the nipple-areola; the perforators of the lateral thoracic artery and the superticial breast perforators of internal thoracic artery, formed extensive anastomoses ~subcutaneously , and particulatly under areola formed arterial rete, from which branches were given out to ~nipple-areola . The intercostal perforators and thoracoacromial perforators did not supply the nipple-areola. Conclusions When nipple-sparing mastectomy is performed, in order to avoid nipple-areola necrosis,it is necessary to protect the arterial rete under the areola, and thus, the thickness of areolar skin flap should not be less than 0.5cm; to ensure the blood supply of nipple-areola from the internal thoracic artery and the ~lateral thoracic artery in breast reduction, the superior-medial or superior-lateral breast pedicle should be used and the thickness of preserved posterior breast should not be less than 1.5cm.

Objective To investigate the value of clinical application of mammotome under ultrasonic guidance for minimal excision and biopsy of breast tumor.Methods Excision and biopsy of 152 breast masses from 115 patients were performed using mammatome under ultrasonic guidance,and the patients were followed up.Results Total resection of 152 breast tumors were accurately performed by mammotome vacuum device and biopsy was performed.On pathological examination,86 cases were fibroadenoma,34 cases were adenosis,2 cases were fat necrosis,3 cases were gynecomastia,1 case was ductal inflammatory change and 26 cases were breast cancer.Postoperatively,hematoma was found in 3 cases,subcutaneous ecchymosis in 4 cases and skin injury in one case.All cases were followed up for a period of time and no residual or recurrent masses were found.Conclusions Mammotome vacuum system is an exact,effective and safe method.It is an ideal minimally invasive operation in treating benign breast masses with few complications.It can also be applied to biopsy for breast cancer before operation.

Objective To analyze the clinicopathologic characterizations and patients prognosis of basal-like breast cancer. Methods The clinicopathologic eharacterizations,patient 5 year disease-free survival rate and overall survival rate of 25 basal-like breast cancer patients were compared with 34 CerbB2 overexpressing subtype and 37 ER positive subtype breast cancer patients admitted in our hospital in the same period. Results Patients of basal-like breast cancer accounted for 15.7% of all patients admitted.Compared with CerbB2 over-expressing subtype(29.4%)and ER positive subtype(35.1%),basal-like breast cancer patients were eider with 56.0% being≥50 years old(P＜0.05).Basal-like subtype breast cancer was larger in tumor size than ER positive subtype(P＜0.05),56% of basal-like subtype were of poor-differentiated grade pathologically compared with 18% in CerbB2 overexpression type and 16% in ER positive subtype respectively. Meanwhile, axillary lymph node metastasis was hishbar in CerbB2 overexpressing and ER positive subtype(64.7%,64.9%)than that of basal-like subtype(40.0%).Most visceral metastases were found in basal-like and CerbB2 subtype,but there were more local lymph node and bone metastases in ER positive subtype.Five year overall survoval rate of CerbB2 overexpressing subtype (48.5%)and basal-like subtype breast cancer patients(44.1%)were poorer than that of ER positive subtype(83.8%).respectively;However,there was no difference in 5 year disease-free surviVal rate between the three subtypes(42.7%,40.4%,58.3%,respectively).Conclusions Similar to CerbB2 over-expressing subtype.tlle clinicopathologic characterization and prognosis in basal-like breast cancer are poorer than that in ER positive subtype.

ObjectiveTo explore the influencing factors in neoadjuvant chemotherapy on pathological complete response (pCR),by analyzing the effect of 6 cycles epirubicine combined with docetaxel(ET) regimen in breast cancer patients. MethodsFrom June 2009 to September 2011,clinical date of 52 Ⅱ,Ⅲ stage breast cancer patients treated with ET regimen for neoadjuvant chemotherapy for 6 cycles were retrospectively analyzed.The curative effect was evaluated by palpation and ultrasonography,and finally compared with postoperative pathological results. ResultsIn these 52 patients,the total pCR rate was 42.3％ after 6 cycles chemotherapy.After the first circle of chemotherapy,pCR rate was higher in patients with tumor size reducing ＞ 30％ than those ＜ 30％ as measured by ultrasonography(60.9％ vs.27.6％,P ＜0.05 ).Higher pCR rate was obtained in patients with tumor size ≤3 cm than those in which the initial tumor size ＞ 3 cm(52.9％ vs.22.2％,P ＜0.05) after 6 cycles ET neoadjuvant chemotherapy.PCR rate was higher in patients with positive HER-2 or triple negative breast cancer after 6 cycles than those with luminal type 1breast cancer ( 77.8％,75.0％ and 25.7％,respectively,P ＜ 0.05 ).Logistic regression analysis showed that tumor size and its early response to neoadjuvant chemotherapy evaluated by ultrasonography were the significant predictive factors. ConclusionsHigher pCR rate can be achieved after 6 cycles ET regimen neoadjuvant chemotherapy in stage ]Ⅱ,Ⅲ breast cancer patients.Tumor's early response to chemotherapy as evaluated by ultrasonography could forecast the pCR.Tumor size and molecular type are important influencing factors on pCR in breast cancer patients.

ObjectiveTo investigate the distribution of thethymidylate synthase (TS) gene polymorphisms inChinese femaleHan-nationality breast cancer patients,including tandemrepeat polymorphisms in the enhancer region ( ER), 6 bp deletion/insertion (del6/ins6) polymorphism in the 3′untranslated region (3′-UTR) and G→C single-nucleotide polymorphism (SNP). The association of TS gene polymorphism with pathological results was retrospectively analyzed.MethodsThis study included 83 breast cancer patients who received no preoperative chemotherapy. The polymorphisms of TS, ER and TS 3′2UTR were determined by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method.Results ( 1 ) Of the 83 patients, the frequencies of the TSER 3R/3 R, 2R/3 R and 2R/2R were 68.7％ ,27. 7％ and 3. 6％, respectively; (2) Due to existence of the G→C single nucleotide polymorphism,TSER genotypes were divided into 2R/2R, 2R/3C, 2R/3G, 3G/3G,3C/3C and 3G/3C,their frequencies were 3. 6％, 19. 3％, 8.4％, 19. 3％, 37. 3％ and 12. 1％, respectively; ( 3 ) Of the 83 patients, the frequencies of the TS 3′-UTR ins6/ias6、ins6/del6 and del6/del6 were 8.4％ 、50.6％ and 41.0％, respectively; (4) TSER polymorphisms were correlated with lymph node metastasis ( P = 0.019 ),Ki67 ( P = 0.022 ) and histological grade ( P = 0.042 ). The TS 3′-UTR polymorphisms were correlated with age ( P = 0.002) and histological grade (P = 0.042). G→C SNP were correlated with lymph node metastasis ( P = 0.021 ) and histological grade ( P = 0.028 ).ConclusionsChinese female Han-nationality breast cancer patients have more genotypes frequencies of the TSER 3R/3R and 3′-UTR del6/del6; The TS polymorphisms are correlated with pathological factors of breast cancer.

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (＜ 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3％ vs.42.7％,P ＜ 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9％ vs.61.7％,P ＜0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4％ vs.4.2％,P ＜ 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.