Compared with initial treatment of primary breast cancer, more uncertainties exist regarding to the prognosis and salvage therapy of local-regional recurrent breast cancer. This article summarized the pattern of recurrence after breast conservative therapy and mastectomy respectively. Comprehensive local treatment comprising re-excision and entire-ifeld radiotherapy are the mainstay of multi-disciplinary treatment. Optimized local treatment is efifcient not only in local disease control but also in preventing subsequent recurrence. Although past data did not fully justify the role of systemic treatment in local-regional recurrent patients, the result of CALOR trial, which was initiated by several international breast cancer co-operative groups has conifrmed that based on individualized endocrine and targeted therapy, salvage surgery plus radiotherapy followed by systemic chemotherapy improved the disease-free survival and overall survival compared to surgery+radiotherapy alone, especially in estrogen receptor negative patients.Thus, systemic treatment based on biomarkers from primary as well as recurrent disease will become an integrated part in the therapeutic strategy of local-regional recurrent breast cancer.

Objective To evaluate the clinical performance of flow cytometry (FCM ) in diagnosis of non-hodgkin′s lymphoma (NHL) .Methods Pathological examination ,immunohistochemical staining and FCM were adopted to detect the 32 patients with NHL and 30 patients with non-NHL .Results In 32 patients with NHL ,the diagnostic sensitivities of pathological examination ,im-munohistochemistry and FCM were 78 .1% ,46 .9% and 84 .4% ,respectively .In 30 patients with non-NHL ,the diagnostic specifici-ties of pathological examination ,immunohistochemical staining and FCM were 100 .0% ,80 .0% and 83 .3% ,respectively .Conclusion FCM improves diagnostic accuracy of lymphoma in lymph node biopsy samples .

Radiation therapy plays an important role in the multidisciplinary treatment of early stage breast cancer. While breast conservative treatment has become an established strategy, recent clinical investigations focus mainly on the possibility of modification to the standard practice, including the significance of tumor bed boost after whole breast irradiation, the criteria for low-risk patients not to receive adjuvant radiotherapy after breast conservative surgery and the feasibility of partial breast irradiation. Post-mastectomy radiotherapy to the chest wall and regional lymph nodes in high-risk patients has been proved to reduce the local-regional recurrence by 2/3. However, only a few trials support the improvement of survival, and significant controversy exists concerning the role of post-mastectomy radiotherapy in intermediate-risk patients. Current review summarizes the advances and controversies stated above for the treatment of early stage breast cancer.

The increasing need for ideal body shape makes more and more patients choose to receive different types of breast reconstruction surgery after mastectomy. Right now, it is a key problem for the multidisciplinary treatment to find an optimal sequence of comprehensive treatment from which those patients can receive the maximum benefits and a good balance between ideal body shape and satisfactory antitumor outcomes. This paper reviews the latest research advances in the effect of postoperative radiotherapy on breast shape after breast reconstruction, the sequential relationship between the replacement of the temporary tissue expander with the permanent breast prosthesis and postoperative radiotherapy, breast construction surgery, and radiotherapy techniques. To provide a basis for clinical practice, this paper proposes a flow chart for decision?making in reconstruction surgery and adjuvant treatment based on the current literature and clinical data.

2 years, no involvement of regional lymph nodes and the recurrence presented as a single nodule.

Objective To investigate the application of improved ABCD2 scoring for predicting the onset of cerebral infarction within 7 days after transient ischemic attack (TIA).Methods A total of 133 patients with TIA adnitted from July 2014 to December 2015 were enrolled in this study.The ABCD2 scoring and ABCD2 combined with carotid ultrasound (CU) scoring were used to predict the risk of cerebral infarction occurred within 7 days after TIA.The univariate analysis and multivariate logistic regression analysis were performed to estimate the contribution of clinical risk factors to triggering the cerebral infarction within 7 days after TIA.Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of two different kinds of scoring process in early cerebral infarction after TIA.Results Of 133 patients with TIA,35 (26.3％) suffered from cerebral infarction within 7 days after TIA.Univariate analysis showed cerebral infarction occurred within 7days after TIA was closely associated with BP≥ 140/90 mmHg,unilateral weakness,speech impairment,TIA duration ≥ 10 minutes,past history of hypertension,diabetes mellitus,carotid plaque,and carotid stenosis.Multivariate logistic regression analysis showed that unilateral weakness (OR =3.52,95％ CI:1.76-12.34),TIA duration ≥ 10 minutes (OR =2.45,95％ CI:1.06-9.27),diabetes mellitus (OR =3.37,95％ CI:1.27-10.94),past history of hypertension (OR =4.15,95％ CI:1.71-13.34),carotid plaque (OR =6.32,95％ CI:2.46-19.40),and carotid stenosis (OR =12.73,95％ CI:2.67-44.35) were significantly correlated with early onset of cerebral infarction after TIA (all P ＜ 0.05).The ROC analysis revealed the ABCD2-CU scoring (AUC =0.802,95％ CI:0.717-0.888,P =0.000) had a larger area under curve compared to ABCD2 scoring (AUC =0.614,95％ CI:0.511-0.717,P =0.036).Conclusions The ABCD2-CU scoring was more accurate in predicting the imminent risk of cerebral infarction in the patients with TIA compared to ABCD2 scoring.And ABCD2 scoring combined with carotid ultrasound could improve the accuracy for predicting the risk of cerebral infarction occurred within 7 days after TIA.

The effect of stress with electric tail-shock on interleukin-1 (IL-1) production by peritoneal exudate jnacrophages of C57 BL/6 mice was studied. The results showed that IL-1 level was decreased to 63.7?5.5%, 59.2?4.8%, and 61.2?3.8% of that of control 6 h, 12h, and 20h after stress, respectively (P

Purpose:To investigate the prognostic factors f or local-regional control and survival in patients with regional lymph nodes re currence following mastectomy. Methods:Seventy-seven patients with their first recurrences in the regional lymph nodes treated during 1994-2003 were retrospectively analyze d. The recurrence were confined to supraclavicular region in 45 patients, in axi llary nodes in 16 patients, in internal mammary nodes in 6 patients, and with mo re than one lymph node region involved in 10 patients. The median follow-up was 34.4months. All patients were treated with radiotherapy to a total dose ranged from 50-74 Gy with a median dose of 60 Gy. Results:The median survival time was 4.67 years with 2-,5-an d 8- year survival rate of 77.8%,47.4% and 31.5% respectively. Disease-free i nterval, hormonal-receptor status were independent prognostic factors for survi val. Thirty patients had a second recurrence either in the original recurrent si te (4 patients) or in the other local-regional sites (26 patients). Chest-wall was the most frequently involved site for second recurrence, with 18 patients h ad a second recurrence including chest-wall, representing 23% of the whole coho rt. The axillary lymph nodes metastatic status of primary surgery was the only i ndependent prognostic factor for local control. Conclusions:Radiotherapy provides an efficient treatment for re gional lymph nodes recurrence following mastectomy. Twenty-three percent of pat ients present a second recurrence involving chest-wall, which suggests the sign ificance of an elective radiation to the chest-wall, especially in patients wit h 4 or more lymph nodes involved in primary surgery. Sub-group with a disease- free interval of more than 2 years, receptor positive has a better survival. The role of systemic treatment in the regional lymph nodes recurrent patients has n ot been established.

With the widespread adoption of screening mammography, the incidence of ductal carcinoma in situ (DCIS) has been dramatically increased. The spectrum of local treatment advances from mastectomy to breast conservation surgery plus whole breast irradiation (WBI), and hypofractionated WBI or accelerated partial breast irradiation. Although the efficacy of WBI on reducing local recurrence is clear, such benefit in the low-risk DCIS is still controversial. Further studies are required to establish a more precise local recurrence risk stratification system for better tailoring local treatment in patients with DCIS. In this review, the latest advances and controversies in surgery, radiation therapy and local recurrence risk stratification system for patients with DCIS were summarized.

As a milestone in the development of personalized comprehensive treatment for breast cancer, molecular subtype classification quantitatively characterizes breast cancer as heterogeneous diseases rather than a single disease in terms of onset risk, natural course, and treatment response. The significance of molecular subtype classification has been widely confirmed in prediction of the efficacy of systemic treatment and prognosis of systemic metastases and risk of death. However, the association between molecular subtype and local?regional recurrence ( LRR) risk as well as the impact of molecular subtype classification on radiotherapy strategy still needs more attention. This review discusses the association between molecular subtype and LRR risk as well as the significance of molecular subtype classification in guiding radiotherapy strategy.