Expression of cytokeratin19(CK19)mRNA was detected by reverse transcription-PCR in bone marrow and integrin α_vβ_3 was detected by immunohistochemistry(IHC streptavidin-biotinperoxidase SP)in breast tissue from 62 breast cancer patients with negative axillary lymph nodes.Out of 62 patients 15cases(24%)presented positive CK19,in which all had positive integrin α_vβ_3;36 cases(58%)presented positive integrinα_vβ_3.Two markers were positively correlated with each other(kappa=0.6839,P＜0.05),and correlated with the size of tumor(P＜0.01).The results indicate that combined detection of CK19 in bone marrow and integrin α_vβ_3 in cancer tissues may be helpful for guiding therapy and estimating prognosis in breast cancer patients with negative axillary lymph nodes.

Objective To study the value of serum tartrate-resistant acid phosphatase 5b (TRACP5b) in bone metastasis in early breast cancer patients with negative axillary lymph nodes.Methods The serum level of TRACP5b was determined by enzyme-linked immumosorbent assay (ELISA) in 26 breast cancer patients and 18 healthy female adults.Results The serum level of TRACP5b was (3.85 ± 0.85) U/L in the group of breast cancer patients and (2.08 ± 0.84) U/L in the control group.The difference had statistical significance (P ＜0.05 ).The sensitivity was 42.31％ and the specificity was 94.44％ for TRACP5 b in predicting bone metastasis of breast cancer with negtive axillary lymph nodes.Conclusions TRACP5b has higher sensitivity and specificity in breast cancer patients than in healthy female adults.TRACP5b is a useful serum marker to predict bone metastasis in breast cancer patients.

Clinical data of 85 patients with breast abscess during lactation treated in our hospital from January 2014 to October 2017 were retrospectively analyzed.Among 85 cases,30 patients received traditional abscess incision drainage,35 received needle aspiration,and 20 received negative pressure drainage with small incision.The pus culture findings,average hospitalization expenses,average treatment time,pain score,postoperative breast appearance were evaluated.The pus culture found 24 cases of staphylococcus aureus infection in 85 cases (28％),including 40 cases of Methicillin resistant Staphylococcus aureus (47％).The proportion of central abscess (14/20) in patients with small incision drainage was significantly higher than that of patients with needle aspiration treatment (4/35) (P＜0.05).The average hospitalization expense of the puncture group was significantly lower than that of other two groups (P＜0.01).The average treatment time of abscess incision drainage group was significantly higher than that of other two groups (P＜0.01),and the recovery time was all longer 1 month.The score of pain in the abscess incision drainage group was significantly higher than that in other two groups (P＜0.01),and all patients had moderate to severe pain.The breast shape satisfaction of abscess incision drainage group was significantly lower than that of other two groups (P＜0.01).The analysis indicates that treatment of breast abscess during lactation with needle aspiration and negative pressure drainage has short treatment time,no scars and less pain;and it is suggested that central abscess may be treated early with negative pressure drainage.

OBJECTIVE To estimate the cost-utility of sacituzumab govitecan （SG） versus single-agent chemotherapy in the treatment of hormone receptor-positive （HR+）/human epidermal growth factor receptor 2-negative （HER2－） advanced metastatic breast cancer. METHODS From the perspective of the Chinese medical system， a three-state partitioned survival model was constructed to examine the cost-utility of SG versus single-agent chemotherapy based on TROPiCS-02 trial. The cycle length was set to 1 month， and the time horizon was 10 years. The annual discount was 5%. The model output included total costs and quality adjusted life month （QALM）， and incremental cost-effectiveness ratio （ICER） was calculated for cost-utility analysis， by setting willingness-to-pay （WTP） threshold at 3 times gross domestic product （GDP） per capita of China in 2023 （22 340 yuan/QALM）. Univariate sensitivity analyses， probability sensitivity analyses， and scenario analyses were performed to evaluate the robustness of the results and calculate the price threshold when SG had economic advantages. RESULTS SG group gained incremental 4.25 QALM and 561 570 yuan compared with single-agent chemotherapy， which resulted in an ICER of 132 102/QALM that was higher than WTP. The results of the univariate sensitivity analysis showed that the monthly average cost of SG had the greatest impact on the results； the results of probability sensitivity analysis showed that the probability of SG scheme being cost-effective at the WTP threshold was 0. The results of scenario analysis showed that the conclusions of this study were robust under different time horizons （5， 10， 15 years）. The price threshold for SG being cost-effective was 1 344 yuan per 180 mg. CONCLUSIONS Based on the perspective of Chinese medical system， SG appears to be not cost-effective compared with single-agent chemotherapy for HR+/ HER2－ advanced metastatic breast cancer at the price of 8 400 yuan per 180 mg. A substantial price cut should be taken to be cost- effective.