Objective To investigate the cosmetic results of endoscopic thyroidectomy via areola of breasts approach.Methods The incision was chosen to be along the areolar margin.One 12 mm incision was made at 3-clock position of the right areolar to introduce a 30? flexible laparoscope.Another 7 mm incision was made at 9-clock position of the right areolar for a grasping forceps.An additional 12 mm incision for the performance of ultrasonic scalpel was made at 11-clock position of the left areolar.Subcutaneous tissues were separated to create enough space for partial or subtotal thyroidectomy according to patient's conditions.Results The surgery was finished successfully in all 10 cases.The operation time ranged 110~230 min(mean,140 min).The estimated blood loss ranged 3~15 ml(mean,9 ml).There were no surgical complications after operation.Follow-up checkups for 3~5 months(mean,3.5 months) in 10 cases showed inconspicuous scars and no recurrence.Conclusions Endoscopic thyroidectomy via areola of breasts approach is a feasible and safe procedure with satisfactory cosmetic results.

Objective With the help of B-US,we studied the dealing method of latent breast lesion of lower echo discovered by B-US in order to find early breast cancer.Methods The latent breast lesion was located using B-US and injection of methylene blue into them, then excised the dyed lesion.the advantages of the method and the rate of lesion excision was analyzed.Results With the above method,we excised 38 latent breast lesion discovered by B-US only. 4 cases of them were early breast cancer.Conclusions It is mini-traumatic,simple and practical that to locate the latent breast lesion, to inject methylene blue into them with the help of B-US,it has higher successful rate to excise lesion . This method can help to deal with nonpalable breast lesion and find early breast cancer.

Objective To study the method of biological dye injection for detecting sentinel lymph node(SLN) in breast cancer, and explore the accuracy of evaluating axillary lymph node status by SLN biopsy(SLNB). Methods Intro-dermal methylthionium injection during operation was applied to identify SLN in 71 breast cancer patients, and the detection results were compared with the metastasis status of dissected axillary lymph nodes. Results SLN was identified in 70 of 71 patients(97%) using methylthionium injection. Total 188 SLNs were detected in all patients, each patient having 1～4 SLNs(average 2 7). The false negative rate of methylthionium injection for detecting SLN was 2%(1/42). The sensitivity, specificity and accurate rate of SLN to predict axillary lymph node metastasis status were 96%, 100% and 97% respectively. Conclusion Intro-dermal methylthionium injection can identify SLN and accurately predict the axillary lymph node status . This method is cheap and can be widely used.

Objective To evaluate needle localized operation biopsy (NLOB) and sterotactic core needle biopsy (SCNB) in the differential diagnosis of nonpalpable breast lesion (NPBL) found by mammography. MethodsIn 82 cases, a total of 90 NPBL were found, NLOB or SCNB were applied to make the diagnosis.ResultsBreast carcinoma (24.4%)was finally diagnosed in 20 cases, 61 cases were diagnosed with benign lesion. Thirty-five cases needed (42.7%) a surgery. Conclusion NLOB and SCNB provide new ways in establishing diagnosis of breast minimal lesions.

Objective To investigate the technique of radio-stereotactic mammography aspiration biopsy(SCNB) and the clinical usage.Methods The stereotactic mammography aspiration biopsy was performed on 38 breast focuses,the results were compared with pathology.The technique and operation skills of SCNB were studied.Results In this 38 breast focuses,the accuracy of diagnostic aspiration,misplay and false negativity were 84.2%,7.89%and 7.89% respectively.No false positive was found.Conclusion In this technique,the distance between the needle tip and focus central was calculated by computer.This is a effective,easy operate and safe tool for the localization and very valuable in the diagnosis of a early cancer.

Objective To analyze the histological underestimation of stereotactic core needle biopsy (SNCB).and tO attract clinicians' attention.Methods SNCB was performed in 146 patients with 179 lesions from September 2000 to June 2005.and 21 lesions were underestimated histologically.0f 21 nonpalpable breast lesions(NPBL).6 lesions were diagnosed as BI-RADS nl,12 8S BI-RADS Ⅳ,3 as BI-RADS V according to BI-RADS before biopsy.Mammography showed 16 lesions with calicification, 2 cases with masses,1 case with asymmetry density and 2 cases with stellate sign.Results Eleven lesions diagnosed as fibrocystic disease with atypical ductal hyperplasia by biopsy were proved to be ductal carcinoma in situ (DCIS)in 7 lesions and early infiltration in 4 lesions by pathology.3 lesions diagnosed as severe atypical hyperplasia by biopsy were finally proved to be 1 carcinoma in situ and early infiltration in 2 lesions by pathology.3 lesions diagnosed as DCIS by biopsy were invasive carcinoma.4 lesions diagnosed papillary lesions by biopsy and finally were 1 carcinoma in situ,1 early infiltration,1 infiltrating ductal carcinoma and l intraductal papillary adenocarcinoma.Conclusion The histological underestimation of SCNB Was related to the stereotactic location technology,lesion and doctor'S understanding,the radiologist should master the biopsy skills.

BACKGROUND: Recently the prevalence rate of mass in mammary gland increases significantly than before. To use which kind of technology is not only related with the post-operation recurrence, but also related with the reconstruction of their confidence. Therefore, how to reduce the trauma physically and psychologically in patients to the maximal degree has become the chief factor to choose technology by surgeons.OBJECTIVE: To observe the effects of transverse rectus abdominis musculocutaneous (TRAM) flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis after skin-sparing mastectomy with immediate breast reconstruction.DESIGN: Case analysis.SETTING: Department of Plastic Surgery, Shenzhen People's Hospital,Second Clinical Medical College of Jinan University.PARTICIPANTS: A total of 15 ductal carcinoma in situ (DCIS) and huge breast benign tumor patients were enrolled into Shenzhen People's Hospital between October 1997 and May 2004, aged from 20 to 46 years. They all got disease in single breast, and 8 of them had preoperative diagnosis of DCIS, T1N0M0 and 7 of them had huge breast benign tumor. Operation program was informed to the patients before operation so as to gain their agreement.METHODS: Skin-sparing mastectomy was performed with circular shape incision at areola and using TRAM flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis to fill breast. Slight skin of musculo-cutaneous flap could compensate the nipple and areola when performing reconstruction. At the reoperation, nipple was made at the transferred flap.MAIN OUTCOME MEASURES: To observe the patients with or without recurrence or transfer after operation and local healing of wound.RESULTS: With the cooperation of general surgeons the operation was done in 15 cases and 14 cases of them were followed up for more than 1 year. The reconstructed breasts were with good symmetry with the opposite one, normal skin sensation, natural shape and inconspicuous scar.CONCLUSION: This is an excellent alternative method for mastectomy and breast reconstruction based on the avoidance of recurrence of breast cancer in severe operation.