This literature review investigates the mechanisms of resistance to human epidermal growth factor receptor 2 (HER2)-targeted therapies in HER2⁺ breast cancer, a subtype that accounts for approximately 20% of breast cancer cases. Despite the effectiveness of treatments such as trastuzumab and lapatinib, many patients experience either primary or acquired resistance, leading to treatment failure. The review systematically categorizes various resistance mechanisms, including the role of receptor activator of nuclear factor kappaΒ (RANK) expression, which has been shown to activate the nuclear factor kappaB (NF-κB) pathway, promoting cell survival and contributing to resistance. Other mechanisms include the activation of alternative signaling pathways, such as the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway, and the involvement of tumor-associated fibroblasts, which can drive resistance through receptor tyrosine kinase (RTK) activation. Additionally, the review highlights the importance of understanding these mechanisms to inform the development of novel therapeutic strategies. By identifying potential biomarkers and therapeutic targets, the review suggests that combining HER2 inhibitors with agents that target resistance pathways may enhance treatment efficacy and improve patient outcomes. Overall, this review underscores the complexity of HER2⁺ breast cancer treatment and the need for continued research to overcome resistance challenges.

Objective:To evaluate the clinical efficacy of microfat on neck wrinkles and its structure and viability.Methods:A retrospective analysis was conducted to review the clinical data of 23 patients with neck wrinkles corrected by microfat injection from June 2018 to June 2021 at the Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, aged (38.1±10.7) years old. A blunt cannula with multiple side holes of 0.8 mm was used to obtain fat particles under low negative pressure and to prepare the microfat by washing and soft centrifugation. A 26-gauge sharp needle was used to inject microfat with small amount and at multiple points into the intradermal and subdermal layer where the neck lines were linearly depressed. Regular follow-ups were carried out after the operation, and the efficacy of the operation was evaluated from routine neck examinations, third-party doctor′s grade scoring and patient′s scoring towards satisfaction. To clarify the structure and viability of microfat, scanning electron microscope was used to observe the structure of fat particles, Calcein-AM/propidium iodide (Calcein-AM/PI) staining to detect tissue viability and Musecell counting to count SVF cells.Results:All of the 23 patients successfully completed the operation without complications such as infection and fat liquefaction. After a follow-up of 3 to 30 months, the neck wrinkles were effectively improved. The postoperative grade scores of third-party doctor was significantly reduced ( P<0.05). And the satisfaction of patients was high, with 20 cases (87.0%) satisfied. Scanning electron microscopy showed that the fat granule cells were tightly arranged and the structure remained intact. Calcein-AM/PI staining showed that most cells in the granules survived. The number of viable SVF cells in fat particles was (9.34±2.68)×10 5/ml. Conclusions:Microfat is easy to obtain with high tissue activity, which is suitable for neck wrinkle filling. Good effects can be achieved with high patients′ satisfaction. It is worthy of clinical application.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

The regulation mechanism of the retention rate of autologous fat grafts is one of the current research hotspots. Macrophages, as inflammatory cells that play an important role in tissue regeneration, are abundant in fat grafts in the early stage after fat transplantation, and are closely related to the outcome of fat grafts. This paper reviews the origin, classification, role, and mechanism of macrophages in autologous fat transplantation, to provide new ideas for consummating the theory of fat graft survival and improving the survival of fat grafts.

Objective:To assess the safety and efficacy of mammaplasty with autologous fat grafting(AFG).Methods:A retrospective analysis was conducted to review cases of mammaplasty with AFG from December 2010 to December 2020 in Department of Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Liposuction was performed using low negative pressure (-60 kPa) by liposuction machine. After lipoaspirate was washed with normal saline, cotton pad or low-speed centrifugation method was utilized to process fat. A blunt cannula with a diameter of 2.5 mm was used for multi-layer injection into the breast. The efficacy of surgery was evaluated from routine breast examinations, ultrasound examinations, third-party evaluations of pre- and post-operative photos, and patient’s scoring on breast appearance and the quality of life. The score interval is 0-100 points, and the higher the score, the better the effect. The Mann-Whitney U test was applied to compare the differences between groups, and the paired t-test was used to compare the difference of chest circumferences before and after surgery and the doctors’ scores. P<0.05 indicates statistically significant difference. Results:449 patients with 829 breasts were enrolled, aged (37.6±9.4) years old with a body mass index of (21.4±2.8) kg/m 2, including 372 patients with breast dysplasia, 42 patients underwent total mastectomy due to breast cancer, 8 patients with breast deformity after breast-conserving surgery, and 27 cases with breast implants for augmentation. Of the 449 cases, 37 cases used Brava before surgery, including 25 patients with breast dysplasia and 12 patients who underwent total mastectomy. All patients successfully completed the operation. Patients with breast dysplasia required (2.0±0.7) times of AFG for breast augmentation, with a unilateral injection volume of (244.4±58.1) ml per session. Patients who underwent total mastectomy required (2.9±1.1) times of AFG, with a unilateral injection volume of (223.2±62.4) ml per session. Patients with breast deformity after breast-conserving surgery required (1.5±0.5) times of AFG, with a unilateral injection volume of (204.0±29.5) ml per session. And for patients with breast implants for augmentation, it takes (2.2±0.8) times of AFG after removal of implants. The postoperative follow-up time was (14.0±6.8) months. Cystic nodules and benign calcifications with a diameter of 0.1-0.3 cm was found in 34 patients in ultrasound, 5 patients had palpable nodules and 3 patients had intramammary infections. No serious complications occurred. The breast circumference of 353 patients with bilateral breast dysplasia increased by (4.8±1.0) cm ( P<0.01) compared with that before operation. Breast circumference of the 27 patients who underwent implant removal and AFG for augmentation reduced by (1.2±1.7) cm ( P<0.01) after operation. The scores of third-party after operation in each group were significantly higher than those before operation ( P<0.05). The doctor’s score of patients with breast reconstruction after total mastectomy for breast cancer increased the most, which was 15.4±4.9 points ( P<0.01). In this group, the scores of patients who underwent radiotherapy increased by (19.3±2.3) points, which was higher than those without radiotherapy 13.4±5.5 points ( P<0.01). Patients with breast reconstruction after total mastectomy for breast cancer had the lowest breast satisfaction and quality of life scores, which were 84.6±2.9 and 84.7±3.2 points respectively, while those with breast deformity correction after breast conserving surgery had the highest scores, 88.8±4.0 and 90.6±3.7 points respectively. Conclusions:The application of AFG to mammaplasty is both safe and effective, with fewer complications, and high satisfaction rate.

Objective:To assess the safety and efficacy of mammaplasty with autologous fat grafting(AFG).Methods:A retrospective analysis was conducted to review cases of mammaplasty with AFG from December 2010 to December 2020 in Department of Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Liposuction was performed using low negative pressure (-60 kPa) by liposuction machine. After lipoaspirate was washed with normal saline, cotton pad or low-speed centrifugation method was utilized to process fat. A blunt cannula with a diameter of 2.5 mm was used for multi-layer injection into the breast. The efficacy of surgery was evaluated from routine breast examinations, ultrasound examinations, third-party evaluations of pre- and post-operative photos, and patient’s scoring on breast appearance and the quality of life. The score interval is 0-100 points, and the higher the score, the better the effect. The Mann-Whitney U test was applied to compare the differences between groups, and the paired t-test was used to compare the difference of chest circumferences before and after surgery and the doctors’ scores. P<0.05 indicates statistically significant difference. Results:449 patients with 829 breasts were enrolled, aged (37.6±9.4) years old with a body mass index of (21.4±2.8) kg/m 2, including 372 patients with breast dysplasia, 42 patients underwent total mastectomy due to breast cancer, 8 patients with breast deformity after breast-conserving surgery, and 27 cases with breast implants for augmentation. Of the 449 cases, 37 cases used Brava before surgery, including 25 patients with breast dysplasia and 12 patients who underwent total mastectomy. All patients successfully completed the operation. Patients with breast dysplasia required (2.0±0.7) times of AFG for breast augmentation, with a unilateral injection volume of (244.4±58.1) ml per session. Patients who underwent total mastectomy required (2.9±1.1) times of AFG, with a unilateral injection volume of (223.2±62.4) ml per session. Patients with breast deformity after breast-conserving surgery required (1.5±0.5) times of AFG, with a unilateral injection volume of (204.0±29.5) ml per session. And for patients with breast implants for augmentation, it takes (2.2±0.8) times of AFG after removal of implants. The postoperative follow-up time was (14.0±6.8) months. Cystic nodules and benign calcifications with a diameter of 0.1-0.3 cm was found in 34 patients in ultrasound, 5 patients had palpable nodules and 3 patients had intramammary infections. No serious complications occurred. The breast circumference of 353 patients with bilateral breast dysplasia increased by (4.8±1.0) cm ( P<0.01) compared with that before operation. Breast circumference of the 27 patients who underwent implant removal and AFG for augmentation reduced by (1.2±1.7) cm ( P<0.01) after operation. The scores of third-party after operation in each group were significantly higher than those before operation ( P<0.05). The doctor’s score of patients with breast reconstruction after total mastectomy for breast cancer increased the most, which was 15.4±4.9 points ( P<0.01). In this group, the scores of patients who underwent radiotherapy increased by (19.3±2.3) points, which was higher than those without radiotherapy 13.4±5.5 points ( P<0.01). Patients with breast reconstruction after total mastectomy for breast cancer had the lowest breast satisfaction and quality of life scores, which were 84.6±2.9 and 84.7±3.2 points respectively, while those with breast deformity correction after breast conserving surgery had the highest scores, 88.8±4.0 and 90.6±3.7 points respectively. Conclusions:The application of AFG to mammaplasty is both safe and effective, with fewer complications, and high satisfaction rate.