术前访视对乳腺癌患者术前焦虑的影响

目的探讨研究术前访视对乳腺癌手术病人术前焦虑的影响。方法选择60例择期手术病人并随机分成两组,观察组接受术前访视,而对照组接受所在病区护士的临床常规治疗和护理。采用Zung焦虑自评量表(SAS),评定访视前后的焦虑值。结果观察组术前焦虑值显著低于对照组(P<0.01)。结论术前访视能有效缓解病人术前焦虑程度。     

Prevalence and risk of depressive symptoms 3–4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer

Background Elevated levels of depressive symptoms are generally found among cancer patients, but results from existing studies vary considerably with respect to prevalence and proposed risk factors. Purpose To study the prevalence of depressive symptoms and major depression 3–4 months following surgery for breast cancer, and to identify clinical risk factors while adjusting for pre-cancer sociodemographic factors, comorbidity, and psychiatric history. Patients and methods The study cohort consists of 4917 Danish women, aged 18–70 years, receiving standardized treatment for early stage invasive breast cancer during the 2 1/2 year study period. Of these, 3343 women (68%) participated in a questionnaire study 12–16 weeks following surgery. Depressive symptoms (Beck’s Depression Inventory II) and health-related behaviors were assessed by questionnaire. The Danish Breast Cancer Cooperative Group (DBCG) and the surgical departments provided disease-, treatment-, and comorbidity data for the study cohort. Information concerning sociodemographics and psychiatric history were obtained from national longitudinal registries. Results The results indicated an increased prevalence of depressive symptoms and major depression (13.7%) compared to population-based samples. The pre-cancer variables: Social status, net-wealth, ethnicity, comorbidity, psychiatric history, and age were all independent risk factors for depressive symptoms. Of the clinical variables, only nodal status carried additional prognostic information. Physical functioning, smoking, alcohol use, and BMI were also independently associated with depressive symptoms. Conclusion Risk factors for depressive symptoms were primarily restricted to pre-cancer conditions rather than disease-specific conditions. Special attention should be given to socio-economically deprived women with a history of somatic- and psychiatric disease and poor health behaviors.     

乳腺癌钼靶X线的诊断体会

目的回顾乳腺癌钼靶X线征象,总结经验,提高诊断准确率。方法总结分析我院2011年中经手术病理证实72例乳腺癌的X线表现。结果 72例乳腺癌中,直接征象:16例表现为小于临床测量的肿块,37例肿块伴毛刺;11例表现为恶性钙化;8例表现局限性致密浸润;72例乳腺癌伴有或不伴有漏斗征、酒窝征、厚皮征、恶性晕圈征、恶性大导管征、异常血管征、塔尖征、彗星尾征、腋淋巴结肿大等间接征象。结论准确识别乳腺癌钼靶X线征象,对乳腺癌的正确诊断具有重要作用。     

41例规范性保乳手术与临床预后分析

目的:探讨乳腺癌规范性保乳手术的术式与其临床预后。方法:41例乳腺癌,Ⅰ期17例,Ⅱ期23例,Ⅲ期1例,均行规范性保乳手术,术后辅以化疗、放疗、内分泌调节等综合治疗,随访6～27个月,中位随访20个月。结果:至目前为止,尚无1例局部复发和远处转移,患者自我形象满意。结论:规范性的保乳手术与局部复发率的控制、理想的美容效果及长期生存率的提高有密切的关系。     

The Implication of microRNAs as non-invasive biomarkers in 179 Egyptian breast cancer female patients

Background: MicroRNAs (miRs) are small (19–25 nucleotides), non-protein coding RNAs that regulate gene expression, and thus play essential roles in cell cycle progression. The evidence has demonstrated that the expression of several miRs is dysregulated in human cancer. Methods: The study includes 179 female patients and 58 healthy women Patients were identified as luminal A, B, Her-2/neu, and basal-like, as well as classified into I, II, and III stages. Analysis of the expression fold change of miR-21 and miR-34a with molecular markers, including the oncogene Bcl-2 (B-cell lymphoma 2) and the tumor suppressor genes BRCA1 (breast cancer susceptibility gene 1), BRCA2 (breast cancer susceptibility gene 2), and the tumor suppressor protein p53, was carried out for all patients, pre- and postchemotherapy, and for all healthy women. Results: At diagnosis (pre-chemotherapy), miR-21 was up-regulated (p < 0.001), while miR-34a was down-regulated (p < 0.001). Post-chemotherapy, the expression of miR-21 decreased significantly (p < 0.001), while the expression of miR-34a increased significantly (p < 0.001). Conclusion: miR-21 and miR-34a may be helpful to non-invasive biomarkers to evaluate the response of breast cancer to chemotherapy.     

Intra-operative evaluation of the sentinel lymph node for T1-N0 breast-cancer patients: Always or never? A risk/benefit and cost/benefit analysis

Aim

To investigate whether omitting intra-operative staging of the sentinel lymph node (SLN) in T1-N0 breast-cancer patients is feasible and convenient because it could allow a more efficient management of human and logistic resources without leading to an unacceptable increase in the rate of delayed axillary lymph node dissection (ALND).

Methods

According to the experimental procedure, T1a–T1b-patients were to not receive any intra-operative SLN evaluation on frozen sections (FS). In all T1c-patients, the SLN was macroscopically examined; if the node appeared clearly free of disease, no further intra-operative assessment was performed; if the node was clearly metastatic or presented a dubious aspect, the pathologist proceeded with analysis on FS. T2-patients, enrolled in the study as reference group, were treated according to the institutional standard procedure; they all received SLN staging on FS.

Results

The study included 395 T1-N0-patients. Among the 118 T1a–T1b-patients whose SLN was not analyzed at surgery, 12 (10.2%) were recalled for ALND. In the group of 258 T1c-patients, 112 received SLN analysis on FS and 146 did not. An SLN falsely negative either at macroscopic or FS examination was found in 33 (12.8%) cases. Overall, the rate of recall for ALND was 11.6% as compared to 8.4% in T2-patients. Using the experimental protocol, the institution reached a 9.6% cost saving, as compared to the standard procedure.

Conclusions

Omission of SLN intra-operative staging in T1-N0-patients is rather safe. It provides the institution with both management and economical advantages.