84例乳腺癌术中局部化疗探讨

目的探讨预防乳腺癌术后局部伤口种植转移可能性的方法。方法设置两组病例,观察组为乳腺癌手术时伤口经化疗药物冲洗;另一组为对照组,手术时不用化疗药物冲洗伤口。结果观察组未发现局部伤口有复发转移结节,对照组发现4例皮肤切口附近有复发转移结节。两组病例皆有发生皮瓣坏死或皮下积液。结论乳腺癌术后伤口采用化疗药物5－FU冲洗对防止手术后皮肤切口附近复发转移结节的发生是一种简单有效的方法。     

中药合并化疗治疗晚期乳腺癌60例

作者采用益气养血、健脾滋肾、和胃止呕合并化疗治疗晚期乳腺癌６０例，疗后细胞免疫——吞噬率、吞噬指数明显升高（Ｐ＜０．０５），可测量肿瘤大小的３６例病人有１９例肿瘤明显缩小，有效率５２．８％。说明中药对减轻化疗的毒副反应、提高机体免疫力、增强抗病能力起到了一定作用，中西医结合是治疗晚期乳腺癌的有效途径，值得研究。     

乳腺癌术前化疗的作用

(摘自2001年5月美国旧金山ASCO会议) 1 术前化疗 对可手术乳腺癌患者术前化疗(新辅助化疗)的概念已涉及到临床以及对肿瘤细胞的研究,通过术前化疗使局部肿瘤缩小,增加了保留乳腺手术的比例,同时腋窝病理检查由阳性转为阴性的比例增加.现在已从强调手术作为乳腺癌的唯一治疗发展到强调全身治疗,因此,对这个领域的研究具有理论和实践意义.     

236例乳腺癌术后化疗的护理体会

目的探讨乳腺癌病人术后化疗期间的护理。方法对236例乳腺癌术后化疗期间的病人加强心理支持、化疗护理、康复指导。结果全部病人完成4~6个疗程的化疗计划,均达到治疗护理的最终目的。结论乳腺癌术后化疗期间的病人只有通过心理疏导使病人接受已经改变的形象,调整病人心态对未来树立信心,从保护病人隐私等方面加强心理支持,做好化疗前全面评估,化疗后及时宣教,从患肢锻炼、避免复发方面进行康复指导,才能达到治疗护理的最终目的而重返社会。     

乳腺癌的新辅助化疗

随着临床和基础研究的不断深入,乳腺癌新辅助化疗逐渐成为乳腺癌临床研究中十分活跃的领域.理论上,新辅助化疗较辅助化疗有诸多优势,但多个大型临床试验结果表明,新辅助化疗并不能显著改善患者生存.许多因素可能与之有关,例如,以往的研究在最初设计时多仅根据患者临床分期来决定患者是否需要新辅助化疗,而忽视了重要生物学指标雌激素受体(ER)、Her-2等对疗效的影响,且不同研究中生物学指标的检测方法及使用的化疗方案也不一致.本文结合最近的文献资料,就生物学指标对乳腺癌新辅助化疗的影响及其他几个临床上十分关注的问题谈一些个人的体会和看法,与同行探讨.     

84例乳腺癌榱局部化疗探讨

目的 探讨预防乳腺癌术后局部伤口种植转移可能性的方法。方法 设置两组病例,观察组为乳腺癌手术时伤口经化疗药物冲洗;另一组为对照组,手术时不用化疗药物冲洗伤口。结果 观察组未发现局部伤口有复发转移结节,对照组发现４例皮肤切口附近有复发转移结节。两组病例皆有发生皮瓣坏死或皮下积液。结论 乳腺癌术后伤口采用化疗药物５－Ｆｕ洗冼冲对防止手术后皮肤切口附近复发转移结节的发生是一种简单有效的方法。     

乳腺癌的新辅助化疗

本文回顾了有关乳腺癌新辅助化疗的临床研究，认为可使大部分原发性乳腺癌体积明显缩小，进而使80％的可手术治疗的患者能选择保留乳房术式。虽然理论上可更大程度地杀灭亚临床的微小转移灶，减少耐药细胞株的产生，但在提高这部分患者的无复发生存率及总体生存率方面尚无临床定论。     

可手术乳腺癌系统性辅助化疗

从上个世纪50年代Fisher等提出乳腺癌是一种全身性疾病开始,乳腺癌系统性辅助治疗在乳腺癌治疗中的地位就开始 得到广泛的重视,乳腺癌辅助性化疗的研究结果显示,辅助性 化疗可使乳腺癌死亡率下降约25%,这些研究结果奠定了辅助 性治疗在乳腺癌治疗中的重要地位,乳腺癌的治疗重点已从以 往的单纯性手术治疗向含系统性治疗在内的综合性治疗发展。 一、新辅助化疗 新辅助化疗指对非转移性的肿瘤,在应用局部治疗前进行 的系统性的辅助性细胞毒性药物治疗。由于各种文献报道中 对新辅助化疗的描述角度不同,这种…     

乳腺癌术后化疗Ⅳ度骨髓抑制2例报告

例1女性,66岁。因发现右乳腺肿物1月入院,穿刺活检确诊为乳腺癌,在全麻下行右乳腺癌改良根治术,术后恢复良好,病理学诊断为右乳腺浸润性导管癌,腋窝淋巴结转移2/12。第5d化验:WBC9·8×109/L,RBC3·62×1012/L,PLT208×109/L,第6d行CMF化疗(CTX400mg/m2MTX20mg/m2FUDR400mg/m2),第1、8d静脉注射。第6d后出现口腔溃疡,经口服维生素B2、局部用口腔溃疡膜治疗,第9d上午发现口腔溃疡进一步扩大,并出现呕血、便血、皮下瘀斑、急查血常规WBC0·55×109/L,RBC2·83×1012/L,PLT18×109/L,诊断为急性骨髓抑制。给予积极抢救,用惠尔…     

乳腺癌术后放疗诱发性肉瘤的治疗进展

【摘要】〓放疗诱发性肉瘤(radiation induced sarcoma, RIS)是一种罕见的、恶性程度较高的肿瘤,可发生于乳腺癌、妇科肿瘤、霍奇金淋巴瘤和其他类型肿瘤放射治疗后,而其中乳腺癌放疗诱发性肉瘤占较大的比例。目前,对于此类肿瘤的治疗仍是临床上一大难题,不管是手术治疗还是手术联合辅助放化疗,其5年生存率仍较低,且治疗后局部复发率很高。为提高临床医生对放疗诱发性肉瘤治疗方案的优化选择,改善患者预后,本文对目前针对放疗诱发性肉瘤的治疗进展做一综述。     

Scleroderma-like skin sclerosis induced by docetaxel chemotherapy for hormone refractory prostate cancer: a case report

We report the first case of scleroderma-like skin sclerosis induced by docetaxel chemotherapy for prostate cancer in Japan. A 67-year-old man underwent radical prostatectomy for cT3aN0M0 prostate cancer in 2003. Thereafter PSA recurrence developed and antiandrogen deprivation therapy was used. However, we diagnosed this case as hormone refractory prostate cancer and began docetaxel chemotherapy in October 2008. There were no nonhematological adverse events through two courses of treatment. He presented to dermatology due to pain and swelling of both upper arms on the second day of the third course. However, when treated with a cooling method, swelling of the upper arms became worse and CPK rose to 1,921 IU/I on the eighth day. We administered a steroid ointment and an antibiotic due to suspicion of thrombophlebitis. Nevertheless, CPK rose to 2,791 IU/I and a skin biopsy was done. In consequence, scleroderma-like skin sclerosis induced by docetaxel chemotherapy was diagnosed. Swelling appeared in both lower limbs and the pain got worse on the 17th day. Therefore docetaxel chemotherapy was discontinued and prednisolone was increased to 30 mg/day, in addition to beginning codeine use for the pain. Thereafter, the painful sclerosis was ameliorated.     

三阴性乳腺癌的新辅助化疗：附31 例报告

目的：探讨三阴性乳腺癌（TNBC）新辅助化疗的疗效。 方法：回顾性分析2009年1月―2013年1月收治的63例I~III期TNBC患者临床资料,其中31例术前行新辅助化疗（新辅助化疗组）,32例行直接手术后辅助化疗（术后辅助化疗组）,新辅助化疗与术后的辅助化疗均采用蒽环类为主序贯紫杉类方案。分析新辅助化疗组患者术前获益情况,并比较两组患者术后复发转移与生存率情况。 结果：新辅助化疗组31例患者术前总获益率为100%,其中完全缓解达61.29%（19/31）;3年内发生局部复发和远处转移者新辅助化疗组13例（41.94%）,术后辅助化疗组22例（68.75%）,两组差异有统计学意义（χ2=4.585,P<0.05）。新辅助化疗组和术后辅助化疗组的3年无病生存率分别为48.38%、25.00%;5年总生存率分别为38.71%、9.78%,新辅助化疗组两者均明显优于术后辅助化疗组（χ2=4.870,P=0.027;χ2=7.469,P=0.006）。 结论：蒽环类为主序贯紫杉类方案的新辅助化疗能使TNBC患者明显获益,且远期疗效优于术后辅助化疗。

     

Brain metastasis of ovarian cancer treated by chemotherapy including cis-platin: a case report

A 57-year-old woman was admitted to our department with headache and dizziness. About 8 months ago, she suffered from ovarian cancer disseminated in pleura and peritoneum, and was treated successfully with CAP therapy only (Cis-platin, Adriamycin and Cyclophosphamide). Intracerebellar metastasis of ovarian cancer was suspected on CT scan, and CAP therapy was employed again. She was relieved from all symptoms a week after starting the therapy. Follow up CT scan showed complete remission of the lesion. She was well for about 3 months, but was admitted again because of consciousness disturbance and headache with multiple brain metastasis. PVB therapy (Cis-platin, Vinblastine and Pepleomycin) was employed this time, and complete remission was seen again. But regrowth of intraabdominal mass lesion appeared, and she died from multiple organ failure 5 months after PVB therapy. Autopsy was not permitted, but CT scan 3 days before death revealed no intracranial lesion. Distant metastasis of ovarian cancer may become more prevalent with the development of combination chemotherapy, but no case of brain metastasis has been reported to have been treated with chemotherapy only. The authors suggest the possibility of successful treatment of such a lesion with chemotherapy including Cis-platin.     

抗雄激素治疗后男性乳腺癌一例

正患者男,77岁,因"发现左乳肿物3个月"入院。患者于2015年2月门诊就诊,乳腺彩超示:左侧乳腺实性肿块(图1),考虑乳腺癌;乳腺磁共振成像示:乳头后方异常信号,考虑乳腺癌。查体:左乳晕旁可见突起肿物,左乳晕至左乳外侧可扪及直径约5 cm质硬肿物,边界欠清,肿物与表面皮肤粘连,活动度差,肿物与胸壁无明显粘连,双侧腋窝、锁骨上未触及肿大淋巴结。粗针穿刺活检病理示:左乳浸润性乳腺癌;免疫组     

Primary breast cancer of the vulva: a case report

The occurrence of primary breast cancer of the vulva is extremely rare (24 cases described in the English-language literature). We report a case of a primary breast carcinoma of the vulva. An 82-year-old woman presented with a nodule of the left labia minor, which was excised. The histologic examination revealed the presence of adenocarcinoma of mammary origin, positive for common breast markers and for estrogen and progesterone receptors. The study for orthotopic breast carcinoma was negative, as well as the study for metastatic disease. The diagnosis of primary breast carcinoma was established. Our patient was then submitted to pelvic and inguinal radiotherapy as well as an aromatase inhibitor (letrozole), and she remained completely asymptomatic. Because of the rarity of this condition, guidelines for therapy are unavailable. The management suggested in the literature is that of primary orthotopic breast neoplasm of a similar stage.     

Spontaneous breast cancer remission: A case report

IntroductionSpontaneous breast cancer remission is a rare phenomenon. We report the disappearance from the remaining breast of a new primary carcinoma that had been confirmed through cytology of a pathological specimen, in a case that is strongly suspected to be spontaneous remission.Presentation of caseA 44-year-old woman underwent breast-conserving surgery for a tumor located on the border between the upper-outer and lower-outer quadrants of the left breast (T2, N1, M0; Stage IIB). Eleven years after surgery, computed tomography indicated a mass in the upper-inner quadrant of the left breast. Excisional biopsy was initially planned for treatment following the definitive diagnosis because cytology revealed malignancy. The patient had noticed tumor regression one month after fine-needle aspiration and repeat ultrasonography performed the day before excisional biopsy confirmed the tumor reduction. On pathological examination, no tumor cells were observed in the mass.DiscussionThere was a discrepancy between FNA cytology and pathological diagnosis in our patient. The cytological findings indicated malignancy, but the pathological findings did not. When a tumor’s pathological diagnosis is not malignant even though its FNA cytology diagnosis was malignant, sampling error, cytological over-diagnosis or some other error may have occurred. In this case, however, these were not detected. Because fibrosis was visible on pathological examination, we believe that these events corresponded to spontaneous remission.ConclusionWe report a rare case of spontaneous remission in which the cancer disappeared on pathological examination although the cytological diagnosis had been malignant.     

Biphenotypic acute leukemia following intensive adjuvant chemotherapy for breast cancer: case report and review of the literature

The risk of secondary leukemia in breast cancer patients who receive adjuvant chemotherapy is an open question. We describe the case a 38-year-old woman who developed acute leukemia 18 months after completion of intense adjuvant chemotherapy with prophylactic granulocyte colony-stimulating factor (G-CSF) support and chest wall irradiation. The diagnosis of biphenotypic T-cell acute myeloid leukemia (AML) was based on morphologic and immunophenotypic criteria. Chromosomal analysis of blasts revealed multiple trisomies and tetrasomies. The patient failed to respond to induction and salvage chemotherapy and died 4 months later. This case of acute leukemia occurred in a cohort of 65 high-risk breast cancer patients who were given intense adjuvant chemotherapy during the last 5 years in our hospital. This is the first case reported in the literature of acute leukemia following intense adjuvant chemotherapy with continuous prophylactic G-CSF, which is an actively investigated therapeutic strategy. Vigilance and investigation are needed to determine the leukemogenic potential of intense adjuvant chemotherapy plus radiotherapy in breast cancer patients. A brief review of the literature that deals with acute leukemia that develops after adjuvant chemotherapy for breast cancer and with secondary biphenotypic acute leukemia is presented.