A comparative analysis of effectiveness of surgical treatment of fibroadenomas in young girls

Results of the examination of young girls (13-17 years of age) who came to consult a doctor for different complaints of the state of their mammary glands are described. Age-dependent peculiarities of the mammary gland tissue in this category of patients imply the thorough preoperative examination. The ultrasonic investigation of the mammary gland is the method of choice. Fibroadenoma was diagnosed in 50 patients, fibrocystic mastopathy in 27, mastopathia cystica in 81, mastitis and other diseases in 5 patients. In 54 patients no pathology of the mammary glands was revealed. A comparative analysis of two groups of patients operated upon is given: a control group (25) with the operations in the volume of a classical sectoral resection and a main group (25) with a sectoral resection performed by a modified method. In the control group the cosmetic effect after the traditional sectoral resection was estimated as dissatisfactory in 76%: there were signs of keloidization of the scar, hypertrophic scar with pigmentation. In the majority of patients there was an atrophic scar with a pronounced deficiency of the volume of the mammary gland and its asymmetry. In the main group patients the complete absence of the signs of postoperative scar was noted in 16 (64%) patients. They were operated on by the modified method (periareolar resection). A conclusion is made that when the operation is thought to be inevitable, the low degree of risk of breast cancer requires a transformation of the surgical strategy towards the reduction of the volume of ablated tissues and employment of modified variants of surgery resulting in the maximum cosmetic effect.     

乳腺积乳囊肿的病因及诊治

本文报告乳腺积乳囊肿56例。年龄23～52岁,平均27.5岁。术前50例诊断正确,误诊6例。特别提出局部肿块波动感试验阳性,A超显示液平段,B起显示无回声,试穿抽出乳汁,对诊断有一定价值。治疗以手术切除为主;仅有7例穿刺抽吸乳汁得以治愈。     

Dual-energy subtraction radiography of the breast

Dual-energy projection radiography was applied to breast examination. To perform the dual-energy subtraction radiography using a digital radiography unit, high and low-energy exposures were made at an appropriate time interval under differing X-ray exposure conditions. Dual-energy subtraction radiography was performed in 41 cancer patients in whom the tumor shadow was equivocal or the border of cancer infiltration was not clearly demonstrated by compression mammography, and 15 patients with benign diseases such as fibrocystic disease, cyst and fibroadenoma. In 21 cases out of the 41 cancer patients, the dual-energy subtraction radiography clearly visualized the malignant tumor shadows and the border of cancer infiltration and the daughter nodules by removing the shadows of normal mammary gland. On the other hand, benign diseases such as fibrocystic disease and cyst could be diagnosed as such, because the tumor shadow and the irregularly concentrated image of mammary gland disappeared by the dual-energy subtraction. These results suggest that this new technique will be useful in examination of breast masses.     

Pleomorphic adenoma of the breast

The pleomorphic adenoma (mixed tumor) of the mammary gland is a rare benign tumor. Clinically, mammographically and histologically it can, on the basis of a quick-biopsy examination, be confounded with a carcinoma. We relate on a case of our own where the diagnostic difficulties conducted to an inadequate amputation of the mammary gland.     

Tuberculosis of the breast]

The author observed 6 cases of mammary gland tuberculosis. 3 patients showed disseminated nodular form of mammary gland tuberculosis, 2--sclerotic form and 1--ulcerative form. Contrast-free mammography is an essential aid in diagnosis. Surgical intervention with postoperative specific antibacterial therapy is a radical method of treatment. Sectoral resection of the mammary gland should be carried out in young patients and amputation--in elderly ones.     

Perinatal ethinyl oestradiol alters mammary gland development in male and female Wistar rats

Increased attention is being paid to human mammary gland development because of concerns for environmental influences on puberty onset and breast cancer development. Studies in rodents have showed a variety of changes in the mammary glands after perinatal exposure to endocrine disrupting chemicals, indicating progressed development of mammary glands when exposed to oestrogens early in life. However, laboratories use different parameters to evaluate the development of mammary glands, making studies difficult to compare. Moreover, studies of whole mounts in Wistar rats are lacking. In the present study, Wistar rats were exposed to 0, 5, 15 or 50 μg/kg of ethinyl oestradiol per day during gestation and lactation. A wide range of morphological parameters were evaluated in whole mounts of mammary glands from male and female offspring PD21-22. This study showed that in both male and female pre-pubertal Wistar rats, mammary gland development was accelerated after perinatal oestrogen exposure with increase in size, density and number of terminal end buds (TEBs). In female rats, the most sensitive parameters were the distance to the fifth gland, the relative growth towards the lymph node and the overall density. The sensitive endpoints in male rats were TEB numbers, both in the whole gland and in the zone C, the overall- and the highest density. The overall density was sensitive in both male and female rats and was considered a good representative of both branching and budding of the gland. The number of TEBs in zone C was representative of the number of TEBs in the whole gland. Further studies in older Wistar rats and with weak oestrogenic compounds could be performed to validate mammary gland examination as an endpoint in reproductive toxicity studies and to examine how early life environmental exposures may alter mammary gland development, disrupt lactation and alter susceptibility to breast cancer.     

New uses of mammary ultrasonography

This article reports the experience acquired through the use of ultrasonography applied to the study of the mammary gland affected by augmentation of reduction mammaplasty. Thirty-eight patients who had undergone either augmentation or reduction mammaplasty were submitted to ultrasonographic examination. Such a technique, besides being easy to perform, noninvasive, specific, and well accepted by the patients, showed to be remarkably interesting. It offered a wide display of the mammary parenchyma, showing its possible alterations, and supplying useful information on any possible postoperative implant ruptures, cicatricial reactions, seromas, and any other possible alterations that occurred.     

Haemangiosarcoma with a Metastasis of a Malignant Mixed Mammary Gland Tumour in a Dog

An 11‐year‐old dog with a history of weight loss, anorexia, anaemia, epistaxis and a nodule in the mammary gland showed multifocal lung masses during radiography. At necropsy as well as in the histological examination two different tumours were identified in several organs including the right heart auricle. By immunohistochemistry, using a double‐staining DAKO® kit (DAKO Diagnostics, Zug, Switzerland), it was possible to identify the two components as haemangiosarcoma and metastasizing malignant mixed mammary gland tumour.     

Magnetic resonance tomography in the diagnosis of surgical diseases]

The authors analyse the first experience in the use of magnetic resonance tomography (MP-tomography) in the diagnosis of some surgical diseases. MR-tomography of the mammary gland (257 patients), thymus (55 patients), adrenals (41 patients), and hypophysis (18 patients) was conducted. The results of the examination were compared with the findings of other diagnostic methods and verified intraoperatively and histologically. The authors claim that the high informativeness of MR-tomography, its noninvasiveness, the absence of a radiation load, and the possibility of repeating the examination many times in three mutually-perpendicular planes distinguish the method favorably and dictate the necessity of its further study in clinical medicine.     

Clinical characteristics and treatment of chest submammary accessory breasts

Accessory breast tissue is remnant mammary gland tissue resulting from a failure of regression during the embryonic development and can occur anywhere along the mammary ridge. Patients with accessory breast tissue may also have chest submammary accessory breasts, which are rare and painless, but are often removed for cosmetic reasons. Herein, we report the clinical characteristics and treatment of patients with chest submammary accessory breasts. This retrospective study included 104 women who had undergone liposuction for chest submammary accessory breast from January 2014 to December 2019. chest submammary accessory breasts were diagnosed by ultrasonography and physical examination. The overall satisfaction of patients with chest submammary accessory breast was evaluated using a 5-point Likert scale. The mean operation time was mean 20.7 min and the mean liposuction volume was mean 223.3 mL. The overall satisfaction score (incisional scar, pain and cosmesis) 6 months after chest submammary accessory breast liposuction was 4.7 (range 4–5). The chest submammary accessory breast consisted mainly of fatty tissue rather than mammary gland tissue; thus, chest submammary accessory breasts are painless and are treated purely for cosmetic reasons. In conclusion, liposuction is therefore a simple and effective treatment for chest submammary accessory breast.     

丘状小乳症的临床治疗探讨

目的:探讨丘状小乳症的病因及手术治疗方法。方法:对我科近一年来4例采用乳房假体矫正丘状小乳的病案进行总结,比较假体置入时同期行乳腺后放射状切开、梯田状切开及乳晕双环法缩小后的治疗效果。结果:单纯假体隆乳术后双乳呈葫芦状,形态不佳;假体置入同时行腺体后放射状切开的1例患者术后乳房仍呈葫芦形,程度较轻;假体置入同时行乳腺后梯田状切开的1例患者术后疗效与放射状切开相似;2例假体置入同时行乳晕旁双环法上提的患者获得满意的疗效。结论:丘状小乳症是比较少见的乳房畸形,此类患者未生育前乳腺覆盖胸壁的面积小(远小于正常乳房基底面积),生育时哺乳期乳腺增生、增大导致乳头、乳晕四周皮肤小面积被牵张,又因哺乳导致乳头、乳晕及四周皮肤小面积松弛下垂,这样就导致乳晕及其旁侧的皮肤松弛度大于基底轮廓线外的胸壁皮肤。此类患者最佳的手术治疗方法是行乳房假体置入的同时用双环法矫正乳晕四周的皮肤松弛畸形。     

Local production of estrogen via aromatase and estrone sulfatase in breast cancer tissue

The activities of aromatase and estrone sulfatase which are important enzymes involved in the local production of estrogen in breast cancer tissue were measured to examine their availability in endocrine therapy and their clinical significance. The materials obtained were breast cancer tissue, noncancerous mammary gland and breast fat tissue from twenty eight patients with breast cancer, and mammary gland tissue from eight patients with benign breast disease. After centrifugation of homogenized tissue at 1000 X g, the supernatant of breast cancer tissue or mammary gland and the subnatant of breast fat tissue were used as enzyme sources. Aromatase activity was measured by 3H2O release assay using (1 beta-3H) androstenedione as the substrate, while estrone sulfatase activity was estimated from the conversion rate of (6,7-3H)estrone-3-sulfate to estrone. Aromatase activities were 25.1 +/- 12.4 (mean +/- S.D.) fmol/mg protein/h in twenty seven breast cancer tissue specimens, 11.0 +/- 6.1 fmol/mg protein/h in sixteen noncancerous mammary gland tissue specimens, 9.3 +/- 10.0 fmol/mg protein/h in twenty seven breast fat tissue specimens, and 7.7 +/- 5.5 fmol/mg protein/h in eight mammary gland tissue specimens from patients with benign breast disease. The aromatase activity in breast cancer tissue was significantly higher than that in noncancerous mammary gland, breast fat tissue and benign breast lesions (p less than 0.001). Estrone sulfatase activity was 4.0 +/- 3.5 nmol/mg protein/h in nineteen breast cancer tissue specimens, but was almost undetectable in eleven noncancerous mammary tissue specimens and eight benign breast lesions. These results suggest the relatively high local production of estrogen, mediated by aromatase or estrone sulfatase in breast cancer tissue.(ABSTRACT TRUNCATED AT 250 WORDS)     

内窥镜双平面假体隆乳术的临床应用

目的：探讨应用内窥镜技术进行双平面假体隆乳术的优缺点及可行性。方法：自2010年6月至2011年5月,应用内窥镜开展双平面隆乳21例,6例为未婚女性,15例为哺乳后乳腺萎缩,其中6例伴轻度或中度的乳腺松垂。结果：21例就医者术后随访1～11个月,除1例乳房轻度欠对称外,其余就医者术后乳房形态良好,手感及动感好,无包膜挛缩,无血肿及感染。结论：采用内窥镜微创技术,可通过腋窝切口完成双平面隆乳手术,切口隐蔽,手术在直视下进行,安全性高,手术创伤小,恢复较快,就医者术后疼痛减轻,包膜挛缩发生率降低。由于结合了乳腺后及胸大肌下两个平面的优势,乳房形态更加自然,手感及动感逼真。适用于大多数需要隆乳者,尤其适用于哺乳后乳腺一定程度松垂的就医者。     

Immune Cell Location and Function During Post-Natal Mammary Gland Development

Post-natal mammary gland development requires complex interactions between the epithelial cells and various cell types within the stroma. Recent studies have illustrated the importance of immune cells and their mediators during the various stages of mammary gland development. However, the mechanisms by which these immune cells functionally contribute to mammary gland development are only beginning to be understood. This review provides an overview of the localization of immune cells within the mammary gland during the various stages of post-natal mammary gland development. Furthermore, recent studies are summarized that illustrate the mechanisms by which these cells are recruited to the mammary gland and their functional roles in mammary gland development.     

Surgical treatment of breast neoplasms in early stages

Analysis of literary data and own investigation results for the modern surgical methods of treatment of mammary gland cancer in early stages was performed. Indexes of patients survival after surgical removal of mammary gland (MG) and quadranthectomy did not differ. Preservation of MG constitutes great social and psycho-emotional significance for women-patients.     

Could use of Selective Serotonin Reuptake Inhibitors During Lactation Cause Persistent Effects on Maternal Bone?

The lactating mammary gland elegantly coordinates maternal homeostasis to provide calcium for milk. During lactation, the monoamine serotonin regulates the synthesis and release of various mammary gland-derived factors, such as parathyroid hormone-related protein (PTHrP), to stimulate bone resorption. Recent evidence suggests that bone mineral lost during prolonged lactation is not fully recovered following weaning, possibly putting women at increased risk of fracture or osteoporosis. Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants have also been associated with reduced bone mineral density and increased fracture risk. Therefore, SSRI exposure while breastfeeding may exacerbate lactational bone loss, compromising long-term bone health. Through an examination of serotonin and calcium homeostasis during lactation, lactational bone turnover and post-weaning recovery of bone mineral, and the effect of peripartum depression and SSRI on the mammary gland and bone, this review will discuss the hypothesis that peripartum SSRI exposure causes persistent reductions in bone mineral density through mammary-derived PTHrP signaling with bone.     

Sarcoma of the breast

Experience with the treatment of 16 patients with sarcoma of the mammary gland is described.     

Mammary Gland Involution as an Immunotherapeutic Target for Postpartum Breast Cancer

Postpartum mammary gland involution has been identified as tumor-promotional and is proposed to contribute to the increased rates of metastasis and poor survival observed in postpartum breast cancer patients. In rodent models, the involuting mammary gland microenvironment is sufficient to induce enhanced tumor cell growth, local invasion, and metastasis. Postpartum involution shares many attributes with wound healing, including upregulation of genes involved in immune responsiveness and infiltration of tissue by immune cells. In rodent models, treatment with non-steroidal anti-inflammatory drugs (NSAIDs) ameliorates the tumor-promotional effects of involution, consistent with the immune milieu of the involuting gland contributing to tumor promotion. Currently, immunotherapy is being investigated as a means of breast cancer treatment with the purpose of identifying ways to enhance anti-tumor immune responses. Here we review evidence for postpartum mammary gland involution being a uniquely defined ‘hot-spot’ of pro-tumorigenic immune cell infiltration, and propose that immunotherapy should be explored for prevention and treatment of breast cancers that arise in this environment.     

IGF and Insulin Action in the Mammary Gland: Lessons from Transgenic and Knockout Models

Transgenic and knockout mice have become valuable experimental systems with which tostudy specific molecular events within the mammary gland of an intact animal. These modelshave provided a wealth of information about the effects of a number of oncogenes and growthfactors. This review focuses on results obtained from the application of transgenic and knockoutmodels to determine the roles of insulin and insulin-like growth factors (IGF)³ in the regulationof mammary gland development, lactation and tumorigenesis. Transgenic models whichoverexpress IGF-I or -II display specific alterations in mammary gland development and an increasedincidence of mammary tumors. Analysis of mammary gland development in knockout micewhich are deficient in IGF-I or the IGF-I receptor supports the conclusion that the IGF systemis important for normal mammary gland development. This review discusses these observationsin detail and attempts to fit them into a larger picture of IGF and insulin action in themammary gland.     

Progesterone Receptors in Mammary Gland Development and Tumorigenesis

The steroid hormone, progesterone (P), is a central coordinator of all aspects of female reproductive activity and plays a key role in pregnancy-associated mammary gland morphogenesis and mammary tumorigenesis. The effects of P on the mammary gland are mediated by two structurally and functionally distinct nuclear receptors PR-A and PR-B that arise from a single gene. Null mutation of both receptors in PR knockout (PRKO) mice has demonstrated a critical role for PRs in mediating pregnancy-associated mammary ductal branching and lobuloalveolar differentiation and in initiation of mammary tumors in response to carcinogen. Analysis of the molecular genetic pathways disrupted in PRKO mice has recently yielded important insights into the molecular mechanisms of regulation of mammary gland morphogenesis by PRs. In addition to its essential role in regulating proliferative and differentiative responses of the adult mammary gland during pregnancy, P plays a critical role in the protection against mammary tumorigenesis afforded by early parity. Thus, the effects of P on postnatal developmental plasticity of the mammary gland differ between young and adult glands. This review will summarize recent advances in our understanding of 1) the molecular mechanisms by which PRs mediate pregnancy-associated mammary gland morphogenesis, 2) the role of PRs in mediating tumorigenic responses of the adult mammary gland to carcinogen, and 3) the role of P in long-term protection of the juvenile mammary gland against tumorigenesis. In addition, we will summarize recent insights into the isoform selective contributions to some of these activities of PRs obtained from comparative analysis of P-dependent mammary gland development in PR isoform specific knockout mice lacking either the PR-A (PRAKO) or PR-B (PRBKO).