Are Rotator Muscle Performance and Posterior Shoulder Capsule Tightness Related to Glenohumeral Internal Rotation Deficit in Male College Baseball Players?

BackgroundPosterior inferior capsule (PIC) tightness in the shoulder joint, a known risk factor for shoulder injury, can be assessed using shear-wave ultrasound elastography (SWE). However, to date, the correlation between PIC elasticity and shoulder rotator muscle performance in college baseball players with glenohumeral internal rotation deficit (GIRD) has not been reported. This study aimed to analyze the differences in PIC elasticity measured using SWE and shoulder rotator muscle performance between male college baseball players with and without GIRD.MethodsTwenty-four male college baseball players participated in this study: 10 with GIRD (G group) vs. 14 without GIRD (NG group). PIC elasticity was measured using SWE in the lateral decubitus position. Shoulder rotator muscle performance tests were performed for the internal rotators (IRs) and external rotators (ERs) at an angular velocity of 180°/sec with 90° shoulder abduction using an isokinetic test device.ResultsMean PIC elasticity was significantly greater in the throwing shoulders of the G group than in those of the NG group (4.8 ± 1.2 kPa vs. 3.7 ± 1.2 kPa, p = 0.036). In the throwing shoulders of the G group, compared with those of the NG-group, the ER/IR ratio was significantly lower (35.7% ± 5.0% vs. 55.5% ± 6.2%, p < 0.001) and IR muscle strength was significantly greater (75.0 ± 7.6 Nm kg⁻¹ × 100 vs. 55.7 ± 6.4 Nm kg⁻¹ × 100, p = 0.002). The mean elasticity of the PIC showed a significant negative correlation with the ER/IR ratio in the throwing shoulders of the G group (r = −0.640, p = 0.046).ConclusionsAmong the male college baseball players with GIRD, SWE could quantitatively assess PIC tightness, and an imbalance in shoulder rotator muscle strength was found in these baseball players. Therefore, clinicians and therapists need to focus on the restoration of shoulder rotator muscle imbalance in addition to improving internal rotation in these players.     

乳腺癌转移抑制基因1抑制乳腺癌转移的作用机理研究进展

目的综述乳腺癌转移抑制基因1（BRMS1）在抑制乳腺癌转移中的作用机理研究进展。方法采用文献回顾的方法，对目前国内、外有关BRMS1在乳腺癌中的研究状况加以分析与综述。结果BRMS1与其他肿瘤转移抑制基因一样，主要抑制肿瘤的转移，并不影响肿瘤的生长，在乳腺癌中主要通过调节细胞间的信号转导及其他转移抑制基因的表达而抑制乳腺癌的转移。结论对BRMS1基因的深入研究有助于进一步深化对乳腺癌转移的认识，为肿瘤转移的分子诊断和基因治疗提供新的思路。     

Breast sarcomas: current and future perspectives

Breast sarcomas are rare neoplasms of the breast that need to be clearly distinguished from the very common breast carcinomas and treated in a multidisciplinary manner modelled after treatment paradigms in other sarcoma locations. An increasing need to differentiate sarcoma sub-types based on molecular characteristics that will also be depicted in differential treatment sensitivities and development of specifically targeted therapies are equally valid in sarcomas in general and in breast sarcomas in particular.Of special interest in breast are sarcomas developing after breast irradiation for a previous breast carcinoma, a scenario that is increasingly common, given the increasing trends of breast conservation in the surgical treatment of breast carcinoma that necessitates the adjuvant use of radiotherapy.     

Breast reconstruction in Nova Scotia: Rate,trends and influencing factors

BACKGROUND:

During their lifetime, approximately 10% of Canadian women will develop breast cancer. An increased awareness of breast reconstruction in patients undergoing mastectomy appears to have increased the demand for breast reconstructive surgery.

OBJECTIVES:

To study the rate of breast reconstructive surgeries performed in the province of Nova Scotia to determine whether the breast reconstructive services now offered are adequate to meet the needs of the population of this area.

METHODS:

The number of breast reconstruction procedures and mastectomies completed in the province of Nova Scotia during the time period of 1992 to 2001 was reviewed. The data were obtained from Maritime Medical Care Incorporated, the provincial medical plan. Information available on patients coded as undergoing breast surgeries was reviewed (n=10,056). The data on the trends and demographics of the Nova Scotia population were obtained from Statistics Canada. The data on incidence, prevalence and trends of breast cancer were obtained from the Canadian Cancer Society and the National Cancer Institute of Canada.

RESULTS AND CONCLUSIONS:

There is strong evidence of an increasing trend in the number of reconstructive surgeries among the women who underwent mastectomy. The number of breast reconstruction procedures increased 15 fold during the study period. This is mainly attributed to the increased awareness of women undergoing mastectomy and improved education by surgeons, family physicians and breast cancer support groups. Health sector employees must evaluate these trends to determine if the breast reconstructive services currently offered in this region are adequate. Reconstructive surgery was negatively associated with increasing age. Place of residency (urban versus rural) seems to play a role in women’s decisions to proceed with breast reconstruction.     

Prolactin and Breast Cancer Etiology: An Epidemiologic Perspective

A number of epidemiologic studies of prolactin and breast cancer etiology have recently become available. Retrospective case-control studies have suggested a modest positive or null relationship between circulating prolactin concentrations and risk of breast cancer. However these studies are limited by small sample sizes and the collection of blood after case diagnosis. Several large prospective studies, in which blood was collected prior to diagnosis, have observed modest positive associations between prolactin and risk. In a pooled analysis of ~80% of the world’s prospective data, the relative risk (RR) comparing women in the top vs bottom quartile of prolactin levels was 1.3 (95% confidence interval (CI): 1.1, 1.6, p-trend = 0.002). The results were similar for premenopausal and postmenopausal women. Most notably, high prolactin levels were associated with a 60% increased risk of estrogen receptor (ER) positive tumors, but not with ER negative tumors. Limited genetic data suggest a role of polymorphisms in the prolactin and prolactin receptor genes in risk of breast cancer. Studies of survival have suggested that high pretreatment prolactin levels were associated with treatment failure, earlier recurrence, and worse overall survival. Parity and certain medications are the only confirmed factors associated with prolactin levels in women. Overall, epidemiologic data suggest that prolactin is involved in breast cancer etiology. Further research to better elucidate these associations and their underlying mechanisms is warranted.     

Triple-Negative Breast Cancer: Clinical and Histological Correlations

SUMMARY: Triple-negative breast cancer (TNBC) is characterized by the lack of estrogen and progesterone receptors and the lack of HER2 expression or amplification. Much interest has recently been focused on these triple-negative (TN) subtypes because they may be aggressive and are more likely to recur and metastasize than other subtypes of breast cancer. TNBC accounts for approximately 10-24% of all breast cancer cases, and typically it occurs in younger patients and in patients with BRCA1 mutation. There is a substantial heterogeneity of TNBCs both at the morphological and the molecular level, but there are also common features, such as low tumor grade and accelerated tumor proliferation. Morphologically, TNBC may present as invasive ductal, metaplastic, medullary, apocrine, or other types. Molecularly, they are most frequently associated with a basal phenotype, but there is a distinct subgroup of cancers that are not of basal type and belong to the claudin-low or molecular-apocrine type. The basal phenotype is frequently associated with the loss of BRCA1.     

Simultaneous Bilateral Breast Cancer in a Male: a Case Report and Review of the Literature

A 63-year-old male presented with a bilateral breast carcinoma. Both axillae showed metastases. The patient was treated with a bilateral modified breast amputation. Study of the literature shows that synchronous bilateral breast cancer in males is uncommon. Even in a male with changing breast tissue a carcinoma has to be considered. In male breast cancer, adherence to diagnostic and treatment guidelines for female breast cancer is generally advocated. In males, hormonal causes have to be excluded.     

Breast Disorders in Adolescence: A Review of the Literature

BackgroundAdolescence is accompanied by a variety of changes in young breast development, which greatly affects the adolescent''s psychology and socialization.SummaryPubMed, EMBASE, and the Cochrane Library were searched for studies relative to epidemiology, clinical characteristics, diagnosis, and management of all breast disorders in adolescence and their consequences. Development disorders are breast asymmetry, breast atrophy, breast hypoplasia, hypomastia, juvenile breast hypertrophy, and tuberous breast. Breast congenital abnormalities include athelia, amastia, accessory breast tissue, polymastia, polythelia, and congenital disorders of nipples. Breast infections are commonly caused from Gram-positive coccus rather than Gram-negative bacteria. Breast abscess occurs when breast infections are not promptly treated. Nipple discharge is caused by a variety of conditions and should be managed carefully. Fibrocystic changes, cysts, and fibroadenomas are the most common benign masses in adolescence. Primary, secondary, or metastatic breast cancer is extremely rare in adolescence. However, clinicians should include breast cancer in the differential diagnosis of a breast mass in adolescence.Key MessagesClinicians should be aware of all breast disorders that may occur in adolescence. Early diagnosis and treatment will result in the reassurance of adolescents and their families without any detrimental effect on their psychology, sexual behavior, and socialization. Adolescents with breast disorders may require a multidisciplinary approach by a pediatrician, a gynecologist specializing in pediatric-adolescent gynecology, a plastic surgeon, and a psychologist for the best management of breast disorders.     

Lipid-rich Carcinoma of the Breast: a Case Report

Lipid-rich carcinoma is a rare variant and accounts for < 2% of all breast cancer diagnoses. We report a case occurring in a 53-year-old female. The patient presented with a painless, right breast mass. Clinical examination and mammography suggested malignancy. Subsequent modified radical mastectomy revealed the diagnosis of lipid-rich carcinoma. The morphological features, differential diagnosis and treatment along with a brief review of the literature are discussed in this article.

Lipid-rich carcinoma (L-RC) is a very rare variant of breast carcinomas with an aggressive clinical course and poor prognosis. It presents only 1% to 2% of all breast cases (1,2). It is classified as a specific variety of mammary carcinoma because the tumour cells possess abundant vacuolated cytoplasm which is strongly positive when stained for neutral fat. Aboumrad (2) first described it in 1963 as lipid-secreting carcinoma. However, Ramos and Taylor (1) renamed it as lipid-rich breast carcinoma. In China, the first case was reported in 1984 (3). Herein, we report a case of lipid-rich carcinoma occurring in a 53-year-old female patient, and the literature is reviewed.     

A Modified Excision for Combined Reduction Mammoplasty and Breast Conservation Therapy in the Treatment of Breast Cancer

Wide local excision combined with postoperative radiotherapy is a useful technique for patients with breast cancer. For patients with macromastia whose tumor is situated in the lower pole of the breast, a breast reduction (keyhole\inverted T pattern ) can be used to achieve wide local excision. However, for patients whose tumor is not in the inferior portion of the breast, and in whom this cancer also is situated close to the skin (requiring excision of skin with a 1-cm margin for oncologic safety), the traditional keyhole pattern cannot be used. A modification of the keyhole pattern\inverted T is described. The pedicle used depends on the site of the tumor. Although the breast scars are in different positions, a similar breast shape as well as symmetry still can be achieved. This is a useful technique for a select subgroup of patients. The outcomes for three patients are presented.     

整形技术在乳腺癌乳房再造治疗中的应用

乳腺癌作为多发的恶性肿瘤疾病之一,临床常采用手术方式进行治疗。近年来,国内的医学诊 断和治疗技术不断得到提高,乳腺癌的手术诊疗手段也有很大的进展。但由于部分患者切除了病变乳房, 生理及精神均受到不同程度的创伤。因此,整形外科诊疗技术在乳腺癌治疗中被广泛使用,在解决患者癌 症病灶的同时能够兼顾患者的生理形态美,保证患者生活质量。基于此,本文就乳房再造术、乳房重建手 术类型及其辅助技术作一综述,旨在为乳腺癌患者的相关手术治疗提供参考     

经直肠实时组织弹性成像联合灰阶超声诊断前列腺周围区病灶的价值

目的:探讨经直肠实时组织弹性成像(TRTE)应变图分类方法联合经直肠超声(TRUS)在前列腺周围区病灶鉴别诊断中的价值。方法:对145例怀疑前列腺癌患者行TRUS检查与TRTE检查,根据病灶内的应变图特点,将其分为5级,并与病理结果对照。结果:145例中124例(52例恶性,72例良性)弹性成像质量好。应变图Ⅰ～Ⅴ级中恶性比例分别为6.8%、23.1%、31.3%、75.6%、100%。TRTE诊断前列腺周围区病灶的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为88.5%、70.8%、78.2%、68.7%和89.5%;而TRTE与TRUS联合诊断后分别为78.8%、86.1%、83.1%、80.4%和84.9%。结论:病灶内应变图分类联合TRUS在前列腺周围区病灶鉴别诊断中具有重要价值。     

家属参与模式对乳腺癌患者围术期并发症及乳房美观性的影响

目的 探讨家属参与模式对乳腺癌患者围术期并发症及乳房美观性的影响。方法 选择2022年 1月-10月于南京市妇幼保健院行乳腺癌手术的患者68例，随机分成对照组和观察组，每组34例。对照组行 常规护理，观察组在对照组基础上增加了家属参与模式，比较两组乳房美观评分、家庭关怀度、并发症发生 率。结果 观察组乳头移位、瘢痕增生、乳房凹陷程度评分均优于对照组，差异有统计学意义（P＜0.05）； 观察组干预后APGAR评分为（7.35±1.35）分，高于对照组的（5.48±1.39）分，差异有统计学意义（P＜0.05）； 观察组并发症发生率为2.94%，低于对照组的11.76%，差异有统计学意义（P＜0.05）。结论 家属参与模式可降 低乳腺癌患者围术期并发症发生率，提升乳房美观度和家属关怀度。     

Breast mass characterization using shear wave elastography and ultrasound

Purpose

To evaluate the role of SWE in characterizing breast masses and ascertain whether additional use of SWE to ultrasound for evaluating BI-RADS 3 and 4a masses could help reduce long-term follow-up and unnecessary biopsies of these suspicious breast masses.

Pregnancy after Breast Cancer: Myths and Facts

Most young breast cancer survivors consider reproductive issues to be of great importance, but many questions remain undervalued and unanswered. Overall, available data support the safety and feasibility of pregnancy and breastfeeding after breast cancer. The accuracy of the evidence is however limited by: i) the retrospective and frequently incomplete population-based nature of the data, ii) data not representing the entire population, iii) patient-related effects, iv) underpowered sample size, and v) lack of control for biological factors and risk determinants. We review the available evidence in light of these limitations which outline the need for prospective data collection and focused priority research.     

乳腺癌端粒酶逆转录酶mRNA和BRCA1蛋白表达及其相互关系

目的探讨人乳腺癌组织中端粒酶逆转录酶（hTERT）mRNA和BRCA1蛋白的表达及其二者间的关系。方法采用RT—PCR和免疫组化方法分别检测43例乳腺癌组织和40例乳腺癌癌旁组织中的hTERT mRNA和BRCA1蛋白的表达。结果乳腺癌组织中hTERT mRNA和BRCA1蛋白表达阳性率分别为72．1％（31／43）和34．9％（15／43），hTERT mRNA和BRCA1蛋白在乳腺癌组织及其癌旁组织中表达[5．0％（2／40），77．5％（31／40）]的差异有统计学意义（P〈0．05）；在乳腺癌组织中，hTERT mRNA和BRCA1蛋白的表达呈负相关（r=-0．995，P〈0．01）。结论BRCA1蛋白弱表达与乳腺癌hTERT转录密切相关，可能参与了乳腺癌发生机理。