[Clinicopathologic features and prognostic significance of basal-like breast cancer.]

Zhonghua Bing Li Xue Za Zhi. 2009 May; 38(5): 316-22Liu H, Fan QH, Li X, Liu GZOBJECTIVE: To analyzed a large group of invasive breast cancers with long-term follow-up information to evaluate the clinicopathologic, morphological and prognostic features of basal-like breast cancers in Chinese population. METHODS: Immunohistochemistry was used to detect the expression of ER, HER2, CK5/6, EGFR on tissue microarray with 1311 invasive breast cancers. Based on the results, these cases were categorized into luminal A, luminal B, basal-like, HER2-overexpressing and null subtypes. Clinicopathological features and survival rates were compared between these groups. RESULTS: Basal-like breast cancers constituted 17.0% of 1311 invasive breast cancers with a significantly larger size, higher grade and higher incidence of the medullary carcinoma, frequent recurrence and infrequent node metastasis. Morphologically, basal-like breast cancers showed a significantly more solid architecture and ribbon-like architecture associated with necrosis (more geographic necrosis) and central scar, a more pushing margin, lymphocytic infiltration and a higher mitosis score, more syncytial growth, presence of basaloid cells, spindle cells and squamous metaplasia. The disease-free survival and overall survival of basal-like breast cancers were significantly poorer than that of luminal A subtype, but similar to the other ER-negative subtypes. Basal markers were not independent prognostic factors. CONCLUSIONS: Basal-like breast cancers in Chinese population has a similar prevalence to that of the western populations. They have distinct clinicopathologic features compared to other non-basal breast cancers, but overlapping with other ER-negative breast cancers. Morphological features are strongly associated with basal-like breast cancers although they are not very specific. The survival of basal-like breast cancers is poorer than luminal A, but similar to the other ER-negative breast cancers, and basal markers are not independent prognostic factors of breast cancers.

A versatile breast reduction technique: Conical plicated central U shaped (COPCUs) mammaplasty.

Ann Surg Innov Res. 2009 Jul 3; 3(1): 7Copcu EABSTRACT: BACKGROUND: There have been numerous studies on reduction mammaplasty and its modifications in the literature. The multitude of modifications of reduction mammaplasty indicates that the ideal technique has yet to be found. There are four reasons for seeking the ideal technique. One reason is to preserve functional features of the breast: breastfeeding and arousal. Other reasons are to achieve the real geometric and aesthetic shape of the breast with the least scar and are to minimize complications of prior surgical techniques without causing an additional complication. Last reason is the limitation of the techniques described before. To these aims, we developed a new versatile reduction mammaplasty technique, which we called conical plicated central U shaped (COPCUs) mammaplasty. METHODS: We performed central plication to achieve a juvenile look in the superior pole of the breast and to prevent postoperative pseudoptosis and used central U shaped flap to achieve maximum NAC safety and to preserve lactation and nipple sensation. The central U flap was 6cm in width and the superior conical plication was performed with 2/0 PDS. Preoperative and postoperative standard measures of the breast including the superior pole fullness were compared. RESULTS: Forty six patients were operated with the above mentioned technique. All of the patients were satisfied with functional and aesthetic results and none of them had major complications. There were no changes in the nipple innervation. Six patients becoming pregnant after surgery did not experience any problems with lactation. None of the patients required scar revision. CONCLUSION: Our technique is a versatile, safe, reliable technique which creates the least scar, avoids previously described disadvantages, provides maximum preservation of functions, can be employed in all breasts regardless of their sizes.

[Clinical, pathological and radiological characteristics of 83 cases of pleural tuberculoma.]

Zhonghua Jie He He Hu Xi Za Zhi. 2009 Apr; 32(4): 262-5Tang SJ, Xiao HP, Chen G, Liu YD, Fan L, Zhang Q, Sun H, Gu J, Yao LOBJECTIVE: To investigate the clinical, pathological and radiological characteristics of pleural tuberculoma, so as to improve the understanding of this disease. METHODS: We retrospectively analyzed the clinical, laboratory, pathological and radiological data of 83 cases of pleural tuberculoma diagnosed by pathology and(or) bacteriology in Shanghai Pulmonary Hospital Affiliated to Tongji University. RESULTS: In the recruited 83 cases, there were 50 males and 33 females, aged from 7 to 85 years old, with a mean age of 37.8 years. Cough, fever and chest pain were common symptoms, but no significant symptoms were seen in 25 patients (31.3%). Some patients had positive physical signs, such as dullness to percussion and low breath sound. Pulmonary tuberculosis was also present in 36 patients (43.3%) with pleural tuberculoma. A history of tuberculous pleurisy was elicited in 80 patients, among whom 45 (56.3%) received delayed antituberculous treatment and 42 (52.5%) received nonstandard treatment. Forty-eight cases (60.0%) did not receive corticosteroids. Fifty-nine cases underwent CT-guided percutaneous biopsy, while 24 underwent thoracoscopic surgery, and tuberculosis was pathologically confirmed in 62 (74.7%). Pathological profiles included granuloma, coagulation or caseation necrosis, lymphocyte infiltration, epithelioid cells, inflammatory cells, histiocytes and scar tissue. Fifteen (18.1%) specimens from percutaneous biopsy were anti-fast smear positive, while Mycobacterium tuberculosis was obtained by culture in 21 (25.3%) cases. Chest X-ray showed that solitary lesions were seen in 68 cases, multiple foci in 15. The lesions of 46 cases (55.4%) occupied the lower right lobes. Round-like shadows were the most common signs, which were present in 63 cases (75.9%). CT examination demonstrated homogeneous density in 20, heterogeneous density in 40, calcification in 9, central attenuation in 34, and peripheral intensification in 28 cases. CONCLUSIONS: Pleural tuberculoma is an important sequelae of tuberculous pleurisy. Understanding its clinical, pathological and radiological characteristics is helpful for the differential diagnosis of pleural and lung diseases.