“Ruyong(breast abscess)”has a high incidence rate.Traditional Chinese medicine(TCM)diagnosis and treatment of this condition demonstrate significant advantages,including diverse therapeuticmethods,outstanding effica...“Ruyong(breast abscess)”has a high incidence rate.Traditional Chinese medicine(TCM)diagnosis and treatment of this condition demonstrate significant advantages,including diverse therapeuticmethods,outstanding efficacy,and high safety.Based on TCM theory and combining relevant ancient texts and modern research,this paper systematically summarizes the different understandings of“Ruyong(breast abscess)”by physicians throughout history in terms of disease names,etiology,pathogenesis,and treatment.The ancient names for Ruyong(breast abscess)were varied,also referred to as“Duru(stagnation in breast)”or“Naichuang(breast sore)”.Its symptoms are diverse,with the main clinical manifestations being localized redness,swelling,heat,pain,and poor milk discharge in the affected breast.The etiology is primarily attributed to“milk stasis”“liver qi stagnation and stomach heat”and“exposure to external pathogens”.Additionally,this paper summarizes the treatment experiences from ancient and modern medical texts and highlights the complementary effects of internal and external therapies.This study provides a reference for modern clinical understanding and treatment of“Ruyong(breast abscess)”in the hope of further improvement of clinical efficacy.展开更多
In the era of precision medicine,the breast cancer surgical treatment field is gradually moving toward a de-escalation model.Through precise preoperative assessments and multidisciplinary decision-making,surgical trau...In the era of precision medicine,the breast cancer surgical treatment field is gradually moving toward a de-escalation model.Through precise preoperative assessments and multidisciplinary decision-making,surgical trauma can be decreased,and patients’quality of life can be improved by ensuring safety.Herein,we explore the axillary de-escalation surgery model for breast cancer.展开更多
The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagn...The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagnostic techniques,such as sentinel lymph node biopsy(SLNB),has markedly diminished the extent of surgery required for regional lymph nodes.展开更多
Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside a...Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside assessments of aesthetic symmetry,functional restoration,complication rates,and long-term stability of the reconstruction.This study aimed to assess the mobility of the reconstructed breast following various breast reconstruction techniques,specifically by comparing deep inferior epigastric perforator(DIEP) flaps and pedicled transverse rectus abdominis musculocutaneous(TRAM) flaps.We conducted a longitudinal case study to investigate the changes in breast movement resulting from different surgical interventions.The comparison showed that DIEP flap reconstruction was more likely to achieve superior breast mobility outcomes than TRAM flap reconstruction.For a better breast aesthetic outcome,it is fundamental to improve the awareness of the dynamic evaluation of the reconstructed breast at the surgical strategy level.展开更多
Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted...Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted among 60 primi postnatal mothers(30 in each group).Study was conducted at the Postnatal ward of IMS and SUM Hospital,Bhubaneswar,Odisha.Tools used were structured sociodemographic pro forma,structured breast milk adequacy questionnaire,and structured rating scale to assess the adequacy of breast milk production.The duration of the study is 1 year.All the postnatal mothers who were primigravida and undergone cesarean section were chosen as the sample through a convenience sampling technique.Then,the samples were assigned to the intervention group(receiving neck massage)and control group(receiving standard postnatal care).The data were collected and analyzed using both descriptive and inferential statistics by SPSS version 20.Results:The study resulted a significant difference between the pretest and posttest score of breast milk production after neck massage(P=0.000).The mean score of the posttest(2.90±0.36)is more than the mean score of the pretest(2.89±0.36)of the baby’s weight(P<0.001).Further,the number of urination and stool passed in 24 h was more in the intervention group than the control group(P<0.001).The Chi-square analysis showed statistical significance between breast milk production after neck massage with religion of the postnatal mothers(P<0.05).Conclusion:The neck massage is found effective in improving the breast milk production among primi c-section mothers with improve newborn parameters.展开更多
Objectives:To explore the efficacy and safety of virtual reality(VR)in relieving negative emotions in patients with breast cancer with different personalities.Methods:A randomized controlled trial was conducted.Betwee...Objectives:To explore the efficacy and safety of virtual reality(VR)in relieving negative emotions in patients with breast cancer with different personalities.Methods:A randomized controlled trial was conducted.Between April 2023 and October 2023,we enrolled patients with breast cancer treated in the Department of Breast Cancer and Oncology at Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangdong Province.The patients were randomly divided into an intervention group(n=118)and a control group(n=119)using block randomization.The intervention group received the VR intervention 3-5 times over 5±2 weeks using natural landscapes with music or relaxation guidance,and the duration of each VR intervention was 15±3 min.The control group received routine nursing care,including disease education and psychological counseling.Patients were assessed using the Type D Scale,Positive and Negative Affect Scale,and Distress Thermometer,and adverse events during the intervention were recorded.Results:Overall,85 patients completed the study(44 in the intervention group and 41 in the control group).Patients with Type D personalities showed more negative emotions[25.0(21.5,27.5)vs.19.0(16.0,24.0),P=0.001]and distressed attitudes[4.0(2.0,5.0)vs.3.0(1.0,4.0),P=0.020]with fewer positive emotions(27.2±5.6 vs.31.0±5.9,P=0.014)than those with non-Type D personalities.Total population analysis revealed no significant differences between the groups.However,in the subgroup analysis,patients with Type D personalities in the intervention group showed greater relief from negative emotions than those in the control group[median difference,-5.0(-9.0,-2.5)vs.-2.0(-4.0,2.0),P=0.046].No significant differences were found between groups of patients with non-Type D personality traits.The proportion of adverse events was not significantly different between groups(P=0.110).Conclusions:Breast cancer patients with Type D personalities suffer more severe negative emotions and distress,and more attention should be paid to them.VR intervention significantly and safely reduced negative emotions in patients with Type D personalities.展开更多
Triple-negative breast cancer(TNBC)is currently the most heterogeneous and aggressive breast cancer type.It has a high recurrence rate,poor clinical prospects,and lack of predictive markers and potential treatment opt...Triple-negative breast cancer(TNBC)is currently the most heterogeneous and aggressive breast cancer type.It has a high recurrence rate,poor clinical prospects,and lack of predictive markers and potential treatment options.Dysregulated microRNAs(miRNAs)are involved in various cellular processes in TNBC.Moreover,variations in the miRNA levels in TNBC may act as a dependable indicator for predicting the effectiveness and specificity of treatments.Currently,the application of miRNAs for breast cancer therapy is primarily in the preclinical stage,with a focus on identifying highly specific and sensitive miRNAs that could offer new possibilities for early diagnosis,clinical treat-ment,and prognostic monitoring of TNBC.展开更多
BACKGROUND Breast cancer is one of the most prevalent causes of morbidity and mortality worldwide,presenting an increasing public health challenge,particularly in lowincome and middle-income countries.However,data on ...BACKGROUND Breast cancer is one of the most prevalent causes of morbidity and mortality worldwide,presenting an increasing public health challenge,particularly in lowincome and middle-income countries.However,data on the knowledge,attitudes,and preventive practices regarding breast cancer and the associated factors among females in Wollo,Ethiopia,remain limited.AIM To assess the impact of family history(FH)of breast disease on knowledge,attitudes,and breast cancer preventive practices among reproductive-age females.METHODS A community-based cross-sectional study was conducted in May and June 2022 in Northeast Ethiopia and involved 143 reproductive-age females with FH of breast diseases and 209 without such a history.We selected participants using the systematic random sampling technique.We analyzed the data using Statistical Package for Social Science version 25 software,and logistic regression analysis was employed to determine odds ratios for variable associations,with statistical significance set at P<0.05.RESULTS Among participants with FH of breast diseases,the levels of knowledge,attitudes,and preventive practices were found to be 83.9%[95%confidence interval(CI):77.9-89.9],49.0%(95%CI:40.8-57.1),and 74.1%(95%CI:66.9-81.3),respectively.In contrast,among those without FH of breast diseases,these levels were significantly decreased to 10.5%(95%CI:6.4-14.7),32.1%(95%CI:25.7-38.4),and 16.7%(95%CI:11.7-21.8),respectively.This study also indicated that knowledge,attitudes,and preventive practices related to breast cancer are significantly higher among participants with FH of breast diseases compared to those without HF breast diseases.CONCLUSION Educational status,monthly income,and community health insurance were identified as significant factors associated with the levels of knowledge,attitudes,and preventive practices regarding breast cancer among reproductive-age females.展开更多
Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were ...Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were sourced from GLOBOCAN 2022,including estimated new cases and deaths from BC across 21 United Nation(UN)regions and 185 countries,the age-standardized incidence rate(ASIR)and mortality rate(ASMR),the estimated annual percentage changes(EAPC),and demographic projections through 2050.The region-specific and country-specific BC burden for women of all ages and for young women(<40 years old)was reorganized and re-plotted to highlight subgroup differences.Linear regression was used to explore the link between ASIR/ASMR and the human development index(HDI).Transitioning countries referred to those with low or medium HDI,while transitioned countries were those with high or very high HDI.Results In 2022,an estimated 2.3 million new BC cases and 666,000 BC-related deaths occurred globally,accounting for 23.8%and 15.4%of all cancer cases and deaths in women,respectively.Regionally,Eastern Asia reported the highest number of cases(480,019,ASIR:37.54/100,000),while South-Central Asia had the highest number of deaths(135,348,ASMR:13.41/100,000).At the country level,China had the highest number of cases due to its large population,whereas India reported the highest number of deaths.ASIR for both overall and early-onset BC increased with HDI,while ASMR for early-onset BC decreased with HDI(P<0.05).Overall BC showed an increasing trend in ASIR during 2003–2015(EAPC:0.92%)and a decreasing trend in ASMR during 2006–2016(EAPC:-1.06%).Early-onset BC showed a more significant rise in ASIR(EAPCs:1.4%)and a slight increase in ASMR(EAPCs:0.16%).If national rates remain stable,BC cases and deaths will increase by 54.7%and 70.9%,respectively,by 2050.Notably,increased early-onset BC cases are only observed in transitioning countries,while decreased cases are seen in transitioned countries.Conclusions Breast cancer remains the leading cancer burden in women,particularly in transitioning countries.Addressing this growing burden requires urgent integration of primary prevention,early detection and high-quality treatment through multi-sectoral collaboration.展开更多
Objective:Early predicting response before neoadjuvant chemotherapy(NAC)is crucial for personalized treatment plans for locally advanced breast cancer patients.We aim to develop a multi-task model using multiscale who...Objective:Early predicting response before neoadjuvant chemotherapy(NAC)is crucial for personalized treatment plans for locally advanced breast cancer patients.We aim to develop a multi-task model using multiscale whole slide images(WSIs)features to predict the response to breast cancer NAC more finely.Methods:This work collected 1,670 whole slide images for training and validation sets,internal testing sets,external testing sets,and prospective testing sets of the weakly-supervised deep learning-based multi-task model(DLMM)in predicting treatment response and pCR to NAC.Our approach models two-by-two feature interactions across scales by employing concatenate fusion of single-scale feature representations,and controls the expressiveness of each representation via a gating-based attention mechanism.Results:In the retrospective analysis,DLMM exhibited excellent predictive performance for the prediction of treatment response,with area under the receiver operating characteristic curves(AUCs)of 0.869[95%confidence interval(95%CI):0.806−0.933]in the internal testing set and 0.841(95%CI:0.814−0.867)in the external testing sets.For the pCR prediction task,DLMM reached AUCs of 0.865(95%CI:0.763−0.964)in the internal testing and 0.821(95%CI:0.763−0.878)in the pooled external testing set.In the prospective testing study,DLMM also demonstrated favorable predictive performance,with AUCs of 0.829(95%CI:0.754−0.903)and 0.821(95%CI:0.692−0.949)in treatment response and pCR prediction,respectively.DLMM significantly outperformed the baseline models in all testing sets(P<0.05).Heatmaps were employed to interpret the decision-making basis of the model.Furthermore,it was discovered that high DLMM scores were associated with immune-related pathways and cells in the microenvironment during biological basis exploration.Conclusions:The DLMM represents a valuable tool that aids clinicians in selecting personalized treatment strategies for breast cancer patients.展开更多
BACKGROUND Breast cancer(BC)continues to occupy a leading position in terms of morbidity and mortality from malignant neoplasms among the female population.One of the promising markers associated with BC progression i...BACKGROUND Breast cancer(BC)continues to occupy a leading position in terms of morbidity and mortality from malignant neoplasms among the female population.One of the promising markers associated with BC progression is programmed death ligand 1(PD-L1).Previously,we investigated PD-L1 expression in BC via a new antibody against programmed cell death protein 1 ligand 1(PDCD1 LG1)and reported that high PDCD1 LG1 expression in tumor cells is an independent factor for a high risk of regional metastasis in patients with BC.However,the prognostic significance of PDCD1 LG1 expression in BC stromal cells has not been adequately studied.AIM To study the features of PDCD1 LG1 expression in BC stromal cells and its relationship with BC clinicopathological characteristics.METHODS In a prospective single-center observational study,tumor samples from 148 patients with newly diagnosed BC were examined.The tumor sections were immunohistochemically stained with antibodies against PDCD1 LG1.In the tumor samples,the PDCD1 LG1-positive lymphocyte(PDCD1 LG1+LF)score,presence of nuclear PDCD1 LG1 expression in the LFs,PDCD1 LG1 expression in polymorphic cell infiltrates(PDCD1 LG1+polymorphic cell infiltrates[PCIs]),and cells of the fibroblastic stroma and endothelial cells of the tumor microvessels were assessed.Statistical analyses were performed using Statistica 10.0 software.RESULTS A PDCD1 LG1+LF score≥3 was detected more often at stages N0 and N3 than at N1 and N2(P=0.03).Moderate and pronounced PDCD1 LG1+PCIs and the presence of PDCD1 LG1+fibroblastic stroma were associated with negative estrogen receptor status(P=0.0008 and P=0.03,respectively),human epidermal growth factor receptor 2-positive(HER2+)BC(P<0.00001 and P=0.0005),and luminal B HER2+,non-luminal HER2+and triple-negative BC(P<0.00001 and P=0.004).The risk of metastasis to regional lymph nodes(RLNs)depend on lymphovascular invasion(LVI)and the PDCD1 LG1+LF score.In the absence of LVI and a PDCD1 LG1+LF score<3 or≥3,metastases in RLNs were absent in 66.6%and 93.9%of patients with BC,respectively.In the presence of LVI and a PDCD1 LG1+LF score<3 or≥3,metastases in RLNs were detected in 82.6%and 92.7%of patients with BC,respectively.CONCLUSION The results indicated that the combined assessment of the PDCD1 LG1+LF score and LVI can improve the accuracy of predicting the risk of metastasis to RLNs in patients with BC.展开更多
Objective:Triple-negative breast cancer(TNBC)is a highly aggressive subtype that lacks targeted therapies,leading to a poorer prognosis.However,some patients achieve long-term recurrence-free survival(RFS),offering va...Objective:Triple-negative breast cancer(TNBC)is a highly aggressive subtype that lacks targeted therapies,leading to a poorer prognosis.However,some patients achieve long-term recurrence-free survival(RFS),offering valuable insights into tumor biology and potential treatment strategies.Methods:We conducted a comprehensive multi-omics analysis of 132 patients with American Joint Committee on Cancer(AJCC)stage III TNBC,comprising 36 long-term survivors(RFS≥8 years),62 moderate-term survivors(RFS:3-8 years),and 34 short-term survivors(RFS<3 years).Analyses investigated clinicopathological factors,whole-exome sequencing,germline mutations,copy number alterations(CNAs),RNA sequences,and metabolomic profiles.Results:Long-term survivors exhibited fewer metastatic regional lymph nodes,along with tumors showing reduced stromal fibrosis and lower Ki67 index.Molecularly,these tumors exhibited multiple alterations in genes related to homologous recombination repair,with higher frequencies of germline mutations and somatic CNAs.Additionally,tumors from long-term survivors demonstrated significant downregulation of the RTK-RAS signaling pathway.Metabolomic profiling revealed decreased levels of lipids and carbohydrate,particularly those involved in glycerophospholipid,fructose,and mannose metabolism,in long-term survival group.Multivariate Cox analysis identified fibrosis[hazard ratio(HR):12.70,95%confidence interval(95%CI):2.19-73.54,P=0.005]and RAC1copy number loss/deletion(HR:0.22,95%CI:0.06-0.83,P=0.026)as independent predictors of RFS.Higher fructose/mannose metabolism was associated with worse overall survival(HR:1.30,95%CI:1.01-1.68,P=0.045).Our findings emphasize the association between biological determinants and prolonged survival in patients with TNBC.Conclusions:Our study systematically identified the key molecular and metabolic features associated with prolonged survival in AJCC stage III TNBC,suggesting potential therapeutic targets to improve patient outcomes.展开更多
Bone metastasis is the primary cause of mortality in breast cancer(BC)patients.The present study elucidates the functional role of the differentiated embryonic chondrocyte-expressed gene 1(DEC1)in promoting BC-related...Bone metastasis is the primary cause of mortality in breast cancer(BC)patients.The present study elucidates the functional role of the differentiated embryonic chondrocyte-expressed gene 1(DEC1)in promoting BC-related bone metastasis.Analysis of patient-derived samples and public databases revealed a significant upregulation of DEC1 and CXCR4 in breast tumors compared with adjacent normal tissues,with elevated levels correlating with increased metastatic potential,suggesting their synergistic involvement in BC progression.Intracardiac injection experiments demonstrated that Dec1-WT 4T1 cells induced more severe osteolysis and larger metastatic lesions than Dec1-KD 4T1 cells.In MDA-MB-231 cells,DEC1 overexpression(OE)upregulated CXCR4 and proliferation/migration-related genes,whereas DEC1 knockdown reversed these effects.Notably,AMD3100,a specific CXCR4 antagonist,partially reversed the DEC1-OE-induced upregulation of CXCR4 and associated pro-metastatic genes.Mechanistically,DEC1 bound to the CXCR4 promoter region(-230 to-326)and activated its transcription,corroborated by ChIP-seq data.Furthermore,pharmacological inhibition of AKT(LY294002)or JAK2(AZD1480),but not ERK(PD98059),attenuated DEC1-mediated CXCR4 upregulation,although all three inhibitors mitigated DEC1-driven migration-related gene expression.Additionally,DEC1 enhanced CXCL12 secretion from mesenchymal stromal cells and osteoblasts,amplifying the CXCR4/CXCL12 axis within the bone microenvironment.Collectively,our findings demonstrate that DEC1 promotes BC bone metastasis by directly transactivating CXCR4 expression,providing a molecular basis for targeting DEC1 to prevent and treat BC bone metastasis.展开更多
Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting...Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition zone.Although cellular origin of this neoplasm remains controversial,most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic differentiation.Despite recent research on the therapeutic strategies against CS neoplastic disorders,surgical resection appears the only potentially curative approach.Since CS metastasize by the lymphatic route,axillary assessment with sentinel lymph node biopsy and/or axillary lymph node dissection is always implemented.Nevertheless,the tumor also presents a hematogenous metastatic pattern including pleural,pulmonary,liver,brain and less commonly bone metastases.Thus,surgical removal of breast CS does not necessarily ensure patient’s long-term recovery.Moreover,alternative therapies,such as radio-and chemotherapy proved insufficient and 5-year survival rate is limited.Nevertheless,there is evidence that following surgery,the combination of radio and chemotherapy is associated with a better prognosis than either treatment alone.The aim of this review is to evaluate the results of surgical treatment for breast CS with special reference to the extent of its histological spread.Clinical features,histogenesis,morphological and immunochemical findings are discussed,while the role of current diagnostic and therapeutic management of this aggressive neoplasm is emphasized.展开更多
Background:Immune checkpoint inhibitors play an important role in the treatment of solid tumors,but the currently used immune checkpoint inhibitors targeting programmed cell death-1(PD-1),programmed cell death ligand-...Background:Immune checkpoint inhibitors play an important role in the treatment of solid tumors,but the currently used immune checkpoint inhibitors targeting programmed cell death-1(PD-1),programmed cell death ligand-1(PD-L1),and cytotoxic T-lymphocyte antigen-4(CTLA-4)show limited clinical efficacy in many breast cancers.B7H3 has been widely reported as an immunosuppressive molecule,but its immunological function in breast cancer patients remains unclear.Methods:We analyzed the expression of B7H3 in breast cancer samples using data from the Cancer Genome Atlas Program(TCGA)and the Gene Expression Omnibus(GEO)databases.MicroRNAs were selected using the TarBase,miRTarBase,and miRBase databases.The regulatory role of the microRNA hsa-miR-214-3p on B7H3 was investigated through dual-luciferase reporter assays,which identified the specific action sites of interaction.The expression levels of B7H3 and hsa-miR-214-3p in human breast cancer tissues and adjacent normal tissues were quantified using Western blotting and quantitative PCR(qPCR).In vitro experiments were performed to observe the effects of modulating the expression of B7H3 or hsa-miR-214-3p on breast cancer cell proliferation and apoptosis.Additionally,the regulatory impact of hsa-miR-214-3p on B7H3 was examined.Enzyme-linked immunosorbent assays(ELISA)and flow cytometry were employed to assess the effects of co-cultured breast cancer cells and normal human peripheral blood mononuclear cells(PBMCs)on immune cells and associated cytokines.Results:In breast cancer tissues,the expression level of B7H3 is inversely correlated with that of hsa-miR-214-3p,as well as with the regulatory effects on breast cancercell behavior.Hsa-miR-214-3p was found to inhibit breast cancer cell growth by downregulating B7H3.Importantly,our research identified,for the first time,two binding sites for hsa-miR-214-3p on the 3’UTR of B7H3,both of which exert similar effects independently.Co-culture experiments revealed that hsamiR-214-3p obstructs the suppressive function of B7H3 on CD8^(+)T cells and natural killer cells.Conclusions:This study confirms the existence of two hsa-miR-214-3p binding sites on the 3’UTR of B7H3,reinforcing the role of hsamiR-214-3p as a regulatory factor for B7H3.In breast cancer,hsa-miR-214-3p reduces tumor cell proliferation and enhances the tumor immune microenvironment by downregulating B7H3.These findings suggest new potential targets for the clinical treatment of breast cancer.展开更多
Background:Triple-negative breast cancer(TNBC),characterized by its lack of traditional hormone receptors and HER2,presents a significant challenge in oncology due to its poor response to conventional therapies.Autoph...Background:Triple-negative breast cancer(TNBC),characterized by its lack of traditional hormone receptors and HER2,presents a significant challenge in oncology due to its poor response to conventional therapies.Autophagy is an important process for maintaining cellular homeostasis,and there are currently autophagy biomarkers that play an effective role in the clinical treatment of tumors.In contrast to targeting protein activity,intervention with proteinprotein interaction(PPI)can avoid unrelated crosstalk and regulate the autophagy process with minimal interference pathways.Methods:Here,we employed Naive Bayes,Decision Tree,and k-Nearest Neighbors to elucidate the complex PPI network associated with autophagy in TNBC,aiming to uncover novel therapeutic targets.Meanwhile,the candidate proteins interacting with Beclin 2 were initially screened in MDA-MB-231 cells using Beclin 2 as bait protein by immunoprecipitation-mass spectrometry assay,and the interaction relationship was verified by molecular docking and CO-IP experiments after intersection.Colony formation,cellular immunofluorescence,cell scratch and 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)tests were used to predict the clinical therapeutic effects of manipulating candidate PPI.Results:By developing three PPI classification models and analyzing over 13,000 datasets,we identified 3733 previously unknown autophagy-related PPIs.Our network analysis revealed the central role of Beclin 2 in autophagy regulation,uncovering its interactions with 39 newly identified proteins.Notably,the CO-IP studies identified the substantial interaction between Beclin 2 and Ubiquilin 1,which was anticipated by our model and discovered in immunoprecipitation-mass spectrometry assay results.Subsequently,in vitro investigations showed that overexpressing Beclin 2 increased Ubiquilin 1,promoted autophagy-dependent cell death,and inhibited proliferation and metastasis in MDA-MB-231 cells.Conclusions:This study not only enhances our understanding of autophagy regulation in TNBC but also identifies the Beclin 2-Ubiquilin 1 axis as a promising target for precision therapy.These findings open new avenues for drug discovery and offer inspiration for more effective treatments for this aggressive cancer subtype.展开更多
Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer...Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer.Methods We retrospectively reviewed the records of 394 consecutive patients with pathologically confirmed breast lesions who had undergone 3-T magnetic resonance imaging(MRI).The morphological characteristics of breast lesions were evaluated using DCE,DWI,and T2WI based on BI-RADS lexicon descriptors by trained radiologists.Patients were categorized into mass and non-mass groups based on MRI characteristics of the lesions,and the differences between benign and malignant lesions in each group were compared.Clinical prediction models for breast cancer diagnosis were constructed using logistic regression analysis.Diagnostic efficacies were compared using the area under the receiver operating characteristic curve(AUC)and DeLong test.Results For mass-like lesions,all the morphological parameters significantly differentiated benign and malignant lesions on consensus DCE,DWI,and T2WI(P<0.05).The combined method(DCE+DWI+T2WI)had a higher AUC(0.865)than any of the individual modality(DCE:0.786;DWI:0.793;T2WI:0.809)(P<0.05).For non-mass-like lesions,DWI signal intensity was a significant predictor of malignancy(P=0.036),but the model using DWI alone had a low AUC(0.669).Conclusion Morphological assessment using the combination of DCE,DWI,and T2WI provides better diagnostic value in differentiating benign and malignant breast mass-like lesions than assessment with only one of the modalities.展开更多
BACKGROUND The programmed cell death protein 1 inhibitor pembrolizumab has become a key treatment for various cancers,including triple-negative breast cancer.However,it is associated with immune-related adverse events...BACKGROUND The programmed cell death protein 1 inhibitor pembrolizumab has become a key treatment for various cancers,including triple-negative breast cancer.However,it is associated with immune-related adverse events,including rare but serious neurological complications such as Guillain-Barrésyndrome(GBS).GBS is a potentially life-threatening autoimmune disorder characterized by muscle weakness and paralysis.We present a unique case of pembrolizumab-induced GBS to highlight the importance of recognizing this complication and managing it promptly in patients receiving immune checkpoint inhibitors.CASE SUMMARY A 69-year-old woman with a medical history of hypertension,anxiety,depression,and stage IIIB triple-negative breast cancer treated with pembrolizumab,carboplatin,and paclitaxel,presented to the emergency department with a 1-month history of tingling,lower extremity weakness,and shooting pain.Symptoms progressed to global weakness,ascending paralysis,and double vision.Neurological examination revealed significant lower extremity weakness and sensory deficits.Magnetic resonance imaging of the lumbar spine and cerebrospinal fluid analysis confirmed GBS.Initial treatment with intravenous immunoglobulin led to relapse,requiring additional intravenous immunoglobulin and high-dose glucocorticoids.The patient’s condition improved,pembrolizumab therapy was permanently discontinued,and she was discharged to a rehabilitation facility.CONCLUSION Pembrolizumab can induce GBS,necessitating early recognition,prompt diagnosis,and multidisciplinary management to prevent serious complications.展开更多
BACKGROUND:Breast hyperplasia is a common benign breast disease mainly caused by endocrine disorders,manifested as abnormal hyperplasia of breast tissue.In recent years,traditional Chinese medicine compounds and probi...BACKGROUND:Breast hyperplasia is a common benign breast disease mainly caused by endocrine disorders,manifested as abnormal hyperplasia of breast tissue.In recent years,traditional Chinese medicine compounds and probiotics have shown good potential in regulating the endocrine system and improving the intestinal microecology,providing new ideas for the treatment of breast hyperplasia.OBJECTIVE:To explore the effects and mechanisms of traditional Chinese medicine compounds and fermented probiotic compounds on breast hyperplasia in mice,providing new theoretical and experimental bases for the clinical treatment and prevention of breast hyperplasia.METHODS:(1)Network pharmacology tools were used to predict the anti-breast-hyperplasia activity of Herba Gueldenstaedtiae(Euphorbia humifusa),as well as its potential targets and signaling pathways.The databases included:TCMSP,OMIM,GeneCards database,UniProt website,Venny2.1.0 website,Metascape,HERB website,and STRING database,all of which are open-access databases.Network pharmacology can predict and screen key information such as the targets corresponding to the active ingredients of traditional Chinese medicine,disease targets,and action pathways through network analysis and computer-system analysis.Therefore,it has been increasingly widely used in the research of traditional Chinese medicine.(2)A breast hyperplasia model was induced in mice by injecting estrogen and progesterone.Mice in the normal blank group were injected intraperitoneally with normal saline every day.Mice in the model group and drugadministration groups were injected intraperitoneally with estradiol benzoate injection at a concentration of 0.5 mg/kg every day for 25 days.From the 26th day,the injection of estradiol benzoate injection was stopped.Mice in the normal blank group were injected intramuscularly with normal saline every day,and mice in the model group and drug-administration groups were injected intramuscularly with progesterone injection at a concentration of 5 mg/kg for 5 days.After the model was established,each group was given drugs respectively.The normal blank group and the model group were gavaged with 0.2 mL/d of normal saline;the positive blank group(Xiaozheng Pill group)was gavaged with an aqueous solution of Xiaozheng Pill at 0.9 mg/g;the low-,medium-and high-dose groups of Compound Herba Gueldenstaedtiae were gavaged with an aqueous solution of the compound medicine at 0.75,1.5,and 3.0 mg/(g·d)respectively;the low-,medium-and high-dose groups of traditional Chinese medicine-bacteria fermentation were gavaged with an aqueous solution of the compound medicine at 0.75,1.5,and 3.0 mg/(g·d)respectively.The administration was continuous for 30 days.RESULTS AND CONCLUSION:(1)The results of network pharmacology research showed that the Compound Herba Gueldenstaedtiae(Euphorbia humifusa)contained 46 active ingredients,which were related to 1213 potential targets.After comparison with 588 known breast-hyperplasia targets,it was speculated that 50 of these targets might be related to the direct effect of the compound on breast hyperplasia.(2)After drug intervention,there was no significant change in the high-dose group of Compound Herba Gueldenstaedtiae compared with the normal blank group.The liver indicators of the other intervention groups all significantly decreased(P<0.05).(3)In terms of kidney and uterine indicators,the medium-dose group of Compound Herba Gueldenstaedtiae decreased significantly compared with the normal blank group(P<0.05).In terms of the uterine index,the model group increased significantly compared with the normal blank group(P<0.01).(4)After 1-month drug treatment,the number of lobules and acini in the breast tissue of the Xiaozheng Pill group,the low,medium,and high-dose group of Compound Herba Gueldenstaedtiae,the low,medium,and highdose groups of traditional Chinese medicine-bacteria fermentation decreased,and the duct openings narrowed.With the increase of drug dose,diffuse hyperplasia of breast tissue was significantly improved.(5)The ELISA results showed that compared with the model group,the estrogen level was lower in the medium-dose group of traditional Chinese medicine-bacteria fermentation after the intervention(P<0.05).In addition,the follicle-stimulating hormone level in the low-dose group of Compound Herba Gueldenstaedtiae was lower than that of the model group(P<0.05).(6)The intervention in the mouse model led to changes in the abundance of short chain fatty acids and intestinal flora in all groups.To conclude,the Compound Herba Gueldenstaedtiae and its probiotic fermentation products significantly improved mammary gland hyperplasia in mice by regulating hormone levels,improving the structure of the gut microbiota,and increasing the content of shortchain fatty acids,providing new ideas and potential sources of drugs for the treatment of breast hyperplasia.展开更多
Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast...Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.展开更多
基金supported by 2024 Henan Provincial Special Research Project on Traditional Chinese Medicine(2024ZY2158)Henan Provincial Key Discipline Construction Project of Traditional Chinese Medicine{Yuwei Traditional Chinese Medicine Science and Education[2024]No.1}+1 种基金Key Disciplines of History and Literature of Chinese Medicine in Henan University of Chinese Medicine for the Year 2025{Henan Traditional Chinese Medicine Office[2025]No.13}National Chinese Medicine Advantage Specialty Construction Project{Chinese Traditional Chinese Medicine Political Letter(2024)No.90}.
文摘“Ruyong(breast abscess)”has a high incidence rate.Traditional Chinese medicine(TCM)diagnosis and treatment of this condition demonstrate significant advantages,including diverse therapeuticmethods,outstanding efficacy,and high safety.Based on TCM theory and combining relevant ancient texts and modern research,this paper systematically summarizes the different understandings of“Ruyong(breast abscess)”by physicians throughout history in terms of disease names,etiology,pathogenesis,and treatment.The ancient names for Ruyong(breast abscess)were varied,also referred to as“Duru(stagnation in breast)”or“Naichuang(breast sore)”.Its symptoms are diverse,with the main clinical manifestations being localized redness,swelling,heat,pain,and poor milk discharge in the affected breast.The etiology is primarily attributed to“milk stasis”“liver qi stagnation and stomach heat”and“exposure to external pathogens”.Additionally,this paper summarizes the treatment experiences from ancient and modern medical texts and highlights the complementary effects of internal and external therapies.This study provides a reference for modern clinical understanding and treatment of“Ruyong(breast abscess)”in the hope of further improvement of clinical efficacy.
基金supported by grants from the Natural Science Foundation of Shandong Province(Grant No.ZR2024QH058).
文摘In the era of precision medicine,the breast cancer surgical treatment field is gradually moving toward a de-escalation model.Through precise preoperative assessments and multidisciplinary decision-making,surgical trauma can be decreased,and patients’quality of life can be improved by ensuring safety.Herein,we explore the axillary de-escalation surgery model for breast cancer.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.81672638 and W2421095)National Natural Science Foundation of Shandong Province(Grant No.ZR2024LMB011)Collaborative Academic Innovation Project of Shandong Cancer Hospital(Grant No.GF003)。
文摘The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagnostic techniques,such as sentinel lymph node biopsy(SLNB),has markedly diminished the extent of surgery required for regional lymph nodes.
文摘Current breast reconstruction evaluations mostly focus on static cosmetic analysis as a measure of the clinical outcomes.Moreover,it is essential to consider the dynamic changes in the reconstructed breast alongside assessments of aesthetic symmetry,functional restoration,complication rates,and long-term stability of the reconstruction.This study aimed to assess the mobility of the reconstructed breast following various breast reconstruction techniques,specifically by comparing deep inferior epigastric perforator(DIEP) flaps and pedicled transverse rectus abdominis musculocutaneous(TRAM) flaps.We conducted a longitudinal case study to investigate the changes in breast movement resulting from different surgical interventions.The comparison showed that DIEP flap reconstruction was more likely to achieve superior breast mobility outcomes than TRAM flap reconstruction.For a better breast aesthetic outcome,it is fundamental to improve the awareness of the dynamic evaluation of the reconstructed breast at the surgical strategy level.
文摘Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted among 60 primi postnatal mothers(30 in each group).Study was conducted at the Postnatal ward of IMS and SUM Hospital,Bhubaneswar,Odisha.Tools used were structured sociodemographic pro forma,structured breast milk adequacy questionnaire,and structured rating scale to assess the adequacy of breast milk production.The duration of the study is 1 year.All the postnatal mothers who were primigravida and undergone cesarean section were chosen as the sample through a convenience sampling technique.Then,the samples were assigned to the intervention group(receiving neck massage)and control group(receiving standard postnatal care).The data were collected and analyzed using both descriptive and inferential statistics by SPSS version 20.Results:The study resulted a significant difference between the pretest and posttest score of breast milk production after neck massage(P=0.000).The mean score of the posttest(2.90±0.36)is more than the mean score of the pretest(2.89±0.36)of the baby’s weight(P<0.001).Further,the number of urination and stool passed in 24 h was more in the intervention group than the control group(P<0.001).The Chi-square analysis showed statistical significance between breast milk production after neck massage with religion of the postnatal mothers(P<0.05).Conclusion:The neck massage is found effective in improving the breast milk production among primi c-section mothers with improve newborn parameters.
基金supported by a project of the National Natural Science Foundation of China:Research on the integration of artificial intelligence and virtual reality technology to promote psychological rehabilitation of breast cancer patients with different personalities(project approval no.82073408).
文摘Objectives:To explore the efficacy and safety of virtual reality(VR)in relieving negative emotions in patients with breast cancer with different personalities.Methods:A randomized controlled trial was conducted.Between April 2023 and October 2023,we enrolled patients with breast cancer treated in the Department of Breast Cancer and Oncology at Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangdong Province.The patients were randomly divided into an intervention group(n=118)and a control group(n=119)using block randomization.The intervention group received the VR intervention 3-5 times over 5±2 weeks using natural landscapes with music or relaxation guidance,and the duration of each VR intervention was 15±3 min.The control group received routine nursing care,including disease education and psychological counseling.Patients were assessed using the Type D Scale,Positive and Negative Affect Scale,and Distress Thermometer,and adverse events during the intervention were recorded.Results:Overall,85 patients completed the study(44 in the intervention group and 41 in the control group).Patients with Type D personalities showed more negative emotions[25.0(21.5,27.5)vs.19.0(16.0,24.0),P=0.001]and distressed attitudes[4.0(2.0,5.0)vs.3.0(1.0,4.0),P=0.020]with fewer positive emotions(27.2±5.6 vs.31.0±5.9,P=0.014)than those with non-Type D personalities.Total population analysis revealed no significant differences between the groups.However,in the subgroup analysis,patients with Type D personalities in the intervention group showed greater relief from negative emotions than those in the control group[median difference,-5.0(-9.0,-2.5)vs.-2.0(-4.0,2.0),P=0.046].No significant differences were found between groups of patients with non-Type D personality traits.The proportion of adverse events was not significantly different between groups(P=0.110).Conclusions:Breast cancer patients with Type D personalities suffer more severe negative emotions and distress,and more attention should be paid to them.VR intervention significantly and safely reduced negative emotions in patients with Type D personalities.
基金supported by Shandong Provincial Natural Science Foundation(no.ZR2020MH319).
文摘Triple-negative breast cancer(TNBC)is currently the most heterogeneous and aggressive breast cancer type.It has a high recurrence rate,poor clinical prospects,and lack of predictive markers and potential treatment options.Dysregulated microRNAs(miRNAs)are involved in various cellular processes in TNBC.Moreover,variations in the miRNA levels in TNBC may act as a dependable indicator for predicting the effectiveness and specificity of treatments.Currently,the application of miRNAs for breast cancer therapy is primarily in the preclinical stage,with a focus on identifying highly specific and sensitive miRNAs that could offer new possibilities for early diagnosis,clinical treat-ment,and prognostic monitoring of TNBC.
文摘BACKGROUND Breast cancer is one of the most prevalent causes of morbidity and mortality worldwide,presenting an increasing public health challenge,particularly in lowincome and middle-income countries.However,data on the knowledge,attitudes,and preventive practices regarding breast cancer and the associated factors among females in Wollo,Ethiopia,remain limited.AIM To assess the impact of family history(FH)of breast disease on knowledge,attitudes,and breast cancer preventive practices among reproductive-age females.METHODS A community-based cross-sectional study was conducted in May and June 2022 in Northeast Ethiopia and involved 143 reproductive-age females with FH of breast diseases and 209 without such a history.We selected participants using the systematic random sampling technique.We analyzed the data using Statistical Package for Social Science version 25 software,and logistic regression analysis was employed to determine odds ratios for variable associations,with statistical significance set at P<0.05.RESULTS Among participants with FH of breast diseases,the levels of knowledge,attitudes,and preventive practices were found to be 83.9%[95%confidence interval(CI):77.9-89.9],49.0%(95%CI:40.8-57.1),and 74.1%(95%CI:66.9-81.3),respectively.In contrast,among those without FH of breast diseases,these levels were significantly decreased to 10.5%(95%CI:6.4-14.7),32.1%(95%CI:25.7-38.4),and 16.7%(95%CI:11.7-21.8),respectively.This study also indicated that knowledge,attitudes,and preventive practices related to breast cancer are significantly higher among participants with FH of breast diseases compared to those without HF breast diseases.CONCLUSION Educational status,monthly income,and community health insurance were identified as significant factors associated with the levels of knowledge,attitudes,and preventive practices regarding breast cancer among reproductive-age females.
基金supported by the National Key R&D Program of China(grant number:2021YFC2500400)Tianjin Health Committee Foundation(grant number:TJWJ2021MS008).
文摘Background Breast cancer(BC)incidence and mortality vary significantly across countries,highlighting the need to update the global burden of female BC,including current trends and future projections.Methods Data were sourced from GLOBOCAN 2022,including estimated new cases and deaths from BC across 21 United Nation(UN)regions and 185 countries,the age-standardized incidence rate(ASIR)and mortality rate(ASMR),the estimated annual percentage changes(EAPC),and demographic projections through 2050.The region-specific and country-specific BC burden for women of all ages and for young women(<40 years old)was reorganized and re-plotted to highlight subgroup differences.Linear regression was used to explore the link between ASIR/ASMR and the human development index(HDI).Transitioning countries referred to those with low or medium HDI,while transitioned countries were those with high or very high HDI.Results In 2022,an estimated 2.3 million new BC cases and 666,000 BC-related deaths occurred globally,accounting for 23.8%and 15.4%of all cancer cases and deaths in women,respectively.Regionally,Eastern Asia reported the highest number of cases(480,019,ASIR:37.54/100,000),while South-Central Asia had the highest number of deaths(135,348,ASMR:13.41/100,000).At the country level,China had the highest number of cases due to its large population,whereas India reported the highest number of deaths.ASIR for both overall and early-onset BC increased with HDI,while ASMR for early-onset BC decreased with HDI(P<0.05).Overall BC showed an increasing trend in ASIR during 2003–2015(EAPC:0.92%)and a decreasing trend in ASMR during 2006–2016(EAPC:-1.06%).Early-onset BC showed a more significant rise in ASIR(EAPCs:1.4%)and a slight increase in ASMR(EAPCs:0.16%).If national rates remain stable,BC cases and deaths will increase by 54.7%and 70.9%,respectively,by 2050.Notably,increased early-onset BC cases are only observed in transitioning countries,while decreased cases are seen in transitioned countries.Conclusions Breast cancer remains the leading cancer burden in women,particularly in transitioning countries.Addressing this growing burden requires urgent integration of primary prevention,early detection and high-quality treatment through multi-sectoral collaboration.
基金supported by the National Natural Science Foundation of China(No.82371933)the National Natural Science Foundation of Shandong Province of China(No.ZR2021MH120)+1 种基金the Taishan Scholars Project(No.tsqn202211378)the Shandong Provincial Natural Science Foundation for Excellent Young Scholars(No.ZR2024YQ075).
文摘Objective:Early predicting response before neoadjuvant chemotherapy(NAC)is crucial for personalized treatment plans for locally advanced breast cancer patients.We aim to develop a multi-task model using multiscale whole slide images(WSIs)features to predict the response to breast cancer NAC more finely.Methods:This work collected 1,670 whole slide images for training and validation sets,internal testing sets,external testing sets,and prospective testing sets of the weakly-supervised deep learning-based multi-task model(DLMM)in predicting treatment response and pCR to NAC.Our approach models two-by-two feature interactions across scales by employing concatenate fusion of single-scale feature representations,and controls the expressiveness of each representation via a gating-based attention mechanism.Results:In the retrospective analysis,DLMM exhibited excellent predictive performance for the prediction of treatment response,with area under the receiver operating characteristic curves(AUCs)of 0.869[95%confidence interval(95%CI):0.806−0.933]in the internal testing set and 0.841(95%CI:0.814−0.867)in the external testing sets.For the pCR prediction task,DLMM reached AUCs of 0.865(95%CI:0.763−0.964)in the internal testing and 0.821(95%CI:0.763−0.878)in the pooled external testing set.In the prospective testing study,DLMM also demonstrated favorable predictive performance,with AUCs of 0.829(95%CI:0.754−0.903)and 0.821(95%CI:0.692−0.949)in treatment response and pCR prediction,respectively.DLMM significantly outperformed the baseline models in all testing sets(P<0.05).Heatmaps were employed to interpret the decision-making basis of the model.Furthermore,it was discovered that high DLMM scores were associated with immune-related pathways and cells in the microenvironment during biological basis exploration.Conclusions:The DLMM represents a valuable tool that aids clinicians in selecting personalized treatment strategies for breast cancer patients.
基金Supported by Russian Science Foundation,No.23-25-00183.
文摘BACKGROUND Breast cancer(BC)continues to occupy a leading position in terms of morbidity and mortality from malignant neoplasms among the female population.One of the promising markers associated with BC progression is programmed death ligand 1(PD-L1).Previously,we investigated PD-L1 expression in BC via a new antibody against programmed cell death protein 1 ligand 1(PDCD1 LG1)and reported that high PDCD1 LG1 expression in tumor cells is an independent factor for a high risk of regional metastasis in patients with BC.However,the prognostic significance of PDCD1 LG1 expression in BC stromal cells has not been adequately studied.AIM To study the features of PDCD1 LG1 expression in BC stromal cells and its relationship with BC clinicopathological characteristics.METHODS In a prospective single-center observational study,tumor samples from 148 patients with newly diagnosed BC were examined.The tumor sections were immunohistochemically stained with antibodies against PDCD1 LG1.In the tumor samples,the PDCD1 LG1-positive lymphocyte(PDCD1 LG1+LF)score,presence of nuclear PDCD1 LG1 expression in the LFs,PDCD1 LG1 expression in polymorphic cell infiltrates(PDCD1 LG1+polymorphic cell infiltrates[PCIs]),and cells of the fibroblastic stroma and endothelial cells of the tumor microvessels were assessed.Statistical analyses were performed using Statistica 10.0 software.RESULTS A PDCD1 LG1+LF score≥3 was detected more often at stages N0 and N3 than at N1 and N2(P=0.03).Moderate and pronounced PDCD1 LG1+PCIs and the presence of PDCD1 LG1+fibroblastic stroma were associated with negative estrogen receptor status(P=0.0008 and P=0.03,respectively),human epidermal growth factor receptor 2-positive(HER2+)BC(P<0.00001 and P=0.0005),and luminal B HER2+,non-luminal HER2+and triple-negative BC(P<0.00001 and P=0.004).The risk of metastasis to regional lymph nodes(RLNs)depend on lymphovascular invasion(LVI)and the PDCD1 LG1+LF score.In the absence of LVI and a PDCD1 LG1+LF score<3 or≥3,metastases in RLNs were absent in 66.6%and 93.9%of patients with BC,respectively.In the presence of LVI and a PDCD1 LG1+LF score<3 or≥3,metastases in RLNs were detected in 82.6%and 92.7%of patients with BC,respectively.CONCLUSION The results indicated that the combined assessment of the PDCD1 LG1+LF score and LVI can improve the accuracy of predicting the risk of metastasis to RLNs in patients with BC.
基金supported by grants from the Medical Engineering Jiont Fund of the Fudan University(No.IDH2310117)。
文摘Objective:Triple-negative breast cancer(TNBC)is a highly aggressive subtype that lacks targeted therapies,leading to a poorer prognosis.However,some patients achieve long-term recurrence-free survival(RFS),offering valuable insights into tumor biology and potential treatment strategies.Methods:We conducted a comprehensive multi-omics analysis of 132 patients with American Joint Committee on Cancer(AJCC)stage III TNBC,comprising 36 long-term survivors(RFS≥8 years),62 moderate-term survivors(RFS:3-8 years),and 34 short-term survivors(RFS<3 years).Analyses investigated clinicopathological factors,whole-exome sequencing,germline mutations,copy number alterations(CNAs),RNA sequences,and metabolomic profiles.Results:Long-term survivors exhibited fewer metastatic regional lymph nodes,along with tumors showing reduced stromal fibrosis and lower Ki67 index.Molecularly,these tumors exhibited multiple alterations in genes related to homologous recombination repair,with higher frequencies of germline mutations and somatic CNAs.Additionally,tumors from long-term survivors demonstrated significant downregulation of the RTK-RAS signaling pathway.Metabolomic profiling revealed decreased levels of lipids and carbohydrate,particularly those involved in glycerophospholipid,fructose,and mannose metabolism,in long-term survival group.Multivariate Cox analysis identified fibrosis[hazard ratio(HR):12.70,95%confidence interval(95%CI):2.19-73.54,P=0.005]and RAC1copy number loss/deletion(HR:0.22,95%CI:0.06-0.83,P=0.026)as independent predictors of RFS.Higher fructose/mannose metabolism was associated with worse overall survival(HR:1.30,95%CI:1.01-1.68,P=0.045).Our findings emphasize the association between biological determinants and prolonged survival in patients with TNBC.Conclusions:Our study systematically identified the key molecular and metabolic features associated with prolonged survival in AJCC stage III TNBC,suggesting potential therapeutic targets to improve patient outcomes.
基金supported by the Natural Science Foundation of China(Grant Nos.82073934,81872937)Office of Jiangsu Provincial Academic Degrees Committee(Grant No.JX10114120).
文摘Bone metastasis is the primary cause of mortality in breast cancer(BC)patients.The present study elucidates the functional role of the differentiated embryonic chondrocyte-expressed gene 1(DEC1)in promoting BC-related bone metastasis.Analysis of patient-derived samples and public databases revealed a significant upregulation of DEC1 and CXCR4 in breast tumors compared with adjacent normal tissues,with elevated levels correlating with increased metastatic potential,suggesting their synergistic involvement in BC progression.Intracardiac injection experiments demonstrated that Dec1-WT 4T1 cells induced more severe osteolysis and larger metastatic lesions than Dec1-KD 4T1 cells.In MDA-MB-231 cells,DEC1 overexpression(OE)upregulated CXCR4 and proliferation/migration-related genes,whereas DEC1 knockdown reversed these effects.Notably,AMD3100,a specific CXCR4 antagonist,partially reversed the DEC1-OE-induced upregulation of CXCR4 and associated pro-metastatic genes.Mechanistically,DEC1 bound to the CXCR4 promoter region(-230 to-326)and activated its transcription,corroborated by ChIP-seq data.Furthermore,pharmacological inhibition of AKT(LY294002)or JAK2(AZD1480),but not ERK(PD98059),attenuated DEC1-mediated CXCR4 upregulation,although all three inhibitors mitigated DEC1-driven migration-related gene expression.Additionally,DEC1 enhanced CXCL12 secretion from mesenchymal stromal cells and osteoblasts,amplifying the CXCR4/CXCL12 axis within the bone microenvironment.Collectively,our findings demonstrate that DEC1 promotes BC bone metastasis by directly transactivating CXCR4 expression,providing a molecular basis for targeting DEC1 to prevent and treat BC bone metastasis.
文摘Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast cancer.It is considered as a mixed,biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition zone.Although cellular origin of this neoplasm remains controversial,most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic differentiation.Despite recent research on the therapeutic strategies against CS neoplastic disorders,surgical resection appears the only potentially curative approach.Since CS metastasize by the lymphatic route,axillary assessment with sentinel lymph node biopsy and/or axillary lymph node dissection is always implemented.Nevertheless,the tumor also presents a hematogenous metastatic pattern including pleural,pulmonary,liver,brain and less commonly bone metastases.Thus,surgical removal of breast CS does not necessarily ensure patient’s long-term recovery.Moreover,alternative therapies,such as radio-and chemotherapy proved insufficient and 5-year survival rate is limited.Nevertheless,there is evidence that following surgery,the combination of radio and chemotherapy is associated with a better prognosis than either treatment alone.The aim of this review is to evaluate the results of surgical treatment for breast CS with special reference to the extent of its histological spread.Clinical features,histogenesis,morphological and immunochemical findings are discussed,while the role of current diagnostic and therapeutic management of this aggressive neoplasm is emphasized.
基金funded by the Natural Science Foundation of Guangdong Province(grant number 2022A1515012315)Guangdong Medical Science and Technology Research Fund Project(grant number A2023185)+2 种基金the Discipline Construction Project of Guangdong Medical University(grant number 4SG22005G)the 2023 Provincial Basic and Applied Basic Research Fund Enterprise Joint Fund Project(grant number 2023A1515220149)Southern Medical University Shunde Hospital 2023 Research Initiation Programme Project(SRSP2023016).
文摘Background:Immune checkpoint inhibitors play an important role in the treatment of solid tumors,but the currently used immune checkpoint inhibitors targeting programmed cell death-1(PD-1),programmed cell death ligand-1(PD-L1),and cytotoxic T-lymphocyte antigen-4(CTLA-4)show limited clinical efficacy in many breast cancers.B7H3 has been widely reported as an immunosuppressive molecule,but its immunological function in breast cancer patients remains unclear.Methods:We analyzed the expression of B7H3 in breast cancer samples using data from the Cancer Genome Atlas Program(TCGA)and the Gene Expression Omnibus(GEO)databases.MicroRNAs were selected using the TarBase,miRTarBase,and miRBase databases.The regulatory role of the microRNA hsa-miR-214-3p on B7H3 was investigated through dual-luciferase reporter assays,which identified the specific action sites of interaction.The expression levels of B7H3 and hsa-miR-214-3p in human breast cancer tissues and adjacent normal tissues were quantified using Western blotting and quantitative PCR(qPCR).In vitro experiments were performed to observe the effects of modulating the expression of B7H3 or hsa-miR-214-3p on breast cancer cell proliferation and apoptosis.Additionally,the regulatory impact of hsa-miR-214-3p on B7H3 was examined.Enzyme-linked immunosorbent assays(ELISA)and flow cytometry were employed to assess the effects of co-cultured breast cancer cells and normal human peripheral blood mononuclear cells(PBMCs)on immune cells and associated cytokines.Results:In breast cancer tissues,the expression level of B7H3 is inversely correlated with that of hsa-miR-214-3p,as well as with the regulatory effects on breast cancercell behavior.Hsa-miR-214-3p was found to inhibit breast cancer cell growth by downregulating B7H3.Importantly,our research identified,for the first time,two binding sites for hsa-miR-214-3p on the 3’UTR of B7H3,both of which exert similar effects independently.Co-culture experiments revealed that hsamiR-214-3p obstructs the suppressive function of B7H3 on CD8^(+)T cells and natural killer cells.Conclusions:This study confirms the existence of two hsa-miR-214-3p binding sites on the 3’UTR of B7H3,reinforcing the role of hsamiR-214-3p as a regulatory factor for B7H3.In breast cancer,hsa-miR-214-3p reduces tumor cell proliferation and enhances the tumor immune microenvironment by downregulating B7H3.These findings suggest new potential targets for the clinical treatment of breast cancer.
基金the National Natural Science Foundation of China(Nos.22307009,82374155,82073997,82104376)the Sichuan Science and Technology Program(Nos.2023NSFSC1108,2024NSFTD0023)+1 种基金the Postdoctoral Research Project of Sichuan Provincethe Xinglin Scholar Research Promotion Project of Chengdu University of TCM.
文摘Background:Triple-negative breast cancer(TNBC),characterized by its lack of traditional hormone receptors and HER2,presents a significant challenge in oncology due to its poor response to conventional therapies.Autophagy is an important process for maintaining cellular homeostasis,and there are currently autophagy biomarkers that play an effective role in the clinical treatment of tumors.In contrast to targeting protein activity,intervention with proteinprotein interaction(PPI)can avoid unrelated crosstalk and regulate the autophagy process with minimal interference pathways.Methods:Here,we employed Naive Bayes,Decision Tree,and k-Nearest Neighbors to elucidate the complex PPI network associated with autophagy in TNBC,aiming to uncover novel therapeutic targets.Meanwhile,the candidate proteins interacting with Beclin 2 were initially screened in MDA-MB-231 cells using Beclin 2 as bait protein by immunoprecipitation-mass spectrometry assay,and the interaction relationship was verified by molecular docking and CO-IP experiments after intersection.Colony formation,cellular immunofluorescence,cell scratch and 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)tests were used to predict the clinical therapeutic effects of manipulating candidate PPI.Results:By developing three PPI classification models and analyzing over 13,000 datasets,we identified 3733 previously unknown autophagy-related PPIs.Our network analysis revealed the central role of Beclin 2 in autophagy regulation,uncovering its interactions with 39 newly identified proteins.Notably,the CO-IP studies identified the substantial interaction between Beclin 2 and Ubiquilin 1,which was anticipated by our model and discovered in immunoprecipitation-mass spectrometry assay results.Subsequently,in vitro investigations showed that overexpressing Beclin 2 increased Ubiquilin 1,promoted autophagy-dependent cell death,and inhibited proliferation and metastasis in MDA-MB-231 cells.Conclusions:This study not only enhances our understanding of autophagy regulation in TNBC but also identifies the Beclin 2-Ubiquilin 1 axis as a promising target for precision therapy.These findings open new avenues for drug discovery and offer inspiration for more effective treatments for this aggressive cancer subtype.
文摘Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer.Methods We retrospectively reviewed the records of 394 consecutive patients with pathologically confirmed breast lesions who had undergone 3-T magnetic resonance imaging(MRI).The morphological characteristics of breast lesions were evaluated using DCE,DWI,and T2WI based on BI-RADS lexicon descriptors by trained radiologists.Patients were categorized into mass and non-mass groups based on MRI characteristics of the lesions,and the differences between benign and malignant lesions in each group were compared.Clinical prediction models for breast cancer diagnosis were constructed using logistic regression analysis.Diagnostic efficacies were compared using the area under the receiver operating characteristic curve(AUC)and DeLong test.Results For mass-like lesions,all the morphological parameters significantly differentiated benign and malignant lesions on consensus DCE,DWI,and T2WI(P<0.05).The combined method(DCE+DWI+T2WI)had a higher AUC(0.865)than any of the individual modality(DCE:0.786;DWI:0.793;T2WI:0.809)(P<0.05).For non-mass-like lesions,DWI signal intensity was a significant predictor of malignancy(P=0.036),but the model using DWI alone had a low AUC(0.669).Conclusion Morphological assessment using the combination of DCE,DWI,and T2WI provides better diagnostic value in differentiating benign and malignant breast mass-like lesions than assessment with only one of the modalities.
文摘BACKGROUND The programmed cell death protein 1 inhibitor pembrolizumab has become a key treatment for various cancers,including triple-negative breast cancer.However,it is associated with immune-related adverse events,including rare but serious neurological complications such as Guillain-Barrésyndrome(GBS).GBS is a potentially life-threatening autoimmune disorder characterized by muscle weakness and paralysis.We present a unique case of pembrolizumab-induced GBS to highlight the importance of recognizing this complication and managing it promptly in patients receiving immune checkpoint inhibitors.CASE SUMMARY A 69-year-old woman with a medical history of hypertension,anxiety,depression,and stage IIIB triple-negative breast cancer treated with pembrolizumab,carboplatin,and paclitaxel,presented to the emergency department with a 1-month history of tingling,lower extremity weakness,and shooting pain.Symptoms progressed to global weakness,ascending paralysis,and double vision.Neurological examination revealed significant lower extremity weakness and sensory deficits.Magnetic resonance imaging of the lumbar spine and cerebrospinal fluid analysis confirmed GBS.Initial treatment with intravenous immunoglobulin led to relapse,requiring additional intravenous immunoglobulin and high-dose glucocorticoids.The patient’s condition improved,pembrolizumab therapy was permanently discontinued,and she was discharged to a rehabilitation facility.CONCLUSION Pembrolizumab can induce GBS,necessitating early recognition,prompt diagnosis,and multidisciplinary management to prevent serious complications.
文摘BACKGROUND:Breast hyperplasia is a common benign breast disease mainly caused by endocrine disorders,manifested as abnormal hyperplasia of breast tissue.In recent years,traditional Chinese medicine compounds and probiotics have shown good potential in regulating the endocrine system and improving the intestinal microecology,providing new ideas for the treatment of breast hyperplasia.OBJECTIVE:To explore the effects and mechanisms of traditional Chinese medicine compounds and fermented probiotic compounds on breast hyperplasia in mice,providing new theoretical and experimental bases for the clinical treatment and prevention of breast hyperplasia.METHODS:(1)Network pharmacology tools were used to predict the anti-breast-hyperplasia activity of Herba Gueldenstaedtiae(Euphorbia humifusa),as well as its potential targets and signaling pathways.The databases included:TCMSP,OMIM,GeneCards database,UniProt website,Venny2.1.0 website,Metascape,HERB website,and STRING database,all of which are open-access databases.Network pharmacology can predict and screen key information such as the targets corresponding to the active ingredients of traditional Chinese medicine,disease targets,and action pathways through network analysis and computer-system analysis.Therefore,it has been increasingly widely used in the research of traditional Chinese medicine.(2)A breast hyperplasia model was induced in mice by injecting estrogen and progesterone.Mice in the normal blank group were injected intraperitoneally with normal saline every day.Mice in the model group and drugadministration groups were injected intraperitoneally with estradiol benzoate injection at a concentration of 0.5 mg/kg every day for 25 days.From the 26th day,the injection of estradiol benzoate injection was stopped.Mice in the normal blank group were injected intramuscularly with normal saline every day,and mice in the model group and drug-administration groups were injected intramuscularly with progesterone injection at a concentration of 5 mg/kg for 5 days.After the model was established,each group was given drugs respectively.The normal blank group and the model group were gavaged with 0.2 mL/d of normal saline;the positive blank group(Xiaozheng Pill group)was gavaged with an aqueous solution of Xiaozheng Pill at 0.9 mg/g;the low-,medium-and high-dose groups of Compound Herba Gueldenstaedtiae were gavaged with an aqueous solution of the compound medicine at 0.75,1.5,and 3.0 mg/(g·d)respectively;the low-,medium-and high-dose groups of traditional Chinese medicine-bacteria fermentation were gavaged with an aqueous solution of the compound medicine at 0.75,1.5,and 3.0 mg/(g·d)respectively.The administration was continuous for 30 days.RESULTS AND CONCLUSION:(1)The results of network pharmacology research showed that the Compound Herba Gueldenstaedtiae(Euphorbia humifusa)contained 46 active ingredients,which were related to 1213 potential targets.After comparison with 588 known breast-hyperplasia targets,it was speculated that 50 of these targets might be related to the direct effect of the compound on breast hyperplasia.(2)After drug intervention,there was no significant change in the high-dose group of Compound Herba Gueldenstaedtiae compared with the normal blank group.The liver indicators of the other intervention groups all significantly decreased(P<0.05).(3)In terms of kidney and uterine indicators,the medium-dose group of Compound Herba Gueldenstaedtiae decreased significantly compared with the normal blank group(P<0.05).In terms of the uterine index,the model group increased significantly compared with the normal blank group(P<0.01).(4)After 1-month drug treatment,the number of lobules and acini in the breast tissue of the Xiaozheng Pill group,the low,medium,and high-dose group of Compound Herba Gueldenstaedtiae,the low,medium,and highdose groups of traditional Chinese medicine-bacteria fermentation decreased,and the duct openings narrowed.With the increase of drug dose,diffuse hyperplasia of breast tissue was significantly improved.(5)The ELISA results showed that compared with the model group,the estrogen level was lower in the medium-dose group of traditional Chinese medicine-bacteria fermentation after the intervention(P<0.05).In addition,the follicle-stimulating hormone level in the low-dose group of Compound Herba Gueldenstaedtiae was lower than that of the model group(P<0.05).(6)The intervention in the mouse model led to changes in the abundance of short chain fatty acids and intestinal flora in all groups.To conclude,the Compound Herba Gueldenstaedtiae and its probiotic fermentation products significantly improved mammary gland hyperplasia in mice by regulating hormone levels,improving the structure of the gut microbiota,and increasing the content of shortchain fatty acids,providing new ideas and potential sources of drugs for the treatment of breast hyperplasia.
文摘Breast cancer is the most common cancer among women worldwide. The term epidemiology generally deals with the branch of medicine and treatment that deals with a specific incident. Thus, considering the topic of breast cancer, this particular study deals with the distribution, determinants, and frequency of the disease. Breast cancer incidence and death data are critical to determining healthcare priorities. Women’s cancer is the most common, accounting for 25.1 percent of all malignancies. According to this specific report, more than 42,000 women die from breast cancer each year. Hence, it is apparent that it is the second leading cause of death among women, especially in the US. Family history/genetics, reproductive, hormone, benign proliferative breast disease, and mammographic density are the four main risk factors for breast cancer that can be meaningfully categorized. These elements are briefly discussed, and the risk estimators are provided. Numerous screening technologies have found breast cancer;some are linked to an increased risk of breast cancer, such as ultrasound techniques and MRI scanning. Breast cancer is more common in developed countries, while relative mortality is highest in developing countries. Women’s education is recommended for early detection and treatment in all nations. Health policymakers must prioritize plans to control and prevent this malignancy and increase awareness of risk factors and early detection in less developed countries.
