ObjectiveTo study on the first metastasis pattern and prognostic factors in patients with recurrent and metastatic breast cancer.MethodsThe study selected 147 patients with metastatic breast cancer who were diagnosed for the first time in the Breast Thyroid Center and Oncology Department, the People's Hospital of Wuhan University from June 2016 to June 2018. The model of first metastasis and the first diagnosis of prognosis may be affected. The age at diagnosis of breast cancer, tumor size, lymph node metastasis, hormone receptor status, HER-2 status, number of metastatic organs, tumor location, molecular typing, etc. were retrospective analyzedResultsThe most common metastatic sites for breast cancer was bone metastases in 55 patients (37.41%), followed by lung metastasis and liver metastases, 29 (19.73%) and 24 (16.33%), respectively. Univariate analysis showed that the number of lymph node metastasis, HER-2 status, organ number of first-time metastasis, and endocrine therapy were significant factors affecting metastatic survival time, and the difference was statistically significant (P<0.05). Multivariate analysis showed that the number of lymph node metastasis, the number of metastatic organs and HER-2 were independent risk factors for advanced breast cancer (P<0.05).ConclusionsThe most common metastasis of breast cancer patients after surgery is bone, followed by lung metastasis and liver metastasis. The number of lymph node metastases, the number of metastatic organs, HER-2 status, and endocrine therapy are independent factors influencing the prognosis of patients with recurrent metastasis.
ObjectiveTo analyze therapeutic effect of ultrasound-guided vacuum-assisted rotary excision with tube irrigation drainage in treatment of granulomatous mastitis (GM).MethodsThe clinical data of 120 patients with GM from January 2018 to December 2018 in the Renmin Hospital of Wuhan University were analyzed. Sixty patients were treated with the ultrasound-guided vacuum-assisted rotary excision with tube irrigation drainage (control group), and the other 60 patients were treated with the metronidazole solution combined with dexamethasone on the basis of the control group (observation group). The therapeutic period, total effective rate, postoperative appearance of breast, and recurrence rate were analyzed. While the pathogenic bacteria was analyzed by the microbial culture and the pathogen gene detection.ResultsThere were no significant differences in the baseline data between the two groups (P>0.05). The ultrasound-guided vacuum-assisted rotary excisions were successfully performed in all 120 patients. The therapeutic period of the observation group was shorter than that of the control group (t=–3.633, P<0.001). The total effective rate and rate of excellent and good of postoperative breast appearance had no significant differences between the two groups (total effective rate: 96.7% versus 90.0%, χ2=1.922, P=0.166; rate of excellent and good of postoperative breast appearance: 96.7% versus 88.3%, χ2=1.205, P=0.272). The recurrence rate of the observation group was lower than that of the control group (χ2=5.175, P=0.023). The positive rates of bacteria were 25.8% and 58.8% in the 120 cases by the microbial culture and 52 cases by the pathogen gene detection, respectively, which had a statistical difference (χ2=16.974, P<0.001), the same conclusions were obtained in the observation group and the control group (χ2=6.691, P=0.010; χ2=9.379, P=0.002).ConclusionsUltrasound-guided vacuum-assisted rotary excision with tube irrigation drainage is well applied in treatment of GM. It could maintain a good shape of breast. Use of metronidazole solution combined with dexamethasone after surgery could shorten therapeutic period and reduce recurrence rate.