ObjectiveTo test the expressions of human mammary gland globin (hMAM) mRNA in the peripheral blood of breast cancer and breast benign lesions patients, try to provide the theory basis for the choice of breast cancer molecular marker. MethodsPolymerase chain reaction (PCR) technology was used to detect the expressions of hMAM mRNA in peripheral blood of 78 cases of breast cancer patients, 15 cases of hyperplasia of mammary gland, and 15 cases of breast fibroadenoma. The relationship between the expressions of hMAM-mRNA in peripheral blood of breast cancer patients with patient's age, tumor size, pathological type, tumor stage, axillary lymph node metastasis, and the ER, PR and HER-2 status were analyzed. ResultsThe expressions of hMAM-mRNA in peripheral blood were not detected in breast hyperplasia and breast fibroadenoma patients, but the peripheral blood hMAM-mRNA expression rate in breast cancer patients was 48.72% (38/78), the difference was statistically significant (χ2=12.357, P=0.000). The expression of peripheral blood hMAM mRNA was not related to the patient's age, tumor size, pathological type, and ER, PR and HER-2 status (P > 0.05), but the expression of peripheral blood hMAM mRNA was related to the clinical staging of tumor (Z=-2.214, P=0.027) and lymph node metastasis status (Z=-2.754, P=0.006). ConclusionPeripheral blood hMAM-mRNA detected is a sign of breast cancer, further research is needed to confirm whether hMAM mRNA detection in peripheral blood correlates with poor prognosis of breast cancer patients.
ObjectiveTo study the infiltration situation of breast cancer surface skin, and explore the characteristics of infiltration of breast cancer surface skin at the molecular level. MethodsNested reverse transcription-polymerase chain reaction technique was used to detect the expressions of human mammaglobin(hMAM)mRNA in 15 cases of hyperplasia of mammary gland tissues, 15 cases of breast fibroadenoma tissues, and 60 cases of breast cancer tissues and their corresponding tumor surface skins. The relationship of the hMAM mRNA expression in the surface skins of breast cancer tissue to its clinicopathologic characteristics was analyzed. ResultsThe hMAM mRNA positive expressions in the breast fibroadenoma tissues, hyperplasia of mammary gland tissues, and breast cancer tissues were 40.00%(6/15), 53.33%(8/15), and 83.33%(50/60), respectively, which in the breast cancer tissues was significantly higher than that in the breast fibroadenoma tissues or hyperplasia of mammary gland tissues(P < 0.05). There was no hMAM mRNA positive expression in the surface skin of fibroadenoma or hyperplasia of mammary gland tissues, but there was 3(5.00%)cases of the hMAM mRNA positive expressions in the breast cancer surface skin. The hMAM mRNA positive expression in the breast cancer surface skin was not related with the patient age, tumor diameter, and tumor staging(P > 0.05), but was related with axillary lymph nodes metastasis and distance from tumor to nipple less than 4 cm(P < 0.05). ConclusionsThe hMAM mRNA highly expresses in breast cancer tissue and it has a certain value in the diagnosis of infiltration of breast cancer surface skin. The patients with axillary lymph node metastasis and distance from tumor to nipple less than 4 cm are more susceptible to infiltration of breast cancer surface skin.
Endoscopic technique is one of the important development directions of modern surgical techniques. Compared with the laparoscopic and thoracoscopic surgery, the development of endoscopic technology in breast surgery is generally slow due to the limitation of the physiological structure of this organ. The characteristics of endoscopic technology such as micro-incision trauma and remote operation are especially suitable for breast (cancer) surgery, which desires flawless skin surface and perfect remodeling. In the meantime, however, the obstacles of breast (cancer) endoscopic surgery include the establishment and maintenance of a satisfactory surgical field, the endoscopic exposure of large and heavy glands, the obstruction by the slope of the skeletal thorax, the remote operation that is difficult to accomplish with conventional endoscopic instruments, and the complete removal of large and tough glands and so on. By studying and pondering the experience of the pioneers of endoscopy, the endoscopic team of West China Hospital took five years to develop this novel one axillary-incision, single-port and liposuction-free endoscopic surgical approach which is low costing and only requires one-port operation platform. The original “inverse sequence method”, “Huaxi hole no. 1, 2, 3” and other endoscopy-assisted approach overcome the aforesaid obstacles. It has significantly reduced the technical threshold and operational difficulty of breast (cancer) endoscopic surgery and contributed our own wisdom to the vigorous development of breast endoscopic technology in China. The author shared her observations and thoughts on the technical details of breast endoscopic surgery based on her nearly 20 years of experience in endoscopic operation.