简介:Theriskofbreastcancer(BC)overdiagnosisattributedtomammographyscreeningisanunresolvedissue,complicatedbyheterogeneityinthemethodologyofquantifyingitsmagnitude,andbothpoliticalandscientificelementssurroundinginterpretationoftheevidenceonthisphenomenon.EvidencefromrandomizedtrialsandalsofromobservationalstudiesshowsthatmammographyscreeningreducestheriskofBCdeath;similarly,thesestudiesprovidesufficientevidencethatoverdiagnosisrepresentsaseriousharmfrompopulationbreastscreening.Forboththeseoutcomesofscreening,BCmortalityreductionandoverdiagnosis,estimatesofmagnitudevarybetweenstudieshoweveroverdiagnosisestimatesareassociatedwithsubstantialuncertainty.Thetrade-offbetweenthebenefitandthecollectiveharmsofBCscreening,includingfalse-positivesandoverdiagnosis,ismorefinelybalancedthaninitiallyrecognized,howeverthesnapshotofevidencepresentedonoverdiagnosisdoesnotmeanthatbreastscreeningisworthless.Futureeffortsshouldbedirectedtowards(a)ensuringthatanychangesintheimplementationofBCscreeningoptimizethebalancebetweenbenefitandharms,includingassessinghowplannedoractualchangesmodifytheriskofoverdiagnosis;(b)informingwomenofalltheoutcomesthatmayaffectthemwhentheyparticipateinscreeningusingwell-craftedandbalancedinformation;and(c)investinginresearchthatwillhelpdefineandreducetheensuingovertreatmentofscreen-detectedBC.
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简介:Thereisalackofinvestigationintothebiologicalcharacteristicsandpreoperativesystemictherapy(PST)foroccultbreastcancer(OBC).Forthisstudy,departmentalrecordsinBreastDiseaseCenterofPekingUniversityFirstHospitalfromJanuary2008toDecember2015wereretrospectivelyreviewedtoidentifycasesofOBC.Elevencaseswereincluded,andallpatientswerefemale,withamedianageof56(range:29–75)years.Thesensitivityofmagneticresonanceimaging(MRI)was100%,andthefalsepositiveratewas33.3%.Basedonhistologicanalysisoftheaxillarynode,9(81.8%)casesweregrade3,and2(18.2%)casesweregrade2;4(36.4%)caseswere≥10%estrogenreceptor(ER)positiveand6(54.5%)humanepidermalgrowthreceptor2(HER2)positive.Ninecases(81.8%)exhibitedover30%Ki67expression.PSTwasperformedin5ofthe11cases.Thelymphnoderesponseratewas100%(5/5),butnocompleteremissionwasachieved.Inconclusion,aggressivesubtypeswerepredominantamongtheincludedcases,andPSTshouldbeconsideredforOBCtreatmentoptions.
简介:Precisionmedicineandpersonalizedtherapyarereceivingincreasedattention,andmolecular-subtypeclassificationhasbecomecrucialinplanningtherapeuticschedulesinclinicalpracticeforpatientswithbreastcancer.Humanepidermalgrowthfactorreceptor2(HER2)isassociatedwithhigh-gradebreasttumors,highratesoflymph-nodeinvolvement,highriskofrecurrence,andhighresistancetogeneralchemotherapy.AnalysisofHER2expressionishighlyimportantfordoctorstoidentifypatientswhocanbenefitfromtrastuzumabtherapyandmonitortheresponseandefficacyoftreatment.Inrecentyears,significanteffortshavebeendevotedtoachievingspecificandnoninvasiveHER2-positivebreastcancerimaginginvivo.Inthiswork,wereviewedexistingliteratureonHER2imaginginthepastdecadeandsummarizedthestudiesfromdifferentpointsofview,suchasimagingmodalitiesandHER2-specificprobes.WeaimedtoimprovetheunderstandingonthetranslationalprocessinmolecularimagingforHER2breastcancer.
简介:Objective:Weretrospectivelyanalyzedtheclinicalprognosticvalueofthe8theditionoftheAmericanJointCommitteeonCancer(AJCC)stagingsystemforluminalAbreastcancer.Methods:Usingboththeanatomicandprognosticstaginginthe8theditionofAJCCcancerstagingsystem,werestagedpatientswithluminalAbreastcancertreatedattheBreastDiseaseCenter,PekingUniversityFirstHospitalfrom2008to2014.Follow-updataincluding5-yeardiseasefreesurvival(DFS),overallsurvival(OS)andotherclinic-pathologicaldatawerecollectedtoanalyzethedifferencesbetweenthetwostagingsubgroups.Results:Thisstudyincluded421patientswithluminalAbreastcancer(medianfollow-up,61months).The5-yearDFSandOSrateswere98.3%and99.3%,respectively.Significantdifferencesin5-yearDFSbutnotOSwereobservedbetweendifferentanatomicdiseasestages.Significantdifferenceswereobservedinboth5-yearDFSandOSbetweendifferentprognosticstages.Applicationoftheprognosticstagingsystemresultedinassignmentof175of421patients(41.6%)toadifferentgroupcomparedtotheiroriginalanatomicstages.Intotal,102of103patientswithanatomicstageIIAchangedtoprognosticstageIB,and24of52patientswithanatomicstageIIBchangedtoprognosticstageIB,while1changedtoprognosticstageIIIB.Twenty-twoof33patientswithanatomicstageIIIAweredown-stagedtoIIAwhenstagedbyprognosticstagingsystem,andtheother11patientsweredown-stagedtoIIB.TwopatientswithanatomicstageIIIBweredown-stagedtoIIIA.AmongsevenpatientswithanatomicstageIIICcancer,twoweredown-stagedtoIIIAandfourweredown-stagedtostageIIIB.Conclusions:The8theditionofAJCCprognosticstagingsystemisanimportantsupplementtothebreastcancerstagingsystem.Moreclinicaltrialsareneededtoproveitsabilitytoguideselectionofpropersystemictherapyandpredictprognosisofbreastcancer.