BACKGROUND The combination of FFDM and DBT can significantly improve the diagnostic efficiency of breast cancer, but with the increase of breast radiation absorbed dose. OBJECTIVES To compare and analyze the radiation dose and diagnostic performance of different mammography positions combinations of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) for different density types of breasts. METHODS This retrospective study involved 1,195 patients who underwent simultaneous breast DBT and FFDM. The mammography combinations were Group A, FFDM(CC+MLO); Group B, FDM(CC)+DBT(MLO); Group C, FFDM(MLO)+DBT(CC); Group D, DBT(CC+MLO); and Group E, FFDM(CC+MLO)+DBT(CC+MLO). An intergroup comparative analysis of radiation dose and diagnostic performance of different combinations of mammography positions for different breast density types was performed using the pathologic and 24-month follow-up results as the diagnostic basis. RESULTS Overall, 2,403 mammograms indicated 477 cases of non-dense breast tissues and 1,926 cases of dense breast tissues. Differences in the mean radiation dose for each non-dense and dense breast group were statistically significant. The areas under the diagnostic receiver operating characteristic (ROC) curves for the non-dense breast group were not statistically significant. In the dense breast group, the z-values were 1.623 (p = 0.105) and 1.724 (p = 0.085) for the area under the ROC curve in Group C compared with Groups D and E, respectively, and 0.724 (p = 0.469) when comparing Group D with Group E. The differences between the remaining groups were statistically significant. CONCLUSION Group A had the lowest radiation dose and no significant difference in diagnostic performance compared with the other non-dense breast groups. Group C had high diagnostic performance in the dense breast group considering the low radiation dose.
Luminal A型乳腺癌是恶性程度相对较低、预后相对良好的分型，其治疗方式和获益程度成为临床医师关注的重点问题。系统性辅助治疗是目前应用广泛的癌症治疗手段，能够提高进行根治性手术的机会和改善远期预后。针对Luminal A型乳腺癌，系统性辅助治疗的方案正在逐渐完善，临床应用最多且最有效的是内分泌治疗，其次是细胞毒化疗。本文主要对Luminal A型乳腺癌的内分泌治疗以及细胞毒化疗的研究进展、临床指南和现存问题进行了总结，期望能够为解决辅助治疗中的耐药及过度治疗问题提供一些新的研究思路，在分子生物学水平上寻找到改进治疗方案的方式，为Luminal A型的乳腺癌患者提供低成本、高收益的治疗选择。
乳腺癌严重危害女性健康，影像学检查是实现乳腺癌早期发现、早期诊断的重要手段。影像组学通过提取医学影像的高通量特征并进行定量分析，在乳腺癌研究领域得到了广泛应用。随着研究的深入，瘤周影像组学特征中蕴含的肿瘤微环境相关信息逐渐受到重视。近年来，研究者将瘤周影像组学特征纳入到乳腺癌相关影像组学研究中，并取得了较好的成果。本文旨在对瘤周影像组学在乳腺癌良恶性病变鉴别、分子标志物和分子分型、新辅助治疗疗效及淋巴结转移预测等方面的研究进展进行总结，从而为乳腺癌患者的精准治疗提供思路。
乳腺韧带样纤维瘤病(breast desmoid-type fibromatosis, BDF)是一种良性浸润性梭形细胞肿瘤，属于乳腺间叶性肿瘤，其特征是纤维母细胞/肌纤维母细胞分化和Wnt/β-catenin通路的激活[1]。BDF具有局部侵袭性生长的特征，术前临床和影像学检查易误诊为恶性肿瘤[2]。笔者报告了一例疑似乳腺癌的BDF，详细介绍了其乳腺超声、X线摄影和MRI表现，并结合文献复习报告如下，以期提高临床医师对该病的认识。
Breast cancer has become the most diagnosed cancer in the world. The prevention and treatment of breast cancer still faces great challenges. With the establishment of diagnosis and treatment model based on molecular subtyping of breast cancer and the development of new therapeutic drugs, the medical treatment of breast cancer has formed a mature system integrated of chemotherapy, targeted therapy, endocrine therapy and immunotherapy. Because of the large number of breast cancer patients in China and their distinctive clinical characteristics in oncogenesis and progression, it is important to develop new drugs and explore appropriate treatment approaches suitable for the Chinese population in order to improve the survival benefits and change treatment pattern. In recent years, Chinese clinicians have achieved significant breakthroughs in breast cancer treatment. This article has reviewed the noteworthy advancement of clinical research on breast cancer in China in the past year, aiming to provide guidance for standardized diagnosis and treatment of breast cancer.
