Background Surgery is the primary treatment for benign breast disease and causes some disruption to the normal physiology of the breast, even when this disruption is localised, it remains unclear whether it affects women's ability to breastfeed. There are only a few studies describing the experience of breastfeeding in women who have undergone benign breast disease (BBD) surgery.Methods We retrospectively analysed data from patients aged 20-40 years in Guangdong, China, who underwent breast lumpectomy for BBD in our department between 01 January 2013 and 30 June 2019, with a follow-up date of 01 February 2022. Patients were included who had a history of childbirth between the time of surgery and the follow-up date. By collecting general information about this group of patients and information about breastfeeding after surgery, we described the breastfeeding outcomes of women of a fertile age who had previously undergone surgery for benign breast disease.Results With a median follow-up of 5.9 years, a total of 333 patients met the inclusion criteria. From the breastfeeding data of the first child born postoperatively, the mean duration of 'exclusive breastfeeding' was 5.1 months, and the mean duration of 'any breastfeeding' was 8.8 months. The rate of 'ever breastfeeding' is 91.0%, which is lower than the national average of 93.7%, while the exclusive breastfeeding rate at six months was 40.8%, was higher than the 29.2% national average. The any breastfeeding rate at 12 months was 30.0%, which was well below the 66.5% national average. The common reason for early breastfeeding cessation was insufficient breast milk. A total of 29.0% of patients who had ever breastfed after surgery voluntarily reduced the frequency and duration of breastfeeding on the operated breast because of the surgery.Conclusions There are some impacts of BBD surgery on breastfeeding and some may be psychological. Institutions should provide more facilities for mothers who have undergone breast surgery to help them breastfeed, such as conducting community education on breastfeeding after breast surgery, training professional postoperative lactation consultants in hospitals, and extending maternity leave. Families should encourage mothers to breastfeed with both breasts instead of only the non-operated breast.

BACKGROUND Cyclin-dependent kinase (CDK) 7 is aberrantly overexpressed in many types of cancer and is an attractive target for cancer therapy due to its dual role in transcription and cell cycle progression. Moreover, CDK7 can directly modulate the activities of estrogen receptor (ER), which is a major driver in breast cancer. Breast cancer cells have exhibited high sensitivity to CDK7 inhibition in pre-clinical studies. Methods In this review, we provide a comprehensive summary of the latest insights into CDK7 biology and recent advancements in CDK7 inhibitor development for breast cancer treatment. We also discuss the current application of CDK7 inhibitors in different molecular types of breast cancer to provide potential strategies for the treatment of breast cancer. Results Significant progress has been made in the development of selective CDK7 inhibitors, which show efficacy in both triple-negative breast cancer (TNBC) and hormone receptor-positive breast cancer (HR+). Moreover, combined with other agents, CDK7 inhibitors may provide synergistic effects for endocrine therapy and chemotherapy. Thus, high-quality studies for developing potent CDK7 inhibitors and investigating their applications in breast cancer therapy are rapidly emerging. Conclusion CDK7 inhibitors have emerged as a promising therapeutic strategy and have demonstrated significant anti-cancer activity in different subtypes of breast cancer, especially those that have been resistant to current therapies.

OBJECTIVE:To investigate the effect of Jianpi Bushen (JPBS) formula on aromatase inhibitor (AI)-associated bone loss after menopause. METHODS:Six-month-old female rats were randomly divided into 6 groups: a sham group, an ovariectomized (OVX) group, an OVX treated with exemestane and 3 OVX groups each treated with a different dose of JPBS formula. Bone mineral density (BMD) at the lumbar vertebrae, histology, bone markers and serum levels of estrogen were assessed. Furthermore, a cohort study was conducted in 130 postmenopausal women with breast cancer that had undergone treatment with AIs. The subjects were given JPBS + caltrate D or caltrate D only, administered orally. BMD at the lumbar vertebrae and femoral neck and bone markers were evaluated in both control and herbal treatment groups at baseline and 12 months. RESULTS:Experimental results indicated that a high dose of JPBS significantly increased the trabecular bone area percentage (Tb.Ar %) and broadened the trabecular thickness (Tb.Th). The JPBS formula enriched the carboxyterrninal propeptide of type ipmcollagen and increased serum estrogen level significantly. The clinical investigation revealed that bone loss was decreased in the group treated with JPBS vs control (BMD T score at lumbar vertebrae, 3.9% increased vs 14.58% decreased, respectively, P = 0.004 and BMD T score on femoral neck, 1.8% decreased vs 22.45% decreased, respectively, P = 0.008). Besides, JPBS formula elevated N- middle osteocalcin and decreased type I collagen cross-linked C-terminal telopeptide. CONCLUSION:JPBS formula prevented aromatase-inhibitor-associated bone loss after menopause by inhibiting bone resorption and promoting bone formation.

林毅教授是广东省中医院乳腺科学科带头人、主任医师,国家人事部、国家中医药管理局确定的第二批全国老中医药专家学术经验继承工作指导老师,其在中医药治疗乳腺癌的临床中积累了丰富的经验.林教授在临床实践中将可手术乳腺癌分为围手术期、围化疗期、围放疗期及巩固期等4期进行辨证治疗,同时主张在乳腺癌的整个分期辨证治疗过程中外治法应该贯穿全程.现将林教授运用中医外治法治疗可手术乳腺癌经验介绍如下.

The present study assessed the effectiveness of individually delivered cognitive behavioral therapy (CBT) interventions in improving depression in patients with breast cancer. A systematic search of Medline (Ovid), PubMed, Cochrane Library, China National Knowledge Infrastructure database, WANFANG, and the VIP database. Quality assessment of included studies was conducted by 2 reviewers independently using the Jadad scale. The pooled effect of the mean difference in the baseline and post-treatment depressive scores was analyzed using different outcome measuring instruments (Self-rating Depression Scale, Hospital Anxiety and Depression Scale, and Hamilton Depression Rating Scale) separately. Thirteen studies involving 966 patients were included. The pooled standardized mean difference (SMD) comparing the intervention groups to the control groups was -0.87 (95% confidence interval [CI], -1.03 to -0.71; overall effect Z, 10.84; P < .0001) in the Self-rating Depression Scale subgroup, which indicated a large effect size based on Cohen's d value (Cohen's d, -0.87). The SMD was -0.50 (95% CI, -0.98 to -0.02; overall effect Z, 20.6; P = .04) in the Hospital Anxiety and Depression Scale subgroup, which indicated a moderate effect size (Cohen's d, -0.50). Finally, the SMD was -2.61 (95% CI, -4.07 to -1.14; overall effect Z, 3.49; P = .0005) in the Hamilton Depression Rating Scale subgroup, which indicated a very large effect size (Cohen's d, -2.61). The overall effect size of the individually delivered CBT in improving depression in breast cancer patients was large. Also, no evidence was found of statistical heterogeneity. The present meta-analysis showed significant efficacy for individually delivered CBT in the reduction of depression in patients after breast cancer surgery. However, further well-designed randomized controlled trials with large sample sizes are needed to provide more valid and reliable results on the long-term outcomes. (C) 2016 Elsevier Inc. All rights reserved.

This study aimed to develop a nomogram to predict fluorescence in situ hybridization (FISH) assay results for HER2-borderline breast cancer as determined via immunohistochemistry (IHC) among patients in China. We reviewed a database of breast cancer patients diagnosed between January 2007 and April 2013 at our institutions. We used logistic regression to develop a nomogram and we used receiver operating characteristic curve analysis and calibration plots to validate our nomogram. In total, 1138, 301 and 344 patients had IHC-determined HER2-negative, HER2-borderline and HER2-positive disease, respectively. Within the training cohort, univariate and multivariate analyses suggested that estrogen receptor (ER) status, progesterone receptor (PR) status and tumor grade were significantly associated with HER2 status (P<0.01). A nomogram was developed and the AUCs for the training and validation cohorts were 0.795 and 0.749, respectively. The calibration plots suggested that the model was well calibrated. This new nomogram can be used to predict HER2 status in HER2-borderline breast cancer patients and will be particularly helpful to resource-limited countries.

林毅教授是广东省中医院主任医师,国家人事部、国家中医药管理局确定的第二批继承工作的老中医专家,享受国务院特殊津贴.其潜心研究乳房疾病五十载,在中医药治疗乳腺癌的临床和理论上均有独到之处,积累了丰富的经验.岭南地处中国大陆南端,气候炎热潮湿,这决定了岭南人特有的体质特点,即脾气虚弱兼有痰湿.林毅教授在岭南地区治疗乳腺癌的临床实践中,注重从脾胃论治,效果显著.

Objective: To explore the therapeutic effect of massage combined with external application of Chinese medicine and combined treatment of TCM in treating early acute mastitis. Methods:58 patients with acute mastitis, diagnosed and treated in department of breast oncology, Guangdong province traditional Chinese medical hospital from November 2014 to June 2015, were randomly assigned to the treatment group (massage combined with external application of Chinese medicine) and the control group (External treatment of TCM combined with Chinese herbs decoction named Gualou Niubang decoction).The treatment lasted 5 days. The case observation table was filled and the adverse reactions were recorded. A database was established and the data was collected into the SPSS17.0 statistical software package, statistical analysis was made after checking the errors. Results:The statistical analysis indicated that 3d, 5d after treatment, the observation indexes of breast pain, breast swelling area, milk secretion, breast tumor size of two groups improved significantly, the difference was statistically significant (P<0.05). 3d after treatment, body temperature, white blood cell count, and neutrophil count of the control group were better than that of the treatment group (P<0.05). The average course of treatment of the treatment group and the control group was (3.54±1.29) d and (3.25±1.30) d respectively, the difference was of no statistical significance (P>0.05).The total effective rate of two groups was 92.9% and 96.4% respectively. The adverse reactions included 2 cases of mild skin allergy in each group and 3 cases of more gas, stool partial rotten in the control group. Conclusions: Massage combined with external application of Chinese medicine and combined treatment of TCM had significant effect in treating early acute mastitis. Considering the advantages and characteristics of simple manipulations, little adverse effect, lower price and being easy to be accepted by patients, it was worth advocating to be applied in clinical treatment.

目的:观察扶正益气法对乳腺癌术后辅助化疗患者Th 1/Th2细胞漂移的影响,为进一步探讨扶正益气法通过改善肿瘤生存的内环境而对化疗起“减毒增效”的作用机制提供理论基础.方法:采用随机对照研究,将68例患者分为观察组和对照组各34例.2组均行6周期TEC方案化疗(21天/周期),观察组加用参芪扶正液静脉滴注.观察比较2组第1周期化疗前、第6周期化疗后第7天血清Th1细胞因子(IL-2、TNF-α、IFN-γ)及Th2细胞因子(IL-4、IL-6、IL-10)的水平.结果:乳腺癌患者化疗后Th1细胞因子IL-2、TNF-α、IFN-γ均较化疗前降低,差异有显著性或非常显著性意义(P＜ 0.05,P＜0.01);Th2细胞因子IL-4、IL-6、IL-10仍呈高表达强势,与化疗前比较,差异均无显著性意义(P＞0.05).对照组化疗后Th1细胞因子IL-2、TNF-α、IFN-y均较化疗前降低,差异均有非常显著性意义(P＜0.01).观察组化疗后Th1细胞因子IL-2、TNF-α、IFN-γ与化疗前比较,差异均无显著性意义(P＞0.05).2组在化疗后Th1细胞因子IL-2、TNF-α、IFN-γ比较,差异有显著性或非常显著性意义(P＜ 0.05,P＜0.01).对照组化疗后Th2细胞因子IL-4、IL-6、IL-10变化不明显,与化疗前比较,差异均无显著性意义(P＞0.05).观察组化疗后Th2细胞因子IL-6、IL-10变化不明显,与化疗前比较,差异均无显著性意义(P＞0.05);而IL-4与化疗前比较,差异有非常显著性意义(P＜ 0.01).化疗后观察组Th2细胞因子IL-4、IL-6、IL-10降低较对照组明显,但差异均无显著性意义(P＞0.05).结论:化疗可降低Th1细胞因子的水平,而Th2呈高表达强势,提示Th1向Th2漂移,表明辅助化疗可导致进一步的免疫抑制.参芪扶正液可改善辅助化疗患者的Th1细胞因子水平,抑制使其在化疗后进一步降低,提示扶正益气法可以抑制Th1向Th2漂移,有效改善机体免疫抑制和纠正免疫紊乱.

Objective To investigate the effect of Xiaopi oral solution on angiogenesis in breast precancerous lesion rats,and to explore its possible reversing mechanism for breast precancerous lesion. Methods The rat model of breast precancerous lesion was established by 1, 7, 12- dimethyl- benzanthracene(DMBA) combined with estrogen and progesterone sequential method. After modeling and treatment, we compared microvessel density(MVD) and the expression of vascular endothelial growth factor(VEGF) in the mammary gland of Xiaopi oral liquid group,tamoxifen group and the model group. Results Xiaopi oral liquid could reduce the incidence of breast cancer in breast precancerous lesion rats,significantly lower MVD,but had no inhibitory effect on the expression level of VEGF in the mammary gland of breast precancerous lesion rats. Conclusion Xiaopi oral liquid can inhibit the angiogenesis in precancerous lesion rats, thus to block the development of breast cancer, but its mechanism is not through the inhibition of the VEGF pathway.

Breast cancer(BC)is one of the most common tumors.The incidence of breast cancer shows an increasing trend.Chemotherapy has become a conventional treatment method for BC.As one of damaging treatment means,it exerted a killing effect on tumor cells,accompanied with killing effect on hypersensitive lymph cell and debilitating effect on immune balance of internal environment.The study indicated that this treatment method could reduce therapeutic efficacy.Improving the curative effect thereby is very important through improving the immune balance of internal environment.Fuzheng Method can regulate the immunologic function and improve the antitumor cytokine activity of the body.Through influence of Fuzheng method on Th1/Th2 cell shift and tumors survival internal environment,synergistic effects of Fuzheng method on chemotherapy against BC could be obtained.