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Objective: To establish a mouse model of breast cancer lung metastasis with miR-155 knockout (miR155-/-) mice, and to compare the difference of peripheral blood immune cell typing between miR155-/- mice and C57BL/6J wide-type (WT) mice. Methods: Bioinformatics analysis was used to explore the expression level of miR-155 in breast cancer tissues and peripheral serum, and its relationship with prognosis. Mouse model of lung metastasis of breast cancer was established by tail vein injection; peripheral blood was collected for flow cytometry, and the immune cell typing was analyzed; the lung tissues were collected for immunohisto-chemical detection to observe the tumor metastasis. Results: Percentage of T lymphocytes and monocytes in peripheral blood of miR155-/- mice was significantly decreased compared with WT mice (P<0.05), percentage of myeloid inhibitory cells (MDSCs) was increased significantly (P<0.05), in which the proportion of monocyte subsets (M-MDSC) was significantly decreased (P<0.05), while the proportion of granulocyte subsets (G-MDSC) was significantly increased (P<0.05). In lung metastasis model of breast cancer, percentage of T lymphocytes in peripheral blood of miR155-/- mice was significantly higher compared with WT mice, while percentage of NK cells was decreased significantly (P<0.05), percentage of neutrophil was significantly decreased (P<0.001), proportion of Th cells in T lymphocytes was significantly decreased (P<0.05), proportion of M-MDSCs was significantly decreased (P< 0.01), while proportion of G-MDSCs was significantly increased (P<0.01). Conclusion: Deletion of miR-155 gene leads to significant differences in peripheral immune cell typing, making mice more susceptible to lung metastasis of breast cancer. [ABSTRACT FROM AUTHOR]

In China, 60% of breast cancer patients were premenopausal women at the time of diagnosis. Compared with postmenopausal women, premenopausal women have strong ovarian function and secrete estrogen to promote breast cancer growth. Ovarian function suppression (OFS) has been used in the treatment of breast cancer for decades, and a large body of evidence-based medical research confirmed that the application of OFS alone or combination therapy can reduce the recurrence risk and improve survival in premenopausal women with breast cancer. The long-term follow-up data of OFS studies have been published successively. SOFT and TEXT study reported the follow-up results of 12 and 13 years, the STO-5 study reported the follow-up data of 20 years, and the ASTRRA study based on Asian populations reported the follow-up data of 8 years. It is further confirmed that the application of OFS for patients with early breast cancer could significantly reduce the recurrence risk over ten years and improve the possibility of cure. MonarchE study and NATALEE study demonstrated that the application of CDK4/6 inhibitors in combination with endocrine therapy and gonadotropin releasing hormone analog (GnRHa) in premenopausal patients with early breast cancer has further improved the survival benefits. Committee of Breast Cancer Society, China Anti-Cancer Association in the field of breast cancer treatment in China jointly discussed and formulated the "Expert consensus on clinical applications of ovarian function suppression for Chinese women with early breast cancer (2024 edition)" based on the "Expert consensus on clinical applications of ovarian function suppression for Chinese women with early breast cancer (2021 edition)". The consensus recommends that medical castration with GnRHa is the first choice for OFS in premenopausal hormone receptor-positive early breast cancer. CDK4/6 inhibitors in combination with endocrine therapy and GnRHa benefit the premenopausal hormone receptor-positive breast cancer population, including patients with node-positive breast cancer, and patients with node-negative breast cancer who meet one of any criteria (G3, G2 and Ki-67 proliferation index ≥20%, G2 and 21-gene assay recurrence score ≥26, G2 and Prosigna PAM50 high risk, G2 and MammaPrint high risk, G2 and EndoPredict high risk). Chemotherapy eligibility (high risk of recurrence) in the 2023 St. Gallen consensus will also be as one of the risk factors to determine whether OFS is applicable for premenopausal hormone receptor positive breast cancer patients. Adjuvant endocrine therapy plan is decided based on the status of ovarian function before chemotherapy for hormone receptor-positive breast cancer. If ovarian protection is considered, GnRHa concurrent chemotherapy is recommended, which does not affect the survival benefit of patients. If ovarian protection is not considered, it is recommended that GnRHa can be used with start of chemotherapy or sequentially after chemotherapy, the latter is more recommended. Endocrine therapy for perimenopausal patients is recommended to refer to the premenopausal regimen. The recommended duration of GnRHa in adjuvant endocrine therapy intermediate- and high-risk patients is 5 years. After 5 years' endocrine therapy combined with GnRHa, if they are not menopausal and well tolerated, they may consider continuing 2 to 5 years of endocrine therapy combined with GnRHa or using selective estrogen receptor modulators (SERM) alone for 2 to 5 years. Adding GnRHa to the adjuvant treatment regimen is safe and tolerable. It is recommended to fully communicate with patients about the use of the drug and possible adverse events before use. Safety management can improve patient adherence. For patients undergoing medical castration, it is not routinely recommended to monitor estrogen levels during medical castration. However, estrogen testing may be performed for clinical decision making when incomplete ovarian suppression is suspected (including changes in usage such as lack of injection experience by the injection provider, changes in dosage forms, or certain physiological changes that may indicate the recovery of ovarian function, such as symptoms of menopause fluctuating periodically). For premenopausal breast cancer patients, whether hormone receptor-positive or hormone receptor-negative, it is recommended to use GnRHa drugs to protect ovarian function, reduce the risk of premature ovarian failure, and reduce fertility damage. It is recommended to start using GnRHa at least 1 week before chemotherapy, once every 28 d, until 2 weeks after the last dose of chemotherapy. Clinical trials conducted on patients with hormone receptor-positive breast cancer are not recommended to include only postmenopausal people. Premenopausal people under GnRHa application conditions should also be explored to clarify the actual effect of experimental drugs on these patients. In addition, this consensus also adds a full management path for OFS drug application in patients with early/locally advanced breast cancer, in order to further assist clinical decision-making. [ABSTRACT FROM AUTHOR]

Metastatic pheochromocytoma and paraganglioma (MPPGL) is a rare neuroendocrine tumour in which genetic factors play an important role. In recent years, with the continuous progress of genetic testing technology, more and more susceptibility genes have been proved to be associated with MPPGL, making early identification of MPPGL possible. Recent studies have shown that genes associated with the development of MPPGL include SDHA, SDHB, SDHC, SDHD, SDHAF2, FH, MDH2, VHL, IDH1, PDH1/2, SLC25A11, GOT2, DLST, CSDE1, MAML3, H3F3A, MERTK, PCDHGC3, and KIF1B, with SDHA, SDHB, SDHC, SDHD, and SDHAF2 being the common pathogenic genes. Potential mutations affect the clinical manifestations of MPPGL, such as malignant potential and genetic prediction, which can help to better understand the clinical course and treat accordingly. Genetic testing for pheochromocytomas and paragangliomas allows for early detection of genetic syndromes and facilitates close follow-up of high-risk patients. This article provides a review of the progress of research on susceptibility genes identified in MPPGL in recent years, with a view to providing a certain theoretical basis for further related research. [ABSTRACT FROM AUTHOR]

Background and purpose: Systematic treatment for breast cancer largely depends on the status of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Discordance in ER, PR and HER2 status between primary breast cancer and distant metastases has been observed in a proportion of patients in previous studies. Liver is one of the frequent metastatic sites of breast cancer. Currently, limited data are available on the receptor conversion between primary breast cancer and matched liver metastases. This study aimed to investigate the prevalence, risk factors and prognostic impact of receptor conversion between primary breast cancer and paired liver metastases. Methods: The data of breast cancer patients who had pathologically confirmed liver metastases from January 2013 to May 2020 at Fudan University Shanghai Cancer Center were retrospectively collected. A total of 353 patients with ER, PR and HER2 status available on both primary breast cancer and matched liver metastases were finally included in this study. ER, PR and HER2 status were interpreted according to the most updated American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines. The evolution of receptor status and phenotype from primary to metastatic breast cancer was illustrated using Sankey diagrams. Kappa coefficient and McNemar's test were used to assess the agreement on receptor status between primary breast cancer and liver metastases. The Kaplan-Meier curves were plotted and survival differences across each group were assessed by log-rank test. Multivariate analyses were performed based on the COX proportional hazard regression model. Results: The total discordance rate of ER, PR and HER2 was 19.5%, 39.4% and 4.8%, respectively (Kappa coefficient: 0.569, 0.258 0.876). In de novo stage IV patients, the discordance rate of ER, PR and HER2 was 15.2%, 28.3% and 2.2%, respectively. Multivariate analysis showed that previous endocrine therapy before liver re-biopsy was an independent risk factor of PR discordance. None of the variables of interest was found to be associated with discordance in ER or HER2 status. Additionally, 37.9% of the HER2-0 tumors converted to HER2-low. A trend of increase in triple-negative and decrease in hormone receptor (HR)+/HER2- cases were observed in liver metastases. Patients with HR+/HER2- primary breast cancer who converted to triple-negative in liver metastases had a significantly shorter overall survival (OS) than those with consistent HR+/HER2- subtype. Patients with the same subtype in liver metastases shared similar OS. Conclusion: This study confirmed discordance in ER, PR and HER2 status between primary breast cancer and liver metastases. The prognosis of breast cancer patients was determined mainly by the subtype in metastases rather than that in primary disease. Our study underlined the necessity of liver re-biopsy in de novo stage IV patients with liver metastases. Over one-third of HER2-0 patients converted to HER2-low in liver metastases after reassessment, which enabled them to be treated with new antibody-drug conjugate (ADC). [ABSTRACT FROM AUTHOR]

Breast cancer is the most common malignant tumor in women and the main cancer causing death in females. Breast cancer therefore seriously threatens women's health and life span. Although there are a variety of comprehensive and multidisciplinary treatments for different types of breast cancer, the overall prognosis of advanced breast cancer remains unsatisfactory. The incidence of breast cancer is increasing year by year, and the age of onset is gradually decreasing, making the discovery of a breakthrough in breast cancer treatment a major problem that needs to be solved urgently. A large number of studies have shown the growth of breast cancer cells can be inhibited by inducing ferroptosis. Acid sphingomyelinase has also been confirmed to be involved in cell death induced by ferroptotic agonists. This article reviews the progress in the use of acid sphingomyelinase and ferroptosis in the treatment of breast cancer, and summarizes the mechanism of ferroptosis in breast cancer cells and its correlation with acid sphingomyelinase. This review will provide a theoretical foundation for seeking new therapeutic targets for breast cancer. [ABSTRACT FROM AUTHOR]

Breast cancer is one of the common malignant tumors in the world. About 6% of the patients are de novo stage Ⅳ breast cancer, which is incurable. Traditionally, the role of surgery has been confined to relieving symptoms, improving quality of life and reducing tumor load. Nowadays, a multidisciplinary team is a prerequisite for optimal management, and patients with oligometastatic lesion always live for a long time. R0 resection of the primary and metastatic foci can extend the time of progressionfree survival (PFS), which may bring survival benefits. Therefore, whether to perform surgery has become a hot clinical issue. This article deeply discussed extensively the surgical value in de novo stage Ⅳ breast cancer patients. [ABSTRACT FROM AUTHOR]

Objective: To study the risk factors of recurrence and metastasis in patients with breast cancer after modified radical mastectomy and the predictive value of serum carbohydrate antigen 125 (CA125), cyclo-oxygenase-2 (COX-2), soluble tumor necrosis factor receptor-P55 (sTNFR-P55). Methods: 109 patients with breast cancer who underwent modified radical mastectomy in The First Affiliated Hospital of Xinjiang Medical University from January 2014 to December 2016 were prospectively studied. All patients were followed up for 5 years after operation, including 2 patients who were lost to follow-up, and 107 patients who completed follow-up. According to the recurrence and metastasis within 5 years, the patients were divided into recurrence and metastasis group (n=31) and non-recurrence and metastasis group (n=76). The clinicopathological data of the patients at admission were collected. Preoperative serum CA125 was detected by electrochemiluminescence method, and preoperative serum COX-2 and sTNFR-P55 were detected by enzyme-linked immunosorbent assay. Logistic regression model was used to analyze the influencing factors of postoperative recurrence and metastasis, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of serum CA125, COX-2 and sTNFR-P55 on postoperative recurrence and metastasis. Results: The tumor diameter greater than 5cm, invasive non-specific carcinoma, vascular tumor thrombus, estrogen receptor (ER)/progesterone receptor (PR) negative, the constituent ratio of no endocrine therapy, TNM stage IIIA, and the number of axillary lymph node metastases 4~9 in the recurrence and metastasis group were higher than those in the non-recurrence and metastasis group (P<0.05). The levels of serum CA125, COX-2 and sTNFR-P55 in the recurrence and metastasis group were higher than those in the non-recurrence and metastasis group (P<0.05). Multivariate logistic regression analysis showed that tumor diameter greater than 5cm, invasive non-specific carcinoma, TNM stage IIIA, vascular tumor thrombus, number of axillary lymph node metastases 4~9, increased CA125, increased COX-2, and increased sTNFR-P55 were independent risk factors for recurrence and metastasis within 5 years after modified radical mastectomy (OR=1.318, 1.213, 1.223, 1.137, 1.257, 1.241, 1.313, 1.351, P<0.05). Serum CA125, COX-2 and sTNFR-P55 could effectively predict postoperative recurrence and metastasis of breast cancer, and the area under the curve (AUC) was 0.803, 0.749 and 0.761, respectively. The AUC of combined prediction of postoperative recurrence and metastasis of the three indexes was 0.915, and the sensitivity and specificity were 0.94 and 0.83, respectively. Conclusion: Tumor diameter, invasive non-specific carcinoma, TNM stage, vascular tumor thrombus, number of axillary lymph node metastases, and abnormal elevation of preoperative serum CA125, COX-2, sTNFR-P55 are risk factors for recurrence and metastasis within 5 years after modified radical mastectomy. Combined detection of preoperative serum CA125, COX-2 and STNFR-P55 can predict the risk of recurrence and metastasis after modified radical mastectomy. [ABSTRACT FROM AUTHOR]

Objective: To observe the efficacy and safety of Eribulin⁃based regimen in patients with HER2 negative metastatic breast cancer in the real world. Methods: We retrospectively analyzed clinical data of 60 patients with HER2⁃negative metastatic breast cancer who received Eribulin⁃based therapy in Jiangsu Province Hospital between January 2020 and November 2021. Results: 30% of patients received Eribulin monotherapy while 70% of patients received Eribulin⁃based combination therapy. After a median follow⁃up of 5 months, the median progression⁃free survival (PFS) was 4.30 months (95%CI: 3.86⁃5.69 months), Median overall survival (OS) was not reached. The overall response rate (ORR) was 25.00%, and disease control rate (DCR) was 76.67%. Log⁃rank univariate analysis showed that there was a statistically significant difference between Eribulin monotherapy versus Eribulin⁃based combination regimen (2.93 months vs. 4.7 months, P=0.042) . Multivariate analysis indicated that age and chemotherapy lines were independent risk factors for PFS in patients with HER2⁃negative metastatic breast cancer treated with Eribulin (P=0.022, 0.048) . The most common grade Ⅲ⁃Ⅳ adverse events (AE) associated with Eribulin include neutropenia, leukopenia, anemia, and lymphopenia, and no treatment⁃ related severe adverse event (SAE) or deaths were observed. Conclusion: Our research indicated that Eribulin⁃based regimen can effectively treat HER2⁃negative metastatic breast cancer with controllable side effects. [ABSTRACT FROM AUTHOR]

With the improvement of comprehensive treatment of breast cancer and the continuous development of anti-tumor drugs, the survival time of breast cancer patients, especially advanced breast cancer, has been further extended. In recent years, the treatment of advanced breast cancer has ushered an era of fine classification and precise tiered therapy. In 2022, many breakthroughs have been made in the field of advanced breast cancer research. With changes in the treatment of each subtype, some treatment schemes affecting clinical practice have been incorporated into treatment guidelines. The treatment for hormone-receptor-positive advanced breast cancer focuses on patients who have failed treatment with cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors. Novel anti-human epidermal growth factor receptor 2 (HER2) antibody-drug conjugates (ADC) in advanced HER2 positive breast cancer are the focus of research. More research evidence is needed for immunotherapy in advanced triple-negative breast cancer (TNBC), and the treatment with ADC targeting Trop-2 has been effective. Treatment with ADC in HER2-low breast cancer are changing clinical practice. In this article, we summarized the research progress of different types of advanced breast cancer in this year, in order to better guide the individualized treatment and improve the prognosis of advanced breast cancer patients. [ABSTRACT FROM AUTHOR]

Background and purpose: The novel centrosomal regulatory protein Sec23 homolog B (SEC23B) regulates autophagy in cells, thereby providing energy and nutrients that contribute to tumor growth and distant metastasis. However, whether this role is involved in the mechanism of infiltrative metastasis in breast cancer is unclear. The aim of this study was to investigate the molecular mechanism by which SEC23B promotes breast cancer infiltration and metastasis. Methods: The association between SEC23B expression and breast cancer prognosis and metastasis was analyzed using Kaplan-Meier Plotter database and HCMDB database. MCF-7 cells were divided into vector group (control) and SEC23B overexpression plasmid group (SEC23B), and MDA231-LM2 cells were divided into SEC23B knockdown group (sh-SEC23B) and control group (sh-NC). Western blot was used to detect the expressions of SEC23B, autophagy-associated proteins [dead bone fragment 1 (SQSTM1, p62), microtubule-associated-protein light-chain-3 (LC3)] and extracellular-regulated protein kinases (ERK)/mammalian target of rapamycin (mTOR) pathway proteins in breast cancer cells. Cell migration was assessed by transwell assay and wound healing assay, and autophagic granules in cells were detected by immunofluorescence staining. In addition, an in vivo intraperitoneal tumor model was constructed to study the effect of SEC23B on breast cancer cell metastasis in vivo. Results: The overall survival of breast cancer patients with high SEC23B expression was significantly shorter than that of patients with low SEC23B expression. The expression of SEC23B in metastatic breast cancer was significantly higher than that in breast cancer without metastasis. SEC23B protein levels were lower in primary breast cancer cells (MCF-7, BT-549, MDA-MB-468 and MDA-MB-453) than in metastatic breast cancer cells (MDA231- LM2 and ZR-75-30). Compared with the control group, the SEC23B group significantly accelerated cell migration (P<0.001). Compared with the sh-NC group, the sh-SEC23B group significantly reduced cell migration (P<0.001). Compared with the control group, the expression level of LC3A/B and the formation of autophagy particles in the SEC23B group were significantly increased, while the expression of p62 protein and the phosphorylation levels of mTOR and ERK were decreased. Compared with the sh-NC group, the LC3A/B expression level and the formation of autophagy particles were significantly decreased in the sh-SEC23B group, and the phosphorylation levels of mTOR and ERK were increased, especially under starvation conditions. In in vivo experiments, tumor weight was significantly lower in the sh-SEC23B group compared with the sh-NC group (P<0.01), and there was an increase in necrotic tissue and a decrease in tumor metastasis in lung tissue in mice. sh-SEC23B group mice had a significantly lower number of lung metastatic tumors and LC3 immunohistochemical staining than the sh-NC group (P<0.01). Conclusions: SEC23B induces breast cancer autophagy and promotes cancer cell metastasis by inhibiting ERK/mTOR signaling pathway. [ABSTRACT FROM AUTHOR]

Background and purpose: Internal mammary lymph node irradiation (IMNI) improves survival in patients with internal mammary lymph node (IMLN) high-risk metastatic breast cancer. The purpose of this study was to study the advantages of internal mammary sentinel lymph node (IMLN) biopsy (IM-SLNB) for assessing prognosis and directing individualized IMNI. Methods: This study evaluated patients recruited in three prospective clinical trials (NCT01642511, NCT03541278, and NCT03024463) from November 2011 to December 2021, assessed for prognostic risk variables based on IMSLN metastatic status and prognosis between subgroups. In patients who received regional lymph node irradiation, the implementation status, survival benefit, and influence of IMNI on radiation-induced lung injury (RILI) were studied. The primary endpoint was disease-free survival (DFS), with overall survival (OS) and RILI as secondary endpoints. Results: The study enrolled 537 patients and had a 60-month median follow-up. Patients with IMSLN metastasis had a significantly worse 5-year DFS and OS (DFS: 95.1% vs 71.4%, OS: 99.1% vs 90.1%, both P<0.05), and IMSLN metastatic status was an independent risk factor for DFS and OS (both P<0.05). Adding IMNI did not improve DFS (P = 0.099) or OS (P = 0.486) in patients with negative IMSLN, while it did increase the risk of RILI (OR = 3.678, P<0.05). However, adding IMNI improved 5-year DFS (87.3% vs 52.5%, P = 0.040) for patients with positive IMSLN but had no effect on OS (P = 0.603). Conclusion: This study discovered that IMSLN metastatic status has significant prognostic importance. Patients with IMSLN metastasis who receive IMNI have significantly improved prognosis, and patients without IMSLN metastasis have a much lower risk of RILI by being exempt from IMNI without worse prognosis. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common cancer in women worldwide with rising prevalence. The human epidermal growth factor receptor 2 (HER2) is crucial to the biological behavior and pathogenic mechanism of breast cancer. Approximately 45%- 55% of all subtypes of breast cancer have low expression of HER2, which are classified as HER2 immunohistochemistry staining 1+ or 2+ and in situ hybridization (ISH) negative. Although in most cases, HER2 low expression (HER2-low) breast cancer is still classified as HER2 negative or triple negative in clinical practice, HER2-low differs from HER2 not detected (HER2-0) breast cancer not only in HER2 expression levels, there are also differences in terms of estrogen receptor (ER) status, primary tumor volume, lymph node involvement, and pathologic complete response (pCR) following neoadjuvant therapy and disease-free survival (DFS). In clinical trials targeting early-stage HER2-low breast cancer, the NSABP B-31 and N9831 trials demonstrated the possibilities for breast cancer patients to benefit from adjuvant trastuzumab therapy; however, in phase III prospective randomized controlled study NSABP B-47, trastuzumab did not alter invasive disease-free survival (iDFS), 5-year interval without distant recurrence, or overall survival (OS) in patients with HER2-low breast cancer. Recent years have seen the emergence of clinical trials for targeted treatments for advanced HER2-low breast cancer, focusing mostly on trastuzumab, lapatinib, and antibody-drug conjugate (ADC), such as trastuzumab emtansine (T-DM1), DS-8201 (also known as trastuzumab deruxtecan, T-DXd, Enhertu), and SYD985. Phase III trial CALGB9840 demonstrated a lack of therapeutic effect of trastuzumab and a narrow therapeutic window that could not be overcome by changing the dose of lumretuzumab in HER2 non-over-expressed breast cancer, respectively. Two randomized phase III trials (EGF30001 and EGF100151) both found that receiving lapatinib did not improve progression-free survival (PFS) in patients with HER2-low breast cancer. T-DM1 sensitivity was initially observed in patients with HER2-low breast cancer in the single-arm phase II studies 4258g and 4374g, but results were still uncertain because of the small number of patients. The phase III clinical study DESTINY-Breast04 proved the safety and efficacy of DS-8201 (5.4 mg/kg) in HER2-low metastatic breast cancer. The phase I clinical trial proved the efficacy and safety of 1.2 mg/kg SYD985 intravenously in HER2-low breast cancer. Additionally, there are currently ongoing clinical trials for several novel anti-HER2 therapeutics, including novel ADC drugs (RC48-ADC, ARX788, A166, etc.), bispecific antibodies (KN026, ZW25, ertumaxomab, etc.), and breast cancer vaccines (nelipepimut-S, GP2, AE37, etc.). In this paper, we will review the major clinical trials of targeted therapies for HER2-low breast cancer. [ABSTRACT FROM AUTHOR]

Objective: To study the risk factors of recurrence and metastasis in patients with breast cancer after modified radical mastectomy and the predictive value of serum carbohydrate antigen 125 (CA125), cyclo-oxygenase-2 (COX-2), soluble tumor necrosis factor receptor-P55 (sTNFR-P55). Methods: 109 patients with breast cancer who underwent modified radical mastectomy in The First Affiliated Hospital of Xinjiang Medical University from January 2014 to December 2016 were prospectively studied. All patients were followed up for 5 years after operation, including 2 patients who were lost to follow-up, and 107 patients who completed follow-up.According to the recurrence and metastasis within 5 years, the patients were divided into recurrence and metastasis group (n=31) and non-recurrence and metastasis group (n=76). The clinicopathological data of the patients at admission were collected. Preoperative serum CA125 was detected by electrochemiluminescence method, and preoperative serum COX-2 and sTNFR-P55 were detected by enzyme-linked immunosorbent assay. Logistic regression model was used to analyze the influencing factors of postoperative recurrence and metastasis, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of serum CA125, COX-2 and sTNFR-P55 on postoperative recurrence and metastasis. Results: The tumor diameter greater than 5cm, invasive non-specific carcinoma, vascular tumor thrombus, estrogen receptor (ER) /progesterone receptor (PR) negative, the constituent ratio of no endocrine therapy,TNM stage ⅢA, and the number of axillary lymph node metastases 4~9 in the recurrence and metastasis group were higher than those in the non-recurrence and metastasis group (P＜0.05). The levels of serum CA125, COX-2 and sTNFR-P55 in the recurrence and metastasis group were higher than those in the non-recurrence and metastasis group (P＜0.05). Multivariate logistic regression analysis showed that tumor diameter greater than 5cm, invasive non-specific carcinoma, TNM stage ⅢA, vascular tumor thrombus, number of axillary lymph node metastases 4~9, increased CA125, increased COX-2, and increased sTNFR-P55 were independent risk factors for recurrence and metastasis within 5 years after modified radical mastectomy (OR=1.318, 1.213, 1.223, 1.137, 1.257, 1.241, 1.313, 1.351, P＜0.05). Serum CA125, COX-2 and sTNFR-P55 could effectively predict postoperative recurrence and metastasis of breast cancer, and the area under the curve (AUC) was 0.803, 0.749 and 0.761, respectively. The AUC of combined prediction of postoperative recurrence and metastasis of the three indexes was 0.915, and the sensitivity and specificity were 0.94 and 0.83, respectively. Conclusion: Tumor diameter, invasive non-specific carcinoma, TNM stage, vascular tumor thrombus, number of axillary lymph node metastases, and abnormal elevation of preoperative serum CA125, COX-2, sTNFR-P55 are risk factors for recurrence and metastasis within 5 years after modified radical mastectomy. Combined detection of preoperative serum CA125, COX-2 and STNFR-P55 can predict the risk of recurrence and metastasis after modified radical mastectomy. [ABSTRACT FROM AUTHOR]

Objective: To study the expression of N-myristoyltransferase 1 (NMT1) and 2 (NMT2) in breast cancer tissues and their biological effects on breast cancer cells. Methods: The expression of NMT1 and NMT2 in 40 breast cancer tissues were detected by ELISA, and their expressions were confirmed by immunohistochemistry. Small RNA interference technology knocked down the expression levels of NMT1 and NMT2 in breast cancer cells MCF-7 and BT-474. CCK-8 and Transwell chamber transmembrane assays were used to detect the changes of cell proliferation and metastasis before and after NMT1 and NMT2 knockdown. Results: The expressions of NMT1 and NMT2 in breast cancer tissues of patients with lymph node metastasis and stage III/IV were significantly increased (P<0.01). Using CCK-8 detection, it was found that the proliferation activity of breast cancer cells BT-474 and MCF-7 after NMT1 or NMT2 knockdown for 48 h was significantly lower than that of control cells (P<0.0001). Transwell chamber penetration test showed that the number of transmembrane cells in the NMT1 or NMT2 knockdown group was significantly lower than that in the control group (P<0.01). Conclusion: NMT1 and NMT2 play a key role in the occurrence and development of breast cancer. Knockdown of NMT1 and NMT2 can weaken the proliferation and metastasis of Breast cancer cancer cells. Targeted inhibition of NMT1 and NMT2 is expected to become an important molecular target for intervention in breast cancer. [ABSTRACT FROM AUTHOR]

Background and purpose: Breast cancer is the most common malignancy in women, and it is also the cancer with the highest number of new cases worldwide in 2020. Human epidermal growth factor receptor 2 (HER2)-positive breast cancer accounts for approximately 20% of all breast cancers, which indicates higher rate of recurrence and metastasis and a poor prognosis. Therefore, it is of great significance to explore the biomarkers related to HER2-positive breast cancer. This study aimed to investigate the expression of circ-0003910 in HER2-positive breast cancer tissues and cells, and to clarify the effect of circ-0003910 on the migration and invasion of breast cancer cells. Methods: Circular RNA (circRNA) microarray was used to screen circRNA differentially expressed in HER2-positive breast cancer cells, and significantly overexpressed circRNA was selected as the research target. Fluorescence in situ hybridization (FISH) assay was used to detect the subcellular localization of circ-0003910. BaseScope assay was used to analyze the expression and clinical significance of circ-0003910 in breast cancer tissues. Circ-0003910 overexpressed and knockdown breast cancer cells were constructed by transfection of cloned plasmid and siRNA in vitro. The effect of circ-0003910 on the migration and invasion ability of breast cancer cells was detected by transwell assay. The molecular mechanism of circ0003910 promoting the migration and invasion of breast cancer cells was preliminarily explored by TMT quantitative proteomics techniques. Results: CircRNA microarray analysis showed that a total of 1 843 differentially expressed circRNAs were screened in HER2-positive breast cancer cells (fold change≥2, P<0.05), including 845 upregulated circRNAs and 998 downregulated circRNAs. Compared with normal breast epithelial cells, the differential expression ratio of circ-0003910 in HER2-positive breast cancer cells was 24.39. Real-time fluorescence quantitative polymerase chain reaction (RTFQ-PCR) results showed that the expression of circ0003910 was higher in HER2-positive breast cancer cells than in other molecular types of breast cancer cells, and BaseScope assay verified that circ-0003910 was mainly located in the cytoplasm of HER2-positive breast cancer tissue cells. Overexpression of circ0003910 promoted the migration and invasion of breast cancer cells, while circ-0003910 knockdown produced the opposite effects. Proteomics identification showed that 197 proteins were changed after overexpression of circ-0003910, of which 104 proteins were upregulated and 93 proteins were downregulated. GO and KEGG enrichment analysis suggested that circ-0003910 may be involved in biological processes such as cell adhesion molecule synthesis, transcriptional dysregulation in cancer, and protein digestion and absorption. Conclusion: Circ-0003910 is upregulated in breast cancer cells and can promote the migration and invasion of breast cancer cells, which may be a new biomarker and target for the treatment of metastatic breast cancer. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the value of preoperative detection of carbohydrate antigen 125 (CA125), osteopontin (OPN), chemokine ligand 8 (CXCL8) and neutrophil lymphocyte ratio (NLR) in evaluating recurrence and metastasis risk of breast cancer patients undergoing modified radical mastectomy. Methods: 384 patients with modified radical mastectomy whow ere treated in our hospital from April 2015 to April 2016 were divided into non recurrent metastasis group (n=345) and recurrent metastasis group(n=39) according to postoperative recurrence and metastasis. Compared with CA125, OPN, CXCL8 and NLR in relapse metastasis group and non recurrence metastasis group, multivariate regression analysis was used to analyze the influencing factors of recurrence and metastasis after modified radical mastectomy. The receiver operating characteristic (ROC) curve was used to determine the value of CA125, OPN, CXCL8 and NLR in evaluating the recurrence and metastasis risk of breast cancer patients undergoing modified radical mastectomy. Results: The levels of CA125, OPN, CXCL8 and NLR in recurrence and metastasis group were higher than those in non recurrence and metastasis group(P<0.05). Postoperative recurrence and metastasis of modified radical mastectomy were related to tumor diameter, clinical stage, preoperative neoadjuvant chemotherapy, human epidermal growth factor receptor 2 (HER2), lymph node metastasis, histological type, cell proliferation marker antigen (Ki-67), estrogen receptor(ER) / progesterone receptor (PR), P53, postoperative radiotherapy, postoperative endocrine therapy (P<0.05). Multivariate Logistic regression analysis showed that OPN was high, CXCL8 was high, NLR was high, tumor diameter was greater than 2 cm, lymph node metastasis was positive, ER/PR was double negative, clinical stage was III stage, and preoperative neoadjuvant chemotherapy was not a risk factor for recurrence and metastasis of breast cancer after modified radical mastectomy (P<0.05). The area under the curve (AUC) of preoperative CA125, OPN, CXCL8 and NLR was 0.855, which was higher than that of each index. Conclusion: The recurrence and metastasis of breast cancer after modified radical mastectomy are related to OPN, CXCL8, NLR, tumor diameter, lymph node metastasis, ER/PR, clinical stage and preoperative neoadjuvant chemotherapy. The combined detection of CA125, OPN, CXCL8 and NLR before operation is of high value in evaluating postoperative recurrence and metastasis. [ABSTRACT FROM AUTHOR]

Bone metastasis is one of the most serious complications in advanced breast cancer patients. Severe osteodynia, pathological fracture and other complications in bone metastasis of breast cancer can seriously affect the quality of life and shorten life span. In recent years, with the further understanding of the mechanism of bone metastases and the cross-talk between tumor cells and bone microenvironment, development and application of many new effective drugs have made significant progress in the treatment of bone metastasis of breast cancer. This article reviewed the mechanism of bone metastasis of breast cancer and current treatment advances. [ABSTRACT FROM AUTHOR]

Objective: To investigate the expression of forkhead box P3 (FOXP3), high mobility group protein A2 (HMGA2) and ras protein activator like 2 (RASAL2) in breast cancer tissues and their relationship with clinicopathological features and prognosis. Methods: 102 cases of breast cancer patients who were treated in our hospital from June 2014 to June 2015 were selected as the research objects. The expressions of FOXP3, HMGA2 and RASAL2 in breast cancer tissues and adjacent tissues were detected. The correlation of expressions of FOXP3, HMGA2 and RASAL2 with clinicopathological parameters was analyzed. Kaplan-Meier survival curve was used to analyze the difference of the overall survival rate of patients with different expressions of FOXP3, HMGA2 and RASAL2. Cox proportional hazard regression analysis of prognostic factors in breast cancer patients. Results: Compared with adjacent tissues, the positive expression rates of FOXP3 and HMGA2 in breast cancer tissues were increased, while the positive expression rate of RASAL2 was decreased (P<0.05). The expressions of FOXP3, HMGA2 and RASAL2 were all correlated with TNM stage and lymph node metastasis (P<0.05). The survival rate of FOXP3 and HMGA2 positive patients were significantly lower than those of FOXP3 and HMGA2 negative patients, and the survival rate of RASAL2 positive patients was significantly higher than that of RASAL2 negative patients (P<0.05). TNM stage Ⅲ, FOXP3 positive expression, HMGA2 positive expression were the risk factor affecting the prognosis of breast cancer patients (P<0.05), the positive expression of RASAL2 was a protective factor for the prognosis of breast cancer patients (P<0.05). Conclusion: The positive expression rates of FOXP3 and HMGA2 in breast cancer tissues are increased, while the positive expression rates of RASAL2 is decreased. The positive expression of FOXP3 and HMGA2 and the negative expression of RASAL2 were correlated with TNM stage and lymph node metastasis in breast cancer patients, and are the influencing factors for poor prognosis of the patients. [ABSTRACT FROM AUTHOR]

Objective To investigate the correlation between preoperative MRI signs and vascular endothelial growth factor (VEGF) in breast cancer, and to provide reference for the prediction of VEGF. Methods The preoperative MRI of 73 patients with breast cancer was retrospectively analyzed. The patients were divided into VEGF over expression (28) and VEGF low expression (45) groups. Clinicopathological and preoperative MR data of the two groups were analyzed by univariate analysis, and a multivariate diagnostic model was established by logistic regression equation. Independent predictors of the model for the diagnosis of VEGF in breast cancer were calculated. Results The results of univariate analysis showed that the expression of VEGF in breast cancer was closely related to the molecular subtype, histological grade and lymph node metastasis of breast cancer (P<0.05). The expression of VEGF was not correlated (P>0.05) with the type of tumor, apparent diffusion coefficient value and time signal curve, but was closely related to tumor diameter, ring enhancement, intratumoral hyperintensity and peritumoral edema (P<0.05). Multivariate logistic :regression analysis showed that histological classification (OR=I0.296, P=0.005), peripheral rim enhancement {OR=I0.819, P=0.030), and peritumoral edema (OR= 15.297, P=0.012) were independent predictors of VEGF in breast cancer (Hosmer-Lemeshow X²=S.224, P=0.733). Conclusion The expression of VEGF is closely related to many malignant biological behaviors of breast cancer. Preoperative MRI sign of peripheral rim enhancement and peritumoral edema can be independent predictor of VEGF expression in breast cancer. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the effects of Shenmai injection on heart function, serum N-terminal B-type natriuretic peptide (NT-proBNP) and hypersensitive cardiac troponin T (hs-cTnT) in elderly patients with advanced breast cancer at heart failure stage. METHODS: Totally 94 patients with advanced breast cancer at heart failure stage admitted into Shanghai Baoshan Integrated Hospital of Traditional Chinese and Western Medicine from Jun. 2018 to Dec. 2019 were extracted to be divided into the control group (n = 47) and the observation group (n = 47) via the random number table. The control group received conventional symptomatic treatment, while the observation group was treated with Shenmai injection on the basis of the control group. Clinical efficacy, changed of cardiac function such as left ventricular ejection fraction (LVEF), cardiac output (CO), early diastolic maximum flow velocity/ late diastolic maximum flow velocity (E/ A), serum creatine kinase isoenzyme (CK-MB), creatine kinase (CK), NT-proBNP and hs-cTnT levels before and after treatment were observed in two groups. RESULTS: After treatment, the total effective rate of the observation group was 87. 23% (41/47), significantly higher than 65. 96% (31/47) of the control group, the difference was statistically significant (P<0. 05). After treatment, the levels of LVEF, ratio of CO and E/ A in two groups increased significantly, and the observation group was significantly better than the control group, with statistically significant difference (P<0. 05). After treatment, the levels of CK-MB, CK, NT-proBNP and hs-cTnT in two groups decreased significantly, and the improvement in the observation group was better than that in the control group, with statistically significant difference ( P < 0. 05). CONCLUSIONS: Shenmai injection can significantly improve the cardiac function of elderly patients with advanced breast cancer by increasing the myocardial contractility and the anti-lipid peroxidation, reducing the risk of myocardial injury and heart failure and improving the clinical efficiency. [ABSTRACT FROM AUTHOR]

Objective: To study Comparison of the diagnostic value of Doppler ultrasonography and 128-slice spiral CT in breast cancer with axillary lymph node metastasis. Methods: A retrospective analysis was performed on 60 cases of breast cancer confirmed by surgery and pathology from March 2017 to March 2019 in our hospital. To compare the detection rate, sonographic characteristics, sensitivity, specificity and accuracy of Doppler ultrasonography and 128-slice spiral CT in axillary lymph node metastasis of breast cancer. Results: Among the 60 patients with breast cancer confirmed by pathology after surgery, 38 had axillary lymph node metastasis and 22 had no axillary lymph node metastasis. In the diagnosis of breast cancer with axillary lymph node metastasis, 36 cases were confirmed by Doppler ultrasound, and 30 cases were confirmed by 128-slice spiral CT. The detection rate of cortical centripetal growth, intra-lymph node calcification, lymph node diameter ratio and lymph node boundary ambiguity by Doppler ultrasound was significantly higher than that by 128-slice spiral CT (P<0.05). Use pathology as the gold standard. The sensitivity, specificity and accuracy of Doppler ultrasound were higher than those of 128-slice spiral CT, and there were significant differences between the two groups (P<0.05). Conclusion: Doppler ultrasonography is of high diagnostic value in breast cancer with axillary lymph node metastasis, which can help to provide correct diagnosis and select appropriate treatment. [ABSTRACT FROM AUTHOR]

Objective To screen out the key genes-related to the prognosis of patients with metastatic breast cancer, and to construct and verify the prognosis-prediction model of patients with metastatic breast cancer. Methods The gene expression dataset GSE124648 of metastatic breast cancer tissue was obtained from GEO database to screen out the differentially expressed genes ( DEGs) between metastatic breast cancer tissues and primary breast cancer tissues, and between metastatic breast cancer tissues and normal breast tissues. The functional enrichment of Gene Ontology (GO) and the anal ysis of Kyoto Encyclopedia of Genes and Genomes ( KEGG) signaling pathway were carried out. Data sets of 140 patients with metastatic breast cancer were randomly divided into the training set ( 72 cases) and test set ( 68 cases) . We used LASSO&COX regression model to screen out the key genes-related to the prognosis of patients with metastatic breast cancer in the training set, and constructed the prognosis prediction model of patients with metastatic breast cancer in the training set. According to the median risk value, the patients in the training set were divided into the high-risk group and low-risk group. The Kaplan-Meier survival curve was drawn to analyze the median survival time, and the ROC curve was drawn to evaluate the predictive effectiveness of the risk model. The prediction model was applied to the patients in the test set to de termine the prediction efficiency of the prediction model. Results A total of 287 DEGs of metastatic breast cancer tissues were screened out, including 29 high expression genes and 258 low expression genes. The functions of DEGs were mainly related to the proliferation and migration of breast cancer cells, the regulation and degradation of extracellular matrix, an giogenesis, and immune inflammatory reaction. Among them, 7 key genes-related to prognosis were EGFR, GEM, PT PRB, RARRESl, LAMA4, NFAT5 and LHFP. We constructed a prediction model for prognosis of metastatic breast cancer patients with training set: risk value = ( 0. 279 x EGFR) + ( 0. 704 x GEM) + ( 0. 326 x PTPRB) + ( 0. 138 x RARRESl) + ( -0. 570 x LAMA4) + (0. 262 x NFAT5) + ( -0. 555 x LHFP). In the training set, the median survival time of the high-risk group was significantly shorter than that of low-risk group (P <0. 001), and the area under the curve of 3-year survival rate of patients with metastatic breast cancer was 0. 787. In the test set, the median survival time of the high-risk group was significantly shorter than that of low-risk group ( P < 0. 05), and the area under the curve of 3-year survival rate of patients with metastatic breast cancer was 0. 785. Conclusion The prognosis-prediction model including seven genes EGFR, GEM, PTPRB, RARRESl, LAMA4, NFAT5 and LHFP is successfully constructed to predict the prognosis of pa tients with metastatic breast cancer. [ABSTRACT FROM AUTHOR]

Objective: Expression and clinicopathological significance of S100 calcium binding protein A14(S100A14) in different molecular subtypes of breast cancer were explored to provide reference for identifying new molecular typing markers. Methods:Breast cancer tissues were taken cases for radical mastectomy patients from January 16, 2013 to 22 May 2014 at the Cancer Hospital Affiliated to the Xiangya Medical College of Central South University & the Cancer Hospital of Hunan province. Using immunohistochemistry to detect the expression of S100A14 in 254 breast cancer tissues, with emphasis on differences expression of the protein in different molecular subtypes of breast carcinoma and its correlation with clinicopathological factors, Kaplan-Meier analysis was applied for the relationship between S100 A14 expression and prognosis of patients with breast cancer. Results: The positive expression of S100 A14 in four molecular subtypes of ER+/PR+/HER2+, ER+/PR+/HER2-, ER-/PR-/HER2+ and ER-/PR-/HER2-breast cancer was 38.5%, 47.1%, 75.5%, 80%, respectively. The expression of the 4 groups was the highest in the ER-/PR-/HER2-type and the lowest in the ER+/PR+/HER2+ type, and the difference between the 4 groups was significant(x2=32.997, P <0.001). The relationship between S100A14 and clinicopathological characteristics of 254 cases of breast cancer was analyzed. The expression of S100A14 was significantly negatively correlated with the expression of ER and PR(all r=-0.353, P<0.001), and was significantly positively correlated with postoperative recurrence of liver metastasis with breast cancer(r=0.134, P=0.040). There is no significant correlation between the expression of S100A14 and the clinicopathological features of type ER+/PR+/HER2+ and ER+/PR+/HER2-type breast cancer(P>0.05).In ER-/PR-/HER2+ type breast cancer. The positive expression rate of S100 A14 in axillary lymph node metastasis group was significantly higher than that without axillary lymph node metastasis group(x2=6.768, P=0.013), and S100A4 expression has a negative correlation with postoperative pulmonary metastasis(r=-0.272, P=0.044). Conclusion: The expression of S100A14 in breast cancer with different molecular subtypes is different, and its high expression is associated with metastasis or recurrence of breast cancer with different molecular types. It may be used as a candidate marker for molecular typing of breast cancer. [ABSTRACT FROM AUTHOR]

Objective: To explore the role of miR-429 in the stemness maintenance of breast cancer and explore the effect of miR-429 on tumorigenic ability in vivo of breast cancer stem cells. Methods: The CD44+CD24- phenotype breast cancer stem cells MCF-7-S, SKBR3-S, MDA-MB-231-S and normal mammary gland stem cells MCF-10 A-S sorted by Flow Cytometry were cultured in serum-free suspension culture. Real-time quantitative polymerase chain reaction(qRT-PCR) was used to detect the expression of miR-429 in the above four stem cells. The recombinant lentiviral vector containing miR-429 and its negative control vector were respectively transfected into MDA-MB-231 cells in the ratio of virus/cell number with 15:1, and screened with 2.0 μg/m L puromycin to construct stable expressing miR-429 and vector MDA-MB-231 cells, CD44+CD24- phenotype breast cancer stem cells MDA-MB-231-Svector and MDA-MB-231-SmiR-429 were sorted by Flow Cytometry from the above two cells, then the cells were serum-free suspension cultured. In order to assess the effects of miR-429 overexpression in MDA-MB-231 cells, Microscope was used to observe of the mammosphere forming ability, Flow cytometry was used to detect of the percentage of CD44+CD24- phenotype cell subsets, Western Blot was used to detect the expression of ALDH1, SOX2 and Bmi1 proteins expression. MDA-MB-231-Svector and MDA-MB-231-SmiR-429 cells were respectively injected into the second pair of breast pat pad on the right side of the chest in BALB/c nude mice to construct the transplanted tumor model of breast cancer stem cells in nude mice. The effects of overexpression miR-429 on the tumorigenic ability in nude mice were observed. Results: The expression of miR-429 in MCF-7-S, SKBR3-S and MDA-MB-231-S was significantly lower than that of MCF-10 A-S, which was lowest in MDA-MB-231-S(P <0.05). The size and number of tumor mammospheres, the proportion of CD44+CD24- phenotype cell subsets after sorting, the protein expression levels of ALDH1, SOX2 and Bmi1, the tumor volume and weight in nude from MDA-MB-231-SmiR-429 cells were both significantly less than or lower than that of MDA-MB-231-Svector cells(P<0.05). Conclusion: miR-429 can decrease the stemness and tumorigenicity of breast cancer stem cells and may be a key molecule in breast cancer metastasis and drug resistance. [ABSTRACT FROM AUTHOR]

Objective: To explore the independent risk factors of axillary lymph node metastasis in early breast cancer and establishing an effective risk prediction model. Methods: The clinical data of 404 early breast cancer patients from June 2016 to December 2017 in Liaoning Cancer Hospital were enrolled in this study. The chi-square test or Fisher's exact test were used to analyze the clinical pathological characteristics and axillary lymph node metastasis. Multivariate stepwise logistic regression analysis was used to explore the independent risk factors of axillary lymph node metastasis. Risk prediction model was established according to the regression coefficients of each risk factor. ROC curve was used to verify the effectiveness of the test and calibration curve was drawn to evaluate its consistency with the real situation. Results: Axillary lymph node metastasis in early breast cancer was significantly different(P＜0.05) between tumor size, pathological grade, vascular invasion, ER expression, size of KI67, molecular subtype and total number of lymph nodes≥ 14 (14 were the average number of lymph nodes), but not related to age, menopause, tumor location, pathological type, PR and other factors (P>0.05). Univariate and multivariate analysis showed that tumor > 2 cm, pathological grade III, vascular invasion and ER expression≧ 50%were independent risk factors for axillary lymph node metastasis in early breast cancer(P＜0.05). The area under the ROC curve was 0.852 (95%CI was (0.812, 0.892), P<0.01). The calibration curve R2=0.9086 (P<0.05).Conclusion: Tumor>2 cm, pathological grade III, vascular invasion, and ER≧50%are independent risk factors for axillary lymph node metastasis in early breast cancer. [ABSTRACT FROM AUTHOR]

Objective: To study the effects of tegafur combined with docetaxel on the serum levels of serum VEGF,CA72-4 and life qualities in patients with metastatic breast cancer (MBC). Methods: 90 patients with MBC in our hospital from April 2015 to December 2016 were enrolled in this study, and they were divided into the control group and the treatment group according to random number table method, with 45 cases in each group. The control group were treated with xeloda combined with docetaxel, the treatment group were treated with tegafur combined with docetaxel. The patients of two groups were given continuous treatment for 2 courses. The clinical efficacy and life qualities of the two groups after treatment were compared. The serum levels of VEGF-A, VEGF-C, CA72-4 in the two groups before and after treatment were compared, and the incidence of adverse reactions of the two groups during treatment were compared. Results: The total effective rate of the treatment group was significantly higher than the control group (P<0.05). There were no significantly differences in the serum levels of VEGF-A, VEGF-C and CA72-4 in the two groups before treatment (P>0.05). The serum levels of VEGF-A, VEGF-C and CA72-4 in the two groups after treatment were significantly lower than before treatment, and the treatment group were significantly lower than the control group (P<0.05). The improvement rate of life qualities in the treatment group after treatment was significantly higher than the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The clinical efficacy of tegafur combined with docetaxel in the treatment of MBC is obvious, and it can significantly improve life qualities of patients, reduce the serum levels of VEGF-A, VEGF-C and CA72-4, which is worthy clinical application. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the outcomes of patients with human epidermal growth factor receptor 2 (HER2)overexpressed(HER2+) breast cancer that were treated or not treated with trastuzumab previously for metastatic breast cancer. Methods: A total of 247 patients (170 1-El stage. 77 IV stage) with metastatic HER2+ breast cancer were selected for this study. There were 211 patients ((134. I-III stage: 77, IV stage) who received trastuzumab treatment for the first time and 36 patients who received trastuzumab treatment previously. The clinical outcomes of patients who had or not received prior trastuzumab were compared using Cox proportional hazards regression and logistic regression analyses. The survival was assessed using the Kaplan-Meier method. Results: The median overall survival of HER2+ metastatic breast cancer (I-III stage) was 36 months in the group who did not receive prior trastuzumab and 28 months in the group previously treated with trastuzumab ( [HR]. 1.45: 95% Cl. 1.05-2.02 [P=0.012]). The median overall survival of HER2+ metastatic breast cancer (I-IV stage) was 37 months, objective response rate was 58%, clinical benefit rates was 76% in the group who did not receive prior trastuzumab and 25 months, 28 %, 37 % in the group previously treated with trastuzumab. respectively. The adjusted odds ratios were 0.37 (P=0.010) for objective response rates and 0.38(P=0.014) for clinical benefit rates. In the univariate analysis, the median overall survival rate was longer in the group who did not receive prior trastuzumab (P=0.012). The multivariate analysis found no significant difference in overall survival (P=0.19). Conclusions: The HER21 metastatic breast cancer patients that had not received treatment of trastuzumab had superior clinical outcomes than those with prior exposure. [ABSTRACT FROM AUTHOR]

Trastuzumab, which was the first HER2-directed agent, has significantly improved outcomes for patients with HER2-positive metastatic breast cancer, however, drug resistance often happened. Other HER2-directed agents such as the pertuzumab,the tyrosine kinase receptor inhibitor lapatinib, and the immunoconjugate trastuzumab emtansine were developed to overcome resistance to trastuzumab and provide more options for patients. Recent data based on these HER2-directed agents has shown good clinical efficacy, but the optimal sequencing of treatments remains unclear. Meanwhile, with the emergence of new HER2-targeted agents, researches about the optimal sequencing become more and more meaningful. This review focused on the development of researches about the optimal sequencing and the condition of new HER2-directed agents nowadays. [ABSTRACT FROM AUTHOR]

Objective: To observe the value of circulating tumor cells in patients with metastatic breast cancer. Methods: Levels of CTCs of 40 patients with metastatic breast cancer were detected by the CellSearch (system, relationships of the characteristics and prognosis of the disease and the level of CTCs were also analysed Results: The positive rate of CTCs detected by the Cell Search system was 42.5%. Patients with a CTCs level ≥ 5/7.5 mL were more likely have metastatic sites such as lung, bone and ≥ 3 metastatic sites than those patients with a level of 5 7.5 mL. but not for metastatic >:tes such as king, lymph node, brain and chest wall, and hormone receptor expression and HER2 expression were irrelevant with levels of CTCs. Patients with a higher CTCs level showed a strong trend of shorter PFS (X2=3.S73, P=0.059). Conclusion: Cell Search system showed a reliable ability in detecting CTCs. In patients with locally advanced or metastatic breast cancer, high level of CTCs is associated with liver metastasis, bone metastasis, or ≥ 3 metastatic sites. The Prognosis of patients with CTCs ≥ 5/7.5 mL is probably poorer than those with CTCs <5/7.5 mL. [ABSTRACT FROM AUTHOR]