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Background: Ductal carcinoma in situ with microinvasion (DCIS-MI) is a subtype of breast cancer with good prognosis, for which both breast conserving surgery plus radiotherapy (BCS+RT) and mastectomy are feasible surgical methods, but their effects on the prognosis of patients are still unclear. Methods: We used the Surveillance, Epidemiology and End Results (SEER) database to extracted DCIS-MI patients who underwent BCS+RT or mastectomy between 2000 and 2014. Participants were divided into BCS+RT group and mastectomy group. We compared the breast cancer-specific survival (BCSS) and overall survival (OS) of the two groups using Kaplan -Meier method and Cox proportional hazard regressions before and after propensity score matching (PSM) with the landmark. Results: We selected 5432 patients, among which 2834 patients (52.17%) were in the BCS+RT group and 2598 patients (47.83%) were in the mastectomy group. With a 101 months median follow-up time in the overall cohort, both univariate and multivariate analysis showed that BCS + RT group showed significantly higher OS and BCSS compared with patients in the mastectomy group (PPP= 0.017). In addition, the subgroup analysis showed that BCS + RT is at least equivalent to mastectomy with respect to OS and BCSS in any subgroup. Conclusion: For patients with DCIS-MI, the prognosis of BCS+RT was superior to mastectomy.

BackgroundTo evaluate the efficacy and safety of radiofrequency ablation (RFA) of breast cancer smaller than 2 cm.MethodsA systematic search was conducted in the PubMed and EMBASE databases to identify published studies investigating the efficacy and safety of RFA for breast cancer smaller than 2 cm. The main outcomes were technical success rate of the ablation, complete ablation rate, complications and local recurrence. Secondary considerations were mode of anesthesia, pain tolerance, mean ablation time and surgical excision after ablation.ResultsSeventeen studies involving 399 patients and 401 lesions met the inclusion criteria. Nearly 99%(95%CI=0.98-1.00) of lesions achieved good technical success rate.Notably, 83.88% of the patients received RFA under general anesthesia (333/397) whereas 15.87% received RFA under local anesthesia (63/397). Of the 63, 98.41% tolerated the pain associated with the procedure. Majority of patients (65.74%, 261/397) underwent surgical excision of the tumor after ablation whereas in a few patients (34.26%, 136/397), the tumor tissue was retained in the breast after ablation. Complete ablation was achieved in 96% of patients for a mean time of 15.8 minutes (95%CI=0.93-0.99). Overall, only 2% (95%CI=0.01-0.04) of the individuals developed complications. Skin burns (2.02%, 8/397) were the most common complications. There was no local recurrence after a median follow-up of 27.29 months, whether or not they underwent surgical resection following RFA.ConclusionThe results show that RFA for breast cancer smaller than 2 cm is safe and effective. However, prospective studies are needed to validate this conclusion.

Background: The effect of postmastectomy radiotherapy (PMRT) on T1-2N1M0 triple-negative breast cancers (TNBC) remains unclear. The population-based study aimed to investigate the survival outcomes of T1-2N1M0 TNBC patients who underwent PMRT or not. Methods: We selected 1743 patients with T1-2N1M0 TNBC who underwent mastectomy between 2010 and 2015 through the Surveillance, Epidemiology and End Results (SEER) database. After propensity score matching (PSM) , the PMRT and no-PMRT groups consisted of 586 matched patients, respectively.The Kaplan-Meier method was applied to calculate breast cancer-specific survival (BCSS) and cox proportional hazard model were used to determine the prognostic factors of T1-2N1M0 TNBC.Results: The 5-year BCSS for the PMRT group and no-PMRT group was 79.1% and 74.7%, respectively. TNBC patients with stage T1-2N1M0 receiving PMRT did not show better BCSS than those did not (HR =0.800, 95% CI =0.605-1.056, P =0.115). Subgroup analysis showed that in patients with three nodes positive, radiotherapy could significantly improve BCSS(HR=0.396, 95% CI = 0.175-0.900, P = 0.027), but it brought no significant advantage in BCSS in patients with one or two nodes positive(HR =1.061, 95% CI =0.725-1.552, P =0.761; HR =0.657, 95% CI =0.405-1.065, P =0.088).In addition, PMRT improves the BCSS in TNBC patients with T2 tumor concomitant with three positive lymph nodes(HR =0.343, 95% CI =0.132-0.890, P =0.028).Conclusion: TNBC patients with T2 tumor concomitant with three positive lymph node can benefit from PMRT.

Background: The prognostic impact of tumor location on breast cancer patients is not consistent and still controversial. We aimed to investigate the prognostic role of primary tumor location on the survival of patients with breast cancer. Methods: Using the Surveillance, Epidemiology, and End Results database, we identified 53,905 patients diagnosed with tumors in the lower quadrants (n=11,065), upper quadrants (n=38,974), or central and nipple (n=3,866). Chi-squared test was used to compare categorical variables across the groups. Cox proportional hazard models were applied to estimate the factors associated with prognosis.Results: Compared with the other quadrants, patients with central and nipple lesions showed generally more unfavorable clinicopathologic features and worse breast cancer-specific survival (BCSS) and overall survival (OS). Multivariate Cox analysis showed a higher hazard ratio (HR) for tumor location of central and nipple (BCSS: HR, 1.145, p = 0.036, 95% confidence interval [CI], 1.009-1.299; OS: HR, 1.118, p = 0.024, 95% CI: 1.015-1.232), while lower HR were observed for upper quadrants (BCSS: HR, 0.888, p = 0.004, 95% CI: 0.818-0.964; OS: HR, 0.930, p = 0.023, 95% CI: 0.873-0.990). Multivariate logistic regression indicated that tumors located in central and nipple were more likely to be inoperable disease (HR, 1.460, 95% CI: 1.300-1.640, p < 0.001), while tumors located in upper quadrants tend to be operable disease (HR, 0.895, p = 0.005, 95% CI, 0.829-0.967).Conclusion: Tumors located in central and nipple had negative contact with BCSS and OS, while tumor located in upper quadrants had favorable contact with survival.

Background The survival outcomes of neoadjuvant chemotherapy (NACT) versus adjuvant chemotherapy (ACT) for patients with triple-negative breast cancer (TNBC) remain unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of NACT versus ACT in TNBC. Methods A systematic search was performed on the PubMed and Embase databases to identify relevant articles investigating the survival outcomes of NACT versus ACT in TNBC. Results A total of nine studies involving 36,480 patients met the selection criteria. Among them, 10,728 (29.41%) received NACT, and 25,752 (70.59%) received ACT. The pathological complete response (pCR) rate was 35% (95% CI = 0.23–0.48). Compared with ACT, the overall survival (OS) of NACT was poor (HR = 1.59; 95% CI = 1.25–2.02; P = 0.0001), and there was no significant difference in disease-free survival (DFS) between the two treatments (HR = 0.85; 95% CI = 0.54–1.34; P = 0.49). NACT with pCR significantly improved the OS (HR = 0.53; 95% CI = 0.29–0.98; P = 0.04) and DFS (HR = 0.52; 95% CI = 0.29–0.94; P = 0.03), while the OS (HR = 1.18; 95% CI = 1.09–1.28; P < 0.0001) and DFS (HR = 2.36; 95% CI = 1.42–3.89; P = 0.0008) of patients with residual disease (RD) following NACT were worse compared to those receiving ACT. Conclusion These findings suggest that, for TNBC, NACT with pCR is superior to ACT in improving OS and DFS, and it turns to be opposite when patients are receiving NACT with RD.

This study investigated the inhibitory action of (131)I-recombinant human EGF ((131)I-rhEGF) on MCF-7 human breast cancer tumor development in nude mice. The activity and tumor uptake of (131)I-rhEGF was measured by tissue distribution assay, and its effect on tumor growth was measured by monitoring tumor size after treatment with (131)I-rhEGF. Changes in tumor cell ultrastructure were observed by transmission electron microscopy (TEM), and pathological changes in tumor tissue were observed by light microscopy. The tissue distribution assay revealed that (131)I-rhEGF was markedly absorbed by the tumor and reached its maximal uptake rate (16.73%ID. g(-1)) at 120 hours at which point the drug concentration in the tumor was 11.1-fold, 8.1-fold, and 6.6-fold higher than that in blood, liver, and kidneys, respectively. Tumor size measurements showed that tumor development was significantly inhibited by intravenously and intratumorally injected (131)I-rhEGF. Tumor inhibition rates (82.0% and 80.7%, respectively) were significantly higher than those of tumors treated with (131)I (7.49%) and (131)I-HSA (6.91%; P < 0.05). TEM and light microscopy revealed that intravenous and intratumoral injection of (131)I-rhEGF could significantly damage and ultimately kill tumor cells. Our results suggest that (131)I-rhEGF suppresses development of xenografted breast cancer cells in nude mice, providing a novel candidate for receptor-mediated targeted radiotherapy.