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Objective:To evaluate the value of serum carcinoembryonic antigen (CEA), glycan antigen 153 (CA153) and CA125 tests in opportunistic screening of breast cancer in a Chinese population with meta-analysis.Methods:The published literatures of opportunistic screening of breast cancer was searched in the databases of China Knowledge Network database, Wanfang database, WIP Chinese Science and Technology Journal Full Text Database, PubMed, Embase, and Cochrane Library were retrieved from the establishment of the databases to May 2023. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) scale was used for quality assessment. The software of Stata 17.0 and RevMan were used for data analysis.Results:A total of 21 studies with a total of 4 583 cases were included. In diagnosis of breast cancer, the sensitivity with CEA was 0.28 (95% CI: 0.23-0.33), and the specificity was 0.98 (95% CI: 0.94-0.99); the sensitivity with CA153 was 0.48 (95% CI: 0.41-0.55) and the specificity was 0.96 (95% CI: 0.94-0.98); the sensitivity with CA125 was 0.31 (95% CI: 0.24-0.39) and specificity was 0.97 (95% CI: 0.94-0.98); the sensitivity of the combined test for the three was 0.76 (95% CI: 0.69-0.81), the specificity was 0.93 (95% CI: 0.91-0.94), and the area under the summary receiver operating characteristic (SROC) curve was 0.94 (95% CI: 0.91-0.95). Conclusion:The combination of serum CEA, CA125, and CA153 tests can improve the diagnostic accuracy of breast cancer to a certain extent, but there is insufficient evidence for its application in opportunistic breast cancer screening in population.
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Objective To explore the clinical significance and treatment regimen of sentinel lymph node(SLN) micrometastases and isolated tumor cell metastasis in breast cancer.Methods Ninety-seven breast cancer patients with sentinel lymph node micrometastases or isolated tumor cell metastasis from January 2013 to December 2015 were retrospectively studied.The patients were assigned to axillary lymph node dissection group (ALND,41 cases) and non axillary lymph node dissection group(non-ALND,56 cases) according to the final surgery mode to the axilla.Disease-free survival(DFS) and overall survival (OS) were compared between the two groups.Results Neither clinico-pathological factors,such as age,tumor size,grade,ER/PR status,HER-2 gene expression,Ki-67 expression and the size of the SLN metastasis,nor the treatment,such as breast surgery,postoperative adjuvant chemotherapy,radiotherapy and hormone therapy were found statistically different between the two groups (P ＞ 0.05).There were 96 patients evaluable with a median follow up of 24 months.The DFS of the ALND and non-ALND group was 97.5％ and 96.6％ (P ＞ 0.05),and the OS was 100％ and 98.2％ (P ＞ 0.05) respectively with no difference between the two groups.There were 2 ispilateral axillary recurrence in the non-ALND group and non in the ALND group.Conclusion Axillary lymph node dissection may be omitted for the breast cancer patients with sentinel lymph node micrometastases and isolated tumor cell metastases.But the postoperative adjuvant systemic treatment should be emphasized.
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Spindle cell carcinoma of the breast (SpCC) is a very rare variant of breast cancer characterized as large tumor size,high histological grade and high negative expression of hormone receptors and HER2/neu protein.It has a high tendency for local recurrence and distant metastasis,while the axillary lymph node metastasis is less common occured,which leads to poor outcomes.Given the relatively low incidence,our knowledge about SpCC is limited.The main unsolved obstacles are the early dection and diagnosis,and the improvement in treatments.Herein,this article reviewed the clinicopathologic characteristic,diagnosis,treatment and prognosis of the spindle cell carcinoma of breast.