Hongye Chen

Introduction: Superparamagnetic iron oxide nanoparticles (SPIONs) have attracted extensive attention in recent years as visualizable and controllable organic nanocarriers. Magnetic particle imaging (MPI), as a quantitative imaging method, enables visual and quantitative characterization of carriers. The quantitative imaging capability of carriers is critically crucial for precise quantitative local drug concentrations. However, the alternating current susceptibility (ACS) of SPIONs is highly susceptible to external interference and, thus, prone to fluctuations, which tend to be multifactorial and poorly defined in the in vivo environment, posing a major challenge to the quantitative analysis of carriers in living organisms. Methods: Through the analysis of the third-harmonic ACS of SPIONs, we proposed that under specific nanoscale dimensions and instrument frequency, the ACS maintained a relatively stable state, with a quantifiable fluctuation range even under complex interference conditions, thus enabling quantitative analysis in the in vivo environment. Meanwhile, to achieve precise detection of carriers with signal loss under the stability model, a novel high-sensitivity detection technique based on the narrow-band mixing-frequency theory was proposed. Results and Discussion: In vitro experiments demonstrated that only SPIONs with reduced core size and increased hydrodynamic diameter could exhibit relatively stable signals, consistent with the theoretical predictions, under strong interference environments. Further validation via a rabbit mammary sentinel lymph node (SLN) experiment demonstrated that the self-developed SPION carrier (with a core size of 20 nm and a hydrodynamic diameter of 80 nm) achieved long-term stable signal output in living animals, with its sensitivity reaching an acceptable level in the MPI detection system.

Background: Breast tubular carcinoma is a special pathological type of invasive breast cancer, accounting for about 0.8% to 10.0% of breast cancer cases, and it is a rare type of breast cancer. Currently, there is still a lack of relevant diagnostic and treatment consensus. Exploring the relationship between the pathological characteristics, molecular subtypes, and prognosis of ductal breast cancer is of great scientific value and clinical significance for improving patients’ survival rate and quality of life. Methods: The clinical data of 22 patients with tubular breast carcinoma diagnosed by pathology in The First Medical Center of PLA General Hospital from January 2001 to December 2021 were collected, and their pathological features, molecular classification, and prognosis were analyzed retrospectively. Results: The clinicopathological features of 22 patients with tubular breast carcinoma were age ≥ 35 years, married, tumor ≤ 2 cm, single focal, mixed type, no lymph node metastasis, estrogen receptor (ER) positive, progesterone receptor (PR) positive, Ki‐67 ≤ 14%, CyclinD1 negative, less recurrence, and metastasis. Twenty‐two patients with breast tubular carcinoma were followed up for 5 years after surgery, and the survival rate of disease‐free survival (DFS) was 90.9% (20/22). The positive rates of ER, PR, and human epidermal growth factor receptor‐2 (HER‐2) are 100.0%, 100.0%, and 40.9%, respectively. The proportion of tumor cells expressing Ki‐67 is 45.4%. Among them, the difference of HER‐2 level, recurrence and metastasis, and postoperative comprehensive treatment showed different prognoses. Conclusion: Tubular breast carcinoma is a kind of tumor with a low malignant degree. The prognosis is significantly related to its HER‐2 level, recurrence and metastasis, and postoperative comprehensive treatment by univariate analysis, in which HER‐2 is an independent risk factor, postoperative comprehensive treatment is a protective factor, but postoperative recurrence and metastasis have nothing to do with the prognosis by the multivariate analysis.

Objective. To investigate the risk factors of axillary lymph node metastasis in patients with invasive breast cancer. Methods. This study retrospectively included 122 cases of invasive breast cancer patients admitted to the First Medical Center of PLA General Hospital from January 2019 to September 2020. According to postoperative pathological results, axillary lymph node metastasis was divided into axillary lymph node metastasis (ALNM) group ( n =40) and non-axillary lymph node metastasis (NALNM) group ( n =82). General demographic information was collected and compared between the two groups. Collected pathological results included lymphovascular invasion (LVI) and the expression of estrogen receptor (ER), progestogen receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 detected by immunohistochemistry. Imaging parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) including apparent diffusion coefficient (ADC), early enhanced rate, and time-intensity curve (TIC) were also included into univariate analysis. The variables with differences between the two groups were compared by univariate analysis, and the related factors of axillary lymph node metastasis were analyzed by logistic regression model. Results. There was no significant difference in general demographic information between the two groups. No significant differences were found in the positive rates of HER-2, ER, PR, Ki-67, pathological types, and clavicular lymph node metastasis and skin chest wall invasion between the two groups ( P > 0.05 ). The proportion of LVI in ALNM group was significantly higher than that in NALNM group (37.50% vs. 6.10%, P < 0.001 ). The proportion of breast cancer on the left side in the ALNM group was higher than that in the NALNM group, and the difference was statistically significant (70.00% vs. 47.56%, P = 0.019 ). There were no significant differences in the imaging parameters obtained by DCE-MRI between the two groups. Binary logistics regression analysis showed that LVI (OR =12.258, 95% CI =3.681-40.812, P < 0.001 ) and left breast cancer (OR =3.598, 95% CI =1.404-9.219, P = 0.008 ) were risk factors for axillary lymph node metastasis in patients with invasive breast cancer. Conclusion. The formation of vascular tumor thrombi in breast cancer tissue and left breast cancer are risk factors for axillary lymph node metastasis in invasive breast cancer and might be helpful for preoperative detailed assessment of the patient’s condition.

Objectives. Stage IIIC breast cancer, as a local advanced breast cancer, has a poor prognosis compared with that of early breast cancer. We further investigated the risk factors of mortality in stage IIIC primary breast cancer patients and their predictive value. Methods. We extracted data from the US Surveillance, Epidemiology, and End Results (SEER) database of female patients with stage IIIC primary breast cancer (n = 1673) from January 2011 to December 2015. Results. Hormone receptor negativity ( and , respectively), aggressive molecular typing ( and , respectively), high T stage ( and , respectively), a high number of positive lymph nodes (≥14) ( and , respectively), and lymph node ratio (≥0.8148) ( and , respectively) were associated with poor disease-specific survival. The indicators of disease-specific survival included estrogen receptor status, progesterone receptor status, molecular typing, T stage, number of positive lymph nodes, and lymph node ratio ( , , , , , and , respectively). Conclusion. Hormone receptor negativity, aggressive molecular typing, high T stage, high number of positive lymph nodes, and lymph node ratio are poor prognostic factors patients with stage IIIC primary breast cancer. The efficient indicators of disease-specific survival include estrogen receptor status, progesterone receptor status, molecular typing, T stage, number of positive lymph nodes, and lymph node ratio.

Introduction. Metaplastic breast carcinoma is a rare special type of breast cancer, which has distinguished clinical characteristics. We aimed to evaluate the clinicopathological features of metaplastic breast carcinoma compared with nonspecific invasive breast carcinoma and study the prognosis of metaplastic breast carcinoma. Methods. We reviewed metaplastic breast carcinoma cases (n = 37) from January 2000 to December 2021 and nonspecific invasive breast carcinoma cases (n = 433) from January 2019 to December 2020 extracted from our institution retrospectively. The following variables were recorded, including the patients’ general information, complications, T stage, expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular subtyping, lymph node status, skin or chest wall involvement, vessel carcinoma embolus, therapy modality (surgical treatments, chemotherapy, and radiotherapy), and survival. Results. Patients with metaplastic breast carcinoma had more advanced disease than patients with nonspecific invasive breast carcinoma (T stage: ). A greater proportion of metaplastic breast carcinoma presented with triple-negative breast cancer than nonspecific invasive breast carcinoma (79.41% vs. 12.47%, ). Our study showed that the skin or chest wall invasion was more frequent in metaplastic breast carcinoma patients (11.76% vs. 1.62%, ). The 5-year survival rate for metaplastic breast carcinoma patients was 57.66% (95% CI: 0.3195∼0.7667). No local recurrence was observed while distant metastasis occurred in 33.33% of patients with metaplastic breast carcinoma. Death due to disease occurred in 24.24% of patients with metaplastic breast carcinoma. Conclusion. The majority of metaplastic breast carcinoma patients had more advanced disease and triple-negative disease than nonspecific invasive breast carcinoma patients. Also, metaplastic breast carcinoma patients had frequent skin or chest wall invasion and a high rate of distant metastasis and mortality.