Dense breast is an independent risk factor for females with breast cancer, and also one of the important reasons for decreased sensitivity of mammography and increased risk of missed diagnosis. Females with dense breast in China account for a high proportion, making the breast cancer screening a key and difficult point in the prevention and control targeting breast cancer in such population. The formulation of specialized screening expert consensus for dense breast populations is conducive to achieving more accurate early detection, improving screening efficiency, and reasonably allocating medical resources. Committee for Integrative Prevention and Screening of Breast Cancer, China Anti-Cancer Association takes the lead and organizes multi-disciplinary experts to systematically review relevant evidence-based medical evidence domestically and internationally, integrate the actual situation, and clinical experience of China, and conform to setting norms of international guidelines to complete evidence integration and form recommendations, thereby formulating “Expert Consensus on Breast Cancer Screening in Chinese Female with Dense Breast (2025 edition)”. This expert consensus puts forward recommendations on the risk stratification, screening age, screening interval, screening methods, joint screening strategies, and other key issues of females with dense breast, aiming to promote the standardized screening practice of such population, improve the level of early diagnosis and treatment of breast cancer, and provide technical support and implementation basis for the prevention and control of Chinese females with breast cancer.
ObjectiveBy comparing the epidemiological characteristics of the incidence and death of female breast cancer in China and the United States, the differences in prevention and screening strategies between China and the United States were analyzed to explore the prevention and control measures of female breast cancer in China. MethodsBased on the relevant data released by the Global Burden of Disease in 2020, the National Cancer Center of China, and the China Health Statistical Yearbook, the new cases and deaths of breast cancer in Chinese and American women in 2023 were estimated respectively, and the incidence, mortality and time trend of breast cancer in Chinese and American women were analyzed. ResultsIn China, 376 789 new cases of female breast cancer and 116 791 deaths were expected in 2023. In the United States, approximately 297 790 women were expected to be newly diagnosed with breast cancer in 2023, representing approximately 15.2% of new cancer cases. About 43 170 women died from breast cancer, accounting for about 7.1% of all cancer deaths. The incidence of breast cancer in women in the United States during the period 1975–2020 gradually increased and then stabilized; In contrast, the incidence of breast cancer among Chinese women increased year by year during the period 1990–2020. In recent years, the incidence and mortality rates of breast cancer in Chinese women had increased more than those in the United States, and there was a large difference between urban and rural areas in China. ConclusionsBoth China and the United States face a large burden of female breast cancer, and the characteristics of female breast cancer in China are similar to those in the United States. To reduce the burden of breast cancer in Chinese women, further efforts should be made in various aspects, such as strengthening breast cancer education, raising public health awareness, improving diet structure, cultivating healthy lifestyle, increasing screening efforts, and improving medical level.
Objective To explore the feasibility and safety of tension-free vaginal tape-obturator for female stress urinary incontinence under the daytime surgical mode based on the concept of enhanced recovery after surgery. Methods The clinical data of female patients with stress urinary incontinence at the First Affiliated Hospital of Kunming Medical University between June 2019 and June 2023 were retrospectively analyzed. According to the perioperative management mode of patients, they were divided into daytime surgery group and routine surgery group. The basic, intraoperative, and postoperative conditions of two groups of patients were compared. Results Finally, 183 patients were included, including 91 in the routine surgery group and 92 in the daytime surgery group. All patients successfully completed the surgery. There was no statistically significant difference in age, preoperative comorbidities, surgeon in chief, or operation duration between the two groups of patients (P>0.05). The preoperative waiting time after hospitalization [(0.00±0.00) vs. (2.42±0.58) d], hospitalization expenses [(13815.10±2906.01) vs. (18095.21±3586.67) yuan], total surgical expenses [(3961.36±707.35) vs. (4440.19±1016.31) yuan], anesthesia expenses [(718.53±61.06) vs. (755.30±74.65) yuan], western medicine expenses [(818.07±259.30) vs. (1282.14±460.75) yuan], total hospitalization duration [(1.11±0.31) vs. (5.77±1.30) d], and postoperative hospitalization duration [(1.11±0.31) vs. (3.35±1.42) d] in the daytime surgery group were lower than those in the routine surgery group (P<0.05). There was no significant difference between the two groups in postoperative complications (respiratory complications, fever, nausea and vomiting, vaginal bleeding, urinary retention, peritonitis), satisfaction, postoperative pain or self perception of symptom improvement (P>0.05). Conclusion The daytime surgery for female stress urinary incontinence based on the concept of enhanced recovery after surgery is safe and feasible, which can shorten hospitalization duration and reduce hospitalization costs.
Objective To investigate the perioperative changes in serum interleukin 6 (IL-6) levels in elderly male patients with intertrochanteric fractures, and provide evidence for inflammatory control in this patient population. Methods The clinical data of 40 male patients aged more than 60 years with intertrochanteric fractures who met the selection criteria between January 2021 and December 2022 were retrospectively analyzed, including 25 non-osteoporosis patients (T value>?2.5, group A) and 15 osteoporosis patients (T value≤?2.5, group B). In addition, 40 healthy men aged more than 60 years old were included as controls (group C) according to the age matching rule. There was no significant difference in age, smoking history, drinking history, body mass index, complications (hypertension and diabetes), alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, and total protein among the 3 groups (P>0.05). Serum samples were collected from group C subjects and from groups A and B patients preoperatively and on postoperative days 1, 3, 5, and 7. IL-6 levels were measured using ELISA assay. Pearson correlation analysis was used to assess the relationship between IL-6 levels and T values at various time points in groups A and B. Postoperative complications during hospitalization and 1-year mortality rates were recorded for groups A and B. Results Preoperative IL-6 levels were significantly higher in groups A and B than in group C (P<0.05), with group B being significantly higher than group A (P<0.05). In groups A and B, IL-6 levels increased significantly on postoperative day 1 compared to preoperative levels and then gradually decreased, approaching preoperative levels by postoperative day 7. IL-6 levels in group B were significantly higher than those in group A at all postoperative time points (P<0.05). Correlation analysis showed that IL-6 levels were negatively correlated with T values at all perioperative time points in all patients from groups A and B (P<0.05). Complications occurred in 4 patients (16.0%) in group A, including 2 cases of pulmonary infection, 1 case of urinary tract infection, and 1 case of heart failure, and in 3 patients (20.0%) in group B, including 2 cases of pulmonary infection and 1 case of gastrointestinal bleeding. There was no significant difference in the incidence of complications between the two groups (χ2=0.104, P=0.747). There were 2 cases (8.0%) and 4 cases (26.7%) died within 1 year after operation in groups A and B, respectively, and there was no significant difference in 1-year mortality rates between the two groups (χ2=2.562, P=0.109). Conclusion Serum IL-6 levels significantly increase in the early postoperative period in elderly male patients with intertrochanteric fractures, especially in those with osteoporosis. Monitoring the inflammatory state and promptly controlling the inflammatory response during the perioperative period, may reduce complications and improve postoperative survival in this patient population.
Objective To study the effectiveness, safety and tolerance of testosterone undecanoate （TU） in improving exhaustion and quality of life （QOL） of the elderly male patients with chronic disease in advanced stage. Methods Using a simple randomized controlled trial design, eighty patients were randomized into two groups. The treatment group took routine therapy and TU and the control group with routine therapy alone. Results 1. Baseline characteristics in both groups were similar. 2. The PADAM grade decreased, and the QOL scale increased in the treatment group （P〈0.05 ）. 3. Serum total testosterone in the treatment group rose, upper arm circumference and right hand grip improved （P〈0.05 ）. 4. There were no significant differences in adverse effects between both groups. Conclusions TU can improve the clinical health status in the elderly male patients with chronic disease in advanced stage and increase serum testosterone level, there is a satisfactory tolerances and few adverse reactions.
The sonographic features of male breast lesions, which underwent ultrasound examination in our hospital for the past 10 years, were retrospectively analyzed. Sonographic features of these lesions were standardized as BI-RADS image lexicon. The differences in ultrasonic malignant signs were assessed between the benign and the malignant diseases. Between the two groups, incomplete boundary was statistically different. The specificity was above 95% within the two groups in terms of speculated margin, echogenic halo, calcification, axillary lymphadenopathy, thickening of skin and eccentric of mass to the nipple. High-frequency sonographic examination has a high level of differential diagnosis for male breast lesions.
Objective To investigate the relationship between skin/pectoral muscle invasion and the prognosis of male breast cancer. Methods Clinical data and follow-up information of 79 male breast cancer patients who received treatment between September 2008 to April 2020 in West China Hospital were retrospectively reviewed, to analyze the clinicopathological features of male breast cancer and prognostic value of skin/pectoral muscle invasion. Results Among 79 male breast cancer patients, a total of 23 patients (29.1%) were with skin/pectoral muscle invasion at diagnosis. All the patients were followed up, with a median follow-up period of 63.3 months (1.0–204.5 months). Within follow-up period, 8 patients (10.1%) suffered from relapse, 19 patients (24.7%, 19/77) suffered from metastasis, and 4 patients (5.1%) died. Multivariate Cox proportional risk regression model suggested that patients with skin/pectoral muscle invaded had poor disease free survival [RR=4.48, 95%CI (1.08, 18.52), P=0.038]. Conclusions Skinor pectoral muscle invasion might be a valuable prognostic factor for male breast cancer patients. However, limited by sample size, the conclusion should be proved by further high-level studies.
Objective To systematically review the prevalence of osteoporosis (OP) in Chinese postmenopausal females. Methods The CNKI, VIP, CBM, WanFang Data, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect studies on the prevalence of OP in Chinese postmenopausal females from inception to March 17th, 2022. Two reviewers independently screened the literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed using Stata 14.0 software. Results A total of 54 studies involving 96 391 cases and 41 651 confirmed OP patients were included. The meta-analysis results showed that the prevalence of OP in Chinese postmenopausal females was 38.8% (95%CI 34.1% to 43.5%). Subgroup analysis showed that the prevalence of OP was 31.7% (95%CI 16.6% to 48.6%) in females who had been menopausal for less than 5 years, 47.4% (95%CI 32.2% to 62.5%) for 5-9 years, 52.7% (95%CI 37.1% to 68.3%) for 10-14 years, 77.5% (95%CI 69.5% to 85.4%) for 15-19 years, and 78.3% (95%CI 56.3% to 100.0%) for more than 20 years. The rate was 16.2% (95%CI 28.8% to 37.2%) in under 50 years age group, 28.8% (95%CI 34.4% to 47.9%) for 50- years group, 41.1% (95%CI 34.4% to 47.9%) for 60- years group, 55.3% (95%CI 45.8% to 64.8%) for 70- years group, 82.0% (95%CI 76.1% to 87.9%) for 80- years group. The prevalence in different regions was between 31.0% and 43.5%, which was lowest in the northeast (31.0%, 95%CI 26.3% to 51.4%) and highest in the northwest (43.5%, 95%CI 22.3% to 64.7%). According to the year of publication, the rate was 43.9% (95%CI 15.7% to 72.0%) from 1997 to 2009 and 38.2% (95%CI 33.8% to 42.5%) from 2010 to 2021. The prevalence of OP was 24.9% (95%CI 20.5% to 29.3%) in postmenopausal females with no birth or 1 birth, and 45.0% (95%CI 37.0% to 53.0%) in females with 2 or more births. Conclusion The prevalence of OP in Chinese postmenopausal females is relatively high. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore the association between radiotherapy and the risk of subsequent primary lung cancer in female patients with breast cancer. MethodsThe EMbase, Web of Science, PubMed, CNKI, VIP and WanFang databases were searched from the establishment date to July 1, 2021. The relative risk (RR) with 95% confidence interval (CI) were combined and all statistical analyses were performed by STATA 12.0 software. ResultsA total of 10 publications including 466 510 participates from 14 studies were included. The meta-analysis indicated that radiotherapy was a risk factor for the occurrence of second primary lung cancer among female breast cancer patients [RR=1.45, 95%CI (1.18, 1.78), P<0.001]. Subgroup analysis based on the relative position of breast cancer and lung cancer was conducted and the results demonstrated that radiotherapy only increased the incidence rate of ipsilateral lung cancer [RR=1.27, 95%CI (1.10, 1.45), P=0.001], without significant change of the risk of contralateral lung cancer [RR=1.16, 95%CI (0.77, 1.74), P=0.487]. ConclusionRadiotherapy is one of the risk factors for subsequent primary pulmonary carcinoma among female breast cancer patients, especially for ipsilateral lung carcinoma. However, more high-quality studies are still needed to verify above findings.
Epilepsy is a chronic neurological disorder resulting from abnormal neuronal discharges in the brain. China has an estimated 10 million people with epilepsy, nearly half of whom are women of reproductive age. The disease significantly affects patients' fertility, pregnancy safety, and delivery outcomes, necessitating specialized cross-cycle health management, with most patients requiring continuous antiseizure medication during pregnancy. Lamotrigine (LTG), levetiracetam (LEV), and oxcarbazepine (OXC) are preferred pharmacological options during gestation due to their lower teratogenic risks. This review focuses on the holistic management of women with epilepsy (WWE) and the application of antiseizure medications (ASMs), aiming to provide evidence-based strategies for clinical practice.