The liver is involved in about half of patients with metastatic breast cancer. Unfortunately systemic chemotherapy as the treatment of choice is limited. Due to multifocality and/or insufficient remnant liver volume, the majority of liver metastases are also unresectable. Currently, thermal ablations are used in these patients with acceptable impact. We reviewed studies on radiofrequency ablation (RFA), laser-induced thermotherapy (LITT) and microwave ablation (MWA) regarding local tumour response, progression and survival indexes in patients with breast cancer liver metastases (BCLM). The reviewed literature showed positive response rates of 63 % to 97 % in RF-ablated lesions, 98.2 % in LITT-treated lesions and 34.5–62.5 % in MW-ablated lesions. Median survival was 10.9–60 months using RFA, 51–54 months after LITT and 41.8 months using MWA. Five-year survival rates were 27–30 %, 35 % and 29 %, respectively. Local tumour progression ranged from 13.5 % to 58 % using RFA, 2.9 % with LITT and 9.6 % with MWA. The reviewed literature demonstrated that ablation therapies either as single therapy or combined with other locoregional therapies are a good alternative as an adjunction to resection in patients with resectable lesions or with positive response using chemotherapy. However, multicentre randomised studies should be conducted to obtain further evidence of the benefits of these treatments in patients with BCLM. • Thermal ablation is an alternative treatment for hepatic metastases from breast cancer
 • This review assesses thermal ablation therapies and local chemoembolisation techniques
 • It helps prioritise treatment options for managing hepatic metastases from breast cancer

Thermal ablation therapies in patients with breast cancer liver metastases: a review.

The current methods for tumor induction in breast cancer research animal models are time-consuming, hazardous, expensive, sometimes irreproducible and inconvenient. We successfully developed a new, simple and cost-effective method in developing solid mammary gland tumor in female Sprague-Dawley rat using LA7 rat mammary tumor cells. Tumors developed in 7- 8 weeks old rats within 6 to 8 days of subcutaneous injection of LA7 cells into the mammary gland pad. Tumor size increased exponentially for four weeks. Histopathology examination confirmed that the induced tumors were adenocarcinomas. Evaluation of blood enzymes showed significantly higher (P < 0.005) serum alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in tumor-bearing than in normal rats. This LA7 cell-induced rat mammary gland tumor model may be useful for studies in breast cancer drug or nutraceutical research and development.

/pdf/induction-of-mammary-gland-tumor-in-female-sprague-dawley-4ig8vrk87x.pdf

Induction of mammary gland tumor in female Sprague- Dawley rats with LA7 cells

An in vivo study was conducted to determine the effect of tamoxifen-loaded solid lipid nanoparticle on LA7 cell-induced rat mammary tumor. After the first tumors appearance, the thirty rats were divided into five groups. Group I served as normal control animal. The other four groups were mammary gland tumor-bearing animals treated with soy oil (Group II), tamoxifen (TAM) dissolved in soy oil (Group III), tamoxifen-loaded solid lipid nanoparticle (Group IV) and solid lipid nanoparticle (SLN) (Group V) dispersed in soy oil. The effect of TAM-loaded SLN in the reduction of tumor size was greater than that of free TAM. The transmission electron microscope analysis showed apoptosis in TAM-loaded SLN and free TAM treatment groups. After treatment, the rats treated with TAM-loaded SLN showed decreases in concentration of serum enzymes. In conclusion, the study suggests that TAM-loaded SLN is very effective for treatment of rat mammary gland tumors and breast cancers.

/pdf/antitumor-activity-of-tamoxifen-loaded-solid-lipid-4sjod3itz0.pdf

Antitumor activity of tamoxifen loaded solid lipid nanoparticles on induced mammary tumor gland in Sprague-Dawley rats

The liver is one of the most frequent metastatic sites of breast cancer with a relatively poor prognosis. Systemic chemotherapy is an effective treatment but the efficacy is different between the subtypes of breast cancer. Percutaneous thermal ablation is considered to be a minimally invasive and effective local treatment for breast cancer liver metastases (BCLM). This case report described a patient with BCLM who adopted a strategy of systemic chemotherapy and repeated ultrasound (US) -guided percutaneous thermal ablation procedures. The survival time already reached 8 years till now with the metastases well-controlled and acceptable life quality was achieved.

Repeated ultrasound-guided percutaneous thermal ablation combined with systemic therapy achieves a stable condition in an end-stage patient with more than 10 liver metastases from breast cancer: The importance of sonazoid assisted contrast-enhanced ultrasound and fusion imaging.

/pdf/wertigkeit-der-kontrastmittelverstarkten-lebersonographie-h65tsdobkz.pdf

Wertigkeit der kontrastmittelverstärkten Lebersonographie zur Detektion hepatischer Filiae bei Mammakarzinom: Vergleich mit der kontrastverstärkten Magnetresonanztomographie

Objective To analyze the clinical characteristics, efficiency of treatment and potential prognostic factors of breast cancer patients with liver metastases （BCLM）. Methods The data of clinical characteristics, response to treatment and survival were retrospectively analyzed in 152 breast cancer patients with liver metastasis using SPSS 11.5. Results The median disease free survival （ DFS）, the median survival of recurrence （MSR） and median time to progress （TTP） of this series was 21 months, 16 months and 7.4 months, respectively. The response rate in chemotherapy group was higher than that in the transcatheter arterial chemoembolization （TACE） group （37.7% vs. 53%, P = 0. 039 ）. The TTP was longer （7 m vs. 10 m, P = 0. 048） and the response rate （63.3% vs. 40.0%, P = 0.04） in taxanes-based chemotherapy group was significantly higher than that in non-taxanes-containing regimen. The MSR in patients with single liver metastases treated by TACE was longer than that by chemotherapy （ 16 m vs. 30 m, P = 0.0052）, but it was not observed in the patients with multiple metastases. Pathological tumor size （PT） and axillary lymph node status at diagnosis, negative estrogen receptor （ER） status, abnormal ALT level induced by liver metastases, metastastic tumor size were significantly correlated with shorter survival. Conclusion The effective chemotherapy especially the taxane-containing regimen and TACE may improve outcome for breast cancer patient with liver metastasis.

Key words: 
Breast neoplasms;  Liver metastases;  Efficiency of treatment ;  Prognosis

Clinical characteristics and potential prognostic factors of breast cancer patients with liver metastases

Objectives: To evaluate the positive rate of left posterior lymph nodes of the superior mesenteric artery (14cd-LN) in patients undergoing pancreaticoduodenectomy for pancreatic head carcinoma,to analyze the impact of 14cd-LN dissection on lymph node staging and tumor TNM staging. Methods: The clinical and pathological data of 103 consecutive patients with pancreatic cancer who underwent pancreaticoduodenectomy at Pancreatic Center,the First Affiliated Hospital of Nanjing Medical University from January to December 2022 were analyzed,retrospectively. There were 69 males and 34 females,with an age(M (IQR))of 63.0 (14.0) years (range:48.0 to 86.0 years). The χ2 test and Fisher's exact probability method was used for comparison of the count data between the groups,respectively. The rank sum test was used for comparison of the measurement data between groups. Univariate and multivariate Logistic regression analyzes were used for the analysis of risk factors. Results: All 103 patients underwent pancreaticoduodenectomy successfully using the left-sided uncinate process and the artery first approach. Pathological examination showed pancreatic ductal adenocarcinoma in all cases. The location of the tumors was the pancreatic head in 40 cases,pancreatic head-uncinate in 45 cases,and pancreatic head-neck in 18 cases. Of the 103 patients,38 cases had moderately differentiated tumor and 65 cases had poorly differentiated tumor. The diameter of the lesions was 3.2 (0.8) cm (range:1.7 to 6.5 cm),the number of lymph nodes harvested was 25 (10) (range:11 to 53),and the number of positive lymph nodes was 1 (3) (range:0 to 40). The lymph node stage was stage N0 in 35 cases (34.0%),stage N1 in 43 cases (41.7%),and stage N2 in 25 cases (24.3%). TNM staging was stage ⅠA in 5 cases (4.9%),stage ⅠB in 19 cases (18.4%),stage ⅡA in 2 cases (1.9%),stage ⅡB in 38 cases (36.9%),stage Ⅲ in 38 cases (36.9%),and stage Ⅳ in 1 case (1.0%). In 103 patients with pancreatic head cancer,the overall positivity rate for 14cd-LN was 31.1% (32/103),and the positive rates for 14c-LN and 14d-LN were 21.4% (22/103) and 18.4% (19/103),respectively. 14cd-LN dissection increased the number of lymph nodes (P<0.01) and positive lymph nodes (P<0.01). As a result of the 14cd-LN dissection,the lymph node stage was changed in 6 patients,including 5 patients changed from N0 to N1 and 1 patient changed from N1 to N2. Similarly,the TNM stage was changed in 5 patients,including 2 patients changed from stage ⅠB to ⅡB,2 patients changed from stage ⅡA to ⅡB,and 1 patient changed from stage ⅡB to Ⅲ. Tumors located in the pancreatic head-uncinate (OR=3.43,95%CI:1.08 to 10.93,P=0.037) and the positivity of 7,8,9,12 LN (OR=5.45,95%CI:1.45 to 20.44,P=0.012) were independent risk factors for 14c-LN metastasis; while tumors with diameter >3 cm (OR=3.93,95%CI:1.08 to 14.33,P=0.038) and the positivity of 7,8,9,12 LN (OR=11.09,95%CI:2.69 to 45.80,P=0.001) were independent risk factors for 14d-LN metastasis. Conclusion: Due to its high positive rate in pancreatic head cancer,dissection of 14cd-LN during pancreaticoduodenectomy should be recommended,which can increase the number of lymph nodes harvested,provide a more accurate lymph node staging and TNM staging.

[Clinical value of lymph node dissection of No. 14cd during pancreaticoduodenectomy in patients with pancreatic head carcinoma].

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Clinical characteristics and potential prognostic factors of breast cancer patients with liver metastases

[Clinical value of lymph node dissection of No. 14cd during pancreaticoduodenectomy in patients with pancreatic head carcinoma].