Mastoscopic skin sparing mastectomy and sentinel lymph node biopsy combined with immediate mammary prosthesis reconstruction for early central breast cancer.

OBJECTIVE: This study aims to evaluate efficacy and safety of mastoscopic skin sparing mastectomy and sentinel lymph node biopsy combined with immediate mammary prosthesis reconstruction for early central breast cancer. MATERIALS AND METHODS: The medical records of patients, who underwent mastoscopic skin sparing mastectomy and sentinel lymph node biopsy combined with immediate mammary prosthesis reconstruction during the period of March 2011 and November 2016, were collected from Fuxing Hospital. Data on clinicopathologic characteristics, operative time, the number of resected sentinel lymph nodes, and complications were analyzed. RESULTS: The procedures were performed in 11 patients with central breast cancer. Among these patients, 10 patients were diagnosed with infiltrating ductal carcinoma, while the remaining patient had Paget's disease with infiltrating ductal carcinoma. The mean operation time was 148.2 minutes with minimal bleeding, and the median number of sentinel lymph nodes dissected from each operation was 4.6. The volume range of implants was 180-245 cc. There were no recurrences and upper limb swelling during the follow-up period. Merely two cases had sporadic axillary pain due to the mastoscopic lymph node dissection performed for the positive sentinel lymph nodes. All patients were satisfied with the reconstructive appearance. CONCLUSION: The present study shows that mastoscopic skin sparing mastectomy and sentinel lymph node biopsy combined with immediate mammary prosthesis reconstruction is a feasible procedure for early central breast cancer. KEY WORDS: Breast cancer, Fat suction, Reconstructive surgery, Sentinel lymph node, Skin sparing mastectomy.

Efficacy evaluation of the C-strain-based vaccines against the subgenotype 2.1d classical swine fever virus emerging in China.

Classical swine fever (CSF) is a devastating infectious disease of pigs caused by classical swine fever virus (CSFV). The disease has been controlled following extensive vaccination with the lapinized attenuated vaccine C-strain for decades in China. However, frequent CSF outbreaks occurred recently in a large number of C-strain-vaccinated pig farms in China and a new subgenotype 2.1d of CSFV has been reported to be responsible for the outbreaks. Here we analyzed the molecular variations and antigenic differences among the C-strain-based commercial vaccines of different origins from different manufacturers in China, and reevaluated the vaccines against the emerging subgenotype 2.1d strain of CSFV. The results showed that the C-strain adapted to the continuous ST cell line (CST) contain a unique M290K variation on the E2 protein, compared to those of primary BT cells (CBT) or rabbit origin (CRT) and the traditional C-strain sequences available in the GenBank database. Serum neutralization test revealed the antigenic differences between CST and CBT or CRT. Notably, the neutralizing titers of porcine anti-C-strain sera against the CSFV isolate of subgenotype 2.1d were significantly lower than those against C-strain or Shimen strain. The C-strain-vaccinated, subgenotype 2.1d HLJZZ2014 strain-challenged pigs did not show any clinical signs and all survived. However, these pigs displayed mild pathological and histological lesions, and the CSFV viral RNA was detected in the various tissue and blood samples. Taken together, the C-strain-based vaccines of different origins showed molecular variations and antigenic differences, and could provide clinical but not pathological and virological protection against the subgenotype 2.1d CSFV emerging in China. Further investigation is needed to comprehensively assess the efficacy of C-strain of different doses against the subgenotype 2.1d CSFV.