Background:Preoperative neutrophil-lymphocyte ratio (NLR) and derived NLR (dNLR) have been suggested to be correlated with the prognosis of patients with breast cancer (BC). However, the results still remain controversial. Therefore, this study was to further evaluate the prognostic potential of preoperative NLR and dNLR for BC patients using a meta-analysis.Methods:Relevant articles were sought in PubMed and Cochrane Library databases up to September 2018. The associations between preoperative NLR/dNLR and overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS) were assessed by the STATA software with the results presented as pooled hazard ratio (HR) with 95% confidence interval (CI).Results:Twenty-one studies were enrolled. Pooled results showed that elevated NLR was significantly associated with poorer OS (HR = 2.45, 95% CI: 1.69–3.54), DFS (HR = 1.54, 95% CI: 1.28–1.87) and RFS (HR = 4.05, 95% CI: 1.94–8.47) in BC patients undergoing surgery. High-preoperative dNLR was also significantly associated with worse OS (HR = 1.75, 95% CI: 1.39–2.19) and DFS (HR = 1.62, 95% CI: 1.09–2.41). Moreover, subgroup analysis showed significant associations between preoperative elevated NLR and poor prognosis were not changed by the stratification of ethnicity, cutoff of NLR, pathological stage, neoadjuvant, and adjuvant therapy.Conclusion:Preoperative NLR and dNLR may be effective predictive biomarkers for prognosis in patients with BC. Detection of NLR and dNLR may be helpful to identify the patients who may benefit from the surgery.

Piezoelectric single-crystal composites (PSCCs) have been studied and applied because of their improved resolution and power source level performance in underwater acoustic transducer applications relative to traditional piezoelectric ceramic composites (PCCs). Currently, the methods to fabricate curved PSCCs are mostly derived from PCCs, including molding with flexible backing, molding with heating, and molding with the casting rubber method. Unfortunately, the methods mentioned above are not suitable for preparing curved PSCCs for underwater acoustic transducer applications because of their brittleness, the large anisotropy of piezoelectric single crystals, and the high thickness (>2 mm) of PSCCs for achieving the low operating frequency (<700 kHz). In the present work, we proposed a preparation method, 3D-printing-assisted dice and insert technology, and successfully prepared curved PSCCs with high performance. Although the PSCCs have a low volume fraction of single crystals in this work (∼33%), a high thickness electromechanical factor k t of 86% and a large piezoelectric coefficient d 33 of 1550 pC/N were achieved in the curved 1−3 PSCCs, which are superior to other reported PSCCs and PCCs with nearly the same volume fraction of single crystals and piezoelectric ceramics. This work presents a paradigm for fabricating curved PSCCs for underwater acoustic transducers, and this method shows the potential for large-area, special-shaped PSCCs, which are key materials for next-generation underwater acoustic transducers.

Rationale: Breast metastasis from serous borderline tumor with micro-invasive carcinoma of ovary is a very rare condition. The breast lump as the only clinical presentation is rarely seen in ovarian carcinoma, which may lead to be misdiagnosed, and the mechanism of breast metastasis from ovarian tumors in early stage still needs to be explored. Differentiation from primary breast cancer and extramammary malignancy is crucial because the treatment and prognosis are significantly different. Patient concerns: A 33-year-old female presented with a painless, movable, 1.0 × 1.0 cm lump in the upper outer quadrant of the right breast for a month. Diagnoses: Breast metastasis of serous borderline tumor with micro-invasive ovarian carcinoma confirmed by pathology and immunohistochemistry. Interventions: The patient underwent lumpectomy, bilateral ovarian tumor stripping operation and prophylactic chemotherapy. Outcomes: No signs of recurrence have been detected in 1.5 years of follow-up. Lessons: Distant metastasis may occur in early stage of ovarian carcinoma. It is important to determine the origin of the primary tumor and develop an effective treatment strategy for patients. Imaging findings and pathological diagnostic criteria are important to accurately differentiate between metastasis and primary breast lesions, which may improve the patient's outcomes.

We describe a rare case of secondary breast carcinoma after chronic myeloid leukemia (CML) in a 56-year-old woman. The patient was treated with hydroxyurea and imatinib for CML and achieved complete remission (she has since been taking imatinib as the maintenance therapy). Four years later, the patient noticed a firm and painless lump in the left breast, which was diagnosed as ductal carcinoma in situ based on a percutaneous biopsy of the mass. Simple resection and sentinel lymph node biopsy of the left breast were then performed. Pathological studies revealed a medium-grade intraductal carcinoma, with local infiltration associated with invasive micropapillary carcinoma. She received adjuvant endocrine therapy with imatinib after surgery. Breast cancer secondary to CML (treated with imatinib and completely remitted) is extremely rare. This report provides evidence to assist in the diagnosis and treatment for this rare manifestation.