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Bibliography on: Invasive Ductal Carcinoma

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Robert J. Robbins is a biologist, an educator, a science administrator, a publisher, an information technologist, and an IT leader and manager who specializes in advancing biomedical knowledge and supporting education through the application of information technology. More About:  RJR | OUR TEAM | OUR SERVICES | THIS WEBSITE

RJR: Recommended Bibliography 19 Feb 2025 at 01:49 Created: 

Invasive Ductal Carcinoma

Invasive ductal carcinoma (IDC), also known as infiltrating ductal carcinoma, is cancer that began growing in a milk duct and has invaded the fibrous or fatty tissue of the breast outside of the duct. IDC is the most common form of breast cancer, representing 80 percent of all breast cancer diagnoses.

Created with PubMed® Query: ("invasive ductal carcinoma" OR IDC) NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)

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RevDate: 2025-02-17

Stavrou S, Paynter JA, Carins T, et al (2025)

Variation in the Definitions of Urinary Retention in Studies of Intravesical Botulinum Toxin for Idiopathic Overactive Bladder: A Narrative Systematic Review.

Neurourology and urodynamics [Epub ahead of print].

PURPOSE: To categorise and quantify definitions of urinary retention reported in studies assessing botulinum toxin (BoNT) injections for idiopathic overactive bladder (iOAB) syndrome.

MATERIALS AND METHODS: A narrative systematic review was conducted using three databases: EMBASE (via Ovid), PubMed, and SCOPUS. Inclusion criteria comprised studies published as full-text articles in English involving adults receiving BoNT injections (any formulation) for iOAB syndrome, where urinary retention was reported as an outcome.

RESULTS: From 1986 screened studies, 135 were assessed, and 57 met the eligibility criteria for the narrative systematic review. Reported rates of urinary retention varied widely, ranging from 0% to 42.6%. A definition of urinary retention was provided in 33 studies (57.9%), which were broadly categorised as follows. 1. Post-void residual (PVR) volume threshold: 14 studies (21.5%). 2. Inability to void: 6 studies (9.2%). 3. Initiation of clean intermittent catheterisation (CIC): 6 studies (9.2%). 4. PVR volume threshold and initiation of CIC/indwelling catheterisation (IDC): 6 studies (9.2%). 5. Bladder symptoms and PVR volume threshold and initiation of CIC/IDC: 6 studies (9.2%). 6. Bladder symptoms and PVR volume threshold: 3 studies (4.6%). Notably, 24 studies (42.1%) omitted a definition altogether.

CONCLUSIONS: Urinary retention rates varied significantly between studies, likely due to the heterogeneous definitions used. The omission of definitions in nearly half of studies further complicates efforts to accurately inform and consent patients regarding the risk of urinary retention and the need for CIC/IDC after intravesical BoNT injection. Standardised definitions are urgently needed to enhance research, improve clinical practice, and support informed patient counselling.

RevDate: 2025-02-16

Zhou S, Shi Y, Huang Z, et al (2025)

Does the Presence of Ductal Carcinoma in situ Affect Prognostic Outcomes After Neoadjuvant Therapy in Invasive Ductal Carcinoma of the Breast?.

Clinical oncology (Royal College of Radiologists (Great Britain)), 40:103781 pii:S0936-6555(25)00036-6 [Epub ahead of print].

AIMS: The presence of ductal carcinoma in situ (DCIS) alongside invasive ductal carcinoma (IDC) of the breast is common in clinical practice and affects clinical outcomes and treatment strategies. This study aimed to compare the clinicopathological characteristics and prognosis of patients with IDC coexisting with DCIS versus pure IDC after neoadjuvant therapy (NAT) and to explore the risk factors for residual DCIS following NAT.

MATERIAL AND METHODS: Patients with Stage II-III IDC who underwent NAT followed by radical surgery between January 2015 and December 2022 were included. Baseline data, clinical characteristics, preoperative treatment, surgical approach, pathological outcomes, and prognostic information were collected and analysed.

RESULTS: A total of 852 patients were enrolled in this study, with 279 and 573 patients in the IDC + DCIS and IDC groups, respectively. Compared with patients in the IDC group, those in the IDC + DCIS group had a lower proportion of triple-negative molecular type (15.1% vs. 33.9%, P < 0.001), better histological grade (52.0% vs. 37.7%, P < 0.001), and higher residual rate of DCIS (71.3% vs. 38.7%, P < 0.001). The 5-year disease-free survival (DFS) (85.2% vs. 82.4%, P = 0.188) and overall survival (OS) (93.2% vs. 93.0%, P = 0.810) rates of patients in the IDC + DCIS group were similar to those in the IDC group. However, in the triple-negative breast cancer population, the DFS (88.6% vs. 75.8%, P = 0.032) of patients with IDC + DCIS was significantly better than that of patients with IDC. For patients with IDC + DCIS, age ≥40 years (odds ratio [OR] = 0.421; 95% confidence interval [CI], 0.163-0.889, P = 0.035) and HR+/HER2-molecular subtype (OR=3.347; 95% CI, 1.237-6.577, P = 0.047) were independent preoperative predictors for residual DCIS after NAT.

CONCLUSION: The presence of DCIS in IDC demonstrated less tumour aggressiveness than pure IDC. However, a survival benefit was only observed in patients with triple-negative IDC combined with DCIS after NAT. Furthermore, patients with IDC + DCIS have a higher risk of residual DCIS after NAT, and age <40 years and the luminal subtype are risk factors for residual DCIS after NAT in patients with IDC + DCIS.

RevDate: 2025-02-15

Nkonde KA, Cheung SM, Senn N, et al (2025)

Understanding cellular proliferation activity in breast cancer using multi-compartment model of transverse relaxation time mapping on 3T MRI.

Frontiers in oncology, 15:1482112.

INTRODUCTION: Precise understanding of proliferative activity in breast cancer holds significant value in the monitoring of neoadjuvant treatment, while current immunostaining of Ki-67 from biopsy or resected tumour suffers from partial sampling error. Multi-compartment model of transverse relaxation time has been proposed to differentiate intra- and extra-cellular space and biochemical environment but susceptible to noise, with recent development of Bayesian algorithm suggested to improve robustness. We hence hypothesise that intra- and extra-cellular transverse relaxation times using Bayesian algorithm might be sensitive to proliferative activity.

MATERIALS AND METHODS: Twenty whole tumour specimens freshly excised from patients with invasive ductal carcinoma were scanned on a 3 T clinical scanner. The overall transverse relaxation time was computed using a single-compartment model with the non-linear least squares algorithm, while intra- and extra-cellular transverse relaxation times were computed using a multi-compartment model with the Bayesian algorithm. Immunostaining of Ki-67 was conducted, yielding 9 and 11 cases with high and low proliferating activities respectively.

RESULTS: For single-compartment model, there was a significant higher overall transverse relaxation time (p = 0.031) in high (83.55 ± 7.38 ms) against low (73.30 ± 11.30 ms) proliferating tumours. For multi-compartment model, there was a significant higher intra-cellular transverse relaxation time (p = 0.047) in high (73.52 ± 10.92 ms) against low (61.30 ± 14.01 ms) proliferating tumours. There was no significant difference in extra-cellular transverse relaxation time (p = 0.203) between high and low proliferating tumours.

CONCLUSIONS: Overall and Bayesian intra-cellular transverse relaxation times are associated with proliferative activities in breast tumours, potentially serving as a non-invasive imaging marker for neoadjuvant treatment monitoring.

RevDate: 2025-02-14
CmpDate: 2025-02-14

Kawai Y, Shinohara R, Fukuda C, et al (2024)

[A Case of Surgical and Chemotherapeutic Treatment for Ipsilateral Breast Tumor Recurrence during Pregnancy].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(13):1833-1835.

A 40-year-old woman was diagnosed with ipsilateral breast tumor recurrence in the conserved breast 1.5 years after undergoing partial mastectomy for right breast cancer at another hospital. She was referred to our hospital at 19 weeks of gestation. At 21 weeks, total mastectomy of the conserved breast with sentinel lymph node biopsy was performed. The postoperative pathological diagnosis was invasive ductal carcinoma mixed with squamous cell carcinoma. AC chemotherapy was initiated at 33 weeks, and she gave birth by cesarean section at 39 weeks. Postpartum, EC therapy followed by paclitaxel therapy were administered. Currently, she is on endocrine therapy, with no new recurrence observed for 3 years after surgery. Pregnancy-associated breast cancer is rare, accounting for approximately 1% of all breast cancers, and there are few reports on the treatment of local recurrence or distant metastasis during pregnancy. This case, involving breast-conserving surgery recurrence during pregnancy, highlights the importance of careful decision-making and treatment strategies tailored to individual cases, considering the safety of both mother and fetus through multidisciplinary collaboration.

RevDate: 2025-02-14
CmpDate: 2025-02-14

Omoto H (2024)

[A Case of Advanced Breast Cancer Resected after the Combined Therapy of Palbociclib and Letrozole].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(13):1704-1706.

A 50's postmenopausal woman, she was diagnosed with breast cancer, cT2N3aM0, Stage ⅢC, invasive ductal carcinoma, estrogen-receptor(ER)-positive, progesterone-receptor(PgR)-negative, human epidermal growth factor 2(HER2)-negative. A combination therapy of palbociclib(PAL)and letrozole(LET)was administered to the patient. A method of administration was 125 mg of PAL per day(14 days of treatment followed by 14 days off, 2 courses and 18 days of treatment followed by 10 days off, 8 courses)and 2.5 mg of LET per day every day. This therapy was effective, and the clinical stage showed down staging, T2N1M0, Stage ⅡB. Left total mastectomy and sentinel lymph node biopsy and swelled axillar lymph node resection was performed. Postoperative pathological histology revealed ypT2N1a(1/9). Subsequently this medication (125 mg of PAL per day, 21 days of treatment followed by 14 days off and 2.5 mg of LET per day every day)was continued as an adjuvant therapy and postmastectomy radiation therapy(PMRT 50 Gy)was underwent for her. This patient has survived without recurrence 12 months after operation. PAL probably has a certain effect even if oral administration method were changed.

RevDate: 2025-02-14
CmpDate: 2025-02-14

Takeda S, Terakawa H, Kawata C, et al (2024)

[A Case in Which Multiple Biopsies from Breast Cancer Skin Metastases Were Performed and Trastuzumab Deruxtecan Was Used after Low HER2 Expression Was Confirmed].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(13):1702-1703.

In March 2023, Trastuzumab deruxtecan(T-DXd)was added for the treatment of inoperable or recurrent breast cancer with low HER2 expression who has a history of chemotherapy. The patient was a 61-year-old woman who had undergone surgery for bilateral breast cancer, and was diagnosed with Stage ⅡA triple negative(HER2-IHC score 0)on the right and non-invasive ductal carcinoma of the breast on the left. Biopsy from metastases was triple-negative(HER2-IHC score 0, PD-L1 negative). Exacerbation of skin metastases was observed despite repeated regimen changes 3rd skin biopsy was diagnosed with low expression of HER2 for the first time, and T-DXd was started. The therapeutic effect of T-DXd was temporarily observed, such as a decrease in tumor markers. It is useful to repeatedly collect tissues from primary and metastatic lesions and re-evaluate biomarkers in order to develop an appropriate treatment plan.

RevDate: 2025-02-14
CmpDate: 2025-02-14

Nakakuma T, Yamasaki K, Ueno S, et al (2024)

[A Case of Resection for a Late-Stage Solitary Hepatic Metastasis from Very Early Breast Cancer].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(13):1492-1494.

A 57-year-old woman underwent left breast conserving surgery(Bp+Ax)for breast cancer at 46 years of age. Histopathological findings were invasive ductal carcinoma(tubule forming type), pN0(0/17), Ly0, V0, NG1, HG1, pT1aN0M0, Stage Ⅰ, ER 100%, HER2 score 0. Postoperatively, only radiotherapy to the preserved breast was performed and no adjuvant drug therapy was administered. This time, a 45 mm liver tumor in segment 4/3 was found by abdominal ultrasound for health checkup. Enhanced ultrasonography showed poor contrast, CT showed a low density tumor with calcification, MRI showed no diffusion reduction, and PET showed no FDG uptake. Although the findings were not typical for suspecting malignancy, but cholangiocellular carcinoma or metastatic liver cancer could not be ruled out. Laparoscopic liver resection was performed. Histopathological findings revealed liver metastasis of breast cancer. We report a rare case, a late-stage solitary hepatic metastasis from very early breast cancer. Although the concept of breast cancer as a systemic disease is well-established, in this case there is a possibility that recurrence would not have occurred if postoperative adjuvant drug therapy had been performed. The importance of postoperative adjuvant drug therapy for breast cancer was suggested. At present, she remains disease-free after hepatectomy.

RevDate: 2025-02-14
CmpDate: 2025-02-14

Sugimoto Y, Terada I, Okamoto J, et al (2024)

[A Case of Mastectomy and Axillary Lymph Node Dissection for Breast Cancer on the Side of Pacemaker Implant].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(13):1446-1448.

The patient was a woman in her 80s with a history of atrial fibrillation at age 80, and catheter ablation and pacemaker implantation for sinus bradycardia. Her chief complaint is a left lateral breast mass. A pacemaker was implanted subcutaneously in the caudal left subclavian region, and palpation revealed a 20 mm-sized elastic hard mass in the left D area. On close examination, she was diagnosed as HER2-enriched invasive ductal carcinoma of the breast, T1cN0M0, cStage Ⅰ. The surrounding fatty tissue was preserved without exposing the pacemaker, and a subtotal left breast resection plus sentinel lymph node biopsy was performed, with additional axillary lymph node dissection due to positive metastasis. Intraoperative pacemaker monitoring was performed and no trouble was observed. The patient was discharged on the 6th postoperative day without complications. Pathology results showed pT2pN2aM0(7/16), pStage ⅢA. Postoperatively, the patient is scheduled to receive radiation to the chest wall without a pacemaker and chemotherapy.

RevDate: 2025-02-14
CmpDate: 2025-02-14

Satoh E, Yamazaki A, Uehira D, et al (2024)

[A Case of Locally Advanced Breast Cancer Reconstructed with Rhomboid Flap after Mastectomy].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(13):1411-1412.

We report a case of right locally advanced breast cancer in an 84-year-old woman. Her breast cancer(pathologically invasive ductal carcinoma)was 42 mm in diameter and located at B area(lower-inner quadrant)with marked skin invasion (cT4bN0M0, Stage ⅢB). Mastectomy with about 10×10 cm skin resection plus sentinel lymph node biopsy was performed in August 2022 after neoadjuvant endocrine therapy(anastrozole). The skin defect after mastectomy was reconstructed with the rhomboid flap designed at D area(lower-outer quadrant). Her cutaneous local flap after the operation showed an excellent condition and she was discharged with no wound complications. The rhomboid flap was designed quickly and easily with no special instruments, and resulted in a good cosmetic outcome. Therefore, rhomboid flap reconstruction was a very useful method to cover the skin defect after mastectomy of locally advanced breast cancer.

RevDate: 2025-02-14
CmpDate: 2025-02-14

Fujimori T, Kasagawa T, Ishii N, et al (2024)

[A Case of Bladder Metastasis from Invasive Ductal Carcinoma of the Breast-A Case Report].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(13):1345-1347.

We report a patient with left breast cancer who underwent total mastectomy and axillary dissection as primary surgery. The patient, a 78-year-old woman, noticed a tumor about 4 cm in the left breast. She was diagnosed with left breast cancer (cT2N2M0, cStage ⅢA). The pathology revealed invasive lobular carcinoma, 46×31 mm, ly(+), v(0), histological grade: 2, n2, hormone receptor positive, HER2 negative, and pStage ⅢA. We recommended adjuvant chemotherapy, but she did not desire. She started oral administration of an aromatase inhibitor and radiation therapy. When DFI was 3 years, an examination was carried out because the increase in CEA value, CT scan revealed a mass extending from the bladder. We suspected bladder cancer. She underwent a bladder biopsy. The result was bladder metastasis of breast cancer. Later, we introduced chemotherapy. Routine screening of the lower urinary tract is not necessary for all patients, but women with a history of breast cancer presenting with urinary symptoms should undergo a thorough examination of the urinary tract.

RevDate: 2025-02-14
CmpDate: 2025-02-14

Aoyagi T, Sakata H, Namura M, et al (2024)

[A Case of Locally Advanced Breast Cancer Showing Local Enlargement during Chemotherapy, followed by Surgery and Suppression of Recurrence].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(13):1342-1344.

A 71-year-old woman was referred to our hospital for a right breast mass urgency. A CT scan revealed a large right breast tumor with skin involvement. Biopsy results confirmed the diagnosis of Luminal-HER2 type invasive ductal carcinoma. Chemotherapy was initiated with a regimen of paclitaxel, trastuzumab, and pertuzumab. Initially, the tumor flattened and significantly decreased in size. However, after 9 months of treatment, disease progression occurred, leading to sequential changes in the treatment regimen to T-DM1 and T-DXd. Despite these efforts, the tumor continued to grow rapidly. At 13 months after starting chemotherapy, the treatment effect was unsatisfactory, prompting a decision to perform a total mastectomy, including resection of the right breast tumor and the pectoralis major muscle, followed by skin grafting. The histopathological effect of the treatment was judged as Grade 1b, with intermediate tumor margins. Postoperatively, the patient received radiation therapy to the chest wall, followed by continued treatment with trastuzumab and pertuzumab. As of 2 years after surgery, no recurrence has been observed.

RevDate: 2025-02-13

Cremer A, Rosewick N, Kelsey M, et al (2025)

A transcriptomic score to classify the inflammation-dysplasia-cancer sequence lesions in Inflammatory Bowel Disease.

Journal of Crohn's & colitis pii:8010955 [Epub ahead of print].

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is associated with a higher risk of developing colorectal cancer, according to the inflammation-dysplasia-cancer (IDC) sequence from inflammation to colitis-associated colorectal cancer (CAC). The objective of this study was to identify and generate a transcriptomic signature and score, related to the IDC sequence, that could ultimately classify dysplasia and cancer in IBD.

METHODS: Demographics, clinical parameters, histological characteristics and RNA-sequencing data were evaluated on 134 formalin-fixed paraffin-embedded lesions from 2 independent cohorts of IBD patients with low- or high-grade dysplasia (LGD, HGD) and/or CAC. An ordinal logistic regression screened for significant IDC sequence-associated genes that were computed in a transcriptomic signature score.

RESULTS: Principal component analysis and unsupervised clustering on 1% of the most variable genes showed a good clustering between the 4 lesion groups (Normal Mucosa, Inflamed Mucosa, LGD/HGD, and CAC). A gene signature was identified on 27 genes that correlated with the lesion groups in the exploratory cohort. The most weighted gene in this transcriptomic signature was the long non-coding regulatory RNA KCNQ1OT1, a gate keeper against genomic instability and transposon activation. Based on these 27- genes expression, we built and validated a transcriptomic signature score to classify dysplasia and CAC. The overall accuracy of the transcriptomic signature score was 85.71% in the exploratory cohort and 90.91% in the validation cohort.

CONCLUSION: We identified a tissue-based transcriptomic score to classify IDC lesions in IBD patients and uncovered some of the pivotal genes in the carcinogenesis related to inflammation in IBD.

RevDate: 2025-02-13

Dillan MM, Piktel J, Perzynski A, et al (2025)

Social determinants and follow-up care after emergency department discharge for traumatic intracranial hemorrhage.

Heliyon, 11(3):e42230.

BACKGROUND: Traumatic brain injury (TBI) is a multifaceted condition associated with occupational, social, physical, cognitive, academic, and economic burdens. Mild TBI including traumatic intracranial hemorrhage (tICH), is commonly discharged from the emergency department (ED). Despite the complexity of factors contributing to TBI outcomes, patient education and comprehensive follow-up plans are frequently lacking. We examined health trajectories, recidivism, and follow-up patterns of patients discharged from the ED with tICH to identify opportunities to improve care.

METHODS: We conducted an IRB approved retrospective observational study at a large urban Level 1 trauma center from January 2017 to July 2022. We identified patients (n = 117) discharged from the ED with acute tICH, using IDC 9/10 codes and confirmed by imaging review. Exclusions were hospital admission, chronic ICH, and age under 18. The primary outcome was an ED-revisit within 180 days. Secondary outcomes included any return TBI visit, scheduled specialty TBI provider visit, and post-TBI mental health disorder diagnoses. Age, gender, race, ethnicity, pre-TBI mental health disorders, and socioeconomic status (SES) were analyzed. SES was measured using area deprivation index (ADI). Statistical analysis was performed with logistic regression and Chi-squared tests.

RESULTS: The average age of enrolled patients was 53 ± 20 years with 39 % female, 26 % Black, 69 % White, and 6 % Hispanic. Overall follow-up rates were low, with 49 % of patients having at least one scheduled follow-up visit within 180 days. Only 16 % of Black patients saw a TBI specialty provider visit within 180 days compared to 36 % of White patients (p = .03). ED recidivism rate was 18 %, with 25 % of patients overall having an unscheduled TBI visit. Lower SES was a significant predictor of any TBI revisit (OR 1.39, CI 1.06, 1.82). New mental health diagnoses following tICH occurred in 15 % of patients; depression and anxiety were most common. There was no association between SES, age, gender, race, or ethnicity and new mental health diagnoses.

CONCLUSION: We observed racial and SES differences in follow-up care from the ED for patients with TBI. Individualized discharge planning and formulation of care pathways that account for the mental health and social needs of all patients may improve long-term outcomes. Further understanding of health disparities present in ED TBI care is needed.

RevDate: 2025-02-13

Li H, Yang L, Sun X, et al (2024)

Changes in hormone receptor when breast cancer metastasizes to the colon: case report and literature review.

Frontiers in oncology, 14:1391393.

The metastasis of breast cancer to the colon is a rare occurrence, especially in the presence of changes in estrogen and progesterone receptors. To date, literature has only reported two cases of invasive ductal carcinoma and two cases of invasive lobular carcinoma metastasizing to the colon with concurrent changes in hormone receptors. This report describes a 65-year-old woman with a history of left breast cancer, who presented with symptoms of bloody stools and abdominal pain. CT and colonoscopy results revealed a malignant tumor in the ascending colon, and the patient underwent surgery. Pathological results post-surgery indicated changes in hormone receptors, differing from the previous breast cancer pathology, ultimately leading to the diagnosis of breast cancer metastasis to the colon. The patient was found to have liver metastasis 14 months after right hemicolectomy, and systemic metastases in various locations were discovered at the 19-month mark.

RevDate: 2025-02-12

Rodriguez M, Du Thanh A, Girard C, et al (2025)

Methotrexate in monotherapy or combined with oral steroids for bullous pemphigoid in a real-life setting: A retrospective monocentric cohort.

Annales de dermatologie et de venereologie, 152(1):103329 pii:S0151-9638(24)00085-1 [Epub ahead of print].

BACKGROUND: In bullous pemphigoid (BP), prolonged treatment with low-dose methotrexate (MTX) may represent an effective strategy to maintain an initial clinical remission achieved by short-duration superpotent topical steroids (STS).).

PATIENTS AND METHODS: To evaluate the efficacy and safety of MTX in a real-life setting, a retrospective analysis was conducted in a reference centre for all BP patients treated between 2015 and 2020 with STS and MTX, either in monotherapy (mMTX) or in combination with oral steroids (MTX+OS). The primary endpoints were BP relapse rate and time to relapse during treatment for patients achieving initial disease control (IDC). Secondary endpoints included IDC achievement rate, relapse rate and time to relapse after MTX discontinuation, adverse effect (AE) and mortality rates, number of patients permanently discontinuing MTX owing to AE, number of patients alive and still in complete remission (CR) at the latest updates, and whether they were off treatment (cure rate).

RESULTS: The BP relapse rate during treatment after achievement of IDC was significantly higher in patients treated with mMTX (32.2%) than with MTX+OS (0%) (p = 0.03); mean time to relapse was 10.3 months. The BP relapse rate after MTX discontinuation and the cure rate did not differ significantly between the two groups. One patient (receiving mMTX) died during follow-up and 27.8% of patients experienced at least one AE during the study. The cure rate in patients achieving IDC was 45.2% with mMTX vs. 30% with MTX+OS (p = 0.15).

CONCLUSION: Our study highlights the value of low-dose mMTX for treating BP in a real-life setting, both for achievement of initial response and for long-term control, with a good overall safety profile and no significant additional mortality risk in elderly subjects. However, relapses appear to have been less frequent during treatment when MTX was initially combined with OS.

RevDate: 2025-02-12

Han M, Chen T, L Ediriwickrema (2025)

Intra-operative visualization of the superior ophthalmic vein in carotid-cavernous fistula.

Orbit (Amsterdam, Netherlands) [Epub ahead of print].

This 55-year-old woman with grade III invasive ductal carcinoma in remission on letrozole and hypertension presented with 4 months of headaches, diplopia, and a left eye with proptosis and circumferential corkscrew vessels extending to the limbus. Computed tomography imaging demonstrated a dilated superior ophthalmic vein consistent with a carotid-cavernous fistula (CCF). Diagnostic direct catheter angiography confirmed a CCF supplied by the left and right meningo-hypophyseal trunks of the internal carotid artery, which is type B by Barrow's classification. Oculoplastic surgery obtained access to the superior ophthalmic vein for direct catheterization on request from the interventional neuroradiology team as demonstrated in the image. Upon catheterization, the fistula had spontaneously thrombosed. Post-procedure, the patient had improved injection and proptosis of the left eye. She was started on apixaban to treat a presumed cavernous sinus thrombosis. She continues to do well at her follow up examinations.

RevDate: 2025-02-12

Kato M, Sato H, Naito Y, et al (2025)

Prospective observational study on the relationships between genetic alterations and survival in Japanese patients with metastatic castration-sensitive prostate cancer: the impact of IDC-P.

International journal of clinical oncology [Epub ahead of print].

BACKGROUND: Intraductal Carcinoma of the Prostate (IDC-P) is a significant prognostic indicator for prostate cancer, which demonstrates significant associations with homologous recombination repair gene mutations (HRRm) and alterations in tumor suppressor genes. However, no study in Japan has investigated the association between IDC-P and genetic mutations in men with metastatic castration-sensitive prostate cancer (mCSPC).

METHODS: This prospective observational study enrolled 102 de novo mCSPC (LATITUDE high-risk) patients diagnosed between 2018 and 2021, with subsequent monitoring of survival outcomes. A single genitourinary pathologist evaluated all needle biopsy slides. Genetic analyses were performed using the Myriad myChoice HRD plus™. These genetic analyses covered 108 genetic loci, including 15 HRRm genes, with a success rate of 91%.

RESULTS: Genetic alterations were observed in 79 patients (77.5%), with 20 exhibiting HRRm (19.6%). Common genetic alterations included FOXA1 (29.4%) and TP53 (17.6%) mutations; BRCA (9.8%) mutations were the most frequent HRRm (BRCA1:2 cases, BRCA2:8 cases, including 6 biallelic). IDC-P-positive patients demonstrated a significantly higher frequency of genetic aberrations (82.6% vs. 50%, p = 0.0082). Patients with biallelic BRCA2, TP53, and PTEN mutations exhibited significantly poorer cancer-specific survival. Multivariate analysis identified lactate dehydrogenase (LDH) (HR 1.005, p = 0.035), TP53 mutations (HR 5.196, p < 0.001), biallelic BRCA2 mutations (HR 10.686, p = 0.005), and IDC-P as independent predictors of poor cancer-specific survival. No cancer-related deaths occurred in IDC-P-negative cases.

CONCLUSION: Our study emphasizes the significant association between IDC-P and an elevated incidence of genetic alterations in Japanese mCSPC patients, emphasizing the need for early genetic testing to guide therapeutic decision-making.

RevDate: 2025-02-12
CmpDate: 2025-02-12

Shah S, Osuala KO, Brock EJ, et al (2025)

Three-Dimensional Models: Biomimetic Tools That Recapitulate Breast Tissue Architecture and Microenvironment to Study Ductal Carcinoma In Situ Transition to Invasive Ductal Breast Cancer.

Cells, 14(3): pii:cells14030220.

Diagnosis of ductal carcinoma in situ (DCIS) presents a challenge as we cannot yet distinguish between those lesions that remain dormant from cases that may progress to invasive ductal breast cancer (IDC) and require therapeutic intervention. Our overall interest is to develop biomimetic three-dimensional (3D) models that more accurately recapitulate the structure and characteristics of pre-invasive breast cancer in order to study the underlying mechanisms driving malignant progression. These models allow us to mimic the microenvironment to investigate many aspects of mammary cell biology, including the role of the extracellular matrix (ECM), the interaction between carcinoma-associated fibroblasts (CAFs) and epithelial cells, and the dynamics of cytoskeletal reorganization. In this review article, we outline the significance of 3D culture models as reliable pre-clinical tools that mimic the in vivo tumor microenvironment and facilitate the study of DCIS lesions as they progress to invasive breast cancer. We also discuss the role of CAFs and other stromal cells in DCIS transition as well as the clinical significance of emerging technologies like tumor-on-chip and co-culture models.

RevDate: 2025-02-12
CmpDate: 2025-02-12

González-Martínez S, Palacios J, Carretero-Barrio I, et al (2025)

Single-Cell RNA Sequencing on Formalin-Fixed and Paraffin-Embedded (FFPE) Tissue Identified Multi-Ciliary Cells in Breast Cancer.

Cells, 14(3): pii:cells14030197.

The purpose of this study was to evaluate the suitability of formalin-fixed and paraffin-embedded (FFPE) samples and fixed fresh (FF) samples for single-cell RNA sequencing (scRNAseq). To this end, we compared single-cell profiles from FFPE and matched FF tissue samples of one invasive carcinoma of no special type carcinoma (invasive ductal carcinoma-IDC) and one invasive lobular carcinoma (ILC) to assess consistency in cell type distribution and molecular profiles. The results were validated using immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and electron microscopy. Additionally, immune cell proportions identified by IHC were quantified using QuPath and compared to the scRNAseq results. FFPE- and FF-derived libraries demonstrated high-quality sequencing metrics, and cellular heterogeneity was similar. No exclusive cell populations were identified by either approach. The four samples analysis identified six types of epithelial cells, as well as tumoral microenvironment populations. The scRNAseq results from epithelial neoplastic cells were concordant with common IHC markers. The proportion of immune cells identified by IHC in FFPE sections were similar to those obtained by scRNAseq. We identified and validated a previously poorly recognized subpopulation of neoplastic multi-ciliated cells (MCCs) (FOXJ1, ROPN1L). Analysis of FOXJ1 in 214 ER-positive invasive carcinomas demonstrated protein expression in one third of tumors, suggesting frequent focal MCC differentiation. Our results support the suitability of scRNAseq analysis using FFPE tissue, and identified a subpopulation of neoplastic MCC in breast cancer.

RevDate: 2025-02-12
CmpDate: 2025-02-10

Khanmammadov N, Doğan I, Khishigsuren B, et al (2025)

Rechallenge of trastuzumab-based therapy in HER2-positive breast cancer patients who progressed after lapatinib plus capecitabine.

Medicine, 104(6):e41468.

Data regarding the use of rechallenge trastuzumab (RTmab)-based therapies in the management of heavily pretreated patients with HER2-positive breast cancer (BC) in the literature are limited. This study aimed to evaluate the efficacy of trastuzumab-based therapy in patients who experienced disease progression after receiving lapatinib plus capecitabine (LC). In this retrospective study, the data of thirty three HER2 positive metastatic BC patients who progressed after LC treatment and subsequently received trastuzumab-based treatment were evaluated. Trastuzumab was administered at an initial loading dose of 8 mg/kg followed by a maintenance dose of 6 mg/kg every 21 days. The average age of patients is 47 years (range 25-72 years). The predominant histopathological subtype was invasive ductal carcinoma, which was observed in 23 (70%) patients. Estrogen receptor (ER) positivity was also noted in 16 (48%) patients. All patients had received palliative trastuzumab plus chemotherapy (Cht) before the lapatinib. In conjunction with trastuzumab-based therapy, vinorelbine was administered to 14 (42%) patients, paclitaxel to 12 (36%), and other chemotherapeutic agents to 4 (12%). For all patients, the objective response and disease control rates were 27% and 69%, respectively. Furthermore, the median progression-free survival (PFS) was 8.8 months (95% confidence interval [CI]: 6.6-11), and the median overall survival was 20 months (95% CI: 15.1-25.8). There were no statistically significant differences in PFS rates based on several factors, including age, ER status, denovo metastasis, brain metastasis, perioperative Cht, pre-Rtmab hormone therapy, and which Cht was used along with Rtmab (P > .05). Mild to moderate adverse events were observed in 17 (52%) patients, whereas only 4 (12%) patients had Grade 3 to 4 toxicity. This study demonstrated that RTmab-based therapy is effective in patients who progressed after LC. These findings contribute to the literature by suggesting that RTmab is a viable treatment option for patients with HER2-positive metastatic BC.

RevDate: 2025-02-12

Sołek JM, Nowicka Z, Fendler W, et al (2024)

Prognostic value of FGFR2 in ER-positive breast cancer is influenced by the profile of stromal gene expression: an in silico analysis based on TCGA data.

Contemporary oncology (Poznan, Poland), 28(4):341-349.

INTRODUCTION: Fibroblast growth factor receptor 2 (FGFR2) activation is associated with endocrine therapy resistance in luminal breast cancer (BC) in vitro, but clinical evidence remains inconsistent. Given the role of FGFRs in mediating tumour microenvironment (TME) interactions, the prognostic value of FGFR2 may depend on the stromal component. This study aimed to validate the association between FGFR-related profile of the stroma and FGFR2 prognostic value in oestrogen receptor-positive invasive ductal carcinoma (IDC).

MATERIAL AND METHODS: An in silico gene expression analysis identified 12 stromal factors (FAP, CXCL12, PDGFRA, COL1A1, HSPG2, CCL2, MMP14, S100A4, MMP9, PDGFA, MCAM, IL6) forming an "FGFR-related profile of the stroma". A cohort of 257 ER+ IDC patients from The Cancer Genome Atlas (TCGA) was analysed. Tumours were clustered using k-means based on stromal gene expression, and Cox proportional hazards regression models were used to assess the association between FGFR2 and overall survival (OS).

RESULTS: Two clusters of ER+ IDC tumours were identified based on the stromal gene expression profile. While both clusters had similar tumour stages and hormone receptor statuses, multivariable analysis adjusted for clinical factors revealed a significant association between FGFR2 expression and cluster assignment. In Cluster I (high expression of stromal genes), high FGFR2 was linked to poor prognosis, whereas in Cluster II (low expression), high FGFR2 indicated favourable prognosis. FGFR1, FGFR3, and FGFR4 showed no significant prognostic value.

CONCLUSIONS: Stromal profiles modulate the prognostic significance of FGFR2 in luminal breast carcinoma, highlighting the importance of TME profiling for biomarker assessment and explaining inconsistencies in FGFR2 studies.

RevDate: 2025-02-10

Peshin S, Iftekher R, Iqbal R, et al (2025)

The Optimal Treatment of Invasive Ductal and Lobular Carcinoma Occurring at the same time needs to be Established.

European journal of case reports in internal medicine, 12(2):005074.

UNLABELLED: Bilateral breast cancer with distinct histological subtypes poses a significant clinical challenge, requiring an individualised approach to management. This case discusses a 61-year-old postmenopausal woman with concurrent invasive ductal carcinoma (IDC) in the right breast and invasive lobular carcinoma (ILC) in the left breast. IDC, the most common breast cancer subtype, is known for its aggressive behaviour, nodal involvement and metastatic potential, while ILC, representing a smaller percentage of breast cancers, often exhibits an indolent course with diffuse growth patterns. Both tumours in this patient were hormone receptor-positive (ER/PR-positive) and HER2-negative, warranting targeted endocrine therapies. The complexity of this case was further heightened by a significant family history of breast and colon cancers, and comorbid conditions including borderline diabetes, hypertension and coronary artery disease (CAD), which required careful therapeutic consideration to balance efficacy and tolerability. Pathological evaluation confirmed stage II, grade 2 IDC in the right breast with one positive sentinel lymph node and stage I, grade 1 ILC in the left breast with no nodal involvement. Given her extensive family history, the patient opted for bilateral mastectomy with sentinel lymph node biopsy. Multidisciplinary tumour board discussions emphasised the integration of genetic testing, including BRCA1/2 evaluation, and Oncotype DX genomic profiling to assess recurrence risk and guide adjuvant chemotherapy decisions. Recommendations included adjuvant radiation therapy for the right breast, endocrine therapy for both tumours and the incorporation of CDK 4/6 inhibitors based on recent evidence from the NATALEE trial, which demonstrated improved outcomes in high-risk, hormone receptor-positive, HER2-negative breast cancers. The case highlights the need for further research into the optimal treatment strategies for synchronous breast cancers, a potential knowledge gap in current oncology practice. A literature review revealed limited reports addressing similar cases, underscoring the lack of consensus guidelines. Our approach integrates the best available evidence with multidisciplinary expertise to inform a personalised treatment plan. The learning points emphasise the need for establishing evidence-based strategies for managing synchronous bilateral breast cancers.

LEARNING POINTS: The optimal treatment of synchronous bilateral breast cancers with differing histological subtypes remains uncertain.This case illustrates the importance of leveraging existing evidence, multidisciplinary collaboration and patient-centred decision-making when addressing knowledge gaps.There is a call for further research to establish guidelines for managing simultaneous, histologically distinct breast cancers.

RevDate: 2025-02-10

Maxey J, D Harvey (2025)

Neisseria weaveri: Atypical Infection in Breast Implant-Based Reconstruction.

Plastic and reconstructive surgery. Global open, 13(2):e6505.

Surgical site infection (SSI) following breast implant surgery can have devastating complications. Infection is most commonly from coagulase-negative Staphylococcus bacteria. Neisseria weaveri is a gram-negative bacterium that is associated with animal bites. We present the first known case of N. weaveri causing SSI following breast implant reconstruction. We report the case of a 61-year-old woman with invasive ductal carcinoma who underwent bilateral skin-sparing mastectomy with immediate implant-based reconstruction. She presented on postoperative day 24 with malodorous drainage from her Jackson-Pratt drain. The patient explained that she has a shih tzu at home that frequently licked her. Cultures from the drain grew N. weaveri. The patient's antibiotic regimen was transitioned, and she completed her course without complications. Practitioners should counsel their patients on adequate postsurgery hygiene and take into consideration rare causes of SSI and how this may affect patient care.

RevDate: 2025-02-08

de Barros HA, Downes MR, Droghetti M, et al (2025)

Prognostic Value of Cribriform and Intraductal Carcinoma in Grade Group 2 Prostate Cancer with and without Synchronous Nodal Metastases at Radical Prostatectomy: Results from a Case-Control Matched, Multicenter Study.

Urology pii:S0090-4295(25)00109-8 [Epub ahead of print].

OBJECTIVES: To evaluate the occurrence and the oncological predictive value of cribriform growth and/or intraductal carcinoma (CR/IDC) in patients with ISUP grade group (GG) 2 prostate cancer (PCa) at radical prostatectomy (RP) with and without synchronous nodal metastases in a multicenter, international cohort.

METHODS: We identified 1060 patients who underwent RP with ISUP GG2 PCa at histopathology and a pelvic lymph node dissection from three tertiary referral centers. Of these, 79 (7.4%) had pN1 disease. Case-control matching was performed using the initial prostate-specific antigen (iPSA) value, pT-stage, age, surgical margin status, and referral center as matching variables to compare histopathological characteristics and oncological outcomes between pN1 and pN0 patients. The predictive value of CR/IDC for biochemical recurrence-free survival (BCRFS), defined as the interval between RP and a PSA of ≥0.2 ng/ml, and radiological recurrence-free survival (RRFS), defined as the interval between RP and an RR, was evaluated using Cox regression analysis.

RESULTS: After case-control matching, 106 patients were included (i.e., 53 cases and 53 controls). CR/IDC was significantly more common in pN1 than pN0 RP specimens (100% vs 51%, p<0.001). In pN0 patients, CR/IDC positivity was not associated with BCRFS (hazard ratio [HR]=0.90, 95% CI 0.32-2.55, p=0.842) or RRFS (HR 2.45, 95% CI 0.45-13.34, p=0.299). pN1 CR/IDC-positive PCa was associated with adverse BCRFS (HR=2.93, 95% CI 1.26-6.83, p=0.013) and RRFS (HR=9.19, 95% CI 2.11-40.04, p=0.003) in multivariable Cox regression analysis.

CONCLUSIONS: In ISUP GG2 PCa, CR/IDC strongly correlates with synchronous nodal metastases, the latter being associated with adverse outcomes.

RevDate: 2025-02-08

Huthwelker T, Borca CN, Altamura D, et al (2025)

Microcalcifications in breast cancer tissue studied by X-ray absorption, emission, scattering and diffraction.

Journal of applied crystallography, 58(Pt 1):233-250.

Microcalcifications (MC) are observed in various tissues and in relation to several diseases. For breast cancer, recent studies have reported differences in the nature of the MC and correlations to the degree of malignancy of the neoplasm. Here, investigations of benign, ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) breast MC using X-ray fluorescence, X-ray absorption spectroscopy and wide-angle X-ray scattering are reported. While Mg has been observed in all MC, only for the benign MC has a rim of crystalline whitlockite been identified as a minor crystalline phase in addition to the major hy-droxy-apatite (HAP) one. MC in DCIS and IDC tissue exhibit a higher abundance of a high-crystallinity HAP phase in comparison with the less well ordered MC in the benign tissue. Moreover, the distribution of other trace elements in the MC, such as Na, S, Cl, Sr and Y, is observed. For the quantitative analysis of the elemental maps, the experimentally determined sample thickness in each pixel has been incorporated as an additional parameter in the fitting process to account for sample roughness.

RevDate: 2025-02-06

Palanjian R, Welk B, Myers JB, et al (2025)

Impact of Bladder Management Strategies on Autonomic Dysreflexia Severity in People With Spinal Cord Injuries.

Neurourology and urodynamics [Epub ahead of print].

PURPOSE: We investigated whether severity of autonomic dysreflexia (AD) was associated with more patient-reported bladder and bowel symptoms and compared AD severity by bladder management strategy in people with spinal cord injury (SCI).

METHODS: The Neurogenic Bladder Research Group SCI Registry is a prospective study which evaluated quality of life after SCI. Bladder and bowel symptoms were assessed through Neurogenic Bladder Symptom Score and Neurogenic Bowel Dysfunction score, respectively. AD severity was assessed with the Autonomic Dysreflexia Following Spinal Cord Injury (ADFSCI) instrument. Bladder management was classified as volitional voiding, clean intermittent catheterization (CIC), indwelling catheter (IDC), and surgery (augmentation and diversion).

RESULTS: AD scores were identified for 1473 people. The mean age was 45. Bladder management was CIC in 754 (51%), IDC in 271 (18%), surgery in 195 (13%) and voiding in 259 (18%). On univariate analysis, higher ADFSCI scores occurred with complete injuries (3.1 vs 3.4, p = 0.03), cervical/thoracic injuries (3.8 vs 1.5, p < 0.0001), and chronic pain (3.9 vs 2.9, p = 0.0004). IDC (5.2) and surgery (4.5) had higher ADFSCI scores than CIC (3.0) and volitional voiding (2.8) (p < 0.0001). Sub-analysis showed bladder augmentation had significantly higher ADSCI scores than diversion (4.7 vs 3.7, p = 0.03). On multivariate analysis, level of injury, bladder management, and bowel and bladder symptoms remained associated with worse AD.

CONCLUSION: Level of injury, age, worse bowel and bladder symptoms and bladder management type were associated with higher AD scores. Bladder management with surgery, particularly bladder augment, and IDC had associated greater AD symptoms compared to CIC or voiding.

TRIAL REGISTRATION: clinicaltrials.gov NTC06216081 and HSRP20153564, U.S. National Library of Medicine, wwwcf.nlm.nih.gov.

RevDate: 2025-02-06
CmpDate: 2025-02-06

Lan HF, Gu YD, Song XF, et al (2025)

The value of ultrasound (US)-based radiomics in predicting axillary lymph node metastasis in patients with T1 stage breast invasive ductal carcinoma with negative axillary US results.

Clinical hemorheology and microcirculation, 89(1):137-148.

OBJECTIVES: To evaluate the potential application value of qualitative and quantitative contrast-enhanced ultrasound (CEUS) features for predicting axillary lymph node metastasis in early-stage breast cancer, with special emphasis on area ratio.

METHODS: 146 patients with 146 T1 stage breast cancers were subjected to conventional ultrasound (US) and CEUS before surgeries. Logistic regression analysis was used to identify the associated risk factors and a prediction model was created to predict T1 stage breast IDCs with positive of axillary lymph node metastasis (ALNM). The diagnostic performance of the prediction model was assessed by the analysis of the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy. The value of area ratio, a quantitative CEUS feature, was evaluated.

RESULTS: Logistic regression analysis indicated that taller than wide shape on conventional US, coarse or twist penetrating vessels, and area ratio > 1.93 on CEUS were independent risk factors for IDCs with ALNM-positive (all P < 0.05). Among all risk factors, the area ratio > 1.93 showed the highest AUC (i.e. 0.818). The prediction equation was established as follows: P = 1/1 + Exp∑ [-2.665 + 1.750×(if taller than wide shape) + 1.791×(if coarse or twist penetrating vessels) + 4.372×(if area ratio > 1.93)]. In comparison with US BI-RADS alone, the AUCs of the prediction model for both readers increased significantly (AUC: 0. 919 vs. 0.677 in reader 1, 0.919 vs. 0.707 in reader 2, both P < 0.001).

CONCLUSION: Conventional US and CEUS features, especially the area ratio > 1.93 on CEUS, may be useful in the noninvasive prediction of ALNM-positive in breast IDCs.

RevDate: 2025-02-05

Jean J, Jochelson MS, Moo TA, et al (2025)

Breast Cancer Recurrence After Cryoablation in Patients Who are Poor Surgical Candidates or Who Refuse Surgery.

Journal of vascular and interventional radiology : JVIR pii:S1051-0443(25)00142-3 [Epub ahead of print].

PURPOSE: To evaluate in-breast recurrence rates after cryoablation in patients with primary breast cancer who were poor surgical candidates or refused surgery.

MATERIALS & METHODS: Patients with primary breast cancer who were poor surgical candidates or who refused surgery and were treated with cryoablation at a single academic cancer center between October 2018-June 2023 were retrospectively reviewed. Out of the sixty treated patients, 45 had invasive ductal carcinoma (IDC), 6 patients had invasive lobular carcinoma, 2 patients had multicentric ductal carcinoma in situ (DCIS), and 7 patients had other histology. Tumor size ranged from (0.3-9cm), with a mean of 2.7cm. Recurrence was defined as new tumor or regrowth of residual tumor in the ipsilateral breast.

RESULTS: With a mean follow up of 21 months and median follow up of 9.8 months, there was a recurrence rate of 10% (6/60 patients). Patients in the recurrence group had more poorly differentiated disease than those in the non-recurrence group (66.7% vs. 22.2%, p= 0.038). Tumor size did not differ between non-recurrence and recurrence groups (no recurrence group mean 2.7 ± 2.6cm, recurrence group mean 2.5 ± 1.0cm, p = 0.506). Patients who were treated with palliative intent rather than curative intent were significantly older (79.7 ± 12.2 vs. 72.5 ± 11.3, p = 0.032).

CONCLUSION: Cryoablation can be considered in patients who are poor surgical candidates or who refuse surgery, with a 10% recurrence rate at a mean follow up of 21 months in this retrospective review that included patients with tumors up to 9 cm, unfavorable pathology, and multicentric disease.

RevDate: 2025-02-05

Ciccarelli S, Eugene N, Z Zhang (2025)

Disparities in breast cancer screening and diagnosis: Urban-suburban contrasts in the wake of the COVID-19 pandemic.

Clinical imaging, 120:110419 pii:S0899-7071(25)00019-1 [Epub ahead of print].

PURPOSE: Compare the reduction and recovery of breast cancer screening and diagnostic services in urban versus suburban communities during the COVID-19 pandemic to identify opportunities for advancing equitable breast cancer detection.

METHODS: This retrospective cohort study used the Montage™ data mining system to analyze percent change in the number of screening and diagnostic mammograms, breast biopsies, and breast cancer diagnoses at a single mid-Atlantic institution with urban and suburban sites centered in and around Philadelphia, Pennsylvania from 1/1/2019 to 12/31/2022, with urban-suburban subset comparison from 1/1/2019 to 12/31/2021.

RESULTS: In 2020, screening mammogram volume dropped 23.9 % at urban sites and 1.6 % at suburban sites while diagnostic mammogram volume decreased 26.4 % at urban and 21.4 % at suburban sites. In 2021, screening volume at urban and suburban sites was 2.6 % and 31.0 % greater than pre-pandemic levels, and diagnostic volume was 28.5 % and 16.9 % below pre-pandemic levels. That same year, the proportion of invasive ductal carcinoma at urban sites increased by 26.2 %. In 2022, screening volume at all sites surpassed pre-pandemic levels by 19.5 % while diagnostic volume remained 21.7 % less than pre-pandemic levels.

CONCLUSION: The COVID-19 pandemic disproportionately reduced breast cancer screening and diagnostic services in urban communities, who experienced slower recovery and increased invasive breast cancer in the subsequent year. Throughout our institution, screening mammograms surpassed pre-pandemic levels in 2021 and 2022 while diagnostic services remained below pre-pandemic levels through 2022. Considering these findings, we must improve access to breast cancer screening and diagnosis to mitigate the long-term consequences of the pandemic.

RevDate: 2025-02-05

Shi J, Qi X, Ran Y, et al (2025)

Saliva-acquired pellicle inspired multifunctional gargle with wet adhesion, photodynamic antimicrobial, and In situ remineralization properties for dental caries prevention.

Bioactive materials, 47:212-228.

Dental caries is primarily caused by cariogenic bacteria metabolizing carbohydrates to produce acidic substances that erode the dental hard tissues. Traditional remineralization treatments often have limited efficacy due to their lack of antibacterial activity. According to the Interrupting Dental Caries (IDC) theory, ideal caries-preventive materials should possess both antibacterial and remineralizing properties. Furthermore, effective adhesion to dental surfaces is crucial. Inspired by the wet adhesion properties of the salivary acquired pellicle, we developed a multifunctional gargle named Ce6@PDN-SAP (CP-SAP). This formulation employed peptide dendrimer nanogels (PDN) as a carrier for the photosensitizer Ce6, further functionalized with saliva-acquired peptide (SAP) to confer wet adhesion properties. CP-SAP rapidly adhered to the dental surface and remained effective for extended periods. Upon laser irradiation, Ce6 generated reactive oxygen species (ROS), disrupting bacterial outer membrane integrity, causing protein leakage, and reducing ATP levels, thereby achieving potent antibacterial effects. Following this, PDN and SAP acted as nucleation templates to promote in situ remineralization of demineralized dental hard tissues. In vivo studies using rat models demonstrated that CP-SAP provided significantly superior caries-preventive effects compared to chlorhexidine gargle. In conclusion, CP-SAP, as an innovative approach grounded in the IDC theory, holds great promise for the prevention and treatment of dental caries.

RevDate: 2025-02-05

Ferreira de Lemos P, R Fidalgo Maia (2025)

Serotonin Syndrome With Concomitant Antidepressant and Tramadol: A Case Report.

Cureus, 17(1):e76968.

Serotonin syndrome (SS) is a potentially life-threatening condition that results from the excess of serotonergic activity in the central nervous system. It is classically described as a triad of neuromuscular abnormalities, altered mental status, and autonomic hyperactivity; these are, most often, due to iatrogenic drug interactions or intentional overdose. This case study is about a 58-year-old woman who was being treated with venlafaxine and tramadol due to her past medical history of major depressive disorder and neuropathic pain. These symptoms appeared after a mastectomy, which was performed to treat an invasive ductal carcinoma. The sudden increase of the antidepressant medication and the interaction with another drug that inhibits serotonin reuptake (tramadol) led to tremor, hyperreflexia, diarrhea, tachycardia, hypertension, and fever, meeting Hunter's criteria for diagnosis of serotonergic syndrome. She received supportive care and diazepam, and the offending agents were removed. The signs and symptoms were reverted in less than 24 hours. An increased use of agents affecting the serotonergic system to treat different medical conditions raises the likelihood of a higher prevalence and clinical impact of SS in the future. For this reason, it is crucial to raise awareness of this condition to prevent adverse outcomes.

RevDate: 2025-02-04

Pastorello J, da Silva NAL, Schuch NB, et al (2022)

Gross hematuria secondary to use of carboplatin in neoadjuvant treatment of breast cancer with HER2 overexpression.

BMJ case reports, 15(9):.

Breast cancer is a high prevalent neoplasia in women worldwide, and platinum compounds are widely used to treat it. On rare occasions, macroscopic hematuria associated with carboplatin has been identified. Thus, the present study aims to report a rare case of a female patient diagnosed with invasive ductal carcinoma, which presented hematuria secondary to carboplatin, showing improvement of the condition after 4 days of expectant treatment with clot lavage. Due to the scant description of hematuria secondary to carboplatin in the scientific literature, it is essential to report such case in order to assist and enrich the understanding of this event.

RevDate: 2025-01-31

Rijstenberg LL, Harikumar H, Verhoef EI, et al (2025)

Identification of intraductal-to-invasive spatial transitions in prostate cancer: proposal for a new unifying model on intraductal carcinogenesis.

Histopathology [Epub ahead of print].

AIMS: Intraductal carcinoma (IDC) is an independent pathological parameter for adverse prostate cancer (PCa) outcome. Although most IDC are believed to originate from retrograde spread of established PCa, rare IDC cases may represent precursor lesions. The actual transition areas between intraductal and invasive cancer, however, have not yet been identified. Our objective was to identify intraductal-invasive PCa transitions using 2- and 3-dimensional microscopy.

METHODS AND RESULTS: Seventy-five samples from 46 radical prostatectomies with PCa were immunohistochemically stained for basal cell keratins. In 35 samples, atypical glands that were indistinguishable from invasive adenocarcinoma (IAC) had focal 34BE12-positive basal cells. These IAC-like glands were present adjacent to IDC and prostatic intra-epithelial neoplasia (PIN) in 21 of 45 (46.7%) and 16 of 58 (27.6%) cases, respectively. Whole-mount confocal imaging of immunofluorescent Ker5/18 double-stained and cleared 1-mm-thick intact tissues revealed spatial continuity between IDC, IAC-like glands and IAC with a gradual loss of basal cells. In 24 of 35 (68.6%) samples more than one IAC-like focus (median 3.0) was present.

CONCLUSIONS: We identified areas of spatial transition between PIN, IDC and IAC, characterised by remnant basal cells in IAC-like glands. Based on the coexistence of IDC and PIN, the gradual loss of basal cells in IAC-like glands and IAC-like glands' multifocality, we propose a novel hypothesis on intraductal carcinogenesis, which we term 'repetitive invasion, precursor progression' (RIPP).

RevDate: 2025-02-02

Bistika M, Marangelo A, Ascione F, et al (2024)

The Novel SSTR3 Full Agonist ITF2984 Shows Antitumor Properties against Pancreatic Neuroendocrine Tumors.

Neuroendocrinology pii:000543136 [Epub ahead of print].

BACKGROUND: Somatostatin analogs (SSAs) binding to and activating somatostatin receptors (SSTRs) have been extensively used for the treatment of neuroendocrine tumors (NETs). The currently approved synthetic SSAs have high affinity for SSTR2 (octreotide/lanreotide) or for SSTR2 and SSTR5 (pasireotide). These agents have shown symptom control and antiproliferative effects in subsets of NET patients and this was associated with the expression of the targeted SSTRs. Pancreatic NETs (Pan-NETs) are uncommon tumors with a propensity to metastasize. For unresectable advanced Pan-NETs expressing SSTRs, SSAs are the first-line medical therapy. Pan-NETs express mainly SSTR1, SSTR2, and SSTR3 and thus should respond to agonists targeting SSTR3.

SUMMARY: We evaluated the efficacy of ITF2984, a novel multireceptor agonist with specificity for SSTR3, against Pan-NET cells representative of well-differentiated, functioning tumors, and expressing high levels of SSTR3. The effect of ITF2984 on cell proliferation/viability and on its ability to promote apoptosis and suppress hormone secretion was evaluated in 2D and 3D organotypic culture systems. Pasireotide was tested in parallel for comparative purposes.

KEY MESSAGE: We found that ITF2984 is as effective as pasireotide at inhibiting both proliferation/viability and hormone secretion, as well as at inducing apoptosis of Pan-NET cells grown as both 2D monolayers and 3D spheroids. High-dose ITF2984 elicits structural alterations in Pan-NET 3D spheroids compatible with cell death more effectively than pasireotide. Altogether, ITF2984 may represent a useful alternative to pasireotide for the medical treatment of Pan-NETs and other tumors with elevated SSTR3 expression.

RevDate: 2025-01-29

Mooshage CM, Tsilingiris D, Schimpfle L, et al (2025)

Intradermal Advanced Glycation End-products Relate to Reduced Sciatic Nerve Structural Integrity in Type 2 Diabetes.

Clinical neuroradiology [Epub ahead of print].

BACKGROUND: Cardiovascular risk management is beneficial, but stringent glycemic control does not prevent the progression of distal sensorimotor polyneuropathy (DSPN). Persistent hyperglycemia-induced alterations and cardiovascular factors may contribute to diabetes-associated nerve damage. This study aimed to evaluate the correlation between skin auto-fluorescence (sAF), an indicator of dermal advanced glycation end-product (AGE) accumulations, cardiovascular risk, and changes in peripheral nerve integrity.

METHODS: Sixty-two individuals with type 2 diabetes (T2D) (20 women and 42 men), including 29 diagnosed with DSPN (7 women and 22 men), and 10 healthy controls (HC) underwent diffusion tensor MR imaging of the sciatic nerve to assess fractional anisotropy (FA), an indicator of nerve structural integrity. sAF measurements were combined with clinical, serological, and electrophysiological evaluations. Arterial stiffness was assessed via pulse wave velocity (PWV).

RESULTS: sAF (HC 2.1 ± 0.25 AU, nDSPN 2.3 ± 0.47, DSPN 2.6 ± 0.43; p = 0.005) was higher in individuals with DSPN compared to HC (p = 0.010) and individuals without DSPN (p = 0.035). Within the group of T2D FA correlated negatively with sAF (r = -0.49, p < 0.001), PWV (r = -0.40, p = 0.009) and high-sensitivity troponin T (hsTNT), a marker of microvascular damage (r = -0.39, p < 0.001). In DSPN, sAF correlated positively with hsTNT (r = 0.58, p = 0.005) and with PWV (r = 0.52, p = 0.007), the sciatic nerve's FA correlated negatively with PWV (r = -0.47, p = 0.010).

CONCLUSIONS: This study is the first to show close correlations between reduced peripheral nerve integrity and both intradermal AGE deposition and arterial stiffness in individuals with T2D. These findings highlight a mechanistic link between glycation-related vascular injury and neuronal damage emphasizing the importance of cardiovascular risk management in preventing DSPN.

RevDate: 2025-01-29
CmpDate: 2025-01-29

Uppal R, Saeed U, Khattak ME, et al (2025)

Epidemiological analysis of Leishmaniasis prevalence in Pakistan during 2016-2023.

Brazilian journal of biology = Revista brasleira de biologia, 84:e284742 pii:S1519-69842024000101357.

Leishmaniasis, caused by the Leishmania parasite, remains a persistent public health challenge in Pakistan. Despite control efforts, the disease prevalence continues to rise, particularly among pediatric populations. Understanding prevalence patterns and transmission dynamics is critical for effective control strategies. This study aims to analyze leishmaniasis prevalence data from January 2016 to July 2023 in Pakistan. Specific objectives include assessing temporal trends, demographic patterns, and geographical hotspots of transmission, while emphasizing the need for enhanced surveillance and research for targeted interventions. Retrospective analysis was conducted on leishmaniasis prevalence data collected from multiple healthcare facilities across Pakistan. Data included results from diagnostic tests on suspected cases, encompassing both pediatric and adult patients. Descriptive statistical analysis was employed to evaluate prevalence rates, demographic characteristics, and geographical distribution of positive cases. Analysis revealed an increasing trend in leishmaniasis prevalence over the study period. Initially, from 2016 to 2020, a positivity rate of 27% was observed exclusively among pediatric patients in Islamabad, with no adult cases. Subsequently, from 2017 to 2022, the positivity rate increased to 42%, affecting both pediatric and adult populations in Islamabad, Rawalpindi, and Swat. Notably, between July 2022 and July 2023, the positivity rate surged to 56%, primarily impacting adult males in the identified hotspots. The study provides evidence of rising leishmaniasis prevalence in Pakistan, particularly among pediatric patients. Identified hotspots suggest localized transmission, warranting targeted interventions. Enhanced surveillance and research efforts are crucial for understanding disease dynamics and implementing effective control measures. Priority should be given to vulnerable populations and high-burden regions to mitigate leishmaniasis impact in Pakistan.

RevDate: 2025-01-29
CmpDate: 2025-01-29

Piracha ZZ, Saeed U, Uppal R, et al (2025)

Prevalence and clinical profile of hepatitis C virus infections in multitransfused thalassemic patients in the capital twin cities of Pakistan.

Brazilian journal of biology = Revista brasleira de biologia, 84:e284453 pii:S1519-69842024000101356.

Hepatitis C virus (HCV) presents a significant global health concern, affecting 3.3% of the world's population. The primary mode of HCV transmission is through blood and blood products. Patients with beta thalassemia, who rely on lifelong blood transfusions, are particularly vulnerable to HCV infections. This study aimed to assess the prevalence of hepatitis C virus infections among multitransfused thalassemic patients in the twin cities of Pakistan's capital. The clinical research, involving the enrollment of 262 multitransfused beta thalassemic patients residing in the capital twin cities of Pakistan. The investigation encompassed the evaluation of hepatitis C virus presence, alanine aminotransferase (ALT) levels, serum creatinine, hepatomegaly, splenomegaly, and the occurrence of splenectomy. The overall prevalence of Hepatitis C virus infections was notably high at 55.73%. This was particularly pronounced among patients aged 20 years and older, with a 100% infection rate. In HCV-positive thalassemic patients, the average ALT level was observed to be 98 U/L, while average creatinine values stood at 0.39 mg/dL. Additionally, hepatomegaly was prevalent in 82.20% of HCV-positive thalassemic patients, featuring an average liver size increase of 4.33 cm. Splenomegaly was evident in 67.12% of HCV-positive thalassemic patients, with an average spleen size augmentation of 4.46 cm. Splenectomy was identified in 15.75% of cases. The incidence of HCV infections in the thalassemic population of Pakistan is alarmingly high. Furthermore, the risk of contracting HCV infections escalates with the advancing age of thalassemic patients. Elevated ALT levels and hepatomegaly were pervasive among the majority of HCV-positive thalassemic patients. Consequently, there is a compelling need for rigorous screening of blood products prior to transfusion to mitigate the future burden of HCV in Pakistan.

RevDate: 2025-01-29
CmpDate: 2025-01-29

Saeed U, Uppal R, Najmi MH, et al (2025)

Cutting-edge: bionanomaterial solutions in the battle against Severe Acute Respiratory Syndrome Coronavirus 2.

Brazilian journal of biology = Revista brasleira de biologia, 84:e279564 pii:S1519-69842024000101355.

Amidst the ongoing COVID-19 pandemic, the imperative of our time resides in crafting stratagems of utmost precision to confront the relentless SARS-CoV-2 and quell its inexorable proliferation. A paradigm-shifting weapon in this battle lies in the realm of nanoparticles, where the amalgamation of cutting-edge nanochemistry begets a cornucopia of inventive techniques and methodologies designed to thwart the advances of this pernicious pathogen. Nanochemistry, an artful fusion of chemistry and nanoscience, provides a fertile landscape for researchers to craft innovative shields against infection. Within this intricate tapestry, nanoparticles emerge as champions, offering multifaceted solutions encompassing detection, treatment, prevention, and the precise targeting of SARS-CoV-2 incursions. Noteworthy among these innovations, the Silver (Ag) Respi-strips command our attention. These strips stand as exemplars of ingenuity, illuminating the path to swift and precise test detection. Moreover, the integration of Ag-based textile materials into the arsenal against viral propagation opens a promising avenue to curtail the virus's insidious reach. The indomitable force of iron nanoparticles, duly sanctioned by the esteemed FDA, shines as a beacon of hope in the treatment of infection. Their interaction with the glycoprotein spikes of the virus unleashes an inhibitory action of profound consequence. Meanwhile, the domain of diagnostics has been revolutionized by the advent of Magnetic Nanoparticles (MNPs). Their role in automating nucleic acid extraction and purification has proven indispensable, particularly in the diagnostic milieu of SARS-CoV-2. These MNPs wield a magnetic allure, streamlining diagnostic processes with unmatched precision. In this realm of nano-wonders, Gold nanoparticles rise as formidable sentinels, poised at the intersection of versatility and innovation. Their functionalization via a kaleidoscope of functional groups or in concert with antiviral drug combinations augments their prowess. These microscopic champions effectively hinder viral ingress into host cells and orchestrate the controlled release of antiviral agents, casting a profound influence on the course of viral infections. The pandemic landscape has borne witness to the ascendancy of nanotechnology, unveiling an arsenal of nanoparticle-based strategies that promise to defy, detect, treat, and ultimately vanquish SARS-CoV-2. The future beckons, and within the infinitesimal realm of nanoparticles, we find the promise of a brighter, healthier tomorrow.

RevDate: 2025-01-29

Pistolese CA, Giuliano FD, Cerocchi M, et al (2025)

Radiological images of an advanced invasive carcinoma with mucinous aspects: A case report.

Radiology case reports, 20(3):1776-1783.

Mucinous carcinoma of the breast, also known as colloid carcinoma, is an uncommon type of differentiated adenocarcinoma, representing only 2% of all invasive breast carcinomas. It usually occurs in women ≥ 60 years of age. Mucinous carcinoma is characterized by clusters of epithelial tumour cells suspended in pools of extracellular mucin and is further divided in 2 subgroups, pure and mixed. Compared to invasive ductal carcinoma, mucinous carcinoma has a better prognosis, being characterized by a lower incidence of nodal involvement and a more favorable histological grade, with low proliferative activity and high expression of hormone receptors. Overall 10-year survival is estimated to be more than 90%. We present a case of a 57-year-old female patient who presented a palpable mass in the right breast for at least 2 years. On examination the whole breast appeared swollen, congestive and painless to palpation. Breast ultrasound, breast MRI and tru-cut biopsy were performed and suggested an advanced infiltrated carcinoma with mucinous aspects. Immunohistochemistry study demonstrated ER positivity (95%), PR low (5%), HER-2-Neu negativity (score 0) and proliferative index (Ki67) of 20%, determining a Luminal B-like (HER 2-negative) subtype. The patient was then candidated to mastectomy surgery and breast reconstruction with DIEP flap. Axillary lymp-nodes were sampled surgically.

RevDate: 2025-01-28

Ma F, Wang H, Tzachor A, et al (2025)

The disparities and development trajectories of nations in achieving the sustainable development goals.

Nature communications, 16(1):1107.

The Sustainable Development Goals (SDGs) provide a comprehensive framework for societal progress and planetary health. However, it remains unclear whether universal patterns exist in how nations pursue these goals and whether key development areas are being overlooked. Here, we apply the product space methodology, widely used in development economics, to construct an 'SDG space of nations'. The SDG space models the relative performance and specialization patterns of 166 countries across 96 SDG indicators from 2000 to 2022. Our SDG space reveals a polarized global landscape, characterized by distinct groups of nations, each specializing in specific development indicators. Furthermore, we find that as countries improve their overall SDG scores, they tend to modify their sustainable development trajectories, pursuing different development objectives. Additionally, we identify orphaned SDG indicators - areas where certain country groups remain under-specialized. These patterns, and the SDG space more broadly, provide a high-resolution tool to understand and evaluate the progress and disparities of countries towards achieving the SDGs.

RevDate: 2025-01-28

Truda G, Howells S, Berry M, et al (2024)

Risk Factors for Positive Resection Margins Following Breast-Conserving Surgery.

Cureus, 16(12):e76406.

Background The incidence of margin re-excision following breast conserving surgery (BCS) is a quality measure in the National Health Service. The threshold is less than 20% of all BCS procedures. Despite three decades of studies and a wealth of literature identifying multiple factors associated with increased risk for margin involvement, an accepted threshold rate affecting one in five procedures remains high. Aim The aim of the study was to identify adverse features that continue to compromise successful margin clearance despite the recognition of risk factors and the implementation of strategies designed to minimise those risks. Methods All margin re-excisions following BCS for invasive breast carcinoma and ductal carcinoma in situ (DCIS) performed from October 2013 to September 2018 were retrieved from the database of a single institution. A total of 1379 patients underwent BCS during the period considered, 194 of which needed margin re-excision. Radiological investigations and histopathology reports for each patient were retrieved. Lesion size and focality on mammogram, ultrasound (US) scan, and magnetic resonance imaging (MRI), and histopathologic tumour characteristics were recorded and analysed. Results The overall re-excision rate was 14.06% (194/1379 patients). Margin re-excisions cleared 69% (134/194) of wide local excision cavities that had at least one involved margin. 53% (103/194) of patients had no further disease after one attempt at re-excision and 15.9% (31/of 194) had further disease, which was cleared after re-excision. Another 15.9% (31/194) had disease within the shave with involved margins. In this sub-group the presence of DCIS at the new resection margin accounted for 90.3% (28/31) of cases, 3% (1/31) were invasive ductal carcinoma (IDC) and 6% (2/31) were unrecorded. In the sub-group of patients who had an excised margin with pathology and a new clear margin (15.9% of all re-excisions), DCIS was found in 61% (19/31) of cases, IDC in 12.9% (4/31), invasive lobular carcinoma (ILC) in 6% (2/31) of cases, lobular neoplasia (LN) in 12.9% (4/31), mixed IDC and DCIS in 6% (2/31)of cases. The correlation between imaging size and actual histopathological size has shown a statistically significant discrepancy in this cohort. The median size on histology was 22 mm, compared to a median size of 16 mm on mammography, 14 mm on ultrasound, and 17 mm on MRI. Conclusion According to our cohort of patients, the most consistent factor associated with a re-excision was the presence of DCIS at the resection margin, whether pure DCIS or IDC admixed with DCIS. The comparison between tumour size on imaging and final histopathological size revealed the best correlation with mammogram followed by US. The weakest correlation was with MRI.

RevDate: 2025-01-26

Metzger Filho O, Cardoso F, Poncet C, et al (2025)

Survival outcomes for patients with invasive lobular cancer by MammaPrint: Results from the MINDACT phase III trial.

European journal of cancer (Oxford, England : 1990), 217:115222 pii:S0959-8049(25)00003-6 [Epub ahead of print].

BACKGROUND: Evaluation of the prognostic performance and clinical utility of the MammaPrint 70-gene signature in early-stage invasive lobular carcinoma (ILC) for whom such analyses in a randomized trial is awaited.

PATIENTS AND METHODS: Exploratory subgroup analysis of MINDACT trial patients with centrally assessed histology (n = 5929) with invasive breast cancer of no-special-type (NST), or pure ILC. In the trial patients were categorized based on the 70-gene signature for genomic risk and modified Adjuvant!Online for clinical risk. Survival outcomes at 8.7 years median follow-up by 70-gene signature were compared between NST and ILC for Distant Metastasis-Free Survival (DMFS), Disease-Free Survival (DFS) and Overall Survival (OS).

RESULTS: 5313 patients were ILC (n = 487) or NST (n = 4826). ILC was further classified into classic ILC (n = 255) or ILC variants (n = 232). The 70-gene signature classified 16.2 % of ILC and 39.1 % of NST as genomic high-risk (gH). Survival outcomes for ILC vs. NST revealed similar estimates according to genomic risk overall and across subsets. The 70-gene signature classified 10.2 % of classic ILC and 22.8 % of ILC variants as gH. 5-yr DFS estimates for ILC variants 88.4 % (95 %CI: 83.1-92.1) was inferior to classic ILC 93.0 % (95 %CI: 88.7-95.7).

CONCLUSIONS: Sixteen percent of ILC were classified high genomic risk by the 70-gene signature, with unfavorable survival outcomes. Survival estimates were similar for patients with ILC and NST classified as either low- or high-genomic risk, suggesting that the 70-gene signature also has prognostic value in ILC and may be a clinically useful tool for adjuvant treatment decision-making in ILC.

RevDate: 2025-01-25

Abello Polo V, Sossa C, Boquimpani C, et al (2024)

Real World Evidence From 2 Decades of First-Line TKI Therapy in Chronic Myeloid Leukemia (CML): Insights From ACHO's RENEHOC Registry.

Clinical lymphoma, myeloma & leukemia pii:S2152-2650(24)02464-9 [Epub ahead of print].

BACKGROUND: Chronic myeloid leukemia (CML) treatment has significantly evolved with the introduction of tyrosine kinase inhibitors. However, access to these treatments and outcomes vary globally. This study examines 2 decades of CML management in Colombia using the RENEHOC registry, focusing on TKI efficacy, safety, and healthcare system challenges.

METHODS: We performed a descriptive analysis of the sociodemographic and clinical characteristics of 994 CML patients from the RENEHOC cohort in Colombia, who were treated over the past 20 years. Trends in first-line TKI use were assessed, and Kaplan-Meier survival curves were used to estimate EFS and OS. The log-rank test was used to compare survival curves between different first-line TKIs.

RESULTS: The analysis shows trends in the use of first-line TKIs over a 20-year period in Colombia, where, as in other countries, the use of second-generation TKIs in the first-line setting is gradually increasing. Despite the difficulties of the Colombian healthcare system, the results in terms of OS are excellent regardless of the first-line TKI; however, patients treated with imatinib switched lines significantly more often than those treated with second-generation TKIs (imatinib 58.7%, nilotinib 19.5%, dasatinib 29.3%). The median duration of treatment was significantly shorter with imatinib compared to dasatinib and nilotinib (4.08, 12.75 and not reached, respectively). Intolerance was the most common reason for switching in this cohort of patients. The median observation time for OS was 64.89 months (SD 60.15), with survival rates of 99.4% at 1 year, 97.7% at 3 years and 96.6% at 5 years.

CONCLUSIONS: The results of this analysis show excellent results in terms of OS for patients with CML treated in Colombia over the last 20 years, despite the difficulties inherent in the health system. Patients treated with first-line imatinib had more frequent line changes. In general, intolerance was the most common reason for switching lines. Despite its retrospective nature, this study allows us to outline how treatment patterns in the country have changed over time. Continued efforts to include more centers and patients in prospective studies are essential to better understand the long-term effects of treatment and to improve adherence to guideline recommendations in clinical practice.

RevDate: 2025-01-25

Taylor H, Spruill L, Jensen-Smith H, et al (2025)

Spatial Localization of Collagen Hydroxylated Proline Site Variation as an Ancestral Trait in the Breast Cancer Microenvironment.

Matrix biology : journal of the International Society for Matrix Biology pii:S0945-053X(25)00012-5 [Epub ahead of print].

Collagen stroma interactions within the extracellular microenvironment of breast tissue play a significant role in breast cancer, including risk, progression, and outcomes. Hydroxylation of proline (HYP) is a common post-translational modification directly linked to breast cancer survival and progression. Changes in HYP status lead to alterations in epithelial cell signaling, extracellular matrix remodeling, and immune cell recruitment. In the present study, we test the hypothesis that the breast cancer microenvironment presents unique PTMs of collagen, which form bioactive domains at these sites that are associated with spatial histopathological characteristics and influence breast epithelial cell signaling. Mass spectrometry imaging proteomics targeting collagens were paired with comprehensive proteomic methods to identify novel breast cancer-related collagen domains based on spatial localization and regulation in 260 breast tissue samples. As ancestry plays a significant role in breast cancer outcomes, these methods were performed on ancestry diverse breast cancer tissues. Lumpectomies from the Cancer Genome Atlas (TCGA; n=10) reported increased levels of prolyl 4-hydroxylase subunit alpha-3 (P4HA3) accompanied by spatial regulation of fibrillar collagen protein sequences. A concise set of triple negative breast cancer lumpectomies (n=10) showed spatial regulation of specific domain sites from collagen alpha-1(I) chain. Tissue microarrays identified proteomic alterations around post-translationally modified collagen sites in healthy breast (n=81) and patient matched normal adjacent (NAT; n=76) and invasive ductal carcinoma (n=83). A collagen alpha-1(I) chain domain encompassing amino acids 506-514 with site-specific proline hydroxylation reported significant alteration between patient matched normal adjacent tissue and invasive breast cancer. Functional testing of domain 506-514 on breast cancer epithelial cells showed proliferation, chemotaxis and cell signaling response dependent on site localization of proline hydroxylation within domain 506-514 variants. These findings support site localized collagen HYP forms novel bioactive domains that are spatially distributed within the breast cancer microenvironment and may play a role in ancestral traits of breast cancer.

RevDate: 2025-01-25

Mun HS, HY Oh (2024)

Analysis of Clinically Symptomatic Patients to Differentiate Inflammatory Breast Cancer from Mastitis in Asian Women.

Life (Basel, Switzerland), 15(1): pii:life15010005.

PURPOSE: To differentiate inflammatory breast cancer (IBC) from mastitis in Asian women presenting with symptoms of inflammation.

METHODS: Between January 2012 and June 2024, 101 Asian women with symptoms of inflammation underwent breast ultrasound (US). Clinical and demographic data were extracted from patients' medical records. US analysis assessed lesion bilaterality, location, type, size, internal changes, and lymph node status. Patients with suspicious findings had US-guided biopsies, and pathology reports were reviewed for tumor histology and immunohistochemical markers. Logistic regression was used to determine odds ratios.

RESULTS: Of the 101 participants, 14 (13.9%) were diagnosed with IBC and 87 (86.1%) were diagnosed with mastitis. Patients with IBC were significantly older (46.4 vs. 38.4 years, p = 0.020) and showed a higher prevalence of postmenopausal status (57.1% vs. 12.6%, p < 0.0001). These patients experienced a longer symptom onset duration (37.7 vs. 12.7 days, p = 0.002) and more frequent localized symptoms like swelling (50.0% vs. 13.8%, p = 0.004). US findings showed that 21.4% of IBC lesions involved the entire breast, compared to only 1.1% in patients with mastitis (p = 0.001). Biopsy results revealed that invasive ductal carcinoma was the most common malignancy (78.6%). Logistic regression identified symptom onset duration (adjusted odds ratio (OR) 1.07, p = 0.014) and swelling (adjusted OR 15.24, p = 0.016) as significant predictors of IBC.

CONCLUSION: In Asian women, age, menopausal status, symptom onset duration, and swelling are effective in differentiating IBC from mastitis. Logistic regression confirmed that symptom onset duration and swelling are significant predictors of IBC, with US findings indicating larger lesion sizes and more frequent whole-breast involvement.

RevDate: 2025-01-25

Iannotti FA (2024)

I. IDC Key-note Lecture: Influence of gut microbiome in Duchenne muscular dystrophy.

Journal of stem cells & regenerative medicine, 20(2):56-57.

RevDate: 2025-01-24

Xavier J, Pham CT, Cheah H, et al (2022)

Bladder injury during laparoscopic appendectomy: Detection, management, and learning point for surgical trainees.

Surgery in practice and science, 9:100075.

BACKGROUND: Laparoscopic appendectomy is one of the most common emergency surgeries. There is a paucity in the literature regarding the incidence and management of iatrogenic bladder injuries. We reviewed a series of iatrogenic bladder injuries during laparoscopic appendectomy to determine incidence, preventable risk factors and management.

METHODS: We performed a retrospective review of laparoscopic appendectomy at two large regional teaching hospitals over a five-year period from February 2014 to February 2019. The outcomes measured included intra-operative data, such as type of port used and surgeon experience, incidence of iatrogenic bladder injury, mechanism and time of bladder injury recognition, management and clinical outcome.

RESULTS: A total of 1147 patients underwent laparoscopic appendectomy. Two iatrogenic bladder injuries secondary to port placement were identified (0.17%). Both procedures were performed after-hours by surgical trainees. There was no previous history of abdominal surgery. Neither patient had an indwelling catheter (IDC) during the procedure. There were no other visceral or major vascular injuries. Both bladder injuries were identified in the early post-operative period. One case was managed conservatively, whilst the other required laparoscopic repair of the bladder perforation.

CONCLUSION: Bladder injury should be suspected in patients with abdominal pain, elevated creatinine and anuria following laparoscopic surgery. Although iatrogenic bladder injury during laparoscopic appendectomy is rare, it has the potential for considerable patient morbidity. Therefore, adequate laparoscopic supervision and specific counselling on port access injuries for surgical trainees, adequate bladder decompression with an IDC, and early detection and management guided by the location of injury are essential.

RevDate: 2025-01-22
CmpDate: 2025-01-22

Nishida H, Kato A, Kaimori R, et al (2025)

Relationship between androgen receptor and androgen receptor-related protein expression in breast cancers focusing on morphologically identified carcinoma with apocrine differentiation.

Scientific reports, 15(1):2892.

Breast cancer (BC) is classified based on the expression of histopathological markers, namely, estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2). Carcinomas with apocrine differentiation (CAD) are classified based on morphology. Androgen receptor (AR) is highly expressed in CAD; however, no study has comprehensively examined AR-related proteins in CAD. Therefore, we examined the expression of AR-related proteins and AR, compared protein expression patterns between morphologically identified CAD and other BC subtypes, and investigated CAD characteristics. We performed immunohistochemistry for AR and various AR-related proteins in 66 invasive ductal carcinoma (32 ER+/PgR+/HER2-, 8 ER+/PgR+/HER2+, 12 ER-/PgR-/HER2+, and 14 ER-/PgR-/HER2- [triple-negative breast cancer)), 21 invasive lobular carcinoma, and 27 CAD cases. In the CAD group, all cases were AR-positive; some AR-related proteins were highly expressed. Nuclear phosphorylated-mammalian target of rapamycin was highly expressed in CAD cases compared with that in other BC groups, with a 33.3% sensitivity and 97.7% specificity. AR-expressing CAD cases exhibited high expression of other AR-related proteins. Specifically, the combination of AR+, GCDFP15+, and ER - or AR+, FOXA1+, and ER - may be useful for the diagnosis and treatment of AR-positive BC and CAD. These results may assist in androgen-related molecular targeted therapy research.

RevDate: 2025-01-22
CmpDate: 2025-01-22

Bergqvist M, Lässer C, Crescitelli R, et al (2025)

A Non-Centrifugation Method to Concentrate and Purify Extracellular Vesicles Using Superabsorbent Polymer Followed by Size Exclusion Chromatography.

Journal of extracellular vesicles, 14(1):e70037.

Extracellular vesicles (EVs) can be isolated and purified from cell cultures and biofluids using different methodologies. Here, we explored a novel EV isolation approach by combining superabsorbent polymers (SAP) in a dialysis membrane with size exclusion chromatography (SEC) to achieve high concentration and purity of EVs without the use of ultracentrifugation (UC). Suspension HEK293 cells transfected with CD63 coupled with Thermo Luciferase were used to quantify the EV yield and purity. The 500 mL conditioned medium volume was initially reduced by pressure ultrafiltration, followed by UC, SAP or a centrifugal filter unit (CFU). Using either of these methods, the EVs were concentrated to a final volume of approximately 1 mL, with retained functionality. The yield, quantified by luciferase activity, was highest with UC (70%-80%), followed by SAP (60%-70%) and CFU (50%-60%). Further purification of the EVs was performed by iodixanol density cushion (IDC) or SEC (Sepharose CL-2B or 6B, in either 10 or 20 mL columns). Although the IDC and Sepharose CL-2B (10 mL) achieved the highest yields, the purity was slightly higher (30%) with IDC. In conclusion, combining SAP concentration with CL-2B SEC is an alternative and efficient way to isolate EVs without using UC.

RevDate: 2025-01-22

Watanabe R, Miura N, Kurata M, et al (2024)

Genetic Analysis of Intraductal Carcinoma of the Prostate Detected in High-Grade Prostatic Intraepithelial Neoplasia Cases.

Cureus, 16(12):e76165.

Background The accurate diagnosis of intraductal carcinoma of the prostate (IDC-P) is occasionally challenging due to the similarity in pathological morphology between IDC-P and high-grade prostatic intraepithelial neoplasia (HGPIN). In this report, we reviewed the pathology of cases previously diagnosed as HGPIN to search for IDC-P cases effectively. In addition, we examined whether those cases had genetic abnormalities. Methods We reviewed 98 patients with HGPIN who underwent prostatectomy at our hospital between 2011 and 2021. They were reviewed by three pathologists to search for IDC-P findings by adding immunostaining for basement membrane markers. Genetic testing of prostatectomy specimens was performed to identify the presence of gene mutations. Results The typical IDC-P was diagnosed in two of the 98 patients. The Gleason score of background prostate cancer (PCa) was 4+5 and 4+4. Genetic testing revealed several mutations in DNA repair-related genes, such as CHEK2, FANCC, TOE1, RECQL, USG2A, and PRPF31. The pathological significance of these mutations has conflicting interpretations, as referenced in the ClinVar. Conclusions IDC-P cases can be identified from past HGPIN cases, and cases with genetic abnormalities of conflicting pathological significance can be efficiently detected. Accurate diagnosis of IDC-P enables early intervention with precision medicine for PCa. It is useful to pay attention to HGPIN cases to avoid missing true IDC-P.

RevDate: 2025-01-22

Zhao X (2025)

Breast Suspicious Microcalcifications on Contrast-Enhanced Mammograms: Practice and Reflection.

International journal of general medicine, 18:273-280.

PURPOSE: To evaluate the use of contrast enhanced mammography (CEM) in suspicious microcalcifications and to discuss strategies to cope with its diagnostic limitations.

METHODS: We retrospectively evaluated patients with suspicious calcifications who underwent CEM at our institution. We collected and analyzed morphological findings, enhancement patterns and pathological findings of suspicious microcalcifications on CEM. A small proportion of these cases underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). The enhancement patterns of CEM in this study were classified into three categories: enhancement, no enhancement, and indeterminate. CEM imaging was independently analyzed by two breast imaging specialists.

RESULTS: A total of 44 patients with 46 lesions were collected from January 2022 to July 2024. Overall, 20 cases (43.5%) microcalcifications showed enhancement on CEM; 23 (50.0%) showed no enhancement; and 3 (6.5%) were indeterminate. Of the 20 enhancement cases, mass enhancement was seen in 9 (45%), and non-mass enhancement (NME) in 11 (55%). DCE-MRI was performed in 13 cases. One case of invasive ductal carcinoma (IDC) showed enhancement on MRI but was indeterminate on CEM due to the masking effect of background parenchymal enhancement (BPE), and one case of ductal carcinoma in situ (DCIS) lacked enhancement on CEM but had significant enhancement on MRI.

CONCLUSION: CEM provides additional information on the enhancement associated with breast suspicious microcalcifications. It is not perfect for diagnosis and strategies are needed to cope with its limitations.

RevDate: 2025-01-21

Prasad SL, A Gudipalli (2025)

An effective range estimation and state-of-charge to mitigate range anxiety in electric vehicles.

Heliyon, 11(1):e41494 pii:S2405-8440(24)17525-1.

This article presents a performance investigation of the range and state of electric charge vehicles based on different drive cycles and analyzed. Range anxiety is the major concern in electric vehicles globally. To mitigate the range anxiety issue by reducing the energy consumption in electric vehicles further reduces the range-related problem, and the state of charge reduces the demand for driver's power. The drive cycles predict, optimize, and simulate the performance range of Ev's real-world driving conditions. This research thoroughly focuses on the performance range of electric vehicles incorporated with the state of charge based on various standard drive cycles. A drive cycle plays a vital role in estimating energy consumption (EC) per km. There are many standard drive cycles World Wide Harmonized Light Vehicles Test Procedure (WLTP Class-3), the New European Drive Cycle (NEDC), the Modified Indian Drive Cycle (MIDC), the Indian Drive Cycle (IDC) used to investigate and evaluate Electric vehicle (EVs) performance range and state of charge (SoC). Range obtained from above drive WLTP Class-3, NEDC, MIDC, and IDC drive cycles 135.1123.8115.7 and 101.5 km, respectively. Due to improved road conditions, the WLTP Class-3 drive cycle offers more than the others. Due to road conditions, the IDC drive cycle offers a shorter range of 101.5 km.

RevDate: 2025-01-20
CmpDate: 2025-01-21

Cao F, Li Q, Xiong T, et al (2025)

Prognostic value of intraductal carcinoma subtypes and postoperative radiotherapy for localized prostate cancer.

BMC urology, 25(1):10.

BACKGROUND: Intraductal carcinoma of the prostate cancer (IDC-P), as a specific pathological type in prostate cancer which usually implies a poor prognosis. IDC-P morphology can be divided into two subtypes: Pattern 1, sieve like or loose cribriform structures; Pattern 2, solid or dense cribriform structures. The purpose of the study is to identify the impact of IDC-P and its subtypes on the prognosis of patients undergoing post-operative radiotherapy (PORT) after radical prostatectomy (RP) due to localized prostate cancer(PCa).

METHODS: We performed a retrospective study of patients with localized PCa treated by RP followed by PORT or not. Patients with localized PCa who underwent RP from August 2013 to December 2020 were included in this study.

INCLUSION CRITERIA: post-operative PSA dropped to less than 0.1 ng/ml after RP, had at least 1 poor prognostic risk factor (including high Gleason's grouping; positive surgical margins; seminal vesicle invasion; extraprostatic extension; and lympho-vascular invasion), and were eligible for adjuvant radiotherapy.; In this study, patients who underwent salvage radiotherapy after RP due to biochemical recurrence (two consecutive PSA > 0.2 ng/ml) were also included, but not patients with persistent postoperative PSA > 0.1 ng/ml.

EXCLUSION CRITERIA: patients using other types of therapy prior to biochemical recurrence. Screening cases with pathological results of intraductal carcinoma, subtyping was completed by a pathologist, grouped by intraductal carcinoma (+/-; pattern 1/ 2) and treatment regimen (RP + PORT / RP only), Kaplan-Meier curves were plotted based on the time to biochemical recurrence-free and overall survival of the patients, and Cox regression analyses were performed. Finally, based on the results of Cox regression analysis, we initially predicted the probability of biochemical recurrence and death of the patients by plotting the nomogram.

RESULTS: A total of 139 patients were included in this study with a median follow-up of 61.5 months. K-M curves showed that patients with "IDC-P (+) RP only" had the worst prognosis; patients with IDC-P could have a survival benefit after receiving PORT; whereas patients with non-intraductal carcinoma had a better prognosis than the above patients with or without PORT. In addition, patients with IDC-P(+) pattern 2 were more likely to experience biochemical recurrence and death. Multivariate Cox regression analysis showed that pattern 2 was a risk factor for biochemical recurrence and death. Other BCR-related risk factors in the research: Gleason grading group 5 (HR = 3.343, 95% CI: 1.616-6.916, P = 0.001), PM (HR = 2.124, 95% CI: 1.044-4.320,P = 0.038) and PORT (HR = 0.266, 95%CI: 0.109-0.647, P = 0.004). Other OS-related risk factors in the research: Grading group 5 (HR = 3.642, 95%CI:1.475-8.991, P = 0.005), SVI (HR = 2.522, 95% CI: 1.118-5.691, P = 0.026) and PORT (HR = 0.319, 95%CI: 0.107-0.949, P = 0.040).

CONCLUSION: Patients suffering from localized prostate cancer with IDC-P(+), especially IDC-P pattern 2, are more susceptible to biochemical recurrence and death after radical prostatectomy. While postoperative radiotherapy can alleviate the negative prognostic impact from IDC-P. It is implied that IDC-P can also be an indicator to be considered in PORT decision making to some extent.

RevDate: 2025-01-20

Mansour A, Ben-David BM, Sasson A, et al (2025)

Association between oral feeding versus enteral feeding and cerumen impaction in older hospitalized adults: A retrospective cohort study.

JPEN. Journal of parenteral and enteral nutrition [Epub ahead of print].

BACKGROUND: Chewing involves jaw movements that propel cerumen along the ear canal. This mechanism may be reduced in dysphagia, especially for older individuals who are enterally fed. Those patients may be at a higher risk for cerumen impaction and may require longer hospital stays. Examining the relationship between diet type, cerumen impaction, and hospital stay duration was the focus of the present study.

METHODS: We performed a retrospective cohort study (not registered) among 114 hospitalized older adults. Data were collected on diet type: (1) oral feeding (individuals fed a solid diet or a pureed diet) or (2) enteral feeding (individuals fed via a feeding tube). The results of an otoscopy that quantified cerumen were recorded, as well as hospital stay duration.

RESULTS: In a mediation analysis, a hospital stay of >1 month was associated with an increased risk of enteral feeding, which in turn, increased the risk of cerumen impaction. Analysis indicated that the link between longer hospitalization and a more severe level of cerumen impaction was fully mediated by diet type (enteral feeding).

CONCLUSIONS: Enteral feeding seems to be a risk factor for cerumen impaction, rather than merely hospitalization length, in our sample of geriatric patients. These results highlight the importance of continuous monitoring by ear, nose, and throat specialists, as well as regular auditory assessments for patients who are enterally fed for early detection and treatment of cerumen impaction. Particular attention should be paid to cases of prolonged hospitalization, which is associated with the severity of dysphagia.

RevDate: 2025-01-19

Matta L, Weber P, Erener S, et al (2025)

Chronic intermittent fasting impairs β cell maturation and function in adolescent mice.

Cell reports, 44(2):115225 pii:S2211-1247(24)01576-6 [Epub ahead of print].

Intermittent fasting (IF) is a nutritional lifestyle intervention with broad metabolic benefits, but whether the impact of IF depends on the individual's age is unclear. Here, we investigated the effects of IF on systemic metabolism and β cell function in old, middle-aged, and young mice. Short-term IF improves glucose homeostasis across all age groups without altering islet function and morphology. In contrast, while chronic IF is beneficial for adult mice, it results in impaired β cell function in the young. Using single-cell RNA sequencing (scRNA-seq), we delineate that the β cell maturation and function scores are reduced in young mice. In human islets, a similar pattern is observed in type 1 (T1D), but not type 2 (T2D), diabetes, suggesting that the impact of chronic IF in adolescence is linked to the development of β cell dysfunction. Our study suggests considering the duration of IF in younger persons, as it may worsen rather than reduce diabetes outcomes.

RevDate: 2025-01-17

Aleksiev T, Popov V, H Dobrev (2024)

Radiation-Associated Herpes Zoster: A Clinical Case.

Cureus, 16(12):e75857.

Herpes zoster (HZ) is a viral infection caused by the reactivation of endogenous and latent varicella-zoster virus that remains dormant in the cranial nerve or dorsal root ganglia. HZ occurs in a portion of the general population, with a higher incidence observed in high-risk individuals. Patients with impaired immunity, including human immunodeficiency virus infection, organ transplantation, old age, and cancer-related treatments such as chemotherapy (CT) and radiotherapy (RT) were found more prone to HZ infection. We present a case of a 50-year-old patient who underwent a surgical excision of an invasive ductal carcinoma of the right breast. Following 15 fractions of RT, the patient presented with HZ appearing in the radiation field. The patient was treated successfully with Acyclovir, and RT was continued while on maintenance therapy with antiviral drugs. This case presents the importance of early diagnosis and the right choice of treatment in cancer patients and HZ due to the higher risk of complications and further development of the primary condition.

RevDate: 2025-01-17
CmpDate: 2025-01-17

Bullock E, VG Brunton (2025)

E-Cadherin-Mediated Cell-Cell Adhesion and Invasive Lobular Breast Cancer.

Advances in experimental medicine and biology, 1464:259-275.

E-cadherin is a transmembrane protein and central component of adherens junctions (AJs). The extracellular domain of E-cadherin forms homotypic interactions with E-cadherin on adjacent cells, facilitating the formation of cell-cell adhesions, known as AJs, between neighbouring cells. The intracellular domain of E-cadherin interacts with α-, β- and p120-catenins, linking the AJs to the actin cytoskeleton. Functional AJs maintain epithelial tissue identity and integrity. Transcriptional downregulation of E-cadherin is the first step in epithelial-to-mesenchymal transition (EMT), a process essential in development and tissue repair, which, in breast cancer, can contribute to tumour progression and metastasis. In addition, loss-of-function mutations in E-cadherin are a defining feature of invasive lobular breast cancer (also known as invasive lobular carcinoma (ILC)), the second most common histological subtype of breast cancer. ILC displays a discohesive, single-file invasive growth pattern due to the loss of functional AJs. Despite being so prevalent, until recently there has been limited ILC-focused research and historically ILC patients have often been excluded from clinical trials. Despite displaying a number of good prognostic indicators, such as low grade and high rates of estrogen receptor positivity, ILC patients tend to have similar or poorer outcomes relative to the most common subtype of breast cancer, invasive ductal carcinoma (IDC). In ILC, E-cadherin loss promotes hyperactivation of growth factor receptors, in particular insulin-like growth factor 1 receptor, anoikis resistance and synthetic lethality with ROS1 inhibition. These features introduce clinical vulnerabilities that could potentially be exploited to improve outcomes for ILC patients, for whom there are currently limited tailored treatments available.

RevDate: 2025-01-17
CmpDate: 2025-01-17

Nair I, F Behbod (2025)

Models for Studying Ductal Carcinoma In Situ Progression.

Advances in experimental medicine and biology, 1464:95-108.

An estimated 55,720 new cases of ductal carcinoma in situ (DCIS) will be diagnosed in 2023 in the USA alone because of the increased use of screening mammography. The treatment goal in DCIS is early detection and treatment with the hope of preventing progression into invasive disease. Previous studies show progression into invasive cancer as well as reduction in mortality from treatment is not as high as previously thought. So, are we overdiagnosing and over-treating DCIS? An understanding of the natural progression of DCIS is paramount to address this. The purpose of this chapter is to describe various models that have been developed to simulate the processes involved in DCIS to invasive ductal carcinoma (IDC) transition. While each model possesses a unique set of strengths and weaknesses, they have collectively contributed to the current understanding of the molecular and cellular mechanisms underlying this transition. Even though much has been learned, continued advancement of the current models to best match the composition of DCIS epithelial and stromal microenvironment including the extracellular matrix (ECM), stromal cell types, and immune microenvironment will be essential. These advances will undoubtedly pave the way toward a full understanding of mechanisms associated with progression and in predicting when a DCIS lesion remains indolent and when triggers tip in the balance toward progression to malignancy.

RevDate: 2025-01-17
CmpDate: 2025-01-17

Klein C, Anract J, Pinar U, et al (2025)

Comparative study of HoLEP in elderly patients with indwelling catheters: a retrospective dual-center study.

World journal of urology, 43(1):75.

INTRODUCTION: This study aimed to evaluate the safety and efficacy of HoLEP in patients aged > 85 years with indwelling catheter (IDC).

METHODS: We retrospectively analyzed our bicentric HoLEP database to identify consecutive patients with IDC and trial without catheter (TWOC) failure who underwent surgery between June 2012 and April 2020. Our primary focus was on the population over 85 years of age; Patients under 70 years of age were used as controls. We evaluated the rate of postoperative spontaneous micturition, adverse events and mortality, as well as catheterization duration, hospital stay, and rate of urinary incontinence.

RESULTS: In total, 144 patients were included, with 71 (49.3%) and 73 (50.8%) in the ≥ 85 and control group, respectively. The median [IQR] prostatic volume and Charlson score was 90 [70-130] vs. 90 [65-120] mL and 6 [5-7] vs. 3 [2-4] in the ≥ 85 and control groups, respectively. Postoperatively, the rates of major complications (2% vs. 3%) and transfusion (11% vs. 9%) were not significantly different. The median length of stay (2 [1-3] vs. 1 [1-2]; p = 0.03) and rate of TWOC failure during hospitalization (24% vs. 5%, p < 0.001) were significantly higher in the ≥ 85 group. At 3 months and one year follow-up visits, 0 and 10 patients (14.1%) in the ≥ 85 group and 0 and 2 patients (3%) in the control group died, respectively. One year after surgery, 69 (97%) and 73 (100%) (p = 0.2) patients in the ≥ 85 and control groups, respectively, could void spontaneously.

CONCLUSION: HoLEP is a safe and effective procedure for elderly patients with indwelling catheters. At one year, 97% of patients achieved spontaneous voiding, while the urinary incontinence rate was 11%. The 1-year mortality rate was 14%, comparable to that of the general male population of the same age.

RevDate: 2025-01-16

Wankhade R, Bhake A, Bankar N, et al (2025)

Evaluation of Ki67 in pathological prognostic staging of breast cancer: a tertiary care center study.

Journal of immunoassay & immunochemistry [Epub ahead of print].

BACKGROUND: The rising global burden of breast cancer demands early detection and effective treatment, with a focus on prognostic and predictive markers. The eighth edition of the American Joint Committee on Cancer staging manual introduced a new prognostic staging system to increase the predictive power of the existing anatomical staging system of breast cancer. The current study aimed to establish the correlation between Ki67 expression with molecular subtypes and with the pathological prognostic stage of invasive ductal carcinoma.

MATERIALS AND METHODS: A total of 40 patients were included in the study with samples from 32 modified radical mastectomies and 8 biopsies. Hematoxylin and Eosin staining, histopathological analysis and Ki67 immunostaining were conducted. Descriptive and inferential statistical analyses were performed.

RESULTS: Bloom Richardson Grade II was the predominant histological grade. In Grade II cases, 15 of 24 had a Ki67 labeling index of 26-45%, while 6 exceeded 45% (p = 0.001). Pathological prognostic staging reclassified 27 cases, with 24 (75%) downstaged, 3 (9.38%) upstaged, and 5 (15.63%) retaining their clinical stage.

CONCLUSIONS: Ki67 immunohistochemistry is an effective tool for assessing proliferative activity of invasive ductal carcinoma, aiding in pathological prognostic stage stratification and offering insights into tumor biology.

RevDate: 2025-01-15

Sossa-Melo C, Abello-Polo V, Salazar LA, et al (2025)

Characteristics, outcomes and treatment patterns in acute myeloid leukemia patients 60 years or older in Colombia: a RENEHOC-PETHEMA study.

Annals of hematology [Epub ahead of print].

There is a limited information available on the clinical characteristics, treatment patterns and outcomes on older patients diagnosed with Acute Myeloid Leukemia (AML) in Latin-America. This multicenter retrospective study analyzed 269 patients over 60 years of age diagnosed with AML in Colombia, using data from RENEHOC-PETHEMA registry, from 2009 to 2023. The median age at diagnosis was 70 years (Range:60-98), 55% were men, 61% had an ECOG < 2, and 75.5% had de novo AML. FLT3-ITD or NPM1 mutations were performed in 23.4% and 15.6% patients, and detected in 14.3% and 16.7% of cases, respectively. Treatment included intensive chemotherapy (IC) (36.8%), Low-Intensity Regimen Based on Low-Dose Cytarabine (LDAC-based) (12.6%), hypomethylating agents (HMAs, with/without venetoclax) (35.3%), and supportive care (15.2%). The overall survival (OS) rate was 35.2% at 1 year and 5.6% at 5 years (13.7% for IC, 9.4% for LDAC-based, and 0% for other treatments); with median OS of 8.2 months (10.6 months after IC, 8.8 months after non-IC, 8.9 months after azacitidine/decitabine, 8.2 months after azacitidine-venetoclax, and 1.9 months with supportive care). Only 1.5% of patients underwent a transplant in the first line. The Leukemia-free survival (LFS) rate was 45.8% at 1-year and 13.7% at 5-years (22.4% for IC, 9.4% and 0% for other treatments); with median LFS of 9.5 months (17.3 months after IC, 7.4 months after LDAC-based, and 10.8 months after HMA). This study provides new insights into the management of patients in Colombia, highlighting the need for a highly individualized approach in treating AML in elderly patients.

RevDate: 2025-01-15
CmpDate: 2025-01-15

Hu J, Dong J, Yang X, et al (2025)

Erythrocyte modified controlling nutritional status as a biomarker for predicting poor prognosis in post-surgery breast cancer patients.

Scientific reports, 15(1):2071.

Nutrition and inflammation are closely related to prognosis in breast cancer patients. However, current nutritional and inflammatory measures predict disease free survival (DFS) of breast cancer are still different, and the most predictive measures remain unknown. This study aimed to compare the predictive effects of commonly used nutritional and inflammatory measures on DFS and to improve existing nutritional or inflammatory measures in order to develop a new model that is more effective for predicting postoperative recurrence and metastasis in breast cancer patients. The clinical data of 536 female breast cancer patients with invasive ductal carcinoma who underwent surgery at Shaoxing People's Hospital from January 2012 to December 2018 were retrospectively evaluated. The predictive effects of nutritional and inflammatory indicators on DFS were evaluated. Machine learning was used to evaluate and rank laboratory indicators, select relatively important variables to modify nutritional or inflammatory indicators with the best predictive power, and evaluate their predictive role in patients' postoperative recurrence and metastasis. Among various metrics predicting DFS, the CONUT score emerged paramount with an area under the curve (AUC) of 0.667. Interestingly, the combination of the erythrocyte levels with the CONUT score (ECONUT) achieved the highest AUC (0.722). The Kaplan-Meier survival analysis showed that the group exhibiting high ECONUT scores experiencing a notably poorer DFS. ECONUT was identified as an independent risk factor for postoperative DFS (P < 0.001). The ECONUT model could provide an effective assessment tool for predicting DFS in breast cancer patients.

RevDate: 2025-01-15

Wei C, Li H, Li J, et al (2025)

Machine learning-based prognostic modeling and surgical value analysis of de novo metastatic invasive ductal carcinoma of the breast.

Updates in surgery [Epub ahead of print].

Whether primary lesion surgery improves survival in patients with de novo metastatic breast cancer (dnMBC) is inconclusive. We aimed to establish a prognostic prediction model for patients with de novo metastatic breast invasive ductal carcinoma (dnMBIDC) based on machine learning algorithms and to investigate the value of primary site surgery. The data used in our study were obtained from the Surveillance, Epidemiology, and End Results database (SEER, 2010-2021) and the First Affiliated Hospital of Nanchang University (1st-NCUH, June 2013-June 2023). We used COX regression analysis to identify prognostic factors. We divided patients into training and validation groups and constructed Extreme Gradient Boosting (XGBoost) prognostic prediction model. In addition, we used propensity score matching (PSM), K-M survival analysis, and COX regression analysis to explore the survival benefit of patients undergoing primary lesion surgery. A total of 13,383 patients were enrolled, with 13,326 from SEER and 57 from 1st-NCUH. The results showed that XGboost had good predictive ability (training set C-index = 0.726, 1 year AUC = 0.788, 3 year AUC = 0.774, 5 year AUC = 0.774; validation set C-index = 0.723, 1 year AUC = 0.785.1, 3 year AUC = 0.770, 5 year AUC = 0.764), which has better predictive power than the Coxph model. We used Shiny-Web to make our model easily available. Furthermore, we found that surgery was associated with a better prognosis in dnMBIDC patients. Based on the XGboost, we can accurately predict the survival of dnMBIDC patients, which can provide a reference for clinicians to treat patients. In addition, surgery may bring survival benefits to dnMBIDC patients.

RevDate: 2025-01-14

Gallas AE, Morenikeji GO, King RE, et al (2025)

An Overview of Invasive Ductal Carcinoma (IDC) in Women's Breast Cancer.

Current molecular medicine pii:CMM-EPUB-145627 [Epub ahead of print].

Invasive ductal carcinoma (IDC) is the most common type of breast cancer, primarily affecting women in the United States and across the world. This review summarizes key concepts related to IDC causes, treatment approaches, and the identification of biological markers for specific prognoses. Furthermore, we reviewed many studies, including those involving patients with IDC and ductal carcinoma in situ (DCIS) that progressed to IDC. We reported various studies on the causes of IDC, including mutations on BRCA1 and BRCA2, different levels of expression of specific genes in signaling pathways, menopause status, alcohol consumption, aging, and hormone imbalances that cause IDC while p-SMAD4 expressions, DNA methylation, regulations of hub genes, and underestimation of IDC affecting prognoses. Prompt IDC diagnosis and early intervention have been reported to demonstrate a greater probability of eradicating IDC and preventing further recurrence in the future. It is crucial for physicians and researchers to equip patients with the best information possible to proactively manage their health, whether it be for IDC prevention or treatment. Overall, our review provided a comprehensive understanding of IDC that enables patients to grasp the nature of the disease with the hope of mitigating IDC risk, decrease the anxiety of a cancer diagnosis, and encourage patients to become more involved in making informed decisions for their healthcare.

RevDate: 2025-01-13

Michelon I, Castro CER, Madeira T, et al (2025)

Trastuzumab deruxtecan in human epidermal growth factor receptor 2-positive breast cancer brain metastases: A systematic review and updated meta-analysis.

Cancer treatment reviews, 133:102882 pii:S0305-7372(25)00004-0 [Epub ahead of print].

BACKGROUND: Trastuzumab deruxtecan (T-DXd) has shown promising activity in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) and central nervous system (CNS) involvement. In this updated meta-analysis, we explore the effectiveness of T-DXd in a large subset of patients with HER2-positive BC and CNS disease.

METHODS: A systematic search was made on September 16th, 2024, for studies investigating T-DXd in the scenario of HER2-positive BC and brain metastases (BMs) and/or leptomeningeal disease (LMD). We used random effects models for all statistical analyses.

RESULTS: We included 18 studies with 786 HER2-positive BC patients with CNS involvement (16 studies with 750 BMs patients and three studies with 36 LMD patients). We observed high overall antitumor responses (objective response rate [ORR], 60.4 %; disease control rate [DCR], 94.4 %; and clinical benefit rate [CBR], 79.3 %) and a 12-month PFS of 64.7 % and OS of 82.7 %. Intracranial ORR, DCR, and CBR were seen in 62.2 %, 88.6 %, and 68.6 % of patients, respectively, and 67.4 % achieved intracranial PFS at 12 months. Both stable and active BMs subgroups derived similar benefit from T-DXd. Better intracranial responses were seen for 33 patients with untreated BMs compared to 56 patients with previously treated or progressing lesions (odds ratio 3.82, 95 % confidence interval 1.3-10.8, p = 0.01). For the LMD group, T-DXd elicited intracranial ORR and CBR in 59.4 % and 94.1 % of patients, respectively.

CONCLUSIONS: This updated meta-analysis continues to support the overall and intracranial activity of T-DXd in patients with HER2-positive BC and CNS involvement, including those with LMD.

RevDate: 2025-01-13
CmpDate: 2025-01-13

Wang K, Fischer A, Maccio U, et al (2025)

Impact of sex hormones on pheochromocytomas, paragangliomas, and gastroenteropancreatic neuroendocrine tumors.

European journal of endocrinology, 192(1):46-60.

OBJECTIVE: The effects of sex hormones remain largely unexplored in pheochromocytomas and paragangliomas (PPGLs) and gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

METHODS: We evaluated the effects of estradiol, progesterone, Dehydroepiandrosterone sulfate (DHEAS), and testosterone on human patient-derived PPGL/GEP-NET primary culture cell viability (n = 38/n = 12), performed next-generation sequencing and immunohistochemical hormone receptor analysis in patient-derived PPGL tumor tissues (n = 36).

RESULTS: In PPGLs, estradiol and progesterone (1 µm) demonstrated overall significant antitumor effects with the strongest efficacy in PPGLs with NF1 (cluster 2) pathogenic variants. Estrogen receptor alpha (ERα) positivity was detected in 11/36 PPGLs, including 4/4 head-and-neck paragangliomas (HNPGLs). ERα-positive tumors responded with a significant cell viability decrease to estradiol. DHEAS and testosterone (1 µm) displayed no effects, but higher doses of testosterone (10 µm) demonstrated significant antitumor effects, including a pheochromocytoma lung metastasis with strong androgen receptor positivity (30%). Driven by the antitumor effects of estrogen, we evaluated G-protein-coupled estrogen receptor (GPER) agonist G-1 as a potential therapeutic option for PPGLs and found strong significant antitumor potential, with the strongest efficacy in tumors with NF1 pathogenic variants. Moreover, we detected sex-related differences-tumors from male patients showed significantly stronger responsivity to G-1 compared with tumors from female patients. In GEP-NETs, sex hormones showed overall no effects, especially no tumor growth-promoting effects.

CONCLUSION: We provide novel data on the effects of elevated sex hormone levels, potentially seen during pregnancy or hormone replacement therapy, on PPGL/GEP-NET tumor growth. G-1 might offer a novel therapeutic approach for some PPGLs depending on patient's sex and the individual tumor's genetic/molecular background. All HNPGLs showed ERα positivity.

RevDate: 2025-01-12

Fu J, Wang J, Ma Z, et al (2025)

CaCO3-coated indoxacarb deep eutectic solvent complexed with diatomaceous earth improves insecticidal activity against the red imported fire ants.

Ecotoxicology and environmental safety, 289:117709 pii:S0147-6513(25)00045-4 [Epub ahead of print].

The red imported fire ants (RIFAs) are a globally important invasive pest that severely affects the ecosystem and human health, and its current control is primarily through chemical pesticides. However, the extensive use of chemical pesticides causes environmental problems, and alternative strategies for controlling this pest are being explored. In our study, we aimed to design a deep eutectic solvent (DES)-CaCO3 system in which RIFAs were used as target insects to increase the lethal activity and behavioural regulation effects on RIFAs via contact and feeding. Indoxacarb (IDC) was made into DESs with three fatty acids, oleic acid (OA), linoleic acid (LA), and linolenic acid (LNA), which showed a significant increase in lethal activity against worker ants compared with IDC. OA@IDC@CaCO3, LA@IDC@CaCO3, and LNA@IDC@CaCO3 nanoparticles were prepared via interfacial precipitation. Characterization of the structures of the three pesticide-carrying nanoparticles revealed that all three fatty acid eutectic solvents formed spherical CaCO3 nanoparticles, with average particle sizes between 0.59 and 0.90 μm, which increased with increasing degree of fatty acid unsaturation. The pesticide loading ranged from 2.13 %⁓3.43 %, and the surfaces were all positively charged and well dispersed. OA@IDC@CaCO3 was relatively more effective and was able to dramatically inhibit the abandonment and foraging behaviours of RIFAs, prolong the time required for these behaviours, and decrease the number of feeding worker ants and the amount of food consumed. OA@IDC@CaCO3 was subsequently compounded with diatomaceous earth (DA), and spiked into baits, which significantly increased the contact and feeding activity of worker ants, inhibited the feeding, digging, and corpse-discarding behaviours of RIFAs. In the field trial, the combined control effect of the DA + OA@IDC@CaCO3 group was 83.38 %, which was greater than the 69.65 % of the commercial agent control group. In this study, IDC bait was co-prepared by using acid as a comelting solvent, CaCO3 as a coating, and DA as a pesticide adjuvant, which improved the activity against RIFAs, prolonged the holding period of IDC, and improved the prevention and control of RIFAs. Therefore, our research provides a simple and feasible approach for designing and constructing novel nanopesticides for RIFAs control.

RevDate: 2025-01-11
CmpDate: 2025-01-11

Caca J, Bartelt A, V Egea (2024)

Hypoxia Regulates Brown Adipocyte Differentiation and Stimulates miR-210 by HIF-1α.

International journal of molecular sciences, 26(1): pii:ijms26010117.

MicroRNAs (miRNAs) are short sequences of single-stranded non-coding RNAs that target messenger RNAs, leading to their repression or decay. Interestingly, miRNAs play a role in the cellular response to low oxygen levels, known as hypoxia, which is associated with reactive oxygen species and oxidative stress. However, the physiological implications of hypoxia-induced miRNAs ("hypoxamiRs") remain largely unclear. Here, we investigate the role of miR-210 in brown adipocyte differentiation and thermogenesis. We treated the cells under sympathetic stimulation with hypoxia, CoCl2, or IOX2. To manipulate miR-210, we performed reverse transfection with antagomiRs. Adipocyte markers expression, lipid accumulation, lipolysis, and oxygen consumption were measured. Hypoxia hindered BAT differentiation and suppressed sympathetic stimulation. Hypoxia-induced HIF-1α stabilization increased miR-210 in brown adipocytes. Interestingly, miR-210-5p enhanced differentiation under normoxic conditions but was insufficient to rescue the inhibition of brown adipocyte differentiation under hypoxic conditions. Although adrenergic stimulation activated HIF-1α signaling and upregulated miR-210 expression, inhibition of miR-210-5p did not significantly influence UCP1 expression or oxygen consumption. In summary, hypoxia and adrenergic stimulation upregulated miR-210, which impacted brown adipocyte differentiation and thermogenesis. These findings offer new insights for the physiological role of hypoxamiRs in brown adipose tissue, which could aid in understanding oxidative stress and treatment of metabolic disorders.

RevDate: 2025-01-11

Cieślik M, Orlikowski J, Krakowiak S, et al (2025)

Dynamic Electrochemical Impedance Spectroscopy in Galvanostatic Mode as a Tool for Passive Layer State Monitoring in a Chloride Solution Under a Mechanical Load.

Materials (Basel, Switzerland), 18(1): pii:ma18010167.

Mechanical stress is one of the factors influencing the initiation of pitting corrosion and deterioration of the protective properties of the passive layer on stainless steel. The tests carried out on AISI 304L stainless steel showed that, in the 3.5% NaCl environment for samples loaded in the elastic and plastic range, no pitting corrosion initiation was observed. Only mechanical damage of the passive layer occurred. Galvanodynamic electrochemical impedance spectroscopy (g-DEIS) was used as the measuring technique. This technique ensures the monitoring of corrosion processes at zero external current (IDC = 0) and no potential perturbation of the system. It also allows one to perform many measurements, so that short-term changes such as cracking of the layer and its repassivation are possible to monitor.

RevDate: 2025-01-11

Khasawneh AI, Himsawi N, Alorjani M, et al (2024)

Triple Viral Infections in Advanced Breast Cancer: Insights from a Three-Case Report and Literature Review.

Diagnostics (Basel, Switzerland), 15(1): pii:diagnostics15010051.

Background and clinical significance: Viral infections are typically considered contributing or secondary factors in the development of breast cancer. Case presentation: This case report presents three instances of advanced breast cancer associated with triple viral infections. Case 1 involves a 78-year-old woman diagnosed with grade 2 invasive ductal carcinoma positive for HPV-18, CMV, and BLV. Case 2 describes a 39-year-old woman with grade 2 invasive ductal carcinoma, positive for HPV-16, CMV, and BLV. Case 3 is a 52-year-old woman with grade 3 invasive ductal carcinoma, positive for HPV-16, BLV, and MMTV. These cases suggest a possible correlation between viral co-infections and breast cancer aggressiveness, posing new questions about the role of viral infections in cancer development and prognosis. Conclusions: The findings contribute to growing evidence that viral infections may influence the progression and therapeutic response of breast cancer, warranting further investigation into targeted preventive measures including vaccinations.

RevDate: 2025-01-10

Rajput P, Datta D, Aggarwal D, et al (2024)

Atypical Presentation of Carcinoma Breast as Paraneoplastic Cerebellar Degeneration on [18F]FDG PET/CT.

Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, India, 39(4):325-326.

Paraneoplastic neurological syndrome (PNS) represents a rare group of central nervous system disorders that are unrelated to direct tumor invasion or metastasis but may be triggered by an immune system reaction to a neoplasm or malignant tumor. In many patients, PNS is diagnosed before identifying the primary cancer. In such instances, positron emission tomography/computed tomography scan can assess individuals with suspected PNS enabling the detection of hidden malignancies. We share an interesting image of paraneoplastic cerebellar degeneration in a case of invasive ductal carcinoma breast.

RevDate: 2025-01-09

Doan VTH, Imai T, Kawazoe N, et al (2025)

Regulation of antigen presentation and interleukin 10 production in murine dendritic cells via the oxidative stimulation of cell membrane using a polycation-porphyrin-conjugate-immobilized cell culture dish.

Acta biomaterialia pii:S1742-7061(25)00004-2 [Epub ahead of print].

Tolerogenic dendritic cells with professional antigen presentation via major histocompatibility complex molecules, co-stimulatory molecules (CD80/86), and interleukin 10 production have attracted significant attention as cellular therapies for autoimmune, allergic, and graft-versus-host diseases. In this study, we developed a cell culture dish equipped with polycation-porphyrin-conjugate-immobilized glass (PA-HP-G) to stimulate immature murine dendritic cell (iDCs). Upon irradiation with a red light at 635 nm toward the PA-HP-G surface, singlet oxygen was generated by the immobilized porphyrins on the PA-HP-G surface. When iDCs were cultured on the PA-HP-G surface, moderate light irradiation generated lipid radicals without excessive generation of reactive oxygen species in the cytoplasm and nucleus, which led to the oxidative stimulation of the iDC cell membrane without cell death. Light irradiation changed the morphology of dendritic cells on the PA-HP-G surface to a tree-like structure with dendrites, accelerated their maturation, and enhanced the antigen-presenting ability for the ovalbumin peptide via major histocompatibility complex class I molecules. Additionally, the antigen-presenting dendritic cells on the PA-HP-G surface produced the anti-inflammatory cytokine interleukin 10 upon light irradiation. These results indicated that upon moderate light irradiation, the PA-HP-G surface regulated the maturation of iDCs into tolerogenic dendritic cells. STATEMENT OF SIGNIFICANCE: • Cell culture dish is developed for selective oxidative stimulus of cell membrane. • [1]O2 is generated from polycation/porphyrin-immobilized glass by light irradiation. • Lipid radicals are generated without generation of ROS in cytoplasm and nuclei. • Immature dendritic cells are maturated by oxidative stimulation of cell membrane. • Oxidative membrane stimulus enhances antigen-presentation and IL-10 secretion.

RevDate: 2025-01-09

Liu C, H Xing (2025)

Occult breast cancer in an older woman: A case report.

Experimental and therapeutic medicine, 29(2):38.

Occult breast cancer (OBC) is a relatively rare clinical condition that can complicate differential diagnosis efforts and delay the administration of specific treatments. The individualized therapy of patients with OBC should be performed based on their clinical symptoms, imaging findings and pathological diagnosis. The present case study describes a 51-year-old woman with a painless left axillary tumor. The axillary lymph nodes of the patient were affected by invasive ductal carcinoma, as determined by histological analysis. However, the primary lesion was missed by numerous testing. The patient underwent surgery and testing for positron emission tomography/computed tomography (PET/CT). The present study comprehensively examined this case and offered a systematic analysis of the relevant scholarly works on the diagnosis, treatment and prognosis of OBC. Ultrasonography revealed the presence of three homogenous hypoechoic masses with irregular margins in the left axilla of the patient. PET/CT scanning identified multiple enlarged left axillary hypermetabolic lymph nodes. After that, the patient underwent a nipple-sparing mastectomy and an axillary lymphadenectomy. With the lymph nodes showing metastatic, infiltrating ductal carcinoma from the breast, ductal carcinoma in situ of the breast diagnosis was supported by a histological examination. Immunohistochemical staining revealed that resected lymph nodes were positive for both estrogen and progesterone receptors, consistent with the status of the breast as the primary tumor site. Following surgery, the patient underwent adjuvant chemotherapy treatment. At 12 months post-surgery, the patient remained well without evidence of disease. OBC cases lack the typical clinical and imaging findings associated with breast cancer, and a combination of axillary lymph node examination and immunohistochemistry is essential for accurately diagnosing affected patients. Ensuring the best patient outcomes necessitates accurate and prompt diagnosis, achieved by thorough physical examination, cautious utilization of diagnostic tools, personalized surgical interventions and histological investigation.

RevDate: 2025-01-08
CmpDate: 2025-01-08

Gao Y, Wang J, Wang S, et al (2025)

Development and validation of a nomogram to predict survival after neoadjuvant chemotherapy in elderly women with triple-negative invasive ductal breast cancer: A SEER population-based study.

Saudi medical journal, 46(1):43-51.

OBJECTIVES: To construct and verify a nomogram for post-neoadjuvant chemotherapy survival predication in elderly women with triple-negative invasive ductal breast cancer.

METHODS: Elderly patients diagnosed as triple-negative invasive ductal breast cancer between 2019-2000 were screened from surveillance, epidemiology, and end results database. Depending on the post-neoadjuvant chemotherapy pathological response, they were assigned to the complete or non-complete response group. Inter-group clinicopathological characteristics and disease-specific and overall survivals were compared. Then, they were allocated randomly into the training or validation cohort. A prediction nomogram was developed in the training cohort and verified in the validation cohort.

RESULTS: A total of 382 patients were included, with 285 patients in non-response group and 97 patients in response group. After propensity score matching, disease-specific survival showed a significant difference between response and non-response groups (88.7% versus 64.6%, p<0.001). The training cohort included 196 patients and the validation cohort included 82 patients. A total of 7 variables (age, race, tumor location, tumor-node-metastasis stage, summary stage, receipt of surgery, and response to neoadjuvant chemotherapy) were integrated to construct a survival prediction nomogram. The C-indexes were 0.756 in the training cohort and 0.791 in the validation cohort. In both cohorts, the predicted survival showed satisfactory coherence with the actual survival in the calibration curve analysis.

CONCLUSION: In elderly women with triple-negative invasive ductal breast cancer, post-neoadjuvant chemotherapy pathological complete response could indicate improved disease-specific survival. A novel survival prediction nomogram was created to have satisfactory performance in these patients.

RevDate: 2025-01-08

Liang R, Lian J, Zhang J, et al (2024)

The benefits of contrast-enhanced ultrasound in the differential diagnosis of suspicious breast lesions.

Frontiers in medicine, 11:1511200.

BACKGROUND: Contrast-enhanced ultrasound (CEUS) shows potential for the differential diagnosis of breast lesions in general, but its effectiveness remains unclear for the differential diagnosis of lesions highly suspicious for breast cancers.

OBJECTIVE: This study aimed to evaluate the diagnostic value of CEUS in differentiating pathological subtypes of suspicious breast lesions defined as category 4 of US-BI-RADS.

METHODS: The dataset of 150 breast lesions was prospectively collected from 150 patients who underwent routine ultrasound and CEUS examination and were highly suspected of having breast cancers. All lesions were pathologically confirmed by US-guided needle biopsy and surgery. The qualitative features and the quantitative parameters of CEUS of these breast lesions were analyzed. The CEUS and biopsy examinations were performed after informed consent.

RESULTS: In the qualitative features, crab clam-like enhancement, the presence of more than two enhanced vessels within lesions, and surrounding enriched vessels inserting into lesions were able to differentiate atypical fibroadenomas (FIB) and mass-like non-puerperal mastitis (NPM) from invasive ductal carcinomas (IDC) and ductal carcinomas in situ (DCIS) (p < 0.05). The enlarged scope, irregular shape, and perfusion deficiency were valuable to the differential diagnosis of FIB from the others (p < 0.05). In the four quantitative parameters of CEUS, only the peak intensity (IMAX) contributed to the differential diagnosis between malignant and benign tumors (p < 0.05, ROCAUC: 0.61, sensitivity: 60.4% and specificity: 65.9%, accuracy: 62.1%). However, IMAX did not show any difference in the paired comparison of IDC, DCIS, FIB, and NPM (p > 0.05). The logistic regression analysis results showed that heterogeneous perfusion, crab clam-like enhancement, and partial_ IMAX were independent risk factors for benign and malignant breast lesions (p < 0.05). The area under a receiver operating characteristic of the integrated model was 0.89. In the diagnosis of benign and malignant pathological subtypes of breast lesions, independent risk factors and integrated models had no statistical significance in the diagnosis of IDC and DCISs, FIB, and NPM (p > 0.05).

CONCLUSION: Some qualitative risk features of CEUS can distinguish malignant breast lesions from NPM and atypical FIB with a high score of US-BI-RADS, aiding physicians to reduce the misdiagnosis of suspicious breast lesions in clinical practice.

RevDate: 2025-01-08
CmpDate: 2025-01-08

Ben-David BM, Bressler TE, Ring L, et al (2025)

Trauma echoes: factors associated with peritraumatic distress and anxiety five days following Iranian missile attack on Israel.

European journal of psychotraumatology, 16(1):2446070.

Introduction: On 13-14 April 2024, Iran launched ∼300 drones and missiles at Israel, in an unprecedented attack. As most studies examine the effects of trauma months or years later, less is known about its effects days later. To fill this gap, this study gauged the population response, five days after the attack. Specifically, we examined the prevalence and factors associated with two precursors for later development of PTSD, peritraumatic distress (PD) and generalized anxiety disorder (GAD).Methods: Five-hundred and fifty-three participants (Mage = 57.51, SD = 13.67 years, range [30-90], 48.3% females) reported their distal and proximal exposure to traumatic events, probable PTSD due to Israel-Hamas-War, sleeping troubles, and media information consumption during the event.Results: Logistic regressions indicated that, after adjusting for demographics, clinical levels of PD and GAD (respectively, using the accepted cutoffs) were significantly linked to probable PTSD due to the Israel-Hamas War (PD:OR = 4.066, 95%CI: 2.236-7.393, p < .001; GAD:OR = 2.397, 95%CI: 1.285-4.471, p = .006), sleeping troubles (PD:OR = 1.248, 95%CI: 1.186-1.314, p < .001; GAD:OR = 1.325, 95%CI: 1.242-1.413, p < .001) and media consumption (PD:OR = 1.442, 95%CI:1.17-1.777, p = .001; GAD:OR = 1.515, 95%CI: 1.144-2.007, p = .004), but not to previous trauma (life-long exposure or Israel-Hamas war).Discussion: Results suggest that previous psychopathology, stress-related reactions (sleeping) and actions (media consumption), rather than previous exposures to traumatic events are the primary indices related to PD and GAD in the first days after exposure to war-related traumatic events. Findings highlight the importance of early detection of reactions and symptoms following trauma exposure. The main limitation of the study is its cross-sectional design. Future longitudinal studies are needed to understand the developmental trajectory of these effects.

RevDate: 2025-01-03
CmpDate: 2025-01-03

Kim DHS, Sonni I, Grogan T, et al (2025)

Quantitative 3-T Multiparametric MRI Parameters as Predictors of Aggressive Prostate Cancer.

Radiology. Imaging cancer, 7(1):e240011.

Purpose To determine which quantitative 3-T multiparametric MRI (mpMRI) parameters correlate with and help predict the presence of aggressive large cribriform pattern (LCP) and intraductal carcinoma (IDC) prostate cancer (PCa) at whole-mount histopathology (WMHP). Materials and Methods This retrospective study included 130 patients (mean age ± SD, 62.6 years ± 7.2; 100% male) with 141 PCa lesions who underwent preoperative prostate 3-T mpMRI, radical prostatectomy, and WMHP between January 2019 and December 2022. Lesions at WMHP were matched to 3-T mpMRI lesions with American College of Radiology Prostate Imaging Reporting and Data System version 2.1 scores of at least 3 or higher, and the following parameters were derived: apparent diffusion coefficient (ADC), volume transfer constant, rate constant, and initial area under the curve (iAUC). Each lesion was categorized into three subcohorts with increasing aggressiveness: LCP negative and IDC negative (subcohort 1), LCP positive and IDC negative (subcohort 2), and LCP positive and IDC negative (subcohort 3). Analysis of variance was performed to assess differences, Jonckheere test was performed to establish trends, and a classification and regression tree (CART) was used to establish a prediction model. Results Of the 141 total lesions, there were 41 (29.1%), 49 (34.8%), and 51 (36.2%) lesions in subcohorts 1, 2, and 3, with mean ADCs of 892 × 10[-6] mm[2]/sec ± 20, 826 × 10[-6] mm[2]/sec ± 209, and 763 × 10[-6] mm[2]/sec ± 163 (P = .007) and mean iAUCs of 5.4 mmol/L/sec ± 2.5, 6.7 mmol/L/sec ± 3.0, and 6.9 mmol/L/sec ± 3.5 (P = .04), respectively. ADC was negatively correlated (P = .004), and rate constant and iAUC were positively correlated (P = .048 and P = .04, respectively) with increasing histologic PCa aggressiveness. The CART model correctly allocated 39.0%, 24.5%, and 84.3% of PCa lesions to subcohorts 1, 2, and 3, respectively. Conclusion Quantitative 3-T mpMRI parameters significantly correlated with and helped predict aggressive LCP and IDC PCa at WMHP. Keywords: Prostate, MRI, Pathology © RSNA, 2025.

RevDate: 2025-01-03

Liu H, Zhao G, Fan Z, et al (2024)

Metaplastic carcinoma of the breast containing three histological components: a case report.

Frontiers in oncology, 14:1470986.

Malignant breast tumors mainly arise from the ductal and lobular epithelium, whereas sarcomas, which originate from the stromal tissues of the breast, account for less than 5% of cases. Mostly, these tumors consist of a single tissue type, rendering malignant breast tumors with three distinct tissue types exceedingly rare. We report a unique case of a malignant breast tumor comprising three tissue types: squamous cell carcinoma (approximately 25%), invasive ductal carcinoma (approximately 5%), and fibrosarcoma (approximately 70%). Given the case's rarity, pre-operative imaging and tumor biopsy failed to yield definitive diagnostic information, we detail the patient's clinical and therapeutic process, providing insights for physicians on clinical diagnosis and treatment.

RevDate: 2025-01-01

Ayoub Y, Cheung SM, Maglan B, et al (2024)

Differentiation of histological calcification classifications in breast cancer using ultrashort echo time and chemical shift-encoded imaging MRI.

Frontiers in oncology, 14:1475090.

INTRODUCTION: Ductal carcinoma in situ (DCIS) accounts for 25% of newly diagnosed breast cancer cases with only 14%-53% developing into invasive ductal carcinoma (IDC), but currently overtreated due to inadequate accuracy of mammography. Subtypes of calcification, discernible from histology, has been suggested to have prognostic value in DCIS, while the lipid composition of saturated and unsaturated fatty acids may be altered in de novo synthesis with potential sensitivity to the difference between DCIS and IDC. We therefore set out to examine calcification using ultra short echo time (UTE) MRI and lipid composition using chemical shift-encoded imaging (CSEI), as markers for histological calcification classification, in the initial ex vivo step towards in vivo application.

METHODS: Twenty female patients, with mean age (range) of 57 (35-78) years, participated in the study. Intra- and peri-tumoural degree of calcification and peri-tumoural lipid composition were acquired on MRI using UTE and CSEI, respectively. Ex vivo imaging was conducted on the freshly excised breast tumour specimens immediately after surgery. Histopathological analysis was conducted to determine the calcification status, Nottingham Prognostic Index (NPI), and proliferative activity marker Ki-67.

RESULTS: Intra-tumoural degree of calcification in malignant classification (1.05 ± 0.13) was significantly higher (p = 0.012) against no calcification classification (0.84 ± 0.09). Peri-tumoural degree of calcification in malignant classification (1.64 ± 0.10) was significantly higher (p = 0.033) against no calcification classification (1.41 ± 0.18). Peri-tumoural MUFA in malignant classification (0.40 ± 0.01) was significantly higher (p = 0.039) against no calcification classification (0.38 ± 0.02). Ki-67 showed significant negative correlation against peri-tumoural MUFA (p = 0.043, ρ = -0.457), significant positive correlation against SFA (p = 0.008, ρ = 0.577), and significant negative correlation against PUFA (p = 0.002, ρ = -0.653).

CONCLUSION: The intra- and peri-tumoural degree of calcification and peri-tumoural MUFA are sensitive to histological calcification classes supporting future investigation into DCIS prognosis.

RevDate: 2024-12-29

Huws AM, Davies GR, Lewis PD, et al (2024)

Comparison of Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer.

Clinical breast cancer pii:S1526-8209(24)00337-9 [Epub ahead of print].

BACKGROUND: Adjuvant therapy decisions in hormone receptor positive, HER2 negative breast cancer are evolving. Gene panel testing has reduced the number of patients recommended for chemotherapy by up to two thirds. Identifying low risk genomic cases before testing could represent a significant economic impact. Systemic inflammatory indices have shown promise as prognostic markers in early breast cancer. We investigated the utility of four systemic inflammatory indices with the Nottingham Prognostic Index to predict the Oncotype DX® recurrence scores threshold level (low or high score), in women aged 50 and over with node negative invasive ductal carcinoma of the breast.

METHODS: A retrospective review of 245 patients with Oncotype DX® Recurrence Score testing from 2007 to 2021 were identified. The Nottingham Prognostic Index and systemic inflammatory indices ratios were estimated from histology results and preoperative peripheral blood samples respectively.

RESULTS: 22.4% of the cohort had a Recurrence Score in the higher risk group. This group had a greater percentage of grade 3 tumours, progesterone receptor negativity, higher Nottingham Prognostic Scores, and inflammatory indices ratios than the lower risk group. A decision tree incorporating the Neutrophil Lymphocyte Ratio with clinicopathological features showed potential as an indicator of a high Oncotype DX® RS score, such that further investigation is warranted to assess whether Recurrence Score testing could be triaged in certain cohorts of patients. In this study, 38% of patients might be able to avoid genomic testing based on the decision tree analysis.

CONCLUSION: Utility of inflammatory indices with clinicopathological features may help triage gene panel testing.

RevDate: 2024-12-28

Qi M, Gao S, Zhang Z, et al (2024)

Secretory breast carcinoma: a multicenter clinicopathologic study of 80 cases with emphasis on prognostic analysis and chemotherapy benefit.

Breast cancer research and treatment [Epub ahead of print].

PURPOSE: To investigate clinicopathologic characteristics and prognosis in secretory breast carcinoma (SBC) and to determine chemotherapy benefits stratified by different subgroups.

METHODS: SBCs and triple-negative invasive ductal carcinoma patients (TN-IDCs) were enrolled from three cancer centers between January 2011 and December 2020. SBCs were further divided into two subgroups: those with triple negativity (TN-SBCs) and those without (non-TN-SBCs). Clinicopathologic characteristics were thoroughly compared among the three subgroups associated with triple negativity. Kaplan-Meier estimates and Cox proportional hazard models were performed for survival analysis.

RESULTS: A total of 80 SBCs and 310 TN-IDCs were included in the study. The TN-SBC subgroup consisted of 35 individuals (43.75%) with mild clinical behaviors and a satisfying prognosis in comparison to non-TN-SBCs and TN-IDCs. In SBCs, N stage (N1 vs. N0: HR = 11.176, 95% CI 0.843-148.132, p = 0.067; N2-3 vs. N0: HR = 30.409, 95% CI 1.378-671.169, p = 0.031), LNR (HR = 23.894, 95% CI 1.614-353.835, p = 0.021), and histological grade (HR = 28.634, 95% CI 2.745-298.703, p = 0.005) were significantly correlated with disease-free survival (DFS). Patients in high LNR group receiving chemotherapy achieved a prolonged DFS (p = 0.025), while chemotherapy did not confer a survival benefit in TN-SBCs of our interest (p = 0.12).

CONCLUSION: TN-SBC is a unique entity with low malignant potential. Advanced N stage, high LNR, and advanced histological grade are adverse determinants of DFS in SBC. Adjuvant chemotherapy provides superior DFS in high LNR SBCs rather than TN-SBCs, hence it is recommended for high LNR SBCs.

RevDate: 2024-12-26

Wang Y, Zhang J, Wang Y, et al (2024)

Lower expression of MMP2, FLNA, and CFL1 is correlated with favorable prognosis in invasive micropapillary breast cancer.

Gene pii:S0378-1119(24)01073-4 [Epub ahead of print].

PURPOSE: Despite its recognized aggressive clinical manifestations, invasive micropapillary carcinoma has a controversial prognosis in comparison to invasive ductal carcinoma of the breast. This retrospective study aimed to explore the prognosis and underlying molecular mechanisms of invasive micropapillary carcinoma.

METHODS: Through the SEER database, we compared patients survival outcomes with invasive micropapillary carcinoma versus invasive ductal carcinoma, and developed a nomogram to predict the overall survival of the former group. We explored gene profiles in the GEO database. Hub genes were identified as the top ten genes in the PPI network with the highest degrees of connectivity, and three of them were selected for validation by immunohistochemistry.

RESULTS: Invasive micropapillary carcinoma patients had better overall survival and breast cancer-specific survival than invasive ductal carcinoma patients did. Multivariate analysis revealed age, marital status, TN stage, ER status, and chemotherapy as independent prognostic factors for invasive micropapillary carcinoma patients, which were used to construct a nomogram with good performance. A total of 294 DEGs were identified, with ten hub genes, including MMP2, FLNA and CFL1, which were expressed at lower levels in invasive micropapillary carcinoma patients than in invasive ductal carcinoma patients, indicating favorable outcomes.

CONCLUSIONS: Patients with invasive micropapillary carcinoma generally have a better prognosis than those with invasive ductal carcinoma does, which could be attributed to the lower expression of pro-oncogenic genes in the former group; however, the underlying mechanism needs further investigation.

RevDate: 2024-12-26

Yang M, Wang C, Ouyang L, et al (2024)

Establishment of prognostic model for invasive ductal carcinoma with distant metastasis within the triple-negative breast cancer: a SEER population-based study.

European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) pii:00008469-990000000-00176 [Epub ahead of print].

Triple-negative breast cancer (TNBC) is a complex and diverse group of malignancies. Invasive ductal carcinoma (IDC) is the predominant pathological subtype and is closely linked to the ominous potential for distant metastasis, a pivotal factor that significantly influences patient outcomes. In light of these considerations, the present study was conceived with the objective of developing a nomogram model. This model was designed to predict the prognosis observed in IDC with distant metastasis in TNBC. This was a retrospective study based on the SEER database. Data of 9739 IDC-TNBC patients diagnosed from 2010 to 2020 were included in our study. Independent risk factors were screened by univariate and multivariate Cox regression analyses successively, which were used to develop a nomogram model predicting for prognosis. Cox multivariable analysis showed statistical significance in bone metastasis, liver metastasis, surgery, and chemotherapy. Incorporating statistically significant variables, as well as clinically significant age, lung metastasis, and brain metastasis into the construction of the prediction model, the C-indexes of the training group and validation group were 0.702 (0.663-0.741) and 0.667 (0.600-0.734), respectively, while the calibration curves were all close to the ideal 45° reference line, and decision curve analysis curves show excellent net benefit in the predictive model. The prognostic prediction model developed in this study demonstrated enhanced predictive accuracy, enabling a more precise evaluation of mortality risks associated with IDC with distant metastasis in TNBC.

RevDate: 2024-12-26

Mitsa G, Florianova L, Lafleur J, et al (2024)

Clinical proteomics reveals vulnerabilities in non-invasive breast ductal carcinoma and drives personalized treatment strategies.

Cancer research communications pii:750703 [Epub ahead of print].

Ductal carcinoma in situ (DCIS) is the most common type (80%) of non-invasive breast lesions in women. The lack of validated prognostic markers, limited patient numbers, and variable tissue quality have a significant impact on diagnosis, risk stratification, patient enrolment, and the results of clinical studies. Here, we performed label-free quantitative proteomics on 50 clinical formalin-fixed, paraffin embedded biopsies, validating 22 putative biomarkers from independent genetic studies. Our comprehensive proteomic phenotyping reveals more than 380 differentially expressed proteins and metabolic vulnerabilities, that can inform new therapeutic strategies for DCIS and invasive ductal carcinoma (IDC). Due to the readily druggable nature of proteins and metabolic enzymes or metabolism inhibitors, this study is of high interest for clinical research and pharmaceutical industry. To further evaluate our findings, and to promote the clinical translation of our study, we developed a highly multiplexed targeted proteomics assay for 90 proteins associated with cancer metabolism, RNA regulation and signature cancer pathways, such as PI3K/AKT/mTOR and EGFR/RAS/RAF.

RevDate: 2024-12-25
CmpDate: 2024-12-25

Nagahara M, K Tezuka (2024)

[Invasive Ductal Carcinoma with Total Infarction and Necrosis-Case Report and Literature Review].

Gan to kagaku ryoho. Cancer & chemotherapy, 51(12):1255-1258.

A 71-year-old woman visited our hospital with pain and itching in her left breast which had commenced the day before admission. On palpation, we detected a 2.0 cm nodule, indicative of an elastic and hard tumor located centrally in the left breast. Mammography revealed an oval, microlobulated mass in the central quadrant of the left breast. Ultrasonography indicated a 1.5×1.3 cm hypoechoic lesion at the 12 o'clock position near the left nipple. Core needle biopsy revealed an invasive ductal carcinoma. Therefore, we mastectomized the left breast. Histologically, the tumor mass exhibited total necrosis, with viable carcinoma cells detected in a paramammary lymph node at the resected breast edge. Consequently, the tumor was diagnosed as a solid tubular carcinoma with total infarction and necrosis. Here, we present a rare case of breast cancer associated with infarction and necrosis.

RevDate: 2024-12-23
CmpDate: 2024-12-23

Zhang W, Huang Y, Zhou Y, et al (2024)

Delving into female breast cancer: Distinct disease-specific survival outcomes between invasive lobular and ductal carcinomas revealed by propensity score matching.

PloS one, 19(12):e0300116 pii:PONE-D-23-15805.

PURPOSE: The difference in prognosis between invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) is still controversial in the academic community. Resolving this controversy can help to more accurately determine patients' prognosis, provide further personalized treatment, alleviate unnecessary psychological burden for some patients, and provide direction for further fundamental research.

PATIENTS AND METHODS: A retrospective cohort study was conducted using the SEER Research Plus Data 8 Registries, Nov 2021 sub (1978-2019), including female breast cancer patients diagnosed with ILC or IDC between 2010 and 2015. Univariate and multivariate Cox regression analyses were performed, and key covariates affecting prognosis were selected. Propensity score matching (PSM) was employed to match patients, and balance tests were conducted to evaluate covariate distribution. Disease-specific survival (DSS) differences between the matched IDC and ILC groups were compared.

RESULTS: Following PSM, the covariate differences between the IDC and ILC groups were significantly reduced. The survival analysis revealed a significantly better prognosis for the IDC group than the ILC group (Log-rank test p < 0.001), with a 28.0% increased risk observed in the ILC group.

CONCLUSION: This study provides evidence supporting the existence of significant differences in prognosis between IDC and ILC patients after rigorous matching. The IDC group displayed a significantly better prognosis than the ILC group. Notably, these findings have implications for personalized treatment in clinical practice and contribute to the ongoing academic debate on survival differences between IDC and ILC. However, further research is needed to investigate the biological mechanisms, gene expression, and signaling pathway disparities between IDC and ILC, aiming to provide more targeted guidance for clinical decision-making.

RevDate: 2024-12-23

Sandhya A, Fahim M, Kulanathan A, et al (2024)

Incidence of a Positive Sentinel Lymph Node Biopsy in Screen-Detected Early Breast Cancer.

Cureus, 16(11):e74250.

Introduction Current guidelines advocate for a sentinel lymph node biopsy (SLNB) in patients with invasive breast cancer with negative axillary ultrasonography. However, emerging evidence has contradicted this, and SLNB omission has been found to be non-inferior in selected low-risk breast cancers. This retrospective study aimed to evaluate the incidence of SLNB in screen-detected invasive breast cancer. The secondary outcome was to identify risk factors in patients with positive SLNB and further axillary disease. Methods All screen-detected histologically confirmed invasive breast cancer and no evidence of spread to ipsilateral axillary lymph nodes (LNs) on ultrasound scans referred from screening between January 2018 and December 2019 were included in the study. All patients underwent surgical excision of the tumor as either breast conservation surgery or mastectomy, along with sentinel node biopsy. SLNB was performed using the dual technique of radioactive dye and blue dye. Results One hundred forty-nine patients were included in the study, all of whom were females. The mean patient age was 61.9 years old, with the majority 65 (43.6%) of the patients being in their 60s. Breast-conserving surgery (BCS) was performed in 138 (92.6%) patients. Eighty (53.7%) patients presented with right breast cancer. The mean size of invasive cancer was 15 mm. The mean total tumor size, including invasive and in situ, was 20.9 mm. One hundred twenty-seven (85.2%) patients had unifocal presentations, 69 (46.3%) of tumor foci were in the upper outer quadrant (UOQ), 122 (81.9%) of all tumors were ductal carcinoma, 81 (54.4%) patients had histologically grade 2 carcinomas, 135 (90.6%) of all patient tumors were ER-positive, HER2-negative, and six (4%) were ER-positive, HER2-positive. Twelve (8.05%) out of 149 included patients had positive sentinel LN biopsy. Of those 12 patients, eight (66.7%) had one to two nodes sampled, three (25%) had three to four nodes, and one (8.3%) had five or more nodes sampled. Out of 12 positive SNB patients, 11 had completed axillary node clearance (ANC) as per the National Institute for Health and Care Excellence (NICE) guidelines: nine (81.8%) had no further disease, and two (18.2%) had four positive nodes. The mean number of nodes taken in ANC was 15.8 ± 11.5. Of the two patients with positive axillary disease, one had BCS, and the other had a mastectomy. Both were grade 3 IDC, and the mean size was 57.5 mm. Nine patients died within four years of diagnosis, with four due to distant breast metastasis. Conclusion Only 8% of patients had positive SLNB in screen-detected breast cancer, which may support the previous studies of omitting SLNB being non-inferior but only in selected postmenopausal small early breast cancers with normal axillary ultrasound in the absence of any other risk factors. However, close follow-up will be required for disease-free survival, overall survival, and locoregional recurrence in this cohort.

RevDate: 2024-12-22

Denimal L, Klein C, Capon G, et al (2024)

Impact of Clean Intermittent Self-Catheterization and Indwelling Catheterization on Perioperative Outcomes in Patients with Urinary Retention Undergoing BPH Surgery: A Comparative Monocentric Retrospective Study.

The French journal of urology pii:S2950-3930(24)00319-X [Epub ahead of print].

INTRODUCTION AND OBJECTIVES: In case of acute urinary retention (AUR) due to benign prostatic hyperplasia (BPH) first trial without catheter (TWOC) may fail in about 30% of cases. In this situation most of patients have to keep an indwelling catheter (IDC) or to perform clean intermittent self-catheterization (CISC) until surgery.Although CISC has shown several advantages over IDC in neurologic patients, it is barely proposed in case of acute or chronic urinary retention due to BPH and comparative data on the outcomes of BPH surgery are very sparse.The aim of this study was to evaluate peri-operative outcomes of BPH surgery depending on the type of urinary drainage (IDC or CISC) in a population of patients with acute or chronic urinary retention and TWOC failure.

PATIENTS AND METHOD: We retrospectively analyzed a prospectively maintained database on BPH surgery to retrieve the records of all men admitted for surgical treatment of BPH following acute or chronic urinary retention with TWOC failure over a one-year period of time (January to December 2022). Two groups were constituted depending on the type of urinary drainage at the time of surgery (IDC or CISC). Peri-operative outcomes were compared between groups regarding pre-operative urine culture, antibiotic consumption, post-operative complications, length of hospital stay, and spontaneous voiding after catheter removal.

RESULTS: Between January and December 2022, 59 patients underwent BPH surgery after urinary retention and TWOC failure. At the time of surgery, 28 patients were on IDC (47%) and 31 patients were on CISC (53%). Despite a shorter delay between AUR and surgery in the IDC group (42 days vs. 80 days, p<0,01), patients had a significantly higher rate of pre-operative positive urine culture (100% vs. 51.6%, p < 0.01), received antibiotics more frequently (93% vs. 42%, p < 0.01), had a higher rate of post-operative complications (50% vs. 13%, p < 0.01), stayed longer in the hospital (3 days vs. 2 days, p= 0.02), and had a higher rate of post-operative retention (36% vs. 6.5%, p < 0.01).

CONCLUSION: In our experience, the use of CISC before BPH surgery improved peri-operative outcomes as compared to IDC. CISC reduced antibiotic consumption, post-operative complications, length of hospital stay, and improved micturition recovery after catheter removal.

RevDate: 2024-12-21
CmpDate: 2024-12-21

Salmi T, Ameur D, Dali-Sahi M, et al (2024)

Exploration of plasma tryptophan levels along with Ki-67 expression binomial investigation for forecasting tumor aggressiveness within invasive ductal breast cancer.

Journal of molecular histology, 56(1):52.

Ki-67 is a histological marker indicating cancer aggressiveness, while tryptophan (TRP) depletion modulates immune responses, including tumor aggressiveness. The study evaluates Ki-67's predictive value in relation to plasma TRP levels in invasive ductal carcinoma of breast cancer, aiming to improve understanding of tumor characteristics and clinical behavior. A study involving 165 women, measured plasma TRP levels and Ki-67 and analyzed their relationship with tumor aggressiveness markers using statistical analyses and predictive models. Our study highlighted a significant correlation between decreased plasma levels of TRP and a high mitotic index, measured by the Ki-67 marker (Pearson correlation coefficient r = - 0.402; p = 0.011). Tryptophan levels below 40 µmol/L were associated with a Ki-67 level above 15%, suggesting more active tumor growth in patients. Additionally, several risk factors for BC were identified within the studied population. The demographic and clinical characteristics of the participants include an average age of 63 years, plasma glucose levels above 1.2 g/L, and plasma TRP levels below 40 µmol/L, which are associated with an increased risk of BC. Furthermore, various polynomial logistic regression models indicate that TRP levels may be predicted based on Ki-67 expression, providing a promising approach to refine prognostic assessments. The study showed a correlation between low levels of tryptophan (TRP) and a high Ki-67 mitotic index in breast cancer patients, particularly in invasive ductal carcinoma, which is strongly linked to the aggressiveness of the disease. The integration of these markers into routine practice remains a technical and economic challenge.

RevDate: 2024-12-21
CmpDate: 2024-12-21

Xie T, Fan G, Tang L, et al (2024)

Artificial neural network systems to predict the response to sintilimab in squamous-cell non-small-cell lung cancer based on data of ORIENT-3 study.

Cancer immunology, immunotherapy : CII, 74(1):29.

BACKGROUND: Existing biomarkers and models for predicting response to programmed cell death protein 1 monoclonal antibody in advanced squamous-cell non-small cell lung cancer (sqNSCLC) did not have enough accuracy. We used data from the ORIENT-3 study to construct artificial neural network (ANN) systems to predict the response to sintilimab for sqNSCLC.

METHODS: Four ANN systems based on bulk RNA data to predict disease control (DC), immune DC (iDC), objective response (OR) and immune OR (iOR) were constructed and tested for patients with sqNSCLC treated with sintilimab. The mechanism exploration on the bulk and the spatial level were performed in patients from the ORIENT-3 study and the real world, respectively.

FINDINGS: sqNSCLC patients with different responses to sintilimab showed each unique transcriptomic spectrum. Four ANN systems showed high accuracy in the test cohort (AUC of DC, iDC, OR and iOR were 0.83, 0.89, 0.93 and 0.94, respectively). The performance of ANN systems was better than that of linear model systems and showed high stability. The mechanism exploration on the bulk level suggested that patients with lower ANN system scores (worse response) had a higher ratio of immune-related pathways enrichment. The mechanism exploration on the spatial level indicated that patients with better response to immunotherapy had fewer clusters of both tumor and cytotoxicity T cell spots.

INTERPRETATION: The four ANN systems showed high accuracy, robustness and stability in predicting the response to sintilimab for patients with sqNSCLC.

RevDate: 2024-12-19

Kayadibi Y, Karagoz SH, Kurt SA, et al (2024)

Diagnostic Characteristics and Clinical Relevance of Incidental Hypermetabolic Breast Lesions Detected on [18]F-FDG PET-CT: A Retrospective Evaluation.

Academic radiology pii:S1076-6332(24)00876-6 [Epub ahead of print].

RATIONALE AND OBJECTIVES: The study aimed to evaluate demographic and radiological characteristics of breast incidentalomas found on 18-fluorodeoxyglucose Positron Emission Tomography-Computed Tomography ([18]F-FDG PET-CT) performed for extramammary indications.

MATERIALS AND METHODS: A total of 12633 [18]F-FDG PET-CT scans performed between January 1, 2018 and January 1, 2024, were retrospectively reviewed. Breast incidentalomas that had undergone breast imaging, tissue diagnosis, or at least 2-year radiological follow-up were included. Demographic data and lesion size were recorded. Maximum and average standardized uptake values (SUVmax-SUVavg) and SUV corrected for lean body mass (SUL) were calculated using region of interest (ROI).

RESULTS: The inclusion criteria were met in 101 lesions (81 benign and 20 malignant). The most common benign lesion was fibroadenoma (n = 21), followed by stable lesions during follow-up (n = 18) and benign breast parenchyma (n = 11). The most common malignant lesion was invasive ductal carcinoma (n = 11). The diagnostic characteristics of SUVmax≥ 3, SULmax≥ 2, SUVavg≥ 0.735, SULavg≥ 0.48, and BI-RADS≥ 4 were 75%, 70%, 75%, 70% and 100% for sensitivity, 69%, 69%, 62%, 62% and 67% for specificity, and 69.3%, 68.3%, 62.4%, 61.4% and 73.3% for accuracy, respectively. The highest negative predictive values (NPV) were obtained with BI-RADS and SUVmax (100% and 92%, respectively). No significant difference in malignancy rate was observed for the lesion size and age of the patients (p > 0.05).

CONCLUSION: There is a risk of detecting malignancy in incidental lesions showing [18]F-FDG uptake. Radiological workup must be done, but SUVmax, with a high NPV value, can be used in conjunction with BI-RADS assessment for appropriate patient selection and effective management of resources.

RevDate: 2024-12-18

Cho SM, Cha JH, Kim HH, et al (2024)

Nonmass Lesions on Breast Ultrasound: Interreader Agreement and Associations With Malignancy.

AJR. American journal of roentgenology [Epub ahead of print].

Background: Nonmass lesions (NMLs) on breast ultrasound lack clear definition and encompass a broad range of benign and malignant entities. Given anticipated inclusion of NMLs in the BI-RADS 6th edition, thorough understanding of these lesions will be critical for optimal management. Objective: To evaluate interreader agreement for classification of lesions on breast ultrasound as NMLs and to identify imaging features associated with malignancy in these lesions. Methods: This retrospective study included 2007 patients (2005 female, 2 male; mean age, 54.0±9.6 years) who underwent ultrasound-guided biopsy of 2381 breast lesions between January 2020 and December 2020. Two radiologists independently classified lesions as masses or NMLs, using a definition of NMLs from a presentation at the 2023 Radiological Society of North America annual meeting. The radiologists attempted to reach consensus for discordant cases. Another radiologist recorded NMLs' mammographic and ultrasound characteristics. Pathological outcomes for NMLs were extracted from the EHR. Results: Interreader agreement for lesion classification (mass vs NML) was substantial (κ=0.73) A total of 216 lesions were classified as NMLs by both readers independently; an additional 101 lesions were classified as NMLs by consensus review after initial discordance. Thus, 317/2381 (13.3%) of lesions were classified as NMLs, of which 101/317 (31.9%) had initial discordance. A total of 133/317 (42.0%) NMLs were malignant, including invasive ductal carcinoma (48/133), ductal carcinoma in situ (43/133), and microinvasive ductal carcinoma (34/133). A total of 30.8% of malignant NML lacked correlative mammographic abnormalities. Ultrasound findings with highest accuracy for identifying malignancy of NMLs were calcifications (65.6%), posterior shadowing (62.8%), and non-parallel orientation (59.3%). In multivariable analysis, variables showing significant independent associations with malignancy included calcifications (OR=8.9), asymmetry (OR=4.7), and mass (OR=4.7) on mammography, and greater size (OR=1.03), non-parallel orientation (OR=8.7), and posterior shadowing (OR=6.3) on ultrasound. Conclusion: The analysis provides insights into reader variability for classifying ultrasound lesions as NML by an existing definition, as well as into imaging findings' potential utility for characterizing such lesions as malignant. Clinical Impact: These findings indicate the need for further precision and clarification regarding the definition of NMLs and for further investigation into which NMLs have greatest malignancy risk.

RevDate: 2024-12-17

Peng Y, Xiao R, Lan HM, et al (2024)

Synchronous bilateral breast carcinoma: Report of a rare case.

RevDate: 2024-12-17
CmpDate: 2024-12-17

Sheehan KJ, Guerra S, Ayis S, et al (2024)

Structured tailored rehabilitation after hip fragility fracture: The 'Stratify' feasibility and pilot randomised controlled trial protocol.

PloS one, 19(12):e0306870 pii:PONE-D-24-12423.

BACKGROUND: Rehabilitation in hospital is effective in reducing mortality after hip fracture. However, there is uncertainty over optimal in-hospital rehabilitation treatment ingredients, and the generalizability of trial findings to subgroups of patients systematically excluded from previous trials. The aim of this study is to determine the feasibility of a randomized controlled trial which aims to assess the clinical- and cost-effectiveness of adding a stratified care intervention to usual care designed to improve outcomes of acute rehabilitation for all older adults after hip fracture.

METHODS: This is a protocol for a single site, feasibility and pilot, pragmatic, parallel group (allocation ratio 1:1) randomised controlled assessor-blind STRATIFY trial (Structured Tailored Rehabilitation AfTer HIp FragilitY Fracture). Adults aged 60 years or more, surgically treated for hip fracture following low energy trauma (fragility fracture), who are willing to provide consent or by consultee declaration (depending on capacity), are eligible. Individuals who experienced in-hospital hip fracture will be excluded. Screening, consent/assent, baseline assessment (demographics, patient reported outcome measures or PROMs [health related quality of life, activities of daily living, pain, falls related self-efficacy], and resource use), and randomization will take place within the first four days post-admission. Participants will then be offered usual care, or usual care plus STRATIFY intervention during their hospital stay. The STRATIFY intervention includes 1) a web-based algorithm to allocate participants to low- medium- or high-risk subgroups; and 2) matched interventions depending on subgroup allocation. The low-risk subgroup will be offered a self-management review, training in advocacy, and a self-managed exercise programme with support for progression, in addition to usual care (1-hour 40 minutes therapist time above usual care). The medium-risk subgroup will be offered education, a goal-orientated mobility programme (with carer training, as available and following carer consent), and early enhanced discharge planning, in addition to usual care (estimated 2-hours 15 minutes therapist time above usual care). The high-risk subgroup will be offered education, enhanced assessment, orientation, and a goal-orientated activities of daily living programme (with carer training, as available and following carer consent), in addition to usual care (estimated 2-hours 45minutes therapist time above usual care). All STRATIFY subgroup treatment interventions are specified using the Rehabilitation Treatment Specification System (RTSS) for treatment theory development and replication. Follow-up PROM data collection, RESOURCE USE alongside readmissions and mortality, will be collected on discharge and 12-weeks post-randomisation. Intervention acceptability will be determined by semi-structured interviews with participants, carers, and therapists at the end of the intervention.

DISSEMINATION: The trial findings will be disseminated to patients and the public, health professionals and researchers through publications, presentations and social media channels.

TRIAL REGISTRATION: The trial has been registered at clinicaltrials.gov (NCT06014554).

RevDate: 2024-12-17

Song B, H Singh (2024)

Rare Breast Cancers Review.

Healthcare (Basel, Switzerland), 12(23): pii:healthcare12232483.

BACKGROUND/OBJECTIVES: Breast cancer is one of the most common malignancies in women, with rare subtypes presenting unique clinical challenges. This review provides a comprehensive analysis of rare breast cancers, including both epithelial and non-epithelial subtypes, and explores their epidemiology, pathology, prognosis, and treatment approaches.

METHODS: A systematic review was conducted focusing on recent advancements in the treatment of rare breast cancer subtypes. Articles were selected based on criteria emphasizing studies from the past five years, with older foundational studies included where necessary. The analysis incorporated molecular profiling, clinical trials, and advancements in targeted and immunotherapies, where possible.

RESULTS: Rare epithelial subtypes, such as tubular, mucinous, and medullary carcinomas, demonstrate distinct clinical and pathological features, with generally favorable prognoses compared to invasive ductal carcinoma (IDC). Non-epithelial cancers, including sarcomas and primary breast lymphomas, require individualized treatment due to aggressive behavior and poor prognosis in certain cases. Recent advancements in targeted therapies (e.g., HER2 inhibitors, PI3K inhibitors, and PARP inhibitors) and immunotherapies (e.g., PD-1 inhibitors) have shown promise in improving outcomes for specific molecularly characterized subtypes.

CONCLUSIONS: While the management of common breast cancers has become increasingly sophisticated, rare subtypes continue to pose challenges due to limited research and small patient populations. Advances in molecular profiling and next-generation sequencing are pivotal in identifying actionable mutations and expanding personalized treatment options. Future research should focus on clinical trials and collaborative efforts to refine treatment strategies and improve outcomes for these rare subtypes.

RevDate: 2024-12-17
CmpDate: 2024-12-17

Galappaththi SPL, Smith KR, Alsatari ES, et al (2024)

The Genomic and Biologic Landscapes of Breast Cancer and Racial Differences.

International journal of molecular sciences, 25(23): pii:ijms252313165.

Breast cancer is a significant health challenge worldwide and is the most frequently diagnosed cancer among women globally. This review provides a comprehensive overview of breast cancer biology, genomics, and microbial dysbiosis, focusing on its various subtypes and racial differences. Breast cancer is primarily classified into carcinomas and sarcomas, with carcinomas constituting most cases. Epidemiology and breast cancer risk factors are important for public health intervention. Staging and grading, based on the TNM and Nottingham grading systems, respectively, are crucial to determining the clinical outcome and treatment decisions. Histopathological subtypes include in situ and invasive carcinomas, such as invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC). The review explores molecular subtypes, including Luminal A, Luminal B, Basal-like (Triple Negative), and HER2-enriched, and delves into breast cancer's histological and molecular progression patterns. Recent research findings related to nuclear and mitochondrial genetic alterations, epigenetic reprogramming, and the role of microbiome dysbiosis in breast cancer and racial differences are also reported. The review also provides an update on breast cancer's current diagnostics and treatment modalities.

RevDate: 2024-12-17
CmpDate: 2024-12-17

Feng M, Cui H, Li S, et al (2024)

Ubiquitin-Activating Enzyme E1 (UBA1) as a Prognostic Biomarker and Therapeutic Target in Breast Cancer: Insights into Immune Infiltration and Functional Implications.

International journal of molecular sciences, 25(23): pii:ijms252312696.

Ubiquitin-Activating Enzyme E1 (UBA1), an E1 enzyme involved in the activation of ubiquitin enzymes, has been involved in the onset and progression of different cancers in humans. Nevertheless, the precise contribution of UBA1 in breast cancer (BC) is still poorly characterized. In this study, a thorough investigation was carried out to elucidate the significance of UBA1 and validate its functionality in BC. Through the analysis of mRNA sequencing data of BC patients, the mRNA expression of UBA1 was observed to be notably enhanced in cancer tissues relative to controls, and high UBA1 expression was linked to worse overall survival (OS), disease-specific survival (DSS), and progress-free survival (PFS). Moreover, UBA1 exhibited potential as an independent prognostic and diagnostic biomarker for individuals with BC. Additionally, functional enrichment analysis revealed the involvement of UBA1 in inflammation-linked pathways, like the TNF-α signaling pathway, the IL-6 signaling pathway, and various immune-related biological processes. Notably, single-sample gene set enrichment analysis (ssGSEA) aided in the identification of a negative link between UBA1 expression and the levels of infiltrating mast cells, Th1 cells, iDC cells, B cells, DC cells, Tem cells, Cytotoxic cells, T cells, CD8T cells, and pDC cells. Finally, this study demonstrated that silencing UBA1 significantly impeded the growth and development of BC cell lines. These findings highlight UBA1 as a potential prognostic biomarker linked to immune infiltration in BC, thereby depicting its potential as a new therapeutic target for individuals with BC.

RevDate: 2024-12-16

Konrad R, Güttler C, Öhl N, et al (2024)

Effects of the Tovertafel[®] on apathy, social interaction and social activity of people with dementia in long-term inpatient care: results of a non-controlled within-subject-design study.

Frontiers in neurology, 15:1455185.

INTRODUCTION: Tovertafel[®] is a VR-based serious game for dementia care (SGDC) that aims to stimulate residents affected by dementia in nursing homes, promote social and cognitive skills and reduce apathy. The aim of this study is to investigate the effects of using Tovertafel[®] on apathy, social interaction and social activity of people with dementia (PWD) in long-term inpatient care in Germany.

METHODS: In this monocentric intervention study, 25 residents of an inpatient long-term care facility with moderate or severe dementia had two weekly applications of Tovertafel[®] over a period of 8 weeks. Effects on the residents' social interaction and activity were recorded before (T1), during (T2) and 1 h after (T3) each intervention using the Engagement of a Person with Dementia Scale (EPWDS). The degree of apathy was assessed using the Apathy Evaluation Scale (AES). Effects of Tovertafel[®] were examined using a simple repeated measures analysis of variance (ANOVA).

RESULTS: Thirteen residents with moderate (52%) and 12 residents with severe dementia (48%) were included. Results showed that residents' apathy changed over the course of the trial and was partially reduced. ANOVA revealed significant changes in the positive expression of social participation in the overall group between individual observation times (p < 0.001; T1: MW = 2.67, SD = 1.352; T2: MW = 3.66, SD = 1.365; T3: MW = 3.10, SD = 1.300) and a significantly lower negative expression of social participation at T2 (MW = 1.09, SD = 0.358) than at T1 (MW = 1.19, SD = 0.579; p = 0.028). There was a significantly higher positive expression of behavioral involvement in the overall group at T3 (MW = 1.17, SD = 0.552) than at T1 (p = 0.003) or T2 (p = 0.045). Analyses did not find any significant interaction between observation times and degree of dementia.

DISCUSSION: Results of the study show that the use of Tovertafel[®] over a period of 2 months had significant effects on apathy, social activity and social interaction in people with moderate or severe dementia. Symptoms of apathy could be reduced and social interaction and activity increased. However, due to limitations of the study design and special circumstances of the COVID-19 pandemic situation, findings might be overestimated and must be interpreted with care. Further research is necessary.

RevDate: 2024-12-13

Liu Y, Shi H, He Q, et al (2024)

Invasive carcinoma segmentation in whole slide images using MS-ResMTUNet.

Heliyon, 10(4):e26413.

Identifying the invasive cancer area is a crucial step in the automated diagnosis of digital pathology slices of the breast. When examining the pathological sections of patients with invasive ductal carcinoma, several evaluations are required specifically for the invasive cancer area. However, currently there is little work that can effectively distinguish the invasive cancer area from the ductal carcinoma in situ in whole slide images. To address this issue, we propose a novel architecture named ResMTUnet that combines the strengths of vision transformer and CNN, and uses multi-task learning to achieve accurate invasive carcinoma recognition and segmentation in breast cancer. Furthermore, we introduce a multi-scale input model based on ResMTUnet with conditional random field, named MS-ResMTUNet, to perform segmentation on WSIs. Our systematic experimentation has shown that the proposed network outperforms other competitive methods and effectively segments invasive carcinoma regions in WSIs. This lays a solid foundation for subsequent analysis of breast pathological slides in the future. The code is available at: https://github.com/liuyiqing2018/MS-ResMTUNet.

RevDate: 2024-12-13

Yoon KH, Kim EK, HC Shin (2024)

Prognostic implications of ductal carcinoma in situ components in BRCA1/2-positive breast cancer: a retrospective cohort study.

Annals of surgical treatment and research, 107(6):327-335.

PURPOSE: Although the breast cancer susceptibility gene (BRCA)-associated invasive breast cancer is well studied, there are limited reports on ductal carcinoma in situ (DCIS) in patients with BRCA1/2 mutations. This study aims to evaluate the differential prognostic effect of DCIS in breast cancer patients with pathologic variants of BRCA1/2 genes.

METHODS: Breast cancer patients who tested positive for BRCA1/2 mutations between August 2003 and January 2022 at a single tertiary referral center were retrospectively analyzed. Survival outcomes were compared between patients with both invasive ductal carcinoma (IDC) and DCIS (IDC-DCIS group, n = 121) and those with IDC alone (IDC group, n = 36).

RESULTS: Of the 157 patients, 65 (41.4%) exhibited mutations in BRCA1, 90 (57.3%) in BRCA2, and 2 (1.3%) in both BRCA1/2. DCIS components were more frequently found in BRCA2 pathological variants (BRCA1, 46 [38.0%] vs. BRCA2, 76 [62.4%]; P = 0.030). No statistically significant difference was found in 10-year recurrence-free survival (IDC-DCIS, 89.3% vs. IDC, 83.6%; P = 0.989). Subgroup analysis indicated that the DCIS component correlated with improved survival outcomes in the BRCA1 subgroup (BRCA1 IDC-DCIS, 85.5% vs. BRCA1 IDC, 51.0%; P = 0.024). Conversely, in the BRCA2 subgroup, IDC-DCIS patients exhibited a worse prognosis (BRCA1 IDC-DCIS, 85.5% vs. BRCA2 IDC-DCIS, 65.8%; P = 0.045).

CONCLUSION: The presence of a DCIS component carries varied prognostic significance in BRCA1 and BRCA2 mutations. A tailored approach may be necessary when determining treatment options for breast cancer patients with BRCA1/2 mutations based on the presence of DCIS.

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RJR Experience and Expertise

Researcher

Robbins holds BS, MS, and PhD degrees in the life sciences. He served as a tenured faculty member in the Zoology and Biological Science departments at Michigan State University. He is currently exploring the intersection between genomics, microbial ecology, and biodiversity — an area that promises to transform our understanding of the biosphere.

Educator

Robbins has extensive experience in college-level education: At MSU he taught introductory biology, genetics, and population genetics. At JHU, he was an instructor for a special course on biological database design. At FHCRC, he team-taught a graduate-level course on the history of genetics. At Bellevue College he taught medical informatics.

Administrator

Robbins has been involved in science administration at both the federal and the institutional levels. At NSF he was a program officer for database activities in the life sciences, at DOE he was a program officer for information infrastructure in the human genome project. At the Fred Hutchinson Cancer Research Center, he served as a vice president for fifteen years.

Technologist

Robbins has been involved with information technology since writing his first Fortran program as a college student. At NSF he was the first program officer for database activities in the life sciences. At JHU he held an appointment in the CS department and served as director of the informatics core for the Genome Data Base. At the FHCRC he was VP for Information Technology.

Publisher

While still at Michigan State, Robbins started his first publishing venture, founding a small company that addressed the short-run publishing needs of instructors in very large undergraduate classes. For more than 20 years, Robbins has been operating The Electronic Scholarly Publishing Project, a web site dedicated to the digital publishing of critical works in science, especially classical genetics.

Speaker

Robbins is well-known for his speaking abilities and is often called upon to provide keynote or plenary addresses at international meetings. For example, in July, 2012, he gave a well-received keynote address at the Global Biodiversity Informatics Congress, sponsored by GBIF and held in Copenhagen. The slides from that talk can be seen HERE.

Facilitator

Robbins is a skilled meeting facilitator. He prefers a participatory approach, with part of the meeting involving dynamic breakout groups, created by the participants in real time: (1) individuals propose breakout groups; (2) everyone signs up for one (or more) groups; (3) the groups with the most interested parties then meet, with reports from each group presented and discussed in a subsequent plenary session.

Designer

Robbins has been engaged with photography and design since the 1960s, when he worked for a professional photography laboratory. He now prefers digital photography and tools for their precision and reproducibility. He designed his first web site more than 20 years ago and he personally designed and implemented this web site. He engages in graphic design as a hobby.

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Cancer is the generic name for more than 100 diseases in which cells begin to grow and divide in an uncontrolled manner. Usually, when cells get too old or damaged, they die and new cells take their place. Cancer begins when genetic changes impair this orderly process so that some cells start to grow uncontrollably. The Emperor of All Maladies is a "biography" of cancer — from its first documented appearances thousands of years ago through the epic battles in the twentieth century to cure, control, and conquer it to a radical new understanding of its essence. This is a must read book for anyone with an interest in cancer. R. Robbins

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Collection of publications by R J Robbins

Reprints and preprints of publications, slide presentations, instructional materials, and data compilations written or prepared by Robert Robbins. Most papers deal with computational biology, genome informatics, using information technology to support biomedical research, and related matters.

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Curriculum Vitae for R J Robbins

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