The Role of MRI in Assessing Residual Breast Cancer After Neoadjuvant Chemotherapy.

INTRODUCTION: Breast cancer is the most common malignancy among women in the world. The role of neoadjuvant chemotherapy (NAC) in the management of breast cancer is increasing. The decision about the management after NAC depends mainly on the tumor response to NAC. OBJECTIVES: The role of the current study is to evaluate the role of the MRI scan in assessing the residual disease after NAC, which would help in decision making regarding the best treatment plan for the patient. PATIENTS AND METHODS: We did this retrospective review for all patients who were diagnosed with breast cancer in our center and had NAC over four years. All patients in our study had a post-NAC magnetic resonance imaging (MRI) scan to assess the residual tumor size. A 2×2 table was used to calculate the diagnostic accuracy, and SPSS software version 25 was used to get the correlation coefficients between the post-NAC MRI measurements and pathological size. RESULTS: 28 female patients were included in our study. The average age was 45.25 ± 10 years. We utilized the tumor size on histology as the standard for comparison. We calculated MRI sensitivity, specificity, PPV, and NPV rates of 90.9%, 100%, 100%, and 94.4%, respectively. The correlation coefficient was strong (r = 0.859, P = 0.01). CONCLUSION: Magnetic resonance imaging is a good test to assess the residual tumor disease after NAC in breast cancer patients. However, cases of under- and overestimation are still seen, which require more caution when making a decision regarding the management of such cases.

Microbiome and Colorectal Cancer Management.

Globally, colorectal cancer (CRC) is one of the most typical lethal cancers. One of the main factors for better outcomes in CRC management is the early detection of the disease. As an integral component of human metabolism and homeostasis, gut microbiome has recently been a subject of extensive research for its role in the pathogenesis, diagnosis, and treatment of CRC. Microbial dysbiosis (the decrease in beneficial gut flora and the increase of detrimental populations) leads to chronic inflammation and genetic alteration in the host cells, triggering and promoting CRC carcinogenesis. Identifying these microbial changes in depth would potentially isolate the pathogenic microbiota species and establish biomarker models for early detection of CRC. On the other hand, modifying these microbial changes would help formulate preventative and therapeutic strategies for CRC, developing a more precise CRC management plan according to each patient's microbial print. This essay explains gut microbiome composition, microbial changes (dysbiosis) in CRC carcinogenesis, the probability of creating microbiome-based CRC biomarkers, and potential microbiome-targeted treatment options.