Breast Cancer Prognosis: A Study on Mortality Indicators.

Background: The prognosis of breast cancer patients is critical for tailored treatment options. While previous observational studies have identified various prognostic markers, a consensus in their clinical application is lacking. This single-center retrospective study aimed to validate the most frequent risk factors associated with increased mortality in breast cancer patients. Methods: Our study spanned an 8-year interval (2014-2020) and included 213 female patients with stage IIA-IIIB breast cancer. Key variables such as age, disease stage, and type of treatment were analyzed in relation to one-year survival as the primary outcome measure. Results: Elevated preoperative levels of tumor markers ACE and CA 15-3, larger tumor size, and advanced lymph nodal invasion were significantly associated with increased mortality. Immunohistochemistry indicated that the presence of Estrogen and Progesterone Receptors (ER and PR) were protective factors, whereas Human Epidermal Growth Factor Receptor 2 (HER2) was a negative prognostic indicator. Among molecular subtypes, Luminal A demonstrated protective effects, whereas HER2-positive and Triple-negative subtypes were identified as risk factors. Conclusion: This study confirms the significant role of tumor size, lymph node stage, and specific molecular markers in predicting breast cancer mortality. These findings contribute to a nuanced understanding of disease prognosis and offer crucial insights for clinicians in managing treatment plans.

Gastro-Intestinal Bleeding in COVID-19 Patients - Is There Any Causal Relation?

The novel Severe Acute Respiratory Syndrome Coronavirus-2 has put an enormous pressure on health systems around the world. The large number of severe cases that had symptoms seemingly unrelated to the respiratory system, continues to create confusion. The digestive tract is not spared either. The most commonly reported digestive symptoms are nausea, vomiting, anorexia, diarrhea and, less frequently but with significant impact, gastrointestinal bleeding. The elderly population is the one more likely to develop severe anemia clinically expressed by hematemesis, melena or hematochezia. From our experience and as we concluded from literature, men confirmed with COVID-19 have a higher risk of developing digestive haemorrhage. The upper gastro-intestinal tract, defined as the digestive segment above the Treitz angle, is more often affected. The gastro-duodenal ulcers are the main cause found in COVID-19 patients with digestive bleeding. In addition, the patients with SARS-COV2 infection and gastro-intestinal bleeding most commonly associate with other comorbidities such as hypertension and diabetes.