Does the presence of sentinel lymph node macrometastases in breast cancer patients require axillary lymph node dissection?-Single-center analysis.

According to the current guidelines on treatment of breast cancer patients, identification of metastases in the sentinel lymph node (SLN (+)) is not an absolute indication for necessary axillary lymph node dissection (ALND). In our study, we present long-term outcomes of treatment among SLN(+) patients referred for conservative treatment, for example, no further ALND. A total of 3145 breast cancer patients subjected to sentinel lymph node biopsy (SLNB) between November 2008 and June 2015. SLN metastases were identified in 719 patients (22.9%). Locoregional recurrences and distant metastases as endpoints were distinquished. The mean follow-up time for patients after ALND was 36.2 months (6-74 months); 18.8 months (6-38 months) for patients with SLN macrometastases without ALND; and 34.0 months (6-74 months) for patients with micrometastases. Adjuvant ALND was performed in 626 of SLN(+) patients. Conservative treatment was applied in the remaining 93 cases. Among SLN(+) patients without adjuvant ALND, there was one case of recurrence (1.07%). In the group of patients without SLN, metastases recurrence was noted in 32 patients (1.32%). Among SLN(+) patients diagnosed with macrometastases, recurrence concerned 2.01% of analyzed cases (all subjected to ALND). Lack of radical surgical treatment in SLN(+) breast cancer patients did not lead to worsening long-term outcomes. In the occurrence of macrometastases to the sentinel lymph node, abandoning completion axillary lymph node dissection might be a reasonable option. However, it would require continuation of current research, preferably involving a clinical trial.

Assessment of quality of life in women five years after breast cancer surgery, members of Breast Cancer Self-Help Groups - non-randomized, cross-sectional study.

AIM OF THE STUDY: To assess the quality of life in patients treated for breast cancer who were 5 years after diagnosis and were active members of Breast Cancer Self-Help Groups. MATERIAL AND METHODS: The study had a non-randomized, cross-sectional design. We enrolled 167 women who were more than 5 years after mastectomy and were active members of Breast Cancer Self-Help Groups (group A1). As a control group we enrolled 117 women after mastectomy - not members of such support groups (group A2). For the evaluation of the quality of life in both groups we used the following standardized questionnaires - EORTC QLQ-C30 and EORTC QLQ-BR23 as well the Mini-MAC scale for the assessment of strategies of coping with disease. RESULTS: Based on QLQ C30 scores, group A1 had better emotional functioning (p = 0.0005) and a higher general quality of life (p = 0.0259), whereas group A2 had better role functioning (p = 0.0042). Based on QLQ BR23 scores, there were statistically significant differences in body image (p = 0.0366) and life perspectives (p = 0.0313) in favor of group A1. In the control group, there was a greater use of destructive coping strategies and anxious preoccupation (p = 0.1957). CONCLUSIONS: Membership in Amazon groups improves functioning in breast cancer patients that can also extend into a five-year period after treatment completion.

Evaluation of changes to foot shape in females 5 years after mastectomy: a case-control study.

PURPOSE: The aim of this study was to evaluate changes in foot shape of women 5 years after undergoing breast amputation. METHODS: Evaluation of foot shape was performed using a non-invasive device for computer analysis of the plantar surface of the foot. Obtained results were compared between feet on the healthy breast side (F1) and on the amputated breast side (F2). RESULTS: 128 women aged 63.60 ± 8.83, 5-6 years after breast amputation were enrolled in this case-control study. Weight bearing on the lower extremity on the amputated breast side (F1) compared with the healthy breast side (F2) showed statistically significant differences (p < 0.01). Patients put more weight onto the healthy breast side. No statistically significant difference was found with regard to F1 and F2 foot length (p = 0.4239), as well as BETA (p = 0.4470) and GAMMA (p = 0.4566) angles. Highly statistically significant differences were noted with respect to foot width, ALPHA angle, and Sztriter-Godunov index-higher values were observed on the healthy breast side (p < 0.001). Highly statistically significant differences were also noted while comparing Clark's angles, higher values being observed on the operated breast side (p < 0.001). CONCLUSIONS: Differences in foot shape on the healthy breast side and amputated breast side constitute a long-term negative consequence of mastectomy, and can be caused by unbalanced weight put on feet on the healthy breast side compared to the amputated breast side.

Prevalence of biological types of breast cancer and their influence on disease staging and therapeutic management - a single-center study.

According to the St. Gallen 2011 consensus, proper qualification of breast cancer patients for treatment requires taking into consideration the division into biological types of neoplasms. The goal of this work was to assess the prevalence of all biological types of breast cancer in the population of Kuyavian-Pomeranian province. We determined the influence of particular types of neoplasms on the degree of disease progression and the choice of therapeutic management. The study was conducted on a group of 2653 patients treated surgically due to malignant breast tumors in the Oncology Centre in Bydgoszcz. In the analyzed clinical material we determined the biological type of cancer as well as other prognostic factors. The most commonly identified types of cancer were luminal B1 type (38.4%) and luminal A type (27.4% of cases), followed by a triple-negative type, luminal B2 type and HER2-positive type (respectively: 11.4%, 10.2%, and 6.9% of patients). Estrogen receptors were present in 81.1% and progesterone receptors in 71.4% of subjects. HER2 overexpression was identified in 17.3% of patients. Routine use of a biology-based division into cancer types influences the choice of anti-cancer treatment. Diagnosis of luminal A type of tumor more commonly than other biological types of cancer coexists with lower clinical and pathological disease staging. It allows for more frequent use of sparing surgical techniques in patients. It also makes systemic neoadjuvant chemotherapy unnecessary in the majority of patients (differences in such cases exhibit statistical significance of p < 0.0001).

Determination of the effect of abiotic stress on the oxidative potential of edible potato tubers.

Stress factors occurring during the growing season and potato storage, can negatively affect the quality of tubers, including an increased tendency to enzymatic darkening. Abiotic stress due to water shortage is a major factor limiting agricultural production. The purpose of the study was to determine the effect of cultivation technology based on the use of biostimulant, hydrogel and irrigation as well as storage on the propensity to darkening and the content of sugars and organic acids. The results show that genotypic and technological variability in interaction with growing season conditions had a significant (p < 0.05) effect on the oxidative potential (OP) of potato tubers. The Denar cultivar, compared to the 'Gardena', was characterized by a lower tendency to enzymatic darkening. Application of biostimulant and hydrogel generally contributed to lowering the oxidative potential of the tested cultivars. The application of anti-stress agents had no effect on organic acid content. The long-term storage caused an increase in the content of total sugars (TS) (22%), reducing sugars (RS) (49%), chlorogenic acid (ACH) (11%), and loss of ascorbic acid (AA) (6%) in the tubers which contributed to an increase in the oxidative potential of potato tubers (16%). The correlation coefficients obtained (p < 0.05) confirm the dependence of OP on the concentration of organic acids.

Foot posture in female patients 5 years after breast-conserving surgery: a case-control study.

PURPOSE: Along with the improvement in the outcomes of breast cancer treatment being observed in the recent years, long-term studies to assess distant adverse effects of the treatment have become increasingly important. The objective of this study was to assess the foot posture in patients subjected to breast-conserving therapy. The assessment was made 5 years after the surgical procedure. METHODS: 116 female patients (mean age of 58.75 years) were qualified into a case-control study. Foot posture on the operated breast side (F1) as well as on the contralateral side (F2) was evaluated using a computer-based foot analysis tool as an extension of projection moiré-based podoscopic examination. Comparisons were made for the following parameters: limb load, L-foot length, W-foot width, L/W-Wejsflog index, ALPHA-hallux valgus angle, BETA-little toe varus angle, GAMMA-heel angle, KY-Sztriter-Godunov index, CL-Clarke's angle, HW-heel width. RESULTS: Five years after BCT, patients placed higher load on the foot on the side of the healthy breast (p = 0.0011). No statistically significant differences were observed between F1 and F2 with respect to other foot posture parameters (p > 0.05). No statistically significant differences were observed in foot posture parameters in patients having undergone BCT + ALND (axillary lymph node dissection) procedure as compared to patients subjected to BCT + SLNB (sentinel lymph node biopsy) procedure (p > 0.05). CONCLUSIONS: No changes in foot posture were observed in patients 5 years after the BCT procedure. The type of the surgical procedure related to the lymph nodes within the axillary fossa has no effect on changes in foot posture.

Analysis of Undesirable Sequelae of Sentinel Node Surgery in Breast Cancer Patients - a Prospective Cohort Study.

Use of sentinel lymph node biopsy limits the frequency and severity of sequelae of surgical treatment. However, the procedure itself may not be completely free of complications. The goal of this work was to analyze prospectively the occurrence of undesirable sequelae in patients undergoing sentinel lymph node biopsy as an isolated intervention in the axillary fossa. This prospective observational study was conducted on a group of 104 women. Patients were examined on five occasions: one day before the procedure, one day after the procedure, one month, three months, and six months after the procedure. At every stage of the study they were assessed for tactile sensation, range of motion in the shoulder joint, upper limb circumference, sensation abnormalities, winged scapula sign, and pain severity according to Visual Analogue Scale (VAS). In the study group we observed statistically significant differences, such as limited mobility in the shoulder joint (p ≤ 0.01), gradual increase in limb circumference on the operated side (p < 0.01) and pain (p ≤ 0.01). Despite relatively low invasiveness of the procedure, sentinel lymph node biopsy is not entirely devoid of the risk of undesirable sequelae.

Chronic imipramine treatment reduces inhibitory properties of group II mGlu receptors without affecting their density or affinity.

An increasing body of evidence indicates an important role of the glutamatergic system in the pathophysiology of depression. Not only ionotropic but also metabotropic glutamate receptors (mGlu receptors) have been suggested to be involved in the mechanism of action of antidepressant drugs. Moreover, several mGlu receptor ligands possess a great antidepressant potential. Group II mGlu receptor antagonists have been shown to induce antidepressant-like effects in rodents. An influence of chronic antidepressant treatment on group II mGlu receptors has also been suggested. In our studies, we examined an influence of repeated (21-day) imipramine treatment on the density of group II mGlu receptors and affinity of mGlu2 and mGlu3 receptor radioligand [3H]-LY341495 for group II mGlu receptors in the rat brain hippocampus and frontal cortex. Moreover, we analyzed an influence of chronic imipramine administration on the ability of group II mGlu receptor agonist, 2R,4R-APDC, to inhibit forskolin-stimulated cAMP accumulation in the rat brain cortical slices. We found that inhibitory properties of group II mGlu receptors were diminished after chronic, but not acute imipramine administration. However, no changes in the density or affinity of the mGlu2 and mGlu3 receptor ligand for group II mGlu receptors were observed.

Activation of the NMDA/glutamate receptor complex antagonizes the NMDA antagonist-induced antidepressant-like effects in the forced swim test.

The antidepressant activity of NMDA receptor antagonists has been demonstrated, and their mechanism of action was based on the assumption of their selectivity for the NMDA receptor only. However, no direct evidence for the NMDA receptor role in this activity was demonstrated. Now, in order to prove the NMDA pathway of antidepressant-like action of the NMDA antagonists in the mouse forced swim test (FST) we examined if antidepressant activity of NMDA receptor antagonists is mediated by NMDA receptors and whether the activation of different modulatory sites of the NMDA receptor complex influence the action of the antagonists of different sites of NMDA receptor. In our study, we used two NMDA ligands: competitive NMDA glutamate site antagonist CGP 37849, and glycineB antagonist L-701,324; both at doses found to be effective in the FST. The antidepressant-like activity of the compounds was abolished by the N-methyl-D-aspartic acid (NMDA) or by D-serine co-treatment. Ligands at the doses active in the FST did not alter locomotor activity. The present study indicates the major role of the NMDA/glutamate pathway in the antidepressant-like activity of NMDA antagonists in the mouse FST.

Increase in synaptic hippocampal zinc concentration following chronic but not acute zinc treatment in rats.

Electroconvulsive seizures (ECS), one of the most effective treatments of depression, induce mossy fiber sprouting (when assayed by means of synaptic zinc method), and this indicates an increase in the synaptic zinc level in the hippocampus following such therapy. The aim of the present study was to investigate the influence of acute and chronic zinc hydroaspartate administration on the synaptic and total zinc level in the rat hippocampus. We used two methods of zinc determination: (1) zinc-selenium method, which images the pool of synaptic zinc, and (2) flame atomic absorption spectrometry, which assays the total concentration of zinc. Our results indicate that chronic (14 x 65 mg/kg), but not acute, zinc hydroaspartate administration intraperitoneally (i.p.) increases the pool of synaptic zinc in the majority of rat hippocampal layers (by 72-190%), except for the stratum moleculare and stratum radiatum CA, and perforant path DG. On the other hand, no changes were found in total hippocampal zinc level, measured by flame atomic absorption spectrometry. These data suggest that chronic zinc treatment increases the pool of synaptic zinc in the hippocampus, and this effect is similar to that observed following chronic ECS treatment. The measurement of zinc concentration in the whole hippocampus by the flame atomic absorption spectrometry method is not sensitive enough to detect such subtle alteration.