ABSTRACT
INTRODUCTION: The use of neoadjuvant therapy (NAT) has been showing an incraesing tendency in the treatment of locally advanced breast cancer. The evaluation of residual cancer could be performed by Residual Cancer Burden (RCB) calculator. The prognostic system takes the two largest diameters of the tumor, the cellularity, the amount of in situ carcinoma, the number of metastatic lymph nodes, and the size of the largest metastatic deposit into account. The aim of our study was to examine the reproducibility of RCB in NAT treated patients. METHODS: Patients who were treated with NAT and had resection specimens between 2018 and 2021 were selected. Histological examination was performed by five pathologists. After assessment of the examined variables, RCB points and RCB classes were defined. For statistical analysis, interclass correlation was used (SPSS Statistics V.22.0 software). RESULTS: Altogether 100 patients were included in our retrospective, cohort study (average age: 57 years). In two-thirds of the cases, third generation chemotherapy was used, and mastectomy was performed. Significant concordance was found in the two largest diameters of the tumor (coefficients, 0.984 and 0.973), the cellularity (coefficient, 0.970), and the largest metastatic deposit (coefficient, 0.998). Although the amount of in situ carcinoma proved to be the least reproducible factor, it resulted in almost 90% of agreement (coefficient, 0.873). Regarding RCB points and classes, similar results were observed (coefficients, 0.989 and 0.960). CONCLUSIONS: Significant agreement was observed between examiners based on almost all RCB parameters, points, and classes, reflecting the optimal reproducibility of RCB. Therefore, we recommend the use of the calculator in routine histopathological reports in NAT cases.
Subject(s)
Breast Neoplasms , Carcinoma , Humans , Middle Aged , Female , Breast Neoplasms/drug therapy , Mastectomy , Retrospective Studies , Neoplasm, Residual/drug therapy , Neoplasm, Residual/pathology , Cohort Studies , Reproducibility of Results , Antineoplastic Combined Chemotherapy ProtocolsABSTRACT
Hydrogen storage in geological formations is one of the most promising technologies for balancing major fluctuations between energy supply from renewable energy plants and energy demand of customers. If hydrogen gas is stored in a porous medium or if it leaks into a shallow aquifer, redox reactions can oxidize hydrogen and reduce electron acceptors such as nitrate, FeIII and MnIV (hydro)oxides, sulfate, and carbonate. These reactions are of key significance, because they can cause unintentional losses in hydrogen stored in porous media and they also can cause unwanted changes in the composition of protected potable groundwater. To represent an aquifer environment enclosing a hydrogen plume, laboratory experiments using sediment-filled columns were constructed and percolated by groundwater in equilibrium with high (2-15 bar) hydrogen partial pressures. Here, we show that hydrogen is consumed rapidly in these experiments via sulfate reduction (18 ± 5 µM h-1) and acetate production (0.030 ± 0.006 h-1), while no methanogenesis took place. The observed reaction rates were independent from the partial pressure of hydrogen and hydrogen consumption only stopped in supplemental microcosm experiments where salinity was increased above 35 g L-1. The outcomes presented here are implemented for planning the sustainable use of the subsurface space within the ANGUS+ project.