microRNAs signature in relapse metastasis and de novo metastasis of breast cancer. A systematic review.

miRNAs have been widely identified as important players in cancer development and progression. Metastasis in breast cancer can occur as relapse of a treated primary tumour or at the time of diagnosis of the tumour. The aim of this review is to show if both metastasis are different molecular entities characterised by different miRNA signatures that could be studied as specific biomarkers for each entity. For this, we systematically searched the PubMed, Scopus and Web of Science databases. After searching and reviewing the literature, a total of 30 records were included in this review. Results showed a genetic signature including a total of 5 upregulated miRNAs in metastasis compared with early stages. Of them, miR-23b and miR-200c were exclusively present in relapse metastasis. Finally, we proposed a molecular signature for future studies that can be used as a complementary tool at clinical trials for the diagnosis and characterization of metastasis.

Asociación entre la neurofibromatosis tipo 1 y el cáncer de mama / Association between neurofibromatosis type 1 and breast cancer

La neurofibromatosis tipo 1 (NF1) o enfermedad de Von Recklinghausen es un trastorno hereditario caracterizado por la aparición de lesiones en la piel y por un mayor riesgo de neoplasias tanto benignas como malignas, siendo las más frecuentes los gliomas intracraneales. Está demostrado que las pacientes menores de 50 años con NF1 pueden tener entre 5 y 11 veces aumentado el riesgo de padecer cáncer de mama. Presentamos el caso de una paciente portadora de la mutación diagnosticada de cáncer de mama unilateral tratada en nuestro centro. Para ello realizamos una actualización y revisión de la asociación entre la NF1 y el cáncer de mama. (AU)

Type I neurofibromatosis (NF1) or von Recklinghausen’s disease is a hereditary disease characterized by skin lesions and increased risk of benign and malignant tumors, especially intracranial gliomas. Patients younger than 50 with NF1 have increased risk of breast cancer. Here we present a case of a NF1 patient diagnosed with unilateral breast cancer at our institution. We also review the evidence of the association between NF1 and breast cancer. (AU)

Mama roja y vacuna contra la covid-19: ¿posible mastitis? Reporte de un caso / Red breast and covid-19 vaccine: possible mastitis? Case report

Las reacciones a la vacuna contra el virus causante de la actual pandemia del covid-19 están todavía en estudio. Presentamos el caso de una mujer de edad avanzada que, tras la administración de dicha vacuna en el brazo izquierdo, desarrolla 24 horas después una mastitis en la mama ipsilateral. Ningún caso previo ha sido descrito en la literatura. (AU)

Reactions to the vaccine against the virus causing the current pandemic are still under investigation. We present the case of an elderly woman who, after administration of the vaccine in the left arm, developed mastitis in the ipsilateral breast 24 h later. No previous case has been described in the literature. (AU)

Consecuencias de la pandemia COVID-19 en la unidad de patología mamaria en un hospital de segundo nivel. Nuestra experiencia / Effects of the COVID-19 pandemic in the breast surgery unit of a second-level hospital. Our experience

Introducción La pandemia por COVID-19 ha modificado nuestra actividad asistencial habitual en los últimos meses. Debido al colapso hospitalario se han suspendido consultas, pruebas diagnósticas e intervenciones quirúrgicas, con el objetivo también de reducir la exposición de pacientes al SARS-CoV-2 en el medio hospitalario. Sin embargo, esto ha provocado un retraso en la atención de otros problemas sanitarios. Material y métodos Analizamos y comparamos los datos de la Unidad de Mama en un hospital de segundo nivel, en cuanto a la actividad del Programa de Diagnóstico Precoz de Cáncer de Mama (PDPCM), los diagnósticos de cáncer realizados, así como las pacientes intervenidas durante los meses de marzo a mayo de 2020, con respecto al mismo período del año anterior. Resultados El número de pacientes atendidas en el PDPCM en los meses de marzo a mayo de 2020 se ha reducido en un 91,7%, y las pacientes atendidas en el Servicio de Radiodiagnóstico del hospital en un 54,2%. La actividad quirúrgica también se ha visto mermada en un 57,69% con respecto al mismo periodo del año anterior. Conclusiones La disminución de la actividad del PDPCM y Radiología conllevan a un retraso diagnóstico que concluirá con un aumento de lista de espera y demora en el tratamiento, lo que posiblemente derive en un diagnóstico en estadios más avanzados de la enfermedad. (AU)

Introduction The COVID-19 pandemic has changed routine clinical activity in the last few months. Because our hospital was overwhelmed and to prevent patient exposure to SARS-CoV-2 in the hospital setting, consultations, diagnostic tests, and surgical interventions have been postponed. However, this has provoked a delay in the care of other health problems. Material and methods We analysed and compared the data from the breast unit of a second-level hospital in terms of the activity of the Early Breast Cancer Detection Programme (EBCDP), the cancer diagnoses made, and the patients undergoing surgery from March to May, 2020, compared with the same period in the previous year. Results The number of patients attended in the EBCDP in March and May decreased by 91.7% and those attended in the Radiodiagnostics Service of the hospital fell by 54.2%. Surgical activity also decreased by 57.69% compared with the same period in 2019. Conclusions The decrease in the activity of the EBCDP and Radiology Service have led to a diagnostic delay which will, in turn, increase waiting lists and delay treatment. These factors will possibly lead to tumours being diagnosed in more advanced stages. (AU)

Angiosarcoma radioinducido de mama. Revisión bibliográfica a propósito de dos casos en nuestro centro / Radiotherapy-related angiosarcoma of the breast. A literature review apropos of two cases treated in our hospital

Objetivo Revisión bibliográfica del diagnóstico y tratamiento actual del angiosarcoma radioinducido de mama. Pacientes Presentamos dos casos de angiosarcoma radioinducido de mama comentándose los aspectos clínicos, diagnósticos y terapéuticos de interés. Conclusión El angiosarcoma de mama radioinducido es un tumor infrecuente que se presenta como complicación tardía en pacientes sometidas a tratamiento conservador del cáncer de mama mediante cirugía y radioterapia. La cirugía es el único tratamiento curativo, aunque su elevada tasa de recaída local requiere de tratamiento multimodal para optimizar los resultados de control local. (AU)

Objective Literature review of the diagnosis and treatment of radiotherapy related angiosarcoma of the breast. Case reportWe present two cases of radiotherapy-related angiosarcoma of the breast treated in our hospital and describe the clinical, diagnostic, and therapeutic features. Conclusion Radiotherapy-related angiosarcoma of the breast is an uncommon tumour that usually presents as a late complication in patients who have undergone surgery and radiotherapy as conservative treatment for breast cancer. Surgery is the only curative treatment. However, because of its high rate of local recurrence, multimodal therapy is required to optimise prevention of recurrence. (AU)

Attenuating Treatment-Related Cardiotoxicity in Women Recently Diagnosed With Breast Cancer via a Tailored Therapeutic Exercise Program: Protocol of the ATOPE Trial.

OBJECTIVE: Therapeutic exercise is already used to ameliorate some of the side effects of cancer treatment. Recent studies examined its preventive potential regarding treatment-related toxicity, which can increase the risk of functional decline and lead to disease recurrence and death. This trial will examine whether the Tailored Therapeutic Exercise and Recovery Strategies (ATOPE) program, performed before treatment, can mitigate the onset and extent of cardiotoxicity beyond that achieved when the program is followed during treatment in recently diagnosed breast cancer patients. METHODS: The intervention has a preparatory phase plus 12 to 18 sessions of tailored, high-intensity exercise, and post-exercise recovery strategies. A total of 120 women recently diagnosed with breast cancer, at risk of cardiotoxicity due to anticancer treatment awaiting surgery followed by chemotherapy and/or radiotherapy, will be randomized to either group. In a feasibility study, measurements related to recruitment rate, satisfaction with the program, adherence to them, the retention of participants, safety, and adverse effects will be explored. In the main trial, the efficacy of these interventions will be examined. The major outcome will be cardiotoxicity, assessed echocardiographically via the left ventricular ejection fraction. Other clinical, physical, and anthropometric outcomes and biological and hormonal variables will also be assessed after diagnosis, after treatment, 1 year after treatment ends, and 3 years after treatment ends. CONCLUSION: Given its potential effect on patient survival, the mitigation of cardiotoxicity is a priority, and physical therapists have an important role in this mitigation. If the ATOPE intervention performed before treatment returns better cardioprotection results, it may be recommendable that patients recently diagnosed follow this program. IMPACT: The ATOPE program will highlight the need for a physical therapist intervention from the moment of diagnosis, in the prevention or mitigation of cardiotoxicity, in women with breast cancer. It could help physical therapists to establish an adequate therapeutic exercise dose adapted to breast cancer patients and to propose correct therapeutic exercise prescription according to the assimilation of the sessions.

Carcinomatosis peritoneal secundaria a cáncer de mama ductal infiltrante sincrónico a adenocarcinoma de sigma. Revisión bibliográfica a propósito de un caso tratado en nuestro hospital / Peritoneal carcinomatosis secondary to invasive ductal carcinoma synchronous to sigmoid adenocarcinoma. Literature review and report of a case treated in our hospital

OBJETIVO: Revisión bibliográfica del diagnóstico, tratamiento y supervivencia del carcinoma de mama metastásico que cursa con carcinomatosis peritoneal. PACIENTES Y MÉTODOS: Presentamos el caso de una paciente en tratamiento en nuestro hospital comentándose los aspectos clínicos, diagnósticos y terapéuticos de interés. CONCLUSIÓN: Las metástasis del tracto gastrointestinal extra-hepáticas secundarias a tumor de mama son poco comunes (8-10%). La carcinomatosis peritoneal presenta una baja incidencia, habiéndose descrito pocos casos en la literatura, siendo la mayoría de tipo lobulillar infiltrante. Nuestro caso tratado de carcinomatosis peritoneal de origen mamario ductal infiltrante lo hace aún más infrecuente

AIM: We provide a literature review of the diagnosis, treatment and survival of metastatic breast cancer with peritoneal carcinomatosis. PATIENTS AND METHODS: We present a case treated in our institution and discuss relevant clinical, diagnostic, and therapeutic features. CONCLUSION: Extra-hepatic gastrointestinal metastasis from breast cancer is infrequent (8%-10%). The incidence of peritoneal carcinomatosis is low, with few cases reported in the literature, mostly from invasive lobular carcinoma. Our case of invasive ductal carcinoma is even less frequent

The Polemic Diagnostic Role of TP53 Mutations in Liquid Biopsies from Breast, Colon and Lung Cancers.

Being minimally invasive and thus allowing repeated measures over time, liquid biopsies are taking over traditional solid biopsies in certain circumstances such as those for unreachable tumors, very early stages or treatment monitoring. However, regarding TP53 mutation status analysis, liquid biopsies have not yet substituted tissue samples, mainly due to the lack of concordance between the two types of biopsies. This needs to be examined in a study-dependent manner, taking into account the particular type of liquid biopsy analyzed, that is, circulating tumor cells (CTCs) or cell-free DNA (cfDNA), its involvement in the tumor biology and evolution and, finally, the technology used to analyze each biopsy type. Here, we review the main studies analyzing TP53 mutations in either CTCs or cfDNA in the three more prevalent solid tumors: breast, colon and lung cancers. We evaluate the correlation for mutation status between liquid biopsies and tumor tissue, suggesting possible sources of discrepancies, as well as evaluating the clinical utility of using liquid biopsies for the analysis of TP53 mutation status and the future actions that need to be undertaken to make liquid biopsy analysis a reality for the evaluation of TP53 mutations.

Cáncer escamoso asentado sobre sinus pilonidal recurrente: la evolución de una patología benigna y frecuente a una causa de muerte infrecuente / Squamous cancer settled on recurrent pilonidal sinus: the evolution of a benign and frequent pathology to an infrequent cause of death

El sinus pilonidal es una patología frecuente cuya malignización es infrecuente aunque su pronóstico puede ser fatal. El objetivo de esta publicación es presentar un caso de un paciente intervenido en múltiples ocasiones de escisiones de sinus pilonidal con degeneración maligna del mismo y evolución fatal, con el fin de recalcar la importancia del examen anatomopatológico sistemático de todas las muestras de escisión quirúrgica. (AU)

The pilonidal sinus is a frequent pathology whose malignization is uncommon although its prognosis can be fatal. The objective of this publication is to present a case of a patient intervened on multiple occasions of pilonidal sinus excisions with malignant degeneration and fatal evolution, in order to emphasize the importance of the systematic pathological examination of all surgical excision samples. (AU)

Consecuencias de la pandemia COVID-19 en la unidad de patología mamaria en un hospital de segundo nivel. Nuestra experiencia / Effects of the COVID-19 pandemic in the breast surgery unit of a second-level hospital. Our experience

INTRODUCCIÓN: La pandemia por COVID-19 ha modificado nuestra actividad asistencial habitual en los últimos meses. Debido al colapso hospitalario se han suspendido consultas, pruebas diagnósticas e intervenciones quirúrgicas, con el objetivo también de reducir la exposición de pacientes al SARS-CoV-2 en el medio hospitalario. Sin embargo, esto ha provocado un retraso en la atención de otros problemas sanitarios. MATERIAL Y MÉTODOS: Analizamos y comparamos los datos de la Unidad de Mama en un hospital de segundo nivel, en cuanto a la actividad del Programa de Diagnóstico Precoz de Cáncer de Mama (PDPCM), los diagnósticos de cáncer realizados, así como las pacientes intervenidas durante los meses de marzo a mayo de 2020, con respecto al mismo período del año anterior. RESULTADOS: El número de pacientes atendidas en el PDPCM en los meses de marzo a mayo de 2020 se ha reducido en un 91,7%, y las pacientes atendidas en el Servicio de Radiodiagnóstico del hospital en un 54,2%. La actividad quirúrgica también se ha visto mermada en un 57,69% con respecto al mismo periodo del año anterior. CONCLUSIONES: La disminución de la actividad del PDPCM y Radiología conllevan a un retraso diagnóstico que concluirá con un aumento de lista de espera y demora en el tratamiento, lo que posiblemente derive en un diagnóstico en estadios más avanzados de la enfermedad

INTRODUCTION: The COVID-19 pandemic has changed routine clinical activity in the last few months. Because our hospital was overwhelmed and to prevent patient exposure to SARS-CoV-2 in the hospital setting, consultations, diagnostic tests, and surgical interventions have been postponed. However, this has provoked a delay in the care of other health problems. MATERIAL AND METHODS: We analysed and compared the data from the breast unit of a second-level hospital in terms of the activity of the Early Breast Cancer Detection Programme (EBCDP), the cancer diagnoses made, and the patients undergoing surgery from March to May, 2020, compared with the same period in the previous year. RESULTS: The number of patients attended in the EBCDP in March and May decreased by 91.7% and those attended in the Radiodiagnostics Service of the hospital fell by 54.2%. Surgical activity also decreased by 57.69% compared with the same period in 2019. CONCLUSIONS: The decrease in the activity of the EBCDP and Radiology Service have led to a diagnostic delay which will, in turn, increase waiting lists and delay treatment. These factors will possibly lead to tumours being diagnosed in more advanced stages

Perforación esofágica idiopática que simula quiste de duplicidad esofágico complicado / Idiopathic oesophageal perforation mimicking complicated oesophageal duplicity cyst

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