Subtype of breast cancer influences sentinel lymph node positivity.

Introduction: The purpose of the study was to determine the correlation between biological subtype of breast cancer and the risk of its metastasis to a sentinel lymph node. Material and methods: In the analysed group there were 1018 women with breast cancer, clinically node negative, untreated previously. Luminal A subtype was recognised in 57% of patients. A positive sentinel lymph node was detected in 26.5% of women. Results: In the multivariate analysis only age and tumour size proved to be significant for the entire group, respectively: OR = 0.59, p = 0.0004; OR = 1.96; p < 0.0001. For Luminal A subtype values were OR = 0.51, p = 0.0007; OR = 1.78, p = 0.0045, respectively. For Luminal B patients, in women over 61 years, the risk of sentinel node metastasis probability decreases by 67% and for tumours over 21 mm the probability of positive sentinel node metastasis increases by 117%. Conclusions: According to our analysis luminal breast cancers are most numerous subtypes, and in these cases we expect more frequent instances of metastasis to a sentinel node. Following the most updated and modern procedures of breast cancer patients' treatment a procedure of sentinel lymph node biopsy is used, replacing an aggressive treatment in the axilla region. In regards to our analysis we should be more vigilant in estimation of regional lymph nodes in luminal patients under sixty with high grade tumours and the tumour diameter more than 20 mm.

Kaiso Protein Expression Correlates with Overall Survival in TNBC Patients.

Triple-negative breast cancers (TNBCs) are histologically heterogenic invasive carcinomas of no specific type that lack distinctive histological characteristics. The prognosis for women with TNBC is poor. Regardless of the applied treatments, recurrences and deaths are observed 3-5 years after the diagnosis. Thus, new diagnostic markers and targets for personalized treatment are needed. The subject of our study-the Kaiso transcription factor has been found to correlate with the invasion and progression of breast cancer. The publicly available TCGA breast cancer cohort containing Illumina HiSeq RNAseq and clinical data was explored in the study. Additionally, Kaiso protein expression was assessed in formalin-fixed and paraffin-embedded tissue archive specimens using the tissue microarray technique. In this retrospective study, Kaiso protein expression (nuclear localization) was compared with several clinical factors in the cohort of 103 patients with TNBC with long follow-up time. In univariate and multivariate analysis, high Kaiso protein but not mRNA expression was correlated with better overall survival and disease-free survival, as well as with premenopausal age. The use of radiotherapy was correlated with better disease-free survival (DFS) and overall survival (OS). However, given the heterogeneity of TNBC and context-dependent molecular diversity of Kaiso signaling in cancer progression, these results must be taken with caution and require further studies.

Nipple-sparing mastectomy with immediate breast reconstruction - early complications and outcomes of the treatment.

AIM OF THE STUDY: To assess the early complications and outcomes of the treatment of patients undergoing nipple-sparing mastectomy (NSM) with immediate breast reconstruction. MATERIAL AND METHODS: A retrospective study was performed on 120 patients who underwent 130 NSM (10 bilateral) procedures between 1.01.2015 and 31.12.2017 in two oncology centers in Poland. In 80 patients a breast cancer was recognized. Sixteen patients underwent operations on the basis of being carriers of the BRCA1 mutation. The follow-up period ranged from 10 to 34 months. The NSM procedures were performed with or without skin reduction and a free nipple-areola complex (NAC) transplant, with 130 prosthetic devices inserted subpectorally. Breast cancer patients followed the standard protocol for adjuvant therapy. RESULTS: The patients for risk-reducing mastectomies were younger. Prevalent histology was no special type (NST) in 60 out of 80 patients, mean tumor - NAC distance was 43.3 mm. The prevalent biological subtype was Luminal B HER2-negative. Adjuvant management consisted of chemotherapy in 61 and radiotherapy in 35 patients. We noted 14 cases of complications, 13 in the cancer group, and 1 in the non-cancer group. Skin necrosis was the most common. The mean time for the appearance of the complications was 2.8 months. No local recurrences were observed. CONCLUSIONS: NSM is a safe and effective surgical option for qualified patients with breast cancer and in risk-reducing mastectomies.

Histone deacetylase inhibitors reinforce the phenotypical markers of breast epithelial or mesenchymal cancer cells but inhibit their migratory properties.

INTRODUCTION: Histone deacetylase inhibitors (HDIs) are a group of compounds that exhibit anticancer activity, but their significance and usefulness in breast cancer (BC) treatment are still controversial. The ability of cancer cells to invade and migrate is augmented by the acquisition of a mesenchymal phenotype - a process known as epithelial-to-mesenchymal transition (EMT). Changes in the expression level of different cadherins, so-called cadherin switches, have been used to monitor the EMT process in development and tumor progression, in particular migration and invasion potential. The aim of this study was to analyze the influence of two HDIs - valproic acid (VPA) and vorinostat (SAHA) - on the migration potential of different BC cell types, as well as on EMT, or its reverse process - mesenchymal-to-epithelial transition, progression by means of shift in epithelial and mesenchymal marker expression. METHODS: HDI treatment-induced expression of E- and N-cadherin at the mRNA and protein levels was evaluated by qPCR, Western blotting and immunostaining methods, respectively. BC cell proliferation and migration were assessed by BrdU, xCELLigence system and wound-healing assay. RESULTS: VPA and SAHA inhibited the proliferation and migration in a dose- and time-dependent manner, regardless of the BC cell type. Unawares, BC cells having a more mesenchymal phenotype (MDA-MB-468) were found to overexpress N-cadherin, whereas BC lines having an epithelial phenotype (T47D, MCF7) responded to HDI treatment by a significant increase of E-cadherin expression. DISCUSSION: We suggest that HDAC inhibition results in a more relaxed chromatin concomitant to an increase in the expression of already expressing genes. CONCLUSION: By using multiple cancer cell lines, we conclude that HDI induction or reversal of EMT is not a universal mechanism, yet inhibition of cell migration is, and thus EMT should not be considered as the only measurement for tumor aggressiveness.

Landscape of oncoplastic breast surgery across Poland.

Oncoplastic and reconstructive techniques are essential tools in the armamentarium of contemporary breast surgeons. The aim of the study was to identify oncoplastic reconstructive patterns in breast cancer centers across Poland. A questionnaire of 18 questions was sent by email to the members of the Polish Society of Surgical Oncology and the Polish Society of Plastic, Reconstructive and Esthetic Surgery via their dedicated websites. The numbers of breast cancer patients operated on in each center ranged from 120 to 904 per year. Breast-conserving surgery (BCS) predominated in all but one center (range 50-70%). Immediate breast reconstructions (IBR) accounted for 6-42% of procedures, The most frequent type of IBR was either a two-stage expander followed by a permanent implant or one-stage implant- based with or without synthetic mesh. The most frequent type of delayed breast reconstruction (DBR) was a two-stage expander followed by implant-based reconstruction. None of the surveyed cancer centers performed free flap reconstruction. Deep inferior epigastric perforator (DIEP) flaps were performed in the plastic surgery department. Reconstructions based on pedicled flaps were performed in cancer centers. Acellular dermal matrices (ADM) and fat transfer were used in selected centers. In the clinical scenario of adjuvant radiotherapy, delayed breast reconstruction was favored. The full range of oncoplastic BCS was performed. Patient-reported outcome measures (PROM) and complications were assessed. Our findings can act as a platform for further improvement in skills, certification, data collection and audit, including patient reported expectation measures. There is also an urgent need to address pan-European inconsistencies in procedural reimbursement.

High-pressure cell for neutron diffraction with in situ pressure control at cryogenic temperatures.

Pressure generation at cryogenic temperatures presents a problem for a wide array of experimental techniques, particularly neutron studies due to the volume of sample required. We present a novel, compact pressure cell with a large sample volume in which load is generated by a bellow. Using a supply of helium gas up to a pressure of 350 bar, a load of up to 78 kN is generated with leak-free operation. In addition, special fiber ports added to the cryogenic center stick allow for in situ pressure determination using the ruby pressure standard. Mechanical stability was assessed using finite element analysis and the dimensions of the cell have been optimized for use with standard cryogenic equipment. Load testing and on-line experiments using NaCl and BiNiO3 have been done at the WISH instrument of the ISIS pulsed neutron source to verify performance.

Simultaneous occurrence of medullary and papillary carcinomas of the thyroid gland with metastases of papillary carcinoma to the cervical lymph nodes and the coinciding small B-cell lymphocytic lymphoma of the lymph nodes--a case report.

We report a case of a simultaneous occurrence of medullary and papillary carcinomas of the thyroid gland with metastases of a papillary carcinoma to the cervical lymph nodes and a concurrent small B-cell lymphocytic lymphoma revealed in the lymph nodes examined in a 71-year-old woman. The diagnosis was based on microscopic examination of surgical specimens and supported by immunohistochemistry. Additionally, P53 and RET mutation analysis was performed. In this case, the coincidence of medullary and papillary carcinomas of the thyroid gland may account for a true composite tumor. The coexistence of a small B-cell lymphoma in our patient may be explained by irradiation treatment undergone during the adolescence.