Mattia Intra

..Although a previous SLNB is often considered a contraindication for a subsequent SLNB, few data support this concern...

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..Synchronous bilateral invasive breast carcinoma (SBIBC) ranged in incidence from 0.3% to as high as 12%...

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..Mastectomy is therefore recommended as the preferred treatment option in these women...

..Sentinel lymph node biopsy (SLNB) may obviate the need for CAD in these patients without compromising the staging of the axilla and the important prognostic information...

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..Little attention has been placed to the presence of intramammary sentinel lymph nodes (intraMSLNs) on preoperative lymphoscintigraphy...

..As the clinical indications to SNB are progressively extending to encompass most breast cancer patients with non-metastatic disease who were previously excluded, great effort should be made to avoid 'unnecessary ALNDs'...

..If axillary nodes remain clinically uninvolved after a previous negative SLNB the question remains whether second SLNB is a suitable option...

..Mastectomy is therefore recommended as the first option treatment in these women...

..We performed a retrospective review to assess the potential of performing breast conservative surgery and intraoperative radiotherapy with electrons (ELIOT), in these patients...

..The presence of a pure DCIS of the breast makes this case really unique, definitively confirming the independent primary origin of both mammary tumors. The inguinal sentinel node biopsy avoided a bilateral inguinal dissection...

..Previous mastectomy is unanimously considered to represent an absolute technical contraindication to sentinel lymph node biopsy (SLNB)...

..In our experience, IORT for limited-stage breast carcinoma is easy to perform and only briefly prolongs the duration of the surgical procedure...

..The new mobile linear accelerators easily moved close to the operating table to allow the full-dose irradiation during surgery...

..Results of our previous trial showed that SLNB accurately screens the ALN for metastasis in breast cancers of diameter 2 mm or less. We aimed to update this trial with results from longer follow-up...

..Perioperative chemotherapy failed to show an increase in the pathological complete remission rate. A biological effect on Ki-67 expression was demonstrated...

..EGFR immunoreactivity significantly correlates with worse prognosis in patients with triple-negative IDC, supporting further studies on the correlation between the degree of EGFR expression and outcome of triple negative breast cancer...

..The 5 year overall survival rate of the whole series was 98%. Patients with negative sentinel node biopsies not submitted to axillary dissection show during follow-up a rate of overt axillary metastases that is lower than that expected...

..Ancillary analyses of the IBCSG 23-01 and AMAROS trials, still in follow-up, may be able to do this...

..Nevertheless, a subset of patients might be at high risk of developing overt axillary disease and efforts should be made to identify such patients by ancillary analyses of the results of ongoing or recently published clinical trials...

..From an oncological perspective, outcome was found to be equally effective, and this key observation provided us with significant impetus to investigate the effects of reducing the radiotherapy field...

..In fact, although removal of the NAC greatly increases the patient's sensation of mutilation, and the risk of tumor involvement of the areola is reported as a very variable percentage, NAC excision still remains the standard treatment...

..In the present study, a further step was made, aiming at the improvement of the effectiveness of in vivo dosimetry, based on a real-time check of the dose...

..After a median follow-up of 30 months (range, 1-63) no axillary reappearance of the disease occurred. As with women, we recommend SLNB in male patients with breast cancer and clinically negative axilla...

..4 and 89.7%. ELIOT appears a promising feature in early breast cancer treated with breast conserving surgery, reducing the exposure of normal tissues to radiations and shortening the radiation course from 6 weeks to one single session...

..We present 10-year follow-up of our single-institute trial designed to compare outcomes in patients who received no axillary dissection if the sentinel node was negative, with patients who received complete axillary dissection...

..Although numerous studies have shown that the status of the sentinel node is an accurate predictor of the status of the axillary nodes in breast cancer, the efficacy and safety of sentinel-node biopsy require validation...

..To evaluate the ipsilateral breast tumor reappearance (IBTR) rate after breast conservative surgery (BCS) following primary chemotherapy (PC) and to assess whether positive margins affects IBTR rate and overall survival (OS)...

..Surgical treatment of breast cancer in very young patients (<35 years) is still a matter of debate, since age is a predictive factor of local recurrence after breast conservation...

..4, 95% CI 3.5-11.6, for DFS; HR 3.6 95% CI 2.4-5.6 for OS). Response and outcome after PCT are correlated with the degree of expression of steroid hormone receptors. Studies on tailored preoperative therapies are needed...

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..We analyzed risk factors and treatment outcome in a large series of women treated at one institution...

..The analysis of the results suggests that the metronomic chemotherapy combined with bevacizumab and erlotinib is effective and well tolerated...

..The purpose of this research was to identify factors predicting response to preoperative chemotherapy...

..Use of lymphoscintigraphy to visualize sentinel nodes reveals that IMNs often receive lymph from the area containing the tumor...

..Endocrine therapy administered together with new intravenous, containing regimens should be explored in the preoperative treatment of endocrine responsive breast cancer...

..Here we report the two different techniques in use in these trials...

..Combined trastuzumab and intravenous vinorelbine yielded high clinical activity as preoperative treatment in patients (pts) with HER 2/neu positive breast cancer...

..Our aim was to evaluate the influence of margin status on outcomes with a view assessing the appropriateness of conservative surgery in this breast cancer subtype...

..The aim of the study was to evaluate the relation between biologic features at first diagnosis of breast carcinoma and treatment choice for postmenopausal women > or = 50 years to optimize treatment in the elderly...

..At the European Institute of Oncology we started our study on ELIOT in 1999; the first step has been a phase I-II trial to test feasibility and tolerance of ELIOT in patients candidate to breast conserving surgery...

..Intraoperative RT delivered with electrons at the total isodose of 2100 rad (21 Gy) could in principle substitute the currently used radiation course of external RT after breast-conserving surgery in selected cases...

..We report a case of a 65-year-old woman affected by follicular dendritic cell sarcoma of the left breast. Six months after breast surgery she developed an axillary metastasis from the same disease...

..Further studies combining chemotherapy and endocrine agents are warranted in patients with hormone receptor-positive tumors...

..We retrospectively evaluate outcome of patients with MF/MC cancers who had breast conservation with specific attention on local control and predictive factors of recurrence...

..CONCLUSIONS: Satisfactory agreement between measured and expected doses was found. The implementation of in vivo dosimetry in IOERT is suggested, particularly for patients enrolled in a clinical trial...

..We designed IBCSG trial 23-01 to determine whether no axillary dissection was non-inferior to axillary dissection in patients with one or more micrometastatic (≤2 mm) sentinel nodes and tumour of maximum 5 cm...

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..Here we discuss the suitability of SLNB in the settings of microinvasive cancer, after breast or axillary surgery and after neoadjuvant chemotherapy...

..We report the experience of the European Institute of Oncology with this unusual disease from January 1996 to January 2006: sixteen patients with angiosarcoma, 9 (56%) of whom had primary AB and 7 (44%), secondary AB, are discussed...

..The main complication of NSM is nipple areolar complex (NAC) necrosis, and it is usually related to surgical technique. However, the patients' clinicopathological factors should be also considered...

..The nipple-sparing mastectomy is performed leaving 5 mm of glandular tissue behind the nipple areola complex to preserve its blood supply. The reconstruction is immediately performed with a prosthesis or an autologous flap...

..GBC is a rare disease and chemotherapy in this setting lacks a standardized approach...

..In published series it has been demonstrated that the external boost can be replaced by intraoperative radiotherapy (IORT) where irradiation at a single dose from 10 up to 15 Gy was safely delivered directly to the tumor bed...

..4%) benign lesions and 407 (52.6%) cancers. The cancers were treated by conservative breast surgery in 99.5% of cases. CONCLUSIONS: We concluded that ROLL enables the surgeon to remove occult breast lesions easily and reliably...

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..Timing and influence on sentinel lymph node biopsy result by primary systemic therapy are current and controversial topics...

..Adenomyoepithelioma is a rare lesion that can involve the breast tissue. The diagnostic appearance of the lesion can give rise to a difficult differential diagnosis with breast carcinoma...

..CONCLUSION: The combination of low-dose tamoxifen and fenretinide is safe but not synergistic in lowering IGF-I levels in premenopausal women. The clinical implications require further follow-up...

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..4%), focal (368, 14.1%), moderate (51, 2.0%) and extensive (170, 6.5%)...

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..High degree of Ki-67 staining and presence of PVI were also indicators of higher risk of early relapse. These factors should be considered in therapeutic algorithms for LABC...

..In the case of ipsilateral breast tumour recurrence (IBTR) after breast-conserving surgery (BCS), a second conservative surgical approach maybe considered in some motivated patients whereas in others mastectomy is unavoidable...

..We aimed to predict disease-free survival (DFS) in patients who failed to achieve a pathologic complete remission (pCR) after preoperative chemotherapy (PC)...

..We investigated whether deep injection of tracer visualized internal mammary chain lymph (IMC) nodes more often, and assessed the impact of IMC status on disease staging...

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..Breast cancer rarely occurs in young women. Our knowledge about disease presentation, prognosis and treatment effects are largely dependent upon older series...

..To test this hypothesis we evaluated the responsiveness to preoperative chemotherapy in patients with ER and progesterone receptors (PgR)-absent tumors...

..g. endocrine primary therapy) might be more useful...

..This conservative approach is completed by the possibility to deliver a partial breast irradiation and to provide patients with more personalized adjuvant treatments tailored on the biological features of the tumour...

..There is limited knowledge about prognosis, and treatment effects in young women with node-negative disease...

..The aim of this study was to compare SNB and -positron emission tomography (-PET) imaging, to assess their values in detecting occult axillary metastases...

..Assessment of biological features and treatment of patients with breast cancer presenting during pregnancy or lactation...

..Dose-dense chemotherapy with anthracyclines and taxanes has improved either disease free survival or overall survival in high risk patients with early breast cancer...

..While data exist to clearly correlate small tumor size to better prognosis, the fact that very small breast cancers may express biological markers of dire prognosis leads many to ignore small tumor size during treatment decision-making...

..Mastectomy is considered the treatment of choice in patients with ipsilateral breast tumour recurrence (IBTR) after breast-conserving surgery (BCS)...

..To identify the role of estrogen (ER), progesterone (PgR), epidermal growth factor 1 (HER1), and HER2 receptors in predicting response to preoperative chemotherapy...

..The aim of this study was to describe outcomes of patients who underwent mastectomy without radiotherapy in a single institution...

..More than 400 patients have been enrolled. In addition a new approach for nipple and areola complex conservation, including ELIOT, is under investigation...

..However, a longer follow-up is needed for a better evaluation of the possible late side-effects...

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..Cosmetic results are excellent and the patient is very satisfied. The surgical technique and the possible advantage of such a procedure are also discussed...

..Treatment recommendations for systemic therapy should not take into account the presence of a single micrometastatic lymph node identified during complete serial sectioning of sentinel node(s)...

..To evaluate the prognostic and predictive value of Ki-67 labeling index (LI) in a trial comparing letrozole (Let) with tamoxifen (Tam) as adjuvant therapy in postmenopausal women with early breast cancer...

..The article goes on to describe the surgical procedures of quadrantectomy and complete axillary dissection as developed by Veronesi, and outlines new indications for, and developments of this established conservative technique...

..To present our experience with sentinel lymph node biopsy (SLNB) performed in patients with multicentric breast cancer...

..In this large and homogeneous series of MBC patients with synchronous bone metastases, the role of breast surgery had a favorable impact on both disease progression and mortality...

..Our purpose was to evaluate the locoregional recurrence (LRR) of patients with false-negative, frozen-section or close margins of retroareolar specimen in nipple-sparing mastectomy (NSM) procedure...

..53%). Patients with tumours larger than 2 cm were at greater risk of local recurrences and distant metastasis. Long-term oncologic results of BCT with oncoplastic surgery are comparable with the results of BCT randomized trials...

..If the SLN is micrometastatic complete axillary dissection is not unavoidable...

..Breast cancer tumors occurring in hormone replacement therapy (HRT) users are less aggressive, but no studies have compared tumor aggressiveness among HRT users by length and mode of therapy...