Breast Disease

Male breast cancer (MBC) accounts for one percent of all breast cancers. Due to the lack of awareness and routine screening programs, most patients present with systemic disease at the time of diagnosis with low overall survival.

This study aims to investigate the prognostic factors of male breast cancer and its correlation with established prognostic parameters and patient outcomes.

Thirty-eight male breast cancer patients are identified from the MKA Breast Cancer Clinic database, and their corresponding clinical and pathological characteristics are obtained. Cut-off values of 1% and 10% are applied to further classify ER and PR results.

Older men are more likely to develop MBC than younger men and are more likely to have spread to axillary lymph nodes. Invasive ductal carcinoma is a more common histologic type in MBC. All the tested patients have ER and PR positivity. Distant metastasis developed in 17/38 (44.7%) patients. Bone metastasis is seen commonly in metastatic MBC.

According to our cohort, MBC is seen in older males, presents in later stages, and shows hormone receptor positivity and a tendency to bone involvement. MBC is a heterogenous but distinct biological entity requiring a specific clinical and pathological approach.

Breast cancer (BC) patients’ diagnosis and management was affected by a global reorganization after the Coronavirus disease 2019 (COVID-19). Our study aimed to assess the impact of the pandemic on the pathological stage of newly diagnosed patients with BC compared to pre-pandemic and to identify predictive factors of tumor advanced stage.

Pathological records of all consecutive newly operated BC patients between March 2020 and December 2021 were reviewed retrospectively. Clinical and pathological prognostic factors of BC were collected and compared between pre-pandemic and pandemic periods. Then, predictive factors of tumor advanced stage were identified.

Of the 225 cases included in the analysis, 98.7% were females and 1.3% were males. The median time from first histological diagnosis to first surgical treatment was enlarged by 42 days with a significant difference between the two periods (p = 0.002). Newly diagnosed BC patients during the COVID-19 pandemic were operated at a more advanced stage (54.1% vs 36.2%, p = 0.007), had a greater lymphovascular invasion (p = 0.002), lymph node metastasis (p = 0.015) and are more commonly of IBC NST histological type (p = 0.005). Moreover, multivariate analyses showed that the pandemic period (AOR = 2.28; p = 0.016) and the lympho-vascular invasion (p < 0.001) were independently associated with advanced stage of tumors.

Our findings proved an increase in alarming rates of advanced stage BC associated with the COVID-19 crisis. These findings support recommendations for a quick restoration of BC screening at full capacity, with adequate prioritization strategies to mitigate harm.

Chemotherapy is conventionally offered to non-stage IV breast cancer patients with metastatic nodes. However, the RxPONDER trial showed that chemotherapy can be omitted in selected patients with 1–3 metastatic nodes if the 21-gene assay recurrence score is ≤25. We aimed to investigate if axillary ultrasound can identify this group of patients with limited nodal burden so that they can undergo upfront surgery followed by gene assay testing, to potentially avoid chemotherapy.

T1-3, node positive, hormone receptor-positive and HER2-negative breast cancer patients ≥50 years old with axillary lymph node dissection (ALND) were reviewed from 2 centres. Patients with neoadjuvant chemotherapy and bilateral cancers were excluded. Number of ultrasound-detected abnormal axillary nodes, demographic and histological parameters were correlated with the number of metastatic nodes found on ALND.

138 patients were included, 59 (42.8%) and 79 (57.2%) patients had 1–3 and >3 metastatic nodes on ALND respectively. On logistic regression and ROC analysis, the number of ultrasound-detected abnormal nodes was significant (p < 0.001) for predicting limited nodal burden (ROC AUC = 0.7135). Probabilities of <4 metastatic nodes with ultrasound cut-offs of 5, 6 and 8 abnormal nodes were 0.057, 0.026 and 0.005 respectively, with 100% specificity.

A cut-off of ≤5 ultrasound-detected abnormal nodes can distinguish between patients with limited versus high nodal burden, with high specificity. Hence, incorporating the number of abnormal ultrasound-detected nodes into clinical practice may prove useful in guiding between upfront surgery and gene assay testing or neoadjuvant chemotherapy in this group of patients.

Tumour microenvironment (TME) contributes to resistance to anti-cancer drugs through multiple mechanisms including secretion of pro-survival factors by cancer associated fibroblasts (CAFs). In this study, we determined the chemotherapy resistance producing potential of CAFs in molecular subtypes of breast cancer.

The CAFs were isolated from fresh lumpectomy/mastectomy specimens of different molecular subtypes of breast cancer. The CAFs were cultured and secretome was collected from each breast cancer subtype. Breast cancer cell lines MCF-7, SK-BR3, MDA-MB-231, and MDA-MB-468 were treated with different doses of tamoxifen, trastuzumab, cisplatin, and doxorubicin alone respectively and in combination with secretome of CAFs from respective subtypes. MTT assay was done to check cell death after drug treatment. Liquid chromatography–mass spectrometry (LCMS) analysis of CAF secretome was also done.

MTT assay showed that anti-cancer drugs alone had growth inhibitory effect on the cancer cells however, presence of CAF secretome reduced the anti-cancer effect of the drugs. Resistant to drugs in the presence of secretome, was determined by increased cell viability i.e., MCF-7, 51.02% to 63.02%; SK-BR-3, 34.22% to 44.88%; MDA-MB-231, 52.59% to 78.63%; and MDA-MB-468, 48.92% to 55.08%. LCMS analysis of the secretome showed the differential abundance of CAFs secreted proteins across breast cancer subtypes.

The treatment of breast cancer cell lines with anti-cancer drugs in combination with secretome isolated from molecular subtype specific CAFs, reduced the cytotoxic effect of the drugs. In addition, LCMS data also highlighted different composition of secreted proteins from different breast cancer associated fibroblasts. Thus, TME has heterogenous population of CAFs across the breast cancer subtypes and in vitro experiments highlight their contribution to chemotherapy resistance which needs further validation.

Breast cancer tumor microenvironment (TME) is a promising target for immunotherapy. Autophagy, and cancer stem cells (CSCs) maintenance are essential processes involved in tumorigenesis, tumor survival, invasion, and treatment resistance. Overexpression of angiogenic chemokine interleukin-8 (IL-8) in breast cancer TME is associated with oncogenic signaling pathways, increased tumor growth, metastasis, and poor prognosis.

Thus, we aimed to investigate the possible anti-tumor effect of neutralizing antibodies against IL-8 by evaluating its efficacy on autophagic activity and breast CSC maintenance.

IL-8 monoclonal antibody supplemented tumor tissue culture systems from 15 females undergoing mastectomy were used to evaluate the expression of LC3B as a specific biomarker of autophagy and CD44, CD24 as cell surface markers of breast CSCs using immunofluorescence technique.

Our results revealed that anti-IL-8 mAb significantly decreased the level of LC3B in the cultured tumor tissues compared to its non-significant decrease in the normal breast tissues.

Anti-IL-8 mAb also significantly decreased the CD44 expression in either breast tumors or normal cultured tissues. While it caused a non-significant decrease in CD24 expression in cultured breast tumor tissue and a significant decrease in its expression in the corresponding normal ones.

Anti-IL-8 monoclonal antibody exhibits promising immunotherapeutic properties through targeting both autophagy and CSCs maintenance within breast cancer TME.

To retrospectively study the therapeutic modalities of primary breast sarcomas in view of the data of a local Tunisian experience.

It is a monocentric, descriptive, retrospective study including 13 cases of primary breast sarcoma treated over a period of 25 years (1995–2020) in the oncological radiotherapy department of a university hospital in Sousse, Tunisia.

In our study, 13 cases of non-metastatic breast sarcomas that has been identified, divided into ten cases of phyllodes sarcomas and three cases of non-phyllodes sarcomas.

Surgically, all our patients had a mastectomy. Among them, seven underwent a lymph node procedure: five underwent axillary lymph node dissection, and two others had primary axillary lymph node biopsy. For the adjuvant treatment, all the patients included in our study received radiotherapy and seven received chemotherapy. Local recurrence occurred on the operative scar in one patient after completion of radiation therapy. Metastatic relapse was described in five patients. The time to onset of metastases varied between two months and five years. Nevertheless, a complete remission was noted in 6 patients with a follow-up varying from four years to 20 years. Two patients were lost to follow-up.

Breast sarcomas remain a very rare entity of aggressive tumors.

The therapeutic approach is poorly codified. For this reason, the therapeutic decision should always be discussed in a multidisciplinary assessment.

Tucatinib is a tyrosine kinase inhibitor currently used in salvage therapy for human epidermal growth factor receptor 2 (HER2)-positive breast and colorectal cancer. The use of tucatinib alone or in combination with ado-trastuzumab emtansine (T-DM1) in the treatment of advanced HER2-positive cancers is rapidly expanding.

We report the case of a 66-year-old female who presented to the dermatology clinic with a one-year history of widespread telangiectasias that began after initiation of combination chemotherapy with tucatinib and T-DM1 for metastatic HER2-positive invasive ductal carcinoma.

The patient’s lesions regressed upon cessation of combination therapy and reappeared in the setting of tucatinib re-initiation, with gradual improvement over the following four months following electrocautery to the affected regions.

We postulate that telangiectasias may be a previously unreported dermatologic side effect of combination treatment with tucatinib and T-DM1. Electrocautery is a safe and effective procedure to reduce the appearance of telangiectasias and improve patient satisfaction during chemotherapy.

Sentinel lymph node biopsy in breast cancer is considered the standard of staging in cases of clinically negative lymph nodes. Its omission in favor of axillary dissection generates significant morbidity.

To determine the total number of sentinel node biopsy procedures in breast cancer in Colombia from 2017 through 2020, model and analyze them as if they were performed only in stage I breast cancer patients, and integrate their results into the concepts of quality of medical care.

Search in a database of the Ministry of Health and Social Protection of Colombia with sentinel lymph node biopsy codes, and filters of breast cancer and year. Their results are contrasted with the number of cases in stage I of breast cancer.

Breast cancer TNM staging was reported in 22154 cases, 3648 stage I. In the same time frame, the number of sentinel lymph node biopsies for breast cancer in Colombia was 1045, 28.64% of the total cases reported in stage I.

Colombia is far from complying with the standard indicator of sentinel lymph node biopsy. It is recommended to concentrate breast cancer cases in hospitals that provide the conditions for its performance.

Molecular subtyping of breast cancer cells is increasingly being developed as an initial step in selecting therapy and predicting the prognosis of breast cancer patients. During breast cancer, the molecular subtype of cancer cells can change. This study aimed to analyze the relationship between changes in the intrinsic subtype of breast cancer with metastasis and progression-free survival in breast cancer patients.

This was a retrospective cohort study of patients diagnosed with breast cancer from 2016 to 2021. The molecular subtypes from the immunohistochemical examination results were recorded twice, and metastasis and progression-free survival (PFS) were recorded. The data were analyzed using the chi-square test and SPSS 26.

Of the 44 patients, 19 (43.2%) experienced a change in molecular subtype, and 25 (56.8%) did not. No significant relationship existed between changes in molecular subtype and metastasis (p = 0.405). No significant relationship existed between changes in molecular subtype and PFS (p = 0.900). A significant relationship was found between changes in the molecular subtype and PFS in the patients with changes in the molecular subtype (p = 0.022).

Changes in the intrinsic subtype were associated with PFS in breast cancer patients. Patients with an intrinsic subtype that changed to triple-negative showed worse PFS.

Immunotherapy has shown encouraging outcomes in breast cancer (BC) treatment in recent years. The programmed cell death ligand 1 (PD-L1) transmembrane protein is suggested to function as a co-inhibitory factor in the immune response, where it collaborates with programmed cell death protein 1 (PD-1) to stimulate apoptosis, suppress cytokine release from PD-1 positive cells, and limit the growth of PD-1 positive cells. Furthermore, in many malignancies, PD-L1 reduces the immune system’s response to neoplastic cells. These observations suggest that the PD-1/PD-L1 axis plays a vital role in cancer therapy and the regulation of cancer immune escape mechanisms. This review aimed to provide an overview of the functions of PD-1 and PD-L1 in BC cancer therapy.

This research design is a literature review. The style is a traditional review on topics or variables relating to the PD-1/PD-L1 pathway. A literature search was carried out using three online databases.

The search using the keywords yielded a total of 248 studies. Each result was filtered again according to the inclusion and exclusion criteria, resulting in a final total of 4 studies to be included in the literature review.

The combination of PD-1/PD-L1 is essential for many malignancies. According to the evidence presented, this combination presents both an opportunity and a challenge in cancer treatment. Since many solid cancers, especially BC, express high levels of PD-1/PD-L1, cancer treatment mainly involves targeted therapies.

Breast cancer (BC) cases in Makassar, Indonesia, are on the rise, with 2723 cases recorded in 2018. Tumor cells in the blood indicate metastasis, emphasizing the need for early diagnosis and monitoring. Pleiotrophin (PTN) is associated with various human malignancies, and recent studies suggest a correlation between PTN expression and advanced BC stages; therefore, PTN could serve as an independent predictor of metastasis. This study aimed to determine the correlation between serum PTN level, histopathological grading, and metastasis occurrence in BC patients in Makassar, Indonesia.

This study used an observational cross-sectional design. Pleiotrophin serum levels were examined using enzyme-linked immunosorbent assays. This study used a t-test and ROC curve analysis for the statistical tests.

Of the 64 samples used in this study, metastasis was present in 26 cases and absent in 38 samples. The mean PTN serum levels in metastatic and non-metastatic breast cancer patients were 4.311 and 1.253, respectively. The PTN receiver operating characteristic curve showed an area under the curve of 2.47 ng/dL, which was statistically significant (p < 0.001). A significant relationship was found between PTN level and metastasis (p < 0.001). The correlation coefficient was 0.791, indicating a positive correlation.

This study revealed that the serum PTN level among breast cancer patients had a cut-off value of 2.47 ng/dL. The research established a clear correlation between PTN level and metastasis occurrence in breast cancer patients, indicating a higher likelihood of distant metastasis with elevated PTN concentration.

Indonesian civilization extensively uses traditional medicine to cure illnesses and preserve health. The lack of knowledge on the security and efficacy of medicinal plants is still a significant concern. Although the precise chemicals responsible for this impact are unknown, ginger is a common medicinal plant in Southeast Asia that may have anticancer qualities.

Using data from Dudedocking, a machine-learning model was created to predict possible breast anticancer chemicals from ginger. The model was used to forecast substances that block KIT and MAPK2 proteins, essential elements in breast cancer.

Beta-carotene, 5-Hydroxy-74 ^′ -dimethoxyflavone, [12]-Shogaol, Isogingerenone B, curcumin, Trans-[10]-Shogaol, Gingerenone A, Dihydrocurcumin, and demethoxycurcumin were all superior to the reference ligand for MAPK2, according to molecular docking studies. Lycopene, [8]-Shogaol, [6]-Shogaol, and [1]-Paradol exhibited low toxicity and no Lipinski violations, but beta carotene had toxic predictions and Lipinski violations. It was anticipated that all three substances would have anticarcinogenic qualities.

Overall, this study shows the value of machine learning in drug development and offers insightful information on possible anticancer chemicals from ginger.

Fat transfer has been widely used after breast conservative surgery (BCS) where it aims to recover shapes as a simple, inexpensive, biocompatible method but the technique is not without complications. Platelet Rich Plasma (PRP) is a promising approach to enhance fat graft survival and subsequently improve the outcome. The aim of this study was to evaluate the effect of enriching fat graft with PRP for delayed correction of deformities after conservative surgery for breast cancer regarding esthetic outcome and incidence of complications.

The current study included 50 female patients who were scheduled for delayed lipofilling for correction of deformities after conservative surgery for breast cancer. The studied patients were randomly allocated into 2 groups: Group I (G I) included 25 patients scheduled for PRP enriched lipoinjection and Group II (G II) included 25 patients scheduled for lipoinjection without PRP as a control group.

Number of sessions of lipoinjection was significantly less in G I in comparison to G II (P = 0.024). During the 2nd session; the amounts of fat injected and harvested were significantly less in G I in comparison to G II (P = 0.049 and 0.001 respectively). Recipient site complications were significantly more evident in G II in comparison to G I (P = 0.01). Surgeon and patient satisfactions were significantly more evident in GI in comparison to G II (P = 0.005 and 0.029 respectively).

The addition of PRP to fat grafts is a simple, cost-effective and safe method to improve esthetic outcome and decrease complications.

Housewives are a population at high risk of breast cancer due to repeated or chronic exposure to stress. Prevention in a simple yet evidence-based manner is needed.

This study is a narrative review of the potential of massage as breast cancer prevention through stress and immune system mechanisms.

Massage is able to prevent chronic stress through improved sleep and fatigue and lower stress levels. Prevention of chronic stress will maximize the function of cells that eliminate cancer cells, such as B cells, T cells, and natural killer (NK) cells, and improve the balance of Foxp3 Tregulator cells. Partnered delivery massage will bring effective benefits for stress reduction.

Massage can provide indirect prevention of breast cancer, and partnered delivery massage can be a good choice to reduce stress.

Breast cancer is the most common cancer in women worldwide and is a significant threat to public health. This study aims to conduct a systematic review of the relationship between hormonal contraceptive use and breast cancer incidence.

The search was conducted using Google Scholar, Proquest, Pubmed and one Indonesian database, Garuda, using English and Indonesian keywords. The inclusion criteria in this study were the publication year of the last five years, namely 2019–2023, English and Indonesian language, case-control observational research, using the Indonesian population, and full-text access.

A total of 165 studies were obtained from the Google Scholar database, including 104 studies. The overall multivariate analysis revealed that there was a statistically significant association of hormonal contraception with the incidence of breast cancer with OR values in the range of 2–6.

The findings of this systematic study suggest that the use of hormones can contribute to hormonal imbalances that further increase breast cell proliferation and disrupt gene expression, resulting in uncontrolled cell development/cancer. In addition, the findings recommend increasing the number of studies on this topic to obtain more adequate and possibly more diverse information.

Breast self-examination (BSE) is a screening method that can help empower, raise awareness, and detect breast abnormalities in women. The use of smartphone applications for breast cancer early detection is able to overcome some of these barriers. This study aimed to conduct a systematic review to assess the effectiveness of the effect of using smartphone application-based technology on breast cancer.

Google Scholar, PubMed, Proquest, and ScienceDirect were searched for “breast self-examination” and “smartphone application” literature. This literature’s study designs were quasi-experimental, prospective cohort, qualitative, and systematic review. The study contained five unique research projects with 828 varied participants.

The use of smartphones was seen to have advantages in terms of increased knowledge, perceived vulnerability, barriers to breast self-examination (BSE), self-efficacy, health motivation, and BSE practices.

The utilization of smartphone apps related to BSE is shown through the availability, accessibility, and focus of information and is in line with the Health Belief Model (HBM).

Breast self-examination (BSE) is an important tool for early detection of breast cancer and can contribute to increased awareness and familiarity with breast tissue. This study aimed to review factors that influenced BSE in preventing breast cancer.

In the initial stage of searching for journal articles, 186 journals were obtained, then screening was carried out within a time span of 2019–2024 and using Indonesian and English 54 journals. Of the 12 journals reviewed, the results showed that 4 journals reviewed had conducted pre and post-BSE practices, and 8 journal reviews conducted BSE practices conducted by students and health workers.

Several factors play an important role in implementing BSE, namely age, knowledge, history of exposure to information, family history, ethnicity, and attitude. Overall, the study shows that the need to create awareness and educate women, especially rural women, on the importance of BSE as a preventive measure for breast cancer is paramount.

Factors influencing the implementation of BSE can be a barrier or an enhancement in breast cancer prevention.

We reviewed the literature on breast cancer patients’ physical activity and quality of life. This paper should urge health services and breast cancer survivors to continue appropriate physical activity and assess its advantages.

A systematic review was conducted.

This systematic review used online databases: PubMed, Web of Science, Scopus, and Google Scholar. A search from the beginning of 2018–2024 was conducted.

Medical Subject Headings (MESH) were used for keyword selection along with other target keywords, such as “Quality of life”, “Breast cancer”, “Chemotherapy”, “Treatment side effects”, “Patient experience”, “Psychosocial well-being”, “Physical functioning”, “Emotional distress”, and “Supportive care”. We reviewed and included all English-language publications. A narrative synthesis was conducted to present the results of the studies.

The search using the keywords yielded a total of 135 studies. Each result was filtered again according to the inclusion and exclusion criteria, resulting in a final total of 15 studies to be included in the systematic review.

The evidence supports the benefits of physical activity in enhancing the quality of life for breast cancer survivors, indicating that further prospective and intervention studies are needed.

Research investigating the quality of life (QOL) of breast cancer patients undergoing chemotherapy has yielded useful knowledge regarding the effects of cancer treatment on the quality of life of patients. This study reviews the assessment of the quality of life for those diagnosed with breast cancer.

A systematic review was conducted.

This systematic review utilized online databases, including PubMed, Web of Science, Scopus, and Google Scholar. A search ranging from 2018 to 2024 was carried out.

Medical Subject Headings (MESH) were used for keyword selection along with other target keywords, such as “Quality of life”, “Breast cancer”, “Chemotherapy”, “Treatment side effects”, “Patient experience”, “Psychosocial well-being”, “Physical functioning”, “Emotional distress”, and “Supportive care”. We reviewed and included all English-language publications. A narrative synthesis was conducted to present the results of the studies.

A total of 300 studies were obtained from the search using the specified keywords. Each result underwent another filtering round after applying the inclusion and exclusion criteria. This process led to a final selection of 20 papers that met the requirements and were included in the systematic review.

The use of instruments to measure the quality of life (QoL) of breast cancer patients is crucial in understanding the impact of breast cancer on patients’ lives, from physical and mental health to social aspects.

The PI3K protein is involved in the PI3K/AKT/mTOR pathway. Deregulation of this pathway through PIK3CA mutation is common in various tumors. The aim of this work is to identify hotspot mutation at exons 9 and 20 in Tunisian patients with sporadic or hereditary breast cancer.

Hotspot mutations in exon 9 and exon 20 of the PIK3CA gene were identified by QPCR-High Resolution Melting followed by COLD-PCR and sequencing in 63 (42 sporadic cases and 21 hereditary cases) tumor tissues collected from Tunisian patient with breast cancer. MCF7, and BT20 breast cancer cell lines harboring the PIK3CA hotspot mutations E545K and H1047R in exon 9 and exon 20 respectively, were used as controls in HRM experiments.

PIK3CA hotspot mutations were detected in 66.7% (28 out of 42) of sporadic BC cases, and in 14.3% (3 out of 21) of hereditary BC. The E545K and the H1048Y were the most prevalent mutations identified in patients with sporadic and hereditary BC, whereas the H1047R hotspot mutation was not found in our patients. Statistical analysis showed that PIK3CA mutation associated with an aggressive behavior in patients with sporadic BC, while it’s correlated with age, tumor stage and tumor size in the group patients with hereditary breast cancer.

Our results showed a novel PIK3CA hotspot mutation in Tunisian breast cancer patients detected by HRM-COLD-PCR. Moreover, the absence of PIK3CA hotspot mutation associated with good prognosis.

Neuro-Behcet’s disease (NBD) is a variant of Behcet’s disease (BD). To our knowledge, there have been no previous reports on concurrent NBD in breast cancer patients undergoing chemotherapy.

Our patient had a history of BD and was asymptomatic. She was diagnosed with human epidermal growth factor receptor 2-positive breast cancer by core needle biopsy and was administered neoadjuvant chemotherapy. After four courses, in addition to the aggravation of the existing adverse events, headache, fever, dysarthria, and muscle weakness in the upper left and lower extremities appeared. On admission, she was diagnosed with acute NBD, and steroid therapy was initiated. After her symptoms improved gradually, she was discharged. Then, she underwent mastectomy and axillary lymph node dissection for breast cancer. Trastuzumab and pertuzumab plus tamoxifen were administered postoperatively. Two years postoperatively, no recurrence of breast cancer and NBD was noted.

When chemotherapy is administered to breast cancer patients with a history of BD, it is necessary to select chemotherapy with as few adverse events as possible and to continue with treatment while paying attention to the risk of NBD.

We aim to evaluate the indication and use of genomic signatures in breast cancer patients and outcomes who in patients undergoing adjuvant chemotherapy or not.

This is a retrospective study of breast cancer patients managed in a private oncology clinic in Teresina, from November 2014 to February 2021. All patients with an indication of genomic signature were included. Clinical and pathological variables, use of genomic signatures, treatment and follow-up were obtained. The nomogram to predict Oncotype DX results (University of Tennessee Medical Center) was also calculated. Clinical risk calculation was based on MINDACT, using the modified version of Adjuvant Online. The genetic signatures performed were: the Oncotype, MammaPrint and EndoPredict.

Fifty (50) female patients were included in the study. The mean age of the participants was 57.1 years. Among the patients receiving a genomic signature (26–52.0%), there was a change in treatment in 8 (30.7%) cases. Chemotherapy was indicated in four patients, It was contraindicated in another four patients. Treatment changed in 30.7% of the tested patients. Chemotherapy was indicated for those who would not receive it before. It was contraindicated in patients who would previously undergo chemotherapy.

The management of mastodynia plays a central role in improving women quality of life. Despite its high occurrence, specific therapeutic guidelines for mastalgia are still lacking. Available therapies include unspecific anti-inflammatories, even though they may often expose to undesirable effects and low compliance.

The aim of this study was to highlight the efficacy of the topical application of combined natural molecules including Boswellia serrata, Betaine and myo-Inositol in improving cyclic mastalgia.

In this retrospective pilot clinical study, patients with cyclic mastalgia applied a specific breast gel for three months. The severity of the pain was measured through the Visual Analogue Score (VAS) in the treated group compared to untreated one. Treated patients also filled in a questionnaire evaluating acceptance and safety of the breast gel.

This pilot clinical study demonstrated for the first time the efficacy of the topical application of a breast gel based on Betaine, Boswellia serrata, and myo-Inositol in improving cyclic mastodynia. The completed questionnaires also revealed high levels of acceptance, as both safety and compliance.

Besides confirming the positive effects of these natural molecules in the management of conditions affecting breast physiology – so far evaluated as oral supplementation – the obtained results pave the way for further studies supporting the use of such molecules as a tailored medical device in the management of breast pain, thus also opening toward a combined oral and topical approach.

Alopecia is one of the main adverse events of chemotherapy in breast cancer. However, its impact is often ignored and underestimated by clinicians. Our aim was to evaluate the quality of life of breast cancer patients with chemotherapy induced alopecia.

We conducted a prospective study including 72 breast cancer patients who developed alopecia on or after stopping chemotherapy in the last 6 months. Clinical information and characteristics of alopecia were assessed using a self-prepared questionnaire. DLQI score was used to evaluate patients’ quality of life.

We interviewed a total of 72 women with a mean age of 53.5 ± 6 years. Alopecia appeared soon after the first course in 62.5%. All patients actively tried to hide induced hair fall (either by a hat in 6.9% or by a headscarf in 93.1%). Quality of life was impacted in 97.2% of patients with a median DLQI score of 6.5. Women who did not underwent mastectomy were significantly more bothered by hair loss than those who had radical surgery (78.1% vs 55%, p = 0.04). Working status was a significant predictor factor of a bad quality of life due to alopecia (100% in working women vs 58.3% in homemaker or retired patients, p = 0.006).

Chemotherapy induced alopecia had a negative impact on quality of life of patients with breast cancer, especially in working women and those who did not have radical surgery. Prior wearing of headscarves did not impact significantly the DLQI score.

Haemorrhagic breast necrosis is an extremely rare, but severe condition.

We report a case of a 56-year-old woman who suffered from spontaneous haemorrhagic breast necrosis. To our knowledge, it is the first published case of breast haemorrhagic necrosis in Denmark.

The diagnosis of spontaneous haemorrhagic breast necrosis is challenging because of its rarity. It is crucial to consider the past medical history of the patient. In particular, if the patient is currently on anticoagulant therapy. Information of complete and accurate family medical history and possible genetic mutations must be obtained. Clinical examination plays an important role in the diagnosis of haemorrhagic breast necrosis.

Patients diagnosed with HER2-positive breast cancer who do not respond to anti-HER2 therapies face unfavorable outcomes. Multiple resistance mechanisms have been described in the literature; however, further exploration at the protein level as well as gene level is necessary. The present study focuses on in vitro elucidation of differentially expressed proteins (DEPs), gene expression profiling, and hotspot HER2 and PIK3CA alterations underlying the resistance mechanisms.

SKBR3, a HER2-positive breast cancer cell line, was used to generate trastuzumab-resistant SKBR3/TR cells by treating with increasing concentrations of trastuzumab, followed by viability assays at each concentration. The cells viable at highest trastuzumab concentration were subjected to LC-MS/MS, immunohistochemistry (IHC), and ddPCR to evaluate differences in protein, gene expression profiling, and hotspot HER2 and PIK3CA alterations between the trastuzumab-resistant SKBR3/TR cells and sensitive SKBR cell line.

Following the generation of trastuzumab-resistant SKBR3/TR cell lines, IHC analysis revealed significantly lower expression of the HER2 membrane receptor. ddPCR further identified PIK3CA hotspot mutations in these resistant cells. Comparative proteomic analysis by LC-MS demonstrated marked upregulation of Ras-related proteins, along with activation of DNA mismatch repair and ATM signaling pathways, compared to the sensitive SKBR3 cells. Additionally, proteins involved in trafficking pathways, including Proteasome subunit beta type-1, RAB 11, and Ras-related proteins, were significantly downregulated in the resistant cells.

Our findings indicate that resistance to trastuzumab in SKBR3/TR cells is mediated by alterations in the PI3K-AKT signaling pathway along with upregulation of Ras-related proteins and activation of DNA mismatch repair and ATM signaling pathways. These molecular changes constitute key mechanisms underlying trastuzumab resistance. Notably, the dysregulation of these pathways presents potential therapeutic targets, offering opportunities for the development of novel strategies aimed at overcoming trastuzumab resistance and enhancing treatment efficacy in HER2-positive breast cancer.

15–30% of breast cancer patients will develop brain metastases (BM) during their illness. The prognosis of this entity remains poor. Several scores were established to predict the prognosis of BM from breast cancer stating by the recursive partitioning analysis to the breast-graded prognostic assessment score (B-GPA) and the modified breast-graded prognostic assessment score (m B-GPA). The objective of this study was to compare the B-GPA and the m B-GPA in the prediction of overall survival.

This was a retrospective and analytical study carried out within the medical oncology department of Sfax between 2008 and 2018, including all patients with breast cancer brain metastases with a known hormone receptor (HR) status and of HER2. We analyzed the overall survival (OS), the B-GPA, and the m-BGPA.

60 patients were included. 32 patients (53%) had a preserved general condition (PS 80–90) while 4 patients (7%) presented an alteration in general condition (KPS ≤ 50). 24 cases (40%) had HR+/HER2-profile, 17 cases (28%) had HR+/HER2+, 9 cases (15%) HR−/HER2+, and 10 cases (17 %) had triple negative profile. Overall survival at 1 year from the diagnosis of BM was 16.7%. The prognostic factors influencing survival were general condition and IHC status (p = 0.038 and 0.013, respectively). Both B-GPA and mB-GPA scores were correlated with overall survival (p < 0.001 for each score). In the predicting of 1-month survival, m B-GPA was superior to the B-GPA (AUC B-GPA: 0.65 vs AUC mB-GPA: 0.67). For 1-year survival, the B-GPA score showed significant superiority with a better AUC index (AUC B-GPA: 0.85 vs AUC mB-GPA: 0.82).

Our study concluded that mB-GPA was better in predicting 1-month OS. However, B-GPA was more interesting in predicting 1-year OS. This means that the prognostic value of the number of brain metastases fades at 1 year.

Emerging research has suggested that axillary staging can be avoided in breast cancer patients in certain conditions.

To highlight these conditions and explore the evidence of such a practice.

We conducted a narrative review of the scenarios in which axillary staging is accepted to be omitted.

The first and oldest condition where sentinel lymph node biopsy (SLNB) can be omitted is Ductal Carcinoma in Situ (DCIS). Studies have shown that for DCIS patients who are prepared for breast-conserving surgery (BCS), SLNB is not necessary. Secondly, the Choosing Wisely guidelines recommend against SLNB for patients over 70 years old with early-stage, Luminal, HER2-negative, node-negative breast cancer as the likelihood of lymph node involvement is low, making SLNB unnecessary. In addition, The SOUND trial further supports the omission of SLNB in certain situations. This trial focused on small, early-stage breast cancer (T1) and negative axillary imaging findings. The results indicated that skipping SLNB was as effective as performing the procedure, suggesting that axillary surgery can be safely avoided in these cases. Another scenario where SLNB may be omitted is in patients with tubular breast carcinoma (TBC), which has a favorable prognosis with minimal lymph node involvement.

In summary, although SLNB remains a useful tool for managing breast cancer in many cases, omitting it in some patient populations could help avoid unnecessary treatment with its subsequent—even if minimal—potential morbidity.