Revista de Senologia y Patologia Mamaria最新文献

{"title":"Histological lesions of risk for breast carcinoma. An updated survival guide","authors":"Vicente Marco Molina,&nbsp;Felip García Hernández","doi":"10.1016/j.senol.2024.100636","DOIUrl":"10.1016/j.senol.2024.100636","url":null,"abstract":"<div><div>Histological lesions of risk of breast cancer are proliferative epithelial lesions associated with a higher incidence of breast cancer. The magnitude of the risk is related to the presence of epithelial atypia. Lesions with atypical hyperplasia have a relative risk of cancer 4 times higher than the control population. Proliferative epithelial lesions present diverse histological characteristics and must be appropriately classified. They include usual ductal hyperplasia, radial scar and complex sclerosing lesions, sclerosing adenosis, apocrine adenosis, microglandular adenosis, papillary lesions, atypical ductal hyperplasia, flat epithelial atypia, lobular neoplasia. They propose the differential diagnosis with ductal carcinoma in situ and invasive carcinoma. When risk lesions type B3 are diagnosed in needle-core and vacuum-assisted biopsies, the underestimation rates for invasive carcinoma should be below 5% and below 10% for ductal carcinoma in situ. In this review, we describe the clinical and histological aspects of the different entities and discuss the possible management options depending on the diagnostic category and the lesion size. Correct management requires close collaboration between surgeons, radiologists, and pathologists.</div></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"38 2","pages":"Article 100636"},"PeriodicalIF":0.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple negative cT1N0 breast cancer: A matter of milimeters","authors":"J. Ignacio Chacon","doi":"10.1016/j.senol.2024.100637","DOIUrl":"10.1016/j.senol.2024.100637","url":null,"abstract":"","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100637"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can we integrate current adjuvant treatment options in triple negative patients with residual disease after neoadjuvant treatment?","authors":"Mª. Teresa Quintanar-Verdúguez ,&nbsp;María Ballester Espinosa ,&nbsp;Javier Pérez-Altozano ,&nbsp;Álvaro Muñoz-Abad ,&nbsp;Álvaro Rodríguez-Lescure","doi":"10.1016/j.senol.2024.100633","DOIUrl":"10.1016/j.senol.2024.100633","url":null,"abstract":"<div><div>Triple negative breast cancer (TNBC) accounts for approximately 12%–20% of all breast cancers but usually has a more aggressive clinical course and worse prognosis than hormone receptor expressing breast cancers. Locoregional treatments as well as systemic chemotherapy are part of the therapeutic algorithm in early breast cancer. Currently, neoadjuvant treatment is the standard for TNBC T1c N0 or higher. This strategy allows treating the disease early as well as selecting subsequent adjuvant treatment based on the pathological response achieved. Those patients with early-stage TNBC who have residual disease after completing neoadjuvant therapy have a higher risk of relapse and worse survival than those who achieve pathological complete response. Different drugs (capecitabine, pembrolizumab, olaparib) have so far demonstrated their benefit in the adjuvant setting after previous neoadjuvant treatment without being comparable because their clinical trials differ in design and study population. This scenario is therefore a clinical challenge where the selection criteria are fundamental to identify those patients who can benefit from each of the available therapeutic strategies.</div></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"38 1","pages":"Article 100633"},"PeriodicalIF":0.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Técnicas de reconstrucción mamaria con colgajos de perforantes: nuestra experiencia y comparación con otras técnicas quirúrgicas","authors":"María del Rosario Martín-Merino Acera,&nbsp;Esther Colmenarejo García,&nbsp;Carla Ferrero San Román,&nbsp;Adela Valdazo Gómez,&nbsp;Iris Sánchez Egido,&nbsp;Lucía Latorre Marlasca,&nbsp;Gloria Paseiro Crespo","doi":"10.1016/j.senol.2024.100628","DOIUrl":"10.1016/j.senol.2024.100628","url":null,"abstract":"<div><h3>Introduction</h3><div>Chest wall perforator flaps (CWPF) have started to be used in the last decade in conservative breast cancer surgery in patients who require relatively large volume of excision (20%).</div></div><div><h3>Methods</h3><div>We present a series of 30 cases who have undergone breast conservation surgery plus CWPF reconstruction in our surgery department between 2020 and 2024. A total of 86.6% were diagnosed with breast cancer, 6.6% were diagnosed with a benign pathology, or needed correction of aesthetic defects following radiotherapy (6.6%).</div><div>This retrospective observational study examines data on flap characteristics, need for re-excision to ensure clear margins after a lumpectomy and surgical complications. These data have been compared with those obtained using other breast reconstruction techniques without CWPF.</div></div><div><h3>Results</h3><div>Immediate post-operative complications occurred in 13.3% of patients, the re-excision rate was 15.3% and no recurrences were detected during the follow-up period. These percentages are similar to those described in previous literature and to other types of surgery that do not use CWPF.</div></div><div><h3>Conclusions</h3><div>Although CWPF breast reconstruction techniques are not yet widely accepted in Spain, we consider that they can be very useful in selected patients to avoid mastectomies and their associated complications, as well as improving breast remodelling before or after radiotherapy.</div></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"38 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumores filoides malignos: serie de casos y revisión de la literatura","authors":"Vanesa Rodríguez-Fernández ,&nbsp;Gonzalo José de Castro Parga ,&nbsp;Jorge F. Cameselle-Teijeiro","doi":"10.1016/j.senol.2024.100600","DOIUrl":"10.1016/j.senol.2024.100600","url":null,"abstract":"<div><h3>Introduction</h3><div>Phyllodes tumours (PT) are rare breast tumours with diverse biological behaviour. The purpose of this paper was to conduct a global study of malignant PTs in our healthcare area.</div></div><div><h3>Material and methods</h3><div>A case series study where we reviewed oncological, clinical-diagnostic, therapeutic and prognostic data of malignant PTs diagnosed between 1978 and 2022 in the Vigo area.</div></div><div><h3>Results</h3><div>Out of the total of 64 PTs collected: 40 were benign, 13 borderline and 11malignant. The mean age of the total PT series was 49.8 years, with no differences being found between categories. All the malignant PTs in our series were in women who consulted for breast lumps. Mean size was 8 cm (2.5-20 cm). With regard to type of surgery, there were 6 cases of mastectomy and 4 cases of conservative surgery, one lymphadenectomy without apparent indication and without metastatic involvement. Radiotherapy was received in only one case, and in another adjuvant hormone therapy was received. Regarding prognostic evolution, one case presented local recurrence (4 years after surgery) and two cases developed metastasis (which was the cause of death after 1.5 and 8 years).</div></div><div><h3>Conclusions</h3><div>Malignant PTs are a rare entity. This was a historical series of only 11 patients. Surgical excision (margins ≥ 1 cm) without lymphadenectomy is the treatment of choice. Radiotherapy was effective in reducing local recurrences, but chemotherapy and hormone therapy are not substantiated. Suspected diagnosis is important to reduce associated morbidity and mortality and further studies are required to guide clinical practice.</div></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"38 1","pages":"Article 100600"},"PeriodicalIF":0.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potencial papel de la tomografía por emisión de positrones con fluorodesoxiglucosa (18F-FDG PET/TC) en la estadificación inicial del cáncer de mama","authors":"Rocío Sánchez Sánchez ,&nbsp;Antonio Daniel González Jiménez ,&nbsp;Tariq Aroui Luquin ,&nbsp;Inmaculada Mendoza Arnau ,&nbsp;Isabel Pérez Herrezuelo","doi":"10.1016/j.senol.2024.100629","DOIUrl":"10.1016/j.senol.2024.100629","url":null,"abstract":"<div><h3>Objective</h3><div>Multiple studies have evaluated the usefulness of ¹⁸F-FDG-PET/CT in the initial staging of breast cancer, demonstrating an important clinical impact with a change in therapeutic management. However, its role in current clinical practice is controversial and its use remains optional for major guidelines. Our objective is to assess the usefulness of PET/CT in this context.</div></div><div><h3>Material and method</h3><div>The results of PET/CT in patients recently diagnosed with breast cancer (2021–2022) have been analyzed visually and semiquantitatively using SUVmax. Positive findings were confirmed by specific imaging procedures.</div></div><div><h3>Results</h3><div>We prospectively evaluated 166 patients (59.8 ± 12.08 years). The primary tumor was detected by PET/CT in all cases. At diagnosis, 58 patients had axillary lymph node involvement by PET/CT. Axillary ultrasound detected lymph node involvement in 79% (46/58). Furthermore, in the 46 patients with lymph node involvement detected by both tests, PET/CT increased the number of lymph node lesions, thus modifying the stage. Unsuspected distant metastases were diagnosed by PET/CT in 12 patients, 10 had axillary lymph node involvement. The variables significantly associated with a higher probability of axillary or distant metastases in PET/CT were: histological grade 2–3 (<em>p</em> = 0.03), elevated Ki67 (<em>p</em> = 0.002) and higher SUVmax of the primary lesion (<em>p</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>Our results suggest a potential usefulness of PET/CT in the initial staging of patients with breast cancer, particularly in those with axillary involvement, for the detection of unsuspected distant metastases.</div></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"38 1","pages":"Article 100629"},"PeriodicalIF":0.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary lymphoma of the breast","authors":"Yoldez Houcine ,&nbsp;Nadia Kouki ,&nbsp;Rahma Yaiche ,&nbsp;Salma Kamoun ,&nbsp;Fatma Saadallah ,&nbsp;Maha Driss","doi":"10.1016/j.senol.2024.100631","DOIUrl":"10.1016/j.senol.2024.100631","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary breast lymphoma (PBL) represents a rare form of breast malignancy, with diffuse large B-cell lymphoma (DLBCL) emerging as the predominant histological subtype. Despite advancements, treatment strategies remain contentious.</div></div><div><h3>Objective</h3><div>This study aims to succinctly outline the clinicopathological and immunohistochemical characteristics of PBL while appraising available therapeutic modalities.</div></div><div><h3>Methods</h3><div>Retrospectively, 22 PBL cases from 2003 to 2021 were culled from pathological records at the Salah Azaiez Institute. Immunohistochemistry was employed to discern DLBCL subtypes.</div></div><div><h3>Results</h3><div>Median age stood at 58, with a predominance of 16 female patients over 6 males, notably with over 50% of women being post-menopausal. Clinical manifestation primarily involved a unilateral right-sided breast mass, with concurrent lymph node involvement detected in 10 cases at diagnosis. Radiological data were available for 6 cases, revealing DLBCL as the prevailing pathological subtype in 16 cases (73%). Non-germinal center B-cell type was notably discerned in 9 out of 16 PB-DLBC cases. Treatment modalities encompassed surgery in 5 patients, chemotherapy in 7, and radiotherapy in 3 cases. Among treated individuals, 7 experienced recurrences, 5 of them had DLBCL.</div></div><div><h3>Conclusion</h3><div>Despite its rarity, PBL warrants careful consideration due to its notably aggressive nature, mandating a clear distinction from breast carcinoma owing to differential therapeutic approaches and prognoses. Hence, an accurate diagnosis grounded in thorough pathological and immunohistochemical examination is imperative for tailoring optimal treatment strategies, thereby potentially enhancing outcomes.</div></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"38 1","pages":"Article 100631"},"PeriodicalIF":0.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carcinomatosis peritoneal secundaria a carcinoma de mama","authors":"Susana Gómez Valmaña ,&nbsp;David Martínez Ramos ,&nbsp;Luis Gómez Quiles ,&nbsp;Jose Manuel Laguna Sastre","doi":"10.1016/j.senol.2024.100608","DOIUrl":"10.1016/j.senol.2024.100608","url":null,"abstract":"<div><div>The incidence of breast cancer is increasing. On the other hand, mortality has decreased in recent years. Increasing survival means that a greater number of recurrences are detected.</div><div>An uncommon and late way of presentation of metastatic disease is at peritoneum. This represents a challenge in management at diagnosis and treatment, given the lack of recommendations and studies in this regard. Therefore, the objective was to carry out a bibliographic review on the latest updates on the diagnostic and therapeutic management of peritoneal carcinomatosis secondary to breast carcinoma and its survival. An exhaustive search has been carried out in different databases on the latest updates on the therapeutic management of peritoneal carcinomatosis in breast cancer. Finally, 31 articles have been included. Breast cancer is the extra-abdominal solid tumor that produces the most peritoneal carcinomatosis and the lobular subtype is the one most associated with this way of dissemination of the disease. The clinical presentation and diagnosis occur usually late, associated with a poor prognosis. The evidence regarding the ideal therapeutic management is scarce, but it has been shown that cytoreduction surgery + HIPEC (hyperthermic intraoperative chemotherapy) presents promising results in selected cases, observing improvement in survival and quality of life of affected patients. Quality prospective studies with a larger sample size are needed to determine the appropriate therapeutic management in peritoneal carcinomatosis due to breast carcinoma.</div></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"38 1","pages":"Article 100608"},"PeriodicalIF":0.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct salivary antioxidant patterns linked to breast cancer molecular subtypes","authors":"Mariane Fontana Mezoni,&nbsp;Aline Graciele Henriques Campos,&nbsp;Ana Carolina Aredes Goulart,&nbsp;Ana Carolina Lopes Federige,&nbsp;Ana Gabriela de Oliveira Silva,&nbsp;Bruna Yukie Koizumi,&nbsp;Rafaela Oliveira Matos,&nbsp;Felipe da Silva Bender,&nbsp;Gustavo Bendlin Padilha,&nbsp;Victor Pereira da Silva,&nbsp;Rafaella Frederico Almeida,&nbsp;Maria Paula de Andrade Berny,&nbsp;Daniel Rech,&nbsp;Aedra Carla Bufalo,&nbsp;Carolina Panis","doi":"10.1016/j.senol.2024.100634","DOIUrl":"10.1016/j.senol.2024.100634","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer (BC) is a heterogeneous and complex disease characterized by distinct biological subtypes and numerous risk factors. Salivary biomarkers for BC are promising indicators of both oral and systemic health. Given the role of antioxidants in the development and progression of BC, assessing patient's antioxidant capacity through saliva may be a valuable strategy.</div></div><div><h3>Material and methods</h3><div>This study aimed to investigate the antioxidant capacity of saliva in 134 women with BC and its correlation with prognostic factors. Total antioxidant capacity (TRAP) was measured using the high-sensitivity chemiluminescence technique.</div></div><div><h3>Results</h3><div>Significantly reduced salivary TRAP levels were observed in women with tumors positive for estrogen and progesterone receptors (<em>p</em> <!-->&lt;<!--> <!-->.05). Conversely, an increase in salivary TRAP levels was noted in patients with triple-negative tumors. No significant changes were observed in other clinical comparisons. Correlation analysis revealed negative associations between reduced salivary TRAP levels and estrogen receptors (<em>R</em> <!-->=−0.1881) and progesterone receptors (<em>R</em> <!-->=−0.1837). Positive correlations were found between TRAP levels and the ki67 proliferation index above 14% (<em>R</em> <!-->=<!--> <!-->0.1697), as well as the presence of the triple-negative tumor molecular subtype (<em>R</em> <!-->=<!--> <!-->0.2078). Additionally, the analysis showed no correspondence between TRAP levels in saliva and blood, with TRAP levels being higher in blood than in saliva.</div></div><div><h3>Conclusions</h3><div>These findings suggest that salivary TRAP levels could serve as a systemic marker associated with BC, particularly in cases with a worse prognosis, such as triple-negative tumors and high proliferation indices.</div></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"38 1","pages":"Article 100634"},"PeriodicalIF":0.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aplicación de un protocolo ERAS (enhanced recovery after surgery) para la práctica cirugía oncológica compleja de la mama en régimen ambulatorio","authors":"Meritxell Medarde-Ferrer ,&nbsp;Xavier Guirao Garriga ,&nbsp;Óscar Aparicio Rodriguez ,&nbsp;Immaculada Viader Barraca ,&nbsp;Angeles Placeres Gago ,&nbsp;Salvador Navarro Soto ,&nbsp;Laura Mora López","doi":"10.1016/j.senol.2024.100614","DOIUrl":"10.1016/j.senol.2024.100614","url":null,"abstract":"<div><h3>Introduction</h3><p>Outpatient mastectomies and lymphadenectomies are not routinely performed in Europe, probably because there are no specific protocols for their correct implementation. The objective of our study is to demonstrate that with the application of an ERAS protocol, complex oncological surgery of the breast can be performed on an outpatient basis in an effective, efficacious and efficient manner.</p></div><div><h3>Methods</h3><p>Prospective observational study including all patients who underwent mastectomy, sentinel node mastectomy, lumpectomy with axillary lymphadenectomy, and mastectomy with axillary lymphadenectomy from September 2018 to September 2021. We evaluated the success rate, admission rate not expected, readmission rate, frequenting the emergency room, telephone consultations, complications and degree of patient satisfaction.</p></div><div><h3>Results</h3><p>A total of 89 patients are included. The success rate was 94.4%. The unexpected admission rate was 5% (5 patients). The reasons for unexpected admission were: nausea and vomiting in 3, pain in 1, and wound bruising in 1. The rate of visits to the emergency room and telephone consultations was 3.4%. The complications were the same as if they had been admitted. 97.6% would recommend the process to a relative or friend of theirs.</p></div><div><h3>Conclusion</h3><p>The implementation of a specific ERAS pathway allows outpatient mastectomies and lymphadenectomies in an effective, safe and efficient manner, allowing the patient to accept the process with a high degree of satisfaction.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100614"},"PeriodicalIF":0.3,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142137220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}