Validation of prognostic and predictive value of total tumoral load after primary systemic therapy in breast cancer using OSNA assay.

Purpose: This study aimed to validate the classification of breast cancer (BC) patients in progression risk groups based on total tumor load (TTL) value to predict lymph node (LN) affectation after neo-adjuvant systemic therapy (NAST) obtained in the NEOVATTL study.

Methods/patients: This was an observational, retrospective, international, multicenter study including patients with infiltrating BC who received NAST followed by sentinel lymph node biopsy (SLNB) analyzed with one-step nucleic acid amplification (OSNA) from nine Spanish and two Italian hospitals. Patients were classified into three groups according to the progression risk, measured as disease-free survival (DFS), based on TTL values (> 250, 250-25,000, and > 25,000 copies/μL).

"HER2 immunohistochemistry inter-observer reproducibility in 205 cases of invasive breast carcinoma additionally tested by ISH" Answer to the statistical issue to avoid misinterpretation.

Assessment of HER2 biomarker in invasive breast carcinoma patients allows a specific therapeutic approach. Clinical guidelines indicate immunohistochemistry (IHC) and in situ hybridization (ISH) to test HER2, however both have drawbacks which results in low reproducibility of results especially in equivocal cases. Our main objective is to quantify inter-observer IHC reproducibility and cross it with the ISH result.

Breast cancer sentinel lymph node and axillary lymphadenectomy: new tools for new challenges.

Axillary lymph node status at the time of diagnosis is the most important prognostic indicator for women with breast cancer, and may influence management decisions. However, at present its role is controversial, as some groups recommend avoiding axillary lymph node dissection (ALND) in cases with metastasis of any size in the sentinel lymph nodes. Molecular analysis allows full examination of the sentinel lymph nodes in a short time period, discriminatation between macrometastasis, micrometastasis and isolated tumor cells, and helps to predict the performance of ALND.

[Dieulafoy's lesion of the gallbladder as a cause of hemobilia with hemoperitoneum].

Dieulafoy's lesion is an uncommon vascular anomaly causing massive gastrointestinal hemorrhage, characterized by bleeding from an arteriole that protrudes through a tiny mucosal defect. Although Dieulafoy's lesion was initially described in the stomach and upper gastrointestinal tract, cases have also been reported in the colon, rectum and anal canal. We report the first case of Dieulafoy's lesion in the gallbladder, which presented as massive peritoneal bleeding.

Molecular diagnosis of sentinel lymph nodes for breast cancer: one step ahead for standardization.

Sentinel node (SN) pathologic analysis shows great limitations related to reproducibility and challenges pathologists with respect to methodology and standardization. Recently, a new, highly specific and sensitive molecular procedure has been developed, based on cytokeratin 19 messenger RNA amplification, which allows for fast and effective intraoperative evaluation of the SN. Our aim in this study was to compare 2 arms for intraoperative evaluation: one study arm with 478 cases in which an exhaustive histopathologic procedure was performed and the other study arm with 211 cases that were analyzed using the new molecular method.

[Radioguided breast surgery. Evolution of the use of minimal-invasive technologies and current situation].

The increase in the detection of occult lesions has led to the development of new localisation methods using radiopharmaceutical products. The use of these products allows us to perform a "thrifty" (less-aggressive) surgical excision and, to simultaneously carry out the biopsy of the sentinel node in cases of breast cancer. On making a search for the most up to date references on this particular topic, we found many articles on radioguided surgery by many leading international work groups.