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  1. Article ; Online: Impact of totally implanted venous access port placement on body image in women with breast cancer.

    Pizzuti, Giada / Cassani, Chiara / Bottazzi, Andrea / Ruggieri, Annamaria / Della Valle, Angelica / Dionigi, Francesca / Anghelone, Chiara Annunziata Pasqualina / Sgarella, Adele / Ferrari, Alberta

    The journal of vascular access

    2022  Volume 25, Issue 2, Page(s) 673–676

    Abstract: Totally implanted venous access ports (TIVAPs) have been established as effective and safe devices for oncologic patients. In breast cancer setting, the implant of the reservoir at mid-arm allows the absence of additional scars on the chest and the ... ...

    Abstract Totally implanted venous access ports (TIVAPs) have been established as effective and safe devices for oncologic patients. In breast cancer setting, the implant of the reservoir at mid-arm allows the absence of additional scars on the chest and the easier access to the port with significant cosmetic and psychological advantages. In the last decades, breast surgery has made great progresses to ameliorate the cosmetic results even in mastectomy techniques. In fact, many studies have demonstrated that negative body image perception affects physical and psychological wellbeing of survivors. Despite this evidence, limited importance is still reserved to TIVAPs placement site, which is traditionally the chest. It is not unusual to see patients after a nipple-sparing mastectomy with excellent cosmetic result who show a disfiguring scar on their upper chest due to TIVAP placement. We report the case of a young woman with BRCA2-related breast cancer who underwent bilateral nipple sparing mastectomy with immediate reconstruction and adjuvant chemotherapy. Her TIVAP was located at the mid-arm, which is still an uncommon site compared to the upper chest. An optimal cosmetic result was obtained both in breast reconstruction and in the arm site of port, with high-rate patient satisfaction. This case presentation aims to raise awareness towards women's body image preservation, particularly in the choice of TIVAP placement: in most cases neckline and upper chest should be avoided for a better patient related outcome.
    MeSH term(s) Humans ; Female ; Catheterization, Central Venous ; Breast Neoplasms/drug therapy ; Body Image ; Mastectomy ; Patient Satisfaction ; Retrospective Studies
    Language English
    Publishing date 2022-11-18
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2252820-9
    ISSN 1724-6032 ; 1129-7298
    ISSN (online) 1724-6032
    ISSN 1129-7298
    DOI 10.1177/11297298221136330
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Concordance of immunohistochemistry for predictive and prognostic factors in breast cancer between biopsy and surgical excision: a single-centre experience and review of the literature.

    Rossi, Chiara / Fraticelli, Sara / Fanizza, Marianna / Ferrari, Alberta / Ferraris, Elisa / Messina, Alessia / Della Valle, Angelica / Anghelone, Chiara Annunziata Pasqualina / Lasagna, Angioletta / Rizzo, Gianpiero / Perrone, Lorenzo / Sommaruga, Maria Grazia / Meloni, Giulia / Dallavalle, Silvia / Bonzano, Elisabetta / Paulli, Marco / Di Giulio, Giuseppe / Sgarella, Adele / Lucioni, Marco

    Breast cancer research and treatment

    2023  Volume 198, Issue 3, Page(s) 573–582

    Abstract: Purpose: Accurate evaluation of breast cancer on bioptic samples is of fundamental importance to guide therapeutic decisions, especially in the neoadjuvant or metastatic setting. We aimed to assess concordance for oestrogen receptor (ER), progesterone ... ...

    Abstract Purpose: Accurate evaluation of breast cancer on bioptic samples is of fundamental importance to guide therapeutic decisions, especially in the neoadjuvant or metastatic setting. We aimed to assess concordance for oestrogen receptor (ER), progesterone receptor (PR), c-erbB2/HER2 and Ki-67. We also reviewed the current literature to evaluate our results in the context of the data available at present.
    Methods: We included patients who underwent both biopsy and surgical resection for breast cancer at San Matteo Hospital, Pavia, Italy, between January 2014 and December 2020. ER, PR, c-erbB2, and Ki-67 immunohistochemistry concordance between biopsy and surgical specimen was evaluated. ER was further analysed to include the recently defined ER-low-positive in our analysis.
    Results: We evaluated 923 patients. Concordance between biopsy and surgical specimen for ER, ER-low-positive, PR, c-erbB2 and Ki-67 was, respectively, 97.83, 47.8, 94.26, 68 and 86.13%. Cohen's κ for interobserver agreement was very good for ER and good for PR, c-erbB2 and Ki-67. Concordance was especially low (37%) in the c-erbB2 1 + category.
    Conclusion: Oestrogen and progesterone receptor status can be safely assessed on preoperative samples. The results of this study advise caution in interpreting biopsy results regarding ER-low-positive, c-erbB2/HER and Ki-67 results due to a still suboptimal concordance. The low concordance for c-erbB2 1 + cases underlines the importance of further training in this area, in the light of the future therapeutic perspectives.
    MeSH term(s) Humans ; Female ; Breast Neoplasms/diagnosis ; Breast Neoplasms/surgery ; Breast Neoplasms/drug therapy ; Receptors, Progesterone ; Ki-67 Antigen ; Biomarkers, Tumor ; Prognosis ; Immunohistochemistry ; Receptor, ErbB-2 ; Biopsy ; Receptors, Estrogen
    Chemical Substances Receptors, Progesterone ; Ki-67 Antigen ; Biomarkers, Tumor ; Receptor, ErbB-2 (EC 2.7.10.1) ; Receptors, Estrogen
    Language English
    Publishing date 2023-02-21
    Publishing country Netherlands
    Document type Review ; Journal Article
    ZDB-ID 604563-7
    ISSN 1573-7217 ; 0167-6806
    ISSN (online) 1573-7217
    ISSN 0167-6806
    DOI 10.1007/s10549-023-06872-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Correlation between outcome and extent of residual disease in the sentinel node after neoadjuvant chemotherapy in clinically fine-needle proven node-positive breast cancer patients.

    Canavese, Giuseppe / Tinterri, Corrado / Carli, Franca / Garrone, Elsa / Spinaci, Stefano / Della Valle, Angelica / Barbieri, Erika / Marrazzo, Emilia / Bruzzi, Paolo / Dozin, Beatrice

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2021  Volume 47, Issue 8, Page(s) 1920–1927

    Abstract: Background: Whether the extent of residual disease in the sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC) influences the prognosis in clinically node-positive breast cancer (BC) patients remains to be ascertained.: Methods: One hundred ...

    Abstract Background: Whether the extent of residual disease in the sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC) influences the prognosis in clinically node-positive breast cancer (BC) patients remains to be ascertained.
    Methods: One hundred and thirty-four consecutive cN+/BC-patients received NAC followed by SLN biopsy and axillary lymph node dissection. Cumulative incidence of overall (OS) and disease-free (DFS) survival, BC-related recurrences and death from BC were assessed using the Kaplan-Meier method both in the whole patient population and according to the SLN status. The log rank test was used for comparisons between groups.
    Results: The SLN was identified in 123/134 (91.8%) patients and was positive in 98/123 (79.7%) patients. Sixty-five of them (66.3%) had other axillary nodes involved. SLN sensitivity and false-negative rate were 88.0% and 2.0%, Median follow-up was 10.2 years. Ten-year cumulative incidence of axillary, breast and distant recurrences, and death from BC were 6.5%, 11.9%, 33.4% and 31.3%, respectively. Ten-year OS and DFS were 67.3% and 55.9%. When stratified by SLN status, 10-year cumulative incidence of BC-related and loco-regional events, and death from BC were similar between disease-free SLN and micrometastatic SLN subgroups (28.9% vs 30.2%, p = 0.954; 21.6% vs 13.4%, p = 0.840; 12.9 vs 24.5%, p=0.494). Likewise, 10-year OS and DFS were comparable (80.0% vs 75.5%, p=0.975 and 68.0% vs 69.8, p=0.836). Both OS and DFS were lower in patients presenting a macrometastatic SLN (60.2% and 47.5%).
    Conclusion: Outcome of patients with micrometastatic SLN was similar to that of patients with disease-free SLN, which was more favorable as compared to that of patients with macrometastatic SLN.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Axilla ; Biopsy, Fine-Needle ; Breast Neoplasms/drug therapy ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Carcinoma, Ductal, Breast/drug therapy ; Carcinoma, Ductal, Breast/pathology ; Carcinoma, Ductal, Breast/surgery ; Carcinoma, Lobular/drug therapy ; Carcinoma, Lobular/pathology ; Carcinoma, Lobular/surgery ; Disease-Free Survival ; False Negative Reactions ; Female ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes/pathology ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Micrometastasis/pathology ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm, Residual ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node Biopsy ; Survival Rate
    Language English
    Publishing date 2021-05-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2021.04.039
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Low neutrophil-to-lymphocyte ratio and pan-immune-inflammation-value predict nodal pathologic complete response in 1274 breast cancer patients treated with neoadjuvant chemotherapy: a multicenter analysis.

    Gasparri, Maria Luisa / Albasini, Sara / Truffi, Marta / Favilla, Karin / Tagliaferri, Barbara / Piccotti, Francesca / Bossi, Daniela / Armatura, Giulia / Calcinotto, Arianna / Chiappa, Corrado / Combi, Francesca / Curcio, Annalisa / Della Valle, Angelica / Ferrari, Guglielmo / Folli, Secondo / Ghilli, Matteo / Listorti, Chiara / Mancini, Stefano / Marinello, Peter /
    Mele, Simone / Pertusati, Anna / Roncella, Manuela / Rossi, Lorenzo / Rovera, Francesca / Segattini, Silvia / Sgarella, Adele / Tognali, Daniela / Corsi, Fabio

    Therapeutic advances in medical oncology

    2023  Volume 15, Page(s) 17588359231193732

    Abstract: Background: Systemic inflammatory markers draw great interest as potential blood-based prognostic factors in several oncological settings.: Objectives: The aim of this study is to evaluate whether neutrophil-to-lymphocyte ratio (NLR) and pan-immune- ... ...

    Abstract Background: Systemic inflammatory markers draw great interest as potential blood-based prognostic factors in several oncological settings.
    Objectives: The aim of this study is to evaluate whether neutrophil-to-lymphocyte ratio (NLR) and pan-immune-inflammation value (PIV) predict nodal pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in node-positive (cN+) breast cancer (BC) patients.
    Design: Clinically, cN+ BC patients undergoing NAC followed by breast and axillary surgery were enrolled in a multicentric study from 11 Breast Units.
    Methods: Pretreatment blood counts were collected for the analysis and used to calculate NLR and PIV. Logistic regression analyses were performed to evaluate independent predictors of nodal pCR.
    Results: A total of 1274 cN+ BC patients were included. Nodal pCR was achieved in 586 (46%) patients. At multivariate analysis, low NLR [odds ratio (OR) = 0.71; 95% CI, 0.51-0.98;
    Conclusion: This study found that low NLR and PIV levels predict axillary pCR in patients with BC undergoing NAC.
    Registration: Eudract number NCT05798806.
    Language English
    Publishing date 2023-09-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2503443-1
    ISSN 1758-8359 ; 1758-8340
    ISSN (online) 1758-8359
    ISSN 1758-8340
    DOI 10.1177/17588359231193732
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Development of a novel nomogram-based online tool to predict axillary status after neoadjuvant chemotherapy in cN+ breast cancer: A multicentre study on 1,950 patients.

    Corsi, Fabio / Albasini, Sara / Sorrentino, Luca / Armatura, Giulia / Carolla, Claudia / Chiappa, Corrado / Combi, Francesca / Curcio, Annalisa / Della Valle, Angelica / Ferrari, Guglielmo / Gasparri, Maria Luisa / Gentilini, Oreste / Ghilli, Matteo / Listorti, Chiara / Mancini, Stefano / Marinello, Peter / Meani, Francesco / Mele, Simone / Pertusati, Anna /
    Roncella, Manuela / Rovera, Francesca / Sgarella, Adele / Tazzioli, Giovanni / Tognali, Daniela / Folli, Secondo

    Breast (Edinburgh, Scotland)

    2021  Volume 60, Page(s) 131–137

    Abstract: Background: Type of axillary surgery in breast cancer (BC) patients who convert from cN + to ycN0 after neoadjuvant chemotherapy (NAC) is still debated. The aim of the present study was to develop and validate a preoperative predictive nomogram to ... ...

    Abstract Background: Type of axillary surgery in breast cancer (BC) patients who convert from cN + to ycN0 after neoadjuvant chemotherapy (NAC) is still debated. The aim of the present study was to develop and validate a preoperative predictive nomogram to select those patients with a low risk of residual axillary disease after NAC, in whom axillary surgery could be minimized.
    Patients and methods: 1950 clinically node-positive BC patients from 11 Breast Units, treated by NAC and subsequent surgery, were included from 2005 to 2020. Patients were divided in two groups: those who achieved nodal pCR vs. those with residual nodal disease after NAC. The cohort was divided into training and validation set with a geographic separation criterion. The outcome was to identify independent predictors of axillary pathologic complete response (pCR).
    Results: Independent predictive factors associated to nodal pCR were axillary clinical complete response (cCR) after NAC (OR 3.11, p < 0.0001), ER-/HER2+ (OR 3.26, p < 0.0001) or ER+/HER2+ (OR 2.26, p = 0.0002) or ER-/HER2- (OR 1.89, p = 0.009) BC, breast cCR (OR 2.48, p < 0.0001), Ki67 > 14% (OR 0.52, p = 0.0005), and tumor grading G2 (OR 0.35, p = 0.002) or G3 (OR 0.29, p = 0.0003). The nomogram showed a sensitivity of 71% and a specificity of 73% (AUC 0.77, 95%CI 0.75-0.80). After external validation the accuracy of the nomogram was confirmed.
    Conclusion: The accuracy makes this freely-available, nomogram-based online tool useful to predict nodal pCR after NAC, translating the concept of tailored axillary surgery also in this setting of patients.
    MeSH term(s) Axilla ; Breast Neoplasms/drug therapy ; Breast Neoplasms/surgery ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Nodes ; Mastectomy ; Neoadjuvant Therapy ; Nomograms ; Sentinel Lymph Node Biopsy
    Language English
    Publishing date 2021-10-02
    Publishing country Netherlands
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1143210-x
    ISSN 1532-3080 ; 0960-9776
    ISSN (online) 1532-3080
    ISSN 0960-9776
    DOI 10.1016/j.breast.2021.09.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The institution of a Multi-disciplinary Italian Breast Unit: Reflections of the first psychosocial research study results on distress and quality of life.

    Dionigi, Francesca / Milani, Roberta / Garcia-Etienne, Carlos Alberto / Praticò, Vincenza / Riboni, Giuseppina / Della Valle, Angelica / Ferrari, Alberta / Grasso, Donatella / Lasagna, Angioletta / Pedrazzoli, Paolo / Klersy, Catherine / Politi, Pierluigi / Sgarella, Adele / Manna, Sara / Conti, Carmen

    The breast journal

    2019  Volume 25, Issue 4, Page(s) 678–681

    Abstract: Breast cancer affects patients both emotionally and physically. It is time to consider distress as the sixth vital sign in breast cancer patients in Europe. Between 2012 and 2015, our EUSOMA-certified multi-disciplinary group conducted a study on ... ...

    Abstract Breast cancer affects patients both emotionally and physically. It is time to consider distress as the sixth vital sign in breast cancer patients in Europe. Between 2012 and 2015, our EUSOMA-certified multi-disciplinary group conducted a study on emotional distress and quality-of-life in breast cancer patients at diagnosis, and observed their trend over the first 8 months of treatment. One hundred and forty-nine patients concluded the program. The psycho-oncologist and the breast nurses gave out SF36, Hospital Anxiety and Depression Scale and Distress Thermometer. Our Italian data go along with the reported literature on distress and quality-of-life. Despite modern advances, experiencing breast cancer impacts on overall quality-of-life.
    MeSH term(s) Breast Neoplasms/psychology ; Breast Neoplasms/surgery ; Female ; Humans ; Italy ; Mastectomy ; Middle Aged ; Quality of Life ; Stress, Psychological ; Surveys and Questionnaires
    Language English
    Publishing date 2019-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1289960-4
    ISSN 1524-4741 ; 1075-122X
    ISSN (online) 1524-4741
    ISSN 1075-122X
    DOI 10.1111/tbj.13244
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Management of the axilla in patients with breast cancer and positive sentinel lymph node biopsy: An evidence-based update in a European breast center.

    Garcia-Etienne, Carlos A / Ferrari, Alberta / Della Valle, Angelica / Lucioni, Marco / Ferraris, Elisa / Di Giulio, Giuseppe / Squillace, Luigi / Bonzano, Elisabetta / Lasagna, Angioletta / Rizzo, Gianpiero / Tancredi, Richard / Scotti Foglieni, Andrea / Dionigi, Francesca / Grasso, Maurizia / Arbustini, Eloisa / Cavenaghi, Giorgio / Pedrazzoli, Paolo / Filippi, Andrea R / Dionigi, Paolo /
    Sgarella, Adele

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2019  Volume 46, Issue 1, Page(s) 15–23

    Abstract: The surgical approach to the axilla in breast cancer has been a controversial issue for more than three decades. Data from recently published trials have provided practice-changing recommendations in this scenario. However, further controversies have ... ...

    Abstract The surgical approach to the axilla in breast cancer has been a controversial issue for more than three decades. Data from recently published trials have provided practice-changing recommendations in this scenario. However, further controversies have been triggered in the surgical community, resulting in heterogeneous diffusion of these recommendations. The development of clinical guidelines for the management of the axilla in patients with breast cancer is a work in progress. A multidisciplinary team discussion was held at the research hospital Policlinico San Matteo from the Università degli Studi di Pavia with the aim to update recommendations for the management of the axilla in patients with breast cancer. An evidence-based approach is presented. Our multidisciplinary panel determined that axillary dissection after a positive sentinel lymph node biopsy may be avoided in cN0 patients with micro/macrometastasis to ≤2 sentinel nodes, with age ≥40y, lesions ≤3 cm, who have not received neoadjuvant chemotherapy and have planned breast conservation (BCS) with whole breast radiotherapy (WBRT). Cases with gross (>2 mm) ECE in SLNs are evaluated on individual basis for completion ALND, axillary radiotherapy or omission of both. Patients fulfilling the criteria listed above who undergo mastectomy, may also avoid axillary dissection after multidisciplinary discussion of individual cases for consideration of axillary irradiation. Women 70 years or older with hormone receptors positive invasive lesions ≤3 cm, clinically negative nodes, and serious or multiple comorbidities who undergo BCS with WBRT, may forgo axillary staging/surgery (if mastectomy or larger tumor, comorbidities and life expectancy are taken into account).
    MeSH term(s) Adult ; Aged ; Axilla/pathology ; Axilla/surgery ; Breast Neoplasms/pathology ; Consensus ; Evidence-Based Medicine ; Female ; Humans ; Italy ; Lymph Node Excision ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Sentinel Lymph Node Biopsy
    Language English
    Publishing date 2019-08-13
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2019.08.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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