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Article ; Online: Sentinel Node Mapping at the Time of COVID-19 Outbreak.

Listorti, Chiara / Bogani, Giorgio / Raspagliesi, Francesco / Folli, Secondo

Journal of investigative surgery : the official journal of the Academy of Surgical Research

2021 Volume 35, Issue 2, Page(s) 475–476

MeSH term(s)	COVID-19 ; Disease Outbreaks ; Humans ; SARS-CoV-2 ; Sentinel Lymph Node ; Sentinel Lymph Node Biopsy
Language	English
Publishing date	2021-01-05
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	639444-9
ISSN	1521-0553 ; 0894-1939
ISSN (online)	1521-0553
ISSN	0894-1939
DOI	10.1080/08941939.2020.1870180
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Article ; Online: Assessing HER2 status in breast cancer through next-generation sequencing of circulating tumor cells.

Di Cosimo, Serena / Silvestri, Marco / De Marco, Cinzia / Reduzzi, Carolina / Folli, Secondo / De Santis, Maria Carmen / Cappelletti, Vera

The International journal of biological markers

2024 , Page(s) 3936155241246542

Language	English
Publishing date	2024-04-22
Publishing country	United States
Document type	Letter
ZDB-ID	645113-5
ISSN	1724-6008 ; 0393-6155
ISSN (online)	1724-6008
ISSN	0393-6155
DOI	10.1177/03936155241246542
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Article ; Online: Psychosocial factors associated with workability after surgery in cancer survivors: An explorative study.

Silvaggi, Fabiola / Mariniello, Arianna / Leonardi, Matilde / Silvani, Antonio / Lamperti, Elena / Di Cosimo, Serena / Folli, Secondo / Trapani, Anna / Schiavolin, Silvia

Journal of health psychology

2023 Volume 28, Issue 11, Page(s) 999–1010

Abstract: This study aimed to evaluate the work ability and its associated factors in patients with glioma (II, III) and breast cancer after 6 (T0) and 12 (T1) months from surgery. A total of 99 patients were evaluated with self-reported questionnaires at T0 and ... ...

Abstract	This study aimed to evaluate the work ability and its associated factors in patients with glioma (II, III) and breast cancer after 6 (T0) and 12 (T1) months from surgery. A total of 99 patients were evaluated with self-reported questionnaires at T0 and T1. Correlation and Mann-Whitney tests were used to investigate the association between work ability and sociodemographic, clinical, and psychosocial factors. The Wilcoxon test was used to investigate the longitudinal change in work ability. Our sample showed a decrease in work ability level between T0 and T1. Work ability was associated with emotional distress, disability, resilience, and social support in glioma III patients at T0, and with fatigue, disability, and clinical treatments in patients with breast cancer at T0 and T1. Work ability levels decreased in patients with glioma and breast cancer and were associated with different psychosocial factors after surgery. Their investigation is suggested to facilitate the return to work.
MeSH term(s)	Humans ; Female ; Cancer Survivors ; Breast Neoplasms/surgery ; Surveys and Questionnaires ; Self Report ; Glioma
Language	English
Publishing date	2023-02-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2021897-7
ISSN	1461-7277 ; 1359-1053
ISSN (online)	1461-7277
ISSN	1359-1053
DOI	10.1177/13591053231151286
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Article ; Online: Mammographic density to predict response to neoadjuvant systemic breast cancer therapy.

Di Cosimo, S / Depretto, C / Miceli, R / Baili, P / Ljevar, S / Sant, M / Cappelletti, V / Folli, S / Gennaro, M / De Braud, F G / Bianchi, G / Vingiani, A / Pruneri, G / Marchianò, A / La Rocca, E / De Santis, M C / Scaperrotta, G P

Journal of cancer research and clinical oncology

2022 Volume 148, Issue 4, Page(s) 775–781

Abstract: Background: Mammographic density (MD) is a risk factor for breast cancer (BC) development, and recurrence. However, its predictive value has been less studied. Herein, we challenged MD as a biomarker associated with response in patients treated with ... ...

Abstract	Background: Mammographic density (MD) is a risk factor for breast cancer (BC) development, and recurrence. However, its predictive value has been less studied. Herein, we challenged MD as a biomarker associated with response in patients treated with neoadjuvant therapy (NAT). Methods: Data on all NAT treated BC patients prospectively collected in the registry of Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy (2009-2019) were identified. Diagnostic mammograms were used to evaluate and score MD as categorized by the Breast Imaging-Reporting and Data System (BI-RADS), which identifies 4 levels of MD in keeping with relative increase of fibro-glandular over fat tissue. Each case was classified according to the following categories a (MD < 25%), b (26-50%), c (51-75%), and d (> 75%). The association between MD and pathological complete response (pCR), i.e., absence of BC cells in surgical specimens, was analyzed in multivariable setting used logistic regression models with adjustment for clinical and pathological variables. Results: A total of 442 patients were analyzed, 120 of which (27.1%) attained a pCR. BI-RADS categories a, b, c, and d accounted for 10.0%, 37.8%, 37.1% and 15.2% of cases. Corresponding pCR were 20.5%, 26.9%, 30.5%, 23.9%, respectively. At multivariable analysis, when compared to cases classified as BI-RADS a, those with denser breast showed an increased likelihood of pCR with odds ratio (OR) of 1.70, 2.79, and 1.47 for b, c and d categories, respectively (p = 0.0996), independently of age, BMI [OR underweight versus (vs) normal = 3.76], clinical nodal and tumor status (OR T1/Tx vs T4 = 3.87), molecular subtype (HER2-positive vs luminal = 10.74; triple-negative vs luminal = 8.19). In subgroup analyses, the association of MD with pCR was remarkable in triple-negative (ORs of b, c and d versus a: 1.85, 2.49 and 1.55, respectively) and HER2-positive BC cases (ORs 2.70, 3.23, and 1.16). Conclusion: Patients with dense breast are more likely to attain a pCR at net of other predictive factors. The potential of MD to assist decisions on BC management and as a stratification factor in neoadjuvant clinical trials should be considered.
MeSH term(s)	Breast Density ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/drug therapy ; Female ; Humans ; Mammography ; Neoadjuvant Therapy ; Odds Ratio ; Receptor, ErbB-2
Chemical Substances	Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2022-01-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	134792-5
ISSN	1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
ISSN (online)	1432-1335
ISSN	0171-5216 ; 0084-5353 ; 0943-9382
DOI	10.1007/s00432-021-03881-3
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Article ; Online: Early stage breast cancer follow-up in real-world clinical practice: the added value of cell free circulating tumor DNA.

La Rocca, E / De Santis, M C / Silvestri, M / Ortolan, E / Valenti, M / Folli, S / de Braud, F G / Bianchi, G V / Scaperrotta, G P / Apolone, G / Daidone, M G / Cappelletti, V / Pruneri, G / Di Cosimo, S

Journal of cancer research and clinical oncology

2022 Volume 148, Issue 6, Page(s) 1543–1550

Abstract: Purpose: Physical examinations and annual mammography (minimal follow-up) are as effective as laboratory/imaging tests (intensive follow-up) in detecting breast cancer (BC) recurrence. This statement is now challenged by the availability of new ... ...

Abstract	Purpose: Physical examinations and annual mammography (minimal follow-up) are as effective as laboratory/imaging tests (intensive follow-up) in detecting breast cancer (BC) recurrence. This statement is now challenged by the availability of new diagnostic tools for asymptomatic cases. Herein, we analyzed current practices and circulating tumor DNA (ctDNA) in monitoring high-risk BC patients treated with curative intent in a comprehensive cancer center. Patients and methods: Forty-two consecutive triple negative BC patients undergoing neoadjuvant therapy and surgery were prospectively enrolled. Data from plasma samples and surveillance procedures were analyzed to report the diagnostic pattern of relapsed cases, i.e., by symptoms, follow-up procedures and ctDNA. Results: Besides minimal follow-up, 97% and 79% of patients had at least 1 non-recommended imaging and laboratory tests for surveillance purposes. During a median follow-up of 5.1(IQR, 4.1-5.9) years, 13 events occurred (1 contralateral BC, 1 loco-regional recurrence, 10 metastases, and 1 death). Five recurrent cases were diagnosed by intensive follow-up, 5 by symptoms, and 2 incidentally. ctDNA antedated disseminated disease in all evaluable cases excepted two with bone-only and single liver metastases. The mean time from ctDNA detection to suspicious findings at follow-up imaging was 3.81(SD, 2.68), and to definitive recurrence diagnosis 8(SD, 2.98) months. ctDNA was undetectable in the absence of disease and in two suspected cases not subsequently confirmed. Conclusions: Some relapses are still symptomatic despite the extensive use of intensive follow-up. ctDNA is a specific test, sensitive enough to detect recurrence before other methods, suitable for clarifying equivocal imaging, and exploitable for salvage therapy in asymptomatic BC survivors.
MeSH term(s)	Biomarkers, Tumor/genetics ; Circulating Tumor DNA/genetics ; Follow-Up Studies ; Humans ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local/epidemiology ; Triple Negative Breast Neoplasms/genetics
Chemical Substances	Biomarkers, Tumor ; Circulating Tumor DNA
Language	English
Publishing date	2022-04-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	134792-5
ISSN	1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
ISSN (online)	1432-1335
ISSN	0171-5216 ; 0084-5353 ; 0943-9382
DOI	10.1007/s00432-022-03990-7
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Article ; Online: Maintaining brain health across the lifespan.

García-García, Isabel / Donica, Olga / Cohen, Armand Aaron / Gonseth Nusslé, Semira / Heini, Adrian / Nusslé, Sébastien / Pichard, Claude / Rietschel, Ernst / Tanackovic, Goranka / Folli, Silvio / Draganski, Bogdan

Neuroscience and biobehavioral reviews

2023 Volume 153, Page(s) 105365

Abstract: Across the lifespan, the human body and brain endure the impact of a plethora of exogenous and endogenous factors that determine the health outcome in old age. The overwhelming inter-individual variance spans between progressive frailty with loss of ... ...

Abstract	Across the lifespan, the human body and brain endure the impact of a plethora of exogenous and endogenous factors that determine the health outcome in old age. The overwhelming inter-individual variance spans between progressive frailty with loss of autonomy to largely preserved physical, cognitive, and social functions. Understanding the mechanisms underlying the diverse aging trajectories can inform future strategies to maintain a healthy body and brain. Here we provide a comprehensive overview of the current literature on lifetime factors governing brain health. We present the growing body of evidence that unhealthy alimentary regime, sedentary behaviour, sleep pathologies, cardio-vascular risk factors, and chronic inflammation exert their harmful effects in a cumulative and gradual manner, and that timely and efficient intervention could promote healthy and successful aging. We discuss the main effects and interactions between these risk factors and the resulting brain health outcomes to follow with a description of current strategies aiming to eliminate, treat, or counteract the risk factors. We conclude that the detailed insights about modifiable risk factors could inform personalized multi-domain strategies for brain health maintenance on the background of increased longevity.
MeSH term(s)	Humans ; Longevity ; Brain ; Aging ; Risk Factors ; Sedentary Behavior
Language	English
Publishing date	2023-08-19
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	282464-4
ISSN	1873-7528 ; 0149-7634
ISSN (online)	1873-7528
ISSN	0149-7634
DOI	10.1016/j.neubiorev.2023.105365
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Article ; Online: Prophylactic Salpingo-Oophorectomy and Survival After BRCA1/2 Breast Cancer Resection.

Martelli, Gabriele / Barretta, Francesco / Vernieri, Claudio / Folli, Secondo / Pruneri, Giancarlo / Segattini, Silvia / Trapani, Anna / Carolla, Claudia / Spatti, Gianbattista / Miceli, Rosalba / Ferraris, Cristina

JAMA surgery

2023 Volume 158, Issue 12, Page(s) 1275–1284

Abstract: Importance: Few studies have investigated whether prophylactic salpingo-oophorectomy (PSO) for patients with previously resected breast cancer who carry pathogenic germline BRCA1 or BRCA2 variants is associated with a reduced risk of cancer-specific ... ...

Abstract	Importance: Few studies have investigated whether prophylactic salpingo-oophorectomy (PSO) for patients with previously resected breast cancer who carry pathogenic germline BRCA1 or BRCA2 variants is associated with a reduced risk of cancer-specific death. Objective: To assess the association of PSO and prophylactic mastectomy (PM) with prognosis after quadrantectomy or mastectomy as primary treatment for patients with BRCA1 or BRCA2 breast cancer. Design, setting, and participants: This retrospective cohort study was performed in a single-institution, tertiary referral center. Consecutive patients with invasive breast cancer treated surgically between 1972 and 2019 were recruited and followed up prospectively after they were found to carry the BRCA1 or BRCA2 gene variant. The data analysis was performed between April 2022 and July 2023. Exposure: Following breast surgery, some patients underwent PSO, PM, or both, whereas others did not. Main outcomes and measures: The primary study end point was overall survival as measured by the Kaplan-Meier method. Secondary end points were crude cumulative incidence of breast cancer-specific mortality, ipsilateral breast tumor recurrence (IBTR), contralateral breast cancer, ovarian cancer, and ovarian cancer-specific mortality. Results: Of 480 patients included in the cohort (median age at initial surgery, 40.0 years; IQR, 34.0-46.0 years), PSO was associated with a significantly reduced risk of death (hazard ratio [HR], 0.40; 95% CI, 0.25-0.64; P < .001). This reduction was most evident for patients carrying the BRCA1 variant (HR, 0.35; 95% CI, 0.20-0.63; P = .001), those with triple-negative disease (HR, 0.21; 95% CI, 0.09-0.46; P = .002), and those with invasive ductal carcinoma (HR, 0.51; 95% CI, 0.31-0.84; P = .008). Prophylactic salpingo-oophorectomy was not associated with risk of contralateral breast cancer or IBTR. Initial or delayed PM was associated with a reduced risk of IBTR but not with overall survival or breast cancer-specific mortality. Conclusions: The study findings suggest that PSO should be offered to all patients with BRCA1/2 breast cancer who undergo surgery with curative intent to reduce risk of death. In particular, PSO should be offered to patients with the BRCA1 variant at the time of breast surgery.
MeSH term(s)	Female ; Humans ; Adult ; Breast Neoplasms/genetics ; Breast Neoplasms/prevention & control ; Breast Neoplasms/surgery ; Salpingo-oophorectomy ; BRCA1 Protein/genetics ; Mastectomy ; Retrospective Studies ; BRCA2 Protein/genetics ; Genes, BRCA1 ; Neoplasm Recurrence, Local/genetics ; Ovariectomy ; Ovarian Neoplasms/genetics ; Ovarian Neoplasms/prevention & control ; Mutation
Chemical Substances	BRCA1 protein, human ; BRCA1 Protein ; BRCA2 protein, human ; BRCA2 Protein
Language	English
Publishing date	2023-10-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2023.4770
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Article ; Online: Magnetic Localization of Breast Lesions: A Large-Scale European Evaluation in a National Cancer Institute.

Depretto, Catherine / Della Pepa, Gianmarco / De Berardinis, Claudia / Suman, Laura / Ferranti, Claudio / Marchesini, Monica / Maugeri, Ilaria / Martelli, Gabriele / Gennaro, Massimiliano / Folli, Secondo / Pruneri, Giancarlo / Scaperrotta, Gianfranco Paride

Clinical breast cancer

2023 Volume 23, Issue 8, Page(s) e491–e498

Abstract: Introduction: For decades the standard for preoperative breast lesions' localization has been wire localization. In recent years the options for nonwired localization have significantly expanded and include radioactive seeds, radar reflectors, ... ...

Abstract	Introduction: For decades the standard for preoperative breast lesions' localization has been wire localization. In recent years the options for nonwired localization have significantly expanded and include radioactive seeds, radar reflectors, radiofrequency identification tags and magnetic seeds. The aim of our study is to evaluate on a large scale the performance of preoperative magnetic seed localization of nonpalpable breast lesions. Material and methods: We prospectively collected data on all patients undergoing image-guided magnetic seed localization from September 2019 to December 2022. We analyzed imaging findings, histological results, and type of surgery. The primary outcome was the successful localization rate. Secondary outcomes were the successful placement rate, the ease of percutaneous positioning, the procedural complications, and the reintervention rate. Results: A total of 1123 magnetic seeds were placed in 1084 patients by 4 radiologists under ultrasound (1053) or stereotactic (70) guidance. All seeds were detectable transcutaneously in all breasts sizes and at all depths by 7 surgeons with a success rate of 100%. A total of 97.5% seeds were correctly placed into the target lesions (only 2.5% were dislocated). All radiologists have shown good compliance during the procedure, and there were no complications or safety issues. The reoperation rate was 5.1%. Conclusions: Image-guided localization with magnetic seeds is an easy, safe, reliable, and effective method for localizing nonpalpable breast lesions. Both radiologists and surgeons agreed that the technology was intuitive to use and that it can be widely applied in preoperative localization in breast units.
MeSH term(s)	United States ; Humans ; Female ; National Cancer Institute (U.S.) ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/surgery ; Breast/diagnostic imaging ; Breast/surgery ; Ultrasonography ; Magnetic Phenomena
Language	English
Publishing date	2023-08-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2106734-X
ISSN	1938-0666 ; 1526-8209
ISSN (online)	1938-0666
ISSN	1526-8209
DOI	10.1016/j.clbc.2023.08.004
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Article ; Online: One-week external beam partial breast irradiation: survival and toxicity outcomes.

Colciago, Riccardo Ray / La Rocca, Eliana / Giandini, Carlotta / Rejas Mateo, Alicia / Bedini, Nice / Capri, Giuseppe / Folli, Secondo / Lozza, Laura / Meroni, Silvia / Emanuele, Pignoli / Rancati, Tiziana / Arcangeli, Stefano / De Santis, Maria Carmen

Journal of cancer research and clinical oncology

2023 Volume 149, Issue 12, Page(s) 10965–10974

Abstract: Purpose: According to ASTRO and ESTRO guidelines, external beam Partial Breast Irradiation (PBI) is a valid option for early-stage breast cancer patients. Nevertheless, there is lack of consensus about the best treatment schedule.: Methods: We ... ...

Abstract	Purpose: According to ASTRO and ESTRO guidelines, external beam Partial Breast Irradiation (PBI) is a valid option for early-stage breast cancer patients. Nevertheless, there is lack of consensus about the best treatment schedule. Methods: We retrospectively analysed data of female patients treated at our institution from 2013 to 2022 with adjuvant "one-week" partial breast irradiation. Clinical Target Volume (CTV) was an isotropic expansion of 15 mm from the tumour bed (identified as the breast tissue between surgical clips). The treatment schedule was 30 Gy delivered with Volumetric Modulated Arc Therapy in 5 daily fractions. The primary endpoint was Local Control (LC). Disease-Free Survival (DFS), Overall Survival (OS) and safety were secondary endpoints. Results: Three hundred and forty-four patients with a median age of 69 (33-87) years were included in the study. After a median follow-up of 34 (7-105) months, 7 patients (2.0%) developed a local recurrence. Three-year LC, DFS and OS actuarial rates were 97.5% (95% CI 96.2%-98.8%), 95.7% (95% CI 94.2%-97.2%), and 96.9% (95% CI 95.7%-98.1%), respectively. Ten (2.9%) patients experienced grade 2 late toxicities. Five (1.5%) patients reported late cardiac major events. Three (0.9%) late pulmonary toxicities were detected. One hundred and five (30.5%) patients reported fat necrosis. Good or excellent cosmetic evaluation following the Harvard Scale was reported in 252 (96.9%) cases by the physicians, while in 241 (89.2%) cases by the patients. Conclusion: "One-week" PBI is effective and safe, and this schedule is a valid option for highly selected early breast cancer patients.
MeSH term(s)	Female ; Humans ; Aged ; Aged, 80 and over ; Retrospective Studies ; Mastectomy, Segmental ; Breast/pathology ; Breast Neoplasms/pathology ; Disease-Free Survival ; Treatment Outcome
Language	English
Publishing date	2023-06-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	134792-5
ISSN	1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
ISSN (online)	1432-1335
ISSN	0171-5216 ; 0084-5353 ; 0943-9382
DOI	10.1007/s00432-023-04973-y
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Article ; Online: VMAT partial-breast irradiation: acute toxicity of hypofractionated schedules of 30 Gy in five daily fractions.

La Rocca, E / Lozza, L / D' Ippolito, E / Dispinzieri, M / Giandini, C / Bonfantini, F / Valdagni, R / Folli, S / Pignoli, E / Di Cosimo, S / De Santis, M C

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico

2020 Volume 22, Issue 10, Page(s) 1802–1808

Abstract: Purpose: To report acute toxicities in breast cancer (BC) patients (pts) recruited in a prospective trial and treated with accelerated partial-breast irradiation (APBI) using Volumetric Modulated Arc Therapy (VMAT) delivered with a hypofractionated ... ...

Abstract	Purpose: To report acute toxicities in breast cancer (BC) patients (pts) recruited in a prospective trial and treated with accelerated partial-breast irradiation (APBI) using Volumetric Modulated Arc Therapy (VMAT) delivered with a hypofractionated schedule. Methods: From March 2014 to June 2019, pts with early-stage BC (Stage I), who underwent breast conservative surgery (BCS), were recruited in a prospective study started at the National Cancer Institute of Milan. Pts received APBI with a hypofractionated schedule of 30 Gy in five daily fractions. Radiotherapy treatment (RT) was delivered using VMAT. Acute toxicity was assessed according to RTOG/EORTC criteria at the end of RT. Results: Between March 2014 and June 2019, 151 pts were enrolled in this study. 79 Pts had right-side and 72 had left-side breast cancer. Median age was 69 (range 43-92). All pts presented with pathological stage IA BC, molecular classification was Luminal A in 128/151 (85%) and Luminal B in 23/151 (15%) cases. Acute toxicity, assessed at the end of RT, consisted of G1 erythema in 37/151 (24. 5%) pts and skin toxicities higher than G1, did not occur. Fibrosis G1 and G2 were reported in 41/151 (27. 1%) pts and in 2/151 pts (1. 3%), respectively. Edema G1 occurred in 8/151 (5. 3%) pts and asthenia G1 occurred in 1/151 (0. 6%) pts. Conclusions: APBI with VMAT proved to be feasible and can be a valid alternative treatment option after BCS in selected early breast cancer pts according to ASTRO guidelines. A longer follow-up is needed to assess late toxicity.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Breast/radiation effects ; Breast Neoplasms/radiotherapy ; Breast Neoplasms/surgery ; Female ; Humans ; Mastectomy, Segmental ; Middle Aged ; Prospective Studies ; Radiation Dose Hypofractionation ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated/adverse effects
Language	English
Publishing date	2020-03-04
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2397359-6
ISSN	1699-3055 ; 1699-048X
ISSN (online)	1699-3055
ISSN	1699-048X
DOI	10.1007/s12094-020-02319-5
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