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Introduction: Nipple‐sparing mastectomy (NSM) has known an exponential diffusion worldwide for prophilaxis and therapeutic mastectomies in selected candidates, being oncologically safe and improving reconstructive outcomes and patients' satisfaction. The two most common used skin incisions are the radial and inframammary fold ones, which represent an imperfect aesthetic solution. The aim of this work was to give insights on our surgical technique, which allows to perform the NSM, node surgery, and endoscopic direct‐to‐implant reconstruction using a cosmetic axillary incision. Materials and methods: Between June 2016 and January 2019, 7 consecutive patients underwent NSM, lymph node surgery and endoscopic direct‐to‐implant reconstruction using a small cosmetic axillary incision for breast cancer treatment in a single Institution. An operative rigid endoscope with working channel (Richard Wolf) was used to dissect the entire submuscular‐subfascial pocket. The mean age of the patients was 42.8 years old (range: 36‐49 years). The evaluation methods were clinical and photography‐based assessments, as well as the BREAST‐Q which was used to quantify patient satisfaction. Results: The average follow‐up time was 9 months (range 3‐22 months). Tumor‐free margins were obtained in all cases. No tumor recurrence or metastasis occurred during follow‐up. No major complications were experienced. There were no cases of malposition, wrinkling, or rippling. All patients were satisfied with their esthetic results, especially the absence of visible scars. Conclusions: From our preliminary experience, NSM combined with endoscopic immediate reconstruction via axillary incision for breast cancer treatment seems to be a promising new procedure in cup A and B breasts alternative to the conventional techniques, as it allowed to have safe and pleasant aesthetic and oncologic outcomes. [ABSTRACT FROM AUTHOR]

Oncoplastic surgery (OPS) has demonstrated its superiority above traditional breast conserving surgery, but is still struggling to consolidate its role in breast cancer therapeutic protocols mainly because of contrasting scientific evidences and reduced follow‐up results available. The objective of our contribution is to analyze results obtained with 381 patients consecutively treated in our Multidisciplinary Breast Center by means of level II OPS between January 1998 and January 2018 for unilateral, primary breast cancer. Surgical endpoints were mean specimen weight and volume, mean diameter of main lesion (MLD), rates of positive margins (PMR), re‐excision (RR), conversion to mastectomy (CMR), complications (CR) and oncological endpoints as overall survival (OS), disease‐free survival (DFS), and local recurrence rate (LR). About 29.1% were treated for multifocal/multicentric disease, and 29.1% previously underwent neo‐adjuvant chemotherapy (NACT). Regarding surgical techniques, 53.0% of patients received "inverted T" and 30.1% "J" mammoplasties, whereas 13.6% underwent "round block," 2.3% "Grisotti," and 1% "batwing" techniques. Regarding surgical outcomes, mean specimen weight was 215 g (50‐2157) and volume 345 mm3 (21‐7980). MLD 23 mm, PMR 7.6%, RR 3.6%, CMR 1.6%, and CR 5.8%. With a mean follow‐up of 118 months, oncological outcomes were: OS 93.7%, DFS 82.3%, LR 4.4%. In conclusion, our analysis confirmed level II OPS reliability even for longer follow‐up timing and in difficult situations as multifocal disease or after NACT. [ABSTRACT FROM AUTHOR]

The artciel discusses that the beginning of the COVID 19 outbreak, a number of guidelines and recommendations have been released on how to best readapt clinical activities, including breast cancer care. It mentions that the COVID 19 outbreak, a number of guidelines and recommendations have been released on how to best readapt clinical activities, including breast cancer care.

The article presents a case study of a 62-year-old woman presented with a mass of her right breast on September 2016. Topics include reports that clinical examination revealed a palpable nontender mass in her right breast, and no lymphadenopathy was apparent; and examines that tumor was composed of a uniform proliferation of spindle cells exhibiting a palely eosinophilic cytoplasm and oval to fusiform nuclei with focal mild to moderate atypia.

The article offers information on the role of prophylactic mastectomy in healthy women with BRCA mutation proposing to surgeons some useful informations for decision‐making. It mentions several strategies are effective in managing the risk of breast cancer in these women, including surveillance, chemoprevention, bilateral salpingo‐oophorectomy, and risk‐reducing mastectomy; and also mentions prophylactic mastectomy provides the greatest reduction in risk of breast cancer development.

The article presents a case study of a 60-year-old man who was presented with a growing breast neoplasm and tested computed tomography for giant metastatic phyllodes tumors.

A letter to the editor is presented in response to article "Breast conserving surgery using volume replacement with oxidized regenerated cellulose: a cosmetic outcome analysis," by S. Tanaka, N. Sato, H. Fujioka and colleagues is presented.

The article discusses a case of a 30-year old primiparous woman who has a lactating adenomas during the ninth week of her gestation. A magnetic resonance imaging (MRI) procedure has been performed and indicates a lesion appeared as an ovoidal homogeneous mass, displacing the normal breast parenchyma and the nipple-areolar complex inferiorly. Furthermore, an open surgical biopsy was performed through a periareolar superior approach with local anesthesia.

Presents a case of bilateral Paget's disease with the coexistence of two synchronous and morphologically different bilateral breast cancers. Case report of a 73-year-old woman presented with bilateral, red, oozing crusted lesions of the nipple-areola complex; Treatment with bilateral radiotherapy and Tamoxifen.

Discusses the magnetic resonance imaging findings and surgical treatment on a 50-year-old woman with phyllodes tumor of the breast. Multilobulated lesion with inhomogeneous signal intensity; Areas of linear enhancement in the posterior margin; Resection of the breast tumor.

Conservative surgery has become a well-established alternative to mastectomy in the treatment of breast cancer. However, in case of larger lesions or small-size breasts, the removal of adequate volumes of breast tissue to achieve tumor-free margins and reduce the risk of local relapse may compromise the cosmetic outcome, causing unpleasant results. In order to address this issue, new surgical techniques, so-called oncoplastic techniques, have been introduced in recent years to optimize the efficacy of conservative surgery both in terms of local control and cosmetic results. This article discusses the indications, advantages, and limitations of these techniques and their results in terms of local recurrence and overall survival. [ABSTRACT FROM AUTHOR]

Early and accurate diagnosis of breast cancer is important for optimizing treatment. Local treatment of early stage breast cancer involves either mastectomy or breast-conserving surgery followed by whole-breast irradiation. The pathologic and biologic properties of a woman's breast cancer may be used to estimate her probability for recurrence of and death from breast cancer, as well as the magnitude of benefit she is likely to receive from adjuvant endocrine therapy or cytotoxic chemotherapy. Ovarian ablation or suppression with or without tamoxifen is an effective endocrine therapy in the adjuvant treatment of breast cancer in premenopausal women with estrogen receptor (ER)-positive or ER-unknown breast cancer. In postmenopausal women with ER- and/or progesterone receptor (PR)-positive or PR-unknown breast cancer, the use of tamoxifen or anastrozole is effective adjuvant endocrine therapy. The benefit of tamoxifen is additive to that of chemotherapy. Cytotoxic chemotherapy also improves recurrence rates and survival, with the magnitude of benefit decreasing with increasing age. Substantial support systems are required to optimally and safely use breast-conserving approaches to local therapy or cytotoxic chemotherapy as systemic therapy. Locally advanced breast cancer (LABC) accounts for at least half of all breast cancers in countries with limited resources and has a poor prognosis. Initial treatment of LABC with anthracycline-based chemotherapy is standard and effective. Addition of a sequential, neoadjuvant taxane thereafter increases the rate of pathologic complete responses. Neoadjuvant endocrine therapy may benefit postmenopausal women with hormone receptor-positive LABC. After an initial response to neoadjuvant chemotherapy, the use of local-regional surgery is appropriate. Most women will require a radical or modified radical mastectomy. In those women in whom mastectomy is not possible after neoadjuvant chemotherapy, the use of whole-breast and... [ABSTRACT FROM AUTHOR]