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Pre-operative localization of non-palpable breast lesions with non-wired non-ionizing (NWNI) techniques may improve clinical outcomes as reoperation rate, cosmetic outcome and contribute to organizational aspects improvement in breast-conserving surgery (BCS). However only limited literature is available and clinical studies involving these forefront devices are often small and non-randomized. Furthermore, there is a lack of consensus on free margins and cosmetic outcomes definitions. The objective of the present meta-analysis was to determine the crude clinical outcomes reported for the NWNI techniques on BCS. A literature search was performed of PubMed, Embase and Scopus databases up to February 2021 in order to select all prospective or retrospective clinical trials on pre-operative breast lesion localization done with NWNI devices. All studies were assessed following the PRISMA recommendations. Continuous outcomes were described in averages corrected for sample size, while binomial outcomes were described using the weighted average proportion. Twenty-seven studies with a total of 2103 procedures were identified. The technique is consolidated, showing for both reflectors' positioning and localization nearly the 100% rate of success. The re-excision and clear margins rates were 14% (95% CI, 11-17%) and 87% (80-92%), respectively. Overall, positive margins rates were 12% (8-17%). In studies that compared NWNI and wire localization techniques, positive margin rate is lower for the first techniques (12%, 6-22% vs 17%, 12-23%) and re-excision rate is slightly higher using the latter (13%, 9-19% vs 16%, 13-18%). Pre-operative NWNI techniques are effective in the localization of non-palpable breast lesions and are promising in obtaining clear (or negative) margins minimizing the need for re-excision and improving the cosmetic outcomes. Randomized trials are needed to confirm these findings., Competing Interests: Declaration of competing interest All authors report no conflict of interest to declare., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Phyllodes tumours (PTs) are rare fibroepithelial tumours accounting for <1% of all breast tumours. We assessed clinicopathological features and their prognostic effect in a single-institution patients' cohort., Methods: Patients diagnosed with PT between 2001 and 2018 at our institution were identified. Clinical, surgical and pathological features were collected. Phyllodes-related relapse was defined as locoregional or distant recurrence (contralateral excluded), whichever first., Results: A total of 166 patients were included: 115 with benign, 30 with borderline and 21 with malignant PTs. Features associated with malignant PT were younger age, larger T size, higher mitotic count, marked cytological atypia, stromal overgrowth, stromal hypercellularity, necrosis and heterologous differentiation (all p<0.01). The majority of patients with malignant PT underwent mastectomy (63.2% vs 3% of benign/borderline, p<0.001) and had negative surgical margins (83.3%). 4-year cumulative phyllodes-related relapse incidence was 7% for benign/borderline PT and 21.3% for malignant PT (p=0.107). In the entire cohort, marked cellular atypia and heterologous differentiation were associated with worse phyllodes-related relapse-free survival (HR 14.10, p=0.036 for marked vs mild atypia; HR 4.21, p=0.031 for heterologous differentiation present vs absent). For patients with benign PT, larger tumour size was associated with worse phyllodes-related relapse-free survival (HR 9.67, p=0.013 for T>5 cm vs T≤2 cm). Higher tumour-infiltrating lymphocytes (TILs) were associated with borderline and malignant PT (p=0.023); TILs were not associated with phyllodes-related relapse-free survival (HR 0.58, p=0.361 for TILs>2% vs≤2%). Overall, four patients died because of PT: three patients with malignant and one with borderline PT., Conclusions: Patients with malignant PT had increased rates of phyllodes-related relapse and phyllodes-related death. Cellular atypia and heterologous differentiation were poor prognostic factors in the entire cohort; large tumour size was associated with an increased risk of phyllodes-related relapse in benign PT., Competing Interests: Competing interests: MVD declares personal fees for consulting/advisory board from Eli Lilly, Celgene and Genomic Health. APDT declares personal fees for advisory boards/speaker’s bureau from PharaMAr, Lilly, Roche, Bayer and Pfizer. PFC reports grants (Institution) from Agenzia Italiana del Farmaco AIFA, Merck KGa and BMS; personal fees for consulting/advisory board from Novartis, EliLilly, AstraZeneca, Tesaro and Roche. VG reports grants (institution) and personal fees for consulting/advisor from Roche; personal fees for consulting/advisory relationship from Novartis and Eli Lilly. All the disclosures are outside the submitted work. All other authors declared no conflicts of interest., (© Author (s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology.)

Purpose: We performed a mono-institutional study for evaluating the biological data, such as p53, Ki67 and BRCA mutations, as well as clinical characteristics of pregnancy associated breast cancer (PABC), its therapeutic management and the prognosis in a small cohort of patients., Materials and Methods: We retrospectively examined 26 patients with PABC. Clinical and histopathological characteristics along with Ki67, p53 and BRCA mutations were analysed. Information about chemotherapy, surgery and radiotherapy was recovered. Data about long-term prognosis was registered and computed by Kaplan-Meier analysis., Results: Of 26 patients, 17 (65%) were considered as having a locally advanced breast cancer. The majority of them (65.4%) had a ductal invasive carcinoma. Oestrogen and progesterone receptors were positive in 13 (50%) patients, resulting both negative in four (15.4%) subjects. HER-2 was positive in 5 subjects (19.2%). Ten patients underwent conservative surgery treatment, and 14 were sent to radical mastectomy (38 vs. 54%) associated with axillary lymph node dissection in 18 cases. Many patients (65%) were further treated with adjuvant chemotherapy and/or hormone therapy. Eight out of 11 patients undergoing the evaluation of BRCA mutation were positive while only 2 out of 3 patients had a mutation of p53. After a median follow-up of 110 months (range: 8.2-1227 mo.), 18 women were still alive, six patients (25%) died and two were lost. Three patients showed a loco-regional recurrence, after a median period of 26 months (range: 2-42 mo.). Distant metastases verified in six patients after a median period of 12.5 months (range: 2-108 mo.). The prognosis was less favourable in BRCA mutated patients than no-BRCA mutated group, although not statistically significant., Conclusions: In women with PABC, the initial stage of disease is more advanced requiring more aggressive treatment., (Copyright © 2013 Elsevier Ltd. All rights reserved.)