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Simple Summary: The sentinel lymph node biopsy technique is widely used in uterine cancers. Some new parameters as ultrastadification or molecular biology have modified our algorithms which are becoming more and more complex. We discuss here the integration of the sentinel node biopsy technique in the global strategy of management of uterine cancers. Since the validation of the sentinel node technique (SLN) for vulvar cancer 20 years ago, this technique has been introduced in the management of operable cervical cancer and endometrial cancer. For cervical cancer a "one fits all" attitude has mainly been presented. However, this approach, consisting of a frozen section during the operation, can be discussed in some stages. We present and discuss the main option for each stage, as well as some secondary possibilities. For endometrial cancer, SLN is now the technique of choice for the nodal staging of low- and intermediate-risk groups. Some discussion exists for the high-risk group. We also discuss the impacts of using preoperatively the molecular classification of endometrial cancer. Patients with POLE or TP53 mutations could have different nodal staging. The story of SLN in uterine cancers is not finished. We propose a comprehensive algorithm of SLN in early cervical and endometrial cancers. However, several ongoing trials will give us important data in the coming years. They could substantially change these propositions. [ABSTRACT FROM AUTHOR]

Simple Summary: The disparities in ovarian cancer care and outcomes have been linked to socioeconomic indicators. Our study mainly demonstrated that women living in economically and socially deprived areas had a significantly higher risk of death after adjustment for individual factors. Our results reflect the complexity of the environment in which the patients live and the impact on overall survival of the combination of negative social, economic and educational factors within that environment. Survival disparities persist in ovarian cancer and may be linked to the environments in which patients live. The main objective of this study was to analyze the global impact of the area of residence of ovarian cancer patients on overall survival. The data were obtained from the Surveillance, Epidemiology and End Results (SEER) database. We included all the patients with epithelial ovarian cancers diagnosed between 2010 and 2016. The areas of residence were analyzed by the hierarchical clustering of the principal components to group similar counties. A multivariable Cox proportional hazards model was then fitted to evaluate the independent effect of each predictor on overall survival. We included a total of 16,806 patients. The clustering algorithm assigned the 607 counties to four clusters, with cluster 1 being the most disadvantaged and cluster 4 having the highest socioeconomic status and best access to care. The area of residence cluster remained a statistically significant independent predictor of overall survival in the multivariable analysis. The patients living in cluster 1 had a risk of death more than 25% higher than that of the patients living in cluster 4. This study highlights the importance of considering the sociodemographic factors within the patient's area of residence when developing a care plan and follow-up. [ABSTRACT FROM AUTHOR]

Simple Summary: There is little available evidence concerning smoking behaviors among breast cancer (BC) patients. This large study addresses smoking-related issues at BC diagnosis and smoking cessation in women with a history of BC. This study suggests that (i) tobacco mention is missing from electronic health records in approximately one-third of patients; (ii) tobacco is not assessed nor addressed systematically during the BC care pathway, and this information depends on the practitioner's specialty; (iii) approximately one-third of patients stop smoking in BC follow-up. These findings call to consider BC treatment and follow-up as a window of opportunity to promote smoking cessation. Breast cancer (BC) is the most commonly diagnosed type of cancer and the leading cause of cancer deaths in women. Smoking is the principal modifiable risk factor for cancers and has a negative influence on long-term survival. We conducted a retrospective study on consecutive BC survivors seen at follow-up consultations between 3 June and 30 October 2019 at Institut Curie, Paris, France. Smoking behaviors were evaluated prospectively via interviewer-administered questionnaires. The aim of this study was to describe smoking-related patient care at diagnosis and smoking cessation patterns in women with a history of BC. A total of 1234 patients were included in the study. Smoking status at diagnosis was missing from electronic health records in 32% of cases, including 13% of patients who smoke. Only 20% of the 197 patients currently smoking at diagnosis recalled having a discussion about smoking with a healthcare professional. Radiotherapists and surgeons were more likely to talk about complications than other practitioners. The main type of information provided was general advice to stop smoking (n = 110), followed by treatment complications (n = 48), while only five patients were referred to tobaccologists. Since diagnosis, 33% (n = 65) of the patients currently smoking had quit. Patients who quit had a lower alcohol consumption, but no other factor was associated with smoking cessation. The main motivation for tobacco withdrawal was the fear of BC relapse (63%). This study highlights room for improvement in the assessment of smoking behavior. Our data raise important perspectives for considering BC treatment and follow-up as a window of opportunity for smoking cessation. [ABSTRACT FROM AUTHOR]

Simple Summary: Little is known on the time necessary to obtain a pregnancy after breast cancer and on the subsequent obstetrical and neonatal outcomes. We analyzed a cohort of breast cancer survivors aged 18–43 years old at diagnosis and having at least one pregnancy after cancer. While 71% of patients attempted to be pregnant, 18% of pregnancies were unplanned. Most pregnancies (86%) were obtained spontaneously and a minority occurred after assisted reproductive technologies (11%). We showed that median time to evolutive pregnancy was 5.6 months, and only menstrual cycles before pregnancy was significantly associated with time to pregnancy after multivariate analysis. Neonatal outcomes were similar to general population, and none of the prior BC treatments affected parameters of newborns. Our findings provide reassuring data for pregnancy counseling both in terms of delay and outcome. Our results also highlight the importance of appropriate contraceptive counseling after breast cancer to avoid unplanned pregnancies. Although an increasing number of young breast cancer (BC) patients have a pregnancy desire after BC, the time necessary to obtain a pregnancy after treatment and subsequent outcomes remain unknown. We aimed to determine the time to evolutive pregnancy in a cohort of BC survivors and subsequent obstetrical and neonatal outcomes. We analyzed BC patients treated at Institut Curie from 2005–2017, aged 18–43 years old (y.o.) at diagnosis having at least one subsequent pregnancy. 133 patients were included, representing 197 pregnancies. Mean age at BC diagnosis was 32.8 y.o. and at pregnancy beginning was 36.8 y.o. 71% pregnancies were planned, 18% unplanned and 86% spontaneous. 64% pregnancies resulted in live birth (n = 131). Median time from BC diagnosis to pregnancy beginning was 48 months and was significantly associated with endocrine therapy (p < 0.001). Median time to pregnancy was 4.3 months. Median time to evolutive pregnancy 5.6 months. In multivariate analysis, menstrual cycles before pregnancy remained significantly associated with time to pregnancy and endocrine therapy with time evolutive to pregnancy. None of the BC treatments (chemotherapy/endocrine therapy/trastuzumab) was significantly associated with obstetrical nor neonatal outcomes, that seemed comparable to global population. Our findings provide reassuring data for pregnancy counseling both in terms of delay and outcome. [ABSTRACT FROM AUTHOR]

Simple Summary: Identifying markers predictive of response and resistance to neoadjuvant chemotherapy (NAC) has become a major research objective. Ductal carcinoma in situ (DCIS) is associated with invasive disease in more than half of invasive breast cancer cases. It is generally assumed that DCIS does not respond to NAC, but the effect of chemotherapy on in situ components has been little studied. We assessed the predictive value of the presence of an in situ component on pre-NAC biopsy on pathological complete response (pCR) in a real-life cohort of patients treated by NAC. We included 1148 patients; 44% of tumors were luminal (n = 508), 31% triple negative breast cancer (TNBC) (n = 359) and 24% HER2-positive (n = 281). DCIS was found in 225 samples (19.6%) before NAC. The presence of a DCIS component on pre-NAC biopsy was not associated with pCR and did not seem to be a critical factor for the prediction of response to NAC. A ductal in situ (DCIS) component is often associated with invasive breast carcinoma (BC), and its effect on response to treatment is unknown. We assessed the predictive value of the DCIS component for pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC). We analyzed a cohort of 1148 T1–3NxM0 breast cancer (BC) patients treated by NAC at Institut Curie between 2002 and 2012. The presence of a DCIS component was retrospectively recorded from both the pre-NAC biopsy pathological report and surgical specimens. We included 1148 BC patients treated by NAC for whom pre- and post-NAC data concerning the in situ component were available. DCIS was present before NAC in 19.6% of the population. Overall, 283 patients (19.4%) achieved pCR after NAC. There was no significant association between the presence of DCIS on pre-NAC biopsy and pCR. In a multivariate analysis including subtype, tumor size, grade, mitotic index, and Ki67 index, only BC subtype (luminal/TNBC/HER2-positive) and Ki67 were significantly associated with pCR. The presence of a DCIS component on pre-NAC biopsy is not associated with pCR and does not seem to be a critical factor for predicting response to NAC. [ABSTRACT FROM AUTHOR]