Search

Background: Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) for assessing axillary lymph node status in clinically node-negative breast cancer patients. However, the approach to axillary surgery after neoadjuvant treatment is still controversial. In the present study, our objective was to predict the pathological nodal stage based on SLNB results and the clinicopathological characteristics of patients who initially presented with clinical N1 positivity but whose disease status was converted to clinical N0 after neoadjuvant chemotherapy (NAC). Materials and methods: After NAC, 150 clinically node-negative patients were included. The relationships between clinicopathologic parameters and the number of positive lymph nodes in SLNBs and ALNDs were assessed through binary/multivariate logistic regression analysis. Results: Among 150 patients, 78 patients had negative SLNBs, and 72 patients had positive SLNBs. According to the ALND data of 21 patients with SLNB1+, there was no additional node involvement (80.8%), 1–2 lymph nodes were positive in 5 patients (19.2%), and no patient had ≥ 3 lymph nodes involved. Following the detection of SLNB1 + positivity, the rate of negative non-sentinel nodes were 75% in the luminal A/B subgroup, 100% in the HER-2-positive subgroup, and 100% in the triple-negative subgroup. Patients with a lower T stage (T1-3 vs. T4), fewer than 4 clinical nodes before NAC (< 4 vs. ≥4), and a decreased postoperative Ki-67 index (< 10% vs. stable/increase) were included. According to both univariate and multivariate analyses, being in the triple-negative or HER2-positive subgroup, compared to the luminal A/B subgroup (luminal A/B vs. HER2-positive/triple-negative), was found to be predictive of complete lymph node response. Conclusion: The number of SLNB-positive nodes, tumor-related parameters, and response to treatment may predict no additional nodes to be positive at ALND. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: We compared the ability of 68Ga-FAPI PET//CT with 18FDG PET/CT imaging techniques to detect additional lesions in breast cancer patients that may affect further chemotherapy options.Methods: A total of 48 patients with breast cancer underwent concurrent 68Ga-FAPI-04 and 18FDG PET/CT regardless of whether they had received chemotherapy or not in the last month before imaging. Both modalities were compared according to various parameters: clinical/pathological features, number of lesions detected, activity uptake (SUVmax), and the effect on the evaluation of response to treatment in the post-chemotherapy group.Results: This retrospective study included 48 patients with breast cancer (mean age 53.3 ± 11.7 years; IDC 89.6%; ILC 10.4%). In the comparison of both modalities, no statistical significance was obtained in terms of the pathological characteristics of the patients. More lesions were demonstrated in all categorized regions in 68Ga-FAPI PET/CT imaging with higher uptake values compared to 18FDG PET/CT in this study. In the treatment response evaluation of the post-chemotherapy group, 12 cases (12/24) who were evaluated as PMR, CMR, or SD according to 18FDG PET/CT results were later accepted as PD due to newly detected lesions in complementary 68Ga-FAPI PET/CT imaging and treatment of patients was managed accordingly by clinicians.Conclusion: It was determined that 68Ga-FAPI PET/CT was superior to 18FDG PET/CT in terms of accuracy and it was thought that 68Ga-FAPI PET/CT could be utilized as an additional complementary imaging to 18FDG PET/CT. Moreover, 68Ga-FAPI PET/CT, with its significant theranostic potential, could become a key element in predicting the pathological response of breast cancer patients in further researches. [ABSTRACT FROM AUTHOR]

Molecular pathological analysis has an expanding role in patient diagnosis and management. The performance of these techniques relies on excellent laboratory procedures. However, the crucial step is obtaining the best samples for molecular analysis. Archiving and selection of these are the responsibilities of all pathologists even if they are not working at a center with molecular pathological facilities. This review focuses on the features of different types of materials for molecular pathological analysis. Many steps that might affect the results, including communication between the pathologist and the oncology team, features of different types of materials (cytological, tissue blocks, biopsy, circulating tumor cells (CTCs) and cell-free circulating nucleic acids), effects of tissue processing, methods for selecting the best material, and tissue saving and tumor enrichment methods are discussed. The procedures for referral to a center for molecular pathological analysis are also mentioned. Awareness of the importance of the cytopathological and histopathological material of the patients for future molecular pathological analysis by pathologists is of the utmost importance. [ABSTRACT FROM AUTHOR]

Accurate staging of invasive lobular carcinoma (ILC), a subtype of breast cancer, is vital for effective clinical management. Although 18 F-FDG PET/CT is a commonly used tool, its efficacy varies across different histologic subtypes. To mitigate this challenge, our investigation delves into the potential utility of 68 Ga-fibroblast activation protein inhibitor (FAPI) PET/CT as an alternative for staging ILC, aiming to address a significant research gap using a more expansive patient cohort than the smaller samples commonly found in the existing literature. Methods: In this retrospective analysis, women diagnosed with primary ILC of the breast underwent both 18 F-FDG PET/CT and 68 Ga-FAPI PET/CT. Both modalities were compared across all lesion locations with the used reference standard. The interval between scans was 1 wk, without any intervening treatments. Lesions were categorized visually, and tracer activity was analyzed using SUV max , tumor-to-background uptake ratio, and uptake ratios. Both modalities were compared across various parameters, and statistical analysis was performed using SPSS 22.0. A P value of less than 0.05 was chosen to determine statistical significance. Results: The study included 23 female ILC patients (mean age, 51 y) with hormone-positive, human epidermal growth factor receptor type 2-negative tumors. Most (65%) had the luminal A subtype. 68 Ga-FAPI PET/CT outperformed 18 F-FDG PET/CT, with higher tumoral activity and tumor-to-background uptake ratios ( P < 0.001). Primary tumors showed significantly increased uptake with 68 Ga-FAPI PET/CT ( P < 0.001), detecting additional foci, including multicentric cancer. Axillary lymph node metastases were more frequent and had higher uptake values with 68 Ga-FAPI PET/CT ( P = 0.012). Moreover, 68 Ga-FAPI PET/CT identified more lesions, including bone and liver metastases. Pathologic features did not significantly correlate with imaging modalities, but a positive correlation was observed between peritumoral lymphocyte ratio and 68 Ga-FAPI PET/CT-to- 18 F-FDG PET/CT uptake ratios ( P = 0.026). Conclusion: This study underscores 68 Ga-FAPI PET/CT's superiority over 18 F-FDG PET/CT for ILC. 68 Ga-FAPI PET/CT excels in detecting primary breast masses, axillary lymph nodes, and distant metastases; can complement 18 F-FDG PET/CT in ILC; and holds potential as an alternative imaging method in future studies., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)

We present a case diagnosed with hepatosplenic sarcoidosis with hypercalcemia. Elevated liver enzymes and hypercalcemia were detected in the patient who was admitted to the hospital with abdominal pain and dyspnea. Abdominal dynamic magnetic resonance imaging (MRI) showed diffuse, multiple, nodular hyperintense lesions on T2 weighted. Multinuclear giant cells and lymphocytic portal inflammation were seen in the patient's liver biopsy, whose angiotensin-converting enzyme level was high, and hepatosplenic sarcoidosis was diagnosed. Shortness of breath, abdominal pain, and calcium level improved with methylprednisolone treatment.

Objective: The aim of this study was to compare subepithelial angiogenesis developing within the perimatrix of the cholesteatoma between pediatric and adult patients., Methods: Sixty-one patients who underwent mastoidectomy for the first intent because of chronic otitis media with cholesteatoma between 1993 and 2013 and from whom appropriate tissue specimens were taken were included in the study. The patients were classified in the pediatric patient group if they were under the age of 18 years and the adult patient group if they were 18 years and older. Immunohistochemical staining for CD-31 was performed on new sections taken during surgery and sections prepared from archived tissues in paraffin blocks. Results were compared between the groups., Results: A total of 61 patients, of whom 25 were pediatric and 36 were adult patients, were included in the study. The mean CD-31 immunopositive microvessel rates were 8.8 (3-15) and 6.61 (2-14) for the pediatric and adult patient groups, respectively. The difference between the groups was statistically significant (p=0.037). Correlation analysis showed a statistically significant negative correlation between the CD-31 immunopositive microvessel rates and age (p=0.036)., Conclusion: Subepithelial angiogenesis developing within the perimatrix of the cholesteatoma of the pediatric patients was more expressed than that of the adult patients., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.