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Introduction: Adrenocortical carcinoma (ACC) represents a rare endocrine malignancy being the second most aggressive endocrine cancer after anaplastic thyroid cancer. [1]. While most of them arise sporadically, up to 15% of adult ACC patients are related to germline mutations associated with familial cancer syndromes.[1,2]. Current treatment strategies include surgery as well as systemic therapy with mitotane and chemotherapy.

Ewing sarcoma with renal localization is one of the rarest members of the Ewing sarcoma family with less than 200 cases reported in the Medline database. Considering the fact that the majority of data published on the Ewing sarcoma with neuroectodermal differentiation is obtained through a few case reports and case series, it becomes understandable why we currently have no universally accepted treatment regimens.

Aim: The aim of the study was to assess the role of Magee Equation 3 (MagEq3), IHC4 score, and HER2-low status in predicting "satisfactory response (SR)" to neoadjuvant chemotherapy (NAC) in HR+/HER2− breast cancer (BC) patients. Methods: In a retrospective study, female patients of any age with T1–4, N0–2, M0 HR+/HER2− BC who received NAC and underwent adequate locoregional surgical treatment were included. Patients were grouped according to 2 outcomes: (a) overall response to NAC in breast and axilla by using residual cancer burden (RCB) criteria and (b) axillary downstaging after NAC by using N staging. 2 cohorts for overall response were overall SR (RCB 0–1) and no SR (RCB 2–3). On the other hand, for axillary downstaging, 2 cohorts constituted from axillary SR (ypN0 and ypN0i+) and no SR (ypNmic-N3). MagEq3 and IHC4 scores were calculated from their pathological tumor slides in each patient. HER2 status was categorized as either "no" or "low." In addition, patient age, family history, tumor histology, stage at admission, and Ki-67 status were compared between cohorts according to predefined outcomes. Results: In a total of 230 BC patients, 228 patients were included to compare according to their RCB levels. The mean age of patients with overall SR was significantly lower than those without. Patients with high Ki-67 expression, high (>30) MagEq3 score, high ICH4 quartile, and HER2-low status had significantly more overall SR. On the other hand, only patients with high Ki-67 expression had significantly more axillary SR. MagEq3 score levels, ICH4 quartiles, and HER2 status were similar between patients with axillary SR and not. Conclusion: MagEq3 and IHC4 tools seemed to be useful to predict those HR+/HER2− BC patients who are most likely to get benefit from NAC. But, only high Ki-67 expression level significantly predicted satisfactory axillary downstaging in HR+/HER2− BC patients. [ABSTRACT FROM AUTHOR]

Aim. The aim of our study was to assess the accuracy of a combination of digital mammography and breast ultrasonography in the prediction of response to neoadjuvant systemic treatment in breast cancer patients with different tumor subtypes. Methods. The study was designed as a retrospective diagnostic accuracy study. Stage I-III female breast cancer patients who received any type of neoadjuvant systemic treatment with radiological response assessment by both mammography and breast ultrasound and followed by surgical treatment in the breast and axilla were included in the study. The primary outcome was the diagnostic accuracy of combined modalities of mammography and breast ultrasonography for predicting the pathological complete response. On mammography and breast ultrasonography, the radiological response was categorized into complete response and non-complete response. Pathological complete response on surgical specimens was described based on current guidelines. True and false positive cases as well as true and false negative cases were counted and compared among patients with 4 different molecular subtypes. The diagnostic accuracy of combined imaging modalities was analyzed for positive and negative predictive values, sensitivity, and specificity rates. All rates were calculated according to the previously described formulas. Results. Eighty-one breast cancer cases were included in the study. Positive predictive values of imaging were 100%, 75%, 100%, and 83%, whereas negative predictive values were 67%, 75%, 100%, and 100% in patients with HR+/HER2-, HR+/HER2+, HR-/HER2+ and HR-/HER2- tumors, respectively. Sensitivity rates were found to be 98%, 90%, 100%, and 100%, whereas specificity rates were 100%, 50%, 100%, and 67% in patients with HR+/HER2-, HR+/HER2+, HR-/HER2+ and HR-/HER2- tumors, respectively. Conclusion. Digital mammography and breast ultrasonography as a combined modality seem to show the pathological complete response after neoadjuvant systemic treatment in HR+/HER2- breast cancer patients with a very high specificity rate. Therefore, these conventional tools may help surgeons to select patients who might benefit from loco-regional treatment de-escalation with higher accuracy. [ABSTRACT FROM AUTHOR]

Introduction: Male breast carcinoma presents a rare and often overlooked aspect of oncology, accounting for only 1% of all breast cancer cases. The infrequency of pathology, combined with the common association of breast cancer primarily with females, leads to delayed diagnosis, management challenges and unfavorable prognosis. Case Report: We report the case of a 64-year-old male with no significant risk factors, diagnosed with invasive NST (no specific type) left breast carcinoma cT4bN0M0, stage IIIB, luminal B HER-2 negative subtype. The patient presented in 2019 with a palpable mass in the left nipple area, accompanied by skin retraction. The ultrasound revealed an ulcerated irregular mass measuring 2x3 cm, with adherence to the pectoral muscle. Ultrasound-guided tru-cut biopsy confirmed the diagnosis of invasive NST breast carcinoma cT4bN0M0, stage IIIB, HER-2 negative, estrogen receptor (ER = 100%) and progesterone receptor (PR = 55%) positive, with a low Ki-67 proliferation index(10%). Neoadjuvant chemotherapy was initiated, consisting of 4 cycles of Epirubicin plus Cyclophosphamide and 4 cycles of Paclitaxel. Following successful neoadjuvant chemotherapy, the patient underwent a left-sided mastectomy with sentinel lymph node biopsy. Histopathological examination established the presence of a residual invasive ductal breast carcinoma stage ypT2ypN0(3sn), with the same molecular profile. Surgical margins were clear and none of the three dissected lymph nodes showed evidence of metastasis. Adjuvant endocrine therapy with Letrozol 2.5 mg was initiated shortly after surgery. Since 2019, the patient has consistently adhered to Letrozole therapy, showing excellent tolerance to the treatment. Discussions : The patient's tumor, classified as invasive ductal NST, HR positive and HER-2 negative, represents a common subtype of male breast carcinoma (90%). Neoadjuvant chemotherapy plays an important role in the management of breast cancer, leading to downstaging and better results. Adjuvant endocrine therapy is a cornerstone in all patients diagnosed with HR positive breast cancer. Despite historically breast cancer in male patients has a poor outcome, the favorable prognostic indicators noted in this case, including clear surgical margins, negative lymph nodes, and a low Ki-67 proliferation index, seem to confer a survival advantage. Regular follow-up examinations, imaging studies and tumor marker monitoring will continue to be essential for tracking disease progression and detecting potential recurrence. Conclusions: This case highlights several key aspects of male breast carcinoma management and serves to raise awareness about breast cancer among males. Although rare, male breast carcinoma can exhibit similar clinical features to breast cancer in women, making early detection and patient adherence to therapy crucial for optimal outcomes. [ABSTRACT FROM AUTHOR]