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Breast carcinosarcoma is a rare malignancy accounting for approximately 0.08–0.2% of all breast tumours. It is a type of metaplastic mammary carcinoma displaying biphasic differentiation with epithelial and mesenchymal cellular characteristics with probable derivation from myoepithelial cells.

A comparison of the radiation exposure to the left anterior descending artery (LAD) and left ventricle (LV) was performed for twenty-three left breast cancer patients. For each participant, two tangential fields 3D-CRT, two- and seven-field IMRT and two and four partial arcs VMAT plans were created. Dose constraints for CTV, ipsilateral lung and heart were followed. The V40Gy, V30Gy, Dav of LAD and V23Gy, V5Gy, Dav of LV were calculated and extracted from the plans. Parametric and non-parametric tests were applied to compare the parameters derived from the five treatment techniques. All generated plans fulfilled the dose constraints. The Dav ranges of the LAD and LV from all examined techniques were 11.77–14.73 Gy and 5.37–6.40 Gy, respectively. The V40Gy and V30Gy ranges of the LAD were 2.90–12.91% and 10.80–18.51%, respectively. The V23Gy and V5Gy of the LV were 4.29–7.43% and 18.24–30.05%, respectively. The VMAT plans and seven-field IMRT significantly reduced the V40Gy, V30Gy of LAD and V23Gy of LV compared with the two-field treatments (p < 0.05). However, 3D-CRT plans provided statistically lower values for V5Gy of LV over the other techniques (p < 0.05). The presented results provide a detailed dataset of the radiation burden of two critical cardiac structures from five radiotherapy techniques. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is the most common malignancy in females, accounting for the majority of cancer-related deaths worldwide. There is well-established understanding about the effective role of radiotherapy (RT) in BC therapeutic strategies, offering a better local–regional control, prolonged survival, and improved quality of life for patients. However, it has been proven that conventional RT modalities, especially in left-sided BC cases, are unable to avoid the administration of high RT doses to the heart, thus resulting in cardiotoxicity and promoting long-term cardiovascular diseases (CVD). Recent radiotherapeutic techniques, characterized by dosimetric dose restrictions, target volume revision/modifications, an increased awareness of risk factors, and consistent follow-ups, have created an advantageous context for a significant decrease inpost-RT CVD incidence. Aim: This review presents the fundamental role of current cardioprotective strategies in the prevention of cardiotoxic effects in left-BCRT. Material and Methods: A literature search was conducted up to January 2023 using the Cochrane Central Register of Controlled Trials and PubMed Central databases. Our review refers to new radiotherapeutic techniques carried out on patients after BC surgery. Specifically, a dose evaluation of the heart and left anterior descending coronary artery (LADCA) was pointed out for all the included studies, depending on the implemented RT modality, bed positioning, and internal mammary lymph nodes radiation. Results: Several studies reporting improved heart sparing with new RT techniques in BC patients were searched. In addition to the RT modality, which definitely determines the feasibility of achieving lower doses for the organs at risk (OARs), better target coverage, dose conformity and homogeneity, and the patient's position, characteristics, and anatomy may also affect the evaluated RT dose to the whole heart and its substructures. Conclusions: Modern BC RT techniques seem to enable the administration of lower doses to the OARs without compromising on the target coverage. The analysis of several anatomical parameters and the assessment of cardiac biomarkers potentiate the protective effect of these new irradiation modalities, providing a holistic approach to the radiation-associated risks of cardiac disease for BC patients. Despite technological advances, an inevitable cardiac radiation risk still exists, while adverse cardiac events may be observed even many years after RT. Studies with longer follow-ups are required in order to determine the effectiveness of modern breast RT techniques. [ABSTRACT FROM AUTHOR]

Introduction: Nutritional status impacts the survival of patients with cancer. There are few studies that investigate the role of nutritional status on breast cancer survival in women with breast cancer, and even fewer regarding the impact of adhering to the Mediterranean diet (MD). The present study aims to assess the nutritional status, MD adherence, physical activity levels and health-related quality of life (HRQOL) in women diagnosed with breast cancer and evaluate these parameters regarding recurrence-free survival. Methods: A total of 114 women, aged 35–87 years old, diagnosed with breast cancer in Larissa, Greece, participated in the study. Tumor histopathology was reported, and anthropometric indices were measured by a trained nurse, while questionnaires regarding nutritional status (via mini nutritional assessment), HRQOL via EORTC QLQ-C30, physical activity levels via IPAQ and Mediterranean diet adherence via MedDietScore were administered. The participants were followed-up for a maximum time interval of 42 months or until recurrence occurred. Results: A total of 74% of patients were overweight or obese, while 4% of women were undernourished, and 28% were at risk of malnutrition. After 42 months of follow-up, 22 patients (19.3%) had relapsed. The median time to recurrence was 38 months (IQR: 33–40 months) and ranged between 23 to 42 months. Higher levels of MD adherence were significantly associated with lower body mass index (BMI) values, earlier disease stage, smaller tumor size, absence of lymph node metastases and better physical activity levels (p < 0.05). Normal nutritional status was significantly associated with higher BMI values and better health-related quality of life (p ≤ 0.05). In univariate analysis, patients with higher levels of MD adherence and well-nourished patients had significantly longer recurrence-free survival (p < 0.05). In multivariate analysis, MD adherence and nutritional status were independently associated with recurrence-free patients' survival after adjustment for several confounding factors (p < 0.05). Conclusions: The impact of MD on time to recurrence is still under investigation, and future interventional studies need to focus on the role of adhering to the MD before and after therapy in survival and breast cancer progression. Furthermore, the present study also highlights the importance of an adequate nutritional status on disease progression, and the need for nutritional assessment, education and intervention in women with breast cancer. [ABSTRACT FROM AUTHOR]

The present study is a Dance Movement Psychotherapy (DMP) pilot intervention designed to address the psychological challenges faced by Greek breast cancer patients, after surgery and around radiotherapy treatment. It was designed as a 12 weeks' project, involving patients of diverse age and educational level, mostly living in rural areas. The personality and psychopathology inventory Symptoms' Check List-90 (SCL-90), the therapist's records and video self-observation were used in a mixed method approach. Thirteen subjects initiated the study, but they were gradually reduced and only four completed it. Statistical analysis was performed using SPSS-25 addressing this fact. Positive results of qualitative interpretation of the therapist's data and SCL-90, as well as changes in movement patterns and self-perception evaluated via video self-observation, showed that the intervention was beneficial for the patients who completed it. However, the fact that not all the participants were able to finish the program, implies that although DMT intervention at an early stage can help some patients deal with strong emotions, careful evaluation of eligible individuals should precede. Besides the patients' medical condition, demographic and personality characteristics should be considered in the design of future similar studies. [ABSTRACT FROM AUTHOR]

Breast carcinosarcoma is a rare malignancy accounting for approximately 0.08–0.2% of all breast tumours. It is a type of metaplastic mammary carcinoma displaying biphasic differentiation with epithelial and mesenchymal cellular characteristics with probable derivation from myoepithelial cells. A 65-year-old woman presented to our hospital with a two-month history of a rapidly growing mass in her left breast. Neither her medical nor family history was positive for malignancies. Subsequently, she underwent a fine needle aspiration, which was positive for adenocarcinoma, followed by a lumpectomy with axillary lymph node dissection. The histology revealed an undifferentiated neoplasm and the immunohistochemical cell staining was positive for pan-cytokeratin, SMA, Vimentin, and S-100, suggesting the diagnosis of breast carcinosarcoma with a triple-negative immunophenotype. There was no evidence of metastasis except for a positive lymph node, indicating a stage IIIA disease. Thus, she received adjuvant chemo-radiotherapy. However, 16 months later, she presented with metastatic disease, and unfortunately, she died 4 months later due to a systemic infection. Aggressive behavior, higher staging, chemoresistance, and higher proportion of triple negative breast cancer seem to be the main characteristics of breast carcinosarcoma, which is recognised as a separate entity from common invasive ductal carcinoma, with significantly worse clinical outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this analysis was a retrospective evaluation of the efficacy and toxicity of 2 hypofractionated irradiation schedules compared to conventional therapy in post-mastectomy patients. Methods: 3 irradiation schedules were analyzed: 48.30 Gy in 21 fractions (group A, n = 60), 42.56 Gy in 16 fractions (group B, n = 27) and 50 Gy in 25 fractions (group C, n = 30) of the front chest wall. All groups were also treated with a supraclavicular field, with 39.10 Gy in 17 fractions (group A), 37.24 Gy in 14 fractions (group B) or 45 Gy in 25 fractions (group C). Results: No local recurrences were noted in any group during 36 months of follow-up. Acute skin toxicity presented in all groups, with 58.3%, 70.4% and 60% of grade I; 35%, 25.9% and 40% of grade II; 6.7%, 3.7% and 0% of grade III being seen in groups A, B and C, respectively. Late skin toxicity was noted only as grade I in 16.7%, 25.9% and 26.7% of groups A, B and C, respectively. No significant difference was noted among all groups for either acute or late skin toxicity, or for radio-pneumonitis (chi2 test, p > 0.05). Conclusion: All schedules were equally effective with equivalent toxicity. A prospective randomized study is needed to confirm our results. [ABSTRACT FROM AUTHOR]