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Background: pregnancy-associated breast cancer (PABC) affects one in 3000 pregnancies, often presenting with aggressive features., Methods: We retrospectively evaluated a cohort of 282 young BC patients (≤45 years old) treated between 1995 and 2019, dividing them into three groups: nulliparous women, women with PABC (diagnosed within 2 years since last pregnancy) and women with BC diagnosed > 2 years since last pregnancy. This last group was further stratified according to the time between pregnancy and BC. The analysis encompassed histological factors (tumor size, histotype, grading, nodal involvement, multifocality, lympho-vascular invasion, hormone receptor expression, Ki-67 index, and HER2 expression), type of surgery and recurrence., Results: Age at diagnosis was younger in nulliparous than in parous women ( p < 0.001). No significant differences were noticed regarding histological characteristics and recurrences. At univariate analysis, nodal involvement (OR = 2.4; p < 0.0001), high tumor grade (OR = 2.6; p = 0.01), and lympho-vascular invasion (OR = 2.3; p < 0.05), but not pregnancy (OR = 0.8; p = 0.30), influenced DFS negatively. Multivariate analysis confirmed nodal involvement as the only negative independent prognostic factor for a worse DFS (OR = 2.4; p = 0.0001)., Conclusions: in our experience, pregnancy is not an independent adverse prognostic factor for BC DFS.

The study is based on the observation of 21 cases of phyllodes tumour of the breast. The mean age of patients was 43 years (range 18-60 years). In all the cases the tumour was monolateral, more common in the right breast (66.7% vs. 33.3%) and in external quadrants. Clinical features and diagnostic investigations were able to make a preoperative diagnosis in 6 out of 21 cases, while frozen sections and histological examination allowed to diagnose in the others. FNAB was not performed in any case. In this way 18 benign and 3 "borderline" tumours were discovered. No malignant lesion was observed. Local recurrence rate was 14.6%. Local recurrence was not associated with age of patients, tumor size and histological type. In neither case axillary nodal involvement was found. The study and the review of the literature suggest that wide local excision is the treatment of choice and adjuvant therapies have no place in the routine management of phyllodes tumours.

The authors referring to a case with a false positive diagnosis which recently came to their observation, describe the clinical, mammographic and echographic patterns to be considered in order to reach a differential diagnosis between benign and malignant lesions of the breast, which occur on surgical scars following quadrantectomy and subsequent radiotherapy. In particular, after an attentive research of the data reported in literature and after careful evaluation based on their personal experience, they conclude that the traditional clinical evaluation occupies a very prominent role in the follow-up of patients who underwent breast cancer surgery. They also believe that the diagnostic techniques, undoubtedly useful and necessary, must always be subjected to a critical evaluation in order to avoid, to the maximum, the possibility of diagnostic errors.

The authors report the diagnostic protocol used in the Breast Disease Unit of the 1st Surgical Department - University of Rome "La Sapienza" - (1987-1990) as well as the techniques for identifying and localizing nonpalpable lesions of the breast. Mammographic screening in women over 40 years, ultrasonography in women under 40 years, X-ray and ultrasound-guided fine needle aspiration and stereotactic guide wire placement with excisional biopsy, resulted to be diagnostic in 79 cases of carcinoma of the breast (2.0%) of which 13 (16.4%) were nonpalpable lesions. Moreover, the importance of nonpalpable lesions is discussed, pointing out how "very early" diagnosis of carcinoma of the breast plays a fundamental role with respect to both prognosis and treatment. The very early diagnosis of a "minimal" carcinoma ensures a significant increase in survival as well as more conservative surgical procedures that offer a better quality of life being less psychologically traumatic.