Abstract P2-09-14: Surveillance program for women carrying BRCA1/BRCA2 genetic predisposition

Between January 2003 and January 2015, women at genetic risk of developing breast and/or ovarian cancer were selected for a surveillance program. The monitoring strategy consisted of the association of breast ultrasound (US), every six months, and Rx-mammography (XM) and breast MRI (MRI) to be performed annually. To date, 29 women have been included in the surveillance program: BRCA1 mutation carriers, 18; BRCA2 mutation carriers, 11.

Eight women (28%) had already developed breast and/or ovarian cancer, while 21 (72%) were unaffected carriers.

At a median surveillance time of 33 months (range 0-144), 4 incidental breast cancers were diagnosed in 4 BRCA1/2 mutation carriers (4/29, 14%), 2 BRCA1+ and 2 BRCA2+; 3/21 (14%) unaffected carriers and 1/8 (13%) previously affected carriers. Two cancers (50%) were detected by all three diagnostic tools; 2 (50%) were identified only by US and MRI in patients aging 33 and 43, respectively.

Characteristics of patients with breast cancer diagnosed during surveillanceagemutated geneprevious cancerUSXMMRIhistologysurveillance time (months)33BRCA2-+-+ductal74+43BRCA2-+-+ductal40+45BRCA1-+++ductal60+40BRCA1yes+++ductal74+

One of these four patients, affected by breast cancer, died at 31 months of overall survival; three underwent surgery, chemotherapy and radiotherapy and are still disease free, in follow-up at 59, 28 and 26 months, respectively.

In conclusion, 29 BRCA1/2 carriers have been included in the surveillance program, the median age was 42.5 months (range 27-68) and the median surveillance time was 33 months (range 0-144). Our preliminary data confirm the 3% expected rate of diagnosed cancers and the effectiveness of performing the triple diagnostic surveillance with US, XM and MRI.

Citation Format: Sidoni T, Cocciolone V, Cannita K, Di Giacomo D, Ciccozzi A, Bafile A, Pizzorno L, Resta V, Marsecano C, Ferrari F, Di Cesare E, Ficorella C, Ricevuto E. Surveillance program for women carrying BRCA1/BRCA2 genetic predisposition. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-09-14.

Patterned structures of in situ size controlled CdS nanocrystals in a polymer matrix under UV irradiation

A method of in situ formation of patterns of size controlled CdS nanocrystals in a polymer matrix by pulsed UV irradiation is presented. The films consist of Cd thiolate precursors with different carbon chain lengths embedded in TOPAS polymer matrices. Under UV irradiation the precursors are photolyzed, driving to the formation of CdS nanocrystals in the quantum size regime, with size and concentration defined by the number of incident UV pulses, while the host polymer remains macroscopically/microscopically unaffected. The emission of the formed nanocomposite materials strongly depends on the dimensions of the CdS nanocrystals, thus, their growth at the different phases of the irradiation is monitored using spatially resolved photoluminescence by means of a confocal microscope. X-ray diffraction measurements verified the existence of the CdS nanocrystals, and defined their crystal structure for all the studied cases. The results are reinforced by transmission electron microscopy. It is proved that the selection of the precursor determines the efficiency of the procedure, and the quality of the formed nanocrystals. Moreover it is demonstrated that there is the possibility of laser induced formation of well-defined patterns of CdS nanocrystals, opening up new perspectives in the development of nanodevices.

[Diagnosis and treatment of non-palpable breast lesions: from the biopsy to the microhistology results. Our experience]

The aim of modern senology lies in the diagnosis and treatment of non-palpable breast lesions (NPBLs). Through the diffusion of regional mammography screening the lesions being observed are continuously smaller, thus calling for more and more accurate methodology. Our experience in this area is based on the use of certain methods for retrieval and removal of NPBLs, such as Kopan's sec. philo-guide, ultrasound and advanced breast biopsy instrumentation. In our opinion methods allowing total removal of lesions in order to obtain complete histopathological characterization and enabling adequate therapeutic programs are to be preferred. In reviewing case studies a noteworthy increase of initial carcinoma (DCIS or LCIS), from 19.5% to 57.1%, has been observed in the last three years due to the extensive use of the aforementioned methods.

[Can analysis of the molecular status of the p53 gene contribute to improving the therapeutic strategy for breast carcinoma?]

The occurrence of mutations in the p53 tumor suppressor gene is a specific and recurring genetic event in solid tumors. P53 plays a pivotal role in multiple cellular processes such as cell growth control, DNA repair and programmed cell death. Genotoxic damage, also induced by chemotherapy or radiotherapy, induces p53 overexpression in order to control the rate of proliferating damaged cells, thus triggering the mismatch repair or apoptotic pathways. P53 inactivation determines a condition of genetic instability, justifying the subsequent susceptibility to acquire mutations of different other genes. P53 mutations are associated with worse prognosis and with chemo/radioresistance, due to the inability to trigger p53-dependent programmed cell death. Molecular diagnostic strategies show 32% p53 mutations in breast cancer. The analysis of the p53 gene performed by FAMA (Fluorescence Assisted Mismatch Analysis) in high-risk breast cancer patients with > or = 10 involved axillary nodes may help identify a subset of very high risk BC patients (vHR-BC) with poorer prognosis and a subset with better prognosis, potentially responsive to medical treatments. The accurate evaluation of the p53 status can predict prognosis and sensitivity to chemotherapy, thus representing the first step toward better definition of therapeutic strategies according to the molecular characterization of the individual patient.

Modulation of potassium current and calcium influx by somatostatin in rod bipolar cells isolated from the rabbit retina via sst2 receptors

Somatostatin (somatotropin release-inhibiting factor, SRIF) receptor subtypes are expressed by several retinal neurons, suggesting that SRIF acts at multiple levels of the retinal circuitry, although functional data on this issue are scarce. Of the SRIF receptors, the sst2A isoform is expressed by rod bipolar cells (RBCs) of the rabbit retina, and in isolated RBCs we studied the role of sst2 receptors in modulating both K+ current (IK) and the intracellular free [Ca2+] ([Ca2+]i) using both voltage-clamp and Ca2+-imaging techniques. SRIF and octreotide (a SRIF agonist that binds to sst2 receptors) inhibited that component of IK corresponding to the activation of large-conductance, Ca2+- and voltage-dependent K+ channels (IBK) and reduced the K+-induced [Ca2+]i accumulation, suggesting that SRIF effects on IBK may have been secondary to inhibition of Ca2+ channels. Octreotide effects on IBK or on [Ca2+]i accumulation were prevented by RBC treatment with L-Tyr8-Cyanamid 154806, a novel sst2 receptor antagonist, indicating that SRIF effects were mediated by sst2 receptor activation. The present data indicate that SRIF may modulate the information flow through second-order retinal neurons via an action predominantly at sst2 receptors, contribute to the proposition that SRIF be added to the growing list of retinal neuromodulators, and suggest that one of its possible roles in the retina is to regulate transmitter release from RBCs.

[Non-palpable lesions of the breast: retrospective clinical study]

A non-palpable breast lesion (NPBL) is a disease of the mammary gland that cannot be detected during clinical examination but that can be visualized by mammography and/or ultrasonography, either during screening programs or sometimes in asymptomatic women. These small lesions require an adequate diagnostic-therapeutic approach to ensure correct treatment. The aim of the present study was to analyse a series of NPBLs retrospectively in order to define them nosologically and establish an adequate diagnostic-therapeutic work-up for such cases. Ninety-three patients with a total of 99 NPBLs were observed from January 1989 to December 1999. The 99 NPBLs were submitted to ultrasonography and 31 (31.3%) were also submitted to US-guided fine needle aspiration biopsy (FNAB). Later on the diagnostic-therapeutic procedure involved surgical biopsy after radiological centering and, in the case of malignant neoplastic lesions, surgical intervention and adjuvant therapy. Ultrasonography confirmed the presence of NPBL in 45 cases of the 99 detected at mammography (45.4%). Cytological examination of the 31 FNABs yielded the following results: unreliable 19.3%, suspected malignancy 42%, negative for neoplastic cytology 6.5%, positive for carcinoma 32.3%. The histological diagnosis was one of mammary carcinoma in 41 patients (43%). Among the 41 carcinomas there were 8 (19.5%) carcinomas in situ, 24 (58.5%) invasive ductal carcinomas, 8 (19.5%) invasive lobular carcinomas, and 1 (2.5%) medullary carcinoma. In the 32 (80%) patients submitted to lymphadenectomy for 33 invasive carcinomas, 6 patients (18.7%) presented positive lymph nodes (N1). The Authors conclude that NPBLs are an important clinical entity because they may be the expression of a malignant lesion; most NPBLs are diagnosed during screening programs or sometimes in asymptomatic women by means of mammography, which is the only standardised method for their identification. The poor diagnostic capability of non-invasive methods and the potential malignancy of NPBL justify the indication for surgical excisional biopsies; in cases of histological findings of malignancy it is often possible to perform conservative surgery with similar results to radical surgery in terms of survival. When NPBLs turn out to be invasive carcinomas, a concomitant lymphadenectomy is mandatory.

The Sentinel Lymph Node in T1N0 Breast Cancer

The authors report their experience gathered from December 1998 to December 1999 in the use of the sentinel lymph node (SN) method in breast cancer treatment. In 20 out of 21 cases (95%) localization of the SN was obtained by scintigraphy while in 19 cases (90.5%) the SN was found during surgery. Histological examination of the axillary lymph nodes gave a 95% accuracy with only one negative SN associated with positive axillary lymph nodes out of a total of 19. However, the authors have subjected all patients to a complete three-level axillary dissection since they believe the method applied has not yet been fully validated.