1
|
Schiavone A, Ventimiglia F, Zarba Meli E, Taffurelli M, Caruso F, Gentilini OD, Del Mastro L, Livi L, Castellano I, Bernardi D, Minelli M, Fortunato L. Third national surgical consensus conference of the Italian Association of Breast Surgeons (ANISC) on management after neoadjuvant chemotherapy: The difficulty in reaching a consensus. Eur J Surg Oncol 2024; 50:108351. [PMID: 38701582 DOI: 10.1016/j.ejso.2024.108351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/15/2024] [Accepted: 04/15/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Neoadjuvant chemotherapy (NAC) has a profound impact on surgical management of breast cancer. For this reason, the Italian Association of Breast Surgeons (ANISC) promoted the third national Consensus Conference on this subject, open to multidisciplinary specialists. MATERIALS AND METHODS The Consensus Conference was held on-line in November 2022, and after an introductory session with five core-team experts, participants were asked to vote on eleven controversial issues, while results were collected in real-time with a polling system. RESULTS A total of 164 dedicated specialists from 74 Breast Centers participated. Consensus was reached for only three of the eleven issues, including: 1) the indication to assess the response with Magnetic Resonance Imaging (79 %); 2) the need to re-assess the biological factors of the residual tumor if present (96 %); 3) the possibility of omitting a formal axillary node dissection for cN1 patients if a pathologic Complete Response (pCR) was confirmed with analysis of one or more sentinel lymph nodes (82 %). The majority voted in favor of mapping both the breast and nodal lesions pre-NAC (59 %), and against the omission of sentinel lymph node biopsy in cN0 patients in the case of pathologic or clinical Complete Response (69 %). In cases of cT3/cN1+ tumors with pCR, only 8 % of participants considered appropriate the omission of Post-Mastectomy Radiation Therapy. CONCLUSION There is still a wide variability in surgical approaches after NAC in the "real world". As NAC is increasingly used, multidisciplinary teams should be attuned to conforming their procedures to the rapid advances in this field.
Collapse
Affiliation(s)
- Alfonso Schiavone
- Breast Center, San Giovanni-Addolorata Hospital, Via Dell'Amba Aradam 8, 00184, Rome, Italy; Department of Surgical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
| | - Fabrizio Ventimiglia
- Breast Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Emanuele Zarba Meli
- Breast Center, San Giovanni-Addolorata Hospital, Via Dell'Amba Aradam 8, 00184, Rome, Italy
| | - Mario Taffurelli
- Breast Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Francesco Caruso
- Breast Unit, Humanitas Istituto Clinico Catanese, Contrada Cubba 11, SP54, 95045, Misterbianco, CT, Italy
| | | | - Lucia Del Mastro
- Breast Unit, IRCCS Ospedale Policlinico San Martino, Department of Internal Medicine and Medical Specialties (DIMI), Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Lorenzo Livi
- Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, P.zza San Marco 4, 50121, Florence, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Via Giuseppe Verdi 8, 10124, Turin, Italy
| | - Daniela Bernardi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Mauro Minelli
- Breast Center, San Giovanni-Addolorata Hospital, Via Dell'Amba Aradam 8, 00184, Rome, Italy
| | - Lucio Fortunato
- Breast Center, San Giovanni-Addolorata Hospital, Via Dell'Amba Aradam 8, 00184, Rome, Italy
| |
Collapse
|
2
|
Giorgi Rossi P, Mancuso P, Pattacini P, Campari C, Nitrosi A, Iotti V, Ponti A, Frigerio A, Correale L, Riggi E, Giordano L, Segnan N, Di Leo G, Magni V, Sardanelli F, Fornasa F, Romanucci G, Montemezzi S, Falini P, Auzzi N, Zappa M, Ottone M, Mantellini P, Duffy SW, Armaroli P, Coriani C, Pescarolo M, Stefanelli G, Tondelli G, Beretti F, Caffarri S, Marchesi V, Canovi L, Colli M, Boschini M, Bertolini M, Ragazzi M, Pattacini P, Giorgi Rossi P, Iotti V, Ginocchi V, Ravaioli S, Vacondio R, Campari C, Caroli S, Nitrosi A, Braglia L, Cavuto S, Mancuso P, Djuric O, Venturelli F, Vicentini M, Braghiroli MB, Lonetti J, Davoli E, Bonelli E, Fornasa F, Montemezzi S, Romanucci G, Lucchi I, Martello G, Rossati C, Mantellini P, Ambrogetti D, Iossa A, Carnesciali E, Mazzalupo V, Falini P, Puliti D, Zappa M, Battisti F, Auzzi N, Verdi S, Degl'Innocenti C, Tramalloni D, Cavazza E, Busoni S, Betti E, Peruzzi F, Regini F, Sardanelli F, Di Leo G, Carbonaro LA, Magni V, Cozzi A, Spinelli D, Monaco CG, Schiaffino S, Benedek A, Menicagli L, Ferraris R, Favettini E, Dettori D, Falco P, Presti P, Segnan N, Ponti A, Frigerio A, Armaroli P, Correale L, Marra V, Milanesio L, Artuso F, Di Leo A, Castellano I, Riggi E, Casella D, Pitarella S, Vergini V, Giordano L, Duffy SW, Graewingholt A, Lang K, Falcini F. Comparing accuracy of tomosynthesis plus digital mammography or synthetic 2D mammography in breast cancer screening: baseline results of the MAITA RCT consortium. Eur J Cancer 2024; 199:113553. [PMID: 38262307 DOI: 10.1016/j.ejca.2024.113553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/01/2024] [Accepted: 01/06/2024] [Indexed: 01/25/2024]
Abstract
AIM The analyses here reported aim to compare the screening performance of digital tomosynthesis (DBT) versus mammography (DM). METHODS MAITA is a consortium of four Italian trials, REtomo, Proteus, Impeto, and MAITA trial. The trials adopted a two-arm randomised design comparing DBT plus DM (REtomo and Proteus) or synthetic-2D (Impeto and MAITA trial) versus DM; multiple vendors were included. Women aged 45 to 69 years were individually randomised to one round of DBT or DM. FINDINGS From March 2014 to February 2022, 50,856 and 63,295 women were randomised to the DBT and DM arm, respectively. In the DBT arm, 6656 women were screened with DBT plus synthetic-2D. Recall was higher in the DBT arm (5·84% versus 4·96%), with differences between centres. With DBT, 0·8/1000 (95% CI 0·3 to 1·3) more women received surgical treatment for a benign lesion. The detection rate was 51% higher with DBT, ie. 2·6/1000 (95% CI 1·7 to 3·6) more cancers detected, with a similar relative increase for invasive cancers and ductal carcinoma in situ. The results were similar below and over the age of 50, at first and subsequent rounds, and with DBT plus DM and DBT plus synthetic-2D. No learning curve was appreciable. Detection of cancers >= 20 mm, with 2 or more positive lymph nodes, grade III, HER2-positive, or triple-negative was similar in the two arms. INTERPRETATION Results from MAITA confirm that DBT is superior to DM for the detection of cancers, with a possible increase in recall rate. DBT performance in screening should be assessed locally while waiting for long-term follow-up results on the impact of advanced cancer incidence.
Collapse
Affiliation(s)
| | | | | | - Cinzia Campari
- Screening coordinating centre, AUSL - IRCCS di Reggio Emilia, Italy
| | - Andrea Nitrosi
- Medical Physics unit, AUSL - IRCCS di Reggio Emilia, Italy
| | | | - Antonio Ponti
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Alfonso Frigerio
- SSD Senologia di Screening AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Loredana Correale
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Emilia Riggi
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Livia Giordano
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Nereo Segnan
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | - Giovanni Di Leo
- IRCC Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
| | - Veronica Magni
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
| | - Francesco Sardanelli
- IRCC Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133 Milan, Italy
| | - Francesca Fornasa
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Giovanna Romanucci
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | - Patrizia Falini
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Noemi Auzzi
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Marco Zappa
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Marta Ottone
- Epidemiology Unit, AUSL - IRCCS di Reggio Emilia, Italy
| | - Paola Mantellini
- ISPRO - Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Stephen W Duffy
- Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Paola Armaroli
- SSD Epidemiologia e Screening. AOU Città della Salute e della Scienza, CPO Piemonte Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Francesca Fornasa
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | - Giovanna Romanucci
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Ilaria Lucchi
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | - Gessica Martello
- Breast Unit ULSS9 Scaligera, Ospedale Fracastoro, Via Circonvallazione, 1, 37047 San Bonifacio, VR, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Giovanni Di Leo
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Veronica Magni
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Andrea Cozzi
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Diana Spinelli
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | | | - Adrienn Benedek
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Laura Menicagli
- IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Axel Graewingholt
- Mammographiescreening-Zentrum Paderborn, Breast Cancer Screening, Paderborn, NRW, Germany
| | - Kristina Lang
- Departement of Translational Medicine, Lund University, Unilabs Mammography Unit, Skåne University Hospital, Malmö, Sweden
| | | |
Collapse
|
3
|
Pepe F, Venetis K, Cursano G, Frascarelli C, Pisapia P, Vacirca D, Scimone C, Rappa A, Russo G, Mane E, Pagni F, Castellano I, Troncone G, Angelis CD, Curigliano G, Guerini-Rocco E, Malapelle U, Fusco N. PIK3CA testing in hormone receptor-positive/HER2-negative metastatic breast cancer: real-world data from Italian molecular pathology laboratories. Pharmacogenomics 2024; 25:161-169. [PMID: 38440825 DOI: 10.2217/pgs-2023-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
Introduction: PIK3CA gene mutations occur in approximately 40% of hormone receptor-positive/HER2-negative (HR+/HER2-) metastatic breast cancers (MBCs), electing them to targeted therapy. Testing PIK3CA status is complex due to selection of biological specimen and testing method. Materials & methods: This work investigates real-life experience on PIK3CA testing in HR+/HER2- MBC. Clinical, technical and molecular data on PIK3CA testing were collected from two referral laboratories. Additionally, the results of a nationwide PIK3CA survey involving 116 institutions were assessed. Results: Overall, n = 35 MBCs were PIK3CA-mutated, with mutations mostly occurring in exons 9 (n = 19; 51.4%) and 20 (n = 15; 40.5%). The nationwide survey revealed significant variability across laboratories in terms of sampling methodology, technical assessment and clinical report signing healthcare figures for PIK3CA molecular testing in diagnostic routine practice. Conclusion: This study provides insights into the real-world routine of PIK3CA testing in HR+/HER2- MBC and highlights the need for standardization and networking in predictive pathology.
Collapse
Affiliation(s)
- Francesco Pepe
- Department of Public Health, Federico II University of Naples, 80131, Naples, Italy
| | - Konstantinos Venetis
- Division of Pathology, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Giulia Cursano
- Division of Pathology, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Chiara Frascarelli
- Division of Pathology, European Institute of Oncology IRCCS, 20141, Milan, Italy
- Department of Oncology & Hemato-Oncology, University of Milan, 20122, Milan, Italy
| | - Pasquale Pisapia
- Department of Public Health, Federico II University of Naples, 80131, Naples, Italy
| | - Davide Vacirca
- Division of Pathology, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Claudia Scimone
- Department of Public Health, Federico II University of Naples, 80131, Naples, Italy
| | - Alessandra Rappa
- Division of Pathology, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Gianluca Russo
- Department of Public Health, Federico II University of Naples, 80131, Naples, Italy
| | - Eltjona Mane
- Division of Pathology, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Fabio Pagni
- Center for Digital Medicine, Department of Medicine & Surgery, University Milan Bicocca, Monza (MB), Italy
- Molecular Pathology & Predictive Medicine PMMP Group, Italian Society of Pathology, SIAPeC, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126, Turin, Italy
- Breast Pathology GIPaM Group, Italian Society of Pathology, SIAPeC, Italy
| | - Giancarlo Troncone
- Department of Public Health, Federico II University of Naples, 80131, Naples, Italy
| | - Carmine De Angelis
- Department of Clinical Medicine & Surgery, University Federico II, 80131, Naples, Italy
| | - Giuseppe Curigliano
- Department of Oncology & Hemato-Oncology, University of Milan, 20122, Milan, Italy
- Division of New Drugs & Early Drug Development, European Institute of Oncology, IRCCS, 20141, Milan, Italy
| | - Elena Guerini-Rocco
- Division of Pathology, European Institute of Oncology IRCCS, 20141, Milan, Italy
- Department of Oncology & Hemato-Oncology, University of Milan, 20122, Milan, Italy
- Molecular Pathology & Predictive Medicine PMMP Group, Italian Society of Pathology, SIAPeC, Italy
| | - Umberto Malapelle
- Department of Public Health, Federico II University of Naples, 80131, Naples, Italy
- Molecular Pathology & Predictive Medicine PMMP Group, Italian Society of Pathology, SIAPeC, Italy
| | - Nicola Fusco
- Division of Pathology, European Institute of Oncology IRCCS, 20141, Milan, Italy
- Department of Oncology & Hemato-Oncology, University of Milan, 20122, Milan, Italy
- Molecular Pathology & Predictive Medicine PMMP Group, Italian Society of Pathology, SIAPeC, Italy
- Breast Pathology GIPaM Group, Italian Society of Pathology, SIAPeC, Italy
| |
Collapse
|
4
|
Borella F, Mancarella M, Preti M, Mariani L, Stura I, Sciarrone A, Bertschy G, Leuzzi B, Piovano E, Valabrega G, Turinetto M, Pino I, Castellano I, Bertero L, Cassoni P, Cosma S, Franchi D, Benedetto C. Uterine smooth muscle tumors: a multicenter, retrospective, comparative study of clinical and ultrasound features. Int J Gynecol Cancer 2023:ijgc-2023-004880. [PMID: 38054268 DOI: 10.1136/ijgc-2023-004880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
OBJECTIVE To evaluate a wide range of clinical and ultrasound characteristics of different uterine smooth muscle tumors to identify features capable of discriminating between these types. METHODS This was a retrospective, multicenter study that included 285 patients diagnosed with uterine smooth muscle tumors (50 leiomyosarcomas, 35 smooth muscle tumors of uncertain malignant potential, and 200 leiomyomas). The patients were divided into three groups based on the histological type of their tumors, and the groups were compared according to the variables collected. RESULTS Leiomyosarcomas were more common in older and post-menopausal women. Compared with leiomyomas, smooth muscle tumors of uncertain malignant potential and leiomyosarcomas had similar ultrasound features such as absence of normal myometrium, multilocular appearance, hyper-echogenicity in case of uniform echogenicity, absence of posterior shadows, echogenic areas, and hyperechoic rim. Leiomyosarcomas were larger, had more cystic areas, and were associated with a higher prevalence of pelvic free fluid. Smooth muscle tumors of uncertain malignant potential were characterized by a higher frequency of International Federation of Gynecology and Obstetrics (FIGO) type 6-7, the absence of internal shadows, and, in the case of cystic area, the presence of a regular internal wall. Tumor outline varied among the three histological types. A color score of 1 was typical of leiomyoma, a color score 2 was mainly observed in leiomyomas and smooth muscle tumors of uncertain malignant potential, a color score 3 did not differ among the tumors, while a color of score 4 was related to leiomyosarcomas. When combining color scores 3 and 4, leiomyosarcomas and smooth muscle tumors of uncertain malignant potential showed a high percentage of both circumferential and intra-lesional vascularization. A cooked appearance was not statistically different among the tumors. CONCLUSIONS Based on our findings, specific ultrasonographic features as well as age and menopausal status are associated with different uterine smooth muscle tumor types. Integration of these data can help the pre-operative assessment of these lesions for proper management.
Collapse
Affiliation(s)
- Fulvio Borella
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Matteo Mancarella
- Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Piemonte, Italy
| | - Mario Preti
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Luca Mariani
- Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Piemonte, Italy
| | - Ilaria Stura
- Department of Public Health and Pediatric Sciences, University of Turin, Torino, Piemonte, Italy
| | | | - Gianluca Bertschy
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Beatrice Leuzzi
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Elisa Piovano
- Division of Gynecology and Obstetrics 2, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | | | | | - Ida Pino
- Preventive Gynecology Unit, Istituto Europeo di Oncologia, Milan, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Stefano Cosma
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Dorella Franchi
- Preventive Gynecology Unit, Istituto Europeo di Oncologia, Milan, Italy
| | - Chiara Benedetto
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| |
Collapse
|
5
|
Castellano I, Gallo F, Durelli P, Monge T, Fadda M, Metovic J, Cassoni P, Borella F, Raucci C, Menischetti M, Beano A, Migliaretti G, Finocchiaro C. Impact of Caloric Restriction in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy: A Prospective Case Control Study. Nutrients 2023; 15:4677. [PMID: 37960330 PMCID: PMC10648206 DOI: 10.3390/nu15214677] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Background and aims: It is well established that caloric restriction (CR) may influence metabolic and hormonal factors involved in cancer development and progression. Recently, several studies have demonstrated that CR may have a favorable impact on the response to systemic therapy in breast cancer (BC) patients. However, there is a lack of data regarding the influence of CR during neoadjuvant chemotherapy (NACT). Our study's primary aim was to evaluate CR's impact on BC patients undergoing NACT. Secondly, we investigated the nutritional efficacy and safety of this intervention. Methods: We performed a prospective, case-control study in two breast units. A diet group consisting of 39 patients undergoing NACT and CR was enrolled in our study at the same time. CR consisted of a 30% reduction in caloric intake, which increased to 50% on the days before, during, and after the administration of chemotherapy. A control group of 60 patients that underwent the same treatment approach only followed the general dietary recommendations for BC according to WCRF guidelines. The diet group was monitored during the study for both dietary adequacy and weight trends. Results: CR combined with NACT showed a statistically significant therapeutic response in tumor size (OR 2.94, IC 1.07-8.01, p = 0.009) and lymph node status (OR 3.22, IC 1.22-8.56, p = 0.001) compared to NACT alone, even after the adjustment for all biological parameters. Our data also showed the efficacy and safety of this intervention in both anthropometric and biochemical analyses. Conclusions: Patients who adhered to CR showed a better response to NACT, both in the breast and in the axillary lymph nodes, compared to the patients in the control group. Furthermore, the CR diet combined with NACT showed good tolerance and safety.
Collapse
Affiliation(s)
- Isabella Castellano
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy; (I.C.); (P.C.)
| | - Francesco Gallo
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| | - Paola Durelli
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| | - Taira Monge
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| | - Maurizio Fadda
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| | - Jasna Metovic
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy; (I.C.); (P.C.)
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy; (I.C.); (P.C.)
| | - Fulvio Borella
- Gynecology and Obstetrics 1U, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy;
| | - Carlo Raucci
- Oncology Unity, Cottolengo Hospital, 10152 Turin, Italy
| | | | - Alessandra Beano
- Medical Breast Oncology Unit, Department of Oncology, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy
| | - Giuseppe Migliaretti
- Department of Public Health and Pediatric Sciences, University of Turin, 10126 Turin, Italy
| | - Concetta Finocchiaro
- Dietetic and Clinical Nutrition Unit, City of Health and Science University Hospital, 10126 Turin, Italy
| |
Collapse
|
6
|
Fusco N, Ivanova M, Frascarelli C, Criscitiello C, Cerbelli B, Pignataro MG, Pernazza A, Sajjadi E, Venetis K, Cursano G, Pagni F, Di Bella C, Accardo M, Amato M, Amico P, Bartoli C, Bogina G, Bortesi L, Boldorini R, Bruno S, Cabibi D, Caruana P, Dainese E, De Camilli E, Dell'Anna V, Duda L, Emmanuele C, Fanelli GN, Fernandes B, Ferrara G, Gnetti L, Gurrera A, Leone G, Lucci R, Mancini C, Marangi G, Mastropasqua MG, Nibid L, Orrù S, Pastena M, Peresi M, Perracchio L, Santoro A, Vezzosi V, Zambelli C, Zuccalà V, Rizzo A, Costarelli L, Pietribiasi F, Santinelli A, Scatena C, Curigliano G, Guerini-Rocco E, Martini M, Graziano P, Castellano I, d'Amati G. Advancing the PD-L1 CPS test in metastatic TNBC: Insights from pathologists and findings from a nationwide survey. Crit Rev Oncol Hematol 2023; 190:104103. [PMID: 37595344 DOI: 10.1016/j.critrevonc.2023.104103] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/11/2023] [Accepted: 08/12/2023] [Indexed: 08/20/2023] Open
Abstract
Pembrolizumab has received approval as a first-line treatment for unresectable/metastatic triple-negative breast cancer (mTNBC) with a PD-L1 combined positive score (CPS) of ≥ 10. However, assessing CPS in mTNBC poses challenges. Firstly, it represents a novel analysis for breast pathologists. Secondly, the heterogeneity of PD-L1 expression in mTNBC further complicates the assessment. Lastly, the lack of standardized assays and staining platforms adds to the complexity. In KEYNOTE trials, PD-L1 expression was evaluated using the IHC 22C3 pharmDx kit as a companion diagnostic test. However, both the 22C3 pharmDx and VENTANA PD-L1 (SP263) assays are validated for CPS assessment. Consequently, assay-platform choice, staining conditions, and scoring methods can significantly impact the testing outcomes. This consensus paper aims to discuss the intricacies of PD-L1 CPS testing in mTNBC and provide practical recommendations for pathologists. Additionally, we present findings from a nationwide Italian survey elucidating the state-of-the-art in PD-L1 CPS testing in mTNBC.
Collapse
Affiliation(s)
- Nicola Fusco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
| | - Mariia Ivanova
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Frascarelli
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Carmen Criscitiello
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Division of New Drugs and Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Bruna Cerbelli
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Maria Gemma Pignataro
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Angelina Pernazza
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| | - Elham Sajjadi
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Giulia Cursano
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Fabio Pagni
- Department of Medicine and Surgery, University Milan Bicocca, Monza (MB), Italy; Department of Pathology, IRCCS San Gerardo Hospital, Monza (MB), Italy
| | - Camillo Di Bella
- Department of Pathology, IRCCS San Gerardo Hospital, Monza (MB), Italy
| | - Marina Accardo
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania "L. Vanvitelli", Naples, Italy
| | - Michelina Amato
- Department of Pathology, San Giovanni-Addolorata Hospital, Rome Italy
| | - Paolo Amico
- Department of Pathology, Ospedale Maria Paternò Arezzo, Ragusa, Italy
| | - Caterina Bartoli
- Morphological Diagnostic and Biomolecular Characterization Area, Complex Unit of Pathological Anatomy Empoli-Prato, Oncological Department Azienda USL Toscana Centro, Italy
| | - Giuseppe Bogina
- Pathology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Laura Bortesi
- Pathology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
| | - Renzo Boldorini
- Pathology Unit, University of Eastern Piedmont, Novara, Italy
| | - Sara Bruno
- Division of Pathology, ASL2 Savona, Liguria, Italy
| | - Daniela Cabibi
- Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy
| | - Pietro Caruana
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Emanuele Dainese
- Surgical Pathology Division, Department of Oncology, ASST Lecco, "A. Manzoni" Hospital, Lecco, Italy
| | - Elisa De Camilli
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Loren Duda
- Department of Clinical and Experimental Medicine, Pathology Unit, University of Foggia, Foggia, Italy
| | - Carmela Emmanuele
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | - Giuseppe Nicolò Fanelli
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Gerardo Ferrara
- Department of Anatomic Pathology and Cytopathology, G. Pascale National Cancer Institute Foundation (IRCCS) Naples, Italy
| | - Letizia Gnetti
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | | | - Giorgia Leone
- Division of Pathology, Clinical Institute Humanitas Catania Cubba, Misterbianco (Catania), Italy
| | - Raffaella Lucci
- Pathology Unit, Monaldi Hospital, A.O. dei Colli of Naples, Naples, Italy
| | - Cristina Mancini
- Division of Pathology, Umberto I Hospital Presidium, Enna Provincial Health Department (ASP), Enna, Italy
| | - Grazia Marangi
- Anatomic Pathology Unit, SS. Annunziata Hospital, Taranto, Italy
| | - Mauro G Mastropasqua
- Department of Precision and Regenerative Medicine and Jonian Area, School of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Lorenzo Nibid
- Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Rome, Italy
| | - Sandra Orrù
- Businco Oncologic Hospital, ARNAS Brotzu, Cagliari, Italy
| | - Maria Pastena
- IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Monica Peresi
- Pathology and Cytopathology Diagnostic Unit, Ospedale Villa Scassi di Genova, Genoa, Italy
| | - Letizia Perracchio
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Angela Santoro
- General Pathology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Vania Vezzosi
- Histopathology and Molecular Diagnostics Unit, Careggi Hospital, Firenze, Italy
| | | | - Valeria Zuccalà
- Pathology Unit, Pugliese-Ciaccio Hospital Catanzaro, Catanzaro, Italy
| | - Antonio Rizzo
- Division of Pathology, Clinical Institute Humanitas Catania Cubba, Misterbianco (Catania), Italy
| | | | | | - Alfredo Santinelli
- Anatomic Pathology, Azienda Sanitaria Territoriale di Pesaro-Urbino, Pesaro, Italy
| | - Cristian Scatena
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Division of New Drugs and Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elena Guerini-Rocco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Maurizio Martini
- Department of Human and Developmental Pathology, University of Messina, Messina, Italy
| | - Paolo Graziano
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | | | - Giulia d'Amati
- Department of Medical-Surgical Sciences and Biotechnologies Sapienza University of Rome, Rome, Italy
| |
Collapse
|
7
|
Lopatina T, Grange C, Cavallari C, Navarro-Tableros V, Lombardo G, Rosso A, Cedrino M, Pomatto MAC, Koni M, Veneziano F, Castellano I, Camussi G, Brizzi MF. Correction: Targeting IL-3Rα on tumor-derived endothelial cells blunts metastatic spread of triple-negative breast cancer via extracellular vesicle reprogramming. Oncogenesis 2023; 12:38. [PMID: 37491339 PMCID: PMC10368711 DOI: 10.1038/s41389-023-00483-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
- Tatiana Lopatina
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Cristina Grange
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | - Giusy Lombardo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Arturo Rosso
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | - Malvina Koni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | | | - Giovanni Camussi
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | |
Collapse
|
8
|
Borella F, Bertero L, Di Giovanni F, Witel G, Orlando G, Ricci AA, Pittaro A, Castellano I, Cassoni P. COVID-19 and Breast Cancer: Analysis of Surgical Management of a Large Referral Center during the 2020-2021 Pandemic Period. Curr Oncol 2023; 30:4767-4778. [PMID: 37232817 DOI: 10.3390/curroncol30050359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Coronavirus disease-19 (COVID-19) has spread worldwide since December 2019 and was officially declared a pandemic in March 2020. Due to the rapid transmission and the high fatality rate, drastic emergency restrictions were issued, with a negative impact on routine clinical activities. In particular, in Italy, many authors have reported a reduction in the number of breast cancer diagnoses and critical problems in the management of patients who accessed the breast units during the dramatic first months of the pandemic. Our study aims to analyze the global impact of COVID-19 in the two years of the pandemic (2020-2021) on the surgical management of breast cancer by comparing them with the previous two years. METHODS In our retrospective study, we analyzed all cases of breast cancer diagnosed and surgically treated at the breast unit of "Città della Salute e della Scienza" in Turin, Italy, making a comparison between the 2018-2019 pre-pandemic period and the 2020-2021 pandemic period. RESULTS We included in our analysis 1331 breast cancer cases surgically treated from January 2018 to December 2021. A total of 726 patients were treated in the pre-pandemic years and 605 in the pandemic period (-121 cases, 9%). No significant differences were observed regarding diagnosis (screening vs. no screening) and timing between radiological diagnosis and surgery for both in situ and invasive tumors. There were no variations in the breast surgical approach (mastectomy vs. conservative surgery), while a reduction in axillary dissection compared to the sentinel lymph node in the pandemic period was observed (p-value < 0.001). Regarding the biological characteristics of breast cancers, we observed a greater number of grades 2-3 (p-value = 0.007), pT stage 3-4 breast cancer surgically treated without previous neoadjuvant chemotherapy (p-value = 0.03), and a reduction in luminal B tumors (p-value = 0.007). CONCLUSIONS Overall, we report a limited reduction in surgical activity for breast cancer treatment considering the entire pandemic period (2020-2021). These results suggest a prompt resumption of surgical activity similar to the pre-pandemic period.
Collapse
Affiliation(s)
- Fulvio Borella
- Obstetrics and Gynecology Unit 1, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Fabrizia Di Giovanni
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Gianluca Witel
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Giulia Orlando
- Pathology Unit, Department of Oncology, University of Turin, 10126 Turin, Italy
| | - Alessia Andrea Ricci
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Alessandra Pittaro
- Pathology Unit, Città della Salute e della Scienza University Hospital, 10126 Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| |
Collapse
|
9
|
Metovic J, Sapino A, Castellano I. Reply to: Neuroendocrine neoplasms of the breast: diagnostic confusion and future perspectives. Virchows Arch 2023; 482:931-932. [PMID: 36670280 DOI: 10.1007/s00428-023-03494-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 01/21/2023]
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - Anna Sapino
- Pathology Division, FPO-IRCCS, Candiolo Cancer Institute, Candiolo, Italy
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy.
| |
Collapse
|
10
|
Gambella A, Bertero L, Rondón-Lagos M, Verdun Di Cantogno L, Rangel N, Pitino C, Ricci AA, Mangherini L, Castellano I, Cassoni P. FISH Diagnostic Assessment of MDM2 Amplification in Liposarcoma: Potential Pitfalls and Troubleshooting Recommendations. Int J Mol Sci 2023; 24:ijms24021342. [PMID: 36674856 PMCID: PMC9863600 DOI: 10.3390/ijms24021342] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
MDM2 amplification represents the leading oncogenic pathway and diagnostic hallmark of liposarcoma, whose assessment is based on Fluorescence In Situ Hybridization (FISH) analysis. Despite its diagnostic relevance, no univocal interpretation criteria regarding FISH assessments of MDM2 amplification have been established so far, leading to several different approaches and potential diagnostic misinterpretations. This study aims to address the most common issues and proposes troubleshooting guidelines for MDM2 amplification assessments by FISH. We retrospectively retrieved 51 liposarcomas, 25 Lipomas, 5 Spindle Cell Lipoma/Pleomorphic Lipomas, and 2 Atypical Spindle Cell Lipomatous Tumors and the corresponding MDM2 FISH analysis. We observed MDM2 amplification in liposarcomas cases only (43 out of 51 cases) and identified three MDM2-amplified patterns (scattered (50% of cases), clustered (14% of cases), and mixed (36% of cases)) and two nonamplified patterns (low number of signals (82% of cases) and polysomic (18% of cases)). Based on these data and published evidence in the literature, we propose a set of criteria to guide MDM2 amplification analysis in liposarcoma. Kindled by the compelling importance of MDM2 assessments to improve diagnostic and therapeutic liposarcoma management, these suggestions could represent the first step to develop a univocal interpretation model and consensus guidelines.
Collapse
Affiliation(s)
- Alessandro Gambella
- Division of Liver and Transplant Pathology, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Milena Rondón-Lagos
- School of Biological Sciences, Universidad Pedagógica y Tecnológica de Colombia, Tunja 150003, Colombia
| | - Ludovica Verdun Di Cantogno
- Department of Laboratory Medicine, Azienda Ospedaliera Città della Salute e della Scienza di Torino, 10126 Turin, Italy
| | - Nelson Rangel
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
| | - Chiara Pitino
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | | | - Luca Mangherini
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | | | - Paola Cassoni
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Correspondence: ; Tel.: +39-011-633-5588
| |
Collapse
|
11
|
Borella F, Cosma S, Ferraioli D, Ray-Coquard I, Chopin N, Meeus P, Cockenpot V, Valabrega G, Scotto G, Turinetto M, Biglia N, Fuso L, Mariani L, Franchi D, Urbinati AMV, Pino I, Bertschy G, Preti M, Benedetto C, Castellano I, Cassoni P, Bertero L. ASO Visual Abstract: Clinical and Histopathologic Predictors Signaling Recurrence of Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Multicenter Retrospective Cohort Study of Tertiary Centers. Ann Surg Oncol 2022; 29:8317-8318. [PMID: 36109407 DOI: 10.1245/s10434-022-12479-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Affiliation(s)
- Fulvio Borella
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy.
| | - Stefano Cosma
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | | | | | | | - Pierre Meeus
- Léon Bérard Comprehensive Cancer Center, Lyon, France
| | | | | | - Giulia Scotto
- Department of Oncology, University of Turin, Turin, Italy
| | | | - Nicoletta Biglia
- Division of Obstetrics and Gynecology-A. O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Luca Fuso
- Division of Obstetrics and Gynecology-A. O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Luca Mariani
- Division of Obstetrics and Gynecology-A. O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Dorella Franchi
- Preventive Gynecology Unit, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Ida Pino
- Preventive Gynecology Unit, European Institute of Oncology IRCCS, Milan, Italy
| | - Gianluca Bertschy
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Mario Preti
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Chiara Benedetto
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| |
Collapse
|
12
|
Borella F, Cosma S, Ferraioli D, Ray-Coquard I, Chopin N, Meeus P, Cockenpot V, Valabrega G, Scotto G, Turinetto M, Biglia N, Fuso L, Mariani L, Franchi D, Vidal Urbinati AM, Pino I, Bertschy G, Preti M, Benedetto C, Castellano I, Cassoni P, Bertero L. Correction: Clinical and Histopathological Predictors of Recurrence in Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Multicenter Retrospective Cohort Study of Tertiary Centers. Ann Surg Oncol 2022; 29:8319. [PMID: 36131118 DOI: 10.1245/s10434-022-12594-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Fulvio Borella
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy.
| | - Stefano Cosma
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | | | | | | | - Pierre Meeus
- Léon Bérard Comprehensive Cancer Center, Lyon, France
| | | | | | - Giulia Scotto
- Department of Oncology, University of Turin, Turin, Italy
| | | | - Nicoletta Biglia
- Division of Obstetrics and Gynecology - A.O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Luca Fuso
- Division of Obstetrics and Gynecology - A.O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Luca Mariani
- Division of Obstetrics and Gynecology - A.O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Dorella Franchi
- Preventive Gynecology Unit, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Ida Pino
- Preventive Gynecology Unit, European Institute of Oncology IRCCS, Milan, Italy
| | - Gianluca Bertschy
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Mario Preti
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Chiara Benedetto
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| |
Collapse
|
13
|
Borella F, Cosma S, Ferraioli D, Ray-Coquard I, Chopin N, Meeus P, Cockenpot V, Valabrerga G, Scotto G, Turinetto M, Biglia N, Fuso L, Mariani L, Franchi D, Vidal Urbinati AM, Pino I, Bertschy G, Preti M, Benedetto C, Castellano I, Cassoni P, Bertero L. Clinical and Histopathological Predictors of Recurrence in Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Multicenter Retrospective Cohort Study of Tertiary Centers. Ann Surg Oncol 2022; 29:8302-8314. [PMID: 35976464 DOI: 10.1245/s10434-022-12353-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 07/21/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND The term uterine smooth muscle tumor of uncertain malignant potential (STUMP) indicates a rare, equivocal entity between benign leiomyomas and leiomyosarcomas. In the present study, we evaluated a comprehensive range of clinical, surgical, and pathological features in a large multicenter series of patients with STUMP to identify risk factors for recurrence. METHODS This is a retrospective study performed by collecting consecutive cases diagnosed between January 2000 and December 2020 in five tertiary centers. Associations between STUMP recurrence and clinicopathological characteristics as well as surgical treatment modality were investigated. RESULTS Eighty-seven patients affected by STUMP were considered. Of them, 18 cases (20.7%) recurred: 11 as leiomyosarcoma (LMS) and 7 as STUMP. The mean time to recurrence was 79 months. We found that fragmentation/morcellation, epithelioid features, high mitotic count, Ki-67 value > 20%, progesterone receptor (PR) < 83%, and p16 diffuse expression were associated with higher risk of recurrence and shorter recurrence-free survival (RFS). Furthermore, morcellation/fragmentation and mitotic count remained independent risk factors for recurrence and shorter RFS after multivariate analysis, while the presence of epithelioid features was an independent risk factor for recurrence only. CONCLUSIONS Our results suggest that morcellation is associated with risk of recurrence and shorter RFS, thus it should be avoided if a STUMP is suspected preoperatively. Epithelioid features, high proliferation activity, low PR expression, and diffuse p16 expression are also unfavorable prognostic factors, so patients presenting these features should be closely followed up.
Collapse
Affiliation(s)
- Fulvio Borella
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy.
| | - Stefano Cosma
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | | | | | | | - Pierre Meeus
- Léon Bérard Comprehensive Cancer Center, Lyon, France
| | | | | | - Giulia Scotto
- Department of Oncology, University of Turin, Turin, Italy
| | | | - Nicoletta Biglia
- Division of Obstetrics and Gynecology - A.O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Luca Fuso
- Division of Obstetrics and Gynecology - A.O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Luca Mariani
- Division of Obstetrics and Gynecology - A.O. Ordine Mauriziano, University of Turin, Turin, Italy
| | - Dorella Franchi
- Preventive Gynecology Unit, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Ida Pino
- Preventive Gynecology Unit, European Institute of Oncology IRCCS, Milan, Italy
| | - Gianluca Bertschy
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Mario Preti
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Chiara Benedetto
- Division of Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science University Hospital, University of Turin, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University and City of Health and Science, Turin, Italy
| |
Collapse
|
14
|
Porpiglia M, Borella F, Chieppa P, Brino C, Ala A, Marra V, Castellano I, Benedetto C. Carbon tattooing of axillary lymph nodes in breast cancer patients before neoadjuvant chemotherapy: A retrospective analysis. Tumori 2022:3008916221107712. [PMID: 35751383 DOI: 10.1177/03008916221107712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study aimed to investigate the feasibility and accuracy of tattooing suspicious axillary lymph nodes with carbon suspension at the time of breast cancer (BC) diagnosis and the intraoperative correspondence between tattooed lymph node (TLN) and sentinel lymph node (SLN) in patients who underwent neoadjuvant chemotherapy (NACT). METHODS In this retrospective study, we analyzed consecutive BC patients who underwent NACT, between April 2019 and May 2021, at the Breast Unit of Sant'Anna Hospital in Turin, Italy. Before NACT, all suspicious biopsied lymph nodes were marked with carbon suspension. All SLNs, TLNs, and axillary nodal dissection specimens were sent for histopathological examination. RESULTS The study group included a total of 49 patients with BC. The overall identification rate of TLNs was 83.7% (41/49; 95%, confidence interval - CI 0.70-0.92). In patients who underwent target axillary dissection (TAD) the carbon tattooing had an intraoperative identification rate of 84.4% (27/32; 95% CI 0.67-0.95) while, in the case of axillary lymph node dissection, TLNs were detected in 82.3% (14/17; 95% CI 0.56-0.96) of patients. The correlation between TLN and SLN was 71.8% (23/32). CONCLUSIONS These results confirmed that tattooing axillary lymph nodes has an acceptable identification rate. We also confirmed that this procedure, in addition to SLN biopsy, improves the accuracy of surgical axillary staging.
Collapse
Affiliation(s)
- Mauro Porpiglia
- Department of Surgical Sciences, Gynecology and Obstetrics 1, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy.,Breast Unit, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy
| | - Fulvio Borella
- Department of Surgical Sciences, Gynecology and Obstetrics 1, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy.,Breast Unit, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy
| | - Pierluigi Chieppa
- Department of Surgical Sciences, Gynecology and Obstetrics 1, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy
| | - Carola Brino
- Department of Surgical Sciences, Gynecology and Obstetrics 1, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy
| | - Ada Ala
- Department of Surgery, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy
| | - Vincenzo Marra
- Department of Radiology, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, A.O.U. City of Health and Science of Turin, Turin, Italy
| | - Chiara Benedetto
- Department of Surgical Sciences, Gynecology and Obstetrics 1, A.O.U. City of Health and Science of Turin, S. Anna Hospital, Turin, Italy
| |
Collapse
|
15
|
Borella F, Cosma S, Ferraioli D, Preti M, Gallio N, Valabrega G, Scotto G, Rolfo A, Castellano I, Cassoni P, Bertero L, Benedetto C. From Uterus to Brain: An Update on Epidemiology, Clinical Features, and Treatment of Brain Metastases From Gestational Trophoblastic Neoplasia. Front Oncol 2022; 12:859071. [PMID: 35493999 PMCID: PMC9045690 DOI: 10.3389/fonc.2022.859071] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
In this review, we provide the state of the art about brain metastases (BMs) from gestational trophoblastic neoplasia (GTN), a rare condition. Data concerning the epidemiology, clinical presentation, innovations in therapeutic modalities, and outcomes of GTN BMs are comprehensively presented with particular attention to the role of radiotherapy, neurosurgery, and the most recent chemotherapy regimens. Good response rates have been achieved thanks to multi-agent chemotherapy, but brain involvement by GTNs entails significant risks for patients’ health since sudden and extensive intracranial hemorrhages are possible. Moreover, despite the evolution of treatment protocols, a small proportion of these patients ultimately develops a resistant disease. To tackle this unmet clinical need, immunotherapy has been recently proposed. The role of this novel option for this subset of patients as well as the achieved results so far are also discussed.
Collapse
Affiliation(s)
- Fulvio Borella
- Division of Gynecology and Obstetrics 1, "City of Health and Science University Hospital", University of Turin, Turin, Italy.,Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Stefano Cosma
- Division of Gynecology and Obstetrics 1, "City of Health and Science University Hospital", University of Turin, Turin, Italy.,Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | - Mario Preti
- Division of Gynecology and Obstetrics 1, "City of Health and Science University Hospital", University of Turin, Turin, Italy.,Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Niccolò Gallio
- Division of Gynecology and Obstetrics 1, "City of Health and Science University Hospital", University of Turin, Turin, Italy.,Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | - Giulia Scotto
- Department of Oncology, University of Torino, Torino, Italy
| | - Alessandro Rolfo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, "City of Health and Science University Hospital", University of Turin, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, "City of Health and Science University Hospital", University of Turin, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, "City of Health and Science University Hospital", University of Turin, Turin, Italy
| | - Chiara Benedetto
- Division of Gynecology and Obstetrics 1, "City of Health and Science University Hospital", University of Turin, Turin, Italy.,Department of Surgical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
16
|
Fusco N, Rizzo A, Costarelli L, Santinelli A, Cerbelli B, Scatena C, Macrì E, Pietribiasi F, d’Amati G, Sapino A, Castellano I. Pathological examination of breast cancer samples before and after neoadjuvant therapy: recommendations from the Italian Group for the Study of Breast Pathology - Italian Society of Pathology (GIPaM-SIAPeC). Pathologica 2022; 114:104-110. [PMID: 35414722 PMCID: PMC9248246 DOI: 10.32074/1591-951x-747] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/30/2022] Open
Abstract
Neoadjuvant therapy (NAT) in breast cancer is administered to downstage the tumor, de-escalate surgery, and provide prognostic information that can be used to tailor subsequent adjuvant therapy. In this respect, the pathological evaluation of both pre-NAT biopsies and post-NAT surgical specimens is crucial to precisely assess the treatment response. With the increasing possibilities of NAT protocols and the rising number of eligible patients, it has become extremely important to standardize the pathological response assessment. Here, we provide an update on the recommendations of the Italian Group for the Study of Breast Pathology - the Italian Society of Pathology (GIPaM-SIAPeC) for the analysis of breast cancer samples before and after NAT.
Collapse
|
17
|
Gambella A, Falco EC, Benazzo G, Osella-Abate S, Senetta R, Castellano I, Bertero L, Cassoni P. The Importance of Being “That” Colorectal pT1: A Combined Clinico-Pathological Predictive Score to Improve Nodal Risk Stratification. Front Med (Lausanne) 2022; 9:837876. [PMID: 35237635 PMCID: PMC8882765 DOI: 10.3389/fmed.2022.837876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/14/2022] [Indexed: 11/24/2022] Open
Abstract
The management of endoscopically resected pT1 colorectal cancer (CRC) relies on nodal metastasis risk estimation based on the assessment of specific histopathological features. Avoiding the overtreatment of metastasis-free patients represents a crucial unmet clinical need. By analyzing a consecutive series of 207 pT1 CRCs treated with colectomy and lymphadenectomy, this study aimed to develop a novel clinicopathological score to improve pT1 CRC metastasis prediction. First, we established the clinicopathological profile of metastatic cases: lymphovascular invasion (OR: 23.8; CI: 5.12–110.9) and high-grade tumor budding (OR: 5.21; CI: 1.60–16.8) correlated with an increased risk of nodal metastasis, while age at diagnosis >65 years (OR: 0.26; CI: 0.09–0.71) and high tumor-infiltrating lymphocytes (OR: 0.19; CI: 0.06–0.59) showed a protective effect. Combining these features, we built a five-tier risk score that, applied to our series, identified cases with a higher risk (score ≥ 2) of nodal metastasis (OR: 7.7; CI: 2.4–24.4). Notably, a score of 0 was only assigned to cases with no metastases (13/13 cases) and all the score 4 samples (2/2 cases) showed nodal metastases. In conclusion, we developed an effectively combined score to assess pT1 CRC nodal metastasis risk. We believe that its adoption within a multidisciplinary pT1 unit could improve patients' clinical management and limit surgical overtreatment.
Collapse
Affiliation(s)
- Alessandro Gambella
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Giacomo Benazzo
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simona Osella-Abate
- Molecular Pathology Unit, “Città della Salute e della Scienza di Torino” University Hospital, Turin, Italy
| | - Rebecca Senetta
- Pathology Unit, Department of Oncology, University of Turin, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- *Correspondence: Luca Bertero
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
18
|
Suárez-Cabrera F, Encinoso M, Artiles A, Castellano I, Melián C, Jaber JR. A mediastinal mass causing Budd-Chiari-like syndrome in a cat. Iran J Vet Res 2022; 23:380-384. [PMID: 36874185 PMCID: PMC9984135 DOI: 10.22099/ijvr.2022.42203.6136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/24/2022] [Accepted: 11/01/2022] [Indexed: 03/07/2023]
Abstract
Background Budd-Chiari syndrome (BCS) is considered a rare condition in cats that is characterized by the obstruction of the hepatic venous outflow tract from the level of the small hepatic veins to the level of the termination of the inferior vena cava into the right atrium in the absence of cardiac or pericardial disease, or sinusoidal obstruction syndrome. Case description This report presents a 13-year-old cat with a two-week history of progressive lethargy, inappetence, weight loss, and abdominal distension. Findings/treatment and outcome The radiological study was consistent with pleural effusion, as well as alveolar and interstitial pulmonary patterns. Ultrasonography confirmed hepatic venin congestion and ascites. Abdominocentesis revealed a modified transudate. A computed tomography (CT) angiography showed a mass at the level of the caudal mediastinum that compressed the caudal vena cava (CVC). Mediastinal lymphoma was considered the most likely differential diagnosis. These findings were interpreted as Budd-Chiari-like syndrome (BCLS) secondary to a mediastinal mass although, unfortunately, no further diagnostic or treatment procedures were accepted by the owners. BCLS is a rare condition in cats, where most of the reported cases occurred as a result of obstruction of the caudal vena cava. In this report, BCLS was caused by a mass located in the caudal mediastinum oppressing the caudal vena cava. Conclusion This is the first report of BCLS in cats diagnosed by CT angiography, and it shows the value of this technique to define the origin and extent of the mass and to evaluate the presence or absence of metastatic lesions.
Collapse
Affiliation(s)
- F Suárez-Cabrera
- Ph.D. Student in Anatomy, Department of Morphology, Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - M Encinoso
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - A Artiles
- Los Tarahales Veterinary Hospital, Las Palmas de Gran Canaria, Spain
| | - I Castellano
- Ph.D. Student in Anatomy, Department of Morphology, Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - C Melián
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - J R Jaber
- Department of Morphology, Faculty of Veterinary Medicine, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| |
Collapse
|
19
|
Metovic J, Cascardi E, Uccella S, Maragliano R, Querzoli G, Osella-Abate S, Pittaro A, La Rosa S, Bogina G, Cassoni P, Marchiò C, Sapino A, Castellano I, Papotti M. Neuroendocrine neoplasms of the breast: diagnostic agreement and impact on outcome. Virchows Arch 2022; 481:839-846. [PMID: 36243799 PMCID: PMC9734208 DOI: 10.1007/s00428-022-03426-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 01/25/2023]
Abstract
The classification of breast neuroendocrine neoplasms (Br-NENs) was modified many times over the years and is still a matter of discussion. In the present study, we aimed to evaluate the diagnostic reproducibility and impact on patient outcomes of the most recent WHO 2019 edition of breast tumor classification, namely, for neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). This multicentric observational study included 287 breast neoplasms with NE differentiation. The cases were blindly classified by three independent groups of dedicated breast and/or endocrine pathologists following the 2019 guidelines. Diagnostic concordance and clinical impact were assessed. We observed only a moderate overall diagnostic agreement across the three centers (Cohen's kappa 0.4532) in distinguishing NET from solid papillary carcinomas (SPCs) and no special type carcinomas (NST) with NE differentiation. Br-NENs were diagnosed in 122/287 (42.5%) cases, subclassified as 11 NET G1 (3.8%), 84 NET G2 (29.3%), and 27 NEC (9.4%), the latter group consisting of 26 large-cell and 1 small-cell NECs. The remaining 165/287 (57.5%) cases were labeled as non-NEN, including SPC, mucinous, NST, and mixed NE carcinomas. While NET and non-NEN cases had a comparable outcome, the diagnosis of NECs showed negative impact on disease-free interval compared to NETs and non-NENs (p = 0.0109). In conclusion, the current diagnostic classification of Br-NENs needs further adjustments regarding morphological and immunohistochemical criteria to increase the diagnostic reproducibility among pathologists. Our data suggest that, apart from high-grade small- and large-cell NECs, Br-NENs behave like non-NEN breast carcinomas and should be managed similarly.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - Eliano Cascardi
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy
| | - Silvia Uccella
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Roberta Maragliano
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Giulia Querzoli
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, Pathology Unit, Città Della Salute E Della Scienza Hospital, Turin, Italy
| | - Alessandra Pittaro
- Department of Medical Sciences, Pathology Unit, Città Della Salute E Della Scienza Hospital, Turin, Italy
| | - Stefano La Rosa
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Giuseppe Bogina
- Department of Pathology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar Di Valpolicella, Verona, Italy
| | - Paola Cassoni
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Caterina Marchiò
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy ,Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Anna Sapino
- Candiolo Cancer Institute, Pathology Division, FPO-IRCCS, Candiolo, Italy ,Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy.
| | - Mauro Papotti
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| |
Collapse
|
20
|
Abstract
According to the 2019 WHO classification of breast tumors, neuroendocrine neoplasms (NENs) are classified into well-differentiated NE tumors (NET) and poorly differentiated NE carcinomas (NEC), while other breast cancers (BCs) of special and no special type with neuroendocrine (NE) features are not incorporated in this scheme anymore. We aimed to assess whether INSM1, a novel NE marker, could have a role in breast NEN subtyping. We selected 63 BCs operated from 2003 to 2018, classified as BCs with NE features, with available clinico-pathological data. Following 2019 WHO criteria, this cohort was reclassified into 37 NETs/NECs, the remaining 26 tumors representing solid-papillary (7), mucinous (7), and mixed type (12) carcinomas with NE differentiation. Chromogranin A (CGA) and synaptophysin (SYN) immunostains were reviewed, and INSM1 was tested by immunohistochemistry. Thirty CGA- and SYN-negative no special type BCs served as negative control. INSM1 was expressed in 52/63 cases of the whole cohort (82.54%). INSM1 positive and negative cases had no significantly different clinico-pathological characteristics. INSM1 expression was not significantly different between the newly reclassified NET/NEC group and other BCs with NE features. No immunoexpression was observed in control BCs. The sensitivity and specificity of INSM1 for the NE phenotype was 82.5% and 100%, respectively, compared to 61.9% and 100% for CGA, and 95.2 and 100% for SYN. In conclusion, INSM1 is as accurate as traditional NE biomarkers to identify NE differentiation in BC. In analogy to standard NE markers, INSM1 could not distinguish NET and NEC from the other BC histotypes with NE differentiation.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy.
| | - Eleonora Marinelli
- Department of Oncology, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
- Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, 10060, Candiolo, Italy
| | - Paola Cassoni
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| |
Collapse
|
21
|
Salgado R, Peg V, Rüschoff J, Vincent-Salomon A, Castellano I, Perner S, Van de Vijver K, Quinn CM, Varga Z. Gene expression signatures for tailoring adjuvant chemotherapy of luminal breast cancer: the pathologists' perspective. Ann Oncol 2021; 32:1316-1321. [PMID: 34461263 DOI: 10.1016/j.annonc.2021.08.1993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/04/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- R Salgado
- Department of Pathology, GZA-ZNA Hospitals, Antwerp, Belgium; Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - V Peg
- Universidad Autónoma de Barcelona, Barcelona, Spain; Department of Pathology, Vall D'Hebron University Hospital, Barcelona, Spain; Spanish Biomedical Research Network Centre in Oncology (CIBERONC), Madrid, Spain
| | - J Rüschoff
- Targos Molecular Pathology GmbH and Institute of Pathology Nordhessen, Kassel, Germany
| | - A Vincent-Salomon
- Department of Pathology and Department of Diagnostic and Theranostic Medicine, Institut Curie, PSL Research University, Paris, France
| | - I Castellano
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - S Perner
- Institute of Pathology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; Pathology, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - K Van de Vijver
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - C M Quinn
- Department of Pathology, St. Vincent's University Hospital, Dublin and University College Dublin, Dublin, Ireland
| | - Z Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
22
|
Bitonto V, Ruggiero MR, Pittaro A, Castellano I, Bussone R, Broche LM, Lurie DJ, Aime S, Baroni S, Geninatti Crich S. Low-Field NMR Relaxometry for Intraoperative Tumour Margin Assessment in Breast-Conserving Surgery. Cancers (Basel) 2021; 13:cancers13164141. [PMID: 34439294 PMCID: PMC8392401 DOI: 10.3390/cancers13164141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Breast cancer is the most diagnosed cancer for women, and clear surgical margins in breast-conserving surgery (BCS) are essential for preventing recurrence. In this study, the potential of fast field-cycling 1H-NMR relaxometry as a new tool for intraoperative margin assessment was evaluated. The technique allows the determination of the tissue proton relaxation rates as a function of the applied magnetic field on small tissue samples excised from surgical specimens, at the margins of tumour resection, prior to histopathological analysis. It was found that a good accuracy in margin assessment, i.e., a sensitivity of 92% and a specificity of 85%, can be achieved. The discriminating ability shown by the relaxometric assay relies mainly on the difference of fat/water content between healthy and tumour cells. The information obtained has the potential to support the surgeon in real-time margin assessment during BCS. Abstract As conserving surgery is routinely applied for the treatment of early-stage breast cancer, the need for new technology to improve intraoperative margin assessment has become increasingly important. In this study, the potential of fast field-cycling 1H-NMR relaxometry as a new diagnostic tool was evaluated. The technique allows the determination of the tissue proton relaxation rates (R1), as a function of the applied magnetic field, which are affected by the changes in the composition of the mammary gland tissue occurring during the development of neoplasia. The study involved 104 small tissue samples obtained from surgical specimens destined for histopathology. It was found that a good accuracy in margin assessment, i.e., a sensitivity of 92% and a specificity of 85%, can be achieved by using two quantifiers, namely (i) the slope of the line joining the R1 values measured at 0.02 and 1 MHz and (ii) the sum of the R1 values measured at 0.39 and 1 MHz. The method is fast, and it does not rely on the expertise of a pathologist or cytologist. The obtained results suggest that a simplified, low-cost, automated instrument might compete well with the currently available tools in margin assessment.
Collapse
Affiliation(s)
- Valeria Bitonto
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
| | - Maria Rosaria Ruggiero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
| | - Alessandra Pittaro
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.P.); (I.C.)
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.P.); (I.C.)
| | | | - Lionel M. Broche
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK; (L.M.B.); (D.J.L.)
| | - David J. Lurie
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK; (L.M.B.); (D.J.L.)
| | - Silvio Aime
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
- IRCCS SDN, Via E. Gianturco 113, 80143 Napoli, Italy
| | - Simona Baroni
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
- Correspondence:
| | - Simonetta Geninatti Crich
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (V.B.); (M.R.R.); (S.A.); (S.G.C.)
| |
Collapse
|
23
|
Pira C, Castellano I, De Francesco A, Durelli P, Finocchiaro C, Ippolito M, Migliaretti G. BREAST CANCER RESPONSE TO NEOADJUVANT CHEMOTHERAPY AND CALORIC RESTRICTION. Nutrition 2021. [DOI: 10.1016/j.nut.2021.111330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
24
|
Rakha EA, Brogi E, Castellano I, Quinn C. Spindle cell lesions of the breast: a diagnostic approach. Virchows Arch 2021; 480:127-145. [PMID: 34322734 PMCID: PMC8983634 DOI: 10.1007/s00428-021-03162-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/27/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022]
Abstract
Spindle cell lesions of the breast comprise a heterogeneous group of lesions, ranging from reactive and benign processes to aggressive malignant tumours. Despite their rarity, they attract the attention of breast pathologists due to their overlapping morphological features and diagnostic challenges, particularly on core needle biopsy (CNB) specimens. Pathologists should recognise the wide range of differential diagnoses and be familiar with the diverse morphological appearances of these lesions to make an accurate diagnosis and to suggest proper management of the patients. Clinical history, immunohistochemistry, and molecular assays are helpful in making a correct diagnosis in morphologically challenging cases. In this review, we present our approach for the diagnosis of breast spindle cell lesions, highlighting the main features of each entity and the potential pitfalls, particularly on CNB. Breast spindle cell lesions are generally classified into two main categories: bland-appearing and malignant-appearing lesions. Each category includes a distinct list of differential diagnoses and a panel of immunohistochemical markers. In bland-appearing lesions, it is important to distinguish fibromatosis-like spindle cell metaplastic breast carcinoma from other benign entities and to distinguish fibromatosis from scar tissue. The malignant-appearing category includes spindle cell metaplastic carcinoma, stroma rich malignant phyllodes tumour, other primary and metastatic malignant spindle cell tumours of the breast, including angiosarcoma and melanoma, and benign mimics such as florid granulation tissue and nodular fasciitis.
Collapse
Affiliation(s)
- Emad A Rakha
- Division of Cancer and Stem Cells, School of Medicine, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, NG5 1PB, UK.
| | - Edi Brogi
- Department of Pathology At Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Cecily Quinn
- Histopathology, BreastCheck, Irish National Breast Screening Programme and St. Vincent's University Hospital, Dublin, Ireland.,University College Dublin, Dublin, Ireland
| |
Collapse
|
25
|
Meduri B, De Rose F, Cabula C, Castellano I, Da Ros L, Grassi MM, Orrù S, Puglisi F, Trimboli RM, Ciabattoni A. Hypofractionated breast irradiation: a multidisciplinary review of the Senonetwork study group. Med Oncol 2021; 38:67. [PMID: 33970358 DOI: 10.1007/s12032-021-01514-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/23/2021] [Indexed: 11/30/2022]
Abstract
The multidisciplinary management represents a crucial part of the care for cancer patients, resulting in better clinical and process outcomes, with evidence of improved survival among different cancer primary sites, including breast. According with international recommendations established by the European Society of Breast Cancer Specialists (EUSOMA), all breast-cancer patients have to be evaluated by a multidisciplinary team including radiologist, pathologist, surgeon, medical oncologist and radiation oncologist. Thus, variations in clinical practice of each specialty should be discussed and shared with all team members to guarantee a fruitful cooperation among the involved specialists. During the last decades, radiation treatment was deeply changed by the evidence-based adoption of hypofractionated radiotherapy (HFRT) as standard of treatment in patients with early-stage breast cancer undergoing conservative surgery. Moreover, mature randomized data have showed that partial breast irradiation (PBI) is an effective and safe alternative to whole breast irradiation in selected patients with low-risk early-stage breast cancer. Based on this background, we reviewed indications and critical issues of HFRT and PBI analyzing impact of their adoption from a multidisciplinary perspective.
Collapse
Affiliation(s)
- Bruno Meduri
- Radiation Oncology Unit, University Hospital of Modena, Modena, Italy
| | - Fiorenza De Rose
- Radiation Oncology Unit, Santa Chiara Hospital, Largo Medaglie d'oro 9, 38123, Trento, Italy.
| | - Carlo Cabula
- Oncologic Surgery, A. Businco Oncologic Hospital, Cagliari, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, "City of Health and Science University Hospital", University of Turin, Turin, Italy
| | - Lucia Da Ros
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Sandra Orrù
- Pathology Unit, P.O. Businco, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Fabio Puglisi
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.,Department of Medicine, University of Udine, Udine, Italy
| | - Rubina Manuela Trimboli
- Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30 San Donato Milanese, 20097, Milan, Italy
| | | |
Collapse
|
26
|
Metovic J, Bragoni A, Osella-Abate S, Borella F, Benedetto C, Gualano MR, Olivero E, Scaioli G, Siliquini R, Ferrando PM, Bertero L, Sapino A, Cassoni P, Castellano I. Clinical Relevance of Tubular Breast Carcinoma: Large Retrospective Study and Meta-Analysis. Front Oncol 2021; 11:653388. [PMID: 33996576 PMCID: PMC8117349 DOI: 10.3389/fonc.2021.653388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Tubular carcinoma (TC) is a low proliferative grade 1 (G1) breast cancer (BC). Despite its favorable outcome and allegedly lower aggressiveness, patients are treated like other luminal G1 BC, with radiotherapy (RT) and hormonal therapy (HT). We performed: (1) a retrospective study comparing a TC cohort and a control series of luminal G1 BC and (2) a systematic review and meta-analysis focused on TC outcome. Materials and Methods: We selected a series of 572 G1 luminal BC patients [111 TC, 350 not otherwise specified (NOS), and 111 special-type (ST) BC] with follow-up and clinico-pathological data, who underwent local excision followed by RT at Città della Salute e della Scienza Hospital, Turin. Moreover, 22 and 13 studies were included in qualitative and quantitative meta-analysis, respectively. Results: TCs were generally smaller (≤10 mm) (P < 0.001), with lower lymph node involvement (P < 0.001). TCs showed no local and/or distant recurrences, while 16 NOS and 2 ST relapsed (P = 0.036). Kaplan–Meier curves confirmed more favorable TC outcome (DFI: log-rank test P = 0.03). Meta-analysis data, including the results of our study, showed that the pooled DFI rate was 96.4 and 91.8% at 5 and 10 years, respectively. Meta-regression analyses did not show a significant influence of RT nor HT on the DFI at 10 years. Conclusions: Compared to the other G1 BCs, TCs have an excellent outcome. The meta-analysis shows that TC recurrences are infrequent, and HT and RT have limited influence on prognosis. Hence, accurate diagnosis of TC subtype is critical to ensuring a tailored treatment approach.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Alberto Bragoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simona Osella-Abate
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fulvio Borella
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - Chiara Benedetto
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - Maria Rosaria Gualano
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Elena Olivero
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Giacomo Scaioli
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Roberta Siliquini
- Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy
| | - Pietro Maria Ferrando
- Plastic Surgery Unit, Department of General and Specialistic Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Anna Sapino
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.,Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
27
|
Metovic J, Abate SO, Borella F, Vissio E, Bertero L, Mariscotti G, Durando M, Senetta R, Ala A, Benedetto C, Sapino A, Cassoni P, Castellano I. The lobular neoplasia enigma: management and prognosis in a long follow-up case series. World J Surg Oncol 2021; 19:80. [PMID: 33736652 PMCID: PMC7976718 DOI: 10.1186/s12957-021-02182-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many oncologists debate if lobular neoplasia (LN) is a risk factor or an obligatory precursor of more aggressive disease. This study has three aims: (i) describe the different treatment options (surgical resection vs observation), (ii) investigate the upgrade rate in surgically treated patients, and (iii) evaluate the long-term occurrences of aggressive disease in both operated and unoperated patients. METHODS A series of 122 patients with LN bioptic diagnosis and follow-up information were selected. Clinical, radiological, and pathological data were collected from medical charts. At definitive histology, either invasive or ductal carcinoma in situ was considered upgraded lesions. RESULTS Atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), and high-grade LN (HG-LN) were diagnosed in 44, 63, and 15 patients, respectively. The median follow-up was 9.5 years. Ninety-nine patients were surgically treated, while 23 underwent clinical-radiological follow-up. An upgrade was observed in 28/99 (28.3%). Age ≥ 54 years (OR 4.01, CI 1.42-11.29, p = 0.009), Breast Imaging-Reporting and Data System (BI-RADS) categories 4-5 (OR 3.76, CI 1.37-10.1, p = 0.010), and preoperatory HG-LN diagnosis (OR 8.76, 1.82-42.27, p = 0.007) were related to upgraded/aggressive disease. During follow-up, 8 patients developed an ipsilateral malignant lesion, four of whom were not initially operated (4/23, 17%). CONCLUSIONS BI-RADS categories 4-5, HG-LN diagnosis, and age ≥ 54 years were features associated with an upgrade at definitive surgery. Moreover, 17% of unoperated cases developed an aggressive disease, emphasizing that LN patients need close surveillance due to the long-term risk of breast cancer.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Simona Osella Abate
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Fulvio Borella
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy
| | - Elena Vissio
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Luca Bertero
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Giovanna Mariscotti
- Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Manuela Durando
- Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Rebecca Senetta
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Ada Ala
- Breast Surgery Unit, Department of General and Specialistic Surgery, AOU Città della Salute e della Scienza, Turin, Italy
| | - Chiara Benedetto
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Via Ventimiglia 3, 10126, Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
- Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, Str. Prov. 142, 10060, Candiolo, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Isabella Castellano
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.
| |
Collapse
|
28
|
Williams TA, Gomez-Sanchez CE, Rainey WE, Giordano TJ, Lam AK, Marker A, Mete O, Yamazaki Y, Zerbini MCN, Beuschlein F, Satoh F, Burrello J, Schneider H, Lenders JWM, Mulatero P, Castellano I, Knösel T, Papotti M, Saeger W, Sasano H, Reincke M. International Histopathology Consensus for Unilateral Primary Aldosteronism. J Clin Endocrinol Metab 2021; 106:42-54. [PMID: 32717746 PMCID: PMC7765663 DOI: 10.1210/clinem/dgaa484] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/20/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Develop a consensus for the nomenclature and definition of adrenal histopathologic features in unilateral primary aldosteronism (PA). CONTEXT Unilateral PA is the most common surgically treated form of hypertension. Morphologic examination combined with CYP11B2 (aldosterone synthase) immunostaining reveals diverse histopathologic features of lesions in the resected adrenals. PATIENTS AND METHODS Surgically removed adrenals (n = 37) from 90 patients operated from 2015 to 2018 in Munich, Germany, were selected to represent the broad histologic spectrum of unilateral PA. Five pathologists (Group 1 from Germany, Italy, and Japan) evaluated the histopathology of hematoxylin-eosin (HE) and CYP11B2 immunostained sections, and a consensus was established to define the identifiable features. The consensus was subsequently used by 6 additional pathologists (Group 2 from Australia, Brazil, Canada, Japan, United Kingdom, United States) for the assessment of all adrenals with disagreement for histopathologic diagnoses among group 1 pathologists. RESULTS Consensus was achieved to define histopathologic features associated with PA. Use of CYP11B2 immunostaining resulted in a change of the original HE morphology-driven diagnosis in 5 (14%) of 37 cases. Using the consensus criteria, group 2 pathologists agreed for the evaluation of 11 of the 12 cases of disagreement among group 1 pathologists. CONCLUSION The HISTALDO (histopathology of primary aldosteronism) consensus is useful to standardize nomenclature and achieve consistency among pathologists for the histopathologic diagnosis of unilateral PA. CYP11B2 immunohistochemistry should be incorporated into the routine clinical diagnostic workup to localize the likely source of aldosterone production.
Collapse
Affiliation(s)
- Tracy Ann Williams
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy
- Correspondence and Reprint Requests: Tracy Ann Williams PhD, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Ziemssenstr. 1, D-80336 München, Germany. E-mail: ; Hironobu Sasano MD, PhD, Department of Pathology, Tohoku University School of Medicine, 2-1 Seiryou-machi, Aoba-Ku, Sendai, Japan 980–8575. E-mail:
| | - Celso E Gomez-Sanchez
- Endocrine Division, G.V. (Sonny) Montgomery VA Medical Center, and Department of Pharmacology and Toxicology and Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - William E Rainey
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
- Division of Metabolism, Endocrine, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Thomas J Giordano
- Division of Metabolism, Endocrine, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Pathology and Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Alfred K Lam
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Alison Marker
- Department of Histopathology, Cambridge University NHS Foundation Trust, Cambridge, UK
| | - Ozgur Mete
- Department of Pathology, University Health Network, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Yuto Yamazaki
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Felix Beuschlein
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
| | - Fumitoshi Satoh
- Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jacopo Burrello
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Holger Schneider
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany
| | - Jacques W M Lenders
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medicine III, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Isabella Castellano
- Division of Pathology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Thomas Knösel
- Institute of Pathology, Ludwig-Maximilians-Universität München, Germany
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | | | - Hironobu Sasano
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Correspondence and Reprint Requests: Tracy Ann Williams PhD, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Ziemssenstr. 1, D-80336 München, Germany. E-mail: ; Hironobu Sasano MD, PhD, Department of Pathology, Tohoku University School of Medicine, 2-1 Seiryou-machi, Aoba-Ku, Sendai, Japan 980–8575. E-mail:
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany
| |
Collapse
|
29
|
Osella-Abate S, Vignale C, Annaratone L, Nocifora A, Bertero L, Castellano I, Avallone G, Conti L, Quaglino P, Picciotto F, Senetta R, Papotti MG, Cassoni P, Ribero S. Microenvironment in cutaneous melanomas: a gene expression profile study may explain the role of histological regression. J Eur Acad Dermatol Venereol 2020; 35:e35-e38. [PMID: 32580236 DOI: 10.1111/jdv.16784] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/09/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022]
Affiliation(s)
- S Osella-Abate
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - C Vignale
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - L Annaratone
- Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - A Nocifora
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - L Bertero
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - I Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - G Avallone
- Pathology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - L Conti
- Pathology Unit, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - P Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| | - F Picciotto
- Dermatologic Surgery Section, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - R Senetta
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - M G Papotti
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - P Cassoni
- Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy
| | - S Ribero
- Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy
| |
Collapse
|
30
|
Mariscotti G, Durando M, Ruggirello I, Belli P, Caumo F, Nori J, Zuiani C, Tagliafico A, Bicchierai G, Romanucci G, Londero V, Campanino PP, Bussone R, Castellano I, Mule' A, Caneva A, Bianchi S, Di Loreto C, Bergamasco L, Calabrese M, Fonio P, Houssami N. Lesions of uncertain malignant potential of the breast (B3) on vacuum-assisted biopsy for microcalcifications: Predictors of malignancy. Eur J Radiol 2020; 130:109194. [PMID: 32795765 DOI: 10.1016/j.ejrad.2020.109194] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/04/2020] [Accepted: 07/21/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate clinical, radiologic and pathologic features of B3 lesions diagnosed on VABB targeting microcalcifications, for identifying predictors of malignancy. METHOD This retrospective multi-centre study included consecutive VABBs performed over a 10-year period on suspicious microcalcifications not associated with other radiological signs diagnosed as B3 on histology from VABB, with outcomes ascertained by surgical excision. Clinical, demographic, radiological and histological (B3 subcategory) data were collected. For statistical analysis (univariate and binary logistic regression), the primary outcome variable was the upgrade rate to malignancy after surgery. Predictors of upgrade to malignancy were identified from clinical, demographic, radiological and pathological variables (including B3 subcategory). RESULTS Amongst 447 VABBs, there were 57(12.7 %) upgrades to malignancy at surgical histology (36 DCIS and 21 invasive cancer). At univariate analysis, variables significantly associated with increased risk of upgrade to malignancy were age>55 years (p = 0.01), lesion size>10 mm (p < 0.0001), BI-RADS 4b-c and 5 (p = 0.0001), and fine pleomorphic morphology (p = 0.002) of microcalcifications. Binary logistic regression confirmed as significant independent risk factors age, lesion size and BI-RADS category (p = 0.02, 0.02 and 0.0006 respectively). Amongst subcategories of B3 lesions, lobular neoplasia was significantly(p = 0.04) associated with upgrade, confirmed as an independent risk factor [p = 0.03, OR = 2.3(1.1-4.7)]. Flat epithelial atypia was significantly(p = 0.004) associated with reduced odds of upgrade, but binary logistic regression showed only borderline association [p = 0.052, OR = 0.4(0.2-1.01)]. CONCLUSIONS Across B3 lesions diagnosed on histology from VABB of suspicious microcalcifications, older age, size>10 mm, BI-RADS category≥ 4b on imaging, and lobular neoplasia were risk factors for upgrade to malignancy. This information can be used to discuss patients' tailored management options.
Collapse
Affiliation(s)
- Giovanna Mariscotti
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Citta della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Manuela Durando
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Citta della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Irene Ruggirello
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Citta della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Paolo Belli
- Department of Radiological, Radiotherapic and Hematological Sciences, Fondazione Policlinico A. Gemelli IRCCS - Universita' Cattolica Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Francesca Caumo
- Radiology Department, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.
| | - Jacopo Nori
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
| | - Chiara Zuiani
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, P.le S. Maria della Misericordia, 15, 33100, Udine, Italy.
| | - Alberto Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy; Department of Radiology, IRCCS San Martino Hospital, 16132, Genova, Italy.
| | - Giulia Bicchierai
- Diagnostic Senology Unit, Azienda Ospedaliero-Universitaria Careggi, Largo G. A. Brambilla 3, 50134, Florence, Italy.
| | - Giovanna Romanucci
- UOSD Breast Unit ULSS9, Ospedale di Marzana, Piazzale Lambranzi, 1, 37034 Verona, Italy.
| | - Viviana Londero
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, P.le S. Maria della Misericordia, 15, 33100, Udine, Italy.
| | - Pier Paolo Campanino
- Breast Imaging Service, Ospedale Koelliker, C.so Galileo Ferraris 256, 10100, Torino, Italy.
| | - Riccardo Bussone
- Breast Surgery, Presidio Sanitario Ospedale Cottolengo, Via S. Giuseppe Benedetto Cottolengo, 9, 10152, Torino, Italy.
| | | | - Antonino Mule'
- Department of Histopathology and Cytodiagnosis, Fondazione Policlinico A. Gemelli IRCCS -Universita' Cattolica Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | | | - Simonetta Bianchi
- Division of Pathological Anatomy, Department of medical and surgical critical care, University of Florence, Florence, Italy.
| | - Carla Di Loreto
- Anatomic Pathology Institute, Department of Medicine (DAME), University of Udine, Udine, Italy.
| | - Laura Bergamasco
- Department of Surgical Sciences, University of Torino, A. O. U. Citta della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, C.so Bramante 88, 10126, Torino, Italy.
| | - Massimo Calabrese
- Diagnostic Senology, IRCCS - Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
| | - Paolo Fonio
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Citta della Salute e della Scienza di Torino - Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Nehmat Houssami
- Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney 2006, NSW, Australia.
| |
Collapse
|
31
|
Bertero L, Dalla Dea G, Osella-Abate S, Botta C, Castellano I, Morra I, Pollo B, Calatozzolo C, Patriarca S, Mantovani C, Rudà R, Tardivo V, Zenga F, Garbossa D, Papotti M, Soffietti R, Ricardi U, Cassoni P. Prognostic Characterization of Higher-Grade Meningiomas: A Histopathological Score to Predict Progression and Outcome. J Neuropathol Exp Neurol 2020; 78:248-256. [PMID: 30689922 PMCID: PMC6380327 DOI: 10.1093/jnen/nly127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Higher-grade meningiomas (WHO grade II and III) represent a diagnostic and prognostic challenge. We assessed the pathological and molecular characteristics of 94 higher-grade meningiomas (85 grade II, 9 grade III) to identify novel prognostic parameters. Higher mitotic count (p = 0.018), diffuse (≥50%) prominent nucleoli (p < 0.001), and sheeting (p < 0.001) were associated with recurrence. Lower SSTR2a-positive cells median rate (p = 0.048) and TERT promoter mutations (p = 0.014) were associated with recurrence and patient death, respectively; further analyses did not identify other outcome associations. Presence of Ki67 hot spots was associated with a shorter progression-free survival (PFS), independently of WHO grade at multivariate analysis (HR = 3.35, p = 0.008). Necrosis was related to a poorer overall survival (OS) at univariate (focal: HR = 4.55, p = 0.041 and diffuse: HR = 7.38, p = 0.020) and Kaplan-Meier analyses. A prognostic score was designed based on previous results: Presence of diffuse (≥50%) prominent nucleoli (0/1 point), diffuse (≥50%) sheeting (0/1 point), focal (<50%) or diffuse (≥50%) necrosis (0/1/2 points), and Ki67 hot spots (0/1 point). A total score ≥4 predicted poorer PFS and OS by Kaplan-Meier (PFS: 1.7 vs 6.4 years, p < 0.001 and OS: 5.2 vs 10.8 years, p = 0.001) and multivariate (PFS: HR = 5.98, p < 0.001 and OS: HR = 2.99, p = 0.048) analyses. These results were confirmed in an independent series of 58 grade II meningiomas (PFS: HR = 7.22, p = 0.002 and OS: HR = 9.69, p = 0.003). These associations and the integrated score could complement WHO grading.
Collapse
Affiliation(s)
- Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy
| | - Giulia Dalla Dea
- Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy
| | - Simona Osella-Abate
- Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy
| | - Cristina Botta
- Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy
| | - Isabella Morra
- Pathology Unit, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Bianca Pollo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico "C. Besta," Milano, Italy
| | - Chiara Calatozzolo
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico "C. Besta," Milano, Italy
| | - Silvia Patriarca
- Piedmont Cancer Registry - CRPT, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Cristina Mantovani
- Radiation Oncology Unit, Department of Oncology, University of Turin, Torino, Italy
| | - Roberta Rudà
- Neuro-oncology Unit, Department of Neurosciences, University of Turin, Torino, Italy
| | - Valentina Tardivo
- Neurosurgery Unit, Department of Neurosciences, University of Turin, Torino, Italy
| | - Francesco Zenga
- Neurosurgery Unit, Department of Neurosciences, University of Turin, Torino, Italy
| | - Diego Garbossa
- Neurosurgery Unit, Department of Neurosciences, University of Turin, Torino, Italy
| | - Mauro Papotti
- Pathology Unit, Department of Oncology, University of Turin, Torino, Italy
| | - Riccardo Soffietti
- Neuro-oncology Unit, Department of Neurosciences, University of Turin, Torino, Italy
| | - Umberto Ricardi
- Radiation Oncology Unit, Department of Oncology, University of Turin, Torino, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Torino, Italy
| |
Collapse
|
32
|
Elhasnaoui J, Miano V, Ferrero G, Doria E, Leon AE, Fabricio ASC, Annaratone L, Castellano I, Sapino A, De Bortoli M. DSCAM-AS1-Driven Proliferation of Breast Cancer Cells Involves Regulation of Alternative Exon Splicing and 3'-End Usage. Cancers (Basel) 2020; 12:cancers12061453. [PMID: 32503257 PMCID: PMC7352480 DOI: 10.3390/cancers12061453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/30/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022] Open
Abstract
DSCAM-AS1 is a cancer-related long noncoding RNA with higher expression levels in Luminal A, B, and HER2-positive Breast Carcinoma (BC), where its expression is strongly dependent on Estrogen Receptor Alpha (ERα). DSCAM-AS1 expression is analyzed in 30 public datasets and, additionally, by qRT-PCR in tumors from 93 BC patients, to uncover correlations with clinical data. Moreover, the effect of DSCAM-AS1 knockdown on gene expression and alternative splicing is studied by RNA-Seq in MCF-7 cells. We confirm DSCAM-AS1 overexpression in high grade Luminal A, B, and HER2+ BCs and find a significant correlation with disease relapse. In total, 908 genes are regulated by DSCAM-AS1-silencing, primarily involved in the cell cycle and inflammatory response. Noteworthily, the analysis of alternative splicing and isoform regulation reveals 2085 splicing events regulated by DSCAM-AS1, enriched in alternative polyadenylation sites, 3′UTR (untranslated region) shortening and exon skipping events. Finally, the DSCAM-AS1-interacting splicing factor heterogeneous nuclear ribonucleoprotein L (hnRNPL) is predicted as the most enriched RBP for exon skipping and 3′UTR events. The relevance of DSCAM-AS1 overexpression in BC is confirmed by clinical data and further enhanced by its possible involvement in the regulation of RNA processing, which is emerging as one of the most important dysfunctions in cancer.
Collapse
Affiliation(s)
- Jamal Elhasnaoui
- Center for Molecular Systems Biology, University of Turin, Orbassano, 10043 Turin, Italy; (J.E.); (V.M.); (G.F.)
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy;
| | - Valentina Miano
- Center for Molecular Systems Biology, University of Turin, Orbassano, 10043 Turin, Italy; (J.E.); (V.M.); (G.F.)
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy;
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - Giulio Ferrero
- Center for Molecular Systems Biology, University of Turin, Orbassano, 10043 Turin, Italy; (J.E.); (V.M.); (G.F.)
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy;
- Department of Computer Science, University of Turin, 10149 Turin, Italy
| | - Elena Doria
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy;
| | - Antonette E. Leon
- Regional Center for Biomarkers, Department of Clinical Pathology, Azienda ULSS 3 Serenissima, Campo SS Giovanni e Paolo 6777, 30122 Venice, Italy; (A.E.L.); (A.S.C.F.)
| | - Aline S. C. Fabricio
- Regional Center for Biomarkers, Department of Clinical Pathology, Azienda ULSS 3 Serenissima, Campo SS Giovanni e Paolo 6777, 30122 Venice, Italy; (A.E.L.); (A.S.C.F.)
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (L.A.); (I.C.); (A.S.)
| | - Isabella Castellano
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (L.A.); (I.C.); (A.S.)
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (L.A.); (I.C.); (A.S.)
- Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Turin, Italy
| | - Michele De Bortoli
- Center for Molecular Systems Biology, University of Turin, Orbassano, 10043 Turin, Italy; (J.E.); (V.M.); (G.F.)
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043 Turin, Italy;
- Correspondence: ; Tel.: +39-0116-7050-58
| |
Collapse
|
33
|
Rangel N, Rondon-Lagos M, Annaratone L, Aristizábal-Pachon AF, Cassoni P, Sapino A, Castellano I. AR/ER Ratio Correlates with Expression of Proliferation Markers and with Distinct Subset of Breast Tumors. Cells 2020; 9:cells9041064. [PMID: 32344660 PMCID: PMC7226480 DOI: 10.3390/cells9041064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 01/11/2023] Open
Abstract
The co-expression of androgen (AR) and estrogen (ER) receptors, in terms of higher AR/ER ratio, has been recently associated with poor outcome in ER-positive (ER+) breast cancer (BC) patients. The aim of this study was to analyze if the biological aggressiveness, underlined in ER+ BC tumors with higher AR/ER ratio, could be due to higher expression of genes related to cell proliferation. On a cohort of 47 ER+ BC patients, the AR/ER ratio was assessed by immunohistochemistry and by mRNA analysis. The expression level of five gene proliferation markers was defined through TaqMan®-qPCR assays. Results were validated using 979 BC cases obtained from gene expression public databases. ER+ BC tumors with ratios of AR/ER ≥ 2 have higher expression levels of cellular proliferation genes than tumors with ratios of AR/ER < 2, in both the 47 ER+ BC patients (P < 0.001) and in the validation cohort (P = 0.005). Moreover, BC cases with ratios of AR/ER ≥ 2 of the validation cohort were mainly assigned to luminal B and HER2-enriched molecular subtypes, typically characterized by higher proliferation and poorer prognosis. These data suggest that joint routine evaluation of AR and ER expression may identify a unique subset of tumors, which show higher levels of cellular proliferation and therefore a more aggressive behavior.
Collapse
Affiliation(s)
- Nelson Rangel
- School of Biological Sciences, Universidad Pedagógica y Tecnológica de Colombia, Tunja 150003, Colombia
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Correspondence: or (N.R.); (I.C.); Tel.: +57-3185087624 (N.R.); +39-3298368290 (I.C.)
| | - Milena Rondon-Lagos
- School of Biological Sciences, Universidad Pedagógica y Tecnológica de Colombia, Tunja 150003, Colombia
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy
| | | | - Paola Cassoni
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy
| | - Isabella Castellano
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
- Correspondence: or (N.R.); (I.C.); Tel.: +57-3185087624 (N.R.); +39-3298368290 (I.C.)
| |
Collapse
|
34
|
Bertero L, Spadi R, Osella-Abate S, Mariani S, Castellano I, Gambella A, Racca P, Morino M, Cassoni P. Metastatic colorectal cancer prior to expanded RAS assessment: evidence from long-term outcome analysis of a real-life cohort within a dedicated colorectal cancer unit. World J Surg Oncol 2020; 18:65. [PMID: 32241284 PMCID: PMC7118966 DOI: 10.1186/s12957-020-01844-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Molecular assessment and treatment of metastatic colorectal cancer (mCRC) quickly evolved during the last decades, hampering longitudinal evaluation of prognostic markers. The aim of this study was to evaluate prognostic predictors of long-term survival in a retrospective series of mCRC, treated prior to the expanded RAS assessment era. METHODS mCRC cases treated at the Città della Salute e della Scienza University Hospital (Turin, Italy) between January 2004 and December 2012 were evaluated, including cases with ≥ 5-year follow-up only. Long-term survival was defined as an overall survival (OS) ≥ 4 years based on the observed OS interquartile range values. Univariate/multivariate Cox proportional hazards regression models were performed to assess the prognostic significance of the clinical/biological features, while binary logistic regression models were used to verify their associations with long-term survival. RESULTS Two hundred and forty-eight mCRC cases were included and analyzed. Sixty out of two hundred and forty-eight (24%) patients were long-term survivors. Univariate binary logistic regression analysis demonstrated a significant association between long-term survival and age at diagnosis < 65 (OR = 2.28, p = 0.007), single metastatic site (OR = 1.89, p = 0.039), surgical resection of metastases (OR = 5.30, p < 0.001), local non-surgical treatment of metastases (OR = 4.74, p < 0.001), and a bevacizumab-including first-line treatment schedule (OR = 2.19, p = 0.024). Multivariate binary logistic regression analysis confirmed the prognostic significance of surgical resection of metastases (OR = 3.96, p < 0.001), local non-surgical treatment of metastases (OR = 3.32, p = 0.001), and of bevacizumab-including first-line treatment schedule (OR = 2.49, p = 0.024). CONCLUSION Long-term survival could be achieved in a significant rate of patients with mCRC even in an era of limited molecular characterization. Local treatment of metastases proved to be a significant predictor of long-term survival.
Collapse
Affiliation(s)
- Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Rosella Spadi
- Colorectal Cancer Unit, Città della Salute e della Scienza University Hospital of Turin, Turin, Italy
| | - Simona Osella-Abate
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Sara Mariani
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Alessandro Gambella
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Patrizia Racca
- Colorectal Cancer Unit, Città della Salute e della Scienza University Hospital of Turin, Turin, Italy
| | - Mario Morino
- General Surgery Unit, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
35
|
Mariscotti G, Durando M, Tagliafico A, Campanino PP, Bosco D, Casella C, Bussone R, Ala A, Castellano I, Sapino A, Bergamasco L, Fonio P, Houssami N. Corrigendum to "Preoperative breast cancer staging with multi-modality imaging and surgical outcomes" [Eur. J. Radiol. 122 (2020) 108766]. Eur J Radiol 2020; 126:108919. [PMID: 32197783 DOI: 10.1016/j.ejrad.2020.108919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Giovanna Mariscotti
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Manuela Durando
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Alberto Tagliafico
- Department of Experimental Medicine, University of Genoa, IRCCS AOU San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, 16132, Genoa, Italy.
| | - Pier Paolo Campanino
- Breast Imaging Service, Ospedale Koelliker, C.so Galileo Ferraris 256, 10100, Torino, Italy.
| | - Davide Bosco
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Cristina Casella
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Riccardo Bussone
- Breast Surgery, Presidio Sanitario Ospedale Cottolengo, Via S. Giuseppe Benedetto Cottolengo, 9, 10152, Torino, Italy.
| | - Ada Ala
- Breast Surgery, Department of Surgery, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero S. Anna, Via Ventimiglia, 1, 10126, Torino, Italy.
| | - Isabella Castellano
- Department of Medical Sciences, University of Turin, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Santena, 7, Torino, Italy.
| | - Anna Sapino
- Candiolo Cancer Institute FPO-IRCCs, 10060, Candiolo, Torino, Italy; Department of Medical Sciences, University of Torino, 10126, Torino, Italy.
| | - Laura Bergamasco
- Department of Surgical Sciences, University of Torino, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, C.so Bramante 88, 10126, Torino, Italy.
| | - Paolo Fonio
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Nehmat Houssami
- Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, 2006, NSW, Australia.
| |
Collapse
|
36
|
Mariscotti G, Durando M, Pavan LJ, Tagliafico A, Campanino PP, Castellano I, Bussone R, Ala A, De Sanctis C, Bergamasco L, Fonio P, Houssami N. Intraoperative breast specimen assessment in breast conserving surgery: comparison between standard mammography imaging and a remote radiological system. Br J Radiol 2020; 93:20190785. [PMID: 32101449 DOI: 10.1259/bjr.20190785] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare standard specimen mammography (SSM) with remote intraoperative specimen mammography (ISM) assessment in breast conserving-surgery (BCS) based on operative times, intraoperative additional excision (IAE) and re-intervention rates. METHODS AND MATERIALS We retrospectively compared 129 consecutive patients (136 lesions) who had BCS with SSM at our centre between 11/2011 and 02/2013 with 138 consecutive patients (144 lesions) who underwent BCS with ISM between 08/2014 and 02/2015.SSM or ISM were performed to confirm the target lesions within the excised specimen and margin adequacy. The utility of SMM and ISM was evaluated considering pathology as gold-standard, using χ2 or Fisher's exact tests for comparison of categorical variables, and non-parametric Mann-Whitney test for continuous variables. RESULTS The two groups did not statistically differ for age (p = 0.20), lesion size (p = 0.29) and morphology (p = 0.82) or tumor histology type (p = 0.65). Intraoperative time was significantly longer (p < 0.00001) for SSM (132 ± 43 min) than for ISM (90 ± 42 min). The proportions requiring IAE did not significantly differ between SSM group (39/136 lesions (40%)) and ISM group (52/144 lesions (57%)) (p = 0.19), overall and in stratified analysis by mammographic features. Re-intervention rates were not statistically different between the two groups [SSM:19/136 (14%), ISM:13/144 (9%); p = 0.27]. CONCLUSION The introduction of ISM in BCS significantly reduced surgical time but did not change IAE and re-intervention rates, highlighting facilitated communication between surgeons and radiologists. ADVANCES IN KNOWLEDGE Compared to standard mammography imaging, the use of ISM significantly reduced surgical time.
Collapse
Affiliation(s)
- Giovanna Mariscotti
- Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette Via Genova 3, 10126 Torino, Italy
| | - Manuela Durando
- Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette Via Genova 3, 10126 Torino, Italy
| | - Luca Jacopo Pavan
- Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette Via Genova 3, 10126 Torino, Italy
| | - Alberto Tagliafico
- Department of Experimental Medicine, University of Genoa IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, 16132 Genoa, Italy
| | - Pier Paolo Campanino
- Breast Imaging Service. Ospedale Koelliker.C.so Galileo Ferraris 256 - 10100, Torino, Italy
| | - Isabella Castellano
- Department of Medical Sciences, University of Turin, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Santena, 7, Torino, Italy
| | - Riccardo Bussone
- Breast Surgery, Presidio Sanitario Ospedale Cottolengo Via S. Giuseppe Benedetto Cottolengo, 9 - 10152, Torino, Italy
| | - Ada Ala
- Breast Surgery, Department of Surgery, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero S. Anna, Via Ventimiglia, 1, 10126, Torino, Italy
| | - Corrado De Sanctis
- Department of Gynecology and Obstetrics, Breast Unit, A.O.U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero S. Anna, Via Ventimiglia, 1, 10126 Torino, Italy
| | - Laura Bergamasco
- Department of Surgical Sciences, University of Torino, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, C.so Bramante 88, 10126 Torino, Italy
| | - Paolo Fonio
- Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette Via Genova 3, 10126 Torino, Italy
| | - Nehmat Houssami
- Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, 2006, NSW, Australia
| |
Collapse
|
37
|
Mariscotti G, Durando M, Tagliafico A, Campanino PP, Bosco D, Casella C, Bussone R, Ala A, Castellano I, Sapino A, Bergamasco L, Fonio P, Houssami N. Preoperative breast cancer staging with multi-modality imaging and surgical outcomes. Eur J Radiol 2019; 122:108766. [PMID: 31809942 DOI: 10.1016/j.ejrad.2019.108766] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 11/10/2019] [Accepted: 11/20/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE To compare the rates of mastectomy and re-operation after breast-conserving surgery (BCS) among patients who had different pre-operative multi-modality imaging, hence identifying significant predictors of mastectomy and re-operations within each group. METHOD Retrospective study of consecutive patients with primary breast cancer treated January 2010 - December 2016, divided in 3 groups, undergoing pre-operative local staging respectively with conventional imaging modalities only (2D mammography, ultrasound (US)), conventional imaging and tomosynthesis (DBT) and/or MRI. The primary outcome was identification of significant predictors of surgical outcomes, within each group. Study variables examined in univariate analysis were age, lesion dimension, breast density, multifocality, tumor size, histology, and if associated with outcomes they were included in binary logistic regression analysis. RESULTS Amongst 1547 patients, patient and tumor characteristics differed across the three groups, as did mastectomy rates which were 18 % (102/562) for 2D + US, 36 % (154/428) for 2D + DBT + US, 45 % (250/557) for 2D+/-DBT + US + MRI(p < 0.001). Variables strongly associated with mastectomy were larger lesions and multifocality (as was multi-modality group). Re-operation rate showed an opposite trend: 12.2 % (56/459) for 2D + US, 8 % (22/272) for 2D + DBT + US, 6.5 % (20/306) for 2D+/-DBT + US + MRI. Re-operation rate for 2D+/-DBT + US + MRI was lower than for 2D + US (p = 0.01) but similar to 2D + DBT + US (p = 0.58). Patients who had 2D + US and re-operations had significantly larger lesions, more underestimation, higher proportion of invasive carcinoma with in-situ component than those who did not require re-operation. CONCLUSIONS Patients who had larger tumors and multifocal disease were more frequently staged by adding DBT and/or MRI to conventional imaging (mammography and US) which was associated with more extensive surgical treatment but lower reoperation rates.
Collapse
Affiliation(s)
- Giovanna Mariscotti
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Manuela Durando
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Alberto Tagliafico
- Department of Experimental Medicine, University of Genoa, IRCCS AOU San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, 16132, Genoa, Italy.
| | - Pier Paolo Campanino
- Breast Imaging Service, Ospedale Koelliker, C.so Galileo Ferraris 256, 10100, Torino, Italy.
| | - Davide Bosco
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Cristina Casella
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Riccardo Bussone
- Breast Surgery, Presidio Sanitario Ospedale Cottolengo, Via S. Giuseppe Benedetto Cottolengo, 9, 10152, Torino, Italy.
| | - Ada Ala
- Breast Surgery, Department of Surgery, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero S. Anna, Via Ventimiglia, 1, 10126, Torino, Italy.
| | - Isabella Castellano
- Department of Biomedical Sciences and Human Oncology, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Santena, 7, Torino, Italy.
| | - Anna Sapino
- Fondazione del Piemonte per l'Oncologia (FPO), Candiolo Cancer Institute (IRCCs), 10060, Candiolo, Torino, Italy.
| | - Laura Bergamasco
- Department of Surgical Sciences, University of Torino, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, C.so Bramante 88, 10126, Torino, Italy.
| | - Paolo Fonio
- Radiology Institute, University of Turin, Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Via Genova 3, 10126, Torino, Italy.
| | - Nehmat Houssami
- Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, 2006, NSW, Australia.
| |
Collapse
|
38
|
Monticelli M, Zeppa P, Zenga F, Altieri R, Mammi M, Bertero L, Castellano I, Cassoni P, Melcarne A, La Rocca G, Sabatino G, Ducati A, Garbossa D. The post-surgical era of GBM: How molecular biology has impacted on our clinical management. A review. Clin Neurol Neurosurg 2019; 170:120-126. [PMID: 29777944 DOI: 10.1016/j.clineuro.2018.05.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/04/2018] [Accepted: 05/13/2018] [Indexed: 12/31/2022]
Abstract
Glioblastoma (GBM) is the most common glioma in adults, with incidence increasing by 3% per year. According to the World Health Organization Classification of Central Nervous System Tumors, GBM is considered a grade IV tumor due to its malignant behavior. The aim of this review is to summarize the main biological aspects of GBM. In particular, we focused our attention on those alterations which have been proven to have an impact on patients' outcome, mainly in terms of overall survival (OS), or on the tumor response to therapies. We have also analyzed the cellular biology and the interactions between GBM and the surrounding environment.
Collapse
Affiliation(s)
- M Monticelli
- Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy.
| | - P Zeppa
- Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - F Zenga
- Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - R Altieri
- Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - M Mammi
- Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - L Bertero
- Pathology Unit, Department of Medical Science, University of Turin, Turin, Italy
| | - I Castellano
- Pathology Unit, Department of Medical Science, University of Turin, Turin, Italy
| | - P Cassoni
- Pathology Unit, Department of Medical Science, University of Turin, Turin, Italy
| | - A Melcarne
- Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - G La Rocca
- Institute of Neurosurgery, Catholic University of Rome, Agostino Gemelli Hospital, Rome, Italy
| | - G Sabatino
- Institute of Neurosurgery, Catholic University of Rome, Agostino Gemelli Hospital, Rome, Italy
| | - A Ducati
- Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy
| | - D Garbossa
- Neurosurgical Unit, Department of Neuroscience, University of Turin, Turin, Italy
| |
Collapse
|
39
|
Borella F, Lucchino F, Bertero L, Ribotta M, Castellano I, Carosso A, Cosma S, Katsaros D, Benedetto C. Clinico-pathological features of gynecological myopericytoma: a challenging diagnosis in an exceptional location. Virchows Arch 2019; 475:763-770. [PMID: 31410559 DOI: 10.1007/s00428-019-02645-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/29/2019] [Accepted: 05/31/2019] [Indexed: 02/01/2023]
Abstract
Myopericytomas (MPC) are rare mesenchymal tumors, originating from the perivascular myoid cells. They predominantly occur in the skin and superficial soft tissues of the extremities, while visceral involvement is rare. Histological features and clinical course are usually benign. To the best of our knowledge, MPC is still an uncharacterized tumor entity of the female internal genital tract. We describe three MPC cases involving the female internal genital tract: (1) a uterine wall MPC arising in a 49-year-old woman with progressive pelvic/abdominal pain; (2) a cervix MPC of a 49-year-old woman who presented with metrorrhagia, and (3) a MPC presenting as a simple ovarian cyst in a 26-year-old woman with pain located in the left iliac fossa. All patients were surgically treated, and recurrence occurred in two cases. The histological and immunohistochemical findings, supporting the diagnosis of MPC, are presented; in particular, one case showed characteristics pointing towards an uncertain biological behavior/low-grade malignancy. A literature search was conducted to identify previous reports of gynecological MPC and for possible alternative diagnoses. Leiomyoma, epithelioid leiomyoma, angioleiomyoma, perivascular epithelioid cell tumor, solitary fibrous tumor, and low-grade endometrial stromal sarcoma should be considered in the differential diagnosis. Awareness of possible occurrence of this rare neoplasm in the female genital tract is important to reach a correct diagnosis in the spectrum of mesenchymal tumors. Considering the risk of recurrence, we recommend careful evaluation of surgical margins and complete surgical removal whenever possible.
Collapse
Affiliation(s)
- Fulvio Borella
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Fabiola Lucchino
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.
| | - Marisa Ribotta
- Pathology Unit, Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Andrea Carosso
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Stefano Cosma
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Dionyssios Katsaros
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Chiara Benedetto
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| |
Collapse
|
40
|
Pozzi G, Castellano I, D'Anna MR, De Matteis A, Milanesio L, Durando M, Ferrando PM, Bergamasco L, Ala A. B3-lesions of the breast: Risk of malignancy after vacuum-assisted breast biopsy versus core needle biopsy diagnosis. Breast J 2019; 25:1308-1309. [PMID: 31338958 DOI: 10.1111/tbj.13476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Giada Pozzi
- Breast Surgery Unit, Department of General and Specialistic Surgery, AOU Città della Salute e della Scienza, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maria Rosa D'Anna
- Breast Surgery Unit, Department of General and Specialistic Surgery, AOU Città della Salute e della Scienza, Turin, Italy
| | - Antonio De Matteis
- Breast Surgery Unit, Department of General and Specialistic Surgery, AOU Città della Salute e della Scienza, Turin, Italy
| | - Luisella Milanesio
- Breast Screening Unit (Regional Reference Center), AOU Città della Salute e della Scienza, Turin, Italy
| | - Manuela Durando
- Radiology Unit, Department of Medical Sciences, AOU Città della Salute e della Scienza, Turin, Italy
| | - Pietro Maria Ferrando
- Plastic Surgery Unit, Department of General and Specialistic Surgery, AOU Città della Salute e della Scienza, Turin, Italy
| | - Laura Bergamasco
- Department of Medical and Surgical Sciences, Division of Statistics, AOU Città della Salute e della Scienza, Turin, Italy
| | - Ada Ala
- Breast Surgery Unit, Department of General and Specialistic Surgery, AOU Città della Salute e della Scienza, Turin, Italy
| |
Collapse
|
41
|
Foschini MP, Miglio R, Fiore R, Baldovini C, Castellano I, Callagy G, Bianchi S, Kaya H, Amendoeira I, Querzoli P, Poli F, Scatena C, Cordoba A, Pietribiasi F, Kovács A, Faistova H, Cserni G, Quinn C. Pre-operative management of Pleomorphic and florid lobular carcinoma in situ of the breast: Report of a large multi-institutional series and review of the literature. Eur J Surg Oncol 2019; 45:2279-2286. [PMID: 31301938 DOI: 10.1016/j.ejso.2019.07.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 06/30/2019] [Accepted: 07/05/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Pleomorphic and Florid Lobular carcinoma in situ (P/F LCIS) are rare variants of LCIS, the exact nature of which is still debated. AIM To collect a large series of P/F LCIS diagnosed on preoperative biopsies and evaluate their association with invasive carcinoma and high grade duct carcinoma in situ (DCIS). Data obtained were compared with those reported in the literature. METHODS A multi-institutional series of P/F LCIS was retrieved. All cases were diagnosed on pre-operative biopsies, which was followed by an open surgical excision. Data on post-operative histopathology were available. A literature review was performed. RESULTS A total of 117 cases were collected; invasive carcinoma and/or DCIS was present in 78/117 cases (66.7%). Seventy cases of P/F LCIS were pure on biopsy and 31 of these showed pathological upgrade in post-surgical specimens. Pre-operative biopsy accuracy was 47/78 (60.3%); pre-operative biopsy underestimation of cancer was 31/78 (39,7.%). In the literature review papers, invasive carcinoma or DCIS was associated with 274 of 418 (65.5%) cases of P/F LCIS. Pre-operative biopsy accuracy was 66% (181/274) whereas pre-operative biopsy underestimation of cancer was 33.9% (93/274). CONCLUSIONS The data presented here indicate that P/F LCIS is frequently associated with invasive carcinoma or high grade DCIS and that pre-operative biopsy is associated with an underestimation of malignancy. Open surgery is indicated when P/F LCIS is diagnosed pre-operatively.
Collapse
Affiliation(s)
- Maria P Foschini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Unit of Anatomic Pathology at Bellaria Hospital, Bologna (Italy). C. Baldovini present address is Anatomic Pathology Unit, Santa Maria delle Croci Hospital, Viale Randi 5, 48121, Ravenna, Italy.
| | - Rossella Miglio
- Department of Statistical Sciences, University of Bologna, Via Belle Arti 42, 40100, Bologna, Italy.
| | - Roberta Fiore
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Unit of Anatomic Pathology at Bellaria Hospital, Bologna (Italy). C. Baldovini present address is Anatomic Pathology Unit, Santa Maria delle Croci Hospital, Viale Randi 5, 48121, Ravenna, Italy.
| | - Chiara Baldovini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Unit of Anatomic Pathology at Bellaria Hospital, Bologna (Italy). C. Baldovini present address is Anatomic Pathology Unit, Santa Maria delle Croci Hospital, Viale Randi 5, 48121, Ravenna, Italy.
| | - Isabella Castellano
- Department of Medical Sciences, Pathology Unit, University of Turin, Via Santena 7, 10126, Turin, Italy.
| | - Grace Callagy
- Discipline of Pathology, Lambe Institute for Translational Research, NUI Galway, Costello Road, Galway, Ireland.
| | - Simonetta Bianchi
- Department of Surgery and Translational Medicine, Section of Pathological Anatomy, Careggi University Hospital, Largo G. Alessandro Brambilla, 3, 50134, Firenze, Florence, Italy.
| | - Handan Kaya
- Department of Pathology, Marmara University Hospital, Istanbul, 81190, Turkey.
| | - Isabel Amendoeira
- Department of Pathology, University Hospital of S. João, Porto and Ipatimup, 4200-319, Porto, Portugal.
| | - Patrizia Querzoli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Unit of Anatomic Pathology, St Anna University Hospital, Via A. Moro 8, 44124, Ferrara, Italy.
| | - Francesca Poli
- Pathology Unit, Ospedale Nuovo "S.Maria della Scaletta", via Montericco 4, 40026, Imola, Bologna, Italy.
| | - Cristian Scatena
- Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126, Pisa, Italy.
| | - Alicia Cordoba
- Department of Pathology Section A, Navarra Health Service, Hospital Complex of Navarra, Irunlarrea 4, 31008, Pamplona, Spain.
| | - Francesca Pietribiasi
- Pathology Division, Santa Croce Hospital, Vicolo Tiziano 5, 10024, Moncalieri, TO, Italy.
| | - Anikó Kovács
- Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Hana Faistova
- The Fingerland Department of Pathology, Charles University Faculty of Medicine and University Hospital Hradec Králové, Sokolská 581, Hradec Králové, 500 03, Czech Republic.
| | - Gábor Cserni
- Bacs-Kiskun County Teaching Hospital, Nyiriut 38, Kecskemet, 6000, Hungary and Department of Pathology, University of Szeged, Allomas u. 1, Szeged, 6720, Hungary.
| | - Cecily Quinn
- Department of Histopathology, St. Vincent's University Hospital, Dublin, and School of Medicine, University College, Dublin, Ireland.
| |
Collapse
|
42
|
Ponti A, Ronco G, Lynge E, Tomatis M, Anttila A, Ascunce N, Broeders M, Bulliard JL, Castellano I, Fitzpatrick P, Frigerio A, Hofvind S, Májek O, Segnan N, Taplin S. Low-grade screen-detected ductal carcinoma in situ progresses more slowly than high-grade lesions: evidence from an international multi-centre study. Breast Cancer Res Treat 2019; 177:761-765. [PMID: 31250357 DOI: 10.1007/s10549-019-05333-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/18/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE Nuclear grade is an important indicator of the biological behaviour of ductal carcinoma in situ (DCIS). De-escalation of treatment has been suggested for low-grade DCIS. Our aim is to estimate the relative rate of progression of DCIS by nuclear grade by analysing the distribution of nuclear grade by detection at initial or subsequent screening. METHODS We asked International Cancer Screening Network sites to complete, based on their screening and clinical databases, an aggregated data file on DCIS detection, diagnosis and treatment. RESULTS Eleven screening programs reported 5068 screen-detected pure DCIS in nearly 7 million screening tests in women 50-69 years of age. For all programs combined, low-grade DCIS were 20.1% (range 11.4-31.8%) of graded DCIS, intermediate grade 31.0% and high grade 48.9%. Detection rates decreased more steeply from initial to subsequent screening in low compared to high-grade DCIS: the ratios of subsequent to initial detection rates were 0.39 for low grade, 0.51 for intermediate grade, and 0.75 for high grade (p < 0.001). CONCLUSIONS These results suggest that the duration of the preclinical detectable phase is longer for low than for high-grade DCIS. The findings from this large multi-centre, international study emphasize that the management of low-grade DCIS should be carefully scrutinized in order to minimize overtreatment of screen-detected slow-growing or indolent lesions. The high variation by site in the proportion of low grade suggests that further pathology standardization and training would be beneficial.
Collapse
Affiliation(s)
- Antonio Ponti
- CPO Piemonte, AOU Città della Salute e della Scienza, Via Cavour 31, 10123, Torino, Italy.
| | - Guglielmo Ronco
- CPO Piemonte, AOU Città della Salute e della Scienza, Via Cavour 31, 10123, Torino, Italy
| | - Elsebeth Lynge
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mariano Tomatis
- CPO Piemonte, AOU Città della Salute e della Scienza, Via Cavour 31, 10123, Torino, Italy
| | - Ahti Anttila
- Mass Screening Registry, Finnish Cancer Registry, Helsinki, Finland
| | - Nieves Ascunce
- Breast Cancer Screening Program, Public Health and Labour Institute of Navarra, Pamplona, Spain
| | - Mireille Broeders
- Dutch Expert Centre for Screening and Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Isabella Castellano
- Unit of Pathology, Department of Medical Sciences, University of Torino, Torino, Italy
| | | | - Alfonso Frigerio
- Breast Cancer Screening Reference Centre, AOU Città della Salute e della Scienza, Torino, Italy
| | | | - Ondřej Májek
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Nereo Segnan
- CPO Piemonte, AOU Città della Salute e della Scienza, Via Cavour 31, 10123, Torino, Italy
| | - Stephen Taplin
- Centre for Global Health, National Cancer Institute, Rockville, MD, USA
| | | |
Collapse
|
43
|
Tayal U, King L, Schofield R, Castellano I, Stirrup J, Pontana F, Earls J, Nicol E. Image reconstruction in cardiovascular CT: Part 2 - Iterative reconstruction; potential and pitfalls. J Cardiovasc Comput Tomogr 2019; 13:3-10. [PMID: 31014928 DOI: 10.1016/j.jcct.2019.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/04/2019] [Accepted: 04/15/2019] [Indexed: 12/22/2022]
Abstract
The use of IR in CT previously has been prohibitively complicated and time consuming, however improvements in computer processing power now make it possible on almost all CT scanners. Due to its potential to allow scanning at lower doses, IR has received a lot of attention in the medical literature and has become a successful commercial product. Its use in cardiovascular CT has been driven in part due to concerns about radiation dose and image quality. This manuscript discusses the various vendor permutations of iterative reconstruction (IR) in detail and critically appraises the current clinical research available on the various IR techniques used in cardiovascular CT.
Collapse
Affiliation(s)
- U Tayal
- Department of Cardiovascular CT, Royal Brompton Hospital, London, UK.
| | - L King
- Joint Department of Physics, The Royal Marsden, London, UK.
| | - R Schofield
- Department of Cardiovascular CT, Royal Brompton Hospital, London, UK.
| | - I Castellano
- Joint Department of Physics, The Royal Marsden, London, UK.
| | - J Stirrup
- Department of Cardiology, Royal Berkshire Hospital, Reading, UK.
| | - F Pontana
- Department of Cardiovascular Imaging, Lille University Hospital, France.
| | - J Earls
- George Washington University Hospital, Washington DC, USA.
| | - E Nicol
- Department of Cardiovascular CT, Royal Brompton Hospital, London, UK.
| |
Collapse
|
44
|
Meyer LS, Wang X, Sušnik E, Burrello J, Burrello A, Castellano I, Eisenhofer G, Fallo F, Kline GA, Knösel T, Kocjan T, Lenders JWM, Mulatero P, Naruse M, Nishikawa T, Peitzsch M, Rump LC, Beuschlein F, Hahner S, Gomez-Sanchez CE, Reincke M, Williams TA. Immunohistopathology and Steroid Profiles Associated With Biochemical Outcomes After Adrenalectomy for Unilateral Primary Aldosteronism. Hypertension 2019; 72:650-657. [PMID: 30012870 DOI: 10.1161/hypertensionaha.118.11465] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Unilateral primary aldosteronism (PA) is the most common surgically curable form of hypertension that must be accurately differentiated from bilateral PA for therapeutic management (surgical versus medical). Adrenalectomy results in biochemical cure (complete biochemical success) in almost all patients diagnosed with unilateral PA; the remaining patients with partial or absent biochemical success comprise those with persisting aldosteronism who were misdiagnosed as unilateral PA preoperatively. To identify determinants of postsurgical biochemical outcomes, we compared the adrenal histopathology and the peripheral venous steroid profiles of patients with partial and absent or complete biochemical success after adrenalectomy for unilateral PA. A large multicenter cohort of adrenals from patients with absent and partial biochemical success (n=43) displayed a higher prevalence of hyperplasia (49% versus 21%; P=0.004) and a lower prevalence of solitary functional adenoma (44% versus 79%; P<0.001) compared with adrenals from age- and sex-matched patients with PA with complete biochemical success (n=52). We measured the peripheral plasma steroid concentrations in a subgroup of these patients (n=43) and in a group of patients with bilateral PA (n=27). Steroid profiling was associated with histopathologic phenotypes (solitary functional adenoma, hyperplasia, and aldosterone-producing cell clusters) and classified patients according to biochemical outcome or diagnosis of bilateral PA. If validated, peripheral venous steroid profiling may be a useful tool to guide the decision to perform surgery based on expectations of biochemical outcome after the procedure.
Collapse
Affiliation(s)
- Lucie S Meyer
- From the Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (L.S.M., X.W., E.S., F.B., M.R., T.A.W.)
| | | | - Eva Sušnik
- From the Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (L.S.M., X.W., E.S., F.B., M.R., T.A.W.)
| | - Jacopo Burrello
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Italy (J.B., P.M., T.A.W.)
| | - Alessio Burrello
- Department of Electronics and Telecommunications, Polytechnic University of Turin, Italy (A.B.)
| | - Isabella Castellano
- Division of Pathology, Department of Medical Sciences, University of Torino, Italy (I.C.)
| | - Graeme Eisenhofer
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany (G.E., M.P.).,Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany (G.E., J.W.M.L.)
| | - Francesco Fallo
- Department of Medicine DIMED, University of Padova, Italy (F.F.)
| | - Gregory A Kline
- Department of Medicine, University of Calgary, Alberta, Canada (G.A.K.)
| | - Thomas Knösel
- Institute of Pathology (T. Knösel), Ludwig-Maximilians-University of Munich, Germany
| | - Tomaz Kocjan
- Department of Endocrinology, Diabetes, and Metabolic Diseases, University Medical Centre, Ljubljana, Slovenia (T. Kocjan)
| | - Jacques W M Lenders
- Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany (G.E., J.W.M.L.).,Department of Medicine, Radboud University Medical Center, Nijmegen, The Netherlands (J.W.M.L.)
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Italy (J.B., P.M., T.A.W.)
| | - Mitsuhide Naruse
- Department of Endocrinology, Metabolism, and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan (M.N.)
| | - Tetsuo Nishikawa
- Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Japan (T.N.)
| | - Mirko Peitzsch
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany (G.E., M.P.)
| | - Lars C Rump
- Department of Nephrology, Heinrich-Heine-University, Düsseldorf, Germany (L.C.R.)
| | - Felix Beuschlein
- From the Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (L.S.M., X.W., E.S., F.B., M.R., T.A.W.).,Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Switzerland (F.B.)
| | - Stefanie Hahner
- Department of Internal Medicine I, Endocrinology and Diabetes Unit, University Hospital of Würzburg, Germany (S.H.)
| | - Celso E Gomez-Sanchez
- Division of Endocrinology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS (C.E.G.-S.).,Research and Medicine Services, G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS (C.E.G.-S.)
| | - Martin Reincke
- From the Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (L.S.M., X.W., E.S., F.B., M.R., T.A.W.)
| | - Tracy Ann Williams
- From the Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (L.S.M., X.W., E.S., F.B., M.R., T.A.W.).,Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Italy (J.B., P.M., T.A.W.)
| |
Collapse
|
45
|
Metovic J, Gallino C, Zanon E, Bussone R, Russo R, Vissio E, Annaratone L, Conti L, Papotti M, Cassoni P, Castellano I. Eccrine spiradenoma of the nipple: Case report, differential diagnosis and literature review. Histol Histopathol 2019; 34:909-915. [PMID: 30806477 DOI: 10.14670/hh-18-094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Eccrine spiradenoma is a rare lesion originating from eccrine sweat glands, with only few cases reported in breast tissue: we here describe for the first time, an eccrine spiradenoma arising in the nipple. An 84 year-old woman with a lesion enlarging her right nipple, showing ulcerations and eczema-like changes of the covering skin, was admitted to our hospital. Surgical excision of the central quadrant with nipple-areola complex was performed, followed by histopathological evaluation which revealed an adenoma with predominantly basaloid epithelial cells. The lesion was composed of tightly packed small and large groups of cells, arranged in diffuse alveolar/pseudorosette formations. The small cells expressed p63 and calponin, while a positive expression of CK7 and CD117 was detected in large cells. After careful and detailed examination, excluding various similar entities, a diagnosis of eccrine spiradenoma has been rendered. Although extremely rare, eccrine spiradenoma should be taken into account in the differential diagnosis of subcutaneous primary breast tumors.
Collapse
Affiliation(s)
- Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Chiara Gallino
- Breast Unit, Department of Radiology, Cottolengo Hospital, Turin, Italy
| | - Eugenio Zanon
- Breast Unit, Department of Radiology, Cottolengo Hospital, Turin, Italy
| | - Riccardo Bussone
- Breast Unit, Department of Surgery, Cottolengo Hospital, Turin, Italy
| | - Roberto Russo
- Department of Public Health Sciences and Pediatrics, University of Turin, Cottolengo Hospital, Turin, Italy
| | - Elena Vissio
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Luca Conti
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | |
Collapse
|
46
|
Grasso S, Chapelle J, Salemme V, Aramu S, Russo I, Vitale N, di Cantogno LV, Dallaglio K, Castellano I, Amici A, Centonze G, Sharma N, Lunardi S, Cabodi S, Cavallo F, Lamolinara A, Stramucci L, Moiso E, Provero P, Albini A, Sapino A, Staaf J, Di Fiore PP, Bertalot G, Pece S, Tosoni D, Confalonieri S, Iezzi M, Di Stefano P, Turco E, Defilippi P. Correction: Author Correction: The scaffold protein p140Cap limits ERBB2-mediated breast cancer progression interfering with Rac GTPase-controlled circuitries. Nat Commun 2018; 9:16203. [PMID: 29600801 PMCID: PMC5882465 DOI: 10.1038/ncomms16203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
47
|
Rinella L, Marano F, Paletto L, Fraccalvieri M, Annaratone L, Castellano I, Fortunati N, Bargoni A, Berta L, Frairia R, Catalano MG. Extracorporeal shock waves trigger tenogenic differentiation of human adipose-derived stem cells. Connect Tissue Res 2018; 59:561-573. [PMID: 29316809 DOI: 10.1080/03008207.2018.1424147] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSES Incomplete tendon healing impairs the outcome of tendon ruptures and tendinopathies. Human Adipose-derived Stem Cells (hASCs) are promising for tissue engineering applications. Extracorporeal Shock Waves (ESW) are a leading choice for the treatment of several tendinopathies. In this study, we investigated the effects of ESW treatment and tenogenic medium on the differentiation of hASCs into tenoblast-like cells. MATERIALS AND METHODS hASCs were treated with ESW generated by a piezoelectric device and tenogenic medium. Quantitative real-time PCR was used to check the mRNA expression levels of tenogenic transcription factors, extracellular matrix proteins, and integrins. Western blot and immunofluorescence were used to detect collagen 1 and fibronectin. Collagen fibers were evaluated by Masson staining. Calcium deposition was assessed by Alizarin Red staining. RESULTS The combined treatment improved the expression of the tendon transcription factors scleraxis and eyes absent 2, and of the extracellular matrix proteins fibronectin, collagen I, and tenomodulin. Cells acquired elongated and spindle shaped fibroblastic morphology; Masson staining revealed the appearance of collagen fibers. Finally, the combined treatment induced the expression of alpha 2, alpha 6, and beta 1 integrin subunits, suggesting a possible role in mediating ESW effects. CONCLUSIONS ESW in combination with tenogenic medium improved the differentiation of hASCs toward tenoblast-like cells, providing the basis for ESW and hASCs to be used in tendon tissue engineering.
Collapse
Affiliation(s)
- Letizia Rinella
- a Department of Medical Sciences , University of Turin , Turin , Italy
| | - Francesca Marano
- a Department of Medical Sciences , University of Turin , Turin , Italy
| | - Laura Paletto
- a Department of Medical Sciences , University of Turin , Turin , Italy
| | | | - Laura Annaratone
- a Department of Medical Sciences , University of Turin , Turin , Italy
| | | | - Nicoletta Fortunati
- c Oncological Endocrinology , AO Città della Salute e della Scienza di Torino , Turin , Italy
| | | | | | - Roberto Frairia
- a Department of Medical Sciences , University of Turin , Turin , Italy
| | | |
Collapse
|
48
|
Mariscotti G, Durando M, Houssami N, Berzovini C, Esposito F, Fasciano M, Campanino P, Bosco D, Bussone R, Ala A, Castellano I, Sapino A, Bergamasco L, Fonio P, Gandini G. Preoperative MRI evaluation of lesion–nipple distance in breast cancer patients: thresholds for predicting occult nipple–areola complex involvement. Clin Radiol 2018; 73:735-743. [DOI: 10.1016/j.crad.2018.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 03/14/2018] [Indexed: 10/17/2022]
|
49
|
Marano F, Zunino V, Frairia R, Arvat E, Castellano I, Bosco O, Catalano MG, Fortunati N. Fibulin-1 interacts with Sex Hormone Binding Globulin and is linked to less aggressive estrogen-dependent breast cancers. Life Sci 2018; 207:372-380. [DOI: 10.1016/j.lfs.2018.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/08/2018] [Accepted: 06/21/2018] [Indexed: 12/27/2022]
|
50
|
Rangel N, Fortunati N, Osella-Abate S, Annaratone L, Isella C, Catalano MG, Rinella L, Metovic J, Boldorini R, Balmativola D, Ferrando P, Marano F, Cassoni P, Sapino A, Castellano I. FOXA1 and AR in invasive breast cancer: new findings on their co-expression and impact on prognosis in ER-positive patients. BMC Cancer 2018; 18:703. [PMID: 29970021 PMCID: PMC6029370 DOI: 10.1186/s12885-018-4624-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/21/2018] [Indexed: 11/10/2022] Open
Abstract
Background The role of forkhead-box A1 (FOXA1) and Androgen receptor (AR) in breast cancer (BC) has been extensively studied. However, the prognostic role of their co-expression in Estrogen receptor positive (ER+) BC has not been investigated so far. The aim of the present study was thus to assess the co-expression (protein and mRNA) of FOXA1 and AR in BC patients, in order to evaluate their prognostic impact according to ER status. Methods Immunohistochemical expression of AR and FOXA1 was evaluated on 479 consecutive BC, with complete clinical-pathological and follow up data. Fresh-frozen tissues from 65 cases were available. The expression of AR and FOXA1 with ER was validated using mRNA analyses. Survival and Cox proportional hazard analyses were used to evaluate the relationship between FOXA1, AR and prognosis. Results Expression of ER, AR and FOXA1 was observed in 78, 60 and 85% of cases respectively. Most AR+ cases (97%) were also FOXA1+. The level of FOXA1 mRNA positively correlated with level of both AR mRNA (r = 0.8975; P < 0.001) and ER mRNA (r = 0.7326; P < 0.001). In ER+ BC, FOXA1 was associated with a good prognosis independently of AR expression in the three subgroups analyzed (FOXA1+/AR+; FOXA1+/AR-; FOXA1−/AR-). Multivariate analyses confirmed that FOXA1 may provide more information than AR in Disease-Free Interval (DFI) of ER+ BC patients. Conclusion Our results suggest that in BC the expression of FOXA1 is directly related to the expression of AR. Despite that, FOXA1 is found as superior predicting marker of recurrences compared to AR in ER+ BC patients. Electronic supplementary material The online version of this article (10.1186/s12885-018-4624-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Nelson Rangel
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.,Natural and Mathematical Sciences Faculty, University of the Rosario, Bogotá, Colombia
| | - Nicoletta Fortunati
- Oncological Endocrinology Unit, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Simona Osella-Abate
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Laura Annaratone
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | | | | | - Letizia Rinella
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Jasna Metovic
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Renzo Boldorini
- Division of Pathology, Department of Health Sciences, University of Eastern Piedmont and Maggiore Hospital, Novara, Italy
| | | | - Pietro Ferrando
- Division of Breast Surgery, Department of General and Specialized Surgery, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Francesca Marano
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Paola Cassoni
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.,Candiolo Cancer Institute - FPO, IRCCS, Candiolo, Italy
| | - Isabella Castellano
- Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.
| |
Collapse
|