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IMPORTANCE: Patients selected to receive neoadjuvant chemotherapy (NAC) are usually those at higher risk of relapse, and there is a need to find better therapeutic options for these patients. OBJECTIVE: To determine the efficacy and safety outcomes for patients with hormone receptor (HR)–positive, ERBB2 (formerly HER2)–, high-risk early breast cancer enrolled in the randomized clinical trial monarchE who received NAC. DESIGN, SETTING, AND PARTICIPANTS: The monarchE randomized clinical trial was a multicenter, phase 3, open-label study that evaluated adjuvant treatment with abemaciclib plus endocrine therapy (ET) compared with ET alone in patients with HR+, ERBB2–, and node-positive early breast cancer who were at high risk of recurrence. Patients were recruited between July 2017 and August 2019 from 603 sites in 38 countries. This subgroup analysis was performed with primary outcome data, with a cutoff date of July 8, 2020. INTERVENTION: Enrolled patients were randomized (1:1) to receive standard of care ET for at least 5 years with or without treatment with abemaciclib (150 mg, twice daily) for 2 years (treatment period) or until criteria were met for discontinuation. MAIN OUTCOMES AND MEASURES: Prior chemotherapy (NAC vs adjuvant vs none) was a stratification factor in monarchE, and and a prespecified exploratory analysis included outcomes in patients who received NAC. The data presented in this article are from the primary outcome analysis (395 invasive disease-free survival [IDFS] events; cutoff date, July 8, 2020; median follow-up 19 months [IQR, 15.6-23.9 months]). Invasive disease-free survival (the primary end point of monarchE) and distant relapse-free survival (DRFS) were evaluated using the Cox proportional hazard model and Kaplan-Meier method. RESULTS: Of the 5637 patients (mean [SD] age, 49.9 [10.6] years; 2046 women [99.5%]; 462 Asian [22.8%], 54 Black [2.7%], and 1473 White participants [70.8%]) enrolled in monarchE, 2056 (37%) received treatment with NAC. In this subgroup, treatment with abemaciclib and ET demonstrated clinically meaningful benefit in IDFS (hazard ratio, 0.61; 95% CI, 0.47-0.80) and DRFS (hazard ratio, 0.61; 95% CI, 0.46-0.81), which corresponded with an absolute improvement of 6.6% in 2-year IDFS rates and 6.7% in 2-year DRFS rates. A consistent treatment benefit was observed across subgroups of pathological breast tumor size or number of positive lymph nodes at surgery. CONCLUSIONS AND RELEVANCE: In the randomized clinical trial monarchE, treatment with adjuvant abemaciclib combined with ET demonstrated a clinically meaningful improvement in IDFS and DRFS for patients with HR+, ERBB2−, node-positive, high-risk early breast cancer who received NAC before trial enrollment. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03155997

•Visceral crisis in metastatic breast cancer is associated with a dismal prognosis.•There is a lack of objective clinical criteria in the definition of visceral crisis.•Visceral crisis management is currently based on limited retrospective evidence and expert opinions.•The role of chemotherapy as the treatment of choice for visceral crisis has been recently questioned.

While general conclusions of historical trials are widely recognized, the nuances regarding precise indications of Sentinel Node Biopsy (SNB) in breast cancer in complex clinical scenarios often remain a source of debate and require further elucidation.

Adenocarcinoma of the seminal vesicle is a rare condition, with fewer than 60 cases described in the literature. Most reports highlight the histopathological characteristics of the tumor; however, the role of chemotherapy, especially in the metastatic setting, is poorly described. In this paper, we describe a patient with metastatic disease, who sustained a response to modified FOLFOX6 as first-line therapy. This platinum-based combination therapy seems effective in this scenario and may provide an opportunity for extended survival and relief of symptoms.

Introduction:Coronavirus disease 2019 (COVID-19) has become one of the more dramatic health problems in the century. This disease has enormous consequence for the health care worldwide. In addition to high mortality rate, patients recovered from COVID-19 present short and long-term cardiovascular sequelae including chest pain, myocardial dysfunction, arrhythmia, dyspnea, breathlessness, postural tachycardia syndrome, and thrombotic complications. The explanations for these clinical manifestations are still uncertain but can involve a constellation of physiological alterations.Hypothesis:To test if COVID-19 survivors have augmented sympathetic outflow, diminished endothelial function, elevated aortic stiffness, and reduced physical capacity compared to healthy individuals.Methods:Nineteen COVID-19 survivors [age: 47.0±2.3 years, BMI: 30.1±1.2 Kg/m2] and eighteen well-matched healthy controls (age: 44.0±2.0 years, BMI: 28.4 ±1.2 Kg.m2] were included in study. COVID-19 survivors were evaluated within 6 months of original diagnosis by RT-PCR. Muscle sympathetic nerve activity (MSNA) from fibular nerve (Microneurography), brachial artery flow-mediated dilation (BAFMD; Doppler-Ultrasound), carotid-femoral pulse wave velocity (cf-PWV; Complior), beat-to-beat blood pressure (Peripheral BP; Finometer), heart rate (HR; Electrocardiography) and peak oxygen uptake (VO2peak, Cardiopulmonary exercise testing) were measured in both groups.Results:MSNA was higher in COVID-19 survivors compared to controls (33.0±1.0 vs. 22.0±1.0 bursts/min, p=0.001). Both BAFMD and VO2peakwere lower in COVID-19 survivors compared to controls (4.6±0.7 vs. 8.2 ±0.8%, p=0.005 and 22.2±1.5 vs. 29.7±1.6 mL/Kg/min p=0.001, respectively). Although COVID-19 survivors had greater cf-PWV than controls (8.6±0.5 m/s vs. 7.4±0.4 m/s, p=0.03), BP and HR were not different between groups.Conclusions:Our study revealed that patients recently recovered from COVID-19 have abnormal neurovascular control, vascular alterations and reduced physical capacity. These findings strongly indicate the need of further long-term investigations to uncover cardiovascular sequelae provoked by COVID-19.

The Lewis-Y antigen is expressed in 44%-90% of breast cancers (BCs). The expression of the antigen in carcinoma tissue differs from that in normal tissues. This study aimed to evaluate the clinical benefit of the humanized anti-Lewis Y monoclonal antibody, hu3S193, in advanced hormone receptor-positive and Lewis Y-positive BC after administration of endocrine therapy (ET).

This article focuses the music album "Even Cowgirls Get the Blues," by K.D. Lang. Some singers release a new recording every year. Others seem to take their own sweet time, or when something does come out it is a compilation album with only a few new songs. It is the case with Lang's newest album, the sound track to Cowgirls. With K.D. Lang inclusion of old songs can be forgiven since some songs have only been available on video or in older albums that many people might not be aware of. So most of the songs on this album might seem new and fresh.

This article presents information on the book "The Good Vibrations Guide to Sex," by Cathy Winks and Anne Semans. This book educates the reader on the parts of the body, what orgasm is and the different places to feel it. There is a wonderful discussion of sex toys from vibrators to dildos to more erotic adventures such as handcuffs and swings. Throughout the book, quotes from average people are scattered; in the section on masturbating people talk about the ways they first masturbated and how good it felt.

Reviews the motion picture "Go Fish," directed by Samuel Goldwyn and starring T. Wendy McMillan and Anastasia Sharp.

Reviews the music album "Swamp Ophelia," by the Indigo Girls.

The article provides information the event, titled, "A Gay Evening in May," in Santa Cruz, California, which has been a fixture of the Santa Cruz Gay and Lesbian scene for ten years now. In the past few years, a preview, less expensive night has been added. The Friday night show is much more sparsely attended, but is still a good place to people watch. Not to put the show itself down, but it is an all amateur production. Run by volunteers, staged by volunteers, the only money goes to the Santa Cruz Civic Auditorium for use of their facilities. Once again, this year the show was a wild mixture of very professional acts, such as the Country Cloggers dance group, to the rank, off-key amateurs.

Reviews the music release "In a Moment," by Disappear Fear.

The article talks about Gay Pride Day celebration in Santa Cruz, California. Unlike San Jose, Santa Cruz has been having a pride parade every year for the last 20 years, through the downtown shopping street of Pacific Ave. Not even the Loma Prieta earthquake stopped the march. When Pacific Avenue was obliterated, the parade just moved one block over, and continued marching. Last year marked the first time since '89 that the march was hack on Pacific. There is a new anti-panhandling law in Santa Cruz these days, which prohibits people from sitting on the sidewalk, a natural place to watch a parade.

The article presents the author's views on cybersex. America On-Line has been pushing itself upon the gay community. The author decided to join it. The author could spend time sending E-mail to her friends. America On-Line has a Lesbian and Gay room. From there, the author and her partner pick up women to chat in private rooms. The author feels that she have had too much going on in her life to spend a whole hour talking dirty to someone far way, via the modem. She would rather talk dirty to someone who she can see and touch.

The article presents information on the book "A Journey of One's Own-Uncommon Advice for the Independent Woman Traveler," by Thalia Zepatos. In her book, the author gives readers tastes of the many travels she has taken on her own. The author gives readers the courage and the knowledge one needs to go out and travel on one's own. Also included are snippets of her travels and the voices of other women travelers, and therein lies the problem. It's hard to recommend the book for armchair travelers, since a lot of it is advice, more than stories of what she encountered.

Reviews the music album "Honey On My Lips," by Pam Hall.

The article presents the author's views on the books related to lesbian and gay history. According to the author the book "Out of All Time" by Terry Boughner is a good choice. It provides brief profiles of famous Gay and Lesbian figures in history. Since some of these people never stated point blank that they were homosexual, it could be quite easy to dismiss these choices as guesses that hold no validity. The book "Another Mother Tongue" by Judy Grahn, which has recently been updated and reissued, is part language history and part Judy's personal history.

This article presents information on Julie Gates, a landscape gardener and owner of the company named "Good Earth Landscaping." With her collection of various hats and "trademark" scarves, Julie is easy to spot. Her body is well-muscled from the physical labor involved in working the land. She wears her brown hair tied back in pony tail. Shaking her hand, one can feel the coarseness of her palm, a product of manual labor. Julie's first horticultural job was weeding an elderly woman's garden. Julie came out to herself as a lesbian in her final year in college, which, she says, was flavored with women.