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Background: Inflammatory breast cancer (IBC) is rare and biologically aggressive. We sought to assess diagnostic and management strategies among the American Society of Breast Surgeons (ASBrS) membership., Patients and Methods: An anonymous survey was distributed to ASBrS members from March to May 2023. The survey included questions about respondents' demographics and information related to stage III and IV IBC management. Agreement was defined as a shared response by >80% of respondents. In areas of disagreement, responses were stratified by years in practice, fellowship training, and annual IBC patient volume., Results: The survey was administered to 2337 members with 399 (17.1%) completing all questions and defining the study cohort. Distribution of years in practice was 26.0% 0-10 years, 26.6% 11-20 years and 47.4% > 20 years. Overall, 51.2% reported surgical oncology or breast fellowship training, 69.2% maintain a breast-only practice, and 73.5% treat < 5 IBC cases/year. Agreement was identified in diagnostic imaging, trimodal therapy, and mastectomy with wide skin excision for stage III IBC. Lack of agreement was identified in surgical management of the axilla; respondents with < 10 years in practice or fellowship training were more likely to perform axillary dissection for cN0-N2 stage III IBC. Locoregional management of stage IV IBC was variable., Conclusions: Among ASBrS members, there is consensus in diagnostic evaluation, treatment sequencing and surgical approach to the breast in stage III IBC. Differences exist in surgical management of the cN0-2 axilla with uptake of de-escalation strategies. Clinical trials are needed to evaluate oncologic safety of de-escalation in this high-risk population., (© 2024. Society of Surgical Oncology.)

Objective: Innovative therapies such as thermoembolization are expected to play an important role in improving care for patients with diseases such as hepatocellular carcinoma. Thermoembolization is a minimally invasive strategy that combines thermal ablation and embolization in a single procedure. This approach exploits an exothermic chemical reaction that occurs when an acid chloride is delivered via an endovascular route. However, comprehension of the complexities of the biophysics of thermoembolization is challenging. Mathematical models can aid in understanding such complex processes and assisting clinicians in making informed decisions. In this study, we used a Hagen-Poiseuille 1D blood flow model to predict the mass transport and possible embolization locations in a porcine hepatic artery., Method: The 1D flow model was used on imaging data of in-vivo embolization imaging data of three pigs. The hydrolysis time constant of acid chloride chemical reaction was optimized for each pig, and LOOCV method was used to test the model's predictive ability., Conclusion: This basic model provided a balanced accuracy rate of 66.8% for identifying the possible locations of damage in the hepatic artery. Use of the model provides an initial understanding of the vascular transport phenomena that are predicted to occur as a result of thermoembolization.

Resorbable inferior vena cava (IVC) filters require embedded contrast for image-guided placement and integrity monitoring. We calculated correction factors to account for partial volume averaging of thin nanoparticle (NP)-embedded materials, accounting for object and slice thicknesses, background signal, and nanoparticle concentration. We used phantoms containing polycaprolactone disks embedded with bismuth (Bi) or ytterbium (Yb): 0.4- to 1.2-mm-thick disks of 20 mg ml -1 NPs (thickness phantom), 0.4-mm-thick disks of 0-20 mg ml -1 NPs in 2 mg ml -1 iodine (concentration phantom), and 20 mg ml -1 NPs in 0.4-mm-thick disks in 0-10 mg ml -1 iodine (background phantom). Phantoms were scanned on a dual-source CT with 80, 90, 100, and 150 kVp with tin filtration and reconstructed at 1.0- to 1.5-mm slice thickness with a 0.1-mm interval. Following scanning, disks were processed for inductively coupled plasma optical emission spectrometry (ICP-OES) to determine NP concentration. Mean and maximum CT numbers (HU) of all disks were measured over a 0.5-cm 2 area for each kVp. HU was converted to concentration using previously measured calibrations. Concentration measurements were corrected for partial volume averaging by subtracting residual slice background and extrapolating disk thickness to both nominal and measured slice sensitivity profiles (SSP, mm). Slice thickness to agreement (STTA, mm) was calculated by replacing the CT-derived concentrations with ICP-OES measurements and solving for thickness. Slice thickness correction factors improved agreement with ICP-OES for all measured data. Yb corrections resulted in lower STTA than Bi corrections in the concentration phantom (1.01 versus 1.31 STTA/SSP, where 1.0 is perfect agreement), phantoms with varying thickness (1.30 versus 1.87 STTA/SSP), and similar ratio in phantoms with varying background iodine concentration (1.34 versus 1.35 STTA/SSP). All measured concentrations correlated strongly with ICP-OES and all corrections for partial volume averaging increased agreement with ICP-OES concentration, demonstrating potential for monitoring the integrity of thin IVC resorbable filters with CT., (Creative Commons Attribution license.)

Luminal androgen receptor (LAR)-enriched triple-negative breast cancer (TNBC) is a distinct subtype. The efficacy of AR inhibitors and the relevant biomarkers in neoadjuvant therapy (NAT) are yet to be determined. We tested the combination of the AR inhibitor enzalutamide (120 mg daily by mouth) and paclitaxel (80 mg/m 2 weekly intravenously) (ZT) for 12 weeks as NAT for LAR-enriched TNBC. Eligibility criteria included a percentage of cells expressing nuclear AR by immunohistochemistry (iAR) of at least 10% and a reduction in sonographic volume of less than 70% after four cycles of doxorubicin and cyclophosphamide. Twenty-four patients were enrolled. Ten achieved a pathologic complete response or residual cancer burden-I. ZT was safe, with no unexpected side effects. An iAR of at least 70% had a positive predictive value of 0.92 and a negative predictive value of 0.97 in predicting LAR-enriched TNBC according to RNA-based assays. Our data support future trials of AR blockade in early-stage LAR-enriched TNBC., Competing Interests: Declaration of interests B.L. served a consultancy/advisory role for Celcuity, Natera, Daichi-Sankyo, Novartis, Pfizer, and AstraZeneca; received honoraria from Puma Biotechnology, Novartis, and Pfizer; received grant/research funding from Genentech, Takeda, Merck, Celcuity, Eli Lilly, Puma Biotechnology, and Calithera Therapeutics; and received funding from NCI, DOD, CPRIT, Hope Foundation, and Adopt-A-Scientist. C.Y. has received research funding (to the institution) from Genentech, Gilead, BostonGene, Sanofi, Amgen, Pfizer, Astellas, and Novartis and has served on advisory boards for Gilead. W.F.S. is a co-inventor of US patent no. 11,459,617 “Targeted measure of transcriptional activity related to hormone receptors” issued on 10/4/2022 (applicant proprietor: University of Texas MD Anderson Cancer Center, licensed to Delphi Diagnostics, Inc.) and has co-founder equity from Delphi Diagnostics, Inc. A.M.T. is related by marriage to an employee of Eli Lilly. D.T. has received research support (to the institution) from Novartis, Pfizer, and Polyphor and has served as a consultant to AstraZeneca, GlaxoSmithKline, Gilead, Oncopep, Pfizer, Novartis, AMBRX, Personalis, Sermonix, Stemline-Menarini, and Puma Biotechnology. S.L.M. is currently employed by Eli Lilly (previously employed by MD Anderson at the time the study was conducted). J.K.L. has received grant or research support from Novartis, Medivation/Pfizer, Genentech, GSK, EMDSerono, AstraZeneca, Medimmune, Zenith, and Jounce; participated in Speaker’s Bureau for MedLearning, Physician’s Education Resource, Prime Oncology, Medscape, and Clinical Care Options; received honoraria from UpToDate; and served on advisory committees or review panels for AstraZeneca, Ayala, Pfizer (all uncompensated), NCCN, ASCO, NIH, PDQ, the SITC Breast Committee, and the SWOG Breast Committee., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)