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Your search keyword '"Accurso, Antonello"' showing total 12 results
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12 results on '"Accurso, Antonello"'

1. The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Author

O'Connell, Rachel L, Rattay, Tim, Dave, Rajiv V, Trickey, Adam, Skillman, Joanna, Barnes, Nicola LP, Gardiner, Matthew, Harnett, Adrian, Potter, Shelley, Holcombe, Chris, Blazeby, Jane, Conroy, Elizabeth, O'Brien, Ciara, Williamson, Paula, Curnier, Alain, Tadros, Amir, Depasquale, Ivan, Masannat, Yazan A, Smyth, Elizabeth, Fuller, Mairi, Bourne, Roger, Heys, Steven, Hamo, Ishrak, Aloraifi, Fatima, Fopp, Laura, Bali, Radhika, Bache, Sarah, Benyon, Sarah L, Irwin, Michael S, Agrawal, Amit, Malata, Charles M, Murphy, Claire, Misky, Adam, Chicken, Dennis Wayne, Abdullah, Nassreen, Hill, Arnold DK, Cullinane, Carolyn, Irwin, Gareth, McIntosh, Stuart A, Refsum, Sigi, Sloan, Samantha, Mallon, Peter, Sirianni, Chiara, Khattak, Ilyas, Nagachandra, Geerthan, Kiruparan, Pasupathy, Debanth, Debasish, Davey, Simon, Curran, Terry-Ann, Svenning, Matilda, Govindarajulu, Sasirekha, Rayter, Zenon, Ainsworth, Rachel, Cawthorn, Simon, Sahu, Ajay, Wilson, Sherif, Prousskaia, Elena, Accurso, Antonello, Rocco, Nicola, Di Micco, Rosa, Limite, Gennaro, Ceccarino, Raffaele, Liccardo, Raffaele, Coco, Guido, Nizamoglu, Metin, Morgan, Mary, Ramakrishnan, Venkat, Catanuto, Giuseppe, Wilkins, Alex, McManus, Penelope, Kneeshaw, Peter, Grover, Kartikae, Mahapatra, Tapan, Wooler, Brendan, Elahi, Bilal, Ihsan, Naila, Bucknor, Alexandra, Reissis, Dimitris, Hunter, Judith, Wood, Simon, Jallali, Navid, Henry, Francis P, Verjee, Liaquat S, Lee, Jason, Khan, Shazia M, Azmy, Iman, Massey, Julia, Hollywood, Ciaran, Oluwajana, Michael, Bathla, Sonia, Seward, Joanna, Harding-MacKean, Claudia, Lane, Risha, Murali, Kothandaraman, Biswas, Bashishta, Trapszo, Pawel, Seetharam, Seema, Kennedy, Katy, Alder, Louise, Graja, Tomasz, Amin, Khalid, Kokan, Jalal, Roshanlall, Chandeena, Gill, Emma, Kulkarni, Dhananjay, Dixon, JM, Young, Oliver, Saleem, Talha, Biddle, M, Kearns, Marie, Weiler-Mithoff, Eva, Chew, Ben, Malyon, Andy, Scott, John, McGill, David, Mackay, Iain, Bains, Salena, Barrows, Sara, Pilgrim, Simon, Shokuhi, Sheila, Lambert, Kelly, Kenny, Frances, Valassiadou, Kalliope, Kaushik, Monika, Krupa, Jaroslaw, Dragoumis, Dimitris, Ain, Quratul, Lampropoulos, Pavlos, Moss, Sarah, Khalil, Haitham, Haq, Anwar, Balasubramanian, Balapathiran, Charalampou-Dis, Petros, Hamed, Hisham, Kothari, Ashutosh, Kovacs, Tibor, Douek, Michael, Mehmood, Iftikhar, Ray, Biswajit, Adelekan, Matthew, Humphreys, Laura, Tayeh, Salim, Choy, Christina, Parvanta, Laila, Michieletto, Silvia, Saibene, Tania, O'Brien, James, Down, Sue, Downey, Sarah, Pereira, Jerome, Sami, AS, Gvaramadze, Anzors, Jibril, Jibril A, Thekkinkattil, Dinesh, Udayasankar, S, Khawaja, Saira, Shariaha, Yousef, Holt, Simon, James, Ruth, Rizki, Hirah, Kirkpatrick, Katharine, Ravichandran, Duraisamy, Shrestha, Deepak, Barua, Ellora, Akolekar, Deepika, Hamad, Ahmed, Kleidi, Eleftheria, Hignett, Susan, Pope, Vanessa, Naseem, Salma, Isherwood, Jennifer, Soulsby, Rachel, Taylor, Amanda, Chin, Kian, Nguyen, Dai, Guest, Francesca, Thorne, Amanda, Kirchhoff, Chris, Murphy, Declan C, Lo, Michelle, Harcourt, Ruth, Pain, Simon J, Hussien, Maged I, Zechmeister, Katalin, Sassoon, EM, Figus, Andrea, Haywood, Richard M, Ali, Rozina, Alexander, Susanna, Geropantas, Konstantinos, Epurescu, Daniel, Lewis, Rebecca, Fafemi, Oladapo, Gahir, Jasdeep, Gandamihardja, Tasha, Kelsall, Jennett, Muhibullah, Nazli, Otieno, Charlene, Mazari, Fayyaz, Dauria, Marta, Whisker, Lisa, Macmillan, Douglas, Gutteridge, Eleanor, Rasheed, Tuabin, Khout, Hazem, Asgeirsson, Kristjan, McCulley, Stephen, Mariniello, Maria Donatella, Roncella, Manuela, Ghilli, Matteo, Colizzi, Livio, Rossetti, Elena, Marzia, Lo Russo, Fustaino, Loredana, Li, Alessandro Quattrini, Harvey, Kate L, Windle, Rebecca, Remoundos, Dionysios Dennis, Roy, Pankaj, MacLean, Gael, Adwani, Asha, Popa, Elena, Goh, Steven, Shetty, Geeta, Clark, Sarah, Bernaudo, Lorenzo, Agrawal, Avi, Mansfield, Lucy, Tebbal, Sally, Patel, Ashraf, Grassi, Veronica, Pujji, Ojas, Hamnett, Kathryn, Basu, Naren, Granger, Emily, Durbar, Michael, Pikoulas, Panagiotis, Garnsey, Clare, Walker, Philip, Vollermere, Angela J, Michalakis, Ioannis, Jones, Robin, Youssef, Mina, Ives, Charlotte, Masood, Mohammad, Dunn, Julie, Olsen, Sisse, Ferguson, Douglas, Tillett, Rachel, Allan, Anna, Woollard, Alex, Canny, Rebecca, Woollard, Alexander, Mosahebi, Afshin, Hamilton, Stephen, Ghali, Shadi, Marsh, Daniel, Chana, Jagdeep, Sojitra, Nilesh, Younis, Ibby, Rainsbury, Dick, Chand, Natalie, Kalles, Vasileios, Stebbing, Anne, Harris, Kevin, Laws, Siobhan, Tansley, Anne, Mitchell, Geraldine, de Sousa, Emma, Henderson, Julia, Chandrashekar, Mysore, Pereira, Bernadette, Constantinou, Chloe, Elfadl, Dalia, Irakleidis, Foivos, Hernan, Izaro, Byrne, Miriam, To, Natalie, O'Connell, Rachel, Rusby, Jennifer, Barry, Peter, Krupa, Katerine, Allum, William, MacNeill, Fiona, Roche, Nicola, Gui, Gerald, Ramsey, Kelvin, Harris, Paul, James, Stuart, Power, Kieran, Sutton, Richard, McIntosh, Jamie, Laurence, Nicola, MacLennan, Louise, Milligan, Robert, Cain, Henry, Critchley, Adam, O'Donoghue, Joe, Kalra, Loraine, Collis, Nick, Weston-Petrides, Gina, Fiddes, Roanne, Brown, Victoria, Aertssen, Anna, Slade-Sharman, Diana, Khan, Mansoor, McGuiness, Caroline, Amorosi, Vittoria, Fabio, Santanelli di Pompeo, Exarchos, Georgios, Jiwa, Natasha, Hu, Jennifer, Ledwidge, Serena, Johnson, Laura, Peel, Anthony, Dhooma, Naseem, Farrell, Eric, Devane, Liam, Tevlin, Ruth, McDermott, Enda, Prichard, Ruth, Evoy, Denis, Rothwell, Jane, Geraghty, James, Morrison, Colin, Lawlor, Catriona, Langlands, Fiona, Taylor, Lauren, Turton, Philip, Achuthan, Raj, Horgan, Kieran, Mckenzie, Shireen, Hogan, Brian, Lansdown, Mark, Navin, Channegowda, Sherwin, Liz, Mortimer, Caroline, Garg, Neeraj, Adam, Rahma, Arif, Tahera, Kryjak, Zbigniew, Ali, Deedar, Sowdi, Ravi, Fage, Elena, Mylvaganam, Senthurun, Matey, Pilar, Vidya, Raghavan, Sircar, Tapan, Asaad, Oubida, Bhaskar, Pud, Dordea, Matei, Chrysafi, Ada, McCartan, Damian, Dave, Rajiv, Foster, Rachel, Wilson, Rebecca, Okwemba, Sylvia, Majeed, Yousef, Mathen, Vinod, Murphy, John, Barnes, Nicola, Gandhi, Ashu, Harvey, James, Kirwan, Cliona C, Johnson, Richard, Patel, Krupali, Ribas, Maria Dalmau, Vigneswaran, Natali, Challoner, Tom, Park, Alan, Rizkalla, Maged, Tomlins, Abigail, McEvoy, Kat, Jafferbhoy, Sadaf, Soumian, Soni, Narayanan, Sankaran, Kirby, Robert, Bajrusevic, Sladana, Maalo, Joseph, Charalambous, Michalis, Lai, Lee Min, Chong, Kelvin, Thomson, Simon, Monib, Sherif, Chagla, Leena, Audisio, Riccardo, Taghizadeh, Rieka, Iqbal, Azhar, James, Karen, Callaghan, Maria, Poonawala, Shabbir, Lund, Jonathan, Vinayagam, Raman, Thrush, Steven, Thomas, Rachel Bright, Mullan, Michelle, Taylor, Jevan, Yoshimura, Ryo, Mathew, Tom, Jones, Ben Mancey, Munot, Kailas, Nasr, Rana, Piper, Jenny, El-Sharief, Deena, Mustafa, Mohammed, Dumitru, Dorin, Christopoulos, Petros, O'Leary, Peter, Athanasiou, Irene, Johns, Neil, Mehta, Disha, Bibi, Saira, Syed, Farah, Koris, Jacob, Healy, Samuel, Shanks, Lindsay, Oliver, James, Bucata, Claudiu, Clarke, Natalie, Bignell, Kym, Akerlund, Malin, Brock, Lisa, Hallam, Kelly, Howes, Rachel, Armstrong, Alexander, Sethu, Claire, Zeidan, Bashar, Sjokvist, Olivia, Tasoulis, Marios, Sundaramoorthy, Souganthy, Harris, Chad, Wintrip, Dorothy, Lymperopoulos, N, Jain, Yogesh, Balata, Safa Ahmed, Grp, iBRA-2 Steering, and Collab, Breast Reconstruction Res

Subjects
Adult, Cancer Research, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Mammaplasty, trainee collaboratives, Breast Neoplasms, Article, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Breast cancer, breast cancer, Adjuvant therapy, cohort study, Medicine, Humans, Prospective Studies, Prospective cohort study, Mastectomy, Aged, Cancer, Aged, 80 and over, Manchester Cancer Research Centre, business.industry, ResearchInstitutes_Networks_Beacons/mcrc, adjuvant therapy, immediate breast reconstruction, Middle Aged, medicine.disease, Surgery, Radiation therapy, Oncology, Centre for Surgical Research, Chemotherapy, Adjuvant, Outcomes research, 030220 oncology & carcinogenesis, Surgical oncology, Female, Breast reconstruction, business, Complication, Cohort study
Abstract

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy.Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored.Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays.Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients.

Published
2019

2. Clinical value of radiomics and machine learning in breast ultrasound: a multicenter study for differential diagnosis of benign and malignant lesions

Author

Simone Maurea, Luigi Insabato, Massimo Imbriaco, Francesco Verde, Renato Cuocolo, M. Amitrano, Valeria Romeo, Roberta Apolito, Annalisa Vitale, Anna Maria Cascone, Antonello Accurso, Maria Rosaria Argenzio, Arnaldo Stanzione, Annarita Gencarelli, Antonio Ventimiglia, Arturo Brunetti, Roberta Buonocore, Romeo, Valeria, Cuocolo, Renato, Apolito, Roberta, Stanzione, Arnaldo, Ventimiglia, Antonio, Vitale, Annalisa, Verde, Francesco, Accurso, Antonello, Amitrano, Michele, Insabato, Luigi, Gencarelli, Annarita, Buonocore, Roberta, Argenzio, Maria Rosaria, Cascone, Anna Maria, Imbriaco, Massimo, Maurea, Simone, and Brunetti, Arturo

Subjects
medicine.medical_specialty, education, Machine learning, computer.software_genre, 030218 nuclear medicine & medical imaging, Diagnosis, Differential, Machine Learning, 03 medical and health sciences, 0302 clinical medicine, McNemar's test, Breast cancer, Diagnosis, Ultrasound, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Breast, Breast ultrasound, Neuroradiology, Retrospective Studies, Ultrasonography, Mammary, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, Confidence interval, Random forest, Female, Ultrasonography, Mammary, 030220 oncology & carcinogenesis, Test set, Differential, Radiology, Artificial intelligence, business, computer
Abstract

Objectives We aimed to assess the performance of radiomics and machine learning (ML) for classification of non-cystic benign and malignant breast lesions on ultrasound images, compare ML’s accuracy with that of a breast radiologist, and verify if the radiologist’s performance is improved by using ML. Methods Our retrospective study included patients from two institutions. A total of 135 lesions from Institution 1 were used to train and test the ML model with cross-validation. Radiomic features were extracted from manually annotated images and underwent a multistep feature selection process. Not reproducible, low variance, and highly intercorrelated features were removed from the dataset. Then, 66 lesions from Institution 2 were used as an external test set for ML and to assess the performance of a radiologist without and with the aid of ML, using McNemar’s test. Results After feature selection, 10 of the 520 features extracted were employed to train a random forest algorithm. Its accuracy in the training set was 82% (standard deviation, SD, ± 6%), with an AUC of 0.90 (SD ± 0.06), while the performance on the test set was 82% (95% confidence intervals (CI) = 70–90%) with an AUC of 0.82 (95% CI = 0.70–0.93). It resulted in being significantly better than the baseline reference (p = 0.0098), but not different from the radiologist (79.4%, p = 0.815). The radiologist’s performance improved when using ML (80.2%), but not significantly (p = 0.508). Conclusions A radiomic analysis combined with ML showed promising results to differentiate benign from malignant breast lesions on ultrasound images. Key Points • Machine learning showed good accuracy in discriminating benign from malignant breast lesions • The machine learning classifier’s performance was comparable to that of a breast radiologist • The radiologist’s accuracy improved with machine learning, but not significantly

Published
2021

3. Mitochondrial Flexibility of Breast Cancers: A Growth Advantage and a Therapeutic Opportunity

Author

Stefania Montagnani, Immacolata Belviso, Maria Rosaria Ruocco, Stefania Masone, Alessandro Arcucci, Federica Aliotta, Antonello Accurso, Angelica Avagliano, Avagliano, Angelica, Ruocco, MARIA ROSARIA, Aliotta, Federica, Belviso, Immacolata, Accurso, Antonello, Masone, Stefania, Montagnani, Stefania, and Arcucci, Alessandro

Subjects
Cell type, oxidative phosphorylation, Breast Neoplasms, Oxidative phosphorylation, Review, Mitochondrion, Biology, Models, Biological, Breast cancer, breast cancer, breast cancer, tumour microenvironment, mitochondrial reprogramming, oxidative phosphorylation, therapeutic strategies, medicine, Humans, Glycolysis, lcsh:QH301-705.5, therapeutic strategies, mitochondrial reprogramming, General Medicine, medicine.disease, Mitochondria, Metabolic pathway, Crosstalk (biology), lcsh:Biology (General), Cancer cell, Cancer research, Female, tumour microenvironment
Abstract

Breast cancers are very heterogeneous tissues with several cell types and metabolic pathways together sustaining the initiation and progression of disease and contributing to evasion from cancer therapies. Furthermore, breast cancer cells have an impressive metabolic plasticity that is regulated by the heterogeneous tumour microenvironment through bidirectional interactions. The structure and accessibility of nutrients within this unstable microenvironment influence the metabolism of cancer cells that shift between glycolysis and mitochondrial oxidative phosphorylation (OXPHOS) to produce adenosine triphosphate (ATP). In this scenario, the mitochondrial energetic pathways of cancer cells can be reprogrammed to modulate breast cancer’s progression and aggressiveness. Moreover, mitochondrial alterations can lead to crosstalk between the mitochondria and the nucleus, and subsequently affect cancer tissue properties. This article reviewed the metabolic plasticity of breast cancer cells, focussing mainly on breast cancer mitochondrial metabolic reprogramming and the mitochondrial alterations influencing nuclear pathways. Finally, the therapeutic strategies targeting molecules and pathways regulating cancer mitochondrial alterations are highlighted.

Published
2019

4. Influence of Fibroblasts on Mammary Gland Development, Breast Cancer Microenvironment Remodeling, and Cancer Cell Dissemination

Author

Daniela Russo, Alessandro Arcucci, Stefania Masone, Antonello Accurso, Eleonora Vecchio, Nunzia Martucci, Stefania Montagnani, Maria Rosaria Ruocco, Giuseppe Fiume, Luigi Insabato, Angelica Avagliano, Avagliano, Angelica, Fiume, G, Ruocco, Mr, Martucci, Nunzia, Vecchio, Eleonora, Insabato, Luigi, Russo, Daniela, Accurso, Antonello, Masone, Stefania, Montagnani, Stefania, and Arcucci, Alessandro

Subjects
0301 basic medicine, mammary gland, Cancer Research, Stromal cell, Mammary gland, Review, Biology, medicine.disease_cause, breast cancer microenvironment, lcsh:RC254-282, Metastasis, Extracellular matrix, ECM remodeling, 03 medical and health sciences, 0302 clinical medicine, fibroblasts, medicine, metastasis, Fibroblast, Cancer, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Cell biology, 030104 developmental biology, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Cancer cell, Carcinogenesis, breast cancer associated fibroblasts (BCAFs)
Abstract

The stromal microenvironment regulates mammary gland development and tumorigenesis. In normal mammary glands, the stromal microenvironment encompasses the ducts and contains fibroblasts, the main regulators of branching morphogenesis. Understanding the way fibroblast signaling pathways regulate mammary gland development may offer insights into the mechanisms of breast cancer (BC) biology. In fact, the unregulated mammary fibroblast signaling pathways, associated with alterations in extracellular matrix (ECM) remodeling and branching morphogenesis, drive breast cancer microenvironment (BCM) remodeling and cancer growth. The BCM comprises a very heterogeneous tissue containing non-cancer stromal cells, namely, breast cancer-associated fibroblasts (BCAFs), which represent most of the tumor mass. Moreover, the different components of the BCM highly interact with cancer cells, thereby generating a tightly intertwined network. In particular, BC cells activate recruited normal fibroblasts in BCAFs, which, in turn, promote BCM remodeling and metastasis. Thus, comparing the roles of normal fibroblasts and BCAFs in the physiological and metastatic processes, could provide a deeper understanding of the signaling pathways regulating BC dissemination. Here, we review the latest literature describing the structure of the mammary gland and the BCM and summarize the influence of epithelial-mesenchymal transition (EpMT) and autophagy in BC dissemination. Finally, we discuss the roles of fibroblasts and BCAFs in mammary gland development and BCM remodeling, respectively.

Published
2020

5. Adjuvant anastrozole versus exemestane versus letrozole, upfront or after 2 years of tamoxifen, in endocrine-sensitive breast cancer (FATA-GIM3): a randomised, phase 3 trial

Author

Sabino De Placido, Ciro Gallo, Michelino De Laurentiis, Giancarlo Bisagni, Grazia Arpino, Maria Giuseppa Sarobba, Ferdinando Riccardi, Antonio Russo, Lucia Del Mastro, Alessio Aligi Cogoni, Francesco Cognetti, Stefania Gori, Jennifer Foglietta, Antonio Frassoldati, Domenico Amoroso, Lucio Laudadio, Luca Moscetti, Filippo Montemurro, Claudio Verusio, Antonio Bernardo, Vito Lorusso, Adriano Gravina, Gabriella Moretti, Rossella Lauria, Antonella Lai, Carmela Mocerino, Sergio Rizzo, Francesco Nuzzo, Paolo Carlini, Francesco Perrone, Antonello Accurso, Biagio Agostara, Michele Aieta, Oscar Alabiso, Maria Grazia Alicicco, Dino Amadori, Laura Amaducci, Gianna Amiconi, Giustino Antuzzi, Mara Ardine, Antonio Ardizzoia, Caterina Aversa, Giuseppe Badalamenti, Sandro Barni, Carlo Basurto, Rossana Berardi, Cinzia Bergamasco, Paolo Bidoli, Claudia Bighin, Edoardo Biondi, Corrado Boni, Karen Borgonovo, Mario Botta, Stefano Bravi, Paolo Bruzzi, Giuseppe Buono, Alfredo Butera, Alessia Caldara, Giampiero Candeloro, Claudia Cappelletti, Cinzia Cardalesi, Elisabetta Carfora, Anna Cariello, Francesco Carrozza, Giacomo Cartenì, Michele Caruso, Virginia Casadei, Claudia Casanova, Luigi Castori, Luigi Cavanna, Giovanna Cavazzini, Marina Cazzaniga, Mario Chilelli, Paolo Chiodini, Silvia Chiorrini, Fortunato Ciardiello, Mariangela Ciccarese, Saverio Cinieri, Mario Clerico, Mariarosa Coccaro, Mario Comande, Claudia Corbo, Giuseppina Cortino, Stefania Cusenza, Gennaro Daniele, Alfonso Maria D'arco, Giuliana D'auria, Claudio Dazzi, Carmine De Angelis, Filippo de Braud, Gianfranco De Feo, Andrea De Matteis, Michele De Tursi, Anna Di Blasio, Giuseppe di Lucca, Liberato Di Lullo, Francesca Di Rella, Gianfranco Di Renzo, Pia Di Stefano, Aida Di Stefano, Anna Diana, Sara Donati, Agnese Fabbri, Alessandra Fabi, Marina Faedi, Gabriella Farina, Antonio Farris, Antonio Febbraro, Palma Fedele, Piera Federico, Francesco Ferraù, Gianluigi Ferretti, Antonella Ferro, Irene Floriani, Rosachiara Forcignanò, Samantha Forciniti, Valeria Forestieri, Gianni Fornari, Michela Frisinghelli, Vittorio Fusco, Giulia Gallizzi, Antonio Galvano, Antonio Gambardella, Angelo Gambi, Vittorio Gebbia, Erika Gervasi, Mara Ghilardi, Alice Giacobino, Giovanni Giardina, Francesco Giotta, Sara Giraudi, Mario Giuliano, Antonino Grassadonia, Donatella Grasso, Federica Grosso, Lorenzo Guizzaro, Pasquale Incoronato, Lorena Incorvaia, Giovanni Iodice, Nicla La Verde, Vincenzo Labonia, Gabriella Landi, Agnese Latorre, Vita Leonardi, Alessia Levaggi, Gennaro Limite, Linda Lina Bascialla, Lorenzo Livi, Evaristo Maiello, Daniela Mandelli, Ilaria Marcon, Daniela Menon, Michele Montedoro, Lucia Moraca, Anna Moretti, Maria Grazia Morritti, Patrizia Morselli, Antonella Mura, Silvia Mura, Michela Musacchio, Alberto Muzio, Donato Natale, Clara Natoli, Cinzia Nigro, Cecilia Nisticò, Antonio Nuzzo, Michele Orditura, Laura Orlando, Carmen Pacilio, Giuliano Palumbo, Raffaella Palumbo, Felice Pasini, Emanuela Paterno, Antonio Pazzola, Silvia Pelliccioni, Matilde Pensabene, Davide Perroni, Angela Pesenti Gritti, Fausto Petrelli, Maria Carmela Piccirillo, Graziella Pinotti, Claudia Pogliani, Davide Poli, Sonia Prader, Francesco Recchia, Daniele Rizzi, Carmen Romano, Rosalba Rossello, Chiara Rossini, Giuseppina Salvucci, Valeria Sanna, Alessandra Santini, Silvana Saracchini, Clementina Savastano, Giovanni Scambia, Francesco Schettini, Paola Schiavone, Alessio Schirone, Elena Seles, Simona Signoriello, Giuseppe Signoriello, Rosa Rita Silva, Antonia Silvestri, Vittorio Simeon, Ilaria Spagnoletti, Stefano Tamberi, Cristina Teragni, Verena Thalmann, Renato Thomas, Guglielmo Thomas, Amelia Tienghi, Nicola Tinari, Vincenza Tinessa, Federica Tomei, Giuseppe Tonini, Valter Torri, Divina Traficante, Marianna Tudini, Monica Turazza, Roberto Vignoli, Maria Giuseppa Vitale, Alessandra Zacchia, Pasquale Zagarese, Alda Zanni, Laura Zavallone, Maria Zavettieri, Alessandra Zoboli, De Placido, S., Gallo, C., De Laurentiis, M., Bisagni, G., Arpino, G., Sarobba, M. G., Riccardi, F., Russo, A., Del Mastro, L., Cogoni, A. A., Cognetti, F., Gori, S., Foglietta, J., Frassoldati, A., Amoroso, D., Laudadio, L., Moscetti, L., Montemurro, F., Verusio, C., Bernardo, A., Lorusso, V., Gravina, A., Moretti, G., Lauria, R., Lai, A., Mocerino, C., Rizzo, S., Nuzzo, F., Carlini, P., Perrone, F., Accurso, A., Agostara, B., Aieta, M., Alabiso, O., Alicicco, M. G., Amadori, D., Amaducci, L., Amiconi, G., Antuzzi, G., Ardine, M., Ardizzoia, A., Aversa, C., Badalamenti, G., Barni, S., Basurto, C., Berardi, R., Bergamasco, C., Bidoli, P., Bighin, C., Biondi, E., Boni, C., Borgonovo, K., Botta, M., Bravi, S., Bruzzi, P., Buono, G., Butera, A., Caldara, A., Candeloro, G., Cappelletti, C., Cardalesi, C., Carfora, E., Cariello, A., Carrozza, F., Carteni, G., Caruso, M., Casadei, V., Casanova, C., Castori, L., Cavanna, L., Cavazzini, G., Cazzaniga, M., Chilelli, M., Chiodini, P., Chiorrini, S., Ciardiello, F., Ciccarese, M., Cinieri, S., Clerico, M., Coccaro, M., Comande, M., Corbo, C., Cortino, G., Cusenza, S., Daniele, G., D'Arco, A. M., D'Auria, G., Dazzi, C., De Angelis, C., de Braud, F., De Feo, G., De Matteis, Ma., De Tursi, M., Di Blasio, A., di Lucca, G., Di Lullo, L., Di Rella, F., Di Renzo, G., Di Stefano, P., Di Stefano, A., Diana, A., Donati, S., Fabbri, A., Fabi, A., Faedi, M., Farina, G., Farris, A., Febbraro, A., Fedele, P., Federico, P., Ferrau, F., Ferretti, G., Ferro, A., Floriani, I., Forcignano, R., Forciniti, S., Forestieri, V., Fornari, G., Frisinghelli, M., Fusco, V., Gallizzi, G., Galvano, A., Gambardella, A., Gambi, A., Gebbia, V., Gervasi, E., Ghilardi, M., Giacobino, A., Giardina, G., Giotta, F., Giraudi, S., Giuliano, M., Grassadonia, A., Grasso, D., Grosso, F., Guizzaro, L., Incoronato, P., Incorvaia, L., Iodice, G., La Verde, N., Labonia, V., Landi, G., Latorre, A., Leonardi, V., Levaggi, A., Limite, G., Lina Bascialla, L., Livi, L., Maiello, E., Mandelli, D., Marcon, I., Menon, D., Montedoro, M., Moraca, L., Moretti, A., Morritti, M. G., Morselli, P., Mura, A., Mura, S., Musacchio, M., Muzio, A., Natale, D., Natoli, C., Nigro, C., Nistico, C., Nuzzo, A., Orditura, M., Orlando, L., Pacilio, C., Palumbo, G., Palumbo, R., Pasini, F., Paterno, E., Pazzola, A., Pelliccioni, S., Pensabene, M., Perroni, D., Pesenti Gritti, A., Petrelli, F., Piccirillo, M. C., Pinotti, G., Pogliani, C., Poli, D., Prader, S., Recchia, F., Rizzi, D., Romano, C., Rossello, R., Rossini, C., Salvucci, G., Sanna, V., Santini, A., Saracchini, S., Savastano, C., Scambia, G., Schettini, F., Schiavone, P., Schirone, A., Seles, E., Signoriello, S., Signoriello, G., Silva, R. R., Silvestri, A., Simeon, V., Spagnoletti, I., Tamberi, S., Teragni, C., Thalmann, V., Thomas, R., Thomas, G., Tienghi, A., Tinari, N., Tinessa, V., Tomei, F., Tonini, G., Torri, V., Traficante, D., Tudini, M., Turazza, M., Vignoli, R., Vitale, M. G., Zacchia, A., Zagarese, P., Zanni, A., Zavallone, L., Zavettieri, M., Zoboli, A., De Placido, Sabino, Gallo, Ciro, De Laurentiis, Michelino, Bisagni, Giancarlo, Arpino, Grazia, Sarobba, Maria Giuseppa, Riccardi, Ferdinando, Russo, Antonio, Del Mastro, Lucia, Cogoni, Alessio Aligi, Cognetti, Francesco, Gori, Stefania, Foglietta, Jennifer, Frassoldati, Antonio, Amoroso, Domenico, Laudadio, Lucio, Moscetti, Luca, Montemurro, Filippo, Verusio, Claudio, Bernardo, Antonio, Lorusso, Vito, Gravina, Adriano, Moretti, Gabriella, Lauria, Rossella, Lai, Antonella, Mocerino, Carmen, Rizzo, Sergio, Nuzzo, Francesco, Carlini, Paolo, Perrone, Francesco, Accurso, Antonello, Agostara, Biagio, Aieta, Michele, Alabiso, Oscar, Alicicco, Maria Grazia, Amadori, Dino, Amaducci, Laura, Amiconi, Gianna, Antuzzi, Giustino, Ardine, Mara, Ardizzoia, Antonio, Aversa, Caterina, Badalamenti, Giuseppe, Barni, Sandro, Basurto, Carlo, Berardi, Rossana, Bergamasco, Cinzia, Bidoli, Paolo, Bighin, Claudia, Biondi, Edoardo, Boni, Corrado, Borgonovo, Karen, Botta, Mario, Bravi, Stefano, Bruzzi, Paolo, Buono, Giuseppe, Butera, Alfredo, Caldara, Alessia, Candeloro, Giampiero, Cappelletti, Claudia, Cardalesi, Cinzia, Carfora, Elisabetta, Cariello, Anna, Carrozza, Francesco, Cartenì, Giacomo, Caruso, Michele, Casadei, Virginia, Casanova, Claudia, Castori, Luigi, Cavanna, Luigi, Cavazzini, Giovanna, Cazzaniga, Marina, Chilelli, Mario, Chiodini, Paolo, Chiorrini, Silvia, Ciardiello, Fortunato, Ciccarese, Mariangela, Cinieri, Saverio, Clerico, Mario, Coccaro, Mariarosa, Comande, Mario, Corbo, Claudia, Cortino, Giuseppina, Cusenza, Stefania, Daniele, Gennaro, D'arco, Alfonso Maria, D'auria, Giuliana, Dazzi, Claudio, De Angelis, Carmine, de Braud, Filippo, De Feo, Gianfranco, De Matteis, Andrea, De Tursi, Michele, Di Blasio, Anna, di Lucca, Giuseppe, Di Lullo, Liberato, Di Rella, Francesca, Di Renzo, Gianfranco, Di Stefano, Pia, Di Stefano, Aida, Diana, Anna, Donati, Sara, Fabbri, Agnese, Fabi, Alessandra, Faedi, Marina, Farina, Gabriella, Farris, Antonio, Febbraro, Antonio, Fedele, Palma, Federico, Piera, Ferraù, Francesco, Ferretti, Gianluigi, Ferro, Antonella, Floriani, Irene, Forcignanò, Rosachiara, Forciniti, Samantha, Forestieri, Valeria, Fornari, Gianni, Frisinghelli, Michela, Fusco, Vittorio, Gallizzi, Giulia, Galvano, Antonio, Gambardella, Antonio, Gambi, Angelo, Gebbia, Vittorio, Gervasi, Erika, Ghilardi, Mara, Giacobino, Alice, Giardina, Giovanni, Giotta, Francesco, Giraudi, Sara, Giuliano, Mario, Grassadonia, Antonino, Grasso, Donatella, Grosso, Federica, Guizzaro, Lorenzo, Incoronato, Pasquale, Incorvaia, Lorena, Iodice, Giovanni, La Verde, Nicla, Labonia, Vincenzo, Landi, Gabriella, Latorre, Agnese, Leonardi, Vita, Levaggi, Alessia, Limite, Gennaro, Lina Bascialla, Linda, Livi, Lorenzo, Maiello, Evaristo, Mandelli, Daniela, Marcon, Ilaria, Menon, Daniela, Montedoro, Michele, Moraca, Lucia, Moretti, Anna, Morritti, Maria Grazia, Morselli, Patrizia, Mura, Antonella, Mura, Silvia, Musacchio, Michela, Muzio, Alberto, Natale, Donato, Natoli, Clara, Nigro, Cinzia, Nisticò, Cecilia, Nuzzo, Antonio, Orditura, Michele, Orlando, Laura, Pacilio, Carmen, Palumbo, Giuliano, Palumbo, Raffaella, Pasini, Felice, Paterno, Emanuela, Pazzola, Antonio, Pelliccioni, Silvia, Pensabene, Matilde, Perroni, Davide, Pesenti Gritti, Angela, Petrelli, Fausto, Piccirillo, Maria Carmela, Pinotti, Graziella, Pogliani, Claudia, Poli, Davide, Prader, Sonia, Recchia, Francesco, Rizzi, Daniele, Romano, Carmen, Rossello, Rosalba, Rossini, Chiara, Salvucci, Giuseppina, Sanna, Valeria, Santini, Alessandra, Saracchini, Silvana, Savastano, Clementina, Scambia, Giovanni, Schettini, Francesco, Schiavone, Paola, Schirone, Alessio, Seles, Elena, Signoriello, Simona, Signoriello, Giuseppe, Silva, Rosa Rita, Silvestri, Antonia, Simeon, Vittorio, Spagnoletti, Ilaria, Tamberi, Stefano, Teragni, Cristina, Thalmann, Verena, Thomas, Renato, Thomas, Guglielmo, Tienghi, Amelia, Tinari, Nicola, Tinessa, Vincenza, Tomei, Federica, Tonini, Giuseppe, Torri, Valter, Traficante, Divina, Tudini, Marianna, Turazza, Monica, Vignoli, Roberto, Vitale, Maria Giuseppa, Zacchia, Alessandra, Zagarese, Pasquale, Zanni, Alda, Zavallone, Laura, Zavettieri, Maria, Zoboli, Alessandra, Mocerino, Carmela, D'Arco, Alfonso Maria, D'Auria, Giuliana, De Placido, S, Gallo, C, De Laurentiis, M, Bisagni, G, Arpino, G, Sarobba, M, Riccardi, F, Russo, A, Del Mastro, L, Cogoni, A, Cognetti, F, Gori, S, Foglietta, J, Frassoldati, A, Amoroso, D, Laudadio, L, Moscetti, L, Montemurro, F, Verusio, C, Bernardo, A, Lorusso, V, Gravina, A, Moretti, G, Lauria, R, Lai, A, Mocerino, C, Rizzo, S, Nuzzo, F, Carlini, P, Perrone, F, Accurso, A, Agostara, B, Aieta, M, Alabiso, O, Alicicco, M, Amadori, D, Amaducci, L, Amiconi, G, Antuzzi, G, Ardine, M, Ardizzoia, A, Aversa, C, Badalamenti, G, Barni, S, Basurto, C, Berardi, R, Bergamasco, C, Bidoli, P, Bighin, C, Biondi, E, Boni, C, Borgonovo, K, Botta, M, Bravi, S, Bruzzi, P, Buono, G, Butera, A, Caldara, A, Candeloro, G, Cappelletti, C, Cardalesi, C, Carfora, E, Cariello, A, Carrozza, F, Carteni, G, Caruso, M, Casadei, V, Casanova, C, Castori, L, Cavanna, L, Cavazzini, G, Cazzaniga, M, Chilelli, M, Chiodini, P, Chiorrini, S, Ciardiello, F, Ciccarese, M, Cinieri, S, Clerico, M, Coccaro, M, Comande, M, Corbo, C, Cortino, G, Cusenza, S, Daniele, G, D'Arco, A, D'Auria, G, Dazzi, C, De Angelis, C, de Braud, F, De Feo, G, De Matteis, A, De Tursi, M, Di Blasio, A, di Lucca, G, Di Lullo, L, Di Rella, F, Di Renzo, G, Di Stefano, P, Di Stefano, A, Diana, A, Donati, S, Fabbri, A, Fabi, A, Faedi, M, Farina, G, Farris, A, Febbraro, A, Fedele, P, Federico, P, Ferrau, F, Ferretti, G, Ferro, A, Floriani, I, Forcignano, R, Forciniti, S, Forestieri, V, Fornari, G, Frisinghelli, M, Fusco, V, Gallizzi, G, Galvano, A, Gambardella, A, Gambi, A, Gebbia, V, Gervasi, E, Ghilardi, M, Giacobino, A, Giardina, G, Giotta, F, Giraudi, S, Giuliano, M, Grassadonia, A, Grasso, D, Grosso, F, Guizzaro, L, Incoronato, P, Incorvaia, L, Iodice, G, La Verde, N, Labonia, V, Landi, G, Latorre, A, Leonardi, V, Levaggi, A, Limite, G, Lina Bascialla, L, Livi, L, Maiello, E, Mandelli, D, Marcon, I, Menon, D, Montedoro, M, Moraca, L, Moretti, A, Morritti, M, Morselli, P, Mura, A, Mura, S, Musacchio, M, Muzio, A, Natale, D, Natoli, C, Nigro, C, Nistico, C, Nuzzo, A, Orditura, M, Orlando, L, Pacilio, C, Palumbo, G, Palumbo, R, Pasini, F, Paterno, E, Pazzola, A, Pelliccioni, S, Pensabene, M, Perroni, D, Pesenti Gritti, A, Petrelli, F, Piccirillo, M, Pinotti, G, Pogliani, C, Poli, D, Prader, S, Recchia, F, Rizzi, D, Romano, C, Rossello, R, Rossini, C, Salvucci, G, Sanna, V, Santini, A, Saracchini, S, Savastano, C, Scambia, G, Schettini, F, Schiavone, P, Schirone, A, Seles, E, Signoriello, S, Signoriello, G, Silva, R, Silvestri, A, Simeon, V, Spagnoletti, I, Tamberi, S, Teragni, C, Thalmann, V, Thomas, R, Thomas, G, Tienghi, A, Tinari, N, Tinessa, V, Tomei, F, Tonini, G, Torri, V, Traficante, D, Tudini, M, Turazza, M, Vignoli, R, Vitale, M, Zacchia, A, Zagarese, P, Zanni, A, Zavallone, L, Zavettieri, M, and Zoboli, A

Subjects
Oncology, Receptor, ErbB-2, Settore MED/06 - Oncologia Medica, letrozole, law.invention, Adjuvant anastrozole, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, Exemestane, law, exemestane, tamoxifen, breast cancer, Antineoplastic Combined Chemotherapy Protocols, 030212 general & internal medicine, Aromatase Inhibitors, Letrozole, Hazard ratio, Middle Aged, Receptors, Estrogen, Tolerability, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Female, Receptors, Progesterone, Breast Neoplasm, Human, medicine.drug, medicine.medical_specialty, Socio-culturale, Anastrozole, Breast Neoplasms, Disease-Free Survival, Drug Administration Schedule, 03 medical and health sciences, Breast cancer, Internal medicine, medicine, Aromatase Inhibitor, Humans, Aged, Antineoplastic Combined Chemotherapy Protocol, Androstadiene, business.industry, medicine.disease, Androstadienes, chemistry, business, Tamoxifen
Abstract

Background: Uncertainty exists about the optimal schedule of adjuvant treatment of breast cancer with aromatase inhibitors and, to our knowledge, no trial has directly compared the three aromatase inhibitors anastrozole, exemestane, and letrozole. We investigated the schedule and type of aromatase inhibitors to be used as adjuvant treatment for hormone receptor-positive early breast cancer. Methods: FATA-GIM3 is a multicentre, open-label, randomised, phase 3 trial of six different treatments in postmenopausal women with hormone receptor-positive early breast cancer. Eligible patients had histologically confirmed invasive hormone receptor-positive breast cancer that had been completely removed by surgery, any pathological tumour size, and axillary nodal status. Key exclusion criteria were hormone replacement therapy, recurrent or metastatic disease, previous treatment with tamoxifen, and another malignancy in the previous 10 years. Patients were randomly assigned in an equal ratio to one of six treatment groups: oral anastrozole (1 mg per day), exemestane (25 mg per day), or letrozole (2·5 mg per day) tablets upfront for 5 years (upfront strategy) or oral tamoxifen (20 mg per day) for 2 years followed by oral administration of one of the three aromatase inhibitors for 3 years (switch strategy). Randomisation was done by a computerised minimisation procedure stratified for oestrogen receptor, progesterone receptor, and HER2 status; previous chemotherapy; and pathological nodal status. Neither the patients nor the physicians were masked to treatment allocation. The primary endpoint was disease-free survival. The minimum cutoff to declare superiority of the upfront strategy over the switch strategy was assumed to be a 2% difference in disease-free survival at 5 years. Primary efficacy analyses were done by intention to treat; safety analyses included all patients for whom at least one safety case report form had been completed. Follow-up is ongoing. This trial is registered with the European Clinical Trials Database, number 2006-004018-42, and ClinicalTrials.gov, number NCT00541086. Findings: Between March 9, 2007, and July 31, 2012, 3697 patients were enrolled into the study. After a median follow-up of 60 months (IQR 46–72), 401 disease-free survival events were reported, including 211 (11%) of 1850 patients allocated to the switch strategy and 190 (10%) of 1847 patients allocated to upfront treatment. 5-year disease-free survival was 88·5% (95% CI 86·7–90·0) with the switch strategy and 89·8% (88·2–91·2) with upfront treatment (hazard ratio 0·89, 95% CI 0·73–1·08; p=0·23). 5-year disease-free survival was 90·0% (95% CI 87·9–91·7) with anastrozole (124 events), 88·0% (85·8–89·9) with exemestane (148 events), and 89·4% (87·3 to 91·1) with letrozole (129 events; p=0·24). No unexpected serious adverse reactions or treatment-related deaths occurred. Musculoskeletal side-effects were the most frequent grade 3–4 events, reported in 130 (7%) of 1761 patients who received the switch strategy and 128 (7%) of 1766 patients who received upfront treatment. Grade 1 musculoskeletal events were more frequent with the upfront schedule than with the switch schedule (924 [52%] of 1766 patients vs 745 [42%] of 1761 patients). All other grade 3–4 adverse events occurred in less than 2% of patients in either group. Interpretation: 5 years of treatment with aromatase inhibitors was not superior to 2 years of tamoxifen followed by 3 years of aromatase inhibitors. None of the three aromatase inhibitors was superior to the others in terms of efficacy. Therefore, patient preference, tolerability, and financial constraints should be considered when deciding the optimal treatment approach in this setting. Funding: Italian Drug Agency.

Published
2018

6. Metabolic and anthropometric changes in early breast cancer patients receiving adjuvant therapy

Author

Anna Crispo, Simona Malgieri, Stefania Cicala, Sabino De Placido, Grazia Arpino, Antonello Accurso, Annamaria Colao, Gennaro Limite, Michelino De Laurentiis, Valeria Forestieri, Giuseppe Buono, Dario Bruzzese, Bianca Maria Veneziani, Rossella Lauria, Carmine De Angelis, Mario Giuliano, Arpino, Grazia, DE ANGELIS, Carmine, Buono, Giuseppe, Colao, Annamaria, Giuliano, Mario, Malgieri, Simona, Cicala, Stefania, DE LAURENTIIS, Michelino, Accurso, Antonello, Crispo, Anna, Limite, Gennaro, Lauria, Rossella, Veneziani, BIANCA MARIA, Forestieri, Valeria, Bruzzese, Dario, and DE PLACIDO, Sabino

Subjects
Adult, Blood Glucose, Cancer Research, medicine.medical_specialty, Waist, Epidemiology, Breast Neoplasms, Gastroenterology, Adjuvant therapy, Body Mass Index, chemistry.chemical_compound, Glucose and lipid metabolism, Breast cancer, Waist–hip ratio, Internal medicine, Medicine, Body Fat Distribution, Humans, Insulin, Obesity, Triglycerides, medicine.diagnostic_test, Triglyceride, business.industry, Body weight and composition, Waist-Hip Ratio, Middle Aged, medicine.disease, Lipids, Postmenopause, Endocrinology, Oncology, chemistry, Female, medicine.symptom, Menopausal status, Waist Circumference, business, Lipid profile, Body mass index, Weight gain
Abstract

Weight gain and metabolic changes have been related to survival of early breast cancer patients (EBC). ‘’However, factors influencing metabolism post-diagnosis are not fully understood. We measured anthropometric [body mass index (BMI), body weight, waist and hip circumferences, and waist-to-hip ratio] and metabolic (levels of insulin, glucose, H1Ac, total, HDL, and LDL cholesterol, triglycerides, and the homeostasis model assessment score [HOMA]) parameters in 433 pre- and post-menopausal women with EBC at diagnosis and 3, 6, 9, 12, and 24 months thereafter. At diagnosis, compared with post-menopausal women, pre-menopausal patients were more likely to be leaner and to have a lower BMI, smaller waist and hip circumferences, and waist-to-hip ratio. They had also lower glucose, HbA1c, and triglyceride levels and a lower HOMA score. Furthermore, they were more likely to have an estrogen- and/or progesterone-positive tumor and a higher proliferating breast cancer. During the first two post-diagnosis years, all women showed a significant increase of weight (+0.72 kg/year, P

Published
2015

7. Combined effect of obesity and diabetes on early breast cancer outcome: a prospective observational study

Author

Massimiliano D’Aiuto, L. S. A. Augustin, Rossella Lauria, Carmine De Angelis, Ernesta Cavalcanti, Alfonso Amore, Raffaele Tortoriello, Anna Crispo, Mario Giuliano, Matilde Pensabene, Sabino De Placido, Grazia Arpino, Maurizio Montella, Gerardo Botti, Francesco Schettini, Valeria Forestieri, Antonello Accurso, Giuseppe Buono, Michelino De Laurentiis, Buono, Giuseppe, Crispo, Anna, Giuliano, Mario, de Angelis, Carmine, Schettini, Francesco, Forestieri, Valeria, Lauria, Rossella, Pensabene, Matilde, de Laurentiis, Michelino, Augustin, Livia Silvia Adriana, Amore, Alfonso, D'Aiuto, Massimiliano, Tortoriello, Raffaele, Accurso, Antonello, Cavalcanti, Ernesta, Botti, Gerardo, Montella, Maurizio, de Placido, Sabino, and Arpino, Grazia

Subjects
0301 basic medicine, medicine.medical_specialty, obesity, Diabete, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, breast cancer, Diabetes mellitus, Internal medicine, Epidemiology, medicine, Risk factor, diabetes, business.industry, Hazard ratio, Cancer, Combined variable, medicine.disease, Obesity, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, outcome, Population study, Clinical Research Paper, business, combined variables
Abstract

// Giuseppe Buono 1, * , Anna Crispo 2, * , Mario Giuliano 1, 3 , Carmine De Angelis 1 , Francesco Schettini 1 , Valeria Forestieri 1 , Rossella Lauria 1 , Matilde Pensabene 1 , Michelino De Laurentiis 4 , Livia Silvia Adriana Augustin 2, 5 , Alfonso Amore 4 , Massimiliano D’Aiuto 4 , Raffaele Tortoriello 4 , Antonello Accurso 6 , Ernesta Cavalcanti 2 , Gerardo Botti 2 , Maurizio Montella 2 , Sabino De Placido 1 and Grazia Arpino 1 1 Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy 2 Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Naples, Italy 3 Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA 4 Breast Unit, National Cancer Institute, G. Pascale Foundation, Naples, Italy 5 Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, Canada 6 Department of Gastroenterology, Endocrinology and Surgery, University of Naples Federico II, Naples, Italy * These authors contributed equally to this work Correspondence to: Grazia Arpino, email: grazia.arpino@unina.it Keywords: breast cancer; obesity; diabetes; combined variables; outcome Received: August 19, 2017 Accepted: November 16, 2017 Published: December 05, 2017 ABSTRACT Background: Previous studies suggested that obesity and diabetes were correlated with breast cancer outcome. The aim of the present study was to investigate the prognostic effect of obesity and diabetes on the outcome of early breast cancer patients. Materials and Methods: Overall, 841 early breast cancer patients were prospectively enrolled between January 2009 and December 2013. Study population was divided into four groups: (1) patients without obesity or diabetes; (2) patients with only diabetes; (3) patients with only obesity; and (4) patients with both diabetes and obesity. Categorical variables were analyzed by the chi-square test and survival data by the log-rank test. Results: At diagnosis, obese and diabetic patients were more likely to be older ( p < 0.0001) and post-menopausal ( p < 0.0001) and to have a tumor larger than 2 cm ( p < 0.0001) than patients in groups 1–3. At univariate analyses, obese and diabetic patients had a worse disease-free survival ( p = 0.01) and overall survival ( p = 0.001) than did patients without obesity and diabetes. At multivariate analyses, the co-presence of obesity and diabetes was an independent prognostic factor for disease-free survival (hazard ratio=2.62, 95% CI 1.23–5.60) but not for overall survival. Conclusions: At diagnosis, patients with obesity and diabetes were older, had larger tumors and a worse outcome compared to patients without obesity or diabetes. These data suggest that metabolic health influences the prognosis of patients affected by early breast cancer.

Published
2017

8. Different types of implants for reconstructive breast surgery

Author

Giuseppe Catanuto, Serena Testa, Andrea Spano, Maurizio B. Nava, Antonello Accurso, Corrado Rispoli, Nicola Rocco, Bruno Amato, Lorenzo Moja, Loredana Iannone, Rocco, Nicola, Rispoli, Corrado, Moja, Lorenzo, Amato, Bruno, Iannone, Loredana, Testa, Serena, Spano, Andrea, Catanuto, Giuseppe, Accurso, Antonello, and Nava, Maurizio B.

Subjects
Reconstructive surgery, medicine.medical_specialty, Breast Implants, Mammaplasty, medicine.medical_treatment, Breast surgery, Breast Neoplasms, Sodium Chloride, 030230 surgery, Prophylactic Surgical Procedure, Silicone Gels, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, medicine, Humans, Pharmacology (medical), Mastectomy, Randomized Controlled Trials as Topic, business.industry, Medicine (all), Hydrogels, Prophylactic Surgical Procedures, Capsular contracture, Middle Aged, Silicone Gel, medicine.disease, Prosthesis Failure, Surgery, Hydrogel, Patient Satisfaction, 030220 oncology & carcinogenesis, Female, Implant, business, Breast reconstruction, Breast Implant, Breast Neoplasm, Human
Abstract

Background Breast cancer is the most common cancer in women worldwide, and is a leading cause of cancer death among women. Prophylactic or curative mastectomy is often followed by breast reconstruction for which there are several surgical approaches that use breast implants with which surgeons can restore the natural feel, size and shape of the breast. Objectives To assess the effects of different types of breast implants on capsular contracture, surgical short- and long-term complications, postoperative satisfaction level and quality of life in women who have undergone reconstructive breast surgery after mastectomy. Search methods We searched the Cochrane Breast Cancer Group's Specialised Register on 20 July 2015, MEDLINE (1985 to 20 July 2015), EMBASE (1985 to 20 July 2015) and the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 8, 2015). We also searched the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov on 16 July 2015. Selection criteria We included randomised controlled trials (RCTs) and quasi-RCTs that compared different types of breast implants for reconstructive surgery. We considered the following types of intervention: implant envelope surfaces - texturised versus smooth; implant filler material - silicone versus saline, PVP-Hydrogel versus saline; implant shape - anatomical versus round; implant volume - variable versus fixed; brands - different implant manufacturing companies and implant generation (fifth versus previous generations). Data collection and analysis Two review authors independently assessed methodological quality and extracted data. We used standard Cochrane methodological procedures. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Main results Five RCTs with 202 participants met the inclusion criteria. The women participants were typically in their 50s, and the majority of them (about 82%) received reconstructive surgery following breast cancer, while the others had reconstructive surgery after prophylactic mastectomy. The studies were heterogenous in terms of implant comparisons, which prevented us from pooling the data. The studies were judged as being at an unclear risk of bias for most risk of bias items owing to poor quality of reporting in the trial publications. Three of the five RCTs were judged to be at high risk of attrition bias, and one at high risk of detection bias. Textured silicone versus smooth silicone implants: textured implants were associated with worse outcomes when compared to smooth implants (capsular contracture: risk ratio (RR) 0.82, 95% CI 0.14 to 4.71; 1 study, 20 participants; very low quality evidence; reintervention: RR 0.82, 95% CI 0.14 to 4.71; 1 study, 20 participants; very low quality evidence). No results in this comparison were statistically significant. Silicone versus saline implants: saline-filled implants performed better than silicone-filled implants for some outcomes; specifically, they produced less severe capsular contracture (RR 3.25, 95% CI 1.24 to 8.51; 1 study, 60 participants; very low quality evidence) and increased patient satisfaction (RR 0.60, 95% CI 0.41 to 0.88; 1 study, 58 participants; very low quality evidence). However reintervention was significantly more frequent in the saline-filled implant group than in the silicone-filled group (OR 0.08, 95% CI 0.01 to 0.43; 1 study, 60 participants; very low quality evidence). Poly(N-vinyl-2-pyrrolidone) hydrogel-filled (PVP-hydrogel) versus saline-filled implants: PVP-hydrogel-filled implants were associated with worse outcomes when compared to saline-filled implants (capsular contracture: RR 3.50, 95% CI 0.83 to 14.83; 1 study, 40 participants; very low quality evidence; short-term complications: RR 2.10, 95% CI 0.21 to 21.39; 1 study, 41 participants; very low quality evidence). Anatomical versus round implants: anatomical implants were associated with worse outcomes than round implants (capsular contracture: RR 2.00, 95% CI 0.20 to 20.15; 1 study, 36 participants; very low quality evidence; short-term complications: RR 2.00, 95% CI 0.42 to 9.58; 1 study, 36 participants; very low quality evidence; reintervention: RR 1.50, 95% CI 0.51 to 4.43; 1 study, 36 participants; very low quality evidence). No results in this comparison were statistically significant. Variable-volume versus fixed-volume implants: data about one-stage reconstruction using variable-volume implants were compared with data about fixed-volume implants positioned during the second surgical procedure of two-stage reconstructions. Fixed-volume implant reconstructions were possibly associated with a greater number of women reporting that their reconstruction corresponded with expected results (RR 0.25, 95% CI 0.10 to 0.62; 1 study, 40 participants; very low quality evidence) and fewer reinterventions (RR 7.00, 95% CI 1.82 to 26.89; 1 study, 40 participants; very low quality evidence) when compared to variable-volume implants. A higher patient satisfaction level (rated from 1 to 6, with 1 being very bad and 6 being very good) was found with the fixed-volume implants for overall aesthetic result (mean difference (MD) -1.10, 95% CI -1.59 to -0.61; 1 study, 40 participants; very low quality evidence). There were no studies that examined the effects of recent (fifth) generation silicone implants versus previous generations or different implant manufacturing companies. Authors' conclusions Despite the central role of breast reconstruction in women with breast cancer, the best implants to use in reconstructive surgery have been studied rarely in the context of RCTs. Furthermore the quality of these studies and the overall evidence they provide is largely unsatisfactory. Some of our results can be interpreted as early evidence of potentially large differences between different surgical approaches, which should be confirmed in new high-quality RCTs that include a larger number of women. These days - even after a few million women have had breasts reconstructed - surgeons cannot inform women about the risks and complications of different implant-based breast reconstructive options on the basis of results derived from RCTs.

Published
2016

9. Contralateral risk reducing mastectomy in Non-BRCA-Mutated patients

Author

Pierpaolo Di Lorenzo, Emanuele Capasso, Guglielmo Ferrari, Claudio Buccelli, Massimo Niola, Antonello Accurso, Nicola Rocco, Daniele Bordoni, Giuseppe Falco, Fabio Policino, Luigi Marano, Falco, Giuseppe, Rocco, Nicola, Bordoni, Daniele, Marano, Luigi, Accurso, Antonello, Buccelli, Claudio, DI LORENZO, Pierpaolo, Capasso, Emanuele, Policino, Fabio, Niola, Massimo, and Ferrari, Guglielmo

Subjects
0301 basic medicine, Secondary cancer, Oncology, medicine.medical_specialty, Risk reducing mastectomy, Sporadic Breast Cancer, Non-mutated patients, Non-mutated patient, Contralateral breast cancer, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Internal medicine, Breast Cancer, medicine, Overall survival, contralateral risk reducing mastectomy, Prospective cohort study, Focus on Medico-Legal and Ethical Topics in Surgery in Italy, skin and connective tissue diseases, business.industry, Medicine (all), Cancer, General Medicine, medicine.disease, 030104 developmental biology, 030220 oncology & carcinogenesis, Medicine, business
Abstract

The use of contralateral risk reducing mastectomy (CRRM) is indicated in women affected by breast cancer, who are at high risk of developing a contralateral breast cancer, particularly women with genetic mutation of BRCA1, BRCA2 and P53. However we should consider that the genes described above account for only 20-30% of the excess familiar risk. What is contralaterally indicated when genetic assessment results negative for mutation in a young patient with unilateral breast cancer? Is it ethically correct to remove a contralateral “healthy” breast? CRRM rates continue to rise all over the world although CRRM seems not to improve overall survival in women with unilateral sporadic breast cancer. The decision to pursue CRRM as part of treatment in women who have a low-to-moderate risk of developing a secondary cancer in the contralateral breast should consider both breast cancer individual-features and patients preferences, but should be not supported by the surgeon and avoided as first approach with the exception of women highly worried about cancer. Prospective studies are needed to identify cohorts of patients most likely to benefit from CRRM.

Published
2016

10. Epithelioid hemangioma of brachial artery: report of a case and review of the literature

Author

Guglielmo Ferrari, Moira Ragazzi, Antonello Accurso, Gianni Antonio Della Corte, Bruno Amato, Nicola Rocco, Daniele Bordoni, Giuseppe Falco, Riccardo Valli, Giovanni Casali, Pierfrancesco Cadenelli, Ragazzi, Moira, Falco, Giuseppe, Valli, Riccardo, Rocco, Nicola, Bordoni, Daniele, Cadenelli, Pierfrancesco, DELLA CORTE, GIANNI ANTONIO, Accurso, Antonello, Amato, Bruno, Casali, Giovanni, and Ferrari, Guglielmo

Subjects
medicine.medical_specialty, Pathology, Brachial Artery, hemic and lymphatic diseases, medicine.artery, medicine, Eosinophilia, Epithelioid Hemangioma, Brachial artery, Head and neck, business.industry, Medicine (all), General Medicine, Vascular lesion, Hyperplasia, Mini-Review, medicine.disease, eye diseases, Surgery, body regions, Medicine, sense organs, medicine.symptom, business
Abstract

Epithelioid hemangioma (EH) is an uncommon benign vascular lesion, also known as angioblastic lymphoid (or angiolymphoid) hyperplasia with eosinophilia, characterized by an unclear etiopathogenesis. It usually affects young to middle-aged adults and develops in the head and neck region, as painless cutaneous or subcutaneous reddish papules or nodules. Large vessels involvement is extremely rare, and to date only two cases affecting the brachial artery have been cited in literature. In this report we present a further case of EH of the brachial artery and review the pertinent literature.

Published
2015

11. Central nervous system metastases in a cohort of metastatic breast cancer patients treated with trastuzumab

Author

M. De Laurentiis, Angela Esposito, Emilia Montagna, Giuseppe Cancello, Rossella Lauria, Diego D'Agostino, Valeria Forestieri, Antonello Accurso, Lucrezia Silvestro, S. De Placido, E., Montagna, G., Cancello, D., D'Agostino, Lauria, Rossella, Forestieri, Valeria, A., Esposito, L., Silvestro, Accurso, Antonello, DE PLACIDO, Sabino, and DE LAURENTIIS, Michelino

Subjects
CA15-3, Oncology, Adult, Cancer Research, medicine.medical_specialty, Receptor, ErbB-2, Antineoplastic Agents, Breast Neoplasms, macromolecular substances, Kaplan-Meier Estimate, Toxicology, Antibodies, Monoclonal, Humanized, Central Nervous System Neoplasms, Cohort Studies, Breast cancer, Trastuzumab, Internal medicine, Medicine, Humans, Pharmacology (medical), skin and connective tissue diseases, neoplasms, Aged, Proportional Hazards Models, Retrospective Studies, Pharmacology, business.industry, Proportional hazards model, Antibodies, Monoclonal, Retrospective cohort study, Middle Aged, medicine.disease, Prognosis, Metastatic breast cancer, Cohort, Female, business, medicine.drug, Cohort study
Abstract

BACKGROUND: Several analyses suggest an increase of brain metastases in HER2 over-expressing breast cancers treated with trastuzumab as compared to historical series of unselected patients. PATIENTS AND METHODS: We analyzed the incidence of central nervous system (CNS) metastases in 78 patients with HER2 over-expressing breast cancer treated with trastuzumab between July 2000 and June 2006 at the Oncology Department of University Federico II in Naples. We also characterized and compared patients with and without CNS involvement. RESULTS: The median follow-up was 35.3 months (95\%CI 26.3-44); median overall survival was 56 months (95\%CIs 46-nr); 5 patients showed CNS involvement before trastuzumab therapy while 31 developed CNS metastases during trastuzumab treatment. The median overall survival after CNS metastases was 25.4 months (95\%CIs 15.2-nr); patients with CNS lesions showed worse overall survival than patients without CNS lesions (39.1 vs. 75 months, p = 0.005). CONCLUSION: CNS metastases are common events in patients with metastatic HER2 over-expressing breast cancer treated with trastuzumab; the impact on survival is detrimental even if survival after CNS metastases is longer than historical reports. Appropriate investigation of the role of CNS imaging screening and the prophylactic treatment strategies for CNS represents a priority research in this setting.

Published
2007

12. Primary angiosarcoma of the breast

Author

Bruno Amato, Cesare Magalotti, Nicola Rocco, Daniele Bordoni, Giuseppe Falco, Antonello Accurso, Elisa Bolletta, Ariel Tessone, Stefania Guarino, Pierfrancesco Cadenelli, Bordoni, Daniele, Bolletta, Elisa, Falco, Giuseppe, Cadenelli, Pierfrancesco, Rocco, Nicola, Tessone, Ariel, Guarino, Stefania, Accurso, Antonello, Amato, Bruno, and Magalotti, Cesare

Subjects
Oncology, medicine.medical_specialty, Breast Sarcoma, medicine.medical_treatment, Case Report, Lesion, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Breast sarcomas, Internal medicine, medicine, Angiosarcoma, 030212 general & internal medicine, Breast sarcoma, business.industry, Radiologic examination, Primary Angiosarcoma, medicine.disease, Radiation therapy, 030220 oncology & carcinogenesis, Surgery, medicine.symptom, business, Adjuvant
Abstract

Primary angiosarcoma (AS) of the breast is a rare neoplasia that is not related to radiation exposure. It represents less than 0.05% of all malignant breast tumors. This lesion is characterized by aggressive patterns and poor prognosis and by the absence of typical features at radiologic examination.Currently there are not evidence-based guidelines regarding surgical and adjuvant treatment for this tumor even though wide surgical resection followed by chemo- radiotherapy appears to improve both disease free survival and overall survival.The aim of this study was to analyze the available series of AS patients suggesting the most reliable treatment options for this rare neoplasia.

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