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Purpose Methods and materials Results Conclusion Personal information and conflict of interest References, Purpose: Metopic suture belongs to the sagittal arch; it closes most frequently between 3 and 9 months (first suture to close), althought it was described a physiologically fusion as early as 3 months [1-3]. Trigonocephaly is a hallmark of metopic synostoses...

Learning objectives Background Findings and procedure details Conclusion Personal information References, Learning objectives: To focus on the role of MRI in vulvar tumor To describe of the imaging features that are important in the study, staging and management of patients affected by vulvar...

Introduzione: Il presente lavoro indaga la qualità delle reazioni emotive e psicologiche delle pazienti affette da cancro mammario, sottoposte a intervento chirurgico e in diversi stadi di malattia. Metodologia: Il campione è composto da 110 pazienti così suddivise: 40 in follow-up, 41 sottoposte a chemioterapia adiuvante, 29 metastatiche. Strumenti: Defense Mechanisms Inventory (DMI, Ihilevich e Gleser, 1986), Toronto Alexithymia Scale (TAS-20, Taylor GJ,1992), EORTC QLQ-C30-BR23 (Fayers PM et al 1998). Risultati: Nei tre gruppi si rivela differenza alle scale F1 (p

Aim. Following the availability of the results ofvalidation studies, the sentinel lymph node biopsy(SLNB) has replaced routine axillary dissection(AD) as the new standard of care in early unifocal breast cancers.Multifocal (MF) and multicentric (MC) tumours have been considered as a contraindication for this technique due to the possible incidence of a higher false-negative rate. In this retrospective study we try to demonstrate the usefulness of SLNB in MF/MC breast carcinoma. Patients and Methods. Eight hundreds and fiftyeightpatients with breast carcinoma underwent a conservative surgery and sentinel node excision. Ninety-four out of 858 patients had histological diagnosis of multifocal breast carcinoma; out of these patients, 22 had SLN localization by both radio-colloid and blue dye, and 72 had localization by radio-colloid only. Results. Using radioisotope technique SLN was identified in 90/94 cases (95.7%). Using radioisotope technique and blue dye the SLN was identified in all 94 cases. SLNs were positive for metastases in 53 of the 94 cases (56.4%), in 39 cases (41%) were negative. The axillary dissection was performed in all 53 patients with positive SLNs: in 22 patients (41.5%) the SLN was the only site of axillary metastasis. None of the patients within this group experienced axillary recurrence at follow-up (median 54 months, ranging from 19 to 110 months). Conclusions. The high accuracy of SLNB in MF and MC breast cancer demonstrates,according to the results of other series published in the literature, that bothMF andMC tumours do not represent a contraindication for SLNB anymore. Eur. J. Oncol., 16 (2), 105-110,2011

Background: Current clinical parameters for breast cancer diagnosis and therapy are: tumour size, axillary lymph node status, histological grading and presence or absence of metastases. Prognostic/predictive properties, such as oestrogen and progesterone receptor status, and human epidermal growth factor receptor (HER-2/neu) status are currently used for therapeutic decision. Conversely, it is now emerging that the number of genetic mutations and epigenetic deregulations in cancer is far more higher than previously thought. Therefore, proteomic screening for differential protein expression in subsets of tumor samples is an essential tool for generating data bases and biomarker discovery. The aim of present study was to extend to a significant number of proteins and patients our previous data, contributing to the knowledge of biological pathways involved in breast cancer and to the molecular-based classification of breast cancer patients. Methods: Aliquots of breast cancer tissues and their adjacent non-tumoral tissues were obtained during surgical intervention from patients who did not receive any neoadiuvant therapy. Diagnosis of ductal infiltrating breast cancer (DIC) was confirmed by histopathology. Sample preparation for proteomics was performed as described (Pucci-Minafra et al. Proteomics Clinical Applications, 1, 118-129, 2007; Pucci-Minafra et al. Journal of Proteome Research 7, 1412-18, 2008). Quantitative determination of protein spots was normalized for actin. Results: We have collected for the present study 100 proteomic maps from G2/G3-DIC patients, and 13 from non-tumoral mammary tissues. All detected proteins were identified, or confirmed, by mass spectrometry. Collectively we have annotated 209 protein spots, corresponding to 122 genes. Genes were analyzed by the instruments of DAVID Bioinformatics Resources (Dennis et al. 2003; Huang et al. 2009). The Gene Accession Conversion tool recognized 112 unambiguous Gene IDs, over the 122 ones present in our list. The gene list was correlated to 136 functional terms, but only 36 correlations were highly significant (Benjamini values from 1x10-8 to 5.6 x10-3). Nine terms over the 36 corresponded to the function of apoptotic processes and in particular 24 genes were related at the highest significant value (1x10-8) with the regulation of programmed cell death; 50% of the genes belonging to this category, codify for proteins with anti-apoptotic functions. The cluster of anti-apoptotic proteins, corresponding to 12 genes and 22 protein isoforms was compared among the 100 proteomics maps and the 13 reference non-tumoral tissue maps. The comparative proteomic profiling showed: 1) a highly significant overexpression of several members of the anti-apoptotic protein cluster in the cancer tissues vs non tumoral counterparts; 2) a relative variability of the expression levels of the normalized proteins within patients. Among proteins of this category reaching the high levels of expression, we observed the nucleophosmin (NPM), a crucial regulator of p53; the translationally-controlled tumor protein (TCTP1), a protein involved in calcium binding and microtubule stabilization; cofilin (COF1), an actin-binding protein responsible also for the signal translocation from cytoplasm to nucleus; annexin A1 (ANXA1) a calcium/phospholipid-binding protein which promotes membrane fusion and ruffling, and the glutathione s-transferase (GSTP1), which plays important roles in detoxification but having also a role in susceptibility to cancer. Conclusions: The application of the powerful Bioinformatics Resources for gene/protein classification provided by DAVID knowledgebase, while confirming our previous protein classification, introduced new terms for further remodulation of protein clusters on the basis of the multiple functions for individual proteins. In particular we found a high number of proteins with specific biochemical functions, converging towards common pathways. Overall, a predominant pathway was the programmed cell-death, which resulted to be the most robust among patients, both as number of proteins involved and as level of significativity.We believe hat the present collection of human breast cancer proteomics represents a valid contribution for clinical applications to breast cancer.

The S-100 family of calcium-binding proteins includes about 20 members of low molecular weight characterized by two consecutive EF hands domains. They make interactions with cellular target proteins in a calcium-dependent manner; therefore they are thought to regulate a variety of physiological functions, such as cell proliferation, signal transduction, cell adhesion, motility as well as cancer metastasis.

The exponentially increasing volume of information extracted from genomic and proteomic applications on cancer, while providing new insights into molecular composition of cancer cells and tissues, imposes new challenges on data rationalization as a tool for clinically relevant biomarker discovery. Breast cancer represents the most frequent and potentially aggressive type of cancer and, moreover, it is one of the most enigmatic and poorly predictable in its evolution, likely because it includes several different forms that behave differently among patients. Current clinical parameters for breast cancer diagnosis and cure are: tumour size, axillary lymph node status, histological grading and presence or absence of metastases. Prognostic/predictive properties, such as oestrogen and progesterone receptor status, and human epidermal growth factor receptor (HER-2/neu) status are currently used for therapeutic decision. Conversely, it is now emerging that the number of genetic mutations and epigenetic deregulations in cancer is far more higher than previously thought. Therefore, proteomic screening for differential protein expression in subsets of tumor samples is an essential tool to generate data bases, to contribute to the knowledge of biological pathways in a given cancer tissue, to allow a molecular classification of cancer for patient stratification and biomarker discovery. To minimize the limitation induced by heterogeneity of breast cancer tissues, we have recently introduced, as objective criterion to compare proteomes of different tissues, the normalization of the expression levels of individual proteins, for actin content in each tissue extract (Pucci-Minafra I. et al., 2008). With the aim to identify candidate markers for stratification of patients and clinical correlations, in the present study we evaluated the surgical tissues proteomic profiles of an increased number of patients diagnosed for ductal infiltrating breast cancer. Differentially expressed proteins were identified by 2D-IPG coupled with Peptide Mass Fingerprint (PMF) and N-terminal microsequencing.

Quadrantectomy and associated sentinel lymph node biopsy (SLNB) is currently employed in most breast surgery centres as the gold standard in the treatment of early breast cancer. This approach has a modest morbidity and can usually be performed in a day-surgery regimen, leading to best acceptance by the patients. This reports outlines the experience of our Breast Unit with quadrantectomy and SLNB in day surgery for early breast cancer. One hundred patients presenting to our institution with primary invasive breast cancer measuring less than 3 cm and clinically negative axillary nodes underwent quadrantectomy and SLNB in day surgery. For 60 women with breast cancer the sentinel node was negative, so the only definitive surgical treatment was performed in the day-surgery regimen; 40 patients with positive sentinel nodes were hospitalised a second time for axillary dissection. In these patients that needed clearance of the axilla, SLNB was performed on the only positive node in 22 cases (55%). None of the patients admitted for quadrantectomy and SLNB in day surgery required re-hospitalisation after discharge. All patients proved to be fully satisfied with early discharge from hospital when questioned on the occasion of subsequent monitoring. Short-stay surgical programs in early invasive breast cancer treatment are feasible today owing to the availability of less invasive approaches such as quadrantectomy and SLNB. There are two main pointers to a distinct advantage for this kind of approach, i.e. recovery and psychological adjustment. Recovery from surgery is faster and the patient tends to play down the seriousness of the operation and to have a better mental attitude to neoplastic disease. Moreover, when performing quadrantectomy with SLNB in day surgery fewer than 50% of breast cancer patients (40% in our experience) require another surgical treatment, concluding the surgery in a single session.