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Background: The management of early breast cancer (BC) has witnessed an uprise in the use of neoadjuvant therapy and a remarkable reshaping of the systemic therapy postneoadjuvant treatment in the last few years, with the evolution of many controversial clinical situations that require consensus., Methods: During the 14th Breast-Gynecological and Immuno-Oncology International Cancer Conference held in Egypt in 2022, a panel of 44 BC experts from 13 countries voted on statements concerning debatable challenges in the neo/adjuvant treatment setting. The recommendations were subsequently updated based on the most recent data emerging. A modified Delphi approach was used to develop this consensus. A consensus was achieved when ≥75% of voters selected an answer., Results and Conclusions: The consensus recommendations addressed different escalation and de-escalation strategies in the setting of neoadjuvant therapy for early BC. The recommendations recapitulate the available clinical evidence and expert opinion to individualize patient management and optimize therapy outcomes. Consensus was reached in 63% of the statements (52/83), and the rationale behind each statement was clarified., (© 2024 American Cancer Society.)

Abstract: Cardoso, F, Costa, MJ, Colaço, P, Vilas-Boas, JP, Pinho, JC, Pyne, DB, and Fernandes, RJ. Ventilatory and perceived ergogenic effects of mandibular forward repositioning during running at maximal oxygen uptake intensity. J Strength Cond Res XX(X): 000-000, 2024-Wearing an intraoral dental splint may enhance ventilatory function and exercise performance. Nineteen runners performed on a 400-m outdoor track: (a) an incremental protocol to assess the velocity at maximal oxygen uptake (vV̇ o2 max) and (b) 2 square wave bouts wearing 2 intraoral splints (with and without mandibular forward repositioning). The time until exhaustion at vV̇ o2 max (TLimv V̇ o2 max), ventilatory variables, oxygen uptake (V̇ o2 ) kinetics, energetic profiling, perceived exertion and kinematics, were all measured. Ventilatory data were assessed breath-by-breath and perceived exertion evaluated using the Borg 6-20-point scale at the end of TLimv V̇ o2 max bouts. Images were recorded by video cameras (120 Hz) and kinematic measures retrieved using Kinovea. A paired t test was computed for comparison of splints ( p ≤ 0.05). With (vs. without) mandibular forward repositioning, runners increased their TLimv V̇ o2 max by ∼6% ( p = 0.03), coupled with higher ventilation (151 ± 22 vs. 147 ± 23 L·min -1 , p = 0.04), end-tidal oxygen tension (114.3 ± 3.7 vs. 112.9 ± 3.9 mm Hg, p = 0.003), and lower inspiratory time (0.526 ± 0.083 vs. 0.540 ± 0.090 seconds, p = 0.02), despite similar V̇ o2 kinetics (e.g., 49.0 ± 8.7 vs. 47.7 ± 8.6 ml∙kg∙min -1 of fast component amplitude) being observed. The energy expenditure was ∼8% higher ( p = 0.03) with the mandible forward, coupled with lower perceived exertion scores ( p = 0.04). Mandibular forward repositioning was effective in acutely improving running performance at vV̇ o2 max with ergogenic effects on ventilatory and perceived variables., (Copyright © 2024 National Strength and Conditioning Association.)

Introduction: There is much literature about the role of 2-[ 18 F]FDG PET/CT in patients with breast cancer (BC). However, there exists no international guideline with involvement of the nuclear medicine societies about this subject., Purpose: To provide an organized, international, state-of-the-art, and multidisciplinary guideline, led by experts of two nuclear medicine societies (EANM and SNMMI) and representation of important societies in the field of BC (ACR, ESSO, ESTRO, EUSOBI/ESR, and EUSOMA)., Methods: Literature review and expert discussion were performed with the aim of collecting updated information regarding the role of 2-[ 18 F]FDG PET/CT in patients with no special type (NST) BC and summarizing its indications according to scientific evidence. Recommendations were scored according to the National Institute for Health and Care Excellence (NICE) criteria., Results: Quantitative PET features (SUV, MTV, TLG) are valuable prognostic parameters. In baseline staging, 2-[ 18 F]FDG PET/CT plays a role from stage IIB through stage IV. When assessing response to therapy, 2-[ 18 F]FDG PET/CT should be performed on certified scanners, and reported either according to PERCIST, EORTC PET, or EANM immunotherapy response criteria, as appropriate. 2-[ 18 F]FDG PET/CT may be useful to assess early metabolic response, particularly in non-metastatic triple-negative and HER2+ tumours. 2-[ 18 F]FDG PET/CT is useful to detect the site and extent of recurrence when conventional imaging methods are equivocal and when there is clinical and/or laboratorial suspicion of relapse. Recent developments are promising., Conclusion: 2-[ 18 F]FDG PET/CT is extremely useful in BC management, as supported by extensive evidence of its utility compared to other imaging modalities in several clinical scenarios., (© 2024. The Author(s).)

Objective: Describe the management practices provided to charrería horses in the state of Guerrero, Mexico and relate them to animal welfare. Design/methodology/approach: Sixty-four owners of charrería horses were interviewed and 10% underwent an evaluation according to the protocol of the Welfare Quality® Results: The most used breeds are Creole, Quarter Horse, Aztec, Spanish and Arabian. The starting age in charrería is two to four years. Hoof shoeing is done every 8 to 12 weeks in 54.3%. The diet is based on forage and commercial feed (82.8%). Deworming is every six months (60.9%), vaccinated against tetanus, rabies, and influenza. The most frequent diseases are digestive and locomotor, skin and respiratory. The stereotypes were rocking, nodding, kicking doors, chewing wood, and walking in circles. Abundant body condition ranged from good to obese in the animals. The majority had white hairs as an indication of injuries caused by the harnesses. Limitations on study/implications: The lack of knowledge of the owners of horses dedicated to charro sport, to relate the five freedoms of well-being that must be given to every animal to improve their sporting performance, has caused problems in the animal's life quality. Findings/conclusions: The findings observed in the horses indicate that the welfare conditions were affected, which led to the development of vices, poor body condition, sick animals, and skin lesions in the animals. [ABSTRACT FROM AUTHOR]

Color is one of the main attributes used to select or reject meat products, with the characteristic reddish-pink color of cured meats being developed by adding nitrate salts, which are rejected by many consumers due to their harmful effects on health. This study aimed to apply a hybrid dye (ZHN-carmine) synthesized from layered zinc hydroxide salt (ZHN) to produce a reddish-pink color in sliced cooked ham and to evaluate color stability during storage. The ham samples were prepared with cochineal carmine and hybrid dye (ZHN-carmine), sliced, vacuum-packed, and non-vacuumpacked, and exposed to white fluorescent light (1100 LUX) (5 ± 1 °C). The instrumental color measurement was performed at 0, 1, 4, 6, 8, 11, 13, and 15 day intervals. Distinction between the vacuum-packed ham samples and the nonvacuum-packed ham samples was possible based on a* value (red color intensity), which showed the importance of oxygen removal for red color stability. The reddish-pink color was more intense in the ham added with ZNHcarmine, and no color reduction was observed over the days, irrespective of it being vacuum-packed or not. Cochineal carmine adsorbed onto layered zinc hydroxide salt may be a potential replacement for curing salts regarding color formation in vacuum-packed or non-vacuum-packed cooked ham. [ABSTRACT FROM AUTHOR]

Small, hormone receptor-positive (HR+), HER2-negative (HER2-), lymph node-negative breast cancers are associated with relatively low rates of disease recurrence and have therefore been underrepresented in clinical trials assessing the effects of systemic therapy. Consequently, it remains uncertain if this patient population derives benefit from these treatments. For this exploratory analysis, we selected MINDACT (NCT00433589) patients with a HR+, HER2-, T1ab (≤1 cm) tumor and negative lymph nodes. Patients with discordant clinical risk and MammaPrint genomic risk classification were randmomized to receive chemotherapy based on either the clinical or the genomic risk assessment. Endocrine therapy treatment was based on local guidelines. 715/6693 (10.7%) MINDACT patients had HR+, HER2-, T1abN0 breast cancer and were included in this analysis. All were clinically low-risk, 124/715 (17.3%) were genomic high-risk. For genomic high-risk tumors, 8-year distant metastasis-free survival (DMFS) was 92.9% (95% CI 86.2-96.4%) compared to 95.0% (95% CI 92.8-96.6%) for genomic low-risk tumors. For genomic high-risk tumors treated with or without chemotherapy, 8-year DMFS was 89.2% (95% CI 73.6-95.8%) and 94.1% (95% CI 82.9-98.1%), respectively. For genomic low-risk tumors, the 8-year DMFS and disease-free survival (DFS) were 96.1% (95% CI 93.4-97.6%) and 89.3% (95% CI 85.5-92.2%) when treated with endocrine therapy and 92.9% (95% CI 87.9-95.9%) and 79.4% (95% CI 72.5-84.8%) without. In conclusion, although the number of randomized patients is small, patients with small, genomic high-risk breast cancer did not seem to derive benefit from chemotherapy. Endocrine therapy was associated with improved outcomes even in genomic low-risk breast cancers., (© 2024. The Author(s).)

Background: The MDS-UPDRS has been available in English since 2008, showing satisfactory clinimetric results and being proposed as the new official benchmark scale for Parkinson's disease (PD), being cited as a core instrument for PD in the National Institutes of Neurological Disorders and Stroke Common Data Elements program. For this reason, the MDS created guidelines for development of MDS-UPDRS official, clinimetrically validated translations., Objective: This study presents the formal process used to obtain the officially approved Portuguese version of the MDS-UPDRS., Methods: The study consisted of three phases: (1) Independent translation by Portuguese and Brazilian teams followed by a challenging consensus process that this article particularly emphasizes; (2) Cognitive pretest involving raters and patients from both Portugal and Brazil; (3) Validation test with a sample of 367 native Portuguese-speaking PD patients., Results: The overall factor structure of the Portuguese version was consistent with the English version based on a comparative fit index ≥0.96 for all four parts of the MDS-UPDRS., Conclusion: This version can be designated as the official Portuguese version of the MDS-UPDRS., (© 2024 International Parkinson and Movement Disorder Society.)

Purpose: Cancer recurrence is an important long-term outcome of cancer survivors that is often not routinely collected and recorded by population-based registries. In this study, we review population-based studies to determine the current availability, landscape, and infrastructure of long-term outcomes, particularly metastatic recurrence, in women initially diagnosed with nonmetastatic breast cancer (MBC)., Methods: We reviewed the literature to identify studies that used population-based registry data to examine the distribution of metastatic recurrence in women diagnosed with non-MBC. Data on outcomes and methods of ascertainment were extracted. Registry infrastructure including sources and funding was also reviewed., Results: A total of 23 studies from 11 registries in eight countries spanning Europe, North America, and Oceania were identified and included in the review. Most studies were retrospective in nature and collected recurrence data only for ad hoc studies rather than as part of their routine registration. Definition of recurrence and data sources varied considerably across studies: the cancer-free time interval between the start of follow-up and risk window ranged from the diagnosis of primary tumor (n = 7) to 6 months from diagnosis (n = 1); the start of follow-up differed between initial diagnosis (n = 16) and treatment (n = 7)., Conclusion: Cancer surveillance should encompass outcomes among survivors for research and monitoring. Studies are underway, but more are needed. Cancer registries should be supported to routinely collect recurrence data to allow complete evaluation of MBC as an outcome to be conducted and inform health care providers and researchers of the prognosis of both nonmetastatic and metastatic patients with breast cancer.

Background: The COVID-19 pandeminc has had widespread impacts, but its specific effects on mental health and cognitive function in patients with cancer remain under-explored., Recent Findings: Data from the general population has suggested that mental health problems were frequent during the pandemic, namely during the initial stage of the outbreak. For patients with cancer, a systematic review and meta-analysis of data published until January 2021 also showed elevated prevalence of depression and anxiety, and suggested that anxiety was more frequent than in health workers and healthy controls., Objective: This systematic review aimed to synthesize existing evidence on the impact of the COVID-19 pandemic on mental health and cognitive function in patients with cancer., Methods: Studies were identified through systematic search of three electronic bibliographic databases (PubMed, Web of Science, and EBSCOHOST) with adapted search strings. We included only peer-reviewed, nonqualitative, original research papers, published between 2019 and 2022, and reporting on mental health and/or cognition outcomes during the COVID-19 pandemic in adult patients with cancer., Results: Of 3260 papers identified, 121 full text articles were retrieved and 71 met inclusion criteria. We found that patients with cancer reported high levels of psychological distress, anxiety and depression, as well as cognitive complaints during the pandemic. However, studies were not consistent in identifying these symptoms as effects of the pandemic specific for this population. In fact, longitudinal studies did not find consistent differences between pre- and post-pandemic periods and, globally, patients with cancer did not report increased severity of these mental health symptoms in relation to the general population., Conclusion: Overall, while the COVID-19 pandemic may have raised mental health challenges for patients with cancer, the diagnosis of cancer and associated treatments seemed to remain the main source of concern for these patients., (© 2024 The Author(s). Cancer Reports published by Wiley Periodicals LLC.)

Background: Heart failure (HF) patients are at constant risk of decompensation, and urgent hospital admissions can be life-threatening events. Monitoring biological variables has been proved to be an important mechanism to anticipate decompensations. TriageHF is a validated diagnostic algorithm tool available on Medtronic® cardiac implantable electronic devices that combines physiological data to stratify a patient's risk of HF hospitalization in the following 30 days in low, medium or high risk. We aimed to evaluate the utility of TriageHF algorithm to predict the occurrence of acute clinical decompensation events (ACDE), including HF and non-HF cardiovascular events, within a 30-day period in a population of HF patients with reduced ejection fraction., Methods: We reviewed the transmissions received by the Medtronic® Carelink™ Network between August 2022 and July 2023. The heart failure risk status (HFRS) and the device parameters contributing to that risk, from the previous 30 days, were collected, along with the occurrence of ACDEs within 30 days., Results: We retrospectively assessed 207 transmissions from the 64 patients included in the study. Among the 93 medium HFRS transmissions, 16 (17.2%) resulted in ACDEs. For the 21 high HFRS transmissions, 10 (47.6%) resulted in ACDEs. Considering the ACDEs, 60.7% were preceded by an alarm-initiated transmission. Except for heart rate variability, each diagnostic parameter demonstrated effectiveness in stratifying risk for ACDEs. Optivol® and the Combined Heart Rhythm showed independent association with ACDEs (p < .001). Patients with medium and high HFRS were, respectively, 8.6 and 29.1 times more likely to experience an ACDE in the next 30 days than low risk patients. A medium-high HFRS conferred a sensitivity of 92.9% and a NPV of 97.8% for an ACDE., Conclusion: TriageHF is a useful method for predicting ACDEs and has the potential to trigger medical actions to prevent hospitalizations., (© 2024 Wiley Periodicals LLC.)

Purpose: To verify the ability of pretreatment [ 18 F]FDG PET/CT and T1-weighed dynamic contrast-enhanced MRI to predict pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients., Methods: This retrospective study includes patients with BC of no special type submitted to baseline [ 18 F]FDG PET/CT, NAC and surgery. [ 18 F]FDG PET-based features reflecting intensity and heterogeneity of tracer uptake were extracted from the primary BC and suspicious axillary lymph nodes (ALN), for comparative analysis related to NAC response (pCR vs. non-pCR). Multivariate logistic regression was performed for response prediction combining the breast tumor-extracted PET-based features and clinicopathological features. A subanalysis was performed in a patients' subsample by adding breast tumor-extracted first-order MRI-based features to the multivariate logistic regression., Results: A total of 170 tumors from 168 patients were included. pCR was observed in 60/170 tumors (20/107 luminal B-like, 25/45 triple-negative and 15/18 HER2-enriched surrogate molecular subtypes). Higher intensity and higher heterogeneity of [ 18 F]FDG uptake in the primary BC were associated with NAC response in HER2-negative tumors (immunohistochemistry score 0, 1 + or 2 + non-amplified by in situ hybridization). Also, higher intensity of tracer uptake was observed in ALN in the pCR group among HER2-negative tumors. No [ 18 F]FDG PET-based features were associated with pCR in the other subgroup analyses. A subsample of 103 tumors was also submitted to extraction of MRI-based features. When combined with clinicopathological features, neither [ 18 F]FDG PET nor MRI-based features had additional value for pCR prediction. The only significant predictors were estrogen receptor status, HER2 expression and grade., Conclusion: Pretreatment [ 18 F]FDG PET-based features from primary BC and ALN are not associated with response to NAC, except in HER2-negative tumors. As compared with pathological features, no breast tumor-extracted PET or MRI-based feature improved response prediction., (© 2024. The Author(s).)

Background: In KEYNOTE-522 (NCT03036488), neoadjuvant pembrolizumab plus chemotherapy and then adjuvant pembrolizumab significantly improved pathological complete response and event-free survival vs neoadjuvant chemotherapy in early-stage triple-negative breast cancer (TNBC). We report patient-reported outcomes (PROs) from KEYNOTE-522., Methods: Patients were randomized 2:1 to neoadjuvant pembrolizumab 200 mg or placebo every 3 weeks, plus 4 cycles of paclitaxel plus carboplatin and then 4 cycles of doxorubicin (or epirubicin) plus cyclophosphamide. After surgery, patients received adjuvant pembrolizumab or placebo for up to 9 cycles. European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and EORTC Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23) were prespecified secondary objectives. Between-group differences in least squares (LS) mean change from baseline (day 1 of cycle 1 in both neoadjuvant and adjuvant phases) to the prespecified latest time point with at least 60% completion and at least 80% compliance were assessed using a longitudinal model (no alpha error assigned)., Results: Week 21 (neoadjuvant phase) and week 24 (adjuvant phase) were the latest time points at which completion/compliance rates were ≥60%/80%. In the neoadjuvant phase, between-group differences (pembrolizumab plus chemotherapy [n = 762] vs placebo plus chemotherapy [n = 383]) in LS mean change from baseline to week 21 in QLQ-C30 global health status/quality of life (GHS/QoL), emotional functioning, and physical functioning were -1.04 (95% confidence interval = -3.46 to 1.38), -0.69 (95% CI = -3.13 to 1.75), and -2.85 (95% CI = -5.11 to -0.60), respectively. In the adjuvant phase, between-group differences (pembrolizumab [n = 539] vs placebo [n = 308]) in LS mean change from baseline to week 24 were -0.41 (95% CI = -2.60 to 1.77), -0.60 (95% CI = -2.99 to 1.79), and -1.57 (95% CI = -3.36 to 0.21)., Conclusions: No substantial differences in PRO assessments were observed between neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab vs neoadjuvant placebo plus chemotherapy in early-stage TNBC., Trial Registration: ClinicalTrials.gov, NCT03036488., (© The Author(s) 2024. Published by Oxford University Press.)

The effects of occlusal splints on sport performance have already been studied, although their biomechanical impacts are often overlooked. We investigated the kinematical changes during running until exhaustion at severe intensity while wearing a mandibular advancement occlusal splint. Twelve trained runners completed (i) an incremental protocol on a track to determine their velocity corresponding to maximal oxygen uptake and (ii) two trials of square wave transition exercises at their velocity corresponding to maximal oxygen until exhaustion, wearing two occlusal splints (without and with mandibular advancement). Running kinematics were compared within laps performed during the square wave transition exercises and between splint conditions. The mandibular advancement occlusal splint increased the running distance covered (~1663 ± 402 vs. 1540 ± 397 m, p = 0.03), along with a noticeable lap effect in decreasing stride frequency ( p = 0.04) and increasing stride length ( p = 0.03) and duty factor ( p < 0.001). No spatiotemporal differences were observed between splints, except for improved balance foot contact times in the mandibular advancement condition. An increased knee flexion angle at initial contact ( p = 0.017) was noted along laps in the non-advancement condition, despite the fact that no differences between splints were found. Running patterns mainly shifted within laps rather than between conditions, indicating that a mandibular advancement occlusal splint had a trivial kinematical effect.

Background: In patients with early-stage triple-negative breast cancer, the phase 3 KEYNOTE-522 trial showed significant improvements in pathological complete response and event-free survival with the addition of pembrolizumab to platinum-containing chemotherapy. Here we report the final results for overall survival., Methods: We randomly assigned, in a 2:1 ratio, patients with previously untreated stage II or III triple-negative breast cancer to receive neoadjuvant therapy with four cycles of pembrolizumab (at a dose of 200 mg) or placebo every 3 weeks plus paclitaxel and carboplatin, followed by four cycles of pembrolizumab or placebo plus doxorubicin-cyclophosphamide or epirubicin-cyclophosphamide. After definitive surgery, patients received adjuvant pembrolizumab (pembrolizumab-chemotherapy group) or placebo (placebo-chemotherapy group) every 3 weeks for up to nine cycles. The primary end points were pathological complete response and event-free survival. Overall survival was a secondary end point., Results: Of the 1174 patients who underwent randomization, 784 were assigned to the pembrolizumab-chemotherapy group and 390 to the placebo-chemotherapy group. At the data-cutoff date (March 22, 2024), the median follow-up was 75.1 months (range, 65.9 to 84.0). The estimated overall survival at 60 months was 86.6% (95% confidence interval [CI], 84.0 to 88.8) in the pembrolizumab-chemotherapy group, as compared with 81.7% (95% CI, 77.5 to 85.2) in the placebo-chemotherapy group (P = 0.002). Adverse events were consistent with the established safety profiles of pembrolizumab and chemotherapy., Conclusions: Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab resulted in a significant improvement, as compared with neoadjuvant chemotherapy alone, in overall survival among patients with early-stage triple-negative breast cancer. (Funded by Merck Sharp and Dohme, a subsidiary of Merck [Rahway, NJ]; KEYNOTE-522 ClinicalTrials.gov number, NCT03036488.)., (Copyright © 2024 Massachusetts Medical Society.)

Purpose: The recently released EANM/SNMMI guideline, endorsed by several important clinical and imaging societies in the field of breast cancer (BC) care (ACR, ESSO, ESTRO, EUSOBI/ESR, EUSOMA), emphasized the role of [ 18 F]FDG PET/CT in management of patients with no special type (NST) BC. This review identifies and summarizes similarities, discrepancies and novelties of the EANM/SNMMI guideline compared to NCCN, ESMO and ABC recommendations., Methods: The EANM/SNMMI guideline was based on a systematic literature search and the AGREE tool. The level of evidence was determined according to NICE criteria, and 85 % agreement or higher was reached regarding each statement. Comparisons with NCCN, ESMO and ABC guidelines were examined for specific clinical scenarios in patients with early stage through advanced and metastatic BC., Results: Regarding initial staging of patients with NST BC, [ 18 F]FDG PET/CT is the preferred modality in the EANM-SNMMI guideline, showing superiority as a single modality to a combination of contrast-enhanced CT of thorax-abdomen-pelvis plus bone scan in head-to-head comparisons and a randomized study. Its use is recommended in patients with clinical stage IIB or higher and may be useful in certain stage IIA cases of NST BC. In NCCN, ESMO, and ABC guidelines, [ 18 F]FDG PET/CT is instead recommended as complementary to conventional imaging to solve inconclusive findings, although ESMO and ABC also suggest [ 18 F]FDG PET/CT can replace conventional imaging for staging patients with high-risk and metastatic NST BC. During follow up, NCCN and ESMO only recommend diagnostic imaging if there is suspicion of recurrence. Similarly, EANM-SNMMI states that [ 18 F]FDG PET/CT is useful to detect the site and extent of recurrence only when there is clinical or laboratory suspicion of recurrence, or when conventional imaging methods are equivocal. The EANM-SNMMI guideline is the first to emphasize a role of [ 18 F]FDG PET/CT for assessing early metabolic response to primary systemic therapy, particularly for HER2+ BC and TNBC. In the metastatic setting, EANM-SNMMI state that [ 18 F]FDG PET/CT may help evaluate bone metastases and determine early response to treatment, in agreement with guidelines from ESMO., Conclusions: The recently released EANM/SNMMI guideline reinforces the role of [ 18 F]FDG PET/CT in the management of patients with NST BC supported by extensive evidence of its utility in several clinical scenarios., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: The KEYNOTE-522 (KN-522) trial showed that the addition of pembrolizumab to standard chemotherapy improved pathological complete response (pCR) and event-free survival (EFS) for patients with early triple negative breast cancer (TNBC). We analyzed results of a real-world cohort of patients treated in a certified Breast Unit, before the introduction of pembrolizumab, to see if high quality care can match outcomes brought by the addition of an innovative anticancer therapy., Methods: Observational, retrospective, single-center cohort study, with real-world data from an ongoing institutional database with prespecified variables. Inclusion criteria matched the ones from KN-522: previously untreated stage II or III TNBC, diagnosed between 2012 and 2022, who received neoadjuvant chemotherapy. The primary endpoints were pCR at the time of definitive surgery and EFS; overall survival (OS) was a secondary endpoint., Results: Total of 168 patients were included, median age 55 years, 55 % received neoadjuvant chemotherapy with dose dense anthracyclines and taxanes and 25 % carboplatin + paclitaxel, sequenced with dose dense anthracyclines. Most had Stage II disease (82.7 %), 47 % node + disease. pCR was achieved in 52.7 % cases. At 36 months, EFS was 83.3 % (95 % CI 75.1-89.0) and OS 89 % (95 % CI, 81.6 to 93.5)., Conclusions: Notwithstanding the study limitations, outcomes of patients treated with chemotherapy without immunotherapy were numerically similar to the experimental arm of KN-522 trial. These data highlight that providing care by a specialized multidisciplinary team in a certified unit might be just as impactful as the incorporation of new technologies., (Copyright © 2024. Published by Elsevier Ltd.)