Surgery after Neoadjuvant Chemotherapy: A Clip-Based Technique to Improve Surgical Outcomes, a Single-Center Experience

SIMPLE SUMMARY: Neoadjuvant chemotherapy (NACT) has an important role in the treatment of locally advanced breast cancer. After NACT, some lesions may be no longer visible at preoperative imaging, making breast and axillary conservative surgery more difficult. Among others, radiopaque clips are the most commonly used method to mark lymph nodes and tumor sites to tailor surgery in the post neoadjuvant setting. ABSTRACT: Background: This study aims to describe the surgical management of breast cancer patients after neoadjuvant chemotherapy, with attention to the impact on surgical outcomes of a clip-based marking technique. Methods: Patients who underwent NACT at the Breast Unit of the A. O Ordine Mauriziano of Turin from January 2018 and had a surgical intervention by January 2022 were included. Data on the feasibility of clip insertion, after-treatment visibility, and successful removal during surgery were collected prospectively. Surgical outcomes in terms of breast-conserving surgery and axillary dissection reduction were described. Results: In 51 patients who had surgery after NACT, 55 clips were placed (34 breast and 21 axillary clips). Ultrasound visibility of the clips was optimal (91%) as well as preoperative localization and retrieval within the surgical specimen. Moreover, the use of the clip positively affected surgical outcomes. In our study, clip insertion allowed to avoid mastectomy and axillary dissection in patients with a complete radiological response. Conclusions: In our findings, the use of breast and/or lymph node clips has proved to be a simple and effective method to improve surgical conservative management of breast cancer patients after NACT

Proliferación y apoptosis en epitelio lingual de ratones con tumores salivales inducidos por Dimetilbenzantraceno (DMBA) y modulados por lípidos dietarios

Introductiomi: Aecorcling to the concept of fielcl defeets during the careinogenesis process, cxcessive cpithelial proliferation/ apoptosis may exist iii arcas near tunlors. Proliferation or apoptosis cou Id be mnodified by dietary lipids. Purpose: The present stucly vas designed ro analyze proltferation and apoptosis in tongue epitheliurn of inice Ucd cliets bascd nn different lipicls followed Uy induction of salivary tumors with DMBA. Mateninls and Methods: Forty-five clays after weaning, ten BALB/c mice were assigned to two chets: coro oil (CO) and fish oil (eod liver, FO). \u27i\vo weeks later. DMBA vas injccteclin the submandibular area. Animals were sacrificed at the 13th post-in(ection weck. Sarnplcs of tongue were fixecl in formnalinethanol and irnmunohistocheinically stained for proliferation (Ki-67) and apoptosis (Bax). By light inicroseopv, the number of nuclei positive for theseniarkers were countcd out of three-hundred total interphase celis both in dorsal and in ventral tongue surfaces. Results were analyzed through Analysis ofVariance and t Test. Resu]ts: Cell proliferation vas greater in dorsal than in ventral tongue surfaces (p<0.0001) with no diet difference. Apoptosis wassignificantly greater in mice fed FO than CO, particularly in tongue dorsal epithelia (p<O.Ol 8). Conclusions: This study shows that FO diet induces higher leveis of apoptosis in tongue epithelia suggesting a tissue defensive mechanism when exposed to a carcinogenic-tumoral agentIntroducción: Según el concepto de cancerización de campo, existiría alteración en la proliferación epitelial en áreas cercanas a tumores. Dicha proliferaciónpodría ser modificarla por lípidos dietarios. Objetivos: Este estudio fue diseñado para analizar proliferación y apoptosis en epitelio lingual ele ratonesportadores de tumores salivales inducidos por DMBAy alimentados con dietas a base de diferentes lípidos. Materiales y Métodos: Cuarenta y cinco días  posteriores al destete, diez ratones BALB/ e fueron asignados a dos nietas: maíz (M) y bacalao (B). Dos semanas después se inyectó DMBA en la zona submandibular.Los animales fueron sacrificados a la 13° semana post-inyección. Muestras de lengua fueron fijadas en formol-etanol y procesadas inrnunohistoquímicamente con marcadores tIc proliferación (Ki-67) y apoptosis (Bax). Mediante microscopia óptica, se efectuó un conteo de núcleospositivos a ambos marcadores en un total de trescientas células en interfase, tanto en cara dorsal como ventral de lengua. Los resultados fueron analizados mediante Análisis tic Varianza y Test t. Resultados: La proliferación celular fue mayor en cara dorsal que en ventral (p<0.0001) sin diferencias por dieta. La apoptosis fue significativamente mayor en ratones alimentados con B que M, en particular en cara dorsal (p<0.018). Conclusiones: Este estudio demuestra que la dieta E induce mayor apoptosis en el epitelio lingual, sugiriendo un mecanismo defensivo de los tejidos ante el agente cancerígeno-tumoral

A Cluster Analysis of the Acceptance of a Contact Tracing App—The Identification of Profiles for the Italian Immuni Contact Tracing App

Digital contact tracing apps have been introduced by governments as a strategy to limit the spread of the COVID-19 pandemic. Digital contact tracking is an alternative to traditional contact tracing performed by human tracers who have to reconstruct each contact an infected person had in the recent past by means of interviews. The Italian government proposed the Immuni digital contact tracking app as a solution. Immuni uses Bluetooth technology to anonymously register all close contacts a person had: if she tests positive for COVID-19 then all registered contacts are notified. The main aim of the paper is to propose a cluster analysis of some factors concerning the possible acceptance of the Immuni app to build behaviour profiles that explain and predict the possible behaviours of the respondents. The factors considered referred to three different pillars: the technological pillar, investigated by considering factors from the technology acceptance models family; the health pillar, where variables of the health belief model were used; and the sociopolitical pillar, where some values of the respondents were considered as possible barriers to or facilitators of the acceptance of this technology. As a result of the cluster analysis, three behavioural profiles were built: the ProApp profile, the Hesitant profile, and the AntiApp profile. The first is the profile grouping the respondents who intend to use the contact tracing app; the second is more about people who are favourable of the use of the app, but some issues such as privacy reduce the strength of their intention; the last profile is about people who are less favourable to use the app. We are confident that the behaviour profiles found would be useful to build more tailored communication campaigns to help promote the use of the app by managing factors that could either be facilitators or barriers.</jats:p

A Cluster Analysis of the Acceptance of a Contact Tracing App—The Identification of Profiles for the Italian Immuni Contact Tracing App

Digital contact tracing apps have been introduced by governments as a strategy to limit the spread of the COVID-19 pandemic. Digital contact tracking is an alternative to traditional contact tracing performed by human tracers who have to reconstruct each contact an infected person had in the recent past by means of interviews. The Italian government proposed the Immuni digital contact tracking app as a solution. Immuni uses Bluetooth technology to anonymously register all close contacts a person had: if she tests positive for COVID-19 then all registered contacts are notified. The main aim of the paper is to propose a cluster analysis of some factors concerning the possible acceptance of the Immuni app to build behaviour profiles that explain and predict the possible behaviours of the respondents. The factors considered referred to three different pillars: the technological pillar, investigated by considering factors from the technology acceptance models family; the health pillar, where variables of the health belief model were used; and the sociopolitical pillar, where some values of the respondents were considered as possible barriers to or facilitators of the acceptance of this technology. As a result of the cluster analysis, three behavioural profiles were built: the ProApp profile, the Hesitant profile, and the AntiApp profile. The first is the profile grouping the respondents who intend to use the contact tracing app; the second is more about people who are favourable of the use of the app, but some issues such as privacy reduce the strength of their intention; the last profile is about people who are less favourable to use the app. We are confident that the behaviour profiles found would be useful to build more tailored communication campaigns to help promote the use of the app by managing factors that could either be facilitators or barriers