Clinicopathological, therapeutic and prognostic features of the triple-negative tumors in moroccan breast cancer patients (experience of Hassan II university hospital in Fez)

<p>Abstract</p> <p>Introduction</p> <p>Triple-negative breast cancer (TNBC) is defined as a group of breast carcinomas that are negative for expression of hormone receptors (ER, PR) and Her2, we can distinguish between two groups: basal-like (ER-, PR-, Her2-, cytokeratin (CK) 5/6+ and/or Her1+) and unclassified subtype (ER-, PR-, Her2-, Her1- and CK5/6-).</p> <p>The aim of this study is to determine the clinicopathological, histological, therapeutic and prognostic features associated with this type of breast cancer.</p> <p>Methods</p> <p>This is a retrospective study of 366 female breast cancer patients, diagnosed between January 2007 and June 2010 at the Department of Pathology. Epidemiological, clinical, histological, therapeutic and evolutive data were analyzed. OS and DFS rates were estimated by Kaplan-Meier analysis and a log-rank test to estimate outcome.</p> <p>Results</p> <p>A total of 64 women were identified as having TNBC (17.5% of all female breast cancer patients), 12.6% were basal-like, 4.9% were unclassified subtype, with a median age of 45 years. The median histological tumor diameter was 4.3 cm. TNBC were most often associated with a high grade, 49.2% grade III (53% for unclassified subtype, 47.6% for basal-like). Vascular invasion was found in 26.6% of cases (22% for unclassified subtype and 28.3% for basal-like). For the lymph node involvement: 51% had positive lymph nodes, and 22.4% had distant metastases. Neoadjuvant chemotherapy was administered to 18% patients with 26% of complete pathologic response; therefore adjuvant chemotherapy was given to 82%. 98% received anthracycline based regimen and only 30% received taxanes.</p> <p>The Kaplan-Meier curves based showed the lowest survival probability at 3-years (49% of OS, and 39% of DFS).</p> <p>Conclusion</p> <p>TNBC is associated with young age, high grade tumors, advanced stage at diagnosis, difference chemo response compared to other subtypes, and shortest survival. Critical to optimal future management is accurate identification of truly triple negative disease, and adequately powered prospective TNBC trials to establish treatment efficacy and define predictive biomarkers.</p

Transhumance, livestock mobility and mutual benefits between crop and livestock production

Grazing-based livestock production, named pastoralism, is classified into nomadism, transhumance and agro-pastoralism. Transhumance is characterised by the seasonal and recurring movement of livestock whereby seasonal grazing areas and routes for livestock movement are fixed. All grazing based livestock production systems including transhumance are constrained globally for a variety of reasons. The major threats to the system are globalisation, nationalisation or privatisation of rangelands, national parks and community forestry policies restricting free grazing and shortage of labour. The collapse or decline of such social-ecological systems (SESs), which have existed for over 1000s years, often induces adverse impacts on societies and ecosystems. Here we review the literature on transhumance, and discuss reasons for transhumance, and the associated advantages and disadvantages of livestock movement in transhumance. Our review also focuses on how the integration of crop and livestock production in transhumance derives mutual benefits. The review indicates that the seasonal movement of livestock is an ecological necessity in areas with harsh climates and low pasture production. Transhumance is also a herders’ adaptive management to adjust to variable grazing resources and environmental conditions. The disadvantages of seasonal movement of livestock such as greater herding labour required and expenditure of more energy for livestock, are far outweighed by the ecological advantages. Some of these are: to minimise grazing competition and to protect rangeland pastures from being overgrazed. Our review also indicates that the integration of crop and livestock production derives mutual benefits and contributes for their enhanced sustainability

SARS-CoV-2 infection in patients with primary Sjögren syndrome: characterization and outcomes of 51 patients

International audienc