Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy.

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

Paramagnetic relaxation of spin polarized He-3 at bare glass surfaces. Part I

In this first in a series of three papers on wall relaxation of spin polarized, gaseous 3He we investigate both by theory and by experiment surface-induced spin relaxation due to paramagnetic sites in the containing glass. We present experimental and theoretical evidence that — contrary to the traditional opinion — distant dipolar coupling to paramagnetic impurities in the glass, in particular iron ions, cannot be the dominant relaxation mechanism of 3He-spins, although iron dominates the bulk static permeability. Instead dangling-bond type defects in the glass matrix are found to interact much stronger via the isotropic Fermi contact interaction. A model of paramagnetic site controlled 3He relaxation including the Fermi contact interaction is presented. With reasonable semi-empirical assumptions our model allows to describe satisfactorily the measured relaxivities, both in the dissolution-dominated regime of fused silica or borosilicate glasses of the Pyrex type as well as in the surface dominated situation of aluminosilicate glasses which have only a low permeability for He atoms. In a large sample of 1.1 litre cells, built from various aluminosilicate glasses, an average relaxation time of 150 h is reached in case contaminant ferromagnetic particles have been demagnetized beforehand. From the maximum observed value of 250 h we derive after subtraction of dipolar relaxation in the gas phase a paramagnetic surface relaxivity of ρ<0.005 cm/h at room temperature

Relaxation of spin polarized He-3 by magnetized ferromagnetic contaminants. Part III

In the first in a series of three papers on wall relaxation of spin polarized 3He we have reported on a breakdown of relaxation times which is observed after exposing the 3He containing glass cells to a strong magnetizing field. In this third paper we give a quantitative analysis of this phenomenon, based on magnetic signal detection by means of SQUIDs, on the pressure dependence of relaxation times in magnetized cells, as well as on Monte Carlo simulations of 3He-relaxation in a macroscopic dipole field. Our analysis allows to identify the contaminants as being aggregates of dust-like Fe3O4 particles (magnetite) with a radius $R \approx 10~\mu$m and a remanent magnetic moment of the order of m ≈O(10$^{-10}~$A m2). The particles are located at or close to the inner glass surface

Deep learning to predict breast cancer sentinel lymph node status on INSEMA histological images

Marme F, Krieghoff-Henning E, Gerber B, et al. Deep learning to predict breast cancer sentinel lymph node status on INSEMA histological images. European Journal of Cancer. 2023;195: 113390.Background Sentinel lymph node (SLN) status is a clinically important prognostic biomarker in breast cancer and is used to guide therapy, especially for hormone receptor-positive, HER2-negative cases. However, invasive lymph node staging is increasingly omitted before therapy, and studies such as the randomised Intergroup Sentinel Mamma (INSEMA) trial address the potential for further de-escalation of axillary surgery. Therefore, it would be helpful to accurately predict the pretherapeutic sentinel status using medical images. Methods Using a ResNet 50 architecture pretrained on ImageNet and a previously successful strategy, we trained deep learning (DL)-based image analysis algorithms to predict sentinel status on hematoxylin/eosin-stained images of predominantly luminal, primary breast tumours from the INSEMA trial and three additional, independent cohorts (The Cancer Genome Atlas (TCGA) and cohorts from the University hospitals of Mannheim and Regensburg), and compared their performance with that of a logistic regression using clinical data only. Performance on an INSEMA hold-out set was investigated in a blinded manner. Results None of the generated image analysis algorithms yielded significantly better than random areas under the receiver operating characteristic curves on the test sets, including the hold-out test set from INSEMA. In contrast, the logistic regression fitted on the Mannheim cohort retained a better than random performance on INSEMA and Regensburg. Including the image analysis model output in the logistic regression did not improve performance further on INSEMA. Conclusions Employing DL-based image analysis on histological slides, we could not predict SLN status for unseen cases in the INSEMA trial and other predominantly luminal cohorts

Pesticide biochemistry and physiology

Herbivore-induced systemic resistance occurs in many plants and is commonly assumed to be adaptive. The mechanisms triggered by leaf-herbivores that lead to systemic resistance are largely understood, but it remains unknown how and why root herbivory also increases resistance in leaves. To resolve this, we investigated the mechanism by which the root herbivore Diabrotica virgifera induces resistance against lepidopteran herbivores in the leaves of Zea mays. Diabrotica virgifera infested plants suffered less aboveground herbivory in the field and showed reduced growth of Spodoptera littoralis caterpillars in the laboratory. Root herbivory did not lead to a jasmonate-dependent response in the leaves, but specifically triggered water loss and abscisic acid (ABA) accumulation. The induction of ABA by itself was partly responsible for the induction of leaf defenses, but not for the resistance against S. littoralis. Root-herbivore induced hydraulic changes in the leaves, however, were crucial for the increase in insect resistance. We conclude that the induced leaf resistance after root feeding is the result of hydraulic changes, which reduce the quality of the leaves for chewing herbivores. This finding calls into question whether root-herbivore induced leaf-resistance is an evolved response. © The Authors (2010). Journal compilation © New Phytologist Trust (2010)