Primary Colorectal Adenocarcinoma Metastatic to the Breast: Case Report and Review of Nineteen Cases

Metastases to the breast from extramammary primaries are uncommon and account for 0.5–6% of all breast malignancies (Georgiannos et al., 2001, and Vizcaíno et al., 2001). Malignant melanoma, lymphoma, and lung and gastric carcinomas are the most frequently encountered nonmammary metastases to the breast in adults (Georgiannos et al., 2001, and Chaignaud et al., 1994). Primary colorectal adenocarcinoma (CRC) metastatic to the breast is extremely rare, with the medical literature having only 19 recorded cases. Typically CRC metastatic to the breast is indicative of widely disseminated disease and a poor prognosis. Here we present a case of poorly differentiated colon cancer metastatic to the breast and review the current literature on this rare event

Inhibition of Human Dendritic Cell ER Stress Response Reduces T Cell Alloreactivity Yet Spares Donor Anti-tumor Immunity

Acute graft- vs. -host disease (GVHD) is an important cause of morbidity and death after allogeneic hematopoietic cell transplantation (HCT). We identify a new approach to prevent GVHD that impairs monocyte-derived dendritic cell (moDC) alloactivation of T cells, yet preserves graft- vs.-leukemia (GVL). Exceeding endoplasmic reticulum (ER) capacity results in a spliced form of X-box binding protein-1 (XBP-1s). XBP-1s mediates ER stress and inflammatory responses. We demonstrate that siRNA targeting XBP-1 in moDCs abrogates their stimulation of allogeneic T cells. B-I09, an inositol-requiring enzyme-1α (IRE1α) inhibitor that prevents XBP-1 splicing, reduces human moDC migration, allo-stimulatory potency, and curtails moDC IL-1β, TGFβ, and p40 cytokines, suppressing Th1 and Th17 cell priming. B-I09-treated moDCs reduce responder T cell activation via calcium flux without interfering with regulatory T cell (Treg) function or GVL effects by cytotoxic T lymphocytes (CTL) and NK cells. In a human T cell mediated xenogeneic GVHD model, B-I09 inhibition of XBP-1s reduced target-organ damage and pathogenic Th1 and Th17 cells without impacting donor Tregs or anti-tumor CTL. DC XBP-1s inhibition provides an innovative strategy to prevent GVHD and retain GVL

Primary Colorectal Adenocarcinoma Metastatic to the Breast: Case Report and Review of Nineteen Cases

Metastases to the breast from extramammary primaries are uncommon and account for 0.5–6% of all breast malignancies (Georgiannos et al., 2001, and Vizcaíno et al., 2001). Malignant melanoma, lymphoma, and lung and gastric carcinomas are the most frequently encountered nonmammary metastases to the breast in adults (Georgiannos et al., 2001, and Chaignaud et al., 1994). Primary colorectal adenocarcinoma (CRC) metastatic to the breast is extremely rare, with the medical literature having only 19 recorded cases. Typically CRC metastatic to the breast is indicative of widely disseminated disease and a poor prognosis. Here we present a case of poorly differentiated colon cancer metastatic to the breast and review the current literature on this rare event

Prediction of positive margins following breast conserving surgery.

INTRODUCTION: Positive margins after breast conserving surgery frequently warrant reoperation. Our objective was to evaluate predictors of positive surgical margins after breast conserving surgery (BCS), including a previously validated online calculator/nomogram. Use of reoperation was also evaluated. METHODS: Patients with clinical T1-2N0-1Mx-0 primary breast cancer who received standard BCS from 2006 to 2012 were selected (N = 292). Exact Pearson Chi-square test was performed for clinical factors and non-parametric tests were used to evaluate the predictive value of the nomogram for positive margins and re-excision. Spearman\u27s correlation analysis was used to compare actual events vs. nomogram calculations. Multivariate logistic regressions were conducted for multiple variables. RESULTS: Tumor multi-focality (p = 0.09) and non-ductal histology (p = 0.05), were associated with re-excision; suspicious calcifications (p = 0.08) were associated with positive margins, although no p-value reached statistical significance. The nomogram predicted a median positive margin risk of 20% for cases with and without positive margins. Spearman\u27s correlation analysis for positive margins vs. nomogram calculated positive margin risk was 0.091 (p = 0.121.) CONCLUSIONS: The Breast Conservation nomogram includes several factors associated with positive margins or reoperation, but none of the variables tested were statistically significant on univariate or multivariate analyses. The nomogram\u27s value could not be confirmed, as there was no significant correlation between the calculated risk values and the presence of positive surgical margins

Role of Axillary Staging in Women Diagnosed With Ductal Carcinoma In Situ With Microinvasion

Despite the low likelihood of nodal extension, a lack of identifiable clinical and pathologic features associated with a positive sentinel lymph node precludes selective use of sentinel lymph node biopsy

Selective Application of Routine Preoperative Axillary Ultrasonography Reduces Costs for Invasive Breast Cancers

Costs associated with the use of highly sensitive axillary ultrasonography in patients with stage ≥T2 invasive breast cancer are evaluated