The management of early-stage and metastatic triple-negative breast cancer: A review

Triple negative breast cancer (TNBC) defined as lacking expression of the estrogen receptor, progesterone receptor and HER2, comprises approximately 15% of incident breast cancers and is over-represented among those with metastatic disease. It is increasingly clear that TNBC is heterogeneous and that there are several biologically distinct subtypes within TNBC, in particular the basal-like subtype but also the claudin-low, among others. While the incidence of BRCA mutations across all subsets of breast cancer is quite low (~5%), BRCA mutations are more common among those with TNBC (~20%) and may have therapeutic implications. The general principles guiding the use of chemotherapy and radiation therapy do not differ dramatically between early stage TNBC and non-TNBC. There is a trend, however, to treat TNBC at a lower stage with chemotherapy as this is the only way to systemically reduce recurrence risk. In the metastatic setting, while cytotoxic chemotherapy is the mainstay of treatment for advanced TNBC, there are many promising targeted therapies in development in both the preclinical and early phase clinical trial settings. While the treatment of TNBC remains a challenge, coordinated efforts between clinician/scientist partnerships providing a comprehensive understanding of TNBC genomic, proteomic and other biologic processes may result in individualized therapy for TNBC faster than other subtypes -- driven by both the heterogeneity we know exists within this clinical entity and the intense need for improved treatment

Wrinkling of foils

Aluminum and copper metal webs less than 150 microns (6-mils) are considered foils. Demand for aluminum and copper foils are growing, driven by growing markets for flexible electronics, flat panel displays, lithium batteries, and solar products. In many of these products, thinner foils have cost or weight advantages, but as with nearly any web, thinner means an increased sensitivity to wrinkling in web handling processes.Nearly all of published web handling research and development work have been based on polymer films and paper webs. Since the web wrinkling theories are based on first principles, they should apply to the foil webs. However, applying models confirmed with paper or foil on narrow widths (less than 0.3m or 12-in wide) to the uncharted territories of foils with 20x elastic modulus and 4x width increases will likely lead to interesting discoveries.This paper will present a comparison of empirical wrinkling results from trials of handling thin and wide aluminum and copper foils (less 25 micron thick by greater than 0.6m wide (less than 0.001-in thick by 24-in. wide). The experimental results will be compared to wrinkling theory, with conclusion about how wrinkling in foils differs from film and paper webs

A Study of the Day - Night Effect for the Super - Kamiokande Detector: I. Time Averaged Solar Neutrino Survival Probability

This is the first of two articles aimed at providing comprehensive predictions for the day-night (D-N) effect for the Super-Kamiokande detector in the case of the MSW \nu_e \to \numt transition solution of the solar neutrino problem. The one-year averaged probability of survival of the solar \nue crossing the Earth mantle, the core, the inner 2/3 of the core, and the (core + mantle) is calculated with high precision (better than 1%) using the elliptical orbit approximation (EOA) to describe the Earth motion around the Sun. Results for the survival probability in the indicated cases are obtained for a large set of values of the MSW transition parameters $\Delta m^2$ and $sin^22\theta_{V}$ from the ``conservative'' regions of the MSW solution, derived by taking into account possible relatively large uncertainties in the values of the $^{8}$B and $^{7}$Be neutrino fluxes. Our results show that the one-year averaged D-N asymmetry in the $\nu_e$ survival probability for neutrinos crossing the Earth core can be, in the case of $sin^22 \theta_{V} \leq 0.13$, larger than the asymmetry in the probability for (only mantle crossing + core crossing) neutrinos by a factor of up to six. The enhancement is larger in the case of neutrinos crossing the inner 2/3 of the core. This indicates that the Super-Kamiokande experiment might be able to test the $sin^22\theta_{V} \leq 0.01$ region of the MSW solution of the solar neutrino problem by performing selective D-N asymmetry measurements.Comment: LaTeX2e - 18 Text Pages + 21 figures = 39 Pages. - Figures in PS + text file sk1b14.tex requires two auxiliary files (included

A Multidisciplinary Breast Cancer Brain Metastases Clinic: The University of North Carolina Experience

Breast cancer brain metastasis (BCBM) confers a poor prognosis and is unusual in requiring multidisciplinary care in the metastatic setting. The University of North Carolina at Chapel Hill (UNC-CH) has created a BCBM clinic to provide medical and radiation oncology, neurosurgical, and supportive services to this complex patient population. We describe organization and design of the clinic as well as characteristics, treatments, and outcomes of the patients seen in its first 3 years