A new risk stratification score for the management of ultrasound‐detected B3 breast lesions

To develop a predictive scoring system for ultrasound-detected B3 lesions at ultrasound-guided core needle biopsy (US-CNB). A total of 2724 consecutive US-CNBs performed in our Institution (January 2011 to December 2014) were retrospectively reviewed. Inclusion criteria were as follows: (a) histopathological examination of the entire lesion or (b) availability of radiologic follow-up (FUP) ≥24 months. Patient- and lesion-related variables-patients' age, lesion consistency, lesion size, vascularization, BI-RADS category, and US-CNB result-were analyzed. Positive predictive values (PPVs) for malignancy were calculated correlating US-CNB results with excision histology or FUP. A scoring system for underlying malignancy was developed using risk factors weighting. A total of 102 B3 lesions were included: 27 atypical ductal hyperplasia (26.5%), 5 lobular intraepithelial neoplasia (4.9%), 32 radial scar (31.4%), 37 papillary lesions (36.3%), and 1 fibroepithelial lesion (0.9%). Surgery was performed on 71/102 (69.6%) lesions, and 22/71 were malignant; the remaining 31/102 lesions (30.4%) were unchanged at FUP. The overall PPV for malignancy was 21.6%. Patients' age (odds ratio [OR] = 3.63, P = 0.008), lesion consistency (OR = 5.96, P = 0.001), BI-RADS category (OR = 17.52, P < 0.001), and CNB result (OR = 3.6, P = 0.008) were associated with a higher risk of malignancy underestimation and selected as risk factors in the score definition. Two risk groups were identified: low (0-2 points) and high risk (3-5 points), with significantly different risk of malignancy underestimation (8.0% vs 59.3%, P < 0.001). The proposed score helps to predict the risk of malignancy underestimation and choose the management of B3 lesions at US-CNB

Digital Breast Tomosynthesis with Synthesized Two-Dimensional Images versus Full-Field Digital Mammography for Population Screening: Outcomes from the Verona Screening Program.

The purpose of this study was to examine the outcomes of a breast cancer screening program based on digital breast tomosynthesis (DBT) plus synthesized two-dimensional (2D) mammography compared with those after full-field digital mammography (FFDM). This prospective study included 16 666 asymptomatic women aged 50–69 years who were recruited in April 2015 through March 2016 for DBT plus synthetic 2D screening in the Verona screening program. A comparison cohort of women screened with FFDM (n = 14 423) in the previous year was included. Screening detection measures for the two groups were compared by calculating the proportions associated with each outcome, and the relative rates (RRs) were estimated with multivariate logistic regression

Unexpected ovarian activity in premenopausal breast cancer survivors treated with exemestane and GnRH analogues

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MEG Upgrade Proposal

We propose the continuation of the MEG experiment to search for the charged lepton flavour violating decay (cLFV) \mu \to e \gamma, based on an upgrade of the experiment, which aims for a sensitivity enhancement of one order of magnitude compared to the final MEG result, down to the $6 \times 10^{-14}$ level. The key features of this new MEG upgrade are an increased rate capability of all detectors to enable running at the intensity frontier and improved energy, angular and timing resolutions, for both the positron and photon arms of the detector. On the positron-side a new low-mass, single volume, high granularity tracker is envisaged, in combination with a new highly segmented, fast timing counter array, to track positron from a thinner stopping target. The photon-arm, with the largest liquid xenon (LXe) detector in the world, totalling 900 l, will also be improved by increasing the granularity at the incident face, by replacing the current photomultiplier tubes (PMTs) with a larger number of smaller photosensors and optimizing the photosensor layout also on the lateral faces. A new DAQ scheme involving the implementation of a new combined readout board capable of integrating the diverse functions of digitization, trigger capability and splitter functionality into one condensed unit, is also under development. We describe here the status of the MEG experiment, the scientific merits of the upgrade and the experimental methods we plan to use.Comment: A. M. Baldini and T. Mori Spokespersons. Research proposal submitted to the Paul Scherrer Institute Research Committee for Particle Physics at the Ring Cyclotron. 131 Page

Il mondo delle radio private

La radiofonia soffre di un’eccessiva frammentazione, per la presenza sia di micro-imprese, sia di tipologie di radio con ragioni sociali differenti: ciò ha comportato la proliferazione di associazioni imprenditoriali contrapposte. Sono nati perciò contratti diversificati, soprattutto relativamente al riconoscimento dei giornalisti come categoria in sé. Poiché i sindacati quasi non riescono a entrare nelle aziende, paradossalmente sperano in un cambiamento affidato all’avvento di nuove tecnologie o alla creazione di agenzie interinali ad hoc, soluzioni certo diverse, ma accomunate dall’essere al di fuori della contrattazione sindacale. Per chi lavora nelle radio, ancor prima del problema del precariato, c’è il problema del lavoro nero in molte radio commerciali, o non retribuito in quelle non commerciali. Per le radio comunitarie e politiche c’è carenza di finanziamenti, che tendono ad essere ulterior-mente tagliati, con il rischio della chiusura anche di radio locali che svolgono un servizio di informazione locale di buona qualità. C’è dunque un problema di insicurezza del lavoro, oltre che di basse retribuzioni, tranne che nelle strutture più grandi ed affermate: è il caso di un gruppo di radio locali romane che ha fatto una politica di stabilizzazione del personale (in cui abbiamo fatto diverse interviste). L’altro aspetto da considerare è l’organizzazione produttiva che può anche essere minimale: nelle radio piccole e medie si fa lavoro di squadra, spesso mescolando produzione e ricerca della pubblicità e/o facendo sì che chi conduce un programma curi anche la parte tecnica di messa in onda. Solo nelle radio più grandi, nazionali o che si ap-poggiano ad un network, c’è netta diversificazione delle figure produttive, con il vantaggio spesso, ma non sempre, di migliori retribuzioni

Digital Breast Tomosynthesis Cancer Screening versus Full Field Digital Mammography Cancer Screening: Imaging and Pathological Features

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Multiple Papillomas of the Breast: A Review of Current Evidence and Challenges

Objectives: To conduct a review of evidence about papillomatosis/multiple papillomas (MP), its clinical and imaging presentation, the association between MP and malignancy and the management strategies that follow. Methods: A computerized literature search using PubMed and Google Scholar was performed up to January 2021 with the following search strategy: &ldquo;papilloma&rdquo; OR &ldquo;intraductal papilloma&rdquo; OR &ldquo;intraductal papillary neoplasms&rdquo; OR &ldquo;papillomatosis&rdquo; OR &ldquo;papillary lesion&rdquo; AND &ldquo;breast&rdquo;. Two authors independently conducted a search, screening and extraction of data from the eligible studies. Results: Of the 1881 articles identified, 29 articles met the inclusion criteria. The most common breast imaging methods (mammography, ultrasound) showed few specific signs of MP, and evidence about magnetic resonance imaging were weak. Regarding the association between MP and malignancy, the risk of underestimation to biopsy methods and the frequent coexistence of MP and other high-risk lesions needs to be taken into consideration. Results about the risk of developing breast carcinoma of patients affected by MP were inconsistent. Conclusions: MP is a challenge for all breast specialists, and familiarity with its features is required to make the correct diagnosis. Further studies are needed to evaluate the factors to take into account to plan management, time of follow-up and imaging methods

Automated Breast Ultrasonography (ABUS) in the Screening and Diagnostic Setting: Indications and Practical Use

Automated breast ultrasonography (ABUS) is a new imaging technology for automatic breast scanning through ultrasound. It was first developed to overcome the limitation of operator dependency and lack of standardization and reproducibility of handheld ultrasound. ABUS provides a three-dimensional representation of breast tissue and allows images reformatting in three planes, and the generated coronal plane has been suggested to improve diagnostic accuracy. This technique has been first used in the screening setting to improve breast cancer detection, especially in mammographically dense breasts. In recent years, numerous studies also evaluated its use in the diagnostic setting: they showed its suitability for breast cancer staging, evaluation of tumor response to neoadjuvant chemotherapy, and second-look ultrasound after magnetic resonance imaging. The purpose of this article is to provide a comprehensive review of the current body of literature about the clinical performance of ABUS, summarize available evidence, and identify gaps in knowledge for future research

The p66Shc Redox Protein and the Emerging Complications of Diabetes

Diabetes mellitus is a chronic metabolic disease, the prevalence of which is constantly increasing worldwide. It is often burdened by disabling comorbidities that reduce the quality and expectancy of life of the affected individuals. The traditional complications of diabetes are generally described as macrovascular complications (e.g., coronary heart disease, peripheral arterial disease, and stroke), and microvascular complications (e.g., diabetic kidney disease, retinopathy, and neuropathy). Recently, due to advances in diabetes management and the increased life expectancy of diabetic patients, a strong correlation between diabetes and other pathological conditions (such as liver diseases, cancer, neurodegenerative diseases, cognitive impairments, and sleep disorders) has emerged. Therefore, these comorbidities have been proposed as emerging complications of diabetes. P66Shc is a redox protein that plays a role in oxidative stress, apoptosis, glucose metabolism, and cellular aging. It can be regulated by various stressful stimuli typical of the diabetic milieu and is involved in various types of organ and tissue damage under diabetic conditions. Although its role in the pathogenesis of diabetes remains controversial, there is strong evidence regarding the involvement of p66Shc in the traditional complications of diabetes. In this review, we will summarize the evidence supporting the role of p66Shc in the pathogenesis of diabetes and its complications, focusing for the first time on the emerging complications of diabetes

ROLE OF COMPLEMENT IN PREGNANCY WITH ANTIPHOSPHOLIPID SYNDROME: MECHANISMS OF PATHOGENESIS AND CLINICAL ASPECTS.

The antiphospholipid syndrome (APS) is a disease discovered just 25 years ago. Although clinical manifestations have been clearly described, pathogenetic mechanisms are still barely understood. A recent hypothesis involves inflammation in the setting of APS morbidity and experimental data support the activation of complement cascade as a pivotal event in its physiopathology. In this review we will analyze the recent literature, focusing on contemporary and emerging aspects of complement-mediated disease pathogenesis and we will point up the clinical significance of this novel finding