Low-Field NMR Relaxometry for Intraoperative Tumour Margin Assessment in Breast-conserving Surgery

Funding: This project has received funding from the European Union Horizon 2020 research and innovation programme under grant agreement no. 668119 (project “IDentIFY”) and from AIRC under IG 2019, ID 23267 project (PI Geninatti Crich Simonetta). The authors acknowledge the Italian Ministry of Research for FOE contribution to the Euro-BioImaging MultiModal Molecular Imaging Italian Node (www.mmmi.unito.it accessed on 1 October 2020). Maria Rosaria Ruggiero was supported by a “FIRC-AIRC fellowship for Italy”. Acknowledgments: This work was performed in the frame of the COST Action CA15209 (EURELAX).Peer reviewedPublisher PD

Dorsolateral medullary ischemic infarction causing autonomic dysfunction and headache: a case report

Stroke can present, among other signs, with headache. Here, we describe the case of a man suffering from severe orbitary pain and autonomic dysfunction secondary to dorsolateral medullary ischemia. The anatomical relationship between lesion and symptomatology could be an indirect sign of hypothalamospinal tract involvement in the genesis of autonomic dysfunction and headache resembling a trigeminal autonomic cephalalgia

Intraoperative breast specimen assessment in breast conserving surgery: comparison between standard mammography imaging and a remote radiological system.

The aim of this paper was to compare standard specimen mammography (SSM) with remote intraoperative specimen mammography (ISM) assessment in breast conserving-surgery (BCS) based on operative times, intraoperative additional excision (IAE) and re-intervention rates. We retrospectively compared 129 consecutive patients (136 lesions) who had BCS with SSM at our centre between 11/2011 and 02/2013 with 138 consecutive patients (144 lesions) who underwent BCS with ISM between 08/2014 and 02/2015. SSM or ISM were performed to confirm the target lesions within the excised specimen and margin adequacy. The utility of SMM and ISM was evaluated considering pathology as gold-standard, using χ2 or Fisher’s exact tests for comparison of categorical variables, and non-parametric Mann–Whitney test for continuous variables

Dynamic infrared imaging for breast cancer diagnosis: a feature based registration approach

An essential, preprocessing step in dynamic infrared imaging applied to breast cancer diagnosis is a proper registration of the thermographic image sequence. The failure to do so may produce artifacts in the FFT power spectra of the temperature sequences due to breast movement which may constitute an important confounding factor potentially invalidating the data analysis. In this work we wish to draw attention to this issue, and show the influence of movement on a case sample of subjects, as well as the correction which may be introduced by realigning the image sequences with four different types of feature-based image registration. The registration process was preventively analyzed in the visible field and then applied to the dynamic thermography images. Results confirm the importance of the registration and encourage further work in the are

Eccrine spiradenoma of the nipple: Case report, differential diagnosis and literature review

Eccrine spiradenoma is a rare lesion originating from eccrine sweat glands, with only few cases reported in breast tissue: we here describe for the first time, an eccrine spiradenoma arising in the nipple. An 84 year-old woman with a lesion enlarging her right nipple, showing ulcerations and eczema-like changes of the covering skin, was admitted to our hospital. Surgical excision of the central quadrant with nipple-areola complex was performed, followed by histopathological evaluation which revealed an adenoma with predominantly basaloid epithelial cells. The lesion was composed of tightly packed small and large groups of cells, arranged in diffuse alveolar/pseudorosette formations. The small cells expressed p63 and calponin, while a positive expression of CK7 and CD117 was detected in large cells. After careful and detailed examination, excluding various similar entities, a diagnosis of eccrine spiradenoma has been rendered. Although extremely rare, eccrine spiradenoma should be taken into account in the differential diagnosis of subcutaneous primary breast tumors

Accuracy of mammography, digital breast tomosynthesis, ultrasound and MR imaging in preoperative assessment of breast cancer

Aim: To define the accuracy of digital breast tomosynthesis (DBT) and magnetic resonance imaging (MRI) added to digital mammography (DM) and ultrasound (US) in the preoperative assessment of breast cancer. Patients and Methods: We performed a prospective study of 200 consecutive women with histologically-proven breast cancer using the above imaging techniques. Accuracy measurements were estimated using a lesion-by-lesion analysis for unifocal, multifocal/multicentric, bilateral and all carcinomas. We also calculated sensitivity according to breast density. Results: DBT had higher sensitivity than DM (90.7% vs. 85.2%). Combined DM and DBT with US yielded a 97.7% sensitivity; despite high sensitivity of MRI (98.8%), the addition of MRI to combined DM with DBT and US did not significantly improve sensitivity. Overall accuracy did not significantly differ between MRI and DM with DBT and US (92.3% vs. 93.7%). Breast density affected sensitivity of DM and DBT (statistically significant difference for DM), not MRI. Conclusion: There is little gain in sensitivity and no gain in overall accuracy, by performing MRI for patients who have been evaluated with DM with DBT and US.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Preoperative breast cancer staging with multi-modality imaging and surgical outcomes

To compare the rates of mastectomy and re-operation after breast-conserving surgery (BCS) among patients who had different pre-operative multi-modality imaging, hence identifying significant predictors of mastectomy and re-operations within each group

A new clinical cut-offof cytokeratin 19 mRNA copy number in sentinel lymph node better identifies patients eligible for axillary lymph node dissection in breast cancer

Aims Cytokeratin 19 (CK19) mRNA copy number predicts the probability of tumour load in axillary lymph nodes (ALN) and can help in decision-making regarding the axillary dissection. The purpose of this study was to define a new cut-offof CK19 mRNA copy number using the one-step nucleic acid amplification (OSNA) assay on metastatic sentinel lymph nodes (SLN) in order to identify cases at risk of having one or more positive ALN. Methods 1296 SLN from 1080 patients were analysed with the OSNA assay. 194 patients with positive SLN underwent ALN dissection and the mean value of CK19 copy number (320 000) of their SLN was set as initial cut-off. Receiver operative characteristics curve identify a best cut-offof 7700 (sensitivity 78%, specificity 57%). A comparison between our and the traditional cut-off(5000) was performed. Results The cut-offof 7700 successfully identifies patients with positive ALN (p=0.001, false- negative cases: 17%). In the range between 5000 and 7700, one patient with positive ALN would not undergo axillary dissection, whereas eight patients with negative ALN would be correctly identified. Conclusions We suggest that the level of CK19 mRNA copy number could be the only parameter to consider in the intraoperative management of the axilla. \ua9 2014 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists