Discordance of Biomarker Expression Profile between Primary Breast Cancer and Synchronous Axillary Lymph Node Metastasis in Preoperative Core Needle Biopsy

Background: Breast cancer (BC) is a heterogeneous disease made up of clones with different metastatic potential. Intratumoral heterogeneity may cause metastases to show divergent biomarker expression, potentially affecting chemotherapy response. Methods: We investigated the immunohistochemical (IHC) and FISH profile of estrogen receptors (ER), progesterone (PR) receptors, Ki67, and HER2 in a series of BC-matched primary tumors (PTs) and axillary lymph node (ALN) metastases in pre-operative core needle biopsies (CNBs). Phenotypical findings were correlated to morphological features and their clinical implications. Results: Divergent expression between PTs and ALNs was found in 10% of the tumors, often involving multiple biomarkers (12/31, 39%). Most (52%) displayed significant differences in ER and PR staining. HER2 divergences were observed in almost three-quarters of the cases (23/31, 74%), with five (16%) switching from negativity to overexpression/amplification in ALNs. Roughly 90% of disparities reflected significant morphological differences between PTs and ALN metastases. Less than half of the discrepancies (12/31, 39%) modified pre/post-operative treatment options. Conclusions: We observed relevant discrepancies in biomarker expression between PTs and metastatic ALNs in a noteworthy proportion (10%) of preoperative BC CNBs, which were often able to influence therapies. Hence, our data suggest routine preoperative assessment of biomarkers in both PTs and ALNs in cases showing significant morphological differences

Synthesis of C37‐Alkenones for Past Climate Reconstructions

The total syntheses of three C37 methyl-alkenones with different degrees of unsaturation and of their 13C-labelled analogues from commercially available starting materials are presented herein for the first time. These molecules are important to improve the reliability of the measurements and reconstructions of the sea surface temperature and salinity

Front Cover: Synthesis of C37‐Alkenones for Past Climate Reconstructions

The Front Cover shows three C37 methyl-alkenones with different degrees of unsaturation synthesized by marine organisms in relative amounts according to temperature and salinity conditions. Since these molecules are particularly resistant to degradation, they can be observed in marine sediments and their relative amounts are indicative of changes in oceans and climate during the Cenozoic Era. This manuscript describes the total synthesis of these substances, as required for chromatographic standards, as well as the synthesis of their 13C-labelled analogues, which enable quality assurance and control procedures. The authors thank Thomas Bassano for creating the artwork. More information can be found in the Full Paper by Berton et al

Organisational challenges, volumes of oncological activity\ua0and patients' perception during the severe acute respiratory syndrome coronavirus 2 epidemic

On February 23rd, the 1st case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed at the University Hospital Trust of Verona, Italy. On March 13th, the Oncology Section was converted into a 22-inpatient bed coronavirus disease (COVID) Unit, and we reshaped our organisation to face the SARS-CoV-2 epidemic, while maintaining oncological activities