Sentinel node biopsy for breast cancer: is it already a standard of care? A survey of current practice in an Italian region

BACKGROUND: Although sentinel node biopsy (SNB) is becoming the standard approach for axillary staging in patients with small breast cancer, criteria for patient selection and some technical aspects of the procedure have yet to be clearly defined. The aim of the present survey was therefore to investigate the way in which SNB is used by general surgeons working in the Veneto region, Italy. METHODS: A 29-item questionnaire regarding various aspects of SNB practice was mailed to surgeons in charge of breast surgery in all the 56 surgical centres of the region. RESULTS: The rate of response to the questionnaire was 82.1% (n = 46); 69.6% (n = 32) of the respondents routinely perform SNB in their clinical practice. Most of the interviewed surgeons (93.5%) expressed the belief that the acceptable false negative rate should be ≤5%. However, among the surgeons who perform SNB, only 34.4% performed more than 20 SNB during the learning phase. Indications are limited to tumours of ≤1 cm by 31.2% (n = 10) of respondents, ≤2 cm by 46.9% (n = 15) and ≤3 cm by 21.9% (n = 7). Almost all respondents (93.7%) agreed that a clinically positive axilla is a contraindication to SNB, while opinions differed widely concerning other potential contraindications. In most of the centres considered, SN identification is undertaken on the day before surgery using a subdermal injection of 30–50 MBq of 99mTc-albumin-nanocolloid followed by lymphoscintigraphy. CONCLUSIONS: SNB is currently performed in the majority of hospitals in the Veneto region. However, the training phase and criteria used for patient selection differ from centre to centre. Certified training courses and shared guidelines are therefore highly desirable

The Aquila prestellar core population revealed by Herschel

The origin and possible universality of the stellar initial mass function (IMF) is a major issue in astrophysics. One of the main objectives of the Herschel Gould Belt Survey is to clarify the link between the prestellar core mass function (CMF) and the IMF. We present and discuss the core mass function derived from Herschel data for the large population of prestellar cores discovered with SPIRE and PACS in the Aquila Rift cloud complex at d ~ 260 pc. We detect a total of 541 starless cores in the entire ~11 deg^2 area of the field imaged at 70-500 micron with SPIRE/PACS. Most of these cores appear to be gravitationally bound, and thus prestellar in nature. Our Herschel results confirm that the shape of the prestellar CMF resembles the stellar IMF, with much higher quality statistics than earlier submillimeter continuum ground-based surveys

Distance of Hi-GAL sources

Aims. Distances are key to determining the physical properties of sources. In the Galaxy, large (> 10 000) homogeneous samples of sources for which distance are available, covering the whole Galactic distance range, are still missing. Here we present a catalog of velocity and distance for a large sample (> 100 000) of Hi-GAL compact sources. Methods. We developed a fully automatic Python package to extract the velocity and determine the distance. To assign a velocity to a Hi-GAL compact source, the code uses all the available spectroscopic data complemented by a morphological analysis. Once the velocity is determined, if no stellar or maser parallax distance is known, the kinematic distance is calculated and the distance ambiguity (for sources located inside the Solar circle) is solved with the H I self-absorption method or from distance-extinction data. Results. Among the 150 223 compact sources of the Hi-GAL catalog, we obtained a distance for 124 069 sources for the 5σ catalog (and 128 351 sources for the 3σ catalog), where σ represents the noise level of each molecular spectrum used for the line detections made at 5σ and 3σ to produce the respective catalogs. © P. Mège et al. 2021

A Herschel study of the properties of starless cores in the Polaris Flare dark cloud region using PACS and SPIRE

The Polaris Flare cloud region contains a great deal of extended emission. It is at high declination and high Galactic latitude. It was previously seen strongly in IRAS Cirrus emission at 100 microns. We have detected it with both PACS and SPIRE on Herschel. We see filamentary and low-level structure. We identify the five densest cores within this structure. We present the results of a temperature, mass and density analysis of these cores. We compare their observed masses to their virial masses, and see that in all cases the observed masses lie close to the lower end of the range of estimated virial masses. Therefore, we cannot say whether they are gravitationally bound prestellar cores. Nevertheless, these are the best candidates to be potentialprestellar cores in the Polaris cloud region.Comment: 5 pages, 2 figures, accepted by A&

Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast

BACKGROUND: Sentinel lymph node (SLN) biopsy is an effective tool for axillary staging in patients with invasive breast cancer. This procedure has been recently proposed as part of the treatment for patients with ductal carcinoma in situ (DCIS), because cases of undetected invasive foci and nodal metastases occasionally occur. However, the indications for SLN biopsy in DCIS patients are controversial. The aim of the present study was therefore to assess the incidence of SLN metastases in a series of patients with a diagnosis of pure DCIS. METHODS: A retrospective evaluation was made of a series of 102 patients who underwent SLN biopsy, and had a final histologic diagnosis of pure DCIS. Patients with microinvasion were excluded from the analysis. The patients were operated on in five Institutions between 1999 and 2004. Subdermal or subareolar injection of 30–50 MBq of 99 m-Tc colloidal albumin was used for SLN identification. All sentinel nodes were evaluated with serial sectioning, haematoxylin and eosin staining, and immunohistochemical analysis for cytocheratin. RESULTS: Only one patient (0.98%) was SLN positive. The primary tumour was a small micropapillary intermediate-grade DCIS and the SLN harboured a micrometastasis. At pathologic revision of the specimen, no detectable focus of microinvasion was found. CONCLUSION: Our findings indicate that SLN metastases in pure DCIS are a very rare occurrence. SLN biopsy should not therefore be routinely performed in patients who undergo resection for DCIS. SLN mapping can be performed, as a second operation, in cases in which an invasive component is identified in the specimen. Only DCIS patients who require a mastectomy should have SLN biopsy performed at the time of breast operation, since in these cases subsequent node mapping is not feasible

A <i>Herschel</i> and BIMA study of the sequential star formation near the W 48A H II region

We present the results of Herschel HOBYS (Herschel imaging survey of OB Young Stellar objects) photometric mapping combined with Berkeley Illinois Maryland Association (BIMA) observations and additional archival data, and perform an in-depth study of the evolutionary phases of the star-forming clumps in W 48A and their surroundings. Age estimates for the compact sources were derived from bolometric luminosities and envelope masses, which were obtained from the dust continuum emission, and agree within an order of magnitude with age estimates from molecular line and radio data. The clumps in W 48A are linearly aligned by age (east-old to west-young): we find a ultra-compact (UC) H II region, a young stellar object (YSO) with class II methanol maser emission, a YSO with a massive outflow and finally the NH2D prestellar cores from Pillai et al. This remarkable positioning reflects the (star) formation history of the region. We find that it is unlikely that the star formation in the W 48A molecular cloud was triggered by the UC H II region and discuss the Aquila supershell expansion as a major influence on the evolution of W 48A. We conclude that the combination of Herschel continuum data with interferometric molecular line and radio continuum data is important to derive trustworthy age estimates and interpret the origin of large-scale structures through kinematic information

Herschel observations of embedded protostellar clusters in the Rosette Molecular Cloud

The Herschel OB young stellar objects survey (HOBYS) has observed the Rosette molecular cloud, providing an unprecedented view of its star formation activity. These new far-infrared data reveal a population of compact young stellar objects whose physical properties we aim to characterise. We compiled a sample of protostars and their spectral energy distributions that covers the near-infrared to submillimetre wavelength range. These were used to constrain key properties in the protostellar evolution, bolometric luminosity, and envelope mass and to build an evolutionary diagram. Several clusters are distinguished including the cloud centre, the embedded clusters in the vicinity of luminous infrared sources, and the interaction region. The analysed protostellar population in Rosette ranges from 0.1 to about 15 Msun with luminosities between 1 and 150 Lsun, which extends the evolutionary diagram from low-mass protostars into the high-mass regime. Some sources lack counterparts at near- to mid-infrared wavelengths, indicating extreme youth. The central cluster and the Phelps & Lada 7 cluster appear less evolved than the remainder of the analysed protostellar population. For the central cluster, we find indications that about 25% of the protostars classified as Class I from near- to mid-infrared data are actually candidate Class 0 objects. As a showcase for protostellar evolution, we analysed four protostars of low- to intermediate-mass in a single dense core, and they represent different evolutionary stages from Class 0 to Class I. Their mid- to far-infrared spectral slopes flatten towards the Class I stage, and the 160 to 70um flux ratio is greatest for the presumed Class 0 source. This shows that the Herschel observations characterise the earliest stages of protostellar evolution in detail.Comment: Astronomy & Astrophysics letter, 6 pages, 4 figures, accepted for publication in the Special Issue for Herschel first result

The Hi-GAL catalogue of dusty filamentary structures in the Galactic plane

The recent data collected by Herschel have confirmed that interstellar structures with a filamentary shape are ubiquitously present in the Milky Way. Filaments are thought to be formed by several physical mechanisms acting from large Galactic scales down to subparsec fractions of molecular clouds, and they might represent a possible link between star formation and the large-scale structure of the Galaxy. In order to study this potential link, a statistically significant sample of filaments spread throughout the Galaxy is required. In this work, we present the first catalogue of 32 059 candidate filaments automatically identified in the Herschel Infrared Galactic plane Survey (Hi-GAL) of the entire Galactic plane. For these objects, we determined morphological (length la and geometrical shape) and physical (average column density NH2 and average temperature T) properties. We identified filaments with a wide range of properties: 2 ≤ la ≤ 100 arcmin, 1020≤NH2≤1023 cm−2 and 10 ≤ T ≤ 35 K. We discuss their association with the Hi-GAL compact sources, finding that the most tenuous (and stable) structures do not host any major condensation. We also assign a distance to ∼18 400 filaments, for which we determine mass, physical size, stability conditions and Galactic distribution. When compared with the spiral arms structure, we find no significant difference between the physical properties of on-arm and inter-arm filaments. We compare our sample with previous studies, finding that our Hi-GAL filament catalogue represents a significant extension in terms of Galactic coverage and sensitivity. This catalogue represents a unique and important tool for future studies devoted to understanding the filament life-cycle

The Hi-GAL catalogue of dusty filamentary structures in the Galactic plane

The recent data collected by Herschel have confirmed that interstellar structures with a filamentary shape are ubiquitously present in the Milky Way. Filaments are thought to be formed by several physical mechanisms acting from large Galactic scales down to subparsec fractions of molecular clouds, and they might represent a possible link between star formation and the large-scale structure of the Galaxy. In order to study this potential link, a statistically significant sample of filaments spread throughout the Galaxy is required. In this work, we present the first catalogue of 32 059 candidate filaments automatically identified in the Herschel Infrared Galactic plane Survey (Hi-GAL) of the entire Galactic plane. For these objects, we determined morphological (length la and geometrical shape) and physical (average column density NH2 and average temperature T) properties. We identified filaments with a wide range of properties: 2 ≤ la ≤ 100 arcmin, 1020 ≤ NH2 ≤ 1023 cm−2 and 10 ≤ T ≤ 35 K. We discuss their association with the Hi-GAL compact sources, finding that the most tenuous (and stable) structures do not host any major condensation. We also assign a distance to ∼18 400 filaments, for which we determine mass, physical size, stability conditions and Galactic distribution. When compared with the spiral arms structure, we find no significant difference between the physical properties of on-arm and inter-arm filaments. We compare our sample with previous studies, finding that our Hi-GAL filament catalogue represents a significant extension in terms of Galactic coverage and sensitivity. This catalogue represents a unique and important tool for future studies devoted to understanding the filament life-cycle

Spatial distribution of star formation related to ionized regions throughout the inner Galactic plane

We present a comprehensive statistical analysis of star-forming objects located in the vicinities of 1360 bubble structures throughout the Galactic plane and their local environments. The compilation of ~70 000 star-forming sources, found in the proximity of the ionized (Hii) regions and detected in both Hi-GAL and GLIMPSE surveys, provided a broad overview of the different evolutionary stages of star-formation in bubbles, from prestellar objects to more evolved young stellar objects (YSOs). Surface density maps of star-forming objects clearly reveal an evolutionary trend where more evolved star-forming objects (Class II YSO candidates) are found spatially located near the center, while younger star-forming objects are found at the edge of the bubbles. We derived dynamic ages for a subsample of 182 H ii regions for which kinematic distances and radio continuum flux measurements were available. We detect approximately 80% more star-forming sources per unit area in the direction of bubbles than in the surrounding fields. We estimate the clump formation efficiency (CFE) of Hi-GAL clumps in the direction of the shell of the bubbles to be ~15%, around twice the value of the CFE in fields that are not affected by feedback effects. We find that the higher values of CFE are mostly due to the higher CFE of protostellar clumps, in particular in younger bubbles, whose density of the bubble shells is higher. We argue that the formation rate from prestellar to protostellar phase is probably higher during the early stages of the (H ii) bubble expansion. Furthermore, we also find a higher fraction of massive YSOs (MYSOs) in bubbles at the early stages of expansion ( < 2 Myr) than older bubbles. Evaluation of the fragmentation time inside the shell of bubbles advocates the preexistence of clumps in the medium before the bubble expansion in order to explain the formation of MYSOs in the youngest H ii regions ( < 1 Myr), as supported by numerical simulations. Approximately 23% of the Hi-GAL clumps are found located in the direction of a bubble, with 15% for prestellar clumps and 41% for protostellar clumps. We argue that the high fraction of protostellar clumps may be due to the acceleration of the star-formation process cause by the feedback of the (Hii) bubbles. © ESO, 2017