Comparative analysis of main clinical features in melanoma patients with and without sentinel lymph node biopsy

Introduction. Sentinel lymph node biopsy is fundamental in the treatment and prognosis of cutaneous malignant melanoma. This study aims to identify differences in baseline clinical characteristics and survival of patients with melanoma with and without a sentinel lymph node biopsy (SLNB) performed.  Material and methods. In 2018, a retrospective study of 151 patients with malignant melanoma (MM) was conducted. The patients were hospitalized at the Second Clinic of University Hospital — Pleven, from 2012 to 2017. The patients were divided into two groups: Group A included 58 (38.4%) patients with SLNB performed; Group B included 93 (61.6%) patients who did not undergo SLNB. A double-detection method was used while performing SLNB.  Results. The incidence of achromatic malignant melanoma is significantly higher in patients without SLNB (12 or 12.9%) than in patients with SLNB (2 or 3.4%) — c2 = 3.796, df = 1, p = 0.051. Of all 151 patients in the study, 46 died, representing 30.5% of patients with melanoma. The mortality rate was higher in the patients without SLNB (32.3% vs. 27.6% in Group A). However, the differences in the two groups are not statistically significant.  Conclusions. Patients with achromatic melanoma have significantly fewer sentinel lymph node (SLN) biopsies performed because of a late diagnosis. Most of our patients are diagnosed at a later stage when lymphatic metastases are already present, which leads to a significant increase in lymph node dissections performed. There is no significant difference in mortality and survival in the SLNB and non-SLNB groups

Resistance to neoadjuvant chemotherapy in breast cancer with proven intratumoral heterogeneity: a clinical case

Breast cancer (BC) is the most common cancer in women in Bulgaria, with a frequency of 26.7% of all newly registered cancer cases in 2020 and ranks first in mortality. In recent years, research and studies have confirmed that breast cancer is a highly heterogeneous disease at the morphological, genomic, and transcriptomic levels, manifested clinically with different behavior and response to therapy. The gold standard for breast cancer diagnostic management is based upon three diagnostic methods, including clinical examination, imaging, and percutaneous biopsy. The main percutaneous biopsy method is an ultrasound-guided core-needle biopsy. It is sufficiently representative of the composition of the tumor although it represents a limited part of it, and some cellular subpopulations are often scantly represented or completely absent. We present a case of a 41-year-old breast cancer patient with primary intratumoral morphological heterogeneity diagnosed through core-needle biopsy and with primary resistance to neoadjuvant targeted therapy