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Background Early hormone-positive breast cancers typically have favorable outcomes, yet long-term surveillance is crucial due to the risk of late recurrences. While many studies associate MMP-11 expression with poor prognosis in breast cancer, few focus on early-stage cases. This study explores MMP-11 as an early prognostic marker in hormone-positive breast cancers. Methods In this retrospective study, 228 women with early hormone-positive invasive ductal carcinoma, treated surgically between 2011 and 2016, were included. MMP-11 expression was measured by immunohistochemistry, and its association with clinical and MRI data was analyzed. Results Among the patients (aged 31–89, median 60, with average tumor size of 15.7 mm), MMP-11 staining was observed in half of the cases. This positivity correlated with higher uPA levels and tumor grade but not with nodal status or size. Furthermore, MMP-11 positivity showed specific associations with MRI features. Over a follow-up period of 6.5 years, only 12 oncological events occurred. Disease-free survival was linked to Ki67 and MMP-11. Conclusion MMP-11, primarily present in tumor-surrounding stromal cells, correlates with tumor grade and uPA levels. MMP-11 immunohistochemical score demonstrates a suggestive trend in association with disease-free survival, independent of Ki67 and other traditional prognostic factors. This highlights the potential of MMP-11 as a valuable marker in managing early hormone-positive breast cancer.

Background. Axillary lymph node biopsy (ALND) has traditionally been considered the gold standard for axillary staging and treatment in clinically node-positive breast cancer patients. However, in patients with nodal disease, the therapeutic benefit of ALND is uncertain. This study, based on a large cohort, aims to evaluate breast cancer-specific survival depending on the extent of axillary surgery in non-metastatic breast cancer using real-world data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods. This retrospective cohort study comprised 825,240 patients diagnosed with breast cancer between 2000 and 2020. Results. ALND was associated with a worse survival outcome in pN0 and pN1 populations (respectively, hazard ratio [HR] 1.16; 95% confidence interval [CI] 1.12–1.2; p < 0.001 and HR 1.38; 95%CI 1.3–1.46; p < 0.001). In pN2 and pN3 populations, there was ~4.3% relative reduction in the hazard of breast cancer-related death for each additional node removed; and higher positive-to-removed lymph node ratio was associated with worse prognosis (HR 3.450; 95%CI 2.99–3.98; p < 0.001). Conclusions. SLNB is associated with significantly better specific survival compared to ALND in negative/low axillary involvement, in higher axillary involvement categories extensive axillary surgery was associated with better prognosis.

Introduction To investigate whether the quarantine periods due to the COVID‐19 pandemic were associated with excessive gestational weight gain. Methods This single‐centre retrospective observational French cohort study studied 23 774 pregnant women from 2017 to 2020 who had an obstetrical follow‐up consultation with a weight measurement in Strasbourg University Hospitals. We defined four time periods according to the two quarantine periods in France: (1) prequarantine, (2) first quarantine (all‐day curfew); (3) between quarantines, and (4) second quarantine (all‐day curfew). Inferential analyses and models were conducted using Bayesian methods. Results We developed three Bayesian models to explore the impact of quarantines on GWG. Mean GWG was 8.3 kg (standard deviation 5.0 kg) for a mean gestational age at consultation of 28.5 weeks. Compared to the same calendar periods from 2017 to 2019, the probabilities of a clinically significant increase in GWG (≥1 kg) during the different quarantine periods were extremely low (<0.001). Mean GWG was stable during the first quarantine (−0.13 kg; 95% confidence interval (CI) −0.30, 0.03) while it increased between quarantines (+0.20 kg; 95% CI 0.07, 0.35) and during the second quarantine (0.30 kg; 95% CI 0.12, 0.52). Conclusion This study showed that COVID‐19 quarantine periods were not associated with a clinically significant excessive GWG, even if during the period between quarantines and during the second quarantine there was a slight increase in GWG. Pregnant women can therefore be reassured concerning this problem.

Dear Editor, The Council of Europe (CoE), based in Strasbourg (France), is an international organization that promotes cooperation among European countries in the areas of human rights, democracy, rule of law, culture and public health. A history of breast cancer (BC) has a prominent place in the debate concerning the transplantation of human organs. Some subtypes are associated with almost no risk of metastases, such as low-grade ductal carcinoma in situ (DCIS), while others are highly proliferative with a particularly unfavorable prognosis in the short term, such as triple negative BC, and others have a risk of late re-evolution, sometimes decades after the diagnosis, for example invasive lobular carcinoma. [...]before deciding on the clinical use of organs obtained from a woman with a past or current history of BC, it is essential to know the BC prognosis based on its histological subtype, molecular characteristics, including expression of hormone receptors, human epidermal growth factor-receptor 2 and proliferation index, together with stage, completeness of treatment, time since the diagnosis and regularity and normality of follow-up. The EDQM has now reconsidered the criteria for acceptance of organs from donors with a history of BC, acknowledging the key role of medical teams in performing a risk-benefit assessment for each particular case. Since BC has high potential for late and aggressive recurrence and metastases, even after many years of complete remission, patients with BC should only be accepted as organ donors with the highest caution and for very selected recipients. [...]donor examination for BC recurrence and/or metastases, including careful clinical examination and imaging, is necessary even after a long disease-free survival.

Background Breast fibromatosis is a rare disease characterized by monoclonal fibroblast proliferation. It has no ability to metastasize but has a high local recurrence rate and often infiltrates surrounding tissues. Surgical treatment is the reference, but recently, new targeted therapies have emerged. We report an original case of a patient with breast fibromatosis who received exclusive medical treatment. Our aim was to analyze these treatments based on the clinical and radiological outcome, iatrogenic effects, and pharmacological action. Case presentation We report the case of a 19-year-old woman who developed a desmoid-type fibromatosis of the lower inner quadrant of the right breast, measuring 50 × 25 mm (i.e., a volume of 27.4 cm 3 ). Initial surgery was not possible because of potential esthetic and functional prejudice. Thus, she had an exclusive medical treatment including several lines: NSAIDs with tamoxifen and triptorelin, followed by sorafenib, then interferon α2b, and finally sunitinib. With tyrosine-kinase inhibitors (TKIs) (sunitinib), a significant partial response was observed (57% reduction of the maximal tumoral volume). For each treatment, we provided the clinical and radiological outcome in association with known pharmacological action. Conclusions TKI had been an interesting alternative option to initial surgery, providing at least a partial response and potentially allowing less mutilating surgery. However, no pharmacological mechanism can unequivocally explain TKI efficacy. In general, breast fibromatosis should be treated along with oncologist and interventional radiologists in a trans-disciplinary modality, thus offering an adapted treatment for this particular desmoid-type fibromatosis localization.

To determine if there is an association between total lipid intake, saturated fatty acid (SFA), Poly- and Mono-Unsaturated Fatty Acid (PUFA and MUFA) and cholesterol intake and breast cancer risk. We conducted a systematic review of the literature and a meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included all cohort and case-control studies published up to December 2020 with subgroup analysis according to menopausal status. We included 44 articles for analysis. There was no association between total fat, SFA, MUFA, PUFA and cholesterol intake and breast cancer in the general population and in pre-menopausal women. In postmenopausal women, high SFA consumption was associated with increased breast cancer risk in case-control studies [relative risk (RR): 1.12; confidence interval (CI) 95%: 1.03-1.21; p = 0.006 but not in cohort studies (RR: 1.01; CI 95%: 0.85-1.19; p = 0.93). There was a weak association between high SFA consumption and breast cancer risk in post-menopausal women, however there was high heterogeneity for this analysis. As lipids can have different actions in the same family, studies should rather focus on specific lipid consumption.

Intracellular cholesterol transport is a complex process involving specific carrier proteins. Cholesterol-binding proteins, such as the lipid transfer protein steroidogenic acute regulatory-related lipid transfer domain-3 (STARD3), are implicated in cholesterol movements between organelles. Indeed, STARD3 modulates intracellular cholesterol allocation by reducing it from the plasma membrane and favoring its passage from the endoplasmic reticulum (ER) to endosomes, where the protein is localized. STARD3 interacts with ER-anchored partners, notably vesicle-associated membrane protein-associated proteins (VAP-A and VAP-B) and motile sperm domain-containing 2 (MOSPD2), to create ER–endosome membrane contacts. Mechanistic studies showed that at ER–endosome contacts, STARD3 and VAP proteins build a molecular machine able to rapidly transfer cholesterol. This review presents the current knowledge on the molecular and cellular function of STARD3 in intracellular cholesterol traffic.

Background The aim of this study was the evaluation of breast MRI in determining the size and focality of invasive non-metastatic breast cancers. Methods The prospective, single-centre study conducted in 2015 compared preoperative MRI with histological analysis of mastectomy. Results One hundred one mastectomies from 98 patients were extensively analysed. The rates of false-positive and false-negative MRI were 2 and 4% respectively. The sensitivity of breast MRI was 84.7% for the detection of all invasive foci, 69% for single foci and 65.7% for multiple foci. In the evaluation of tumour size, the Spearman rank correlation coefficient r between the sizes obtained by MRI and histology was 0.62. The MRI-based prediction of a complete response to neoadjuvant chemotherapy was 75%. Discussion MRI exhibits high sensitivity in the detection of invasive breast cancers. False positives were linked to the inflammatory nature of the tumour bed. False negatives were associated with small or low-grade tumours and their retro-areolar location. The size of T1 tumours was overestimated by an average of 7%, but MRI was the most efficient procedure. The sensitivity of MRI for the diagnosis of unifocal tumours was higher than that for multifocal sites. Our study confirmed the positive contribution of preoperative MRI for invasive lobular carcinomas and complete response predictions after neoadjuvant chemotherapy.

Breast cancer is the most common malignancy among women worldwide, particularly in developed countries. In 2017 in France, it represents 31.8% of newly diagnosed cancers and responsible for 18.2% of cancer mortality in women (1). While it is recognized that age is the first breast cancer risk factor – incidence grows with age – the over-mortality among elderly women due to breast cancer is underestimated. Indeed, the specific mortality associated with breast cancer increases with ageing (2). Moreover, Europe’s population is getting older. It is estimated that, between now and 2050, its population over the age of 65 is set to increase from about 20% to about 30% (3). Within this context, it can be predicted that breast cancer, which right now is already a major public health concern, will grow in importance in the future and will be a serious concern for the forthcoming medical practice.

Conclusion:This survey provided an overview of the current practices of DCIS management worldwide. It showed that some areas are rather consensual: incidence increases over time, treatment in young women, pathological classifications, definition of healthy margins, the skin-sparing mastectomy and immediate breast reconstruction. However, some topics are still debated and result in heterogeneous practices, such as evolution in the age of diagnosis, the benefit of de-escalation in low-risk DCIS among elderly women, indications for hormone therapy, radiotherapy omission, or multigene assays. Further evidence is needed to reach consensus on these points, and innovative approaches are still under evaluation in clinical trials. The International Senologic Society, by its members, encourages precision medicine and personalized treatments for DCIS, to avoid overtreatment and overdiagnosis, and provide better healthcare to women with DCIS.Results:Twenty-two responses from 20 different countries showed that organized breast cancer screening programs were present for 87% participants, and DCIS cases represented 13.7% of all breast cancers. Most participants used the grade classification (100%), the morphological classification (78%) and performed immunohistochemistry assays (73%). In case of conservative treatment, the mean re-excision rate was 10.3% and clear margins of mean 2.5 mm were considered healthy. Radical mastectomy rate was 35.5% with a breast reconstruction rate of 53%. Tumor bed boost indications were heterogeneous, and 73% of participants indicated hormone therapy for hormone-positive DCIS. Surgery and radiotherapy omission for some low-risk DCIS were considered by 73% of participants. Multigene assays were used by 43% of participants. Concerning future changes in DCIS management, participants mostly answered surgical de-escalation (48%), radiotherapy de-escalation (35) and/or active surveillance for some cases (22%).Materials and Methods:The Senologic International Society network members participated to an online survey using a questionnaire, between November 2021 and February 2022.Objective:Therapeutic management of ductal carcinoma in situ (DCIS) is heterogeneous among countries worldwide, and some treatment indications are still controversial. To investigate DCIS management in different countries; identify both consensual practices and controversial topics; and survey opinions about the future management of DCIS.