Background
Microinvasive breast cancer is an uncommon pathological entity. Owing to the rarity of this condition, its surgical axillary management and overall prognosis remain controversial.
Methods
...A database was analysed to identify patients with microinvasive ductal carcinoma in situ (DCIS) who had surgery for invasive breast cancer at the European Institute of Oncology, Milan, between 1998 and 2010. Women who had undergone axillary staging by sentinel lymph node biopsy were included in the study.
Results
Of 257 women with microinvasive breast cancer who underwent sentinel lymph node biopsy (SLNB), 226 (87·9 per cent) had negative sentinel lymph nodes (SLNs) and 31 had metastatic SLNs. Twelve patients had isolated tumour cells (ITCs), 14 had micrometastases and five had macrometastases in sentinel nodes. Axillary lymph node dissection was performed in 16 of the 31 patients with positive SLNs. After a median follow‐up of 11 years, only one regional first event was observed in the 15 patients with positive SLNs who did not undergo axillary lymph node dissection. There were no regional first events in the 16 patients with positive SLNs who had axillary dissection.
Conclusion
Good disease‐free and overall survival were found in women with positive SLNs and microinvasive DCIS. This study is in line with studies showing that SLNB in microinvasive DCIS may not be useful, and supports the evidence that less surgery can provide the same level of overall survival with better quality of life.
No added value
We study the 30 October 2016 Norcia earthquake (MW 6.5) to retrieve the rupture history by jointly inverting seismograms and coseismic Global Positioning System displacements obtained by dense local ...networks. The adopted fault geometry consists of a main normal fault striking N155° and dipping 47° belonging to the Mt. Vettore‐Mt. Bove fault system (VBFS) and a secondary fault plane striking N210° and dipping 36° to the NW. The coseismic rupture initiated on the VBFS and propagated with similar rupture velocity on both fault planes. Updip from the nucleation point, two main slip patches have been imaged on these fault segments, both characterized by similar peak‐slip values (~3 m) and rupture times (~3 s). After the breakage of the two main slip patches, coseismic rupture further propagated southeastward along the VBFS, rupturing again the same fault portion that slipped during the 24 August earthquake. The retrieved coseismic slip distribution is consistent with the observed surface breakages and the deformation pattern inferred from interferometric synthetic aperture radar measurements. Our results show that three different fault systems were activated during the 30 October earthquake. The composite rupture model inferred in this study provides evidences that also a deep portion of the NNE trending section of the Olevano‐Antrodoco‐Sibillini thrust broke coseismically, implying the kinematic inversion of a thrust ramp. The obtained rupture history indicates that in this sector of the Apennines, compressional structures inherited from past tectonics can alternatively segment boundaries of NW trending active normal faults or break coseismically during moderate‐to‐large magnitude earthquakes.
Key Points
Rupture history of the 30 October 2016 Norcia earthquake is modeled by jointly inverting seismograms and GPS coseismic data
Two main slip patches, with similar slip value and rupture times, occur updip from the nucleation on two differently oriented faults
This result has implications for dynamic control of segmented fault systems in the Central Apennines due to geological structures inherited from past tectonics
Nipple- and areola-sparing mastectomy is a novel surgical approach that preserves the nipple–areolar complex. Patients with moderate and/or severe breast ptosis are usually not eligible for this ...surgical approach. In this study, we aimed to demonstrate the feasibility of nonconventional surgical approaches for nipple-sparing mastectomy.
One hundred consecutive patients diagnosed with primary breast cancer (BC) were enrolled in this study. Clinical and pathological data such as body mass index, smoking status, breast ptosis, complications, and aesthetic satisfaction (Breast-Q test) were collected. According to different types of breast ptosis, surgical procedures were classified as (a) hemi-periareolar, (b) round block, (c) vertical pattern, and (d) wise pattern skin incisions. We performed statistical analysis to assess the correlation with complications, degree of ptosis, and breast-Q scores.
Among the 117 surgical procedures performed in 100 patients with BC, no significant associations are verified considering clinical and pathological data, complications, pre- and postsurgery satisfactions, and other parameters.
Different surgical approaches represent the evolution of “classic” nipple-sparing mastectomy, thus meeting the cosmetic and oncological results. These procedures are safe and also indicated in cases conventionally considered as not eligible for nipple–areola preservation.
Moment tensor inversions of broadband velocity data are usually managed by adopting Green's functions for 1D layered seismic wave speed models. This assumption can impact on source parameter ...estimates in regions with complex 3D heterogeneous structures and discontinuities in rock properties. In this work, we present a new centroid moment tensor (CMT) catalog for the Amatrice‐Visso‐Norcia (AVN) seismic sequence based on a recently generated 3D wave speed model for the Italian lithosphere. Forward synthetic seismograms and Fréchet derivatives for CMT‐3D inversions of 159 earthquakes with Mw ≥ 3.0 are simulated using a spectral‐element method (SEM) code. By comparing the retrieved solutions with those from time domain moment tensor (TDMT) catalog, obtained with a 1D wave speed model calibrated for Central Apennines (Italy), we observe a remarkable degree of consistency in terms of source geometry, kinematics, and magnitude. Significant differences are found in centroid depths, which are more accurately estimated using the 3D model. Finally, we present a newly designed parameter, τ, to better quantify and compare a‐posteriori the reliability of the obtained MT solutions. τ measures the goodness of fit between observed and synthetic seismograms accounting for differences in amplitude, arrival time, percentage of fitted seconds, and the usual L2‐norm estimate. The CMT‐3D solutions represent the first Italian CMT catalog based on a full‐waveform 3D wave speed model. They provide reliable source parameters with potential implications for the structures activated during the sequence. The developed approach can be readily applied to more complex Italian regions where 1D models are underperforming and not representative of the area.
Plain Language Summary
The moment tensor (MT) is a mathematical representation of the movement on a fault during an earthquake, and of the size, or magnitude, of the event. Such tensor is often described through the beachballs, a graphic symbol that indicates the fault orientation and the type of slip that occurs during an earthquake. Usually, seismologists use 1D wave speed models (i.e., describing only the vertical velocity of seismic waves in the Earth interior) in order to compute MTs. In recent years, due to the incredible progresses of computer sciences, also 3D models, which are able to describe lateral velocity variations, have been successfully adopted to compute MTs. In this work, we use the recently developed 3D Italian wave speed model “IMAGINE_IT” (“Im25” for brevity) to compute the MT solutions for the Amatrice‐Visso‐Norcia (AVN) 2016–2018 earthquakes with magnitude larger than 3. This seismic sequence ruptured almost 80 km of the Apennines normal faults and resulted in 299 casualties and >20,000 homeless. Our newly developed MT catalog allows us to better understand the characteristics of the faults activated during the seismic sequence and to provide more reliable source parameters as magnitude and depth.
Key Points
A new centroid moment tensor catalog for Central Italy earthquakes has been built based on a 3D wave speed model for the Italian lithosphere
Moment magnitude, kinematic source parameters, and centroid depths inferred with a 3D wave speed model are accurately estimated
The goodness of moment tensor solutions is tested via a newly designed quality factor
Dipartimento di Scienze Biomolecolari e Biotecnologie, Università degli Studi di Milano, Via Celoria 26, 20133 Milano, Italy
Correspondence D. Ghisotti Daniela.Ghisotti{at}unimi.it
Phage P4 int gene ...encodes the integrase responsible for phage integration into and excision from the Escherichia coli chromosome. Here, the data showing that P4 int expression is regulated in a complex manner at different levels are presented. First of all, the P int promoter is regulated negatively by both Int and Vis, the P4 excisionase. The N-terminal portion of Int appears to be sufficient for such a negative autoregulation, suggesting that the Int N terminus is implicated in DNA binding. Second, full-length transcripts covering the entire int gene could be detected only upon P4 infection, whereas in P4 lysogens only short 5'-end covering transcripts were detectable. On the other hand, transcripts covering the 5'-end of int were also very abundant upon infection. It thus appears that premature transcription termination and/or mRNA degradation play a role in Int-negative regulation both on the basal prophage transcription and upon infection. Finally, comparison between P int lacZ transcriptional and translational fusions suggests that Vis regulates Int expression post-transcriptionally. The findings that Vis is also an RNA-binding protein and that Int may be translated from two different start codons have implications on possible regulation models of Int expression.
Present address: Max F. Perutz Laboratories at the Vienna Biocenter, Department of Microbiology and Genetics, University of Vienna, 1030 Vienna, Austria.
Present address: Keryos, Via della Filanda 5, 20060 Gessate (MI), Italy.
Present address: Molmed SpA, Via Olgettina 58, 20132 Milano, Italy.
Seismic signals propagating across a fault may yield information on the internal structure of the fault zone. Here we have assessed the amplification of seismic noise (i.e., ambient vibrations ...generated by natural or anthropogenic disturbances) across the Vado di Corno Fault (Campo Imperatore, central Italy). The fault zone is considered as an exhumed analogue of the normal faults activated during the L'Aquila 2009 earthquake sequence. Detailed structural geological survey of the footwall block revealed that the fault zone is highly anisotropic and is affected by a complex network of faults and fractures with dominant WNW–ESE strike. We measured seismic noise with portable seismometers along a ∼500 m long transect perpendicular to the average fault strike. Seismic signals were processed calculating the horizontal-to-vertical spectral ratios and performing wavefield polarization analyses. We found a predominant NE–SW to NNE–SSW (i.e., ca. perpendicular to the average strike of the fault-fracture network) amplification of the horizontal component of the seismic waves. Numerical simulations of earthquake-induced ground motions ruled out the role of topography in controlling the polarization and the amplitude of the waves. Therefore, the higher seismic noise amplitude observed in the fault-perpendicular direction was related to the measured fracture network and the resulting stiffness anisotropy of the rock mass. These observations open new perspectives in using measures of ambient seismic noise, which are fast and inexpensive, to estimate the dominant orientation of fracture networks within fault zones.
•We recorded ambient seismic noise across a well-exposed fault zone.•Detailed structural geological survey revealed high anisotropy of the fault zone structure.•Directional amplification is perpendicular to the strike of measured faults/fractures.•We ruled out the role of topography performing 3D simulation of wave propagation.•Directional amplification is due to stiffness anisotropy of the fractured rock mass.
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