Background
Preoperative staging of the axilla is important to allow decisions regarding neoadjuvant treatment and the management of the axilla. Invasive lobular carcinoma metastases are difficult to ...detect because of the infiltrative pattern of the nodal spread. In this study the sensitivity of preoperative axillary staging between invasive lobular (ILC) and ductal (IDC) carcinoma was compared.
Methods
All women diagnosed with pure ILC or IDC in the West of Scotland in 2012–2014 were identified from a database maintained prospectively within the Managed Clinical Network. Pretreatment axillary ultrasound imaging (AUS), core biopsy and fine‐needle aspiration cytology (FNAC) results were compared between ILC and IDC.
Results
Some 602 women with ILC and 4199 with IDC had undergone axillary surgery, of whom 209 and 1402 respectively had nodal metastases. Pretreatment AUS sensitivity was significantly lower in ILC than in IDC (32·1 versus 50·1 per cent respectively, P < 0·001; OR 0·47, 95 per cent c.i. 0·34 to 0·64). Core biopsy had equally high sensitivity of 86 per cent in both subtypes; however, FNAC was significantly less sensitive in both ILC (55 per cent; P = 0·003) and IDC (75·6 per cent; P = 0·006). Multivariable analysis revealed that cT3–4 status and symptomatic presentation were both significant in predicting nodal metastasis in patients with ILC and false‐negative AUS findings (OR 3·77, 95 per cent c.i. 1·69 to 8·42, P = 0·001; and OR 1·92, 1·24 to 2·98, P = 0·003, respectively).
Conclusion
AUS is inferior in detecting axillary node metastasis in ILC compared with IDC. Women with cT3–4 lobular carcinoma may benefit from ultrasound‐guided axillary biopsy regardless of the ultrasonographic appearance of the nodes.
Less sensitive in lobular carcinoma
Abstract Background The incidence of local recurrence (LR) after conservative surgery for early breast cancer without adjuvant therapy is unacceptably high even with favourable tumours. The aim of ...this study was to examine the effect of adjuvant therapies in tumours with excellent prognostic features. Methods Patients with primary invasive breast cancer <2 cm diameter, grade 1 or good prognosis special type, and node negative, treated by wide local excision (WLE) with clear margins were randomised into a 2 × 2 clinical trial of factorial design with or without radiotherapy and with or without tamoxifen. Trial entry was allowed to either comparison or both. Findings The actuarial breast cancer specific survival in 1135 randomised patients at 10 years was 96%. Analysis by intention to treat showed that LR after WLE was reduced in patients randomised to radiotherapy (RT) (HR 0.37, CI 0.22-0.61 p < 0.001) and to tamoxifen (HR 0.33, CI 0.15 – 0.70 p < 0.004). Actuarial analysis of patients entered into the four-way randomisation showed that LR after WLE alone was 1.9% per annum (PA) versus 0.7% with RT alone and 0.8% with tamoxifen alone. No patient randomised to both adjuvant treatments developed LR. Analysis by treatment received showed LR at 2.2% PA for surgery alone versus 0.8% for either adjuvant radiotherapy or tamoxifen and 0.2% for both treatments. Conclusions Even in these patients with tumours of excellent prognosis, LR after conservative surgery without adjuvant therapy was still very high. This was reduced to a similar extent by either radiotherapy or tamoxifen but to a greater extent by the receipt of both treatments.
Abstract Background Support for the oncological safety of oncoplastic breast conservation surgery (OBCS) is mostly based on evidence comparing recurrence rates after OBCS to wide local excision ...(WLE). However, OBCS is often indicated for larger cancers and oncological results should also be compared to patients treated with mastectomy. In this study we compared recurrence and survival following OBCS, mastectomy and WLE. Methods Patients treated with OBCS between 2009 and 2012 were identified from a prospectively maintained database. For comparison, consecutive patients treated with WLE or mastectomy with or without immediate reconstruction (Ms ± IR) over the same time period were identified. Histological variables of patients were compared using Fisher Exact or Chi squared tests, and recurrence and survival were compared using Kaplan-Meier and Cox regression survival analysis. Results 980 patients' data were analysed (OBCS: n = 104; WLE: n = 558; Ms ± IR: n = 318). Tumour size, grade, nodal status, ER, and PR expression of patients treated with OBCS were all significantly more adverse compared with patients treated with WLE (p < 0.001). These histological variables were similar in patients treated with Ms ± IR and OBCS. 5-year local recurrence rates were similar in all three groups (WLE: 3.4 per cent, OBCS: 2 per cent, Ms ± IR: 2.6 per cent; log rank = 0.973), while distant recurrence rates were higher after Ms ± IR and OBCS (Ms ± IR:13.1 per cent, OBCS:7.5 per cent, WLE:3.3 per cent; log rank: p < 0.001). Conclusion OBCS is oncologically safe in patients even when histological results are similar to patients treated with Ms ± IR.
Polymer/graphite nanocomposites (PGNs) were synthesized using graphite oxide (GO) by miniemulsion polymerization. GO was prepared by the oxidation process of natural graphite using potassium ...permanganate in the presence of concentrated sulfuric acid. The resultant functionalized graphite (GO) was used to prepare poly(styrene-co-butyl acrylate) (poly(St-co-BA)) nanocomposites latices in miniemulsions. The functional groups of GO were then reduced by treating the nanocomposite latices using a strong reducing agent, hydrazine hydrate. The water barrier properties (hydrophobicity, water uptake and moisture vapor transmission rate) of the resultant films produced from the obtained nanocomposite latices containing the reduced GO (RGO) were studied. Results showed that the nanocomposite films containing the RGO had less affinity to water and better water barrier properties compared to those of the same nanocomposites, which contain unmodified (i.e., as-prepared) GO. Display omitted
•The barrier properties of polymer/graphene nanocomposites were studied.•Nanocomposites made with reduced graphene oxide showed improved barrier properties.•This was due to the hydrophobic nature of reduced graphene oxide nanosheets.•This resulted in better barrier properties compared to as-prepared graphite oxide.
Water barrier properties (i.e., water resistance) of poly(styrene-co-butyl acrylate)/graphite oxide (poly(St-co-BA)/GO) nanocomposites were studied using hydrophobicity and permeability analysis. Poly(St-co-BA)/GO nanocomposite latices were obtained using the miniemulsion polymerization technique. The hydrophobicity of the synthesized nanocomposites was studied using contact angle measurements, while water permeability was obtained by measuring the moisture vapor transmission rate (MVTR). The nanocomposites were treated with hydrazine hydrate in order to reduce the functional groups on graphite oxide (GO). The focus was on determining the effect of reducing the functional groups of GO on the water barrier properties of its polymer nanocomposites. In general, the nanolayered graphene platelets in GO and RGO resulted in lower water permeation in the final films compared to pure polymer. However, results showed that nanocomposites containing the reduced-GO (RGO) had better water resistance and barrier properties compared to those made with unreduced GO (i.e., as-prepared GO). The nanocomposites containing RGO had higher hydrophobicity and lower water uptake and MVTR compared to those made with as-prepared GO, resulting in better barrier performance. This was attributed to the high hydrophobic nature of the RGO, which exhibited lower water solubility that resulted in films with lower MVTR values compared to those made with as-prepared GO.
Poly(styrene-co-butyl acrylate) (poly(St-co-BA)) nanocomposite latices based on graphene oxide (GO) were synthesized by miniemulsion polymerization. The polymerization procedure involved dispersing ...an aqueous solution of graphite oxide in a monomer phase, followed by emulsification in the presence of a hydrophobe and a surfactant into miniemulsions. The focus was to investigate the suitability of miniemulsion for the synthesis of polymer nanocomposites based on a graphene derivative (i.e., GO) with exfoliated structure in a one-step nano-incorporation technique. Poly(St-co-BA) nanocomposites containing the exfoliated GO nanoplatelets, which have improved mechanical and thermal properties were successfully synthesized by the miniemulsion process. The nanostructure of the nanocomposites was investigated by transmission electron microscopy (TEM) and X-ray diffraction (XRD). TEM and XRD indicated that the nanocomposites mainly showed exfoliated morphologies, except at relatively high GO content. TEM also revealed that the nanocomposite latices had the so-called ‘‘armored’’ structure, where the nanosized GO sheets are distributed around the edges of the copolymer particles.
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Immune response dynamics in insects from natural host−parasite associations are poorly understood, despite accumulating evidence of ecological immune phenomena in these systems. Using a gene ...discovery approach, we have identified genes relating to signalling, enzymatic processes and respiration that were up-regulated in the bumblebee, Bombus terrestris, during infection with the trypanosomatid parasite, Crithidia bombi. In addition, we have mapped dynamic changes in the temporal expression of these genes and three candidate antimicrobial peptide (AMP) immune genes, Abaecin, Defensin and Hymenoptaecin, from 1 to 24 h after C. bombi infection. We show that dynamic changes in expression occur for individual genes at distinct phases of the immune response to C. bombi that correspond to early, intermediate and late stages of infection.
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•HMF/fructose adsorption from DMSO onto commercial and synthetic carbons elucidated.•Adsorption capacity/selectivity linked to carbon microporosity/oxygenate ...functionality.•Structure–function relations found to transcend different classes of synthetic carbons.•Design rules leveraged for synthesizing new class of meso–microporous carbons.•Synthetic carbons achieve superior HMF adsorption selectivity and capacity.
5-Hydroxymethyl furfural (HMF) production from fructose dehydration in DMSO with various catalytic systems has shown superior selectivity and high yields. Yet, the subsequent need for energy-intensive separation of HMF from HMF/fructose/DMSO mixtures challenges the practical feasibility of this process. Microporous carbon materials have shown promise as substrates for alternative adsorption-based separations, but the origin of HMF selectivity and adsorption capacity, and thereby structure–properties relations enabling rational design of enhanced sorbents, has remained elusive. Through systematic quantification of the functionality and texture of various commercial (BP2000, Norit1240) and synthetic carbons (three-dimensionally ordered macroporous carbons; mesoporous carbons), we link, for the first time, adsorption capacity and HMF adsorption selectivity to two tunable materials properties of the carbon sorbents: microporosity and oxygenate functionality (i.e., carbon polarity). In the process, we exploit these newly elucidated structure–properties relations for realizing a class of synthetic carbons with sub-micron particulate morphology that achieve more than 60% higher selectivity and more than 20% higher capacity for HMF over fructose as compared to the best performing commercial product, BP2000.
We present a retrospective analysis on a cohort of low-grade, node-negative patients showing that human epidermal growth factor receptor 2 (HER2) status significantly affects the survival in this ...otherwise very good prognostic group. Our results provide support for the use of adjuvant trastuzumab in patients who are typically classified as having very good prognosis, not routinely offered standard chemotherapy, and who as such do not fit current UK prescribing guidelines for trastuzumab.
This study determined mRNA expression levels for Src kinase family (SFK) members in breast tissue specimens and assessed protein expression levels of prominent SFK members in invasive breast cancer ...to establish associations with clinical outcome. Ki67 was investigated to determine association between SFK members and proliferation.
The mRNA expression levels were assessed for eight SFK members by quantitative real-time PCR. Immunohistochemistry was performed for c-Src, Lyn, Lck and Ki67.
mRNA expression was quantified in all tissue samples. SRC and LYN were the most highly expressed in malignant tissue. LCK was more highly expressed in oestrogen receptor (ER)-negative, compared with ER-positive tumours. High cytoplasmic Src kinase protein expression was significantly associated with decreased disease-specific survival. Lyn was not associated with survival at any cellular location. High membrane Lck expression was significantly associated with improved survival. Ki67 expression correlated with tumour grade and nuclear c-Src, but was not associated with survival.
All eight SFK members were expressed in different breast tissues. Src kinase was highest expressed in breast cancer and had a negative impact on disease-specific survival. Membrane expression of Lck was associated with improved clinical outcome. High expression of Src kinase correlated with high proliferation.
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