BACKGROUND: Due to improvements in breast cancer diagnosis and treatment, the healthcare system faces a growing number of cancer survivors. Breast cancer survivors experience many difficulties when returning to work, including discrimination at work and lack of support by employers and colleagues. OBJECTIVE: To point out the knowledge in literature up to date about return to work (RTW) after breast cancer, the factors influencing it and the interventions to facilitate it. METHODS: A literature search was conducted in January 2017 using the databases Medline (PubMed) and Scopus. Studies were included if they analyzed the problem of RTW in women treated for breast cancer. RESULTS: Twenty-six articles met the inclusion criteria. The studies were divided into four themes: factors facilitating or impeding RTW; interventions to enhance RTW; lived experiences of RTW; economic aspects related to cancer survivors and RTW. CONCLUSIONS: The heterogeneity of the interventions suggests the need for a better definition of the concept of RTW. To compare interventions, studies should use a rigorous approach and better outcome measures should be identified to evaluate RTW.

BackgroundOxidative stress is responsible for some alterations in the chemical structure and, consequently, in the function of proteins, lipids, and DNA. Recent studies have linked oxidative stress to cancers, particularly thyroid cancer, but the mechanisms remain unclear. Here, we further characterize the role of oxidative stress in thyroid cancer by analyzing the expression of two selenium antioxidant molecules, glutathione peroxidase (GPx1) and thioredoxin reductase (TrxR1) in thyroid cancer cells.MethodsSamples of both healthy thyroid tissue and thyroid tumor were taken for analysis after total thyroidectomy. The expression of GPx1 and TrxR1 was revealed by Western blot analysis and quantified by densitometric analyses, while the evaluation of free radicals was performed by Electron Paramagnetic Resonance (EPR)-spin trapping technique.ResultsOur results show a decrease in the expression of GPx1 and TrxR1 (− 45.7 and − 43.2% respectively, p < 0.01) in the thyroid cancer cells compared to the healthy cells. In addition, the EPR technique shows an increase of free radicals in tumor tissue, significantly higher than that found in healthy thyroid tissue (+ 116.3%, p < 0.01).ConclusionsOur findings underscore the relationship between thyroid cancer and oxidative stress, showing the imbalance of the oxidant/antioxidant system in thyroid cancer tissue. These results suggest that either the inability to produce adequate antioxidant defense or an increased consumption of antioxidants, due to the hyper-production of free radicals, may play a crucial role in thyroid cancer.

Mucinous carcinoma (MC) is a rare breast cancer characterized by the presence of large extracellular mucin amount. Two main subtypes can be distinguished: pure (PMC) and mixed (MMC). We conducted a retrospective MC analysis in our prospective maintained database, calculating disease-free survival (DFS) and 5-year overall survival (OS). We found a global 92.1% OS (higher in MMC group and statistically significative) and a DFS of 95.3% (higher in MMC group but not statistically significative).

Multiple primary malignant neoplasms are multiple tumors with different pathogenetic origin. They may be synchronous or metachronous. The management of these conditions represents an interesting clinical scenario. A crucial aspect is the decision regarding which tumor to treat initially, and how to schedule further treatments according to individual tumor risk. This process involves a multidisciplinary physician team to ensure favorable outcomes. We describe a case report of a female patient affected by primary synchronous tumors of the breast and pectoral skin, which raised a series of diagnostic, etiological and therapeutic issues persuading us to carry out a critical review of the literature. Multiple primary malignant neoplasms (MPMNs), or multiple primary cancers, are defined as multiple tumors with different pathogenetic origin. The phenomenon of MPMN was first described by Billroth at the end of the 19th century (1) and since then several cases of double or even triple primary malignant neoplasms have been reported (1-3). Neoplasms can be synchronous or metachronous and may appear in a single organ or in multiple organs concurrently. According to Moertel (2), synchronous neoplasms are defined as those that occur within 6 months from the diagnosis of a previous malignant tumor, and metachronous neoplasms are defined as neoplasms that appear 6 months after the first diagnosed tumor (2). Despite many changes in the definition have been proposed, the diagnosis of MPMNs that is widely accepted is based on the criteria described by Warren and Gates (3). These criteria require that: (i) each tumor must have a clear picture and histological confirmation of malignancy; (ii) each tumor must be topographically distinct and separated by healthy mucosa (at least 2 cm of normal mucosa between two tumors of the same region); (iii) the lesions must be not metastases of each other (3). In this report, we describe our recent observation and treatment of a female patient affected by primary synchronous tumors of the breast and pectoral skin. This combination, to the best of our knowledge, has never been previously reported in the literature, and it raised a series of diagnostic, etiological and therapeutic issues persuading us to carry out a critical review of the literature.