Triple therapy is independently associated with a higher survival rate among patients with CAPS.

Supported employment in many European countries is spreading somewhat slowly, with specific nationwide programs being required to enable significant progress in integrating people with disabilities and other limitations into the ordinary labor market. This article describes the Caja Madrid SE Program, deployed throughout every province in Spain, for people with disabilities and people who experience social exclusion. We set out the characteristics of the program, the profile of those taking part, and the results achieved in terms of employment between 2005 and 2007. Finally, we include the results of the research related to the participants' quality of life and self-determination.

Background: Most breast cancer (BC) patients fail to achieve pathological complete response (pCR) after neoadjuvant chemotherapy (NAC). The aim of this study was to evaluate whether imaging features (perfusion/diffusion imaging biomarkers + radiomic features) extracted from pre-treatment multiparametric (mp)MRIs were able to predict, alone or in combination with clinical data, pCR to NAC. Methods: Patients with stage II-III BC receiving NAC and undergoing breast mpMRI were retrospectively evaluated. Imaging features were extracted from mpMRIs performed before NAC. Three different machine learning models based on imaging features, clinical data or imaging features + clinical data were trained to predict pCR. Confusion matrices and performance metrics were obtained to assess model performance. Statistical analyses were conducted to evaluate differences between responders and non-responders. Results: Fifty-eight patients (median [range] age, 52 [45–58] years) were included, of whom 12 showed pCR. The combined model improved pCR prediction compared to clinical and imaging models, yielding 91.5% of accuracy with no false positive cases and only 17% false negative results. Changes in different parameters between responders and non-responders suggested a possible increase in vascularity and reduced tumour heterogeneity in patients with pCR, with the percentile 25th of time-to-peak (TTP), a classical perfusion parameter, being able to discriminate both groups in a 75% of the cases. Conclusions: A combination of mpMRI-derived imaging features and clinical variables was able to successfully predict pCR to NAC. Specific patient profiles according to tumour vascularity and heterogeneity might explain pCR differences, where TTP could emerge as a putative surrogate marker for pCR.

BackgroundBreast cancer is one of the most common cancers diagnosed during pregnancy. Pregnancy-associated breast cancer (PABC) is defined as breast cancer diagnosed during pregnancy or within 12 months of delivery. Nowadays PABC can be safely diagnosed, staged, and treated during pregnancy with good outcomes for both the mother and the fetus. Recent studies suggest that prognosis of women diagnosed during postpartum seems to be worse. In order to gain a better understanding of the PABC, we reviewed our centre’s experience.Patients and methodsWe assessed the clinicopathological parameters, evolution, and outcome of patients treated in the Fundación Instituto Valenciano de Oncología of Valencia, Spain, from October 1990 to October 2013, and compared the results of patients diagnosed during pregnancy (group ‘A’) and patients diagnosed within one year of delivery (group ‘B’).Of 12,000 cases of breast cancer registered in our database, 35 cases of PABC were identified. We included 11 patients in group ‘A’ and 24 in group ‘B’.ResultsIn our group the median age was 35 years (range 29–42), of which ten (28%) patients had family history (first grade) of breast cancer, four patients were BRCA 1 mutation carriers. Axillary node compromise was found in 19 patients (53.5%), 24 patients were stage II or III at diagnosis (68.5%), 22 (62.8%) were ER positive, and nine (25.7%) were HER-2 positive.In group A (n = 11), five patients diagnosed before 18th week decided that a therapeutic abortion be performed before treatment, two patients were treated during pregnancy, one with chemotherapy without treatment associated complications during delivery. Four women diagnosed after 28th week decided to delay the treatment until delivery.After a follow up of 172 months, the relapse free survival (RFS) was 69% at five years and 45% at ten years. Overall survival (OS) at five years was 90.8% and 74.2% at ten years for all patients. For group ‘A’ OS was higher with 90% at five years versus 80% in group ‘B’. The differences between the groups were not statistically significant p = 0.368.ConclusionIn our experience, there is a higher OS in patients diagnosed during pregnancy suggesting a better prognosis for this group of women but the difference between the groups is not statistically significant. Our study is limited because of our small sample.

We present the case of a 52-year-old female who developed sudden, uncomfortable swelling in her right (reconstructed) breast and small, smooth, firm, mobile nodules with mastitis-like symptoms and without skin ulceration. Image studies and histo-cytopathology examination confirmed the presence breast implantassociated anaplastic large cell lymphoma. The patient was treated with implant removal.