In December 2019, reports of an atypical pneumonia emerged from the city of Wuhan, Hubei province of China. 1 The infectious agent was soon identified as a novel enveloped betacoronavirus. 2,3 Coronaviruses are enveloped non-segmented positive sense RNA viruses belonging to the family Coronaviridae. 4 This newly identified coronavirus, has been named Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) by the World Health Organization (WHO). This is the third large scale health crises caused by a betacoronavirus. Severe Acute Respiratory Syndrome CoronaVirus (SARS-CoV) and Middle East Respiratory Syndrome CoronaVirus (MERS-CoV) represent the previous health crises. Mortality rate of SARS-CoV and MERS-CoV was 10% and 37%, respectively. SARS-CoV and MERS-CoV infections were reported in 26 and 27 countries, respectively. A total 10,590 cases of infections were caused by both viruses. 5-11 On January 30, WHO declared the novel coronavirus outbreak (2019-nCoV) a public health emergency of

Metabolic syndrome, which can include weight gain and central obesity, elevated serum insulin and glucose, and insulin resistance, has been strongly associated with breast cancer recurrence and worse outcomes after treatment. Epidemiologic and prospective data do not show conclusive evidence as to which dietary factors may be responsible for these results. Current strategies employ low-fat diets which emphasize supplementing calories with increased intake of fruit, grain, and vegetable carbohydrate sources. Although results thus far have been inconclusive, recent randomized trials employing markedly different dietary strategies in noncancer patients may hold the key to reducing multiple risk factors in metabolic syndrome simultaneously which may prove to increase the long-term outcome of breast cancer patients and decrease recurrences. Since weight gain after breast cancer treatment confers a poor prognosis and may increase recurrence rates, large-scale randomized trials are needed to evaluate appropriate dietary interventions for our breast cancer patients.

Purpose-Incidental radiation dose to the heart and lung during breast radiotherapy (RT) has been associated with an increased risk of cardiopulmonary morbidity. We conducted a prospective trial to determine if RT with the Active Breathing Coordinator (ABC) can reduce the mean heart dose (MHD) by ≥20% and dose to the lung.Methods & Materials-Patients with Stages 0-III left breast cancer (LBC) were enrolled and underwent simulation with both free breathing (FB) and ABC for comparison of dosimetry. ABC was used during the patient's RT course if the MHD was reduced by ≥5%. The median prescription dose was 50.4 Gy plus a boost in 77 patients (90%). The primary endpoint was the magnitude of MHD reduction when comparing ABC to FB. Secondary endpoints included dose reduction to the heart and lung, procedural success rate, and adverse events.Results-112 pts with LBC were enrolled from 2002 to 2011 and 86 eligible patients underwent both FB and ABC simulation. Ultimately, 81 pts received RT using ABC, corresponding to 72% procedural success. The primary endpoint was achieved as use of ABC reduced MHD by 20% or greater in 88% of patients (p<0.0001). The median values for absolute and relative reduction in MHD were 1.7 Gy and 62%, respectively. RT with ABC provided a statistically significant dose reduction to the left lung. After a median follow up of 81 mos., 8-year estimates of locoregional relapse, disease-free, and overall survival were 7%, 90%, and 96%, respectively.

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