Objective: Unknown ethiology Background: Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon benign breast lesion. Case Report: PASH is reported in a young female in treatment for neurological diseases with multi-drug therapy (clonazepam, valproate and risperidone). Her menstrual cycles are irregular, and she reached menarche very late. Conclusions: The higher PASH prevalence in premenopausal woman (the majority of whom are actively taking oral contraceptive pills), in 24% to 47% of men with gynecomastia and during pregnancy supports a hormonal etiology; the interaction between clonazepam, valproate, risperidone and progesterone could increase the level of progesterone that could stimulate PASH growth.

This study confirms in vivo that the administration of EPI is enhanced by the concomitant LND administration.

We assessed the activity and tolerability of a cisplatin, epirubicin, and lonidamine combination regimen as first-line chemotherapy in 28 advanced breast cancer patients. The schedule of treatment was as follows: 60 mg/ m2 epirubicin followed by 40 mg/m2 cisplatin given on days 1 and 2 every 21 days, with 450 mg lonidamine being given per os (three tablets) on days of chemotherapy administration and in the period intervening between one cycle and the next. Patients received a median of 5 (range 1-6) cycles. Overall, 22 patients were evaluable for response and 28, for toxicity. Four patients refused to continue the treatment after the first course, one was lost to follow-up, and one died due to toxicity (septic shock). The incidence of grade 3/4 nausea and vomiting was found to be greater than that expected with epirubicin and lonidamine alone. The addition of cisplatin resulted in an increase in platelet and hemoglobin toxicities, whereas the WBC toxicity did not differ from that expected with epirubicin and lonidamine. The hematological toxicity was found to be cumulative, leading to treatment delay in about 50% of patients at the fifth and sixth courses. The activity of this cytotoxic regimen was noteworthy, with the overall response rate being 81.8% (31.8% complete responses and 50.0% partial responses) in evaluable patients. This response rate decreased to 64.2% when all registered patients were included according to an intent-to-treat analysis. In conclusion, the association of cisplatin, epirubicin, and lonidamine given on the schedule described herein, appears to be very active but substantially toxic. We are now testing this combination in a randomized comparison, with the cisplatin dose being reduced to 30 mg/m2 given on days 1 and 2.

Background/Aim: Axillary surgery of breast cancer patients is undergoing a paradigm shift, as axillary lymph node dissection's (ALND) usefulness is being questioned in the treatment of patients with tumor-positive sentinel lymph node biopsy (SLNB). The aim of this study was to investigate the overall survival (OS) and relapse-free survival (RFS) of patients with positive SLNB treated with ALND or not. Patients and Methods: We investigated 617 consecutive patients with cN0 operable breast cancer with positive SLNB undergoing mastectomy or conservative surgery. A total of 406 patients underwent ALND and 211 were managed expectantly. Results: No significant difference in OS and RFS was found between the two groups. The incidence of loco-regional recurrence in the SLNB-only group and the ALND group was low and not significant. Conclusion: The type of breast cancer surgery and the omission of ALND does not improve OS or RSF rate in cases with metastatic SLN. Sentinel lymph node biopsy (SLNB) is the standard technique used for nodal staging in all patients with invasive breast cancer and clinically-negative axillary lymph nodes. Nowadays, SLNB has replaced conventional axillary lymph node dissection (ALND) as a standard procedure (1-4). For years, axillary dissection was considered the standard procedure in cases with positive SLNB for macrometastasis (>2 mm) (5-6). The rationale behind this procedure is the control of local recurrence and the increase of overall survival (OS). However, several authors have questioned the actual role of ALND in cases with positive SLNB. This procedure can lead to severe side effects such as lymphedema and reduction of limb and/or shoulder function in 5-39% of cases (7-9). The American College of Surgeons Oncology Groups (ACOSOG) Z0011 Study showed that there was no statistically significant difference in local recurrence-free survival patients undergoing breast-conserving surgery and avoiding ALND at 6.3 years and at 9.25 years of follow-up compared with patients treated with ALND (10-12). Similar results were observed in the AMAROS trial (13) and in the IBCSG 23-01 trial (14). A recent meta-analysis that included the above-mentioned trials (ACOSOG Z011, IBCSG 23-01, AMAROS) and two other studies (OTOSAOR and AATRM-048-13-2000) did not show differences in survival or recurrence between ALND, SLNB or axillary RT, observing more local complications in patients treated with ALND (15). Bilimoira et al. (16) reviewed 20,075 SLNB-positive breast cancer patients from the National Cancer Database and Yi et al. (17) reviewed 26,986 SLNB-positive breast cancer patients from the surveillance, epidemiology and end results (SEER) database: both Authors did not show any significant differences in OS rates between patients treated with SLNB only and SLNB plus ALND. However, 1941 This article is freely accessible online.

Thalassemias are genetic disorders characterized by decreased synthesis of one of the globin chains. Beta-thalassemia is caused by impairment in the production of beta-globin chains leaving the excess alpha chains unstable. With better treatment approaches and improvement in chelation therapy, thalassemic patients are living longer. As a consequence, new complications and associations with other conditions including malignancy have emerged. The occurrence of malignancies in thalassemia has rarely been reported, and our review of the literature revealed only few cases. We report the first case of a thalassemic patient developing breast cancer and discuss the possibility of a link between the two disease entities. This case is intended to alert physicians of the possibility of a malignancy in thalassemia patients.