Blood-based biomarkers reflect systemic inflammation status and have prognostic and predictive value in solid malignancies. As a recently defined biomarker, Pan-Immune-Inflammation-Value (PIV) integrates different peripheral blood cell subpopulations. This retrospective study of collected data aimed to assess whether PIV may predict the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in Turkish women with breast cancer. The study consisted of 743 patients with breast cancer who were scheduled to undergo NAC before attempting cytoreductive surgery. A pre-treatment complete blood count was obtained in the two weeks preceding NAC, and blood-based biomarkers were calculated from absolute counts of relevant cell populations. The pCR was defined as the absence of tumor cells in both the mastectomy specimen and lymph nodes. Secondary outcome measures included disease-free survival (DFS) and overall survival (OS). One hundred seven patients (14.4%) had pCR. In receiver operating characteristic analysis, optimal cut-off values for the neutrophile-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte (PLR), PIV, and Ki-67 index were determined as ≥ 2.34, ≥ 0.22, ≥ 131.8, ≥ 306.4, and  ≥ 27, respectively. The clinical tumor (T) stage, NLR, MLR, PLR, PIV, estrogen receptor (ER) status, human epidermal growth factor receptor-2 (HER-2) status, and Ki-67 index were significantly associated with NAC response in univariate analyses. However, multivariate analysis revealed that the clinical T stage, PIV, ER status, HER-2 status, and Ki-67 index were independent predictors for pCR. Moreover, the low PIV group patients had significantly better DFS and OS than those in the high PIV group (p = 0.034, p = 0.028, respectively). Based on our results, pre-treatment PIV seems as a predictor for pCR and survival, outperforming NLR, MLR, PLR in predicting pCR in Turkish women with breast cancer who received NAC. However, further studies are needed to confirm our findings.

European Journal of Breast Health (Eur J Breast Health) is an international, scientific, open access periodical published by independent, unbiased, and double-blinded peer-review principles. It is the official publication of the Turkish Federation of Breast Diseases Societies, and Senologic International Society is the official supporter of the journal.

We conclude that our granulomatous lobular mastitis cases have similar characteristics with the series reported earlier, when all features are taken into consideration.

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Granulomatous lobular mastitis is a rare chronic breast disease, firstly described by Kessler and Wolloch in 1972. In this article we present a 35-year-old patient with granulomatous lobular mastitis and in situ ductal carcinoma and discuss clinicopathological characteristics of the disease with literature data. A 35-year-old female patient admitted to the outpatient clinic with a complaint of swelling in right breast ongoing since March 2017. On the basis of physical examination and radiological examinations, antibiotic therapy was initiated considering the inflammatory breast disease and the patient was referred to our general surgery clinic because she did not benefit from treatment. On the recommendation of histopathological correlation, trucut biopsy was performed and reported as granulomatous mastitis. In the histopathological examination of the prepared sections, we found lobule-restricted, non-caseous granulomas and neoplastic epithelial cell proliferation in 4 different foci, the largest being 0.7×0.4 cm in diameter, limited to the ductal lobular system. The case was diagnosed as granulomatous lobular mastitis and in situ ductal carcinoma. This lesion, which clinically and radiologically can be confused with carcinoma, rarely coexists with breast carcinoma. Our case demonstrates the coexistence of granulomatous lobular mastitis and in situ ductal carcinoma.