These data suggest a defective DC function in patients with operable breast cancer. Switched-off DCs in patients with early breast cancer and decreased IL-12 production may be important factors for progressive tumour growth.

BackgroundWeekly docetaxel has occasionally been used in the neoadjuvant to downstage breast cancer to reduce toxicity and possibly enhance quality of life. However, no studies have compared the standard three weekly regimen to the weekly regimen in terms of quality of life. The primary aim of our study was to compare the effects on QoL of weekly versus 3-weekly sequential neoadjuvant docetaxel. Secondary aims were to determine the clinical and pathological responses, incidence of Breast Conserving Surgery (BCS), Disease Free Survival (DFS) and Overall Survival (OS).MethodsEighty-nine patients receiving four cycles of doxorubicin and cyclophosphamide were randomised to receive twelve cycles of weekly docetaxel (33 mg/m2) or four cycles of 3-weekly docetaxel (100 mg/m2). The Functional Assessment of Cancer Therapy-Breast and psychosocial questionnaires were completed.ResultsAt a median follow-up of 71.5 months, there was no difference in the Trial Outcome Index scores between treatment groups. During weekly docetaxel, patients experienced less constipation, nail problems, neuropathy, tiredness, distress, depressed mood, and unhappiness. There were no differences in overall clinical response (93% vs. 90%), pathological complete response (20% vs. 27%), and breast-conserving surgery (BCS) rates (49% vs. 42%). Disease-free survival and overall survival were similar between treatment groups.ConclusionsWeekly docetaxel is well-tolerated and has less distressing side-effects, without compromising therapeutic responses, Breast Conserving Surgery (BCS) or survival outcomes in the neoadjuvant setting.Trial registrationISRCTN: ISRCTN09184069

Background: Dendritic cells (DCs) play a crucial role in initiating effective cell-mediated immune responses, but are dysfunctional and anergic in breast cancer. Reversal of this dysfunction and establishment of optimal DC function is a key prerequisite for the induction of effective anti-cancer immune responses.

BACKGROUNDNipple-areola complex (NAC) is a signature of the breast. Preservation of the NAC has a positive impact on patients' satisfaction with cosmetic results and feeling of mutilation. 1 Nowadays, there are still no reconstruction techniques quite as satisfying as the real NAC. Nipplesparing mastectomy (NSM) is developed to optimize es-thetic outcomes. However, the oncologic safety and the postoperative viability of the NAC are important concerns. Welling and Jensen 2 postulated that the origin and progression of ductal carcinoma in the breast are from terminal duct lobular unit, and pathological study found only 9% of terminal duct lobular unit at the base of the nipple from mastectomy specimens. 3 According to the aforementioned data, preservation of NAC can still be performed if there is no evidence of cancer cell at the base of the nipple. NSM is also an option for patients requiring riskreduction mastectomy and has a role in treating breast cancer in selected patients. 4 Several studies reported an occult NAC involvement on mastectomy specimens varying from 0% to 58%. These results are due to the differences in the inclusion criteria and the pathological assessment method between stud- From the Breast and

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