PURPOSE Multiple studies have reported that breast cancer in young patients is associated with aggressive characteristics, and it is suggested that prognosis is worse independently of pathologic variables. PATIENTS AND METHODS We performed a retrospective analysis of the Breast Cancer Registry of the Argentinian Society of Mastology, including public and private centers. Patients ≤ 40 years of age at diagnosis were classified as “young,” and patients ≤ 35 years of age at diagnosis were classified as “very young.” Univariate and multivariate analyses were performed to detect differences between groups. RESULTS Patients ≤ 40 years of age comprised 10.40% (739/7,105) of the participants, with an average age of 35.61 ± 4.04 years. Multivariate analysis showed that human epidermal growth factor receptor 2 (HER2)-positive tumor phenotype (odds ratio [OR], 1.82), nodal involvement (OR, 1.69), histologic grade (grade 3 OR, 1.41), and tumor size (T2 OR, 1.37; T3-T4, 1.47) were independently associated with younger age at diagnosis. Patients ≤ 35 years of age (n = 286), compared with patients 36 to 40 years of age, had a higher proportion of HER2 tumors (24.58% v 16.94%; P = .021), absence of progesterone receptor expression (29.85% v 22.95%; P = .043), and stage 3 cancer (29.34% v 18.52%; P < .001). Fewer breast-conserving surgeries (75.37% v 62.89%; P < .001) and more adjuvant chemotherapy (59.04% v 36.66%; P < 0.001) were reported in patients ≤ 40 years of age. CONCLUSION In the population studied, breast cancer in young women was associated with aggressive pathologic features and locally advanced disease at the time of diagnosis. Moreover, tumor characteristics in very young patients with breast cancer nested in the population ≤ 40 years of age showed differences in important prognostic factors. More high-quality evidence is needed to improve treatment strategies in these patients.

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IntroducciónLa mastopatía diabética (MD) es una entidad infrecuente, descrita por primera vez en 1984 por Soler y Khardori. Su frecuencia es difícil de precisar, aunque se estima que representa menos de 1% de las lesiones benignas de la mama; aparece en alrededor del 13% de las diabéticas insulinodependientes de larga data (1) . Se caracteriza por una inusual lesión mamaria fibroinflamatoria, más frecuente en pacientes preMysler D y cols. Imagenes en mastopatía diabética. Rev Chil Radiol 2009; 15 (4): 192-196.

Sentinel Lymph Node Biopsy (SLNB) is the standard technique for axillary staging of patients with operable breast cancer and a clinically negative axilla because it avoids unwarranted axillary dissection and consequently reduces postoperative morbidity. Purpose: The aim of this study is to determinate the feasibility and accuracy of the second SLNB for patients with ipsilateral breast cancer recurrences with clinically negative axilla, who were treated previously with breast surgery and study of the axilla. Methods: Retrospective review of the database of the Instituto Alexander Fleming. Between October 2009 and October 2014, 1029 patients with diagnosis of breast cancer required surgery. The study included 26 patients with the diagnosis of operable local breast cancer recurrence, who had previously undergone axillary surgery either as SLNB, sampling or axillary lymph node dissection (ALND). They subsequently underwent additional breast surgery and a second SLNB. Results: The mean age of the ipsilateral breast cancer recurrences was 59.23 years (range: 32-87) and the most common histologic subtype was invasive ductal carcinoma in 22 patients (84.6%) and 4 patients (15.4%) with invasive lobular carcinoma. 4 patients (15.4%) had previously ALND or sampling and 22 patients (84.6%) SLNB. The identification rate of the second SLNB was 92.31%. Only 2 patients were not identify, one patient with a previous axillary sampling and another one with previous SLNB. In those patients the ALND was performed and the axilla was negative. Lymphoscintigraphy failed to identify any SLN in 6 patients (23%), 2 patients which were not identify and 4 patients only detected with patent blue. The average number of nodes removed at second SLNB was 1.8 (range: 1-5). Second SLNBs were negative in 21 patients (80.8%), and macrometastasis disease was identified in 2 patients and complete ALND was performed. In 1 patients additional extra-axillary aberrant drainages was observed in the contralateral axilla and interpectoral, and other 3 patients had aberrant drainage in the contralateral axilla (1 patient), internal mammary regions (1 patient), and interpectoral (1 patient). Aberrant drainage pathways were not routinely dissected. Only those accessible during surgery were removed. The median time between first surgery and ipsilateral breast tumor recurrence was 7.19 years (range: 1-22). The disease free survival (DFS) was 9.16 years (range: 2.25-24). Conclusion: In the present serie we show a high identification rate of 92.31% in the second SLNB, comparable with other international series published in the literature (range: 51-97%). A second SLNB should be considered for patients with ipsilateral breast tumor recurrence who underwent conservative surgery and have clinically negative axilla. The procedure is technically feasible and accurate for selected patients, and avoids unnecessary ALND. Extra-axillary sentinel lymph node localization rates are higher than for primary SLNB but the clinical significance and management of extra-axillary nodes needs to be clarified. Citation Format: Maino M, Fabiano V, Ponce C, Loza M, Costanzo V, Nervo A, Nadal J, Mysler D, Amat M, Coló F, Loza J, Chacón R. Second axillary sentinel lymph node biopsy for breast tumor recurrence: Instituto Alexander Fleming experience in Buenos Aires, Argentina. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-01-07.

The study objective is to review the rate of identification of the biopsied lymph node during surgery by placing activated charcoal in patients with node-positive breast cancer prior to neoadjuvant chemotherapy (NAC). The secondary objective is to validate the concordance of tattooed lymph node with the sentinel nodes resected during surgery at the final pathological examination. Background: The SENTINA study concluded that for cN1 breast cancer patients that had neoadjuvant chemotherapy and afterwards had two or more sentinel node localization examined, the false negative rate (FNR) was above 10%. The ACOSOG Z1071 study showed that clipping the positive lymph node and its preoperative localization reduces the false negative rate (FNR) significantly. The use of charcoal suspension for tattooing positive nodes during the biopsy is an effective and minimal invasive technique. It avoids placing a clip and posteriorly marking it with wire or radioactive seed previous to surgery, reducing the number of procedures, costs and time. When correctly placed charcoal suspension does not affect the pathological examination. Methods: This is a retrospective pilot study form January 2016 to March 2019 that enrolled 13 cancer patients aged (26 -50 years) with clinical T1-4, N 1-2, M0 in which NAC was performed. Ultrasound axillary lymph node core biopsy and tattooing with 0,3 ml of activated charcoal suspension (Mamograf ™) in positive lymph nodes was performed prior to NAC. Patients after NAC had axillary surgery. The sentinel nodes (SN) were identified as the nodes that contained blue dye and technetium-99m. During surgery both the SN, and also the tattooed lymph nodes were removed. Evaluation of the final pathological analysis concordance between the sentinel nodes and the tattooed lymph node was performed. Results: The analysis showed that surgeons were able to successfully identify the biopsied lymph node marked with activated charcoal in 11 (84,6%) cases. The final pathology results showed concordance between the sentinel nodes and the tattooed lymph in 11 cases. There were no cases in which the tattooed lymph node did not correspond to the sentinel node. In 2 (15,4%) cases charcoal wasn´t identified neither during the surgery nor during the pathological examination. No charcoal migration to other lymph nodes was identified during surgery and in all of the cases pathological examination was not affected when the final pathology was analyzed. The final pathology results in tattooed lymph nodes was of metastases in 4 cases (36,4%), post NAC nodal fibrosis in 2 cases (18,2%) and reactive adenitis in 5 cases (45,4%). Conclusion: When visualized on ultrasound, placing activated charcoal in patients with node-positive breast cancer prior to NAC, had shown to be successful and have a high identification rate during axillary surgery. This subset analysis provides preliminary information that using charcoal suspension for tattooing positive lymph nodes before NAC has a high identification rate during axillary surgery. Larger prospective studies may probe that this new technique may change clinical approach when it comes to identifying positive lymph nodes in breast cancer patients after NAC by successfully targeting and removing them with the need of fewer radiological exams and reducing surgical times as well as overall costs. Citation Format: Africa Pineiro, Maria L Cosaka, Mora Amat, Federico Colo, Maria L Negri, Juliana Marulanda Salinas, Varela Alejandra, Loza Martin, Ponce Carolina, Victoria Constanzo, Adrian Nervo, Daniel C Mysler. Our preliminary experience: Ultrasound guided localization of axillary lymph nodes using activated charcoal before neoadjuvant chemotherapy for guidance in axillary surgery in breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-02-03.

Background: Local or regional recurrence in breast cancer is associated with poor prognosis. Mastectomy is the classic indication in these situations. However, second attempts of breast conservation in previously radiated patients with small, histologically favorable local relapse have been reported. Also, prospective data (The CALOR Trial) suggest that adjuvant chemotherapy should be recommended in patients with isolated loco-regional recurrence, especially if the recurrence is HR negative. The purpose of our study was to determine the frequency of use of re-quadrantectomy and systemic treatment in isolated loco-regional recurrence (ILR) in breast cancer. Methods: Retrospective review of the database of our institution. Inclusion criteria: ILR in surgical bed, breast or lymph nodes with complete resection (mastectomy, re-quadrantectomy or axillary resection) with or without systemic treatment and radiotherapy. Findings: 4695 patients were analyzed from april 2000 to april 2014. 78 patients had a ILR, 66 were analyzed. Median age 49,5 years (27-86). 54,5% of the patients were postmenopausal and 16,6% had bilateral involvement at diagnosis. Characteristics of the primary tumor: Mean tumor size 2 cm, 66,6% were HR positive, 6% HER2 positive, 13,6% TN and 14% unknown. Initial treatment: breast conserving surgery 62 p (sentinel node 25, axillary node disection 36); mastectomy 4 patients. 42 patients underwent adjuvant chemotherapy, 57 patients radiotherapy and 62 patients hormonotherapy. Time to recurrence: 94,3 months. Characteristics of the ILR: Mean tumor size 1.8 cm. 65% were HR positive, 12% triple negative, 6% HER positive and 17% unknown. Treatment at relapse was as follows: 27 re-quadrantectomy, 34 mastectomy, 1 lymph node dissection; all these patients had previous quadrantectomy. The other patients underwent to mastectomy (1) and complete resection of the lesion (3). 29 patients received chemotherapy (43.9%), : 70% anthracyclines and taxanes, 6% trastuzumab, 30% other and 65% received hormonotherapy. Local progression free survival 30,7 months; distance progression free survival 100 months. Local relapse was evidenced in 30% of patients who had a re-quadrantectomy procedure. Conclusions: Second attemp of breast conservation in previously radiated patients with small, histologically favorable ILR and long recurrence free interval disease is feasible as described. The target population is of good prognosis as evidenced the long free disease interval at recurrence (94,3 m), the mean size of tumor at recurrence (1.8 cm) and the high proportion of HR positive disease. The percentage of local recurrence after re quadrantectomy is as described in some reports, 30% (20-35%). The indication of chemotherapy was mostly in HR negative or HER 2 positive tumors, but the low number of patients does not permit a valid comparaison. Citation Format: Victoria Costanzo, Veronica Fabiano, Mercedes Maino, Federico Colo, Reinaldo Chacon, Adrian Nervo, Jorge Nadal, Martin Loza, Jose Loza, Daniel Mysler, Mora Amat. Isolated loco-regional recurrence in the breast: Re-quadrantectomy and systemic treatment [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-18-05.

La Sociedad Argentina de Radiología acaba de cumplir 100 años de existencia, siendo la segunda sociedad americana más antigua. Dicen que con los años llega la madurez y la sabiduría al ser humano y por qué no también a las sociedades. Vemos por ello y con sumo agrado, el restablecimiento de las relaciones entre SAR y FAARDIT, con la idea directriz de sentar las bases para que ambas trabajen y se potencien juntas por otros 100 años.Luego de muchos años de gran desarrollo y confraternidad de toda la radiología en general y de las sociedades en particular, sobrevinieron algunos años de distanciamiento, seguramente basados en intereses que en dicho momento se consideraron genuinos y de buena fe para las autoridades conductoras, pero que a la luz de los hechos, impactaron negativamente en la radiología argentina. La separación de SAR y FAARDIT hoy es cosa del pasado.Las fortalezas y oportunidades de progreso de cada una de las entidades potenciarán la misión y visión de toda la radiología argentina, sin por ello dejar de lado el valor de las identidades. Por esa razón, hemos constituido acuerdos de cooperación mutua que beneficiarán en forma ecuánime a ambas sociedades.Estamos orgullosos y satisfechos de emprender el desafío de volver a contar con una Revista Argentina de Radiología unida, trabajando en equipo para lograr una publicación de excelencia, sumando los valores de todos los radiólogos.Algunas actividades serán nuevamente compartidas de aquí en adelante por SAR y FAARDIT, enriqueciendo y jerarquizando la calidad, el diseño y el currículum. Podemos citar como ejemplos: la RAR, el CONAEDI, el CADI, los congresos internacionales y algunos cursos virtuales nacionales y latinoamericanos.La SAR perdurará con su autonomía, sus asociados y sus lineamientos particulares de una gran familia radiológica ya centenaria, así como también lo hará FAARDIT. Hemos hecho hincapié en el pilar básico de la sociedad, la educación médica continua, trabajando en todas las áreas programáticas del postgrado.Dentro de los valores que hemos querido estimular, nos volcamos a los jóvenes. A ellos destinamos gran parte del presupuesto societario, renovando completamente el Curso Superior que otorga los certificados habilitantes para la práctica de la radiología, el rediseño de los cursos virtuales y presenciales, otorgando becas de formación, asistencia y participación en los congresos nacionales y en las actividades internacionales. Nos hemos avocado especialmente a definir los criterios de selección a la hora de otorgar esos beneficios a nuestros jóvenes radiólogos, privilegiando la idoneidad, el talento y la igualdad de oportunidades.Haciendo foco en el futuro y en la búsqueda de nuevos líderes para nuestra sociedad decidimos crear una comisión de profesionales jóvenes, surgida de aquellos radiólogos que egresan de nuestro Curso Superior. Esta comisión se reúne desde hace más de un año para debatir y emitir opiniones y sugerencias para la comisión directiva, otorgando una mirada lozana con puntos de vista originales que intentan conduc...