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The most common breast cancer (BC) susceptibility genes beyond BRCA1/2 are ATM and CHEK2. For the purpose of exploring the clinicopathologic characteristics of BC developed by ATM or CHEK2 mutation carriers, we reviewed the archive of our Family Cancer Clinic. Since 2018, 1185 multi-gene panel tests have been performed. Nineteen ATM and 17 CHEK2 mutation carriers affected by 46 different BCs were identified. A high rate of bilateral tumors was observed in ATM (26.3%) and CHEK2 mutation carriers (41.2%). While 64.3% of CHEK2 tumors were luminal A-like, 56.2% of ATM tumors were luminal B-like/HER2-negative. Moreover, 21.4% of CHEK2-related invasive tumors showed a lobular histotype. About a quarter of all ATM-related BCs and a third of CHEK2 BCs were in situ carcinomas and more than half of ATM and CHEK2-related BCs were diagnosed at stage I-II. Finally, 63.2% of ATM mutation carriers and 64.7% of CHEK2 mutation carriers presented a positive BC family history. The biological and clinical characteristics of ATM and CHEK2-related tumors may help improve diagnosis, prognostication and targeted therapeutic approaches. Contralateral mastectomy should be considered and discussed with ATM and CHEK2 mutation carriers at the first diagnosis of BC.

Background/Aim: Due to the SARS-CoV-2 pandemic, many scientific committees proposed neoadjuvant therapy (NACT) bridging treatment as a novel strategy and indication. The aim of the study was to evaluate the impact of COVID-19 pandemic on breast cancer patients undergoing NACT. Patients and Methods: All breast cancer patients referred to two Breast Units during 43(5.3%) were enrolled in the COVID-19-group and compared with 94 (7.9%) similar Pre-COVID-19 patients. We observed a reduction in the number of patients undergoing NACT, p=0.0019. No difference was reported in terms of clinical presentation, indications, and tumor response. In contrast, a higher number of vascular adverse events was reported (6.9% vs. 0% p=0.029). Immediate breast cancer reconstructions following invasive surgery suffered a significant slowdown (5.9% vs. 47.7%, p=0.019). Conclusion: COVID-19 caused a reductionin the number of patients undergoing NACT, with no changes in terms of indications, clinical presentation, and tumor response. Furthermore, there was an increased incidence of vascular events.Neoadjuvant therapy (NACT) was introduced in the 1970s, aiming to downstage inoperable locally advanced breast cancer and turn it operable (1). Subsequently, NACT indications were extended to early breast cancer, aiming to permit more conservative breast surgeries (2). Nowadays, NACT is widely used, with the indications and aims changing frequently (3). NACT, a systemic treatment, might be somewhat more likely to eradicate micro-metastatic disease and improve overall survival than might a therapy delayed until after breast surgery (4, 5). Moreover, it permits to test tumor response to drug therapy in-vivo, which could be used as adjuvant treatment (5).Since the beginning of the past year (2020), SARS-CoV-2 has dramatically spread worldwide and an epidemiological emergency was declared (6). Several restrictions and preventive measures were introduced as a strategy to flatten the epidemiological curve of the pandemic (7). All these measures have disturbed daily life and impacted public health; especially in non-COVID-19 related disease (8).

Background: Type of axillary surgery in breast cancer (BC) patients who convert from cN þ to ycN0 after neoadjuvant chemotherapy (NAC) is still debated. The aim of the present study was to develop and validate a preoperative predictive nomogram to select those patients with a low risk of residual axillary disease after NAC, in whom axillary surgery could be minimized. Patients and methods: 1950 clinically node-positive BC patients from 11 Breast Units, treated by NAC and subsequent surgery, were included from 2005 to 2020. Patients were divided in two groups: those who achieved nodal pCR vs. those with residual nodal disease after NAC. The cohort was divided into training and validation set with a geographic separation criterion. The outcome was to identify independent predictors of axillary pathologic complete response (pCR). Results: Independent predictive factors associated to nodal pCR were axillary clinical complete response (cCR) after NAC (OR 3.11, p < 0.0001), ER-/HER2þ (OR 3.26, p < 0.0001) or ERþ/HER2þ (OR 2.26, p ¼ 0.0002) or ER-/HER2-(OR 1.89, p ¼ 0.009) BC, breast cCR (OR 2.48, p < 0.0001), Ki67 > 14% (OR 0.52, p ¼ 0.0005), and tumor grading G2 (OR 0.35, p ¼ 0.002) or G3 (OR 0.29, p ¼ 0.0003). The nomogram showed a sensitivity of 71% and a specificity of 73% (AUC 0.77, 95%CI 0.75e0.80). After external validation the accuracy of the nomogram was confirmed.