Background
The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions.
Methods
This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting.
Findings
Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey.
Conclusions
The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown.
In this paper we provide some insights in Homer's Iliad from the perspective of social network analysis. We use the original text and other public available data to create a social network (i.e. a graph) that comprises of all actors in the Iliad together with their interactions. We present some visualizations of these data and discuss concepts like connectivity, connected components and groupings. Furthermore, we calculate some well-established metrics, coming from social network analysis in this social network and discuss the numerical results. These results indicate that the Iliadic network is a smallworld network, rather dissasortative and relatively easy to disconnect.
Objectives: The imaging features of Mucoepidermoid carcinoma (MEC) of the breast are unfamiliar to the
breast radiologists due to its rarity. In this paper, we aimed to review the literature, do an analysis and find
a common pattern of those lesions that could potentially give a better understanding of this entity.
Methods: A review is performed with searching keywords “mucoepidermoid carcinoma breast”, without
limitations in the dates or the article types, in the PubMed database. Information about the number of cases,
the age of the patients, the presenting symptom, the time-interval between the onset of the symptoms and
the time of diagnosis, the diagnostic approach, the imaging, the treatment and the outcome have been
reviewed and tabulated.
Results: We identified 40 cases. The mean age of the patients was 57. The commonest symptom was a
palpable mass, few months to up to 37 years, prior to the diagnosis, with the size ranging 5-82 mm. On US,
the lesions appeared as irregular masses or had cystic benign features. The majority underwent a
radical/modified radical mastectomy with a form of axillary lymph node procedure. 15 cases were Highgrade, 3 Intermediate-grade, and 19 Low-grade MEC. No chemotherapy was administered in most cases
and in a mean follow-up time of 30 months, 5 died because of metastasis.
Conclusion: Due to its rarity, the diagnostic and therapeutic approach of MEC in the breast is not welldocumented, causing challenges in daily practice, even at experienced Breast Centers. Review of the
published cases is essential for multidisciplinary team meetings to plan treatment strategies.
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