The clinical use of circulating tumor cells (CTCs) enumeration for staging of metastatic breast The clinical use of circulating tumor cells (CTCs) enumeration for staging of metastatic breast cancer (MBC): International expert consensus paper.

Purpose: High levels of tumor-infiltrating lymphocytes (TIL) before neoadjuvant chemotherapy (NAC) are associated with higher pathologic complete response (pCR) rates and better survival in triple-negative breast cancer (TNBC) and HER2-positive breast cancer. We investigated the value of TIL levels by evaluating lymphocyte infiltration before and after NAC.Experimental Design: We assessed stromal TIL levels in 716 pre-and posttreatment matched paired specimens, according to the guidelines of the International TIL Working Group.Results: Pre-NAC TIL levels were higher in tumors for which pCR was achieved than in cases with residual disease (33.9% vs. 20.3%, P ¼ 0.001). This was observed in luminal tumors and TNBCs, but not in HER2-positive breast cancers (P Interaction ¼ 0.001). The association between pre-NAC TIL levels and pCR was nonlinear in TNBCs (P ¼ 0.005). Mean TIL levels decreased after chemotherapy completion (pre-NAC TILs: 24.1% vs. post-NAC TILs: 13.0%, P < 0.001). This decrease was strongly associated with high pCR rates, and the variation of TIL levels was strongly inversely correlated with pre-NAC TIL levels (r ¼ À0.80, P < 0.001). Pre-NAC TILs and disease-free survival (DFS) were associated in a nonlinear manner (P < 0.001). High post-NAC TIL levels were associated with aggressive tumor characteristics and with impaired DFS in HER2-positive breast cancers (HR, 1.04; confidence interval, 1.02-1.06; P ¼ 0.001), but not in luminal tumors or TNBCs (P Interaction ¼ 0.04).Conclusions: The associations of pre-and post-NAC TIL levels with response to treatment and DFS differ between breast cancer subtypes. The characterization of immune subpopulations may improve our understanding of the complex interactions between pre-or post-NAC setting, breast cancer subtype, response to treatment, and prognosis.

Bariatric surgery has been a field of intense research in the last 20 years. We observed a growing interest of non-surgical journals and an increasing participation of new countries. Nevertheless, latest trends suggest a saturation of scientific production in this field.

Post-NAC LVI is a strong independent prognostic factor that: (i) should be systematically reported in pathology reports; (ii) should be used as stratification factor after NAC to propose inclusion in second-line trials or adjuvant treatment; (iii) should be included in post-NAC scoring systems.