The most frequent cutaneous side effect reported in this series was acneiform eruption. The authors observed that all women with acneiform rash had only limited facial involvement, whereas all but one man experienced more widespread lesions of the face, the back and the chest. We found no association between the extent and severity of cutaneous eruptions (grade 1 vs. grade 2) and patients' response to therapy.

Topical pre-treatment with phytomenadione cream might become useful in epidermal growth factor inhibitor-associated acneiform eruptions.

No abstract

Sentinel lymph node biopsy (SLNB) has emerged as an alternative to axillary lymph node dissection during breast cancer surgery during the last 2 decades. However, there are several controversies regarding the indication of the sentinel node biopsy after neoadjuvant chemotherapy which can convert positive lymph nodes to negative. The false negative rate after neoadjuvant chemotherapy is unacceptably high. This high false negative rate can be decreased by marking of the positive lymph nodes and removal during sentinel lymph node biopsy procedure in addition to the sentinel lymph nodes. The aim of this study was to investigate the possibility of carbon tattooing of the positive sentinel lymph nodes before neoadjuvant chemotherapy. In 2016, a prospective protocol was launched investigating the black carbon tattooing procedure of the suspective and positive axillary lymph nodes by injecting 0.1-0.5 carbon ink in normal saline under ultrasound guidance. All patients underwent black carbon tattooing of the suspected or positive axillary lymph nodes before the chemotherapy or one week before the primary surgery when chemotherapy was not indicated in the neoadjuvant setting. Sentinel lymph nodes together with lymph nodes marked by the black carbon ink were removed and histologically evaluated. So far 27 patients were treated under this protocol. Breast saving surgery was performed in 22 cases and mastectomy in 5 cases. All patients had invasive ductal carcinoma. In 20 patients neoadjuvant chemotherapy was indicated and in 7 patients primary surgery was performed. All lymph nodes marked by black carbon ink were successfully identified and removed. Sentinel lymph node biopsy was performed in 8 cases and sentinel lymph node biopsy followed by axillary dissection in 15 cases. Axillary dissection alone was performed in 4 cases. In 19 cases the black carbon ink was present in the sentinel lymph node at the same time and in 4 cases carbon dye was present in other lymph nodes than lymph node identified during SLNB, which corresponds to 17.4%. In the group of patients undergoing primary surgery, in one case from six, the sentinel lymph node was negative and the lymph node marked with carbon ink positive which represents false negative lymph node and failure of the SLNB procedure. After neoadjuvant chemotherapy, there was no false negative lymph node identified, but the conversion of the positive lymph nodes to negative was present in 10 cases (50%). There were no complications attributed to carbon ink tattooing.

Purpose To analyze clinicopathologic characteristics, treatment procedures, and prognosis of men with breast cancer (MBC) in the Czech Republic and compare them with international data. Methods Men diagnosed with breast cancer in 2007–2017 were retrospectively identified from the databases of Complex Oncological Centers in the Czech Republic, and subsequently clinical, histopathological, and molecular-genetic characteristics, treatment procedures, and long-term treatment outcomes were evaluated. Prognostic factors of survival outcomes (overall survival, relapse-free survival, and breast cancer-specific mortality) were analyzed using Cox and the competing risks model. Results In this study, data from 256 patients with MBC at a median age of 66 years were analyzed. Of 201 patients with primary non-metastatic (M0) radically treated MBC, 6% were younger than 40 years, 29% had stage I, 55% were node-negative (cN0), and 54% were indicated to genetic testing. Estrogen receptor (ER) expression over 10% had 97% of tumors, 61% had high mitotic activity (Ki67), 40% high grade (G3), and 68% Luminal B-like (HER2- negative) subtype. Regarding the therapy, 97% of men underwent mastectomy (ME), 34% sentinel lymph node biopsy (SLNB), 48% adjuvant radiotherapy (RT), 13% neoadjuvant therapy, 44% adjuvant chemotherapy (CT), 90% adjuvant endocrine therapy (ET), of which 74% adjuvant tamoxifen (TMX). Patients treated with aromatase inhibitor (AI) alone had significantly shortened RFS (p < 0.001). There were also associations between OS/RFS/BCSM and disease stage, T, N, progesterone receptor (PR) expression, G and Ki67. Median OS reached 122 months in curatively treated M0 patients, 42 months in the de novo metastatic (M1) group (N = 30), and 39 months in the group of M0/X patients treated with palliative intention (N = 25). Conclusion Although the number of MBC cases with unfavorable features (young age, M1 cases, predominant Luminal B-like tumors) was higher in the Czech dataset compared to international studies, the prognosis of men remains consistent with the real-world published data.