Introduction. Less than 1% of all breast cancers are diagnosed in males. In females, postmastectomy breast reconstruction is associated with increased patient satisfaction. However, there is a paucity of literature describing reconstructive options for postmastectomy deformity in the male chest. The purpose of this systematic review was to evaluate postmastectomy reconstruction outcomes in males with breast cancer. Methods. A systematic review was performed in accordance with PRISMA guidelines. Ovid MEDLINE, Embase, Cochrane, and Web of Science were queried for records pertaining to the study question using medical subject heading (MeSH) terms such as “male breast cancer,” “mastectomy,” and “reconstruction.” No limitations were placed on the year of publication, country of origin, or study size. Study characteristics and patient demographics were collected. Primary outcomes of interest included postoperative complications, recurrence rate, and mortality rate. Results. A total of 11 articles examining 29 male patients with breast cancer who underwent postmastectomy reconstruction were included for analysis. Literature was most commonly available in the form of case reports. The average age was 59.6 +/−11.4 years. Reconstruction methods included fat grafting (n = 1, 3.4%), silicone implants (n = 1, 3.4%), and autologous chest wall reconstruction with local flaps (n = 26, 89.7%). Postoperative complications occurred in two patients (6.8%), including partial nipple necrosis (n = 1) and hypertrophic scarring (n = 1). Of the studies reporting patient satisfaction, all patients were pleased with the aesthetic appearance of their chest. Conclusion. This systematic review revealed the limited availability of research regarding postmastectomy chest reconstruction in males with breast cancer. Nevertheless, the evidence available suggests that reconstruction can restore a patient’s body image and, thus, should be regularly considered and discussed with male patients. Larger studies are warranted to further shed light on this population.

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Background: Inherited germline mutations in PALB2 are known to predispose patients to a higher risk of breast, ovarian and pancreatic cancer with an estimated risk of developing breast cancer in over half of all affected women by age 80 years. Current guidelines for screening patients with PALB2 mutations include annual mammograms beginning at age 30 years and consideration of breast magnetic resonance imaging (MRI) and tomosynthesis. Existing evidence regarding risk-reducing surgery with mastectomy is insufficient to make a definitive recommendation to patients. In this case series, we describe the presentation and management of 5 patients with unilateral breast cancer and PALB2 mutations. To our knowledge, this is the first reported case series discussing the role of contralateral risk-reducing mastectomy (CRRM) in breast cancer patients with PALB2 mutations. The aim of our study was to evaluate the challenges in managing breast cancer risk in patients with PALB2 pathogenic variants with illustration through real-world clinical cases and a review of the literature. Methods:In this retrospective observational study, we present 5 patients with PALB2 mutations between the ages of 29 and 61 years who were diagnosed with breast cancer and underwent surgical management of their breast cancer at our institution between November 2020 and March 2022. Through their clinical courses and a literature review, we discuss the role of CRRM in breast cancer patients with PALB2 gene mutations.Results: Out of the 5 patients, 3 patients underwent CRRM and 2 patients chose unilateral surgery for their breast cancer and active surveillance for the contralateral breast. Of the 3 patients who underwent CRRM, 1 patient experienced a surgical complication from reconstruction on the prophylactic side. None of the patients developed any recurrences with an average length of follow up of 15.4 months.Conclusions: Based on our experience and the currently available literature, CRRM in patients with a PALB2 mutation should be performed on a case-by-case basis through a shared decision-making process taking into consideration overall risk, family history, patient preference and quality of life.

Because anurans are highly dependent on water for hydroregulation and respiration, they may use microhabitats that are in proximity to standing water preferentially to other microhabitats, especially during dry periods. We examined the anuran assemblage of Sachavacayoc, Peru during the dry season to test if lake proximity, distance to trees, temperature, and humidity influenced anuran abundance and diversity in the leaf litter of a rainforest habitat. We conducted quadrat searches of paired plots at the shore of a lake and 25 m distant from the lake's shore. Both overall abundance of anurans and abundance of the most common species, Leptodactylus andreae, a terrestrial breeding species, were significantly higher in the lakeshore quadrats. Temperatures at capture sites in the shore quadrats were significantly higher; frogs were significantly closer to trees in the away-from-water quadrats. Humidities at points of capture did not differ significantly with quadrat position. For eight of the 14 species captured, more individuals were found in shore quadrats than inland quadrats, which supports our hypothesis. Likewise, L. andreae was more abundant at the lake's shore, even though previous studies have not recorded this species utilizing lakeshore habitats. The extreme lack of rain experienced immediately preceding and during the study may have caused the frogs, including L. andreae, to shift their microhabitats to a more humid area to prevent dehydration. Additional studies that examine the fine scale spacing in relation to large water bodies will shed more light on this phenomenon.

Background: Breast cancer management has rapidly evolved over the past decade leading to successful pathologic complete response (pCR) in patients. Recurrence after pCR is uncommon but has been documented in the literature.Case Description: This report presents a rare case of locoregional breast cancer recurrence in a young 38-year-old woman with biomarker phenotype conversion from triple-negative breast cancer who had initially achieved pCR after nipple-sparing mastectomy and sentinel lymph node biopsy to human epidermal growth factor 2 (HER2) biomarker positive. In this report, we discuss biomarker phenotype conversion, including preanalytical and analytical variability, intratumor heterogenicity, and treatment options. Conclusions:We posit that performing simultaneous repeated receptor measurement and analysis on the original primary tumor specimen and the repeat biopsy may yield better results when discordance is suspected. Further, it is possible that local excision and axillary lymph node dissection followed by adjuvant therapy may provide a robust option to optimize progression-free survival. Medical therapies, including endocrine and chemotherapy, should be adjusted swiftly and accordingly in such cases. Finally, novel therapy options such as trastuzumab-deruxtecan may provide an additional approach for patients who continue to clinically progress despite prior targeted therapy. Through this case report, we aim to highlight the significance of proper tissue diagnosis and biomarker analysis in breast cancer recurrence.