Local recurrences and distant metastases after breast-conserving surgery and radiation therapy for early breast cancer

PURPOSE: To identify predicting factors for local failure and increased risk of distant metastases by statistical analysis of the data after breast-conserving treatment for early breast cancer. METHODS AND MATERIALS: Between January 1976 and December 1993, 528 patients with nonmetastatic T1 (tumors < or = 1 cm [n = 197], >1 cm [n = 220]) or T2 (tumors < or = 3 cm [n = 111]) carcinoma of the breast underwent wide excision (n = 435) or quadrantectomy (n = 93) with axillary dissection (negative nodal status [n-]: 396; 1-3 involved nodes: 100; >3 involved nodes: 32). Radiotherapy consisted of 45 Gy to the entire breast via tangential fields. Patients with positive axillary lymph nodes received 45 Gy to the axillary and supraclavicular area. Patients with positive axillary nodes and/or inner or central tumor locations received 50 Gy to the internal mammary lymph node area. A boost dose was delivered to the primary site by iridium 192 Implant in 298 patients (mean total dose: 15.2+/-0.07 Gy, range: 15-25 Gy) or by electrons in 225 patients (mean total dose: 14.8+/-0.09 Gy, range: 5-20 Gy). The mean age was 52.5+/-0.5 years (range: 26-86 years) and 267 patient were postmenopausal. Histologic types were as follows: 463 infiltrating ductal carcinomas, 39 infiltrating lobular carcinomas, and 26 other histotypes. Grade distribution according to the Scarff, Bloom, and Richardson (SBR) classification was as follows: 149 grade 1, 271 grade 2, 73 grade 3, and 35 nonclassified. The mean tumor size was 1.6+/-0.3 cm (range: 0.3-3 cm). The intraductal component of the primary tumor was extensive (EIC = IC > or = 25%) in 39 patients. Tumors were microscopically bifocal in 33 cases. Margins were assessed in the majority of cases by inking of the resection margins and were classified as positive in 13 cases, close (< or = 2 mm) in 21, negative (>2 mm tumor-free margin) in 417, and indeterminate in 77. Peritumoral vascular invasion was observed in 40 patients. Tamoxifen was administered for at least 2 years in 176 patients. At least six cycles of adjuvant systemic chemotherapy were administered in 116 patients. The mean follow-up period from the beginning of the treatment was 84.5+/-1.7 months. RESULTS: First events included 44 isolated local recurrences, 8 isolated axillary node recurrences, 44 isolated distant metastases, 1 local recurrence with synchronous axillary node recurrence, 7 local recurrences with synchronous metastases, and 2 local recurrences with synchronous axillary node recurrences and distant metastases. Of 39 pathologically evaluable local recurrences, 33 were classified as true local recurrences and 6 as ipsilateral new primary carcinomas. Seventy patients died (47 of breast carcinoma, 4 of other neoplastic diseases, 10 of other diseases and 9 of unknown causes). The 5- and 10-year rates were, respectively: specific survival 93% and 86%, disease-free survival 85% and 75%, distant metastasis 8.5% and 14%, and local recurrence 7% and 14%. Mean intervals from the beginning of treatment for local recurrence or distant metastases were, respectively, 60+/-6 months (median: 47 months, range: 6-217 months) and 49.5+/-5.4 months (median: 33 months, range: 6-217 months). After local recurrence, salvage mastectomy was performed in 46 patients (85%) and systemic hormonal therapy and/or chemotherapy was administered to 43 patients. The 5-year specific survival rate after treatment for local recurrence was 78+/-8.2%. Multivariate analysis (multivariate generalization of the proportional hazards model) showed that the probability of local control was decreased by the following four independent factors: young age (< or = 40 yr vs. >40 yr; relative risk [RR]: 3.15, 95% confidence interval [CI]: 1.7-5.8, p = 0.0002), premenopausal status (pre vs. post; RR: 2.9, 95% CI: 1.4-6, p = 0.0048), bifocality (uni- vs. bifocal; RR: 2.7, 95% CI: 2.6-2.8,p = 0.018), and extensive intraductal component (IC <25% vs. IC > or = 25%; RR: 2.6, 95% CI: 13-5.2, p = 0     

Engineering Liganded Gold Nanoclusters as Efficient Theranostic Agents for Cancer Applications

Luminescent gold nanoclusters are rapidly gaining attention as efficient theranostic targets for imaging and therapeutics. Indeed, their ease of synthesis, their tunable optical properties and tumor targeting make them potential candidates for sensitive diagnosis and efficacious therapeutic applications. This concept highlights the key components for designing gold nanoclusters as efficient theranostics focusing on application in the field of oncology.     

Bayesian statistics study of a sustainable dissolution of cobalt-bearing minerals from Cu-Co ores

The present paper discusses the dissolution of cobalt-bearing minerals from a copper-cobalt ore using probabilistic models where a priori and a posteriori knowledge of leaching are used to predict the dissolution of cobalt-bearing minerals in a sulphuric acid medium in the presence of a reducing agent. Priorly, the dissolution of cobalt-bearing minerals depends on their mineralogy, leading to the use of FeSO₄ as a reducing agent for the trivalent (Co³⁺) form of cobalt (CoOOH). A posteriori, the dissolution of Co³⁺ is improved by the presence of ferrous ions, resulting from the dissolution of Fe-bearing minerals, including Fe from Co(Fe)OOH. The results showed that the predictive-oriented probabilistic graphic models based on the Bayesian approach, in combination with the design of the experiment data, made it possible to model the leaching of cobalt-bearing minerals. The results from the design of the experiment using the experimental tree methodology associated with the optimization of the multiple responses in a multiple input for a multiple output set-up derived the following optimized parameters: 60°C for the temperature (T), 850 rpm for the agitation, 40% for the solid percentage, 1.5 for the pH, and 4 g/L for the concentration of the Fe²⁺ ion. The cobalt dissolution yield obtained was 89.95%. The analysis of the dependence between the random variables only (P(Fe²⁺|T), P(pH|T), and P(Fe²⁺|pH)) and the dependence between the random variables and the responses (P(Co-yield|pH, Eh)) allowed the construction of two Bayesian networks, respectively, with and without posterior knowledge. For the Bayesian network with posteriori knowledge, the {5–2} structure was found to be the most appropriate arrangement. The model predicted a cobalt yield value, and the experimental value indicated a correlation coefficient (R²) of 0.861.     

Targeting the IspD Enzyme in the MEP Pathway: Identification of a Novel Fragment Class

The enzymes of the 2-C-methylerythritol-d -erythritol 4-phosphate (MEP) pathway (MEP pathway or non-mevalonate pathway) are responsible for the synthesis of universal precursors of the large and structurally diverse family of isoprenoids. This pathway is absent in humans, but present in many pathogenic organisms and plants, making it an attractive source of drug targets. Here, we present a high-throughput screening approach that led to the discovery of a novel fragment hit active against the third enzyme of the MEP pathway, PfIspD. A systematic SAR investigation afforded a novel chemical structure with a balanced activity–stability profile ( 16 ). Using a homology model of PfIspD, we proposed a putative binding mode for our newly identified inhibitors that sets the stage for structure-guided optimization.     

On the extension of the grain loop concept from 2D to 3D granular assemblies

Granular Matter - We study the local structural changes along the jamming transitions in asymmetric bidisperse granular packings. The local structure of the packing is assessed by the contact...     

What Has Happened to Territory?

In the concluding article of the main section of this issue, Antoine Picon evokes the earlier meaning of territory for administrators, architects and engineers, as lands that were integrated into nations or colonies by the early modern European countries. Picon traces how 18th- and 19th-century perceptions of territory with an emphasis on administrative separation fed into an attitude of both distance and sensitivity to landscape, as exemplified by the Romantic movement in painting and literature; a heritage that continued into the 20th century in architecture with its emphasis on rationalisation. Copyright © 2010 John Wiley & Sons, Ltd.     

The Design of 4D-Printed Hygromorphs: State-of-the-Art and Future Challenges

In recent years, 4D printing has allowed the rapid development of new concepts of multifunctional/adaptive structures. The 4D printing technology makes it possible to generate new shapes and/or property-changing capabilities by combining smart materials, multiphysics stimuli, and additive manufacturing. Hygromorphs constitute a specific class of new smart materials where their properties and morphing capabilities are dependent on the surrounding humidity, which drives actuation. Although multiple efforts have been made to fabricate hygromorph demonstrators, a comprehensive design process to produce hygromorphs by multiple 4D printing techniques is not yet available. The broad aim of this review and concept paper is to i) highlight existing scientific and technology gaps in the field of 4D-printed hygromorphs, ii) identify tools existing in other research fields for filling those gaps, and iii) discuss a series of guidelines for tackling future challenges and opportunities to develop 4D-printed composite hygromorph materials and related manufacturing processes. Accordingly, this review describes the materials and additive manufacturing techniques used for hygromorph composite fabrication. Moreover, the relevant parameters that control actuation, the models selection and performance, the design methods and the actuation measurements for customized 4D-printed hygromorph materials, are discussed.     

The LINPACK Benchmark: past,present and future

This paper describes the LINPACK Benchmark and some of its variations commonly used to assess the performance of computer systems. Aside from the LINPACK Benchmark suite, the TOP500 and the HPL codes are presented. The latter is frequently used to obtained results for TOP500 submissions. Information is also given on how to interpret the results of the benchmark and how the results fit into the performance evaluation process. Copyright © 2003 John Wiley & Sons, Ltd.     

Synthesis of Volcanic Ash‐based Porous Inorganic Polymers Using Biomass as Pore Inducing Agent: Phase Evolution and Descriptive Microstructure

Silicon - In the present study, multi-scale sized porous inorganic polymers were produced by alkaline activation of volcanic ash. Rice husk ash, an agricultural biomass, was used both in the...     

Generalizable Features for Anonymizing Motion Signals Based on the Zeros of the Short-Time Fourier Transform

Journal of Signal Processing Systems - Thanks to the recent development of sensors and Internet of Things (IoT), it is now common to use mobile application to monitor health status. These...