ABSTRACT
Background: In 2020, in Italy, an estimated 54,976 new diagnoses of breast cancer were made. The State-Regions Agreement has issued the “Guidelines on the organizational and welfare methods of the network on breast unit”, for diagnostic-therapeutic paths in senology. Methods: In the 2018 the Molise Region established a Breast Unit (B.U.);the personalized approach, especially in breast cancer, is more effective by integrating the progress of breast surgery, with staging methods such as MRI, treatment methods, such as neoadjuvant therapy (NACT), able to improve survival and quality of life especially in positive HER2 tumors and typically more aggressive “triple negative” diseases. Every week, in the COVID era on an online platform, the GOM meets to discuss cases;preoperative cases are discussed for which the methods of diagnosis and staging are proposed and the therapeutic hypothesis is discussed. All patients eligible for conservative treatments are stadiated with imaging techniques, in particular MRI, the most accurate tool for the basic evaluation of disease extent, and a biopsy for the evaluation of biological variables. Patological complete response (pCR), defined as the absence of invasive disease in the breast and lymphnodes, should be use to measure response to guide decision making. Results: There were 125 patients diagnosed in 2019, in 2020 there were 157, in 2021 there were 50 (until 18 May). In the year 2019, the B.U. gradually structured. In 2020 the median age was 52 a. (32-72 BC). Of the 157 patients evaluated, 8 or 5.1%, performed neoadjuvant chemotherapy (7 T2 cases, 1 T1c case;5 G3 cases, 3 G2 cases;7 cases with positive RE of which 1 HER-2 score 3+, 1 triple negative). All have undergone quadrantectomy. In 2021 the median age of the 50 patients was 64.5 a. (35-81 BC) and 14 cases, or 28%, performed neoadjuvant chemotherapy (9 T2 cases, 5 T4 cases;13 G3 cases, 1 Case G2;6 HER-2 score 3+ cases;3 triple negative cases and 11 cases with positive RE (all patients are still being treated). Conclusions: In Italy NACT is proposeed to about 20% of women with breast cancer, the European average is about 30% with peaks of 50-60% in Germany and the United Kingdom. The activity data of the B.U. Molise and the systemic treatment with NACT indicate an approach in line with Italian data and with the tendency to improve them since closer to European standards denoting a more modern method and perhaps a real cultural change.
ABSTRACT
A coronavirus disease 2019 (COVID-19) surveillance study was performed in March-April 2020 among asymptomatic healthcare workers (HCWs) at a specialist infectious diseases hospital in Naples, Italy. All HCWs underwent two rounds of molecular and serological testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). One hundred and fifteen HCWs were tested; of these, two cases of infection were identified by reverse transcriptase polymerase chain reaction and two HCWs were SARS-CoV-2 immunoglobulin G seropositive. The overall prevalence of current or probable previous infection was 3.4%. The infection rate among HCWs was reasonably low. Most of the infected HCWs had been asymptomatic for the preceding 30 days, which supports the need for periodic screening of HCWs for COVID-19.