SEOM clinical guidelines in early stage breast cancer (2018).

Breast cancer is the most common cancer in women in our country and it is usually diagnosed in the early and potentially curable stages. Nevertheless, around 20-30% of patients will relapse despite appropriate locoregional and systemic therapies. A better knowledge of this disease is improving our ability to select the most appropriate therapy for each patient with a recent diagnosis of an early stage breast cancer, minimizing unnecessary toxicities and improving long-term efficacy.

Bevacizumab plus preoperative chemotherapy in operable HER2 negative breast cancer: biomarkers and pathologic response.

PURPOSE: The primary aim of this trial was to assess the rate of pathologic complete responses (pCR) of doxorubicin/cyclophosphamide (AC) followed by bevacizumab/docetaxel (BT), as neoadjuvant therapy for breast cancer (BC). Furthermore, the association between biomarkers and the pCR was explored. METHODS: Patients with HER-negative operable stage II-III BC ≥ 2 cm were enrolled. Four cycles of AC (A 60 mg/m(2) and C 600 mg/m(2), every 3 weeks) followed by 4 cycles of BT (B 15 mg/kg and T 75 mg/m(2), every 3 weeks), were planned. A core-biopsy was performed for biological markers assessment. RESULTS: Seventy-two women were included. Forty-three (63 %) patients were hormone receptor-positive. Sixty-four (89 %) completed the planned treatment, and 66 evaluable patients underwent surgery (92 %): a pCR was achieved in 16 of them (24, 95 % CI 15-36 %). pCR was significantly higher in tumors hormone receptor-negative, and in those with Angiotensin II type 1 receptor (AGTR1) protein overexpression. The overall clinical response rate was 86 % (95 % CI 76-93 %), including 42 complete responses. No unexpected toxicities or treatment-related deaths were observed. CONCLUSION: This regimen showed a remarkable clinical and pathological activity: the suggested relation between pCR and AGTR1 overexpression should be confirmed in larger trials.

[Use of magnetic resonance imaging to evaluate morphological disorders in the brains of patients with sickle cell anaemia]. / Evaluación de las afecciones morfológicas en el cerebro de pacientes con anemia de células falciformes con el uso de imágenes de resonancia magnética.

INTRODUCTION: Blocked blood flow in the brain of patients with sickle cell anaemia (SCA) gives rise to disorders in this organ and, occasionally, courses with no clinical symptoms. AIMS: Our objective was to determine the most common lesions in the brains of patients with SCA in the eastern region of Cuba. PATIENTS AND METHODS: We conducted a study with children and adults with SCA, who were voluntarily included in the research protocol. The 28 adult patients had no history of vaso-occlusive crises of the central nervous system, and their ages ranged from 17 to 48 years. In addition, 50 paediatric-aged patients between the ages of 2 and 17 years were evaluated. Images were obtained with the Cuban magnetic resonance imaging equipment Giroimag 01 at 0.05 T. RESULTS: Both studies showed that cortical atrophy (CA) is the most frequent brain lesion among those found in the population of patients evaluated. The study revealed 35.7% of patients with silent lesions in adults and 18% in the children. CONCLUSIONS: CA is the lesion that is most commonly seen in the population studied. The brain lesions that were found are possibly triggered by the effect of blockages in the blood flow in the brain. A population study must be conducted in order to determine the first disorders triggered by the blocked blood flow in the brains of these patients. There is also a need to evaluate the possible risk factors that favour the development of these lesions.