Despite their abundance throughout the body, adipocytes are often ignored for their contributions within the tumor microenvironment (TME). However, their role in fueling cancer is becoming increasingly apparent as interest in the TME has seen remarkable advances in recent years. A seminal study by Dirat and colleagues highlighted the essential impact of the peritumoral adipose tissue in breast cancer progression and was among the first to demonstrate that tumor cells can reprogram adipocytes within their immediate niche to adopt unique characteristics. These “cancer-associated adipocytes” (CAA) were found to exchange cytokines and lipids with tumor cells, leading to their metabolic rewiring and acquisition of proinflammatory and invasive phenotypes. These important discoveries have represented a breakthrough in understanding the bidirectional metabolic dialog between adipocytes and tumor cells, and have contributed renewed perspectives on the functional contributions of adipocytes within the TME. Moreover, the effects of CAA may be further amplified in the setting of obesity as lipids dramatically accumulate, providing insights into the link between breast cancer and its more advanced clinical state in obese conditions. Thus, the different molecular actors involved in the dialog between tumor cells and CAA represent promising therapeutic targets that may have particular relevance in improving prognosis in obese patients with cancer.See related article by Dirat and colleagues, Cancer Res 2011;71:2455–65.

Objective: The aim of this retrospective cohort study is to evaluate the concordance between the preoperative MRI and histology data with the final histopathological examination. Method: This is a retrospective observational study of 183 patients operated for endometrioid cancer between January 2009 and December 2019 in the surgical oncology department of the Lorraine Cancer Institute (ICL) in Vandœuvre-lès-Nancy. The patients included are all women operated on for endometrioid-type endometrial cancer over this period. The exclusion criteria are patients for whom the pre-therapy check-up does not include pelvic MRI and those who have not had first-line surgery. The final anatomopathological results were compared with preoperative imaging data and with endometrial biopsy data. Results: For the myometrial infiltration, the sensitivity of MRI was of 37% and the specificity of 54%. To detect nodal metastases, the sensitivity of MRI was of 21% and the specificity of 93%. We observed an under estimation of the FIGO classification (p = 0.001) with the MRI in 42.7% of cases (n = 76) and an overestimation in 24.2% of cases (n = 43). There was a concordance in 33.1% of cases (n = 59). We had a poor agreement between the MRI and final histopathological examination with an adjusted kappa (κ) of 0.12 [95% IC (0.02; 0.24)]. There was a moderate concordance on the grade between the pretherapeutic biopsy and the final histopathological examination on excised tissue with an adjusted kappa of 0.52 [95% IC 0.42–0.62)]. Endometrial biopsy underestimated the tumor grade in 28.9% of cases (n = 50) (p < 0.001), overestimated the tumor grade in 6.9% of cases (n = 12) and we observed a concordance in 64.2% of cases (n = 111). Conclusion: The pre-operative assessment of endometrial cancer is inconsistent with the results obtained on final histopathological examination. A study with a systematic review should be done to assess the performance of MRI, only in expert centers, in order to consider a a specific care management for endometrial cancer patients: patients who have had an MRI in an outpatient center should have their imaging systematically reviewed, with the possibility of a new examination in case of incomplete sequences, by expert radiologists, and discussed in multidisciplinary concertation meeting in expert centers, before any therapeutic decision. The sentinel node biopsy must be used for low and intermediate risk endometrial cancer.

What Changes are Mandatory in Breast Surgery Training? An International Survey and Recommendations of the French Academy of Surgery and the Senologic International Society - European Journal of Breast Health

Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast lesion frequently discovered incidentally during imaging or biopsy for other conditions. We present two cases of PASH associated with fibroadenomas in premenopausal women, both presenting as palpable, symptomatic breast masses. In the first case, a 26-year-old woman exhibited a 5.2 cm hypoechoic lesion, initially diagnosed as PASH on core biopsy, later confirmed as fibroadenoma with PASH components post-excision. The second case involved a 37-year-old woman with a painful 5.6 cm mass, diagnosed similarly via biopsy, and later confirmed as fibroadenoma fully colonized by PASH after surgical removal. Both cases highlight the diagnostic challenge in distinguishing PASH from fibroadenomas, given overlapping clinical and imaging features. Hormonal factors, particularly contraceptive use, may contribute to PASH development. Management remains controversial, with surgery indicated for symptomatic lesions, while conservative approaches may suffice for smaller, asymptomatic cases. Based on our findings and current literature, we propose a management algorithm to guide clinicians in differentiating cases warranting surgical intervention from those suitable for monitoring. Further studies are needed to validate this approach.

Hemochromatosis: A Risk Factor for Breast Cancer? Systematic Review and Meta-Analysis - European Journal of Breast Health