Background: Liver metastases are common in patients with breast cancer, and determining the factors associated with such metastases may improve both their early detection and treatment. Given that liver function protein level changes in these patients have not been determined, the aim of our study was to investigate liver function protein level changes over time, spanning 6 months before the detection of liver metastasis to 12 months after. Methods: We retrospectively studied 104 patients with hepatic metastasis from breast cancer who were treated at the Departments of Internal Medicine I and the Department of Obstetrics and Gynecology at the Medical University of Vienna between 1980 and 2019. Data were extracted from patient records. Results: Aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, lactate dehydrogenase and alkaline phosphatase were significantly elevated when compared to normal range 6 months before the detection of liver metastases (p<0.001) Albumin was decreased (p<0.001). The values of aspartate aminotransferase, gamma-glutamyltransferase, and lactate dehydrogenase were significantly increased at the time of diagnosis compared to 6 months prior (p<0.001). Patient- and tumor-specific parameters had no influence on these liver function indicators. Elevated aspartate aminotransferase (p = 0.002) and reduced albumin (p = 0.002) levels at the time of diagnosis were associated with shorter overall survival. Conclusion: Liver function protein levels should be considered as potential indicators when screening for liver metastasis in patients with breast cancer. With the new treatment options available, it could lead to prolonged life.

Objective: Perceived parental influence on diet in early adolescence in the context of the parental relationship had previously not been studied in a clinical sample. The aim of this study was to investigate a possible association between eating disorders and characteristics of the relationship with parents and the parental feeding practices in early adolescence. Methods: 21 female adolescents and young adults with an eating disorder (ED)–bulimia nervosa or anorexia nervosa–and 22 females without eating disorder (healthy control; HC), aged between 16 and 26, were assessed via self-report questionnaires for problematic eating behaviour, relationship with parents, perceptions of parent’s feeding practices at the age of 10–13 years and personality. Statistical evaluation was performed by means of group comparisons, effect sizes, regression analyses and mediator analyses. Results: Adolescent and young adult females with ED reported more fears/overprotection and rejection/neglect by their mothers and less self-responsibility in terms of eating behaviour during adolescence than did the HC. The relationship with the fathers did not differ significantly. Females who perceived more cohesion, rejection/neglect and fears/overprotection by the mother were more likely to suffer from an ED. Rejection/neglect by both parents were associated with less self-acceptance of the young females with even stronger effect sizes for the fathers than the mothers. Harm prevention in the young females was a partial mediator between fears/overprotection and the drive for thinness. Conclusions: The parental relationship is partly reflected in the self-acceptance and self-responsibility in eating of the adolescent and young females, both of them are particularly affected in EDs. Stressors in the parent-child relationship should be targeted in treatment of eating disorders. Nutritional counselling for parents might be useful in early adolescence.

Summary: Background: This study investigated the impact of curative breast cancer surgery on patient satisfaction concerning cosmetic results and quality of life (QoL).Methods: In this study 61 participants completed questionnaires to evaluate their QoL and patient satisfaction with cosmetic results following breast cancer surgery. Cosmetic outcomes were evaluated by the breast surgeon and an independent breast specialist using the Harris scale and the breast analyzing tool (BAT).Results: Of the participants 71% completed all 4 follow-up visits, 38 (62%) patients received breast-conserving therapy (BCT) and 23 (38%) received a mastectomy. Surgery-associated complications arose in 2.6% of the patients who received BCT and 17.4% of patients who received a mastectomy. No significant differences in QoL between BCT patients and mastectomy patients were observed immediately after surgery, or after 6 and 12 months. Breast asymmetry, measured using the BAT score, and QoL scores were worst immediately after surgery. The surgeon rated the cosmetic results as better compared to the independent breast expert (p = 0.001). Furthermore, patients aged over 60 years old were less satisfied with the cosmetic outcome compared to younger patients at the time of discharge (p = 0.024). Patients who received a mastectomy were less satisfied when the resected volume was higher.Conclusion: Patient satisfaction was lowest immediately after surgery but improved during the following months, despite continued breast asymmetry. For mastectomy patients, a lower resected volume led to a higher satisfaction with cosmetic results. Satisfaction is subjective and cannot be determined from the esthetic satisfaction of the surgeon or using an objective tool measuring breast asymmetry.

Germline variations in the BRCA‐1 and BRCA‐2 genes are associated with an increased risk of breast cancer. These variants are found in 5% of all breast cancer cases. Prophylactic mastectomy is the most effective risk‐reducing method and shows high rates of patient satisfaction and acceptance. We established a registry of Austrian BRCA‐1 and BRCA‐2 mutation carriers who had undergone mastectomy for oncologic or prophylactic reasons. Data were collected on the type of operation, complications, and type of reconstructive surgery for patients between 2014 and 2017. The complication rate in patients with nipple‐sparing mastectomy was significantly lower (23.1%) than in those with other types of mastectomies (60.7%; P = .005). In patients with implant‐based breast reconstruction, subpectoral placement was associated with a significantly higher rate of complications than prepectoral placement (P = .025). Median implant volume was 350 cc (range: 155‐650 cc), and a 100‐cc increase was associated with doubling of the odds of a complication (regression coefficient = 0.007); based on this finding, some surgeons may decide on using smaller implants. In summary, we identified significant associations between the risk of complications and surgical characteristics, and found host factors like diabetes, BMI, and smoking among Austrian patients with BRCA‐1 and BRCA‐2 variants.

In sodium (²³Na) magnetic resonance imaging (MRI), partial volume effects (PVE) are one of the most common causes of errors in the in vivo quantification of apparent tissue sodium concentration (aTSC). Advanced image reconstruction algorithms, such as compressed sensing (CS), have the potential to reduce PVE. This study aimed to investigate the feasibility of CS-based reconstruction techniques for improving image quality, and to assess whether differences in aTSC exist when images are reconstructed using different methods. In this study, three healthy participants and 12 female participants with breast cancer were examined on a 7T MRI scanner. ²³Na-MRI images were reconstructed using weighted total variation (wTV), directional total variation (dTV), anatomically guided total variation (AG-TV) and adaptive combine (ADC) methods. The consistency of tumor volume delineations based on sodium data was assessed using the Dice score, and aTSC quantification was performed for various image reconstruction methods. Pairwise comparisons of aTSC values between reconstruction methods (wTV, dTV, AG-TV, and ADC) were conducted using the Wilcoxon signed-rank test. All methods provided breast MRI images with well-preserved sodium signal and tissue structures. The mean Dice scores for wTV, dTV, and AG-TV were 65±11%, 72±9%, and 75±6%, respectively. Mean aTSC (in mmol/L) values in glandular tissue were 52.0±4.0 for wTV, 55.0±4.0 for dTV, 63±3.0 for AG-TV, and 69.0±3.0 for ADC reconstructions. In adipose tissue, mean values of aTSC were 32.0±4.0, 29.0±3.0, 19.0±2.0, and 23.0±3.0 for wTV, dTV, AG-TV, and ADC, respectively. In tumors, mean aTSC were as follows: 80.0±5.0 for wTV, 85.0±5.0 for dTV, 99.0±5.0 for AG-TV, and 105.0±7.0 for ADC. Post-hoc Wilcoxon signed-rank tests showed that AG-TV differed significantly from both wTV and dTV across all tissues (all p< 0.001), and that wTV also differed significantly from dTV (p=0.038 in gland, p=0.027 in adipose, and p=0.009 in tumor). Tumor appearance and aTSC estimations depend on the reconstruction method and parameter selection, likely due to differences in PVE reduction. Among the evaluated approaches, AG-TV showed the most favorable overall performance for ²³Na-MRI of breast tumors under the studied conditions.