Purpose: Based on the KEYNOTE-522 study, neoadjuvant pembrolizumab plus chemotherapy has become the standard treatment for early-stage triple-negative breast cancer (TNBC).This study evaluated the real-world efficacy, safety, and predictors of pathologic complete response (pCR) in Korean patients. Methods: We conducted a retrospective cohort study of 174 patients with early-stage TNBC who received the KEYNOTE-522 regimen (neoadjuvant pembrolizumab plus paclitaxel and carboplatin, followed by doxorubicin and cyclophosphamide) at a tertiary cancer center between August 2022 and July 2024. We assessed the primary endpoints, including pCR rate and event-free survival (EFS). We performed univariable and multivariable logistic regression analyses to identify independent predictors of pCR. Results: The median patient age was 50 years (range, 24–74 years). The clinical stages were II and III in 79.3% and 20.1% of patients, respectively, and 10.9% had clinical N3 disease. The overall pCR rate was 62.1%, and the N3 subgroup had a pCR rate of 47.4%. On multivariable analysis, high baseline Ki-67 expression (≥ median, 75%) was significantly associated with pCR (odds ratio, 2.84; 95% confidence interval, 1.45 to 5.66; p = 0.002). At a median followup of 18.4 months, the 12-month EFS rate was 97.4%, with significantly superior outcomes observed in patients who achieved pCR compared with those who did not achieve pCR (100% vs. 93.1%, p = 0.007). The treatment completion rate was 92.0%, and immune-related adverse events occurred in 13.8% of patients. Conclusion In this real-world analysis of one of the largest Asian cohorts of patients with earlystage TNBC treated with neoadjuvant pembrolizumab, the KEYNOTE-522 regimen demonstrated substantial efficacy and manageable toxicity, consistent with the original trial findings.

Ectopic breast tissue and male breast cancer are both very rare diseases with only a few reports in the literature. Here, we present the first case of ectopic male breast cancer in the perineum. The patient was a 70-year-old man with a palpable mass in the perineum. A wide local excision and inguinal lymph node dissection revealed invasive breast carcinoma of no special type involving the skin and subcutis, and inguinal lymph node metastases. Immunohistochemical staining showed that the tumor cells were strongly positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2. Moreover, no p53 overexpression was observed. Herein, the clinical and pathologic features, as well as a review of ectopic male breast cancer are discussed.
Aged ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Estrogens ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Male* ; Mammary Glands, Human ; Neoplasm Metastasis ; Perineum* ; Rare Diseases ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Skin

BACKGROUND: Simian virus 40 (SV40), a polyomavirus, was discovered as a contaminant of a human polio vaccine in the 1960s. It is known that malignant mesothelioma (MM) is associated with SV40, and that the virus works as a cofactor to the carcinogenetic effects of asbestos. However, the reports about the correlation between SV40 and MM have not been consistent. The purpose of this study is to identify SV40 in MM tissue in Korea through detection of SV40 protein and DNA. METHODS: We analyzed 62 cases of available paraffin-blocks enrolled through the Korean Malignant Mesothelioma Surveillance System and performed immunohistochemistry for SV40 protein and real-time polymerase chain reaction (PCR) for SV40 DNA. RESULTS: Of 62 total cases, 40 had disease involving the pleura (64.5%), and 29 (46.8%) were found to be of the epithelioid subtype. Immunostaining demonstrated that all examined tissues were negative for SV40 protein. Sufficient DNA was extracted for real-time PCR analysis from 36 cases. Quantitative PCR of these samples showed no increase in SV40 transcript compared to the negative controls. CONCLUSIONS: SV40 is not associated with the development of MM in Korea.
Asbestos ; DNA ; Humans ; Immunohistochemistry ; Korea ; Mesothelioma ; Pleura ; Poliomyelitis ; Polymerase Chain Reaction ; Polyomavirus ; Real-Time Polymerase Chain Reaction ; Simian virus 40 ; Viruses

BACKGROUND: Vancomycin-resistant enterococci (VRE) infection is an emerging nosocomial problem. VRE usually multidrug-resistant, poses therapeutic dilemmas. The gene that encodes the resistance against vancomycin may spread the resistance to Staphylococcus aureus. However, there are no well-organized studies on the clinical manifestations and the factors that contribute to mortality in Korea. Herein, this study was focused on the clinical manifestations and mortality risks of patients with VRE infection during 8 years (1994-2001) in a university hospital. Understanding of the epidemiology and clinical manifestations of VRE would help develop control strategy of VRE outbreak in a hospital. METHOD: Sixty seven cases that had the VRE infection in Korea University Guro Hospital from January 1, 1994to December 12, 2001, were reviewed. We analyzed the risk factors of VRE infection and death by using univariable and multivariable statistic analyses. RESULTS: VRE infections have recently been increasing. Most of VRE infections were caused by Enterococcus faecium (85.1%) and Enterococcus faecalis (10.4%). Among 67 cases, 40 cases (59.7%) expressed VanA phenotype, 23 cases (34.3%) expressed VanB phenotype, and 3 cases expressed VanC phenotype (6%). The risk factors for death were renal dysfunction, central venous catheter insertion, and tracheostomy by using univariable analysis. The risk factor for death was renal dysfunction by using multivariable analysis. CONCLUSION: VRE has been increasing during the late 1990s in Korea. The VRE infection occurs especially in the patients who have renal dysfunction, long-term hospitalization, and ICU care. The implementation of careful isolation, infection control measures, prudent use of antibiotics, especially vancomycin, and periodic screening of patients populations are required to control VRE infection.
Anti-Bacterial Agents ; Central Venous Catheters ; Enterococcus faecalis ; Enterococcus faecium ; Epidemiology ; Hospitalization ; Humans ; Infection Control ; Korea ; Mass Screening ; Mortality ; Phenotype ; Risk Factors* ; Staphylococcus aureus ; Tracheostomy ; Vancomycin

BACKGROUND: Vancomycin-resistant enterococci (VRE) infection is an emerging nosocomial problem. VRE usually multidrug-resistant, poses therapeutic dilemmas. The gene that encodes the resistance against vancomycin may spread the resistance to Staphylococcus aureus. However, there are no well-organized studies on the clinical manifestations and the factors that contribute to mortality in Korea. Herein, this study was focused on the clinical manifestations and mortality risks of patients with VRE infection during 8 years (1994-2001) in a university hospital. Understanding of the epidemiology and clinical manifestations of VRE would help develop control strategy of VRE outbreak in a hospital. METHOD: Sixty seven cases that had the VRE infection in Korea University Guro Hospital from January 1, 1994to December 12, 2001, were reviewed. We analyzed the risk factors of VRE infection and death by using univariable and multivariable statistic analyses. RESULTS: VRE infections have recently been increasing. Most of VRE infections were caused by Enterococcus faecium (85.1%) and Enterococcus faecalis (10.4%). Among 67 cases, 40 cases (59.7%) expressed VanA phenotype, 23 cases (34.3%) expressed VanB phenotype, and 3 cases expressed VanC phenotype (6%). The risk factors for death were renal dysfunction, central venous catheter insertion, and tracheostomy by using univariable analysis. The risk factor for death was renal dysfunction by using multivariable analysis. CONCLUSION: VRE has been increasing during the late 1990s in Korea. The VRE infection occurs especially in the patients who have renal dysfunction, long-term hospitalization, and ICU care. The implementation of careful isolation, infection control measures, prudent use of antibiotics, especially vancomycin, and periodic screening of patients populations are required to control VRE infection.
Anti-Bacterial Agents ; Central Venous Catheters ; Enterococcus faecalis ; Enterococcus faecium ; Epidemiology ; Hospitalization ; Humans ; Infection Control ; Korea ; Mass Screening ; Mortality ; Phenotype ; Risk Factors* ; Staphylococcus aureus ; Tracheostomy ; Vancomycin