Medical treatment of breast cancer today depends on the tumor profile. For triple-negative breast cancer, the standard treatment before surgery now combines chemotherapy and immunotherapy, significantly improving the chances of cure. In the metastatic stage, new therapies such as the antibody conjugate (ADC) sacituzumab-govitécan have substantially prolonged survival. For HER2-positive tumours, the strategy is also to treat before surgery. For metastatic forms, a new-generation ADC, trastuzumab deruxtecan, has proved its immense efficacy, becoming a benchmark. Finally, for hormone-dependent (HR+) cancers at high risk, the addition of CDK4/6 inhibitors to hormone therapy after surgery reduces the risk of recurrence. In addition, ADCs are also of interest in advanced forms, particularly for tumours known as "HER2-low".

Breast cancer accounts for approximately 24% of all new cancer cases in women worldwide and remains a major challenge for the medical community despite advances in screening and treatment. The management of axillary lymph nodes is crucial for local-regional control and tumor staging. Historically, radical mastectomy was introduced by William Halsted in the late 19th century; however, this method resulted in significant morbidity. Over time, less invasive techniques have been developed, notably sentinel lymph node biopsy (SLNB) in the 1990s, which assesses the status of axillary lymph nodes based on the sentinel node. If this node is disease-free, a complete axillary dissection can often be avoided, thereby reducing complications. SLNB is now recognized as the standard of care for patients with early-stage breast cancer without clinical nodal involvement, supported by studies such as ACOSOG Z0011 and AMAROS. However, questions remain regarding the best surgical approach for patients with specific tumor subtypes or extensive nodal involvement. This article offers an analysis of the scientific foundations of lymph node surgery, technical advancements, clinical trial outcomes, and the future prospects of increasingly personalized medicine.

Immediate breast reconstruction (IBR) following total mastectomy is now an established surgical approach that combines oncological safety with aesthetic benefits. This review discusses indications, techniques, and surgical adaptations of IBR based on breast morphology and adjuvant therapy planning. At Institut Curie, experience with over 600 reconstructions has led to refined patient selection, with an overall implant removal rate of 5.8%, dropping to 4% in "low risk" patients. Prepectoral implant placement, with or without acellular dermal matrices (ADM), has emerged as a reliable alternative to subpectoral techniques. It offers less postoperative pain, eliminates animation deformity, and significantly reduces capsular contracture. For large or ptotic breasts, skin-reducing mastectomy or two-stage reconstruction enhances outcomes.

Histopathological examination is a cornerstone in the diagnosis, prognostic stratification, and therapeutic planning of breast cancer. It combines morphological, immunophenotypic, and molecular data to guide clinical decision-making. This article provides a comprehensive overview of the main histological types, technical modalities, and conventional and emerging biomarkers in breast cancer pathology. Breast carcinomas are categorized into in situ (DCIS, LCIS) and invasive forms. The most frequent invasive types are invasive carcinoma of no special type (NST) and invasive lobular carcinoma (ILC). Rare histologic variants (e.g., mucinous, micropapillary, metaplastic) exhibit distinct biological and prognostic features. The diagnostic workflow includes standardized steps: sampling, formalin fixation, paraffin embedding, H&E staining, immunohistochemistry (ER, PR, HER2, Ki-67), and molecular testing when needed (FISH, PCR, NGS). Routine biomarkers help define surrogate molecular subtypes (luminal A/B, HER2-positive, triple-negative) and guide systemic therapies. The emergence of the HER2-low category exemplifies how biomarker refinement impacts clinical practice. Additional markers such as PIK3CA and ESR1 mutations, BRCA/HRD status, PD-L1 expression, and tumor-infiltrating lymphocytes (TILs), along with multigene signatures (e.g., Oncotype DX, MammaPrint), further individualize prognostic assessment and treatment selection. Innovative approaches such as liquid biopsy and next-generation sequencing (NGS) enable minimally invasive monitoring and personalized care, especially in advanced disease. Breast cancer pathology is thus a dynamic, integrative discipline central to precision oncology, driven by ongoing technological and molecular advances, and essential to multidisciplinary cancer care.

Merkel's carcinoma is a rare but highly aggressive cutaneous neuroendocrine tumor whose incidence has increased due to an aging population and increased UV exposure. It is characterized by rapid growth, high risk of recurrence and early metastatic spread. Two subtypes have been identified: Merkel polyomavirus-related (MCPyV), present in 80% of cases in Europe, and UV-related. The main risk factors are advanced age, male gender, light phototypes and immunosuppression. Clinically, it appears as a painless, red or purplish nodule, often on photo-exposed areas. Diagnosis is based on histopathology and immunohistochemistry (CK20+ and synaptophysin+). Extension assessment is essential, and relies on PET-CT, brain MRI and lymph node ultrasound. Staging follows the AJCC 8th edition, distinguishing between localized (I/II), lymph node involved (III) and metastatic (IV) stages. Treatment is based on surgery (excision with 1cm margins) and adjuvant radiotherapy. In the case of lymph node involvement, lymph node dissection and radiotherapy are recommended. Metastatic forms now benefit from immunotherapy (anti-PD-1/PD-L1), which has improved prognosis. Merkel carcinoma has a high recurrence rate (25-50%). Monitoring is based on regular clinical and radiological follow-up over several years. Biomarkers such as NSE and anti-MCPyV serology are currently being evaluated.

Since the 2010s, the management of locally advanced and metastatic melanoma has been completely transformed by the use of immune checkpoint inhibitors and anti-BRAF/anti-MEK targeted therapies. These therapies have also recently been used as neoadjuvant and adjuvant treatments in certain high-risk melanoma indications (stage IIB to stage IIID).

Cutaneous squamous cell carcinoma (CSC), formerly known as squamous cell carcinoma, is the most common skin cancer after basal cell carcinoma, accounting for 20% of all skin cancers. It is a malignant epithelial tumor of keratinocytic origin. Its incidence has risen sharply in recent decades. CEC is characterized by a more rapid evolution than basal cell carcinoma, with a risk of local recurrence and distant lymphatic and hematogenous metastatic dissemination. Early surgical management usually leads to a cure; adjuvant radiotherapy should be considered in cases of poor prognosis. Finally, immunotherapy has supplanted conventional chemotherapy in the management of advanced forms of the disease, thanks to its superior efficacy (40-50% response rate) and much better tolerability.

Cystic diseases are a group of diseases characterised by the formation of cysts in some organs, particularly the lungs and kidneys, which progressively lead to respiratory or renal failure, requiring organ transplantation in advanced cases. Understanding the mechanisms of these cystic diseases has led to advances in early detection and the development of new treatments to slow their progression to end-stage failure.

Fine needle aspiration is a well-known procedure for the diagnosis and management of solid lesions. The approach to cystic lesions on fine needle-aspiration is becoming a popular diagnostic tool due to the increased availability of high-quality cross-sectional imaging such as computed tomography and ultrasound guided procedures like endoscopic ultrasound. Cystic lesions are closed cavities containing liquid, sometimes partially solid with various internal neoplastic and non-neoplastic components. The most frequently punctured cysts are in the neck (thyroid and salivary glands), mediastinum, breast and abdomen (pancreas and liver). The diagnostic accuracy of cytological cyst sampling is highly dependent on laboratory material management. This review highlights how to approach the main features of superficial and deep organ cysts using basic cytological techniques (direct smears, cytocentrifugation), liquid-based cytology and cell block. We show the role of a multimodal approach that can lead to a wider implementation of ancillary tests (biochemical, immunocytochemical and molecular) to improve diagnostic accuracy and clinical management of patients with cystic lesions. In the near future, artificial intelligence models will offer detection, classification and prediction capabilities for various cystic lesions. Two examples in pancreatic and thyroid cytopathology are particularly developed.

Monocytes, circulating mononuclear phagocytes, play a fundamental role in innate immunity and the maintenance of tissue homeostasis. Using advanced technologies like flow cytometry, the characterization of monocytes has evolved from a simplistic view of a homogeneous population to a more complex understanding of a heterogeneous system comprising three main subtypes: classical monocytes (CD14++CD16-), intermediate monocytes (CD14++CD16+), and non-classical monocytes (CD14+CD16++). The identification of these subpopulations has enabled precise characterization of their functional profiles, enhancing the understanding of their roles in various pathological contexts, particularly in oncology. While anti-tumoral functions of monocytes have been clearly established in certain categories of cancers through tumor antigen presentation, induction of cytotoxic responses, and inhibition of metastatic progression, their role in promoting the development and progression of other cancers has also been highlighted during recent years. The utilization of monocytes in cancer immunotherapy presents promising opportunities, particularly by reprogramming their activity to enhance anti-tumoral responses or suppress their pro-tumoral functions. This review provides a comprehensive analysis of recent advances in the phenotypic and functional diversity of monocytes and their role in tumor progression, while highlighting emerging therapeutic strategies targeting these cells to optimize cancer treatment.

Over the past decade, targeted therapies have significantly improved the prognosis of metastatic breast cancer. CDK4/6 and PARP inhibitors are now gaining traction in the adjuvant setting, and their potential use in the neoadjuvant context is also being explored. This review presents an analysis of the current scientific evidence and associated clinical perspectives. CDK4/6 inhibitors act on cell cycle dysregulation, commonly observed in hormone receptor-positive breast cancers. In the adjuvant setting, abemaciclib and ribociclib have shown improvements in progression-free survival (PFS) in the monarchE and NATALEE trials, respectively, leading to their approval by the European Medicines Agency. In the neoadjuvant context, although these agents have demonstrated a reduction in proliferation markers such as Ki67, their impact on clinical practice remains limited to date. PARP inhibitors are based on the concept of synthetic lethality, specifically targeting cancers with germline BRCA1 or BRCA2 mutations. In the adjuvant setting, the OlympiA trial demonstrated a significant improvement in both PFS and overall survival (OS). In the neoadjuvant setting, these agents have also shown effects on pathological markers, though the clinical relevance of these findings has yet to be clearly established. Overall, these results underscore the growing role of targeted therapies in the adjuvant management of breast cancer. The identification and validation of predictive biomarkers will be crucial in optimizing their use, both in adjuvant and neoadjuvant settings.

In this review we summarised published clinical trials evaluating neoadjuvant treatment with imatinib for locally advanced gastro-intestinal stromal tumours. We illustrate the practice through a clinical vignette, allowing us to highlight practical suggestions.

Breast cancer is the second most common cause of brain metastases, after lung cancer. The risk of developing brain metastases varies according to the molecular subtype of breast cancer, with a higher incidence for triple-negative or HER2-positive cancers. The discovery of brain metastases, whether synchronous or metachronous, is a turning point in oncology management, and requires discussion at a neuro-oncology multidisciplinary consultation meeting to assess the value and modalities of local treatment by surgery and/or radiotherapy (stereotactic or total brain). Systemic treatments also play a major role in the control of breast cancer brain metastases. The most abundant literature on brain metastases concerns HER2-positive breast cancers, with robust data on the intracerebral efficacy of tyrosine kinase inhibitors (tucatinib, neratinib) and drug-conjugated antibodies (trastuzumab deruxtecan). The size of the brain metastases, whether they are stable or progressive, any previous irradiation, whether the brain involvement is symptomatic or not, the extracerebral evolution of the disease, the patient's general condition and the systemic options available must all be taken into account before deciding on a therapeutic strategy. This article does not deal with the specific management of leptomeningeal disease, which will be the subject of a separate article.

Hormone therapy is essential in the adjuvant management of early-stage HR+ breast cancer. Risk assessment for recurrence is a fundamental pillar in guiding therapeutic strategies and personalizing patient care. Tumors with a low risk of recurrence, eligible for treatment de-escalation, can be managed with standard hormone therapy. High-risk or intermediate-risk tumors warrant intensified approaches, including targeted therapies. This article reviews recent questions regarding the extension of hormone therapy to ovarian suppression and current strategies, with a focus on clinical studies such as OlympiA, monarchE, and NATALEE, which currently guide therapeutic decisions.

Adjuvant radiotherapy for breast cancer has demonstrated its benefit both in terms of local control and overall survival. However, it now appears possible to de-escalate both the indications and the technical modalities of treatment. Some of these new approaches are already validated, while others require further studies. Hypofractionation has been the subject of several trials, which have shown that shorter regimens (42.5Gy in 16 fractions, 41.6Gy in 13 fractions, or 40Gy in 15 fractions) are equivalent to longer schedules. It can be proposed for almost all patients and can be complemented, if necessary, by a boost to the original tumor volume. Accelerated partial breast irradiation, which can be used in patients with favourable local prognosis (tumor size≤3cm, unifocal, hormone receptor-positive, no HER2 overexpression), is ideally delivered via interstitial brachytherapy, as accelerated 3D radiotherapy has not yet shown benefit in this setting. However, partial breast irradiation can be delivered using moderate hypofractionation with 3D radiotherapy. Intraoperative radiotherapy, which has more restrictive indications, is an interesting alternative for elderly patients. Patient selection for these approaches must be rigorous and depends partly on the technique chosen. Patients should be fully informed about the potential side effects of each technique.

Past decade was marked by development of several new drug for HR+/HER2- metastatic breast cancer leading to several major question in terms of strategy. We propose here to review state of art in terms of targeted therapy for advanced luminal breast cancer and how treatment strategy will be more and more personalized in a near future.

The diagnosis of B- and T-cell lymphomas relies on a multidisciplinary approach that combines morphological, immunological (via flow cytometry - FCM), and genetic analyses. The integration of cytological evaluation from tissue biopsy imprints with FCM enables rapid diagnostic orientation, which is valuable for guiding further complementary investigations. This atlas illustrates the main types of B- and T-cell lymphomas using cytology images, FCM data, and histological analyses derived from lymph node and splenic samples. The FCM profiles were established using routinely employed antibody panels. While results may show slight variations depending on the cytometer settings and fluorochromes used, they remain generally comparable across different instruments. An orientation panel consisting of 16 antibodies is used for the initial classification of lymphomas, with specific markers allowing for subsequent assessment of antigen expression according to cell type and pathological context. The combined study of cytological and histological features provides an integrated perspective of lymphoid pathology.

Cysts, common and ubiquitous pathological anomalies, are defined as cavities lined by a distinct wall and filled with fluid or semi-solid material. They result from complex mechanisms involving genetic alterations, biophysical forces, and tissue microenvironment interactions. Recent advances in genomics have identified key mutations that disrupt cell polarity, intracellular signaling, and fluid dynamics. Concurrently, biophysical models elucidate the impact of mechanical and osmotic forces on cyst growth and rupture. Multiscale models, integrating these approaches, connect molecular mechanisms to tissue dynamics, providing powerful tools to unravel the complex interactions driving cyst formation. These advances offer promising perspectives in terms of diagnosis, through genetic and biophysical biomarkers and therapeutics. This article provides an integrative update on the genetic and biophysical mechanisms of cysts and explores their clinical applications within a multidisciplinary framework.

The treatment of rectal cancer has evolved dramatically in recent years. Today, specialists have more options to choose from, ranging from primary surgical resection with or without neoadjuvant treatment to an organ-preserving strategy (such as Watch-and-Wait) after total neoadjuvant treatment. The aim of this article is to review the advantages, limits, and risks of the Watch-and-Wait strategy for the treatment of rectal cancer.

Locoregional treatment of breast cancer is based on surgery of the breast and axilla, radiotherapy of the breast or chest wall and regional lymph node areas. A progressive therapeutic de-escalation was carried out in order to reduce the impact of the treatments. This de-escalation will be considered for breast treatment and for lymph node area during primary surgical treatment and for neo-adjuvant chemotherapy.