Minimally invasive breast surgery (MIS), including robotic and endoscopic mastectomy, has emerged as an alternative to conventional mastectomy (CM). However, robust prospective multicenter data comparing postoperative complications between MIS and CM have been lacking. The MARRES study (NCT004585074) is a multicenter, prospective cohort was conducted at 18 institutions in South Korea. Women with breast cancer or BRCA1/2 mutation carriers who underwent total, skin-sparing, or nipple-sparing mastectomy followed by immediate breast reconstruction were enrolled. The primary endpoint is the rate of postoperative complications of Clavien-Dindo grade ≥3 between the MIS and CM groups. A prespecified non-inferiority analysis with 1:1 matching was conducted according to the protocol. A total of 1,914 women (2,140 cases) were enrolled. After applying eligibility criteria, 1,875 women were included in the analysis: 584 underwent MIS and 1,291 underwent CM. A total of 2,095 cases were analyzed, including 678 MIS cases (52 endoscopic and 626 robotic) and 1,417 CM cases. Among them, 615 cases (90.7%) in the MIS group and 1,358 cases (95.8%) in the CM group were performed for breast cancer, while the remaining cases involved benign disease or risk-reducing mastectomy in BRCA1/2 mutation carriers. Meanwhile, out of 1,875 women analyzed, 253 women (13.5%) underwent bilateral mastectomy, of which 116 women (45.8%) were diagnosed with bilateral breast cancer. Among women with unilateral breast cancer (N=1,616), those undergoing MIS were younger (median age, 46.0 vs. 47.0 years; p=0.0003) and more frequently aged <50 years (69.9% vs. 61.4%; p=0.0012). The MIS group had a higher prevalence of normal to mild breast ptosis (74.7% vs. 52.1%; p<0.0001) and more frequently presented with early-stage disease, including preoperative diagnoses of DCIS (37.8% vs. 28.9%; p=0.001). In terms of tumor biology, the MIS group had higher rates of progesterone receptor positivity (72.8% vs. 66.6%; p=0.033), HER2 negativity (71.1% vs. 68.6%; p=0.002), and low Ki-67 expression (41.0% vs. 30.0%; p<0.0001). Postoperative complications of Clavien-Dindo grade ≥3 were significantly lower in the MIS group than in the CM group (11.2% vs. 19.3%; p<0.0001). Overall complication rates were also lower in the MIS group, with a higher proportion of patients experiencing no complications (Grade 0: 71.2% vs. 61.7%; p<0.0001). Early postoperative complications (within 30 days) occurred less frequently in the MIS group than in the CM group (25.7% vs. 33.5%; p=0.0003). No significant difference was observed in late complications (beyond 30 days) between the two groups (10.8% vs. 13.5%; p=0.073). In the prespecified 1:1 matched analysis, Clavien-Dindo grade ≥3 complications were reported in 9.5% of MIS cases and 18.0% of CM cases, with an absolute difference of -8.5%, satisfying the predefined non-inferiority margin of 5%. This study indicates that MIS is not inferior to CM followed by reconstruction regarding severe complication rates; furthermore, MIS shows better outcomes of postoperative complication rates in the early postoperative period. MIS is safely administered in breast surgery in terms of surgical outcomes. H. Park, J. Ryu, J. Lee, H. Kim, S. Lee, H. Lee, Y. Kang, J. Kim, H. Choi, K. Kim, H. Shin, A. Han, Y. Lee, J. Cheun, M. Lee, J. You, S. Bae, Y. Kim, N. Kim. Postoperative Complication Rates of Minimally Invasive Mastectomy Compared to Conventional Mastectomy: A Prospective Multicenter Cohort Study (MARRES) [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr RF1-01.
Background/Objectives: Emergency departments (EDs) are particularly prone to medication errors because of urgent treatment environments and high decision density. Automated dispensing cabinets (ADCs) integrated with the hospital information system (HIS) may improve medication safety, yet real-world evidence in centralized-pharmacy settings remains limited. This study evaluated the impact of an HIS-integrated ADC on medication use, medication errors, and nurses' perception of safety in the ED of a Korean tertiary hospital. Methods: In this prospective before-and-after study, prescribing patterns, medication storage, and related costs were compared in the two months before (Phase 1; September-October 2019) and after (Phase 2; May-June 2020) ADC installation. Medication errors reported through the hospital safety incident reporting system were analyzed over corresponding 6-month windows from July 2019 to June 2020. Long-term sustainability was assessed using follow-up data collected from October to November 2023 (Phase 3), and all 46 ED nurses completed a 5-point Likert-scale survey on perceived medication safety. Results: Daily injectable prescriptions were unchanged (221.1 ± 34.6 vs. 227.7 ± 35.2; p = 0.301), whereas returned injectable prescriptions increased (17.9 ± 5.9 vs. 25.1 ± 6.0; p < 0.001) and non-injectable prescriptions decreased (163.1 ± 42.2 vs. 140.0 ± 22.7; p < 0.001). The number of medication items stored in the ED storage room declined by 95.6%, with a 92.5% reduction in related maintenance cost. Total medication errors decreased from 41 (74.5%) before to 14 (25.5%) after implementation (p < 0.001), with the largest reduction in delivery errors (17 [30.9%] to 2 [3.6%]). These improvements were sustained at the three-year follow-up. Nurses reported high overall satisfaction with medication safety (4.27 ± 0.62 on a 5-point Likert scale). Conclusions: Implementation of an HIS-integrated ADC in the ED was associated with improved prescription patterns, fewer reported medication errors, and enhanced perceived medication safety. In addition, these improvements were sustained over time, indicating stable and consistent implementation of the ADC system. Nurses also reported improved perceptions of medication safety.
Abstract Background Anemia is a common systemic manifestation in interstitial lung disease (ILD), including idiopathic pulmonary fibrosis (IPF), yet longitudinal patterns of hemoglobin (Hb) change remain poorly characterized. Understanding Hb trajectories may provide insights into systemic disease burden and prognosis in ILD. Methods Data were drawn from the Korean National Health Insurance Service-Health Screening Cohort, covering the period from January 1, 2004, to December 31, 2019. This study included ILD patients who had at least two Hb measurements following their diagnosis. We conducted a 1:1 matched cohort of 674 patients with ILD (ICD-10: J841) and 674 controls without ILD, matched by age, sex, and index year. Hemoglobin levels from serial health screenings were analyzed using linear mixed-effects models with random intercepts. The interaction between time and ILD status was evaluated to assess differential Hb trajectories. Multivariable models were adjusted for demographic, clinical, and lifestyle factors, including body mass index (BMI), smoking, comorbidities, and Charlson Comorbidity Index (CCI). Subgroup and sensitivity analyses were conducted according to age (<60 vs ≥ 60 years), sex, baseline Hb level. 95% confidence intervals were computed using profile likelihood, and p values were obtained from t tests with Satterthwaite’s approximation. Results Baseline characteristics were well balanced between groups (mean age 65.7 years, 72.3% male). Median follow-up was 3.0 years in ILD (IQR 2.2-3.9) and 2.3 years in controls (IQR 1.9-2.9); mean follow-up was 3.2 ± 1.35 vs 2.6 ± 1.08 years, respectively (p < 0.0001). In the unadjusted model, Hb increased slightly over time in the ILD group but declined in controls (Figure 1). In the adjusted model, Hb levels declined over time in both groups, but the rate of decline differed significantly between ILD and controls (interaction β = +0.0707 g/dL per year; p = 0.0051). Higher BMI (≥25 kg/m², p < 0.001) and elevated CCI scores (≥5, p < 0.001) were independently associated with Hb variation. Subgroup analyses revealed consistent Hb trajectory differences across sex and age strata, though no significant effect modification by sex was observed. Among younger patients (<60 years), the interaction term was not significant (p = 0.13). Conclusion This study provides evidence of distinct Hb trajectories in ILD patients compared to matched controls. These findings support the clinical value of longitudinal Hb monitoring in ILD and warrant further investigation into modifiers of Hb change. This abstract is funded by: None
Lingual osseous choristoma is an exceedingly rare benign lesion characterized by the presence of mature bone tissue within the soft tissue of the tongue, where osseous structures are not normally found. Thyroglossal duct cysts (TGDCs) are common congenital midline neck lesions resulting from incomplete involution of the thyroglossal duct during embryogenesis. Both entities share a common embryological pathway extending from the tongue base through the hyoid bone to the lower cervical region. However, the synchronous occurrence of a lingual osseous choristoma and a suprahyoid TGDC in a single patient has rarely been reported. A 26-year-old woman presented with a slowly enlarging posterior tongue mass and a persistent foreign-body sensation during swallowing. Intraoral examination revealed a firm, pedunculated lesion covered by intact mucosa at the midline posterior tongue near the circumvallate papillae. Contrast-enhanced cervical magnetic resonance imaging incidentally demonstrated a well-circumscribed cystic lesion posterior to the hyoid bone, suggestive of a suprahyoid TGDC. Under general anesthesia, the lingual mass was excised via an endoscope-assisted intraoral approach, followed by transcervical excision of the TGDC with partial segmental resection of the hyoid bone and en bloc removal of the thyroglossal duct tract extending approximately 5 cm superiorly. Histopathological examination confirmed the diagnosis of lingual osseous choristoma, showing mature lamellar bone covered by stratified squamous epithelium, and a thyroglossal duct cyst with characteristic cyst wall features. The patient recovered without complications, with intact swallowing function and no recurrence at 18 months. This case suggests that lingual osseous choristoma and suprahyoid TGDC may represent dual manifestations of residual mesenchymal tissue along the thyroglossal duct-hyoid embryological axis, giving rise to osseous and cystic lesions at distinct anatomical levels. These findings raise the possibility of an embryological link between posterior lingual osseous lesions and the thyroglossal duct system, highlighting the need for thorough imaging of the entire thyroglossal tract when encountering osseous lesions of the tongue base.
