Breast cancer (BC) remains the most common malignancy among women worldwide, with incidence and mortality rates continuing to rise. Alongside tumor heterogeneity and diverse clinical outcomes, increasing attention has been directed toward the role of the intratumoral microbiome as a regulator of breast tumorigenesis. Recent evidence demonstrates that breast tissue harbors one of the most diverse microbial communities compared with other cancer types, with marked differences between normobiota and malignant tissue. Intratumoral microorganisms are potentially associated with BC progression through multiple mechanisms, including modulation of inflammation, steroid hormone metabolism, and extracellular matrix remodeling. Specific taxa, including Staphylococcus , Bacillus , Fusobacterium , and Paenibacillus , have been associated with tumor aggressiveness, molecular subtypes, and patient prognosis. Moreover, the microbiome actively shapes the tumor microenvironment by altering immune infiltration, inducing resistance to anticancer therapy, and regulating immune checkpoint signaling, including PD‐1/PD‐L1 pathways. Microbial proteases and bacterial analogs of matrix metalloproteinases further contribute to extracellular matrix degradation and stromal remodeling, enhancing metastatic potential. Despite rapid advances, the clinical utility of intratumoral microbial signatures as predictive biomarkers of BC aggressiveness remains under investigation. Comprehensive characterization of microbial profiles across clinical and molecular subgroups may offer novel diagnostic, prognostic, and therapeutic opportunities in BC management.
Objective This study aims to compare and evaluate the dosimetric characteristics of five radiotherapy techniques in left‐sided breast cancer patients following breast‐conserving surgery. The five radiotherapy techniques include three‐dimensional conformal radiation therapy (3D‐CRT), fixed‐field intensity‐modulated radiation therapy (ff‐IMRT), volumetric modulated arc therapy (VMAT), hybrid 3D‐CRT with IMRT (CRT + IMRT), and hybrid 3D‐CRT with VMAT (CRT + VMAT). Patients and Methods Ten patients with left‐sided breast cancer who received postlumpectomy radiotherapy at the Department of Radiation Oncology, First Hospital of Qinhuangdao, between June 1, 2020, and June 1, 2021, were randomly enrolled in this study. For each patient, five distinct treatment plans were designed using the five aforementioned techniques (3D‐CRT, ff‐IMRT, VMAT, CRT + IMRT, and CRT + VMAT) based on identical computed tomography (CT) imaging datasets. Dosimetric parameters for the tumor target volume, organs at risk (OARs), and normal tissues (defined as body minus planning target volume [PTV], termed B‐P) were analyzed and compared using dose–volume histograms (DVHs) and isodose distributions. Results The CRT + VMAT technique demonstrated superior PTV dose coverage, conformity, and homogeneity compared to 3D‐CRT, ff‐IMRT, VMAT, and CRT + IMRT ( p < 0.05). In contrast, the VMAT technique achieved significantly lower V 30 (%) values for bilateral lungs and ipsilateral lung than 3D‐CRT, ff‐IMRT, CRT + IMRT, and CRT + VMAT ( p < 0.05). The CRT + IMRT technique reduced V 5 (%) values for bilateral lungs, ipsilateral lung, and heart compared to 3D‐CRT, ff‐IMRT, VMAT, and CRT + VMAT ( p < 0.05). Finally, 3D‐CRT required the fewest monitor units (MUs) and shortest treatment time among all techniques ( p < 0.05). Conclusion Clinicians may tailor radiotherapy plans to individual patients based on the distinct dosimetric profiles of each technique. For patients requiring optimal PTV dose distribution, the CRT + VMAT technique is suggest. For enhanced cardiopulmonary protection (e.g., reduced lung/heart doses), ff‐IMRT or CRT + IMRT may be prioritized. Additionally, 3D‐CRT should be the first choice for patients needing rapid fractionated treatment due to its efficiency in minimizing MUs and treatment time.
Background Male breast cancer (MBC) represents a rare type of malignant tumor, comprising less than 1% of all breast cancer cases. Therapies for MBC patients are typically adapted from breast cancer treatments in women. This study systematically performed a retrospective evaluation of the clinicopathological features and prognostic determinants to offer evidence for a therapeutic strategy for MBC patients. Methods A total of 29 MBC patients were selected from PLA General Hospital in China from 2006 to 2023 and 2589 patients were retrieved from the Surveillance, Epidemiology, and End Results database with their registration periods spanning from 2016 to 2020. The clinicopathological features between different groups were compared using Pearson’s chi‐square test ( χ 2 test) or Fisher’ s exact test, as appropriate. Multivariate Cox proportional hazards regression analysis was utilized to assess the predictors of overall survival (OS). Subgroup analyses were further conducted to evaluate the therapeutic efficacy across different stages. Results We identified 2618 patients totally. The primarily diagnosed median age of Chinese patients was younger than that of Western patients (59.8 years old vs 67.7 years old, p = 0.001). The infiltrating duct carcinoma was the most common pathological type for both groups. The subtypes ( p = 0.622) and stages ( p = 0.385) at diagnosis were similar between the two groups. Surgery at the primary site could improve the OS of MBC patients including Stage IV ( p = 0.019). In stratified subgroup analyses, postoperative chemotherapy significantly improved OS in stages T2N1‐3M0 and T3‐4N1‐3M0 MBC patients. Postoperative radiation was associated with favorable OS in early‐stage (T1N0M0) and locally advanced (T3‐4N1M0 and T1‐4N2‐3M0) MBC patients. Conclusions The median age at diagnosis for MBC patients in China was significantly younger compared to other populations. Postoperative chemotherapy significantly improved OS in patients with positive axillary lymph nodes and primary lesions exceeding 2 cm. Postoperative radiotherapy demonstrated survival benefits in partial early‐stage and locally advanced patients. Additionally, surgery at the primary site represented a viable therapeutic option for selected Stage IV patients. Trial Registration: Chinese Clinical Trial: ChiCTR2500110646
Background Erector spinae plane block (ESPB) and modified pectoral nerve block (PECS‐II) are being increasingly used to control pain following breast surgeries. However, evidence comparing their effects on postoperative analgesia and surgical stress response is limited. The current study compared analgesic efficacy and surgical stress response attenuation of ESPB and PECS‐II in patients undergoing modified radical mastectomy (MRM). Methods In this prospective, randomised, comparative study, 42 patients undergoing elective MRM were randomly divided to receive either ESPB or PECS‐II. Both groups received 30 mL of 0.2% ropivacaine with 0.5 μg/kg dexmedetomidine after induction of general anaesthesia (GA). The primary outcome was time to first rescue analgesia requirement. Secondary outcomes were postoperative numerical rating scale (NRS) scores, rescue analgesic consumption, intraoperative fentanyl requirement, serum cortisol, interleukin‐6 (IL‐6) and neutrophil‐to‐lymphocyte ratio (NLR), patient satisfaction and block‐related complications. Results The mean time to first rescue analgesia was significantly larger in the PECS‐II group than in the ESPB group (9.05 ± 1.12 h vs 6.95 ± 1.16 h; p < 0.001). Patients receiving PECS‐II had lower 24‐h diclofenac (114.3 ± 38.4 mg vs 146.4 ± 16.4 mg; p = 0.002) and tramadol consumption (7.1 ± 17.9 mg vs 23.8 ± 25.6 mg; p = 0.021). NRS scores were lower in the PECS‐II group at 6 h postoperatively ( p < 0.001). Intraoperative fentanyl requirement was comparable between the two groups ( p = 0.133). Postoperative serum cortisol (363.48 ± 41.79 vs 495.95 ± 52.20 nmol/L), IL‐6 (14.48 ± 4.39 vs 24.43 ± 6.33 pg/mL) and NLR (4.15 ± 0.55 vs 4.98 ± 0.85) were also lower in the PECS‐II group ( p ≤ 0.001). Patient satisfaction scores were higher following PECS‐II (5.62 ± 0.74 vs 5.05 ± 0.67; p = 0.022). No block‐related complications were observed in either group. Conclusion PECS‐II provided longer postoperative analgesia than ESPB in patients undergoing MRM under GA. Exploratory analyses showed lower postoperative analgesic consumption, lower pain scores at 6 h, lower postoperative stress response markers and higher patient satisfaction with PECS‐II. These secondary findings should be considered hypothesis‐generating and warrant confirmation in larger, adequately powered studies. Intraoperative fentanyl requirement was comparable between the two groups. Trial Registration: Clinical Trials Registry: CTRI/2024/04/066198
Background A systematic mapping of nonsurgical, lower‐cost primary prevention strategies for women at high risk of breast cancer remains limited. Objective To identify and summarize lower‐cost (i.e., lower economic cost relative to surgical and pharmaceutical alternatives; not dependent on expensive equipment, patented drugs, or complex medical procedures; implementable through community, family, or self‐management models), nonsurgical primary prevention strategies for women at high risk of breast cancer, providing empirical evidence to inform clinical practice, health education, and public health policy. Methods Following the Joanna Briggs Institute (JBI) methodology for scoping reviews and the Participants, Concept, and Context (PCC) framework, we systematically searched 9 Chinese and English databases. Search terms covered “breast cancer,” “high‐risk women,” “primary prevention,” and various nonsurgical strategies. Two independent reviewers performed literature screening and data extraction. Results Seventeen studies were included, and six prevention strategy categories were identified: nutritional dietary interventions, physical activity interventions, comprehensive lifestyle interventions, chemoprevention, digital health interventions, and health education with self‐management. Comprehensive lifestyle intervention emerged as the core strategy with robust evidence and manageable costs. Nutritional interventions have shifted from single nutrients to overall dietary patterns. Chemoprevention, limited by cost and side effects, is more suitable for very high‐risk women. Digital health interventions and health education offer advantages in medically underserved areas. Conclusion This scoping review systematically maps lower‐cost, nonsurgical primary prevention strategies for women at high risk of breast cancer, identifying six categories of promotable interventions. Comprehensive lifestyle intervention represents the most evidence‐supported and economically manageable core strategy. For the first time from the dual perspectives of “nonsurgical” and “lower cost,” this review provides practical references for primary healthcare systems, clinical education, and public health policy, with particular relevance for resource‐limited settings.
