This study aims to compare the clinical and patient-reported outcomes (PROs) between oncoplastic breast-conserving surgery (OBCS) and conventional breast-conserving surgery (CBCS) in early breast cancer (EBC) patients. Additionally, we applied machine learning (ML) to explore clinicopathologic variables associated with satisfaction with breasts, providing exploratory insights into individualized and patient-centered care in breast-conserving surgery (BCS). A retrospective analysis was conducted on 350 breast cancer patients who underwent either OBCS (n = 182) or CBCS (n = 168). Clinical data, including patient characteristics, surgical details, and complications, were collected and compared between the two groups. Patient satisfaction was measured using the BREAST-Q questionnaire. Disease-free survival (DFS) was analyzed using Kaplan–Meier survival curves. ML models were developed to predict satisfaction with their breasts. SHapley Additive exPlanations (SHAP) values were employed to determine the importance of variables in the optimal model. Patients in the OBCS group had significantly larger tumor sizes (23.0 ± 9.2 mm vs. 17.5 ± 6.2 mm, p < 0.001) and longer operative times (179 ± 50 min vs. 90 ± 43 min, p < 0.001) compared to the CBCS group. Despite these differences, complication rates were comparable between the groups. The OBCS group reported higher satisfaction with breasts (78 vs. 65, p < 0.001) and better psychosocial well-being (84 vs. 71, p < 0.001). Kaplan–Meier analysis showed no significant difference in DFS between the two groups during the available follow-up period (p = 0.267). ML model performance, evaluated through accuracy, ROC curves and calibration curves, identified the neural network (NN) (AUC: 0.76 and 0.77) as the optimal model in both the training and validation cohorts. SHAP analysis indicated that surgery type, menopause status, location of carcinoma and BMI were among the variables associated with breast satisfaction. OBCS was associated with higher breast satisfaction and psychosocial well-being than CBCS in this cohort, with no significant difference in long-term outcomes during the available follow-up period. ML and SHAP analysis provided exploratory insights into factors associated with breast satisfaction, highlighting the potential value of personalized approaches in BCS.

Background Male breast cancer (MBC) is a rare malignancy that has been under-investigated, with limited global epidemiological research dedicated to it. A comprehensive estimate of the global, regional, and national burden of MBC is valuable for policy planning. This study aims to evaluate the burden of MBC across 204 countries and territories. Methods MBC data were collected from the 2021 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates spanning from 1990 to 2021. The global incidence, prevalence, deaths, and disability-adjusted life-years (DALYs) attributed to MBC, as well as corresponding age-standardized rates, were calculated. Temporal trends, projections of incidence and mortality to 2050, lifetime risk, and risk factors of MBC were also estimated according to regions and countries. Findings In 2021, there were 38,827 (95% uncertainty interval [UI], 24,650-47,846) new cases, 320,459 (95% UI, 220,533-384,317) prevalent cases, 13,274 (95% UI, 9074-16,240) deaths, and 380,917 (95% UI, 252,922-476,417) DALYs attributed to MBC worldwide, with the highest disease burden observed in the Eastern Sub-Saharan Africa region. From 1990 to 2021, the age-standardized incidence and mortality rates of MBC significantly increased, but they are projected to decrease over the next 30 years. High-middle Socio-demographic Index (SDI) quintile had the highest lifetime risk of developing MBC, while the low SDI quintile had the highest lifetime risk of dying from MBC. Dietary risk and alcohol use were identified as important risk factors for MBC deaths and DALYs globally. Interpretation The global burden of MBC significantly increased from 1990 to 2021, with notable geographic disparities. Efforts aimed at MBC prevention and control strategies should take into account the inequities in its global distribution. Funding This study was supported by the National Natural Science Foundation of China (grant numbers 82372996 and 82202913) and the Chongqing Natural Science Foundation (grant number CSTB2023NSCQ-MSX0480). Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Introduction Autologous breast reconstruction (ABR) provides distinct aesthetic and functional advantages; however, its adoption in China remains relatively limited. This nationwide survey evaluated the current status, trends and institutional disparities in ABR practice across the country. Materials and methods A national cross-sectional survey was conducted in 2022 among 215 hospitals, with 198 valid responses (response rate = 92%). Data on institutional characteristics, reconstruction techniques, complications and influencing factors were collected and analysed. Results Among the hospitals performing breast reconstruction (n = 169), 110 (65.1%) offered ABR. The most common techniques were latissimus dorsi flaps (LDFs) (28.9%), LDF with implants (28.0%), pedicled transverse rectus abdominis myocutaneous (TRAM) (15.7%) and free abdominal flaps (12.9%). Compared with 2017, the use of LDF and pedicled TRAMs declined, whereas perforator-based procedures showed a notable rise. ABR was more prevalent in economically developed eastern regions and in hospitals equipped with plastic surgery departments. Considerable regional and institutional disparities persist in the availability and implementation of ABR. Conclusions ABR is steadily increasing in China, accompanied by a gradual shift towards perforator-based techniques such as deep inferior epigastric artery perforator flaps. However, its provision remains concentrated in tertiary centres with strong surgical capacity and multidisciplinary support. Addressing regional disparities through targeted training, resource allocation, and standardised practice guidelines will be key to improving equity and quality in breast reconstruction nationwide.

To investigate the treatment pattern, adverse events, and quality of life of Chinese patients treated with CDK4/6 inhibitors (CDK4/6i) for hormone receptor (HR)+/HER2- advanced breast cancer. This multicenter cross-sectional survey enrolled patients with HR+/HER2- advanced breast cancer currently treated with CDK4/6i. The patients reported adverse events and quality of life during CDK4/6i treatment with a questionnaire and EORTC QLQ-BR23. Meanwhile, the oncologists collected the treatment information, adverse events and patient characteristics from medical record. The analysis included 1254 patients. Most patients received only one CDK4/6i, of which 38.92

Background: HER2-positive breast cancer patients with a high risk of recurrence are recommended extended treatment involving sequential therapy with anti-HER2 monoclonal antibody followed by maintenance therapy with HER2-targeted tyrosine kinase inhibitor (TKI). Pyrotinib, an oral irreversible pan-HER TKI, commonly induces diarrhea. This study aims to develop strategies to reduce the incidence and severity of diarrhea and evaluate the efficacy and safety of pyrotinib as an extended adjuvant treatment for early-stage HER2-positive breast cancer. Methods: In this multicenter, prospective, randomized cohort study (ChiCTR2200060339), stage II-III HER2-positive high-risk breast cancer patients who had completed adjuvant treatment post-surgery, stratified by disease stage (II vs. III) and hormone receptor (HR) status (positive vs. negative), were randomized 1:1:1 into three cohorts to receive extended adjuvant therapy with 12 months of pyrotinib. Cohort 1 received pyrotinib 240 mg daily from D1-14, 320 mg from D15-28, and 400 mg from D29-364. Cohort 2 received pyrotinib 320 mg daily from D1-28 and 400 mg from D29-364. Cohort 3 received pyrotinib 400 mg daily from D1-364, combined with loperamide 4 mg thrice daily from D1-7 and twice daily from D8-28. The primary endpoint was the incidence of grade ≥3 diarrhea. Secondary endpoints included serious adverse events (AEs), other AEs, incidence of diarrhea, invasive disease-free survival, and overall survival. Results: Between June 2022 and May 2024, 102 patients were enrolled, with 34 patients in each cohort. Twelve patients (35.3%) in Cohort 1, 13 (38.2%) in Cohort 2, and 13 (38.2%) in Cohort 3 had ≥4 lymph nodes involved post-surgery. Additionally, 19 patients (55.9%) in Cohort 1, 21 (61.8%) in Cohort 2, and 19 (55.9%) in Cohort 3 were HR positive. Grade ≥3 diarrhea was reported in 9 (26.5%) patients in Cohort 1, 9 (26.5%) in Cohort 2, and 5 (14.7%) in Cohort 3. The median time to the first occurrence of grade ≥3 diarrhea was 15 days (range: 8-296) in Cohort 1, 4 days (range: 1-43) in Cohort 2, and 3 days (range: 1-14) in Cohort 3. The median number of grade ≥3 diarrhea episodes was 1 (range: 1-3) in Cohort 1, 3 (range: 1-4) in Cohort 2, and 1 (range: 1-2) in Cohort 3. The median duration of each grade ≥3 diarrhea episode was 1 day (range: 1-2) in Cohort 1, 1 day (range: 1-4) in Cohort 2, and 1 day (range: 1-3) in Cohort 3. Dose reduction due to diarrhea occurred in 2 (5.9%) patients in Cohort 1, 7 (20.6%) in Cohort 2, and 10 (29.4%) in Cohort 3. Dose interruption for diarrhea was observed in 14 (41.2%) patients in Cohort 1, 15 (44.1%) in Cohort 2, and 16 (47.1%) in Cohort 3. Discontinuation of pyrotinib due to diarrhea was reported in 2 (5.9%) patients in Cohort 1, 4 (11.8%) in Cohort 2, and 2 (5.9%) in Cohort 3. The most common AEs were diarrhea (79.4% vs. 91.2% vs. 88.2%), nausea (17.6% vs. 20.6% vs. 44.1%), vomiting (11.8% vs. 8.8% vs. 35.3%), fatigue (14.7% vs. 17.6% vs. 26.5%), abdominal pain (8.8% vs. 11.8% vs. 20.6%), and abdominal distension (5.9% vs. 5.9% vs. 17.6%). Grade 1 constipation was observed in 1 patient (2.9%) in Cohort 1, 1 patient (2.9%) in Cohort 2, and 3 patients (8.8%) in Cohort 3. Conclusions: Loperamide prophylaxis showed a numerically lower incidence of grade ≥3 diarrhea. Diarrhea is a predictable and manageable side effect of pyrotinib treatment, occurring early after initiation and rarely in the later treatment course. It is advisable to combine loperamide with pyrotinib to reduce grade ≥3 pyrotinib-induced diarrhea. Additionally, timely adjustment of loperamide dose is necessary to prevent other gastrointestinal AEs, such as nausea and abdominal distension. Citation Format: Qiao Cheng, Hongyuan Li, Xiaowei Qi, Zhen Zhang, Fuyun Tong, Maoshan Chen, Hai Lei, Lei Xing, Xiang Zhang, Mengyuan Wang, Chao Zhang, Chunyan Li, Qian Wang, Yuxian Wei, Fan Li, Jinxiang Tan, Xuedong Yin, Yixiao Feng, Xiaoyi Wang, Man Huang. Optimizing Tolerability of Pyrotinib in HER2-Positive Early-Stage High-Risk Breast Cancer: A Multicenter, Randomized, Three-Cohort Study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P1-04-12.

INTRODUCTION:Although autologous fat grafting has been widely adopted globally to improve poor cosmetic outcomes following breast cancer surgery, oncologic concerns persist regarding the potential risk of cancer recurrence associated with fat transfer performed near the tumor bed. We sought to prospectively evaluate the oncologic safety and clinical benefits for breast cancer women undergoing breast-conserving surgery (BCS) with immediate autologous fat grafting (IAFG). METHODS:This multicenter, prospective, randomized controlled clinical trial enrolled 360 women diagnosed with breast cancer between 3 March 2017 and 31 May 2021. Participants were randomly assigned in a 1:1 ratio to either the BCS with IAFG (IAFG group) or the BCS without IAFG (control group). The primary outcomes were the cumulative incidence rates of locoregional and systemic recurrence. The secondary outcomes included adverse events, patient's satisfaction, and psychosocial well-being. RESULTS:The average volume resected and volume grafted were 45.5 g and 66.5 mL, respectively, in the IAFG group. At a median follow-up period of 62.8 months (range: 4.3-86 months), the proportions of local relapse were 0.6% and 2.4% in the IAFG group and the control group, respectively (P = 0.65). There was no increased risk of distant recurrence (3.6% vs. 3.5%) or breast cancer-specific mortality (0.6% vs. 0.6%) in the IAFG group. Among the secondary outcomes, the occurrence rates of complications were similar; however, the IAFG group showed significantly higher scores of satisfaction with breast appearance, psychosocial well-being, and sexual well-being than the controls (78 vs. 65, P < 0.001; 83 vs. 71, P < 0.001; 74 vs. 66, P < 0.001, respectively). CONCLUSION:Our results provide clear evidence that IAFG is a safe and effective surgical technique that does not increase the risk of local or distant recurrence in breast cancer patients and yields higher satisfaction with postoperative breast appearance and psychosocial outcomes.

Bone health management for breast cancer spans the entire cycle of patient care, including the prevention and treatment of bone loss caused by early breast cancer treatment, the adjuvant application of bone-modifying agents to improve prognosis, and the diagnosis and treatment of advanced bone metastases. Making good bone health management means formulating appropriate treatment strategies and dealing with adverse drug reactions, and will help to improve patients' quality of life and survival rates. The Breast Cancer Expert Committee of the National Cancer Center for Quality Control organized relevant experts to conduct an in-depth discussion on the full-cycle management of breast cancer bone health based on evidence-based medicine, and put forward reasonable suggestions to guide clinicians to better deal with health issues in bone health clinics.

Background The global BOLERO-2 trial established the efficacy and safety of combination everolimus (EVE) and exemestane (EXE) in the treatment of estrogen receptor positive (ER +), HER2-, advanced breast cancer (ABC). BOLERO-5 investigated this combination in a Chinese population (NCT03312738).Methods BOLERO-5 is a randomized, double-blind, multicenter, placebo controlled, phase II trial comparing EVE (10 mg/day) or placebo (PBO) in combination with EXE (25 mg/day). The primary endpoint was progression-free survival (PFS) per investigator assessment. Secondary endpoints included PFS per blinded independent review committee (BIRC), overall survival (OS), overall response rate (ORR), clinical benefit rate (CBR), pharmacokinetics, and safety.Results A total of 159 patients were randomized to EVE + EXE (n = 80) or PBO + EXE (n = 79). By investigator assessment, treatment with EVE + EXE prolonged median PFS by 5.4 months (HR 0.52; 90% CI 0.38, 0.71), from 2.0 months (PBO + EXE; 90% CI 1.9, 3.6) to 7.4 months (EVE + EXE; 90% CI 5.5, 9.0). Similar results were observed following assessment by BIRC, with median PFS prolonged by 4.3 months. Treatment with EVE + EXE was also associated with improvements in ORR and CBR. No new safety signals were identified in BOLERO-5, with the incidence of adverse events in Chinese patients consistent with the safety profile of both drugs.Conclusion The efficacy and safety results of BOLERO-5 validate the findings from BOLERO-2, and further support the use of EVE + EXE in Chinese post-menopausal women with ER + , HER2- ABC. NCT03312738, registered 18 October 2017.

1054 Background: It is reported that the adverse event (AE) profile may vary with different CDK4/6 inhibitors. With the prolongation of survival, AEs occurred during the treatment period may affect quality of life (QoL) for patients with advanced disease. Currently, there has been no study focusing on the safety and patient-reported outcomes in Chinese patients treated with different CDK4/6 inhibitors. Methods: This was a large cross-sectional study conducted at 10 sites in China. Randomly selected patients with hormone receptor-positive, HER2-negative advanced breast cancer and their physicians were asked to fill the self-designed questionnaires. Disease characteristics and AEs were collected from the perspectives of both patients and physicians, while the patient questionnaire additionally included feedback on the AE management and the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire-breast cancer module (QLQ-BR23). Results: Between Jan 30, 2023 and Sep 15, 2023, a total of 1254 patients (median age, 55 years) were included; 212 (16.9%) patients were treated with palbociclib, 483 (38.5%) with abemaciclib, 550 (43.9%) with dalpiciclib, and 9 (0.7%) with ribociclib. Of them, 197 (15.7%) had switching history or dose adjustment of CDK4/6 inhibitor, with the main reason being AEs (51.8%). From the perspective of physicians, the most common AEs for patients were decreased white blood cell (63.3%), decreased neutrophil count (58.7%), and diarrhea (36.3%). The incidence of increased alanine aminotransaminase (ALT) and increased aspartate aminotransaminase (AST) was 9.3% (grade ≥3, 6.0%) and 8.4% (grade ≥3, 6.7%), respectively. Dalpiciclib showed the lowest incidence of increased ALT (3.5%; grade ≥3, none), increased AST (4.2%; grade ≥3, none), and diarrhea (10.5%) compared with other CDK4/6 inhibitors (P<0.001). From the perspective of patients, dalpiciclib showed the lowest incidence of fatigue, alopecia, hot flashes, insomnia, arthralgia, nausea, vomiting, diarrhea, and anorexia (P<0.05). Regarding QoL, the mean scores of upset by hair loss for different CDK4/6 inhibitors were higher than other symptom subscale scores. Dalpiciclib showed the lowest mean score of upset by hair loss compared with abemaciclib and palbociclib, whether in total (19.74 vs 27.23 vs 21.47, P=0.006) or in patients with >6 months of treatment (12.59 vs 27.78 vs 17.95, P<0.001). Conclusions: AEs are different among various CDK4/6 inhibitors. Dalpiciclib has the lowest risk of diarrhea and hepatotoxicity based on physicians' reports, and shows the best patient-perceived safety. Regarding QoL, CDK4/6 inhibitors can result in upset by hair loss, while patients have the least concern about this issue when using dalpiciclib, especially for those with long treatment duration (>6 months).

ObjectiveThis study aimed to explore possible associations between molecular subtypes and site of distant metastasis in advanced breast cancer (ABC).Methods3577 ABC patients were selected from 21 hospitals of seven geographic regions in China from 2012-2014. A questionnaire was designed to collect medical information regarding demographic characteristics, risk factors, molecular subtype, recurrence/metastasis information, and disease-free survival (DFS). The cancers were classified into Luminal A, Luminal B, HER2-enriched and Triple Negative subtypes. Chi-square test and multivariate Cox proportional hazard models were performed to explore the associations between molecular subtypes and distant metastasis sites.ResultsA total of 2393 cases with molecular subtypes information were finally examined. Patients with Luminal A (51.1%) and Luminal B (44.7%) were most prone to bone metastasis, whereas liver metastasis was more frequently observed in HER2-enriched ABC patients (29.1%).The cumulative recurrence and metastasis rates of ABC patients at 36 months of DFS were the most significant within molecular types, of which Triple Negative was the highest (82.7%), while that of Luminal A was the lowest (58.4%). In the adjusted Cox regression analysis, Luminal B, HER2-enriched and Triple Negative subtypes increased the risk of visceral metastasis by 23%, 46% and 87% respectively. In addition, Triple Negative patients had a higher probability of brain metastasis (HR 3.07, 95% CI: 1.04-9.07).ConclusionMolecular subtypes can predict the preferential sites of distant metastasis, emphasizing that these associations were of great help in choices for surveillance, developing appropriate screening and cancer management strategies for follow-up and personalized therapy in ABC patients.

Background: The prevalence, awareness, treatment and the hemoglobin A1c (HbA1c) diagnostic cut-off points of diabetes and prediabetes in Chinese breast cancer (BC) women is unknown. We estimated the prevalence, awareness, treatment and investigate the HbA1c diagnostic cut-off points of diabetes and prediabetes in Chinese BC women at early stage.Methods: We conducted the data from 7995 initially diagnosed Chinese BC women without distant metastasis and 767 BC women without diagnosed diabetes who have undergone oral glucose tolerance test (OGTT) and insulin release test (IRT) from China Database for Concomitant Disease of Breast Cancer (CDCDBC) between 2012 to 2020. Primary outcomes were total diabetes and prediabetes defined according to the American Diabetes Association criteria. Awareness, treatment, and control of diabetes were also evaluated. HbA1c<7.0%, blood pressure (BP) <130/80 mm Hg, and low-density lipoprotein cholesterol (LDL-C)<100 mg/dL (2.6mmol/L) or individualized LDL-C targets were considered adequate glycemic, BP, or lipid control, respectively. The cut-off points of HbA1c for diagnosis of diabetes and prediabetes were determined by the receiver operating characteristic (ROC) curve.Findings: Among 7995 Chinese BC women, the estimated prevalence of total diabetes was 24.4% (95% CI, 23.4%-25.3%); that of prediabetes, 50.0% (95% CI, 48.9%-51.1%); and that of diagnosed diabetes, 4.3%. Among BC women with diabetes, only 17.5% (95%CI, 15.8%-19.2%) were aware of their diagnosis and 13.2% (95%CI, 11.8%-14.7%) were treated; 33.6% (95%CI, 24.9%-42.3%) of patients treated achieved adequate glycemic control. 34.9% (95%CI, 27.2%-42.6%), 44.1% (95%CI, 38.8%-49.3%), and 25.3% (95%CI, 19.7%-30.9%) of Chinese BC women with diagnosed diabetes achieved HbA1c<7.0%, BP<130/80 mm Hg, and individualized LDL-C targets, respectively.Using OGTT as reference, the optimal cut-off points of HbA1c for diagnosis of diabetes and prediabetes were 6.0% & 5.4% [the area under the ROC curve were 0.903 (P<0.001, 95%CI, 0.867-0.938) & 0.703 (P<0.001, 95% CI, 0.632-0.774), the sensitivity were 78.1% & 76.9%, and the specificity were 86.4% & 51.8%], respectively.Interpretation: Diabetes and prediabetes were highly prevalent in Chinese BC women but with much lower awareness, treatment, and glycol control rates, indicating the pivotal of diabetes as a severe health problem in Chinese BC women.Funding: None.Declaration of Interest: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.Ethical Approval: This study received approval from Ethics Committee of the First Affiliated Hospital of Chongqing Medical University. Informed consent was not obtained as this was a retrospective study.

Metastatic vascular calcification and calcinosis universalis, as severe complications of parathyroid hyperfunction and hyperparathyroidism, have attracted more attention in patients with renal secondary hyperparathyroidism and primary hyperparathyroidism. But, they are of little concern in patients with long-term negative calcium balance related parathyroid hyperfunction or hyperparathyroidism caused by calcium and/or vitamin D insufficiency (CVI). CVI is common in the population. Relatively low level of serum calcium and negative calcium balance caused by long-term CVI result in parathyroid hyperfunction or hyperparathyroidism, which may cause secretion of PTH beyond the physiological level, leading to bone absorption and release of a large amount of bone calcium into the blood. It may not only cause bone loss and osteoporosis, but also form metastatic vascular calcification or calcinosis universalis presented by cardiovascular diseases and other multi-organ lesions. Early calcium deposition can gradually fade after reasonable treatment, but middle arterial calcification is not easy to fade once it occurs. Therefore, vascular calcification and calcium deposition should be actively prevented and early screened and diagnosed. The early prevention, diagnosis and treatment of parathyroid hyperfunction or hyperparathyroidism can prevent, delay, or even reverse the occurrence and development of metastatic vascular calcification and calcinosis universalis, which is significant for disease prevention and protecting the patients' health influenced by these diseases.

Background: Conventional breast conserving surgery (CBCS) considered as a confined alternative to mastectomy could lead to potentially breast deformities. Oncoplastic breast conserving surgery (OBCS) as well as breast conserving surgery (BCS) plus immediate lipofilling have been shown to be reliable techniques for maintaining the natural breast contours, however, few studies compared those three surgical options for oncological safety, complications and aesthetic outcomes in early breast cancer (EBC). Methods: We retrospectively reviewed the data of BC patients who underwent BCS between January 2017 and December 2021 from The First Affiliated Hospital of Chongqing Medical University. We included female patients who received BCS for unilateral stage 0-III BC. Those who had bilateral BC, incomplete surgical records, unfinished adjuvant therapy, multiple primary malignant tumors and lost to follow-up and were excluded. Patient-reported outcome measures (PROMs) were assessed using the BREAST-Q Version 2.0. We utilized a multivariable linear regression model to identify clinical factors correlated with the BREAST-Q score, and the log-rank test and Cox regression models were used to compare the survival difference between groups. Results: Of 268 patients, 90 (33.6%) underwent CBCS, 53 (19.8%) underwent OBCS and 125 (46.6%) underwent BCS plus immediate lipofilling. Patients in OBCS and BCS plus immediate lipofilling groups were younger than those in CBCS group (mean age: 43.9yrs vs 49.1yrs, P=0.001 and 45.7yrs vs 49.1yrs, P=0.008). The largest tumor size and heaviest BCS specimen were observed in the OBCS group compared with CBCS (mean tumor size: 23.4mm vs 17.3mm, P< 0.001 and median excised weight: 122.0g vs 36.5g, P< 0.001) and BCS plus immediate lipofilling group (mean tumor size: 23.4mm vs 17.4mm, P< 0.001 and median excised weight: 122.0g vs 37.0g, P< 0.001). It was balanced for pathological type, Ki-67, ER and PR expression between three groups. In the multivariable linear regression models, with the CBCS group as referent, either OBCS or BCS plus immediate lipofilling groups had a significantly higher score in satisfaction with breast (Estimate: 9.27, P=0.001 and Estimate: 13.08, P< 0.001) and psychosocial well-being (Estimate: 6.06, P=0.021 and Estimate: 9.34, P< 0.001). Additionally, sexual well-being was improved among patients receiving BCS plus immediate lipofilling (Estimate: 6.19, P=0.029). Nevertheless, patients in OBCS group harbored worse physical well-being compared with CBCS (Estimate: -15.89, P< 0.001). There was no significantly statistical difference among three groups on re-excision rate (P=0.721) and postoperative complications (P=0.663). After 37-month median follow-up, identical event-free survival (EFS) was revealed among three groups (HROBCS vs CBCS: 3.93; 95%CI, 0.78-19.81, P=0.098; HRBCS plus Lipofilling vs CBCS: 1.15, 95%CI, 0.28-4.67, P=0.847). Conclusion: This study demonstrated that OBCS as well as BCS plus immediate lipofilling shared equivalent oncological safety but better cosmetic outcomes and patient satisfaction when compared with CBCS for EBC patients, suggesting that further prospective randomized clinical trials are warranted to confirm our findings. Citation Format: JH Ren, Yuanyuan Wang, Xiang Zhang, Kang Wang, Renxi Tang, Ling Yang, Junge Gong, Jiawei Xu, Qing Li, WM Zhu, Qiao Cheng, Guosheng Ren, Hongyuan Li. Comparisons of aesthetic outcomes and prognosis of conventional breast conserving surgery, oncoplastic breast conserving surgery and breast conserving surgery plus immediate lipofilling in early breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-09-08.

三阴性乳腺癌和HER-2阳性乳腺癌患者新辅助化疗后pCR率较高，而高pCR率会使患者生存获益。激素受体(HR)阳性、HER-2阴性乳腺癌患者则较难通过新辅助化疗达到pCR，新辅助化疗对HR阳性、HER-2阴性乳腺癌患者的治疗效果是否优于术后辅助化疗也尚不清楚。因此，笔者针对HR阳性、HER-2阴性乳腺癌患者接受新辅助化疗后的临床疗效、预后以及影响疗效的相关因素等方面进行综述，为对此类患者制定个体化治疗方案提供参考。

Purpose Approximately 25-30% of patients suffer from breast deformity and/or asymmetry after conventional breast-conserving surgery (CBCS). Generally, it is thought that oncoplastic breast-conserving surgery (OBCS) results in an improved cosmetic result; however, studies comparing the prognosis and aesthetic outcomes of CBCS and OBCS in early breast cancer (EBC) are inadequate.Methods A total of 143 patients were included in this retrospective cohort study; 53 underwent OBCS and 90 underwent CBCS. The resected weight, complications, esthetic results, patient satisfaction, and recurrence rate were compared between the groups. Patient-reported outcomes (PRO) were assessed by the BREAST-Q questionnaire.Results The mean age of the patients in OBCS group was 43.8 years. This was younger than that in CBCS group (49.1 years, p < 0.001). Postoperative complications (11.3% vs. 8.9%, p = 0.64) and re-excision (5.7% vs. 6.7%, p > 0.99) rates were similar. The OBCS group had higher breast satisfaction and psychosocial well-being than the CBCS group (75 vs. 63, p < 0.001 and 84 vs. 77, p = 0.05); however, sexual well-being (56 vs. 66, p = 0.05) and physical well-being (65 vs. 76, p < 0.001) were worse in OBCS. After 42.3 (range: 12.6-69.2)-month median follow-up, no difference in event-free survival (EFS) was demonstrated between the groups (p = 0.13).Conclusion Although OBCS has the better aesthetic outcomes and identical oncological safety in comparison with CBCS, the sexual and physical well-being in OBCS are not improved for Asian patients. Hence, choosing an appropriate procedure may be more important for the typically small to moderate-sized breasts characteristic of Asian females unlike Westerners.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

"因地制宜"选择手术 "新辅助化疗后效果很好的病人,如果现阶段可以延期手术,允许延迟三周内手术."对此,在国内最大患者互助社区觅健平台上,重庆市医科大学附属第一医院内分泌乳腺外科主任医师厉红元介绍说,新辅助化疗后肿块没有缩小反而开始增大时,给患者带来很大困扰,影响患者的生存预后,应因地制宜选择治疗.

BACKGROUND Reproductive period for women, begins at menarche and ends at menopause, which represented the total time period of exposure to cycling reproductive hormones. The potential associations between clinicopathological features and the exposure of cycling reproductive hormones has not been extensively studied. The retrospective study enrolled 14,731 patients diagnosed with invasive breast cancer was designed to evaluate factors associated with the reproductive period on breast cancer type and patient outcomes. MATERIAL AND METHODS 14, 731 female breast cancer (BC) patients from Western China Clinical Cooperation Group (WCCCG) between January 1, 2008 to December 31, 2017 were identified. Unconditional logistic regression was performed to assess the associations between clinicopathological features and menarche age, menopause age, and reproductive years. The differences in risk factors between lower and higher number of reproductive years (<35 and ³35 yrs) were examined with the chi-square test. RESULTS First, patients with late menarche age were more likely to present with tumors of higher histological grade and larger sizes. Second, the findings suggested a higher likelihood of smaller tumor sizes in postmenopausal patients with a greater length of reproductive years. Conversely, higher histological grade was associated with this group of patients, compared to their counterparts with shorter reproductive years. Third, in luminal breast cancer, patients with a greater length of reproductive years were more probably present larger tumor. CONCLUSIONS Our findings indicated that several clinicopathologic factors including tumor size and histological grade were associated with the length of reproductive years in patients diagnosed with breast cancer.

乳房重建手术可以解决乳腺癌根治手术后的乳房缺失,但乳房重建后皮瓣缺血、坏死、感染等并发症会导致住院时间延长、再次手术、重建失败等问题,尤其是皮瓣坏死,会显著增大乳房重建失败的风险.吲哚菁绿造影技术是应用最广泛的方法之一,但在方法学及造影结果的分析等方面仍未达成共识.该综述根据国内外现有相关文献分析了激光辅助吲哚菁绿血管造影技术在乳房重建术中的使用情况,分析其价值并认为该技术在中国人群中的应用仍值得进一步探讨.