Purpose Kidney diseases substantially increase breast cancer (BC)-related mortality. This study explored the status of renal function and ultrasound manifestations in Chinese women with initially diagnosed BC. Methods A total of 7,052 female patients with initially diagnosed BC and 70,520 age-matched controls from the health screening population during the same period were included from 2012 to 2020. Renal function data, including estimated glomerular filtration rate based on serum creatinine (eGFRcr), and renal ultrasound data were collected. Group differences were analyzed using the Mann-Whitney U test and the chi-square test. Results (1) BC patients had poorer renal function than controls, manifested by higher rates of: hypercreatinemia (7.69% vs. 5.53%), hyperuremia (5.80% vs. 3.96%), eGFRcr < 90 ml/min/1.73m 2 (21.27% vs. 17.08%), and eGFRcr < 60 ml/min/1.73m 2 (1.66% vs. 1.22%); all P < 0.001. (2) BC patients showed lower proportions of hyperuricemia ( 2.78% vs. 2.92%, P = 0.006). (3) BC patients had higher rates of hypocalcemia (7.07% vs. 4.09%), hyperphosphatemia (2.36% vs. 0.88%), and hypoalbuminemia (20.24% vs. 0.68%), all P < 0.001. (4) Abnormal renal ultrasound manifestations were more common in BC patients: renal cysts: 12.06% vs. 7.85%, renal/ureteral stones: 4.23% vs. 3.13%, hydronephrosis: 0.90% vs. 0.44%, all P < 0.001. Conclusion Chinese women with initially diagnosed BC exhibit poorer renal function, lower serum uric acid, and higher rates of hypocalcemia, hyperphosphatemia, hypoalbuminemia, and renal ultrasound abnormalities such as cysts and stones.

The relationship between metabolic associated fatty liver disease (MAFLD) and thyroid nodule (TN) is unknown, despite the overweight obese individuals showed a greater risk of nonalcoholic fatty liver disease(NAFLD) and thyroid cancer compared to the normal Body mass index(BMI) individuals. This is a cross-sectional study examining the association between TN and MAFLD in healthy Chinese population undergoing simultaneous abdominal and thyroid ultrasonography. A total of 78,077 healthy individuals with complete biochemical, thyroid and liver ultrasonography data from the Quality Control Center of Health Examination in Chongqing, China were included in the study. TNs were classified into malignancy risk levels of 5 different categories in accordance with Thyroid Imaging Reporting and Data System(TI-RADS). We investigated the association between MAFLD and TNs by binomial logistic regression analyses, and multinomial logistic regression analyses were performed to test the independence of associations between TNs or different TI-RADS categories of TNs and MAFLD.This study was designed and reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines to ensure transparency and completeness in reporting observational research. The prevalence of TN, MAFLD and combined TN with MAFLD were 30.4

Primary hyperparathyroidism (PHPT) is the third most common endocrine disorder and is traditionally considered to result from intrinsic pathology. However, this traditional view is challenged by several persistent clinical and epidemiological observations. Therefore, we hypothesize that some cases of PHPT may not be truly primary in origin. Some of them may be irreversible secondary hyperparathyroidism (tertiary hyperparathyroidism), which may be initiated and perpetuated by widely existed chronic calcium and/or vitamin D insufficiency. The “primary” (in fact, irreversible secondary hyperparathyroidism or “tertiary” hyperparathyroidism) and “secondary” hyperparathyroidism states are not dichotomous but are linked through a process of chronic stimulation, adaptive hyperplasia, and eventual clonal transformation. This model is supported by epidemiological evidence demonstrating an association between low lifelong calcium intake and increased PHPT risk, physiological evidence of persistent PTH suppressibility by calcium intake, and the high rate of clinical misdiagnosis between primary and secondary hyperparathyroidism. If validated, this reframing would mandate a paradigm shift in the understanding and management of PHPT or irreversible secondary hyperparathyroidism. It emphasizes the critical need to rigorously identify and correct underlying nutritional deficiency as a fundamental diagnostic and therapeutic step, transforming the management approach from a predominantly surgical model to one focused on prevention, early medical intervention, and addressing a key modifiable environmental cause

Background/Objectives: This study aimed to evaluate whether artificial intelligence-derived vertebral volumetric bone mineral density (AI-vBMD) and paraspinal intermuscular adipose tissue (IMAT) ratio from routine computed tomography (CT) could identify moderate-to-severe vertebral compression fractures (VCFs) in breast cancer survivors, and whether paraspinal IMAT ratio and routinely available clinical variables improved diagnostic performance. Methods: This retrospective study included 275 women with breast cancer who underwent routine non-contrast CT and lumbar quantitative computed tomography (QCT). Hounsfield unit-derived volumetric bone mineral density (HU-vBMD) was derived using a QCT-referenced HU-to-vBMD conversion equation, whereas AI-vBMD and paraspinal IMAT ratio were extracted using automated software. Moderate-to-severe VCF was defined as Genant grade ≥ 2. Agreement with QCT-vBMD was assessed using correlation, intraclass correlation coefficient (ICC), and Bland-Altman analysis. Model discrimination was evaluated using receiver operating characteristic analysis and DeLong tests. Results: Moderate-to-severe VCF was present in 75 patients (27.3%). HU-vBMD and AI-vBMD showed excellent agreement with QCT-vBMD (ICC, 0.978 and 0.987, respectively). AI-vBMD outperformed HU-vBMD for identifying VCFs (AUC, 0.738 vs. 0.714; p < 0.001). IMAT ratio showed comparable standalone discrimination to AI-vBMD (AUC, 0.760 vs. 0.738; p = 0.604). Adding IMAT ratio to AI-vBMD improved discrimination (AUC, 0.786 vs. 0.738; p = 0.038). The full model incorporating clinical covariates achieved the highest AUC (0.828; 95% CI, 0.778-0.878). Conclusions: AI-vBMD and paraspinal IMAT ratio automatically extracted from routine CT improved the diagnostic assessment of prevalent moderate-to-severe VCFs in breast cancer survivors. This study supports an automated CT-based approach that integrates vertebral bone density and paraspinal muscle-fat information for opportunistic identification of clinically relevant VCFs.

Cohort studies have suggested that breast-conserving therapy (BCT) offers better survival outcomes compared to mastectomy in patients with early breast cancer (BC). However, survival comparisons between BCT and mastectomy with breast reconstruction (Mastectomy + BR) are lacking. To investigate this, we conducted a cohort study using data from the SEER database. Patients with first-diagnosed locoregional BC between 2010 and 2016 were included and categorized into BCT and Mastectomy + BR groups. Propensity score matching (PSM) was performed to reduce selection bias. Breast cancer-specific survival (BCSS) and overall survival (OS) were compared between the groups. After PSM, 56,420 patients were matched (1:1) into the BCT and Mastectomy + BR groups. No significant differences in BCSS or OS were observed between the two matched groups overall. However, subgroup analyses based on tumor size and nodal status showed that, among patients with node-negative and tumors ≤ 5 cm, Mastectomy + BR was associated with decreased BCSS compared to BCT (HR 1.23, 95% CI 1.02-1.49, P = 0.03). Inferior BCSS for Mastectomy + BR was also observed in tumors located in the upper-outer quadrant (HR  1.54, 95% CI 1.07-2.20, P = 0.02), nipple & central area (HR 4.98, 95% CI 1.44-17.21, P = 0.01), and in triple-negative BC (HR  1.45, 95% CI 1.07-1.98, P = 0.02). Additionally, in triple-negative BC, Mastectomy + BR was associated with worse OS (HR  1.33, 95% CI 1.00-1.76, P = 0.048). For patients with node-positive or tumors > 5 cm, no significant differences in BCSS or OS were found between the BCT and Mastectomy + BR groups, except in the HER2-enriched subtype, where Mastectomy + BR was associated with improved BCSS (HR 0.43, 95% CI 0.22-0.85, P = 0.015) and a marginal better OS (HR 0.54, 95% CI 0.29-1.01, P = 0.055). This study suggests that, except for the HER2-enriched subtype, BCT remains an equivalent or, in specific clinical scenarios, a superior alternative to Mastectomy + BR for the treatment of breast cancer.

Background This study investigated the clinicopathological differences among breast cancer patients with distinct hepatitis B virus serological profiles.Methods Data were collected from 5004 female patients newly diagnosed with breast cancer at the First Affiliated Hospital of Chongqing Medical University between 2012 and 2020. A comparative analysis was conducted to determine intergroup differences in clinicopathological characteristics among breast cancer patients with distinct hepatitis B virus serological profiles.Results Of the 5004 patients, 8.0% were infected with hepatitis B virus, 55.6% had prior hepatitis B virus infection, and 13.8% were positive only for hepatitis B surface antibody (HBsAb). Hepatitis B virus-infected patients demonstrated a higher incidence of liver enzyme abnormalities (14.1%) and a lower incidence of Ki67 >= 20% (54.2%) than HBsAb(+) patients (61.0%). HBsAb(+) patients showed lower progesterone receptor and hormone receptor positivity than hepatitis B virus-negative patients (51.7% vs. 57.2% and 65.5% vs. 70.4%, respectively). Logistic regression analysis indicated that hepatitis B virus-infected patients had a higher incidence of liver dysfunction (odds ratio: 1.535) but a lower incidence of Ki67 >= 20% (odds ratio: 0.777). Patients with hepatitis B virus infection had lower hormone receptor (odds ratio: 0.829) and human epidermal growth factor receptor 2 (odds ratio: 0.788) positivity.Conclusions The hepatitis B virus serological status influences the clinicopathological features of breast cancer, particularly Ki67, hormone receptor, and human epidermal growth factor receptor 2 expression. Routine hepatitis B virus screening and monitoring are crucial during breast cancer diagnosis and chemotherapy.

Background: Breast cancer patients with hepatitis B virus (HBV) infection or past HBV infection face heightened risks of chemotherapy-induced hepatotoxicity and HBV reactivation (HBVr). This study aims to evaluate the impact of different HBV serological statuses on the safety of chemotherapy regimens based on paclitaxel throughout the treatment cycle. Methods: This retrospective cohort study analyzed 4562 female breast cancer patients, categorized into three groups: 366 with HBV infection (HBsAg+), 2529 with past HBV infection (HBsAg−/HBcAb+), and 1667 without HBV infection (control group). The Primary events included liver injury, HBVr, treatment interruption, and laboratory indicator evaluation. Demographic characteristics and periodic laboratory parameters were recorded for within-subject longitudinal analysis. Results: Before chemotherapy, the incidence of liver injury was highest in the HBV-infected group (18.2%), intermediate in the past-infection group (13.2%), and lowest in the control group (12.0%). Throughout chemotherapy, the cumulative incidence of liver injury remained highest in the HBV-infected group (83.2%), compared to the past-infection (71.2%) and control (70.9%) groups. Chemotherapy interruption rates followed a similar gradient: 12.4% in the HBV-infected group, 6.9% in the past-infection group, and 5.5% in the control group. HBV-infected patients had a significantly higher risk of hepatotoxicity than controls during cycle 4 (relative risk 1.56, 95% CI 1.06 to 2.29) and cycle 5 (1.28, 1.09 to 1.75). HBVr occurred in 13 patients with HBV-infected. Conclusions: HBV serological status significantly impacts chemotherapy safety and treatment interruption. Prophylactic antiviral therapy and intensified monitoring during high-risk cycles (cycle 4 and cycle 5) are critical. These findings underscore the necessity of stratified management for HBV-affected breast cancer patients during chemotherapy.

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.

Background: For papillary thyroid cancer (PTC) patients, no consensus has been reached for the impact of diagnosis-to-treatment interval (DTI) on patient survival outcomes. We evaluated the impact of DTI on prognosis among patients with PTC. Methods: Patients diagnosed as PTC were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2019. The initial treatment strategies include surgery, radiation therapy, chemotherapy, hormone, immunotherapy, and/or active surveillance according to the SEER. Patients were grouped as follows: (I) DTI 0 (interval < 1 month or immediate treatment), (II) DTI 1-3 months, (III) DTI 4-5 months, and (IV) DTI >= 6 months. Results: A total of 168,969 patients with PTC were included in this cohort study. Median follow-up time was 84.0 months. No significant overall survival (OS) difference was observed between patients with immediate treatment and DTI 1-3 months. However, DTI 4-5 months and >= 6 months were associated with poorer OS compared to patients with immediate treatment. Although Kaplan-Meier analysis suggested slight TCSS differences between the delayed and immediate treatment groups, these disappeared after adjusting for tumor characteristics and treatment factors. Conclusions: A short-term delay (1-3 months) had no significant impact on OS, whereas more than 3 months of DTI resulted in poorer OS. Notably, delayed treatment had no impact on TCSS. These findings suggest that short-term delays are unlikely to affect survival, supporting decision-making flexibility for patients with low-risk PTC within three months of diagnosis.

Bone health problem is one of the important concomitant diseases of breast cancer (BC). This study aimed to investigate the bone health status of newly diagnosed female BC patients in China. A total of 636 newly diagnosed female BC patients and 268 women undergoing routine physical examinations (control group) were included. Bone mineral density and bone metabolism parameters were assessed. The association between BC and abnormal bone mass (ABM) was analyzed by logistic regression. We found that approximately 15.3% of BC patients presented with hypocalcemia after albumin adjustment. 25-OHVitD deficiency or insufficiency was observed in 92.3% of BC patients. ABM was identified in 63.2% of BC patients, comprising 36.4% with osteopenia and 26.8% with osteoporosis. ABM prevalence was significantly higher in BC patients under 40 years old (40.8%) compared to 8% in the age-matched control group. The severity of bone loss correlated with elevated bone turnover markers. Logistic regression analysis showed that a 5.5-fold and 3.4-fold increased risk of ABM and osteoporosis, respectively, in newly diagnosed BC patients versus the control group. All BC subtypes were associated with a markedly higher risk of ABM. Young BC patients (< 45 years) exhibited a nearly 9-fold higher risk of ABM compared to their age-matched counterparts. Vitamin D deficiency/insufficiency, osteopenia, and osteoporosis were highly prevalent among newly diagnosed female BC patients. Regardless of age and BC subtype, BC patients face a higher risk of ABM compared to those physical examination women, especially among the young.

Descriptions of the effect of chemotherapy on all the electrocardiographic parameters in breast cancer women during chemotherapy are limited. A retrospective and within-subject longitudinal study of the effect of chemotherapeutics and different chemotherapeutic regimens on electrocardiographic parameters was conducted in 948 breast cancer women who had completed chemotherapy with ECG recording at initial diagnosis and before each cycle of chemotherpy. Heart rate (HR), QRS interval, P-R interval, QRS axis, QT interval, QTc interval, and the incidence of QTc interval prolongation were analyzed. Age, body mass index (BMI), history of hypertension, diabetes, and coronary heart disease were also collected for further stratified study. Compared to initial diagnosis, changes in HR [74 (67, 82) bpm vs. 79 (73, 87)bpm], P-R interval [148 (136, 160) ms vs. 150 (138, 162) ms], QRS axis [41° (19.25°°, 60°) vs. 33° (15°, 53.75°)], QT interval [376 (358, 394) ms vs. 372 (354, 386) ms], QTc interval [417 (404, 431) ms vs. 426 (414, 436) ms], and incidence of QTc interval prolongation (9.6

The correlation between breast cancer and hepatitis B virus (HBV) remains inconclusive. This study aims to explore the serological status of HBV infection and past infection in different age groups of female breast cancer patients, patients with benign breast diseases, and individuals undergoing routine physical examinations. Serum data on HBV serological markers were collected and analyzed from 6072 female breast cancer patients first diagnosed from September 2012 to July 2020 at the First Affiliated Hospital of Chongqing Medical University, along with 4019 women with benign breast diseases and 54,740 healthy females undergoing routine physical examinations in the same period. The data were stratified by age for comparison between groups. The prevalence of HBV infection and past infection in the breast cancer group (7.9

Introduction: There is ongoing debate about the safety of breast reconstruction for patients with locally advanced breast cancer (LABC) who have undergone total mastectomy (TM). More and more LABC patients are undergoing breast reconstruction after TM, but its long-term survival outcomes remain unclear. This study aimed to compare the survival outcomes of LABC patients who underwent breast reconstruction after TM with those who did not, based on a large sample. Methods: We collected data for all LABC patients who underwent TM with or without breast reconstruction in the Surveillance, Epidemiology, and End Results (SEER) database. We divided patients into two groups: TM group and total mastectomy with reconstruction (TM+R) group. The primary outcomes were overall survival (OS) and breast cancer-specific survival (BCSS). Propensity score matching (PSM) analysis was used to eliminate imbalances of baseline data between the two groups. Data were analyzed using chi(2) tests, Kaplan-Meier methods, and univariate and multivariate Cox regression analyses. Result: We identified 39,112 eligible patients (33,169 patients received TM and 5,943 received TM+R), and 8,680 patients were matched after PSM (4,340 patients received TM and 4,340 received TM+R). Patients with middle age, white, married, lived in urban, IIB-IIIA stage, invasive ductal carcinoma, pathological grade II-III, hormone receptor-positive, and undergone chemotherapy were more likely to receive breast reconstruction. After PSM, Kaplan-Meier survival analysis showed better OS and BCSS in the TM+R group versus the TM group (OS: p < 0.001; BCSS: p = 0.008). Multivariate Cox regression analysis showed that TM+R significantly improved OS and BCSS (OS: hazard ratio 0.73, 95% confidence interval [CI] [0.68, 0.79], p < 0.001; BCSS: 95% CI [0.79, 0.94], p = 0.001). Subgroup analysis showed that patients with old age, white, and hormone receptor-positive had better OS and BCSS by TM+R compared to TM. Conclusions: Breast reconstruction after TM is associated with better OS and BCSS in patients with LABC.

Association between breast cancer (BC) and thyroid nodules (TNs) is still unclear. This research was to estimate the prevalence and risk factors of TN in Chinese BC women at initial diagnosis. 1731 Chinese early-stage BC women at initial diagnosis underwent thyroid ultrasound and 1:1 age-matched Chinese healthy women underwent health examination in corresponding period were enrolled for analysis. Prevalence of TN and TI-RADS ≥ 4 TN in BC patients (56.27

Racial and ethnic disparities in mortality persist among US cancer survivors, with social determinants of health (SDoH) may have a significant impact on these disparities. A population-based cohort study of a nationally representative sample of adult cancer survivors, who participated in the US National Health and Nutrition Examination Survey from 1999 to 2018 was included. Sociodemographic characteristics and SDoH were self-reported using standardized questionnaires in each survey cycle. The SDoH was examined by race and estimated for associations with primary outcomes, which included all-cause and cancer-specific mortality. Multiple mediation analysis was performed to assess the contribution of each unfavorable SDoH to racial disparities to all-cause and cancer-specific mortality. Among 5163 cancer survivors (2724 [57.7

Hormone receptor-positive breast cancer (BC) is the most prevalent subtype of BC and is generally correlated with a favorable prognosis. This study aimed to determine the incidence and survival trends among women diagnosed with hormone receptor-positive BC between 1990 and 2019. Female patients with hormone receptor-positive BC for calendar years 1990-2019 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database and categorized into six diagnostic groups according to the year of diagnosis. Age-adjusted incidence rates (IRs) were calculated using joinpoint regression. We used the Kaplan-Meier method and multivariate Cox regression analyses to determine the association between diagnostic groups, and overall survival (OS) and BC-specific survival (BCSS). The final analysis included 370,729 women, among whom 37,943 (10.2%), 49,266 (13.3%), 55,652 (15.0%), 64,451 (17.4%), 77,127 (20.8%), and 86,290 (23.3%) were diagnosed between 1990 and 1994, 1995-1999, 2000-2004, 2005-2009, 2010-2014, and 2015-2019, respectively. Within the overall cohort, IRs gradually increased from 70 per 100,000 in 1990 to 113 per 100,000 in 2019 (average annual percent change, 1.59%; 95% CI, 1.18-1.99). Multivariate Cox regression analysis revealed that the survival outcomes gradually improved over nearly three decades among hormone receptor-positive BC patients, with a 0.8% and 1.3% decrease in risk for all-cause and BC-specific mortality each year, respectively. Compared to 1990-1994, hormone receptor-positive BC patients diagnosed in 2015-2019 had a 22% lower risk of all-cause death (hazard ratio [HR], 0.78; 95% CI, 0.76-0.81) and a 27% lower risk of BC-specific death (HR, 0.73; 95% CI, 0.70-0.76). The development of treatment strategies within the past three decades, especially endocrine therapy, may contribute to the continuous improvement of clinical outcomes in patients with hormone receptor-positive BC.

Abstract Background Breast cancer is the most common malignancy in women and also shares similar risk factors with fatty liver, especially metabolic associated fatty liver disease (MAFLD). Chemotherapy can lead to hepatic impairment and hepatic steatosis (HS), which seriously affects the treatment and quality of life of breast cancer women (BCW). Therefore, this study aims to investigate the incidences of HS and MAFLD based on liver ultrasound elastography (USE), liver function abnormalities, and metabolic syndrome in Chinese BCW in the initially diagnosed, during chemotherapy and follow-up stages. Methods A total of 767 BCW treated at Chongqing Breast Cancer Centre were finally enrolled and classified into initially diagnosed group, chemotherapy group, and the follow-up group. The related conditions of HS and MAFLD as well as liver function abnormalities and metabolic syndrome were assessed by liver conventional ultrasound (US) or USE in all groups. Results Compare to US-diagnosed HS (21.7%, 36.7%, 38%), higher incidence of HS (60.4%, 78.6%, 68.0%) were detected by USE in the initially diagnosed, chemotherapy and follow-up groups. 50–70% of US-negative patients were detected by USE as having a fatty liver, which was predominantly mild to moderate. Based on the USE diagnosis, there was a higher prevalence of MAFLD in the initially diagnosed group (49.8%), which increased to 68.1% in the chemotherapy group and decreased in the follow-up group (59.1%), with a predominantly decrease of mild-to-moderate cases. BMI and age subgroups showed a higher incidence of MAFLD in patients with BMI ≥ 23 kg/m2 or age ≥ 60 years old. In addition, BCW combined with MAFLD had a higher incidence of liver function abnormalities and metabolic syndrome. Conclusion Patients treated with chemotherapy for breast cancer have a higher incidence of HS and MAFLD, especially overweight or obese and menopausal patients. Breast cancer patients with combined MAFLD have higher rates of liver function abnormalities and metabolic syndrome. USE has a higher sensitivity than US and can detect more patients with mild to moderate fatty liver disease, enabling early intervention.

Purpose:Glycated hemoglobin (HbA1c) is widely used in diabetes management and now recommended for diagnosis and risk assessment. Our research focused on investigating the optimal cutoff points of HbA1c for diagnosis of diabetes and prediabetes in Chinese breast cancer women, aiming to enhance early detection and tailor treatment strategies.Patients and Methods:This study involved 309 breast cancer women without diabetes history in China. Patients were categorized into groups of newly diagnosed diabetes, prediabetes, and normal glucose tolerance using oral glucose tolerance test (OGTT) according to the 2010 ADA criteria. HbA1c data were collected from all patients. Receiver operating characteristic (ROC) curve analysis was used to assess the effectiveness of the HbA1c screening.Results:Among the 309 breast cancer women without diabetes history, 96 (31.0%) were identified with diabetes and 130 (42.1%) had prediabetes according to OGTT, and the incidence of normal glucose tolerance was only 26.9% (83). ROC curve analysis, using OGTT as a reference, revealed that the area under the curve of 0.903 (P<0.001, 95% CI, 0.867-0.938) for HbA1c alone, indicating high accuracy. The optimal HbA1c cutoff for identifying diabetes was determined to be 6.0%, with a sensitivity of 78.1% and specificity of 86.4%. For prediabetes, the ROC curve for HbA1c alone showed that the area under the ROC curve of 0.703 (P<0.001, 95% CI, 0.632-0.774), with an optimal cutoff of 5.5% (sensitivity of 76.9% and specificity of 51.8%).Conclusion:The prevalence of undiagnosed diabetes is very high in breast cancer women without diabetes history in China. The optimal cutoff points of HbA1c for identifying diabetes and prediabetes are 6.0% and 5.5% in Chinese breast cancer women, respectively.

Osteoporosis is a global public health problem, characterized by severe morbidity and mortality of osteoporotic fractures. Meanwhile, there is a significant global prevalence of calcium intake insufficiency and/or vitamin D insufficiency/deficiency (CVI). Long-term of CVI may result in a negative calcium balance, leading to parathyroid hyperplasia, hypertrophy and hyperfunction, causing increased secretion of parathyroid hormone (PTH) which is still within the normal range. This condition is called parathyroid hyperfunction. Parathyroid hyperfunction plays a crucial role in maintaining calcium homeostasis by increasing bone resorption and raising serum calcium levels, which is a rapid and sustained process. Osteoporosis resulting from parathyroid hyperfunction is often diagnosed as primary osteoporosis because it does not meet the criteria for hyperparathyroidism. Therefore, partial primary osteoporosis is not truly primary but rather secondary osteoporosis due to parathyroid hyperfunction caused by CVI. Early recognition and intervention for this secondary osteoporosis can effectively prevent issues such as decreased height, humpback, pain, fatigue, fracture, nephrolithiasis, metastatic vascular calcification, and abnormal calcium migration and precipitation of the whole body.

BACKGROUND:Contralateral prophylactic mastectomy (CPM) has been performed for several decades in patients with unilateral breast cancer (BC). However, the survival benefits of CPM are controversial, particularly in young women. MATERIALS AND METHOD:In this retrospective study, the clinical total of 69,000 young female patients (age ≤ 40 years) who were diagnosed to have unilateral BC and underwent unilateral mastectomy (UM) or CPM between January 1, 2000 and December 31, 2019 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was performed to minimize selection bias and overcome differences in tumor characteristics between the CPM and UM groups. Overall survival (OS) and BC-specific survival (BCSS) were assessed using Kaplan-Meier curves and compared across groups using log-rank test. Multivariable Cox proportional hazards regression analysis was performed to estimate hazard ratios (HRs). RESULTS:A total of 36,528 patients (21,600 and 14,928 patients in the UM and CPM groups, respectively) were included in follow study. The CPM group showed a higher 5-year OS rate (82.1% vs. 75.8%) and a higher 5-year BCSS rate (83.5% vs. 77.7%) than the UM group. Multivariate Cox analysis after PSM (n = 13,089) showed that CPM significantly decreased 25% risk of all-cause mortality (OS, HR: 0.75, 95% confidence interval [CI]: 0.70-0.80; P < .001) and 25% risk of BC-specific mortality (BCSS, HR: 0.75, 95% CI: 0.70-0.80; P < .001) in young BC patients as compared to UM. CONCLUSION:This study suggests that CPM improved OS and BCSS benefits in young BC patients as compared to UM. Randomized clinical trials with a larger sample size are required in the future to confirm these results.