Background Optimal surgical management for differentiated thyroid cancer (DTC) remains controversial, particularly regarding initial hemithyroidectomy versus total thyroidectomy. Understanding factors predicting the need for completion thyroidectomy and residual disease in the remnant lobe is critical for risk-adapted treatment. Methods We conducted a multicentre retrospective cohort study of 387 patients undergoing surgical management of DTC between 2015 and 2024 across three tertiary centres. Demographic, clinical, cytological, and pathological data were extracted and compared by surgical extent. Among patients initially treated with hemithyroidectomy, predictors of proceeding to completion thyroidectomy were assessed. In patients undergoing completion thyroidectomy, clinicopathological factors associated with residual disease in the completion lobe were identified using both univariate and multivariate logistic regression analyses. Results Of 387 patients (median age 44 years, 78.0% female), 243 (63.0%) initially underwent hemithyroidectomy, and 143 (37.0%) underwent total thyroidectomy. Among hemithyroidectomy patients, 174 (71.3%) proceeded to completion thyroidectomy. Among completion thyroidectomy patients, residual disease was found in 63 (36.2%). Those undergoing completion thyroidectomy were more likely to have larger tumour (p < 0.001), nodal disease (0.006), extrathyroidal spread (0.003) and lymphovascular invasion (0.004). On multivariate analysis, male sex (OR 4.20, 95% CI [1.13, 15.63], p = 0.034) was independently associated with higher odds of residual disease in the completion lobe, while papillary subtype was associated with a lower odds of residual disease (OR 0.12, 95% CI [0.03, 0.50], p = 0.0045). Conclusion Larger nodule size and adverse pathological features were associated with higher rates of completion thyroidectomy. Among patients undergoing completion surgery, male sex independently predicted residual disease (OR 4.20, p = 0.034), while papillary histology was associated with a reduced risk (OR 0.12, p = 0.0045). These findings support risk-adapted surgical strategies and highlight the need for individualised decision-making and further prospective research to refine risk prediction in DTC.

Background BioBANC Symposium has become a key forum for the Irish biobanking community. The third annual event focused on networking and quality, featuring a workshop to explore the role and value of networked biobanking for Ireland. The Director General of BBMRI-ERIC advanced these discussions by addressing an audience of interdisciplinary experts, high-level stakeholders, and policymakers from the Irish biobanking community, as well as representatives from the Health Research Charities Ireland (HRCI), the National Clinical Trials Office (NCTO), the European Clinical Research Infrastructure Network (ECRIN-ERIC) research infrastructure, and the Department of Health. Methods A panel discussion brought together an array of experts from patient advocacy, clinical trials, pharmaceutical industry, government, healthcare policy and BBMRI-ERIC representation to explore the integration of Ireland into the BBMRI-ERIC network. This diverse panel discussed strategies to enhance Ireland’s biobanking capabilities and leverage international collaborations. Themes explored included the benefits, gaps and changes needed if Ireland was to consider membership of BBMRI-ERIC. VEVOX live polling was used to gauge audience views and questions on posed topics, enabling interactive audience participation and capturing real-time feedback to enrich the discussion. Results Substantial benefits that BBMRI-ERIC membership would bring for Ireland were highlighted, including enhanced infrastructure, standardised practices, and greater economic opportunities. Attendees also delved into how Ireland could address current gaps and align its biobanking operations with broader European standards. The discussion identified several critical themes and recommendations to address the need for funding, legislative support, education, public engagement, and strategic planning. Conclusion This article aims to encapsulate the discussions and outcomes of BioBANC Symposium III, focusing on the strategic moves Ireland must consider harnessing the full potential of its biobanking community. It serves not just as a record of proceedings but as a guide for action, urging stakeholders at all levels to collaborate towards a unified goal.

OBJECTIVES:Approximately 10% of breast and 20% of ovarian cancers are hereditary in nature. The most commonly implicated genes are the BRCA genes, and the current gold standard for testing is by direct DNA sequencing. This process is expensive, time-consuming, and has a turnaround time of several weeks. Radiogenomics involves extracting quantitative data from medical imaging and using mathematical models to predict the underlying genetic makeup of tissues. AIM:To perform a systematic review and meta-analysis evaluating the accuracy of radiogenomics in determining BRCA alteration status. METHODS:A systematic review was performed in accordance with PRISMA guidelines. Diagnostic test accuracy analyses (i.e. pooled sensitivity and specificity) were performed. Statistical analyses were performed using RevMan V5.4. RESULTS:Thirteen studies compromising 2835 patients were included. Of these, 857 were BRCA alteration carriers. The mean age of patients was 46 years. Radiogenomic methods correctly identified BRCA alteration with a strong diagnostic test accuracy (pooled sensitivity: 0.82, 95% confidence interval [CI]: 0.79-0.84, pooled specificity: 0.81, 95% CI: 0.78-0.83). CONCLUSIONS:Radiogenomics may be an accurate method to predict BRCA alterations. However, these findings should be validated in larger, prospective studies to determine their utility in clinical practice. Until further refinement of these methods, DNA sequencing should remain the gold standard. ADVANCES IN KNOWLEDGE:To the best of our knowledge, this is the first systematic review and meta-analysis that has been carried out on this topic. We believe that our results demonstrate the potential clinical utility radiogenomics could have in the BRCA alteration testing process.

Background:BioBANC Symposium has become a key forum for the Irish biobanking community. The third annual event focused on networking and quality, featuring a workshop to explore the role and value of networked biobanking for Ireland. The Director General of BBMRI-ERIC advanced these discussions by addressing an audience of interdisciplinary experts, high-level stakeholders, and policymakers from the Irish biobanking community, as well as representatives from the Health Research Charities Ireland (HRCI), the National Clinical Trials Office (NCTO), the European Clinical Research Infrastructure Network (ECRIN-ERIC) research infrastructure, and the Department of Health. Methods:A panel discussion brought together an array of experts from patient advocacy, clinical trials, pharmaceutical industry, government, healthcare policy and BBMRI-ERIC representation to explore the integration of Ireland into the BBMRI-ERIC network. This diverse panel discussed strategies to enhance Ireland's biobanking capabilities and leverage international collaborations. Themes explored included the benefits, gaps and changes needed if Ireland was to consider membership of BBMRI-ERIC. VEVOX live polling was used to gauge audience views and questions on posed topics, enabling interactive audience participation and capturing real-time feedback to enrich the discussion. Results:Substantial benefits that BBMRI-ERIC membership would bring for Ireland were highlighted, including enhanced infrastructure, standardised practices, and greater economic opportunities. Attendees also delved into how Ireland could address current gaps and align its biobanking operations with broader European standards. The discussion identified several critical themes and recommendations to address the need for funding, legislative support, education, public engagement, and strategic planning. Conclusion:This article aims to encapsulate the discussions and outcomes of BioBANC Symposium III, focusing on the strategic moves Ireland must consider harnessing the full potential of its biobanking community. It serves not just as a record of proceedings but as a guide for action, urging stakeholders at all levels to collaborate towards a unified goal.

Microwave Breast Imaging (MWBI) is an emerging imaging modality aiming to detect breast lesions, which are dielectrically contrasted against the background healthy tissue, in the microwave frequency spectrum. MWBI holds potential to outperform X-ray mammography’s low sensitivity in young and dense breasts, thus supporting timelier detection of interval cancers, as a supplemental screening or diagnostic imaging method. The specificity of MWBI remains unknown, however, as management of false positives has not been systematically addressed yet. An earlier First-In-Human clinical investigation on 24 symptomatic patients provided proof-of-concept for the Wavelia MWBI sectorized multi-static radar imaging technology, which generates clinically meaningful 3D images of the breast, performs semi-automated detection of breast lesions and extracts diagnostic features to distinguish malignant from benign lesions. This paper focuses on a set of technological upgrades, accessories and data processing modules, designed and implemented in the 2nd generation prototype of Wavelia, to handle the diversity in breast geometry, tissue consistency and deformability, in a larger clinical investigation reporting on the bilateral MWBI scan of 62 patients. The presented add-on modules contribute to enhanced quality of scan and a more valid reference reporting space for the MWBI imaging outputs, with a direct positive impact on overall specificity.

Background BioBANC Symposium has become a key forum for the Irish biobanking community. The third annual event focused on networking and quality, featuring a workshop to explore the role and value of networked biobanking for Ireland. The Director General of BBMRI-ERIC advanced these discussions by addressing an audience of interdisciplinary experts, high-level stakeholders, and policymakers from the Irish biobanking community, as well as representatives from the Health Research Charities Ireland (HRCI), the National Clinical Trials Office (NCTO), the European Clinical Research Infrastructure Network (ECRIN-ERIC) research infrastructure, and the Department of Health. Methods A panel discussion brought together an array of experts from patient advocacy, clinical trials, pharmaceutical industry, government, healthcare policy and BBMRI-ERIC representation to explore the integration of Ireland into the BBMRI-ERIC network. This diverse panel discussed strategies to enhance Ireland’s biobanking capabilities and leverage international collaborations. Themes explored included the benefits, gaps and changes needed if Ireland was to consider membership of BBMRI-ERIC. VEVOX live polling was used to gauge audience views and questions on posed topics, enabling interactive audience participation and capturing real-time feedback to enrich the discussion. Results Substantial benefits that BBMRI-ERIC membership would bring for Ireland were highlighted, including enhanced infrastructure, standardised practices, and greater economic opportunities. Attendees also delved into how Ireland could address current gaps and align its biobanking operations with broader European standards. The discussion identified several critical themes and recommendations to address the need for funding, legislative support, education, public engagement, and strategic planning. Conclusion This article aims to encapsulate the discussions and outcomes of BioBANC Symposium III, focusing on the strategic moves Ireland must consider harnessing the full potential of its biobanking community. It serves not just as a record of proceedings but as a guide for action, urging stakeholders at all levels to collaborate towards a unified goal.

The breast tumor microenvironment (TME) consists of a complex and heterogeneous network of cancer cells, cancer-associated fibroblasts (CAFs), immune cells, and an acellular extracellular matrix (ECM). These components critically impact treatment responses, emphasizing the utilization of patient-derived models that closely mimic the TME. Such models provide valuable insights into chemotherapy responses and facilitate the development of personalized treatment strategies. Natural products represent a vast and diverse source for anti-tumor drug discovery due to their structural diversity and wide range of biological activities. This study aims to utilize patient-derived models to screen a library of natural products to identify lead compounds with potential for personalized breast cancer therapy. A primary screen was performed using a patient-derived co-culture system comprising breast cancer cells and matched CAFs. A library of 61 natural products and 6 standard chemotherapy drugs was evaluated for their impact on cell viability, with IC50 values calculated to assess efficacy. Positive hits were further investigated in a secondary screen using 3D patient-derived organoid (PDO) models derived from four breast cancer subtypes. These PDOs included patient-derived cancer cells, matched CAFs, and autologous tumor-infiltrating lymphocytes (TILs), representing the tumor immune microenvironment. The anti-tumor effects of these compounds on PDO viability, growth, TIL recruitment, TIL activity and induction of apoptosis were assessed. The patient-derived co-culture and PDO models retained characteristics of their respective primary breast cancers and showed varied responses to different chemotherapeutics. Among standard drugs, doxorubicin and camptothecin showed uniform IC50 values across all PDOs, while paclitaxel primarily inhibited proliferation rather than inducing significant cell death. Conversely, 5-fluorouracil and etoposide displayed limited efficacy. In the natural product screen, Emodin (an anthraquinone) and Platycodin D (PD, a triterpenoid steroid) demonstrated potent anti-tumor activity. Both compounds caused a dose-dependent reduction in PDO size and a significant increase in cell death. Apoptosis assays revealed enhanced tumor cell and CAF apoptosis following treatment. Additionally, Emodin and PD increased TIL cytotoxicity, evidenced by elevated Granzyme B expression in CD4+ and CD8+ T cells. This study highlights the utility of patient-derived models in precision medicine and drug screening, providing a valuable platform for identifying effective therapeutic agents for breast cancer. Emodin and PD emerge as promising candidates with broad efficacy across multiple breast cancer subtypes, highlighting their potential for future development in breast cancer therapies. Rui Li,Xiao Hu,Ning Ge,Michael Kerin,Laura Barkley. Patient-derived models of breast cancer for drug screening and precision medicine approaches [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3142.

Background/Objectives: The Wavelia Microwave Breast Imaging (MWBI) technology aims to increase sensitivity in dense breasts, where X-ray mammography is of limited value. Its potential contribution to the reduction in the false positives in breast cancer diagnosis, by developing MWBI image descriptors supporting malignant-to-benign lesion discrimination, is also being investigated. After a First-In-Human (FiH) study with interesting findings on a small dataset of 24 symptomatic breast lesions, an upgraded 2nd prototype of Wavelia was manufactured and tested on a larger and more diverse dataset, including 62 patients and a balanced distribution of malignant and benign symptomatic breast lesions. Methods: A set of technological and methodological evolutions, outlined in this article, was implemented in Wavelia#2 to handle the diversity in larger patient datasets. Multi-modal MWBI imaging is employed to parameterize the interaction mechanisms between the microwaves and the imaged breast at varying geometrical and tissue consistency conditions. MWBI Region-Of-Interest (ROI) extraction and characterization based on multidimensional radiomic feature vectors is implemented to expand the malignant-to-benign lesion diagnostics potential of MWBI compared to the limited scope of the FiH study with Wavelia#1, which employed three specific preselected features. Results: This study demonstrates significant diagnostic accuracy of multiple texture-based and intensity-based features to discriminate between malignant and benign breast lesions with Wavelia#2 MWBI. A phenomenological qualitative assessment of the false positive rate on healthy breasts is also presented for the MWBI technology for the first time. Conclusions: The analysis contributes to the rationalization of the MWBI imaging and image analysis outputs towards standardization, objective interpretability, and ultimate clinical acceptance.

INTRODUCTION:Parathyroid lipoadenomas are a rare parathyroid phenomenon and an unusual cause of primary hyperparathyroidism. A difficult diagnosis to make, there are less than 100 cases in the literature since they were first described in 1958, and to our knowledge this is the largest parathyroid lipoadenoma to be reported. PRESENTATION OF CASE:A minimally-invasive parathyroidectomy with intraoperative parathyroid hormone monitoring was performed in the case of a male with a large neck mass and symptomatic primary hyperparathyroidism. A giant parathyroid lipoadenoma was excised, with an appropriate decrease in intraoperative parathyroid hormone level observed. DISCUSSION:This lesion poses a challenge to the surgeon, radiologist and pathologist alike and is an important addition to the scant literature available. Clinically it presents similarly to a simple adenoma. The high adipose content of this lesion leads to difficulty localising it on imaging, and the histology study can lead pathologists astray. CONCLUSION:We highlight the importance of having the parathyroid lipoadenoma as a differential diagnosis for patients who develop primary hyperparathyroidism.

About 762 cases of ER + breast cancer have been included in this analysis of the influence of histological subtype on long-term outcomes in breast cancer. Following rigorous propensity matching, cases of ILC have been compared to IDC and demonstrate, better long-term survival in the ILC cohort. ILC cases are also more likely to undergo mastectomy and less likely to undergo neoadjuvant chemotherapy. Introduction: Invasive lobular carcinoma (ILC) contributes significantly to the global cancer burden and is the most common of the histological "special types" of breast cancer. ILC has unique features setting it apart from the more common invasive ductal carcinoma (IDC). Despite differences, treatment algorithms do not consider histological differences. Aim: To determine the differences in treatment and outcomes of ILC relative to IDC in a strict case-matched cohort study at a tertiary referral, specialist, breast cancer center. Methods: All Estrogen receptor positive (ER + ) ILCs from 1999 to 2015 were matched for; age, tumor size, grade, PR/HER2 status, nodal stage and metastases with ER + IDCs from the same period. Surgical and systemic treatments were assessed along with overall (OS) and disease-free survival (DFS). Results: 762 cases in total were analyzed (1:1 matching; ILC:IDC). ILC cases were more often treated with mastectomy (37.5% vs. 28.6%, P .009) and those who received breast conserving surgery (BCS) more often had an incomplete resection (30.2% vs. 19.6%, P .01). IDC were more often treated with NACT (5.5% vs. 14.4%, P < .001). Mean DFS were similar between ILC and IDC; 148.3 vs. 141.4 months ( P .112) but OS was significantly longer in the ILC group; 165.7 vs. 134 months ( P .002). This trend was consistent among the subset of patients undergoing BCS. For ILC undergoing BCS, mean DFS was 129.8 vs. 128.3 months for IDC ( P .418) and OS was 155.4 and 110.7 months respectively ( P < .001). Incomplete resection at the time of index surgery did not alter the disease free or overall survival in either the ILC or IDC patients to a level that reached statistical significance. Conclusion: In this cohort study, the strict matching of ILC and IDCs for a number of prognostic indicators, demonstrates the impact of lobular histology with a clarity not previously observed. ILCs have comparable survival outcomes to patients with IDC but at the expense of more extensive index and revisional surgery. There is a need for awareness of these facts among surgeons and patients for optimal treatment prioritization and provision.

Multimorbidity refers to the presence of two or more chronic diseases and is associated with adverse outcomes for patients. Factors such as an ageing population have contributed to a rise in prevalence of multimorbidity globally; however, multimorbidity is often neglected in clinical guidelines. This is largely because patients with multimorbidity are systematically excluded from clinical trials. Accordingly, there is an urgent need to develop novel biomarkers and methods of prognostication for this cohort of patients. The hallmarks of ageing are now thought to potentiate the pathogenesis of multimorbidity. MicroRNAs are small, regulatory, noncoding RNAs which have been implicated in the pathogenesis and prognostication of numerous chronic diseases; there is a substantial body of evidence now implicating microRNA dysregulation with the different hallmarks of ageing in the aetiology of chronic diseases. This article proposes using the hallmarks of ageing as a framework to develop a panel of microRNAs to assess the prognostic burden of multimorbidity. This putative molecular morbidity score would have many potential applications, including assessing the efficacy of clinical interventions, informing clinical decision making and facilitating wider inclusion of patients with multimorbidity in clinical trials.

Introduction: There is uncertainty surrounding the role of resection as an option for curative treatment of breast cancer with liver metastases (BCLM). Aim: To perform a systematic review and meta-analysis evaluating the role of liver resection for BCLM. Methods: A systematic review was performed as per PRISMA guidelines. Hazard ratio (HR) for overall survival (OS) and standard error was obtained from each study and expressed using the generic inverse variance method, with a corresponding 95% confidence interval (CI). OS outcomes at 1- 3- and 5-years were expressed as dichotomous variables and pooled as odds ratios (OR) using the Mantel-Haenszel method. Results: Nine studies with 1732 patients were included. Of these, 24.5% underwent surgical resection of BCLM (424/1732) and 75.5% did not (1308/1732). Overall, OS was significantly better among those who underwent surgery versus controls (HR: 0.69, 95% CI: 0.59-0.80, P < 0.00001). Mortality rates were significantly reduced at 1-year (7.5% (10/134) vs 20.3% (79/390), OR: 0.25, 95% CI: 0.08-0.74, P = 0.010) and 5-years (54.0% (190/352) vs 75.3% (940/1249), OR: 0.46, 95% CI: 0.25-0.87, P = 0.020) respectively for those undergoing surgery versus controls. Mortality rates at 3 years after surgery were lower than the control group (19.1% (29/152) vs 53.0% (222/419)), however this failed to achieve statistical significance at meta-analysis (OR: 0.32, 95% CI: 0.09-1.12, P = 0.070). Conclusion: Liver resection may be considered at multidisciplinary meetings for those with BCLM and offers a potentially curative option. However, judicious patient selection is crucial prior to making decisions in relation to resection of BCLM. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Identifying patients likely to develop breast cancer recurrence remains a challenge. Thus, the discovery of biomarkers capable of diagnosing recurrence is of the utmost importance. MiRNAs are small, non-coding RNA molecules which are known to regulate genetic expression and have previously demonstrated relevance as biomarkers in malignancy. To perform a systematic review evaluating the role of miRNAs in predicting breast cancer recurrence. A formal systematic search of PubMed, Scopus, Web of Science, and Cochrane databases was performed. This search was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist. A total of 19 studies involving 2287 patients were included. These studies identified 44 miRNAs which predicted breast cancer recurrence. Results from nine studies assessed miRNAs in tumour tissues (47.4%), eight studies included circulating miRNAs (42.1%), and two studies assessed both tumour and circulating miRNAs (10.5%). Increased expression of 25 miRNAs were identified in patients who developed recurrence, and decreased expression of 14 miRNAs. Interestingly, five miRNAs (miR-17-5p, miR-93-5p, miR-130a-3p, miR-155, and miR-375) had discordant expression levels, with previous studies indicating both increased and reduced expression levels of these biomarkers predicting recurrence. MiRNA expression patterns have the ability to predict breast cancer recurrence. These findings may be used in future translational research studies to identify patients with breast cancer recurrence to improve oncological and survival outcomes for our prospective patients.