Triple-negative breast cancer (TNBC) remains difficult to treat because of poor immunogenicity and an immunosuppressive tumor microenvironment (TME). Pyroptotic signaling can enhance antitumor immunity through inflammatory cytokine release, but upstream regulators linking this process to macrophage phenotypic remodeling in TNBC remain incompletely understood. We investigated whether zinc finger protein 831 (ZNF831) restrains TNBC progression in association with enhanced NLR family pyrin domain containing 3 (NLRP3)-related pyroptotic signaling and macrophage phenotypic remodeling. We integrated The Cancer Genome Atlas (TCGA-BRCA), Gene Expression Omnibus bulk datasets (GSE103091, GSE176078), and breast cancer single-cell RNA-sequencing datasets from Tumor Immune Single-cell Hub 2 (BRCA_GSE114727_inDrop, BRCA_GSE148673, BRCA_GSE150660, and BRCA_GSE161529) to evaluate ZNF831 expression, prognosis, pathway enrichment, and macrophage-related immune features. ZNF831 was overexpressed or silenced in MDA-MB-231 and 4T1-luc cells to assess macrophage recruitment, macrophage phenotypic changes, NLRP3-associated pyroptotic signaling, and IL-1β/IL-18 release. Chromatin immunoprecipitation (ChIP)-qPCR, actinomycin D chase assays, and RNA immunoprecipitation (RIP)-qPCR were performed primarily in MDA-MB-231 cells to evaluate promoter association, mRNA stability, and transcript interaction. In vivo efficacy was assessed in 6-week-old female BALB/c mice bearing orthotopic 4T1-luc tumors treated intratumorally with MCC950 or PBS. Across cohorts, higher ZNF831 expression was associated with favorable outcome, an M1-skewed macrophage signature, and enrichment of pyroptosis-related pathways. In vitro, ZNF831 overexpression enhanced macrophage recruitment, shifted macrophage phenotypes toward a more pro-inflammatory M1-like state while suppressing M2-like features, promoted NLRP3-associated pyroptotic signaling, and increased IL-1β and IL-18 release, whereas ZNF831 knockdown produced opposite trends. Mechanistically, ZNF831 showed association with the NLRP3 promoter and selective enrichment of NLRP3 mRNA, consistent with multi-level regulation of NLRP3 expression. In vivo, pharmacologic inhibition with MCC950 attenuated the antitumor effects and macrophage-related changes associated with ZNF831 overexpression. These findings support a role for the ZNF831–NLRP3 axis in shaping a more inflammatory TNBC microenvironment and suggest that ZNF831 may contribute to macrophage M1-like phenotypic remodeling through NLRP3-associated pyroptotic signaling.

Transoral robotic thyroidectomy (TORT) offers a virtually scarless outcome but requires comparative validation studies against open thyroidectomy (OT). Patients who underwent thyroid surgery at our institution between January 2020 and October 2024 were enrolled. Through propensity score matching analysis, a final cohort of 322 adults with pathologically confirmed thyroid carcinoma was identified, comprising 161 patients in each group. We analyzed and compared clinical outcomes between the two surgical cohorts, along with patient-reported outcomes including Numerical Rating Scale (NRS) for pain, Voice Handicap Index-10 (VHI-10), and Scar Assessment Questionnaire-Cosmetic (SAQCO) for scar satisfaction assessed at 1 week postoperatively. Among the 322 propensity score-matched patients (age: median [IQR]: 41.0 [34.0, 51.0] years vs. 43.0 [34.0, 52.0] years; 231 females [71.7

Thyroid cancer is a common endocrine disease, and surgery is the most important means of treating thyroid cancer. Thyroid surgery and postoperative complications have been increasing in recent years. Among them, recurrent laryngeal nerve (RLN) injury is a common complication after thyroid surgery, which is mainly manifested as paralysis of the vocal cords and respiratory difficulties, negatively affecting the quality of life of patients. In recent years, with the continuous development of the concept of minimally invasive technology, we introduced a robotic surgical system into thyroidectomy via the oral vestibular approach and used a combination of blunt and sharp detachment to explore the RLN without the aid of an RLN monitor. Identification and protection of the RLN were successfully accomplished along with thyroid lobectomy and ipsilateral central lymph node dissection. Follow-up observations were conducted 1 week, 1 month, and 6 months after surgery to assess patient recovery. Overall, using this method in robotic thyroidectomy via the oral vestibular approach helped the operator quickly explore and protect the RLN, decreasing the occurrence of postoperative complications.

BackgroundMajor advances have been achieved in the characterization of primary breast cancer genomic profiles. Limited information is available on the genomic profile of tumors originating from different metastatic locations in recurrent/metastatic (R/M) breast cancer, especially in Asian patients. This study aims to decipher the mutational profiles of primary and R/M breast cancer in Chinese patients using next-generation sequencing.MethodsA total of 563 breast cancer patients were enrolled, and 590 tumor tissues and matched peripheral blood samples were collected and subjected to targeted sequencing with a panel of 1,021 cancer-related genes. The mutation spectrum, DNA damage response (DDR) genes, commonly altered signal pathways, and immunotherapy-related markers were compared between primary and R/M breast cancer. The molecular differences between our cohort and the Memorial Sloan Kettering Cancer Center (MSKCC) dataset were also explored.ResultsA total of 361 samples from primary and 229 samples from R/M breast cancer were analyzed. BRCA2, ATRX, and ATM were more frequently observed in R/M lesions among the 36 DDR genes. An ESR1 mutation and PD-L1 and PD-L2 amplification were enriched in R/M breast cancer (all p<0.05). Compared with the MSKCC dataset, we recruited more patients diagnosed at age 50 or younger and more patients with triple-negative breast cancer (TNBC) subtypes. The TNBC patients in our dataset had a higher percentage of PD-L1 amplification in metastasis tumors (p<0.05).ConclusionsThis study revealed the distinctive mutational features of primary and R/M tumors in Chinese breast cancer patients, which are different from those from Western countries. The enrichment of PD-L1 amplification in metastatic TNBC indicates the necessity to re-biopsy metastatic tumors for immunotherapy.

(编者按:随着现代科学技术的飞速发展临床诊疗技术和方法不断发展和完善.本专栏的开辟旨在创建一个学术交流平台针对本学科临床工作中的热点和难点邀请在相关领域做出大量工作并颇有建树的专家和教授介绍他们的见解和经验以飨读者.圆桌论坛为个人意见不具共识性.)

The tumor microenvironment (TME) of breast cancer is a complex ecosystem, in which cancer-associated fibroblasts (CAFs), as the most abundant stromal cell type, meticulously construct an ecological niche that supports tumor growth through mechanisms including extracellular matrix (ECM) remodeling, secretion of bioactive factors, and interactions with neighboring cells. High-resolution technologies, including single-cell sequencing and spatial transcriptomics, have revealed the high heterogeneity, functional diversity, and spatial distribution within the CAF population. Significant differences exist in the interactions between distinct CAF subpopulations and immune cells. Through complex crosstalk with the immune system, they collaboratively establish an immunosuppressive network, becoming a core driving force for tumor immune escape. This review focuses on the latest research advances in heterogeneous subpopulations of CAFs within the breast cancer microenvironment, delves into how the complex bidirectional crosstalk between different CAF subpopulations and immune cells collaboratively shapes the tumor immune microenvironment (TIME), and summarizes various CAF-based therapeutic strategies for breast cancer, aiming to provide critical theoretical basis and novel therapeutic perspectives for the clinical translation of CAF heterogeneity research.

The integration of robotic platforms in breast oncology has witnessed substantial expansion, fueled by their inherent advantages in minimally invasive access and enhanced intraoperative maneuverability. Most of the robotic-assisted breast surgery has been performed using multi-arm robots. However, the implementation of single-port robotic (SPr) systems in mammary interventions continues to undergo rigorous clinical evaluation, particularly regarding long-term oncological safety and cost-effectiveness metrics. Notably, multi-arm robotic systems demonstrate constrained operability in the restricted mammary workspace, whereas the transaxillary, single-port approach demonstrates enhanced spatial adaptability, achieving more optimal instrument articulation in confined surgical fields while concurrently optimizing aesthetic outcomes through precise subcutaneous tissue dissection. The study (ClinicalTrials.gov ID: NCT06738654) constituted a prospective, single-arm, non-randomized trial for primary exploration of feasibility and safety regarding a single-port robotic system in breast-conserving surgery (BCS) in six patients with early-stage breast cancer undergoing transaxillary, SPr-assisted, partial mastectomy with sentinel lymph node biopsy (SLNB). A total of 6 patients from Daping Hospital (Army Medical Center) between December 2024 and February 2025 were included in this study, with the first successful implementation performed on December 24, 2024. Intraoperative frozen-section histopathology confirmed negative resection margins in all patients, meeting the criteria for surgical success. The mean operative time was 232 min, with an average postoperative drainage volume of 250 mL. The axillary drainage tubes remained for an average of 10 days; the mean hospital stay was 10 days. Quality of life assessment through FACT-B demonstrated satisfaction scores. The six cases demonstrate the procedural safety and oncological feasibility of transaxillary SPr-assisted BCS within minimally invasive breast oncology. Mechanistically, the axillary portal approach achieves scar containment through only one incision in the inframammary fold, while preserving the native breast architecture. This technique significantly improves postoperative quality of life metrics through precise subcutaneous fascia preservation, reducing psycho-emotional distress associated with visible scarring. The technical paradigm aligns with oncoplastic principles by reconciling radical tumor excision with contemporary aesthetic demands in breast cancer candidates.

10559 Background: Phthalates are ubiquitous environmental endocrine disruptors. As the predominant phthalate, di-2-ethylhexyl phthalate (DEHP) has been considered possibly carcinogenic to humans but large-scale longitudinal evidence is needed to further clarify its carcinogenicity. Up to date, no study have examined the in-situ DEHP exposure in breast cancer, in comparison with normal breast tissue or benign breast tumor.The present study aims to examine the association between DEHP exposure and incidence of hormone receptor-positive breast cancer (HR+BC) , both in a large cohort and in a group of patients whose in-situ DEHP exposure was analyzed. Methods: In 116,885 women of UK Biobank cohort, diagnosis of HR+BC was ascertained using general practitioner prescription records and information from National Health Service Cancer Registry and National Death Index. Baseline and yearly-average level of external DEHP exposure via water were estimated for each individual by linking chemical monitoring record of European Environment Agency with home address of the participants by Kriging interpolation model. We used Cox proportional hazards regression to estimate the association between DEHP exposure by water and risk of breast cancer. Furthermore, in-situ internal exposure level of DEHP in tumor tissue and normal breast tissue in 67 Chinese women with HR+BC or benign tumors was quantified using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS), then binary Logistic regression was used to explore whether the in-situ DEHP level was higher in HR+BC compared to benign tumor or normal breast tissues. Results: In the UKB cohort women, during a median of 13.5 years follow up, the fourth quartile of baseline DEHP was associated with 1.20 fold risk of HR+BC (95% CI, 1.1 to1.4, P < 0.001). As for yearly-average exposure, each quartile of DEHP was positively associated with higher risk of HR+BC (HR, 1.12; 95% CI, 1.1 to 1.17, P trend < 0.001). The fourth quartile of yearly-average DEHP was associated with 1.52 fold risk of HR+BC (95% CI, 1.31 to 1.78, P < 0.001). No significant association was found between DEHP exposure and hormone receptor-negative breast cancer ( P = 0.294). In the Chinese women, the overall detection rate of DEHP (detected in any tissue type) in HR+BC women was significantly higher than in women with benign tumors (96.2% V.S. 7.1%, P < 0.001), and the detection rate of DEHP in breast cancer tissues was higher than in benign tumor tissue (55.7% V.S. 4.5%, P < 0.001). Logistic regression showed that breast cancer tissue was associated with a higher risk of DEHP contamination compared with benign tumor tissue (OR,11.77; 95% CI, 1.20 to 115.25, P = 0.034). Conclusions: Real-world level of DEHP exposure was associated with higher risk of HR+BC. The results may be crucial for effective and precise prevention of breast cancer.

Early Triple negative breast cancer (eTNBC) is the subtype with the worst outcome. Circulating tumor DNA (ctDNA) is shown to predict the prognosis of breast cancer, but its utility in eTNBC remains unclear. 130 stage II-III female eTNBC patients receiving neoadjuvant chemotherapy (NAC) have been enrolled prospectively and subjected to ctDNA analysis. ctDNA at post-NAC (pre-surgery) and post-surgery, but not at baseline, is associated with worse prognosis. A threshold of 1.1% maximum variant allele frequency at baseline stratifies patients with different relapse risk, which is validated internally and externally. A systemic tumor burden model integrating baseline and post-surgery ctDNA is independently prognostic (p = 0.022). Combining systemic tumor burden with pathologic response identifies a highly curable subgroup and a subgroup of high-risk eTNBC patients. ctDNA surveillance during follow-up identifies patients with high relapse risk. In conclusion, systemic ctDNA analysis demonstrates the utility of a systemic tumor burden model of ctDNA in risk stratification of eTNBC patients, which may guide future treatment escalation or de-escalation trials. ctDNA is a promising method to monitor tumor burden in triple negative breast cancer. Here, the authors show that ctDNA detection correlated with prognosis after neoadjuvant chemotherapy but not at baseline.

Adenoid cystic carcinoma (ACC) is a rare type of breast cancer, and predominant adenoid cystic carcinomas are low grade and triple-negative by histology. Unlike other triple-negative breast carcinomas, ACC of the breast generally have a low propensity for recurrence and metastasis, with complete surgical excision alone being curative in most circumstances in early-stage disease. Here, we presents a case study detailing the clinical course of a 32-year-old female patient diagnosed with ACC of the breast. We emphasized the efficacy of standardized treatment protocols and highlighted recent advancements in research pertaining to this uncommon malignancy.

PURPOSE:Molecular residual disease (MRD) is the main cause of postoperative recurrence of breast cancer. However, the baseline tumor genomic characteristics and therapeutic implications of breast cancer patients with detectable MRD after surgery are still unknown.MATERIALS AND METHODS:In this study, we enrolled 80 patients with breast cancer who underwent next-generation sequencing-based genetic testing of 1,021 cancer-related genes performed on baseline tumor and postoperative plasma, among which 18 patients had detectable MRD after surgery.RESULTS:Baseline clinical characteristics found that patients with higher clinical stages were more likely to have detectable MRD. Analysis of single nucleotide variations and small insertions/deletions in baseline tumors showed that somatic mutations in MAP3K1, ATM, FLT1, GNAS, POLD1, SPEN, and WWP2 were significantly enriched in patients with detectable MRD. Oncogenic signaling pathway analysis revealed that alteration of the Cell cycle pathway was more likely to occur in patients with detectable MRD (p=0.012). Mutational signature analysis showed that defective DNA mismatch repair and activation-induced cytidine deaminase (AID) mediated somatic hypermutation (SHM) were associated with detectable MRD. According to the OncoKB database, 77.8% (14/18) of patients with detectable MRD had U.S. Food and Drug Administration-approved mutational biomarkers and targeted therapy.CONCLUSION:Our study reports genomic characteristics of breast cancer patients with detectable MRD. The cell cycle pathway, defective DNA mismatch repair, and AID-mediated SHM were found to be the possible causes of detectable MRD. We also found the vast majority of patients with detectable MRD have the opportunity to access targeted therapy.

Background: Phthalates are ubiquitous environmental endocrine disruptors. As the predominant phthalate, di-2ethylhexyl phthalate (DEHP) has been considered possibly carcinogenic to humans but large-scale longitudinal evidence is needed to further clarify its carcinogenicity. Objectives: To examine the association between DEHP exposure and incidence of breast malignant neoplasm, carcinoma in situ and benign neoplasm. Methods: A total of 273,295 women from UK Biobank cohort were followed up for a median of 13.5 years. Disease information was collected from National Health Service Cancer Registry and National Death Index. Baseline and yearly -average level of DEHP exposure were estimated for each individual by linking chemical monitoring record of European Environment Agency with home address of the participants by Kriging interpolation model. Cox proportional hazard model was employed to estimate the association between DEHP exposure and breast neoplasms. Results: The median (IQR) of baseline and yearly -average DEHP concentration were 8000.25 (interquartile range: 6657.85 - 11,948.83) and 8000.25 (interquartile range: 1819.93 - 11,359.55) mu g/L. The highest quartile of baseline DEHP was associated with 1.11 fold risk of carcinoma in situ (95 % CI, 1.00, 1.23, p < 0.001) and 1.27 fold risk of benign neoplasm (95 % CI, 1.05, 1.54, p < 0.001). As for yearly -average exposure, each quartile of DEHP was positively associated with higher risk of malignant neoplasm (HR, 1.05; 95 % CI, 1.03, 1.07, p < 0.001), carcinoma in situ (HR, 1.08; 95 % CI, 1.04, 1.11, p < 0.001) and benign neoplasm (HR, 1.13; 95 % CI, 1.07, 1.20, p < 0.001). Stratification analysis showed no significant modification effects on the DEHP-neoplasm relationship by menopausal status or ethnicity but a suggestive higher risk in younger women and those who underwent oral contraceptive pill therapy. In sensitivity analysis, the associations remained when excluding the cases diagnosed within 2 years post baseline. Conclusions: Real -world level of DEHP exposure was associated with higher risk of breast neoplasms. Because of the health risks associated with DEHP, its release to the environment should be managed.

Emerging evidence suggested that zinc finger protein 831 (ZNF831) was associated with immune activity and stem cell regulation in breast cancer. Whereas, the roles and molecular mechanisms of ZNF831 in oncogenesis remain unclear. ZNF831 expression was significantly diminished in breast cancer which was associated with promoter CpG methylation but not mutation. Ectopic over-expression of ZNF831 suppressed breast cancer cell proliferation and colony formation and promoted apoptosis in vitro, while knockdown of ZNF831 resulted in an opposite phenotype. Anti-proliferation effect of ZNF831 was verified in vivo. Bioinformatic analysis of public databases and transcriptome sequencing both showed that ZNF831 could enhance apoptosis through transcriptional regulation of the JAK/STAT pathway. ChIP and luciferase report assays demonstrated that ZNF831 could directly bind to one specific region of STAT3 promoter and induce the transcriptional inhibition of STAT3. As a result, the attenuation of STAT3 led to a restraint of the transcription of Bcl2 and thus accelerated the apoptotic progression. Augmentation of STAT3 diminished the apoptosis-promoting effect of ZNF831 in breast cancer cell lines. Furthermore, ZNF831 could ameliorate the anti-proliferation effect of capecitabine and gemcitabine in breast cancer cell lines. Our findings demonstrate for the first time that ZNF831 is a novel transcriptional suppressor through inhibiting the expression of STAT3/Bcl2 and promoting the apoptosis process in breast cancer, suggesting ZNF831 as a novel biomarker and potential therapeutic target for breast cancer patients.

Abstract Background: Breast cancer constitutes approximately 30% of cancers in women, with a mortality-to-incidence ratio of 15%. While early and middle-stage breast cancer patients can undergo radical surgical resection, postoperative recurrence remains a significant challenge for clinicians. Molecular residual disease (MRD) is the main cause of postoperative recurrence of breast cancer. However, the baseline tumor genomic characteristics and therapeutic implications of breast cancer patients with detectable MRD are still unknown. Methods: In this study, we enrolled 80 patients with breast cancer who underwent next-generation sequencing (NGS)-based genetic testing of 1,021 cancer-related genes performed on baseline tumor and postoperative plasma from Army Specialty Medical Center between June 2017 and January 2023. The criteria for the patient’s enrollment were: (1) pathological diagnosis as breast cancer, (2) no distal metastasis, (3) radical surgery and R0 resection, (4) 1021 cancer-related gene testing of the tumor, (5) plasma MRD testing performed within 3 months after surgery and before adjuvant therapy. Results: A total of 18 patients in our cohort had detectable MRD. Baseline clinical characteristics found that patients with higher clinical stages were more likely to have detectable MRD. Analysis of single nucleotide variations and small insertions/deletions in baseline tumors showed that somatic mutations in MAP3K1, ATM, FLT1, GNAS, POLD1, SPEN, and WWP2 were significantly enriched in patients with postoperative MRD. Oncogenic signaling pathway analysis revealed that alteration of the Cell cycle pathway was more likely to occur in patients with detectable MRD (p=0.0125). Mutational signature analysis showed that defective DNA mismatch repair and activation-induced cytidine deaminase (AID) mediated somatic hypermutation (SHM) were associated with detectable MRD. Somatic copy number variation analysis found that amplification of CDKN2A, HOXB13, PPM1D, MPL, and VHL was significantly enriched in patients with detectable MRD. According to the OncoKB database, 77.8% (14/18) of patients with detectable MRD had U.S. Food and Drug Administration-approved mutational biomarkers and targeted therapy. Conclusion: For the first time, our study reports genomic characteristics of breast cancer patients with detectable MRD. The tumor biology is probably the main driver of detectable MRD. We also found the vast majority of patients with detectable MRD have the opportunity to access targeted therapy. Keywords: Breast cancer, MRD, Genomic character, Cell cycle pathway, Defective DNA mismatch repair, Activation-induced cytidine deaminase Figure 1. Somatic mutational landscape and clinical actionability of breast cancer patients with detectable MRD A. Oncoplot of top 20 genes altered in patients with detectable MRD. B. Forest plot of different mutant genes between patients with detectable and undetectable MRD. OR means odds ratio. Inf means infinity. ＊ means P-value < 0.05. C. The ten cancer-related signaling pathways were affected by somatic mutations both in patients with detectable and undetectable MRD. ＊ means P-value < 0.05. D&E. The fraction and etiology of each signature in patients with detectable (D) or undetectable (E) MRD. F. The number of patients with detectable MRD in different actionable alterations. gBRCA1 means germline BRCA1 mutation. sBRCA1 means somatic BRCA1 mutation. sBRCA2 means somatic BRCA2 mutation. TMB-H means TMB-High. Citation Format: Xu Yan, Shu Zhang, Lu zhou, Yan Jiang, Jing Xu, Gang Zhang, Lu Shen. Genomic characteristics and its therapeutic implications in breast cancer patients with detectable molecular residual disease [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-13-05.

Background Early Triple negative breast cancer (eTNBC) is the breast cancer subtype with the least favorable outcome. Tools to identify their individual relapse risk are in great need. Circulating tumor DNA (ctDNA) analysis is shown to predict the prognosis in breast cancer, but its utility in eTNBC remains unclear.Patients and methods In this prospective study, 130 eTNBC patients receiving neoadjuvant chemotherapy (NAC) were successfully enrolled. Their blood samples were taken at the baseline, post-NAC, post-surgery and during follow-up, and were subjected to tumor-guided ctDNA analysis.Results ctDNA positivity at post-NAC and post-surgery, but not at baseline, was associated with significantly worse prognosis. A threshold of 1.1% maximum variant allele frequency (MVAF) at baseline better stratified eTNBC patients with different relapse risk, which was validated both internally and externally. A systemic tumor burden model integrating baseline and post-surgery ctDNA was highly prognostic and independent of clinical characteristics. Combining systemic tumor burden with pathologic response identified a highly curable subgroup and a subgroup of high-risk eTNBC patients that need more effective adjuvant treatments. ctDNA surveillance during follow-up showed that the patients with negative ctDNA had 100% distant recurrence free survival (DRFS), but the ones with positive ctDNA had high relapse rate with relatively short lead time.Conclusions This systemic ctDNA analysis from baseline to follow-up demonstrates the utility of baseline ctDNA with a threshold and a systemic tumor burden model in risk stratification of eTNBC patients, which may guide future treatment escalation or de-escalation trials.

Abstract Objective:Previous studies have shown that circadian disruption can affect thyroid hormone levels, but whether it elevates the risk of thyroid cancer (TC) is still controversial. The present study investigates the relationship between rotating shift work (RSW) and the incidence of TC. Methods:The prevalence of RSW in the 35 European countries from 2000 to 2015 was estimated based on the data of 89257 men and 81749 women of the European Working Condition Survey. The incidence of TC was obtained from the Global Burden of Disease database. We analyzed the relationship between the prevalence of RSW and the incidence of TC 5 years later (TC5). We used a mixed model with adjustment of country-specific GDP per capita, Volcanic region, age, Education attainment rate, obesity rate and occupational radiation exposure rate. Results: The prevalence of RSW was significantly associated with the incidence of TC5 (β = 0.03 95%CI:0.01, 0.06, P=0.03). For a quartile increase in RSW, the incidence of TC5 increased by 0.18 per 100000（95%CI：0.05 per 100000,0.33 per 100000）. When separately analyzed in the two genders, we found an association between the two in women (β = 0.04, 95%CI: 0.01, 0.08, P=0.02), but not in men (β = 0.01, 95% CI: -0.03, 0.04, P=0.75). Conclusion: Circadian disruption may be associated with an increase in the overall risk of TC, but it only seems to affect the occurrence of TC in women, not men. Further research is needed to verify the findings of the present study.

Currently, the common approaches to thyroid surgery include conventional thyroidectomy, bilateral axillo-breast, axillary, retroauricular, and oral vestibule approaches. Essentially, various approaches to thyroid surgery only move the traditional surgical incision to a more concealed position but still leave scars on the body surface. Among them, thyroid surgery via the oral vestibule approach can obtain the best cosmetic outcome through the shortest natural cavity. However, in the early time, thyroid surgery via the oral vestibule approach usually requires three incisions in the mouth and one axillary incision. We have introduced a robotic surgical system into thyroidectomy via the oral vestibule approach and successfully completed total thyroidectomy and bilateral central lymph node dissection. During the operation, only three incisions were made at the oral vestibule without an axillary incision. This article aims to present the unique three-port method of robotic thyroidectomy via oral vestibule for the treatment of patients with papillary thyroid cancer.

Background: Dual HER2 targeted therapy with trastuzumab (H) and pertuzumab (P) has been approved as neoadjuvant therapy for patients with HER2-positive breast cancer in China in 2019 based on the results from NeoSphere and PEONY study. However, the real-world efficacy and safety data are currently lack of evidence in China. Therefore, this multi-center real-world study aims to retrospectively analyze the efficacy and safety of neoadjuvant trastuzumab and pertuzumab combined with different chemotherapy regimens of HER2-positive early breast cancer. Methods: Patients received trastuzumab and pertuzumab in combination with different chemotherapy regimens, including taxanes (T), cyclophosphamide (C), anthracyclines (A) were collected retrospectively from 12 centers. The primary endpoint was total pathological complete response (tpCR, ypT0/is ypN0) rate. Results: A total of 357 patients were enrolled, among which 204 (57.5%) recieved TCbHP, 92 (25.9%) recieved EC-THP, and 51 (14.4%) received THP as chemotherapy regimens. The median age was 48 years old (range, 22-76), 142 (39.8%) of patients were classified as hormone receptor (HR)-positive, and 215 (60.2%) were HR-negative. The overall tpCR rate was 58.5% (95%CI, 53.2%-63.7%). tpCR rate for HR-negative patients was significantly higher than HR-positive patients (65.6% vs. 47.9%, p=0.001) and there was not any statistical difference according to chemotherapy regimens (56.9% for TCbHP, 56.5% for EC-THP, and 66.7% for THP, p=0.445). The most common adverse events included anemia (40.1%), white blood cell count decreased (34.3%), ejection fraction decreased (19.5%), Alanine aminotransferase increased (18.9%), platelet count decreased (12.8%) and neutrophil count decreased (12.0%). There was not any toxicity leading to death. Conclusions: Multi-center real-world data show satisfactory tpCR rate and tolerable adverse events of trastuzumab and pertuzumab in combination with different chemotherapy regimens in China. Citation Format: Xiaowei Qi, Hong Hu, chen wenlin, xu yan, liu shu, fang yanman, Taolang Li, ming jia, zhou sihai, chai fan, liang yueyang, fan yuanming, Yi Zhang, Peng Tang, jiang jun, nie jianyun, Li Chen, Shushu Wang. The efficacy and safety of trastuzumab and pertuzumab in combination with different chemotherapy regimens for neoadjuvant treatment of HER2-posotive breast cancer: a multi-center real-world study in China [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 P1-11-18.

The objective of this study is to observe the effect of indwelling needle puncture and irrigation in the conservative treatment of breast abscesses in the non-lactation period. Non-lactating breast abscess patients were treated at the Daping Medical Breast Surgery Clinic, Chongqing. In the Incisive drainage group, 21 patients were treated with conventional incision and drainage. In the Indwelling needle group, 20 patients were treated by puncture and irrigation with a 20 G indwelling needle. The pain VAS scores and wound satisfaction in the Indwelling needle group were significantly lower than those in the Incisive drainage group (P < 0.001), and the cure time and complications were also significantly lower in the Indwelling needle group (P < 0.05). The cure rates of the two groups were similar (P > 0.05). There was a difference in the duration of illness, location, and number of pus cavities between the treatment failure and the treatment recovery (P < 0.05). However, there was no difference in the size of the pus cavity and the maximum amount of pus aspiration (P > 0.05). The indwelling needle can be used as an effective tool for puncture and irrigation of single breast abscess in a non-lactation period, potentially for non-invasive treatment of breast abscesses.