Inflammatory breast cancer(IBC)is a rare but highly aggressive subtype of breast cancer characterized by rapid clinical progression and poor prognosis.Although it accounts for only 2%-4%of all breast cancer cases,it is responsible for 8%-10%of breast cancer-related mortality.The etiology of IBC is multifactorial,involving genetic,hormonal,environmental,and socioeconomic factors.Pathologically,IBC is marked by the presence of dermal lymphatic tumor emboli,and molecular subtypes are predominantly HER2-positive and triple-negative,indicating high tumor invasiveness.Diagnosis relies on characteristic clinical manifestations and histopathological confirmation,while imaging techniques such as MRI and PET/CT play important roles in evaluating disease extent and metastasis.Given that IBC is often diagnosed at a locally advanced or metastatic stage,there is currently no specific treatment protocol.Instead,management generally follows the treatment paradigm of non-IBC,emphasizing systemic therapy within a multidisciplinary framework.HER2-positive IBC benefits from chemotherapy combined with dual-targeted anti-HER2 therapy;triple-negative IBC may respond to immune checkpoint inhibitors;and CDK4/6 inhibitors show potential efficacy in hormone receptor-positive subtypes.Despite advancements,the prognosis remains poor,with a high risk of early recurrence and distant metastasis.Prognostic factors include lymph node involvement,molecular subtype,and response to neoadjuvant therapy.As research into the tumor microenvironment and molecular mechanisms deepens,targeted and individualized therapies hold promise for improving outcomes.This review summarizes the epidemiology,pathology,diagnostic criteria,treatment strategies,and prognostic factors of IBC,aiming to inform clinical practice and future research.

The incidence of thyroid cancer has been increasing,and early diagnosis and treatment are crucial for improving patient prognosis.With the advancement of artificial intelligence(AI)technology,significant progress has been made in its application in the diagnosis and treatment of thyroid cancer.AI technology has notably enhanced the diagnostic accuracy of thyroid cancer.By optimizing imaging examinations such as ultrasound and CT scans,it can more precisely identify malignant features of thyroid nodules.In fine-needle aspiration biopsy,the integration of AI with genetic testing technologies has improved both the accuracy and efficiency of diagnosis.In terms of treatment,AI assists in intraoperative functional preservation,reducing the risk of surgical trauma.For instance,it can accurately identify the locations of the recurrent laryngeal nerve and parathyroid glands.Additionally,AI is capable of predicting the efficacy of 131I treatment and the risk of complications,thereby guiding postoperative follow-up and management.The core strength of AI technology lies in its powerful data processing and analytical capabilities,enabling it to uncover latent patterns within data and provide a scientific basis for treatment decision-making.Looking ahead,with continuous technological advancements,AI is expected to propel the diagnosis and treatment of thyroid cancer towards greater intelligence and precision.However,challenges such as data privacy and algorithm transparency need to be addressed.This article provides a review of the research progress of AI technology in the fields of diagnosis,treatment,and prognosis prediction of thyroid cancer,explores the current strengths and weaknesses of AI technology,and looks forward to its future development directions while acknowledging challenges like data privacy and algorithm transparency.

Background and Aims:Breast-conserving surgery,which balances tumor excision with preservation of breast tissue,has become a widely adopted surgical approach for breast cancer.However,postoperative tumor recurrence remains a major factor affecting patient prognosis.Accurate risk prediction tools are urgently needed to guide personalized treatment strategies.This study aimed to develop a risk prediction model for tumor recurrence after BCS based on admission clinical data and to evaluate its predictive performance to provide a scientific and practical tool for clinical decision-making.Methods:A total of 224 breast cancer patients who underwent breast-conserving surgery between May 2017 and May 2019 were enrolled.Postoperative recurrence was recorded during follow-up.Multivariate Logistic regression analysis was used to identify independent risk factors for recurrence and to construct a risk prediction model.The model's discriminative ability was assessed using the receiver operating characteristic(ROC)curve,and its calibration was evaluated using a calibration curve.Results:208 patients completed follow-up,ranging from 32 to 84 months,with a mean duration of(58.41±7.33)months.The recurrence rate was 17.79%.Multivariate Logistic regression analysis revealed that TNM stage Ⅲ(OR=2.029),tumor diameter≥4 cm(OR=1.782),≥4 lymph node metastases(OR=1.958),lymphovascular invasion(OR=1.984),and HER2 positivity(OR=1.774)were independent risk factors for recurrence(all P<0.05).The Logistic regression model was established as follows:Y=-12.788+0.707X?+0.578X?+0.672X?+0.685X?+0.573X?.The model yielded an area under the ROC curve(AUC)of 0.934(95%CI=0.891-0.963),with a sensitivity of 86.49%and specificity of 96.49%.The calibration curve demonstrated good agreement between predicted and observed outcomes(χ2=0.501,P=0.392).Conclusion:TNM stage Ⅲ,tumor diameter≥4 cm,≥4 lymph node metastases,lymphovascular invasion,and HER2 positivity are independent risk factors for tumor recurrence after breast-conserving surgery.The risk prediction model based on these factors demonstrates favorable discrimination and calibration,offering valuable guidance for postoperative risk assessment and clinical intervention.

Calcitonin-negative medullary thyroid carcinoma(CNMTC)is a rare subtype of medullary thyroid carcinoma,characterized by normal serum calcitonin levels,which often leads to misdiagnosis or missed diagnosis.The pathogenesis of CNMTC remains unclear and may involve impaired secretion mechanisms or assay-related false negatives.Diagnostic approaches include ultrasound-guided fine needle aspiration cytology,serum CEA and ProGRP measurements,and RET gene testing.Surgical resection remains the mainstay of treatment,while neoadjuvant therapy may be considered in selected cases.This review summarizes recent advances in the understanding,diagnosis,treatment,and prognosis of CNMTC,aiming to provide clinical guidance for better management of this challenging condition.

Perioperative rehabilitation aims to alleviate symptoms,restore function,and improve quality of life.These goals largely involve subjective patient experiences,which are not fully captured by traditional outcome measures.In recent years,patient-reported outcomes(PROs)have emerged as essential tools to quantify patients'perceptions of health and have been widely used in drug and device clinical trials.This review summarizes the current applications of PROs in general surgery,including symptom description,comparison of surgical methods,complication warning,and patient management.Practical cases and evidence from domestic and international studies are discussed.With the integration of electronic PROs(ePROs),artificial intelligence,and natural language processing,future efforts should focus on developing localized,specialty-specific tools and establishing stronger correlations between PROs and clinical outcomes to support the transition from disease-centered to patient-centered surgical care.

With the continuous advancement of precision medicine,robotic surgical techniques have been rapidly promoted,and robotic thyroidectomy has been increasingly applied in China,demonstrating advantages such as refined manipulation,minimal invasiveness,and improved cosmetic outcomes.Since the initiation of this procedure,our center has completed over 4 000 cases of robotic thyroidectomy,accumulating extensive practical experience and establishing a comprehensive system for surgical coordination and assistant training.An excellent surgical assistant plays a pivotal role in ensuring procedural efficiency and patient safety.Based on our center's experience,this article systematically summarizes key training elements and intraoperative coordination techniques for assistants in robotic thyroidectomy.Key areas include preoperative preparation(such as patient selection,imaging review,and assessment of non-recurrent laryngeal nerve risk)and intraoperative cooperation(including Trocar placement,instrument exchange,gauze management,and hemostasis).This paper aims to provide practical reference for surgical teams engaged in robotic thyroidectomy,promote the standardization of related techniques,enhance team coordination and surgical quality,and ultimately deliver safer and more efficient medical services to patients.

Thyroid cancer has become one of the fastest-growing malignancies in recent years,with a significant improvement in the 5-year relative survival rate among Chinese patients.Accurate diagnosis,standardized treatment,and effective follow-up are essential to improve clinical outcomes,while the promotion and implementation of clinical guidelines are critical for achieving standardized and homogeneous management.In 2022,the China Anti-Cancer Association(CACA)released the 2022 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer,which systematically applied the concept of multidisciplinary integrated management to the entire care continuum of thyroid cancer,reflecting both Chinese characteristics and local experience.Building upon this,the 2025 edition of the guidelines was updated and revised based on the latest evidence and clinical practices.This article provides a systematic interpretation of the 2025 CACA guidelines,focusing on the diagnosis,treatment,and follow-up of thyroid cancer,with the aim of offering practical guidance for clinicians and promoting standardized,integrated management of thyroid cancer in clinical practice.

Background and Aims:The BRAFV600E mutation is the most common genetic alteration in papillary thyroid carcinoma(PTC)and is widely used to guide surgical extent and risk stratification.However,other genetic variants are increasingly identified in clinical practice,and their association with lymph node metastasis(LNM)remains unclear.Most existing studies have compared BRAFV600E-mutated cases with BRAF wild-type cases without stratifying specific mutation types,potentially affecting the accuracy of risk assessment.This study aimed to compare the lymph node metastatic features between PTC patients with different common genetic alterations and those with the BRAFV600E mutation.Methods:A retrospective analysis was conducted on 4 795 PTC patients who underwent surgery and genetic testing at Fudan University Shanghai Cancer Center from January 2019 to January 2025.Patients with a single genetic alteration were included and grouped accordingly.Propensity score matching(PSM)was used to control for confounding factors including age,sex,and T stage.The number of metastatic lymph nodes and N stage were compared between each mutation group and the BRAFV600E group.Results:After PSM,patients in the CCDC6-RET and NCOA4-RET fusion groups had significantly higher numbers of metastatic lymph nodes and N1b stage rates compared to the BRAFV600E group(all P<0.05).No significant differences were observed between the ETV6-NTRK3 fusion or RAS mutation groups and the BRAFV600E group in terms of lymph node metastasis or N stage(all P>0.05).Conclusion:PTC patients harboring CCDC6-RET or NCOA4-RET fusions exhibit a significantly higher lymph node metastatic burden than those with the BRAFV600E mutation,suggesting more aggressive behavior.In contrast,ETV6-NTRK3 and RAS-mutated PTCs show similar metastatic profiles to BRAFV600E-mutated cases.Preoperative genetic profiling may help identify patients at high risk of metastasis and guide individualized lymph node dissection strategies.

Background and Aims:Medullary thyroid carcinoma(MTC)is an aggressive malignancy that is frequently associated with cervical lymph node metastasis,significantly affecting patient prognosis.However,the risk factors for lateral cervical lymph node metastasis(LLNM)in MTC remain inconclusive.This study aims to identify the risk factors associated with LLNM in MTC patients,in order to inform individualized surgical decision-making.Methods:The clinicopathologic data of 242 patients with MTC who underwent surgical treatment at Tianjin Medical University Cancer Institute and Hospital from 2011 to 2019 were retrospectively collected.The relationships between preoperative tumor markers,including calcitonin and carcinoembryonic antigen(CEA),and LLNM were evaluated.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for LLNM.Results:Preoperative calcitonin level was significantly associated with tumor diameter,the number of lymph node metastases,and the extent of lymph node involvement,while preoperative CEA level was significantly associated with tumor diameter(all P<0.05).The area under the ROC curve for preoperative calcitonin in diagnosing LLNM was 0.750(P=0.000),with an optimal cutoff value of 266.00 ng/L(sensitivity 0.854,specificity 0.577).The diagnostic value of preoperative CEA for LLNM was limited.Univariate analysis showed that sex,extracapsular extension,T stage,central lymph node metastasis(CLNM),bilateral lesions,preoperative calcitonin,tumor diameter,and multifocality were significantly associated with LLNM in MTC patients(all P<0.05).Multivariate analysis revealed that CLNM(OR=17.645,95%CI=7.728-40.290)and preoperative calcitonin≥266.00 ng/L(OR=7.832,95%CI=3.132-19.582)were independent risk factors for LLNM.Conclusion:CLNM and elevated preoperative calcitonin level are closely associated with LLNM in patients with MTC.The combination of these two indicators may help identify high-risk patients for LLNM,thereby and promoting individualized and precise treatment strategies for MTC.

Background and Aims:Implant-based breast reconstruction is one of the most common reconstructive approaches after mastectomy for breast cancer.However,the incidence of postoperative complications remains significant,and the associated risk factors have not been fully elucidated.This study aimed to analyze the incidence of surgical complications following implant-based breast reconstruction in patients undergoing mastectomy at our center and to identify potential risk factors.Methods:A retrospective analysis was conducted on patients who underwent mastectomy and implant-based breast reconstruction at Sun Yat-sen Memorial Hospital between May 2004 and August 2022.Patients were grouped according to the presence or absence of postoperative surgical complications,and multivariate Logistic regression was used to identify independent risk factors.Results:A total of 545 patients with 602 reconstructed breasts were included.Surgical complications occurred in 13.6%(82/602)of the cases,including infection,wound dehiscence/poor healing,flap or nipple-areola necrosis,and implant leakage/rupture.Multivariate analysis revealed that nipple-areola complex resection(OR=1.934,95%CI=1.056-3.542,P=0.033),postoperative radiotherapy(OR=2.483,95%CI=1.527-4.036,P<0.001),implant volume≥300 mL(OR=1.663,95%CI=1.025-2.696,P=0.039),and surgeon experience with fewer than 10 cases(OR=1.804,95%CI=1.092-2.979,P=0.021)were all independent risk factors for complications.Conclusion:NAC resection,radiotherapy,large implant volume,and limited surgical experience are important independent risk factors for postoperative surgical complications following implant-based breast reconstruction.Thorough preoperative evaluation and appropriate surgical planning are essential to minimize risks.