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Background Breast cancer has been a disease in which treatment strategy has changed over time under the influence of different hypotheses and evidence for more than a century. We analyzed the contribution of radiotherapy to disease-free survival and overall survival by classifying according to stage, 1–3 lymph node involvement, and molecular subgroups. Methods Following the approval of the Institutional Review Board, records of patients with breast cancer who were admitted to University School of Medicine Departments of Radiation Oncology and Medical Oncology between July 1999 and December 2020 were reviewed. Using data propensity score matching was performed between the groups that did and did not receive radiotherapy using an optimal matching algorithm (optimum, 1:1). Disease-free survival and overall survival after propensity score matching were calculated using the Kaplan-Meier method. Univariate and multivariate Cox regression analysis was used to estimate hazard ratios. Results In the radiotherapy and non-radiotherapy groups, disease-free survival was 257.42 ± 5.46 (246.72- 268.13), 208,96 ± 8,15 (192,97–224,94) months respectively, ( p = < 0.001) , overall survival was 272,46 ± 8,68 (255,43–289,49), 219,05 ± 7,32 (204,70–233,41) months respectively ( p  = .002). We compared the 19 N1 patient groups who received radiotherapy with the 19 patients who did not receive radiotherapy and calculated the disease-free survival times was 202,21 ± 10,50 (181,62–222,79) and 148,82 ± 24,91 (99,99–197,65) months respectively ( p  = .011) and overall survival times was 200,85 ± 12,79 (175,77–225,92) and 166,90 ± 20,39 (126,93–206,82) months respectively ( p  = .055). We examined disease-free survival and overall survival times in both groups according to Luminal A, Luminal B, TNBC, and HER2-enriched subgroups. In the Luminal B subgroup, the disease-free survival duration in the groups receiving radiotherapy and not receiving radiotherapy was 264.83 ± 4.95 (255.13-274.54) and 187.09 ± 11.06 (165.41-208.78) months ( p  < .001), and overall survival times were 252.29 ± 10.54 (231.62-272.97) and 197.74 ± 9.72 (178.69–216.80) months ( p  = .001) respectively. Conclusions Thanks to studies proving that RT increases long-term survival rates in breast cancer as a result of reducing locoregional recurrence and systemic metastasis rates, it has been understood that the spectrum hypothesis is the hypothesis that most accurately describes breast cancer to date. We found that patients with Luminal B invasive breast cancer benefited significantly more from RT compared to other subgroups.

Background: Buccal mucosa metastasis is rare in breast cancer patients. Case Presentation: A 50-year-old female breast cancer patient with invasive lobular carcinoma (ILC) in his eight years follow-up period presented with a swelling in the right eye. Head and neck MRI was showed soft tissue formation with dimensions of 59x31 mm was detected in the axial plane, extending from the level of the right infratemporal fossa to the right buccinator muscle and right maxillary sinus in front of the alveolar process. In the right periorbital region, there was a thickness increase of up to 1 cm in the thickest part of the globe, which was evident in the anterolateral. In addition, there was no bone destruction in the right infratemporal region in maxillofacial CT, and no additional organ metastasis was detected in PET-CT performed for systemic scanning. In the histopathological examination of the tissue, carcinoma infiltration was detected. Radiotherapy was applied to the right buccal and orbital region of the patient as 30 Gy in 12 fractions (2.5 Gy per fraction) with volumetric modulated arc therapy technique and then 15 Gy in 6 fractions (2.5 Gy per fraction) boost radiotherapy with the adaptive technique were applied. At the follow-up 2 months later, clinical response was observed in the patient, and significant regression of the lesion was observed in facial and orbital MRI. At the 15th month follow-up of the patient, clinical and radiological remission continues. All clinical complaints regressed. Conclusion: ILC is a subtype of breast cancer that is characterized by unusual metastasis. Therefore, during the follow-up of these patients, it is necessary to monitor both laboratory values and clinical complaints very carefully.

Background Nonadherence to antipsychotic treatment increases the likelihood of relapse and progressive symptomatology in patients with schizophrenia. Atypical long-acting injectables, including paliperidone palmitate (PP), may increase adherence and improve symptoms. This study compared and assessed predictors of treatment patterns and symptom remission among schizophrenia patients treated with PP versus atypical oral antipsychotic therapy (OAT) in community behavioral health organizations (CBHOs). Methods This retrospective cohort analysis evaluated 763 patients with schizophrenia and new (PP-N; N  = 174) or continuing (PP-C; N  = 308) users of PP, or new users of OAT ( N  = 281) at enrollment in the REACH-OUT study (2010–2013). Treatment outcomes assessed at 1 year were discontinuation, and adherence, measured by proportion of days covered (PDC) or medication possession ratio (MPR). Remission status was assessed using the Structured Clinical Interview for Symptoms of Remission (SCI-SR). A machine learning platform, Reverse Engineering and Forward Simulation (REFS™), was used to identify predictors of study outcomes. Multivariate Cox and generalized linear regressions estimated the adjusted hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals. Results Among PP-N users, 27% discontinued their initial treatment regimen versus 51% ( p  < 0.001) of OAT users. PP-N (vs OAT; HR = 0.49 [0.31–0.76]) users and males (HR = 0.65 [0.46–0.92]) had significantly lower rates of discontinuation. Relative to OAT, PP-N had a 36% [31%–42%] higher MPR and a 10-fold increased achievement of PDC ≥80% (OR = 10.46 [5.72–19.76]). PP users were significantly more likely to achieve remission in follow-up (PP-N vs OAT: OR = 2.65 [1.39–5.05]; PP-C vs OAT: OR = 1.83 [1.03–3.25]). Conclusions Relative to OAT, PP was associated with improved adherence, less frequent treatment discontinuation, and improved symptom remission in this CBHO study population.