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This study aimed to investigate the clinical importance and prognostic value of nonmass lesions (NMLs) identified via preoperative magnetic resonance imaging (MRI) in patients with breast cancer, with an emphasis on understanding how these lesions affect treatment decisions and survival outcomes. A retrospective analysis was conducted on 6971 patients diagnosed with breast cancer who underwent surgery at Asan Medical Center, Seoul, between January 2000 and December 2021. Patients were categorized based on the presence or absence of NMLs on preoperative MRI. Various clinicopathological parameters were compared, and survival outcomes, such as overall survival (OS), distant metastasis-free survival (DMFS), regional recurrence-free survival (RFS), and local recurrence-free survival (LFS), were analyzed using Kaplan–Meier and Cox regression methods. Subgroup analyses were performed based on the type of surgery and the administration of neoadjuvant chemotherapy and adjuvant radiation therapy. Of the total cohort, 21.9% ( n  = 1524) had NMLs. The presence of NMLs was associated with a significant improvement in OS ( P  = 0.017) for the entire patient group. Multivariate analysis revealed the presence of NMLs as a favorable prognostic factor (hazard ratio 0.47, 95% confidence intervals 0.25–0.90, P  = 0.022). Subgroup analyses demonstrated significantly improved OS, DMFS, and RFS outcomes for patients with NMLs who underwent mastectomy after neoadjuvant chemotherapy. NMLs on preoperative MRI in patients with breast cancer are associated with improved overall survival (OS) and serve as an independent prognostic factor. However, further research is needed to elucidate the underlying reasons for these outcomes.

Background Nipple-sparing mastectomy (NSM) has become a preferred surgical option for breast cancer patients due to its oncologic safety and aesthetic benefits. Robotic NSM (RNSM) offers enhanced precision and minimally invasive access, yet its feasibility in cases with a tumor-to-nipple distance (TND) ≤ 1 cm remains unclear. This study evaluates the oncologic safety and surgical outcomes of RNSM in patients with TND ≤ 1 cm by comparing it with both RNSM in patients with TND > 1 cm and conventional NSM (CNSM) in patients with TND ≤ 1 cm. Methods A retrospective analysis of 1427 patients who underwent NSM with immediate reconstruction between October 2020 and October 2023 was conducted. Propensity score matching (PSM) was applied to compare three groups: TND ≤ 1 cm, RNSM vs. TND > 1 cm, RNSM and TND ≤ 1 cm, RNSM vs. TND ≤ 1 cm, CNSM. Oncologic safety was assessed by analyzing subareolar resection margin status, while surgical outcomes included postoperative complications such as nipple-areolar complex (NAC) necrosis. Result After PSM, no statistically significant differences were observed in subareolar resection margin results or the incidence of adverse events between the TND ≤ 1 cm and TND > 1 cm RNSM groups. Similarly, no significant differences were found in oncologic or surgical outcomes between RNSM and CNSM in patients with TND ≤ 1 cm. Conclusions RNSM is a safe and feasible option for patients with TND ≤ 1 cm, achieving oncologic outcomes comparable to CNSM in patients with TND ≤ 1 cm and RNSM in patients with TND > 1 cm. These findings suggest that TND ≤ 1 cm should not be a contraindication for RNSM. Further prospective studies with long-term follow-up are necessary to validate these results.

Background: Breast cancer requires long-term surveillance, as recurrence and mortality risks extend beyond 10 years. Mammography (MMG) is the standard imaging modality; however, its effectiveness is reduced in Asian women owing to dense breast tissue. The optimal timing of surveillance MMG after breast-conserving surgery remains unclear, particularly the value of routine 6-month MMG. We evaluated the roles of MMG and ultrasound in detecting ipsilateral and contralateral breast cancer recurrence after breast-conserving surgery. Methods: This retrospective study included 961 patients with operable breast cancer who underwent breast-conserving surgery with or without axillary surgery between 2011 and 2015 at Kyungpook National University Chilgok Hospital. Surveillance consisted of biannual imaging for the first 2 years, followed by annual imaging for up to 10 years. Ipsilateral and contralateral breast cancer recurrences were analyzed according to detection modality, including MMG and ultrasound. Multivariate Cox proportional hazards regression analysis was performed to identify independent risk factors for recurrence. Results: During a mean follow-up of 139 months, 56 patients (5.8%) experienced locoregional recurrence, and 41 (4.3%) developed distant metastasis. Among 35 in-breast recurrences, 14 (40.0%) were ipsilateral and 21 (60.0%) contralateral. Ipsilateral recurrences were more often detected via either MMG or ultrasound alone, whereas contralateral cancers were typically detected through both modalities. During the first postoperative year, all ipsilateral and contralateral recurrences were detected exclusively by ultrasound, with no cancers identified by 6-month MMG (95% CI for 6-month detection: 0–0.38%). Multivariate analysis identified positive axillary lymph node status as the only independent predictor of locoregional recurrence (HR 2.52, 95% CI 1.14–5.54, p = 0.022). Detection patterns showed no significant differences across molecular subtypes (p = 0.665). Conclusions: Annual MMG remains appropriate for breast cancer surveillance in accordance with current guidelines. However, MMG at 6 months post-surgery may be unnecessary, as early detection during the first year was achieved solely by ultrasound. The complementary role of MMG and ultrasound is consistent regardless of molecular subtype.

Background/Objectives: Considering the increasing importance placed on the quality of life among those who survive cancer, breast reconstruction is no longer limited to only compensating for breast loss; achieving the patient’s preferences is now considered. However, the optimal surgical approach (subpectoral plane vs. prepectoral plane) in single-stage direct-to-implant breast reconstruction (DTIBR) has not been established. The aim of this study was to summarize the principles for selecting between the subpectoral and prepectoral planes in DTIBR. Methods: In this retrospective study, we evaluated 543 patients with breast cancer who underwent DTIBR between March 2018 and October 2025. Postmastectomy reconstruction was performed in the subpectoral plane when the defect showed greater breast height than width, whereas the prepectoral plane was used when breast width exceeded height. Complications requiring reoperation were analyzed. Patient satisfaction was evaluated based on overall satisfaction, esthetic outcome, physical symptoms, psychosocial impact, and decision satisfaction using a visual analog scale. Results: The subpectoral dual-plane approach was most commonly used between 2018 and 2019, while the prepectoral plane became predominant after 2020. Overall, 83 (14.4%) patients developed major complications. The overall satisfaction score was 4.1 ± 0.80 in the subpectoral group and 4.35 ± 0.70 in the prepectoral group, showing a statistically significant difference (p value = 0.012). Conclusions: The subpectoral and prepectoral planes have distinct advantages and limitations. Ultimately, the reconstructive surgeon should determine the most appropriate option in DTIBR. Selecting the surgical plane based on the postmastectomy defect reduces complications while improving patient satisfaction.

Inhibitors of the secretion of cancer exosomes, which promote cancer progression and metastasis, may not only accelerate exosome biology research but also offer therapeutic benefits for cancer patients. Here we identify sulfisoxazole (SFX) as an inhibitor of small extracellular vesicles (sEV) secretion from breast cancer cells through interference with endothelin receptor A (ETA). SFX, an FDA-approved oral antibiotic, showed significant anti-tumor and anti-metastatic effects in mouse models of breast cancer xenografts, the reduced expression of proteins involved in biogenesis and secretion of sEV, and triggered co-localization of multivesicular endosomes with lysosomes for degradation. We demonstrate the important role of ETA, as target of SFX, by gain- and loss-of-function studies of the ETA protein, through a direct binding assay, and pharmacological and genetic approaches. These findings may provide a foundation for sEV-targeted cancer therapies and the mechanistic studies on sEV biology. Extracellular vesicles are released from cells and permit communication between different cell types. Here, the authors identify that the FDA approved antibiotic sulfisoxazole, can block the release of these vesicles in breast cancer cells resulting in reduced cell growth in vitro and in vivo.

Lactobacillus plantarum DK119 (DK119) isolated from the fermented Korean cabbage food was used as a probiotic to determine its antiviral effects on influenza virus. DK119 intranasal or oral administration conferred 100% protection against subsequent lethal infection with influenza A viruses, prevented significant weight loss, and lowered lung viral loads in a mouse model. The antiviral protective efficacy was observed in a dose and route dependent manner of DK119 administration. Mice that were treated with DK119 showed high levels of cytokines IL-12 and IFN-γ in bronchoalveolar lavage fluids, and a low degree of inflammation upon infection with influenza virus. Depletion of alveolar macrophage cells in lungs and bronchoalveolar lavages completely abrogated the DK119-mediated protection. Modulating host innate immunity of dendritic and macrophage cells, and cytokine production pattern appeared to be possible mechanisms by which DK119 exhibited antiviral effects on influenza virus infection. These results indicate that DK119 can be developed as a beneficial antiviral probiotic microorganism.

Acute kidney injury is considered an independent prognostic factor for mortality in patients with liver cirrhosis. Non-treated acute kidney injury can progress to hepatorenal syndrome with a poor prognosis. As suppression of tumorigenicity 2 (ST2) is a member of the interleukin-1 receptor family that aggravates inflammation and fibrotic changes in multiple organs, we measured soluble ST2 (sST2) level in the serum and urine of liver-transplant recipients at the time of transplantation. The serum sST2 level significantly increased in liver-transplant recipients with suppressed kidney function compared with that in recipients with normal function. In recipients with severely decreased liver function (model for end-stage liver disease score ≥ 30), the serum sST2 level was higher than that in recipients with preserved liver function (model for end-stage liver disease score ≤ 20, P = 0.028). The serum sST2 level in recipients with hepatorenal syndrome was higher than that in liver-transplant recipients without hepatorenal syndrome ( P = 0.003). The serum sST2 level in patients with hepatorenal syndrome was higher than that in recipients without a history of acute kidney injury ( P = 0.004). Recipients with hepatorenal syndrome and recovered kidney function showed higher sST2 levels than those who did not recover ( P = 0.034). Collectively, an increase in the serum sST2 level reflects a decrease in both kidney and liver functions. Thus, measuring sST2 level at the time of liver transplantation can help predict renal outcomes.

•Multivariate EEG recordings reveal the neural representation of motion prediction.•Delta oscillation dominantly represents motion prediction.•Delta-phase gradient carries information flow for motion prediction.•Anterior-to-posterior information flow explains the predictive behavioral bias. Predictive tracking demonstrates our ability to maintain a line of vision on moving objects even when they temporarily disappear. Models of smooth pursuit eye movements posit that our brain achieves this ability by directly streamlining motor programming from continuously updated sensory motion information. To test this hypothesis, we obtained sensory motion representation from multivariate electroencephalogram activity while human participants covertly tracked a temporarily occluded moving stimulus with their eyes remaining stationary at the fixation point. The sensory motion representation of the occluded target evolves to its maximum strength at the expected timing of reappearance, suggesting a timely modulation of the internal model of the visual target. We further characterize the spatiotemporal dynamics of the task-relevant motion information by computing the phase gradients of slow oscillations. We discovered a predominant posterior-to-anterior phase gradient immediately after stimulus occlusion; however, at the expected timing of reappearance, the axis reverses the gradient, becoming anterior-to-posterior. The behavioral bias of smooth pursuit eye movements, which is a signature of the predictive process of the pursuit, was correlated with the posterior division of the gradient. These results suggest that the sensory motion area modulated by the prediction signal is involved in updating motor programming.

Despite the high success rate in reconstruction using free tissue transfer, flap failure is often caused by microvascular thrombosis. In a small percentage of cases with complete flap loss, a salvage procedure is performed. In the present study, the effectiveness of intra-arterial urokinase infusion through the free flap tissue was investigated to develop a protocol to prevent thrombotic failure. The retrospective study evaluated the medical records of patients who underwent salvage procedure with intra-arterial urokinase infusion after reconstruction with free flap transfer between January 2013 and July 2019. Thrombolysis with urokinase infusion was administered as salvage treatment for patients who experienced flap compromise more than 24 hours after free flap surgery. Because of an external venous drainage through the resected vein, 100,000 IU of urokinase was infused into the arterial pedicle only into the flap circulation. A total of 16 patients was included in the present study. The mean time to re-exploration was 45.4 hours (range: 24–88 hours), and the mean quantity of infused urokinase was 69,688 IU (range: 30,000–100,000 IU). 5 cases presented with both arterial and venous thrombosis, while 10 cases had only venous thrombosis and 1 case had only arterial thrombosis; in a study of 16 patients undergoing flap surgery, 11 flaps were found to have survived completely, while 2 flaps experienced transient partial necrosis and 3 were lost despite salvage efforts. In other word, 81.3% (13 of 16) of flaps survived. Systemic complications, including gastrointestinal bleeding, hematemesis, and hemorrhagic stroke, were not observed. The free flap can be effectively and safely salvaged without systemic hemorrhagic complications using high-dose intra-arterial urokinase infusion within a short period of time without systemic circulation, even in delayed salvage cases. Urokinase infusion results in successful salvage and low rate of fat necrosis.

The gut microbiome can influence the development of tumours and the efficacy of cancer therapeutics 1 – 5 ; however, the multi-omics characteristics of antitumour bacterial strains have not been fully elucidated. In this study, we integrated metagenomics, genomics and transcriptomics of bacteria, and analyses of mouse intestinal transcriptome and serum metabolome data to reveal an additional mechanism by which bacteria determine the efficacy of cancer therapeutics. In gut microbiome analyses of 96 samples from patients with non-small-cell lung cancer, Bifidobacterium bifidum was abundant in patients responsive to therapy. However, when we treated syngeneic mouse tumours with commercial strains of B. bifidum to establish relevance for potential therapeutic uses, only specific B. bifidum strains reduced tumour burden synergistically with PD-1 blockade or oxaliplatin treatment by eliciting an antitumour host immune response. In mice, these strains induced tuning of the immunological background by potentiating the production of interferon-γ, probably through the enhanced biosynthesis of immune-stimulating molecules and metabolites. An analysis of gut microbiomes of patients with non-small-cell lung cancer reveals an association between Bifidobacterium bifidum abundance and response to cancer therapy. In murine models of syngeneic tumours, administration of commercial B. bifidum strains synergizes with immune checkpoint blockade to reduce tumour burden, but the therapeutic potential of B. bifidum is affected by strain-level variation.