Currently, surgical resection remains the primary local treatment for breast cancer. However, some breast cancer patients are unable to undergo or refuse surgical resection due to multiple comorbidities, advanced age, locally advanced disease, or fear of recurrence. Lack of treatment for the local breast cancer leads to a high risk of both uncontrolled local progression and distant metastasis. Image-guided ablation therapy demonstrates advantages such as minimal invasiveness, high tolerability, precise tumor inactivation, repeatability for recurrent tumors, excellent cosmetic outcomes without scars, and preservation of glandular structure and function. Compared with surgery, ablation therapy has achieved similar clinical efficacy in early stage solid tumors. In recent years, the application of ablation therapy in breast cancer has been steadily increasing. Based on the latest research progress and China's clinical practice, the expert consensus standardizes treatment protocols and procedures of ablation therapy, in order to enhance the safety and efficacy of ablation therapy for non-surgical breast cancer candidates.

The principal applications of robotic breast surgery include robotic nipple-sparing mastectomy （RNSM） with immediate reconstruction, robotic harvest of autologous tissue for breast reconstruction, single-port robotic breast-conserving surgery, and robotic axillary lymph node dissection. Overall, existing studies suggest that with appropriate patient selection and implementation by experienced teams, robotic breast surgery offers short-term safety and oncologic outcomes comparable to those of conventional techniques. Some researches indicate potential advantages in reducing nipple necrosis and major complications, improving incision concealment, and enhancing aesthetic satisfaction. However, its wider adoption remains constrained by high cost of equipments and consumables, longer setup and operative time, lack of haptic feedback, instrument interference in confined working spaces, and substantial training requirements. This article provides a systematic review of the clinical applications of robotic technology in breast surgery, outlining the evolution of related techniques and surgical platforms and summarizing the main procedures currently feasible in practice as well as the available evidence. In the future, with advances such as 5G-enabled telesurgery, domestic manufacturing, and the integration of dedicated breast robotic systems with AI-based imaging navigation, robotic surgery may further promote precise, minimally invasive and individualized approaches in breast surgery. Nevertheless, more high-quality multicenter studies with long-term follow-up are needed to validate durable oncologic outcomes and the robustness of functional and aesthetic benefits.

To investigate the role of kinesin family member 18A (KIF18A) in breast cancer and its impact on cellular biological behaviors, and explore its potential as a novel molecular target for triple negative breast cancer (TNBC).

A total of 138 TNBC surgical specimens were collected from the Foshan First People's Hospital between August 2012 and December 2016. Tissue microarray was used to detect KIF18A expression, and its impact on patients' overall survival was analyzed. KIF18A-overexpressing and KIF18A-knockdown TNBC cell lines were constructed [overexpression: H23570 group (experimental group) and overexpression NC group (control group); knockdown: Y20559 group (experimental group) and knockdown NC group (control group)]. Cell proliferation, apoptosis, invasion and migration abilities were assessed using CCK-8 assay, flow cytometry, Transwell assay and wound healing assay, respectively. Western blot analysis was performed to detect the expression of related signaling pathway proteins and explore the potential mechanism of KIF18A. The chi-square test was used to analyze the correlation between KIF18A expression and clinical indicators. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Univariate and multivariate Cox proportional hazards regression models were used to evaluate independent prognostic factors. Measurement data conforming to a normal distribution were presented as

The expression of KIF18A differed significantly between patients of different ages (≤48 years vs >48 years, 71.4% vs 49.1%, χ²=4.478, P=0.034) and tumor sizes (≤3 cm vs >3 cm, 67.9% vs 43.0%, χ²=8.111, P=0.004). The OS of KIF18A low expression group (n=64) was significantly higher than that of KIF18A high expression group (n=74) at all time points, with distinct separation of survival curves between two groups (HR=4.330, 95%CI: 2.277-6.252, P<0.001). High KIF18A expression (HR=3.080, 95%CI: 1.374-6.906, P=0.006) and advanced TNM stage (HR=2.551, 95%CI: 1.204-5.402, P=0.014) were independent risk factors for OS in TNBC patients. The mRNA expression levels of KIF18A in MDA-MB-231, MDA-MB-468, MDA-MB-453 and BT474 cell lines were 9.042±0.074, 5.340±0.108, 6.040±0.171 and 7.068±0.259, respectively, with significant differences among groups (F=274.67, P<0.0001). Compared with the corresponding control group, KIF18A overexpression promoted cell proliferation (t=5.450, P=0.031), whereas KIF18A knockdown had no significant effect on cell proliferation (t=1.708, P=0.163). Cell proliferation was significantly inhibited by the KIF18A inhibitor Sovilesib at a concentration of 18.77 μmol/L. KIF18A overexpression mainly suppressed early apoptosis (P<0.05), while KIF18A knockdown increased the overall apoptotic level (P<0.001). In the overexpression group, the migration rate of H23570 cells was significantly higher than that of the overexpression NC group [(80.18±2.96) % vs (38.18±4.32) %, t=13.901, P<0.001]. KIF18A knockdown did not significantly affect cell migration ability initially, but after 72 hours, the migration ability of TNBC cells with KIF18A knockdown was significantly lower than that of knockdown NC group (P<0.001). KIF18A overexpression enhanced cell invasion ability (t=29.502, P<0.001), while KIF18A knockdown exerted an inhibitory effect on cell invasion (t=20.210, P<0.001). Western blot results demonstrated that compared with the control group, KIF18A overexpression upregulated the expression levels of mTOR, PD-L1, and CDK4 (t=7.471, 9.729, 4.064, all P<0.05) and downregulated PARP1 expression (t=12.310, P<0.05) in the H23570 group. Conversely, KIF18A knockdown reduced the expression levels of mTOR, PI3K, Akt, PD-L1, Cyclin D1, and CDK4 (t=2.792, 6.035, 4.091, 15.750, 12.940, 3.979, all P<0.05) in the Y20559 group.

High expression of KIF18A is correlated with poor prognosis and malignant biological behaviors of TNBC, and KIF18A may play its role by regulating the expression of proteins such as CDK4/cyclin D1.

To investigate the efficacy of different first-line treatment methods in hormone receptor-positive, HER-2-negative (HR+/HER-2-) breast cancer patients with bone-only metastases (BOM).

Clinical data of 373 HR+/HER-2- breast cancer patients with BOM between October 2001 and November 2018 in the Senior Department of Oncology Medicine, Chinese PLA General Hospital were retrospectively analyzed. Patients were divided into two groups according to the different initial treatment, including chemotherapy (CT) group (initial CT group, n=165) and endocrine therapy (ET) group (initial ET group, n=208). Patients without disease progression at least 3 months after initial treatment were divided into different groups based on their maintenance therapy, including continuous CT (CT cohort), maintenance ET following initial CT (CT-ET cohort) and continuous ET (ET cohort). The clinicopathological characteristics and prognostic factors were analyzed between different treatment groups. The log-rank test was used for univariate analysis, and Cox regression model for multivariate analysis. Propensity score matching and standardized mean difference with inverse probability weighting were adopted to evaluate the balance between groups. Survival analysis was performed using the Kaplan-Meier method.

The median progression-free survival (PFS) of patients in the initial CT group and the initial ET group was 10 months (95%CI: 6.76-13.23) and 12 months (95%CI: 10.33-13.66), respectively, while the median overall survival (OS) was 61 months (95%CI: 45.42-76.57) and 52 months (95%CI: 41.28-62.71), respectively. No statistically significant difference was observed between the two groups (χ²=1.057, 1.044, both P>0.05). After propensity score matching, both initial CT and ET group had 106 cases, with median PFS of 12 months (95%CI: 8.70-15.29) and 14 months (95%CI: 11.48-16.51), indicating a significant difference (χ²=4.254, P=0.039); and the median OS was 68 months (95%CI: 49.20-86.79) and 64 months (95%CI: 51.21-76.79), indicating no significant difference (χ²=0.018, P=0.894). A total of 332 patients showed no disease progression for at least 3 months after initial treatment, including 58 in the CT cohort, 82 in the CT-ET cohort, and 192 in the ET cohort. The median PFS for the CT cohort, CT-ET cohort and ET cohort was 6 months (95%CI: 6.74-11.20), 19 months (95%CI: 21.60-30.43), and 13 months (95%CI: 15.45-19.62), indicating a significant difference (χ²=59.586, P<0.001). The median OS was 48 months (95%CI: 46.16-68.64), 72 months (95%CI: 70.78-93.54), and 54 months (95%CI: 61.40-80.91), indicating a significant difference (χ²=5.984, P=0.050). After inverse probability weighting, the median PFS was 7 months (95%CI: 5.00-12.00), 20 months (95%CI: 16.00-25.00), and 13 months (95%CI: 12.00-16.50) in the three corhort, with significant differences among groups (χ²=51.493, P<0.001). The median OS was 46 months (95%CI: 32.00 to not reached), 92 months (95%CI: 61.00-114.00), and 54 months (95%CI: 48.00-67.00), with no statistically significant difference (χ²=5.334, P=0.069). The Cox multivariate analysis results showed that different first-line treatment methods (CT-ET cohort vs CT cohort: HR=0.02, 95%CI: 0.01-0.06; ET cohort vs CT cohort: HR=0.57, 95%CI: 0.40-0.81) was an independent factor affecting PFS; the time from diagnosis to recurrence (≥24 months vs <24 months, HR=0.64, 95%CI: 0.46-0.89) was an independent influencing factor of OS.

In HR+/HER2- breast cancer patients with BOM, after propensity score matching, the median PFS of initial ET was better than that of initial CT among the patients in the front-line preferred endocrine group, and the median OS of the two groups of patients was similar. In patients without progression after initial first-line therapy, the CT-ET cohort yielded better outcomes than CT or ET cohort.

To systematically evaluate the incidence and influencing factors of radiation dermatitis (RD) in breast cancer patients treated with radiotherapy.

A meta-analysis was conducted on the incidence of RD and its influencing factors in breast cancer patients receiving radiotherapy in the CNKI, Wanfang Database, VIP Database, Chinese Biomedical Literature Database, PubMed, Embase, Web of Science, OVID, CINAHL and Cochrane Library, and the time range was from the establishment of the database to December 2024. Two researchers independently conducted literature screening, quality evaluation and data collation, and used RevMan 5.4 and Stata 15.0 software for statistical analysis.

A total of 33 articles were included, of which 24 articles reported the incidence of RD in 8 696 breast cancer patients receiving radiotherapy and the overall incidence of RD was 82% (95%CI: 69%-91%). Intensive irradiation (OR=1.49, 95%CI: 1.22-1.83, P<0.001), large breast volume (OR=1.10, 95%CI: 1.04-1.16, P<0.001), body mass index ≥25 kg/m² (OR=1.29, 95%CI: 1.11-1.51, P<0.001), conventional fractionated radiotherapy (OR=1.97, 95%CI: 1.33-2.94, P<0.001), smoking (OR=1.58, 95%CI: 1.00-2.50, P=0.050), diabetes (OR=1.47, 95%CI: 1.12-1.95, P<0.05), chemotherapy before radiotherapy(OR=1.25, 95%CI: 1.06-1.47, P<0.05), and use of compensation membranes (OR=3.53, 95%CI: 2.74-4.55, P<0.001) were risk factors for RD in patients undergoing radiotherapy for breast cancer. However, the results of this study could not support hypertension (OR=1.16, 95%CI: 0.82-1.66, P=0.550) and age (OR=1.02, 95%CI: 0.99-1.04, P=0.230) as the risk factors for RD in breast cancer patients with radiotherapy.

The incidence of RD in breast cancer patients undergoing radiotherapy is high due to various factors, among which intensified irradiation, large breast volume, body mass index ≥25 kg/m², conventional fractionated radiotherapy, smoking, diabetes, chemotherapy before radiotherapy and use of compensatory membranes increase the risk of RD.