Endocrine therapy is a crucial treatment modality for hormone receptor-positive breast cancer. However, off-label use of endocrine agents is widely observed in clinical practice. To provide evidence-based guidance, a panel of experts from the Breast Cancer Committee of the Chinese Society of Clinical Oncology (CSCO), the Oncology Multidisciplinary Committee of the Chinese Medical Doctor Association, and the Guangdong Pharmaceutical Association systematically reviewed and evaluated the evidence supporting off-label endocrine therapy for breast cancer. This process involved comprehensive literature searches, critical appraisal of existing guidelines, consensus statements, and practice standards, as well as a re-evaluation of randomized controlled trials (RCTs) involving approved endocrine agents. Using the CSCO evidence grading and recommendation system, the strength of evidence and recommendations were determined. Consequently, 23 recommendations addressing 21 clinical questions were developed. This consensus aims to provide clinicians with a basis for rational drug use and offers a reference for pharmacy departments in managing off-label endocrine therapies.

To construct a prediction model of high load axillary lymph node metastasis (ALNM) in breast cancer based on multiple ultrasound characteristic parameters.

According to the inclusion and exclusion criteria, a retrospective study was conducted on the clinical data of 250 patients with breast cancer who underwent preoperative ultrasound examinations (conventional ultrasound, acoustic radiation force impulse imaging, automated breast volume scanner, and contrast-enhanced ultrasound) in the Longyan First Hospital between January 2020 and June 2024. The patients were divided into a training group (n=175) and a validation group (n=75) at a ratio of 7∶3. The risk factors of high load ALNM in breast cancer patients of the training group were analyzed by univariate and multivariate logistic regression analyses. The prediction model was constructed accordingly and the nomogram was drawn. Receiver operating characteristic curve (ROC) and Hosmer-Lemeshow test were used to evaluate the discrimination degree and calibration degree of the model. Clinical decision curve analysis (DCA) was used to evaluate the clinical net benefit. The model was verified by the data of the validation group.

Multivariate logistic regression analysis revealed that lesion edge maximum shear wave velocity (SWV_max) (OR=2.742, 95%CI: 1.175-6.399) , lymphatic contrast-enhanced ultrasound (LCEUS) enhancement type (Ⅲ-Ⅳ type) (OR=11.993, 95%CI: 4.407-32.632) , intravenous contrast-enhanced ultrasound (ICEUS) enhancement type (concentric/mixed type) (OR=10.424, 95%CI: 3.583-30.326) , portal structure disappearance of sentinel lymph node (SLN) (OR=12.305, 95%CI: 2.758-54.901) , and blood flow of SLN edge (OR=5.280, 95%CI: 1.852-15.050) were predictive factors of high load ALNM in the training group. Based on this, a nomogram model was constructed and the model formula was as follow: Logit (P) =1 009×lesion edge SWV_max+1.664×blood flow of SLN edge flow+2.510×SLN portal structure disappearance+2.344×ICEUS enhancement type (concentric/mixed type) +2.484×LCEUS enhancement type (Ⅲ-Ⅳ type) -7.276. In the training group, the area under the ROC curve (AUC) of the prediction model was 0.920 (95%CI: 0.878-0.962), and the Hosmer-Lemeshow test revealed a chi-square value of 6.951 (P=0.542) . In the validation group, the AUC was 0.907 (95%CI: 0.842-0.973), and the Hosmer-Lemeshow test manifested a chi-square value of 8.965 (P=0.345). DCA results showed that when the threshold probabilities were 3%-97% and 8%-95% in the training group and validation group, the model could be used as a reference to obtain net benefits.

The prediction model based on lesion edge SWV_max, LCEUS enhancement type (Ⅲ-Ⅳ type) , ICEUS enhancement type (concentric/mixed type) , SLN portal structure disappearance and blood flow of SLN edge has a high predictive ability for high load ALNM in breast cancer patients.

To compare the clinical efficacy and safety of excisional biopsy (EB) and core-needle biopsy (CNB) in breast cancer patients undergoing breast-conserving surgery (BCT) .

A retrospective study was conducted on the clinical data of 243 breast cancer patients who underwent BCT in the Chengdu Women and Children's Central Hospital between July 2017 and October 2024. According to the preoperative biopsy method, the patients were divided into the EB group (n=70) and the CNB group (n=173) . A dual-tracer method using methylene blue combined with indocyanine green was used for sentinel lymph node (SLN) mapping. The number of intraoperative SLNs detected, positive margin rate, postoperative complication rate, and patient satisfaction with breast appearance were compared between the two groups. Normally distributed continuous variables were compared using the independent sample t test, and continuous variables with a skewed distribution were analyzed using the Mann–Whitney U test. Categorical variables were compared using χ² test or Fisher's exact test. Ordinal variables were compared using nonparametric tests.

The number of SLNs detected intraoperatively was 4.0 (0.0, 9.0) in the EB group and 4.0 (1.0, 13.0) in the CNB group (Z=-0.267, P=0.790) . The positive margin rate was 22.9% (16/70) and 32.4% (56/173) , respectively, indicating no significant difference ( χ²=2.163, P=0.141) . Patients were followed up for 1.0 to 89.3 months. The follow-up time was 32.2 (13.3, 53.1) months in the EB group and 32.8 (17.6, 52.6) months in the CNB group, indicating no significant difference (Z=-0.491，P=0.624). There was no significant difference in the postoperative complication rate between the EB group and the CNB group [5.7% (4/70) vs 5.8% (10/173) , χ²=0.000, P=1.000]. One patient in the EB group developed local recurrence, and two patients in the CNB group developed distant metastasis. For patients in the EB group and CNB group, the breast appearance was assessed as excellent, good, fair, and poor in 45, 24, 0, 1 cases and 91, 80, 1, 1 cases， respectively, suggesting no significant difference between the two groups (Z=-1.612, P=0.107) .

In breast cancer patients undergoing BCT, preoperative EB and CNB demonstrate comparable clinical efficacy and safety.

To investigate the influencing factors of readiness for hospital discharge in breast cancer patients undergoing their first daycare chemotherapy and its correlation with medical coping modes.

A cross-sectional survey was conducted among 252 breast cancer patients receiving their first daycare chemotherapy in the Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Army Medical University, from June to September 2024, according to inclusion and exclusion criteria. Patients completed a general information questionnaire, the discharge readiness scale, and the medical coping modes questionnaire. Pearson correlation analysis was used to examine the correlation between discharge readiness and medical coping modes. Multiple linear stepwise regression analysis was employed to identify influencing factors of discharge readiness and establish a regression equation.

The total score for discharge readiness in breast cancer patients receiving their first daycare chemotherapy was 78.55±6.14. The scores for facing, avoidance and yielding in medical coping modes were 19.13±3.44, 19.96±3.46 and 13.81±2.62, respectively. Univariate analysis showed that age, occupation status, place of residence, payment method, education level, and household monthly income per capita were associated with patients' discharge readiness (all P<0.05) . The total score for discharge readiness was positively correlated with facing (r=0.922, P<0.05) , and negatively correlated with yielding and avoidance (r=-0.915, -0.952, both P<0.05) . Avoidance, yielding, facing, household monthly income per capita, age, education level, and occupation status were significant influencing factors for discharge readiness (all P<0.05) . The established regression equation was as follow: Discharge Readiness=96.87-0.86×Avoidance-0.520×Yielding+0.310×Facing+0.714×Monthly Household Income per Capita -0.937×Age+0.267×Education Level -0.511×Employment Status. This regression equation is statistically significant (F=68.48, P<0.001).

The readiness for hospital discharge in breast cancer patients undergoing their first daycare chemotherapy is primarily influenced by medical coping modes and some sociodemographic factors. Healthcare professionals should identify risk factors and focus on guiding patients to adopt active coping strategies, such as providing psychological intervention and individualized health guidance, to reduce avoidance and yielding behaviors.