There is little evidence determining whether elderly patients (from 70 to 90 years old) with triple-negative breast cancer could benefit from adjuvant chemotherapy (AC). This study explores the effect of AC in these population following surgery. A total of 4610 patients were identified in the Surveillance, Epidemiology, and End Results database (2010-2018). Multiple imputation by chained equations was performed to impute missing data. Inverse probability of treatment weighting (IPTW) was applied to reduce the selection bias. IPTW-adjusted Kaplan-Meiers survival analysis and Cox proportional hazards models were performed to compare breast cancer specific survival (BCSS) and overall survival (OS) in the two treatment groups. The patients were classified into the chemotherapy (n=1989) and the observation (n=2621) groups. The percentage of patients receiving AC versus observation increased significantly from 2010 to 2018 (estimated annual percentage change, 1.49%; 95%CI, 0.75-2.16%, p=0.002). The 5-year IPTW-adjusted rates of BCSS and OS in AC group were better than that in observation group (BCSS: 82.32% vs. 78.42%, p=0.010; OS: 75.54% vs. 64.65%, p<0.001). The patients could benefit from AC based on the results of IPTW-adjusted Cox proportional hazards regression analysis (BCSS: HR, 0.77, 95%CI, 0.62-0.94, p=0.012; OS: HR, 0.66, 95%CI, 0.57-0.78, p<0.001). AC was associated with a significant outcome benefit across the year at diagnosis, marital status, stage, lymph node, surgery, and radiation subgroups (all p0.050). In conclusion, we presented a BCSS and OS benefit from AC in elderly patients with triple-negative breast cancer (TNBC). AC remained a reasonable treatment approach in these specific patients. For the patients with T1ab, de-escalated treatment would be administrated with caution.

Background: Breast cancer among adolescent and young adult (AYA) women requires greater awareness and concern due to the aggressive nature of the tumor. Therefore, this study aimed to examine the spatiotemporal trends in the burden of breast cancer in AYA women between 1990 and 2019. Methods: Data on breast cancer in AYA women were obtained from the Global Burden of Disease (GBD) 2019 study, and the estimated annual percentage change (EAPC) was computed to assess trends over time. Results: In 2019, the age-standardized prevalence rate (ASPR) of breast cancer among AYA women was 94.8 per 100,000 population, while the age-standardized incidence rate (ASIR) was 11.29 per 100,000 population. From 1990 to 2019, the age-standardized mortality rate (ASMR) declined from 3.02 (95% uncertainty interval (UI): 2.78–3.26) to 2.86 (95% UI: 2.58–3.17) per 100,000 population, and the EAPC was –0.41 (95% confidence interval (CI): –0.53 to –0.30). The age-standardized disability-adjusted life year (DALY) rate (ASDR) was 165.2 (95% UI: 148.54–182.26) in 2019, and the EAPC was –0.34 (95% CI: –0.46 to –0.23). The regions with a mid-level sociodemographic index (SDI) exhibited the fastest increases in both the ASPR and ASIR, with EAPCs of 1.77 (95% CI: 1.66 to 1.84) and 1.57 (95% CI: 1.45 to 1.67), respectively. There was an increased trend in the ASDR and ASMR in the low-middle and low SDI regions. The most substantial contributors to the DALYs and death were alcohol consumption, tobacco use, and low physical activity, which were closely followed by high fasting plasma glucose and higher red meat consumption. Conclusions: We comprehensively evaluated the burden of breast cancer in AYA women while considering factors such as SDI, age, risk elements, and geographical distribution. These findings could inform resource allocation and the development of effective policies.

Objective To study the effect of transversus abdominis plane (TAP) block under direct vision with acupoint injection on the rapid recovery of patients after laparoscopic cholecystectomy. Methods Ninety-three patients undergoing laparoscopic cholecystectomy at Hangzhou Hospital of Traditional Chinese Medicine from January 2023 to December 2023 were selected and divided into control, TAP block under direct vision (TAP-DV), and TAP-DV with acupoint injection (TAP-DVA) groups using a random number table method. Postoperative VAS, Ramsay score, IL-6, CRP, and postoperative rehabilitation indices were compared among the three groups. Results The VAS pain score at 6 h after surgery was significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05). The VAS pain score at 24 h after surgery was significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05) and was significantly lower in the TAP-DVA group than in the TAP-DV group (P < 0.05). The VAS pain score 48 h after surgery was significantly lower in the TAP-DVA group than in the control and TAP-DV groups (P < 0.05). The mean IL-6 level was significantly lower in the TAP-DVA and TAP-DV groups than in the control group (P < 0.05). The postoperative nausea and vomiting rate was significantly lower in the TAP-DVA group than in the control group (P < 0.05). The postoperative exhaust time was earlier in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05) and was earlier in the TAP-DVA group than in the TAP group (P < 0.05). The postoperative hospitalization days and total cost were significantly lower in the TAP-DV and TAP-DVA groups than in the control group (P < 0.05). Conclusion TAP-DVA has a stable and good analgesic effect and can promote rapid recovery after laparoscopic cholecystectomy.

Background Cuproptosis is a copper-dependent cellular death mechanism linked to tumor progression, prognosis, and immune response. Yet, the precise impact of copper-related genes (CRGs) on the tumor microenvironment (TME) within triple-negative breast cancer (TNBC) remains enigmatic. Methods In total, we collected 222 samples of triple-negative breast cancer (TNBC) from The Cancer Genome Atlas database and three Gene Expression Omnibus datasets. The classification was carried out utilizing R software packages. Simultaneously, unsupervised clustering analysis using the ConsensusClusterPlus R package was applied to establish a consensus molecular subtyping of copper subtypes. We thoroughly investigated the relationships between the various subgroups and their clinical pathological characteristics, immune infiltration traits, as well as the mutation status of the tumor microenvironment (TME). Lastly, to enhance the clinical utility of the CRG_score, we developed a nomogram and a calibration curve to predict the probability of patient survival. Results A comprehensive set of 196 CRGs underwent meticulous analysis, leading to the identification of 14 genes that distinctly impact the survival outcomes of patients across all cohorts. Based on risk scores, patients were stratified into different groups. Pathway enrichment analysis revealed pronounced enrichment of immune-related pathways across all datasets. Intriguingly, our observations unveiled that the high-risk CRG group exhibited heightened expression of all immune checkpoints and genes associated with antitumor activities. Correspondingly, a substantial proportion of the mentioned immune genes, with the exception of CD274, HAVCR2, CXCL9, and TNF, showcased elevated expression within gene cluster A. Furthermore, a predictive nomogram was meticulously crafted, leveraging patient characteristics and risk scores, to prognosticate the outcomes of patients diagnosed with hepatocellular carcinoma (HCC). Conclusion In this study, we constructed a cuproptosis least absolute shrinkage and selection operator (LASSO) Cox regression model. It was revealed to be a potential independent prognostic indicator of HCC and high CRGs samples showed a poor prognosis. Interestingly, CRGs were correlated with TME characteristics as well as clinical treatment efficacy. Importantly, compared with the low-risk CRGs group, the high-risk CRGs group may benefit from immunotherapy treatment.