Development of safe and effective chemopreventive agents is a winning strategy in reducing the morbidity and mortality of breast cancer. The current study was to investigate the mechanism-based chemopreventive potential of a Chinese herb formula Yanghe Huayan (YHHY) Decoction on the classical 7,12-dimethylbenz(a)anthracene (DMBA) induced rat mammary carcinogenesis model. Female Sprague-Dawley rats at 42 days of age were orally administered with a human equivalent dose of YHHY Decoction at 0.02 ml/g (10 mg/ml) once daily, starting 1 wk. before and 4 wks following DMBA treatment. Mammary tumor occurrence was monitored every day. The length of time before palpable tumor is examined is defined as tumor-free survival time. High performance liquid chromatography (HPLC) analyses were adopted to identify major chemical compositions of the decoction. Following bioinformatics data mining and experimental analyses were performed to demonstrate the underlying mechanism of action. DMBA animals receiving YHHY Decoction exhibited a significant delay (P = 0.014) and in some animals prevention (P = 0.046) of tumor occurrence without obvious toxicity. Oncogenic myc activation was significantly suppressed in the DMBA-induced rats by the YHHY treatment. Eight major chemical compositions of the decoction were identified and were shown to interfere with multiple tumorigenic pathways simultaneously in the mammary tumors, including inducing tumor apoptosis and up-regulating pro-apoptotic protein Bax and down-regulating anti-apoptotic protein Bcl-2; suppressing abnormal cell proliferation and the MAPK/ERK, PI3K/AKT signalings; blocking neo-angiogenesis and the VEGF/KDR signaling, and inhibiting oxidative stress in the mammary tumors. The multi-components and multi-targeting properties of the YHHY Decoction support its use as a potent chemopreventive drug in breast cancer.

Background: Thyroid extramedullary plasmacytoma (EMP) is an exceedingly rare malignancy, often coexisting with Hashimoto’s thyroiditis (HT). Due to its nonspecific clinical presentation, it is frequently misdiagnosed. Here, we presented a complete diagnostic workup of a primary thyroid EMP patient, including imaging and comprehensive pathology. Furthermore, we have provided an in-depth literature review of this rare entity. Case presentation: This is a case of a 70-year-old woman who presented with a neck mass. A fine-needle aspiration before the surgery suggested HT, and intraoperative frozen section rapid pathology suspected medullary thyroid carcinoma. What surprised us was that postoperative immunohistochemistry confirmed the diagnosis of EMP. The patient had favorable outcomes at 6 months after completing the treatment course, which included surgical resection. Conclusion: Thyroid EMP is highly associated with HT, and many researchers hypothesize that its development may be linked to chronic antigenic stimulation within the inflammatory microenvironment of HT. Cytopathological diagnosis of thyroid EMP can mimic medullary thyroid carcinoma or lymphoma. Therefore, immunohistochemical analysis is mandatory for accurate differentiation. Generally, the prognosis of thyroid EMP is favorable, with recurrence and metastasis being relatively uncommon.