Objective: This retrospective cohort study compares surgical outcomes among patients with endometrial carcinoma (EC) after the implementation of a robotic-assisted (RA) surgical program at a tertiary care center. Methods: A total of 122 EC patients who underwent surgery between March 2022 and February 2025 were included. Patients were divided into two cohorts based on the implementation of RA surgery: Group 1 (March 2022–August 2023) and Group 2 (September 2023–February 2025). Data collected included demographics, surgical approach, operative time, hospital stay, completion of staging procedures, and 30-day postoperative complications. Results: RA laparoscopy was used predominantly in Group 2, replacing conventional laparoscopy (CL). Laparotomy was significantly less frequent in group 2 (11.9% vs. 36.4%; p < 0.001). Among patients with FIGO stage I, all patients underwent minimally invasive surgery (MIS) in Cohort 2 (100% vs. 71.9%; p < 0.001). Median hospital stay was significantly shorter in Group 2 (3 days vs. 4 days; p < 0.001). A 30-day mortality occurred in one patient (n = 1) within the total study cohort (0.82%) and was attributed to pulmonary embolism on postoperative day 14 after RA laparoscopy. Rates of Grade ≥3 postoperative complications were similar (7.3% vs. 7.5%), as were wound complications (5.5% vs. 3%). The use of sentinel lymph node (SLN) mapping increased significantly in Group 2 (91% vs. 54.5%; p < 0.001). Completion staging procedures were significantly reduced in group 2 (9.1% vs. 0%; p = 0.017). Conclusions: The integration of RA laparoscopy significantly reduced laparotomy rates and hospital stays while increasing SLN mapping. These results support the continued adoption of RA laparoscopy to enhance MIS and improve patient outcomes.

Background: Accurate intraoperative assessment of sentinel lymph node (SLN) status is critical for staging and guiding surgical management in gynaecological malignancies. Frozen-section histopathology remains the gold standard, but it is time-consuming and resource-intensive. Shear-wave elastography (SWE) quantifies tissue stiffness in real time and may offer a rapid alternative. Methods: In this prospective single-centre study, 63 women (median age 62 years) undergoing primary surgery with sentinel lymph node biopsy (SLNB) for endometrial, cervical, vulvar, or early ovarian carcinoma were enrolled. A total of 172 SLNs were excised, submerged in coupling gel, and scanned ex vivo using a 9 MHz linear probe. Results: A total of 172 SLNs underwent SWE (mean 2.7 nodes/patient). Endometrial primaries accounted for 58% of nodes, mostly retrieved by robotic-assisted surgery (71.8%). Node dimensions were significantly larger in malignant lesions for sonographic (long-axis: 13.02 ± 3.31 mm vs. 10.80 ± 3.28 mm; p = 0.002) and pathological long-axis measurements (11.45 ± 2.83 mm vs. 9.75 ± 2.61 mm; p = 0.004). Mean SWE velocities were similar between groups (1.381 ± 0.307 vs. 1.343 ± 0.236 m/s; p = 0.541). Histopathology identified metastases in 18% of SLNs, comprising macrometastases (7%), micrometastases (5%), and isolated tumour cells (6%). Conclusions: Although ex vivo SWE is rapid, reproducible, and integrates seamlessly into the sterile field, stiffness measurements alone lack sufficient discriminatory power for SLN staging in gynaecological cancers. Future research should focus on three-dimensional SWE, advanced radiomic analyses, and machine-learning algorithms to improve the detection of low-volume metastatic disease.

Background/Objectives: To evaluate the diagnostic accuracy of different imaging modalities in patients with pathologic nipple discharge. Methods: This is a single-centre retrospective analysis of patients with pathologic nipple discharge. All performed imaging modalities were reviewed for their sensitivity and specificity in correctly diagnosing malignancy, as well as lesions with uncertain malignant potential (B3). Results: Of 388 patients, pathology or follow-up confirmed 41 cases of malignancy (15 breast cancer, 26 ductal carcinoma in situ (DCIS)), 151 cases of B3 lesions, and 196 benign cases. The combination of ultrasound and mammography/tomosynthesis achieved a sensitivity of 82.5% (95% CI 68.1–91.3) and a specificity of 83.5% (77.4–88.2) for the detection of malignancy. For the classification of B3 lesions as suspicious (BI-RADS 4/5), the sensitivity and specificity were 33.8% (26.7–41.7) and 83.5% (77.4–88.2), respectively. Ductography demonstrated a sensitivity of 89.3% (72.8–96.3) and a specificity of 13.3% (8.2–20.8) for malignancy, while MRI showed a sensitivity of 71.4% (45.4–88.3) and a specificity of 90.0% (76.9–96.0). In classifying B3 lesions as suspicious, ductography reached a sensitivity of 94.8% (89.7–97.5) and a specificity of 13.3% (8.2–20.8), compared to 75.9% (57.9–87.8) and 90.0% (76.9–96.0), respectively, for MRI. Conclusions: While the combination of ultrasound and mammography/tomosynthesis correctly classified 82.5% of breast malignancies associated with pathologic nipple discharge as suspicious, their sensitivity for classifying B3 lesions as suspicious was only moderate (33.8%). In patients with negative or inconclusive conventional imaging but persistent clinical suspicion, MRI may be considered as an additional diagnostic tool, whereas ductography, given its low specificity, is of limited value for assessing lesion dignity and may primarily serve to localize the affected duct prior to surgery. Further research is needed to determine which diagnostic modality provides the greatest benefit in specific cases.

Background: Genetic counseling and germline genetic testing are essential components of ovarian cancer care; however, their implementation in routine clinical practice remains inconsistent. This study aimed to evaluate the utilization of genetic counseling and testing among patients with ovarian cancer and identify barriers to implementation within routine care. Methods: A single-center, retrospective questionnaire-based study was conducted among patients who underwent surgical treatment for ovarian malignancies between January 2021 and June 2025. Patient-reported data on information provision, referral pathways, organizational access, satisfaction, and barriers were linked with clinical and demographic characteristics. Descriptive analyses were performed, reflecting the exploratory nature of the study. A problem frequency (PF) framework, defined as the proportion of responses indicating a problem, was applied to identify and rank patient-reported barriers. Results: Of 321 identified patients, 61 were deceased prior to study initiation. Among 256 successfully contacted patients, 132 responded (51.6%). Overall, 115/132 (87.1%) reported receiving information regarding genetic counseling, primarily from hospital-based physicians (106/132; 80.3%). Among the 132 questionnaire respondents, 96/132 (72.7%) attended genetic counseling and 93/132 (70.5%) proceeded to genetic testing; pathogenic variants were identified in 26/93 tested patients (28.0%). Genetic counseling among respondents increased from 37.5% in 2021 to 94.7% in 2025. The majority of appointments were self-initiated. The most frequently reported barriers were limited information provision, appointment scheduling difficulties, and travel-related barriers, whereas emotional burden at the time of diagnosis was reported less frequently. Uptake was significantly associated with family history of breast and/or ovarian cancer, higher educational attainment, and parity. Notably, nearly half of the participants who had not attended genetic counseling (17/36;47.2%) reported reconsidering uptake after completing the questionnaire. Conclusion: Despite recommendations for universal genetic counseling in ovarian cancer care, gaps in implementation remain evident in routine clinical practice. Organizational and informational barriers represent prominent obstacles to uptake. Our findings highlight the potential value of standardized referral pathways, proactive information provision, and repeated patient engagement to facilitate access to genetic services.