Background and Objectives: The objective of this review is to evaluate the current evidence regarding hormone treatments for both premenopausal and postmenopausal women with early-stage hormone receptor (HR) positive breast cancer. Materials and Methods: An in-depth exploration of the existing literature was conducted, with landmark clinical trials such as TEXT, SOFT, ATLAS, and aTTom serving as primary references. Results: Through an extensive review of the literature, our findings indicate that for premenopausal women with HR-positive, HER2-negative BC with a low risk of recurrence, standard 5-year monotherapy with tamoxifen represents the optimal therapeutic management, given its favorable clinical outcomes and lower associated toxicity. In contrast, for premenopausal women with an intermediate to high risk of recurrence with the same tumor characteristics, the most effective approach stated in the literature is a combination of ovarian suppression therapy (chemical/surgical) and an aromatase inhibitor/selective estrogen receptor modulator (tamoxifen), with a possible extension of the standard therapeutic period. In postmenopausal patients with HR-positive, HER2-negative breast cancer with a low recurrence risk, the first line of treatment is usually a standard 5-year period of treatment with aromatase inhibitors (AIs)(letrozole, anastrozole, or exemestane). On the other hand, in postmenopausal women with an intermediate to high risk, combination therapy might be needed, as well as an extension of the standard therapeutic time. Conclusions: Treatment consensus depends on pre- vs. postmenopausal status and recurrence risk.

Background/Objectives: Introduction: Breast cancer remains a leading cause of cancer morbidity and mortality among women, and timely diagnosis is critical for improving outcomes. Organized screening programs strive to function efficiently, with minimal delays; however, evidence indicates that longer waiting times may be present at different stages of the diagnostic process. Few studies have evaluated how socio-demographic, reproductive, lifestyle, and clinical characteristics may influence diagnostic timeliness in a regional screening context. Materials and Methods: We retrospectively analyzed data from 240 women who underwent breast biopsy following abnormal screening assessment, out of 24,000 patients enrolled in a regional breast cancer screening program conducted in Northeastern and Southeastern Romania. Diagnostic timeliness was observed across three consecutive intervals of the screening pathway: mammography to biopsy (T1), biopsy to histopathological confirmation (T2), and cumulative presentation-to-diagnosis time (T3). Baseline population characteristics were described, subgroup comparisons performed, and multivariable regression models applied to identify independent predictors of diagnostic delay and to explore interaction effects at different stages of the screening process. Results: The interval between mammography and biopsy accounted for the most substantial waiting times (T1 median 24 days). The cumulative time to diagnosis (T3) reached a median of 32 days. Territorial inequalities were the strongest determinant of delay: rural patients experienced approximately five additional days before histopathological confirmation compared with urban patients (p = 0.003). Social vulnerability further contributed to prolonged T1 and T3 intervals, while lifestyle, reproductive, and anthropometric factors showed only minor or inconsistent associations. Interaction analyses revealed that delays linked to rural residence were most pronounced among younger women, an age group at higher risk for aggressive subtypes such as triple-negative breast cancer. Conclusions: In our findings, regional background and social vulnerability outweighed individual risk factors in shaping total diagnostic time. These results support the careful monitoring of interval-specific performance to strengthen equitable access to biopsy among vulnerable populations, where the effectiveness of early breast cancer detection is often challenged.

Background: Radical cystectomy (RC) remains associated with substantial perioperative morbidity despite advances in minimally invasive surgery and reconstructive techniques. Comparisons between intracorporeal reconstruction, robotic-assisted approaches, and urinary diversion strategies are frequently confounded by clinical heterogeneity and patient selection. This study aimed to perform a stratified surgical systematic review evaluating perioperative outcomes across distinct reconstructive pathways following RC. Methods: A PRISMA-guided systematic review identified comparative studies evaluating intracorporeal versus extracorporeal/open orthotopic neobladder reconstruction, robotic-assisted versus open radical cystectomy in frail patients undergoing ureterocutaneostomy, and ileal conduit versus orthotopic urinary diversion. Analyses were performed within predefined clinical modules to preserve surgical context. Outcomes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs), complemented by rare-event sensitivity analyses and exploratory absolute risk metrics, including number needed to treat or harm (NNT/NNH). Continuous outcomes such as estimated blood loss and length of hospital stay were assessed descriptively. Results: Three comparative observational cohorts met inclusion criteria. Intracorporeal neobladder reconstruction and robotic-assisted cystectomy demonstrated consistent reductions in transfusion rates and favourable trends in perioperative morbidity. In frail patient populations, robotic surgery showed reduced intraoperative burden without increased readmission or mortality. Ileal conduit diversion was associated with increased wound-related complications and infectious outcomes; however, these findings likely reflect baseline differences in patient frailty and selection. Rare-event sensitivity analyses confirmed directional consistency of treatment effects despite wide confidence intervals. Integration of absolute risk differences and NNT/NNH metrics provided clinically interpretable context for stratified outcomes. Conclusions: Minimally invasive and intracorporeal strategies following radical cystectomy may reduce perioperative burden, whereas diversion type primarily influences complication patterns rather than overall morbidity. A stratified analytical framework integrating relative and absolute effect measures may offer a more clinically meaningful approach to evaluating reconstructive strategies in heterogeneous surgical populations.

Background: Transvenous embolisation (TVE) has emerged as a promising treatment option for selected brain arteriovenous malformations (bAVMs). Objective: To evaluate the safety and efficacy of TVE-based treatment strategies for bAVMs. Methods: This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020-compliant systematic review and meta-analysis was registered in PROSPERO (CRD420261397818). PubMed, Embase, Cochrane CENTRAL, and Scopus were searched on 20 May 2026, supplemented by citation screening. Studies reporting TVE for bAVMs in ≥5 patients were included. Binary outcomes were pooled using random-effects binomial-normal generalised linear mixed models (GLMMs) with a logit link under an intention-to-treat framework. Results: Twelve studies comprising 239 patients were included; 57.7% underwent combined transarterial/transvenous embolisation. Complete angiographic occlusion was 92.2% (217/239; 95% CI, 84.5–96.2%; I² = 0%) overall and 97.1% (149/160; 95% CI, 76.6–99.7%; I² = 0%) among patients with ≥3 months of imaging follow-up. Functional independence (mRS 0–2) was 85.0% (155/180; 95% CI, 68.7–93.7%; I² = 55%), and technical success was 97.1% (219/227; 95% CI, 91.5–99.0%; I² = 0%). GLMM pooled rates were 0.7% for ischaemic complications, 12.3% for haemorrhagic complications, 3.3% for permanent neurological morbidity, 2.3% for overall mortality, 0.8% for procedure-related mortality, and 13.9% for any procedure-related complication or death. Conclusions: TVE-based strategies are associated with high angiographic occlusion and favourable functional outcomes in carefully selected bAVMs, but the evidence is predominantly observational and safety estimates remain uncertain. As most patients underwent combined transarterial/transvenous treatment, these findings should not be interpreted as estimates of standalone TVE.

Langer’s axillary arch, also known as the axillopectoral muscle, represents a relatively uncommon anatomical variation of the axillary region. Although often asymptomatic, its presence may have important implications in surgical procedures involving the axilla, particularly during breast surgery, axillary lymph node dissection, and reconstructive procedures. Despite numerous anatomical and surgical reports describing this variation, the true prevalence of Langer’s axillary arch remains uncertain due to variability in study design and detection methods. Objective: The aim of this systematic review and meta-analysis was to evaluate the reported prevalence of Langer’s axillary arch and to assess methodological variability among anatomical and surgical studies. Methods: A systematic literature search was conducted in accordance with PRISMA guidelines using electronic databases including PubMed, Scopus, and Web of Science. Studies reporting original data on the presence or prevalence of Langer’s axillary arch in cadaveric or surgical populations were included. Data extraction included study characteristics, sample size, number of detected axillary arches, and reported prevalence. A random-effects meta-analysis was performed to estimate the pooled prevalence and to evaluate heterogeneity between studies. Results: The analysis included studies comprising both cadaveric anatomical investigations and surgical series. Considerable variability in reported prevalence was observed across studies. Cadaveric studies generally reported higher prevalence rates compared with surgical series, reflecting differences in detection methods. Meta-analytic synthesis demonstrated that Langer’s axillary arch represents a relatively uncommon but clinically relevant anatomical variation. Conclusions: Langer’s axillary arch should be recognized as an important anatomical variant of the axillary region. Awareness of this variation is essential for surgeons performing axillary procedures, as its presence may influence surgical exposure and lymph node identification. Further large-scale anatomical and clinical studies are needed to better define its prevalence and surgical implications.