Search Results (9,079)

Background/Objectives: To develop and validate a predictive model that combines morphological features and dual-energy CT (DECT) parameters to non-invasively distinguish metastatic from benign axillary lymph nodes in patients with breast cancer (BC). Methods: In this retrospective study, 117 patients (median age, 65 years; 111 women and 6 men) who underwent DECT followed by axillary lymphadenectomy between April 2015 and July 2023, were analyzed. A total of 375 lymph nodes (180 metastatic, 195 benign) were evaluated. Two radiologists recorded morphological criteria (adipose hilum status, cortical appearance, extranodal extension, and short-axis diameter) and placed regions of interest to measure dual-energy parameters: attenuation at 40 and 70 keV, iodine concentration, water concentration and spectral slope. Normalized iodine concentration was calculated using the aorta as reference. Univariate analysis identified variables associated with metastasis. Multivariate logistic regression with cross-validation was used to construct two models: one based solely on morphological features and one integrating water concentration. Results: On univariate testing, all DECT parameters and morphological criteria differed significantly between metastatic and benign nodes (p < 0.01). In multivariate analysis, water concentration emerged as the only independent DECT predictor (odds ratio = 0.97; p = 0.002) alongside cortical abnormality, absence of adipose hilum, extranodal extension and short-axis diameter. The morphologic model achieved an area under the receiver operating characteristic curve (AUC) of 0.871. Increasing water concentration increased the AUC to 0.883 (ΔAUC = 0.012; p = 0.63, not significant), with internal cross-validation confirming stable performance. Conclusions: A model combining standard morphologic criteria with water concentration quantification on DECT accurately differentiates metastatic from benign axillary nodes in BC patients. Although iodine-based metrics remain valuable indicators of perfusion, water concentration offers additional tissue composition information. Future multicenter prospective studies with standardized imaging protocols are warranted to refine parameter thresholds and validate this approach for routine clinical use. Full article

The article presents the current state of knowledge on genetic modifiers of ovarian cancer risk in women carrying pathogenic variants (PVs) in the BRCA1 and BRCA2 genes, which are major contributors to hereditary susceptibility to this malignancy. Although PV carriers have high disease penetrance (BRCA1: ~40% and BRCA2: 11–27%), substantial variability in individual risk is observed, suggesting the influence of additional genetic variants. Background: Ovarian cancer is characterized by late detection and high mortality, and a significant portion of risk among BRCA1/2 carriers is shaped by reproductive and environmental factors as well as genetic modifiers. The article emphasizes that carriers of the same BRCA PV can exhibit markedly different risk levels depending on additional variants that modulate key biological processes, such as DNA repair, cell cycle regulation, and apoptosis. Methods: A systematic literature search covering the years 1996–2025 was conducted in the PubMed database. Initially, 734 publications were identified; after removing duplicates, thematically irrelevant articles, non-full-text papers, and studies not meeting the inclusion criteria, 47 articles were included in the review. These studies covered candidate gene analyses, GWAS, and data from the CIMBA consortium, which enables the examination of large cohorts of PV carriers. Results: The review identified numerous variants associated with increased or decreased ovarian cancer risk in BRCA1 carriers, including the following: OGG1, DR4, MDM2, CYP2A7, CASP8, ITGB3, HRAS1, TRIM61, and MTHFR. The reviewed studies also identified both protective and risk-increasing variants among BRCA2 PV carriers: UNG, TDG, and PARP2, and haplotypes in ATM, BRIP1, BARD1, MRE11, RAD51, and 9p22.2. The analysis identified 11 variants affecting both BRCA1 and BRCA2 carriers, most of which increase risk, including the following: IRS1, RSPO1, SYNPO2, BABAM1, MRPL34, PLEKHM1, and TIPARP. Protective variants include BNC2 and LINC00824. The only SNP reaching genome-wide significance (p < 5 × 10⁻⁸) was in BNC2. Conclusions: The article summarizes the growing number of genetic modifiers of ovarian cancer risk among BRCA1/2 carriers and highlights their potential to improve individualized risk assessment, enhance patient stratification, support personalized prevention and surveillance strategies, deepen the understanding of disease biology, and identify potential therapeutic targets. Full article

Introduction: [¹⁸F]-DCFPyL (Piflufolastat [¹⁸F]) is a prostate-specific membrane antigen (PSMA)-targeted position emission tomography (PET) radiotracer for detecting the biochemical recurrence (BCR) of prostate cancer (PCa). This study evaluates its economic impact compared with [⁶⁸Ga]-PSMA-11, [¹⁸F]-FCH, and [¹⁸F]-PSMA-1007 from the Spanish National Healthcare System’s perspective. Methods: A cost–consequence model, over a 5-year time horizon, simulated the diagnostic and treatment pathway based on radiotracer-specific accuracy and disease localization. Treatment options included a radical prostatectomy, radiation therapy, androgen deprivation therapy (ADT), and radiation therapy + ADT. Costs were calculated for true/false positives and negatives. Due to limited data availability, key inputs were informed by expert opinions, supported by published meta-analyses, public sources, and literature. Officially published Spanish prices were applied: EUR 2000 for [¹⁸F]-DCFPyL, [⁶⁸Ga]-PSMA-11, and [¹⁸F]-PSMA-1007, and EUR 1144 for [¹⁸F]-FCH. Results: The use of [¹⁸F]-DCFPyL led to fewer unnecessary therapies; specifically, it led to 11,229 (74%) fewer than [⁶⁸Ga]-PSMA-11, and 5180 (56%) and 7771 (66%) fewer than [¹⁸F]-FCH and [¹⁸F]-PSMA-1007, respectively. It achieved significant cost savings for repeated testing: EUR 15M (43%) versus [⁶⁸Ga]-PSMA-11, EUR 37M (65%) versus [¹⁸F]-FCH, and EUR 27M (58%) versus [¹⁸F]-PSMA-1007. Cost savings for false positives were EUR 15M (50%) against [⁶⁸Ga]-PSMA-11, EUR 22M (60%) versus [¹⁸F]-FCH, and EUR 29M (66%) compared with [¹⁸F]-PSMA-1007. The cost per correct diagnosis was reduced by EUR 198 (8%) compared with [⁶⁸Ga]-PSMA-11 and EUR 377 (15%) relative to [¹⁸F]-PSMA-1007, while showing a EUR 635 (40%) increase compared with [¹⁸F]-FCH. Conclusions: [¹⁸F]-DCFPyL offers a cost-saving option for BCR detection within the Spanish National Healthcare System by reducing the number of unnecessary therapies, the cost of false positives, and repeat testing compared with alternative radiotracers. These improvements support the potential for better diagnostic outcomes and more informed downstream clinical decision-making. Full article

Objective: To assess the effectiveness of a fixed contrast injection protocol—75 mL of contrast followed by 40 mL saline at 5 mL/s with an injection duration of 23 s—in achieving diagnostic enhancement in coronary CT angiography (CCTA) using 64-slice detector CT scanner. Materials and Methods: 456 consecutive patients with suspected coronary disease who underwent CCTA on a 64-slice detector CT scanner between January 2023 and December 2024 and were retrospectively enrolled. Each patient received 75 mL of contrast medium followed by 40 mL of saline at a flow rate of 5 mL/s, with a total injection duration of 23 s. Two radiologists, blinded to patient information, independently measured the contrast enhancement (HU) values in the coronary segments, ascending and descending aorta, and left ventricle. Attenuation levels ≥250 HU were considered diagnostic. Patients were grouped by body weight into two categories: Group 1 (≤75 kg) and Group 2 (>75 kg). The independent t-test and Mann–Whitney U test were used to compare HU values in each vessel between the two groups, while the Chi-square test was applied to compare enhancement success rates (HU ≥ 250) between the groups per vessel. Results: A total of 281 patients (mean age: 51.88 years ± 11.15 [SD]; 167 male, 114 female), were included. Statistically significant differences in the HU enhancement measurements were found between groups (p < 0.001–0.007). However, all segments showed mean and median HU values above 250 HU. Enhancement success rates were significantly higher in Group 1 (p = 0.005–0.04), except in the ascending aorta, descending aorta, left main coronary artery, middle right coronary, distal right coronary artery, and middle left circumflex artery, where the rates were statistically comparable between the groups (p = 0.054–0.61). Conclusions: A fixed contrast protocol (75 mL of contrast medium followed by 40 mL of saline at a 5 mL/s flow rate with a total injection duration of 23 s) appears to be feasible for achieving diagnostic contrast enhancement in CCTA using a 64-slice multidetector CT scanner. This protocol may offer a simplified alternative to individualized, weight-based contrast dosing strategies. Full article

Objective: This randomized, double-blind, placebo-controlled clinical trial assessed the efficacy and safety of steamed ginger extract (GGE03), standardized to high levels of 1-dehydro-6-gingerdione (GD), in reducing body fat and weight among overweight individuals. Methods: Eighty adults aged 18 to 60 years, with a body mass index (BMI) of 25.0 to 29.9 kg/m², were randomly assigned to receive either GGE03 (n = 40; 480 mg/day) or a placebo (n = 40) for 12 weeks. Efficacy and safety parameters were evaluated at baseline and after the intervention period. Results: After 12 weeks, the GGE03 group showed statistically significant reductions in body fat percentage and body fat mass compared to the placebo group, as measured by dual-energy X-ray absorptiometry (DEXA). Additionally, significant decreases in body weight, BMI, waist circumference, and hip circumference were observed following GGE03 supplementation. Serum triglyceride (TG) and total cholesterol (TC) levels were also significantly lower in the GGE03 group compared to the placebo group. No product-related adverse events or clinically significant laboratory abnormalities were noted, indicating that GGE03 was well tolerated. Conclusions: Twelve weeks of GGE03 supplementation were associated with statistically significant improvements in body composition and lipid parameters without safety concerns. These findings support the potential of GD-standardized GGE03 as a well-tolerated functional dietary ingredient for body fat management and metabolic health. Full article

The study of muscle signal classification has been widely explored for the control of myoelectric prostheses. Traditional approaches rely on manually designed features extracted from time- or frequency-domain representations, which may limit the generalization and adaptability of EMG-based systems. In this work, an autoencoder-based framework is proposed for automatic feature extraction, enabling the learning of compact latent representations directly from raw EMG signals and reducing dependence on handcrafted features. A custom instrumentation system with three surface EMG sensors was developed and placed on selected forearm muscles to acquire signals associated with five hand movements from 20 healthy participants aged 18 to 40 years. The signals were segmented into 200 ms windows with 75% overlap. The proposed method employs a recurrent autoencoder with a symmetric encoder–decoder architecture, trained independently for each sensor to achieve accurate signal reconstruction, with a minimum reconstruction loss of $3.3\times {10}^{-4}{V}^2$. The encoder’s latent representations were then used to train a dense neural network for gesture classification. An overall efficiency of 93.84% was achieved, demonstrating that the proposed reconstruction-based approach provides high classification performance and represents a promising solution for future EMG-based assistive and control applications. Full article

The optimal branch bending angle for Pyrus sinkiangensis Yü (Korla fragrant pear) remains undefined. In this study, the optimal angle was determined by integrating the phenological, nutritional, hormonal, and fruit-quality responses across a 15-day bloom window. Four branch angles (40°, 60°, 80°, and 100°) were applied to 8-year-old trees in spring 2022, and flowering dynamics, bud carbon/nitrogen status, leaf morphology/mineral content, fruiting-shoot architecture, endogenous hormones, and fruit quality were comprehensively evaluated. The 80° angle maximized the fruit set (11.77%) and bud soluble sugar content (8.84 mg/g DW), significantly outperforming the other angles (p < 0.05). The flowering rate peaked at 100° (7.89%) but was statistically comparable to that at 60° and 80° (p > 0.05); calyx removal was greatest at 60° (73.33%), with no significant difference from that at 80° (71%, p > 0.05). These reproductive benefits aligned with enhanced leaf source capacity—80° pulling resulted in the greatest leaf area (59.51 cm²), the greatest amount of chlorophyll (3.11 mg/g DW), and elevated N/Mg/Cu concentrations. Branch architecture was optimized at 80°, with the percentage of medium fruiting spurs reaching 41.1% and the xylem:phloem dry-weight ratio peaking at 1.78, indicating the development of efficient assimilate transport pathways. Hormonally, 80° triggered a distinct cascade: a transient GA₄/GA₇ surge (50.6 and 1.34 ng/g DW) on 28 April, followed by sustained IAA elevation (2.05 ng/g DW) and zeatin stabilization (0.27–0.29 ng/g DW) during ovary development. Consequently, the fruit quality was comprehensively improved at 80°—the single-fruit weight (110.7 g), soluble sugar content (10.08 mg/g DW), and sugar/acid ratio (17.08) were greatest, whereas the stone-cell content was lowest (0.49 mg/g DW). Principal component analysis of 57 traits confirmed 80° as the system-wide optimum (D = 0.718). These results demonstrate that an 80° bending angle synchronizes carbohydrate supply, hormone signaling, and fruit quality in Korla fragrant pear, providing a low-cost, nonchemical benchmark for precision canopy management in high-density orchards. An 80° branch-bending angle optimizes carbon-hormone synergy via a transient GA₄/GA₇ surge and sustained IAA-zeatin signaling, maximizing fruit set and quality in high-density Korla fragrant pear orchards. Full article

Background: Hyaluronic acid (HA) injections have become a cornerstone of minimally invasive aesthetic medicine. While the demand for these procedures continues to grow globally, large-scale longitudinal analyses of patient demographics and specific injection site trends remain limited, particularly in Asian populations. Existing data in Japan are largely confined to aggregate procedure numbers. This study aimed to elucidate the transition in patient demographics and site-specific treatment trends using a nationwide big-data approach. Methods: This retrospective study analyzed 299,413 treatment sessions (417,590 injection sites) from patients who underwent facial HA injections at 110 clinics across Japan between October 2020 and December 2024. Data were analyzed by year, patient age, and injection site to evaluate demographic shifts and treatment patterns. Results: The annual number of treatment sessions increased steadily during the study period. A significant demographic shift was observed: while patients in their 20s were predominant in 2020–2022, the proportion of patients aged ≥ 40 years increased markedly from 2023 onward, accounting for more than half of all cases (63.7% in 2024). Treatment preferences varied distinctly by age; younger patients favored localized contouring (e.g., pretarsal fullness, chin), whereas older patients required multi-site rejuvenation. By 2024, the orbital rim became the most frequently treated site (22.6%). Statistical analysis confirmed that age was a significant predictor for multi-site treatments (p < 0.001). Conclusions: This large-scale analysis reveals a clear transition in the Japanese aesthetic market from contour enhancement in younger demographics to anatomy-based rejuvenation in middle-aged and older populations. Full article

Objective: This paper describes the development of a speech intelligibility test in Swiss German dialects, designed for children aged four to nine who are not yet familiar with standard German. Method: Suitable monosyllabic words and trochees in different Swiss German dialects were compiled, illustrated, and evaluated. Picture-pointing test procedures appropriate for children were developed. The selected test words and the pictures representing them were evaluated in a preliminary trial with forty-six normal-hearing children between two and nine years of age. Results: A set of 60 monosyllabic words and 40 trochees was recorded in four different Swiss German dialects as well as in standard German, resulting in a total of 500 recordings. Drawings were created to illustrate each word and found to be appropriate for children aged four years old or older. A non-adaptive and an adaptive test procedure using a weighted up–down method to measure speech reception thresholds in quiet and in noise were developed. Conclusions: A novel test to determine speech intelligibility in children in four different Swiss dialects was developed and evaluated in a pilot study. A validation study with more participants was designed to evaluate the test material and procedures. Full article

Collateral status is an important therapeutic indicator for acute ischemic stroke (AIS), yet visual collateral grading remains subjective and suffers from inter-observer variability. To address this limitation, this study automatically extracted binarized vascular morphological features from CTA images and developed a convolutional neural network (CNN) for automated collateral classification. Performance trends were systematically analyzed across diverse hyperparameter combinations to meet different clinical decision needs. A total of 157 AIS patients (median age 65 [⁵⁷,⁵⁸,⁵⁹,⁶⁰,⁶¹,⁶²,⁶³,⁶⁴,⁶⁵,⁶⁶,⁶⁷,⁶⁸,⁶⁹,⁷⁰,⁷¹,⁷²,⁷³,⁷⁴] years; 61.8% were male) were retrospectively enrolled and stratified by Menon score into good (3–5, n = 117) and poor (0–2, n = 40) collateral groups. A total of 192 architectures were established, and three representative model tendencies emerged: a sensitivity-oriented model (AUC = 0.773; sensitivity = 87.18%; specificity = 65.00%), a balanced model (AUC = 0.768; sensitivity = 72.65%; specificity = 77.50%), and a specificity-oriented model (AUC = 0.753; sensitivity = 63.25%; specificity = 85.00%). These results demonstrate that kernel size, the number of filters in the first layer, and the number of convolutional layers are key determinants of performance directionality, allowing tailored model selection depending on clinical requirements. This work highlights the feasibility of CTA-based automated collateral classification and provides a systematic framework for developing models optimized for sensitivity, specificity, or balanced decision-making. The findings may serve as a reference for clinical model deployment and have potential for integration into multi-objective AI systems for endovascular thrombectomy patient triage. Full article

Non-communicable diseases, particularly cardiovascular diseases (CVD) and metabolic syndrome (MS), remain a major challenge for primary health care (PHC). This study aimed to assess cardiometabolic risk and health behaviours in adult PHC patients using routine preventive screening. This prospective observational study included 506 adults attending routine consultations in an urban PHC centre in Poland. Preventive assessment included anthropometric measurements (body weight, height, BMI, and waist circumference), blood pressure, lipid profile, and fasting glucose levels. Health behaviours were recorded using the standardised NFZ CHUK questionnaire. The 10-year CVD risk was estimated using the SCORE2 algorithm. Multivariable logistic regression was used to identify independent factors associated with high cardiovascular risk (SCORE2 ≥ 5%) and of a composite endpoint defined as the presence of any non-optimal biochemical parameter. Nearly half of the participants had excess body weight (overweight or obesity), and more than half met criteria for central obesity. Borderline or elevated total cholesterol was found in 47% of patients, abnormal LDL in 27%, low HDL-C (<40 mg/dL) in 80% (84% when applying sex-specific cut-offs), and impaired fasting glucose or diabetes in about 12%. High SCORE2 risk (≥5%) was observed in approximately 9% of the cohort. In multivariable models, SCORE2 components (age, sex, and smoking) were, as expected, associated with high SCORE2 risk, and obesity (BMI ≥ 30 kg/m²)—a factor not included in SCORE2—was additionally associated with higher risk. Additionally, age, male sex, and obesity also predicted the presence of at least one non-optimal biochemical marker. The prevalence of high SCORE2 risk increased from 1.2% in patients with 0–1 modifiable risk factor to 25.7% in those with 4–5 factors. Lower educational attainment was associated with a higher proportion of high-risk individuals in univariate analysis. Routine preventive activities in PHC enable the identification of important lipid and glucose abnormalities and the clustering of modifiable risk factors, even in a relatively young, highly educated population. Systematic cardiovascular screening and a focus on patients with accumulated risk factors should remain a priority in PHC to enable early identification of high-risk patients and timely implementation of lifestyle and therapeutic interventions. Full article

Background: Veno-venous extra-corporeal membrane oxygenation (ECMO) cannulations are mostly performed while patients are heavily sedated and mechanically ventilated. For patients with acute respiratory distress syndrome (ARDS), cannulating for ECMO while awake and spontaneously breathing, as well as treating without sedation and mechanical ventilation, has potential advantages. This study aimed to compare clinical outcomes between patients cannulated for ECMO while awake and patients cannulated while sedated and mechanically ventilated. Methods: A retrospective multicenter study. Data were accessed from the Israeli ECMO registry of patients with COVID-19-induced ARDS treated at eight ECMO centers in Israel. The study group comprised 24 patients who were cannulated while awake and spontaneously breathing. A control group comprised 96 patients who were cannulated after sedation and mechanical ventilation, matched 1:4 by age, sex, and body mass index. The primary outcome was six-month survival. Secondary outcomes were: the duration of ECMO therapy, the duration of invasive mechanical ventilation-free ECMO therapy, and the duration of invasive mechanical ventilation. Results: The mean age was 52 + 11 years; 78% were males. Fifteen patients (63%) in the study group were eventually intubated. The mean durations on ECMO and in the intensive care unit did not differ between the groups. The study group had a higher six-month survival (75% vs. 49%, p = 0.02) and fewer infectious complications such as pneumonia or bacteremia (21% vs. 40%, p < 0.001) compared to the control group. After adjusting for PO₂/FiO₂ ratio and for the COVID-19 variant, the hazard ratio was 0.45 (C.I 0.19–1.06, p = 0.069). Conclusions: Awake VV-ECMO cannulation in COVID-19-induced ARDS is feasible in selected patients and was associated with higher survival in unadjusted analyses. However, after adjustment for key covariates, this association was attenuated and did not reach statistical significance. Full article

Background/Objectives: Large osteochondral lesions of the talus (OLT) pose a major challenge because their size and depth often exceed the indications for bone marrow stimulation, and durable biological repair remains difficult to achieve. However, evidence for autologous osteochondral transplantation (AOT) in extensive talar defects is still limited. Methods: In this retrospective cohort, 40 consecutive patients ≥ 14 years with ICRS grade III–IV lesions of the talar dome were treated with AOT at a tertiary referral center. One to three overlapping cylindrical osteochondral grafts (mean diameter 0.9 cm) were harvested from non-weight-bearing regions of the ipsilateral patellofemoral groove using a water-cooled diamond trephine system and implanted press-fit into the talar dome. Donor sites were refilled with autologous iliac crest bone cylinders and hydroxyapatite substitute. Pain (Numeric Rating Scale, NRS) and function (AOFAS Ankle–Hindfoot Score) were recorded preoperatively and at 3, 6, 9, and 12 months, and changes over time were analyzed using generalized estimating equations. Results: Mean defect size was 137.4 ± 31.9 mm², and 82.5% of lesions were ICRS grade III. NRS pain improved from 5.69 ± 2.52 preoperatively to 0.53 ± 0.98 at 12 months (p < 0.001). AOFAS score increased from 63.79 ± 2.55 to 97.36 ± 2.49 (p < 0.001). Age and graft location significantly influenced postoperative pain, whereas graft size and sex did not. No infections, graft failures, conversions to arthrodesis or arthroplasty, or clinically relevant donor-site symptoms occurred. Conclusions: Multi-plug AOT using a diamond trephine system provides substantial and durable pain relief and functional improvement in patients with large OLT, with low complication and donor-site morbidity rates. These findings support AOT as a joint-preserving option for extensive talar defects and justify further prospective, comparative studies with long-term follow-up. Full article

Background/Objectives: Dopamine agonists (DAs) are the first-line therapy for prolactinomas; however, a subset of patients exhibits resistance or incomplete response. Methods: This retrospective study included 85 of 125 eligible consecutive patients with prolactinoma who were treated with DA, followed for a median of 52.0 (31.5–86.8) months. Clinical, biochemical, and radiological parameters were analyzed at baseline and at 6 and 12 months. Resistance was defined as failure to normalize serum prolactin concentration (PRL) or achieve ≥ 30% reduction in tumor maximal diameter after standard DA therapy. Logistic regression analyses were performed to identify predictors of DA resistance and treatment response. Results: The cohort comprised 54 males (63.5%) and 31 females (36.1%), with a mean age of 41.5 ± 17.2 years. In total, 22.4% had giant prolactinomas. After 6 months of treatment, 24.7% achieved PRL normalization, and 29.4% demonstrated ≥ 50% reduction in tumor volume. At 12 months, PRL normalized in 40% of patients, and a ≥50% volume reduction was observed in 41.2%. DA-resistant patients, compared to DA-non-resistant, were predominantly men (80.0% vs. 56.7%, p = 0.042), with a higher proportion of giant adenomas (44.0% vs. 13.3%, p = 0.002) and significantly higher baseline PRL (2000.000 ng/mL vs. 478.985 ng/mL, p = 0.012). Early reduction in maximal tumor diameter at 6 months predicted a favorable therapeutic response at 12 months (aOR = 1.156; 95% CI = 1.001–1.335, p = 0.049). Conclusions: Male sex, higher baseline PRL, and larger tumor size can be predictors of DA resistance. On the other hand, early radiological tumor shrinkage may predict favorable treatment outcomes. However, new markers of DA resistance, particularly molecular ones, should be identified. Full article

Background/Objectives: Male breast cancer (MBC) is rare, accounting for less than 1% of all breast cancers. Given its low incidence, male breast cancer (MBC) remains understudied; this 33-year Serbian cohort was assessed for clinicopathological features, therapeutic approaches, genetic alterations, and survival. Methods: We retrospectively analyzed MBC patients diagnosed between 1991 and 2024 at the Institute for Oncology and Radiology of Serbia. Data included demographics, tumor characteristics, and stage, treatment, hormone receptor and HER2 status, Ki-67 index, genetic testing, and survival. Results: A total of 191 patients were identified (median age 66). Family history was negative in 91% and positive in 5.8%. T2 tumors were most frequent (36%), and 96% presented without metastasis. Mastectomy with axillary or sentinel lymph node dissection was performed in 78.5%. Neoadjuvant chemotherapy and radiotherapy were administered in 5.8% and 8.4%. Estrogen receptor positivity was 72%, progesterone receptor 88%, HER2 overexpression 11.0%, and triple-negative tumors 2.6% (40% with axillary involvement). High Ki-67 (≥15%) was recorded in 28.8%. Adjuvant chemotherapy, radiotherapy, and hormone therapy were given in 36%, 58%, and 68%. Among 37 genetically tested patients, seven had pathogenic variants (BRCA1, BRCA2, CHEK2, PALB2). Disease recurrence occurred in 30%. Median follow-up was 53 months. Median disease-free survival (DFS) was 82 months (1-, 2-, 5-, 10-year DFS: 87%, 73%, 57%, 39%). Median overall survival (OS) 131 months (1-, 2-, 5-, 10-year OS: 95%, 93%, 73%, 53%). Conclusions: This long-term cohort highlights the predominance of hormone-receptor positivity, the infrequency of germline mutations, and moderate survival rates, informing patient management and guiding future studies. Full article