Latest Breast and Endocrine Surgery research

Top 10 this week

Week of 20 September 2026

1. 1

   Short or Long Antibiotic Regimens in Orthopedics

   The New England journal of medicine · Q1 journal · RCT · Evidence level 1 (High) · 16 September 2026

   In 475 adults who received a local-antibiotic implant during surgery, definite treatment failure by 12 months occurred in 11% of those given up to 7 days of systemic antibiotics versus 14% of those given at least 4 weeks, meeting the pre-specified non-inferiority margin. Short-course patients also reported far fewer treatment-related symptoms (17% vs 45%). The finding supports limiting systemic therapy, though longer-term outcomes remain to be studied.

2. 2

   Circulating Tumor DNA and Circulating Tumor Cells in Liquid Biopsy as Post-Treatment Prognostic Biomarkers in Early Breast Cancer: A Systematic Review and Meta-Analysis

   International journal of molecular sciences · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 28 August 2026

   Systematic review of ctDNA/CTC as prognostic biomarkers

3. 3

   Intravenous ferric carboxymaltose and exercise capacity in iron-deficient kidney transplant recipients: a randomised, placebo-controlled trial in the Netherlands

   EClinicalMedicine · Q1 journal · RCT · Evidence level 1 (High) · 1 September 2026

   In a double-blind trial of 148 iron-deficient kidney-transplant patients, four doses of ferric carboxymaltose raised hemoglobin but improved 6-minute walk distance by only 9 m versus placebo, a change deemed clinically insignificant. The treatment did not enhance cardiac, muscle, cognitive function or quality of life, leaving routine iron supplementation for functional gain unsupported.

4. 4

   Comparative oncological efficacy of chemotherapy, cytoreductive surgery with or without HIPEC in recurrent ovarian cancer: A network meta-analysis

   European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 11 September 2026

   A network meta-analysis of 1,831 patients showed that both secondary cytoreductive surgery alone and surgery plus HIPEC lengthened five-year progression-free survival by roughly one-quarter compared with chemotherapy, while overall survival was unchanged overall. Benefit appeared strongest in patients with complete tumor removal, and the survival advantage of adding HIPEC remains uncertain and based on indirect evidence.

5. 5

   Menopausal hormone therapy and primary liver cancer: long-term follow-up of the women's health initiative randomized trials

   British journal of cancer · Q1 journal · RCT · Evidence level 1 (High) · 16 September 2026

   Menopausal hormone therapy and liver cancer, no surgical focus

6. 6

   Short-term versus long-course neoadjuvant chemotherapy for resectable and borderline resectable pancreatic ductal adenocarcinoma (PACT-21 CASSANDRA): results from the second randomisation analysis of a randomised, open-label, 2 × 2 factorial phase 3 trial

   EClinicalMedicine · Q1 journal · RCT · Evidence level 1 (High) · 5 September 2026

   In the PACT-21/CASSANDRA trial, 86 patients receiving two extra months of chemotherapy before surgery and 79 receiving it after surgery had identical event-free survival (hazard ratio about 1). However, the longer regimen yielded higher CA19-9 response, a 5% complete pathological response rate and more N0 resections. Overall survival data are pending, underscoring the need for more effective neoadjuvant strategies.

7. 7

   Survival After Irreversible Electroporation in Unresectable Locally Advanced Pancreatic Cancer: A Meta-analysis

   The Journal of surgical research · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 15 September 2026

   In a meta-analysis of 31 studies (1,296 patients), patients receiving irreversible electroporation lived a median 16.3 months, roughly seven months longer than those treated without it. Survival was unrelated to age, sex, tumor size or location, and was similar whether the procedure was surgical or percutaneous. The finding, based on low-to-moderate certainty evidence, underscores the need for randomized trials.

8. 8

   Blinatumomab for Replacing Chemotherapy in Pediatric Acute Lymphoblastic Leukemia

   The New England journal of medicine · Q1 journal · RCT · Evidence level 1 (High) · 17 September 2026

   In a randomized trial of 709 children with high-risk B-cell ALL, replacing two chemotherapy cycles with blinatumomab raised 4-year event-free survival to 83% compared with 70% for standard therapy. Infections fell dramatically (24% vs 69%), but neuro-toxic events were three times more common. Long-term safety and optimal integration into treatment regimens remain to be defined.

9. 9

   Eplontersen with and without background transthyretin stabilizers in transthyretin amyloid cardiomyopathy: secondary analysis of a phase 3, randomized controlled trial

   Nature medicine · Q1 journal · RCT · Evidence level 1 (High) · 30 August 2026

   In the CARDIO-TTRansform trial, eplontersen lowered the combined risk of cardiovascular death and repeat events by 29% among patients who were not taking a TTR stabilizer at baseline, while showing no benefit for those already on stabilizers. Safety was comparable across groups, suggesting the drug's advantage may be limited to stabilizer-naïve patients.

10. 10

    Intrauterine Mepivacaine Instillation vs Placebo for Pain During IUD Placement: A Randomized Clinical Trial

    JAMA · Q1 journal · RCT · Evidence level 1 (High) · 17 September 2026

    In a double-blind trial of 370 nulliparous women, a 10 mL intrauterine dose of mepivacaine lowered average pain scores from 59 mm to 44 mm during IUD insertion, and 98% reported tolerable pain versus 91% with saline. The modest but statistically solid benefit suggests a simple option to improve comfort, though its impact on overall IUD uptake remains to be seen.

Paper of the day, last two weeks

• Single-port, via a midline approach, Robotic Transaxillary Thyroidectomy (SMART-Thyroidectomy): description of the technique and evaluation of feasibility in the first case series

  Journal of robotic surgery · Q1 journal · Case series · Evidence level 4 (Very Low) · 18 September 2026

  SMART‑Thyroidectomy: single‑port robotic transaxillary technique feasibility

• Axillary nodal burden and preoperative predictors in biopsy-proven node-positive breast cancer undergoing upfront surgery

  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · Q1 journal · Cohort · Evidence level 3 (Low) · 17 September 2026

  In a review of 1,671 patients undergoing upfront axillary dissection, 60% harbored extensive nodal disease (at least 3 positive nodes). A higher number of suspicious nodes on pre-operative ultrasound and larger tumor size independently increased this risk, but predictive accuracy was modest, suggesting ALND cannot be uniformly omitted without further validation.

• Margin Assessment in Breast-Conserving Surgery: A Comparative Analysis of Frozen Section and Cavity Shave Techniques

  Annals of surgical oncology · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 17 September 2026

  In a review of 2,224 breast-conserving operations, cavity shave margins achieved the same 12% re-excision rate as intraoperative frozen section but shortened the procedure by about 18 minutes for lumpectomy alone and 5 minutes when sentinel node biopsy was added. The finding supports a faster, equally effective margin strategy, though prospective validation is still needed.

• Real-World Clinical, Enviro-Logistical and Economic Implications of Sentinel Lymph Node Biopsy Omission in Early Breast Cancer

  Annals of surgical oncology · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 18 September 2026

  In a real-world cohort, 28% of early-stage, hormone-positive breast cancers met criteria to omit sentinel lymph node biopsy, with postoperative upstaging rates around 15% for tumor size and 13% for nodal status. Skipping the procedure saves roughly 2.2 hours of patient time, cuts 0.5 kg CO2 per case and could free 52 hours of operating-room capacity nationally, though reimbursement falls by about 23%.

• Complication Profile of Reoperative Thyroidectomy Versus First-Time Thyroidectomy: A Systematic Review and Meta-analysis

  The Journal of surgical research · Q1 journal · SR of cohorts · Evidence level 2 (Moderate) · 17 September 2026

  In a meta-analysis of 23 studies involving over 42,000 patients, repeat thyroid surgery was linked to about twice the odds of transient hypocalcemia and a 1.8-fold rise in permanent hypocalcemia, as well as a 1.8-fold increase in postoperative hematoma. The striking four-fold rise in permanent recurrent laryngeal nerve injury underscores the need for careful patient selection and counseling.

• Can Contrast-Enhanced Ultrasound Reduce the False-Negative Rate of Metastatic Axillary Lymph Nodes After Neoadjuvant Therapy in Breast Cancer?

  Cancers · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 24 August 2026

  In a retrospective series of 179 node-positive breast cancer patients, adding post-NAT contrast-enhanced ultrasound to sentinel lymph node biopsy lowered the false-negative rate to 13.3%, compared with higher rates using biopsy alone or standard ultrasound. The benefit was linked to HER2 status and residual tumor, but prospective validation is still needed.

• Near-infrared autofluorescence parathyroid imaging during total thyroidectomy to reduce the rate of postoperative hypoparathyroidism: A prospective two-center randomized clinical trial with a comprehensive long-term follow-up

  Surgery · Q1 journal · RCT · Evidence level 1 (High) · 16 July 2026

  In a randomized trial of 189 patients, using near-infrared autofluorescence during total thyroidectomy increased the number of glands seen (average 3.1 vs 2.8) but did not reduce permanent hypoparathyroidism at 3 or 12 months (15.6% vs 16.9%). The technique did not lengthen surgery and showed a hint of benefit only when central neck dissection was performed, leaving its routine use unproven.

• Prospective Comparison of Long-Term Outcomes in Prepectoral vs. Subpectoral Implant Breast Reconstruction After Post-Mastectomy Radiotherapy

  Plastic and reconstructive surgery · Q1 journal · Unclassified · Evidence level 5 (Expert Opinion) · 11 September 2026

  Prospective comparison of prepectoral vs subpectoral reconstruction

• Clinical Characteristics and Use of Poly-4-Hydroxybutyrate Scaffold (GalaFLEX™) in Primary and Secondary Implant-Based Breast Reconstruction: A Structured Review of the Literature and Preliminary Single-Center Experience

  Aesthetic plastic surgery · Q1 journal · Retrospective cohort · Evidence level 4 (Very Low) · 9 September 2026

  Implant-based reconstruction, P4HB scaffold outcomes

• Safety, short-term patient-reported outcomes, and cosmetic satisfaction of gasless transaxillary endoscopic thyroidectomy: a retrospective analysis of 530 patients

  Frontiers in endocrinology · Q1 journal · Cohort · Evidence level 4 (Very Low) · 25 August 2026

  Safety and cosmetic outcomes of gasless transaxillary endoscopic thyroidectomy

• The iBRA-NET localization study: international IDEAL 2a/2b multicentre cohort study comparing the safety and effectiveness of wire- and radar-guided localization for impalpable breast lesions

  BJS open · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 4 September 2026

  In a multicentre cohort of 1,297 patients, radar-guided SCOUT localization identified the target lesion in 95% of cases, comparable to 99% with wires, but achieved positive margins in only 9% of lumpectomies versus 15% with wire guidance. The technique also allowed earlier surgery start times, suggesting a safer, more efficient alternative, though lesion identification remains slightly lower.

• Thermal Ablation for Autonomously Functioning Thyroid Nodules: A Prospective Comparison of Radiofrequency and Microwave Ablation

  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · Q1 journal · Prospective cohort · Evidence level 4 (Very Low) · 7 September 2026

  Thermal ablation for autonomously functioning thyroid nodules

• Pitfalls of minimally invasive parathyroidectomy for the treatment of primary hyperparathyroidism

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · Q1 journal · Cohort · Evidence level 4 (Very Low) · 7 September 2026

  Pitfalls of minimally invasive parathyroidectomy for PHPT