Breast cancer (BC) is the most prevalent and destructive tumor in developing countries. The implementation of mammography screening programs has enabled access to appropriate therapeutic interventions, including adjuvant endocrine therapy and breast-conserving surgery; earlier diagnosis translates into a wider survival-rate range, making hypofractionated radiotherapy (HFRT) the preferred option. This review examines the current literature comparing the two radiation therapies, HFRT and conventional radiotherapy (CR), with reconstructed breasts, focusing on efficacy, toxicity, cosmetic outcomes, quality of life (QOL), and cost-effectiveness. A comprehensive literature search was conducted using major scientific databases, including PubMed, Scopus, Web of Science, and Google Scholar. The search focused on articles published primarily in English, from 2010 to 2024, and the period is about 15 years. The following search terms and Boolean operators were used: "hypofractionated radiotherapy" OR "hypofractionation" AND "breast cancer" AND "toxicity" OR "complications" OR "reconstruction" OR "quality of life" OR "HFRT versus CFRT" OR "intensity-modulated radiation therapy" OR "proton therapy". CR can be safely replaced with HFRT in terms of overall survival and local recurrence rates. HFRT is associated with lesser risks of both acute and chronic side effects, breast complications, increased patient satisfaction, and reduced breast problems. In addition, new radiotherapy modalities, such as intensity-modulated radiation therapy, have shown great potential in targeting tumors. In treating BC, HFRT is gradually becoming standard, especially for patients who undergo reconstruction after surgery. Its low toxicity and equal effectiveness make it a key element in improving the QOL of BC survivors. It is recommended that future studies focus on long-term outcomes to provide better care to patients.

Aromatase inhibitor-induced musculoskeletal symptoms (AIMSS), especially joint pain, have been widely reported in postmenopausal women undergoing endocrine therapy for hormone receptor-positive breast cancer and are a major cause of treatment termination. Aerobic exercise has emerged as a promising nonpharmacological intervention to counteract AIMSS in this population. This study aimed to perform a systematic review and meta-analysis to assess the effect of aerobic exercise on aromatase inhibitor-induced worst joint pain in postmenopausal breast cancer. A systematic literature search was performed using ClinicalTrials.gov, PubMed, and the Cochrane Library that yielded 1415 records. Studies comparing the effect of aerobic exercise with usual care on the worst joint pain through brief pain inventory (BPI) scoring in postmenopausal women with breast cancer receiving aromatase inhibitor therapy were included. For each group, the mean change from baseline and standard deviation (SD) of worst joint pain (BPI score) were calculated. Mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analyses were conducted to explore heterogeneity based on exercise intervention. Three randomized controlled trials (n = 297) were included. Pooled analysis showed no significant overall effect of exercise compared with control (standardized mean difference [SMD] = -0.16; 95% CI [-1.45, 1.14]; p = 0.65; I² = 74%). Subgroup analysis indicated a significant difference by exercise type (p = 0.003), suggesting exercise modality influenced outcomes. Aerobic exercise, evaluated in two RCTs, significantly reduced worst joint pain (SMD = -0.41; 95% CI [-0.50, -0.32]; p = 0.01; I² = 0%), indicating consistent benefit across studies. In contrast, the single study assessing Nordic walking showed no significant improvement (SMD = 0.56; 95% CI [-0.08, 1.19]; p = 0.08). Risk-of-bias assessment revealed variability across studies, with one trial rated low risk, one with some concerns, and one at high risk, which may partly explain the observed heterogeneity (I² = 74%). Aerobic exercise interventions did not show an overall significant effect on the worst joint pain. However, subgroup analysis revealed that multi-component aerobic exercise programs were associated with significant pain reduction, while the study with only Nordic walking intervention was not. Considering the clinical burden of aromatase inhibitor-induced musculoskeletal symptoms, aerobic exercise can be a potentially useful non-pharmacologic adjunct to endocrine therapy. However, given the variation in the assessed risk of bias among the included studies, these outcomes should be interpreted with due caution. To confirm these results and determine the optimal exercise type and duration for managing aromatase inhibitor–associated musculoskeletal symptoms in breast cancer survivors, further large-scale trials are necessary.

Background: Malignant bowel obstruction (MBO) is a highly morbid complication of advanced intra-abdominal malignancies. This study aims to identify clinicopathologic factors and intervention strategies associated with improved survival and reduced rates of re-obstruction.

Methods: A single centre, retrospective data analysis was performed for all consecutive patients admitted with MBO to a tertiary cancer centre in Melbourne, Australia over a 2-year period.

Results: We identified a total of 102 patients with 137 admission episodes for MBO. Median age was 62 years, and 55 patients (54%) were female. 61 patients (60%) had a gastrointestinal primary (colorectal, gastric or appendiceal), while 17 patients (16%) had a gynaecological primary and 24 (24%) other primaries. Median overall survival was 120 days (95% confidence interval (CI) [76, 167]). 41 patients (40%) died within 90 days of initial admission with MBO. Clinicopathological variables associated with reduced 90-day survival included hypoalbuminaemia (odds ratio [OR] = 3.33 for serum albumin < 30 g/L, 95% CI [1.43, 7.69]) and peritoneal disease (OR = 5.80, 95% CI [2.26, 14.9]). 41 patients (40%) received surgical management. We identified no factors significantly associated with the decision for surgical rather than conservative management. Of the 113 total admissions that reached discharge, 55 (49%) were followed by patient readmission within 90 d. Almost half (48%) of patients were referred to the inpatient palliative care service and this was associated with a reduction in the odds of 90 d readmission (OR = 0.31, 95% CI [0.14, 0.71]).

Conclusion: MBO heralds a poor prognosis, with high rates of readmission, morbidity and mortality. Careful patient selection is imperative to identify patients likely to benefit from operative management.

Background: Hepatocellular carcinoma (HCC) rupture and hemorrhage is one of the critical emergencies in HCC, with a high mortality rate upon occurrence. The mortality rate after rupture and hemorrhage is nearly 25%, while the recurrence rate of bleeding is approximately 20%, with a mortality rate exceeding 50%. Even after bleeding cessation, related complications pose significant challenges for treatment.

Case Presentation: Here, we report a case of multi-vessel rupture and hemorrhage in HCC, where initial hemostasis was successfully achieved via trans arterial embolization (TAE), but another vessel ruptured and bled again within 48 h. The total blood loss in this case was about 3300 mL, accompanied by severe complications such as infection, liver function deterioration, hepatic encephalopathy, and malnutrition. Additionally, we conducted a literature review on the mechanisms and treatment of HCC rupture and hemorrhage, aiming to provide insights and lessons for its diagnosis and management.

Conclusion: (1) After TAE for ruptured hepatocellular carcinoma with hemorrhage, it is still necessary to be vigilant against the possibility of secondary hemorrhage. During the TAE procedure, precise embolization should be achieved as much as possible to reduce liver function damage. (2) After ruptured hepatocellular carcinoma with hemorrhage, complications such as abdominal infection, hepatic encephalopathy, malnutrition, and deterioration of liver function need to be watched out for. Early identification and active intervention can help patients achieve better prognosis.

Background: Sarcomatoid carcinoma is a rare and aggressive malignancy with a poor prognosis, capable of arising in diverse tissues. Pulmonary artery sarcomatoid carcinoma is particularly uncommon and highly invasive.

Case Presentation: We present the case of a 40-year-old male who experienced dry cough and dyspnea, and was subsequently diagnosed with a mass obstructing the bilateral main pulmonary artery, predominantly involving the left main branch shortly after contracting COVID-19. Histopathological analysis of a lung biopsy and positron emission tomography (PET) scan confirmed the diagnosis of sarcomatoid carcinoma involving the bilateral main pulmonary artery. Following six cycles of combined chemotherapy and immunotherapy, the patient's condition remained relatively stable.

Conclusion: This case report aims to discuss the clinical presentation, diagnostic approach, and therapeutic management of this rare condition, thereby contributing to the broader understanding of sarcomatoid carcinoma.