A PTMC≤7 mm is less likely to have aggressive features, including central lymph node metastasis, capsule invasion, extrathyroidal extension, and lymphovascular invasion, than a PTMC>7 mm. Because the aggressiveness of PTMC was found mainly in the patients with tumors >7 mm, we think that a cutoff value of 7 mm may be considered the threshold of aggressiveness of PTMCs.

Bilaterality is found more frequently when the tumor is large. Multifocality also can help predict the possibility of bilaterality. Therefore, total thyroidectomy may be necessary for patients with a multifocal or large tumor. It should be noted that the presence of a contralateral cancer is missed in 4.7 and 5.5 % of patients with preoperatively diagnosed unilateral PTC and PTMC, respectively.

Necrotizing fasciitis (NF) is a rare and rapidly progressive disease involving the skin, subcutaneous tissue, and deep soft tissue. Although NF can occur any part of the body, the breast is an uncommon primary site for NF, and its occurrence in the breast during pregnancy has never previously been reported. Here, we report the case of a healthy 31-year-old pregnant woman who presented with NF of the left breast that was successfully treated with breast-conserving debridement and secondary wound closure using negative-pressure wound therapy.

BackgroundOvarian function suppression (OFS) has been shown to be effective as adjuvant endocrine therapy in premenopausal women with hormone receptor-positive breast cancer. However, it is currently unclear if addition of OFS to standard tamoxifen therapy after completion of adjuvant chemotherapy results in a survival benefit. In 2008, the Korean Breast Cancer Society Study Group initiated the ASTRRA randomized phase III trial to evaluate the efficacy of OFS in addition to standard tamoxifen treatment in hormone receptor-positive breast cancer patients who remain or regain premenopausal status after chemotherapy.MethodsPremenopausal women with estrogen receptor-positive breast cancer treated with definitive surgery were enrolled after completion of neoadjuvant or adjuvant chemotherapy. Ovarian function was assessed at the time of enrollment and every 6 months for 2 years by follicular-stimulating hormone levels and bleeding history. If ovarian function was confirmed as premenopausal status, the patient was randomized to receive 2 years of goserelin plus 5 years of tamoxifen treatment or 5 years of tamoxifen alone. The primary end point will be the comparison of the 5-year disease-free survival rates between the OFS and tamoxifen alone groups. Patient recruitment was finished on March 2014 with the inclusion of a total of 1483 patients. The interim analysis will be performed at the time of the observation of the 187th event.DiscussionThis study will provide evidence of the benefit of OFS plus tamoxifen compared with tamoxifen only in premenopausal patients with estrogen receptor-positive breast cancer treated with chemotherapy.Trial registrationClinicalTrials.gov Identifier NCT00912548. Registered May 31 2009. Korean Breast Cancer Society Study Group Register KBCSG005. Registered October 26 2009.

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In our experience, the transition from standard hernioplasty to SPLS TEP inguinal hernia repair by an experienced SPLS surgeon was feasible. However, a learning curve is necessary.

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