Rationale and Objectives: Microwave Breast Imaging (MBI) is an emerging non-ionising technology with the potential to detect breast pathology. The investigational device considered in this article is a low-power electromagnetic wave MBI prototype that demonstrated the ability to detect dielectric contrast between tumour phantoms and synthetic fibroglandular tissue in preclinical studies. Herein, we evaluate the MBI system in the clinical setting. The capacity of the MBI system to detect and localise breast tumours in addition to benign breast pathology is assessed. Secondly, the safety profile and patient experience of this device is established.Materials and Methods: Female patients were recruited from the symptomatic unit to 1 of 3 groups: Biopsy-proven breast cancers (Group-1), unaspirated cysts (Group-2) and biopsy-proven benign breast lesions (Group-3). Breast Density was determined by Volpara VDM (Volumetric Density Measurement) Software. MBI, radiological, pathological and histological findings were reviewed. Subjects were surveyed to assess patient experience.Results: A total of 25 patients underwent MBI. 24 of these were included in final data analysis (11 Group-1, 8 Group-2 and 5 Group-3). The MBI system detected and localised 12 of 13 benign breast lesions, and 9 out of the 11 breast cancers. This included 1 case of a radiographically occult invasive lobular cancer. No device related adverse events were recorded. 92% (n = 23) of women reported that they would recommend MBI imaging to other women. Conclusion:The MBI system detected and localized the majority of breast lesions. This modality may have the potential to offer a noninvasive, non-ionizing and painless adjunct to breast cancer diagnosis. Further larger studies are required to validate the findings of this study.

Global statistics have demonstrated that breast cancer is the most frequently diagnosed invasive cancer and the leading cause of cancer death among female patients. Survival following a diagnosis of breast cancer is grossly determined by the stage of the disease at the time of initial diagnosis, highlighting the importance of early detection. Improving early diagnosis will require a multi-faceted approach to optimizing the use of currently available imaging modalities and investigating new methods of detection. The application of microwave technologies in medical diagnostics is an emerging field of research, with breast cancer detection seeing the most significant progress in the last twenty years. In this review, the application of current conventional imaging modalities is discussed, and recurrent shortcomings highlighted. Microwave imaging is rapid and inexpensive. If the preliminary results of its diagnostic capacity are substantiated, microwave technology may offer a non-ionizing, non-invasive, and painless adjunct or stand-alone modality that could possibly be implemented in routine diagnostic breast care. Author Contributions: Conceptualization, B.M.M., D.O.'L, S.A.E., and M.J.K.; writing-original draft preparation, B.M.M., D.O.'L and S.A.E., writing-review and editing, B.M.M., D.O.'L, S.A.E., and M.J.K.; supervision, M.J.K.; funding acquisition, M.J.K.; All authors have read and agreed to the published version of the manuscript.

Background In early 2020, the COVID‐19 pandemic significantly altered management of surgical patients globally. International guidelines recommended that non-operative management be implemented wherever possible (e.g. in proven uncomplicated appendicitis) to reduce pressure on healthcare services and reduce risk of peri-operative viral transmission. We sought to compare our management and outcomes of appendicitis during lockdown versus a non-pandemic period. Methods All presentations to our department with a clinical diagnosis of acute appendicitis between 12/03/2020 and 30/06/2020 were compared to the same 110-day period in 2019. Quantity and severity of presentations, use of radiological investigations, rate of operative intervention and histopathological findings were variables collected for comparison. Results There was a reduction in appendicitis presentations (from 74 to 56 cases), and an increase in radiological imaging (from 70.27% to 89.29%)( P =0.007) from 2019 to 2020. In 2019, 93.24% of patients had appendicectomy, compared to 71.42% in 2020(P<0.001). This decrease was most pronounced in uncomplicated cases, whose operative rates dropped from 90.32% to 62.5%( P =0.009). Post-operative histology confirmed appendicitis in 73.9% in 2019, compared to 97.5% in 2020 ( P =0.001). Normal appendiceal pathology was reported for 17 cases (24.64%) in 2019, compared to none in 2020 ( P <0.001) – a 0% negative appendicectomy rate (NAR). Discussion The 0% NAR in 2020 is due to a combination of increased CT imaging, a higher threshold to operate, and is impacted by increased disease severity due to delayed patient presentation. This study adds to growing literature promoting routine use of radiological imaging to confirm appendicitis diagnosis. As we enter a second lockdown, patients should be encouraged to avoid late presentations, and surgical departments should continue using radiological imaging more liberally in guiding appendicitis management.

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Background Papillary thyroid cancer (PTC) is the most common subtype of thyroid cancer. The incidence of PTC is rising in tandem with an obesity epidemic. Associations have been demonstrated between increased body mass index (BMI) and worse oncological outcomes in a number of malignancies. However, research on this topic in PTC to date has been inconsistent, often due to limited data. This study aimed to measure the association between BMI and potentially adverse clinicopathological features of PTC. Methods A meta‐analysis of studies reporting outcomes after surgical treatment of PTC was performed. PubMed, Embase and the Cochrane Library were searched systematically to identify studies which provided data on BMI and clinicopathologic features of PTC. Relevant data were extracted and synthesis performed using adjusted odds ratios where available and crude values when not. Data were analysed by inverse variance using random and fixed effects models. Results Data on 35,237 patients from 15 studies met the criteria for inclusion. Obesity was associated with larger tumour size (MD = 0.17 cm [0.05, 0.29]), increased rates of multifocality (OR = 1.41 [1.16, 1.70]), extrathyroidal extension (OR = 1.70 [1.39, 2.07]) and nodal spread (OR = 1.18 [1.07, 1.30]). Associations were more pronounced as BMI increased. There was no association between BMI and bilaterality, vascular invasion or metastatic spread. Conclusion Increased BMI is significantly associated with multiple potentially adverse features of PTC. The effect on long‐term oncological outcomes requires further evaluation.

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Microwave Breast Imaging (MBI) is an emerging non-ionizing imaging modality, with the potential to support breast diagnosis and management. Wavelia is an MBI system prototype, of 1st generation, which has recently completed a First-In-Human (FiH) clinical investigation on a 25-symptomatic patient cohort, to explore the capacity of the technology to detect and characterize malignant (invasive carcinoma) and benign (fibroadenoma, cyst) breast disease. Two recent publications presented promising results demonstrated by the device in this FiH study in detecting and localizing, as well as delineating size and malignancy risk, of malignant and benign palpable breast lesions. In this paper, the methodology that has been employed in the Wavelia semi-automated Quantitative Imaging Function (QIF), to support breast lesion detection and characterization in the FiH clinical investigation of the device, is presented and the critical design parameters are highlighted.