Integrating the Principles of Academic Freedom and Patient-Centered Care to Promote Tolerant Listening Skills in Health Care Providers.

ABSTRACT: Collaboration is a vital skill that needs to be developed in health professions students. Developing tolerance for differing viewpoints and valuing an understanding of others' lived experiences are instrumental skills in learning to provide patient-centered care. Fostering the expression of diverse viewpoints and working through uncomfortable and distressful situations are a part of the experience in acquiring these skills. It is the educator's duty to facilitate these encounters in a way that upholds the tenants of academic freedom and civility to create optimal educational outcomes. Doing so creates opportunities for transformative learning and the facilitation of higher cognitive development when compared with the avoidance of exposing students to divergent viewpoints. It is through freedom of discussion that one must teach students that ultimately the pursuit of truth, even when it may be unwelcome, disagreeable, or deeply offensive, greatly outweighs the discomfort the process of discovering it may bring.

Stakeholders' Perceptions on the Implementation of the HPV Vaccine School-Entry Requirement in Puerto Rico during the COVID-19 Pandemic.

This study explored the implementation of the human papillomavirus (HPV) vaccine school-entry requirement in Puerto Rico during the COVID-19 pandemic. We conducted 26 semi-structured interviews with stakeholders and community-based organizations from August 2021 to March 2022. The interview guide was developed using the 2009 Consolidated Framework for Implementation Research (CFIR). The interviews were recorded and transcribed in Spanish. Data were analyzed using applied thematic techniques. These themes included the following: (i) Intervention characteristics: Participants noted that the school-entry requirement was effective in increasing vaccination uptake prior to the pandemic. Issues with the immunization registry were noted; (ii) Outer setting: External influences, access barriers, and an increase in HPV vaccine exemptions since the implementation of the COVID-19 vaccine were discussed; (iii) Inner setting: Communication within organizations and HPV vaccination efforts improved as the pandemic progressed; (iv) Characteristics of individuals: Most agreed with the school-entry requirement, including exemptions; and (v) Process: Results showed the need to reinforce the population's education about HPV and the vaccine. Implementation of the policy was challenging during the early stages of the pandemic due to measures enacted to stop the spread of COVID-19 and focus on the COVID-19 vaccine. Efforts to increase HPV vaccine should focus on increasing HPV vaccine education and creating collaborations.

Cardiovascular, Kidney Failure, and All-Cause Mortality Events in Patients with Focal Segmental Glomerulosclerosis in a U.S. Real-World Database.

BACKGROUND: Focal segmental glomerulosclerosis (FSGS) leads to proteinuria and progressive decline in glomerular filtration rate which correlates with kidney failure and increased cardiovascular risk. The purpose of this study was to estimate the effects of proteinuria on kidney failure status/all-cause mortality and cardiovascular disease events/all-cause mortality, as well as the relationship between progression to kidney failure and occurrence of cardiovascular disease/mortality events among adult patients (≥18 years old) with FSGS. METHODS: This was an observational, retrospective cohort study utilizing Optum® de-identified Market Clarity Data and proprietary Natural Language Processing (NLP) data. The study period was from January 1, 2007 through March 31, 2021, with patients in the overall cohort being identified from July 1, 2007 through March 31, 2021. The index date was the first FSGS ICD-10 diagnosis code or FSGS-related NLP term within the identification period. RESULTS: Elevated proteinuria >1.5 g/g and ≥3.5 g/g increased risk for kidney failure/all-cause mortality (adjusted hazard ratio [95% CI]: 2.34 [1.99-2.74] and 2.44 [2.09-2.84], respectively) and cardiovascular disease/all-cause mortality (adjusted hazard ratio [95% CI]: 2.11 [1.38-3.22] and 2.27 [1.44-3.58], respectively). Progression to kidney failure was also associated with a higher risk of cardiovascular disease/all-cause mortality (adjusted hazard ratio [95% CI]: 3.04 [2.66-3.48]. CONCLUSIONS: A significant proportion of FSGS patients experience kidney failure and cardiovascular disease events. Elevated proteinuria and progression to kidney failure were associated with a higher risk of cardiovascular disease/all-cause mortality events, and, elevated pre-kidney failure proteinuria was associated with progression to kidney failure/all-cause mortality events. Treatments that meaningfully reduce proteinuria and slow the decline in glomerular filtration rate have the potential to reduce the risk of cardiovascular disease, kidney failure and early mortality in patients with FSGS.

Testing intergroup contact theory through a natural experiment of randomized college roommate assignments in the United States.

Many colleges and universities seek to leverage the promise of intergroup contact theory by adopting housing policies that randomly assign first-year students to roommates, with the goal of increasing intergroup contact. Yet, it is unclear whether random roommate assignment policies increase cross-race contact, whether this (potentially involuntary, but sanctioned by authorities) contact improves racial attitudes or behaviors, or how these effects may differ for racial majority and minority students. The present studies used a natural experiment of random roommate assignment to directly test roommate relationship, attitudinal, and behavioral changes based on roommate race. Across three samples drawn from two student cohorts, the random assignment policy increased the likelihood that students had a cross-race roommate because without the policy, students tended to self-segregate by race. Moreover, selecting (Study 1) or being randomly assigned (Study 2) a cross-race roommate was associated with having more racial outgroup friends and demonstrating more positive verbal and nonverbal behavior during a novel cross-race interaction (Study 3). There were no roommate group (same vs. cross-race roommates) differences in relationship quality, and the results were largely independent of participant race. These findings suggest randomized roommate assignment is a promising avenue for universities to promote cross-race contact amid persistent racial segregation on college campuses with limited negative consequences for relationship quality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring the Orgasm Gap Across Racial/Ethnic Groups: A Descriptive Analysis.

Orgasm gaps between heterosexual men and women, and for women across sexual orientations, are well-established in research. However, no large-scale assessments of orgasm frequency by race/ethnicity exist. Here, we analyzed 10 years of cross-sectional Singles in America survey data between 2011 and 2021 to investigate the orgasm gap at the intersection of gender and racial/ethnic identity (i.e. White, Black, Hispanic/Latino, and Asian) for heterosexual participants (N = 27,347). White and Hispanic/Latino men reported greater orgasm frequency than Black and Asian men. Hispanic/Latino women reported the greatest orgasm frequency, and Asian women reported the lowest, with White and Black women's frequencies in between. The orgasm gap between men and women was largest for White (d = 0.89) and Asian (d = 0.86) groups, although Asian participants reported a lower orgasm frequency than White participants overall. The orgasm gap was smaller for Hispanic/Latino participants (d = 0.66), because Hispanic/Latino women reported a greater orgasm frequency than other racial/ethnic groups of women. The orgasm gap was smaller for Black participants (d = 0.61), because Black men reported a lower orgasm frequency than some other racial/ethnic groups of men. This descriptive study serves as an important starting point for future research on orgasm experiences across racial/ethnic groups.

Changing Course: Understanding the Legal Landscape of Race-Conscious Admission Practices and Implications to Diversity-Promoting Strategies in Higher Education.

ABSTRACT: The 2023 US Supreme Court holding in Students for Fair Admissions, Inc. v. President and Fellows of Harvard College and Students for Fair Admissions, Inc. v. University of North Carolina, et al. has changed the landscape in higher education admissions processes by declaring affirmative action unlawful. It is imperative that those working in higher education admissions understand the ruling and implement contemporary best practices. Institutions of higher education who wish to promote student diversity are tasked with developing alternative strategies to affirmative action and must steer clear from using race as a determinant factor in admissions decisions. Aiming to identify diversity in individuals' lived experiences, focusing on recruitment efforts that organically lead to diverse applicants, adopting holistic, mission-driven admissions processes, and enhancing robust retention efforts may be effective means of fostering student diversity.

Can the processing of task-irrelevant threatening stimuli be inhibited? - The role of shape and valence in the saliency of threatening objects.

Numerous studies have demonstrated that attention is quickly oriented towards threatening stimuli, and that this attentional bias is difficult to inhibit. The root cause(s) of this bias may be attributable to the affective (e.g., valence) or visual features (e.g., shape) of threats. In two experiments (behavioral, eye-tracking), we tested which features play a bigger role in the salience of threats. In both experiments, participants looked for a neutral target (butterfly, lock) among other neutral objects. In half of the trials a threatening (snake, gun) or nonthreatening (but visually similar; worm, hairdryer) task-irrelevant distractor was also present at a near or far distance from the target. Behavioral results indicate that both distractor types interfered with task performance. Rejecting nonthreatening distractors as nontargets was easier when they were presented further from the target but distance had no effect when the distractor was threatening. Eye-tracking results showed that participants fixated less often (and for less time) on threatening compared to nonthreatening distractors. They also viewed targets for less time when a threatening distractor was present (compared to nonthreatening). Results suggest that visual features of threats are easier to suppress than affective features, and the latter may have a stronger role in eliciting attentional biases.

"What's Something You've Heard About Sex, But Are Unsure If It's True?": Assessing Middle and High School Students' Sex Education Questions.

PURPOSE: Comprehensive sex education (CSE) encourages safer sex behavior for teens and young adults. However, young people recognize a gap between sex education as taught in the classroom and the reality of their sexual experiences. Thus, CSE should take into account the perspectives of its target population. METHODS: The current project assesses young people's sexual uncertainties by analyzing open-ended responses that were anonymously submitted during in-person sex education sessions. These education programs were administered in middle and high schools in New York State by facilitators from Planned Parenthood Hudson Peconic, Inc. The authors analyzed 1,335 responses from a racially diverse sample of students between the ages of 10 and 21, with 75% of participants between 15 and 17 years old. RESULTS: Using content analysis, the authors identified 49 recurring content codes in participants' responses, which were organized into 16 categories. Most responses centered around pregnancy, sexually transmitted infections, and how to prevent these outcomes. However, responses also highlighted topics that are not always covered with nuance and transparency, if at all, in sex education (e.g., withdrawal, effectiveness of condoms and other contraception, anal and oral sex). Additionally, gender analyses indicated that girls made greater reference to pain, while boys made greater reference to pleasure, which has implications for girls' development of a positive sexuality. DISCUSSION: These results should be interpreted with a social equity lens to inform the development of needs-driven, target-based CSE programming.

Personality traits as identity threat cues: Stigmatized perceivers infer prejudice from disagreeableness.

OBJECTIVE: Across four studies, we examined whether certain personality traits cue prejudice and serve as identity threat cues. BACKGROUND: Stigmatized group members may be vigilant to personality cues that signal prejudice. METHOD: In Study 1 (N = 76), perceivers selected traits and behaviors associated with disagreeableness and closedness to experience as indicators of prejudice. In Studies 2-4, perceivers with stigmatized identities (Total N = 907) learned about a target person who was depicted as disagreeable or agreeable (Studies 2 and 3) and as disagreeable or another trait matched on perceived negativity (i.e., low in conscientiousness, Study 4). RESULTS: Participants perceived the disagreeable target as more discriminatory and hierarchy-endorsing (Studies 2-4), more morally disengaged (Study 3), and more likely to discriminate against stigmatized identity groups (Studies 2 and 4) than the agreeable or low conscientious targets. The relationship between target disagreeableness and perceived discrimination was partially explained by higher perceived hierarchy endorsing beliefs (Studies 2-4) and perceived moral disengagement (Study 3). CONCLUSIONS: This research finds that perceivers with stigmatized identities utilize target disagreeableness as a cue of identity threat, inferring that disagreeable people are more likely to be discriminatory, prejudicial, and hierarchy-endorsing than agreeable and low conscientious people.

Combined Targeting of NAD Biosynthesis and the NAD-dependent Transcription Factor C-terminal Binding Protein as a Promising Novel Therapy for Pancreatic Cancer.

Cancer therapies targeting metabolic derangements unique to cancer cells are emerging as a key strategy to address refractory solid tumors such as pancreatic ductal adenocarcinomas (PDAC) that exhibit resistance to extreme nutrient deprivation in the tumor microenvironment. Nicotinamide adenine dinucleotide (NAD) participates in multiple metabolic pathways and nicotinamide phosphoribosyl transferase (NAMPT) is one of the key intracellular enzymes that facilitate the synthesis of NAD. C-terminal binding proteins 1 and 2 (CtBP) are paralogous NAD-dependent oncogenic transcription factors and dehydrogenases that nucleate an epigenetic complex regulating a cohort of genes responsible for cancer proliferation and metastasis. As adequate intracellular NAD is required for CtBP to oligomerize and execute its oncogenic transcriptional coregulatory activities, we hypothesized that NAD depletion would synergize with CtBP inhibition, improving cell inhibitory efficacy. Indeed, depletion of cellular NAD via the NAMPT inhibitor GMX1778 enhanced growth inhibition induced by either RNAi-mediated CtBP1/2 knockdown or the CtBP dehydrogenase inhibitor 4-chlorophenyl-2-hydroxyimino propanoic acid as much as 10-fold in PDAC cells, while untransformed pancreatic ductal cells were unaffected. The growth inhibitory effects of the NAMPT/CtBP inhibitor combination correlated pharmacodynamically with on-target disruption of CtBP1/2 dimerization, CtBP2 interaction with the CoREST epigenetic regulator, and transcriptional activation of the oncogenic target gene TIAM1. Moreover, this same therapeutic combination strongly attenuated growth of PDAC cell line xenografts in immunodeficient mice, with no observable toxicity. Collectively, our data demonstrate that targeting CtBP in combination with NAD depletion represents a promising therapeutic strategy for PDAC. SIGNIFICANCE: Effective precision therapies are lacking in PDAC. We demonstrate that simultaneous inhibition of NAD metabolism and the oncoprotein CtBP is potently effective at blocking growth of both PDAC cells in culture and human PDAC-derived tumors in mice and should be explored further as a potential therapy for patients with PDAC.

Impact of Proteinuria and Kidney Function Decline on Health Care Costs and Resource Utilization in Adults With IgA Nephropathy in the United States: A Retrospective Analysis.

Rationale & Objective: Among patients with IgA nephropathy (IgAN), proteinuria and decline in kidney function may be associated with increased economic burden. This study aimed to provide current information on the epidemiology and economic burden of IgAN in the United States. Study Design: Retrospective cohort study. Setting & Study Population: Overall, 9,984 patients in the Optum's Market Clarity database identified by the presence of at least 2 natural language processing-derived IgAN signs and disease and symptoms terms; 813 with linked claims data included in a health care resource utilization/cost subcohort. Predictor: High-risk proteinuria (≥1 g/d), chronic kidney disease (CKD) stage. Outcomes: Standardized prevalence, health care resource utilization, costs. Analytical Approach: Descriptive statistics for categorical and continuous variables. Direct standardization for prevalence estimation. Generalized linear models for health care resource utilization/costs, reported as per-patient-per-month (PPPM) costs in 2020 US dollars. Results: The estimated standardized US prevalence of IgAN (2016-2020) was 329.0 per 1,000,000 persons. High-risk proteinuria (≥1 vs <1 g/d) was associated with a higher mean PPPM number of outpatient visits (3.49 vs 1.74; P = 0.01) and pharmacy claims (3.79 vs 2.41; P = 0.01), contributing to higher mean total costs PPPM ($3,732 vs $1,457; P = 0.01). Furthermore, higher CKD stage was also associated with higher health care resource utilization (number of outpatient visits PPPM, number of pharmacy claims PPPM, proportion of patients with inpatient visits and emergency department visits; P < 0.001) and mean total cost PPPM (from $2,111 CKD stage 1 to $10,703 CKD stage 5/kidney failure; P < 0.001). Limitations: Generalizability outside of the catchment group for the database, missing data/errors inherent in retrospective database studies, relatively small sample size, use of Optum Market Clarity standardized pricing algorithms, exclusion of out-of-pocket costs. Conclusions: Health care resource utilization and costs were higher for IgAN patients with high-risk proteinuria and worsening kidney function. Treatments that reduce proteinuria and slow CKD disease progression may reduce the economic burden associated with IgAN. Plain-Language Summary: Immunoglobulin A nephropathy (IgAN) is a rare kidney disease. Over time, the kidneys may leak protein into the urine (proteinuria). IgAN can lead to kidney failure. Because IgAN is rare, it is hard to know how many people have it. This study used electronic health records to estimate the number of patients with IgAN in the United States, describe the characteristics of patients, and understand their treatments and the costs. The number of patients with IgAN increased between 2016 and 2020. The researchers think this is because doctors learned more about IgAN. Patients with severe disease used more health care resources and had higher costs. The authors believe treatments that slow kidney damage may reduce the cost of treating IgAN.

Factors that contribute to accurately perceiving anti-black racism and sexism overlap.

Past research demonstrates that prejudice toward women and Black Americans often co-occur in individuals. The present studies examine factors related to accuracy in estimating the co-occurrence, or overlap, of prejudice toward women and Black Americans. Across two studies, criterion overlap percentages were computed using national datasets and separate participant samples estimated prejudice overlap. Results indicate that beliefs about the generalized nature of prejudice can improve accuracy by reducing faulty underestimation of the overlap in anti-Black racism and sexism. In addition to greater displayed accuracy in perceptions of prototypical perpetrators of prejudice (i.e., estimates of White men compared to White women), the present work suggests that accuracy is improved when estimating sexist attitudes from racist attitudes, rather than vice versa. Together, this work documents the accuracy of prejudice overlap perceptions, for the first time, and factors that facilitate accuracy (i.e., perpetrator prototypicality, known prejudicial attitude), with implications for intergroup dynamics research.

Benzodiazepine Usage, Healthcare Resource Utilization, and Costs Among Older Adults Treated with Common Insomnia Medications: A Retrospective Cohort Study.

Background: Benzodiazepines are commonly prescribed for insomnia management but are often associated with negative safety outcomes such as falls and abuse, particularly among older adults. Objective: The purpose of this real-world study was to compare the impact of benzodiazepines, low-dose trazodone, and zolpidem immediate release (IR) on healthcare resource utilization (HCRU), and costs among older adults (age ≥ 65 years) with insomnia in the US. Methods: Using the IBM MarketScan Medicare Supplemental Database, older adults with >1 physician-assigned diagnosis of insomnia and treated with benzodiazepines were matched 1:1 on age, sex, and index-date to individuals treated with trazodone, and separately matched 1:1 on age and sex, to individuals treated with zolpidem immediate release (IR). Between-groups differences were analyzed using general linear models (GLMs) that controlled for multiple confounders. Results: Significant between-groups differences in HCRU and costs were observed such that relative to zolpidem IR and separately relative to low-dose trazodone, benzodiazepines were consistently associated with worsened outcomes. Conclusion: These findings build upon and extend prior knowledge on the negative impact of benzodiazepines and suggest directions for future research.

Henry gas solubility optimization double machine learning classifier for neurosurgical patients.

This study aims to predict head trauma outcome for Neurosurgical patients in children, adults, and elderly people. As Machine Learning (ML) algorithms are helpful in healthcare field, a comparative study of various ML techniques is developed. Several algorithms are utilized such as k-nearest neighbor, Random Forest (RF), C4.5, Artificial Neural Network, and Support Vector Machine (SVM). Their performance is assessed using anonymous patients' data. Then, a proposed double classifier based on Henry Gas Solubility Optimization (HGSO) is developed with Aquila optimizer (AQO). It is implemented for feature selection to classify patients' outcome status into four states. Those are mortality, morbidity, improved, or the same. The double classifiers are evaluated via various performance metrics including recall, precision, F-measure, accuracy, and sensitivity. Another contribution of this research is the original use of hybrid technique based on RF-SVM and HGSO to predict patient outcome status with high accuracy. It determines outcome status relationship with age and mode of trauma. The algorithm is tested on more than 1000 anonymous patients' data taken from a Neurosurgical unit of Mansoura International Hospital, Egypt. Experimental results show that the proposed method has the highest accuracy of 99.2% (with population size = 30) compared with other classifiers.

Place of care and costs associated with acute episodes and remission in schizophrenia.

BACKGROUND: Schizophrenia imposes significant economic burden on patients, families, caregivers, and society. To our knowledge, place of care and associated costs of acute schizophrenia episodes have not been well characterized. OBJECTIVE: To describe the care settings and costs associated with likely acute episodes and untreated remission periods among patients with schizophrenia. METHODS: Adults with schizophrenia were identified using the IBM MarketScan Commercial and Medicare Supplemental databases (2009-2018); claims for capitated benefits plans were excluded. Acute episode index date was defined as at least 1 inpatient schizophrenia claim or outpatient schizophrenia claim (frequency of claim dependent on visit type, such as hospitalization, emergency department, private practice, clinic, urgent care, or laboratory). Mental health-related medical costs (health plan+patient) associated with acute episodes were collected over a 2-month follow-up period and stratified by setting (inpatient vs outpatient); acute episode data were reported in subgroups of patients without or with prior clozapine use, as an indication of disease severity. Remission index date was defined as at least 1 outpatient claim with a schizophrenia diagnosis with no acute episode and no oral or injectable antipsychotic therapy. Remission costs were assessed over a 3-month period. All data were analyzed descriptively. RESULTS: A total of 14,824 patients with schizophrenia met criteria for an acute episode (12,896 [87.0%] without prior clozapine use; 1,427 [9.6%] with prior clozapine use). Most acute episodes were treated in an outpatient setting (all patients, 76.3%; without prior clozapine use, 74.5%; with prior clozapine use, 87.1%). When treated inpatient, mean (SD) episode medical costs were $17,045 ($28,101) for all patients, $16,060 ($22,786) for those without prior clozapine use, and $22,827 ($55,860) for those with prior clozapine use. When treated outpatient, mean (SD) medical costs for acute episodes were $2,478 ($6,961) for all patients, $2,609 ($7,068) for those without prior clozapine use, and $1,770 ($6,560) for those with prior clozapine use. For all patients with acute episodes, regardless of clozapine use, patient-incurred out-of-pocket costs were approximately 30% of total medical costs. For an untreated period of remission, 6,950 patients with schizophrenia met criteria. Total medical costs were $2,399 for these patients over a 3-month period. CONCLUSIONS: The majority of acute schizophrenia episodes were treated in the outpatient setting. For episodes that required inpatient care, inpatient episodes were approximately 7 times more costly than episodes treated in outpatient-only settings. For acute episodes and remission periods, health plans covered most costs; however, there were additional patient-incurred out-of-pocket costs. DISCLOSURES: All authors met the International Committee of Medical Journal Editors authorship criteria. Neither honoraria nor payments were made for authorship. Dr McIntyre has received research grant support from CIHR/GACD/National Natural Science Foundation of China (NSFC) and the Milken Institute; speaker/consultation fees from Lundbeck, Janssen, Alkermes, Neumora Therapeutics, Boehringer Ingelheim, Sage, Biogen, Mitsubishi Tanabe, Purdue, Pfizer, Otsuka, Takeda, Neurocrine, Sunovion, Bausch Health, Axsome, Novo Nordisk, Kris, Sanofi, Eisai, Intra-Cellular, NewBridge Pharmaceuticals, Viatris, AbbVie, Atai Life Sciences. Dr McIntyre is a CEO of Braxia Scientific Corp. Mr Doan, Dr Amari, and Mr Mercer are employees of Genesis Research, which was funded to perform the study. Ms Higa, Dr Gillard, and Dr Harrington were employees of AbbVie at the time of the study and may hold stock. This study was sponsored by AbbVie.

Attitudes towards HPV and COVID school-entry policies among adults living in Puerto Rico.

Prior to the COVID pandemic, Puerto Rico (PR) had one of the highest Human Papillomavirus (HPV) vaccine rates in the United States. The COVID pandemic and administration of COVID vaccines might have impacted attitudes toward HPV vaccination. This study compared attitudes toward HPV and COVID vaccines with respect to school-entry policies among adults living in PR. A convenience sample of 222 adults (≥21 years old) completed an online survey from November 2021 to January 2022. Participants answered questions about HPV and COVID vaccines, attitudes toward vaccination policies for school-entry, and perceptions of sources of information. We assessed the magnitude of association between the agreement of school-entry policies for COVID and HPV vaccination by estimating the prevalence ratio (PRadjusted) with 95% Confidence Intervals (95% CI). The most trusted source of information for HPV and COVID vaccines were healthcare providers (42% and 17%, respectively) and the CDC (35% and 55%, respectively), while the least trusted were social media (40% and 39%, respectively), and friends and family (23% n = 47, and 17% n = 33, respectively). Most participants agreed that HPV (76% n = 156) and COVID vaccines (69% n = 136) should be a school-entry requirement. Agreement with school policy requiring COVID vaccination was significantly associated with agreement of school policy requiring HPV vaccination (PRadjusted:1.96; 95% CI:1.48-2.61) after controlling for potential confounders. Adults living in PR have an overall positive attitude about mandatory HPV and COVID vaccination school-entry policies, which are interrelated. Further research should elucidate the implications of the COVID pandemic on HPV vaccine attitudes and adherence rates.

"An Unusual Pattern of Metastasis" Metastatic Malignant Thymoma Presented with Breast Lump: A Case Report and Literature Review.

Metastatic lesions to the breast from extramammary malignant neoplasms are rare and reported account for 0.5-6.6% of all breast malignancies. Distant metastasis of thymoma is even rarer, especially to extrathoracic regions. We reported a woman with invasive malignant thymoma postneoadjuvant and resection of the thymoma, who developed breast metastasis 7 years later. Breast imaging showed high-density lesion with no intralesional microcalcifications and no significant axillary lymphadenopathy. Core biopsy and histopathology proved the lesion to be metastatic thymic carcinoma. Despite rarity, breast lumps with underlying extramammary malignancy should raise the suspicious of breast metastasis.