Breast conservative surgery, partial breast irradiation, whole breast irradiation, , cosmetic results, Brachytherapy Breast-conserving therapy consists of wide local excision (WLE) followed by whole-breast irradiation (WBI).It is already widely accepted as an alternative to mastectomy. It is used for the treatment of patients with early-stage breast cancer. Accelerated partial-breast irradiation (APBI) is a new strategy. It is characterized by being shorter & an alternative radiation technique for a highly selected patients with favorable early-stage breast cancer. The objective of this review article is to analyze different modalities of APBI delivery and discuss the possible benefits and harms associated with this new platform. …………………………………………………………………………………………………….... Introduction:-Breast cancer has the highest incidence among all cancers in female. In early-stage breast cancer (stage ≤ II), the use of breast-conserving therapy (BCT) is a well-established treatment option. It is comparable to total mastectomy with good results as far as rates of local-regional control and overall survival. It enables patients to maintain their breasts with an acceptable cosmetic results [1]. In the initial trials regarding BCT that were done in the 1970s and 1980s, the new strategy typically involved segmental mastectomy with level I & II axillary lymph node dissection, followed by whole-breast irradiation (WBI). Radiation therapy (RT) is given with a dose of 45-50 Gy over the course of 5 weeks, with or without a boost to the tumor bed. WBI is a relatively well-tolerated treatment. This modality has resulted in good long-term cosmetic results, with low rates of treatment-associated morbidity. The Early Breast Cancer Trialists' Collaborative Group in their meta-analysis has demonstrated that the addition of radiation therapy (RT) to breast-conserving surgery has improved not only local-regional control, but also long-term overall survival [2]. In accelerated partial breast irradiation (APBI) a limited volume of breast tissue is irradiated. This includes tumor bed, lumpectomy or wide local excision with safety margins. It is delivered over a short period of time with increasing the fraction dose. Changing the strategy from whole breast irradiation to a small target (only part of the breast) as in APBI needs full investigation & scrutiny not only because of potential changes in local control but also for its possible impact on the overall survival . Aim of This Review:-Despite of the presence of advanced studies, the role, indication and the optimum APBI technique are still yet to be clearly identified. Therefore, in this review, we will try to find an answer for a number of controversial issues for better identification of the following:

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Objectives: Thyroid cancer is one of the most common cancers and its incidence continues to grow in high-income countries. Combined with an excellent survival and stable mortality rate, this increase in incidence is due to overdiagnosis, particularly with the wide use of ultrasonography and other imaging modalities. This study aims to address the issue of thyroid cancer overdiagnosis, and how the recent guidelines can reduce the burden of diagnosis of incidental and indolent lesions, as well as de-escalating the treatment. Materials and Methods: All thyroid cancer cases diagnosed at King Salman Armed Forces Hospital from 2012 to 2020 were reviewed. A descriptive analysis was performed on the clinicopathologic relevant variables, including age, gender, tumor type, pathologic variant type, tumor size, stage, papillary micro-carcinoma, extra-thyroid extension, tumor focality, lymphovascular invasion, recurrence, and baseline thyroglobulin. We excluded subjects with nay (not applicable or missing) data points to get accurate statistical results and were left with pure papillary carcinoma cases Results: Of the cases of papillary thyroid carcinoma, a significant proportion of which (23%) are microcarcinoma (≤1 cm), a tumor usually found incidentally and rarely causes clinical symptoms. Only two cases out of the microcarcinomas have shown regional lymph node metastasis (4%). No distant metastasis or tumor-related death is encountered. A similar proportion of our cases is the previously called noninvasive follicular variant of papillary thyroid carcinoma encapsulated follicular variant papillary thyroid carcinomas (PTC). Conclusions: Awareness of thyroid cancer overdiagnosis is important to reduce the unnecessary surgical interventions, patient psychological distress, and postoperative complications.