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Background/Aim: Currently, several ongoing prospective studies are investigating the safety of breast surgery omission in patients with breast cancer who are exceptional responders to neoadjuvant chemotherapy. However, there is little information about the preferences of these patients regarding omission of breast surgery. Patients and Methods: We conducted a questionnaire survey to assess preferences regarding omission of breast surgery among patients with breast cancer who had human epidermal growth factor receptor 2-positive or estrogen receptornegative tumors and good clinical response after neoadjuvant chemotherapy. Patients' estimation of the risk of ipsilateral breast tumor recurrence (IBTR) after definitive surgery or breast surgery omission was also assessed. Results: Of 93 patients, only 22 (23.7%) said they would omit breast surgery. Under the scenario of omitting breast surgery, the 5-year IBTR rate estimated by patients who said they would omit breast surgery was significantly lower (median, 10%) than the rate estimated by patients who preferred undergoing definitive surgery (median, 30%) (p=0.017). Conclusion: The proportion of our surveyed patients who were willing to omit breast surgery was low. Patients who said they preferred to omit breast surgery overestimated the 5-year IBTR risk.Neoadjuvant chemotherapy (NAC) for breast cancer has become the standard therapy not only for locally advanced cases but also for operable, early-stage breast cancer. Recently, owing to the advances in chemotherapy and targeted therapy, the rate of pathologic complete response (pCR) is reaching 60% among human epidermal growth factor receptor 2 (HER2)-positive and triple-negative breast cancer (1, 2). This finding has attracted physicians' interest in "breast surgery omission" in reference to the ultimate breast-conserving therapy (3). Several ongoing worldwide prospective studies are investigating the safety of breast surgery omission in patients with breast cancer who are exceptional responders to NAC (4, 5). To date, however, these prospective studies have not provided sufficient safety data on omission of breast surgery.In addition of the lack of safety data about breast surgery omission, a remaining problem for the introduction of breast surgery omission into clinical practice is the lack of information about the preferences of patients with breast cancer. In their commentary to an article about research into breast surgery omission, Caballero et al. stated that an important aspect of de-escalation strategies such as breast surgery omission is to listen to the patient's perspective during the early stages of developing future clinical trials, and to 794

Human papillomavirus (HPV) is a common sexually transmitted infection worldwide, which spreads via contact with infected genital, anal, and oral/pharyngeal areas (oral sex) owing to diverse manners of sexual intercourse. In this study, we devised an oral HPV detection method using mouthwash waste fluids that causes less psychological resistance to visiting the outpatient otolaryngology departments. We successfully detected only the specific unique reverse sequencing probe (using pyro-genotyping) and identified the nine genotypes of HPV targeted for vaccination by pyrosequencing the mouthwash waste fluids of non-head and neck cancer patient volunteers (n = 52). A relatively large number (11/52) of mouthwash waste fluids tested positive for HPV (21.2%; genotype 6, n = 1; 11, n = 1; 16, n = 1; and 18, n = 8). These results surpassed the sensitivity observed testing the same specimens using the conventional method (1/52, 1.9%). Our method (pyro-genotyping) was developed using nine HPV genotypes targeted for vaccination and the results were highly sensitive compared to those of the conventional method. This less expensive, high-throughput, and simple method can be used for detecting oral HPV infection with fewer socio-psychological barriers.

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