RESUMEN
PURPOSE: We analyzed data from the National Health Insurance Research Database (NHIRD) in Taiwan, collected information regarding human papillomavirus (HPV) and breast cancer prevalence, and explored the association between HPV infection and the risk of breast carcinoma. METHODS: We included the NHIRD data of 30,936 insured patients aged 20 years an older without breast cancer prior to the index date (date of HPV diagnosis) and matched each patient with a reference subject according to age, comorbidities, and index year (1:1 ratio). We calculated the incidence rates of breast cancer in the cohorts, age groups, and comorbidity groups, as well as the relative risk of breast cancer stratified by age and comorbidity in the HPV and non-HPV groups. RESULTS: The patients with and without HPV had incidence rates of 12.5 and 9.81 per 10,000 person years, respectively. The risk of breast cancer for the 50-64 and ≥65 age groups was 1.67 and 1.36 times higher than that in patients younger than 49 years, respectively, and hypertension, chronic obstructive pulmonary disease, and diabetes mellitus were significant risk factors for breast cancer. The HPV group had a higher risk of developing breast cancer than the non-HPV group, regardless of age group and the presence or absence of comorbidities. Patients with HPV in the 50-64 age group were 1.39 times more likely to develop breast cancer than patients of the same age without HPV. CONCLUSION: Patients older than 49 were more likely to develop breast cancer, and patients with HPV had a higher likelihood of developing breast cancer, regardless of age and the presence or absence of comorbidities. HPV likely plays a causal role in breast cancer.
RESUMEN
The recurrent laryngeal nerve (RLN), a branch of the vagus nerve, supplies the motor and sensation function of the larynx. Generally, RLN detours around the right subclavian artery on the right side and the aortic arch on the left side. In a rare anatomical variant, called nonrecurrent laryngeal nerve (NRLN), the nerve takes an aberrant path rather than descending into the thorax as usual. First reported in 1823, NRLN is a rare anomaly arising almost exclusively on the right side, reported in 0.3-0.8% of people, and associated with vascular anomalies of embryonic aortic arch development. The atypical vascular pattern of aberrant subclavian artery (arteria lusoria) running behind the trachea and esophagus allows the vagus nerve to pass freely, which then directly branches out as NRLN at the level of the larynx. On the other hand, cases of left NRLN, only reported in 0.004% of people, are all accompanied by significant pathologies such as situs inversus totalis with opposite vascular pattern of left aberrant subclavian artery. This rare anatomical variation is clinically important, as NLRN is a major risk factor for iatrogenic injury during thyroidectomy, parathyroidectomy, and other invasive procedures in the head and neck region.