Yoon KH, Yoon Y, Jeong S
… +5 more, Kang J, Oh JH, Koh HW, Shin HC, Kim EK
Breast Cancer Res Treat
· 2025 Dec · PMID 41118047
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PURPOSE: To evaluate the effect of body mass index (BMI) on oncologic outcomes in patients with breast cancer stratified by menopausal status and histological subtype. Although studies have focused on the relationship be...PURPOSE: To evaluate the effect of body mass index (BMI) on oncologic outcomes in patients with breast cancer stratified by menopausal status and histological subtype. Although studies have focused on the relationship between obesity and breast cancer risk, the association between BMI and breast cancer recurrence after surgery remains controversial. METHODS: This retrospective study included patients who underwent curative surgery for breast cancer between June 2003 and November 2017. Normal weight and overweight groups were defined based on the World Health Organization classification. The primary outcome was recurrence-free survival, evaluated at 1, 5, and 10 years after curative surgery. Patients were stratified by BMI category, histological subtype, and menopausal status. The main measures included tumor characteristics, recurrence events, and survival outcomes across groups. RESULTS: Among 4506 patients included in the analysis, 3384 (75.1%) had luminal-type breast cancer. The overweight group (n = 1259) was associated with older age (normal weight (NW): 50.2 ±10.9 vs. overweight (OW): 56.5 ± 1.9, P < 0.001) and higher T stage (≥ T2: NW: 1226 (37.7%) vs. OW: 577 (45.8%), P < 0.001). In patients with luminal-type breast cancer, 10-year recurrence-free survival was significantly worse in the overweight group (NW 89.3% vs. OW 85.7%, P = 0.018). Subgroup analysis showed that premenopausal patients with luminal-type breast cancer who were overweight had an increased risk of recurrence (P = 0.003). CONCLUSIONS: Obesity is a significant, potentially modifiable risk factor for recurrence in premenopausal females with luminal-type breast cancer.
Amitani M, Oba T, Kitazawa A
… +9 more, Iji R, Kiyosawa N, Katsuyama S, Morikawa H, Chino T, Shimizu T, Ono M, Kanai T, Ito KI
Breast Cancer Res Treat
· 2025 Dec · PMID 41091279
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PURPOSE: In breast cancer, a low skeletal muscle index (SMI) and prognostic nutritional index (PNI) negatively affect patient outcomes. However, the prognostic implications of changes in these values in patients with met...PURPOSE: In breast cancer, a low skeletal muscle index (SMI) and prognostic nutritional index (PNI) negatively affect patient outcomes. However, the prognostic implications of changes in these values in patients with metastatic breast cancer (MBC) remain unclear. We evaluated the association between baseline levels and changes in SMI and PNI during eribulin treatment and patient outcomes. METHODS: We retrospectively analyzed 67 patients with MBC treated with eribulin. SMI and PNI were assessed at baseline (pre-SMI, and pre-PNI) and at disease progression; changes from baseline were calculated. Patient outcomes were compared according to baseline status and direction of change. RESULTS: SMI and PNI were not significantly correlated (p = 0.26, R = 0.02). High pre-SMI and high pre-PNI were associated with significantly improved overall survival (OS) (SMI; hazard ratio [HR] = 0.54, p = 0.04, PNI; HR = 0.33, p < 0.001). Patients with SMI gain during eribulin had longer OS than those with stable SMI or loss (HR = 0.48, p = 0.04), whereas PNI increase was not significantly associated with OS (HR = 0.74, p = 0.32). CONCLUSION: Baseline SMI and PNI provide complementary prognostic information in patients with MBC receiving eribulin. Furthermore, on-treatment SMI gain, but not PNI increase, was associated with improved survival. Monitoring and enhancing skeletal muscle mass may improve outcomes, highlighting the importance of integrating supportive care strategies during chemotherapy.
Pieniążek M, Polakiewicz-Gilowska A, Las-Jankowska M
… +4 more, Wronowicz J, Jarząb M, Łacko A, Püsküllüoğlu M
Breast Cancer Res Treat
· 2025 Dec · PMID 41014400
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PURPOSE: This study aimed to evaluate the prognostic significance of baseline laboratory parameters and inflammatory indices in patients with metastatic triple-negative breast cancer (mTNBC) treated with sacituzumab govi...PURPOSE: This study aimed to evaluate the prognostic significance of baseline laboratory parameters and inflammatory indices in patients with metastatic triple-negative breast cancer (mTNBC) treated with sacituzumab govitecan (SG) in the second line and beyond, potentially aiding personalized patient management. METHODS: This retrospective cohort study analyzed data from 83 female patients with mTNBC who initiated SG therapy at four Polish oncology centers between August 2021 and September 2024. Hematological parameters-white blood cell count (WBC), hemoglobin (Hb), platelets (Plt) and inflammatory indices-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were assessed at baseline and before each dose of first four SG cycles. Median progression-free survival (mPFS) and overall survival (mOS) were estimated, and, as the primary objectives, associations between baseline laboratory variables and survival outcomes were assessed using multivariate Cox regression models (α = 0.05). Secondary objectives included assessing their associations with patient and disease characteristics, prior treatment lines, and adverse events (AEs), which were classified using the National Cancer Institute Common Terminology Criteria for AEs (NCI-CTCAE), version 5.0. RESULTS: The mPFS was 4.07 months (95% CI 3.05-6.18), while the mOS was 8.01 months (95% CI 6.05-9.75). Lower baseline Hb was significantly associated with shorter PFS (HR = 0.82, p = 0.03) but not OS. Elevated baseline NLR predicted worse OS (HR = 1.18, p = 0.03), while PLR and SII lacked prognostic significance. Changes in blood parameters within initial four SG cycles showed no significant correlations with survival outcomes. Furthermore, baseline hematological markers and inflammatory indices showed no significant association with clinical characteristics, prior therapy lines, tumor burden, or the occurrence and severity of AEs. CONCLUSIONS: Baseline Hb and NLR were identified as independent prognostic biomarkers in patients with mTNBC receiving SG treatment, predicting PFS and OS, respectively. Other inflammatory indices (PLR, SII) did not demonstrate prognostic relevance. Prospective validation in larger cohorts is essential to confirm these findings and potentially guide personalized treatment strategies.
Yang W, Alongi A, Ma Z
… +8 more, Styblo TM, Arciero CA, Farley C, Ho C, O'Regan RM, Cohen MA, Bagadiya N, Li X
Breast Cancer Res Treat
· 2025 Dec · PMID 41004069
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BACKGROUND: The management of high-risk breast lesions is controversial. There is a lack of long-term follow-up studies to evaluate clinical management decisions. METHODS: We included 267 consecutive high-risk breast les...BACKGROUND: The management of high-risk breast lesions is controversial. There is a lack of long-term follow-up studies to evaluate clinical management decisions. METHODS: We included 267 consecutive high-risk breast lesions with pathology-radiology concordance that were prospectively recommended for surgery or follow-up at a multidisciplinary conference. The 267 lesions included 149 papillomas and 118 other high-risk lesions. The 149 papillomas included 119 benign papillomas, 17 atypical papillomas, 6 papillomas with adjacent atypical ductal hyperplasia (ADH), 7 papillomas with adjacent atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS). The 118 high-risk lesions included 43 ADH, 36 radial scar (RS), 23 ALH, 13 LCIS, 2 flat epithelial atypia (FEA), and 1 mucocele-like lesion (ML). The patients were recommended for surgery or follow-up using established guidelines. RESULTS: 90 (60.4%) patients with papillomas, who did not undergo immediate excision and were followed, had a median follow-up time of 61.6 months; 70 patients had a follow-up time > 2 years (25.1-103.4 months). Two patients (2.1%) with benign papilloma had history of breast cancer and developed carcinoma in 62.7 at the lumpectomy site and 40.8 months at the biopsy site which showed 2 mm benign papilloma; both papillomas were sufficiently sampled, and we believe the recommendation of follow-up to both patients was appropriate. 65 (55.1%) patients with other high-risk lesions, who did not undergo excision and were followed, had a median follow-up time of 64.1 months; 50 patients had a follow-up time > 2 years (24.2-101.6 months). Four (6.2%) of these 65 patients developed carcinoma during follow-up including 2 patients with ADH who were recommended for surgery but chose for follow-up; 1 patient with ALH developed invasive carcinoma in a different quadrant at 76.6 months; and 1 patient with RS developed invasive carcinoma in the same quadrant at 51.2 months. In the 112 patients who underwent immediate excision, all upgrades (n = 15) occurred in patients who were recommended for surgery. During follow-up of these 112 patients, 2 patients developed carcinoma and both had benign pathology in the excisional specimens. CONCLUSIONS: This long-term follow-up study confirms that a multidisciplinary conference can successfully triage patients with high-risk breast lesions to surgery or follow-up with established guidelines and careful pathology, radiology, and clinical evaluations. Patients with high-risk breast lesions have increased cancer risk and should be followed.
Willert CB, Mellemkjær L, Tolver A
… +6 more, Gerdes AA, Rosthøj S, Wadt K, Kroman N, Bidstrup PE, Hölmich LR
Breast Cancer Res Treat
· 2025 Dec · PMID 40974500
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PURPOSE: Knowledge of the uptake and breast and ovarian cancer-preventive and survival effects of bilateral risk-reducing mastectomy (BRRM) and salpingo-oophorectomy (RR-BSO) in female BRCA1/2 carriers is essential for o...PURPOSE: Knowledge of the uptake and breast and ovarian cancer-preventive and survival effects of bilateral risk-reducing mastectomy (BRRM) and salpingo-oophorectomy (RR-BSO) in female BRCA1/2 carriers is essential for optimized decision-making. This study aimed to examine time trends in the number of registered unaffected BRCA1/2 carriers, BRRM and RR-BSO uptake, and oncological effects of risk-reducing surgeries in a nationwide Danish cohort with matched controls. METHODS: We included 3067 female BRCA1/2 carriers registered in the Hereditary Breast and Ovarian Cancer Registry and 30,652 age-matched controls between 2000 and 2022. Data were retrieved from national health registries. Uptake and oncological effects of risk-reducing surgeries were assessed using cumulative incidences and Cox proportional hazards models with 95% confidence intervals (CI). RESULTS: Annual numbers of registered unaffected BRCA1/2 carriers, BRRM, and RR-BSO increased over time. BRRM and RR-BSO uptake 10 years after genetic test varied with the age at genetic test and parity. BRRM reduced the hazard rate of breast cancer by 94% [hazard ratio (HR) 0.06, CI 0.01-0.25]. The same pattern was not found for RR-BSO (HR = 1.31, CI 0.90-1.91). Compared to controls, BRCA1/2 carriers had an increased hazard rate for breast cancer before BRRM (HR 7.49, CI 5.81-9.42). CONCLUSION: BRRM's large protective effect against breast cancer in BRCA1/2 carriers was confirmed, in contrast to that of RR-BSO. There were tendencies toward a reduction in overall mortality rates after BRRM, and compared with controls, we saw tendencies toward higher mortality rates before BRRM.
Ji L, Chen X, Lyu H
… +11 more, Song G, Xiao M, Li Q, Wang J, Fan Y, Luo Y, Li Q, Chen S, Ma F, Xu B, Zhang P
Breast Cancer Res Treat
· 2025 Dec · PMID 40963050
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BACKGROUND: Previous studies often combined double hormone receptor-positive (dHR +) and single HR-positive (sHR +) tumors, thus not accounting for the distinct characteristics of sHR + , particularly in the neoadjuvant...BACKGROUND: Previous studies often combined double hormone receptor-positive (dHR +) and single HR-positive (sHR +) tumors, thus not accounting for the distinct characteristics of sHR + , particularly in the neoadjuvant setting. Moreover, adding immunotherapy to cytotoxic chemotherapy has shown encouraging efficacy in certain HR-positive early breast cancers. This study sought to assess pathological complete response (pCR) and survival outcomes in sHR + /HER2- breast cancer after neoadjuvant chemotherapy, while also investigating its specific biological traits and immune profile. METHODS: Clinical data were sourced from the Cancer Hospital, Chinese Academy of Medical Sciences (CHCAMS, n = 1049), and the Surveillance, Epidemiology, and End Results (SEER, n = 21,092) database to examine neoadjuvant chemosensitivity and survival outcomes. Additionally, clinicopathological and subtype data from CHCAMS, SEER, the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC, n = 1052), and Fudan University Shanghai Cancer Center (FUSCC, n = 570) were analyzed to identify biological features that correlate with pCR rates and prognosis in sHR + /HER2- breast cancer. Further genomic and transcriptomic data from METABRIC, The Cancer Genome Atlas (TCGA, n = 741), and MSK-IMPCAT (n = 1535) were reviewed to uncover their potential links with endocrine and immunotherapy responses. RESULTS: In comparison to dHR + (ER + and PR +)/HER2- breast cancer, sHR + (ER + /PR- or ER-/PR +)/HER2- breast cancer displayed a higher pCR rate (20.2% vs. 3.2%, P < 0.001), but considerably worse survival (hazard ratio, 2.97; 95% confidence interval, 1.62-5.43, P < 0.001) within the CHCAMS neoadjuvant cohort. Clinically, sHR + /HER2- tumors were associated with higher histological grades and proliferation rates compared to dHR + /HER2- tumors, along with a greater rate of HR-low positivity (50.9% vs. 3.0%, P < 0.001) in primary tumors and a tendency to transition to triple-negative tumors in residual disease (42.7% vs. 1.8%, P < 0.001). Furthermore, sHR + /HER2- breast cancers demonstrated lower endocrine sensitivity scores, with about 20% classified as PAM50-defined basal-like subtype. Immunologically, sHR + /HER2- tumors had elevated tumor mutation burden (TMB), higher expression of immune checkpoint genes (e.g., PD-1, PD-L1, CTLA4), and greater infiltration by tumor-infiltrating lymphocytes (TILs), particularly CD8 + T cells, than dHR + /HER2- tumors. CONCLUSION: Compared to dHR + /HER2- breast cancer, sHR + /HER2- cases showed a relative sensitivity to neoadjuvant chemotherapy but poorer prognosis. The immune-activated phenotype of sHR + /HER2- breast cancer indicates that it may benefit from immunotherapy approaches, but these findings warrant validation in prospective studies.
Graciano N, López L, Rodriguez CA
… +2 more, Montoya K, Cortés J
Breast Cancer Res Treat
· 2025 Nov · PMID 40956510
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PURPOSE: Patients with triple-negative breast cancer (TNBC) who do not achieve pathological complete response (non-pCR) after neoadjuvant chemotherapy (NACT) have a high-risk of relapse. While adjuvant capecitabine (AdjC...PURPOSE: Patients with triple-negative breast cancer (TNBC) who do not achieve pathological complete response (non-pCR) after neoadjuvant chemotherapy (NACT) have a high-risk of relapse. While adjuvant capecitabine (AdjCape) has demonstrated improved overall survival (OS) and disease-free survival (DFS) in Asian populations, its effectiveness in non-Asian settings remains uncertain. We aimed to evaluate the effect of AdjCape on survival outcomes using real-world data from a Latin American population. METHODS: We conducted a retrospective cohort study (2008-2024) including 360 women with non-metastatic TNBC and non-pCR treated at a single institution. Propensity score matching (PSM) was applied to adjust for baseline differences. Cox regression models assessed the association of AdjCape with OS and DFS, and stratified analyses identified subgroups with differential treatment effects. RESULTS: Among 360 patients, 106 (29.4%) received AdjCape. After PSM, 187 patients (72 AdjCape, 115 controls) were analyzed. AdjCape was not associated with improved OS (HR 0.79, 95% CI 0.51-1.23, p = 0.302) or DFS (HR 0.81, 95% CI 0.53-1.23, p = 0.321). However, significant benefit was observed in patients with high residual tumor burden (pT3-pT4: OS HR 0.29, p = 0.020; DFS HR 0.37, p = 0.044) and in those not receiving radiotherapy (DFS HR 0.47, p = 0.038). CONCLUSIONS: AdjCape did not improve OS or DFS in the overall TNBC non-pCR cohort but may offer benefit in patients with extensive residual disease or those not treated with radiotherapy. These findings highlight the need for individualized treatment strategies and further evaluation of capecitabine in the context of modern therapies.
Palmquist E, Kiernan R, Sevilimedu V
… +3 more, Le T, Morrow M, El-Tamer M
Breast Cancer Res Treat
· 2025 Dec · PMID 40940562
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PURPOSE: Postoperative infection rates in the United States following breast cancer surgery, including mastectomy with or without reconstruction, range from 2-26%. Management of post-lumpectomy defects may involve simple...PURPOSE: Postoperative infection rates in the United States following breast cancer surgery, including mastectomy with or without reconstruction, range from 2-26%. Management of post-lumpectomy defects may involve simple skin closure or oncoplastic closure; however, the effect of defect repair on postoperative infection rates has not been well documented. Here we determine how oncoplastic closure of partial mastectomy defects affects postoperative infection rates and antibiotic use. METHODS: In this retrospective single-institution study, patients undergoing lumpectomy with and without oncoplastic closure of defect were included between 2018-2020. Clinicopathologic/treatment data were collected from medical records. Patients receiving antibiotics on postoperative days 5-30 were reviewed to confirm wound infection. Associations between demographic and clinicopathologic factors and postoperative infections were analyzed. RESULTS: 3937 patients met eligibility criteria; 2273 (58%) had oncoplastic closure. The overall postoperative wound infection rate (includes cellulitis) was 8.4% (332), and true surgical site infection, as defined by the CDC (excludes cellulitis), was seen in 70 (1.8%) patients. On univariate analysis, age ≥ 60 years, diabetes, hypertension, and BMI ≥ 30 were associated with increased breast infection. Oncoplastic closure was protective against postoperative breast infections (odds ratio [OR]0.70, p = 0.040). On multivariable analysis oncoplastic closure had marginally decreased breast infection rates (OR 0.71, p = 0.053); however, this was not significant. BMI ≥ 30 was the only risk factor that remained a significant predictor of increased breast infection rates (OR1.63, p = 0.021). CONCLUSIONS: Oncoplastic closure of lumpectomy defects had marginally significant lower rates of postoperative breast infections. As oncoplastic techniques are increasingly adopted in breast-conserving surgery, it is important to further study the protective nature of lumpectomy defect closure to reduce postoperative infection rates.
Dinger TL, Volders JH, Kuijer A
… +4 more, Kelder JC, Doeksen A, Postma EL, van Dalen T
Breast Cancer Res Treat
· 2025 Nov · PMID 40940561
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PURPOSE: Endocrine therapy (ET) can be used as a definitive treatment in frail and elderly breast cancer patients who are unwilling or deemed unfit to undergo surgical treatment. This study evaluated the clinical respons...PURPOSE: Endocrine therapy (ET) can be used as a definitive treatment in frail and elderly breast cancer patients who are unwilling or deemed unfit to undergo surgical treatment. This study evaluated the clinical response to ET as primary treatment in elderly patients with non-metastatic, oestrogen receptor (ER) positive breast cancer, by evaluating its effectiveness over time. METHODS: Elderly patients (≥ 70 years) with ER-positive breast cancer who had been treated with ET as primary treatment between 2008 and 2015 in two Dutch hospitals were identified through the Netherlands Cancer Registry. The primary outcome was the objectively measured clinical response at various time intervals after initiation of ET. RESULTS: Out of 122 patients (median age, 86 years), 100 (82%) received ET as definitive treatment, whereas 22 (18%) received ET as neo-adjuvant endocrine therapy. Over the 3-year observation period, 25% of patients had died and 29% underwent invasive local treatment. The overall response rate after 3 years was 14% for all 122 patients and 30% for the 56 patients who were still alive and had not undergone local treatment after 3 years. CONCLUSION: The observed clinical response to ET in a consistent proportion of patients over time suggests it may be a viable option for a selection of frail and elderly breast cancer patients with limited life expectancy.
Elias N, Karak FE, Damaj N
… +4 more, Hajj A, Kourie H, Eid R, Kattan J
Breast Cancer Res Treat
· 2025 Nov · PMID 40932628
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INTRODUCTION: This study examines the intermittent discontinuation of palbociclib based on its availability and its clinical outcomes during the Lebanese economic crisis in patients with metastatic Breast Cancer (BC) HR+...INTRODUCTION: This study examines the intermittent discontinuation of palbociclib based on its availability and its clinical outcomes during the Lebanese economic crisis in patients with metastatic Breast Cancer (BC) HR+ between the years 2019 and 2023. METHODS: This study carries out a retrospective analysis on 46 patients treated with palbociclib - Letrozole during the years 2019 and 2023 in Lebanon. It used descriptive tables and figures to summarize demographic, clinical, and outcome characteristics. It analyzed the data using Student T test for parametric variables, Wilcoxon and Kruskal-Wallis tests for non-parametric variables, and Chi-squared and Fisher tests for qualitative variables. Pearson's correlation and regression models were used to associate between the intermittent administration of palbociclib and its clinical outcomes. RESULTS: Our sample had a mean age of 59.33 +/-13.27 years. 87% had ductal carcinomas and 13% had lobular carcinomas. 52.2% of patients had treatment for their metastases prior to palbociclib, and a discontinuation was observed in 63.1 %. Intermittent discontinuation is associated with advanced age (p=0.048) and statistically reduces PFS (p=0.026). The intermittent drug intake also affects PFS (p=0.03) but has no effect on the disease progression. CONCLUSION: This study is the only research in the world focused on intermittent intake of palbociclib. The intermittent discontinuation of palbociclib is influenced by age and affects the PFS. These results highlight the significance of adherence and protocol compliance.
Nezirevic S, Anders C, Dent S
… +4 more, Bansal R, Yang LZ, Erkanli A, Moore H
Breast Cancer Res Treat
· 2025 Dec · PMID 40931303
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PURPOSE: Limited data is available assessing sequencing of antibody drug conjugates (ADCs) in patients with hormone receptor-positive (HR +), human epidermal growth factor 2 (HER2)-negative, HER2-low, and triple-negative...PURPOSE: Limited data is available assessing sequencing of antibody drug conjugates (ADCs) in patients with hormone receptor-positive (HR +), human epidermal growth factor 2 (HER2)-negative, HER2-low, and triple-negative metastatic breast cancer (MBC), including patients with brain metastases (BrM) or leptomeningeal disease (LMD). This study assesses the efficacy and safety of sequential sacituzumab govitecan (SG) and trastuzumab deruxtecan (T-DXd) in MBC and impact on chemotherapy (CTX). METHODS: This is a single-center, retrospective, cohort study in adult patients with HR + , HER2-negative, or low MBC who received T-DXd and/or SG. RESULTS: A total of 112 patients were divided into three cohorts: ADCs given sequentially (cohort A), ADC then CTX (cohort B), or CTX between ADCs (cohort C). The median progression-free survival (mPFS) in cohort A was 4.5 months for SG before T-DXd and 3.1 months for T-DXd before SG. In cohort B, mPFS was 3.1 months for CTX following T-DXd. For CTX following SG, mPFS for CTX was 2.5 months. In patients who received both ADCs, PFS was 2.1 months. In cohort C, mPFS for SG following T-DXd and CTX was 2.1 months and 3.3 months for T-DXd following SG and CTX. The mPFS for ADC1 was longer than ADC2 (5.5 months SG, 3.4 months T-DXd). Those with BrM and/or LMD demonstrated stable disease. CONCLUSION: Sequential administration of ADCs results in a shorter PFS. CTX efficacy is impacted by prior ADC administration. Outcomes for patients with BrM and LMD do not differ for those without recurrence to the brain.
Fielder AM, Kim S, Ruterbusch JJ
… +7 more, Martin C, Gottschlich A, Schwartz AG, Beebe-Dimmer JL, Assad H, Hamel L, Purrington KS
Breast Cancer Res Treat
· 2025 Dec · PMID 40924292
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PURPOSE: Black women with hormone receptor-positive (HR +) breast cancer are twice as likely as White women to have weakly HR + tumors (1-10% positive cells). Patients with weakly HR + tumors are less frequently prescrib...PURPOSE: Black women with hormone receptor-positive (HR +) breast cancer are twice as likely as White women to have weakly HR + tumors (1-10% positive cells). Patients with weakly HR + tumors are less frequently prescribed ET and have 60% higher mortality than strongly HR + tumors (> 10% positive cells). We evaluated factors associated with ET prescription and self-reported use among Black women with HR + breast cancer. METHODS: Among 922 Detroit ROCS participants, we evaluated associations between demographics, socioeconomic status, and health, tumor, oncologist, and hospital characteristics and ET prescription intent and self-reported ET use. Logistic mixed-effects regression was used to account for oncologist and hospital group effects. RESULTS: Oncologists intended to prescribe ET to 83.4% of participants (n = 769), of which 54.4% (n = 502) reported use. In multivariable models, participants with weakly HR + tumors were 90% less likely to be prescribed ET (OR = 0.10, p < 0.0001). Other significant characteristics of ET prescription included a BMI of 25-29.9 kg/m (OR = 0.45, p = 0.0085), HR positivity > 90% vs. 11-90% (OR = 0.37, p = 0.00045), unknown HR percentage (OR = 0.12, p < 0.0001), OncotypeDx testing (OR = 2.65, p < 0.0001), and receiving radiation (OR = 2.20, p = 0.00016). Self-reported ET use was lower among those with lower health literacy (OR = 0.017, p < 0.001), weak HR positivity (OR = 0.46, p = 0.0053), unknown HR percentage (OR = 0.074, p = 0.034), and older age at diagnosis (OR = 0.88, p = 0.002). Increased ET use was associated with an income between $60,000-$79,900 vs. < $20,000 (OR = 1.54, p = 0.035), higher comorbidity count (OR = 1.09, p = 0.0054), distant stage (OR = 2.03, p = 0.029), and surgery (OR = 2.35, p = 0.001). CONCLUSION: Identifying multilevel factors related to ET use may inform strategies to improve ET uptake and survival among Black women with HR + breast cancer.
Taruno K, Den H, Takeuchi M
… +5 more, Inuzuka M, Arai M, Nakamura S, Ishida T, Registration Committee of the Japanese HBOC consortium
Breast Cancer Res Treat
· 2025 Nov · PMID 40913733
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PURPOSE: This large-scale study presents the clinicopathological characteristics and cumulative incidence of contralateral breast cancer (CBC) in Japanese BRCA1/2 pathogenic variant carriers, including cases diagnosed af...PURPOSE: This large-scale study presents the clinicopathological characteristics and cumulative incidence of contralateral breast cancer (CBC) in Japanese BRCA1/2 pathogenic variant carriers, including cases diagnosed after the implementation of national insurance coverage. METHODS: We analyzed 2949 breast cancer cases from the registry database of the Japanese Organization of Hereditary Breast and Ovarian Cancer. RESULTS: BRCA1 carriers predominantly developed triple-negative breast cancer, whereas BRCA2 carriers more frequently developed luminal-type tumors, with a younger age of onset observed in BRCA1 carriers. No significant clinicopathological differences were found between the age groups. The cumulative incidence of CBC was 10.0% at five years and 29.0% at 10 years among BRCA1 carriers and 14.0% at five years and 19.0% at 10 years among BRCA2 carriers. CBC was observed in all age groups, including older patients. These findings highlight the importance of individualized decision-making in surgical planning and surveillance strategies. CONCLUSIONS: This study included a broad age range of patients, reflecting real-world data following the expansion of insurance coverage in Japan. Further case studies and long-term follow-up are warranted. Our findings support the development of appropriate clinical care and preventive strategies for BRCA1/2 carriers in Japan.
Sirek A, Sirek T, Nowakowski R
… +10 more, Borawski P, Ossowski P, Mitka-Krysiak E, Zmarzły N, Boroń K, Chalcarz M, Kuraszewska B, Szulik M, Boroń D, Grabarek BO
Breast Cancer Res Treat
· 2025 Dec · PMID 40911221
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Lee JJ, Jettinghoff W, Arbour G
… +4 more, Zepeda A, Isaac KV, Ng RT, Nichol AM
Breast Cancer Res Treat
· 2025 Nov · PMID 40897953
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PURPOSE: Cancer registries rarely track breast cancer relapse due to the resource-intensive nature of manual chart review. To address this gap, we developed natural language processing (NLP) models to automate the identi...PURPOSE: Cancer registries rarely track breast cancer relapse due to the resource-intensive nature of manual chart review. To address this gap, we developed natural language processing (NLP) models to automate the identification of breast cancer relapse in pathology reports. METHODS: We collected pathology reports from patients diagnosed with breast cancer between January 1, 2005, and December 31, 2014, in British Columbia, Canada, and manually annotated each for the presence or absence of local, regional, distant, and any breast cancer relapses. With these reports, we fine-tuned large language models to classify pathology reports. RESULTS: The corpus contained 1,888 pathology reports from a cohort of 993 breast cancer patients. Of these reports, 673 (35.6%) described local, 296 (15.7%) regional, and 654 (34.6%) distant relapses. In addition, 1,510 (80.0%) described at least one of any relapse type. The median time from diagnosis to first relapse was 7.3 years (range 0.2-18.2). All models demonstrated excellent performance. The local-relapse model performed particularly well, with > 93% accuracy, sensitivity, specificity, and 0.98 area under the receiver operating characteristic curve (AUC) score. CONCLUSION: We developed NLP models to detect breast cancer relapses from pathology reports with excellent accuracy, sensitivity, specificity, and AUC. NLP may facilitate more efficient and accurate collection of breast cancer outcomes data from clinical reports.
Breast Cancer Res Treat
· 2025 Dec · PMID 40888991
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PURPOSE: Our goal is to leverage publicly available whole transcriptome and genome-wide CRISPR-Cas9 screen data to identify and prioritize novel breast cancer therapeutic targets. METHODS: We used DepMap dependency score...PURPOSE: Our goal is to leverage publicly available whole transcriptome and genome-wide CRISPR-Cas9 screen data to identify and prioritize novel breast cancer therapeutic targets. METHODS: We used DepMap dependency scores > 0.5 to identify genes that are potential therapeutic targets in 48 breast cancer cell lines. We removed genes that were pan-essential or were not expressed in TCGA breast cancer cohort. Genes were prioritized based on druggability using the Drug-Gene Interaction Database. Targets were defined separately for ER+, HER2+, and TNBC. A broader list of genes with dependency score > 0.25 were used to assess the associations between dependency scores and mutations and copy number variations (CNV) to identify potential synthetic lethal relationships and to map survival critical genes into biological pathways. RESULTS: 66, 53, and 29 genes were prioritized as targets in ER+, HER2+, and TNBC, respectively. These included known actionable targets and many novel targets. ER+ included FOXA1, GATA3, LDB1, TRPS1, NAMPT, WDR26, and ZNF217; HER2+ cancers included STX4, HECTD1, and TBL1XR1; and TNBC included GFPT1 and GPX4. Synthetic lethal associations revealed 5 and 19 significant associations between potential survival critical genes and mutations in HER2+ and TNBC, respectively. For example, PIK3CA mutation increased dependency on NDUFS3 in HER2+ cancers, and CNTRL mutation increased dependency on electron transport chain (ETC) genes in TNBC. 329, 747, and 622 CNVs showed synthetic lethal association in ER+, HER2+, and TNBC, respectively. CONCLUSION: We provide a genome-wide drug target prioritization list for breast cancer derived from integrated large-scale omics data.
Sanli AN, Turan B, Tekcan Sanli DE
… +3 more, Karaca I, Altundag MK, Aydogan F
Breast Cancer Res Treat
· 2025 Nov · PMID 40877552
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BACKGROUND: This study aimed to evaluate the prognostic relevance of stratified pathological response -complete response (CR), partial response (PR), and no response (NR)- to neoadjuvant chemotherapy (NAC) in patients wi...BACKGROUND: This study aimed to evaluate the prognostic relevance of stratified pathological response -complete response (CR), partial response (PR), and no response (NR)- to neoadjuvant chemotherapy (NAC) in patients with hormone receptor-positive and HER2-positive (HR + /HER2 +) breast cancer. METHODS: A total of 8277 HR + /HER2 + breast cancer patients treated with NAC between 2010 and 2021 were retrospectively identified from the SEER database. Patients were categorized into CR, PR, and NR groups. Overall survival (OS) and disease-specific survival (DSS) were analyzed using Kaplan-Meier and Cox regression models. RESULTS: CR, PR, and NR rates were 52.3%, 41.4%, and 6.2%, respectively. Five-year OS rates were 96.3% (CR), 91.1% (PR), and 79.3% (NR), while 10-year DSS rates were 94.0% (CR), 83.4% (PR), and 76.2% (NR) (p < 0.001). In multivariate analysis, PR and NR were associated with significantly increased mortality risk compared to CR (OS HR: 2.16 and 4.20; DSS HR: 2.95 and 5.46; all p < 0.001). Progesterone receptor (PrgR) negativity independently predicted worse OS and DSS, whereas ER status had no significant impact. Additional adverse prognostic factors included advanced age, nodal metastasis, rural residence, and mastectomy. Radiotherapy did not retain significance in multivariate models. CONCLUSION: Pathological response to NAC is a strong independent prognostic marker in HR + /HER2 + breast cancer. Partial responders represent a clinically distinct group with intermediate outcomes, highlighting the need for response-adapted therapeutic strategies beyond conventional staging systems.