Breast Cancer Research And Treatment[JOURNAL]
Sun
200 papers
Real-world outcomes of reduced-dose versus standard-dose antibody drug conjugates in metastatic breast cancer: a retrospective cohort study.
Stabellini N, Kaur J, Owusu C … +4 more , Moftakhar B, Mizukami T, de Oliveira SD, Montero AJ
Breast Cancer Res Treat · 2026 Jan · PMID 41557039 · Full text
PURPOSE: To evaluate whether reduced doses (RD) of trastuzumab deruxtecan (T-DXd) or sacituzumab govitecan (SG) provide similar outcomes to the approved standard doses (SD) in metastatic breast cancer (mBC). METHODS: Thi...
PURPOSE: To evaluate whether reduced doses (RD) of trastuzumab deruxtecan (T-DXd) or sacituzumab govitecan (SG) provide similar outcomes to the approved standard doses (SD) in metastatic breast cancer (mBC). METHODS: This retrospective cohort included mBC patients receiving at least one cycle of SG (April 2021-May 2024) or T-DXd (February 2020-December 2024). Primary outcomes were progression-free survival (PFS) and overall survival (OS). Kaplan-Meier curves and Log-Rank tests estimated and compared PFS and OS from treatment initiation. Subgroup analyses were performed by HER2 and hormone receptor status. RESULTS: 48 patients received SG (24 RD vs. 24 SD) and 66 received T-DXd (29 RD vs. 37 SD). Median PFS for SG was 3 months in both SD (95% CI, 2-10) and RD (95% CI, 2-8; p = 0.8). Median OS for SG was 10 months (95% CI, 7-13) for SD and 11 months (95% CI, 5-30; p = 0.4) for RD. For T-DXd, median PFS was 10.4 months for SD (95% CI, 7.0-14.5) and 11.2 months for RD (95% CI, 5.4-31.1; p = 0.8), while median OS was 18.3 months (95% CI, 13.9-NA) for SD and 28.1 months (95% CI, 18.2-NA; p = 0.9) for RD. Overall response rates were similar between patients receiving RD and SD SG or T-DXd. CONCLUSIONS: This real-world data suggest RD of SG or T-DXd achieve outcomes comparable to SD, supporting prospective evaluation of lower-dose regimens.
Translational and real-world evidence of trastuzumab biosimilar CT-P6 plus pertuzumab in neoadjuvant HER2-positive early breast cancer.
Alonso-Romero JL, Martínez-García J, Carrillo-Vicente R … +10 more , Aramburo AF, Díez AF, Henarejos PS, de la Morena Barrio P, Boix AP, Jiménez MD, Siles JP, Maestre JAP, de Las Heras-Rubio A, Carreño PR
Breast Cancer Res Treat · 2026 Jan · PMID 41557021 · Full text
BACKGROUND: Data on neoadjuvant treatment with trastuzumab biosimilars, particularly CT-P6, in combination with pertuzumab, are limited. This study evaluates the efficacy, tolerability, and immunogenicity of CT-P6 plus p...
BACKGROUND: Data on neoadjuvant treatment with trastuzumab biosimilars, particularly CT-P6, in combination with pertuzumab, are limited. This study evaluates the efficacy, tolerability, and immunogenicity of CT-P6 plus pertuzumab and chemotherapy, in routine clinical practice for HER2-positive early breast cancer, including translational biomarker analyses related to pathologic complete response (pCR). METHODS: Prospective, multicenter, observational study in 102 patients with HER2-positive early breast cancer. Patients received hospital-preferred neoadjuvant regimens protocols, with (scheme 1 and 3) or without anthracyclines (scheme 2). The primary endpoint was pCR, defined as the absence of invasive tumor in both the breast and axillary lymph nodes (ypT0/ypTis and ypN0). Translational endpoints included soluble HER2, anti-trastuzumab CT-P6 antibodies, and exploratory response-related modeling approaches supported by machine learning techniques. RESULTS: Among patients who underwent surgery, pCR (ypT0/ypTis and ypN0) was achieved in 57.43% of cases, with no significant differences between anthracycline-based and non-anthracycline-based regimens. Soluble HER2 and anti-trastuzumab CT-P6 antibodies were not significantly associated with pCR. Treatment was well-tolerated; the most relevant Grade 3-4 treatment-related adverse events were diarrhea (2.25%) and asthenia (0.50%). No immunogenicity or clinically relevant cardiotoxicity was observed. CONCLUSIONS: Trastuzumab CT-P6 combined with pertuzumab and chemotherapy can be used in neoadjuvant treatment for HER2-positive early breast cancer, showing pCR rates comparable to the reference trastuzumab and without evidence of immunogenicity. Exploratory analyses of soluble HER2 and anti-trastuzumab CT-P6 antibodies did not demonstrate a significant association with pCR, although this possibility cannot be excluded. Their assessment contributes to the translational understanding of biosimilar integration into curative regimens. TRIAL REGISTRATION: The study has been registered in Clinicaltrials.gov ( https://clinicaltrials.gov/study/NCT06907082 ).
Trends in postmastectomy radiotherapy for early and locally advanced breast cancer in Switzerland: a population-based cross-sectional and longitudinal analysis.
Blum M, Koch SM, Mousavi M … +5 more , Vorburger D, Müller A, Zimmermann MEN, Oehler C, Zwahlen DR
Breast Cancer Res Treat · 2026 Jan · PMID 41528580 · Publisher ↗
PURPOSE: Postmastectomy radiotherapy (PMRT) reduces locoregional recurrence and improves survival in high-risk breast cancer (BC), yet its real-world use remains variable. Population-based data on PMRT utilization and gu...
PURPOSE: Postmastectomy radiotherapy (PMRT) reduces locoregional recurrence and improves survival in high-risk breast cancer (BC), yet its real-world use remains variable. Population-based data on PMRT utilization and guideline adherence in Switzerland are lacking. We evaluated PMRT patterns, determinants, and adherence to ASCO-ASTRO-SSO recommendations among women with stage I-III BC over two time periods and interpreted findings in the context of the 2025 guideline. METHODS: This retrospective, population-based study analyzed data from seven Swiss cancer registries, including Eastern Switzerland (2003-2005; n = 4,246), and from Eastern Switzerland alone (2015-2017; n = 976). Eligible patients were women aged ≥ 18 years with stage I-III invasive BC treated by simple mastectomy. PMRT use was examined across original ASCO-ASTRO-SSO-defined risk groups: low-risk (T1-2N0), intermediate-risk (T1-2N1, T3N0), and high-risk (T4 or N2-3). Multivariable regression identified clinicopathologic determinants of PMRT use. Trends in PMRT guideline adherence and regional nodal irradiation (RNI) were evaluated within the framework of evolving clinicobiologic risk paradigms. Overall survival (OS) was analyzed using Kaplan-Meier and Cox regression methods. RESULTS: Overall PMRT utilization remained low (25-30%) across both periods. PMRT was independently associated with younger age, higher T-/N-stage, lymphovascular invasion (p < 0.01), positive margins, G3 histology, and ER negativity (p < 0.05). Adherence to guidelines improved in low-risk patients (93% to 96%) but declined in high-risk patients (64% to 54%), with decreasing PMRT use in T4 (53% to 27%), N2 (73% to 57%), and N3 disease (83% to 73%). In contrast, PMRT use increased among intermediate-risk patients (23% to 39%), particularly in T1-2N1 disease (19% to 38%) and in the presence of adverse features: LVI + (21%), HER2 + (23%), TNBC (30%), G3 (38%), and age < 45 years (57%). Supraclavicular/axillary RNI declined overall but increased in node-negative patients, paralleling reduced axillary dissection and increased sentinel biopsy (26% to 70%). PMRT was not associated with a statistically significant OS benefit; supraclavicular RNI showed a non-significant trend toward improved OS in N2-3 disease. CONCLUSIONS: This first national analysis provides real-world evidence that PMRT utilization in Switzerland remains low, with underuse in high-risk patients and selective, biologically informed escalation in intermediate-risk disease. While patterns reflect evolving multidisciplinary care, persistent gaps in ASCO-ASTRO-SSO guideline implementation underscore the need for continued surveillance and individualized, risk-adapted PMRT decision-making.
Updated systematic review and meta-analysis: taking the next step in physical activity behavioral interventions for post-treatment breast cancer survivors.
Leitzelar BN, Willis AR, Price SN … +4 more , Tooze JA, VonVille HM, Lintz R, Bluethmann SM
Breast Cancer Res Treat · 2026 Jan · PMID 41518388 · Full text
PURPOSE: To provide an updated review of the literature on physical activity (PA) intervention studies, their characteristics, and their effect size estimates for PA behavior change among early post-treatment breast canc...
PURPOSE: To provide an updated review of the literature on physical activity (PA) intervention studies, their characteristics, and their effect size estimates for PA behavior change among early post-treatment breast cancer survivors (BCS). METHODS: Eligible studies were published between 2014-2025 in English, were quasi- or randomized controlled trials, studied BCS ≤ 5 years post-treatment, tested a PA intervention, and assessed PA behavior. We searched PubMed, APA PsycINFO, Embase, and CINAHL (latest search October 2025; CINAHL June 2020). Extracted data included study, participant, intervention, and outcome descriptors. The ROB 2 assessed risk of bias. A random effects model on post-intervention Cohen's d standardized mean differences (SMD) values meta-analysis was performed. RESULTS: Twenty-two RCTs with a total sample size of 2,390 (mean = 109, range = 26-692) were included. All included BCS were female, were on average 57 years old, and predominantly (> 60%) non-Hispanic White. Most study populations were mixed in terms of cancer stage and treatment type. Intervention duration ranged from 6-104 weeks. All studies except one were partially or fully home-based. All behavioral counseling interventions were theory-based. The overall SMD was d = 0.36 (95% confidence interval: 0.22, 0.50) in favor of the intervention. Two studies had some concerns for risk of bias; all others were rated as low. CONCLUSION: The present updated review found a small-to-moderate positive effect of PA interventions on PA behavior change among early post-treatment BCS. We note some shifts in the participant samples and study design since the originally published review. Practical implications for improving the reporting of future research include following established reporting guidelines to enhance reporting transparency, which would allow for more precise quantification of specific intervention effects and deeper contextual understanding of this body of work.
Outcomes of patients with de novo oligometastatic breast cancer treated with curative intent at a single institution.
Chen EL, Heiling H, Li T … +11 more , Bellon JR, Nakhlis F, Parsons HA, Martin A, Burstein HJ, Tolaney SM, Snow C, Tayob N, Braunstein LZ, Lin NU, Sammons S
Breast Cancer Res Treat · 2026 Jan · PMID 41501299 · Publisher ↗
PURPOSE: De novo oligometastatic breast cancer (OMBC) is often defined as up to five metastases in two or fewer organs at presentation. Studies have suggested favorable outcomes for patients with OMBC; however, managemen...
PURPOSE: De novo oligometastatic breast cancer (OMBC) is often defined as up to five metastases in two or fewer organs at presentation. Studies have suggested favorable outcomes for patients with OMBC; however, management remains controversial. We analyzed outcomes of patients with de novo OMBC treated with physician-expressed curative intent at a single institution. METHODS: We identified patients by performing a keyword search for terms of interest within institutional electronic medical records. We defined OMBC as four or fewer metastases in one organ. Primary surgery was required for inclusion in the analytic cohort. Recurrence-free survival (RFS) and overall survival (OS) were evaluated using Kaplan-Meier methods. RESULTS: Thirty-nine patients were identified: 12 hormone receptor-positive (HR+)/HER2+ , 2 HR-negative (HR-)/HER2-, 21 HR+ /HER2-, and 4 HR-/HER2+ . Thirty-three patients (84.6%) had 1 metastasis at diagnosis. Median age was 47 years (28-69). Twenty-nine patients (74.4%) underwent adjuvant radiation to the breast. Two-thirds of patients underwent metastasis-directed therapy. Five-year OS was 77% (95% CI 61-95%). Median RFS was 7.1 years (95% CI 4.62-not reached). Five-year RFS was 58% (95% CI 42-81%). CONCLUSIONS: Survival outcomes were favorable among this select cohort. Optimal treatment for de novo OMBC remains unclear. Curative intent trials are underway for HER2+ de novo OMBC.
Anti-HER2 treatment in everyday practice: how we treat older women with breast cancer differently.
Hjorth S, Vandraas KF, Trewin-Nybråten CB … +4 more , Botteri E, Ursin G, Andreassen BK, Støer NC
Breast Cancer Res Treat · 2026 Jan · PMID 41498846 · Full text
PURPOSE: Targeted therapies have improved survival in human epidermal growth factor receptor 2 positive breast cancer (HER2 + BC). However, patients over 75 years of age are often excluded from clinical trials of anti-HE...
PURPOSE: Targeted therapies have improved survival in human epidermal growth factor receptor 2 positive breast cancer (HER2 + BC). However, patients over 75 years of age are often excluded from clinical trials of anti-HER2 therapies, and it is unclear to what extent they receive these treatments in routine care. To address this, we examined age-related patterns of anti-HER2 therapy use in real-world clinical practice in Norway. METHODS: In a nationwide registry-based cohort, we identified women diagnosed with stage I-III HER2 + BC during 2012-2021. We investigated treatment patterns using descriptive statistics and estimated the direct effect of age on anti-HER2 therapy use by Poisson regression. RESULTS: Among 3526 women with HER2 + BC, anti-HER2 therapy use was consistently high (83-95%) in those under 75 years, decreased to 60% at ages 75-79, and declined further with advancing age to 8% at ≥ 90 years. Neoadjuvant anti-HER2 therapy also decreased with age (from 24% in patients under 75 to 12% in patients over 75 years). Accounting for cancer characteristics, comorbidities, polypharmacy, and socio-economic factors, older patients had reduced likelihood of receiving any anti-HER2 therapy compared with patients younger than 55 (RR 0.75, 95% CI 0.66-0.85, p < 0.001, at age 75-84 and RR 0.21, 95% CI 0.11-0.41, p < 0.001, at age 85 +). CONCLUSIONS: Anti-HER2 therapy use declined substantially after the age of 75 even when accounting for comorbidities and polypharmacy. Chronological age appears important in planning treatment for patients with HER2 + BC. Specific guidelines pertaining to older patients with HER2 + BC are needed to avoid potential undertreatment.
Prognosis and endocrine therapy efficacy in early breast cancer with estrogen receptor low expression.
Liu S, Du B, Zhang M … +8 more , Zhai D, Zhao X, Shao N, Kuang X, Zhang Y, Shi Y, Yu L, Lin Y
Breast Cancer Res Treat · 2026 Jan · PMID 41493657 · Publisher ↗
PURPOSE: To investigate the prognosis and endocrine therapy (ET) efficacy in patients with estrogen receptor (ER)-low breast cancer. METHODS: This retrospective cohort study included patients diagnosed with early-stage b...
PURPOSE: To investigate the prognosis and endocrine therapy (ET) efficacy in patients with estrogen receptor (ER)-low breast cancer. METHODS: This retrospective cohort study included patients diagnosed with early-stage breast cancer at a single institution in China from January 2010 to December 2020. Clinicopathological features, survival outcomes, and the effect of ET were compared among patients with ER-low, ER-high, and ER-negative breast cancer. Analyses were stratified by human epidermal growth factor receptor 2 (HER2) status (positive or negative). RESULTS: A total of 2951 patients were included, consisting of 131 (4.4%) ER-low, 2040 (69.1%) ER-high, and 780 (26.4%) ER-negative patients. In the HER2-negative subgroup, ER-low patients had significantly worse breast cancer-free survival (BCFS) (P = 0.016) and a higher risk of locoregional recurrence (P < 0.001) compared to ER-high patients, while no significant differences were observed in prognosis between ER-low and ER-negative patients. In the HER2-positive subgroup, there were no significant differences in prognosis among patients with different ER expression levels. ET could significantly reduce the risk of locoregional recurrence and distant metastasis and significantly improve BCFS for ER-low patients, especially in the HER2-negative subgroup. However, in the HER2-positive subgroup, ET did not improve BCFS or overall survival for ER-low patients. CONCLUSION: HER2-negative/ER-low breast cancer has a similar clinical behavior to triple-negative breast cancer, and ET could significantly reduce the risk of recurrence and metastasis for this subgroup. However, in HER2-positive patients, ER-low breast cancer lacks a predictive role in prognosis and derives no clear benefit from ET.
Inhibition of GPX4 induces the death of p53-mutant triple-negative breast cancer cells.
Tahaney WM, Lanier A, Qian J … +9 more , Moyer CL, Nguyen N, Ma Y, Hill J, Powell RT, Stephan CC, Davies PJA, Mazumdar A, Brown PH
Breast Cancer Res Treat · 2026 Jan · PMID 41493644 · Full text
BACKGROUND: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer characterized by high rates of tumor protein 53 (TP53) mutation and with limited targeted therapies. Despite being clinically adv...
BACKGROUND: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer characterized by high rates of tumor protein 53 (TP53) mutation and with limited targeted therapies. Despite being clinically advantageous, direct targeting of mutant TP53 has been challenging. Therefore, we hypothesized that p53-mutant TNBC cells rely upon other potentially targetable survival pathways. METHODS: In vitro and in silico screens were used to identify drugs that induced preferential death in TP53-mutant cells. The effect of the ferroptosis inducer ML-162 was tested both in vitro and in vivo and the mechanism of cell death following ML-162 treatment or GPX4 knockout was determined. RESULTS: High-throughput drug screening demonstrated that TP53-mutant TNBCs are highly sensitive to peroxidase, cell cycle, cell division, and proteasome inhibitors. We further characterized the effect of the ferroptosis inducer ML-162 and demonstrated that ML-162 induces preferential ferroptosis in TP53-mutant TNBC cells. Treatment of TP53-mutant xenografts with ML-162 suppressed tumor growth and increased lipid peroxidation in vivo. Testing ferroptosis inducers demonstrated TP53-missense mutant, and not TP53-null or wild-type cells, were more sensitive to ferroptosis, and expression of mutant TP53 genes in p53-null cells sensitized cells to ML-162 treatment. CONCLUSIONS: This study demonstrates that TP53-mutant TNBC cells have unique survival pathways that can be effectively targeted. Our results illustrate the intrinsic vulnerability of TP53-mutant TNBCs to ferroptosis and highlight GPX4 as a potential target for the precision treatment of TP53-mutant TNBC.
Risk of second non-breast primary cancer in Chinese breast cancer patients with germline BRCA1/2 pathogenic variants.
Liu J, Chu F, Yao L … +5 more , Sun J, Chen J, Zhang J, Xu Y, Xie Y
Breast Cancer Res Treat · 2026 Jan · PMID 41493635 · Publisher ↗
PURPOSE: The risk of second non-breast primary cancer in Chinese women with breast cancer who carry germline BRCA1/2 pathogenic variants (PVs) is largely unknown. METHODS: From October 2003 to February 2023, 11,212 women...
PURPOSE: The risk of second non-breast primary cancer in Chinese women with breast cancer who carry germline BRCA1/2 pathogenic variants (PVs) is largely unknown. METHODS: From October 2003 to February 2023, 11,212 women with breast cancer were recruited. BRCA1/2 mutation status of these patients was determined; the age-specific cumulative risk of second non-breast primary cancer was estimated. RESULTS: Of the 11,212 breast cancer patients, 284 carried BRCA1 PVs, 433 carried BRCA2 PVs, and 10,495 were non-carriers. After a median follow-up of 8.4 years, 10.9% of BRCA1 carriers, 7.2% of BRCA2 carriers, and 3.6% of non-carriers developed second non-breast primary cancers; and 6.7% of BRCA1 carriers, 1.4% of BRCA2 carriers, and 0.1% of non-carriers developed ovarian cancer. Cumulative risks of second primary cancer to age 70 years were 28.4% for BRCA1 carriers, 17.3% for BRCA2 carriers, and 6.2% for non-carriers. Cumulative risks of ovarian cancer to age 70 years were 19.8% for BRCA1 carriers, 3.9% for BRCA2 carriers, and 0.4% for non-carriers. No BRCA1 and BRCA2 carriers developed ovarian cancer before the ages of 40 and 45 years, respectively. BRCA2 carriers had higher risks of thyroid cancer (relative risk [RR] 2.16; 95% CI, 1.04-4.51; P = 0.039) and endometrial adenocarcinoma (RR 3.90; 95% CI, 1.47-10.32; P = 0.006) than non-carriers. CONCLUSIONS: BRCA1/2 carriers exhibit a 2- to 3-fold higher risk of second primary cancer than non-carriers. Ovarian cancer represents the majority of second primary cancers in BRCA1 carriers, while BRCA2 carriers have a wider spectrum of second primary cancers.
Changes in compliance with cardiovascular medication after a breast cancer diagnosis: a latent class trajectory analysis using French nationwide data.
Artignan J, Capmas P, Panjo H … +2 more , Bejarano-Quisoboni D, Pelletier-Fleury N
Breast Cancer Res Treat · 2026 Jan · PMID 41493628 · Publisher ↗
BACKGROUND: Managing cardiovascular risk is key for breast cancer survivors, many of whom have pre-existing conditions like hypertension and hyperlipidaemia. Research suggests compliance with cardiovascular medication de...
BACKGROUND: Managing cardiovascular risk is key for breast cancer survivors, many of whom have pre-existing conditions like hypertension and hyperlipidaemia. Research suggests compliance with cardiovascular medication declines after a breast cancer diagnosis. However, these studies rely on population-level averages, which mask patient heterogeneity and longitudinal variations in compliance. This study aimed to identify compliance trajectories with cardiovascular medication around a breast cancer diagnosis and describe associated characteristics. METHODS: Using the French National Health Data System, we constructed a cohort of women diagnosed with incident breast cancer (2016-2020) who received at least 2 cardiovascular drug classes before diagnosis for primary prevention, defined as treatment of cardiovascular risk factors in the absence of established cardiovascular disease. Compliance trajectories were analysed over 3 years using group-based trajectory modelling. RESULTS: Among 35,399 women, 6 trajectories were identified: stable high compliance (49.9%), moderate stable (21.2%), low stable (12.8%), sharp decline post-diagnosis (9.8%), treatment discontinuation post-diagnosis (3.4%), and very low and declining (2.9%). Declining trajectories were associated with higher rates of metastases and chemotherapy. CONCLUSION: This study revealed substantial heterogeneity in compliance responses post-diagnosis. While most women maintained stable compliance, a significant subset experienced sharp declines, likely linked to cancer severity. Early interventions post-diagnosis could reduce cardiovascular risk and improve outcomes.
RISE UP for breast cancer 2024: conference highlights & takeaways.
Glatt T, Leggat-Barr K, Seth N … +22 more , Heditsian D, van 't Veer L, Pusztai L, Price E, Hylton N, Formenti S, Rugo H, Fejerman L, Toriola AT, Fabian C, De Censi A, Grossman D, Olopade O, Jackson A, Horton S, Rhoads K, Lange C, Borges V, Garner E, Garber J, Yee D, Esserman L
Breast Cancer Res Treat · 2026 Jan · PMID 41493489 · Full text
RISE UP (Revolutionizing Investigations to StEp Up Prevention) for breast cancer brought together leading cancer specialists, women's health providers, basic and population scientists, regulators, politicians, industry l...
RISE UP (Revolutionizing Investigations to StEp Up Prevention) for breast cancer brought together leading cancer specialists, women's health providers, basic and population scientists, regulators, politicians, industry leaders, patient advocates, and more from around the world to discuss and chart a radical rethinking of breast cancer prevention and risk reduction through a lens of hormonal management across a woman's life course. The presentations at RISE UP were organized to outline a path forward by leveraging what we know about breast cancer biology, early detection, treatment, and endocrine therapy toward a better and sustainable approach for breast cancer prevention. Important conference considerations were to expand our thinking about prevention by broadly considering how the hormonal environment during different life phases or common benign conditions could be better managed to minimize breast cancer risk. This set the stage for transitioning to advances in risk prediction, promising risk-reducing agents, and biomarker-driven trials to test them. Biomarker-based trials discussed focused on 1) lower or intermittent doses of standard prevention agents, 2) drugs already approved for other health purposes, and 3) maximizing benefits from lifestyle interventions alone or in combination. Throughout RISE UP, there was a strong focus on promoting health equity, including comprehensive reproductive health access, equitable representation in clinical trials, and strategies to educate women, providers, and advocates about disparities in care and how to successfully reduce them. The meeting concluded with a competition for innovative approaches to breast cancer prevention that could be integrated into hormonal and women's health interventions. RISE UP was an innovative conference that provided a forum for cross-cutting topics in women's health that do not currently exist. The insights shared at RISE UP will be paradigm shifting in breast cancer prevention and women's health space in the years to come.
The impact of breast cancer treatment on sleep disturbance: a systematic review.
Carson EK, Dhillon HM, Vardy JL … +4 more , Brown C, Mok C, Panambalana A, Kiely BE
Breast Cancer Res Treat · 2025 Dec · PMID 41460589 · Publisher ↗
BACKGROUND: People receiving treatment for breast cancer often report sleep disturbance. This systematic review explored the prevalence and impact of breast cancer treatment on sleep disturbance. METHODS: The Medline, Em...
BACKGROUND: People receiving treatment for breast cancer often report sleep disturbance. This systematic review explored the prevalence and impact of breast cancer treatment on sleep disturbance. METHODS: The Medline, Embase, CINAHL Plus with full text, Psych INFO, Cochrane Library/Central Register of Controlled Trials, and Scopus databases were searched up to December 2024. Eligible studies recruited people undergoing breast cancer treatment and reported the impact of treatment on their sleep. Two authors reviewed full-text publications for eligibility, data extraction, and quality appraisal. Demographics and sleep outcomes were summarised via descriptive statistics. RESULTS: Among the 32,119 studies identified, 80 met the eligibility criteria. Studies have used a variety of sleep assessment measures and thresholds to define sleep disturbance. The Pittsburgh Sleep Quality Index (PSQI) and actigraphy were the most frequently used, 63% and 24%, respectively. The mean prevalence of poor sleep quality (as per the PSQI) for each treatment was as follows: surgery, 63%; chemotherapy, 62%; radiation therapy, 64%; and endocrine therapy, 57%; and clinically significant insomnia (as per the Insomnia Severity Index) for surgery, 20%; chemotherapy, 24%; radiation therapy, 23%; and endocrine therapy, 35%. A significant increase in sleep disturbance related to cancer treatment was reported in 62% of the studies assessing chemotherapy, 39% assessing radiation therapy, 20% assessing endocrine therapy, and 17% assessing breast surgery. CONCLUSION: Sleep disturbance is reported in approximately 60% of people receiving treatment for breast cancer, with chemotherapy being the most studied treatment. The prevalence and severity of sleep disturbance vary across studies due to the heterogeneity of assessment tools used, and thresholds to define poor sleep. This highlights the need for a consistent method of assessing sleep disturbance and the need for effective strategies to improve sleep.
Assessing barriers to genomic testing in breast cancer among diverse patients: a qualitative community-engaged research study.
Olomu MUO, Scherer C, Wood E … +17 more , Escobar K, Moufarrej S, Kamran R, Muir S, Muñoz F, Stern M, Gomez S, Blayney DW, Chew H, Tealer LM, Alanes A, Moorehead D, Sanchez M, Sánchez KB, Tinianov S, Duron Y, Patel MI
Breast Cancer Res Treat · 2025 Dec · PMID 41460588 · Publisher ↗
PURPOSE: Genomic testing informs treatment decisions for estrogen receptor-positive, progesterone receptor-positive, and HER2-negative early-stage breast cancer, yet uptake remains disproportionately low among racially a...
PURPOSE: Genomic testing informs treatment decisions for estrogen receptor-positive, progesterone receptor-positive, and HER2-negative early-stage breast cancer, yet uptake remains disproportionately low among racially and ethnically minoritized and low-income populations. Understanding the multilevel barriers driving these disparities is essential for equitable delivery of personalized cancer care. This study explores barriers to and potential solutions for equitable access to genomic testing, incorporating perspectives from patients, caregivers, clinicians, navigators, payers, and policymakers. METHODS: We conducted a qualitative study using community-based participatory research principles in partnership with five community-based organizations. Semi-structured interviews were completed with 32 participants: patients (n = 20), caregivers (n = 2), clinicians (n = 4), navigators (n = 2), payers (n = 2), and policymakers (n = 2). Transcripts were analyzed using constructivist grounded theory and interpretive description. RESULTS: Three major themes emerged: (1) Limited awareness and information across interested groups, including confusion between genomic and genetic testing, particularly among patients, caregivers, and some healthcare staff; (2) Modifiable challenges in accessing genomic testing, such as administrative complexity, insurance barriers, and financial toxicity; and (3) Racial, ethnic, and socioeconomic factors, including language barriers and lack of culturally appropriate materials, that impede equitable access to testing. CONCLUSIONS: Equitable delivery of genomic testing in breast cancer requires multilevel interventions targeting structural barriers, administrative complexity, and culturally tailored education. Addressing these barriers is likely to reduce disparities and further improve health equity in cancer care.
Tumor biology and access to care and metastatic breast cancer outcomes.
Dunn MR, Van Alsten SC, Emerson MA … +3 more , Reeder-Hayes K, Hyslop T, Troester MA
Breast Cancer Res Treat · 2025 Dec · PMID 41452486 · Full text
PURPOSE: To understand how access to care influences metastatic breast cancer burden (MBC) while accounting for molecular tumor characteristics, and identify interventions to reduce metastatic disease burden. METHODS: Th...
PURPOSE: To understand how access to care influences metastatic breast cancer burden (MBC) while accounting for molecular tumor characteristics, and identify interventions to reduce metastatic disease burden. METHODS: The Carolina Breast Cancer Study is a population-based cohort with invasive breast cancer (diagnosed 2008-2013). Both de novo metastasis (stage IV at diagnosis) and distant recurrence were evaluated (12 years of follow-up. Tumor data were from medical records, pathology reports, and RNA expression data. Social variables and access to care were from participant surveys. Generalized linear models were used to estimate associations of biological and access characteristics with MBC; Cox models were used to estimate recurrence hazards. RESULTS: 464/2998 patients (15.5%) had MBC (n = 109 de novo; n = 355 recurrent). MBC was associated with grade 3 vs 1 (odds ratio (OR) = 4.15, 95% CI: 2.60, 6.99), LumB vs LumA (OR = 2.08, 95% CI: 1.48, 2.90), and high vs low PAM50 risk of recurrence score (OR = 4.45, 95% CI: 2.93, 6.99) vs. non-MBC. MBC was associated with Black race (Hazard ratio (HR) = 1.66, 95% CI: 1.32, 2.11), poverty (HR = 1.47; 95% CI: 1.09, 1.99), and low education (HR = 1.48, 95% CI: 1.03, 2.13). Controlling for healthcare access (screening, regular care, delayed treatment, and community healthcare) attenuated associations with metastasis for poverty and education, but had lesser effects on race associations. CONCLUSIONS: Disparities in MBC burden persist after adjustment for individual- and community-level healthcare access. Reducing burden of MBC in Black women necessitates simultaneous targeting of biological and access to care factors.
Assessing the accuracy of inflammatory breast cancer self-reported diagnoses through the metastatic breast cancer project from the count me in initiative database.
De Placido P, Troll E, Niman SM … +11 more , Ryan S, Mason G, Powell M, Hazra A, Wagle N, McGillicuddy M, Lin NU, Tolaney SM, Nakhlis F, Regan MM, Lynce F
Breast Cancer Res Treat · 2025 Dec · PMID 41441993 · Publisher ↗
PURPOSE: This study assessed the accuracy of self-reported inflammatory breast cancer (IBC) diagnoses within the Count Me In (CMI) Metastatic Breast Cancer Project. Given IBC's aggressive nature and diagnostic complexity...
PURPOSE: This study assessed the accuracy of self-reported inflammatory breast cancer (IBC) diagnoses within the Count Me In (CMI) Metastatic Breast Cancer Project. Given IBC's aggressive nature and diagnostic complexity, we aimed to evaluate the reliability of patient-reported data by quantifying concordance rates between self-reported and clinically confirmed diagnoses. METHODS: Medical records from 79 patients who self-identified as having IBC were reviewed to confirm the diagnosis through provider documentation. When explicit confirmation was absent, a recently validated quantitative IBC scoring system was applied. Each patient's diagnosis was adjudicated by an expert physician, with cases classified as concordant or discordant based on predefined criteria. A concordance threshold of 90% was established to consider patient-reported diagnoses as sufficiently reliable. RESULTS: Among the 79 patients, 57/79 (72.2%) had concordant diagnoses based on either explicit documentation or scoring system verification. Specifically, 51/79 (64.6%) had explicit documentation, while an additional 6/79 (7.6%) met scoring system criteria. However, 22/79 (27.8%) were discordant, either lacking evidence or unable to be confirmed due to incomplete medical records, falling below the 90% concordance threshold required for reliability. CONCLUSION: Although patient self-reporting via the CMI initiative allows rapid data collection, reliance solely on self-identification for diagnosing IBC may lead to misclassification. Future strategies should incorporate refined symptom-specific screening and prioritize enrolling patients with stage III IBC. Advanced technologies such as AI-assisted medical record analysis could further enhance diagnostic accuracy and facilitate high-quality data collection for improved diagnosis and outcomes.
Body composition, chemotherapy dosing and hematologic toxicity among Black and non-Black women being treated for breast cancer.
Wopat H, Patel R, Provenzano D … +10 more , Rao YJ, Ozoglu B, Limay A, Brem RF, Earls JP, Kaltman R, Anderson K, Aldous A, Ciarleglio A, Robien K
Breast Cancer Res Treat · 2025 Dec · PMID 41441920 · Full text
INTRODUCTION: Black women in the United States have higher breast cancer mortality rates compared to women of other races/ethnicities. Heterogeneity in body composition between Black and non-Black women may contribute to...
INTRODUCTION: Black women in the United States have higher breast cancer mortality rates compared to women of other races/ethnicities. Heterogeneity in body composition between Black and non-Black women may contribute to differences in relative drug dosing and chemotherapy toxicities, leading to treatment delays and lower treatment completion rates. This study evaluated the extent to which drug dose/kilogram (kg) fat free mass (FFM) differs by race, and whether measures of FFM or adipose tissue (AT) are independently and/or jointly associated with hematologic toxicity, treatment delays, treatment discontinuation, and relative dose intensity (RDI). METHODS: Women who were treated with neo/adjuvant anthracycline- and/or taxane-containing regimens for breast cancer between 2012-2019 and had an abdominal CT scan within 12 weeks of chemotherapy initiation were included in this retrospective study. Visceral and subcutaneous AT area and FFM were measured using CT scan slices at the L3 vertebra level. RESULTS: A total of 230 women met the inclusion criteria. On average, Black women were older and had higher weight, FFM and AT compared to non-Black women; however, Black women had lower percent FFM. No statistically significant differences in initial or cumulative drug dose/kg FFM were observed between Black vs non-Black women for any individual drug. Similarly, neither FFM or AT were independently or jointly associated with incidence of hematologic toxicity, treatment delays or discontinuation for any individual chemotherapy drug. CONCLUSION: Current BSA-based chemotherapy dosing regimens do not appear to contribute to disparities in treatment-associated toxicity or chemotherapy completion.
Trimodal therapy is associated with higher overall survival than chemotherapy only in patients with metastatic inflammatory breast cancer.
Schupp E, Gokun Y, Eckstein J … +11 more , Stover DG, Jhawar S, Quiroga D, Gatti-Mays ME, Cherian M, Cho MJ, Johnson KCC, LeFebvre H, Chen JC, Elsaid MI, Obeng-Gyasi S
Breast Cancer Res Treat · 2025 Dec · PMID 41400715 · Publisher ↗
PURPOSE: Systemic therapy is standard for metastatic inflammatory breast cancer (MIBC), but the role of locoregional therapy in survival remains unclear. The objective of this study was to compare overall survival (OS) b...
PURPOSE: Systemic therapy is standard for metastatic inflammatory breast cancer (MIBC), but the role of locoregional therapy in survival remains unclear. The objective of this study was to compare overall survival (OS) between patients with MIBC who received trimodal therapy vs chemotherapy alone. METHODS: Patients diagnosed with MIBC between 2004 and 2021 were identified in the NCDB. The cohort was divided into those who received trimodal therapy vs chemotherapy only. Trimodal therapy included receipt of chemotherapy, surgery (modified radical or radical mastectomy), and radiation therapy. Overlap Propensity Score Weighted Cox proportional hazard models examined the association between treatment (chemotherapy versus trimodal therapy) and OS. RESULTS: A total of 2872 patients with MIBC were included, of whom 403 (14.0%) underwent trimodal therapy and 2469 (86.0%) received chemotherapy alone. Median OS was longer with trimodality therapy than with chemotherapy alone (47.0 months vs 34.4 months, p < 0.001). Receiving trimodal therapy was associated with a 28% lower hazard of mortality compared to chemotherapy only (aHR: 0.72, 95% CI 0.62-0.84). CONCLUSIONS: In this NCDB cohort of patients with MIBC, receipt of trimodal therapy improved OS compared with chemotherapy only.
Lymphovenous bypass for the treatment of secondary lymphedema: A meta-analysis of prospective outcomes.
Brown S, Shen Y, Klimitz FJ … +7 more , Nair M, Glaeser-Khan S, Shamoun V, Pomahac B, Lotfi P, Golshan M, Haykal S
Breast Cancer Res Treat · 2025 Dec · PMID 41396216 · Publisher ↗
BACKGROUND: Despite the increasing popularity of microsurgical techniques for the treatment of lymphedema, there is a lack of high-level, prospective, long-term data and standardized outcome metrics. The purpose of this...
BACKGROUND: Despite the increasing popularity of microsurgical techniques for the treatment of lymphedema, there is a lack of high-level, prospective, long-term data and standardized outcome metrics. The purpose of this study was to analyze the long-term outcomes of Lymphovenous Bypass (LVB) surgery throughout the past two decades. METHODS: We conducted a systematic review of PubMed, Embase, and Web of Science databases to identify prospective clinical trials investigating LVB for lymphedema treatment. Reported outcome data included limb volume measurements, number of cellulitis episodes, compression garment use, and the assessment of complications. For studies involving multiple procedures, only outcomes from the respective LVB cohorts were analyzed. Retrospective data analyses were excluded. RESULTS: Eight prospective studies (2009-2023) were included in the meta-analysis, comprising a total of 431 patients undergoing LVB with a mean follow-up of 21.8 ± 7.7 months. An average of 3.4 ± 1.0 anastomoses were performed per patient. LVB was associated with a 14.26% mean reduction in limb volume (95% CI 6.63-21.88; p < 0.0001) at one-year, and 46.3% (95% CI 24.9%-69.1%; p < 0.01) reduction/discontinuation of compression therapy following surgery. Patients also reported subjective symptom relief and reduced cellulitis episodes. CONCLUSIONS: This systematic review provides the most comprehensive synthesis to date of long-term outcomes following LVB surgery for lymphedema. The findings support LVB as a safe and effective microsurgical intervention, with consistent reductions in limb volume, cellulitis episodes, and reliance on compression therapy.
Compression sleeves for prevention and treatment of breast cancer-related lymphedema: a systematic review and meta-analysis.
Cheng H, Gong J, Yu L … +5 more , Feng X, Ou W, Wang H, Zhong H, Zhang EM
Breast Cancer Res Treat · 2025 Dec · PMID 41389304 · Publisher ↗
BACKGROUND: Compression sleeves are widely used for breast cancer-related lymphedema, but evidence on their effectiveness of prevention and treatment in volume reduction is limited. OBJECTIVE: To compare the effects of c...
BACKGROUND: Compression sleeves are widely used for breast cancer-related lymphedema, but evidence on their effectiveness of prevention and treatment in volume reduction is limited. OBJECTIVE: To compare the effects of compression sleeves and conventional care on breast cancer-related lymphedema, providing evidence-based support for clinical application. METHODS: A systematic search of 9 databases was conducted up to June 9, 2025. Meta-analysis was performed using RevMan 5.4, and evidence quality was assessed with GRADE profiler 3.6. RESULTS: 1532 patients were included. Compression sleeves significantly reduced lymphedema incidence post-surgery (P =0 .02) and edema volume/circumference (P <0 .001), and improved shoulder flexion (P =0.02). No significant effects were seen on shoulder abduction (P =0 .18), subjective symptoms (P =0.62), or quality of life (P = 0.32). Evidence quality was moderate for incidence and volume/circumference reduction, and low for other outcomes. CONCLUSION: This meta-analysis shows that compression sleeves reduce lymphedema incidence and volume/circumference, and improve shoulder flexion. They should be considered in lymphedema management, though further research is needed for other outcomes.
Disparities in delays and outcomes in patients with HER2-positive breast cancer.
Wooster M, DeStephano D, Beauchemin M … +5 more , Wang S, Wright JD, Hur C, Hershman DL, Accordino MK
Breast Cancer Res Treat · 2025 Dec · PMID 41385136 · Publisher ↗
PURPOSE: Neoadjuvant chemotherapy (NACT) is often the preferred systemic treatment modality for advanced breast tumors. Delays in NACT initiation are associated with worse outcomes although it is unclear which patients a...
PURPOSE: Neoadjuvant chemotherapy (NACT) is often the preferred systemic treatment modality for advanced breast tumors. Delays in NACT initiation are associated with worse outcomes although it is unclear which patients are at the highest risk for delays and whether these delays impact pathologic complete response (pCR). We sought to determine the incidence, predictors, and cancer-related outcomes associated with delays in NACT initiation among patients with HER2-positive (HER2 +) breast cancer in the modern era. METHODS: We retrospectively analyzed a cohort of patients with stage II-III HER2 + breast cancer who were treated with NACT and surgery using the National Cancer Database. Multivariable logistic regression, adjusted for demographic, socioeconomic and tumor characteristics, was used to identify characteristics associated with and the likelihood of achieving a pCR with delays in NACT initiation. RESULTS: 56,868 patients were included in the analysis. Delays in NACT initiation of > 60 days from diagnosis was observed in 9% of patients. In a multivariable analysis, patients who were Black (OR 1.88 95%CI 1.74-2.04), Hispanic (OR 2.19, 95%CI 2.00-2.39), had Medicaid (2.14, 95%CI 1.97-2.32), or no insurance (2.39, 95%CI 2.09-2.72) were more likely to be delayed. Delay was associated with a lower likelihood of achieving pCR (OR 0.86 95% CI 0.81-0.92) and an increased risk of death (HR 1.15 95%CI 1.03-1.29). CONCLUSION: There are racial, ethnic, and socioeconomic disparities in NACT initiation delays and an association with worse cancer-related outcomes. Future studies and interventions are needed to mitigate these delays.
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