Breast Cancer Research And Treatment[JOURNAL]
Sun
200 papers
The association of contemporary mortgage lending bias and receipt of guideline-concordant systemic treatment among older women with breast cancer.
Yen TWF, Canales B, McGinley EL … +3 more , Tarima S, Zhou Y, Beyer KMM
Breast Cancer Res Treat · 2025 Dec · PMID 41385117 · Publisher ↗
PURPOSE: Structural racism may be associated with disparities in breast cancer access to care and outcomes. We examined the association between contemporary mortgage lending bias (redlining) and the receipt of guideline-...
PURPOSE: Structural racism may be associated with disparities in breast cancer access to care and outcomes. We examined the association between contemporary mortgage lending bias (redlining) and the receipt of guideline-concordant systemic treatment. METHODS: Women with stage I-III invasive breast cancer in 2010-2017 were identified from the Surveillance, Epidemiology, and End Results-Medicare linked database. Contemporary redlining was estimated using 2010-2017 Home Mortgage Disclosure Act data. Simple and multiple logistic regression models estimated the unadjusted and adjusted odds of receiving guideline-concordant systemic treatment: appropriate receipt of chemotherapy, HER2/neu (HER2)-targeted therapy, hormonal therapy, and a composite systemic treatment measure. RESULTS: Overall compliance rates were 85%, 96%, and 87% for chemotherapy, HER2-targeted therapy, and hormonal therapy, respectively. For the composite outcome, 95% received some or fully concordant care. In unadjusted and adjusted models, women living in higher redlined neighborhoods were less likely to receive guideline-concordant care for all modalities, except hormonal therapy (p = 0.846). For HER2-targeted therapy and composite score, the redlining effect differed by dual Medicare-Medicaid enrollment eligibility status. Dual eligibility eliminated the negative effect of redlining. Among those not dual eligible, the negative effect of redlining persisted. CONCLUSIONS: Older breast cancer survivors living in higher redlined areas were less likely to receive guideline-concordant chemotherapy, HER2-targeted therapy, and overall systemic treatment. While more work is needed to better understand structural racism and neighborhood socioeconomic disinvestment to address equitable access to cancer care, the housing sector may be one actionable policy target. Care teams should consider patient context to ensure high quality care.
Exploring the effect of Duffy status on patients with breast cancer receiving cyclin-dependent kinase 4/6 inhibitors.
Ferri GM, Martinez CB, Acevedo J … +6 more , Bhatt S, Verma KP, Lee J, Abdallah M, Szalat RE, Sloan JM
Breast Cancer Res Treat · 2025 Dec · PMID 41385110 · Publisher ↗
PURPOSE: To improve clinical decision-making in patients with breast cancer receiving CDK 4/6 inhibitors, we examined Duffy status and relative medication modification at Boston Medical Center. METHODS: We performed a re...
PURPOSE: To improve clinical decision-making in patients with breast cancer receiving CDK 4/6 inhibitors, we examined Duffy status and relative medication modification at Boston Medical Center. METHODS: We performed a retrospective chart review of patients with breast cancer receiving CDK 4/6 inhibitors at Boston Medical Center between January 1, 2021 and June 1, 2024. We included Duffy status as a covariate, where those with unknown Duffy status were assumed to be Duffy non-null. RESULTS: Of the 71 patients included, race was White in 21% and Black in 54%, where 90% of patients with Duffy-null associated neutrophil count (DANC) were Black. When stratifying by Duffy status, Duffy non-null (38/71) and null patients (21/71) had median pre-treatment nadir absolute neutrophil count (ANC) 2.6 (IQR 1.8) and 1.7 (IQR 1.0) and post-treatment nadir ANC 1.6 (IQR 1.2) and 1.0 (IQR 0.6). Overall, no patients meeting criteria for grades 3-4 neutropenia were hospitalized for neutropenic fever. Older patients had higher odds of dose reduction or treatment delay (adjusted odds ratio [aOR] 3.04, 95% confidence interval [CI] 1.06-9.07). However, patients with DANC had no significant differences in rates of dose reduction or treatment delay [aOR 1.31, 95% confidence interval (CI) 0.37-4.73]. CONCLUSION: Despite having lower ANC than their non-null counterparts, Duffy null patients on CDK 4/6 inhibitors received standard starting doses without significant differences in dose reduction or treatment delay.
Efficacy and safety of abemaciclib plus endocrine therapy versus endocrine therapy alone in HR + and HER2-negative breast cancer; a systematic review and meta-analysis.
Sadia K, Talia T, Hussain I … +11 more , Chaudhry M, Shahid N, Javaid MK, Kamil MF, Chaudry HZ, Azhar L, Khan HA, Ejaz A, Akram MU, Mahmood S, Abdul Qadeer M
Breast Cancer Res Treat · 2025 Dec · PMID 41385109 · Publisher ↗
PURPOSE: Breast cancer is the most commonly diagnosed cancer worldwide. To evaluate the safety and efficacy of abemaciclib in combination with endocrine therapy (ET) for the treatment of Hormone Receptor/ Human Epidermal...
PURPOSE: Breast cancer is the most commonly diagnosed cancer worldwide. To evaluate the safety and efficacy of abemaciclib in combination with endocrine therapy (ET) for the treatment of Hormone Receptor/ Human Epidermal Growth Factor Receptor 2 (HR + /HER2-) advanced or metastatic breast cancer, this systematic review and meta-analysis compared several treatment regimens and patient groups. METHODS: In this systematic review and meta-analysis, we searched (PubMed, Scopus, and the Cochrane from inception to 5 April 2025) to identify the studies that compared abemaciclib plus ET to ET alone. The measure effects used were hazard ratios (HR) for overall survival (OS), progression-free survival (PFS), and invasive disease-free survival (IDFS), while risk ratios (RR) for objective response rate (ORR), clinical benefit rate (CBR), and adverse effects· Forest plots were created using a random effects model, with a p-value < 0·05 was considered statistically significant. This study is registered on PROSPERO (CRD420251009464). RESULTS: We included fourteen studies comprising 16,116 patients (8592 with abemaciclib plus ET and 7524 with ET alone), abemaciclib plus ET significantly improved PFS (HR 0·54; 95% CI 0·49-0·59, p = 0·00001), IDFS (HR 0·68; 95% CI 0·59-0·78, p = 0·00001), ORR (RR 2·87; 95% CI 1·85-4·44, p = 0·0001), and CBR (RR 1·32; 95% CI 1·14-1·52, p = 0·0002), and a non-statistically significant OS (HR of 0·86; 95% CI 0·74-1·01, p = 0·06). Abemaciclib increased the risk of adverse events; cardiovascular events (4·82 times), increased blood creatinine (8·51 times), nausea (1·95 times), vomiting (2·51 times), abdominal pain (2·64 times), decreased appetite (2·59 times), diarrhea (4·20 times), aspartate aminotransferase (AST) (2·15 times), alanine aminotransferase (ALT) (2·28 times), anemia (3·79 times), thrombocytopenia (5·73 times), leukopenia (5·48 times), neutropenia (8·74 times)· However, it showed a reduced risk of arthralgia (0·73 times). CONCLUSION: The combination therapy provides a clinically significant improvement in survival and treatment responses, even though the toxicity is increased but manageable, and requires careful prescription.
Risk factors for postoperative bleeding following breast cancer surgery: a systematic review and meta-analysis.
Yang Z, Qing M, Zhang Y … +1 more , Wu J
Breast Cancer Res Treat · 2025 Dec · PMID 41385105 · Full text
OBJECTIVE: Surgical operation serves as a primary approach for addressing cancer of the breast, but it also has potential complications, including hemorrhaging following surgery. Identifying the risk variables associated...
OBJECTIVE: Surgical operation serves as a primary approach for addressing cancer of the breast, but it also has potential complications, including hemorrhaging following surgery. Identifying the risk variables associated with this problem may assist individuals in stratifying and optimizing their risks. A meta-analysis and comprehensive review was conducted to pinpoint the risk variables associated with postoperative hemorrhaging in breast carcinoma. METHODS: We performed a systematic review and searched through Cochrane Library, PubMed, WoS, Embase, China National Knowledge Infrastructure, and Wanfang. The investigation spanned from the creation of the records until May 2025. A meta-analysis was performed to investigate the risk variables associated with postoperative hemorrhaging in breast carcinoma patients. RESULTS: 8 studies were included, comprising 82,012 patients. A total of 10 risk factors were analyzed. They are mastectomy and axillary lymph node dissection, antithrombotic medication, age ≥ 60 years old, hypertension, and diabetes, chronic pulmonary illness, congestive heart failure, reconstruction and neoadjuvant chemotherapy. These results indicated that among the multiple risk factors included in the analysis, 3 had statistically significant effects on postoperative bleeding following breast cancer surgery: specifically, mastectomy (OR = 1.93,95%CI:1.20-3.09), hypertension(OR = 1.23,95%CI:1.05-1.44), CHF(OR = 2.18,95%CI:1.54-3.08). CONCLUSION: Breast cancer risk factors for postoperative hemorrhage include mastectomy, hypertension and CHF. Understanding the risk factors closely related to postoperative bleeding in breast cancer is helpful for identifying high-risk patients with postoperative bleeding, who can benefit from enhanced prevention and treatment. In the future, more and larger sample size studies are needed to continue to investigate additional indicators of risk for hemorrhaging following surgery in breast carcinoma.
Overview of ocular toxicities associated with breast cancer therapies.
Greenberg MR, Noveihed A, George M
Breast Cancer Res Treat · 2025 Dec · PMID 41364346 · Publisher ↗
INTRODUCTION: Breast cancer remains the most frequently diagnosed malignancy among women worldwide. Advances in treatment with the approval of multiple novel therapeutics have led to significant improvements in long-term...
INTRODUCTION: Breast cancer remains the most frequently diagnosed malignancy among women worldwide. Advances in treatment with the approval of multiple novel therapeutics have led to significant improvements in long-term survival and reduced mortality. Although clinicians are familiar with the more common toxicities linked to targeted therapies, ocular adverse effects often receive less attention. Increasing provider awareness of these potential eye-related toxicities is essential to ensure prompt recognition and timely referral to ophthalmologists for early intervention. METHODS: We reviewed evidence on the prevalence, characteristics, and management of ocular toxicities associated with novel targeted breast cancer therapies. CONCLUSION: This review summarizes the major ocular toxicities linked to targeted therapies used in breast cancer and describes current strategies for their effective clinical management.
Assessing endocrine resistance: monitoring circulating ESR1 mutations in Irosustat-treated ER positive breast cancer.
Page K, Martinson LJ, Hastings RK … +7 more , Acheampong E, Wadsley MK, Allsopp RC, Luo JL, Coombes RC, Shaw JA, Palmieri C
Breast Cancer Res Treat · 2025 Dec · PMID 41364261 · Full text
PURPOSE: We aimed to investigate the prevalence and spectrum of ESR1 mutations alongside cell-free DNA (cfDNA) dynamics in patients with estrogen receptor-positive metastatic breast cancer recruited to the phase II IRIS...
PURPOSE: We aimed to investigate the prevalence and spectrum of ESR1 mutations alongside cell-free DNA (cfDNA) dynamics in patients with estrogen receptor-positive metastatic breast cancer recruited to the phase II IRIS study who had progressed on first-line aromatase inhibitor (AI) therapy and then continued their AI in combination with Irusostat (40 mg), an irreversible steroid sulfatase inhibitor. METHODS: cfDNA was isolated from 96 serial plasma samples from 24 patients, alongside primary tumour DNA (n = 16), and analysed by next-generation sequencing using a custom-designed mutation panel on the Illumina NovaSeq platform. RESULTS: Thirteen of 16 tumour DNA samples harboured at least one somatic mutation across nine genes. Twenty one of the 24 patients (88%) had at least one somatic mutation in cfDNA (248 total mutations across 10 genes). Circulating tumour DNA ESR1 mutations (ctESR1m) were the most prevalent, present in 16 patients (76%) with both stable (SD) and progressive disease (PD), showing no clear association with disease progression. Eleven patients had polyclonal ctESR1m within the ligand-binding domain, six at baseline, while five harboured a single ctESR1m variant. Five other patients acquired polyclonal mutations over treatment. CONCLUSIONS: Analysis of serial plasma samples revealed highly dynamic ctESR1m during AI treatment and frequent detection of polyclonal ctESR1m in patients (both with SD and PD) recruited to the IRIS study. These findings, albeit in a limited sample size, underscore the challenge of targeting a single ESR1 mutation and emphasise the need for careful patient selection, specifically those with wild-type ESR1, in trials investigating sequential estrogen-lowering therapies.
Efficacy and safety of sacituzumab govitecan in patients with metastatic metaplastic triple-negative breast cancer: a multinational retrospective case series from CEBCC-102 study.
Żubrowska J, Pieniążek M, Polakiewicz-Gilowska A … +11 more , Malejčíková M, Holánek M, Soumarová R, Konieczna A, Danielewicz I, Lisik-Habib M, Łacko A, Kubeczko M, Pacholczak-Madej R, Bielčiková Z, Püsküllüoğlu M
Breast Cancer Res Treat · 2025 Dec · PMID 41364253 · Full text
BACKGROUND: Metastatic metaplastic triple-negative breast cancer (mMpTNBC) is a rare, aggressive subtype with poor responsiveness to standard therapies. Sacituzumab govitecan (SG) is effective in metastatic TNBC (mTNBC),...
BACKGROUND: Metastatic metaplastic triple-negative breast cancer (mMpTNBC) is a rare, aggressive subtype with poor responsiveness to standard therapies. Sacituzumab govitecan (SG) is effective in metastatic TNBC (mTNBC), but data in mMpTNBC are limited to case reports. PATIENTS AND METHODS: This multinational, multicenter, retrospective case series was conducted within the CEBCC-102 real-world evidence project across 18 cancer centers. Female patients with histologically confirmed mMpTNBC treated with ≥ 2L SG outside of clinical trials in Poland, the Czech Republic and Slovakia between August 2021 and June 2025 were included. Clinical data, treatment outcomes, and adverse events (AEs) were collected from medical records and analysed. RESULTS: Among 303 patients with mTNBC treated with SG in second and later lines within the CEBCC-102 project, 13 women (4.3%) had mMpTNBC and were included in this analysis. Median age was 58 years. PD-L1 CPS ≥ 10 was found in 83% of tested cases. Overall response rate was 36.4%, clinical benefit rate 45.5%, median progression-free survival 3.2 months and median overall survival 8.9 months. Neutropenia (N = 9, 69%) was the most common AE; no febrile neutropenia or treatment discontinuations due to toxicity occurred. CONCLUSIONS: This first international real-world series of SG in mMpTNBC shows clinically relevant activity and manageable toxicity, addressing a critical evidence gap and supporting further prospective studies, particularly in PD-L1-positive disease.
Prospective validation of the prognostic and predictive impact of uPA/PAI-1 in early breast cancer.
Wieder V, Engel J, Eichstädt K … +14 more , Kaufhold S, Bauer M, Hanf V, Uleer C, Peschel S, John J, Pöhler M, Lantzsch T, Weigert E, Bürrig KF, Buchmann J, Kantelhardt EJ, Thomssen C, Vetter M
Breast Cancer Res Treat · 2025 Dec · PMID 41359204 · Full text
INTRODUCTION: An emerging challenge in early breast cancer (eBC) is improving risk assessment through the use of biomarkers. Clinical guidelines have recommended urokinase-type plasminogen activator (uPA) and its inhibit...
INTRODUCTION: An emerging challenge in early breast cancer (eBC) is improving risk assessment through the use of biomarkers. Clinical guidelines have recommended urokinase-type plasminogen activator (uPA) and its inhibitor PAI-1. This study aimed to validate the prognostic and predictive impact of uPA/PAI-1. PATIENTS AND METHODS: From a prospective cohort of 1270 patients (PiA-study, Prognostic assessment in routine Application, NCT01592825), concentrations of uPA and PAI-1 were determined in fresh tumor tissue (n = 813) by ELISA (FEMTELLE®; LOXO Diagnostics). The uPA/PAI-1 status was defined as low if both uPA and PAI-1 levels were low and as high if one or both were elevated. Primary objectives were the distribution of the uPA/PAI-1 status and its association with clinical/histopathological parameters. Secondary objectives were the association of the uPA/PAI-1 status with recurrence-free interval (RFI), overall survival (OS), and benefit from adjuvant chemotherapy. RESULTS: A low uPA/PAI-1 status was observed in 37.6% (306 of 813) of the entire cohort and in 47.9% (181 of 378) of those classified as intermediate-risk patients (≥ 35yrs, ≤ pN1, G2, sHR positive/HER2 negative). A low uPA/PAI-1 status was associated with parameters that predict a favorable prognosis. Overall, 96.7% (95% CI 94.5-98.9) of patients with a low uPA/PAI-1-status remained recurrence-free at five years and 87.2% (95% CI 84.1-90.3) with a high uPA/PAI-1 status even after adjustment to tumor size, nodal status, grading, steroid hormone receptor (sHR) status and HER2 status (adjusted HR 2.6, 95% CI 1.29-5.23). Among intermediate-risk patients without chemotherapy (n = 197), the prognostic value was even more pronounced (HR 10.10, 95% CI 1.13-16.12). Similar results were observed for OS. Only patients with a high uPA/PAI-1 status appeared to benefit from chemotherapy (adjusted HR 0.28, 95% CI 1.12-0.07, p = 0.07). CONCLUSION: This prospective analysis confirms the uPA/PAI-1 status as an independent prognostic factor and suggests a predictive impact considering benefit from chemotherapy.
The impact of adjuvant chemotherapy on overall survival in premenopausal (age ≤ 50 years) hormone and node positive breast cancer patients with an Oncotype Dx score of 25 or less. A NCDB analysis.
Ashok Kumar P, Ghelani G, Koorapati G … +4 more , Paulraj S, Wang D, Huang D, Sivapiragasam A
Breast Cancer Res Treat · 2025 Dec · PMID 41359180 · Publisher ↗
PURPOSE: The RxPONDER trial showed improved outcomes in premenopausal hormone positive breast cancer (BC) with 1-3 nodes and OncotypeDx (RS) score ≤ 25 with adjuvant chemotherapy (Chemo) use. This study aims to determine...
PURPOSE: The RxPONDER trial showed improved outcomes in premenopausal hormone positive breast cancer (BC) with 1-3 nodes and OncotypeDx (RS) score ≤ 25 with adjuvant chemotherapy (Chemo) use. This study aims to determine whether adjuvant chemotherapy improves survival outcomes in young women (≤ 50 years) with node positive, hormone receptor-positive breast cancer and oncotypeDx score ≤ 25. METHODS: The 2010-2018 National Cancer Database was used to include M0 BC patients aged ≤ 50 years with N1-N3 lymph nodes stages, any T stage, and RS ≤ 25. Kaplan-Meier (KM) and multivariate (MV) propensity score (PS) weighted Cox model was used to compare survival between patients without and with chemo. RESULTS: 8628 women were included of which 3519 (40.8%) received chemo. KM curves showed that chemo use had better survival at 10 years (93 vs 91%) compared to hormonal therapy alone. Hazard Ratio (HR) comparison between the 2 groups favored chemo [0.602(0.482,0.751)]. Subgroup analysis for mortality benefits showed favorable results in Caucasian race [0.512(0.348,0.752)], both age groups of 18-40 years [0.429(0.217,0.847) and 41-50 years [0.585(0.394,0.869)], and RS 12-25 [0.549(0.379,0.795)]. CONCLUSIONS: Based on our analysis, chemo use was noted in 40.8% of young, lymph node + BC patients with an RS score of 0-25. This group of patients had a relative overall survival advantage of around 40% with chemo use, further supporting the findings of the RxPONDER trial. This benefit is of particular significance in patients with a RS of 12-25. The survival advantage was present in all patients less than 50 years, regardless of the age subgroups.
Side effects and adherence trajectories of adjuvant endocrine therapy in breast cancer patients: results from the VICAN2 study.
Radwan E, Memoli V, Seguin L … +2 more , Mancini J, Bouhnik AD
Breast Cancer Res Treat · 2025 Dec · PMID 41359087 · Publisher ↗
PURPOSE: Adjuvant endocrine therapy (AET) lowers breast cancer recurrence risk and improves overall survival. However, some women have suboptimal adherence, mainly due to difficulties coping with side effects. We identif...
PURPOSE: Adjuvant endocrine therapy (AET) lowers breast cancer recurrence risk and improves overall survival. However, some women have suboptimal adherence, mainly due to difficulties coping with side effects. We identified different long-term AET adherence trajectories and investigated associated side effects. METHODS: We used multisource data from the French national VICAN2 study, which interviewed women two years after breast cancer diagnosis. We measured AET adherence using the monthly proportion of days covered (PDC) over 41 months (median) after enrolment in VICAN2. Group-Based Trajectory Modelling (GBTM) helped identify adherence trajectory groups. RESULTS: The 637 women included were categorized into three trajectories: continuous optimal adherence (70.6%), late non-adherence (19.8%), and near-simultaneous discontinuation (9.6%). The most common side effects were hot flashes (78.2%) and joint pain (74.4%). Living alone, always or regularly feeling sad or blue, not receiving chemotherapy, and switching AET were all associated with increased odds of belonging to the near-simultaneous discontinuation group. Younger age (44-54 years), low household income, no contact with a social worker, not receiving chemotherapy, being first prescribed aromatase inhibitors for AET, always experiencing hot flashes, and occasionally experiencing joint pain were all associated with increased odds of belonging to the late non-adherence group. CONCLUSION: This study provides valuable insight into the dynamics of AET adherence patterns and related side effects. Identifying women who experience hot flashes and joint pain two years after diagnosis may strongly predict future non-adherence. Managing these side effects could foster long-term adherence and optimise health outcomes.
Antitumor activity of the combination of vinorelbine and gemcitabine in patients with HR + /HER2- advanced breast cancer after CDK4/6 inhibitor.
Jara P, Ariant M, Jiménez R … +10 more , Bringas M, Herrero B, Echavarría I, Jerez Y, López-Tarruella S, Márquez-Rodas I, Del Monte-Millán M, Massarrah T, de la Peña FA, Martín M
Breast Cancer Res Treat · 2025 Dec · PMID 41348333 · Publisher ↗
OBJECTIVES: To evaluate the clinical benefit of the vinorelbine-gemcitabine every two weeks (VNR-GEMQ2W) regimen in patients with hormone receptor-positive (HR +)/HER2- advanced breast cancer (ABC) treated at a tertiary...
OBJECTIVES: To evaluate the clinical benefit of the vinorelbine-gemcitabine every two weeks (VNR-GEMQ2W) regimen in patients with hormone receptor-positive (HR +)/HER2- advanced breast cancer (ABC) treated at a tertiary care hospital and with previous progression on cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i). STUDY DESIGN: A retrospective analysis was conducted on women treated for HR + /HER2-ABC, with VNR 25 mg/m and GEM 1000 mg/m administered every two weeks between 2019 and 2024 at a single hospital. MAIN OUTCOME MEASURES: Progression-free survival (PFS), overall response rate (ORR), overall survival, and treatment-related adverse events (AEs) evaluated according to CTCAE version 5.0 were retrospectively analyzed. A subanalysis of the data was performed based on major prognostic factors. RESULTS: A total of 53 patients were included, with a median age of 56.70 years. The majority had visceral metastases (81.13%). Patients had received a median of three prior lines of therapy - two lines of endocrine therapy and one line of chemotherapy. The median follow-up time was 28 months [interquartile range 15-34]. The median PFS was 4.27 months (95% confidence interval 3.25-6.34), and ORR was 18.87%. Grade ≥ 3 neutropenia was the most frequent severe AE (10.77%), with no treatment discontinuations due to toxicity. Only one case of grade 2 alopecia was reported (1.88%). CONCLUSIONS: Administering after CDK4/6i and capecitabine, VNR-GEMQ2W regimen shows activity in HR + /HER2- ABC and a manageable safety profile. This regimen should be considered as a potential control arm in the design of future clinical trials targeting HR + /HER2- ABC.
Factors associated with receipt of surveillance breast MRI among racially and ethnically diverse women with operable breast cancer.
Kakani P, Ro V, McGuinness JE … +2 more , Michel A, Crew KD
Breast Cancer Res Treat · 2025 Dec · PMID 41348256 · Publisher ↗
PURPOSE: Due to increased sensitivity for early detection compared to mammography, breast MRI is increasingly used for surveillance screening in women with breast cancer, especially in those diagnosed at a young age or w...
PURPOSE: Due to increased sensitivity for early detection compared to mammography, breast MRI is increasingly used for surveillance screening in women with breast cancer, especially in those diagnosed at a young age or with dense breasts. We investigated factors associated with receipt of breast MRI in women with operable breast cancer. METHODS: Our cohort included women with stage 0-III breast cancer seen at an urban academic medical center from January 2018 to June 2023. We collected demographic and clinical data from the electronic health record. The primary endpoint was receipt of surveillance breast MRI > 1 year after diagnosis. Multivariable logistic regression was used to identify factors associated with breast MRI use. RESULTS: Among 1989 racially/ethnically diverse women, a total of 355 (17.8%) women received at least one surveillance breast MRI. In multivariable analysis, Hispanic and non-Hispanic Black women were less likely to receive surveillance breast MRI than non-Hispanic White women (odds ratio [OR] = 0.44, 95% confidence interval [CI] = 0.31-0.63 and OR = 0.57, 95% CI = 0.38-0.86, respectively). However, compared to women with commercial insurance, women with Medicaid were more likely to receive surveillance breast MRI (OR = 1.57, 95% CI = 1.10-2.25). Results were similar when restricting to women diagnosed under age 50 or with dense breasts. Receipt of breast MRI was associated with smaller breast tumor size at recurrence (p = 0.016). Among women who received breast MRI, 22.5% had a false-positive biopsy compared with 11.5% of women who received mammography alone (p < 0.001). CONCLUSION: Receipt of breast MRI among breast cancer survivors differed by race, ethnicity, and insurance payor mix. These disparities in the use of breast MRI highlight the need for more standardized guidelines surrounding the optimal role of surveillance breast MRI among women with breast cancer, which can inform targeted public health interventions aimed at promoting more equitable screening practices in this population.
Impact of public vs. private insurance coverage on quality of life of women with early-stage estrogen receptor-positive breast cancer.
Laperche-Santos D, Assad-Suzuki D, Resende H … +17 more , Moura FC, Oliveira SCS, Shimada AK, Arakelian R, Galvão ALZ, de Souza BSW, Custodio AGC, de Andrade MCFM, Bittencourt YCRB, Magalhães MCF, de Pádua Souza C, Paiva CE, Signorini PA, Pereira DJ, Nogueira-Rodrigues A, Rosa DD, Barroso-Sousa R
Breast Cancer Res Treat · 2025 Dec · PMID 41348250 · Full text
BACKGROUND: Quality of life (QOL) data for the Brazilian population with breast cancer are scarce. This study aimed to evaluate QOL in Brazilian women with early-stage breast cancer treated with adjuvant endocrine therap...
BACKGROUND: Quality of life (QOL) data for the Brazilian population with breast cancer are scarce. This study aimed to evaluate QOL in Brazilian women with early-stage breast cancer treated with adjuvant endocrine therapy (ET) and to explore its relationship with patients' clinical and social characteristics and type of healthcare insurance. METHODS: We performed a cross-sectional study among women with early-stage estrogen receptor-positive (ER +) invasive carcinoma of the breast in Brazil. Eligible patients who had received locoregional care and had undergone adjuvant ET for more than 6 months were contacted in person during clinic visits. The EORTC QLQ-C30-V3 and QLQ-BR23 scales were used as questionnaires to assess the QOL of patients. RESULTS: From June 2021 to March 2024, 774 women with ER + early-stage breast cancer from 14 Brazilian institutions were contacted. A total of 347 women (44.8%) were treated at private institutions. The mean age was 56.5 years (SD 11.9). The median duration of ET use was 3.2 years (SD, 2.1). Multivariate regression analysis revealed that treatment at a public institution was a significant predictor of higher nausea and vomiting scores (p = 0.042), pain (p = 0.0008), financial difficulty (p < 0.0001), arm symptoms (p < 0.0001), and breast symptoms (p < 0.0001). CONCLUSION: In this cohort, patients treated at public institutions had lower QOL. Younger age (< 60 years), presence of comorbidities, and ovarian suppression associated with ET were key predictors of poor QOL. These findings provide insights for guiding the development of tailored interventions for the Brazilian population.
Comment on "Baseline hemoglobin and neutrophil-to-lymphocyte ratio as prognostic biomarkers in patients with metastatic triple-negative breast cancer treated with sacituzumab govitecan in second line and beyond: a real-world analysis".
Dedeepya SD, Goel V, Desai NN
Breast Cancer Res Treat · 2025 Dec · PMID 41348236 · Publisher ↗
This commentary appraises Pieniążek et al.'s study on hematologic prognostic markers in sacituzumab govitecan-treated mTNBC, emphasizing residual confounding, absent Trop-2 data, limited modeling flexibility, and incompl...
This commentary appraises Pieniążek et al.'s study on hematologic prognostic markers in sacituzumab govitecan-treated mTNBC, emphasizing residual confounding, absent Trop-2 data, limited modeling flexibility, and incomplete handling of missingness. Methodological refinement and integration of biological, longitudinal, and clinical variables are proposed to enhance prognostic accuracy and translational applicability.
Patient perspectives on artificial intelligence in mammography interpretation: a comparative survey study of safety-net and academic hospital settings.
Ogu JC, Ozcan BB, Dogan BE … +2 more , Xi Y, Knippa EE
Breast Cancer Res Treat · 2025 Dec · PMID 41335376 · Publisher ↗
PURPOSE: To evaluate and compare patient perceptions of artificial intelligence (AI) use in mammogram interpretation across academic and safety-net healthcare settings. METHODS: We offered a 29-item survey to patients vi...
PURPOSE: To evaluate and compare patient perceptions of artificial intelligence (AI) use in mammogram interpretation across academic and safety-net healthcare settings. METHODS: We offered a 29-item survey to patients visiting our safety-net (SNH) and academic (ACH) hospital breast imaging clinics between 04/2024-06/2024 and 02/2023-08/2023, respectively. Demographic data was compared between populations using Chi-squared tests. We used ORs (95% CI) to estimate response odds by patient factors. Significant group differences were further analyzed via multivariable regression. RESULTS: A total of 924 [ACH: 518(56.1%), SNH: 406(43.9%)] surveys were collected. Participants from the ACH were older (≥ 70 years: 20%vs3.1%, p < 0.001), mostly identified as Non-Hispanic White (56%vs7.2%, p < 0.001), had higher income (≥ $100,000: 49%vs3.2%, p < 0.001), higher education (≥ college: 71%vs20%, p < 0.001) and higher self-reported knowledge of AI (68%vs56%, p < 0.001) compared to SNH. Use of AI alone or as a second reader was accepted by 74%, with SNH participants being less likely to accept [OR(95%CI): 0.71(0.53-0.96), p = 0.02]. SNH participants were more likely to request a reading by AI following radiologist-interpreted abnormalities [1.83(1.35-2.49), p < 0.001], rate AI as the same or better than a radiologist at detecting cancer [1.54(1.12-2.15), p = 0.01], and have higher concern regarding data privacy [1.87(1.22-2.93), p = 0.01]. Higher education [1.99(1.33-2.99), p < 0.001] and self-reported AI knowledge [1.98(1.38-2.83), p < 0.001] were associated with higher acceptance of AI use, while Non-Hispanic Black race [0.40(0.25-0.65), p < 0.001] was associated with lower acceptance when controlled for other covariates. CONCLUSION: Significant differences exist in patients' views of AI between the demographically distinct academic and safety-net populations. Our study revealed lower educational attainment and Non-Hispanic Black race as independent factors associated with lower acceptance of AI.
Using the cancer aging and research group- breast cancer (CARG-BC) predictive model in older adults (OA) with early breast cancer: an external validation study.
Pathak N, Kimmel A, Berner-Wygoda Y … +6 more , Almuthri SA, Santiago AT, Jin R, Monginot S, Alibhai SMH, Nadler MB
Breast Cancer Res Treat · 2025 Dec · PMID 41326760 · Publisher ↗
PURPOSE: Decision-making for chemotherapy in early breast cancer (EBC) in OA (older adults: age ≥ 65 years) is complex due to frailty, multimorbidity, and competing risks for mortality. Magnuson (2021) developed a chemot...
PURPOSE: Decision-making for chemotherapy in early breast cancer (EBC) in OA (older adults: age ≥ 65 years) is complex due to frailty, multimorbidity, and competing risks for mortality. Magnuson (2021) developed a chemotherapy toxicity prediction score, CARG-BC; its external validation can improve generalizability. OBJECTIVES: CARG-BC's ability to predict grade 3 + chemotoxicity in OA with EBC (primary), unplanned healthcare use, and changes to chemotherapy protocol (secondary). METHODS: A single center retrospective cohort study comprising OA with EBC who received (neo) adjuvant chemotherapy from 2013-2023. Clinical, demographic, CARG-BC, and healthcare usage variables were extracted from patient records. Risk groups based on CARG-BC score were compared using T-test (continuous variables) & χ2 test (categorical variables). Toxicity risk based on CARG-BC score was assessed using logistic regression. The predictive ability of the CARG-BC score was evaluated by calculating AUC. RESULTS: Of 243 patients, the median age was 70 years (range 65-86), 99.6% female, 80.2% with comorbidities, 33.7% with polypharmacy, 28.8% living alone, and 8.2% seen in the geriatric oncology clinic. Over half (53.9%) had grade 3 + toxicities. Healthcare utilization included 19.8% of patients with at least one unplanned clinic visit, 29.6% an emergency care visit, and 14.4% a hospitalization. The median CARG-BC score was 7 (IQR 3, 8) and the CARG-BC AUC was 0.76 (95% Confidence interval [CI] 0.70, 0.82). The odds of grade 3 + toxicity is increased by 1.33 times per CARG-BC point increase. CONCLUSION: The CARG-BC model retained good discrimination for grade ≥ 3 chemotoxicity and should be used in shared-decision-making with OA.
Evaluating post-T-DXd treatment strategies in HER2-positive metastatic breast cancer.
Zelizer S, Gallagher GB, Gonen M … +4 more , Dang C, Modi S, Chandarlapaty S, Drago JZ
Breast Cancer Res Treat · 2025 Nov · PMID 41307769 · Full text
PURPOSE: Trastuzumab deruxtecan (T-DXd) is an antibody drug conjugate (ADC) approved for the treatment of HER2-positive metastatic breast cancer (MBC). Despite its efficacy, eventual resistance and disease progression ar...
PURPOSE: Trastuzumab deruxtecan (T-DXd) is an antibody drug conjugate (ADC) approved for the treatment of HER2-positive metastatic breast cancer (MBC). Despite its efficacy, eventual resistance and disease progression are common, and no prospective studies exist to guide therapy in T-DXd-resistant HER2-positive MBC. METHODS: This retrospective study analyzed patients with HER2-positive MBC who received cancer-directed therapies following treatment with T-DXd at Memorial Sloan Kettering Cancer Center. RESULTS: Eighty-one eligible patients were identified, who received 199 lines of therapy collectively. Post-T-DXd therapies included other ADCs, chemotherapy, HER2-targeted antibodies, hormone-based therapy, tyrosine kinase inhibitors (TKIs), and clinical trials. The median overall survival (OS) after stopping T-DXd treatment was 19 months, with a median progression-free survival (mPFS) of 3.7 months per subsequent treatment line. Chemotherapy was the most common treatment (42% of treatment lines; mPFS 3.4 months). No single therapeutic approach was clearly superior, although subsets of patients appeared to benefit from hormone therapy or TKIs. In a multivariate analysis including treatment type, treatment line, hormone receptor (HR) status, presence of brain metastases, and reason for T-DXd cessation, patients who discontinued T-DXd due to toxicity, rather than disease progression, had significantly better outcomes on subsequent therapy lines (HR 0.35; p < 0.001). CONCLUSION: Our study indicates that patients emerge from T-DXd treatment with highly refractory disease. These findings highlight the urgent need for optimized treatment strategies and novel therapeutic options for this patient population.
Impact of concurrent lobular carcinoma in situ on recurrence outcomes in patients with classic and pleomorphic invasive lobular carcinoma of the breast.
Kaur M, Quirarte A, Vertido A … +4 more , Torosian T, Li TM, Mouabbi JA, Mukhtar RA
Breast Cancer Res Treat · 2025 Nov · PMID 41307765 · Full text
PURPOSE: We investigated outcomes of invasive lobular carcinoma (ILC) with or without concurrent lobular carcinoma in situ (LCIS) in patients with classic or pleomorphic ILC. METHODS: We retrospectively analyzed a single...
PURPOSE: We investigated outcomes of invasive lobular carcinoma (ILC) with or without concurrent lobular carcinoma in situ (LCIS) in patients with classic or pleomorphic ILC. METHODS: We retrospectively analyzed a single-institution database of patients with stage I-III ILC. We compared tumor features, treatment, and recurrence free survival (RFS) in patients with ILC-alone versus ILC + LCIS stratified by ILC tumor subtype. Multivariable Cox proportional hazards models were used for multivariate analysis. RESULTS: Of the 786 cases of ILC, 542 were classic and 92 were pleomorphic, with 70.6% overall having concurrent LCIS. Overall, ILC + LCIS cases were less often T3 (p = 0.037) and had lower rates of N2/N3 disease (p = 0.026) than ILC-alone. Concomitant LCIS was also associated with greater progesterone receptor (PR) positivity (p = 0.016), and was more commonly grade 2 and less often grade 1 compared to ILC-alone (p = 0.008). Treatment differed, with ILC + LCIS cases receiving less chemotherapy (p = 0.016) and more mastectomy (p = 0.015). Among patients with classic ILC, the presence of concomitant LCIS was not associated with different RFS. However, among those with pleomorphic ILC, ILC + LCIS was associated with significantly improved RFS compared to ILC-alone (HR 0.31, 95% confidence interval 0.10-0.96, p = 0.043). CONCLUSION: While the presence of LCIS was not associated with RFS in classic ILC in this dataset, it is a favorable prognostic factor in pleomorphic ILC, suggesting a potentially differential role in ILC subtypes.
High PARP1 expression is associated with proliferative tumor biology in breast cancer.
Ghasemi F, Arima J, Takabe K
Breast Cancer Res Treat · 2025 Nov · PMID 41307731 · Publisher ↗
BACKGROUND: Poly [ADP-ribose] polymerase (PARP) 1 enzyme is vital in DNA repair mechanisms. PARP1 inhibitors are in clinical use due to synthetic lethality in homologous-recombination repair-deficient tumors with germlin...
BACKGROUND: Poly [ADP-ribose] polymerase (PARP) 1 enzyme is vital in DNA repair mechanisms. PARP1 inhibitors are in clinical use due to synthetic lethality in homologous-recombination repair-deficient tumors with germline BRCA1/2 mutations. Given that highly proliferative cancer requires excessive DNA replication and thus repair, we hypothesized that high PARP1 expression is associated with aggressive tumor biology in primary breast cancer regardless of subtype. METHODS: The gene expression profile of the primary breast cancer from 6351 patients from 3 independent cohorts (TCGA, METABRIC and SCAN-B) were analyzed by PARP1 expression. Transcriptomics data were analyzed in different subtypes of breast cancer separately. PARP1 high vs low expression groups was divided by the median in each cohort. PARP1 expression was also compared by response to neoadjuvant chemotherapy in 3 cohorts (GSE173839, GSE20566 and GSE20194). RESULTS: PARP1 expression varied significantly across breast cancer subtypes, with lower expression in hormone-receptor positive (HR +) patients. High PARP1 expression was linked to increased mutation burden, particularly in HR + tumors. It also correlated with increased activity across multiple DNA repair pathways and increased cell proliferation, with enrichment in pathways related to cell cycle. Additionally, high-PARP1 tumors exhibited greater immune cell infiltration, particularly in HR + cases. In neoadjuvant chemotherapy studies, higher PARP1 expression levels were seen in patients with pathologic complete response (pCR) rates after preoperative chemotherapy, especially in HR + subtype. CONCLUSION: Expression of PARP1 gene is associated with aggressive cancer biology, especially in the HR + subtype of breast cancer, and may serve as a biomarker for response to chemotherapy.
Promoting Resilience in Stress Management (PRISM) for women with breast cancer: a qualitative analysis of patient impressions and recommendations.
Ream M, Taub CJ, Rosenbaum AR … +9 more , Olguin EO, Padalkar T, Henderson NL, Shuey J, Yi-Frazier JP, Junkins CC, Reeder-Hayes K, Rocque GB, Rosenberg AR
Breast Cancer Res Treat · 2025 Nov · PMID 41307714 · Publisher ↗
PURPOSE: The Promoting Resilience in Stress Management (PRISM) intervention is a brief, positive psychological skills-based intervention delivered by lay-coaches with demonstrated efficacy at decreasing distress in young...
PURPOSE: The Promoting Resilience in Stress Management (PRISM) intervention is a brief, positive psychological skills-based intervention delivered by lay-coaches with demonstrated efficacy at decreasing distress in young adults with cancer. We recently completed a pilot trial of "PRISM for women with breast cancer" (PRISM-BC) and demonstrated feasibility. Here, we conducted qualitative analyses to better understand the experiences of women who participated in PRISM-BC. METHODS: For this single-armed, pilot study of PRISM-BC, we recruited women who were receiving chemotherapy for any stage of breast cancer. All received the PRISM intervention, including six individual, virtual sessions and access to a companion mobile app for skill practice. Following PRISM completion, participants completed a 30-60-minute semi-structured, qualitative interview. We employed coding reliability thematic analysis to identify themes, with two team members applying codes to ensure satisfactory inter-rater reliability. RESULTS: Women (N=33) were on average 54.1 years old (SD=9.5); most had early stage disease (76%), identified as Black/African American (58%), and downloaded the companion app (70%). We identified four themes: 1) PRISM was helpful due to both new skill acquisition and experiential relevance; 2) The app was helpful to many, but barriers prevented use among some; 3) Both facilitators and barriers to PRISM engagement were present; 4) Opportunities exist to tailor PRISM further to the specific needs of breast cancer survivors CONCLUSION: PRISM was well-received among women with breast cancer. Future work should examine the efficacy of PRISM in larger, controlled trials in breast oncology incorporating suggested modifications (e.g., content around medication adherence).
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe