Breast Cancer Research And Treatment[JOURNAL]
Sun
200 papers
Breast cancer patients treated at a New York City academic health system during the COVID-19 pandemic in 2021 had delayed presentations and more advanced disease than pre-pandemic cases.
Bernik S, Balija TM, Kim D … +12 more , Cuadros A, Jackson D, Lee JH, Kona N, Malhotra S, May ML, Nandwani J, Nevid D, Oladoja K, Mohabbatizadeh B, Moshier E, Port E
Breast Cancer Res Treat · 2025 Nov · PMID 41307593 · Publisher ↗
PURPOSE: The COVID-19 pandemic was associated with a decrease in the incidence of breast cancers in 2020 and was expected to be associated with advanced stage at presentation in the post-pandemic era. The primary objecti...
PURPOSE: The COVID-19 pandemic was associated with a decrease in the incidence of breast cancers in 2020 and was expected to be associated with advanced stage at presentation in the post-pandemic era. The primary objective of this study is to compare stage at presentation and biological tumor characteristics of breast cancers treated before and after the initial phase of the COVID pandemic. METHODS: A retrospective chart review was performed of patients diagnosed with breast cancer within a single New York City health care system between March-August 2019 (pre-pandemic; PP) and March - August 2021 (post- acute phase pandemic; PAP). RESULTS: There were 381 patients with breast cancer in the 2019 PP cohort and 558 patients diagnosed in the 2021 PAP cohort. The PAP cohort was more likely to have a larger median tumor size (16 mm vs 12 mm, p < 0.001) and more tumors > 2 cm at surgery (OR 1.48, p = .048). PAP patients were more likely to have node positive disease at surgery (OR 2.54, p = 0.0003), grade 3 tumors (OR 1.29, p = 0.046) and pathologic stage II or III disease at upfront surgery (OR 2.89, p = 0.003). The PAP cohort was also more likely to have > 24 months since their last imaging test (p < 0.001) and less likely to have their breast cancer detected by screening breast MRI (OR .36, p = .016). CONCLUSION: Breast cancer diagnosed in the post-acute pandemic period had a greater odds of having a > 24-month interval since their last screening mammogram and pathologic stage II & III disease than pre-pandemic patients.
The significance of perioperative glucocorticoids in the prevention of seroma formation after mastectomies: a systematic review and meta-analysis.
Doleviczényi L, Frivaldszky L, Rancz A … +4 more , Fedorcsák DL, Szentes BL, Hegyi P, Klárik Z
Breast Cancer Res Treat · 2025 Nov · PMID 41288819 · Full text
PURPOSE: Seroma formation is one of the most common complications after mastectomy. Seromas can lead to repeated aspirations, increase the risk of infection, and potentially delay oncologic treatment. Several strategies...
PURPOSE: Seroma formation is one of the most common complications after mastectomy. Seromas can lead to repeated aspirations, increase the risk of infection, and potentially delay oncologic treatment. Several strategies have recently been employed to prevent seromas, but there is no definitive standard. We aim to determine whether perioperative glucocorticoids (GC) are safe and effective in preventing seromas in patients undergoing mastectomy. METHODS: We performed a systematic search in five databases on November 12, 2024. Eligible studies included women who underwent mastectomy and received perioperative GCs. Results are reported as risk ratios (RR), odds ratios (OR), or mean differences (MDs) with 95% confidence intervals (CIs), and are presented as forest plots. A random-effects model was used to pool effect sizes. RESULTS: Altogether, 13 studies (12 RCTs and 1 case-control study) with 1011 patients were included; all were eligible for meta-analysis. The rate of seroma formation was significantly lower in the GC groups compared to the placebo groups (RR = 0.56, CI 0.38; 0.82, p = 0,008). Total volume of drainage (MD = -213.36 ml, CI -312.5; -114.22, p = 0.001) and days to drain removal (MD =-3.01 days, CI -4.06; -1.96, p = 0.001) were also lower in the GC groups. The rate of wound infection showed a higher trend in the intervention groups (RR = 1.26, CI 0.82; 1.92, p = 0.224), although the results did not reach statistical significance, CONCLUSIONS: Our results suggest that perioperative glucocorticoid administration may reduce seroma formation in patients undergoing mastectomy. A potential increase in wound infection rates was also observed, but this requires further investigation.
Association between hospital volume and survival in patients with locally advanced breast cancer.
Malhotra S, Choi DX, Sevilimedu V … +2 more , Greenup RA, Tadros AB
Breast Cancer Res Treat · 2025 Nov · PMID 41288803 · Publisher ↗
PURPOSE: Prior studies have shown favorable post-surgical outcomes for patients with breast cancer treated at higher-volume hospitals. However, the impact of hospital volume on the management and outcomes for patients wi...
PURPOSE: Prior studies have shown favorable post-surgical outcomes for patients with breast cancer treated at higher-volume hospitals. However, the impact of hospital volume on the management and outcomes for patients with locally advanced breast cancer (LABC) is unknown. METHODS: This retrospective study included 42,980 patients from the National Cancer Database (NCDB) with LABC treated between 2010 and 2017 at 1306 cancer-accredited centers. Centers were categorized as high-, medium-, and low-volume centers based on the number of patients with LABC seen annually. We assessed the association between hospital volume, receipt of trimodality therapy (TMT), and overall survival (OS), adjusting for demographic, clinical, and treatment variables. RESULTS: High-volume centers treated a median of 18.6 patients (range 15.4, 90.7) per year compared to 8.0 and 2.9 patients at medium- and low-volume centers, respectively. High-volume centers included more academic/research centers; served younger, higher-income, and racially diverse patients; and achieved higher rates of timely (within 60 days of diagnosis) neoadjuvant systemic therapy (NST) initiation and pathologic complete response (pCR) compared to low-volume centers (all P < .001). Treatment at high-volume centers (hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.82, 0.97; P < .001) and receipt of recommended TMT (HR, 0.52; 95% CI 0.50, 0.54; P < .001) were independently associated with improved 5-year OS. CONCLUSION: Higher hospital volume was associated with improved survival outcomes in patients with LABC, influenced by greater adherence to guideline-concordant care. Efforts should focus on enhancing the capacity of low-volume centers to replicate high-volume care standards, addressing access and outcomes for vulnerable populations.
Mesothelin-expressing triple-negative breast cancer: a highly invasive and immunosuppressive subtype.
Zhao Z, Lei H, Wang B … +5 more , Guo L, Gao L, Wang B, Zheng S, Ying J
Breast Cancer Res Treat · 2025 Nov · PMID 41288782 · Publisher ↗
INTRODUCTION: Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer with limited therapeutic options. Mesothelin (MSLN), a tumor-associated antigen with potential targeted drugs, has been r...
INTRODUCTION: Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer with limited therapeutic options. Mesothelin (MSLN), a tumor-associated antigen with potential targeted drugs, has been reported to be positive in some TNBC patients. However, there is a lack of studies on the clinicopathological characteristics of MSLN-expressing TNBC. MATERIALS AND METHODS: We first demonstrated the significance of MSLN through pan-cancer analysis. We utilized local cohort to demonstrated that MSLN is associated with an immunosuppressive microenvironment and patients with high MSLN expression have poorer response to neoadjuvant chemotherapy combined with immunotherapy. Moreover, MSLN-expressing TNBC exhibit extensive lymphovascular tumor thrombi. Furthermore, spatial transcriptomics investigated T1N3-stage TNBC and identified MSLN as a highly expressed target in this aggressive subtype, public single-cell data identified MSLN-expressing tumor sub-cluster and their characteristics. CONCLUSION: This study provides novel insights into the role of MSLN in TNBC and lays the foundation for future therapeutic strategies targeting MSLN in this aggressive breast cancer subtype.
Analysis of factors associated with loco-regional failure in breast cancer patients following neoadjuvant chemotherapy.
Ababneh HS, Naoum GE, Niemierko A … +2 more , Ly A, Taghian AG
Breast Cancer Res Treat · 2025 Nov · PMID 41288781 · Publisher ↗
PURPOSE/OBJECTIVES: For patients undergoing neoadjuvant chemotherapy (NAC), many clinical factors were identified to be associated with failure. Yet, for patients achieving pathologic complete response (pCR), it remains...
PURPOSE/OBJECTIVES: For patients undergoing neoadjuvant chemotherapy (NAC), many clinical factors were identified to be associated with failure. Yet, for patients achieving pathologic complete response (pCR), it remains unknown what factors are associated with any subsequent failures. Our goal is to assess the patterns and predictors of locoregional failure (LRF), distant failure (DF), and invasive disease-free survival (IDFS) post-NAC, with a particular focus on those who achieved pCR. METHODS/MATERIALS: Between 2000 and 2021, we retrospectively reviewed 1115 consecutive patients in a single-institution database following NAC. Multivariable analysis was performed using the Cox proportional hazards model to identify the independent predictors of LRF, DF, and IDFS for the entire cohort and stratified by type of breast surgery. A univariable analysis was conducted to ascertain the independent predictors of any failure (IDFS) among patients who achieved pCR in both the breast and axilla. RESULTS: The median follow-up was 8.0 years [interquartile range: 4.1-12.4 years]. For the entire cohort, the 15-year cumulative incidence rates were 9.7% for LRF and 27.4% for DF, and the 15 year IDFS was 69.6%. The 15-year IDFS rates were 73.6% and 67.2% in breast-conserving surgery (BCS) and mastectomy cohorts, respectively (HR = 0.76, p = 0.03). On multivariable analysis, we found that LVI, ECE, number of malignant LNs post-NAC, triple-negative disease (TNBC), and tumor size were associated with IDFS for mastectomy patients, while achieving pCR in the breast was associated with a decreased risk for any failure. For BCS patients, the number of malignant LNs post-NAC, and TNBC were associated with IDFS, while achieving pCR in the axilla was associated with a decreased risk for any failure. On univariable analysis, we found that cT3-4 vs. cT1-2 pre-NAC was significantly associated with inferior IDFS among patients who achieved pCR in both the breast and axilla (n = 209). Patients with cN0 pre-NAC had a lower, albeit non-significant, risk of IDFS events. In patients with cN-positive disease pre-NAC who achieved pCR in both the breast and axilla (n = 117), RNI or PMRT (n = 95) did not significantly impact IDFS compared to those without RNI or PMRT (n = 22), with a median time to IDFS post-pCR of 7.1 years vs. 7.8 years, respectively. CONCLUSION: We identified predictors of failure in this cohort, including among patients who achieved pCR. The median time to failure after pCR is around 7 years with or without adjuvant RNI/PMRT, highlighting the need to wait for mature results from the B51 trial and warranting further follow-up.
Cardiovascular adverse events associated with denosumab versus zoledronic acid in patients with breast cancer: a propensity score overlap weighted analysis.
Iwai C, Konishi T, Miyawaki A … +4 more , Okada A, Isogai T, Jo T, Yasunaga H
Breast Cancer Res Treat · 2025 Nov · PMID 41288760 · Full text
BACKGROUND: To compare the risks of cardiovascular events, fractures, and all-cause mortality between denosumab and zoledronic acid in patients with breast cancer bone metastases. PATIENTS AND METHODS: We identified fema...
BACKGROUND: To compare the risks of cardiovascular events, fractures, and all-cause mortality between denosumab and zoledronic acid in patients with breast cancer bone metastases. PATIENTS AND METHODS: We identified female patients with breast cancer and bone metastases who received denosumab or zoledronic acid between April 2014 and August 2023 from a nationwide database of routinely collected administrative claims data in Japan. After adjusting for potential confounders using propensity score overlap weighting, we estimated the incidence of outcomes (per 10,000 person-years) and hazard ratios (HRs) using Cox proportional hazards models. RESULTS: Among the eligible 4350 patients, 2953 received denosumab and 1397 received zoledronic acid. The participants' median age was 76 years (interquartile range, 68 to 81). The adjusted incidence of composite cardiovascular disease was 118 in the denosumab group and 152 in the zoledronic acid group (HR 0.80, 95% confidence interval, 0.67 to 0.95). Heart failure was less frequent in patients administered denosumab [65 vs. 92; HR, 0.69 (0.55 to 0.87)] than in those administered zoledronic acid, whereas the rates of stroke and myocardial infarction were similar between the two groups. Denosumab was also associated with lower risks of any fracture [237 vs. 298; HR 0.80 (0.71 to 0.90)], hip (31 vs. 43), vertebral (135 vs. 168), and non-vertebral (114 vs. 142) fractures. Overall, 471 all-cause mortality events occurred in the denosumab group and 610 in the zoledronic acid group [HR 0.75 (0.69 to 0.82)]. CONCLUSION: In patients with breast cancer bone metastases, denosumab was associated with lower risks of cardiovascular events, fractures, and mortality than those with zoledronic acid.
Breast cancer diagnosis at age 85 and older.
Candell L, Foulad D, Wapnir I … +1 more , Tsai J
Breast Cancer Res Treat · 2025 Nov · PMID 41288755 · Publisher ↗
INTRODUCTION: Limited data is available on patients diagnosed with breast cancer at age 85 and older, and there is no consensus on mammographic screening guidelines for older women, including those with a history of brea...
INTRODUCTION: Limited data is available on patients diagnosed with breast cancer at age 85 and older, and there is no consensus on mammographic screening guidelines for older women, including those with a history of breast cancer. We sought to describe characteristics of presentation in this patient population and to determine whether differences exist between older women with a history of breast cancer and those without. METHODS: A retrospective review was conducted of all female patients aged 85 and older who consulted a breast surgeon for a diagnosis of new or recurrent breast cancer. RESULTS: From January 1, 2009 to September 30, 2024, 132 patients with newly diagnosed or recurrent breast cancer were identified. Mean age was 88.3 years (range 85-99). Ninety patients (68.2%) were diagnosed with breast cancer for the first time and the remainder (42; 31.8%) had a history of breast cancer. 57.1% of patients with a history of breast cancer were diagnosed on screening imaging compared to 31.1% with no prior history, who more commonly were diagnosed based on symptoms. In patients with a history of breast cancer, there was a mean time of 14.6 years from index cancer to ipsilateral breast tumor recurrence and 19.2 years from index cancer to contralateral cancer event. DISCUSSION: Roughly one-third of patients had a prior breast cancer and were significantly more likely to be diagnosed on screening studies compared to women who did not have a history of breast cancer. Women without a history of breast cancer were more likely to be symptomatic at the time of diagnosis and more likely to be diagnosed at a later disease stage. In patients with a prior breast cancer, second breast cancer events tended to happen late, which raises the question of how long screening should continue after a breast cancer diagnosis in older patients and whether guidelines should distinguish between those with a prior history of breast cancer and those without.
Worse survival despite indolent features for triple-negative invasive lobular carcinoma: a Swedish nationwide registry-based study.
Nyqvist-Streng J, Chamalidou C, Kovacs A … +1 more , Parris TZ
Breast Cancer Res Treat · 2025 Nov · PMID 41269430 · Full text
PURPOSE: To evaluate differences in clinical outcomes, treatments received, recurrence, and sociodemographic characteristics in patients with triple-negative breast cancer (TNBC) classified as invasive lobular carcinoma...
PURPOSE: To evaluate differences in clinical outcomes, treatments received, recurrence, and sociodemographic characteristics in patients with triple-negative breast cancer (TNBC) classified as invasive lobular carcinoma (TNBC-ILC) or invasive carcinoma of no special type (TNBC-NST). METHODS: Using national registry data, we conducted a retrospective, population-based cohort study of 6449 women diagnosed with primary TNBC (stratified by histological subtype) in Sweden (2007-2021). Clinical and treatment data were analyzed using descriptive statistics, logistic regression, machine learning (Boruta/XGBoost), and Cox proportional hazards models adjusted for patient age, tumor size, grade, nodal status, comorbidities, and receipt of adjuvant chemotherapy (ACT). RESULTS: TNBC-ILC accounted for 2.7% of all TNBC cases and affected older patients (median age 70 vs 62 years). Compared to TNBC-NST, TNBC-ILC had lower Ki-67, fewer high-grade tumors, higher T stage, and greater socioeconomic vulnerability. Machine learning identified age and post-operative tumor size as key predictive features of TNBC-ILC. ACT was administered to 40% of TNBC-ILC versus 59% of TNBC-NST cases (P < 0.001), with a survival benefit observed only in TNBC-NST. TNBC-ILC patients aged 50-64 years were less likely to receive ACT. Despite lower proliferative activity, TNBC-ILC was associated with worse overall (OS; adj-HR 1.39, 95% CI 1.04-1.86) and disease-specific survival (DSS; adj-HR 1.98, 95% CI 1.41-2.79), particularly in patients ≥ 50 years of age. TNBC-ILC patients ≥ 75 years had the poorest 5-year survival (DSS 55%; OS 42%). CONCLUSIONS: TNBC-ILC is a distinct subgroup with older age, lower grade and Ki-67, undertreatment, and poorer survival, emphasizing the need for age- and subtype-specific treatment strategies.
Collateral damage: rhabdomyolysis from concurrent abemaciclib and rosuvastatin use.
Kim TH, Zobi A, Teplinsky E
Breast Cancer Res Treat · 2025 Nov · PMID 41269418 · Publisher ↗
Abstract loading — click title to view on PubMed.
Impact of lymph node status on the prognosis of female breast cancer patients who underwent immediate reconstruction after total mastectomy: a multi-institutional retrospective cohort study.
Xu Q, Li X, Deng X … +2 more , Li M, Zong X
Breast Cancer Res Treat · 2025 Nov · PMID 41269414 · Publisher ↗
PURPOSE: This study aims to evaluate the impact of lymph node status on survival outcomes in female breast cancer patients underwent immediate breast reconstruction (IBR) after mastectomy. METHODS: Data from 8418 cases (...
PURPOSE: This study aims to evaluate the impact of lymph node status on survival outcomes in female breast cancer patients underwent immediate breast reconstruction (IBR) after mastectomy. METHODS: Data from 8418 cases (2010-2017) receiving IBR were divided into regional lymph node negative (LN-) and positive (LN+) groups. Propensity score matching (PSM) was used to balance covariates between groups. Subgroup Cox regression analysis was performed to assess overall survival (OS) and breast cancer-specific survival (BCSS), considering sociodemographic, oncological, and treatment-related factors. RESULTS: Inpatients underwent IBR, the LN+ group exhibited significantly poorer OS and BCSS than the LN- group, both before and after PSM. Higher income, specific tumor characteristics, and implant-based reconstruction were related to better survival outcomes. Subgroup analysis revealed that in LN- group, lower income, HR-, HER2- status, and higher tumor grade were OS/BCSS risk factors. In the LN+ group, advanced T stage independently predicted worse OS/BCSS, and contralateral breast removal was associated with a decrease in OS risk. CONCLUSIONS: Caution is warranted when recommending IBR for patients with N2-3, and implant-based reconstruction may represent a more favorable option in selected cases. LN+ status is a significant adverse prognostic factor in IBR patients. Personalized treatment strategies based on LN status are essential for optimizing survival outcomes.
Racial and ethnic disparities and socioeconomic determinants of male breast cancer mortality in the United States.
Freeman JQ, Schechter K, Nguyen LC … +2 more , Omoleye OJ, Hara JH
Breast Cancer Res Treat · 2025 Nov · PMID 41269413 · Full text
PURPOSE: Male breast cancer (mBC) is rare and accounts for ~ 1% of all breast cancer cases in the United States (US), and mBC incidence has risen in recent years. This study sought to examine mBC mortality disparities ac...
PURPOSE: Male breast cancer (mBC) is rare and accounts for ~ 1% of all breast cancer cases in the United States (US), and mBC incidence has risen in recent years. This study sought to examine mBC mortality disparities across racial/ethnic groups and associated socioeconomic determinants at the national level. METHODS: This retrospective study analyzed the 2010-2021 National Cancer Database. Patients were eligible if they were ≥ 18 years, were male sex, and had stage I-IV disease, with available data on receptor status. Overall survival (OS) was modeled using Cox regression adjusting for demographic, socioeconomic, and clinicopathologic factors. RESULTS: Of 20,470 mBC (mean age, 66.2 [SD, 12.6] years), 2.5% were Asian or Pacific Islander, 13.8% Black, 4.0% Hispanic, and 78.2% White. After controlling for clinicopathologic characteristics, Black patients had worse OS than White patients (adjusted hazard ratio [AHR], 1.22; 95% CI, 1.12-1.32); however, when further adjusting for socioeconomic factors, this difference was no longer significant (AHR, 1.09; 95% CI, 0.99-1.21). Hispanic patients (AHR, 0.76; 95% CI, 0.62-0.94) had a lower mortality risk. OS varied across tumor stages and molecular subtypes. In the triple-negative mBC cohort, Asian or Pacific Islander patients had worse OS than White patients (AHR, 2.35; 95% CI, 1.21-4.55), warranting further investigation. Additionally, lower median household income, lack of health insurance, Medicaid/Medicare, and comorbidities were associated with a higher mortality risk. CONCLUSION: Our findings highlight elevated mortality risks of mBC among Black patients, among Asian or Pacific Islander patients with TNBC, and associations with household income and insurance status. Interventions addressing socioeconomic inequities that impact access to cancer care programs and services may help reduce racial/ethnic disparities and improve mBC survival outcomes.
HER2 testing results, practices, and preferences among pathologists and oncologists in the US community setting: a mixed-methods study.
Collin SM, Lam C, Sredni ST … +7 more , Haji-Noor ZM, Haviland MJ, Okazaki L, Espinal-Dominguez E, Cochran JD, Valladares AF, Tesic-Schnell M
Breast Cancer Res Treat · 2025 Nov · PMID 41269400 · Full text
PURPOSE: To quantify the proportion of HER2-negative metastatic breast cancers with low or ultralow levels of HER2 expression and identify facilitators and barriers to HER2 testing and reporting in US community settings....
PURPOSE: To quantify the proportion of HER2-negative metastatic breast cancers with low or ultralow levels of HER2 expression and identify facilitators and barriers to HER2 testing and reporting in US community settings. METHODS: Analysis of electronic medical record data from a retrospective cohort of patients diagnosed with HER2-negative breast cancer from 2018 to 2023 within the Guardian Research Network, classifying HER2 status by immunohistochemistry (IHC) score. Analysis of responses to surveys of community-based pathologists and oncologists, supplemented by qualitative analysis of one-to-one interview transcripts. RESULTS: The retrospective study identified 13,824 patients diagnosed with HER2-negative breast cancer from seven healthcare organizations, with 13,100 patients included in the final cohort. Patients were classified as HER2 IHC 0 (32%), 1 + (35%), 2 + (18%), and 3 + (1%); 15% of patients did not have a documented IHC score. Surveys and interviews with 63 community-based pathologists and oncologists found that most pathologists (93%) reported discrete IHC scoring on pathology reports, but 16% had difficulty assigning scores between IHC 0 and IHC 1 + . Barriers included inadequate standards, increased interpretation time, and workflow disruptions. Digital pathology was used by 39% of pathologists, with improved accuracy, higher efficiency, and reduced subjectivity stated as advantages, and high costs and lack of practice standards as barriers to adoption. CONCLUSION: While innovative testing tools were viewed favorably by pathologists and oncologists, cost and need for training were barriers to adoption. Improving documentation practices, standardizing protocols, and adopting tools such as digital pathology could enhance the accuracy and consistency of HER2 testing.
Chronic inflammatory diseases and survival among breast cancer patients in the U.S. military health system.
Lin J, Lipkowitz S, Hu H … +3 more , Nealeigh M, Shriver CD, Zhu K
Breast Cancer Res Treat · 2025 Nov · PMID 41269389 · Publisher ↗
PURPOSE: There have been few studies on the relationship between chronic inflammatory diseases and breast cancer outcome. We evaluated the relationship between chronic inflammatory diseases and survival among breast canc...
PURPOSE: There have been few studies on the relationship between chronic inflammatory diseases and breast cancer outcome. We evaluated the relationship between chronic inflammatory diseases and survival among breast cancer patients in the U.S. military health system (MHS), a universal healthcare system. METHODS: The study used the Military Cancer Epidemiology database (MilCanEpi), which linked databases from the Department of War's Central Cancer Registry (CCR) and the Military Health System (MHS) Data Repository (MDR). A total of 33 chronic inflammatory diseases were identified. A time-dependent Cox proportional hazard regression model was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of death associated with chronic inflammatory diseases while adjusting for potential confounders. RESULTS: The final data included 14,258 patients with histologically confirmed primary breast cancer. Among them, 7883 had a diagnosis of chronic inflammatory diseases at or after breast cancer and 6375 had no diagnosis at any time in the data. A diagnosis of chronic inflammatory diseases was independently associated with a significantly increased risk of all-cause death after adjustment for confounders (adjusted HR = 1.76, 95% CI = 1.56-1.98). Notably, the increased risk of death associated with the inflammatory diseases persisted among stage-IV patients who usually died of breast cancer. The association was also observed regardless of age, comorbidity, hormone receptor status, timing of disease diagnosis relative to breast cancer diagnosis, or other characteristics. CONCLUSION: Chronic inflammation, characterized by chronic inflammatory diseases, was independently associated with increased all-cause death among breast cancer patients in MHS. Future research with cancer-specific death as the outcome is warranted.
Adverse effects of scalp cooling for the reduction of chemotherapy-induced alopecia: A systematic review and meta-analysis.
Kearney CA, Brinks AL, Needle CD … +6 more , Adhikari S, Marks DK, Shapiro J, Tattersall IW, Lo Sicco KI, Lacouture ME
Breast Cancer Res Treat · 2025 Nov · PMID 41269388 · Publisher ↗
PURPOSE: Chemotherapy-induced alopecia (CIA) affects approximately 65% of patients receiving chemotherapy and has a negative impact on quality of life (QoL). Scalp cooling (SC) is the only FDA-cleared intervention for CI...
PURPOSE: Chemotherapy-induced alopecia (CIA) affects approximately 65% of patients receiving chemotherapy and has a negative impact on quality of life (QoL). Scalp cooling (SC) is the only FDA-cleared intervention for CIA. This systematic review and meta-analysis evaluated SC adverse events (AEs), reasons for discontinuation, and scalp metastasis incidence. METHODS: Meta-analyses using random-effects models estimated pooled prevalences of SC AEs, SC discontinuation, and reasons for discontinuation. A generalized linear mixed model was used to estimate the incidence of scalp metastasis. RESULTS: Sixty-seven studies met the inclusion criteria. The most common AEs were generalized chills (42%, 95% confidence interval (CI) 26-58%), cap heaviness (35%, 95% CI 18-52%), and headache (30%, 95% CI 21-39%). The SC discontinuation rate was 18% (95% CI 13-23%). The most common reasons for discontinuation were progressive alopecia (15%, 95% CI 10-20%) and reasons unrelated to SC (9%, 95% CI 5-13%). The most frequent AEs leading to SC discontinuation were headache (4%, 95% CI 2-6%), cold intolerance (4%, 95% CI 3-5%), and general discomfort (4%, 95% CI 2-7%). Secondary analysis of scalp metastases yielded an incidence of 0.15% (95% CI 0.05-0.47%). Analysis of FDA Manufacturer and User Facility Device Experience (MAUDE) database medical device reports revealed that user error contributed to cold thermal injuries. Prevalence estimates were limited by significant heterogeneity between studies, reflecting variations in study methodology and real-world SC practices. CONCLUSION: SC is generally well tolerated with minimal safety concerns. Clinical comfort strategies like supportive medications and improved patient education could enhance SC tolerability and support its implementation.
Improving adjuvant endocrine therapy initiation among patients with breast cancer: a nurse-led, culturally sensitive pilot study.
Post KE, Dunderdale L, Datta S … +7 more , Varella L, Horick N, Traeger L, Greer JA, Moy B, Temel JS, Jacobs JM
Breast Cancer Res Treat · 2025 Nov · PMID 41269378 · Publisher ↗
PURPOSE: Up to 30% of patients with hormone receptor-positive (HR +) breast cancer do not start adjuvant endocrine therapy (AET) as prescribed. AET non-initiation is associated with increased recurrence and decreased sur...
PURPOSE: Up to 30% of patients with hormone receptor-positive (HR +) breast cancer do not start adjuvant endocrine therapy (AET) as prescribed. AET non-initiation is associated with increased recurrence and decreased survival. We conducted a single-arm, open-pilot study to assess the feasibility and acceptability of a nurse-led, culturally sensitive intervention ('INITIATE') to optimize AET initiation. METHODS: From 9/2022 to 8/2024, we recruited 35 patients with stage I-IIIB, HR + breast cancer who delayed or reported hesitancy to start AET. INITIATE included two virtual sessions delivered in English or Spanish with an oncology nurse. Feasibility was defined by enrollment rates (> 50% eligible patients), intervention attendance (≥ 70% of patients attending one of two sessions), and retention (> 70% completing the 3-month questionnaire). At baseline, 1 month, and 3 months post-baseline, patients self-reported sociodemographics, AET initiation, intervention acceptability (Client Satisfaction Questionnaire-3), and other psychosocial outcomes. We conducted semi-structured, qualitative exit interviews to gather additional feedback. We computed descriptive statistics for the quantitative outcomes and conducted a rapid qualitative analysis of the interview data. RESULTS: We enrolled 45.5% (35/77) of eligible patients; 82.9% (29/35) attended at least one intervention session, and 77.1% (27/35) completed the 3-month assessment. Most patients (68.6%) were White, and 37.1% identified as a racial or ethnic minority. Qualitatively, patients reported that INITIATE helped them understand the importance of taking AET and improved their coping skills. Ninety-six percent reported high acceptability, and 88.9% started their AET by three months post-baseline. CONCLUSION: INITIATE is mostly feasible and acceptable and demonstrates promise for promoting AET initiation among patients with HR + breast cancer.
Risk prediction models for malignancy upgrade in high-risk breast lesions: a qualitative systematic review.
Dalton JC, Nierenberg TC, Leonard A … +5 more , Liang J, Kaplan S, Wang T, Chiba A, Plichta JK
Breast Cancer Res Treat · 2025 Nov · PMID 41269377 · Publisher ↗
BACKGROUND: Atypical breast lesions are high-risk findings found on some core needle biopsies that may represent concurrent malignancy. Clinical management remains uncertain due to wide variability in reported upgrade ra...
BACKGROUND: Atypical breast lesions are high-risk findings found on some core needle biopsies that may represent concurrent malignancy. Clinical management remains uncertain due to wide variability in reported upgrade rates and an incomplete understanding of contributing risk factors. Risk prediction models have been developed to estimate likelihood of malignant upgrade (from atypia to malignancy), but these models are highly variable in performance and predictor selection. This systematic review evaluates existing models predicting upgrade to malignancy in high-risk breast lesions, focusing on clinical applicability. METHODS: A qualitative systematic review was conducted following PRISMA guidelines. Searches in MEDLINE, Embase, and Scopus identified studies that developed risk prediction models estimating breast malignancy upgrade after atypia diagnosis. Studies analyzing multiple risk factors and providing quantitative risk estimates were included. Extracted data included study characteristics, statistical methods, key predictors, and model performance. Prediction model Risk of Bias Assessment Tool (PROBAST) was used for quality assessment. RESULTS: Of the 3202 studies screened, 17 met inclusion criteria. Sample sizes ranged from 20 to 525, with reported upgrade rates from 14.9 to 67.3%. Common predictors of upgrade included lesion size, histology, and radiologic-pathologic concordance. Discriminatory performance varied (AUROC 0.514-0.909), and calibration was rarely assessed, limiting reliability. Most studies lacked external validation and exhibited a high risk of bias. CONCLUSION: Current risk prediction models for malignant upgrade for high-risk lesions demonstrate significant variability and limitations in widespread use. While they may supplement clinical judgment, further external validation and improved calibration are needed before they can reliably guide management.
Mammary small cell neuroendocrine carcinomas that showed excellent pathologic response following etoposide-based neoadjuvant chemotherapy.
Hammer PM, Enamandram S, Ikeda DM … +7 more , Lam MM, Wapnir IL, Chamberlain ED, Shaheen S, Caswell-Jin JL, Itakura H, Bean GR
Breast Cancer Res Treat · 2025 Nov · PMID 41269341 · Publisher ↗
PURPOSE: Small cell neuroendocrine carcinoma (SCNEC) is a very rare, highly aggressive subtype of breast cancer. There are no standard recommendations for the management of mammary SCNEC, and the use and response to neoa...
PURPOSE: Small cell neuroendocrine carcinoma (SCNEC) is a very rare, highly aggressive subtype of breast cancer. There are no standard recommendations for the management of mammary SCNEC, and the use and response to neoadjuvant chemotherapy are not well studied. Etoposide is an agent not included in guidelines for the management of breast cancer but traditionally used in the treatment of small cell carcinoma of the lung. METHODS: We searched for institutional and consultation cases of breast SCNEC and identified those treated with neoadjuvant chemotherapy. Clinical, pathologic, and genetic findings of two patients with SCNEC of the breast treated with etoposide are described. Additionally, we performed a literature review of all known cases of mammary SCNEC treated with neoadjuvant chemotherapy to date. RESULTS: These two women were the sole patients who underwent neoadjuvant etoposide-based chemotherapy followed by surgery for breast SCNEC at our institution in the past 25 years. Both patients achieved excellent imaging and pathologic responses, with no evidence of residual carcinoma in the subsequent breast excisions. CONCLUSION: Etoposide may be considered as a therapeutic option in the neoadjuvant setting of breast SCNEC. More reports on this very rare breast cancer subtype and response to treatment are needed.
The promise of ctDNA-based, molecularly-driven early switch therapy from PADA-1 to SERENA-6.
Oliveira LJC, Mano MS, Barrios C … +1 more , Dienstmann R
Breast Cancer Res Treat · 2025 Nov · PMID 41269338 · Publisher ↗
PURPOSE: Circulating tumor DNA (ctDNA) enables early detection of ESR1 mutations in hormone receptor-positive, HER2-negative metastatic breast cancer. Building on the PADA-1, the SERENA-6 trial demonstrated significant p...
PURPOSE: Circulating tumor DNA (ctDNA) enables early detection of ESR1 mutations in hormone receptor-positive, HER2-negative metastatic breast cancer. Building on the PADA-1, the SERENA-6 trial demonstrated significant progression-free survival and quality-of-life benefits from ctDNA-guided early endocrine switching before radiologic progression. METHODS: We examine the evolving clinical utility of liquid biopsy in this setting and review evidence from trials evaluating biomarker-guided treatment adaptation. We also compare imaging- versus biomarker-guided strategies. CONCLUSION: This review outlines the key challenges to validating and implementing ctDNA-guided early endocrine switching in routine clinical practice and discusses its potential to reshape monitoring and decision-making in metastatic hormone receptor-positive, HER2-negative breast cancer.
Socioeconomic and ethnic disparities in breast cancer-related lymphedema and quality-of-life after immediate lymphatic reconstruction.
Hassan AM, Hajj JP, Lewis JP … +8 more , Fisher CS, Imeokparia FO, Ludwig KK, Danforth RM, VonDerHaar RJ, Bamba R, Lester ME, Hassanein AH
Breast Cancer Res Treat · 2025 Nov · PMID 41264041 · Full text
PURPOSE: Breast cancer-related lymphedema (BCRL) disproportionately impacts patients facing socioeconomic challenges. The influence of socioeconomic disparities on preventive procedures such as immediate lymphatic recons...
PURPOSE: Breast cancer-related lymphedema (BCRL) disproportionately impacts patients facing socioeconomic challenges. The influence of socioeconomic disparities on preventive procedures such as immediate lymphatic reconstruction (ILR) is unclear. We sought to determine the impact of area deprivation index (ADI) on BCRL incidence and patient-reported outcomes (PROs) following ILR. METHODS: We retrospectively studied consecutive patients who underwent ILR following ALND between 2017 and 2024 across multiple hospitals within a hospital network. Patients were stratified into quartiles based on ADI (Q1 = least deprived, Q4 = most deprived). BCRL prevalence and condition-specific (LYMPH-Q) quality-of-life performance was compared and correlated across quartiles via multivariable regression, including subgroup analysis by ethnicity. RESULTS: We identified 172 patients with follow-up time of 23.1 ± 15.2 months. Patients residing in the most deprived neighborhoods (ADI Q4) demonstrated significantly higher BCRL rates compared to those from less deprived neighborhoods (Q1-3) (16.3% vs. 3.9%; p = 0.006). In multivariable regression, residence in the most deprived neighborhoods remained independently associated with a significantly higher risk of BCRL (OR 5.10, 95% CI 1.30-20.30; p = 0.021). Subgroup analysis revealed that Black patients in the highest ADI quartile reported significantly worse LYMPH-Q function scores (median 62.0 vs 100.0; p = 0.020), compared to Black patients residing in less deprived areas. ADI was not significantly associated with surgical complications or unplanned reoperations. CONCLUSIONS: Neighborhood socioeconomic disadvantage significantly increases BCRL risk following ILR and is associated with significantly worse patient-reported functional outcomes among Black patients. Targeted interventions addressing neighborhood-level factors are critical to mitigate these disparities and ensure equitable outcomes.
Identifying patients most likely to benefit from routine post-operative mammogram after breast-conserving surgery.
Hermann N, Faermann R, Grinin K … +7 more , Sklair-Levy M, Gal-Yam EN, Levanon K, Menes TS, Kaidar-Person O, Balint-Lahat N, Globus O
Breast Cancer Res Treat · 2025 Dec · PMID 41148452 · Full text
BACKGROUND: Routine post-operative mammograms (RPMs) are performed at some institutions after breast-conserving surgery (BCS) in patients who presented with malignant calcifications in order to rule out residual malignan...
BACKGROUND: Routine post-operative mammograms (RPMs) are performed at some institutions after breast-conserving surgery (BCS) in patients who presented with malignant calcifications in order to rule out residual malignancy. However, their clinical utility and optimal application remain uncertain. AIM: To evaluate whether patients diagnosed with breast malignancy due to calcifications on mammography benefit from RPMs after BCS. METHODS: After institutional review board approval, we conducted a retrospective cohort study of patients presenting with malignant calcifications on initial screening mammograms who underwent RPMs at our institution between 2018 and 2022. Patients with positive surgical margins or those who underwent imaging for clinical indications were excluded. Imaging findings, pathology results, and clinical characteristics were analyzed to identify factors associated with residual malignancy. RESULTS: During the study period, 2054 patients underwent BCS, of whom 306 (15%) had a post-operative mammogram within three months of surgery, and 218 fitted the final inclusion category. Suspicious residual calcifications after BCS were identified in 22 of 218 patients (10%), of whom 19 underwent biopsy and 3 proceeded directly to surgery. Residual malignancy was confirmed by biopsy in 9 patients (4%), with a positive predictive value of 41%. Multivariate analysis demonstrated that younger age and the extent of calcifications on preoperative mammograms were independently associated with residual malignancy on RPM. CONCLUSIONS: RPMs were found to be more beneficial for patients aged 50 years or younger, and for patients with extensive calcifications on preoperative mammograms. Tailoring RPM use to these subgroups may improve diagnostic efficiency and reduce unnecessary interventions.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe