The Breast Journal[JOURNAL]
Sun
200 papers
The Impact of Socioeconomic Factors and Racial Disparities on Complications in Breast Conservation Surgery: A Single-Institution Retrospective Cohort Study.
Obaid LN, Zhang JS, Lee GY … +10 more , Bhimani F, Jao SL, Rachofsky C, Coe LG, Cavalli A, Ki M, Lin J, Gupta A, Feldman S, McEvoy M
Breast J · 2026 · PMID 41934150 · Full text
BACKGROUND: Breast conservation surgery (BCS) is considered to be a low-morbidity procedure; however, postoperative complications may adversely affect the quality of life of breast cancer survivors. Social determinants o...
BACKGROUND: Breast conservation surgery (BCS) is considered to be a low-morbidity procedure; however, postoperative complications may adversely affect the quality of life of breast cancer survivors. Social determinants of health have previously been shown to impact postoperative outcomes in various other medical conditions. However, there is a paucity of literature that comprehensively examines the social determinants that impact BCS complications or how race influences specific surgical outcomes. This study thus seeks to address this gap by analyzing the impact of these factors within our diverse patient population in the Bronx. METHODS: A retrospective chart review was conducted that examined patients who underwent BCS between January 2016 and December 2022 at a single institution. Patient information, such as comorbidities, Distressed Communities Index (DCI), BMI, race, insurance status, age, pathology, surgery details, adjuvant therapy, and complications, was collected. Univariate and multivariate analyses were utilized to determine the relationship between these variables and postoperative complications. RESULTS: A total of 627 patients were included in the study. Of these patients, 512 (81.5%) were either Hispanic or African American, 46 patients (7.3%) were White, and 69 (11%) belonged to other races. There was a delay in 37 (6.2%) patients receiving adjuvant therapy. Our study found that higher DCI quintile and higher BMI were associated with a statistically significant increase in overall complication rate (p = 0.044, p = 0.05, respectively). Race had an association with persistent pain (p = 0.003). Former smokers (OR = 3.44, 95% CI [1.419, 8.34], p = 0.0062), hypertensive patients (OR = 3.846, 95% CI [1.13, 13.12], p = 0.0314), and patients who received adjuvant chemotherapy (OR = 2.756, 95% CI [1.117, 6.801], p = 0.0278) had higher odds of developing any complication. Patients who developed any complication were more likely to have a delay in adjuvant therapy than patients who did not have complications (OR = 6.452, CI [2.696, 15.44], p < 0.001). CONCLUSION: BCS is generally a safe procedure with minimal complications; however, patient-specific factors are associated with increased complication rates which can lead to delays in adjuvant therapy. Future studies with larger sample sizes are needed to adequately compare outcomes among minority racial groups to a larger reference population.
Defining Multiple Fibroadenomas: A Systematic Review of Clinical Characteristics and Management.
Math P, Sajith G, Mahadevappa K … +1 more , Hegde SG
Breast J · 2026 · PMID 41919577 · Full text
This review systematically evaluates the published literature on multiple fibroadenomas (MFAs) of the breast, focusing on clinical presentation, diagnostic challenges, and treatment strategies. A systematic search of Pub...
This review systematically evaluates the published literature on multiple fibroadenomas (MFAs) of the breast, focusing on clinical presentation, diagnostic challenges, and treatment strategies. A systematic search of PubMed, Medline, Scopus, and Embase from 1948 to June 2025 was conducted using a Boolean search strategy following the PRISMA 2020 guidelines. Of the 409 studies initially screened, 43 met the inclusion criteria. The level of evidence was assessed using the Oxford Centre for Evidence-Based Medicine guidelines, and 72% were found to be of Levels 4 and 5. MFA most commonly affects adolescents. Bilateral involvement was observed in 64.6% of patients, and more than 10 lesions were present in 52% of cases. Risk factors included hormonal contraceptive use, family history, and cyclosporine therapy. Ultrasonography was the most common diagnostic tool, followed by MRI and FNAC. Treatment was mainly surgical, with recurrence noted in 15.4% of patients. There was no evidence to suggest that the risk of cancer in MFA was greater than that of solitary FA. The review highlights inconsistencies in MFA definitions and calls for consensus on diagnostic criteria, prospective research, and the creation of standardized treatment algorithms to improve care and outcomes for this particularly distressing subset of benign breast diseases.
Lentinula edodes Cultured Extract Intake at Puberty Mitigates Inflammatory Signals at the Mammary Glands by the Involvement of Epigenetic Mechanisms in BALB/c Mice.
Yasavoli-Sharahi H, Shahbazi R, Alsadi N … +6 more , Sahebi NB, Cuenin C, Cahais V, Chung FF, Herceg Z, Matar C
Breast J · 2026 · PMID 41915463 · Full text
Exposure to immune stress or lipopolysaccharide (LPS) during critical developmental stages like puberty may lead to gut microbiome dysbiosis and epigenetic dysregulation in mammary glands, affecting gene expression and p...
Exposure to immune stress or lipopolysaccharide (LPS) during critical developmental stages like puberty may lead to gut microbiome dysbiosis and epigenetic dysregulation in mammary glands, affecting gene expression and potentially elevating breast cancer susceptibility in adulthood. Although LPS's adverse impacts on intestinal and brain functions are well-documented, its effects on mammary glands remain underexplored. Using an immunocompetent BALB/c mouse model, we administered an acute LPS dose (1.5 mg/kg body weight) during puberty. The study evaluated the long-term consequences of LPS exposure alone and combined with AHCC (Lentinula edodes cultured extract, 2 g/kg body weight/day) on DNA methylation patterns, cytokine profiles, and microRNA expression in mammary glands at 9 weeks of age. Analyses included DNA methylation sequencing, multiplex immunoassays, quantitative PCR, and image processing. Pubertal LPS exposure produced persistent molecular dysregulation in mammary glands, including differential DNA methylation (> 5% change vs. control; FDR-adjusted p < 0.05), elevated inflammatory mediators, and altered microRNA expression. Differentially methylated regions were enriched in regulatory features, with decreased methylation at transcription start sites, promoters, and 5' UTRs of genes implicated in mammary development and oncogenic signaling (including Vav3, Pdgfa, Pdgfc, Jag2, Hras, Ksr1, Il2rb, Il17b, and Il17rb) in the LPS group, whereas the AHCC + LPS group exhibited a shift toward hypermethylation at these loci (approximately 5%-10% decrease). Inflammatory profiling showed increased IL-17A/F (∼2-fold vs. control; p < 0.05), while microRNA analyses indicated reduced let-7a/c (∼30% vs. control; p < 0.05). Notably, miR-130a and miR-34a increased ∼1.5-fold across all treatment groups relative to control. Pubertal LPS exposure induces enduring epigenetic and inflammatory changes in mammary glands that may heighten breast cancer risk. AHCC's mitigating role indicates potential for dietary interventions to counteract these effects.
A Five-Year Retrospective Analysis of Neoadjuvant Therapy in Early-Stage Breast Cancer: Subtype Outcomes and Imaging Concordance.
Javed SR, DeSouza K, Tanzim U … +10 more , Ottaviani D, Roylance R, Raja F, Walsh T, Koutoukoglou P, Creed C, McFarlane E, Mathur S, Mahapatra A, Papadimitraki E
Breast J · 2026 · PMID 41913651 · Full text
Although neoadjuvant systemic treatment (NST) is well established in the management of early breast cancer, there are limited clinical data available beyond the highly selected population evaluated in clinical trials. In...
Although neoadjuvant systemic treatment (NST) is well established in the management of early breast cancer, there are limited clinical data available beyond the highly selected population evaluated in clinical trials. In this study, we assessed real-world outcomes of NST in early breast cancer through a retrospective review of 201 patients treated between November 2019 and February 2025. Pathological complete response (pCR) rates were highest in HER2-positive (60.2%) and triple-negative (53.1%) breast cancer subtypes and lowest in those who were identified as oestrogen receptor-positive (ER-positive)/HER2-negative (11.1%). In HER2-positive disease, pCRs were more frequent in ER-negative (75.8%) than ER-positive (50.0%) cases, while pCR rates in triple-negative breast cancer were similar with and without immunotherapy. Baseline positron emission tomography/computed tomography (PET/CT) upstaged 37% (35/94) of patients and showed 87% concordance with pathology, whereas magnetic resonance imaging (MRI) demonstrated a false-negative rate of 17% and a false-positive rate of 1.1%. In these cases, MRI results suggested residual disease despite a complete pathological response, with discrepancies varying by tumour subtype. Forty-two percent of the patients underwent chemotherapy dose reductions; 12% required hospitalisation. NST was effective across aggressive subtypes, with pCR rates comparable to those observed in clinical trials. In summary, our results highlighted the contributions of functional imaging with PET/CT and MRI to staging, treatment response assessments and surgical planning in real-world clinical practice.
"Going Flat" in Nipple-Sparing Mastectomy-An Analysis of Patient-Reported Outcome Measurements of Preliminary 57 Procedures.
Su J, Lee YY, Kao WB … +5 more , Abdul Rauf NH, Hwang BF, Chen CY, See MH, Lai HW
Breast J · 2026 · PMID 41891684 · Full text
BACKGROUND: Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) has become an increasingly popular procedure offering satisfactory aesthetic outcomes with adequate oncologic safety. However, outcom...
BACKGROUND: Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) has become an increasingly popular procedure offering satisfactory aesthetic outcomes with adequate oncologic safety. However, outcomes of NSM without IBR have been rarely evaluated. We aim to assess the clinical outcomes of NSM in patients refusing IBR with a focus on patient-reported outcome measurements. METHODS: This retrospective study enrolled female breast cancer patients who underwent NSM but refused IBR from February 2010 to April 2022 in a single institution. Clinical outcomes and patient-reported aesthetic results were evaluated and analyzed. RESULTS: During the study period, there were 57 cases of primary breast cancer patients who underwent NSM but refused IBR. The mean operative duration was 186.6 min, and median length of hospital stay was 4 days. Median intraoperative blood loss was 30 mL with the median resected specimen weight at 360.5 g. There was no incidence of margin involvement in this study. The complication rate was 12.3% with all of them being minor complications with Clavien-Dindo I and II scores. Locoregional recurrence and distant metastasis during the study period were 5.3% and 1.8%, respectively, with a mean follow-up period of 64.4 months. There was no mortality during the study duration. Aesthetic outcomes assessed via the BREAST-Q questionnaire were satisfactory with mean scores ranging between 35.1 and 68.4. CONCLUSION: This study concludes that NSM in patients refusing IBR is an alternative compared to conventional mastectomy with acceptable aesthetic outcomes. These findings underscore the importance of individualized patient choices in breast cancer treatment.
The Effect of Breast Cancer and Breast Self-Examination Health Education on Awareness, Beliefs, and Practices of Female Students at the Faculty of Health Sciences of a University in Somalia.
Altunkurek ŞZ, Yeşilyurt E, Hassan Mohamed S
Breast J · 2026 · PMID 41885785 · Full text
BACKGROUND AND AIMS: Breast cancer is the most common malignancy among women globally, and early detection remains the cornerstone of reducing mortality. In low-resource settings such as Somalia, limited access to mammog...
BACKGROUND AND AIMS: Breast cancer is the most common malignancy among women globally, and early detection remains the cornerstone of reducing mortality. In low-resource settings such as Somalia, limited access to mammography and diagnostic services makes breast self-examination (BSE) an important awareness practice. This study aimed to assess the effect of an educational intervention based on the health belief model (HBM) on Somali female university students' knowledge, beliefs, and practices related to breast cancer and BSE. METHODS: A randomized controlled study was conducted among 86 female undergraduate students enrolled at the Faculty of Health Sciences, University of Health Sciences, Mogadishu, Somalia, between September 2021 and June 2022. Participants were randomly assigned to an intervention group (n = 43) or a control group (n = 43) using the sealed opaque envelope method. Data were collected through a structured questionnaire including a sociodemographic form and the Champion's Health Belief Model Scale (CHBMS). The intervention group attended a structured 90-min HBM-based breast health education session delivered by two public health lecturers, while the control group received no education during the study period. Three months after the intervention, posttest data were collected from both groups. Statistical analyses were performed using descriptive and inferential tests, with significance set at p < 0.05 (two-tailed). RESULTS: The mean age of participants was 20.3 ± 1.63 years. Postintervention, the intervention group showed significant improvements in knowledge of breast cancer and BSE (p < 0.001), perceived benefits (p = 0.02), health motivation, and self-confidence in performing BSE (p < 0.001). The frequency and correct practice of BSE also increased significantly after 3 months (p < 0.001). CONCLUSION: HBM-based breast health education improved students' knowledge, awareness, and BSE practice. Although BSE is not a screening tool, it is an essential awareness method in settings with limited access to diagnostic services.
Treatment Outcomes of Lobular Granulomatous Mastitis: Impact of Hyperprolactinemia, Diabetes, and Erythema Nodosum-Insights From a 7-Year Cohort Study.
AkbariRad M, Sheybani F, Firoozi A … +5 more , Sajjadi S, Emadzadeh M, Kazerani M, Ataei Azimi S, Mottaghi M
Breast J · 2026 · PMID 41871228 · Full text
BACKGROUND: This study presents our observations on the management and follow-up of patients diagnosed with lobular granulomatous mastitis (LGM) in a cohort study. Additionally, characteristics associated with a longer d...
BACKGROUND: This study presents our observations on the management and follow-up of patients diagnosed with lobular granulomatous mastitis (LGM) in a cohort study. Additionally, characteristics associated with a longer disease course, as well as treatment challenges in patients with erythema nodosum, diabetes, and hyperprolactinemia, would be discussed. METHODS: From 2015 to 2021, a total of 246 consecutive LGM patients referred to the internal medicine clinic of Ghaem teaching hospital, Mashhad, Iran, were enrolled. Regular assessments were conducted every 3 months until complete symptom resolution. Treatment responses were categorized into five groups: complete resolution, incomplete resolution, resolution with subsequent relapse, no significant improvement, and treatment cessation, with all data meticulously recorded. Telephone follow-ups were conducted with all patients at the end of the study in December 2022. RESULTS: A total of 156 episodes were analyzed. Prednisone was administered to 136 patients, while oral methotrexate (MTX) was prescribed to 48 cases. The median age of the cohort was 33 years (interquartile range [IQR], 29-38). Of those on prednisone, 57 (41.9%) achieved complete resolution, with 15 (11%) experiencing subsequent relapse, 33 (24.3%) showing no significant improvement, and 31 (19.9%) discontinuing treatment. Among the MTX recipients, 23 (47.9%) achieved complete resolution, while one showed incomplete resolution. Over the median follow-up of five years (IQR, 4-6), 139 (89.1%) reported complete resolution, nine (5.8%) showed incomplete resolution, and 8 (5.1%) remained symptomatic. The median disease duration was 18 months (IQR, 7-36). Abscess formation during treatment correlated with prolonged disease duration (p < 0.04), and higher plasma prolactin levels were associated with extended disease duration (p = 0.001). However, the disease course did not significantly differ in diabetic cases or those with erythema nodosum compared to others. CONCLUSIONS: Although more than half of LGM patients experienced no significant improvement, recurrence, or discontinued treatment on prednisone or MTX, however, over a median follow-up of 5 years, approximately 90% of LGM patients achieved complete resolution within a median course of 18 months. The presence of abscesses during treatment and elevated plasma prolactin levels was linked to longer disease duration.
Exploring the Application of Contrast-Enhanced Ultrasound in ACR BI-RADS 4A Lesions (≤ 2 cm): A Prospective Multicenter Study in China.
Xiao X, Zhang W, Luo X … +10 more , Peng Y, Zheng Y, Zhou Q, Hu Q, Zhu Y, Zhang H, Li Y, Zhou Q, He W, Luo B
Breast J · 2026 · PMID 41823355 · Full text
PURPOSE: To assess the added diagnostic value of contrast-enhanced ultrasound (CEUS) in differentiating small breast lesions initially categorized as ACR BI-RADS 4A. MATERIALS AND METHODS: A total of 1595 patients with s...
PURPOSE: To assess the added diagnostic value of contrast-enhanced ultrasound (CEUS) in differentiating small breast lesions initially categorized as ACR BI-RADS 4A. MATERIALS AND METHODS: A total of 1595 patients with small breast lesions (≤ 20 mm) from 37 tertiary hospitals were enrolled from August 2021 to August 2022. B-mode ultrasound, color Doppler, and CEUS were performed to evaluate the lesions. The integration of CEUS led to the reclassification of BI-RADS 4A lesions into three pathways: upgrade to 4B, downgrade to 3, or no change in category. The diagnostic performance of CEUS was evaluated, and the contrast modes which could be used to correctly downgrade or upgrade BI-RADS 4A lesions were explored. RESULTS: A total of 1340 lesions were finally included in the analysis of CEUS performance. The average age of all included participants was 43 ± 8 (range from 20 to 84). The average diameter of the lesions was 12.4 ± 3.8 mm (range from 5 mm to 20 mm). The diagnostic performances of CEUS + BI-RADS were 98.3% for sensitivity, 81.7% for specificity, 34.1% for positive predictive value, 99.8% for negative predictive value, and 83.1% for overall accuracy, respectively. The sensitivity was slightly downgraded (98.3% vs. 100%, p = 0.1555), while the specificity and accuracy were greatly elevated (p < 0.05). The receiver operating characteristic curve (ROC) value was calculated using a binary classification threshold, with BI-RADS 3 as low-risk and BI-RADS 4A as high-risk. The area under ROC was 0.896 (95% CI: 0.878, 0.911) for BI-RADS + CEUS. The decision curve analysis showed that using CEUS + BI-RADS to guide biopsy decisions provided net benefit compared to the default strategy of biopsying all lesions. CONCLUSION: The addition of CEUS allows for the correct downgrading of most benign BI-RADS 4A lesions, thereby avoiding unnecessary biopsies. An upgrade from BI-RADS 4A to 4B on CEUS warrants immediate biopsy to ensure prompt diagnosis and treatment. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2100050719.
Recurrence Rate Following Breast Conservation Surgery: A Retrospective Cohort Study.
Wang L, Yuan Y, Jain U … +1 more , Kleidi E
Breast J · 2026 · PMID 41821351 · Full text
BACKGROUND: Breast-conserving surgery (BCS) has become the standard treatment for early-stage breast cancer, offering oncological safety, better breast aesthetics, and enhanced health-related quality of life. The optimal...
BACKGROUND: Breast-conserving surgery (BCS) has become the standard treatment for early-stage breast cancer, offering oncological safety, better breast aesthetics, and enhanced health-related quality of life. The optimal margins for BCS have been debated. However, evidence on the impact of margin widths greater than 0 mm for invasive breast cancer remains limited. Cambridge Breast Unit (CBU) has adopted a policy where a single margin of < 1 mm (not at ink) for invasive disease would be acceptable, provided the other three radial margins are ≥ 1 mm. METHOD: Retrospective cohort study analyzed 372 women who underwent BCS for invasive breast cancer at CBU between 2015 and 2016. Patients with pure ductal carcinoma in situ (DCIS), prior breast cancer treatment, or neoadjuvant chemotherapy were excluded. Clinical data, including patient demographics, tumor characteristics, margin status, and recurrence and survival outcomes, were extracted from electronic records. RESULTS: At a median follow-up of 5.2 years, the ipsilateral breast tumor recurrence (IBTR) rate was 1.6% (6/372) with an overall recurrence rate of 5.6% (21/372). No significant association was found between final resection margins and local or overall recurrence rates, nor was margin status correlated with breast cancer recurrence-free survival. A total of 53 patients (14.2%) required additional surgeries due to margin status. By accepting a single radial margin < 1 mm, our margin policy reduced reoperations by 33%. CONCLUSION: Margin assessment in breast surgery is multifaceted, requiring a personalized approach that considers tumor biology, systemic treatments, and pathological variability. Our findings support accepting a margin width of < 1 mm (no tumor on ink) for a single radial margin in invasive breast cancer, provided the other three radial margins are ≥ 1 mm. It reduces reoperations without compromising oncological outcomes. Integrating advanced intraoperative techniques and multidisciplinary decision-making will further optimize patient care and long-term outcomes.
Evaluation of Shoulder Mobility After Breast Reconstruction With a Lipofilled Latissimus Dorsi Mini-Flap: A Prospective Cohort Study.
Carelli BC, Bagnoli F, Rocha EMC … +2 more , Rinaldi JF, de Oliveira VM
Breast J · 2026 · PMID 41810155 · Full text
BACKGROUND: The lipofilled latissimus dorsi mini-flap (LDMF-L) broadens autologous breast-reconstruction options, yet its functional impact on the shoulder remains uncertain. OBJECTIVE: To evaluate shoulder strength, ran...
BACKGROUND: The lipofilled latissimus dorsi mini-flap (LDMF-L) broadens autologous breast-reconstruction options, yet its functional impact on the shoulder remains uncertain. OBJECTIVE: To evaluate shoulder strength, range of motion (ROM) and patient-reported upper-limb function QuickDash 90 days after breast reconstruction with the LDMF-L. METHODS: Prospective cohort of 20 patients operated on between November 2022 and November 2024. Inclusion: Breast cancer requiring immediate or delayed reconstruction with LDMF-L; exclusion: Implant use or major pre-existing limitation. Strength (Oxford scale), ROM (goniometry) and QuickDASH score were assessed preoperatively and at 90 days. Wilcoxon, Student's -test, Mann-Whitney and McNemar tests were used appropriately ( = 0.05). RESULTS: Mean age 54 ± 11.8 years; immediate/delayed reconstruction = 50/50%. Strength remained unchanged in 85% ( = 1.000). Active flexion and abduction showed significant reductions ( = 0.016 and 0.045), with no difference in rotations. QuickDASH increased from 8 ± 16 to 19 ± 24 ( = 0.008); nevertheless, 80% stayed within minimal/mild disability. CONCLUSIONS: The LDMF-L preserves strength and produces only mild early ROM decreases with limited functional impact, supporting its functional safety as an implant-free autologous option.
Understanding Disparities in Breast Reconstruction Rates in Regional Populations Following Oncologic Resection of Breast Cancer: A 10-Year Retrospective Observational Cohort Study.
Jansson SM, Austin CJ, Liu M … +1 more , Craig SJ
Breast J · 2026 · PMID 41810154 · Full text
INTRODUCTION: Breast cancer is the most common cancer among women globally, with 2.3 million new cases in 2020. Globally, incidence rates of breast cancer are highest in Australia, yet only 29% of Australian women opt fo...
INTRODUCTION: Breast cancer is the most common cancer among women globally, with 2.3 million new cases in 2020. Globally, incidence rates of breast cancer are highest in Australia, yet only 29% of Australian women opt for breast reconstruction (BR). The decision-making process for BR is complex, involving various surgical and nonsurgical considerations. Approximately 50% of women would choose BR if adequately informed and given the option. This study evaluates the factors contributing to reduced BR rates in regional and rural New South Wales over a 10-year period. METHODS: A multicentre, retrospective observational cohort study analysed 2052 women who were diagnosed with breast cancer in the Illawarra Shoalhaven Local Health District between 2012 and 2022, focussing on primary resection outcomes and other objective factors that contributed to BR rates. Descriptive statistics, chi-squared tests and logistic regression were used to assess relationships between age, comorbidities, language and rurality, with reconstruction rates. RESULTS: Among the 2052 women diagnosed with breast cancer who required oncologic resection, the mean age was 65 years. Only 127 (6.2%) underwent BR across the total cohort of 2052 patients, and just 65 of the 724 (9%) patients in the post-mastectomy subgroup underwent BR, significantly lower than state averages. Significant relationships were found between age and reconstruction rates ( < 0.001), with younger patients (< 55 years old) more likely to opt for BR. Logistic regression confirmed that increased age and rurality both significantly affected the likelihood of undergoing reconstruction. CONCLUSION: Women aged < 55 years old and those residing in metropolitan areas showed a higher likelihood of opting for BR, highlighting the influence of age and rural residency on access to reconstruction services. These findings emphasise the need for targeted interventions to enhance BR access, particularly for older and rural patients.
Symptom Clusters in Brazilian Women With Stage I and Stage III Nonmetastatic Breast Cancer: A Cross-Sectional Study.
Lopes-Júnior LC, Minarini EJCDS, Pessanha RM … +9 more , Neto LCBS, D'Agostini NS, Grassi J, Vasconcellos KA, Silva RJG, de Azevedo LB, Giacomin LM, Enriquez-Martinez OG, Grippa WR
Breast J · 2026 · PMID 41777643 · Full text
BACKGROUND: Breast cancer is the most commonly diagnosed malignancy among women worldwide and a leading cause of cancer-related morbidity. As treatment advances have improved survival rates, symptom management has become...
BACKGROUND: Breast cancer is the most commonly diagnosed malignancy among women worldwide and a leading cause of cancer-related morbidity. As treatment advances have improved survival rates, symptom management has become a key component of comprehensive cancer care. Cancer-related symptoms often present in clusters rather than in isolation, potentially amplifying patient discomfort and negatively impacting quality of life. Identifying stage-specific symptom cluster patterns may provide critical insights for developing personalized supportive care strategies. This study aimed to identify and compare the prevalence, intensity, and discomfort of symptom clusters in women with Stage I and Stage III nonmetastatic breast cancer. METHOD: This cross-sectional study included 87 women aged > 18 years with histopathological diagnoses of Stages I-III breast cancer, undergoing any phase of antineoplastic treatment at an oncology hospital in Brazil. Symptoms were assessed using the Memorial Symptom Assessment Scale (MSAS). The bootstrap resampling method was used to estimate 95% confidence intervals (CIs) for prevalence ratios (PRs) of MSAS symptoms, stratified by cancer stage. Symptom clusters were identified using hierarchical and k-means clustering analyses. RESULTS: Among Stage I patients, the most prevalent symptoms were pain (68.6%), worrying (62.8%), difficulty sleeping (62.8%), and fatigue (60.8%). In Stage III patients, the most frequent symptoms were pain (72.0%), fatigue (66.7%), worrying (63.9%), and dry mouth (50.0%). Stage I patients had a higher prevalence of difficulty concentrating (PR = 1.50; = 0.015), shortness of breath (PR = 1.51; < 0.001), feeling sad (PR = 1.41; = 0.002), and hair loss (PR = 1.60; = 0.037) compared to those with Stage III disease. Four clusters were identified for Stage I patients-neuropsychological, gastrointestinal, neurocognitive, and psychological-and for Stage III patients-psychoneurocognitive, gastrointestinal, chemotherapy-related, and neurocognitive. CONCLUSION: These findings highlight the heterogeneity of symptom experiences in women with nonmetastatic breast cancer, with distinct cluster profiles emerging at different disease stages. Understanding stage-specific symptom patterns may inform more personalized and targeted supportive care strategies to improve quality of life and clinical outcomes in this population.
OGT-Mediated O-GlcNAcylation Stabilizes c-Myc Activity and Promotes Chemoresistance in Triple-Negative Breast Cancer.
Li J, Zhang J
Breast J · 2026 · PMID 41767044 · Full text
The transcription factor c-Myc is often overexpressed in chemotherapy-resistant triple-negative breast cancer (TNBC). c-Myc function and stability are considered key factors regulating chemoresistance. Recent studies hav...
The transcription factor c-Myc is often overexpressed in chemotherapy-resistant triple-negative breast cancer (TNBC). c-Myc function and stability are considered key factors regulating chemoresistance. Recent studies have revealed a potential link between the O-linked β-N-acetylglucosamine modification (O-GlcNAcylation) of c-Myc and its function and stability; however, the underlying mechanisms remain unexplored. This study aimed to investigate the role of O-GlcNAcylation in promoting chemoresistance and to explore the underlying mechanisms. A cisplatin (DDP)-resistant MDA-MB-231 cell line was established using a dose escalation. CCK-8, flow cytometry, and colony formation assays were used to evaluate cell resistance under different treatments. Western blotting and coimmunoprecipitation analyses were performed to evaluate the expression of c-Myc and its O-GlcNAcylation under different conditions. The possible O-GlcNAcylation sites were predicted using DictyOGlyc 1.1. Inhibition of O-linked N-acetylglucosamine transferase (OGT) significantly suppressed colony formation and promoted apoptosis of DDP-resistant cells. c-Myc expression was downregulated when OGT-mediated O-GlcNAcylation was inhibited. Additionally, OGT interacted with c-Myc, promoting its stability at the Thr58 residue. Mutation of Thr58 not only resulted in lower c-Myc stability, reduced colony formation ability, and increased apoptosis but also resulted in a decrease in both the total expression and O-GlcNAcylation of c-Myc. Therefore, O-GlcNAcylation at Thr-58 regulates c-Myc activity to promote chemoresistance of TNBC cells.
Axillary Recurrence After a Negative Sentinel Lymph Node Biopsy (SLNB) for Initial Positive Node Breast Cancer Postneoadjuvant Therapy: Insights From a Systematic Review and Meta-Analysis.
Alghamdi MA, Deshpande H, Maksoud WMAE … +9 more , Amri FSA, Bawahab MA, Abbas KS, Dalboh A, Alzahrani HA, Alshandeer MH, Bosaily AJM, Fayed HM, Alghamdi IA
Breast J · 2026 · PMID 41742963 · Full text
BACKGROUND: Despite the use of sentinel lymph node biopsy (SLNB) to stage the axilla in clinically node-negative breast cancer patients' postneoadjuvant therapy, the incidence and clinical significance of axillary recurr...
BACKGROUND: Despite the use of sentinel lymph node biopsy (SLNB) to stage the axilla in clinically node-negative breast cancer patients' postneoadjuvant therapy, the incidence and clinical significance of axillary recurrence (AR) after a negative SLNB remain under-explored in the literature. Understanding these factors is essential to improving patient outcomes and guiding future treatment strategies. METHODS: We conducted a systematic review and meta-analysis using PubMed, Scopus, ScienceDirect, and Google Scholar. A random effects model was used to calculate pooled incidence of AR, while heterogeneity was assessed using the I and Q-statistics. Publication bias was evaluated with a funnel plot and Egger's test. We performed all analyses using the R meta and metafor packages. RESULTS: A total of 37 studies were included in the qualitative synthesis and meta-analysis. The pooled analysis of these studies highlights a remarkably low incidence of AR, with an overall proportion of 1% (95% CI: [0.0%, 1.0%]) under a random-effects model and no significant heterogeneity ( = 0%, = 0.95). Egger's test for publication bias was conducted to assess the presence of funnel plot asymmetry in the meta-analysis, indicating no significant evidence of publication bias (-value = 0.6074, -value = 0.5436). CONCLUSION: The meta-analysis demonstrated a remarkably low incidence of AR after a negative SLNB in initially node-positive breast cancer patients postneoadjuvant therapy. These findings suggest that such recurrences are rare, supporting the reliability of SLNB in accurately staging the axilla. This highlights its importance in clinical decision-making for treatment strategies.
Rising Breast Cancer Incidence and Poor Outcomes in Young Women: A Retrospective Study.
Den J, Nelson N, Vaghjiani R … +2 more , Tyler D, Klimberg VS
Breast J · 2026 · PMID 41742962 · Full text
BACKGROUND AND AIMS: Recent studies suggest a rise in breast cancer (BC) among young women. We analyzed BC incidence patterns among women aged 18-40 in the TriNetX network from 2014 to 2023, stratifying by age, race, and...
BACKGROUND AND AIMS: Recent studies suggest a rise in breast cancer (BC) among young women. We analyzed BC incidence patterns among women aged 18-40 in the TriNetX network from 2014 to 2023, stratifying by age, race, and ethnicity. We also examined mortality and local recurrence (LR) in women aged 18-40 diagnosed with primary BC. METHODS: This retrospective study used data from the TriNetX network. Female patients aged 18-40 were identified, and the incidence proportion of primary BC from 2014 to 2023 was assessed using the TriNetX Incidence and Prevalence Analytics function, with stratification by age, ethnicity, and race. A second cohort of women aged 18-40 with a primary BC diagnosis was created to evaluate mortality and LR over the same period. All analyses were descriptive. RESULTS: Among the 18,250,987 women aged 18-40 years in the TriNetX network, the incidence proportion of BC increased from 635 cases in 2014 to 4475 in 2023. White women accounted for the greatest number of BC cases; however, increasing incidence proportions were also observed among American Indian/Alaskan Native (AI/AN), Asian, and Native Hawaiian/Pacific Islanders (NHPIs) women over the last four years. Non-Hispanic women initially had higher incidence proportions but were surpassed by Hispanic women in 2022. Among 38,683 women aged 18-40 with primary BC, both mortality (0.09%-0.851%) and LR (0.3%-2.9%) increased over the study period. CONCLUSION: Within the TriNetX network, BC incidence proportion among women aged 18-40 demonstrated an upward trend from 2014 to 2023, particularly among non-Hispanic White women 30-39 years old. An uptrend was also seen in young AI/AN, Asian, NHPI, and Hispanic women. In addition, increased documented mortality and LR were also observed. These findings underscore the importance of further research to understand these trends and develop diagnostic and therapeutic approaches tailored to younger patients.
Mastitis and Mammary Abscess Management Audit (MAMMA): A Survey of Patients' Perspective on the Management of Mammary Abscesses in the UK.
Patel R, Courtney A, Jiwa NE … +3 more , Bakri NAC, Paterson S, Leff DR
Breast J · 2026 · PMID 41710250 · Full text
BACKGROUND: The recent Mastitis and Mammary Abscess Management Audit demonstrated widespread variation in the management of breast abscesses across the United Kingdom (UK), with up to one-fifth undergoing surgical draina...
BACKGROUND: The recent Mastitis and Mammary Abscess Management Audit demonstrated widespread variation in the management of breast abscesses across the United Kingdom (UK), with up to one-fifth undergoing surgical drainage rather than image-guided needle aspiration. The impact of these practices on patient's perspective and quality of life is unclear. This study aimed to assess patients' experiences following breast abscess treatment, focusing on treatment modality, cosmesis, breastfeeding and quality of life. METHODS: A cross-sectional online survey was conducted between February and August 2024, aimed at UK-wide adult women with a history of breast abscess. Descriptive and thematic analyses were performed using SPSS and NVivo software, with multiple imputation for missing data. RESULTS: Of 172 participants, half underwent needle aspiration (50.58%), while 23.84% received surgical incision and drainage. Among those undergoing surgery, 68.29% reported prolonged wound healing, 85.37% experienced permanent scarring and a significant negative impact on their breast appearance ( = 0.029). Breastfeeding was disrupted in 58.12%, and 40.17% were unable to resume breastfeeding following treatment. Amongst participants who underwent surgery, 36.5% reported negative impacts on sexual well-being, 31.7% on mental health, and 24.4% on self-confidence. Thematic analysis revealed two major themes: repercussions of the treatment and issues with provision of care, highlighting delays in diagnosis, inadequate breastfeeding support, and negative cosmetic outcomes. DISCUSSION: This study is the first to investigate patients' experiences of breast abscess management, highlighting significant variability in practice and the association of worse cosmetic and breastfeeding outcomes with surgical treatment. Standardisation of care and improved patient counselling may improve patient experience and outcomes.
Efficacy and Tolerability of Methotrexate for Idiopathic Granulomatous Mastitis: A Systematic Review and Meta-Analysis.
Han Y, Shi L, Zhang Y
Breast J · 2026 · PMID 41694557 · Full text
BACKGROUND: Idiopathic granulomatous mastitis (IGM) is a challenging inflammatory breast disease with limited standardized treatment guidelines. METHODS: This meta-analysis systematically evaluated the efficacy and safet...
BACKGROUND: Idiopathic granulomatous mastitis (IGM) is a challenging inflammatory breast disease with limited standardized treatment guidelines. METHODS: This meta-analysis systematically evaluated the efficacy and safety of methotrexate (MTX) in IGM, pooling data from observational studies. We assessed complete remission rates, recurrence rates, and severe side effects leading to MTX discontinuation using both common and random effects models, accounting for heterogeneity. RESULTS: Nine studies were included. In analyses without control groups, the pooled complete response rate for MTX was 61.6% (95% CI: 40.4-79.2%), with significant heterogeneity ( = 81.4%). Combination therapy showed a higher complete response rate in the common effect model (78.0%, 95% CI: 71.4-83.3%) compared to monotherapy (46.6%, 95% CI: 34.2-59.3%), though this difference was not significant in the random effects model. The overall pooled proportion of severe side effects leading to MTX discontinuation was low at 1.23% (95% CI: 0.40-3.74%) in the common effect model and 0.51% (95% CI: 0.03-9.37%) in the random effects model, with no significant heterogeneity. In controlled studies, MTX showed no significant difference in complete remission compared to steroid-containing controls. CONCLUSION: Based on a pooled complete response rate of 61.6%, MTX appears to be an effective and well-tolerated treatment for IGM, though substantial heterogeneity exists in uncontrolled studies.
Identifying Disparities in Timely Receipt of Radiation After Breast-Conserving Surgery.
Reyes N, Ortega C, Mendiola A … +4 more , Murray M, Fenton A, Brett-Morris A, Mangira C
Breast J · 2026 · PMID 41641173 · Full text
INTRODUCTION: Radiation therapy after breast-conserving surgery reduces local recurrence and improves survival. The new standard set forth by the Commission on Cancer (CoC) requires that radiation be initiated in less th...
INTRODUCTION: Radiation therapy after breast-conserving surgery reduces local recurrence and improves survival. The new standard set forth by the Commission on Cancer (CoC) requires that radiation be initiated in less than or equal to 60 days of definitive surgery for patients receiving breast-conserving surgery for Stages I-III breast cancer who do not undergo adjuvant chemo or immunotherapy. Timely access to radiation is critical, and yet there still exists a modest number of patients who experience delays in the initiation of radiation. We aim to highlight this disparity at our institution and identify the socioeconomic factors that contribute to it. METHODS: Using the Breast Cancer Registry, we conducted a retrospective analysis of women diagnosed with Stages I-III breast cancer, who underwent breast-conserving surgery between 2011 and 2021. Women who received chemotherapy were excluded. We stratified patients based on socioeconomic and other factors and examined which factors attributed to an increased interval from surgery to initiation of radiation greater than the current standard of 60 days. RESULTS: A cohort of 427 women meeting the inclusion criteria was identified. Most patients received adjuvant radiation within the new standard of 60 days from definitive surgery (72.4%). However, patients of White race were significantly more likely to receive adjuvant radiation within 60 days of final surgery (74.7%) compared to patients of Black race (55.6%). In addition, patients with private insurance or Medicare were more likely to receive adjuvant radiation within the current set standard (74.9% and 74.5%, respectively) in comparison to patients with Medicaid (50.0%). CONCLUSION: This analysis identifies disparities in breast cancer treatment among minority populations at our institution. It also suggests that insurance status can affect the receipt of treatment in a recommended time frame. There is research that shows a delay in radiation impairs survival. These results indicate that improving access to timely adjuvant radiation may be leveraged to lessen disparities experienced by minority races regardless of insurance status.
Hoffman's Exercise for Breastfeeding Support Among Postnatal Mothers With Nipple Defects: A Scoping Review and Exploratory Meta-Analysis.
Lacey H, Jain N, King ICC
Breast J · 2026 · PMID 41641172 · Full text
BACKGROUND: Hoffman's exercise is a widely promoted nonsurgical technique to assist breastfeeding among postpartum mothers with inverted or flat nipples. Prior reviews have suggested benefit but did not account for diffe...
BACKGROUND: Hoffman's exercise is a widely promoted nonsurgical technique to assist breastfeeding among postpartum mothers with inverted or flat nipples. Prior reviews have suggested benefit but did not account for differences in effect by comparator, nor did they distinguish between-group from within-group change. This limits clinical guidance and planning for rigorous trials. AIM: To present an analytic discussion that is comparator-aware, separates effect types, and foregrounds uncertainty; clarifying what the literature can credibly support and highlighting gaps in study design and reporting standards. DISCUSSION: Across a small and heterogeneous evidence base ( = 10 studies), the quality of primary studies was critically low. This limited the appropriateness of definitive synthesis using meta-analytic methods. Nonetheless, acknowledging the risk of estimate inflation, we still conducted an exploratory, hypothesis-generating analysis. Stratification by comparator suggested a possible benefit versus routine care, but no clear advantage against the inverted syringe technique. Within-group pre-post improvements were common yet remained noncausal and vulnerable to confounding. Coupled with our wide prediction intervals and high risk of bias, these findings suggest that confident claims of effectiveness maybe premature in this population. CONCLUSIONS AND RECOMMENDATIONS: Current evidence neither supports strong effectiveness claims for Hoffman's exercise nor warrants abandoning the technique outright. Clinically, we suggest offering the exercise as part of a broader lactation-support bundle rather than presenting it as a stand-alone, proven or validated intervention. More robust data are needed to determine the clinical effectiveness of the technique.
Adolescent Girls' Breast Self-Examination Practices in Eastern Region of Ghana.
Sagoe S, Clottey PT, Kwakye IN … +5 more , Lamptey E, Sagoe S, Degley TA, Nukpezah RN, Adom-Fynn D
Breast J · 2026 · PMID 41625211 · Full text
BACKGROUND AND AIMS: Breast cancer incidence is rising globally, including in Ghana, making early detection vital. Breast self-examination (BSE) is key to reducing morbidity and mortality. This study assessed BSE practic...
BACKGROUND AND AIMS: Breast cancer incidence is rising globally, including in Ghana, making early detection vital. Breast self-examination (BSE) is key to reducing morbidity and mortality. This study assessed BSE practices among adolescent girls in Ghana's Eastern Region to inform prevention efforts. METHODS: A cross-sectional design was adopted, and the simple random sampling strategy was used to recruit 385 female students from Aburi Girls' Senior High School. Data were collected using a structured questionnaire covering demographic information, BSE knowledge, and practices and were analyzed using SPSS Version 21. Descriptive statistics were used to summarize the data, while Pearson's correlation assessed the association between knowledge and practice. Logistic regression was performed to determine the predictive effects of demographic variables on BSE practice. RESULTS: Participants demonstrated moderate to high knowledge of BSE with mean scores ranging from 1.00 to 1.92, with strongest awareness of palpation techniques (mean = 1.92, SD = 0.272) but lower understanding of positional and visual inspection methods. Most respondents (67.3%) knew how to perform BSE, yet only 25.2% adhered to monthly timing guidelines. Hands (75%) and mirrors (25%) were commonly used, with 41.3% performing both palpation and observation. Knowledge and practice were positively correlated ( = 0.149, = 0.003). Logistic regression identified age, educational level, knowing someone with breast cancer, and workshop attendance as significant predictors of BSE practice ( < 0.001). CONCLUSION: Educating adolescent girls on breast cancer and proper BSE practices is essential. Targeted interventions can strengthen knowledge and skills among young Ghanaian women, supporting early detection and broader prevention efforts.
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