The Breast Journal[JOURNAL]
Sun
200 papers
Tyrer-Cuzick Lifetime Risk Is Not Associated With Non-BRCA1/2 Pathogenic Variants for Breast Carcinoma.
Rao D, Wernecke C, Baron L … +8 more , Cai S, Beitsch P, Patel R, Whitworth P, Rosen B, Tran NN, Hughes K, Baron PL
Breast J · 2026 · PMID 41568159 · Full text
BACKGROUND: The Tyrer-Cuzick (TC) or IBIS risk calculator is a widely used tool to estimate the probability of developing breast cancer. The latest version incorporates various factors to assess the risk of breast cancer...
BACKGROUND: The Tyrer-Cuzick (TC) or IBIS risk calculator is a widely used tool to estimate the probability of developing breast cancer. The latest version incorporates various factors to assess the risk of breast cancer, including family history, personal history, breast density, and past medical history. The TC is commonly used to guide patients toward further diagnostic imaging, genetic testing, chemoprevention, or risk-reducing surgery. However, it is unclear whether the TC is associated with non-BRCA1/2 pathogenic variants (PVs) in breast cancer susceptibility genes. METHODS: A population of 964 patients with TC was evaluated for 12 PVs and variants of unknown significance (VUS) using lab-agnostic genetic testing. Patients were enrolled from 2019 to 2022. Historical TC were used for the subgroup of patients who developed breast cancer after enrollment. TC scores were compared between the three patient cohorts that had BRCA gene mutations, non-BRCA PVs, and negative for PVs, using the Kruskal-Wallis test followed by pairwise comparison using DSCF adjustment for multiple comparisons. Data collection for patient cohorts occurred simultaneously and was only separated in analysis. Logistic regression was carried out to predict BRCA versus negative in a model with TC scores, as well as non-BRCA versus negative. Area under the receiver operating characteristic (ROC) curve (AUC) was calculated to assess model fit. RESULTS: This study found an average TC of 7.71%. A family history of cancer was noted in 78.30% of patients, and a personal history of cancer other than breast occurred in 20.74% of patients. The presence of PVs and VUS was evaluated, and 12.03% of patients were found to have a PV, with an average TC of 8.98%. The most common PVs were CHEK2, BRCA2, BRCA1, and BARD1. Out of those with PVs, 52% had non-BRCA1/2 PVs with an average TC of 5.47%. A total of 102 patients (10.58%) had a VUS, with an average TC of 8.29%. In further statistical analysis, TC were distributed significantly differently among the three groups, with differences observed between the BRCA group and negative group, as well as between BRCA and non-BRCA1/2 PVs group. A higher TC was also associated with BRCA1/BRCA2 variants compared to non-BRCA1/2 PVs. CONCLUSION: TC scores provide valuable information regarding the lifetime risk of an individual of developing breast cancer. However, the study found they were not associated with prediction of non-BRCA1/2 PVs. When choosing a genetic testing panel for breast cancer genes, TC is not as a reliable predictor on individual patient's family history, NCCN guidelines, or ASBrS guidelines. Our study supports the need to develop a genetic risk calculator that incorporates the predictive value for these non-BRCA1/2 PVs in otherwise low or average TC women.
Expression Characteristics of PAX7 and Its Prognostic Correlation in Breast Cancer.
Silafu B, Huang J, Aizezi X
Breast J · 2026 · PMID 41532150 · Full text
OBJECTIVE: To conduct a thorough analysis of public databases to investigate the expression patterns of the PAX7 gene in breast cancer. METHODS: We gathered gene expression data, clinical details, immunohistochemistry im...
OBJECTIVE: To conduct a thorough analysis of public databases to investigate the expression patterns of the PAX7 gene in breast cancer. METHODS: We gathered gene expression data, clinical details, immunohistochemistry images, and genomic information from breast cancer patients through various public databases, such as TCGA, THPA, GEPIA, and cBioPortal. To analyze differential expression, we used the limma package. We assessed the relationship between PAX7 and clinical characteristics using chi-square tests and Fisher's exact tests. For survival analysis, we employed Kaplan-Meier survival curves and Cox regression models to evaluate prognostic factors. Furthermore, we conducted functional clustering analysis to explore the roles of related genes. The MCPcounter and TIMER packages were utilized for analyzing immune infiltration, while statistical computations and visualizations were carried out using the R programming language and its associated packages. RESULTS: The expression levels of PAX7 in breast cancer tissues were significantly higher than normal tissues. Survival analyses showed that patients with high PAX7 expression had notably lower overall survival, disease-specific survival, and progression-free survival, establishing PAX7 as an independent prognostic factor. Assessments of immune infiltration demonstrated a significant relationship between PAX7 and the levels of Th2 cells, TReg, and TFH. Additionally, Clustering analysis of PAX7 genes showed enrichment in cell division, chromosome regions, and pathways like the cell cycle. CONCLUSION: PAX7 was highly expressed in cancer tissues and had a notable impact on patient survival. Furthermore, it was identified as an independent prognostic factor, with related genes being enriched in various biological processes.
Information Needs and Preferences of Men With Breast Cancer: A Qualitative Analysis of Internet Forum Posts.
Schemmel N, Lauberger J, Lühnen J … +1 more , Steckelberg A
Breast J · 2026 · PMID 41524023 · Full text
BACKGROUND AND AIMS: Sex-/gender-specific health information for men with breast cancer is lacking. Health information supports patients in shared decision-making. When developing evidence-based health information, it is...
BACKGROUND AND AIMS: Sex-/gender-specific health information for men with breast cancer is lacking. Health information supports patients in shared decision-making. When developing evidence-based health information, it is important to identify the patients' information needs and preferences with regard to age, sex or gender, and other diversity aspects, including how the content is provided for the target group. However, studies show that sex/gender differences have rarely been considered. Our study investigates the information needs and preferences of cisgender men with breast cancer. METHODS: A content-structuring, qualitative content analysis of forum posts was performed. Internet forums and posts were selected according to the following criteria: relevance of the topic, English or German language, and public availability without registration. A qualitative content analysis according to Kuckartz was conducted. The selected posts were coded using MAXQDA. RESULTS: A total of 1025 posts from three Internet forums were screened, and 96 posts were included for analysis-most of them from a German Internet forum. We identified seven main categories and 26 subcategories. Information needs and preferences are represented by the following main categories: "Epidemiology and general questions about the disease," "Diagnostics," "Therapy," "Physician specialist services," "Rehabilitation and lifestyle adaption," and "Mental health." Additionally, the "Preference for and access to current information" plays a role for the patients. CONCLUSIONS: Our study provides new insights into the information needs and preferences of men with breast cancer, mainly from German-speaking countries. Providing accurate and reliable health information that meets patients' needs and preferences is an ethical duty and has to be provided by healthcare systems. Such patient-centered and inclusive health care will empower patients to make informed decisions.
Nerve Grafts in Breast Reconstruction: A Narrative Review.
Shen Y, Zhang J, Liu Y … +1 more , Cai H
Breast J · 2025 · PMID 41497795 · Full text
Breast reconstruction post-mastectomy restores breast aesthetics and significantly enhances patients' self-confidence and psychological well-being. However, despite the effectiveness of current breast reconstruction tech...
Breast reconstruction post-mastectomy restores breast aesthetics and significantly enhances patients' self-confidence and psychological well-being. However, despite the effectiveness of current breast reconstruction techniques in restoring the aesthetic appearance of the breast, many patients continue to experience the loss of breast sensation following surgery, particularly the loss of nipple sensitivity, which significantly impacts postoperative quality of life. To address this issue, the use of nerve grafting techniques in breast reconstruction is increasingly being recognized and explored. This review summarizes the research progress of nerve grafting in breast reconstruction, highlighting its clinical applications, technical challenges, and future directions.
Predictive Value of Pyroptosis Markers (NLRP3, HMGB1, and Caspase-1) in the Prognosis of Patients With Metastatic Breast Cancer: A Prospective Observational Study.
Zhang Y, He Y, Liu Q … +1 more , Deng H
Breast J · 2025 · PMID 41479846 · Full text
OBJECTIVE: The predictive value of serum pyroptosis markers, including NOD-like receptor family pyrin domain containing 3 (NLRP3), high mobility group box 1 (HMGB1), and caspase-1, in metastatic breast cancer (MBC) patie...
OBJECTIVE: The predictive value of serum pyroptosis markers, including NOD-like receptor family pyrin domain containing 3 (NLRP3), high mobility group box 1 (HMGB1), and caspase-1, in metastatic breast cancer (MBC) patients was investigated. METHODS: A prospective observational study was conducted, enrolling MBC patients who had not undergone prior radiotherapy or chemotherapy. Serum levels of pyroptosis markers (NLRP3, HMGB1, and caspase-1) and conventional tumor markers, including carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), and cancer antigen 15-3 (CA15-3), were measured using enzyme-linked immunosorbent assay (ELISA) kits. Demographic and clinical data were collected, including age, tumor size, hormone receptor status, and metastatic sites. Patients were followed up for 24 months, and overall survival (OS) was recorded. RESULTS: The study included 122 MBC patients, categorized into the favorable and poor prognosis groups based on 24-month survival. Elevated levels of NLRP3 and HMGB1 were significantly associated with poor prognosis, whereas lower levels of caspase-1 were observed in patients with unfavorable outcomes. Receiver operating characteristic (ROC) curve analysis demonstrated that pyroptosis markers, particularly caspase-1, had significant predictive value for MBC prognosis. Kaplan-Meier curves showed that patients with high HMGB1 levels had a shorter 24-month OS, whereas those with low caspase-1 levels also exhibited a shorter 24-month OS. Multivariate logistic regression analysis identified tumor diameter, Ki67, molecular subtype, number of metastatic sites per patient, and HMGB1 were independent risk factors for poor prognosis in MBC patients, whereas caspase-1 was an independent protective factor against poor prognosis. CONCLUSION: Serum pyroptosis markers (HMGB1 and caspase-1) were valuable prognostic indicators in MBC patients. Elevated HMGB1 levels, along with reduced caspase-1 levels, were associated with poorer outcomes.
PMAIP1 Enhances DNA Damage and Induces ROS-Mediated Mitochondrial Dysfunction to Suppress Tumorigenesis in Triple-Negative Breast Cancer.
Shang F, Xu L, Liu H … +6 more , Dong X, Wu H, Yin L, Yan L, Qi Y, Zhao L
Breast J · 2025 · PMID 41476687 · Full text
BACKGROUND: PMAIP1 (NOXA) is a pro-apoptotic factor that is closely related to cancer development, but its role in triple-negative breast cancer (TNBC) is unclear. This study aimed to explore the effect of PMAIP1 on TNBC...
BACKGROUND: PMAIP1 (NOXA) is a pro-apoptotic factor that is closely related to cancer development, but its role in triple-negative breast cancer (TNBC) is unclear. This study aimed to explore the effect of PMAIP1 on TNBC cell viability, apoptosis, DNA damage, and mitochondrial function. METHODS: qRT-PCR and western blot were used to detect the expression level of PMAIP1 in TNBC tissues and cells, and its biological role was evaluated in combination with MTT, TUNEL, comet assay, and mitochondrial function indicators (ROS, ATP, mtDNA, and JC-1). RESULTS: PMAIP1 is significantly upregulated in TNBC and is negatively correlated with cell viability: Overexpression of PMAIP1 inhibits cell viability, while knockdown of PMAIP1 enhances viability. Upregulation of PMAIP1 promotes apoptosis by increasing the Bax/Bcl-2 ratio, induces DNA damage, elevates ROS levels, and reduces ATP, mtDNA, and JC-1 levels, leading to mitochondrial dysfunction; conversely, knockdown of PMAIP1 alleviates these changes. CONCLUSION: PMAIP1 exerts a tumor suppressor effect by regulating apoptosis, DNA damage, and mitochondrial dysfunction, providing potential target support for the treatment of TNBC.
Fear of Cancer Recurrence Contributes Largely to Patient Anxiety and Depression and Quality of Life in a Prospective Cohort of Chinese Breast Cancer Patients for Postoperative Radiotherapy.
Li Z, Liu Y, Li Y … +7 more , Shang Y, Zhang J, Ji X, Zhao Z, Duan X, Geng W, Yin J
Breast J · 2025 · PMID 41446440 · Full text
BACKGROUND: Fear of cancer recurrence (FCR) is common among Chinese breast cancer (BC) patients following surgery, chemotherapy, and radiotherapy (RT). Understanding the prevalence and impact of FCR, particularly during...
BACKGROUND: Fear of cancer recurrence (FCR) is common among Chinese breast cancer (BC) patients following surgery, chemotherapy, and radiotherapy (RT). Understanding the prevalence and impact of FCR, particularly during the RT period, on anxiety, depression, and quality of life may inform strategies to manage patient distress. METHODS: From July 2015 to December 2016, 486 women undergoing RT for BC at the Fourth Hospital of Hebei Medical University, China, were prospectively enrolled in the study. Anxiety, depression, and quality-of-life changes were assessed using the Hospital Anxiety and Depression Scale (HADS) and the European Organization for Research and Treatment of Cancer's Quality-of-Life questionnaires (QLQ-C30, QLQ-BR23) before and after RT. FCR was assessed using a modified question from the QLQ-BR23, which demonstrated the satisfactory construct validity and reliability in a prior pilot study. ANOVA, multivariate linear regressions, and ordinal logistic regressions were performed to evaluate odds ratio (OR) and values. Pain and sleep disturbance were included as covariates in secondary models. RESULTS: Of the 486 women enrolled, 23 (4.7%) patients declined participation. Of the 463 analyzed patients, the mean age was 47 years old. 386 patients (83.4%) elected for mastectomies. FCR levels prior to RT were reported as "" (29.4%), "" (51.2%), "" (12.1%), and "" (7.3%). Increased FCR severity was associated with elevated median anxiety score (1.5, 5.0, 7.0, 8.5) and increased rates of clinically significant anxiety (anxiety score ≥ 11; 0%, 3.4%, 12.5%, 26.5%). Similarly, median depression scores (2.0, 4.0, 6.0, 6.5) rose with FCR severity, accompanied by higher prevalence of atypical depression (depression score ≥ 11; 2.2%, 3.4%, 5.4%, 17.7%) (all < 0.001). Compared to the reference " each unit increase of FCR severity was independently associated with one category ("," "," and "") of increased anxiety with OR () of 2.593 ( = 0.011), 5.889 (), and 14.621 () and increased depression with OR () of 2.406 (), 3.045 (), and 7.210 (), respectively. FCR severity was negatively associated with most quality-of-life domains ( < 0.05). Similar associations persisted post RT. CONCLUSIONS: FCR is a significant contributor to psychological distress and reduced quality of life among Chinese breast cancer patients during the RT period. Routine screening for anxiety and depression and targeted intervention for FCR should be prioritized in this population.
Effectiveness of Duct Excision Procedures in Detecting Preneoplastic and Malignant Lesions in Pathological Nipple Discharge: A Retrospective Cohort Study.
Ata B, Karadağ V, Çetin K
Breast J · 2025 · PMID 41438122 · Full text
BACKGROUND AND AIMS: Nipple discharge ranges from benign to pathological, indicating inflammation or epithelial proliferation. In 5%-28% of cases, pathological nipple discharge (PND) may indicate breast carcinoma. Our ob...
BACKGROUND AND AIMS: Nipple discharge ranges from benign to pathological, indicating inflammation or epithelial proliferation. In 5%-28% of cases, pathological nipple discharge (PND) may indicate breast carcinoma. Our objective was to evaluate the detection rates of malignant and high-risk lesions (HRL) in patients undergoing major duct excision (MDE) and microductectomy for diagnostic purposes due to PND and to assess the need for re-excision in malignancies. METHOD: Patients diagnosed with PND between October 2015 and December 2023 underwent duct excision procedures after physical, imaging, and histopathological examinations, if necessary. Patients with malignancies detected by histopathological evaluation underwent oncological procedures and were excluded from the study. RESULTS: Among 118 patients, 80 underwent microductectomy and 38 underwent MDE. Intraductal lesions (ILs) were detected in 62% of cases, with higher detection rates in the microductectomy group (69% vs. 47%, < 0.03). Of these lesions, 23 were classified as HRL (24% in the microductectomy group vs. 11% in the MDE group, = 0.09). Malignancy was detected in 16 patients (13.6%), with a higher rate in the MDE group (18% vs. 11%, = 0.3). Five patients required re-excision for clear surgical margins, with no significant difference between the groups (microductectomy: = 2; MDE: = 3, = 0.3). CONCLUSION: The malignancy detection rate was slightly higher in the MDE group; however, this difference was not statistically significant. Similarly, there was no significant difference in the need for re-excision. Microductectomy, which preserves lactation function, may be preferred for premenopausal individuals or those considering future pregnancies when clinical presentation supports single-duct involvement. The differing distribution of IL and HRL between procedures reflects the pathology associated with their respective clinical indications rather than a difference in diagnostic performance.
Adherence to Aromatase Inhibitor Therapy in Breast Cancer: Insights From a Multicenter Italian Study.
Fabbri MA, Fulvi A, Vergati M … +22 more , D'Auria G, Vici P, Filomeno L, Arcuri T, Palazzo A, Nelli F, Fiore C, Portarena I, Falbo PT, Rossi R, Alesini D, Sini V, Pace R, Frittelli P, Corsi DC, Palombi L, Pisegna S, Botticelli A, Scagnoli S, Pistillucci G, Giordani E, La Cesa A
Breast J · 2025 · PMID 41438121 · Full text
BACKGROUND: In estrogen-receptor positive breast cancer (BC), oral adjuvant endocrine therapy (ET) administered for at least 5 years significantly reduces risks of disease recurrence and mortality. Among available therap...
BACKGROUND: In estrogen-receptor positive breast cancer (BC), oral adjuvant endocrine therapy (ET) administered for at least 5 years significantly reduces risks of disease recurrence and mortality. Among available therapies, aromatase inhibitors (AI) showed high efficacy. However, adherence to ET is very poor. Effective support by physicians requires the identification of factors influencing AI treatment adherence. MATERIALS AND METHODS: A prospective/retrospective multicentric study was conducted in adult BC women currently undergoing adjuvant treatment with AI. Study endpoints were assessed through a questionnaire after at least 12 months of adjuvant therapy. The primary objective was the assessment of the adherence to AI; secondary objectives were the assessment of adverse events (AEs) of the therapy and the solutions adopted for AEs. RESULTS: Overall, 903 patients with a median age of 63 years were enrolled. Two hundred and forty-three patients (26.9%) stated they do not respect the intake times. Adherence was not influenced by the number of drugs other than the ones for BC or by age. Most patients (87%) suffered from one or more AEs. The most frequent are musculoskeletal symptoms, which occurred in 86.2% of the patients. 74.5% and 74.4% of participants reported hot flashes and tiredness, respectively. No structured or uniform responses were reported regarding the strategy for solving side effects: answers were almost generic, but for more than 50% of patients, the final outcome was positive. AEs were a driver for nonadherence in only 19.6% of patients. CONCLUSION: Survey results should be considered as an overview of AI therapy adherence in BC patients. We showed that the oncologist has a key role in improving therapeutic adherence and, as a consequence, in improving clinical outcome. Through a dialogue with the patient and a synergistic interaction with other clinical specialists, a greater awareness of the importance of the treatment could be warranted.
Examining the Role of Matrix Metalloproteinase-2 and MicroRNAs Regulation in Breast Cancer.
Vand Beilankouhi EA, Kheradi N, Vaez-Gharamaleki Y … +4 more , Roshani S, Abbasi S, Safaralizadeh R, Valilo M
Breast J · 2025 · PMID 41356146 · Full text
Matrix metalloproteinase (MMPs) is a class of zinc-dependent enzymes that play an important role in the invasion and metastasis of cancer cells and have different types. MMP-2 is one of the important enzymes of this fami...
Matrix metalloproteinase (MMPs) is a class of zinc-dependent enzymes that play an important role in the invasion and metastasis of cancer cells and have different types. MMP-2 is one of the important enzymes of this family. MicroRNAs (miRNAs) are noncoding RNAs that are involved in the regulation of gene expression of many enzymes and factors in the body. Emerging data have highlighted the relationship between MMP-2 and miRNAs. Studies have shown that miRNAs regulate MMP-2 by binding to the 3' untranslated region (3' UTR), which leads to a decrease or increase in MMP-2 expression and its enzymatic activity. For example, decreased expression of miR-106b leads to increased growth and invasion of breast cancer (BC) cells through increased expression of MMP-2. Therefore, understanding the regulatory mechanisms related to MMP-2 and miRNAs will provide new insights into the molecular pathways that drive BC progression and highlight potential therapeutic targets for the management of invasion and metastasis. Hence, in this study, we aimed to elucidate the relationship between MMP-2 and miRNAs in BC.
Regulates Tumor Stemness and Immune-Related Pathways in Triple-Negative Breast Cancer: A Bioinformatics and Experimental Validation Study.
Zhou L, Wang X, Zhu H … +7 more , Chen Y, Bai L, Hu C, Wang Y, Qi M, Yin L, Sun J
Breast J · 2025 · PMID 41321870 · Full text
OBJECTIVE: Given the crucial roles of in epithelial-mesenchymal transition (EMT), we assume that it may also be involved in tumor stemness, immune evasion, and drug resistance in triple-negative breast cancer (TNBC). Th...
OBJECTIVE: Given the crucial roles of in epithelial-mesenchymal transition (EMT), we assume that it may also be involved in tumor stemness, immune evasion, and drug resistance in triple-negative breast cancer (TNBC). This study was designed to analyze the expression and clinical significance of and investigate its association with tumor stemness-related and immune-related genes. METHODS: expression and clinical data of TNBC patients were obtained from TCGA. Survival analysis, differential gene expression, and gene set enrichment analysis (GSEA) were performed to explore associations between and tumor stemness, immune response, and clinical outcomes in TNBC. Immune cell infiltration was assessed using xCell, and key -related proteins were validated via parallel reaction monitoring-based proteomics. RESULTS: expression was significantly upregulated in TNBC and was associated with poorer overall survival. In TNBC, 24 -associated genes linked to tumor stemness and immune response were identified, all of which were downregulated in the high expression group. Proteomic analysis further validated differential expression of key proteins, including upregulation of SERPINB2, KIT, and NOTCH1 and downregulation of DNMT1, MAPK1, and EP300 in -overexpressing cells. CONCLUSION: overexpression was associated with poor prognosis and was found to influence tumor stemness, immune modulation, and key signaling pathways that drive tumor progression and therapeutic resistance.
Correction to "Evaluating DNA Methylation in Random Fine Needle Aspirates from the Breast to Inform Cancer Risk".
Breast J · 2025 · PMID 41282048 · Full text
[This corrects the article DOI: 10.1155/2022/9533461.].
[This corrects the article DOI: 10.1155/2022/9533461.].
Influence of HER2 Changes on Survival Outcomes After Neoadjuvant Chemotherapy in Peruvian Patients With Triple-Negative Breast Cancer.
Morante Z, Ferreyra Y, Otoya I … +12 more , Valdiviezo N, Huarcaya-Chombo N, Polo-Mendoza G, Calle C, Meza J, Castañeda C, Vidaurre T, Valencia G, Rioja P, Fuentes H, Neciosup SP, Gomez HL
Breast J · 2025 · PMID 41282047 · Full text
BACKGROUND: Lack of human epidermal growth factor receptor 2 (HER2) expression limits targeted treatments for triple-negative breast cancer (TNBC). HER2 status changes after neoadjuvant chemotherapy (NAC) have been repor...
BACKGROUND: Lack of human epidermal growth factor receptor 2 (HER2) expression limits targeted treatments for triple-negative breast cancer (TNBC). HER2 status changes after neoadjuvant chemotherapy (NAC) have been reported, but their impact on survival in Peruvian TNBC patients remains unexplored. Here, we aimed to assess HER2 status before and after NAC and its association with clinical characteristics, treatment response, and survival outcomes. METHODS: Our analysis included clinicopathological data from 159 TNBC patients diagnosed between 2015 and 2019 at the Instituto Nacional de Enfermedades Neoplásicas (Lima, Peru) who received NAC. Logistic regression was used to assess the association between HER2 status at diagnosis and pathological complete response (pCR). Cohen's Kappa analysis evaluated the agreement between pre- and post-NAC HER2 status, while Kaplan-Meier analysis estimated the impact of HER2 changes on overall survival (OS) and disease-free survival (DFS). RESULTS: Among TNBC patients, 40.3% were HER2-low at diagnosis and 14.9% achieved pCR. Pretherapeutic HER2 status was not associated with pCR (OR = 1.4, 95% CI = 0.55-3.61, and =0.5). HER2 status remained unchanged in 62.8% of HER2-zero and 75.9% of HER2-low patients post-NAC, showing moderate concordance (Cohen's kappa = 0.3418, < 0.001). No significant OS improvements were observed in patients with HER2 transitions: HER2-zero/HER2-low (HR = 0.52, 95% CI = 0.22-1.24, and =0.14), HER2-low/HER2-zero (HR = 0.9, 95% CI = 0.34-2.40, and =0.8), or HER2-low/HER2-low (HR = 0.71, 95% CI = 0.34-1.49, and =0.4) compared with HER2-zero/HER2-zero. Similar findings were reported for DFS. CONCLUSION: These findings suggest that HER2 status conversion may not be prognostic for patients with TNBC treated with neoadjuvant therapy.
Patient-Reported Outcomes After Same-Day Mastectomy Among Older Breast Cancer Patients: Results From a Prospective Clinical Trial.
Gooch JC, McClelland QY, Paschalis K … +6 more , Anand M, Magnuson A, Dobbins J, Skinner KA, Olzinski-Kunze A, Weiss A
Breast J · 2025 · PMID 41246288 · Full text
BACKGROUND: The safety and value of same-day mastectomy are well-documented but the patient perspective is underreported, especially among older patients. This study aimed to investigate older patient-reported recovery q...
BACKGROUND: The safety and value of same-day mastectomy are well-documented but the patient perspective is underreported, especially among older patients. This study aimed to investigate older patient-reported recovery quality after mastectomy; we hypothesized that patients who were discharged same day would report better recovery. METHODS: A prospective trial included frailty screening and prehabilitation for patients age ≥ 65 undergoing mastectomy for breast cancer. Primary endpoint, same-day discharge rate, was previously reported and was significantly higher than the year prior. Secondary endpoint was patient-reported postoperative recovery quality, per the Quality of Recovery-15 measure (QoR-15; 15 questions scored 1-10, 10 being best). Patients responded by phone 24-72 h postdischarge. One-tailed -tests compared responses between same-day and admitted patients. RESULTS: 37/55 (67.3%) patients ≥ 65 who underwent unilateral/bilateral mastectomy for early-stage breast cancer responded. Mean age was 73.6 (standard deviation 7.6), most had invasive carcinoma (44, 80.0%), and mean 5-factor Modified Frailty Index (mFI-5) was 1.3 of 5 (standard deviation 0.9); nonresponders had similar characteristics. There were no significant differences in any QoR-15 item (all > 0.05). In fact, most responses were very similar, different by only one-tenth of 1 point or identical. The following answers slightly (0.2 difference or more) numerically favored same-day discharge: feeling rested, having good sleep, less moderate pain, and freedom from feeling anxious or depressed. No items favored admission. CONCLUSIONS: Although this trial was not powered for secondary analyses, it is clinically meaningful that older patients undergoing same-day mastectomy reported similar recovery quality as those admitted. Same-day mastectomy should be considered for older patients.
Clinical Characteristics and Independent Risk Factors for Pathologic Nipple Discharge of 375 Cases.
Wang J, Zhang D, Huang Q … +6 more , Fu N, Zhao W, Zhou Y, Guo Y, Xu X, Li Y
Breast J · 2025 · PMID 41195359 · Full text
BACKGROUND: While the characteristics of pathologic nipple discharge (PND) are well documented in the literature, comparative clinical and risk factor analyses across different pathologic subtypes are lacking. METHODS: M...
BACKGROUND: While the characteristics of pathologic nipple discharge (PND) are well documented in the literature, comparative clinical and risk factor analyses across different pathologic subtypes are lacking. METHODS: Medical records of patients with nipple discharge were retrospectively retrieved from an electronic medical record database and analyzed. In this study, 375 patients with a postoperative pathologically confirmed diagnosis of PND were included. RESULTS: Age serves as an important independent risk factor for precancerous lesions and breast cancer, with the median age increasing alongside the severity of the pathology. Individuals under 45 years of age predominantly exhibited non-neoplastic and benign neoplastic lesions, whereas those over 45 were more likely to have precancerous lesions or breast cancer, with statistical significance ( < 0.01). Discharge color was a significant factor in distinguishing between different pathological findings ( < 0.01). Discharge color serves as an important independent risk factor for breast cancer. Bloody discharge was associated with a significantly higher incidence of breast cancer and precancerous lesions compared to non-bloody discharges. Upon dividing bloody discharge into brown and bright red for in-depth analysis, no significant difference was observed among the different pathological types ( > 0.05). Ductoscopy has a higher diagnostic rate for breast cancer and precancerous lesions ( < 0.01). CONCLUSION: These results suggest the clinical characteristics of PND patients across four pathological types: non-neoplastic lesions, benign neoplastic lesions, precancerous lesions, and breast cancer, at the same time emphasizing the importance of age and discharge color as independent risk factors in the prognosis and management of nipple discharge.
MicroRNA-195-5p Targets MYB to Regulate Proliferation and Malignant Metastasis in Triple-Negative Breast Cancer via PI3K/AKT/mTOR Signaling.
Tang K, Bai S, Zhou Q … +6 more , Liu S, Yin L, Tong Y, Long L, Ou L, Yin Q
Breast J · 2025 · PMID 41141380 · Full text
OBJECTIVE: To investigate the effect of microRNA-195-5p (miRNA-195-5p) on proliferation and malignant metastasis in triple-negative breast cancer (TNBC) cells and its underlying mechanism. METHODS: Expression levels of m...
OBJECTIVE: To investigate the effect of microRNA-195-5p (miRNA-195-5p) on proliferation and malignant metastasis in triple-negative breast cancer (TNBC) cells and its underlying mechanism. METHODS: Expression levels of miRNA-195-5p and MYB were determined by quantitative real-time PCR (RT-qPCR) in TNBC cells (MDA-MB-231 and BT-549) and normal human mammary epithelial cells (MCF-10A). Cell proliferation was assessed via CCK-8 assays after miRNA-195-5p overexpression or knockdown in MDA-MB-231 cells. Transwell assays evaluated cellular invasion and migration. Western blotting analyzed impacts on the PI3K/AKT/mTOR pathway. Targeting of MYB by miRNA-195-5p was confirmed using TargetScan prediction and dual-luciferase reporter assays. RT-qPCR measured MYB expression upon miRNA-195-5p modulation. Rescue experiments (co-overexpression of MYB and miRNA-195-5p) further assessed proliferation and PI3K/AKT/mTOR signaling via CCK-8 and Western blotting. RESULTS: Compared to MCF-10A cells, miRNA-195-5p expression was significantly downregulated ( < 0.01), while MYB was markedly upregulated ( < 0.001) in TNBC cells. Overexpression of miRNA-195-5p inhibited MDA-MB-231 proliferation, invasion, and migration; conversely, its knockdown promoted these phenotypes. MiRNA-195-5p directly targeted and negatively regulated MYB. MYB overexpression activated the PI3K/AKT/mTOR pathway, enhancing cell proliferation. Rescue experiments indicated that MYB upregulation counteracted the tumor-suppressive effects of miRNA-195-5p and reactivated PI3K/AKT/mTOR signaling. CONCLUSION: miRNA-195-5p suppresses proliferation and metastasis in TNBC by targeting MYB and inhibiting the PI3K/AKT/mTOR pathway.
Characteristics, Outcomes, and Risk Factors in Primary and Secondary Angiosarcoma: A Retrospective Cohort Study.
Puscz F, Ahmadi N, Schmidt SV … +6 more , Reinkemeier F, Drysch M, Steubing Y, Völlmecke M, Lehnhardt M, Wallner C
Breast J · 2025 · PMID 41113956 · Full text
BACKGROUND: Angiosarcomas (ASs) are a heterogeneous subtype of soft tissue sarcomas. They can be subdivided into primary and secondary AS, with secondary AS being predominant, particularly those following radiotherapy. T...
BACKGROUND: Angiosarcomas (ASs) are a heterogeneous subtype of soft tissue sarcomas. They can be subdivided into primary and secondary AS, with secondary AS being predominant, particularly those following radiotherapy. The aim of this study was first to analyze our patient cohort on a descriptive level and then to identify possible risk factors with regard to one and 5-year survival using logistic regression. METHODS: The study was designed as a retrospective, single-center cohort study. All patients with histologically confirmed AS over 18 years of age were included in the study. Binary logistic regression was used for univariate analysis screening of continuous or dichotomous variables, respectively. For multivariate analysis, binary multivariate logistic regression was performed to assess independent associations between chosen variables and AS. RESULTS: A total of 39 patients were included in this study. 14 (35.9%) had primary and 25 (64%) had secondary AS. Women were more frequently affected (76.9%) than men (23.1%). The 1-year survival rate was 87.2%, and the 5-year survival rate was 51.3%. In the logistic regression analyses, nicotine consumption and a history of carcinoma were identified as significant factors influencing the 1-year survival rate. For the 5-year survival rate, only breast cancer was found to be a significant influencing factor in the univariate analysis. Based on univariate logistic regression, all variables with a value of < 0.1 were chosen to be included into multivariate analysis. The multivariate analysis showed diabetes mellitus (=0.067) with an association to influence the 5-year survival rate. CONCLUSIONS: We were able to show that the proportion of secondary ASs is predominant. These occur after radiation treatment of the breast. Diabetes mellitus may be associated with reduced 5-year survival, although this finding did not reach statistical significance and requires further investigation. Due to its small sample size, this study should be regarded more as hypothesis-generating.
Nipple Areolar Complex (NAC) Neurotization After Nipple-Sparing Mastectomy (NSM) in Implant-Based Breast Reconstruction: A Systematic Review of the Literature.
Sorenson TJ, Boyd CJ, Park JJ … +7 more , Hemal K, Amro C, Vernice N, Lakatta A, Cohen O, Karp N, Choi M
Breast J · 2025 · PMID 41089735 · Full text
BACKGROUND: Nipple-sparing mastectomy (NSM) with implant-based breast reconstruction (IBBR) preserves the nipple-areolar complex (NAC) with superior aesthetic results but results in loss of nipple sensation. Nipple neuro...
BACKGROUND: Nipple-sparing mastectomy (NSM) with implant-based breast reconstruction (IBBR) preserves the nipple-areolar complex (NAC) with superior aesthetic results but results in loss of nipple sensation. Nipple neurotization has emerged as a technique to restore the sensory function, yet outcomes remain variable across studies. This systematic review synthesizes the available evidence on nipple neurotization in IBBR, focusing on sensory recovery, patient satisfaction, and surgical techniques. METHODS: A systematic review was conducted following PRISMA guidelines. PubMed, Ovid EMBASE, and Cochrane Library were searched through April 1, 2025, for studies evaluating nipple neurotization in IBBR. Eligible studies included randomized controlled trials, cohort studies, and case series reporting surgical technique, sensory, and/or patient satisfaction outcomes. Data extraction included study characteristics, surgical techniques, sensory outcomes, and patient-reported satisfaction. Risk of bias was assessed using standardized tools. RESULTS: Six studies met inclusion criteria, comprising 212 patients and 257 neurotized breasts. Sensory recovery was assessed using monofilament testing and patient-reported outcomes. Studies demonstrated overall improvement of NAC sensory outcomes and high patient satisfaction after neurotization. However, variability in neurotization methods, follow-up duration, and specific measured sensory outcomes limited direct comparisons. CONCLUSION: Nipple neurotization in IBBR shows promise in enhancing sensory recovery and patient satisfaction after NSM, but heterogeneity in surgical techniques and outcome measures, as well as poor study designs, limits definitive conclusions. Standardized protocols and randomized studies with long-term patient follow-up are needed to establish best practices and optimize neurotization outcomes.
Programmed Death Ligand 1 (PDL1) Expression in Neoadjuvant Triple-Negative Breast Cancer: Association With Chemotherapy Response and Residual Cancer Burden.
Hashmi AA, Wahid N, Mudassir G … +5 more , Irfan M, Malik UA, Khan EY, Abu Bakar SM, Faridi N
Breast J · 2025 · PMID 41064538 · Full text
BACKGROUND: Programmed death ligand 1 (PDL1) expression in tumors is linked to immune evasion in various cancers, making these patients potential candidates for PDL1 inhibitors. Although immune checkpoint blockade therap...
BACKGROUND: Programmed death ligand 1 (PDL1) expression in tumors is linked to immune evasion in various cancers, making these patients potential candidates for PDL1 inhibitors. Although immune checkpoint blockade therapy has gained approval for breast cancer treatment, especially triple-negative breast cancer (TNBC), there is a lack of PDL1 expression data in Pakistani breast cancer patients. In our study, PDL1 expression was assessed in TNBC to determine eligibility for PDL1 inhibitors. Our study aimed to evaluate the frequency of PDL1 expression in TNBC. We also examined how PDL1 expression correlates with clinicopathological characteristics and prognostic factors in patients with TNBC. Moreover, the association of neoadjuvant chemotherapy response with PDL1 expression was also evaluated. METHODS: This cross-sectional study was conducted at the Liaquat National Hospital Histopathology Department from January 2022 to June 2023. A total of 128 biopsy-proven cases of TNBCs were administered neoadjuvant chemotherapy before surgery during this period. PDL1 immunohistochemical staining was performed on prechemotherapy needle biopsies. Expression was determined using the combined positive score (CPS). CPS is the number of PDL1-stained cells (tumor cells, lymphocytes, and macrophages) divided by the total number of viable tumor cells multiplied by 100. Cases with CPS ≥ 10 were considered PDL1-positive. RESULTS: Complete pathological response (pCR) was observed in 32.8% ( = 42) of cases. PDL1 expression was observed in 18.8% ( = 24) of cases. The majority of cases showed a high residual cancer burden (RCB-III) ( = 53, 41.4%). A significant association was noted between PDL1 expression and neoadjuvant chemotherapy response ( < 0.01). PDL1-positive cases had a higher pCR ( = 16, 66.7%) than PDL1-negative cases ( = 26, 25%). PDL1-positive cases showed a lower frequency of RCB-II-III (RCB-II: 8.3%; RCB-III: 0%) than PDL1-negative cases (RCB-II: 25%; RCB-III: 51%), with a significant value ( < 0.01). CONCLUSION: Overall, PDL1 expression was low in TNBC cases in our study; however, identifying these cases is important to identify those that can benefit from immunotherapy. We found a significant association of PDL1 expression with neoadjuvant chemotherapy response and RCB. Moreover, PDL1 positivity was associated with lower Ki67 index and older age. Therefore, we recommend routine PDL1 testing in all cases of TNBC to predict neoadjuvant chemotherapy response.
The Era "or Error" of Second Localization Procedures.
Nelson N, Den J, Weiser R … +5 more , Digbeu B, Silva HC, Robinson AS, Poselman F, Klimberg VS
Breast J · 2025 · PMID 41059021 · Full text
Clips placed after core needle biopsy are often several millimeters to centimeters from the biopsy cavity. Radiofrequency and radar (R) localization involve a second localization procedure based on the prior clip placeme...
Clips placed after core needle biopsy are often several millimeters to centimeters from the biopsy cavity. Radiofrequency and radar (R) localization involve a second localization procedure based on the prior clip placement, potentially compounding the distance from the area localized to the original biopsy site. Fluoroscopic intraoperative neoplasm detection (FIND) obviates the need for a second localization by using intraoperative fluoroscopy to localize the original biopsy clip. We hypothesized that intraoperative localization using FIND is feasible and may result in fewer positive margins. A retrospective review was performed of patients with nonpalpable malignancy who underwent partial mastectomy from September 2016 to August 2023. Results were compared between patients who underwent R localization vs. FIND. The Pythagorean theorem was used to calculate the distance in space between the biopsy clip and the R localization device. Chi-square was used to calculate the two-tailed value. We identified 219 patients: 161 localized with FIND and 55 with R. Three percent (6 out of 161) of the patients with FIND and 12% (7 out of 55) of the patients with R had positive margins (=0.01). The average distance between the R device and biopsy clip in patients with positive margins was 19.1 mm, and with negative margins, it was 12.45 mm (=0.09). The positive margin rate with R localization was significantly greater than with FIND. The positive margin rate trended toward increased distance from the localization device to the biopsy clip. Eliminating the second localization decreases painful procedures for the patient and may result in improved tumor-free margins.
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