The Breast Journal[JOURNAL]
Sun
200 papers
Florid Lobular Carcinoma In Situ: Imaging Characteristics and Pathologic Upgrade Rates on Surgical Excision.
Desai A, Kesmodel SB, Susnik B … +4 more , Goel N, Feliciano Y, Gomez-Fernandez C, Tjendra Y
Breast J · 2025 · PMID 40196387 · Full text
Florid lobular carcinoma in situ is an uncommon lobular neoplasia variant that is frequently associated with invasive carcinoma. However, there remains a paucity of information to guide management. The authors aimed to s...
Florid lobular carcinoma in situ is an uncommon lobular neoplasia variant that is frequently associated with invasive carcinoma. However, there remains a paucity of information to guide management. The authors aimed to study imaging features associated with pathologic upgrade rates for patients with florid lobular carcinoma in situ identified on core biopsy undergoing surgical excision. Patients with florid lobular carcinoma in situ on core biopsy were selected from an institutional pathology database. Patients were excluded if pleomorphic lobular carcinoma in situ was also present on core biopsy. Clinical, radiologic, and pathologic features for each case were reviewed focusing on imaging features which led to core biopsy and those associated with pathologic upgrade on surgical excision. Eighteen cases of florid lobular carcinoma in situ underwent surgical excision. Upgrade rates on surgical excision were higher in cases with suspicious calcifications (8/11, 73%, =0.049) compared to those without (1/7, 14.3%) and in cases with larger breast lesions (=0.011). The overall upgrade rate was 50% (9/18), 89% (8/9) with invasive lobular carcinoma and 11% (1/9) with ductal carcinoma in situ. Of the 8 cases with upgrade to invasive lobular carcinoma, 7/8 (87.5%) were Stage I cancers and only 1/8 (12.5%) had macroscopic lymph node involvement and was upgraded to Stage II. Florid lobular carcinoma in situ on core biopsy had an upgrade rate on surgical excision of 50% overall, with 89% of these cases upgraded to invasive lobular carcinoma. Pathologic upgrade was seen more frequently with suspicious calcifications and larger breast lesions. These findings can help guide surgical management of this uncommon lobular neoplasia variant including planning extent of excision and consideration for lymph node evaluation.
NOTIFICATION: The Changing Role of Pathologists from Morphologists to Molecular Pathologists in the Era of Precision Medicine.
Journal TB
Breast J · 2025 · PMID 40078588 · Full text
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Extreme Nipple-Sparing Mastectomy: Feasibility of Nipple Preservation and Immediate Reconstruction in Breasts Weighing Over 600 Grams in a Cohort of 43 Patients.
Purohit V, Dwyer J, Moreira A … +6 more , Li J, Fernando E, Gomez J, Saldanha J, Julian T, Coopey S
Breast J · 2025 · PMID 40026848 · Full text
Limited data exist on complication rates in nipple-sparing mastectomy (NSM) in patients with large-volume breasts. Our aim was to evaluate the early complication rates of NSM with immediate reconstruction in a consecutiv...
Limited data exist on complication rates in nipple-sparing mastectomy (NSM) in patients with large-volume breasts. Our aim was to evaluate the early complication rates of NSM with immediate reconstruction in a consecutive cohort of patients with large-volume breasts. After IRB approval, patients treated with prophylactic or therapeutic NSM and immediate reconstruction from January 2020 to June 2022 at our health network were identified. Patients with breast weights > 600 g (the extreme NSM group) were compared to patients with breast weights of 600 g or less (the average-volume NSM group). A total of 184 patients underwent NSM with immediate reconstruction. Forty-three of 184 (23.37%) NSM patients had breast weights > 600 g. Of these, 30 patients had bilateral NSM, for a total of 73 breasts with volumes over 600 g, ranging from 603 to 1658 g. There were significantly more total complications in the extreme NSM compared to average-volume NSM groups (41.86% vs. 21.99%, =0.009852). When broken down into major and minor complications, the extreme NSM group had significantly more major complications than the average-volume NSM group (27.91% vs. 12.86%, =0.01072), but no difference in minor complications (13.95% vs. 9.29%, =0.2205). Overall, one (2.33%) patient in the extreme NSM group had a reconstruction failure, compared to three (2.14%) in the average-volume NSM group. Only two of 43 (4.65%) patients in the extreme NSM group lost their nipples due to total or partial nipple necrosis. NSM with immediate reconstruction was successful in the majority of patients with large-volume breasts. The rate of nipple loss was acceptably low. Women with breast volumes larger than 600 g who are motivated to save their nipples at the time of mastectomy could be offered NSM.
Predictive Value of Excision Repair Cross Complementation Group 1 (ERCC1) by Immunohistochemistry for Determining Neoadjuvant Chemotherapy Response in Triple-Negative Breast Cancers.
Hashmi AA, Ajaz Y, Sajjad M … +5 more , Zia F, Irfan M, Abu Bakar SM, Khan EY, Faridi N
Breast J · 2025 · PMID 40008380 · Full text
Triple-negative breast cancers (TNBCs) constitute a significant proportion of breast cancers in Pakistan. Owing to the lack of expression of hormone (estrogen/progesterone) receptor and human epidermal growth factor rece...
Triple-negative breast cancers (TNBCs) constitute a significant proportion of breast cancers in Pakistan. Owing to the lack of expression of hormone (estrogen/progesterone) receptor and human epidermal growth factor receptor 2 (HER2neu), treatment options for TNBCs are limited. Therefore, it is important to identify markers that predict response to chemotherapy in these patients. Previous studies have demonstrated that the excision repair cross complementation group 1 (ERCC1) protein can successfully augur the response to chemotherapy in cancer; however, data related to TNBCs, particularly in Pakistan, are limited. Therefore, in this study, we evaluated the role of ERCC1 in predicting the response to neoadjuvant chemotherapy in patients with TNBCs. This cross-sectional study was conducted at the Liaquat National Hospital, Histopathology Department, between January 2019 and June 2023. A total of 132 biopsy-proven cases of breast cancer that were negative for estrogen receptor (ER), progesterone receptor (PR), and HER/2neu and were administered neoadjuvant chemotherapy before surgery were included in the study. ERCC1 immunohistochemical (IHC) staining was performed on prechemotherapy needle biopsies. The results were scored semiquantitatively by assessing the average intensity on a scale of 0-3 (0, no staining; 1, weak nuclear staining; 2, intermediate nuclear staining; and 3, strong nuclear staining) and the proportion of tumor cells showing positive nuclear staining. The intensity and proportion scores were then multiplied to give a score that was divided by 100 to give an overall score, and scores equal to or higher than 1.0 were considered positive. Neoadjuvant chemotherapy response was categorized as pathological complete response (pCR) when no residual invasive breast carcinoma was found on the postneoadjuvant chemotherapy excision specimen and as pathological partial response (pPR) when residual cancer cells were present in admixed chemotherapy-related changes. The residual cancer burden (RCB) was calculated using the MD Anderson RCB calculator. The association between ERCC1 expression and the chemotherapy response/RCB class was determined. We found that 90.9% ( = 120) of TNBC cases expressed ERCC1, whereas pCR was noted in 24 (18.2%) cases. A significant association was observed between ERCC1 expression and pCR. Cases with negative ERCC1 expression had a significantly higher frequency of pCR (66.7%) than those with positive ERCC1 expression (13.3%). Additionally, the ERCC1-positive group showed a higher frequency of RCB classes II (36.7%) and III (43.3%) than the ERCC1-negative group (RCB II: 25%; RCB III: 0%). Moreover, positive ERCC1 expression was associated with higher nodal (N) stage. In this study, we established the role of negative ERCC1 expression in predicting the response to chemotherapy in neoadjuvant TNBC. Therefore, ERCC1 can be used as a predictive marker to stratify patients who will benefit from neoadjuvant therapy. Moreover, we also noted an association between ERCC1 expression and nodal metastasis; however, more large-scale studies are needed to establish its role as a prognostic biomarker in TNBC.
Diagnosis of Benign and Malignant Newly Developed Nodules on the Surgical Side After Breast Cancer Surgery Based on Machine Learning.
Wang Z, Li Q, Wang Y … +3 more , Qian L, Hu X, Liu D
Breast J · 2025 · PMID 39996101 · Full text
To enhance the diagnostic accuracy of new nodules on the surgical side after breast cancer surgery using machine learning techniques and to explore the role of multifeature fusion. Data from 137 breast cancer postoperat...
To enhance the diagnostic accuracy of new nodules on the surgical side after breast cancer surgery using machine learning techniques and to explore the role of multifeature fusion. Data from 137 breast cancer postoperative patients with new nodules from January 2016 to April 2024 were analyzed. Clinical, ultrasound, immunohistochemistry, and surgical features were combined. Multiple machine learning models, including support vector machine (SVM), random forest, gradient boosting, AdaBoost, and XGBoost, were trained and tested. Model performance was evaluated using stratified ten-fold cross-validation. Ablation experiments assessed the impact of different feature combinations on diagnostic performance. The SVM model performed best, with an AUC of 0.8664, an accuracy of 0.8099, a sensitivity of 0.565, and a specificity of 0.9267. Ablation experiments indicated that multifeature fusion significantly improved diagnostic performance, especially when combining clinical, ultrasound, immunohistochemistry, and surgical features. Gradient boosting and random forest models showed slightly inferior performance, while AdaBoost had balanced but lower effectiveness. Machine learning, particularly the multifeature fusion SVM model, shows significant potential in diagnosing new nodules after breast cancer surgery. It can assist doctors in developing more effective treatment plans, improving patient outcomes. Future studies should expand sample sizes, include multicenter data, and explore advanced algorithms to further enhance diagnostic performance.
NOTIFICATION: Development of a Novel Approach for Breast Cancer Prediction and Early Detection Using Minimally Invasive Procedures and Molecular Analysis: How Cytomorphology Became a Breast Cancer Risk Predictor.
Journal TB
Breast J · 2025 · PMID 39996100 · Full text
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NOTIFICATION: The Role of Pathologists in Recognition of Morphologic and Biologic Features of Genetically Mutated Breast Cancer.
Journal TB
Breast J · 2025 · PMID 39996099 · Full text
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NOTIFICATION: Is it Ductal Carcinoma in Situ with Microinvasion or "Ductogenesis"? The Role of Myoepithelial Cell Markers.
Journal TB
Breast J · 2025 · PMID 39996098 · Full text
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The Relationship Between Clinicopathological Features and Prognosis of 22 Cases of Tubular Breast Carcinoma.
Tian L, Meng X, Si H … +3 more , Qiu Y, Qu R, Chen H
Breast J · 2025 · PMID 39950032 · Full text
Breast tubular carcinoma is a special pathological type of invasive breast cancer, accounting for about 0.8% to 10.0% of breast cancer cases, and it is a rare type of breast cancer. Currently, there is still a lack of re...
Breast tubular carcinoma is a special pathological type of invasive breast cancer, accounting for about 0.8% to 10.0% of breast cancer cases, and it is a rare type of breast cancer. Currently, there is still a lack of relevant diagnostic and treatment consensus. Exploring the relationship between the pathological characteristics, molecular subtypes, and prognosis of ductal breast cancer is of great scientific value and clinical significance for improving patients' survival rate and quality of life. The clinical data of 22 patients with tubular breast carcinoma diagnosed by pathology in The First Medical Center of PLA General Hospital from January 2001 to December 2021 were collected, and their pathological features, molecular classification, and prognosis were analyzed retrospectively. The clinicopathological features of 22 patients with tubular breast carcinoma were age ≥ 35 years, married, tumor ≤ 2 cm, single focal, mixed type, no lymph node metastasis, estrogen receptor (ER) positive, progesterone receptor (PR) positive, Ki-67 ≤ 14%, CyclinD1 negative, less recurrence, and metastasis. Twenty-two patients with breast tubular carcinoma were followed up for 5 years after surgery, and the survival rate of disease-free survival (DFS) was 90.9% (20/22). The positive rates of ER, PR, and human epidermal growth factor receptor-2 (HER-2) are 100.0%, 100.0%, and 40.9%, respectively. The proportion of tumor cells expressing Ki-67 is 45.4%. Among them, the difference of HER-2 level, recurrence and metastasis, and postoperative comprehensive treatment showed different prognoses. Tubular breast carcinoma is a kind of tumor with a low malignant degree. The prognosis is significantly related to its HER-2 level, recurrence and metastasis, and postoperative comprehensive treatment by univariate analysis, in which HER-2 is an independent risk factor, postoperative comprehensive treatment is a protective factor, but postoperative recurrence and metastasis have nothing to do with the prognosis by the multivariate analysis.
Switching to Tumescent Dissection in Mastectomy.
Bakillah E, Brooks AD, Adekeye S
Breast J · 2025 · PMID 39950031 · Full text
Tumescent dissection (TUM) combines the use of crystalloid, local anesthetic, and epinephrine to create a bloodless plane to raise skin flaps. We aim to compare outcomes of TUM versus standard electrocautery dissection i...
Tumescent dissection (TUM) combines the use of crystalloid, local anesthetic, and epinephrine to create a bloodless plane to raise skin flaps. We aim to compare outcomes of TUM versus standard electrocautery dissection in mastectomies with and without reconstruction. We conducted a retrospective cohort study of patients who underwent mastectomy by a single surgeon between January 2016 and October 2020 utilizing the electronic medical record. The primary outcome was complication rate, and the secondary outcome was operative time. Chi-squared analysis and two-sample -tests were used to examine outcomes. Among 242 patients, 141 patients underwent TUM and 101 patients underwent electrocautery. 44.68% of TUM patients experienced one or more complications compared to 59.41% of electrocautery patients (=0.024). There were fewer cases of wound healing complications in the TUM group with reconstruction compared to the electrocautery group with reconstruction (6.1% vs. 21%, =0.005). Infection rate was higher in the TUM group with reconstruction compared to the electrocautery group with reconstruction (14.3% vs. 3.2%, =0.023). There was no significant difference in rates of hematoma, seroma, skin flap necrosis, nipple areolar complex necrosis, or re-exploration by dissection technique. The mean operative time was shorter with TUM compared to electrocautery (216.09 min vs. 250.16 min, =0.016). TUM yields comparable results with decreased overall complication rates compared to electrocautery dissection. Electrocautery thermal effect may account for skin-related complications. Additionally, tumescent mastectomies have shorter length of operative time which could reduce the risk of complications associated with increased time under general anesthesia.
The Risk of Haematoma and Venous Thrombosis Associated With Thromboprophylaxis Use in Breast Cancer Surgery: A Meta-Analysis and Systematic Review.
Dhannoon A, Balasubramanian I, Dhannoon AA … +2 more , Butt A, Hill ADK
Breast J · 2025 · PMID 39950030 · Full text
The routine use of venous thromboembolism (VTE) prophylaxis in breast cancer surgery has caused substantial polarity among breast cancer surgeons across the globe. The aim of this study is to assess the use of VTE prophy...
The routine use of venous thromboembolism (VTE) prophylaxis in breast cancer surgery has caused substantial polarity among breast cancer surgeons across the globe. The aim of this study is to assess the use of VTE prophylaxis in breast cancer surgery outcomes. A comprehensive electronic search was undertaken of all comparative studies that described the role of VTE prophylaxis in breast cancer surgery. Studies that reported on postoperative outcomes between patients who received VTE prophylaxis (prophylaxis) and those who did not (no prophylaxis) were included in the review. A meta-analysis using random-effect model was used to analyse key outcomes, with data presented as odd ratio (OR). A total of 2470 patients from 6 studies were included in this study. Among these patients, 60.9% (: 1504) received prophylaxis. The haematoma rate in this study is 0.05% (: 133). The incidence of haematoma was significantly associated with the use of prophylaxis (6.85% versus 3.11%, : 0.001). Surgical intervention for haematomas was also significantly associated in this group (3.15% versus 0.83%, : 0.004). However, there was no difference in VTE events between both groups (0.26% versus 0.36%, : 0.88). The use of VTE prophylaxis in breast cancer surgery is associated with increased haematomas without any benefit in preventing VTE events. Future studies that examine the use of risk assessment tools for VTE prophylaxis in high risk patients may be beneficial.
Management of Idiopathic Granulomatous Mastitis: Effectiveness of a Steroid-Free Regimen Using -A Single-Institution Experience.
Das Sheth A, Joshi S, Kumar A … +9 more , Nair N, Shet T, Sahay A, Thakkar P, Haria P, Katdare A, Parmar V, Desai S, Badwe R
Breast J · 2025 · PMID 39886361 · Full text
Idiopathic granulomatous mastitis (IGM) is a benign, chronic inflammatory disease with no effective treatment and high relapse rate. The pathophysiology is poorly understood. Tinosporin, an immunomodulator obtained from...
Idiopathic granulomatous mastitis (IGM) is a benign, chronic inflammatory disease with no effective treatment and high relapse rate. The pathophysiology is poorly understood. Tinosporin, an immunomodulator obtained from , is known to be useful in treating immune-mediated diseases. We report our experience of using Tinosporin for IGM and the effectiveness of this "steroid-free" regimen. We analysed the clinicopathological characteristics of patients diagnosed with IGM on histopathology during January 2018 and December 2022. Tinosporin tablet (500 mg Guduchi stem extract) was prescribed for 3-6 months; data were collected from electronic medical records and analysed in SPSS v-29. Of 315 patients, 132 had complete clinical records. Median age was 39 years (25-77), and 107 (81.7%) were premenopausal. Seventy-eight (59.09%) had clinical suspicion of malignancy. On imaging, 84 (63.64%) were BIRADS 4/5 lesions. Empirical broad-spectrum antibiotics were prescribed to 101 patients. Tinosporin tablets were prescribed to 91 patients. Symptomatic response was seen in 72 (79.12%). Five patients did not achieve response, while 14 patients (15.38%) were lost to follow-up. At a median follow-up of 36 months (14-62 months), only 2 patients on Tinosporin had recurrence. None of the patients needed surgical intervention other than diagnostic biopsy or control of infection, and none received steroids. IGM is a benign, often self-limiting disorder. However, it mimics malignancy in 60% cases, and histology clinches the diagnosis. We report the efficacy of steroid-free management of IGM with immunomodulatory herbal origin phytopharmaceutical drug Tinosporin. It is safe, inexpensive and effective. Large volume excisions or mastectomies can be reserved for severe and refractory cases.
Intralesional Steroid Injections for Management of Granulomatous Mastitis: A Systematic Review of Treatment Protocols and Clinical Outcomes.
Vercoe J, Sedaghat N, Brennan ME
Breast J · 2025 · PMID 39877834 · Full text
Although idiopathic granulomatous mastitis (GM) of the breast is a benign condition, it can be locally aggressive and frequently chronic, causing significant pain and distress to the patient. Treatment often involves mul...
Although idiopathic granulomatous mastitis (GM) of the breast is a benign condition, it can be locally aggressive and frequently chronic, causing significant pain and distress to the patient. Treatment often involves multiple disciplines including general practice, breast surgery/physicians, rheumatology and/or immunology. Traditional options for treatment include observation, oral steroids, methotrexate and/or surgery, all with variable outcomes. A more recent alternative treatment option involves intralesional steroid injections. Using PRISMA methodology, a systematic review of intralesional steroid injection for the management of GM was conducted. Medline, PubMed, Embase and Cochrane databases were searched for original studies reporting treatment protocols and clinical outcomes, published up to the end of September 2023. Nine eligible studies reported outcomes in 474 patients undergoing treatment of GM with intralesional injections. All studies reported success (improvement in clinical and/or imaging appearance) with intralesional injections. Studies that had a comparison group showed statistically significantly fewer side effects compared to oral steroids or surgical management. The recurrence rate was less for intralesional injections than for other treatments in all studies except one. No studies included patient-reported outcomes. There is consistent evidence for the safety, efficacy and low recurrence rate with intralesional steroid injections for GM. The existing literature is heterogenous with respect to injection protocols, and the optimal protocol is unclear. Future research should compare the various steroid agents and dose/frequency of administration. Future studies should include cost analysis and patient-reported outcomes to ensure that the treatment is cost-effective and acceptable to people with idiopathic GM.
The Dynamic Changes of COL11A1 Expression During the Carcinogenesis and Development of Breast Cancer and as a Candidate Diagnostic and Prognostic Marker.
Wang Y, Wang J
Breast J · 2025 · PMID 39845732 · Full text
Collagen type XI alpha 1 (COL11A1), a critical member of the collagen superfamily, is essential for tissue structure and integrity. This study aimed to validate previously identified variations in COL11A1 expression duri...
Collagen type XI alpha 1 (COL11A1), a critical member of the collagen superfamily, is essential for tissue structure and integrity. This study aimed to validate previously identified variations in COL11A1 expression during breast cancer carcinogenesis and progression, as well as elucidate their clinical implications. COL11A1 mRNA expression levels were assessed using real-time reverse transcription-PCR (RT-PCR) in 30 pairs of normal breast tissue and primary breast cancer, 30 pairs of primary breast cancer and lymph node metastases, 30 benign tumors, and 107 primary breast cancers. COL11A1 protein expression was evaluated by Western blot in six matched trios of normal tissue, primary cancer, and lymph node metastasis. COL11A1 mRNA levels were significantly higher in primary breast cancer tissues ( = 30) than in adjacent normal breast tissues ( < 0.001). Conversely, lymph node metastases ( = 30) showed significantly lower COL11A1 mRNA levels compared to their primary breast cancer counterparts (=0.005). In a larger cohort, primary breast cancers ( = 107) had significantly elevated COL11A1 mRNA levels relative to adjacent normal tissues ( = 30) and benign tumors ( = 30) ( < 0.001). Benign tumors also demonstrated higher levels compared to normal tissues (=0.012). The protein expression patterns were consistent with the mRNA findings. Receiver operating characteristic (ROC) curve analysis confirmed the diagnostic relevance of COL11A1 expression levels. Significant associations were found between COL11A1 mRNA levels and clinical parameters including lymph node involvement (=0.046), clinical stage (=0.004), and progesterone receptor status (=0.048). Overexpression of COL11A1 was correlated with poor prognosis. COL11A1 expression varies during breast tumor initiation and progression, with elevated levels linked to worse prognoses. These findings underscore COL11A1's potential as a biomarker in breast cancer, suggesting its assessment could enhance diagnostic and prognostic strategies for more personalized patient management.
Evaluating YouTube Videos With Prophylactic Mastectomy Content in Terms of Their Quality and Reliability.
Altintas T, Bilgi Kirmaci M
Breast J · 2025 · PMID 39830622 · Full text
Purpose of this study is to investigate the quality and reliability of YouTube video contents on prophylactic mastectomy. The search terms "prophylactic mastectomy," "prophylactic mastectomy surgery," "preventive surger...
Purpose of this study is to investigate the quality and reliability of YouTube video contents on prophylactic mastectomy. The search terms "prophylactic mastectomy," "prophylactic mastectomy surgery," "preventive surgery for breast cancer," "risk-reducing mastectomy," and "prophylactic mastectomy and breast reconstruction" were searched on YouTube. The uploader, video content, length (seconds), upload date, number of days since upload date, number of views, number of comments, and likes were recorded and evaluated. Finally, the videos included in the study were evaluated using modified Quality Criteria for Consumer Health Information (DISCERN) and Global Quality Scale (GQS). The total number of views of the 50 videos reviewed in the study was found as 3.674.469. The mean DISCERN score of the two observers was calculated as 3.35 ± 1, and the videos were found to be of medium reliability. The mean GQS score of all videos was 3.39 ± 0.9 and the videos were of medium quality. The researchers gave 1-2 points (misleading) to 7 (14%) videos, 3 points (somewhat helpful) to 20 (40%) videos, 4 points (beneficial) to 16 (32%) videos, and 5 points (excellent) to 7 (14%) videos. In our study, we found that the videos uploaded by doctors were of good quality, the videos uploaded by health channels were of medium quality, and the videos uploaded by patients were of poor quality and misleading. The videos with health contents should be evaluated by the relevant specialists, and only useful videos should be broadcast.
Relationship Between Mitochondrial Biological Function and Breast Cancer: An Approach Based on Mendelian Randomization Analysis.
Miao S, Ni Q, Fang J
Breast J · 2024 · PMID 39742384 · Full text
This study aims to investigate the potential causal link between mitochondrial function and breast cancer using the Mendelian randomization (MR) analysis. The data used for this study were obtained from genomewide assoc...
This study aims to investigate the potential causal link between mitochondrial function and breast cancer using the Mendelian randomization (MR) analysis. The data used for this study were obtained from genomewide association studies (GWAS) databases on mitochondrial biological function and breast cancer. Mitochondrial function was considered the exposure variable, breast cancer the outcome variable, and specific single nucleotide polymorphisms (SNPs) were selected as instrumental variables (IVs). Two MR methods, inverse variance weighting (IVW) and MR-Egger regression, were used to assess the causal association between mitochondrial function and breast cancer. Data analysis and visualization were performed using R software. The results of the analysis revealed that several genes, including 39S ribosomal protein L34, pyruvate carboxylase, rRNA methyltransferase 3, and cytochrome c oxidase assembly factor 3 homolog, are causally linked to an increased risk of breast cancer in European populations. In addition, cytochrome c oxidase subunit 8A and ADP-ribose pyrophosphatase were found to be protective factors against breast cancer in European populations. In East Asian populations, 39S ribosomal protein L52, ATP synthase subunit beta, and pyruvate dehydrogenase (acetyl-transferring) were identified as causal risk factors for breast cancer. Conversely, 39S ribosomal protein L32, ADP-ribose pyrophosphatase, and cytochrome c oxidase subunit 8A were identified as protective factors against breast cancer in this population. In conclusion, this study provides evidence of a causal relationship between mitochondrial function and breast cancer in both European and East Asian populations. Additional research is warranted to further elucidate the mechanisms underlying this association.
Targeted Treatment of Metastatic Triple-Negative Breast Cancer: A Systematic Review.
Hammershøi Madsen AM, Løvendahl Eefsen RH, Nielsen D … +1 more , Kümler I
Breast J · 2024 · PMID 39742383 · Full text
INTRODUCTION: Triple-negative breast cancer (TNBC) is a subgroup of breast cancer characterized by the absence of estrogen and the human epidermal 2 receptor and also a lack of targeted therapy options. Chemotherapy has...
INTRODUCTION: Triple-negative breast cancer (TNBC) is a subgroup of breast cancer characterized by the absence of estrogen and the human epidermal 2 receptor and also a lack of targeted therapy options. Chemotherapy has so far been the only approved treatment option, and patients with metastatic cancer have a dismal prognosis with a median overall survival (OS) of approximately 14 months. Identification of druggable targets for metastatic TNBC is therefore of special interest. METHODS: A systematic search was performed, to review the existing evidence on targeted therapies in metastatic TNBC. RESULTS: A total of 37 phase 2/3 studies were identified, evaluating 29 different targeted agents. In this review, results on progression free survival (PFS) and OS are presented. CONCLUSION: In most of the studies included, no improvement was observed for neither PFS nor OS; however, a few studies did show improvement with targeted agents and have led to new treatment options in subgroups of patients. The antibody drug conjugate, sacituzumab govitecan, demonstrated superior PFS and OS in comparison to chemotherapy. Immunotherapy with checkpoint inhibitors such as atezolizumab and pembrolizumab is now recommended as a first-line treatment option for patients with expression a PD-L1 positive tumor. Finally, the poly adenosine diphosphate-ribose polymerase (PARP) inhibitors talazoparib and olaparib are recommended, as first-line treatment options in patients with metastatic breast cancer and a germline BRCA mutation, but an immune checkpoint inhibitor should be considered for the subset of these patients who are PD-L1 positive.
The Effects of Anlotinib Combined with Chemotherapy following Progression on Cyclin-Dependent Kinase 4/6 Inhibitor in Hormone Receptor-Positive Metastatic Breast Cancer.
Xu T, Xiong W, Zhang L … +1 more , Yuan Y
Breast J · 2024 · PMID 39742382 · Full text
PURPOSE: Endocrine therapy combined with cyclin-dependent kinase (CDK) 4/6 inhibitors (CDK4/6i) is the preferred treatment for hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) met...
PURPOSE: Endocrine therapy combined with cyclin-dependent kinase (CDK) 4/6 inhibitors (CDK4/6i) is the preferred treatment for hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC). However, there are currently no recommendations for therapeutic strategies after progression on CDK4/6i-based treatment. This study aimed to examine the efficacy and safety of anlotinib plus chemotherapy in HR+/HER2- MBC after progression on CDK4/6 inhibitors. METHODS: We collected data from 32 patients with HR+/HER2- MBC treated with anlotinib plus chemotherapy after progressing on CDK4/6i at Jiangsu Cancer Hospital from March 2020 to October 2023. The median follow-up was 9.1 months (range, 2.0-19.7 months) as of the data cutoff date in October 2023. The primary endpoint was median progression-free survival (PFS); secondary endpoints included objective response rate (ORR), disease control rate (DCR), and adverse events. RESULTS: The median PFS (mPFS) of all patients was 7.6 months (95% confidence interval (CI), 5.75-9.45). There was no significant difference in mPFS between patients who responded to prior CDK4/6i treatment and those who did not (8.3 months vs. 6.8 months, =0.580). Besides, the ORR was 34.4% and DCR was 93.8%. The most frequently observed adverse events were anemia (50.0%), neutropenia (40.6%), thrombocytopenia (34.4%), and epistaxis (34.4%). Dose interruption or reductions due to adverse events occurred in 2 (6.3%) and 5 (15.6%) patients, respectively. CONCLUSIONS: The study preliminarily demonstrates that anlotinib combined with chemotherapy may be an optional recommendation for patients with HR+/HER2- metastatic breast cancer who have progressed after CDK4/6i.
Upregulated SAE1 Drives Tumorigenesis and Is Associated with Poor Clinical Outcomes in Breast Cancer.
Liu H, Wang J, Li Y … +2 more , Luo F, Xing L
Breast J · 2024 · PMID 39742381 · Full text
BACKGROUND: The purpose of this study was to analyze SUMO activating enzyme subunit 1 (SAE1) expression in breast cancer (BC). Through bioinformatics analysis and in vitro experiments, the biological function and possibl...
BACKGROUND: The purpose of this study was to analyze SUMO activating enzyme subunit 1 (SAE1) expression in breast cancer (BC). Through bioinformatics analysis and in vitro experiments, the biological function and possibly associated signal pathways of SAE1 in BC were further analyzed. METHODS: Bioinformatics analysis was applied to analyze SAE1 expression in BC and normal breast tissues, its relationship with clinicopathologic characteristics and prognosis in BC patients, and data from the Cancer Genome Atlas database and Gene Expression Omnibus dataset. We performed immunohistochemistry to analyze SAE1 expression in BC tissues and para-cancer tissues in 79 breast cancer patients. BC cell proliferation was detected with the Cell Counting Kit-8 and by the colony formation assay. Cell cycle progression was analyzed by flow cytometry, and the expression of cell cycle-related proteins (E2F1, cyclin D3, and cyclin-dependent kinase 2) was determined by western blots in SAE1 small interfering RNA (siRNA) transfected cells. The GSE1456 dataset was used to analyze possible signal pathways associated with SAE1 by gene set enrichment analysis (GSEA), and the expression of PI3K/AKT/mTOR pathway-related proteins (such as p-PI3K, p-AKT, and mTOR) in SAE1-siRNA cells was detected by western blots. RESULTS: The bioinformatics and immunohistochemical results showed that SAE1 mRNA and protein expression in BC tissues were significantly higher than those in normal tissues. The SAE1 overexpression was significantly associated with the tumor size, tumor-node-metastasis stage, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and whether or not it was a triple-negative BC. Patients with SAE1 overexpression had a worse overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival compared with lower expression patients. Multivariate Cox regression analysis showed that SAE1 may be an independent prognostic factor for OS of BC patients. The proliferation and cell cycle process of BC cells were inhibited by SAE1-siRNA in vitro. The result of GSEA showed that SAE1 was significantly associated with 12 gene sets, including unfolded protein reaction, DNA repair, oxidative phosphorylation, and cell cycle, among others. Additionally, two signal pathways, mTORC1 and PI3K/Akt/mTOR, were significantly correlated with SAE1 overexpression. Western blots confirmed that the expression of PI3K/Akt/mTOR pathway-related proteins (p-PI3K, p-AKT, and mTOR) in BC cells was decreased after knocking down SAE1. CONCLUSION: SAE1 was highly expressed in BC. Its overexpression was associated with poor BC prognosis. Additionally, it was an independent prognostic factor for BC patients. We demonstrated that in vitro SAE1 knockdown effectively inhibited BC proliferation and its cell cycle process. Furthermore, the biological function of SAE1 may be associated with the PI3K/Akt/mTOR pathway. SAE1 will be a potential target for BC treatment.
Catheter Tip Migration in Female Patients With Breast Cancer: A Retrospective Comparative Study of Right- and Left-Sided Chest Ports.
O'Mahony AT, Coffey A, O'Regan PW … +7 more , Walsh E, Carey B, Ryan J, Dorney N, O'Connor OJ, Gleeson J, Power SP
Breast J · 2024 · PMID 39742380 · Full text
Chest ports are typically inserted via the right internal jugular vein with the left side being utilized in certain patient populations. The purpose of this study was to evaluate the dynamic position of the chest port an...
Chest ports are typically inserted via the right internal jugular vein with the left side being utilized in certain patient populations. The purpose of this study was to evaluate the dynamic position of the chest port and catheter tip, comparing a demographically matched cohort of female breast cancer patients with right- or left-sided chest ports. 142 female patients with breast cancer requiring chest port insertion for chemotherapy and imaging confirming catheter tip position initially with supine fluoroscopy and follow-up with erect chest radiography over a 5-year period were identified. Data points analyzed were catheter tip-to-carina distance and the distance from the port to the ipsilateral infraclavicular border. Intraprocedural measurements were taken in the supine position during chest port insertion and compared with follow-up erect chest radiography. The catheter tip position was also allocated a zone within the venous system on both image sets to assess for significant retraction to a more proximal zone in the erect position. Imaging within 12-months of chest port insertion was also screened to identify port-related complications. The whole cohort showed significant retraction of the catheter tip (cephalad) ( < 0.001) and protraction of the port (caudal) ( < 0.001). The median tip-to-carina distance decreased from 38.3 mm to 28.6 mm and the port-to-clavicle distance increased from 31.3 mm to 64.6 mm. Right-sided chest ports had increased tip-to-catheter retraction (15 mm) compared with left-sided (6.9 mm) (=0.310). A complication was identified in 8.5% of the right-sided and 11% of the left-sided ports. Zone migration was significantly associated with the occurrence of a complication in left-sided ports (=0.023). When assessing chest port catheter tip position between supine and erect radiographic studies in female patients with breast cancer, retraction cephalad will occur and this is more apparent in right-sided ports. Change in catheter tip position was not associated with a significant increase in complication rate unless it occurred in left-sided ports where zone migration was evident.
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