The Breast Journal[JOURNAL]
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200 papers
Intramammary Tumor Location and Ipsilateral Lymphatic Spread in Early Breast Cancer Patients Using One-Step Nucleic Acid Amplification (OSNA) Assay.
Cordeiro MR, Gante I, David D … +2 more , Gomes A, Figueiredo-Dias M
Breast J · 2024 · PMID 39742379 · Full text
Establishing an accurate prognosis for women diagnosed with breast cancer (BC) is extremely challenging. Axillary lymph node (ALN) evaluation is considered of major prognostic value. The one-step nucleic acid amplificati...
Establishing an accurate prognosis for women diagnosed with breast cancer (BC) is extremely challenging. Axillary lymph node (ALN) evaluation is considered of major prognostic value. The one-step nucleic acid amplification (OSNA) assay is currently used for assessing axillary sentinel lymph node (SLN) status in BC. Additionally, total tumor load (TTL) may help predict further metastatic axillary involvement beyond the SLN. The prognostic value of primary BC location remains controversial due to lack of consensus on the biological differences among tumors at various sites. Evidence suggests that tumors in the internal quadrants (INLs) have worse prognosis compared to those in the external quadrants. Furthermore, ALN involvement is believed to be mainly associated with external quadrant tumors, mainly due to the lymphatic drainage system of the breast. This pilot observational study, despite lacking a control group and having a relatively small sample size, is the first to evaluate the potential relationship between primary BC location and ALN metastasis using the OSNA assay. A sample of consecutive BC patients undergoing axillary staging with the OSNA assay were included. Tumors were categorized into three groups based on primary location: external quadrants and axillary tail (EXL), INLs, and nipple and areola location (NAL). Although not statistically significant, the INL group exhibited a higher mean TTL. Additionally, no significant differences were observed between groups concerning SLN detection techniques, SLN status, number of metastatic SLN, or mean TTL. These findings support the use of the innovative tracer superparamagnetic iron oxide regardless of tumor site. This study underscores the importance of understanding the relationship between BC location and ALN status, which may improve prognostic stratification and targeted therapies based on tumor site. If these observations are confirmed in larger, multicentric studies, the potential conclusions may shift the paradigm of INL tumor treatment, significantly impacting clinical practice and research.
Comparison of BRCA1 Gene Expression and CA15-3 Tumor Marker Level in Different Stages of Breast Cancer.
Soltani Irdmusa N, Bashi Zadeh Fakhar H, Heshmati M … +2 more , Akbari ME, Rahimi S
Breast J · 2024 · PMID 39742378 · Full text
Breast cancer (BC), a globally prevalent malignancy, shows significant variability in incidence across different geographical regions. In this study, we examined the expression of the tumor suppressor gene BRCA1 and the...
Breast cancer (BC), a globally prevalent malignancy, shows significant variability in incidence across different geographical regions. In this study, we examined the expression of the tumor suppressor gene BRCA1 and the tumor marker CA15-3 in women diagnosed with BC, focusing on different cancer grades. Our research, conducted at the Baqiyat Elah Hospital in Tehran in 2021, involved collecting blood and serum samples from BC patients. These samples underwent BRCA1 gene expression analysis and CA15-3 tumor marker assessment. Using the AJCC grading system, we categorized BC patients into various grades. Our findings revealed that BRCA1 gene expression was present in 28.57% of patients, while 71.43% showed negative expression. Both BRCA1 expression and CA15-3 levels significantly increased with advanced cancer stages ( < 0.001). These results suggest the potential utility of BRCA1 gene expression and CA15-3 tumor marker assessment in BC prognosis and management, particularly concerning staging and disease progression. This study provides valuable insights into the biology of BC and the development of prognostic markers for improved patient outcomes.
The Prognostic Quality of Risk Prediction Models to Assess the Individual Breast Cancer Risk in Women: An Overview of Reviews.
Wolf S, Zechmeister-Koss I, Fruehwirth I
Breast J · 2024 · PMID 39742377 · Full text
PURPOSE: Breast cancer is the most common cancer among women globally, with an incidence of approximately two million cases in 2018. Organised age-based breast cancer screening programs were established worldwide to dete...
PURPOSE: Breast cancer is the most common cancer among women globally, with an incidence of approximately two million cases in 2018. Organised age-based breast cancer screening programs were established worldwide to detect breast cancer earlier and to reduce mortality. Currently, there is substantial anticipation regarding risk-adjusted screening programs, considering various risk factors in addition to age. The present study investigated the discriminatory accuracy of breast cancer risk prediction models and whether they suit risk-based screening programs. METHODS: Following the PICO scheme, we conducted an overview of reviews and systematically searched four databases. All methodological steps, including the literature selection, data extraction and synthesis, and the quality appraisal were conducted following the 4-eyes principle. For the quality assessment, the AMSTAR 2 tool was used. RESULTS: We included eight systematic reviews out of 833 hits based on the prespecified inclusion criteria. The eight systematic reviews comprised ninety-nine primary studies that were also considered for the data analysis. Three systematic reviews were assessed as having a high risk of bias, while the others were rated with a moderate or low risk of bias. Most identified breast cancer risk prediction models showed a low prognostic quality. Adding breast density and genetic information as risk factors only moderately improved the models' discriminatory accuracy. CONCLUSION: All breast cancer risk prediction models published to date show a limited ability to predict the individual breast cancer risk in women. Hence, it is too early to implement them in national breast cancer screening programs. Relevant randomised controlled trials about the benefit-harm ratio of risk-adjusted breast cancer screening programs compared to conventional age-based programs need to be awaited.
Associations between PIK3CA Mutations and Disease Free Survival in Patients with HR+, HER2- Tumors Treated with Adjuvant Hormonal Therapy: A Real-World Study in Croatia.
Čerina Pavlinović D, Dedić Plavetić N, Belac Lovasić I … +6 more , Šeparović R, Flam J, Pancirov M, Bajić Ž, Tomić S, Vrdoljak E
Breast J · 2024 · PMID 39742376 · Full text
INTRODUCTION: Disease recurrence in patients with the early hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast tumor subtype is particularly challenging to manage due to its...
INTRODUCTION: Disease recurrence in patients with the early hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast tumor subtype is particularly challenging to manage due to its complex and very heterogeneous biological nature. Namely, due to primary and secondary resistance, one-quarter of patients with early-stage disease will experience disease recurrence. This variability in the timing of recurrence highlights the need to better identify key biomarkers that could predict therapeutic outcomes and guide personalized treatment strategies for these patients. Mutations in the phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene are highly prevalent (30-40%) in HR+/HER2- advanced breast cancer. They lead to activation of the PI3K/AKT/mTOR pathway, promoting cell growth, and proliferation, and are associated with poor prognosis in advanced breast cancer. Our aim was to examine the association between and impact of PIK3CA mutation status on disease-free survival (DFS) in HR+/HER2- early breast cancer patients. METHODS: This cohort study was multicentric and retrospective in nature and was conducted at five Croatian institutions from July 2020 to December 2021. The study included initially early and locally advanced operable HR+/HER2- breast cancer patients who were diagnosed with disease recurrence during adjuvant hormonal treatment or within the first six years of follow-up. RESULTS: A total of 186 patients were included, 40.9% of whom tested positive for the PIK3CA mutation. Primary and adjuvant treatment, particularly adjuvant endocrine treatment, were similar between the two groups. After adjustment for 14 relevant covariates, we found that patients with a positive PIK3CA status and the H1047 PIK3CA mutation had a significantly lower hazard of disease recurrence than patients with no PIK3CA mutation (HR 0.65; 95% CI 0.45; 0.95; =0.024; false discovery rate, FDR <10%). CONCLUSIONS: This study highlights the potential impact of PIK3CA mutations on disease recurrence during or following adjuvant endocrine therapy and potentially opens the door for further investigation of possibly more personalized treatment strategies.
Single-Port Three-Dimensional Endoscopic-Assisted Axillary Lymph Node Dissection (S-P 3D E-ALND): Surgical Technique and Preliminary Results.
Sae-Lim C, Lai HW, Chennavasin P … +5 more , Huang HI, Lin SL, Huang RH, Chen ST, Chen DR
Breast J · 2024 · PMID 39742375 · Full text
Endoscopic-assisted breast surgery (EABS) provides better cosmetic outcomes for breast cancer patients with small incisions in an inconspicuous area. However, an extended incision and heavy assistant retraction are usual...
Endoscopic-assisted breast surgery (EABS) provides better cosmetic outcomes for breast cancer patients with small incisions in an inconspicuous area. However, an extended incision and heavy assistant retraction are usually required for an adequate exposure for conventional axillary lymph node dissection (ALND). Therefore, we propose an innovative single-port three-dimensional endoscopic-assisted ALND (S-P 3D E-ALND) to facilitate better visualization, and report its preliminary outcomes herein. The surgical technique of the S-P 3D E-ALND, using either monopolar Endo Hook, LigaSure, or , is described. A total of 11 breast cancer patients who received the S-P 3D E-ALND in a single institution from January 2023 to September 2023 were enrolled. The preliminary results of the S-P 3D E-ALND, including perioperative parameters, complication, and short-term oncological outcomes, were retrospectively analyzed. Endoscopic breast and axillary procedures were conducted via a single axillary incision. The primary success rate of the S-P 3D E-ALND was 100% without a conversion to open surgery. The median operative time for the S-P 3D E-ALND was 39 (IQR = 28, 49) minutes. Average blood loss during E-ALND was 3 (IQR = 3, 5) mL. The median number of harvested LN was 10 (IQR = 8, 11) LNs. During the median follow-up time of 7 months, there was no complication, lymphedema, shoulder stiffness, or chronic arm numbness found. None of the patients reported locoregional recurrence, distant metastasis, or mortality. The S-P 3D E-ALND can serve as an alternative approach for ALND in breast cancer patients undergoing EABS, as our findings indicate it results in only minor complications.
Causes of Unwarranted Variation and Disparity in Breast Cancer Management in Regional and Rural Area.
Davis KJ, Campbell C, Costelloe R … +4 more , Song T, Fylyk G, Yu P, Craig SJ
Breast J · 2024 · PMID 39742374 · Full text
INTRODUCTION: Breast cancer management is complex, requiring personalised care from multidisciplinary teams. Research shows that there is unwarranted clinical variation in mastectomy rates between rural and metropolitan...
INTRODUCTION: Breast cancer management is complex, requiring personalised care from multidisciplinary teams. Research shows that there is unwarranted clinical variation in mastectomy rates between rural and metropolitan patients; that is, variation in treatment which cannot be explained by disease progression or medical necessity. This study aims to determine the clinical and nonclinical factors contributing to any unwarranted variation in breast cancer management in rural patients and to evaluate how these factors and variations relate to patient outcomes. METHODS: Comprehensive data from patients who had primary breast cancer surgery from 2010 to 2014 in either a rural or metropolitan location in a single local health district was analysed ( = 686). Records were subset into two rurality groupings based on the postcode in which the patient resided, and the Modified Monash Model (MMM), an Australian system for classifying rurality. Statistical analysis was used to compare rural and metropolitan cohorts on treatments, patient characteristics, timeliness, and outcomes (recurrence and survival). RESULTS: Rural patients had higher mastectomy rates than metropolitan patients (57% vs. 34%, < 0.001), despite a lack of difference in clinical or demographic factors accounting for such variation. The length of time between treatment pathway stages was consistently longer amongst rural patients ( < 0.01). Rural women also had worse survival outcomes, especially amongst HER2-positive patients who had significantly lower survival (5-year 74% vs 82%; 10-year 49% vs 71%, < 0.05) than metropolitan HER2-positive patients. CONCLUSION: This study reveals clinical disparities among rural breast cancer patients, that cannot be explained by demographic and clinical factors alone. Rural patients face lower rates of breast-conserving surgery and treatment delays, attributable to systemic barriers such as limited access to specialist care, high travel costs, and suboptimal care coordination. These findings have important implications for improving equity and collaboration in delivering person-centred breast cancer care.
Breast Desmoid Tumours: A Review of the Literature.
Wu M, Hughes TM, Edirimanne S … +1 more , Ngui N
Breast J · 2024 · PMID 39742373 · Full text
Breast desmoid tumour is a rare type of benign breast disease that presents like malignancy. Current guidelines are based on limited evidence derived from case reports and small case series and recommend resection with m...
Breast desmoid tumour is a rare type of benign breast disease that presents like malignancy. Current guidelines are based on limited evidence derived from case reports and small case series and recommend resection with microscopically-negative margin (R0). There is a high risk of recurrence despite negative surgical margins. A review of the published cases of breast desmoid since 2000 was conducted using Medline and Embase to descriptively analyse the clinical presentation, diagnosis, treatment, and outcomes of this rare disease. After screening, we identified 46 patients from 39 articles. Most cases did not have risk factors, but 17/46 (37%) had prior procedures on the ipsilateral breast. Mammography was able to detect 65% of the cases, ultrasound detected 74%, and both CT and MRI detected all cases when used. Preoperative diagnosis was best performed using core needle biopsy showing typical histology and positive beta-catenin staining. 42/46 cases underwent definitive surgical management, with 8 cases of recurrence. Recurrence occurred within 3 years of the initial surgery. Median time of recurrence was 8 months, and the median follow-up of the recurrence-free patients was 12 months. There were no predictive factors identified for recurrence. There were 7 cases treated with a nonsurgical modality, with 3 showing at least a partial response.
Health Information Needs of Breast Cancer Survivors: An Umbrella Review.
Gavili N, Sedghi S, Panahi S … +1 more , Razmgir M
Breast J · 2024 · PMID 39742372 · Full text
PURPOSE: The aim of this umbrella review was to identify the main information needs of breast cancer survivors. Since several reviews have already been done on this topic, conducting an umbrella review not only combines...
PURPOSE: The aim of this umbrella review was to identify the main information needs of breast cancer survivors. Since several reviews have already been done on this topic, conducting an umbrella review not only combines their results but also gives a comprehensive picture and informative summary of breast cancer survivors' needs. METHOD: The search was performed in PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane, and Google Scholar from inception to the end of March 2024. This review was conducted according to the JBI methodology for umbrella reviews, and the report was based on Rutten's category for information needs of patients with cancer. After removing duplicate and irrelevant articles, 14 systematic reviews were included in the analysis. The JBI checklist was used for evaluating the quality of eligible articles. RESULTS: The information needs were classified into 11 main categories and 86 subcategories. As a result of this umbrella review, one category was added to Rutten's 10 categories. Also, treatment information needs were introduced as the main identified category. Information on supportive care needs ranked second, and body image/sexuality information needs ranked third with a slight difference. CONCLUSION: The information needs outlined in the present study can serve as a general model to help clinical decision makers and policymakers in order to better understand the needs of the group and meet the information needs of the population. . These recommendations can promote and develop targeted interventions to reduce the psychosocial consequences of breast cancer survivors and increase their quality of life.
Screening of Breast among Women: A Cross-Sectional Study in Nepal.
Shah S, Dahal K, Pangeni P … +10 more , Niroula S, Paudel K, Subedi P, Dhakal S, Mandal P, Rawal L, Bhatta N, Shrestha A, Bhattarai G, Bhandari P
Breast J · 2024 · PMID 39742371 · Full text
BACKGROUND: Breast cancer ranks as the second most prevalent malignancy among women in Nepal. This cancer has a high likelihood of cure, if detected early. Therefore, it is imperative to emphasize awareness and screening...
BACKGROUND: Breast cancer ranks as the second most prevalent malignancy among women in Nepal. This cancer has a high likelihood of cure, if detected early. Therefore, it is imperative to emphasize awareness and screening for breast cancer in Nepal. It indeed underscores the importance of clinical breast examination. The study aims to find the disease burden, association of abnormal breast condition with sociodemographic variables, and the need for change in the breast cancer screening protocol. METHODS: A cross-sectional study was conducted from July to September 2023 on 100 female participants who were older than 18 years. Data were collected through face-to-face interviews using a structured questionnaire. The chi-square test was used to compare nominal variables while the independent sample -test and the paired sample -test were used to compare nominal and continuous variables. RESULTS: The findings of the study showed that 19% of all participants complained about abnormal breast, out of which 31.7% reported lumps, 26.31% reported discharge , another 26.31% reported pain, and the remaining 15.7% reported soreness. The upper outer quadrant and lower inner quadrant each individually accounted for 33.33% of the abnormal findings. The complaints of the participants in our study were significantly correlated with age at marriage, number of pregnancies, and use of contraception. CONCLUSION: Our study revealed considerable abnormal breast findings. This warrants the need for the change in breast cancer screening protocols which lead to early diagnosis and higher curability.
Is the ≥1 cm Width of the Resection Margin in Benign and Borderline Phyllodes Tumor Necessary to Reduce Recurrence?
Changchit N, Laokulrath N, Rushatamukayanunt P … +1 more , Pisarnturakit P
Breast J · 2024 · PMID 39742370 · Full text
BACKGROUND: Phyllodes tumors (PTs) are fibroepithelial neoplasms of the breast, with current treatment guidelines recommending wide excision to achieve surgical margins of ≥1 cm to minimize the recurrence risk. However,...
BACKGROUND: Phyllodes tumors (PTs) are fibroepithelial neoplasms of the breast, with current treatment guidelines recommending wide excision to achieve surgical margins of ≥1 cm to minimize the recurrence risk. However, diagnostic challenges with core biopsy specimens often result in suboptimal surgical margins. This study aims to elucidate the correlation between margin status and PT recurrence, thereby informing surgical decision-making and enhancing patient outcomes. METHODS: This single-center, retrospective study reviewed records of Thai women diagnosed with PTs between 2011 and 2018, collecting data on demographics, clinical presentation, surgical approach, tumor grade, size, and margin status. The primary endpoint was recurrence. RESULTS: Among 165 PT cases analyzed-49.1% borderline, 38.2% benign, and 12.7% malignant-the overall recurrence rate was 13.9% ( = 23) over a median follow-up of 4.5 years. No significant difference in recurrence rates was observed between patients with negative resection margins <1 cm (ranging from <1 mm to 9 mm) compared to those with ≥1 cm (10.2% vs. 7.1%, =1.00). Notably, in negative resection margins <1 cm group, a margin <1 mm (close margin) was associated with a significantly higher recurrence rate compared to margins of 1-9 mm (17.0% vs. 4.9%, =0.04). Borderline PTs followed the overall trend, while benign PTs showed increased recurrence with positive margins. Multivariate analysis indicated a significant association between margins <1 mm and recurrence (adjusted HR = 10.78 (95% CI 1.32-88.07), =0.027), highlighting an increased recurrence risk with more extensive positive margins. CONCLUSION: Our findings suggest that a wide surgical margin of ≥1 centimeter may not be necessary to prevent recurrence in benign and borderline PTs. Notably, surgical margins narrower than 1 millimeter substantially elevate the recurrence likelihood in cases of borderline PTs. Furthermore, the presence of positive surgical margins correlates with an increased recurrence rate in benign PTs. These findings highlight the critical need for a strategic approach in determining surgical margins, tailored specifically to the type of PT, to enhance patient outcomes effectively.
The Impact of the Coexpression of and Genes on Prognosticators and Clinical Outcomes of Breast Cancer: An Analysis for the METABRIC Dataset.
Ayoub NM, Al-Taani GM, Alkhalifa AE … +2 more , Ibrahim DR, Shatnawi A
Breast J · 2024 · PMID 39742369 · Full text
PURPOSE: Breast cancer is a heterogeneous disease. Exploring new prognostic and therapeutic targets in patients with breast cancer is essential. This study investigated the expression of MET, ESR1, and ESR2 genes and the...
PURPOSE: Breast cancer is a heterogeneous disease. Exploring new prognostic and therapeutic targets in patients with breast cancer is essential. This study investigated the expression of MET, ESR1, and ESR2 genes and their association with clinicopathologic characteristics and clinical outcomes in patients with breast cancer. METHODS: The METABRIC dataset for breast cancer was obtained from the cBioPortal public domain. Gene expression data for , , and , as well as the putative copy number alterations (CNAs) for were retrieved. RESULTS: The mRNA expression levels correlated inversely with the expression levels of and positively with the expression levels of ( = -0.379, < 0.001 and = 0.066, and =0.004, respectively). The mRNA expression was significantly different among CNAs groups ( < 0.001). Patients with high / coexpression had favorable clinicopathologic tumor characteristics and prognosticators compared to low coexpression in terms of greater age at diagnosis, reduced Nottingham Prognostic Index, lower tumor grade, hormone receptor positivity, HER2-negative status, and luminal subtype ( < 0.001). In contrast, patients with high / coexpression had unfavorable tumor features and advanced prognosticators compared to patients with low / coexpression ( < 0.001). No significant difference in overall survival was observed based on the coexpression status. However, when data were stratified based on the treatment type (chemotherapy and hormonal therapy), survival was significantly different based on the coexpression status of . CONCLUSIONS: Findings from our study add to the growing evidence on the potential crosstalk between MET and estrogen receptors in breast cancer. The expression of the MET/ESR genes could be a novel prognosticator and calls for future studies to evaluate the impact of combinational treatment approaches with MET inhibitors and endocrine drugs in breast cancer.
Gene Associated with Breast Cancer: A Genetic and Bioinformatic Study.
Chen X, Xiao H, Ning S … +3 more , Liu B, Zhou H, Fu T
Breast J · 2024 · PMID 39742368 · Full text
Female breast cancer is the most common and the fifth deadliest cancer worldwide. It is influenced by a combination of genetic, hormonal, and environmental factors. The excision repair cross-complementation group 3 gene...
Female breast cancer is the most common and the fifth deadliest cancer worldwide. It is influenced by a combination of genetic, hormonal, and environmental factors. The excision repair cross-complementation group 3 gene () has recently been identified as a breast cancer susceptibility gene in various cohorts of different geographical and ethnic origin. To explore the role of mutations in breast cancer development and pathological diagnosis, genetic analysis was conducted in 291 patients and 291 controls from mainland China. Bioinformatic analysis and immunohistochemistry (IHC) were performed. A novel mutation p.Y116X was identified in a breast cancer family, while no frequency bias for the genotype and allele of rs754010782 and rs371627165 was observed (all > 0.05). Bioinformatic analysis revealed that expression was negatively associated with estrogen receptor (ER), progesterone receptor (PR), nontriple-negative status, and nodal status of breast cancers. amplifications and deep deletions primarily occurred in breast invasive cancer not otherwise specified (NOS) and metaplastic breast cancer, respectively. The decreased ERCC3 expression in tumor tissues of patient with p.Y116X mutation was found by IHC. The 3 mutation p.Y116X may increase breast cancer risk in the Han-Chinese population. exhibits potential as a biomarker for the pathological diagnosis of breast cancer.
Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy.
Horisawa N, Yoshimura A, Oze I … +10 more , Sawaki M, Hattori M, Kotani H, Kataoka A, Ozaki Y, Nozawa K, Endo Y, Takatsuka D, Isogai A, Iwata H
Breast J · 2024 · PMID 39742367 · Full text
PURPOSE: Breast cancer-related lymphedema (LE) significantly impairs the patients' quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperativ...
PURPOSE: Breast cancer-related lymphedema (LE) significantly impairs the patients' quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE in patients who undergo ALND. Herein, we performed the risk of objective LE after ALND. METHODS: Patients who visited the medical follow-up clinic between 12 November 2018 and 11 January 2019 and at least one year postoperatively were eligible for this study. The risk factors for objective LE according to taxane-containing regimen, radiation therapy, and body mass index and the effects of a taxane-containing regimen followed by supraclavicular irradiation on LE were examined. RESULTS: A total of 214 patients were included in this analysis, and objective LE was observed in 52 patients (24%). Univariate and multivariate analyses showed that only supraclavicular field irradiation was a statistically significant risk factor for objective LE. In addition, the sequential use of taxane-containing regimens and supraclavicular RT was shown to be a more likely risk factor for LE than ALND alone. We also compared each taxane regimen with supraclavicular RT and found that DTX was more likely to be a risk factor for LE in cases of sequential use of supraclavicular RT than with ALND alone. However, when comparing DTX with supraclavicular RT and PTX with supraclavicular RT directly, there was no statistically significant difference in the risk of objective LE between the two groups. CONCLUSION: The risk for LE was more likely to be higher with the sequential use of taxane-containing chemotherapy and supraclavicular field irradiation. Therefore, management of LE is important in these cases.
Neoadjuvant Endocrine Therapy Compared to Neoadjuvant Chemotherapy in Node-Positive HR+, HER2- Breast Cancer (Nodal pCR and the Rate of ALND): A Systematic Review and Meta-Analysis.
Vasigh M, Karoobi M, Williams AD … +8 more , Abreha FM, Bleicher RJ, Yazd SMM, Shamsi T, Omranipour R, Elahi A, Farhat D, Habibi M
Breast J · 2024 · PMID 39742366 · Full text
INTRODUCTION: Patients with hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancers have the lowest response to neoadjuvant therapy of all subtypes. The role of neoadjuvant endocrine therapy (NET) in clinic...
INTRODUCTION: Patients with hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancers have the lowest response to neoadjuvant therapy of all subtypes. The role of neoadjuvant endocrine therapy (NET) in clinically node-positive (cN+), HR+, HER2- patients is evaluated in this meta-analysis. METHODS: This study was performed between January 2010 and August 2022. We evaluated the node pathologic complete response (pCR) and axillary lymph node dissection (ALND) rates after neoadjuvant endocrine therapy (NET). RESULTS: 18,037 HR+, HER2-, cN+ stage II and stage III breast cancer patients within eleven studies received neoadjuvant treatments. 3,707 (20.6%) patients received NET and 14,330 (79.4%) received NAC. The average age of the NET patients was higher than that of the neoadjuvant chemotherapy (NAC) patients (64.1 versus 47.6 years old, < 0.001). 45.0% and 26.9% of the NET and the NAC groups underwent a lumpectomy. The pooled estimates of node pCR in NET and NAC groups were 8.9% and 14.9%, and the pooled proportion of ALND was 39.1% and 58.5%, respectively. CONCLUSION: The rate of node pCR was lower among cN+ patients who received NET compared to the NAC group. The rate of ALND among cN+ NET patients was lower than the NAC group, revealing more patients with residual nodal disease do not get ALND in the NET group. Further prospective studies are required to compare survival outcomes as a more reliable surrogate.
Flat Aesthetic Mastectomy Closure with the Angel Wing Technique to Address Lateral Adiposity: Technique and Outcome Analysis.
Klenotic E, Ochoa D, Stephenson K … +4 more , Croswell C, Sullivan S, Sherman AC, Henry-Tillman R
Breast J · 2024 · PMID 39742365 · Full text
INTRODUCTION: Oncologic mastectomy in the setting of obesity poses challenges in achieving a flat closure that includes the lateral adiposity. The angel wing (AW) technique was developed to address this issue. We aim to...
INTRODUCTION: Oncologic mastectomy in the setting of obesity poses challenges in achieving a flat closure that includes the lateral adiposity. The angel wing (AW) technique was developed to address this issue. We aim to demonstrate the safety of AW by evaluating incidence of arm lymphedema (AL) and decreased range of motion (dROM) in patients postmastectomy with and without the AW closure. METHODS: We performed a single-center retrospective cohort study at an academic referral center of patients who underwent mastectomy with and without the AW technique from May 2014 to October 2022. Those who received breast reconstruction (immediate or delayed), partial mastectomy, and male patients were excluded. The presence of postoperative AL and dROM was evaluated. Subgroup analysis was performed for patient factors including BMI, extent of axillary surgery, PMRT, and pathologic stage. RESULTS: A total of 390 patients met inclusion criteria. Of those, 173 (44.4%) underwent AW and 217 (55.6%) had non-AW mastectomy. Expectedly, the average BMI was significantly higher in the AW cohort ( < 0.0001). The overall rate of AL was 51/390 (13.1%), seen in 27 (15.6%) undergoing AW and 24 (11.1%) non-AW ( value = 0.18). While the rate of dROM within the cohort was 52/390 (13.1%), 27 (15.6%) underwent AW vs. 24 (11.1%) non-AW ( value = 0.22), resulting in no statistical significance between AW and non-AW mastectomy upon subsequent development of AL or dROM. CONCLUSION: Our study demonstrates the AW technique does not convey an increased risk of overall AL or dROM, even when considering known risk factors such as obesity, PMRT, and extent of axillary surgery. As we strive to provide our patients with improved surgical techniques for oncologic resection, we submit that this technique is a viable and safe option for achieving the goals of cosmesis with oncologic safety.
Duration of Breastfeeding and Risk Reduction of Breast Cancer among Mothers Who Have Ever Breastfed: A Case-Control Study Conducted in Bahir Dar, Ethiopia.
Tiruneh FN, Ntenda PAM
Breast J · 2024 · PMID 39742364 · Full text
INTRODUCTION: Breast cancer is currently the most frequently detected cancer in women and the primary cause of cancer-related deaths globally. The incidence of breast cancer has significantly increased in countries acros...
INTRODUCTION: Breast cancer is currently the most frequently detected cancer in women and the primary cause of cancer-related deaths globally. The incidence of breast cancer has significantly increased in countries across sub-Saharan Africa, counting Ethiopia. There are multiple determinants of breast cancer, a few of these can be changeable whereas others are not. Evidence suggests that breastfeeding, which is a changeable determinant, reduces breast cancer risk. However, there is a lack of evidence specifically linking the duration of breastfeeding to breast cancer risk. To date, no study has been conducted on the association between the duration of breastfeeding and the likelihood of breast cancer among Ethiopian women. OBJECTIVE: The aim of this study was to evaluate the relationship between breastfeeding duration and breast cancer risk in Ethiopian mothers who had breastfed, taking into account other significant determinants. METHODS: A hospital-based case-control study was carried out in Bahir Dar, Ethiopia, involving 203 women (70 cases and 133 controls). Face-to-face interviews were performed using a standardized, validated questionnaire that assessed various sociodemographic, reproductive, lifestyle, and dietary characteristics. Differences between cases and controls were evaluated using the chi-square test. The associations among factors were examined through bivariate and multivariable binary logistic regression, with results presented as odds ratios and 95% confidence intervals. RESULTS: The multivariable investigation revealed that an inverse relationship between breastfeeding duration and breast cancer risk. Mothers who breastfed for a longer period had a 93% lower risk of breast cancer (AOR = 0.07; 95% CI: 0.021-0.21) compared to those who breastfed for a shorter duration. Younger mothers had a 95% lower likelihood of developing breast cancer (AOR = 0.05; 95% CI: 0.003-0.91) than older mothers. Additionally, mothers with sedentary behaviour were 10.53 times more likely to develop breast cancer (AOR = 10.53; 95% CI: 5.21-21.36) than those who were moderately or highly active. Mothers who experienced chest therapy were 6.43 times more likely to develop breast cancer (AOR = 6.43; 95% CI: 3.20-13.90) compared to those who had not. CONCLUSIONS: Interventions such as breastfeeding counselling and promoting the recommended duration of breastfeeding are crucial in minimizing the risk of breast cancer. Enhancing physical activity should also be viewed as a vital approach for lowering breast cancer risk. Additionally, healthcare professionals need to limit exposure to chest radiation therapy to reduce the likelihood of breast cancer.
Brain Metastasis in Triple-Negative Breast Cancer.
Bustamante E, Casas F, Luque R … +11 more , Piedra L, Barros-Sevillano S, Chambergo-Michilot D, Torres-Roman JS, Narvaez-Rojas A, Morante Z, Enriquez-Vera D, Desai A, Razuri C, De la Cruz-Ku G, Araujo J
Breast J · 2024 · PMID 39742363 · Full text
BACKGROUND: Breast cancer is an important cause of cancer-related death in women worldwide and represents the second most frequent cause of brain metastases after lung cancer. The aim of this study was to determine the c...
BACKGROUND: Breast cancer is an important cause of cancer-related death in women worldwide and represents the second most frequent cause of brain metastases after lung cancer. The aim of this study was to determine the characteristics and outcomes of triple-negative breast cancer (TNBC) patients with brain metastasis (BM). METHODS: We retrospectively reviewed a cohort of patients diagnosed with TNBC at the "Instituto Nacional de Enfermedades Neoplasicas" (period 2000-2014) to evaluate patients who developed BM. Survival rates were assessed by the Kaplan-Meier method, and prognostic factors were identified with the Cox regression analysis. RESULTS: Of a total of 2007 TNBC patients, 193 (9.62%) developed BM. Of these, 169 stages I-III patients with a median age of 45 years (range:21-78) were included. The stage in this cohort was 4 (2.4%) clinical stage (CS) I, 23 (13.6%) with CS II and 142 (84.0%) with CS III. Most of these patients presented ECOG ≥2 (68.6%). The most common symptom was headache (74.0%), followed by nausea-vomiting (46.7%). Imaging showed that 80 patients (53.0%) had ≥1 metastatic brain lesion. Regarding the treatment of BM in this cohort, 132 patients (84.6%) received radiotherapy (RT), 2 (1.5%) surgery, and 6 (4.5%) surgery plus RT. The overall survival (OS) rate of BM was 59.8%, 37.3%, and 15.0% at 3, 6, and 12 months, respectively. A multivariate analysis showed RT to be the only factor with a positive impact on the OS of BM (hazard ratio (HR) = 0.48, 95% confidence interval (CI):0.30-0.77, and = 0.002), while ECOG ≥2 was associated with a worse OS (HR = 1.69, 95%CI:1.15-2.48, and = 0.007). CONCLUSION: Despite the poor prognosis of TNBC patients who develop BM, RT showed a benefit in OS rates, while ECOG ≥2 was the only prognostic factor associated with a worse OS. These results may be useful for multidisciplinary teams for treatment planning in patients with TNBC and BM.
Primary Breast Malignancy in Children and Adolescents: A Population-Based Study.
He G, Shen N, Zhao L … +2 more , Liu X, Zhang C
Breast J · 2024 · PMID 39742362 · Full text
Primary breast cancer in children and adolescents is extremely uncommon and presents with different characteristics from those found in adult women. We aimed to conduct a population-based cohort study to predict overall...
Primary breast cancer in children and adolescents is extremely uncommon and presents with different characteristics from those found in adult women. We aimed to conduct a population-based cohort study to predict overall survival (OS) in pediatric patients with breast cancer. Demographic and clinicopathological data on pediatric breast cancer patients were obtained from the Surveillance, Epidemiology, and End Results database (2000-2019). The survival rates were measured using the Kaplan-Meier method. Univariate survival analysis used the log-rank test, while multivariate analysis used Cox proportional hazards regression to identify factors influencing OS. Furthermore, we created a nomogram to predict OS in pediatric patients. A total of 115 pediatric patients were analyzed, with a median age at diagnosis of 18 years (range: 2-19 years). In terms of tumor grade, 27 (23.4%) patients had well or moderately differentiated tumors and 32 (27.8%) had poorly or undifferentiated tumors. The predominant histological type was phyllodes tumor, accounting for 36.5%, followed by infiltrating duct carcinoma at 31.3%, and other types at 32.2%. The SEER and M stages were substantial independent indicators of OS. A nomogram was created to predict OS in pediatric breast cancer patients. Our findings confirmed that the SEER stage and M stage were the most critical predictors of OS in pediatric patients with breast cancer. By focusing on this rare demographic, our study fills an important gap in the literature, as there are few comprehensive studies available that explore a prognosis in pediatric breast cancer.
Effect of Estrogen Receptor on the Relationship Between HER2 Immunohistochemistry Score and Pathological Complete Response to Neoadjuvant Treatment in HER2-Positive Breast Cancer.
Jia M, Yang H, Pan L … +2 more , Gao J, Guo F
Breast J · 2024 · PMID 39742361 · Full text
We aimed to investigate whether estrogen receptor (ER) status affects the predictive role of the human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) score on the efficacy of neoadjuvant treatment f...
We aimed to investigate whether estrogen receptor (ER) status affects the predictive role of the human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) score on the efficacy of neoadjuvant treatment for HER2-positive breast cancer. This retrospective study comprised 167 individuals diagnosed with HER2-positive invasive breast cancer who had undergone neoadjuvant treatment and surgery. Uni- and multivariable logistic regression analyses were performed on the relationship between the HER2 IHC score and total pathological complete response (tpCR), breast pathological complete response (bpCR), or axillary partial response (apCR). Subgroup analyses were used to investigate whether the relationship between the HER2 IHC score and tpCR, bpCR, or apCR differed by ER or PR status. The overall tpCR rate for HER2-positive breast cancers treated with neoadjuvant treatment was 41.32% (69 of 167). The tpCR, bpCR, and apCR rates were greater in the HER2 IHC 3+ group (tpCR: IHC 3 + 47.69% vs. IHC 2 + 18.92%, =0.009). Significant interactions between HER2 IHC score and tpCR or bpCR were found in subgroup analyses based on ER status (tpCR: for interaction = 0.001; bpCR: for interaction = 0.001). Among ER-positive patients, the HER2 IHC 2+ group had substantially decreased tpCR, bpCR, and apCR rates than the HER2 IHC 3+ group (tpCR rate: =0.003; bpCR rate: =0.002; apCR rate: =0.002). For ER-negative individuals, the tpCR, bpCR, and apCR rates did not differ significantly among the HER2 IHC 3+ versus HER2 IHC 2+ groups. Similarly, interactions between HER2 IHC score and tpCR, bpCR, or apCR were found in subgroup analyses based on PR status. HER2 IHC 2+ may indicate a decreased tpCR rate, bpCR rate, and apCR rate to neoadjuvant treatment in HR-positive patients having HER2-positive breast cancer, but not in HR-negative patients.
Clinical Radiologic Analysis of 2964 Papillary Breast Lesions.
Zhang H, Hu A, Li Y … +16 more , Li M, Rong Z, Cheng W, Liu Y, Duan Y, Feng J, Chen Z, Yu T, Zhang J, Wang T, Shang Y, Fang Z, Liu J, Kong F, Ma F, Guo B
Breast J · 2024 · PMID 39742360 · Full text
Clinical management of papillary breast lesions (PBLs) remains controversial. Our objective was to analyze the independent risk factors associated with malignant PBLs. A retrospective review of clinical variables in 296...
Clinical management of papillary breast lesions (PBLs) remains controversial. Our objective was to analyze the independent risk factors associated with malignant PBLs. A retrospective review of clinical variables in 2964 patients with papillary lesions available for evaluation. This retrospective study screened that older patients (≥ 50 years), postmenopausal, palpable tumor, tumor size ≥ 15 mm, peripheral tumor, and tumor with calcification were independent risk factors affecting malignant PBLs. Moreover, the probability of malignant PBLs without the appealed risk factors was only 3.4%. Patients without risk factors for papillary lesions can manage their health with imaging surveillance. The choice of surgical treatment for the remaining patients is a reasonable recommendation.
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