International Journal Of Breast Cancer[JOURNAL]
Sun
200 papers
High Mammographic Density in Younger Women and Its Implications for Breast Cancer Subtypes.
Hikmawati S, Kardinah, Putri RI … +9 more , Laiman V, Mupangat I, Irfan RM, Noor ZA, Laskarsantri PN, Safitri LS, Wahyono A, Heriyanto DS, Choridah L
Int J Breast Cancer · 2026 · PMID 42383253 · Full text
BACKGROUND: High breast density is commonly observed in younger breast cancer patients (<45 years), and Asian women generally have dense breasts even beyond the age of 45 years. Its relationship with breast cancer subtyp...
BACKGROUND: High breast density is commonly observed in younger breast cancer patients (<45 years), and Asian women generally have dense breasts even beyond the age of 45 years. Its relationship with breast cancer subtypes and its profile remains unclear. This study is aimed at exploring the association between mammographic density and breast cancer molecular subtypes. METHODS: A cross-sectional study evaluating mammographic density based on the 2013 BI-RADS classification among breast cancer patients at Dharmais Cancer Hospital between 2021 and 2023 was conducted. Clinicopathological variables-including histological subtype, tumor grade, ER, PR, HER2 status, Ki-67 index, and molecular subtypes by immunohistochemistry-were analyzed. RESULTS: High breast density (BI-RADS C and D) was observed in 69% of patients, with Category C being the most common (57.1%). Invasive ductal carcinoma of no special type was the most prevalent and 47.2% of tumors were high grade. Most tumors were ER-negative (67.1%), PR-negative (59.6%), and HER2 0 (54.0%), with high Ki-67 index in 70.2% of cases. Age was associated with breast Density C and D and TNBC molecular subtype ( < 0.05). HER2, Ki-67, and molecular subtype were negatively correlated with ER ( = -0.217, = -0.283, and = -0.851, respectively; < 0.05) and with PR ( = -0.169, = -0.287, and = -0.840, respectively; < 0.05). Conversely, HER2 and Ki-67 expressions were positively correlated with more aggressive molecular subtypes ( = 0.307 and = 0.354, respectively; < 0.05). CONCLUSION: Younger breast cancer patients were associated with higher breast density and more aggressive tumor subtypes, which correlated with HER2 and Ki-67 expressions in breast cancer. These underscore the relevance of age-related biological factors in shaping breast cancer characteristics. However, among Indonesian women over 45 years old, the proportion of high breast density remains remarkably high (65.6%), suggesting that factors beyond age-such as genetic, hormonal, or lifestyle influences-may contribute to the persistence of dense breast tissue in this population.
Comparing Disease-Free Survival (DFS) and Overall Survival (OS) Rates in Breast Cancer Patients: Axillary Lymph Node Dissection (ALND) Versus Sentinel Lymph Node Biopsy (SLNB).
Amiri B, Mellat Ardakani M, Pajouhi A … +6 more , Akbari A, Farokhi S, Akbari ME, Tahmasebi Ghorabi S, Karimi Rouzbahani A, Beiranvand M
Int J Breast Cancer · 2026 · PMID 42368789 · Full text
BACKGROUND: Examining the survival rate in breast cancer patients serves as a metric for assessing and advancing various treatment modalities. In light of the significant incidence of breast cancer in Iran, this study is...
BACKGROUND: Examining the survival rate in breast cancer patients serves as a metric for assessing and advancing various treatment modalities. In light of the significant incidence of breast cancer in Iran, this study is aimed at examining and comparing the disease-free survival (DFS) and overall survival (OS) rates among breast cancer patients who underwent axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB). PATIENTS AND METHODS: This retrospective cohort research included 1071 patients at Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, from 1991 to 2021. The recurrence and survival rates of patients undergoing ALND and SLNB in both groups were examined and evaluated. The data were analyzed using SPSS statistical software using descriptive statistical techniques (percentage, frequency, mean, and standard deviation), Kaplan-Meier analysis, and Cox regression tests. A significance threshold of 0.05 is used. RESULTS: The average OS among all patients was 18.08 ± 0.51. The average OS in the ALND group was 18.1 ± 0.53; in the SLNB group, it was 12.8 ± 0.39, which was insignificant ( < 0.05). The average DFS among all patients was 17.13 ± 0.51. The average DFS in the ALND group was 16.95 ± 0.54; in the SLNB group, it was 11.96 ± 0.3; the difference was insignificant ( = 0.11). CONCLUSION: OS and DFS in the ALND group were higher than in the SLNB group, but they were not statistically significant.
Efficacy of AC-T Versus TAC Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer: A Retrospective Analysis.
Mirzania M, Anari F, Emami SAH … +5 more , Roudini K, Karimi M, Saleh K, Mortezazadeh M, Khajeh-Mehrizi A
Int J Breast Cancer · 2026 · PMID 42328209 · Full text
PURPOSE: Locally advanced breast cancer (LABC) remains a major therapeutic challenge, with neoadjuvant chemotherapy (NAC) serving as a cornerstone of management. However, direct evidence comparing the efficacy of sequent...
PURPOSE: Locally advanced breast cancer (LABC) remains a major therapeutic challenge, with neoadjuvant chemotherapy (NAC) serving as a cornerstone of management. However, direct evidence comparing the efficacy of sequential (AC-T) and concurrent (TAC) anthracycline-taxane regimens in real-world Middle Eastern populations remains scarce. This study is aimed at comparing the clinical outcomes of AC-T and TAC in Iranian women with LABC. METHODS: A retrospective cohort study was conducted among 118 patients with Stage III breast cancer treated at Tehran, Iran. Patients received either AC-T (doxorubicin/cyclophosphamide followed by paclitaxel; = 70) or TAC (docetaxel/doxorubicin/cyclophosphamide; = 48). Outcomes included pathological complete response (pCR), overall survival (OS), disease-free survival (DFS), distant recurrence-free survival (DRFS), and locoregional recurrence-free survival (LRFS). RESULTS: Baseline demographic and clinical characteristics were comparable between groups. No significant difference in pCR rates was observed between the groups. The AC-T regimen showed higher, though nonsignificant, OS at 3, 5, and 10 years (90%, 82%, and 71%, respectively) compared with TAC (83%, 74%, and 57%). Conversely, TAC demonstrated significantly superior 10-year DRFS (62% vs. 45%, = 0.019). DFS and LRFS were similar between regimens. Multivariable Cox regression analysis identified ER positivity as the only independent predictor of improved OS (HR = 0.42, 95% CI: 0.29-0.82, = 0.012) and DFS (HR = 0.36, 95% CI: 0.18-0.73, = 0.005), whereas the chemotherapy regimen was not independently associated with survival after adjustment for confounders. CONCLUSION: Both AC-T and TAC provided effective neoadjuvant control in LABC, with comparable survival outcomes. These findings support individualized regimen selection based on patient profile and tumor biology. Prospective studies are needed to refine region-specific treatment strategies.
The Role of Angiogenesis in Breast Cancer and Obesity: Unravelling the Connection.
Sikuza YOK, Basson C, Oberholzer N … +1 more , Ambele MA
Int J Breast Cancer · 2026 · PMID 42328208 · Full text
Breast cancer remains one of the leading causes of cancer-related mortality amongst women worldwide, with rising incidence rates paralleling the global obesity epidemic. Obesity has been increasingly recognised as a risk...
Breast cancer remains one of the leading causes of cancer-related mortality amongst women worldwide, with rising incidence rates paralleling the global obesity epidemic. Obesity has been increasingly recognised as a risk factor for breast cancer, yet the molecular mechanisms underlying the association remain poorly understood. This review explores the role of angiogenesis as the central mechanism linking obesity to breast cancer progression. Angiogenesis is essential for both adipose tissue expansion and tumour growth. It is dysregulated in obesity and breast cancer, resulting in the formation of abnormal vasculature that perpetuates hypoxia and malignancy. Obesity contributes to this process through hypertrophic adipose tissue, altered adipokine profiles and elevated expression of proangiogenic factors, such as VEGF. These changes create a tumour microenvironment conducive to cancer progression, treatment resistance and poor clinical outcomes. Emerging evidence also implicates endothelial cells, pericytes and lipid metabolism in this interaction, suggesting novel therapeutic targets.
Preliminary Effectiveness of the Comprehensive Oncology Rehabilitation and Exercise (CORE) Clinical Workflow Algorithm on Health Outcomes During Nonmetastatic Breast Cancer Care.
Simon LH, Saviers-Steiger C, Dunston ER … +13 more , Zickmund SL, Hansen PA, Ulrich CM, LaStayo PC, Steinberg D, Noren CS, Finch A, Seckinger L, Braun E, Chipman J, Oza S, Brownson KE, Coletta AM
Int J Breast Cancer · 2026 · PMID 42292298 · Full text
BACKGROUND: The Comprehensive Oncology Rehabilitation and Exercise (CORE) pilot trial aimed to test the feasibility and acceptability of a clinical workflow algorithm that integrated exercise and rehabilitation services...
BACKGROUND: The Comprehensive Oncology Rehabilitation and Exercise (CORE) pilot trial aimed to test the feasibility and acceptability of a clinical workflow algorithm that integrated exercise and rehabilitation services from breast cancer diagnosis throughout the first 24 weeks of care. Here, we investigated the preliminary effectiveness of the CORE algorithm compared with standard of care (SOC) on changes in physical function, health-related quality of life (HRQoL), and exercise engagement in women newly diagnosed with Stage I-III breast cancer with plans for surgery as first-line treatment. METHODS: Seventy-two women were randomly assigned in a 2:1 ratio to CORE or SOC. All participants completed study assessments at three time points that aligned with routine breast surgical oncology clinic visits: surgical consultation (i.e., baseline), postoperative, and 24 weeks postoperative. The following outcomes and associated assessments were carried out in the clinic: physical function: PROMIS physical function survey (primary function assessment), five-time chair stand, 10-m walk, back scratch, and QuickDASH survey; HRQoL: FACT-B survey; and exercise engagement: modified Godin physical activity survey (primary engagement assessment) and accelerometer wear for 1 week following each clinic visit. RESULTS: Fifty-nine participants had evaluable data, with the majority having Stage I disease (83%), being primarily White (75%) and non-Hispanic (90%), and having a median age and BMI of 58 years and 26.0 kg/m, respectively. Mean difference in change in PROMIS physical function score from baseline to 24 weeks postoperative between CORE and SOC was not statistically significant (-1.86, 95% CI -6.02 to 2.3). A modest advantage in exercise engagement was observed in the CORE arm (Godin: 5.46, 95% CI -1.06 to 11.98; effect size: 0.36, 95% CI -0.07 to 0.78; accelerometry: median difference 12 min, bootstrapped 95% CI -37 to 40). CONCLUSION: The CORE clinical workflow algorithm demonstrates promise in improving exercise engagement. More work is needed in an adequately powered trial to confirm these findings and evaluate effectiveness on other outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04594473.
Acute Skin Toxicities After Ultrahypofractionated Versus Hypofractionated Postoperative Radiotherapy in Patients With Early Breast Cancer-A Single-Institution Clinical Study.
Petkovska G, Ratosa I, Trajanovska VB … +5 more , Iljovska M, Lazareva E, Lazarevska A, Klisarovska V, Smichkoska S
Int J Breast Cancer · 2026 · PMID 42254469 · Full text
BACKGROUND: Real-world safety data from Southeastern Europe are limited for ultrahypofractionated (UHF) whole-breast irradiation (WBI). We aimed to evaluate acute skin toxicity with UHF versus hypofractionated (HF) posto...
BACKGROUND: Real-world safety data from Southeastern Europe are limited for ultrahypofractionated (UHF) whole-breast irradiation (WBI). We aimed to evaluate acute skin toxicity with UHF versus hypofractionated (HF) postoperative radiation therapy in early breast cancer, following implementation of this fractionation regimen. METHODS: This combined prospective-retrospective study included women aged ≥50 years following breast-conserving surgery (pT1-2, pN0-1, M0). The UHF cohort (prospective) received 26 Gy in 5 fractions over one week between 2023 and 2024. The control group consisted of retrospective data obtained from institutional records of patients who received WBI using a HF schedule of 40.5-42.6 Gy in 15-16 fractions over 3 weeks between 2015 and 2020. All patients were treated with 3D-CRT WBI without regional nodal irradiation or boost. Acute skin toxicity was graded by CTCAE v5.0 at end of treatment and at 4 and 12 weeks. RESULTS: This study included 80 patients, with 40 in each group, with a mean age of 61.1 ± 6.6 years. Baseline clinicopathological characteristics were comparable, except for a slightly larger median tumor size in the UHF group ( = 0.037). At the end of radiation therapy, acute radiodermatitis occurred in 36 of 40 (90%) patients receiving UHF and in 38 of 40 (95%) patients receiving HF (p = 0.396). The grade distribution was comparable across the two groups ( = 0.53), and no grade ≥3 events were recorded. At 4 weeks, no adverse skin reactions were observed in patients receiving UHF, and by twelve weeks, no active radiodermatitis persisted in either group. CONCLUSIONS: UHF WBI (26 Gy/5 fractions) demonstrated comparable acute skin toxicity to standard HF regimens, supporting its safety and clinical feasibility in routine practice.
Machine Learning-Based Prediction of Breast Cancer in Women: Insights From Feature Selection of Clinical and Lifestyle Data.
Allahqoli L, Behzadi MH, Aghamohammadi SZ … +8 more , Hakimi S, Salehiniya H, Fallahi A, Rahmani A, Shahabinia Z, Mazidimoradi A, Momenimovahed Z, Ghiyasvand M
Int J Breast Cancer · 2026 · PMID 42158462 · Full text
OBJECTIVE: This study is aimed at developing and evaluating a machine learning-based model for breast cancer classification using integrated clinical, demographic, reproductive, and lifestyle data. METHODS: A retrospecti...
OBJECTIVE: This study is aimed at developing and evaluating a machine learning-based model for breast cancer classification using integrated clinical, demographic, reproductive, and lifestyle data. METHODS: A retrospective machine learning framework was developed using data from a case-control study conducted in Tehran. The dataset included demographic, clinical, reproductive, lifestyle, and screening-related variables. Data preprocessing was performed within machine learning pipelines to ensure data quality and prevent data leakage. Duplicate records and noninformative variables were removed. Missing values were imputed using median values for numerical variables and the most frequent value for categorical variables. Categorical features were encoded appropriately, and Min-Max normalization was applied where required. Feature selection was conducted using mutual information (MI) and analysis of variance (ANOVA) within a stratified cross-validation framework. The data were split into training (80%) and test (20%) sets. Several supervised learning algorithms, including Gaussian Naive Bayes (GNB), K-nearest neighbors (KNN), decision tree (DT), random forest (RF), support vector machine (SVM), logistic regression (LR), and artificial neural network (ANN), were trained and evaluated. Model performance was assessed using accuracy, precision, recall (sensitivity), F1-score, and receiver operating characteristic-area under the curve (ROC-AUC), with stratified 5-fold cross-validation and final evaluation on an independent test set. RESULTS: Significant differences were observed between breast cancer patients and healthy controls across multiple demographic and clinical variables. Patients were generally older and more likely to be widowed, belong to higher socioeconomic classes, and be housewives, whereas higher education levels and employment were more frequent among healthy individuals ( < 0.001). Reproductive factors, including age at first marriage and breastfeeding duration, also showed significant differences. Feature selection reduced 414 initial variables to 40 key predictors. The most influential features included genetic factors (BRCA1/2 mutations and family history), reproductive and hormonal characteristics (age at menarche, menopause, and infertility), lifestyle behaviors (dietary patterns and physical activity), anthropometric measures (BMI and weight at age 30), and screening-related variables (mammography, ultrasound, and biopsy). All models demonstrated strong and stable performance with minimal differences between cross-validation and test results, indicating good generalization. RF achieved the highest performance (accuracy: 0.9897, precision: 0.9946, recall: 0.9840, F1-score: 0.9892), followed by SVM and LR, whereas ANN showed the lowest overall performance. CONCLUSION: Machine learning models can effectively classify breast cancer using multidimensional patient data. Ensemble methods, particularly RF, demonstrated superior accuracy and robustness, highlighting their ability to capture complex nonlinear relationships. The identified predictors are consistent with established clinical and epidemiological risk factors, supporting the validity of the proposed models. These findings suggest that machine learning approaches hold strong potential for personalized risk assessment and early detection of breast cancer; however, external validation across diverse populations is necessary to confirm generalizability.
Patterns of Postmastectomy Radiotherapy in Immediate Breast Reconstruction-Results From the iBRA-2 Cohort Study.
Rattay T, Trickey A, O'Connell RL … +6 more , Dave RV, Skillman J, Barnes NLP, Gardiner MD, Holcombe C, Potter S
Int J Breast Cancer · 2026 · PMID 42158461 · Full text
PURPOSE: Long-term data indicate that postmastectomy radiotherapy (PMRT) is associated with improved overall survival in node-positive breast cancer patients. Immediate breast reconstruction (IBR) remains controversial i...
PURPOSE: Long-term data indicate that postmastectomy radiotherapy (PMRT) is associated with improved overall survival in node-positive breast cancer patients. Immediate breast reconstruction (IBR) remains controversial in the context of planned PMRT, but rates of IBR are increasing. The aim of this study was to examine patterns of PMRT in patients undergoing mastectomy with or without IBR. METHODS: Data were collected from 2526 patients enrolled in the iBRA-2 prospective cohort study undergoing 2606 mastectomies with and without IBR between 1 July 2016 and 31 December 2016. Patients were recruited consecutively at 71 centres across the United Kingdom (UK) and Ireland and at five international centres. Univariable and multivariable logistic regression models were used to explore associations between recommendation for PMRT and patient- and procedure-related factors. RESULTS: Of 2590 breast procedures included in the analysis, 696 were implant-based, 105 pedicled-flap and 230 free-flap reconstructions, and 32.5% of implant-based, 34.3% of pedicled-flap and 35.7% of free-flap reconstructions were recommended for PMRT. PMRT recommendation by cancer stage was 21% for T1-2 N0, 65% for T1-2 N1 and 89% for T N2 and T3 N. In multivariable analyses, patients with invasive disease undergoing implant-only reconstruction, but not pedicled-flap or free-flap reconstruction, were less likely to be recommended for PMRT than those undergoing mastectomy alone. The likelihood of being recommended for PMRT differed by region. CONCLUSION: Although IBR was more likely to be performed for lower-stage cancers and in younger patients with fewer comorbidities, a third of patients undergoing IBR were recommended for PMRT. This adds to a growing body of evidence that IBR is becoming an acceptable option for women requiring PMRT. The study also highlighted regional variation in PMRT practice within the UK and Ireland, which merits further investigation.
Implementation of a Multidisciplinary Protocol for the Safe Handling of Iodine-125 Radioactive Seeds in the Pathology Laboratory.
Rodríguez-Villena A, Schmülling UCV, Zapata IV … +6 more , Rivas-Fidalgo S, Gión-Cortés M, López-Rodríguez MJ, Carretero-Barrio I, Palacios J, Pérez-Mies B
Int J Breast Cancer · 2026 · PMID 42130810 · Full text
BACKGROUND: Iodine-125 radioactive seeds (I-RS) are increasingly used for preoperative localization of nonpalpable breast lesions due to their precision, safety, and logistical advantages. However, due to radiation safet...
BACKGROUND: Iodine-125 radioactive seeds (I-RS) are increasingly used for preoperative localization of nonpalpable breast lesions due to their precision, safety, and logistical advantages. However, due to radiation safety regulations, their use requires a coordinated and strictly regulated workflow to ensure safe handling and retrieval of radioactive material. This study assesses the first year of a multidisciplinary protocol implemented to standardize I-RS management and minimize incidents. METHODS: A protocol involving Radiology, Surgery, Nuclear Medicine, and Pathology was established to ensure proper documentation, transport, radiographic confirmation, seed retrieval, and incident reporting. All I-RS recovered from formalin-fixed specimens between May 2022 and September 2023 were evaluated. Incidents were classified as protocol deviations (Category I) or technical retrieval difficulties (Category II). Clinicopathological data were collected, and analyses were performed using chi-square and ANOVA tests ( < 0.05). RESULTS: A total of 146 seeds were retrieved from 130 specimens from 123 patients. Most samples were lumpectomies (89.2%); 24.4% of patients received neoadjuvant therapy. Invasive carcinoma accounted for 82.3% of diagnoses. Double-seed placement was used in 16 cases. Positive margins occurred in 9.1%, and 7.2% required reoperation. There were 18 incidents (14.6%): Category I, 10 (55.6%), mainly documentation errors or seed displacement within containers; and Category II, 8 (44.4%), mostly seeds hidden within tissue slices. Nuclear Medicine was consulted in 11 cases. Importantly, no seeds were lost. No significant associations were found between incidents and clinicopathological variables. CONCLUSIONS: The multidisciplinary protocol ensured safe and efficient handling of I-RS, preventing seed loss and improving traceability. Most incidents were minor, manageable, and reduced with staff training and adherence to standardized procedures. Continuous monitoring supports workflow optimization and maintains safety standards in pathology laboratories. This approach may serve as a model for institutions implementing I-RS localization.
Establishment of Breast Cancer Organoids: A Systematic Review and Meta-Analysis.
Rocha VM, Katayama MLH, Amorim LO … +3 more , de Oliveira BD, Lopez RVM, Folgueira MAAK
Int J Breast Cancer · 2026 · PMID 42124939 · Full text
BACKGROUND: Organoid culture has emerged as a promising model for studying normal and tumor tissues. Organoids may resemble their tissue of origin, allowing assessment of disease behavior and drug response. In breast can...
BACKGROUND: Organoid culture has emerged as a promising model for studying normal and tumor tissues. Organoids may resemble their tissue of origin, allowing assessment of disease behavior and drug response. In breast cancer (BC), successful organoid establishment may depend on factors like time from tissue collection to culture, dissociation methods, and media composition, which may affect tumor growth and tissue similarity across culture passages. This systematic review and meta-analysis are aimed at assessing the success rate of BC organoid establishment and their similarity to parental tumors. METHODS: Following PRISMA guidelines, we conducted an electronic search in PubMed, Embase, and Web of Science using terms related to "breast cancer" and "organoids". Heterogeneity was assessed by I2 (%), with forest plots for all studies and subgroups. A fixed-effects meta-analysis estimated the overall establishment rate with 95% confidence intervals. RESULTS: We analyzed 59 full-text articles. Five culture media types and 37 added components were reported, most frequent EGF (80%), glutamine, FGF, R-spondin (66%, each), Y27632, and N-acetylcysteine (64%, each). Ten studies provided data on initial samples and established organoids, totaling 504 and 349, respectively, with an establishment rate of 71.34% (95% CI: 67.55-75.14), varying from 31.25% to 86.21%. By subtype, establishment rates were as follows: Luminal A (57.47%), Luminal B (72.51%), HER2+ (71.24%), and triple-negative (78.75). Concordance between receptor expression in tumors and organoids was observed, with kappa values of 0.692 for ER, 0.597 for PR, and 0.711 for HER2. However, positive receptor expression reverted to negative in 19%, 31%, and 28% of organoids for ER, PR, and HER2, respectively. CONCLUSION: Breast cancer organoids were successfully established from primary tumor samples, demonstrating good overall concordance in receptor expression with the original tumors. These findings support the feasibility of patient-derived organoids as translational models; however, continuous phenotypic characterization across passages is recommended.
The Roles of MicroRNAs, Oncogenes, and Tumor Suppressor Gene Molecular Subtypes of Breast Cancer: Therapeutic Potential of Pharmaceutical and Natural Products.
Jaman MS, Maniruzzaman M, Bhuiyan MRH … +1 more , Haque MS
Int J Breast Cancer · 2026 · PMID 42111864 · Full text
BACKGROUND: Breast cancer (BC) is the most common malignancy among women, with 2.3 million new cases and over 670,000 deaths annually. Despite advances in detection and therapy, relapse, metastasis, and resistance remain...
BACKGROUND: Breast cancer (BC) is the most common malignancy among women, with 2.3 million new cases and over 670,000 deaths annually. Despite advances in detection and therapy, relapse, metastasis, and resistance remain significant challenges. Tumor suppressor genes (TSGs) regulate abnormal cell division, whereas oncogenes, which arise from proto-oncogenes, can inhibit TSGs and promote cancer progression. MicroRNAs further influence cellular processes in both normal and malignant states. Pharmaceutical agents such as tamoxifen and paclitaxel have demonstrated efficacy, while natural products, including baicalin and ursolic acid, show promise in modulating oncogenic pathways. Understanding BC subtypes is crucial, as they guide prognosis and enable more precise and personalized treatment strategies. These insights emphasize the complex molecular landscape and evolving approaches to BC therapy. OBJECTIVE: The review was conducted using a defined set of keywords to search PubMed, Web of Science, Embase, Scopus, Google Scholar, and SciSearch databases covering publications from the inception of each database through August 2, 2025. KEY FINDINGS: This review outlines BC subtypes and their molecular features, highlighting TSGs, oncogenes, and miRNAs as therapeutic targets. Both synthetic drugs and natural compounds demonstrate potential applications in advancing BC treatment strategies. CONCLUSION: BC subtypes, defined by morphology and molecular features, remain vital for targeted therapy advancement. TSGs, oncogenes, and miRNAs play key roles in subtype regulation and require further study for precise detection and treatment. Synthetic drugs and natural compounds show promise as therapeutic agents. However, continued molecular research is essential to improve personalized strategies and overcome relapse, metastasis, and resistance in BC management.
Validity and Reliability of the Breast Cancer Screening Beliefs Questionnaire Among Ghanaian Women.
Teye-Kwadjo E
Int J Breast Cancer · 2026 · PMID 42099428 · Full text
BACKGROUND: Breast cancer screening allows early detection of treatable breast cancer malignancies. However, the use of breast cancer screening among asymptomatic women in Ghana is reported to be generally low. In additi...
BACKGROUND: Breast cancer screening allows early detection of treatable breast cancer malignancies. However, the use of breast cancer screening among asymptomatic women in Ghana is reported to be generally low. In addition, Ghana does not have a standardized measure to assess and quantify breast cancer knowledge and screening beliefs. METHODS: This study examined the factor structure and internal consistency reliability of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ-12) in the context of Ghana. A total of 857 women from the Greater Accra Region of Ghana completed the BCSBQ-12. Exploratory structural equation modelling (ESEM) and traditional confirmatory factor analysis (CFA) were applied to the data via robust maximum likelihood estimation. RESULTS: The results showed that, compared with the CFA solution, the ESEM solution provided a better fit to the data, with reduced interfactor correlations and adequate internal consistency reliability. The ESEM with target rotation supported the first-order three-factor structure proposed by the BCSBQ-12, indicating the importance of considering breast cancer screening uptake from, at least, three key domains (i.e., , and ) in the context of Ghana. CONCLUSIONS: The results provide sound evidence of construct validity and psychometric properties for the use of the BCSBQ-12 for assessing breast cancer knowledge and screening beliefs among asymptomatic women in Ghana.
Associations Between Apparent Diffusion Coefficient Values and Histopathologic Prognostic Factors in Breast Cancer: A Retrospective Study.
Mahdavi Sabet F, Zeinalkhani F, Forghani S … +3 more , Kamali Hakim P, Zeinalkhani H, Tahanian F
Int J Breast Cancer · 2026 · PMID 42094985 · Full text
BACKGROUND: This study is aimed at investigating the correlation between apparent diffusion coefficient (ADC) values obtained from diffusion-weighted imaging (DWI) and prognostic factors in breast cancer. We hypothesized...
BACKGROUND: This study is aimed at investigating the correlation between apparent diffusion coefficient (ADC) values obtained from diffusion-weighted imaging (DWI) and prognostic factors in breast cancer. We hypothesized that lower ADC values would be observed in more aggressive tumors, including those with higher histological grades and Ki-67 expression levels. A retrospective analysis was conducted on patients with malignant breast lesions who underwent breast magnetic resonance imaging (MRI), including DWI sequences, at our center between January 2022 and January 2023. MRI was performed on a 1.5 T scanner using a bilateral phased-array eight-channel breast coil. ADC values were calculated utilizing values of 400 and 800 s/mm and evaluated in relation to prognostic factors, including age, tumor size, tumor grade, lymph node involvement, Ki-67 proliferation index, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status. RESULTS: This study included 88 patients with 89 malignant lesions. ADC values showed no significant association with age, tumor size, histological type, lymph node involvement, or receptor status (ER, PR, and HER2). However, tumors with higher Ki-67 expression exhibited significantly lower median ADC values. For Ki-67 thresholds of ≥ 14% and ≥ 30%, values were 0.02 and < 0.01, respectively. A negative correlation between ADC values and the Ki-67 index was noted ( = 0.01, = -0.28). Additionally, Grade I tumors had higher ADC values than Grade II and III tumors ( < 0.01), while no difference was observed between Grade II and III tumors ( = 0.61). CONCLUSION: Lower ADC values correlate with higher tumor grades and Ki-67 expression, suggesting their potential role as imaging biomarkers for assessing breast cancer aggressiveness.
Multimodal Imaging of Diabetic Mastopathy: A 62-Case Study With Ultrasound-Based Classification and Diagnostic Accuracy.
Xu Y, Wang Y, Li X … +5 more , Li Y, Liu X, Zhao Y, Zhu Y, Lu H
Int J Breast Cancer · 2026 · PMID 42094984 · Full text
PURPOSE: The purpose of this study is to investigate the application of multimodal imaging technology in diagnosing diabetic mastopathy (DM). METHOODS: This study retrospectively analyzed ultrasound, mammography, and MRI...
PURPOSE: The purpose of this study is to investigate the application of multimodal imaging technology in diagnosing diabetic mastopathy (DM). METHOODS: This study retrospectively analyzed ultrasound, mammography, and MRI findings of pathologically confirmed DM from October 2014 to October 2024. RESULTS: Ultrasonography was performed on all 62 patients with DM, identifying a total of 67 lesions. The ultrasound findings were classified into four types: Type I presented as a focal thickening and bulging of the gland with a mix of high and low echoes (42/67, 62.7%); Type II showed focal or overall hypoechoic areas with indistinct margins (19/67, 28.3%); Type III exhibited diffuse hypoechoicity in the lesion area, poorly visualized internal structures, and markedly attenuated posterior echoes (4/67, 6.0%); and Type IV consisted of slightly hypoechoic areas (2/67, 3.0%). The overall diagnostic accuracy of ultrasound was 58.2%. Fifty-one patients with a total of 58 lesions underwent mammography. Eighteen lesions (31.0%) were negative on mammography, whereas 32 lesions (55.2%) displayed asymmetric density. The diagnostic accuracy of mammography was 69%. Five patients with five lesions underwent MRI, which revealed nonmass-like inhomogeneous progressive enhancement, isointensity and hypointensity in T2-weighted images, insignificant or slight hyperintensity in diffusion-weighted imaging, and no significant decrease in apparent diffusion coefficient value, yielding a diagnostic accuracy of 80%. CONCLUSION: The ultrasound characteristics of DM were marked by nonmass-type lesions with distinctive echogenic and structural features. Mammography demonstrated insignificant or nonspecific asymmetric densities without suspicious calcifications or structural distortions. Breast MRI indicated nonmassive lesions exhibiting benign features based on hemodynamic parameters and diffusion-weighted imaging. The combined application of multimodal imaging enhanced diagnostic accuracy, particularly when incorporated with patient history.
Vacuum-Assisted Excision and Assessing Residual Tumor Burden in Patients With Breast Cancer Following Neoadjuvant Chemotherapy (A Pilot Study).
Hashemi H, Olfatbakhsh A, Moghadam S … +4 more , Aghanajafi A, Heydari L, Rostami M, Haghighat S
Int J Breast Cancer · 2026 · PMID 42046781 · Full text
AIM: The objective of this study is to evaluate the accuracy of vacuum-assisted excision as a minimally invasive method for assessing residual tumor burden in distinct breast cancer subtypes following neoadjuvant chemoth...
AIM: The objective of this study is to evaluate the accuracy of vacuum-assisted excision as a minimally invasive method for assessing residual tumor burden in distinct breast cancer subtypes following neoadjuvant chemotherapy. MATERIALS AND METHODS: In this pilot clinical trial, 20 patients with breast cancer scheduled for neoadjuvant chemotherapy were assessed. Upon completion of chemotherapy, patients underwent ultrasound-guided vacuum-assisted excision of the tumor site, performed by a radiologist. Subsequently, surgical excision of the tumor was carried out. The pathology reports from the vacuum excision were compared with the surgical specimens to determine the concordance in detecting residual tumor tissue. RESULTS: Among the 20 patients who underwent vacuum-assisted excision, 13 patients demonstrated no residual tumor in both vacuum pathology and surgical pathology. However, in four patients, including three cases of Ductal Carcinoma In Situ (DCIS) and one case of Invasive Ductal Carcinoma (IDC), a false negative vacuum excision was reported. In three patients, residual tumor was reported both in surgical and vacuum pathology. The positive predictive value, negative predictive value, and accuracy of vacuum excision for detecting residual tumor were 100%, 76.5%, and 80%, respectively. The sensitivity and specificity of vacuum excision were 42.9% and 100%, respectively. CONCLUSION: Based on the findings of this study and considering the accuracy of vacuum excision in identifying residual tumors (80%), it is evident that vacuum excision cannot currently serve as a substitute modality for surgery in the management of patients with post-neoadjuvant breast cancer. Further research with a larger sample size is warranted to enhance our understanding in this area. TRIAL REGISTRATION: IRCT20241204063942N1.
Age-Related Trends in Breast Cancer Incidence.
Mahdi BM, Abbas NK, Hameed HK … +1 more , Abdualdayeam SJ
Int J Breast Cancer · 2026 · PMID 42038170 · Full text
BACKGROUND: Breast cancer is one of the diseases in which abnormal, mutated breast cells grow out of control and form tumors. If left unchecked, the tumors can spread throughout the body and become fatal. AIM OF THE STUD...
BACKGROUND: Breast cancer is one of the diseases in which abnormal, mutated breast cells grow out of control and form tumors. If left unchecked, the tumors can spread throughout the body and become fatal. AIM OF THE STUDY: This study is aimed at assessing the combined effect of age-specific trends over time on breast cancer. MATERIALS AND METHODS: The cross-sectional study included 100 patients diagnosed with breast cancer over a period extending from January 2024 to January 2025 at Al-Amal Hospital in Baghdad. The data were collected from the records of the hospital, including the demographic ones, and another section of the data included the medical ones. RESULTS: A total of 100 breast cancer patients were included in this study, with ages ranging from 25 to 75 years (mean ± SD : 50.47 ± 10.96 years). The highest percentage of breast cancer patients (39%) belonged to the 50-59 years age group, followed by 40-49 years (25%), while the lowest percentages were observed in the 21-29 years (5%) and 70-79 years (5%) categories. Menstrual history illustrated that 52% of patients were postmenopausal, while 44% were premenopausal, and 4% had irregular cycles. Most cancer patients were married (78%), while 11% were widowed, 8% were single, and 3% were divorced. CONCLUSIONS: This study highlights the demographic and clinical characteristics of breast cancer patients, emphasizing the predominance of cases in postmenopausal women and those residing in urban areas. It highlights the prevalence of advanced-stage and metastatic breast cancer, emphasizing the urgent need for enhanced screening and early detection.
Real-World Safety and Efficacy of Biosimilar Trastuzumab Emtansine (T-DM1) in HER2-Positive Breast Cancer: A Prospective Single-Institution Study From India.
Gandrala D, Rajappa SJ, Mallavarapu K … +9 more , Santa A, Pavan Kumar B, Pinninti R, Ladda PS, Pathi N, Kandem S, Tewani RK, Thummar V, Mehta P
Int J Breast Cancer · 2026 · PMID 42022915 · Full text
BACKGROUND: Trastuzumab emtansine (T-DM1) represents an advancement in HER2-targeted therapy, offering a unique combination of trastuzumab's specificity and the cytotoxic potency of maytansine. It demonstrates therapeuti...
BACKGROUND: Trastuzumab emtansine (T-DM1) represents an advancement in HER2-targeted therapy, offering a unique combination of trastuzumab's specificity and the cytotoxic potency of maytansine. It demonstrates therapeutic efficacy across the spectrum of breast cancer, including both early-stage and advanced disease. With the emergence of biosimilar formulations, there is a growing need to generate real-world evidence supporting their clinical performance. This study investigates the effectiveness and safety of a T-DM1 biosimilar in routine oncology practice across adjuvant and metastatic HER2-positive breast cancer populations. METHODS: In this prospective, single-institute study conducted at a tertiary oncology center in India, 116 patients with HER2-positive breast cancer (51 adjuvant and 65 metastatic) received T-DM1 biosimilar (Ujvira) between June 2021 and October 2023. Outcomes assessed included overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and treatment-emergent adverse events (AEs), graded using CTCAE v5.0. RESULTS: In the metastatic cohort, ORR was 63.4%, median PFS was 8.0 months (95% CI: 5.8-10.2), and estimated median OS was 18.0 months (95% CI: 16.1-19.9). Clinical benefit rate was 75%. In the adjuvant cohort, 62.7% completed the planned 14 cycles, and treatment was well tolerated. Grade ≥ 3 AEs occurred in 6.9% of all patients, with fatigue and thrombocytopenia being the most common AEs. No unexpected safety signals were observed. CONCLUSION: T-DM1 biosimilar showed outcomes consistent with those reported for the originator in real-world settings, supporting its broader adoption in both early and advanced HER2-positive breast cancer. Its affordability may improve access and outcomes in resource-limited settings.
The Association Between Adherence to Mediterranean, DASH, and MIND Diets and the Risk of Breast Cancer: A Case-Control Study in Iranian Women.
Bakhshimoghaddam F, Mohtadi N, Haghighatkhah A … +5 more , Javid AZ, Zadeh MR, Razzaghi S, Moradpour M, Razmi H
Int J Breast Cancer · 2026 · PMID 42004208 · Full text
PURPOSE: Breast cancer is a leading cause of cancer-related morbidity and mortality among women worldwide. This study was aimed at investigating the association between adherence to the Mediterranean diet (MD), Dietary A...
PURPOSE: Breast cancer is a leading cause of cancer-related morbidity and mortality among women worldwide. This study was aimed at investigating the association between adherence to the Mediterranean diet (MD), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets and the odds of developing breast cancer. METHODS: A hospital-based case-control study was conducted with 106 histopathologically confirmed breast cancer cases and 107 age-matched controls. Dietary intake was assessed using a validated 147-item food frequency questionnaire. Adherence scores for the MD, DASH, and MIND diets were calculated and categorized into tertiles. Multivariable logistic regression models were used to estimate odds ratios (ORs), adjusting for age, body mass index, waist-to-hip ratio, physical activity, education, employment, and family history of cancer. RESULTS: After full adjustment, compared to the lowest tertile, women in the highest tertile of MD, DASH, and MIND diet adherence had a 75% (OR = 0.25, 95% CI: 0.10-0.64), 76% (OR = 0.24, 95% CI: 0.09-0.62), and 72% (OR = 0.28, 95% CI: 0.11-0.75) reduced odds of breast cancer, respectively. All trends were statistically significant. However, stratification by menopausal status revealed no significant associations within pre- or postmenopausal subgroups. CONCLUSION: Greater adherence to the MD, DASH, and MIND diets is associated with a substantially lower likelihood of breast cancer in Iranian women. These findings highlight the potential of healthy dietary patterns as a modifiable factor for breast cancer prevention in this population.
Improvement of Dosimetry Planning in 3D Conformal Radiotherapy for Breast Cancer With Lymph Nodes Using the High-Tangential Tilted-Supraclavicular Technique.
Moussallem M
Int J Breast Cancer · 2026 · PMID 41993775 · Full text
PURPOSE: Despite the emergence of advanced radiotherapy techniques such as volumetric modulated arc therapy (VMAT), three-dimensional conformal radiotherapy (3DCRT) continues to be used due to its advantages in treating...
PURPOSE: Despite the emergence of advanced radiotherapy techniques such as volumetric modulated arc therapy (VMAT), three-dimensional conformal radiotherapy (3DCRT) continues to be used due to its advantages in treating breast cancer. This study aimed to optimize the 3DCRT technique for breast cancer cases that require lymph node irradiation. METHODS AND MATERIALS: A total of 100 consecutive patients were included. For the first 50 patients, standard (ST) 3DCRT dosimetry plans were prepared. For the remaining 50 patients, plans were generated using an optimized High-tangential Tilted-supraclavicular (HT) technique, which consists of tilting the supraclavicular beam to reduce ipsilateral lung irradiation; raising the tangential fields superiorly to enhance coverage of axillary levels I and II; and intentionally creating an internal overlap between the supraclavicular and tangential fields. This overlap was resolved using the field-in-field (FIF) technique, primarily applied to the supraclavicular field, which is the main contributor to ipsilateral lung dose in this region. RESULTS: The HT technique demonstrated promising results compared with the ST technique and other published 3DCRT methods. It achieved improved coverage of axillary levels I and II while reducing the dose to the ipsilateral lung. However, further adjustments are needed to enhance coverage of axillary level III, the supraclavicular region, and internal mammary nodes (IMN). These include the following: completing targets contouring prior to dosimetry planning to enable precise field adjustments; relaxing the 2 cm constraint on ipsilateral lung irradiation by tangential fields when IMN is included; relaxing the maximum dose constraint for the supraclavicular and IMN fields; and using a fully electron-based field instead of a mixed electron-photon technique for IMN dedicated field. CONCLUSIONS: The HT technique was quantitatively validated, and a modified version was proposed and qualitatively assessed. This new version may be considered for clinical use, and comparison with VMAT in a larger patient cohort is recommended.
T-Cell Immunoglobulin and Mucin Domain 1 (Tim1) as a Prognostic Factor Associated With Therapeutic Resistance in Human Breast Carcinoma.
Yamaguchi-Tanaka M, Takagi K, Sawafuji M … +5 more , Sato A, Nakamura K, Miki Y, Miyashita M, Suzuki T
Int J Breast Cancer · 2026 · PMID 41993774 · Full text
BACKGROUND: Therapeutic resistance, including resistance to endocrine therapy in ER-positive tumors and to chemotherapy in aggressive subtypes, remains a major clinical challenge in breast cancer. T-cell immunoglobulin a...
BACKGROUND: Therapeutic resistance, including resistance to endocrine therapy in ER-positive tumors and to chemotherapy in aggressive subtypes, remains a major clinical challenge in breast cancer. T-cell immunoglobulin and mucin domain 1 (Tim1), a Type I transmembrane glycoprotein, has been reported to be aberrantly expressed in various cancer cells and contribute to tumor progression. However, its clinical significance in breast cancer and association with therapy resistance remain largely unclear. METHODS: We investigated Tim1 expression by immunohistochemistry in 116 breast carcinoma tissues and analyzed its correlation with clinicopathological parameters and clinical outcomes according to chemotherapy and endocrine therapy status. RESULTS: Tim1 immunoreactivity was detected in the cytoplasm and cell membranes of breast carcinoma cells but was negligible in the normal breast epithelium. Tim1 expression was significantly associated with pathological T factor, lymph node metastasis, histological grade, and Ki67 labeling index. Tim1 immunoreactivity was significantly correlated with an increased risk of recurrence, and multivariate analyses demonstrated Tim1 as an independent adverse prognostic factor for disease-free survival. In addition, Tim1 remained correlated with the risk of recurrence in patients who had received chemotherapy or endocrine therapy. CONCLUSIONS: Tim1 might be an important therapeutic target for improving therapy in breast cancer patients and could be a strong adverse prognostic factor associated with therapeutic resistance.
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