Clinical breast cancer最新文献

{"title":"Response to \"The Impact of Baseline Comorbidities and Performance Status on HER2-Targeted Therapy Outcomes\".","authors":"Yoonwon Kook, Sung Gwe Ahn","doi":"10.1016/j.clbc.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.011","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Assessment of Breast Cancer Surgery Information on YouTube.","authors":"Chenhong Li, Chengfei Du","doi":"10.1016/j.clbc.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.010","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Growth Rate of Luminal and Nonluminal Invasive Breast Cancer Calculated on MRI Imaging.","authors":"Uwe Fischer","doi":"10.1016/j.clbc.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.008","url":null,"abstract":"<p><strong>Purpose: </strong>Calculation of the size growth of different types of breast carcinoma based on follow-up data in breast MRI.</p><p><strong>Patients and methods: </strong>Patients were included if they had been diagnosed with an invasive breast carcinoma in the current MRI (aMRI), and had also undergone a breast MRI (pMRI) with unsuspicious findings (MR BIRADS 1 or 2) within 5 years prior to diagnosis. If retrospective analysis of pMRI revealed signs of the current carcinoma, a quantitative one-dimensional-analysis of size progression of the carcinoma over time was performed, and growth rates for different tumor types were calculated.</p><p><strong>Results: </strong>About 204 patients with 208 invasive breast carcinomas (74 luminal A, 105 luminal B, nonluminal 29) were included. In 129 carcinomas, there were signs of the current tumor in the pMRI. Based on the interval between pMRI and aMRI (average 21 months), the average tumor doubling time was 1126 days (3.1 years), 624 days (1.7 years), and 254 days (0.7 years) of luminal A, luminal B, and nonluminal. The average tumor size was 4.3 mm in the pMRI, and 9.5 mm in aMRI. In 79 cases, the pMRI showed no signs of the actual carcinoma. In this group, the average current tumor size was 8.5 mm.</p><p><strong>Conclusion: </strong>The study provides specific information on the growth rate of luminal and nonluminal breast cancer. According to this, early detection intervals for nonhigh-risk women using MRI of 2 to 3 years, and for high-risk (HR) women of 1 year appear reasonable. Data also provide a well-founded basis for medico-legal judgements.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Undertreatment With Chemotherapy Impact the Outcomes of Elderly Patients With Early-Stage Breast Cancer? A Real-World Data Analysis.","authors":"Jéssica Monteiro Vasconcellos, Renata Colombo Bonadio, Sofia Vidaurre Mendes, Bruna Zanin Orsi, Letícia Vecchi Leis, Ana Paula Messias, Otávio Augusto Moreira Noschang, Maurício Baptista Pereira, Pedro José Galvão Freire, Augusto Rodrigues de Araújo Neto, Erika Andrade Rocha, Theodora Karnakis, Laura Testa","doi":"10.1016/j.clbc.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.007","url":null,"abstract":"<p><strong>Background: </strong>The management of breast cancer (BC) in elderly patients remains a topic of debate among specialists, with concerns regarding potential undertreatment. This study aimed to evaluate the impact of undertreatment on outcomes in older patients with early-stage BC.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed patients aged over 70 years with early breast cancer who were treated at an academic cancer center between 2009 and 2021.Indications for (neo)adjuvant chemotherapy (CT) were assessed based on institutional guidelines. Undertreatment was defined as patients who had an indication for CT but did not receive it. The study evaluated undertreatment rate, recurrence rate, disease-free survival, breast cancer-specific survival (BCSS), overall survival (OS), and prognostic factors.</p><p><strong>Results: </strong>A total of 1455 patients had early-stage BC. The majority of patients were between 70 and 80 years old (71%), had luminal tumors (79%), and mild comorbidities (60%). Of the 921 patients for whom (neo)adjuvant chemotherapy (CT) was indicated, 57% did not receive it, mainly due to age and comorbidities. The 5-year BCSS was 90.3% in the undertreated group compared to 86.3% in the CT group (P = .024). The 5-year OS was 76.3% in the undertreated group compared to 81% in the CT group (P = .389). Multivariable analysis identified predictors of worse OS, but undertreatment was not directly associated.</p><p><strong>Conclusion: </strong>Undertreatment rates were high in this older population, yet outcomes were not negatively impacted. Thus, not offering (neo)adjuvant CT may be a wise choice for selected elderly pts with early BC, taking into account their comorbidities and functional status.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the COVID-19 Pandemic on the Diagnosis and Treatment of Breast Cancer at a Community Hospital.","authors":"Mariah Mack, Matthew McGee, Barbara Bennie, Andrea Arenz, Leah Dietrich","doi":"10.1016/j.clbc.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.005","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted breast cancer care, potentially affecting diagnosis stage, time to treatment initiation, and treatment modalities. This study evaluated how pandemic-related restrictions affected these factors at a community hospital.</p><p><strong>Methods: </strong>We conducted a retrospective review of electronic health records for 941 patients diagnosed with breast cancer. Patients were categorized by diagnosis time. We used Kruskal-Wallis tests to compare median time to first treatment by modality, COX proportional hazard models to analyze time to treatment in relation to diagnosis time period and clinical stage, and Chi-square tests to evaluate changes in modality of first treatment and cancer stage.</p><p><strong>Results: </strong>Clinical stage at diagnosis varied significantly across time periods (P = .01), with more advanced stages during Peak-COVID and Post-Peak-COVID. Median time to first treatment increased during Peak-COVID (47 days) and Post-Peak-COVID (54 days) compared to Pre-COVID (38 days) (P < .001). Time to surgery as first treatment modality increased over the 3 periods (P < .001), while no significant differences were found for chemotherapy (P = .06) or hormone therapy (P = .28). The modality of first treatment shifted significantly (P < .001), with a decline in hormone therapy use during Peak-COVID, followed by an increase Post-Peak-COVID.</p><p><strong>Conclusions: </strong>Our study highlights the pandemic's impact on breast cancer care, demonstrating significant differences in clinical stage at diagnosis, time to first treatment, and modality of first treatment. These disparities persisted into 2022, reflecting lasting effects of pandemic-related disruptions. Addressing these delays is essential for mitigating care gaps in future times of healthcare disruption.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic Agents as Therapeutic Tools in Breast Cancer: Insights into Cancer Progression and Recurrence.","authors":"Jiaqiao Wu, Jindong Yang, Jiqing Duan","doi":"10.1016/j.clbc.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.009","url":null,"abstract":"<p><p>Breast cancer (BC) remains one of the leading causes of cancer-related mortality worldwide, necessitating continuous advancements in therapeutic strategies. While anesthetic agents are traditionally used for managing pain and sedation during BC surgeries, emerging evidence suggests their potential influence on cancer progression and recurrence. This comprehensive review examines the role of various anesthetic agents as therapeutic tools in BC, exploring the molecular mechanisms underlying their interaction with tumor biology. The review categorizes anesthetics into volatile, intravenous, and local agents, discussing their differential effects on cancer cell proliferation, immune modulation, and metastatic potential. Key findings indicate that volatile anesthetics such as sevoflurane and isoflurane may promote tumor progression, whereas intravenous anesthetics like propofol exhibit anticancer properties. Local anesthetics, particularly lidocaine, and bupivacaine, show promise through voltage-gated sodium channel (VGSC) blockade, while opioids have mixed effects, with tramadol being less favorable in cancer settings. Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ketorolac and diclofenac have demonstrated potential in reducing BC recurrence, and regional anesthesia techniques like paravertebral blocks may provide immunomodulatory benefits. Clinical studies assessing the correlation between anesthetic choice and BC recurrence suggest that perioperative anesthetic strategies may impact circulating tumor cells and postoperative metastasis. However, most findings are derived from preclinical and retrospective studies, highlighting the need for large-scale prospective trials. Future research should focus on tailoring anesthetic regimens to tumor biology and patient-specific factors, integrating anesthetic pharmacology into cancer care to improve both immediate surgical outcomes and long-term prognosis. This article underscores the need for a paradigm shift in anesthetic use, positioning it as a crucial player in BC treatment strategies.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 10-Year Survival Between Patients With Axillary Pathologic Complete Response After Neoadjuvant Chemotherapy and Patients With Initially Negative Nodes in Breast Cancer.","authors":"Jiwei Wang, Xing Wang, Yingjian He, Tianfeng Wang, Jinfeng Li, Zhaoqing Fan, Tao Ouyang","doi":"10.1016/j.clbc.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.006","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to determine whether patients with cytologically proven node-positive disease who achieved axillary pathologic complete response (ypN0) after neoadjuvant chemotherapy (NAC) have similar survival outcomes to those with initially pathologically negative lymph nodes (pN0).</p><p><strong>Methods: </strong>Patients with cytologically proven node-positive breast cancer who achieved ypN0 after NAC and those with pN0 between June 2005 and March 2012 in a large cancer hospital were reviewed. The relapse-free survival (RFS), distant-disease-free survival (DDFS) and overall survival (OS) of the 2 groups were calculated and compared.</p><p><strong>Results: </strong>A total of 2285 patients, including 183 patients with ypN0 and 2102 patients with pN0, were included in this study. The median follow-up time for patients was 121 (range 2-182) months. The 10-year cumulative RFS was 79.7% for ypN0 patients and 90.2% for pN0 patients (log-rank P < .001). The 10-year cumulative DDFS was 81.4% for ypN0 patients and 92.2% for pN0 patients (log-rank P < .001). The 10-year cumulative OS was 86.3% for ypN0 patients and 94.0% for pN0 patients (log-rank P < .001). The multivariable Cox proportional hazards models showed that compared with pN0 patients, ypN0 patients had a 2.00-fold increase in the risk of recurrence (HR = 2.00, 95% CI, 1.33-3.01, P = .001), a 2.34-fold increase in the risk of distant recurrence (HR = 2.34, 95% CI, 1.52-3.62, P < .001) and a 2.10-fold increase in the risk of death (HR = 2.10, 95% CI, 1.25-3.53, P = .005).</p><p><strong>Conclusion: </strong>Patients with axillary pCR showed inferior RFS, DDFS and OS to patients with pN0.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omitting Axillary Dissection in Triple-Negative and HER2-Overexpressed Breast Cancers With Positive Sentinel Lymph Nodes During Upfront Surgery: SENATURK-OTHELLO Study.","authors":"Neslihan Cabıoğlu, Hasan Karanlık, Vahit Özmen, Mustafa Tükenmez, Abdullah İğci, Yusuf E Aytin, Hande Köksal, Halime Mutlu, Süleyman Bademler, Cihan Uras, Onur Dülgeroğlu, Enver Özkurt, Selman Emiroğlu, Mahmut Müslümanoğlu, Nilüfer Yıldırım, Atakan Sezer, Güldeniz Karadeniz Çakmak, Hakan Balbaloğlu, İsmail Zihni, Bahadır M Güllüoğlu","doi":"10.1016/j.clbc.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.002","url":null,"abstract":"<p><strong>Purpose: </strong>Randomized trials including ACOSOG Z0011 and SENOMAC mostly included patients with hormone receptor-positive breast cancer, but a limited number of patients with aggressive tumor biology. Therefore, we assessed the oncological safety of omitting axillary dissection in patients with SLN-positive HER2-positive or triple-negative breast cancer at upfront surgery.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included patients with clinically node-negative HER2-positive and triple-negative breast cancer who had sentinel lymph node biopsy (SLNB) alone with pN+ disease. Almost all patients (97.5%) received nodal irradiation.</p><p><strong>Results: </strong>Between 2015 and 2020, 118 patients with HER2-positive (n = 79, 67%) and triple-negative (n = 39, 33%) tumors were included in the study from 8 centers. Of those, 94.9% were cT1-2 and 72% underwent breast-conserving surgery. Most patients (n = 98, 83.1%) had 1 metastatic sentinel lymph node. Among those with involved sentinel lymph nodes, 59 (50%) had macrometastasis, 43 (36.4%) had micrometastasis and 16 (13.6%) had isolated tumor cells. After a median follow-up of 53 months, the locoregional recurrence rate was 2.5% without any axillary recurrence, and systemic recurrence rate was 11.9%. Factors associated with worse disease-free survival were having a cT2-3 stage and a triple-negative subtype disease. Having triple-negative tumor was the only significant factor associated with worse disease-specific survival.</p><p><strong>Conclusion: </strong>Patients with cN0 HER2-positive and triple-negative breast cancer with low-volume axillary metastases treated with upfront SLNB-alone showed excellent local control with nodal irradiation.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Cannabidiol Use in a Breast Cancer Population.","authors":"Nicole M G Fleege, Bradley T Loeffler, Kevin F Boehnke, Norah Lynn Henry","doi":"10.1016/j.clbc.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.003","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabidiol (CBD) is a phytocannabinoid found in the plant Cannabis sativa and is thought to have broad potential therapeutic value. Little is reported on CBD use in patients with breast cancer (BC). This survey study aimed to characterize CBD use patterns and reported benefits among patients with BC, while also identifying barriers and limitations to its use.</p><p><strong>Patients and methods: </strong>Individuals seen at the University of Michigan Rogel Cancer Center for a diagnosis of BC accessed the anonymous online survey characterizing current and former CBD use via flyer posted in clinic. Survey questions were adapted from a previously published questionnaire conducted in patients with chronic pain conditions. The survey was accessed between September 2020 and February 2024.</p><p><strong>Results: </strong>Of 141 evaluable surveys, 68 patients (48.2%) reported prior or current CBD use. The most common reasons for current CBD use were management of pain (75.6%), anxiety (61.0%), and insomnia (58.5%). The biggest median self-reported improvement with use of CBD was in insomnia followed by pain. Patients mainly stopped using CBD because it was ineffective (46.2%), although some stopped due to negative side effects (7.7%).</p><p><strong>Conclusion: </strong>Almost half of patients in this survey study reported previous or current CBD use, with improvements in symptoms. As CBD use increases in the clinical setting, it is important for physicians to help navigate concerns related to its use. Additional research is needed to determine which patient-reported symptoms are most likely to be impacted by CBD.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Surgical Axillary Staging and Clinical Outcomes Among Breast Cancer Patients With Neoadjuvant Therapy: A Population-Based Cohort Study.","authors":"Xihan Xiang, Xunxi Lu, Mengting He, Zongchao Gou","doi":"10.1016/j.clbc.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.001","url":null,"abstract":"<p><strong>Objectives: </strong>Surgical management of the axilla with neoadjuvant treatment has been a significant research focus over the past decade, resulting in numerous publications. The trends in surgical choices based on lymph node status and survival outcomes in large populations were previously unclear.</p><p><strong>Methods: </strong>Breast cancer patients who underwent neoadjuvant therapy were identified from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2021 and categorized into 2 cohorts: LN- (no lymph node metastasis) and LNm (1-2 sentinel node metastases). We analyzed the trends in surgical axillary staging and compared the 10-year overall survival between sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND).</p><p><strong>Results: </strong>Among 26,320 patients, 18,548 were in the LN- cohort (16,607 with SLNB and 1,941 with ALND) and 7,772 were in the LNm cohort (3,601 with SLNB and 4,171 with ALND). The proportion of patients undergoing SLNB increased from 76.4% in 2010 to 93.8% in 2021 in the LN- cohort and doubled from 25.2% in 2010 to 55.0% in 2021 in the LNm cohort. ALND was identified as a favorable factor over SLNB in the LNm cohort (hazard ratio [HR] 0.84; 95% CI, 0.73-0.96; P = .014).</p><p><strong>Conclusion: </strong>Omission of ALND for patients with 1 to 2 node metastases after neoadjuvant therapy has doubled since 2010. SLNB is an efficient and safe approach of surgical axillary staging for the LN- cohort but not for patients with residual axillary cancer, even with low-volume disease.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}