Clinical breast cancer最新文献

{"title":"A Review of Current Literature and Real-World Outcomes With Neoadjuvant Chemotherapy in Hormone Receptor Positive, HER2 Negative Breast Cancer.","authors":"Gregory Guzik, Matthew Kurian, Kanchi Patell, Marcus Trybula, Pingfu Fu, Seunghee Margevicius, Alberto Montero, James Martin","doi":"10.1016/j.clbc.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.008","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy has been used to downstage locally advanced ER+/HER2- breast cancer with low response rates. The optimal neoadjuvant regimen for this population is unknown.</p><p><strong>Patients and methods: </strong>Between 2017 and 2022, 192 patients (ages 28-78) with stage II/III ER+/Her2- breast cancer at our institution were evaluated. Patients were divided into 4 groups based on the neoadjuvant chemotherapy regimen used (AC-T, TC, TAC, or other). The responses were categorized as complete (ypT0/is ypN0), partial, no response, or progressive disease.</p><p><strong>Results: </strong>The choice of neoadjuvant chemotherapy was not predictive of pCR (P = .3864), even among those with more advanced nodal disease. No significant difference was noted in OS or IDFS at 24 or 48 months between the AC-T and TC groups. In the AC-T group (n = 130), 9 patients had a CR (6.98%), while no patients in TC group had a CR. Those who were premenopausal were more likely to achieve pCR compared to those postmenopausal. Race significantly impacted IDFS.</p><p><strong>Conclusions: </strong>In this single center study, we found no differences in IDFS or OS when comparing neoadjuvant TC to AC-T. The AC-T regimen group had a higher pCR rate of 6.98% compared to 0% in TC regimen group. Further exploration is needed to understand why non-white populations have inferior IDFS.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779326","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":"Postmastectomy Radiation Therapy for Intermediate-Risk Breast Cancer Patients With 0-3 Positive Axillary Lymph Nodes: Emulating the SUPREMO Trial Using Real-World Data.","authors":"Sarah E Kulkarni, Sagar A Patel, Chen Jiang, Lara Schwieger, Lauren M Postlewait, Cletus A Arciero, Theresa W Gillespie, Yuan Liu","doi":"10.1016/j.clbc.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.007","url":null,"abstract":"<p><strong>Purpose: </strong>To emulate the Selective Use of Postoperative Radiotherapy After Mastectomy (SUPREMO) phase III clinical trial using real-world data to assess the impact of postmastectomy radiation therapy (PMRT) on overall survival (OS) among patients with intermediate-risk breast cancer.</p><p><strong>Patients and methods: </strong>Using the National Cancer Database, women diagnosed between 2006 and 2013 with intermediate-risk breast cancer (defined as pT1-2N1; pT3N0; or pT2N0 and grade III or with lymphovascular invasion) and 0-3 positive axillary lymph nodes, who underwent total mastectomy, were identified as being in accordance with the SUPREMO trial protocol and included in this study. Multivariable logistic regression, Cox proportional hazards regression, and stabilized inverse probability of treatment weighting were used to explore the relationship between PMRT and OS. The effects of PMRT within subgroups were explored using multivariable interaction models.</p><p><strong>Results: </strong>In total, 49335 patients were included in the study, with 6882 (13.9%) receiving PMRT. Patients with stage T3N0 cancer, 1-3 positive axillary lymph nodes, or positive surgical margins were more likely to receive PMRT. Overall, PMRT was associated with no significant improvement in OS (HR: 0.98, 95% CI, 0.92-1.04). However, improved survival was observed among women with stage T3N0 cancer who received PMRT (HR: 0.72, 95% CI, 0.58-0.89).</p><p><strong>Conclusion: </strong>Although PMRT may not be associated with improved OS among all intermediate-risk breast cancer patients with 0-3 positive axillary lymph nodes, the subgroup of patients with stage T3N0 cancer seemed to benefit from PMRT. The study's retrospective nature introduces some uncertainty, but preliminary findings of the SUPREMO trial support these results.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787930","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":"Forequarter Amputation for Breast Cancer. Systematic Review and Survival Analysis.","authors":"Flávia Cardoso Franca, Idam de Oliveira-Junior, René Aloisio da Costa Vieira","doi":"10.1016/j.clbc.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.005","url":null,"abstract":"<p><strong>Introduction: </strong>Forequarter amputation (FA) or Interscapulothoracic disarticulation is indicated in patients with invasive breast carcinoma (BC) in selected cases: primary resection of a locally advanced or recurrent tumor, Stewart & Treves syndrome (STS), or sarcoma secondary to radiation due to breast cancer (radiation-induced sarcoma, RIS). However, no studies have robustly evaluated the indications, results, complications, recurrence and overall survival in the context of FA in patients with BC.</p><p><strong>Material and methods: </strong>We performed a systematic review of 8 databases according to the PICOS and PRISMA methodology through December 31, 2022. Descriptive statistics are presented, and Kaplan‒Meier survival curves were generated and compared with the log-rank method.</p><p><strong>Results: </strong>We identified 54 articles and collected data from 100 patients. The intention of FA was curative for 48 patients (57.1%) and palliative in 32 (38.1%). The procedure was performed due to STS (35%), upper limb dysfunction (18%), lymphedema (10%), recurrent axillary tumors (10%) and RIS (9%). Complications were low. The survival rates at 12, 24, 36, and 60 months were 65.6%, 42.8%, 36.4%, and 32.4%, respectively. The main factors associated with survival were tumor's condition (P = .05) and surgical intent (P < .001; multivariate analysis).</p><p><strong>Conclusion: </strong>FA has few complications and attenuates symptoms in patients treated with both curative and palliative intent. Surgery is justified in select cases, such as locally advanced tumors, infiltration of axillary structures, upper limb lymphedema with loss of function, and STS and RIS, and often represents the best chance for local disease control and improvement in quality of life.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779327","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":"Harnessing Artificial Intelligence for Precision Diagnosis and Treatment of Triple Negative Breast Cancer.","authors":"Md Sadique Hussain, Prasanna Srinivasan Ramalingam, Gayathri Chellasamy, Kyusik Yun, Ajay Singh Bisht, Gaurav Gupta","doi":"10.1016/j.clbc.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.006","url":null,"abstract":"<p><p>Triple-Negative Breast Cancer (TNBC) is a highly aggressive subtype of breast cancer (BC) characterized by the absence of estrogen, progesterone, and HER2 receptors, resulting in limited therapeutic options. This article critically examines the role of Artificial Intelligence (AI) in enhancing the diagnosis and treatment of TNBC treatment. We begin by discussing the incidence of TNBC and the fundamentals of precision medicine, emphasizing the need for innovative diagnostic and therapeutic approaches. Current diagnostic methods, including conventional imaging techniques and histopathological assessments, exhibit limitations such as delayed diagnosis and interpretative discrepancies. This article highlights AI-driven advancements in image analysis, biomarker discovery, and the integration of multi-omics data, leading to enhanced precision and efficiency in diagnosis and treatment. In treatment, AI facilitates personalized therapeutic strategies, accelerates drug discovery, and enables real-time monitoring of patient responses. However, challenges persist, including issues related to data quality, model interpretability, and the societal impact of AI implementation. In the conclusion, we discuss the future prospects of integrating AI into clinical practice and emphasize the importance of multidisciplinary collaboration. This review aims to outline key trends and provide recommendations for utilizing AI to improve TNBC management outcomes, while highlighting the need for further research.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751249","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":"It Does Not Matter Which Anesthetic We Use for Long-Term Survival After Breast Cancer Surgery.","authors":"Mats Enlund","doi":"10.1016/j.clbc.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.015","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691314","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":"Development of Machine Learning Models for Predicting Radiation Dermatitis in Breast Cancer Patients Using Clinical Risk Factors, Patient-Reported Outcomes, and Serum Cytokine Biomarkers.","authors":"Neil Lin, Farnoosh Abbas-Aghababazadeh, Jie Su, Alison J Wu, Cherie Lin, Wei Shi, Wei Xu, Benjamin Haibe-Kains, Fei-Fei Liu, Jennifer Y Y Kwan","doi":"10.1016/j.clbc.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.002","url":null,"abstract":"<p><strong>Background: </strong>Radiation dermatitis (RD) is a significant side effect of radiotherapy experienced by breast cancer patients. Severe symptoms include desquamation or ulceration of irradiated skin, which impacts quality of life and increases healthcare costs. Early identification of patients at risk for severe RD can facilitate preventive management and reduce severe symptoms. This study evaluated the utility of subjective and objective factors, such as patient-reported outcomes (PROs) and serum cytokines, for predicting RD in breast cancer patients. The performance of machine learning (ML) and logistic regression-based models were compared.</p><p><strong>Patients and methods: </strong>Data from 147 breast cancer patients who underwent radiotherapy was analyzed to develop prognostic models. ML algorithms, including neural networks, random forest, XGBoost, and logistic regression, were employed to predict clinically significant Grade 2+ RD. Clinical factors, PROs, and cytokine biomarkers were incorporated into the risk models. Model performance was evaluated using nested cross-validation with separate loops for hyperparameter tuning and calculating performance metrics.</p><p><strong>Results: </strong>Feature selection identified 18 predictors of Grade 2+ RD including smoking, radiotherapy boost, reduced motivation, and the cytokines interleukin-4, interleukin-17, interleukin-1RA, interferon-gamma, and stromal cell-derived factor-1a. Incorporating these predictors, the XGBoost model achieved the highest performance with an area under the curve (AUC) of 0.780 (95% CI: 0.701-0.854). This was not significantly improved over the logistic regression model, which demonstrated an AUC of 0.714 (95% CI: 0.629-0.798).</p><p><strong>Conclusion: </strong>Clinical risk factors, PROs, and serum cytokine levels provide complementary prognostic information for predicting severe RD in breast cancer patients undergoing radiotherapy. ML and logistic regression models demonstrated comparable performance for predicting clinically significant RD with AUC>0.70.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742494","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":"Comparing the Combination of Clinical Risk and Ki-67 Using EndoPredict as an Alternative to Multigene Assays in Prognostic Evaluation of Breast Cancer.","authors":"Hyunjik Kim, Jisu Kang, Heungkyu Park, Yongsoon Chun, Yunyeong Kim","doi":"10.1016/j.clbc.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.017","url":null,"abstract":"<p><strong>Purpose: </strong>Many studies have examined the relationship between prognostic factors and multigene assays; however, their use as alternatives remains insufficient. This study evaluated the concordance of the combination of clinical risk (CR)-which was determined using the modified version of Adjuvant! Online-and the Ki-67 index using EndoPredict (EP).</p><p><strong>Methods: </strong>Retrospective data from 709 patients were analyzed. The diagnostic accuracy, including concordance, was assessed between CR and EP (EPclin risk vs. EP risk), along with the Ki-67 index (cut-off: 20%). The clinical significance was analyzed using an area under the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>EPclin risk showed higher concordance with both CR and Ki-67 than EP risk, and CR showed higher concordance with both EPclin and EP risk than Ki-67. Differences in concordance with CR based on Ki-67 were limited; however, the negative predictive value (NPV) increased in the Ki-67 < 20% group (86.9% in EPclin), whereas the positive predictive value (PPV) increased in the Ki-67 ≥ 20% group (82.7% in EPclin). Improvement in PPV and NPV, as well as concordance, was observed with EPclin in 447 patients with high CR/high Ki-67 and low CR/low Ki-67. ROC analysis confirmed the clinical significance of combining CR with the Ki-67 index, as their combined area under the curve increased to 0.794, compared to 0.660 for CR and 0.742 for Ki-67 alone in EPclin risk.</p><p><strong>Conclusion: </strong>Integrating CR with the Ki-67 index improves prognostic accuracy and provides a cost-effective alternative to the EP test for luminal-type early breast cancer.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742483","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":"Activity and Efficacy of Neoadjuvant Chemotherapy in Luminal-HER2 Negative Early Breast Cancer According to HER2 Score (Low vs. Score 0): A Retrospective Study.","authors":"Giovanna Garufi, Luca Mastrantoni, Noemi Maliziola, Elena Di Monte, Giorgia Arcuri, Valentina Frescura, Angelachiara Rotondi, Alessandra Fabi, Ida Paris, Fabio Marazzi, Antonio Franco, Gianluca Franceschini, Antonella Palazzo, Armando Orlandi, Giovanni Scambia, Giampaolo Tortora, Carbognin Luisa, Emilio Bria","doi":"10.1016/j.clbc.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.02.016","url":null,"abstract":"<p><strong>Background: </strong>The predictive and prognostic role of HER2 status in patients with luminal-HER2 negative early breast cancer (BC) undergoing neoadjuvant chemotherapy is unclear. A retrospective analysis evaluating the correlation between HER2 status (low vs. score 0) and pCR/IDFS was conducted.</p><p><strong>Methods: </strong>Patients with BC undergoing neoadjuvant chemotherapy and surgery were included. HER2 low BC was defined as IHC 1+ or 2+ with negative FISH. Logistic regression model and Cox proportional hazard model were adopted to investigate the independent role of HER2 status and outcomes of interest (pCR, CPS-EG and IDFS).</p><p><strong>Results: </strong>About 566 patients were included: 60% were HER2 low and 40% were HER2 0. pCR was achieved in 13.2% of HER2 low versus 17.7% of HER2 0 (P = .15). There was no correlation between baseline HER2 status and CPS-EG score (P = .18). A trend toward improved IDFS for HER2 low BC was observed (P = .07). The relapse rate of the HER2 0 cohort peaked at 12 months after surgery, similar to the HER2 low cohort, which showed an additional peak at 36 months after surgery.</p><p><strong>Conclusions: </strong>Among Luminal-HER2 negative early BCs, our results do not support a clear predictive and prognostic effect of HER2 status, although a trend of worse pCR and better survival for HER2 low BCs cannot be ruled out.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742482","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":"Real-World Treatment Efficacy of Ribociclib or Palbociclib Plus Fulvestrant in Hormone Receptor-Positive/HER2-Negative Metastatic Breast Cancer: Turkish Oncology Group (TOG) Study.","authors":"Seda Kahraman, Enes Erul, Ozge Gumusay, Deniz Can Guven, Sercan Aksoy, Gul Basaran, Mustafa Seyyar, Elif Sahin, Devrim Cabuk, Ertugrul Bayram, Semra Paydas, Burcin Cakan Demirel, Arzu Yaren, Burcu Gulbagci, Ilhan Hacibekiroglu, Naziyet Kose Baytemur, Umut Demirci, Sena Ece Davarci, Hacer Demir, Eda Eylemer Mocan, Ozlem Dogan, Ebru Cilbir, Alper Yasar, Ibrahim Vedat Bayoglu, Mutlu Hizal, Erkan Kayikcioglu, Bulent Cetin, Omer Acar, Atike Pinar Erdogan, Merve Keskinkilic, Tugba Yavuzsen, Olcun Umit Unal, Funda Yilmaz, Mutlu Dogan, Sibel Oyucu Orhan, Erdem Cubukcu, Cihan Erol, Teoman Sakalar, Ozgecan Dulgar, Yusuf Karakas, Gulhan Ozkanli, Berna Bozkurt Duman, Deniz Isik, Muge Karaoglanoglu, Sadi Kerem Okutur, Nilgun Yildirim, Esra Aydin, Basak Oyan Uluc, Murat Keser, Burak Bilgin, Asude Aksoy, Onder Eren, Nurhan Onal Kalkan, Muhammed Muhiddin Er, Hakan Yucel, Veli Sunar, Nail Paksoy, Dincer Aydin, Nazim Serdar Turhal, Serkan Menekse, Engin Kut, Musa Baris Aykan, Ozlem Ozdemir, Melike Ozcelik, Yakup Iriagac, Fatih Selcukbiricik, Ali Inal, Nuri Karadurmus, Muhammed Bulent Akinci, Mehmet Ali Nahit Sendur","doi":"10.1016/j.clbc.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.003","url":null,"abstract":"<p><strong>Background: </strong>Real-world (RW) data provide valuable information about the effectiveness and safety of treatment modalities in the general population that is not limited by selection criteria in clinical studies. The aim of this study was to evaluate the effectiveness of palbociclib or ribociclib plus fulvestrant in hormone receptor-positive and human epidermal factor 2-negative metastatic breast cancer (HR+/HER2-MBC).</p><p><strong>Materials and methods: </strong>We conducted a multicenter, retrospective cohort study that included 522 patients with HR+/HER2-MBC treated with ribociclib or palbociclib in combination with fulvestrant.</p><p><strong>Results: </strong>Median real-world progression-free survival (mPFS) was 12.9 months (95% CI, 11.16-14.65) for the entire cohort, and no statistically significant difference was present between the palbociclib and ribociclib groups (P = .70). Real-world median overall survival (mOS) was estimated to be 43.3 months (95% CI, 20-66.6) for the palbociclib group and 48.5 months (95% CI, NA-NA) for the ribociclib group and similar between the 2 groups (P = .56). When evaluated for the entire group, there was a significant difference in mPFS between patients with primary and secondary endocrine resistance (8.6 and 13.5 months, P = .002), and this difference was more pronounced in the palbociclib arm (6.6 and 14.4 months, P = .006) than in the ribociclib arm (11.6 and 13.3 months, P = .064).</p><p><strong>Conclusion: </strong>Although the 3 CDK4/6 inhibitors did not seem to differ significantly from each other in terms of effectiveness in a real-world context, they may vary depending primarily on the specific characteristics of the patient population being treated.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794822","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":"Primary Stereotactic Body Radiation Therapy for Breast Cancer Spinal Metastases.","authors":"Kuan-Nien Chou, David J Park, Yusuke S Hori, Sara C Emrich, Louisa Ustrzynski, Armine Tayag, Cynthia Chuang, Erqi Pollom, Cheng-Hsiang Lo, Steven D Chang","doi":"10.1016/j.clbc.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.001","url":null,"abstract":"<p><strong>Background: </strong>To present insights gained from a decade of employing stereotactic body radiation therapy (SBRT) as a primary intervention for spinal bone metastasis (SBM) originating from breast cancer (BC).</p><p><strong>Methods: </strong>We retrospectively examined the application of primary SBRT (the CyberKnife System) for BC SBMs between March 2012 and January 2023.</p><p><strong>Results: </strong>We recruited 47 female patients with 82 SBMs affecting 104 vertebrae. The mean age was 53.2 ± 12.7 years. The overall local control (LC) rate of primary SBRT for BC SBMs was 84.1%. The median local progression (LP) occurred at 12 (3-66) months. The LP rates were 9.7%, 13.3%, and 18.3% at 1, 3, and 5 years following SBRT. We observed a lower LC rate in White patients than that in Asian patients. Factors associated with an increased risk of LP included SBMs from invasive lobular carcinoma, and patients with lower revised Tokuhashi scores. Additionally, the 1-, 3-, and 5-year LP rates of different SFED (≥20 Gy vs. <20 Gy) were 4.3% versus 19.1%, 7.2% versus 24.0%, and 11.5% versus 28.9%. The incidence of acute local adverse events (AEs) was 24.4% and was significantly associated with advanced age and prescribed target coverage of less than 95%.</p><p><strong>Conclusions: </strong>We have demonstrated SBRT using the CyberKnife System as an effective primary intervention for BC SBMs. Our findings underscore the importance of treatment planning to optimize outcomes and minimize AEs in patients undergoing SBRT for SBMs.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691331","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}