Clinical breast cancer最新文献

{"title":"Another Biosignature for Ductal Carcinoma In Situ-Have We Moved the Needle?","authors":"Hannah Bacon, Ezra Hahn","doi":"10.1016/j.clbc.2024.10.017","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.017","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695220","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":"Association of Skeletal Muscle Mass and Muscle Quality at Diagnosis With Survival in Young Women With Breast Cancer: Retrospective Observational Study.","authors":"Aynur Aktas, Rebecca Sheaff Greiner, Matthew Flores, Danielle Boselli, Taylor Stone, Eric Wang, Lejla Hadzikadic-Gusic, Michelle L Wallander, Anna Hecksher, Chasse Bailey-Dorton, Declan Walsh","doi":"10.1016/j.clbc.2024.10.014","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.014","url":null,"abstract":"<p><strong>Background: </strong>Low skeletal muscle mass and poor muscle quality are associated with poor outcomes in women with breast cancer. However, gaps exist in our understanding of prognostic factors for young women (≤ 40 years), as they often have different body composition than older women. We evaluated pretreatment body composition measures in young women with breast cancer, including associations with overall survival (OS) and progression-free survival (PFS).</p><p><strong>Methods: </strong>The Young Women's Database at Levine Cancer Institute was queried for women aged 18 to 40 at diagnosis (2009-2018) of single primary breast cancer (N = 870); patients with Stage 0 and 4 were excluded. Deceased patients with pretreatment computed tomography (CT) scans were identified (N = 40) and matched (1:1) to patients presumed alive by age, diagnosis year, and disease characteristics. CT-derived body composition measures included skeletal muscle index (SMI) and intramuscular adipose tissue corrected (IMAT-C). Sarcopenia (low muscle mass) was defined as SMI<40.</p><p><strong>Results: </strong>Of 80 subjects, median age at diagnosis was 35 years. Median follow-up 8.6 years. Total 33% had low muscle mass (sarcopenic), and 56% had poor muscle quality (high IMAT-C). Independent of age, clinical disease stage, and primary insurer, high IMAT-C was associated with shorter PFS (HR 2.33, 95% CI 1.15-4.72; P = .020).</p><p><strong>Conclusions: </strong>Poor muscle quality at diagnosis was associated with shorter progression-free survival in young women with breast cancer. Future research should determine the significance of changes in muscle quality throughout treatment.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692560","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 and Validation of a Novel Conditional Survival Nomogram for Predicting Real-Time Prognosis in Patients With Breast Cancer Brain Metastasis.","authors":"Yongqing Zhang, Mingjie Zhang, Guoxiu Yu, Wenhui Wang","doi":"10.1016/j.clbc.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.016","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer brain metastasis (BCBM) prognosis has not been evaluated dynamically, which may underestimate patient survival. This study aimed to perform a conditional survival (CS) analysis and develop and validate an individualized real-time prognostic monitoring model for survivors.</p><p><strong>Methods: </strong>The study included patients with BCBM from the Surveillance, Epidemiology, and End Results database (training group, n = 998) and our institution (validation group, n = 45) and updated patient overall survival (OS) over time using the CS method: CS(t2|t1)=OS(t1+t2)OS(t1). Multivariate Cox regression was used to identify prognostic factors for the nomogram, which estimated individualized OS. Furthermore, a novel CS-nomogram and its web version were further developed based on the CS formula.</p><p><strong>Results: </strong>CS analysis showed that the 5-year OS of BCBM survivors gradually improved from 13.5% estimated at diagnosis to 26.0%, 39.7%, 57.9%, and 77.6% (surviving 1-4 years, respectively). Cox regression identified age, marital status, estrogen receptor status, human epidermal growth factor receptor 2 (Her-2) status, histological grade, surgery, and chemotherapy as significant factors influencing OS (P < .05). We then constructed and deployed the CS-nomogram based on the CS formula and the nomogram to predict real-time prognosis dynamically (https://wh-wang.shinyapps.io/BCBM/). During performance evaluation, the model performed well in both the training and validation groups.</p><p><strong>Conclusions: </strong>CS analysis showed a gradual improvement in prognosis over time for BCBM survivors. We developed and deployed on the web a novel real-time dynamic prognostic monitoring system, the CS-nomogram, which provided valuable survival data for clinical decision-making, patient counseling, and optimal allocation of healthcare resources.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680997","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":"Transforming Breast Cancer Care and Clinical Outcomes: Local Experience in Yanbu Industrial City, Saudi Arabia.","authors":"Hend Samir Ibrahim, Salman M Albeshan, Manal Ahmed ElRefaei","doi":"10.1016/j.clbc.2024.10.011","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.011","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to enhance outcomes for women undergoing breast cancer screening in a low utilization setting by implementing structured improvement cycles.</p><p><strong>Methods: </strong>Improvement cycles were conducted using the Plan-Do-Study-Act (PDSA) methodology. Three cycles were implemented: (1) dedicating a specific day for breast screening and increasing appointment slots; (2) establishing a breast screening clinic with same-day registration; and (3) introducing a breast surgery clinic to expedite biopsy procedures for BI-RADS-4 category cases.</p><p><strong>Results: </strong>Following each improvement cycle, dramatic increases in patient attendance were observed. In 2021, there was a 67.5% rise compared to the previous year, and a 72% increase in 2022 compared to 2021 figures. Patient characteristics revealed that 60% of attendees were new patients, with 53% of cancer and precancerous cases observed in women below 50 years old. Before the third cycle, the estimated diagnosis turnaround time (TAT) showed that only 23% of patients had their biopsy completed within 5 working days. However, after the third cycle (n = 131), 63.5% of biopsies were done within five working days.</p><p><strong>Conclusion: </strong>Structured improvement cycles guided by the PDSA methodology effectively enhanced breast cancer screening outcomes. These cycles led to increased patient attendance, expedited biopsy procedures, and improved access to timely diagnosis. The findings highlight the importance of systematic approaches in optimizing breast cancer screening and improving patient care.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681003","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":"Letter to the Editor Regarding the Article \"The Impact of COVID-19 on Breast Cancer Care: A Qualitative Analysis of Surgeons' Perspectives\".","authors":"Akshaya Viswanathan, Pitchaipillai Sankar Ganesh, Naji Naseef Pathoor, Rajesh Kanna Gopal","doi":"10.1016/j.clbc.2024.10.015","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.015","url":null,"abstract":"<p><p>The COVID-19 pandemic exposed significant challenges in breast cancer care including healthcare inequities, limited access to surgeries, and difficulties in delivering virtual care. This letter builds upon the findings from the article \"The Impact of COVID-19 on Breast Cancer Care\" and proposes innovative solutions to address these challenges. Key suggestions include the use of AI-powered digital platforms for remote monitoring, robotic-assisted surgery for enhanced precision, mobile health applications for marginalized populations, and 3D printing for personalized breast reconstruction. Additionally, wearable health devices, nanotechnology for targeted drug delivery, and blockchain for secure medical data sharing are proposed to further improve the future of breast cancer care. These innovations offer practical approaches to overcoming the obstacles highlighted during the pandemic and aim to create a more equitable and efficient healthcare system.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647040","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":"Nonpharmacological Interventions for Postmastectomy Pain Syndrome-A Systematic Review of the Literature.","authors":"Edmundo Gónima Valero, Cristian D Rodríguez Miranda, Sandra Contreras Arrieta, Maria I Daza Morelli, Daniela Seija Butnaru, Mariana Reyes Carrillo, Laura D Aponte Camacho, Sebastian Amaya","doi":"10.1016/j.clbc.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.007","url":null,"abstract":"<p><strong>Objective: </strong>Literature regarding nonpharmacological interventions (NPI) for PMPS or CP after mastectomy is scarce and not fully appraised, therefore we conducted this systematic review to explore the current panorama of treatment options.</p><p><strong>Methods: </strong>A systematic review to assess the existing evidence regarding nonpharmacological approaches for PMPS. We reviewed the following databases: PubMed-MEDLINE, Embase, and Ovid (including the Cochrane Database for Clinical studies) using the following search terms: CP, mastectomy, and PMPS, and adjusted the terms depending on the database used. We included observational studies including case reports, cross sectional studies, cohort studies, and clinical trials (randomized or not) that included a NPI to treat PMPS.</p><p><strong>Results: </strong>Total 1061 records were identified. After duplicate elimination, 863 records were screened for eligibility. A total of 717 records were excluded using our criteria, 138 records were sought for retrieval, and 117 full text records were assessed. Finally, 30 studies were included: seven case series, one cross-sectional study, two cohort studies, one case-control study, five nonrandomized clinical trials, ten randomized clinical trials (RCT), one qualitative study, and three systematic reviews of the literature, including two meta analyses, were included.</p><p><strong>Discussion: </strong>Findings suggest that there is a great response of patients to some NPI. Regarding surgical interventions, autologous fat grafting and lymph node transplantation showed to have the greatest benefit for patients in terms of quality of life and reduced pain scores. Pulsed radiofrequency demonstrated the highest quality of evidence for energy related procedures. Within the physical therapy interventions, transcutaneous electric nerve stimulation and dry needling showed the greatest benefit. Finally, virtual reality demonstrated the greatest benefit in educational interventions.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675231","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 Evidence Study to Assess Incidence, Treatment Patterns, Clinical Outcomes, and Health Care Resource Utilization in Early-Stage, High-Risk HER2-Negative Breast Cancer in Alberta, Canada.","authors":"Jan-Willem Henning, Devon J Boyne, Darren R Brenner, Chantelle Carbonell, Simran Shokar, Diana P Granados, Anna Parackal, Winson Y Cheung","doi":"10.1016/j.clbc.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.008","url":null,"abstract":"<p><strong>Background: </strong>Data are needed to improve the current understanding of the epidemiology of patients with high-risk, HER2-negative, early breast cancer (eBC) (hormone receptor positive [HR+]/HER2-negative BC and triple-negative BC [TNBC]).</p><p><strong>Patients and methods: </strong>This retrospective longitudinal cohort study used real-world, population-level data that included all individuals newly diagnosed with high-risk, HER2-negative eBC in Alberta, Canada, between 2010 and 2019. Data on treatment, laboratory results and pathology findings were collected through electronic health records and administrative databases.</p><p><strong>Results: </strong>The annual cumulative incidence of high-risk, HER2-negative eBC ranged from 6% to 9% of all incident BC cases. Individuals with TNBC were more likely to be younger, had stage II disease, grade 3 histology and received systemic therapy at a community centre (P < .05) compared to individuals with HR+/HER2-negative eBC. Only 14% of individuals diagnosed in 2010-2017 underwent germline BRCA testing postdiagnosis. Neoadjuvant systemic therapy was given to 37% of individuals. Adjuvant systemic therapy use increased from 77% (2012-2015) to 84% (2019). The 5-year overall survival (OS) from initiation of adjuvant systemic therapy or date of surgery (for individuals who did not receive adjuvant systemic therapy) was 77% (95% CI: 75-79). OS was significantly worse among individuals who were older, had grade 3 histology, had stage III disease, or had nodal involvement (P < .05). OS among individuals with TNBC between 2016 and 2019 who initiated adjuvant capecitabine was markedly worse compared to the overall cohort (2-year OS: 70% vs. 89%).</p><p><strong>Conclusion: </strong>Outcomes analyses in this high-risk, HER2-negative eBC population suggest a continued unmet clinical need.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638528","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":"Assessing and Comparing the Diagnostic Effectiveness of [¹⁸F]FDG PET/CT and [¹⁸F]FDG PET/MRI for Distant Metastases in Breast Cancer Patients With Invasive Lobular Carcinoma Histology: An Ongoing Topic of Debate?","authors":"Kadri Altundag","doi":"10.1016/j.clbc.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.012","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615804","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":"Local Recurrence and Survival Outcomes of Multifocal/Multicentric Breast Cancer After Breast Conserving Therapy: A systematic Review and Meta-Analysis.","authors":"Youshi Sun, Lu Gao, Xingtong Zhou, Zihao Wang, Yan Li, Qiang Sun","doi":"10.1016/j.clbc.2024.10.009","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.009","url":null,"abstract":"<p><strong>Background: </strong>The appropriateness of BCT for MF/MCBC is debated, with concerns about higher recurrence rates. This study aims to provide an updated systematic review and meta-analysis of LR and survival outcomes for MF/MCBC patients undergoing BCT.</p><p><strong>Methods: </strong>PubMed, Web of Science, Embase, and the Cochrane Library were searched up to May 2024. Eligible studies included original research articles comparing LR, DFS, or OS in patients with MF/MC or UF breast cancer undergoing BCT or mastectomy. Meta-analyses for LR were conducted using the Mantel-Haenszel method. Published Kaplan-Meier curves for DFS and OS were digitized and aggregated to estimate summary survival curves.</p><p><strong>Results: </strong>21 studies were included in the meta-analysis for LR, comprising 28,589 participants, and 7 studies for survival analysis. The meta-analysis revealed that MF/MC breast cancer patients undergoing BCT had a significantly higher LR rate compared to UF patients (OR = 1.76, 95% CI: 1.24-2.49, P = .002), though recent studies indicated comparable LR rates. No significant difference in LR was found between MF/MC patients treated with BCT versus mastectomy (OR = 1.72, 95% CI: 0.96-3.10, P = .07). The estimated 3-, 5-, and 8-year DFS rates were 92.4%, 88.3%, and 84.5%, respectively, while the OS rates were 98.0%, 95.8%, and 91.8%.</p><p><strong>Conclusion: </strong>BCT for MF/MC breast cancer was associated with higher LR rates compared to UF breast cancer, but the disparity was reducing in recent years. BCT offers comparable LR outcomes to mastectomy in MF/MC patients. Survival outcomes for MF/MC patients treated with BCT were favorable, affirming its oncological safety.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615819","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":"Navigating Lymphedema: The Impact of Indocyanine Green Lymphography on Personalized Therapy Outcomes in Breast Cancer Patients.","authors":"Atilla Soran, Kazim Senol, Kristin Lupinacci","doi":"10.1016/j.clbc.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.10.010","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the role of Indocyanine Green Lymphography (ICG_L) in the early diagnosis and personalized management of breast cancer-related lymphedema (BCRL) among high-risk breast cancer (BC) survivors.</p><p><strong>Methods: </strong>Patients who admitted to the UPMC Magee-Womens Hospital Lymphedema Program between October 2018 and December 2021 with episodic symptoms were enrolled into the study. Patient demographics, clinical characteristics, and outcomes were prospectively collected and retrospectively analysed. Lymphatic flow disruptions were identified and guided personalized therapeutic interventions were guided by ICG_L.</p><p><strong>Results: </strong>Among 154 BC survivors, 184 arms were evaluated. Initial ICG_L showed 57.1% had no lymphedema, while 42.9% were classified as stage 1 to 3 lymphedema. Early diagnosis and personalized interventions provided improved outcomes, with only 4.3% developing clinical lymphedema after a median follow-up of 27 months. Patients exhibited stable or improved symptoms with individualized treatments such as manual lymphatic drainage, compression therapies, and physiotherapy.</p><p><strong>Conclusion: </strong>ICG_L evaluation is essential for patients at high-risk of developing BCRL. Early diagnosis before clinical onset of lymphedema, and ICG_L guided therapy significantly enhances the clinical outcomes and improves lymphedema management.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615823","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}