Clinical breast cancer最新文献

{"title":"Evaluating the Neutrophil-Lymphocyte Ratio as a Predictor of Long-Term Oncological and Survival Outcomes in Patients Treated Surgically for Breast Cancer","authors":"Alisha A. Jaffer ,&nbsp;Carolyn Cullinane ,&nbsp;Matthew G Davey ,&nbsp;Amirhossein Jalali ,&nbsp;Juliette Buckley ,&nbsp;Chwanrow Baban ,&nbsp;Brigid Anne Merrigan ,&nbsp;Shona Tormey","doi":"10.1016/j.clbc.2025.08.015","DOIUrl":"10.1016/j.clbc.2025.08.015","url":null,"abstract":"<div><h3>Background</h3><div>Neutrophil-lymphocyte ratio (NLR) is an emerging prognostic biomarker with potential utility in solid malignancies. Routine draw of full blood count in preoperative workup positions NLR as a cost-effective adjunct in risk stratification. This project explores associations between preoperative NLR and breast cancer outcomes.</div></div><div><h3>Methods</h3><div>This retrospective cohort study reviewed an institutional database of breast cancer patients undergoing primary curative surgery at University Hospital Limerick from January 1, 2010 to June 1, 2017. Primary endpoints included recurrence at 5 years, disease free survival (DFS) and OS (OS). Regression modelling examined associations between preoperative NLR ≥2.5 and endpoints, controlling for confounders.</div></div><div><h3>Results</h3><div>Median preoperative NLR was 2.63 (SD 1.42). The cohort comprised 579 patients, with a recurrence rate of 15.7% (6% local recurrence and 9.7% distant metastasis). 106 (18.3%) patients were deceased at the administrative censoring time. Patients with NLR ≥ 2.5 had a 2-fold increase in rate of distant metastasis at 5 years (OR 2.00, 95% CI, 1.05-3.81, <em>P</em> = .036) and experienced worse OS (HR 1.84, 95% CI, 1.20-2.84, <em>P</em> = .006). Outcomes between NLR ≥2.5 and local recurrence at 5 years, as well as NLR ≥2.5 and DFS were equivocal.</div></div><div><h3>Conclusions</h3><div>Preoperative NLR ≥2.5 was found to be an independent predictor of distant metastasis at 5 years and an independent predictor of OS, following adjustment of confounders. This finding is consistent with published literature and may help risk stratify patients at higher risk of breast cancer recurrence.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 136-145.e2"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111533","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":"ADAM and ADAMTS Proteases in Breast Cancer: Molecular Mechanisms and Therapeutic Implications","authors":"Chanchal Badhai,&nbsp;Manju Rawat Singh PhD,&nbsp;Shradha Devi Dwivedi,&nbsp;Deependra Singh","doi":"10.1016/j.clbc.2025.12.001","DOIUrl":"10.1016/j.clbc.2025.12.001","url":null,"abstract":"<div><div>Breast cancer ranks as the second most significant cause of cancer-related mortality on a global scale, with its incidence demonstrating a continual upward trajectory. Investigating gene targets for cancer therapies has advanced through innovative methodologies focusing on genes and pathways driving cancer progression. A disintegrin and metalloproteinases (ADAMs) and ADAMs with thrombospondin motifs (ADAMTSs) constitute related protease families, with ADAMs primarily functioning as membrane-anchored cell-surface enzymes and ADAMTSs secreted into the extracellular matrix. These proteases drive oncogenic signaling via ectodomain shedding of growth factors and receptors, modulating EGFR, PI3K/AKT/mTOR, TNF-α, Notch, and JAK-STAT pathways. ADAM10 and ADAM17 particularly promote breast cancer invasion and metastasis in HER2-positive and triple-negative subtypes, establishing them as biomarkers and therapeutic targets. Conversely, certain ADAMTS members exhibit tumor-suppressive functions by inhibiting angiogenesis and ECM remodeling. Regulatory cofactors such as iRhom proteins modulate ADAM17 maturation and substrate selectivity, adding complexity to this proteolytic network. This review synthesizes recent advances in ADAMs/ADAMTs in breast cancer, highlighting roles in promoting or suppressing tumorigenesis depending on isoform and molecular context. Multiple therapeutic modalities have been validated, including small-molecule inhibitors (INCB7839, INCB3619, GI254023X) that suppress ligand shedding and enhance trastuzumab efficacy, RNA interference (siRNA/miRNA) for targeted gene silencing, and engineered nanocarrier drug delivery platforms that overcome therapeutic resistance. The epigenetic regulation, post-translational modifications, and diagnostic advancements, such as SERS-based serum profiling, further underscore their value as biomarkers and druggable targets. Collectively, ADAM/ADAMTS-centered interventions represent a promising direction for precision oncology and therapeutic targets for improving clinical outcomes in breast cancer.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 17-35"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908801","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 Surgical Management and Reconstruction of Breast Cancer Patients at a Tertiary Care Center and an Associated Safety-Net Institution","authors":"Charles A. Keane ,&nbsp;Magdalena A. Iannello ,&nbsp;Sumeet S. Teotia ,&nbsp;Nicholas T. Haddock ,&nbsp;Lisa Wintonli","doi":"10.1016/j.clbc.2025.11.012","DOIUrl":"10.1016/j.clbc.2025.11.012","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the rates of breast conservation therapy and mastectomy with and without immediate postmastectomy reconstruction (IPMR) amongst racially distinct subgroups being treated with neoadjuvant chemotherapy (NAC).</div></div><div><h3>Methods</h3><div>Women who received NAC for newly diagnosed breast cancer from 2010 to 2017 were identified from an institutional tumor registry at a tertiary care center and an associated safety-net institution. Patient demographics, insurance status, tumor characteristics, and surgical procedures were compared after women were stratified by race.</div></div><div><h3>Results</h3><div>At the tertiary care facility, a higher proportion of White women were treated with bilateral mastectomy (35.7%) compared to Black (19.3%) and Hispanic women (9.8%). White women were also more likely to receive IPMR as compared to Black and Hispanic women (63.7% vs. 42.7% and 33.3% respectively). At the associated safety-net institution, women were more likely to undergo a unilateral mastectomy, regardless of race, and there was no statistical difference in the rates of IPMR amongst the different racial cohorts (17.2%-18.7%). IPMR was performed in 52.4% of cases at the tertiary care center compared to 18.2% at the safety-net institution.</div></div><div><h3>Conclusion</h3><div>Despite controlling for confounding factors, disparities exist in the treatment of breast cancer patients. This study focuses on differing rates of mastectomy and IPMR when comparing an associated tertiary care center and safety-net institution. The discrepancy is profound and appears to be driven by race, insurance, and institution type.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 45-49"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017607","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":"When Obesity Meets Lymphedema: Interaction Effects on Lymphatic Pain Among Chinese Breast Cancer Survivors","authors":"Aomei Shen ,&nbsp;Yuhua Yang ,&nbsp;Li Zhang ,&nbsp;Nada Lukkahatai ,&nbsp;Mei R. Fu ,&nbsp;Shengwen Dong ,&nbsp;Ying Wang ,&nbsp;Hongmeng Zhao ,&nbsp;Peipei Wu ,&nbsp;Pan Yang ,&nbsp;Qian Lu","doi":"10.1016/j.clbc.2025.12.002","DOIUrl":"10.1016/j.clbc.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Lymphatic pain is an underrecognized symptom among breast cancer survivors and may indicate early lymphatic dysfunction. This study examined the prevalence of lymphatic pain and its associated factors, with a particular focus on the interaction between obesity and breast cancer-related lymphedema (BCRL).</div></div><div><h3>Methods</h3><div>A secondary analysis was conducted using datasets from 2 previously completed studies. 894 participants who completed arm circumference measurements and symptom assessments were included. Independent t-tests, chi-square tests, Fisher’s exact tests, and binary logistic regression analyses were performed to explore group differences and potential predictors of lymphatic pain. An interaction term between obesity and BCRL was incorporated to evaluate effect modification.</div></div><div><h3>Results</h3><div>The prevalence of lymphatic pain was 18.12% (<em>n</em> = 162, 95% CI, 15.8%-20.8%). Participants with lymphatic pain reported a greater number, higher severity, and higher frequency of all symptoms compared to those without lymphatic pain (all <em>P</em> &lt; .001). BCRL was the strongest independent predictor of lymphatic pain (OR = 2.955, 95% CI, 1.957-4.460). Although the main effect of obesity was not statistically significant, a significant obesity × BCRL interaction was identified (<em>P</em> = .032). Predicted probabilities indicated that obesity had minimal effect among participants without BCRL, but increased lymphatic pain risk among those with BCRL.</div></div><div><h3>Conclusion</h3><div>Obesity and BCRL are key factors associated with lymphatic pain, and obesity markedly amplifies pain risk in the presence of BCRL. These findings highlight the need for early lymphatic assessment and weight-management–informed survivorship care. Ongoing research is needed to clarify mechanisms and to evaluate targeted interventions.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 36-44"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951706","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":"American Radium Society Appropriate Use Criteria Report on Radiation in the Management of Ductal Carcinoma in Situ (DCIS) of the Breast","authors":"Eleanor Harris ,&nbsp;Parima Daroui ,&nbsp;Victor Gonzalez ,&nbsp;Jason C. Ye ,&nbsp;Wendy Gao ,&nbsp;Catherine Park ,&nbsp;Amar Rewari ,&nbsp;W. Warren Suh ,&nbsp;Kristina Novick ,&nbsp;J. Isabelle Choi ,&nbsp;Expert Panel on Breast Cancer","doi":"10.1016/j.clbc.2025.12.007","DOIUrl":"10.1016/j.clbc.2025.12.007","url":null,"abstract":"<div><div>Ductal carcinoma in situ (DCIS) of the breast is a distinct biologic entity from invasive cancer with an excellent prognosis which represents about 20% of all mammographically detected breast neoplasms. The primary goal of treatment is to minimize the risk of invasive in-breast recurrence. The American Radium Society (ARS) Appropriate Use Criteria (AUC) expert panel examined the evidence for key questions in contemporary treatment of DCIS related to the benefit of radiation after lumpectomy, the established dose and fractionation radiation regimens and the use of predictive and prognostic assays in treatment management of DCIS. For patients undergoing breast conserving surgery, postoperative radiation to the breast reduces the risk of local recurrence by at least 50%. The absolute benefit depends upon the baseline risk of in breast recurrence based on clinicopathologic features identified in randomized or prospective clinical trials and meta-analyses. These features include age and menopausal status, grade, margin width, tumor size, receptor expression, and presence of comedonecrosis. Randomized and prospective studies have not identified a definitive cohort of patients who do not benefit from adjuvant radiation to reduce in breast recurrence. Margin width appears to be the most significant factor in local recurrence risk. Patients with close or positive margins demonstrate a higher local recurrence risk and benefit from dose escalation by use of a tumor bed boost. Recently developed biosignatures of DCIS in-breast recurrence risk have been validated and found to confer potential clinical utility in the decision-making process regarding recommendations to undergo treatment with adjuvant breast radiation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 105-112"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099603","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":"Patient-Provider Relationships Influence Reception of Postmastectomy Breast Reconstruction: An Analysis of the All of Us Research Program","authors":"Dylan K. Kim,&nbsp;Hao Huang,&nbsp;Julia A. Kim,&nbsp;Christine H. Rohde","doi":"10.1016/j.clbc.2025.09.016","DOIUrl":"10.1016/j.clbc.2025.09.016","url":null,"abstract":"<div><h3>Background</h3><div>Although existing literature has comprehensively investigated socioeconomic disparities in postmastectomy breast reconstruction, the effect of patient-provider relationships on the receipt of breast reconstruction is still not completely described. This study incorporates a large national data platform to investigate the effect of such interactions on the likelihood of reconstruction after mastectomy.</div></div><div><h3>Methods</h3><div>Patients who underwent mastectomy were identified in the All of Us Research Program, a large and diverse United States patient registry. Patient-provider relationships were quantified through a series of survey questions assessing themes of respect, understanding, and apprehension from patient-provider interactions. The main outcome of interest was the receipt of breast reconstruction, which was assessed with multivariable logistic regression (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The final cohort included 547 patients with complete survey data. The rate of postmastectomy breast reconstruction was 47.3%. Patient perceptions of receiving respectful treatment by providers “most of the time” (OR: 0.47, 95% CI, 0.30-0.74, <em>P</em> = .0012) and “some of the time” (OR: 0.21, 95% CI, 0.05-0.89, <em>P</em> = .034) predicted lower odds of breast reconstruction when compared to “always.” Nervousness about seeing a health care provider was also associated with lower odds of breast reconstruction (OR: 0.51, 95% CI, 0.27-0.96, <em>P</em> = .034).</div></div><div><h3>Conclusion</h3><div>Despite increasing volume of breast reconstruction in the United States, the receipt of such reconstruction may still be influenced by aspects of the patient-provider relationship. This analysis supports the importance of cultivating patient-centered relationships for patients with breast cancer.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 287-295"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354086","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":"Practical Considerations for the Use of Antiemetics in Pregnant Patients With Breast Cancer","authors":"Arianne Duong ,&nbsp;Dane Fritzsche ,&nbsp;Amy Ly Indorf","doi":"10.1016/j.clbc.2025.12.012","DOIUrl":"10.1016/j.clbc.2025.12.012","url":null,"abstract":"<div><div>Early breast cancer treatment commonly includes highly emetogenic chemotherapy and immunotherapy regimens. Both pregnancy and chemotherapy treatment are associated with nausea and vomiting, and many agents used to treat pregnancy-associated nausea have limited data for CINV. Guidelines recommend a 4-drug antiemetic regimen for highly emetogenic chemotherapy regimens. Designing antiemetic regimens for pregnant women undergoing treatment for early breast cancer remains a challenge because of a lack of safety data for commonly used antiemetics as well as physiologic changes that occur throughout pregnancy This review aims to discuss current literature and guideline recommendations and provide practical considerations for agents used in chemotherapy-induced nausea and vomiting prevention in pregnant patients with breast cancer. A literature search on nausea pathophysiology, treatment of pregnant breast cancer patients, antiemetic use in pregnancy and chemotherapy-induced nausea and vomiting was conducted. Primary and tertiary literature sources were reviewed and cited. An overview of nausea pathophysiology and general treatment principles of treatment and supportive care in pregnant breast cancer patients is outlined. Five major antiemetic drug classes are reviewed in this article. When designing antiemetic regimens for pregnant patients undergoing chemotherapy treatment, clinicians must consider the current evidence, including safety, side effects, and pharmacokinetics of various agents, as well as pregnancy trimester and associated physiologic changes. Optimal management and prevention of chemotherapy-induced nausea and vomiting is crucial to avoid treatment delays and hospitalization, and to maximize patient quality of life.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 80-86"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035522","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":"Diagnostic Performance of AI-Assisted Radiologists in Breast Cancer Detection Using Digital Mammography: A Systematic Review and Meta-Analysis","authors":"Jiayin Lu ,&nbsp;Xiaonan Xu ,&nbsp;Yanyan Zhang ,&nbsp;Kunyu Zhuang ,&nbsp;Tali Fang ,&nbsp;Chifa Zhang ,&nbsp;Kairong Chen ,&nbsp;Xiaomei Huang ,&nbsp;Yingjia Li","doi":"10.1016/j.clbc.2025.08.013","DOIUrl":"10.1016/j.clbc.2025.08.013","url":null,"abstract":"<div><div>To evaluate the diagnostic performance of AI-assisted and standalone human radiologists in breast cancer detection using digital mammography (DM). A comprehensive search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases for studies published from January 2019 to December 2024. Study quality was assessed using the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) and quality assessment of diagnostic accuracy studies-comparative (QUADAS-C). Summary receiver operating characteristic (SROC) curves and prediction regions of pooled sensitivity, specificity, and estimated area under the curves (AUCs) were used to evaluate the diagnostic performance of AI-assisted radiologists versus standalone human radiologists. Sources of heterogeneity were explored using meta-regression analysis. Overall, 30 studies were included in the qualitative synthesis. Among them, data from 20 studies were separately utilized for quantitative synthesis, categorized into three scenario groups: concurrent assistant, AI reader-replacement, and additional reader scenarios. Pooled sensitivity was significantly higher for AI-assisted radiologists compared to standalone human radiologists in the concurrent scenario (0.84 vs. 0.78, <em>P</em> &lt; .001), and pooled specificity was superior in the concurrent and replacement scenarios, respectively (0.84 vs. 0.80, <em>P</em> &lt; .001; 0.96 vs. 0.95, <em>P</em> &lt; .001). There were no significant differences in area under the curves (AUCs) among these three scenarios. In breast cancer diagnosis, AI-assisted radiologists demonstrated superior sensitivity compared to standalone human radiologists in the concurrent scenario, and superior specificity in both the concurrent and replacement scenarios. Further research is needed to confirm these findings and explore the optimal strategies for integrating AI into breast cancer diagnostic workflows.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 121-135"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063608","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":"Robot-Assisted Versus Open Surgery in Early-Stage Breast Cancer: A Systematic Review and Meta-Analysis","authors":"Shrouk Elghazaly ,&nbsp;Sara Fakeh ,&nbsp;Shaymaa Elbarbary ,&nbsp;Khaled Mahmoud ,&nbsp;Abdeljalil El Hilali ,&nbsp;Peter Gamal ,&nbsp;Elsayed Motawa","doi":"10.1016/j.clbc.2025.08.019","DOIUrl":"10.1016/j.clbc.2025.08.019","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most frequently diagnosed malignancy among women and remains a leading cause of cancer-related mortality. Nipple-sparing mastectomy (NSM), especially when combined with immediate reconstruction, has demonstrated oncologic safety and improved aesthetic outcomes. Robotic-assisted NSM (R-NSM) is a recent advancement offering better visualization and minimally invasive benefits, though its long-term safety and effectiveness remain under evaluation.</div></div><div><h3>Methods</h3><div>Databases searched included PubMed, Scopus, Web of Science, and the Cochrane Library. Eligible studies compared R-NSM with open NSM for early-stage breast cancer and reported surgical or oncologic outcomes.</div></div><div><h3>Results</h3><div>Eight studies including 1743 patients were included in the meta-analysis. R-NSM was associated with a significantly longer operative time (mean difference: 47.95 minutes; 95% CI, 13.89-82.02) but significantly lower intraoperative blood loss (mean difference: −34.29 mL; 95% CI, −43.63 to −24.95). Major complication risk was also lower (RR: 0.45; 95% CI, 0.23-0.86). Nipple-areola complex necrosis was significantly lower in R-NSM (RR: 0.55; 95% CI, 0.35-0.88). No significant differences were observed for skin necrosis, seroma, or surgical site infections. Heterogeneity was high in several outcomes.</div></div><div><h3>Discussion</h3><div>R-NSM may improve perioperative outcomes by enabling precise dissection through remote incisions, potentially preserving vascular supply to the nipple–areola complex and reducing severe complications. The trade-off is longer operative time, largely due to robotic system setup and surgeons experience.</div></div><div><h3>Conclusion</h3><div>Robotic-assisted NSM reduces blood loss and major complication at the cost of longer operative times. Further high-quality studies are needed to confirm its long-term oncologic outcomes and guide patient selection.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 181-190"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079736","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":"Clinical Implementation Study of Genetic Risk-Based Breast Cancer Screening","authors":"Madli Tamm ,&nbsp;Peeter Padrik ,&nbsp;Kristiina Ojamaa ,&nbsp;Anette Paas ,&nbsp;Anni Lepland ,&nbsp;Krista Kruuv-Käo ,&nbsp;Liis Leitsalu ,&nbsp;Siim Sõber ,&nbsp;Laura Roht ,&nbsp;Sander Pajusalu ,&nbsp;Tiina Kahre ,&nbsp;Anna Padrik ,&nbsp;Jagnar Pindmaa ,&nbsp;Kadri Luga ,&nbsp;Ly Rootslane ,&nbsp;Anne Ilves ,&nbsp;Sulev Ulp ,&nbsp;Kersti Kallak ,&nbsp;Ave-Triin Tihamäe ,&nbsp;Inna Feldman ,&nbsp;Neeme Tõnisson","doi":"10.1016/j.clbc.2025.08.021","DOIUrl":"10.1016/j.clbc.2025.08.021","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) remains the most common type of cancer and the leading cause of cancer-related deaths in women despite the widespread screening programs and personalized treatment options. Current age-based screening programs are suboptimal missing high-risk young women. The “Be RIGHT with breast cancer risk management” (BRIGHT) study evaluated a genetic risk-based personalized BC screening service model in real-world healthcare settings, focusing on younger women excluded from standard screening.</div></div><div><h3>Methods</h3><div>The BRIGHT study included 800 healthy Estonian women aged 35 to 49 using telemedicine and home-based testing. Participants underwent polygenic risk score (PRS) testing and based on the questionnaire those meeting the monogenic pathogenic variant (MPV) testing criteria were referred to clinical geneticists. All women received personalized genetic risk-based clinical recommendations, and if needed, referral to BC screening. Participants’ and healthcare professionals’ feedback was collected.</div></div><div><h3>Results</h3><div>330 (41.3%) women with elevated polygenic risk received recommendations to start screening earlier than the current standard. 124 (15.5%) women were advised to begin BC screening immediately, among whom one was diagnosed with stage 0 cancer and one with a precancerous lesion. Of the 90 participants completing MPV testing, four (4.4%) were MPV-positive. Feedback indicated high satisfaction with the digital approach and a clear understanding of results and recommendations.</div></div><div><h3>Conclusions</h3><div>The study demonstrated the feasibility and acceptability of a personalized genetic risk-based BC screening model. It has the potential to enhance BC screening programs, particularly for younger women and those at higher genetic risk, while avoiding unnecessary interventions for low-risk individuals.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 204-215"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408461","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}