Clinical breast cancer最新文献

{"title":"Breast Cancer Patient Flap Management After Mastectomy: A Best Practice Implementation Project.","authors":"Minshan Liang, Yuanzhen Luo, Xiaojun Wang, Chunhua Chen, Piao Chen, Zhenchong Xiong, Li Liu, Mengxiao Jiang, Huiting Zhang","doi":"10.1016/j.clbc.2024.09.004","DOIUrl":"10.1016/j.clbc.2024.09.004","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a prevalent malignancy in women, with mastectomy as the main surgery. Common postmastectomy complications are seroma (15%-81%), infections (2.9%-3.8%), and flap necrosis (10%-18%), severely impacting quality of life and costs. However, there's a lack of standardized flap care protocols and limited staff knowledge.</p><p><strong>Objectives: </strong>This study aims to apply best evidence for flap management post-mastectomy to standardize practices, reduce complications, and enhance patient's quality of life.</p><p><strong>Methods: </strong>This project followed JBI PACES and GRiP principles, implementing evidence-based practices in a Chinese tertiary hospital between January and May 2023. It entailed evidence identification, integration into clinical context, protocol development, baseline audits, barrier/enabler analysis. The study compared pre- and post-evidence implementation rates of flap complications, healthcare staff's knowledge/skill scores on mastectomy flap management, and audit indicator adherence by both staff and patients.</p><p><strong>Results: </strong>After evidence application, flap ischemia/necrosis rates dropped from 8.57% to 5.56% (P < .001), wound infection rates after surgery reduced from 5.71% to 2.78% (P < .001), and seroma rates decreased from 17.14% to 2.78% (P < .001). Healthcare staff's knowledge and skill scores for flap management following mastectomy increased from 50.67 ±18.32 preimplementation to 98.33 ± 4.01 (t = -13.90, P < .001). Audit criterion compliance rates increased from 8.57% to 94.29% to between 91.67% and 100%, with statistically significant differences in all 15 criteria (P < .001).</p><p><strong>Conclusions: </strong>Evidence-based management of flaps after mastectomy improves healthcare staff's knowledge and skills, enhances nursing quality, effectively reduces flap complications in patients, and boosts their quality of life.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":"46-55"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364604","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":"Deep Learning for Distinguishing Mucinous Breast Carcinoma From Fibroadenoma on Ultrasound.","authors":"Yuan Yao, Yang Zhao, Xu Guo, Xiangli Xu, Baiyang Fu, Hao Cui, Jian Xue, Jiawei Tian, Ke Lu, Lei Zhang","doi":"10.1016/j.clbc.2024.09.001","DOIUrl":"10.1016/j.clbc.2024.09.001","url":null,"abstract":"<p><strong>Purpose: </strong>Mucinous breast carcinoma (MBC) tends to be misdiagnosed as fibroadenomas (FA) due to its benign imaging characteristics. We aimed to develop a deep learning (DL) model to differentiate MBC and FA based on ultrasound (US) images. The model could contribute to the diagnosis of MBC for radiologists.</p><p><strong>Methods: </strong>In this retrospective study, 884 eligible patients (700 FA patients and 184 MBC patients) with 2257 US images were enrolled. The images were randomly divided into a training set (n = 1805 images) and a test set (n = 452 images) in a ratio of 8:2. First, we used the training set to establish DL model, DL+ age-cutoff model and DL+ age-tree model. Then, we compared the diagnostic performance of three models to get the optimal model. Finally, we evaluated the diagnostic performance of radiologists (4 junior and 4 senior radiologists) with and without the assistance of the optimal model in the test set.</p><p><strong>Results: </strong>The DL+ age-tree model yielded higher areas under the receiver operating characteristic curve (AUC) than DL model and DL+ age-cutoff model (0.945 vs. 0.835, P < .001; 0.945 vs. 0.931, P < .001, respectively). With the assistance of DL+ age-tree model, both junior and senior radiologists' AUC had significant improvement (0.746-0.818, P = .010, 0.827-0.860, P = .005, respectively).</p><p><strong>Conclusions: </strong>The DL+ age-tree model based on US images and age showed excellent performance in the differentiation of MBC and FA. Moreover, it can effectively improve the performance of radiologists with different degrees of experience that may contribute to reducing the misdiagnosis of MBC.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":"75-84"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342707","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":"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":"19-26"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","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}

{"title":"Potential of MRI in Assessing Treatment Response After Neoadjuvant Radiation Therapy Treatment in Breast Cancer Patients: A Scoping Review.","authors":"Ayyaz Qadir, Nabita Singh, Aung Aung Kywe Moe, Glenn Cahoon, Jessica Lye, Michael Chao, Farshad Foroudi, Sergio Uribe","doi":"10.1016/j.clbc.2024.05.010","DOIUrl":"10.1016/j.clbc.2024.05.010","url":null,"abstract":"<p><p>The objective of this scoping review is to evaluate the potential of Magnetic Resonance Imaging (MRI) and to determine which of the available MRI techniques reported in the literature are the most promising for assessing treatment response in breast cancer patients following neoadjuvant radiotherapy (NRT). Ovid Medline, Embase, CINAHL, and Cochrane databases were searched to identify relevant studies published from inception until March 13, 2023. After primary selection, 2 reviewers evaluated each study using a standardized data extraction template, guided by set inclusion and exclusion criteria. A total of 5 eligible studies were selected. The positive and negative predictive values for MRI predicting pathological complete response across the studies were 67% to 88% and 76% to 85%, respectively. MRI's potential in assessing postradiotherapy tumor sizes was greater for volume measurements than uni-dimensional longest diameter measurements; however, overestimation in surgical tumor sizes was observed. Apparent diffusion coefficient (ADC) values and Time to Enhance (TTE) was seen to increase post-NRT, with a notable difference between responders and nonresponders at 6 months, indicating a potential role in assessing treatment response. In conclusion, this review highlights tumor volume measurements, ADC, and TTE as promising MRI metrics for assessing treatment response post-NRT in breast cancer. However, further research with larger cohorts is needed to confirm their utility. If MRI can accurately identify responders from nonresponders to NRT, it could enable a more personalized and tailored treatment approach, potentially minimizing radiation therapy related toxicity and enhancing cosmetic outcomes.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":"e1-e9.e2"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436414","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":"Influence of Postmastectomy Radiotherapy on Overall Survival in Patients With Clinical Prognostic Stage I-III Breast Cancer With Positive Responses and Achieving YPN0 Following Neoadjuvant Therapy: A Propensity Score Matching Based on the SEER Database.","authors":"YuFeng Zhang, GuoDong Wang, Jia Si, MaoYi Xu","doi":"10.1016/j.clbc.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.010","url":null,"abstract":"<p><strong>Introduction: </strong>The role of postmastectomy radiotherapy (PMRT) in clinical prognostic stage I-III breast cancer patients with positive responses and achieving ypN0 after Neoadjuvant therapy (NAT) is controversial.</p><p><strong>Methods: </strong>3557 patients with TNM clinical prognostic stage (AJCC 8th Edition) I-III breast cancer with positive responses and achieving ypN0 following neoadjuvant therapy were selected from the Surveillance, Epidemiology, and End Results (SEER) database and followed through the end of 2020. COX proportional hazards models were employed to examine the associations between clinical or pathological parameters and OS. Propensity score matching (PSM) was employed to control for confounding variables and multiple association inference models were used for progressive sensitivity analysis.</p><p><strong>Results: </strong>In the multivariate analysis, PMRT did not demonstrate a significant improvement in OS (P = .127), while in univariate analysis, it was linked to worse OS (P < .001). PSM and multiple association inference models indicated that PMRT did not confer any significant improvement in patients' OS (all P > .05). Further stratified analysis of the prematch subgroup revealed that PMRT was linked to the 68% lower risk of mortality in patients with the cN3 subgroup (HR: 0.32; 95%CI, 0.11-0.97), and expressly enhanced the OS in cN3 subgroup patients with ER-, PR-, HER-2- status, and PR to NAT.</p><p><strong>Conclusions: </strong>Our research indicated that PMRT did not show any survival benefits for clinical prognostic stage I-III breast cancer patients who had positive responses and achieved ypN0 after NAT. PMRT was linked to the reduction in mortality among patients in the cN3 subgroup.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926561","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 Difference of RCB 0 and RCB I in Prognosis of Breast Cancer After Neoadjuvant Therapy: A Meta-Analysis.","authors":"Xinlong Tao, Jingqi Han, Yongxin Li, Yaming Tian, Zhou Juan Li, Jinming Li, Xinjian Guo, Jiuda Zhao","doi":"10.1016/j.clbc.2024.11.023","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.023","url":null,"abstract":"<p><strong>Background: </strong>The use of the residual cancer burden (RCB) for assessing breast cancer after neoadjuvant therapy (NAT) is increasingly common, but the prognostic difference between RCB 0 and RCB I is unclear.</p><p><strong>Methods: </strong>We systematically reviewed literature from PubMed, Embase, Web of Science, and oncology conferences until September 24, 2023. We used fixed- and random-effects models to calculate hazard ratio (HR) with 95% confidence interval (CI) for event-free survival (EFS), overall survival (OS), and distant disease-free survival (DDFS).</p><p><strong>Results: </strong>Our meta-analysis, encompassing 19 studies with 5894 patients, revealed that in the general population, RCB I had worse EFS (HR = 2.13; 95% CI: 1.75-2.58), OS (HR = 2.08; 95% CI: 1.48-2.93), and DDFS (HR = 2.10; 95% CI: 1.65-2.67) than RCB 0. Consistent with results from the general population, RCB I exhibited poorer EFS, OS, and DDFS in human epidermal growth factor 2-positive (HER2+) subtype and triple-negative breast cancer (TNBC) compared to RCB 0. Conversely, luminal subtype with RCB 0 and RCB I showed similar EFS (HR = 1.04; 95% CI: 0.62-1.72).</p><p><strong>Conclusions: </strong>RCB I experienced a poorer prognosis compared to RCB 0 in the general population, a pattern also observed in the HER2+ subtype and TNBC. However, no significant prognostic disparity was noted between RCB 0 and RCB I in the luminal subtype.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892556","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":"Menopausal Symptom Burden in Premenopausal Breast Cancer Patients: Interaction of Chemotherapy and Ovarian Function Suppression on Tamoxifen Treatment.","authors":"Young-Won Lee, Seunghee Baek, Jong Won Lee, Young-Jin Lee, Tae-Kyung Robyn Yoo, Jisun Kim, Il Yong Chung, Beom Seok Ko, Byung Ho Son, Kyung Hae Jung, Sung-Bae Kim, Sae Byul Lee, Yul Ha Min","doi":"10.1016/j.clbc.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.007","url":null,"abstract":"<p><strong>Aim: </strong>To compare menopausal symptoms between tamoxifen alone and tamoxifen with ovarian function suppression (OFS) over 12 months, identifying related factors.</p><p><strong>Methods: </strong>This prospective, observational study included 209 premenopausal patients with breast cancer on tamoxifen, recruited from Asan Medical Center, Republic of Korea. We collected demographic and clinical information from the participants' medical records and assessed menopausal symptoms using the Korean Menopause Rating Scale (MRS) at 3-, 6-, and 12-months postdiagnosis.</p><p><strong>Results: </strong>Of the 209 participants, 27.8% were administered tamoxifen in conjunction with OFS. Compared with the tamoxifen alone group, the tamoxifen plus OFS group had lower baseline MRS scores but higher scores at 6 and 12 months, and the scores showed a plateau within a year for both groups. Factors contributing to higher MRS scores at 6 months included the baseline MRS score (estimate, -0.326; standard error, 0.077) and addition of OFS (estimate, 6.084; standard error, 1.306; P < .001 for both). A significant interaction between OFS and prior chemotherapy was identified, with the OFS impact being significantly notable only in patients without prior chemotherapy (estimate, -6.643; standard error, 2.946; P = .025).</p><p><strong>Conclusions: </strong>Addition of OFS to tamoxifen in premenopausal patients with breast cancer can exacerbate menopausal symptoms relative to those when tamoxifen is used alone, especially in patients without prior chemotherapy. Thus, personalized treatment decisions about ovarian function suppression should consider potential symptom burdens, particularly for chemotherapy-naive patients, to balance treatment efficacy and quality of life.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909338","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 Systemic Inflammatory Indices With the Oncotype DX Recurrence Score and the Nottingam Prognostic Index in Early Hormone Receptor Positive Ductal Breast Cancer.","authors":"Anita M Huws, Gareth R Davies, Paul D Lewis, Claire Morgan","doi":"10.1016/j.clbc.2024.11.022","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.022","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant therapy decisions in hormone receptor positive, HER2 negative breast cancer are evolving. Gene panel testing has reduced the number of patients recommended for chemotherapy by up to two thirds. Identifying low risk genomic cases before testing could represent a significant economic impact. Systemic inflammatory indices have shown promise as prognostic markers in early breast cancer. We investigated the utility of four systemic inflammatory indices with the Nottingham Prognostic Index to predict the Oncotype DX® recurrence scores threshold level (low or high score), in women aged 50 and over with node negative invasive ductal carcinoma of the breast.</p><p><strong>Methods: </strong>A retrospective review of 245 patients with Oncotype DX® Recurrence Score testing from 2007 to 2021 were identified. The Nottingham Prognostic Index and systemic inflammatory indices ratios were estimated from histology results and preoperative peripheral blood samples respectively.</p><p><strong>Results: </strong>22.4% of the cohort had a Recurrence Score in the higher risk group. This group had a greater percentage of grade 3 tumours, progesterone receptor negativity, higher Nottingham Prognostic Scores, and inflammatory indices ratios than the lower risk group. A decision tree incorporating the Neutrophil Lymphocyte Ratio with clinicopathological features showed potential as an indicator of a high Oncotype DX® RS score, such that further investigation is warranted to assess whether Recurrence Score testing could be triaged in certain cohorts of patients. In this study, 38% of patients might be able to avoid genomic testing based on the decision tree analysis.</p><p><strong>Conclusion: </strong>Utility of inflammatory indices with clinicopathological features may help triage gene panel testing.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902629","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":"Axillary Reverse Mapping Using Indocyanine Green in Breast Cancer: Standardization of the Technique.","authors":"Ortega-Expósito Carlos, Pla Maria, Campos Miriam, Falo Catalina, Perez-Montero Hector, Azcarate Juan, Benítez Ana, Salinas Sira, Bosch Jan, Aranguena-Peñacoba Marina, Pernas Sonia, Ponce Jordi, Garcia-Tejedor Amparo","doi":"10.1016/j.clbc.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.003","url":null,"abstract":"<p><strong>Purpose: </strong>To validate the Axillary Reverse Mapping (ARM) technique with indocyanine green (ICG), focusing on the detection rate and the procedure's feasibility. The predictive factors for metastatic involvement of ARM nodes are also analyzed to define the target population for ARM indication.</p><p><strong>Methods: </strong>This prospective, observational, non-randomized study of patients with breast cancer included patients with an indication for axillary lymph node dissection (ALND) performed between June 2021 and June 2023. Participants were divided into two cohorts based on pattern of ICG migration: standard technique (all ARM nodes) and targeted technique (in contact with axillary vein). The feasibility of identifying and preserving ARM nodes during ALND was assessed. Multivariate logistic regression was used to analyze predictive factors (eg, tumor size, molecular surrogate subtype, multifocality, and neoadjuvant therapy) for metastatic ARM nodes.</p><p><strong>Results: </strong>Of the 41 patients in whom we performed the ARM technique, ARM nodes were identified and preserved after ALND in 36 patients (87.8%). Of these, 17 (89.5%) underwent the standard technique and 19 (86.4%) underwent the targeted technique. ARM metastases were identified in 12 patients: 9 (47.1%) with the standard technique and 3 (15.7%) with the targeted technique (P = .026). The ARM technique was the only risk factor for ARM involvement (odds ratio, 15.9; 95% confidence interval, 1.1-218.6).</p><p><strong>Conclusions: </strong>ICG facilitates the successful completion of ARM in almost 90% of patients undergoing ALND. In addition, by selecting the ARM nodes closest to the axillary vein, the number of cross metastases can be significantly reduced.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926557","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":"Unveiling Inequities: Racial Disparities in Risk-Reducing Mastectomy for Breast Cancer Prevention.","authors":"Samuel Knoedler, Fortunay Diatta, Felix J Klimitz, Olivier Noel, Joanna Kempa, Doha Obed, Seung-Yong Song, Horacio Mayer, Bong-Sung Kim, Martin Kauke-Navarro, Bohdan Pomahac, Paris D Butler","doi":"10.1016/j.clbc.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.004","url":null,"abstract":"<p><strong>Background: </strong>Risk-reducing mastectomy (RRM) significantly lowers breast cancer risk as a preventive surgery. While racial disparities in breast cancer treatment are well-documented, research on racial differences in the utilization and outcomes of RRM is limited.</p><p><strong>Methods: </strong>We retrospectively analyzed the American College of Surgeons National Surgical Quality Improvement Program (2008-2022) to identify women who underwent RRM. Patient demographics, comorbidities, surgical characteristics, and 30-day postoperative outcomes were compared between White and racial minority patients, including Black/African American women.</p><p><strong>Results: </strong>Among 1,285 patients, 88% (n = 1,126) self-identified as White and 12.4% (n = 159) as racial minorities, including 5.8% (n = 74) Black. Minority patients were younger than White patients (50.7±11.4 years vs. 52.6±12.6 years; P = .66). Black patients had a significantly higher mean BMI than White patients (33.6±8.4 kg/m² vs. 30.6±8.0 kg/m²; P = .03), and higher prevalence of obesity (65%, n = 48 vs. 47%, n = 524; P = .03) and hypertension (51%, n = 38 vs. 30%, n = 342; P = .007). Racial minority patients were more likely to undergo outpatient surgery (81%, n = 129 vs. 57%, n = 645; P < .001) and had shorter hospital stays than White patients (0.8±1.3 days vs. 1±2 days; P = .001). Black patients experienced higher rates of superficial incisional infections (9.5%, n = 7 vs. 2.9%, n = 33; P = .18) and overall complications (18%, n = 13 vs. 10%, n = 113; P = .48) CONCLUSION: This multi-institutional study reveals racial disparities in RRM, with minority patients significantly more likely to present with comorbidities and experience higher complication rates. These findings underscore the need for targeted strategies to ensure equitable access to RRM and improve outcomes for minority patients, advancing health equity in breast cancer prevention.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913672","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}