Clinical breast cancer最新文献

{"title":"Real-World Analysis of Breast Cancer Patients Qualifying for Adjuvant CDK4/6 Inhibitors","authors":"Yada Kanjanapan ,&nbsp;Wayne Anderson ,&nbsp;Mirka Smith ,&nbsp;Jenny Green ,&nbsp;Elizabeth Chalker ,&nbsp;Paul Craft","doi":"10.1016/j.clbc.2024.08.022","DOIUrl":"10.1016/j.clbc.2024.08.022","url":null,"abstract":"<div><h3>Background</h3><div>Adjuvant CDK4/6 inhibitors abemaciclib and ribociclib improved disease-free survival (DFS) added to endocrine therapy in hormone receptor (HR)-positive HER2-negative early breast cancer (EBC), in monarchE (<span><span>NCT03155997</span><svg><path></path></svg></span>) and NATALEE (<span><span>NCT03701334</span><svg><path></path></svg></span>) trials respectively. We assessed the proportion and outcome of EBC patients qualifying for adjuvant CDK4/6 inhibitors in the real-world.</div></div><div><h3>Methods</h3><div>Consecutive female patients with HR-positive HER2-negative EBC between 1997 and 2017 from the Australian Capital Territory and South-East New South Wales Breast Cancer Treatment Group registry were analyzed. Patients eligible for abemaciclib had ≥4 axillary nodes involved or 1-3 nodes plus primary &gt;5 cm or grade 3. Ribociclib eligibility was defined as node-positive and node-negative with primary &gt;5 cm or &gt;2 cm grade 3.</div></div><div><h3>Results</h3><div>Of 3840 patients, 671 (17.5%) were abemaciclib-eligible and 1587 (41.3%) ribociclib-eligible . The 5-year DFS was 77% and 94% in abemaciclib-eligible and noneligible registry patients respectively (HR 2.6, 95% CI 2.26-3.05, <em>P</em> &lt; .001). The 5-year DFS was 86% and 97% in ribociclib-eligible and noneligible registry patients respectively (HR 1.92, 95% CI 1.67-2.19, <em>P</em> &lt; .001). Compared with monarchE trial patients, abemaciclib-eligible registry patients were older (median 55 years in registry vs. 51 years in trial), with lower nodal burden (≥4 nodes in 44% in registry vs. 60% in trial). There were more stage III cancers in NATALEE trial patients (60%) than ribociclib-eligible registry patients (24%).</div></div><div><h3>Conclusions</h3><div>Many women with EBC will qualify for adjuvant CDK4/6 inhibitors (17.5% abemaciclib, 41.3% ribociclib) with resource and workforce implications. In the real-world setting, a greater proportion of adjuvant CDK4/6-eligible patients have lower stage disease, therefore the absolute benefit from treatment may be smaller than estimated by the trials.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages e159-e169.e2"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Digital Breast Tomosynthesis Versus Digital Mammography in Women With a Family History of Breast Cancer: A Systematic Review","authors":"Tong Li ,&nbsp;Jennifer Isautier ,&nbsp;Janie M. Lee ,&nbsp;M. Luke Marinovich ,&nbsp;Nehmat Houssami","doi":"10.1016/j.clbc.2024.09.013","DOIUrl":"10.1016/j.clbc.2024.09.013","url":null,"abstract":"<div><h3>Background</h3><div>There is limited evidence on the performance of digital breast tomosynthesis (DBT) in populations at increased risk of breast cancer. Our objective was to systematically review evidence on the performance of DBT versus digital mammography (DM) in women with a family history of breast cancer (FHBC).</div></div><div><h3>Methods</h3><div>We searched 5 databases (2011–January 2024) for studies comparing DBT and DM in women with a FHBC that reported any measure of cancer detection, recall, sensitivity and specificity. Findings were presented using a descriptive and narrative approach. Risk of bias was assessed using QUADAS-2/C.</div></div><div><h3>Results</h3><div>Five (4 screening, 1 diagnostic) studies were included (total 3089 DBT, 3024 DM) with most (4/5) being prospective including 1 RCT. All studies were assessed as being at high risk of bias or applicability concern. Four screening studies reported recall rate (range: DBT: 2.7%-4.5%, DM: 2.8%-11.5%) with 3 reporting DBT had lower rates than DM. Cancer detection rates (CDR) were reported in the same studies (DBT: 5.1-11.6 per 1000, DM: 3.8-8.3); 3 reported higher CDR for DBT (vs. DM), and 1 reported same CDR for both. Compared with DM, higher values for sensitivity, specificity and PPV for DBT were reported in 2 studies.</div></div><div><h3>Conclusion</h3><div>This review provides early evidence that DBT may outperform DM for screening women with a FHBC. Our findings support further evaluation of DBT in this population. However, summarized findings were based on few studies and participants, and high-quality studies with improved methodology are needed to address biases identified in our review.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages e103-e112"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Early Breast Cancer Diagnosis With Contrast-Enhanced Ultrasound Radiomics: Insights From Intratumoral and Peritumoral Analysis","authors":"Guoqiu Li ,&nbsp;Xiaoli Huang ,&nbsp;Huaiyu Wu ,&nbsp;Hongtian Tian ,&nbsp;Zhibin Huang ,&nbsp;Mengyun Wang ,&nbsp;Qinghua Liu ,&nbsp;Jinfeng Xu ,&nbsp;Ligang Cui ,&nbsp;Fajin Dong","doi":"10.1016/j.clbc.2024.11.011","DOIUrl":"10.1016/j.clbc.2024.11.011","url":null,"abstract":"<div><h3>Introduction</h3><div>To develop and validate contrast-enhanced ultrasound (CEUS) radiomics model for the accurate diagnosis of breast cancer by integrating intratumoral and peritumoral regions.</div></div><div><h3>Materials and Methods</h3><div>This study enrolled 333 patients with breast lesions from Shenzhen people's hospital between March 2022 and March 2024. Radiomics features were extracted from both intratumoral and peritumoral (3 mm) regions on CEUS images. Significant features were identified using the Mann–Whitney U test, Spearman's correlation coefficient, and least absolute shrinkage and selection operator logistic regression. These features were used to construct radiomics models. The model's performance was evaluated using the area under the receiver operating characteristic curve, area under curve (AUC), decision curve analysis, and calibration curves.</div></div><div><h3>Results</h3><div>The radiomics models demonstrated robust diagnostic performance in both the training and testing sets. The model that combined intratumoral and peritumoral features showed superior predictive accuracy, with AUCs of 0.933 (95% CI: 0.891, 0.974) and 0.949 (95% CI: 0.916, 0.983), respectively, compared to the intratumoral model alone. Calibration curves indicated excellent agreement between predicted and observed outcomes, with Hosmer–Lemeshow test <em>P</em> = .97 and <em>P</em> <strong>=</strong> .62 for the both the training and testing sets, respectively. decision curve analysis revealed that the combined model provided significant clinical benefits across a wide range of threshold probabilities, outperforming the intratumoral model in both sets.</div></div><div><h3>Conclusion</h3><div>The radiomics model integrating intratumoral and peritumoral features shows significant potential for the accurate diagnosis of breast cancer, enhancing clinical decision-making and guiding treatment strategies.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages 180-191"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845944","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":"Plasma-free Amino Acid Profile is Beneficial for Breast Cancer Screening in Women With Dense Breasts","authors":"Saeko Teraoka ,&nbsp;Hiroshi Yamamoto ,&nbsp;Shinya Kikuchi ,&nbsp;Yoshiya Horimoto ,&nbsp;Kimito Yamada ,&nbsp;Hiroshi Kaise ,&nbsp;Mari Hosonaga ,&nbsp;Takahiko Kawate ,&nbsp;Kana Miyahara ,&nbsp;Ai Ueda ,&nbsp;Mariko Asaoka ,&nbsp;Miki Okazaki ,&nbsp;Natsuki Uenaka ,&nbsp;Saori Kawai ,&nbsp;Takashi Ishikawa","doi":"10.1016/j.clbc.2024.11.001","DOIUrl":"10.1016/j.clbc.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>AminoIndex™ Cancer Screening (AICS breast) was developed as a breast cancer screening test using multivariate analysis of plasma free amino acid (PFAA) profiles. This study investigated the relationship between the AICS breast rank and breast density on mammography (MMG) for the detection of breast cancer.</div></div><div><h3>Materials and Methods</h3><div>MMG and blood samples were obtained preoperatively from 224 patients with breast cancer who did not receive neoadjuvant chemotherapy between 2017 and 2019. PFAA concentration was measured using liquid chromatography-mass spectrometry, and the AICS breast and AICS ranks were calculated. Detection rates were compared between MMG (categories 3-5) and AICS breasts (ranks B and C) according to breast density.</div></div><div><h3>Results</h3><div>Breast density was classified as extremely dense in 9.4%, heterogeneously dense in 48.2%, scattered in 29.9%, and fatty in 12.5% of patients. Dense breasts (extremely dense and heterogeneously dense) represented 57.6%. The overall detection rate by MMG was 82.6% and significantly lower in patients with dense breasts (74.4%) compared to non-dense breasts (93.7%). The overall detection rate by AICS breast was 50.0%, with no difference between patients with dense breasts (45.7%) and those with non-dense breasts (55.8%). The combination of MMG and AICS breast increased the detection rate to 91.5% overall, 88.3% in patients with dense breasts, and 95.8% in those with non-dense breasts.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that the detection rate of AICS breast was not associated with breast density, unlike MMG. Adding AICS breast to MMG may be beneficial for breast cancer screening in patients with dense breasts.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages 149-156"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 7-Gene Biosignature for Ductal Carcinoma in situ of the Breast Identifies Subpopulations of HER2-positive Patients With Distinct Recurrence Rates After Breast-Conserving Surgery and Radiation Therapy","authors":"Frank Vicini ,&nbsp;Chirag Shah ,&nbsp;Karuna Mittal ,&nbsp;Jame Abraham ,&nbsp;Megan Kruse ,&nbsp;Sheila Weinmann ,&nbsp;Michael Leo ,&nbsp;Rachel Rabinovitch ,&nbsp;Fredrik Wärnberg ,&nbsp;Pat W. Whitworth ,&nbsp;Brian J. Czerniecki ,&nbsp;Steven C. Shivers ,&nbsp;Troy Bremer","doi":"10.1016/j.clbc.2024.08.016","DOIUrl":"10.1016/j.clbc.2024.08.016","url":null,"abstract":"<div><h3>Purpose</h3><div>A subpopulation of women with ductal carcinoma in situ (DCIS) remains at risk for in-breast recurrence (IBR) following breast-conserving surgery (BCS) and radiation therapy (RT). The NSABP B-43 trial evaluated the role of concurrent RT and trastuzumab in patients with HER2-positive DCIS but did not reach the prespecified endpoint. We hypothesized that a 7-gene biosignature (DCISionRT) with its Residual Risk subtype (RRt) could identify 2 groups of HER2(3+) patients with significantly different IBR risks after BCS plus RT.</div></div><div><h3>Patients and Methods</h3><div>All patients with HER2(3+) DCIS (n = 178) treated with BCS plus RT were selected from a combined multinational patient cohort. Treatment decisions were neither randomized nor strictly rules-based. Biosignature testing was performed on all patients and stratified with previously defined groups: (1) Combined Low Risk group (DS ≤ 2.8) and Elevated Risk group (DS &gt; 2.8) without RRt or (2) Residual Risk subtype. Kaplan–Meier analysis was used to compute IBR curves.</div></div><div><h3>Results</h3><div>Sixty-three percent of HER2(3+) patients (113/178) were classified into the Residual Risk subtype. These patients had significantly higher 10-year rates of IBR compared to the nonresidual risk group (16.2% vs. 1.6%, <em>P</em> = .01). The Residual Risk subtype had more nuclear grade 3 disease (87% vs. 63%, <em>P</em> &lt; .001), but age, size, and grade were not associated with IBR rate (<em>P</em> = NS) on univariate and multivariable analysis. Only the Residual Risk group was associated with IBR (<em>P</em> = .05) in multivariate analysis.</div></div><div><h3>Conclusion</h3><div>The 7-gene biosignature with RRt identified a subset of HER2(3+) patients with greater IBR rates following BCS and RT beyond traditional clinical and pathologic features. Consideration of therapies to reduce these elevated IBR rates should be evaluated, including the incorporation of HER2-targeted therapy.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages e152-e158.e1"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of [18F] FDG PET/CT and [18F]FDG PET/MRI in the Detection of Distant Metastases in Breast Cancer: A Meta-Analysis","authors":"Fangqian Shen,&nbsp;Qi Liu,&nbsp;Yishuang Wang,&nbsp;Can Chen,&nbsp;Hu Ma","doi":"10.1016/j.clbc.2024.09.015","DOIUrl":"10.1016/j.clbc.2024.09.015","url":null,"abstract":"<div><h3>Purpose</h3><div>This meta-analysis aims to assess and compare the diagnostic effectiveness of [¹⁸F] FDG PET/CT and [¹⁸F] FDG PET/MRI for distant metastases in breast cancer patients.</div></div><div><h3>Methods</h3><div>A comprehensive search of the PubMed and Embase databases was performed to identify relevant articles until September 22, 2023. Studies were eligible to be included if they assessed the diagnostic performance of [¹⁸F] FDG PET/CT and/or [¹⁸F] FDG PET/MRI in detecting distant metastases of breast cancer patients. The DerSimonian and Laird method was used to assess sensitivity and specificity, and then transformed through the Freeman-Tukey double arcsine transformation.</div></div><div><h3>Results</h3><div>29 articles consisting of 3779 patients were finally included in this study. The overall sensitivity of [¹⁸F] FDG PET/CT in diagnosing distant metastases of breast cancer was 0.96 (95% CI: 0.93-0.98), and the overall specificity was 0.95 (95% CI: 0.92-0.97). The overall sensitivity of [¹⁸F] FDG PET/MRI was 1.00 (95% CI: 0.97-1.00), and the specificity was 0.97 (95% CI: 0.94-1.00). The results suggested that [¹⁸F] FDG PET/CT and [¹⁸F] FDG PET/MRI appears to have similar sensitivity (<em>P</em> = .16) and specificity (<em>P</em> = .30) in diagnosing distant metastases of breast cancer.</div></div><div><h3>Conclusions</h3><div>The results of our meta-analysis indicated that [¹⁸F] FDG PET/CT and [¹⁸F] FDG PET/MRI in diagnosing distant metastases of breast cancer appear to have similar sensitivity and specificity. Patients who have access to only one of these modalities will not have the accuracy of their staging compromised. In clinical practice, both of these imaging techniques have their respective strengths and limitations, and physicians should take these into account when making the most suitable choice for patients.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages e113-e123.e4"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496139","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 ,&nbsp;Cristian D. Rodríguez Miranda ,&nbsp;Sandra Contreras Arrieta ,&nbsp;Maria I. Daza Morelli ,&nbsp;Daniela Seija Butnaru ,&nbsp;Mariana Reyes Carrillo ,&nbsp;Laura D. Aponte Camacho ,&nbsp;Sebastian Amaya","doi":"10.1016/j.clbc.2024.10.007","DOIUrl":"10.1016/j.clbc.2024.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Discussion</h3><div>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.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages e133-e151.e6"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Imaging Features Associated With Malignant Focal Nonmass Enhancement on Breast MRI","authors":"Eumee Cha ,&nbsp;Emily B. Ambinder ,&nbsp;Eniola T. Oluyemi ,&nbsp;Lisa A. Mullen ,&nbsp;Babita Panigrahi ,&nbsp;Joanna Rossi ,&nbsp;Philip Di Carlo ,&nbsp;Kelly S. Myers","doi":"10.1016/j.clbc.2024.11.002","DOIUrl":"10.1016/j.clbc.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Focal non-mass enhancement (NME) is a common breast MRI finding with limited data to guide management. This study aimed to assess clinical and imaging features of malignant BI-RADS 4 focal NME.</div></div><div><h3>Methods</h3><div>This IRB-approved, retrospective study included breast MRI exams between August 1, 2013 and September 1, 2022 yielding BI-RADS 4 focal NME lesions that underwent core biopsy or excision with available pathology result or demonstrated decrease or resolution during follow-up MRI or at least 2 years of MRI stability.</div></div><div><h3>Results</h3><div>A total of 296 BI-RADS 4 focal NME lesions in 246 patients were included in the study. The overall malignancy rate of BI-RADS 4 focal NME was 36/296 (12.2%). Focal NME in a patient presenting for evaluation of extent of disease or other diagnostic concern was 5.5 and 3.4 times more likely, respectively, to be malignant compared to focal NME seen on a high-risk screening exam. There was also a significant association between malignancy and focal NME that was brighter than background parenchymal enhancement (BPE) on maximum intensity projection (MIP) images. There was no significant association between malignancy and lesion size, internal enhancement pattern, amount of BPE, amount of fibroglandular tissue, or signal intensity on T2-weighted images.</div></div><div><h3>Conclusion</h3><div>Our study yielded a malignancy rate of 12.2% for BI-RADS 4 focal NME lesions. Indication for MRI and signal intensity compared to BPE on MIP images were features associated with malignancy that may provide guidance on the management for focal NME.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages 157-163"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738647","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":"Maximizing Breast Cancer Detection Through Screening: A Comparative Analysis of Imaging-Based Approaches","authors":"Matthew F. Covington","doi":"10.1016/j.clbc.2024.09.012","DOIUrl":"10.1016/j.clbc.2024.09.012","url":null,"abstract":"<div><h3>Introduction/Background</h3><div>This study estimates the percentage of detectable breast cancers in the screening population that could be found with primary and supplemental screening, and provides cost estimates for population wide supplemental screening in the U.S.</div></div><div><h3>Materials and Methods</h3><div>Published estimates on cancer detection rates of 2D mammography, tomosynthesis (DBT), whole breast ultrasound (US), molecular breast imaging (MBI), contrast-enhanced mammography (CEM), and MRI, the number of mammograms conducted in the United States in 2023, and the proportion of dense breast tissue, were utilized. The maximum number of detectable cancers was projected from incremental cancer detection rates of the most sensitive supplemental screening method. The proportion of cancers detectable for each modality was calculated. In 2023, Medicare reimbursement rates were used to estimate supplemental screening costs.</div></div><div><h3>Results</h3><div>Out of 469,437 detectable cancers, 2D mammography could detect 190,531 (41%), leaving 278,906 undetected. Adding supplemental screening could detect a combined 220,165 cancers (47%) with DBT, 237,596 (51%) with US, 331,727 (71%) with MBI, 377,049 (80%) with CEM and 469,437 (100%) with MRI. The imaging cost in US dollars to provide supplemental screening to all individuals with dense breasts in 2023 was $933M for tomosynthesis, $1.84B for US, $3.87B for CEM, $4.16B for MBI, and $6.36B for MRI.</div></div><div><h3>Conclusion</h3><div>The study highlights potential benefits from supplemental breast cancer screening, suggesting the combination of mammography and breast MRI offers the most effective detection method though at the highest imaging cost. These findings provide valuable insights to guide future research and inform decision-making in supplemental breast cancer screening strategies.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages 117-121.e1"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Regional Differences for Fertility Preservation Procedures in Women With Breast Cancer","authors":"Volkan Turan ,&nbsp;Giuliano Bedoschi ,&nbsp;Dong-Yun Lee ,&nbsp;Caio Parente Barbosa ,&nbsp;Renato de Oliveira ,&nbsp;Koray Gorkem Sacinti ,&nbsp;Murat Sonmezer ,&nbsp;Matteo Lambertini ,&nbsp;Claudia Massarotti ,&nbsp;Amelia Schaub ,&nbsp;Erica Wang ,&nbsp;Sonia Gayete-Lafuente ,&nbsp;Cheryl Dunlop ,&nbsp;Richard A. Anderson ,&nbsp;Heejung Bang ,&nbsp;Kutluk H. Oktay","doi":"10.1016/j.clbc.2024.09.011","DOIUrl":"10.1016/j.clbc.2024.09.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer is the most common malignancy in women of reproductive age and chemotherapy protocols impair fertility, frequently necessitating fertility preservation (FP) referral. Embryo, oocyte, or ovarian tissue cryopreservation are established FP modalities in women with breast cancer but there are few data on their uptake over time. In this study our aim was to determine the regional time trends and utility differences for fertility preservation methods of reproductive tissue cryopreservation.</div></div><div><h3>Methods</h3><div>This multicenter study included 1623 women diagnosed with breast cancer from 7 tertiary centers in 6 countries (Brazil, Italy, Scotland, South Korea, Turkey, USA). Participant centers provided the details of FP cryopreservation approaches broken down annually from 2012 to 2021. Women with newly diagnosed breast cancer, aged 18-45 years who were referred for FP at participating centers and had normal ovarian function at the time were included.</div></div><div><h3>Results</h3><div>We found a mean increase of 7% per year (<em>P</em> = .002, adjusting for centers) in the number of women referred for FP. Of those who were referred (<em>n</em> = 1623), a mean 38.7% underwent FP (<em>n</em> = 629), with a range of 12% in South Korea) to 95% in Brazil. The number of women undergoing ovarian stimulation for FP continually increased until 2021, with oocyte cryopreservation being the most common procedure throughout the study period (<em>P</em> = .014 for time trend). The proportion of random start ovarian stimulation cycles increased each year from 58.3% in 2012 to 86.8% in 2021, (<em>P</em> = .005 for time trend, and <em>P</em> = .04 for 2012 vs. 2021).</div></div><div><h3>Conclusions</h3><div>The utility of FP has steadily increased for young women with breast cancer over the last decade, although regional differences significantly influence FP practices. The findings of our study could have value for policy making in FP care for young women with breast cancer at the local, regional, or global level.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages 108-116.e1"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459372","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}