Clinical breast cancer最新文献

{"title":"Cost-effectiveness of Prosigna for Adjuvant Treatment Decisions in Early Breast Cancer: Healthcare Sector and Societal Perspectives.","authors":"Lars Asphaug, Lars A Akslen, Egil S Blix, Beate Boge, Elin F Borgen, Marianne B Brekke, Ragnhild S Falk, Gry A Geitvik, Bjørnar Gilje, Berit Gravdehaug, Anette Heie, Emiel Janssen, Cecilie E Kiserud, Torgunn Kursetgjerde, Anita Langerød, Jon Lømo, Bård Mannsåker, Elin Mortensen, Pernilla Olsson, Alina C Porojnicu, Sunil X Raj, Oluf D Roe, Hege E G Russnes, Helle K Skjerven, Silje Songe-Møller, Magdalena A Vestlid, Hege O Ohnstad, Bjørn Naume","doi":"10.1016/j.clbc.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.04.011","url":null,"abstract":"<p><strong>Background: </strong>Gene expression profiling tests such as the Prosigna-assay are used to aid adjuvant treatment decisions in hormone receptor positive (HR+) HER2 negative (HER2-) early breast cancer (EBC). In this evaluation, the cost-effectiveness of Prosigna against immunohistochemical (IHC) markers including Ki-67, was evaluated from the Norwegian healthcare- and societal perspective.</p><p><strong>Materials and methods: </strong>The treatment decision impact of Prosigna was tested in the prospective, observational EMIT-1 trial. Using individual data collected the first 12 months post-surgery, a decision model was built to project the economic consequences of using the Prosigna compared to IHC-markers for the adjuvant treatment decisions. Health benefits were measured by cost per quality-adjusted life-years (QALYs) and data on income and welfare benefit was obtained from Statistics Norway.</p><p><strong>Results: </strong>Of 2,178 HR+/HER2- pN0 EBC patients in the EMIT-1 trial, 1,985 had available health economic data and 1,850 had complete income and welfare benefit records. Including all pN0 patients in the Prosigna-test strategy, the test was above the cost-effective threshold (€26,000; incremental cost-per QALY gained (ICER) €255,622) in a healthcare sector perspective. Incorporating also productivity costs, Prosigna was cost-saving (ICER €-435,677). Restricting Prosigna-testing to patients assessed as clear/uncertain chemotherapy candidates, the strategy was cost-effective in both the healthcare and societal perspective (ICER €8884 and €-620170, respectively).</p><p><strong>Conclusions: </strong>Using the Prosigna-assay for all HR+/HER2- pN0 EBC patients was not cost-effective from a healthcare perspective, but from the societal perspective it was cost-saving. Selecting patients who are clear/uncertain candidates for chemotherapy based on IHC-classification, Prosigna is cost-effective from both perspectives.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989612","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":"A Multi-Omics-Based Prognostic Model for Elderly Breast Cancer by Machine Learning: Insights From Hypoxia and Immunity of Tumor Microenvironment.","authors":"Yu Song, Changjun Wang, Yidong Zhou, Qiang Sun, Yan Lin","doi":"10.1016/j.clbc.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.04.008","url":null,"abstract":"<p><strong>Introduction: </strong>Older adult breast cancer (OABC) patients (≥ 65 years) frequently experience poorer prognoses compared to younger adults, attributed to complex tumor biology and age-related factors. The present study employs a multiomics approach combined with machine learning to develop a novel prognostic model for OABC, with a focus on the hypoxic and immune characteristics of the tumor microenvironment.</p><p><strong>Methods: </strong>Genetic and molecular data from 503 OABC and 589 younger adult breast cancer (YABC) patients were analyzed using The Cancer Genome Atlas (TCGA) database. An ensemble machine-learning model was developed, integrating multiomics data-including mRNA, miRNA, lncRNA, copy number variations (CNVs), and single nucleotide variants (SNVs)-along with clinicopathological features, to predict survival outcomes. The model was trained on 300 OABC samples and validated on 203 samples.</p><p><strong>Results: </strong>The ensemble machine-learning model achieved a predictive accuracy of 69.5% for survival outcomes in OABC patients. Distinct hypoxia-related gene expression patterns and reduced immune cell infiltration were observed in OABC compared to YABC. Hypoxia was significantly associated with poorer disease-free survival (DFS) in OABC (P = .037), but not in YABC (P = .38).</p><p><strong>Conclusions: </strong>The multiomics-based prognostic model developed for OABC showed clinical potential, and the findings highlight the critical role of hypoxia and the immune microenvironment in the prognosis of OABC. Further research is warranted to validate this model in larger cohorts and to explore its potential application in guiding personalized treatment strategies for OABC patients.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092926","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 Relationship Between Radiation History and Outcomes of Immediate Implant-Based Breast Reconstruction.","authors":"Mallika Datta, Sarah Abouassali, Shreya Raman, Christian Blue, Robert Marcaccini, Paschalia Mountziaris, Xiaoyan Deng, Dipankar Bandyopadhyay, Kandace P McGuire","doi":"10.1016/j.clbc.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.04.005","url":null,"abstract":"<p><strong>Background: </strong>Postmastectomy Radiotherapy (PMRT) has become standard of care for patients with breast cancer. However, local recurrence following breast conserving therapy is increasing in incidence due to increased survivorship. The relationship between prior radiation therapy, PMRT and immediate breast reconstruction (IBR) outcomes has not been widely studied. We aim to assess factors that correlate with post-IBR complications in the face of radiation therapy.</p><p><strong>Methods: </strong>An IRB approved retrospective cohort review of 262 patients was completed using our tumor registry to identify female patients age ≥ 18 with and without history of radiation who underwent mastectomy with IBR. Operative, clinical, and pathological data was collected, and univariate and multiple logistic regression analyses were conducted to evaluate the relationship between receipt of radiation and major and minor complications. Kaplan-Meier analysis was also conducted to assess the differences between the time to receipt of radiation and cancer recurrence amongst the 3 treatment groups.</p><p><strong>Results: </strong>There was no correlation between major or minor complications and a history of prior radiation. Patients with PMRT demonstrated a higher incidence of \"other\" minor complications (OR 2.8, CI 1.27-6.28, P = .01), such as erythema and edema. There was a higher incidence of implant exposure requiring reoperation (OR 5.7, CI 1.36-23.78, P = .01) and \"other'' minor complications (OR 3.1, CI 1.32-7.35, P < .001) in patients with PMRT. Receipt of PMRT was associated with lower survival in compared to patients with no history of radiation treatment.</p><p><strong>Conclusion: </strong>Our study found no significant associations between history of prior radiation and surgical complications after mastectomy and IBR. However, patients with PMRT were at increased risk of developing minor complications requiring reoperation. This suggests that we should discuss radiation concerns preoperatively and manage expectations regarding its effect on outcome.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961218","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":"Breast Cancer Clinical Characteristics, Management, and Outcomes in Women Living With HIV/AIDS Globally: A Systematic Review and Meta-Analysis.","authors":"Diana Jaber, Tina Vaziri, Jennifer Beckerman, Medhasweta Sen, Yuan Rao, Pavani Chalasani, Sharad Goyal","doi":"10.1016/j.clbc.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.017","url":null,"abstract":"<p><p>Although associations between HIV and breast cancer (BC) have been investigated, the global literature remains inconsistent regarding clinical features and outcomes in HIV-positive patients. This study aims to clarify the clinicopathologic characteristics, management strategies, and survival in HIV-positive versus HIV-negative patients with BC. We searched PubMed, Scopus, and Cochrane Library for articles published until June 2023. We included observational studies presenting original data on tumor stage, receptor status, management, and survival in HIV-infected patients. We retrieved 5214 records and, after abstract and full-text screening, identified 17 papers that met inclusion criteria. Risk of bias and study quality were assessed with a modified Newcastle-Ottawa Scale. The I² statistic was used to assess inter-study heterogeneity. Results were analyzed using a random-effects model. A total of 1201 HIV-positive and 4077 HIV-negative patients diagnosed with BC were identified. No significant differences in receptor status or stage at presentation were observed between the two groups in our pooled analysis. Management in HIV-positive patients was similar to HIV-negative for surgery (pooled odds ratio [pOR]: 1.43, 95% confidence interval [CI]: 0.82-2.04), radiation (pOR: 1.63, 95% CI 0.84-2.43), and chemotherapy (pOR: 1.27, 95% CI: 0.72-1.83). Despite presenting with similar clinicopathologic characteristics and management patterns as HIV-negative, HIV-positive patients had worse overall survival (pooled hazard ratio: 1.51, 95% CI: 1.21-1.88). Further research is needed to optimize treatment strategies and establish standardized guidelines for HIV-positive patients with BC, particularly in resource-limited settings where a high HIV burden and barriers to timely cancer care access may contribute to poor survival outcomes.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955273","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 the COVID-19 Pandemic on the Diagnosis and Treatment of Breast Cancer at a Community Hospital\".","authors":"Qi Xu, Yuwan Gao","doi":"10.1016/j.clbc.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.04.009","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968057","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 Reported Outcomes in Breast Cancer: A Plea for the Silent and Forgotten.","authors":"Olivia Inez Solano, Cora Withers, Kirsten Allen, Chris Baliski","doi":"10.1016/j.clbc.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.04.006","url":null,"abstract":"<p><strong>Background: </strong>There are an increasing number of reports addressing patient reported outcomes (PRO's) following breast conserving surgery (BCS) and mastectomy with reconstruction (MR), but few addressing mastectomy alone (MA). Patients' choice of procedure is often preference-based, making PRO's essential to inform decision making. The current research aims to evaluate PRO's associated with all three surgical procedures, along with patient participation rates.</p><p><strong>Methods: </strong>Patients with unilateral, nonrecurrent breast cancer were prospectively enrolled in the study (June 2020 to September 2023). Participants received the BREAST-Q (BQ) survey preoperatively (Q1), 2 to 6 weeks (Q2) and 1 year (Q3) postoperatively. Forced multiple regression analyses were performed to compare postoperative BQ scores.</p><p><strong>Results: </strong>199 patients were eligible, with 73.4% (146/199) participating in the study. While MA had lower satisfaction with breast scores than BCS (B = -11.6), they were equivalent to those of MR (B = -16.5), with similar pathologic and treatment related factors. Physical well being was similar between all three procedures, while psychosocial well being scores were lower following MR (B = -15.5), but not MA. Patient age, BMI, and tumor size variably impacted BQ scores, but preoperative BQ scores independently correlated with postoperative scores across all domains.</p><p><strong>Conclusion: </strong>Patient response rates are consistent with the literature, but require improvement to ensure meaningful conclusions, generalizability of results, and comparisons between studies. Patients undergoing BCS reported the highest satisfaction and quality of life, with MA being noninferior to MR. Efforts to increase patient participation in PRO's are required, especially in those undergoing MA.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963698","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":"Single-Pedicled, Supercharged, or Bi-Pedicled? A Multi-Institutional Outcome Comparison of Pedicled TRAM Flap for Autologous Breast Reconstruction.","authors":"Samuel Knoedler, Dany Y Matar, Thomas Schaschinger, Sam Boroumand, Savas Tsolakidis, Sören Könneker, Dennis P Orgill, Adriana C Panayi, Bong-Sung Kim","doi":"10.1016/j.clbc.2025.03.022","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.03.022","url":null,"abstract":"<p><strong>Introduction: </strong>A direct comparison of outcomes among the 3 main types of pedicled TRAM-single-, supercharged, and bi-pedicled-has yet to be conducted.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program database (2008-2022) was analyzed to identify female patients who underwent pedicled TRAM flap breast reconstruction. Patients were stratified by TRAM flap type, and their 30-day postoperative outcomes were compared.</p><p><strong>Results: </strong>A total of 2022 patients (mean age: 53 ± 9.4 years; mean BMI: 29 ± 6.4 kg/m²) were included, of whom 73% (n = 1473) received single-pedicled, 16% (n = 327) supercharged, and 11% (n = 222) bi-pedicled TRAM flaps. Overall, 433 (21%) patients experienced complications, with 155 (7.7%) surgical and 190 (9.4%) medical complications. Multivariate analysis showed generally comparable outcomes among the 3 types, but bi-pedicled flaps had a higher risk of medical complications (OR: 1.6; P = .04). Smoking, higher ASA classes, and higher BMI were independently associated with the occurrence of any complication (OR: 1.74, P = .001; OR: 1.76, P < .001; OR: 1.04, P < .001), surgical complications (OR: 1.85, P = .01; OR: 1.71, P = .002; OR: 1.035, P = .002), and readmission (OR: 2.54, P < .001; OR: 1.62, P = .02; OR: 1.04, P = .002). Smoking (OR: 2.38, P < .001), higher BMI (OR: 1.03, P = .004), and hypertension (OR: 1.47, P = .02) correlated with an increased likelihood of reoperation.</p><p><strong>Conclusion: </strong>This study revealed that outcomes after single-, supercharged, and bi-pedicled TRAM flaps are generally comparable. Yet, bi-pedicled TRAM flap reconstruction was seen to be associated with a higher risk of medical complications. Smoking, obesity, higher ASA class, and hypertension were identified as risk factors for adverse events.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978947","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":"Impact of Racial Disparities on Treatment of Early Triple Negative Breast Cancer Among American Indians/Alaska Natives and Non-Hispanic Whites.","authors":"Anu G Gaba, Li Cao, Rebecca J Renfrew, Abe E Sahmoun, Sanjay Goel","doi":"10.1016/j.clbc.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.04.002","url":null,"abstract":"<p><strong>Background: </strong>Differences in patient and tumor characteristics among American Indian/Alaska Native (AI/AN) and non-Hispanic White (NHW) breast cancers (BC) adversely impact overall survival (OS) in AI/AN. The aims of this study were to: 1) investigate disparities in treatment of early triple negative breast cancers (TNBC); 2) assess differences in OS.</p><p><strong>Methods: </strong>A hospital-based, retrospective cohort study using the National Cancer Database included AI/AN and NHW women, 18 years or older, diagnosed with TNBC between 2010 and 2019, stages I-III. Propensity score matching (1:3 ratio) was used for age, year, and analytic stage at diagnosis.</p><p><strong>Results: </strong>A total of 489 AI/AN and 1465 available matched NHW women with TNBC were analyzed. Time to first treatment (TFT) was significantly longer for AI/AN (P = .005). Multivariate analysis revealed that longer TFT was associated with only higher Charlson-Deyo Score (CDS) (P = .014) and nonprivate insurance (P < .001), but not race (P = .568). Overall treatment compliance was similar (AI/AN - 89.6% vs. NHW - 92.2%, P = .074). Compliance was significantly associated with only insurance status (P < .001). On multivariate analysis OS did not differ by race (P = .687, HR = 1.06; 95% CI: 0.79-1.44). Cancer stage, CDS, insurance status, and treatment compliance were associated with worse OS.</p><p><strong>Conclusion: </strong>In patients with TNBC, there was no difference in TFT, compliance with recommended treatment or OS among AI/AN in comparison to White women when matched for age, stage, and year of diagnosis. In order to improve BC survival, it is important to manage comorbid conditions and improve detection of cancer at earlier stages.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954951","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":"Expert Perspectives on Controversies and Critical Knowledge Gaps in Breast Cancer Management: Proceedings of the First Bridging the Gaps in Breast Cancer Symposium.","authors":"Komal Jhaveri, Carey K Anders, Aditya Bardia, Manali Bhave, A Jo Chien, Ian Krop, Tiffany A Traina, Yara Abdou, Reva Basho, Alison K Conlin, Francisco J Esteva, Kevin R Fox, Vijayakrishna Gadi, Peter A Kaufman, Anya Litvak, Cynthia X Ma, Eleftherios P Mamounas, Heather McArthur, Kelly McCann, Zahi Mitri, Rebecca Shatsky, Melinda Telli, Mylin A Torres, Kevin Kalinsky","doi":"10.1016/j.clbc.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.04.007","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer is the most common type of cancer for women in the United States and accounts for nearly 25% of all cancers and 16% of cancer deaths worldwide. New treatment options continue to emerge offering improved management options for patients with breast cancer. However, as these new treatments become available, clinicians are left with many questions regarding how to best utilize these treatments and improve outcomes for patients with breast cancer.</p><p><strong>Materials and method: </strong>The Bridging the Gaps in Breast Cancer panel was assembled to address challenges in the management of breast cancer. Bridging the Gaps in Breast Cancer co-chairs and session moderators identified areas of controversy and uncertainty in breast cancer management and were responsible for organizing the presentations and discussion with the expert panel of faculty throughout the meeting.</p><p><strong>Results: </strong>The Bridging the Gaps in Breast Cancer panel discussions are presented. Key critical knowledge gaps surrounding the evolving breast cancer treatment landscape identified include how to identify which patients will benefit the most from therapeutic intervention, the mechanism of resistance to newly approved therapies, which therapies may be safely omitted from a treatment regimen without harm to the patient, and the most important metric(s) in defining successful treatment in various stages and subtypes of breast cancer.</p><p><strong>Conclusions: </strong>The treatment armamentarium for the management of breast cancer continues to grow and evolve. With those new treatment options, new questions continue to arise for clinicians. Future studies are needed to address these critical gaps in knowledge about how to best utilize treatments for improved patient outcomes.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978522","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":"High Ki-67 expression is associated with increased risk of distant recurrence in Oncotype Dx low risk breast cancer.","authors":"Soumaya Labidi, Nasser Mulla, Islam E Elkholi, Mariana Pilon Capella, April A N Rose, Lawrence Panasci, Cristiano Ferrario, Mark Basik, Parvaneh Fallah","doi":"10.1016/j.clbc.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.04.001","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether high Ki-67 protein expression level could independently predict the distant recurrence in early-stage breast cancer with low Oncotype Dx scores (≤ 25).</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 278 patients with hormone receptor positive (HR+) human epidermal growth factor receptor 2 negative (HER2-), T1-2N0M0, low Oncotype Dx recurrence score (RS) (≤ 25) breast cancer. We identified 2 groups: \"high Ki-67″ ≥ 15% (n = 130, 47%) and \"low Ki-67″ < 15% (n = 148, 53%). Clinical characteristics, treatment and survival were abstracted from chart review. Fisher's exact test was used to assess differences between Ki-67 groups. Cox-regression models were used to assess differences in survival.</p><p><strong>Results: </strong>After a median follow up of 7 years, 13 (4.7%) patients experienced distant metastasis. Recurrence rate was significantly higher in the \"high Ki-67″ group 9.2% (12/130) versus the \"low Ki-67″ group 0.7% (1/148) (P = .001). Distant metastasis-free survival (dMFS) was significantly shorter in the \"high Ki-67″ group (HR 12.90, 95% CI, 12.53-13.27, P = .008). Tumor size ≥ 2 cm was associated with shorter dMFS (HR, 12.90; 95% CI, 12.53-13.27; P < .001). In a multivariable analysis, tumor size ≥ 2 cm and \"High Ki-67″ were independent prognosis factors for dMFS.</p><p><strong>Conclusion: </strong>Ki-67 expression level may help to identify a subset of low risk Oncotype Dx patients who could benefit from adjuvant chemotherapy.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955614","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}