Clinical breast cancer最新文献

{"title":"The Clinical Impact of Not Performing Axillary Lymph Node Dissection in pN+sn Breast Cancer Patients Undergoing Total Mastectomy","authors":"Beatriz Maganinho,&nbsp;Bárbara Peleteiro,&nbsp;Ricardo Pereira,&nbsp;José Luís Fougo","doi":"10.1016/j.clbc.2026.05.009","DOIUrl":"10.1016/j.clbc.2026.05.009","url":null,"abstract":"<div><h3>Background</h3><div>The sentinel lymph node (SLN) concept has changed the paradigm of surgical staging of breast cancer (BC) patients, allowing fewer patients to undergo axillary lymph node dissection (ALND) when the SLN is metastasized. This study aimed to evaluate regional and distant recurrences, axillary node metastasis-free survival and overall survival in patients with metastasized SLN submitted to total mastectomy (TM), following the application of the Clinical Decision Rule of Unidade Local de Saúde São João (ULSSJ). Additionally, we assessed the impact on adjuvant radiotherapy (RT) proposals and upper limb morbidity in these patients.</div></div><div><h3>Patients and Methods</h3><div>We performed a retrospective analysis with 121 patients treated for BC at ULSSJ, between July 1st, 2012 and September 30th, 2022 and followed up until September 30th, 2025, submitted to SLN biopsy (SLNB) and TM. Patients receiving neoadjuvant chemotherapy or who had bilateral disease were excluded.</div></div><div><h3>Results</h3><div>No statistically significant differences were observed in overall survival (OS) and disease-free survival (DFS) between the patients who underwent ALND and those treated with SLNB alone (<em>P</em> = .131 and <em>P</em> = .223, respectively). Adjuvant axillary RT was administered to most patients, regardless of whether ALND was performed, with no statistically significant differences between the stages (<em>P</em> = .378; <em>P</em> = .129). Upper limb morbidity was higher in the ALND group (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>These findings support the surgical de-escalation of axillary management, showing no differences in OS and DFS, while reducing upper limb morbidity. Therefore, omission of ALND should be considered an option for a selected group of patients, according to selecting tools.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 7","pages":"Pages 56-63"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327052","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":"Reducing Clip Migration in Mammographic-Guided Vacuum Assisted Biopsy With Direct Insertion of the UltraCor Twirl Clip Marker: A Quality Improvement Project","authors":"Sabrina Omar Bintalib,&nbsp;Shiu Suwn Yeo,&nbsp;Hin Yeung Marcus Loh,&nbsp;Awesh Shamrao Gambre,&nbsp;Ling Fung Amanda Liew","doi":"10.1016/j.clbc.2026.05.007","DOIUrl":"10.1016/j.clbc.2026.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Clip migration is frequently observed in mammographic-guided vacuum-assisted biopsies (VAB) and is associated with greater tissue excision and re-excision rates. Our institutional baseline clip migration rate was 23.5%, with one-third of cases yielding borderline or malignant histology potentially requiring localisation. Studies on modifiable factors affecting clip migration have yielded mixed results.</div></div><div><h3>Materials and Methods</h3><div>We implemented a direct puncture technique using the UltraCor Twirl clip to reduce clip migration in mammographic-guided VAB, targeting below 15%. Data were collected from September 2021 to July 2023 across two PDSA cycles: PDSA 1 introduced UltraCor Twirl clip deployment; PDSA 2 incorporated education and stock supply securing. Primary outcome measured was clip migration rate. Additional factors were analysed using Chi Square test and multivariable analysis, tracked via run-chart.</div></div><div><h3>Results</h3><div>790 procedures were analysed. Clip migration rate dropped from 23.5% to 21.0% after PDSA 1 and to 13.5% after PDSA 2, sustained over 6 months. UltraCor Twirl clip was the only statistically significant modifiable factor associated with reduced clip migration at 7.9%, compared to 20.7% for bare metal clips and 24.0% for clips with bioabsorbable coating (<em>p</em> = 0.000233). Fatty breast was associated with higher migration (<em>p</em> = 0.015) but is non-modifiable.</div></div><div><h3>Conclusion</h3><div>Deployment of the UltraCor Twirl clip via direct puncture, as part of a bundled intervention, was associated with significantly reduced clip migration rates. While the relative contributions of clip design, operator education, and system maturation cannot be fully isolated, the intervention is practical, sustainable, and potentially scalable. Multi-centre validation is needed to establish broader applicability.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 7","pages":"Pages 46-55"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307314","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":"LINC01234 Coordinates Protein Interactions and ceRNA Networks to Enhance YWHAZ-Driven Malignancy in Triple-Negative Breast Cancer","authors":"Diping Yu,&nbsp;Li Chen,&nbsp;Huimin Li,&nbsp;Shiyao Kang,&nbsp;Pingyuan Huang,&nbsp;Xin Gao,&nbsp;Fei Hu,&nbsp;Chao Yuan,&nbsp;Hongjun Yuan,&nbsp;Ming Li,&nbsp;Miaomiao Sheng,&nbsp;Yuan Zhao","doi":"10.1016/j.clbc.2026.06.002","DOIUrl":"10.1016/j.clbc.2026.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Triple-negative breast cancer (TNBC) lacks effective therapies. Long noncoding RNA LINC01234 is upregulated in TNBC and promotes progression, but its molecular mechanism requires elucidation.</div></div><div><h3>Methods</h3><div>RNA-pulldown with mass spectrometry and RNA immunoprecipitation (RIP) identified LINC01234-interacting proteins. Clinical correlation, functional assays (proliferation, migration, apoptosis), and mechanistic studies involving miR-204-5p and YWHAZ knockdown were performed.</div></div><div><h3>Results</h3><div>LINC01234 directly binds to and promotes phosphorylation of the scaffolding protein YWHAZ (14-3-3ζ). Clinical analysis showed that YWHAZ was highly expressed in TNBC tissues and correlated with poor patient prognosis. Mechanistically, LINC01234 regulated YWHAZ expression via targeting miR-204-5p, thereby influencing tumor progression. Further functional validation demonstrated that either miR-204-5p overexpression or YWHAZ knockdown significantly inhibited TNBC cell proliferation/migration and promoted apoptosis.</div></div><div><h3>Conclusion</h3><div>LINC01234 promotes TNBC progression through a dual “protein interaction-ceRNA crosstalk” mechanism, directly enhancing YWHAZ function and indirectly increasing its expression via sponging miR-204-5p, providing a theoretical foundation and potential therapeutic strategy for TNBC treatment.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 7","pages":"Pages 64-74"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381785","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":"Palbociclib in Patients With HR+/HER2− Advanced or Metastatic Breast Cancer and Bone-Only Metastasis: A Systematic Literature Review","authors":"Joyce O’Shaughnessy,&nbsp;Nusrat Jahan,&nbsp;Anna Louise Barry,&nbsp;Rebecca Jean Watters,&nbsp;Beata Korytowsky,&nbsp;Diana Avery,&nbsp;Vinay Pasupuleti,&nbsp;Andrew Proctor","doi":"10.1016/j.clbc.2026.04.010","DOIUrl":"10.1016/j.clbc.2026.04.010","url":null,"abstract":"<div><h3>Background</h3><div>Bone-only metastatic breast cancer remains generally incurable and is associated with considerable morbidity and mortality. The limited data available on palbociclib treatment outcomes in patients with HR+/HER2− advanced/metastatic breast cancer (ABC) and bone-only metastasis are dispersed across a myriad of publications reporting subgroup analyses from individual randomized clinical trials (RCTs) or real-world evidence (RWE) studies. Therefore, we conducted a systematic literature review of all available evidence from RCTs and RWE studies to date to better understand palbociclib treatment outcomes and inform clinical management of this patient subset.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Cochrane Library, and relevant conference proceedings were systematically searched through December 2024. Phase 2/3 RCTs and RWE studies evaluating efficacy/effectiveness, safety, or health-related quality of life (HRQoL) of palbociclib in patients with HR+/HER2− ABC and bone-only metastasis were included.</div></div><div><h3>Results</h3><div>Qualitative synthesis was performed for 61 articles, including 13 and 48 reporting RCT and RWE data, respectively. Our analysis included data from &gt;5000 patients with bone-only metastasis treated with palbociclib. All RCTs and RWE studies (3 each) comparing palbociclib plus endocrine therapy (ET) versus ET alone in patients with bone-only metastasis showed reduced risk of disease progression and/or death with palbociclib plus ET (RCTs, 37% to 71% reduction; RWE, 26% to 45% reduction). Trends suggesting an overall survival benefit with palbociclib plus ET versus ET alone were observed in 2 RCTs (23 to 64% reduction in risk of death) and 3 RWE studies (16 to 28% reduction); however, statistical significance was not often reached. Although data are limited, available evidence suggests palbociclib is generally tolerable and maintains HRQoL in this patient subgroup.</div></div><div><h3>Conclusion</h3><div>Data from RCTs and RWE studies indicate that palbociclib plus ET is effective in patients with HR+/HER2− ABC and bone-only metastasis. Further research is needed on safety and HRQoL in this subgroup.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 113-127"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004626","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":"Immune Checkpoint Inhibitors in Elderly Patients With Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis of Subgroup Evidence","authors":"Maria Isadora Rodrigues Carlos,&nbsp;Julia Scaramal Mello,&nbsp;Ana Luiza Marçalo de Tolosa,&nbsp;Marina Romero Cardoso,&nbsp;Becerra-Galindo Brando S,&nbsp;Ana Cláudia Rodrigues Carlos,&nbsp;Francisco Cezar Aquino de Moraes","doi":"10.1016/j.clbc.2026.04.005","DOIUrl":"10.1016/j.clbc.2026.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have advanced the treatment for triple-negative breast cancer (TNBC), but evidence in older adults remains limited. This study assessed the efficacy and safety of ICIs in elderly patients through a systematic review and meta-analysis of randomized clinical trials</div></div><div><h3>Methods</h3><div>A systematic search identified trials evaluating ICIs in TNBC. Data from nine studies were pooled using random-effects models. Subgroup analyses examined progression-free survival (PFS) and overall survival (OS) in PD-L1–positive tumors and adults aged ≥65 years.</div></div><div><h3>Results</h3><div>ICIs improved PFS in the intention-to-treat population (HR 0.69; 95% CI 0.56-0.86; <em>I</em>² = 0%), while OS improvement did not reach statistical significance (HR 0.83; 95% CI 0.69-1.01; <em>I</em>² = 0%). In PD-L1–positive subgroups, pooled results showed reduced mortality risk (OS HR 0.70; 95% CI 0.49-1.01; <em>I</em>² = 28.9%) and a nonsignificant trend toward improvement in PFS (HR 0.71; 95% CI 0.43-1.16; <em>I</em>² = 50.5%). Benefits were consistent in sensitivity analyses and in adults aged 65 years or older. Safety reporting by age was limited, but available data suggest similar rates of immune-related adverse events, although frailty may influence tolerance</div></div><div><h3>Conclusion</h3><div>ICIs provide a meaningful PFS benefit in older adults with TNBC, particularly in PD-L1–positive disease, although overall survival improvement represents a numerical trend rather than a statistically confirmed effect. These findings are based on subgroup analyses and should be interpreted cautiously. Future trials should ensure adequate elderly representation, standardized PD-L1 testing, and comprehensive reporting of toxicity and quality-of-life outcomes to optimize treatment decisions in this population.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 89-96"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986962","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 Typical Somatic Gene Mutation Characteristics on Homologous Recombination Deficiency in Breast Cancer","authors":"Jinsui Du,&nbsp;Chenglong Duan,&nbsp;Jiaqi Zhang,&nbsp;Yudong Zhou,&nbsp;Yalong Wang,&nbsp;Lizhe Zhu,&nbsp;Junyi Li,&nbsp;Jianing Zhang,&nbsp;Yi Pan,&nbsp;Danni Li,&nbsp;Zhihao Liu,&nbsp;Chenrong Zhang,&nbsp;Yuhan Zhang,&nbsp;Yu Ren,&nbsp;Xi Liu,&nbsp;Bin Wang","doi":"10.1016/j.clbc.2026.04.014","DOIUrl":"10.1016/j.clbc.2026.04.014","url":null,"abstract":"<div><h3>Background</h3><div>Homologous recombination deficiency (HRD) is an important contributor to genomic instability in breast cancer. This study aimed to characterize the mutational landscape of HRD breast cancer in a Shaanxi cohort and explore its clinicogenomic and immune microenvironment characteristics.</div></div><div><h3>Methods</h3><div>Gene mutation profiles were analyzed in 130 breast cancer patients, and HRD status were quantified using Genomic Scar Scores (GSS). Multivariate logistic regression was used to identify clinicogenomic factors associated with HRD status. Immunohistochemistry for AR, CD8, and FOXC1 was further performed in tumor samples from 20 triple-negative breast cancer patients with different mutation patterns to evaluate molecular subtype characteristics.</div></div><div><h3>Results</h3><div>The most frequently mutated genes in HRD patients were <em>TP53</em> (61 cases), <em>BRCA</em> (29 cases; <em>BRCA1</em>: 18, <em>BRCA2</em>: 11), and other genes such as <em>FANCA, PTEN</em>. Tumors harboring comutations of <em>TP53</em> and <em>BRCA</em> exhibited significantly higher GSS compared with tumors without detectable somatic mutations (82.33 vs. 22.25, <em>P</em> &lt; .001). Among HRD-related triple-negative breast cancer, tumors with germline <em>BRCA</em> mutations alone were predominantly classified as basal-like immunosuppressed, whereas <em>TP53</em>-mutated tumors were mainly immunomodulatory. Tumors with co-occurring germline <em>BRCA</em> and <em>TP53</em> mutations demonstrated higher CD8⁺ T cell infiltration and were primarily classified as the immunomodulatory subtype.</div></div><div><h3>Conclusions</h3><div><em>BRCA</em> and <em>TP53</em> represent the most common genomic alterations in HRD-associated breast cancer in this cohort. Co-occurring <em>BRCA</em> and <em>TP53</em> mutations were associated with higher genomic instability and distinct immune-related subtype characteristics in triple-negative breast cancer, highlighting the molecular heterogeneity of HRD-associated tumors.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 141-152.e5"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940090","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":"Methodological Concerns Regarding the Assessment of Breast Cancer Risk Following Gender-Affirming Care","authors":"Alison May Berner ,&nbsp;Chloe Pasin","doi":"10.1016/j.clbc.2026.05.002","DOIUrl":"10.1016/j.clbc.2026.05.002","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 179-180"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053004","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":"Global Burdens and Trends of Breast Cancer Attributable to Dietary and Metabolic Risks: A 30-Year Analysis With Projections to 2050, Including Males and Females","authors":"Ranze Zhang,&nbsp;Xingpeng Qiu,&nbsp;Xiangzhan Kong,&nbsp;Ping-Pui Wong","doi":"10.1016/j.clbc.2026.04.011","DOIUrl":"10.1016/j.clbc.2026.04.011","url":null,"abstract":"<div><h3>Objectives</h3><div>Modifiable dietary and metabolic factors are leading risk factors for breast cancer (BC). This study comprehensively analyzed their attributable burdens and trends across global, regional, sex, and age dimensions, with projections to 2050.</div></div><div><h3>Methods</h3><div>Data were sourced from the Global Burden of Disease (GBD) Study 2021, including BC-related deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR) from 1990 to 2021. These metrics, covering 204 countries and territories, were stratified by sex, age, Socio-demographic Index (SDI) quintiles, and 21 GBD regions. Temporal trends were quantified using estimated annual percentage change (EAPC), while locally estimated scatterplot smoothing (LOESS) regression analyzed SDI relationships. Projections employed AutoRegressive Integrated Moving Average (ARIMA) and Exponential Smoothing (ES) models.</div></div><div><h3>Results</h3><div>Globally in 2021, dietary and metabolic risks accounted for approximately 0.08 and 0.07 million BC deaths, with 2.45 and 1.78 million DALYs, respectively. From 1990 to 2021, ASMR and ASDR attributable to dietary risk declined, while those from metabolic risks increased. The SDI-burden relationship exhibited an inverted U-shaped pattern, peaking in high-middle and middle SDI regions. Dietary risk affected younger adults (25-49 years), while metabolic risk surpassed dietary risk in the peak-burden 50-69 years group. Projections indicated rising BC deaths and DALYs until 2050.</div></div><div><h3>Conclusions</h3><div>BC burden attributable to modifiable dietary and metabolic factors remains a growing global challenge, with significant disparities across SDI regions and age groups. High-middle/middle SDI regions and adults aged 50-69 years need priority interventions, while early-life dietary interventions may reduce long-term BC burden.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 128-140.e13"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866970","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":"Severe Adverse Events in Neoadjuvant Therapy of Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Phase 3 Trials","authors":"Marcelo Antonini,&nbsp;André Mattar,&nbsp;Marcelo Madeira,&nbsp;Francisco Pimentel Cavalcante,&nbsp;Felipe Pereira Zerwes,&nbsp;Fabricio Palermo Brenelli,&nbsp;Antonio Luis Frasson,&nbsp;Eduardo Camargo Millen,&nbsp;Giuliano Tavares Tosello,&nbsp;Marina Diogenes Teixeira,&nbsp;Gil Facina,&nbsp;Sabrina Monteiro Rondelo,&nbsp;Renata Arakelian,&nbsp;Larissa Chrispim de Oliveira,&nbsp;Lucas M. Okumura,&nbsp;Patrícia Carvalho Baruel,&nbsp;Henrique Lima Couto,&nbsp;Marina Fleury de Figueiredo,&nbsp;Rogerio Fenile,&nbsp;Renata Montarroyos Leite,&nbsp;Luiz Henrique Gebrim","doi":"10.1016/j.clbc.2026.04.016","DOIUrl":"10.1016/j.clbc.2026.04.016","url":null,"abstract":"<div><div>Neoadjuvant therapy (NAT) is standard treatment for triple-negative breast cancer (TNBC) but toxicity is a major concern. This study aimed to assess the incidence and risk of grade ≥ 3 adverse events (AEs) associated with NAT in nonmetastatic TNBC. We performed a systematic review and meta-analysis registered in PROSPERO (CRD42024562785). Four databases were searched for randomized controlled trials (RCTs) from 2010 to 2025 reporting grade ≥ 3 AEs in TNBC. Pooled prevalence and risk ratios (RRs) were estimated using random-effects models. Six RCTs including 3316 patients were analyzed. Neutropenia was the most common severe AE, with pooled prevalence of 33.5% for ICIs, 23.7% for PARP inhibitors, and 16.0% for platinum regimens. PARP inhibitors significantly increased neutropenia (RR 1.84) and anemia (RR 2.08), while thrombocytopenia risk was also higher (RR 3.56). ICIs were associated with more febrile neutropenia (14.9%) but without a significant risk increase. ALT elevation was more frequent with platinum regimens (6.4%). Fatal AEs were rare (&lt;1%). NAT improves outcomes in TNBC but is associated with substantial severe toxicity. PARP inhibitors carry the greatest hematologic risks, ICIs add immune-related AEs, and platinum regimens showed the lowest AE burden. Biomarker-driven patient selection and vigilant monitoring are essential to optimize safety.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 161-178.e1"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980798","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 Characteristics and Cancer Histories Among Breast Cancer Patients With Li-Fraumeni Syndrome From a Single Institution","authors":"Ashley H. Woodson ,&nbsp;Aydah Al-Awadhi ,&nbsp;Jessica Corredor ,&nbsp;Jacynda Casey ,&nbsp;Hiam M. Abdel-Salam ,&nbsp;Angelica M. Gutierrez ,&nbsp;Dawen Sui ,&nbsp;Roland L. Bassett Jr ,&nbsp;Guillermina Lozano ,&nbsp;Courtney D. DiNardo ,&nbsp;Banu K. Arun","doi":"10.1016/j.clbc.2026.04.018","DOIUrl":"10.1016/j.clbc.2026.04.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Li-Fraumeni syndrome increases the risks of multiple cancers, including early-onset breast cancer (BC). At The University of Texas MD Anderson Cancer Center, we aimed to describe the complete cancer histories of women with BC and LFS.</div></div><div><h3>Methods</h3><div>Patients with BC and LFS were identified from a prospective BC database between 2001 and 2024. We described their cancer histories, BC characteristics, and genetic testing patterns. Summary statistics and statistical methods for associations between factors of interest were generated.</div></div><div><h3>Results</h3><div>Ninety-six women were identified with a history of BC and LFS. Among 96 women, 127 breast tumors were diagnosed, and 29% (28/96) of women developed at least 2 BCs. Individuals had histories of 1-7 total cancers, totaling 226 cancers in the cohort; 56% of individuals (54/96) had at least 1 other cancer besides BC. BC was the first cancer diagnosis in 67% (36/54) of patients. More than half of the women (54%) underwent genetic testing after developing at least 2 cancer diagnoses. Radiation-induced malignancies occurred in 26% of patients who received radiation treatment.</div></div><div><h3>Conclusions</h3><div>Genetic testing for LFS often occurred after the diagnosis of multiple primary malignancies; therefore, earlier genetic testing for LFS may reduce patients’ cancer burden owing to increased screening and/or prevention. Treatment-related malignancies were high in this population and contribute to the importance of early LFS diagnosis. These observations contribute to the greater understanding of a rare but high-risk cancer syndrome and highlight opportunities for early intervention and prevention that may reduce the cancer burden among women with LFS.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 83-88"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155440","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}