Clinical breast cancer最新文献

{"title":"Perceptions of Delayed Alopecia Among Breast Cancer Survivors.","authors":"Sarah K Premji, Kathryn J Ruddy, Robert A Vierkant, Nicole Larson, Charles Loprinzi, Brittany Dulmage, Maryam Lustberg, Fergus J Couch, Janet E Olson, Elizabeth Cathcart-Rake","doi":"10.1016/j.clbc.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.09.008","url":null,"abstract":"<p><strong>Background: </strong>Retrospective studies suggest that some breast cancer survivors report treatment-associated hair loss or thinning years after their diagnosis. This study investigates frequency and perceptions of alopecia persisting 6 years after patients' breast cancer diagnoses.</p><p><strong>Methods: </strong>Breast cancer survivors participating in the Mayo Clinic Breast Disease Registry (MCBDR) were mailed a survey 6 years after diagnosis. They were asked about their degree of bother from hair thinning and hair loss and mental health was explored.</p><p><strong>Results: </strong>A total of 969 of 1476 participants (65.7%) responded to the survey. Of these, 755 patients were eligible for inclusion and had stage I-III breast cancer. Respondents' median age was 65.6 years (35-95 years). Chemotherapy (± endocrine therapy) was administered to 216 (29%) participants, and 342 (45%) received only endocrine therapy. Nearly half (345, 46%) of respondents reported hair loss and over half (431, 57%) reported hair thinning. Moderate to extreme bother from hair loss was reported by 27% of chemotherapy recipients, by 18% of endocrine therapy only recipients, and by 14% of patients who received neither. Moderate to extreme bother from hair thinning was reported by 31% of chemotherapy recipients, by 21% of endocrine therapy-only recipients, and by 19% of those who had received neither. Hair growth product usage was reported by 31% of chemotherapy recipients and 14% of endocrine therapy-only recipients.</p><p><strong>Conclusions: </strong>Hair loss and thinning are frequently reported as persistently bothersome symptoms by breast cancer survivors. Future investigations into the incidence, predictors, and treatment of therapy-associated alopecia are needed.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726413","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":"Enhancing Breast Imaging Strategies: The Role of ChatGPT in Optimizing Screening Pathways","authors":"Sultan Alam,&nbsp;Shahab Saquib Sohail","doi":"10.1016/j.clbc.2024.09.007","DOIUrl":"10.1016/j.clbc.2024.09.007","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 8","pages":"Page e772"},"PeriodicalIF":2.9,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399570","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":"Reductions in Chronic Postsurgical Neuropathic Pain and Mechanical Allodynia in Breast Cancer Patients Treated With Laser Acupuncture: A Retrospective Observational Study","authors":"Ian R.N. Relf ,&nbsp;Tanishka Brahmanand","doi":"10.1016/j.clbc.2024.09.005","DOIUrl":"10.1016/j.clbc.2024.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic postsurgical neuropathic pain (CPSNP) and related static mechanical allodynia (SMA) is recognised as a significant long-term complication after breast cancer surgery (BCS). This study investigates the effectiveness of a novel laser acupuncture technique in treating CPSNP and SMA post-BCS whilst patients underwent standard cancer treatments.</div></div><div><h3>Methods</h3><div>Thirty patients with significant breast area CPSNP and SMA (DN4 ≥ 4) were treated with 60Milliwatt, 658nm laser acupuncture at Austin Hospital between January 2021 and 2024. Patient data was analysed retrospectively: 29 with CPSNP, 22 with SMA. The cohort had exposures to pain aggravating cancer therapies (e.g. chemotherapy, radiotherapy and antihormonal medications). An online patient questionnaire assessed treatment outcomes qualitatively.</div></div><div><h3>Results</h3><div>Patients received an average of 6·4 treatments and their average CPSNP showed significant reduction from 6·86 to 1.29 (<em>P</em> &lt; .001), with a mean 5.57 point decrease (95% CI, 4.90-6.24). Average SMA showed significant reduction from an average of 6.77-1.75 (<em>P</em> &lt; .001), with a mean 5.02-point decrease (95% CI, 4.09-5.96). Pain reductions occurred despite NP aggravating treatment and ongoing usage by 40% of the cohort. 92% of patients reported acute reductions in SMA in the online questionnaire.</div></div><div><h3>Conclusion</h3><div>The significant pain reductions observed may indicate effectiveness of laser acupuncture in reducing both CPSNP and SMA in breast cancer patients post-BCS.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 8","pages":"Pages 763-770"},"PeriodicalIF":2.9,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459371","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 “Effectiveness and Safety of Pyrotinib-Based Therapy in the Treatment of HER2-Positive Breast Cancer Patients with Brain Metastases: A Multicenter Real-World Study”","authors":"Akshaya Viswanathan,&nbsp;Naji Naseef Pathoor,&nbsp;Rajesh Kanna Gopal,&nbsp;Pitchaipillai Sankar Ganesh","doi":"10.1016/j.clbc.2024.09.009","DOIUrl":"10.1016/j.clbc.2024.09.009","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 8","pages":"Pages e773-e774"},"PeriodicalIF":2.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388503","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":"Is There Any Association Between Multifocal and Multicentric Disease and Survival Outcome in Breast Cancer Patients?","authors":"Kadri Altundag","doi":"10.1016/j.clbc.2024.09.010","DOIUrl":"10.1016/j.clbc.2024.09.010","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 8","pages":"Page e775"},"PeriodicalIF":2.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399571","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 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":"https://doi.org/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":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-08","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":"Madarosis Among Breast Cancer Survivors","authors":"Sarah K. Premji ,&nbsp;Kathryn J. Ruddy ,&nbsp;Nicole Larson ,&nbsp;Charles L. Loprinzi ,&nbsp;Brittany Dulmage ,&nbsp;Maryam Lustberg ,&nbsp;Fergus J. Couch ,&nbsp;Janet E. Olson ,&nbsp;Elizabeth Cathcart-Rake","doi":"10.1016/j.clbc.2024.09.002","DOIUrl":"10.1016/j.clbc.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Eyebrow and eyelash loss, known as madarosis, can occur after breast cancer-directed therapy. The purpose of this study was to ascertain the proportion of breast cancer survivors who experience madarosis, contributing factors, and associations between this symptom and quality of life.</div></div><div><h3>Methods</h3><div>Breast cancer survivors were invited to participate in an ongoing longitudinal cohort study as a part of the Mayo Clinic Breast Disease Registry (MCBDR). Consenting participants were mailed a survey approximately 1 year after diagnosis. The proportions of participants who reported eyebrow and eyelash loss were evaluated overall and according to treatment type. Quality of life (QOL) was also explored in this cohort.</div></div><div><h3>Results</h3><div>Eight hundred and thirty-eight breast cancer survivors responded to survey. The median age of survivors was 59.4 years (range 22-100 years), 315 (37%) had received chemotherapy (± endocrine therapy), 415 (50%) had received endocrine therapy only. Nearly half of participants reported eyebrow loss (49%) or eyelash loss (49%) that occurred after their diagnosis of breast cancer. Eyebrow loss was reported by 89% of chemotherapy recipients, by 27% of endocrine therapy only recipients, and by 19% of those not treated with either therapy. 102 (32%) of those with chemotherapy-associated eyebrow loss reported that it was complete. Eyelash loss was reported by 274 (87%) of chemotherapy recipients, 112 (27%) of endocrine therapy only recipients, and 23 (21%) of those who received neither therapy.</div></div><div><h3>Conclusions</h3><div>Madarosis is a common symptom in breast cancer survivors and future investigation into the predictors and treatment of madarosis is needed.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 8","pages":"Pages e757-e763"},"PeriodicalIF":2.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375222","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 Retrospective Study of Fertility Counseling and Preservation Rates for Women of Reproductive Age With Breast Care After Integrating a Fertility Specialist Into a Multidisciplinary Tumor Board","authors":"Monique Swain ,&nbsp;Madison Miller ,&nbsp;Cara Cannella ,&nbsp;Samfee Doe ,&nbsp;Lindsay Petersen ,&nbsp;Jessica Bensenhaver","doi":"10.1016/j.clbc.2024.09.003","DOIUrl":"10.1016/j.clbc.2024.09.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Many breast centers have adopted multidisciplinary tumor boards to discuss and develop treatment plans for patients diagnosed with breast cancer. This study aims to determine whether adding a fertility specialist to tumor board will improve fertility counseling and utilization in breast cancer patients</div></div><div><h3>Methods</h3><div>A retrospective study of reproductive age patients diagnosed with breast cancer between January 1, 2012, and January 31, 2020, before and after integrating a designated fertility specialist into a comprehensive multidisciplinary care (cMDC) tumor board. Rates of fertility counseling and preservation were assessed for patients treated before (pre-cMDC) and after (post-cMDC) tumor board enhancement. Associations of race/ethnicity, age, chemotherapy, hormone receptor status, insurance type, parity, stage, site of treatment, and home county with fertility care rates were assessed in the post-cMDC group.</div></div><div><h3>Results</h3><div>Of 306 patients diagnosed with breast cancer, 117 (38%) were in the pre-cMDC and 189 (62%) were in the post-cMDC tumor board group. Significantly more patients in the post-cMDC tumor board group were offered fertility counseling than patients in the pre-cMDC tumor board group (23.3% (44) vs. 0.9% (1); <em>P</em> &lt; .001). However, rate of fertility preservation did not differ significantly between groups.</div></div><div><h3>Conclusion</h3><div>Integrating a fertility specialist within a cMDC tumor board may help improve rates of fertility counseling among breast cancer patients but may not improve preservation rates.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 8","pages":"Pages e764-e771"},"PeriodicalIF":2.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342706","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":"Prediction of Mastectomy Skin Flap Necrosis With Indocyanine Green Angiography and Thermography: A Retrospective Comparative Study","authors":"Domenico Pagliara ,&nbsp;Pietro Luciano Serra ,&nbsp;Nicola Pili ,&nbsp;Francesco Ruben Giardino ,&nbsp;Federica Grieco ,&nbsp;Laurenza Schiavone ,&nbsp;Melba Lattanzi ,&nbsp;Corrado Rubino ,&nbsp;Diego Ribuffo ,&nbsp;Giorgio De Santis ,&nbsp;Marzia Salgarello ,&nbsp;Maurice Y. Nahabedian ,&nbsp;Alberto Rancati","doi":"10.1016/j.clbc.2024.08.024","DOIUrl":"10.1016/j.clbc.2024.08.024","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates the predictive role of indocyanine green angiography and thermography in assessing mastectomy skin flap necrosis in the intraoperative and postoperative setting.</div></div><div><h3>Methods</h3><div>A retrospective review of 45 patients who underwent nipple-sparing mastectomy and immediate prepectoral reconstruction was performed. Mastectomy flap viability was evaluated intraoperatively with indocyanine green angiography and thermography after placement of an implant sizer and again postoperatively at 24 hours. Fluorescence pattern was analyzed with a near-infrared camera (IC-Flow^TM Imaging System, Diagnostic Green GmbH, Germania) and thermographic images with FLIR ONE device. FLIR ONE and ICG images were then transposed on macroscopic breast images with a scale 1:1. The mastectomy skin flap was evaluated using the SKIN score (Mayo Clinic Classification).</div></div><div><h3>Results</h3><div>Overlap between angiography and thermography images was 87.95% intraoperatively and 95.95% 24 hours postoperatively. Overlay with mastectomy flap necrosis was higher in the intraoperative angiography group with statistical significance. Contrarily, such a difference was not apparent in the postoperative period.</div></div><div><h3>Conclusions</h3><div>ICG appears to be a superior tool when used intraoperatively with fundamental implications on reconstructive decision-making, while thermography could be a valuable assessment method in the postoperative setting. Further studies are necessary to confirm such results and determine their clinical applicability.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"24 8","pages":"Pages 755-762"},"PeriodicalIF":2.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342708","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 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, Chirag Shah, Karuna Mittal, Jame Abraham, Megan Kruse, Sheila Weinmann, Michael Leo, Rachel Rabinovitch, Fredrik Wärnberg, Pat W Whitworth, Brian J Czerniecki, Steven C Shivers, Troy Bremer","doi":"10.1016/j.clbc.2024.08.016","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.08.016","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Patients and methods: </strong>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 > 2.8) without RRt or (2) Residual Risk subtype. Kaplan-Meier analysis was used to compute IBR curves.</p><p><strong>Results: </strong>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%, P = .01). The Residual Risk subtype had more nuclear grade 3 disease (87% vs. 63%, P < .001), but age, size, and grade were not associated with IBR rate (P = NS) on univariate and multivariable analysis. Only the Residual Risk group was associated with IBR (P = .05) in multivariate analysis.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-04","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}