Clinical breast cancer最新文献

{"title":"The Role of Adjuvant Radiation Therapy in Treating Older Breast Cancer Patients With Low Adherence to Endocrine Therapy.","authors":"M Judy Lubas, Jill Hasler, Jordan Fredette, Ana Sandoval-Leon, Richard Bleicher, Austin Williams, Lindsay Taylor, Joshua Meyer, Rebecca Shulman","doi":"10.1016/j.clbc.2025.07.028","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.07.028","url":null,"abstract":"<p><strong>Background: </strong>Older patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early-stage breast cancer (HPEsBC) typically undergo breast-conserving surgery (BCS) followed by adjuvant radiation therapy (RT) and/or endocrine therapy (ET). Our study aimed to identify predictors of low ET adherence and evaluate the role of RT in modifying survival among patients with low ET adherence.</p><p><strong>Methods: </strong>A retrospective analysis was performed using a US-based, electronic health record-derived, de-identified database. Patients aged ≥65 years with HPEsBC treated with BCS from 2011 to 2018 were included. Four adjuvant treatment groups were identified. Low ET adherence was defined as ET use for <80% of the 5-year post surgery follow-up period. Multinomial logistic regression was used to identify predictors of low adherence. Survival outcomes were assessed using hazard ratios (HRs) adjusted for covariates.</p><p><strong>Results: </strong>A total of 1,488 patients were included in the study. Among patients receiving ET, 23% demonstrated low adherence. After adjustment for covariates, mortality was higher for RT alone (HR = 1.79, p = .011) and no adjuvant therapy (HR = 2.65, p < .001) compared with ET + RT. Predictors of low ET adherence included increasing age (odds ratio [OR] = 1.06, p < .010) and treatment at an academic practice (OR = 2.58, p < .001). A 10% decline in ET adherence was associated with increased mortality (HR = 1.17, p < .001). An interaction analysis revealed no differential effect of RT in the context of ET adherence.</p><p><strong>Conclusion: </strong>Low ET adherence occurred in approximately one-quarter of patients and was associated with advancing age and treatment at academic centers. Reduced ET adherence was linked to significantly increased mortality. Further investigation into the role of RT in patients with low ET adherence is warranted.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944809","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":"Receptor Discordance During the Treatment Course of Patients With Metastatic Breast Cancer: Results From the SONABRE Registry","authors":"Karlijn E.P.E. Hermans ,&nbsp;Sandra M.E. Geurts ,&nbsp;Franchette Van den Berkmortel ,&nbsp;Jolien Tol ,&nbsp;Joan B. Heijns ,&nbsp;Marcus W. Dercksen ,&nbsp;Birgit E.P.J. Vriens ,&nbsp;Kirsten N.A. Aaldering ,&nbsp;Manon J.A.E. Pepels ,&nbsp;Natascha A.J.B. Peters ,&nbsp;Linda van de Winkel ,&nbsp;Eline Boon ,&nbsp;Nathalie Teeuwen ,&nbsp;Maartje A.C.E. van Kats ,&nbsp;Vivianne C.G. Tjan-Heijnen","doi":"10.1016/j.clbc.2025.07.020","DOIUrl":"10.1016/j.clbc.2025.07.020","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim was to evaluate factors associated with taking 2 biopsies during the disease course of metastatic breast cancer (mBC) and to assess discordance rates for the oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2).</div></div><div><h3>Methods</h3><div>Patients diagnosed with mBC in ten Dutch hospitals between 2007 and 2020 were retrieved from the SONABRE Registry (NCT-03577197). Patients were identified if they had at least 2 biopsies at different time points during their mBC disease course. Last follow-up was collected in September 2023. Frequencies and factors related to a second biopsy were studied using competing risk analysis with subdistribution hazard ratios (sHR). Discordance rates and factors associated with receptor subtype discordance were analysed using logistic regression using odds ratios (OR).</div></div><div><h3>Results</h3><div>Of 4,470 patients with mBC, 65% had 1 and 10% 2 biopsies during the course of mBC. Having 2 biopsies for mBC was related to age (sHR: 0.61), comorbidity (sHR: 0.76), WHO performance score (sHR: 0.30 for ≥2), initial TN subtype (sHR: 0.67), and initial metastatic site (sHR: 3.68 for soft tissue only), compared with the reference categories. Patients had an overall receptor subtype discordance of 23% compared to the second biopsy. Only HR+/HER2+ status was related to receptor subtype discordance (OR: 6.45).</div></div><div><h3>Conclusion</h3><div>Only the minority of patients with mBC underwent a second biopsy during their mBC disease course. Receptor subtype heterogeneity is however frequent, particularly in patients with initially HR+/HER2+ mBC. Future studies are needed to guide treatment decisions as heterogeneity may play a role.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 7","pages":"Pages 704-713.e3"},"PeriodicalIF":2.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944822","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":"Short-Term Prediction Model for Breast Cancer Risk Based on One Million Medical Records.","authors":"Ofer Feinstein, Dan Ofer, Eitan Bachmat, Sivan Gazit, Michal Linial, Tehillah S Menes","doi":"10.1016/j.clbc.2025.07.025","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.07.025","url":null,"abstract":"<p><strong>Background: </strong>Despite progress in breast cancer screening many women are diagnosed with advanced stage. We sought to develop a short-term (one year) prediction model for breast cancer risk, based on readily available data from electronic medical records (EMRs), to support decision-making.</p><p><strong>Methods: </strong>A retrospective cohort study using data of 1,039,212 members of a large healthcare organization between the years 1985 and 2021. During the study years, 18,959 people were diagnosed with breast cancer. Longitudinal personal medical information such as demographics, cancer-related family history, smoking habits, medical history, fertility treatments, surgeries, biopsies, medications, BMI, blood pressure and lab tests was used to predict the outcome: breast cancer diagnosis one year from the recorded data. Prediction models were trained using the CatBoost decision tree methodology. SHapley Additive exPlanations (SHAP) values were used to estimate the marginal impact of a feature on the model performance, considering the other features.</p><p><strong>Results: </strong>The model includes numerous features not utilized in existing breast cancer risk models (e.g., medications, systolic blood pressure, TSH levels and more), available from the EMR. The informative features, ranked by SHAP values, include age, the number of surgical consultations and the number of breast biopsies. The model achieved high performance with an area under the ROC curve (AUC-ROC) of 0.85.</p><p><strong>Conclusions: </strong>Use of data readily available from the EMR, can assist clinicians when assessing the short-term breast cancer risk.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944794","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 Overall and Relapse-Free Survival in Triple-Negative Breast Cancer Patients Through Machine Learning-Based Clustering on Clinical Data","authors":"Juan Pablo Alzate-Granados ,&nbsp;Luis Fernando Niño","doi":"10.1016/j.clbc.2025.07.027","DOIUrl":"10.1016/j.clbc.2025.07.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Triple-negative breast cancer (TNBC) accounts for 15% to 20% of breast cancer cases and is characterized by its aggressiveness and high relapse rate. Due to the absence of hormonal receptors and HER2, standard treatment relies on chemotherapy, yielding limited outcomes in overall survival (OS) and relapse-free survival (RFS). The molecular heterogeneity of TNBC complicates risk stratification and personalized treatment approaches. In this context, unsupervised machine learning could improve the identification of clinically homogeneous subgroups and facilitate prognostic predictions.</div></div><div><h3>Objective</h3><div>To develop predictive models for OS and RFS in TNBC patients using machine learning algorithms, specifically k-prototypes for subgroup identification and random forest for outcome prediction.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 4808 TNBC patients diagnosed between 2012 and 2024. Clinical, demographic, and biomolecular variables were analyzed from anonymized clinical records. The k-prototypes algorithm was applied to cluster patients into groups based on shared characteristics. Subsequently, predictive models using random forest were trained and evaluated through stratified cross-validation and metrics such as AUC, sensitivity, and specificity. Cox regression was used to identify risk factors associated with mortality and relapse.</div></div><div><h3>Results</h3><div>Four clusters with distinct risk profiles were identified. Overall mortality was 28.8%, and relapse occurred in 40.9%, with a median follow-up time of 8.46 years. The highest-risk group exhibited a mortality rate of 42.3% and a relapse rate of 54.2%, associated with poorer functional status (ECOG ≥3) and a high prevalence of BRCA1/2 mutations (71%). The random forest model achieved 80% accuracy in mortality prediction (AUC = 0.78) and 75% accuracy in relapse prediction (AUC = 0.76). Factors such as the Charlson Comorbidity Index, ECOG, BRCA1/2 status, and PD-L1 expression were key determinants in outcome prediction.</div></div><div><h3>Discussion</h3><div>The findings confirm the relevance of machine learning in TNBC stratification. A clinically meaningful classification was achieved, outperforming traditional models based solely on clinical or genomic variables. Comorbid burden and tumor biomarkers played crucial roles in outcome prediction. Despite its strengths, the study has limitations, including its retrospective nature and the absence of transcriptomic data. Prospective validation of these models could enhance their applicability in clinical practice.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 7","pages":"Pages 714-719"},"PeriodicalIF":2.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944987","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":"Preferences for Breast Cancer Survivorship Programs Among Multiracial and Ethnic Women.","authors":"Lisa Anderson, Oindrila Bhattacharyya, Akia Clark, Sharnell Smith, Michael Grimm, Elizabeth Fox, Annie Trance, Bridget A Oppong","doi":"10.1016/j.clbc.2025.07.019","DOIUrl":"10.1016/j.clbc.2025.07.019","url":null,"abstract":"<p><strong>Purpose: </strong>With advancements in breast cancer treatment, survivorship has increased, leading to 3.8 million survivors in the US. These women have diverse supportive care needs, often addressed through survivorship programs (SPs), which provide clinical and nonclinical support services. SPs aim to deliver a holistic approach to comprehensive breast cancer treatment and recurrence prevention. Historically, disparities in SP utilization exist among minority and elderly women. This study aims to explore trends varying in SP participation by age and race within a single institution.</p><p><strong>Methods: </strong>A retrospective analysis of breast cancer patients' survivorship needs at a tertiary referral academic cancer center program was conducted. Data were collected from programs between 2019 and 2022, including demographics and referrals to clinical resources such as Adolescent/Young Adult care, Fertility preservation, Palliative care, Psychosocial support, and Survivorship. Participation in nonclinical areas, including Art, Education, Exercise, Mind-Body-Spirit, and Nutrition, was also evaluated. Descriptive statistics summarized patterns based on age, race, and ethnicity.</p><p><strong>Results: </strong>From 2019 to 2022, 2198 patients attended SPs, with Nutrition and Exercise being the most popular. Most attendees were 60-69 years old and White. Black attendees declined from 9.9% (2019) to 5.7% (2022). Clinical resources showed the highest referral rate to survivorship clinics. Black patients saw an increase in palliative care referrals, rising from 11% to 21%.</p><p><strong>Conclusion: </strong>Data reveal differences in clinical referrals by age and race, with fewer referrals for older women and more for Black patients. Participation in nonclinical SPs was similar across groups. Future program development will focus on inclusivity and equitable access.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945006","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":"Integrated Prognostic Model for Young Breast Cancer Patients: Insights from SEER, METABRIC, and TCGA Databases.","authors":"Yongxin Li, Dexiang Li, Xinlong Tao, Yinyin Ye, Chengrong Zhang, Zhengbo Xu, Zhilin Liu, Miaozhou Wang, Zhen Liu, Zitao Li, Hongxia Liang, Fanzhen Kong, Jiuda Zhao","doi":"10.1016/j.clbc.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.07.015","url":null,"abstract":"<p><p>This study aims to develop a prognostic model for breast cancer in young women (BCY) by integrating clinical and genomic data. We analyzed clinical data from SEER and identified key prognostic genes using METABRIC and TCGA datasets. Machine learning (LASSO and XGBoost) was used for gene selection, and a survival prediction model was built. The model was validated in independent datasets, and an interactive online nomogram was developed. The study included 139,994 breast cancer patients, confirming that age under 40 is an independent adverse factor for overall survival (OS). Using gene expression data from METABRIC and TCGA, PLA2G2A and C8orf76 were identified as critical prognostic biomarkers. These genes were incorporated into a predictive model that stratified patients into high- and low-risk groups with significant survival differences. The model achieved strong predictive performance, with AUC values of 0.862, 0.813, and 0.756 for 3-, 5-, and 8-year overall survival (OS), respectively. Additionally, a web-based tool (https://lyx00.shinyapps.io/BCY-Model-CG/) was developed to facilitate clinical implementation, allowing individualized survival predictions based on patient-specific clinical and genetic data. This integrated prognostic model, combining clinical and genomic data, improves survival prediction for breast cancer in young women (BCY) patients. It offers a more precise tool for risk assessment and personalized treatment planning.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798320","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":"Clinical and Pathological Features of Early-Stage Metaplastic Carcinoma and Associated Patient Outcomes","authors":"Malcolm Su ,&nbsp;Stevie Saxon-Filipe ,&nbsp;Chul Ahn ,&nbsp;Ang Gao ,&nbsp;Yisheng Feng ,&nbsp;Samira Syed","doi":"10.1016/j.clbc.2025.07.018","DOIUrl":"10.1016/j.clbc.2025.07.018","url":null,"abstract":"<div><h3>Background</h3><div>Metaplastic breast carcinoma (MpBC) is an aggressive subtype of breast cancer that is usually resistant to chemotherapy. Few studies have analyzed the role of immunotherapy and other treatments in early stage MpBC. We identified clinicopathological and sociodemographic factors associated with treatment response and recurrence of disease among patients with nonmetastatic MpBC within 2 hospital systems.</div></div><div><h3>Methods</h3><div>A retrospective study was performed to evaluate female patients diagnosed with Stage I to Stage III MpBC within a safety-net hospital and private cancer center from January 2013 to October 2024.</div></div><div><h3>Results</h3><div>We identified 54 patients with MpBC with a mean age of diagnosis of 55.2 years. There were 14 (25.95%) White, 26 (48.1%) Black, and 10 (18.5%) Hispanic patients. Thirteen (24.1%) patients were uninsured at the time of diagnosis. In total, 49 (90.7%) patients received chemotherapy and 19 (35.2%) received immunotherapy. Eight (14.8%) patients experienced MpBC recurrence at the time of this review. Patients with squamous features (<em>P</em> = .04) and Ki-67 ≥ 51% (<em>P</em> = .02) on histology were more likely to have a recurrence of disease. Patients with squamous histology (<em>P</em> = .02) were more likely to have greater residual cancer burden after neoadjuvant therapy. Treatment with immunotherapy, such as PD-L1 inhibitors, in addition to chemotherapy did not reduce disease recurrence.</div></div><div><h3>Conclusions</h3><div>MpBC remains an aggressive and treatment-resistant form of breast cancer. In our cohort of early-stage cases, the addition of immunotherapy to chemotherapy did not reduce the recurrence of disease. Additionally, treatment response and resistance may vary among the various histologic subtypes of MpBC.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 7","pages":"Pages 693-703"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858990","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":"Appropriate Treatment for Stage 1 and 2 Her2-Positive and Triple-Negative Breast Cancer by Immigration Status in Ontario, Canada.","authors":"Omolara Fatiregun, Rinku Sutradhar, Sho Podolsky, Andrea Eisen, Lawrence Paszat, Eileen Rakovitch","doi":"10.1016/j.clbc.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.07.013","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored appropriate treatment received for stage 1 and 2 Her2-positive and triple-negative (TN) breast cancer (BC) among immigrants and long-term residents.</p><p><strong>Methods: </strong>We identified women aged 18- 75 years diagnosed with BC in Ontario from 2012 to 2019. We stratified them into immigrants and long-term residents using the Immigration, Refugee, and Citizenship Canada Permanent Resident database (CIC). We linked to population-wide treatment databases to extract information on breast surgery, chemotherapy, and radiotherapy. We categorized them into 4 mutually exclusive groups based on subtype (Her-2 positive or TNBC) and breast surgery (breast-conserving surgery (BCS) vs. mastectomy). Appropriate treatment included chemotherapy for all (plus Herceptin if Her-2 overexpressing), plus breast radiation therapy if breast-conserving surgery was performed. We could not assess the receipt of endocrine therapy for the hormone receptor-positive subset of Her-2 overexpressors, or indications for postmastectomy radiation therapy. Odds ratios for receiving appropriate treatment were calculated using logistic regression, adjusting for age, resource utilization and area-level residential ethnicity concentration.</p><p><strong>Results: </strong>Crude and univariate analyses showed no differences in the receipt of appropriate treatment. Similarly, adjusted analyses in each of the 4 subgroups showed no difference between immigrants and long-term residents. Among Her2-positive treated by(BCS) group,(Odds Ratio[OR] = 0.82, 95% Confidence Interval[CI] 0.65-1.03, and treated by mastectomy, OR = 0.95 (95% CI, 0.67-1.35). Among TNBC treated by BCS, OR = 0.81 (95% CI, 0.58-1.13), and treated by mastectomy,OR 0.85 (95% CI, 0.49-1.46).</p><p><strong>Conclusion: </strong>Immigration status was not associated with the receipt of appropriate treatment amongst early-stage Her2-positive or TNBC breast cancer in Ontario.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871662","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":"Prognostic Value of Tumor-Infiltrating Lymphocytes in Breast Cancer Patients Treated With Radiotherapy: A Systematic Review of Literature.","authors":"Yasmin A Civil, Nora D Purcell, Ralph de Vries, Arlene L Oei, Victor L J L Thijssen, Tanja D de Gruijl, Berend J Slotman, Famke L Schneiders, H J G Desirée van den Bongard","doi":"10.1016/j.clbc.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.07.005","url":null,"abstract":"<p><p>High tumor-infiltrating lymphocytes (TILs) levels in triple-negative and HER2-positive breast cancer are associated with better survival outcomes, highlighting its potential as prognostic biomarkers. Radiotherapy can also trigger immune cell infiltration. This systematic review evaluates the prognostic value of TILs in radiotherapy-treated breast cancer patients. A literature search (in PubMed, Embase and Web of Science) was performed up to April 5, 2024 (PROSPERO registration CRD42024401741). Two independent reviewers screened articles according to predefined criteria, resolving discrepancies through consensus. The collected outcomes were prognostic value of TILs for ipsilateral breast tumor recurrence (IBTR), any recurrence, distant metastasis (DM), overall survival (OS) and disease-free survival (DFS). Of 10,927 records, 11 studies (3899 patients) were included. Patients underwent lumpectomy or mastectomy, with or without postoperative radiotherapy. Three studies examined neoadjuvant partial breast irradiation. The stroma threshold for high vs. low TILs ranged from 5 to 50%, with most patients (73%) having low TILs. Low TILs patients significantly benefited from radiotherapy in reducing IBTR and any recurrence. In luminal B, triple-negative and HER2-positive subtypes, high TILs were associated with better outcomes in DM, OS and DFS. For radiotherapy-treated luminal A breast cancer, low TILs were associated with improved OS. For DCIS patients, low TILs correlated with reduced IBTR. TILs could be a prognostic biomarker for radiotherapy-treated breast cancer patients. However, study heterogeneity complicates comparisons. To refine personalized treatment, further prospective studies are necessary to investigate TILs levels and the impact of neoadjuvant radiotherapy on oncological outcomes across different breast cancer subtypes.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803723","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":"Does Epstein-Barr Virus Contribute to Breast Cancer Risk Worldwide? A Systematic Review and Meta-Analysis.","authors":"Francisco Cezar Aquino de Moraes, Pedro Henrique de Souza Wagner, Ana Beatriz Nardelli da Silva, Maria Cristina Figueroa Magalhães, Rommel Mario Rodríguez Burbano","doi":"10.1016/j.clbc.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.07.017","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer (BC) is the most common cancer among women worldwide, accounting for over 2.3 million new cases annually. Recent evidence suggests Epstein-Barr virus (EBV) may play a role in its pathogenesis. Given EBV's known oncogenic potential, this study investigates the prevalence and possible role of EBV in BC pathogenesis.</p><p><strong>Methods: </strong>Random-effects meta-analyses were conducted to estimate raw proportions and risk ratio (RR), with 95% confidence intervals (CIs). Heterogeneity was assessed using I². Statistical significance was set at P < .05. Analyses were performed in R 4.2.3 RESULTS: Our meta-analysis included 57 studies, comprising a total of 5,133 BC tissues to analyze the presence of EBV. Our analysis revealed a prevalence of 25% (95% CI: 21%-30%) of EBV in BC tissues. In the analysis by continent, Europe, Africa, and Oceania showed a similar proportion of 33%. Regarding the risk of EBV in BC tissues compared to healthy controls, the analysis identified a statistically significant difference, presenting higher risk of EBV in the BC group (RR: 3.35; P < .001). South America showed the highest and significant RR of 12.34 (P = .007) among the continents. Subgroup analysis by income revealed that the low-income-group exhibited the highest EBV prevalence (44%; 95% CI: 28%-61%). According to the subtype BC analysis, triple-negative BC exhibited the highest EBV prevalence (30%; 95% CI: 19%-44%).</p><p><strong>Conclusion: </strong>This meta-analysis underscores the global prevalence of EBV in BC and highlights a potential association between EBV presence and breast cancer. Further standardized, prospective studies using robust detection methods, including paired tissue analyses, are needed to confirm these observations and to clarify the possible role of EBV in breast tumorigenesis.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944992","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}