Clinical breast cancer最新文献

{"title":"Development and Validation of a Novel Conditional Survival Nomogram for Predicting Real-Time Prognosis in Patients With Breast Cancer Brain Metastasis","authors":"Yongqing Zhang ,&nbsp;Mingjie Zhang ,&nbsp;Guoxiu Yu ,&nbsp;Wenhui Wang","doi":"10.1016/j.clbc.2024.10.016","DOIUrl":"10.1016/j.clbc.2024.10.016","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer brain metastasis (BCBM) prognosis has not been evaluated dynamically, which may underestimate patient survival. This study aimed to perform a conditional survival (CS) analysis and develop and validate an individualized real-time prognostic monitoring model for survivors.</div></div><div><h3>Methods</h3><div>The study included patients with BCBM from the Surveillance, Epidemiology, and End Results database (training group, <em>n</em> = 998) and our institution (validation group, <em>n</em> = 45) and updated patient overall survival (OS) over time using the CS method: <span><math><mrow><mi>C</mi><mi>S</mi><mrow><mo>(</mo><mi>t</mi><mn>2</mn><mo>|</mo><mi>t</mi><mn>1</mn><mo>)</mo></mrow><mo>=</mo><mfrac><mrow><mi>O</mi><mi>S</mi><mo>(</mo><mrow><mi>t</mi><mn>1</mn><mo>+</mo><mi>t</mi><mn>2</mn></mrow><mo>)</mo></mrow><mrow><mi>O</mi><mi>S</mi><mo>(</mo><mrow><mi>t</mi><mn>1</mn></mrow><mo>)</mo></mrow></mfrac></mrow></math></span>. Multivariate Cox regression was used to identify prognostic factors for the nomogram, which estimated individualized OS. Furthermore, a novel CS-nomogram and its web version were further developed based on the CS formula.</div></div><div><h3>Results</h3><div>CS analysis showed that the 5-year OS of BCBM survivors gradually improved from 13.5% estimated at diagnosis to 26.0%, 39.7%, 57.9%, and 77.6% (surviving 1-4 years, respectively). Cox regression identified age, marital status, estrogen receptor status, human epidermal growth factor receptor 2 (Her-2) status, histological grade, surgery, and chemotherapy as significant factors influencing OS (<em>P</em> &lt; .05). We then constructed and deployed the CS-nomogram based on the CS formula and the nomogram to predict real-time prognosis dynamically (<span><span>https://wh-wang.shinyapps.io/BCBM/</span><svg><path></path></svg></span>). During performance evaluation, the model performed well in both the training and validation groups.</div></div><div><h3>Conclusions</h3><div>CS analysis showed a gradual improvement in prognosis over time for BCBM survivors. We developed and deployed on the web a novel real-time dynamic prognostic monitoring system, the CS-nomogram, which provided valuable survival data for clinical decision-making, patient counseling, and optimal allocation of healthcare resources.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages 141-148.e1"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680997","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":"RBM15 Drives Breast Cancer Cell Progression and Immune Escape via m6A-Dependent Stabilization of KPNA2 mRNA","authors":"Hu Wang ,&nbsp;Yu Cao ,&nbsp;Li Zhang ,&nbsp;Qian Zhao ,&nbsp;Shuangjian Li ,&nbsp;Dan Li","doi":"10.1016/j.clbc.2024.09.006","DOIUrl":"10.1016/j.clbc.2024.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most frequently diagnosed cancer among women worldwide with high morbidity and mortality. Previous studies have indicated that RNA-binding motif protein-15 (RBM15), an N6-methyladenosine (m6A) writer, is implicated in the growth of breast cancer cells. Herein, we aimed to explore the function and detailed mechanism of RBM15 in breast cancer.</div></div><div><h3>Methods</h3><div>In this research, UALCAN databases were applied to analyze the expression of RBM15 or Karyopherin-2 alpha (KPNA2) in BRCA. RBM15 and KPNA2 mRNA levels were determined using real-time quantitative polymerase chain reaction (RT-qPCR) assay. RBM15, KPNA2, and Programmed cell death ligand 1 (PD-L1) protein levels were measured using western blot. Cell proliferation, migration, and invasion were assessed using 5-ethynyl-2′-deoxyuridine (EdU) and Transwell assays. The biological role of RBM15 on breast cancer tumor growth was verified using the xenograft tumor model <em>in vivo.</em> Effects of breast cancer cells on the proliferation and apoptosis of CD8⁺ T cells were analyzed using flow cytometry. Interaction between RBM15 and KPNA2 was validated using methylated RNA immunoprecipitation (MeRIP) and dual-luciferase reporter assays.</div></div><div><h3>Results</h3><div>RBM15 and KPNA2 were highly expressed in breast cancer tissues and cell lines. Furthermore, RBM15 silencing might suppress breast cancer cell proliferation, migration, invasion, and lymphocyte immunity <em>in vitro</em>, as well as block tumor growth <em>in vivo</em>. At the molecular level, RBM15 might improve the stability and expression of KPNA2 mRNA via m6A methylation.</div></div><div><h3>Conclusion</h3><div>RBM15 might contribute to the malignant progression and immune escape of breast cancer cells partly by modulating the stability of KPNA2 mRNA, providing a promising therapeutic target for breast cancer.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages 96-107"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563861","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 Axillary Lymph Node Dissection Needed? Clinicopathological Correlation in a Series of 224 Neoadjuvant Chemotherapy-Treated Node-Positive Breast Cancers","authors":"Sean M. Hacking ,&nbsp;Dongling Wu ,&nbsp;Charu Taneja ,&nbsp;Theresa Graves ,&nbsp;Liang Cheng ,&nbsp;Yihong Wang","doi":"10.1016/j.clbc.2024.11.007","DOIUrl":"10.1016/j.clbc.2024.11.007","url":null,"abstract":"<div><div>Background: Axillary lymph node status is valuable in determining systemic and radiation therapy. Following neoadjuvant therapy for patients with clinically involved axillary nodes, the role of axillary lymph node dissection (ALND) following a positive sentinel lymph node biopsy (SLNB) is a subject of controversy. Materials and Methods: We retrospectively analyzed 224 neoadjuvant chemotherapy-treated node-positive breast cancer cases and evaluated the role of ALND in optimizing staging accuracy and treatment outcomes. Results: About 63 (27.8%) underwent ALND based on post neoadjuvant persistent positive lymph nodes on exam /imaging. SLNBs were performed in 161 (71.9%) patients as initial surgical planning; 67 (41.6%) patients had positive SLNB results, and 51 (76.1%) underwent further ALND. In patients with 1 positive sentinel lymph node, follow-up ALND yielded additional positive lymph nodes in 10.5% of cases, whereas in patients with 2 or more positive sentinel lymph nodes, follow-up ALND yielded additional positive lymph nodes in 87.5% of cases. The presence of 2 positive macro-metastatic sentinel lymph nodes significantly predicts additional nodal involvement, especially in patients without a pathologic complete response. Conclusion: De-escalation of axillary surgery to SLNB alone in this context may be safely considered in neoadjuvant-treated clinical node positive patient with &lt;2 positive sentinel lymph nodes. Our findings help guide surgeons to appropriately select patients who can potentially benefit from ALND for locoregional control and recommendation for adjuvant radiation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages 172-179"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754874","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":"Perceptions of Delayed Alopecia Among Breast Cancer Survivors","authors":"Sarah K. Premji ,&nbsp;Kathryn J. Ruddy ,&nbsp;Robert A. Vierkant ,&nbsp;Nicole Larson ,&nbsp;Charles Loprinzi ,&nbsp;Brittany Dulmage ,&nbsp;Maryam Lustberg ,&nbsp;Fergus J. Couch ,&nbsp;Janet E. Olson ,&nbsp;Elizabeth Cathcart-Rake","doi":"10.1016/j.clbc.2024.09.008","DOIUrl":"10.1016/j.clbc.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 2","pages":"Pages e170-e177"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","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":"Robotic Nipple-Sparing Mastectomy: A Critical Appraisal","authors":"Mariam Rizk,&nbsp;Kefah Mokbel","doi":"10.1016/j.clbc.2025.01.015","DOIUrl":"10.1016/j.clbc.2025.01.015","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 3","pages":"Pages e328-e329"},"PeriodicalIF":2.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482373","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":"Evaluation of Neutrophil Activation Biomarkers in Response to Programmed Cell Death Protein-1 (PD-1) and Toll-like Receptor 9 (TLR-9) Inhibition in Triple Negative Breast Cancer.","authors":"Sara Youssry, Amina Hussein, Nadia Abd El Moneim, Alaa Samy, Asmaa Mostafa, Mohamed H Sultan","doi":"10.1016/j.clbc.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.01.013","url":null,"abstract":"<p><strong>Background and objective: </strong>Activation of neutrophils has proven to be useful in different models of cancer therapy. However, more comprehensive studies are required to further characterize these potential targets. Thus, we aimed to evaluate the effects of programmed cell death protein-1 (PD-1) and toll-like receptor 9 (TLR-9) inhibition on markers of neutrophil activation in different breast cancer subtypes.</p><p><strong>Methods: </strong>Neutrophils were cultured and treated with PD-1 and TLR-9 inhibitors after being isolated from 43 triple negative breast cancer (TNBC), 31 non-TNBC patients and 30 healthy females. Enzyme linked immunosorbent assay (ELISA) was then used to detect neutrophil elastase (NE) and myeloperoxidase (MPO) in culture supernatants.</p><p><strong>Results: </strong>The results revealed that increased NE and MPO were significantly associated with advanced clinical stage and vascular invasion, respectively. In addition, treatment with either anti-PD-1 or anti-TLR-9 was associated with a significant decrease in NE and MPO levels of both TNBC and non-TNBC samples compared to untreated samples. Moreover, the ameliorative effect of both treatments was observed to be more obvious on MPO levels compared to NE levels in breast cancer subtypes.</p><p><strong>Conclusion: </strong>These results may highlight the possible therapeutic role of PD-1 and TLR-9 inhibitors in modulating neutrophil activation markers (NE and MPO) in breast cancer subtypes.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472400","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 Risk of Metabolic Dysfunction in Nonobese Breast Cancer Survivors.","authors":"Pedro Paulo P da Silva-Filho, Daniel A B Buttros, Luciana A B Buttros, Giulliano Esperança, Pedro Luiz F Gubolino, Eduardo Carvalho-Pessoa, Heloisa D L Vespoli, Eliana A P Nahas","doi":"10.1016/j.clbc.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.01.009","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the metabolic profile of non-obese postmenopausal women with breast cancer (BC) compared to non-obese women without breast cancer.</p><p><strong>Methods: </strong>In this case-control study, 130 women with BC, aged 45-75years, body mass index < 30kg/m² and without established cardiovascular disease were included. The control group consisted of 130 women with the same inclusion criteria, but without BC. The groups were matched by age and time since menopause. Clinical, anthropometric, and biochemical data were collected. Women who presented three or more diagnostic criteria were considered to have metabolic syndrome (MetS): waist circunference > 88cm; triglycerides ≥ 150mg/dL; HDL-cholesterol < 50mg/dL; blood pressure (BP) ≥ 130/85mmHg; glucose ≥ 100mg/dL.</p><p><strong>Results: </strong>Women with BC had a higher occurrence of MetS and elevated BP compared to the control (30.8% vs. 20.0% and 25.4% vs. 14.6%, respectively) (P < 0.05). A higher percentage of women with BC had values above the desirable range for total cholesterol and glucose compared to the control (56.2% vs. 43.1% and 29.2% vs. 15.4%, respectively) (P < 0.05). In the risk analysis of the metabolic profile, adjusted for age and menopausal status, women with BC had a significantly higher risk for MetS (OR =%2.76, 95% CI 1.48-5.15), elevated glucose (OR = 2.69, 95% CI 1.46-4.96), and hypertension (OR = 3.03, 95% CI 1.51-6.10).</p><p><strong>Conclusion: </strong>Non-obese women with BC had a higher risk for MetS, hypertension, and diabetes, with a worse metabolic profile compared to non-obese women without BC. Prospective studies are needed to validate our results.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381640","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":"Evaluation of Disease Severity, Respiratory Muscle Strength, Respiratory Functions, Functionality, and Quality of Life in Patients With Upper Limb Lymphedema.","authors":"Gamze Aydin, Emine Atici, Ezgi Yarasir, Songul Baglan Yentur, Muhammet Sahin Elbasti","doi":"10.1016/j.clbc.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.01.008","url":null,"abstract":"<p><strong>Objective: </strong>Lymphedema is a chronic, progressive disease that results from the accumulation of protein-rich fluid in the interstitial tissue spaces. The aim of this study is to assess disease severity, respiratory muscle strength, respiratory functions, pectoralis minor muscle shortening, functionality, and quality of life(QoL) in patients with upper limb lymphedema (ULL), and to compare these findings with healthy controls.</p><p><strong>Methods: </strong>The disease severity was assessed using the Stillwell classification system; respiratory muscle strength was measured through maximum inspiratory and expiratory intraoral pressures (MIP, MEP, respectively); respiratory functions were evaluated with a spirometer; muscle length of pectoralis minor (PM) was measured with a tape measure; functionality was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH); and QoL was evaluated with the Lymphedema Quality of Life Questionnaire - Arm (LYMQOL-Arm). The participants were divided into 2 groups, patients with ULL in Group 1; the healthy individuals were included in Group 2.</p><p><strong>Results: </strong>The group 1 had lower values for MIP, MEP, FEV₁, FVC, FEF₂₅, FEF₇₅, PEF, muscle length of PM, and DASH scores compared to group 2(p:0.018, p:0.010, P < .001, P < .001, p:0.001, p:0.043, P < .001, P < .001, P < .001, respectively). A negative correlation was found between disease severity and MIP, MEP, FEV1, FVC, and muscle length of PM (r:-0.598, r:-0.451, r:-0.458, r:-0.347, r:-0.498 (fair to good) respectively, P < .05). A positive correlation was observed between disease severity and LYMQOL-Arm (r:0.496 (good), P < .05).</p><p><strong>Conclusion: </strong>Patients with ULL were found to be impaired in respiratory muscle strength, respiratory function tests, functionality and muscle length of PM compared to healthy individuals.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425082","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 Outcomes and Prognostic Factors in Epithelial-Myoepithelial Carcinoma (EMC) of the Breast.","authors":"Utsav Joshi, Pravash Budhathoki, Suman Gaire, Sumeet Kumar Yadav, Chengu Niu, Vishakha Agrawal, Soon Khai Low, Hatem Hussein Soliman","doi":"10.1016/j.clbc.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.01.012","url":null,"abstract":"<p><strong>Background: </strong>Most published data on EMC consists of individual case reports, and survival outcomes are not clearly defined to guide evidence-based management.</p><p><strong>Methods: </strong>All women with a histologic diagnosis of EMC irrespective of age and stage at diagnosis till 2018 in the National Cancer Database were included (N = 111). Overall survival (OS) was compared among groups using the Kaplan-Meier and log-rank methods.</p><p><strong>Results: </strong>The median age at diagnosis was 67 years, and 101 (88.6%) were over 50 years of age. Ten percent were ER+/Her2-, 29.7% were ER-/Her2-, 0.9% were Her2+, 5.4% were ER+/Her2 unknown, 24% were ER-/Her2 unknown, and 29.7% had no data on ER status. Most patients underwent surgical resection (91.9%), whereas chemotherapy and radiation were utilized in 35.2% and 40.6% of the patients, respectively. At a median follow-up of 67.6 months, the 5-year OS was 74.3%. Among patients who received chemotherapy or radiation, the 5-year OS was 80.1% (vs. 68.9% in nonrecipients, P = .02) and 83.1% (vs. 68.5% in nonrecipients, P = .03), respectively. The 5-year OS was 82.7%, 76.5%, and 50% for tumor ≤ 2 cm, 2 to 5 cm, and > 5 cm respectively (P = .009). Chemotherapy or radiation treatment were associated with improved OS in tumors >5 cm (both P < .05).</p><p><strong>Conclusion: </strong>EMC demonstrates distinctive clinicopathologic features and receptor status. Receipt of adjuvant chemotherapy and radiation demonstrates improved survival in larger tumor (> 5cm) although small sample size and lack of recurrence data limit this conclusion. Studies using larger cohorts are needed to demonstrate objective efficacy of systemic treatment in lymph node positive and metastatic EMC.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398503","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":"Tranexamic Acid in Breast Surgery - A Systematic Review and Meta-Analysis.","authors":"Ali Raed Buheiri, Louise Tveskov, Laura Marie Dines, Josephine Dissing Bagge, Sören Möller, Camilla Bille","doi":"10.1016/j.clbc.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.01.011","url":null,"abstract":"<p><strong>Background: </strong>Hematoma formation is a possible postoperative occurrence following breast surgery. It might increase the risk of long-term complications and thereby delay start of adjuvant therapy. Tranexamic acid (TXA) is suggested to decrease the risk of postoperative hematoma, but the evidence is based on small and heterogeneous studies. The primary objective of this systematic review and meta-analysis is to assess the impact of TXA on hematoma formation and secondarily on drain output, time upon drain removal, seroma formation, infection incidents, and thromboembolic events.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Embase, Medline, Cochrane Library, and Google Scholar. Studies examining either intravenous or topically administered TXA were included and underwent risk of bias assessment.</p><p><strong>Results: </strong>A total of 989 studies were screened and 19 studies fulfilled the inclusion criteria. Of the 7673 breasts in total, topical TXA was given to 2106 breasts, intravenous to 1722 and the remaining 4347 breasts were controls having no TXA. Hematoma formation was significantly reduced by both topical administered TXA (RR, 0.33; 95% CI, 0.15-0.75) and intravenous TXA (RR, 0.45; 95% CI, 0.29-0.68) across all breast procedures. The same result was found when only including oncological breast procedures; topical TXA (RR, 0.16; 95% CI, 0.05-0.56) and intravenous TXA (RR, 0.50; 95% CI, 0.31-0.81). A reduction in drain output and time until drain removal was noted. No significant reduction in seroma formation was observed.</p><p><strong>Conclusion: </strong>Both topical and intravenous TXA in breast surgery significantly reduce hematoma and reduce drain output and time upon drain removal. Studies show no effect on seroma formation, infection rates, or thromboembolic events.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381648","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}