Clinical breast cancer最新文献

{"title":"A Decade of Human Epidermal Growth Factor Receptor 2 (HER2) Testing in Breast Cancer in Spain: A Comprehensive Real-World Data Analysis (2013-2023)","authors":"Vicente Peg,&nbsp;Octavio Burgués,&nbsp;Irune Ruiz,&nbsp;David Carcedo,&nbsp;José Francisco García,&nbsp;Mario A. Monzón Naranjo,&nbsp;Ivana Tonic,&nbsp;Teresa Echeverría,&nbsp;Ana Segura,&nbsp;Natividad Alfonsín,&nbsp;María Concepción Fiaño,&nbsp;Belén Pérez-Mies","doi":"10.1016/j.clbc.2026.04.009","DOIUrl":"10.1016/j.clbc.2026.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Evaluating human epidermal growth factor receptor 2 (HER2) expression is essential for guiding targeted therapies in breast cancer (BC). In Spain, the CONFIRMA-HER2 registry is the main source of information on HER2 testing in BC. The aim of this analysis was to describe the HER2 status in BC and how it has evolved over the 10 years of the CONFIRMA-HER2 registry.</div></div><div><h3>Materials and Methods</h3><div>A retrospective observational study of HER2 testing (2013-2023) was conducted in BC samples from 160 Spanish hospitals, recorded in the CONFIRMA-HER2 registry. The analysis assessed rates and performance of immunohistochemistry (IHC) and in situ hybridization (ISH), as well as assessing changes in HER2 positivity over time.</div></div><div><h3>Results</h3><div>A total of 199,934 HER2 determinations recorded in the CONFIRMA HER2 registry were analyzed. IHC results showed 35.5% IHC 0, 27.8% IHC 1+, 22.7% IHC 2+, 11.2% IHC 3+, and 2.9% invalid/not evaluable. ISH was performed in 26.4% of cases, with 82.1% showing nonamplified HER2 gene status. Overall, 15.0% were HER2-positive, 83.2% HER2-negative, and 1.8% invalid/not assessable. Among HER2-negative cases, 54.9% were classified as HER2-low. Over time, HER2 positivity rates varied, likely reflecting changes in clinical practice influenced by updated guidelines.</div></div><div><h3>Conclusion</h3><div>To our knowledge, this study is the first to compile and analyze the largest amount of real-world HER2 testing data in Spain. The CONFIRMA-HER2 registry is a key tool that provides comprehensive information on HER2 status as determined by IHC and ISH.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 104-112.e1"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811718","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":"Despite Advances, Repeat Breast-Conserving Surgery Rates Persist: A 25-Year National Analysis of Breast-Conserving Surgery in Australia","authors":"Magdalena Sejka MD,&nbsp;Anita Skandarajah MD,&nbsp;Christobel Saunders MBBS","doi":"10.1016/j.clbc.2026.04.015","DOIUrl":"10.1016/j.clbc.2026.04.015","url":null,"abstract":"<div><div><strong>Using Australian Medicare Benefits Schedule data from 2000-2024, this national study examined repeat breastconserving surgery after initial excision for breast cancer. Repeat procedures remained persistently high (18.6%) despite evolving margin guidelines and surgical advances, with marked interstate variation. Younger patients had higher repeat surgery rates, and estimated annual system costs exceeded AUD $12 million</strong>.</div></div><div><h3>Background</h3><div>Re-excision following breast-conserving surgery (BCS) remains a key indicator of surgical quality. Although adoption of the 2014 Society of Surgical Oncology and American Society for Radiation Oncology (SSO–ASTRO) “no tumor on ink” margin guideline, advances in imaging and oncoplastic techniques were expected to substantially reduce re-excision, national trends in Australia have not been well studied.</div></div><div><h3>Methods</h3><div>We performed a retrospective population-based analysis using publicly available Medicare Benefits Schedule (MBS) procedural data from 2000 to 2024. Initial BCS procedures (MBS 31512 and, from 2023, 31513-31514) were used as denominators and re-excisions (MBS 31515) as numerators to calculate annual and state-based re-excision proportions. Demographic variation was assessed by age group and jurisdiction. Health-system costs were estimated using 2024 to 2025 National Weighted Activity Unit pricing.</div></div><div><h3>Results</h3><div>Over 25 years, 171,715 BCS procedures and 31,987 repeat BCS were recorded, yielding a national repeat BCS proportion of 18.6%. Following publication of the SSO–ASTRO guideline, repeat BCS decreased modestly from 19.5% (2003-2013) to 18.1% (2014-2024; <em>P</em> &lt; .001) but remained persistently high. Younger patients exhibited higher re-excision proportions, while substantial geographic variation was observed across states and territories (range 12.1%-24.1%). Mastectomy volumes stabilized over time while BCS volumes continued to rise. System-level costs attributable to re-excision exceeded AUD $12 million in 2024 alone.</div></div><div><h3>Conclusions</h3><div>Despite technical advances and consensus margin guidelines, national re-excision proportions after BCS have shown only marginal improvement over 25 years and remain geographically heterogeneous. Though our data cannot describe the true national re-excision rate, these findings indicate persistent system-level barriers to optimal margin clearance and highlight opportunities for national quality improvement.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 153-160"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027631","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":"Clinicopathological Characterization of HER2-Low-Expressing Triple-Negative Breast Cancer: Distinct Features From HER2-Zero Subtype","authors":"Michiko Kato,&nbsp;Hiroko Masuda,&nbsp;Sayuka Nakayama,&nbsp;Jun Ohara,&nbsp;Miharu Kano,&nbsp;Karen Suyama,&nbsp;Reika Yoshida,&nbsp;Asako Tsuruga,&nbsp;Yosuke Sasaki,&nbsp;Masafumi Takimoto,&nbsp;Naoki Hayashi,&nbsp;Toshiko Yamochi","doi":"10.1016/j.clbc.2026.04.008","DOIUrl":"10.1016/j.clbc.2026.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Triple-negative breast cancer (TNBC) is an aggressive disease characterized by a poor prognosis and marked biological heterogeneity. Recently, HER2-low tumors have emerged as potential therapeutic targets. However, the clinical and biological significance of HER2-low TNBC remains unclear.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 195 patients with primary TNBC treated at our institution between April 2014 and May 2023. Clinicopathological data, including histological subtype, androgen receptor (AR) expression, <em>BRCA</em> mutation status, Ki-67 index, epidermal growth factor receptor, CK5/6, nuclear grade, and treatment response, were collected. Tumor-infiltrating lymphocytes (TILs) and programmed cell death 1 ligand 1 (PD-L1) expression were assessed in available biopsy samples. Patients were classified into HER2-low (immunohistochemistry [IHC] 1+ or IHC 2+ and fluorescence in situ hybridization negative) and HER2-zero (IHC 0) groups.</div></div><div><h3>Results</h3><div>Among the 195 TNBC cases, 74 (38%) were HER2-low and 121 (62%) were HER2-zero. HER2-low tumors showed higher rates of apocrine carcinoma (32% vs. 15%) and AR positivity (47% vs. 21%). Conversely, HER2-zero tumors exhibited a higher prevalence of <em>BRCA</em> mutations (36% vs. 15%), elevated Ki-67 expression (69% vs. 54%), and increased PD-L1 positivity (63% vs. 44%). TILs correlated with PD-L1, but not with HER2 status. The pathological complete response rates after neoadjuvant chemotherapy were similar between groups.</div></div><div><h3>Conclusion</h3><div>HER2-low and HER2-zero TNBC are biologically distinct subgroups. HER2-low tumors are enriched in luminal AR-like characteristics, whereas HER2-zero tumors exhibit basal-like, highly proliferative, and immunogenic features. Although the treatment outcomes did not differ significantly, these findings suggest that HER2-low and HER2-zero TNBC may require different therapeutic approaches. Prospective studies are warranted to validate these findings and further explore tailored treatment strategies.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 6","pages":"Pages 97-103"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013939","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":"Beyond Pathology: MRI-derived Metrics Unlock Preoperative Prognostic Risk Stratification in Breast Cancer","authors":"Mehrad Zare ,&nbsp;Alisa Mohebbi ,&nbsp;Afshin Mohammadi ,&nbsp;Seyed Mohammad Tavangar","doi":"10.1016/j.clbc.2026.03.017","DOIUrl":"10.1016/j.clbc.2026.03.017","url":null,"abstract":"<div><h3>Background</h3><div>The Nottingham Prognostic Index (NPI) remains the gold-standard for breast cancer (BC) prognostic risk stratification, yet its reliance on postoperative pathology delays critical treatment decisions. We hypothesized that MRI could unlock prognostic insights before surgery, enabling immediate preoperative risk classification without waiting for histology.</div></div><div><h3>Methods</h3><div>In a retrospective cohort of 791 patients with invasive BC, we leveraged quantitative (tumor size, volume, and enhancement metrics) and categorical (presence or absence of axillary lymphadenopathy, multicentricity, contralateral disease, chest wall and skin involvement) MRI features to predict high-risk NPI grades (&gt;3.4). Discriminative performance was determined by receiver operating characteristic analysis and multivariable logistic regression, with stratification by molecular subtype, tumor size, and breast density.</div></div><div><h3>Results</h3><div>Quantitative MRI metrics demonstrated strong discriminatory power; tumor size and total enhancing volume achieved area under curve (AUC) of 0.855 and 0.867, while washout-enhancing volume provided vascular insights (AUC 0.828). Notably, performance varied by tumor biology; volumetric metrics dominated in HER2-enriched tumors (AUC 0.965) and washout kinetics excelled in triple-negative disease (AUC 0.932). Among categorical features, axillary lymphadenopathy and multicentricity contributed complementary prognostic value. Integration of 3 selected parameters of tumor size, lymphadenopathy, and multicentricity yielded a robust combined model (AUC 0.883) with 89.8% sensitivity and 72.0% specificity. Critically, MRI metrics remained robust across breast density categories.</div></div><div><h3>Conclusion</h3><div>MRI serves as a powerful noninvasive proxy for pathological NPI, enabling risk-stratified preoperative counseling and treatment planning. Molecular subtype-tailored MRI interpretation offers a precision medicine pathway toward individualized breast cancer management before surgery.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 5","pages":"Pages 140-153.e3"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764202","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":"Real-World Evidence of Immunohistochemical Discordance in Breast Cancer Brain Metastases","authors":"Giselle de Souza Carvalho ,&nbsp;Fabiana Resende Rodrigues ,&nbsp;Priscila Valverde Fernandes ,&nbsp;Isabele Ávila Small ,&nbsp;Jessé Lopes da Silva ,&nbsp;Luiz Henrique Lima Araujo","doi":"10.1016/j.clbc.2026.03.002","DOIUrl":"10.1016/j.clbc.2026.03.002","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer brain metastases (BCBM) occur in 20-40% of patients with advanced breast cancer (BC), mainly in HER2-positive and triple-negative subtypes. Phenotypic shifts may arise, driven by alterations in the tumor microenvironment. However, due to the limited availability of BCBM specimens, data on immunohistochemical (IHC) discordance at this site remains scarce. This study aimed to determine the frequency of IHC discordance between primary BC and paired BCBM.</div></div><div><h3>Methods</h3><div>This retrospective study included women who underwent neurosurgical resection for BCBM between January 2015 and December 2022 at the Brazilian National Cancer Institute (INCA). IHC markers — ER, PR, HER2, and Ki67 — were assessed in BCBM samples and compared with the corresponding archival of primary BC specimens. A descriptive analysis was primarily conducted to determine the frequency of IHC discordance, followed by survival analyses.</div></div><div><h3>Results</h3><div>Among the 105 eligible patient-cases, 33 (32%) were HR⁺/HER2⁻, 35 (33%) HR⁺/HER2⁺, 16 (15%) HR⁻/HER2⁺, and 19 (18%) triple-negative. IHC discordance between primary BC and BCBM was found in 46 (44%) patients. The most common phenotypic changes were loss of ER/PR expression (35, 76%) and enrichment of HER2 expression (7, 15%). IHC profile change was not associated with differences in survival outcomes, including progression-free survival after BCBM diagnosis (p = 0.81), overall survival (OS) (<em>p</em> = 0.96), or OS after BCBM diagnosis (<em>p</em> = 0.53).</div></div><div><h3>Conclusion</h3><div>A notably high frequency of IHC discordance between primary BC and BCBM was observed, exceeding rates previously reported. Recognizing this heterogeneity may guide more personalized treatment approaches.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 5","pages":"Pages 112-120.e3"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590453","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":"Thromboelastography Characterizes the Hypercoagulable State in Murine and Human Breast Cancer","authors":"Britney Niemann ,&nbsp;William Harvey ,&nbsp;Kristen Ranson ,&nbsp;Cristal Espinosa ,&nbsp;Hannah E. Hoblitzell ,&nbsp;Pavan Rao ,&nbsp;Kristin Lupinacci ,&nbsp;Kimberly Bailey ,&nbsp;Hannah Hazard-Jenkins ,&nbsp;Jessica Partin ,&nbsp;Timothy D. Eubank ,&nbsp;Brian A. Boone","doi":"10.1016/j.clbc.2026.03.018","DOIUrl":"10.1016/j.clbc.2026.03.018","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is associated with an increased risk of cancer-associated thrombus (CAT), which is linked to worsened prognosis. Despite malignancy being a known risk factor for hypercoagulability, methods to quantify the pro-thrombotic state and stratify patients are lacking. The goal of our study is to utilize whole blood TEG to quantify a hypercoagulable state in breast cancer murine models and patients.</div></div><div><h3>Methods</h3><div>Citrated whole blood was obtained for TEG analysis from polyoma middle tumor-antigen (PyMT) transgenic mice, who develop spontaneous breast tumors, their age-matched control litter mates, and newly diagnosed, untreated breast cancer patients seen in our multi-disciplinary clinic. Blood samples were placed in disposable cups without heparinase. Calcium chloride was added to reverse effects of sodium citrate. Values for R (min), K (min), alpha angle (degrees), maximum amplitude (MA, mm), coagulation index (CI), and lysis 30 (LY30) were analyzed.</div></div><div><h3>Results</h3><div>PyMT mice demonstrated elevated MA levels relative to age-matched controls, with a stepwise increase observed with advancing breast cancer stages. CI was significantly elevated in stage II through stage IV. Patient correlative samples also exhibited a hypercoagulable state across all invasive stages, as well as in ductal carcinoma in situ, characterized by increased R, alpha angle, and CI values, alongside a reduction in K. Stage IV patients exhibited an elevated MA. Estrogen receptor status did not impact TEG parameters. Four patients developed CAT.</div></div><div><h3>Conclusion</h3><div>TEG effectively identified hypercoagulability in murine and human breast cancer, normalized by aspirin in mice. This supports TEG’s potential for dynamic CAT risk stratification for personalized prophylaxis.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 5","pages":"Pages 154-161.e1"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764318","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 in Transgender Patients Following Medical and Surgical Intervention","authors":"David Gilbert ,&nbsp;Ayush Thakur ,&nbsp;Tomasz Tabernacki ,&nbsp;Matthew Loria ,&nbsp;Mart Andrew Maravillas ,&nbsp;Shubham Gupta ,&nbsp;Kirtishri Mishra ,&nbsp;Megan McNamara","doi":"10.1016/j.clbc.2026.03.014","DOIUrl":"10.1016/j.clbc.2026.03.014","url":null,"abstract":"<div><h3>Background</h3><div>Current breast cancer (BCa) screening guidance does not adequately address transgender populations despite differences in hormone exposure and post-surgical anatomy.</div></div><div><h3>Materials and Methods</h3><div>Using the TriNetX network (2003-2023), transgender adults were identified using ICD-10 codes and grouped by sex assigned at birth and intervention: no intervention (NI), hormone therapy (HT ≥ 1 year), or HT with surgery (SX). BCa was defined as ≥ 2 diagnoses of malignant breast neoplasm (ICD-10 C50.x).</div></div><div><h3>Results</h3><div>Among 33,775 transgender women, 12 (0.036%) developed BCa. HT alone was not associated with increased odds of BCa diagnosis. Among 44,117 transgender men, 37 (0.084%) developed BCa. Combined HT and chest surgery was associated with higher odds of BCa diagnosis compared with NI. Older age at diagnosis and Black race were significant predictors in both cohorts.</div></div><div><h3>Conclusions</h3><div>HT alone was not associated with increased breast cancer risk in transgender individuals. However, residual breast tissue after chest surgery may contribute to persistent risk in transgender men, supporting individualized screening strategies based on intervention type, age, and race.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 5","pages":"Pages 100-111"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802927","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":"Cost-Minimization Analysis of Vacuum-Assisted Biopsy Versus Surgical Biopsy for the Diagnosis of Suspicious Breast Lesions in the Brazilian Public Health System","authors":"Andressa Gonçalves Amorim ,&nbsp;André Mattar ,&nbsp;Marcelo Antonini ,&nbsp;Claudia Ribeiro Martins Cabrera ,&nbsp;Marina Diógenes Teixeira ,&nbsp;Francisco Pimentel Cavalcante ,&nbsp;Felipe Pereira Zerwes ,&nbsp;Eduardo Camargo Millen ,&nbsp;Fabricio Palermo Brenelli ,&nbsp;Antônio Luiz Frasson ,&nbsp;Marcelo Madeira ,&nbsp;Gil Facina ,&nbsp;Henrique Lima Couto ,&nbsp;Marcellus do Nascimento Moreira Ramos ,&nbsp;Patrícia Rodrigues Alves de Figueiredo Moraes ,&nbsp;Marina Fleury de Figueiredo ,&nbsp;Reginaldo Guedes Coelho Lopes ,&nbsp;Luiz Henrique Gebrim","doi":"10.1016/j.clbc.2026.03.013","DOIUrl":"10.1016/j.clbc.2026.03.013","url":null,"abstract":"<div><h3>Background</h3><div>Breast biopsy is important in the diagnostic pathway for suspicious mammographic findings. Although vacuum-assisted biopsy (VAB) offers recognized technical and clinical advantages over surgical biopsy (SB), including reduced invasiveness and faster recovery, its economic impact within public healthcare systems remains insufficiently characterized, especially in low- and middle-income countries.</div></div><div><h3>Methods</h3><div>We performed a cost-minimization analysis comparing VAB and SB within the Brazilian public healthcare system. A decision tree model with a 1-month time horizon was developed using real-world data from 1833 consecutive biopsy procedures conducted at a high-volume public cancer center. Clinical equivalence was assumed based on comparable diagnostic accuracy between techniques. Costs were assessed from institutional (hospital provider), public payer (Sistema Único de Saúde [SUS]), and societal. Deterministic sensitivity and break-even analyses were conducted to test model robustness.</div></div><div><h3>Results</h3><div>From the institutional perspective, VAB generated mean savings of USD 223 per patient compared with SB. From the societal perspective, savings reached USD 353 per patient, largely driven by shorter recovery times and lower productivity losses. Conversely, from the SUS payer perspective, VAB was associated with higher direct reimbursement costs, with an incremental cost of USD 146 per patient. Sensitivity and break-even analyses confirmed the stability of these findings across wide parameter variations.</div></div><div><h3>Conclusion</h3><div>Within a public healthcare setting, VAB represents a more economically efficient diagnostic strategy than SB from institutional and societal perspectives, despite higher upfront reimbursement costs. Aligning payment policies with high-value, minimally invasive approaches may improve efficiency and equitable access in breast cancer diagnosis.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 5","pages":"Pages 130-139.e1"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764166","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":"Subtype-Specific Risk and Temporal Dynamics of Brain Metastases in Metastatic Breast Cancer","authors":"Kyoo Hyun Kim ,&nbsp;Joohyuk Sohn ,&nbsp;Min Hwan Kim ,&nbsp;Jee Hung Kim ,&nbsp;Jee Hyun Ahn ,&nbsp;Jee Ye Kim ,&nbsp;Hyung Seok Park ,&nbsp;Seho Park ,&nbsp;Seung-Il Kim ,&nbsp;Joon Jeong ,&nbsp;Gun Min Kim","doi":"10.1016/j.clbc.2026.03.010","DOIUrl":"10.1016/j.clbc.2026.03.010","url":null,"abstract":"<div><h3>Background</h3><div>Despite advancements in breast cancer treatments, brain metastases (BM) remain a major clinical challenge in metastatic breast cancer (MBC), adversely affecting survival and quality of life. This study investigates the lifetime incidence, temporal trends, and survival outcomes of BM across different breast cancer subtypes in patients with MBC.</div></div><div><h3>Patients and Methods</h3><div>We retrospectively analyzed a database of 2311 MBC patients treated between 2005 and 2024 at Yonsei Cancer Center and Gangnam Severance Hospital in Korea. Clinical, radiologic, and molecular data were extracted from the institutional database. BM incidence rates were compared across subtypes. Survival outcomes were analyzed based on BM burden and local treatment strategies.</div></div><div><h3>Results</h3><div>BM developed in 22.7% (525/2311) of MBC patients throughout the disease course. The incidence was highest in HER2-positive(+) (34.2%) and triple-negative breast cancer (TNBC) (33.0%) subtypes, while significantly lower in HR+/HER2− breast cancer (14.4%). The annual incidence of BM showed an early peak pattern, with 94.7% of TNBC cases and 82.2% of HER2+ cases occurring within the first 3 years of metastatic disease. In contrast, HR+/HER2− cases showed no distinct peak pattern over time. Survival outcomes were closely linked to tumor burden, including the number of BM lesions (<em>P</em> <em>&lt;</em> .0001) and the presence of symptoms (<em>P</em> <em>=</em> .021).</div></div><div><h3>Conclusion</h3><div>This study highlights the high risk of early BM in HER2+ and TNBC subtypes, with most cases occurring within the first 3 years of metastatic disease. These findings support the need for early surveillance strategies in these high-risk groups to enable timely detection and intervention.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 5","pages":"Pages 121-129.e4"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697261","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 Post-Neoadjuvant Chemotherapy Biomarker Changes on Long-Term Oncological Outcomes in Non-pCR Breast Cancer","authors":"Yige Lu ,&nbsp;Quan Yuan ,&nbsp;Hao Yu ,&nbsp;Xiaoming Li ,&nbsp;Yupeng Sha ,&nbsp;Yingze Zhu ,&nbsp;Ming Niu ,&nbsp;Hui Pang","doi":"10.1016/j.clbc.2026.02.006","DOIUrl":"10.1016/j.clbc.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>The present study is designed to ascertain the occurrence rate of biomarker changes in different subtypes and their influence on the survival prognosis of breast cancer (BC) patients after neoadjuvant chemotherapy (NAC). A pathological complete response (pCR) in BC after NAC foretells a favorable prognosis, while patients who do not achieve pCR (non-pCR) may have alterations in certain biomarker profiles.</div></div><div><h3>Methods</h3><div>Upon institutional review board approval, we analyzed data from 3151 BC patients treated with NAC from August 2008 to December 2019. Biomarker alterations (HR, HER2) were independently evaluated by 2 to 3 senior pathologists, with follow-up ending December 31, 2024. We applied the Cox model and Kaplan–Meier curves to assess the impact of biomarker changes on Overall Survival (OS), Invasive Disease-Free Survival (iDFS), and Distant Disease-Free Survival (DDFS).</div></div><div><h3>Result</h3><div>A total number of 2417 non-pCR patients were included in the analysis, with 14.15% experiencing changes in biomarker profiles. HER2-positive patients had the highest rate of change post-NAC (28.01%, 184/657). HR-positive patients converting to TNBC or HR-/HER2+ had significantly poorer outcomes, with hazard ratios of 2.58 (95% CI, 1.75-3.80; <em>P</em> &lt; .001) and 1.61 (95% CI, 1.61-2.50; <em>P</em> = .035), respectively. Conversely, TNBC patients with upregulated hormone receptors experienced improved prognosis, with a hazard ratio of 0.67 (95% CI, 0.46-0.97; <em>P</em> = .036).</div></div><div><h3>Conclusion</h3><div>Reassessment of biomarkers in residual disease (RD) may help inform Post-NAC decisions in routine clinical practice. This study reveals the impact of subtype conversion on long-term outcomes and offers theoretical support for re-evaluating RD and molecular re-stratification.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 4","pages":"Pages 144-149.e2"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472842","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}