Clinical breast cancer最新文献

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Improving Prognostic Value in Invasive Triple Negative Breast Cancer Through a Combined Nomogram Approach. 联合影像学检查改善侵袭性三阴性乳腺癌的预后价值。
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-22 DOI: 10.1016/j.clbc.2024.11.013
Lian Li, Zhi Liu, Kairong Chen, Yingjia Li
{"title":"Improving Prognostic Value in Invasive Triple Negative Breast Cancer Through a Combined Nomogram Approach.","authors":"Lian Li, Zhi Liu, Kairong Chen, Yingjia Li","doi":"10.1016/j.clbc.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.013","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the potential prognostic value of ultrasound (US) features in conjunction with pathological markers and to develop a preliminary working model for predicting poor outcomes in patients with invasive triple-negative breast cancer (TNBC).</p><p><strong>Methods: </strong>From January 2012 to December 2018, we enrolled 209 TNBC patients treated with standard therapy, systematically gathered data on US parameters, stromal tumor-infiltrating lymphocytes (TILs), lymphovascular invasion (LVI) status, and other relevant information, and recorded follow-up data. A nomogram combining AJCC staging with US score, stromal TILs, and LVI was constructed and validated to predict poor outcomes, defined as recurrence or death, in patients with invasive TNBC.</p><p><strong>Results: </strong>The US score of 4 was best related to poor outcomes in patients with TNBC (HR 3.87, P = .015). In the training set, the nomogram had a considerably greater prognostic value [area under the curve (AUC), 0.74 vs. 0.64, P = .045] than AJCC staging alone, and it was comparable to that of the validation set (AUC, 0.71 vs. 0.63, P = .804). An acceptable consistency between the nomogram-predicted and actual survival probabilities was found both in the training and validation sets, with Brier scores of 0.15 and 0.13, respectively.</p><p><strong>Conclusions: </strong>The incorporation of AJCC stage with US score, stromal TILs, and LVI improved the model performance for predicting poor outcomes in patients with invasive TNBC compared to routine AJCC staging alone.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824027","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}
引用次数: 0
Climate Therapy: Sustainability Solutions for Breast Cancer Care in the Anthropocene Era. 气候疗法:人类世时代乳腺癌护理的可持续性解决方案。
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-21 DOI: 10.1016/j.clbc.2024.11.010
Seamus O'Reilly, Emer Lynch, E Shelley Hwang, Maura Brown, Theresa O'Donovan, Maeve A Hennessy, Geraldine McGinty, Aisling Barry, Catherine S Weadick, Roelof van Leeuwen, Matthijs van de Poll, Giuseppe Curigliano, Martin J O'Sullivan, Alexandra Thomas
{"title":"Climate Therapy: Sustainability Solutions for Breast Cancer Care in the Anthropocene Era.","authors":"Seamus O'Reilly, Emer Lynch, E Shelley Hwang, Maura Brown, Theresa O'Donovan, Maeve A Hennessy, Geraldine McGinty, Aisling Barry, Catherine S Weadick, Roelof van Leeuwen, Matthijs van de Poll, Giuseppe Curigliano, Martin J O'Sullivan, Alexandra Thomas","doi":"10.1016/j.clbc.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.010","url":null,"abstract":"<p><p>Climate change is the greatest threat to human existence. Currently it impacts breast cancer care by disrupting treatment, by food poverty and economic hardship and through fossil fuel pollution which increases breast cancer incidence. These impacts are greatest in those already experiencing deprivation. However, healthcare (including breast cancer care) is not an innocent bystander in climate change. The carbon emissions of healthcare are equivalent to the continent of Africa with 1.5 billion people. Like all other enterprises healthcare has an obligation to move to net zero carbon emissions. Previously conducted studies of healthcare professionals have highlighted the role of guidance documents to facilitate climate engagement by them. This prompted the formation of an interdisciplinary group to review the intersection points between breast cancer care and planetary health. A solution tree of sustainable solutions for practicing clinicians is proposed which can be integrated into daily clinical practice and into their personal lives.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817452","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}
引用次数: 0
Impact of METTL3/14/16 Gene Polymorphisms on Risk of Breast Cancer in Chinese Women. METTL3/14/16基因多态性对中国女性乳腺癌风险的影响
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-17 DOI: 10.1016/j.clbc.2024.11.008
Tiantian Wu, Ziang Shi, Saba Fida, Mingming Zhou, Yuanlin Zou, Shaobo Zhang, Haoqing Cheng, Pengxia Guo, Chuying Zhang, Gege Zhang, Chunhua Song
{"title":"Impact of METTL3/14/16 Gene Polymorphisms on Risk of Breast Cancer in Chinese Women.","authors":"Tiantian Wu, Ziang Shi, Saba Fida, Mingming Zhou, Yuanlin Zou, Shaobo Zhang, Haoqing Cheng, Pengxia Guo, Chuying Zhang, Gege Zhang, Chunhua Song","doi":"10.1016/j.clbc.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.008","url":null,"abstract":"<p><strong>Objectives: </strong>Methyltransferase-like 3/14/16 (METTL3/14/16) presents the regulating valve in N6-methyladenosine (m<sup>6</sup>A) modification, involved in carcinogenesis. We addressed elucidating the relationship between single-nucleotide polymorphisms (SNPs) of the METTL3/14/16 gene and breast cancer (BC) susceptibility.</p><p><strong>Study design: </strong>A case-control study included 680 BC patients and 680 healthy controls, individually matched for age (±2 years).</p><p><strong>Methods: </strong>7 SNPs were screened by bioinformatics tools. Conditional Logistic analysis was used to explore the association between SNPs and BC susceptibility. SNPs-reproductive factors interaction was assessed. qRT-PCR was conducted to detect the METTL3/14/16 expression of different SNPs. The potential biomechanism was explored using bioinformatics tools.</p><p><strong>Results: </strong>Among the 7 analyzed SNPs, METTL3 rs1061026 T>G exhibited a significant association with reduced susceptibility to BC. The TC+CC genotype of METTL14 rs428409 elevated BC risk, while the AG+GG genotype of METTL14 rs3087958 restrained BC risk. The stratified analysis further identified the protective effect of rs1061026 T>G and rs3087958 T>G, and the detrimental effect of rs428409 T>G in specific subgroups. Haplotype analysis revealed that haplotypes G<sub>rs1061026</sub>C<sub>rs1061027</sub> and G<sub>rs368669</sub>Tr<sub>s428409</sub>G<sub>rs3087958</sub> were protective for BC. BC patients who carried the C allele in METTL14 rs428409 were more likely to be HER-2 positive. Individuals with age at menarche ≥14, number of pregnancies >1, and G allele in rs1061026 had a 47.7% decreased risk of BC. There were considerable multiplicative interactions between SNPs and reproductive factors. The relative expression of METTL3/14 was altered due to rs1061026 T>G, rs428409 T>C, and rs3087958 A>G. These three SNPs might interfere with the m<sup>6</sup>A modification and the expression level of BC-related genes.</p><p><strong>Conclusion: </strong>Our findings suggested that rs1061026 T>G, rs428409 T>C, and rs3087958 A>G might be associated with the risk of BC.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791273","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}
引用次数: 0
Assessing Outcomes of Tapering 12-Hour and 6-Hour Dexamethasone Prior to Paclitaxel Infusions in Patients With Breast Cancer. 评估乳腺癌患者在紫杉醇输注前逐渐减少12小时和6小时地塞米松的结果。
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-17 DOI: 10.1016/j.clbc.2024.11.009
Shawna L Kuhlers, Emily Kathol, David Hartnett-Quach, Jairam Krishnamurthy, Kealy Marth
{"title":"Assessing Outcomes of Tapering 12-Hour and 6-Hour Dexamethasone Prior to Paclitaxel Infusions in Patients With Breast Cancer.","authors":"Shawna L Kuhlers, Emily Kathol, David Hartnett-Quach, Jairam Krishnamurthy, Kealy Marth","doi":"10.1016/j.clbc.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.009","url":null,"abstract":"<p><strong>Background: </strong>Paclitaxel has a boxed warning for causing severe hypersensitivity reactions, however, the majority (95%) of these reactions occur during the first or second infusion. Corticosteroids can reduce the incidence of paclitaxel hypersensitivity reactions from 30% to around 1%-3% but are not without adverse effects. Current practice at our institution is to prescribe dexamethasone 20 mg to be given orally 12 and 6 hours prior to paclitaxel infusion, however, some medical oncology providers have elected to decrease or omit dexamethasone premedication.</p><p><strong>Methods: </strong>This retrospective study analyzed dexamethasone dose adjustment(s) prior to paclitaxel and the incidence of hypersensitivity reactions. Patients were included if they were ≥19 years, had breast cancer, received ≥3 doses of paclitaxel as part of (neo)adjuvant therapy, and received reduced or omitted oral dexamethasone prior to paclitaxel between January 1, 2015, and July 31, 2023. The primary outcome was incidence of rescue medication administration in those with reduced or omitted premedication dexamethasone. Secondary outcomes included dexamethasone prescribing practices and the incidence of corticosteroid-associated insomnia and hyperglycemia.</p><p><strong>Results: </strong>The analysis included 306 infusions (corticosteroid reduction: 283; omission: 23). A hypersensitivity reaction requiring the administration of rescue medications occurred in 5 infusions in the reduction group (1.6%) and 0 infusions in the omission group, leading to a 1.6% overall incidence of infusions requiring the administration of rescue medications.</p><p><strong>Conclusion: </strong>In conclusion, decreasing home dexamethasone prior to paclitaxel infusions did not increase the incidence of hypersensitivity reactions compared to rates reported in the literature.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812211","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}
引用次数: 0
Adjuvant Trastuzumab Plus Pertuzumab Versus Trastuzumab Alone in Patients Achieving Pathologic Complete Response After Chemotherapy With Trastuzumab and Pertuzumab: A Retrospective Cohort Study. 辅助曲妥珠单抗联合帕妥珠单抗与单独曲妥珠单抗在曲妥珠单抗和帕妥珠单抗化疗后达到病理完全缓解的患者:一项回顾性队列研究
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-13 DOI: 10.1016/j.clbc.2024.11.006
Yoonwon Kook, Jee Hung Kim, Ji Soo Jang, Soong June Bae, Seung Ho Baek, Joon Jeong, Joon Young Choi, Dong Seung Shin, Jai Min Ryu, Sung Gwe Ahn
{"title":"Adjuvant Trastuzumab Plus Pertuzumab Versus Trastuzumab Alone in Patients Achieving Pathologic Complete Response After Chemotherapy With Trastuzumab and Pertuzumab: A Retrospective Cohort Study.","authors":"Yoonwon Kook, Jee Hung Kim, Ji Soo Jang, Soong June Bae, Seung Ho Baek, Joon Jeong, Joon Young Choi, Dong Seung Shin, Jai Min Ryu, Sung Gwe Ahn","doi":"10.1016/j.clbc.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>For patients who achieve pathologic complete response (pCR) after neoadjuvant chemotherapy with trastuzumab (T) and pertuzumab (P), the benefit of adding P to T remains uncertain. We compared survival outcomes according to the type of adjuvant anti-HER2 therapy in patients with pCR after chemotherapy with TP.</p><p><strong>Method: </strong>Patients who achieved pCR in both the breast and axilla after neoadjuvant chemotherapy with TP were included. Recurrence-free survival (RFS) and distant recurrence-free survival (DRFS) were evaluated. Univariate and multivariate Cox proportional hazards analyses were used to assess the impact of different adjuvant therapies on RFS and DRFS.</p><p><strong>Results: </strong>In total, 386 patients were included, with 69 (17.9%) receiving adjuvant TP and 317 (82.1%) receiving adjuvant T alone. At a median follow-up of 49 months, the 3-year RFS rate was 96.1%. There was no significant difference in the 3-year RFS between groups (94.2% in TP and 95.6% in T), with an adjusted hazard ratio (HR) of 1.15 (95% CI, 0.37-3.55, P = .806). In the clinical node-positive group (n = 294), there was no difference in survival between groups (HR 1.64, 95% CI, 0.58-4.65, P = .35). The multivariate analysis showed no significant predictors of recurrence or distant recurrence, including clinical tumor size, nodal status, ER/PR/HER2 status, and adjuvant radiotherapy receipt. Among 11 patients with brain metastasis after pCR, there was no difference according to the type of adjuvant anti-HER2 therapy.</p><p><strong>Conclusions: </strong>In patients with pCR who responded to chemotherapy and dual HER2 blockade (TP), the 3-year RFS and brain metastasis-free survival did not differ according to the type of adjuvant anti-HER2 therapy.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766638","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}
引用次数: 0
Metronomic Chemotherapy in Breast Cancer as a Strategy to Deliver More Sustainable and Less Toxic Treatments: Time to Debunk the Myth? 节拍化疗在乳腺癌中作为提供更可持续和更低毒性治疗的策略:是时候揭穿这个神话了?
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-12 DOI: 10.1016/j.clbc.2024.11.003
Elena Battaiotto, Simeone d'Ambrosio, Dario Trapani, Giuseppe Curigliano
{"title":"Metronomic Chemotherapy in Breast Cancer as a Strategy to Deliver More Sustainable and Less Toxic Treatments: Time to Debunk the Myth?","authors":"Elena Battaiotto, Simeone d'Ambrosio, Dario Trapani, Giuseppe Curigliano","doi":"10.1016/j.clbc.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.003","url":null,"abstract":"<p><p>Breast cancer is the most commonly diagnosed cancer in women, worldwide. With the increasing burden of breast cancer, the search for more tolerable and sustainable treatments is required, to result in broader access to cancer treatments. Metronomic chemotherapy defines the use of chemotherapy agents based on low-dose, continuous regimens, as opposed to traditional treatments administered for limited intervals, at higher dose. The use of metronomic chemotherapies has been envisioned often as a way to reduce toxicity while maintaining similar efficacy, and result in reduced health system resource utilization, while tailoring some special populations' needs, such as the older adults with cancer. In our review, we provide a revision of the data available on the use of metronomic chemotherapy in breast cancer, as stratified per setting of use and subtypes of diseases. Clinical trials evaluating head-to-head metronomic and nonmetronomic schedules of chemotherapies broadly failed to meet their endpoints of noninferiority and/or superiority in term of safety, showing more often similar burden of adverse effect. Efficacy was also usually comparable. Data on financial implications appeared limited, and not conclusive of economic and health system benefits with the use of metronomic schedules. Our review of the evidence suggests that broad implementation of metronomic chemotherapy to enhance sustainability and safety may be not appropriate in all settings, as data for the optimized use are still warranted. The use of metronomic chemotherapy in breast cancer as a mean to improve tolerability, reduce treatment-related complications and associate costs and enhance sustainability of cancer treatments should not be pursued as an ultimate solution, in all settings of breast cancer treatment. Standard treatments having robustly proved to improve patient outcomes are to be prioritised for first, unless data suggest otherwise with these regimens.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766747","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}
引用次数: 0
Plasma-free Amino Acid Profile is Beneficial for Breast Cancer Screening in Women With Dense Breasts. 无血浆氨基酸谱对致密乳房妇女的乳腺癌筛查有益。
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-12 DOI: 10.1016/j.clbc.2024.11.001
Saeko Teraoka, Hiroshi Yamamoto, Shinya Kikuchi, Yoshiya Horimoto, Kimito Yamada, Hiroshi Kaise, Mari Hosonaga, Takahiko Kawate, Kana Miyahara, Ai Ueda, Mariko Asaoka, Miki Okazaki, Natsuki Uenaka, Saori Kawai, Takashi Ishikawa
{"title":"Plasma-free Amino Acid Profile is Beneficial for Breast Cancer Screening in Women With Dense Breasts.","authors":"Saeko Teraoka, Hiroshi Yamamoto, Shinya Kikuchi, Yoshiya Horimoto, Kimito Yamada, Hiroshi Kaise, Mari Hosonaga, Takahiko Kawate, Kana Miyahara, Ai Ueda, Mariko Asaoka, Miki Okazaki, Natsuki Uenaka, Saori Kawai, Takashi Ishikawa","doi":"10.1016/j.clbc.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>AminoIndex™ Cancer Screening (AICS breast) was developed as a breast cancer screening test using multivariate analysis of plasma free amino acid (PFAA) profiles. This study investigated the relationship between the AICS breast rank and breast density on mammography (MMG) for the detection of breast cancer.</p><p><strong>Materials and methods: </strong>MMG and blood samples were obtained preoperatively from 224 patients with breast cancer who did not receive neoadjuvant chemotherapy between 2017 and 2019. PFAA concentration was measured using liquid chromatography-mass spectrometry, and the AICS breast and AICS ranks were calculated. Detection rates were compared between MMG (categories 3-5) and AICS breasts (ranks B and C) according to breast density.</p><p><strong>Results: </strong>Breast density was classified as extremely dense in 9.4%, heterogeneously dense in 48.2%, scattered in 29.9%, and fatty in 12.5% of patients. Dense breasts (extremely dense and heterogeneously dense) represented 57.6%. The overall detection rate by MMG was 82.6% and significantly lower in patients with dense breasts (74.4%) compared to non-dense breasts (93.7%). The overall detection rate by AICS breast was 50.0%, with no difference between patients with dense breasts (45.7%) and those with non-dense breasts (55.8%). The combination of MMG and AICS breast increased the detection rate to 91.5% overall, 88.3% in patients with dense breasts, and 95.8% in those with non-dense breasts.</p><p><strong>Conclusion: </strong>This study demonstrated that the detection rate of AICS breast was not associated with breast density, unlike MMG. Adding AICS breast to MMG may be beneficial for breast cancer screening in patients with dense breasts.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817454","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}
引用次数: 0
Is Axillary Lymph Node Dissection Needed? Clinicopathological Correlation in a Series of 224 Neoadjuvant Chemotherapy-Treated Node-Positive Breast Cancers. 腋窝淋巴结是否需要清扫?224例新辅助化疗治疗淋巴结阳性乳腺癌的临床病理相关性
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-10 DOI: 10.1016/j.clbc.2024.11.007
Sean M Hacking, Dongling Wu, Charu Taneja, Theresa Graves, Liang Cheng, Yihong Wang
{"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, Dongling Wu, Charu Taneja, Theresa Graves, Liang Cheng, Yihong Wang","doi":"10.1016/j.clbc.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>De-escalation of axillary surgery to SLNB alone in this context may be safely considered in neoadjuvant-treated clinical node positive patient with <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.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-10","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}
引用次数: 0
Madarosis Among Breast Cancer Survivors: Correspondence. 乳腺癌幸存者中的马达病:通信。
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-08 DOI: 10.1016/j.clbc.2024.11.004
Hinpetch Daungsupawong, Viroj Wiwanitkit
{"title":"Madarosis Among Breast Cancer Survivors: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.clbc.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.004","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766717","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}
引用次数: 0
Clinical and Imaging Features Associated With Malignant Focal Nonmass Enhancement on Breast MRI. 与乳腺 MRI 恶性病灶非肿块增强相关的临床和成像特征。
IF 2.9 3区 医学
Clinical breast cancer Pub Date : 2024-11-07 DOI: 10.1016/j.clbc.2024.11.002
Eumee Cha, Emily B Ambinder, Eniola T Oluyemi, Lisa A Mullen, Babita Panigrahi, Joanna Rossi, Philip Di Carlo, Kelly S Myers
{"title":"Clinical and Imaging Features Associated With Malignant Focal Nonmass Enhancement on Breast MRI.","authors":"Eumee Cha, Emily B Ambinder, Eniola T Oluyemi, Lisa A Mullen, Babita Panigrahi, Joanna Rossi, Philip Di Carlo, Kelly S Myers","doi":"10.1016/j.clbc.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.11.002","url":null,"abstract":"<p><strong>Introduction: </strong>Focal non-mass enhancement (NME) is a common breast MRI finding with limited data to guide management. This study aimed to assess clinical and imaging features of malignant BI-RADS 4 focal NME.</p><p><strong>Methods: </strong>This IRB-approved, retrospective study included breast MRI exams between August 1, 2013 and September 1, 2022 yielding BI-RADS 4 focal NME lesions that underwent core biopsy or excision with available pathology result or demonstrated decrease or resolution during follow-up MRI or at least 2 years of MRI stability.</p><p><strong>Results: </strong>A total of 296 BI-RADS 4 focal NME lesions in 246 patients were included in the study. The overall malignancy rate of BI-RADS 4 focal NME was 36/296 (12.2%). Focal NME in a patient presenting for evaluation of extent of disease or other diagnostic concern was 5.5 and 3.4 times more likely, respectively, to be malignant compared to focal NME seen on a high-risk screening exam. There was also a significant association between malignancy and focal NME that was brighter than background parenchymal enhancement (BPE) on maximum intensity projection (MIP) images. There was no significant association between malignancy and lesion size, internal enhancement pattern, amount of BPE, amount of fibroglandular tissue, or signal intensity on T2-weighted images.</p><p><strong>Conclusion: </strong>Our study yielded a malignancy rate of 12.2% for BI-RADS 4 focal NME lesions. Indication for MRI and signal intensity compared to BPE on MIP images were features associated with malignancy that may provide guidance on the management for focal NME.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738647","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}
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