Clinical breast cancer最新文献

{"title":"Effect of HER2-Low Expression on the Efficacy of CDK4/6 Inhibitors in Breast Cancer: A Meta-Analysis","authors":"Lingling Ye ,&nbsp;Yan Dai ,&nbsp;Liushan Chen ,&nbsp;Yuqi Liang ,&nbsp;Jiafa He ,&nbsp;Shenying Chen ,&nbsp;Xue Song ,&nbsp;Rui Xu ,&nbsp;Qianjun Chen","doi":"10.1016/j.clbc.2025.10.018","DOIUrl":"10.1016/j.clbc.2025.10.018","url":null,"abstract":"<div><div>CDK4/6 inhibitors combined with endocrine therapy have become the standard first-line and second-line therapy for advanced HR+/HER2- breast cancer. This study aimed to evaluate the impact of HER2 low expression on the efficacy of breast cancer patients treated with CDK4/6 inhibitors. We systematically searched 4 major databases and important conference proceedings up to May 2025, and screened out studies that reported the progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) in HR+/HER2-low breast cancer patients and HR+/HER2-zero breast cancer patients treated with CDK4/6 inhibitors. We calculated the pooled hazard ratio (HR) and its 95% confidence interval (CI). A total of 18 studies involving 8461 patients were finally included. Among them, HER2-low breast cancer patients accounted for 41.25% of the sample, and HER2-zero breast cancer patients accounted for 57.98% of the sample. The results showed that the progression-free survival (PFS) of HR+/HER2-low breast cancer patients treated with the combination of CDK4/6 inhibitors and endocrine therapy was significantly lower than that of HR+/HER2-zero breast cancer patients (HR = 1.19, 95% CI, 1.10-1.28, <em>P</em> &lt; .0001). Further subgroup analysis indicated that among HER2-low patients, whether they received first-line treatment, subsequent treatment, or were treated with Ribociclib, their prognosis was worse. Analysis of OS showed no statistically significant difference between groups (HR = 1.00, 95% CI, 0.93-1.07, <em>P =</em> .93). Similarly, no significant differences were observed in ORR. In addition, no significant differences in the PFS were observed in HR+/HER2-low breast cancer patients, regardless of whether the HER2 status changed due to treatment, the presence of visceral metastases. In conclusion, among patients receiving CDK4/6 inhibitor combined with endocrine therapy, HER2-low status was associated with significantly shorter PFS but not with significant differences in OS or ORR. However, it is worth noting that most of these studies are retrospective and real-world studies, with limited adjustments for confounding factors, and the statistical power of testing may be insufficient.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 223-234.e5"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582023","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":"Systemic Evaluation of Quality, Readability, and Integrity of Online Breast Reconstruction Resources","authors":"Reza Shahriarirad ,&nbsp;Nishant Kumar ,&nbsp;Aparna Vijayasekaran","doi":"10.1016/j.clbc.2025.09.021","DOIUrl":"10.1016/j.clbc.2025.09.021","url":null,"abstract":"<div><h3>Background</h3><div>Patients increasingly turn to online resources for breast reconstruction information, yet the quality, readability, and inclusivity of such materials remain unclear. This study assessed top-ranking websites for content accuracy, usability, visual representation, readability, and search engine visibility.</div></div><div><h3>Methods</h3><div>The top 10 English-language websites were selected based on rankings from major search engines and top search engine optimization (SEO) metrics. Two independent reviewers evaluated each site using JAMA benchmarks, the DISCERN instrument, and a modified EQIP tool. Readability was assessed using Flesch-Kincaid Reading Ease, Gunning Fog, SMOG, Coleman-Liau, Automated Readability Index, and the percentage of complex words. Additional analyses examined image diversity (skin tone and body type) and content. Inter-rater reliability was confirmed using Cohen’s κ and intraclass correlation coefficients.</div></div><div><h3>Results</h3><div>Twelve websites were analyzed, and only 41.7% met all 4 JAMA benchmarks. DISCERN scores rated just 1 site as “excellent,” with nonprofit sources performing significantly better (<em>P</em> = .019). EQIP findings showed only 25% were of good quality, with frequent gaps in procedural details and decision-making support. Sites covered 62.2% of essential content, with limited focus on financial aspects or patient experiences. Only 33.4% met the recommended 8th-grade reading level. Image analysis showed 76.7% of websites portrayed only light skin tones, and 71% depicted a lean body type.</div></div><div><h3>Conclusion</h3><div>Online breast reconstruction resources are often inconsistent, hard to understand, and lack diversity. More readable, inclusive, and trustworthy content is needed. Clinicians should guide patients to reliable sources and support efforts to improve online health education.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 133-146"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430317","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":"Non-Wire Bracketed Localization Techniques and Decreased Margin Positive Rates in Breast Cancer","authors":"Nicole Harris,&nbsp;Paige Aiello,&nbsp;David Detz,&nbsp;Junmin Whiting,&nbsp;Weihong Sun,&nbsp;Susan Hoover,&nbsp;Nazanin Khakpour,&nbsp;John Kiluk,&nbsp;Laura Kruper,&nbsp;Christine Laronga,&nbsp;Melissa Mallory,&nbsp;Blaise Mooney,&nbsp;Brian Czerniecki,&nbsp;M. Catherine Lee","doi":"10.1016/j.clbc.2025.09.020","DOIUrl":"10.1016/j.clbc.2025.09.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast conserving therapy (BCT) for nonpalpable lesions can be performed using various localization devices. For larger or multifocal lesions, “bracketing” with multiple localizers is required for complete excision. SAVI Scout utilizes radar localization (RL) to target clip location(s), while SmartClip employs electromagnetic chips (EMC) to provide 3D navigation and distinguish up to three devices. This study aimed to compare the excision of breast lesions using non wire localization devices such as EMC and RL versus traditional wires.</div></div><div><h3>Methods</h3><div>A single institution, retrospective study was conducted from August 25, 2020 to August 6, 2024, comparing EMC, RL, and wire localization in bracketed BCT. Case length, positive margins requiring re-excision, and complete retrieval of localizers in a single specimen were analyzed. Statistical analyses were performed using Kruskal–Wallis, and χ² or Fisher’s exact tests.</div></div><div><h3>Results</h3><div>A total of 118 cases were analyzed: 43 wire, 44 RL, and 31 EMC cases. The groups were similar in lesion size and number of localizers used (<em>P</em> = .736 and <em>P</em> = 1.000, respectively). There were fewer positive margins when EMC or RL were utilized (EMC 29%, RL 22.7%, wires 50%, <em>P</em> = .022). EMC was also associated with significantly shorter operative times (33.9 minutes vs. RL 45.6 minutes, wire 40 minutes, <em>P</em> = .025). There was no significant difference in complete retrieval of localizers among the groups (EMC 93.5%, RL 97.7%, wire 100%, <em>P</em> = .264).</div></div><div><h3>Conclusion</h3><div>Non-wire localization method is effective for bracketed BCT with lower rates of margin positivity and faster operative times with EMC. This supports their use in BCS, especially when multiple localizers are needed.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 128-132"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444119","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":"Quality of Life and Fear of Recurrence or Progression in Women With DCIS Who Did and Did Not Receive Radiotherapy","authors":"Michelle Sinclair ,&nbsp;G. Bruce Mann ,&nbsp;Christina Kozul ,&nbsp;Allan Park ,&nbsp;Lesley Stafford","doi":"10.1016/j.clbc.2025.11.001","DOIUrl":"10.1016/j.clbc.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Ductal carcinoma in situ (DCIS) is frequently identified during mammographic screening and treated to minimize the risk of development of invasive cancer. Local recurrence is a recognised risk after breast conserving surgery (BCS), and radiotherapy (RT) is frequently used to reduce this, despite having no impact on overall survival. Little is known about the impact of RT on patient-reported outcomes. We conducted a retrospective study to assess differences in health-related quality of life (HRQoL), fear of recurrence or progression (FRP), risk perceptions, and illness beliefs in women with DCIS, based on RT status.</div></div><div><h3>Patients and Methods</h3><div>Women with DCIS diagnosed or treated at a tertiary hospital in Melbourne from 2010 to 2022 who underwent BCS were eligible. HRQoL (QLQ-C30; BR45), FRP (FCRI-SF), illness perceptions (BIPQ) and perceptions of risk of DCIS recurrence or progression were assessed by self-report.</div></div><div><h3>Results</h3><div>Questionnaires from 160 women (RT <em>n</em> = 80, no RT <em>n</em> = 80) were analysed. Median age was 65 and median time since diagnosis was 7.7 years. Overall impact on HRQoL of treatment was low irrespective of treatment. There was no difference in FRP according to RT status. Women who received RT had larger tumours (<em>P</em> &lt; .001), more breast symptoms (<em>P</em> = .015) and stronger beliefs in the effectiveness of treatment (<em>P = .</em>034). In multivariate analysis, neuroticism, perceived likelihood of DCIS progression to invasive disease and emotional impact of DCIS predicted FRP.</div></div><div><h3>Conclusion</h3><div>DCIS treatment was associated with minimal long-term HRQoL impact and low FRP, irrespective of RT. Improving understanding of recurrence/progression risk may protect against persistent FRP in these women.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 235-246.e4"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630357","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":"Immunohistochemical Changes After Neoadjuvant Chemotherapy and Their Impact on Breast Cancer Survival: A Systematic Review and Meta-analysis","authors":"Marcelo Antonini ,&nbsp;André Mattar ,&nbsp;Gil Facina ,&nbsp;Francisco Pimentel Cavalcante ,&nbsp;Felipe Zerwes ,&nbsp;Fabricio Palermo Brenelli ,&nbsp;Antônio Luis Frasson ,&nbsp;Eduardo Camargo Millen ,&nbsp;Rodrigo Caires Campos ,&nbsp;Letícia Xavier Félix ,&nbsp;Juliana Calado Vieira ,&nbsp;Marina Diógenes Teixeira ,&nbsp;Marcelo Madeira ,&nbsp;Rogério Fenile ,&nbsp;Henrique Lima Couto ,&nbsp;Leonardo Ribeiro Soares ,&nbsp;Ruffo de Freitas Junior ,&nbsp;Renata Arakelian ,&nbsp;Renata Montarroyos Leite ,&nbsp;Vitoria Rassi Mahamed Rocha ,&nbsp;Luiz Henrique Gebrim","doi":"10.1016/j.clbc.2025.10.017","DOIUrl":"10.1016/j.clbc.2025.10.017","url":null,"abstract":"<div><div>Changes in immunohistochemical (IHC) profiles following neoadjuvant chemotherapy (NAC) may impact therapeutic decisions and prognosis in breast cancer patients. However, the clinical significance of these biomarker conversions remains uncertain. To evaluate the frequency of IHC marker conversion (estrogen receptor [ER], progesterone receptor [PR], and HER2) after NAC and its association with pathological complete response (pCR), overall survival (OS), and disease-free survival (DFS). We conducted a systematic review and meta-analysis of cohort studies reporting pre- and post-NAC IHC profiles in breast cancer. A comprehensive search was performed in PubMed, Embase, Scopus, and Web of Science. The ROBINS-I tool was used to assess risk of bias. Random-effects models were applied to calculate pooled conversion rates and assess the prognostic impact of IHC changes. Twenty-four studies (<em>n</em> = 5891 patients) were included. The pooled conversion rates were 9.2% for ER, 15.1% for PR, 8.6% for HER2. Loss of hormone receptor positivity was associated with a lower pCR rate and worse DFS (HR 1.42; 95% CI, 1.11-1.81). HER2 gain correlated with improved pCR. High heterogeneity was observed, and sensitivity analyses confirmed the robustness of the results. IHC profile changes after NAC are frequent and clinically relevant. Loss of hormone receptor expression may indicate poorer prognosis, while HER2 gain suggests improved treatment sensitivity. Reassessment of IHC markers post-NAC should be considered to optimize adjuvant therapy decisions.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 208-222.e11"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630313","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 Vaccines: A Review of Emerging Opportunities and Persistent Challenges","authors":"I. Jeya Sheela ,&nbsp;A. Amala Jeya Ranchani ,&nbsp;Aravindh Murali ,&nbsp;H. Premkumar","doi":"10.1016/j.clbc.2026.01.004","DOIUrl":"10.1016/j.clbc.2026.01.004","url":null,"abstract":"<div><div>Breast cancer, the most diagnosed malignancy globally, poses a significant health burden, with approximately 2.3 million new cases and 700,000 deaths annually. Breast cancer vaccines represent an innovative approach to prevention and treatment, harnessing the immune system to target tumor-specific antigens such as α-lactalbumin, HER2, and MUC1. Prophylactic vaccines aim to reduce risk in high-risk groups like BRCA1/2 mutation carriers, while therapeutic vaccines, particularly for triple-negative breast cancer, stimulate T-cell responses to combat aggressive tumors. Advances in mRNA technology, nanoparticle delivery, and neoantigen identification enhance vaccine precision and efficacy. However, challenges including tumor heterogeneity, immune evasion, and production scalability limit clinical success. Ongoing phase I and II trials explore combination therapies with checkpoint inhibitors and antibody-drug conjugates to overcome these barriers. This review examines the current landscape, mechanisms, and challenges of breast cancer vaccines, highlighting their potential to transform oncology through personalized, less invasive strategies.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 54-64"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146186188","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":"Surveillance Contrast-Enhanced Mammography in Patients With Dense Breasts and a Personal History of Breast Cancer","authors":"Maria Gosein FRCR ,&nbsp;Edwin Khoo ,&nbsp;Charlotte Yong-Hing ,&nbsp;Janette Sam ,&nbsp;Tetyana Martin","doi":"10.1016/j.clbc.2026.01.006","DOIUrl":"10.1016/j.clbc.2026.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic performance of contrast-enhanced mammography (CEM) for breast cancer surveillance in patients with dense breast tissue and a personal history of breast cancer.</div></div><div><h3>Methods</h3><div>In this single-center retrospective study, we reviewed consecutive CEM surveillance examinations performed between April 2022 and April 2025 in asymptomatic patients with a personal history of breast cancer and dense breasts. BI-RADS classifications, lesion characteristics, follow-up imaging, and histopathology were reviewed. Sensitivity, specificity, cancer detection rate (CDR), positive predictive values (PPV), and negative predictive values (NPV) were calculated using biopsy or at least 12 months imaging follow-up as reference standards.</div></div><div><h3>Results</h3><div>A total of 176 patients underwent 376 CEM studies. Of the initial exams, 29.5% of patients (52 of 176) were classified as positive (BI-RADS 3 or 4; no BI-RADS 5 cases), with a CDR of 34 per 1000 exams. Sensitivity and specificity were 100% and 72.9%, respectively, with a PPV 1 of 11.5% and NPV of 100%. Over the study period, 39 biopsies yielded 8 malignancies in 7 patients, corresponding to a PPV3 of 20.5%. Three of the eight CEM-detected cancers (37.5%) were visible only on recombined images. Palpable axillary recurrences in two patients were outside the CEM field of view. One mild contrast reaction was recorded.</div></div><div><h3>Conclusion</h3><div>Although recall rates were higher than in prior studies, CEM demonstrated high sensitivity and NPV and substantial CDR; all of which were early-stage, node-negative cancers. These findings support broader consideration of CEM in intermediate- to high-risk surveillance settings, particularly where access to MRI is limited.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 17-26"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140822","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":"Reconciling Sentinel Node Omission with CDK4/6 Inhibitor Eligibility in HR+/HER2- Early Breast Cancer: A Real-World Cohort Analysis","authors":"Jannik Daniel Kandzi ,&nbsp;Alexander Englisch ,&nbsp;Bettina Boeer ,&nbsp;Markus Hahn ,&nbsp;Markus Wallwiener ,&nbsp;Léa Volmer ,&nbsp;Sara Brucker ,&nbsp;Andreas Hartkopf ,&nbsp;Tobias Engler","doi":"10.1016/j.clbc.2025.10.003","DOIUrl":"10.1016/j.clbc.2025.10.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Omission of sentinel lymph node biopsy (SLNB) in selected hormone receptor-positive (HR+), HER2-negative (HER2−) early breast cancer patients has demonstrated safety in prospective trials. However, accurate axillary staging remains important for identifying candidates for adjuvant CDK4/6 inhibitor therapy. We quantified the impact of SLNB omission on CDK4/6 eligibility and explored predictors of occult nodal disease in a real-world cohort.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 948 patients treated 2014 to 2022 at Tübingen University Hospital who met criteria proposed for potential SLNB omission: age ≥ 50 years, cT1 cN0, HR+/HER2−, grade 1 to 2 tumors treated with breast-conserving surgery and whole-breast irradiation. We assessed the prevalence of occult nodal metastases and potential eligibility for adjuvant abemaciclib (monarchE-criteria) or ribociclib (NATALEE-criteria) based on final pathology and fitted multivariable logistic models.</div></div><div><h3>Results</h3><div>Among 948 patients meeting SLNB omission criteria, 143 (15.1%) harbored occult nodal disease. Of these node-positive patients, 17 fulfilled the criteria for abemaciclib eligibility. For ribociclib, 105 node-positive patients were eligible. On multivariable analysis, multifocality (OR = 2.3; <em>P</em> ≤ .001) and cT1c tumor stage (OR = 1.76; <em>P</em> = .008) predicted axillary upstaging; invasive lobular carcinoma (ILC) showed higher crude upstaging than IDC/NST (22.6% vs. 14.0%) but did not retain independent significance after adjustment.</div></div><div><h3>Conclusions</h3><div>Omitting sentinel node biopsy in selected patients leads to under-detection of nodal metastasis in a relevant proportion of patients, particularly with cT1c tumors, multi-focal tumors and ILC. As these patients may benefit from more intensive adjuvant treatment, omission of sentinel-node biopsy should be part of decision-making. Future trials should investigate the impact of adjuvant treatment for patients with occult lymph node metastases.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 169-175"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512322","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":"Canadian Women’s Attitudes Toward Receiving Personalized Breast Cancer Risk Information: Insights From the PERSPECTIVE I&I Project","authors":"Jennifer D. Brooks ,&nbsp;Kristina M. Blackmore ,&nbsp;Nguyet N.M. Ngo ,&nbsp;Meghan J. Walker ,&nbsp;Amy Chang ,&nbsp;Laurence Lambert-Côté ,&nbsp;Annie Turgeon ,&nbsp;Aisha K. Lofters ,&nbsp;Hermann Nabi ,&nbsp;Antonis C. Antoniou ,&nbsp;Kathleen A. Bell ,&nbsp;Mireille J.M. Broeders ,&nbsp;Tim Carver ,&nbsp;Jocelyne Chiquette ,&nbsp;Philippe Després ,&nbsp;Douglas F. Easton ,&nbsp;Andrea Eisen ,&nbsp;Laurence Eloy ,&nbsp;D. Gareth Evans ,&nbsp;Samantha Fienberg ,&nbsp;Anna M. Chiarelli","doi":"10.1016/j.clbc.2025.12.009","DOIUrl":"10.1016/j.clbc.2025.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Risk-stratified breast cancer screening has been proposed as an alternative to the age-based approach currently used by most screening programs. This study, part of the Canadian PERSPECTIVE I&amp;I project, examined perceived advantages and disadvantages of learning your breast cancer risk category and associated screening plans.</div></div><div><h3>Method</h3><div>Women aged 40 to 69 from Ontario and Quebec (<em>N</em> = 3319) had multifactorial risk assessments using the CanRisk tool. Risk categories (average [78.9%], higher than average [16.4%], high [4.6%]) were communicated along with screening plans. Participants completed questionnaires on attitudes toward learning their risk before, at the time of, and 1 year later risk communication. Participant characteristics associated with these attitudes were assessed using multinomial logistic regression.</div></div><div><h3>Results</h3><div>At the time of risk communication, most participants (72.9%) perceived ``Easing worry'' as an advantage of learning their risk. However, participants at higher risk were more likely to report that it did not ease their worry. Visible minority participants (OR = 1.86, 95% CI, 1.16, 2.98) and those with lower education attainment were more likely to view “complicated information” as a disadvantage (College/Apprenticeship/Trades: OR = 1.54, 95% CI, 1.24, 1.92; High School or below: OR = 1.77, 95% CI, 1.29, 2.42). Ontario participants were more likely to view risk communication as “information I do not want to know” (OR = 0.44, 95% CI, 0.32, 0.59) compared to Quebec participants.</div></div><div><h3>Conclusion</h3><div>Most women responded positively to learning their breast cancer risk category and screening plan. Successful implementation of risk-stratified screening will require clear communication, healthcare provider support, and adaptation to regional resources.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 267-278.e6"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123890","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 Lobular Histology a Predictor of Sentinel Node Positivity in Early Breast Cancer? An Integrated Analysis of Histological Subtype and Preoperative Imaging","authors":"Francesca Accomasso ,&nbsp;Gaia Ruggeri ,&nbsp;Silvia Actis ,&nbsp;Elena Paradiso ,&nbsp;Pier Giorgio Spanu ,&nbsp;Luca Giuseppe Sgro ,&nbsp;Annamaria Ferrero ,&nbsp;Valentina Elisabetta Bounous","doi":"10.1016/j.clbc.2026.01.002","DOIUrl":"10.1016/j.clbc.2026.01.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess whether lobular histology independently predicts sentinel lymph node biopsy (SLNB) positivity in early-stage clinically node-negative (cN0) breast cancer (BC), to identify other predictive factors of SLNB positivity, and to evaluate the diagnostic performance of preoperative axillary imaging. The cumulative incidence of local and distant recurrences were also evaluated.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 661 patients with early-stage, cN0 BC undergoing surgery with SLNB. Clinical, pathological, and radiological data were assessed. Univariate and multivariate analyses were performed to identify predictors of SLNB positivity. The cumulative incidence of axillary and distant recurrences were calculated including only patients with at least 2 years follow up, for a total of 495 patients.</div></div><div><h3>Results</h3><div>ILC was present in 16.9% of cases. SLNB positivity occurred in 16.1% of invasive lobular cancers (ILC) and 20% of nonspecial type tumors (NST) (<em>P</em> = .3). No significant differences in axillary lymph node dissection (ALND) rates or nodal upstaging were found between histologies. Tumor size &gt; 20 mm and vascular invasion were independent predictors of SLNB positivity. Axillary ultrasound and magnetic resonance (MRI) showed high specificity (95% and 79%) and negative predictive value (80% and 98%) in identifying node-negative patients. No axillary recurrences occurred after a median follow-up of 49.3 months.</div></div><div><h3>Conclusions</h3><div>ILC does not independently predict SLNB positivity or nodal upstaging. Tumor size and vascular invasion remain the strongest predictors. Axillary ultrasound and MRI are reliable tools to guide de-escalation. SLNB omission in well-selected cN0 patients, including those with ILC, may be considered in tailored and selected patients.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 9-16"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112496","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}