Clinical breast cancer最新文献

{"title":"Time-Dependent Apparent Diffusion Coefficient Changes in Breast MR Images With Contrast for Tumor Characterization.","authors":"Yongsheng Ao, Xuanle Li, Lan Mu, Jierui Zhao, Hongliang Chen, Yunling Wang, Shuheng Zhang, Shimin Yang, Na Zhang, Lihua Qiu","doi":"10.1016/j.clbc.2025.05.019","DOIUrl":"10.1016/j.clbc.2025.05.019","url":null,"abstract":"<p><strong>Background: </strong>To assess the effect of scan time after contrast injection on breast MRI DWI sequence ADC values and its role in lesion differentiation.</p><p><strong>Patients and methods: </strong>Between 2022 and 2023, two hundred and fifty-one breast magnetic resonance (MR) images were collected from 251 patients, who had a total of 258 lesions. Pathology results obtained within 1 month of the MR imaging were utilized. Apparent diffusion coefficient (ADC) values were measured at 3 time-points: precontrast, 3 minutes postcontrast, and 6 minutes postcontrast. For the analysis, statistical methods including the Friedman test, linear mixed models, Bonferroni correction, receiver operating characteristic (ROC) curve analysis, and DeLong test were applied.</p><p><strong>Results: </strong>Contrast agents cause ADC values to decrease within 3 minutes after injection and recover within 6 minutes (e.g., invasive ductal carcinoma). ADC can distinguish between benign tumors and cancers but not between carcinoma in situ and invasive carcinoma. Time-dependent changes do not affect the differentiation of benign from malignant lesions.</p><p><strong>Conclusion: </strong>Contrast injection time has little effect on the effectiveness of ADC in differentiating benign from malignant lesions on DWI sequences. The findings support the feasibility of postcontrast DWI without compromising diagnostic accuracy.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339961","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 Data on First-Line Treatment of Hormone Receptor-Positive, HER2-Negative, Metastatic Breast Cancer in Brazil (BRAVE Study).","authors":"Gustavo Werutsky, Daniela Dornelles Rosa, Tomás Reinert, Romualdo Barroso-Sousa, Heloísa Resende, Poliana Signorini, Eduardo Cronemberger, Juliana Góes Martins Fagundes, Jorge Henrique Santos Leal, Marina Bachmann Guimarães, Aline Vieira, Luiza Nardin Weis, José Márcio Barros de Figueiredo, Tatiana Strava Correa, Fernando Castilho Venero, Maiane Maria Pauletto, Luísa Mostardeiro Tabajara Franche, Marina Musse Bernardes, André Henrique Ornelas de Oliveira, Rafaela Gomes de Jesus, Gustavo Gössling, José Bines","doi":"10.1016/j.clbc.2025.05.020","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.05.020","url":null,"abstract":"<p><strong>Introduction: </strong>Endocrine therapy (ET) plus CDK4/6 inhibitors has become the standard first-line therapy for hormone receptor-positive/HER2-negative metastatic breast cancer (MBC). Utilizing real-world data, we aimed to characterize treatment patterns, assess the impact of health insurance type, and evaluate outcomes among Brazilian MBC patients with this subtype treated in the first-line setting.</p><p><strong>Patients and methods: </strong>This is an observational retrospective study assessing female patients aged ≥ 18 years diagnosed with HR+/HER2- MBC between January/2018 and December/2020 at 13 sites in Brazil. The primary objective was to describe the treatment patterns within both the public and private healthcare systems. Secondary outcomes were progression-free survival (PFS) and overall survival (OS).</p><p><strong>Results: </strong>In total, 307 patients were included. The most frequent treatment was ET alone (42.4%), followed by chemotherapy (31.6%), and ET plus CDK4/6 inhibitors (25.1%). The greatest difference in access to treatment was observed in the use of ET plus CDK4/6 inhibitors between the private (48.3%) and public healthcare systems (2.6%), (P < .0001). Of the 84 patients that received CDK4/6 inhibitors, ribociclib was the most used (56.0%). With a median follow-up of 32.2 months (95% CI, 29.4-34.4), the median progression-free survival (PFS) was 24.2 months (95% CI, 18.6-30.4) in the public and 23.80 months (95% CI, 18.3-34.2) in the private healthcare system (P = .9294). The median OS was 52.7 months (95% CI, 49.4-NR) in the overall population.</p><p><strong>Conclusion: </strong>ET remains the most used first-line treatment in Brazil. However, access to therapies varies significantly between public and private healthcare sectors. This disparity highlights inequality in access to treatment.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526623","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":"Changes in Glucose level During Chemotherapy Treatment in Patients With Stage I-IV Breast Cancer.","authors":"Patrick M Schnell, Mahmoud Kassem, Abdul Miah, Bhuvaneswari Ramaswamy, Nicole Williams, Mathew Cherian, Daniel G Stover, Margaret E Gatti-Mays, Ashley Pariser, Robert Wesolowski, Sagar Sardesai, Preeti K Sudheendra, Kate Ormiston, Jessica N Mezzanotte, Tonya S Orchard, Maryam Lustberg","doi":"10.1016/j.clbc.2025.05.021","DOIUrl":"10.1016/j.clbc.2025.05.021","url":null,"abstract":"<p><strong>Purpose: </strong>Glucose dysregulation may occur during chemotherapy treatment of patients with breast cancer. Absent appropriate management, patients may experience worsened morbidity and mortality. Mechanisms regarding glucose dysregulation are well-studied, but the role of chemotherapy is not. Previous studies of glucose dysregulation among patients undergoing chemotherapy have yielded inconsistent results.</p><p><strong>Methods: </strong>We evaluate changes in blood glucose in women with breast cancer undergoing chemotherapy and explore effects of covariates. Records of 981 patients with stage I-IV breast cancer were evaluated, including blood glucose levels and other clinical and histopathological data. Patients were treated at The Ohio State University, an NCI-designated Comprehensive Cancer Center, from 2016 to 2018. Subgroups reflecting populations studied by previous reports were analyzed.</p><p><strong>Results: </strong>Overall, blood glucose decreased slightly after chemotherapy versus baseline (131.3 mg/dL vs. 134.8 mg/dL, P = .048). Among patients with baseline random glucose levels lower than 125 mg/dL, levels increased versus baseline (113 vs 99 mg/dL, P < .001). Among patients younger than 70 and without diabetes mellitus, there was no statistically significant change (120 vs 122 mg/dL, P = .47). Adjusting for baseline variables including glucose levels, estimated change from baseline is higher among patients exposed to docetaxel/cyclophosphamide versus other regimens assessed (P < .001).</p><p><strong>Conclusions: </strong>Random blood glucose decreased slightly during chemotherapy. Differences in results in previous reports are attributable to differing study populations. Baseline glucose levels, age, and chemotherapy regimen are predictors of change in glucose level.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336374","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":"Decrease in Calcifications After Neoadjuvant Treatment Predicts Invasive Tumor Response but Not Complete DCIS Eradication: Systematic Review and Meta-Analysis","authors":"Noam Weiner ,&nbsp;Yaron Niv ,&nbsp;Eran Sharon","doi":"10.1016/j.clbc.2025.05.012","DOIUrl":"10.1016/j.clbc.2025.05.012","url":null,"abstract":"<div><div>Changes in calcifications after neoadjuvant treatment and their relationship with pathological complete response in breast cancer remain unclear. We conducted a systematic review and meta-analysis to evaluate this association. A PubMed and EMBASE search was conducted for English-language studies assessing changes in calcification size or number before and after neoadjuvant treatment and their correlation with post-treatment histology. Pooled odds ratios and 95% confidence intervals were calculated using a random-effects model. Study heterogeneity, publication bias, and quality were assessed using the Cochrane Q test, I² statistic, funnel plot, and Slim's method. Of 2261 records screened, 8 studies comprising 707 patients were eligible. Decreased calcifications after neoadjuvant treatment were associated with higher odds of achieving pathologic complete response (pooled odds ratio of 1.691, p &lt; 0.001). Subgroup analyses showed significance for decrease vs. no-decrease (odds ratio = 2.045; p = 0.004), a trend for decrease vs. increase, and no significance for no-increase vs. increase. Stratification by pathologic complete response definition demonstrated significance when residual DCIS was permitted (odds ratio of 2.196; p &lt; 0.001) but not when complete absence of DCIS was required. Patients with a decrease in calcifications after neoadjuvant treatment are twice as likely to achieve pathologic complete response, particularly when residual DCIS is permitted within the pathologic complete response definition. Calcification changes may serve as an additional tool for guiding surgical planning after neoadjuvant treatment.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 7","pages":"Pages e990-e1000.e2"},"PeriodicalIF":2.5,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494977","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":"Final Overall Survival Analysis of the Phase II SAKK 21/12 Trial of Transdermal CR1447 in Patients With Metastatic Breast Cancer","authors":"Marcus Vetter ,&nbsp;Lisa Holer ,&nbsp;Karin Rothgiesser ,&nbsp;Wolfgang Schönfeld ,&nbsp;Salome Riniker ,&nbsp;Roger von Moos ,&nbsp;Andreas Trojan ,&nbsp;Elena Kralidis ,&nbsp;Manuela Rabaglio ,&nbsp;Mathias K. Fehr ,&nbsp;Andreas Müller ,&nbsp;Markus Borner ,&nbsp;Lorenzo Rossi ,&nbsp;Christian Kurzeder ,&nbsp;Beat Thürlimann ,&nbsp;Swiss Group for Clinical Cancer Research (SAKK)","doi":"10.1016/j.clbc.2025.05.015","DOIUrl":"10.1016/j.clbc.2025.05.015","url":null,"abstract":"<div><h3>Objective</h3><div>CR1447 is a transdermal formulation of 4-hydroxytestosterone with aromatase-inhibiting and androgen receptor (AR)-modulating activity. This multicenter, phase II study assessed the efficacy and safety of CR1447 in patients with metastatic breast cancer. The primary endpoint, the disease control rate at week 24, was published in 2019. Here, we report the final overall survival (OS) data of this study.</div></div><div><h3>Patients and methods</h3><div>This study enrolled patients with estrogen receptor (ER)-positive, HER2-negative breast cancer pretreated with a maximum of 1 line of prior endocrine therapy (ET) without progression for at least 6 months (cohort A) (<em>n</em> = 29) and patients with AR-positive triple-negative metastatic breast cancer treated with a maximum of 2 prior lines of chemotherapy (cohort B) (<em>n</em> = 8). The intention-to-treat (ITT) population included eligible patients who received at least 1 dose of the study drug. The non-ITT population in cohort A comprised patients with more than 1 line of prior ET. Accrual was stopped in 2018 due to futility in cohort A and slow accrual in cohort B.</div></div><div><h3>Results</h3><div>At the data cut-off, 92% of patients had died. The median OS in cohort A was 35.4 months (95% CI: 24.6-49.1) in the ITT population (<em>n</em> = 21) and 19.4 months (95% CI: 2.3-36.8) in the non-ITT population (<em>n</em> = 8). In cohort B, the median OS was 10.8 months (95% CI: 3.3-28.6). Most adverse events were grade 1 − 2 and most frequently included hypertriglyceridemia, increased levels of aspartate aminotransferase and dry skin.</div></div><div><h3>Conclusions</h3><div>In this final OS analysis, CR1447 was associated with an OS in line with other ET agents in patients with metastatic ER-positive, HER2-negative breast cancer who had received no more than 1 prior line of ET. Therapy was well tolerated with no treatment-related grade 3 to 5 toxicities.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 6","pages":"Pages 583-588"},"PeriodicalIF":2.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332506","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":"Disparities in Access to Multigene Testing in Early-Stage, HR-positive, HER2-negative, Lymph Node-negative Breast Cancer","authors":"María Herrán ,&nbsp;Emily C. Zabor ,&nbsp;Saad Sabbagh ,&nbsp;Nadeem Bilani ,&nbsp;Ali Hijazi ,&nbsp;Mohamed Mohanna ,&nbsp;Mira Itani ,&nbsp;Zeina Nahleh","doi":"10.1016/j.clbc.2025.05.018","DOIUrl":"10.1016/j.clbc.2025.05.018","url":null,"abstract":"<div><h3>Background</h3><div>Multigene testing (MGT) has refined breast cancer treatment. We examined real-world access to MGT for early-stage (I-II), HR-positive, HER2-negative, node-negative breast cancer and identified factors related to disparities.</div></div><div><h3>Materials and Methods</h3><div>This retrospective analysis used the National Cancer Database (2007-2017). Socio-demographic and clinical-pathologic factors of interest were included in a multivariable logistic regression to examine associations with MGT use. Multiple imputation was used to find missing data.</div></div><div><h3>Results</h3><div>A total of <em>N</em> = 107,642 patients were eligible, of which 65,066 (60%) underwent MGT. The odds of undergoing MGT were lower among Black patients compared to White (OR 0.83, 95% CI, 0.79-0.87, <em>P</em> &lt; .001), Hispanic compared to non-Hispanic (OR 0.91, 95% CI, 0.86-0.97, <em>P</em> = .004), uninsured compared to privately insured (OR 0.73,95% CI, 0.64-0.83, <em>P</em> &lt; .001), and those in the West South-Central compared to New England region (OR 0.76, 95% CI, 0.70-0.82, <em>P</em> &lt; .001). Increased odds were observed among those treated at an Integrated Network Cancer Program (OR 1.12, 95% CI, 1.05-1.19, <em>P</em> &lt; .001), higher education level (OR 1.12, 95% CI, 1.06-1.18, <em>P</em> &lt; .001), and a household income between $50,354 to $63,332 (OR 1.08, 95% CI, 1.02-1.14, <em>P</em> = .006). Those with access to MGT had higher odds of receiving adjuvant chemotherapy (OR 1.89,95% CI, 1.80-1.99, <em>P</em> &lt; .001) and hormonal therapy (OR 3.17, 95% CI, 3.02-3.32, <em>P</em> &lt; .001) compared to those without access to MGT after adjusting for other factors of interest.</div></div><div><h3>Conclusions</h3><div>This study highlights gaps in access to MGT in breast cancer. Ensuring equitable access to diagnostic and prognostic precision tools could positively impact the odds of receiving appropriate adjuvant therapy and improve patient outcomes.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 6","pages":"Pages 589-599.e7"},"PeriodicalIF":2.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336375","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":"MRI Response Pattern of Breast Invasive Micropapillary Carcinoma After Neoadjuvant Chemotherapy: A Matched Cohort Study With Invasive Breast Cancer of no Special Type","authors":"Dan Gao ,&nbsp;Zeng Yongjia ,&nbsp;Yingying Gao ,&nbsp;Liujin Zeng ,&nbsp;Meichan Yang ,&nbsp;Zhouyang Lian ,&nbsp;Chunling Liu","doi":"10.1016/j.clbc.2025.05.014","DOIUrl":"10.1016/j.clbc.2025.05.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Neoadjuvant chemotherapy (NAC) is more widely used to treat localized invasive breast cancer. Invasive micropapillary carcinoma (IMPC) is considered more aggressive than invasive breast cancer of no special type (IBC- NST), as an independent histological type of invasive breast cancer (IBC). However, it is rarely reported about the response of IMPC to NAC. Therefore, we compared the NAC response of IMPC and IBC<img>NST groups to provide an evidence-based foundation for precise clinical management of breast IMPC about NAC.</div></div><div><h3>Methods</h3><div>The retrospective study included 127 patients with pathologically confirmed IMPC or IBC<img>NST patients from December 2016 to April 2021, and divided them into 3 group. The MRI feature and Clinicopathologic data of all the patients were assessed before and after NAC. One-way ANOVA test and Krukal-Wallis test were used for statistical analysis.</div></div><div><h3>Results</h3><div>After NAC, IMPC patients showed less changes in lesion size, EER, shrinking rate and ADC values compared to the IBC patients (<em>P</em> &lt; .05). In IPMC patients, 7.7% of lesions achieved a pathologic complete response (pCR), 61.5% with partial response (PR), 2.6% with progressive disease (PD) and 28.2% with stable disease (SD). Moreover, the lesions response to NAC was not significantly different between IMPC group and IBC2 group.</div></div><div><h3>Conclusions</h3><div>Most patients with IMPC can obtain the same PR rates after NAC as IBC<img>NST. Breast-conserving treatment (BCT) can be applied in More patients with IMPC. Therefore, we hold the opinion that NAC can be strongly suggested to be used for IMPC patients.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 7","pages":"Pages e1001-e1007"},"PeriodicalIF":2.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293416","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":"Tumor ki67 Impact on Survival in Male Breast Cancer Patients: A Systematic Review and Meta-Analysis.","authors":"Stephen Kinsey-Trotman, Alain Nguyen, Suzanne Edwards, Adam Swalling, Pallave Dasari, David Walsh, Wendy V Ingman","doi":"10.1016/j.clbc.2025.05.013","DOIUrl":"10.1016/j.clbc.2025.05.013","url":null,"abstract":"<p><strong>Purpose: </strong>Histological features with prognostic utility for survival in male breast cancer remain elusive. Tumor ki67 expression may provide an early prognostic marker in this disease. This systematic review investigated ki67 prognostication for overall survival in male breast cancer patients.</p><p><strong>Methods: </strong>Following prospective registration MEDLINE, PUBMED Central and EMBASE databases were searched to identify suitable studies. Studies were considered for meta-analysis when both comparable research methodologies were utilized and survival outcomes were reported for the same threshold value for ki67.</p><p><strong>Results: </strong>A total of fifteen observational type studies were included in the review with 9 meeting inclusion criteria for data extraction. Six studies contributed to a meta-analysis. Two studies demonstrated a statistically-significant difference in survival outcome at a ki67 threshold of 20%, however meta-analysis for ki67 set at 2 thresholds (14% and 20%) did not demonstrate any significant association with overall survival.</p><p><strong>Conclusions: </strong>This review did not confirm an association between ki67 and overall survival in male breast cancer patients. Further research including the use of artificial intelligence methods and consideration of a higher threshold value are needed to better define Tumor ki67 in this patient group.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332507","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":"Use and Benefit of Neoadjuvant Versus Adjuvant Chemotherapy in Node-Negative, T1 Triple Negative Breast Cancer","authors":"Jesus D. Anampa ,&nbsp;Alvaro Alvarez Soto ,&nbsp;Shuwen Lin ,&nbsp;Ana M. Bernal ,&nbsp;Xiaonan Xue ,&nbsp;Maja H. Oktay","doi":"10.1016/j.clbc.2025.05.011","DOIUrl":"10.1016/j.clbc.2025.05.011","url":null,"abstract":"<div><h3>Purpose</h3><div>There are scarce data about the use and benefit of neoadjuvant chemotherapy (NACT) in small size, node-negative triple-negative breast cancer (TNBC). We examined pathological response and survival outcomes of patients with T1N0 TNBC who received NACT.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study using data from the Surveillance, Epidemiology, and End Results database of patients with T1N0 TNBC diagnosed between 2010 and 2020. Cox regression models were used to compare overall survival (OS) for adjuvant chemotherapy (ACT) and NACT cohorts. Cumulative incidence functions and breast cancer-specific hazard models were used to compare breast cancer specific survival (BCSS) between ACT and NACT cohorts.</div></div><div><h3>Results</h3><div>We found 8146 patients treated with ACT and 1263 patients treated with NACT. Age &lt; 50 years, mastectomy and radiation therapy were associated with higher odds of receiving NACT. There was no difference in BCSS or OS for patients with T1b/T1cN0 TNBC who received NACT or ACT. However, patients with T1aN0 TNBC had worse BCSS and OS when treated with NACT as compared to those who received ACT. Pathological complete response (pCR) in T1N0 tumors was associated with improved OS (HR, 0.28) and BCSS (HR, 0.21). Furthermore, T1aN0 tumors had lower pCR rate than T1cN0 tumors (18% vs. 47%).</div></div><div><h3>Conclusion</h3><div>Patients with node-negative, T1b and T1c tumors benefit equally from the use of ACT and NACT. The results of worse outcome in patients with node-negative, T1a tumors treated with NACT compared to ACT are intriguing and need further investigation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 7","pages":"Pages e979-e989.e11"},"PeriodicalIF":2.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Immune-Inflammation Indexes for Breast Cancer Patients Undergoing Endocrine Therapy: A Systematic Review and Meta-analysis","authors":"Yue Yang ,&nbsp;Bing Shao ,&nbsp;Chao Wei ,&nbsp;Xuewen Zhang","doi":"10.1016/j.clbc.2025.05.010","DOIUrl":"10.1016/j.clbc.2025.05.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Research suggests that systemic immune-inflammation index (SII), neutrophil lymphocyte (NLR), platelet lymphocyte (PLR) and lymphocyte monocyte (LMR) can act as potential prognostic indicators for breast cancer (BC). However, its prognostic value for BC patients undergoing endocrine therapy (ET) remains inconclusive.</div></div><div><h3>Methods</h3><div>We systematically searched Embase, Cochrane Library, PubMed, and Web of Science for studies on the prognostic significance of immune-inflammation indexes for BC patients undergoing ET from inception to May 5, 2024. Overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) were the primary outcomes, and they were statistically analyzed by hazard ratios (HR) with 95% confidence intervals (CI). Sensitivity and subgroup analyses were performed to explore the source of heterogeneity. STATA 15.1 and Review Manager 5.4 were adopted for data analyses.</div></div><div><h3>Results</h3><div>Fifteen studies with 27 cohorts of 3168 BC patients undergoing ET were included. The results showed that low NLR was associated with prolonged OS (HR = 2.19, 95% CI, 1.67-2.87; <em>P</em> &lt; .00001) and PFS (HR = 1.64, 95% CI, 1.32-2.04; <em>P</em> &lt; .00001) in overall BC patients receiving ET. High LMR was associated with longer OS (HR = 2.67, 95% CI, 1.64-4.33; <em>P</em> &lt; .0001) in the overall BC patients undergoing ET. Low PLR was significantly associated with prolonged PFS (HR = 1.89, 95% CI, 1.40-2.55; <em>P</em> &lt; .0001). Additionally, low PLR was associated with longer OS (HR = 2.16, 95% CI, 1.03-4.52, <em>P</em> = .04), but sensitivity analysis showed that its significance was not robust enough. All subgroup analyses revealed overall roboust results.</div></div><div><h3>Conclusion</h3><div>Immune-inflammation indexes can potentially act as prognostic biomarkers for BC patients undergoing ET, contributing to wiser decision-making in BC treatment.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 7","pages":"Pages e968-e978.e2"},"PeriodicalIF":2.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293417","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}