Clinical breast cancer最新文献

{"title":"A Comparative Analysis of HER2 Immunohistochemistry in Core Biopsy Versus Excision in the Era of HER2 ``Low'' Breast Cancers","authors":"Swati Bhardwaj ,&nbsp;Shabnam Jaffer","doi":"10.1016/j.clbc.2025.11.016","DOIUrl":"10.1016/j.clbc.2025.11.016","url":null,"abstract":"<div><h3>Background</h3><div>The Destiny B04 trial led to the recognition of HER2 low as a new entity defined as HER2 immunohistochemistry (IHC) score of 1 +/2 + and negative in situ hybridization (ISH) requiring detailed HER2 IHC scoring (negative = 0 &amp; 1 +, equivocal = 2 +, and positive = 3 +). As per ASCO–CAP guidelines, biomarkers need not be repeated on excisions when done on core biopsy with some exceptions. The goal of our study was to compare the concordance of HER2 low between core biopsies and excisions and assess the need to repeat on excision.</div></div><div><h3>Methods</h3><div>At the study institution biomarkers are first performed on core biopsies and then repeated on all excisions in negative cases. We identified 301 cases of primary breast carcinomas with matched HER2 IHC on core biopsies and excisions. We reviewed and scored all HER2 IHC slides as per 2018 ASCO/CAP guidelines.</div></div><div><h3>Results</h3><div>The incidence of HER2 low on core biopsies decreased from 64% to 46% on excisions. The best concordance was seen in HER2 + (82%) and negative cases (84%), with most variability in predominantly 1 + and some 2 + cases in both directions. There was a greater loss (38%) than gain (16%) in HER2 low values from core biopsy to excision.</div></div><div><h3>Conclusions</h3><div>HER2 low discordance in our series was predominantly due to loss from core biopsies to excisions, which maybe attributed to better meeting the pre analytic criteria on core biopsy. In contrast, the gain maybe due to intratumoral heterogeneity and or interobserver variability and despite low, worth repeating HER2 IHC on excisions in negative cases.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 39-43"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178201","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":"Overall Survival and Related Clinicopathologic Features to Identify Low-Risk Patients With Early Breast Cancer Suitable For Radiation Therapy Omission After Conservative Surgery: A Meta-Analysis","authors":"Zhi Ouyang,&nbsp;Songlian Li,&nbsp;Ai Quan","doi":"10.1016/j.clbc.2025.10.002","DOIUrl":"10.1016/j.clbc.2025.10.002","url":null,"abstract":"<div><div>Post-operative radiation therapy (PORT) following breast-conserving surgery (BCS) has become a conventional care for early-stage breast cancer (EBC). This meta-analysis aimed to compare overall survival (OS) between patients receiving PORT and those not receiving PORT and to identify clinicopathologic features of low-risk patients with EBC who may be suitable for PORT omission after BCS with respect to OS. Comparative studies investigating PORT versus non-PORT in EBC patients after BCS were included, focusing on hazard ratio (HRs) for OS. Medline, Embase, and the Cochrane Central Library were searched from First January 2014 to First January 2025. A meta-analysis was performed to determine the HR for OS between PORT and non-PORT groups. Subgroup analyses were conducted to identify potential clinicopathologic features associated with low-risk patients suitable for PORT omission. A total of 28 studies (2 randomized controlled trials and 26 retrospective cohort studies) with 589,508 patients were included in the final analysis. According to the meta-analysis, patients with EBC derived an OS benefit from PORT (pooled HR = 0.60 [95% CI, 0.55-0.65]). Subgroup analyses identified clinicopathologic features associated with low-risk patients suitable for PORT omission. This systematic review and meta-analysis demonstrated that PORT is associated with improved OS in patients with EBC following BCS. However, certain clinicopathologic features, including age 65-70 years, progesterone receptor (−), luminal B subtype, triple-negative breast cancer, and low-risk 21-gene recurrence score, were identified as potential low-risk factors in patients who may be considered for PORT omission.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 154-168.e4"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494620","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":"Accelerated Partial Breast Irradiation (APBI) For Ductal Carcinoma In Situ","authors":"Diana Roth O’Brien ,&nbsp;Lillian Boe ,&nbsp;Andrea Barrio ,&nbsp;Boris Mueller ,&nbsp;J. Isabelle Choi ,&nbsp;John Cuaron ,&nbsp;Beryl McCormick ,&nbsp;Atif J. Khan ,&nbsp;Simon N. Powell ,&nbsp;Lior Z. Braunstein","doi":"10.1016/j.clbc.2025.10.001","DOIUrl":"10.1016/j.clbc.2025.10.001","url":null,"abstract":"<div><h3>Purpose/Objectives</h3><div>Suitability criteria for partial breast irradiation (PBI) are narrowly constrained for those with ductal carcinoma in situ (DCIS). In comparison to invasive disease, guidance is limited regarding the optimal application of PBI to treat DCIS. Here, we report disease outcomes for a heterogeneous cohort of patients with DCIS who received PBI.</div></div><div><h3>Materials/Methods</h3><div>Using a prospectively maintained institutional database, we identified patients with DCIS who underwent lumpectomy and adjuvant PBI from 2008 to 2022. Based on clinicopathologic characteristics patients were classified as suitable, cautionary, or unsuitable for PBI by American Society for Radiation Oncology (ASTRO) criteria. The primary endpoint was local recurrence (LR).</div></div><div><h3>Results</h3><div>The cohort comprised 176 patients with DCIS who received PBI, median age 60 years (interquartile range (IQR) 52, 66). Median DCIS size was 9 mm (IQR 4, 15 mm), and approximately 20% had multifocal disease. Most patients had negative (≥ 2 mm) final surgical margins (<em>n</em> = 160, 91%), 10 had &lt; 2 mm margins and 6 had ≤ 1 mm margins for DCIS. 18 (10%) patients had nuclear grade 1 disease, 111 (63%) had grade 2 disease, and 33 (19%) had grade 3 disease, with a small subset classified as grade 1-2 or 2-3. Most patients (<em>n</em> = 161, 91%) had estrogen receptor (ER) positive DCIS, and 72 (41%) received endocrine therapy. By ASTRO criteria, 118 (67%) patients were suitable for PBI, 57 (32%) were considered cautionary, and 1 (0.6%) was unsuitable. At a median 24 months of follow up (range 2-127 months) we observed a single LR, yielding a 2-year LR rate of 0.6%. The LR occurred in a patient classified as cautionary, yielding a 2-year LR rate of 1.8% for the cautionary subset. No breast cancer mortality events were observed.</div></div><div><h3>Conclusions</h3><div>These early-term results exhibit excellent local control for patients with DCIS who received lumpectomy and PBI, even among those classified as “cautionary” by national guidelines. Although our findings are limited by short follow up, these results suggest that broadening the application of PBI for patients with DCIS may warrant further investigation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 147-153"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145387603","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":"Omission of Axillary Lymph Node Dissection in Early-Stage Breast Cancer With Limited Sentinel Lymph Node Metastasis: A Propensity Score-Matched Analysis","authors":"Changzai Li ,&nbsp;Pan Zhang ,&nbsp;Jiaxing Wang ,&nbsp;Cuizhi Geng","doi":"10.1016/j.clbc.2025.12.006","DOIUrl":"10.1016/j.clbc.2025.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Whether axillary lymph node dissection (ALND) can be safely omitted clinically node-negative (cN0) breast cancer with limited sentinel lymph (SLN) metastasis remains uncertain, particularly after mastectomy.</div></div><div><h3>Methods</h3><div>This retrospective cohort included women with T1-T2 cN0 breast cancer and positive SLN between 2015 and 2020. Patents underwent sentinel lymph node biopsy (SLNB) alone or ALND. Propensity score matching (1:1, nearest neighbor, caliper 0.02 on logit) balanced age, T stage, tumor grade, vascular invasion, number of positive SLNs, ER/PR/HER2, Ki-67, surgery type, chemotherapy, and radiotherapy. Kaplan–Meier and Cox regression estimated overall survival (OS) recurrence-free survival (RFS).</div></div><div><h3>Results</h3><div>Of 1244 patients screened, 1038 were analyzed (577 ALND, 461 SLNB alone; median follow-up 68 months), After matching (283 pairs), 5-year OS was 97.1% (95% CI, 95.0-99.3) for ALND and 96.1% (93.8-98.5) for SLNB alone. Five-year RFS was 96.8% (94.7-99.0) versus 97.0% (94.9-99.0). No statistically significant difference was found in OS (HR, 1.14, 95% CI, 0.51-2.54, <em>P</em> = .75) and RFS (HR, 0.86, 95% CI, 0.36-2.05, <em>P</em> = .74) between the ALND and SLNB alone. Findings were consistent among patients with 1 to 3 positive SLNs, regardless of surgery type. All 22 patients with 4 to 6 positive SLNs underwent ALND, precluding comparison.</div></div><div><h3>Conclusion</h3><div>In cN0 breast cancer patients with 1 to 3 positive SLNs, omitting ALND did not compromise OS or RFS after mastectomy or breast-conserving surgery. These results support broader application of de-escalated axillary surgery while prospective validation for higher nodal burden remains necessary.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 257-266.e3"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099664","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":"Noninvasive Prediction of Axillary Sentinel Lymph Node Metastasis via Contrast-Enhanced Ultrasound to Guide Omission of SLNB in Breast Cancer","authors":"Zhijian He ,&nbsp;Xiaoyang Li ,&nbsp;Jun He ,&nbsp;Peizhen Huang ,&nbsp;Rizeng Li ,&nbsp;Jian Yu","doi":"10.1016/j.clbc.2026.01.008","DOIUrl":"10.1016/j.clbc.2026.01.008","url":null,"abstract":"<div><h3>Background</h3><div>The evaluation of axillary sentinel lymph node (SLN) is integral to the treatment of breast cancer. This study aims to build a noninvasive prediction model of SLN metastasis based on percutaneous contrast-enhanced ultrasound (p-CEUS) for low-risk patients.</div></div><div><h3>Materials and Methods</h3><div>Patients with breast cancer were enrolled in this study at Wenzhou Central Hospital between June 2023 and October 2024. The patients were divided into a modeling group and a validation group in a 2:1 ratio. Clinical and pathological features were assessed with univariate analysis and multivariate logistic regression. A nomogram based on p-CEUS enhancement patterns and other independent predictors for the SLN metastasis identified by multivariate logistic regression was constructed.</div></div><div><h3>Results</h3><div>A total of 120 patients were included, comprising 80 in the modeling group (mean age, 55.01 ± 9.91 years) and 40 in the validation group (mean age, 55.20 ± 8.35 years). Independent predictors of SLN metastasis by the multivariate logistic regression analysis included tumor size, Ki-67 status and p-CEUS enhancement pattern. The areas under the receiver operating characteristic (ROC) curve of the modeling group and the validation group were 0.855 and 0.873, respectively. At a ≤ 20% probability threshold, the false-negative rate was 6.5%.</div></div><div><h3>Conclusions</h3><div>The p-CEUS-based nomogram can accurately predict the risk of SLN metastasis in early breast cancer patients with negative-node status. Patients with predicted metastasis probability ≤ 20%, especially those with tumor size ≤ 2 cm, Ki-67 ≤ 20%, and p-CEUS Type I enhancement, can safely omit SLNB.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 74-83"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146186190","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":"Comment on: Prognostic Ability of the Indication for Adjuvant Systemic Therapy Based on Preoperative Biopsy and the Surgical Excision Specimen in Cases of Small Breast Tumors (CONSCIENCE): A Retrospective Cohort Study","authors":"Xuezheng Zhu,&nbsp;Daquan Liao,&nbsp;Shiye Huang,&nbsp;Yubin Feng,&nbsp;Ziye Zhuang","doi":"10.1016/j.clbc.2025.10.007","DOIUrl":"10.1016/j.clbc.2025.10.007","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 198-199"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Thymidine Kinase 1 Activity Linked to Poor Breast Cancer Survival: A Systematic Review and Meta-Analysis","authors":"Simin Li,&nbsp;Guoxue Tang,&nbsp;Shuzhen Lin,&nbsp;Xiaofeng Guan,&nbsp;Wei Qin,&nbsp;Xiaoyun Xiao","doi":"10.1016/j.clbc.2025.10.006","DOIUrl":"10.1016/j.clbc.2025.10.006","url":null,"abstract":"<div><div>Studies were meticulously selected based on a literature search conducted across multiple databases. Data on overall survival (OS), progression-free survival (PFS), and clinicopathological characteristics were extracted. Heterogeneity was assessed among studies for reliability. Sensitivity analysis confirmed result stability, and Egger’s test checked for publication bias. Ten studies with 1761 cases were analyzed. Patients with high TK1a level had a significantly higher risk of poor OS (HR 1.80; 95% CI, 1.35-2.41, Z = 3.99, <em>P</em> &lt; .05) compared to those with low TK1a level. Similar finding is revealed in PFS analysis. The overall heterogeneity in the analysis was substantial. After regression analysis, sample type likely caused it. We performed an analysis to indicate that high TK1a level linked to negative ER status (OR: 0.651, 95% CI, 0.43-0.985, <em>P</em> &lt; .001) but not other factors. Funnel plot test showed no publication bias in the included articles. Assessing TK1a level may offer supportive insights into the prognosis of breast cancer patients. This biomarker could potentially aid in evaluating patient outcomes and gauging the effectiveness of treatment strategies in clinical interventions.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 189-197"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476811","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":"Hard and Soft MRI Signs of Nipple-Areolar Complex Involvement in Breast Cancer","authors":"Tal Friehmann ,&nbsp;Hana Shpitzer ,&nbsp;Marva Dahan Shemesh ,&nbsp;Eli Atar ,&nbsp;Noa Rotbart ,&nbsp;Tzippy Shochat ,&nbsp;Meirav Wolff-Bar ,&nbsp;Shlomit Tamir ,&nbsp;Vladyslav Gaisinskyi ,&nbsp;Eran Sharon ,&nbsp;Ahuva Grubstein","doi":"10.1016/j.clbc.2026.01.012","DOIUrl":"10.1016/j.clbc.2026.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Accurate preoperative assessment of nipple-areolar complex (NAC) involvement is essential for determining the feasibility of nipple-sparing surgery in breast cancer. Magnetic resonance imaging (MRI) offers high sensitivity, but interpretation may be confounded by benign mimics of malignancy.</div></div><div><h3>Purpose</h3><div>To identify and evaluate MRI features predictive of pathologically confirmed NAC involvement in breast cancer.</div></div><div><h3>Material and Methods</h3><div>This retrospective study included 78 breast cancer patients with suspected NAC involvement on preoperative MRI performed between 2015 to 2024. All cases had surgical pathology confirmation. MRI findings were assessed for tumor morphology, tumor-to-nipple distance, ductal enhancement, and direct tumor extension. Logistic regression analyses were used to determine the association between imaging features and NAC involvement.</div></div><div><h3>Results</h3><div>Among 58 eligible cases (excluding 20 patients), 31 (53%) had pathologically confirmed NAC involvement. Direct tumor extension and tumor proximity &lt; 10 mm was most frequently associated with positive findings. On multivariate analysis, mass-forming tumors within 10 mm of the nipple demonstrated significantly increased odds of NAC involvement (OR 4.32; <em>P</em> = .0095), particularly when combined with ductal enhancement or hormone receptor positivity.</div></div><div><h3>Conclusion</h3><div>MRI features most predictive of NAC involvement include direct tumor extension and short tumor-to-nipple distance. These “hard signs” support excision of the NAC. In contrast, “soft signs” such as ductal enhancement or ductal dilatation, without direct continuity may warrant further diagnostic workup before ruling out nipple preservation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 94-101"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282619","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":"Evaluating Breast Reconstruction Equity Using the Social Vulnerability Index: A Single-Institution Cohort Study","authors":"Wooram F. Jung,&nbsp;Evan Rothchild,&nbsp;Armen K. Kasabian","doi":"10.1016/j.clbc.2026.01.015","DOIUrl":"10.1016/j.clbc.2026.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Socioeconomic disparities continue to influence access to and outcomes of postmastectomy breast reconstruction. The Social Vulnerability Index (SVI), a validated public health metric incorporating 16 socioeconomic and demographic factors, offers a standardized framework to assess community-level vulnerability. This study evaluated the association between SVI and breast reconstruction timing and outcomes at a single academic institution.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted of patients undergoing breast reconstruction following mastectomy for breast cancer between January 2021 and December 2024 by a single surgeon. Residential addresses were geocoded and linked to the 2020 CDC SVI census tract–level data. Patients were stratified into quartiles of vulnerability. The primary outcome was time from breast cancer diagnosis to earliest treatment. Kaplan–Meier and Cox proportional-hazards models were used for time-to-treatment analyses, adjusted for race, tumor stage, and grade.</div></div><div><h3>Results</h3><div>Among 264 patients, higher SVI quartiles were associated with greater racial diversity, increased Medicaid/Medicare coverage, and fewer prior reconstructions. Median age and comorbidities were similar across quartiles. Time to earliest treatment did not differ significantly between quartiles. SVI was not independently associated with treatment delay; however, Black patients and those categorized as “Other” experienced significant delays compared to White patients. Tumor stage strongly predicted earlier treatment initiation.</div></div><div><h3>Conclusions</h3><div>While SVI correlated with demographic differences, it was not associated with treatment delays or worse perioperative outcomes in this cohort. These findings suggest that equitable institutional practices and national policy initiatives may mitigate structural disparities in reconstructive access, though racial inequities persist and warrant continued attention.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 119-127"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324963","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":"Novel Genetic Susceptibility Markers for Breast Cancer in Iraqi Women: First Evidence of CYP3A4*1B Protective Effects and GSTP1/MTHFR Risk Associations","authors":"Wisam Hindawi Hoidy ,&nbsp;Mohammed Ouda Orabiy ,&nbsp;Shaimaa Mohsen Essa ,&nbsp;Layth Samir Jasim","doi":"10.1016/j.clbc.2025.10.004","DOIUrl":"10.1016/j.clbc.2025.10.004","url":null,"abstract":"<div><h3>Background</h3><div>This is the first study looking at breast cancer risk using the polymorphisms CYP3A4*1B, GSTP1 Ile105Val, MTHFR C677T, and COMT Val158Met for breast cancer predisposed Iraqi population with specific environmental carcinogenic exposures.</div></div><div><h3>Methods</h3><div>Aged matched healthy controls were 610 individuals of Iraqi origin alongside 414 histologically confirmed breast cancer patients forming a case-control study cohort. CDNA was obtained from peripheral blood samples, which underwent genotyping via tetra-primer ARMS-PCR. Statistical evaluation was performed based on several genetic models with odds ratios (OR) and 95% confidence intervals (CI) calculated by logistic regression.</div></div><div><h3>Results</h3><div>For 3 polymorphisms, crucial associations were found and these include CYP3A4*1B which showed a protective effect against breast cancer (OR = 0.72, 95% CI, 0.54-0.96, <em>P</em> = .027), the effect being strong in women less than 50 years old. Increased cancer risk was associated with GSTP1 Ile105Val (OR = 1.68, 95% CI, 1.23-2.31, <em>P</em> = .001) especially in older females and those with elevated BMI. The same risk was also conferred by MTHFR C677T (OR = 1.45; 95% CI, 1.12-1.89, <em>P</em> = .005). No significant association for COMT Val158Met was observed (<em>P</em> = .156). All polymorphisms among controls were in Hardy–Weinberg equilibrium.</div></div><div><h3>Conclusions</h3><div>The study presented the taw evidence of both CYP3A4*1B and GSTP1 Ile105Val along with MTHFR C677T polymorphisms associating them to breast cancer susceptibility in Iraqi population which reflects these specific genetic risks and reinforces middle eastern populations towards precision medicine frameworks concerning breast cancer treatment and intervention strategies.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 176-188"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444147","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}