Clinical breast cancer最新文献_第9页

Prognostic Factors for Long-Term Eribulin Response in a Cohort of Patients With HER2-Negative Metastatic Breast Cancer 一组 HER2 阴性转移性乳腺癌患者长期依利布林反应的预后因素

IF 2.9 3区医学

Clinical breast cancer Pub Date : 2024-06-19 DOI: 10.1016/j.clbc.2024.06.006

{"title":"Prognostic Factors for Long-Term Eribulin Response in a Cohort of Patients With HER2-Negative Metastatic Breast Cancer","authors":"","doi":"10.1016/j.clbc.2024.06.006","DOIUrl":"10.1016/j.clbc.2024.06.006","url":null,"abstract":"<div><h3>Context and Aims</h3><p>Eribulin is used in taxane and anthracycline refractory HER2-negative metastatic breast cancers (MBC). Patients treated in pivotal clinical trials achieved low survival rates, therefore, the identification of prognostic criteria for long progression-free survival (PFS) is still an unmet medical need. In this study, we sought to determine potential prognostic criteria for long-term eribulin response in HER2-negative MBC.</p></div><div><h3>Methods</h3><p>Our retrospective cohort includes female patients with HER2-negative MBC treated with eribulin in Franche-Comté, France. We defined a long-term response as at least 6 months of eribulin treatment. The primary endpoint was the analysis of criteria that differ according to the progression-free survival. Secondary outcomes concerned overall survival and response rate.</p></div><div><h3>Results</h3><p>From January 2011 to April 2020, 431 patients treated with eribulin were screened. Of them, 374 patients were included. Median PFS was 3.2 months (2.8-3.7). Eighty-eight patients (23.5%) had a long-term response to eribulin. Four discriminant criteria allowed to separate PFS in 2 arms (PFS < 3 months or > 6 months) with a 78% positive predictive value: histological grade, absence of meningeal metastasis, response to prior chemotherapy, and OMS status. We have developed a nomogram combining these 4 criteria. Median overall survival was 8.5 months (7.0-9.5).</p></div><div><h3>Conclusion</h3><p>Eribulin response in MBC can be driven by clinical and biological factors. Application of our nomogram could assist in the prescription of eribulin.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S152682092400171X/pdfft?md5=0491519e50c1ddeb5f4579c78122fb89&pid=1-s2.0-S152682092400171X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Challenges of Lobular Carcinomas from a Surgeon`s Point of View 从外科医生的角度看肺叶癌的挑战

IF 3.1 3区医学

Clinical breast cancer Pub Date : 2024-06-19 DOI: 10.1016/j.clbc.2024.06.007

Margit L.H. Riis

引用次数: 0

Development of a Preoperative Prediction Model Based on Spectral CT to Evaluate Axillary Lymph Node With Macrometastases in Clinical T1/2N0 Invasive Breast Cancer 基于光谱 CT 的术前预测模型的开发，用于评估临床 T1/2N0 浸润性乳腺癌腋窝淋巴结大转移情况

IF 3.1 3区医学

Clinical breast cancer Pub Date : 2024-06-18 DOI: 10.1016/j.clbc.2024.06.010

Fang Zeng, Weifeng Cai, Lin Lin, Cong Chen, Xiaoxue Tang, Zheting Yang, Yilin Chen, Lihong Chen, Lili Chen, Jing Li, Suping Chen, Chuang Wang, Yunjing Xue

{"title":"Development of a Preoperative Prediction Model Based on Spectral CT to Evaluate Axillary Lymph Node With Macrometastases in Clinical T1/2N0 Invasive Breast Cancer","authors":"Fang Zeng, Weifeng Cai, Lin Lin, Cong Chen, Xiaoxue Tang, Zheting Yang, Yilin Chen, Lihong Chen, Lili Chen, Jing Li, Suping Chen, Chuang Wang, Yunjing Xue","doi":"10.1016/j.clbc.2024.06.010","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.06.010","url":null,"abstract":"To develop a prediction model based on spectral computed tomography (CT) to evaluate axillary lymph node (ALN) with macrometastases in clinical T1/2N0 invasive breast cancer. A total of 217 clinical T1/2N0 invasive breast cancer patients who underwent spectral CT scans were retrospectively enrolled and categorized into a training cohort (n = 151) and validation cohort (n = 66). These patients were classified into ALN nonmacrometastases (stage pN0 or pN0 [i+] or pN1mi) and ALN macrometastases (stage pN1-3) subgroups. The morphologic criteria and quantitative spectral CT parameters of the most suspicious ALN were measured and compared. Least absolute shrinkage and selection operator (Lasso) was used to screen predictive indicators to build a logistic model. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate the models. The combined arterial-venous phase spectral CT model yielded the best diagnostic performance in discrimination of ALN nonmacrometastases and ALN macrometastases with the highest AUC (0.963 in the training cohort and 0.945 in validation cohorts). Among single phase spectral CT models, the venous phase spectral CT model showed the best performance (AUC = 0.960 in the training cohort and 0.940 in validation cohorts). There was no significant difference in AUCs among the 3 models (DeLong test, > .05 for each comparison). A Lasso-logistic model that combined morphologic features and quantitative spectral CT parameters based on contrast-enhanced spectral imaging potentially be used as a noninvasive tool for individual preoperative prediction of ALN status in clinical T1/2N0 invasive breast cancers.","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141574921","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

Psychiatric Diagnoses and Their Treatment in Women With Breast Cancer: A Latent Class Analysis of 1062 Inpatients 乳腺癌女性患者的精神诊断及其治疗：对 1062 名住院患者的潜类分析

IF 3.1 3区医学

Clinical breast cancer Pub Date : 2024-06-18 DOI: 10.1016/j.clbc.2024.06.011

Jan Ben Schulze, Marc Dörner, Mona Huber, Katja-Daniela Jordan, Roland von Känel, Sebastian Euler

{"title":"Psychiatric Diagnoses and Their Treatment in Women With Breast Cancer: A Latent Class Analysis of 1062 Inpatients","authors":"Jan Ben Schulze, Marc Dörner, Mona Huber, Katja-Daniela Jordan, Roland von Känel, Sebastian Euler","doi":"10.1016/j.clbc.2024.06.011","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.06.011","url":null,"abstract":"Psycho-oncological support (POS) and psychopharmacological interventions are effective in treating psychiatric symptoms in patients with breast cancer. However, despite high prevalences of psychiatric disorders in patients with breast cancer, a significant proportion remains untreated. Data from 1062 breast cancer patients who had been diagnosed and treated at a Comprehensive Cancer Center between 2012 and 2019 were analyzed retrospectively. We descriptively evaluated the number of patients with a psychiatric diagnosis, POS and psychiatric medication. Latent class analysis was used to examine the relationship between ICD-10 coded psychiatric diagnoses, POS, psychiatric medication, and, as important prognostic factors, tumor stage and somatic comorbidity. 31.5% of all patients had a psychiatric diagnosis, 20% received POS and up to 60% received psychiatric medication. Latent class analysis revealed three subgroups: 1) patients with a low cancer stage, low somatic comorbidity, no psychiatric diagnosis, no POS and no psychiatric medication; 2) patients with a low cancer stage, low somatic comorbidity, a psychiatric diagnosis, and a higher probability of POS and psychiatric medication than class 1 and class 3; 3) patients with advanced cancer stage, high somatic comorbidity, a higher probability of a psychiatric diagnosis and POS than class 1, and no psychiatric medication. This study indicated a high prevalence of psychiatric disorders among patients with breast cancer and a discrepancy between the number of patients having a psychiatric disorder and those receiving psychiatric medication. The identification of subgroups might contribute to better tailored treatment for those patients whose needs are insufficiently met.","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141574918","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 Outcomes of Benign Concordant MRI-Guided Breast Biopsies 良性一致磁共振成像引导下乳腺活检的临床结果

IF 2.9 3区医学

Clinical breast cancer Pub Date : 2024-06-18 DOI: 10.1016/j.clbc.2024.06.009

{"title":"Clinical Outcomes of Benign Concordant MRI-Guided Breast Biopsies","authors":"","doi":"10.1016/j.clbc.2024.06.009","DOIUrl":"10.1016/j.clbc.2024.06.009","url":null,"abstract":"<div><h3>Introduction</h3><p><span>MRI-guided biopsy is the standard of care for breast imaging findings seen only by MRI. Although a non-zero false-negative rate of MRI-guided </span>breast biopsy has been reported by multiple studies, there are varied practice patterns for imaging follow-up after a benign concordant MRI guided biopsy. This study assessed the outcomes of benign concordant MRI-guided biopsies at a single institution.</p></div><div><h3>Patients and Methods</h3><p><span>This IRB-approved, retrospective study included patients with MRI-guided biopsies of breast lesions<span> from November 1, 2014, to August 31, 2020. Only image-concordant breast lesions with benign </span></span>histopathology and those follow up with MRI imaging or excision were included in the study.</p></div><div><h3>Results</h3><p><span><span>Out of 275 lesions in 216 patients that met the inclusion criteria, 274 lesions were followed with MRI (range, 5-79 months; average, 25.5 months) and showed benign or stable features upon follow-up. One out of 275 lesions (0.4%), a 6 mm focal nonmass enhancement, was ultimately found to represent malignancy after initial MRI-guided biopsy yielded fibrocystic changes. The lesion was stable at a 6-month follow-up MRI but increased in size at 18 months. Repeat biopsy by ultrasound guidance yielded </span>invasive ductal carcinoma (IDC) and </span>ductal carcinoma in situ (DCIS).</p></div><div><h3>Conclusion</h3><p>Breast MRI-guided biopsy has a low false-negative rate. Our single malignancy from a total of 275 lesions gives a false negative rate of 0.4%. This data also supports a longer follow-up interval than the commonly performed 6-month follow-up, in order to assess for interval change.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141574920","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

A Pericardium Bovine Matrix Pocket in DTI Prepectoral Breast Reconstruction DTI 胸前乳房重建中的包膜牛基质袋

IF 2.9 3区医学

Clinical breast cancer Pub Date : 2024-06-12 DOI: 10.1016/j.clbc.2024.06.004

{"title":"A Pericardium Bovine Matrix Pocket in DTI Prepectoral Breast Reconstruction","authors":"","doi":"10.1016/j.clbc.2024.06.004","DOIUrl":"10.1016/j.clbc.2024.06.004","url":null,"abstract":"<div><p>Breast reconstructive surgery has evolved significantly over the years. One of the recent advancements is the use of prepectoral implants in combination with synthetic and biological material as a natural and effective coverage. To date, there is little published data on breast reconstruction using acellular bovine pericardium matrix and most concern submuscular breast reconstruction. This study aimed to describe the multicentric-multisurgeon experience in performing direct to implant (DTI) prepectoral breast reconstructions using acellular bovine pericardium matrix (ABPM) pocket.</p><p>A retrospective multicentric data collection of the all the immediate prepectoral breast reconstructions using acellular bovine pericardium was carried out by the authors. Surgical data including type of mastectomy, axillary surgery, type and size of implant, size of ABPM, duration of surgery were collected for each patient. Postoperative data including adjuvant treatments, complications, necessity to perform other interventions, patient's satisfaction were collected. Cosmetic results were also evaluated by 7 different observers at minimum 1 year follow-up.</p><p>A total of 65 breast reconstruction were included in the study. Mean follow up was 21.3 months.</p><p>Average surgical time was 1,42 hours. Minor complications occurred in 4 breasts; major complications occurred in 2 breasts. After 6 months follow-up, 7 patients underwent fat grafting to correct any rippling and /or wrinkling. Breast aesthetic and patients reported outcomes were satisfactory.</p><p>Not significant capsular contracture was noted at the follow up control.</p><p>To date, this is the largest study about prepectoral breast reconstruction with ABPM. On the basis of our results, prepectoral breast reconstruction ABPM assisted is a reliable, safe and suitable option providing good patient satisfaction outcomes.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398209","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

Correlating Predicted Adjuvant Therapy Benefit and Risk of Recurrence Between Breast Cancer Index (BCI) and the 21-Gene Oncotype DX Recurrence Score (RS) 乳腺癌指数（BCI）与 21 基因 Oncotype DX 复发评分（RS）之间的预测辅助治疗获益与复发风险的相关性

IF 2.9 3区医学

Clinical breast cancer Pub Date : 2024-06-12 DOI: 10.1016/j.clbc.2024.06.005

{"title":"Correlating Predicted Adjuvant Therapy Benefit and Risk of Recurrence Between Breast Cancer Index (BCI) and the 21-Gene Oncotype DX Recurrence Score (RS)","authors":"","doi":"10.1016/j.clbc.2024.06.005","DOIUrl":"10.1016/j.clbc.2024.06.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Breast Cancer Index (BCI) is a genomic assay that evaluates the benefit of extending endocrine therapy<span> (ET) from 5 to 10 years and predicts recurrence risk (RR). We evaluated the association between BCI and Oncotype DX (ODX).</span></p></div><div><h3>Patients</h3><p>Women with hormone receptor (HR)-positive early-stage breast cancer (EBC) who had BCI and ODX performed were included.</p></div><div><h3>Methods</h3><p>We performed a retrospective review of women with HR-positive EBC. BCI was categorized as predictive of extended ET versus not and ODX recurrence score (RS) as low (0-10), intermediate (11-25), and high (26-100). Univariate and multivariable logistic and linear regression models assessed the relationship between BCI and ODX, factors associated with each, and discordance between scores.</p></div><div><h3>Results</h3><p><span>We identified 153 women, 22% were premenopausal and 18% were lymph node positive. The univariate logistic and linear models revealed an association between BCI predictive score and ODX RS (OR 7.84, CI, 2.63-23.36, </span><em>P</em> < .001) and log of BCI RR (Beta 0.04, CI, 0.02-0.06, <em>P</em><span> < .001). Seventy-four percent of BCI predictive scores were concordant with ODX RS and 83% of BCI RR was concordant with ODX RR. In a univariate logistic regression model, BCI predictive of ET benefit was associated with discordance (OR 28.00, CI, 10.58-74.02, </span><em>P</em> < .001). Higher ODX RR was associated with discordance (OR 1.92, CI, 1.42-2.59, <em>P</em> < .001).</p></div><div><h3>Conclusion</h3><p>We found a significant association between ODX and BCI predictive and prognostic scores. BCI predictive of extended ET benefit was associated with discordance with ODX RS. Higher predicted RR on ODX was associated with discordance with BCI predicted RR.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141407075","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

Intraoperative diagnosis of breast cancer metastasis in axillary lymph nodes: Cytological Smear vs. Frozen Section 腋窝淋巴结乳腺癌转移的术中诊断：细胞涂片与冰冻切片

IF 2.9 3区医学

Clinical breast cancer Pub Date : 2024-06-07 DOI: 10.1016/j.clbc.2024.06.002

{"title":"Intraoperative diagnosis of breast cancer metastasis in axillary lymph nodes: Cytological Smear vs. Frozen Section","authors":"","doi":"10.1016/j.clbc.2024.06.002","DOIUrl":"10.1016/j.clbc.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><p>Intraoperative evaluation of axillary lymph nodes is sometimes required to determine the extent of surgery. In this study, we wished to assess the reliability of cytologic smear (CS) in determining lymph node involvement with tumor. Theoretically, CS provides more substance for examination than touch-imprint cytology and is faster to perform than frozen section (FS). We hypothesized that CS sensitivity for tumor cell detection in the lymph nodes would be similar to FS, at least 0.90.</p></div><div><h3>Methods</h3><p>This was a retrospective observational study at the Rambam Health Care Campus (January, 2013-June, 2020). Lymph nodes underwent intraoperative evaluation using either CS or FS, based on the availability of a cytologist at the time of the examination. Both intraoperative evaluations were compared to the final pathology following fixation with formalin.</p></div><div><h3>Results</h3><p>Eighty-eight patients undergoing intraoperative analysis were analyzed (51 CS, 37 FS). False-negative tests were recorded in only 1 patient evaluated by each of the 2 methods. This resulted in sensitivity 0.91 (95%CI 0.59, 1.00) for CS and 0.88 (95%CI 0.47, 1.00) for FS, specificity 1.00 (95%CI 0.91, 1.00) for CS and 1.00 (95%CI 0.88, 1.00) for FS, positive predictive value 1.00 (95%CI 0.69, 1.00) for CS and 1.00 (95%CI 0.59, 1.00) for FS, and negative predictive value 0.98 (95%CI 0.87, 1.00) for CS and 0.97 (95%CI 0.83, 1.00) for FS.</p></div><div><h3>Conclusions</h3><p>The sensitivity of the CS in this study is comparable to that of FS and due to shorter analysis time required is the preferred method at our institution.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141392936","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

S-ketamine Infusion on Chronic Postoperative Pain Following Breast Cancer Surgery: A Randomized Double-Blind Placebo-Controlled Trial 输注 S-Ketamine 对乳腺癌术后慢性疼痛的影响：随机双盲安慰剂对照试验

IF 2.9 3区医学

Clinical breast cancer Pub Date : 2024-06-07 DOI: 10.1016/j.clbc.2024.06.003

{"title":"S-ketamine Infusion on Chronic Postoperative Pain Following Breast Cancer Surgery: A Randomized Double-Blind Placebo-Controlled Trial","authors":"","doi":"10.1016/j.clbc.2024.06.003","DOIUrl":"10.1016/j.clbc.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><p>Chronic postoperative surgical pain (CPSP) is a frequent complication following breast surgery and poses a challenge in terms of treatment. We hypothesized that the incidence of CPSP would be reduced at 3 months post-breast surgery with the administration of S-ketamine compared to a placebo.</p></div><div><h3>Patients and methods</h3><p>Participants were recruited and randomly assigned to either the S-ketamine group (S) or the control group (C). In group S, S-ketamine was administered as a 1.5 mg kg<sup>−1</sup> bolus followed by 2 mg kg<sup>−1</sup>h<sup>−1</sup><span> infusion, while in group C, a placebo of 0.9% saline was administered in the same volume and rate as S-ketamine. The primary outcome was the incidence of CPSP, measured using a 0-10 numeric rating scale (NRS), at 3 months postsurgery.</span></p></div><div><h3>Results</h3><p>A total of 72 patients scheduled for mastectomy<span> were enrolled (group S, n = 33; group C, n = 32). The incidence of CPSP at 3 months postsurgery was significantly lower in group S compared to group C (18.2% vs. 48.3%, P < .05). There was no statistical difference between the 2 groups in terms of the incidence of moderate to severe pain. NRS scores for postoperative pain at rest and during movement were significantly lower at 4 h and 24 h post-surgery (P < .05, respectively). Patients in Group S had lower Patient Health Questionnaire-9 (PHQ-9) scores at one week and 3 months post-surgery compared to Group C (P < .05, respectively).</span></p></div><div><h3>Conclusion</h3><p>S-ketamine infusion reduces the incidence of CPSP 3 months after breast surgery.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415346","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

Avoiding Locoregional Overtreatment in Older Adults With Early-Stage Breast Cancer 避免对患有早期乳腺癌的老年人进行局部过度治疗

IF 3.1 3区医学

Clinical breast cancer Pub Date : 2024-06-01 DOI: 10.1016/j.clbc.2024.02.004

Eliza H. Lorentzen , Christina A. Minami

{"title":"Avoiding Locoregional Overtreatment in Older Adults With Early-Stage Breast Cancer","authors":"Eliza H. Lorentzen , Christina A. Minami","doi":"10.1016/j.clbc.2024.02.004","DOIUrl":"10.1016/j.clbc.2024.02.004","url":null,"abstract":"<div><p>Advances in the treatment of older women with early-stage breast cancer, particularly opportunities for de-escalation of therapy, have afforded patients and providers opportunity to individualize care. As the majority of women ≥65 have estrogen receptor-positive, HER2-negative disease, locoregional therapy (surgery and/or radiation) may be tailored based on a patient's physiologic age to avoid either over- or undertreatment. To determine who would derive benefit from more or less intensive therapy, an accurate assessment of an older patient's physiologic age and incorporation of patient-specific values are paramount. While there now exist well-validated geriatric assessment tools whose use is encouraged by the American Society of Clinical Oncology when considering systemic therapy, these instruments have not been widely integrated into the locoregional breast cancer care model. This review aims to highlight the importance of assessing frailty and the concepts of and over- and undertreatment, in the context of trial data supporting opportunities for safe deescalation of locoregional therapy, when treating older women with early-stage breast cancer.</p></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139816946","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