Clinical breast cancer最新文献

{"title":"Breast Cancer Patient Flap Management After Mastectomy: A Best Practice Implementation Project","authors":"Minshan Liang ,&nbsp;Yuanzhen Luo ,&nbsp;Xiaojun Wang ,&nbsp;Chunhua Chen ,&nbsp;Piao Chen ,&nbsp;Zhenchong Xiong ,&nbsp;Li Liu ,&nbsp;Mengxiao Jiang ,&nbsp;Huiting Zhang","doi":"10.1016/j.clbc.2024.09.004","DOIUrl":"10.1016/j.clbc.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is a prevalent malignancy in women, with mastectomy as the main surgery. Common postmastectomy complications are seroma (15%-81%), infections (2.9%-3.8%), and flap necrosis (10%-18%), severely impacting quality of life and costs. However, there's a lack of standardized flap care protocols and limited staff knowledge.</div></div><div><h3>Objectives</h3><div>This study aims to apply best evidence for flap management post-mastectomy to standardize practices, reduce complications, and enhance patient's quality of life.</div></div><div><h3>Methods</h3><div>This project followed JBI PACES and GRiP principles, implementing evidence-based practices in a Chinese tertiary hospital between January and May 2023. It entailed evidence identification, integration into clinical context, protocol development, baseline audits, barrier/enabler analysis. The study compared pre- and post-evidence implementation rates of flap complications, healthcare staff's knowledge/skill scores on mastectomy flap management, and audit indicator adherence by both staff and patients.</div></div><div><h3>Results</h3><div>After evidence application, flap ischemia/necrosis rates dropped from 8.57% to 5.56% (<em>P</em> &lt; .001), wound infection rates after surgery reduced from 5.71% to 2.78% (<em>P</em> &lt; .001), and seroma rates decreased from 17.14% to 2.78% (<em>P</em> &lt; .001). Healthcare staff's knowledge and skill scores for flap management following mastectomy increased from 50.67 ±18.32 preimplementation to 98.33 ± 4.01 (<em>t</em> = -13.90, <em>P</em> &lt; .001). Audit criterion compliance rates increased from 8.57% to 94.29% to between 91.67% and 100%, with statistically significant differences in all 15 criteria (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Evidence-based management of flaps after mastectomy improves healthcare staff's knowledge and skills, enhances nursing quality, effectively reduces flap complications in patients, and boosts their quality of life.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages 46-55"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364604","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":"Psychiatric Diagnoses and Their Treatment in Women With Breast Cancer: A Latent Class Analysis of 1062 Inpatients","authors":"Jan Ben Schulze ,&nbsp;Marc Dörner ,&nbsp;Mona Huber ,&nbsp;Katja-Daniela Jordan ,&nbsp;Roland von Känel ,&nbsp;Sebastian Euler","doi":"10.1016/j.clbc.2024.06.011","DOIUrl":"10.1016/j.clbc.2024.06.011","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages e22-e29"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Lymphedema: The Impact of Indocyanine Green Lymphography on Personalized Therapy Outcomes in Breast Cancer Patients","authors":"Atilla Soran ,&nbsp;Kazim Senol,&nbsp;Kristin Lupinacci","doi":"10.1016/j.clbc.2024.10.010","DOIUrl":"10.1016/j.clbc.2024.10.010","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the role of Indocyanine Green Lymphography (ICG_L) in the early diagnosis and personalized management of breast cancer-related lymphedema (BCRL) among high-risk breast cancer (BC) survivors.</div></div><div><h3>Methods</h3><div>Patients who admitted to the UPMC Magee-Womens Hospital Lymphedema Program between October 2018 and December 2021 with episodic symptoms were enrolled into the study. Patient demographics, clinical characteristics, and outcomes were prospectively collected and retrospectively analysed. Lymphatic flow disruptions were identified and guided personalized therapeutic interventions were guided by ICG_L.</div></div><div><h3>Results</h3><div>Among 154 BC survivors, 184 arms were evaluated. Initial ICG_L showed 57.1% had no lymphedema, while 42.9% were classified as stage 1 to 3 lymphedema. Early diagnosis and personalized interventions provided improved outcomes, with only 4.3% developing clinical lymphedema after a median follow-up of 27 months. Patients exhibited stable or improved symptoms with individualized treatments such as manual lymphatic drainage, compression therapies, and physiotherapy.</div></div><div><h3>Conclusion</h3><div>ICG_L evaluation is essential for patients at high-risk of developing BCRL. Early diagnosis before clinical onset of lymphedema, and ICG_L guided therapy significantly enhances the clinical outcomes and improves lymphedema management.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages 19-26"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615823","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":"Deep Learning for Distinguishing Mucinous Breast Carcinoma From Fibroadenoma on Ultrasound","authors":"Yuan Yao ,&nbsp;Yang Zhao ,&nbsp;Xu Guo ,&nbsp;Xiangli Xu ,&nbsp;Baiyang Fu ,&nbsp;Hao Cui ,&nbsp;Jian Xue ,&nbsp;Jiawei Tian ,&nbsp;Ke Lu ,&nbsp;Lei Zhang","doi":"10.1016/j.clbc.2024.09.001","DOIUrl":"10.1016/j.clbc.2024.09.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Mucinous breast carcinoma (MBC) tends to be misdiagnosed as fibroadenomas (FA) due to its benign imaging characteristics. We aimed to develop a deep learning (DL) model to differentiate MBC and FA based on ultrasound (US) images. The model could contribute to the diagnosis of MBC for radiologists.</div></div><div><h3>Methods</h3><div>In this retrospective study, 884 eligible patients (700 FA patients and 184 MBC patients) with 2257 US images were enrolled. The images were randomly divided into a training set (<em>n</em> = 1805 images) and a test set (<em>n</em> = 452 images) in a ratio of 8:2. First, we used the training set to establish DL model, DL+ age-cutoff model and DL+ age-tree model. Then, we compared the diagnostic performance of three models to get the optimal model. Finally, we evaluated the diagnostic performance of radiologists (4 junior and 4 senior radiologists) with and without the assistance of the optimal model in the test set.</div></div><div><h3>Results</h3><div>The DL+ age-tree model yielded higher areas under the receiver operating characteristic curve (AUC) than DL model and DL+ age-cutoff model (0.945 vs. 0.835, <em>P</em> &lt; .001; 0.945 vs. 0.931, <em>P</em> &lt; .001, respectively). With the assistance of DL+ age-tree model, both junior and senior radiologists’ AUC had significant improvement (0.746-0.818, <em>P</em> = .010, 0.827-0.860, <em>P</em> = .005, respectively).</div></div><div><h3>Conclusions</h3><div>The DL+ age-tree model based on US images and age showed excellent performance in the differentiation of MBC and FA. Moreover, it can effectively improve the performance of radiologists with different degrees of experience that may contribute to reducing the misdiagnosis of MBC.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages 75-84"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342707","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":"Potential of MRI in Assessing Treatment Response After Neoadjuvant Radiation Therapy Treatment in Breast Cancer Patients: A Scoping Review","authors":"Ayyaz Qadir ,&nbsp;Nabita Singh ,&nbsp;Aung Aung Kywe Moe ,&nbsp;Glenn Cahoon ,&nbsp;Jessica Lye ,&nbsp;Michael Chao ,&nbsp;Farshad Foroudi ,&nbsp;Sergio Uribe","doi":"10.1016/j.clbc.2024.05.010","DOIUrl":"10.1016/j.clbc.2024.05.010","url":null,"abstract":"<div><div>The objective of this scoping review is to evaluate the potential of Magnetic Resonance Imaging (MRI) and to determine which of the available MRI techniques reported in the literature are the most promising for assessing treatment response in breast cancer patients following neoadjuvant radiotherapy (NRT). Ovid Medline, Embase, CINAHL, and Cochrane databases were searched to identify relevant studies published from inception until March 13, 2023. After primary selection, 2 reviewers evaluated each study using a standardized data extraction template, guided by set inclusion and exclusion criteria.</div><div>A total of 5 eligible studies were selected. The positive and negative predictive values for MRI predicting pathological complete response across the studies were 67% to 88% and 76% to 85%, respectively. MRI's potential in assessing postradiotherapy tumor sizes was greater for volume measurements than uni-dimensional longest diameter measurements; however, overestimation in surgical tumor sizes was observed. Apparent diffusion coefficient (ADC) values and Time to Enhance (TTE) was seen to increase post-NRT, with a notable difference between responders and nonresponders at 6 months, indicating a potential role in assessing treatment response.</div><div>In conclusion, this review highlights tumor volume measurements, ADC, and TTE as promising MRI metrics for assessing treatment response post-NRT in breast cancer. However, further research with larger cohorts is needed to confirm their utility. If MRI can accurately identify responders from nonresponders to NRT, it could enable a more personalized and tailored treatment approach, potentially minimizing radiation therapy related toxicity and enhancing cosmetic outcomes.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages e1-e9.e2"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436414","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}

{"title":"Impacts of Tumor Stage at Diagnosis and Adjuvant Therapy on Long-Term Survival Outcomes in Patients With Triple-Negative Breast Cancer Achieving Pathologic Complete Response After Neoadjuvant Chemotherapy","authors":"Ao-Xiang Chen ,&nbsp;Xiao Chen ,&nbsp;Xin-Xin Li ,&nbsp;Zhang-Yin Guo ,&nbsp;Xu-Chen Cao ,&nbsp;Xin Wang ,&nbsp;Bin Zhang","doi":"10.1016/j.clbc.2024.06.013","DOIUrl":"10.1016/j.clbc.2024.06.013","url":null,"abstract":"<div><h3>Background</h3><div>It remains unknown whether the tumor stage at initial diagnosis and adjuvant treatments had any impacts on the long-term survival outcomes of patients with triple-negative breast cancer (TNBC) achieving pathologic complete response (pCR) following neoadjuvant chemotherapy (NACT).</div></div><div><h3>Methods</h3><div>Clinical stage II-III patients with TNBC who achieved pCR after NACT were identified from the Surveillance, Epidemiology, and End Results (SEER) program (SEER cohort) and the National Clinical Research<span> Center for Cancer (Tianjin) in China (TMUCIH cohort). Survival analyses were conducted based on tumor stages and the types of adjuvant treatment received by the patients. The outcomes of interest were overall survival (OS) and breast cancer-specific survival (BCSS).</span></div></div><div><h3>Results</h3><div>The TMUCIH cohort comprised 178 patients with a median follow-up of 55.5 months. Two and 3 patients experienced BCSS and OS events, respectively. The SEER cohort included 1218 patients with a median follow-up of 65.5 months, where 53 and 78 patients experienced BCSS and OS events, respectively. Patients diagnosed with stage III disease had significantly higher hazards of death compared to stage II disease (OS: hazard ratio [HR], 3.34; 95% confidence interval [CI], 1.84-6.07; <em>P</em> &lt; .001; BCSS: HR, 2.86; 95% CI, 1.38-5.92; <em>P</em> &lt; .001). Adjuvant systemic and radiation therapy did not confer additional benefits to OS and BCSS.</div></div><div><h3>Conclusion</h3><div>Tumor stage at initial diagnosis remains an independent predictor of long-term survival outcomes in patients with TNBC achieving pCR after NACT. Postoperative adjuvant chemotherapy and radiation therapy do not appear to provide additional benefit to their long-term prognosis.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages e30-e39"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141574917","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":"The Predictive Value of Blood-Derived Exosomal miRNAs as Biomarkers in Breast Cancer: A Systematic Review","authors":"Marina Linares-Rodríguez ,&nbsp;Isabel Blancas ,&nbsp;Fernando Rodríguez-Serrano","doi":"10.1016/j.clbc.2024.06.016","DOIUrl":"10.1016/j.clbc.2024.06.016","url":null,"abstract":"<div><div>Breast cancer (BC) remains a widespread disease worldwide, despite advances in its detection and treatment. microRNAs (miRNAs) play a significant role in cancer, and their presence within exosomes may confer several advantages in terms of tumor initiation, propagation, immune evasion, and drug resistance compared to freely circulating miRNAs in the blood. The objective of this study was to conduct a systematic review to analyze the role of exosomal miRNAs present in serum or plasma as biomarkers in BC. Bibliographic sources were collected from various databases with no starting date limit until March 2023. The search terms used were related to “breast cancer,” “microRNAs,” and “exosomes.” Following the search, inclusion and exclusion criteria were applied, resulting in a total of 46 articles. Data were extracted from the selected studies and summarized to indicate the miRNAs, type of dysregulation, sample source, number of patients and controls, and clinical relevance of the miRNAs. We carried out an enrichment study of the microRNAs that appeared in at least 3 studies, those that were suitable for selection were miR-16, miR-21 and miR-155. Exosomal miRNAs isolated from blood samples of patients diagnosed with BC could be valuable in the clinical setting. They could provide information about early diagnosis, disease progression, recurrence, treatment response, and metastases. It is crucial to reach a consensus on the specific exosomal miRNAs to detect and the most appropriate type of sample for comprehensive utilization of miRNAs as biomarkers for BC.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages e48-e55.e15"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707551","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}

{"title":"Axillary Recurrence in Sentinel Lymph Node Negative Mastectomy Patients at 16 Years Median Follow Up: Natural History in the Absence of Radiation","authors":"Heidi S. Santa Cruz ,&nbsp;Francys C. Verdial ,&nbsp;Julia N. Shanno ,&nbsp;Alexandra J. Webster ,&nbsp;Rachel B. Jimenez ,&nbsp;Tawakalitu O. Oseni ,&nbsp;Tolga Ozmen ,&nbsp;Rebecca M. Kwait ,&nbsp;Michele A. Gadd ,&nbsp;Michelle C. Specht ,&nbsp;Barbara L. Smith","doi":"10.1016/j.clbc.2024.07.010","DOIUrl":"10.1016/j.clbc.2024.07.010","url":null,"abstract":"<div><h3>Background</h3><div>Axillary recurrence following lumpectomy with a negative sentinel lymph node biopsy (SLNB) is rare, possibly due to routine use of whole breast radiation. In this study, we characterized the rate of any axillary recurrence among mastectomy patients with a negative SLNB and no adjuvant radiation therapy.</div></div><div><h3>Methods</h3><div>We identified women who underwent mastectomy with SLNB for early-stage breast cancer (1999-2005) and included patients with pathologically negative nodes and no axillary dissection or adjuvant radiation. The primary outcome was ipsilateral axillary recurrence.</div></div><div><h3>Results</h3><div>A total of 234 women, median age 50 years, underwent 242 mastectomies. Histology showed 112 (46%) invasive cancers, 16 (7%) ductal carcinoma in-situ (DCIS) with microinvasion, and 114 (47%) pure DCIS. Cancers were predominantly estrogen receptor positive (59%) and moderate (41%) or high grade (32%). A mean of 2 final sentinel nodes were excised (range 1-6) and 21 patients (9%) had isolated tumor cells on SLNB pathology. At 16 years median follow up (range 1-22 years), 3 patients (1.2%) developed an isolated axillary failure, and 1 had concurrent axillary and chest wall recurrences (total axillary recurrence rate 1.7%). Three of four axillary recurrences occurred in patients with moderate or high-grade estrogen receptor-positive DCIS without invasion on mastectomy histology. Median time to axillary recurrence was 70.5 months (range 29-132 months).</div></div><div><h3>Conclusions</h3><div>Axillary recurrence is rare after a negative SLNB, even in the absence of adjuvant radiation. This supports the safety of forgoing additional surgery or radiation to the axilla in the early-stage breast cancer and a negative SLNB.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages e63-e70"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215828","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":"Evaluation of the Effect of Menopausal Status and BMI on Polymorphisms in Fas/Fas L and the Risk of Breast Cancer","authors":"Zahra Tahmasebi Fard","doi":"10.1016/j.clbc.2024.07.006","DOIUrl":"10.1016/j.clbc.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><div>FAS and FAS ligand play an essential role in cell apoptosis. An identifying feature of malignant cells is the loss of FAS and increased FASL expression. A study analyzing the effects of menopausal status and body mass index (BMI) on functional polymorphisms of FAS-(1377G/A; rs2234767 &amp; 670 A/G; rs1800682) and FASL (−844T/C; rs763110 &amp; Ivs-2nt; rs5030772) in breast cancer evaluated these effects.</div></div><div><h3>Patients and Methods</h3><div>316 blood samples were collected from breast cancer patients and healthy controls in this case/control study. RFLP-PCR was used after DNA extraction to determine genotypes. Age, BMI, menopausal status, smoking, and family history were also analyzed with genotypes. It was analyzed using SPSS software, X2 statistical tests, logistic regression, and Pearson's correlation. The study evaluated the role of indices and polymorphisms in breast cancer risk.</div></div><div><h3>Results</h3><div>While BMI and family history were significantly different, age, menopause status, and smoking were not. Examining the average BMI between menopausal and nonmenopausal people in the 2 groups showed a statistically significant difference between menopausal people (<em>P</em> &lt;0.0001). As a result of 1377AA, 670GG, 844TT, and IVS-2ntGG, the risk of breast cancer increased by 1.83 times, 2.35 times, and 2.38 times respectively. In addition, mutant alleles increased disease risk significantly. The risk of disease increased considerably for postmenopausal females with certain genotypes (except 1377GA and 844CT genotypes) and high BMI.</div></div><div><h3>Conclusion</h3><div>Having a high BMI during postmenopause increases your risk of breast cancer. In addition to menopause, BMI also influences disease progression. Different genotypes are needed to clarify this issue.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"25 1","pages":"Pages e56-e62"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838460","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":"Optimizing Postneoadjuvant Treatment of Residual Breast Cancer With Adjuvant Bevacizumab Alone, With Metronomic or Standard-Dose Chemotherapy: A Combined Analysis of DFCI 05-055 and DFCI 09-134/TBCRC 012/ABCDE Clinical Trials.","authors":"Dario Trapani, Qingchun Jin, Kathy D Miller, Hope S Rugo, Katherine E Reeder-Hayes, Tiffany Traina, Yara Abdou, Carla Falkson, Vandana Abramson, Jennifer Ligibel, Wendy Chen, Steven Come, Anju Nohria, Nicole Ryabin, Nabihah Tayob, Sara M Tolaney, Harold J Burstein, Erica L Mayer","doi":"10.1016/j.clbc.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.clbc.2024.12.018","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer patients with residual disease after neoadjuvant therapy have increased risk of recurrence. Novel therapies to decrease this risk are urgently needed.</p><p><strong>Methods: </strong>Two clinical trials (05-055 and 09-134) offered adjuvant bevacizumab-based therapy to stage I-III breast cancer patients with residual disease after neoadjuvant chemotherapy. Study 05-055 evaluated four treatment regimens: bevacizumab (cohort A); bevacizumab with metronomic cyclophosphamide and methotrexate (CM) (cohort B); and bevacizumab with body surface area-dosed capecitabine (cohorts C); or flat-dosed capecitabine (cohort D). The primary endpoint was feasibility and tolerability. In 09-134, patients were randomized to bevacizumab with or without CM; the primary endpoint was recurrence-free survival (RFS). Study 09-134 closed prematurely for lack of accrual. A pooled survival analysis with participants from 05-055 and 09-134 was conducted.</p><p><strong>Results: </strong>Among 213 total patients (05-055, n = 163; 09-134, n = 50), the most common adverse events (AEs) of any grade were headache (49.3%) and fatigue (57.3%). Grade 3-4 AEs were highest in cohorts C (71.4%) and D (72.5%). The 36-month RFS was 58.0% with bevacizumab monotherapy, 62.3% with bevacizumab plus CM, and 72.7%-75.0% with bevacizumab plus capecitabine (depending on schedule). Treatment with capecitabine was independently associated with improved RFS in triple-negative breast cancer (TNBC) (HR: 0.47; 95% CI, 0.23-0.96).</p><p><strong>Conclusion: </strong>This pooled analysis demonstrates that postneoadjuvant bevacizumab plus capecitabine may be associated with improved RFS, especially in TNBC. Each regimen carries moderate toxicity, and despite these treatments, patients with residual disease after neoadjuvant therapy still experience high rates of recurrence, indicating that new strategies are warranted.</p><p><strong>Clinical trial registration: </strong>clinicaltrials.gov, NCT00121134 (DFCI Protocol Number: 05-055); NCT00925652 (DFCI Protocol Number: 09-134).</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074066","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}