Journal of Breast Cancer最新文献

{"title":"Predicting Pathological Complete Response in Breast Cancer After Two Cycles of Neoadjuvant Chemotherapy by Tumor Reduction Rate: A Retrospective Case-Control Study.","authors":"Litong Yao,&nbsp;Xiaoyan Liu,&nbsp;Mozhi Wang,&nbsp;Keda Yu,&nbsp;Shouping Xu,&nbsp;Pengfei Qiu,&nbsp;Zhidong Lv,&nbsp;Xinwen Zhang,&nbsp;Yingying Xu","doi":"10.4048/jbc.2023.26.e12","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e12","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to identify effectiveness-associated indicators and evaluate the optimal tumor reduction rate (TRR) after two cycles of neoadjuvant chemotherapy (NAC) in patients with invasive breast cancer.</p><p><strong>Methods: </strong>This retrospective case-control study included patients who underwent at least four cycles of NAC at the Department of Breast Surgery between February 2013 and February 2020. A regression nomogram model for predicting pathological responses was constructed based on potential indicators.</p><p><strong>Results: </strong>A total of 784 patients were included, of whom 170 (21.68%) reported pathological complete response (pCR) after NAC and 614 (78.32%) had residual invasive tumors. The clinical T stage, clinical N stage, molecular subtype, and TRR were identified as independent predictors of pCR. Patients with a TRR > 35% were more likely to achieve pCR (odds ratio, 5.396; 95% confidence interval [CI], 3.299-8.825). The receiver operating characteristic (ROC) curve was plotted using the probability value, and the area under the ROC curve was 0.892 (95% CI, 0.863-0.922).</p><p><strong>Conclusion: </strong>TRR > 35% is predictive of pCR after two cycles of NAC, and an early evaluation model using a nomogram based on five indicators, age, clinical T stage, clinical N stage, molecular subtype, and TRR, is applicable in patients with invasive breast cancer.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 2","pages":"136-151"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/56/jbc-26-136.PMC10139844.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9730599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological and Histological Clues in the Diagnosis of Solitary and Synchronous Breast Metastasis From Small Cell Lung Carcinoma.","authors":"Jung Hee Byon,&nbsp;Kyoung Min Kim,&nbsp;Eun Jung Choi","doi":"10.4048/jbc.2023.26.e20","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e20","url":null,"abstract":"<p><p>Breast metastases from small cell lung carcinoma (SCLC) are extremely rare. Although reports of breast metastases from SCLC exist, only three studies have reported solitary and synchronous breast metastases. Herein, we present a case of SCLC with solitary and synchronous breast metastases. This unusual case highlights the importance of the combined use of radiological and immunohistochemical features to accurately distinguish solitary metastatic SCLC from primary breast carcinoma or metastatic carcinoma of other types of lung cancer. It also emphasizes the importance of the differences between solitary metastatic SCLC and primary breast carcinoma or metastatic carcinoma of other types of lung cancer for the respective prognoses and development of appropriate therapeutic plans.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 2","pages":"201-206"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/ff/jbc-26-201.PMC10139847.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9759172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Preliminary Experience of Endoscopic Total Mastectomy With Immediate Free Abdominal-Based Perforator Flap Reconstruction Using Minimal Incisions, and Literature Review.","authors":"Sabrina Ngaserin,&nbsp;Allen Wei-Jiat Wong,&nbsp;Faith Qi-Hui Leong,&nbsp;Jia-Jun Feng,&nbsp;Yee Onn Kok,&nbsp;Benita Kiat-Tee Tan","doi":"10.4048/jbc.2023.26.e10","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e10","url":null,"abstract":"<p><strong>Purpose: </strong>Endoscopic total mastectomy (ETM) is predominantly performed with reconstruction using prostheses, lipofilling, omental flaps, latissimus dorsi flaps, or a combination of these techniques. Common approaches include minimal incisions, e.g., periareolar, inframammary, axillary, or mid-axillary line, which limit the technical ability to perform autologous flap insets and microvascular anastomoses, as such the ETM with free abdominal-based perforator flap reconstruction has not been robustly explored.</p><p><strong>Methods: </strong>We studied female patients with breast cancer who underwent ETM and abdominal-based flap reconstruction. Clinical-radiological-pathological characteristics, surgery, complications, recurrence rates, and aesthetic outcomes were reviewed.</p><p><strong>Results: </strong>Twelve patients underwent ETM with abdominal-based flap reconstruction. The mean age was 53.4 years (range 36-65). Of the patients, 33.3% were surgically treated for stage I, 58.4% for stage II, and 8.3% for stage III cancer. Mean tumor size was 35.4 mm (range 1-67). Mean specimen weight was 458.75 g (range 242-800). Of the patients, 92.3% successfully received endoscopic nipple-sparing mastectomy and 7.7% underwent intraoperative conversion to skin-sparing mastectomy after carcinoma was reported on frozen section of the nipple base. Mean operative time for ETM was 139 minutes (92-198), and the average ischemic time was 37.3 minutes (range 22-50). Fifty percent of patients underwent deep inferior epigastric perforator, 33.4% underwent MS-2 transverse rectus abdominis musculocutaneous (TRAM), 8.3% underwent MS-1 TRAM, and 8.3% underwent pedicled TRAM flap reconstruction. No cases required re-exploration, no flap failure occurred, margins were clear, and no skin or nipple-areolar complex ischemia/necrosis developed. In the aesthetic outcome evaluation, 16.7% were excellent, 75% good, 8.3% fair, and none were unsatisfactory. No recurrences were observed.</p><p><strong>Conclusion: </strong>ETM through a minimal-access inferior mammary or mid-axillary line approach, followed by immediate pedicled TRAM or free abdominal-based perforator flap reconstruction, can be a safe means of achieving an \"aesthetically scarless\" mastectomy and reconstruction through minimal incisions.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 2","pages":"152-167"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/0f/jbc-26-152.PMC10139846.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9730598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Role of Axillary Lymph Node Fine-Needle Aspiration Cytology in Early Breast Cancer With or Without Neoadjuvant Chemotherapy.","authors":"Daiki Takatsuka,&nbsp;Akiyo Yoshimura,&nbsp;Masataka Sawaki,&nbsp;Masaya Hattori,&nbsp;Haruru Kotani,&nbsp;Ayumi Kataoka,&nbsp;Nanae Horisawa,&nbsp;Yuri Ozaki,&nbsp;Yuka Endo,&nbsp;Kazuki Nozawa,&nbsp;Hiroji Iwata","doi":"10.4048/jbc.2023.26.e13","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e13","url":null,"abstract":"<p><strong>Purpose: </strong>Fine-needle aspiration cytology (FNAC) of axillary lymph nodes (AxLNs) is performed to diagnose nodal metastasis in patients with breast cancer. Although the sensitivity of ultrasound-guided FNAC for identifying AxLN metastasis is in the range of 36%-99%, whether sentinel lymph node biopsy (SLNB) should be performed for neoadjuvant chemotherapy (NAC) patients with negative FNAC results is uncertain. This study aimed to determine the role of FNAC before NAC in the evaluation and management of AxLN in early breast cancer patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 3,810 clinically node-negative (a lymph node with no clinical metastasis without FNAC or radiological suspicion of metastasis with negative FNAC results) patients with breast cancer who underwent SLNB between 2008 and 2019. We compared the positivity rate of sentinel lymph nodes (SLNs) between patients who received and those who did not receive NAC with negative FNAC results or without FNAC and axillary recurrence rate in the neoadjuvant group with negative SLNB results.</p><p><strong>Results: </strong>In the non-neoadjuvant (primary surgery) group, the positivity rate of SLNs in patients with negative FNAC results was higher than that in patients without FNAC (33.2% vs. 12.9%; <i>p</i> < 0.001). However, the SLN positivity rate of patients with negative FNAC results (false-negative rate for FNAC) in the neoadjuvant group was lower than that in the primary surgery group (3.0% vs. 33.2%; <i>p</i> < 0.001). After a median follow-up of 3 years, one axillary nodal recurrence was observed, which was a case from the neoadjuvant non-FNAC group. None of the patients in the neoadjuvant group with negative FNAC results had axillary recurrence.</p><p><strong>Conclusion: </strong>The false-negative rate for FNAC in the primary surgery group was high; however, SLNB was the proper axillary staging procedure for NAC patients who have clinically suspicious AxLN metastases on radiologic examination but negative FNAC results.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 2","pages":"117-125"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/54/jbc-26-117.PMC10139842.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Elevation of Cancer Antigen 15-3 (CA15-3) in Patients With Early Breast Cancer With Normal Serum CA15-3 Level.","authors":"Jai Min Ryu,&nbsp;Danbee Kang,&nbsp;Juhee Cho,&nbsp;Jeong Eon Lee,&nbsp;Seok Won Kim,&nbsp;Seok Jin Nam,&nbsp;Se Kyung Lee,&nbsp;Yeon Jin Kim,&nbsp;Young-Hyuck Im,&nbsp;Jin Seok Ahn,&nbsp;Yeon Hee Park,&nbsp;Ji-Yeon Kim,&nbsp;Hyunjong Lee,&nbsp;Mira Kang,&nbsp;Jong Han Yu","doi":"10.4048/jbc.2023.26.e17","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e17","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer antigen 15-3 (CA15-3) is a serum tumor marker for breast cancer (BC) extensively used in clinical practice. CA15-3 is non-invasive, easily available, and a cost-effective tumor marker for immediate diagnosis, monitoring and prediction of BC recurrence. We hypothesized that an elevation of CA15-3 may have prognostic impact in patients with early BC with normal serum CA15-3 level.</p><p><strong>Methods: </strong>This was a retrospective cohort study, which included patients with BC who received curative surgery at a comprehensive single institution between 2000 and 2016. CA15-3 levels from 0 to 30 U/mL were considered normal, and patients who had CA15-3 > 30 U/mL, were excluded from the study.</p><p><strong>Results: </strong>The mean age of study participants (n = 11,452) was 49.3 years. The proportion of participants with elevated CA15-3 ≥ 1 standard deviation (SD) compared with the previous examination during follow-up was 23.3% (n = 2,666). During the follow-up (median follow-up 5.8 years), 790 patients experienced recurrence. The fully-adjusted hazard ratio (HR) for recurrence comparing participants with stable CA15-3 level to subjects with elevated CA15-3 level was 1.76 (95% confidence interval [CI], 1.52-2.03). In addition, if the CA15-3 was elevated ≥ 1 SD, the risk was much higher (HR, 6.87; 95% CI, 5.81-8.11) than in patients without elevated CA15-3 ≥ 1 SD. In sensitivity analysis, the recurrence risk was consistently higher in participants with elevated CA15-3 levels than in participants without elevated CA15-3 levels. The association between elevated CA15-3 levels and incidence of recurrence was observed in all subtypes and the association was stronger in patients with N+ than in patients with N0 stage (<i>p</i>-value for interaction < 0.01).</p><p><strong>Conclusion: </strong>The results of the present study demonstrated that elevation of CA15-3 in patients with early BC and initial normal serum CA15-3 levels has a prognostic impact.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 2","pages":"126-135"},"PeriodicalIF":2.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/84/jbc-26-126.PMC10139845.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Strategies for Partial Breast Reconstruction in Medial-Located Breast Cancer: A 12-Year Experience.","authors":"Myeong Jae Kang,&nbsp;Hyun Ki Hong,&nbsp;Pil Seon Eo,&nbsp;Joon Seok Lee,&nbsp;Jeong Woo Lee,&nbsp;Jeeyeon Lee,&nbsp;Ho Yong Park,&nbsp;Jung Dug Yang","doi":"10.4048/jbc.2023.26.e8","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e8","url":null,"abstract":"<p><strong>Purpose: </strong>Partial breast reconstruction is challenging in medially located breast cancer, particularly in terms of achieving satisfactory aesthetic coverage. Thus, we aimed to investigate surgical strategies for filling medial defects resulting from breast-conserving surgery to improve patient satisfaction and aesthetic outcomes.</p><p><strong>Methods: </strong>We retrospectively evaluated 113 patients (114 cases) with medially located breast cancer between 2007 and 2018. We analysed the patient data, such as breast size, specimen weight, complications, and aesthetic results obtained using a questionnaire.</p><p><strong>Results: </strong>The mean body mass index and specimen weight were 23.43 kg/m² (range, 18.5-26.8) and 83.29 g (range, 15-290 g), respectively. The tennis racket and round-block techniques were chosen for small defects (< 10%-15%) in small- and medium-sized breasts. The rotational and perforator flap techniques were used for medium-sized defects. The latissimus dorsi (LD) flap technique was used for large defects (> 30%). Hematoma was found in 1 case (0.96%), linear skin necrosis was found in 1 case (0.96%), seroma in the LD flaps was found in 8 cases (7.69%); fat necrosis in the rotational flaps was found in 2 cases (1.92%); and fat necrosis in an anterior intercostal artery perforator flap was found in 1 case (0.96%). 91 patients (87.5%) were satisfied with the aesthetic results.</p><p><strong>Conclusion: </strong>The techniques used in this study for medially located breast cancer can produce fine aesthetic outcomes with regard to breast size and resection volume, with few complications.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 1","pages":"35-45"},"PeriodicalIF":2.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/a1/jbc-26-35.PMC9981984.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9376912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications Including Capsular Contracture in Direct-to-Implant Breast Reconstruction With Textured Anatomical Versus Smooth Round Implants: A Single Center Retrospective Analysis.","authors":"Hong Bae Jeon,&nbsp;Minyoung Lee,&nbsp;Tai Suk Roh,&nbsp;Joon Jeong,&nbsp;Sung Gwe Ahn,&nbsp;Soong June Bae,&nbsp;Nara Lee,&nbsp;Young Seok Kim","doi":"10.4048/jbc.2023.26.e7","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e7","url":null,"abstract":"<p><strong>Purpose: </strong>Implant-based breast reconstruction is the most common reconstruction method used after mastectomy in breast cancer patients. Many studies have compared the smooth round implants and textured anatomical implants. This study aimed to compare the complications, including capsular contracture, between these two implants used in direct-to-implant (DTI) breast reconstruction.</p><p><strong>Methods: </strong>This retrospective chart review was performed using a prospectively maintained database from a single center. We identified patients who underwent mastectomy with DTI single-stage breast reconstruction at our hospital between August 2011 and June 2021. The overall complications, including capsular contracture, postoperative infection, seroma, hematoma, implant rupture, implant exposure, rippling, implant malposition, and nipple necrosis, were analyzed.</p><p><strong>Results: </strong>In total, 340 breasts of 323 patients were reconstructed by the DTI approach using either textured anatomical (n = 203) or smooth round (n = 137) implants. The incidence of overall complications and capsular contracture was significantly lower with smooth round implants than with textured anatomical implants. Multivariate analysis showed that smooth round implants were associated with a reduced risk of overall complications (odds ratio [OR], 0.465; 95% confidence interval [CI], 0.265-0.813) and capsular contracture (OR, 0.475; 95% CI, 0.235-0.962). Particularly, smooth round implants were associated with a decreased risk of overall complications in patients not receiving adjuvant chemotherapy and a decreased risk of capsular contracture in patients with body mass index < 25 kg/m² and in those not receiving adjuvant radiotherapy.</p><p><strong>Conclusion: </strong>Smooth round implants demonstrated a decreased risk of overall complications and capsular contracture when compared with textured anatomical implants. These results may be utilized in counseling patients regarding the advantages and disadvantages of smooth round implants in DTI breast reconstruction.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 1","pages":"25-34"},"PeriodicalIF":2.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/38/jbc-26-25.PMC9981986.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9376911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AKR1C2 Promotes Metastasis and Regulates the Molecular Features of Luminal Androgen Receptor Subtype in Triple Negative Breast Cancer Cells.","authors":"Songbin Li,&nbsp;Woochan Lee,&nbsp;Woohang Heo,&nbsp;Hye-Youn Son,&nbsp;Yujeong Her,&nbsp;Jong-Il Kim,&nbsp;Hyeong-Gon Moon","doi":"10.4048/jbc.2023.26.e1","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e1","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with triple-negative breast cancer (TNBC) have an increased risk of distant metastasis compared to those with other subtypes. In this study, we aimed to identify the genes associated with distant metastasis in TNBC and their underlying mechanisms.</p><p><strong>Methods: </strong>We established patient-derived xenograft (PDX) models using surgically resected breast cancer tissues from 31 patients with TNBC. Among these, 15 patients subsequently developed distant metastases. Candidate metastasis-associated genes were identified using RNA sequencing. <i>In vitro</i> wound healing, proliferation, migration, and invasion assays and <i>in vivo</i> tumor xenograft and metastasis assays were performed to determine the functional importance of aldo-keto reductase family 1 member C2 (AKR1C2). Additionally, we used the METABRIC dataset to investigate the potential role of AKR1C2 in regulating TNBC subtypes and their downstream signaling activities.</p><p><strong>Results: </strong>RNA sequencing of primary and PDX tumors showed that genes involved in steroid hormone biosynthesis, including AKR1C2, were significantly upregulated in patients who subsequently developed metastasis. <i>In vitro</i> and <i>in vivo</i> assays showed that silencing of AKR1C2 resulted in reduced cell proliferation, migration, invasion, tumor growth, and incidence of lung metastasis. AKR1C2 was upregulated in the luminal androgen receptor (LAR) subtype of TNBC in the METABRIC dataset, and AKR1C2 silencing resulted in the downregulation of LAR classifier genes in TNBC cell lines. The androgen receptor (AR) gene was a downstream mediator of AKR1C2-associated phenotypes in TNBC cells. AKR1C2 expression was associated with gene expression pathways that regulate AR expression, including JAK-STAT signaling or interleukin 6 (IL-6). The levels of phospho-signal transducer and activator of transcription and IL-6, along with secreted IL-6, were significantly downregulated in AKR1C2-silenced TNBC cells.</p><p><strong>Conclusion: </strong>Our data indicate that AKR1C2 is an important regulator of cancer growth and metastasis in TNBC and may be a critical determinant of LAR subtype features.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 1","pages":"60-76"},"PeriodicalIF":2.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d9/80/jbc-26-60.PMC9981988.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin Use Is Associated With Improved Outcomes in Inflammatory Breast Cancer Patients.","authors":"Christopher Johns,&nbsp;Allen Yen,&nbsp;Asal Rahimi,&nbsp;Yu-Lun Liu,&nbsp;Ann Marilyn Leitch,&nbsp;Ann Spangler,&nbsp;Prasanna Alluri,&nbsp;Chika Nwachukwu,&nbsp;Rachel Wooldridge,&nbsp;Deborah Farr,&nbsp;D W Nathan Kim","doi":"10.4048/jbc.2023.26.e3","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e3","url":null,"abstract":"<p><strong>Purpose: </strong>Inflammatory breast cancer (IBC) is the most aggressive form of breast cancer and has a high propensity for distant metastases. Our previous data suggested that aspirin (acetylsalicylic acid, ASA) use may be associated with reduced risk of distant metastases in aggressive breast cancer; however, there are no reported studies on the potential benefit of ASA use in patients with IBC.</p><p><strong>Methods: </strong>Data from patients with non-metastatic IBC treated between 2000-2017 at two institutions, were reviewed. Overall survival (OS), disease-free survival (DFS), and distant metastasis-free survival (DMFS) were performed using Kaplan-Meier analysis. Univariate and multivariable logistic regression models were used to identify significant associated factors.</p><p><strong>Results: </strong>Of 59 patients meeting the criteria for analysis and available for review, 14 ASA users were identified. ASA users demonstrated increased OS (<i>p</i> = 0.03) and DMFS (<i>p</i> = 0.02), with 5-year OS and DMFS of 92% (<i>p</i> = 0.01) and 85% (<i>p</i> = 0.01) compared to 51% and 43%, respectively, for non-ASA users. In univariate analysis, pT stage, pN stage, and ASA use were significantly correlated (<i>p</i> < 0.05) with OS and DFS. On multivariable analysis, ASA use (hazard ratio [HR], 0.11; 95% confidence interval [CI], 0.01-0.8) and lymph node stage (HR, 5.9; 95% CI, 1.4-25.9) remained significant for OS and DFS ASA use (HR, 0.13; 95% CI, 0.03-0.56) and lymph node stage (HR, 5.6; 95% CI, 1.9-16.4).</p><p><strong>Conclusion: </strong>ASA use during remission was associated with significantly improved OS and DMFS in patients with IBC. These results suggest that ASA may provide survival benefits to patients with IBC. Prospective clinical trials of ASA use in patients with high-risk IBC in remission should be considered.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 1","pages":"14-24"},"PeriodicalIF":2.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/23/jbc-26-14.PMC9981985.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9373732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Breast Cancer-Related Lymphedema With Topical Tacrolimus: A Prospective, Open-Label, Single-Arm, Phase II Pilot Trial.","authors":"Frederik C Gulmark Hansen,&nbsp;Mads Gustaf Jørgensen,&nbsp;Jens Ahm Sørensen","doi":"10.4048/jbc.2023.26.e2","DOIUrl":"https://doi.org/10.4048/jbc.2023.26.e2","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer-related lymphedema (BCRL) is a chronic, progressive side effect of breast cancer treatment, occurring in one-third of patients treated with axillary lymph node dissection and nodal radiotherapy. Cluster of differentiation 4-positive (CD4⁺) cells plays a key role in BCRL by facilitating inflammation and inhibiting lymphangiogenesis. Tacrolimus is an anti-inflammatory and immunosuppressive macrolide that targets CD4⁺ cells. Treatment of lymphedema with topical tacrolimus has revealed promising results in preclinical trials. This clinical trial was aimed at evaluating the feasibility, safety, and effect of tacrolimus in women with stage I or II BCRL, according to the International Society of Lymphology.</p><p><strong>Methods: </strong>We conducted this open-label, single-arm, phase II pilot trial from September 2020 to April 2021. Eighteen women with BCRL stage I or II BCRL were treated with topical tacrolimus for 6 months and followed up at 3 and 6 months. The primary outcome was arm volume, and secondary outcomes were the lymphedema index (L-Dex), health-related quality of life (HRQoL), lymph flow and function, and safety and feasibility of the trial design.</p><p><strong>Results: </strong>The mean lymphedema arm volume and L-Dex reduced significantly by 130.44 ± 210.13 mL (<i>p</i> < 0.05; relative reduction: 3.6%) and 3.54 ± 4.98 (<i>p</i> < 0.05), respectively, and health-related quality of life scores was improved significantly (<i>p</i> < 0.05). According to the MD Anderson scale, in terms of lymph flow and function, three patients (16.7%) showed improvement, while none showed worsening. Lymph flow or function showed no change according to the Arm Dermal Backflow scale.</p><p><strong>Conclusion: </strong>In this trial, treatment with tacrolimus was safe and feasible in women with stage I or II BCRL. Tacrolimus alleviated BCRL in terms of improved arm volume, L-Dex, and HRQoL. Assessments of lymph flow and function were positive, although inconclusive. Larger randomized controlled trials are required to verify these findings.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04541290.</p>","PeriodicalId":15206,"journal":{"name":"Journal of Breast Cancer","volume":"26 1","pages":"46-59"},"PeriodicalIF":2.4,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/42/jbc-26-46.PMC9981991.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10830761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}