Breast cancer (Tokyo, Japan)最新文献

{"title":"Internal mammary node failure in invasive breast cancer patients who received post-operative radiotherapy without prophylactic internal mammary node irradiation.","authors":"Yasushi Hamamoto, Kenji Makita, Kei Nagasaki, Hiromitsu Kanzaki, Mariko Kochi, Michiko Yamashita, Mina Takahashi, Daisuke Takabatake, Kenjiro Aogi","doi":"10.1007/s12282-025-01746-y","DOIUrl":"https://doi.org/10.1007/s12282-025-01746-y","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) patients who would benefit the most from prophylactic internal mammary node (IMN) irradiation have not been clearly identified. Risk factors for ipsilateral IMN failure in BC patients who received post-operative radiotherapy (PORT) without prophylactic IMN irradiation were investigated.</p><p><strong>Methods: </strong>Between January 2012 and March 2013, unilateral invasive BC patients who had no clinically positive IMN and received PORT without prophylactic IMN irradiation after breast-conserving surgery or mastectomy were retrospectively reviewed. At that time, prophylactic IMN irradiation was not recommended for clinically negative IMN by Japanese BC guidelines. To identify risk factors of IMN failure, the following factors were assessed using univariate and multivariate analyses: primary tumor location, hormone receptor status, human epidermal growth factor receptor 2 (HER2), axillary node status, and administration of neoadjuvant chemotherapy (NAC).</p><p><strong>Results: </strong>A total of 194 BC patients (median age, 53 years; pStage I, 92; pStage II, 57; pStage III, 17; received NAC, 28) were analyzed. Median follow-up time with CT and/or FDG-PET/CT was 110 months (range, 4-132 months). IMN failure-free rates were 99% at 5 year and 98% at 10 year. The 10-year overall survival rate was 93%. In multivariate analysis, hormone receptor negativity was the only significant unfavorable factor for IMN failure (Hazard ratio 20.389, [95% CI 1.601-259.610], p = 0.02).</p><p><strong>Conclusions: </strong>Hormone receptor status may have a greater impact on IMN failure compared to the primary tumor location and axillary lymph node status in the modern systemic therapy era. Because our study was a small retrospective study, further large-scale studies are needed.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline risk variability by eligibility criteria in Cohort 1 of the monarchE trial for high-risk HR-positive, HER2-negative breast cancer.","authors":"Mai Hoshino, Tatsunori Shimoi, Taro Yamanaka, Rui Kitadai, Munehiro Ito, Ayumi Saito, Shosuke Kita, Asuka Kawachi, Hitomi Sumiyoshi Okuma, Aiko Maejima, Yuki Kojima, Kazuki Sudo, Emi Noguchi, Yasuhiro Fujiwara, Jun Kato, Kan Yonemori","doi":"10.1007/s12282-025-01747-x","DOIUrl":"https://doi.org/10.1007/s12282-025-01747-x","url":null,"abstract":"<p><strong>Background: </strong>Baseline recurrence risk increasingly guides adjuvant endocrine therapy for hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer (BC). The monarchE trial demonstrated the benefits of adding abemaciclib to endocrine therapy for high-risk patients. However, differences in baseline recurrence risks within monarchE Cohort 1 subgroups and their impact on absolute benefit remain unclear. This study assessed these prognostic differences.</p><p><strong>Methods: </strong>We retrospectively analysed 989 patients with HR-positive, and HER2-negative BC who underwent surgery between January 2017 and August 2019 at our institution. Patients were categorised into four groups: non-eligible (not meeting monarchE criteria), N1 + >5 cm (1-3 lymph node metastases with tumours >5 cm), N1 + G3 (1-3 lymph node metastases with Grade 3 tumours), and ≥N2 (≥4 lymph node metastases). Survival outcomes, including invasive disease-free survival (iDFS), distant disease-free survival, and overall survival, were analysed using Kaplan-Meier and Cox proportional hazards models.</p><p><strong>Results: </strong>The 5-year iDFS rates were 94.7% (non-eligible), 88.9% (N1 + >5 cm), 83.3% (N1 + G3), and 77.3% (≥N2) (p < 0.001). Multivariate analysis identified N1 + G3 HR3.38, p = 0.005), ≥N2 (HR 3.39, p < 0.001), and neoadjuvant chemotherapy (HR 2.71, p = 0.003) as poor prognostic factors.</p><p><strong>Conclusions: </strong>This study highlights the prognostic variability among high-risk subgroups aligned with monarchE Cohort 1 criteria. Individualized risk assessment will be key to optimizing the benefit of adjuvant therapy in HR-positive, HER2-negative breast cancer.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the clinical topography and progression of venous thromboembolism in Chinese breast cancer surgical patients: a prospective longitudinal study.","authors":"Hongxiu Chen, Wu Zhou, Jiali Zhang, Jieying Lv, Xiaotian Su, Qiuzhou Wang, Zhoupeng Wu, Xiaoxia Zhang, Xiuying Hu","doi":"10.1007/s12282-025-01748-w","DOIUrl":"https://doi.org/10.1007/s12282-025-01748-w","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a serious complication in breast cancer patients. However, limited attention has been given to its clinical characteristics and progression, particularly in Asian populations. Therefore, this study aimed to comprehensively investigate the clinical topography and progression of VTE in breast cancer patients using ultrasound in China.</p><p><strong>Methods: </strong>This prospective study was conducted at a 4500-bed tertiary hospital from August 2021 to September 2022. VTE was assessed routinely before discharge and upon self-reported symptoms. Patients without VTE during hospitalization were followed up at the 1, 3, and 6 months post-operation. Patients with VTE received weekly ultrasounds to monitor their progression. Data on clinical features, progression, and VTE-related healthcare burden were collected.</p><p><strong>Results: </strong>The cumulative incidence of VTE within six months was 19.96%, comprising lower-extremity superficial vein thrombosis (LE-SVT), lower-extremity deep vein thrombosis (LE-DVT), central venous catheter-related thrombosis (CRT), upper-extremity vein thrombosis, and pulmonary embolism (PE). VTE occurred as early as the first postoperative day, with 88.8% of cases developing during hospitalization, primarily LE-SVT and LE-DVT. CRT became predominant one month post-surgery. Early common symptoms included pain or tenderness along the puncture site, fullness pain/cramping pain/aching pain during activity. By the end of follow-up, most thrombi resolved, with minimal progression. VTE led to an additional 236 outpatient/emergency visits, three hospitalizations, and ¥148,211 costs.</p><p><strong>Conclusion: </strong>VTE incidence in breast cancer patients was high post-surgery, with distinct patterns of occurrence and progression. Early symptoms were often mild, nonspecific, and transient. While most thrombi resolve, VTE imposes a heavy medical burden and requires medical attention.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast tumors with intermediate ER expression differ biologically from ER-low tumors and exhibit a more favorable prognosis.","authors":"Yuko Ueki, Yoshiya Horimoto, Kazuharu Harada, Yumiko Ushiyama, Yumiko Ishizuka, Hiroko Onagi, Takuo Hayashi, Tsuyoshi Saito, Takahiko Kawate, Takashi Ishikawa, Junichiro Watanabe, Goro Kutomi","doi":"10.1007/s12282-025-01745-z","DOIUrl":"https://doi.org/10.1007/s12282-025-01745-z","url":null,"abstract":"<p><strong>Background: </strong>Estrogen receptor (ER) expression in breast cancer exhibits a widely recognized bimodal distribution, with increasing focus on the biological and clinical characteristics of the low-expression group. However, tumors with intermediate ER expression have been relatively understudied. This study aimed to clarify the clinicopathological and prognostic features of ER-intermediate (ER-int) tumors by comparing them with ER-low tumors.</p><p><strong>Methods: </strong>Tumors were classified into ER-low (1-10%), ER-int (11-70%), and ER-high (71-100%) groups based on immunohistochemistry. We retrospectively analyzed 261 breast cancer patients with ER-low or ER-int tumors who underwent curative surgery. Clinicopathological features and treatment outcomes were compared, and factors influencing distant recurrence-free survival (DRFS) and overall survival (OS) were evaluated using Cox proportional hazard models. For analysis of clinical outcomes, after excluding HER2-positive tumors, an additional cohort of 604 patients with ER-high and HER2-negative tumors was also compared.</p><p><strong>Results: </strong>ER-int tumors showed lower nuclear grade, higher progesterone receptor expression, and lower Ki67 labeling index compared with ER-low tumors. Pathological stage was independently associated with both DRFS and OS. In addition, ER status was also an independent factor for OS, with ER-int tumors showing significantly better OS than ER-low tumors (P = 0.014).</p><p><strong>Conclusions: </strong>Our findings, based on comparison with ER-low tumors, suggest that intermediate ER expression may represent a biologically and clinically heterogeneous subgroup within ER-positive breast cancers. Recognition of this heterogeneity could help refine classification and support more individualized treatment strategies.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life and physical activity collected via mobile application and wearable device in patients with HR +/HER2 - advanced breast cancer treated with palbociclib plus endocrine therapy or endocrine therapy alone: 6-month longitudinal study (JBCRG-26).","authors":"Hiroko Bando, Aya Ueda, Kaori Terata, Mihoko Doi, Shigenori E Nagai, Masaya Hattori, Kenichi Watanabe, Nobuko Tamura, Manabu Futamura, Kei Koizumi, Naoki Niikura, Tempei Miyaji, Yasuaki Muramatsu, Linghua Xu, Norikazu Masuda, Shigehira Saji","doi":"10.1007/s12282-025-01744-0","DOIUrl":"https://doi.org/10.1007/s12282-025-01744-0","url":null,"abstract":"<p><strong>Objectives: </strong>To summarize descriptively health-related quality of life (HRQOL) and physical activity (PA) evaluated with a mobile application and wearable device among patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR + /HER2 -) advanced breast cancer (ABC) treated with first- or second-line palbociclib plus endocrine therapy (ET) or ET alone.</p><p><strong>Methods: </strong>HRQOL was assessed with the EORTC QLQ-C30 at baseline and Day 15 of 6 treatment cycles (~ 24 weeks). PA metrics were averaged on a weekly basis for 24 weeks. Co-primary endpoints were mean change from baseline in Global Health Status (GHS) and sedentary time.</p><p><strong>Results: </strong>Ninety-nine patients were enrolled; 78 received palbociclib plus ET (mean age: 57.2 years; 75.6% initiated first-line treatment) and 21 received ET alone (mean age: 56.3 years; 90.5% initiated first-line treatment). Baseline mean GHS score was 60.9 in the palbociclib plus ET group and 64.3 in the ET alone group; mean changes from baseline to Day 15 of Cycle 6 were +4.8 and +2.9, respectively, and not deteriorated beyond the 10-point clinically significant threshold in either treatment group. Baseline mean sedentary time was 581 min/day in the palbociclib plus ET group and 513 min/day in the ET alone group; mean changes from baseline to Week 24 were -22 and -102 min/day, respectively.</p><p><strong>Conclusions: </strong>In this real-world study of women with HR+/HER2- ABC in Japan, neither palbociclib plus ET nor ET alone had any substantial detrimental impacts on HRQOL, according to patients' assessments recorded in a smartphone-based mobile application, and PA, as measured by a wearable device.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04736576; registered, February 3, 2021.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major anatomic variations of the lateral upper arm lymphatic pathway in a healthy female population.","authors":"James E Fanning, Madeleine Givant, Angela Chen, Sarah Thomson, Elizabeth Tillotson, Aaron Fleishman, Kevin Donohoe, Dhruv Singhal","doi":"10.1007/s12282-025-01742-2","DOIUrl":"https://doi.org/10.1007/s12282-025-01742-2","url":null,"abstract":"<p><strong>Background: </strong>The lateral upper arm (LUA) pathway is a route of superficial lymphatic drainage that bypasses the axilla by draining to the deltopectoral, clavicular, and cervical lymph nodes. Despite the fact that anatomic variations of the LUA pathway have been implicated in breast cancer-related lymphedema (BCRL) risk after axillary lymph node dissection (ALND), the incidence of the LUA pathway variations in the healthy population has never been reported.</p><p><strong>Methods: </strong>Healthy female volunteers underwent bilateral lymphatic mapping of the upper extremities with indocyanine green (ICG) lymphography. ICG was injected in six standard sites in the hand/wrist and upper arm. Major anatomic variations of the LUA pathway were recorded including bundle phenotype (long, short, or absent), proximal visualization sites, and forearm pathway continuation to the long bundle phenotype.</p><p><strong>Results: </strong>90 arms of 45 volunteers were included. The LUA pathway was present in 99% of arms and a long-versus-short bundle phenotype was observed in 71% versus 28% of arms. When the long bundle was present, it was formed by continuity with the forearm posterior radial channel alone (47%), posterior ulnar channel alone (34%), or both channels (19%). The LUA pathway was traced proximally to the deltopectoral groove in 89% of arms and to the axilla in 11% of arms.</p><p><strong>Conclusions: </strong>We observed similar proportions of arms with long and short bundle phenotypes in comparison to our previous report of the LUA pathway in breast cancer patients with nodal disease. Defining the incidence of the LUA pathway with its variations in the general population is important as variations in this pathway may have implications for an individual's risk of developing BCRL.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy and cognition: a promising start, but mechanistic clarity still needed.","authors":"Guohua Ren, Ling Qiang, Shu Fang","doi":"10.1007/s12282-025-01743-1","DOIUrl":"https://doi.org/10.1007/s12282-025-01743-1","url":null,"abstract":"","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a deep learning-based automated diagnostic system (DLADS) for classifying mammographic lesions - a first large-scale multi-institutional clinical trial in Japan.","authors":"Takeshi Yamaguchi, Yoichi Koyama, Kenichi Inoue, Kanako Ban, Koichi Hirokaga, Yuka Kujiraoka, Yuko Okanami, Norimitsu Shinohara, Hiroko Tsunoda, Takayoshi Uematsu, Hirofumi Mukai","doi":"10.1007/s12282-025-01741-3","DOIUrl":"https://doi.org/10.1007/s12282-025-01741-3","url":null,"abstract":"<p><strong>Background: </strong>Recently, western countries have built evidence on mammographic artificial Intelligence-computer-aided diagnosis (AI-CADx) systems; however, their effectiveness has not yet been sufficiently validated in Japanese women. In this study, we aimed to establish a Japanese mammographic AI-CADx system for the first time.</p><p><strong>Methods: </strong>We retrospectively collected screening or diagnostic mammograms from 63 institutions in Japan. We then randomly divided the images into training, validation, and test datasets in a balanced ratio of 8:1:1 on a case-level basis. The gold standard of annotation for the AI-CADx system is mammographic findings based on pathologic references. The AI-CADx system was developed using SE-ResNet modules and a sliding window algorithm. A cut-off concentration gradient of the heatmap image was set at 15%. The AI-CADx system was considered accurate if it detected the presence of a malignant lesion in a breast cancer mammogram. The primary endpoint of the AI-CADx system was defined as a sensitivity and specificity of over 80% for breast cancer diagnosis in the test dataset.</p><p><strong>Results: </strong>We collected 20,638 mammograms from 11,450 Japanese women with a median age of 55 years. The mammograms included 5019 breast cancer (24.3%), 5026 benign (24.4%), and 10,593 normal (51.3%) mammograms. In the test dataset of 2059 mammograms, the AI-CADx system achieved a sensitivity of 83.5% and a specificity of 84.7% for breast cancer diagnosis. The AUC in the test dataset was 0.841 (DeLong 95% CI; 0.822-0.859). The Accuracy was almost consistent independent of breast density, mammographic findings, type of cancer, and mammography vendors (AUC (range); 0.639-0.906).</p><p><strong>Conclusions: </strong>The developed Japanese mammographic AI-CADx system diagnosed breast cancer with a pre-specified sensitivity and specificity. We are planning a prospective study to validate the breast cancer diagnostic performance of Japanese physicians using this AI-CADx system as a second reader.</p><p><strong>Trial registration: </strong>UMIN, trial number UMIN000039009. Registered 26 December 2019, https://www.umin.ac.jp/ctr/.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-hit events occurred independently in bilateral breast cancers in a germline double heterozygous carrier for BRCA1 and BRCA2.","authors":"Ryoko Semba, Hidetaka Eguchi, Mizuki Takatsu, Toko Hashizume, Hideaki Moteki, Kazuma Maeno, Fumi Murakami, Junichiro Watanabe, Goro Kutomi, Masami Arai","doi":"10.1007/s12282-025-01740-4","DOIUrl":"https://doi.org/10.1007/s12282-025-01740-4","url":null,"abstract":"<p><p>While patients with hereditary breast and ovarian cancer with germline double heterozygosity (GDH) for BRCA1 and BRCA2 are rare, carcinogenesis in these cases remains unclear. We examined two-hit events of heterochronous bilateral breast cancers in a patient with GDH for BRCA1 and BRCA2. A 65-year-old woman developed right breast cancer (triple-negative type) at the age of 49 and left breast cancer (triple-negative type) at 55. Family history indicated that multiple relatives on her mother's side also developed breast cancer. BRCA1/2 genetic testing (BRACAnalysis®) showed that she had variants in both the BRCA1 and BRCA2 (BRCA1:c.5193 + 2dup, BRCA2:c.6952C > T/p.Arg2318Ter). According to the data from the test, the former was interpreted as likely pathogenic at Myriad Inc. Further examination regarding two-hit events in her bilateral breast cancers was obtained by somatic mutation analysis using DNA isolated from cut slide specimens of formalin-fixed and paraffin-embedded tumor samples. We first confirmed the pathogenicity of the BRCA2 variant by detecting unusual splicing of BRCA2 that entirely skipped exon 19 using cultured T cells of the proband. Loss of heterozygosity in BRCA1 was observed in her right breast cancer. On the other hand, a somatic nonsense pathogenic variant in BRCA2 (variant allele frequency = 15%) and a two-hit event in APC (VAF = 80%) were also found in her left breast cancer. These data provide evidence of different carcinogenesis between left and right breast cancer. Clinical and pathogenic characteristics of cancers with GDH for BRCA1 and BRCA2 depend on the genes somatically mutated in wild alleles.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate breast reconstruction surgery for breast cancer: current status and future directions.","authors":"Tadahiko Shien, Hiroko Nogi, Akiko Ogiya, Makoto Ishitobi, Chikako Yamauchi, Ayaka Shimo, Kazutaka Narui, Naomi Nagura, Hirohito Seki, Kaori Terata, Miho Saiga, Tatsuya Uchida, Shinsuke Sasada, Teruhisa Sakurai, Naoki Niikura, Hiroki Mori","doi":"10.1007/s12282-025-01723-5","DOIUrl":"10.1007/s12282-025-01723-5","url":null,"abstract":"<p><strong>Background: </strong>Immediate breast reconstruction (IBR) has become increasingly recognized in Japan as an important component of breast cancer care, improving patients' quality of life after mastectomy. While the adoption of IBR is growing, the reconstruction rate in Japan remains lower than in Western countries. To clarify the current practice and challenges, the Japanese Breast Cancer Society (JBCS) conducted a nationwide survey.</p><p><strong>Methods: </strong>We conducted a comprehensive web-based questionnaire survey among all JBCS-certified institutions between December 2020 and February 2021. The survey assessed institutional capabilities, surgical techniques, decision-making criteria for BR, and the integration of adjuvant therapy.</p><p><strong>Results: </strong>A total of 429 institutions responded, with 72.5% offering BR and 61.7% capable of providing immediate reconstruction. Nipple-sparing mastectomy (NSM) was performed at 73.7% of institutions offering reconstruction. Multidisciplinary conferences with plastic surgeons were held at 70.5% of institutions. Approximately 30% of institutions discontinued IBR if sentinel lymph node metastases were detected intraoperatively, and 62.8% avoided recommending IBR for patients likely to require postoperative radiation therapy. In 94% of institutions, BR did not cause delays in the administration of adjuvant chemotherapy. However, 15% of institutions modified their radiation therapy approach in reconstructed patients. Additionally, 27% of physicians still believed that BR could negatively affect prognosis.</p><p><strong>Conclusions: </strong>The survey confirmed that IBR is widely performed and feasible in Japan. However, institutional differences, limited access to plastic surgeons, and persistent misconceptions remain significant barriers. Strengthening multidisciplinary collaboration and establishing standardized guidelines will help improve BR rates and patient outcomes in Japan.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"630-637"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}