Breast cancer (Tokyo, Japan)最新文献

{"title":"Validation of the predictive ability for recurrence and the clinical utility of the 95-gene classifier (95GC) through an integrated analysis of five studies.","authors":"Aya Imai, Ryo Tsunashima, Yu Hidaka, Sae Kitano, Chikage Kato, Akira Watanabe, Midori Morita, Koichi Sakaguchi, Yoshiaki Sota, Masahiko Suzuki, Takayuki Kinoshita, Seiichi Imanishi, Masahiro Oikawa, Yoshihiko Kamada, Ken-Ichi Ito, Takaaki Oba, Shin Takayama, Fumine Tsukamoto, Mina Takahashi, Yutaka Hatanaka, Naoto T Ueno, Kenzo Shimazu, Satoshi Morita, Yasuto Naoi","doi":"10.1007/s12282-025-01734-2","DOIUrl":"10.1007/s12282-025-01734-2","url":null,"abstract":"<p><strong>Background: </strong>In recent years, multigene assays have become indispensable tools for predicting the recurrence risk of estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative early-stage breast cancer and guiding adjuvant chemotherapy decisions. Curebest™ 95GC Breast (95GC), developed in 2011 as a domestically produced multigene assay for postoperative recurrence prediction, has been commercially available since 2013. Since 2021, five validation studies evaluating the predictive performance 95GC have been published. This study presents an integrated analysis of these studies to validate the prognostic utility of 95GC further.</p><p><strong>Methods: </strong>The integrated analysis included 719 real-world cases of luminal-type node-negative breast cancer patients who underwent adjuvant hormone therapy alone without extended endocrine treatment. In addition, an expanded cohort incorporating 294 cases from Western patients within the GEO public database was analyzed, resulting in a total of 1013 cases.</p><p><strong>Results: </strong>Among the 719 real-world cases, 550 (76.5%) were classified into the 95GC Low-risk group, demonstrating a significantly superior prognosis compared to the High-risk group (P < 1.00e-12). The 5-year distant recurrence-free survival (DRFS) rate in the Low-risk group was approximately 98%, with consistent findings observed in the expanded cohort. Furthermore, an analysis of 754 CEL files using 21GC (a proxy for Oncotype DX®) identified 318 cases (42.2%) as the 21GC intermediate risk. 95GC successfully stratified these cases into two prognostically distinct subgroups.</p><p><strong>Conclusions: </strong>These findings underscore the clinical utility of 95GC in safely omitting chemotherapy for Low-risk patients with good prognosis and in further stratifying the 21GC Intermediate-risk cases, thereby contributing to personalized treatment strategies.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1075-1087"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487657","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":"Marital status as an independent prognostic factor in male breast cancer: a SEER-based cohort study.","authors":"Ahmet Necati Sanli, Bilal Turan, Deniz Esin Tekcan Sanli, Fatih Aydogan, M Kadri Altundag","doi":"10.1007/s12282-025-01733-3","DOIUrl":"10.1007/s12282-025-01733-3","url":null,"abstract":"<p><strong>Background: </strong>Male breast cancer (MBC) is a rare malignancy, and research on its prognostic factors remains limited. Marital status has been identified as a prognostic determinant in various cancers; however, the impact of marital status on MBC survival outcomes remains understudied. This study examines the relationship between marital status and survival in MBC patients using a large, population-based cohort.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) 17 Registries database (2010-2021). MBC patients (n = 5,994) were categorized into four marital status groups: married, unmarried, divorced, and widowed. Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazards models were used to assess overall survival (OS) and disease-specific survival (DSS).</p><p><strong>Results: </strong>Significant differences in OS and DSS were observed among marital status groups (p < 0.001). Widowed patients had the poorest survival outcomes, with a 2.59 times higher increased mortality risk (HR = 2.594, 95% CI: 2.246-2.996, p < 0.001) compared to married individuals in univariate analysis. This association remained significant in multivariate analysis, with widowed patients demonstrating a 1.72 times higher mortality risk (HR = 1.724, 95% CI: 1.421-2.092, p < 0.001) after adjustment for clinicopathological and demographic variables. Unmarried and divorced patients also had poorer survival outcomes than married patients, albeit with lower hazard ratios.</p><p><strong>Conclusions: </strong>Marital status is an independent prognostic factor in MBC, with widowed patients experiencing the poorest outcomes. These findings underscore the important role of social and psychological support in cancer prognosis. Integrating psychosocial support programs and patient-centered care approaches into oncological practice can help reduce survival disparities.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1061-1074"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311185","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}

{"title":"Axillary surgery in patients with breast cancer with one to three positive micro- or macrometastases in the sentinel lymph nodes: an observational study.","authors":"Shigeru Imoto, Hiroyuki Yasojima, Takeshi Nagashima, Tatsuya Onishi, Tsutomu Takashima, Masahiro Kitada, Masaya Kawada, Tetsu Hayashida, Yasuto Naoi, Tomohiko Aihara, Noriaki Wada, Hidetaka Kawabata, Masayuki Yoshida, Uhi Toh, Kimiyasu Yoneyama, Akimitsu Yamada, Hitoshi Tsuda, Norikazu Masuda, Mari Saito-Oba, Junichi Sakamoto","doi":"10.1007/s12282-025-01726-2","DOIUrl":"10.1007/s12282-025-01726-2","url":null,"abstract":"<p><strong>Background: </strong>The Japanese Society for Sentinel Node Navigation Surgery conducted a multi-institutional prospective cohort study to compare sentinel node biopsy (SNB) with SNB followed by axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel lymph node (SLN).</p><p><strong>Patients and methods: </strong>Female patients with breast cancer with cT1-3N0-1M0 were eligible. In cases of one to three positive micro- or macrometastases in the SLN confirmed by histological or molecular diagnosis, SNB alone (SNB group) or additional ALND (ALND group) was performed under physician's discretion. The primary endpoint was the 5-year regional node (RN) recurrence rate in the SNB group. Propensity score matching (PSM) was performed to compare the prognosis between the two groups.</p><p><strong>Results: </strong>Of the 871 eligible cases registered between 2013 and 2016, 308 underwent SNB alone. At the median follow-up of 6.3 years, 5-year RN recurrence rate was 2.7%. After PSM, 209 cases were matched in each group. Breast-conserving surgery and mastectomy were performed in 225 (54%) and 193 cases (46%), respectively. One-positive SLN was recorded in 366 cases (88%), two in 48 (11%), and three in 4 (1%). Macro- and micrometastases in SLN were diagnosed in 271 (65%) and 147 cases (35%), respectively. Regional nodal irradiation (RNI) was performed in 42 (20%) and 13 (6%) cases of the SNB and ALND group. The 5-year RN recurrence rate was 2.1% and 2.0%, respectively.</p><p><strong>Conclusions: </strong>ALND is not necessary for early breast cancer patients with one-positive SLN despite type of breast surgery.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1013-1022"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145307","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}

{"title":"Impact of margin status on ipsilateral breast tumor recurrence after breast-conserving treatment for patients with breast cancer who received neoadjuvant chemotherapy: a retrospective multi-institutional study of 1813 cases.","authors":"Makoto Ishitobi, Atsushi Yoshida, Yuri Kimura, Yasuaki Sagara, Yuka Ono, Koji Takada, Yuko Takahashi, Takahiro Tsukioki, Mao Kimoto, Tomo Osako, Takehiko Sakai","doi":"10.1007/s12282-025-01732-4","DOIUrl":"10.1007/s12282-025-01732-4","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus regarding the optimal margin status among patients with breast cancer treated with neoadjuvant chemotherapy (NAC), breast-conserving surgery, and radiotherapy (breast-conserving treatment [BCT]).</p><p><strong>Methods: </strong>In total, 1813 patients with newly diagnosed stage 1-3 breast cancer who underwent BCT after NAC were evaluated to determine the impact of margin status on ipsilateral breast tumor recurrence (IBTR).</p><p><strong>Results: </strong>During a median follow-up period of 8.0 years (range 0.1-17.0 years), the 8-year IBTR-free survival rate was 95.9%. Patients with positive margins had significantly worse IBTR-free survival than those with negative margins (8-year IBTR-free survival rate: 87.6% vs. 96.2%, p = 0.010). Multivariate analysis showed that margin status was significantly associated with IBTR-free survival (hazard ratio: 3.1; 95% confidence interval 1.3-7.2; p = 0.0081).</p><p><strong>Conclusions: </strong>This multicenter retrospective study demonstrated that margin status is significantly associated with IBTR-free survival in patients who received NAC and BCT, consistent with findings in upfront-surgery cases.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1044-1051"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251863","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":"Comparison of transcriptome profiles of radiotherapy beams on MCF-7 breast cancer xenografts.","authors":"Tuğba Kul Köprülü, Serhat Aras, Burçin Erkal Çam, Altan Kara","doi":"10.1007/s12282-025-01735-1","DOIUrl":"10.1007/s12282-025-01735-1","url":null,"abstract":"<p><p>The objective of this study was to investigate the acute radiobiological mechanisms underlying Flattening Filter (FF) and Flattening Filter Free (FFF) radiotherapy-induced inhibition of breast cancer (BCa) by detecting changes in gene expression levels. The study involved thirty-six adult nude mice models that were randomly divided into five groups: control (G1), breast cancer (BCa) (G2), FF-400 (G3), FFF-1120 (G4), and FFF-1820 (G5). The control group had no radiation or treatment, while the BCa group had a cancer model but no radiation. The BCa models were subjected to a single dose of 20 Gy of radiotherapy at varying dose rates: 400, 1120, and 1820 MU/min (G3, G4, and G5, respectively). Twenty days after implantation of the MCF-7 cancer cell line, nude mice were irradiated and sacrificed 48 h later for genetic analysis. A transcriptome library was created by extracting RNA from tissue samples. In the differentially expressed genes (DEG) analysis, a total of 1565 genes were found to be significantly altered in the G2 vs. G1 groups. When radiotherapy groups (G3, G4, and G5) were analyzed, 334 DEGs (231 down, 103 up) were identified in G3 vs G2 data, 167 DEGs (103 down, 64 up) in G4 vs G2 data, and 187 DEGs (116 down, 71 up) in G5 vs G2 data. Gene Ontology molecular function analysis revealed significant differences between groups G3 and G2, with an emphasis on protein binding, glutamate receptor activity, and interleukin-8 receptor activation. Similar features were observed when comparing groups G5 and G2. The analysis showed significant differences in the expression of the key ERAD pathway genes Ufd1 and Cav1 between the BCa and radiotherapy groups. It was concluded that the FFF beam significantly alters the processes underlying the ERAD pathway and glutamate receptor activation compared to the FF beam.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1052-1060"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513045","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}

{"title":"Correction to: Prognostic impact of ER‑staining patterns and heterogeneity of ER positive HER2 negative breast cancer.","authors":"Yumiko Akita, Ravi Velaga, Madoka Iwase, Satoko Shimada, Toyone Kikumori, Dai Takeuchi, Yuko Takano, Takahiro Ichikawa, Tomoki Ebata, Norikazu Masuda","doi":"10.1007/s12282-025-01729-z","DOIUrl":"10.1007/s12282-025-01729-z","url":null,"abstract":"","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1156"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251862","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}

{"title":"A systematic review of the efficacy of cancer vaccines in advanced breast cancer.","authors":"Anna Charalampopoulou, Charalampos Filippatos, Panagiotis Malandrakis, Flora Zagouri, Maria Gavriatopoulou, Ioannis Ntanasis-Stathopoulos","doi":"10.1007/s12282-025-01751-1","DOIUrl":"10.1007/s12282-025-01751-1","url":null,"abstract":"<p><strong>Background: </strong>Cancer vaccines offer an innovative approach to treating advanced breast cancer, by activating the immune system to recognize and target cancer cells, aiming to boost immune response, reduce relapse, and enhance patients' quality of life.</p><p><strong>Methods: </strong>A systematic database search was conducted for peer-reviewed, full-text articles on clinical trials focused on cancer vaccines for advanced breast cancer, in the MEDLINE, SCOPUS, Cochrane and ClinicalTrials.gov databases, from conception until October 23, 2024.</p><p><strong>Results: </strong>A total of 19 trials, involving 747 patients with advanced breast cancer, were included in this systematic review. Cancer vaccine trials rely primarily on immunological endpoints, with initial small-scale studies showing modest efficacy improvements and highly variable immune response rates (44-100%), suggesting opportunities for further optimization and broader clinical application.</p><p><strong>Conclusion: </strong>While the overall quality of the studies was acceptable, heterogeneity in results and limited survival or progression outcomes prevented data synthesis. In conclusion, despite promising findings, the lack of large-scale randomized trials limits definitive conclusions on cancer vaccine efficacy, highlighting the need for Phase III trials to confirm their clinical utility and long-term impact.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"892-904"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786395","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}

{"title":"Regional disparities in breast cancer healthcare in Japan: REAL-BC study.","authors":"Hiroshi Kitagawa, Kazuki Fukuzawa, Masaki Tanaka","doi":"10.1007/s12282-025-01739-x","DOIUrl":"10.1007/s12282-025-01739-x","url":null,"abstract":"<p><strong>Background: </strong>Since 2007, the Basic Plans for Promoting Cancer Control (BPPCCs) have sought to enhance cancer care at designated cancer care hospitals (DCCHs) and implement population (PBCR)- and hospital (HBCR)-based cancer registries, among other activities. However, the impact of the BPPCCs on breast cancer care in Japan remains uncertain. This study sought to reveal the reality of regional disparities in the proportion of breast cancer patients' initial visits to DCCHs and the functionality of breast cancer in DCCHs.</p><p><strong>Methods: </strong>We obtained data from the PBCR and HBCR in Japan, as well as administrative healthcare claims data (JMDC claims data), and data published by clinical societies in Japan for the period 2018 to 2021. We conducted descriptive analyses to determine the proportions of patients who received initial treatment for breast cancer at a DCCH. We also examined the quality of care in terms of staffing and functions.</p><p><strong>Results: </strong>In 2020, out of 79,062 breast cancer patients registered in the HBCR, 57.7% started initial treatment at a DCCH (range across 47 prefectures: 15.5%-89.8%) in Japan. The proportion of patients who visited a DCCH for initial treatment increased from 53.8% (2018) to 57.7% (2020). The median proportion of DCCHs certified by the Japanese Breast Cancer Society (JBCS) among the 47 prefectures was 62.50% (range: 16.7%-100.0%). The median number of patients per JBCS-certified specialist was 77.40 (range: 37.6-142.0). The proportions of DCCHs with claims for breast cancer-related service fees were 15.2% (range: 0.0%-50.0%) for cancer genome profiling tests, 62.0% (range: 0.0%-100.0%) for cancer BRCA1/2 genetic tests, and 92.8% (range: 60.0%-100.0%) for patient support system enhancement.</p><p><strong>Conclusion: </strong>We found regional disparities in the initial treatment and medical services for breast cancer care in Japan. The findings uncover opportunities to enhance the treatment of breast cancer in Japan. We anticipate that our data will be utilized as a valuable resource and as a key input for informing policy development tailored to the specific characteristics of the region and for designing programs to address the different needs of each prefecture.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1102-1114"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769534","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}

{"title":"Stereotactic radiosurgery for HER2-positive breast cancer brain metastases: prognostic factors and the evolving role of anti-HER2 therapies.","authors":"Menekse Turna, Berna Akkus Yıldırım, Çakır Numanoglu, Muhammed Emin Gül, Mustafa Halil Akboru, Rashad Rzazade, Mehmet Doğu Canoğlu, Hale Başak Çağlar","doi":"10.1007/s12282-025-01731-5","DOIUrl":"10.1007/s12282-025-01731-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the clinical outcomes of SRS in patients with HER2-positive breast cancer brain metastases, focusing on survival, local control, and the influence of systemic therapies and clinical factors.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 60 patients with HER2-positive breast cancer and brain metastases treated with SRS. Patient demographics, tumor characteristics, treatment parameters, and follow-up data were collected.</p><p><strong>Results: </strong>The median follow-up was 21 months. 1-year, 2-year, and 3-year survival rates of 96%, 73%, and 50%, respectively. Factors associated with shorter OS included the presence of neurological deficits (p = 0.003), tumor diameter > 2.5 cm (p = 0.016), more than three brain metastases (p = 0.046), cumulative GTV volume greater than 2.63 cm³ (p =  < 0.001), and the development of brain metastases within 3 years of the primary cancer diagnosis (p = 0.022). Local control rates were 98% at 1 year and 80% at 2 years. Distant brain metastasis-free survival rates were 91% at 1 year and 63% at 2 years. Patients receiving more than one line of anti-HER2 therapy before SRS showed significantly improved OS (p = 0.007) but had a higher incidence of leptomeningeal disease (p = 0.048). Radiation necrosis occurred in 8.3% of patients, predominantly after prolonged follow-up.</p><p><strong>Conclusion: </strong>SRS combined with modern systemic therapies achieves favorable outcomes in HER2-positive breast cancer brain metastases, with improved survival and high local control rates. These findings highlight the need for personalized treatment strategies integrating local and systemic therapies to optimize intracranial disease management in this patient population.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1035-1043"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251864","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":"Treatment and prognosis of patients with hormone receptor-low positive (1%-10%) breast cancer: a retrospective propensity score-matched analysis.","authors":"Yulou Luo, Yilina Saibaidula, Yutian Sun, Yinghui Ye, Jianghua Ou","doi":"10.1007/s12282-025-01730-6","DOIUrl":"10.1007/s12282-025-01730-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the clinicopathological characteristics, treatment patterns, and survival outcomes of hormone receptor (HR)-low positive (1%-10%) breast cancer, with a focus on evaluating the prognostic impact of endocrine therapy (ET) and its interplay with HR-low positive categories (ER-low/PR-low, ER-low/PR-negative, ER-negative/PR-low).</p><p><strong>Methods: </strong>A retrospective analysis of 16,578 patients with stage I-III breast cancer (July 2009 to December 2019) identified 388 HR-low positive cases. Propensity score match (PSM) was used to balance baseline characteristics in two comparisons: (1) HR-low positive patients receiving ET vs. HR-negative patients; (2) HR-low positive patients with vs. without ET. 5-year disease-free survival (DFS) and breast cancer-specific survival (BCSS) were analyzed via Kaplan-Meier and Cox regression analyses. Subgroup and interaction analyses assessed ET efficacy across HR-low positive categories.</p><p><strong>Results: </strong>HR-low positive tumors (2.34%) exhibited clinicopathological similarities to HR-negative tumors but distinct from HR-positive tumors. ET administration significantly improved DFS of HR-low positive patients compared to HR-negative counterparts (84.89% vs. 75.87%; HR = 0.59 [0.37-0.93], P = 0.024). Within HR-low positive cohort, ET omission was significantly associated with a 74% increased risk of DFS compared to ET-treated patients (75.54% vs. 85.37%; HR = 1.74 [1.01-3.00], P = 0.047). ET duration (1-4 vs. 5 years) did not affect survival outcomes (DFS: P = 0.533; BCSS: P = 0.675). Multivariate analysis confirmed ET omission as an independent risk factor for worse DFS (HR = 1.75 [1.01-3.05], P = 0.046). Subgroup analysis revealed equivalent ET benefit across all HR-low positive categories (P for interaction > 0.9).</p><p><strong>Conclusion: </strong>HR-low positive breast cancer has similar clinicopathological characteristics and therapeutic options with HR-negative disease but derives significant DFS benefits from ET, irrespective of ET duration or HR category. These findings support integrating ET into standard management protocol for HR-low positive breast cancer to ameliorate survival outcomes.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1023-1034"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259908","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}