Breast cancer (Tokyo, Japan)最新文献

{"title":"Comparison of ultrasound visibility and retrieval success of two ultrasound-visible clips in targeted axillary dissection after neoadjuvant chemotherapy.","authors":"Naomi Sakamoto, Hiroki Matsui, Eisuke Fukuma","doi":"10.1007/s12282-026-01895-8","DOIUrl":"10.1007/s12282-026-01895-8","url":null,"abstract":"<p><strong>Background: </strong>Targeted axillary dissection (TAD) is a less invasive alternative to axillary lymph node dissection (ALND) for patients with clinically node-positive breast cancer who convert to node-negative status after neoadjuvant chemotherapy (NAC). However, the effect of preoperative ultrasound visibility of different clip types on TAD outcomes remains unclear.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study of patients with biopsy-proven axillary node-positive breast cancer who underwent NAC followed by TAD between August 2017 and December 2024. Two ultrasound-visible clips, the UltraCor™ Twirl™ (Twirl) and HydroMARK™, were evaluated. Outcomes included ultrasound visibility, clipped node retrieval success, localization techniques, and false-negative rate (FNR).</p><p><strong>Results: </strong>Twenty-nine patients were included (Twirl, n = 15; HydroMARK, n = 14). Ultrasound visibility was higher with Twirl than with HydroMARK (86.7% versus 64.3%; p = 0.330). All Twirl cases underwent combined wire and dye-guided localization, whereas HydroMARK cases used multiple localization techniques. Retrieval success reached 100% with Twirl and 78.6% with HydroMARK (p = 0.199). When clips were visible on ultrasound, retrieval rates were high for both clips at 100% for Twirl and 88.9% for HydroMARK (p = 0.850). When clips were not clearly visible, Twirl maintained 100% retrieval compared with 60.0% for HydroMARK (p = 0.895). Among patients who underwent scheduled ALND, the FNR of TAD was 0% (0/6).</p><p><strong>Conclusions: </strong>Preoperative ultrasound visibility of the clip was associated with successful clip-based TAD. Twirl showed more consistent ultrasound visibility and retrieval success than HydroMARK, which suggests that Twirl may be a more reliable clip for routine clinical practice.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1173-1182"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595376","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":"Prognostic impact of progesterone receptor status in patients with breast cancer and isolated locoregional recurrence.","authors":"Takeshi Murata, Hiraku Kumamaru, Masayuki Yoshida, Naoko Kinukawa, Shin Takayama, Akihiko Suto, Hiromitsu Jinno, Takanori Ishida, Naoki Niikura, Shigehira Saji","doi":"10.1007/s12282-026-01882-z","DOIUrl":"10.1007/s12282-026-01882-z","url":null,"abstract":"<p><strong>Background: </strong>The impact of progesterone receptor (PR) status on the prognosis of breast cancer after isolated locoregional recurrence (ILRR) remains unclear. This study assessed the prognostic impact of the PR status of ILRR tumors in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) breast cancer.</p><p><strong>Methods: </strong>The study utilized data from the Japanese National Clinical Database (2004-2015), including 1,625 patients with ER+/HER2- ILRR. All participants were patients aged between 20 and 75 years at diagnosis who underwent curative surgery for ER+/HER2- primary breast cancer. Patients were classified into three groups based on the PR status of primary (p) and recurrent (r) tumors. We compared the overall survival (OS) and breast cancer-specific survival (BCSS) among the three groups using the Kaplan-Meier method with the log-rank test. ER and PR were considered positive if immunohistochemistry staining was positive in > 1% of tumor cells. For the ER expression levels in ILRR tumors, 1-10% were considered as ER-low positive.</p><p><strong>Results: </strong>Patients with PR- ILRR (pPR-/rPR- and pPR+/rPR-) had significantly worse OS and BCSS than those with PR+ ILRR (pPR+/rPR+). Factors associated with worse outcomes included lymph node metastasis, a shorter disease-free interval, ER-low positivity, and no surgery for ILRR tumor.</p><p><strong>Conclusions: </strong>This study highlights PR-negativity in ER+/HER2- ILRR tumors as a poor prognostic factor after ILRR, independent of the PR status of the primary breast cancer, emphasizing the need for tailored treatment strategies.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1070-1081"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298646","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":"Publisher Correction: PTX3 induces the expression of PD-L1 and promotes breast cancer immune escape : Liyuan Jing.","authors":"Liyuan Jing, Jie Lun, Jianxin Xu, Zhengyu Jin, Xingqian Liu, Yu Wang, Yuying Zhang, Min Gao, Mengchao Yu, Hongwei Zhang, Jing Fang","doi":"10.1007/s12282-026-01910-y","DOIUrl":"https://doi.org/10.1007/s12282-026-01910-y","url":null,"abstract":"","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877184","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":"Reevaluating sentinel lymph node biopsy in older adults with T1 HR+/HER2- breast cancer: a SEER competing risk and nomogram study.","authors":"Ziqiang Wang, Yangyang Xie, Weijun Zhang, Xue Song, Qiwei Du, Nian Liu, Rongguo Li, Lanlan Gao","doi":"10.1007/s12282-026-01896-7","DOIUrl":"10.1007/s12282-026-01896-7","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLNB) is the standard procedure for axillary staging. However, its necessity in older patients (≥ 70 years) with HR+/HER2- T1 breast cancer remains debated in the context of contemporary de-escalation strategies. Existing evidence often incompletely accounts for the competing risk of death in this population. We evaluated the association between SLNB and breast cancer-specific death (BCSD) using real-world data.</p><p><strong>Methods: </strong>Women aged ≥ 70 years with HR+/HER2- T1 (≤ 20 mm) breast cancer treated with breast-conserving surgery between 2010 and 2021 were identified from the SEER database and classified into SLNB and No-SLNB groups. Propensity score matching (PSM) and Fine-Gray competing risk models were used to estimate subdistribution hazard ratios (sHRs) for BCSD and other-cause death (OCD). A prognostic nomogram was constructed.</p><p><strong>Results: </strong>Among 47,838 eligible patients, 37,732 underwent SLNB and 10,106 did not. After PSM, SLNB was associated with a lower 5-year cumulative incidence of BCSD (2.50% vs. 3.50%); differences in OCD were also observed. In multivariable competing risk analysis, SLNB remained independently associated with reduced BCSD (sHR 0.69, 95% CI 0.60-0.80). The association was most pronounced in patients aged ≥ 80 years and those with T1c (11-20 mm) tumors, whereas the absolute risk difference was minimal in the 1-5 mm subgroup. The nomogram showed good discrimination (time-dependent AUC up to 0.821 in the training set and 0.857 in the validation set) and calibration.</p><p><strong>Conclusions: </strong>In this real-world cohort, SLNB was associated with lower BCSD in older adults with HR+/HER2- T1 breast cancer, particularly in those aged ≥ 80 years or with T1c tumors. While the incremental value of SLNB appears limited in ultra-low-risk groups, age alone should not dictate omission of axillary staging. The nomogram may support individualized decision-making.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1160-1172"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564271","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":"Crossing the milestone: landmark-based conditional survival after first-line CDK4/6 inhibitor therapy in HR+/HER2-metastatic breast cancer.","authors":"Tuğba Önder, Öztürk Ateş","doi":"10.1007/s12282-026-01903-x","DOIUrl":"10.1007/s12282-026-01903-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer (mBC), cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) have transformed long-term disease control; however, survival trajectories remain markedly heterogeneous. While a subset of patients experiences early progression reflecting endocrine-resistant and biologically aggressive disease, others maintain durable endocrine-sensitive control for several years. As a result, baseline survival estimates calculated from treatment initiation become progressively less representative for patients who remain progression-free during ongoing therapy. We therefore evaluated landmark-based conditional survival outcomes in a real-world cohort of patients receiving first-line CDK4/6i-based therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively evaluated 390 patients with HR+/HER2- mBC treated with first-line CDK4/6i plus endocrine therapy. Landmark analyses were performed at 6, 12, 24, and 36 months following treatment initiation. Conditional progression-free survival (cPFS), conditional overall survival (cOS), and post-landmark OS according to progression status were estimated using Kaplan-Meier analyses from each landmark time point. Baseline clinicopathological factors were additionally evaluated using landmark-specific logistic regression analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Median progression-free survival (PFS) and overall survival (OS) from treatment initiation were 29.2 months (95% CI, 24.6-33.9) and 68.0 months (95% CI, 55.7-80.4), respectively. Disease progression had occurred in 11.5%, 26.1%, 50.8%, and 70.4% of patients by the 6-, 12-, 24-, and 36-month landmarks, respectively. Among patients remaining progression-free at these time points, median cPFS was 27.15, 28.08, 34.58, and 41.90 months, respectively, suggesting increasingly durable conditional disease control with successive progression-free milestones. Landmark progression status strongly stratified subsequent survival outcomes, with significantly inferior post-landmark OS observed among patients with progression at all evaluated landmarks (all log-rank p &lt; 0.001). Endocrine resistance, visceral disease, and adverse tumor biology were consistently associated with an increased risk of progression. However, estimates beyond the 36-month landmark were less precise owing to the limited risk set and greater censoring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Landmark-based conditional survival analysis provides clinically meaningful, time-updated prognostic information in HR+/HER2- mBC treated with first-line CDK4/6 inhibitors. Crossing successive progression-free milestones identifies a subgroup with increasingly durable long-term disease control while maintaining favorable post-landmark survival. These findings support the integration of milestone-based conditional survival estimates alongside conventional baseline survival metrics in the CDK4/6i ","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1214-1226"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687549","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":"Effect of exercise based prehabilitation on postoperative pain in breast cancer patients: a systematic review with meta-analysis.","authors":"Asier Del Arco, Celia García-Chico, Kayvan Khoramipour, Arkaitz Castañeda-Babarro, Alejandro Santos-Lozano, Jose Pinto-Fraga","doi":"10.1007/s12282-026-01899-4","DOIUrl":"10.1007/s12282-026-01899-4","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain is a common complication following breast cancer surgery, adversely influencing recovery and quality of life. Exercise-based prehabilitation, initiated before surgery to enhance physical readiness, has shown benefits in other surgical settings. However, its specific impact on postoperative pain in breast cancer patients remains unclear.</p><p><strong>Methods: </strong>This systematic review and meta-analysis evaluated the effectiveness of exercise-based prehabilitation in reducing postoperative pain in women undergoing breast cancer surgery. Following PRISMA guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science up to June 2025 (search conducted prior to submission). Eligible studies were randomized controlled trials (RCTs) comparing exercise-based prehabilitation with usual care or educational interventions. The primary outcome was pain at one month post-surgery. Risk of bias was assessed using the Cochrane RoB 2 tool, and methodological quality via the TESTEX scale.</p><p><strong>Results: </strong>Six RCTs (n = 519) were included in the qualitative synthesis, and three (n = 157) in the meta-analysis. Interventions varied in duration (1-9 weeks), modality (aerobic, resistance, mobility, stretching), and supervision. Pain was measured using tools such as VAS, NPRS, EORTC QLQ-C30 and SPADI. Meta-analysis showed a small, non-significant effect (SMD = -0.24; 95% CI: -0.55 to 0.08; p = 0.14). Heterogeneity was statistically low (I² = 0%; 95% CI: 0% to 79%), although this estimate was based on only three studies and should not be interpreted as evidence of true consistency across trials.</p><p><strong>Conclusions: </strong>Exercise-based prehabilitation was reported as safe and feasible in the included studies, with a possible but non-significant benefit in reducing postoperative pain. Given the low certainty of evidence, further high-quality RCTs are needed to clarify its role in breast cancer surgical care.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"964-977"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623703","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":"The value of LAR in predicting neoadjuvant therapy response and prognosis in HER2-positive breast cancer.","authors":"Xiaojing Li, Xin Xin, Wenjing Xiong, Haoyue Zhang, Yue Zhang","doi":"10.1007/s12282-026-01892-x","DOIUrl":"https://doi.org/10.1007/s12282-026-01892-x","url":null,"abstract":"<p><strong>Background: </strong>In the personalized treatment of HER2-positive breast cancer, identifying biomarkers predictive of neoadjuvant therapy (NAT) response and long-term prognosis is crucial. This study investigates the association between the lactate dehydrogenase-to-albumin ratio (LAR) and both NAT efficacy and survival outcomes, while examining clinical-pathological factors influencing LAR.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed clinical and pathological data from 302 HER2-positive breast cancer patients who underwent NAT followed by surgical resection. Patients were stratified into two groups based on median pre-NAT LAR levels. Logistic regression identified independent predictors of NAT response. Kaplan-Meier survival analysis and Cox proportional hazards regression evaluated correlations between LAR and disease-free survival (DFS) or overall survival (OS). Univariate and multivariate analyses determined clinical and pathological factors influencing LAR.</p><p><strong>Results: </strong>Logistic regression analysis identified LAR levels, hormone receptor status, and pre-NAT tumor size as independent predictors of NAT response. Patients in the high-LAR group exhibited a higher probability of achieving pathological complete response (pCR) following neoadjuvant therapy. Cox regression and Kaplan-Meier analyses demonstrated significantly shorter disease-free survival (DFS) in the high-LAR cohort compared to the low-LAR group. Furthermore, among patients who experienced disease progression, high pre-NAT LAR was significantly associated with early recurrence (≤ 24 months) (P = 0.005). Crucially, subgroup and interaction analyses revealed that the predictive and prognostic value of LAR was more pronounced in the hormone receptor (HR)-negative subgroup (P for interaction = 0.043). Among clinical and pathological factors, LAR levels correlated significantly with hormone receptor-negative status and postmenopausal condition.</p><p><strong>Conclusion: </strong>In HER2-positive breast cancer, elevated pre-NAT LAR serves as an independent predictor for pCR after NAT, while concurrently constituting an independent risk factor for reduced DFS. This dual effect is particularly pronounced in HR-negative patients. Furthermore, HR-negative status and postmenopausal condition were significantly associated with higher LAR levels, highlighting LAR as a potential indicator of a hostile host systemic environment.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815107","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":"Correction: Cost-effectiveness analysis of the Oncotype DX Breast Recurrence Score^® test among node-negative early breast cancer patients in Japan.","authors":"Kei Koizumi, Ataru Igarashi, Mark Gouldson, Sandeep Bilthare, Sebastien Eymere, Gebra Cuyún-Carter, Steve Millen, Mariko Nomoto, Yoshie Onishi, Aki Kudo, Pieter Drost, Naoko Sugiyama, Tom Kanazawa Tang, Naoki Niikura","doi":"10.1007/s12282-026-01905-9","DOIUrl":"https://doi.org/10.1007/s12282-026-01905-9","url":null,"abstract":"","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805051","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":"Hormonal contraceptives and cancer risk in women with a BRCA1 or BRCA2 pathogenic variant.","authors":"Chen Nahshon, Leen Fahoum, Dana Hadar, Hila Cohen, Rachel Michaelson-Cohen, Shira Regev, Meirav Schmidt, Wisam Assaf, Steven A Narod, Yakir Segev","doi":"10.1007/s12282-026-01890-z","DOIUrl":"https://doi.org/10.1007/s12282-026-01890-z","url":null,"abstract":"<p><strong>Background: </strong>Women with BRCA1/2 pathogenic variants face increased risks of breast and ovarian cancers. Our study aimed to evaluate the impact of hormonal contraceptive use on these risks.</p><p><strong>Methods: </strong>This matched cohort study included 1677 women who were found to carry a BRCA1/2 pathogenic variant. A Cox proportional hazards model was used to estimate hazard ratios associated with oral contraceptive use and with levonorgestrel-releasing intrauterine device use.</p><p><strong>Results: </strong>Among BRCA1 carriers (n = 990), oral contraceptive use was not associated with breast cancer risk (HR = 0.90, 95% CI 0.77-1.05, p = 0.2). Among BRCA2 carriers (n = 687), oral contraceptive use was associated with reduced breast cancer risk (HR = 0.80, 95% CI 0.65-0.99, p = 0.04), although duration-stratified analyses did not demonstrate a consistent dose-response relationship. Oral contraceptive use was associated with a decrease in the risk of ovarian cancer in BRCA2 carriers (HR = 0.57, 95% CI 0.35-0.94, p = 0.028), with the strongest protective effect observed among BRCA2 carriers who used an oral contraceptive for more than 5 years (HR = 0.13; 95% CI 0.02-0.92). The protective effect of oral contraceptive use was less profound for BRCA1 carriers. The use of a levonorgestrel-releasing intrauterine device was not associated with breast or ovarian cancer risk.</p><p><strong>Conclusion: </strong>The use of an oral contraceptive was associated with reduced risks of breast and ovarian cancer among BRCA2 carriers, although the observed association with breast cancer should be interpreted cautiously given the absence of a consistent duration-response pattern. There was no increase in the risk of breast cancer among BRCA1 carriers who used an oral contraceptive. No association with either cancer was found among users of a levonorgestrel-releasing intrauterine device.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805153","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":"Risk of febrile neutropenia in breast cancer chemotherapy despite the prophylactic use of pegfilgrastim: a retrospective analysis.","authors":"Hiroki Kusama, Yoshiya Horimoto, Kyoko Iwai, Yuki Kitaoku, Fujina Takeda, Ryo Hamaoka, Minami Iwai, Mizuki Mizuuchi, Tomoka Ushio, Kyoko Orimoto, Takashi Ishikawa","doi":"10.1007/s12282-026-01907-7","DOIUrl":"https://doi.org/10.1007/s12282-026-01907-7","url":null,"abstract":"<p><strong>Background: </strong>Pegfilgrastim, a long-acting granulocyte colony-stimulating factor (G-CSF), is used to prevent febrile neutropenia (FN) in breast cancer patients undergoing chemotherapy. However, a small subset of patients still develops FN. This study aimed to assess the real-world incidence of FN and identify potential risk factors in this specific population.</p><p><strong>Methods: </strong>This retrospective study included breast cancer patients who received pegfilgrastim prophylaxis at Tokyo Medical University Hospital between February 2019 and December 2024. Inclusion required pegfilgrastim use at least once during chemotherapy. FN was defined as an absolute neutrophil count below 500/µL (or a predicted ANC below 1,000/µL) and an axillary temperature 37.5 °C or higher. Cases of FN and associated risk factors were analyzed using logistic regression models.</p><p><strong>Results: </strong>This study included 378 patients (median age 53). Tumor subtypes were luminal (50.0%), HER2-positive (20.9%), and triple-negative (29.1%), with dose-dense regimens being the most common (55.8%). Of 2,784 total chemotherapy administrations, pegfilgrastim was used in 2,125 cycles (76.3%). The incidence of FN despite pegfilgrastim was 2.1% (8/378), with the highest rate observed in immune checkpoint inhibitor-containing regimens (9.1%, 2/22). Multivariate analysis identified a low baseline platelet count as a significant independent risk factor for combined FN and grade 3-4 neutropenia (OR: 0.98; 95% CI: 0.96-0.99; P = 0.02).</p><p><strong>Conclusion: </strong>Although pegfilgrastim is effective, FN still occurs in a small percentage of patients. A low baseline platelet count was associated with an increased risk of FN or severe neutropenia despite pegfilgrastim prophylaxis, though this finding requires confirmation in larger studies given the limited number of events.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763419","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}