Breast cancer (Tokyo, Japan)最新文献

{"title":"PTX3 induces the expression of PD-L1 and promotes breast cancer immune escape.","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/s12282-026-01902-y","DOIUrl":"10.1007/s12282-026-01902-y","url":null,"abstract":"<p><strong>Background: </strong>Pentraxin 3 (PTX3) is an inflammatory mediator involved in tumorigenesis; however, its role in tumor immune evasion remains elusive. Herein, we demonstrate that PTX3 promotes immune evasion in breast cancer by upregulating PD-L1.</p><p><strong>Methods: </strong>RT-qPCR and Western blot were performed to assess PD-L1 expression in human and murine breast cancer cells. Cell surface PD-L1 was assayed by flow cytometry. Small interfering RNA and CRISPR-Cas9 were used to inhibit PTX3 expression. Co-culture experiments were conducted to evaluate the suppressive effects of tumor cells on CD8 + T cell activation. An immunocompetent BALB/c mouse allograft model was utilized, and tumor-infiltrating CD8 + T cells were analyzed by flow cytometry and immunohistochemistry.</p><p><strong>Results: </strong>PTX3 enhanced PD-L1 protein levels through the inhibition of autophagy. PTX3 increased the expression of the E3 ligase RNF216 and caused Beclin-1 degradation, which suppressed autophagy, thereby preventing autophagy-mediated PD-L1 degradation. Co-culture experiments demonstrate that PTX3-overexpressing breast cancer cells suppressed CD8 + T cell function, as evidenced by reduced production of IFN-γ and Granzyme B, whereas PTX3-depleted cells had the opposite effects. In vivo allograft studies revealed that depletion of PTX3 reduced PD-L1 expression, enhanced CD8 + T cell infiltration, and inhibited tumor growth in immunocompetent mice.</p><p><strong>Conclusion: </strong>PTX3 promotes PD-L1 expression and immune evasion in breast cancer. Therefore, targeting PTX3 may represent a potential therapeutic strategy to counteract this immune escape.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665447","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 factors associated with molecular subtypes of breast cancer among indian women: a multicentre matched case-control study.","authors":"Preethi Sara George, Aleyamma Mathew, Tanvir Kaur, R S Dhaliwal, Rekha A Nair, Pranay Tanwar, Showket Hussain, Usha Agrawal, Goura Kishor Rath","doi":"10.1007/s12282-026-01891-y","DOIUrl":"10.1007/s12282-026-01891-y","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a biologically diverse disease with distinct molecular subtypes, each linked to specific risks and outcomes. However, subtype-specific risk factors remain insufficiently explored, particularly in diverse populations such as Indian women. This study examined the associations of reproductive, lifestyle, and psychosocial factors with the risk of developing breast cancer subtypes defined by hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) status.</p><p><strong>Materials and methods: </strong>We conducted a multicentric matched case-control study among Indian women at three tertiary cancer centres. Pathologically confirmed breast cancer cases and age-matched controls were recruited, and detailed information on socio-demographic, reproductive, lifestyle, and psychosocial characteristics was collected through structured interviews. Breast cancer cases were classified into four molecular subtypes (HR+HER2-, HR+HER2+, HR-HER2+, and HR-HER2-). Multivariable conditional logistic regression models were used to estimate subtype-specific odds ratios and 95% confidence intervals.</p><p><strong>Results: </strong>HR+HER2 - was the most prevalent subtype. Increased risks for this subtype were observed among women with later age at marriage, artificial menopause, prolonged breastfeeding, unmarried status, obesity in midlife, frequent fried-food consumption, benign breast disease, and higher psychological stress. HR+HER2 + breast cancer was strongly associated with artificial menopause and low physical activity. HR-HER2 - breast cancer was linked to artificial menopause, family history of ovarian cancer, passive smoking, limited physical activity, and psychosocial stress.</p><p><strong>Conclusion: </strong>Distinct molecular subtypes of breast cancer among Indian women exhibit heterogeneous risk profiles shaped by reproductive, lifestyle, and psychosocial factors. This underscores the need for targeted public health strategies focusing on modifiable risk factors such as promoting breastfeeding, maintaining healthy body weight, increasing physical activity, and improving dietary habits. Enhancing psychosocial well-being, awareness of family history, community education, and early screening programmes may help reduce the breast cancer burden in India.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431877","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":"Real-world uptake of gBRCA testing as a companion diagnostic for olaparib in patients with high-risk HER2-negative early breast cancer in Japan: a cross-sectional multicenter study (BRCAwareness).","authors":"Tomoe Taji, Yukari Uemura, Yuri Kimura, Noriko Maeda, Aki Ito, Hirohito Seki, Daisuke Takabatake, Michiko Harao, Shogo Nakamoto, Ryoichi Matsunuma, Chinatsu Koganezawa, Takayuki Iwamoto, Hirofumi Mukai, Yuichiro Kikawa","doi":"10.1007/s12282-026-01867-y","DOIUrl":"10.1007/s12282-026-01867-y","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant olaparib significantly improves invasive disease-free and overall survival in high-risk human epidermal growth factor receptor 2 (HER2)-negative, early breast cancer patients carrying germline breast cancer susceptibility gene 1/2 (gBRCA) pathogenic variants (PVs). Timely gBRCA testing as a companion diagnostic for adjuvant olaparib is essential. However, its real-world uptake remains unclear.</p><p><strong>Methods: </strong>We enrolled patients with invasive HER2-negative early breast cancer who underwent curative surgery during 2023 in Japan. Eligibility was based on the OlympiA trial criteria. Estrogen receptor (ER)-positive patients required ≥ 4 positive nodes after surgery or non-pathological complete response (non-pCR) with clinical and pathologic stage (CPS) and estrogen receptor status and histologic grade (EG) score ≥ 3 following neoadjuvant chemotherapy (NAC). ER-negative patients required invasive tumor > 2 cm or ≥ 1 nodal metastasis after surgery, or non-pCR after NAC. The primary outcome was gBRCA testing rate; secondary outcomes included a proportion of patients with gBRCA PVs and a proportion of patients starting adjuvant olaparib. We also explored factors associated with not undergoing testing.</p><p><strong>Results: </strong>Of 824 patients enrolled from 46 facilities, 691 were analyzed after random sampling and exclusions. The testing rate was 63.2% (95% confidence interval 59.5-66.9). Among 254 untested patients, 168 (66%) were not informed-mainly due to physician oversight in recognizing eligibility (57%) or physician-perceived patient ineligibility (40%). Of 69 informed but untested patients, reasons included psychological distress (46%), testing cost (35%), and familial concerns (12%). Of 42 patients (9.6%) with gBRCA PVs, 32 received olaparib. Multivariable analysis (female only) showed that age ≥ 65 years, postmenopausal status, major comorbidities, upfront surgery, absence of family history of hereditary breast and ovarian cancer-related cancers, and absence of bilateral or multiple primary breast cancers were associated with lower testing rates.</p><p><strong>Conclusion: </strong>Greater physician awareness of companion diagnostic is needed to ensure timely gBRCA testing and equitable access to adjuvant olaparib.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"919-927"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008280","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":"Prognosis of patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative, 1-3 node-positive breast cancer meeting the high-risk criteria of the monarchE trial: a comparison between macrometastasis and micrometastasis.","authors":"Takeshi Murata, Masayuki Yoshida, Chikashi Watase, Hinako Maeda, Ayako Nakashoji, Ayumi Ogawa, Natsuko Ohgi, Mengge Chen, Sayako Tsubota, Akiko Maeshima, Eriko Iwamoto, Shin Takayama","doi":"10.1007/s12282-026-01871-2","DOIUrl":"10.1007/s12282-026-01871-2","url":null,"abstract":"<p><strong>Background: </strong>The monarchE trial enrolled patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive, high-risk early breast cancer (EBC). Although both macrometastasis and micrometastasis were eligible, the number of patients with only micrometastasis was not reported, leaving their prognosis uncertain. This study compared outcomes of patients with 1-3 positive axillary lymph nodes (pALNs), including those with only micrometastases and those with macrometastases, according to monarchE high-risk criteria.</p><p><strong>Methods: </strong>We retrospectively reviewed 844 patients with HR-positive/HER2-negative/node-positive EBC from a prospectively maintained institutional database and classified them into four groups: Group 1, 1-3 pALNs (including macrometastasis) with grade 3 tumors or tumors ≥ 5 cm; Group 2, 1-3 pALNs (only micrometastasis) with grade 3 tumors or tumors ≥ 5 cm; Group 3, 1-3 pALNs (including macrometastasis) with grade < 3 tumors and tumors < 5 cm; and Group 4, 1-3 pALNs (only micrometastasis) with grade < 3 tumors and tumors < 5 cm. Invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) were analyzed using the Kaplan-Meier method and log-rank test. Univariable Cox models assessed associations between clinical factors and outcomes.</p><p><strong>Results: </strong>Group 2 showed outcomes comparable to Group 1 (5-year IDFS: 80.7% vs. 83.7%; DRFS: 89.5% vs. 87.9%). In univariate analysis, only tumor size-rather than Group 2 or histological grade-was prognostic for IDFS and DRFS. Sensitivity analyses restricted to patients undergoing axillary lymph node dissection yielded consistent results.</p><p><strong>Conclusions: </strong>Among HR-positive/HER2-negative EBC, high-risk patients with only micrometastasis demonstrated prognoses similar to those with macrometastasis.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"928-937"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008273","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":"Short- and long-term effectiveness of physical activity interventions for women living with and beyond breast cancer: a systematic review and meta-analysis.","authors":"Alejandro Dominguez Garcia, Barbara A Mullan, Kylie Hill, Lauren J Breen, Chloe Maxwell-Smith","doi":"10.1007/s12282-026-01859-y","DOIUrl":"10.1007/s12282-026-01859-y","url":null,"abstract":"<p><p>BACKGROUND: Physical activity is beneficial for women living with and beyond breast cancer. Many interventions aim to increase physical activity in this population; however, their effectiveness is uncertain. This review examines changes in physical activity levels across short- and long-term timepoints following these interventions. METHODS: Online databases (CINAHL Ultimate, Medline, ProQuest, PsycINFO, SCOPUS, and Web of Science) were systematically searched for studies evaluating physical activity interventions for women living with and beyond breast cancer, assessing physical activity outcomes at baseline, post-intervention (short-term), and at least 3 months from the end of the intervention (long-term). Random-effects multilevel models were used for meta-analyses. RESULTS: The review included 43 studies with 5295 participants. Of these, 28 had sufficient data for meta-analyses. For between-group analyses, moderate-to-vigorous physical activity (MVPA) showed moderate effects at post-intervention (SMD = 0.46, 95% CI [0.17, 0.75]), while total physical activity showed small-to-moderate effects (SMD = 0.33, [0.15, 0.51]). At long-term follow-up (range 3 months to 5 years), effects were small for MVPA (SMD = 0.24, [0.14, 0.35]) and total physical activity (SMD = 0.25, [0.08, 0.43]). For within-group analyses, MVPA showed small-to-moderate effects (SMD = 0.38, [0.12, 0.63]) at post-intervention, while total physical activity showed moderate effects (SMD = 0.46, [0.14, 0.77]). At long-term follow-up, change from baseline MVPA was not statistically significant, while total physical activity showed a moderate effect (SMD = 0.33, [0.18, 0.47]). CONCLUSIONS: Physical activity interventions for women with and beyond breast cancer appear effective in the short term. However, long-term effects are inconsistent, especially for intensive activity. Identifying influential factors, including psychological determinants, that promote long-term physical activity would support sustained survivorship outcomes. </p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"801-819"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794984","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":"HER2-positive apocrine carcinoma of the breast and PIK3CA mutations.","authors":"Semir Vranic","doi":"10.1007/s12282-026-01872-1","DOIUrl":"10.1007/s12282-026-01872-1","url":null,"abstract":"","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"945-946"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978572","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 three arm-positioning techniques for minimizing motion artifacts in breast magnetic resonance imaging: a prospective volunteer study.","authors":"Norikazu Koori, Minami Suzuki, Nobukiyo Yoshida, Shohei Yamamoto, Shin Miyakawa, Kota Sasaki, Hiroki Nosaka, Kenji Yasue, Masato Takahashi, Koichi Hanada, Hajime Ichikawa, Kazuyuki Sumi, Kazuya Takeda, Hiraku Fuse","doi":"10.1007/s12282-026-01860-5","DOIUrl":"10.1007/s12282-026-01860-5","url":null,"abstract":"<p><strong>Background: </strong>Breast magnetic resonance imaging (MRI) assesses signal intensity changes across sequential image series (kinetic curves). Motion artifacts are common and often degrade image quality. However, the optimal patient positioning to minimize motion during breast MRI remains unclear. This study aimed to identify the most effective arm-positioning method for reducing motion artifacts during breast MRI.</p><p><strong>Methods: </strong>Six female volunteers underwent MRI at seven time points using enhanced T₁ high-resolution isotropic volume excitation, a three-dimensional T₁-weighted gradient-echo sequence with fat suppression. Each phase lasted 60 s and comprised seven serial images. Three arm-positions were tested: both-arms-raised, right-arm-raised, and both-arms-down. Motion was assessed using the visual evaluation score (VES) and the distance discordance metric (DDM).</p><p><strong>Results: </strong>VES results were higher with both-arms-raised (2.52 ± 0.43; median: 2.60) than with arms-down (2.39 ± 0.61; median: 2.40) or the right-arm-raised (2.33 ± 0.57; median: 2.40). A significant difference in VES was observed between the both-arms-raised and right-arm-raised groups (P = .04). DDM values were lowest with both-arms-raised (1.02 ± 0.64; median: 0.85), followed by arm-down (1.89 ± 1.19; median: 1.50) and right-arm raised (1.65 ± 0.98; median: 1.56). Significant differences in DDM were observed between the both-arms-raised position and the other two positions (P < .05 and P < .001, respectively).</p><p><strong>Conclusion: </strong>Positioning patients with both-arms-raised effectively minimized motion-related artifacts during breast MRI. Conversely, the right-arm-raised position was associated with increased artifacts and should be avoided to maintain image quality.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"853-861"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148039028","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":"Evaluation of serum microRNA-9-5p expression and its predicted target genes as potential biomarkers for breast cancer.","authors":"Mahsa Najari Nabi, Omid Asgari Oskoei, Dena Mohammad Bagheri Parvin, Mohammad Taghizadeh-Teymorloei, Mehdi Haghi","doi":"10.1007/s12282-026-01866-z","DOIUrl":"10.1007/s12282-026-01866-z","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is a complex genetic disorder and a major global health concern among women. The rising incidence of BC highlights the need for reliable molecular biomarkers to enable early diagnosis, monitor disease progression, and guide therapeutic interventions. MicroRNAs (miRNAs) have emerged as promising candidates due to their key regulatory roles in gene expression and their diagnostic and prognostic potential.</p><p><strong>Methods: </strong>In this study, serum miR-9-5p expression was evaluated in 100 BC patients and 100 healthy controls using quantitative real-time PCR (qPCR). Potential target genes of hsa-miR-9-5p were predicted using the miRDB database and ranked according to interaction scores.</p><p><strong>Results: </strong>Serum miR-9-5p was significantly upregulated in BC patients compared with healthy controls (P-value < 0.0001).</p><p><strong>Conclusion: </strong>The marked elevation of serum miR-9-5p in BC patients suggests its possibility potential as a non-invasive biomarker for early detection. The predicted target genes warrant further functional validation to clarify the molecular mechanisms underlying hsa-miR-9-5p-mediated regulation in breast cancer. Independent cohort studies are recommended to confirm these findings and further explore their clinical utility.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"896-904"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059181","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":"Clinical outcomes of postoperative radiotherapy with regional nodal irradiation excluding internal mammary lymph nodes in breast cancer: a multi-institutional retrospective analysis.","authors":"Kanako Nakatsu, Yuka Ono, Michio Yoshimura, Kimiko Hirata, Chikako Yamauchi, Masakazu Ogura, Takahiro Kishi, Kota Fujii, Shuji Ohtsu, Takashi Sakamoto, Kazuhito Ueki, Kengo Ogura, Setsuko Okumura, Itaru Ikeda, Takamasa Mitsuyoshi, Masaki Kokubo, Takashi Mizowaki","doi":"10.1007/s12282-026-01864-1","DOIUrl":"10.1007/s12282-026-01864-1","url":null,"abstract":"<p><strong>Background: </strong>Postoperative regional nodal irradiation (RNI) is a standard treatment for breast cancer at high risk of regional recurrence; however, the necessity of including the internal mammary node (IMN) region in the radiation field remains unclear. This study aimed to evaluate treatment outcomes in a large cohort of patients who received postoperative radiotherapy with RNI excluding the IMN region.</p><p><strong>Methods: </strong>This study included patients with breast cancer who underwent surgery followed by RNI without IMN irradiation between 2007 and 2018. The primary endpoint was disease-free survival (DFS), and the secondary endpoints were overall survival (OS), breast cancer-specific mortality (BCM), distant metastasis-free survival (DMFS), recurrence patterns, and treatment-related adverse events.</p><p><strong>Results: </strong>In total, 799 patients were included. The 5-year DFS, OS, BCM, and DMFS rates were 75.9, 88.3, 9.7, and 77.1%, respectively. Worse outcomes were associated with a higher number of positive lymph nodes and estrogen receptor (ER)-negative disease. Medial/central tumor location and younger age were each significantly associated with poorer outcomes, being associated with worse DFS and DMFS. Bone was the most common recurrence site. ER-negative disease, a higher number of positive lymph nodes, medial/central location, and younger age were significant risk factors for recurrence, particularly distant metastasis. IMN recurrence was rare.</p><p><strong>Conclusions: </strong>In this cohort, medial/central tumor location, ER-negative disease, and extensive nodal involvement were associated with poorer outcomes, suggesting that these factors may identify patients who can benefit from IMN irradiation. These findings may serve as important reference data when determining the indication for IMN irradiation on an individual patient basis.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"876-886"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966959","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":"Limits of substitution and context-dependent selective omission of Oncotype DX recurrence score testing.","authors":"Yoshiya Horimoto, Ryoko Semba, Takeshi Ushigusa, Hiroki Kusama, Takashi Ishikawa","doi":"10.1007/s12282-026-01868-x","DOIUrl":"10.1007/s12282-026-01868-x","url":null,"abstract":"<p><p>The Oncotype DX 21-gene recurrence score (RS) is widely used to guide adjuvant chemotherapy decisions in early-stage estrogen receptor-positive, HER2-negative breast cancer. However, its high cost and frequent discordance with conventional clinicopathologic risk assessment raise questions regarding whether RS can be substituted by other indicators or selectively omitted in specific clinical settings. In this narrative review, we examined whether RS can be reliably predicted or replaced by clinicopathologic or pathology-derived factors, and whether there are patient groups in whom RS testing has limited impact on treatment decision-making. A comprehensive literature search and structured screening process identified 54 studies that treated RS as an outcome variable, together with additional reports addressing selective testing strategies. Across diverse analytical approaches, RS could not be consistently substituted by existing indicators. Although modest correlations were observed, substantial case-level discordance persisted, particularly within the intermediate RS range, where predictive performance deteriorated near clinically relevant decision thresholds. In contrast, RS testing appeared less influential in treatment decisions for patients with clearly defined low- or high-risk clinicopathologic profiles or favorable special histologic subtypes. Overall, current evidence indicates that RS cannot be reliably replaced by other indicators, while its clinical value varies by context, suggesting that a selective rather than uniform application of RS testing may be reasonable in some settings.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"820-828"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966961","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}