Breast cancer (Tokyo, Japan)最新文献

{"title":"Female breast cancer burden among adolescent and young adults in North Africa.","authors":"Davidi Tawfiles, Jenny Chen, Miriam Tawfiles, Sybil Jones, Frances Dominique V Ho, Erin Jay G Feliciano, James Fan Wu, Jonas Willmann, Puneeth Iyengar, Maria Jocelyn Kara Magsanoc-Alikpala, Khaled Elsayad, Abeir El-Mogassabi, Adda Bounedjar, Edward Christopher Dee","doi":"10.1007/s12282-025-01755-x","DOIUrl":"https://doi.org/10.1007/s12282-025-01755-x","url":null,"abstract":"<p><strong>Introduction: </strong>This study examines the growing burden of breast cancer among adolescents and young adults (AYAs, ages 15-39) in North Africa from 1990 to 2021. Despite breast cancer primarily affecting postmenopausal women, its increasing incidence among AYAs presents unique clinical and biological challenges that remain under explored in North Africa.</p><p><strong>Methods: </strong>Using Global Burden of Disease 2021 data, we analyzed temporal trends in AYA breast cancer incidence and mortality across North Africa compared to other global regions (seven GBD super regions and Central Africa, Eastern Africa, Northern Africa, Southern Africa, and Western Africa). For individual North African countries (Algeria, Egypt, Libya, Mauritania, Morocco, and Tunisia), we calculated the relative percentage change from 1990 to 2021 for all regions and the Estimated Annual Percent Change (EAPC), derived from log-linear expression models.</p><p><strong>Results: </strong>North Africa demonstrated the second-highest global increase in AYA breast cancer incidence (166%) and third-highest increase in mortality (58%), significantly exceeding global averages. Within Africa, North Africa exhibited the steepest rise in incidence and was one of only two regions showing a statistically significant increase in mortality. In North Africa, Libya showed the most alarming trajectory with the highest annual percent change in both incidence (4.36%) and mortality (3.06%), while Algeria maintained the lowest regional mortality rates.</p><p><strong>Interpretation: </strong>AYA breast cancer in North Africa poses challenges including limited screening, cultural barriers, and healthcare disparities. Despite varied infrastructures, rising trends demand action. Solutions include AYA-specific awareness, mobile screening, better registries, and regional collaboration for early detection and treatment.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812832","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":"Impact of modified dexamethasone administration sequence on infusion reaction incidence in HER2-positive breast cancer: a randomized multicenter trial.","authors":"Ryoichi Matsunuma, Shigeru Nakagaki, Eiji Nakatani, Masayuki Kikuchi, Noriaki Wada, Kei Yonezawa, Tadahiro Isono, Ryosuke Hayami, Mayumi Kaga, Michiko Tsuneizumi","doi":"10.1007/s12282-025-01752-0","DOIUrl":"https://doi.org/10.1007/s12282-025-01752-0","url":null,"abstract":"<p><strong>Background: </strong>Infusion reactions (IRs) are common adverse events associated with HER2-targeted monoclonal antibodies, such as trastuzumab and pertuzumab. Although dexamethasone is routinely administered before docetaxel to prevent hypersensitivity, its optimal timing relative to HER2-targeted agents has not been established. This study assessed whether premedication with dexamethasone reduces the incidence of IRs associated with HER2-targeted therapy.</p><p><strong>Methods: </strong>In this randomized, multicenter trial, 100 patients with HER2-positive early breast cancer were randomized to receive dexamethasone either before (experimental group) or after (control group) HER2-targeted agents. All patients received trastuzumab, pertuzumab, and docetaxel. The primary endpoint was the incidence of IRs during the first treatment cycle. Secondary endpoints included the incidence of grade ≥ 3 IRs, IRs in cycle 2, and overall adverse events.</p><p><strong>Results: </strong>Incidence of IRs in cycle 1 was significantly lower in the experimental group (24.0%) than in the control group (60.0%) (P < 0.001), corresponding to an absolute risk reduction of 36.0%. No grade ≥ 3 IRs occurred in either group. The incidence of IRs during cycle 2 was low and similar between groups (8.0% vs. 10.2%; P = 0.703). The incidence of treatment-related adverse events was similar between groups (98.0% vs. 100.0%, P > 0.999). Time-course analysis revealed that most of IRs in the control group occurred before dexamethasone administration.</p><p><strong>Conclusions: </strong>Premedication with dexamethasone before HER2-targeted therapy substantially reduced IRs without additional toxicity. This straightforward, cost-effective modification to the premedication protocol may improve tolerability in HER2-positive breast cancer and other antibody-based therapies.</p><p><strong>Trial registration: </strong>UMIN000045181 (registered on August 18, 2021).</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769533","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":"A retrospective multi-center cohort study investigating safety of sentinel lymph node biopsy for axillary staging in clinical T3-4c breast cancer.","authors":"Sayaka Kuba, Yasuaki Sagara, Hiroshi Yano, Shigeto Maeda, Takehiko Sakai, Yasuyuki Kojima, Masaya Hattori, Sota Asaga, Eriko Tokunaga, Tadahiko Shien, Hiroko Bando, Keisei Anan, Nobutaka Iwakuma, Shigeki Minami, Miki Yamaguchi, Michiko Harao, Masahiro Oikawa, Takafumi Sangai, Makoto Ishitobi, Takahiro Nakayama, Tetsu Hayashida, Manami Tada, Kentaro Tamaki, Goro Kutomi, Mai Tomiguchi, Narumi Harada-Shoji, Kaname Kurashita, Kaori Terata, Kosho Yamanouchi, Makoto Kubo, Chika Yumura, Yoko Takahashi, Shigeru Imoto, Shinji Ohno, Naoki Hayashi","doi":"10.1007/s12282-025-01749-9","DOIUrl":"https://doi.org/10.1007/s12282-025-01749-9","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLNB) has become a standard procedure for patients with breast cancer (BC) without clinically evident axillary metastasis. However, its role in cT3-4cN0 BC remains underexplored, leading to uncertainty regarding its safety.</p><p><strong>Methods: </strong>This retrospective, multicenter observational study included patients with cT3-4cN0M0 BC who underwent radical surgery between 2006 and 2016. Patients were divided into an SLNB group, which included those who underwent SLNB exclusively and ALND after SLNB, and an ALND group, which included those who underwent ALND exclusively. Inverse probability treatment weighting was applied to balance the patient characteristics, with recurrence-free survival (RFS) as the primary endpoint.</p><p><strong>Results: </strong>The study included 930 patients: 716 in the SLNB group and 214 in the ALND group. The ALND group had a higher proportion of patients diagnosed earlier, more T4 tumors, and more frequent use of neoadjuvant chemotherapy. During a median follow-up period of 89 months, 176 RFS events and 51 loco-regional recurrence events occurred. After adjusting for confounding factors, no significant difference was found in 10-year RFS between the groups (74.2% vs. 79.2%). Adjusted hazard ratios for RFS did not differ between the groups, even when stratified by tumor stage (cT3, cT4) or neoadjuvant chemotherapy. No significant differences were observed between the SLNB and ALND groups in loco-regional recurrence rate (LRR), with 10-year LRR rates of 93.1% and 90.8%, respectively.</p><p><strong>Conclusions: </strong>SLNB was a safe axillary staging method for patients with cT3-4cN0M0 BC and does not impact RFS or LRR negatively when compared with ALND.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763041","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":"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":"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}

{"title":"Real-world evidence from Japan regarding survival outcomes and treatment sequence in patients receiving CDK4/6 inhibitor plus endocrine therapy as first- or second-line treatment for hormone receptor-positive, HER2-negative advanced or metastatic breast cancer.","authors":"Tetsuhiro Yoshinami, Yuko Takano, Yukinori Ozaki, Yukiko Kajiwara, Mitsugu Yamamoto, Ken-Ichi Watanabe, Masami Tsukabe, Fumie Fujisawa, Shigenori E Nagai, Nobuhiro Shibata, Chiya Oshiro, Hiroko Bando, Nobuyuki Tsunoda, Kazuhiko Yamagami, Kei Koizumi, Masahiro Takada, Naoko Toriguchi, Nobuyuki Sekine, Tsutomu Kawaguchi, Shigehira Saji, Yasuaki Sagara, Satoshi Morita, Norikazu Masuda","doi":"10.1007/s12282-025-01713-7","DOIUrl":"10.1007/s12282-025-01713-7","url":null,"abstract":"<p><strong>Background: </strong>A cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) plus endocrine therapy (ET) is a current standard first-/second-line treatment for hormone receptor (HR)-positive, HER2-negative advanced/metastatic breast cancer (AMBC). We aimed to provide real-world evidence regarding CDK4/6i therapy in this population.</p><p><strong>Methods: </strong>In this multicenter observational study, data from patients who had started CDK4/6i therapy between January 1, 2019, and December 31, 2021, as first-/second-line treatment for AMBC were used; real-world progression-free survival (rwPFS), chemotherapy-free survival, and overall survival were analyzed using the Kaplan-Meier method. Additionally, data were analyzed by separating patients with treatment-free interval (TFI) < 12 months (deemed resistant to ET) from the first-line treatment group (hereafter, the exclusive first-line treatment group).</p><p><strong>Results: </strong>Data from 745 patients were analyzed. Compared with palbociclib, abemaciclib was used in younger patients and those with expected poor prognosis. Median rwPFS was 36.8, 17.8, and 31.4 months in patients with de novo stage IV disease, TFI < 12 months, and TFI ≥ 12 months, respectively, in the first-line treatment group, and 17.4 months in the second-line treatment group. In the exclusive first-line treatment group, median rwPFS of the subsequent treatment after initial CDK4/6i plus ET was < 7 months, regardless of the type of subsequent treatment; prognosis was especially poor in those who were switched to chemotherapy.</p><p><strong>Conclusions: </strong>The real-world survival outcomes found in this study for patients receiving first-/second-line CDK4/6i therapy were consistent with those of randomized phase 3 studies. As outcomes of subsequent treatment after initial CDK4/6i plus ET remain insufficient, further improvement in treatment is necessary.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"841-856"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113255","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}