Breast Journal最新文献

{"title":"Neoadjuvant Endocrine Therapy Compared to Neoadjuvant Chemotherapy in Node-Positive HR+, HER2− Breast Cancer (Nodal pCR and the Rate of ALND): A Systematic Review and Meta-Analysis","authors":"Mahtab Vasigh,&nbsp;Mohammadreza Karoobi,&nbsp;Austin D. Williams,&nbsp;Fasika Molla Abreha,&nbsp;Richard J. Bleicher,&nbsp;Seyed Mostafa Meshkati Yazd,&nbsp;Tahereh Shamsi,&nbsp;Ramesh Omranipour,&nbsp;Ahmad Elahi,&nbsp;David Farhat,&nbsp;Mehran Habibi","doi":"10.1155/2024/8866756","DOIUrl":"https://doi.org/10.1155/2024/8866756","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Patients with hormone receptor-positive (HR+), HER2-negative (HER2−) breast cancers have the lowest response to neoadjuvant therapy of all subtypes. The role of neoadjuvant endocrine therapy (NET) in clinically node-positive (cN+), HR+, HER2− patients is evaluated in this meta-analysis. <i>Methods</i>. This study was performed between January 2010 and August 2022. We evaluated the node pathologic complete response (pCR) and axillary lymph node dissection (ALND) rates after neoadjuvant endocrine therapy (NET). <i>Results</i>. 18,037 HR+, HER2−, cN+ stage II and stage III breast cancer patients within eleven studies received neoadjuvant treatments. 3,707 (20.6%) patients received NET and 14,330 (79.4%) received NAC. The average age of the NET patients was higher than that of the neoadjuvant chemotherapy (NAC) patients (64.1 versus 47.6 years old, <i>p</i> &lt; 0.001). 45.0% and 26.9% of the NET and the NAC groups underwent a lumpectomy. The pooled estimates of node pCR in NET and NAC groups were 8.9% and 14.9%, and the pooled proportion of ALND was 39.1% and 58.5%, respectively. <i>Conclusion</i>. The rate of node pCR was lower among cN+ patients who received NET compared to the NAC group. The rate of ALND among cN+ NET patients was lower than the NAC group, revealing more patients with residual nodal disease do not get ALND in the NET group. Further prospective studies are required to compare survival outcomes as a more reliable surrogate.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8866756","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141966749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the ≥1 cm Width of the Resection Margin in Benign and Borderline Phyllodes Tumor Necessary to Reduce Recurrence?","authors":"Nattakarn Changchit,&nbsp;Natthawadee Laokulrath,&nbsp;Pradit Rushatamukayanunt,&nbsp;Pongthep Pisarnturakit","doi":"10.1155/2024/1432313","DOIUrl":"https://doi.org/10.1155/2024/1432313","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Phyllodes tumors (PTs) are fibroepithelial neoplasms of the breast, with current treatment guidelines recommending wide excision to achieve surgical margins of ≥1 cm to minimize the recurrence risk. However, diagnostic challenges with core biopsy specimens often result in suboptimal surgical margins. This study aims to elucidate the correlation between margin status and PT recurrence, thereby informing surgical decision-making and enhancing patient outcomes. <i>Methods</i>. This single-center, retrospective study reviewed records of Thai women diagnosed with PTs between 2011 and 2018, collecting data on demographics, clinical presentation, surgical approach, tumor grade, size, and margin status. The primary endpoint was recurrence. <i>Results</i>. Among 165 PT cases analyzed—49.1% borderline, 38.2% benign, and 12.7% malignant—the overall recurrence rate was 13.9% (<i>n</i> = 23) over a median follow-up of 4.5 years. No significant difference in recurrence rates was observed between patients with negative resection margins &lt;1 cm (ranging from &lt;1 mm to 9 mm) compared to those with ≥1 cm (10.2% vs. 7.1%, <i>p</i> = 1.00). Notably, in negative resection margins &lt;1 cm group, a margin &lt;1 mm (close margin) was associated with a significantly higher recurrence rate compared to margins of 1–9 mm (17.0% vs. 4.9%, <i>p</i> = 0.04). Borderline PTs followed the overall trend, while benign PTs showed increased recurrence with positive margins. Multivariate analysis indicated a significant association between margins &lt;1 mm and recurrence (adjusted HR = 10.78 (95% CI 1.32–88.07), <i>p</i> = 0.027), highlighting an increased recurrence risk with more extensive positive margins. <i>Conclusion</i>. Our findings suggest that a wide surgical margin of ≥1 centimeter may not be necessary to prevent recurrence in benign and borderline PTs. Notably, surgical margins narrower than 1 millimeter substantially elevate the recurrence likelihood in cases of borderline PTs. Furthermore, the presence of positive surgical margins correlates with an increased recurrence rate in benign PTs. These findings highlight the critical need for a strategic approach in determining surgical margins, tailored specifically to the type of PT, to enhance patient outcomes effectively.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/1432313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141966750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supraclavicular Irradiation Induces Lymphedema in Breast Cancer Patients Treated with Axillary Lymph Node Dissection and Taxane-Containing Chemotherapy","authors":"Nanae Horisawa,&nbsp;Akiyo Yoshimura,&nbsp;Isao Oze,&nbsp;Masataka Sawaki,&nbsp;Masaya Hattori,&nbsp;Haruru Kotani,&nbsp;Ayumi Kataoka,&nbsp;Yuri Ozaki,&nbsp;Kazuki Nozawa,&nbsp;Yuka Endo,&nbsp;Daiki Takatsuka,&nbsp;Ayaka Isogai,&nbsp;Hiroji Iwata","doi":"10.1155/2024/3250143","DOIUrl":"https://doi.org/10.1155/2024/3250143","url":null,"abstract":"<div>\u0000 <p><i>Purpose</i>. Breast cancer-related lymphedema (LE) significantly impairs the patients’ quality of life. Axillary lymph node dissection (ALND) is a strong risk factor for LE in breast cancer surgery. In addition, postoperative administration of docetaxel (DTX) has been reported to be a risk factor for LE in patients who undergo ALND. Herein, we performed the risk of objective LE after ALND. <i>Methods</i>. Patients who visited the medical follow-up clinic between 12 November 2018 and 11 January 2019 and at least one year postoperatively were eligible for this study. The risk factors for objective LE according to taxane-containing regimen, radiation therapy, and body mass index and the effects of a taxane-containing regimen followed by supraclavicular irradiation on LE were examined. <i>Results</i>. A total of 214 patients were included in this analysis, and objective LE was observed in 52 patients (24%). Univariate and multivariate analyses showed that only supraclavicular field irradiation was a statistically significant risk factor for objective LE. In addition, the sequential use of taxane-containing regimens and supraclavicular RT was shown to be a more likely risk factor for LE than ALND alone. We also compared each taxane regimen with supraclavicular RT and found that DTX was more likely to be a risk factor for LE in cases of sequential use of supraclavicular RT than with ALND alone. However, when comparing DTX with supraclavicular RT and PTX with supraclavicular RT directly, there was no statistically significant difference in the risk of objective LE between the two groups. <i>Conclusion</i>. The risk for LE was more likely to be higher with the sequential use of taxane-containing chemotherapy and supraclavicular field irradiation. Therefore, management of LE is important in these cases.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/3250143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Information Needs of Breast Cancer Survivors: An Umbrella Review","authors":"Nahid Gavili,&nbsp;Shahram Sedghi,&nbsp;Sirous Panahi,&nbsp;Maryam Razmgir","doi":"10.1155/2024/5889622","DOIUrl":"https://doi.org/10.1155/2024/5889622","url":null,"abstract":"<div>\u0000 <p><i>Purpose</i>. The aim of this umbrella review was to identify the main information needs of breast cancer survivors. Since several reviews have already been done on this topic, conducting an umbrella review not only combines their results but also gives a comprehensive picture and informative summary of breast cancer survivors’ needs. <i>Method</i>. The search was performed in PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane, and Google Scholar from inception to the end of March 2024. This review was conducted according to the JBI methodology for umbrella reviews, and the report was based on Rutten’s category for information needs of patients with cancer. After removing duplicate and irrelevant articles, 14 systematic reviews were included in the analysis. The JBI checklist was used for evaluating the quality of eligible articles. <i>Results</i>. The information needs were classified into 11 main categories and 86 subcategories. As a result of this umbrella review, one category was added to Rutten’s 10 categories. Also, treatment information needs were introduced as the main identified category. Information on supportive care needs ranked second, and body image/sexuality information needs ranked third with a slight difference. <i>Conclusion</i>. The information needs outlined in the present study can serve as a general model to help clinical decision makers and policymakers in order to better understand the needs of the group and meet the information needs of the population. <i>Implications for Cancer Survivors</i>. These recommendations can promote and develop targeted interventions to reduce the psychosocial consequences of breast cancer survivors and increase their quality of life.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/5889622","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141624570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ERCC3 Gene Associated with Breast Cancer: A Genetic and Bioinformatic Study","authors":"Xiangyu Chen,&nbsp;Heng Xiao,&nbsp;Shuangcheng Ning,&nbsp;Bang Liu,&nbsp;Huashan Zhou,&nbsp;Ting Fu","doi":"10.1155/2024/7278636","DOIUrl":"https://doi.org/10.1155/2024/7278636","url":null,"abstract":"<div>\u0000 <p>Female breast cancer is the most common and the fifth deadliest cancer worldwide. It is influenced by a combination of genetic, hormonal, and environmental factors. The excision repair cross-complementation group 3 gene (<i>ERCC3</i>) has recently been identified as a breast cancer susceptibility gene in various cohorts of different geographical and ethnic origin. To explore the role of <i>ERCC3</i> mutations in breast cancer development and pathological diagnosis, genetic analysis was conducted in 291 patients and 291 controls from mainland China. Bioinformatic analysis and immunohistochemistry (IHC) were performed. A novel <i>ERCC3</i> mutation p.Y116X was identified in a breast cancer family, while no frequency bias for the genotype and allele of rs754010782 and rs371627165 was observed (all <i>P</i> &gt; 0.05). Bioinformatic analysis revealed that <i>ERCC3</i> expression was negatively associated with estrogen receptor (ER), progesterone receptor (PR), nontriple-negative status, and nodal status of breast cancers. <i>ERCC3</i> amplifications and deep deletions primarily occurred in breast invasive cancer not otherwise specified (NOS) and metaplastic breast cancer, respectively. The decreased ERCC3 expression in tumor tissues of patient with p.Y116X mutation was found by IHC. The <i>ERCC</i>3 mutation p.Y116X may increase breast cancer risk in the Han-Chinese population. <i>ERCC3</i> exhibits potential as a biomarker for the pathological diagnosis of breast cancer.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7278636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141624448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast Desmoid Tumours: A Review of the Literature","authors":"Mike Wu,&nbsp;Thomas Michael Hughes,&nbsp;Senarath Edirimanne,&nbsp;Nicholas Ngui","doi":"10.1155/2024/5803290","DOIUrl":"https://doi.org/10.1155/2024/5803290","url":null,"abstract":"<div>\u0000 <p>Breast desmoid tumour is a rare type of benign breast disease that presents like malignancy. Current guidelines are based on limited evidence derived from case reports and small case series and recommend resection with microscopically-negative margin (R0). There is a high risk of recurrence despite negative surgical margins. A review of the published cases of breast desmoid since 2000 was conducted using Medline and Embase to descriptively analyse the clinical presentation, diagnosis, treatment, and outcomes of this rare disease. After screening, we identified 46 patients from 39 articles. Most cases did not have risk factors, but 17/46 (37%) had prior procedures on the ipsilateral breast. Mammography was able to detect 65% of the cases, ultrasound detected 74%, and both CT and MRI detected all cases when used. Preoperative diagnosis was best performed using core needle biopsy showing typical histology and positive beta-catenin staining. 42/46 cases underwent definitive surgical management, with 8 cases of recurrence. Recurrence occurred within 3 years of the initial surgery. Median time of recurrence was 8 months, and the median follow-up of the recurrence-free patients was 12 months. There were no predictive factors identified for recurrence. There were 7 cases treated with a nonsurgical modality, with 3 showing at least a partial response.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/5803290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted Treatment of Metastatic Triple-Negative Breast Cancer: A Systematic Review","authors":"Anna Martha Hammershøi Madsen,&nbsp;Rikke Helene Løvendahl Eefsen,&nbsp;Dorte Nielsen,&nbsp;Iben Kümler","doi":"10.1155/2024/9083055","DOIUrl":"https://doi.org/10.1155/2024/9083055","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Triple-negative breast cancer (TNBC) is a subgroup of breast cancer characterized by the absence of estrogen and the human epidermal 2 receptor and also a lack of targeted therapy options. Chemotherapy has so far been the only approved treatment option, and patients with metastatic cancer have a dismal prognosis with a median overall survival (OS) of approximately 14 months. Identification of druggable targets for metastatic TNBC is therefore of special interest. <i>Methods</i>. A systematic search was performed, to review the existing evidence on targeted therapies in metastatic TNBC. <i>Results</i>. A total of 37 phase 2/3 studies were identified, evaluating 29 different targeted agents. In this review, results on progression free survival (PFS) and OS are presented. <i>Conclusion</i>. In most of the studies included, no improvement was observed for neither PFS nor OS; however, a few studies did show improvement with targeted agents and have led to new treatment options in subgroups of patients. The antibody drug conjugate, sacituzumab govitecan, demonstrated superior PFS and OS in comparison to chemotherapy. Immunotherapy with checkpoint inhibitors such as atezolizumab and pembrolizumab is now recommended as a first-line treatment option for patients with expression a PD-L1 positive tumor. Finally, the poly adenosine diphosphate-ribose polymerase (PARP) inhibitors talazoparib and olaparib are recommended, as first-line treatment options in patients with metastatic breast cancer and a germline BRCA mutation, but an immune checkpoint inhibitor should be considered for the subset of these patients who are PD-L1 positive.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9083055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141597120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upregulated SAE1 Drives Tumorigenesis and Is Associated with Poor Clinical Outcomes in Breast Cancer","authors":"Hong Liu,&nbsp;Jing Wang,&nbsp;Yunhai Li,&nbsp;Feng Luo,&nbsp;Lei Xing","doi":"10.1155/2024/2981722","DOIUrl":"https://doi.org/10.1155/2024/2981722","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The purpose of this study was to analyze SUMO activating enzyme subunit 1 (SAE1) expression in breast cancer (BC). Through bioinformatics analysis and in vitro experiments, the biological function and possibly associated signal pathways of SAE1 in BC were further analyzed. <i>Methods</i>. Bioinformatics analysis was applied to analyze SAE1 expression in BC and normal breast tissues, its relationship with clinicopathologic characteristics and prognosis in BC patients, and data from the Cancer Genome Atlas database and Gene Expression Omnibus dataset. We performed immunohistochemistry to analyze SAE1 expression in BC tissues and para-cancer tissues in 79 breast cancer patients. BC cell proliferation was detected with the Cell Counting Kit-8 and by the colony formation assay. Cell cycle progression was analyzed by flow cytometry, and the expression of cell cycle-related proteins (E2F1, cyclin D3, and cyclin-dependent kinase 2) was determined by western blots in SAE1 small interfering RNA (siRNA) transfected cells. The GSE1456 dataset was used to analyze possible signal pathways associated with SAE1 by gene set enrichment analysis (GSEA), and the expression of PI3K/AKT/mTOR pathway-related proteins (such as p-PI3K, p-AKT, and mTOR) in SAE1-siRNA cells was detected by western blots. <i>Results</i>. The bioinformatics and immunohistochemical results showed that SAE1 mRNA and protein expression in BC tissues were significantly higher than those in normal tissues. The SAE1 overexpression was significantly associated with the tumor size, tumor-node-metastasis stage, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and whether or not it was a triple-negative BC. Patients with SAE1 overexpression had a worse overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival compared with lower expression patients. Multivariate Cox regression analysis showed that SAE1 may be an independent prognostic factor for OS of BC patients. The proliferation and cell cycle process of BC cells were inhibited by SAE1-siRNA in vitro. The result of GSEA showed that SAE1 was significantly associated with 12 gene sets, including unfolded protein reaction, DNA repair, oxidative phosphorylation, and cell cycle, among others. Additionally, two signal pathways, mTORC1 and PI3K/Akt/mTOR, were significantly correlated with SAE1 overexpression. Western blots confirmed that the expression of PI3K/Akt/mTOR pathway-related proteins (p-PI3K, p-AKT, and mTOR) in BC cells was decreased after knocking down SAE1. <i>Conclusion</i>. SAE1 was highly expressed in BC. Its overexpression was associated with poor BC prognosis. Additionally, it was an independent prognostic factor for BC patients. We demonstrated that in vitro SAE1 knockdown effectively inhibited BC proliferation and its cell cycle process. Furthermore, the biological function of SAE1 may be associated with the PI3K/Akt/mTOR pathwa","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/2981722","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141488968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of Unwarranted Variation and Disparity in Breast Cancer Management in Regional and Rural Area","authors":"Kimberley J. Davis,&nbsp;Chantal Campbell,&nbsp;Rebekah Costelloe,&nbsp;Ting Song,&nbsp;Glaucia Fylyk,&nbsp;Ping Yu,&nbsp;Steven J. Craig","doi":"10.1155/2024/9354395","DOIUrl":"https://doi.org/10.1155/2024/9354395","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Breast cancer management is complex, requiring personalised care from multidisciplinary teams. Research shows that there is unwarranted clinical variation in mastectomy rates between rural and metropolitan patients; that is, variation in treatment which cannot be explained by disease progression or medical necessity. This study aims to determine the clinical and nonclinical factors contributing to any unwarranted variation in breast cancer management in rural patients and to evaluate how these factors and variations relate to patient outcomes. <i>Methods</i>. Comprehensive data from patients who had primary breast cancer surgery from 2010 to 2014 in either a rural or metropolitan location in a single local health district was analysed (<i>n</i> = 686). Records were subset into two rurality groupings based on the postcode in which the patient resided, and the Modified Monash Model (MMM), an Australian system for classifying rurality. Statistical analysis was used to compare rural and metropolitan cohorts on treatments, patient characteristics, timeliness, and outcomes (recurrence and survival). <i>Results</i>. Rural patients had higher mastectomy rates than metropolitan patients (57% vs. 34%, <i>p</i> &lt; 0.001), despite a lack of difference in clinical or demographic factors accounting for such variation. The length of time between treatment pathway stages was consistently longer amongst rural patients (<i>p</i> &lt; 0.01). Rural women also had worse survival outcomes, especially amongst HER2-positive patients who had significantly lower survival (5-year 74% vs 82%; 10-year 49% vs 71%, <i>p</i> &lt; 0.05) than metropolitan HER2-positive patients. <i>Conclusion</i>. This study reveals clinical disparities among rural breast cancer patients, that cannot be explained by demographic and clinical factors alone. Rural patients face lower rates of breast-conserving surgery and treatment delays, attributable to systemic barriers such as limited access to specialist care, high travel costs, and suboptimal care coordination. These findings have important implications for improving equity and collaboration in delivering person-centred breast cancer care.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/9354395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141430254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Optimize Deimplementation of Sentinel Lymph Node Biopsy?","authors":"Ida Dragvoll,&nbsp;Anna M. Bofin,&nbsp;Håvard Søiland,&nbsp;Monica Jernberg Engstrøm","doi":"10.1155/2024/7623194","DOIUrl":"10.1155/2024/7623194","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. The omission of sentinel lymph node biopsy in low-risk elderly breast cancer patients has been introduced in several guidelines. Despite evidence to support its safety, this recommendation has not been implemented by many clinicians. We have examined two aspects of this recommendation that may explain why sentinel lymph node biopsy continues to be performed in most of these patients. Firstly, we quantified the proportion of patients diagnosed with axillary metastases postoperatively. Secondly, we examined adherence to antihormonal therapy in the same group of patients. <i>Methods</i>. In this single-centre retrospective cohort study, the study population comprised 98 patients with breast cancer. Patients were aged ≥70 years and diagnosed with hormone receptor positive breast cancers less than 20 mm (T1). All patients underwent surgery and were subsequently prescribed five years of adjuvant antihormonal treatment. <i>Results</i>. Axillary lymph node metastases, as confirmed by the postoperative histology report, were seen in 36.3%. Nonadherence was seen in 33.7% of the patients. Primary nonadherence, that is, patients that never collect their first or subsequent prescriptions at the pharmacy, comprised 11.2% of the total study population. <i>Conclusion</i>. The high proportion of axillary metastases demonstrated suggests that clinical examination of the axilla alone is not sufficient in the preoperative assessment of the axilla. The less-than-optimal adherence rates show that adherence in these patients cannot be taken for granted. We suggest that these factors reflect some of the reluctance among clinicians to omit the sentinel lymph node procedure in these patients.</p>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/7623194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141149925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}