Breast Journal最新文献

{"title":"The Impact of Socioeconomic Factors and Racial Disparities on Complications in Breast Conservation Surgery: A Single-Institution Retrospective Cohort Study","authors":"Liane N. Obaid, Janice S. Zhang, Grace Y. Lee, Fardeen Bhimani, Susan L. Jao, Carolyn Rachofsky, Lesley G. Coe, Arianna Cavalli, Michelle Ki, Juan Lin, Anjuli Gupta, Sheldon Feldman, Maureen McEvoy","doi":"10.1155/tbj/8459253","DOIUrl":"10.1155/tbj/8459253","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breast conservation surgery (BCS) is considered to be a low-morbidity procedure; however, postoperative complications may adversely affect the quality of life of breast cancer survivors. Social determinants of health have previously been shown to impact postoperative outcomes in various other medical conditions. However, there is a paucity of literature that comprehensively examines the social determinants that impact BCS complications or how race influences specific surgical outcomes. This study thus seeks to address this gap by analyzing the impact of these factors within our diverse patient population in the Bronx.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective chart review was conducted that examined patients who underwent BCS between January 2016 and December 2022 at a single institution. Patient information, such as comorbidities, Distressed Communities Index (DCI), BMI, race, insurance status, age, pathology, surgery details, adjuvant therapy, and complications, was collected. Univariate and multivariate analyses were utilized to determine the relationship between these variables and postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 627 patients were included in the study. Of these patients, 512 (81.5%) were either Hispanic or African American, 46 patients (7.3%) were White, and 69 (11%) belonged to other races. There was a delay in 37 (6.2%) patients receiving adjuvant therapy. Our study found that higher DCI quintile and higher BMI were associated with a statistically significant increase in overall complication rate (<i>p</i> = 0.044, <i>p</i> = 0.05, respectively). Race had an association with persistent pain (<i>p</i> = 0.003). Former smokers (OR = 3.44, 95% CI [1.419, 8.34], <i>p</i> = 0.0062), hypertensive patients (OR = 3.846, 95% CI [1.13, 13.12], <i>p</i> = 0.0314), and patients who received adjuvant chemotherapy (OR = 2.756, 95% CI [1.117, 6.801], <i>p</i> = 0.0278) had higher odds of developing any complication. Patients who developed any complication were more likely to have a delay in adjuvant therapy than patients who did not have complications (OR = 6.452, CI [2.696, 15.44], <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BCS is generally a safe procedure with minimal complications; however, patient-specific factors are associated with increased complication rates which can lead to delays in adjuvant therapy. Future studies with larger sample sizes are needed to adequately compare outcomes among minority racial groups to a lar","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617166","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":"Defining Multiple Fibroadenomas: A Systematic Review of Clinical Characteristics and Management","authors":"Prathiksha Math,&nbsp;Gayathri Sajith,&nbsp;Kiran Mahadevappa,&nbsp;Shalini G. Hegde","doi":"10.1155/tbj/5572826","DOIUrl":"10.1155/tbj/5572826","url":null,"abstract":"<p>This review systematically evaluates the published literature on multiple fibroadenomas (MFAs) of the breast, focusing on clinical presentation, diagnostic challenges, and treatment strategies. A systematic search of PubMed, Medline, Scopus, and Embase from 1948 to June 2025 was conducted using a Boolean search strategy following the PRISMA 2020 guidelines. Of the 409 studies initially screened, 43 met the inclusion criteria. The level of evidence was assessed using the Oxford Centre for Evidence-Based Medicine guidelines, and 72% were found to be of Levels 4 and 5. MFA most commonly affects adolescents. Bilateral involvement was observed in 64.6% of patients, and more than 10 lesions were present in 52% of cases. Risk factors included hormonal contraceptive use, family history, and cyclosporine therapy. Ultrasonography was the most common diagnostic tool, followed by MRI and FNAC. Treatment was mainly surgical, with recurrence noted in 15.4% of patients. There was no evidence to suggest that the risk of cancer in MFA was greater than that of solitary FA. The review highlights inconsistencies in MFA definitions and calls for consensus on diagnostic criteria, prospective research, and the creation of standardized treatment algorithms to improve care and outcomes for this particularly distressing subset of benign breast diseases.</p>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13042352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596447","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":"Lentinula edodes Cultured Extract Intake at Puberty Mitigates Inflammatory Signals at the Mammary Glands by the Involvement of Epigenetic Mechanisms in BALB/c Mice","authors":"Hamed Yasavoli-Sharahi,&nbsp;Roghayeh Shahbazi,&nbsp;Nawal Alsadi,&nbsp;Nasim Bondar Sahebi,&nbsp;Cyrille Cuenin,&nbsp;Vincent Cahais,&nbsp;Felicia Fei-Lei Chung,&nbsp;Zdenko Herceg,&nbsp;Chantal Matar","doi":"10.1155/tbj/2122220","DOIUrl":"10.1155/tbj/2122220","url":null,"abstract":"<p>Exposure to immune stress or lipopolysaccharide (LPS) during critical developmental stages like puberty may lead to gut microbiome dysbiosis and epigenetic dysregulation in mammary glands, affecting gene expression and potentially elevating breast cancer susceptibility in adulthood. Although LPS’s adverse impacts on intestinal and brain functions are well-documented, its effects on mammary glands remain underexplored. Using an immunocompetent BALB/c mouse model, we administered an acute LPS dose (1.5 mg/kg body weight) during puberty. The study evaluated the long-term consequences of LPS exposure alone and combined with AHCC (<i>Lentinula edodes</i> cultured extract, 2 g/kg body weight/day) on DNA methylation patterns, cytokine profiles, and microRNA expression in mammary glands at 9 weeks of age. Analyses included DNA methylation sequencing, multiplex immunoassays, quantitative PCR, and image processing. Pubertal LPS exposure produced persistent molecular dysregulation in mammary glands, including differential DNA methylation (&gt; 5% change vs. control; FDR-adjusted <i>p</i> &lt; 0.05), elevated inflammatory mediators, and altered microRNA expression. Differentially methylated regions were enriched in regulatory features, with decreased methylation at transcription start sites, promoters, and 5′ UTRs of genes implicated in mammary development and oncogenic signaling (including <i>Vav3, Pdgfa, Pdgfc, Jag2, Hras, Ksr1, Il2rb, Il17b,</i> and <i>Il17rb</i>) in the LPS group, whereas the AHCC + LPS group exhibited a shift toward hypermethylation at these loci (approximately 5%–10% decrease). Inflammatory profiling showed increased IL-17A/F (∼2-fold vs. control; <i>p</i> &lt; 0.05), while microRNA analyses indicated reduced let-7a/c (∼30% vs. control; <i>p</i> &lt; 0.05). Notably, miR-130a and miR-34a increased ∼1.5-fold across all treatment groups relative to control. Pubertal LPS exposure induces enduring epigenetic and inflammatory changes in mammary glands that may heighten breast cancer risk. AHCC’s mitigating role indicates potential for dietary interventions to counteract these effects.</p>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/tbj/2122220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596430","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":"A Five-Year Retrospective Analysis of Neoadjuvant Therapy in Early-Stage Breast Cancer: Subtype Outcomes and Imaging Concordance","authors":"Sohail Rooman Javed,&nbsp;Karen DeSouza,&nbsp;Ubaid Tanzim,&nbsp;Diego Ottaviani,&nbsp;Rebecca Roylance,&nbsp;Fharat Raja,&nbsp;Thomas Walsh,&nbsp;Prodromos Koutoukoglou,&nbsp;Chiara Creed,&nbsp;Ewan McFarlane,&nbsp;Sanjana Mathur,&nbsp;Arun Mahapatra,&nbsp;Elisavet Papadimitraki","doi":"10.1155/tbj/9197063","DOIUrl":"10.1155/tbj/9197063","url":null,"abstract":"<p>Although neoadjuvant systemic treatment (NST) is well established in the management of early breast cancer, there are limited clinical data available beyond the highly selected population evaluated in clinical trials. In this study, we assessed real-world outcomes of NST in early breast cancer through a retrospective review of 201 patients treated between November 2019 and February 2025. Pathological complete response (pCR) rates were highest in HER2-positive (60.2%) and triple-negative (53.1%) breast cancer subtypes and lowest in those who were identified as oestrogen receptor-positive (ER-positive)/HER2-negative (11.1%). In HER2-positive disease, pCRs were more frequent in ER-negative (75.8%) than ER-positive (50.0%) cases, while pCR rates in triple-negative breast cancer were similar with and without immunotherapy. Baseline positron emission tomography/computed tomography (PET/CT) upstaged 37% (35/94) of patients and showed 87% concordance with pathology, whereas magnetic resonance imaging (MRI) demonstrated a false-negative rate of 17% and a false-positive rate of 1.1%. In these cases, MRI results suggested residual disease despite a complete pathological response, with discrepancies varying by tumour subtype. Forty-two percent of the patients underwent chemotherapy dose reductions; 12% required hospitalisation. NST was effective across aggressive subtypes, with pCR rates comparable to those observed in clinical trials. In summary, our results highlighted the contributions of functional imaging with PET/CT and MRI to staging, treatment response assessments and surgical planning in real-world clinical practice.</p>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/tbj/9197063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583137","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":"“Going Flat” in Nipple-Sparing Mastectomy—An Analysis of Patient-Reported Outcome Measurements of Preliminary 57 Procedures","authors":"Jun Su,&nbsp;Yi-Yuan Lee,&nbsp;Wen-Bin Kao,&nbsp;Nurul Hidayah Abdul Rauf,&nbsp;Bing-Fang Hwang,&nbsp;Chiu-Ying Chen,&nbsp;Mee-Hoong See,&nbsp;Hung-Wen Lai","doi":"10.1155/tbj/5032690","DOIUrl":"10.1155/tbj/5032690","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) has become an increasingly popular procedure offering satisfactory aesthetic outcomes with adequate oncologic safety. However, outcomes of NSM without IBR have been rarely evaluated. We aim to assess the clinical outcomes of NSM in patients refusing IBR with a focus on patient-reported outcome measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study enrolled female breast cancer patients who underwent NSM but refused IBR from February 2010 to April 2022 in a single institution. Clinical outcomes and patient-reported aesthetic results were evaluated and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, there were 57 cases of primary breast cancer patients who underwent NSM but refused IBR. The mean operative duration was 186.6 min, and median length of hospital stay was 4 days. Median intraoperative blood loss was 30 mL with the median resected specimen weight at 360.5 g. There was no incidence of margin involvement in this study. The complication rate was 12.3% with all of them being minor complications with Clavien–Dindo I and II scores. Locoregional recurrence and distant metastasis during the study period were 5.3% and 1.8%, respectively, with a mean follow-up period of 64.4 months. There was no mortality during the study duration. Aesthetic outcomes assessed via the BREAST-Q questionnaire were satisfactory with mean scores ranging between 35.1 and 68.4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study concludes that NSM in patients refusing IBR is an alternative compared to conventional mastectomy with acceptable aesthetic outcomes. These findings underscore the importance of individualized patient choices in breast cancer treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/tbj/5032690","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535007","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":"The Effect of Breast Cancer and Breast Self-Examination Health Education on Awareness, Beliefs, and Practices of Female Students at the Faculty of Health Sciences of a University in Somalia","authors":"Şeyma Zehra Altunkurek,&nbsp;Eylül Yeşilyurt,&nbsp;Samira Hassan Mohamed","doi":"10.1155/tbj/8854280","DOIUrl":"10.1155/tbj/8854280","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Breast cancer is the most common malignancy among women globally, and early detection remains the cornerstone of reducing mortality. In low-resource settings such as Somalia, limited access to mammography and diagnostic services makes breast self-examination (BSE) an important awareness practice. This study aimed to assess the effect of an educational intervention based on the health belief model (HBM) on Somali female university students’ knowledge, beliefs, and practices related to breast cancer and BSE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized controlled study was conducted among 86 female undergraduate students enrolled at the Faculty of Health Sciences, University of Health Sciences, Mogadishu, Somalia, between September 2021 and June 2022. Participants were randomly assigned to an intervention group (<i>n</i> = 43) or a control group (<i>n</i> = 43) using the sealed opaque envelope method. Data were collected through a structured questionnaire including a sociodemographic form and the Champion’s Health Belief Model Scale (CHBMS). The intervention group attended a structured 90-min HBM-based breast health education session delivered by two public health lecturers, while the control group received no education during the study period. Three months after the intervention, posttest data were collected from both groups. Statistical analyses were performed using descriptive and inferential tests, with significance set at <i>p</i> &lt; 0.05 (two-tailed).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of participants was 20.3 ± 1.63 years. Postintervention, the intervention group showed significant improvements in knowledge of breast cancer and BSE (<i>p</i> &lt; 0.001), perceived benefits (<i>p</i> = 0.02), health motivation, and self-confidence in performing BSE (<i>p</i> &lt; 0.001). The frequency and correct practice of BSE also increased significantly after 3 months (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HBM-based breast health education improved students’ knowledge, awareness, and BSE practice. Although BSE is not a screening tool, it is an essential awareness method in settings with limited access to diagnostic services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/tbj/8854280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517110","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":"Treatment Outcomes of Lobular Granulomatous Mastitis: Impact of Hyperprolactinemia, Diabetes, and Erythema Nodosum—Insights From a 7-Year Cohort Study","authors":"Mina AkbariRad,&nbsp;Fereshte Sheybani,&nbsp;Abdollah Firoozi,&nbsp;Samaneh Sajjadi,&nbsp;Maryam Emadzadeh,&nbsp;Marzieh Kazerani,&nbsp;Sajad Ataei Azimi,&nbsp;Mahdieh Mottaghi","doi":"10.1155/tbj/2672157","DOIUrl":"10.1155/tbj/2672157","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study presents our observations on the management and follow-up of patients diagnosed with lobular granulomatous mastitis (LGM) in a cohort study. Additionally, characteristics associated with a longer disease course, as well as treatment challenges in patients with erythema nodosum, diabetes, and hyperprolactinemia, would be discussed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;From 2015 to 2021, a total of 246 consecutive LGM patients referred to the internal medicine clinic of Ghaem teaching hospital, Mashhad, Iran, were enrolled. Regular assessments were conducted every 3 months until complete symptom resolution. Treatment responses were categorized into five groups: complete resolution, incomplete resolution, resolution with subsequent relapse, no significant improvement, and treatment cessation, with all data meticulously recorded. Telephone follow-ups were conducted with all patients at the end of the study in December 2022.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 156 episodes were analyzed. Prednisone was administered to 136 patients, while oral methotrexate (MTX) was prescribed to 48 cases. The median age of the cohort was 33 years (interquartile range [IQR], 29–38). Of those on prednisone, 57 (41.9%) achieved complete resolution, with 15 (11%) experiencing subsequent relapse, 33 (24.3%) showing no significant improvement, and 31 (19.9%) discontinuing treatment. Among the MTX recipients, 23 (47.9%) achieved complete resolution, while one showed incomplete resolution. Over the median follow-up of five years (IQR, 4–6), 139 (89.1%) reported complete resolution, nine (5.8%) showed incomplete resolution, and 8 (5.1%) remained symptomatic. The median disease duration was 18 months (IQR, 7–36). Abscess formation during treatment correlated with prolonged disease duration (&lt;i&gt;p&lt;/i&gt; &lt; 0.04), and higher plasma prolactin levels were associated with extended disease duration (&lt;i&gt;p&lt;/i&gt; = 0.001). However, the disease course did not significantly differ in diabetic cases or those with erythema nodosum compared to others.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Although more than half of LGM patients experienced no significant improvement, recurrence, or discontinued treatment on prednisone or MTX, however, over a median follow-up of 5 years, approximately 90% of LGM patients achieved complete resolution within a median course of 18 months. The presence of abscesses during treatment and elevated plasma prolactin levels was linked to longer disease duration.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/tbj/2672157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505553","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":"Exploring the Application of Contrast-Enhanced Ultrasound in ACR BI-RADS 4A Lesions (≤ 2 cm): A Prospective Multicenter Study in China","authors":"Xiaoyun Xiao,&nbsp;Wei Zhang,&nbsp;Xiaomao Luo,&nbsp;Yulan Peng,&nbsp;Yanling Zheng,&nbsp;Qi Zhou,&nbsp;Qiao Hu,&nbsp;Ying Zhu,&nbsp;Heng Zhang,&nbsp;Yinghua Li,&nbsp;Qing Zhou,&nbsp;Wen He,&nbsp;Baoming Luo","doi":"10.1155/tbj/6622181","DOIUrl":"10.1155/tbj/6622181","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess the added diagnostic value of contrast-enhanced ultrasound (CEUS) in differentiating small breast lesions initially categorized as ACR BI-RADS 4A.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 1595 patients with small breast lesions (≤ 20 mm) from 37 tertiary hospitals were enrolled from August 2021 to August 2022. B-mode ultrasound, color Doppler, and CEUS were performed to evaluate the lesions. The integration of CEUS led to the reclassification of BI-RADS 4A lesions into three pathways: upgrade to 4B, downgrade to 3, or no change in category. The diagnostic performance of CEUS was evaluated, and the contrast modes which could be used to correctly downgrade or upgrade BI-RADS 4A lesions were explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1340 lesions were finally included in the analysis of CEUS performance. The average age of all included participants was 43 ± 8 (range from 20 to 84). The average diameter of the lesions was 12.4 ± 3.8 mm (range from 5 mm to 20 mm). The diagnostic performances of CEUS + BI-RADS were 98.3% for sensitivity, 81.7% for specificity, 34.1% for positive predictive value, 99.8% for negative predictive value, and 83.1% for overall accuracy, respectively. The sensitivity was slightly downgraded (98.3% vs. 100%, <i>p</i> = 0.1555), while the specificity and accuracy were greatly elevated (<i>p</i> &lt; 0.05). The receiver operating characteristic curve (ROC) value was calculated using a binary classification threshold, with BI-RADS 3 as low-risk and BI-RADS 4A as high-risk. The area under ROC was 0.896 (95% CI: 0.878, 0.911) for BI-RADS + CEUS. The decision curve analysis showed that using CEUS + BI-RADS to guide biopsy decisions provided net benefit compared to the default strategy of biopsying all lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The addition of CEUS allows for the correct downgrading of most benign BI-RADS 4A lesions, thereby avoiding unnecessary biopsies. An upgrade from BI-RADS 4A to 4B on CEUS warrants immediate biopsy to ensure prompt diagnosis and treatment.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Chinese Clinical Trial Registry: ChiCTR2100050719</p>\u0000 </section>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/tbj/6622181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445719","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":"Recurrence Rate Following Breast Conservation Surgery: A Retrospective Cohort Study","authors":"Liyang Wang,&nbsp;Yuchen Yuan,&nbsp;Urvashi Jain,&nbsp;Eleftheria Kleidi","doi":"10.1155/tbj/5063047","DOIUrl":"10.1155/tbj/5063047","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breast-conserving surgery (BCS) has become the standard treatment for early-stage breast cancer, offering oncological safety, better breast aesthetics, and enhanced health-related quality of life. The optimal margins for BCS have been debated. However, evidence on the impact of margin widths greater than 0 mm for invasive breast cancer remains limited. Cambridge Breast Unit (CBU) has adopted a policy where a single margin of &lt; 1 mm (not at ink) for invasive disease would be acceptable, provided the other three radial margins are ≥ 1 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Retrospective cohort study analyzed 372 women who underwent BCS for invasive breast cancer at CBU between 2015 and 2016. Patients with pure ductal carcinoma in situ (DCIS), prior breast cancer treatment, or neoadjuvant chemotherapy were excluded. Clinical data, including patient demographics, tumor characteristics, margin status, and recurrence and survival outcomes, were extracted from electronic records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At a median follow-up of 5.2 years, the ipsilateral breast tumor recurrence (IBTR) rate was 1.6% (6/372) with an overall recurrence rate of 5.6% (21/372). No significant association was found between final resection margins and local or overall recurrence rates, nor was margin status correlated with breast cancer recurrence-free survival. A total of 53 patients (14.2%) required additional surgeries due to margin status. By accepting a single radial margin &lt; 1 mm, our margin policy reduced reoperations by 33%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Margin assessment in breast surgery is multifaceted, requiring a personalized approach that considers tumor biology, systemic treatments, and pathological variability. Our findings support accepting a margin width of &lt; 1 mm (no tumor on ink) for a single radial margin in invasive breast cancer, provided the other three radial margins are ≥ 1 mm. It reduces reoperations without compromising oncological outcomes. Integrating advanced intraoperative techniques and multidisciplinary decision-making will further optimize patient care and long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/tbj/5063047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445680","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":"Understanding Disparities in Breast Reconstruction Rates in Regional Populations Following Oncologic Resection of Breast Cancer: A 10-Year Retrospective Observational Cohort Study.","authors":"Samuel M Jansson, Calyb J Austin, Mingchun Liu, Steven J Craig","doi":"10.1155/tbj/1281318","DOIUrl":"10.1155/tbj/1281318","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is the most common cancer among women globally, with 2.3 million new cases in 2020. Globally, incidence rates of breast cancer are highest in Australia, yet only 29% of Australian women opt for breast reconstruction (BR). The decision-making process for BR is complex, involving various surgical and nonsurgical considerations. Approximately 50% of women would choose BR if adequately informed and given the option. This study evaluates the factors contributing to reduced BR rates in regional and rural New South Wales over a 10-year period.</p><p><strong>Methods: </strong>A multicentre, retrospective observational cohort study analysed 2052 women who were diagnosed with breast cancer in the Illawarra Shoalhaven Local Health District between 2012 and 2022, focussing on primary resection outcomes and other objective factors that contributed to BR rates. Descriptive statistics, chi-squared tests and logistic regression were used to assess relationships between age, comorbidities, language and rurality, with reconstruction rates.</p><p><strong>Results: </strong>Among the 2052 women diagnosed with breast cancer who required oncologic resection, the mean age was 65 years. Only 127 (6.2%) underwent BR across the total cohort of 2052 patients, and just 65 of the 724 (9%) patients in the post-mastectomy subgroup underwent BR, significantly lower than state averages. Significant relationships were found between age and reconstruction rates (<i>p</i> < 0.001), with younger patients (< 55 years old) more likely to opt for BR. Logistic regression confirmed that increased age and rurality both significantly affected the likelihood of undergoing reconstruction.</p><p><strong>Conclusion: </strong>Women aged < 55 years old and those residing in metropolitan areas showed a higher likelihood of opting for BR, highlighting the influence of age and rural residency on access to reconstruction services. These findings emphasise the need for targeted interventions to enhance BR access, particularly for older and rural patients.</p>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2026 ","pages":"1281318"},"PeriodicalIF":2.4,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437991","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}