Breast最新文献

{"title":"Awareness of genomic testing among patients with breast cancer in Europe","authors":"Antonella Cardone ,&nbsp;Dany Bell ,&nbsp;Conchi Biurrun ,&nbsp;Francesco Cognetti ,&nbsp;Fatima Cardoso ,&nbsp;Ana Ramirez Piris ,&nbsp;Csaba Degi ,&nbsp;Michael Patrick Lux ,&nbsp;Richard Simcock ,&nbsp;Johanna Wassermann ,&nbsp;Rosanna D'Antona ,&nbsp;Isabel T. Rubio","doi":"10.1016/j.breast.2025.104436","DOIUrl":"10.1016/j.breast.2025.104436","url":null,"abstract":"<div><h3>Purpose</h3><div>Genomic testing, involving expression profiling of tumour tissue, is a powerful tool for determining appropriate treatments for certain cancer patients. This study aimed to evaluate awareness of genomic testing in breast cancer patients in five European countries.</div></div><div><h3>Methods</h3><div>The survey was initiated by Cancer Patients Europe and developed with patient associations, oncologists, and a psycho-oncologist. Participants were recruited via email and social media and completed a 42-question internet survey.</div></div><div><h3>Results</h3><div>Of 1383 participants in eligible countries completing the survey, 566 women with current or previous HR+/HER2- breast cancer, potentially eligible for genomic testing, were analysed. 245 (43.3 %) were aged 50–59 years and 381 (67.3 %) had received higher education. 238 participants (42.1 %) had heard about genomic testing; 122 (21.6 %) were informed of their eligibility for testing, and 104 (18.4 %) were given reasons for the test. The majority (N = 479; 84.6 %) felt they lacked sufficient information to decide, and only 139 (24.6 %) opted for testing. Overall, 246 (43.5 %) wanted more information on additional testing and 234 (41.3 %) wanted more information on treatment options. The main information sources were medical professionals (N = 363; 64.1 %) and the internet (N = 351; 62.0 %). However, 398 participants (70.3 %) indicated that their healthcare professionals did not advise them on where to find more information.</div></div><div><h3>Conclusions</h3><div>This study highlights insufficient awareness of, and access to, genomic testing in breast cancer. Healthcare professionals need to improve communication with patients regarding genomic testing and involve them in shared decision-making. Likewise, patient associations have a role in providing clear information to patients.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104436"},"PeriodicalIF":5.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between decision regret, quality of life, and mindfulness in early-stage breast cancer survivors","authors":"Yu-Ling Kao ,&nbsp;Ming-Shen Dai ,&nbsp;Wan-Chen Tsai ,&nbsp;Fei-Hsiu Hsiao","doi":"10.1016/j.breast.2025.104435","DOIUrl":"10.1016/j.breast.2025.104435","url":null,"abstract":"<div><h3>Purpose</h3><div>The shared decision-making empowers breast cancer patients’ autonomy in joining treatment decision. However, unexpected side effects or unsatisfactory outcomes can lead to decision regret. This study examines decision regret levels and its relationship with quality of life, and the impact of mindfulness awareness and self-compassion on this relationship among early-stage breast cancer patients in post-treatment survivorship.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted from March 2021 to March 2022. The early-stage breast cancer patients who completed treatments within the past 36 months were recruited from a medical center and a regional hospital. Participants completed the Decision Regret Scale, Mindful Awareness Attention Scale, Self-Compassion Scale, and the EORTC QLQ-C30 and QLQ-BR45.</div></div><div><h3>Results</h3><div>Among the 138 participants, 17.39 % reported no regret, 55.80 % expressed mild regret, and 26.81 % reported moderate to strong regret. Decision regret differed significantly based on the congruence between patients’ preferred and actual decision-making roles. Multiple regression analysis showed that, after controlling for covariates, lower decision regret levels were associated with higher EORTC QLQ-C30 and QLQ-BR45 function scores. Mindfulness awareness significantly mediated the relationship between decision regret and QOL, while self-compassion was not identified as a mediator.</div></div><div><h3>Conclusion</h3><div>Most breast cancer survivors experienced mild or moderate decision regret. Decision regret influences survivors’ general and breast specific functions. Mindfulness awareness could reduce the impact of decision regret on QOL. The mindfulness-based interventions could cultivate breast cancer patients living at the present moment experiences to reduce their negative rumination about the past treatment decision and enhance their QOL.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104435"},"PeriodicalIF":5.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A composite 18F-FDG PET/CT and HER2 tissue-based biomarker to predict response to neoadjuvant pertuzumab and trastuzumab in HER2-positive breast cancer (TBCRC026)","authors":"Maeve A. Hennessy ,&nbsp;Ashley Cimino-Mathews ,&nbsp;Jodi M. Carter ,&nbsp;Jennifer M. Kachergus ,&nbsp;Yaohua Ma ,&nbsp;Jeffrey P. Leal ,&nbsp;Lilja B. Solnes ,&nbsp;Vandana G. Abramson ,&nbsp;Lisa A. Carey ,&nbsp;Mothaffar Rimawi ,&nbsp;Jennifer Specht ,&nbsp;Anna Maria Storniolo ,&nbsp;Christos Vaklavas ,&nbsp;Ian Krop ,&nbsp;Eric Winer ,&nbsp;Rita Denbow ,&nbsp;Vincente Valero ,&nbsp;Antonio C. Wolff ,&nbsp;Richard L. Wahl ,&nbsp;Chiung-Yu Huang ,&nbsp;Roisin M. Connolly","doi":"10.1016/j.breast.2025.104432","DOIUrl":"10.1016/j.breast.2025.104432","url":null,"abstract":"<div><h3>Background</h3><div>Early metabolic change on PET/CT was predictive of response to neoadjuvant trastuzumab/pertuzumab (HP) in TBCRC026. We hypothesized that a composite biomarker incorporating PET/CT and HER2 tissue-based biomarkers could improve biomarker performance.</div></div><div><h3>Methods</h3><div>83 patients with estrogen receptor-negative/HER2-positive breast cancer received neoadjuvant HP alone [pathologic complete response (pCR) 22 %]. PET/CT was performed at baseline and 15 days post initiation of therapy (C1D15). Promising imaging biomarkers included ≥40 % SULmax decline between baseline and C1D15, and C1D15 SULmax ≤3. Baseline tissue-based biomarkers included HER2-enriched intrinsic subtype (72 %, 46/64; NanoString), tumor HER2 protein abundance (median log2 13.5, range log2 7.1–15.9; NanoString DSP), and HER2 3+ (83 %, 64/77; immunohistochemistry). Logistic regressions were fitted to predict pCR with HER2/PET-CT biomarkers. The C statistic assessed overall prediction power. The optimal composite score cut-off was determined by maximizing Youden's index.</div></div><div><h3>Results</h3><div>Factors most predictive for pCR in single predictor models included C1D15 SULmax (OR 0.43; p = 0.007, c = 0.77), % reduction in SULmax (OR 1.03, p = 0.006, c = 0.72) and tumor HER2 protein abundance (OR 1.75; p = 0.01, c = 0.76). The composite of C1D15 SULmax and % reduction in SULmax and their interaction term, had improved probability (c = 0.89 from c = 0.78), with high sensitivity (100 %) and negative predictive value (100 %). The addition of tumor HER2 protein did not further improve prediction power (c = 0.90).</div></div><div><h3>Conclusion</h3><div>The HER2/PET-CT biomarker had high prediction power for pCR, however was not superior to the prediction power of PET/CT alone. Non-invasive PET/CT biomarkers may facilitate a response-guided approach to neoadjuvant therapy, allowing intensification and de-intensification of treatment, pending further evaluation.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104432"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovations in the localization techniques for non-palpable breast lesions: Make invisible visible","authors":"Quankun Lin ,&nbsp;Qiwen Hou ,&nbsp;Chenyu Zhang ,&nbsp;Wei Zhai ,&nbsp;Feng Cheng ,&nbsp;Sen Lu ,&nbsp;Xuan Yang ,&nbsp;Aiping Dong ,&nbsp;Baosan Han","doi":"10.1016/j.breast.2025.104430","DOIUrl":"10.1016/j.breast.2025.104430","url":null,"abstract":"<div><div>Non-palpable breast cancer lesions pose a challenge for surgeons to resect cancer lesions. Making ‘invisible’ lesions ‘visible’ is the main strategy. Currently, multiple preoperative localization techniques have been applied in clinical. Among them, wire-guided localization (WGL) is the most common procedure due to its convenience and low cost. However, its limitations including discomfort, wire migration and the coupling of localization and operation procedures cause troubles for surgeons and patients. The desire for localization methods improvement, accompanied by the advance of emerging science and technology, leads to the development of a series of locating approaches for breast non-palpable lesions, aiming to improve locating accuracy while reducing adverse events. These emerging methods have undergone improvements from steel wire to functional particles, from radioactivity to non-radioactive, which help doctors and patients choose a more appropriate scheme. This review outlines the principles, procedures, advantages and disadvantages of these locating methods, and highlights the latest progress and related clinical data on innovative locating approaches. Finally, we briefly discuss the current challenges and future opportunities for the clinical application of these localization approaches.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104430"},"PeriodicalIF":5.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibody-drug conjugates in elderly patients with breast cancer","authors":"Marta Bonotto ,&nbsp;Giulia De Pieri ,&nbsp;Rocco Esposto ,&nbsp;Ludovica Lay ,&nbsp;Giuseppe Aprile ,&nbsp;Fabio Puglisi ,&nbsp;Alessandro Marco Minisini","doi":"10.1016/j.breast.2025.104428","DOIUrl":"10.1016/j.breast.2025.104428","url":null,"abstract":"<div><div>Breast cancer remains a leading cause of cancer-related mortality worldwide, with elderly patients (aged &gt;65 years) comprising a substantial portion of those affected. The treatment of breast cancer in this population is often complicated by frailty, comorbidities and polypharmacy. This review explores the application of antibody-drug conjugates (ADCs), such as trastuzumab emtansine (T-DM1), trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan (SG), in treating breast cancer among elderly populations. The underrepresentation of older patients in clinical trials complicates efficacy and safety assessments in this group. Current evidence indicates that ADCs are both effective and tolerable in elderly patients, demonstrating improved progression-free survival (PFS) and overall survival (OS) alongside a manageable safety profile. Data from several trials like the EMILIA, TH3RESA and DestinyBreast studies demonstrate that T-DM1 and T-DXd maintained benefit in PFS and OS for HER2-positive breast cancer in older patients, despite a slight increase in adverse events. The ASCENT and TROPiCS-02 trials further confirm that SG provides significant improvements in PFS and OS in elderly patients at the cost of an increase in some toxicity. Emerging ADCs, including datopotamab deruxtecan and ARX-788, show promise but lack extensive geriatric-specific data. While the ADCs offer encouraging results in terms of efficacy and safety, with appropriate dose adjustments, further research is needed to optimize their use in elderly patients with breast cancer.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104428"},"PeriodicalIF":5.7,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the CTS5 in four prospective, multicenter, randomized ABCSG trials","authors":"Kerstin Wimmer ,&nbsp;Dominik Hlauschek ,&nbsp;Marija Balic ,&nbsp;Georg Pfeiler ,&nbsp;Richard Greil ,&nbsp;Christian F. Singer ,&nbsp;Stefan Halper ,&nbsp;Günther Steger ,&nbsp;Christoph Suppan ,&nbsp;Simon Peter Gampenrieder ,&nbsp;Ruth Helfgott ,&nbsp;Daniel Egle ,&nbsp;Martin Filipits ,&nbsp;Raimund Jakesz ,&nbsp;Lidija Sölkner ,&nbsp;Christian Fesl ,&nbsp;Michael Gnant ,&nbsp;Florian Fitzal ,&nbsp;Austrian Breast & Colorectal Cancer Study Group","doi":"10.1016/j.breast.2025.104415","DOIUrl":"10.1016/j.breast.2025.104415","url":null,"abstract":"<div><h3>Background</h3><div>The Clinical Treatment Score post-5 years (CTS5) is a clinicopathological tool designed to estimate late distant recurrence (LDR) in hormone receptor-positive (HR+) breast cancer patients after 5 years of adjuvant endocrine therapy (ET). While intended as a prognostic algorithm, its predictive value for ET extension remains uncertain.</div></div><div><h3>Methods</h3><div>The score was calculated in 4931 patients from four prospective randomized ABCSG trials (ABCSG-6, -6a, -8, and -16) with 250 LDR events. We assessed its prognostic power, calibration accuracy, and predictive value. Time to LDR was analyzed using Cox regression models.</div></div><div><h3>Results</h3><div>In our cohorts, the CTS5 provided prognostic information whether used as a continuous or categorical score. In the ABCSG-8 cohort (n = 2054) and the combined ABCSG-6+8 cohort (n = 3308), a higher continuous score was significantly associated with increased LDR risk. The categorical CTS5 showed that high-risk patients had significantly higher LDR rates compared to low- or intermediate-risk patients. The score slightly overestimated LDR risk, regardless of predicted risk. Although no significant predictive value was found on the relative scale, an absolute LDR risk reduction of 23.4 % was found in patients with a high CTS5 of 5 when extended ET was administered additional five than two years. In patients with a CTS5 of 2, no benefit was found when ET was extended to 10 instead of 7 years.</div></div><div><h3>Conclusion</h3><div>The CTS5 is a valid tool for LDR risk stratification in HR + breast cancer, but should be used cautiously for determining benefits from ET extension, as no significant predictive value was found.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104415"},"PeriodicalIF":5.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic delay in women with cancer: What do we know and which factors contribute?","authors":"Liza A. Hoveling ,&nbsp;Melinda Schuurman ,&nbsp;Sabine Siesling ,&nbsp;Kristel M. van Asselt ,&nbsp;Christina Bode","doi":"10.1016/j.breast.2025.104427","DOIUrl":"10.1016/j.breast.2025.104427","url":null,"abstract":"<div><div>Timely cancer diagnosis is important, but delays are common, also among women. This study reviews recent literature on diagnostic delays in women with breast cancer, focusing on individual-level factors and their interaction with micro, meso, exo, and macrosystem factors. Following PRISMA-ScR guidelines, we conducted a scoping review on diagnostic delays in cancer among women, including qualitative and quantitative studies with oncological patients or healthcare professionals. We searched PubMed/MEDLINE and Scopus for publications from 2018 to November 28, 2023, excluding studies not meeting the inclusion criteria, not in English or Dutch, or focused solely on cancer screening. Titles and full texts were screened, with disagreements resolved through discussion. Two reviewers independently extracted study details, population characteristics, study design, and factors contributing to diagnostic delays. Initially, 9699 records were retrieved, resulting in 129 relevant studies after exclusions. We focused on women's health and breast cancer, narrowing our scope to 22 studies in high-income countries. Studies explored diagnostic delays and factors at various levels: microsystem (demographics, health behaviours, psychology, healthcare interactions), mesosystem (schedules, peer and support networks), exosystem (social, cultural, environmental, accessibility factors), and macrosystem (broader cultural, societal contexts, healthcare policies). In high-income countries, diagnostic delays in breast cancer care involve factors across various systems, affecting individuals, peers, healthcare, and policies. Enhancing awareness, communication, and access is important, requiring targeted campaigns and infrastructure upgrades. The Bronfenbrenner's ecological model effectively addresses the multifaceted factors influencing diagnostic delays. Future research can benefit from applying this model to various cancers and income settings.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104427"},"PeriodicalIF":5.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate breast reconstruction on overall and breast cancer-specific survival: A propensity score matched analysis","authors":"Qianrui Xu ,&nbsp;Yuntian Wan ,&nbsp;Zhangyue Sun ,&nbsp;Xiaolu Tan ,&nbsp;Xiangyun Zong","doi":"10.1016/j.breast.2025.104422","DOIUrl":"10.1016/j.breast.2025.104422","url":null,"abstract":"<div><h3>Background</h3><div>The trend towards breast reconstruction post-mastectomy has increased, aiming to enhance patient outcomes and quality of life. This study examines the impact of immediate breast reconstruction (IBR) on survival outcomes compared to mastectomy alone (MA).</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective cohort study of breast cancer patients aged 20–79 years with MA or IBR from 2010 to 2015. Propensity score matching (PSM) was utilized to balance the cohorts. Survival analysis assessed overall survival (OS) and breast cancer specific survival (BCSS), with subgroup analysis was performed.</div></div><div><h3>Results</h3><div>The median follow-up period was 93 months. After PSM, 16,220 female patients were matched. IBR was associated with improved OS (HR = 0.74, 95 % CI 0.69–0.79, p &lt; 0.001) and BCSS (HR = 0.84, 95 % CI 0.78–0.91, p &lt; 0.001). Patients who needed radiotherapy tended not to receive IBR. IBR achieved a survival advantage in OS across the subgroups including age, marital status, histology grade, T stage, N stage, chemotherapy status, and radiotherapy status. In patients aged 60−79 years, with Black ethnicity, with local median household income &lt;$50,000, IBR's survival advantage is in OS but not BCSS and IBR was not inclined to be chosen among these groups.</div></div><div><h3>Conclusion</h3><div>IBR's OS advantage over MA is universal in all stratified age groups, marital statuses, histology grades, T/N stages, and chemo/radiotherapy statuses. For patients aged 60−79 years, with Black ethnicity, with a local median household income &lt;$50,000 and requiring radiotherapy, IBR is survival-beneficial but these groups tend not to receive it.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104422"},"PeriodicalIF":5.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility preservation in young breast cancer patients: A nationwide survey on knowledge, attitudes, and practices among breast surgical healthcare providers in China","authors":"Xiaoling Yuan ,&nbsp;Jingdan Li ,&nbsp;Nan Zhang ,&nbsp;Jiayi Peng ,&nbsp;Xiaoran Yang ,&nbsp;Wen Li","doi":"10.1016/j.breast.2025.104426","DOIUrl":"10.1016/j.breast.2025.104426","url":null,"abstract":"<div><h3>Purpose</h3><div>Fertility preservation (FP) is a critical concern for young breast cancer (YBC) patients receiving gonadotoxic treatments. Breast surgical healthcare providers (HCPs) play a pivotal role in discussing FP options and facilitating timely referrals. This study aimed to assess the knowledge, attitudes, and practices of breast surgical HCPs in China regarding FP, identify barriers to FP discussions, and examine factors influencing referral practices.</div></div><div><h3>Methods</h3><div>A nationwide cross-sectional survey was conducted from March to June 2023 among board-certified breast surgeons and nurses across China using a 24-item questionnaire. Participants were recruited via WeChat through BestOnco, a professional platform for oncology HCPs. The survey assessed FP knowledge, attitudes, clinical practices, and perceived barriers. Multivariate logistic regression was performed to determine factors associated with FP referral practices.</div></div><div><h3>Results</h3><div>A total of 355 valid responses were analyzed. The mean FP knowledge score was 6.05 ± 1.94 (range 0–10), with 49.3 % of HCPs never consulting FP guidelines. While 82.8 % expressed a favorable attitude toward FP, only 42.3 % routinely discussed FP options, and 44.7 % referred patients to reproductive specialists. Major barriers included poor prognosis concerns (87.0 %), treatment urgency (67.9 %), and financial burden (60.0 %). Multivariate analysis revealed that higher FP knowledge (OR = 1.23, p &lt; 0.0001), longer clinical experience (OR = 2.93, p = 0.001), and hospital-based FP integration (OR = 1.83, p &lt; 0.0001) were significant predictors of referral.</div></div><div><h3>Conclusions</h3><div>Notable gaps were identified in FP knowledge, discussions, and referrals among breast surgical HCPs in China. Targeted FP training programs, culturally informed shared decision-making strategies, and oncofertility navigation systems are recommended to enhance FP service delivery and improve patient outcomes.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104426"},"PeriodicalIF":5.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis","authors":"Eva L. Claassens ,&nbsp;Roxanne A.W. Ploumen ,&nbsp;Loes F.S. Kooreman ,&nbsp;Maartje A.C.E. van Kats ,&nbsp;Sabine Siesling ,&nbsp;Thiemo J.A. van Nijnatten ,&nbsp;Marjolein L. Smidt","doi":"10.1016/j.breast.2025.104425","DOIUrl":"10.1016/j.breast.2025.104425","url":null,"abstract":"<div><h3>Purpose</h3><div>Recent studies show that ductal carcinoma in situ (DCIS) accompanying HER2+ breast cancer can be completely eradicated following neoadjuvant systemic therapy in up to 52 %. We aimed to determine the complete response rate of DCIS in triple-negative breast cancer (TNBC) patients in a nationwide cohort and to assess clinicopathological variables associated with response. Furthermore, the impact on surgical treatment after neoadjuvant chemotherapy (NACT) was investigated.</div></div><div><h3>Methods</h3><div>Women diagnosed with TNBC, treated with NACT followed by surgery, between 2010 and 2020, were selected from the Netherlands Cancer Registry (NCR). Pre-NACT and postoperative pathology reports were obtained from Palga, the Dutch nationwide pathology databank, to determine presence of DCIS. Clinicopathological factors associated with DCIS response were investigated using uni- and multivariable logistic regression analysis.</div></div><div><h3>Results</h3><div>In total, 4494 patients were included. A DCIS component was present in the pre-NACT biopsy of 442 (9.8 %) patients. Pathologic complete response of the DCIS component was achieved in 53.6 % of these patients. The presence of calcifications in the pre-NACT biopsy was associated with a lower chance of DCIS response in univariable logistic regression analysis (OR 0.52, CI 95 % 0.27–0.98, p = 0.04). In multivariable analysis, no statistically significant associations were found between DCIS response and clinicopathological variables. Mastectomy rates were higher in case of IBC + DCIS compared to IBC (53.4 % vs 40.1 %, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Pathologic complete response of DCIS to NACT occurred in 53.6 % of TNBC patients. Future studies are required to be able to predict DCIS response based on clinicopathological variables and imaging.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104425"},"PeriodicalIF":5.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}