Breast最新文献

{"title":"Development and validation of a 10-gene signature for predicting recurrence risk in HR+/HER2- early breast cancer undergoing chemo-endocrine therapy","authors":"Xiaoyan Wu ,&nbsp;Xunxi Lu ,&nbsp;Wenchuan Zhang ,&nbsp;Xiaorong Zhong ,&nbsp;Hong Bu ,&nbsp;Zhang Zhang","doi":"10.1016/j.breast.2025.104484","DOIUrl":"10.1016/j.breast.2025.104484","url":null,"abstract":"<div><h3>Background</h3><div>While existing multi-gene assays aid adjuvant treatment decisions, no gene signature has identified HR+/HER2- early breast cancer (EBC) patients at high recurrence risk post-chemo-endocrine therapy (C-ET).</div></div><div><h3>Methods</h3><div>Clinical data and RNA sequencing information from 1457 HR+/HER2- breast cancer patients were collected from West China Hospital, the GEO database, and the TCGA database. Using univariate Cox regression, gene set enrichment analysis, and LASSO regression, ten key genes associated with recurrence were identified. A comprehensive prognostic model was developed by combining the 10-gene risk score with clinicopathological features, and a nomogram was created to predict 3-, 5-, and 7-year recurrence-free survival (RFS). The model's performance was evaluated using AUC and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>The 10-gene risk score was significantly associated with recurrence risk of HR+/HER2- EBC after C-ET and effectively distinguished between high-risk and low-risk patients (training: HR: 6.37, <em>P</em> &lt; 0.001; validation: HR: 4.51, <em>P</em> &lt; 0.001). It maintained consistent stratification efficacy across different treatment regimens, clinical stages, and grades. Compared to existing multi-gene signatures (21-gene, 70-gene, EndoPredict, PAM50, GGI), HR+/HER2- EBC patients identified as high-risk by the 10-gene risk score exhibited a higher 10-year cumulative recurrence rate following C-ET. In multivariate Cox regression analysis, the 10-gene risk score remained an independent prognostic factor in both the training and validation sets. The comprehensive model, integrating the 10-gene score and clinicopathological features, showed high predictive accuracy (AUC: 0.734, 0.778, 0.792 for 3, 5, 7 years in training; 0.691, 0.715, 0.709 in validation).</div></div><div><h3>Conclusion</h3><div>The 10-gene risk score can serve as a tool to predict recurrence risk in HR+/HER2- EBC patients following C-ET, assisting clinicians in developing personalized treatment plans for high-risk patients and ultimately improving patient prognosis.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104484"},"PeriodicalIF":5.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Options for postoperative radiation therapy in patients with de novo metastatic breast cancer","authors":"Chaofan Li ,&nbsp;Yusheng Wang ,&nbsp;Biyun Fang ,&nbsp;Mengjie Liu ,&nbsp;Shiyu Sun ,&nbsp;Jingkun Qu ,&nbsp;Shuqun Zhang ,&nbsp;Chong Du","doi":"10.1016/j.breast.2025.104483","DOIUrl":"10.1016/j.breast.2025.104483","url":null,"abstract":"<div><h3>Background</h3><div>Although meta-analyses have demonstrated survival benefits associated with primary tumor resection in MBC, guidelines lack consensus on the survival benefit of postoperative radiation therapy (RT).</div></div><div><h3>Methods</h3><div>In this study, we included 1392 patients with de novo metastatic breast cancer (dnMBC) by integrating data from the SEER database (2010–2019) to systematically assess the efficacy of postoperative RT and develop a machine learning-driven prognostic tool. The primary endpoint was overall survival (OS).</div></div><div><h3>Results</h3><div>Propensity score matching (PSM) results showed that postoperative RT significantly improved OS (HR = 0.573, 95 % CI = 0.475–0.693), but this survival gain showed great heterogeneity among different subgroups. It is found that patients with HR-/HER2-or HR+/HER2-subtypes gained significant OS benefit from (p &lt; 0.001) postoperative RT, whereas patients with HER2+ subtype did not gain any survival benefit since the effect of targeted therapy overshadowed the postoperative RT. Further risk stratification by the random survival forest (RSF) model revealed that high-risk patients with T4/N3 stage, high tumor grade and poor response to chemotherapy had significantly prolonged OS after receiving RT (p &lt; 0.001), while low-risk patients showed no additional benefit. The model had excellent predictive efficacy (training set C-index = 0.741, validation set C-index = 0.720) with key predictors including HER2 status, chemotherapy response and tumor grade. The research team developed an interactive web application (<span><span>https://lee2287171854.shinyapps.io/RSFshiny/</span><svg><path></path></svg></span>) based on this model, which can generate individualized survival risk scores in real-time to guide clinical decision-making.</div></div><div><h3>Conclusion</h3><div>This study is the first to propose a risk stratification strategy for postoperative RT in dnMBC, and innovatively integrates machine learning and clinical tools to provide a new paradigm for optimizing precision therapy.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104483"},"PeriodicalIF":5.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current pattern of care in radiation therapy for DCIS in Australia and New Zealand - where are we heading?","authors":"Adam Ofri ,&nbsp;Sze Ki Melanie Tam ,&nbsp;Suki Gill ,&nbsp;Andrew J. Spillane","doi":"10.1016/j.breast.2025.104482","DOIUrl":"10.1016/j.breast.2025.104482","url":null,"abstract":"<div><h3>Background</h3><div>Ductal carcinoma in-situ (DCIS) is a non-obligate precursor breast lesion with variable tendency to become invasive malignancy. Multiple studies have attempted to identify patient groups that could avoid radiation therapy (RT). We investigated the recent surgical management of DCIS in Australia and New Zealand (ANZ) and evaluated the likely rates of RT delivery dependent on differing low risk predictive criteria compared to actual practice.</div></div><div><h3>Method</h3><div>The BreastSurgANZ Quality Audit identified patients with DCIS from 2018 to 2022. Data were analysed on multiple DCIS characteristics as well as postoperative RT recommendations. Existing potential RT avoidance characteristics, low risk classification criteria (LRCC) and RTOG 9804, were tested against the cohort.</div></div><div><h3>Results</h3><div>7790 cases were analysed with 5323 (68.33 %) undergoing breast conservation surgery (BCS). There was higher median age, lower tumour grade and smaller size in the BCS group compared to mastectomy (p &lt; 0.001). According to the BQA, 25.38 % of patients had RT omitted. Using LRCC, 1659 patients (31.17 %) could omit RT but only 760 (45.81 %) of those patients did. When using RTOG 9804 criterion, 1287 patients (24.18 %) could omit RT but only 447 (34.73 %) did. Of 3477 patients with neither low risk classifying characteristics, 553 (15.9 %) had no RT.</div></div><div><h3>Conclusion</h3><div>BCS is the preferred surgical management of DCIS in ANZ. Currently RT is omitted following BCS in 25 % of cases. Using LRCC and RTOG 9804 low risk classifiers there was inconsistent avoidance of RT, whereas RT was avoided in 15.9 % of higher risk patients. More consistent and transparent selection methods are desirable and currently genomic testing and clinico-molecular tools appears promising.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104482"},"PeriodicalIF":5.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Microsurgical breast reconstruction - A salvage option for failed implant-based breast reconstruction”","authors":"Amir Khosrow Bigdeli ,&nbsp;Jia Wei Tee ,&nbsp;Felix Hubertus Vollbach ,&nbsp;Yannick Fabian Diehm ,&nbsp;Florian Falkner ,&nbsp;Felix Strübing ,&nbsp;Maximilian Mahrhofer ,&nbsp;Emre Gazyakan ,&nbsp;Ulrich Kneser ,&nbsp;Laura Cosima Siegwart","doi":"10.1016/j.breast.2025.104480","DOIUrl":"10.1016/j.breast.2025.104480","url":null,"abstract":"<div><h3>Background</h3><div>The objective of this study was to evaluate microsurgical breast reconstruction as a salvage option for patients with failed implant-based breast reconstruction.</div></div><div><h3>Methods</h3><div>We conducted a retrospective single-center study including all patients with failed unilateral implant-based breast reconstruction who elected to undergo conversion surgery to microsurgical breast reconstruction from January 2015 to December 2023. Patients were grouped according to the urgency for conversion surgery in the urgent (implant infection or extrusion) or elective (capsular contracture, patients’ desire) group. Both groups were compared.</div></div><div><h3>Results</h3><div>120 patients were included in the study. 101 patients (84 %) were grouped in the elective group and 19 patients (16 %) in the urgent group. Patient characteristics and intraoperative variables including the utilization of DIEP/MS-TRAM and TMG flap for microsurgical reconstruction were similar in group comparison. Patients in the urgent group had significantly more surgical interventions (3.3 vs. 2.0, p &lt; 0.001) and suffered from significantly more major complications requiring re-operation (32 % vs. 11 %, p = 0.018) compared to the elective group. There was one flap loss in the urgent group (5 % vs. 0 %, p = 0.158).</div></div><div><h3>Conclusion</h3><div>Microsurgical breast reconstruction is a reliable and safe salvage option in patients with failure of implant-based breast reconstruction. Urgent conversion to microsurgical breast reconstruction due to implant-associated complications, such as infection or extrusion, requires more surgical interventions to achieve successful breast reconstruction and has a higher rate of major complications compared to elective conversion.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104480"},"PeriodicalIF":5.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of adjuvant capecitabine in triple-negative breast cancer with residual disease after neoadjuvant therapy: a real-world study","authors":"Youzhao Ma ,&nbsp;Mingda Zhu ,&nbsp;Jingyang Zhang ,&nbsp;Dechuang Jiao ,&nbsp;Yangyang Hou ,&nbsp;Xiuchun Chen ,&nbsp;Zhenzhen Liu","doi":"10.1016/j.breast.2025.104477","DOIUrl":"10.1016/j.breast.2025.104477","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the beneficiaries of capecitabine in patients with triple-negative breast cancer (TNBC) who failed to achieve pathological complete response (pCR) by analyzing the efficacy of the drug in different HER2 statuses and TNM stages.</div></div><div><h3>Methods</h3><div>The Kaplan–Meier survival curve was plotted to estimate the effect of capecitabine therapy on disease-free survival (DFS) and overall survival (OS). Furthermore, the Cox proportional hazards model was used to analyze the factors that influence DFS and OS.</div></div><div><h3>Results</h3><div>A total of 296 patients with TNBC who had non-pCR after undergoing neoadjuvant therapy (NAT) were included in this study. There were 152 patients (51.4 %) in the capecitabine group and 144 patients (48.6 %) in the no-capecitabine group. The 3-year DFS and OS rates of the capecitabine group were better than those of the no-capecitabine group (DFS 80.0 % vs. 68.0 % p = 0.012, OS 95.9 % vs. 86.9 % p = 0.011). In addition, the capecitabine group exhibited significantly better DFS and OS than the no-capecitabine group in the HER2-low (DFS p = 0.004, OS p = 0.009) and stage III (DFS p = 0.004, OS p = 0.008) populations but not in the HER2-0 or stage II population.</div></div><div><h3>Conclusion</h3><div>Adjuvant capecitabine therapy significantly improved the prognosis of patients with TNBC who had residual disease after NAT, and the improvements in the outcomes were significant in patients with HER2-low expression and stage III disease. Other effective treatment methods should be explored for patients with HER2-0 expression or stage II disease.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104477"},"PeriodicalIF":5.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of factors influencing chemotherapy-induced peripheral neuropathy in breast cancer patients using a random forest model","authors":"Huiqian Xu ,&nbsp;Hong Li ,&nbsp;Yijing Fan ,&nbsp;Yaqi Wang ,&nbsp;Zeyuan Li ,&nbsp;Lizhi Zhou ,&nbsp;Xijun Hao","doi":"10.1016/j.breast.2025.104457","DOIUrl":"10.1016/j.breast.2025.104457","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to analyze the factors influencing chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients, identify modifiable factors, and provide a theoretical basis for targeted interventions.</div></div><div><h3>Methods</h3><div>A total of 542 patients with breast cancer who were hospitalized for chemotherapy in multiple hospitals from September 2022 to September 2023 were selected as the study objects. Data were collected using questionnaires covering demographic characteristics, disease-related information, lifestyle, and psychological status. Lasso-logistic regression was employed to identify influencing factors, and a random forest model was used to rank the importance of variables.</div></div><div><h3>Results</h3><div>Lasso-logistic regression analysis identified age, BMI, cumulative chemotherapy dose, hypertension, physical activity level, and depression as significant factors associated with CIPN (P &lt; 0.05). The variable importance ranking from the random forest model was as follows: age, BMI, cumulative chemotherapy dose, physical activity, hypertension, and depression.</div></div><div><h3>Conclusion</h3><div>Early identification of high-risk CIPN patients is crucial for guiding clinical nursing practices. These findings provide a foundation for the management and intervention of CIPN in breast cancer patients.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104457"},"PeriodicalIF":5.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic disparities and osteoarthritis impact hormone therapy adherence in breast cancer","authors":"B.S. Jang ,&nbsp;J.H. Chang ,&nbsp;K.H. Shin","doi":"10.1016/j.breast.2025.104476","DOIUrl":"10.1016/j.breast.2025.104476","url":null,"abstract":"<div><h3>Purpose</h3><div>Adherence to adjuvant hormone therapy (AHT) is critical for improving survival in breast cancer patients. This study examines how socioeconomic disparities, osteoarthritis (OA), and OA symptom onset timing influence AHT adherence and survival outcomes.</div></div><div><h3>Patients and methods</h3><div>This retrospective cohort study included 33,142 women with invasive breast cancer (2011–2015) from the Korean National Health Insurance Service. Group-based trajectory modeling (GBTM) identified AHT adherence patterns based on the proportion of days covered (PDC) over five years. Competing risk regression and Cox models assessed the impact of socioeconomic factors, pre-treatment OA, NSAID use, and other variables on AHT discontinuation and survival.</div></div><div><h3>Results</h3><div>GBTM revealed two adherence patterns: high adherence (83.4 %) and low adherence (16.6 %), with the latter showing a rapid decline in PDC. The low adherence group had a significantly higher risk of treatment discontinuation (SHR: 14.06; 95 % CI: 12.50–14.96; p &lt; 0.001) and mortality (HR: 3.56; 95 % CI: 3.09–4.09; p &lt; 0.001). A longer OA history before AHT (p = 0.001) and pre-AHT NSAID use (p &lt; 0.001) were linked to higher discontinuation risk. Patients with Medical Aid/Veteran insurance (OR: 0.60; 95 % CI: 0.53–0.67; p &lt; 0.001) and those in non-capital regions (OR: 0.74; 95 % CI: 0.69–0.79; p &lt; 0.001) were less likely to show high adherence.</div></div><div><h3>Conclusion</h3><div>AHT adherence is influenced by socioeconomic factors, pre-existing OA, and OA symptom timing, affecting survival outcomes. Tailored interventions are needed to improve AHT adherence and survival.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104476"},"PeriodicalIF":5.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate change impacts and sustainability integration among breast international group members","authors":"Seamus O'Reilly ,&nbsp;Jessica Griffiths ,&nbsp;Lisa Fox ,&nbsp;Catherine S. Weadick ,&nbsp;Nay My Oo ,&nbsp;Lucy Murphy ,&nbsp;Robert O'Leary ,&nbsp;Theodora Goulioti ,&nbsp;Virginie Adam ,&nbsp;Evangelia D. Razis ,&nbsp;Barbro Lindholm ,&nbsp;Gustavo Werustsky ,&nbsp;David Cameron ,&nbsp;Judith Bliss","doi":"10.1016/j.breast.2025.104469","DOIUrl":"10.1016/j.breast.2025.104469","url":null,"abstract":"<div><h3>Background</h3><div>Integration of sustainability measures into clinical research would translate into less healthcare related climate impacts.</div></div><div><h3>Methods</h3><div>We assessed climate change impacts, existing sustainability engagement, and challenges and facilitators to climate change mitigation strategies among Breast International Group (BIG) members. A 30 item web based survey assessing climate impacts, sustainability engagement, challenges to and facilitators of engagement, and sustainability integration in funding applications was developed, and circulated electronically between November 2023 and March 2024.</div></div><div><h3>Results</h3><div>Thirty four members (research groups and data centres) and participating sites across 5 continents, and BIG headquarters responded. Twenty six responses were received from 21 organisations, 20 from 17 participating sites. No responses were obtained from 28 groups. Trial conduct at a third of member groups had been impacted by climate change impacts such as destroyed infrastructure. 78 % of groups agreed that sustainability should feature in future funding applications. Most respondents engaged in sustainability initiatives at a host institute and organisational level. However, 39 % of coordinating centres and 65 % of representative sites had none within clinical trials conducted by their organisation. The majority of respondents foresaw challenges to sustainability engagement including competing time pressure, staff attitudes and resource constraints. Of nine potential facilitators to engagement, funding, an evidence base for sustainable research practice and training were the leading themes.</div></div><div><h3>Conclusion</h3><div>In the first global survey of its kind, a third of respondents reported that climate change had impacted trial conduct. Integration of sustainability measures was absent in a significant minority. Funding and dedicated resourcing would facilitate increased engagement in cancer clinical trials.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104469"},"PeriodicalIF":5.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta blocker use and breast cancer survival by subtypes: A population-based cohort study","authors":"Oliver William Scott ,&nbsp;Sandar Tin Tin ,&nbsp;Edoardo Botteri","doi":"10.1016/j.breast.2025.104474","DOIUrl":"10.1016/j.breast.2025.104474","url":null,"abstract":"<div><h3>Background</h3><div>The associations between beta blocker (BB) use and breast cancer outcomes have been examined in previous observational studies, however the results are inconsistent. We examine these associations in a large population-based cohort of New Zealand (NZ) women with breast cancer.</div></div><div><h3>Methods</h3><div>Postmenopausal women diagnosed with a first primary early invasive breast cancer between 2006 and 2020 were identified from the NZ Breast Cancer Foundation National Register and linked to national pharmaceutical data, hospital discharges, and death records. Cox proportional hazard models were used to estimate hazards of breast cancer-specific death (BCD), recurrence free interval (RFI), and distant recurrence free interval (DRFI) associated with BB use at diagnosis. Analyses were stratified by subtype.</div></div><div><h3>Results</h3><div>Of the 13,535 women included in analyses, 2,238 (17 %) were using a BB at diagnosis and the median follow up time with BCD as the outcome was 5.6 years. BB use (vs non-use) was not associated with BCD (adjusted hazard ratio: 1.03; 0.86–1.23), RFI (HR = 0.94; 0.81–1.09), or DRFI (HR = 0.98; 0.83–1.15) overall. In women with triple negative breast cancer (TNBC), BB use was associated with a significantly longer RFI (HR = 0.71; 0.52–0.98) and DRFI (HR = 0.70; 0.50–0.98), and there was a suggestion of a decreased risk of BCD (HR = 0.74; 0.52–1.06). BB use was also associated with a significantly longer RFI in women with Luminal B HER2+ cancers (HR = 0.52; 0.29–0.92).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that any protective effect on breast cancer prognosis associated with BB use may be confined to specific subtypes, particularly TNBC.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104474"},"PeriodicalIF":5.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarker alteration following chemotherapy-based systemic therapy in de novo metastatic breast cancer","authors":"Lingjun Kong,&nbsp;Chongxi Ren","doi":"10.1016/j.breast.2025.104471","DOIUrl":"10.1016/j.breast.2025.104471","url":null,"abstract":"<div><h3>Introduction</h3><div>It is unclear whether the expression of biomarkers such as estrogen receptor (ER), progesterone receptor(PR), human epidermal growth factor receptor-2(HER2), and Ki-67 proliferation index changes following chemotherapy-based systemic therapy(CST) in patients with de novo metastatic breast cancer(dnMBC). The study aimed to investigate the expression of the biomarkers before and after CST and its impact on the prognosis of dnMBC patients.</div></div><div><h3>Methods</h3><div>Using hospital-based database, we conducted a retrospective cohort study on dnMBC patients who received CST between February 2010 and December 2017. Based on clinicopathological data, changes in pathological findings(ER,PR,HER-2,Ki-67) following CST were examined. The effect of biomarker conversion on prognosis was evaluated. The primary outcome was overall survival(OS). Kaplan-Meier method and log-rank test was used for survival analyses.</div></div><div><h3>Results</h3><div>The study included 192 female patients. The change rates of ER,PR,HER-2 and Ki-67 before and after CST were 9.9 %,17.2 %,6.2 % and 25.5 % respectively. Among them, the change in negative-to-positive expression of Ki-67 was the most common type of discordance observed. There was no statistical difference in OS between patients with changes in the four biomarkers and patients with no changes in the biomarkers(all p &gt; 0.05). Interestingly, positive conversion of ER and PR, as well as persistent positive HER2 and Ki-67, were significantly associated with poor prognosis(p &lt; 0.001,p &lt; 0.001; p = 0.029,p &lt; 0.001). Family history, initial metastatic site, and tumor grade were independent variables related to survival(p = 0.002,p &lt; 0.001,p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Changes in ER, PR, HER2, and Ki-67 status were observed in patients following CST. Positive conversion of ER and PR, and persistent positive expression of HER2 and Ki-67 may indicate a poor prognosis. Further research is needed to determine whether biomarker expression investigations are needed following CST to optimize treatment options and improve survival.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104471"},"PeriodicalIF":5.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}