Breast最新文献

{"title":"Corrigendum to “Development and evaluation of a decision aid for women eligible for organized breast cancer screening according to international standards: A multi-method study” [Breast 73 (2024) 103613]","authors":"Sandrine Hild , Delphine Teigné , Damien Fairier , Yannick Ruelle , Isabelle Aubin-Auger , Stéphanie Sidorkiewicz , Marie Citrini , Xavier Gocko , Catherine Cerisey , Emilie Ferrat , Cédric Rat","doi":"10.1016/j.breast.2025.104529","DOIUrl":"10.1016/j.breast.2025.104529","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104529"},"PeriodicalIF":5.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672597","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":"BEBT-209, a primary CDK4 selective inhibitor, for the treatment of HR+/HER2- advanced breast cancer (BECTOP1): a phase 1, multicentre, open-label study","authors":"Zhe-Yu Hu ,&nbsp;Kegang Jiang ,&nbsp;Can Tian ,&nbsp;Fan Zhang ,&nbsp;Yehui Shi ,&nbsp;Ying Wang ,&nbsp;Wei Li ,&nbsp;Biao Wu ,&nbsp;Boni Ding ,&nbsp;Liping Liu ,&nbsp;Huawu Xiao ,&nbsp;Xiaohong Yang ,&nbsp;Jing Li ,&nbsp;Ning Xie ,&nbsp;Binliang Liu ,&nbsp;Shouman Wang ,&nbsp;Quchang Ouyang","doi":"10.1016/j.breast.2025.104527","DOIUrl":"10.1016/j.breast.2025.104527","url":null,"abstract":"<div><h3>Purpose</h3><div>Several cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have been approved for the treatment of hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer. Despite the side effects that affect patients' quality of life, most patients still opt for CDK4/6 inhibitors due to their significant benefits. However, to further enhance treatment efficacy and safety, new approaches are still needed.</div></div><div><h3>Patients and methods</h3><div>This multicentre, open-label, Phase 1 trial enrolled Chinese patients with HR+, HER2-advanced breast cancers. The primary endpoints were dose-limiting toxicity (DLT), maximum tolerated dose (MTD). Secondary endpoints included the objective response rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), and pharmacokinetic parameters.</div></div><div><h3>Results</h3><div>During the dose-escalation phase, a DLT was observed in the 150 mg bid dose cohort, specifically, 2 patients experienced grade 4 neutropenia. MTD of BEBT-209 was 100 mg bid, and the most common adverse event (AE) was neutropenia. In Phase 1b, the median PFS of patients with BEBT-209 alone, BEBT-209 plus letrozole, and BEBT-209 plus fulvestrant was 10.38 months, 24.94 months, and not reached, respectively. At doses of 25 mg qd–150 mg bid, steady state areas under the concentration–time curve and peak concentration increased proportionally with dose. The most common grade 3 or 4 AEs were neutropenia (65.4 %), lymphocytopenia (7.4 %), and anaemia (4.9 %).</div></div><div><h3>Conclusion</h3><div>BEBT-209 was a primary CDK4 selective inhibitor and showed an acceptable safety profile and dose-dependent plasma exposure. The results highlight the potential of combination treatments as compelling options, particularly in combination with fulvestrant.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104527"},"PeriodicalIF":5.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685621","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":"Prognostication and treatment predictions for estrogen receptor positive early-stage breast cancer: incorporating the 70-gene signature into the PREDICT prognostication model","authors":"Ellen G. Engelhardt ,&nbsp;Mary Ann E. Binuya ,&nbsp;Paul D.P. Pharoah ,&nbsp;Coralie Poncet ,&nbsp;Emiel J.T. Rutgers ,&nbsp;Martine Piccart ,&nbsp;Fatima Cardoso ,&nbsp;Laura J. van ‘t Veer ,&nbsp;Ewout W. Steyerberg ,&nbsp;Sabine C. Linn ,&nbsp;Marjanka K. Schmidt","doi":"10.1016/j.breast.2025.104542","DOIUrl":"10.1016/j.breast.2025.104542","url":null,"abstract":"<div><h3>Background</h3><div>The 70-gene signature (70-GS) has been shown to identify women at low-risk of distant recurrence who can safely forgo adjuvant chemotherapy. Incorporating this GS into the well-validated and widely used PREDICT breast cancer model could improve the model's ability to estimate breast cancer prognosis, and thereby further reduce overtreatment and its long-term impact on patients' quality of life. We incorporated the 70-GS into PREDICT-v2.3 and assessed the new PREDICT-GS model's ability to predict 5-year risk of breast cancer death.</div></div><div><h3>Methods</h3><div>Data from the MINDACT trial (N = 5920) was used to estimate the 70-GS's prognostic effect (coefficient = 0.70), which was then incorporated into PREDICT-v2.3. Netherlands Cancer Registry (NCR) data (N = 3323) was used to assess PREDICT-GS's discrimination (area under curve (AUC)), calibration and clinical utility.</div></div><div><h3>Results</h3><div>Compared to PREDICT-v2.3 (AUC: 0.71 (95 % CI: 0.63–0.79)), PREDICT-GS (AUC: 0.76 (95 % CI: 0.69–0.83)) had better discrimination. Both models tended to overestimate the 5-year risk of breast cancer death in the NCR cohort, but the absolute overestimation was smaller for PREDICT-GS. Regarding clinical utility, only at the 10 % decision threshold did we find modest improvement: four extra patients per 1000 tests were correctly classified as not needing chemotherapy by PREDICT-GS compared to PREDICT-v2.3.</div></div><div><h3>Conclusion</h3><div>Extending PREDICT-v2.3 with 70-GS led to modest improvement in its ability to predict 5-year risk of breast cancer death. Future research should focus on assessing the added value of the 70-GS for longer-term prediction of recurrence and death with the incorporation of quality of life in risk prediction tools.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104542"},"PeriodicalIF":5.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702583","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":"Acute presentations in neoadjuvant chemotherapy/immune checkpoint inhibition for triple negative breast cancer: experiences and impact from real-world data","authors":"Tim Cooksley ,&nbsp;Safwaan Adam ,&nbsp;Bence Nagy ,&nbsp;Sophie Raby ,&nbsp;Anne Armstrong ,&nbsp;Jamie MJ. Weaver","doi":"10.1016/j.breast.2025.104536","DOIUrl":"10.1016/j.breast.2025.104536","url":null,"abstract":"<div><h3>Background</h3><div>Recent data showed benefit of the addition of immune checkpoint inhibitor (ICI) therapy to cytotoxic chemotherapy in the neoadjuvant setting for patients with early triple negative breast cancer. Acute presentations in patients treated with ICI therapy and combined chemotherapy/ICI therapy can be challenging and have significant resource implications.</div></div><div><h3>Materials and methods</h3><div>A prospective analysis was performed at a specialist oncology hospital in England from December 1, 2022 to December 31, 2024. The primary outcome measure was whether the acute presentation was due to an ICI-related toxicity. Secondary outcome measures were number of inpatient bed days and the proportion of patients with grade ≥3 diarrhoea or transaminases that were diagnosed with ICI-related toxicity.</div></div><div><h3>Results</h3><div>During the study period, 285 patients were treated with neoadjuvant PC-EC/Pembro for triple negative breast cancer with 210 emergency presentations in 168 patients to the acute floor. Fifty-three (25.2 %) patients were diagnosed with an ICI-related toxicity of which 5 were a relapsed/recurrent presentation. One hundred and nine patients (51.9 %) were discharged on the day of presentation. A total of 576 inpatient bed days were used in the management of the cohort.</div><div>Sixteen (7.6 %) patients had grade 3 diarrhoea at presentation; only 5 (31.3 %) of these were ICI-mediated. Eleven (5.2 %) patients had a grade ≥3 ALT rise at presentation; only 3 (27.2 %) of these were ICI-mediated.</div></div><div><h3>Conclusion</h3><div>In triple negative breast cancer being treated in the neoadjuvant setting with chemotherapy/immune checkpoint inhibition only 25.2 % of acute presentations had an ICI-related toxicity driving their attendance. Toxicities in this cohort may require a different approach to those treated with chemotherapy or ICI alone and may necessitate new clinical practice guidance.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104536"},"PeriodicalIF":5.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702584","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":"Effectiveness of the lymphatic microsurgical preventive healing approach for avoiding breast cancer-related arm lymphedema","authors":"Summer Sami Yono ,&nbsp;Andrew Hannoudi ,&nbsp;Hassan Chamseddine ,&nbsp;Sanjay Rama ,&nbsp;Jessica M. Bensenhaver ,&nbsp;Daniel Yoho ,&nbsp;Donna Tepper ,&nbsp;Maristella S. Evangelista ,&nbsp;Saul D. Nathanson ,&nbsp;Dunya M. Atisha","doi":"10.1016/j.breast.2025.104540","DOIUrl":"10.1016/j.breast.2025.104540","url":null,"abstract":"<div><h3>Background</h3><div>There is currently no proven surgical approach that prevents breast cancer related arm lymphedema (BCRAL). We hypothesized that the lymphatic microsurgical preventive healing approach (LyMPHA) during axillary lymph node dissection (ALND) could reduce BCRAL development.</div></div><div><h3>Study design</h3><div>We conducted a single-center retrospective cohort study of patients with breast cancer who underwent ALND with or without immediate LyMPHA between 2016 and 2022. Primary outcomes were development of BCRAL and quality of life measures within 4 years of surgery. Secondary outcomes were days to drain removal and postoperative complications. Kaplan-Meier analysis determined risk of BCRAL over time. Cox regression analysis was used to determine risk factors associated with development of BCRAL.</div></div><div><h3>Results</h3><div>Of 187 patients who underwent ALND, 121 (64.7 %) received LyMPHA and 66 (35.3 %) underwent ALND only. The mean age was 56.4 ± 13.6 years. Patients who underwent LyMPHA had lower risk of lymphedema over time (p = 0.003), lower median percent functional impairment (4.7 % vs 11.6 %, p = 0.045), and shorter median drain duration (13.0 vs 15.0 days; p = 0.042). Regression analysis showed that those who received LyMPHA were half as likely to develop BCRAL (hazard ratio 0.53; 95 % CI 0.28–0.98; p = 0.043). Groups did not differ in the rate of postoperative complications. No other factors were associated with BCRAL, including age, body mass index, smoking status, or history of other cancer therapies.</div></div><div><h3>Conclusion</h3><div>Performing immediate lymphatic reconstruction with LyMPHA after ALND may prevent arm lymphedema and reduce morbidity in patients with breast cancer.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104540"},"PeriodicalIF":5.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655541","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":"Does RSClin provide additional information over classic clinico-pathologic scores (PREDICT 2.1, INFLUENCE 2.0, CTS5)?","authors":"Ana-Alicia Beltran-Bless ,&nbsp;Gregory R. Pond ,&nbsp;Jane Bayani ,&nbsp;Sarah L. Barker ,&nbsp;Melanie Spears ,&nbsp;Elizabeth Mallon ,&nbsp;Karen J. Taylor ,&nbsp;Annette Hasenburg ,&nbsp;Christos Markopoulos ,&nbsp;Luc Dirix ,&nbsp;Elma Meershoek-Klein Kranenbarg ,&nbsp;Cornelis J.H. van de Velde ,&nbsp;Daniel W. Rea ,&nbsp;Lisa Vandermeer ,&nbsp;John Hilton ,&nbsp;John M.S. Bartlett ,&nbsp;Mark Clemons","doi":"10.1016/j.breast.2025.104528","DOIUrl":"10.1016/j.breast.2025.104528","url":null,"abstract":"<div><h3>Purpose</h3><div>Few studies have compared the performance of gene-expression profiling tests (e.g. Oncotype-Dx) to clinico-pathologic risk calculators (e.g. PREDICT 2.1, INFLUENCE 2.0, and CTS5) or tools that combine both (e.g. RSClin) in patients with early breast cancer (EBC). A large trial dataset was used to evaluate the prognostic performance of different tests based on patient outcomes.</div></div><div><h3>Methods</h3><div>The TEAM pathology cohort accrued samples from 4736 postmenopausal hormone positive women with EBC, treated with either exemestane or tamoxifen followed by exemestane. Oncotype-Dx-trained risk scores were previously generated by gene-expression profiling. Patient data was used to calculate various recurrence scores. Analysis was restricted to the N0/N1 population and prognostic ability of selected risk tools was assessed using Cox regression analysis and Harrell's C-statistic.</div></div><div><h3>Results</h3><div>Results were available for 2065 patients. There was low correlation between PREDICT 2.1 (r = -0.12), INFLUENCE 2.0 (r = 0.20), CTS5 (r = 0.16) with Oncotype-Dx-trained results. In N0 patients, RSClin had improved prognostic ability (C-statistic = 0.66) on DMFS compared to PREDICT 2.1 (0.60), INFLUENCE 2.0 (0.57), CTS-5 (0.62), and Oncotype-Dx (0.63).</div></div><div><h3>Conclusion</h3><div>Combining molecular and clinico-pathologic factors enhances prognostic information. However, the impact of this on actual patient management requires further prospective validation.</div><div>The trial is registered with clinicaltrials.gov NCT00279448 and NCT00032136; with Netherlands Trial Register, number NTR 267; and the Ethics Commission Trial, number 27/2001.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104528"},"PeriodicalIF":5.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571692","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":"Prognostic value of tumor-infiltrating lymphocytes in irradiated node-positive breast cancer patients","authors":"Demet Özcan ,&nbsp;Anders Winther Mølby Nielsen ,&nbsp;Jan Alsner ,&nbsp;Lise Bech Jellesmark Thorsen ,&nbsp;Jens Overgaard ,&nbsp;Birgitte Vrou Offersen ,&nbsp;Trine Tramm","doi":"10.1016/j.breast.2025.104525","DOIUrl":"10.1016/j.breast.2025.104525","url":null,"abstract":"<div><h3>Introduction</h3><div>Radiotherapy significantly reduces locoregional recurrence (LRR) and improves survival. Yet, reliable biomarkers predicting radiotherapy response are not well-defined. Tumor-infiltrating lymphocytes (TILs) have emerged as a promising prognostic and predictive marker, but their role in irradiated patients remains underexplored.</div></div><div><h3>Methods</h3><div>This case-cohort study included 1461 node-positive, irradiated breast cancer patients from the Danish Breast Cancer Group (DBCG) internal mammary node (IMN)2 study. IMN irradiation (IMNI) was allocated by tumor laterality. TILs were assessed in treatment-naïve primary tumors and dichotomized using a 30 % cut-off. Endpoints included overall mortality (OM), breast cancer-specific mortality (BCM), distant recurrence (DR), and LRR. Flexible parametric survival models estimated adjusted hazard ratios (HRs).</div></div><div><h3>Results</h3><div>TILs were evaluated in 1353 patients; 20 % had high TILs. Low TILs were associated with higher OM (HR 0.53, 95 % CI: 0.36–0.77), BCM (HR 0.45, CI: 0.29–0.71) and DR (HR 0.40, CI: 0.26–0.62), but not LRR (HR 0.82, CI: 0.31–2.17). These associations were strongest in estrogen receptor-negative (ER-) tumors. ER-/low TILs were associated with increased OM (HR 0.31, CI: 0.18–0.56) compared to ER-/high TILs, whereas TILs were not prognostic in ER+ tumors (HR 0.86, CI: 0.56–1.32). A significant survival benefit after IMNI was observed in patients with low TILs tumors (HR 0.64, CI: 0.48–0.85), but TILs did not predict IMNI-benefit.</div></div><div><h3>Conclusion</h3><div>TILs in the pre-immunotherapy setting were not predictive of IMNI-benefit but prognostic for post-radiotherapy outcomes in node-positive patients. The effect was dependent on ER status, as patients with ER-/low TILs tumors had poorer survival with a trend toward increased DR-risk.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104525"},"PeriodicalIF":5.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571758","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":"Omitting anthracyclines for the adjuvant treatment of patients with triple-negative breast cancer: A non-inferiority meta-analysis","authors":"Fabio Girardi ,&nbsp;Caterina Barbieri ,&nbsp;Gaia Griguolo ,&nbsp;Daniela Iannaccone ,&nbsp;Christian Zurlo ,&nbsp;Maria Vittoria Dieci ,&nbsp;Valentina Guarneri","doi":"10.1016/j.breast.2025.104524","DOIUrl":"10.1016/j.breast.2025.104524","url":null,"abstract":"<div><h3>Introduction</h3><div>For patients diagnosed with triple-negative breast cancer (TNBC), the sequential use of anthracyclines and taxanes is the standard adjuvant treatment, when this is indicated. However, anthracycline-related toxicities represent a concern. We conducted a meta-analysis to assess whether anthracycline-free regimens are non-inferior to standard, sequential regimens.</div></div><div><h3>Patients and methods</h3><div>We used a complex search strategy to query multiple databases. The population included patients who underwent primary surgery for TNBC, eligible for adjuvant chemotherapy and randomised in a phase 2 or 3 clinical trial. We fitted non-inferiority (NI) margins using published treatment effects. We calculated risk ratios (RR) for recurrence or death.</div></div><div><h3>Results</h3><div>Eight studies out of 3410 potentially eligible records were included in the meta-analysis, for an overall population of 4292 patients. The RR for recurrence was 1.05 (95 % confidence interval (CI) 0.93–1.19), with an upper bound superimposing on the NI margin of 1.19. In a sensitivity analysis excluding the two studies using CMF, the recurrence RR for the comparison between taxane-only chemotherapy and anthracycline-based sequential chemotherapy was RR 0.97 (95 % CI 0.84–1.11). The RR for death was 1.17 (95 % CI 1.00–1.37), with an upper bound crossing the NI margin of 1.16.</div></div><div><h3>Conclusions</h3><div>Anthracycline-free adjuvant chemotherapy may represent an option for patients with early TNBC who are not eligible for pre-operative treatment and for whom sparing anthracyclines should be considered (e.g., young patients with small tumours, patients at risk of adverse effects). Non-inferiority was more evident for taxane-only chemotherapy than for anthracycline-free regimens at large. However, our results call for caution considering the remarkable heterogeneity in the study patient populations. This meta-analysis should prompt further research into strategies for patient selection, including the use of prognostic biomarkers for risk stratification.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104524"},"PeriodicalIF":5.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557358","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":"Corrigendum to “Neoadjuvant chemotherapy for breast cancer in Italy: A Senonetwork analysis of 37,215 patients treated from 2017 to 2022” [The Breast 78 (2024) 103790]","authors":"A. De Luca ,&nbsp;M.I. Amabile ,&nbsp;F. Santori ,&nbsp;S. Di Matteo ,&nbsp;M. Tomatis ,&nbsp;A. Ponti ,&nbsp;F. Frusone ,&nbsp;M. Taffurelli ,&nbsp;C. Tinterri ,&nbsp;L. Marotti ,&nbsp;M. Calabrese ,&nbsp;C. Marchiò ,&nbsp;F. Puglisi ,&nbsp;I. Palumbo ,&nbsp;L. Fortunato","doi":"10.1016/j.breast.2025.104511","DOIUrl":"10.1016/j.breast.2025.104511","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104511"},"PeriodicalIF":5.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511498","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":"Partial breast irradiation after sentinel lymph node biopsy omission: Is it a valid alternative to whole breast Irradiation? Analysis of the dose to the sentinel lymph node region during whole breast irradiation vs. partial breast irradiation","authors":"Sophie T. Behzadi ,&nbsp;Rebecca Moser ,&nbsp;Mathias Düsberg ,&nbsp;Maximilian Aigner ,&nbsp;Jana Nano ,&nbsp;Sophia Kiesl ,&nbsp;Jacqueline Lammert ,&nbsp;Evelyn Klein ,&nbsp;Georg P. Schmidt ,&nbsp;Marion Kiechle ,&nbsp;Thomas Huber ,&nbsp;Stefanie Corradini ,&nbsp;Stephanie E. Combs ,&nbsp;Kai J. Borm","doi":"10.1016/j.breast.2025.104523","DOIUrl":"10.1016/j.breast.2025.104523","url":null,"abstract":"<div><h3>Background</h3><div>Sentinel lymph node biopsy (SLNB) can be safely omitted in selected early-stage, clinically node-negative breast cancer (BC) patients. While these patients are also candidates for partial breast irradiation (PBI), the dosimetric effects of PBI on the sentinel lymph node region (SLNs) and axillary levels remain unclear.</div></div><div><h3>Methods</h3><div>In this study, SLNs were identified and contoured in 100 BC patients using pre- and postoperative imaging. Axillary levels were contoured following ESTRO guidelines. Dose distribution to the SLN (n = 9000 data points) and axillary levels (n = 270 data points) were analyzed for whole breast irradiation (WBI) and PBI across different techniques (3D-conformal radiation therapy [3D-CRT] vs. volumetric modulated arc therapy [VMAT]), deep inspiration breath-hold [DIBH] vs. free breathing [FB]), and anatomical variations (breast size, tumor site, and upper breast border).</div></div><div><h3>Results</h3><div>WBI provided full therapeutic dose coverage (&gt;95 % of the prescribed dose) to 65 % of SLNs, compared to only 10 % (3D-CRT) and 3 % (VMAT) with PBI. DIBH significantly reduced dose distribution to SLN and axillary levels compared to FB. Lower incidental dose coverage was also observed in patients with medial/central tumors, smaller breasts, and lower upper breast borders.</div></div><div><h3>Conclusion</h3><div>These results demonstrate that PBI delivers substantially lower incidental dose to the SLN than WBI. Since patients in the INSEMA and SOUND trials were predominantly treated with WBI, combining SLNB omission with PBI should not be considered a standard approach and warrants further investigation.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104523"},"PeriodicalIF":5.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524311","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}