Breast最新文献

{"title":"The impact of age on physical functioning after treatment for breast cancer, as measured by patient-reported outcome measures: A systematic review","authors":"V.R. Robins ,&nbsp;S. Gelcich ,&nbsp;K. Absolom ,&nbsp;G. Velikova","doi":"10.1016/j.breast.2024.103734","DOIUrl":"10.1016/j.breast.2024.103734","url":null,"abstract":"<div><h3>Purpose</h3><p>This systematic review aims to explore the impact of age on physical functioning post-treatment for early-stage, locally advanced, or locally recurrent breast cancer, as measured by patient-reported outcome measures (PROMs), identify PROMs used and variations in physical functioning terms/labels.</p></div><div><h3>Methods</h3><p>MEDLINE, EmBase, PsycINFO, CINAHL and AMED were searched, along with relevant key journals and reference lists. Risk of bias (quality) assessment was conducted using a Critical Appraisal Skills Programme checklist. Data was synthesised through tables and narrative.</p></div><div><h3>Results</h3><p>28,207 titles were extracted from electronic databases, resulting in 44 studies with age sub-groups, and 120 without age sub-groups. Of those with findings on the impact of age, there was variability in the way findings were reported and 21 % found that age did not have a significant impact. However, 66 % of the studies found that with older age, physical functioning declined post-treatment. Comorbidities were associated with physical functioning declines. However, findings from sub-groups (breast cancer stage, treatment type and time post-treatment) lacked concordance. Twenty-eight types of PROM were used: the EORTC QLQ-C30 was most common (50.6 %), followed by the SF-36 (32.3 %). There were 145 terms/labels for physical functioning: ‘physical functioning/function’ was used most often (82.3 %).</p></div><div><h3>Conclusions</h3><p>Findings point towards an older age and comorbidities being associated with more physical functioning declines. However, it was not possible to determine if stage, treatment type and time since treatment had any influence. More consistent use of the terminology ‘physical functioning/function’ would aid future comparisons of study results.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103734"},"PeriodicalIF":3.9,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000651/pdfft?md5=2a7044fadc04ee74136fc190a5f2d1a7&pid=1-s2.0-S0960977624000651-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794371","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":"Financial toxicity, family resilience and negative emotions among young and middle-aged breast cancer patients: A multicentre cross-sectional study","authors":"Xuelei Chen ,&nbsp;Qilin Yan ,&nbsp;Youjuan Tang ,&nbsp;Jianing Zhu ,&nbsp;Wenlu Zhang ,&nbsp;Jingping Zhang","doi":"10.1016/j.breast.2024.103735","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103735","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine financial toxicity in young and middle-aged women with breast cancer and examine the associations between family resilience and negative emotions.</p></div><div><h3>Methods</h3><p>A multicentre cross-sectional study was conducted, 538 women with breast cancer were recruited from four hospitals. FT, family resilience, and negative emotions were collected using the Comprehensive Score for FT, the Chinese version of the Family Resilience Assessment in Breast Cancer Patients, Patient Health Questionnaire-9 item, and Generalized Anxiety Disorder-7. This study adhered to the STROBE guidelines.</p></div><div><h3>Results</h3><p>The valid response rate was 96.8 % (N = 521). Overall, the score for FT was 19.63 ± 10.13. FT was significantly correlated with family resilience (<em>r</em> = 0.30, <em>p</em> &lt; 0.010) and depression (<em>r</em> = −0.11, <em>p</em> &lt; 0.050). The hierarchical multiple linear regression analysis showed that career status, monthly income, religion, and family resilience were the main factors influencing FT in patients with breast cancer (<em>R</em>^<em>2</em> = 0.37; <em>F</em> = 6.83; <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>FT was more prevalent among women from low-income career. Women with poor family resilience, no religious also suffer greater financial toxicity. It is necessary to pay more attention of the financial toxicity of female’ low-income career, no religious belief and poor family resilience. Developing effective interventions based on family resilience might be helpful in promoting their well-being.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103735"},"PeriodicalIF":3.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000663/pdfft?md5=31341f0bbaaa627372c648ae44f0b360&pid=1-s2.0-S0960977624000663-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140605500","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":"Erratum to ‘The benefit of adding polygenic risk scores, lifestyle factors, and breast density to family history and genetic status for breast cancer risk and surveillance classification of unaffected women from germline CHEK2 c.1100delC families’ [The Breast 73 (2024) 103611]","authors":"Maartje A.C. Schreurs ,&nbsp;Teresa Ramón y Cajal ,&nbsp;Muriel A. Adank ,&nbsp;J. Margriet Collée ,&nbsp;Antoinette Hollestelle ,&nbsp;Jeroen van Rooij ,&nbsp;Marjanka K. Schmidt ,&nbsp;Maartje J. Hooning","doi":"10.1016/j.breast.2024.103723","DOIUrl":"10.1016/j.breast.2024.103723","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103723"},"PeriodicalIF":3.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000547/pdfft?md5=acffe6bc23cbe1c8ae24b26dd3c457f6&pid=1-s2.0-S0960977624000547-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763643","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":"Enhancing clinical decision support with genomic tools in breast cancer: A Scottish perspective","authors":"A.L. Peters ,&nbsp;P.S. Hall ,&nbsp;L.B. Jordan ,&nbsp;F.Y. Soh ,&nbsp;L. Hannington ,&nbsp;S. Makaranka ,&nbsp;G. Urquhart ,&nbsp;M. Vallet ,&nbsp;D. Cartwright ,&nbsp;H. Marashi ,&nbsp;B. Elsberger","doi":"10.1016/j.breast.2024.103728","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103728","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;p&gt;The &lt;em&gt;Oncotype DX Breast RS&lt;/em&gt; test has been adopted in Scotland and has been the subject of a large population-based study by a Scottish Consensus Group to assess the uptake of the recurrence score (RS), evaluate co-variates associated with the RS and to analyse the effect it may have had on clinical practice.&lt;/p&gt;&lt;p&gt;Materials &amp; Methods: Pan-Scotland study between August 2018–August 2021 evaluating 833 patients who had a RS test performed as part of their diagnostic pathway. Data was extracted retrospectively from electronic records and analysis conducted to describe change in chemotherapy administration (by direct comparison with conventional risk assessment tools), and univariate/multivariate analysis to assess relationship between covariates and the RS.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Chemotherapy treatment was strongly influenced by the RS (p &lt; 0.001). Only 30 % of patients received chemotherapy treatment in the intermediate and high risk PREDICT groups, where chemotherapy is considered. Additionally, 55.5 % of patients with a high risk PREDICT had a low RS and did not receive chemotherapy. There were 17 % of patients with a low risk PREDICT but high RS who received chemotherapy.&lt;/p&gt;&lt;p&gt;Multivariate regression analysis showed the progesterone receptor Allred score (PR score) to be a strong independent predictor of the RS, with a negative PR score being associated with high RS (OR 4.49, p &lt; 0.001). Increasing grade was also associated with high RS (OR 3.81, p &lt; 0.001). Classic lobular pathology was associated with a low RS in comparison to other tumour pathology (p &lt; 0.01). Nodal disease was associated with a lower RS (p = 0.012) on univariate analysis, with menopausal status (p = 0.43) not influencing the RS on univariate or multivariate analysis.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Genomic assays offer the potential for risk-stratified decision making regarding the use of chemotherapy. They can help reduce unnecessary chemotherapy treatment and identify a subgroup of patients with more adverse genomic tumour biology. A recent publication by Health Improvement Scotland (HIS) has updated guidance on use of the RS test for NHS Scotland. It suggests to limit its use to the intermediate risk PREDICT group. Our study shows the impact of the RS test in the low and high risk PREDICT groups. The implementation across Scotland has resulted in a notable shift in practice, leading to a significant reduction in chemotherapy administration in the setting of high risk PREDICT scores returning low risk RS. There has also been utility for the test in the low risk PREDICT group to detect a small subgroup with a high RS.&lt;/p&gt;&lt;p&gt;We have found the PR score to have a strong independent association with high risk RS. This finding was not evaluated by the key RS test papers, and the potential prognostic information provided by the PR score as a surrogate biomarker is an outstanding question that requires more researc","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103728"},"PeriodicalIF":3.9,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000596/pdfft?md5=703e432b55617af843c42f577d624ac4&pid=1-s2.0-S0960977624000596-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638537","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":"Survival outcomes for women with a solitary extracranial metastasis from breast cancer","authors":"Patrick Dyer ,&nbsp;Jing Xie ,&nbsp;Phillip K. Tran ,&nbsp;Keelan Byrne","doi":"10.1016/j.breast.2024.103730","DOIUrl":"10.1016/j.breast.2024.103730","url":null,"abstract":"<div><h3>Background</h3><p>Aggressive metastasis directed treatment of extracranial oligometastatic breast cancer with the aim of increasing disease-free survival has emerged as a new potential treatment paradigm, however there is currently a lack of data to assist in identifying the subset of patients who will potentially benefit most. This single-institute retrospective cohort study aimed to evaluate survival outcomes for patients with a solitary extracranial metastasis from breast cancer and to assess for significant prognostic factors.</p></div><div><h3>Methods and materials</h3><p>Medical records of 70 female breast cancer patients with a solitary extracranial metastasis actively managed at the Peter MacCallum Cancer Centre (PMCC) Melbourne Campus between 2000 and 2019 were reviewed. Kaplan-Meier curves were used to estimate overall survival (OS), local progression free survival (LPFS) and distant progression free survival (DPFS).</p></div><div><h3>Results</h3><p>Median follow-up period was 9.4 years. The study included 40 hormone receptor positive/HER2 negative (HR+HER2-), 14 hormone receptor positive/HER2 positive (HR+HER2+), 3 hormone receptor negative/HER2 positive (HR-HER2+), 9 triple negative (TNBC) and 4 unclassified breast cancer patients. 5-year OS rate for all patients was 46%, LPFS rate was 56% and DPFS was 20%. Tumour receptor group had a statistically significant association with OS and DPFS rates. TNBC patients had significantly poorer OS and DPFS rates in comparison to HR+HER2-patients.</p></div><div><h3>Conclusion</h3><p>Among patients with a solitary extracranial metastasis from breast cancer, TNBC was associated with the poorest OS and DPFS rates. Identification of other significant prognostic factors for oligometastatic breast cancer patients may inform guidelines for metastasis directed treatments.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103730"},"PeriodicalIF":3.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000614/pdfft?md5=a9a32a349003fbe3973a25e85eb55937&pid=1-s2.0-S0960977624000614-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140615431","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":"Metastases of primary mixed no-special type and lobular breast cancer display an exclusive lobular histology","authors":"Gitte Zels ,&nbsp;Karen Van Baelen ,&nbsp;Maxim De Schepper ,&nbsp;Kristien Borremans ,&nbsp;Tatjana Geukens ,&nbsp;Edoardo Isnaldi ,&nbsp;Hava Izci ,&nbsp;Sophia Leduc ,&nbsp;Amena Mahdami ,&nbsp;Marion Maetens ,&nbsp;Ha Linh Nguyen ,&nbsp;Anirudh Pabba ,&nbsp;François Richard ,&nbsp;Josephine Van Cauwenberge ,&nbsp;Ann Smeets ,&nbsp;Ines Nevelsteen ,&nbsp;Patrick Neven ,&nbsp;Hans Wildiers ,&nbsp;Wouter Van Den Bogaert ,&nbsp;Giuseppe Floris ,&nbsp;Christine Desmedt","doi":"10.1016/j.breast.2024.103732","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103732","url":null,"abstract":"<div><p>Primary tumors with a mixed invasive breast carcinoma of no-special type (IBC-NST) and invasive lobular cancer (ILC) histology are present in approximately five percent of all patients with breast cancer and are understudied at the metastatic level. Here, we characterized the histology of metastases from two patients with primary mixed IBC-NST/ILC from the postmortem tissue donation program UPTIDER (NCT04531696). The 14 and 43 metastatic lesions collected at autopsy had morphological features and E-cadherin staining patterns consistent with pure ILC. While our findings still require further validation, they may challenge current clinical practice and imaging modalities used in these patients.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103732"},"PeriodicalIF":3.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000638/pdfft?md5=64943219ac0bd86fe556bd4ec789168b&pid=1-s2.0-S0960977624000638-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140631670","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 benefit of adding polygenic risk scores, lifestyle factors, and breast density to family history and genetic status for breast cancer risk and surveillance classification of unaffected women from germline CHEK2 c.1100delC families","authors":"Maartje A.C. Schreurs ,&nbsp;Teresa Ramón y Cajal ,&nbsp;Muriel A. Adank ,&nbsp;J. Margriet Collée ,&nbsp;Antoinette Hollestelle ,&nbsp;Jeroen van Rooij ,&nbsp;Marjanka K. Schmidt ,&nbsp;Maartje J. Hooning","doi":"10.1016/j.breast.2024.103724","DOIUrl":"10.1016/j.breast.2024.103724","url":null,"abstract":"<div><p>To determine the changes in surveillance category by adding a polygenic risk score based on 311 breast cancer (BC)-associated variants (PRS₃₁₁), questionnaire-based risk factors and breast density on personalized BC risk in unaffected women from Dutch <em>CHEK2</em> c.1100delC families.</p><p>In total, 117 unaffected women (58 heterozygotes and 59 non-carriers) from <em>CHEK2</em> families were included. Blood-derived DNA samples were genotyped with the GSAMDv3-array to determine PRS₃₁₁. Lifetime BC risk was calculated in CanRisk, which uses data from the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA). Women, were categorized into three surveillance groups.</p><p>The surveillance advice was reclassified in 20 (34.5%) heterozygotes and 21 (35.6%) non-carriers after adding PRS₃₁₁. Including questionnaire-based risk factors resulted in an additional change in 11 (20.0%) heterozygotes and 8 (15.1%) non-carriers; and a sub-analysis showed that adding breast density on top shifted another 9 (23.1%) heterozygotes and 5 (27.8%) non-carriers. Overall, the majority of heterozygotes were reclassified to a less intensive surveillance, while non-carriers would require intensified surveillance.</p><p>The addition of PRS₃₁₁, questionnaire-based risk factors and breast density to family history resulted in a more personalized BC surveillance advice in <em>CHEK2</em>-families, which may lead to more efficient use of surveillance.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103724"},"PeriodicalIF":3.9,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000559/pdfft?md5=f94574c2f6c19054854df1169992ae02&pid=1-s2.0-S0960977624000559-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141062347","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":"Distinct ER and PR expression patterns significantly affect the clinical outcomes of early HER2-positive breast cancer: A real-world analysis of 871 patients treated with neoadjuvant therapy","authors":"Haizhu Chen ,&nbsp;Xiujuan Gui ,&nbsp;Ziwei Zhou ,&nbsp;Fengxi Su ,&nbsp;Chang Gong ,&nbsp;Shunrong Li ,&nbsp;Wei Wu ,&nbsp;Nanyan Rao ,&nbsp;Qiang Liu ,&nbsp;Herui Yao","doi":"10.1016/j.breast.2024.103733","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103733","url":null,"abstract":"<div><h3>Introduction</h3><p>The impact of distinct estrogen receptor (ER) and progesterone receptor (PR) expression patterns on tumor behavior and treatment outcomes within HER2-positive breast cancer is not fully explored. This study aimed to comprehensively examine the clinical differences among patients with HER2-positive breast cancer harboring distinct ER and PR expression patterns in the neoadjuvant setting.</p></div><div><h3>Methods</h3><p>This retrospective analysis included 871 HER2-positive breast patients treated with neoadjuvant therapy at our hospital between 2011 and 2022. Comparisons were performed across the three hormone receptor (HR)-specific subtypes, namely the ER-negative/PR-negative/HER2-positive (ER-/PR-/HER2+), the single HR-positive (HR+)/HER2+, and the triple-positive breast cancer (TPBC) subtypes.</p></div><div><h3>Results</h3><p>Of 871 patients, 21.0% had ER-/PR-/HER2+ tumors, 33.6% had single HR+/HER2+ disease, and 45.4% had TPBC. Individuals with single HR+/HER2+ tumors and TPBC cases demonstrated significantly lower pathological complete response (pCR) rates compared to those with ER-/PR-/HER2+ tumors (36.9% vs. 24.3% vs. 49.2%, p &lt; 0.001). Multivariate analysis confirmed TPBC as significantly associated with decreased pCR likelihood (OR = 0.42, 95%CI 0.28–0.63, p &lt; 0.001). Survival outcomes, including disease-free survival (DFS) and overall survival (OS), showed no significant differences across HR-specific subtypes in the overall patient population. However, within patients without anti-HER2 therapy, TPBC was linked to improved DFS and a trend towards better OS.</p></div><div><h3>Conclusions</h3><p>HER2-positive breast cancer exhibited three distinct HR-specific subtypes with varying clinical manifestations and treatment responses. These findings suggest personalized treatment strategies considering ER and PR expression patterns, emphasizing the need for further investigations to unravel molecular traits underlying HER2-positive breast cancer with distinct HR expression patterns.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103733"},"PeriodicalIF":3.9,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S096097762400064X/pdfft?md5=2df04cfffdb86bbbfcfc69511787336f&pid=1-s2.0-S096097762400064X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140548867","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 impact of symptom clusters on endocrine therapy adherence in patients with breast cancer","authors":"Sommer Agnew ,&nbsp;Megan Crawford ,&nbsp;Iain MacPherson ,&nbsp;Victor Shiramizu ,&nbsp;Leanne Fleming","doi":"10.1016/j.breast.2024.103731","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103731","url":null,"abstract":"<div><h3>Background</h3><p>When taken as prescribed, endocrine therapy is effective in reducing risk of recurrence and mortality in the treatment of patients with breast cancer. However, treatment side effects can act as a barrier to medication adherence. Existing research has not identified any specific side effects as consistent predictors of nonadherence. Our aim was to explore the influence of symptom clusters on self-reported adherence in patients with breast cancer.</p></div><div><h3>Methods</h3><p>A cross-sectional online survey was conducted, including patients with breast cancer currently or previously prescribed endocrine therapy (<em>N</em> = 1051). This included measures of self-reported endocrine therapy adherence and common symptoms among this population (insomnia, depression, anxiety, fatigue, musculoskeletal, and vasomotor symptoms).</p></div><div><h3>Results</h3><p>Unintentional nonadherence was higher than intentional nonadherence (50.8 % vs 31.01 %). The most troublesome symptom was insomnia (73.83 % displayed probable insomnia disorder). K-means cluster analysis identified 2 symptom clusters: overall High symptoms, and overall Low symptoms. Participants in the Low symptoms cluster were significantly more likely to be classed as adherent based on unintentional and intentional items.</p></div><div><h3>Conclusions</h3><p>Nonadherence was high in the current sample, and significantly more likely in participants reporting overall severe symptoms. Clinicians should be aware of the scale of common side effects and facilitate open conversation about potential barriers to adherence. Follow-up care should include assessment of common symptoms and signpost patients to appropriate support or treatment when required. Future research should explore potential for a central symptom to act as a target for intervention, to relieve overall side effect burden and facilitate better medication adherence.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103731"},"PeriodicalIF":3.9,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000626/pdfft?md5=0a746b7c52ee2f138fd4d94de17c38c6&pid=1-s2.0-S0960977624000626-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140539603","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":"Radiological, pathological and surgical outcomes after neoadjuvant endocrine treatment in patients with ER-positive/HER2-negative breast cancer with a clinical high risk and a low-risk 70-gene signature","authors":"Josefien P. van Olmen ,&nbsp;Chaja F. Jacobs ,&nbsp;Sanne A.L. Bartels ,&nbsp;Claudette E. Loo ,&nbsp;Joyce Sanders ,&nbsp;Marie-Jeanne T.F.D. Vrancken Peeters ,&nbsp;Caroline A. Drukker ,&nbsp;Frederieke H. van Duijnhoven ,&nbsp;Marleen Kok","doi":"10.1016/j.breast.2024.103726","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103726","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to evaluate the response to and surgical benefits of neoadjuvant endocrine therapy (NET) in ER+/HER2-breast cancer patients who are clinically high risk, but genomic low risk according to the 70-gene signature (MammaPrint).</p></div><div><h3>Methods</h3><p>Patients with ER+/HER2-invasive breast cancer with a clinical high risk according to MINDACT, who had a genomic low risk according to the 70-gene signature and were treated with NET between 2015 and 2023 in our center, were retrospectively analyzed. RECIST 1.1 criteria were used to assess radiological response using MRI or ultrasound. Surgical specimens were evaluated to assess pathological response. Two breast cancer surgeons independently scored the eligibility of breast conserving therapy (BCS) pre- and post- NET.</p></div><div><h3>Results</h3><p>Of 72 included patients, 23 were premenopausal (100% started with tamoxifen of which 4 also received OFS) and 49 were postmenopausal (98% started with an aromatase inhibitor). Overall, 8 (11%) showed radiological complete response. Only 1 (1.4%) patient had a pathological complete response (RCB-0) and 68 (94.4%) had a pathological partial response (RCB-1 or RCB-2). Among the 26 patients initially considered for mastectomy, 14 (53.8%) underwent successful BCS. In all 20 clinical node-positive patients, a marked axillary lymph node was removed to assess response. Four out of 20 (20%) patients had a pathological complete response of the axilla.</p></div><div><h3>Conclusion</h3><p>The study showed that a subgroup of patients with a clinical high risk and a genomic low risk ER+/HER2-breast cancer benefits from NET resulting in BCS instead of a mastectomy. Additionally, NET may enable de-escalation in axillary treatment.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103726"},"PeriodicalIF":3.9,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000572/pdfft?md5=867505bc41e17ebd169e0f211be78d48&pid=1-s2.0-S0960977624000572-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140539604","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}