Breast最新文献

{"title":"Identifying premenopausal patients with early-stage hormone receptor–positive breast cancer at minimal risk of distant recurrence by breast cancer index","authors":"Ruth M. O'Regan ,&nbsp;Yue Ren ,&nbsp;Yi Zhang ,&nbsp;Gini F. Fleming ,&nbsp;Prudence A. Francis ,&nbsp;Olivia Pagani ,&nbsp;Barbara A. Walley ,&nbsp;Roswitha Kammler ,&nbsp;Patrizia Dell’Orto ,&nbsp;Giuseppe Viale ,&nbsp;Sherene Loi ,&nbsp;Marco Colleoni ,&nbsp;Kai Treuner ,&nbsp;Meredith M. Regan","doi":"10.1016/j.breast.2026.104714","DOIUrl":"10.1016/j.breast.2026.104714","url":null,"abstract":"<div><h3>Background</h3><div>An adjusted Breast Cancer Index (BCI) model with an additional cutpoint identified postmenopausal women with hormone-receptor-positive node-negative disease at minimal (&lt;5%) risk of distant recurrence (DR) within 10 years.</div></div><div><h3>Methods</h3><div>2025 premenopausal patients with hormone-receptor-positive node-negative breast cancer, randomized to adjuvant endocrine therapy in SOFT and TEXT (35.6% and 40.4% received adjuvant chemotherapy, respectively), previously had BCI assessed. The additional BCI cutpoint re-classified a subset of the low-risk group into minimal-risk; those in intermediate- or high-risk groups were unchanged. The 10-year DR was estimated by Kaplan-Meier method.</div></div><div><h3>Results</h3><div>The adjusted BCI model re-classified 17.8 % and 19.6 % of node-negative disease in SOFT and TEXT into BCI minimal-risk groups; 43.2 % and 38.3 % remained classified in low-risk groups, respectively. In SOFT, the estimated 10-year DR was 2.3 % (95 %CI 0.9–6.0 %) and 4.1 % (95 %CI 2.6–6.5 %) in the minimal-risk and revised low-risk groups, respectively. In TEXT, the estimated 10-year DR was 2.0 % (95 %CI 0.7–6.2 %) and 4.6 % (95 %CI 2.8–7.7 %) in the minimal- and low-risk groups, respectively.</div></div><div><h3>Conclusions</h3><div>This study confirmed prognostic ability of the minimal-risk BCI cutpoint to classify patients estimated to have minimal-risk of distant recurrence within 10 years among premenopausal patients treated for hormone-receptor-positive node-negative breast cancer, providing relevant information for personalizing adjuvant endocrine therapy.</div></div><div><h3>Soft</h3><div>(<span><span>clinicaltrials.gov</span><svg><path></path></svg></span> NCT00066690)</div></div><div><h3>Text</h3><div>(<span><span>clinicaltrials.gov</span><svg><path></path></svg></span> NCT00066703)</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104714"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117864","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":"Letter to the Editor “Adjuvant ovarian function suppression and aromatase inhibitors in premenopausal patients with hormone receptor–positive, HER2-positive breast cancer”","authors":"Akshat Verma,&nbsp;Dileep Ramesh Hoysal,&nbsp;Amar Deshpande,&nbsp;Rajendra A. Badwe","doi":"10.1016/j.breast.2026.104716","DOIUrl":"10.1016/j.breast.2026.104716","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104716"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123828","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":"Global mammographic asymmetry and short-term breast cancer risk by breast density: a nationwide screening cohort of 5.5 million women","authors":"Sangjun Lee ,&nbsp;Soyeoun Kim","doi":"10.1016/j.breast.2026.104708","DOIUrl":"10.1016/j.breast.2026.104708","url":null,"abstract":"<div><div>Global mammographic asymmetry (GA) is generally considered benign, and its association with subsequent breast cancer risk is unclear. We examined whether GA on screening mammography predicts short-term and long-term breast cancer and whether this varies by Breast Imaging Reporting and Data System (BI-RADS) breast density. In this retrospective cohort study using the Korean National Health Insurance Service screening programme, we included women aged ≥40 years who underwent screening mammography in 2009–2010 and had no prior breast cancer. GA and BI-RADS density were recorded on baseline mammograms; incident invasive breast cancer through December 31, 2019 was ascertained from insurance claims. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) for breast cancer associated with GA overall and by BI-RADS density and follow-up interval (&lt;1, 1–2 and ≥2 years), adjusting for demographic, reproductive and lifestyle factors. Among 5,475,113 women, GA was present in 4.0 %. Overall, GA was associated with a modestly increased breast cancer risk (aHR 1.15; 95 % CI 1.11–1.19), strongest within 1 year of screening (aHR 1.90; 95 % CI 1.70–2.12). In women with BI-RADS 1 breasts, GA doubled overall risk (aHR 2.03) and quadrupled short-term risk (&lt;1 year: aHR 4.14), whereas in BI-RADS 4 breasts GA did not increase overall risk (aHR 0.94). GA is uncommon but identifies women at substantially elevated short-term breast cancer risk, particularly those with non-dense breasts, and has limited long-term prognostic value in extremely dense breasts. These findings support consideration of short-interval follow-up or supplemental imaging when GA is reported in non-dense breasts.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104708"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146075840","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":"Breast cancer risk in women with neurofibromatosis type 1: a register-based cohort study from Denmark and Sweden","authors":"Giorgio Tettamanti ,&nbsp;Annie Pedersen ,&nbsp;Maria Feychting ,&nbsp;Bianca Tesi ,&nbsp;Cecilie Ejerskov ,&nbsp;Mia Aagaard Doherty ,&nbsp;Emma Tham ,&nbsp;Anna Skarin Nordenvall ,&nbsp;Line Kenborg ,&nbsp;Ann Nordgren","doi":"10.1016/j.breast.2026.104717","DOIUrl":"10.1016/j.breast.2026.104717","url":null,"abstract":"<div><h3>Background</h3><div>An increased risk of breast cancer has been reported in women with neurofibromatosis type 1 (NF1), especially at younger ages, and NF1-related breast cancer has been associated with poor survival. We performed a large population-based cohort study to estimate the age-related breast cancer risk and survival in Danish and Swedish women with NF1.</div></div><div><h3>Patients and methods</h3><div>We used national registers to identify all women with a diagnosis of NF1 in Denmark and Sweden born between 1930 and 1990 (Denmark) or 1987 (Sweden). Age- and sex-matched comparisons were randomly selected from population registers. Cox proportional hazards models were used to study the association between NF1, breast cancer risk, and overall 5-year mortality after a breast cancer diagnosis.</div></div><div><h3>Results</h3><div>We included 2164 women with NF1 and 71 586 comparisons. A two-fold increased risk of breast cancer was observed in women with NF1 (hazard ratio (HR) 1.94, 95% confidence interval (CI) 1.59–2.36). The strongest association was observed in women between 30 and 39 years of age (HR = 3.98, 95% CI 2.16–7.32). Five-year mortality after a breast cancer diagnosis was higher in women with NF1 (HR = 1.98, 95% CI 1.31–2.99).</div></div><div><h3>Conclusions</h3><div>Our results suggest that although increased, the risk of breast cancer in women with NF1 is not as high as previously reported, particularly among young women. These findings add to previous data and will contribute to the gathered knowledge needed to accurately address the risk of breast cancer in women with NF1.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104717"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123808","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 mindfulness-based interventions on quality of life in women breast cancer survivors: a systematic review and meta-analysis","authors":"Paulo Gustavo Tenorio do Amaral ,&nbsp;Giuliano Tavares Tosello ,&nbsp;Pedro Paulo Silva Filho ,&nbsp;Eliana Aguiar Petri Nahas ,&nbsp;Daniel de Araujo Brito Buttros","doi":"10.1016/j.breast.2026.104701","DOIUrl":"10.1016/j.breast.2026.104701","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer survivors frequently experience acute and chronic psychological distress, which negatively affects quality of life. Mindfulness-based interventions have emerged as integrative supportive care strategies to improve psychosocial outcomes in this population.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of mindfulness practices compared with standard care in improving quality of life among women surviving breast cancer.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) including women aged ≥18 years at any breast cancer stage who had completed primary treatment, had no psychiatric disorders, and no previous mindfulness experience. Twelve RCTs met eligibility criteria, comprising 1620 participants—849 assigned to mindfulness interventions and 771 to standard care. Risk of bias was predominantly low across studies.</div></div><div><h3>Results</h3><div>Mindfulness-based interventions resulted in a small but statistically significant improvement in quality of life (SMD = 0.36; 95 % CI: 0.20 to 0.53). According to the GRADE approach, the certainty of evidence was rated as moderate due to moderate heterogeneity (I² = 59.9 %) and serious imprecision, although no publication bias was detected.</div></div><div><h3>Limitations</h3><div>Considerable heterogeneity across interventions and outcomes, the predominance of Mindfulness-Based Stress Reduction (MBSR) protocols, the limited inclusion of metastatic patients, and potentially attenuated benefits in individuals with early-stage disease may have influenced effect estimates.</div></div><div><h3>Conclusion</h3><div>Mindfulness practices are associated with meaningful improvements in quality of life in breast cancer survivors and, given their accessibility and applicability, may be recommended as part of comprehensive survivorship care.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104701"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006664","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":"Treatment patterns and clinical outcomes according to PD-L1 status in >2000 patients with early-stage or metastatic triple-negative breast cancer treated in the real-world setting: VANESSA study results","authors":"Lazar Popovic ,&nbsp;Romualdo Barroso-Sousa ,&nbsp;Nagi S. El Saghir ,&nbsp;Rebecca Dent ,&nbsp;Sitki Tuzlali ,&nbsp;Saad Akhtar ,&nbsp;Elona Juozaityté ,&nbsp;Janis Eglitis ,&nbsp;Dinesh C. Doval ,&nbsp;Carlos A. Castaneda ,&nbsp;Alisan Zirtiloglu ,&nbsp;Götz Hartleben ,&nbsp;Regula Deurloo ,&nbsp;Paula Toro ,&nbsp;Iman Estaytieh ,&nbsp;Enya Weber ,&nbsp;João Mouta ,&nbsp;Corrado D’Arrigo","doi":"10.1016/j.breast.2026.104720","DOIUrl":"10.1016/j.breast.2026.104720","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic effect of PD-L1 status in triple-negative breast cancer (TNBC) is uncertain and little is known about PD-L1-positive prevalence and outcomes in the real-world setting.</div></div><div><h3>Patients and methods</h3><div>The multicentre retrospective observational VANESSA study evaluated the prevalence and impact of PD-L1-positive status in 2054 patients receiving systemic therapy for early-stage or metastatic (e/m)TNBC between 2014 and 2017. PD-L1 expression was assessed locally and centrally on archival samples. Descriptive analyses of demographic and clinicopathological characteristics, treatment patterns and clinical outcomes (extracted from patients’ medical records) according to PD-L1 status were prespecified.</div></div><div><h3>Results</h3><div>Among 1902 patients with eTNBC, 681 (36%) received neoadjuvant chemotherapy and 1261 (66%) adjuvant chemotherapy. Demographic characteristics were generally similar regardless of PD-L1 status, but lower-risk tumour characteristics were more common in the PD-L1-positive subgroup. Invasive disease-free and overall survival were more favourable in PD-L1-positive eTNBC. In the mTNBC cohort, 120/145 (83%) patients had de novo mTNBC. Median progression-free survival on first-line treatment was 7.6 months (95% CI: 4.1–15.0) in PD-L1-positive mTNBC (n = 30) and 4.9 months (95% CI: 3.6–6.1) in PD-L1-negative mTNBC (n = 83).</div></div><div><h3>Conclusion</h3><div>In eTNBC and mTNBC, PD-L1-positive status was associated with more favourable long-term outcomes, possibly due to tumour-intrinsic characteristics and/or the host immune response. The high proportion with de novo mTNBC may suggest enrolment bias and/or geographic variations in stage at diagnosis.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104720"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164095","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":"Predicting progression-free survival in hormone-receptor positive (HR+/HER2–) metastatic breast cancer (MBC) treated with CDK4/6 inhibitors: A machine learning approach","authors":"Sergio Pannunzio ,&nbsp;Luca Mastrantoni ,&nbsp;Noemi Maliziola ,&nbsp;Letizia Pontolillo ,&nbsp;Giovanna Garufi ,&nbsp;Elena Di Monte ,&nbsp;Alessandra Emiliani ,&nbsp;Margherita Sgambato ,&nbsp;Anna Cardillo ,&nbsp;Antonella Palazzo ,&nbsp;Armando Orlandi ,&nbsp;Giampaolo Tortora ,&nbsp;Emilio Bria","doi":"10.1016/j.breast.2026.104715","DOIUrl":"10.1016/j.breast.2026.104715","url":null,"abstract":"<div><h3>Background</h3><div>In HR+/HER2– metastatic breast cancer (MBC), CDK4/6 inhibitors combined with endocrine therapy (ET) significantly improve progression-free survival (PFS). Machine learning (ML) approaches may improve individualized progression risk estimation.</div></div><div><h3>Methods</h3><div>We retrospectively analysed HR+/HER2– MBC patients treated with first-line CDK4/6i plus ET to develop CoxNet regression and Gradient Boosting Machine (GBM) models from baseline clinicopathological features. The primary endpoint was PFS prediction. The dataset was split into a 70/30 train/validation set. Performance was assessed by Harrell's C-index (1000 bootstrap replicates). Risk stratification was performed using Gaussian Mixture Modeling (GMM) to define high- and low-risk groups. Cox regression estimated the corresponding hazard ratios (HR). Early progression at 6 months (EP) prediction was evaluated using the area under the receiver operating characteristic curve (AUROC).</div></div><div><h3>Results</h3><div>459 patients were included, with a median follow-up of 43.7 months (95% CI 39.6–48.3). Median PFS was 29.3 months (95% CI 24.0–33.7). Both ML models achieved strong predictive performance, with a Harrell's C-index of 0.74 (95% CI 0.67–0.80) in the validation set. The main predictors were liver metastases, Ki67 expression, and primary endocrine resistance. Stratification defined two risk groups with significantly different PFS in the validation set (HR 2.58, 95% CI 1.65–4.03, p = 3.3 × 10⁻⁵). Median PFS was 34.8 (95%CI 24.0–52.4) in the low-risk and 10.6 (95%CI 7.7–14.6) in the high-risk group. For EP prediction, the model achieved an AUROC of 0.77 (95% CI 0.61–0.89).</div></div><div><h3>Conclusions</h3><div>This study supports the clinical applicability ML models using baseline clinicopathological variables for individualized risk stratification in HR+/HER2– MBC.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104715"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117853","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":"Association between body mass index and risk of breast cancer according to breast cancer subtypes: A systematic review and meta-analysis","authors":"Chiara Dauccia ,&nbsp;Marco Bruzzone ,&nbsp;Luca Arecco ,&nbsp;Eva Blondeaux ,&nbsp;Marianna Sirico ,&nbsp;Riccardo Gerosa ,&nbsp;Maria Alice Franzoi ,&nbsp;Mariana Brandão ,&nbsp;Lorenzo Perrone ,&nbsp;Paolo Pedrazzoli ,&nbsp;Christine Desmedt ,&nbsp;Serena Di Cosimo ,&nbsp;Claudio Vernieri ,&nbsp;Laetitia Collet ,&nbsp;Matteo Lambertini ,&nbsp;Evandro de Azambuja ,&nbsp;Elisa Agostinetto","doi":"10.1016/j.breast.2026.104710","DOIUrl":"10.1016/j.breast.2026.104710","url":null,"abstract":"<div><h3>Background</h3><div>Higher body mass index (BMI) is a risk factor for breast cancer (BC) development, but the relationship with BC subtypes in pre- and post-menopausal women remains unclear.</div></div><div><h3>Methods</h3><div>We performed a systematic search from PubMed, Embase and Cochrane databases until 09/24 (CRD42020206108) for cohort and case-control studies assessing the association between BMI and BC subtypes and/or menopausal status. BC risk in overweight (BMI 25–29.9 kg/m²) or obese (BMI≥30 kg/m²) subjects was compared to risk in under/normal weight (BMI&lt;25 kg/m²). BC subtypes were classified as i) ER-positive (regardless HER2-status) ii) ER-negative (regardless HER2-status) iii) HER2-positive (regardless ER-status); iv) triple-negative BC (TNBC).</div></div><div><h3>Results</h3><div>Out of 2841 records screened, 33 studies (9 cohort and 24 case-control) including 2,103,181 women were eligible. Obesity was associated with a modestly increased risk of ER-positive BC (pOR 1.13; 95 % CI 1.03–1.24). In postmenopausal women, obesity was associated with a moderate higher risk of ER-positive BC (pOR 1.29; 95 % CI 1.18–1.41), while overweight was associated with an increased risk of ER-positive (pOR 1.14; 95 % CI 1.06–1.22) and HER2-positive BC (pOR 1.13; 95 % CI 1.05–1.22). In premenopausal women, overweight was linked with reduced risk of ER-positive (pOR 0.80 95 % CI 0.71–0.91) but increased risk of ER-negative BC (pOR 1.15 95 % CI 1.05–1.26) and TNBC (pOR 1.30; 95 % CI 1.15–1.47).</div></div><div><h3>Conclusions</h3><div>Obesity was associated with a modestly higher risk of ER-positive BC, driven by postmenopausal status. Considering potential confounders, in premenopausal women, higher BMI was associated with lower risk of ER-positive BC, and an increased risk of ER-negative BC.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104710"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131250","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":"“You're really walking along the razor's edge”: A meta-synthesis on the existential cost of breast cancer related to financial toxicity","authors":"Sara Paltrinieri ,&nbsp;Margherita Schiavi ,&nbsp;Barbara Bressi ,&nbsp;Angela Contri ,&nbsp;Martina Torreggiani ,&nbsp;Laura Bernardi ,&nbsp;Elisa Mazzini ,&nbsp;Maria Chiara Bassi ,&nbsp;Silvia di Leo ,&nbsp;Luca Ghirotto ,&nbsp;Stefania Costi","doi":"10.1016/j.breast.2026.104705","DOIUrl":"10.1016/j.breast.2026.104705","url":null,"abstract":"<div><div>Cancer-related financial toxicity (FT) is a challenge of living with and beyond breast cancer (BC). A systematic review and meta-synthesis was conducted to report the experience of individuals with BC regarding cancer-related FT. Data were searched in MEDLINE, Embase, Cinahl, Scopus, PsycINFO, and Web of Science from inception. Eligibility was restricted to original qualitative studies. We performed a meta-synthesis by generating interpretative themes and a model of cancer-related FT. Thirty-two studies were included, encompassing 1080 individuals with BC. Of these studies, 17 were conducted in North America (719 individuals), nine in South, East, and West Asia (238 individuals), two in Oceania (53 individuals), and four in Northwest Africa (70 individuals). Five themes were identified: (i) the existential cost of cancer, (ii) the impact of insurance complexity, (iii) the need for timely and accessible information, (iv) seeking possible help, (v) negotiating daily life. The review highlights the lack of original qualitative studies conducted in Europe. Socioeconomic status, insurance, and employment amplify inequalities and shape the experience of FT. The interpretative model could support individuals with BC and providers’ communication.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104705"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037359","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":"Large-scale DNA organization analysis of primary breast cancers for prediction of axillary lymph node metastases","authors":"Nikolay Alabi ,&nbsp;Alan Nichol ,&nbsp;Fumiya Inaba ,&nbsp;Anita Carraro ,&nbsp;Soufiane El-Hallani ,&nbsp;Martial Guillaud","doi":"10.1016/j.breast.2026.104712","DOIUrl":"10.1016/j.breast.2026.104712","url":null,"abstract":"<div><div>Breast cancer is the leading cause of cancer-related deaths among women worldwide. It is standard practice for patients to undergo a sentinel lymph node biopsy (SLNB) with breast surgery for staging. However, more than 60% of patients with primary operable breast cancers do not have axillary lymph node metastases. Hence, most patients risk complications from SLNB, but do not benefit. There has been considerable research into non-invasive methods for axillary lymph node staging, but few are externally validated. We hypothesized that a new method using large-scale DNA organization (LDO) analysis on a biopsy of the breast primary could predict axillary metastases. LDO, which measures various nuclear characteristics such as the size, shape, and chromatin texture, has been correlated with a variety of clinical outcomes in different cancers, including survival in breast cancer. In this study, we determined that Random Forest models performed best for LDO analysis. On an external test set, our models using LDO features alone achieved an area under the curve (AUC) = 0.711 and clinicopathological features alone achieved AUC = 0.741. Our best and final model using LDO and clinicopathological features together achieved AUC = 0.775. We identified several LDO features that were important for predicting axillary lymph node metastases, including nuclear radius and staining intensity. We present the first histologically-based, externally-validated, and explainable machine learning model capable of predicting axillary lymph node metastases preoperatively.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104712"},"PeriodicalIF":7.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117929","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}