Breast最新文献

{"title":"Neoadjuvant chemotherapy for radiation associated angiosarcoma (RAAS) of the breast: A retrospective single center study","authors":"Stijn J.C. van der Burg ,&nbsp;Sophie J.M. Reijers ,&nbsp;Anke Kuijpers ,&nbsp;Lotte Heimans ,&nbsp;Astrid N. Scholten ,&nbsp;Rick L.M. Haas ,&nbsp;Hester van Boven ,&nbsp;Willemijn M. Kolff ,&nbsp;Marie-Jeanne T.F.D. Vrancken Peeters ,&nbsp;Martijn Kerst ,&nbsp;Beatrijs A. Seinstra ,&nbsp;Neeltje Steeghs ,&nbsp;Winette T.A. van der Graaf ,&nbsp;Yvonne M. Schrage ,&nbsp;Winan J. van Houdt","doi":"10.1016/j.breast.2024.103825","DOIUrl":"10.1016/j.breast.2024.103825","url":null,"abstract":"<div><h3>Background</h3><div>Radiation associated angiosarcoma (RAAS) of the breast is a rare malignancy with poor survival. Optimal treatment strategies remain uncertain due to a lack of data, and vary between surgery alone and a combination of surgery with (neo)adjuvant chemotherapy (NACT) and/or re-irradiation. The aim of this study was to evaluate the potential benefit of taxane based NACT.</div></div><div><h3>Methods</h3><div>In this retrospective single center study, all patients with RAAS of the breast treated between 1994 and 2024 are included. Since 2018, NACT is considered a treatment option for this patient population in our institute. The difference in oncological outcomes of patients with and without NACT were compared.</div></div><div><h3>Results</h3><div>Thirty-five women were included. Thirteen (37 %) received NACT of which five (39 %) also had neoadjuvant re-irradiation with hyperthermia. Eleven patients (85 %) received paclitaxel, the other two (15 %) had doxorubicine/docetaxel. Complete pathological response was found in 69 % (n = 9). Median follow up was 41 months (range 24–56) for patients with NACT and 44 (range 20–108) for patients without NACT. In the NACT group, only one patient developed a recurrence after 6.5 years. Patients with NACT had improved oncological outcomes compared to patients without NACT in terms of 3-year local recurrence free survival (100% vs. 63.9 %, p = 0.14), distant metastasis free survival (100 % vs. 47.5 %, p = 0.005), and overall survival (100% vs. 56.1 %, p = 0.016).</div></div><div><h3>Conclusion</h3><div>In this study, neoadjuvant taxanes for RAAS of the breast leads to improved distant metastasis free survival and overal survival in patients treated with NACT compared to no NACT</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103825"},"PeriodicalIF":5.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543578","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":"Radiotherapy and increased risk of second primary cancers in breast cancer survivors: An epidemiological and large cohort study","authors":"Niuniu Hou ,&nbsp;Zhe Wang ,&nbsp;Yuwei Ling ,&nbsp;Guangdong Hou ,&nbsp;Bo Zhang ,&nbsp;Xue Zhang ,&nbsp;Mei Shi ,&nbsp;Zhuling Chu ,&nbsp;Yaoling Wang ,&nbsp;Jun Hu ,&nbsp;Chong Chen ,&nbsp;Rui Ling","doi":"10.1016/j.breast.2024.103824","DOIUrl":"10.1016/j.breast.2024.103824","url":null,"abstract":"<div><h3>Background</h3><div>Radiotherapy (RT) for breast cancer (BC) may raise the risk of second primary cancers (SPCs), a relationship inadequately studied.</div></div><div><h3>Methods</h3><div>We analyzed 248268 female BC patients from 9 SEER registries, 1988–2018, identifying SPCs &gt;5 years after initial treatment, comparing SPC risks between RT and non-RT cohorts using Fine-Gray and Poisson regressions.</div></div><div><h3>Results</h3><div>Of all participants, 55.4 % received surgery and RT. The RT group had a higher SPC incidence, with excess incidence significantly dropped from 6.9 % in 1990 to 0.2 % in 2012. The 30-year SPC incidence was 24.69 % in the RT cohort and 18.11 % in the NRT cohort. RT increased the risk of SPCs(HR, 1.29 [95%CI,1.26–1.33]; P &lt; 0.001), BC(HR, 1.58[1.52–1.64]; P &lt; 0.001), cancer of respiratory system(HR, 1.21[1.13–1.30]; P = 0.013), skin cancer(HR, 1.26[1.10–1.44]; P &lt; 0.001), leukemia(HR, 1.30[1.11–1.54]; P = 0.001), soft tissue cancer(HR, 1.78[1.34–2.37]; P &lt; 0.001), and eye &amp; orbit cancer(HR, 2.21[1.02–4.80]; P = 0.044), except for reducing the risk of multiple myeloma (HR 0.76). Notably, RT-related risks(RR) for BC declined with increasing age and the year of BC diagnosed, increased with longer latency, but the dynamic RR for cancer of respiratory system presented the almost opposite trends. The RT cohort had higher standardized incidence ratios for SPCs compared to both the NRT cohort and the general population overall. Although 15-year overall survival for SPCs was similar between RT and NRT cohorts, SPC presence significantly lowered 30-year survival from 35.64 % to 23.90 %.</div></div><div><h3>Conclusions</h3><div>RT might increase susceptibility to SPC in breast, respiratory system, skin, soft tissue, eye and orbit, and leukemia in BC survivors. Efforts should be made to timely diagnose SPCs based on their specific patterns to improve patient's quality of life.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103824"},"PeriodicalIF":5.7,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494877","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":"Did Michelangelo paint a young adult woman with breast cancer in “The Flood” (Sistine Chapel, Rome)?","authors":"Andreas G. Nerlich ,&nbsp;Johann C. Dewaal ,&nbsp;Antonio Perciaccante ,&nbsp;Laura Cortesi ,&nbsp;Serena Di Cosimo ,&nbsp;Judith Wimmer ,&nbsp;Simon T. Donell ,&nbsp;Raffaella Bianucci","doi":"10.1016/j.breast.2024.103823","DOIUrl":"10.1016/j.breast.2024.103823","url":null,"abstract":"<div><div><em>The Flood</em> is the first pictorial scene that Michelangelo Buonarroti painted on the ceiling of the Sistine Chapel in the Vatican. On the right side of the fresco a woman with abnormal breast morphology is presented and the nature of her disease is considered using the Guidelines for Iconodiagnosis. A team of experts covering art history, art expertise, medicine, genetics, and pathology undertook the process and concluded that the pathology shown is probably breast cancer, most likely linked to the symbolic significance of an inevitable death as expressed in the Book of Genesis.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103823"},"PeriodicalIF":5.7,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533644","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":"Nodal involvement in patients with small, clinically node-negative HER2-positive breast cancer after staging with FDG-PET/CT and neoadjuvant systemic therapy","authors":"Josefien P. van Olmen ,&nbsp;Veerle CM. Geurts ,&nbsp;Marie-Jeanne TFD. Vrancken Peeters ,&nbsp;Caroline A. Drukker ,&nbsp;Marcel PM. Stokkel ,&nbsp;Marleen Kok ,&nbsp;Frederieke H. van Duijnhoven","doi":"10.1016/j.breast.2024.103822","DOIUrl":"10.1016/j.breast.2024.103822","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines recommend systemic therapy for stage I HER2+ breast cancer (BC). Neoadjuvant systemic treatment (NAST) allows response-guided adjuvant treatment. However, prior to NAST only clinical nodal staging is available, risking undertreatment if ypN+ is observed. Here, we aim to evaluate the impact of FDG-PET/CT and NAST on nodal disease status in patients with small, node-negative HER2+ BC.</div></div><div><h3>Methods</h3><div>This retrospective study included patients with small (≤3 cm), clinically node-negative HER2+ BC diagnosed between 2011 and 2023. Primary outcome was the proportion of patients with nodal disease on final pathology after upfront surgery or NAST followed by surgery with or without FDG-PET/CT. Patients received either paclitaxel + trastuzumab (PT) or a more extensive regimen.</div></div><div><h3>Results</h3><div>Of the 370 included patients, 183 underwent FDG-PET/CT, detecting regional or distant metastases in 14 patients (7.7 %).</div><div>Among 356 patients with cN0 disease, 44.1 % (n = 157/356) had upfront surgery, with only 3 % (5/157) having an FDG-PET/CT. The remaining 55.9 % (199/356) started with NAST, with 82 % (n = 164/199) having an FDG-PET/CT. Among patients treated with NAST, 36 % received PT.</div><div>Nodal involvement on pathology was seen in 19.1 % (n = 29/152) after upfront surgery without FDG-PET/CT and 6.1 % (10/164) after NAST combined with FDG-PET/CT.</div><div>After NAST, 58 % had a pCR (PT: 49 %, other: 63 %). Nodal involvement on final pathology was seen in 6.9 % after PT and in 5.5 % after more extensive regimen.</div></div><div><h3>Conclusions</h3><div>The proportion of patients with ypN + after NAST combined with FDG-PET/CT was only 6.1 %. Neoadjuvant treatment can be a safe treatment strategy for patients with stage I HER2+ BC.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103822"},"PeriodicalIF":5.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494968","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 efficacy and safety of CDK4/6 inhibitors combined with endocrine therapy versus endocrine therapy alone in the adjuvant treatment of patients with high-risk invasive HR+/HER2-early breast cancer: A comprehensive updated meta-analysis of randomized clinical trials","authors":"Merve Keskinkilic ,&nbsp;Mehmet Emin Arayici ,&nbsp;Yasemin Basbinar ,&nbsp;Hulya Ellidokuz ,&nbsp;Tugba Yavuzsen ,&nbsp;Ilhan Oztop","doi":"10.1016/j.breast.2024.103815","DOIUrl":"10.1016/j.breast.2024.103815","url":null,"abstract":"<div><h3>Background</h3><div>This paper aimed to evaluate the effectiveness of incorporating CDK 4/6 inhibitors (CDK4/6i) into ET for the adjuvant treatment of HR + HER2-resected early-stage breast cancer (ESBC) patients, employing meta-analysis.</div></div><div><h3>Methods</h3><div>In this paper, we compiled randomized clinical trials focusing on CDK4/6i used in the adjuvant treatment of high-risk invasive HR-positive and HER2-ESBC patients. A meta-analysis was performed in line with the PRISMA guidelines.</div></div><div><h3>Results</h3><div>We identified four clinical trials that met our inclusion criteria and were published between 2020 and 2024. These trials involved a combined sample size of 17,749 patients diagnosed with breast cancer. The data obtained from the pooled analysis revealed a remarkable beneficial trend in terms of invasive disease-free survival (iDFS) for the use of ET in combination with CDK4/6i compared to the group receiving ET alone (HR = 0.81, 95 % CI: 0.67–0.98, <em>p</em> = 0.03). Of note, CDK4/6 inhibitors demonstrated a notably beneficial effect in both grade 2 (HR = 0.69, 95 % CI: 0.59–0.81, p &lt; 0.001) and grade 3 (HR = 0.76, 95 % CI: 0.65–0.89, p &lt; 0.001). Significant improvements were noted in terms of distant relapse-free survival (dRFS) in the groups treated with abemaciclib and ribociclib (HR = 0.65, 95 % CI: 0.56–0.76, <em>p</em> &lt; 0.001; HR = 0.72, 95 % CI: 0.58–0.89, <em>p</em> = 0.003, respectively). CDK4/6i didn't yield a statistically significant difference in overall survival (OS) (HR = 0.96, 95 % CI: 0.77–1.19, <em>p</em> = 0.69). The use of CDK4/6i with ET was associated with an increased risk of adverse events, particularly anemia and neutropenia, compared with ET alone (OR = 9.12, 95 % CI = 5.04–16.48, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The findings of this paper demonstrate a significant improvement in iDFS when ET is combined with CDK4/6i, compared to ET alone. Specifically, treatments with abemaciclib and ribociclib showed notable enhancements in dRFS.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103815"},"PeriodicalIF":5.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434103","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":"Chemotherapy in older patients with early breast cancer","authors":"Marcus Schmidt ,&nbsp;Sibylle Loibl","doi":"10.1016/j.breast.2024.103821","DOIUrl":"10.1016/j.breast.2024.103821","url":null,"abstract":"<div><div>The incidence of breast cancer increases with age. Particularly in ageing societies, breast cancer has a significant impact on both the older patient and the healthcare system. In older patients with early breast cancer, there is a complex interplay between (i) tumor biology, (ii) risk of recurrence, (iii) comorbidities, (iv) frailty, (v) life expectancy and (vi) patient expectations and preferences. Our treatment guidelines are often based on large meta-analyses that have shown that (neo)adjuvant chemotherapy improves the survival rate in early breast cancer in general. This is particularly important in triple-negative and HER2-positive breast cancer, but hormone receptor (HR)-positive, HER2-negative patients with a higher risk of recurrence also benefit from chemotherapy. However, most studies included younger and carefully selected patients. Since there is a positive correlation between age and estrogen receptor status, as well as between age and the number of concomitant diseases and the tolerability of chemotherapy, it is of great importance to evaluate the effects of additional (neo)adjuvant chemotherapy, especially in older patients with early-stage breast cancer. There are only a few studies in which only older patients with early breast cancer were included. On the whole, they show that older patients with HR-positive, HER2-negative tumors hardly benefit from chemotherapy in addition to endocrine therapy. In these patients, additional chemotherapy should be considered critically when weighing up the potential benefits and harms. However, this critical evaluation should not be confused with abandoning standard chemotherapy when it is feasible and clinically indicated based on geriatric assessment, risk assessment, and patient preference. The aim of our narrative review is to provide a concise overview of the evidence on chemotherapy in older women with breast cancer and place it in the context of geriatric assessment and risk evaluation in older HR-positive, HER2-negative patients with early breast cancer. This in turn should help to critically weigh up the risks and benefits of chemotherapy for the individual older patient with early-stage breast cancer, which should ultimately lead to more individualized and at the same time more evidence-based treatment recommendations that take into account the complex interplay of different and sometimes contradictory patient- and tumor-specific factors.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103821"},"PeriodicalIF":5.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434101","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":"Could macrocytosis predict survival In advanced breast cancer patients that were treated with CDK 4–6 inhibitors?","authors":"Ilkay Gültürk ,&nbsp;Rumeysa Colak ,&nbsp;Caner Kapar ,&nbsp;Murad Guliyev ,&nbsp;Cigdem Yıldırım ,&nbsp;Mesut Yilmaz","doi":"10.1016/j.breast.2024.103820","DOIUrl":"10.1016/j.breast.2024.103820","url":null,"abstract":"<div><h3>Introduction</h3><div>Cyclin Dependent Kinase (CDK) 4–6 inhibitors are the recommended first-line treatment option for hormone-positive metastatic breast cancer (MBC). They show their effects by causing cell cycle arrest in G1-S phase. Neutropenia is the most common haematological side effect. In the literature, data on the association between CDK 4–6 inhibitors and macrocytosis are limited. We aimed to investigate the effect of macrocytosis on survival.</div></div><div><h3>Methods</h3><div>We retrospectively analysed 133 patients with de novo hormone positive MBC using CDK 4–6 inhibitors in first line treatment. Mean Corpuscular Volume (MCV) &gt; 100 was considered macrocytosis and patients were divided into two groups; MCV&lt;100 and MCV &gt;100. The association of macrocytosis with clinicopathological features, Progression Free Survival (PFS) and Overall Survival (OS) were evaluated.</div></div><div><h3>Results</h3><div>42 patients were receiving palbociclib and 81 patients were receiving ribociclib. Median OS was determined as 33 months and median PFS was determined as 22 months. Macrocytosis ever rate was 45.8 % during follow-up. Macrocytosis was observed in 4.2 % of the patients in the first month, 16.7 % in the third month, 41.6 % in the sixth month and 42.2 % in the twelfth month. ER receptor level, ki-67, macrocytosis at 6–12 months and macrocytosis-ever which were found to affect OS as a result of univariate Cox regression analysis, were evaluated with multivariate Cox regression models and it was observed that they had significant effect on PFS and OS.</div></div><div><h3>Conclusion</h3><div>Macrocytosis may be a useful biomarker for the prediction of PFS and OS in MBC patients receiving CDK 4–6 inhibitors.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103820"},"PeriodicalIF":5.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434102","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 fractionation on secondary malignancies in postoperative breast cancer irradiation","authors":"Sophia Kiesl ,&nbsp;Mathias Düsberg ,&nbsp;Sophie T. Behzadi ,&nbsp;Rebecca Moser ,&nbsp;Jana Nano ,&nbsp;Thomas Huber ,&nbsp;Evelyn Klein ,&nbsp;Marion Kiechle ,&nbsp;Denise Bernhardt ,&nbsp;Stephanie E. Combs ,&nbsp;Kai J. Borm","doi":"10.1016/j.breast.2024.103819","DOIUrl":"10.1016/j.breast.2024.103819","url":null,"abstract":"<div><h3>Purpose</h3><div>Randomized studies demonstrated the oncological equivalence of (ultra-)hypofractionation compared to a 5-week schedule in postoperative radiotherapy of breast cancer. Due to the low incidence and long latency of secondary malignancies, there are currently no reliable clinical data regarding the influence of fractionation regimens on the development of secondary malignancies.</div></div><div><h3>Material and methods</h3><div>For 20 patients with right or left-sided breast cancer, postoperative treatment plans were created using 3D-CRT (n = 10) or VMAT (n = 10) for three different fractionation schedules: 5-week schedule with 50.4Gy in 1.8Gy (28fx), hypofractionation with 40.05Gy in 2.67Gy (15fx) and ultra-hypofractionation with 26Gy in 5.2Gy (5fx). The EARs (absolute additional cases of disease per 10,000 patient-years) for secondary malignancies in the lung, contralateral breast, esophagus, liver, thyroid, spinal cord, bones and soft tissue were calculated using a fraction-dependent dose-response model.</div></div><div><h3>Results</h3><div>Based on risk modulation, (ultra-)hypofractionation resulted in significantly lower EARs for lung cancer (LC), contralateral breast cancer (CBC) and soft tissue sarcoma (STS) (p &lt; .001). For the ultra-hypofractionated dose concept the median EARs for LC, CBC and STS were 42.8 %, 39.4 % and 58.1 % lower compared to conventional fractionation and 31.2 %, 25.7 % and 20.3 % compared to hypofractionation. The influence of fractionation on the risk of secondary malignancies for LC and CBC was less pronounced with 3D-CRT than with VMAT. For STS, however, the influence of fractionation was greater with 3D-CRT than with VMAT.</div></div><div><h3>Conclusion</h3><div>Based on this simulation study (ultra-)hypofractionated postoperative breast cancer irradiation may be associated with a lower risk of secondary malignancies compared to a 5-week schedule.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103819"},"PeriodicalIF":5.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387917","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":"Clinical significance of serum estradiol monitoring in women receiving adjuvant aromatase inhibitor for hormone receptor-positive early breast cancer","authors":"Shuqin Dai ,&nbsp;Xingping Wu ,&nbsp;Xuefang Huang ,&nbsp;Jibin Li ,&nbsp;Xi Wang ,&nbsp;Shusen Wang ,&nbsp;Jun Tang ,&nbsp;Yanxia Shi ,&nbsp;Xiaoming Xie ,&nbsp;Fei Xu ,&nbsp;Peng Liu ,&nbsp;Jiajia Huang ,&nbsp;Xinhua Xie ,&nbsp;Xin An ,&nbsp;Meiting Chen ,&nbsp;Rouxi Hong ,&nbsp;Wen Xia ,&nbsp;Qiufan Zheng ,&nbsp;Kuikui Jiang ,&nbsp;Yongyi Zhong ,&nbsp;Cong Xue","doi":"10.1016/j.breast.2024.103818","DOIUrl":"10.1016/j.breast.2024.103818","url":null,"abstract":"<div><h3>Purpose</h3><div>The limited understanding of long-term estradiol (E2) suppression poses challenges to the effectiveness of adjuvant therapy with aromatase inhibitors (AI), necessitating comprehensive serum E2 monitoring to address this issue. Therefore, our objective was to investigate serum E2 levels in women undergoing adjuvant AI treatment and evaluate the significance of such monitoring.</div></div><div><h3>Patients and methods</h3><div>In this prospective cohort study, we recruited women who had received adjuvant AI treatment, including those who underwent ovarian function suppression (OFS). Serum E2 levels were measured using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). The primary endpoint was the proportion of women with E2 levels exceeding 2.72 pg/mL, indicating inadequate suppression achieved with AI therapy.</div></div><div><h3>Results</h3><div>A total of 706 patients were enrolled, including 482 women with OFS in combination with AI. Among them, 116 women (16.4 %) exhibited E2 levels exceeding 2.72 pg/mL. The majority of serum E2 elevations (77.6 %) occurred within the first two years of initiating endocrine therapy. Younger age, no prior chemotherapy, shorter duration of the current treatment regimen, and lower follicle stimulating hormone (FSH) levels were associated with inadequate E2 suppression. Serum E2 concentrations demonstrated dynamic variations and occasional rebound following adjuvant AI therapy.</div></div><div><h3>Conclusions</h3><div>Despite receiving adjuvant AI treatment for nearly two years, a certain proportion of patients failed to achieve the adequate threshold of E2 suppression. Our findings emphasize the significance of monitoring serum E2 levels during adjuvant AI therapy, particularly within the first two years. Further research is imperative to facilitate a more comprehensive comprehension of E2 monitoring.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103818"},"PeriodicalIF":5.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364341","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":"Breast-cancer specific comprehensive archive of Patient-Reported Outcome Measures (PROMs) for clinical research and clinical practice in oncology: Results from the PRO4All project","authors":"Anna Amela Valsecchi ,&nbsp;Filippo Giovanardi ,&nbsp;Francesco Malandrini ,&nbsp;Michela Meregaglia ,&nbsp;Alberto Servetto ,&nbsp;Chiara Bennati ,&nbsp;Carmine Pinto ,&nbsp;Massimo Di Maio ,&nbsp;Oriana Ciani","doi":"10.1016/j.breast.2024.103817","DOIUrl":"10.1016/j.breast.2024.103817","url":null,"abstract":"<div><h3>Background</h3><div>Inclusion of patient-reported outcomes (PROs) in oncology clinical trials is strongly recommended. However, selecting the most appropriate patient-reported outcome measures (PROMs) is not easy. This study aimed to develop a breast cancer (BC) specific comprehensive archive of PROMs.</div></div><div><h3>Methods</h3><div>As part of the PRO4All project, we identified available PROMs in oncology by searching <span><span>facit.org</span><svg><path></path></svg></span>, <span><span>eortc.org</span><svg><path></path></svg></span>, <span><span>eprovide.mapi-trust.org</span><svg><path></path></svg></span>, PubMed, ema.europa.eu (European Public Assessment Reports) and published reviews. For this analysis, only BC tools were extracted. We described information about PROM name, type of questionnaire, questionnaire variant(s), recall period, number of items, and presence of minimum clinically important difference (MCID) reference in literature. Then, we assigned each item to a specific domain according to a predefined taxonomy of 38 items for outcome classification.</div></div><div><h3>Results</h3><div>We identified and analyzed 383 PROMs. Of these, 29 were BC specific, but 2 were excluded because the questionnaires description was not available. 6 (22.2 %) were variants of another questionnaire. All questionnaires were self-reported. In 6 cases (22.2 %) the recall period to consider was the “last week”. The mean number of items per questionnaire was 25.81 (range 6–71). 602 items were assigned to an outcome domain: emotional functioning/wellbeing in 26.6 % of cases, physical functioning in 14.1 %, delivery of care in 10.8 %, and general outcomes in 10.5 %. MCID reference was found only in 4 (14.8 %) cases.</div></div><div><h3>Conclusions</h3><div>The newly developed archive represents a useful tool to optimize the use of PROMs in the evaluation of treatments in BC patients, promoting a patient-centered approach both in clinical research and practice.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"78 ","pages":"Article 103817"},"PeriodicalIF":5.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370958","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}