Breast最新文献

{"title":"HER2 testing in multifocal/multicentric breast cancer: should all foci be tested in the context of HER2-low and HER2-ultralow?","authors":"Si Wu ,&nbsp;Hongbo Liu ,&nbsp;Tianyu Wang,&nbsp;Jiaxian Miao,&nbsp;Jiamei Zhuan,&nbsp;Zhongze Cui,&nbsp;Meng Yue,&nbsp;Kun Wang,&nbsp;Jinze Li,&nbsp;Mengxue Han,&nbsp;Wenhan Hu,&nbsp;Xiaoxiao Wang,&nbsp;Yueping Liu","doi":"10.1016/j.breast.2025.104572","DOIUrl":"10.1016/j.breast.2025.104572","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines for HER2 testing in multifocal and multicentric breast cancer (MMBC) are typically based only on the evaluation of the main focus, which may lead to underdetection of HER2-low and HER2-ultralow, potentially resulting in missed treatment opportunities with trastuzumab deruxtecan. Therefore, this study aimed to evaluate the heterogeneity of HER2 expression among different foci in MMBC and to assess the clinical applicability of current HER2 testing strategies.</div></div><div><h3>Methods</h3><div>A retrospective collection of all invasive cancer foci specimens was conducted from 490 consecutive MMBC patients, with HER2 testing and evaluation performed on each individual focus.</div></div><div><h3>Results</h3><div>In the binary classification of HER2-negative and HER2-positive cases, 4.0 % of cases exhibited HER2 discordance among different foci, and in 2.5 % of cases, the main focus did not show the highest HER2 expression. However, when HER2-negative cases were further subdivided into HER2-null, HER2-ultralow, and HER2-low, 23.7 % of cases demonstrated HER2 heterogeneity among different foci, and in 12.0 % of cases, the main focus failed to present the highest HER2 expression. And no statistically significant correlation was observed between clinicopathological characteristics and the lack of highest HER2 expression in the main focus. Additionally, cases in which all foci were HER2-null accounted for only 11.0 %.</div></div><div><h3>Conclusion</h3><div>In MMBC, significant intertumoral heterogeneity exists in the low levels of HER2 expression across different foci. Therefore, it is essential to perform HER2 testing on all foci, regardless of similarities in histological subtype or grade.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104572"},"PeriodicalIF":7.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085077","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":"Capacity and cost benefits of subcutaneous versus intravenous pertuzumab/trastuzumab: The EASE-SC study","authors":"Michiel Zietse ,&nbsp;Jacky Hu ,&nbsp;Esther R. van Staveren ,&nbsp;Leontine E.A.M.M. Spierings ,&nbsp;Agnes Jager ,&nbsp;Birgit C.P. Koch ,&nbsp;Ron H.J. Mathijssen ,&nbsp;Roelof W.F. van Leeuwen ,&nbsp;Frederick W. Thielen","doi":"10.1016/j.breast.2025.104573","DOIUrl":"10.1016/j.breast.2025.104573","url":null,"abstract":"<div><h3>Objectives</h3><div>Subcutaneous administration of pertuzumab and trastuzumab offers a faster alternative to intravenous infusion for patients with HER2-positive breast cancer. However, real-world data on its impact on costs and capacity remain limited. Therefore, this study aimed to compare healthcare resource utilization and costs associated with subcutaneous versus intravenous administration of pertuzumab and trastuzumab from a societal perspective.</div></div><div><h3>Methods</h3><div>This study was conducted at two Dutch hospitals. Observational data were collected on drug preparation, administration times, and resource use for both formulations. Patient questionnaires assessed societal costs, including travel expenses and productivity losses. Costs were calculated for patient chair time, healthcare professional time, disposables, societal expenses, and drug costs. A nationwide impact analysis estimated potential capacity and productivity gains from switching from intravenous to subcutaneous administration across the Netherlands.</div></div><div><h3>Results</h3><div>Subcutaneous administration reduced patient chair time compared to intravenous administration, by an average of 106 min (85.5%) for maintenance doses (from 124.3 to 18.1 min) and 287 min (96.0%) for loading doses (from 299.0 to 12.0 min). Active healthcare professional time decreased by 17 min (54.1%) for maintenance doses and 25 min (66.7%) for loading doses. Drug administration costs (excluding drug costs) were lower subcutaneous administration saved approximately €172 per maintenance dose and €403 per loading dose. Nationwide adoption could create capacity for around 22,000 additional treatments annually and save 4.0 full-time equivalent healthcare professionals.</div></div><div><h3>Conclusion</h3><div>Switching from intravenous to subcutaneous pertuzumab/trastuzumab administration substantially reduces healthcare resource use and may offer cost savings, supporting more efficient delivery of HER2-targeted therapies.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104573"},"PeriodicalIF":7.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079779","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":"Artificial intelligence and radiomics biomarkers for treatment response prediction in advanced HER2-negative breast cancer","authors":"Laurent Dercle ,&nbsp;Jeremy McGale ,&nbsp;Binsheng Zhao ,&nbsp;Julia Schmitt ,&nbsp;Alexander Peltzer ,&nbsp;Lawrence H. Schwartz ,&nbsp;Mario Amend","doi":"10.1016/j.breast.2025.104571","DOIUrl":"10.1016/j.breast.2025.104571","url":null,"abstract":"<div><h3>Study Aim</h3><div>Despite the development of novel therapies, breast cancer mortality remains high. Improved treatment response assessment tools are needed. We aimed to test the transferability of externally validated AI/radiomics biomarkers for predicting treatment response in advanced, hormone receptor-positive (HR+), HER2-breast cancer treated with xentuzumab, exemestane, and everolimus.</div></div><div><h3>Methods</h3><div>Patient data from a phase Ib/II trial (May 2014–October 2016) were analyzed retrospectively. Eight imaging biomarkers (liver and overall tumor volume, two radiomics features representing tumor heterogeneity at both baseline and week 8) were validated for predicting clinical benefit using AUC analysis. An ancillary AI analysis developed a signature for predicting best overall response using 40 variables (3 clinical and 37 imaging) in the same cohort.</div></div><div><h3>Results</h3><div>Of 106 patients with data available for analysis, 28 had no clinical benefit from treatment (Group A) vs. 78 with clinical benefit (Group B). Seven of eight imaging biomarkers demonstrated significant predictive value. Participants in Group B exhibited significantly lower baseline and follow-up measures of liver and overall tumor volume, alongside marked changes in tumor heterogeneity by week 8. In our ancillary AI/radiomics model, the dominant drivers of prediction were changes in both liver tumor and overall tumor volume during treatment and the number of osteoblastic lesions on baseline bone scans.</div></div><div><h3>Conclusion</h3><div>This cross-cancer proof-of-concept testing study supports the feasibility of applying multimodal AI/radiomics biomarkers to predict treatment response in advanced HR+, HER2− breast cancer, laying the foundation for broader pancancer and pantreatment applications pending further validation.</div></div><div><h3>Clinical trial registration number</h3><div>NCT02123823</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104571"},"PeriodicalIF":7.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102570","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":"Palbociclib treatment in patients with HR+/HER2− advanced or metastatic breast cancer and visceral metastasis: A systematic literature review","authors":"Julia C. Radosa ,&nbsp;Sara López-Tarruella Cobo ,&nbsp;Johanna Dzieran ,&nbsp;Esther Glastetter ,&nbsp;Connie Chen ,&nbsp;Melissa Lingohr-Smith ,&nbsp;Vinay Pasupuleti ,&nbsp;Adam Brufsky","doi":"10.1016/j.breast.2025.104569","DOIUrl":"10.1016/j.breast.2025.104569","url":null,"abstract":"<div><h3>Background</h3><div>Visceral metastasis is prevalent among patients with advanced/metastatic breast cancer (ABC) and is a prognostic indicator of poor survival. We conducted a systematic literature review of the evidence for palbociclib plus endocrine therapy (ET) in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−) ABC and visceral metastasis.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, Cochrane Library, and relevant conference proceedings were searched through September 2023. Phase 2/3 randomized clinical trials (RCTs) and real-world evidence (RWE) studies evaluating efficacy/effectiveness, safety, and health-related quality-of-life (QoL) of palbociclib plus ET were included.</div></div><div><h3>Results</h3><div>Qualitative synthesis was conducted on 70 articles; 24 reported results from 8 RCTs; 46 were RWE studies. Data from &gt;10,000 patients with visceral metastasis treated with palbociclib were included. All RCTs and RWE studies (5 each) that assessed palbociclib plus ET versus ET alone in patients with HR+/HER2− ABC and visceral metastasis showed significant reduction in risk of disease progression and/or death with palbociclib plus ET (34 %–50 % reduction in RCTs; 31 %–47 % in RWE studies). In RCTs, overall survival was not significantly different between the treatment groups; however, 4 of 5 RWE studies showed a significant benefit (36 %–42 % reduced risk of death) with palbociclib plus ET. Although data for other outcomes were limited, palbociclib plus ET was generally safe and well tolerated while QoL was maintained.</div></div><div><h3>Conclusion</h3><div>Both RCTs and RWE studies consistently showed that palbociclib plus ET is efficacious/effective in patients with HR+/HER2− ABC and visceral metastasis; further research is warranted focused on safety, tolerability, and QoL in this patient group.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104569"},"PeriodicalIF":7.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047908","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":"Survival of patients with squamous cell carcinoma of the breast compared with invasive ductal carcinoma by biological subtype: A matched analysis of the Japanese national clinical database-breast cancer registry","authors":"Mami Ogita ,&nbsp;Hiraku Kumamaru ,&nbsp;Makoto Kubo ,&nbsp;Naoko Kinukawa ,&nbsp;Naoki Niikura ,&nbsp;Shigehira Saji ,&nbsp;Masakazu Toi","doi":"10.1016/j.breast.2025.104567","DOIUrl":"10.1016/j.breast.2025.104567","url":null,"abstract":"<div><h3>Purpose</h3><div>Owing to the rarity of primary squamous cell carcinoma (SCC) of the breast, the prognosis of SCC remains uncertain. We aimed to investigate the clinical features and prognosis of breast SCC by subtype.</div></div><div><h3>Methods</h3><div>A total of 350,977 patients with breast SCC or invasive ductal carcinoma (IDC) were identified from the National Clinical Database-Breast Cancer Registry from 2004 to 2014. SCC and IDC patients with triple-negative and luminal subtypes were matched 1:1 via exact matching. Overall survival (OS), breast cancer-specific survival (BCSS), and recurrence-free survival (RFS) were compared between patients with SCC and those with IDC. In-field area recurrence was analyzed among patients who received adjuvant radiotherapy.</div></div><div><h3>Results</h3><div>The study included 452 SCC patients and 182,707 IDC patients. SCC patients were more likely than IDC patients to have advanced-stage disease. The crude 10-year OS, BCSS, and RFS were 70 %, 80 %, and 66 % for patients with SCC, and 88 %, 93 %, and 81 % for patients with IDC, respectively. After 204 patients with the triple-negative subtype and 68 patients with the luminal subtype in each group were matched, the 10-year BCSS was significantly worse for SCC (76.7 %) than for IDC (85.5 %) within the triple-negative subtype. There were no differences in OS, BCSS, or RFS for the luminal subtype. The rates of in-field area recurrence were similar between patients with SCC and those with IDC with either the triple-negative subtype or the luminal subtype.</div></div><div><h3>Conclusions</h3><div>Within the triple-negative subtype, SCC histology was associated with a significantly worse prognosis than IDC.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104567"},"PeriodicalIF":7.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925247","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":"Baseline neutrophil-lymphocyte ratio (NLR) predicts toxicity and survival in HR+/HER-2 breast cancer patients treated with CDK4/6 inhibitors","authors":"Omar Badran ,&nbsp;Ali Darawshe ,&nbsp;Sireen Sharif ,&nbsp;Samih Yosef ,&nbsp;Gil Bar-Sela","doi":"10.1016/j.breast.2025.104568","DOIUrl":"10.1016/j.breast.2025.104568","url":null,"abstract":"<div><div>The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that has been associated with prognosis in various malignancies. Its role in predicting toxicity and survival in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer treated with cyclin-dependent kinase 4/6 (CDK4/6) inhibitors remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 2218 patients with HR+/HER2− metastatic breast cancer treated with palbociclib or ribociclib between 2017 and 2024, using data from Israel's largest health maintenance organization. We compared baseline NLR values between patients who developed grade 4 neutropenia (absolute neutrophil count &lt;0.5 × 10⁹/L) and those with higher counts during the first three months of treatment. Additional comparisons were conducted using different neutropenia thresholds. We also assessed the association between baseline NLR (cut-off 2.5), progression-free survival (PFS), and treatment-related adverse events.</div></div><div><h3>Results</h3><div>Patients with grade 4 neutropenia had significantly higher baseline NLR values compared to those with higher neutrophil counts. The effect size was large in all comparisons. Patients with an NLR of ≥2.5 had a shorter median progression-free survival (PFS) than those with an NLR of &lt;2.5. Hepatotoxicity was more frequently observed in patients with NLR &lt;2.5, while the incidence of dermatologic adverse events was similar across groups.</div></div><div><h3>Conclusions</h3><div>Elevated baseline NLR is associated with an increased risk of severe neutropenia and shorter progression-free survival in patients treated with CDK4/6 inhibitors. These findings highlight a potential link between systemic inflammation and treatment outcomes, suggesting that NLR may be a valuable predictive biomarker in this setting.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104568"},"PeriodicalIF":7.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931803","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":"Denosumab versus zoledronic acid in metastatic breast cancer: A retrospective observational analysis of 24-dose regimens on analgesia and skeletal-related event prevention","authors":"Giacomo Massa ,&nbsp;Noemi Simeone ,&nbsp;Gabriele Tinè ,&nbsp;Paola Bracchi ,&nbsp;Rosalba Miceli ,&nbsp;Alessandra Pigni ,&nbsp;Silvia Lo Dico ,&nbsp;Luca Zambelli ,&nbsp;Francesca Ricchini ,&nbsp;Giulia Valeria Bianchi ,&nbsp;Augusto Caraceni ,&nbsp;Ernesto Zecca","doi":"10.1016/j.breast.2025.104565","DOIUrl":"10.1016/j.breast.2025.104565","url":null,"abstract":"<div><h3>Background</h3><div>Based on available data in the literature, current evidence supporting the analgesic role of antiresorptive drugs is weak. This study compared the efficacy of zoledronic acid (ZA) and denosumab (Dmab) in reducing bone pain and first Skeletal Related Events (SREs) in real world setting.</div></div><div><h3>Methods</h3><div>A retrospective observational cohort study was conducted in patients with female breast cancer-related bone metastases at the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan, Italy, from January 2008 to January 2023. Patients were included if they had undergone at least 24 consecutive administrations of ZA or Dmab. The primary endpoint was the analgesic effect, evaluated in terms of average pain intensity, analgesic drug use (Word Health Organization analgesic ladder), and daily opioid doses (oral morphine equivalent, OME) assessed at 3, 6, 12, 18, and 24 months, analyzed by Bayesian longitudinal mixed-effects models. Secondary endpoints included first SREs and radiotherapy/surgery incidence.</div></div><div><h3>Results</h3><div>Among 364 patients (194 ZA, 170 Dmab), Dmab demonstrated a significant analgesic advantage. Dmab group showed an 89 % lower likelihood of increasing one analgesic ladder step, a mean reduction of 0.4 points on the numerical rating scale (95 % CI, −0.7, −0.1), and lower daily OME doses (0.77 mg vs. 6.2 mg for ZA). At 12 and 24 months, ZA and Dmab showed similar cumulative incidences of SREs and radiotherapy/surgery (p = 0.601 and p = 0.923).</div></div><div><h3>Conclusions</h3><div>Dmab showed consistent superior effect than ZA in reducing bone pain in metastatic BC, yet both treatments delivered similar protection against SREs and the need for radiotherapy or surgery.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104565"},"PeriodicalIF":7.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931802","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":"Cost-effectiveness of genetic risk-stratified screening for breast cancer in Taiwan","authors":"Yu-Chen Hou ,&nbsp;Fang-Ju Lin ,&nbsp;Yu-Hsuan Joni Shao","doi":"10.1016/j.breast.2025.104566","DOIUrl":"10.1016/j.breast.2025.104566","url":null,"abstract":"<div><h3>Background</h3><div>Risk-stratified breast screening has gained international attention, as individualized risk assessments can inform screening initiation, frequency, and whether to screen. In this study, we evaluated the cost-effectiveness of risk-stratified screening based on genetic testing for breast cancer-associated single nucleotide polymorphisms (SNPs) compared to the current age-based screening program in Taiwan.</div></div><div><h3>Methods</h3><div>A Markov model was used to estimate lifetime health outcomes and costs for 35-year-old Taiwanese women without a family history of breast cancer. The model adopted the healthcare payer's perspective, applied a 3 % annual discount rate, and utilized epidemiological and cost data primarily derived from Taiwanese sources whenever possible. Scenario analyses included various percentile thresholds used to define polygenic risk groups in the risk-stratified screening strategy. Within this strategy, no screening was modeled for women in the low-risk group, while those in the intermediate- and high-risk groups were offered standard biennial mammography, beginning at ages 40 and 35, respectively, and continuing until 69.</div></div><div><h3>Results</h3><div>Compared to the current age-based mammogram-only screening, polygenic risk scores (PRS)-informed risk-stratified breast cancer screening generated additional costs and quality-adjusted life years (QALYs), with an incremental cost-effectiveness ratio (ICER) of US$75.71/QALY. Scenario analyses using different PRS cutoffs consistently yielded ICERs well below one time Taiwan's gross domestic product per capita per QALY, suggesting cost-effectiveness of genetic risk-stratified screening.</div></div><div><h3>Conclusion</h3><div>Incorporating polygenic risk into the current breast cancer screening program may improve health outcomes at an acceptable cost. These findings support implementing risk-stratified screening in future policy.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104566"},"PeriodicalIF":7.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018483","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":"Artificial intelligence as treatment support in breast cancer: current perspectives","authors":"Stefan Lukac ,&nbsp;Florian Putz ,&nbsp;Giacomo De Micheli ,&nbsp;Chiara Corti ,&nbsp;Wolfgang Janni ,&nbsp;Sara M. Tolaney ,&nbsp;Giuseppe Curigliano ,&nbsp;Sibylle Loibl ,&nbsp;Paolo Tarantino ,&nbsp;Jose Pablo Leone","doi":"10.1016/j.breast.2025.104564","DOIUrl":"10.1016/j.breast.2025.104564","url":null,"abstract":"<div><div>With the increasing amount of information related to breast cancer (BC) management, artificial intelligence (AI) has emerged as a tool with the potential to enhance the quality of treatment through the efficient integration of large datasets; however, the specific areas for which AI may be ready for clinical implementation remain unclear. In this narrative review, we recapitulate the available data on AI utilization in BC treatment by focusing on surgical therapy, radiation therapy, systemic and supportive treatment, but including the diagnostics, too. While AI has been implemented successfully in mammography screening, preoperative consultation, and radiation oncology, its use intraoperatively, post-operatively, and in systemic and supportive treatment is still in development. AI has potential to improve care, but since the accuracy of AI varies, careful consideration of its benefits and limitations is necessary.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104564"},"PeriodicalIF":7.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908558","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":"Development and validation of a predictive model for disease-free progression in triple-negative breast cancer: A retrospective study using color Doppler ultrasound and magnetic resonance imaging","authors":"Fan Li ,&nbsp;Huan-huan Yan ,&nbsp;Ben-kai Wei ,&nbsp;Jun Shen","doi":"10.1016/j.breast.2025.104560","DOIUrl":"10.1016/j.breast.2025.104560","url":null,"abstract":"<div><h3>Objective</h3><div>Because triple-negative breast cancer has a poor prognosis, adjuvant intensive therapy can effectively improve its prognosis. How to make accurate decisions is lacking of research.This study aimed to develop and validate a model to predict disease-free progression in triple-negative breast cancer (TNBC) using breast color Doppler ultrasound and magnetic resonance imaging (MRI), to facilitate precision in clinical intervention.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on data from 380 individuals with TNBC between June 2018 and June 2022. Collected variables included patient demographics, pathological characteristics, and imaging parameters. Predictive models were developed using variable selection through Cox regression analysis, random forest, and eXtreme gradient boosting (XGBoost). Model performance was evaluated using receiver operating characteristic (ROC) curves, area under the ROC curve (AUC) values, calibration curves, and measures such as net reclassification improvement and integrated discrimination improvement (IDI). The optimal model was visualized and subjected to clinical testing.</div></div><div><h3>Results</h3><div>Comparative analysis revealed that the Cox model outperformed the Rf.cox and XGBoost.cox models. Specifically, at the 48-month time point in the validation set, the XGBoost.cox model demonstrated inferior performance compared to the Cox model. The Cox model was chosen as the optimal model, incorporating seven variables: Age, T-Stage, N-Stage, Ki-67, SE-Score, time-signal intensity curve, and early-phase enhancement. The AUC was 0.937 (0.904–0.971) in the training set and 0.906 (0.855–0.957) in the validation set. Decision curve analysis and clinical impact curve supported the potential utility of the model in guiding clinical interventions.</div></div><div><h3>Conclusion</h3><div>The predictive model for disease-free progression in TNBC, based on imaging parameters from breast color Doppler ultrasound and MRI, demonstrates feasibility. Further studies are recommended to confirm its clinical applicability.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104560"},"PeriodicalIF":7.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903753","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}