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Oncological outcomes following extreme oncoplastic breast conserving surgery (eOPBCS) for locally advanced breast cancer (LABC): A systematic review and meta-analysis 局部晚期乳腺癌(LABC)极端保乳手术(eOPBCS)后的肿瘤预后:一项系统综述和荟萃分析。
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103869
Megan Chua Wern Ee , Ashley Lee Shi Hui , Wong Hung Chew , Emmeline Elaine Cua-Delos Santos , Sean Li Siwei , Sng Ming Xian , Qin Xiang Ng , Serene Goh Si Ning
{"title":"Oncological outcomes following extreme oncoplastic breast conserving surgery (eOPBCS) for locally advanced breast cancer (LABC): A systematic review and meta-analysis","authors":"Megan Chua Wern Ee ,&nbsp;Ashley Lee Shi Hui ,&nbsp;Wong Hung Chew ,&nbsp;Emmeline Elaine Cua-Delos Santos ,&nbsp;Sean Li Siwei ,&nbsp;Sng Ming Xian ,&nbsp;Qin Xiang Ng ,&nbsp;Serene Goh Si Ning","doi":"10.1016/j.breast.2024.103869","DOIUrl":"10.1016/j.breast.2024.103869","url":null,"abstract":"<div><h3>Introduction</h3><div>Locally advanced breast cancer (LABC) accounts for 5 % of new breast cancer diagnoses in developed countries and 30–60 % in developing regions. Historically, treatment relied on mastectomy guided by the Halstedian theory. Advances in neoadjuvant chemotherapy (NACT), breast-conserving surgery (BCS), and radiation have transformed treatment into a multimodal approach. Extreme oncoplastic BCS (eOPBCS) has expanded the boundaries of BCS, enabling large-volume resections with breast reshaping. However, its oncologic outcomes compared to mastectomy remain unclear, particularly in LABC.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA guidelines (PROSPERO: CRD42024535182). Studies involving eOPBCS for LABC were reviewed, and those comparing outcomes with mastectomy were included in the meta-analysis. The primary outcomes were overall survival (OS), disease-free survival (DFS), and local recurrence rates (LRR). Data were synthesized using a random-effects model.</div></div><div><h3>Results</h3><div>Of 866 identified studies, 33 were included in the systematic review and 4 in the meta-analysis, involving 2902 patients with LABC. Among them, 16.1 % underwent eOPBCS. Patients receiving eOPBCS were younger, had larger tumours, and more frequently underwent axillary clearance. The pooled hazard ratio (HR) for OS comparing mastectomy to eOPBCS was 1.72 (95% CI 1.04-2.83). Meanwhile, HRs for DFS (1.11, 95% CI 0.60-2.08) and LRR (0.67, 95% CI 0.38-1.18) showed that there were no statistically significant differences but a trend toward lower recurrence rates with mastectomy.</div></div><div><h3>Conclusion</h3><div>eOPBCS demonstrates comparable to superior oncological outcomes to mastectomy in LABC, offering a promising option for selected patients. However, slightly elevated local recurrence rates, though not statistically significant, highlight the importance of careful patient selection and further research. High-quality prospective studies are essential to validate these findings and refine criteria for incorporating eOPBCS into routine clinical practice.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103869"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969566","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}
引用次数: 0
Breast cancer patients with a pre-existing mental illness are less likely to receive guideline-recommended cancer treatment: A systematic review and meta-analysis 先前存在精神疾病的乳腺癌患者不太可能接受指南推荐的癌症治疗:一项系统回顾和荟萃分析。
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103855
Katie Elliott , Emily Haworth , Iakov Bolnykh , R. Hamish McAllister-Williams , Alastair Greystoke , Adam Todd , Linda Sharp
{"title":"Breast cancer patients with a pre-existing mental illness are less likely to receive guideline-recommended cancer treatment: A systematic review and meta-analysis","authors":"Katie Elliott ,&nbsp;Emily Haworth ,&nbsp;Iakov Bolnykh ,&nbsp;R. Hamish McAllister-Williams ,&nbsp;Alastair Greystoke ,&nbsp;Adam Todd ,&nbsp;Linda Sharp","doi":"10.1016/j.breast.2024.103855","DOIUrl":"10.1016/j.breast.2024.103855","url":null,"abstract":"<div><div>Breast cancer is the most commonly diagnosed cancer worldwide, with early detection and advanced treatments contributing to declining mortality rates. However, managing comorbid conditions, particularly mental illness, presents significant challenges for cancer treatment. This study systematically reviews and meta-analyses the impact of having a pre-existing mental illness on breast cancer treatment utilisation, focusing on specific treatments and comparing different mental illnesses. MEDLINE, EMBASE, CINAHL, and APA PsycInfo databases were searched. After screening, fifteen studies were identified as meeting the inclusion criteria. The included studies were predominantly from high-income countries, and compared breast cancer treatment in patients with and without pre-existing mental illnesses including anxiety, mood disorders, schizophrenia and psychotic disorders, and neurodevelopmental disorders. Meta-analysis revealed that patients with mental illnesses were significantly less likely to receive guideline-recommended treatments (OR = 0.78, 95 % CI 0.72–0.83, N = 5), chemotherapy (OR = 0.56, 95 % CI 0.34–0.78, N = 6), or radiotherapy (OR = 0.79, 95 % CI 0.66–0.93, N = 5). They were also significantly more likely to undergo mastectomy instead of breast-conserving surgery (OR = 1.38, 95 % CI 1.24–1.52, N = 4). Findings were consistent across different mental illnesses. This review highlights the need for targeted interventions to improve healthcare access and address provider biases, promoting better integration of mental health and oncology care.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103855"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871298","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}
引用次数: 0
General obesity, abdominal obesity, and the risk of cardiovascular disease including stroke in 5-year breast cancer survivors 乳腺癌五年期幸存者的全身肥胖、腹部肥胖和包括中风在内的心血管疾病风险。
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103857
Ji Soo Kim , Jihun Song , Seulggie Choi , Sang Min Park
{"title":"General obesity, abdominal obesity, and the risk of cardiovascular disease including stroke in 5-year breast cancer survivors","authors":"Ji Soo Kim ,&nbsp;Jihun Song ,&nbsp;Seulggie Choi ,&nbsp;Sang Min Park","doi":"10.1016/j.breast.2024.103857","DOIUrl":"10.1016/j.breast.2024.103857","url":null,"abstract":"<div><h3>Background</h3><div>To assess the association between discrepancies between general obesity and abdominal obesity and the risk of subsequent cardiovascular disease (CVD), including stroke, in breast cancer survivors.</div></div><div><h3>Methods</h3><div>We undertook a retrospective cohort study using data from the National Health Insurance Service of South Korea. Among 72,174 5-year breast cancer survivors aged 40 years and above, body mass index (BMI) and waist circumference (WC) were used to determine obesity status. Cox proportional hazards models were used to evaluate the association of obesity and risk of CVD, including stroke.</div></div><div><h3>Results</h3><div>Compared to those with normal WC and BMI, those who were overweight without abdominal obesity, had abdominal obesity only, and overweight with abdominal obesity, had higher risks of CVD [aHR(95 % CI) 1.23(1.02–1.48), 1.51(1.16–1.95), and 1.55(1.31–1.75), respectively] and total stroke [1.09(0.86–1.38), 1.63(1.20–2.23), and 1.40(1.17–1.68), respectively]. Compared to those overweight, those with abdominal obesity only had a significantly higher risk of ischemic stroke [2.04(1.14–3.65)].</div></div><div><h3>Conclusions</h3><div>Breast cancer survivors with higher BMI and/or abdominal obesity were associated with an elevated risk of CVD, including stroke.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103857"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827446","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}
引用次数: 0
A multicenter retrospective study of early cardiac toxicity in operable breast cancer patients receiving concurrent dual or mono anti-HER2 therapy with postoperative radiation therapy 一项多中心回顾性研究可手术乳腺癌患者在术后放疗同时接受双抗或单抗her2治疗的早期心脏毒性。
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103879
Jing Yang , Meng-Yun Zhou , Bo Yu , Qing Lin , Yuan Yao , Hua-Ling Wu , Qi-Wei Zhu , Ming Ye , Hua-Ying Xie , Jian-Wei Wu , Gang Cai , Rong Cai , Wei-Xiang Qi , Jia-Yi Chen , Lu Cao
{"title":"A multicenter retrospective study of early cardiac toxicity in operable breast cancer patients receiving concurrent dual or mono anti-HER2 therapy with postoperative radiation therapy","authors":"Jing Yang ,&nbsp;Meng-Yun Zhou ,&nbsp;Bo Yu ,&nbsp;Qing Lin ,&nbsp;Yuan Yao ,&nbsp;Hua-Ling Wu ,&nbsp;Qi-Wei Zhu ,&nbsp;Ming Ye ,&nbsp;Hua-Ying Xie ,&nbsp;Jian-Wei Wu ,&nbsp;Gang Cai ,&nbsp;Rong Cai ,&nbsp;Wei-Xiang Qi ,&nbsp;Jia-Yi Chen ,&nbsp;Lu Cao","doi":"10.1016/j.breast.2025.103879","DOIUrl":"10.1016/j.breast.2025.103879","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to assess whether dual anti-HER2 therapy with trastuzumab and pertuzumab increases early cardiac toxicity compared to trastuzumab alone in breast cancer (BC) patients receiving postoperative radiation therapy (RT).</div></div><div><h3>Methods</h3><div>Consecutive operable BC patients receiving postoperative RT and trastuzumab with or without pertuzumab between January 2017 and September 2020 at seven tertiary hospitals in China were retrospectively reviewed. Cardiac examinations included echocardiography, electrocardiogram (ECG), NT-proBNP, and cTnI at baseline before RT and during the follow-up. The cardiac event is any new-onset symptomatic heart disease or abnormality in the cardiac examination after RT.</div></div><div><h3>Results</h3><div>In total, 681 patients were enrolled in the analysis, of whom 567 were treated with trastuzumab-alone and 124 patients received dual anti-HER2 therapy. The median follow-up was 11 months. Multivariate analysis showed that left-sided breast cancer (HR 2.38; 95%CI 1.65–3.44, p &lt; 0.001) and IMN RT (HR 1.47; 95 % CI 1.01–2.15, P-value = 0.047) are independent risk factors for ECG abnormalities. Age &gt;50 years is an independent risk factor for developing LVDD (HR 5.16; 95%CI 1.17–22.73, P-value = 0.030). Dosimetric analysis showed that patients who developed subclinical cardiac events had increased mean heart dose (412.0 ± 249.6 vs. 347.2 ± 242.6 cGy, P-value = 0.010). Among right-sided patients or patients receiving anthracycline-based chemotherapy, the dual-targeted cohort had a higher risk of developing ECG abnormalities compared to the trastuzumab-only cohort.</div></div><div><h3>Conclusion</h3><div>Compared with trastuzumab-only, dual anti-HER2 therapy does not increase early cardiac toxicity in combination with postoperative RT in BC patients. Cardiac radiation exposure remains the primary risk factor for early toxicity.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103879"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969567","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}
引用次数: 0
Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer 推进治疗选择:CDK4/6抑制剂在HR+/HER2-转移性乳腺癌中的转换
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103875
Paola Zagami , Angela Esposito , Beatrice Taurelli Salimbeni , Pier Paolo Maria Berton Giachetti , Roberta Scafetta , Matteo Lambertini , Massimo Di Maio , Giuseppe Curigliano , Carmen Criscitiello , Saverio Cinieri
{"title":"Advancing treatment choices: CDK4/6 inhibitor switching in HR+/HER2- metastatic breast cancer","authors":"Paola Zagami ,&nbsp;Angela Esposito ,&nbsp;Beatrice Taurelli Salimbeni ,&nbsp;Pier Paolo Maria Berton Giachetti ,&nbsp;Roberta Scafetta ,&nbsp;Matteo Lambertini ,&nbsp;Massimo Di Maio ,&nbsp;Giuseppe Curigliano ,&nbsp;Carmen Criscitiello ,&nbsp;Saverio Cinieri","doi":"10.1016/j.breast.2025.103875","DOIUrl":"10.1016/j.breast.2025.103875","url":null,"abstract":"<div><h3>Purpose</h3><div>CDK4/6 inhibitors (CDK4/6i) use has revolutionized the treatment of hormone receptor-positive/human epidermal growth factor receptor 2 negative (HR+/HER2-) metastatic breast cancer. The choice of a specific CDK4/6i may be influenced by adverse events (AEs). Recently, the Italian Medicines Agency (AIFA) approved the possibility of switching between CDK4/6i for unacceptable toxicity. This study explores oncologists' experiences and future perspectives on CDK4/6 inhibitor switching following this new approval.</div></div><div><h3>Methods</h3><div>With the support of the Italian Association of Medical Oncology (AIOM), we conducted a survey among 92 oncologists to assess the impact of AIFA's approval on patient management.</div></div><div><h3>Results</h3><div>The survey showed that 48 % of participants were not surprised regarding AIFA's decision, with 76 % of respondents believing that this opportunity would significantly influence their treatment choices, enhancing AEs management for patients. Yet, 49 % of respondents emphasized the need for more real world evidence on CDK4/6i switch safety and efficacy. 96 % of respondents reported discontinuation rates between 0% and 25 % of patients, with constipation and hematological toxicity being the most frequent treatment discontinuation reasons. The oncologists prescribing CDK4/6i switch reported that most of these patients were in first line treatment (85 %) and the most common second CDK4/6i most frequently initiated was palbociclib (69 %), then abemaciclib (17 %) and ribociclib (14 %). Among those who started the second CDK4/6i at full dosage, 66 % of patients didn't require a dose reduction.</div></div><div><h3>Conclusion</h3><div>Our survey highlights the importance of allowing CDK4/6i switching, thus likely prompting oncologists to adapt their treatment choices, leading to better AEs management for improving patients’ outcome.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103875"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000000","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}
引用次数: 0
Comparative survival outcomes of neoadjuvant and adjuvant therapy in patients with T1c, node-negative, triple-negative breast cancer: A population-based analysis
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103877
Yi-Zi Zheng , Jia-Qi Ying , Ting-Ting Wu , Yong-Hui Su , Ou-Chen Wang
{"title":"Comparative survival outcomes of neoadjuvant and adjuvant therapy in patients with T1c, node-negative, triple-negative breast cancer: A population-based analysis","authors":"Yi-Zi Zheng ,&nbsp;Jia-Qi Ying ,&nbsp;Ting-Ting Wu ,&nbsp;Yong-Hui Su ,&nbsp;Ou-Chen Wang","doi":"10.1016/j.breast.2025.103877","DOIUrl":"10.1016/j.breast.2025.103877","url":null,"abstract":"<div><h3>Background</h3><div>Ongoing discussions persist concerning the precedence of neoadjuvant therapy (NAT) relative to adjuvant therapy (AT) for patients with T1c, node-negative, triple-negative breast cancer (TNBC), and pertinent guidelines for these individuals are absent.</div></div><div><h3>Methods</h3><div>Women diagnosed with T1cN0M0-stage TNBC who received chemotherapy and surgery were selected from the Surveillance, Epidemiology and End Results database (2010–2020). To balance baseline characteristics and mitigate selection bias, propensity score matching (PSM) was used to create the NAT and AT cohorts. Kaplan–Meier (KM) analysis and Cox proportional hazards models were performed to assess the prognostic factors for overall survival (OS) and breast cancer–specific survival (BCSS). Logistic regression models were utilized to identify predictive factors for response to NAT.</div></div><div><h3>Results</h3><div>A total of 1033 patient pairs passed the PSM process, resulting in a well-balanced distribution. The KM analysis demonstrated that patients who received AT and those who underwent NAT had similar OS and BCSS, no matter before or after PSM. The multivariate Cox model showed that not achieving pathological complete response (non-pCR) following NAT, compared to AT, was associated with considerably worse OS (hazard ratio [HR], 2.207; 95 % confident intervaI [CI], 1.431–3.405; <em>p</em> &lt; 0.001) and worse BCSS (HR, 2.184; 95 % CI, 1.348–3.537; <em>p</em> = 0.002). The logistic regression model revealed that being under 50 years old and having grade III or undifferentiated disease were independent predictors of pCR.</div></div><div><h3>Conclusions</h3><div>In patients with T1cN0M0-stage TNBC, both NAT and AT resulted in equivalent OS and BCSS. However, NAT precisely helped select patients with worse prognosis.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103877"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022105","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}
引用次数: 0
Corrigendum to ‘Raising awareness of alcohol as a modifiable risk factor for breast cancer: A randomized controlled trial comparing the efficacy of accessing an interactive website with a non-interactive website’ [The Breast (2025) 103868]
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103888
Claudia Sardu , Fabrizio Angius , Paolo Contu , Sofia Cosentino , Monica Deiana , Matteo Fraschini , Clelia Madeddu , Elena Massa , Alessandra Mereu , Luigi Minerba , Carola Politi , Silvia Puxeddu , Francesco Salis , Julia M.A. Sinclair , Roberta Agabio
{"title":"Corrigendum to ‘Raising awareness of alcohol as a modifiable risk factor for breast cancer: A randomized controlled trial comparing the efficacy of accessing an interactive website with a non-interactive website’ [The Breast (2025) 103868]","authors":"Claudia Sardu ,&nbsp;Fabrizio Angius ,&nbsp;Paolo Contu ,&nbsp;Sofia Cosentino ,&nbsp;Monica Deiana ,&nbsp;Matteo Fraschini ,&nbsp;Clelia Madeddu ,&nbsp;Elena Massa ,&nbsp;Alessandra Mereu ,&nbsp;Luigi Minerba ,&nbsp;Carola Politi ,&nbsp;Silvia Puxeddu ,&nbsp;Francesco Salis ,&nbsp;Julia M.A. Sinclair ,&nbsp;Roberta Agabio","doi":"10.1016/j.breast.2025.103888","DOIUrl":"10.1016/j.breast.2025.103888","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103888"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036853","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}
引用次数: 0
Personalized treatment strategies for breast adenoid cystic carcinoma: A machine learning approach 乳腺腺样囊性癌的个体化治疗策略:机器学习方法。
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2025.103878
Sakhr Alshwayyat , Mahmoud Bashar Abu Al Hawa , Mustafa Alshwayyat , Tala Abdulsalam Alshwayyat , Siya sawan , Ghaith Heilat , Hanan M. Hammouri , Sara Mheid , Batool Al Shweiat , Hamdah Hanifa
{"title":"Personalized treatment strategies for breast adenoid cystic carcinoma: A machine learning approach","authors":"Sakhr Alshwayyat ,&nbsp;Mahmoud Bashar Abu Al Hawa ,&nbsp;Mustafa Alshwayyat ,&nbsp;Tala Abdulsalam Alshwayyat ,&nbsp;Siya sawan ,&nbsp;Ghaith Heilat ,&nbsp;Hanan M. Hammouri ,&nbsp;Sara Mheid ,&nbsp;Batool Al Shweiat ,&nbsp;Hamdah Hanifa","doi":"10.1016/j.breast.2025.103878","DOIUrl":"10.1016/j.breast.2025.103878","url":null,"abstract":"<div><h3>Background</h3><div>Breast adenoid cystic carcinoma (BACC) is a rare subtype of breast cancer that accounts for less than 0.1 % of all cases. This study was designed to assess the efficacy of various treatment approaches for BACC and to create the first web-based tool to facilitate personalized treatment decisions.</div></div><div><h3>Methods</h3><div>The Surveillance, Epidemiology, and End Results (SEER) database was used for this study's analysis. To identify the prognostic variables, we conducted Cox regression analysis and constructed prognostic models using five Machine Learning (ML) algorithms to predict the 5-year survival. A validation method incorporating the area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to validate the accuracy and reliability of ML models. We also performed a Kaplan-Meier (K-M) survival analysis.</div></div><div><h3>Results</h3><div>This study included 1212 patients. The median age was 60 years, with most tumors being localized and less than 2 cm in size. The 5-year overall survival (OS) rates were highest for surgery + radiotherapy (RT) (94.9 %) and lowest for surgery + chemotherapy (CTX) + RT (80.1 %). Positive estrogen receptor (ER) status and younger age were associated with better survival outcomes. ML models identified key predictive features for survival, including age, nodal status, and ER status.</div></div><div><h3>Conclusion</h3><div>Age, lymph node metastasis, and ER status are crucial prognostic indicators for BACC. Although postoperative RT enhances survival, the advantages of adjuvant CTX are uncertain, implying that it may be eschewed to avert adverse effects. Our online tool offers essential resources for prognostication and treatment optimization.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103878"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000003","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}
引用次数: 0
Adverse health effects after breast cancer up to 14 years after diagnosis
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103865
Marianne J. Heins , Kelly M. de Ligt , Janneke Verloop , Sabine Siesling , Joke C. Korevaar , PSCCR group , Annette Berendsen , Daan Brandenbarg , Anneriet Dassen , Agnes Jager , Jacqueline Hugtenburg , Gerda van der Weele
{"title":"Adverse health effects after breast cancer up to 14 years after diagnosis","authors":"Marianne J. Heins ,&nbsp;Kelly M. de Ligt ,&nbsp;Janneke Verloop ,&nbsp;Sabine Siesling ,&nbsp;Joke C. Korevaar ,&nbsp;PSCCR group ,&nbsp;Annette Berendsen ,&nbsp;Daan Brandenbarg ,&nbsp;Anneriet Dassen ,&nbsp;Agnes Jager ,&nbsp;Jacqueline Hugtenburg ,&nbsp;Gerda van der Weele","doi":"10.1016/j.breast.2024.103865","DOIUrl":"10.1016/j.breast.2024.103865","url":null,"abstract":"<div><h3>Background</h3><div>The number of breast cancer survivors increases, but information about long-term adverse health effects in breast cancer survivors is sparse. We aimed to get an overview of the health effects for which survivors visit their general practitioner up to 14 years after diagnosis.</div></div><div><h3>Methods</h3><div>We retrieved data on 11,495 women diagnosed with breast cancer in 2000–2016 and 23,242 age and sex matched controls from the PSCCR-Breast Cancer, a database containing data about cancer diagnosis, treatment and primary healthcare. We built Cox regression models for 685 health effects, with time until the health effect as the outcome and survivor/control and cancer treatment as predictors. Models were built separately for four age groups (aged 18/44, 45/59, 60/74 and 75/89) and two follow-up periods (1/4 and 5/14 years after diagnosis).</div></div><div><h3>Results</h3><div>148 health effects occurred statistically significantly more often in survivors than in controls (p &lt; 0.05). Health effects varied by age, time since diagnosis and treatment, but osteoporosis, coughing, fatigue, skin and urinary infections, were statistically significantly increased in breast cancer survivors. Osteoporosis and chest symptoms were associated with hormone therapy; osteoporosis and skin infections with chemotherapy and lymphedema and skin infections with axillary dissection.</div></div><div><h3>Conclusions</h3><div>Breast cancer survivors may experience numerous adverse health effects up to 14 years after diagnosis. Insight in individual risks may assist healthcare professionals in managing patient expectations and improve monitoring, detection and treatment of adverse health effects.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"79 ","pages":"Article 103865"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378646","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}
引用次数: 0
Corrigendum to ‘Adverse health effects after breast cancer up to 14 years after diagnosis’ [The Breast 61 (2022) 22–28]
IF 5.7 2区 医学
Breast Pub Date : 2025-02-01 DOI: 10.1016/j.breast.2024.103864
Marianne J. Heins , Kelly M. de Ligt , Janneke Verloop , Sabine Siesling , Joke C. Korevaar , PSCCR group , Annette Berendsen , Daan Brandenbarg , Anneriet Dassen , Agnes Jager , Jacqueline Hugtenburg , Gerda van der Weele
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引用次数: 0
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