Breast最新文献

{"title":"Corrigendum to “Beta blocker use and breast cancer survival by subtypes: A population-based cohort study” [The Breast 81 (2025) 104474]","authors":"Oliver William Scott , Sandar Tin Tin , Edoardo Botteri","doi":"10.1016/j.breast.2025.104478","DOIUrl":"10.1016/j.breast.2025.104478","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104478"},"PeriodicalIF":5.7,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942408","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 10-gene signature for predicting recurrence risk in HR+/HER2- early breast cancer undergoing chemo-endocrine therapy","authors":"Xiaoyan Wu ,&nbsp;Xunxi Lu ,&nbsp;Wenchuan Zhang ,&nbsp;Xiaorong Zhong ,&nbsp;Hong Bu ,&nbsp;Zhang Zhang","doi":"10.1016/j.breast.2025.104484","DOIUrl":"10.1016/j.breast.2025.104484","url":null,"abstract":"<div><h3>Background</h3><div>While existing multi-gene assays aid adjuvant treatment decisions, no gene signature has identified HR+/HER2- early breast cancer (EBC) patients at high recurrence risk post-chemo-endocrine therapy (C-ET).</div></div><div><h3>Methods</h3><div>Clinical data and RNA sequencing information from 1457 HR+/HER2- breast cancer patients were collected from West China Hospital, the GEO database, and the TCGA database. Using univariate Cox regression, gene set enrichment analysis, and LASSO regression, ten key genes associated with recurrence were identified. A comprehensive prognostic model was developed by combining the 10-gene risk score with clinicopathological features, and a nomogram was created to predict 3-, 5-, and 7-year recurrence-free survival (RFS). The model's performance was evaluated using AUC and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>The 10-gene risk score was significantly associated with recurrence risk of HR+/HER2- EBC after C-ET and effectively distinguished between high-risk and low-risk patients (training: HR: 6.37, <em>P</em> &lt; 0.001; validation: HR: 4.51, <em>P</em> &lt; 0.001). It maintained consistent stratification efficacy across different treatment regimens, clinical stages, and grades. Compared to existing multi-gene signatures (21-gene, 70-gene, EndoPredict, PAM50, GGI), HR+/HER2- EBC patients identified as high-risk by the 10-gene risk score exhibited a higher 10-year cumulative recurrence rate following C-ET. In multivariate Cox regression analysis, the 10-gene risk score remained an independent prognostic factor in both the training and validation sets. The comprehensive model, integrating the 10-gene score and clinicopathological features, showed high predictive accuracy (AUC: 0.734, 0.778, 0.792 for 3, 5, 7 years in training; 0.691, 0.715, 0.709 in validation).</div></div><div><h3>Conclusion</h3><div>The 10-gene risk score can serve as a tool to predict recurrence risk in HR+/HER2- EBC patients following C-ET, assisting clinicians in developing personalized treatment plans for high-risk patients and ultimately improving patient prognosis.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104484"},"PeriodicalIF":5.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873364","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":"Physicians’ knowledge, practice, and attitudes on fertility and pregnancy-related issues in young women with advanced breast cancer: results of the ABC6 and ABC7 survey","authors":"Simone Nardin ,&nbsp;Luca Arecco ,&nbsp;Virginia Delucchi ,&nbsp;Eva Blondeaux ,&nbsp;Mihaela Stana ,&nbsp;Luciana de Moura Leite ,&nbsp;Luiza Nardin Weis ,&nbsp;Giang Pham Hoang ,&nbsp;Arianna Daneri ,&nbsp;Francesca Bruzzone ,&nbsp;Arianna Meacci ,&nbsp;Chiara Molinelli ,&nbsp;Maria Grazia Razeti ,&nbsp;Martina Perrone ,&nbsp;Shani Paluch-Shimon ,&nbsp;Ann H. Partridge ,&nbsp;Fatima Cardoso ,&nbsp;Tanja Spanic ,&nbsp;Joanna Kufel-Grabowska ,&nbsp;Matteo Lambertini","doi":"10.1016/j.breast.2025.104479","DOIUrl":"10.1016/j.breast.2025.104479","url":null,"abstract":"<div><h3>Background</h3><div>Fertility and pregnancy-related issues are critical for young patients with breast cancer. No proper evidence exists on physicians' knowledge, practice, and attitudes on dealing with these concerns in the specific group of patients with advanced disease.</div></div><div><h3>Methods</h3><div>A 26-item questionnaire was administered via e-mail in December 2023 to physicians who attended the ABC6 consensus conference (virtually, November 2021) and those who were registered for the ABC7 consensus conference (Lisbon, November 2023). The questionnaire was divided into 3 main sections: 1) demographic, medical training, and background information; 2) knowledge, practice, and attitudes of physicians towards fertility preservation and pregnancy-related issues in patients with advanced breast cancer; 3) approach to hypothetical clinical cases.</div></div><div><h3>Results</h3><div>A total of 133 physicians completed the survey. Most reported discussing always (40.6 %) or usually (36.1 %) the possible treatment-related loss of ovarian function in patients with advanced breast cancer. Regarding fertility preservation and pregnancy-related issues, 23.3 % would always feel comfortable discussing these topics with patients, and 45.9 % would feel comfortable depending on the clinical situation. 20.3 % reported not prescribing any type of contraception, and 10–20 % would prescribe treatments that are contraindicated during pregnancy.</div></div><div><h3>Conclusions</h3><div>Our survey showed that many concerns exist when discussing and dealing with fertility and pregnancy-related issues in patients with advanced breast cancer. It is essential to increase physicians' awareness on how to address fertility and pregnancy-related issues in patients with advanced breast cancer, especially as oncological treatments continue to improve, resulting in longer survival and, in some cases, potential cure.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104479"},"PeriodicalIF":5.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911728","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":"Effect of AI-based pre-hospital health education via QR code on APAIS scores in patients with breast nodules: A retrospective study","authors":"Guozhen Ma ,&nbsp;Chuyuan Miao ,&nbsp;Pengjun Jiang ,&nbsp;Guiqing He ,&nbsp;Huiping Li ,&nbsp;Yanhui Huang ,&nbsp;Huiwen Yu ,&nbsp;Tianwen Chen","doi":"10.1016/j.breast.2025.104481","DOIUrl":"10.1016/j.breast.2025.104481","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the effect of AI-based pre-hospital health education via QR code on preoperative anxiety and information needs in patients with breast nodules and provide a decision-making reference for ongoing optimizing clinical workflows.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed the clinical data of 718 breast nodule patients from January to December 2024. Patients were sequentially divided into a non-viewed group (receiving routine health education) and a viewed group (receiving AI-based pre-hospital health education) to compare Amsterdam Preoperative Anxiety and Information Scale (APAIS) scores between the two groups. Univariate analysis and multivariate regression were used to examine factors influencing preoperative anxiety and information needs in patients with breast nodules.</div></div><div><h3>Results</h3><div>718 patients were included, with 367 in the non-viewed group and 351 in the viewed group. Patients in the viewed group reported higher satisfaction scores and had shorter hospital stay compared to those in the non-viewed group. The multiple linear regression analysis revealed a significant negative correlation between the viewed group and preoperative anxiety (<em>β</em> = −5.31, 95 % CI: −6.03, −4.59; <em>P</em> = 0.001) and information needs (<em>β</em> = −1.40, 95 % CI: −1.63, −1.18; <em>P</em> = 0.001). Additionally, patient satisfaction also influences their preoperative anxiety and information needs (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>AI-based pre-hospital health education can help reduce patients with breast nodules' preoperative anxiety and information needs, as well as increase their satisfaction and shorten hospital stay. AI-based pre-hospital health education via QR code can be applied in clinical practice.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104481"},"PeriodicalIF":5.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934850","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":"Options for postoperative radiation therapy in patients with de novo metastatic breast cancer","authors":"Chaofan Li ,&nbsp;Yusheng Wang ,&nbsp;Biyun Fang ,&nbsp;Mengjie Liu ,&nbsp;Shiyu Sun ,&nbsp;Jingkun Qu ,&nbsp;Shuqun Zhang ,&nbsp;Chong Du","doi":"10.1016/j.breast.2025.104483","DOIUrl":"10.1016/j.breast.2025.104483","url":null,"abstract":"<div><h3>Background</h3><div>Although meta-analyses have demonstrated survival benefits associated with primary tumor resection in MBC, guidelines lack consensus on the survival benefit of postoperative radiation therapy (RT).</div></div><div><h3>Methods</h3><div>In this study, we included 1392 patients with de novo metastatic breast cancer (dnMBC) by integrating data from the SEER database (2010–2019) to systematically assess the efficacy of postoperative RT and develop a machine learning-driven prognostic tool. The primary endpoint was overall survival (OS).</div></div><div><h3>Results</h3><div>Propensity score matching (PSM) results showed that postoperative RT significantly improved OS (HR = 0.573, 95 % CI = 0.475–0.693), but this survival gain showed great heterogeneity among different subgroups. It is found that patients with HR-/HER2-or HR+/HER2-subtypes gained significant OS benefit from (p &lt; 0.001) postoperative RT, whereas patients with HER2+ subtype did not gain any survival benefit since the effect of targeted therapy overshadowed the postoperative RT. Further risk stratification by the random survival forest (RSF) model revealed that high-risk patients with T4/N3 stage, high tumor grade and poor response to chemotherapy had significantly prolonged OS after receiving RT (p &lt; 0.001), while low-risk patients showed no additional benefit. The model had excellent predictive efficacy (training set C-index = 0.741, validation set C-index = 0.720) with key predictors including HER2 status, chemotherapy response and tumor grade. The research team developed an interactive web application (<span><span>https://lee2287171854.shinyapps.io/RSFshiny/</span><svg><path></path></svg></span>) based on this model, which can generate individualized survival risk scores in real-time to guide clinical decision-making.</div></div><div><h3>Conclusion</h3><div>This study is the first to propose a risk stratification strategy for postoperative RT in dnMBC, and innovatively integrates machine learning and clinical tools to provide a new paradigm for optimizing precision therapy.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104483"},"PeriodicalIF":5.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868197","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":"Current pattern of care in radiation therapy for DCIS in Australia and New Zealand - where are we heading?","authors":"Adam Ofri ,&nbsp;Sze Ki Melanie Tam ,&nbsp;Suki Gill ,&nbsp;Andrew J. Spillane","doi":"10.1016/j.breast.2025.104482","DOIUrl":"10.1016/j.breast.2025.104482","url":null,"abstract":"<div><h3>Background</h3><div>Ductal carcinoma in-situ (DCIS) is a non-obligate precursor breast lesion with variable tendency to become invasive malignancy. Multiple studies have attempted to identify patient groups that could avoid radiation therapy (RT). We investigated the recent surgical management of DCIS in Australia and New Zealand (ANZ) and evaluated the likely rates of RT delivery dependent on differing low risk predictive criteria compared to actual practice.</div></div><div><h3>Method</h3><div>The BreastSurgANZ Quality Audit identified patients with DCIS from 2018 to 2022. Data were analysed on multiple DCIS characteristics as well as postoperative RT recommendations. Existing potential RT avoidance characteristics, low risk classification criteria (LRCC) and RTOG 9804, were tested against the cohort.</div></div><div><h3>Results</h3><div>7790 cases were analysed with 5323 (68.33 %) undergoing breast conservation surgery (BCS). There was higher median age, lower tumour grade and smaller size in the BCS group compared to mastectomy (p &lt; 0.001). According to the BQA, 25.38 % of patients had RT omitted. Using LRCC, 1659 patients (31.17 %) could omit RT but only 760 (45.81 %) of those patients did. When using RTOG 9804 criterion, 1287 patients (24.18 %) could omit RT but only 447 (34.73 %) did. Of 3477 patients with neither low risk classifying characteristics, 553 (15.9 %) had no RT.</div></div><div><h3>Conclusion</h3><div>BCS is the preferred surgical management of DCIS in ANZ. Currently RT is omitted following BCS in 25 % of cases. Using LRCC and RTOG 9804 low risk classifiers there was inconsistent avoidance of RT, whereas RT was avoided in 15.9 % of higher risk patients. More consistent and transparent selection methods are desirable and currently genomic testing and clinico-molecular tools appears promising.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104482"},"PeriodicalIF":5.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868198","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":"“Microsurgical breast reconstruction - A salvage option for failed implant-based breast reconstruction”","authors":"Amir Khosrow Bigdeli ,&nbsp;Jia Wei Tee ,&nbsp;Felix Hubertus Vollbach ,&nbsp;Yannick Fabian Diehm ,&nbsp;Florian Falkner ,&nbsp;Felix Strübing ,&nbsp;Maximilian Mahrhofer ,&nbsp;Emre Gazyakan ,&nbsp;Ulrich Kneser ,&nbsp;Laura Cosima Siegwart","doi":"10.1016/j.breast.2025.104480","DOIUrl":"10.1016/j.breast.2025.104480","url":null,"abstract":"<div><h3>Background</h3><div>The objective of this study was to evaluate microsurgical breast reconstruction as a salvage option for patients with failed implant-based breast reconstruction.</div></div><div><h3>Methods</h3><div>We conducted a retrospective single-center study including all patients with failed unilateral implant-based breast reconstruction who elected to undergo conversion surgery to microsurgical breast reconstruction from January 2015 to December 2023. Patients were grouped according to the urgency for conversion surgery in the urgent (implant infection or extrusion) or elective (capsular contracture, patients’ desire) group. Both groups were compared.</div></div><div><h3>Results</h3><div>120 patients were included in the study. 101 patients (84 %) were grouped in the elective group and 19 patients (16 %) in the urgent group. Patient characteristics and intraoperative variables including the utilization of DIEP/MS-TRAM and TMG flap for microsurgical reconstruction were similar in group comparison. Patients in the urgent group had significantly more surgical interventions (3.3 vs. 2.0, p &lt; 0.001) and suffered from significantly more major complications requiring re-operation (32 % vs. 11 %, p = 0.018) compared to the elective group. There was one flap loss in the urgent group (5 % vs. 0 %, p = 0.158).</div></div><div><h3>Conclusion</h3><div>Microsurgical breast reconstruction is a reliable and safe salvage option in patients with failure of implant-based breast reconstruction. Urgent conversion to microsurgical breast reconstruction due to implant-associated complications, such as infection or extrusion, requires more surgical interventions to achieve successful breast reconstruction and has a higher rate of major complications compared to elective conversion.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104480"},"PeriodicalIF":5.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873363","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":"Efficacy of adjuvant capecitabine in triple-negative breast cancer with residual disease after neoadjuvant therapy: a real-world study","authors":"Youzhao Ma ,&nbsp;Mingda Zhu ,&nbsp;Jingyang Zhang ,&nbsp;Dechuang Jiao ,&nbsp;Yangyang Hou ,&nbsp;Xiuchun Chen ,&nbsp;Zhenzhen Liu","doi":"10.1016/j.breast.2025.104477","DOIUrl":"10.1016/j.breast.2025.104477","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the beneficiaries of capecitabine in patients with triple-negative breast cancer (TNBC) who failed to achieve pathological complete response (pCR) by analyzing the efficacy of the drug in different HER2 statuses and TNM stages.</div></div><div><h3>Methods</h3><div>The Kaplan–Meier survival curve was plotted to estimate the effect of capecitabine therapy on disease-free survival (DFS) and overall survival (OS). Furthermore, the Cox proportional hazards model was used to analyze the factors that influence DFS and OS.</div></div><div><h3>Results</h3><div>A total of 296 patients with TNBC who had non-pCR after undergoing neoadjuvant therapy (NAT) were included in this study. There were 152 patients (51.4 %) in the capecitabine group and 144 patients (48.6 %) in the no-capecitabine group. The 3-year DFS and OS rates of the capecitabine group were better than those of the no-capecitabine group (DFS 80.0 % vs. 68.0 % p = 0.012, OS 95.9 % vs. 86.9 % p = 0.011). In addition, the capecitabine group exhibited significantly better DFS and OS than the no-capecitabine group in the HER2-low (DFS p = 0.004, OS p = 0.009) and stage III (DFS p = 0.004, OS p = 0.008) populations but not in the HER2-0 or stage II population.</div></div><div><h3>Conclusion</h3><div>Adjuvant capecitabine therapy significantly improved the prognosis of patients with TNBC who had residual disease after NAT, and the improvements in the outcomes were significant in patients with HER2-low expression and stage III disease. Other effective treatment methods should be explored for patients with HER2-0 expression or stage II disease.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104477"},"PeriodicalIF":5.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838626","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":"Analysis of factors influencing chemotherapy-induced peripheral neuropathy in breast cancer patients using a random forest model","authors":"Huiqian Xu ,&nbsp;Hong Li ,&nbsp;Yijing Fan ,&nbsp;Yaqi Wang ,&nbsp;Zeyuan Li ,&nbsp;Lizhi Zhou ,&nbsp;Xijun Hao","doi":"10.1016/j.breast.2025.104457","DOIUrl":"10.1016/j.breast.2025.104457","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to analyze the factors influencing chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients, identify modifiable factors, and provide a theoretical basis for targeted interventions.</div></div><div><h3>Methods</h3><div>A total of 542 patients with breast cancer who were hospitalized for chemotherapy in multiple hospitals from September 2022 to September 2023 were selected as the study objects. Data were collected using questionnaires covering demographic characteristics, disease-related information, lifestyle, and psychological status. Lasso-logistic regression was employed to identify influencing factors, and a random forest model was used to rank the importance of variables.</div></div><div><h3>Results</h3><div>Lasso-logistic regression analysis identified age, BMI, cumulative chemotherapy dose, hypertension, physical activity level, and depression as significant factors associated with CIPN (P &lt; 0.05). The variable importance ranking from the random forest model was as follows: age, BMI, cumulative chemotherapy dose, physical activity, hypertension, and depression.</div></div><div><h3>Conclusion</h3><div>Early identification of high-risk CIPN patients is crucial for guiding clinical nursing practices. These findings provide a foundation for the management and intervention of CIPN in breast cancer patients.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104457"},"PeriodicalIF":5.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838625","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":"Socioeconomic disparities and osteoarthritis impact hormone therapy adherence in breast cancer","authors":"B.S. Jang ,&nbsp;J.H. Chang ,&nbsp;K.H. Shin","doi":"10.1016/j.breast.2025.104476","DOIUrl":"10.1016/j.breast.2025.104476","url":null,"abstract":"<div><h3>Purpose</h3><div>Adherence to adjuvant hormone therapy (AHT) is critical for improving survival in breast cancer patients. This study examines how socioeconomic disparities, osteoarthritis (OA), and OA symptom onset timing influence AHT adherence and survival outcomes.</div></div><div><h3>Patients and methods</h3><div>This retrospective cohort study included 33,142 women with invasive breast cancer (2011–2015) from the Korean National Health Insurance Service. Group-based trajectory modeling (GBTM) identified AHT adherence patterns based on the proportion of days covered (PDC) over five years. Competing risk regression and Cox models assessed the impact of socioeconomic factors, pre-treatment OA, NSAID use, and other variables on AHT discontinuation and survival.</div></div><div><h3>Results</h3><div>GBTM revealed two adherence patterns: high adherence (83.4 %) and low adherence (16.6 %), with the latter showing a rapid decline in PDC. The low adherence group had a significantly higher risk of treatment discontinuation (SHR: 14.06; 95 % CI: 12.50–14.96; p &lt; 0.001) and mortality (HR: 3.56; 95 % CI: 3.09–4.09; p &lt; 0.001). A longer OA history before AHT (p = 0.001) and pre-AHT NSAID use (p &lt; 0.001) were linked to higher discontinuation risk. Patients with Medical Aid/Veteran insurance (OR: 0.60; 95 % CI: 0.53–0.67; p &lt; 0.001) and those in non-capital regions (OR: 0.74; 95 % CI: 0.69–0.79; p &lt; 0.001) were less likely to show high adherence.</div></div><div><h3>Conclusion</h3><div>AHT adherence is influenced by socioeconomic factors, pre-existing OA, and OA symptom timing, affecting survival outcomes. Tailored interventions are needed to improve AHT adherence and survival.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"81 ","pages":"Article 104476"},"PeriodicalIF":5.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835104","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}