Breast最新文献

{"title":"Effectiveness of the lymphatic microsurgical preventive healing approach for avoiding breast cancer-related arm lymphedema","authors":"Summer Sami Yono ,&nbsp;Andrew Hannoudi ,&nbsp;Hassan Chamseddine ,&nbsp;Sanjay Rama ,&nbsp;Jessica M. Bensenhaver ,&nbsp;Daniel Yoho ,&nbsp;Donna Tepper ,&nbsp;Maristella S. Evangelista ,&nbsp;Saul D. Nathanson ,&nbsp;Dunya M. Atisha","doi":"10.1016/j.breast.2025.104540","DOIUrl":"10.1016/j.breast.2025.104540","url":null,"abstract":"<div><h3>Background</h3><div>There is currently no proven surgical approach that prevents breast cancer related arm lymphedema (BCRAL). We hypothesized that the lymphatic microsurgical preventive healing approach (LyMPHA) during axillary lymph node dissection (ALND) could reduce BCRAL development.</div></div><div><h3>Study design</h3><div>We conducted a single-center retrospective cohort study of patients with breast cancer who underwent ALND with or without immediate LyMPHA between 2016 and 2022. Primary outcomes were development of BCRAL and quality of life measures within 4 years of surgery. Secondary outcomes were days to drain removal and postoperative complications. Kaplan-Meier analysis determined risk of BCRAL over time. Cox regression analysis was used to determine risk factors associated with development of BCRAL.</div></div><div><h3>Results</h3><div>Of 187 patients who underwent ALND, 121 (64.7 %) received LyMPHA and 66 (35.3 %) underwent ALND only. The mean age was 56.4 ± 13.6 years. Patients who underwent LyMPHA had lower risk of lymphedema over time (p = 0.003), lower median percent functional impairment (4.7 % vs 11.6 %, p = 0.045), and shorter median drain duration (13.0 vs 15.0 days; p = 0.042). Regression analysis showed that those who received LyMPHA were half as likely to develop BCRAL (hazard ratio 0.53; 95 % CI 0.28–0.98; p = 0.043). Groups did not differ in the rate of postoperative complications. No other factors were associated with BCRAL, including age, body mass index, smoking status, or history of other cancer therapies.</div></div><div><h3>Conclusion</h3><div>Performing immediate lymphatic reconstruction with LyMPHA after ALND may prevent arm lymphedema and reduce morbidity in patients with breast cancer.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104540"},"PeriodicalIF":5.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655541","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":"The association between breast fibrosis, cosmetic outcomes, and long-term health-related quality of life after breast-conserving therapy: a multicenter cross-sectional observational cohort study","authors":"M.C.A.W. Notenboom ,&nbsp;T.M.A.L. Klem ,&nbsp;C.M.E. Contant ,&nbsp;S.P. Ribbe ,&nbsp;M. Franckena ,&nbsp;J.J. Penninkhof ,&nbsp;L.B. Koppert ,&nbsp;P.W. Plaisier ,&nbsp;M.A.M. Mureau ,&nbsp;E.D. van Werkhoven ,&nbsp;F.J.C. van der Veen ,&nbsp;M. de Kraker ,&nbsp;R.A. Nout ,&nbsp;M.B.E. Menke-Pluijmers ,&nbsp;F.E. Froklage","doi":"10.1016/j.breast.2025.104541","DOIUrl":"10.1016/j.breast.2025.104541","url":null,"abstract":"<div><h3>Background</h3><div>Breast fibrosis is a well-known late side-effect of breast-conserving therapy (BCT) and may lead to breast retraction, asymmetry, and pain. Since life expectancy of breast cancer patients has significantly improved in the past decades, cosmetic outcomes and health-related quality of life (HRQoL) have gained importance. This study aimed to investigate the association between breast fibrosis, cosmetic outcomes, and various HRQoL domains.</div></div><div><h3>Methods</h3><div>In this multicenter, cross-sectional, observational cohort (STARLINGS study), breast fibrosis was assessed (CTCAE version 5), breast photos were analyzed with BCCT.core software, and participants completed BREAST-Q, EORTC QLQ-BR23/C30, and 9-item cosmetic questionnaire. Associations between breast fibrosis and HRQoL and between cosmetic outcomes and HRQoL, were analyzed using multivariable linear regression, both unadjusted and adjusted for age, smoking and body mass index.</div></div><div><h3>Results</h3><div>A total of 775 patients treated between 2016 and 2020 were included, with median follow-up of 4 years. Compared to patients with moderate/severe breast fibrosis, patients with none/mild breast fibrosis reported better HRQoL on all domains, except Sexual Functioning, Sexual Enjoyment, and Physical and Social Functioning. Patients with excellent/good cosmetic outcomes reported better HRQoL than patients with fair/poor cosmetic outcomes on five out of 18 HRQoL domains, but not on any of the Symptoms domains.</div></div><div><h3>Conclusion</h3><div>Our results indicate that breast fibrosis and unfavorable cosmetic outcomes are negatively associated with various HRQoL domains. Additionally, breast fibrosis is associated with locoregional symptoms and fatigue, whereas unfavorable cosmetic outcomes are not. This large multicenter study corroborates the interrelated nature of breast fibrosis, cosmetic outcomes, and HRQoL (ID: NCT05263362).</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104541"},"PeriodicalIF":7.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781329","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":"Does RSClin provide additional information over classic clinico-pathologic scores (PREDICT 2.1, INFLUENCE 2.0, CTS5)?","authors":"Ana-Alicia Beltran-Bless ,&nbsp;Gregory R. Pond ,&nbsp;Jane Bayani ,&nbsp;Sarah L. Barker ,&nbsp;Melanie Spears ,&nbsp;Elizabeth Mallon ,&nbsp;Karen J. Taylor ,&nbsp;Annette Hasenburg ,&nbsp;Christos Markopoulos ,&nbsp;Luc Dirix ,&nbsp;Elma Meershoek-Klein Kranenbarg ,&nbsp;Cornelis J.H. van de Velde ,&nbsp;Daniel W. Rea ,&nbsp;Lisa Vandermeer ,&nbsp;John Hilton ,&nbsp;John M.S. Bartlett ,&nbsp;Mark Clemons","doi":"10.1016/j.breast.2025.104528","DOIUrl":"10.1016/j.breast.2025.104528","url":null,"abstract":"<div><h3>Purpose</h3><div>Few studies have compared the performance of gene-expression profiling tests (e.g. Oncotype-Dx) to clinico-pathologic risk calculators (e.g. PREDICT 2.1, INFLUENCE 2.0, and CTS5) or tools that combine both (e.g. RSClin) in patients with early breast cancer (EBC). A large trial dataset was used to evaluate the prognostic performance of different tests based on patient outcomes.</div></div><div><h3>Methods</h3><div>The TEAM pathology cohort accrued samples from 4736 postmenopausal hormone positive women with EBC, treated with either exemestane or tamoxifen followed by exemestane. Oncotype-Dx-trained risk scores were previously generated by gene-expression profiling. Patient data was used to calculate various recurrence scores. Analysis was restricted to the N0/N1 population and prognostic ability of selected risk tools was assessed using Cox regression analysis and Harrell's C-statistic.</div></div><div><h3>Results</h3><div>Results were available for 2065 patients. There was low correlation between PREDICT 2.1 (r = -0.12), INFLUENCE 2.0 (r = 0.20), CTS5 (r = 0.16) with Oncotype-Dx-trained results. In N0 patients, RSClin had improved prognostic ability (C-statistic = 0.66) on DMFS compared to PREDICT 2.1 (0.60), INFLUENCE 2.0 (0.57), CTS-5 (0.62), and Oncotype-Dx (0.63).</div></div><div><h3>Conclusion</h3><div>Combining molecular and clinico-pathologic factors enhances prognostic information. However, the impact of this on actual patient management requires further prospective validation.</div><div>The trial is registered with clinicaltrials.gov NCT00279448 and NCT00032136; with Netherlands Trial Register, number NTR 267; and the Ethics Commission Trial, number 27/2001.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104528"},"PeriodicalIF":5.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571692","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":"Prognostic value of tumor-infiltrating lymphocytes in irradiated node-positive breast cancer patients","authors":"Demet Özcan ,&nbsp;Anders Winther Mølby Nielsen ,&nbsp;Jan Alsner ,&nbsp;Lise Bech Jellesmark Thorsen ,&nbsp;Jens Overgaard ,&nbsp;Birgitte Vrou Offersen ,&nbsp;Trine Tramm","doi":"10.1016/j.breast.2025.104525","DOIUrl":"10.1016/j.breast.2025.104525","url":null,"abstract":"<div><h3>Introduction</h3><div>Radiotherapy significantly reduces locoregional recurrence (LRR) and improves survival. Yet, reliable biomarkers predicting radiotherapy response are not well-defined. Tumor-infiltrating lymphocytes (TILs) have emerged as a promising prognostic and predictive marker, but their role in irradiated patients remains underexplored.</div></div><div><h3>Methods</h3><div>This case-cohort study included 1461 node-positive, irradiated breast cancer patients from the Danish Breast Cancer Group (DBCG) internal mammary node (IMN)2 study. IMN irradiation (IMNI) was allocated by tumor laterality. TILs were assessed in treatment-naïve primary tumors and dichotomized using a 30 % cut-off. Endpoints included overall mortality (OM), breast cancer-specific mortality (BCM), distant recurrence (DR), and LRR. Flexible parametric survival models estimated adjusted hazard ratios (HRs).</div></div><div><h3>Results</h3><div>TILs were evaluated in 1353 patients; 20 % had high TILs. Low TILs were associated with higher OM (HR 0.53, 95 % CI: 0.36–0.77), BCM (HR 0.45, CI: 0.29–0.71) and DR (HR 0.40, CI: 0.26–0.62), but not LRR (HR 0.82, CI: 0.31–2.17). These associations were strongest in estrogen receptor-negative (ER-) tumors. ER-/low TILs were associated with increased OM (HR 0.31, CI: 0.18–0.56) compared to ER-/high TILs, whereas TILs were not prognostic in ER+ tumors (HR 0.86, CI: 0.56–1.32). A significant survival benefit after IMNI was observed in patients with low TILs tumors (HR 0.64, CI: 0.48–0.85), but TILs did not predict IMNI-benefit.</div></div><div><h3>Conclusion</h3><div>TILs in the pre-immunotherapy setting were not predictive of IMNI-benefit but prognostic for post-radiotherapy outcomes in node-positive patients. The effect was dependent on ER status, as patients with ER-/low TILs tumors had poorer survival with a trend toward increased DR-risk.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104525"},"PeriodicalIF":5.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571758","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":"Omitting anthracyclines for the adjuvant treatment of patients with triple-negative breast cancer: A non-inferiority meta-analysis","authors":"Fabio Girardi ,&nbsp;Caterina Barbieri ,&nbsp;Gaia Griguolo ,&nbsp;Daniela Iannaccone ,&nbsp;Christian Zurlo ,&nbsp;Maria Vittoria Dieci ,&nbsp;Valentina Guarneri","doi":"10.1016/j.breast.2025.104524","DOIUrl":"10.1016/j.breast.2025.104524","url":null,"abstract":"<div><h3>Introduction</h3><div>For patients diagnosed with triple-negative breast cancer (TNBC), the sequential use of anthracyclines and taxanes is the standard adjuvant treatment, when this is indicated. However, anthracycline-related toxicities represent a concern. We conducted a meta-analysis to assess whether anthracycline-free regimens are non-inferior to standard, sequential regimens.</div></div><div><h3>Patients and methods</h3><div>We used a complex search strategy to query multiple databases. The population included patients who underwent primary surgery for TNBC, eligible for adjuvant chemotherapy and randomised in a phase 2 or 3 clinical trial. We fitted non-inferiority (NI) margins using published treatment effects. We calculated risk ratios (RR) for recurrence or death.</div></div><div><h3>Results</h3><div>Eight studies out of 3410 potentially eligible records were included in the meta-analysis, for an overall population of 4292 patients. The RR for recurrence was 1.05 (95 % confidence interval (CI) 0.93–1.19), with an upper bound superimposing on the NI margin of 1.19. In a sensitivity analysis excluding the two studies using CMF, the recurrence RR for the comparison between taxane-only chemotherapy and anthracycline-based sequential chemotherapy was RR 0.97 (95 % CI 0.84–1.11). The RR for death was 1.17 (95 % CI 1.00–1.37), with an upper bound crossing the NI margin of 1.16.</div></div><div><h3>Conclusions</h3><div>Anthracycline-free adjuvant chemotherapy may represent an option for patients with early TNBC who are not eligible for pre-operative treatment and for whom sparing anthracyclines should be considered (e.g., young patients with small tumours, patients at risk of adverse effects). Non-inferiority was more evident for taxane-only chemotherapy than for anthracycline-free regimens at large. However, our results call for caution considering the remarkable heterogeneity in the study patient populations. This meta-analysis should prompt further research into strategies for patient selection, including the use of prognostic biomarkers for risk stratification.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104524"},"PeriodicalIF":5.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557358","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":"Corrigendum to “Neoadjuvant chemotherapy for breast cancer in Italy: A Senonetwork analysis of 37,215 patients treated from 2017 to 2022” [The Breast 78 (2024) 103790]","authors":"A. De Luca ,&nbsp;M.I. Amabile ,&nbsp;F. Santori ,&nbsp;S. Di Matteo ,&nbsp;M. Tomatis ,&nbsp;A. Ponti ,&nbsp;F. Frusone ,&nbsp;M. Taffurelli ,&nbsp;C. Tinterri ,&nbsp;L. Marotti ,&nbsp;M. Calabrese ,&nbsp;C. Marchiò ,&nbsp;F. Puglisi ,&nbsp;I. Palumbo ,&nbsp;L. Fortunato","doi":"10.1016/j.breast.2025.104511","DOIUrl":"10.1016/j.breast.2025.104511","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104511"},"PeriodicalIF":5.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511498","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":"Partial breast irradiation after sentinel lymph node biopsy omission: Is it a valid alternative to whole breast Irradiation? Analysis of the dose to the sentinel lymph node region during whole breast irradiation vs. partial breast irradiation","authors":"Sophie T. Behzadi ,&nbsp;Rebecca Moser ,&nbsp;Mathias Düsberg ,&nbsp;Maximilian Aigner ,&nbsp;Jana Nano ,&nbsp;Sophia Kiesl ,&nbsp;Jacqueline Lammert ,&nbsp;Evelyn Klein ,&nbsp;Georg P. Schmidt ,&nbsp;Marion Kiechle ,&nbsp;Thomas Huber ,&nbsp;Stefanie Corradini ,&nbsp;Stephanie E. Combs ,&nbsp;Kai J. Borm","doi":"10.1016/j.breast.2025.104523","DOIUrl":"10.1016/j.breast.2025.104523","url":null,"abstract":"<div><h3>Background</h3><div>Sentinel lymph node biopsy (SLNB) can be safely omitted in selected early-stage, clinically node-negative breast cancer (BC) patients. While these patients are also candidates for partial breast irradiation (PBI), the dosimetric effects of PBI on the sentinel lymph node region (SLNs) and axillary levels remain unclear.</div></div><div><h3>Methods</h3><div>In this study, SLNs were identified and contoured in 100 BC patients using pre- and postoperative imaging. Axillary levels were contoured following ESTRO guidelines. Dose distribution to the SLN (n = 9000 data points) and axillary levels (n = 270 data points) were analyzed for whole breast irradiation (WBI) and PBI across different techniques (3D-conformal radiation therapy [3D-CRT] vs. volumetric modulated arc therapy [VMAT]), deep inspiration breath-hold [DIBH] vs. free breathing [FB]), and anatomical variations (breast size, tumor site, and upper breast border).</div></div><div><h3>Results</h3><div>WBI provided full therapeutic dose coverage (&gt;95 % of the prescribed dose) to 65 % of SLNs, compared to only 10 % (3D-CRT) and 3 % (VMAT) with PBI. DIBH significantly reduced dose distribution to SLN and axillary levels compared to FB. Lower incidental dose coverage was also observed in patients with medial/central tumors, smaller breasts, and lower upper breast borders.</div></div><div><h3>Conclusion</h3><div>These results demonstrate that PBI delivers substantially lower incidental dose to the SLN than WBI. Since patients in the INSEMA and SOUND trials were predominantly treated with WBI, combining SLNB omission with PBI should not be considered a standard approach and warrants further investigation.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104523"},"PeriodicalIF":5.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524311","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":"The effects of adjuvant endocrine therapy on long-term outcomes from ductal carcinoma in situ: a systematic review and meta-analysis","authors":"Qian Chen ,&nbsp;Ian Campbell ,&nbsp;Mark Elwood ,&nbsp;Alana Cavadino ,&nbsp;Phyu Sin Aye ,&nbsp;Sandar Tin Tin","doi":"10.1016/j.breast.2025.104521","DOIUrl":"10.1016/j.breast.2025.104521","url":null,"abstract":"<div><h3>Background</h3><div>Although adjuvant endocrine therapy (ET) is a standard treatment for hormone receptor positive ductal carcinoma in situ (DCIS), its use is variably recommended by clinicians. This paper reviewed the effects of ET in relation to recurrence and survival across diverse populations.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Web of Science, and Cochrane were searched for studies that reported outcomes of DCIS treated with ET versus no ET.</div></div><div><h3>Results</h3><div>Three randomised trials and 42 cohort studies were included. In the trials, tamoxifen significantly reduced the risk of in-breast recurrence with a pooled hazard ratio (HR) of 0.69 (95 % CI: 0.60, 0.80). In the cohort studies, ET was associated with lower risks of any recurrence (HR 0.67; 95 % CI: 0.55, 0.83), ipsilateral breast tumour recurrence (HR 0.59; 0.51, 0.69), loco-regional recurrence (HR 0.74; 0.53, 1.02) and contralateral breast cancer (HR 0.70; 0.49, 1.00), and improved overall survival (HR 0.85; 0.79, 0.90). No significant association between ET and breast cancer specific survival was observed in either trials or cohort studies. Subgroup analyses within the cohort studies showed no significant differences in the pooled HRs for recurrence and survival by follow-up length, confounding adjustment or treatment type.</div></div><div><h3>Conclusions</h3><div>The use of adjuvant ET reduces the risk of recurrence in patients with DCIS in clinical trials, as well as in the real-world setting. Survival benefits, however, warrant further study.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104521"},"PeriodicalIF":5.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322471","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":"High impact of chemotherapy on ovarian reserve in breast cancer survivors of reproductive age: A systematic review and meta-analysis","authors":"Susanna Weidlinger ,&nbsp;Magdalena Weidlinger ,&nbsp;Rose-Maria Schramm ,&nbsp;Angela Vidal ,&nbsp;Janna Pape ,&nbsp;Tanya Karrer ,&nbsp;Manuela Rabaglio ,&nbsp;Michael von Wolff","doi":"10.1016/j.breast.2025.104514","DOIUrl":"10.1016/j.breast.2025.104514","url":null,"abstract":"<div><h3>Introduction</h3><div>The risk of infertility following breast cancer (BC) treatment is critical for women of reproductive age. Accurate risk assessment is essential for fertility counseling and preservation. Amenorrhoea as an infertility marker is unreliable due to endocrine therapies. Anti-Mullerian hormone (AMH) is a reliable fertility marker, but its role in assessing chemotherapy-induced loss of ovarian reserve in BC survivors remains underexplored.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis evaluates AMH decline and the prevalence of low (AMH &lt;1 ng/mL) and very low (&lt;0.5 ng/mL) ovarian reserve in BC survivors &lt;40 years old, 12–24 months post-chemotherapy, to quantify the gonadotoxic impact of BC treatments.</div></div><div><h3>Methods</h3><div>A systematic literature search of PubMed, Embase, and the Cochrane Library identified studies with AMH levels before and 12–24 months after chemotherapy in BC patients &lt;40 years of age. Data on AMH levels were pooled using random-effects meta-analysis. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. This study is part of the FertiTOX project (<span><span>www.fertitox.com</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>Ten studies (860 BC survivors) were included. Mean AMH decline was −1.61 (95 % CI: -2.31; −0.91) post-chemotherapy. The pooled prevalence of AMH &lt;1 ng/mL and &lt;0.5 ng/mL was 58 % (46–70 %) and 53 % (41–64 %), respectively. High heterogeneity was observed (I² &gt;80 %).</div></div><div><h3>Conclusions</h3><div>More than half of BC survivors have severely reduced ovarian reserve after chemotherapy, which is associated with a shortened fertile window and an increased risk of premature ovarian insufficiency. These findings highlight the need for pre-treatment fertility counseling and post-treatment ovarian insufficiency surveillance in routine oncology care.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104514"},"PeriodicalIF":5.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330815","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":"Hyaluronic acid 0.2 % cream for preventing radiation dermatitis in breast cancer patients treated with postoperative radiotherapy: A randomized, double-blind, placebo-controlled study","authors":"Letizia Deantonio ,&nbsp;Giulia Borgonovo ,&nbsp;Serena Caverzasio ,&nbsp;Maria Antonietta Piliero ,&nbsp;Paola Canino ,&nbsp;Andrea Puliatti ,&nbsp;Thomas Zilli ,&nbsp;Maria Carla Valli ,&nbsp;Antonella Richetti","doi":"10.1016/j.breast.2025.104513","DOIUrl":"10.1016/j.breast.2025.104513","url":null,"abstract":"<div><h3>Introduction</h3><div>This randomized trial evaluated the efficacy and safety of the prophylactic use of a hyaluronic acid (HA) 0.2 %-containing cream to reduce acute radiodermatitis in breast cancer patients undergoing adjuvant radiotherapy (RT).</div></div><div><h3>Methods</h3><div>Candidates for conventionally-fractionated or hypofractionated adjuvant RT for unilateral stage I-III breast cancer were randomized 1:1 to the HA cream or neutral comparator applied twice daily from 14 days before starting until 14 days after completing local RT. The primary endpoint was the development of acute skin dermatitis of grade ≥2 according to RTOG scale at the end of RT.</div></div><div><h3>Results</h3><div>The study closed early after 86 of the planned 120 patients were enrolled because of an unexpectedly low frequency of acute skin toxicity. Cumulative acute grade ≥2 radiodermatitis was lower with the HA cream (21.1 %) than the comparator group (35.3 %) but did not reach statistical significance in the primary endpoint (p = 0.3). At the end of RT, acute dermatitis grade ≥1 occurred in 92 % of patients undergoing conventionally-fractionated RT and 50 % in the hypofractionation subgroup. Physician-based RTOG grading scale and quantitative assessment with skin reflectance spectrophotometry (SRS) measures were comparable in detecting skin toxicity. However, an increase in SRS values was detectable a week before the first signs of radiodermatitis were depicted using RTOG scores.</div></div><div><h3>Conclusion</h3><div>Compared to physician-based grading, SRS enabled earlier detection of skin toxicity and may be used as a valid and effective tool for assessing radiodermatitis. Prophylactic topical HA may help mitigate this toxicity; however adequately powered prospective trials are needed.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"82 ","pages":"Article 104513"},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314584","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}