Breast最新文献

{"title":"The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis","authors":"Eva L. Claassens ,&nbsp;Roxanne A.W. Ploumen ,&nbsp;Loes F.S. Kooreman ,&nbsp;Maartje A.C.E. van Kats ,&nbsp;Sabine Siesling ,&nbsp;Thiemo J.A. van Nijnatten ,&nbsp;Marjolein L. Smidt","doi":"10.1016/j.breast.2025.104425","DOIUrl":"10.1016/j.breast.2025.104425","url":null,"abstract":"<div><h3>Purpose</h3><div>Recent studies show that ductal carcinoma in situ (DCIS) accompanying HER2+ breast cancer can be completely eradicated following neoadjuvant systemic therapy in up to 52 %. We aimed to determine the complete response rate of DCIS in triple-negative breast cancer (TNBC) patients in a nationwide cohort and to assess clinicopathological variables associated with response. Furthermore, the impact on surgical treatment after neoadjuvant chemotherapy (NACT) was investigated.</div></div><div><h3>Methods</h3><div>Women diagnosed with TNBC, treated with NACT followed by surgery, between 2010 and 2020, were selected from the Netherlands Cancer Registry (NCR). Pre-NACT and postoperative pathology reports were obtained from Palga, the Dutch nationwide pathology databank, to determine presence of DCIS. Clinicopathological factors associated with DCIS response were investigated using uni- and multivariable logistic regression analysis.</div></div><div><h3>Results</h3><div>In total, 4494 patients were included. A DCIS component was present in the pre-NACT biopsy of 442 (9.8 %) patients. Pathologic complete response of the DCIS component was achieved in 53.6 % of these patients. The presence of calcifications in the pre-NACT biopsy was associated with a lower chance of DCIS response in univariable logistic regression analysis (OR 0.52, CI 95 % 0.27–0.98, p = 0.04). In multivariable analysis, no statistically significant associations were found between DCIS response and clinicopathological variables. Mastectomy rates were higher in case of IBC + DCIS compared to IBC (53.4 % vs 40.1 %, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Pathologic complete response of DCIS to NACT occurred in 53.6 % of TNBC patients. Future studies are required to be able to predict DCIS response based on clinicopathological variables and imaging.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104425"},"PeriodicalIF":5.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive genomic profiling can predict response to neoadjuvant chemotherapy in triple-negative breast cancer","authors":"Monika Drobniene ,&nbsp;Dominyka Breimelyte ,&nbsp;Ieva Sadzeviciene ,&nbsp;Rasa Sabaliauskaite ,&nbsp;Ruta Barbora Valkiuniene ,&nbsp;Raimundas Meskauskas ,&nbsp;Daiva Dabkeviciene ,&nbsp;Sonata Jarmalaite","doi":"10.1016/j.breast.2025.104423","DOIUrl":"10.1016/j.breast.2025.104423","url":null,"abstract":"<div><h3>Background</h3><div>The rate of pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) in triple-negative breast cancer (TNBC) varies, and adjuvant therapy treatment for residual cancer remains a challenge. The aim of our study was to assess the added value of FoundationOne®CDx (F1CDx) testing in the non-metastatic TNBC in predicting responses to NACT and disease outcomes.</div></div><div><h3>Methods</h3><div>Ninety-three eligible patients with stage II-III TNBC were treated with NACT without immunotherapy. Response to NACT was evaluated postoperatively. Comprehensive genomic profiling with NGS-based molecular test F1CDx was performed on diagnostic biopsies (N = 93). Hierarchical clustering and logistic regression were applied for data analysis.</div></div><div><h3>Results</h3><div>Genomic profiling and data clustering revealed heterogeneous genetic landscapes of TNBC with subsets displaying multilayered co-amplifications of oncogenes and overlapping changes in crucial signaling pathways. <em>TP53</em> mutations were detected in 95 % of all TNBCs. <em>BRCA1/BRCA2</em> mutations were significant molecular factors in predicting favorable responses to NACT (OR = 0.09, p = 0.002), while CCNDs co-mutations with FGFs (OR = 13.4, p = 0.016) and PI3Ks family mutations in AR-positive cases (OR = 6.1, p = 0.008) – poor responses. Low tumor mutational burden (TMB) ≤ 3 (OR = 9.4, p = 0.009) was a significant factor for the disease progression after NACT.</div></div><div><h3>Conclusions</h3><div>This study suggests that comprehensive CDx testing can be explored as a prognostic tool in early-stage TNBC to predict responses to NACT and disease progression. Based on these results, genomic analysis should be performed early in the patient journey, possibly guiding adjuvant treatment choices and participation in randomized clinical trials, mainly when pCR is not achieved, as the ultimate goal is improving patient outcomes.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104423"},"PeriodicalIF":5.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic chemotherapy-induced peripheral neuropathy and pain following paclitaxel versus docetaxel in breast cancer survivors: A cross-sectional study","authors":"Nina Lykkegaard Gehr ,&nbsp;Signe Timm ,&nbsp;Kristine Bennedsgaard ,&nbsp;Kasper Grosen ,&nbsp;Erik Jakobsen ,&nbsp;Anders Bonde Jensen ,&nbsp;Jeanette Dupont Rønlev ,&nbsp;Ann Søegaard Knoop ,&nbsp;Nanna B. Finnerup ,&nbsp;Lise Ventzel","doi":"10.1016/j.breast.2025.104424","DOIUrl":"10.1016/j.breast.2025.104424","url":null,"abstract":"<div><div>Chemotherapy-induced peripheral neuropathy (CIPN) is a concerning late effect of taxane treatment. This study aimed to explore and compare long-term symptoms and consequences of CIPN after docetaxel and paclitaxel treatment.</div><div>Patients with breast cancer who had followed Danish recommended adjuvant docetaxel or paclitaxel treatment regimens completed an online questionnaire 2–3 years after treatment. The questionnaire comprised the Michigan Neuropathy Screen Instrument, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CIPN20, EORTC QLQ C30, and CIPN-specific symptoms. Painful CIPN was assessed using the Douleur Neuropathique 4 Questions.</div><div>Questionnaires from 411 patients (docetaxel: 192, paclitaxel: 219) were analyzed. No significant difference in the prevalence of possible CIPN between the two groups was observed (docetaxel: 48.4 % [93/192] vs. paclitaxel: 45.2 % [99/219]; 95 % CI: 6.4 - 12.9, p = 0.51). However, the EORTC-QLQ-CIPN20 sum score was higher in the docetaxel group (difference: 3.0; 95 % CI: 0.0–6.1, p = 0.05).</div><div>Among patients with reported CIPN symptoms, significantly more in the docetaxel group reported painful CIPN (docetaxel: 53.8 % [50/93] than in the paclitaxel group: 34.3 % [34/99]; p = 0.01). Quality of life scores from the EORCT-QLQ-C30 questionnaire were significantly lower in those with possible CIPN than in those without and lower in patients with painful possible CIPN than in those with painless CIPN.</div><div>Docetaxel caused more severe and painful CIPN symptoms than paclitaxel. These findings are highly relevant, as docetaxel remains a crucial component of cancer treatments.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104424"},"PeriodicalIF":5.7,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of combined trastuzumab-deruxtecan and concurrent radiation therapy in breast cancer. The TENDANCE multicentric French study","authors":"K. Debbi ,&nbsp;M.A. Benderra ,&nbsp;J. Medioni ,&nbsp;C. Durdux ,&nbsp;N.H. To ,&nbsp;C. Boukhobza ,&nbsp;N. Grellier ,&nbsp;A. Benmaziane ,&nbsp;L. Monnier ,&nbsp;J. Gligorov ,&nbsp;E. Assaf ,&nbsp;Y. Belkacemi","doi":"10.1016/j.breast.2025.104421","DOIUrl":"10.1016/j.breast.2025.104421","url":null,"abstract":"<div><h3>Purpose</h3><div>Trastuzumab Deruxtecan (T DXD), a new antibody drug conjugate is a new treatment option for 2nd line metastatic breast cancer (MBC) for HER2 + or HER2 low tumors. Palliative or ablative radiotherapy (RT) may be required in patients who are being treated with T-DXd. However there is a lack of evidence regarding the safety profile of combining T-DXd with RT. TENDANCE study aimed to evaluate safety and efficacy of combined T-DXd and RT.</div></div><div><h3>Materials and methods</h3><div>This retrospective multicenter study included 54 patients treated concurrently with T-DXd and RT for HER2+ and HER2 low MBC between February 2021 and December 2023. All data were collected from a web-questionnaire, centralized after medical records and validation of the protocol by the local ethical committee. Primary endpoint was the safety of combined therapy.</div></div><div><h3>Results</h3><div>Median age was 60 years. Patients who received T-DXD were further categorized into HER2+ (40.7 %), HER2 low/hormonal receptors HR+ (40.8 %) or HER2 low/HR- (18.5 %). In the HER2+ patients, T-DXd was administered as 2nd (18.2 %) or 3rd (31.8 %) or 4th (50 %) line therapy. RT was delivered using palliative (72.2 %) or ablative doses (27.8 %). Indications consisted mostly of palliative bone irradiation (46.3 %) and stereotactic radiosurgery (SRS) (25.9 %). With the median follow-up of 9 months, 22.2 % of patients had a complete response and 77.8 % had either a partial response or stable disease. Grade 1 or 2 asthenia was observed in 51.8 % of patients, while only 16.6 % experienced other grade 1 or 2 adverse effects. There was no T-DXd therapy discontinuation related to RT.</div></div><div><h3>Conclusion</h3><div>To our knowledge, TENDANCE is the largest study evaluating concurrent T-DXd and RT. This preliminary report suggests the feasibility of the combination of RT and T-DXd with manageable toxicity rate. Longer follow-up and further prospective studies are required to confirm these results.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104421"},"PeriodicalIF":5.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Impact of adjuvant trastuzumab therapy and its discontinuation on cardiac function and mortality in patients with early-stage breast cancer: An analysis based on the Japanese Receipt Claim Database’ [The Breast 79 (2025) 103871]","authors":"Keiko Miyazato ,&nbsp;Hiroshi Ohtsu ,&nbsp;Akihiko Shimomura ,&nbsp;Naohiro Yonemoto ,&nbsp;Chikako Shimizu ,&nbsp;Kazuhiro Sase ,&nbsp;Shinichiro Ueda","doi":"10.1016/j.breast.2025.103894","DOIUrl":"10.1016/j.breast.2025.103894","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 103894"},"PeriodicalIF":5.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in access to anti-HER2 therapies in neoadjuvant chemotherapy: A prognostic analysis based on real-world data comparing Brazil's public and private healthcare systems","authors":"Marcelo Antonini ,&nbsp;André Mattar ,&nbsp;Denise Joffily Pereira da Costa Pinheiro ,&nbsp;Isabela Bastos Maia ,&nbsp;Marina Diógenes Teixeira ,&nbsp;Andressa Gonçalves Amorim ,&nbsp;Odair Ferraro ,&nbsp;Larissa Chrispim de Oliveira ,&nbsp;Marcellus do Nascimento Moreira Ramos ,&nbsp;Francisco Pimentel Cavalcante ,&nbsp;Felipe Zerwes ,&nbsp;Marcelo Madeira ,&nbsp;Romualdo Barroso-Sousa ,&nbsp;Eduardo de Camargo Millen ,&nbsp;Antonio Luiz Frasson ,&nbsp;Fabricio Palermo Brenelli ,&nbsp;Gil Facina ,&nbsp;Rogério Fenile ,&nbsp;Luiz Henrique Gebrim ,&nbsp;Juliana Monte Real","doi":"10.1016/j.breast.2025.104417","DOIUrl":"10.1016/j.breast.2025.104417","url":null,"abstract":"<div><h3>Background</h3><div>Trastuzumab has significantly improved the treatment of HER2-positive breast cancer, particularly in the neoadjuvant setting, where its combination with chemotherapy increases the pathologic complete response (pCR) rate. This retrospective cohort study assesses the implications of disparities in access to trastuzumab within the Brazilian public healthcare system, focusing on pCR, overall survival (OS) and disease-free survival (DFS) in non-metastatic, HER2-positive breast cancer patients undergoing neoadjuvant chemotherapy (NAC).</div></div><div><h3>Methods</h3><div>The study was conducted in the <em>Hospital Pérola Byington</em> (PEROLA), a public institution, and in the <em>Hospital do Servidor Público Estadual</em> (HSPE), a private institution. pCR was defined as the absence of residual invasive or in situ tumors in the breast and axillary nodes. OS and DFS were calculated by Kaplan-Meier survival analysis for a 5-year period.</div></div><div><h3>Results</h3><div>From 2011 to 2020, 381 patients at PEROLA and 78 at HSPE underwent NAC. Trastuzumab availability was higher at HSPE (83.4 % vs. 60.0 %, p &lt; 0.0001). Use of trastuzumab correlated with significantly higher pCR rates at both the PEROLA (54.3 % vs. 26.4 %, p &lt; 0.0001) and the HSPE (52.7 % vs. 26.4 %, p &lt; 0.0001). HER2-positive patients with pCR at HSPE also had better OS (80 % vs. 61 %, p &lt; 0.0001) and DFS (89 % vs. 67 %, p &lt; 0.0001) compared to those at PEROLA.</div></div><div><h3>Conclusion</h3><div>There were significant differences in the provision of trastuzumab between the public and private healthcare systems, adversely affecting clinical outcomes and patient survival. The current data highlight the pressing need to address equity in cancer treatment to improve prognosis for every patient.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104417"},"PeriodicalIF":5.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Side-effects in women treated with adjuvant endocrine therapy for breast cancer","authors":"L.M. Rademaker ,&nbsp;R. Gal ,&nbsp;A.M. May ,&nbsp;M.C.T. Batenburg ,&nbsp;F. van der Leij ,&nbsp;R.M. Bijlsma ,&nbsp;H.M. Verkooijen ,&nbsp;A. Doeksen ,&nbsp;M.F. Ernst ,&nbsp;D.J. Evers ,&nbsp;C.C. van der Pol ,&nbsp;E.M. Monninkhof","doi":"10.1016/j.breast.2025.104416","DOIUrl":"10.1016/j.breast.2025.104416","url":null,"abstract":"<div><div>Many women with breast cancer prematurely discontinue adjuvant endocrine therapy, leading to increased mortality. We performed a cross-sectional survey (n = 456) within the Dutch UMBRELLA-cohort to gain insight into the prevalence of side-effects and its association with premature discontinuation. Almost all current endocrine therapy users experienced side-effects (92.7 %), most frequent were vasomotor- and musculoskeletal symptoms. The most reported reason for premature discontinuation was side-effects (88.1 %). Former treatment with chemotherapy was associated with more reported side-effects (97.2 % vs 82.5 %, ORadj 6.31), but less premature discontinuation of endocrine therapy (18.6 % vs 28.6 %, p-value 0.016).</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104416"},"PeriodicalIF":5.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences and preferences about information on treatment-related side effects among patients with early breast cancer","authors":"Antonio Di Meglio ,&nbsp;Giuseppe Catanuto ,&nbsp;Marzia Zambon ,&nbsp;Alexandre Chan ,&nbsp;Angelos P. Kassianos ,&nbsp;Constantina Cloconi ,&nbsp;Silvia Rohr ,&nbsp;Rebecca Steele ,&nbsp;Monique Coersmeyer ,&nbsp;Sonia Ujupan ,&nbsp;Fedro Peccatori","doi":"10.1016/j.breast.2025.104414","DOIUrl":"10.1016/j.breast.2025.104414","url":null,"abstract":"<div><h3>Background</h3><div>Treatment-related side effects are common among women treated for early breast cancer and their effective management is essential to maintain quality of life, ensure treatment adherence, and optimise survival outcomes. This study aimed to investigate patient-reported experiences and preferences about information regarding side effects received during breast cancer care.</div></div><div><h3>Methods</h3><div>An international multi-stakeholder expert group conducted an online patient survey assessing comprehensiveness, timing, and delivery modality of information regarding treatment-related side effects among patients undergoing primary therapy (surgery, radiation, and [neo]adjuvant chemotherapy) and endocrine therapy for early breast cancer. Descriptive analyses were performed.</div></div><div><h3>Results</h3><div>From June–August 2023, 608 respondents from Brazil, France, Germany, Italy, Japan, and Spain completed the survey: 57.5 % were &lt;50 years old, and all were or had been on endocrine therapy. Fatigue was the most reported side effect (47.0 % for primary and 42.3 % for endocrine therapy). A variable proportion of patients (14.4%–46.8 % across side effects) reported receiving information only after having experienced the side effect. Up to 43.6 % of respondents reported receiving insufficient or no information on side effects from their healthcare providers. Most patients reported preference for proactive communication from healthcare providers about side effects and prevention strategies. Respondents valued direct interactions with physicians and nurses and capitalised on a relevant role for peer-support, however utility of smartphone and web-based platforms to record and manage symptoms was acknowledged.</div></div><div><h3>Conclusion</h3><div>The survey underscores critical needs and offers insight informing the provision of comprehensive and timely information on treatment-related side effects across the cancer survivorship continuum.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104414"},"PeriodicalIF":5.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer","authors":"Christina B. Walter ,&nbsp;Andreas D. Hartkopf ,&nbsp;Alexander Hein ,&nbsp;Peter A. Fasching ,&nbsp;Hans-Christian Kolberg ,&nbsp;Peyman Hadji ,&nbsp;Hans Tesch ,&nbsp;Lothar Häberle ,&nbsp;Johannes Ettl ,&nbsp;Diana Lüftner ,&nbsp;Markus Wallwiener ,&nbsp;Volkmar Müller ,&nbsp;Matthias W. Beckmann ,&nbsp;Laura L. Michel ,&nbsp;Erik Belleville ,&nbsp;Hanna Huebner ,&nbsp;Sabrina Uhrig ,&nbsp;Chloë Goossens ,&nbsp;Pauline Wimberger ,&nbsp;Carsten Hielscher ,&nbsp;Carlo Fremd","doi":"10.1016/j.breast.2025.104412","DOIUrl":"10.1016/j.breast.2025.104412","url":null,"abstract":"<div><h3>Background</h3><div>Patients with first-line metastatic breast cancer (MBC) comprise patients with de novo metastases (dnMBC) or recurrent disease after primary breast cancer (rMBC). This analysis aimed to explore the prognostic value of dnMBC versus rMBC overall and particularly in subgroups according to age and metastasis site, in addition to other prognostic clinicopathological parameters in a first-line, hormone receptor (HR)-positive, HER2-negative (HRpos/HER2neg) population.</div></div><div><h3>Methods</h3><div>Within the prospective PRAEGNANT MBC registry (NCT02338167), 508 HRpos/HER2neg patients, receiving first-line treatment for advanced disease, were identified. Clinicopathological parameters (age, body mass index, performance status, tumor grading, metastasis site and therapy) were assessed according to metastatic status (dnMBC, rMBC within 5 years of primary diagnosis (rMBC &lt;5 years), rMBC after more than 5 years (rMBC ≥5 years)). Cox regression analyses were performed to investigate whether metastatic status influences progression-free survival (PFS) and overall survival (OS).</div></div><div><h3>Results</h3><div><em>De novo</em> metastatic disease was present in 180 patients (35.4 %), whereas 132 patients (26.0 %) had rMBC &lt;5 years and 196 patients (38.6 %) had rMBC ≥5 years. Patients with dnMBC had the most favorable prognosis. Relative to dnMBC, hazard ratios for PFS were 1.75 (95%CI: 1.31–2.34) in rMBC&lt;5 years and 1.25 (95%CI: 0.94–1.65) for rMBC ≥5 years. Subgroup-specific differences were not observed.</div></div><div><h3>Conclusion</h3><div>HRpos/HER2neg first-line MBC patients have a more favorable prognosis if the disease was previously not treated. This difference was similar across all examined clinicopathological parameters. It may therefore be beneficial to incorporate MBC categories as a stratification factor in clinical trials.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104412"},"PeriodicalIF":5.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omitting axillary lymph node dissection in breast cancer patients with extensive nodal disease and excellent response to primary systemic therapy using the MARI protocol","authors":"Annemiek K.E. van Hemert ,&nbsp;Ariane A. van Loevezijn ,&nbsp;Marie-Sophie P.D. Baas ,&nbsp;Marcel P.M. Stokkel ,&nbsp;Emma J. Groen ,&nbsp;Vincent van der Noort ,&nbsp;Claudette E. Loo ,&nbsp;Gabe S. Sonke ,&nbsp;Nicola Russell ,&nbsp;Frederieke H. van Duijnhoven ,&nbsp;Marie-Jeanne T.F.D. Vrancken Peeters","doi":"10.1016/j.breast.2025.104411","DOIUrl":"10.1016/j.breast.2025.104411","url":null,"abstract":"<div><h3>Purpose</h3><div>Axillary lymph node staging techniques after primary systemic therapy (PST) show low false negative rates, stimulating the omission of axillary lymph node dissection (ALND). Breast cancer patients with extensive nodal disease are underreported in studies on response-guided axillary treatment. In this study, we present the oncologic outcome of breast cancer patients with ≥4 involved axillary lymph nodes treated according to the MARI-protocol.</div></div><div><h3>Methods</h3><div>This prospective single arm registration study included breast cancer patients with extensive nodal disease defined as ≥4 involved axillary lymph nodes on FDG-PET/CT pre-PST between July 2014 and December 2021. After PST, the marked (MARI) lymph node was excised. Patients with a pathologic complete response (pCR) of the MARI node (ypN0) received locoregional radiation treatment (RT). In patients with residual disease of the MARI node (ypN+), ALND was performed followed by RT. Primary endpoint was axillary recurrence rate. Secondary endpoints were invasive disease-free survival (DFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>In total, 218 patients were registered of which 39 % of patients also had extra-axillary nodal disease. Median (IQR) age was 50 (42–57) years. After PST 47 % of patients (103/218) had ypN0, whereas 53 % of patients (115/218) had ypN+. After a median follow up of 44 (26–62) months, axillary recurrence rate was 2.9 % (<em>n</em> = 3) in the ypN0 group and 3.5 % (<em>n</em> = 4) in the ypN + group. Five-year invasive DFS and OS were respectively 89 % (95 % CI 83 %–96 %) and 95 % (95 % CI 91 %–99 %) in ypN0 patients.</div></div><div><h3>Conclusion</h3><div>Omission of ALND after PST in breast cancer patients with extensive nodal involvement who achieve pCR of the MARI node is associated with excellent five-year oncologic outcome.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"80 ","pages":"Article 104411"},"PeriodicalIF":5.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420145","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}