Breast最新文献

{"title":"Denosumab versus zoledronic acid in metastatic breast cancer: A retrospective observational analysis of 24-dose regimens on analgesia and skeletal-related event prevention","authors":"Giacomo Massa ,&nbsp;Noemi Simeone ,&nbsp;Gabriele Tinè ,&nbsp;Paola Bracchi ,&nbsp;Rosalba Miceli ,&nbsp;Alessandra Pigni ,&nbsp;Silvia Lo Dico ,&nbsp;Luca Zambelli ,&nbsp;Francesca Ricchini ,&nbsp;Giulia Valeria Bianchi ,&nbsp;Augusto Caraceni ,&nbsp;Ernesto Zecca","doi":"10.1016/j.breast.2025.104565","DOIUrl":"10.1016/j.breast.2025.104565","url":null,"abstract":"<div><h3>Background</h3><div>Based on available data in the literature, current evidence supporting the analgesic role of antiresorptive drugs is weak. This study compared the efficacy of zoledronic acid (ZA) and denosumab (Dmab) in reducing bone pain and first Skeletal Related Events (SREs) in real world setting.</div></div><div><h3>Methods</h3><div>A retrospective observational cohort study was conducted in patients with female breast cancer-related bone metastases at the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan, Italy, from January 2008 to January 2023. Patients were included if they had undergone at least 24 consecutive administrations of ZA or Dmab. The primary endpoint was the analgesic effect, evaluated in terms of average pain intensity, analgesic drug use (Word Health Organization analgesic ladder), and daily opioid doses (oral morphine equivalent, OME) assessed at 3, 6, 12, 18, and 24 months, analyzed by Bayesian longitudinal mixed-effects models. Secondary endpoints included first SREs and radiotherapy/surgery incidence.</div></div><div><h3>Results</h3><div>Among 364 patients (194 ZA, 170 Dmab), Dmab demonstrated a significant analgesic advantage. Dmab group showed an 89 % lower likelihood of increasing one analgesic ladder step, a mean reduction of 0.4 points on the numerical rating scale (95 % CI, −0.7, −0.1), and lower daily OME doses (0.77 mg vs. 6.2 mg for ZA). At 12 and 24 months, ZA and Dmab showed similar cumulative incidences of SREs and radiotherapy/surgery (p = 0.601 and p = 0.923).</div></div><div><h3>Conclusions</h3><div>Dmab showed consistent superior effect than ZA in reducing bone pain in metastatic BC, yet both treatments delivered similar protection against SREs and the need for radiotherapy or surgery.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104565"},"PeriodicalIF":7.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of genetic risk-stratified screening for breast cancer in Taiwan","authors":"Yu-Chen Hou ,&nbsp;Fang-Ju Lin ,&nbsp;Yu-Hsuan Joni Shao","doi":"10.1016/j.breast.2025.104566","DOIUrl":"10.1016/j.breast.2025.104566","url":null,"abstract":"<div><h3>Background</h3><div>Risk-stratified breast screening has gained international attention, as individualized risk assessments can inform screening initiation, frequency, and whether to screen. In this study, we evaluated the cost-effectiveness of risk-stratified screening based on genetic testing for breast cancer-associated single nucleotide polymorphisms (SNPs) compared to the current age-based screening program in Taiwan.</div></div><div><h3>Methods</h3><div>A Markov model was used to estimate lifetime health outcomes and costs for 35-year-old Taiwanese women without a family history of breast cancer. The model adopted the healthcare payer's perspective, applied a 3 % annual discount rate, and utilized epidemiological and cost data primarily derived from Taiwanese sources whenever possible. Scenario analyses included various percentile thresholds used to define polygenic risk groups in the risk-stratified screening strategy. Within this strategy, no screening was modeled for women in the low-risk group, while those in the intermediate- and high-risk groups were offered standard biennial mammography, beginning at ages 40 and 35, respectively, and continuing until 69.</div></div><div><h3>Results</h3><div>Compared to the current age-based mammogram-only screening, polygenic risk scores (PRS)-informed risk-stratified breast cancer screening generated additional costs and quality-adjusted life years (QALYs), with an incremental cost-effectiveness ratio (ICER) of US$75.71/QALY. Scenario analyses using different PRS cutoffs consistently yielded ICERs well below one time Taiwan's gross domestic product per capita per QALY, suggesting cost-effectiveness of genetic risk-stratified screening.</div></div><div><h3>Conclusion</h3><div>Incorporating polygenic risk into the current breast cancer screening program may improve health outcomes at an acceptable cost. These findings support implementing risk-stratified screening in future policy.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104566"},"PeriodicalIF":7.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence as treatment support in breast cancer: current perspectives","authors":"Stefan Lukac ,&nbsp;Florian Putz ,&nbsp;Giacomo De Micheli ,&nbsp;Chiara Corti ,&nbsp;Wolfgang Janni ,&nbsp;Sara M. Tolaney ,&nbsp;Giuseppe Curigliano ,&nbsp;Sibylle Loibl ,&nbsp;Paolo Tarantino ,&nbsp;Jose Pablo Leone","doi":"10.1016/j.breast.2025.104564","DOIUrl":"10.1016/j.breast.2025.104564","url":null,"abstract":"<div><div>With the increasing amount of information related to breast cancer (BC) management, artificial intelligence (AI) has emerged as a tool with the potential to enhance the quality of treatment through the efficient integration of large datasets; however, the specific areas for which AI may be ready for clinical implementation remain unclear. In this narrative review, we recapitulate the available data on AI utilization in BC treatment by focusing on surgical therapy, radiation therapy, systemic and supportive treatment, but including the diagnostics, too. While AI has been implemented successfully in mammography screening, preoperative consultation, and radiation oncology, its use intraoperatively, post-operatively, and in systemic and supportive treatment is still in development. AI has potential to improve care, but since the accuracy of AI varies, careful consideration of its benefits and limitations is necessary.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104564"},"PeriodicalIF":7.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a predictive model for disease-free progression in triple-negative breast cancer: A retrospective study using color Doppler ultrasound and magnetic resonance imaging","authors":"Fan Li ,&nbsp;Huan-huan Yan ,&nbsp;Ben-kai Wei ,&nbsp;Jun Shen","doi":"10.1016/j.breast.2025.104560","DOIUrl":"10.1016/j.breast.2025.104560","url":null,"abstract":"<div><h3>Objective</h3><div>Because triple-negative breast cancer has a poor prognosis, adjuvant intensive therapy can effectively improve its prognosis. How to make accurate decisions is lacking of research.This study aimed to develop and validate a model to predict disease-free progression in triple-negative breast cancer (TNBC) using breast color Doppler ultrasound and magnetic resonance imaging (MRI), to facilitate precision in clinical intervention.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on data from 380 individuals with TNBC between June 2018 and June 2022. Collected variables included patient demographics, pathological characteristics, and imaging parameters. Predictive models were developed using variable selection through Cox regression analysis, random forest, and eXtreme gradient boosting (XGBoost). Model performance was evaluated using receiver operating characteristic (ROC) curves, area under the ROC curve (AUC) values, calibration curves, and measures such as net reclassification improvement and integrated discrimination improvement (IDI). The optimal model was visualized and subjected to clinical testing.</div></div><div><h3>Results</h3><div>Comparative analysis revealed that the Cox model outperformed the Rf.cox and XGBoost.cox models. Specifically, at the 48-month time point in the validation set, the XGBoost.cox model demonstrated inferior performance compared to the Cox model. The Cox model was chosen as the optimal model, incorporating seven variables: Age, T-Stage, N-Stage, Ki-67, SE-Score, time-signal intensity curve, and early-phase enhancement. The AUC was 0.937 (0.904–0.971) in the training set and 0.906 (0.855–0.957) in the validation set. Decision curve analysis and clinical impact curve supported the potential utility of the model in guiding clinical interventions.</div></div><div><h3>Conclusion</h3><div>The predictive model for disease-free progression in TNBC, based on imaging parameters from breast color Doppler ultrasound and MRI, demonstrates feasibility. Further studies are recommended to confirm its clinical applicability.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104560"},"PeriodicalIF":7.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of the omission of axillary surgery in node-negative early breast cancer: a systematic review and meta-analysis","authors":"James Lucocq ,&nbsp;Hassan Baig ,&nbsp;Kenneth Elder ,&nbsp;Gordon Urquhart ,&nbsp;Ravi Sharma ,&nbsp;Laszlo Romics ,&nbsp;Beatrix Elsberger","doi":"10.1016/j.breast.2025.104559","DOIUrl":"10.1016/j.breast.2025.104559","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent and historical trials have suggested that the omission of axillary surgery is oncologically safe in node-negative early breast cancer. This meta-analysis investigates the feasibility of the omission of axillary surgery (SLNB or ALND) in terms of oncological outcomes and adjuvant treatment decisions.</div></div><div><h3>Method</h3><div>A systematic search of Medline, Embase and Cochrane Central was conducted. Random-effect meta-analysis was conducted to compare recurrence and survival outcomes between omission of axillary surgery and SLNB or ALND. Differences in real-world adjuvant treatment decisions and patient reported outcomes were investigated.</div></div><div><h3>Results</h3><div>Ten studies (omission, n = 3716; SLNB/ALND, n = 4604/785) investigated oncological outcomes (pooled rates, T1 88 %; Grade 1–2 80 %; ER-positive 91.2 %; HER2-positive 4.4 %; ductal carcinoma 74 %). In the omitted group, the pooled rates of local, axillary and distant recurrence (follow-up, 8 years 9 months) were 3.0 % (95 %CI,1.5–5.9 %), 2.5 % (95 %CI,1.3–4.8 %; 5year, 1.0 %) and 3.6 % (95 %CI,2.0–6.5 %; 5year, 2.7 %), respectively. When comparing omission to SLNB/ALND, there were no differences in local recurrence (OR 0.91; 95 %CI,0.56–1.50), distant metastasis (OR 0.91; 95 %CI,0.56–1.50), BCM (OR 1.00; 95 %CI,0.63–1.60), OS (HR 0.88; 95 %CI,0.65–1.19) or DFS (HR 0.91; 95 %CI,0.76–1.11). Axillary recurrence was higher in the omission group compared to SLNB/ALND (OR 4.42; 95 %CI,1.5–12.8) but not in SLNB alone (OR 2.85; 95 %CI,0.1–133.8). Omission of axillary surgery was associated with lower rates of adjuvant chemotherapy, radiotherapy and hormonal treatment but quality of evidence was poor.</div></div><div><h3>Conclusion</h3><div>Omission of axillary surgery is safe in node-negative early breast cancer. Prospective data is required to investigate the impact of omission on adjuvant treatment decision.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104559"},"PeriodicalIF":7.9,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903752","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 “Artificial intelligence in breast cancer radiotherapy: Insights from the Toolbox Consortium Delphi study” [The Breast, Volume 83 (2025) 104537]","authors":"Orit Kaidar-Person ,&nbsp;André Pfob ,&nbsp;Vincenzo Valentini ,&nbsp;Marianne Aznar ,&nbsp;Andre Dekker ,&nbsp;Icro Meattini ,&nbsp;Jana de Boniface ,&nbsp;David Krug ,&nbsp;Maria Joao Cardoso ,&nbsp;Giuseppe Curigliano ,&nbsp;Peter Dubsky ,&nbsp;Philip Poortmans","doi":"10.1016/j.breast.2025.104557","DOIUrl":"10.1016/j.breast.2025.104557","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104557"},"PeriodicalIF":7.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865351","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":"Early prediction of menopausal status after chemotherapy in women with early breast cancer in order to optimize adjuvant endocrine therapy","authors":"Charissa van Zwol-Janssens ,&nbsp;Mandy M. van Rosmalen ,&nbsp;Esther Oomen-de Hoop ,&nbsp;Jan C. Drooger ,&nbsp;Annemieke van der Padt-Pruijsten ,&nbsp;Hanneke J.M. Zuetenhorst ,&nbsp;Yvonne V. Louwers ,&nbsp;Jenny A. Visser ,&nbsp;Joop S.E. Laven ,&nbsp;Agnes Jager","doi":"10.1016/j.breast.2025.104562","DOIUrl":"10.1016/j.breast.2025.104562","url":null,"abstract":"<div><h3>Background</h3><div>Optimal endocrine therapy for premenopausal breast cancer patients after chemotherapy requires accurate menopausal status assessment. Current methods for determining resumption of ovarian function after chemotherapy are suboptimal. This study aims to evaluate the predictive value of pretreatment anti-Müllerian hormone (AMH) serum levels for predicting resumption of ovarian function after chemotherapy (CT).</div></div><div><h3>Methods</h3><div>This prospective study included premenopausal women with hormone receptor-positive breast cancer undergoing CT. AMH was measured using the picoAMH assay of Anshlabs. The primary outcome was resumption of ovarian function, defined as menstrual cycle resumption or estradiol levels above 110 pmol/L within 24 months after CT.</div></div><div><h3>Results</h3><div>Among 109 patients, pretreatment AMH was a strong predictor of resumption of ovarian function (AUC 0.86) and an optimal cut-off of 0.62 μg/L was calculated. AMH &gt;0.62 μg/L identified women at higher risk for ovarian function resumption (sensitivity 69.9 %, specificity 88.5 %), with a false negative rate of 11.5 % and false positive rate of 30.1 %. Combining AMH and age improved predictive accuracy only slightly. No additional predictors were identified. Survival analysis confirmed that women with low pretreatment AMH (&lt;0.62 μg/L) or older age (&gt;40.2 years) experienced significantly less frequent and delayed ovarian function resumption.</div></div><div><h3>Conclusion</h3><div>Pretreatment AMH is a valuable tool for predicting ovarian function resumption after chemotherapy in breast cancer patients, so that a GnRH agonist can be recommended appropriately. However, the predictive value of pretreatment AMH for permanent ovarian insufficiency is too limited to determine the postmenopausal status sufficiently accurately to switch upfront to another endocrine treatment, the aromatase inhibitors.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104562"},"PeriodicalIF":7.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890738","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":"Awareness of modifiable lifestyle risk factors and acceptability of secondary risk reduction services amongst Irish breast cancer survivors and oncology healthcare professionals.","authors":"Clara Steele, Janas M Harrington, Seamus O'Reilly","doi":"10.1016/j.breast.2025.104561","DOIUrl":"https://doi.org/10.1016/j.breast.2025.104561","url":null,"abstract":"<p><p>Breast cancer is the most common non cutaneous cancer in Irish women. Diagnosis offers a key opportunity to promote lifestyle change. This study assessed awareness of modifiable lifestyle risk factors and acceptability of secondary risk reduction services amongst breast cancer survivors and healthcare professionals. A cross-sectional study was conducted between September and December 2021. Surveys were developed using previously validated questionnaires: the Mitchelstown Cohort Survey and the International Physical Activity Questionnaire. A survey was offered to healthcare professionals working in and patients attending the early breast cancer outpatient clinic at the South Infirmary Victoria and Cork University Hospitals', Ireland. 322 patients and 29 healthcare professionals participated. Many patients met at-risk lifestyle factors; body mass index >25kg/m2 (66 % [n = 203/313]), low physical activity (19 % [n = 60/322]), frequent consumption of high fat, sugar and salt containing foods (42 % [n = 135/320]), increased alcohol consumption (39 % [n = 125/322]) and current smoker (5 % [n = 17/322]). 83 % of patients and HCPs agreed that modifiable lifestyle risk factors are important in cancer prevention. Only 17 % (n=5/29) of HCPs had training in secondary risk reduction; however, 90 % were willing to refer to services. Patients who had increased alcohol intake or weight gain since diagnosis were more likely to engage with services (44 %, n = 15/34 [p=<0.008]) and (74 %, n = 99/134, [p = <0.001]). A large proportion of patients met at-risk lifestyle criteria. Gaps in knowledge of at-risk lifestyle behaviours exist. Patients intended engagement with some secondary risk reduction services was associated with their lifestyle behaviours. Our study highlights the challenges of implementing survivorship health promotion programs.</p>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"104561"},"PeriodicalIF":7.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312444","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":"Brain imaging screening in metastatic breast cancer: patients' and physicians' perspectives.","authors":"Leonor Matos, Mette van Ramshorst, Volkmar Müller, Elisa Agostinetto, Sabine Linn, Matteo Lambertini, Veronique Dieras, Fanny le Du, Sofia Braga, Carmen Criscitiello, Katarzyna J Jerzak, Gil Morgan, Sara Brucker, Patricia von Kroge, Renate Haidinger, Gema Rodríguez Recio, Eva Schumacher-Wulf, Mario Fontes Sousa, Francesco Schettini, Elena Laakmann","doi":"10.1016/j.breast.2025.104558","DOIUrl":"https://doi.org/10.1016/j.breast.2025.104558","url":null,"abstract":"<p><strong>Background: </strong>Routine brain imaging screening (BIS) in patients with metastatic breast cancer (BC) without neurological symptoms is currently not recommended, as no survival/quality-of-life improvements have been demonstrated. We aimed to examine physicians and patients' attitudes and perceptions toward BIS.</p><p><strong>Methods: </strong>International cross-sectional online survey for patients and physicians, distributed from May 2023 to February 2024. Patients with BC diagnosis were deemed eligible for patients' survey completion and BC-treating physicians were invited to fill the physicians' questionnaire.</p><p><strong>Results: </strong>A total of 529 physicians from 50 countries (80 % European) responded, mostly medical oncologists (70 %) working in academic hospitals (53 %). Most physicians request BIS (65 %), mainly when extracranial progression occurs, especially for HER2+ and triple negative BC (TNBC). Among physicians never performing BIS (35 %), 91 % would in case of proved clinical benefit. A total of 545 patients from 14 European countries completed the questionnaire. Median age was 50 years, 86 % had metastatic BC, 51 % hormone receptor-positive (HR+)/HER2-negative, 30 % HER2-positive (HER2+) and 19 % TNBC. BM were diagnosed in 11.5 % patients with metastatic BC. 85 % patients would like to undergo BIS, especially younger ones (p = 0.02) and with HR-disease (p = 0.03), despite the uncertain clinical benefit. Notably, 91 % of patients would like to receive information regarding BM, while only 13 % of physicians routinely address the issue.</p><p><strong>Conclusions: </strong>These results underline the willingness of patients to know more about the prospects of BM development, in contrast to the lack of routine discussion of this topic by physicians. Further investigation is warranted to demonstrate the clinical utility of routine BIS.</p>","PeriodicalId":9093,"journal":{"name":"Breast","volume":" ","pages":"104558"},"PeriodicalIF":7.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942450","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":"Clinical and economic research of bone modifiers as adjuvant therapy for early breast cancer: A systematic literature review","authors":"Wenhua Wu ,&nbsp;Yixiao Zhu ,&nbsp;Huiting Lin ,&nbsp;Jia Liu ,&nbsp;Suyan Liu ,&nbsp;Lirong Zhang ,&nbsp;Jiaqin Cai ,&nbsp;Hong Sun ,&nbsp;Xiaoxia Wei","doi":"10.1016/j.breast.2025.104551","DOIUrl":"10.1016/j.breast.2025.104551","url":null,"abstract":"<div><h3>Background</h3><div>Adjuvant bisphosphonate therapy is recommended by some guidelines for postmenopausal breast cancer, but its application is not ideal due to inconsistent study results and economic burden considerations. This review aims to provide a comprehensive overview of bone modifiers in breast cancer adjuvant treatment to inform clinical practice and health policy.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Cochrane Library, and Web of Science were searched using terms related to bone modifiers and breast cancer. The included studies comprised clinical trials evaluating adjuvant bone modifiers in early breast cancer (EBC) that reported recurrence, metastasis, or survival outcomes, as well as economic studies that reported costs and effects. Quality was assessed using Cochrane Risk of Bias tool and Quality of Health Economic Studies scale. We also summarized current international guideline recommendations regarding adjuvant bone modifiers in EBC.</div></div><div><h3>Results</h3><div>Of the 31 eligible articles, findings showed that zoledronic acid and clodronate demonstrated reduced recurrence and improved survival in low-estrogen EBC patients, whereas ibandronate showed no significant benefit. Other bisphosphonates and denosumab require further investigation. Bone modifiers were generally well-tolerated, with mild adverse events. Serious events like nephrotoxicity, osteonecrosis of the jaw, and atypical femoral fractures were rare but necessitate monitoring and prevention. Economic studies suggest that adjuvant zoledronic acid may be cost-effective for postmenopausal EBC patients.</div></div><div><h3>Conclusion</h3><div>Many unresolved issues remain regarding bone modifiers in EBC adjuvant therapy. Insufficient clinical and economic evidence precludes drawing comprehensive conclusions at present. Future studies need to provide higher-quality evidence to deepen our understanding of adjuvant therapy with bone modifiers.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104551"},"PeriodicalIF":7.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827427","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}