Breast最新文献

{"title":"Impact of stereotactic body radiation therapy on systemic therapeutic line change in oligometastatic breast cancer","authors":"Julie Leblanc , Alexandre de Nonneville , Camille Nicolas , Anthony Gonçalves , Véronique Favrel , Marguerite Tyran , Morgan Guenole , Leonel Varela , Laurence Gonzague , Agnès Tallet , Claire Petit","doi":"10.1016/j.breast.2025.104546","DOIUrl":"10.1016/j.breast.2025.104546","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104546"},"PeriodicalIF":7.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721125","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":"Biomarkers of response and resistance to immune checkpoint inhibitors in breast cancer","authors":"Michelle Li ,&nbsp;François Panet ,&nbsp;Vittoria Barberi ,&nbsp;Roberto Salgado ,&nbsp;Mafalda Oliveira ,&nbsp;Sherene Loi","doi":"10.1016/j.breast.2025.104545","DOIUrl":"10.1016/j.breast.2025.104545","url":null,"abstract":"<div><div>Immune checkpoint inhibitors (ICIs) have recently been approved in subsets of patients with breast cancer (BC). Currently, programmed death ligand 1 (PD-L1) immunohistochemistry is used as a biomarker of response for metastatic triple negative breast cancer (TNBC). Other tumor-agnostic indications in metastatic BC include high tumor mutational burden and mismatch repair deficiency. In early TNBC, the ICI pembrolizumab is routinely added to neoadjuvant chemotherapy, yet no biomarker is currently available to predict response or resistance. Further, while luminal BC is often thought to be immune-depleted, preliminary efficacy data in early-stage disease suggests that the addition of ICIs to neoadjuvant chemotherapy can significantly improve rates of pathological complete response. However, not all patients will benefit from ICI treatment and it also comes with significant treatment toxicities. This review will describe biomarkers of response and resistance to ICIs in BC. These currently include tumor infiltrating lymphocytes, homologous recombination deficiency, CD274 gain or amplification, estrogen receptor and/or progesterone receptor expression, more precise tumoral immune characterization, gene expression analysis, and the T-cell receptor repertoire. Although still investigational, these approaches hold the potential to advance personalized medicine by tailoring the use of ICIs to BC patients who will benefit.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104545"},"PeriodicalIF":5.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712852","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":"BEBT-209, a primary CDK4 selective inhibitor, for the treatment of HR+/HER2- advanced breast cancer (BECTOP1): a phase 1, multicentre, open-label study","authors":"Zhe-Yu Hu ,&nbsp;Kegang Jiang ,&nbsp;Can Tian ,&nbsp;Fan Zhang ,&nbsp;Yehui Shi ,&nbsp;Ying Wang ,&nbsp;Wei Li ,&nbsp;Biao Wu ,&nbsp;Boni Ding ,&nbsp;Liping Liu ,&nbsp;Huawu Xiao ,&nbsp;Xiaohong Yang ,&nbsp;Jing Li ,&nbsp;Ning Xie ,&nbsp;Binliang Liu ,&nbsp;Shouman Wang ,&nbsp;Quchang Ouyang","doi":"10.1016/j.breast.2025.104527","DOIUrl":"10.1016/j.breast.2025.104527","url":null,"abstract":"<div><h3>Purpose</h3><div>Several cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have been approved for the treatment of hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer. Despite the side effects that affect patients' quality of life, most patients still opt for CDK4/6 inhibitors due to their significant benefits. However, to further enhance treatment efficacy and safety, new approaches are still needed.</div></div><div><h3>Patients and methods</h3><div>This multicentre, open-label, Phase 1 trial enrolled Chinese patients with HR+, HER2-advanced breast cancers. The primary endpoints were dose-limiting toxicity (DLT), maximum tolerated dose (MTD). Secondary endpoints included the objective response rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), and pharmacokinetic parameters.</div></div><div><h3>Results</h3><div>During the dose-escalation phase, a DLT was observed in the 150 mg bid dose cohort, specifically, 2 patients experienced grade 4 neutropenia. MTD of BEBT-209 was 100 mg bid, and the most common adverse event (AE) was neutropenia. In Phase 1b, the median PFS of patients with BEBT-209 alone, BEBT-209 plus letrozole, and BEBT-209 plus fulvestrant was 10.38 months, 24.94 months, and not reached, respectively. At doses of 25 mg qd–150 mg bid, steady state areas under the concentration–time curve and peak concentration increased proportionally with dose. The most common grade 3 or 4 AEs were neutropenia (65.4 %), lymphocytopenia (7.4 %), and anaemia (4.9 %).</div></div><div><h3>Conclusion</h3><div>BEBT-209 was a primary CDK4 selective inhibitor and showed an acceptable safety profile and dose-dependent plasma exposure. The results highlight the potential of combination treatments as compelling options, particularly in combination with fulvestrant.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104527"},"PeriodicalIF":5.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685621","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":"Prognostication and treatment predictions for estrogen receptor positive early-stage breast cancer: incorporating the 70-gene signature into the PREDICT prognostication model","authors":"Ellen G. Engelhardt ,&nbsp;Mary Ann E. Binuya ,&nbsp;Paul D.P. Pharoah ,&nbsp;Coralie Poncet ,&nbsp;Emiel J.T. Rutgers ,&nbsp;Martine Piccart ,&nbsp;Fatima Cardoso ,&nbsp;Laura J. van ‘t Veer ,&nbsp;Ewout W. Steyerberg ,&nbsp;Sabine C. Linn ,&nbsp;Marjanka K. Schmidt","doi":"10.1016/j.breast.2025.104542","DOIUrl":"10.1016/j.breast.2025.104542","url":null,"abstract":"<div><h3>Background</h3><div>The 70-gene signature (70-GS) has been shown to identify women at low-risk of distant recurrence who can safely forgo adjuvant chemotherapy. Incorporating this GS into the well-validated and widely used PREDICT breast cancer model could improve the model's ability to estimate breast cancer prognosis, and thereby further reduce overtreatment and its long-term impact on patients' quality of life. We incorporated the 70-GS into PREDICT-v2.3 and assessed the new PREDICT-GS model's ability to predict 5-year risk of breast cancer death.</div></div><div><h3>Methods</h3><div>Data from the MINDACT trial (N = 5920) was used to estimate the 70-GS's prognostic effect (coefficient = 0.70), which was then incorporated into PREDICT-v2.3. Netherlands Cancer Registry (NCR) data (N = 3323) was used to assess PREDICT-GS's discrimination (area under curve (AUC)), calibration and clinical utility.</div></div><div><h3>Results</h3><div>Compared to PREDICT-v2.3 (AUC: 0.71 (95 % CI: 0.63–0.79)), PREDICT-GS (AUC: 0.76 (95 % CI: 0.69–0.83)) had better discrimination. Both models tended to overestimate the 5-year risk of breast cancer death in the NCR cohort, but the absolute overestimation was smaller for PREDICT-GS. Regarding clinical utility, only at the 10 % decision threshold did we find modest improvement: four extra patients per 1000 tests were correctly classified as not needing chemotherapy by PREDICT-GS compared to PREDICT-v2.3.</div></div><div><h3>Conclusion</h3><div>Extending PREDICT-v2.3 with 70-GS led to modest improvement in its ability to predict 5-year risk of breast cancer death. Future research should focus on assessing the added value of the 70-GS for longer-term prediction of recurrence and death with the incorporation of quality of life in risk prediction tools.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104542"},"PeriodicalIF":5.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702583","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 a machine learning prediction model on the false-negative rate of sentinel lymph node biopsy for clinically node-positive breast cancer after neoadjuvant chemotherapy","authors":"Minyan Chen ,&nbsp;Tianzi Hong ,&nbsp;Yali Wang ,&nbsp;Shengmei Li ,&nbsp;Bangwei Zeng ,&nbsp;Cong Chen ,&nbsp;Jie Zhang ,&nbsp;Wenhui Guo ,&nbsp;Lili Chen ,&nbsp;Yuxiang Lin ,&nbsp;Chuan Wang ,&nbsp;Fangmeng Fu","doi":"10.1016/j.breast.2025.104543","DOIUrl":"10.1016/j.breast.2025.104543","url":null,"abstract":"<div><h3>Background</h3><div>Machine learning (ML) models can be used to predict axillary pathological complete responses (pCRs) in clinically node-positive (cN+) breast cancer after neoadjuvant chemotherapy (NAC). We developed an ML model combining clinicopathological characteristics and axillary ultrasound features before and after NAC to predict the possibility of axillary pCR in NAC-treated cN + breast cancer.</div></div><div><h3>Methods</h3><div>Patients with cN + breast cancer who received NAC were categorized into training and verification cohorts (7:3 ratio). Independent predictors of axillary pCR were selected using univariate and multivariate logistic regression analyses; six ML models were developed to predict pCRs. Another independent prospective cohort of 126 patients was enrolled to evaluate false-negative cases when the best-performing model was used to guide patient selection for sentinel lymph node biopsy (SLNB).</div></div><div><h3>Results</h3><div>Overall, 614 patients with breast cancer were included. Age, menstrual status, cN staging before NAC, molecular subtype, histological grade, tumor shrinkage percentage after NAC, and lymph node cortical thickening ≥3 mm before and after NAC were independent predictors of axillary pCR. A multilayer perceptron model had the best stability and predictive performance, yielding the highest area under the receiver operating characteristic curve of 0.801 (training) and 0.774 (validation). When applying this model to the independent test cohort to guide patient selection for SLNB, the false-negative rate was reduced from 22.2 % to 1.4 %.</div></div><div><h3>Conclusion</h3><div>We established an ML model with excellent performance to predict pCR in cN + breast cancer after NAC. The ML model demonstrated potential to reduce the false-negative rate of single-tracer SLNB when used as an adjunct to clinical judgment.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104543"},"PeriodicalIF":7.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721124","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":"Acute presentations in neoadjuvant chemotherapy/immune checkpoint inhibition for triple negative breast cancer: experiences and impact from real-world data","authors":"Tim Cooksley ,&nbsp;Safwaan Adam ,&nbsp;Bence Nagy ,&nbsp;Sophie Raby ,&nbsp;Anne Armstrong ,&nbsp;Jamie MJ. Weaver","doi":"10.1016/j.breast.2025.104536","DOIUrl":"10.1016/j.breast.2025.104536","url":null,"abstract":"<div><h3>Background</h3><div>Recent data showed benefit of the addition of immune checkpoint inhibitor (ICI) therapy to cytotoxic chemotherapy in the neoadjuvant setting for patients with early triple negative breast cancer. Acute presentations in patients treated with ICI therapy and combined chemotherapy/ICI therapy can be challenging and have significant resource implications.</div></div><div><h3>Materials and methods</h3><div>A prospective analysis was performed at a specialist oncology hospital in England from December 1, 2022 to December 31, 2024. The primary outcome measure was whether the acute presentation was due to an ICI-related toxicity. Secondary outcome measures were number of inpatient bed days and the proportion of patients with grade ≥3 diarrhoea or transaminases that were diagnosed with ICI-related toxicity.</div></div><div><h3>Results</h3><div>During the study period, 285 patients were treated with neoadjuvant PC-EC/Pembro for triple negative breast cancer with 210 emergency presentations in 168 patients to the acute floor. Fifty-three (25.2 %) patients were diagnosed with an ICI-related toxicity of which 5 were a relapsed/recurrent presentation. One hundred and nine patients (51.9 %) were discharged on the day of presentation. A total of 576 inpatient bed days were used in the management of the cohort.</div><div>Sixteen (7.6 %) patients had grade 3 diarrhoea at presentation; only 5 (31.3 %) of these were ICI-mediated. Eleven (5.2 %) patients had a grade ≥3 ALT rise at presentation; only 3 (27.2 %) of these were ICI-mediated.</div></div><div><h3>Conclusion</h3><div>In triple negative breast cancer being treated in the neoadjuvant setting with chemotherapy/immune checkpoint inhibition only 25.2 % of acute presentations had an ICI-related toxicity driving their attendance. Toxicities in this cohort may require a different approach to those treated with chemotherapy or ICI alone and may necessitate new clinical practice guidance.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104536"},"PeriodicalIF":5.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702584","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 in breast cancer radiotherapy: Insights from the Toolbox Consortium Delphi study","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.2025.104537","DOIUrl":"10.1016/j.breast.2025.104537","url":null,"abstract":"<div><div>Artificial intelligence (AI) is being incorporated in several breast cancer care domains, including for radiation therapy (RT). Herein we provide a review about AI for the management and planning of RT for breast cancer, which is part of the Toolbox-3 project's multidisciplinary Delphi study, including a literature review of studies related to the topic raised by the Delphi questionnaire. Our review shows that available evidence mainly consists of small single institutional studies, often at least partly supported by commercial companies. Current studies suffer from a lack of transparency regarding how these systems were developed, the information they are based on, the algorithms used, and potential proprietary issues. This review provides a critical inter- and multidisciplinary assessment of existing systems to help us in guiding development and utilisation of AI-based tools in the field of radiation oncology. As medical professional users, we must remain vigilant and continue to improve our personal experience and knowledge that serves as the \"ground truth\". Employing AI required a critical mindset, particularly in medical applications which may influence the lives of our patients.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"83 ","pages":"Article 104537"},"PeriodicalIF":7.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772345","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":"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}