Breast最新文献

{"title":"Baseline systemic inflammatory indices predict late radiation-induced fibrosis and toxicity in patients with early breast cancer","authors":"Lorenzo Vinante ,&nbsp;Jerry Polesel ,&nbsp;Andrea Sacilotto ,&nbsp;Anna Giroldi ,&nbsp;Angela Caroli ,&nbsp;Alberto Revelant ,&nbsp;Cristina Cappelletto ,&nbsp;Paola Chiovati ,&nbsp;Alessia Chiofalo ,&nbsp;Samuele Massarut ,&nbsp;Barbara Belletti ,&nbsp;Maurizio Mascarin ,&nbsp;Agostino Steffan ,&nbsp;Lorena Baboci","doi":"10.1016/j.breast.2025.104685","DOIUrl":"10.1016/j.breast.2025.104685","url":null,"abstract":"<div><div>Radiation therapy (RT) is a standard component of treatment for early breast cancer and ductal carcinoma in situ. Although survival is excellent, RT-related side effects can impair long-term quality of life. We aimed to develop models to predict the risk of Grade ≥2 fibrosis and other late toxicities by combining clinical risk factors with baseline systemic inflammatory indices.</div><div>In this prospective study, 324 women underwent breast-conserving surgery followed by whole-breast RT and were followed for 24 months. Pre-surgical blood counts were used to calculate inflammatory indices, including NLR, dNLR, PLR, MLR, NLPR, SII, SIRI and AISI. Optimal cut-offs for each index was determined using ROC curves. Predictive models integrated clinical factors (surgical complications, post-menopausal status, chemotherapy, smoking, RT dose) with individual inflammatory indices to predict Grade ≥2 fibrosis and overall late side effects (fibrosis, skin side effects, chronic pain, lymphoedema).</div><div>At 24 months, 13.0 % of patients had developed Grade ≥2 fibrosis and 17.9 % had at least one Grade ≥2 late side effect. Patients who developed fibrosis had higher baseline NLR, dNLR, MLR, NLPR and SIRI. Models incorporating MLR or NLPR achieved area under the curve values &gt; 0.70 and negative predictive values ≥ 93 %, outperforming models based on clinical risk factors alone. These findings suggest that routinely measured systemic inflammatory indices can identify patients at low risk of late RT side effects. If validated in external cohorts, these models may help tailor RT regimens to minimize long-term complications while maintaining therapeutic benefit.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104685"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910443","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 overlooked publication: Forrest (1880) as the earliest report of male mammary Paget's disease","authors":"Wiebren A. Tjalma M.D., Ph.D., FEBS (Hon)","doi":"10.1016/j.breast.2025.104688","DOIUrl":"10.1016/j.breast.2025.104688","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104688"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910460","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":"Timing of final oncologist visit and systemic treatment use near the end of life in pretreated patients with metastatic triple-negative breast cancer: a multinational cohort study","authors":"Justyna Żubrowska ,&nbsp;Małgorzata Pieniążek ,&nbsp;Anna Polakiewicz-Gilowska ,&nbsp;Lenka Rušinová ,&nbsp;Renáta Soumarová ,&nbsp;Hana Študentová ,&nbsp;Aleksandra Konieczna ,&nbsp;Agnieszka Młodzińska ,&nbsp;Karolina Winsko-Szczęsnowicz ,&nbsp;Maja Lisik-Habib ,&nbsp;Anika Pękala ,&nbsp;Daniel Krejčí ,&nbsp;Jan Šustr ,&nbsp;Iveta Kolářová ,&nbsp;Iwona Danielewicz ,&nbsp;Magdalena Szymanik-Resko ,&nbsp;Tomasz Ciszewski ,&nbsp;Miloš Holánek ,&nbsp;Bogumiła Czartoryska-Arłukowicz ,&nbsp;Aleksandra Łacko ,&nbsp;Mirosława Püsküllüoğlu","doi":"10.1016/j.breast.2026.104699","DOIUrl":"10.1016/j.breast.2026.104699","url":null,"abstract":"<div><h3>Background</h3><div>In heavily pretreated patients with metastatic triple-negative breast cancer (mTNBC), further systemic therapy offers limited benefit and increased toxicity. Recognizing the end-of-life (EOL) phase in time helps avoid overtreatment and ensure goal-concordant care. This study analyzed the interval between the last oncologist visit and death in pretreated women with mTNBC, as well as systemic therapy status, palliative care involvement and related factors.</div></div><div><h3>Methods</h3><div>This multinational ambispective cohort study included women with mTNBC who received ≥2 lines of palliative systemic therapy and died between June 20, 2022 and June 20, 2025. Data from 17 centers in Poland, the Czech Republic and Slovakia were extracted from medical records. The primary endpoint was the interval between the final oncologist visit and death.</div></div><div><h3>Results</h3><div>183 women with median age at death 53.6 years (28.6–86.5) were included. Patients had a median of 4 prior palliative chemotherapy lines (2–12) and the median interval from last oncologist visit to death was 17 days (0–410). At the final visit, 29.5 % continued systemic therapy and 49 % had prior palliative care involvement. Longer intervals were associated with PS 0–1 vs ≥ 2 (p = 0.005), while palliative care involvement had no significant effect (p = 0.849).</div></div><div><h3>Conclusions</h3><div>The results highlight the need for earlier recognition of clinical decline and timely palliative care in mTNBC. Limiting non-beneficial systemic therapy near EOL supports symptom control, autonomy, and quality of life. Despite European efforts, including the Network of Expertise on Complex and Poor Prognosis Cancers, structured EOL planning remains a major gap.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104699"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017392","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":"Supplemental imaging modalities for breast cancer screening in women with dense breasts: A systematic review with economic considerations","authors":"Sinéad N. Duggan ,&nbsp;Mohammad Azharuddin ,&nbsp;Rodolfo Hernández ,&nbsp;Clare Robertson ,&nbsp;David Cooper ,&nbsp;Emma McCall ,&nbsp;Paul Manson ,&nbsp;Gianni Virgili ,&nbsp;Mike Clarke ,&nbsp;Shaun Treweek ,&nbsp;Miriam Brazzelli","doi":"10.1016/j.breast.2025.104668","DOIUrl":"10.1016/j.breast.2025.104668","url":null,"abstract":"<div><h3>Background</h3><div>Underdiagnosis of breast cancer is a concern for women with dense breasts. This systematic review and meta-analysis evaluates the performance and cost-effectiveness of supplementary imaging modalities plus standard mammography, versus mammography alone, for detecting breast cancer in women with dense breasts.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, Embase, Scopus, Cochrane Database, Web of Science, and CENTRAL for English-language studies published January 2014 to November 2024. Eligible studies compared the performance of a supplementary imaging modality with standard mammography in terms of cancer detection rate (CDR) in women with dense breasts undergoing screening. Risk of bias was assessed using QUADAS-2/QUADAS-C. Screening, data extraction, and quality assessment was conducted by one reviewer and checked by a second reviewer. PROSPERO: CRD42024550250.</div></div><div><h3>Results</h3><div>Out of 1740 search results, 36 studies met the inclusion criteria. Versus mammography alone, magnetic resonance imaging (MRI) identified 18·92 (95 % CI 15·41-22·43) additional cancers per 1000 screenings while digital breast tomosynthesis (DBT), automated breast ultrasound (ABUS), and handheld ultrasound (HHUS) detected 1·69 (95 % CI 0·81-2·58), 2·3 (95 % CI 1·28-3·33), and 2·57 (95 % CI 0·99-4·14) additional cancers, respectively. One study of contrast-enhanced mammography (CEM) reported a CDR comparable to MRI. Economic modelling studies revealed heterogeneous results, with MRI showing potential under specific model assumptions.</div></div><div><h3>Concluding statement</h3><div>Standard mammography often fails to detect cancers in women with dense breasts. Supplementary MRI provides better detection than DBT, ABUS, and HHUS. CEM seems comparable to MRI, based on limited evidence. These findings should be considered in future screening policy reviews for women with dense breasts.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104668"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676551","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":"A prognostic gene model with psychological stress-related genes captures immune activation in breast cancer","authors":"Tian Du ,&nbsp;Jiayi Tang ,&nbsp;Hanqi Zhang ,&nbsp;Qianwen Liu,&nbsp;Yanan Kong","doi":"10.1016/j.breast.2025.104678","DOIUrl":"10.1016/j.breast.2025.104678","url":null,"abstract":"<div><h3>Background</h3><div>Chronic stress and depression play critical roles in modulating breast cancer oncogenesis. Psychological stress-related genes can regulate tumor behavior and serve as prognostic factors. Here, we constructed a signature with psychological stress-related tumor genes to predict breast cancer survival and sensitivity to immunotherapy.</div></div><div><h3>Methods</h3><div>37 genes among the 374 psychological stress-related tumor genes were significantly associated with overall survival in The Cancer Genome Atlas (TCGA) and/or the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). The logistic least absolute shrinkage and selection operator (LASSO) regression was used to select genes to build the gene signature to predict overall survival. Area under the curve (AUC) and calibration curve were used to evaluate the performance of the prediction model. Pathway analysis and immune cell infiltration analysis were used to further understand the differences between tumors with high- and low-signature scores.</div></div><div><h3>Results</h3><div>18 psychological stress-related tumor genes were selected to construct the final signature. The AUCs were 0.764 and 0.646 for predicting 5-year overall survival in METABRIC and TCGA, slightly lower than the 10-year AUCs of 0.772 and 0.703. The Hosmer-Lemeshow goodness-of-fit test p-value of the model was 1, showing a good calibration performance. Low 18-gene signature score was associated with better prognosis, activated immune pathways, immune-active tumor microenvironment (TME) characterized by higher proportions of CD8⁺ T cells and NK cells, and better response to immunotherapy.</div></div><div><h3>Conclusion</h3><div>The 18-gene signature of literature reported psychological stress-related genes establishes a model with consistent performance for predicting clinical outcomes and captures immune activation, which could improve prognostic precision and predict immunotherapy response.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104678"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910455","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 inavolisib plus palbociclib-fulvestrant versus palbociclib plus fulvestrant as first-line treatment in HR+/HER2-advanced breast cancer","authors":"Jiaming Zhu ,&nbsp;Ye Ding ,&nbsp;Zhengxiong Li ,&nbsp;Wen Liu","doi":"10.1016/j.breast.2026.104693","DOIUrl":"10.1016/j.breast.2026.104693","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the cost-effectiveness of inavolisib plus palbociclib-fulvestrant versus palbociclib-fulvestrant for treating advanced HR⁺/HER2^-breast cancer patients with PIK3CA mutations from both United States (U.S.) and Chinese healthcare system perspectives.</div></div><div><h3>Methods</h3><div>A partitioned survival model was used, with survival data from the INAVO120 clinical trials. Primary outcomes assessed were costs, life-years, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER). Sensitivity analysis was performed to explore the uncertainty of model inputs. Changes in treatment efficacy were modeled to assess their impact on cost-effectiveness. Subgroup analysis was also conducted to refine the findings.</div></div><div><h3>Results</h3><div>In the base-case analysis, the inavolisib triple regimen showed an ICER of $249,487.22/QALY in the U.S. and $43,812.01/QALY in China, both exceeding their respective willingness-to-pay thresholds. Price simulation indicated that the inavolisib-based combination would be preferred in China if the price were reduced to $133.19/9 mg, while a price of $421.13/9 mg would be required to achieve cost-effectiveness in the U.S. Sensitivity analysis demonstrated robust results from the U.S. perspective, while for China, variations in the price of inavolisib and utility of progression-free-survival influenced the conclusions. Subgroup analyses suggested certain patient subgroups could be cost-effective in the Chinese context.</div></div><div><h3>Conclusion</h3><div>Compared with palbociclib-fulvestrant, the inavolisib triple regimen is not cost-effective at its current price. A substantial price reduction or careful selection of the target patient may be required for the regimen to be economically viable.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104693"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910469","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":"Breaking down the costs for breast cancer: Insights from Sweden's national quality register","authors":"Xiaoyang Du ,&nbsp;Leo Gkekos ,&nbsp;Balram Rai ,&nbsp;Anna L.V. Johansson ,&nbsp;Irma Fredriksson ,&nbsp;Mattias Rantalainen ,&nbsp;Emelie Heintz ,&nbsp;Shuang Hao ,&nbsp;Mark Clements","doi":"10.1016/j.breast.2025.104646","DOIUrl":"10.1016/j.breast.2025.104646","url":null,"abstract":"<div><h3>Background</h3><div>With new emerging technologies for diagnostics and treatment for breast cancer, there is a demand for updated breast cancer costs based on current clinical practice. The objectives of this study were to estimate recent societal costs of breast cancer in Sweden and provide population-based patient-level cost estimates for health economic evaluations.</div></div><div><h3>Methods</h3><div>This prevalence-based cost-of-illness study was based on 2019 data linking multiple Swedish national registers. The analysis employed a societal perspective considering direct health care, informal care, and productivity losses. Total costs were estimated using a bottom-up micro-costing approach. Direct costs per patient-year were also estimated by subgroups, including age group, breast cancer subtype, breast cancer stage at diagnosis, and disease state defined by metastatic status.</div></div><div><h3>Findings</h3><div>82,960 breast cancer patients diagnosed since 2008 were alive by the end of 2019. The annual societal cost of breast cancer in Sweden was €632 million, where the direct health care, informal care, and productivity losses accounted for 37 %, 5 %, and 57 %, respectively. The cost per capita was €61. Costs of direct health care, including inpatient/outpatient care and prescribed drugs, varied by subgroups, where younger age, higher stage, and more adverse subtypes were associated with higher costs per patient-year. Patients with a diagnosis of de novo metastatic cancer incurred the highest mean cost per patient-year.</div></div><div><h3>Conclusion</h3><div>Breast cancer represents a large economic burden in Sweden. The mean cost estimates per patient-year are informative to future health economic evaluations for breast cancer screening and treatment.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104646"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518957","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":"“Silent Spring” revisited: Implications for breast cancer care","authors":"Seamus O'Reilly ,&nbsp;Hans Wildiers ,&nbsp;Alexandra Thomas","doi":"10.1016/j.breast.2025.104643","DOIUrl":"10.1016/j.breast.2025.104643","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104643"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518956","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":"Emerging technologies for monitoring breast cancer response to neoadjuvant chemotherapy: a systematic scoping review","authors":"Georgia C. Wright ,&nbsp;Luke T. Glover ,&nbsp;Thomas J.E. Hubbard","doi":"10.1016/j.breast.2025.104663","DOIUrl":"10.1016/j.breast.2025.104663","url":null,"abstract":"<div><h3>Introduction</h3><div>Neoadjuvant chemotherapy (NACT) is increasingly used in early breast cancer treatment and responses are highly variable. Accurate monitoring of tumour response is crucial for enabling precise surgical de-escalation, yet current methods are inadequate.</div><div>This systematic scoping review explores emerging technologies for predicting, monitoring, and diagnosing pre-operative breast cancer response to NACT.</div></div><div><h3>Methods</h3><div>A search of Embase, Medline, PubMed, and Cochrane databases was conducted until January 26, 2024. Studies investigating ability to detect tumour response during or after NACT, and prior to surgery, were included, and placed into 12 technology categories. Those investigating novel technologies were further categorised by Technology Readiness Level.</div></div><div><h3>Results</h3><div>From 2497 studies, 1329 met the inclusion criteria. 479/1329 (36 %) investigated conventional imaging; 19 % (253) investigated MRI, 5 % (64) mammography/ultrasound, 0.5 % (6) computed tomography, 0.4 % (5) digital breast tomosynthesis. Established technologies included gene panels (134/1329; 10 %) and post treatment core biopsy 35/1329; (3 %). 107/1329 (8 %) of studies developed nomograms based on routine clinical investigations, and 493/1329 (37 %) correlated established biomarkers e.g. Ki-67 with pathological response.</div><div>81 studies (6 %) addressed novel technologies, such as circulating nucleic acids (49/81), diffuse optical imaging (17/81), and elastography (15/81). A Technology Readiness Assessment revealed that all were between Technology Readiness Level 2 (Invention and Research) and 6 (Large Scale).</div></div><div><h3>Conclusions</h3><div>The majority of current research activity focuses on optimising existing technologies which may never provide the step change in diagnostic accuracy required to advance surgical de-escalation. Research activity should be focused on identifying effective novel technologies and driving translation into the clinical environment.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104663"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681782","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":"Eligibility for bilateral prophylactic mastectomy: An expert opinion study in the Netherlands","authors":"L.P. Jansen ,&nbsp;G.M. Kramer ,&nbsp;E.G. Engelhardt ,&nbsp;C.W. van der Zee ,&nbsp;I. van de Beek ,&nbsp;M.A. Adank ,&nbsp;M.T.F.D. Vrancken Peeters ,&nbsp;M.K. Schmidt ,&nbsp;C.A. Drukker","doi":"10.1016/j.breast.2025.104645","DOIUrl":"10.1016/j.breast.2025.104645","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104645"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569972","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}