Breast最新文献

{"title":"Impact of neoadjuvant compared to adjuvant chemotherapy on prognosis in patients with hormone-receptor positive / HER2-negative breast cancer: A propensity score matching population-based study","authors":"Servah Hosseini-Mellner ,&nbsp;Åsa Wickberg ,&nbsp;Andreas Karakatsanis ,&nbsp;Antonis Valachis","doi":"10.1016/j.breast.2024.103741","DOIUrl":"10.1016/j.breast.2024.103741","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this population-based cohort study was to investigate the impact of neoadjuvant chemotherapy (NACT) compared to adjuvant chemotherapy in prognosis among patients with HR+/HER2 negative breast cancer.</p></div><div><h3>Method</h3><p>This population-based study utilized data from the research database BCBaSe 3.0, based on the Swedish National Quality breast cancer register, including all patients with breast cancer diagnosis in Sweden between 2008 and 2019. Propensity score matching approach was applied. The outcomes of interest consisted of distant-disease free (DDFS), breast-cancer specific (BCSS), and overall survival (OS).</p></div><div><h3>Results</h3><p>In total, 14 459 patients were included in the study cohort of whom 2086 received NACT. After 1:1 propensity score matching (PSM), 1539 patients in each study group were available for analyses. No statistically significant difference in survival outcomes were observed between patients treated with NACT compared to those treated with adjuvant chemotherapy (Hazard Ratio (HR) for DDFS: 1.20; 95 % CI: 0.80–1.79; HR for BCSS: 1.16; 95 % CI: 0.54–2.49; HR for OS: 1.14; 95 % CI: 0.64–2.05).</p></div><div><h3>Conclusion</h3><p>In this population-based cohort study of patients with HR+/HER2-breast cancer, the use of NACT seems to be comparable to adjuvant chemotherapy in terms of prognosis, although non-inferiority cannot be proven by this study design. Until further evidence suggesting a survival benefit in favor of either treatment is available, NACT can be pursued when surgical-de-escalation is intended.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103741"},"PeriodicalIF":3.9,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000729/pdfft?md5=32d568a62edb626f90f948f72dede7a0&pid=1-s2.0-S0960977624000729-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956172","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":"Screening optimal candidates with operable, early-stage triple-negative breast cancer benefitting from capecitabine maintenance: A post-hoc analysis of the SYSUCC-001 study","authors":"Fangfang Duan ,&nbsp;Xin Hua ,&nbsp;Xiwen Bi ,&nbsp;Shusen Wang ,&nbsp;Yanxia Shi ,&nbsp;Fei Xu ,&nbsp;Li Wang ,&nbsp;Jiajia Huang ,&nbsp;Zhongyu Yuan ,&nbsp;Yuanyuan Huang ,&nbsp;South China Breast Cancer Group (SCBCG)","doi":"10.1016/j.breast.2024.103740","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103740","url":null,"abstract":"<div><h3>Background</h3><p>To explore whether specific clinicopathological covariates are predictive for a benefit from capecitabine maintenance in early-stage triple-negative breast cancer (TNBC) in the SYSUCC-001 phase III clinical trial.</p></div><div><h3>Methods</h3><p>Candidate covariates included age, menstrual status, type of surgery, postoperative chemotherapy regimen, Ki-67 percentage, histologic grade, primary tumor size, lymphovascular invasion, node status, and capecitabine medication. Their nonlinear effects were modeled by restricted cubic spline. The primary endpoint was disease-free survival (DFS). A survival prediction model was constructed using Cox proportional hazards regression analysis.</p></div><div><h3>Results</h3><p>All 434 participants (306 in development cohort and 128 in validation cohort) were analyzed. The estimated 5-year DFS in development and validation cohorts were 77.8 % (95 % CI, 72.9%–82.7 %) and 78.2 % (95 % CI, 70.9%–85.5 %), respectively. Age and node status had significant nonlinear effects on DFS. The prediction model constructed using four covariates (node status, lymphovascular invasion, capecitabine maintenance, and age) demonstrated satisfactory calibration and fair discrimination ability, with C-index of 0.722 (95 % CI, 0.662–0.781) and 0.764 (95 % CI, 0.668–0.859) in development and validation cohorts, respectively. Moreover, patient classification was conducted according to their risk scores calculated using our model, in which, notable survival benefits were reported in low-risk subpopulations. An easy-to-use online calculator for predicting benefit of capecitabine maintenance was also designed.</p></div><div><h3>Conclusions</h3><p>The evidence-based prediction model can be readily assessed at baseline, which might help decision making in clinical practice and optimize patient stratification, especially for those with low-risk, capecitabine maintenance might be a potential strategy in the early-disease setting.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103740"},"PeriodicalIF":3.9,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000717/pdfft?md5=b730cbcca6c33356795ce29d270dc38e&pid=1-s2.0-S0960977624000717-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140902306","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":"Invasive lobular carcinoma of the breast; clinicopathologic profile and response to neoadjuvant chemotherapy over a 15-year period","authors":"N.P. Quirke ,&nbsp;C. Cullinane ,&nbsp;M.A. Turk ,&nbsp;N. Shafique ,&nbsp;D. Evoy ,&nbsp;J. Geraghty ,&nbsp;D. McCartan ,&nbsp;C. Quinn ,&nbsp;J.M. Walshe ,&nbsp;E. McDermott ,&nbsp;C. Rutherford ,&nbsp;R.S. Prichard","doi":"10.1016/j.breast.2024.103739","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103739","url":null,"abstract":"<div><h3>Introduction</h3><p>Invasive lobular carcinoma (ILC) accounts for 5–15% of invasive breast cancers. Typical ILC is oestrogen receptor (ER) positive and human epidermal growth factor receptor 2 (HER2) negative. Atypical biomarker profiles (ER- and HER2+, ER+ and HER2+ or triple negative) appear to differ from typical ILCs. This study compared subtypes of ILC in terms of clinical and pathological parameters, and response to neoadjuvant chemotherapy (NACT) according to biomarker profile.</p></div><div><h3>Methods</h3><p>All patients with ILC treated in a single centre from January 2005 to December 2020 were identified from a prospectively maintained database. Clinicopathologic and outcome data was collected and analysed according to tumour biomarker profile.</p></div><div><h3>Results</h3><p>A total of 582 patients with ILC were treated. Typical ILC was observed in 89.2% (n = 519) and atypical in 10.8% (n = 63). Atypical ILCs were of a higher grade (35% grade 3 vs 9.6% grade 3, p &lt; 0.001).</p><p>A larger proportion of atypical ILC received NACT (31.7% vs 6.9% p &lt; 0.001). Atypical ILCs showed a greater response to NACT (mean RCB (Residual Cancer Burden Score) 2.46 vs mean RCB 3.41, p = 0.0365), and higher pathological complete response rates (15% vs 0% p = 0.017). Despite this, overall 5-year disease-free survival (DFS) was higher in patients with typical ILC (91% vs 83%, p = 0.001).</p></div><div><h3>Conclusions</h3><p>Atypical ILCs have distinct characteristics. They are more frequently of a higher grade and demonstrate a superior response to NACT. Despite the latter, atypical ILCs have a worse 5-year DFS which should be taken into consideration in terms of prognostication and may assist patient selection for NACT.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103739"},"PeriodicalIF":3.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000705/pdfft?md5=2c6aac61ae021fca8a18e1ce2d5e9e5b&pid=1-s2.0-S0960977624000705-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140948462","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":"Early evaluation of circulating tumor DNA as marker of therapeutic efficacy and prognosis in breast cancer patients during primary systemic therapy","authors":"Ru Wang ,&nbsp;Bin Wang ,&nbsp;Huimin Zhang ,&nbsp;Xiaoqin Liao ,&nbsp;Bohui Shi ,&nbsp;Yuhui Zhou ,&nbsp;Can Zhou ,&nbsp;Yu Yan ,&nbsp;Wei Zhang ,&nbsp;Ke Wang ,&nbsp;Guanqun Ge ,&nbsp;Yu Ren ,&nbsp;Xiaojiang Tang ,&nbsp;Baoyu Gan ,&nbsp;Jianjun He ,&nbsp;Ligang Niu","doi":"10.1016/j.breast.2024.103738","DOIUrl":"10.1016/j.breast.2024.103738","url":null,"abstract":"<div><h3>Background</h3><p>We assessed the potential role of serial circulating tumor DNA (ctDNA) as a biomarker to monitor treatment response to primary systemic therapy (PST) in breast cancer and evaluated the predictive value of ctDNA to further identify patients with residual disease.</p></div><div><h3>Methods</h3><p>We prospectively enrolled 208 plasma samples collected at three time points (before PST, after 2 cycles of treatment, before surgery) of 72 patients with stage Ⅱ-III breast cancer. Somatic mutations in plasma samples were identified using a customized 128-gene capture panel with next-generation sequencing. The correlation between early change in ctDNA levels and treatment response or long-term clinical outcomes was assessed.</p></div><div><h3>Results</h3><p>37 of 72 (51.4%) patients harbored detectable ctDNA alterations at baseline. Patients with complete response showed a larger decrease in ctDNA levels during PST. The median relative change of variant allele fraction (VAF) was −97.4%, −46.7%, and +21.1% for patients who subsequently had a complete response (n = 11), partial response (n = 11), and no response (n = 15) (<em>p</em> = 0.0012), respectively. In addition, the relative change of VAF between the pretreatment and first on-treatment blood draw exhibited the optimal predictive value to tumor response after PST (area under the curve, AUC = 0.7448, <em>p</em> = 0.02). More importantly, early change of ctDNA levels during treatment have significant prognostic value for patients with BC, there was a significant correlation between early decrease of VAF and longer recurrence-free survival compared to those with an VAF increase (HR = 12.54; 95% CI, 2.084 to 75.42, <em>p</em> = 0.0063).</p></div><div><h3>Conclusion</h3><p>Early changes of ctDNA are strongly correlated with therapeutic efficacy to PST and clinical outcomes in BC patients. The integration of preoperative ctDNA evaluation could help improving the perioperative management for BC patients receiving PST.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103738"},"PeriodicalIF":3.9,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000699/pdfft?md5=139144f8d2493f0f902f2d4d26d9b111&pid=1-s2.0-S0960977624000699-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773825","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":"Prediction of breast cancer and axillary positive-node response to neoadjuvant chemotherapy based on multi-parametric magnetic resonance imaging radiomics models","authors":"Yingyu Lin ,&nbsp;Jifei Wang ,&nbsp;Meizhi Li ,&nbsp;Chunxiang Zhou,&nbsp;Yangling Hu,&nbsp;Mengyi Wang,&nbsp;Xiaoling Zhang","doi":"10.1016/j.breast.2024.103737","DOIUrl":"10.1016/j.breast.2024.103737","url":null,"abstract":"<div><h3>Purpose</h3><p>Accurate identification of primary breast cancer and axillary positive-node response to neoadjuvant chemotherapy (NAC) is important for determining appropriate surgery strategies. We aimed to develop combining models based on breast multi-parametric magnetic resonance imaging and clinicopathologic characteristics for predicting therapeutic response of primary tumor and axillary positive-node prior to treatment.</p></div><div><h3>Materials and methods</h3><p>A total of 268 breast cancer patients who completed NAC and underwent surgery were enrolled. Radiomics features and clinicopathologic characteristics were analyzed through the analysis of variance and the least absolute shrinkage and selection operator algorithm. Finally, 24 and 28 optimal features were selected to construct machine learning models based on 6 algorithms for predicting each clinical outcome, respectively. The diagnostic performances of models were evaluated in the testing set by the area under the curve (AUC), sensitivity, specificity, and accuracy.</p></div><div><h3>Results</h3><p>Of the 268 patients, 94 (35.1 %) achieved breast cancer pathological complete response (bpCR) and of the 240 patients with clinical positive-node, 120 (50.0 %) achieved axillary lymph node pathological complete response (apCR). The multi-layer perception (MLP) algorithm yielded the best diagnostic performances in predicting apCR with an AUC of 0.825 (95 % CI, 0.764–0.886) and an accuracy of 77.1 %. And MLP also outperformed other models in predicting bpCR with an AUC of 0.852 (95 % CI, 0.798–0.906) and an accuracy of 81.3 %.</p></div><div><h3>Conclusions</h3><p>Our study established non-invasive combining models to predict the therapeutic response of primary breast cancer and axillary positive-node prior to NAC, which may help to modify preoperative treatment and determine post-NAC surgery strategy.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103737"},"PeriodicalIF":3.9,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000687/pdfft?md5=b02f76f00c88d34c1e87d43b44d30910&pid=1-s2.0-S0960977624000687-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140797023","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":"Mammographic features at primary breast cancer diagnosis in relation to recurrence-free survival","authors":"Kristina Lång ,&nbsp;Li Sturesdotter ,&nbsp;Ylva Bengtsson ,&nbsp;Anna-Maria Larsson ,&nbsp;Hanna Sartor","doi":"10.1016/j.breast.2024.103736","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103736","url":null,"abstract":"<div><h3>Purpose</h3><p>The number of women living with breast cancer (BC) is increasing, and the efficacy of surveillance programs after BC treatment is essential. Identification of links between mammographic features and recurrence could help design follow up strategies, which may lead to earlier detection of recurrence. The aim of this study was to analyze associations between mammographic features at diagnosis and their potential association with recurrence-free survival (RFS).</p></div><div><h3>Methods</h3><p>Women with invasive BC in the prospective Malmö Diet and Cancer Study (n = 1116, 1991–2014) were assessed for locoregional and distant recurrences, with a median follow-up of 10.15 years. Of these, 34 women were excluded due to metastatic disease at diagnosis or missing recurrence data. Mammographic features (breast density [BI-RADS and clinical routine], tumor appearance, mode of detection) and tumor characteristics (tumor size, axillary lymph node involvement, histological grade) at diagnosis were registered. Associations were analyzed using Cox regression, yielding hazard ratios (HR) with 95 % confidence intervals (CI).</p></div><div><h3>Results</h3><p>Of the 1082 women, 265 (24.4 %) had recurrent disease. There was an association between high mammographic breast density at diagnosis and impaired RFS (adjusted HR 1.32 (0.98–1.79). In analyses limited to screen-detected BC, this association was stronger (adjusted HR 2.12 (1.35–3.32). There was no association between mammographic tumor appearance and recurrence.</p></div><div><h3>Conclusion</h3><p>RFS was impaired in women with high breast density compared to those with low density, especially among women with screen-detected BC. This study may lead to insights on mammographic features preceding BC recurrence, which could be used to tailor follow up strategies.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103736"},"PeriodicalIF":3.9,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000675/pdfft?md5=7ebe82fc9b010abdd0141a306eba92b7&pid=1-s2.0-S0960977624000675-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638484","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":"The impact of age on physical functioning after treatment for breast cancer, as measured by patient-reported outcome measures: A systematic review","authors":"V.R. Robins ,&nbsp;S. Gelcich ,&nbsp;K. Absolom ,&nbsp;G. Velikova","doi":"10.1016/j.breast.2024.103734","DOIUrl":"10.1016/j.breast.2024.103734","url":null,"abstract":"<div><h3>Purpose</h3><p>This systematic review aims to explore the impact of age on physical functioning post-treatment for early-stage, locally advanced, or locally recurrent breast cancer, as measured by patient-reported outcome measures (PROMs), identify PROMs used and variations in physical functioning terms/labels.</p></div><div><h3>Methods</h3><p>MEDLINE, EmBase, PsycINFO, CINAHL and AMED were searched, along with relevant key journals and reference lists. Risk of bias (quality) assessment was conducted using a Critical Appraisal Skills Programme checklist. Data was synthesised through tables and narrative.</p></div><div><h3>Results</h3><p>28,207 titles were extracted from electronic databases, resulting in 44 studies with age sub-groups, and 120 without age sub-groups. Of those with findings on the impact of age, there was variability in the way findings were reported and 21 % found that age did not have a significant impact. However, 66 % of the studies found that with older age, physical functioning declined post-treatment. Comorbidities were associated with physical functioning declines. However, findings from sub-groups (breast cancer stage, treatment type and time post-treatment) lacked concordance. Twenty-eight types of PROM were used: the EORTC QLQ-C30 was most common (50.6 %), followed by the SF-36 (32.3 %). There were 145 terms/labels for physical functioning: ‘physical functioning/function’ was used most often (82.3 %).</p></div><div><h3>Conclusions</h3><p>Findings point towards an older age and comorbidities being associated with more physical functioning declines. However, it was not possible to determine if stage, treatment type and time since treatment had any influence. More consistent use of the terminology ‘physical functioning/function’ would aid future comparisons of study results.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"76 ","pages":"Article 103734"},"PeriodicalIF":3.9,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000651/pdfft?md5=2a7044fadc04ee74136fc190a5f2d1a7&pid=1-s2.0-S0960977624000651-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794371","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":"Financial toxicity, family resilience and negative emotions among young and middle-aged breast cancer patients: A multicentre cross-sectional study","authors":"Xuelei Chen ,&nbsp;Qilin Yan ,&nbsp;Youjuan Tang ,&nbsp;Jianing Zhu ,&nbsp;Wenlu Zhang ,&nbsp;Jingping Zhang","doi":"10.1016/j.breast.2024.103735","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103735","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine financial toxicity in young and middle-aged women with breast cancer and examine the associations between family resilience and negative emotions.</p></div><div><h3>Methods</h3><p>A multicentre cross-sectional study was conducted, 538 women with breast cancer were recruited from four hospitals. FT, family resilience, and negative emotions were collected using the Comprehensive Score for FT, the Chinese version of the Family Resilience Assessment in Breast Cancer Patients, Patient Health Questionnaire-9 item, and Generalized Anxiety Disorder-7. This study adhered to the STROBE guidelines.</p></div><div><h3>Results</h3><p>The valid response rate was 96.8 % (N = 521). Overall, the score for FT was 19.63 ± 10.13. FT was significantly correlated with family resilience (<em>r</em> = 0.30, <em>p</em> &lt; 0.010) and depression (<em>r</em> = −0.11, <em>p</em> &lt; 0.050). The hierarchical multiple linear regression analysis showed that career status, monthly income, religion, and family resilience were the main factors influencing FT in patients with breast cancer (<em>R</em>^<em>2</em> = 0.37; <em>F</em> = 6.83; <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>FT was more prevalent among women from low-income career. Women with poor family resilience, no religious also suffer greater financial toxicity. It is necessary to pay more attention of the financial toxicity of female’ low-income career, no religious belief and poor family resilience. Developing effective interventions based on family resilience might be helpful in promoting their well-being.</p></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103735"},"PeriodicalIF":3.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000663/pdfft?md5=31341f0bbaaa627372c648ae44f0b360&pid=1-s2.0-S0960977624000663-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140605500","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":"Erratum to ‘The benefit of adding polygenic risk scores, lifestyle factors, and breast density to family history and genetic status for breast cancer risk and surveillance classification of unaffected women from germline CHEK2 c.1100delC families’ [The Breast 73 (2024) 103611]","authors":"Maartje A.C. Schreurs ,&nbsp;Teresa Ramón y Cajal ,&nbsp;Muriel A. Adank ,&nbsp;J. Margriet Collée ,&nbsp;Antoinette Hollestelle ,&nbsp;Jeroen van Rooij ,&nbsp;Marjanka K. Schmidt ,&nbsp;Maartje J. Hooning","doi":"10.1016/j.breast.2024.103723","DOIUrl":"10.1016/j.breast.2024.103723","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103723"},"PeriodicalIF":3.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000547/pdfft?md5=acffe6bc23cbe1c8ae24b26dd3c457f6&pid=1-s2.0-S0960977624000547-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763643","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":"Enhancing clinical decision support with genomic tools in breast cancer: A Scottish perspective","authors":"A.L. Peters ,&nbsp;P.S. Hall ,&nbsp;L.B. Jordan ,&nbsp;F.Y. Soh ,&nbsp;L. Hannington ,&nbsp;S. Makaranka ,&nbsp;G. Urquhart ,&nbsp;M. Vallet ,&nbsp;D. Cartwright ,&nbsp;H. Marashi ,&nbsp;B. Elsberger","doi":"10.1016/j.breast.2024.103728","DOIUrl":"https://doi.org/10.1016/j.breast.2024.103728","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;p&gt;The &lt;em&gt;Oncotype DX Breast RS&lt;/em&gt; test has been adopted in Scotland and has been the subject of a large population-based study by a Scottish Consensus Group to assess the uptake of the recurrence score (RS), evaluate co-variates associated with the RS and to analyse the effect it may have had on clinical practice.&lt;/p&gt;&lt;p&gt;Materials &amp; Methods: Pan-Scotland study between August 2018–August 2021 evaluating 833 patients who had a RS test performed as part of their diagnostic pathway. Data was extracted retrospectively from electronic records and analysis conducted to describe change in chemotherapy administration (by direct comparison with conventional risk assessment tools), and univariate/multivariate analysis to assess relationship between covariates and the RS.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Chemotherapy treatment was strongly influenced by the RS (p &lt; 0.001). Only 30 % of patients received chemotherapy treatment in the intermediate and high risk PREDICT groups, where chemotherapy is considered. Additionally, 55.5 % of patients with a high risk PREDICT had a low RS and did not receive chemotherapy. There were 17 % of patients with a low risk PREDICT but high RS who received chemotherapy.&lt;/p&gt;&lt;p&gt;Multivariate regression analysis showed the progesterone receptor Allred score (PR score) to be a strong independent predictor of the RS, with a negative PR score being associated with high RS (OR 4.49, p &lt; 0.001). Increasing grade was also associated with high RS (OR 3.81, p &lt; 0.001). Classic lobular pathology was associated with a low RS in comparison to other tumour pathology (p &lt; 0.01). Nodal disease was associated with a lower RS (p = 0.012) on univariate analysis, with menopausal status (p = 0.43) not influencing the RS on univariate or multivariate analysis.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Genomic assays offer the potential for risk-stratified decision making regarding the use of chemotherapy. They can help reduce unnecessary chemotherapy treatment and identify a subgroup of patients with more adverse genomic tumour biology. A recent publication by Health Improvement Scotland (HIS) has updated guidance on use of the RS test for NHS Scotland. It suggests to limit its use to the intermediate risk PREDICT group. Our study shows the impact of the RS test in the low and high risk PREDICT groups. The implementation across Scotland has resulted in a notable shift in practice, leading to a significant reduction in chemotherapy administration in the setting of high risk PREDICT scores returning low risk RS. There has also been utility for the test in the low risk PREDICT group to detect a small subgroup with a high RS.&lt;/p&gt;&lt;p&gt;We have found the PR score to have a strong independent association with high risk RS. This finding was not evaluated by the key RS test papers, and the potential prognostic information provided by the PR score as a surrogate biomarker is an outstanding question that requires more researc","PeriodicalId":9093,"journal":{"name":"Breast","volume":"75 ","pages":"Article 103728"},"PeriodicalIF":3.9,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960977624000596/pdfft?md5=703e432b55617af843c42f577d624ac4&pid=1-s2.0-S0960977624000596-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638537","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}