Breast最新文献

{"title":"Impact of treatment response to neoadjuvant chemotherapy on brain metastasis patterns and breast cancer prognosis","authors":"Jihwan Yoo ,&nbsp;Yoon Jin Cha ,&nbsp;Sung Gwe Ahn ,&nbsp;Joon Jeong ,&nbsp;Hun Ho Park ,&nbsp;Sung Jun Ahn ,&nbsp;Bio Joo ,&nbsp;Ji Hyun Park ,&nbsp;Jee Hung Kim ,&nbsp;Soong June Bae","doi":"10.1016/j.breast.2025.104650","DOIUrl":"10.1016/j.breast.2025.104650","url":null,"abstract":"<div><h3>Background</h3><div>Brain metastases (BM) are a major cause of mortality in breast cancer. While pathologic complete response (pCR) after neoadjuvant chemotherapy is associated with favorable survival outcomes, its impact on BM development and prognosis remains unclear.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 1,244 patients with early-stage breast cancer who underwent neoadjuvant chemotherapy followed by surgery. Clinicopathological features, BM incidence, and survival outcomes were assessed. Propensity score matching (PSM) was applied to adjust for baseline differences. Gene expression profiling was performed in BM samples from pCR and non-pCR patients.</div></div><div><h3>Results</h3><div>Of these, 437 (35.1 %) patients achieved pCR and 52 (4.2 %) developed BM. In TNBC, non-pCR patients had a significantly higher BM rate (9.2 % vs. 3.3 %, <em>P</em> = 0.026), whereas no differences were observed in other subtypes. Patients with BM who achieved pCR were more likely to present with single brain lesion (42.9 % vs. 10.5 %, <em>P</em> = 0.016), undergo craniotomy (71.4 % vs. 31.6 %, <em>P</em> = 0.010), and less frequently had extracranial metastases (28.6 % vs. 73.7 %, <em>P</em> = 0.003). Median overall survival after BM was longer in the pCR (42 vs. 4 months, <em>P</em> = 0.002), and this benefit remained significant after PSM (43 vs. 10 months, <em>P</em> = 0.033). Transcriptomic analysis identified distinct molecular profiles, with upregulation of RPL27A and CTLA4 in pCR BM and non-pCR BM.</div></div><div><h3>Conclusions</h3><div>pCR was associated with lower metastatic burden and improved survival following BM diagnosis. Molecular differences between pCR and non-pCR BM suggest distinct mechanisms of metastatic evolution, suggesting the need for tailored surveillance and preventive strategies.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104650"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556382","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":"Trends in local, regional and contralateral breast tumor recurrence within five years after diagnosis in the Netherlands: a population-based study including 121347 patients","authors":"J. Meijer ,&nbsp;H.J.G.D. van den Bongard ,&nbsp;L.B. Koppert ,&nbsp;C.W. Menke-van der Houven van Oordt ,&nbsp;L. de Munck ,&nbsp;T.J.A. van Nijnatten ,&nbsp;M.J.C. van der Sangen ,&nbsp;R.J. Schipper ,&nbsp;M.K. Schmidt ,&nbsp;M.L. Smidt ,&nbsp;W. Vreuls ,&nbsp;M.C. van Maaren ,&nbsp;S. Siesling","doi":"10.1016/j.breast.2025.104673","DOIUrl":"10.1016/j.breast.2025.104673","url":null,"abstract":"<div><h3>Background</h3><div>The objective was to provide an overview of trends in five-year local recurrence (LR), regional recurrence (RR) and contralateral breast cancer (CBC) rates in the Netherlands from 2003 to 2008 and 2012–2016.</div></div><div><h3>Methods</h3><div>Women ≥18 years diagnosed with primary early breast cancer between 2003-2008 and 2012–2016 in the Netherlands were included. LR was defined as invasive tumor on the same side as the primary breast cancer. RR was defined as regional lymph node metastasis. CBC was defined as second primary invasive breast tumor in the contralateral breast. Five-year LR, RR and CBC rates were calculated and stratified for age, stage, subtype, and grade.</div></div><div><h3>Results</h3><div>Of the 121347 included patients, 5618 were diagnosed with a LR, RR or CBC. Five-year LR, RR and CBC rates decreased from 3.3 %, 1.9 % and 2.2 % in 2003 to 1.5 %, 1.6 % and 1.5 % in 2016, respectively, with fluctuations over the years. Slight increases were observed in RR rates for stage II-III, HR-/HER2+ and HR-/HER2-.</div></div><div><h3>Conclusion</h3><div>(s). The observed overall decline in LR, RR and CBC rates could reflect more effective and personalized breast cancer treatment. Our results provide realistic insights in LR, RR and CBC rates and might contribute to further optimization of treatment and surveillance strategies.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104673"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733460","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":"Concomitant radiation therapy and trastuzumab deruxtecan in metastatic breast cancer: feasibility, safety, and outcomes from a real-life multicentre international cohort","authors":"Luca Visani ,&nbsp;Ivica Ratosa ,&nbsp;Rupert Bartsch ,&nbsp;Barbro Linderholm ,&nbsp;Gaia Griguolo ,&nbsp;Calogero Saieva ,&nbsp;Carlotta Becherini ,&nbsp;Marianna Valzano ,&nbsp;Viola Salvestrini ,&nbsp;Angelika M. Starzer ,&nbsp;Peter Kus ,&nbsp;Niccolò Bertini ,&nbsp;Andrea Rampini ,&nbsp;Chiara Mattioli ,&nbsp;Domen Ribnikar ,&nbsp;Jacopo Nori Cucchiari ,&nbsp;Lorenzo Orzalesi ,&nbsp;Simonetta Bianchi ,&nbsp;Matteo Lambertini ,&nbsp;Valentina Guarneri ,&nbsp;Icro Meattini","doi":"10.1016/j.breast.2026.104691","DOIUrl":"10.1016/j.breast.2026.104691","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Radiation therapy (RT) remains a cornerstone of management for metastatic breast cancer (mBC), though systemic therapy drives overall disease control. Administering RT concomitantly with systemic treatment may raise concerns regarding toxicity. This multicentre retrospective study evaluated the safety of trastuzumab deruxtecan (T-DXd), an antibody–drug conjugate, when delivered alongside RT.</div></div><div><h3>Materials and methods</h3><div>Data from six European centres were analysed. Concomitancy was defined as RT administered during T-DXd or within 10 days of a treatment cycle. The primary endpoint was the incidence of grade ≥3 adverse events (AEs). Exploratory endpoints included progression-free survival (PFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>A total of 147 patients were included; 67 received concomitant RT (71 courses) and 80 received T-DXd alone. Median age was 49 years (range 25–85). The central nervous system was the most frequent RT site (54.9 %). Grade ≥3 AEs occurred in 24 patients (16.3 %), with no significant difference between RT and no-RT cohorts (11.9 % vs 20.0 %; p = 0.30). Permanent T-DXd discontinuation due to toxicity occurred in 19 patients (12.9 %), with similar rates in the RT and no-RT groups (11.9 % vs 13.8 %). One case of symptomatic radionecrosis was observed after intracranial RT. Exploratory analyses showed no adverse effect of concomitant RT on PFS or OS.</div></div><div><h3>Conclusion</h3><div>Concomitant administration of T-DXd and RT appears feasible and well tolerated, without increased risk of severe or treatment-limiting toxicity. These real-world findings support the safety of this combination and warrant confirmation in prospective studies.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104691"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910433","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":"Guiding treatment decisions in early breast cancer: A model-based comparison of the OncotypeDX and MammaPrint tests","authors":"Frank Doornkamp ,&nbsp;Liesbeth C. de Wreede ,&nbsp;Elfi Verheul ,&nbsp;Agnes Jager ,&nbsp;Ewout W. Steyerberg","doi":"10.1016/j.breast.2026.104698","DOIUrl":"10.1016/j.breast.2026.104698","url":null,"abstract":"<div><h3>Introduction</h3><div>Genomic tests may improve chemotherapy allocation in early-stage breast cancer beyond traditional clinical factors. We compared the clinical usefulness of two multi-genomic tests, MammaPrint and OncotypeDX, in guiding adjuvant chemotherapy decisions.</div></div><div><h3>Methods</h3><div>The MINDACT and TAILORx trials provided prospective validation for the MammaPrint and OncotypeDX tests, respectively. We generated two synthetic cohorts to evaluate both tests in both trial contexts. Chemotherapy was assumed to be indicated if it was expected to reduce the risk of an event by at least 5 %, defining events as 10-year distant metastases or breast cancer–related death. We compared treatment decision making informed by clinical risk information alone versus clinical information plus either the MammaPrint (dichotomous score: high/low risk) or OncotypeDX test (dichotomous and continuous scores). These strategies were evaluated using Net Benefit: a weighted difference of preventing events through treatment and the number of treatments given.</div></div><div><h3>Results</h3><div>Treatment decision-making informed by clinical information alone would result in a positive balance between preventing events and treatments given in both synthetic cohorts (4.8 net benefit in MINDACT, 3.0 in TAILORx per 1000 patients). Incorporating OncotypeDX into risk assessment improved treatment allocation more than MammaPrint (+2.6 vs + 1.6 in MINDACT, +1.3 vs + 1.0 in TAILORx contexts), with substantial uncertainty. Using the dichotomized OncotypeDX score limited its clinical usefulness compared to using its underlying continuous score.</div></div><div><h3>Discussion</h3><div>Both MammaPrint and OncotypeDX tests improve identifying candidates for chemotherapy among women with early breast cancer, with broadly equivalent clinical usefulness. The tests should be implemented into existing risk algorithms to maximize their clinical usefulness.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104698"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973296","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 UK study of the experiences, information needs and attitudes to clinical research among patients living with secondary breast cancer in the UK: A prospective co-developed study","authors":"Lesley Stephen ,&nbsp;Janet Dunn ,&nbsp;Claire Balmer ,&nbsp;Nada Elbeltagi ,&nbsp;Sophie Gasson ,&nbsp;Ellen Copson ,&nbsp;Carlo Palmieri","doi":"10.1016/j.breast.2025.104644","DOIUrl":"10.1016/j.breast.2025.104644","url":null,"abstract":"<div><h3>Background</h3><div>Clinical research is key to improving the outcomes of patients with metastatic breast cancer (MBC). However, participation is low, with little data on patients’ attitudes and experiences of clinical research. This study aimed to explore the experience and attitude of patients in accessing and participating in clinical research in the UK.</div></div><div><h3>Methods</h3><div>An online survey, available between May and November 2021, was open to people living with MBC in the UK; this was complemented with by qualitative interviews.</div></div><div><h3>Findings</h3><div>768 responses were received (766 female, 2 male); median age was 51–60 years with 235 (31 %) having de novo disease. 660 (86 %) respondents were confident in their understanding of clinical research. Discussion of participation in research with an oncologist was reported by 173 (23 %) respondents. Accessing new treatments was the most common reason for study participants wanting to take part in research, 737 (96 %). Of the 107 (14 %) respondents who had taken part in clinical trials, 77 (72 %) reported a positive experience. 276 (36 %) would consider travelling to participate in research and 430 (56 %) would be more likely to travel if expenses were met. Themes emerging from the qualitative interviews include ‘lack of information’, ‘barriers to participation’ and ‘participants research priorities’.</div></div><div><h3>Interpretation</h3><div>This is the largest UK prospective study in regards to the views of MBC patients towards research. It demonstrates keenness to be involved in research, but participants face barriers as well as a lack of opportunity for participation. Key messages include importance of clinical staff in providing research information, need to develop patient accessible information, and to support travel costs. Improvements within the UK health care system are necessary to enable MBC patients to have equitable access to clinical research.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104644"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570208","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":"Critical appraisal of a machine learning model for predicting internal mammary lymph node metastasis in breast cancer","authors":"Kun Fang ,&nbsp;Suxiao Jiang ,&nbsp;Ping Zhang","doi":"10.1016/j.breast.2025.104652","DOIUrl":"10.1016/j.breast.2025.104652","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104652"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145629741","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":"Beyond survival: Confronting the unmet needs in oncofertility care for young women with breast cancer","authors":"Sophie Richard ,&nbsp;Megan Tesch ,&nbsp;Nathalie LeVasseur","doi":"10.1016/j.breast.2025.104676","DOIUrl":"10.1016/j.breast.2025.104676","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104676"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792664","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":"Optimizing adjuvant endocrine therapy in premenopausal patients with HER2-positive, hormone receptor-positive breast cancer","authors":"Carmine Valenza MD, MPH ,&nbsp;Ann H. Partridge MD, MPH ,&nbsp;Meredith M. Regan ScD","doi":"10.1016/j.breast.2026.104696","DOIUrl":"10.1016/j.breast.2026.104696","url":null,"abstract":"","PeriodicalId":9093,"journal":{"name":"Breast","volume":"85 ","pages":"Article 104696"},"PeriodicalIF":7.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994399","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 mobile mammography unit on participation and equity in breast cancer screening: a cluster randomised trial in Normandy, France","authors":"Gniré Koné ,&nbsp;Séverine Beuriot ,&nbsp;Ludivine Launay ,&nbsp;Guy Launoy ,&nbsp;Elodie Guillaume","doi":"10.1016/j.breast.2025.104686","DOIUrl":"10.1016/j.breast.2025.104686","url":null,"abstract":"<div><h3>Background</h3><div>Participation in organised breast cancer screening (OBCS) in France has declined over the past decade. This study evaluated the contribution of mobile mammography units (MMUs) to increasing screening participation through a prospective cluster-randomised controlled trial conducted in France.</div></div><div><h3>Methods</h3><div>This interventional study was conducted among the general population in four departments of the Normandy region. Areas located &gt;15 min from a radiology centre were grouped into clusters and randomly assigned (1:1) to either an intervention or control arm. In total, 320 areas inhabited by 87,449 women aged 50 to 74 years were included. In the intervention arm, women whose last mammogram was performed at least 22 months earlier received, besides to the usual invitation, an appointment at the MMU sent by the regional screening management structure. The primary outcome was the BCS participation rate. A cluster-adjusted proportion test was used to compare participation between arms.</div></div><div><h3>Results</h3><div>In the intervention arm, 22,964 women were screened out of the 38,382 invited, yielding a participation rate of 59.8% vs 51.1% in the control areas (25,099/49,067). The MMU intervention was associated with a statistically significant increase in participation of 8.7% (p&lt;0.0001) compared with the control arm. In the intervention arm, women screened in the MMU tended to be younger and more deprived than those who opted for a radiology centre.</div></div><div><h3>Conclusions</h3><div>The addition of an MMU to the OBCS programme in France significantly increased participation among women living furthest from radiology centres and can reduce social and geographic inequities.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"86 ","pages":"Article 104686"},"PeriodicalIF":7.9,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037361","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":"FDA and EMA approval of datopotamab-deruxtecan: A paradigm shift in breast cancer drug evaluation?","authors":"Armando Orlandi","doi":"10.1016/j.breast.2025.104589","DOIUrl":"10.1016/j.breast.2025.104589","url":null,"abstract":"<div><div>The January 2025 FDA and EMA approvals of datopotamab-deruxtecan for metastatic HR-positive, HER2-negative breast cancer represents an unprecedented regulatory decision. The TROPION-Breast01 trial demonstrated significant progression-free survival improvement (6.9 vs 4.9 months; HR 0.63) but failed to show overall survival benefit (18.6 vs 18.3 months; HR 1.01)[1,2]. This marks the first full approval of a breast cancer therapeutic that failed a co-primary overall survival endpoint. Subsequently, the European Medicines Agency also granted marketing authorization in January 2025, creating a concerning precedent across both major regulatory agencies. With both major regulatory agencies now having approved this agent, breast cancer specialists must grapple with fundamental questions: What constitutes meaningful clinical benefit in heavily pretreated patients? How should we interpret trials with divergent endpoint results? This commentary examines the implications for breast cancer practice and argues for urgent reassessment of evidence standards as the therapeutic landscape evolves.</div></div>","PeriodicalId":9093,"journal":{"name":"Breast","volume":"84 ","pages":"Article 104589"},"PeriodicalIF":7.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156081","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}