Breast Cancer Research and Treatment最新文献

{"title":"Patterns of social determinants of health screening and health-related social needs among patients with newly diagnosed breast cancer in a safety-net system.","authors":"Malcolm Su, Hannah Klatzkow, Ronald Bass, Samar Bhat, Teresita Oaks, Marieshia Person, Shifa Kanjwal, Samira Syed, Arthur S Hong, Deborah G Freeland, Navid Sadeghi","doi":"10.1007/s10549-026-08095-0","DOIUrl":"10.1007/s10549-026-08095-0","url":null,"abstract":"<p><strong>Purpose: </strong>Various social determinants of health (SDOH) have been shown to negatively impact breast cancer outcomes. Though there are recommendations for comprehensive SDOH assessment, little is known about the optimal frequency of reassessments and change in health-related social needs (HRSN) over time for specific patient populations. We sought to characterize SDOH screening and HRSN patterns among patients with breast cancer in a safety-net system.</p><p><strong>Methods: </strong>A retrospective study was conducted to evaluate SDOH survey responses in the electronic medical records and screening frequency from patients diagnosed with breast cancer between January 2021 to January 2024 at Parkland Health.</p><p><strong>Results: </strong>There were 566 patients diagnosed with breast cancer with a mean age at diagnosis of 55.0 (standard deviation, SD: 11.4) years. There were 54 (9.5%) with Stage IV breast cancer. Patients were initially at risk for 1.36 (SD: 1.39) out of the 11 HRSN domains. Patients completed an average 17.3 (SD: 8.9) out of 28 questions on initial survey. The most common risk domains identified were Alcohol Use and Food Insecurity. No patients were screened for Interpersonal Violence. The median time from initial survey to first change in risk level for any domain was 8.7 months. Patients with Stage IV disease underwent fewer SDOH re-screenings compared to patients with Stage I, II, and III disease (p < 0.001).</p><p><strong>Conclusion: </strong>Within our system, greater attention should be placed towards fully assessing patients' HRSN and screening for interpersonal violence. SDOH screening at 6-month intervals may help to capture changes in HSRNs and assess the impact of resource interventions.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"220 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis-to-surgery lead time and future-health worry in women with primary breast cancer: a longitudinal Swedish registry-based cohort study.","authors":"Johan Eriksson, Irma Fredriksson, Lena Lindholm, Micael Appelblad, Malin Sund","doi":"10.1007/s10549-026-08107-z","DOIUrl":"10.1007/s10549-026-08107-z","url":null,"abstract":"<p><strong>Purpose: </strong>The interval between breast cancer diagnosis and surgery is psychologically demanding, and meeting the Swedish standardised care pathway target has remained challenging. We examined whether diagnosis-to-surgery lead time is associated with patient-reported psychological outcomes.</p><p><strong>Methods: </strong>We conducted a longitudinal cohort study using Swedish National Quality Register for Breast Cancer data (2020-2024). The cohort comprised 2,906 women with primary invasive breast cancer undergoing surgery, with patient-reported outcome measure (PROM) data at baseline (n = 2,906), 6 months (n = 2,638), and 12 months (n = 2,678). Lead time from biopsy to surgery was modelled continuously (per 1 SD ≈ 19 days). The primary outcome was worry about future health (EORTC QLQ-BR23 item 43); secondary outcomes were general worry, tension, depressed mood, and overall quality of life. Associations were estimated using mixed-effects cumulative link models adjusted for clinical and tumour factors, pandemic era, patient, and healthcare region.</p><p><strong>Results: </strong>Median lead time was 32 days (IQR 23-42). Longer lead time was associated with greater worry about future health (adjusted OR 1.15 per SD, 95% CI 1.04-1.27), while associations with the secondary outcomes were smaller and not statistically significant. At baseline, high future-health worry was more common with lead times > 35 vs. ≤ 35 days (42.2% vs. 35.1%).</p><p><strong>Conclusion: </strong>Longer diagnosis-to-surgery lead time was associated with greater future-health worry, with smaller, non-significant associations for general distress and quality of life. The findings highlight the preoperative waiting period as a potential context for improved communication about expected timelines and reasons for delay.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"220 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of surgical breast cancer treatment at regional or community hospitals with patient-reported experience measures.","authors":"Savannah R Gonzales, Uma Ramesh, A James O'Malley, Gabriel A Brooks, Tracy Onega, Erika L Moen","doi":"10.1007/s10549-026-08105-1","DOIUrl":"10.1007/s10549-026-08105-1","url":null,"abstract":"<p><strong>Purpose: </strong>High-volume hospitals deliver improved outcomes for patients with breast cancer, supporting referrals for breast cancer surgical care to high-volume regional facilities. This retrospective cohort study investigated how multidisciplinary cancer care trajectories and patient care experiences varied by surgical facility classification (regional vs. community as a proxy for high- vs. low-volume) and whether effects differed by rural-residence.</p><p><strong>Methods: </strong>We used Surveillance, Epidemiology, and End Results-Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) data for Medicare beneficiaries who received surgery for non-metastatic breast cancer from 2009 to 2019. We mapped cancer care trajectories using facility classification and oncologist specialty and performed state sequence analysis to identify care trajectory clusters. We used linear mixed-effects models to examine associations of surgical facility classification with patient-reported experience measures and assessed effect modification by rurality.</p><p><strong>Results: </strong>Of the 3,327 patients in our cohort, 15.4% were rural-residing and 68.8% received surgery at a regional facility. Care trajectories indicated that patients tended to receive adjuvant care from the same type of facility as their surgical treatment. Patients who received surgery at community facilities (vs. regional) were significantly more likely to report better experiences with getting needed care (Est. (95%CI) = 3.5 (0.10,6.9), p = 0.043), with no significant differences for getting care quickly, care coordination, or doctor communication. Rural-residence was not a significant effect modifier.</p><p><strong>Conclusion: </strong>Receiving surgery at community facilities is associated with better patient-reported experiences for getting needed care. Moreover, surgical facility classification appears to influence the setting for subsequent cancer care, which may impact patient experiences in getting needed care.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"220 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of DNA methylation levels before and after treatment in breast cancer patients receiving neoadjuvant chemotherapy.","authors":"Halime Yildirim, Ender Coskunpinar, Mustafa Tukenmez, Baran Mollavelioglu, Aysel Bayram","doi":"10.1007/s10549-026-08101-5","DOIUrl":"https://doi.org/10.1007/s10549-026-08101-5","url":null,"abstract":"<p><strong>Purpose: </strong>Drug resistance is a major cause of treatment failure in breast cancer patients. Numerous genetic and epigenetic markers have been proposed to influence Neoadjuvant Chemotherapy (NACT) response, and genes that regulate the effectiveness of chemotherapeutic agents undergo expression regulation via methylation. In this study, we aimed to investigate the methylation levels of KDM5A, KDM5B, and KDM5C, as well as their associated genes, EZH2, TFAP2C, ZMYND8, and SIN3B (Exon 1-2 and 19-20), in blood samples collected from patients before and after NACT treatment. Besides, we also examined potential variations in the KDM5A, KDM5B, and KDM5C gene regions.</p><p><strong>Methods: </strong>Twenty patients were diagnosed with breast cancer, and 30 healthy control individuals were included in the study. Blood samples were taken from the patients twice, before and after NACT. Methylation levels of KDM5 family genes and related genes were analyzed using Methylation-specific PCR (MSP). Additionally, potential variants in the KDM5A, KDM5B, and KDM5C gene regions were identified using Sanger sequencing.</p><p><strong>Results: </strong>According to the methylation analysis results, the SIN3B (Exon 19-20), KDM5C, EZH2, and TFAP2C genes were prominent in patients with pathological partial response, while the KDM5A, KDM5B, KDM5C, EZH2, TFAP2C, and SIN3B (Exon 19-20) genes were prominent in patients with pathological complete response. According to genotyping results, rs41308616 and rs971896841 variants were detected as heterozygous in the KDM5C gene region in two patients, respectively.</p><p><strong>Conclusion: </strong>The methylation percentages and genetic variations in the KDM5 family and related gene regions identified in this study may serve as potential biomarkers for developing treatment strategies for breast cancer patients.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"220 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness, need and utilization of breast cancer risk management resources in women with hereditary cancer susceptibility.","authors":"Gerneiva Parkinson, Sue Friedman, Rachel Hodan, Allison W Kurian","doi":"10.1007/s10549-026-08104-2","DOIUrl":"https://doi.org/10.1007/s10549-026-08104-2","url":null,"abstract":"<p><strong>Background: </strong>Germline genetic testing is increasing. While testing barriers are well characterized, less is known about post-testing needs and utilization of screening and prevention resources by women with pathogenic variants (PVs) in breast cancer susceptibility genes.</p><p><strong>Methods: </strong>A 38-question online survey was developed by Facing Our Risk of Cancer Empowered (FORCE), a patient advocacy group, and administered electronically to subscribers from February-May 2024. Study eligibility criteria included female sex and a germline PV conferring elevated lifetime risk of breast cancer (ATM, BARD1, BRCA1, BRCA2, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, STK11, or TP53).</p><p><strong>Results: </strong>Of 1,025 respondents who initiated the survey, 937 were women. Most were non-Hispanic White (91.7%) and from the United States (81.6%). The most common PVs were BRCA2 (31.4%), BRCA1 (25.5%) and CHEK2 (9.2%). The most frequently used resources were education and information services about medical options (39.3%) and peer support (28.1%). Few respondents used financial navigation (4.0%) or financial support (5.3%), but up to 45% reported needing these services. Among breast screening users (53.8% used mammogram, 42.2% magnetic resonance imaging, 19.4% ultrasound), 37.8% found it hard to prepare emotionally for results and 14% found it hard to pay for screening. One-third (37.1%) of respondents found deciding whether to have risk-reducing mastectomy hard; two-thirds (64.0%) found physical recovery hard, more than half (60.2%) found emotional recovery hard, and one-quarter (24.7%) found paying for risk-reducing mastectomy hard.</p><p><strong>Conclusion: </strong>In this contemporary sample of women at elevated risk of breast cancer, more than one-third had unmet financial needs and up to two-thirds had difficulty with screening or risk-reducing surgery. Closing these gaps will be essential to improve outcomes for women with hereditary breast cancer.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"220 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management in HER2 + de novo metastatic breast cancer: disease progression and survival.","authors":"Malia Brennan, Sara H Javid, Meghan R Flanagan, Robert Schmicker, William R Gwin, Sophie Fleuret, Emily Palmquist","doi":"10.1007/s10549-026-08108-y","DOIUrl":"https://doi.org/10.1007/s10549-026-08108-y","url":null,"abstract":"<p><strong>Purpose: </strong>Advancements in human epidermal growth factor (HER)-targeted therapy have significantly improved survival in patients with de novo metastatic HER-2 positive (HER2+) breast cancer (dnMBC). The role of breast surgery is debated. We examined which HER2 + dnMBC patients undergo surgery and compared outcomes to systemic therapy alone.</p><p><strong>Methods: </strong>We performed a single institution retrospective review of patients with HER2 + dnMBC diagnosed 2011-2023. Data included demographics, clinicopathologic details, treatment information, local and distant disease progression, and survival outcomes. Analyses included logistic regression, Kaplan Meier, and Cox proportional hazards models.</p><p><strong>Results: </strong>The study included 103 patients. Of these, 42.7% underwent breast surgery (70.5% mastectomy, 29.5% lumpectomy). Of these, 72.7% underwent axillary surgery (38.6% axillary lymph node dissection, 27.3% sentinel lymph node biopsy, 6.8% targeted axillary dissection). The median age at diagnosis was 48 years (surgery) and 56 years (no surgery) (p = 0.10). The surgery group had lower number of metastatic sites (1.3 vs. 1.9, p = 0.003) and exhibited higher rates of local disease progression pre-operatively (39% vs. 23.5%, p = 0.05). Post-operatively, there was no significant difference in local disease progression (17.1% vs. 23.5%, p = 0.42). After adjusting for age, sites of metastases, and number of metastatic sites, those who underwent surgery had improved overall survival (HR 0.33 (0.14-0.77), p = 0.02).</p><p><strong>Conclusion: </strong>Patients with HER2 + dnMBC with lower metastatic disease burden and local disease progression were more likely to undergo breast surgery. There was no significant difference in local disease control post-operatively. The significant association between surgery and improved survival must be interpreted with caution due selection bias in this retrospective study.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"220 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National trends in dual de-escalation of axillary surgery and adjuvant radiation in early-stage HR+/HER2- breast cancer.","authors":"Dylan S Brokaw, Leonardo Kozian, Cecilia Chang, Rebecca M Shulman, Richard J Bleicher, Alycia So, Allison A Aggon, Austin D Williams","doi":"10.1007/s10549-026-08106-0","DOIUrl":"10.1007/s10549-026-08106-0","url":null,"abstract":"<p><strong>Purpose: </strong>De-escalation has become standard across breast cancer management. Many early-stage HR+/HER2-negative breast cancers are eligible for both SLNB omission and accelerated partial breast irradiation (APBI). However, the oncologic safety of dual de-escalation has not been evaluated except in patients ≥ 70 years. We sought to characterize national practice patterns and factors associated with adoption of this dual de-escalation approach.</p><p><strong>Methods: </strong>Women aged 50-69 years with clinical T1-T2N0 breast cancer who underwent upfront breast-conserving surgery between (2012 - 2022) were identified from the National Cancer Database. Patients were categorized by axillary surgery and by adjuvant radiation modality (WBI, APBI, or none). We assessed trends and factors associated with de-escalation.</p><p><strong>Results: </strong>316,324 patients met inclusion criteria, of whom 98% underwent SLNB. Among patients who underwent SLNB, 83% received WBI, 11% received APBI, and 6% received no radiation. In contrast, among patients in whom SLNB was omitted, 63% received WBI, 8% received APBI, and 30% received no radiation. SLNB omission remained low throughout the study period at < 3%, while APBI use increased from 8% to 16.5%. Dual de-escalation was rarely performed throughout the study period remaining < 0.30%. Shared predictors of de-escalation included cT1 tumors, ductal histology, low grade, and treatment at academic/research programs.</p><p><strong>Conclusion: </strong>These findings highlight the need for prospective studies to define the safety, outcomes, and patient selection criteria for combined de-escalation strategies. Until these data are available, patient-centered discussions are essential to determine the most appropriate strategy for patients with low-risk disease.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"220 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A dermal backflow atlas of lymphatic dysfunction in breast cancer-related lymphedema with machine learning-based stage prediction.","authors":"Lalida Sutejitsiri, Hiroo Suami, Poul M F Nielsen, Anthony R J Phillips, Hayley M Reynolds","doi":"10.1007/s10549-026-08093-2","DOIUrl":"10.1007/s10549-026-08093-2","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer-related lymphedema (BCRL) is a chronic condition caused by impaired lymphatic drainage following cancer treatment, manifesting as fluid accumulation, adipogenesis, and lymph reflux to the skin (dermal backflow). The affected regions are diverse and therefore, improved understanding of the spatial distribution of lymphatic dysfunction may facilitate earlier detection and disease monitoring. This study aimed to develop a spatial atlas of dermal backflow in BCRL and apply machine learning (ML) models to predict disease severity.</p><p><strong>Methods: </strong>Data from 282 female BCRL patients (289 affected limbs) were obtained from the Australian Lymphedema Education, Research and Treatment (ALERT) Centre Databank, including indocyanine green (ICG) lymphography studies and clinical information. A spatial atlas of dermal backflow prevalence in the upper extremities was constructed by co-registering and segmenting clinician-annotated ICG diagrams. Five ML models were developed to classify MD Anderson Cancer Center (MDACC) lymphedema stage, incorporating dermal backflow percentage and clinical features.</p><p><strong>Results: </strong>The atlas revealed consistent spatial patterns of dermal backflow, with the highest prevalence in the wrist, forearm, and the olecranon region. Subgroup-specific heat maps stratified by MDACC stage, L-Dex ratio, limb volume difference, drainage regions, and hand dermal backflow further demonstrated distinct spatial variations with disease severity. The inclusion of dermal backflow percentage improved ML prediction of MDACC stage, with the best performance achieved by multinomial logistic regression and random forest models.</p><p><strong>Conclusion: </strong>Dermal backflow prevalence revealed non-uniform, region-specific patterns in BCRL patients, which can be visualized using spatial atlases. Integrating quantitative imaging features into ML models improves BCRL staging and supports objective, data-driven disease assessment.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain-only metastatic breast cancer as a distinct clinical entity: evidence from national and institutional cohorts with implications for radiation therapy.","authors":"Marshall Harrell, Tugce Kutuk, Yevgeniya Gokun, Rituraj Upadhyay, Sachin R Jhawar, Daniel Stover, Nicole Williams, Margaret E Gatti-Mayes, Gina Sizemore, Heather LeFebvre, John C Grecula, Raju R Raval, Raj Singh, Simeng Zhu, Dukagjin M Blakaj, Arnab Chakravarti, Joshua D Palmer, Sasha J Beyer","doi":"10.1007/s10549-026-08092-3","DOIUrl":"10.1007/s10549-026-08092-3","url":null,"abstract":"<p><strong>Purpose: </strong>Brain-only metastatic breast cancer (BO-MBC), defined as breast cancer with brain metastases (BrM) in the absence of extracranial metastatic disease (ECM), may represent a distinct metastatic phenotype. We characterized clinicopathologic features, treatment patterns, and outcomes of BO-MBC and evaluated associations between metastatic pattern, treatment, and survival.</p><p><strong>Methods: </strong>Patients with isolated BrM at our institution were evaluated for intracranial progression-free survival (iPFS), extracranial progression-free survival (ePFS), leptomeningeal disease-free survival (LMD-PFS), and overall survival (OS). Patients with MBC diagnosed between 2010 and 2020 were identified from the NCDB and classified as BO-MBC or BrM with concurrent ECM (BrM + ECM). Overlap propensity score-weighted Cox models evaluated associations between metastatic pattern, treatment, and OS.</p><p><strong>Results: </strong>In the institutional cohort (n = 30), intracranial progression was the predominant pattern of failure, with median iPFS of 14.6 months versus ePFS of 30.4 months. In the NCDB cohort (n = 8,909), 1,540 patients (17.3%) had BO-MBC. Compared with BrM + ECM, BO-MBC was associated with node-negative, triple-negative, and fewer HR+/HER2- disease (p < 0.001). BO-MBC patients were more likely to receive brain radiotherapy (54.8% vs. 41.0%, p < 0.001) but less likely to receive systemic therapy (67.2% vs. 74.5%, p < 0.001). In unadjusted Kaplan-Meier analyses, BO-MBC was associated with longer median OS than BrM + ECM (12.5 months [95% CI, 3.6-43.6] vs. 10.6 months [95% CI, 2.6-33.8]). Systemic therapy was associated with improved OS, with the greatest benefit in BO-MBC (adjusted HR 0.22, 95%CI 0.18-0.27). Brain radiotherapy was associated with improved OS in BO-MBC but not BrM + ECM.</p><p><strong>Conclusions: </strong>BO-MBC may represent a distinct clinical subgroup with unique clinicopathologic characteristics, treatment patterns, and improved survival. Intracranial progression predominated despite durable extracranial control, supporting optimized brain-directed management and prospective investigation of BO-MBC as a unique metastatic phenotype.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic metaplastic triple negative breast cancer response to sacituzumab govitecan and biomarker targetability.","authors":"Shivahamy Maheswaran, Aylin S Dedeoglu, Andrzej Niemierko, Rachel O Abelman, Rachel Jimenez, Olivia Rieur, Jennifer Hutchinson, Neelima Vidula, Laura M Spring, Leif W Ellisen, Steven J Isakoff, Seth A Wander, Aditya Bardia, Arielle J Medford","doi":"10.1007/s10549-026-08079-0","DOIUrl":"https://doi.org/10.1007/s10549-026-08079-0","url":null,"abstract":"<p><strong>Purpose: </strong>Optimizing metaplastic breast cancer (MpBC) management remains an unmet clinical need. Current literature on MpBC response toantibody drug-conjugates is limited to individual case reports and case series. This study investigates outcomes in metastatic MpBC treated withsacituzumab govitecan (SG) and characterizes actionable targets to inform future studies.</p><p><strong>Methods: </strong>Patients (pts) with metastatic triple negative breastcancer (TNBC) treated at the Massachusetts General Hospital Cancer Center between 2000 and 2025 were assessed for MpBC and receipt of SG. MpBCcases were interrogated for biomarkers qualifying for targeted therapy: HER2-low status (IHC 1+/2+), combined positive score (CPS), and targetablegenomic variants based on next-generation sequencing of plasma and/or tissue ordered by the treating provider. Multivariable Cox regression analysisassessed the association of MpBC under SG treatment with progression-free survival (PFS) and overall survival.</p><p><strong>Results: </strong>MpBC cases (n = 17) had anumerically shorter median PFS under SG compared to non-MpBC TNBC (n = 133) [2.6 vs. 6.8 months, p = 0.16]. While most patients with MpBC hadlimited response to SG monotherapy, two patients on SG + talazoparib had prolonged PFS. Annotation of available genomic and pathology data from allpatients with MpBC (n = 58) revealed targetable alterations including 34/56 patients with HER2-low status, 8/45 patients with germline BRCA1/2mut, and9/30 patients with somatic PIK3CAmut. MpBC response to matched therapies showed variable PFS.</p><p><strong>Conclusion: </strong>To our knowledge, this study is one ofthe largest analyses of MpBC response to SG and highlights challenges of treating rare diseases at large. Multi-institutional collaboration and inclusive trialdesign are essential to optimize treatments for MpBC.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}