Breast Cancer Research and Treatment最新文献

{"title":"A 40-year-old woman with early-stage triple-negative breast cancer and a retinal lesion.","authors":"Shivahamy Maheswaran, Arielle J Medford, Tomasz P Stryjewski, Janice N Thai, Seth A Wander","doi":"10.1007/s10549-025-07770-y","DOIUrl":"10.1007/s10549-025-07770-y","url":null,"abstract":"<p><p>The development of highly sensitive diagnostic imaging tools has created a challenge in localized cancer therapy; incidental findings can complicate staging and decision making. In the absence of clinical symptoms suggestive of metastatic disease, the diagnostic approach to localized breast cancer typically does not mandate staging scans. While metastatic disease is often referred to as an incurable entity, oligometastatic disease, confined to a limited number of sites, may be amenable to curative-intent ablative therapy. There is a growing body of evidence supporting the deployment of multidisciplinary treatment involving radiotherapy and/or surgical intervention in oligometastatic disease. This report describes a 40-year-old woman with triple-negative breast cancer who was incidentally found to have an right chorioretinal lesion, identified on a routine annual eye exam prior to her breast cancer diagnosis, with ophthalmic features suggestive for metastatic disease. She was asymptomatic, and did not have other findings suggestive of metastatic disease. Staging CT chest/abdomen/pelvis and brain MRI were negative. Biopsy of the ocular lesion was deferred given its close proximity to the macula and potential for vision threatening complications. Curative-intent localized treatment was undertaken, and the retinal lesion was monitored with serial ophthalmologic examinations. The patient received neoadjuvant chemotherapy, followed by bilateral mastectomy, and adjuvant chemotherapy. Follow-up imaging remained negative for disease progression, and routine ophthalmic exams over years of follow up showed no changes to the retinal lesion. The patient granted verbal consent to share her clinical story, imaging, and data.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"15-19"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583070","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":"Stage at diagnosis and breast cancer-specific mortality in breast cancer patients treated with antidepressants, anxiolytics, and antipsychotics: a population-based cohort study from Northern Ireland.","authors":"Sarah M Baxter, Charlene M McShane, Stuart A McIntosh, Damien Bennett, Lynne Lohfeld, Daniel R S Middleton, Gerard Savage, Deirdre Fitzpatrick, Joseph Kane, Ann McBrien, David McCallion, Anna Gavin, Chris R Cardwell","doi":"10.1007/s10549-025-07766-8","DOIUrl":"10.1007/s10549-025-07766-8","url":null,"abstract":"<p><strong>Purpose: </strong>We examined the stage at diagnosis and breast cancer-specific mortality in a cohort of breast cancer patients prescribed medications used for mental health conditions before diagnosis.</p><p><strong>Methods: </strong>Women newly diagnosed with breast cancer from 2011 to 2021 were identified from the Northern Ireland Cancer Registry. The primary outcome was time to breast cancer-specific mortality up to March 2023. The secondary outcomes included stage at diagnosis. We identified anxiolytic, antidepressant, and antipsychotic prescriptions dispensed in the year before breast cancer diagnosis from the Northern Ireland Enhanced Prescribing Database. Cox regression models were used to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (95%CIs) for cancer-specific mortality by use of medications.</p><p><strong>Results: </strong>We included 13,846 women with breast cancer. In the year before breast cancer diagnosis, 31.5% were dispensed antidepressants, 12.7% anxiolytics, and 3.5% antipsychotics. The odds of late-stage disease presentation in breast cancer patients dispensed medications for mental health conditions was similar to breast cancer patients not dispensed these medications, but patients dispensed antipsychotics had higher odds of unknown stage. We found no difference in the hazard rate of breast cancer-specific mortality in patients dispensed, versus not dispensed, anxiolytics (aHR = 1.06 95%CI 0.93-1.20), a small increase in patients dispensed, versus not dispensed, antidepressants (aHR = 1.11 95%CI 1.01-1.23) and a moderate increase in patients dispensed, versus not dispensed, antipsychotics (aHR = 1.45 95%CI 1.17-1.81).</p><p><strong>Conclusions: </strong>Breast cancer patients dispensed medications for mental health conditions were not at higher odds of presenting with late-stage disease, but patients dispensed antidepressants, and especially antipsychotics, had worse breast cancer-specific mortality.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"137-150"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567096","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":"Insurer and patient costs for repeat breast surgery after initial lumpectomy for breast cancer.","authors":"Sam E Wing, Yuki Liu, Feibi Zheng, Naomi C Hamm, Nayana S Dekhne, Jesse C Selber","doi":"10.1007/s10549-025-07735-1","DOIUrl":"10.1007/s10549-025-07735-1","url":null,"abstract":"<p><strong>Purpose: </strong> ~ 14-25% of patients who undergo a primary lumpectomy for the treatment of breast cancer require a reoperation due to adverse outcomes like positive surgical margins or early cancer recurrence, adding burden to the patients, providers, and payors. We analyze the economic impact of patients who require repeat breast tissue resection as part of their treatment following initial resection.</p><p><strong>Methods: </strong>We utilized the Merative™ MarketScan Research Database to identify a cohort of women in the United States who received an index lumpectomy between 2016 and 2021 and identified their healthcare encounters one year postoperatively, including any repeat lumpectomies or mastectomies, as well as the use of any intraoperative adjuncts (e.g. localization methods or frozen sections).</p><p><strong>Results: </strong>Among 8,869 patients with a primary lumpectomy, 25% (n = 2197) underwent a second surgery, of which 75% (n = 1644) was a repeat lumpectomy and 25% (n = 553) was a mastectomy. Median healthcare expenditure for primary lumpectomy plus one year follow up was $55,985 USD ($2,500 out-of-pocket). Among patients with secondary procedures, median healthcare expenditure from primary lumpectomy plus one year follow up was $63,416 ($3,005 out-of-pocket) for repeat lumpectomy and $87,961 ($3,100 out-of-pocket) for subsequent mastectomy patients. Repeat procedures were more common among patients who did not receive an intraoperative adjunct for lesion localization or margin assessment.</p><p><strong>Conclusion: </strong>While lumpectomy is the most common surgery for early-stage breast cancer, it often is not definitive, which can result in large added financial and operational burdens. Patient risk stratification and intraoperative adjuncts are needed to minimize risk of reoperation.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"457-465"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207640","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":"Patient decision aids in breast surgery and breast reconstruction reduce decisional conflict: a systematic review and meta-analysis.","authors":"Tokoya Williams, Keenan Fine, Emily Duckworth, Tarifa Adam, Caden Bozigar, Annie McFarland, Antoinette Nguyen, Brigid M Coles, Robert D Galiano","doi":"10.1007/s10549-025-07752-0","DOIUrl":"10.1007/s10549-025-07752-0","url":null,"abstract":"<p><strong>Purpose: </strong>Around 310,000 new cases of breast cancer (BC) are diagnosed each year. Complex treatment options often overwhelm patients. Patient decision aids (PDAs) assist in surgical decision-making, but reviews of their quality and efficacy are limited. This study systematically reviews breast surgery (BS) and breast reconstruction (BR) PDAs using the International Patient Decision Aid Standards and Cochrane tools to identify gaps and provide evidence-based recommendations.</p><p><strong>Methods: </strong>A systematic review following PRISMA guidelines examined the impact of PDAs on decision-making for BC patients considering BS and BR. From 1198 articles, 35 met the inclusion criteria. Data on PDA components, study design, and results were extracted, focusing on decisional conflict and anxiety, measured by the Decisional Conflict Scale (DCS) and the State-Trait Anxiety Inventory (STAI). PDA quality and study design were assessed using Cochrane, IPDASi, and ROBINS-I tools.</p><p><strong>Results: </strong>Eight studies evaluated the effect of PDAs on decisional conflict. The pooled mean difference of 3.08 points (95% CI: - 0.62 to 6.79, p = 0.10) favored the PDA group but was not statistically significant. Two studies, however, reported notable reductions in decisional conflict with effect sizes of 13.50 and 12.80 points, respectively. The pooled effect size of PDA exposure on patient anxiety was 1.93 (95% CI: - 0.46 to 4.31) in favor of PDAs, but was not statistically significant (p = 0.11). The evaluation of PDA content quality revealed variable results.</p><p><strong>Conclusion: </strong>BS and BR PDAs were not found to significantly reduce decisional conflict and anxiety in breast cancer patients. Standardized, evidence-based tools are needed.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526414","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":"PD-L1 22C3 CPS in paired primary breast cancer and lung metastasis.","authors":"Eunah Shin, Yoon Jin Cha, Hye Min Kim, Ja Seung Koo","doi":"10.1007/s10549-025-07757-9","DOIUrl":"10.1007/s10549-025-07757-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the expression of PD-L1 22C3 in primary breast cancer and lung metastasis tissues using the Combined Positive Score (CPS) and to investigate the concordance and differences between them.</p><p><strong>Methods: </strong>Immunohistochemical staining for PD-L1 22C3 was performed on 52 paired cases of primary breast cancer and lung metastases. The CPS was measured and analyzed for comparison.</p><p><strong>Results: </strong>The PD-L1 positivity rate (CPS ≥ 10) was 13.5% in primary breast cancers and 30.8% in lung metastases. The overall percent agreement (OPA) for PD-L1 CPS between primary tumors and lung metastases was 78.8%, with a positive percent agreement (PPA) of 85.7% and a negative percent agreement (NPA) of 77.8%. The mean CPS was 2.69 ± 6.67 (mean ± SD) in primary breast cancers and 7.67 ± 14.49 (mean ± SD) in lung metastases, with a significantly higher CPS observed in lung metastases (p < 0.001). The primary cause of discordance, where PD-L1 was negative in the primary tumor but positive in the metastasis, was the presence of PD-L1-positive alveolar macrophages predominantly located around or within the metastatic tumor.</p><p><strong>Conclusion: </strong>PD-L1 22C3 demonstrated approximately 80% concordance between primary breast cancers and lung metastases; however, discordance was mainly attributable to the presence of inherently PD-L1-positive peritumoral and/or intratumoral alveolar macrophages.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"569-576"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265247","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":"Continuous glucose monitoring to characterize hyperglycemia during chemotherapy for early stage breast cancer.","authors":"Sophie R Ulene, Shikun Wang, Joshua R Cook, Fiona McAuley, Margaux E Wooster, Khadija F Faheem, Andrew Varoli, Julia E McGuinness, Neil Vasan, Meghna S Trivedi, Katherine D Crew, Erik Harden, Cynthia Law, Dawn L Hershman, Melissa K Accordino","doi":"10.1007/s10549-025-07745-z","DOIUrl":"10.1007/s10549-025-07745-z","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes (DM) and hyperglycemia during chemotherapy increase the risk of toxicity, yet the prevalence and patterns of hyperglycemia in early-stage breast cancer (ESBC) patients undergoing chemotherapy with concurrent dexamethasone remain poorly understood.</p><p><strong>Methods: </strong>We conducted a prospective single-arm study using FreeStyle Libre Pro continuous glucose monitoring in patients with ESBC receiving chemotherapy from 12/2020-2/2022. Sensors measured interstitial glucose every 15 min and were reapplied every 2-3 weeks. Primary endpoints were (1) prevalence of hyperglycemia (≥ 1 reading ≥ 140 mg/dL), and (2) for those with hyperglycemia, the proportion of time spent hyperglycemic. Secondary endpoints included baseline glucose tolerance by A1c, changes in glucose-related biomarkers, and changes in patient-reported neuropathy, quality of life, and fatigue. Analysis was stratified by baseline A1c (euglycemic < 5.7%, prediabetes [pre-DM] 5.7-6.4%, diabetes [DM] ≥ 6.5%).</p><p><strong>Results: </strong>Among 20 evaluable patients (median age: 60, BMI: 29.5 kg/m²), common chemotherapy regimens included docetaxel/cyclophosphamide (25%), paclitaxel/trastuzumab (20%), paclitaxel then doxorubicin/cyclophosphamide (15%), docetaxel/carboplatin/trastuzumab/pertuzumab (15%), and cyclophosphamide/methotrexate/fluorouracil (15%). All patients received Dexamethasone. At baseline, 10 patients were euglycemic, 7 had pre-DM, and 3 had DM. All experienced hyperglycemia. Of 124,165 total glucose readings, 17% were ≥ 140 mg/dL. By cohort, the proportion of time spent hyperglycemic was 3.9% (euglycemic), 10% (pre-DM), and 73.3% (DM) (p < .0001). Mean glucose values were 95.5 mg/dL (euglycemic), 104.5 mg/dL (pre-DM), and 183.0 mg/dL (DM) (p < .0001).</p><p><strong>Conclusion: </strong>All patients receiving chemotherapy for ESBC experienced hyperglycemia, with time spent hyperglycemic varying significantly by baseline A1c. Future research should explore approaches to and benefits of improving glycemic control during treatment in patients with baseline dysglycemia.</p><p><strong>Trial registration: </strong>NCT04473378.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"511-519"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224253","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":"Socioeconomic status impacts tumor biology, treatment, and outcomes in over 200,000 patients with invasive lobular carcinoma of the breast: an analysis of the National Cancer Database.","authors":"Mandeep Kaur, Astrid Quirarte, Amy M Shui, Anna Vertido, Elle Clelland, Harriet Rothschild, Laura J Esserman, Cheryl Ewing, Rita A Mukhtar","doi":"10.1007/s10549-025-07769-5","DOIUrl":"10.1007/s10549-025-07769-5","url":null,"abstract":"<p><strong>Purpose: </strong>While the impact of socioeconomic factors on breast cancer diagnosis, treatment, and outcomes are well-documented, few studies have focused on invasive lobular carcinoma (ILC), the second most common type of breast cancer. We evaluated the relationships between race and socioeconomic status (SES) with clinicopathological characteristics and outcomes in patients with stage I-III ILC using the National Cancer Database (NCDB).</p><p><strong>Methods: </strong>We used the NCDB, a national oncology database, to evaluate insurance status, a composite measure of SES (education and income), clinicopathological characteristics, and outcomes in patients with stage I-III ILC. Clinicopathologic variables included tumor size, presence of lymphovascular invasion (LVI), and tumor receptor subtype (hormone receptor, HR), and tumor grade. Overall survival was analyzed with multivariable Cox proportional hazards models.</p><p><strong>Results: </strong>We identified 269,657 patients with stage I-III ILC. Patients in the Medicaid/no insurance group and those with lower SES had larger tumors, more positive lymph nodes, fewer HR+ tumors, and higher-grade tumors. Those in the low SES group had higher rates of chemotherapy use and, in those with HR+ tumors, lower rates of endocrine therapy use. In a multivariable model adjusting for SES, self-identified race/ethnicity, age, stage, receptor subtype, grade, treatment, and Charlson-Deyo score, patients with low SES had a 24% higher risk of death by 5 years compared to patients with high SES (HR 1.24, 95% CI 1.19-1.30, p < 0.001).</p><p><strong>Conclusion: </strong>While our study confirms several known disparities in the presentation, outcomes, and treatment of breast cancer, this is the first evaluation to assess how different components of SES influence ILC specifically.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"161-169"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494643","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":"Utility of plasma circulating DNA tumor fraction in bone-only metastatic breast cancer: a real-world outcomes study.","authors":"Gilbert Bader, Julia C F Quintanilha, Deloris Veney, Ryon P Graf, Mia Levy, Lincoln W Pasquina, Daniel G Stover","doi":"10.1007/s10549-025-07740-4","DOIUrl":"10.1007/s10549-025-07740-4","url":null,"abstract":"<p><strong>Purpose: </strong>Bone metastases develop in 50-70% of patients with metastatic breast cancer (MBC), with around one-third having bone as only site of distant disease (bone-only [BO]). Standard imaging is frequently insufficient to track bone metastases. Evidence suggests that circulating tumor DNA (ctDNA) tumor fraction (TF) is prognostic in MBC. We hypothesized that TF would be detectable and prognostic for BO-MBC.</p><p><strong>Methods: </strong>MBC patients who underwent FoundationOne LiquidCDX comprehensive genomic profiling within 60 days before starting therapy were included. Clinical data was obtained from the nationwide deidentified Flatiron Health/Foundation Medicine Clinico-Genomic Database between 01/2011 and 12/2023.</p><p><strong>Results: </strong>We identified 778 patients for inclusion: 299 TF < 1% (TF-low), 175 TF 1-10% (TF-intermediate [int]), 304 TF > 10% (TF-high). Of these, 155 had BO-MBC, 622 had non-BO MBC (1 missing metastasis data). Among samples collected prior to first-line therapy (n = 256), there was no significant difference in the proportion of patients with detectable ctDNA comparing BO-MBC to non-BO MBC patients (P = 1.0). TF was prognostic among patients with BO-MBC: TF-low demonstrated more favorable real-world overall survival (rwOS) relative to TF-int (hazard ratio [HR] 2.19, 95% confidence interval [CI] 1.1-4.35) and TF-high (HR 2.07, 95% CI 1.12-3.82; log-rank P = 0.027). Multivariable analyses confirmed the independent and additive association of TF and less favorable rwOS. In multivariable analyses evaluating clinicopathologic factors associated with TF, non-BO metastases were not associated with higher ctDNA TF.</p><p><strong>Conclusion: </strong>BO-MBC patients are as likely as non-BO-MBC to have detectable ctDNA and TF remains prognostic among BO-MBC patients, with TF < 1% associated with significantly better prognosis.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"475-486"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186481","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":"National trends in neoadjuvant systemic therapy utilization in patients with early-stage HER2-positive breast cancer from 2016-2021: The impact of the KATHERINE trial.","authors":"Lauren N Cohen, Christine C Rogers, Jan Irene C Lloren, Sailaja Kamaraju, Lubna N Chaudhary, Chiang-Ching Huang, Adrienne N Cobb, Puneet Singh, Amanda L Kong, Mediget Teshome, Chandler S Cortina","doi":"10.1007/s10549-025-07750-2","DOIUrl":"10.1007/s10549-025-07750-2","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant systemic therapy (NST) for HER2 + breast cancer (HER2 + BC) has historically been used to downstage disease to facilitate surgical de-escalation; however, in 2019, the KATHERINE trial identified a survival benefit to adjuvant T-DM1 for those with residual disease after NST. We aimed to determine national rates of NST for patients with cT1-2 N0 M0 HER2 + BC and identify factors associated with receipt of NST vs upfront surgery with adjuvant systemic therapy (US-AST).</p><p><strong>Methods: </strong>A retrospective cohort study of women with cT1-2 N0 M0 HER2 + BC was performed using the National Cancer Database from 2016-2021. ANOVA, Kruskal-Wallis, Chi-square, Fisher's Exact tests, and a multivariable logistic regression analysis were used.</p><p><strong>Results: </strong>54,449 patients met inclusion: 30,546 (56.1%) received US-AST and 19,562 (35.9%) received NST. NST utilization increased from 31.1% in 2016-17 to 43.3% in 2020-21. On regression analysis, women diagnosed in 2020-21 were more likely to receive NST (OR 1.9, 95% CI 1.8-2.0). Populations less likely to receive NST included NH-Black women (OR 0.87, 95% CI 0.8-0.95), age ≥ 70 (OR 0.7, 95% CI 0.6-0.8), increasing comorbidities (OR 0.7, 95% CI 0.5-0.9), and Medicare insurance (OR 0.8, 95% CI 0.7-0.8). Patients with cT2 disease were more likely to receive NST vs those with cT1 disease (p < 0.001).</p><p><strong>Conclusion: </strong>From 2016-2021, national rates of NST for patients with cT1-2 N0 HER2 + BC significantly increased. Race/ethnicity and insurance type were associated with receipt of NST underscoring ongoing disparities in care. Future studies are needed to determine the impact of the disparate rates of NST utilization on oncologic outcomes, given the survival benefit with adjuvant T-DM1 in those with residual disease after NST.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"531-543"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207641","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":"Genomic and proteomic profiling of GATA3 mutant metastatic hormone receptor-positive breast cancer and impact on clinical outcomes.","authors":"Arielle J Medford, Marko Velimirovic, Yifat Gefen, Andrzej Niemierko, Lorenzo Gerratana, Andrew A Davis, Katherine Clifton, Jennifer Keenan, Emily Podany, Whitney L Hensing, Carolina Reduzzi, Charles S Dai, Lesli A Kiedrowski, Laura M Spring, Leif W Ellisen, Robert C Doebele, Massimo Cristofanilli, Gad Getz, Aditya Bardia","doi":"10.1007/s10549-025-07710-w","DOIUrl":"10.1007/s10549-025-07710-w","url":null,"abstract":"<p><strong>Purpose: </strong>GATA3 mutations are among the most common alterations in hormone receptor-positive (HR+) breast cancer (BC), yet these have no targeted therapies. MDM2 is an E3 ubiquitin ligase that targets p53 for degradation, and pre-clinical data suggests MDM2 inhibition may effectively treat GATA3^mut HR+ BC. The GATA3 co-mutational landscape has been described only in primary BC tissue, and the mechanism of MDM2-driven efficacy is incompletely understood.</p><p><strong>Experimental design: </strong>Circulating tumor DNA (ctDNA) was assessed for GATA3 mutations via targeted sequencing. Associations with co-alterations and clinical/pathologic factors were estimated using Pearson's chi-squared test, two-sample Wilcoxon rank-sum, and multivariable logistic regression. Impact on survival was analyzed using multivariable Cox regression analysis. Tissue-based data from the Clinical Proteomic Tumor Analysis Consortium (CPTAC) database was evaluated for expression and phosphorylation of GATA3 and associated proteins.</p><p><strong>Results: </strong>Among 609 patients with HR + /HER2- MBC, ctDNA detected non-synonymous GATA3 variants ctDNA in 69 (11%) patients, and the genomic landscape was unique from tissue-based primary BC data; GATA3^mut were not mutually exclusive from TP53^mut (p = 0.30) or PIK3CA^mut (p = 0.52) and were associated with poorer survival on endocrine monotherapy. CPTAC analysis showed no difference in GATA3 or breast cancer-associated gene abundance, however there was increased USP48 (LogFC = 0.76, FDR = 1.7 × 10^-5), which stabilizes MDM2.</p><p><strong>Conclusion: </strong>The distinct landscape in GATA3^mut MBC ctDNA highlights critical information when assessing candidacy for targeted therapies. To our knowledge, this is the first ctDNA-based GATA3^mut landscape analysis in MBC. Furthermore, tissue-based proteomic analysis suggests mechanisms for endocrine resistance and sensitivity to MDM2 inhibition in HR+ /HER2- GATA3^mut BC.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"437-447"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172835","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}