Breast Cancer Research and Treatment最新文献

{"title":"Estrogen receptor positivity in stromal cells of the tumor bed predicts the response to neoadjuvant chemotherapy for breast carcinoma.","authors":"Aysel Bayram, Sidar Bagbudar, Hasan Karanlık, Neslihan Cabıoglu, Adnan Aydıner, Semen Onder, Ekrem Yavuz","doi":"10.1007/s10549-024-07601-6","DOIUrl":"https://doi.org/10.1007/s10549-024-07601-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine estrogen receptor (ER) expression in stromal cells in postchemotherapy tumor bed (PCTB) and its relationship with tumor regression and tumor characteristics.</p><p><strong>Methods: </strong>The study included 490 breast cancer patients who received neoadjuvant chemotherapy (NAC). We performed ER in stromal cells in all resection specimens and available pre-treatment core biopsy materials of 299 patients immunohistochemically.</p><p><strong>Results: </strong>Two hundred and forty-two (49.4%) cases were negative for ER in the stromal cells of the PCTB, and 248 (50.6%) cases were positive. ER-positive stromal cells in the PCTB correlated with a higher regression rate (90.2 vs 68.6%) and lower mean residual cancer burden value (1.366 vs 2.424) compared to ER-negative cases (p < 0.001). Stromal ER positivity was more prevalent in cases achieving pathologic complete response (pCR) (68.1%) compared to those without pCR (39.8%, p < 0.001). ER positivity in stromal cells was more common in non-luminal tumors than in luminal ones. Multivariate analysis identified stromal ER positivity (OR: 3.059, 95% CI [1.947-4.807], p < 0.001), intrinsic subtype (Odds ratio (OR): 1.477, 95% confidence interval (CI) [1.102-1.980], p = 0.009), and Ki67 index (OR: 1.028, 95% CI [1.104-1.041], p < 0.001) as independent predictors of pCR. In core biopsies before NAC, 270 cases (90.3%) and 29 cases (9.7%) were negative and positive in stromal cells, respectively. Out of the cases with ER-negativity in stromal cells before NAC, 132 (48.9%) converted to ER positivity in stromal cells of PCTB and displayed a high regression rate (89.8%).</p><p><strong>Conclusion: </strong>This is the first study regarding ER expression in the stroma of breast carcinoma that compares treatment response after NAC. We showed that the increase in ER positivity in the stromal cells of the PCTB is correlative with the complete response and tumor subtypes. In this manner, ER positivity in stromal cells will soon serve as a cornerstone for individualized treatment options.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944674","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":"Shifting from axillary dissection to targeted axillary surgery after neoadjuvant treatment: the evolving management of occult breast cancer in a monoinstitutional series of 114 patients.","authors":"Elisa Vicini, Viviana Galimberti, Maria Cristina Leonardi, Sabrina Kahler-Ribeiro-Fontana, Andrea Polizzi, Salvatore Petitto, Eleonora Pagan, Vincenzo Bagnardi, Emilia Montagna, Matteo Cavallone, Pietro Caldarella, Mattia Intra, Paolo Veronesi","doi":"10.1007/s10549-024-07604-3","DOIUrl":"https://doi.org/10.1007/s10549-024-07604-3","url":null,"abstract":"<p><strong>Purpose: </strong>The use of neoadjuvant systemic therapy for primary breast cancer can achieve tumor shrinkage, enabling less invasive surgical treatments, such as breast-conserving surgery instead of mastectomy, and sentinel node biopsy instead of axillary dissection. In recent years, an increasing number of studies have explored the use of primary systemic therapy for occult breast cancer with axillary presentation. These studies suggest that a more conservative approach, involving targeted axillary surgery could be cautiously proposed for occult breast cancer after neoadjuvant chemotherapy in selected patients. In cases where a complete pathological response in the lymph nodes is achieved, there may also be the possibility to omit radiotherapy.</p><p><strong>Methods: </strong>We retrospectively reviewed surgical interventions for carcinoma of unknown primary (CUP) syndrome with axillary presentation at the European Institute of Oncology from April 2004 to October 2022. Demographic and clinicopathological characteristics of the patients were collected and follow-up information has been updated.</p><p><strong>Results: </strong>A total of 114 patients who underwent axillary surgery for occult breast cancer were included. The 5-year disease-free survival was 74.5%, while overall survival was 88.5%. A total of 22.8% of patients underwent neoadjuvant treatment. Complete pathological response was achieved in 38.5%. Patients with complete nodal pathological response showed fewer events compared to patients with no complete pathological response after neoadjuvant treatment.</p><p><strong>Conclusion: </strong>Although the sample size is limited, recent advances in breast cancer multimodal treatment indicate that targeted axillary surgery may be considered for the rare clinical presentation of occult breast cancer after neoadjuvant treatment.</p><p><strong>Trial registry: </strong>Trial registration number UID 4184 24/07/2024 \"retrospectively registered\".</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944693","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":"The impact of surgical technique on the number of sentinel lymph nodes removed and its effect on complication rates.","authors":"Kathleen Stutz, Holly Mason, Shiva Niakan, Aixa Perez Coulter, Jesse Casaubon, Ann-Kristin U Friedrich","doi":"10.1007/s10549-024-07598-y","DOIUrl":"https://doi.org/10.1007/s10549-024-07598-y","url":null,"abstract":"<p><strong>Purpose: </strong>Sentinel lymph node biopsy (SLNB) is a staging procedure used to guide treatment for patients with breast cancer. Multiple variations in the SLNB technique have been described. We questioned how technique impacts the number of sentinel lymph nodes (SLNs) removed and associated complications.</p><p><strong>Methods: </strong>Patients with breast cancer who were treated with lumpectomy and SLNB between 2018 and 2023 were analyzed. Patients were excluded if they had prior ipsilateral breast or axillary surgery or chest wall radiation, underwent neoadjuvant chemotherapy or endocrine therapy, or subsequently required ALND. Demographics, surgical technique, and operative and pathological data were collected. Complication rates were compared between more (4+) or fewer (1-3) SLNs removed.</p><p><strong>Results: </strong>A total of 643 patients were included, with an average of 2.44 LNs removed (range 1-11). The overall complication rate was 19.8%, with a 4.4% lymphedema rate. The lymphedema rate was higher among patients who had more nodes removed. An average of 2.5 LNs were removed with dual mapping vs. 2.0 with technetium alone (p = 0.15). Breast massage had no effect on the number of SLNs removed (p = 0.12) but did impact blue dye uptake (p = 0.001).</p><p><strong>Conclusions: </strong>Surgical technique did not significantly impact the number of nodes removed. Removing more nodes was associated with a greater risk of lymphedema.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944704","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":"Application of genetic testing criteria for hereditary breast cancer in South Africa.","authors":"T S Osler, M Schoeman, W J S Pretorius, C G Mathew, J Edge, M F Urban","doi":"10.1007/s10549-024-07585-3","DOIUrl":"https://doi.org/10.1007/s10549-024-07585-3","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer (BC) is the commonest cancer in South African women. A proportion are associated with a pathogenic or likely pathogenic (P/LP) variant in a BC susceptibility gene. Clinical guidelines for genetic testing are used to optimise variant detection while containing costs. We assessed the detection rate in women of diverse ancestries who met the South African National Department of Health (NDOH) testing guidelines, and analysed relationships between testing criteria, participant characteristics and presence of a BRCA1/2 P/LP variant.</p><p><strong>Methods: </strong>Records from 376 women with BC who met NDOH criteria and had genetic testing were included. Demographic, clinical and test result data were collated to describe detection rates according to criteria met, and a multivariate analysis conducted to find variables most frequently associated with a P/LP variant.</p><p><strong>Results: </strong>P/LP variant prevalence in women meeting NDOH testing criteria was 19.9% (75/376). Women meeting ≥ 2 guideline criteria were over twice as likely to have a P/LP variant (OR 2.27, 95%CI 1.27-4.07, p = 0.006), highlighting the guidelines' capacity to stratify risk. Family history (OR 1.97; 95%CI 1.05-3.70, p = 0.03) and Black African ancestry (OR 2.58; 95%CI 1.28-5.18, p < 0.01) were independently associated with having a BRCA1/2 P/LP variant when controlling for other variables. Notably, although Black African participants were less likely to report a family history, those that did had higher odds of a P/LP variant in BRCA1/2.</p><p><strong>Conclusion: </strong>These results demonstrate the usefulness of the NDOH guidelines in women of diverse ancestries and provide insight into the factors associated with P/LP variants in understudied African populations.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944641","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":"Demographic and clinical trends of young breast cancer patients from the national cancer database: disproportionate effect on minority populations.","authors":"Cynthia Mark, Vivek Pujara, Marissa K Boyle, Yuan Yuan, Jin Sun Lee","doi":"10.1007/s10549-024-07588-0","DOIUrl":"https://doi.org/10.1007/s10549-024-07588-0","url":null,"abstract":"<p><strong>Purpose: </strong>There is an increasing incidence of young breast cancer (YBC) patients with uncertainty surrounding the factors and patterns that are contributing.</p><p><strong>Methods: </strong>We obtained characteristics and survival data from 206,156 YBC patients (≤ 40 years of age) diagnosed between 2005 and 2019 from the National Cancer Database (NCDB). Patients were subdivided into two comparison groups based on year of diagnosis (2005-2009, Old vs. 2015-2019, New group). A Chi-square test of independence was employed to measure the changes. Cox proportional hazards model was used to explore the variables influencing overall survival (OS).</p><p><strong>Results: </strong>Comparison between Old (55,397 patients) and New groups (67,930 patients) showed an increase in the proportion of Hispanic (8.4% vs 10.0%), Black (16.0% vs 16.6%), and Asian (4.8% vs 6.7%) populations. In the New group, black patients had a significantly worse OS, p < 0.001. Additionally, there was a reduction in the proportion of patients with private insurance (43,940 (81.7%) vs 51,104 (76.4%)) and an increase in patients with Medicaid (5,893 (11.0%) vs 10,694 (16.0%)). Finally, there was a significant increase in hormone positive disease (35,142 (70.0%) vs 49,409 (75.8%), p = < 0.001).</p><p><strong>Conclusions: </strong>Within YBC patients, the proportion of underrepresented and underserved population is increasing, with an impact on OS. We also see an increase in hormone positive disease. Awareness of these at-risk populations is important for early identification of breast cancer and mitigation of poorer outcomes. Also, there are increasing rates of hormone positive disease which can cause substantial personal and societal implications, such as impacts on family planning and early menopause.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142929960","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":"Frequency of somatic and germline variants of predisposition genes in young Chinese women with breast cancer.","authors":"Yuchun Xu, Qindong Cai, Jing Li, Wenhui Guo, Lili Chen, Minyan Chen, Yuxiang Lin, Yali Wang, Weifeng Cai, Yibin Qiu, Peng He, Shunyi Liu, Chuan Wang, Fangmeng Fu","doi":"10.1007/s10549-024-07602-5","DOIUrl":"https://doi.org/10.1007/s10549-024-07602-5","url":null,"abstract":"<p><strong>Purpose: </strong>Age stratification influences the clinicopathological features and survival outcomes of breast cancer. We aimed to understand the effect of age on gene variants in young Chinese women with breast cancer compared with those from The Cancer Genome Atlas (TCGA).</p><p><strong>Methods: </strong>Enrolled patients ≤ 40 years old (N = 370) underwent germline or somatic genetic testing using a 32-gene hereditary cancer panel at Fujian Union Hospital. Significant alterations of germline and somatic genes were analyzed. The frequency of somatic variants was compared between enrolled patients and patients from TCGA who were divided into two groups (≤ 40 years and > 40 years).</p><p><strong>Results: </strong>Among the enrolled patients (median age 36; range 25-40), 335 underwent germline genetic testing and 174 underwent simultaneous somatic genetic testing. We detected 44 germline pathogenic/likely pathogenic variants in 42 (12.5%) patients, where BRCA1/2 was the most common gene (29.8.5%). Family history of first-degree relatives was significantly associated with pathogenic variants (p < 0.001). Somatic Tier I/II mutation frequency was like that of patients ≤ 40 from TCGA (N = 97). More PIK3CA and TP53 mutations in luminal A and basal-like tumors, respectively, were detected in young patients than in patients > 40 from TCGA (N = 975). No significant differences were observed in other breast cancer subtypes.</p><p><strong>Conclusion: </strong>These results provide a spectrum of genomic alterations in young Chinese women and highlight different frequencies of gene variants in young Asian patients versus Western patients with breast cancer. Further research should explore the biological mechanism to provide more treatment strategies for young Asian women.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930039","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":"Correction: Prognostic and predictive impact of NOTCH1 in early breast cancer.","authors":"Julia Engel, Vanessa Wieder, Marcus Bauer, Sandy Kaufhold, Kathrin Stückrath, Jochen Wilke, Volker Hanf, Christoph Uleer, Tilmann Lantzsch, Susanne Peschel, Jutta John, Marleen Pöhler, Edith Weigert, Karl-Friedrich Bürrig, Jörg Buchmann, Pablo Santos, Eva Johanna Kantelhardt, Christoph Thomssen, Martina Vetter","doi":"10.1007/s10549-024-07520-6","DOIUrl":"10.1007/s10549-024-07520-6","url":null,"abstract":"","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"209-210"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675154","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":"The cytokine profile correlates with less tumor-infiltrating lymphocytes in luminal A breast cancer.","authors":"Eri Ishikawa, Takahiro Watanabe, Takako Kihara, Mamiko Kuroiwa, Miki Komatsu, Sayaka Urano, Masayuki Nagahashi, Seiichi Hirota, Yasuo Miyoshi","doi":"10.1007/s10549-024-07492-7","DOIUrl":"10.1007/s10549-024-07492-7","url":null,"abstract":"<p><strong>Purpose: </strong>Tumor-infiltrating lymphocyte (TIL) levels are prognostic and predictive factors for breast cancer. Unlike other subtypes, most luminal A breast cancers are immune deserts; however, the underlying mechanisms are poorly understood.</p><p><strong>Methods: </strong>Immune-related cytokines, chemokines, and growth factors were measured in the sera of 103 patients with breast cancer using a multiplex panel. The TILs were evaluated for hotspot lesions.</p><p><strong>Results: </strong>Circulating interleukin 1 receptor antagonist (IL-1ra), IL-8, IL-12, IL-17, macrophage inflammatory protein-1β (MIP-1b), and platelet-derived growth factor B homodimer (PDGF-bb) concentrations were significantly associated with TIL levels. Cluster analysis using these six variables identified six clusters related to TIL levels. Breast cancers with high TILs (≥ 50%) were most frequent in cluster 3 (9 out of 15 cases, 60.0%), followed by cluster 1 (8 out of 34 cases, 23.5%), and the fewest in cluster 6 (1 out of 21 cases, 4.8%), whereas only one or three cases were present in clusters 2, 4, and 5 (p = 0.0064). Cluster 6, consisting mostly of luminal A (19 out of 21 cases, 90.5%), showed high levels of IL-12, IL-17, and PDGF-bb, and low levels of MIP-1b.</p><p><strong>Conclusion: </strong>We identified a luminal A-associated immunosuppressive cytokine signature in circulation. These results suggest that a tumor microenvironment with high levels of IL-17 and PDGF-bb, and low levels of MIP-1b in luminal A breast cancers results in low induction of TILs. Our data may partially explain the low TIL levels observed in the patients with luminal A breast cancer.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"291-302"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457996","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":"BRCA promoter methylation in triple-negative breast cancer is preserved in xenograft models and represents a potential therapeutic marker for PARP inhibitors.","authors":"Kavitha Däster, Jürgen Hench, Maren Diepenbruck, Katrin Volkmann, Adelin Rouchon, Marta Palafox, Jorge Gomez Miragaya, Bogdan Tiberius Preca, Christian Kurzeder, Walter Paul Weber, Mohamed Bentires-Alj, Savas Deniz Soysal, Simone Muenst","doi":"10.1007/s10549-024-07502-8","DOIUrl":"10.1007/s10549-024-07502-8","url":null,"abstract":"<p><strong>Purpose: </strong>Most triple-negative breast cancers (TNBC) are sporadic in nature and often associated with dysfunction of the BRCA1 or BRCA2 genes. Since somatic BRCA mutations are rare in breast cancer (BC), this dysfunction frequently is the result of BRCA promoter methylation. Despite the phenotypic similarities of these tumors to those with germline or somatic BRCA mutation, the evidence of response to PARP inhibitors is unclear.</p><p><strong>Methods: </strong>We analyzed the prevalence of BRCA promoter methylation in 29 BC metastases through the well-established Illumina Infinium EPIC Human Methylation Bead Chip. In cases with BRCA methylation, the xenograft of the same tumor was tested. Additionally, we compared BC xenografts with an identified BRCA methylation to their matched primary tumors and subsequently investigated the efficacy of PARP inhibitors on tumor organoids from a BRCA2 promoter-methylated BC.</p><p><strong>Results: </strong>BRCA2 promotor hypermethylation was identified in one pleural metastasis of a young patient as well as in the xenograft tissue. We also identified five more xenograft models with BRCA2 promotor hypermethylation. Analysis of one matched primary tumor confirmed the same BRCA2 methylation. PARP inhibitor treatment of tumor organoids derived from the BRCA2 methylated xenograft tumor tissue of the young patient showed a significant decline in cell viability, similar to organoids with somatic BRCA1 mutation, while having no effect on organoids with BRCA1 wildtype.</p><p><strong>Conclusion: </strong>BRCA promotor hypermethylation seems to be a rare event in metastatic BC but is preserved in subsequent xenograft models and might represent an attractive therapeutic marker for PARP inhibitors.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"389-396"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399380","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":"Barriers and facilitators to breast cancer screening among high-risk women: a qualitative study.","authors":"Claire C Conley, Alaina Anderson, Jennifer D Rodriguez, Hannah Kang, Emily P Taylor, Conor Luck, Jacqueline Rosas Torres, Nora Cheraghi, Noelle Newton, Bethany L Niell, Suzanne C O'Neill, Susan T Vadaparampil","doi":"10.1007/s10549-024-07471-y","DOIUrl":"10.1007/s10549-024-07471-y","url":null,"abstract":"<p><strong>Purpose: </strong>Women with greater than 20-25% lifetime breast cancer risk are recommended to have breast cancer screening with annual mammogram and supplemental breast MRI. However, few women follow these screening recommendations. The objective of this study was to identify barriers and facilitators of screening among women at high risk for breast cancer, guided by the Health Services Utilization Model (HSUM).</p><p><strong>Methods: </strong>Unaffected high-risk women (N=63) completed semi-structured qualitative interviews exploring their experiences with breast cancer screening. Interviews were audio recorded, transcribed verbatim, and analyzed using a combined deductive and inductive approach.</p><p><strong>Results: </strong>Most participants (84%) had received a screening mammogram; fewer (33%) had received a screening breast MRI. Only 14% had received neither screening. In line with the HSUM, qualitative analysis identified predisposing factors, enabling factors, and need factors associated with receipt of breast cancer screening. Enabling factors - including financial burden, logistic barriers, social support, and care coordination - were most frequently discussed. Predisposing factors included knowledge, health beliefs, and self-advocacy. Need factors included healthcare provider recommendation, family history of breast cancer, and personal medical history. Although HSUM themes were consistent for both mammography and breast MRI, participants did highlight several important differences in barriers and facilitators between the two screening modalities.</p><p><strong>Conclusion: </strong>Barriers and enabling factors associated with supplemental screening for high-risk women represent possible intervention targets. Future research is needed to develop and test multilevel interventions targeting these factors, with the ultimate goal of increasing access to supplemental screening for high-risk women.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"61-71"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072024","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}