Breast Cancer Research and Treatment最新文献

{"title":"Patient preferences for CDK4/6 inhibitor treatments in HR+/HER2- early breast cancer: a discrete choice survey study.","authors":"Erica L Mayer, Mary Lou Smith, Annie Guérin, Dominick Latremouille-Viau, Nisha C Hazra, Yan Meng, Wendi Qu, Remi Bellefleur, Vaidyanathan Ganapathy, Liz Santarsiero, Robert Morlock, Maryam B Lustberg","doi":"10.1007/s10549-025-07627-4","DOIUrl":"10.1007/s10549-025-07627-4","url":null,"abstract":"<p><strong>Purpose: </strong>Adding CDK4/6 inhibitors (CDK4/6is) to endocrine therapy (ET) for HR+/HER2- early breast cancer (EBC) demonstrated statistically significant invasive disease-free survival (iDFS) benefits in monarchE (node positive, high risk, stage II/III) and NATALEE (select N0 and all macroscopic N1, stage II/III). This study evaluated patient preferences for EBC treatment attributes and how these may translate for CDK4/6i selection.</p><p><strong>Methods: </strong>A web-based discrete choice experiment survey was conducted among US-based adult women with self-reported stage II/III HR+/HER2- EBC. Eight attributes were included, informed by 14 qualitative interviews (to identify most relevant attributes), expert clinical input, and differentiating features between CDK4/6is: efficacy (5-year iDFS), adverse events (venous thromboembolic event [VTE], diarrhea, fatigue), number of blood tests, number of electrocardiograms (EKGs), treatment duration, and schedule. Participants selected scenarios that best reflected their preferences from 10 choice cards, each displaying a pair of hypothetical treatment profiles. A conditional logit regression model was used to estimate preference weights and relative importance (RI) of attributes.</p><p><strong>Results: </strong>A total of 409 women participated. Patient preferences, from high to low RI, were higher efficacy, lower diarrhea risk, lower fatigue risk, shorter treatment duration, and lower VTE risk. Number of blood tests, number of EKGs, and treatment schedule were less important. Utility scores were higher for reconstructed treatment profiles that resembled ribociclib.</p><p><strong>Conclusion: </strong>This study demonstrated that patients prefer adjuvant treatment with higher efficacy and lower risk of adverse events. These data will aid shared decision-making when discussing the addition of CDK4/6is to adjuvant ET for eligible patients with HR+/HER2- EBC.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"121-130"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363650","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":"Radar reflectors for marking of target lymph nodes in initially node-positive patients receiving neoadjuvant chemotherapy for breast cancer-a subgroup analysis of the prospective AXSANA (EUBREAST-03) trial.","authors":"Maggie Banys-Paluchowski, Steffi Hartmann, Timo Basali, Maria Luisa Gasparri, Jana de Boniface, Oreste Davide Gentilini, Güldeniz Karadeniz Cakmak, Nina Ditsch, Elmar Stickeler, Ellen Schlichting, Isabel Rubio, Florentia Peintinger, Michael Untch, Christine Mau, Frederike Klaassen Federspiel, Susanne Bucher, Kerstin Ramaker, Peter Paluchowski, Lelia Bauer, Sabine Riemer, Dagmar Langanke, Tanja Durpektova Leuf, Jens Schnabel, Ekkehard von Abel, Christine Solbach, Sonja Cáradenas Ovalle, Kerstin Hilmer, Vesna Bjelic-Radisic, Nicole Stahl, Jose I Sanchez-Mendez, Vibeke Hagen, Marit Helene Hansen, Natalia Krawczyk, Bilge Aktas Sezen, Katharina Jursik, Marc Thill, Hans-Christian Kolberg, Toralf Reimer, Franziska Ruf, Kristina Wihlfahrt, Angelika Rief, Tomasz Berger, Esther Schmidt, Nikolas Tauber, Sarah Fröhlich, Thorsten Kühn","doi":"10.1007/s10549-025-07635-4","DOIUrl":"10.1007/s10549-025-07635-4","url":null,"abstract":"<p><strong>Background: </strong>Surgical staging procedures of the axilla in initially clinically node-positive (cN +) breast cancer patients receiving neoadjuvant chemotherapy (NACT) vary across countries. Different procedures such as axillary lymph node dissection, sentinel lymph node biopsy, target lymph node biopsy and targeted axillary dissection are currently in use. To date, data on radar reflectors as a non-wire and non-radioactive technique for marking target lymph nodes are limited. The present study aims at examining the detection rate, the rate of lost markers, and magnetic resonance imaging artifacts after TLN marking using a radar reflector before NACT in the largest available cohort of breast cancer patients enrolled in the international prospective AXSANA study.</p><p><strong>Methods: </strong>AXSANA (EUBREAST-03) is an international prospective cohort study including cN + patients managed with different surgical axillary staging techniques after NACT. Eligible patients have cT1-4c cN + breast cancer and receive neoadjuvant chemotherapy. Patients are followed up for 5 years. In the present subgroup analysis, only patients with a TLN marked by a radar reflector were included.</p><p><strong>Results: </strong>A TLN was marked by radar reflector insertion in 158 patients prior to NACT. Of these, 136 had final surgery results available at the time of analysis, and in 135 out of these 136 patients, localization of TLN was attempted. All radar markers were successfully removed. While lymphoid tissue corresponding to the TLN was identified in 132 patients (97.8%), no lymphoid tissue was detected on histopathology in three patients. It remains unclear whether the TLN was excised in these cases or not. In 1 out of 27 patients (3.7%) who underwent preoperative MRI, image assessment was compromised due to artifacts after radar marker placement.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the largest prospective series of patients receiving a radar reflector for the marking of a TLN prior to NACT for breast cancer. Our data demonstrate that radar reflectors are a reliable tool for marking target lymph nodes before neoadjuvant treatment.</p><p><strong>Trial registration number: </strong>NCT04373655 (date of registration May 4, 2020).</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"203-211"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456922","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":"Returning to work after breast cancer: a longitudinal analysis of employment and financial hardship.","authors":"Enoch Park, Lindsay Peterson, Shawn McKeon, Mark A Fiala","doi":"10.1007/s10549-025-07624-7","DOIUrl":"10.1007/s10549-025-07624-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored changes in employment and financial hardship following breast cancer diagnosis.</p><p><strong>Methods: </strong>We used data from a single-institution, longitudinal study of women with newly diagnosed breast cancer who received curative intent chemotherapy. The primary outcomes of interest in this analysis were breaks in active employment, defined as being out of work for the four weeks prior, and patient-reported acute financial burden during chemotherapy and up to 24 months following chemotherapy completion. Mixed-effects logistic regression models were used to identify factors associated with breaks in employment and financial burden.</p><p><strong>Results: </strong>The cohort consisted of 104 women who were employed at time of breast cancer diagnosis. The mean age was 49.6 years and 86% were non-Hispanic White, 11% African American or Black, and 4% another race or ethnicity. In multivariable models, African-American women were 168% more likely to report a break from active employment than their non-Hispanic white counterparts (adjusted odds ration [aOR] 2.68; p = 0.026). A break from active employment was not statistically associated with greater self-reported acute financial burden, but patients from the lowest socioeconomic status tertile were 173% more likely to report financial burden than those in the highest tertile (aOR 2.73; p = 0.022).</p><p><strong>Conclusion: </strong>African-American breast cancer survivors were more likely to report breaks from active employment than their White peers, even after adjusting for type of work and socioeconomic status.</p><p><strong>Implication for cancer survivors: </strong>African-American and Black breast cancer survivors may face greater challenges returning to work.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"91-97"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078209","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":"Risk factors for interval breast cancer: insights from a decade of a mammography screening program.","authors":"Jonas Subelack, Rudolf Morant, Marcel Blum, Alena Eichenberger, Alexander Geissler, David Ehlig","doi":"10.1007/s10549-025-07619-4","DOIUrl":"10.1007/s10549-025-07619-4","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data.</p><p><strong>Methods: </strong>In this retrospective cohort study, we merged data from the Swiss MSP \"donna\" with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses.</p><p><strong>Results: </strong>We identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC (p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages (p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative (p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55-59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant (p < 0.05) risk factors for IBC diagnoses.</p><p><strong>Conclusions: </strong>Women with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics).</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"23-33"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398158","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":"Malignant upgrade in lesions of uncertain malignant potential in the breast (B3 lesions) - is open excision always necessary?","authors":"Felix Heindl, Janina Schiel, Carolin C Hack, Niklas Amann, Sebastian M Jud, Caroline I Preuss, Lothar Häberle, Arndt Hartmann, Rüdiger Schulz-Wendtland, Matthias Wetzl, Matthias W Beckmann, Ramona Erber","doi":"10.1007/s10549-025-07632-7","DOIUrl":"10.1007/s10549-025-07632-7","url":null,"abstract":"<p><strong>Purpose: </strong>Unclear or suspicious breast findings are typically clarified by interventional breast biopsy. Lesions with uncertain malignant potential are grouped as B3 lesions in histopathology. The B3 group according to the European Working Group for Breast Screening Pathology (EWGBSP) comprises various breast lesions with different upgrade rates to invasive breast cancer (BC) or ductal carcinoma in situ (DCIS) if surgical removal is performed. The objective of this study was to investigate malignant upgrade rates to DCIS and/or invasive breast cancer (BC) after open surgical excision for the different B3 lesions.</p><p><strong>Methods: </strong>A total of 192 patients with histologically verified B3 lesions were followed up retrospectively for this analysis. Patients with the B3 lesions atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), and classical lobular neoplasia (LN1-2) were combined into one group, while cellular fibroepithelial lesions (CFL) and phyllodes tumors without suspicion of malignancy, as well as papillomas and radial scars/complex sclerosing lesions (RS/CSL) were summarized in two other groups. We investigated the association of the different B3 lesions with invasive BC or DCIS after open surgical excision.</p><p><strong>Results: </strong>Histopathological investigation revealed in 21 (10.9%) of the 192 patients invasive BC or DCIS after open surgical excision. The rate of patients with BC and/or DCIS significantly differed between the patient groups (p < 0.01, Fisher's exact test): The highest rate was 17.5% (95% confidence interval (CI), 10.7-26.2) in patients within the group of ADH, FEA, and LN1-2. In the other two groups, fewer malignant lesions occurred. In the group with papillomas and RS/CSL the malignant upgrade rate was 4.3% (95% CI, 0.9-12.2), while within the group with CFL and phyllodes tumors without suspicion of malignancy no malignant upgrade was observed (0.0%, 95% CI, 0.0-16.9).</p><p><strong>Conclusions: </strong>B3 lesions harbor the risk of malignant upgrade after surgical excision. In our collective ADH, FEA, and LN1-2 had significant higher upgrade rates than other B3 lesions.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"173-183"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440008","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":"Prolonged time to breast cancer surgery and the risk of metastasis: an explorative simulation analysis using epidemiological data from Germany and the USA.","authors":"D Hölzel, A Schlesinger-Raab, G Schubert-Fritschle, K Halfter","doi":"10.1007/s10549-025-07630-9","DOIUrl":"10.1007/s10549-025-07630-9","url":null,"abstract":"<p><strong>Purpose: </strong>Growing breast cancer is associated with an inherent risk of metastasis. If surgical treatment of breast cancer is delayed, the prognosis worsens with increasing tumor size. This justifies the search for a safe time interval between diagnosis and surgery.</p><p><strong>Methods: </strong>The 2022 population-based data on incidence and the time interval to initial surgery for the United States (U.S.) and Germany are used. Tumor growth and initiation of metastases can be calculated using public data on hormone receptor status, volume doubling time, and tumor size-dependent relative survival. Our assumptions are based on an initial 19.8 mm mean tumor size. 15-year BC-specific mortality in both countries is assumed to be 19.6% without surgical delay. Volume doubling time stratified by hormone receptor status, assumed to be continuous may differ by a factor of 2.4.</p><p><strong>Results: </strong>The U.S. and Germany report 287,850/71,375 new breast cancers for the year 2022 and 2019. If tumor removal is delayed by 8 weeks, mortality rate increases by 2.25/4.79% (HR + /HR-) as estimated by our model. The currently reported mean delay in the U.S. and Germany of 33.7/26.0 days or 4.8/3.7 weeks, respectively, would lead to an estimated 4,676/918 additional BC deaths or a 1.6/1.2% rise in the 15-year BC-specific mortality rate.</p><p><strong>Conclusions: </strong>This study offers reasonable evidence that confirmed cases of breast cancer should be prioritized and treated according to hormone receptor status and tumor size as soon as possible. Effective screening measures should be followed by timely treatment.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"151-160"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440009","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":"Use of adjuvant capecitabine in older patients with early-stage triple-negative breast cancer.","authors":"Marija Sullivan, Xiudong Lei, Meghan Karuturi, Catalina Malinowski, Sharon H Giordano, Mariana Chavez-MacGregor","doi":"10.1007/s10549-025-07637-2","DOIUrl":"10.1007/s10549-025-07637-2","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with triple-negative breast cancer (TNBC) who have residual disease after neoadjuvant chemotherapy (NACT) benefit from adjuvant capecitabine. Older patients are not always treated according to guidelines, likely due to concerns regarding tolerance. We examined the use of adjuvant capecitabine, its association with outcomes, and subsequent emergency room visits (ER) and hospitalizations (HSP) among older patients with early-stage TNBC.</p><p><strong>Methods: </strong>Retrospective, observational study using data in the SEER-Medicare database. Older patients (≥ 66 years) with early-stage TNBC, diagnosed in 2010-2019, who received NACT, underwent surgery, and were prescribed adjuvant capecitabine were included. We analyzed capecitabine use, its association with overall survival and breast-cancer specific survival, and time to first ER/HSP. Logistic regression, Kaplan-Meier estimates, and Cox regression models with propensity score adjustments were used.</p><p><strong>Results: </strong>239 of 1,799 older patients with TNBC received adjuvant capecitabine. Capecitabine use increased from 1.3% in 2010 to 29.6% in 2019. Older age, ≥ 71 years, (OR = 0.54, 95%CI 0.32-0.92) and ≥ 2 comorbidities (OR = 0.42, 95%CI 0.2-0.9) were associated with decreased odds of receiving ≥ 6 cycles of capecitabine. Increasing number of cycles of capecitabine was associated with decreased risks of death (HR = 0.74, 95%CI 0.66-0.83) and breast cancer-specific death (HR = 0.73, 95%CI 0.61-0.89). 55 patients (23%) treated with capecitabine experienced ER/HSP.</p><p><strong>Conclusion: </strong>In recent years, adjuvant capecitabine is increasingly used for patients with early-stage TNBC. Patients with older age and more comorbidities received fewer cycles of capecitabine. While one-fourth of patients had ER/HSP, receipt of more cycles was associated with better survival.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"213-221"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522710","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":"Racial and ethnic disparities in conversion to mastectomy following lumpectomy.","authors":"Jasmine A Khubchandani, Madhav Kc, Pranam Dey, Ellie M Proussaloglou, Monica G Valero, Elizabeth Berger, Tristen Park, Cary P Gross, Paris D Butler, Oluwadamilola M Fayanju, Eric P Winer, Mehra Golshan, Rachel A Greenup","doi":"10.1007/s10549-025-07625-6","DOIUrl":"10.1007/s10549-025-07625-6","url":null,"abstract":"<p><strong>Purpose: </strong>Advances in contemporary breast cancer care (e.g., early detection, increased use of preoperative chemotherapy, and updated SSO-ASTRO margin guidelines) have the collective potential to influence successful breast conservation. We evaluated contemporary trends in conversion to mastectomy (lumpectomy followed by definitive mastectomy) among women with breast cancer undergoing initial lumpectomy.</p><p><strong>Methods: </strong>Women with unilateral clinical stage 0-III breast cancer were identified from the National Cancer Database (2009-2019). Treatment sequence was categorized into surgery first or neoadjuvant chemotherapy (NACT) followed by surgery. We used a multivariable logistic regression model to calculate the predicted probability of conversion to mastectomy across diagnosis year and race and ethnicity, controlling for socio-demographic and clinical factors. We then calculated the relative change in conversion to mastectomy over time for each race and ethnic group.</p><p><strong>Results: </strong>The study included N = 1,543,702 women. Approximately 9.2% received NACT. Conversion to mastectomy differed significantly between those who underwent surgery first (10.6%) versus women who received NACT (6.1%, p < 0.0001). For those who underwent surgery first, success of breast conservation differed significantly by race/ethnicity. During the study period, White women had a relative decrease of 7.6% (95% CI - 10.58, - 4.59), while Black women had a relative increase of 8.9% (95% CI 1.53, 16.19) in predicted probability of conversion to mastectomy.</p><p><strong>Conclusion: </strong>Over the past decade, Black women deemed candidates for initial lumpectomy were more likely to be converted to mastectomy when compared to White women. A greater understanding of contributing factors is needed to improve disparities in successful breast conservation.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"99-110"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398154","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":"Triaging mammography with artificial intelligence: an implementation study.","authors":"Sarah M Friedewald, Marcin Sieniek, Sunny Jansen, Fereshteh Mahvar, Timo Kohlberger, David Schacht, Sonya Bhole, Dipti Gupta, Shruthi Prabhakara, Scott Mayer McKinney, Stacey Caron, David Melnick, Mozziyar Etemadi, Samantha Winter, Thidanun Saensuksopa, Alejandra Maciel, Luca Speroni, Martha Sevenich, Arnav Agharwal, Rubin Zhang, Gavin Duggan, Shiro Kadowaki, Atilla P Kiraly, Jie Yang, Basil Mustafa, Yossi Matias, Greg S Corrado, Daniel Tse, Krish Eswaran, Shravya Shetty","doi":"10.1007/s10549-025-07616-7","DOIUrl":"10.1007/s10549-025-07616-7","url":null,"abstract":"<p><strong>Purpose: </strong>Many breast centers are unable to provide immediate results at the time of screening mammography which results in delayed patient care. Implementing artificial intelligence (AI) could identify patients who may have breast cancer and accelerate the time to diagnostic imaging and biopsy diagnosis.</p><p><strong>Methods: </strong>In this prospective randomized, unblinded, controlled implementation study we enrolled 1000 screening participants between March 2021 and May 2022. The experimental group used an AI system to prioritize a subset of cases for same-visit radiologist evaluation, and same-visit diagnostic workup if necessary. The control group followed the standard of care. The primary operational endpoints were time to additional imaging (T_A) and time to biopsy diagnosis (T_B).</p><p><strong>Results: </strong>The final cohort included 463 experimental and 392 control participants. The one-sided Mann-Whitney U test was employed for analysis of T_A and T_B. In the control group, the T_A was 25.6 days [95% CI 22.0-29.9] and T_B was 55.9 days [95% CI 45.5-69.6]. In comparison, the experimental group's mean T_A was reduced by 25% (6.4 fewer days [one-sided 95% CI > 0.3], p<0.001) and mean T_B was reduced by 30% (16.8 fewer days; 95% CI > 5.1], p=0.003). The time reduction was more pronounced for AI-prioritized participants in the experimental group. All participants eventually diagnosed with breast cancer were prioritized by the AI.</p><p><strong>Conclusions: </strong>Implementing AI prioritization can accelerate care timelines for patients requiring additional workup, while maintaining the efficiency of delayed interpretation for most participants. Reducing diagnostic delays could contribute to improved patient adherence, decreased anxiety and addressing disparities in access to timely care.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063505","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":"Population-based study of recurrent DNA damage response gene variants in breast cancer cases.","authors":"Anna Tervasmäki, Timo A Kumpula, Mervi Grip, Susanna Koivuluoma, Meeri Seuranen, Robert Winqvist, Tuomo Mantere, Katri Pylkäs","doi":"10.1007/s10549-025-07634-5","DOIUrl":"10.1007/s10549-025-07634-5","url":null,"abstract":"<p><strong>Purpose: </strong>Several variants in DNA damage response (DDR) genes increase the probability to develop breast cancer and show enrichment in Northern Finland. Here, the population prevalence and risk estimations were refined for sixteen recurrent pathogenic/likely pathogenic DDR gene variants.</p><p><strong>Methods: </strong>Variant genotyping was performed in 2343 unselected Northern Finnish breast cancer cases and 4607 cancer-free controls, and tumor features and family history of cancer for the carriers were examined.</p><p><strong>Results: </strong>Based on their prevalence and carrier family history, the studied BRCA1 and BRCA2 variants, PALB2 c.1592delT, and ATM c.7570G > C were confirmed as high-risk alleles, whereas CHEK2 c.1100delC, MCPH1 c.909_921del, and RAD50 c.687delT were moderate-risk alleles. FANCM c.5101C > T and c.5791C > T did not associate with overall breast cancer risk. Double carriers were significantly more common in cases (0.5%, 11/2343) than controls (0.07%, 3/4601, OR 7.2). The BRCA1/2 and PALB2 c.1592delT carrier tumors all had high proliferation rates, PALB2 c.1592delT associating also with grade 3 tumors (p = 0.002). Progesterone receptor (p < 0.05) and estrogen receptor positive tumors were enriched in ATM c.7570G > C and CHEK2 c.1100delC carriers, whereas MCPH1 c.904_916del carriers had a significantly high percentage of multifocal tumors (38%, p = 0.001). Moreover, one FANCM c.5101C > T homozygote case suffered severe side effects from chemotherapy.</p><p><strong>Conclusion: </strong>The studied DDR gene variants were present in 9% of the unselected cases. As the presence of germline pathogenic variants can provide additional value for surgical decision-making and affect the choice of oncological treatments, the results promote the benefits of genetic testing as a part of breast cancer diagnostics.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"195-202"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499111","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}