Breast Cancer Research and Treatment最新文献

{"title":"Implementation and evaluation of the Routine Assessment and Integration of Screening for Employment (RAISE) program in adults with metastatic breast cancer.","authors":"Laura C Pinheiro, Caroline Zeng, Darima Dorzhieva, Lovely Joseph, Zori Hamilton, Kathryn Edick, Anne Marie Mercurio, Desiree Walker, Victoria Blinder, Shoshana M Rosenberg","doi":"10.1007/s10549-026-08089-y","DOIUrl":"https://doi.org/10.1007/s10549-026-08089-y","url":null,"abstract":"<p><strong>Purpose: </strong>Adults living with metastatic breast cancer (mBC) often have unmet employed-related needs. To address this gap, we developed, implemented, and evaluated the Routine Assessment and Integration of Screening for Employment (RAISE) program for adults with mBC.</p><p><strong>Methods: </strong>We designed a quality improvement project informed by the Specific, Measurable, Attainable, Relevant, and Timebound framework. In Phase 1 (development), we built and integrated an English/Spanish screener into the electronic health record (EHR) platform. In Phase 2 (implementation), 48 h before an oncology visit, patients received alerts through the patient portal that a screening assessment was available. Patients who reported needing support for employment-related concerns triggered an EHR alert to a patient navigator who reached out to offer educational resources (physical booklet and/or mobile app). Phase 3 (evaluation) was guided by the RE-AIM framework and included surveys and interviews with patients, providers, and staff to evaluate acceptability and feasibility of RAISE.</p><p><strong>Results: </strong>Between March 2024 and August 2025, 179 patients with mBC completed the RAISE screener Of these, 22 (22/179, 12.2%) requested assistance/navigation and were provided with educational resources. Among 41 (41/179, 23%) patients surveyed (evaluation phase), 33 patients had completed the screener, and 8 had not. Of those who completed the screener and the evaluation survey, 91% (29/33) reported they were somewhat or very satisfied with RAISE and 78% (25/33) reported the EHR screening questions were clear to them. Key themes that emerged from 5 patient and 10 provider interviews included utility of the resources offered, screening preferences, and barriers to incorporation of screening into the clinical workflow.</p><p><strong>Conclusions: </strong>Screening for unmet employment needs and delivering resources and navigation is preliminarily feasible and acceptable to patients with mBC, providers, and staff at two NYC hospitals, though key barriers to implementation exist, including low pre-visit screening uptake and integration into the clinical workflow.</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":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104135","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":"Geographic access to triple negative breast cancer clinical trials: are trials located near patients?","authors":"Laura Burns Amin, M Kelsey Kirkwood, Laura A Levit, Erin P Balogh, David Michael Waterhouse, Joseph M Unger, Elizabeth Garrett-Mayer, Mariana Chavez-MacGregor","doi":"10.1007/s10549-026-08084-3","DOIUrl":"10.1007/s10549-026-08084-3","url":null,"abstract":"<p><strong>Background: </strong>Geographic proximity to clinical trials is a major barrier to trial participation, but geographic access to trials has not been specifically characterized for triple-negative breast cancer (TNBC). We evaluated the geographic distribution of TNBC treatment trials across U.S. counties and examined associated social and demographic characteristics.</p><p><strong>Methods: </strong>All trials registered on ClinicalTrials.gov as of September 30, 2024 (n = 510,397) were queried, and active phase II and III TNBC treatment trials were identified through keyword searches. County-level population estimates from the 2018-2022 U.S. Census Bureau 5-year estimates and county adjacency data were used to evaluate trial availability and geographic access. Trial availability was examined according to sponsorship, rurality, health vulnerability, race and ethnicity, and U.S. region.</p><p><strong>Results: </strong>We identified 108 active TNBC trials, including 58 (54%) for metastatic and 50 (46%) for non-metastatic disease. Overall, 76% of U.S. counties had no TNBC trials, 12% had exclusively federally sponsored trials, 10% had both federally and non-federally sponsored trials, and 2% had only non-federally sponsored trials. Trial availability was significantly lower in counties with the highest health vulnerability and in rural counties, which were more likely to rely exclusively on federally sponsored trials. Counties with predominantly Black, Hispanic, and American Indian and Alaska Native populations were less likely to have TNBC trials than predominantly non-Hispanic White counties. Women in the South were more likely than women in the Northeast to have no TNBC trial available in either their county of residence or a neighboring county.</p><p><strong>Conclusions: </strong>TNBC clinical trials are geographically concentrated across the United States, with substantial disparities in access affecting rural and highly vulnerable counties, counties with predominantly racial and ethnic minority populations, and women living in the South. Federally sponsored trials may play an important role in supporting trial availability in underserved areas. Expanding the geographic distribution of TNBC trials may help improve equitable access to clinical trial participation.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073435","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":"Dermatologic adverse events associated with Sacituzumab Govitecan: an international retrospective study from the EADV Task Force \"Dermatology for Cancer Patients\" and pharmacovigilance analysis.","authors":"Ioannis-Alexios Koumprentziotis, Alexander Cawley, Elliot Ewig, Alexandre O Gérard, Maëlys Labat, Grażyna Kamińska-Winciorek, Marcin Kubeczko, Luca Rapparini, Michela Starace, Katerina Grafanaki, Maria Kamaratou, Dimitrios Mavroudis, Alexander Katoulis, Vasiliki Nikolaou, Kara Heelan, Dimitra Koumaki","doi":"10.1007/s10549-026-08090-5","DOIUrl":"https://doi.org/10.1007/s10549-026-08090-5","url":null,"abstract":"<p><strong>Purpose: </strong>Sacituzumab govitecan (SG) is an antibody-drug conjugate approved across multiple metastatic breast cancer settings. Although hematologic and gastrointestinal toxicities dominate its safety profile, dermatologic adverse events (dAEs) remain poorly characterized, despite the physiological expression of Trop-2 in epidermal keratinocytes. We aimed to comprehensively characterize the spectrum, severity, time to onset, and oncologic impact of SG-associated dAEs across real-world and pharmacovigilance data sources.</p><p><strong>Methods: </strong>An international retrospective cohort study was conducted within the EADV Task Force \"Dermatology for Cancer Patients\" (n = 56 breast cancer patients). Findings were triangulated with disproportionality analyses of the WHO Global Pharmacovigilance database (VigiBase^®; n = 696 cases) and the French Pharmacovigilance Database (FPVD; n = 46 cases), alongside a literature review of SG clinical trials reporting dAEs.</p><p><strong>Results: </strong>Across all data sources, alopecia was the most frequently reported dAE (EADV cohort: 41.1%; FPVD: 52.2%; VigiBase^®: 67.6%), followed by stomatitis/mucositis, pruritus, xerosis, and maculopapular rash. In the EADV cohort, 13 distinct dAE types were identified; median time to first dAE was 56 days, and 96.4% of events were grade 1-2. Treatment discontinuation attributable to dAEs occurred in only 3.6% of patients. VigiBase^® disproportionality analysis identified significant reporting signals for alopecia (IC 3.3 [3.09; 3.53]), infusion-related reactions (IC 1.9 [1.07; 2.55]), and stomatitis (IC 1.6 [0.86; 2.30]). Preliminary signals of cutaneous infections were observed but did not consistently meet the threshold for statistical significance.</p><p><strong>Conclusion: </strong>SG-associated dAEs are predominantly low-grade and infrequently precipitate treatment discontinuation. Pharmacovigilance data raises a potential signal for cutaneous infections that warrants further investigation. As SG increasingly enters combination regimens, structured dermatologic monitoring and prospective characterization of dAEs are essential to guide oncodermatologic management and protect oncological outcomes.</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":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073370","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":"HER2 status change in residual breast carcinoma after neoadjuvant HER2-targeted therapy in patients with HER2-positive breast cancer.","authors":"Payu Raval, Qingqing Ding, Puneet Singh, Alaaeddin Alrohaibani, Hongxia Sun, Di Ai, Kerollos Nashat Wanis, Ming Zhao, Hui Chen, Vicente Valero, Mariana Chavez-MacGregor, Aysegul Sahin","doi":"10.1007/s10549-026-08088-z","DOIUrl":"10.1007/s10549-026-08088-z","url":null,"abstract":"<p><strong>Purpose: </strong>Assessment of HER2 status change in HER2-positive breast carcinoma (BC) prior to and after HER2-targeted neoadjuvant therapy (NAT) may potentially impact adjuvant HER2-targeted therapy. Reported rates of HER2 status change vary widely (< 10-56%), underscoring the need for further study. This study evaluated the frequency of HER2 status change and its clinicopathologic correlations in HER2-positive BC cases.</p><p><strong>Design: </strong>Residual breast carcinomas were retrospectively assessed at a single institution after HER2-targeted NAT. HER2 status on residual tumor was evaluated by immunohistochemistry (IHC) and, for IHC 2 + cases, confirmed by fluorescence in situ hybridization (FISH). Tumors were categorized as HER2-retained (IHC 3 + or 2+/FISH amplified) or HER2-change (IHC 0/1 + or 2+/FISH non-amplified). Clinicopathologic features were correlated with post-treatment HER2 status.</p><p><strong>Results: </strong>Among 161 HER2-positive BC patients treated with HER2-targeted NAT between 2016 and 2025, 65 had adequate residual invasive tumor for HER2 assessment. Invasive ductal carcinoma was the predominant histologic type. Retained HER2 overexpression was observed in 28/65 (43%) cases, while 37/65 (57%) showed HER2 status change. Pre-NAT hormone receptor positivity was present in 23 (82.1%) HER2-retained and 33 (89.2%) HER2- status changed cases. Clinicopathologic parameters were comparable between the groups.</p><p><strong>Conclusion: </strong>HER2 status change from HER2 overexpression to loss of overexpression occurred in more than half of residual breast carcinomas following HER2-targeted NAT. The current national and international guidelines recommend adjuvant HER2-targeted therapy regardless of post-treatment HER2. Prospective randomized phase II/III trials are needed to determine the benefit of adjuvant HER2-targeted therapy in this subgroup of patients with HER2-positive BC.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073360","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":"Circulating tumour DNA and its clinical relevance in predicting progression-free survival and overall survival in patients with advanced breast cancer: a systematic review and meta-analysis.","authors":"Cæcilie Ottosen, Ea Kragelund, Mette Abildgaard Pedersen, Vivi Quoc Nguyen, Sakina Kousgaard Khan, Helene Borup Larsen, Anders Lerche Møller, Sofie Høier Gamborg-Kvist, Karen-Lise Garm Spindler, Anne Sofie Brems-Eskildsen, Louise Bach Callesen","doi":"10.1007/s10549-026-08087-0","DOIUrl":"10.1007/s10549-026-08087-0","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment strategies for advanced breast cancer (ABC) are rapidly evolving, but treatment decisions and monitoring remain dependent on imaging-based assessments. Circulating tumour DNA (ctDNA) has emerged as a minimally invasive biomarker with potential to provide real-time assessments, yet its clinical relevance in ABC has not been established. This systematic review and meta-analysis evaluates the prognostic value of ctDNA in ABC.</p><p><strong>Methods: </strong>Medline, Embase, and Cochrane databases were systematically searched up to 07/02/2025. Eligible studies analysed associations between ctDNA and progression free survival (PFS) and/or overall survival (OS) in patient with ABC. Study quality was assessed using the Quality in Prognosis Studies Tool. Hazard ratios (HR) with 95% confidence intervals (CI) were extracted, and meta-analyses were performed using random-effects models.</p><p><strong>Results: </strong>Sixty-four studies were included and divided into subgroups. Elevated ctDNA levels at baseline were significantly associated with shorter PFS (n = 2,586, pooled HR = 2.0; 95% CI: 1.8-2.3) and OS (n = 2,454, pooled HR = 2.6; 95% CI: 2.1-3.3). Unfavourable changes in ctDNA levels were associated with reduced PFS (n = 710, pooled HR = 2.5; 95% CI: 1.9-3.4) and OS (n = 154, pooled HR = 2.4; 95% CI: 1.5-3.8). Additionally, analyses on specific genetic alterations in ctDNA and survival outcomes indicated a less favourable prognosis when detected at baseline. However, results were not consistent.</p><p><strong>Conclusions: </strong>This review supports an association between baseline ctDNA levels, on-treatment changes in ctDNA levels, and survival outcomes in ABC. Furthermore, specific genetic alterations in ctDNA add prognostic information and may support treatment tailoring.</p><p><strong>Trial registration: </strong>Registered in PROSPERO (CRD42024534851).</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073444","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":"Recovery of ovarian function after chemotherapy in premenopausal women with breast cancer: a systematic review and meta-analysis.","authors":"Phi Y Huynh, Binh V Tran, Vinh T Ngo, Tu T Tran","doi":"10.1007/s10549-026-08083-4","DOIUrl":"10.1007/s10549-026-08083-4","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the probability, timing, and predictors of ovarian function recovery after chemotherapy in premenopausal women with breast cancer.</p><p><strong>Methods: </strong>The PubMed, Embase, Scopus, and Cochrane Library databases were searched systematically. Pooled odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated using random-effects models. Proportions were synthesized using restricted maximum likelihood with logit transformation. Subgroup analyses were conducted to explore factors associated with ovarian function recovery. PROSPERO registration: CRD420261343270.</p><p><strong>Results: </strong>A total of 34 studies, including 10,216 premenopausal women, were analyzed. The probability of ovarian function recovery at 12, 24, and 60 months after chemotherapy was 30.4% (95% CI, 17.5-47.3), 38.5% (95% CI, 15.6-68.1), and 43.4% (95% CI, 9.4-84.9), respectively. The mean time to recovery was 12.3 months (95% CI, 8.7-15.9). Older age (OR, 0.25; 95% CI, 0.12-0.50) and longer chemotherapy duration (OR, 0.68; 95% CI, 0.50-0.92) were associated with a lower probability of ovarian function recovery. In individual studies, higher pretreatment anti-Müllerian hormone levels appeared to be associated with improved recovery, although pooled estimates were not statistically significant.</p><p><strong>Conclusions: </strong>The probability of ovarian function recovery after chemotherapy remains limited in premenopausal women; although recovery improves over time, overall rates remain modest. This represents an important treatment-related outcome that should be addressed during pretreatment counseling, through early discussions of reproductive risks, multidisciplinary fertility preservation counseling, and consideration of established fertility preservation methods before cancer-directed therapy.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023863","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 retrospective, observational cohort study of treatment patterns and outcomes among patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer in the United States following endocrine therapy.","authors":"Joyce O'Shaughnessy, M K Rehnquist, Natalia Sadetsky, Wendy Verret, Pelin Cinar, Nikoleta Sjekloca, Linda Nguyen, Rita Nanda, Priyanka Sharma","doi":"10.1007/s10549-026-08075-4","DOIUrl":"10.1007/s10549-026-08075-4","url":null,"abstract":"<p><strong>Purpose: </strong>To describe patient characteristics, treatment patterns and real-world survival in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer (mBC) who received chemotherapy in the post-endocrine therapy (ET) setting where cytotoxic agents are the mainstay of treatment.</p><p><strong>Methods: </strong>This retrospective, observational cohort study utilized data from the US nationwide Flatiron Health Research Database. Women aged ≥ 18 years with HR+/HER2 - mBC who received chemotherapy post-ET from January 1, 2015, to December 31, 2024, were included. Patient characteristics, treatment patterns, real-world overall survival (rwOS), and time to next treatment or death (rwTTNTD) were described post-ET.</p><p><strong>Results: </strong>5041 patients were included; median age was 63 years at mBC diagnosis. Most were non-Hispanic White (63%) and treated in the community setting (82%) and had Eastern Cooperative Oncology Group performance status 0-1 (59%) at the start of first-line treatment (1L) post-ET, recurrent mBC (68%), and ≥ 2 prior lines of ET-based treatment in the mBC setting (65%). Median time from mBC diagnosis to 1L post-ET was 19 months. Most patients (97%) received chemotherapy 1L post-ET. Median (95% CI) rwOS from start of 1L post-ET was 13.5 (13.0-14.1) months. 30% of patients who initiated 1L post-ET did not survive to the next treatment line; there was a decrease in rwOS with each subsequent treatment. Similar findings were observed for rwTTNTD.</p><p><strong>Conclusions: </strong>These findings reinforce the high unmet need in patients with HR+/HER2 - mBC whose disease has become resistant to ET, highlighting the need for effective treatments in this setting.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023812","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":"Ki-67 expression and rates of pathologic complete response in T1cN0M0 triple-negative breast cancer: a national cancer database analysis.","authors":"Andrew Venardi, Fatemeh Shojaeian, Sophia Diaz, Calvin R Schuster, Piyush Rath, Ishrar Shaid, Ambika Singh, Cesar Santa-Maria, Olutayo Sogunro","doi":"10.1007/s10549-026-08086-1","DOIUrl":"https://doi.org/10.1007/s10549-026-08086-1","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment sequencing for T1cN0M0 triple-negative breast cancer (TNBC) remains controversial because neoadjuvant chemotherapy (NACT) has not demonstrated improved overall survival (OS) compared to adjuvant chemotherapy (ACT). Using pathologic complete response (pCR) as an early, positive prognostic indicator, this study evaluates how Ki-67 expression levels impact pCR rates in T1cN0M0 TNBC to identify patients who benefit most from upfront chemotherapy.</p><p><strong>Methods: </strong>The National Cancer Database (NCDB) was queried (2018-2022) for female patients aged ≥ 18 with T1N0M0 TNBC undergoing chemotherapy and surgery. Patients were grouped into NACT or ACT cohorts and balanced using inverse probability of treatment weighting (IPTW). Cox multivariate analysis evaluated OS predictors, while logistic regression identified factors associated with pCR. A ROC curve was created for Ki-67 expression in the setting of pCR and the maximum Youden index established a threshold value.</p><p><strong>Results: </strong>An analysis of 8,831 patients from the NCDB found no significant difference in OS between NACT and ACT, but multivariate analysis revealed lymphovascular invasion (LVI), invasive lobular subtype (ILC), and mixed invasive lobular/ductal subtype were associated with worse OS. In the NACT group, there was a 3.59 h for worse OS in non-pCR patients compared to those achieving pCR. Ki-67 expression was strongly associated with pCR rates, with Ki-67 ≥ 45.8% yielding a 45.3% pCR rate compared to 21.8% for Ki-67 < 45.8%.</p><p><strong>Conclusion: </strong>Although OS did not differ between NACT and ACT in T1cN0M0 TNBC, achieving pCR after NACT significantly improved survival. A Ki-67 threshold of ≥ 45.8% predicted higher pCR rates and can guide patient selection for upfront chemotherapy.</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":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023809","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":"Equivalent survival in targeted axillary dissection compared to axillary lymph node dissection in patients with node positive breast cancer receiving neoadjuvant chemotherapy.","authors":"Callie Hlavin, Zainab Balogun, Danielle R Lavage, Michael S Cowher, Kristin Lupinacci, Quratulain Sabih, Atilla Soran, Jennifer G Steiman, Priscilla F McAuliffe, Emilia J Diego","doi":"10.1007/s10549-026-08078-1","DOIUrl":"https://doi.org/10.1007/s10549-026-08078-1","url":null,"abstract":"<p><strong>Background: </strong>The role of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) in node-positive breast cancer (N + BC) is evolving with opportunities to de-escalate surgery in those with complete axillary pathologic response. SLNB may lead to equivalent outcomes while avoiding the morbidity of axillary lymph node dissection (ALND).</p><p><strong>Methods: </strong>This is a retrospective analysis of patients with N + BC who received NAC and targeted axillary dissection (TAD) with or without ALND from 2014 to 2021. Patients were categorized according to pathology of the previously positive radioactive seed marked lymph node into complete pathologic response (dSLN-) and persistent disease (dSLN+). We assessed the impact of axillary surgery on recurrence, disease-free survival (DFS), and overall survival (OS).</p><p><strong>Results: </strong>We included 284 female patients with median follow-up of 36.3 months. 128 patients had dSLN-of which 13 (10.2%) had ALND and 115 (89.9%) had TAD. There were 156 dSLN+ patients: 107 (68.6%) ALND and 49 TAD. In both groups, TAD resulted in similar mortality (dSLN-: 15.4% vs. 8.9%, p=.309; dSLN+: 9.3% vs. 10.2%, p = 1.000), DFS (dSLN-:19.6 mos vs. 30.7 mos, p=.166; dSLN+: 30 mos vs. 37 mos, p=.650) and OS (dSLN-: 49.3 mos vs. 45.8 mos, p=.868; dSLN+: 36.4 months vs. 36.2 months, p=.982) compared to ALND.</p><p><strong>Conclusion: </strong>For patients with dSLN-, there was no difference in recurrence, mortality, DFS, or OS between ALND and TAD. While there was a higher frequency of recurrence in patients who had dSLN + and underwent ALND compared to TAD, there was no difference in DFS or OS.</p><p><strong>Clinical trials number: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015401","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":"Metastatic phenotype and post-metastatic survival across HER2-0, HER2-low, and HER2-positive breast cancer.","authors":"Ali Sanjari Moghaddam, Zhirui Deng, Susan M Sereika, Maryam Habib, Anna Homeniuk, Adam M Brufsky, Margaret Q Rosenzweig","doi":"10.1007/s10549-026-08067-4","DOIUrl":"https://doi.org/10.1007/s10549-026-08067-4","url":null,"abstract":"<p><strong>Purpose: </strong>HER2-low breast cancer is treatment-relevant, but whether it is clinically distinct from HER2-0 disease remains unclear. We evaluate metastasis-free interval (MFI), first metastatic site, and survival after metastasis among HER2 classes in metastatic breast cancer.</p><p><strong>Methods: </strong>We retrospectively examined patients with metastatic breast cancer classified as HER2-0, HER2-low, or HER2-positive. Analyses included the chi-square test of independence, Welch one-way ANOVA, Kaplan-Meier estimation, and binary and ordinal logistic and Cox regression models.</p><p><strong>Results: </strong>Among 1,599 patients, 647 (40.5%) had HER2-0 tumors, 672 (42%) had HER2-low tumors, and 280 (17.5%) had HER2-positive tumors. HER2-positive tumors had the shortest MFI compared with HER2-low and HER2-0 tumors (median 2.7 vs. 3.3 vs. 3.7 years, respectively; p = 0.002) and lower odds of late recurrence (≥ 5 years) compared with HER2-0 tumors (OR 0.39, 95% CI 0.22-0.68). HER2-low and HER2-0 tumors had similar metastatic timing. First metastatic site differed across HER2 groups in unadjusted analyses, although HER2 status was not independently associated with bone-only or CNS-only presentation in adjusted binary models. In adjusted Cox regression, HER2-low disease (HR 0.85, 95% CI 0.74-0.97) and HER2-positive disease (HR 0.73, 95% CI 0.60-0.88) were associated with lower hazard of death compared with HER2-0 disease.</p><p><strong>Conclusion: </strong>HER2-positive disease was associated with earlier metastatic recurrence but more favorable post-metastatic survival. HER2-low disease had modestly improved post-metastatic survival but otherwise resembled HER2-0 disease in metastatic timing and adjusted metastatic presentation. These findings support HER2-low status for outcome stratification but suggest it may not independently define a distinct metastatic pattern.</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":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982086","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}