Breast Cancer Research and Treatment最新文献

{"title":"Outcomes of the Saudi breast cancer early detection program: a nine-year analysis (2012-2020).","authors":"Salman M Albeshan, Maha M Almuqbil, Mahoud M Elsharkawi, Hifa Nassri, Nuha A Khoumais","doi":"10.1007/s10549-025-07633-6","DOIUrl":"https://doi.org/10.1007/s10549-025-07633-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to report the preliminary outcome of the Saudi breast cancer early detection program (SBCEDP).</p><p><strong>Methods: </strong>Mammography screens were done for Saudi women (age 40-69 years old) who participated in the SBCEDP from April 2012 to December 2020. Independent double-blind reading of the mammograms was performed by two radiologists. Analysis of age at diagnosis, cancer characteristics, and available screening indicators will be reported within this timeframe.</p><p><strong>Results: </strong>Among 72,774 screened women, 504 had breast cancer cases, yielding a cancer detection rate of 6.93 per 1000 screened women. DCIS detection rate was 0.87 per1000 screened women (n = 63). Mean age at diagnosis was 53.61 years (SD = 8.85) and the majority women had fatty breast tissue (A and B, 65%). Luminal A subtype was predominant (N = 58.6%), whereas triple-negative breast cancers constituted about 12.6% of cases. Estrogen and progesterone positivity was common (more than 65% of cases). Early and localized breast cancer was reported among 28% and 45.8% of women, respectively. Lesions mean size was 23.88 mm and mastectomy rate was 54.2%.</p><p><strong>Conclusion: </strong>Although not all screening indicators were available, the SBCEDP demonstrates encouraging results, with notable rates of early-stage diagnosis. Continuous evaluation and improvement of screening strategies are essential for further enhancing the program effectiveness in reducing breast cancer mortality and morbidity among Saudi women.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413334","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":"https://doi.org/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":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/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":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-12","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":"The impact of cardiovascular risk factors on cancer progression: a prospective study in female breast cancer survivors.","authors":"Xinyi Feng, Zhengyi Deng, Michelle S McCullough, Betty J May, Erica Selznick, Jennifer Y Sheng, Avonne E Connor, Deborah K Armstrong, Kala Visvanathan","doi":"10.1007/s10549-025-07611-y","DOIUrl":"https://doi.org/10.1007/s10549-025-07611-y","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the effect of selected cardiovascular disease (CVD) risk factors over time on early cancer outcomes in breast cancer (BC) survivors.</p><p><strong>Methods: </strong>A prospective study was conducted among women aged 20-65 years with an incident invasive BC enrolled in the Breast and Ovarian Surveillance Service (BOSS) Cohort between 2005 and 2013. CVD risk based on selected risk factors was assessed at baseline and two follow-ups. Participants were categorized into low, medium, and high-risk groups. The primary outcome was BC recurrence (distant or local) or second primary cancer (SPC). Kaplan-Meier failure curves and multivariable Cox proportional hazard models were performed to compare the hazards across CVD risk score groups.</p><p><strong>Results: </strong>A total of 212 women with invasive BC contributed to 2211 person-years (median follow-up 11.7 years), 103 had low, 73 medium, and 36 high CVD risk scores at baseline. In multivariable analyses, BC survivors with medium CVD risk score had 2.09 times higher risk (95%CI = 1.09-4.02; p = 0.027) of recurrence/SPC compared to survivors with low CVD risk score. This association was particularly pronounced in postmenopausal women, those with estrogen receptor-positive BC, regional disease, or newly diagnosed BC. After excluding women taking cardiac medications, a higher risk of recurrence/SPC was also observed among those in the high-CVD-risk-score group, although not significant.</p><p><strong>Conclusion: </strong>Higher CVD risk score based on selected risk factors was significantly associated with BC recurrence or SPC, particularly in certain subgroups. Monitoring and treating a combination of CVD risk factors in BC survivors may help reduce BC progression.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381494","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 randomized phase II trial of nab-paclitaxel with or without mifepristone for advanced triple-negative breast cancer.","authors":"Nan Chen, Margarite Matossian, Poornima Saha, Murtuza Rampurwala, Salaija Kamaraju, Olwen Hahn, Frederick M Howard, Gini F Fleming, Jincong Q Freeman, Theodore Karrison, Suzanne Conzen, Rita Nanda, Erica M Stringer-Reasor","doi":"10.1007/s10549-025-07626-5","DOIUrl":"10.1007/s10549-025-07626-5","url":null,"abstract":"<p><strong>Purpose: </strong>Glucocorticoid receptor (GR) activity may mediate chemoresistance in advanced triple-negative breast cancer (TNBC). Preclinical studies demonstrate that GR antagonism can augment the effect of taxanes in TNBC models. We hypothesized that pretreatment with mifepristone, a potent GR antagonist, would enhance nab-paclitaxel efficacy in advanced TNBC.</p><p><strong>Methods: </strong>This trial was terminated early due to poor accrual. 29 of 64 planned patients were enrolled. Patients were randomized to receive nab-paclitaxel with or without mifepristone; oral mifepristone 300 mg was administered the day prior and day of each dose of nab-paclitaxel. The primary endpoint was progression-free survival (PFS); secondary/exploratory endpoints included response rate and correlation of response with GR expression.</p><p><strong>Results: </strong>The addition of mifepristone to nab-paclitaxel did not improve PFS (3.0 m vs 3.0 m, p = 0.687) or overall response rate (23% vs 31.5%) compared to nab-paclitaxel alone. There was a trend towards improved overall survival in the combination group, primarily driven by one long-term responder. Increased rates of grade 3 neutropenia (46% vs 7%) and febrile neutropenia were observed in the combination arm, while other toxicities were similar in both groups. Increased GR expression was not correlated with clinical response in the combination arm.</p><p><strong>Conclusions: </strong>While there were responders to the combination, the study was underpowered to meet the primary endpoint. Higher rates of neutropenia were observed in the combination, but overall it was well tolerated. Preclinical data in TNBC and clinical data in other malignancies support further investigation of GR modulators. Future studies should incorporate biomarkers to select patients who benefit from GR inhibition.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381417","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":"Lumpectomy surgery for large ductal carcinoma in situ.","authors":"Daniela Bresciani Padilla, Jacqueline Tsai, Amanda Sutherland Beck, Irene L Wapnir","doi":"10.1007/s10549-025-07621-w","DOIUrl":"https://doi.org/10.1007/s10549-025-07621-w","url":null,"abstract":"<p><strong>Purpose: </strong>Breast-conserving surgery for larger ductal carcinoma in situ (DCIS) remains limited. We compare the attempted use and success rates of lumpectomy surgery in patients with DCIS measuring ≥ 4 cm versus < 4 cm.</p><p><strong>Methods: </strong>A retrospective review was conducted using the institutional tumor registry to identify cases of pure DCIS that were surgically treated from 2015 to 2022. Clinical-pathological data were abstracted from electronic medical records. Pathologic tumor size on initial surgery was used to define the two cohorts. Comparisons of variables were made using Chi-square and ANOVA tests.</p><p><strong>Results: </strong>A total of 669 patients, 84% (562) with tumors measuring < 4 cm and 16% (107) ≥ 4 cm were identified. Lumpectomy was the initial surgery performed for 89% of women with lesions measuring < 4 cm on preoperative imaging studies compared to 64% of those ≥ 4 cm. Overall, 461 (92.9%) of 496 in the < 4 cm succeeded at lumpectomy compared to 36 (56.3%) of 64 in the ≥ 4 cm group. Re-excision lumpectomies or mastectomy were performed in 27% and 44% of the < 4 cm and ≥ 4 cm subgroups. Lumpectomy was achieved for 70% of women with tumors in the 4 to 5.9 cm range compared to 33% in the 6-7.9 cm and the ≥ 8 cm groups. There were no local recurrences in the ≥ 4 cm group at an average of 4.4 years follow-up.</p><p><strong>Conclusion: </strong>Lumpectomy is a viable option for many patients with DCIS ≥ 4 cm, especially those measuring < 6 cm, though repeat re-excisions may be required after initial attempt.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381424","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":"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":"https://doi.org/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":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraductal laser ablation during ductoscopy in patients with pathological nipple discharge.","authors":"Seher Makineli, Menno R Vriens, Paul J van Diest, Arjen J Witkamp","doi":"10.1007/s10549-024-07568-4","DOIUrl":"https://doi.org/10.1007/s10549-024-07568-4","url":null,"abstract":"<p><strong>Background: </strong>Ductoscopy is a minimally invasive micro-endoscopic approach for direct visualization and removal of intraductal lesions of the breast. A challenge of ductoscopy is an adequate treatment of intraductal lesions by complete removal to prevent exploratory duct excision surgery. This study aimed to determine the in vivo feasibility of intraductal laser ablation during ductoscopy to remove intraductal lesions in patients suffering from pathological nipple discharge (PND).</p><p><strong>Methods: </strong>A prospective, single-center diagnostic feasibility trial was conducted between October 2022 and November 2023, enrolling adult women with unilateral PND and no radiological suspicion of malignancy. Intraductal laser ablation was performed after incomplete intraductal biopsy using a Thulium laser.</p><p><strong>Results: </strong>Duct cannulation and subsequent ductoscopic exploration were successful in 21 patients revealing an intraductal lesion in 13 patients (61.9%). From these 13 patients, 9 patients (69.2%) underwent intraductal laser ablation due to a residual lesion after biopsy. Pathology of the removed intraductal lesions showed a papilloma in eight (88.9%) patients and a papilloma/DCIS combination in one patient (11.1%). Post-procedure, PND stopped in 77.8% of the patients (7/9). Two patients had recurrent PND complaints caused by a residual lesion.</p><p><strong>Conclusion: </strong>Intraductal laser ablation during ductoscopy in patients with papillary lesions seems to be feasible and safe. The Thulium laser enables ablation of residual lesions and is therefore suitable for an immediate second intervention after ductoscopic removal of intraductal lesions. Further refinement and validation in a follow-up clinical trial are necessary to further assess its therapeutic efficacy.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187768","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":"Gene expression profiling tests to guide adjuvant chemotherapy decisions in lymph node-positive early breast cancer: a systematic review.","authors":"Katy Cooper, Gamze Nalbant, Munira Essat, Sue Harnan, Ruth Wong, Jean Hamilton, Uzma S Asghar, Nicolò M L Battisti, Lynda Wyld, Paul Tappenden","doi":"10.1007/s10549-024-07596-0","DOIUrl":"https://doi.org/10.1007/s10549-024-07596-0","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the effectiveness of gene expression profiling tests to inform adjuvant chemotherapy decisions in people with hormone receptor-positive (HR+), lymph node-positive (LN+) breast cancer.</p><p><strong>Methods: </strong>This systematic review assessed the effectiveness of Oncotype DX, Prosigna, EndoPredict and MammaPrint for guiding adjuvant chemotherapy decisions in HR+ early breast cancer with 1-3 positive nodes, in terms of prognostic ability, prediction of chemotherapy benefit, impact on chemotherapy decisions, quality of life and anxiety. Searches covered MEDLINE, EMBASE and Cochrane databases in April 2023.</p><p><strong>Results: </strong>Fifty-five articles were included. All four tests were prognostic for distant recurrence in LN+ patients. The RxPONDER trial reported no chemotherapy benefit in post-menopausal LN+ patients with low Oncotype DX (RS 0-25), whilst pre-menopausal patients had statistically significant chemotherapy benefit. An RCT reanalysis of Oncotype DX (SWOG-8814) suggested greater chemotherapy benefit with higher RS in post-menopausal LN+ patients. The MINDACT trial reported that LN+ patients with high clinical risk and low MammaPrint risk had a non-statistically significant chemotherapy benefit, but was not designed assess differential chemotherapy benefit per risk group. Decisions to undergo chemotherapy reduced by 12-75% following Oncotype DX testing in LN+ patients in the UK and Europe. No studies in LN+ populations were identified for prediction of chemotherapy benefit by Prosigna or EndoPredict; or for chemotherapy decisions for Prosigna, EndoPredict or MammaPrint; or for anxiety or quality of life impact for any test.</p><p><strong>Conclusions: </strong>All four tests have prognostic ability in LN+ patients. Evidence on predictive benefit is weaker, with equivocal evidence that Oncotype DX may predict chemotherapy benefit in LN+ post-menopausal patients. Use of Oncotype DX leads to fewer patients being recommended chemotherapy.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078121","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":"Patient-reported outcomes after immediate and delayed DIEP-flap breast reconstruction in the setting of post-mastectomy radiation therapy-results of the multicenter UMBRELLA breast cancer cohort.","authors":"Britt A M Jansen, Claudia A Bargon, Maria A Bouman, Dieuwke R Mink van der Molen, Emily L Postma, Femke van der Leij, Erik Zonnevylle, Quinten Ruhe, Sven E Bruekers, Wiesje Maarse, Sabine Siesling, Danny A Young-Afat, Annemiek Doeksen, Helena M Verkooijen","doi":"10.1007/s10549-025-07613-w","DOIUrl":"https://doi.org/10.1007/s10549-025-07613-w","url":null,"abstract":"<p><strong>Purpose: </strong>Timing of Deep Inferior Epigastric artery Perforator (DIEP)-flap breast reconstruction in the context of post-mastectomy radiotherapy for breast cancer patients is topic of debate. We compared the impact of immediate (before radiotherapy) versus delayed (after radiotherapy) DIEP-flap breast reconstruction (IBR versus DBR) on short- and long-term patient-reported outcomes (PROs).</p><p><strong>Methods: </strong>Within the prospective, multicenter breast cancer cohort (UMBRELLA), we identified 88 women who underwent immediate or delayed DIEP-flap breast reconstruction and received PMRT. At 6 and 12 months post-mastectomy, as well as on long-term (≥ 12 months post-reconstruction) body image, breast symptoms, physical functioning, and pain were measured by EORTC-QLQ-30/BR23. Additionally, long-term evaluation included satisfaction with breast(s), physical well-being and self-reported adverse effects of radiation as measured by BREAST-Q, and late treatment toxicity. PROs were compared between groups using independent sample T-test.</p><p><strong>Results: </strong>IBR was performed in 56 patients (64%) and DBR in 32 patients (36%), with 15 months of median time to reconstruction. At 6 and 12 months post-mastectomy, better body image and physical functioning were observed after IBR. No statistically nor clinically relevant differences were observed in long-term EORTC and BREAST-Q outcomes (median follow-up 37-41 months for IBR vs. 42-46 months for DBR). Patients with IBR reported more fibrosis and movement restriction (median follow-up 29 vs. 61 months, resp.).</p><p><strong>Conclusion: </strong>Long-term PROs were comparable for patients with IBR and DBR, despite more patient-reported fibrosis and movement restriction after IBR. Therefore, both treatment pathways can be considered when opting for autologous breast reconstruction in the setting of PMRT.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078185","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}