Breast Cancer Research and Treatment最新文献

{"title":"Self-administered versus lymphedema therapist-administered complex decongestive therapy protocol in breast cancer-related lymphedema: a non-inferiority randomized controlled trial with three-month follow-up.","authors":"Sukriye Cansu Gultekin, Didem Karadibak, Ahmet Burak Cakir, Zeynep Gulsum Guc, Tugba Yavuzsen","doi":"10.1007/s10549-025-07709-3","DOIUrl":"10.1007/s10549-025-07709-3","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to demonstrate that a self-administered complex decongestive therapy (CDT) protocol is not inferior to certified lymphedema therapist (CLT)-administered CDT in the management of lymphedema and health-related outcomes in patients with breast cancer-related lymphedema (BCRL).</p><p><strong>Methods: </strong>Fifty patients with BCRL were randomly assigned to two experimental groups: (1) a CLT-administered CDT group (n = 25) or a self-administered CDT group (n = 25). CDT was a multimodal approach in two experimental conditions consisting of patient education, manual lymph drainage, multi-layer bandaging, therapeutic exercises and skin/nail care. Lymphedema severity was assessed using circumference measurement, and BCRL-related symptoms were assessed using a numerical rating scale. The following measurement methods were used to assess health-related outcomes: universal goniometer for range of motion (ROMs), hand grip dynamometer for peripheral muscle strength, disabilities of the arm, shoulder and hand (DASH) questionnaire for disability level, International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity level, the checklist for individual strength (CIS) for fatigue and upper limb lymphedema quality of life questionnaire (ULL-27) for quality of life.</p><p><strong>Results: </strong>Following CDT, there was a significant decrease in lymphedema severity and lymphedema-related symptoms in both groups (p < 0.001). There was no significant difference between the groups regarding the mean difference in health-related outcomes following CDT (post-treatment-baseline) (p < 0.05). Lymphedema severity and symptoms remained stable during the 3-month follow-up periods in the CLT-administered CDT group (p > 0.05). There was a decrease in the severity of lymphedema, stiffness, heaviness and fatigue in the self-administered CDT group at 3-month follow-up (p < 0.05), while pain and tingling remained unchanged (p > 0.05).</p><p><strong>Conclusion: </strong>The present findings demonstrated self-administered CDT protocol is not inferior to CLT-administered CDT in the management of lymphedema and reduction of lymphedema-related disabilities.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"123-138"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968578","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":"Social determinants of cardiovascular disease in women with and without breast cancer.","authors":"Elena Wadden, Vidhushei Yogeswaran, Roberta M Ray, Alexi Vasbinder, Aladdin H Shadyab, Qian Xiao, Phyllis A Richey, Nazmus Saquib, Yangbo Sun, Su Yon Jung, Margaret S Pichardo, JoAnn E Manson, Garnet Anderson, Michael Simon, Marcia L Stefanick, Kerryn Reding, Ana Barac, Richard K Cheng","doi":"10.1007/s10549-025-07731-5","DOIUrl":"10.1007/s10549-025-07731-5","url":null,"abstract":"<p><strong>Purpose: </strong>Social determinants of health (SDOH) may impact cardiovascular (CV) risk in women with and without breast cancer (BC).</p><p><strong>Methods: </strong>In 153,401 participants without prevalent CV disease from the Women's Health initiative (WHI), we assessed key SDOH factors: geographic region, rurality, insurance status, and household income. Multivariable Cox proportional hazards models were used to assess associations between SDOH factors and a composite CV outcome, which included incident myocardial infarction, incident stroke, hospitalization for heart failure, or CV death.</p><p><strong>Results: </strong>In the final cohort, 10,954 (mean ± standard deviation [SD] age 62 ± 7 years) women developed BC, and 142,144 (mean age 63 ± 7 years) women remained free of BC. During a median follow-up time of 13 years, 18,148 women experienced the composite CV outcome. Rurality, low household income, and non-private insurance were associated with an increased risk of the composite CV outcome and CV death, both in women with and without BC.</p><p><strong>Conclusions: </strong>SDOH factors are associated with an increased risk of CV events among women, irrespective of BC status. These associations highlight the importance of socioeconomic factors across cardiovascular health outcomes.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"371-386"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109603","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":"Tolerance for chemotherapy-induced peripheral neuropathy among women with metastatic breast cancer: a discrete-choice experiment.","authors":"Rotana M Radwan, Anne L R Schuster, Daniel L Hertz, Maryam B Lustberg, Hetal R Vachhani, Erin Hickey Zacholski, Vanessa B Sheppard, John F P Bridges, Teresa M Salgado","doi":"10.1007/s10549-025-07715-5","DOIUrl":"10.1007/s10549-025-07715-5","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify preferences for chemotherapy-induced peripheral neuropathy (CIPN) risks and survival benefits of continuing neurotoxic chemotherapy and explore differences in preferences by race among women with metastatic breast cancer (mBC).</p><p><strong>Methods: </strong>Women with mBC and CIPN experience completed a discrete-choice experiment that included 12 choice tasks presenting paired profiles that varied four attributes across three levels each: progression-free survival (PFS) (6, 12, 24 months), neuropathy in hands (mild, moderate, severe), neuropathy in feet (mild, moderate, severe), and neuropathy persistence (short-term, long-term, permanent). Aggregate and exploratory stratified (White versus non-White) conditional logit models were estimated from which patients' minimum acceptable benefit was calculated using the willingness-to-pay approach.</p><p><strong>Results: </strong>Women (n = 189) were on average 52.5 years and 47.1% were non-White. Fewer women who were non-White held a bachelor's degree or higher (p < 0.01) and reported a household income of $85,000 or higher (p = 0.03). In both the aggregate and the stratified analyses, women preferred longer duration of PFS, less severe CIPN in hands and feet, and shorter CIPN duration. In aggregate, respondents were willing to tolerate a one-level increase in neuropathy severity (mild to moderate or moderate to severe) in their hands and feet in exchange for 6.7 and 2.9 months of PFS, respectively. In exchange for 9.3 months of PFS, respondents were willing to tolerate a one-level increase in neuropathy persistence (short-term to long-term or long-term to permanent). Exploratory stratified analysis showed that non-White women had different preferences from White women (p < 0.01), with non-White women requiring more months of PFS benefit to tolerate increases in neuropathy severity and duration compared to White women.</p><p><strong>Conclusion: </strong>Women with mBC favored longer duration of progression-free survival, less severe CIPN in hands and feet, and shorter CIPN duration. Different preferences by race warrant additional future investigation.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"149-159"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972199","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":"Radiation recall dermatitis induced by abemaciclib with successful rechallenge: a case series and literature review.","authors":"Zi-Lu Yi, Bei-Bei Yang, Jia-Ning Zhang, Meng-Jun Zhao, Meng-Lu Shen, Xi-Rui Zhou, Hong Liu","doi":"10.1007/s10549-025-07712-8","DOIUrl":"10.1007/s10549-025-07712-8","url":null,"abstract":"<p><strong>Purpose: </strong>To raise awareness of radiation recall dermatitis (RRD) in the context of radiotherapy combined with abemaciclib, and to explore its potential mechanisms, characteristics, and treatment options.</p><p><strong>Methods: </strong>We conducted a case series study reporting the first instances of RRD induced by abemaciclib in two women with locally advanced luminal breast cancer. Both patients experienced skin reactions in previously irradiated areas following abemaciclib administration. Additionally, a comprehensive literature review was performed to analyze the potential mechanisms of RRD, characteristics of radiotherapy, triggering drugs, and available treatments.</p><p><strong>Results: </strong>The case series demonstrated that abemaciclib can induce RRD in patients who have undergone radiotherapy. Both patients experienced significant skin reactions, which were successfully managed and resolved upon rechallenge with abemaciclib. The literature review highlighted the importance of recognizing RRD as a potential adverse effect of cyclin-dependent kinase 4/6 inhibitors (CDK4/6is), emphasizing the need for careful monitoring and appropriate management strategies.</p><p><strong>Conclusion: </strong>Radiation recall dermatitis is a potential adverse effect of abemaciclib in patients receiving radiotherapy for breast cancer. Our findings underscore the importance of awareness and vigilance in managing patients on CDK4/6is.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"189-193"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963332","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":"Utilization of weight management treatment and subsequent cardiovascular events among patients with breast cancer.","authors":"Margaux Wooster, Ling Chen, Melissa K Accordino, Claire Sathe, Jason D Wright, Dawn L Hershman","doi":"10.1007/s10549-025-07714-6","DOIUrl":"10.1007/s10549-025-07714-6","url":null,"abstract":"<p><strong>Purpose: </strong>Overweight and obese breast cancer (BC) survivors face higher risks of recurrence and all-cause mortality, including from cardiovascular disease (CVD). Weight management therapy (WMT) may reduce cardiovascular events (CVE). We assessed trends in WMT in BC survivors and evaluated rates of CVE.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the MarketScan Database, including overweight and obese patients (18-95 years) with invasive BC (2009 -2021), who underwent breast surgery. Exclusions were prior bariatric surgery or secondary cancers. Patients were categorized by weight status and by WMT, including nutrition counseling, medications, and bariatric surgery. We utilized descriptive statistics, univariate analysis for factors associated with WMT receipt and rates of CVE, and a multivariable logistic regression model to determine WMT-associated factors.</p><p><strong>Results: </strong>We identified 35,206 patients: 18.8% overweight, 53.7% obese class I/II/unspecified, and 27.4% obese class III. WMT was utilized by 5.3%, 6.4%, and 9.6%, respectively (p < 0.001). Among 2,484 patients who received WMT, 72.7% had nutrition counseling, 26.7% received weight loss medication, and 4.9% underwent bariatric surgery. From 2009 to 2021, WMT use increased from 3.7% to 11.3% (p < 0.001), and use of weight loss medication increased from 0.3% to 5.1% (p < 0.001). Factors associated with receipt of WMT included younger age, greater degree of obesity, more recent year of surgery, lumpectomy, higher comorbidity score, and prior WMT. CVE incidence was lower in WMT recipients (0.8% vs.1.3%, p = 0.02).</p><p><strong>Conclusion: </strong>In patients with BC, WMT has increased over time, and most markedly weight loss medication use. WMT is associated with lower incidence of CVE.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"217-223"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971129","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":"COVID-19 pandemic interruption of breast cancer screening is linked to clinical upstaging at presentation: the roles of demographics, socioeconomic status and unmet social needs.","authors":"Roham Hadidchi, Katie S Duong, Julia Hou, Takouhie Maldjian, Julie Chung, Wei Hou, Susan Fineberg, Jinyu Lu, Della Makower, Tim Q Duong","doi":"10.1007/s10549-025-07713-7","DOIUrl":"10.1007/s10549-025-07713-7","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 pandemic-related disruptions of mammography screening, breast cancer diagnosis, staging, and treatment options are not well understood with respect to social determinants of health, especially three years post-pandemic.</p><p><strong>Methods: </strong>This retrospective observational study included patients screened by mammography or diagnosed with breast cancer from January 2019 to February 2023 in the urban population in the Bronx.</p><p><strong>Results: </strong>Screening and diagnostic mammography, and breast cancer diagnoses from April to August 2020 dropped by 61%, 47%, and 42%, respectively, compared to pre-pandemic (Jan 2019-Mar 2020) and largely recovered by September 2020. Compared to pre-pandemic baseline, patients diagnosed with breast cancer from September 2020 to January 2021 were 1.48 times (95% CI [1.03, 2.13]) more likely to present with clinical stage 2-4, and 1.47 [1.04-2.08] times more likely to present with T stage 2-4. Black patients experienced a more significant increase in odds of presenting with clinical stage 2-4 (4.41 [1.36, 14.24]) and nodal involvement (4.61 [1.27, 16.82]) compared to non-Hispanic Whites from Apr 2020 to Jan 2021.</p><p><strong>Conclusion: </strong>Interruption of breast cancer screening during the pandemic coincided with increased proportions of patients presenting with more advanced disease, especially among Black patients. The results underscore the need for targeted public health interventions to address health disparities among these populations.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"205-216"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075989","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":"Management of ipsilateral breast tumor recurrence after prior breast conservation therapy.","authors":"Jacob M Jasper, Halley Vora, Olga Kantor, Monica McGrath, Jennifer R Bellon, Elizabeth A Mittendorf, Tari A King","doi":"10.1007/s10549-025-07730-6","DOIUrl":"10.1007/s10549-025-07730-6","url":null,"abstract":"<p><strong>Purpose: </strong>Mastectomy is traditionally recommended for local recurrence after breast conservation therapy (BCT), the combination of lumpectomy followed by whole-breast radiotherapy. Recent studies suggest that repeat BCT (lumpectomy and re-irradiation) may be feasible for select patients. We sought to evaluate the clinical characteristics, management strategies, and outcomes of patients treated for ipsilateral breast tumor recurrence (IBTR) after initial BCT and assess the impact of a newly adopted multidisciplinary algorithm for repeat BCT (lumpectomy and re-irradiation).</p><p><strong>Methods: </strong>We identified patients with stage 0-III breast cancer treated with initial BCT who underwent surgery for IBTR between January 2016 and May 2023. Patient, tumor, and treatment characteristics were analyzed, and outcomes were compared before and after the adoption of the repeat BCT algorithm.</p><p><strong>Results: </strong>Among 546 patients treated for IBTR, 48% were eligible for repeat BCT. After criteria adoption, mastectomy rates decreased by 16%. The proportion of eligible patients undergoing lumpectomy alone (BCS) for IBTR increased by 9% while only a modest increase in lumpectomy and re-irradiation (repeat BCT) was observed (7%). Rates of BCS for IBTR were higher than repeat BCT among older patients. Clinical outcomes were comparable between patients treated with BCS, BCT, or mastectomy.</p><p><strong>Conclusion: </strong>Repeat BCT (lumpectomy and re-irradiation) is a viable option for select patients with IBTR, offering comparable outcomes to mastectomy. The adoption of standardized criteria for repeat BCT has increased its use, highlighting the importance of multidisciplinary approaches in treatment planning.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"361-369"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109586","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":"Subtype-specific dysregulation of biogenic amine-related genes and miRNAs in breast cancer: identification of DRD2, HRH2, and HRH4 as potential therapeutic targets in TNBC and HER2+ subtypes.","authors":"Agata Sirek, Tomasz Sirek, Robert Nowakowski, Przemysław Borawski, Piotr Ossowski, Katarzyna Mitka-Krysiak, Nikola Zmarzły, Kacper Boroń, Michał Chalcarz, Bernadeta Kuraszewska, Mariola Szulik, Dariusz Boroń, Beniamin Oskar Grabarek","doi":"10.1007/s10549-025-07732-4","DOIUrl":"10.1007/s10549-025-07732-4","url":null,"abstract":"<p><strong>Purpose: </strong>Biogenic amines (BAs) are known to influence tumorigenesis, yet their precise role in breast cancer remains unclear. This study aimed to investigate the expression patterns of BA-related genes, proteins, and their regulatory miRNAs across different breast cancer subtypes to identify potential biomarkers and therapeutic targets.</p><p><strong>Methods: </strong>A cohort of 501 breast cancer patients was classified into luminal A (n = 130), luminal B HER2- (n = 100), luminal B HER2+ (n = 96), non-luminal HER2+ (n = 36), and triple-negative breast cancer (TNBC; n = 43). Gene expression was assessed via microarray analysis and validated using RT-qPCR. Protein levels were quantified using ELISA, while miRNA profiling was conducted to identify post-transcriptional regulatory interactions. Statistical significance was determined using ANOVA and Tukey's post-hoc test (p < 0.05).</p><p><strong>Results: </strong>Histamine-related genes (HRH1-HRH4) were upregulated across all subtypes, with HRH2 and HRH4 most elevated in TNBC (FC = 7.18, p < 0.01). DRD2 showed widespread upregulation (FC = 15.98, p < 0.001), whereas DRD5 was markedly downregulated, especially in non-luminal HER2+ tumors (FC =  - 13.01, p < 0.01). miRNA analysis revealed downregulation of hsa-miR-30b-3p and hsa-miR-372-5p in TNBC and HER2+ subtypes, correlating with HRH2 and HRH4 overexpression (p < 0.05). EGR1 and ICAM1 exhibited strong subtype-specific expression, with ICAM1 significantly upregulated in TNBC (FC = 25.76, p < 0.001).</p><p><strong>Conclusion: </strong>Subtype-specific dysregulation of BA-related genes and miRNAs suggests their involvement in tumor progression, immune modulation, and metabolic regulation. The findings highlight potential therapeutic targets, particularly in TNBC and HER2+ subtypes.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"387-406"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156749","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":"Brain metastases in patients with metastatic breast cancer and BRCA1/2 mutations in cell-free DNA.","authors":"Neelima Vidula, Erica Blouch, Katherine Hesler, Andrzej Niemierko, Aditya Bardia","doi":"10.1007/s10549-025-07705-7","DOIUrl":"10.1007/s10549-025-07705-7","url":null,"abstract":"<p><strong>Purpose: </strong>Brain metastases (BM) in patients with metastatic breast cancer (MBC) cause significant morbidity/mortality. A relatively high prevalence of BM is seen in patients with germline BRCA1/2 mutations. Some patients with MBC have somatic BRCA1/2 mutations but the prevalence of BM in this setting is not known.</p><p><strong>Methods: </strong>Here, we evaluated the prevalence and clinical and genomic characteristics of BM in patients with MBC with somatic BRCA1/2 mutations in cell-free DNA (cfDNA) using the Guardant360 assay. Clinical and genomic features of patients with somatic BRCA1/2 mutations and brain metastases, and those without brain metastases were compared using a Chi-squared test for categorical variables and Wilcoxon rank-sum test for continuous variables.</p><p><strong>Results: </strong>Of 36 patients with MBC and somatic BRCA1/2 mutations, 9 (25%) developed BM. The median time to development of BM was 6.7 months after somatic BRCA detection by cfDNA testing. Among patients with BM, somatic BRCA mutations were commonly BRCA1, clonal, and present at a higher mutant allelic fraction. The coexisting genomic landscape in patients with BM commonly included PIK3CA, TP53, MYC, EGFR, CCNE1, and KIT mutations.</p><p><strong>Conclusion: </strong>A relatively high prevalence of BM in patients with MBC harboring cfDNA somatic BRCA1/2 mutations was observed. CfDNA somatic BRCA1/2 mutations may help identify patients with MBC at risk for BM. To our knowledge, this is the first report linking cfDNA somatic BRCA mutations with BM, and requires further investigation in additional datasets and studies.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"107-112"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976232","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":"Effect of chemotherapy timing in triple-negative breast cancer: a real-world evidence study.","authors":"Noiver Graciano, Lucelly López, Carlos A Rodriguez, Katherine Montoya, Diego M González, Luis Rodolfo Gómez, Maycos L Zapata, Javier Cortés","doi":"10.1007/s10549-025-07716-4","DOIUrl":"10.1007/s10549-025-07716-4","url":null,"abstract":"<p><strong>Purpose: </strong>Triple-negative breast cancer (TNBC) is an aggressive, heterogeneous malignancy with poor prognosis. The optimal timing of chemotherapy-neoadjuvant (NACT) versus adjuvant (ACT)-remains controversial. This study assessed real-world outcomes in non-metastatic TNBC patients according to chemotherapy timing.</p><p><strong>Methods: </strong>This retrospective study (2008-2023) evaluated the impact of chemotherapy timing on overall survival (OS) and event-free survival (EFS) in a cohort of 711 patients. Propensity score (PS) matching with preoperative variables was used to adjust for baseline imbalances, and Cox regression models were applied to account for treatment-related variables.</p><p><strong>Results: </strong>NACT was administered to 525 patients (73.8%), with a 37.3% pathological complete response (pCR) rate. PS matching yielded 177 patient pairs; tumor stage, age and histologic grade remained unbalanced. In the unadjusted analysis, NACT was associated with worse OS (HR 1.56, 95% CI1.08-2.25, p = 0.018). However, multivariate analysis adjusting for unmatched and postoperative variables showed a potential benefit of NACT for OS (HR 0.53, 95% CI 0.07-4.13, p = 0.545) and EFS (HR 0.94, 95% CI 0.21-4.17, p = 0.932). Tumor stage acted as an effect modifier, and stratified analyses revealed that NACT was superior to ACT in patients with advanced-stage disease who achieved pCR (HR 0.22, 95% CI 0.07-0.7, p < 0.010).</p><p><strong>Conclusions: </strong>In our TNBC cohort, chemotherapy timing significantly influenced OS and EFS, particularly in relation to initial tumor stage and pCR status. NACT was more beneficial than ACT in patients with advanced disease who achieve pCR, underscoring its role in both prognostic stratification and therapeutic decision-making.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"225-236"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118793","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}