Breast Cancer Research and Treatment最新文献

{"title":"Racial disparities in treatment and outcomes between Hispanic and non-Hispanic black women with triple-negative breast cancer.","authors":"Jesus D Anampa, Alvaro Alvarez Soto, Ana M Bernal, Ana Acuna-Villaorduna","doi":"10.1007/s10549-024-07565-7","DOIUrl":"10.1007/s10549-024-07565-7","url":null,"abstract":"<p><strong>Introduction: </strong>Triple-negative breast cancer (TNBC) is an aggressive breast cancer (BC) subtype with higher incidence and mortality rates in non-Hispanic Black (NHB) women than non-Hispanic Whites. Studies assessing disparities between NHB and Hispanic women, the two largest US racial/ethnic minorities, are lacking. This study evaluates disparities in the treatment and outcomes between NHB and Hispanic women with non-metastatic TNBC.</p><p><strong>Methods: </strong>This observational, population-based study using the SEER database included adult, female patients diagnosed with non-metastatic TNBC between 2010 and 2015 and identified as NHB or Hispanic. Logistic regression analysis was used to examine the adjusted odds of receiving breast cancer-directed treatment. Kaplan-Meier and cumulative incidence of death curves were plotted to assess overall survival (OS) and risk of breast cancer-related death, respectively. Multivariate regression analyses with Cox and Fine-Gray methods were calculated to assess factors associated with OS and breast cancer-related death, respectively.</p><p><strong>Results: </strong>There were 3426 Hispanic and 5419 NHB patients with non-metastatic TNBC. Hispanics had better 5-year OS relative to NHB (76% vs. 72%). No differences in the odds of receiving chemotherapy or surgery between cohorts was seen. However, the odds of undergoing breast-conserving surgery (BCS) and receiving radiation was higher in NHB than Hispanics, (OR, 1.22; 95% CI, 1.10-1.36) and (OR, 1.50; 95% CI, 1.36-1.66), respectively. Lack of radiation therapy was associated with increased BC-related death in NHB relative to Hispanics (sHR, 1.40; 95% CI, 1.19-1.65). Nevertheless, this difference was not seen when radiation was given, (sHR, 1.03; 95% CI, 0.87-1.23).</p><p><strong>Conclusions: </strong>We found racial disparities in treatment and outcomes between NHB and Hispanics. NHB were more likely to receive radiation therapy and have BCS. Still, after adjusting for demographic and treatment-related factors, NHB had worse OS and BCSS relative to Hispanics. Additional research is needed to understand the drivers of these disparities.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"307-317"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and clinical trends of young breast cancer patients from the national cancer database: disproportionate effect on minority populations.","authors":"Cynthia Mark, Vivek Pujara, Marissa K Boyle, Yuan Yuan, Jin Sun Lee","doi":"10.1007/s10549-024-07588-0","DOIUrl":"10.1007/s10549-024-07588-0","url":null,"abstract":"<p><strong>Purpose: </strong>There is an increasing incidence of young breast cancer (YBC) patients with uncertainty surrounding the factors and patterns that are contributing.</p><p><strong>Methods: </strong>We obtained characteristics and survival data from 206,156 YBC patients (≤ 40 years of age) diagnosed between 2005 and 2019 from the National Cancer Database (NCDB). Patients were subdivided into two comparison groups based on year of diagnosis (2005-2009, Old vs. 2015-2019, New group). A Chi-square test of independence was employed to measure the changes. Cox proportional hazards model was used to explore the variables influencing overall survival (OS).</p><p><strong>Results: </strong>Comparison between Old (55,397 patients) and New groups (67,930 patients) showed an increase in the proportion of Hispanic (8.4% vs 10.0%), Black (16.0% vs 16.6%), and Asian (4.8% vs 6.7%) populations. In the New group, black patients had a significantly worse OS, p < 0.001. Additionally, there was a reduction in the proportion of patients with private insurance (43,940 (81.7%) vs 51,104 (76.4%)) and an increase in patients with Medicaid (5,893 (11.0%) vs 10,694 (16.0%)). Finally, there was a significant increase in hormone positive disease (35,142 (70.0%) vs 49,409 (75.8%), p = < 0.001).</p><p><strong>Conclusions: </strong>Within YBC patients, the proportion of underrepresented and underserved population is increasing, with an impact on OS. We also see an increase in hormone positive disease. Awareness of these at-risk populations is important for early identification of breast cancer and mitigation of poorer outcomes. Also, there are increasing rates of hormone positive disease which can cause substantial personal and societal implications, such as impacts on family planning and early menopause.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"521-528"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142929960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the clinical utility of pre-operative neutrophil-lymphocyte ratio as a predictor of clinicopathological parameters in patients being treated for primary breast cancer.","authors":"Burce Isik, Matthew G Davey, Alisha A Jaffer, Juliette Buckley, Chwanrow Baban, Bridget Anne Merrigan, Shona Tormey","doi":"10.1007/s10549-025-07615-8","DOIUrl":"10.1007/s10549-025-07615-8","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data supporting the role of neutrophil-lymphocyte ratios (NLR) to determine clinicopathological parameters in patients being treated for primary breast cancer.</p><p><strong>Aims: </strong>To evaluate the association between pre-operative NLR and clinicopathological parameters in patients diagnosed with breast cancer.</p><p><strong>Methods: </strong>A retrospective cohort study was performed. This included consecutive patients indicated to undergo surgery for primary breast cancer at University Hospital Limerick between January 2010 and June 2017. NLR was expressed as a continuous variable. Univariable and multivariable linear regression analyses were used to determine the correlation between NLR and clinicopathological data. Data analytics was performed using SPSS v29.0.</p><p><strong>Results: </strong>673 patients met the inclusion criteria. Overall, the median preoperative NLR is 2.63 (standard deviation: 1.42). At univariable analysis, patient age (beta coefficient: 0.009, 95% confidence interval (CI) 0.001-0.017, P = 0.027), tumour size (beta coefficient: 0.013, 95% CI 0.005-0.021, P = 0.001), and human epidermal growth factor receptor-2 status (beta coefficient: - 0.370, 95% CI - 0.676-0.065, P = 0.017) were all predicted using NLR. However, at multivariable analysis, tumour size was the sole parameter predictable by NLR (beta coefficient: 0.011, 95% CI 0.002-0.019, P = 0.013).</p><p><strong>Conclusions: </strong>This study demonstrates that pre-operative NLR may serve as an independent predictor of tumour size in patients being treated with primary breast cancer. Ratification of these preliminary findings is warranted before robustly adopted into clinical practice.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"783-790"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000089","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":"Sentinel lymph node biopsy in breast cancer: the role of ICG fluorescence after neoadjuvant chemotherapy.","authors":"Paweł Bogacz, Zuzanna Pelc, Radosław Mlak, Katarzyna Sędłak, Sebastian Kobiałka, Katarzyna Mielniczek, Magdalena Leśniewska, Katarzyna Chawrylak, Wojciech Polkowski, Karol Rawicz-Pruszyński, Andrzej Kurylcio","doi":"10.1007/s10549-025-07608-7","DOIUrl":"10.1007/s10549-025-07608-7","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the feasibility and safety of indocyanine green (ICG) fluorescence as an alternative to traditional sentinel lymph node biopsy (SLNB) techniques in breast cancer (BC) patients undergoing neoadjuvant chemotherapy (NAC). Specifically, the study aimed to assess sentinel node identification rates and the effectiveness of ICG in axillary staging without the use of radioactive tracers.</p><p><strong>Methods: </strong>This retrospective study included 71 BC patients treated with NAC, who underwent SLNB using ICG fluorescence between 2020 and 2024. ICG was injected intradermally around the nipple-areolar complex, and the lymphatic pathways were visualized with a fluorescence camera. SN identification rate (IR) and retrieval of three or more SNs were the primary and secondary endpoints, respectively. Statistical analyses were performed using the Mann-Whitney U test for continuous variables and Fisher's exact test for categorical variables.</p><p><strong>Results: </strong>ICG-guided SNs were identified in 91.5% of patients, with a median retrieval time of 25 min (range: 10-50). Three or more SNs were successfully collected among 66.2% of cases and 38% of patients achieved a complete pathological response to NAC, while 53.5% had partial responses. Metastatic SNs were found in 21.1% of patients, and no serious intraoperative or postoperative complications were observed.</p><p><strong>Conclusion: </strong>ICG fluorescence-guided SLNB proved to be a feasible and promising method for SNs identification among BC patients after NAC. While ICG shows potential as an alternative to traditional techniques, further studies are required to confirm these findings and to establish ICG role in post-NAC axillary staging.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"699-707"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982806","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":"Clinicopathologic characteristics of ductal carcinoma in situ and risk of subsequent invasive breast cancer: a multicenter, population-based cohort study.","authors":"Thomas E Rohan, Yihong Wang, Fergus Couch, Heather Spencer Feigelson, Robert T Greenlee, Stacey Honda, Azadeh Stark, Dhananjay Chitale, Chenxin Zhang, Xiaonan Xue, Mindy Ginsberg, Olivier Loudig","doi":"10.1007/s10549-024-07599-x","DOIUrl":"10.1007/s10549-024-07599-x","url":null,"abstract":"<p><strong>Purpose: </strong>To study the association between clinicopathologic characteristics of ductal carcinoma in situ (DCIS) and risk of subsequent invasive breast cancer (IBC).</p><p><strong>Methods: </strong>We conducted a case-control study nested in a multicenter, population-based cohort of 8175 women aged ≥ 18 years with DCIS diagnosed between 1987 and 2016 and followed for a median duration of 83 months. Cases (n = 497) were women with a first diagnosis of DCIS who developed a subsequent IBC ≥ 6 months later; controls (2/case; n = 959) were matched to cases on age at and calendar year of DCIS diagnosis. Univariable and multivariable conditional logistic regression models were used to examine the associations between the DCIS characteristics of interest (non-screen detection of DCIS, tumor size, positive margins, grade of DCIS, necrosis, architectural pattern, microcalcification, and estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status) and risk of IBC.</p><p><strong>Results: </strong>In the total study population, the associations were largely null. In subgroup analyses, there were strong position associations with punctate necrosis (pre/perimenopausal women), detection by physical exam (postmenopausal women), architectural patterns other than the main types (breast-conserving surgery [BCS]), and DCIS margins (ipsilateral cases), and inverse associations with HER2 positivity (BCS) and microcalcification (mastectomy); however, the associated confidence intervals were mostly very wide.</p><p><strong>Conclusion: </strong>The results of this study provide limited support for associations of the DCIS clinicopathologic characteristics studied here and risk of IBC.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"615-625"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999367","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":"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":"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":"759-769"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953195/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photodynamic therapy as a strategic ally in radiotherapy for triple-negative breast cancer: the importance of treatment order.","authors":"Camila Ramos Silva, Daniel Perez Vieira, Anderson Zanardi de Freitas, Martha Simões Ribeiro","doi":"10.1007/s10549-024-07607-0","DOIUrl":"10.1007/s10549-024-07607-0","url":null,"abstract":"<p><strong>Purpose: </strong>Triple-negative breast cancer (TNBC) accounts for 20% of all breast cancer cases and is notably resistant to radiotherapy (RT). Photodynamic therapy (PDT) using porphyrins or their derivatives has shown promise as a potential cancer treatment and immune activator. This study evaluated the effects of combining PDT and RT in sublethal conditions for TNBC using in vitro and in vivo models.</p><p><strong>Methods: </strong>In vitro, PDT was combined with RT (2.5 Gy) using a porphyrin (TMPyP, 32 μmolL^-1) and red light (660 ± 15 nm) with a dose of 50 Jcm^-2. We assessed cell viability, survival, apoptosis, ROS, singlet oxygen, and GSH/GSSG ratio. In vivo, we used a TNBC-bearing mouse model and combined PDT with RT in four sessions, comparing treatment sequences. We evaluated tumor volume, clinical manifestations, survival, metastasis in the lungs, ROS, singlet oxygen, and glutathione levels.</p><p><strong>Results: </strong>Cells treated with PDT + RT had a lower survival fraction, although PDT alone showed higher apoptosis and singlet oxygen levels than RT-treated groups. In vivo, the treatment sequence plays a crucial role: PDT after RT resulted in better clinical outcomes, prolonged survival, and fewer lung nodules compared to RT, with higher singlet oxygen levels likely stimulating an immune response.</p><p><strong>Conclusion: </strong>Our results show that PDT can be a valuable adjunct in the RT of TNBC, with the treatment sequence playing a crucial role in enhancing efficacy.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"687-697"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944690","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":"Incidence, treatment patterns, and mortality for patients with breast cancer during the first year of the COVID-19 pandemic: a population-based study.","authors":"José Pablo Leone, Julieta Leone, Michael J Hassett, Rachel A Freedman, Jorge Avila, Carlos T Vallejo, Nabihah Tayob, Sara M Tolaney, Nancy U Lin","doi":"10.1007/s10549-024-07562-w","DOIUrl":"10.1007/s10549-024-07562-w","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic created significant disruptions in the diagnosis and treatment of breast cancer (BC). Several public health measures were taken with limited evidence on their potential impact. In this observational study, we sought to compare the incidence of BC, treatment patterns, and mortality during 2020 versus 2018 and 2019.</p><p><strong>Methods: </strong>Using the Surveillance, Epidemiology, and End Results program, we identified 37,834 patients with ductal carcinoma in situ (DCIS) and 199,594 with invasive BC between 2018 and 2020. We assessed age-adjusted incidence rates of DCIS and invasive BC as cases per 100,000, treatment patterns, and mortality in 2020 versus 2018 and 2019.</p><p><strong>Results: </strong>From 2019 to 2020, the incidence of female DCIS decreased from 36.4 to 31.0, and the incidence of female invasive BC decreased from 184.2 to 166.6. Among females, the relative reductions in incidence from 2019 to 2020 were 14.8% for DCIS, 12.1% for stage I, 5.8% for stage II, 2.6% for stage III, and 1.9% for stage IV. Comparing 2020 to 2018-2019 in invasive BC, we observed significant changes in treatment patterns with decreased use of surgery or radiation and increased use of chemotherapy. The 12-month mortality rates were 4.49%, 4.37%, and 4.57% for 2018, 2019 and 2020, respectively. In the Cox model, there were no significant differences in mortality between patients diagnosed in 2020 versus 2018 or 2019.</p><p><strong>Conclusions: </strong>During 2020, the incidence of BC decreased significantly. There were reductions in surgery and radiation use, but not in chemotherapy. Although vaccines were largely unavailable and COVID-19 treatments were in development, we saw no differences in 12-month mortality in 2020 versus prior years. The impact on BC-specific outcomes requires further follow-up.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"285-294"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766006","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":"Evaluation of alternative prognostic thresholds for SP142 and 22C3 immunohistochemical PD-L1 expression in triple-negative breast cancer: results from a population-based cohort.","authors":"Gudbjörg Sigurjonsdottir, Tommaso De Marchi, Anna Ehinger, Johan Hartman, Susann Ullén, Karin Leandersson, Ana Bosch, Johan Staaf, Fredrika Killander, Emma Niméus","doi":"10.1007/s10549-024-07561-x","DOIUrl":"10.1007/s10549-024-07561-x","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors are now a part of the treatment arsenal for triple-negative breast cancer (TNBC) but refinement of PD-L1 as a prognostic and predictive biomarker is a clinical priority. We aimed to evaluate the relevance of novel PD-L1 immunohistochemical (IHC) thresholds in TNBC with regard to PD-L1 gene expression, prognostic value, tumor infiltrating lymphocytes (TILs), and TNBC molecular subtypes.</p><p><strong>Material & methods: </strong>PD-L1 was scored in a tissue microarray with the SP142 (immune cell (IC) score) and the 22C3 (combined positive score; CPS) IHC assays and TIL abundance evaluated in whole slides in a population-based cohort of 237 early-stage TNBC patients. Survival analysis was performed and RNA sequencing data employed for molecular profiling.</p><p><strong>Results: </strong>As expected, PD-L1 positivity (IC ≥ 1% and/or CPS ≥ 1) was significantly associated with better prognosis compared to zero PD-L1 expression. Importantly however, also patients with intermediate expression (IC > 0%, < 1%; CPS > 0, < 1) showed a trend toward improved outcome. Tumors with intermediate PD-L1 IHC expression also had intermediate PD-L1 (CD274) gene expression (mRNA). Patients who were both low in TILs (< 30%) and PD-L1 (IC < 1%; CPS < 1) tended to have the poorest prognosis. PD-L1 positive tumors clustered significantly more often as Immunomodulatory-high and Basal-Like 1-high TNBC molecular subtypes and were enriched in immune response and cell cycle/proliferation signaling pathways. PD-L1-zero tumors on the other hand were enriched in cell growth, differentiation, and metastatic potential pathways and clustered more prevalently as Luminal-Androgen-Receptor-high and Mesenchymal-high. PD-L1-intermediate tumors categorized with neither PD-L1-positive nor PD-L1-zero tumors on the hierarchical clustering level, consigning them as a unique subgroup.</p><p><strong>Conclusion: </strong>With both SP142 and 22C3, we identified an intermediate IHC PD-L1 group within TNBCs that was supported on the molecular level. Any PD-L1 IHC expression, even though it is < 1, tended to have positive prognostic impact. We suggest that the generally accepted threshold of PD-L1 IHC positivity in TNBC should be investigated further. The Swedish Cancerome Analysis Network - Breast (SCAN-B) study was retrospectively registered 2nd Dec 2014 at ClinicalTrials.gov; ID NCT02306096.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"271-284"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799335","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":"Receipt of guideline-concordant care and survival among young adult women with non-metastatic breast cancer.","authors":"Manami Bhattacharya, Benmei Liu, Allison W Kurian, Jennifer Stevens, Lindsey Enewold, Dolly C Penn","doi":"10.1007/s10549-024-07570-w","DOIUrl":"10.1007/s10549-024-07570-w","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent and young adults (AYA) with breast cancer, compared to older adults, are diagnosed with more aggressive cancers, at more advanced stages and may undergo more aggressive treatment but have worse survival. Despite this, no research has studied the effects of the receipt of National Comprehensive Cancer Network (NCCN) defined guideline-concordant care (GCC) for breast cancer on AYA survival. We examined the association of GCC with survival among young adult (20-39 years old) breast cancer survivors.</p><p><strong>Methods: </strong>We used the Patterns of Care Study; a stratified random sample of 952 young adult women diagnosed with Stage I-III breast cancer in 2013. NCCN guidelines were used to categorize treatment as GCC or non-GCC. We used Kaplan-Meier curves, log-rank tests, and Cox-proportional hazards models to evaluate the effect of GCC on breast cancer-specific survival, stratifying by triple-negative breast cancer (TNBC) and non-TNBC, and adjusting for sociodemographic and clinical factors.</p><p><strong>Results: </strong>All univariate analyses showed that non-GCC was associated with worse survival than GCC. The association was statistically significant for non-TNBC (Hazard ratio: 3.45, CI 1.64-7.29) and TNBC (Hazard ratio: 3.70, CI 1.02-13.43) in multivariable Cox models adjusted for sociodemographic variables and for non-TNBC (Hazard ratio: 3.13, CI 1.13-8.72) when the model was adjusted for sociodemographic and clinical variables.</p><p><strong>Conclusion: </strong>Among young adult women with non-metastatic breast cancer, while receipt of NCCN GCC is univariately associated with better survival for both TNBC and non-TNBC, the effect of sociodemographic and clinical factors on the association differs by TNBC status. Further investigation with larger TNBC samples is needed.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"347-354"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799367","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}