Breast Cancer Research and Treatment最新文献

{"title":"Real-world estrogen receptor alpha 1 (ESR1) testing patterns and results for ER+/HER2- metastatic breast cancer in the United States, 2018-2024.","authors":"Jane Meisel, Tim Pham, Clara Chen, Ayush Kris, James Roose","doi":"10.1007/s10549-026-08060-x","DOIUrl":"10.1007/s10549-026-08060-x","url":null,"abstract":"<p><strong>Purpose: </strong>To understand historical and recent ESR1 testing rates, and when ESR1 mutations emerge during first-line (1 L) treatment.</p><p><strong>Methods: </strong>This retrospective, observational cohort study used the Flatiron Health Research Database (FHRD) and the Flatiron Health-Foundation Medicine metastatic breast cancer (mBC) Clinico-Genomic Database (CGDB). Adult patients with a confirmed diagnosis of hormone receptor-positive/human epidermal growth factor receptor 2-negative mBC from 1/1/2018 to 6/30/2024 were included. ESR1 testing patterns and test results were descriptively analyzed.</p><p><strong>Results: </strong>Among 7772 patients with mBC in the FHRD who initiated 1 L therapy, tumor ESR1 mutation status was evaluated for 222 (3%) patients at baseline (≤ 90 days before 1 L) and 1355 (17%) during 1 L. The percentage of patients who had an ESR1 test result reported during 1 L increased over time (11% in 2018-19, 19% in 2020-21, 22% in 2022-24). Median time from 1 L start to first ESR1 test was 7.4 months (mos) among tested patients. A positive test result was reported for 29/222 (13%) patients tested at baseline and 240/1355 (18%) tested during 1 L. Most (60%) tests during 1 L used tissue specimens, while the remaining 40% were liquid biopsies, and the median time from specimen collection to result reporting in 1 L was 28 (IQR:10-84) days. Focusing on time periods wherein specimens were provided, ESR1 test positivity was 6.7% (76/1,127) for specimens provided at baseline, 23% (15/65) for specimens provided 9 to 12 months into 1L therapy, 38% (26/69) for those provided 15 to 18 months into 1L, and 40% (38/94) for those provided from 18 to 24 months into 1L.</p><p><strong>Conclusions: </strong>ESR1 mutations can be detected at any time interval during 1L.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918358","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":"Real-world treatment patterns and clinical outcomes in patients with emerging estrogen receptor 1 (ESR1)-mutated ER+ metastatic breast cancer in the U.S., 2018-2024.","authors":"Jane L Meisel, Clara Chen, Ayush Kris, Meng Ru, Timothy Pham, James Roose","doi":"10.1007/s10549-026-08061-w","DOIUrl":"10.1007/s10549-026-08061-w","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical studies have highlighted the potential utility of monitoring for Estrogen receptor alpha 1 (ESR1) mutation (m) (ESR1m) emergence during first-line therapy (1L) for metastatic breast cancer (mBC). However, less is known about the real-world practice for patients with emergent ESR1m before progression and their outcomes. This study aimed to characterize real-world treatment patterns among patients with mBC who underwent ESR1m mutation testing during first-line (1L) therapy, and to evaluate the association between ESR1m detection during 1L and clinical outcomes.</p><p><strong>Methods: </strong>This retrospective, observational cohort study used the US-based, deidentified Flatiron Health Research Database and included patients diagnosed with ER+/human epidermal growth factor receptor 2-negative (HER2-) metastatic BC between 2018 and June 2024. rwOS and rwPFS were estimated using the Kaplan-Meier methodology and compared after propensity score matching. Clinical outcomes were evaluated from the time of first ESR1 test during 1L therapy to minimize time-related bias.</p><p><strong>Results: </strong>7772 patients who initiated 1L therapy were included. Treatment patterns in 1L were comparable between patients with (n = 240) and without (n = 1095) ESR1m detected during 1L. Among patients tested for ESR1m mutations during 1L, detection of ESR1m was associated with significantly shorter rwPFS and OS from the time of testing, both before and after propensity score matching (rwPFS hazard ratio [HR] 0.68 [95%CI: 0.48-0.96], rwOS HR: 0.58 [95%CI: 0.36-0.95]).</p><p><strong>Conclusions: </strong>Detection of ESR1m during 1L was associated with poorer clinical outcomes. These findings highlight the clinical relevance of ESR1m emergence prior to progression and underscore the need for strategies to better identify and manage patients with emerging endocrine resistance.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918374","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":"Exploring trop-2-directed ADCs monotherapy and combination therapy in pretreated mTNBC: a real-world study.","authors":"Jingze Liu, Linxiaoxiao Ding, Jiayi Wang, Tao Chen, Tianzhu Long, Qian Li, Jie Chai, Herui Yao, Ying Wang, Jianli Zhao","doi":"10.1007/s10549-026-08070-9","DOIUrl":"10.1007/s10549-026-08070-9","url":null,"abstract":"<p><strong>Purpose: </strong>Although Trop-2 antibody-drug conjugates (ADCs) have improved outcomes in pretreated metastatic triple-negative breast cancer (mTNBC), resistance remains common and the optimal combination strategy in routine practice is unclear.</p><p><strong>Methods: </strong>In this retrospective real-world study, we identified patients with mTNBC from a health record-derived database who received sacituzumab govitecan or sacituzumab tirumotecan in the later-line setting between April 2020 and December 2025. Patients received at least two cycles of Trop-2 ADC therapy as monotherapy, plus a PD-1 inhibitor (dual-agent combination), or plus a PD-1 inhibitor and an antiangiogenic agent (triple-agent combination).</p><p><strong>Results: </strong>Descriptively, the ORR was 57.1% in the triple-agent combination group, 38.5% in the dual-agent combination group, and 31.7% in the monotherapy group. Median follow-up was 15.2 months (95% CI, 8.7-20.6). Median progression-free survival (mPFS) was 15.4 months (95% CI, 5.3-NA) in the triple-agent combination group, 10.0 months (95% CI, 4.2-NA) in the dual-agent combination group, and 3.8 months (95% CI, 3.2-5.2) in the monotherapy group. Severe treatment-related toxicity was not increased in the combination groups. Exploratory analyses identified a genomic scoring system that may enable stratification of patients with a higher likelihood of benefiting from the triple-agent combination.</p><p><strong>Conclusion: </strong>To our knowledge, this study represents one of the earliest real-world evaluations of this triple-agent strategy in previously treated mTNBC, providing a basis for further prospective validation and biomarker-guided application.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918456","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":"Anthracycline-containing versus anthracycline-free carboplatin-based regimens in early-stage triple-negative breast cancer: real-world outcomes.","authors":"Matthew R Kroll, Mary C Schroeder, Joan M Neuner, Brahmendra R Viyyuri, Aditya Ravindra, Dana McDougall, Cole G Chapman, Nicole M G Fleege, Elizabeth A Chrischilles, Xing Song, Sneha Phadke","doi":"10.1007/s10549-026-08071-8","DOIUrl":"10.1007/s10549-026-08071-8","url":null,"abstract":"<p><strong>Purpose: </strong>Triple‑negative breast cancer (TNBC) is an aggressive disease with poor survival outcomes. With the integration of immunotherapy, the optimal neoadjuvant chemotherapy backbone remains poorly defined. We examined real-world treatment patterns and response rates among patients receiving a carboplatin-based regimen, with or without anthracyclines.</p><p><strong>Methods: </strong>In this retrospective cohort study, women diagnosed 2012-2024 with stage I-III TNBC who received neoadjuvant carboplatin plus taxane (CbT) or CbT with anthracyclines (AC-CbT) were identified from electronic health records data from 10 sites within the Greater Plains Collaborative network. Registry-recorded physician assessment of pathologic complete response (pCR) was the primary outcome. Multivariable logistic regression evaluated whether adding anthracyclines to carboplatin-based treatment was associated with pCR.</p><p><strong>Results: </strong>Among 878 patients with TNBC, 41.2% received CbT and 58.8% received AC-CbT. Overall, 46% received pembrolizumab, 11.7% in the CbT group and 66.3% in the AC-CbT group. On univariate analysis, pCR rates did not differ between the CbT and AC-CbT groups (47.2% vs. 51.9%, OR = 1.21, 95%CI 0.92-1.58), among patients who underwent surgery. In multivariate adjusted analyses, AC-CbT was not associated with higher odds of pCR (aOR = 1.05, 95%CI 0.69-1.59), among patients who underwent surgery. Other patient characteristics associated with pCR included pembrolizumab use, higher-grade disease, lower stage, and age at diagnosis (40-49 versus 60+). Use of carboplatin-containing regimens increased substantially over time.</p><p><strong>Conclusion: </strong>In this real-world cohort, addition of anthracycline to carboplatin-containing regimen was not associated with an improvement in pCR rates. These findings suggest clinical equipoise regarding anthracycline omission in early-stage TNBC, to be validated in prospective trials. Additional work evaluating adherence, toxicity, and long-term outcomes is needed.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918435","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":"Oestrogen receptor testing and initiation of adjuvant endocrine therapy in women with ductal carcinoma in situ: a population-based study.","authors":"Qian Chen, Ian Campbell, Mark Elwood, Alana Cavadino, Phyu Sin Aye, Sandar Tin Tin","doi":"10.1007/s10549-026-08072-7","DOIUrl":"10.1007/s10549-026-08072-7","url":null,"abstract":"<p><strong>Introduction: </strong>Use of adjuvant endocrine therapy (ET) for ductal carcinoma in situ (DCIS) varies widely in clinical practice. We investigated oestrogen receptor (ER) testing, the initiation of ET, and the effect of ET on outcomes for DCIS in New Zealand.</p><p><strong>Methods: </strong>Women with DCIS (2000-2022) were identified from the New Zealand Breast Cancer Foundation National Register and linked to the national pharmaceutical data. Logistic regression identified factors associated with ER testing, and cumulative incidence of breast cancer events was estimated with death as a competing risk.</p><p><strong>Results: </strong>Among 5813 women with DCIS, 894 patients (15.4%) had ER testing, with the rate increasing from 11.1% in 2000 to 23.3% in 2006, before declining to 13.9% in 2022. The Waikato region contributed 65.6% of ER tests. In Waikato, testing was more likely among women who received adjuvant radiotherapy after breast-conserving surgery, likely reflecting a site-specific clinical practice. In other regions, testing was more frequent among older women, Māori ethnicity, those with symptomatic presentation, and those with DCIS size > 20 mm, potentially reflecting selective testing. Among 729 patients with ER-positive DCIS, only 183 (25.1%) commenced ET, of whom 80.3% were in Waikato. ET users had the lowest cumulative risk of breast cancer event, but differences were not statistically significant.</p><p><strong>Conclusions: </strong>ER testing and initiation of ET for DCIS remained low, except in Waikato, where clinical centres participated in ET trials and ER testing became more common. Standardised ER testing and greater clinician participation in clinical trials may lead to improved evidence-based care.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879125","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":"Associations of neighborhood deprivation with breast cancer tumor genomics, targeted treatment use, and survival.","authors":"Emily L Podany, Lorenzo Foffano, Lorenzo Gerratana, Arielle J Medford, Natalie K Heater, Eleonora Nicolò, Shaili Tapiavala, Letizia Pontolillo, Annika Putur, Diana A Jaber, Katherine Clifton, Nitin Katakam, Sarah Addison, Marla Lipsyc-Sharf, Carolina Reduzzi, Foluso O Ademuyiwa, Fabio Puglisi, William J Gradishar, Cynthia X Ma, Aditya Bardia, Massimo Cristofanilli, Andrew A Davis","doi":"10.1007/s10549-026-08068-3","DOIUrl":"10.1007/s10549-026-08068-3","url":null,"abstract":"<p><strong>Purpose: </strong>Neighborhood environments appear to influence breast cancer biology and outcomes. This study evaluated somatic, treatment, and outcome differences by Area Deprivation Index in patients with metastatic breast cancer.</p><p><strong>Methods: </strong>Retrospective, population-based cohort study using clinical and genomic data gathered between 2015 and 2024 at four academic institutions in the United States. The outcomes were differences in circulating tumor DNA mutation profiles, PI3K inhibitor use, and survival between patients with metastatic breast cancer living in high deprivation (Area Deprivation Index ≥ 60 by national rank) and low deprivation (< 60) neighborhoods.</p><p><strong>Results: </strong>Among 1127 patients with metastatic breast cancer, 335 (29.7%) lived in high deprivation areas. These patients were more likely to have TP53 mutations (Odds ratio 1.49, 95% Confidence Interval 1.07-2.08, P = 0.018). Among hormone receptor-positive, HER2-negative patients eligible for PI3K inhibitors, those from high deprivation areas were less likely to receive them (17.4% vs. 36.7%, p = 0.02). Median survival from the time of circulating tumor DNA testing was significantly shorter in the high deprivation group (24 months versus 28 months, p = 0.04) and for Black patients in the high deprivation group versus Black patients in low deprivation group and all White patients (15 months versus 25-28 months, p = 0.02).</p><p><strong>Conclusions: </strong>We found that patients with metastatic breast cancer living in high deprivation neighborhoods were more likely to have TP53 mutations, an indicator of aggressive disease biology, less likely to receive PI3K inhibitors, and had shorter overall survival compared to patients living in low deprivation neighborhoods by Area Deprivation Index.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872723","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":"Efficacy, safety, and biomarker analysis of neoadjuvant camrelizumab plus apatinib as a chemotherapy-free strategy for early-stage triple-negative breast cancer: a phase II study.","authors":"Zhenluan Tian, Hengyu Li, Yuxin Deng, Herui Yao, Ying Wang, Liang Jin, Heran Deng, Na Chen, Jieqiong Liu","doi":"10.1007/s10549-026-08066-5","DOIUrl":"10.1007/s10549-026-08066-5","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy, a cornerstone of early-stage triple-negative breast cancer (TNBC) treatment, has limited efficacy and is often accompanied by substantial toxicity. As a promising chemotherapy-free alternative, the combination of immune checkpoint inhibitors and anti-angiogenic agents provides the potential to enhance antitumor efficacy by remodeling the tumor microenvironment while reducing treatment-related adverse events (TRAEs). This study aimed to assess the clinical value and feasibility of neoadjuvant camrelizumab plus apatinib in patients with early-stage TNBC.</p><p><strong>Methods: </strong>This study enrolled stage II-III TNBC patients with baseline tumor-infiltrating lymphocytes (TILs) > 10%. Participants received 8 cycles of neoadjuvant treatment, consisting of intravenous camrelizumab 200 mg every 21 days (or 3 mg/kg for patients weighing < 50 kg), combined with oral apatinib 250 mg daily. The primary endpoint was pathological complete response (pCR) rate; secondary endpoints included objective response rate (ORR), disease-free survival (DFS), overall survival, and safety.</p><p><strong>Results: </strong>Between December 2022 and March 2024, 25 patients were screened, 14 were recruited and treated, 13 were evaluable for efficacy, and 11 subsequently underwent surgery. The results showed a pCR rate of 27.3% (3/11), an ORR of 46.2% (6/13), and a 24-month DFS rate of 90.9%. TRAEs were predominantly of grade 1-2, with grade ≥ 3 events occurring in 28.6% patients. Exploratory transcriptomic analysis identified differences in genes related to extracellular matrix remodeling and immune regulation.</p><p><strong>Conclusions: </strong>Camrelizumab plus apatinib demonstrated manageable toxicity and preliminary antitumor activity, supporting further investigation of this chemotherapy-free strategy in early-stage TNBC patients with enriched TILs.</p><p><strong>Trial registration: </strong>NCT05556200 (Registration Date: September 27, 2022).</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862982","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":"Body mass index-associated gut microbial taxa and functional pathways in women with benign and malignant breast disease.","authors":"Jack W Sample, Stephen Johnson, Tanya L Hoskin, Matteo Redaelli, Marina R Walther-Antonio, Jun Chen, Amy C Degnim, Tina J Hieken","doi":"10.1007/s10549-026-08065-6","DOIUrl":"10.1007/s10549-026-08065-6","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity is an established risk factor for breast cancer and is associated with alterations in gut microbial composition. We evaluated associations among body mass index (BMI), breast density, gut microbial diversity and composition and microbial functional pathways in women undergoing surgery for benign, high-risk/non-invasive, and invasive breast disease.</p><p><strong>Methods: </strong>Preoperative stool samples were collected from 131 women (median age 59) with benign (n = 23), high-risk/non-invasive (n = 47), or malignant (n = 61) disease. Shallow shotgun metagenomic sequencing was performed. Taxonomic profiling used Sourmash 4.2.4 (GTDBv207 reference database); functional profiling employed HUMAnN 3.6 with gene families mapped to MetaCyc pathways.</p><p><strong>Results: </strong>α-diversity differed across diagnosis groups and inversely correlated with increasing BMI (Inverse Simpson p = 0.025). β-diversity differed by diagnosis group and BMI. No significant differences in diversity were observed based on age, menopausal status or mammographic breast density. BMI was also associated with enrichment of Dorea, Blautia, and Streptococcus species. Functional pathway profiling showed greater relative abundance of genes involved in NAD biosynthesis, folate metabolism, and aromatic amino acid metabolism pathways with higher BMI. Cross-referencing the most significant taxonomic and functional pathway findings suggested enrichment of Blautia species, via tryptophan metabolism, might link to NAD biosynthesis.</p><p><strong>Conclusion: </strong>In this study of women with benign, high-risk/non-invasive, and invasive breast disease, BMI was associated with distinct differences in gut microbial taxonomy and functional pathway profiles. These hypothesis-generating findings provide a rationale for future study to determine how the obesity-associated microbiome contributes to breast cancer development.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863660","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":"Low pectoralis major muscle mass predicts the risk of post-surgical bleeding after mastectomy in patients with breast cancer.","authors":"Ryoko Iji, Takaaki Oba, Reina Miyazawa, Ayaka Kitazawa, Nami Kiyosawa, Shota Katsuyama, Hiroki Morikawa, Masatsugu Amitani, Tatsunori Chino, Tadafumi Shimizu, Mayu Ono, Keiko Natori, Toshiharu Kanai, Ken-Ichi Ito","doi":"10.1007/s10549-026-08063-8","DOIUrl":"10.1007/s10549-026-08063-8","url":null,"abstract":"<p><strong>Purpose: </strong>Post-surgical bleeding is a clinically relevant complication after mastectomy. Although high body mass index (BMI) is associated with the risk of this complication, the impact of regional skeletal muscle mass adjacent to the operative field remains unclear. This study aims to evaluate the association between pectoralis major muscle mass and post-surgical bleeding after mastectomy in patients with breast cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed 669 patients who underwent mastectomy between 2015 and 2022, involving a total of 709 breasts. The pectoralis major muscle area was measured using preoperative computed tomography (CT) at the Th2 level, and the pectoralis major muscle index (PMI) was then calculated as the muscle area divided by height squared. We analyzed the association between BMI and PMI, and the incidence of post-surgical bleeding.</p><p><strong>Results: </strong>Post-surgical bleeding occurred in 42 cases (5.9%). Patients who experienced bleeding had significantly higher BMI (26.1 ± 4.7 vs. 22.8 ± 3.8, p < 0.0001) and lower PMI (2.76 ± 0.69 vs. 3.12 ± 0.82, p < 0.001) than those without bleeding. BMI and PMI were weakly correlated (r = 0.16). On multivariate analysis, high BMI (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.27-1.52, p < 0.0001) and low PMI (HR 0.18, 95% CI 0.09-0.32, p < 0.0001) were independently associated with an increased risk of post-surgical bleeding. Combined stratification demonstrated that patients with a high BMI and low PMI had the highest incidence of bleeding (20.1%), whereas those with a low BMI and high PMI had the lowest risk (1.3%).</p><p><strong>Conclusions: </strong>Low PMI and high BMI are independent predictors of post-surgical bleeding after mastectomy. Assessment of regional muscle mass using preoperative CT may enhance perioperative risk stratification in patients with breast cancer.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872695","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":"History of the early development of aromatase inhibitors for treatment of breast cancer.","authors":"R J Santen, L M Demers","doi":"10.1007/s10549-026-08059-4","DOIUrl":"10.1007/s10549-026-08059-4","url":null,"abstract":"<p><strong>Purpose: </strong>To review the early history of the development of aromatase inhibitors for treatment of breast cancer by the Penn State Hershey collaborative group and to acknowledge the support and advice of Dr. William L. McGuire in the studies conducted.</p><p><strong>Methods: </strong>The historical information reported here reflect the memories of Drs. Richard J. Santen and Laurence L. Demers and comprehensive documentation provided in the literature references cited.</p><p><strong>Results: </strong>The project of development of aromatase inhibitors began with the mis-assumption that the regimen of aminoglutethimide and hydrocortisone represented a \"medical adrenalectomy\" and primarily represented the blockade of adrenal steroidogenesis. Later studies demonstrated that aminoglutethimide blocked the aromatase enzyme by 95-98%. A key research step involved isotopic kinetic studies in post-menopausal women using ³H-androstenedione and ¹⁴C estrone to precisely measure aromatase under equilibrium conditions. Dr. William L. McGuire provided major advice to the investigators, suggested enlistment of key collaborators, provided laboratory assistance in measuring ER levels, and facilitated funding for the studies. Observational studies involved 147 patients treated with the AG/HC regimen and the results demonstrated efficacy of the regimen. Later, randomized controlled trials demonstrated the equivalence of this regimen to surgical adrenalectomy and tamoxifen. In order eliminate the need for HC, three selective inhibitors of aromatase were developed and shown to induce remissions statistically significantly greater than achieved with the anti-estrogen, tamoxifen.</p><p><strong>Conclusion: </strong>These studies provided definitive evidence of the superiority of aromatase inhibitors over tamoxifen in postmenopausal women with hormone responsive breast cancer.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"219 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788126","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}