Breast Cancer Research and Treatment最新文献

{"title":"Trastuzumab therapy and new-onset hypertension in adolescents and young adults with breast cancer.","authors":"Renata Abrahão, Kathryn J Ruddy, Cecile A Laurent, Jessica Chubak, Eric C Haupt, Ann M Brunson, Erin E Hahn, Chun R Chao, Lisa M Moy, Ted Wun, Lawrence H Kushi, Theresa H M Keegan, Candice A M Sauder","doi":"10.1007/s10549-025-07760-0","DOIUrl":"https://doi.org/10.1007/s10549-025-07760-0","url":null,"abstract":"<p><strong>Background: </strong>Trastuzumab therapy carries a risk of acute cardiotoxicity, particularly when combined with anthracyclines. To date, no study has assessed hypertension as a potential long-term adverse effect of trastuzumab therapy in adolescent and young adult (AYA) cancer survivors.</p><p><strong>Methods: </strong>We identified all female AYAs aged 15-39 years diagnosed with first primary invasive breast cancer between 2006 and 2020 in Kaiser Permanente Northern and Southern California, who survived at least 2 years post-diagnosis. Patients were categorized into two groups: those who received chemotherapy plus trastuzumab and those who received chemotherapy alone. We examined hypertension occurrence starting 2 years post-diagnosis, compared the 2-5-year cumulative incidence of hypertension between the trastuzumab and non-trastuzumab groups, and evaluated associated risk factors.</p><p><strong>Results: </strong>Among 2382 female AYAs with breast cancer, 33.0% received trastuzumab. The 2-5-year cumulative incidence of hypertension did not differ between the trastuzumab (6.79%, 95% Confidence Interval [CI] 4.96-8.99%) and non-trastuzumab (7.85%, CI 6.41-9.48%) groups, p = 0.67. Trastuzumab was not associated with hypertension (hazard ratio (HR) = 1.01, CI 0.731-1.38) in multivariable analysis. Factors associated with higher hypertension included older age at diagnosis (35-39 vs. 15-34y), non-Hispanic Black or non-Hispanic Asian race/ethnicity (vs. non-Hispanic White), overweight or obesity (vs. underweight or normal weight), smoking, and endocrine therapy. History of diabetes and dyslipidemia showed borderline association with hypertension.</p><p><strong>Conclusion: </strong>Trastuzumab was not associated with new-onset hypertension among AYA breast cancer survivors. However, sociodemographic and clinical factors significantly contributed to hypertension risk, highlighting the importance of interventions targeting modifiable risk factors.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504849","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 use of indocyanine green and technetium-99 for dual-tracer sentinel lymph node biopsy in breast cancer.","authors":"Madison Kolbow, Qianyun Luo, Alicia Cerrato Grande, Schelomo Marmor, Jennifer Witt, Sydne Muratore, Todd M Tuttle, Jane Y C Hui","doi":"10.1007/s10549-025-07767-7","DOIUrl":"https://doi.org/10.1007/s10549-025-07767-7","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to determine if indocyanine green (ICG) is a suitable replacement for blue dye for dual-tracer sentinel lymph node biopsy (SLNB).</p><p><strong>Methods: </strong>A single-center retrospective review of female breast cancer patients aged ≥ 18 years who underwent SLNB with technetium-99 (Tc⁹⁹) and ICG was performed from November 2022 to April 2024. Operative reports were reviewed to determine sentinel lymph node (SLN) identification rates with ICG (fluorescent) and Tc⁹⁹ (radioactive). Pathology reports were reviewed to determine the pathology of excised SLNs.</p><p><strong>Results: </strong>One hundred and nineteen SLNBs were performed on 117 patients. At least one radioactive or fluorescent SLN was identified in 93.2% of all patients. The mean number of SLNs retrieved per SLNB was 1.6 (fluorescent, 1.5; radioactive, 1.5). Of all excised SLNs, 89.4% were fluorescent, 88.4% were radioactive, and 81.9% were both fluorescent and radioactive. SLN metastases were present in 26 patients (22.2%); of SLNs identified with metastases on pathologic examination, 87.2% were fluorescent, 74.4% were radioactive, and 71.8% were both radioactive and fluorescent. Two patients (1.7%) experienced skin flap necrosis and one patient (0.9%) experienced prolonged skin discoloration. No patients experienced allergic reactions.</p><p><strong>Conclusion: </strong>This study demonstrates that SLN identification rates using ICG and Tc⁹⁹ are comparable to those using blue dye and Tc⁹⁹. Thus, ICG is a suitable alternative for blue dye. Future work should assess if ICG is a suitable tracer for SLNB in low-resource settings where Tc⁹⁹ is not available.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504848","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":"Analysis of the impact of the COVID-19 pandemic on the stage at diagnosis in breast cancer patients at a French comprehensive cancer centre, through two different methods: a preliminary study.","authors":"Zago Alessandra, Lévêque Emilie, Augustynen Aline, Leheurteur Marianne, Ottaviani Marie, Loeb Agnès, Vermeulin Thomas","doi":"10.1007/s10549-025-07762-y","DOIUrl":"https://doi.org/10.1007/s10549-025-07762-y","url":null,"abstract":"<p><strong>Purpose: </strong>In early 2020, the Coronavirus-19 (COVID-19) pandemic led to widespread lockdowns, disrupting cancer-screening programs and limiting access to care. Although a temporary drop in new breast cancer diagnosis had been noted, variations in stage of disease have been explored less frequently, and with methodological approaches that might lead to imprecise or approximative results. This preliminary study aimed to assess possible variations in breast cancer stage at diagnosis over a long-time period using two different approaches.</p><p><strong>Methods: </strong>We analysed data from 3 787 women with invasive breast cancer treated at our comprehensive cancer centre between 2017 and 2022. We evaluated changes in proportions of staging parameters using two different approaches: a traditional \"pre-to-post pandemic\" traditional comparison and time series models. The latter included ARIMA (AutoRegressive Integrated Moving Average) models, complemented by the research of potential significant estimated structural breakpoints over time in linear regression models.</p><p><strong>Results: </strong>The pre-to-post comparison suggested an overall positive overview of the differences observed before and after the pandemic. However, ARIMA and logistic models demonstrated a relative stability in tumour size and metastatic status, with only one significant breakpoint observed: a shift in the rate of patients with no lymph node involvement (N0), likely unrelated to the pandemic.</p><p><strong>Conclusions: </strong>This is the first study to assess changes in breast cancer stage at diagnosis using time series and structural breakpoint analysis over an extended period. Our preliminary results highlight the importance of using advanced statistical techniques when evaluating the impact of systemic disruptions (like COVID-19) on cancer care.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504847","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":"Socioeconomic status impacts tumor biology, treatment, and outcomes in over 200,000 patients with invasive lobular carcinoma of the breast: an analysis of the National Cancer Database.","authors":"Mandeep Kaur, Astrid Quirarte, Amy M Shui, Anna Vertido, Elle Clelland, Harriet Rothschild, Laura J Esserman, Cheryl Ewing, Rita A Mukhtar","doi":"10.1007/s10549-025-07769-5","DOIUrl":"https://doi.org/10.1007/s10549-025-07769-5","url":null,"abstract":"<p><strong>Purpose: </strong>While the impact of socioeconomic factors on breast cancer diagnosis, treatment, and outcomes are well-documented, few studies have focused on invasive lobular carcinoma (ILC), the second most common type of breast cancer. We evaluated the relationships between race and socioeconomic status (SES) with clinicopathological characteristics and outcomes in patients with stage I-III ILC using the National Cancer Database (NCDB).</p><p><strong>Methods: </strong>We used the NCDB, a national oncology database, to evaluate insurance status, a composite measure of SES (education and income), clinicopathological characteristics, and outcomes in patients with stage I-III ILC. Clinicopathologic variables included tumor size, presence of lymphovascular invasion (LVI), and tumor receptor subtype (hormone receptor, HR), and tumor grade. Overall survival was analyzed with multivariable Cox proportional hazards models.</p><p><strong>Results: </strong>We identified 269,657 patients with stage I-III ILC. Patients in the Medicaid/no insurance group and those with lower SES had larger tumors, more positive lymph nodes, fewer HR+ tumors, and higher-grade tumors. Those in the low SES group had higher rates of chemotherapy use and, in those with HR+ tumors, lower rates of endocrine therapy use. In a multivariable model adjusting for SES, self-identified race/ethnicity, age, stage, receptor subtype, grade, treatment, and Charlson-Deyo score, patients with low SES had a 24% higher risk of death by 5 years compared to patients with high SES (HR 1.24, 95% CI 1.19-1.30, p < 0.001).</p><p><strong>Conclusion: </strong>While our study confirms several known disparities in the presentation, outcomes, and treatment of breast cancer, this is the first evaluation to assess how different components of SES influence ILC specifically.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494643","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 deltopectoral lymph node: a potential protective biomarker for breast cancer-related lymphedema.","authors":"James E Fanning, Angela Chen, Sarah Thomson, Elizabeth Tillotson, Aaron Fleishman, John A Parker, Kevin Donohoe, Dhruv Singhal","doi":"10.1007/s10549-025-07748-w","DOIUrl":"https://doi.org/10.1007/s10549-025-07748-w","url":null,"abstract":"<p><strong>Background: </strong>The lateral upper arm lymphatic pathway is theorized as a route of superficial lymphatic drainage protective against breast cancer-related lymphedema (BCRL) after axillary lymph node dissection (ALND). This study describes lymph nodes draining the lateral upper arm pathway.</p><p><strong>Methods: </strong>Healthy female volunteers underwent bilateral ICG lymphography and nuclear lymphoscintigraphy. Nuclear tracer was injected over the cephalic vein in the upper arm. Lymph nodes with tracer uptake were recorded as deltopectoral, Station 1 (Axillary Levels I or II and Interpectoral), or Station 2 (Axillary Level III, Infraclavicular, Supraclavicular Levels IV or Vb, and Cervical Level Va).</p><p><strong>Results: </strong>72 arms of 36 volunteers were included. Functional drainage to deltopectoral lymph nodes was observed in 38% (27/72) of arms. Drainage to Station 1, Station 2, and neither station was observed in 96% (69/72), 36% (26/72), and 3% (2/72) of arms, respectively. No differences were observed between arms with or without deltopectoral lymph nodes draining to Station 1 lymph nodes (93% vs 98%, p = 0.286) or neither station (4% vs 2%, p = 0.711), respectively. A significant difference was observed between arms with or without deltopectoral lymph nodes draining to Station 2 lymph nodes (52% vs 27%, p = 0.031).</p><p><strong>Conclusions: </strong>Deltopectoral lymph node drainage is significantly correlated with Station 2 lymph node drainage. As Station 2 lymph nodes are preserved in an ALND, the presence of deltopectoral lymph node drainage represents an important potential protective biomarker for BCRL development.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494644","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":"Adjunctive statistical standardization of quantitated adjuvant HER2 and ultra-low HER2 in Canadian Cancer Trials Group MA.27 trial of exemestane versus anastrozole.","authors":"Judith-Anne W Chapman, Jane Bayani, Sandip SenGupta, John M S Bartlett, Tammy Piper, Mary Anne Quintayo, Shakeel Virk, Paul E Goss, James N Ingle, Matthew J Ellis, George W Sledge, G Thomas Budd, Manuela Rabaglio, Rafat H Ansari, Richard Tozer, David P D'Souza, Haji Chalchal, Silvana Spadafora, Vered Stearns, Edith A Perez, Karen A Gelmon, Timothy J Whelan, Catherine Elliott, Lois E Shepherd, Bingshu E Chen, Karen J Taylor","doi":"10.1007/s10549-025-07749-9","DOIUrl":"https://doi.org/10.1007/s10549-025-07749-9","url":null,"abstract":"<p><strong>Purpose: </strong>Statistically standardized estrogen receptor (ER) and progesterone receptor (PgR) differentiated prognosis. Here we examined statistically standardized human epidermal growth receptor 2 (HER2).</p><p><strong>Methods: </strong>CCTG MA.27 (NCT00066573) was an adjuvant phase III trial of exemestane versus anastrozole in postmenopausal women with ER + and/or PgR + tumors. We centrally quantitated machine-image immunohistochemical HER2, defined American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) dual-probe FISH HER2/CEP17 categories, determined ultra-low HER2 (IHC 0 with (0,10%] 1 + stain), and standardized HER2 to mean 0, standard deviation 1. Univariate distant disease-free survival (DDFS) was described with Kaplan-Meier plots and examined with Wilcoxon (Peto-Prentice) test statistic. Adjusted Cox multivariable regressions 2-sided Wald tests had nominal significance p < 0.05.</p><p><strong>Results: </strong>Of 7576 women, 2900 had ER results; 2726, PgR; 2680, HER2; and 2325, ER/PgR/HER2 for multivariable investigations. ASCO/CAP categorization significantly differentiated univariate DDFS (p = 0.01), although not values of IHC 0 (N = 864) and ultra-low HER2 (N = 1143). Statistical standardization did not differentiate univariate DDFS (p = 0.08-0.27); however, (natural logarithm-) standardized values ≤ - 1.0 (ultra-low 1 + /2 + /3 + HSCORE, or % + , < 0.1) were similar to > 1.0 (HSCORE > 19; % +  > 14). Neither ASCO/CAP, nor statistically standardized, ER (p = 0.65-0.94) or HER2 (p = 0.20-0.97) were associated with DDFS in models with PgR; higher PgR had better DDFS (p ≤ .003).</p><p><strong>Conclusions: </strong>ASCO/CAP categories significantly differentiated DDFS, while statistical standardization did not. Patients with ultra-low HER2 and IHC 0 without stain had similar 5-year DDFS, while standardization indicated similar prognosis for very low 1 + /2 + /3 + and highest HER2 stain. We caution about assessment of ultra-low, or very low, HER2 due to HER2 assay dynamic range.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474021","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":"Area deprivation index and breast cancer outcomes among patients in Western New York.","authors":"Malak Alharbi, Jayasree Krishnan, Arya Mariam Roy, Archit Patel, Ankita Kapoor, Riya Patel, Kayla Catalfamo, Kristopher Attwood, Han Yu, Varsha Gupta, Sheheryar Kabraji, Kazuaki Takabe, Thaer Khoury, Ellis Levine, Angela Omilian, Elizabeth Bouchard, Song Yao, Shipra Gandhi","doi":"10.1007/s10549-025-07733-3","DOIUrl":"10.1007/s10549-025-07733-3","url":null,"abstract":"<p><strong>Background: </strong>Several studies have shown that residing in regions with high area deprivation index (ADI) is associated with worse outcomes. We evaluated associations between ADI and breast cancer (BC) outcomes among patients in Western New York (WNY), a region that includes multiple underserved areas.</p><p><strong>Methods: </strong>This retrospective, single-institution study analyzed data from 404 BC patients diagnosed between 2014 and 2018. Demographic and clinicopathological data were abstracted. Data were compared between high (≥ 60) and low (< 60) ADI groups, reflective of high and low levels of socioeconomic disadvantage, respectively. The primary objective was overall survival (OS) by ADI. Secondary objectives included assessment of recurrence free survival (RFS) or time to next treatment (TNT) by ADI and frequency of germline and somatic testing.</p><p><strong>Results: </strong>Over half of the patients (59%) resided in ADI ≥ 60. 77% of patients had stage I-III BC and 23% had de novo metastatic BC. Patients in ADI ≥ 60 had a lower 5-year OS rate (73%) than those in ADI < 60 (84%) (95%CI: 67.5-79.7, P = 0.05). In multivariable analysis, similar trend was observed but was not statistically significant (HR 1.56, 95%CI: 0.98-2.46, P = 0.058). There were no differences in TNT or RFS by ADI. Germline testing was performed less frequently (33%) in ADI ≥ 60 than ADI < 60 group (45%) (P = 0.04) for patients with stage I-III BC, while no difference observed for stage IV patients. Finally, prevalence of somatic mutations in TP53, PIK3CA, and ESR1 were higher in ADI ≥ 60.</p><p><strong>Conclusions: </strong>We observed a trend towards worse OS in areas with high ADI, though not statistically significant. The incidence of germline testing was lower in high ADI compared to low ADI regions.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367895","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":"Correction: Evaluating the impact of histological vs. nuclear grading on CPS + EG Score for HR + /HER2-early breast cancer.","authors":"M Braun, M Hamann, C Hanusch, A Andrulat, E Bensmann, M Pölcher, M Beer, E Huber","doi":"10.1007/s10549-025-07755-x","DOIUrl":"https://doi.org/10.1007/s10549-025-07755-x","url":null,"abstract":"","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324488","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 pretreatment lab abnormalities on the time-to-treatment discontinuation and overall survival of metastatic breast cancer patients receiving CDK 4/6i, PI3Ki, and/or mTORi.","authors":"Jeffrey Franks, Andres Azuero, Kelly Kenzik, Nusrat Jahan, Mackenzie Fowler, Russell Griffin, Gabrielle Rocque","doi":"10.1007/s10549-025-07751-1","DOIUrl":"https://doi.org/10.1007/s10549-025-07751-1","url":null,"abstract":"<p><strong>Purpose: </strong>Metastatic breast cancer (MBC) randomized controlled trials (RCTs) enroll healthier patients than the general population; however, many women have a lab abnormality at the time of their diagnosis, RCTs inadequately represent this patient population. To better understand this population, this study estimated time-to-treatment discontinuation (TTD) and overall survival (OS) for patients with and without lab abnormalities receiving a targeted therapy for MBC.</p><p><strong>Methods: </strong>This retrospective study used the nationwide, de-identified electronic health record-derived Flatiron Health database to include women with hormone receptor-positive, Human epidermal growth factor receptor 2- negative MBC with receipt of a targeted therapy between 2011 and 2020. Abnormalities were defined by common exclusionary cut-offs in targeted therapy clinical trials. TTD was defined as time from treatment initiation to the first occurrence of either treatment change or death. The secondary outcome was OS defined as time from treatment initiation to death from any cause. Accelerated failure time models estimating the survival time ratio, predicted mean survival time differences, and 95% confidence intervals (CIs) were used for the association between lab abnormalities and TTD or OS.</p><p><strong>Results: </strong>Among patients with receipt of a CDK 4/6 inhibitor, patients with at least one lab abnormality had a 33% shorter TTD (MR 0.67; 95% CI 0.59, 0.68) and 25% shorter OS (MR 0.75; 95% CI 0.70, 0.81) than those with no lab abnormalities. More modest differences were seen in TTD and OS for patients with receipt of Everolimus or Alpelisib. Patients saw the largest impact with liver abnormalities with 25% to 45% shorter TTD and 38% to 66% shorter OS across the treatment types. Interestingly, while only patients with receipt of a CDK 4/6i saw significantly shorter TTD for patients with blood abnormalities, patients with receipt of Alpelisib additionally saw shorter OS.</p><p><strong>Conclusion: </strong>Patients with lab abnormalities saw significantly lower TTD and OS than those without abnormalities. Patients with liver abnormalities saw significantly shorter TTD and OS across all treatments likely driving this association. More real-world studies of patients with lab abnormalities are needed to empower oncologists when making treatment decisions in high-risk populations, to discuss prognosis and to inform RCT eligibility criteria.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324489","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":"Mammographic calcifications association with risk of advanced breast cancer.","authors":"Karla Kerlikowske, Linn Abraham, Brian L Sprague, Olivia Sattayapiwat, Sarah J Nyante, Jeffrey A Tice, Diana L Miglioretti","doi":"10.1007/s10549-025-07753-z","DOIUrl":"https://doi.org/10.1007/s10549-025-07753-z","url":null,"abstract":"<p><strong>Purpose: </strong>Mammographic calcifications on mammograms with a negative/benign assessment are associated with increased breast cancer risk. Associations with advanced breast cancer risk are unknown. We evaluated whether calcifications recorded on mammography reports are associated with advanced invasive breast cancer risk.</p><p><strong>Methods: </strong>We included 3,710,313 screening mammograms with a negative/benign final assessment performed on 991,991 women aged 40-74 in the Breast Cancer Surveillance Consortium associated with 7229 advanced cancers. We calculated cumulative 5-year advanced (prognostic pathologic stage ≥II) breast cancer risk and hazards ratios (HR) adjusted for clinical risk factors according to presence or absence of calcifications by menopausal status, dense (heterogeneously or extremely dense) vs. non-dense (almost entirely fatty or scattered fibroglandular density) breasts, body mass index (BMI) < 25 kg/m² vs. ≥ 25 kg/m².</p><p><strong>Results: </strong>Prevalence of calcifications was 6.1% among women who developed advanced breast cancer vs. 3.6% among others. Overall associations of advanced cancer with calcifications were similar for premenopausal (HR = 1.4; 95% CI 1.1-1.9) and postmenopausal (HR = 1.5; 95% CI 1.2-1.7) women. Compared to postmenopausal women with non-dense breasts and BMI < 25 kg/m² without calcifications [cumulative 5-year advanced cancer incidence = 1.6 (95% CI 1.3-2.0) per 1000 women], postmenopausal women with dense breasts, BMI ≥ 25 kg/m², and calcifications had 5.5-fold (95% CI 3.9-7.7) higher advanced cancer risk [cumulative 5-year advanced cancer incidence = 10.2; (95% CI 7.0-13.3) per 1000 women]. Results were similar for premenopausal women.</p><p><strong>Conclusion: </strong>Mammographic calcifications increase advanced cancer risk beyond having dense breasts and being overweight/obese. Future research should investigate strength of associations by type of calcification and incorporation of calcifications into advanced cancer risk models for improvement in model accuracy.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315897","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}