Katy Cooper, Gamze Nalbant, Munira Essat, Sue Harnan, Ruth Wong, Jean Hamilton, Uzma S Asghar, Nicolò M L Battisti, Lynda Wyld, Paul Tappenden
{"title":"Gene expression profiling tests to guide adjuvant chemotherapy decisions in lymph node-positive early breast cancer: a systematic review.","authors":"Katy Cooper, Gamze Nalbant, Munira Essat, Sue Harnan, Ruth Wong, Jean Hamilton, Uzma S Asghar, Nicolò M L Battisti, Lynda Wyld, Paul Tappenden","doi":"10.1007/s10549-024-07596-0","DOIUrl":"10.1007/s10549-024-07596-0","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the effectiveness of gene expression profiling tests to inform adjuvant chemotherapy decisions in people with hormone receptor-positive (HR+), lymph node-positive (LN+) breast cancer.</p><p><strong>Methods: </strong>This systematic review assessed the effectiveness of Oncotype DX, Prosigna, EndoPredict and MammaPrint for guiding adjuvant chemotherapy decisions in HR+ early breast cancer with 1-3 positive nodes, in terms of prognostic ability, prediction of chemotherapy benefit, impact on chemotherapy decisions, quality of life and anxiety. Searches covered MEDLINE, EMBASE and Cochrane databases in April 2023.</p><p><strong>Results: </strong>Fifty-five articles were included. All four tests were prognostic for distant recurrence in LN+ patients. The RxPONDER trial reported no chemotherapy benefit in post-menopausal LN+ patients with low Oncotype DX (RS 0-25), whilst pre-menopausal patients had statistically significant chemotherapy benefit. An RCT reanalysis of Oncotype DX (SWOG-8814) suggested greater chemotherapy benefit with higher RS in post-menopausal LN+ patients. The MINDACT trial reported that LN+ patients with high clinical risk and low MammaPrint risk had a non-statistically significant chemotherapy benefit, but was not designed assess differential chemotherapy benefit per risk group. Decisions to undergo chemotherapy reduced by 12-75% following Oncotype DX testing in LN+ patients in the UK and Europe. No studies in LN+ populations were identified for prediction of chemotherapy benefit by Prosigna or EndoPredict; or for chemotherapy decisions for Prosigna, EndoPredict or MammaPrint; or for anxiety or quality of life impact for any test.</p><p><strong>Conclusions: </strong>All four tests have prognostic ability in LN+ patients. Evidence on predictive benefit is weaker, with equivocal evidence that Oncotype DX may predict chemotherapy benefit in LN+ post-menopausal patients. Use of Oncotype DX leads to fewer patients being recommended chemotherapy.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"229-247"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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
{"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}
Julie Williamson, Kristen Kelley, Mary Beth Scholand, Christine Crossno, Shelly Hummert, Patricia Jeppson, Holly Jacobson, Saundra Buys
{"title":"Efficacy of a novel interstitial lung disease monitoring program in breast cancer patients undergoing treatment with trastuzumab-deruxtecan.","authors":"Julie Williamson, Kristen Kelley, Mary Beth Scholand, Christine Crossno, Shelly Hummert, Patricia Jeppson, Holly Jacobson, Saundra Buys","doi":"10.1007/s10549-024-07586-2","DOIUrl":"10.1007/s10549-024-07586-2","url":null,"abstract":"<p><strong>Purpose: </strong>Interstitial lung disease (ILD) is a well described and potentially fatal complication of trastuzumab-deruxtecan (T-DXd). It is currently unknown if specific monitoring is beneficial in the early detection of ILD in these patients. We describe the efficacy and feasibility of a novel ILD monitoring protocol in breast cancer patients treated with T-DXd at our institution.</p><p><strong>Methods: </strong>An ILD monitoring protocol developed at our institution included baseline and ongoing monitoring with pulmonary function testing (PFTs) and high-resolution chest computed tomography (HRCT) at pre-specified intervals. Patients with metastatic HER2+ or HER2-low breast cancer treated at Huntsman Cancer Institute who received ≥ 1 cycle of T-DXd between 2020 and 2023 were included (n = 68). Patient outcomes and provider adherence to the protocol were retrospectively evaluated. Providers were classified as \"no adherence\" if they did not elect to participate in any elements of the recommended protocol or as \"some adherence\" if they had at least some monitoring per protocol.</p><p><strong>Results: </strong>10 cases of ILD were identified with an incidence of 12% (3/25) in the no adherence group and 16% (7/43) in the some adherence group. ILD cases in the no adherence group included one grade 2 and two grade 5 cases. The some adherence group included three grade 1 and four grade 2 cases.</p><p><strong>Conclusion: </strong>An ILD monitoring protocol consisting of baseline PFTs and ongoing monitoring with PFTs and HRCT is a feasible approach as evidenced by a majority provider adherence rate. This type of protocol may be effective in preventing severe cases of ILD and identifying grade 1 events that may permit treatment re-challenge.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"487-491"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999678","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":"Targeting BMP-1 enhances anti-tumoral effects of doxorubicin in metastatic mammary cancer: common and distinct features of TGF-β inhibition.","authors":"Nuray Erin, Esra Tavşan, Seren Haksever, Azmi Yerlikaya, Chiara Riganti","doi":"10.1007/s10549-024-07592-4","DOIUrl":"10.1007/s10549-024-07592-4","url":null,"abstract":"<p><strong>Purpose: </strong>Mammary carcinoma is comprised heterogeneous groups of cells with different metastatic potential. 4T1 mammary carcinoma cells metastasized to heart (4THM), liver (4TLM) and brain (4TBM) and demonstrate cancer-stem cell phenotype. Using these cancer cells we found thatTGF-β is the top upstream regulator of metastatic process. In addition, secretion of bone morphogenetic protein 1 (BMP-1), which is crucial for the proteolytic release of TGF-β, was markedly high in metastatic mammary cancer cells compared to non-metastatic cells. Although TGF-β inhibitors are in clinical trials, systemic inhibition of TGF-β may produce heavy side effects. We here hypothesize that inhibition of BMP-1 proteolytic activity inhibits TGF-β activity and induces anti-tumoral effects.</p><p><strong>Method and results: </strong>Effects of specific BMP-1 inhibitor on liver and brain metastatic murine mammary cancer cells (4TLM and 4TBM), as well as on human mammary cancer MDA-MB-231 and MCF-7 cells, were examined and compared with the results of TGF-β inhibition. Inhibition of BMP-1 activity markedly suppressed proliferation of cancer cells and enhanced anti-tumoral effects of doxorubicin. Inhibition of BMP-1 activity but not of TGF-β activity decreased colony and spheroid formation. Differential effects of BMP-1 and TGF-β inhibitors on TGF-β secretion was also observed.</p><p><strong>Conclusions: </strong>These results demonstrated for the first time that the inhibition of BMP-1 activity has therapeutic potential for treatment of metastatic mammary cancer and enhances the anti-tumoral effects of doxorubicin.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"563-574"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944696","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}
Manisha Bahl, Ashwini Kshirsagar, Scott Pohlman, Constance D Lehman
{"title":"Traditional versus modern approaches to screening mammography: a comparison of computer-assisted detection for synthetic 2D mammography versus an artificial intelligence algorithm for digital breast tomosynthesis.","authors":"Manisha Bahl, Ashwini Kshirsagar, Scott Pohlman, Constance D Lehman","doi":"10.1007/s10549-024-07589-z","DOIUrl":"10.1007/s10549-024-07589-z","url":null,"abstract":"<p><strong>Purpose: </strong>Traditional computer-assisted detection (CADe) algorithms were developed for 2D mammography, while modern artificial intelligence (AI) algorithms can be applied to 2D mammography and/or digital breast tomosynthesis (DBT). The objective is to compare the performance of a traditional machine learning CADe algorithm for synthetic 2D mammography to a deep learning-based AI algorithm for DBT on the same mammograms.</p><p><strong>Methods: </strong>Mammographic examinations from 764 patients (mean age 58 years ± 11) with 106 biopsy-proven cancers and 658 cancer-negative cases were analyzed by a CADe algorithm (ImageChecker v10.0, Hologic, Inc.) and an AI algorithm (Genius AI Detection v2.0, Hologic, Inc.). Synthetic 2D images were used for CADe analysis, and DBT images were used for AI analysis. For each algorithm, an overall case score was defined as the highest score of all lesion marks, which was used to determine the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>The overall AUC was higher for 3D AI than 2D CADe (0.873 versus 0.693, P < 0.001). Lesion-specific sensitivity of 3D AI was higher than 2D CADe (94.3 versus 72.6%, P = 0.002). Specificity of 3D AI was higher than 2D CADe (54.3 versus 16.7%, P < 0.001), and the rate of false marks on non-cancer cases was lower for 3D AI than 2D CADe (0.91 versus 3.24 per exam, P < 0.001).</p><p><strong>Conclusion: </strong>A deep learning-based AI algorithm applied to DBT images significantly outperformed a traditional machine learning CADe algorithm applied to synthetic 2D mammographic images, with regard to AUC, sensitivity, and specificity.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"529-537"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944708","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}
Meng Yue, Jianing Zhao, Si Wu, Lijing Cai, Xinran Wang, Ying Jia, Xiaoxiao Wang, Yongjun Wang, Yueping Liu
{"title":"Establishment of multiple machine learning prognostic model for gene differences between primary tumors and lymph nodes in luminal breast cancer.","authors":"Meng Yue, Jianing Zhao, Si Wu, Lijing Cai, Xinran Wang, Ying Jia, Xiaoxiao Wang, Yongjun Wang, Yueping Liu","doi":"10.1007/s10549-024-07574-6","DOIUrl":"10.1007/s10549-024-07574-6","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the correlation between primary tumors (PT) and paired metastatic lymph nodes (LN) and to develop a predictive model to provide evidence for forecasting patient prognoses.</p><p><strong>Methods: </strong>We obtained single-cell and bulk transcriptome data from the Gene Expression Omnibus database. Furthermore, mRNA transcriptomic data, encompassing 112 normal tissues and 1066 breast cancer samples, along with survival, clinical, and mutation information for breast cancer patients, were acquired from The Cancer Genome Atlas (TCGA). Employing a machine learning integration framework incorporating ten distinct algorithms, we developed and validated a prognostic model.</p><p><strong>Results: </strong>We constructed a prognostic model named Lymph Node Metastasis-Related Scores (LMRS) using 26 differentially expressed genes trained on eight TCGA datasets. Across validation sets, the model demonstrated a high C-index, signifying its stability and effectiveness, outperforming 64 models from other studies. Notably, cytolytic activity and T cell co-stimulation were downregulated in the high LMRS group, alongside a downregulation of immune cells, including B cells, CD8 + T cells, iDCs, and TILs. Similarly, most immune checkpoints exhibited a decreasing trend with high LMRS expression. Finally, we selected the hub biomarkers PGK1 and HSP90 for pathological verification. Results indicated higher expression levels in PT and LN compared to normal and benign tumors, with higher expression levels in LN than in PT.</p><p><strong>Conclusion: </strong>This comprehensive analysis sheds light on gene expression differences between PT and LN in breast cancer, culminating in the development of a multiple-gene prognostic model with high clinical accuracy for prognosis prediction.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"365-376"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799331","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}
Mengyang Qi, Shuang Gao, Zhe Zhang, Ronggang Lang, Zhidong Huang, Jinhui Wang, Xiaolong Qian, Kuisheng Chen, Hong Liu
{"title":"Secretory breast carcinoma: a multicenter clinicopathologic study of 80 cases with emphasis on prognostic analysis and chemotherapy benefit.","authors":"Mengyang Qi, Shuang Gao, Zhe Zhang, Ronggang Lang, Zhidong Huang, Jinhui Wang, Xiaolong Qian, Kuisheng Chen, Hong Liu","doi":"10.1007/s10549-024-07583-5","DOIUrl":"10.1007/s10549-024-07583-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate clinicopathologic characteristics and prognosis in secretory breast carcinoma (SBC) and to determine chemotherapy benefits stratified by different subgroups.</p><p><strong>Methods: </strong>SBCs and triple-negative invasive ductal carcinoma patients (TN-IDCs) were enrolled from three cancer centers between January 2011 and December 2020. SBCs were further divided into two subgroups: those with triple negativity (TN-SBCs) and those without (non-TN-SBCs). Clinicopathologic characteristics were thoroughly compared among the three subgroups associated with triple negativity. Kaplan-Meier estimates and Cox proportional hazard models were performed for survival analysis.</p><p><strong>Results: </strong>A total of 80 SBCs and 310 TN-IDCs were included in the study. The TN-SBC subgroup consisted of 35 individuals (43.75%) with mild clinical behaviors and a satisfying prognosis in comparison to non-TN-SBCs and TN-IDCs. In SBCs, N stage (N1 vs. N0: HR = 11.176, 95% CI 0.843-148.132, p = 0.067; N2-3 vs. N0: HR = 30.409, 95% CI 1.378-671.169, p = 0.031), LNR (HR = 23.894, 95% CI 1.614-353.835, p = 0.021), and histological grade (HR = 28.634, 95% CI 2.745-298.703, p = 0.005) were significantly correlated with disease-free survival (DFS). Patients in high LNR group receiving chemotherapy achieved a prolonged DFS (p = 0.025), while chemotherapy did not confer a survival benefit in TN-SBCs of our interest (p = 0.12).</p><p><strong>Conclusion: </strong>TN-SBC is a unique entity with low malignant potential. Advanced N stage, high LNR, and advanced histological grade are adverse determinants of DFS in SBC. Adjuvant chemotherapy provides superior DFS in high LNR SBCs rather than TN-SBCs, hence it is recommended for high LNR SBCs.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"451-461"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892080","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}
Francesco Bettariga, Dennis R Taaffe, Cristina Crespo-Garcia, Timothy D Clay, Daniel A Galvão, Robert U Newton
{"title":"Effects of resistance training vs high intensity interval training on body composition, muscle strength, cardiorespiratory fitness, and quality of life in survivors of breast cancer: a randomized trial.","authors":"Francesco Bettariga, Dennis R Taaffe, Cristina Crespo-Garcia, Timothy D Clay, Daniel A Galvão, Robert U Newton","doi":"10.1007/s10549-024-07559-5","DOIUrl":"10.1007/s10549-024-07559-5","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer treatments often lead to unfavourable changes in body composition, physical fitness, and quality of life (QoL). We compared the effects of resistance training (RT) and high-intensity interval training (HIIT) on these outcomes in survivors of breast cancer.</p><p><strong>Methods: </strong>Twenty-eight survivors of breast cancer, post-treatment (Stage I-III), aged 55.5 ± 8.8 years and body mass index 27.9 ± 5 kg/m<sup>2</sup> were randomly allocated to a 12-week supervised RT (n = 14) or HIIT (n = 14) intervention, 3 days per week. Body composition (dual energy x-ray absorptiometry), upper and lower body muscle strength (1-repetition maximum), cardiorespiratory fitness (CRF) (Ekblom Bak Cycle Test), and QoL domains (EORTC QLQ-C30 and EORTC QLQ-BR45) were assessed at baseline and 12 weeks.</p><p><strong>Results: </strong>There were no significant differences between groups at baseline. Exercise attendance ranged from 81 to 85%. Between groups, there were significant differences (p ≤ 0.001) after 12 weeks in chest press strength for RT (mean difference [MD] = 4.7 kg) and CRF for HIIT (MD = 1.9 ml/min/kg). Within groups, there were significant improvements (p < 0.05) for % lean mass and % fat mass in both RT and HIIT, as well as for upper and lower body muscle strength, CRF, and QoL domains. No major adverse events were noted.</p><p><strong>Conclusion: </strong>Both exercise groups improved body composition, physical fitness, and QoL domains over 12 weeks of RT or HIIT, although mode-specific benefits were apparent with more substantial improvements in lean mass and muscle strength with RT and reductions in % fat mass and improved CRF with HIIT. Tailored exercise programs should address the specific health needs of each patient.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"261-270"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667264","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}
M Jogendran, J A Flemming, M Djerboua, M Korzeniowski, B E Wilson, S J Merchant, S Bennett
{"title":"The association between cirrhosis and outcomes among female patients undergoing surgery for breast cancer in Ontario: a population-based study.","authors":"M Jogendran, J A Flemming, M Djerboua, M Korzeniowski, B E Wilson, S J Merchant, S Bennett","doi":"10.1007/s10549-025-07612-x","DOIUrl":"10.1007/s10549-025-07612-x","url":null,"abstract":"<p><strong>Background: </strong>The association between cirrhosis and post-operative breast cancer outcomes has not been explored. We evaluated the association between cirrhosis and surgical outcomes in female patients with breast cancer.</p><p><strong>Methods: </strong>We performed a retrospective population-based cohort study of female patients undergoing surgery for breast cancer between 2007 and 2018 using health administrative data from Ontario, Canada. Patients were stratified by cirrhosis status. Overall survival (OS) was described using the Kaplan-Meier method and the association between cirrhosis and long-term cancer-specific mortality (CSM) was evaluated using adjusted competing risks regression and subdistribution hazard ratios (sHR).</p><p><strong>Results: </strong>A total of 902 patients with breast cancer and cirrhosis were compared to 81,514 patients with breast cancer without cirrhosis. The median age at diagnosis was 65 years vs 61 years in patients with and without cirrhosis, respectively (p < .001). The most common etiologies of cirrhosis were metabolic dysfunction-associated steatotic liver disease (n = 595, 66%) and alcohol-associated (n = 143, 16%) liver disease. The median model for end-stage liver disease sodium score was 8 (IQR 6-11, n = 215). Furthermore, cirrhosis was associated with a twofold higher 90-day rate of post-operative mortality (RR 2.82; 95% CI 1.49-5.33). OS was lower in patients with cirrhosis (HR 1.41, 95% CI 1.26-1.58); however, there was no association with CSM (sHR 1.11, 95% CI 0.93-1.32).</p><p><strong>Conclusion: </strong>This large population-based study demonstrates that patients with cirrhosis have lower OS compared to those without cirrhosis; however, there is no difference in CSM. Their outcomes remain favorable, and they should be considered for curative-intent therapies.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"749-758"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122129","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}
Aysel Bayram, Sidar Bagbudar, Hasan Karanlık, Neslihan Cabıoglu, Adnan Aydıner, Semen Onder, Ekrem Yavuz
{"title":"Estrogen receptor positivity in stromal cells of the tumor bed predicts the response to neoadjuvant chemotherapy for breast carcinoma.","authors":"Aysel Bayram, Sidar Bagbudar, Hasan Karanlık, Neslihan Cabıoglu, Adnan Aydıner, Semen Onder, Ekrem Yavuz","doi":"10.1007/s10549-024-07601-6","DOIUrl":"10.1007/s10549-024-07601-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine estrogen receptor (ER) expression in stromal cells in postchemotherapy tumor bed (PCTB) and its relationship with tumor regression and tumor characteristics.</p><p><strong>Methods: </strong>The study included 490 breast cancer patients who received neoadjuvant chemotherapy (NAC). We performed ER in stromal cells in all resection specimens and available pre-treatment core biopsy materials of 299 patients immunohistochemically.</p><p><strong>Results: </strong>Two hundred and forty-two (49.4%) cases were negative for ER in the stromal cells of the PCTB, and 248 (50.6%) cases were positive. ER-positive stromal cells in the PCTB correlated with a higher regression rate (90.2 vs 68.6%) and lower mean residual cancer burden value (1.366 vs 2.424) compared to ER-negative cases (p < 0.001). Stromal ER positivity was more prevalent in cases achieving pathologic complete response (pCR) (68.1%) compared to those without pCR (39.8%, p < 0.001). ER positivity in stromal cells was more common in non-luminal tumors than in luminal ones. Multivariate analysis identified stromal ER positivity (OR: 3.059, 95% CI [1.947-4.807], p < 0.001), intrinsic subtype (Odds ratio (OR): 1.477, 95% confidence interval (CI) [1.102-1.980], p = 0.009), and Ki67 index (OR: 1.028, 95% CI [1.104-1.041], p < 0.001) as independent predictors of pCR. In core biopsies before NAC, 270 cases (90.3%) and 29 cases (9.7%) were negative and positive in stromal cells, respectively. Out of the cases with ER-negativity in stromal cells before NAC, 132 (48.9%) converted to ER positivity in stromal cells of PCTB and displayed a high regression rate (89.8%).</p><p><strong>Conclusion: </strong>This is the first study regarding ER expression in the stroma of breast carcinoma that compares treatment response after NAC. We showed that the increase in ER positivity in the stromal cells of the PCTB is correlative with the complete response and tumor subtypes. In this manner, ER positivity in stromal cells will soon serve as a cornerstone for individualized treatment options.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"627-633"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944674","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}