Breast Cancer Research and Treatment最新文献

{"title":"Comparative effectiveness of CDK4/6 inhibitors in metastatic breast cancer: using the target trial emulation framework to investigate overall survival in routine care.","authors":"Adam M Brufsky, Richard S Finn, Otto Metzger, Rodrigo Goncalves, Cynthia Huang-Bartlett, Sameet Sreenivasan, Ula Nur, Jessica Davies, Alex Grigorenko, Gráinne H Long","doi":"10.1007/s10549-026-07935-3","DOIUrl":"10.1007/s10549-026-07935-3","url":null,"abstract":"<p><strong>Purpose: </strong>Cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) plus aromatase inhibitor (AI) is the recommended first-line treatment for hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer (mBC). CDK4/6i head-to-head trials have not been conducted, and randomized controlled trials (RCTs) report inconsistent overall survival (OS) results despite similar effects on the primary endpoint of progression-free survival. Real-world evidence can complement RCTs but selection biases and confounders can challenge interpretation. Target trial emulation applies the principles of RCTs to observational data to overcome such challenges. We emulated a hypothetical target trial to investigate whether causal differences in OS between patients receiving first-line CDK4/6i plus AI exist in the real-world clinical setting.</p><p><strong>Methods: </strong>We used de-identified data (Flatiron Health mBC Enhanced Data Mart) from patients ≥ 18 years old at primary diagnosis who were treated with first-line palbociclib/ribociclib/abemaciclib plus AI for mBC between 2018 and 2024. Statistical adjustments included stabilized inverse-probability weighting (sIPTW), investigation of missing data mechanisms, and analyses for unmeasured confounders.</p><p><strong>Results: </strong>2626 patients were included (palbociclib n = 1686; ribociclib n = 537; abemaciclib n = 403). After sIPTW, baseline characteristics were balanced between groups and there was no observable difference in real-world OS (ribociclib vs palbociclib, adjusted hazard ratio 1.00, 95% CI: 0.81-1.24; abemaciclib v palbociclib: 0.91, 95% CI: 0.74-1.14). Results were consistent after sensitivity analyses.</p><p><strong>Conclusion: </strong>Using target trial emulation, real-world OS is similar with palbociclib/ribociclib/abemaciclib plus AI. These findings may contribute to the development of combination strategies to improve clinical outcomes and to guide clinical decision-making.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372452","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 second- and third-line progression-free survival after progression on first-line CDK4/6 inhibitors in HR+/HER2- metastatic breast cancer by PAM50 intrinsic subtype: the SOLTI-1801 CDK-PREDICT study.","authors":"Pablo Tolosa, Isabel García-Fructuoso, Tomás Pascual, Olga Martínez-Sáez, Juan Miguel Cejalvo, Sonia Servitja, María Fernández Abad, Javier David Benitez Fuentes, Fara Brasó-Maristany, Ester Sanfeliu, Laura Lema, Yolanda Ruano, Lucía Parrilla, Ana María Roncero, María Ángeles Cobos, Irene Díaz, Karla Alicia Centelles López, Rodrigo Sánchez-Bayona, Manuel Alva, Ainhoa Madariaga, Guillermo Villacampa, Fernando Salvador, Agustín Sánchez-Belmonte, Marcos Malumbres, Aleix Prat, Eva Ciruelos","doi":"10.1007/s10549-026-07931-7","DOIUrl":"10.1007/s10549-026-07931-7","url":null,"abstract":"<p><strong>Purpose: </strong>Estrogen receptor-positive (ER+), HER2-negative (HER2-) metastatic breast cancer (MBC) shows variable outcomes after first-line CDK4/6 inhibitors (CDK4/6i) plus endocrine therapy (ET). The prognostic role of PAM50 intrinsic subtypes (IS) in this setting remains unestablished. We evaluated IS and biomarker profiles in the SOLTI-1801 CDK-PREDICT cohort, focusing on real-world second- and third-line progression-free survival (rwPFS-2L and rwPFS-3L).</p><p><strong>Methods: </strong>This multicenter observational study reports a post hoc secondary analysis of ER+ /HER2- MBC patients previously treated with first-line CDK4/6i plus ET. Baseline metastatic biopsies were molecularly profiled (PAM50, CCNE1, PDCD1) using the nCounter platform. rwPFS-2L and rwPFS-3L were defined from initiation of second- or third-line therapy to progression or death. Kaplan-Meier and Cox models assessed associations with clinical, molecular, and treatment variables.</p><p><strong>Results: </strong>Among evaluable patients (n = 125 for rwPFS-2L; n = 95 for rwPFS-3L), Luminal A/B subtypes represented most cases, while advanced lines showed more aggressive profiles. Median rwPFS-2L was 7.2 months in luminal IS vs. 6.1 in non-luminal (HR 1.40; 95% CI 0.86-2.30); the Basal-like (BL) subtype correlated with significantly shorter rwPFS-2L (HR 3.82; 95% CI 1.07-13.63). In rwPFS-3L, similar trends were seen (6.4 vs. 3.3 months; HR 1.74; 95% CI 0.98-3.08), with BL showing the poorest outcomes (HR 5.63; 95% CI 1.17-27.02). High CCNE1 expression was linked to shorter rwPFS-2L (HR 1.22; 95% CI 1.02-1.47). Targeted agents were frequent in 2L (51%) and capecitabine in 3L (36%), while endocrine monotherapy yielded poorest rwPFS.</p><p><strong>Conclusions: </strong>Outcomes after CDK4/6i progression differ by PAM50 IS, supporting its role in guiding post-progression treatment.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316254","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":"Effect of a supervised intermittent exercise program on insomnia in breast cancer patients undergoing chemotherapy.","authors":"Chloé Drozd, Elsa Curtit, Quentin Jacquinot, Pauline Roux, Sophie Paget-Bailly, Valérie Gillet, Nathalie Meneveau, Fabienne Mougin","doi":"10.1007/s10549-026-07923-7","DOIUrl":"10.1007/s10549-026-07923-7","url":null,"abstract":"<p><strong>Background: </strong>Patients with localized breast cancer receiving adjuvant chemotherapy often experience sleep disturbances, especially insomnia, which significantly impacts quality of life. This study primarily aimed to evaluate the effects of a 12-week exercise program on insomnia, with secondary outcomes on sleep quality, anxiety/depression, fatigue, pain, and exercise adaptation.</p><p><strong>Methods: </strong>In this randomized controlled multicenter trial, 20 women with non-metastatic breast cancer and clinically diagnosed insomnia were assigned to a control or training group. The training group underwent a 12-week supervised intermittent aerobic exercise program during chemotherapy. The primary outcome was objective total sleep time; secondary outcomes included insomnia severity, sleep architecture, sleep quality, anxiety/depression, fatigue, pain, and cardiorespiratory capacity. Assessments were performed before chemotherapy (T-1), at baseline (T0), and post-intervention (T3) using polysomnography, actigraphy, validated questionnaires, and a maximal graded exercise test.</p><p><strong>Results: </strong>The prevalence of clinical insomnia increased from 47% before diagnosis to 71% at T-1, reaching 100% at T0. Total sleep time did not increase after training (p = 0.97), although sleep fragmentation decreased. Clinical improvement was observed in physical and activity-related fatigue. Finally, both submaximal exercise adaptation parameters (power and VO₂/HR) and maximal parameters (power, VO₂ peak, VO₂/HR) significantly improved.</p><p><strong>Conclusions: </strong>The training did not increase total sleep time, likely due to insomnia's multifactorial origin. However, training yielded beneficial effects on objective sleep quality and exercise-induced adaptation. Future research is needed to investigate the various etiologies of insomnia to develop tailored and personalized management approaches.</p><p><strong>Clinical trials number: </strong>NCT04867096.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289269","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":"Baseline and early postoperative bioimpedance spectroscopy and perometry measurements in patients treated for breast cancer: insights from a prospective screening program.","authors":"Alexa J Taghian, Mahek Aggarwal, Amy M Shui, Kaeleigh O'Donnell, George E Naoum, Cheryl L Brunelle","doi":"10.1007/s10549-026-07926-4","DOIUrl":"10.1007/s10549-026-07926-4","url":null,"abstract":"<p><strong>Purpose: </strong>To describe bioimpedance spectroscopy (BIS) L-Dex values at breast cancer (BC) diagnosis and within the first year post-surgery in a cohort prospectively screened for breast cancer-related lymphedema (BCRL). We also aim to explore BCRL diagnostic overlap utilizing perometry and BIS thresholds.</p><p><strong>Methods: </strong>Patients undergoing treatment for unilateral BC were prospectively assessed for subclinical BCRL using BIS and perometry at preoperative baseline and during follow-up. Normal baseline scores were considered an absolute arm volume difference < 5% and an L-Dex score between -10 and + 10. BCRL was defined as relative volume change (RVC) ≥ 5% via perometry or L-Dex > 6.5 increase from preoperative baseline during follow-up.</p><p><strong>Results: </strong>The study cohort included 490 patients who underwent same-day perometry and BIS measurements at preoperative baseline, 306 of whom had same-day measurements postoperatively. At baseline, 99 patients (20.2%) had an absolute arm-volume difference ≥ 5%, and 39 patients (8.0%) had an L-Dex value > 6.5. Among patients with follow-up data (N = 306), 36 (11.8%) were diagnosed with BCRL using one or both tools. Of these, 16 patients (44.4%) were diagnosed by RVC-only, 17 (47.2%) by BIS-only, and 3 (8.3%) by both methods. Kaplan-Meier estimates for BCRL at 1, 2, and 3 years were 7.6%, 8.5% and 8.5% for RVC-only; 5.7%, 8.0%, and 15% for BIS-only; and 15%, 18%, and 25% via any method.</p><p><strong>Conclusion: </strong>Although BIS and perometry detected a comparable percentage of subclinical BCRL cases, they identified different individuals, indicating that combining both methods may increase case detection. Preoperative baseline measurements are imperative.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282302","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":"Prognostic significance of circulating tumor DNA in early breast cancer: a systematic review and meta-analysis.","authors":"L Sisca, M G Polito, M Silletta, A La Cesa, R Scafetta, M Donato, C M Gullotta, A Guarino, G Barnini, E Speziale, R Troiano, S Foderaro, M Iuliani, S Simonetti, S Cavalieri, S Calagna, A Cortellini, B Vincenzi, G Tonini, F Pantano","doi":"10.1007/s10549-026-07919-3","DOIUrl":"10.1007/s10549-026-07919-3","url":null,"abstract":"<p><strong>Background: </strong>Circulating tumor DNA (ctDNA) has emerged as a promising noninvasive biomarker for monitoring minimal residual disease (MRD) and predicting recurrence in early-stage breast cancer (EBC). Despite growing interest, the prognostic impact of ctDNA detection in this setting remains to be fully elucidated.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted on prospective studies assessing the association between ctDNA positivity and outcomes in early or locally advanced non-metastatic breast cancer. Databases including PubMed and the Cochrane Library were systematically searched. Studies were included if they reported hazard ratios (HRs) for disease-free survival (DFS) and/or overall survival (OS) according to ctDNA status. Pooled HRs were calculated using random-effects models; heterogeneity was evaluated with the I² statistic.</p><p><strong>Results: </strong>Eighteen studies comprising 1670 patients were included. ctDNA positivity was significantly associated with shorter DFS (pooled HR 6.92, 95% CI 3.64-13.13; p < 0.0001; I² = 79.7%). This association held across subtypes and timepoints, including post-surgical and longitudinal assessments. In the neoadjuvant setting, ctDNA positivity was associated with increased recurrence risk (HR 6.06, 95% CI 2.85-12.87; p < 0.0001), while in the adjuvant setting, it was an even stronger predictor of relapse (HR 14.76, 95% CI 1.11-197.02; p = 0.042). In a combined early-stage setting, ctDNA positivity correlated with significantly worse DFS (HR 6.55, 95% CI 1.41-30.39; p = 0.017). A non-significant trend was observed for worse OS (HR 3.91, 95% CI 0.78-19.72; p = 0.098).</p><p><strong>Conclusions: </strong>ctDNA positivity is a robust prognostic biomarker for recurrence in early breast cancer. Its integration into post-treatment surveillance and interventional trials may enable risk-adapted strategies and early therapeutic intervention.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269816","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":"Ovarian function suppression decision-making and uptake in premenopausal women with breast cancer: a mixed methods analysis.","authors":"N L Henry, L K Monkman, K Griffith, K Scheu, T Ghormley, J Armstrong, M Secor, D Jasthi, S T Hawley, T Guetterman","doi":"10.1007/s10549-026-07929-1","DOIUrl":"10.1007/s10549-026-07929-1","url":null,"abstract":"<p><strong>Purpose: </strong>Ovarian function suppression (OFS) reduces the risk of recurrence of hormone receptor-positive breast cancer but increases the likelihood of toxicity and nonpersistence with endocrine therapy. In addition, rates of OFS utilization are lower than expected. To increase understanding of these issues, we sought to identify patient factors associated with the use of OFS injections, as well as treatment decision-making and education needs.</p><p><strong>Methods: </strong>In this convergent mixed methods designed study, patients receiving OFS, who started then discontinued OFS injections, and who never initiated OFS injections underwent 1:1 semi-structured interviews and completed questionnaires on shared decision-making and medication beliefs.</p><p><strong>Results: </strong>Of 33 enrolled participants, 30 completed both the questionnaires and the interview. Median age was 43 (range 32-55), 24 were white (80%), and 20 (66.7%) had received chemotherapy. Four key themes emerged. (1) There was concern about need for more education, especially about short- and long-term side effects of OFS. (2) For those receiving OFS injections, the decision to take OFS was mainly due to a desire to reduce cancer recurrence risk. (3) For those who stopped OFS, injections were often used as a stop-gap measure, with a preference for permanence of oophorectomy. (4) For those who never took OFS, there was often perceived lack of strong physician recommendation.</p><p><strong>Conclusion: </strong>Tailored support for patients is needed to optimize decision-making regarding OFS, related to both potential benefits and risks of OFS in addition to adjuvant endocrine therapy. Educational strategies such as peer mentors or decision aids should be explored in this clinical setting.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269798","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":"Impact of immune-related adverse events on response to neoadjuvant chemoimmunotherapy in triple-negative breast cancer: a single-institution retrospective study.","authors":"Michelle Sterpi, Nechama Dreyfus, Yungtai Lo, Susan Fineberg, Harjot Gill, Della Makower","doi":"10.1007/s10549-026-07930-8","DOIUrl":"10.1007/s10549-026-07930-8","url":null,"abstract":"<p><strong>Purpose: </strong>Immune-related adverse events (irAEs) have emerged as a potential surrogate marker for immunotherapy response across tumor types. We evaluated the association between irAEs and pathologic complete response (pCR) in a racially diverse cohort of patients with triple-negative breast cancer (TNBC) treated with neoadjuvant chemoimmunotherapy.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 46 patients with early-stage TNBC treated with neoadjuvant chemoimmunotherapy between January 2021 and March 2023 at a single NCI-designated Comprehensive Cancer Center. irAEs, tumor-infiltrating lymphocytes (TILs), and clinicopathologic characteristics were abstracted from the medical record. Associations with pCR were analyzed using Fisher's exact and Wilcoxon rank-sum tests.</p><p><strong>Results: </strong>Among 46 patients, the median age was 60.5 years. Most identified as Black (n = 27, 58.7%) or Hispanic (n = 14, 30.4%). irAEs occurred in 13 patients (28.2%), most commonly hypothyroidism, rash, and arthritis. The pCR rate was 55.8% (24/43 evaluable patients). Patients who developed irAEs were more likely to achieve pCR (84.6% vs. 45.2%, p = 0.039). Higher TILs (median 29%) were associated with pCR both as a continuous variable (p = 0.004) and categorically (p = 0.002), but not with irAE development (p = 0.341). pCR was more common among Hispanic patients (p = 0.005), and inversely associated with Black race (p = 0.003) and older age (p = 0.028).</p><p><strong>Conclusion: </strong>IrAEs may serve as a surrogate for treatment response to neoadjuvant chemoimmunotherapy in early TNBC. Additionally, racial and age-based differences in treatment response suggest underlying immunologic or biologic variation. These findings highlight the importance of diverse cohort representation in immunotherapy studies and warrant validation in prospective trials.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269844","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":"Investigating initial patterns of progression on first-line treatment in patients with de novo metastatic breast cancer.","authors":"Emily Huber, Gaorav P Gupta, Ryan Morse, Yara Abdou, Jeffrey Aldrich, Lisa A Carey, E Claire Dees, Emily M Ray, Katherine E Reeder-Hayes, Ellen Jones, Jean L Wright, Shivani Sud, Dana L Casey","doi":"10.1007/s10549-026-07933-5","DOIUrl":"10.1007/s10549-026-07933-5","url":null,"abstract":"<p><strong>Purpose: </strong>De novo metastatic breast cancer (dnMBC), defined as stage IV disease at initial diagnosis, comprises 6-10% of all metastatic breast cancer cases. Despite therapeutic advances, the unique clinical course of dnMBC remains underexplored, particularly with regard to patterns of first treatment failure and the potential role of metastasis-directed therapy (MDT). This study investigated patterns of treatment failure in patients with dnMBC treated with first line systemic therapy to understand how to better direct local therapies.</p><p><strong>Methods: </strong>A prospective single-institution database was used to examine patient and tumor characteristics, treatment response, and outcome among 326 patients with dnMBC diagnosed between 2011 and 2022. Anatomic site of first disease progression was categorized as occurring at a pre-existing site only (in breast and/or pre-existing metastatic sites only) vs other (including any combination involving a new metastatic site). Progression patterns were analyzed overall and stratified by clinical subtype. Cumulative incidence functions were used to evaluate time to first treatment failure by site and subtype.</p><p><strong>Results: </strong>Among the full cohort, progression-free survival at 2 years was 32.7% (95% CI [27.3, 38.0]) and at 5 years, 7.8% (95% CI [4.5, 11.2]). In total, 40.8% experienced first progression at pre-existing sites only, while 46.5% progressed at new sites. The cumulative incidence of first progression at a pre-existing site only at 5 years by clinical subtype was: 45.4% for HR + /HER2-, 43.8% for HR-/HER2 + , 39.3% for HR-/HER2-, and 34.5% for HR + /HER2 +.</p><p><strong>Conclusion: </strong>A substantial proportion (approximately 40%) of dnMBC patients experience initial progression at pre-existing sites, highlighting a potential role for locoregional and MDT in delaying progression and extending time on first-line systemic therapy. These findings support further prospective evaluation of MDT in dnMBC, with an emphasis on subtype-specific strategies and quality-of-life outcomes.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257347","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":"The role of regional nodal irradiation in clinically node-positive breast cancer patients who undergo neoadjuvant chemotherapy and breast-conserving surgery.","authors":"Mahtab Vasigh, Austin D Williams, Jill S Hasler, Allison Aggon, Randy Cohen, Rebecca Shulman, Shelly B Hayes, Penny R Anderson, Andrea S Porpiglia, Mary T Pronovost, Matthew Pierotti, Christian Cruz Pico, Richard J Bleicher","doi":"10.1007/s10549-026-07914-8","DOIUrl":"10.1007/s10549-026-07914-8","url":null,"abstract":"<p><strong>Purpose: </strong>The use of neoadjuvant chemotherapy (NAC) in breast cancer management has increased, leading to uncertainties in adjuvant treatment benefits.</p><p><strong>Methods: </strong>We reviewed (cN +) stage II-III breast cancers that underwent NAC and breast-conserving treatment (BCT) between 2010 and 2020 in the National Cancer Database (NCDB). Overall survival (OS) was compared between those who did and did not receive regional nodal irradiation (RNI).</p><p><strong>Results: </strong>The 7137 cN + patients had a mean age of 54.3 ± 10.9. Breast and nodal pCR rates were 25.9% and 35%. RNI was administered in 57.7% (50.0% of the ypN0 and 61.9% of the ypN +). The mean number of nodes removed was 10.3 ± 7.7 in the RNI + and 9.5 ± 7.6 in the RNI- groups (p < 0.01). The mean number of positive nodes was 2.5 ± 4.0 in the RNI + and 1.8 ± 3.5 in the RNI- groups (p < 0.01). In a median follow-up of 68 months, RNI + patients had a worse OS than RNI- patients (79.9% vs. 84.4%, p < 0.001). In the ypN0 population, there was no OS difference between RNI + and RNI- groups (p = 0.4), however, ypN + patients had worse OS if they were RNI + than RNI- (p = 0.007).</p><p><strong>Conclusion: </strong>RNI does not improve OS in cN + patients undergoing a complete response from NAC after BCT. Although recurrence cannot be assessed via this data set, these results support individualized decisions to omit RNI in ypN0 patients following NAC and BCT and emphasize the need for further investigation into the potential benefits or harms of RNI in ypN + patients treated with NAC and BCT.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":"14"},"PeriodicalIF":3.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225374","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":"Optimal time to surgery post-neoadjuvant chemotherapy: lessons from recent evidence and historical patterns.","authors":"Alan Nguyen, Joshua Kra","doi":"10.1007/s10549-026-07924-6","DOIUrl":"10.1007/s10549-026-07924-6","url":null,"abstract":"","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"216 2","pages":"13"},"PeriodicalIF":3.0,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218743","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}