Breast Cancer Research and Treatment最新文献

{"title":"Body-mind exercise for cancer-related cognitive impairment in breast cancer patients: a network meta-analysis.","authors":"Huilin Jia, Chunlei Liu, Yanjuan Lu, Xiaoge He, Qian Lu","doi":"10.1007/s10549-025-07774-8","DOIUrl":"10.1007/s10549-025-07774-8","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer-related cognitive impairment (CRCI) is one of the most common adverse effects in breast cancer patients, which seriously affects their quality of life. Existing studies have shown that mind-body exercise (MBE) can improve CRCI in breast cancer patients, but the differences in efficacy between various MBEs have not been clarified. This review aimed to evaluate the efficacy of different types of MBEs on CRCI in breast cancer patients through network meta-analysis, and identify the optimal MBE intervention.</p><p><strong>Methods: </strong>Eight databases were searched from their construction up to September 24, 2024. Randomized controlled trials and quasi-randomized controlled trials concerning the effects of MBEs on CRCI in breast cancer patients were included. The Cochrane Risk of Bias Tool 2.0 (RoB 2.0) and the Cochrane-recommended Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool were used to assess the quality of the included studies. Network meta-analysis was performed using Stata 18 software.</p><p><strong>Results: </strong>A total of 20 studies were included, involving 1,353 patients and covering four types of MBEs: yoga, Tai Chi/Qigong, Baduanjin, and dance. The network meta-analysis results showed that Baduanjin, compared with usual care, can alleviate cognitive impairment in breast cancer patients (P < 0.05). Among the four included MBEs, the comparison between Baduanjin and yoga showed statistically significant differences (P < 0.05). The surface under the cumulative ranking curve value indicated that the best MBE for cognitive impairment in breast cancer patients is Baduanjin, followed by yoga and Tai Chi/Qigong.</p><p><strong>Conclusion: </strong>Baduanjin is the most effective in improving cognitive impairment in breast cancer patients, while yoga, Tai Chi/Qigong, and dance show no significant improvement effects. More large-sample, rigorously designed interventional studies are still needed to further verify the impact of different MBEs on cognitive impairment in breast cancer patients.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"193-204"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658392","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":"Time and location of specialty palliative care for women dying with metastatic breast cancer.","authors":"Andrea King, Cynthia Ortiz, Rachna Goswami, Tara L Kaufmann, MinJae Lee, Lynn Ibekwe-Agunanna, Navid Sadeghi, Donghan M Yang, Lindsay G Cowell, Timothy P Hogan, Lauren P Wallner, Megan A Mullins","doi":"10.1007/s10549-025-07780-w","DOIUrl":"10.1007/s10549-025-07780-w","url":null,"abstract":"<p><strong>Background: </strong>Despite guideline recommendations, evidence suggests many women with metastatic breast cancer (mBC) do not receive specialty palliative care services despite high morbidity burden. Given the varied prognoses and disease trajectories of women with mBC, relatively little is known about palliative care delivery in this growing population, including timing and frequency of visits, location (inpatient vs. outpatient), and reasons for referral.</p><p><strong>Methods: </strong>Using electronic health record and tumor registry data from a North Texas Comprehensive Cancer Center (2010-2023), we identified women who died with de novo or recurrent mBC. We examined receipt of palliative care (inpatient and outpatient), reasons for referral, and timing of palliative care encounters by duration of patient survival. We used multivariable logistic regression to assess associations between receipt of specialty palliative care and demographic, clinical, and survival characteristics.</p><p><strong>Results: </strong>Among 265 women with mBC, 55.5% received no palliative care. Only women with short survival (< 18 months) received palliative care within 8 weeks of diagnosis. Most palliative care encounters were inpatient and occurred within ~ 1 month of death. In adjusted models, comorbidities and younger age were strongly associated with receiving outpatient palliative care. Most women were referred to palliative care for multiple reasons, with long-term survivors more likely to be referred for goals of care discussions alone.</p><p><strong>Conclusion: </strong>Palliative care for women with mBC is infrequent and often late, with referrals seemingly driven by the imminence of death rather than metastatic diagnosis. Strategies to better identify and triage specialty palliative care needs and make timely referrals are needed.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"261-272"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636100","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":"A direct comparison of classical oral Navelbine vs metronomic Navelbine in metastatic breast cancer: results from the Danish Breast Cancer Group's (DBCG) NAME-trial.","authors":"Anne Sofie Brems-Eskildsen, Julia Kenholm, Annette Torbøl Brixen, Jeanette Dupont Rønlev, Lars Stenbygaard, Hella Danø, Mie Grunnet, Erik Hugger Jakobsen, Jeppe Neimann, Sven Tyge Langkjer, Jürgen Geisler","doi":"10.1007/s10549-025-07777-5","DOIUrl":"10.1007/s10549-025-07777-5","url":null,"abstract":"<p><strong>Purpose: </strong>The metronomic principle of chemotherapy for malignancies, using frequent small doses, has been suggested to show superior efficacy compared with classical administration. Thus, we aimed at investigating whether treatment with Navelbine, according to the metronomic drug schedule, was superior to conventional oral treatment in terms of clinical efficacy and safety. EUDRACT no: 2016-002165-63.</p><p><strong>Methods: </strong>The NAME-trial was an open label, randomized, multicenter phase II study. We included 163 patients with metastatic breast cancer in Denmark between 2017 and 2022. All participants were randomized between standard treatment in arm A with classical per oral Vinorelbine day 1 and day 8, every three weeks, or in arm B metronomic treatment with per oral Vinorelbine given as daily doses.</p><p><strong>Results: </strong>The distribution of patients was well balanced between the two treatment arms. The median age was 68-69 years in both arms, with a good performance status at study entry. We found a median progression-free survival (PFS) in arm A of 3.9 months and a median PFS in arm B of 2.3 months (P = 0.236). The median overall survival (OS) was 16.6 months in arm A and 15.1 months in arm B (P = 0.355). The evaluation of the adverse events showed that both regimes were well tolerated without significant differences.</p><p><strong>Conclusion: </strong>Our overall evaluation of the NAME-trial results showed that metronomic oral Navelbine is not superior to the standard treatment with Vinorelbine and without any significant differences concerning side effects.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"237-246"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607328","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":"Genomic landscape of hormone therapy-resistant HR-positive, HER2-negative breast cancer.","authors":"Rohan Chaubal, Elizabeth Talker, Jaya Chitra, Rasika Kadam, Nilesh Gardi, Riddhi Ursekar, Anushree Kadam, Ankita Singh, Suhani Sale, Shwetali Pandey, Mrudula Madhav, Aishwarya Raja, Rushikesh Mukhare, Pallavi Parab, Nitin Shetty, Kunal Gala, Suyash Kulkarni, Khushboo A Gandhi, Seema Gulia, Shalaka Joshi, Tanuja Shet, Sudeep Gupta","doi":"10.1007/s10549-025-07759-7","DOIUrl":"10.1007/s10549-025-07759-7","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to characterize the genomic landscape of hormone receptor-positive (HR+)/HER2-negative breast cancer in patients with hormone therapy-resistant and -sensitive phenotypes.</p><p><strong>Methods: </strong>HR+/HER2-negative patients who were disease-free for ≥2 years were considered hormone therapy-sensitive (n = 19), while those who experienced disease progression within 2 years were considered hormone therapy-resistant (n = 48). Whole-exome sequencing (WES) was performed on paired (treatment-naïve and relapse-site) tumor and germline-derived DNA from resistant patients (n = 19), and targeted next-generation sequencing (NGS) was performed on plasma-derived circulating tumor DNA (ctDNA) from resistant (n = 35) and sensitive (n = 19) patients.</p><p><strong>Results: </strong>In 19 resistant patients, the mutation burden was higher in relapse-site compared with treatment-naïve samples (median 0.883 vs 0.655 mutations/mb, p = 0.03), there were 64 driver mutations (median treatment-naïve versus relapse-site; 2/sample vs. 3/relapse), of which 21 mutations in 8 genes in 15 (78.9%) patients were classified as actionable, and branching evolutionary trajectories were seen in 18 (94.7%) patients, with the presence of PIK3CA and/or TP53 mutations in stem clones of 13 (68.4%) patients. ctDNA analysis in 35 resistant patients identified 27 actionable hotspot mutations, such as PIK3CA H1047X, AKT1 p.E17K, CDH1 p.R63X, CDKN2A p.X50*, ERBB2 p.D769Y, and ESR1 p.E380Q, in 25 (71.4%) patients. Among 19 patients with hormone therapy-sensitive disease who were in remission at the time of sample collection, ctDNA analysis showed driver mutations in 10 (52.6%) patients, of whom 2 patients subsequently experienced relapse and died.</p><p><strong>Conclusion: </strong>Hormone therapy-resistant HR+/HER2-negative breast cancers are polyclonal, acquire actionable alterations at relapse, and moderate-depth ctDNA successfully identifies many clonal mutations, suggesting a role for liquid biopsy monitoring in these patients.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"247-259"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616219","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":"Circulating tumor DNA detection of local recurrence in a patient with early stage triple-negative breast cancer.","authors":"Samer Alkassis, Yashila Suresh, Marla Lipsyc-Sharf, Shiliang Zhang, Caterina Gianni, Arielle Medford, Aditya Bardia, Shahryar Ashouri, Nimmi Kapoor","doi":"10.1007/s10549-025-07773-9","DOIUrl":"10.1007/s10549-025-07773-9","url":null,"abstract":"<p><p>Triple-negative breast cancer (TNBC) comprises 10-15% of all breast cancers and is associated with high recurrence rates and limited treatment options. No guideline-recommended blood-based surveillance tests currently exist for early recurrence detection. Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for molecular residual disease (MRD) assessment and recurrence prediction, though its role in detecting local recurrence remains unclear. We present the case of a 53-year-old postmenopausal woman with early stage TNBC who underwent neoadjuvant chemotherapy, bilateral mastectomy with axillary lymph node dissection, and adjuvant treatment. One month after completion of therapy, ctDNA monitoring using the Signatera MRD assay detected was positive at 0.07 mean tumor molecules per milliliter (MTM/mL) despite no radiographic evidence of disease. Serial ctDNA testing at 2, 3, and 6 months remained positive, with increasing MTM/mL values. Seven months after initial ctDNA detection, a breast MRI was done due to palpation of a lesion at the surgical site near the nipple, identifying multifocal masses within the reconstructed right breast, and surgical resection confirmed TNBC recurrence. Following post-mastectomy radiation, serial ctDNA testing was negative, and the patient remained radiographically and molecularly disease-free at 20 months following the resection of the recurrent disease. This case highlights the potential of ctDNA testing for MRD detection in the adjuvant setting and identifying local recurrence. If systemic imaging fails to detect metastases, dedicated breast imaging remains crucial, even after bilateral mastectomy. Early ctDNA testing may refine surveillance and treatment decisions. Prospective trials are needed to validate its role in improving breast cancer outcomes.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"219-223"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673865","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":"Clinical subtypes and prognosis of invasive breast cancer with Paget's disease: a SEER study.","authors":"Soo Youn Bae, Chai Won Kim, Jehyun Chin, Jin Ah Lee, Dooreh Kim, Young Joo Lee, Chang Ik Yoon, Woo-Chan Park","doi":"10.1007/s10549-025-07784-6","DOIUrl":"10.1007/s10549-025-07784-6","url":null,"abstract":"<p><strong>Purpose: </strong>Paget's disease of the breast is rare but commonly associated with underlying carcinoma. Despite frequent HER2 overexpression, its clinical relevance in Paget's disease remains unclear. We evaluated the prognostic impact of ER and HER2 expression in invasive ductal carcinoma (IDC) with Paget's disease and assessed whether clinical subtypes affect survival outcomes.</p><p><strong>Methods: </strong>Using SEER 17 data, we identified patients with IDC and HER2 status available, diagnosed from 2010 onward. Two groups were analyzed: IDC with Paget's disease (ICD-O-3 code 8541/3, n = 1,000) and IDC alone (ICD-O-3 code 8500/3, n = 487,162).</p><p><strong>Results: </strong>Compared to IDC alone, patients with Paget's disease had lower ER (60.5% vs. 82.0%) and PR (45.5% vs. 71.7%) expression, and higher HER2 overexpression (52.5% vs. 15.4%) (all P < 0.001). The ER + HER2 - subtype was less common in the Paget's group (34.9% vs. 71.6%), while ER - HER2 + was more frequent (29.2% vs. 4.8%) (P < 0.001). Among ER + HER2 - and ER + HER2 + subtypes, those with Paget's disease had worse breast cancer-specific survival (BCSS) than those with IDC alone (HR 1.519, 95% CI 1.074-2.149; HR 1.030, 95% CI 1.027-1.033, respectively). No BCSS differences were observed in ER - HER2 - and ER - HER2 + subtypes.</p><p><strong>Conclusion: </strong>ER + HER2 - subtype in IDC with Paget's disease is linked to worse BCSS, differing from IDC alone. These findings suggest distinct tumor biology in IDC with Paget's disease, highlighting the need for subtype-specific management strategies.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"281-289"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658393","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 impact of mammographic breast density on locoregional recurrence in breast cancer: a systematic review and meta-analysis.","authors":"Lily Nolan, Huilun Huan, William McDonnell, Stewart Walsh, Aoife Lowery","doi":"10.1007/s10549-025-07804-5","DOIUrl":"https://doi.org/10.1007/s10549-025-07804-5","url":null,"abstract":"<p><strong>Background: </strong>Understanding locoregional recurrence (LRR) risk is important in breast cancer, as it relates directly to breast cancer-associated mortality. Individualised LRR risk estimation should inform treatment and surveillance strategies. Increased mammographic breast density has been identified as a risk factor for the development of breast cancer. However, the precise relationship between mammographic density and breast cancer LRR remains unclear.</p><p><strong>Aims: </strong>To perform a systematic review and relative risk meta-analysis to explore the assocation between breast mammographic density and breast cancer LRR.</p><p><strong>Methods: </strong>A systematic review was performed as per PRISMA guidelines. Mammographic breast density (MBD) was classified as BI-RADs A-B (breast density < 50%, predominately fatty or scattered areas of fibroglandular density) or BI-RADs C-D breast density > 50%, heterogeneously dense or extremely dense). A meta-anlysis was performed using Meta-Disc and Statsdirect 2.8.0.</p><p><strong>Results: </strong>Seven studies published between 2004 and 2023 met the inclusion criteria, comprising 3008 patients with reported mammographic breast density (MBD) (age range: 20-94 years). Overall, 59.1% (1779/3008) were classified as low MBD (BI-RADS A-B) and 40.9% (1229/3008) were classified as high MBD (BI-RADS C-D). Of these patients, 68.9% (2073/3008) were treated for invasive breast carcinoma and 31.1% had ductal carcinoma in-situ (DCIS). Breast-conserving surgery (BCS) was performed in 71.1% (2139/3008) of patients, mastectomy was performed in 28.2% (850/3008),. The median follow-up was 94.1 months, and the overall LRR rate was 12.8% (386/3008). Five of the seven studies reported a correlation between BI-RADs C-D and the development of LRR. LRR rates were lower in patients with low mammographic breast density (9.9% for BI-RADS A-B (177/1779)) compared to those with higher mammogaphic breast density (17.0% for BI-RADs C-D. (209/1229)) [P < 0.001, Chi Square]. BI-RADS C-D density on mammography was associated with an increased risk of locoregional recurrence (pooled relative risk 1.41; 95% confidence interval 1.17 to 1.70).</p><p><strong>Conclusion: </strong>Increased mammographic breast density may be associated with an increased risk of LRR. Multidisciplinary team discussions should consider MBD as a potential prognostic factor in when considering surveillance and locoregional control after breast cancer treatment.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942829","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":"A 40-year-old woman with early-stage triple-negative breast cancer and a retinal lesion.","authors":"Shivahamy Maheswaran, Arielle J Medford, Tomasz P Stryjewski, Janice N Thai, Seth A Wander","doi":"10.1007/s10549-025-07770-y","DOIUrl":"10.1007/s10549-025-07770-y","url":null,"abstract":"<p><p>The development of highly sensitive diagnostic imaging tools has created a challenge in localized cancer therapy; incidental findings can complicate staging and decision making. In the absence of clinical symptoms suggestive of metastatic disease, the diagnostic approach to localized breast cancer typically does not mandate staging scans. While metastatic disease is often referred to as an incurable entity, oligometastatic disease, confined to a limited number of sites, may be amenable to curative-intent ablative therapy. There is a growing body of evidence supporting the deployment of multidisciplinary treatment involving radiotherapy and/or surgical intervention in oligometastatic disease. This report describes a 40-year-old woman with triple-negative breast cancer who was incidentally found to have an right chorioretinal lesion, identified on a routine annual eye exam prior to her breast cancer diagnosis, with ophthalmic features suggestive for metastatic disease. She was asymptomatic, and did not have other findings suggestive of metastatic disease. Staging CT chest/abdomen/pelvis and brain MRI were negative. Biopsy of the ocular lesion was deferred given its close proximity to the macula and potential for vision threatening complications. Curative-intent localized treatment was undertaken, and the retinal lesion was monitored with serial ophthalmologic examinations. The patient received neoadjuvant chemotherapy, followed by bilateral mastectomy, and adjuvant chemotherapy. Follow-up imaging remained negative for disease progression, and routine ophthalmic exams over years of follow up showed no changes to the retinal lesion. The patient granted verbal consent to share her clinical story, imaging, and data.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"15-19"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583070","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":"Stage at diagnosis and breast cancer-specific mortality in breast cancer patients treated with antidepressants, anxiolytics, and antipsychotics: a population-based cohort study from Northern Ireland.","authors":"Sarah M Baxter, Charlene M McShane, Stuart A McIntosh, Damien Bennett, Lynne Lohfeld, Daniel R S Middleton, Gerard Savage, Deirdre Fitzpatrick, Joseph Kane, Ann McBrien, David McCallion, Anna Gavin, Chris R Cardwell","doi":"10.1007/s10549-025-07766-8","DOIUrl":"10.1007/s10549-025-07766-8","url":null,"abstract":"<p><strong>Purpose: </strong>We examined the stage at diagnosis and breast cancer-specific mortality in a cohort of breast cancer patients prescribed medications used for mental health conditions before diagnosis.</p><p><strong>Methods: </strong>Women newly diagnosed with breast cancer from 2011 to 2021 were identified from the Northern Ireland Cancer Registry. The primary outcome was time to breast cancer-specific mortality up to March 2023. The secondary outcomes included stage at diagnosis. We identified anxiolytic, antidepressant, and antipsychotic prescriptions dispensed in the year before breast cancer diagnosis from the Northern Ireland Enhanced Prescribing Database. Cox regression models were used to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (95%CIs) for cancer-specific mortality by use of medications.</p><p><strong>Results: </strong>We included 13,846 women with breast cancer. In the year before breast cancer diagnosis, 31.5% were dispensed antidepressants, 12.7% anxiolytics, and 3.5% antipsychotics. The odds of late-stage disease presentation in breast cancer patients dispensed medications for mental health conditions was similar to breast cancer patients not dispensed these medications, but patients dispensed antipsychotics had higher odds of unknown stage. We found no difference in the hazard rate of breast cancer-specific mortality in patients dispensed, versus not dispensed, anxiolytics (aHR = 1.06 95%CI 0.93-1.20), a small increase in patients dispensed, versus not dispensed, antidepressants (aHR = 1.11 95%CI 1.01-1.23) and a moderate increase in patients dispensed, versus not dispensed, antipsychotics (aHR = 1.45 95%CI 1.17-1.81).</p><p><strong>Conclusions: </strong>Breast cancer patients dispensed medications for mental health conditions were not at higher odds of presenting with late-stage disease, but patients dispensed antidepressants, and especially antipsychotics, had worse breast cancer-specific mortality.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"137-150"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567096","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":"Insurer and patient costs for repeat breast surgery after initial lumpectomy for breast cancer.","authors":"Sam E Wing, Yuki Liu, Feibi Zheng, Naomi C Hamm, Nayana S Dekhne, Jesse C Selber","doi":"10.1007/s10549-025-07735-1","DOIUrl":"10.1007/s10549-025-07735-1","url":null,"abstract":"<p><strong>Purpose: </strong> ~ 14-25% of patients who undergo a primary lumpectomy for the treatment of breast cancer require a reoperation due to adverse outcomes like positive surgical margins or early cancer recurrence, adding burden to the patients, providers, and payors. We analyze the economic impact of patients who require repeat breast tissue resection as part of their treatment following initial resection.</p><p><strong>Methods: </strong>We utilized the Merative™ MarketScan Research Database to identify a cohort of women in the United States who received an index lumpectomy between 2016 and 2021 and identified their healthcare encounters one year postoperatively, including any repeat lumpectomies or mastectomies, as well as the use of any intraoperative adjuncts (e.g. localization methods or frozen sections).</p><p><strong>Results: </strong>Among 8,869 patients with a primary lumpectomy, 25% (n = 2197) underwent a second surgery, of which 75% (n = 1644) was a repeat lumpectomy and 25% (n = 553) was a mastectomy. Median healthcare expenditure for primary lumpectomy plus one year follow up was $55,985 USD ($2,500 out-of-pocket). Among patients with secondary procedures, median healthcare expenditure from primary lumpectomy plus one year follow up was $63,416 ($3,005 out-of-pocket) for repeat lumpectomy and $87,961 ($3,100 out-of-pocket) for subsequent mastectomy patients. Repeat procedures were more common among patients who did not receive an intraoperative adjunct for lesion localization or margin assessment.</p><p><strong>Conclusion: </strong>While lumpectomy is the most common surgery for early-stage breast cancer, it often is not definitive, which can result in large added financial and operational burdens. Patient risk stratification and intraoperative adjuncts are needed to minimize risk of reoperation.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"457-465"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207640","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}