Breast Cancer Research and Treatment最新文献

{"title":"Patient decision aids in breast surgery and breast reconstruction reduce decisional conflict: a systematic review and meta-analysis.","authors":"Tokoya Williams, Keenan Fine, Emily Duckworth, Tarifa Adam, Caden Bozigar, Annie McFarland, Antoinette Nguyen, Brigid M Coles, Robert D Galiano","doi":"10.1007/s10549-025-07752-0","DOIUrl":"10.1007/s10549-025-07752-0","url":null,"abstract":"<p><strong>Purpose: </strong>Around 310,000 new cases of breast cancer (BC) are diagnosed each year. Complex treatment options often overwhelm patients. Patient decision aids (PDAs) assist in surgical decision-making, but reviews of their quality and efficacy are limited. This study systematically reviews breast surgery (BS) and breast reconstruction (BR) PDAs using the International Patient Decision Aid Standards and Cochrane tools to identify gaps and provide evidence-based recommendations.</p><p><strong>Methods: </strong>A systematic review following PRISMA guidelines examined the impact of PDAs on decision-making for BC patients considering BS and BR. From 1198 articles, 35 met the inclusion criteria. Data on PDA components, study design, and results were extracted, focusing on decisional conflict and anxiety, measured by the Decisional Conflict Scale (DCS) and the State-Trait Anxiety Inventory (STAI). PDA quality and study design were assessed using Cochrane, IPDASi, and ROBINS-I tools.</p><p><strong>Results: </strong>Eight studies evaluated the effect of PDAs on decisional conflict. The pooled mean difference of 3.08 points (95% CI: - 0.62 to 6.79, p = 0.10) favored the PDA group but was not statistically significant. Two studies, however, reported notable reductions in decisional conflict with effect sizes of 13.50 and 12.80 points, respectively. The pooled effect size of PDA exposure on patient anxiety was 1.93 (95% CI: - 0.46 to 4.31) in favor of PDAs, but was not statistically significant (p = 0.11). The evaluation of PDA content quality revealed variable results.</p><p><strong>Conclusion: </strong>BS and BR PDAs were not found to significantly reduce decisional conflict and anxiety in breast cancer patients. Standardized, evidence-based tools are needed.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"1-14"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526414","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":"PD-L1 22C3 CPS in paired primary breast cancer and lung metastasis.","authors":"Eunah Shin, Yoon Jin Cha, Hye Min Kim, Ja Seung Koo","doi":"10.1007/s10549-025-07757-9","DOIUrl":"10.1007/s10549-025-07757-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the expression of PD-L1 22C3 in primary breast cancer and lung metastasis tissues using the Combined Positive Score (CPS) and to investigate the concordance and differences between them.</p><p><strong>Methods: </strong>Immunohistochemical staining for PD-L1 22C3 was performed on 52 paired cases of primary breast cancer and lung metastases. The CPS was measured and analyzed for comparison.</p><p><strong>Results: </strong>The PD-L1 positivity rate (CPS ≥ 10) was 13.5% in primary breast cancers and 30.8% in lung metastases. The overall percent agreement (OPA) for PD-L1 CPS between primary tumors and lung metastases was 78.8%, with a positive percent agreement (PPA) of 85.7% and a negative percent agreement (NPA) of 77.8%. The mean CPS was 2.69 ± 6.67 (mean ± SD) in primary breast cancers and 7.67 ± 14.49 (mean ± SD) in lung metastases, with a significantly higher CPS observed in lung metastases (p < 0.001). The primary cause of discordance, where PD-L1 was negative in the primary tumor but positive in the metastasis, was the presence of PD-L1-positive alveolar macrophages predominantly located around or within the metastatic tumor.</p><p><strong>Conclusion: </strong>PD-L1 22C3 demonstrated approximately 80% concordance between primary breast cancers and lung metastases; however, discordance was mainly attributable to the presence of inherently PD-L1-positive peritumoral and/or intratumoral alveolar macrophages.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"569-576"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265247","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":"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":"161-169"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259733/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous glucose monitoring to characterize hyperglycemia during chemotherapy for early stage breast cancer.","authors":"Sophie R Ulene, Shikun Wang, Joshua R Cook, Fiona McAuley, Margaux E Wooster, Khadija F Faheem, Andrew Varoli, Julia E McGuinness, Neil Vasan, Meghna S Trivedi, Katherine D Crew, Erik Harden, Cynthia Law, Dawn L Hershman, Melissa K Accordino","doi":"10.1007/s10549-025-07745-z","DOIUrl":"10.1007/s10549-025-07745-z","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes (DM) and hyperglycemia during chemotherapy increase the risk of toxicity, yet the prevalence and patterns of hyperglycemia in early-stage breast cancer (ESBC) patients undergoing chemotherapy with concurrent dexamethasone remain poorly understood.</p><p><strong>Methods: </strong>We conducted a prospective single-arm study using FreeStyle Libre Pro continuous glucose monitoring in patients with ESBC receiving chemotherapy from 12/2020-2/2022. Sensors measured interstitial glucose every 15 min and were reapplied every 2-3 weeks. Primary endpoints were (1) prevalence of hyperglycemia (≥ 1 reading ≥ 140 mg/dL), and (2) for those with hyperglycemia, the proportion of time spent hyperglycemic. Secondary endpoints included baseline glucose tolerance by A1c, changes in glucose-related biomarkers, and changes in patient-reported neuropathy, quality of life, and fatigue. Analysis was stratified by baseline A1c (euglycemic < 5.7%, prediabetes [pre-DM] 5.7-6.4%, diabetes [DM] ≥ 6.5%).</p><p><strong>Results: </strong>Among 20 evaluable patients (median age: 60, BMI: 29.5 kg/m²), common chemotherapy regimens included docetaxel/cyclophosphamide (25%), paclitaxel/trastuzumab (20%), paclitaxel then doxorubicin/cyclophosphamide (15%), docetaxel/carboplatin/trastuzumab/pertuzumab (15%), and cyclophosphamide/methotrexate/fluorouracil (15%). All patients received Dexamethasone. At baseline, 10 patients were euglycemic, 7 had pre-DM, and 3 had DM. All experienced hyperglycemia. Of 124,165 total glucose readings, 17% were ≥ 140 mg/dL. By cohort, the proportion of time spent hyperglycemic was 3.9% (euglycemic), 10% (pre-DM), and 73.3% (DM) (p < .0001). Mean glucose values were 95.5 mg/dL (euglycemic), 104.5 mg/dL (pre-DM), and 183.0 mg/dL (DM) (p < .0001).</p><p><strong>Conclusion: </strong>All patients receiving chemotherapy for ESBC experienced hyperglycemia, with time spent hyperglycemic varying significantly by baseline A1c. Future research should explore approaches to and benefits of improving glycemic control during treatment in patients with baseline dysglycemia.</p><p><strong>Trial registration: </strong>NCT04473378.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"511-519"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224253","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":"National trends in neoadjuvant systemic therapy utilization in patients with early-stage HER2-positive breast cancer from 2016-2021: The impact of the KATHERINE trial.","authors":"Lauren N Cohen, Christine C Rogers, Jan Irene C Lloren, Sailaja Kamaraju, Lubna N Chaudhary, Chiang-Ching Huang, Adrienne N Cobb, Puneet Singh, Amanda L Kong, Mediget Teshome, Chandler S Cortina","doi":"10.1007/s10549-025-07750-2","DOIUrl":"10.1007/s10549-025-07750-2","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant systemic therapy (NST) for HER2 + breast cancer (HER2 + BC) has historically been used to downstage disease to facilitate surgical de-escalation; however, in 2019, the KATHERINE trial identified a survival benefit to adjuvant T-DM1 for those with residual disease after NST. We aimed to determine national rates of NST for patients with cT1-2 N0 M0 HER2 + BC and identify factors associated with receipt of NST vs upfront surgery with adjuvant systemic therapy (US-AST).</p><p><strong>Methods: </strong>A retrospective cohort study of women with cT1-2 N0 M0 HER2 + BC was performed using the National Cancer Database from 2016-2021. ANOVA, Kruskal-Wallis, Chi-square, Fisher's Exact tests, and a multivariable logistic regression analysis were used.</p><p><strong>Results: </strong>54,449 patients met inclusion: 30,546 (56.1%) received US-AST and 19,562 (35.9%) received NST. NST utilization increased from 31.1% in 2016-17 to 43.3% in 2020-21. On regression analysis, women diagnosed in 2020-21 were more likely to receive NST (OR 1.9, 95% CI 1.8-2.0). Populations less likely to receive NST included NH-Black women (OR 0.87, 95% CI 0.8-0.95), age ≥ 70 (OR 0.7, 95% CI 0.6-0.8), increasing comorbidities (OR 0.7, 95% CI 0.5-0.9), and Medicare insurance (OR 0.8, 95% CI 0.7-0.8). Patients with cT2 disease were more likely to receive NST vs those with cT1 disease (p < 0.001).</p><p><strong>Conclusion: </strong>From 2016-2021, national rates of NST for patients with cT1-2 N0 HER2 + BC significantly increased. Race/ethnicity and insurance type were associated with receipt of NST underscoring ongoing disparities in care. Future studies are needed to determine the impact of the disparate rates of NST utilization on oncologic outcomes, given the survival benefit with adjuvant T-DM1 in those with residual disease after NST.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"531-543"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207641","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":"Utility of plasma circulating DNA tumor fraction in bone-only metastatic breast cancer: a real-world outcomes study.","authors":"Gilbert Bader, Julia C F Quintanilha, Deloris Veney, Ryon P Graf, Mia Levy, Lincoln W Pasquina, Daniel G Stover","doi":"10.1007/s10549-025-07740-4","DOIUrl":"10.1007/s10549-025-07740-4","url":null,"abstract":"<p><strong>Purpose: </strong>Bone metastases develop in 50-70% of patients with metastatic breast cancer (MBC), with around one-third having bone as only site of distant disease (bone-only [BO]). Standard imaging is frequently insufficient to track bone metastases. Evidence suggests that circulating tumor DNA (ctDNA) tumor fraction (TF) is prognostic in MBC. We hypothesized that TF would be detectable and prognostic for BO-MBC.</p><p><strong>Methods: </strong>MBC patients who underwent FoundationOne LiquidCDX comprehensive genomic profiling within 60 days before starting therapy were included. Clinical data was obtained from the nationwide deidentified Flatiron Health/Foundation Medicine Clinico-Genomic Database between 01/2011 and 12/2023.</p><p><strong>Results: </strong>We identified 778 patients for inclusion: 299 TF < 1% (TF-low), 175 TF 1-10% (TF-intermediate [int]), 304 TF > 10% (TF-high). Of these, 155 had BO-MBC, 622 had non-BO MBC (1 missing metastasis data). Among samples collected prior to first-line therapy (n = 256), there was no significant difference in the proportion of patients with detectable ctDNA comparing BO-MBC to non-BO MBC patients (P = 1.0). TF was prognostic among patients with BO-MBC: TF-low demonstrated more favorable real-world overall survival (rwOS) relative to TF-int (hazard ratio [HR] 2.19, 95% confidence interval [CI] 1.1-4.35) and TF-high (HR 2.07, 95% CI 1.12-3.82; log-rank P = 0.027). Multivariable analyses confirmed the independent and additive association of TF and less favorable rwOS. In multivariable analyses evaluating clinicopathologic factors associated with TF, non-BO metastases were not associated with higher ctDNA TF.</p><p><strong>Conclusion: </strong>BO-MBC patients are as likely as non-BO-MBC to have detectable ctDNA and TF remains prognostic among BO-MBC patients, with TF < 1% associated with significantly better prognosis.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"475-486"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186481","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 and proteomic profiling of GATA3 mutant metastatic hormone receptor-positive breast cancer and impact on clinical outcomes.","authors":"Arielle J Medford, Marko Velimirovic, Yifat Gefen, Andrzej Niemierko, Lorenzo Gerratana, Andrew A Davis, Katherine Clifton, Jennifer Keenan, Emily Podany, Whitney L Hensing, Carolina Reduzzi, Charles S Dai, Lesli A Kiedrowski, Laura M Spring, Leif W Ellisen, Robert C Doebele, Massimo Cristofanilli, Gad Getz, Aditya Bardia","doi":"10.1007/s10549-025-07710-w","DOIUrl":"10.1007/s10549-025-07710-w","url":null,"abstract":"<p><strong>Purpose: </strong>GATA3 mutations are among the most common alterations in hormone receptor-positive (HR+) breast cancer (BC), yet these have no targeted therapies. MDM2 is an E3 ubiquitin ligase that targets p53 for degradation, and pre-clinical data suggests MDM2 inhibition may effectively treat GATA3^mut HR+ BC. The GATA3 co-mutational landscape has been described only in primary BC tissue, and the mechanism of MDM2-driven efficacy is incompletely understood.</p><p><strong>Experimental design: </strong>Circulating tumor DNA (ctDNA) was assessed for GATA3 mutations via targeted sequencing. Associations with co-alterations and clinical/pathologic factors were estimated using Pearson's chi-squared test, two-sample Wilcoxon rank-sum, and multivariable logistic regression. Impact on survival was analyzed using multivariable Cox regression analysis. Tissue-based data from the Clinical Proteomic Tumor Analysis Consortium (CPTAC) database was evaluated for expression and phosphorylation of GATA3 and associated proteins.</p><p><strong>Results: </strong>Among 609 patients with HR + /HER2- MBC, ctDNA detected non-synonymous GATA3 variants ctDNA in 69 (11%) patients, and the genomic landscape was unique from tissue-based primary BC data; GATA3^mut were not mutually exclusive from TP53^mut (p = 0.30) or PIK3CA^mut (p = 0.52) and were associated with poorer survival on endocrine monotherapy. CPTAC analysis showed no difference in GATA3 or breast cancer-associated gene abundance, however there was increased USP48 (LogFC = 0.76, FDR = 1.7 × 10^-5), which stabilizes MDM2.</p><p><strong>Conclusion: </strong>The distinct landscape in GATA3^mut MBC ctDNA highlights critical information when assessing candidacy for targeted therapies. To our knowledge, this is the first ctDNA-based GATA3^mut landscape analysis in MBC. Furthermore, tissue-based proteomic analysis suggests mechanisms for endocrine resistance and sensitivity to MDM2 inhibition in HR+ /HER2- GATA3^mut BC.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"437-447"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172835","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 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":"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":"545-553"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209387/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"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":"81-92"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","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 DCIS-IBC guide board on predicting postoperative upgrading in breast ductal carcinoma in situ: clinical insights from a multicenter study.","authors":"Chenglong Duan, Jinsui Du, Lizhe Zhu, Man Niu, Dong Fan, Siyuan Jiang, Jiaqi Zhang, Yudong Zhou, Yi Pan, Danni Li, Jianing Zhang, Yu Ren, Bin Wang","doi":"10.1007/s10549-025-07763-x","DOIUrl":"10.1007/s10549-025-07763-x","url":null,"abstract":"<p><strong>Background: </strong>Ductal carcinoma in situ (DCIS) carries a significant risk of postoperative upgrading to invasive breast cancer (IBC), yet existing prediction models lack validation in Asian populations. This study aimed to develop and validate a population-specific nomogram to preoperatively predict DCIS-to-IBC upgrading in Asian patients.</p><p><strong>Methods: </strong>A multicenter retrospective cohort of 465 Asian women diagnosed with DCIS by core needle biopsy (2015-2021) was analyzed. Patients were randomly divided into training (n = 257), internal validation (n = 110), and external validation cohorts (n = 98). Predictors were selected via LASSO regression and multivariable logistic regression. Model performance was assessed using AUC, calibration curves, and decision curve analysis (DCA). An interactive online nomogram was developed for clinical application.</p><p><strong>Results: </strong>Postoperative upgrading occurred in 49.46% (230/465) of patients. Four independent predictors were identified: palpable mass (OR = 2.55, p = 0.096), lesion palpability (OR = 2.58, p = 0.043), low nuclear grade (OR = 0.55, p = 0.098), and suspected invasion (OR = 6.59, p < 0.001). The nomogram demonstrated robust discrimination in the training cohort (AUC = 0.802, 95% CI 0.748-0.856), with maintained performance in internal validation (AUC = 0.753) and acceptable generalizability in external validation (AUC = 0.680). DCA confirmed clinical utility across risk thresholds. The dynamic nomogram ( https://duancl777.shinyapps.io/dynnomapp/ ) enabled real-time risk stratification.</p><p><strong>Conclusions: </strong>The DCIS-IBC Guide Board is the first Asian-specific model integrating clinicopathological predictors to identify high-risk DCIS patients. It facilitates personalized decisions, such as omitting sentinel lymph node biopsy while reducing overtreatment. Although external validation showed moderate performance, this tool addresses critical population heterogeneity and enhances preoperative risk assessment. Prospective multicenter studies are warranted to optimize generalizability and explore multimodal predictors.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"101-114"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526364","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}