Breast Cancer Research and Treatment最新文献

{"title":"Real-world clinical outcomes of intermediate-risk PAM50 (i-ROR) in HR+/HER2- early breast cancer and eligibility for adjuvant CDK4/6 inhibitors.","authors":"Santiago Terán, María Illia, María Carla Quevedo, Marina López Moreno, Manuel Alva Bianchi, Laura Lema, Cristina González, Pablo Tolosa, Ainhoa Madariaga, Luis Manso, Yolanda Ruano, Lucía Parrilla, María Ángeles Cobos, Eva Ciruelos, Rodrigo Sánchez-Bayona","doi":"10.1007/s10549-026-08027-y","DOIUrl":"10.1007/s10549-026-08027-y","url":null,"abstract":"<p><strong>Introduction: </strong>Risk-adapted strategies are central to early breast cancer (EBC) management, particularly in HR+/HER2 - disease. Prosigna/PAM50 combined with clinicopathologic factors refines prognosis, with clearer guidance at ROR extremes, while decisions in the intermediate-risk (i-ROR) group remain challenging. Although adjuvant iCDK4/6 therapy improves outcomes in high-risk patients, eligibility in i-ROR may be overlooked. This study outlines clinicopathologic features, recurrence-free survival, and iCDK4/6 eligibility in i-ROR EBC to support treatment decision-making.</p><p><strong>Methods: </strong>We performed a retrospective analysis of 554 EBC patients who underwent PAM50 testing at Hospital Universitario 12 de Octubre (2015-2024). Clinical, pathological, diagnostic, follow-up, and recurrence data were obtained from records. Kaplan-Meier analyses estimated RFS, while multivariate logistic regression identified predictors of chemotherapy use within i-ROR. Descriptive statistics assessed eligibility for adjuvant ribociclib (NATALEE) and abemaciclib (monarchE).</p><p><strong>Results: </strong>Among 212 i-ROR patients (38%), 71.7% were postmenopausal, 65.5% Luminal A and 34% Luminal B intrinsic subtypes, and 53.7% node-negative. 68.4% did not receive chemotherapy. There were 11 relapses, predominantly Luminal A (72.7%), node-negative (63.6%), and chemotherapy-naive (90.9%). RFS at 12, 36, and 60 months was 100%, 97.9%, and 96.9%. Chemotherapy use was associated with younger age (p = 0.006), node positivity (p = 0.021), and luminal B subtype (p = 0.001). CDK4/6 eligibility was 44.3% for NATALEE and 14.6% for monarchE, with 10.8% meeting both; chemotherapy use was higher in monarchE-eligible patients (41.9% vs. 31.9%).</p><p><strong>Conclusions: </strong>This real-world cohort of PAM50 i-ROR HR+/HER2 - EBC patients showed excellent prognosis (5-year RFS > 96%), yet relapses still occurred, highlighting the need for improved risk stratification and consideration of adjuvant therapies, including iCDK4/6.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435015","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":"Clinicopathologic features, treatment patterns and survival outcomes of acinic cell carcinoma of the breast: a national cancer database analysis.","authors":"Cher Ying Foo, Ojasav Sehrawat, Akshjot Puri, Waqar Haque, Bin S Teh","doi":"10.1007/s10549-026-08026-z","DOIUrl":"10.1007/s10549-026-08026-z","url":null,"abstract":"<p><strong>Purpose: </strong>Acinic cell carcinoma (ACC) of the breast is a rare malignancy characterized by serous acinar differentiation resembling salivary gland ACC. Although historically described as a triple-negative malignancy, its immunophenotypic profile and clinical behavior remain incompletely characterized. This study leverages a large national database to characterize the clinicopathologic features, treatment approaches, and survival outcomes of breast ACC.</p><p><strong>Methods: </strong>The National Cancer Database (NCDB) was queried for patients with invasive breast ACC diagnosed between 2004 and 2023. Overall survival (OS) was assessed using Kaplan-Meier analysis and compared with log-rank tests. Multivariable Cox regression analysis was used to evaluate independent associations with OS.</p><p><strong>Results: </strong>A total of 149 patients with breast ACC were identified. Mean age was 57.8 ± 14.3 years, and median tumor size was 2.0 cm. Most patients presented with early-stage disease (Stage I-II, 86.7%). 44.6% demonstrated poorly differentiated or anaplastic tumors. Node-positive disease was present in 27.0% of patients. Hormone receptor expression was common (ER 57.1%, PR 50.7%), while 93.5% were HER2-negative. The 5-year OS was 82.9%. Older age (p < 0.001), advanced stage (p < 0.001), and nodal positivity (p = 0.038) were associated with worse OS. Surgical resection was associated with improved survival (p < 0.001), while radiation, chemotherapy and hormonal therapy were not associated with OS. On multivariable analysis, surgical resection remained independently associated with survival (HR 0.03, 95% CI 0.005-0.25, p < 0.001).</p><p><strong>Conclusions: </strong>Breast ACC presents at an early stage with hormone receptor heterogeneity. Surgical resection was the only modality independently associated with improved survival.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435019","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":"EVERolimus effectiveness after proGREssion on ENdocrine therapy plus CDK4/6 inhibitor for ER-positive/HER2-negative advanced breast cancer: EVERGREEN study.","authors":"Diogo Martins-Branco, Soraia Lobo-Martins, Philippe Aftimos, Bernardo Pereira, Leonor Vasconcelos de Matos, Leonor Fernandes, Elsa Campôa, Guilherme Nader-Marta, Michel Moreau, Donatienne Taylor, Francois P Duhoux, Pedro Simões, Ana Rita Garcia, Vanessa Patel, Caterina Confente, Diogo Alpuim Costa, José Pereira, Catarina Santos, Marianne Paesmans, Frederico Sarmento, Teresa Gantes Padrão, Diana Simão, Daniel Bandarra, Berta Sousa, Margarida Brito, Andrea Gombos, Lieveke Ameye, Evandro de Azambuja","doi":"10.1007/s10549-026-08012-5","DOIUrl":"10.1007/s10549-026-08012-5","url":null,"abstract":"<p><strong>Purpose: </strong>There is limited evidence supporting the addition of everolimus to endocrine therapy in women with ER-positive/HER2-negative advanced breast cancer disease progression on CDK4/6 inhibitors. We aimed to assess the effectiveness and safety of everolimus in this setting.</p><p><strong>Methods: </strong>EVERGREEN is a multicentre, international, retrospective quasi-experimental study of women with ER-positive/HER2-negative advanced breast cancer who started an immediate next line of endocrine therapy after progression on CDK4/6 inhibitors until 31/12/2022. We compared patients exposed to endocrine therapy plus everolimus in centres where this is the standard-of-care with those treated in centres where endocrine therapy alone is the standard-of-care. The primary endpoint was real-world progression-free survival (rwPFS). Secondary endpoints were time to everolimus failure, time to chemotherapy, and overall survival.</p><p><strong>Results: </strong>We included 207 women (everolimus n = 150, endocrine therapy alone n = 57), with a median follow-up of 31.8 months. Baseline characteristics were well balanced, except for a higher number of prior lines of therapy in the everolimus cohort. Median rwPFS was 5.0 for patients exposed to everolimus vs 4.3 months for endocrine therapy alone (adjusted hazard ratio 0.68, 95% confidence interval 0.47-0.99). Time to everolimus failure was 4.2 months. There were no statistically significant differences in time to chemotherapy or overall survival. The safety profile was consistent with previous reports.</p><p><strong>Conclusion: </strong>The addition of everolimus to standard endocrine therapy resulted in a modest clinical benefit for patients with ER-positive/HER2-negative advanced breast cancer candidates for endocrine therapy after CDK4/6 inhibitors. This limited benefit and the toxicity profile warrants careful selection of patients with favourable risk-benefit profile.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418624","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":"Age-stratified difference in patient-reported health-related quality of life following breast cancer surgery.","authors":"Claire Liu, Rebecca Warburton, Jin-Si Pao, Carol K Dingee, Amy Bazzarelli, Guiping Liu, Trafford Crump, Jason Sutherland, Elaine C McKevitt","doi":"10.1007/s10549-026-08028-x","DOIUrl":"10.1007/s10549-026-08028-x","url":null,"abstract":"<p><strong>Purpose: </strong>To examine age-stratified changes in patient-reported health-related quality of life (HRQoL) following breast cancer surgery across surgical modalities.</p><p><strong>Methods: </strong>In this prospective cohort study, 471 breast cancer patients undergoing breast-conserving surgery (BCS), total mastectomy no reconstruction (TMNR), or mastectomy with immediate breast reconstruction (MIBR) completed validated breast cancer-specific and general patient-reported outcome measures preoperatively and six months postoperatively. Patients were stratified into three age categories (≤ 49, 50-69, ≥ 70 years). The primary outcome was postoperative BREAST-Q breast satisfaction. Multivariable linear regression evaluated associations between age category and six-month postoperative scores, adjusting for surgical modality and patient characteristics.</p><p><strong>Results: </strong>Surgical modality, rather than age category, was independently associated with postoperative breast satisfaction. Compared with BCS, TMNR was associated with significantly lower breast satisfaction (β = -13.47, p < 0.01) and lower physical and sexual well-being, whereas MIBR demonstrated comparable breast satisfaction but lower physical chest well-being. Older age category was independently associated with higher postoperative psychosocial, chest physical well-being and perceived health, as well as lower anxiety, depression, and pain. Surgical modality was not associated with postoperative depression, anxiety, pain, or perceived health.</p><p><strong>Conclusion: </strong>Surgical modality determined postoperative breast satisfaction, with TMNR associated with worse breast-specific outcomes compared with BCS across age categories. Psychosocial and symptom-related outcomes instead varied significantly by age, with older patients reporting higher well-being and lower symptom burden. These findings support age-informed surgical counseling and targeted supportive care strategies.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418691","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":"Curative-intent stereotactic ablative body radiation, surgery, and systemic therapy in non-osseous oligometastatic breast cancer.","authors":"Adhar Amritt, Abhilash Dagar, Adrija Ghosh, Arjun Maiti, Jaswin Raj, Sangeeta Hazarika, Ashish Datt Upadhyay, Jitendra K Meena, Abhinav Singhal, Aman Sharma, Jyoti Sharma, Akash Kumar, Sandeep Mathur, Jyoutishman Saikia, Supriya Mallick","doi":"10.1007/s10549-026-08021-4","DOIUrl":"10.1007/s10549-026-08021-4","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic ablative body radiation (SABR), combined with systemic therapy (ST), is increasingly used to improve survival in oligometastatic breast cancer (OMBC).</p><p><strong>Methods: </strong>Patients with no brain or bone metastases on whole-body PET-CT received curative-intent local and systemic treatment, including SABR to metastatic site. Doses were: liver (45-50 Gy/5 fractions), peripheral lung (54 Gy/3fractions), central lung (60 Gy/8fractions), lymph nodes (30 Gy/3fractions), and peritoneal deposits (45 Gy/5fractions). Response was assessed at 3 months (RECIST v1.1); pain, gross tumour volume (GTV), planning target volume (PTV), and toxicity (CTCAE) were documented.</p><p><strong>Results: </strong>From Dec 2021 to Mar 2025, 39 patients (42 sites; median age 47) were treated: liver (17), lung (14), nodes (5), other (6). At a median follow-up of 23.9 months, median PFS was 16.3 months (95% CI: 10.3-24.1); median OS was not reached; restricted mean OS for the cohort was 89.2 months. Twenty-eight patients were alive, 11 died, two were lost to follow-up. Subtypes included TNBC (36%) and HER2+ (33%), luminal B (23%). Univariate analysis showed older age, smaller PTV, and higher BED₁₀ improved PFS; multivariate analysis confirmed age (HR 0.20, p = 0.006), PTV (HR 6.57, p = 0.001), and luminal subtype. Most common toxicity: grade 2 pain flare and hepatitis (10%).</p><p><strong>Conclusion: </strong>Curative-intent treatment with SABR for visceral OMBC offers promising survival outcomes. Molecular subtyping may aid treatment selection.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418603","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":"Association of tumor-infiltrating lymphocytes and proinflammatory biomarkers with breast cancer molecular subtypes: analysis of the MEND study.","authors":"Jovita Byemerwa, Drew Neish, Lukeman Forgah, April Deveaux, Oyomoare Osazuwa-Peters, Ashwini Joshi, Omolola Salako, Adetola Daramola, Olusegun Alatise, Gabriel Ogun, Allison Hall, Adewale Adeniyi, Omobolaji Ayandipo, Thomas Olajide, Olalekan Olasehinde, Olukayode Arowolo, Adewale Adisa, Oludolapo Afuwape, Aralola Olusanya, Aderemi Adegoke, Trygve O Tollefsbol, Donna Arnett, Michael J Muehlbauer, Tomi Akinyemiju","doi":"10.1007/s10549-026-08022-3","DOIUrl":"10.1007/s10549-026-08022-3","url":null,"abstract":"<p><strong>Purpose: </strong>Tumor-infiltrating lymphocytes (TILs) and proinflammatory biomarkers shape breast cancer (BC) progression and outcomes. We estimated the association between TILs and BC subtypes in Nigerian women and, in exploratory analyses, evaluated relationships between serum biomarkers (IL-6, IL-8, IL-1β, TNF-α, and leptin), TILs and BC subtypes.</p><p><strong>Methods: </strong>TILs were quantified on H&E-stained tumors from 436 treatment-naïve Nigerian BC patients, serum biomarkers (n = 109) were profiled by Meso Scale Discovery immunoassays. TILs and proinflammatory biomarkers were assessed across BC subtypes using descriptive analyses and multinomial logistic regression; cytokine ratios were also explored to characterize TNF-α dominance.</p><p><strong>Results: </strong>Median age was 49, and subtypes were triple-negative (TNBC, 43%), luminal A (31%), luminal B (12%), and HER2-enriched (15%). Median TIL percentage was 10.0 (Q1, Q3: 4.0, 21.0), with 49% of patients classified as low TIL (< 10%), 41% as intermediate (10- < 40%) and 10% as high (≥ 40%). Compared to low TILs, medium (OR 1.94, 95% CI 1.11-3.38, p = 0.020) and high TILs (OR 2.65, 95% CI 1.00-6.99, p = 0.049) were associated with higher odds of TNBC vs. ER+ after demographic and clinical adjustments. TNF-α correlated with TILs (ρ: 0.21; p = 0.026) and higher TNF-α:IL-1β (OR 4.16, 95% CI 1.35-12.84) and TNF-α:IL-8 (OR 3.81, 95% CI 1.29-11.23) ratios were associated with TNBC but not HER2 (vs. ER+); individual biomarkers were not associated with subtypes.</p><p><strong>Conclusion: </strong>Elevated TILs and TNF-α-dominant profiles are associated with TNBC (vs. ER+) in Nigerian women, highlighting potential immunotherapy relevance in Nigerian TNBC cases and a suggestive prognostic/therapeutic role for TNF-α.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418694","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":"Breast cancer screening adherence after multigene panel testing among women with pathogenic variants in moderate-risk genes or with empirically increased breast cancer risk.","authors":"Jacob G Comeaux, Natalia Gutierrez, Charité N Ricker, Qi Nie, Averi Nguyen, Ivan Garcia, Emmeline Y Chang, Rebecca M Waggoner, Susan Groshen, Caryn Lerman, Darcy Spicer, Julie O Culver","doi":"10.1007/s10549-026-08020-5","DOIUrl":"10.1007/s10549-026-08020-5","url":null,"abstract":"<p><strong>Purpose: </strong>To identify factors associated with adherence to breast cancer (BC) screening among women with a pathogenic or likely pathogenic (P/LP) variant in a moderate-risk gene, ATM, BARD1, CHEK2, RAD51C, and RAD51D or with empiric lifetime risk ≥ 20%.</p><p><strong>Methods: </strong>We reviewed medical records of women without breast cancer who underwent genetic counseling and testing and were advised to undergo annual breast MRI and mammography. Adherence to screening for up to three years was compared between women with a P/LP variant in a moderate-risk gene and women with an elevated empiric risk of 20-40% by the Tyrer-Cuzick model.</p><p><strong>Results: </strong>The study population included 44 women with P/LP variants (P/LP group) and 117 with lifetime BC estimates of 20-40% (Empiric group). Within one year, the P/LP group had significantly higher rates of screening than the Empiric group with 58% vs. 37% obtaining breast MRI and 88% vs. 55% obtaining mammograms. Time-to-event analysis demonstrated the P/LP group initiated screening significantly sooner than the Empiric group. After adjusting for having family history of BC or personal history of non-BC, the P/LP group was 3.18 and 7.04 times more likely to obtain breast MRI and mammograms, respectively. Adherence declined in both groups in the second and third year of follow-up.</p><p><strong>Conclusion: </strong>Women with P/LP variants were more adherent to BC screening than those with empiric risk, underscoring the role that genetic test results may play in screening behavior. Future efforts should focus on understanding the barriers to screening and improving long-term adherence.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418618","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":"Early first-line systemic anticancer therapeutic attrition after metastatic recurrence in triple-negative breast cancer following neoadjuvant chemo-immunotherapy: a multicenter real-world study.","authors":"Palma Fedele, Alessandro Rizzo, Matteo Landriscina, Luigia Stefania Stucci, Carmela Inneo, Maria Morritti, Franco Morelli, Francesco Giuliani, Lucia Moraca, Giuseppe Cairo, Marianna Giampaglia, Beatrice Tedesco, Assunta Melaccio, Felicia M Maselli, Antonio Gnoni, Antonella Licchetta, Federica Fumai, Elsa Vitale, Fiorella Restaino Marino, Emanuela Zifarone, Laura Lanotte, Raffaele Ardito, Gennaro Gadaleta-Caldarola","doi":"10.1007/s10549-026-08023-2","DOIUrl":"10.1007/s10549-026-08023-2","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the incidence and determinants of early first-line systemic anticancer therapeutic attrition after metastatic recurrence in triple-negative breast cancer (TNBC) treated with neoadjuvant chemo-immunotherapy.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter analysis of 209 consecutive patients with early-stage TNBC treated with neoadjuvant chemo-immunotherapy. After a median follow-up of 24 months, 54 developed metastatic recurrence. Early first-line systemic anticancer therapeutic attrition was defined as failure to initiate systemic anticancer therapy within 90 days of documented recurrence. Associations were evaluated using univariate and multivariable logistic regression.</p><p><strong>Results: </strong>Among patients who developed metastatic recurrence, 17 of 54 evaluable patients (32.7%) experienced early first-line systemic anticancer therapeutic attrition. Patients who did not initiate treatment had a significantly shorter disease-free interval compared with those who received first-line therapy (median 7.4 vs. 14.3 months; p = 0.011). PD-L1 positivity was more frequent in the attrition group (64.7% vs. 28.6%; p = 0.021), and central nervous system metastases were more commonly observed (41.2% vs. 20.0%). Median overall survival from metastatic recurrence was 3.4 months in the attrition group compared with 12.4 months in the no-attrition group. In multivariable analysis, shorter disease-free interval (OR 0.87 per month; 95% CI 0.78-0.97), PD-L1 positivity (OR 8.73; 95% CI 1.81-42.04), and presence of central nervous system metastases (OR 7.09; 95% CI 1.41-35.57) were independently associated with early first-line therapeutic attrition.</p><p><strong>Conclusion: </strong>In this real-world multicenter cohort, nearly one-third of patients with TNBC experiencing metastatic recurrence after neoadjuvant chemo-immunotherapy did not initiate first-line systemic therapy within a clinically relevant timeframe. Early first-line systemic anticancer therapeutic attrition represents a meaningful gap in the care continuum and warrants improved surveillance and multidisciplinary management strategies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418666","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 variation in adherence to follow-up after an abnormal screening mammogram in the Danish breast cancer screening program.","authors":"C M B Lundorff, S H Njor, S L Madsen, S F Jørgensen","doi":"10.1007/s10549-026-08014-3","DOIUrl":"10.1007/s10549-026-08014-3","url":null,"abstract":"<p><strong>Objectives: </strong>Timely and guideline-consistent follow-up after abnormal mammography findings is essential for early diagnosis and improved breast cancer outcomes. While socioeconomic position (SEP) is known to affect participation in screening, less is known about whether SEP also shapes women's adherence to follow-up once an abnormal result is identified. We aimed to investigate socioeconomic and regional differences in the timeliness and adequacy of follow-up after abnormal screening mammograms in Denmark.</p><p><strong>Methods: </strong>We included women aged 50-69 years with an abnormal screening result in Denmark, 2016-2021. Follow-up was classified as timely if initiated within 30 days and as adequate if aligned with national guidelines. SEP indicators were income, wealth, education, employment, cohabitation, country of origin, and comorbidity. Risk ratios (RR) were estimated using binomial generalized linear models.</p><p><strong>Results: </strong>Among 35,087 women, 99.3% received follow-up within six months, and 96.2% had guideline-consistent follow-up. Delays varied regionally, with higher risks in the Capital, Northern, and Zealand Regions. Delayed follow-up was more common among non-Western immigrants (RR = 1.445, 95% CI: 1.298-1.609), unemployed women (RR = 1.084, 95% CI: 1.009-1.165), and those living alone (RR = 1.073, 95% CI: 1.014-1.135). Low SEP increased the risk of no follow-up within six months, particularly among women with low wealth, low education, or immigrant background.</p><p><strong>Conclusions: </strong>Although adherence was high, regional and socioeconomic disparities persist. Women with low SEP, immigrants, unemployed, and those living alone face higher risks of delayed or inadequate follow-up, highlighting a need to reduce inequalities in the diagnostic pathway.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410390","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":"SERENA-6 and the regulatory limits of radiologic progression in modern oncology.","authors":"Saeed Rafii, Humaid O Al-Shamsi, Adam Brufsky","doi":"10.1007/s10549-026-08001-8","DOIUrl":"10.1007/s10549-026-08001-8","url":null,"abstract":"<p><strong>Background: </strong>The emergence of real-time molecular monitoring has challenged traditional oncology paradigms, where radiologic progression has historically represented the primary trigger for therapeutic intervention. The SERENA-6 clinical trial introduced a novel treatment approach by adapting therapy based on ctDNA-detected molecular progression before radiologic progression in patients with HR-positive, HER2-negative advanced breast cancer with emergent ESR1 mutations. The trial has prompted important discussion regarding the integration of molecular biomarkers into treatment decision-making and regulatory frameworks.</p><p><strong>Methods: </strong>We reviewed the ODAC deliberations, regulatory discussions, published data, and expert perspectives surrounding SERENA-6 to examine the clinical, scientific, and regulatory implications of ctDNA-guided treatment adaptation and molecularly adaptive trial designs.</p><p><strong>Results: </strong>The SERENA-6 trial demonstrated significant improvements in progression-free survival, durable disease control, and quality of life outcomes. However, important considerations remain regarding the optimal timing of treatment adaptation, evidence required to support molecularly guided switching strategies, interpretation of crossover and survival outcomes, and the regulatory evaluation of adaptive precision oncology trials.</p><p><strong>Conclusion: </strong>As oncology transitions toward biologically driven treatment strategies, new clinical and regulatory frameworks are needed to define when molecular alterations should become actionable. SERENA-6 challenges the traditional reliance on radiologic progression as the sole trigger for therapeutic intervention and provides important lessons for the future development and evaluation of molecularly adaptive precision oncology strategies beyond breast cancer.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"218 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403638","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}