Breast Cancer Research and Treatment最新文献

{"title":"Tumor characteristics associated with tomosynthesis versus digital mammography in older women with screen-detected breast cancer.","authors":"Sida Huang, Sarah J Westvold, Pamela R Soulos, John M Lewin, Haiying Zhan, Maryam B Lustberg, Rachel A Greenup, Ilana B Richman, Eric P Winer, Timothy J Robinson, Michaela A Dinan","doi":"10.1007/s10549-026-08013-4","DOIUrl":"10.1007/s10549-026-08013-4","url":null,"abstract":"<p><strong>Background: </strong>Digital breast tomosynthesis (DBT) has demonstrated improved cancer detection compared with digital mammography (DM) in trials of women aged 50-74, identifying more invasive cancers and detecting tumors at smaller sizes. However, its benefits for women over the age of 75 have not been examined.</p><p><strong>Purpose: </strong>To assess whether DBT versus DM is associated with favorable tumor characteristics and detection of less conspicuous histologic subtypes in women aged ≥ 75 compared with those aged 67-74, thereby informing screening strategies and overdiagnosis risks.</p><p><strong>Methods: </strong>We conducted a SEER-Medicare retrospective cohort study of women aged ≥ 67 diagnosed with screen-detected ER+/HER2- breast cancer from 2015 to 2021. The primary exposure was screening modality (DBT vs. DM). Outcomes included tumor size, nodal involvement, grade, and histology (invasive lobular carcinoma [ILC] vs. other). Multivariable logistic regression was used to assess the association between screening modality and tumor characteristics among women aged 67-74 and ≥ 75.</p><p><strong>Results: </strong>Among 17,201 women with screen-detected breast cancer, 43.6% were ≥ 75 at diagnosis and 60.4% were detected by DBT. In women aged 67-74, DBT was associated with higher odds of smaller tumors (adjusted odds ratio [aOR] = 1.18, 95% confidence interval [CI] = 1.08-1.29), grade I vs. II or III disease (aOR = 1.14, CI = 1.04-1.26), node-negative disease (aOR = 1.15, CI = 1.00-1.31, P = 0.048), and ILC histology (aOR = 1.29, CI = 1.13-1.48). In contrast, among women aged ≥ 75, DBT remained associated with higher odds of grade I tumors (aOR = 1.21, CI = 1.08-1.35) and node-negative disease (aOR = 1.18, CI = 1.00-1.39, P = 0.049), but was not significantly associated with smaller tumor size (aOR = 0.99, CI = 0.90-1.10) or ILC histology (aOR = 1.13, CI = 0.98-1.32).</p><p><strong>Conclusions: </strong>DBT was associated with lower grade and node negative disease in women ≥ 75, but not with smaller tumor size or ILC histology. The incremental advantage of DBT over DM may diminish with age, making the two modalities more comparable in women ≥ 75.</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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410405","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":"mRNA and protein expression of fetal insulin receptor in breast cancer cell lines and tissues.","authors":"Xihong Zhang, Albert Barrios, LeeAnn Higgins, Todd Markowski, Kevin Murray, Bruce Witthuhn, Tzu-Yi Yang, Douglas Yee","doi":"10.1007/s10549-026-08018-z","DOIUrl":"10.1007/s10549-026-08018-z","url":null,"abstract":"<p><strong>Background: </strong>The insulin receptor (IR) is expressed in breast cancer cells and plays a role in regulating tumor biology. There are two IR isoforms generated from the same gene. Alternate splicing with exclusion or inclusion of exon 11 accounts for the two isoforms. The exon 11 excluded isoform (IR-A) is expressed during fetal development while the full-length adult IR (IR-B) is the primary form expressed during adult life. This splice variant results in a 12 amino acid variation in peptide sequence. Breast cancer cells overexpress IR-A with an increased IR-A: IR-B ratio. Most of these data were obtained by examining mRNA expressions.</p><p><strong>Methods: </strong>In this work, we examined over 40 breast cancer cell lines and patient tumor samples for mRNA expression of the IR isoforms. Further we used mass spectrometry to evaluate IR-A protein expression.</p><p><strong>Results: </strong>Most breast cancer cell lines and tissues overexpress IR-A compared to IR-B. Mass spectrometry analysis demonstrated IR-A protein expression in the Du4475 cell line which has a high level of IR-A mRNA expression.</p><p><strong>Conclusion: </strong>IR-A mRNA is frequently expressed in breast cancer cells. To our knowledge, this is the first demonstration of IR-A protein expression. Thus, IR-A mRNA and protein expression demonstrate a potential role for this insulin receptor isoform in breast cancer biology.</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/PMC13346282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410353","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":"Efficacy and safety of eribulin mesylate vs. docetaxel or paclitaxel, combined with trastuzumab and pertuzumab, as first-line treatment for HER2-positive locally advanced or metastatic breast cancer: updated subgroup analyses of JBCRG-M06/EMERALD.","authors":"Norikazu Masuda, Shigehira Saji, Yasuyuki Kojima, Masahiro Kitada, Hiroshi Tada, Tsutomu Iwasa, Kei Koizumi, Tsuguo Iwatani, Yasuaki Sagara, Takashi Kuwayama, Masafumi Shimoda, Tatsunari Sasada, Koichiro Tsugawa, Yoshihiro Kawaguchi, Akihiko Shimomura, Takuhiro Yamaguchi, Hiroki Hasegawa, Shun Osaka, Satoshi Morita, Toshinari Yamashita","doi":"10.1007/s10549-026-08004-5","DOIUrl":"10.1007/s10549-026-08004-5","url":null,"abstract":"<p><strong>Purpose: </strong>We performed updated subgroup analyses of the EMERALD study to investigate efficacy, safety, and quality of life (QoL) in patients treated with eribulin (E) vs. either docetaxel (DTX) or paclitaxel (PTX).</p><p><strong>Methods: </strong>Patients with HER2+ locally advanced/metastatic breast cancer (LABC/MBC) were randomized to receive E or taxane (T) (physician's choice of DTX or PTX; declared in advance at registration) in 21-day cycles, each combined with trastuzumab + pertuzumab. Survival outcomes, treatment patterns, antitumor efficacy, safety, and QoL were examined.</p><p><strong>Results: </strong>The intention-to-treat (and safety) populations comprised 224 (224) patients who received E, 186 (184) who received DTX, and 36 (34) who received PTX. Baseline characteristics were balanced. Progression-free survival (E vs. DTX: 14.0 vs. 13.1 months; hazard ratio [HR], 0.94 [95% CI, 0.74-1.21]; E vs. PTX: 14.1 vs. 10.8 months; HR, 1.00 [95% CI, 0.58-1.73]) and overall survival (E vs. DTX: not reached [NR] vs. NR; E vs. PTX: 75.5 months vs. NR) were similar among the subgroups. Although the incidences of adverse events (AEs) were generally similar, peripheral sensory neuropathy was more frequent with PTX and less frequent with DTX, compared with E. Neutropenia tended to be more frequent with E. Median time to QoL deterioration was longer with E vs. DTX (7.8 vs. 4.7 months) and E vs. PTX (6.1 vs. 3.9 months).</p><p><strong>Conclusions: </strong>This trial revealed comparable efficacy of E vs. either DTX or PTX, when combined with dual HER2 blockade as first-line treatment for HER2+ LABC/MBC. AEs were generally similar between the E and T subgroups. QoL was maintained for longer in the E subgroups vs. T subgroups.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT03264547; registered: 28 June 2017); University Hospital Medical Information Network (UMIN000027938; registered: 26 June 2017).</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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410415","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":"Discrimination, spectrum, and clinical utility: ICG lymphography drainage time in axillary staging.","authors":"Çağrı Akalın, Gökhan Zaim, Mümin Demir","doi":"10.1007/s10549-026-08017-0","DOIUrl":"10.1007/s10549-026-08017-0","url":null,"abstract":"<p><p>This Correspondence responds to the prospective study by Anuszkiewicz et al., which assessed dynamic indocyanine green (ICG) lymphography drainage time as a marker of axillary nodal burden. We raise three methodological points relevant to how the results should be read. First, the cohort included only patients selected for axillary lymph node dissection, so it represents a narrow, non-representative spectrum in which discrimination tends to be optimistic; the reported area under the curve of 0.995 was obtained without internal or external validation. Second, an ipsilateral-to-contralateral ratio may be more transportable than the absolute threshold that was used. Third, discrimination is not the same as clinical utility, which also depends on calibration and net benefit. We outline directions for validation and future study.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"217 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337726","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":"Tumor infiltrating lymphocytes (TILs) as a predictive marker of pathological complete response (pCR) in a diverse patient population with early triple negative breast cancer (TNBC) treated with neoadjuvant real-world KEYNOTE-522 regimen.","authors":"Riya Albert, Joshua Thomas, Navid Sadeghi, Sangeetha M Reddy, Glenda Delgado Ramos, Heather McArthur, Samira Syed, Deborah Farr, Nisha Unni","doi":"10.1007/s10549-026-08002-7","DOIUrl":"10.1007/s10549-026-08002-7","url":null,"abstract":"<p><strong>Introduction: </strong>Triple-negative breast cancer (TNBC) is an aggressive subtype characterized by poor prognosis. Based on the KEYNOTE-522 trial, neoadjuvant pembrolizumab plus chemotherapy has become the standard of care due to significantly improved pathological complete response (pCR) rates. The presence of tumor-infiltrating lymphocytes (TILs) is a predictive biomarker of pCR. This retrospective cohort study examines a diverse patient population treated with the K522 regimen to determine if TILs predict pCR relative to other clinical and tumor-specific factors.</p><p><strong>Methods: </strong>We retrospectively reviewed 187 patients with early-stage TNBC at two institutions (one tertiary care, one safety-net) who completed neoadjuvant K522 treatment between 2021 and 2024. Statistical analyses included Chi-squared tests, Z-tests, and univariate logistic regression to evaluate associations between TILs, ethnicity, tumor grade, and pCR, and multivariate logistic regression to assess whether the association between dose intensity and pCR differed by the presence of TILs at baseline.</p><p><strong>Results: </strong>The overall pCR rate was 57%; TILs were present in 52.8% of cases. TILs were associated with a significantly higher pCR rate (70% vs. 48% without TILs; p = 0.0027). While pCR rates were similar across ethnicities, Hispanic patients with TILs had significantly higher pCR than those without (80.0% vs. 51.5%; p = 0.0254). Controlling for grade, patients with TILs were 2.442 times more likely to achieve pCR (CI: 1.310-4.553; p = 0.0050). Grade 3 tumors and node-positivity with TILs also showed statistically significant rates of pCR. Logistic regression analysis revealed a significant interaction between TIL status and immunotherapy dose intensity on pCR. While dose intensity did not influence pCR in TIL-negative patients, TIL-positive patients achieved higher pCR rates with lower dose intensity (OR = 1.54, p = 0.036).</p><p><strong>Conclusion: </strong>TILs serve as a strong predictive biomarker for immunotherapy response in a real-world TNBC population. Our findings regarding Hispanic, node-positive patients, and the interaction between TIL status and dose intensity suggest that TILs could guide treatment de-escalation to reduce K522-related toxicity. Standardizing TILs reporting is critical to optimizing treatment strategies and improving outcomes in underrepresented populations.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"217 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337824","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":"Comments on: Predictors of pathologic complete response in early-stage triple-negative breast cancer treated with neoadjuvant chemo-immunotherapy.","authors":"Rajesh Prasad Jayaswal, Shailendra Thapliyal, Rama Kumari Badyal","doi":"10.1007/s10549-026-08015-2","DOIUrl":"10.1007/s10549-026-08015-2","url":null,"abstract":"<p><p>This correspondence comments on LeVee et al.'s real-world study of neoadjuvant chemo-immunotherapy in early-stage triple-negative breast cancer. We highlight diabetes as a potentially modifiable host-state factor influencing pathologic complete response and propose a metabolic immunotherapy-readiness framework integrating glycaemic control, treatment delivery, endocrine monitoring, and equity-focused implementation. This perspective aims to support globally applicable strategies for improving chemo-immunotherapy effectiveness and access.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"217 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337562","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":"Subjective socioeconomic status moderates the relationship between objective neighborhood disadvantage and quality of life in middle- and older-aged women with breast cancer.","authors":"Rachel L Plotke, Millan R Kanaya, Paula J Popok, Sarah N Webster, Jenna L Hansen, Mason J Krueger, Mary Roberts, Sara Ebrahimi, Estefany Saez-Clarke, Chloe J Taub, Neha Goel, Michael H Antoni","doi":"10.1007/s10549-026-08008-1","DOIUrl":"10.1007/s10549-026-08008-1","url":null,"abstract":"<p><strong>Purpose: </strong>Living in a disadvantaged neighborhood is linked to higher mortality rates and poorer quality of life (QoL) among patients with breast cancer (BC). Subjective socioeconomic status (SSS), reflecting one's perceived socioeconomic \"rank\" or social standing relative to others, may be associated with differences in the relationship between objective neighborhood disadvantage and QoL. Therefore, we sought to evaluate whether SSS moderated the association between objective neighborhood disadvantage and QoL in middle- and older-aged women undergoing BC treatment.</p><p><strong>Methods: </strong>Women (≥ 50yrs) diagnosed with non-metastatic BC participating in a stress management trial completed a baseline assessment of SSS (MacArthur Network Sociodemographic Questionnaire) and QoL (Functional Assessment of Cancer Therapy-Breast) in the weeks after surgery. The Area Deprivation Index (ADI), which ranks the degree of neighborhood disadvantage via participants' addresses, measured objective neighborhood disadvantage. Multivariate linear regressions related ADI, SSS, and QoL, adjusting for age, cancer stage, and race/ethnicity.</p><p><strong>Results: </strong>Greater SSS relative to the community (B = 3.60, SE = 1.12, p=.002) and the USA (B = 3.01, SE = 1.09, p=.006) related to better QoL. Also, SSS USA interacted with ADI in predicting QoL (B = 0.95, SE = 0.45, p=.038), such that greater ADI related to poorer QoL in women with lower but not higher SSS.</p><p><strong>Conclusion: </strong>Greater SSS relative to one's community and the USA population related to better QoL in women treated for BC. Conversely, greater objective neighborhood disadvantage related to poorer QoL but not among those with greater SSS. Future work could examine whether SSS is a modifiable intervention target through coping effectiveness training, or by enhancing community and social engagement.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"217 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337864","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":"Comments on: Cost-effectiveness of DPYD genotyping prior to capecitabine administration for metastatic breast cancer.","authors":"Rajesh Prasad Jayaswal, Anuj Kumar Rana, Rama Kumari Badyal","doi":"10.1007/s10549-026-08016-1","DOIUrl":"10.1007/s10549-026-08016-1","url":null,"abstract":"<p><p>DPYD genotyping before capecitabine therapy represents a clinically actionable pharmacogenomic strategy to reduce avoidable fluoropyrimidine-related toxicity in metastatic breast cancer. Commenting on the cost-effectiveness analysis by Chiddarwar, Blaes and Kuntz, this correspondence supports the authors' findings while extending the discussion from economic value to implementation readiness. We propose that DPYD testing should be evaluated through a globally transferable framework incorporating ancestry-aware variant coverage, rapid turnaround pathways, genotype-linked dose decision support, budget-impact assessment and real-world toxicity surveillance. Such an approach may help translate cost-effective pharmacogenomics into equitable, operationally feasible breast cancer care across diverse health systems.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"217 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337554","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":"Role of individualized intervention(s) on quality of life and adherence to adjuvant endocrine therapy in premenopausal women with early-stage breast cancer: MyCHOICE study.","authors":"Shahid Ahmed, Sonya Mannala, Prosanta Mondal, Wardah Mahmood, Haji Ibrahim Chalchal, Lynn Dwernychuk, Nayyer Iqbal, Muhammad Salim, Muhammad Imtiaz Khan, Osama Ahmed, Mita Manna, Donelda Gowan Leverick, Ambika Chandrasekhar, Ayesha Bashir, Kamal Haider, Anne Leis, Saija Kontulainen, Amer Sami","doi":"10.1007/s10549-026-07999-1","DOIUrl":"10.1007/s10549-026-07999-1","url":null,"abstract":"<p><strong>Background: </strong>Premenopausal women receiving combination endocrine therapy often experience substantial declines in quality of life (QOL), cognitive functioning, and treatment adherence. The MyChoice study evaluated whether individualized behavioral and complementary interventions could help maintain or improve QOL and treatment adherence in women with early-stage hormone receptor-positive breast cancer undergoing aromatase inhibitor- or tamoxifen-based therapy with ovarian suppression.</p><p><strong>Methods: </strong>In this prospective multicenter phase II study, premenopausal women with newly diagnosed hormone receptor-positive breast cancer were enrolled prior to initiation of combination endocrine therapy. Tailored supportive interventions, including structured exercise programs, restorative yoga, acupuncture, and massage therapy, were offered, and women could choose one or more interventions either alone or in combination. QOL and cognitive function were assessed at baseline, 3 months, and every 6 months for up to 3 years using FACT-B, FACT-ES, and FACT-Cognitive Function instruments. Adherence to endocrine therapy was assessed at each follow-up visit using physician-conducted patient interviews and pharmacy refill records. Longitudinal changes in QOL and their demographic and clinical predictors were analyzed using linear mixed-effects models.</p><p><strong>Results: </strong>Forty premenopausal women participated, with a median age of 43 years. Exercise was the most frequently selected intervention (61%), followed by massage therapy (44%), acupuncture (35%), and yoga (30%). Functional well-being improved significantly over time (1.65 points per year, p = 0.0005). Emotional well-being, social/family well-being, physical well-being, endocrine symptoms, and perceived cognitive abilities remained stable. Adherence to endocrine therapy was high at 92.5% over the follow-up period. In multivariable analyses, younger age (< 35 years) was associated with less favorable outcomes across several domains, including lower FACT-ES scores and lower physical well-being.</p><p><strong>Conclusion: </strong>Individualized, patient-selected supportive interventions may help maintain key aspects of quality of life and support adherence to endocrine therapy in premenopausal women with early-stage breast cancer. These findings support further evaluation in larger, controlled trials.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"217 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337849","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":"Surgeon interpretation of margin status utilizing intraoperative 3D tomosynthesis during breast-conserving surgery.","authors":"Laura D Leonard, Ethan Cohen, Rachel Perry, Jia Sun, Richie Ehlers, Ana Refinetti, Helen M Johnson, Catherine Akay, Jessica Suarez Colen, Sarah DeSnyder, Fedra Fallahian, Rosa Hwang, Kelly K Hunt, Yun Wu, Nina Tamirisa","doi":"10.1007/s10549-026-08005-4","DOIUrl":"10.1007/s10549-026-08005-4","url":null,"abstract":"<p><strong>Introduction: </strong>Obtaining negative margins at the time of segmental mastectomy (SM) is important to reduce risk of local recurrence and avoid the need for a second surgery due to positive margins. Our current institutional standard practice (ISP) includes intraoperative assessment of the gross specimen and specimen radiographs by a multidisciplinary team including radiologists and pathologists.</p><p><strong>Methods: </strong>In this study, we utilized digital breast tomosynthesis (DBT) images of SM specimens in the operating room and recorded when additional (selective) shave margins were proposed by the surgeon. A breast radiologist later reviewed the archived DBT images. The timing and accuracy of surgeon and breast radiologists' margin assessment using DBT was then compared to our ISP.</p><p><strong>Results: </strong>There were 193 patients enrolled and included in the analysis. Of 196 SM specimens, 9.7% (n = 19) had positive margins prior to excision of selective shave margins. Of these, 16 were identified by ISP with a sensitivity of 84%, specificity of 29%, false-negative rate (FNR) of 16%, positive predictive value (PPV) of 11%, and negative predictive value (NPV) of 95%. Surgeon assessment of DBT images identified 16/19 specimens with positive margins, with a sensitivity of 84% (p > 0.05), specificity of 49% (p < 0.001), FNR of 16% (> 0.05), PPV of 15% (p > 0.05), and NPV of 97% (p > 0.05). The median time for surgeon interpretation was 6 (range 2-35) minutes vs. 33 (range 15-88) for ISP.</p><p><strong>Conclusions: </strong>Surgeon interpretation of DBT images offers an alternative to a more time- and labor-intensive ISP for detecting positive margins during breast-conserving surgery, with comparable accuracy and higher sensitivity.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":"217 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293047","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}