Breast Care最新文献

{"title":"Online Training to Increase Genetic and Risk Literacy in Physicians Counseling Breast and Ovarian Cancer Patients for Genetic Testing.","authors":"Kerstin Rhiem, Clara Breidenbach, Anke Waha, Britta Blümcke, Christine Fischer, Tiemo Grimm, Andrea Hahne, Eric Hahnen, Anke Harney, Jan Hauke, Karin Kast, Friedhelm Meier, Anne Quante, Alexander Volk, Tanja Zimmermann, Simone Wesselmann, Rita Schmutzler","doi":"10.1159/000545408","DOIUrl":"10.1159/000545408","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing use of germline genetic testing for the clinical management of patients with a family history of breast and ovarian cancer requires an improvement in the genetic and risk literacy of physicians and healthcare professionals. In order to offer high-quality care throughout Germany, from genetic counseling to risk-adapted prevention, the German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) and the German Cancer Society (DKG) have established a nation-wide cooperation partner network with certified gynecological and breast cancer centers. As a core element of this cooperation, an online-based training program has been developed in which the \"state-of-the-art knowledge\" on the topic is conveyed.</p><p><strong>Methods: </strong>The training is aimed at physicians and healthcare professionals working in the specialized centers of the GC-HBOC/certified centers for familial breast and ovarian cancer (FBREK centers) or the cooperating certified gynecological and breast cancer centers. It consists of an online-based part (15 lectures) covering interdisciplinary basics and competencies on political frameworks, genetic and nongenetic risk factors including individual risk calculation, and nondirective communication on risk-adapted prevention options. Patient involvement with voting rights during the development and implementation of the training increased its accuracy of fit for patient needs. After a successful online knowledge test, employees of certified gynecological and breast cancer centers participate in a 1-day, on-site internship at an FBREK center with which a cooperation is planned.</p><p><strong>Results: </strong>From November 2021 to July 2024, 1,860 participants registered for the online training, of which 1,329 have started to work on the content. So far, 898 participants have passed the online knowledge test. More than 560 participants took part in the accompanying evaluation in which the majority stated that the course helped to increase their professional knowledge, it was relevant to their practical medical work, and it contributed to a more confident approach to patients with a family history of cancer. Most participants stated that it was worthwhile participating in the training in terms of time and organization and that the content, didactics, visual presentations, and comprehensibility were appropriate.</p><p><strong>Conclusion: </strong>The online-based training serves to impart and expand interdisciplinary knowledge and skills in genetics and risk counseling. It is well received, has been positively evaluated and the format proves to be suitable for strengthening the networked care of patients across sectoral boundaries and promoting the rapid translation of new research findings into clinical practice within the framework of knowledge-generating care.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Assessment Using Gene Expression Profiling Correlates with Clinical Prognosis Estimation in Hormone Receptor-Positive/HER2-Negative Early Breast Cancer.","authors":"Alexa Binder, Kristina Tendl-Schulz, Maximilian Marhold, Kerstin Wimmer, Margaretha Rudas, Rupert Bartsch, Zsuzsanna Bago-Horvath, Elisabeth S Gruber, Ruth Exner","doi":"10.1159/000545785","DOIUrl":"10.1159/000545785","url":null,"abstract":"<p><strong>Background: </strong>Gene expression profiles (GEPs) are recommended for tailoring adjuvant treatment in patients with hormone receptor (HR)-positive/HER2-negative breast cancer (BC) with intermediate clinical and pathological risk. This single-center retrospective study aimed at evaluating the clinical relevance of the additive information provided by GEPs in clinical routine at a tertiary care center.</p><p><strong>Methods: </strong>From 03/2010 to 07/2019, GEPs by either MammaPrint (MP) or PAM50 of HR-positive/HER2-negative early-stage BC were retrospectively included in the study. Pseudonymized data were processed for statistical analysis. Correlations between clinical and molecular risk markers were calculated. Survival was estimated using the Kaplan-Meier method.</p><p><strong>Results: </strong>Clinical and molecular risk data were available for 213 patients; complete follow-up data were available for 189 patients. According to GEPs by either MP (<i>n</i> = 69) or PAM50 (<i>n</i> = 144), 67 patients (31.5%) had low, 58 (27.2%) intermediate only in PAM50, and 88 (41.3%) high-risk BC. The MP group showed a higher rate of molecular low-risk tumors, while tumors analyzed by PAM50 were more frequent in a molecular high-risk situation. A significant correlation of proliferation rate and grading with the molecular risk score was observed (<i>p</i> < 0.001 each). Adjuvant chemotherapy was recommended in 87.5% of molecular high-risk tumors but administered in 64.8% only. Interestingly, a worse DFS was detected in the molecular low-risk group compared to the high-risk group (<i>p</i> = 0.55). It may be assumed that this is associated with an advanced tumor stage in these patients.</p><p><strong>Conclusion: </strong>In HR-positive/HER2-negative BC, proliferation rate as well as tumor grade correlated significantly with risk assessment by GEPs. Despite a high-risk result, chemotherapy is often omitted due to patient-specific factors such as age, comorbidities, or patients' preference. On the other hand, survival with genomic low-risk tumors is likely to be compromised to more advanced stage, questioning the clinical validity of GEPs in these cases.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenge of Calculating EUSOMA Quality Indicators with Administrative Data: A Pilot Study in Belgium.","authors":"Roos Leroy, Cindy De Gendt, Jolyce Bourgeois, Julie Verbeeck, Isabelle Savoye, Nancy Van Damme, Sabine Stordeur, Pieter De Visschere, Donatienne Taylor, Hans Wildiers, Jean-Luc Canon, Birgit Carly, Pino G Cusumano, Evandro de Azambuja, Joëlle Desreux, Francois P Duhoux, Peter van Dam, Didier Verhoeven, Liv Veldeman","doi":"10.1159/000543676","DOIUrl":"https://doi.org/10.1159/000543676","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to assess the feasibility of calculating the European Society of Breast Cancer Specialists (EUSOMA) quality indicators (QIs) using Belgian Cancer Registry data coupled to administrative health data and to provide national results.</p><p><strong>Methods: </strong>Women diagnosed with ductal carcinoma in situ (DCIS) or invasive breast cancer (IBC) in 2014-2018 were selected from the cancer registry. Fourteen EUSOMA QIs were chosen to assess the quality of care.</p><p><strong>Results: </strong>Overall, 46,035 patients with IBC and 3,973 patients with DCIS were included. Most QIs had to be rephrased so that they could be calculated with the available data. None of the selected QIs on systemic treatment could be calculated due to a lack of reliable receptor status information. For some Qis, there is ample room for improvement in Belgian clinical practice: cTNM stage reporting, multidisciplinary team meetings, sentinel lymph node biopsy only in IBC with clinically negative lymph nodes. The result was 1-5% lower than the target for mammography and breast ultrasound, pTNM reporting, start of treatment, single breast surgery in DCIS, and no axillary clearance in DCIS. For histological or cytological assessment, receptor status assessment, start of radiotherapy, and single breast surgery in IBC, the results were at or above the target.</p><p><strong>Conclusion: </strong>Several EUSOMA QIs can be calculated with routinely collected data, while for several important aspects of care additional data collection is indicated so that its quality can be assessed. The validity of the obtained results depends on the reporting accuracy.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"88-94"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Decade of AGO QS-Mamma: Adherence to the Recommendations of the AGO Breast Committee for Diagnosis and Treatment in EBC in Routine Therapy in Germany.","authors":"Christian Jackisch, Wolfgang Janni, Volkmar Müller, Jalid Sehouli, Athanasios Argyriadis, Patrik Lindenmaier, Andreas Jaeger, Sabine Predehl","doi":"10.1159/000543237","DOIUrl":"https://doi.org/10.1159/000543237","url":null,"abstract":"<p><strong>Introduction: </strong>The cure for early breast cancer (EBC) is increasing over the last decades due to the improvement of diagnosis and therapy. Individualization of cancer treatment in EBC requires constant optimization by implementing current guidelines. The AGO (working group gynecologic oncology) QS-Mamma initiative, a quality assurance program (QS) of the AGO Breast Committee, was introduced to provide insight in guideline adherence in real-world practice in Germany. We evaluated 10 years of QS-Mamma data to identify gaps and trends implementing those guidelines.</p><p><strong>Methods: </strong>QS-Mamma is a retrospective sample survey providing a representative overview of the treatment landscape of breast cancer in Germany. The last six cohorts were analyzed over a period of 10 years. Across all cohorts, an average of 264 centers documented a total of <i>n</i> = 4,577 patients with EBC.</p><p><strong>Results: </strong>Testing for BRCA mutations in triple-negative patients increased significantly. Breast conserving surgery has been standard of care since the start of data collection; choice of surgical procedure depends primarily on tumor size and nodal status according to the patient's preference, if possible. Axillary intervention has shifted toward SLNE or targeted axillary procedures in patients with negative preoperative nodal staging. Neoadjuvant systemic therapy in operable EBC is established. Anthracycline administration in the adjuvant setting decreases. We noted an uptake on using platinum-containing CTx in TNBC, corresponding to AGO recommendations. Dual HER2 blockade is established in HER2-positive EBC with increased risk of relapse. Changes in guidelines are reflected in real-world data.</p><p><strong>Conclusion: </strong>Guideline adherence in breast cancer care is high and new treatments and diagnostic options are implemented promptly. Finally, escalation and de-escalation of treatment depend on individual tumor characteristics resulting in the individual risk of recurrence. Guidelines should be flanked by real-world evidence to ensure and survey their impact.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"66-74"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life after Alloplastic versus Autologous Breast Reconstruction: The Influence of Patient Characteristics on Outcomes.","authors":"Iris L Holt-Kedde, Nadia Sadok, Irene S Krabbe-Timmerman, Geertruida H de Bock, Grigory Sidorenkov, Paul M N Werker","doi":"10.1159/000543677","DOIUrl":"https://doi.org/10.1159/000543677","url":null,"abstract":"<p><strong>Objective: </strong>Quality of life (QoL) following autologous breast reconstruction has been found to be higher compared to alloplastic breast reconstruction. However, evaluating QoL is complex as it is influenced by various factors, including patient characteristics and treatment types. Previous studies comparing QoL between reconstruction techniques have not sufficiently addressed baseline differences between patient groups, some of which contribute to indication bias. Using an alternative approach to identify the confounders, this study aimed to evaluate which factors affect the patient satisfaction and QoL after alloplastic or autologous reconstruction, with follow-up extending up to 3 years post-surgery.</p><p><strong>Method: </strong>QoL and satisfaction were measured using the Breast-Q preoperatively and after breast reconstruction (post-BR) at 6 weeks, 6 months, 1 year, and 3 years. General and mental health were measured using the SF-36 and the HADS. A generalized linear mixed model was utilized to assess which factors confound the relationship between reconstruction technique and Breast-Q scores.</p><p><strong>Results: </strong>Factors contributing to the disparity in Breast-Q scores between autologous and alloplastic breast reconstruction varied across Breast-Q subscales. Autologous breast reconstruction patients consistently reported higher \"Satisfaction with Breasts\" and \"Physical Well-being,\" while the minimal important differences in \"Psychosocial\" and \"Sexual Well-being\" were lost after adjustment for confounding factors.</p><p><strong>Conclusion: </strong>This study confirms that even when adjusted for confounders, scores on two QoL subscales autologous breast reconstruction patients score significantly higher over time. Although autologous reconstruction remained superior regarding \"Satisfaction with Breasts,\" scores decreased in autologous reconstruction patients when they were depressed at baseline, underwent radiotherapy, had a history of breast cancer, or faced major complications.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"95-110"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phyllodes Tumor of the Breast: Histomorphological Transformation to High-Grade Tumor during Pregnancy and Challenging Oncoplastic Surgery.","authors":"Caroline Ines Preuss, Peter Schrenk, Marco Affortunati, Nina Brandstetter, Stefanie Schuster, Heike Kathleen Schwarz, Bruno Schneeweiss, Thomas Gitter, Peter Oppelt, Andreas Shamiyeh, Rupert Langer, Farid Moinfar, Claudia Grosse, Maria Steinmair","doi":"10.1159/000543655","DOIUrl":"https://doi.org/10.1159/000543655","url":null,"abstract":"<p><strong>Introduction: </strong>Phyllodes tumors of the breast are a very rare tumor entity. There are two different classifications according to AFIP (low-grade and high-grade phyllodes tumors of the breast) and WHO (three subtypes: benign, borderline, and malignant phyllodes tumors). Phyllodes tumors have an increased risk of recurrence. Primary clinical treatment of phyllodes tumors is surgery, although the width of the required resection margins often presents a challenge for surgical management.</p><p><strong>Case presentation: </strong>This case report deals with a 24-year-old woman with second recurrence of borderline phyllodes tumor. The challenge of this case lays first in surgical removal of the large tumor by breast-conserving therapy with tumor-free margins and favorable aesthetic outcome. Achieving this goal by tumor-adapted reduction mammoplasty, skin excision, and slide-swing skin flap was challenging. The second exciting aspect of this case is the histomorphology of the tumor and the transformation in vivo from fibroadenoma with stromal atypia in 2021 to the first recurrence with a low-grade phyllodes tumor in 2022 and the further transformation to a high-grade tumor with stromal overgrowth in the second recurrence of phyllodes tumor in 2023 during pregnancy and childbed.</p><p><strong>Conclusion: </strong>This case of a phyllodes tumor shows how quickly tumor characteristics can change in fast-growing tumors due to transformation from low-grade to high-grade tumor. The influence of pregnancy on this process remains unclear at present. Surgical removal of phyllodes tumors should be performed during pregnancy.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"132-140"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted Axillary Dissection Using Surgical Marker Navigation after Neoadjuvant Systemic Treatment in Breast Cancer Patients: A Single-Center Experience.","authors":"Daniel Egle, Christine Brunner, Magdalena Ritter, Verena Wieser, Katharina Knoll, Birgit Amort, Afshin Soleiman, Heidelinde Fiegl, Christian Marth, Carmen Albertini, Rupert Bartsch","doi":"10.1159/000541704","DOIUrl":"https://doi.org/10.1159/000541704","url":null,"abstract":"<p><strong>Background: </strong>In early-stage breast cancer with initially positive axillary lymph nodes, reliable assessment of the involvement of the axilla is important because of the prognostic importance of lymph node metastases. After neoadjuvant chemotherapy (NACT), targeted axillary dissection (TAD), including sentinel lymph node biopsy and primarily involved lymph nodes, is currently regarded as the standard of care. The target lymph node must be marked using a clip/marker and later localized using a reliable guidance technique to identify the node, to avoid the indication of axillary lymph node dissection.</p><p><strong>Methods: </strong>The present study aimed to evaluate retrospective data collected from April 25, 2022, until March 30, 2023, on a consecutive series of patients, to determine the efficacy and safety of using the Sirius Pintuition GPSDetect^™ surgical marker navigation system.</p><p><strong>Results: </strong>This consecutive case series shows that identification of the target node with surgical marker navigation is feasible and safe, with a 100% identification rate at surgery, in a population of 20 patients with histologically verified axillary lymph node involvement before NACT.</p><p><strong>Conclusion: </strong>Magnetically guided localization systems may therefore be a valid alternative to ultrasound-guided wire placement. The data highlight the practicality of the magnetically guided approach, which potentially contributes to a reduction in treatment-related morbidity by avoiding unnecessary axillary lymph node dissection.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"57-65"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Immunophenotypic Variation in Subcapsular Sinus Endothelium of Sentinel Lymph Nodes in Invasive Breast Carcinoma.","authors":"Jonas Derben, Markus Oeruem, Carolin Blasberg, Akira Hattesohl, Paul Jank, Matthias Kalder, Carsten Denkert, Christina C Westhoff","doi":"10.1159/000543600","DOIUrl":"https://doi.org/10.1159/000543600","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies demonstrated the de novo formation of lymphatic vessels in tumor-draining lymph nodes (LNs), partly preceding lymphatic metastases. This \"lymphovascular niche\" supposedly facilitates survival of metastatic tumor cells. This study aims at evaluating the previously observed immunophenotypic variations of subcapsular endothelial cells (SECs) in a larger cohort by software-assisted image analysis.</p><p><strong>Methods: </strong>Suitable cases with sentinel-LN (SLN) of invasive breast cancer were identified in the Institute of Pathology, corresponding data were extracted. LN of 231 patients were stained for HE, D2-40, CD31, and Prox1. QuPath software was used for assessing the immunohistochemical stained area of endothelial cells of the subcapsular sinus. The Cutoff Finder web application was used for identification of the best cutoff for continuous parameters according to overall survival (OS). Collected data were statistically evaluated for available data.</p><p><strong>Results: </strong>A larger area of CD31-positive SEC was significantly associated with worse OS (<i>p</i> = 0.001), as was a higher proportion of D2-40-stained subcapsular sinus (<i>p</i> = 0.045). Larger area of D2-40-/CD31-/Prox1-positive SEC and higher proportion of D2-40 stained subcapsular sinus were independent marker for worse OS in multivariate analysis in the whole cohort, for D2-40- and CD31-positive SECs as well as higher proportion of D2-40-stained sinus including nodal-negative status, respectively.</p><p><strong>Conclusion: </strong>QuPath-assisted evaluation of immunophenotypic variation in subcapsular sinus endothelium in SLN essentially confirmed and extended our previous findings. Larger positive area of D2-40- and CD31-positive SECs emerged as a strong independent negative prognostic factor, even before evident nodal metastasis. The potential function of alterations in D2-40-/CD31-expression in SECs has yet to be elucidated.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"75-87"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-Scale Population Screening for <i>BRCA1</i> and <i>BRCA2</i> Ashkenazi Founder Mutations: Perspectives of Professionals Providing Oncogenetic Consultations.","authors":"Yael Furman, Yoel Gofin, Shira Litz Philipsborn, Shulamit Hartmajer, Rivka Sukenik-Halevy","doi":"10.1159/000543678","DOIUrl":"https://doi.org/10.1159/000543678","url":null,"abstract":"<p><strong>Introduction: </strong>In March 2020, a nationwide population carrier screening for <i>BRCA1/2</i> pathogenic variants among Ashkenazi Jewish women was initiated in Israel. We aimed to assess views regarding the program among professionals who provide oncogenetic counseling for detected carriers.</p><p><strong>Methods: </strong>An online survey was distributed to clinical geneticists and genetic counselors.</p><p><strong>Results: </strong>The participants' impression was that most carriers did not comprehend the implications of a positive result when deciding to take the test. Some carriers, in retrospect, regretted taking it. Some had a known mutation carrier in the family, and some had a family history that justified a broader test (and so should not have been tested through the screening program). Eight survey participants (29%) reported they were initially against the screening program, but half of them are currently in favor of it. Most participants are unsatisfied with the way the screening is conducted and suggested various improvements. Emotional distress of carriers, as assessed by participants, was higher for those detected by the screening program, compared to those tested after oncogenetic counseling. No association was found between the age, profession, and prior experience of participants and their responses.</p><p><strong>Conclusions: </strong>While the general attitude toward the screening program is positive, most professionals feel the need to improve the current screening program by defining exclusion criteria, providing comprehensive pretest information and adding other BRCA1/2 founder mutations, as well as expanding the screening to include ethnicities other than Ashkenazi Jews.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"111-117"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Risk Factors and Development and Validation of a Nomogram for Predicting Overall Survival in Breast-Invasive Lobular Carcinoma.","authors":"Mingjie Yuan, Ying Yin, Zhaoxin Chu, Jianming Yan","doi":"10.1159/000543865","DOIUrl":"https://doi.org/10.1159/000543865","url":null,"abstract":"<p><strong>Objective: </strong>Invasive lobular carcinoma (ILC) of the breast is a common pathological subtype of breast cancer, ranks second in terms of incidence rate following invasive ductal carcinoma. The aims of this study were to construct a nomogram for predicting overall survival (OS) in patients with ILC and to identify risk factors that affect their survival prognosis.</p><p><strong>Methods: </strong>The patients diagnosed with ILC between 2010 and 2015 were extracted from Surveillance, Epidemiology, and End Results (SEER) database. They were randomly split into a training set with 18,365 samples for model training and parameter tuning and a validation set with 7,872 samples for independent accuracy verification. The independent risk factors were screened by lasso regression and multivariable Cox regression. A nomogram was constructed for the 3-year, 5-year, and 10-year OS rates based on these independent risk factors. Model efficiency was assessed through Harrell's concordance index (C-index), calibration curves, receiver operating characteristic curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 26,237 patients diagnosed with ILC were included. The following factors were identified as independent risk factors associated with OS: age, marital status, grade, estrogen receptor, progesterone receptor, surgery, radiation therapy, tumor size (T), lymph node (N), and metastasis (M) stages. The C-index was 0.795 in the training set, while in the validation set it was 0.791. The corresponding areas under the curve for 3-year, 5-year, and 10-year OS were 0.837, 0.828, and 0.791 in the training set and 0.832, 0.826, and 0.781 in the validation set, respectively. The calibration curve of the nomogram showed good consistency, and the DCA curves also suggested that it can provide valuable guidance for clinical decision-making.</p><p><strong>Conclusions: </strong>The established nomogram predicting 3-year, 5-year, and 10-year OS for patients with ILC showed a good performance and it can help clinicians make more favorable clinical decisions.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"118-131"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}