Breast Care最新文献

{"title":"Clinical Relevance of HER2-Low and HER2-Zero Subgroups in Hormone Receptor-Negative Breast Cancer: A Retrospective Single-Center Cohort Study 2014-2024.","authors":"Ariana Plasger, Sarah Meurer, Marie-Kristin von Wahlde, Ludwig Kiesel, Isabel Radke, Carl Opitz, Wolfgang Roll, Lars Hanker, Joke Tio","doi":"10.1159/000553131","DOIUrl":"10.1159/000553131","url":null,"abstract":"<p><strong>Introduction: </strong>HER2-negative and hormone receptor (HR)-negative breast cancer is typically associated with poor prognosis due to limited treatment options. Recent research has demonstrated efficacy of anti-HER2 antibody-drug conjugates in patients with HER2-low (HER2 1+ and HER2 2+/ISH-negative) breast cancer, suggesting this subgroup as a distinct clinical and biological entity with actionable therapeutic targets. Retrospective analyses of cohorts prior to the introduction of targeted agents in HER2-low patients are essential to establish natural disease course and prognostic relevance of this subgroup independent of targeted therapy.</p><p><strong>Methods: </strong>We retrospectively analyzed data of HR-negative and either HER2-zero or HER2-low breast cancer patients treated in a single clinical center between 2014 and 2024. Primary endpoints included overall survival (OS) and event-free survival (EFS), secondary endpoints included pathological complete response (pCR) after neoadjuvant chemotherapy and clinicopathological characteristics across the HER2 subgroups.</p><p><strong>Results: </strong>Among 277 patients, 160 (57.8%) had HER2-zero, 75 (27.1%) had HER2 1+ and 42 (15.2%) HER2 2+/ISH-negative tumors. Higher tumor stages (<i>p</i> = 0.053) and lower Ki-67 indices (<i>p</i> = 0.038) were notably more prevalent in HER2 2+/ISH-negative patients. OS was significantly worse in HER2 2+/ISH-negative patients (HR 8.12, 95% CI: 1.98-33.37, <i>p</i> = 0.004), whereas EFS and pCR rates did not differ significantly across the HER2 subgroups. Patients with pCR after neoadjuvant chemotherapy had significantly better OS (<i>p</i> = 0.007) and EFS (<i>p</i> = 0.003) compared to those with non-pCR, without differences observed among the HER2 subgroups.</p><p><strong>Conclusions: </strong>HER2 2+/ISH-negative status was associated with poorer OS. While EFS and pCR rates also tended to be lower, the differences were not statistically significant. Distinct clinicopathological features associated with lower pCR rates may have contributed to the inferior survival in this group.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987884","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 Impact of Nipple-Areolar Complex Micropigmentation on the Health of Mastectomised Breast Cancer Survivors: Protocol for a Multicentre Descriptive Prospective Cohort Study.","authors":"Laura García-Garcés, Raquel Carcelén-González, María Inmaculada Sánchez-López, Cayetana Ruíz-Zaldíbar, María Rovira Navalón, Laura Pérez Lledó, Ana Belén Gil Moreno, Marina Jaime Arranz, María Dolores Rodríguez Sánchez, María José Díaz Gutiérrez, Marta Lluesma-Vidal","doi":"10.1159/000552139","DOIUrl":"10.1159/000552139","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer survivors often face physical changes that affect their psychological and social well-being. Among these, the loss of the nipple-areolar complex (NAC) can significantly impact body image, self-esteem, and intimate relationships. To address this, surgical reconstruction techniques have evolved, with micropigmentation or tattooing of the NAC emerging as a preferred method due to its simplicity, natural appearance, and minimal invasiveness.</p><p><strong>Methods: </strong>This study is a multicentre, descriptive, prospective cohort study conducted in Spain. It aims to evaluate the impact of NAC micropigmentation on body image, self-esteem, sexual function, and partner interaction among mastectomised breast cancer survivors. Participants will be women over 18 who have undergone mastectomy and are receiving NAC micropigmentation for the first time. They must have a good understanding of Spanish and internet access. Exclusion criteria include prior NAC tattooing, pregnancy, breastfeeding, or refusal to participate. An initial pilot phase involving 30 participants was used to estimate the necessary sample size. Power calculations based on these preliminary data established a recruitment target of 164 participants Recruitment is consecutive, and ethical approval has been obtained from all participating hospitals.</p><p><strong>Conclusion: </strong>The study addresses a critical gap in post-mastectomy care by focusing on the final phase of breast reconstruction. It highlights the growing popularity of NAC micropigmentation and its potential to enhance psychological recovery and quality of life. Findings may inform future clinical practices and improve patient satisfaction in breast cancer care.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073572","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":"Differences in Biomarkers between the Primary Tumor and Axillary Lymph Nodes in Invasive Lobular Carcinoma: A Retrospective Study.","authors":"Caglar Kazim Pekuz, Mahmut Zenciroglu, Serdar Basim, Pelin Basim","doi":"10.1159/000552733","DOIUrl":"10.1159/000552733","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive lobular carcinoma (ILC) is a distinct histological subtype of breast cancer characterized by hormone receptor positivity, low proliferative activity, and unique metastatic patterns. However, recent evidence suggests that biomarker profiles in metastatic sites may differ from those in primary tumors, potentially reflecting biological heterogeneity.</p><p><strong>Methods: </strong>A retrospective review was conducted on 108 patients diagnosed with ILC who underwent immunohistochemical evaluation of both primary breast tumor and metastatic axillary lymph node specimens between 2012 and 2021. Differences in estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 expression were analyzed using paired statistical tests, including McNemar's and Wilcoxon signed-rank tests. Subgroup analyses were performed according to the receipt of neoadjuvant chemotherapy (NeoCT), although findings in the NeoCT subgroup were interpreted as exploratory because treatment may influence biomarker expression. Histological grade was also evaluated, and its association with primary tumor Ki-67 was analyzed exploratorily.</p><p><strong>Results: </strong>No significant differences were observed in ER, PR, or HER2 expression between primary tumors and metastatic axillary lymph nodes (<i>p</i> > 0.05). However, a significant increase in the Ki-67 proliferation index was found in metastatic lymph nodes compared with matched primary tumors (median 28% vs. 18%, <i>p</i> < 0.001). Consequently, 37.9% of patients exhibited a surrogate molecular subtype conversion from Luminal A-like to Luminal B-like. Histological grade was significantly associated with primary tumor Ki-67, with median values of 10%, 12.5%, and 32.5% for grade 1, grade 2, and grade 3 tumors, respectively (<i>p</i> = 0.00014).</p><p><strong>Conclusion: </strong>Metastatic axillary lymph nodes in ILC display higher proliferative activity compared to primary tumors, resulting in a substantial rate of conversion from Luminal A-like to Luminal B-like. These findings support biological heterogeneity between primary and nodal disease; however, their direct prognostic and therapeutic implications remain uncertain.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577154","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":"Neurotization of the Nipple-Areola Complex in Nipple Sparing Mastectomy: Systematic Review of Techniques, Sensitivity, and Sexual Well-Being.","authors":"Nadielle Brandani Suzart, Carlos Eduardo da Silva, Sabrina Thalita Dos Reis","doi":"10.1159/000553253","DOIUrl":"https://doi.org/10.1159/000553253","url":null,"abstract":"<p><strong>Introduction: </strong>Nipple sparing mastectomy (NSM) can improve domains of body image and sexuality, but preservation of the nipple-areola complex (NAC) does not guarantee sensory maintenance. NAC neurotization/reinnervation techniques have been proposed to restore sensitivity and optimize quality of life. The aim was to synthesize evidence on ACN reinnervation after NSM with immediate reconstruction, including techniques, objective measures, PROs, and complications.</p><p><strong>Methods: </strong>This is a systematic review according to PRISMA (CRD420261331412). We searched PubMed/MEDLINE, Embase, and Cochrane, without date restriction, for terms related to NSM, NAC, neurotization/cooptation/neural grafts, and sensory evaluation. Included were studies on NSM with immediate reconstruction that described reinnervation/preservation directed at the NAC and reported objective sensory outcomes and/or BREAST-Q.</p><p><strong>Results: </strong>Overall, 411 records were identified and 12 studies were included. There was a predominance of series and cohorts in implant-based reconstruction, often pre-pectoral. The techniques were convergent, with intercostal branches (mainly 4th; 3rd-5th) and, in the majority, processed allografts (∼7 cm) directed to the subareolar plexus/areolar dermis; there were variations with autologous graft and delayed neurotization. Objective measures (PSSD, monofilaments, and two-point discrimination) suggested improvement throughout follow-up, with gains in the first 6-12 months. In a comparative prospective cohort, neurotization was associated with better psychosocial and sexual well-being scores and greater perception of nipple sensation. Major complications were uncommon and no persistent neuromas or dysesthesias were reported; oncological outcomes were poorly reported.</p><p><strong>Conclusion: </strong>NAC reinnervation after NSM is feasible and demonstrates progressive sensory recovery, with emerging evidence suggesting benefits in patient-centered outcomes, including psychosocial and sexual well-being. Current evidence also highlights the clinical relevance of sensory preservation as part of a more functional and humanized reconstructive approach. However, important gaps remain due to heterogeneous methodologies, non-randomized designs, and limited oncological reporting, reinforcing the need for standardized prospective studies.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13485307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788566","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":"Triple-Negative Breast Cancer: Predictive Factors for Pathological Complete Response and Prognostic Impact of Clinical, Pathological, and Radiological Parameters.","authors":"Mahmut Zenciroglu, Perya Abbasoglu, Merih Yılmaz, Oguzhan Hakan Topgul, Caglar Kazım Pekuz, Pelin Basım","doi":"10.1159/000552361","DOIUrl":"10.1159/000552361","url":null,"abstract":"<p><strong>Introduction: </strong>Triple-negative breast cancer (TNBC) represents a biologically aggressive subtype characterized by the absence of estrogen receptor, progesterone receptor, and HER2 expression. TNBC accounts for approximately 15% of all breast cancers and represents a heterogeneous group of diseases. The aim of this thesis was to investigate the sociodemographic, clinical, pathological, and radiological characteristics of patients with TNBC, their response to neoadjuvant chemotherapy (NACT) regimens, the factors influencing this response, and the disease-related variables affecting disease-free survival (DFS) and overall survival (OS).</p><p><strong>Methods: </strong>The study consisted of 90 female patients, age between 30 and 65 years, diagnosed with stage IIA-IIIB TNBC, between December 2012 and September 2017. All patients received treatment protocols starting with NACT and subsequently underwent surgery performed in the same clinic.</p><p><strong>Results: </strong>Postmenopausal status and high ki-67 values at biopsy were found to be the strongest predictors of achieving a pathological complete response (pCR). Magnetic resonance imaging (MRI) performed after NACT and prior to surgery had the highest predictive value in assessing pCR (<i>p</i> = 0.027, <i>p</i> = 0.036, and <i>p</i> = 0.0001, respectively). Pretreatment tumor size, presence of pCR, and post-surgical ki-67 values were statistically associated with 5-year OS. Presence of pCR, pathological nodal stage, necrosis, and post-surgical ki-67 values were significantly correlated with 5-year DFS.</p><p><strong>Conclusion: </strong>In patients with TNBC, achieving pCR after NACT and detecting low ki-67 values in residual tumors were associated with improved DFS and OS.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683445","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":"Ultra-Hypofractionated Palliative Radiotherapy for Symptomatic Locoregionally Advanced Breast Cancer: A Prospective, Single-Arm Phase II Trial of Toxicity and Quality-of-Life Outcomes.","authors":"Haresh Kunhi Parambath, Subhash Gupta, Arun Thimmarayappa, Yousra Izzuddeen Kn, Anjali V Ramdulari","doi":"10.1159/000552778","DOIUrl":"10.1159/000552778","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to report the safety, efficacy, and patient-reported outcomes of a prospective trial of weekly hypofractionated radiotherapy (RT) for symptomatic locoregionally advanced breast cancer.</p><p><strong>Methods: </strong>In this single-arm, prospective phase II trial, 24 patients received a palliative RT course of 40 Gy delivered in five, weekly 8-Gy fractions. The primary endpoint was dose-limiting toxicity (DLT), defined as grade ≥3 acute radiation dermatitis. Secondary endpoints included objective response rate (ORR) and health-related quality of life (HRQoL), assessed longitudinally using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30/BR23 and Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaires.</p><p><strong>Results: </strong>All 24 enrolled patients completed the prescribed treatment. The regimen led to profound and statistically significant improvements in EORTC Global Health/QoL scores (+44.1 points; 95% Confidence Intetval [CI]: 34.6 to 53.7; <i>p</i> < 0.001) and pain scores (-33.3; 95% CI: -39.0 to -27.7; <i>p</i> < 0.001) at 3 months, which were sustained at 6 months. At 3 months, the Overall Response Rate (ORR) was 40.9% (95% CI: 20.7% to 63.6%). The primary DLT was grade ≥3 acute dermatitis, occurring in 29.2% of patients; however, this toxicity was transient, with all events occurring at treatment completion and the rate decreasing to 8.3% by the 1-month follow-up.</p><p><strong>Conclusion: </strong>This signal-seeking study demonstrates the feasibility of a 40 Gy in 5-fraction palliative regimen. It presents a manageable, transient acute toxicity profile and offers promising signals of symptom palliation, locoregional disease control, and associated improvements in patient-reported QoL.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683468","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":"Direct Hospital Costs of Ambulatory versus Inpatient Needle-Localized Breast Biopsy: A Retrospective Cohort Study.","authors":"Chayaporn Subanphanichkul Thong-Aek, Chutida Sungworawongpana, Srila Samphao, Somrit Mahattanobon, Seechad Noonpradej, Wongsakorn Chaochankit","doi":"10.1159/000553242","DOIUrl":"10.1159/000553242","url":null,"abstract":"<p><strong>Introduction: </strong>As healthcare systems aim to optimize resource utilization, ambulatory breast surgery has been proposed as an alternative to inpatient care. However, data comparing direct hospital costs and identifying cost drivers for needle-localized breast biopsy (NLB) remain limited, particularly in low- and middle-income settings.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients who underwent NLB at a tertiary academic medical center between January 2020 and December 2024. Patients were classified as ambulatory (day surgery) or inpatient according to admission status. Total direct hospital costs were compared between groups, and multivariable linear regression was used to identify factors associated with increased cost. Costs were reported in Thai Baht (THB) and converted to U.S. dollars (USD) using an exchange rate of 1 USD = 33.82 THB.</p><p><strong>Results: </strong>A total of 392 patients were included, of whom 33 underwent ambulatory surgery and 359 underwent inpatient surgery. The ambulatory group was younger (47.9 ± 8.7 vs. 53.3 ± 10.5 years; <i>p</i> = 0.005) and had lower median hospital costs (13,250 THB [391.7 USD] vs. 21,470 THB [634.9 USD]; <i>p</i> < 0.001). In multivariable analysis, inpatient admission (β = 6,378.03 THB [188.48 USD]; <i>p</i> < 0.001) and longer operative time (β = 122.86 THB [3.63 USD] per minute; <i>p</i> < 0.001) were independently associated with higher costs. Age, American Society of Anesthesiologists (ASA) classification, and preoperative biopsy status were not significant predictors.</p><p><strong>Conclusions: </strong>Ambulatory NLB was associated with lower direct hospital costs than inpatient care in this single-center cohort. Admission status and operative time were associated with higher expenditure. These findings reflect real-world practice in selected patients; however, the observational design, marked group imbalance, and absence of safety events limit causal inference and preclude firm conclusions regarding comparative safety.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677415","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":"Idiopathic Granulomatous Mastitis in India: Imaging Spectrum and Outcomes across Different Management Strategies.","authors":"Shiveta Razdan, Adhrit Jha, Megha Tandon, Gaurav Khanna, Manya Giri Nishad","doi":"10.1159/000553051","DOIUrl":"10.1159/000553051","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic granulomatous mastitis (IGM) is a benign inflammatory breast condition that frequently mimics carcinoma, posing significant diagnostic and therapeutic challenges. In tuberculosis-endemic regions, differentiation from tuberculous granulomatous mastitis (TGM) is particularly critical. This dual-centre retrospective study from North India evaluates the clinical, radiological, and pathological profiles of granulomatous mastitis and compares outcomes across different management strategies.</p><p><strong>Methods: </strong>We retrospectively reviewed 67 consecutive patients with histopathologically confirmed granulomatous mastitis treated between 2022 and 2024. Diagnosis was established using core needle biopsy, followed by a standardized evaluation to exclude tuberculosis. Patients were managed with observation with aspiration, corticosteroid therapy (systemic or intralesional), or surgical intervention based on disease severity and treatment response.</p><p><strong>Results: </strong>Of the 67 patients, 58 (86.5%) were diagnosed with IGM and 9 (13.4%) with TGM. Observation with aspiration was the most common initial approach for IGM (<i>n</i> = 37, 63.7%). Although 35.1% experienced recurrence by 6 months, all achieved complete remission by 18 months without treatment escalation. Systemic corticosteroid therapy (<i>n</i> = 3) was associated with recurrence in all cases, whereas intralesional steroid injections (<i>n</i> = 3) resulted in sustained remission without recurrence. Surgical intervention was reserved for 13 patients with refractory disease and yielded favourable long-term outcomes.</p><p><strong>Conclusion: </strong>Accurate distinction between IGM and tuberculosis is essential in endemic settings. Our findings support a step-wise approach to IGM with a long-term follow-up to address the high rate of recurrence in these patients.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629552","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":"Pre-Pectoral Breast Reconstruction after Mastectomy: Current Evidence, Knowledge Gaps, and Rationale for the I-PREPARE EUBREAST-11R Trial.","authors":"Rosa Di Micco, Lorenzo Scardina, Edoardo Botteri, Maggie Banys-Paluchowski, Maria João Cardoso, Jana de Boniface, Maria Luisa Gasparri, Bahadir M Gulluoglu, Orit Kaidar-Person, Maurizio Bruno Nava, Philip Poortmans, Shelley Potter, Nicola Rocco, Tanja Spanic, Marc Thill, Luzia Travado, Kristina Veselinovic, Walter Paul Weber, Veronica Zuber, Giovanni Cisternino, Sara Baleri, Mario Rampa, Silvia P Corona, Francesca Calabretto, Raffaele Ceccarino, Antonio Rottino, Gianluca Franceschini, Thorsten Kühn, Oreste Davide Gentilini","doi":"10.1159/000551101","DOIUrl":"10.1159/000551101","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-pectoral implant-based breast reconstruction (IBR) has emerged as a promising alternative to conventional subpectoral approaches following nipple- or skin-sparing mastectomy. However, long-term oncological safety, complication profiles, and outcomes in specific subgroups, such as patients receiving radiation therapy (RT), remain under investigation. Contemporary evidence is mainly derived from retrospective studies with limited follow-up, reporting heterogeneous results. The I-PREPARE trial (EUBREAST-11R) was initiated by the EUBREAST (European Breast Cancer Research Association of Surgical Trialists, https://www.eubreast.org/) in order to provide high-quality data on the outcomes of pre-pectoral IBR in terms of oncological safety, complications, aesthetic results, and patient-reported outcomes, with particular attention to the impact of RT.</p><p><strong>Methods: </strong>The I-PREPARE trial is a prospective, international, observational cohort study assessing outcomes of IBR after therapeutic mastectomy. Adult women undergoing nipple- or skin-sparing mastectomy followed by pre-pectoral IBR (with or without synthetic/biologic mesh) are eligible. Primary endpoint is implant loss at 3 months; secondary endpoints include early and late onset complications, reoperations (≤24 months), quality of life (6, 12, and 24 months), and time to start of adjuvant treatments. Tertiary endpoints will address oncological outcomes (loco-regional recurrence, disease-free survival, breast cancer specific survival, distant-disease-free survival, overall survival, implant-associated anaplastic T-cell non-Hodgkin lymphoma). The evaluation of these endpoints will be undertaken only subject to the availability of additional dedicated funding. Data are collected via a secure eCRF and the EUBreast patient App for smartphones (https://apps.apple.com/it/app/eubreast/id6469623234; https://play.google.com/store/apps/details?id=com.brightfish.appstore.eubreast.patient&hl=it&pli=1). The study plans to enrol 1,236 patients across multiple centres and countries. The study was registered on ClinicalTrials.gov under the Trial Registration Number NCT05817175.</p><p><strong>Conclusion: </strong>The I-PREPARE trial (EUBREAST-11R) aims to generate high-quality real-world evidence on the safety, efficacy, and patient-reported outcomes of pre-pectoral IBR. This initiative will address current knowledge gaps on the outcomes of pre-pectoral IBR and could help clinical decision-making for patient selection, surgical planning, and multidisciplinary care in breast reconstruction.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359701","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":"Microbial Biomarkers of Breast Tumor and Mastitis: Deciphering the Delicate Balance between Potentially \"Evil\" and \"Benign\" Alliances in Mammary Microbiomes.","authors":"Zhanshan Sam Ma","doi":"10.1159/000548037","DOIUrl":"10.1159/000548037","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer and mastitis significantly impact women's health and their infants' wellbeing. The advent of metagenomic sequencing technology has opened new avenues to explore the relationships between mammary microbiomes and these diseases. Despite recent extensive studies, detailed understanding of the mammary microbiome-disease relationships remains incomplete.</p><p><strong>Methods and results: </strong>Here, we apply the Specificity and Specificity Diversity framework (Ma 2024, BMC Biology) to identify unique/enriched species (US/ES) associated with mastitis, breast cancer, or their healthy controls. The US/ES lists contain potential biomarkers and offer fresh insights into the intricacies of mastitis etiology and the relationship between breast tissue microbiomes and breast cancer.</p><p><strong>Conclusions: </strong>(i) The dynamic balance between coexisting alliances of beneficial microbes and harmful microbes (including opportunistic pathogens) holds key to understanding mastitis etiology. (ii) Intra-tumor microbes may serve multiple roles - as oncogenic microbes, neutral bystanders, or tumor suppressors, and their dynamic balance can influence breast cancer onset and progression. (iii) Significant challenges remain in developing effective probiotics, prebiotics and infant formulas due to complex entanglements between beneficial and harmful microbes. This complexity suggests that broad-spectrum or one-size-fits-all probiotic approaches may prove inadequate, pointing instead to the need for personalized prebiotic/probiotic/infant-formula solutions to restore and maintain healthy mammary microbiomes.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"179-189"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539046","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}