Breast Care最新文献

{"title":"Three-Fraction External Beam Radiotherapy in Patients with Early Breast Cancer.","authors":"Budhi Singh Yadav, Habeeb Kudukkil Appakattu Kuzhi, Divya Dahiya, Monsu Rathod, Arun Oinam Singh, Gaganpreet Singh","doi":"10.1159/000543855","DOIUrl":"10.1159/000543855","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with early breast cancer (EBC) can be treated with accelerated partial breast irradiation (APBI). The objective of this study was to determine if a three-fraction APBI schedule is feasible for these patients.</p><p><strong>Methods: </strong>This single-institutional, phase 2 study included patients with age ≥45 years, tumor size <3.5 cm, negative nodes, negative surgical margins, and unicentric tumors. Patients were treated with 3D-CRT technique with a dose of 22.5 Gy in 3 fractions on 3 consecutive days. The primary end point of the study was cosmesis as assessed by physicians at 3 years. Secondary end points were cosmesis as assessed by patients, dosimetry, acute and late toxicities, disease-free and overall survival.</p><p><strong>Results: </strong>From October 2019 to October 2022, 49 patients were treated. Mean age of the patients was 55 years (range 40-75). At 3 years, physician- and patient-reported cosmetic results were excellent/good/fair in 33 (67%)/14 (29%)/2 (4%) of patients and in 29 (59%)/16 (33%)/4 (8%) of patients, respectively. Acute dermatitis grades 1 and 2 were observed in 14 (29%) and 3 (6%) of patients, respectively. At 6 months, breast edema, skin induration, subcutaneous fibrosis, pain, and pigmentation were observed in 3 (6%), 6 (12%), 3 (6%), 2 (4%), and 8 (16%) of patients, respectively. At 3 years, 1 (2%) patient had mild pain; no breast edema, skin induration, subcutaneous fibrosis, or pigmentation was observed. At a median follow-up of 39 months (range 24-60), there were no local/regional recurrences. One patient developed distant metastases in the bones, liver, and lungs at 46 months. All patients were alive at last follow-up.</p><p><strong>Conclusion: </strong>In patients with EBC, three-fraction APBI is feasible. Physician- and patient-reported cosmesis was excellent/good in 96% and 92% of patients, respectively. Late effects were only grade 1.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 3","pages":"154-162"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474052","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":"Axillary Surgical Management in Breast Cancer Patients after Neoadjuvant Systemic Therapy: A Delphi Study.","authors":"Michael Stanczyk, Ayat ElSherif, Tiffany Cheung, Alicia Fanning, Amanda Mendiola, Andrew Fenton, Debra Pratt, Mary Murray, Stephanie Valente, Zahraa Al-Hilli, Julie E Lang","doi":"10.1159/000546267","DOIUrl":"10.1159/000546267","url":null,"abstract":"<p><strong>Introduction: </strong>The use of sentinel lymph node biopsy in post-neoadjuvant systemic therapy (NST) patients is an evolving practice for breast cancer surgeons. Our study sought to determine if controversial areas in the treatment of post-NST breast cancer patients had consensus among our panel of breast cancer surgeons at a single institution. Our group updated our care path for the surgical management of breast cancer in November 2022. We aimed to see the influence of the care path update on reaching consensus for the management of the axilla post-NST.</p><p><strong>Methods: </strong>We performed two rounds of a modified eDelphi in 2021 and 2024 with a panel of 13 and 8 breast cancer surgeons, respectively, to evaluate a shift in expert opinion regarding axillary management in that period. Concordant responses were defined as greater than 75%.</p><p><strong>Results: </strong>The panel reached consensus on sentinel lymph node biopsy for initially clinically node-negative patients, management of extracapsular extension, similar treatment of post-neoadjuvant chemotherapy patients and post-neoadjuvant endocrine therapy patients, and the value of dual tracer, MRI, and SAVI Scout. There was lack of consensus among the panel on management of micrometastases, management of isolated tumor cells, management of initially node-positive patients that downgraded to node-negative, use of lymphovenous bypass, and use of axillary radiation in post-neoadjuvant chemotherapy patients. Consensus was reached in 45% of questions in 2021 and 47% in 2023.</p><p><strong>Conclusion: </strong>Despite having an institutional care path, our expert panel reached consensus regarding contemporary issues in breast surgery less than 50% of the time. Our study advocates for further research in the management of topics that did not reach consensus.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526508","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":"St. Gallen/Vienna 2025 Summary of Key Messages on Therapy in Early Breast Cancer from the 2025 St. Gallen International Breast Cancer Conference.","authors":"Nina Ditsch, Michael Gnant, Christoph Thomssen, Nadia Harbeck","doi":"10.1159/000546080","DOIUrl":"10.1159/000546080","url":null,"abstract":"<p><strong>Background: </strong>In 2025, the St. Gallen Conference was held from March 12th-15th, with the largest attendance since the pandemic and more than 3,000 participants from over 100 countries.</p><p><strong>Summary: </strong>The conference chairs professionally guided through the program on Early Breast Cancer, featuring abstracts submitted from all over the world. In addition, Prof. Dr. Herold J. Burstein (USA) led the panel through the difficult topics of local and systemic treatment modalities in an excellent, clearly structured and engaging way. Almost 80 experts from all continents and more than 30 nations formed the panel and summarized the current literature in excellent presentations and discussions.</p><p><strong>Key messages: </strong>Final voting covered the topics of genetic testing, DCIS, breast and axillary surgery, radiation therapy, systemic treatment based on subtypes, treatment of the elderly, therapy of local-regional recurrence and oligometastatic breast cancer.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367920","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":"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":"Brain Metastases of a Triple-Negative Breast Cancer: A Systematic Literature Review of the Systemic Treatment Options.","authors":"Patricia von Kroge, Kerstin Riecke, Johann Kornowski, Barbara Schmalfeldt, Volkmar Müller, Elena Laakmann","doi":"10.1159/000545549","DOIUrl":"10.1159/000545549","url":null,"abstract":"<p><strong>Background: </strong>The development of brain metastases (BM) is an increasing concern for patients with metastatic triple-negative breast cancer (mTNBC). This systematic review aimed to summarize the current evidence regarding systemic treatment options for patients with mTNBC and BM.</p><p><strong>Methods: </strong>A systematic literature review was conducted by searching the database PubMed with the keywords metastatic triple-negative breast cancer,\" \"therapy\" and \"brain metastases.\" Articles were screened and included if they focused on the treatment of mTNBC. Both prospective and retrospective clinical trials were eligible for inclusion.</p><p><strong>Results: </strong>The literature search identified 3,413 articles, of which eight met the inclusion criteria. These studies provided evidence for the treatment of patients with stable BM using sacituzumab govitecan, pembrolizumab combined with chemotherapy, trastuzumab deruxtecan (T-DXd), nab-paclitaxel combined with cisplatin, and talazoparib. No evidence was found for active BM or leptomeningeal metastases.</p><p><strong>Conclusion: </strong>Based on the current evidence discussed in this review, testing for programmed death-ligand 1 (PD-L1), HER2, including immunohistochemistry (IHC) status as well as germline BRCA 1/2 mutation, should be considered in all mTNBC patients with BM as the results have significant treatment implications. Moreover, PD-L1 expression should be evaluated on primary tumor and (if tissue sample available) reevaluated on BMs if negative on primary BC, to maximize the opportunity for treatment with immune checkpoint inhibitors. Furthermore, if brain tissue is available, HER2 IHC should also be tested in order to evaluate the status switch and to assess the therapeutic effectiveness of treatment with T-DXd. Further targeted agents are urgently needed in order to improve the survival of patients with TNBC and BM.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367919","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":"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":"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":"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":"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}