Breast Care最新文献

{"title":"Prevention of Severe Postoperative Pain after Breast Surgery Using Opioid-Sparing Analgesia with Intraoperative and Drain-Based Ropivacaine Infiltration: A Prospective Observational Study.","authors":"Jorge Jiménez Cruz, Norah L A Emrich, Kristin Nicolaus-Tellenbach, Felix Roser, Angela Kather, Winfried Meissner, Ingo B Runnebaum","doi":"10.1159/000547185","DOIUrl":"10.1159/000547185","url":null,"abstract":"<p><strong>Background and aim: </strong>Breast surgery is frequently associated with high postoperative pain, which if not adequately managed can delay recovery and increase the risk of chronic postsurgical pain. This study evaluated whether perioperative opioid application and/or incisional infiltration with long-acting local anaesthetics can improve postoperative pain control as part of an effective preventive strategy.</p><p><strong>Study design and methods: </strong>A total of 536 consecutive patients undergoing breast surgery at Jena University Hospital were prospectively evaluated on the first postoperative day using a standardized pain questionnaire as part of the QUIPS (Quality Improvement in Postoperative Pain Management) project. Analgesic strategies were introduced sequentially in addition to the standard postoperative pain management (group A, first 9 months), addition of prophylactic oxycodone (group B, 17 months), combined oxycodone and wound infiltration with ropivacaine (group D, 4 months), and finally, ropivacaine alone (group C, 6 months).</p><p><strong>Results: </strong>All three intervention groups showed significant improvements over standard care, with more patients pain-free at 24 h (group A: 9.5%, B: 18.5%, C: 16.3%, D: 25.6%; <i>p</i> = 0.01), fewer requiring opioids on demand (A: 26.5%, B: 15.9%, C: 4.1%, D: 4.7%; <i>p</i> < 0.05), and a significantly delayed first opioid request. The incidence of nausea and vomiting was significantly lower in the ropivacaine-only group compared to other regimens (<i>p</i> = 0.03). Ropivacaine infiltration alone (group C) was associated with the fewest opioid-related side effects.</p><p><strong>Conclusion: </strong>Intraoperative and drain-based ropivacaine wound infiltration, alone or in combination with pre-emptive oxycodone, effectively reduced acute postoperative pain and opioid requirements after breast surgery, while reducing opioid-related side effects like nausea and vomiting. As part of a multimodal, opioid-sparing strategy, this technique demonstrated favourable patient-reported outcomes and may contribute to faster recovery, fewer side effects, and improved patient-reported satisfaction. These findings support the clinical relevance of preventive local anaesthetic techniques in breast surgery.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"169-178"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200223","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":"Breast Cancer Specialist Training across Europe: A European Union of Medical Specialists Multidisciplinary Joint Committee Breast Care Survey.","authors":"Angelika Rief, Maria Luisa Gasparri, Thorsten Kühn, Andrea Borenich, Florentia Peintinger","doi":"10.1159/000548360","DOIUrl":"10.1159/000548360","url":null,"abstract":"<p><strong>Introduction: </strong>The UEMS (European Union of Medical Specialists) MJC (Multidisciplinary Joint Committee) Breast Care surveyed current practice in training, research, and continuous education among European breast cancer (BC) specialists. The goal was to describe the landscape of BC care across Europe and identify areas for improvement.</p><p><strong>Methods: </strong>In collaboration with EUBREAST (European Breast Cancer Research Association of Surgical Trialists), a 20-question online questionnaire was developed and distributed to physicians specializing in the diagnosis and treatment of BC across Europe. The survey targeted geneticists, general surgeons, gynecologists, medical oncologists, pathologists, plastic and reconstructive surgeons, radiologists, and radiation oncologists.</p><p><strong>Results: </strong>A total of 471 respondents (208 female, 263 male) from 26 countries (20 EU member states, 6 nonmember states) provided data. BC caseload strongly differed among the respondents. Approximately 50% of respondents dedicated more than half of their working time to BC diagnosis or treatment. Training backgrounds and additional BC education varied widely, with 63% of respondents having pursued certified BC training post-specialization. Nearly all respondents attended BC educational meetings at least annually, and 68% had authored or coauthored peer-reviewed publications within the last 3 years. Noteworthy discrepancies were identified based on respondents' gender and workplace.</p><p><strong>Conclusion: </strong>BC caseload, training, additional education, teaching, and research activities of European BC specialists vary widely. Standardization of training protocols and promotion of research and continuous education initiatives are needed to ensure consistent, high-quality care for BC patients across Europe. Establishing quality standards will be essential in fostering improved outcomes and advancing the field of BC care continent-wide.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"190-198"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538928","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":"Overall Survival in Metastatic Breast Cancer Patients: Real-World Data from 1,000 Patients Treated at the NCT Heidelberg between 2014 and 2022.","authors":"Laura L Michel, Manuel Feisst, Verena Thewes, Dirk Jäger, Andreas D Hartkopf, Sara Y Brucker, Sabrina Uhrig, Philipp Ziegler, Matthias W Beckmann, Erik Belleville, Christian Maurer, Peter A Fasching, Katharina Smetanay, Carlo Fremd, Andreas Schneeweiss","doi":"10.1159/000548610","DOIUrl":"10.1159/000548610","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, targeted therapeutic options for metastatic breast cancer (mBC) have improved significantly. In this analysis, we evaluated overall survival (OS) data of a prospectively documented cohort of 1,000 patients with mBC treated at the NCT Heidelberg from 2014 to 2022.</p><p><strong>Patients and methods: </strong>Clinical data were prospectively collected and documented in the Prospective Academic Translational Research PRAEGNANT Network. OS was analyzed according to molecular subtype and line of therapy at study entry. We further evaluated the clinical characteristics associated with long-term (>5 years) and short-term (<1 year) survival.</p><p><strong>Results: </strong>The median age at first diagnosis of metastasis was 57 years. A total of 132 patients (13%) presented with triple-negative, 189 (19%) with HER2 positive, and 609 (61%) with hormone receptor-positive, HER2-negative mBC. Median OS was 31.7 months. The longest median OS was observed in patients with HER2-positive and luminal A-like mBC (42 and 39 months, respectively). Patients with luminal B-like and triple-negative mBC showed significantly shorter OS (21 and 14 months, respectively). In univariable Cox regression analysis, significantly shorter OS was associated with higher tumor grade; negative estrogen receptor (ER), progesterone receptor (PR), and HER2 status; triple-negative molecular subtype; use of (neo)adjuvant chemotherapy; and later line of therapy at study entry. Multivariable Cox regression analysis revealed that higher tumor grade, negative ER and HER2 status, triple-negative or luminal B-like tumor biology, and study entry during later lines of therapy were the main risk factors for shorter OS. At 5-year follow-up, 17% of patients were still alive. Long-term survivors (>5 years) were more frequently ER, PR, and HER2 positive, received less often (neo)adjuvant chemotherapy, and had a longer disease-free interval.</p><p><strong>Conclusion: </strong>This single-center, real-world analysis of 1,000 mBC patients revealed significant OS differences across molecular subtypes and provided valuable information on prognostic factors. These findings underscore the impact of tumor biology and the need for personalized treatment approaches.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"199-211"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539084","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":"Surgical Outcome Parameters in Breast Cancer: A Survey Comparing Oncoplastic and Non-Oncoplastic Surgeons as well as Certified with Non-Certified Breast Health Centers.","authors":"Kerstin Wimmer, Kathia Gordon, Klaus Emmanuel, Günther Steger, Michael Gnant, Walter Paul Weber, Florian Fitzal","doi":"10.1159/000548657","DOIUrl":"10.1159/000548657","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer surgery has evolved over the past few decades, with an increase in the number of oncoplastic surgeons and certified breast centers worldwide. However, it remains unclear whether this has led to an improvement in the overall quality of care. Oncoplastic surgery combines oncologic tumor resection with plastic-reconstructive surgical techniques, performed either by two surgeons (two-team approach) or by a single oncoplastic surgeon (one-team approach), depending on the respective training system. The one-team approach offers organizational advantages but raises concerns regarding oncological outcomes. This study compares surgical outcome parameters between oncoplastic and non-oncoplastic surgeons and between certified and non-certified breast health centers.</p><p><strong>Methods: </strong>A two-part questionnaire with 9 general and 16 specific questions regarding surgical treatment between 2018 and 2022 was developed to assess parameters such as the rate of R1 resections, re-operations due to complications, immediate reconstructions and the number of mastectomies. A total of 173 members of four major international professional societies, representing more than 1,000 individuals in total, responded to the questionnaire.</p><p><strong>Results: </strong>A total of 125 individuals were included in the analysis. Most respondents specialized in general surgery, and most performed oncoplastic procedures in certified breast centers. The majority of respondents reported a need for further training. Oncoplastic surgeons had the highest caseload. Non-oncoplastic surgeons had the lowest rates of mastectomy, while surgeons specializing exclusively in breast surgery had the highest rates of immediate breast reconstruction. R1 resection rates varied between surgeons and centers, and higher complication rates were observed in non-certified centers.</p><p><strong>Conclusion: </strong>Our study showed that oncoplastic surgeons performed more oncoplastic procedures and immediate reconstruction after mastectomy. The use of intraoperative frozen section analysis and advances in training play a crucial role in minimizing complications or re-resection.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"212-223"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200207","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":"Macroareolar Changes following Periareolar Mastopexy: A Postoperative Assessment.","authors":"Therese Peter, Konstantin C Koban, Denis Ehrl, Nadia Harbeck, Steffen Kahlert, Carolin Luczak, Johannes Schmid, Rachel Wuerstlein, Friederike Hagemann","doi":"10.1159/000548681","DOIUrl":"10.1159/000548681","url":null,"abstract":"<p><strong>Background: </strong>Breast-conserving therapy (BCT) combined with periareolar mastopexy aims to optimize oncological safety and aesthetic outcomes. One known complication is postoperative enlargement of the nipple-areola complex (NAC), which may affect patient satisfaction. This study investigates the frequency and extent of NAC changes following BCT and radiotherapy, using both conventional and three-dimensional imaging for objective measurement.</p><p><strong>Methods: </strong>This retrospective single-center study included 50 women who underwent BCT with periareolar mastopexy and adjuvant radiotherapy between 2019 and 2023. Standardized postoperative assessments were performed ≥6 months after surgery and ≥4 months after radiotherapy. NAC diameters were measured using 3D surface imaging and conventional 2D photographs. Patient-reported satisfaction was assessed using the Breast-Q™ BCT module.</p><p><strong>Results: </strong>A statistically significant enlargement of the NAC was observed on the operated side. Horizontal diameter increased by 4.4 mm (<i>p</i> < 0.001) and vertical diameter by 3.5 mm (<i>p</i> = 0.006) compared to the contralateral breast. Similar trends were confirmed in 2D images. Postoperative Breast-Q™ scores showed high satisfaction with the nipple (mean: 73 ± 23) and generally favorable ratings in psychosocial and physical well-being.</p><p><strong>Conclusion: </strong>NAC enlargement is a measurable postoperative change following periareolar mastopexy in the context of BCT and radiotherapy. These findings highlight the relevance of realistic preoperative counseling and planning. While 3D imaging was used exclusively postoperatively, it offers a reproducible tool for outcome evaluation. Future studies should aim to include preoperative baseline data and prospective quality-of-life assessments.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"224-231"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539035","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":"Breast Conservation Therapy vs. Mastectomy Survival in Young Breast Cancer Patients: Systematic Review and Meta-Analysis.","authors":"Qi Guo, Feng Zhang, XiaoWen Ma, QingGe Guo, YiMing Sun, Wei Wei, HuiMin Tang","doi":"10.1159/000548895","DOIUrl":"10.1159/000548895","url":null,"abstract":"<p><strong>Background: </strong>While young breast cancer patients exhibit lower overall survival (OS) than older groups, it remains unclear whether OS differs between breast-conserving therapy (BCT) and mastectomy specifically in this younger population. Although BCT carries a higher recurrence risk than mastectomy in young patients, OS appears similar across all ages. This meta-analysis therefore directly compares OS and breast cancer specific survival (BCSS) in young patients treated with BCT versus mastectomy.</p><p><strong>Methods: </strong>Our review included 6 studies that compared OS between BCT and mastectomy in patients aged 40 years or younger diagnosed with stage I-III breast cancer. The endpoint was OS/BCSS, and only studies presenting hazard ratios (HRs) were included in the analysis. Meta-analyses used inverse-variance random effects (REML with Hartung-Knapp confidence intervals [CIs]); heterogeneity was assessed with Q and <i>I</i> ². Leave-one-out, fixed-effect, and DerSimonian-Laird models tested robustness; Egger's test explored small-study effects. Analyses were performed in RevMan 5.3 and Stata 17, with <i>p</i> < 0.05 or 95% CIs excluding 1.00 considered significant.</p><p><strong>Results: </strong>OS showed no difference between BCT and mastectomy (pooled HR = 0.99, 95% CI: 0.88-1.10, <i>I</i> ² = 54%). BCSS favored BCT with a small but significant reduction in mortality (HR 0.92, 95% CI: 0.86-0.98, <i>I</i> ² = 0%). Subgroup analyses of OS suggested stage dependence: benefit with T1-2 (HR 0.93, 0.87-0.99) and N0-1 (HR 0.93, 0.87-0.99), but no advantage in T1-3 or N2-3 disease (both HR 1.19, 0.99-1.44). Leave-one-out and model checks did not change inference; unadjusted estimates suggested benefit but this attenuated after adjustment.</p><p><strong>Conclusion: </strong>In women ≤40 years with stage I-III breast cancer, BCT with radiotherapy achieves OS comparable to mastectomy and may yield a modest BCSS benefit, particularly in lower-burden disease (T1-2 or N0-1). Given the observational nature of the evidence and residual heterogeneity, results should be interpreted cautiously and individualized clinical decision-making is recommended; randomized or prospectively adjusted data are still needed.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"21 3","pages":"240-252"},"PeriodicalIF":2.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315680","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":"Assessing Patient Satisfaction with Mammography Using Patient-Reported Measures: A Prospective Observational Study.","authors":"Gaia Garuffi, Dirk Lehnick, Gioia Fischer, Justus Roos, Alexander von Hessling, Simone Schrading","doi":"10.1159/000552696","DOIUrl":"10.1159/000552696","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Negative experiences during mammography can reduce patient's adherence. Yet patient-reported measures focusing on the diagnostic pathway remain limited, particularly in general radiology departments that are not specialized in breast imaging only. This prospective study evaluated the overall patient satisfaction with digital mammography (DM) using a tailored patient-reported experience measure (PREM) and examined associations with personal, clinical, and procedural factors to identify actionable quality-assurance targets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Women undergoing DM or digital breast tomosynthesis for screening, surveillance, follow-up of high-risk lesions, or diagnostic clarification at a medium-sized general hospital were recruited between February and July 2023. Of 885 eligible women, 549 (62%) aged 29-88 years completed a validated 23-item PREM questionnaire. Associations between satisfaction and personal (age, anxiety, pain), clinical (breast density, cancer history), and procedural factors (radiographer communication, radiologist consultation) were assessed using Fisher's exact test, Kendall's tau-b (τb) correlations, and ordered logistic regression. Significance was set at &lt;i&gt;p&lt;/i&gt; &lt; 0.05. Free-text comments were analyzed using IRaMuTeQ to identify thematic clusters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 78% (428/549) of participants reported full satisfaction with DM. Satisfaction was significantly related to personal and procedural factors (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), particularly anxiety (τb = -0.2), pain (τb = -0.3), age (τb = 0.1), radiographer communication (τb = 0.3), and efforts to reduce discomfort (τb = 0.4). Consultations with a breast radiologist immediately after DM markedly increased the likelihood of full satisfaction (+14 percentage points). In contrast, clinical variables, including breast cancer history, breast density, and familial risk, showed no significant association with satisfaction (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). Free-text analysis revealed four influencing dominant themes: waiting time before radiologist consultation, staff competence, gratitude toward radiographers and radiologists, and the physical environment of examination rooms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patient satisfaction with DM in a nonspecialized general radiology department is predominantly shaped by modifiable procedural and interpersonal factors rather than clinical factors. Radiographers' communication and efforts to reduce discomfort emerged as key determinants of satisfaction, alongside immediate result communication by radiologists. PREMs are feasible to implement in routine breast imaging workflows and offer valuable insights for quality assurance and patient-centered optimization of mammography services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance statement: &lt;/strong&gt;Systematically measuring women's experiences using PREMs help identify practical improvement targets, such as communication quality, workflow design, and timely","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583704","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":"Comprehensive Liquid Biopsy Testing in Metastatic Hormone Receptor-Positive HER2-Negative Breast Cancer Patients: First Results from Routine Clinical Practice.","authors":"Karsten M Warwas, Anna-Lena Volckmar, Daniel Kazdal, Markus Ball, Katharina Smetanay, Christian Maurer, Carlo Fremd, Lea Sych, Verena Thewes, Jan Budczies, Albrecht Stenzinger, Andreas Schneeweiss, Laura L Michel","doi":"10.1159/000552643","DOIUrl":"10.1159/000552643","url":null,"abstract":"<p><strong>Introduction: </strong>Liquid biopsy (LBx) is a minimally invasive diagnostic approach that allows molecular profiling of circulating tumor DNA. In hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer, early detection of actionable mutations is critical for guiding therapy. <i>ESR1</i> mutations mediate resistance to aromatase inhibitors and predict response to (oral) selective estrogen receptor degraders. Despite its clinical relevance, data on the real-world application of LBx remain limited.</p><p><strong>Methods: </strong>We retrospectively analyzed 162 patients with HR-positive, HER2-negative metastatic breast cancer who underwent LBx testing in routine clinical care. Hybrid capture-based next-generation sequencing with high read depth (∼5,000-7,000×) was used to assess mutation profiles across a multigene panel, rather than single-gene assays such as ddPCR. Particular focus was placed on the detection of <i>ESR1</i> mutations and their therapeutic implications.</p><p><strong>Results: </strong>Of 162 patients, <i>ESR1</i> mutations were detected in <i>n</i> = 46 (28.4%). Among these, 20 (43.5%) patients received elacestrant based on the molecular findings. LBx was feasible, rapidly implemented (∼8.7 days), and repeatable in routine practice. Detection of <i>ESR1</i> mutations directly influenced treatment decisions, enabling the timely initiation of targeted endocrine therapy. Other recurrent mutations included <i>PIK3CA</i>, <i>PTEN</i>, and <i>AKT</i>, with potential therapeutic relevance.</p><p><strong>Conclusion: </strong>These real-world data support the clinical utility of LBx guidance in the metastatic setting. It is a rapid, minimally invasive, and informative diagnostic method for identifying resistance mutations such as <i>ESR1</i> and guiding endocrine therapy decisions, including the use of elacestrant. LBx should be integrated as early as possible in the treatment algorithm and not reserved for late treatment stages when therapeutic options are limited. Repeating LBx at the time of progression of disease should be discussed depending on possible therapeutic implications.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583812","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":"Breast-Conserving Surgery in Multicentric Breast Cancer: Progress, Pitfalls, and Risks.","authors":"Isabell Witzel","doi":"10.1159/000552608","DOIUrl":"10.1159/000552608","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454763","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":"Expanding the Boundaries of Breast Conservation: Oncoplastic Surgery in Multifocal and Multicentric Breast Cancer.","authors":"Mehmet Furkan Sağdıç, Mahmut Onur Kültüroğlu, Emre Tunç, Lütfi Doğan","doi":"10.1159/000552575","DOIUrl":"10.1159/000552575","url":null,"abstract":"<p><strong>Introduction: </strong>The development of oncoplastic surgical techniques has reshaped the management of multifocal and multicentric breast cancers. Previously treated mainly with mastectomy due to concerns about positive margins and local recurrence, these cases can now be safely managed with breast-conserving surgery (BCS) through advances in imaging, adjuvant therapy, and surgical methods.</p><p><strong>Method: </strong>We retrospectively reviewed the data from 2,155 patients who underwent breast cancer surgery at a tertiary surgical oncology center between October 2022 and May 2025. A total of 246 patients were identified as having multicentric or multifocal disease. While 68 patients underwent BCS, 178 received mastectomy. Demographic, radiological, histopathological, and surgical data were evaluated. Complications were categorized as minor or major, and aesthetic satisfaction was assessed using a structured questionnaire.</p><p><strong>Results: </strong>Among 1,253 BCS patients, 5.4% (<i>n</i> = 68) had multifocal or multicentric disease. The median age was 55 years. Negative surgical margins were achieved in 90% of patients during the initial surgery. Re-excision was performed in 5 patients (7.4%), and completion mastectomy was required in 2 patients (2.9%). The overall complication rate was 19%, with reoperation due to complications required in only one patient (1.5%). Of 46 patients evaluated, 90% rated their aesthetic outcome as \"excellent\" or \"good.\"</p><p><strong>Conclusion: </strong>Oncoplastic BCS is a safe and effective option for well-selected patients with multifocal or multicentric breast cancer. With modern imaging, multidisciplinary evaluation, and experienced surgical teams, high rates of negative margins and satisfactory cosmetic outcomes can be achieved.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454720","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}