Breast Care最新文献

{"title":"Mastalgia, Radiological Yield, and Psychological Burden: A Cross-Sectional Comparative Study.","authors":"Seda Aladag Kurt, Irem Hacisalihoglu Aydin, Busra Ucar Bostan, Yasemin Kayadibi, Mehmet Velidedeoglu, Cana Aksoy Poyraz","doi":"10.1159/000550195","DOIUrl":"10.1159/000550195","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the clinical, radiological, and psychological correlates of mastalgia and to determine the factors independently associated with anxiety and depression in women presenting with breast pain.</p><p><strong>Methods: </strong>In this cross-sectional study, 151 women with mastalgia and 69 controls undergoing breast imaging were assessed. Sociodemographic variables, pain characteristics, clinical history, visual analog scale (VAS) scores, and Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scores were collected. Radiological evaluation was performed using ultrasound or mammography based on age, and magnetic resonance imaging findings were included when available. Group comparisons were performed statistically using univariate tests and multivariate linear regression was used to identify predictors of anxiety and depression among patients with mastalgia.</p><p><strong>Results: </strong>Women with mastalgia demonstrated significantly higher anxiety scores than controls (median BAI 10 vs. 7; <i>p</i> = 0.009), whereas depression scores did not differ. Among patients with mastalgia, noncyclic pain, palpable abnormalities, and a history of breast surgery were associated with greater anxiety according to univariate analysis. In the multivariate model, palpable breast stiffness (β = 5.30; <i>p</i> = 0.013) and a history of previous breast surgery (β = 8.67; <i>p</i> = 0.022) independently predicted increased anxiety, whereas cyclic pain was protective (β = -6.40; <i>p</i> = 0.007). Imaging yielded predominantly benign or normal findings, underscoring the low diagnostic contribution of routine radiological workup.</p><p><strong>Conclusion: </strong>Mastalgia is characterized by a substantial psychological burden despite a low prevalence of radiological abnormalities. Clinical features, such as palpable stiffness and a history of prior breast surgery, are more strongly linked to anxiety than the findings from imaging studies. These results support a more selective imaging strategy and highlight the importance of incorporating psychological assessment in the evaluation of breast pain.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12928731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282647","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":"Postoperative Chylous Leakage in Breast Cancer Patients: A Multicentre Case Series.","authors":"Billy Ho Hung Cheung, Ka Yan Theresa Tse, Sara Wing Yung Li, Ava Kwong","doi":"10.1159/000548842","DOIUrl":"10.1159/000548842","url":null,"abstract":"<p><strong>Introduction: </strong>Chylous leakage is a rare complication following breast cancer surgery, characterized by milky, lipid-rich fluid collection in surgical drains. While well documented in thoracic and abdominal surgeries, its occurrence after breast procedures remains poorly understood with limited literature. This study evaluates the incidence, characteristics, and management of this complication.</p><p><strong>Methods: </strong>A retrospective analysis was conducted, and seven patients with confirmed chyle leakage were identified among 1,441 breast cancer patients who underwent breast cancer surgery at two Hong Kong surgical centres within a 5-year period. Patients with prolonged drainage or milky fluid underwent laboratory analysis to confirm chylous leakage. Demographics, tumour characteristics, surgical details, management strategies, and outcomes were analysed.</p><p><strong>Results: </strong>Seven patients (0.49%) developed chylous leakage. The median age was 67 years, and the median BMI was 22.2 kg/m². Four patients had right-sided, and three had left-sided breast cancer. Most tumours (85.7%) were located in the upper outer quadrant. All patients underwent mastectomy with various axillary procedures. Chylous drainage was identified between postoperative days 2 and 15 in 6 patients, with 1 late presentation at 6 months. Six patients (85.7%) were successfully managed with dietary modifications (medium-chain triglyceride or low-fat diet), with resolution within 3-11 days. One patient with late presentation required surgical intervention as definitive treatment. No recurrences or delays in adjuvant therapy occurred.</p><p><strong>Conclusion: </strong>Chylous leakage after breast cancer surgery can occur on either side and can occur in patient with sentinel lymph node biopsy. Conservative management with dietary modification is highly effective as first-line treatment. This study highlights the need for increased awareness of this complication and provides foundation for further investigation into its incidence, pathophysiology, and optimal management.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12830030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049984","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":"Comparison of Prosigna® Assay and Urokinase Plasminogen Activator/Plasminogen Activator Inhibitor-1 Results in Early-Stage Breast Cancer Patients.","authors":"Laura Rickerl, Harald Bartsch, Nadia Harbeck, Daniel Maria Hofmann, Thomas Kolben, Tom Degenhardt, Karl Sotlar, Rachel Wuerstlein","doi":"10.1159/000549807","DOIUrl":"10.1159/000549807","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The decision-making process regarding adjuvant treatment in estrogen receptor-positive (ER+), HER2-negative early-stage breast cancer (EBC) is often not sufficient, when based on established clinicopathological parameters. Additional prognostic tests could facilitate these decisions. This paper compares the well-validated invasion marker urokinase plasminogen activator/plasminogen activator inhibitor-1 (uPA/PAI-1) with the Prosigna® assay, which is based on the PAM50 gene signature. Prosigna® also provides a prognostic risk assessment (risk of recurrence, Prosigna®-ROR), taking tumor burden and the intrinsic molecular subtype into account.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From October 2013 to April 2014, we selected 42 postmenopausal EBC patients (ER+/HER2-) from the database of the Breast Centre of the University of Munich (LMU). In the context of therapy decision-making, uPA/PAI-1 testing had already been performed on the selected patients' fresh frozen tumor tissue. The patient's data were pseudonymized, and the Prosigna® assay was performed retrospectively using archived Formalin-fixed paraffin-embedded tumor samples. A 5-year follow-up was carried out in March 2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All patients (&lt;i&gt;n&lt;/i&gt; = 42) had ER+/HER2-negative invasive breast cancers. According to Prosigna®, 22 (52.4%) tumors were classified as low-risk, 14 (33.3%) as intermediate-risk, and 6 (14.3%) as high-risk. Among the 22 Prosigna® low-risk tumors, 13 (59.1%) were classified as uPA/PAI-1 low-risk and 9 (40.9%) were classified as uPA/PAI-1 high-risk. The 14 Prosigna® intermediate-risk tumors divided into 6 (42.9%) uPA/PAI-1 low-risk and 8 (57.1%) uPA/PAI-1 high-risk. Among the 6 patients classified as high-risk using Prosigna®-ROR, one (16.7%) was classified as low-risk and the other 5 (83.3%) as high-risk using uPA/PAI-1. The comparison of the intrinsic subtypes (luminal A, luminal B, basal-like) based on Prosigna® assay with the risk groups of uPA/PAI-1 showed only poor correlation. A 5-year follow-up with the endpoints ipsilateral recurrence, contralateral recurrence, distant metastasis, and death could be obtained in 67% (28/42) of the initially included patients. In two of these cases, one of these events occurred. The risk stratification of uPA/PAI-1 and Prosigna® did not match in these tumors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In luminal EBC, there is only limited concordance between risk group classification according to the Prosigna®-ROR, Prosigna®-luminal subtypes, and risk classification by uPA/PAI-1. Risk classification by uPA/PAI-1 compared to the Prosigna® assay resulted in a larger high-risk group with a clear recommendation for adjuvant chemotherapy (CTX). A larger study population in a prospective setting and more detailed outcome data would be necessary to understand the clinical relevance of the observed discrepancies. Only one evidence-based guideline-recommended prognostic test should be used in a ","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050450","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":"Distinct Immune Landscape and Gene Expression Profiles in Breast Cancer: Young versus Non-Young Patients.","authors":"Zijun Zhu, Chen Gao, Yongxin Li, Xiao Liang, Zhancai Ye, Xinlong Tao, Yinyin Ye, Yaming Tian, Xiaorong Bai, Jiuda Zhao","doi":"10.1159/000547029","DOIUrl":"10.1159/000547029","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer remains a prevalent malignancy worldwide, particularly affecting younger women more aggressively. Significant differences in clinical and biological characteristics exist between breast cancer with young patients (BCY) and breast cancer with non-young patients (BCNY). However, the role of the immune microenvironment in these differences is not fully understood.</p><p><strong>Methods: </strong>Data from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) database were analyzed to compare tumor-infiltrating immune cells (TIICs) and gene expression between BCY and BCNY. The CIBERSORT algorithm was used to estimate the relative abundance of 22 immune cell types, and differentially expressed genes were identified using the \"limma\" package in R.</p><p><strong>Results: </strong>The BCY group had a higher prevalence of M0 macrophages and activated dendritic cells, while the BCNY group exhibited greater infiltration of CD4 memory T cells, M2 macrophages, and neutrophils. Differential gene expression analysis identified 11 significantly expressed genes between the groups, with genes such as FDCSP and GABRP upregulated in the BCY group. GSEA revealed that pro-inflammatory pathways, such as cytokine-cytokine receptor interaction, were enriched in the BCY group, while pathways related to metabolism and extracellular matrix interactions were enriched in the BCNY group. Kaplan-Meier analysis demonstrated that high expression of certain genes, such as NAT1, CA12, and SRARP, was associated with better relapse-free survival.</p><p><strong>Conclusion: </strong>This study reveals significant differences in immune cell infiltration, gene expression, and pathways between BCY and BCNY, providing insights into the aggressive tumor biology that may explain the poorer prognosis of BCY.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"410-421"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249815","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 Risk of Cardiovascular Disease following Aromatase Inhibitor Therapy for Breast Cancer in Postmenopausal Women: A Systematic Review and Meta-Analysis.","authors":"Elijah Berbari, Arsalan Anees, Rajneesh Kaur, Femi E Ayeni, Senarath Edirimanne","doi":"10.1159/000546089","DOIUrl":"10.1159/000546089","url":null,"abstract":"<p><strong>Background: </strong>More women are recovering and living longer lives due to advancement in breast cancer therapies. Aromatase inhibitors (AIs) are one form of endocrine therapy for breast cancer that may have an impact on the risk of developing cardiovascular diseases later in life. This study investigated whether AI therapy for breast cancer in postmenopausal women increases the risk of developing cardiovascular disease in comparison with tamoxifen therapy or no hormonal therapy.</p><p><strong>Methods: </strong>Comparisons were made between tamoxifen and no hormonal therapy using PRISMA guidelines. We searched publicly available databases for studies including postmenopausal women who underwent AI therapy for breast cancer investigating the risk ratio of specific cardiovascular outcomes and cardiovascular death.</p><p><strong>Results: </strong>There was a significant increase in the risk of ischaemic heart disease (RR 1.59, 95% CI: 1.25-2.02, <i>p</i> < 0.05), myocardial infarction (RR 1.50, 95% CI: 1.13-1.99, <i>p</i> < 0.05), heart failure (RR 1.63, 95% CI: 1.14-2.32, <i>p</i> < 0.05), and other cardiovascular events (RR 1.26, 95% CI: 1.12-1.40, <i>p</i> < 0.05) in the AI group when compared to tamoxifen. However, there was a significant decrease in the risk of myocardial infarction (RR 0.77, 95% CI: 0.65-0.90, <i>p</i> < 0.05) in the AI group when compared to no hormonal treatment.</p><p><strong>Conclusion: </strong>There is an increased risk of cardiovascular disease for AI therapy in comparison to tamoxifen therapy. However, further research is needed to establish the cardiovascular risk of AIs when compared to no hormonal therapy. Prognosis and survival of patients should be an important consideration in choosing between tamoxifen and AI therapy among patients receiving treatment for breast cancer. Regular monitoring is essential to facilitate personalized approaches aimed at mitigating the risk of cardiovascular toxicity.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"422-436"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641867","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 Surveillance of Young Israeli <i>BRCA1</i>/<i>BRCA2</i> Pathogenic Sequence Variant Carriers: A Single-Institution Experience.","authors":"Renata Faermann, Eitan Friedman, Dana Madorsky Feldman, Malka Brodsky, Noam Nissan, Anat Shalmon, Osnat Halshtok Neiman, Michael Gotlieb, David Samoocha, Yael Yagil, Miri Sklair-Levy","doi":"10.1159/000546782","DOIUrl":"10.1159/000546782","url":null,"abstract":"<p><strong>Introduction: </strong>The surveillance scheme for early detection of breast cancer (BC) in <i>BRCA1/BRCA2</i> (=<i>BRCA</i>) PSV carriers in Israel includes semiannual imaging: MRI alternating with ultrasound (US) from age 25 to 29 years, with mammography (MG) replacing US from age 30 onward. The purpose of the study was to assess the added value and yield of MG/US to annual screening MRI in the surveillance scheme of young <i>BRCA</i> PSV carriers when BC was diagnosed ≤35 years of age.</p><p><strong>Methods: </strong>This retrospective study encompassed female <i>BRCA</i> PSV carriers attending the Meirav high-risk clinic at Sheba Medical Center, who were diagnosed with BC ≤35 years after joining the clinic between 2010 and 2023. Relevant clinical, radiological, pathological, genetic data, and imaging modalities used were retrieved from the computerized-archiving system, using an IRB-approved protocol.</p><p><strong>Results: </strong>Overall, 28/1,375 <i>BRCA</i> PSV carriers undergoing surveillance at the clinic during the study period met the inclusion criteria: 24/28 (86%) were <i>BRCA1</i>, and 4/28 (14%) were <i>BRCA2</i> PSV carriers. In 17/28 (61%), BC was diagnosed by screening MRI and in 11/28 (39%) by MG/US (<i>p</i> > 0.05), of whom 7 underwent MG/US because they were either pregnant or breastfeeding. In the group diagnosed by MG/US, 5/11 had a palpable mass (interval cancers) and none in the MRI group. In 17/24 non-pregnant patients, BC was diagnosed by MRI (<i>p</i> = 0.03). Mean MRI-diagnosed tumor size was 12.5 ± 6.2 mm (range 5-30 mm) and 24.6 ± 13.8 mm for MG/US-based diagnosed tumors (range 6-50 mm) (<i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>In the current study, young (≤35 years) <i>BRCA</i> PSV carriers diagnosed with BC were effectively diagnosed by MRI screening, and MRI-diagnosed BCs were smaller than MG/US-diagnosed BC. Thus, it seems that MRI screening is sufficient for early-stage BC detection in young, non-pregnant or breastfeeding <i>BRCA</i> PSV carriers with no palpable breast mass. For pregnant <i>BRCA</i> PSV carriers, US surveillance seems important to minimize risk for interval cancers.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"387-395"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249817","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":"Comparison of Local Recurrence Outcomes between Breast Conservation Therapy and Mastectomy for the Treatment of Breast Cancer among Young Women: A Systematic Review and Meta-Analysis.","authors":"Yiming Sun, Feng Zhang, Qi Guo, Xiaowen Ma","doi":"10.1159/000546783","DOIUrl":"10.1159/000546783","url":null,"abstract":"<p><strong>Background: </strong>Recent clinical trials comparing local recurrence rates in young breast cancer (BC) patients after breast-conserving therapy (BCT) versus mastectomy are limited. The local recurrence (LR) rate in young BC patients is notably higher than in other age groups, whether the recurrence rates after the two surgical options are comparable remains unclear. This meta-analysis aimed to assess the safety of BCT and mastectomy for young age BC patients by comparing LR rates between the two procedures.</p><p><strong>Methods: </strong>We conducted a systematic search of four electronic databases (Medline, PubMed, Cochrane Library, and Web of Science) for relevant studies comparing LR rates in BC patients aged 40 years or younger who were treated with BCT or mastectomy. Studies that met the inclusion criteria were synthesized using a random-effects model, with a primary focus on LR rates. Sensitivity analyses and meta-regression were performed to evaluate bias and heterogeneity, ensuring a thorough assessment of the available evidence.</p><p><strong>Results: </strong>Among the 2,936 studies screened, 10 studies encompassing 9,215 patients were included, with 5,236 undergoing BCT and 5,803 undergoing mastectomy. The summary odds ratio (OR) indicated a significantly greater risk of LR for BCT compared to mastectomy among young BC patients (OR = 1.48; 95% CI: 1.12-1.96). In subgroup analysis, the BCT group exhibited a higher 5-year LR rate (OR = 1.67; 95% CI: 1.13-2.46) compared to the mastectomy group. This trend persisted across tumor stages, with the BCT group showing an increased LR risk in both the T1-2 (OR = 1.84; 95% CI: 1.44-2.36) and T1-4 (OR = 1.74, 95% CI: 1.50-2.03) stages. Nodal status analysis indicated a higher LR risk for BCT in the N0-1 (OR = 2.549, 95% CI: 1.79-3.46) stages. Among very young women (aged ≤35), the difference in LR rates between BCT and mastectomy was even more pronounced (OR = 2.04, 95% CI: 1.47-2.82).</p><p><strong>Conclusion: </strong>Our meta-analysis found that young BC patients undergoing BCT had a significantly higher risk of LR, with a 48% increased risk compared to those who underwent mastectomy (OR = 1.48; 95% CI: 1.12-1.96). This difference was even more pronounced in patients aged 35 years or younger. While the elevated LR risk with BCT in young patients is well documented, individualized treatment planning should weigh this against potential survival advantages and quality-of-life preservation.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"452-465"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590513","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":"Development and Validation of a Predictive Model for Sentinel Lymph Node Biopsy Exemption in Ductal Carcinoma in situ Patients.","authors":"Zhihong Xu, Dan Tao, Qihua Jiang, Wensong Wei, Qian Ma","doi":"10.1159/000546885","DOIUrl":"10.1159/000546885","url":null,"abstract":"<p><strong>Introduction: </strong>There is no uniform standard on whether total mastectomy for ductal carcinoma in situ (DCIS) can exempt sentinel lymph node biopsy (SLNB). This study attempts to find the risk factors for the underestimation of DCIS pathology and establish the corresponding prediction model to screen suitable DCIS patients for exemption from SLNB.</p><p><strong>Methods: </strong>A total of 826 patients with DCIS met the inclusion criteria. Logistic regression identified lesion size, Ki67, estrogen receptor (ER) status, human epidermal growth factor receptor 2 (HER2) status, histological grade, and diagnostic method as independent predictors of pathological underestimation (<i>p</i> < 0.05). Based on these variables, a predictive model was developed: <i>p</i> = 0.354 × lesion size + 0.017 × Ki67 + 1.186 × ER - 2.501 × diagnosis method (1) - 1.575 × diagnosis method (2) - 0.050 × HER2 (1) - 1.578 × HER2 (2) + 1.160 × grade (1) + 1.497 × grade (2) - 2.418 (if age <50) - 0.156 × 1 (if age >50). The model showed good performance with a sensitivity of 79.2%, specificity of 73.8%, and overall accuracy of 76.2%. The area under the ROC curve (AUC) was 0.856 (95% confidence interval: 0.831-0.881, <i>p</i> < 0.001). Subgroup analyses indicated that age, presence of mass, ER, HER2, tumor grade, and histological grade significantly affected model performance (AUC = 0.787; sensitivity = 0.695; specificity = 0.753). Stratified analysis showed higher sensitivity in patients <50 years (0.840 vs. 0.656) and higher AUC in ER-positive cases (0.865). In HER2-based analysis, only the presence of a mass remained significant. Mass-based analysis revealed all variables except age were significant, with a higher AUC in patients without a mass (0.784 vs. 0.727).</p><p><strong>Conclusion: </strong>This study developed a predictive model based on lesion size, Ki67, ER status, HER2 status, histological grade, and diagnostic method to assess the risk of pathological underestimation in DCIS. The model demonstrated good predictive performance (AUC = 0.856) with high sensitivity and specificity, indicating its potential clinical utility. Subgroup analyses revealed that factors such as age, presence of a mass, and ER status influenced model performance, with particularly better accuracy observed in patients under 50 and those with ER-positive tumors. This model may serve as a useful tool to support clinical decision-making, especially in preoperative evaluation of invasive potential in DCIS patients.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"396-409"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673949","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":"Using Virtual Therapy for Lymphedema and Disability Post-Mastectomy: Meta-Analysis with Systematic Review.","authors":"Islam Bani Mohammad, Muayyad Ahmad","doi":"10.1159/000546605","DOIUrl":"10.1159/000546605","url":null,"abstract":"<p><strong>Introduction: </strong>This review and meta-analysis aimed to examine the effects of virtual reality (VR) therapy on lymphedema and disability management in post-mastectomy breast cancer patients, following PRISMA protocol.</p><p><strong>Methods: </strong>Databases were extensively searched, including Wiley Online Library, ProQuest, MEDLINE, CINAHL, Google Scholar, Science Direct, and SAGE Journals, covering studies from January 2016 to August 2024. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>Nine studies met the inclusion criteria. The findings indicate VR therapy effectively reduces post-mastectomy lymphedema and aids upper limb disability rehabilitation, with sessions lasting 10-50 min. The meta-analysis statistics showed a significant decrease in disability, measured by the disability of the arm, shoulder, and hand (DASH) scale, with an effect size of -0.931 (<i>Z</i> score = -2.713, <i>p</i> = 0.007) and a 95% confidence interval of -1.604 to -0.259.</p><p><strong>Conclusions: </strong>These results strongly support VR's efficacy in managing lymphedema and disability, recommending its integration into routine care at oncology centers and hospitals. This article explains compelling evidence that VR is effective in helping patients with lymphedema manage their disabilities. Rehabilitation programs using VR after mastectomy should be incorporated into the daily care in oncology centers and hospitals. Further interventional studies are needed to strengthen evidence and refine VRs clinical application.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"437-451"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607370","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":"338-347"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","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}