Breast Care最新文献

{"title":"Current Standards and Future Outlooks in Metastatic Her2-Positive Breast Cancer.","authors":"Christoph Suppan, Marija Balic","doi":"10.1159/000528756","DOIUrl":"10.1159/000528756","url":null,"abstract":"<p><strong>Background: </strong>Approximately 20% of all breast cancer cases show overexpression or amplification of the human epidermal growth factor receptor 2 (Her2) [Cancer Epidemiol Biomarkers Prev. 2017;26(4):632-41]. With the introduction of trastuzumab, lapatinib, and pertuzumab to the realm of treatment, a new era of antibody-drug conjugates had only begun. Within the last two decades, survival for patients with this tumor subtype has fundamentally improved.</p><p><strong>Summary: </strong>Beginning with a taxane plus trastuzumab/pertuzumab followed by trastuzumab deruxtecan, the first- and second-line treatments are set in stone. With the introduction of tucatinib as a newer tyrosine kinase inhibitor in combination with capecitabine and trastuzumab, there is one efficient line of treatment available after trastuzumab deruxtecan or even earlier in selected cases with active brain metastasis. Especially for later stages of disease, several combination strategies are under investigation. There is still a lack of positive results on immune checkpoint inhibition combined with Her2-targeted therapy, but hopefully an extension to the treatment algorithm will be on its way soon.</p><p><strong>Key messages: </strong>With the HER2CLIMB trial, patients with brain metastasis were no longer excluded from bigger trials, and international guidelines implemented its presence or absence in their decision trees [N Engl J Med. 2020;382(7):597-609]. Curing Her2-positive metastatic breast cancer, or at least living a long life with this disease, is increasingly becoming a reality.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9982349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9413326","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":"CDK4/6 Inhibitors in Advanced HR+/HER2 - Breast Cancer: A Multicenter Real-World Data Analysis.","authors":"Carolin Müller, Verena Kiver, Erich-Franz Solomayer, Gudrun Wagenpfeil, Caroline Neeb, Jens-Uwe Blohmer, Alina Valik Abramian, Nicolai Maass, Florian Schütz, Cornelia Kolberg-Liedtke, Damian Johannes Ralser, Anna-Christina Rambow","doi":"10.1159/000527917","DOIUrl":"10.1159/000527917","url":null,"abstract":"<p><strong>Purpose: </strong>CDK4/6 inhibitors (CDK4/6i) combined with endocrine therapy are considered standard-of-care for first-line therapy of patients with hormone receptor positive, HER2 negative, advanced breast cancer (HR+/HER2- ABC). Superiority of combination therapy over endocrine monotherapy has been demonstrated in a multitude of randomized controlled trials (RCTs) in phase III and IV. However, RCTs reflect clinical reality only to a limited extent, as narrow inclusion criteria lead to a selected patient collective. Here, we present real-world data (RWD) on CDK4/6i treatment in patients with HR+/HER2- ABC at four certified German university breast cancer centers.</p><p><strong>Methods: </strong>Patients diagnosed with HR+/HER2- ABC who were treated in clinical routine with CDK4/6i between November 2016 and December 2020 at four certified German university breast cancer centers (Saarland University Medical Center, University Medical Center Charité Berlin, University Medical Center Bonn, and University Medical Center Hospital Schleswig-Holstein, Campus Kiel) were identified and enrolled in this retrospective study. Clinicopathological characteristics and clinical outcomes were recorded with particular emphasis on CDK4/6i therapy course [progression-free survival (PFS) following treatment initiation, toxicity, dose reduction, therapy discontinuation, prior and subsequent therapy line].</p><p><strong>Results: </strong>Data from <i>n</i> = 448 patients were evaluated. The mean patient age was 63 (±12) years. Of these patients, <i>n</i> = 165 (36.8%) were primarily metastasized, and <i>n</i> = 283 (63.2%) had secondary metastatic disease. <i>N</i> = 319 patients (71.3%) received palbociclib, <i>n</i> = 114 patients (25.4%) received ribociclib, and <i>n</i> = 15 patients (3.3%) received abemaciclib, respectively. Dose reduction was performed in <i>n</i> = 132 cases (29.5%). <i>N</i> = 57 patients (12.7%) discontinued the treatment with CDK4/6i due to side effects. <i>N</i> = 196 patients (43.8%) experienced disease progression under CDK4/6i treatment. The median PFS was 17 months. Presence of hepatic metastases and prior therapy lines were associated with shorter PFS, whereas estrogen positivity and dose reduction due to toxicity were positively associated with PFS. Presence of bone and lung metastases, progesterone positivity, Ki67 index, grading, <i>BRCA1/2</i> and <i>PIK3CA</i> mutation status, adjuvant endocrine resistance, and age did not significantly impact on PFS.</p><p><strong>Conclusion: </strong>Our RWD analysis on CDK4/6i treatment in Germany supports data from RCTs regarding both treatment efficacy and safety of CDK4/6i for treatment of patients with HR+/HER2- ABC. In comparison to data from the pivotal RCTs, median PFS was lower but within the expected range for RWD, which could result from inclusion of patients with more advanced diseases (i.e., higher therapy lines) to our dataset.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9982335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9413327","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 Preliminary Study of Ultrasound-Guided Microwave Ablation for Nonpuerperal Mastitis Treatment.","authors":"Shengluan Zhou, Chenyi Sheng, Ping Hu, Xuejun Ni, Xiaoping Xu, Qian Song, Xiaoxiao Jiang, Hui Zhao, Xiaoyang Chen","doi":"10.1159/000527128","DOIUrl":"10.1159/000527128","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the feasibility of ultrasound (US)-guided microwave ablation (MWA) as a treatment for nonpuerperal mastitis (NPM).</p><p><strong>Methods: </strong>Fifty-three patients with NPM diagnosed by biopsy and treated with US-guided MWA at the Affiliated Hospital of Nantong University between September 2020 and February 2022 were classified according to whether they underwent MWA alone (<i>n</i> = 29) or MWA with incision and drainage (<i>n</i> = 24). Patients were followed up by interviews, physical and US examinations, and evaluation of breast skin at 1 week and 1, 2, and 3 months after treatment. Data from these patients were prospectively collected and retrospectively analyzed.</p><p><strong>Results: </strong>The overall mean patient age was 34.42 ± 9.20 years. The groups differed significantly by age, involved quadrants, and the initial maximum diameter of lesions. In the MWA group, the cure rate was 34.48%, and the apparent efficiency rate was 65.52%. In the MWA with incision and drainage, the apparent efficiency rate was 91.66%, and the effective rate was 4.17%. The excellent rate for breast aesthetics in the MWA group was 79.31%, and the good rate was 20.69%. The excellent rate in the MWA with incision and drainage group was 45.83%, the good rate was 41.67%, and the qualified rate was 12.5%. The mean maximum diameter of lesions in the two groups decreased significantly.</p><p><strong>Conclusion: </strong>For NPM with small lesions in a single quadrant, MWA therapy is a direct and effective method. For larger lesions involving two or more quadrants, the combined treatment of MWA with incision and drainage showed significant improvement in a short period. MWA treatment of NPM has importance for further research and clinical applications.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9982351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9413323","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 Breast Awareness on the Early Detection of Breast Cancer in Young Women: A Systematic Review.","authors":"Dorsa Banihashemi, Meagan E Brennan","doi":"10.1159/000526990","DOIUrl":"10.1159/000526990","url":null,"abstract":"<p><strong>Background: </strong>\"Breast awareness\" is a recommendation that women understand the symptoms of breast cancer and become familiar with the usual look and feel of their breasts. It is recommended for women of all ages in breast cancer screening guidelines around the world. The objective of this study was to assess the evidence for breast awareness by investigating its effect on breast cancer outcomes in women of pre-mammographic-screening age (under age 40), at average risk of breast cancer.</p><p><strong>Methods: </strong>A systematic review was performed using PRISMA methodology. Following the search, abstracts and full-text articles were assessed against eligibility criteria. Data were extracted into evidence tables, risk of bias was assessed, narrative synthesis was performed, and results were described. Eligible studies were original research studies assessing the impact of breast awareness on cancer outcomes (such as stage at diagnosis or survival) in women ≤40. Medline, PubMed, and Cochrane Library were searched.</p><p><strong>Results: </strong>After screening the 6,204 abstracts identified in the search, no studies meeting all eligibility criteria were found. Two partially eligible studies were identified. These met the intervention and outcomes criteria but included mixed-age cohorts that included but were not limited to women ≤40. These studies provided low-level (Level IV) evidence of moderate quality that there is some benefit (earlier stage at diagnosis and/or improved survival) of breast awareness in a mixed-age cohort that included some younger women.</p><p><strong>Conclusions: </strong>No studies evaluating the impact of breast awareness exclusively in young women were identified. Limited evidence of benefit of breast awareness was found. Guidelines that recommend breast awareness should be reviewed and qualified with an explanation that the evidence of benefit is weak. Women have limited screening options available to them for the early detection of breast cancer until they reach mammographic screening age. The study was registered on Prospero (ID: CRD42021279457).</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9982355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9413325","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":"PharmaNews","authors":"","doi":"10.1159/000534478","DOIUrl":"https://doi.org/10.1159/000534478","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136257268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PharmaNews","authors":"","doi":"10.1159/000533369","DOIUrl":"https://doi.org/10.1159/000533369","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135989402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Latest Clinical Data among Patients with Breast Cancer in Low- and Middle-Income Countries.","authors":"Shaheenah Dawood, A F M Kamal Uddin, Sewanti Limaye","doi":"10.1159/000527987","DOIUrl":"10.1159/000527987","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9801395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458811","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":"Evolution of HER2 Targeting in Metastatic Breast Cancer.","authors":"Rupert Bartsch, Marija Balic","doi":"10.1159/000528002","DOIUrl":"10.1159/000528002","url":null,"abstract":"","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9801393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458814","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 Response and Discussion with Respect to Gulcelik's Study in Oncoplastic Level II Surgical Techniques for Breast Cancer Treatment.","authors":"Andres Rivera, Dafne Gascon","doi":"10.1159/000524546","DOIUrl":"10.1159/000524546","url":null,"abstract":"The present is a response to the research article entitled “Oncoplastic Level II Surgical Techniques for Breast Cancer Treatment: Long-Term Outcomes” by Gulcelik MA, Dogan L, Karaman N, Bahcecitapar M and Ozaslan C published in Breast Care (2022;17:24–30).\u0000We would like to emphasize the psicosocial and personal aspect in conservative breast surgery and focus on this issue. \u0000We open the debate of the need of using systematically the measure of this aspect in breast oncology surgery, specially in oncoplastic techniques.","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9801399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458817","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":"Treatment Outcomes according to the EndoPredict Score in ER-Positive, HER2-Negative Early Breast Cancer.","authors":"Wonguen Jung, Kyubo Kim, Byung-In Moon","doi":"10.1159/000525838","DOIUrl":"10.1159/000525838","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the treatment outcomes of estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2-) breast cancer according to the risk group using EndoPredict (EP) score.</p><p><strong>Patients and methods: </strong>Between 2015 and 2019, 207 patients with ER+/HER2- pN0-N1 early breast cancer who underwent surgery, EP test, and adjuvant radiotherapy were accrued. The EPclin score, which combines the molecular EP score with nodal status and tumor size, was calculated, and patients were divided into EPclin low- or high-risk groups by the cutoff value of 3.3.</p><p><strong>Results: </strong>There were 154 and 53 patients in the EPclin low- and high-risk groups, respectively. Forty-one patients (81.1%) of the high-risk group received adjuvant chemotherapy, while only 1 (0.6%) of the low-risk group did. With a median follow-up of 54.1 months (range 8.2-76.6), the 5-year disease-free survival rates of low- and high-risk groups were 100% and 88.9%, respectively (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The EPclin score was associated with recurrences in ER+/HER2- early breast cancer.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9801398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458818","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}