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":2.1,"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":"AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2025.","authors":"Marc Thill, Wolfgang Janni, Ute-Susann Albert, Maggie Banys-Paluchowski, Rupert Bartsch, Ingo Bauerfeind, Vesna Bjelic-Radisic, Jens Blohmer, Wilfried Budach, Peter Dall, Nina Ditsch, Eva Maria Fallenberg, Peter A Fasching, Tanja Fehm, Michael Friedrich, Bernd Gerber, Oleg Gluz, Nadia Harbeck, Andreas Hartkopf, Jörg Heil, Juliane Hörner-Rieber, Jens Huober, Hans-Heinrich Kreipe, David Krug, Thorsten Kühn, Sherko Kümmel, Sibylle Loibl, Diana Lüftner, Michael Patrick Lux, Nicolai Maass, Christoph Mundhenke, Mattea Reinisch, Toralf Reimer, Kerstin Rhiem, Achim Rody, Marcus Schmidt, Andreas Schneeweiss, Florian Schütz, Hans-Peter Sinn, Christine Solbach, Erich-Franz Solomayer, Elmar Stickeler, Christoph Thomssen, Michael Untch, Marion van Mackelenbergh, Isabell Witzel, Achim Wöckel, Rachel Würstlein, Volkmar Müller, Tjoung-Won Park-Simon","doi":"10.1159/000545018","DOIUrl":"10.1159/000545018","url":null,"abstract":"<p><p>The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO; German Gynecological Oncology Group) presents the 2025 update of the evidence-based recommendations for the diagnosis and treatment of patients with locally advanced and metastatic breast cancer (mBC).</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":" ","pages":"208-219"},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970087","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":"Pyoderma Gangrenosum of the Breast: A Diagnostic Challenge.","authors":"Joaquim Marcoval, Clara Muntaner-Virgili, Júlia Boronat-Cucarull, Marta Gangonells-Dols, Alvaro Lagos-Tapia","doi":"10.1159/000544905","DOIUrl":"10.1159/000544905","url":null,"abstract":"<p><strong>Introduction: </strong>Pyoderma gangrenosum (PG) is a rare, noninfectious neutrophilic dermatosis usually located in the legs. PG of the breast is infrequent and may be a diagnostic challenge. Our objective was to review our patients with breast PG in order to analyse their clinical features.</p><p><strong>Methods: </strong>Patients diagnosed with PG involving the breast in Bellvitge University Hospital (Barcelona, Spain) between 2000 and 2023 were included in the study. Medical charts were retrospectively reviewed to obtain clinical data.</p><p><strong>Results: </strong>Ten patients were diagnosed with breast PG (10 women aged between 30 and 63 years, median 49.5). Evolution time at diagnosis ranged between 4 days and 7 months. In all cases, PG lesions were painful. All patients presented ulcerated lesions. In 2 cases, nodular abscess-like lesions and cribriform scars were also observed. The nipple was involved in 4 cases. Two patients had underlying diseases recognized as frequently associated with PG (ulcerative colitis and rheumatoid arthritis). Seven patients had a previous breast surgery that was considered related to PG (removal of breast carcinoma with breast reconstruction in 6 cases and breast reduction in one). The diagnosis of postsurgical breast PG was delayed in 6 patients by between 3 and 7 months. One patent developed radiation therapy induced pathergy after healing of postsurgical PG.</p><p><strong>Conclusion: </strong>The most common triggering factor for breast PG in our study was reconstruction following surgery for breast carcinoma. Medical professionals who treat breast diseases should be aware of this disease in order to lessen diagnostic delay.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 3","pages":"182-188"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474051","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":"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":2.1,"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":2.1,"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":"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":2.1,"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}

{"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":2.1,"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":"Targeted Axillary Dissection Using Surgical Marker Navigation after Neoadjuvant Systemic Treatment in Breast Cancer Patients: A Single-Center Experience.","authors":"Daniel Egle, Christine Brunner, Magdalena Ritter, Verena Wieser, Katharina Knoll, Birgit Amort, Afshin Soleiman, Heidelinde Fiegl, Christian Marth, Carmen Albertini, Rupert Bartsch","doi":"10.1159/000541704","DOIUrl":"10.1159/000541704","url":null,"abstract":"<p><strong>Background: </strong>In early-stage breast cancer with initially positive axillary lymph nodes, reliable assessment of the involvement of the axilla is important because of the prognostic importance of lymph node metastases. After neoadjuvant chemotherapy (NACT), targeted axillary dissection (TAD), including sentinel lymph node biopsy and primarily involved lymph nodes, is currently regarded as the standard of care. The target lymph node must be marked using a clip/marker and later localized using a reliable guidance technique to identify the node, to avoid the indication of axillary lymph node dissection.</p><p><strong>Methods: </strong>The present study aimed to evaluate retrospective data collected from April 25, 2022, until March 30, 2023, on a consecutive series of patients, to determine the efficacy and safety of using the Sirius Pintuition GPSDetect^™ surgical marker navigation system.</p><p><strong>Results: </strong>This consecutive case series shows that identification of the target node with surgical marker navigation is feasible and safe, with a 100% identification rate at surgery, in a population of 20 patients with histologically verified axillary lymph node involvement before NACT.</p><p><strong>Conclusion: </strong>Magnetically guided localization systems may therefore be a valid alternative to ultrasound-guided wire placement. The data highlight the practicality of the magnetically guided approach, which potentially contributes to a reduction in treatment-related morbidity by avoiding unnecessary axillary lymph node dissection.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"57-65"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967676","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":"Prognostic Impact of Immunophenotypic Variation in Subcapsular Sinus Endothelium of Sentinel Lymph Nodes in Invasive Breast Carcinoma.","authors":"Jonas Derben, Markus Oeruem, Carolin Blasberg, Akira Hattesohl, Paul Jank, Matthias Kalder, Carsten Denkert, Christina C Westhoff","doi":"10.1159/000543600","DOIUrl":"10.1159/000543600","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies demonstrated the de novo formation of lymphatic vessels in tumor-draining lymph nodes (LNs), partly preceding lymphatic metastases. This \"lymphovascular niche\" supposedly facilitates survival of metastatic tumor cells. This study aims at evaluating the previously observed immunophenotypic variations of subcapsular endothelial cells (SECs) in a larger cohort by software-assisted image analysis.</p><p><strong>Methods: </strong>Suitable cases with sentinel-LN (SLN) of invasive breast cancer were identified in the Institute of Pathology, corresponding data were extracted. LN of 231 patients were stained for HE, D2-40, CD31, and Prox1. QuPath software was used for assessing the immunohistochemical stained area of endothelial cells of the subcapsular sinus. The Cutoff Finder web application was used for identification of the best cutoff for continuous parameters according to overall survival (OS). Collected data were statistically evaluated for available data.</p><p><strong>Results: </strong>A larger area of CD31-positive SEC was significantly associated with worse OS (<i>p</i> = 0.001), as was a higher proportion of D2-40-stained subcapsular sinus (<i>p</i> = 0.045). Larger area of D2-40-/CD31-/Prox1-positive SEC and higher proportion of D2-40 stained subcapsular sinus were independent marker for worse OS in multivariate analysis in the whole cohort, for D2-40- and CD31-positive SECs as well as higher proportion of D2-40-stained sinus including nodal-negative status, respectively.</p><p><strong>Conclusion: </strong>QuPath-assisted evaluation of immunophenotypic variation in subcapsular sinus endothelium in SLN essentially confirmed and extended our previous findings. Larger positive area of D2-40- and CD31-positive SECs emerged as a strong independent negative prognostic factor, even before evident nodal metastasis. The potential function of alterations in D2-40-/CD31-expression in SECs has yet to be elucidated.</p>","PeriodicalId":9310,"journal":{"name":"Breast Care","volume":"20 2","pages":"75-87"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965440","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}