European journal of breast health最新文献

{"title":"Integrating Genetic Testing, Combined Polygenic Risk, and Family History Assessment to Improve High-Risk Breast Cancer Identification in a Community Breast Imaging Center.","authors":"Tami Hudson, Shayna Giardina Leggett, Tammy McKamie, Laura Brzeskiewicz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This initiative evaluated whether the Tyrer-Cuzick (TC) v8 model alone is sufficient for breast cancer (BC) risk assessment compared to a comprehensive strategy incorporating detailed family history intake, germline multigene panel testing, and a combined risk score (CRS) that integrates TC with a polygenic score validated for all ancestries. The aim was to determine whether this integrated approach more accurately identifies individuals at increased risk for breast and other cancers in a community breast imaging center and better supports personalized screening and management decisions.</p><p><strong>Materials and methods: </strong>Beginning in November 2020, Singing River Health System implemented a comprehensive breast risk assessment program that combined TC modeling, multigene germline testing, and CRS into its breast imaging program. During routine mammography, patients completed TC and were screened for genetic testing eligibility based on NCCN guidelines. Eligible patients received a telephone-based family history review and genetic education, followed by same day blood sample collection after consenting to testing. Testing included a germline multigene panel and CRS to determine individualized BC risk. After results were available, a nurse navigator reviewed results and guideline-based recommendations with patients. Program outcomes were analyzed to determine clinical management implications and to identify individuals who would not have met high-risk criteria using TC alone.</p><p><strong>Results: </strong>From November 2020 through December 2025, TC results were determined for 3,017 patients; eligible patients underwent germline genetic testing and CRS. Among these, 895 (30%) required changes in medical management despite having a TC-estimated lifetime BC risk <20% as follows: • 75 (8.3%) carried a pathogenic variant. • 186 (20.7%) had lifetime BC risk >20% based on CRS. • 634 (70%) required modified management after expanded family history was obtained during counseling. Downstream clinical actions that have the potential for meaningful impact on breast cancer outcomes included: • 175 risk-reduction counseling visits. • 103 breast MRIs for patients whose CRS revealed a lifetime BC risk >20%. • 63 gastroenterology consults resulting in 26 colonoscopies.</p><p><strong>Conclusion: </strong>A multifaceted risk assessment program integrating TC with CRS and germline genetic testing identified substantially more individuals requiring high-risk management than TC alone. This approach revealed patients who benefited from guideline recommended surveillance, preventive interventions, and specialty referrals, many of whom would have been missed using TC as a standalone assessment. These findings support the value of integrated genetic, polygenic, and family history-based evaluation within community imaging centers.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"9"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of 6-Week Progressive Resistance Training Program on Functional Strength and Quality of Life in Breast Cancer Survivors: Retrospective Analysis.","authors":"Ashwini Kadam, Grant Abbuhl, Chen Yang, Joshua Thatch, Meghan Ring","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Persistent muscular weakness and reduced quality of life is a common treatment related adverse effect among breast cancer survivors. The benefits of progressive resistance training (PRT) for 12 weeks and longer time using 1 repetition max (RM) are well documented. This is a retrospective analysis investigating the effects of a 6-week resistance training program performed to volitional fatigue on functional strength and quality of life (QOL) in survivors.</p><p><strong>Materials and methods: </strong>This single-arm retrospective pilot analysis examined the effects of PRT in 20 breast cancer survivors (mean age 62.9±11.1 years). Participants completed PRT twice per week for six consecutive weeks. We evaluated changes in grip strength, skeletal muscle mass (SMM), lower body strength, and QOL. Participants completed pre and post measurements of grip strength, sit-to-stand test, SMM measured by bioelectrical impedance, and QOL measured by FACT-G scale. Women who had completed surgery, chemo, and/or radiation treatment within the two years preceding the study (2024-2025) were included in the program. Training sessions included 30- 45 minutes of PRT along with 5 to 10 minutes of warm-up and cool-down, respectively. Intensity was standardized by training to fatigue, rather than percentage of 1RM. Paired t-tests were used to assess change in SMM and grip strength. Wilcoxon signed rank test was used to analyze change in sit to stand test, and FACT-G scores.</p><p><strong>Results: </strong>There was a significant increase in functional lower-body strength [sit to stand: +2.50 reps, 95% confidence interval (CI) (1.54, 3.46), p<0.001] and bilateral grip strength [right: +3.48 lbs., 95% CI (0.11, 6.86), p = 0.043; left: 5.35 lbs., 95% CI (2.52, 8.18), p<0.001]. Positive impact on QOL was observed [FACT-G: + 7.00 points, 95% CI (1.22, 12.78), p = 0.003]. No significant changes were seen in SMM [+0.21 lbs., 95% CI (-0.16, 0.58), p = 0.254). Strength gains were not correlated with QOL improvements.</p><p><strong>Conclusion: </strong>A 6-week resistance training program performed to volitional fatigue is an effective rehabilitation strategy for breast cancer patients. The intervention yielded significant improvements in functional lower-body strength, grip strength, and overall QOL. No changes in SMM occurred. Improvements in FACT G scores were independent of strength.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"7"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting Breast Cancer Diagnosis to Earlier Stages Through Program Alignment with National Accreditation Program for Breast Centers (NAPBC) Standards.","authors":"Lisa McGuire","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Nationally, approximately 66% of breast cancers are diagnosed at an early stage (0-II). Review of the 2022 analytic breast cancer cases at HCA Florida Ocala Hospital demonstrated an early-stage diagnosis rate of 65%, slightly below the national benchmark. In 2023, breast oncology physician stakeholders aligned the program with National Accreditation Program for Breast Centers (NAPBC) standards, pursuing accreditation in 2024. The objective was to improve breast oncology program quality, shift diagnoses to earlier stages, and enhance patient outcomes.</p><p><strong>Materials and methods: </strong>Three initiatives were implemented to align with NAPBC standards. • A dedicated bi-weekly multidisciplinary breast cancer conference was established for prospective case review, involving radiology, pathology, surgery, medical oncology, radiation oncology, and genetic counseling. Post-operative pathology was also reviewed to confirm adjuvant treatment plans, re-excision needs, and supportive service referrals. • A high-risk women's program (HRWP) launched in June 2023, incorporating cancer risk assessments for mammography patients and offering point-of-care genetic testing for those meeting National Comprehensive Cancer Network criteria. Identifying high-risk patients and coordinating follow-up in clinic enabled personalized screening and surveillance. • Outmigration was addressed as a quality initiative through improved breast imaging access, enhanced nurse navigation, and targeted outreach to referring providers.</p><p><strong>Results: </strong>Outcomes on the three components above demonstrated: • Breast cancer conference case presentations increased 62% in 2023 compared to prior year, with continued growth of 10% in 2024 and 16% in 2025. • Prospective pathology review of outside biopsies identified four non-concordant cases between 2023-2025, resulting in changes to surgical management. • The HRWP achieved 98% assessment completion rate, identified over 1,000 patients with elevated Tyrer-Cuzick scores, and detected more than 150 pathogenic mutations. Program care coordination enabled cascade family testing, a 69% increase in breast magnetic resonance imaging utilization from 2023-2025, and personalized surveillance plans. • Breast cancer outmigration decreased from 71% in 2024 to 62% in 2025.</p><p><strong>Conclusion: </strong>Alignment with NAPBC standards resulted in a 9% improvement in early-stage breast cancer diagnosis, increasing from 66% in 2022 to 75% in 2023, and sustaining at 73% in 2024. The HRWP emerged as the program's primary service differentiator and continues to drive early detection and quality outcomes. Completion of 2025 abstraction is anticipated to demonstrate continued improvement.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"4"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eight-year Post-accreditation Outcomes Following Implementation of an Oncoplastic-dedicated Surgical Team and Digital Same-day Oncology-surgery Workflow: Sustained Breast-conserving Therapy Rate of 96% Ten Years Post-initiation.","authors":"Dom Van Loggerenberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>After international accreditation in 2016, a structured oncoplastic service was introduced at our multidisciplinary breast centre, incorporating a dedicated surgical team, integrated oncology anaesthetic clinic, and direct digital communication pathways between oncology, radiology, and surgery. This initiative aimed to optimise breast-conserving therapy (BCT) utilisation, reduce theatre delays, and enhance margin clearance through coordinated imaging, localisation, and intraoperative assessment.</p><p><strong>Materials and methods: </strong>A retrospective analysis was performed of all malignant breast surgeries (2016-2024). Service development milestones included: • 2016-2018: Establishment of oncoplastic unit and protocol alignment. • 2019-2020: Integration of real-time radiology support and pre-surgical localisation workflow. • 2021-2024: Implementation of a secure digital oncology-surgery same-day referral system, intraoperative radiology communication, and in-theatre pathology review. Procedures were categorised as BCT (wide local excision/oncoplastic BCT) or mastectomy. Yearly and aggregate BCT rates were calculated.</p><p><strong>Results: </strong>Over the eight years post-accreditation, the proportion of patients treated with BCT rose from 54.5% (2016) to 96.1% (2024). Key transitional improvements included: • Pre-digitisation period (2016-2020): Mean BCT 64.1%, reflecting gradual integration of oncoplastic principles. • Digital workflow period (2021-2024): Mean BCT 90.8% (1,423/1,567 cases; 95% confidence interval 89.3-92.1). Margin clearance rates exceeded 90% in all recent years. The adoption of MRI-guided magnetic marker placement, same-day oncology-to-surgery referral, and intraoperative radiology-pathology collaboration were associated with a sustained rise in BCT utilisation and reduction in re-excision rates.</p><p><strong>Conclusion: </strong>Ten years after program inception, the integration of a dedicated oncoplastic surgical team, real-time digital oncology-surgery pathways, and multimodal intraoperative support has resulted in a sustained BCT rate of 96%, exceeding international benchmarks. This model demonstrates how combining accreditation standards, workflow digitisation, and subspecialist coordination can deliver durable service-wide improvements in breast-conserving outcomes.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"5"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hereditary Cancer Genetic Testing for All? A Retrospective Analysis on Genetic Mutations Found in Individuals Not Meeting NCCN® Guidelines.","authors":"Jenna Cooke, Meghan E Burgess, Heather Fecteau","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Hereditary cancer genetic testing has been routinely recommended for individuals whose personal or family history meets the National Comprehensive Cancer Network® (NCCN®) guidelines. Midstate Radiology Associates (MRA) implemented universal risk screening in 2021 using the Ambry CARE Program®. This digital tool collects personal and family history, applies NCCN® guidelines, and identifies patients meeting criteria for hereditary breast, ovarian, pancreatic, prostate cancer, Lynch syndrome, and familial adenomatous polyposis. However, many individuals fall outside these guidelines or have limited knowledge of their family history. To address this gap, all patients were offered genetic testing regardless of guideline eligibility. This study analyzes four years of data from 15 MRA sites throughout Connecticut, where all were offered hereditary cancer genetic testing after risk assessment.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted across MRA sites from 11/1/2021 to 10/20/2025 to evaluate patients who underwent hereditary cancer genetic testing and tested positive for a pathogenic variant. Testing was performed using Ambry Genetics' CancerNext-Expanded® Hereditary Cancer Panel, which includes 77 genes. The primary outcome was the proportion of positive cases among individuals not meeting NCCN® guidelines. Secondary analyses stratified this cohort by personal and family cancer history, age, ethnicity, and positive gene distribution.</p><p><strong>Results: </strong>A total of 8,100 individuals underwent genetic testing; 58% (4,731) met NCCN® guidelines, and 42% (3,369) did not. Among all tested, 801 were positive for a pathogenic variant: 66% (539) met NCCN® criteria, while 34% (262) fell into the non-guideline cohort (NGC). Within the 262 NGC positives, 60 reported no personal or family cancer history; 32 had a personal cancer diagnosis (40% breast cancer, 38% non-melanoma skin cancer); and 65% (170) had family history that did not meet NCCN® criteria. The cohort was predominantly White/Caucasian (74%), with smaller representation from Hispanic/Latino (6.5%) and Black/African American (3.4%). Most pathogenic variants were found in older adults, with the highest representation in ages 60-69 (26%) and 50-59 (24%), while those under 40 accounted for only ~15%. The most frequent genetic mutation in the NGC was MUTYH (20%), followed by CHEK2 (16%). Genetic mutations were also present in the following genes: APC, ATM, BAP1, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CDKN2A, CFTR, CHEK2, FH, FLCN, HOXB13, LZTR1, MBD4, MITF, MLH1, MSH2, MSH3, MSH6, MUTYH, NBN, NF1, NTHL1, PALB2, PMS2, POT1, RAD51C, RAD51D, SDHA, SDHB, SDHD, SMAD4, and VHL.</p><p><strong>Conclusion: </strong>These findings support the potential value of expanded or universal genetic testing strategies, particularly in populations with limited family history or those outside current clinical criteria.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"6"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrative Approach to Improving Outcomes for Inflammatory Breast Cancer (IBC) Patients: Creating a Diagnostic Tool, Advocating for ICD-10-CM Codes, and Establishing a Task Force to Address Critical Research Gaps.","authors":"Lindsey J Anstine, Alexandra A Erwin, Molly L Guthrie, Hosea D Baker, Sunil S Badve, Mary L Alpaugh, Kimberly A Sabelko, Glendon M Zinser","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory breast cancer (IBC) is a rare, highly aggressive form of advanced breast cancer that is challenging to diagnose due to its ambiguous clinical nature. Gaps in awareness in clinical and patient communities further contribute to diagnostic delays. Together these issues hinder research, leaving patients with few treatment options and poor prognoses.</p><p><strong>Materials and methods: </strong>To address these challenges, Susan G. Komen partnered with IBCRF and the Milburn Foundation to form the IBC Collaborative, launching a multidimensional initiative to overcome systemic barriers to IBC research and care.</p><p><strong>Results: </strong>Early efforts focused on developing the IBC Scoring System, a quantitative diagnostic scoring rubric for IBC. Available as an online tool (komen.org/ibc-calc), the IBC scoring system is gaining global adoption, with over 7,800 users in more than 115 countries to date. Additionally, IBC-dedicated clinics, multi-institutional IBC networks and community oncology centers have reported using the tool to support clinical decision making in ambiguous patient cases. Validation studies have shown that the system can distinguish IBC from non-IBC cases (AUC-ROC 0.84; 95% confidence interval: 0.82-0.87). Additional efforts to enhance its clinical utility are underway and funded by Komen. With a diagnostic system in hand, Komen pursued formal disease recognition by engaging with the U.S Centers for Disease Control and Prevention to establish three ICD-10-CM codes (C50.A0, C50. A1, C50.A2) for IBC. Effective October 2025, use of these codes is expected to enhance tracking of IBC incidence, facilitate IBC inclusion in national health datasets and improve coordination of multidisciplinary care. In parallel, a task force was convened to identify key knowledge gaps limiting progress in IBC research and to propose actionable solutions. Through structured discussions, three priority areas in IBC biology emerged: (1) IBC onset and development, (2) detection and monitoring and (3) metastatic dissemination. The group also identified limited shared resources, data silos and the lack of open-access datasets as major obstacles and prioritized areas with high potential to improve the understanding and management of IBC.</p><p><strong>Conclusion: </strong>Together, this integrative approach has advanced IBC research, diagnosis and care through development of a validated diagnostic tool, formal disease coding and identification of critical research gaps. Continued momentum in these areas is expected to improve IBC outcomes.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"11"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survivor Perspectives on Artificial Intelligence Integration in Breast Cancer Treatment: A Qualitative Study of Trust, Equity, and Application.","authors":"Peggy Rosenzweig, Margaret Quinn Rosenzweig, Xueying Pei, Margarita Zuley, Dooman Arefan, Lars Grimm, Jessica W T Leung, Yan Ma, Jennifer K Plichta, Rohit Bhargava, Jules Sumkin, Adam Brufsky, Shandong Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Funding: </strong>Funding (NIH #1OT2OD037972-01).</p><p><strong>Objective: </strong>Artificial intelligence (AI) may enhance the efficiency and personalization of breast cancer (BC) treatment care. It is imperative to include patient viewpoint into AI design for clinical care but there is limited research exploring how survivors perceive AI to inform BC care. To explore BC survivors' understanding of, trust in, and acceptance of AI applications to inform BC treatment, and to examine variations in perspective by age, race/ethnicity, income, and neighborhood deprivation index.</p><p><strong>Materials and methods: </strong>This IRB-approved qualitative descriptive study used purposive sampling of adult BC survivors recruited from a large academic cancer center and affiliated community outreach programs. Inclusion included the ability to speak and understand English and BC diagnosis within the past 10 years, participants completed a brief demographic survey followed by a 15-30-minute semi-structured interview focusing on awareness of AI, perceived benefits, risks, equity implications, and any suggested strategies for AI to be reincorporated into BC care. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic and content analysis. A second reviewer verified coding. Demographic data were analyzed descriptively and dichotomized.</p><p><strong>Results: </strong>Participant (n = 20) ages range from 38 to 74 years old (mean 57); 80% identified as White, 20% as Black. Most participants had some college education, and neighborhood area deprivation index scores, mean 68.2, (standard deviation 19.2) spanned 8-95 (indicating broad socioeconomic representation). Time since diagnosis ranged from 1 to 10 years. Three themes are identified: 1) Awareness of AI ranging from no knowledge to very familiar. 2) Concerns included loss of human interaction, clinician over-reliance on algorithms, and security assurance (data privacy breaches and model safety). Acceptance of AI was highest when framed as augmenting rather than replacing clinician judgment. 3) Equity-some survivors viewed AI as a force that might reduce disparities, while others feared exclusion of under-represented groups due to non-diverse datasets or institutional access barriers. Notably, all Black participants emphasized the necessity of dataset representation to avoid perpetuating inequities. Variations in perspective by dichotomized age, income, years since diagnosis, and neighborhood deprivation index were otherwise not identified.</p><p><strong>Conclusion: </strong>AI is welcomed when it enhances, but does not substitute for human-led care, and when transparency, safety, equitable inclusion, and governance are assured. These findings underscore the imperative and proactive attention needed to ensure patients with BC participate in AI system design, development, evaluation, and deployment, particularly when related to critical BC treatment decision-making.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"15"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axillary De-Escalation: Precision Matters.","authors":"Wiebren A Tjalma","doi":"10.4274/ejbh.galenos.2026.2025-12-10","DOIUrl":"10.4274/ejbh.galenos.2026.2025-12-10","url":null,"abstract":"","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"368-369"},"PeriodicalIF":2.1,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining Margin Assessment in Breast Conservation Surgery: Surgeon-Performed Intraoperative Ultrasound as a Reliable Alternative to Radiologic and Mammographic Assessment.","authors":"Tabrej Alam, Arvind Baghel, Devashish Mishra, Ranu Tiwari Mishra, Shyam Ji Rawat, Sanjay Kumar Yadav, Dhananjaya Sharma","doi":"10.4274/ejbh.galenos.2026.2026-1-3","DOIUrl":"10.4274/ejbh.galenos.2026.2026-1-3","url":null,"abstract":"<p><strong>Objective: </strong>Accurate intraoperative margin assessment during breast-conserving surgery (BCS) is essential to minimize re-excision and preserve cosmesis. In resource-constrained settings, advanced imaging and frozen section analysis are often unavailable, and surgeons frequently rely on visual-tactile judgment. This study compared the diagnostic accuracy of surgeon-performed intraoperative specimen ultrasound (IOSpUS-S), radiologist-performed specimen ultrasound (IOSpUS-R), specimen mammography, and gross inspection against final histopathology.</p><p><strong>Materials and methods: </strong>This prospective study included 40 patients with early breast cancer undergoing wide local excision at a tertiary centre in central India. Each excised specimen was evaluated intraoperatively, ex vivo, by gross inspection, IOSpUS (surgeon and radiologist), and specimen mammography. Diagnostic parameters, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and correlation with the final histopathological margins, were calculated. Receiver operating characteristic analysis was performed to determine discriminative performance.</p><p><strong>Results: </strong>Both surgeon- and radiologist-performed IOSpUS achieved identical diagnostic performance: sensitivity 100%, specificity 100.0%, PPV 100.0%, NPV 97.5%, and accuracy 97.6%. Specimen mammography showed similar results, whereas gross inspection had zero sensitivity but 100% specificity, with an overall accuracy of 95.0%. The mean histopathological margin width was 13.2±3.7 mm. IOSpUS showed a strong correlation with histopathology (<i>r</i> = 0.87 for surgeon-performed and <i>r</i> = 0.83 for radiologist-performed; <i>p</i><0.001). Only one patient (2.5%) had a close margin that was correctly identified by both IOSpUS modalities and mammography, but was missed on gross inspection.</p><p><strong>Conclusion: </strong>Surgeon-performed IOSpUS provides real-time, workflow-efficient intraoperative margin assessment, with diagnostic performance comparable to that of radiologist-performed ultrasound and specimen mammography in this prospective cohort. In low-resource environments, gross examination, though less sensitive, remains a viable adjunct when imaging facilities are limited. A combined approach has the potential to reduce re-excision by supporting intraoperative decision-making.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":" ","pages":"279-284"},"PeriodicalIF":2.1,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and Survival Analysis Show High Mobility Group (HMG) Family as Prognostic Biomarkers in Breast Cancer.","authors":"Ehtesham Ahmed Shariff, Ahmed Azharuddin, Rateb Abu-Zaid, Ahmed Al-Wathinani, Eid Basheer Alenazy, Raiyan Ehtesham Ahmed Sharieff","doi":"10.4274/ejbh.galenos.2025.2025-10-10","DOIUrl":"10.4274/ejbh.galenos.2025.2025-10-10","url":null,"abstract":"<p><strong>Objective: </strong>High-mobility group (HMG) protein families are critical regulators of chromatin structure and gene expression in breast cancer. This study systematically evaluates their expression patterns, genetic interactions, and clinical relevance.</p><p><strong>Materials and methods: </strong>Expression profiles of HMG proteins were analyzed using mRNA data from gene expression profiling interactive analysis 2. We performed protein-level validation using the Human Protein Atlas. Prognostic significance was assessed through survival analysis, while genetic alterations were mapped using cBioPortal. Pathway enrichment and protein-protein interactions were explored with EnrichR and Search Tool for the retrieval of interacting genes/proteins, respectively. Associations with p53 mutation status were investigated using University of Alabama at Birmingham Cancer Data Analysis Portal.</p><p><strong>Results: </strong>HMGA1 emerged as a central driver in triple-negative breast cancer (TNBC), forming a transcriptional complex with FOXM1 that activated VEGFA-mediated angiogenesis, which correlated withwas associated with poor patient survival. In contrast, HMGA2 overexpression was paradoxically associated with favorable outcomes despite promoting tumor angiogenesis. HMGB1 regulation was linked to genomic instability and metastasis, yet it showed potential protective effects in survival analyses. HMGB2 independently predicts poor prognosis in large tumors, and HMGB3 correlates with aggressive progression. HMGB4, though expressed at low levels, is associated with improved survival in early-stage patients. HMGN1 and HMGN4 promoted tumor growth, while HMGN2 suppressed proliferation and induced apoptosis, highlighting its therapeutic potential.</p><p><strong>Conclusion: </strong>HMG proteins exhibit context-dependent roles in breast cancer, with HMGA1, HMGB2-3, and HMGN1/4 driving tumors, while HMGA2, HMGB1, HMGB4, and HMGN2 show protective or paradoxical effects. These findings position HMG proteins as both biomarkers and therapeutic targets, particularly HMGA1 in TNBC angiogenesis and HMGN2 in the induction of apoptosis.</p>","PeriodicalId":93996,"journal":{"name":"European journal of breast health","volume":"22 3","pages":"248-260"},"PeriodicalIF":2.1,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}