Clinical breast cancer最新文献

When Obesity Meets Lymphedema: Interaction Effects on Lymphatic Pain Among Chinese Breast Cancer Survivors 当肥胖遇到淋巴水肿：中国乳腺癌幸存者淋巴疼痛的相互作用。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-12-18 DOI: 10.1016/j.clbc.2025.12.002

Aomei Shen , Yuhua Yang , Li Zhang , Nada Lukkahatai , Mei R. Fu , Shengwen Dong , Ying Wang , Hongmeng Zhao , Peipei Wu , Pan Yang , Qian Lu

Background

Lymphatic pain is an underrecognized symptom among breast cancer survivors and may indicate early lymphatic dysfunction. This study examined the prevalence of lymphatic pain and its associated factors, with a particular focus on the interaction between obesity and breast cancer-related lymphedema (BCRL).

Methods

A secondary analysis was conducted using datasets from 2 previously completed studies. 894 participants who completed arm circumference measurements and symptom assessments were included. Independent t-tests, chi-square tests, Fisher’s exact tests, and binary logistic regression analyses were performed to explore group differences and potential predictors of lymphatic pain. An interaction term between obesity and BCRL was incorporated to evaluate effect modification.

Results

The prevalence of lymphatic pain was 18.12% (n = 162, 95% CI, 15.8%-20.8%). Participants with lymphatic pain reported a greater number, higher severity, and higher frequency of all symptoms compared to those without lymphatic pain (all P < .001). BCRL was the strongest independent predictor of lymphatic pain (OR = 2.955, 95% CI, 1.957-4.460). Although the main effect of obesity was not statistically significant, a significant obesity × BCRL interaction was identified (P = .032). Predicted probabilities indicated that obesity had minimal effect among participants without BCRL, but increased lymphatic pain risk among those with BCRL.

Conclusion

Obesity and BCRL are key factors associated with lymphatic pain, and obesity markedly amplifies pain risk in the presence of BCRL. These findings highlight the need for early lymphatic assessment and weight-management–informed survivorship care. Ongoing research is needed to clarify mechanisms and to evaluate targeted interventions.

背景：淋巴疼痛在乳腺癌幸存者中是一种未被充分认识的症状，可能预示着早期淋巴功能障碍。本研究调查了淋巴疼痛的患病率及其相关因素，特别关注肥胖与乳腺癌相关淋巴水肿（BCRL）之间的相互作用。方法：使用先前完成的2项研究的数据集进行二次分析。894名参与者完成了臂围测量和症状评估。采用独立t检验、卡方检验、Fisher精确检验和二元logistic回归分析来探讨组间差异和淋巴疼痛的潜在预测因素。纳入肥胖与BCRL之间的相互作用项来评价效果的改变。结果：淋巴疼痛的发生率为18.12% （n = 162, 95% CI, 15.8% ~ 20.8%）。与没有淋巴疼痛的参与者相比，有淋巴疼痛的参与者报告的所有症状的数量、严重程度和频率都更高（均P < 0.001）。BCRL是淋巴性疼痛最强的独立预测因子（OR = 2.955, 95% CI, 1.957-4.460）。虽然肥胖的主要影响没有统计学意义，但发现了显著的肥胖与BCRL的相互作用（P = 0.032）。预测概率表明，肥胖在没有BCRL的参与者中影响最小，但在有BCRL的参与者中增加了淋巴疼痛的风险。结论：肥胖和BCRL是引起淋巴疼痛的关键因素，肥胖可显著增加BCRL存在时的疼痛风险。这些发现强调了早期淋巴评估和体重管理的生存护理的必要性。需要进行持续的研究以澄清机制并评估有针对性的干预措施。

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引用次数: 0

ADAM and ADAMTS Proteases in Breast Cancer: Molecular Mechanisms and Therapeutic Implications 乳腺癌中的ADAM和ADAMTS蛋白酶：分子机制和治疗意义

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-12-10 DOI: 10.1016/j.clbc.2025.12.001

Chanchal Badhai, Manju Rawat Singh PhD, Shradha Devi Dwivedi, Deependra Singh

Breast cancer ranks as the second most significant cause of cancer-related mortality on a global scale, with its incidence demonstrating a continual upward trajectory. Investigating gene targets for cancer therapies has advanced through innovative methodologies focusing on genes and pathways driving cancer progression. A disintegrin and metalloproteinases (ADAMs) and ADAMs with thrombospondin motifs (ADAMTSs) constitute related protease families, with ADAMs primarily functioning as membrane-anchored cell-surface enzymes and ADAMTSs secreted into the extracellular matrix. These proteases drive oncogenic signaling via ectodomain shedding of growth factors and receptors, modulating EGFR, PI3K/AKT/mTOR, TNF-α, Notch, and JAK-STAT pathways. ADAM10 and ADAM17 particularly promote breast cancer invasion and metastasis in HER2-positive and triple-negative subtypes, establishing them as biomarkers and therapeutic targets. Conversely, certain ADAMTS members exhibit tumor-suppressive functions by inhibiting angiogenesis and ECM remodeling. Regulatory cofactors such as iRhom proteins modulate ADAM17 maturation and substrate selectivity, adding complexity to this proteolytic network. This review synthesizes recent advances in ADAMs/ADAMTs in breast cancer, highlighting roles in promoting or suppressing tumorigenesis depending on isoform and molecular context. Multiple therapeutic modalities have been validated, including small-molecule inhibitors (INCB7839, INCB3619, GI254023X) that suppress ligand shedding and enhance trastuzumab efficacy, RNA interference (siRNA/miRNA) for targeted gene silencing, and engineered nanocarrier drug delivery platforms that overcome therapeutic resistance. The epigenetic regulation, post-translational modifications, and diagnostic advancements, such as SERS-based serum profiling, further underscore their value as biomarkers and druggable targets. Collectively, ADAM/ADAMTS-centered interventions represent a promising direction for precision oncology and therapeutic targets for improving clinical outcomes in breast cancer.

在全球范围内，乳腺癌是导致癌症相关死亡的第二大原因，其发病率呈持续上升趋势。研究癌症治疗的基因靶点已经通过专注于驱动癌症进展的基因和途径的创新方法取得了进展。崩解素和金属蛋白酶（ADAMs）和亚当斯与血栓反应蛋白基元（ADAMTSs）构成相关的蛋白酶家族，亚当斯主要作为膜锚定的细胞表面酶和ADAMTSs分泌到细胞外基质。这些蛋白酶通过生长因子和受体的外域脱落驱动致癌信号，调节EGFR、PI3K/AKT/mTOR、TNF-α、Notch和JAK-STAT通路。ADAM10和ADAM17在her2阳性和三阴性亚型中特别促进乳腺癌的侵袭和转移，使其成为生物标志物和治疗靶点。相反，某些ADAMTS成员通过抑制血管生成和ECM重塑表现出肿瘤抑制功能。调控辅助因子如irhomm蛋白调节ADAM17的成熟和底物选择性，增加了这个蛋白水解网络的复杂性。本文综述了ADAMs/ adamt在乳腺癌中的最新进展，强调了其在促进或抑制肿瘤发生中的作用，这取决于其异构体和分子背景。多种治疗方式已经得到验证，包括抑制配体脱落并增强曲妥珠单抗疗效的小分子抑制剂（INCB7839, INCB3619, GI254023X），用于靶向基因沉默的RNA干扰（siRNA/miRNA），以及克服治疗耐药性的工程纳米载体药物递送平台。表观遗传调控、翻译后修饰和诊断方面的进步，如基于sers的血清分析，进一步强调了它们作为生物标志物和可药物靶点的价值。总之，以ADAM/ adamts为中心的干预为精确肿瘤学和改善乳腺癌临床结果的治疗靶点提供了一个有希望的方向。

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引用次数: 0

Combined Compression and Exercise Therapy for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer: A Randomized Controlled Trial 联合压迫和运动治疗化疗引起的乳腺癌周围神经病变：一项随机对照试验。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-12-02 DOI: 10.1016/j.clbc.2025.11.013

Xiaoqian Yu , Yijing Fan , Shufang Zhang , Lizhi Zhou , Jingxin Liu , Aiyun Du

Background

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of taxane-based chemotherapy, significantly affecting patients’ quality of life. We investigated the effects of exercise combined with compression therapy on CIPN, 25-hydroxyvitamin D level, and body mass index in patients with breast cancer.

Methods

A total of 108 patients with peripheral neuropathy treated with albumin/paclitaxel (250 mg/m²) chemotherapy in the Breast Department of Tangshan People’s Hospital were selected and randomly divided into a general treatment group (Group G), compression therapy group (Group CG), and a combined exercise (EXCAP) and compression therapy group (Group ECG). The incidence of chemotherapy-induced peripheral neuropathy, 25-hydroxyvitamin D levels, and body mass index (BMI) were measured at baseline (preintervention) and after the 4-cycle intervention, and the differences between the 3 groups were compared.

Results

After intervention, Group ECG showed a 0.0% incidence of grade 2 CIPN versus 25.0% in CG and 50.0% in G (P < .001), with an absolute risk reduction of 50.0% (95% CI, 33.8% to 66.2%) compared to Group G, and a 100.0% incidence of grade 1 CIPN versus 75.0% in CG and 50.0% in G (P < .001). With a 19.99 ± 5.82 ng/mL in 25-hydroxyvitamin D (vs. 15.45 ± 4.58 in G, P < .001; mean difference: 4.54 ng/mL, 95% CI, 1.56-7.53) and BMI reduction to 23.10 ± 2.27 (vs. 26.96 ± 2.91 in G, P < .001, mean difference: −3.86 kg/m², 95% CI, −5.54 to −2.32).

Conclusion

Combined compression and exercise therapy can effectively reduce the incidence of chemotherapy-induced peripheral neuropathy, alleviate the decline in 25-hydroxyvitamin D levels, and control the body mass index in patients undergoing breast cancer chemotherapy. We recommend integrating compression therapy with EXCAP exercise into routine chemotherapy care to reduce CIPN incidence, manage BMI, and maintain vitamin D levels for better patient outcomes.

背景：化疗引起的周围神经病变（CIPN）是紫杉烷类化疗常见且衰弱的副作用，显著影响患者的生活质量。我们研究了运动联合压迫疗法对乳腺癌患者CIPN、25-羟基维生素D水平和体重指数的影响。方法：选择唐山市人民医院乳腺科接受白蛋白/紫杉醇（250 mg/m2）化疗的周围神经病变患者108例，随机分为普通治疗组（G组）、压迫治疗组（CG组）和运动（EXCAP）联合压迫治疗组（ECG组）。在基线（干预前）和4周期干预后测量化疗引起的周围神经病变发生率、25-羟基维生素D水平和体重指数（BMI），并比较3组之间的差异。结果：干预后，ECG组2级CIPN发生率为0.0%，CG组为25.0%，G组为50.0% (P < 0.001)，绝对风险比G组降低50.0% (95% CI, 33.8% ~ 66.2%)， 1级CIPN发生率为100.0%，CG组为75.0%，G组为50.0% （P < 0.001）。25-羟基维生素D含量为19.99±5.82 ng/mL (G组为15.45±4.58,P < 0.001；平均差值为4.54 ng/mL， 95% CI为1.56 ~ 7.53)，BMI降至23.10±2.27 （G组为26.96±2.91,P < 0.001，平均差值为-3.86 kg/m²，95% CI为-5.54 ~ -2.32）。结论：压迫与运动联合治疗可有效降低乳腺癌化疗患者化疗所致周围神经病变的发生率，缓解25-羟基维生素D水平下降，控制体重指数。我们建议将压缩治疗与EXCAP运动整合到常规化疗护理中，以减少CIPN发生率，控制BMI，维持维生素D水平，以获得更好的患者预后。

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引用次数: 0

Research Progress of Radiotherapy Combined With Immunotherapy for Breast Cancer: Mechanism Exploration and Clinical Translation 放疗联合免疫治疗乳腺癌的研究进展：机制探索及临床转化

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-12-02 DOI: 10.1016/j.clbc.2025.11.017

He Yijun, Lu Huixing, Wang Liping

Radiation therapy (RT) dynamically modulates the breast cancer immune microenvironment by inducing immunogenic cell death (ICD) and reshaping the tumor microenvironment. However, RT alone is often insufficient to achieve complete tumor eradication due to compensatory immunosuppressive mechanisms within the tumor microenvironment. The combination of RT with immune checkpoint inhibitors (ICIs) has thus emerged as a potent strategy to overcome these limitations, particularly in triple-negative breast cancer (TNBC).Preclinical studies confirm that radiotherapy fractionation regimens critically influence immune regulation: moderate hypo fractionated doses (eg, 8-12 Gy per fraction) optimally activate the cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway and promote CD8⁺T cell infiltration, whereas single ablative doses exceeding 15 Gy may attenuate immunogenicity by upregulating the DNA exonuclease Trex1. Clinical trials such as PEARL demonstrate that this combination regimen, Stereotactic body radiotherapy (SBRT) with ICIs and neoadjuvant chemotherapy) achieves a pathological complete response (pCR) rate of 59.2% in TNBC patients. Key challenges remain, including optimizing RT-ICI sequencing, managing overlapping toxicities (eg, pneumonitis), and validating predictive biomarkers such as tumor-infiltrating lymphocytes (TILs) and circulating tumor DNA (ctDNA). Future research will focus on integrating AI-driven radiotherapy with multi-omics to address tumor heterogeneity. Targeting immunosuppressive pathways like indoleamine 2,3-dioxygenase1 (IDO1) and histone deacetylase (HDAC) may enhance treatment efficacy. This review synthesizes mechanistic, clinical, and translational advances in radiotherapy-ICI combinations, providing a theoretical foundation and strategic outlook for optimizing precision breast cancer therapy.

放射治疗（RT）通过诱导免疫原性细胞死亡（ICD）和重塑肿瘤微环境来动态调节乳腺癌免疫微环境。然而，由于肿瘤微环境中存在代偿性免疫抑制机制，单纯放疗往往不足以完全根除肿瘤。因此，RT联合免疫检查点抑制剂（ICIs）已成为克服这些局限性的有效策略，特别是在三阴性乳腺癌（TNBC）中。临床前研究证实，放疗分割方案对免疫调节有重要影响：中等次分割剂量（例如，每部分8-12 Gy）最佳地激活干扰素基因环GMP-AMP合酶刺激因子（cGAS-STING）途径并促进CD8+T细胞浸润，而单次消融剂量超过15 Gy可能通过上调DNA外切酶Trex1而减弱免疫原性。PEARL等临床试验表明，这种联合方案，立体定向放疗（SBRT）与ICIs和新辅助化疗)在TNBC患者中实现了59.2%的病理完全缓解（pCR）率。关键的挑战仍然存在，包括优化RT-ICI测序，管理重叠毒性（如肺炎），以及验证预测性生物标志物，如肿瘤浸润淋巴细胞（TILs）和循环肿瘤DNA （ctDNA）。未来的研究重点是将人工智能驱动的放疗与多组学相结合，以解决肿瘤异质性问题。靶向免疫抑制途径如吲哚胺2,3-双加氧酶1 （IDO1）和组蛋白去乙酰化酶（HDAC）可提高治疗效果。本文综述了放疗- ici联合治疗的机制、临床和转化方面的进展，为优化乳腺癌精准治疗提供了理论基础和战略展望。

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引用次数: 0

Histiocyte Quantity in Tumor-Negative Sentinel Lymph Nodes Predicts 10-Year Disease-Free Survival in Patients With Breast Cancer. 肿瘤阴性前哨淋巴结组织细胞数量预测乳腺癌患者10年无病生存期

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-12-01 DOI: 10.1016/j.clbc.2025.11.015

Sabine Dieleman, Loes F S Kooreman, Michiel T H M Henkens, Axel Zur Hausen, Marjolein L Smidt, Heike I Grabsch

Background and aim: The sentinel lymph node (SLN) play a key role in the host antitumor immune response. Microarchitectural patterns in tumor-negative SLNs (SLNneg) may provide important clinical information about the host's antitumor immune response against breast cancer.

Methods: This retrospective cohort study included SLNneg from 339 breast cancer patients. SLNneg microarchitectural features (percentage (%) SLNneg area occupied by histiocytes, germinal centers, lymphocytes outside germinal centers, adipocytes, vessels or connective tissue) were quantified morphometrically. The relationship with 10-year disease-free survival (DFS) was investigated using Cox regression analyses. Variables showing a nonlinear relationship with survival, cubic spline analysis was used to identify distinct groups.

Results: SLNnegs were predominantly occupied by lymphocytes (median % SLNneg area: 60%) followed by histiocytes (14%), vessels (7%), connective tissue (5%), adipocytes (5%) and germinal centers (0.4%). Histiocyte quantity was related to survival in a nonlinear fashion with 9% and 21% as relevant cutoffs. Patients with < 9% or > 21% SLNneg area occupied by histiocytes had poorer survival compared to patients with 9% to 21% SLNneg area occupied by histiocytes (< 9% SLNneg area Hazard Ratio (HR) 2.5 (95% CI, 1.4-4.5), P = .001; > 21% SLNneg area HR 2.7 (1.5;4.7), P < .001; 9% to 21% SLNneg area = ref.), remaining significant in multivariable analysis. The other microarchitectural features were not related to survival.

Conclusion: This is the first study showing that quantity of histiocytes in SLNneg is associated with 10-year DFS in breast cancer in a nonlinear manner. This suggests that cell type specific morphological changes within the SLNneg reflect the host's antitumor immune response providing clinically relevant information in breast cancer patients.

背景与目的：前哨淋巴结（SLN）在宿主抗肿瘤免疫应答中起关键作用。肿瘤阴性sln （SLNneg）的微结构模式可能为宿主对乳腺癌的抗肿瘤免疫反应提供重要的临床信息。方法：对339例乳腺癌患者的SLNneg进行回顾性队列研究。SLNneg微建筑特征（组织细胞、生发中心、生发中心外淋巴细胞、脂肪细胞、血管或结缔组织占据的SLNneg面积百分比（%））进行了形态计量学量化。采用Cox回归分析研究与10年无病生存（DFS）的关系。变量显示与生存的非线性关系，三次样条分析用于识别不同的群体。结果：SLNneg主要由淋巴细胞占据（SLNneg面积中位数%:60%），其次是组织细胞（14%）、血管（7%）、结缔组织（5%）、脂肪细胞（5%）和生发中心（0.4%）。组织细胞数量与存活率呈非线性关系，相关临界值分别为9%和21%。与组织细胞占SLNneg面积9% ~ 21%的患者相比，组织细胞占SLNneg面积< 9%或> 21%的患者生存率较低(SLNneg面积< 9%的危险比（HR） 2.5 (95% CI, 1.4 ~ 4.5), P = .001；> 21% SLNneg区HR 2.7 (1.5;4.7), P < 0.001；9%至21%的SLNneg面积= ref.)，在多变量分析中仍然显著。其他微结构特征与生存无关。结论：该研究首次显示SLNneg组织细胞数量与乳腺癌10年DFS呈非线性关系。这表明SLNneg内细胞类型特异性形态学变化反映了宿主的抗肿瘤免疫反应，为乳腺癌患者提供了临床相关信息。

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引用次数: 0

Survival Outcomes and Recurrence Patterns of Early-Stage HER2-Positive Breast Cancer Patients on Adjuvant T-DM1 Treatment: Turkish Oncology Group (TOG) Study 早期her2阳性乳腺癌患者接受辅助T-DM1治疗的生存结局和复发模式：土耳其肿瘤组（TOG）研究

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-12-01 DOI: 10.1016/j.clbc.2025.11.014

Alper Türkel , İlknur Deliktaş Onur , Anıl Karakayalı , Merve Bıyıklı Alemdar , Emine Türkmen , Ali Alkan , Sedat Yıldız , Nargiz Majidova , Gamze Emin , Ali Fuat Gürbüz , Elif Şahin , Teoman Şakalar , Özge Yalıcı , Atike Pınar Erdoğan , Ramazan Coşar , Elanur Karaman , Melek Karakurt Eryılmaz , Mutlu Doğan

Purpose

This study aimed to investigate the survival outcomes of adjuvant trastuzumab emtansine (T-DM1) in patients with early-stage HER2-positive breast cancer and the recurrence patterns in those who experienced recurrence.

Methods

This multicenter, retrospective study included 121 patients with early-stage HER2-positive breast cancer who underwent surgery following neoadjuvant chemotherapy and anti-HER2 therapy and received adjuvant T-DM1 for residual disease. Recurrence within the first 12 months of adjuvant T-DM1 was defined as ``early recurrence,'' while recurrence after 12 months (> 12 months) was defined as ``late recurrence.''

Results

With a median follow-up of 36 months, recurrence occurred in 23 patients (median time: 11 months). Twenty-two had distant metastases—most commonly lung (n = 14) and CNS (n = 6)—and one had local recurrence. The recurrent subgroup had higher Ki67, tumor grade, and HR-negativity rate (P = .015, P = .034, and P = .014, respectively). Among recurrences, 12 were early (≤ 12 months) and 11 were late recurrence (> 12 months). Patients with early recurrence were significantly younger (P = .007) and had a numerically higher median Ki67 (40% vs. 30%, P = .062). DFS rates at 12, 24, and 36 months were 93.3%, 75.2%, and 62.8%, respectively; OS rates were 100%, 98.3%, and 93.1%.

Conclusions

Younger patients with HR-negative, high-grade, high Ki67 tumors had significantly higher rates of recurrence. Defining patient subpopulations through biomarker identification is crucial for tailoring escalation and de-escalation strategies, thereby enabling more effective treatments and improved long-term survival. The mechanisms of T-DM1 resistance require investigation through larger trials and molecular profiling.

目的本研究旨在探讨曲妥珠单抗emtansine （T-DM1）辅助治疗早期her2阳性乳腺癌患者的生存结局以及复发患者的复发模式。方法本多中心回顾性研究纳入121例早期her2阳性乳腺癌患者，这些患者在新辅助化疗和抗her2治疗后接受手术，并对残留病变接受辅助T-DM1治疗。T-DM1辅助治疗前12个月内的复发定义为“早期复发”，12个月后（>； 12个月）的复发定义为“晚期复发”。结果中位随访36个月，23例患者出现复发（中位时间11个月）。22例远处转移-最常见的是肺（n = 14）和中枢神经系统(n = 6) - 1例局部复发。复发亚组Ki67、肿瘤分级、hr阴性率均高于复发亚组（P = 0.015、P = 0.034、P = 0.014）。早期复发（≤12个月）12例，晚期复发（≤12个月）11例。早期复发的患者明显更年轻（P = 0.007），并且Ki67的中位数更高（40%比30%，P = 0.062）。12、24、36个月的DFS率分别为93.3%、75.2%、62.8%；总有效率分别为100%、98.3%和93.1%。结论hr阴性、高级别、高Ki67肿瘤的低龄患者复发率明显增高。通过生物标志物识别来定义患者亚群对于调整升级和降级策略至关重要，从而实现更有效的治疗并提高长期生存率。T-DM1耐药机制需要通过更大规模的试验和分子谱分析来研究。

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引用次数: 0

From Mobility to Management: A Scoping Review on Exercise in Breast Cancer-Related Lymphedema 从活动能力到管理：乳腺癌相关淋巴水肿运动的范围综述

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-11-28 DOI: 10.1016/j.clbc.2025.11.011

Cansu Sahbaz Pirincci , Hasan Gercek , Emine Cihan , Elif Dilara Durmaz , Zübeyir Sari

Purpose

Breast cancer-related lymphedema (BCRL) is a prevalent complication that adversely affects survivors’ physical function and quality of life. Exercise is increasingly used in BCRL management, yet the diversity in exercise types and lack of standardization present challenges for clinical implementation. This scoping review aimed to systematically map and synthesize the available literature on exercise interventions for BCRL, focusing on the types of exercises used, their frequency and duration, and their effects on clinical and functional outcomes.

Methods

Studies were included if they were randomized or non-randomized controlled trials involving adult women with BCRL, evaluated at least one lymphedema-related outcome, and were published in English within the last 10 years. A comprehensive search was conducted in PubMed, Scopus, Web of Science, PEDro, and CINAHL databases using MeSH terms. Data were extracted on study design, sample size, exercise type, frequency and duration, and outcome measures.

Results

Out of 974 records, 21 studies met the inclusion criteria. Exercises examined included resistance, aerobic, aquatic, Pilates, and scapulothoracic stabilization. Most interventions were 6 to 12 weeks in duration and applied 2 to 5 times per week. Exercise was found to be effective in reducing edema volume and severity, improving range of motion, pain, function, and quality of life, both independently and alongside CDT.

Conclusion

Exercise is a safe and effective intervention for BCRL management. However, variability in exercise protocols highlights the need for standardized recommendations. Future studies should aim to determine optimal parameters to guide clinical decision-making.

目的乳腺癌相关淋巴水肿（BCRL）是一种普遍的并发症，对幸存者的身体功能和生活质量产生不利影响。运动在BCRL管理中的应用越来越多，但运动类型的多样性和缺乏标准化给临床实施带来挑战。本综述旨在系统地绘制和综合有关运动干预BCRL的现有文献，重点关注所使用的运动类型、频率和持续时间，以及它们对临床和功能结果的影响。方法纳入随机或非随机对照试验，涉及成年女性BCRL患者，评估至少一项淋巴水肿相关结局，并在过去10年内以英文发表。在PubMed、Scopus、Web of Science、PEDro和CINAHL数据库中使用MeSH词进行了全面的检索。从研究设计、样本量、运动类型、频率和持续时间以及结果测量中提取数据。结果974篇文献中有21篇符合纳入标准。检查的运动包括阻力、有氧、水上运动、普拉提和肩胸稳定。大多数干预持续时间为6至12周，每周应用2至5次。研究发现，运动在减少水肿体积和严重程度、改善活动范围、疼痛、功能和生活质量方面都是有效的，无论是独立的还是与CDT一起。结论运动是治疗BCRL安全有效的干预手段。然而，运动方案的可变性突出了标准化建议的必要性。未来的研究应旨在确定最佳参数来指导临床决策。

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引用次数: 0

Rethinking First-Line Therapy and Beyond: HER2-Positive and Hormone Receptor–Positive/HER2-Negative Metastatic Breast Cancer—Commentary Based on a Live Symposium Presented at the 2025 ESMO Congress in Berlin, Germany 重新思考一线治疗及以后：her2阳性和激素受体阳性/ her2阴性转移性乳腺癌——基于2025年德国柏林ESMO大会现场研讨会的评论

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-11-27 DOI: 10.1016/j.clbc.2025.11.009

Wolfgang Janni , Rebecca A. Dent , Peter Schmid

Recent advances in metastatic breast cancer have fundamentally altered treatment paradigms, offering new hope for patients while challenging clinicians to adapt their approaches to patient care. This article summarizes expert perspectives from a symposium presented at the 2025 European Society for Medical Oncology Congress, examining how emerging data in HER2-positive metastatic breast cancer and hormone receptor–positive metastatic breast cancer are reshaping clinical decision-making, patient selection strategies, and personalized approaches. Key developments include the evolution of antibody-drug conjugates in HER2-positive disease, biomarker-guided therapy selection using ESR1 mutation monitoring, and novel treatment strategies for patients with hormone-refractory disease. These advances necessitate understanding of patient selection criteria, toxicity management, and sequential therapy planning to optimize outcomes in this expanding therapeutic landscape.

转移性乳腺癌的最新进展从根本上改变了治疗模式，为患者提供了新的希望，同时也挑战了临床医生适应患者护理的方法。本文总结了专家在2025年欧洲肿瘤医学学会大会上发表的研讨会上的观点，研究了her2阳性转移性乳腺癌和激素受体阳性转移性乳腺癌的新数据如何重塑临床决策、患者选择策略和个性化方法。主要进展包括her2阳性疾病中抗体-药物偶联物的发展，使用ESR1突变监测的生物标志物引导治疗选择，以及激素难治性疾病患者的新治疗策略。这些进步需要了解患者选择标准、毒性管理和序贯治疗计划，以优化这一不断扩大的治疗领域的结果。

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引用次数: 0

How Can Online Resource Assessment Better Meet Patient Needs? 在线资源评估如何更好地满足患者需求？

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-11-26 DOI: 10.1016/j.clbc.2025.11.010

Yuning Tang , Ruotong Zhu

引用次数: 0

The Influence of Socioeconomic Status on Stage at Diagnosis and Survival in Young Breast Cancer Patients 社会经济地位对年轻乳腺癌患者诊断分期及生存的影响。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2025-11-24 DOI: 10.1016/j.clbc.2025.11.008

Alexandra Harris , Ryan Conrardy , Aniko Szabo , Lubna N. Chaudhary

Background

Breast cancer is the most common cancer in women. Women of low socioeconomic status (SES) are at increased risk for being diagnosed with later stage breast cancer and experience poorer survival. However, younger women, especially women under 40, are underrepresented in breast cancer research given screening mammography is not recommended until age 40. How SES impacts stage at diagnosis and survival rates in women under 40 diagnosed with breast cancer has not been addressed.

Methods

Data was obtained from the national Surveillance, Epidemiology, and End Results (SEER)*Stat Research Plus Census Tract Attributes Specialty Database, including 27 unique variables representing patient, tumor, and treatment characteristics. Proportional odds logistic regression models were used to assess the relationship between SES and stage at diagnosis and Kaplan–Meier curves along with Cox-proportional hazards models were used to assess the relationship between SES and survival months.

Results

In both women of all ages and in women under 40, lower SES was significantly associated with later stage at breast cancer diagnosis (P < .001), poorer five-year (P < .001), and ten-year (P < .001) overall and breast-cancer specific survival rates in an incremental fashion.

Conclusion

SES significantly impacts breast cancer stage at diagnosis and survival rates in a graded fashion, with lowering SES corresponding with later stage at breast cancer diagnosis and poorer five-year and ten-year survival rates across all age groups, including women under 40. Improving screening rates in low SES populations and initiating high risk screening strategies at an earlier age in women with low SES may help ameliorate these disparities.

背景：乳腺癌是女性中最常见的癌症。社会经济地位较低的妇女被诊断为晚期乳腺癌的风险增加，生存期也较差。然而，年轻女性，尤其是40岁以下的女性，在乳腺癌研究中的代表性不足，因为乳房x光检查在40岁之前是不推荐的。SES如何影响40岁以下诊断为乳腺癌的女性的诊断阶段和生存率尚未得到解决。方法：数据来自国家监测、流行病学和最终结果(SEER)*Stat Research +普查区属性专业数据库，包括27个代表患者、肿瘤和治疗特征的唯一变量。采用比例odds logistic回归模型评估SES与诊断阶段之间的关系，采用Kaplan-Meier曲线和cox比例风险模型评估SES与生存月之间的关系。结果：在所有年龄段的女性和40岁以下的女性中，较低的社会经济地位与乳腺癌诊断晚期（P < 0.001）、较差的5年（P < 0.001）和10年（P < 0.001）总体生存率和乳腺癌特异性生存率呈递增趋势显著相关。结论：社会经济地位对乳腺癌诊断分期和生存率有显著影响，社会经济地位越低，乳腺癌诊断阶段越晚，5年和10年生存率越低，包括40岁以下妇女。提高低社会经济地位人群的筛查率，并在低社会经济地位妇女早期启动高风险筛查策略，可能有助于改善这些差异。

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引用次数: 0