Clinical breast cancer最新文献

Background: The prognosis for adolescent and young adult (AYA) breast cancer patients has increased significantly. Research concerning long-term health problems is especially relevant given the long life expectancy of these young patients. This study aimed to compare the long-term health issues registered by general practitioners (GPs) of AYA breast cancer survivors to age-matched controls.

Methods: Data of all female AYAs diagnosed with invasive breast cancer between 1999 and 2020 were obtained from the Netherlands Cancer Registry (NCR) and linked with longitudinal data on health problems recorded by GPs organized in the Nivel Primary Care Database (Nivel-PCD). A female normative sample was obtained from the Nivel Primary Care Database (Nivel-PCD). Cox proportional hazard models were used to compare the hazard of a GP consult for a specific health condition after diagnosis between AYA breast cancer survivors and controls.

Results: A total of 793 AYA breast cancer survivors (mean age 35.3 years, mean follow-up 4.7 years) and 2379 controls were included. AYA breast cancer survivors had significantly increased hazards of consulting the GP for eye (HR = 1.25), musculoskeletal (HR = 1.12), psychological/psychiatric (HR = 1.18), skin (HR = 1.26), and urinary tract conditions (HR = 1.20) and decreased hazards for pregnancy-related conditions (HR = 0.47) and conditions of the female genital system (HR = 0.85) compared to controls.

Conclusion: AYA breast cancer survivors face a higher risk of various long-term health challenges compared to age-matched controls, including physical and psychological conditions. This emphasizes the need for the development of multidisciplinary follow-up programs tailored to the specific and ongoing health needs of this young population.

Studies were meticulously selected based on a literature search conducted across multiple databases. Data on overall survival (OS), progression-free survival (PFS), and clinicopathological characteristics were extracted. Heterogeneity was assessed among studies for reliability. Sensitivity analysis confirmed result stability, and Egger's test checked for publication bias. Ten studies with 1761 cases were analyzed. Patients with high TK1a level had a significantly higher risk of poor OS (HR 1.80; 95% CI, 1.35-2.41, Z = 3.99, P < .05) compared to those with low TK1a level. Similar finding is revealed in PFS analysis. The overall heterogeneity in the analysis was substantial. After regression analysis, sample type likely caused it. We performed an analysis to indicate that high TK1a level linked to negative ER status (OR: 0.651, 95% CI, 0.43-0.985, P < .001) but not other factors. Funnel plot test showed no publication bias in the included articles. Assessing TK1a level may offer supportive insights into the prognosis of breast cancer patients. This biomarker could potentially aid in evaluating patient outcomes and gauging the effectiveness of treatment strategies in clinical interventions.

Purpose: Omission of sentinel lymph node biopsy (SLNB) in selected hormone receptor-positive (HR+), HER2-negative (HER2-) early breast cancer patients has demonstrated safety in prospective trials. However, accurate axillary staging remains important for identifying candidates for adjuvant CDK4/6 inhibitor therapy. We quantified the impact of SLNB omission on CDK4/6 eligibility and explored predictors of occult nodal disease in a real-world cohort.

Methods: We retrospectively analyzed 948 patients treated 2014 to 2022 at Tübingen University Hospital who met criteria proposed for potential SLNB omission: age ≥ 50 years, cT1 cN0, HR+/HER2-, grade 1 to 2 tumors treated with breast-conserving surgery and whole-breast irradiation. We assessed the prevalence of occult nodal metastases and potential eligibility for adjuvant abemaciclib (monarchE-criteria) or ribociclib (NATALEE-criteria) based on final pathology and fitted multivariable logistic models.

Results: Among 948 patients meeting SLNB omission criteria, 143 (15.1%) harbored occult nodal disease. Of these node-positive patients, 17 fulfilled the criteria for abemaciclib eligibility. For ribociclib, 105 node-positive patients were eligible. On multivariable analysis, multifocality (OR = 2.3; P ≤ .001) and cT1c tumor stage (OR = 1.76; P = .008) predicted axillary upstaging; invasive lobular carcinoma (ILC) showed higher crude upstaging than IDC/NST (22.6% vs. 14.0%) but did not retain independent significance after adjustment.

Conclusions: Omitting sentinel node biopsy in selected patients leads to under-detection of nodal metastasis in a relevant proportion of patients, particularly with cT1c tumors, multi-focal tumors and ILC. As these patients may benefit from more intensive adjuvant treatment, omission of sentinel-node biopsy should be part of decision-making. Future trials should investigate the impact of adjuvant treatment for patients with occult lymph node metastases.

Post-operative radiation therapy (PORT) following breast-conserving surgery (BCS) has become a conventional care for early-stage breast cancer (EBC). This meta-analysis aimed to compare overall survival (OS) between patients receiving PORT and those not receiving PORT and to identify clinicopathologic features of low-risk patients with EBC who may be suitable for PORT omission after BCS with respect to OS. Comparative studies investigating PORT versus non-PORT in EBC patients after BCS were included, focusing on hazard ratio (HRs) for OS. Medline, Embase, and the Cochrane Central Library were searched from First January 2014 to First January 2025. A meta-analysis was performed to determine the HR for OS between PORT and non-PORT groups. Subgroup analyses were conducted to identify potential clinicopathologic features associated with low-risk patients suitable for PORT omission. A total of 28 studies (2 randomized controlled trials and 26 retrospective cohort studies) with 589,508 patients were included in the final analysis. According to the meta-analysis, patients with EBC derived an OS benefit from PORT (pooled HR = 0.60 [95% CI, 0.55-0.65]). Subgroup analyses identified clinicopathologic features associated with low-risk patients suitable for PORT omission. This systematic review and meta-analysis demonstrated that PORT is associated with improved OS in patients with EBC following BCS. However, certain clinicopathologic features, including age 65-70 years, progesterone receptor (-), luminal B subtype, triple-negative breast cancer, and low-risk 21-gene recurrence score, were identified as potential low-risk factors in patients who may be considered for PORT omission.

Background: This is the first study looking at breast cancer risk using the polymorphisms CYP3A4*1B, GSTP1 Ile105Val, MTHFR C677T, and COMT Val158Met for breast cancer predisposed Iraqi population with specific environmental carcinogenic exposures.

Methods: Aged matched healthy controls were 610 individuals of Iraqi origin alongside 414 histologically confirmed breast cancer patients forming a case-control study cohort. CDNA was obtained from peripheral blood samples, which underwent genotyping via tetra-primer ARMS-PCR. Statistical evaluation was performed based on several genetic models with odds ratios (OR) and 95% confidence intervals (CI) calculated by logistic regression.

Results: For 3 polymorphisms, crucial associations were found and these include CYP3A4*1B which showed a protective effect against breast cancer (OR = 0.72, 95% CI, 0.54-0.96, P = .027), the effect being strong in women less than 50 years old. Increased cancer risk was associated with GSTP1 Ile105Val (OR = 1.68, 95% CI, 1.23-2.31, P = .001) especially in older females and those with elevated BMI. The same risk was also conferred by MTHFR C677T (OR = 1.45; 95% CI, 1.12-1.89, P = .005). No significant association for COMT Val158Met was observed (P = .156). All polymorphisms among controls were in Hardy-Weinberg equilibrium.

Conclusions: The study presented the taw evidence of both CYP3A4*1B and GSTP1 Ile105Val along with MTHFR C677T polymorphisms associating them to breast cancer susceptibility in Iraqi population which reflects these specific genetic risks and reinforces middle eastern populations towards precision medicine frameworks concerning breast cancer treatment and intervention strategies.

Introduction: Breast conserving therapy (BCT) for nonpalpable lesions can be performed using various localization devices. For larger or multifocal lesions, "bracketing" with multiple localizers is required for complete excision. SAVI Scout utilizes radar localization (RL) to target clip location(s), while SmartClip employs electromagnetic chips (EMC) to provide 3D navigation and distinguish up to three devices. This study aimed to compare the excision of breast lesions using non wire localization devices such as EMC and RL versus traditional wires.

Methods: A single institution, retrospective study was conducted from August 25, 2020 to August 6, 2024, comparing EMC, RL, and wire localization in bracketed BCT. Case length, positive margins requiring re-excision, and complete retrieval of localizers in a single specimen were analyzed. Statistical analyses were performed using Kruskal-Wallis, and χ² or Fisher's exact tests.

Results: A total of 118 cases were analyzed: 43 wire, 44 RL, and 31 EMC cases. The groups were similar in lesion size and number of localizers used (P = .736 and P = 1.000, respectively). There were fewer positive margins when EMC or RL were utilized (EMC 29%, RL 22.7%, wires 50%, P = .022). EMC was also associated with significantly shorter operative times (33.9 minutes vs. RL 45.6 minutes, wire 40 minutes, P = .025). There was no significant difference in complete retrieval of localizers among the groups (EMC 93.5%, RL 97.7%, wire 100%, P = .264).

Conclusion: Non-wire localization method is effective for bracketed BCT with lower rates of margin positivity and faster operative times with EMC. This supports their use in BCS, especially when multiple localizers are needed.