Clinical breast cancer最新文献_第10页

Efficacy of Topical Betamethasone Valerate and Olive Oil in Preventing Acute Radiation Dermatitis in Breast Cancer: A Randomized Double-Blind Placebo-Controlled Study 外用戊酸倍他米松和橄榄油预防乳腺癌急性放射性皮炎的疗效：一项随机双盲安慰剂对照研究

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-08-21 DOI: 10.1016/j.clbc.2025.08.008

Israa K. Mohamed , Maggie M. Abbassi , Mohamed R. Kelany , Samar F. Farid

Aim

The purpose of this study is to compare topical betamethasone-17-valerate and olive oil cream in preventing radiation-induced dermatitis (RID) in breast cancer patients and to provide prospective data evaluating the quality of life, subjective symptoms, and treatment satisfaction reported by the patients.

Methods

This was a prospective, double-blind, randomized, parallel, placebo-controlled trial. A total of 132 patients were randomized into three groups to receive either olive oil cream (G1), betamethasone-17-valerate (Betnovate® cream, GlaxoSmithKline) (G2), or unmedicated cream base (G3) throughout radiotherapy (RT) and 2 weeks after. The study is registered on clinicaltrials.gov with ID: NCT05285943, Date: November 2021.

Results

A total of 128 patients were included in the final analysis. Betamethasone and olive oil significantly differed from the unmedicated cream base at weeks 1 to 4 (P < 0.05). At week 5, only significance was observed between olive oil and unmedicated cream base (P = 0.013), and the mean RTOG (Radiation Therapy Oncology Group) score was significantly lower in olive oil and betamethasone groups than in the unmedicated cream base group (P < 0.05 at weeks 1-5) but, there was no significant difference between olive oil and betamethasone (P > 0.999). Furthermore, the percentage of patients who developed grade 3 at the end of the follow-up was significantly different between the olive oil group and the unmedicated cream base group (27.9% vs. 61%, P = 0.004). Additionally, olive oil and betamethasone had non-significant delayed grade 2 and grade 3 development (P > 0.999).

Conclusion

Olive oil cream is as effective as betamethasone in alleviating RID in patients treated with adjuvant radiotherapy for breast cancer.

目的：本研究的目的是比较外用倍他米松-17-戊酸橄榄油乳膏和橄榄油乳膏预防乳腺癌患者放射性皮炎（RID）的效果，并提供评估患者生活质量、主观症状和治疗满意度的前瞻性数据。方法：这是一项前瞻性、双盲、随机、平行、安慰剂对照试验。132名患者被随机分为三组，分别在放疗期间（RT）和2周后接受橄榄油乳膏（G1）、倍他米松-17-valerate (Betnovate®乳膏，GlaxoSmithKline) （G2）或无药乳膏基础（G3）。该研究已在clinicaltrials.gov注册，ID: NCT05285943，日期：2021年11月。结果：最终分析共纳入128例患者。在第1 ~ 4周，倍他米松和橄榄油与未给药乳膏基础相比差异有统计学意义（P < 0.05）。第5周时，橄榄油组和倍他米松组的RTOG（放射治疗肿瘤组）平均评分显著低于未给药的膏底组（P = 0.013），第1-5周时，橄榄油组和倍他米松组的RTOG（放射治疗肿瘤组）平均评分显著低于未给药的膏底组（P < 0.05），而橄榄油组和倍他米松组的RTOG（放射治疗肿瘤组）平均评分差异无统计学意义（P < 0.05）。此外，在随访结束时，橄榄油组和未使用乳膏基础组的患者发展为3级的百分比有显著差异（27.9%比61%，P = 0.004）。此外，橄榄油和倍他米松对2级和3级发育的延迟不显著（P > 0.999）。结论：橄榄油乳膏缓解乳腺癌辅助放疗患者RID的效果与倍他米松相同。

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引用次数: 0

Mechanistic Insights and Therapeutic Implications of Endothelial Nitric Oxide Synthase and Reactive Oxygen Species in Breast Cancer 内皮型一氧化氮合酶和活性氧在乳腺癌中的作用机制及其治疗意义。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-08-08 DOI: 10.1016/j.clbc.2025.08.004

Mohammed Dlshad Mohsin , Abbas Salihi

Breast cancer (BC) remains a significant health problem globally, with complex underlying processes that are not fully understood. This study investigates the intricate relationship between endothelial nitric oxide synthase (eNOS) and reactive oxygen species (ROS) in the progressions of BC. Here we examine the essential roles of superoxide (O2·¯), hydrogen peroxide (H₂O₂), and hydroxyl free radicals (OH·) in promoting tumor development, angiogenesis, and metastasis. In addition, this review also analyzes the significant role of eNOS in BC, which highlighting its activation by estrogen and the impact of eNOS gene polymorphisms on cancer risk. Furthermore, we elucidate the mechanisms of eNOS uncoupling, primarily focusing on the deficiency of tetrahydrobiopterin (BH4), the depletion of L-Arginine (L-Arg), and the buildup of asymmetric dimethylarginine (ADMA). This extensive study provides novel insights into the molecular mechanisms connecting oxidative stress and NO signaling in BC. It identifies prospective targets for innovative treatment strategies. Hence, the outcomes of the study may highlight the importance of comprehending the complex balance between eNOS activity and ROS production in the progression of BC. This provides the foundation for further studies and targeted therapies in BC treatment.

乳腺癌（BC）仍然是一个全球性的重大健康问题，其复杂的潜在过程尚未完全了解。本研究探讨了内皮型一氧化氮合酶（eNOS）和活性氧（ROS）在BC进展中的复杂关系。在这里，我们研究了超氧化物（O2·¯）、过氧化氢（H2O2）和羟基自由基（OH·）在促进肿瘤发展、血管生成和转移中的重要作用。此外，本文还分析了eNOS在BC中的重要作用，强调了雌激素对eNOS的激活以及eNOS基因多态性对癌症风险的影响。此外，我们阐明了eNOS解偶联的机制，主要集中在四氢生物蝶呤（BH4）的缺乏、l -精氨酸（L-Arg）的消耗和不对称二甲基精氨酸（ADMA）的积累。这项广泛的研究为BC中氧化应激和NO信号的分子机制提供了新的见解。它确定了创新治疗策略的潜在目标。因此，该研究结果可能强调了理解BC进展中eNOS活性和ROS产生之间复杂平衡的重要性。这为进一步研究和靶向治疗BC提供了基础。

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引用次数: 0

Area Deprivation Index (ADI) as a Predictor of Surgical Complications in Patients Undergoing Mastectomy 区域剥夺指数（ADI）作为乳房切除术患者手术并发症的预测因子。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-07-07 DOI: 10.1016/j.clbc.2025.07.004

Felix J. Klimitz , Laetitia S. Chiarella , Lioba Huelsboemer , Stav Brown , Sam Boroumand , Alejandro Kochen , Alexander J. Kammien , SeungJu Jackie Oh , Martin Kauke-Navarro , Fortunay Diatta , Bohdan Pomahac

Introduction

Socioeconomic disparities significantly influence health outcomes, particularly in surgical care. The Area Deprivation Index (ADI), a comprehensive measure of neighborhood-level socioeconomic status, is increasingly recognized as a predictor of clinical outcomes. This study examines the association between ADI and postoperative complications in patients undergoing mastectomy, hypothesizing that higher ADI scores correlate with worse outcomes.

Methods

A retrospective cohort analysis was conducted using the ACS-NSQIP database to evaluate 1141 female patients who underwent mastectomy between 2017 and 2022. Patients were categorized into tertiles based on their ADI scores. Preoperative characteristics, surgical details, and 30-day postoperative outcomes were analyzed. Statistical significance was assessed using chi-square tests for categorical variables and ANOVA for continuous variables.

Results

Patients in the highest ADI tertile had significantly higher rates of medical complications (17.3%) compared to those in the lowest tertile (9.2%, P = .01). Pneumonia was notably more frequent in the most deprived group (4.7% vs. 0.8%, P = .01). Other complications, such as unplanned readmissions and surgical complications, showed no significant differences between tertiles. Black patients were disproportionately represented in the highest ADI tertile, highlighting intersectional disparities. Household income and insurance type varied significantly across ADI tertiles, reflecting broader socioeconomic inequities.

Conclusion

Higher ADI scores are associated with increased medical complications, particularly pneumonia, in mastectomy patients. These findings emphasize the importance of integrating socioeconomic factors into surgical risk assessments and developing targeted interventions to address disparities in care and outcomes.

引言：社会经济差异显著影响健康结果，特别是在外科护理方面。区域剥夺指数（ADI）是一种衡量社区社会经济地位的综合指标，越来越被认为是临床结果的预测指标。本研究探讨了接受乳房切除术患者的ADI与术后并发症之间的关系，并假设较高的ADI评分与较差的结果相关。方法：采用ACS-NSQIP数据库进行回顾性队列分析，对2017 - 2022年1141例接受乳房切除术的女性患者进行评估。根据患者的ADI评分将患者分为几组。分析术前特征、手术细节和术后30天的结果。分类变量采用卡方检验，连续变量采用方差分析。结果：最高ADI值组患者的并发症发生率（17.3%）明显高于最低ADI值组（9.2%,P = 0.01）。最贫困组肺炎发生率明显高于对照组（4.7% vs. 0.8%, P = 0.01）。其他并发症，如意外再入院和手术并发症，在两组之间没有显着差异。黑人患者在最高ADI百分比中所占比例不成比例，突出了交叉差异。家庭收入和保险类型在ADI纺织品中差异显著，反映了更广泛的社会经济不平等。结论：在乳房切除术患者中，较高的ADI评分与增加的医疗并发症，特别是肺炎相关。这些发现强调了将社会经济因素纳入手术风险评估和制定有针对性的干预措施以解决护理和结果差异的重要性。

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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 : 2026-01-01 Epub 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

Study on Different Staining Platforms for HER2 Cytoplasmic Granular Staining Pattern in Pure Apocrine Carcinoma of the Breast 乳腺纯大汗腺癌HER2细胞质颗粒染色不同染色平台的研究。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-07-14 DOI: 10.1016/j.clbc.2025.07.016

Xue-Xue Xiao , Peng-Fei Xu , Ming-Wei Wang , Su Jin , Na Fang , Jun-Qiu Yue

Objective

Accurate interpretation of HER2 low/ultralow expression has attracted increasing attention. This study aimed to explore the characteristics and interpretation strategies for the HER2 cytoplasmic granular staining pattern observed in pure apocrine carcinoma (AC), while investigating its impact on the interpretation of HER2 low/ultra-low expression cases.

Methods

The clinicopathologic information of 74 patients with pure AC and their previous HER2 (PATHWAY 4B5, Ventana platform) IHC results were retrospectively collected. All enrolled cases underwent Dako HER2 (HercepTest [poly]) IHC staining, among which 43 cases were further subjected to FISH testing. Clinical targeted drug information was collected concurrently.

Results

Previous PATHWAY 4B5 staining revealed punctate and/or diffuse cytoplasmic granular staining in 35.14% (26/74) of pure AC. In contrast, only 9 cases (12.16%, 9/74) of HercepTest staining exhibited cytoplasmic granular staining, all of which belonged to the PATHWAY 4B5 cytoplasmic granular staining subset (34.62%, 9/26). HercepTest IHC interpretation demonstrated 89.19% (66/74) concordance with PATHWAY 4B5 interpretations. Furthermore, 88.46% (23/26) of PATHWAY 4B5 cytoplasmic granular staining cases exhibited concordant interpretations between both antibody platforms. 44.59% (33/74) were HER2-positive, and 55.41% (41/74) were triple-negative apocrine carcinoma (TNAC). About 18.19% (6/33) of HER2-positive cases and 48.78% (20/41) of TNAC cases showed cytoplasmic granular staining on PATHWAY 4B5, and 95.00% (19/20) of the latter cases were HER2 low expression.

Conclusions

Pure ACs on the PATHWAY 4B5 platform primarily present HER2 cytoplasmic granular staining in TNAC and HER2 low expression cases. The rate of HER2 cytoplasmic granular staining on HercepTest platform was significantly lower than that of PATHWAY 4B5, and is more suitable for the detection and interpretation of HER2 0 and low expression cases.

目的：准确解释HER2低/超低表达越来越受到人们的关注。本研究旨在探讨纯大汗腺癌（AC）中观察到的HER2细胞质颗粒染色模式的特征和解释策略，同时研究其对HER2低/超低表达病例解释的影响。方法：回顾性收集74例单纯AC患者的临床病理资料及既往HER2 （PATHWAY 4B5， Ventana平台）免疫组化结果。所有入组病例均行Dako HER2 （HercepTest [poly]）免疫组化染色，其中43例进一步行FISH检测。同时收集临床靶向药物信息。结果：既往的PATHWAY 4B5染色显示35.14%（26/74）纯AC呈点状和/或弥漫性胞浆颗粒染色，而HercepTest染色仅9例（12.16%,9/74）为胞浆颗粒染色，均属于PATHWAY 4B5胞浆颗粒染色亚群（34.62%,9/26）。HercepTest IHC解释与PATHWAY 4B5解释的一致性为89.19%（66/74）。此外，88.46%（23/26）的PATHWAY 4B5细胞质颗粒染色病例在两种抗体平台之间表现出一致的解释。44.59%（33/74）为her2阳性，55.41%（41/74）为三阴性大汗腺癌（TNAC）。约18.19%（6/33）的HER2阳性病例和48.78%（20/41）的TNAC病例细胞质4B5呈颗粒状染色，后者为95.00%（19/20）的HER2低表达。结论：在TNAC和HER2低表达病例中，PATHWAY 4B5平台上的纯ACs主要呈现HER2细胞质颗粒染色。HercepTest平台上HER2细胞质颗粒染色率明显低于PATHWAY 4B5，更适合于her20及低表达病例的检测和解释。

{"title":"Study on Different Staining Platforms for HER2 Cytoplasmic Granular Staining Pattern in Pure Apocrine Carcinoma of the Breast","authors":"Xue-Xue Xiao , Peng-Fei Xu , Ming-Wei Wang , Su Jin , Na Fang , Jun-Qiu Yue","doi":"10.1016/j.clbc.2025.07.016","DOIUrl":"10.1016/j.clbc.2025.07.016","url":null,"abstract":"<div><h3>Objective</h3><div>Accurate interpretation of HER2 low/ultralow expression has attracted increasing attention. This study aimed to explore the characteristics and interpretation strategies for the HER2 cytoplasmic granular staining pattern observed in pure apocrine carcinoma (AC), while investigating its impact on the interpretation of HER2 low/ultra-low expression cases.</div></div><div><h3>Methods</h3><div>The clinicopathologic information of 74 patients with pure AC and their previous HER2 (PATHWAY 4B5, Ventana platform) IHC results were retrospectively collected. All enrolled cases underwent Dako HER2 (HercepTest [poly]) IHC staining, among which 43 cases were further subjected to FISH testing. Clinical targeted drug information was collected concurrently.</div></div><div><h3>Results</h3><div>Previous PATHWAY 4B5 staining revealed punctate and/or diffuse cytoplasmic granular staining in 35.14% (26/74) of pure AC. In contrast, only 9 cases (12.16%, 9/74) of HercepTest staining exhibited cytoplasmic granular staining, all of which belonged to the PATHWAY 4B5 cytoplasmic granular staining subset (34.62%, 9/26). HercepTest IHC interpretation demonstrated 89.19% (66/74) concordance with PATHWAY 4B5 interpretations. Furthermore, 88.46% (23/26) of PATHWAY 4B5 cytoplasmic granular staining cases exhibited concordant interpretations between both antibody platforms. 44.59% (33/74) were HER2-positive, and 55.41% (41/74) were triple-negative apocrine carcinoma (TNAC). About 18.19% (6/33) of HER2-positive cases and 48.78% (20/41) of TNAC cases showed cytoplasmic granular staining on PATHWAY 4B5, and 95.00% (19/20) of the latter cases were HER2 low expression.</div></div><div><h3>Conclusions</h3><div>Pure ACs on the PATHWAY 4B5 platform primarily present HER2 cytoplasmic granular staining in TNAC and HER2 low expression cases. The rate of HER2 cytoplasmic granular staining on HercepTest platform was significantly lower than that of PATHWAY 4B5, and is more suitable for the detection and interpretation of HER2 0 and low expression cases.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 221-228"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physician and Software Assessed Cosmetic Outcomes Following Whole Breast or Partial Breast Radiation Therapy for Breast Cancer 医生和软件评估乳腺癌全乳房或部分乳房放射治疗后的美容效果。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-07-08 DOI: 10.1016/j.clbc.2025.07.006

Anna Okabe , Wai Lone J. Ho , May Lin Tao , Jason C. Ye

Aim

This study aims to compare the cosmetic outcomes in early-stage breast cancer patients treated with whole breast irradiation (WBI) or partial-breast irradiation (PBI), using both subjective and objective tools, to assess clinical factors contributing to cosmesis scores, and to compare radiation toxicity outcomes.

Methods

Breast cosmesis was scored by using the physician-rated Harvard cosmesis scale at the time of consultation and at each follow-up visit and objectively using the BCCT.core software on standardized photographs.

Results

Ninety-nine patients received WBI, and thirty-six received PBI. 91% of patients treated with WBI and 86.1% with PBI scored excellent/good by physician ratings at follow-up vs. 68.4% and 72.2 % by BCCT.core software. Agreement between both tools was low (

κ

= 0.057 for WBI patients and

κ

= 0.012 for PBI patients). There was less than a 15% decline in physician-rated cosmetic scores for either WBI or PBI patients, but a 27.3% decline for WBI patients by BCCT.core software scoring. There was no association of prone vs. supine position, tumor bed boost, fractionation scheme, or addition of regional nodal irradiation with long-term cosmesis scores determined by either assessment tool, except for oncoplastic surgery which was associated with a higher score.

Conclusions

Breast cosmesis scores after either WBI or PBI are favorable; however, the agreement between physician rating and the BCCT.core software is poor. The BCCT.core software was more likely to indicate a decline in cosmetic results over time. Surgical outcomes may be the most impactful clinical factor in predicting long-term breast cosmesis.

目的：本研究旨在比较早期乳腺癌患者接受全乳照射（WBI）和部分乳房照射（PBI）治疗的美容效果，采用主观和客观的工具，评估影响美容评分的临床因素，并比较辐射毒性结果。方法：在会诊时和每次随访时采用医生评定的哈佛美容量表对乳房美容进行评分，客观采用BCCT。标准化照片的核心软件。结果：99例患者接受WBI治疗，36例患者接受PBI治疗。在随访中，91%的WBI患者和86.1%的PBI患者的医生评分为优秀/良好，而BCCT患者的评分为68.4%和72.2%。核心软件。两种工具之间的一致性较低（WBI患者的κ = 0.057， PBI患者的κ = 0.012）。WBI或PBI患者的医师评定美容评分下降不到15%，但BCCT对WBI患者的美容评分下降了27.3%。核心软件评分。俯卧位与仰卧位、肿瘤床提升、分割方案或增加区域淋巴结照射与任一评估工具确定的长期美容评分均无关联，除了肿瘤整形手术与较高评分相关。结论：WBI和PBI术后乳房美容评分均较好；然而，医师等级和BCCT之间的一致性。核心软件很差。BCCT。随着时间的推移，核心软件更有可能表明美容效果的下降。手术结果可能是预测长期乳房整形最具影响的临床因素。

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引用次数: 0

Comment on “The USP8/CEP55/CHMP6 Axis Orchestrates Triple-Negative Breast Cancer Progression by Regulating Ferroptosis and Macrophage M2 Polarization” 评论“USP8/CEP55/CHMP6轴通过调节铁凋亡和巨噬细胞M2极化来协调三阴性乳腺癌的进展”。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-10-28 DOI: 10.1016/j.clbc.2025.10.015

Wenyan Zhang, Zhongzhu Tang

引用次数: 0

Do Not Rush to Omit Sentinel Lymph Node Biopsy for Early Breast Cancer Patients 早期乳腺癌患者不要急于忽略前哨淋巴结活检。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-11-14 DOI: 10.1016/j.clbc.2025.11.006

Níamh M. Smyth , Alexandra M. Zaborowski , Bukola V. Bolarinwa , Sandra Hembrecht , Rose Joyce Culhane , Abhi Narsiman , Clodagh T. Canavan , Jan Sørensen , Eithne Downey , Michael Allen , Abeeda Butt , Colm Power , Orla McArdle , Patrick G. Morris , Nuala Healy , Laura McKenna , Arnold D.K. Hill

Introduction

Recent data suggest that sentinel lymph node biopsy (SLNB) can be omitted in select patients with early breast cancer. The aim of this study was to determine the utility of SLNB for patients with early breast cancer.

Methods

A retrospective analysis of patients diagnosed with breast cancer in a Level IV hospital in Dublin, Ireland, between December 2013 and March 2024 was conducted. Inclusion criteria included: female patients ≥ 18 years, with cT1 disease and a negative preoperative axillary ultrasound, who underwent breast conserving surgery and a SLNB.

Results

In total, 334 patients were included. The median age was 59 years (26-91 years). The majority had invasive ductal carcinoma (261 patients, 78.1%) and were hormone receptor-postive and human epidermal growth factor receptor 2-negative (274 patients, 82%). Final N stage was N0 in 282 (84%) of patients. Fifty-two patients (16%) had a positive-SLNB, despite a negative preoperative axilla. Twenty-four patients underwent an axillary clearance, of which 7 (14%) were positive, with only 3 patients (12.5%) upstaged following axillary clearance. Eighty-four patients (25%) received chemotherapy due to positive-SLNB. In line with contemporary data, 9 patients (2.7%) were eligible for CDK4/6 inhibitors, 48 patients (14%) for escalation to nodal radiation, or 275 patients (82%) for de-escalation to partial breast radiation.

Conclusion

While SLNB may be safely omitted in specific contexts, its omission carries the risk of under- and over-treatment. Our findings demonstrate that SLNB continues to guide adjuvant therapy for breast cancer patients, and thus, support the ongoing use of SLNB.

简介：最近的数据表明，前哨淋巴结活检（SLNB）可以在选择早期乳腺癌患者中省略。本研究的目的是确定SLNB对早期乳腺癌患者的效用。方法：回顾性分析2013年12月至2024年3月在爱尔兰都柏林一家四级医院诊断为乳腺癌的患者。纳入标准：女性患者≥18岁，cT1病变，术前腋窝超声阴性，行保乳手术和SLNB。结果：共纳入334例患者。中位年龄为59岁（26-91岁）。大多数为浸润性导管癌（261例，78.1%），激素受体阳性，人表皮生长因子受体2阴性（274例，82%）。282例（84%）患者最终N期为0。52例（16%）患者的slnb阳性，尽管术前腋窝阴性。24例患者接受了腋窝清除率，其中7例（14%）阳性，只有3例（12.5%）患者在腋窝清除率后被抢镜。84例（25%）患者因slnb阳性接受化疗。与当代数据一致，9名患者（2.7%）符合CDK4/6抑制剂，48名患者（14%）符合升级到淋巴结放疗，275名患者（82%）符合降级到部分乳房放疗。结论：虽然在特定情况下可以安全地省略SLNB，但省略会带来治疗不足和过度治疗的风险。我们的研究结果表明，SLNB继续指导乳腺癌患者的辅助治疗，因此，支持SLNB的持续使用。

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引用次数: 0

Trajectory of Chemotherapy-Induced Peripheral Neuropathy and Its Predictive Factors in Breast Cancer Patients: A Prospective Longitudinal Study 乳腺癌患者化疗诱导周围神经病变的发展轨迹及其预测因素：一项前瞻性纵向研究。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-08-10 DOI: 10.1016/j.clbc.2025.08.002

Huiqian Xu , Hong Li , Yijing Fan , Shufang Zhang , Yang Wang , Yiying Wang , Lizhi Zhou , Jinghua Zhang

Objective

To explore the trajectory patterns and influencing factors of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients using latent class growth analysis (LCGA).

Methods

This study was conducted from September 2022 to September 2023 at a tertiary hospital in Tangshan, China. A total of 350 hospitalized breast cancer patients undergoing chemotherapy were recruited. Data were collected through questionnaires, including general demographic information, disease-related characteristics, lifestyle factors, and psychological status. CIPN was assessed at 5 time points: baseline (T0) and the 21st day after the completion of the 1st (T1), 2nd (T2), 3rd (T3), and 4th (T4) chemotherapy cycles. Latent class growth models (LCGMs) were used to identify distinct trajectory patterns. Univariate analysis and multinomial logistic regression models were applied to examine the influencing factors.

Results

Three distinct CIPN trajectory groups were identified: the low-risk stable group (42.3%, n = 148), the moderate-risk progressive group (41.4%, n = 145), and the high-risk rapidly progressing group (16.3%, n = 57). Compared with the low-risk stable group, the predictive factors for the moderate-risk progressive group included body mass index (BMI), hypertension, and depression. For the high-risk rapidly progressing group, predictive factors included BMI, physical activity, social support, hypertension, vitamin D levels, nutritional status, and depression.

Conclusion

This study elucidates the heterogeneous trajectory patterns of chemotherapy-induced peripheral neuropathy (CIPN) in breast cancer patients and identifies key influencing factors. Recognizing these characteristics in clinical practice may facilitate the early identification of high-risk patients and enable timely interventions to mitigate CIPN severity.

目的：应用潜在类生长分析（LCGA）探讨乳腺癌化疗诱导周围神经病变（CIPN）的发展轨迹及影响因素。方法：本研究于2022年9月至2023年9月在中国唐山市某三级医院进行。共招募了350名接受化疗的住院乳腺癌患者。通过问卷调查收集数据，包括一般人口统计信息、疾病相关特征、生活方式因素和心理状态。CIPN在5个时间点进行评估：基线（T0）和第1 （T1）、第2 （T2）、第3 （T3）和第4 （T4）化疗周期完成后的第21天。潜在类别增长模型（LCGMs）用于识别不同的轨迹模式。采用单因素分析和多项logistic回归模型对影响因素进行分析。结果：确定了三个不同的CIPN轨迹组：低危稳定组（42.3%,n = 148），中危进展组（41.4%,n = 145）和高危快速进展组（16.3%,n = 57）。与低危稳定组相比，中度危进展组的预测因素包括体重指数（BMI）、高血压和抑郁。对于高危快速进展组，预测因素包括BMI、身体活动、社会支持、高血压、维生素D水平、营养状况和抑郁。结论：本研究阐明了乳腺癌患者化疗诱导的周围神经病变（CIPN）的异质性轨迹模式，并确定了关键影响因素。在临床实践中认识到这些特征可能有助于早期识别高风险患者，并能够及时干预以减轻CIPN的严重程度。

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引用次数: 0

The Role of Adjuvant Radiation Therapy in Treating Older Breast Cancer Patients With Low Adherence to Endocrine Therapy 辅助放射治疗在内分泌治疗依从性低的老年乳腺癌患者中的作用。

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical breast cancer

Pub Date : 2026-01-01 Epub Date: 2025-07-30 DOI: 10.1016/j.clbc.2025.07.028

M. Judy Lubas , Jill Hasler , Jordan Fredette , Ana Sandoval-Leon , Richard J. Bleicher , Austin D. Williams , Lindsey Taylor , Joshua E. Meyer , Rebecca M. Shulman

Background

Older patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early-stage breast cancer (HPEsBC) typically undergo breast-conserving surgery (BCS) followed by adjuvant radiation therapy (RT) and/or endocrine therapy (ET). Our study aimed to identify predictors of low ET adherence and evaluate the role of RT in modifying survival among patients with low ET adherence.

Methods

A retrospective analysis was performed using a US-based, electronic health record-derived, de-identified database. Patients aged ≥65 years with HPEsBC treated with BCS from 2011 to 2018 were included. Four adjuvant treatment groups were identified. Low ET adherence was defined as ET use for <80% of the 5-year post surgery follow-up period. Multinomial logistic regression was used to identify predictors of low adherence. Survival outcomes were assessed using hazard ratios (HRs) adjusted for covariates.

Results

A total of 1,488 patients were included in the study. Among patients receiving ET, 23% demonstrated low adherence. After adjustment for covariates, mortality was higher for RT alone (HR = 1.79, p = .011) and no adjuvant therapy (HR = 2.65, p < .001) compared with ET + RT. Predictors of low ET adherence included increasing age (odds ratio [OR] = 1.06, p < .010) and treatment at an academic practice (OR = 2.58, p < .001). A 10% decline in ET adherence was associated with increased mortality (HR = 1.17, p < .001). An interaction analysis revealed no differential effect of RT in the context of ET adherence.

Conclusion

Low ET adherence occurred in approximately one-quarter of patients and was associated with advancing age and treatment at academic centers. Reduced ET adherence was linked to significantly increased mortality. Further investigation into the role of RT in patients with low ET adherence is warranted.

背景：激素受体阳性，人表皮生长因子受体2 （HER2）阴性的早期乳腺癌（HPEsBC）的老年患者通常接受保乳手术（BCS），然后进行辅助放射治疗（RT）和/或内分泌治疗（ET）。我们的研究旨在确定低ET依从性的预测因素，并评估RT在改善低ET依从性患者生存中的作用。方法：使用基于美国的电子健康记录衍生的去识别数据库进行回顾性分析。纳入2011年至2018年接受BCS治疗的年龄≥65岁的HPEsBC患者。确定了四个辅助治疗组。低ET依从性被定义为ET使用的结果：共有1488名患者纳入研究。在接受ET治疗的患者中，23%表现出低依从性。调整协变量后，与ET + RT相比，单独RT组（HR = 1.79, p = 0.011）和无辅助治疗组（HR = 2.65, p < 0.001）的死亡率更高。低ET依从性的预测因素包括年龄增加（优势比[OR] = 1.06, p < 0.010）和学术实践治疗（OR = 2.58, p < 0.001）。ET依从性下降10%与死亡率增加相关（HR = 1.17, p < 0.001）。相互作用分析显示，在ET依从性的背景下，RT没有差异效应。结论：低ET依从性发生在大约四分之一的患者中，并且与年龄的增长和学术中心的治疗有关。降低ET依从性与死亡率显著增加有关。进一步研究RT在低ET依从性患者中的作用是必要的。

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