Clinical breast cancer最新文献

{"title":"CBCT-Guided Online Adaptive Radiation Therapy for Accelerated Partial Breast Irradiation: A Single-Institution Experience","authors":"Claudia Warden,&nbsp;Kayla Steed,&nbsp;Whitney Hotsinpiller,&nbsp;Joel Pogue,&nbsp;Joseph Harms ,&nbsp;Michael Soike,&nbsp;Kimberly Keene,&nbsp;Michael Dobelbower,&nbsp;Markus Bredel ,&nbsp;Dennis Stanley,&nbsp;D. Hunter Boggs","doi":"10.1016/j.clbc.2025.08.018","DOIUrl":"10.1016/j.clbc.2025.08.018","url":null,"abstract":"<div><h3>Purpose/Objectives</h3><div>Accelerated partial breast irradiation (APBI) using stereotactic body radiation therapy (SBRT) offers shorter treatment, comparable local control, and improved cosmesis for early-stage breast cancer (ESBC). Cone beam CT (CBCT)-guided online adaptive radiation therapy (OART) enhances target coverage and minimizes normal tissue exposure. This retrospective study evaluates clinical characteristics and outcomes in patients treated with APBI using OART.</div></div><div><h3>Materials/Methods</h3><div>From January 2022 to May 2024, 40 patients (including 2 with bilateral disease) received SBRT with OART. Targets included the lumpectomy cavity (GTV), a 1 cm CTV margin, and a 3 mm PTV margin. Patients received 30 Gy in 5 fractions. Daily CBCT guided alignment and adaption of targets and organs-at-risk was performed. Either the scheduled or adapted plan was selected each day. Outcomes were assessed at 1 month and most recent follow-up using CTCAE criteria.</div></div><div><h3>Results</h3><div>Patients (ages 50-83) had predominantly right-sided (59.5%) and upper outer quadrant tumors (61.9%), with a median size of 0.9 cm. The median interval from lumpectomy to radiation was 62 days; treatment lasted a median of 9 days. The adapted plan was used in 90% of fractions. At 1 month, 48% had no toxicity; all reported events were grade 1. At a median 14.3-month follow-up, most toxicities remained grade 1; 3 patients had grade 2 effects. No recurrences were observed.</div></div><div><h3>Conclusions</h3><div>This study, the largest APBI with OART cohort to date, demonstrates excellent cosmesis, minimal toxicity, and promising early oncologic outcomes for ESBC patients.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 170-180"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074638","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}

{"title":"WITHDRAWN: Editorial for “Real World Safety of Adjuvant Ultra Hypofractionated Radiotherapy in Nonmetastatic Breast Cancer: Acute Cutaneous Toxicity and Esthetic Outcomes”","authors":"Reza Chaman ,&nbsp;James S Welsh ,&nbsp;Seyedehhoda Khatibmasjedi ,&nbsp;Mobina Mohammadkhani ,&nbsp;Seyed Alireza Javadinia","doi":"10.1016/j.clbc.2025.09.010","DOIUrl":"10.1016/j.clbc.2025.09.010","url":null,"abstract":"<div><div>The Publisher regrets that this article is an accidental duplication of an article that has already been published, <span><span>http://dx.doi.org/10.1016/j.clbc.2025.09.009</span><svg><path></path></svg></span>. The duplicate article has therefore been withdrawn.</div><div>The full Elsevier Policy on Article Withdrawal can be found at <span><span>https://www.elsevier.com/about/policies-and-standards/article-withdrawal</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Page 313"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426772","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}

{"title":"The Use and Impact on Treatment Decision of the 21-Gene Recurrence Score Assay for Patients With HR+/HER2− Early Breast Cancer in Portugal: A Nationwide Retrospective Cohort Study","authors":"Teresa Gantes Padrão ,&nbsp;Diana Pessoa ,&nbsp;Joana Alves Luís ,&nbsp;Diogo Alpuim Costa ,&nbsp;Mário Fontes e Sousa ,&nbsp;Ídilia Pina ,&nbsp;Susana Palma de Sousa ,&nbsp;Débora Cardoso ,&nbsp;Sandra Bento ,&nbsp;Joana Simões ,&nbsp;Ana Ferreira ,&nbsp;Renato Cunha ,&nbsp;Diogo Martins-Branco ,&nbsp;Tiago Dias Domingues ,&nbsp;José Luís Passos-Coelho","doi":"10.1016/j.clbc.2025.09.013","DOIUrl":"10.1016/j.clbc.2025.09.013","url":null,"abstract":"<div><h3>Background</h3><div>The 21-Gene Recurrence Score Assay (Oncotype DX) is a genomic test that quantifies the likelihood of distant recurrence and predicts the potential benefit from adjuvant chemotherapy in patients with hormone receptor–positive (HR+), HER2– early breast cancer. This study aimed to evaluate the use and impact of the assay on treatment decision-making in Portugal through a nationwide retrospective cohort analysis.</div></div><div><h3>Methods</h3><div>We conducted a nationwide, multicenter, retrospective cohort study of 1083 RSA tests in 1079 patients with HR+/HER2− breast cancer between 2012 and 2021, across 36 oncology centers. We analyzed Recurrence Score (RS) distribution, adjuvant chemotherapy (ACT) prescribing patterns, correlations with clinicopathologic features, and recurrence data. Predictors of RS &gt; 25 were evaluated using multivariable analysis and the Johns Hopkins RS Estimator (JHRE).</div></div><div><h3>Results</h3><div>Most patients had pT1 tumors (&gt; 60%) and luminal B-like profiles (75%) with high hormone receptor expression (median ER 100%, PR 80%). RS &gt; 25 occurred in 14.9% of node-negative and 15.5% of node-positive cases. ACT use shifted after TAILORx publication, with decreased use in RS &lt; 16 and increased use in RS &gt; 25, including among patients ≤50. ACT use for intermediate RS (16-25) dropped from 62% to 30% in patients ≤50. PR and Ki-67 were independent predictors of RS &gt; 25. The JHRE showed moderate accuracy (53.6%) and specificity (47.7%). Among patients with a predicted RS &gt; 25 risk &lt; 5%, only 5% had actual high scores. Recurrence was observed in 2.3% of patients (median follow-up: 29 months).</div></div><div><h3>Conclusion</h3><div>RSA has been increasingly adopted in Portugal and influenced ACT decisions. PR and Ki-67 can help refine patient selection for RSA, particularly in resource-limited settings. Clinical trial results significantly shaped treatment patterns.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 268-280"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400106","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}

{"title":"Association of Limited English Proficiency With Completion of the Reconstructive Paradigm in Implant-Based Breast Reconstruction","authors":"Ying Yu,&nbsp;Dylan K. Kim,&nbsp;Nadeem E. Jones,&nbsp;Neelam I. Shaikh,&nbsp;Christine H. Rohde","doi":"10.1016/j.clbc.2026.01.009","DOIUrl":"10.1016/j.clbc.2026.01.009","url":null,"abstract":"<div><h3>Background</h3><div>Limited English proficiency (LEP) has been associated with worse postoperative outcomes and lower follow-up in plastic surgery, although its impact in two-stage implant-based breast reconstruction is not well characterized. This study evaluates the effects of LEP on postoperative outcomes in patients who received tissue expander placement for breast reconstruction.</div></div><div><h3>Methods</h3><div>Patients who underwent tissue expander placement for implant-based breast reconstruction were identified within a single urban academic center. LEP was defined as preference for a non-English primary language. Primary outcomes included completion of reconstruction, emergency department (ED) visits, readmissions, and postoperative complications. Multivariable regression models were used to identify independent predictors of ED visits/readmissions, complications, and time to completion of reconstruction (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The final cohort included 563 patients over a median (IQR) follow-up period of 18.4 (11.0-28.7) months. The rate of overall completion of breast reconstruction was 87.0%. LEP was identified in 171 (30.4%) patients. Rates of breast reconstruction completion (<em>P</em> = .20), ED visits (<em>P</em> = .82), readmissions (<em>P</em> = .38), and postoperative complications (<em>P</em> = .30) were not significantly different depending on LEP status. In a multivariable linear regression model, LEP status was independently associated with a delay in time from TE placement to completion of breast reconstruction (β: 30.9 days, 95% CI, 8.5-53.3, <em>P</em> = .0070). Mean time to completion was 282 days for patients with LEP and 245 days for non-LEP patients.</div></div><div><h3>Conclusion</h3><div>LEP was associated with a delay in time to completion of reconstruction, suggesting delays in surgical care coordination in patients with limited English proficiency.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 65-73"},"PeriodicalIF":2.5,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146186189","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}

{"title":"Contralateral Risk Reduction Mastectomy in Patients With Unilateral Breast Cancer Scheduled for Mastectomy: A Multidisciplinary Survey; Physicians’ Perspective","authors":"Nina M. Verghis ,&nbsp;Kazim Senol ,&nbsp;Shigeru Imoto ,&nbsp;Claudine Ordoñez ,&nbsp;Kristin Lupinacci ,&nbsp;Jamila Alazhri ,&nbsp;Alexander Mundinger ,&nbsp;Carole Mathelin ,&nbsp;Vahit Ozmen ,&nbsp;Atilla Soran ,&nbsp;Senologic International Society Working Group","doi":"10.1016/j.clbc.2026.01.010","DOIUrl":"10.1016/j.clbc.2026.01.010","url":null,"abstract":"<div><h3>Introduction</h3><div>The number of contralateral risk reduction mastectomies (RRM) continues to rise.</div><div>Despite the existence of many guidelines, there is no general consensus on which patients should be considered for RRM. This survey was distributed among various breast specialists with the goal of evaluating current practices, perspectives, and attitudes towards RRM.</div></div><div><h3>Methods</h3><div>An English-language survey containing ten questions was designed and distributed electronically to members of the Senologic International Society (SIS). The findings of this survey align with existing research and also provide areas for further investigation.</div></div><div><h3>Results</h3><div>This survey demonstrates the different practices and viewpoints on RRM across various specialties and areas around the world. These variations highlight the need for uniform recommendations and further research to enhance patient outcomes and address the challenges of managing RRM patients.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 44-53"},"PeriodicalIF":2.5,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146186526","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}

{"title":"Noninvasive Prediction of Axillary Sentinel Lymph Node Metastasis via Contrast-Enhanced Ultrasound to Guide Omission of SLNB in Breast Cancer","authors":"Zhijian He ,&nbsp;Xiaoyang Li ,&nbsp;Jun He ,&nbsp;Peizhen Huang ,&nbsp;Rizeng Li ,&nbsp;Jian Yu","doi":"10.1016/j.clbc.2026.01.008","DOIUrl":"10.1016/j.clbc.2026.01.008","url":null,"abstract":"<div><h3>Background</h3><div>The evaluation of axillary sentinel lymph node (SLN) is integral to the treatment of breast cancer. This study aims to build a noninvasive prediction model of SLN metastasis based on percutaneous contrast-enhanced ultrasound (p-CEUS) for low-risk patients.</div></div><div><h3>Materials and Methods</h3><div>Patients with breast cancer were enrolled in this study at Wenzhou Central Hospital between June 2023 and October 2024. The patients were divided into a modeling group and a validation group in a 2:1 ratio. Clinical and pathological features were assessed with univariate analysis and multivariate logistic regression. A nomogram based on p-CEUS enhancement patterns and other independent predictors for the SLN metastasis identified by multivariate logistic regression was constructed.</div></div><div><h3>Results</h3><div>A total of 120 patients were included, comprising 80 in the modeling group (mean age, 55.01 ± 9.91 years) and 40 in the validation group (mean age, 55.20 ± 8.35 years). Independent predictors of SLN metastasis by the multivariate logistic regression analysis included tumor size, Ki-67 status and p-CEUS enhancement pattern. The areas under the receiver operating characteristic (ROC) curve of the modeling group and the validation group were 0.855 and 0.873, respectively. At a ≤ 20% probability threshold, the false-negative rate was 6.5%.</div></div><div><h3>Conclusions</h3><div>The p-CEUS-based nomogram can accurately predict the risk of SLN metastasis in early breast cancer patients with negative-node status. Patients with predicted metastasis probability ≤ 20%, especially those with tumor size ≤ 2 cm, Ki-67 ≤ 20%, and p-CEUS Type I enhancement, can safely omit SLNB.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 74-83"},"PeriodicalIF":2.5,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146186190","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}

{"title":"A Comparative Analysis of HER2 Immunohistochemistry in Core Biopsy Versus Excision in the Era of HER2 ``Low'' Breast Cancers","authors":"Swati Bhardwaj ,&nbsp;Shabnam Jaffer","doi":"10.1016/j.clbc.2025.11.016","DOIUrl":"10.1016/j.clbc.2025.11.016","url":null,"abstract":"<div><h3>Background</h3><div>The Destiny B04 trial led to the recognition of HER2 low as a new entity defined as HER2 immunohistochemistry (IHC) score of 1 +/2 + and negative in situ hybridization (ISH) requiring detailed HER2 IHC scoring (negative = 0 &amp; 1 +, equivocal = 2 +, and positive = 3 +). As per ASCO–CAP guidelines, biomarkers need not be repeated on excisions when done on core biopsy with some exceptions. The goal of our study was to compare the concordance of HER2 low between core biopsies and excisions and assess the need to repeat on excision.</div></div><div><h3>Methods</h3><div>At the study institution biomarkers are first performed on core biopsies and then repeated on all excisions in negative cases. We identified 301 cases of primary breast carcinomas with matched HER2 IHC on core biopsies and excisions. We reviewed and scored all HER2 IHC slides as per 2018 ASCO/CAP guidelines.</div></div><div><h3>Results</h3><div>The incidence of HER2 low on core biopsies decreased from 64% to 46% on excisions. The best concordance was seen in HER2 + (82%) and negative cases (84%), with most variability in predominantly 1 + and some 2 + cases in both directions. There was a greater loss (38%) than gain (16%) in HER2 low values from core biopsy to excision.</div></div><div><h3>Conclusions</h3><div>HER2 low discordance in our series was predominantly due to loss from core biopsies to excisions, which maybe attributed to better meeting the pre analytic criteria on core biopsy. In contrast, the gain maybe due to intratumoral heterogeneity and or interobserver variability and despite low, worth repeating HER2 IHC on excisions in negative cases.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 39-43"},"PeriodicalIF":2.5,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178201","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}

{"title":"Event-Free Survival After Stereotactic Body Radiation Therapy for Oligoprogressive Metastatic Breast Cancer","authors":"Riccardo Ray Colciago ,&nbsp;Carlotta Giandini ,&nbsp;Anna Cavallo ,&nbsp;Maria Grazia Carnevale ,&nbsp;Giuseppe Fotia ,&nbsp;Giacomo Mazzoli ,&nbsp;Giulia Valeria Bianchi ,&nbsp;Serena Di Cosimo ,&nbsp;Daniele Presti ,&nbsp;Riccardo Lobefaro ,&nbsp;Laura Lozza ,&nbsp;Maria Carmen De Santis","doi":"10.1016/j.clbc.2025.12.011","DOIUrl":"10.1016/j.clbc.2025.12.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Oligoprogressive advanced breast cancer (aBC) is becoming an increasingly frequent scenario in which prognosis can be meaningfully improved through targeted local interventions. However, evidence is still lacking. In this study, we aimed to evaluate the role of progression-directed radiation therapy (PDRT) in the management of oligoprogressive aBC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and Methods&lt;/h3&gt;&lt;div&gt;We performed a single-institution retrospective analysis of consecutive patients with oligoprogressive aBC who underwent progression-directed radiation therapy (PDRT) between January 2018 and December 2024. Oligoprogression was defined as emergence of up to 5 progressing lesions across a maximum of 3 distinct organs, after at least 1 line of systemic therapy. The primary endpoint was the event-free survival (EFS), defined as interval from the completion of PDRT to one of the following: change of systemic therapy [which is also called time to next treatment (TNT)], progression &lt; 6 months, or ≥ 3 new or progressing lesions, death, or last follow-up. Secondary endpoints included progression-free survival (PFS), and overall survival (OS).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We analyzed 56 patients, with 17 months [interquartile range (IQR): 8-27] of median follow-up. Median age at PDRT was 58 years (IQR: 49-68). Prior to PDRT, 28 patients (50%) had received only 1 line of treatment, 12 (21.4%) had received 2 lines, and 16 (28.6%) had undergone 3 or more lines. Before the onset of oligoprogression, in response to systemic therapy, 31 patients (55.4%) had achieved stable disease, 9 patients (16.0%) a partial response, and 16 patients (28.6%) a complete response at all disease sites.&lt;/div&gt;&lt;div&gt;In 39 patients (69.6%) an event occurred after PDRT, with a median event free survival (EFS) of 7 months (IQR: 3-15). The 1-year and 2-year actuarial EFS rates were 39% (95% CI, 33.1%-45.9%) and 24% (95% CI, 17.2%-30.8%), respectively. Among these 39 patients, thirty-three (84.6%) initiated a new line of systemic therapy after PDRT, with a median TNT of 8 months (IQR 4-17), with a 1-year actuarial rate of 46.6%. At the multivariate analysis, HER2 positive and Luminal A subtypes were confirmed as significant predictive factors for increased EFS (adjusted HR = 0.31, &lt;em&gt;P&lt;/em&gt; = .01; aHR = 0.27, &lt;em&gt;P&lt;/em&gt; = .01, respectively). Furthermore, lymph nodal PDRT appeared to be associated with a protective effect in the univariate analysis (&lt;em&gt;P&lt;/em&gt; = .04); however, this association was not retained in the multivariate analysis.&lt;/div&gt;&lt;div&gt;Median PFS was 7 months (IQR: 3-12), with 41 patients (73.2%) experiencing disease progression, while the median OS was 17 months (IQR: 8-27). Multivariate analysis confirmed lobular histology as an independent adverse prognostic factor (HR = 9.05, &lt;em&gt;P&lt;/em&gt; = .006).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our findings suggest that PDRT may delay the occurrence of events and the need to change systemic therapy i","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 27-38"},"PeriodicalIF":2.5,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140839","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}

{"title":"Surveillance Contrast-Enhanced Mammography in Patients With Dense Breasts and a Personal History of Breast Cancer","authors":"Maria Gosein FRCR ,&nbsp;Edwin Khoo ,&nbsp;Charlotte Yong-Hing ,&nbsp;Janette Sam ,&nbsp;Tetyana Martin","doi":"10.1016/j.clbc.2026.01.006","DOIUrl":"10.1016/j.clbc.2026.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic performance of contrast-enhanced mammography (CEM) for breast cancer surveillance in patients with dense breast tissue and a personal history of breast cancer.</div></div><div><h3>Methods</h3><div>In this single-center retrospective study, we reviewed consecutive CEM surveillance examinations performed between April 2022 and April 2025 in asymptomatic patients with a personal history of breast cancer and dense breasts. BI-RADS classifications, lesion characteristics, follow-up imaging, and histopathology were reviewed. Sensitivity, specificity, cancer detection rate (CDR), positive predictive values (PPV), and negative predictive values (NPV) were calculated using biopsy or at least 12 months imaging follow-up as reference standards.</div></div><div><h3>Results</h3><div>A total of 176 patients underwent 376 CEM studies. Of the initial exams, 29.5% of patients (52 of 176) were classified as positive (BI-RADS 3 or 4; no BI-RADS 5 cases), with a CDR of 34 per 1000 exams. Sensitivity and specificity were 100% and 72.9%, respectively, with a PPV 1 of 11.5% and NPV of 100%. Over the study period, 39 biopsies yielded 8 malignancies in 7 patients, corresponding to a PPV3 of 20.5%. Three of the eight CEM-detected cancers (37.5%) were visible only on recombined images. Palpable axillary recurrences in two patients were outside the CEM field of view. One mild contrast reaction was recorded.</div></div><div><h3>Conclusion</h3><div>Although recall rates were higher than in prior studies, CEM demonstrated high sensitivity and NPV and substantial CDR; all of which were early-stage, node-negative cancers. These findings support broader consideration of CEM in intermediate- to high-risk surveillance settings, particularly where access to MRI is limited.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 17-26"},"PeriodicalIF":2.5,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140822","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}

{"title":"Breast Cancer Vaccines: A Review of Emerging Opportunities and Persistent Challenges","authors":"I. Jeya Sheela ,&nbsp;A. Amala Jeya Ranchani ,&nbsp;Aravindh Murali ,&nbsp;H. Premkumar","doi":"10.1016/j.clbc.2026.01.004","DOIUrl":"10.1016/j.clbc.2026.01.004","url":null,"abstract":"<div><div>Breast cancer, the most diagnosed malignancy globally, poses a significant health burden, with approximately 2.3 million new cases and 700,000 deaths annually. Breast cancer vaccines represent an innovative approach to prevention and treatment, harnessing the immune system to target tumor-specific antigens such as α-lactalbumin, HER2, and MUC1. Prophylactic vaccines aim to reduce risk in high-risk groups like BRCA1/2 mutation carriers, while therapeutic vaccines, particularly for triple-negative breast cancer, stimulate T-cell responses to combat aggressive tumors. Advances in mRNA technology, nanoparticle delivery, and neoantigen identification enhance vaccine precision and efficacy. However, challenges including tumor heterogeneity, immune evasion, and production scalability limit clinical success. Ongoing phase I and II trials explore combination therapies with checkpoint inhibitors and antibody-drug conjugates to overcome these barriers. This review examines the current landscape, mechanisms, and challenges of breast cancer vaccines, highlighting their potential to transform oncology through personalized, less invasive strategies.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 54-64"},"PeriodicalIF":2.5,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146186188","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}