{"title":"Comment on: Prognostic Ability of the Indication for Adjuvant Systemic Therapy Based on Preoperative Biopsy and the Surgical Excision Specimen in Cases of Small Breast Tumors (CONSCIENCE): A Retrospective Cohort Study","authors":"Xuezheng Zhu, Daquan Liao, Shiye Huang, Yubin Feng, Ziye Zhuang","doi":"10.1016/j.clbc.2025.10.007","DOIUrl":"10.1016/j.clbc.2025.10.007","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 198-199"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512314","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}
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.
研究是根据在多个数据库中进行的文献检索精心选择的。提取总生存期（OS）、无进展生存期（PFS）和临床病理特征数据。对研究的可靠性进行异质性评估。敏感性分析证实了结果的稳定性，Egger检验检查了发表偏倚。对10项研究1761例病例进行分析。TK1a水平高的患者发生不良OS的风险明显高于TK1a水平低的患者（HR 1.80; 95% CI, 1.35-2.41, Z = 3.99, P < 0.05）。在PFS分析中也有类似的发现。分析中的整体异质性是实质性的。经回归分析，样本类型可能是造成这一现象的原因。我们进行了分析，表明高TK1a水平与ER阴性状态相关（OR: 0.651, 95% CI, 0.43-0.985, P < .001），但与其他因素无关。漏斗图检验显示纳入的文章无发表偏倚。评估TK1a水平可能为乳腺癌患者的预后提供支持性见解。这种生物标记物可能有助于评估患者预后和衡量临床干预治疗策略的有效性。
{"title":"High Thymidine Kinase 1 Activity Linked to Poor Breast Cancer Survival: A Systematic Review and Meta-Analysis","authors":"Simin Li, Guoxue Tang, Shuzhen Lin, Xiaofeng Guan, Wei Qin, Xiaoyun Xiao","doi":"10.1016/j.clbc.2025.10.006","DOIUrl":"10.1016/j.clbc.2025.10.006","url":null,"abstract":"<div><div>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, <em>P</em> < .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, <em>P</em> < .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.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 189-197"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476811","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}
Pub Date : 2026-03-01Epub Date: 2026-01-29DOI: 10.1016/j.clbc.2026.01.012
Tal Friehmann , Hana Shpitzer , Marva Dahan Shemesh , Eli Atar , Noa Rotbart , Tzippy Shochat , Meirav Wolff-Bar , Shlomit Tamir , Vladyslav Gaisinskyi , Eran Sharon , Ahuva Grubstein
Background
Accurate preoperative assessment of nipple-areolar complex (NAC) involvement is essential for determining the feasibility of nipple-sparing surgery in breast cancer. Magnetic resonance imaging (MRI) offers high sensitivity, but interpretation may be confounded by benign mimics of malignancy.
Purpose
To identify and evaluate MRI features predictive of pathologically confirmed NAC involvement in breast cancer.
Material and Methods
This retrospective study included 78 breast cancer patients with suspected NAC involvement on preoperative MRI performed between 2015 to 2024. All cases had surgical pathology confirmation. MRI findings were assessed for tumor morphology, tumor-to-nipple distance, ductal enhancement, and direct tumor extension. Logistic regression analyses were used to determine the association between imaging features and NAC involvement.
Results
Among 58 eligible cases (excluding 20 patients), 31 (53%) had pathologically confirmed NAC involvement. Direct tumor extension and tumor proximity < 10 mm was most frequently associated with positive findings. On multivariate analysis, mass-forming tumors within 10 mm of the nipple demonstrated significantly increased odds of NAC involvement (OR 4.32; P = .0095), particularly when combined with ductal enhancement or hormone receptor positivity.
Conclusion
MRI features most predictive of NAC involvement include direct tumor extension and short tumor-to-nipple distance. These “hard signs” support excision of the NAC. In contrast, “soft signs” such as ductal enhancement or ductal dilatation, without direct continuity may warrant further diagnostic workup before ruling out nipple preservation.
背景：准确的术前评估乳头-乳晕复核（NAC）累及情况对于确定乳腺癌保留乳头手术的可行性至关重要。磁共振成像（MRI）提供了高灵敏度，但解释可能混淆良性模拟恶性肿瘤。目的：鉴别和评价经病理证实的乳腺癌NAC受累的MRI特征。材料与方法：本回顾性研究纳入2015 - 2024年间术前MRI疑似NAC累及的78例乳腺癌患者。所有病例均经手术病理证实。MRI检查结果评估肿瘤形态，肿瘤到乳头的距离，导管增强和直接肿瘤扩展。采用Logistic回归分析确定影像学特征与NAC受累之间的关系。结果：在58例符合条件的病例中（不包括20例患者），31例（53%）病理证实NAC受累。肿瘤直接延伸和肿瘤接近度< 10 mm最常与阳性结果相关。在多变量分析中，乳头10mm内肿块形成的肿瘤显示NAC累及的几率显著增加（OR 4.32; P = 0.0095），特别是当合并导管增强或激素受体阳性时。结论：最能预测NAC累及的MRI特征是肿瘤直接延伸和肿瘤到乳头的距离较短。这些“硬信号”支持切除NAC。相反，“软征象”，如导管增强或导管扩张，没有直接连续性，在排除乳头保留之前可能需要进一步的诊断检查。
{"title":"Hard and Soft MRI Signs of Nipple-Areolar Complex Involvement in Breast Cancer","authors":"Tal Friehmann , Hana Shpitzer , Marva Dahan Shemesh , Eli Atar , Noa Rotbart , Tzippy Shochat , Meirav Wolff-Bar , Shlomit Tamir , Vladyslav Gaisinskyi , Eran Sharon , Ahuva Grubstein","doi":"10.1016/j.clbc.2026.01.012","DOIUrl":"10.1016/j.clbc.2026.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Accurate preoperative assessment of nipple-areolar complex (NAC) involvement is essential for determining the feasibility of nipple-sparing surgery in breast cancer. Magnetic resonance imaging (MRI) offers high sensitivity, but interpretation may be confounded by benign mimics of malignancy.</div></div><div><h3>Purpose</h3><div>To identify and evaluate MRI features predictive of pathologically confirmed NAC involvement in breast cancer.</div></div><div><h3>Material and Methods</h3><div>This retrospective study included 78 breast cancer patients with suspected NAC involvement on preoperative MRI performed between 2015 to 2024. All cases had surgical pathology confirmation. MRI findings were assessed for tumor morphology, tumor-to-nipple distance, ductal enhancement, and direct tumor extension. Logistic regression analyses were used to determine the association between imaging features and NAC involvement.</div></div><div><h3>Results</h3><div>Among 58 eligible cases (excluding 20 patients), 31 (53%) had pathologically confirmed NAC involvement. Direct tumor extension and tumor proximity < 10 mm was most frequently associated with positive findings. On multivariate analysis, mass-forming tumors within 10 mm of the nipple demonstrated significantly increased odds of NAC involvement (OR 4.32; <em>P</em> = .0095), particularly when combined with ductal enhancement or hormone receptor positivity.</div></div><div><h3>Conclusion</h3><div>MRI features most predictive of NAC involvement include direct tumor extension and short tumor-to-nipple distance. These “hard signs” support excision of the NAC. In contrast, “soft signs” such as ductal enhancement or ductal dilatation, without direct continuity may warrant further diagnostic workup before ruling out nipple preservation.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 94-101"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282619","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}
Pub Date : 2026-03-01Epub Date: 2026-01-31DOI: 10.1016/j.clbc.2026.01.015
Wooram F. Jung, Evan Rothchild, Armen K. Kasabian
Background
Socioeconomic disparities continue to influence access to and outcomes of postmastectomy breast reconstruction. The Social Vulnerability Index (SVI), a validated public health metric incorporating 16 socioeconomic and demographic factors, offers a standardized framework to assess community-level vulnerability. This study evaluated the association between SVI and breast reconstruction timing and outcomes at a single academic institution.
Methods
A retrospective cohort study was conducted of patients undergoing breast reconstruction following mastectomy for breast cancer between January 2021 and December 2024 by a single surgeon. Residential addresses were geocoded and linked to the 2020 CDC SVI census tract–level data. Patients were stratified into quartiles of vulnerability. The primary outcome was time from breast cancer diagnosis to earliest treatment. Kaplan–Meier and Cox proportional-hazards models were used for time-to-treatment analyses, adjusted for race, tumor stage, and grade.
Results
Among 264 patients, higher SVI quartiles were associated with greater racial diversity, increased Medicaid/Medicare coverage, and fewer prior reconstructions. Median age and comorbidities were similar across quartiles. Time to earliest treatment did not differ significantly between quartiles. SVI was not independently associated with treatment delay; however, Black patients and those categorized as “Other” experienced significant delays compared to White patients. Tumor stage strongly predicted earlier treatment initiation.
Conclusions
While SVI correlated with demographic differences, it was not associated with treatment delays or worse perioperative outcomes in this cohort. These findings suggest that equitable institutional practices and national policy initiatives may mitigate structural disparities in reconstructive access, though racial inequities persist and warrant continued attention.
{"title":"Evaluating Breast Reconstruction Equity Using the Social Vulnerability Index: A Single-Institution Cohort Study","authors":"Wooram F. Jung, Evan Rothchild, Armen K. Kasabian","doi":"10.1016/j.clbc.2026.01.015","DOIUrl":"10.1016/j.clbc.2026.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Socioeconomic disparities continue to influence access to and outcomes of postmastectomy breast reconstruction. The Social Vulnerability Index (SVI), a validated public health metric incorporating 16 socioeconomic and demographic factors, offers a standardized framework to assess community-level vulnerability. This study evaluated the association between SVI and breast reconstruction timing and outcomes at a single academic institution.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted of patients undergoing breast reconstruction following mastectomy for breast cancer between January 2021 and December 2024 by a single surgeon. Residential addresses were geocoded and linked to the 2020 CDC SVI census tract–level data. Patients were stratified into quartiles of vulnerability. The primary outcome was time from breast cancer diagnosis to earliest treatment. Kaplan–Meier and Cox proportional-hazards models were used for time-to-treatment analyses, adjusted for race, tumor stage, and grade.</div></div><div><h3>Results</h3><div>Among 264 patients, higher SVI quartiles were associated with greater racial diversity, increased Medicaid/Medicare coverage, and fewer prior reconstructions. Median age and comorbidities were similar across quartiles. Time to earliest treatment did not differ significantly between quartiles. SVI was not independently associated with treatment delay; however, Black patients and those categorized as “Other” experienced significant delays compared to White patients. Tumor stage strongly predicted earlier treatment initiation.</div></div><div><h3>Conclusions</h3><div>While SVI correlated with demographic differences, it was not associated with treatment delays or worse perioperative outcomes in this cohort. These findings suggest that equitable institutional practices and national policy initiatives may mitigate structural disparities in reconstructive access, though racial inequities persist and warrant continued attention.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 119-127"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324963","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}
Pub Date : 2026-03-01Epub Date: 2025-10-13DOI: 10.1016/j.clbc.2025.10.004
Wisam Hindawi Hoidy , Mohammed Ouda Orabiy , Shaimaa Mohsen Essa , Layth Samir Jasim
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.
{"title":"Novel Genetic Susceptibility Markers for Breast Cancer in Iraqi Women: First Evidence of CYP3A4*1B Protective Effects and GSTP1/MTHFR Risk Associations","authors":"Wisam Hindawi Hoidy , Mohammed Ouda Orabiy , Shaimaa Mohsen Essa , Layth Samir Jasim","doi":"10.1016/j.clbc.2025.10.004","DOIUrl":"10.1016/j.clbc.2025.10.004","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>P</em> = .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, <em>P</em> = .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, <em>P</em> = .005). No significant association for COMT Val158Met was observed (<em>P</em> = .156). All polymorphisms among controls were in Hardy–Weinberg equilibrium.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 176-188"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444147","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}
Pub Date : 2026-03-01Epub Date: 2026-01-05DOI: 10.1016/j.clbc.2025.12.010
Sirui Huang , Yiqing Xi , Jingbo Gao , Shilong Yu , Le Chen , Yuxia Duan , Zelin Yang , Yu Peng , Lei Wei , Jingwei Zhang
Background
Breast cancer remains a significant health issue, with a persistent annual increase in incidence rates and high mortality. MYC, a critical transcription factor, is often dysregulated in breast cancer, driving tumor progression. Long noncoding RNAs (lncRNAs) have emerged as key regulators in cancer, influencing gene expression through various mechanisms. This study investigates the role of lncRNAs in mediating MYC function and their impact on breast cancer progression.
Methods
We analyzed 1212 breast cancer samples from The Cancer Genome Atlas (TCGA) database to identify lncRNAs related to MYC targets. The expression levels of lncRNAs were correlated with MYC-TARGET scores to develop a prognostic model. Functional studies were performed on LINC00511, a key lncRNA identified in the model, to elucidate its role in breast cancer progression. RNA Immunoprecipitation (RIP), Chromatin Immunoprecipitation (ChIP) and Dual-Luciferase Reporter Gene Assay assays were used to validate interactions between LINC00511, MYC, and the target gene VASP (vasodilator-stimulated phosphoprotein).
Results
MYC-TARGET scores were significantly correlated with poor prognosis in breast cancer patients. We identified 38 lncRNAs associated with MYC targets, and LINC00511 was selected for further analysis due to its high expression and correlation with poor prognosis. A prognostic model composed of 5 lncRNAs (including LINC00511) was developed, with a risk score that independently predicted patient outcomes . Functional experiments showed that LINC00511 promoted breast cancer cell proliferation, migration, and invasion. Mechanistically, LINC00511 interacted with MYC to upregulate VASP expression. VASP knockdown significantly reduced breast cancer cell proliferation and migration. Overexpression of MYC rescued the inhibitory effects of LINC00511 knockdown on VASP expression and cell invasion/migration.
Conclusions
LINC00511 promotes breast cancer progression by mediating MYC to regulate VASP expression. This study highlights the importance of lncRNAs in cancer transcriptional networks and identifies LINC00511 as a potential therapeutic target for breast cancer.
{"title":"LINC00511 Promotes Breast Cancer Cell Proliferation and Invasion by Mediating MYC-Mediated Regulation of VASP","authors":"Sirui Huang , Yiqing Xi , Jingbo Gao , Shilong Yu , Le Chen , Yuxia Duan , Zelin Yang , Yu Peng , Lei Wei , Jingwei Zhang","doi":"10.1016/j.clbc.2025.12.010","DOIUrl":"10.1016/j.clbc.2025.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer remains a significant health issue, with a persistent annual increase in incidence rates and high mortality. MYC, a critical transcription factor, is often dysregulated in breast cancer, driving tumor progression. Long noncoding RNAs (lncRNAs) have emerged as key regulators in cancer, influencing gene expression through various mechanisms. This study investigates the role of lncRNAs in mediating MYC function and their impact on breast cancer progression.</div></div><div><h3>Methods</h3><div>We analyzed 1212 breast cancer samples from The Cancer Genome Atlas (TCGA) database to identify lncRNAs related to MYC targets. The expression levels of lncRNAs were correlated with MYC-TARGET scores to develop a prognostic model. Functional studies were performed on LINC00511, a key lncRNA identified in the model, to elucidate its role in breast cancer progression. RNA Immunoprecipitation (RIP), Chromatin Immunoprecipitation (ChIP) and Dual-Luciferase Reporter Gene Assay assays were used to validate interactions between LINC00511, MYC, and the target gene VASP (vasodilator-stimulated phosphoprotein).</div></div><div><h3>Results</h3><div>MYC-TARGET scores were significantly correlated with poor prognosis in breast cancer patients. We identified 38 lncRNAs associated with MYC targets, and LINC00511 was selected for further analysis due to its high expression and correlation with poor prognosis. A prognostic model composed of 5 lncRNAs (including LINC00511) was developed, with a risk score that independently predicted patient outcomes . Functional experiments showed that LINC00511 promoted breast cancer cell proliferation, migration, and invasion. Mechanistically, LINC00511 interacted with MYC to upregulate VASP expression. VASP knockdown significantly reduced breast cancer cell proliferation and migration. Overexpression of MYC rescued the inhibitory effects of LINC00511 knockdown on VASP expression and cell invasion/migration.</div></div><div><h3>Conclusions</h3><div>LINC00511 promotes breast cancer progression by mediating MYC to regulate VASP expression. This study highlights the importance of lncRNAs in cancer transcriptional networks and identifies LINC00511 as a potential therapeutic target for breast cancer.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 279-296.e1"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084308","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}
Neoadjuvant chemotherapy combined with dual HER2-targeted therapy improves pathological complete response (pCR) rates in early-stage HER2-positive breast cancer. However, data on its efficacy and tolerability in older adults remain limited.
Objective
To evaluate the efficacy, toxicity, and survival outcomes of neoadjuvant dual anti-HER2 therapy in older adults with HER2-positive early breast cancer.
Methods
This retrospective cohort included patients with HER2-positive early breast cancer treated with neoadjuvant dual anti-HER2 therapy at Queen Mary Hospital, Hong Kong, between January 2017 and December 2023. Patients were stratified by age (< 65 vs. ≥ 65 years). The primary outcome was pCR. Multivariable logistic regression identified predictors of pCR. Progression-free survival (PFS) was assessed using the Kaplan–Meier method with log-rank testing. Treatment-related toxicities (TRT) were graded according to CTCAE v5.0.
Results
A total of 227 patients were included, 43 (18.9%) were aged ≥ 65 years. The pCR rate was 51.2% in older patients and 62.0% in younger patients (P = .194). Higher clinical T-stage was significantly associated with lower pCR (OR = 0.25, 95% CI, 0.06-0.67, P = .02). Older patients experienced more grade ≥ 3 TRT (55.8% vs. 28.3%, P < .001), with neutropenia (32.6% vs. 12.0%) and diarrhoea (16.3% vs. 7.1%) being most common. Unplanned hospitalisations were more frequent (14.0% vs. 4.9%, P = .001). No significant difference in PFS was observed (P = .21). Five-year PFS rates were 87.4% (95% CI, 76.3%-100%) in older patients and 95.2% (95% CI, 92.0-98.6%) in younger patients.
Conclusion
Older patients achieved pCR and PFS comparable to younger counterparts but experienced higher toxicity and hospitalisation rates. Age-specific and de-escalation strategies warrant further study.
背景：新辅助化疗联合双重her2靶向治疗可提高早期her2阳性乳腺癌的病理完全缓解率（pCR）。然而，关于其在老年人中的有效性和耐受性的数据仍然有限。目的：评价新辅助双重抗her2治疗老年早期her2阳性乳腺癌的疗效、毒性和生存结局。方法：该回顾性队列包括2017年1月至2023年12月在香港玛丽医院接受新辅助双重抗her2治疗的her2阳性早期乳腺癌患者。患者按年龄分层（< 65岁vs.≥65岁）。主要结果为pCR。多变量logistic回归确定了pCR的预测因子。采用Kaplan-Meier法和log-rank检验评估无进展生存期（PFS）。治疗相关毒性（TRT）按CTCAE v5.0分级。结果：共纳入227例患者，年龄≥65岁43例（18.9%）。老年患者的pCR率为51.2%，年轻患者为62.0% （P = 0.194）。较高的临床t分期与较低的pCR显著相关（OR = 0.25, 95% CI, 0.06-0.67, P = 0.02）。老年患者有更多≥3级TRT (55.8% vs. 28.3%, P < 0.001)，中性粒细胞减少症（32.6% vs. 12.0%）和腹泻（16.3% vs. 7.1%）最为常见。计划外住院更频繁（14.0%比4.9%,P = .001）。两组PFS无显著差异（P = 0.21）。老年患者5年PFS率为87.4% (95% CI, 76.3%-100%)，年轻患者为95.2% （95% CI, 92.0-98.6%）。结论：老年患者获得了与年轻患者相当的pCR和PFS，但经历了更高的毒性和住院率。针对特定年龄和降低风险的策略值得进一步研究。
{"title":"Efficacy and Safety of Neoadjuvant Dual HER2-Targeted Therapy in Older and Younger Patients With HER2-Positive Early Breast Cancer: A Real-World Retrospective Analysis","authors":"Lok-Sze Joyce Au , Yu-ning Zhang , Kary Yeung , Ka-Long Cheung , Li-Yu Holly Hou , Mai-Yee Luk , Ching-Yu Roland Leung , Wing-Lok Chan","doi":"10.1016/j.clbc.2026.01.007","DOIUrl":"10.1016/j.clbc.2026.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Neoadjuvant chemotherapy combined with dual HER2-targeted therapy improves pathological complete response (pCR) rates in early-stage HER2-positive breast cancer. However, data on its efficacy and tolerability in older adults remain limited.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy, toxicity, and survival outcomes of neoadjuvant dual anti-HER2 therapy in older adults with HER2-positive early breast cancer.</div></div><div><h3>Methods</h3><div>This retrospective cohort included patients with HER2-positive early breast cancer treated with neoadjuvant dual anti-HER2 therapy at Queen Mary Hospital, Hong Kong, between January 2017 and December 2023. Patients were stratified by age (< 65 vs. ≥ 65 years). The primary outcome was pCR. Multivariable logistic regression identified predictors of pCR. Progression-free survival (PFS) was assessed using the Kaplan–Meier method with log-rank testing. Treatment-related toxicities (TRT) were graded according to CTCAE v5.0.</div></div><div><h3>Results</h3><div>A total of 227 patients were included, 43 (18.9%) were aged ≥ 65 years. The pCR rate was 51.2% in older patients and 62.0% in younger patients (<em>P</em> = .194). Higher clinical T-stage was significantly associated with lower pCR (OR = 0.25, 95% CI, 0.06-0.67, <em>P</em> = .02). Older patients experienced more grade ≥ 3 TRT (55.8% vs. 28.3%, <em>P</em> < .001), with neutropenia (32.6% vs. 12.0%) and diarrhoea (16.3% vs. 7.1%) being most common. Unplanned hospitalisations were more frequent (14.0% vs. 4.9%, <em>P</em> = .001). No significant difference in PFS was observed (<em>P</em> = .21). Five-year PFS rates were 87.4% (95% CI, 76.3%-100%) in older patients and 95.2% (95% CI, 92.0-98.6%) in younger patients.</div></div><div><h3>Conclusion</h3><div>Older patients achieved pCR and PFS comparable to younger counterparts but experienced higher toxicity and hospitalisation rates. Age-specific and de-escalation strategies warrant further study.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 84-93"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257721","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}
Pub Date : 2026-03-01Epub Date: 2026-01-20DOI: 10.1016/j.clbc.2026.01.009
Ying Yu, Dylan K. Kim, Nadeem E. Jones, Neelam I. Shaikh, Christine H. Rohde
Background
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.
Methods
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 (P < .05).
Results
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 (P = .20), ED visits (P = .82), readmissions (P = .38), and postoperative complications (P = .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, P = .0070). Mean time to completion was 282 days for patients with LEP and 245 days for non-LEP patients.
Conclusion
LEP was associated with a delay in time to completion of reconstruction, suggesting delays in surgical care coordination in patients with limited English proficiency.
{"title":"Association of Limited English Proficiency With Completion of the Reconstructive Paradigm in Implant-Based Breast Reconstruction","authors":"Ying Yu, Dylan K. Kim, Nadeem E. Jones, Neelam I. Shaikh, 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> < .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":"2026-03-01","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}
Pub Date : 2026-03-01Epub Date: 2025-10-22DOI: 10.1016/j.clbc.2025.10.009
Noëlle J.M.C. Vrancken Peeters , Marianne J. Heins , Gioele Re , Marleen Kok , Iris M.C. van der Ploeg , Winette T.A. van der Graaf , Olga Husson
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.
{"title":"Long-Term Health Issues of Adolescent and Young Adult Breast Cancer Survivors","authors":"Noëlle J.M.C. Vrancken Peeters , Marianne J. Heins , Gioele Re , Marleen Kok , Iris M.C. van der Ploeg , Winette T.A. van der Graaf , Olga Husson","doi":"10.1016/j.clbc.2025.10.009","DOIUrl":"10.1016/j.clbc.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 3","pages":"Pages 200-207.e4"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502472","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}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 10.1016/j.clbc.2026.01.010
Nina M. Verghis , Kazim Senol , Shigeru Imoto , Claudine Ordoñez , Kristin Lupinacci , Jamila Alazhri , Alexander Mundinger , Carole Mathelin , Vahit Ozmen , Atilla Soran , Senologic International Society Working Group
Introduction
The number of contralateral risk reduction mastectomies (RRM) continues to rise.
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.
Methods
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.
Results
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.
{"title":"Contralateral Risk Reduction Mastectomy in Patients With Unilateral Breast Cancer Scheduled for Mastectomy: A Multidisciplinary Survey; Physicians’ Perspective","authors":"Nina M. Verghis , Kazim Senol , Shigeru Imoto , Claudine Ordoñez , Kristin Lupinacci , Jamila Alazhri , Alexander Mundinger , Carole Mathelin , Vahit Ozmen , Atilla Soran , 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":"2026-03-01","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}
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