Pub Date : 2026-01-01DOI: 10.1016/j.clbc.2025.08.003
Lin Wang , Ye Wang , Changgen Liu , Yixin Zhao
Background
Triple-negative breast cancer (TNBC) carries a substantial risk of recurrence and metastasis, posing significant threats to patients’ health and quality of life. Centrosomal protein 55 (CEP55) has been demonstrated to exhibit elevated expression levels in TNBC. However, its molecular regulatory mechanism in TNBC remains unclear.
Methods
Bioinformatics databases, qRT-PCR, and Western blot were employed to analyze CEP55 expression in TNBC tissues and cells. EdU assays, flow cytometry, and Transwell assays were utilized to monitor cell proliferation, apoptosis, and invasion. Subsequently, macrophage polarization was detected by flow cytometry. Fe2+, malondialdehyde (MDA), glutathione (GSH), and reactive oxygen species (ROS) levels were determined using corresponding kits. Immunoprecipitation (IP) was used to detect the ubiquitination level of CEP55, and co-IP was applied to confirm the interaction between CEP55 and Charged Multivesicular Body Protein 6 (CHMP6). Finally, a xenograft tumor model was established, and immunohistochemistry (IHC) was conducted to evaluate the expression of specific proteins.
Results
CEP55 levels were increased in TNBC tissues and cells. Silencing CEP55 repressed TNBC cell proliferation, invasion, and macrophage M2 polarization, and facilitated cell apoptosis and ferroptosis. Additionally, ubiquitin-specific protease 8 (USP8) maintained CEP55 stability through deubiquitination, and CEP55 overexpression reversed the cellular effects caused by USP8 knockdown. Moreover, CEP55 bound to CHMP6 to promote its expression, thereby facilitating the malignant progression of TNBC cells. CEP55 overexpression abolished the inhibitory influence of USP8 silencing on tumor growth in vivo.
Conclusion
USP8 stabilized CEP55 expression through deubiquitination, and CEP55 further promoted CHMP6 expression to inhibit ferroptosis progression, thereby facilitating macrophage M2 polarization and malignant biological behaviors of TNBC cells.
背景：三阴性乳腺癌（TNBC）具有很大的复发和转移风险，对患者的健康和生活质量构成重大威胁。中心体蛋白55 （CEP55）已被证实在TNBC中表达水平升高。然而，其在TNBC中的分子调控机制尚不清楚。方法：采用生物信息学数据库、qRT-PCR和Western blot技术分析CEP55在TNBC组织和细胞中的表达。EdU法、流式细胞术、Transwell法监测细胞增殖、凋亡和侵袭。随后用流式细胞术检测巨噬细胞极化。采用相应试剂盒检测Fe2+、丙二醛（MDA）、谷胱甘肽（GSH）、活性氧（ROS）水平。采用免疫沉淀法（Immunoprecipitation， IP）检测CEP55的泛素化水平，采用协同沉淀法（co-IP）确定CEP55与带电多泡体蛋白6 （charge Multivesicular Body Protein 6, CHMP6）的相互作用。最后，建立异种移植瘤模型，免疫组化（IHC）评价特异性蛋白的表达。结果：TNBC组织和细胞中CEP55水平升高。沉默CEP55可抑制TNBC细胞增殖、侵袭和巨噬细胞M2极化，促进细胞凋亡和铁死亡。此外，泛素特异性蛋白酶8 （USP8）通过去泛素化维持CEP55的稳定性，并且CEP55过表达逆转了USP8敲低引起的细胞效应。此外，CEP55结合CHMP6促进其表达，从而促进TNBC细胞的恶性进展。在体内，CEP55过表达消除了USP8沉默对肿瘤生长的抑制作用。结论：USP8通过去泛素化作用稳定CEP55的表达，CEP55进一步促进CHMP6的表达，抑制铁凋亡的进展，从而促进TNBC细胞巨噬细胞M2极化和恶性生物学行为。
{"title":"The USP8/CEP55/CHMP6 Axis Orchestrates Triple-Negative Breast Cancer Progression by Regulating Ferroptosis and Macrophage M2 Polarization","authors":"Lin Wang , Ye Wang , Changgen Liu , Yixin Zhao","doi":"10.1016/j.clbc.2025.08.003","DOIUrl":"10.1016/j.clbc.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Triple-negative breast cancer (TNBC) carries a substantial risk of recurrence and metastasis, posing significant threats to patients’ health and quality of life. Centrosomal protein 55 (CEP55) has been demonstrated to exhibit elevated expression levels in TNBC. However, its molecular regulatory mechanism in TNBC remains unclear.</div></div><div><h3>Methods</h3><div>Bioinformatics databases, qRT-PCR, and Western blot were employed to analyze CEP55 expression in TNBC tissues and cells. EdU assays, flow cytometry, and Transwell assays were utilized to monitor cell proliferation, apoptosis, and invasion. Subsequently, macrophage polarization was detected by flow cytometry. Fe<sup>2+</sup>, malondialdehyde (MDA), glutathione (GSH), and reactive oxygen species (ROS) levels were determined using corresponding kits. Immunoprecipitation (IP) was used to detect the ubiquitination level of CEP55, and co-IP was applied to confirm the interaction between CEP55 and Charged Multivesicular Body Protein 6 (CHMP6). Finally, a xenograft tumor model was established, and immunohistochemistry (IHC) was conducted to evaluate the expression of specific proteins.</div></div><div><h3>Results</h3><div>CEP55 levels were increased in TNBC tissues and cells. Silencing CEP55 repressed TNBC cell proliferation, invasion, and macrophage M2 polarization, and facilitated cell apoptosis and ferroptosis. Additionally, ubiquitin-specific protease 8 (USP8) maintained CEP55 stability through deubiquitination, and CEP55 overexpression reversed the cellular effects caused by USP8 knockdown. Moreover, CEP55 bound to CHMP6 to promote its expression, thereby facilitating the malignant progression of TNBC cells. CEP55 overexpression abolished the inhibitory influence of USP8 silencing on tumor growth <em>in vivo</em>.</div></div><div><h3>Conclusion</h3><div>USP8 stabilized CEP55 expression through deubiquitination, and CEP55 further promoted CHMP6 expression to inhibit ferroptosis progression, thereby facilitating macrophage M2 polarization and malignant biological behaviors of TNBC cells.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 317-329.e1"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029015","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 : 2026-01-01DOI: 10.1016/j.clbc.2025.10.005
Javed Iqbal , Brijesh Sathian , Syed Muhammad Ali , Ayesha parvaiz malik
{"title":"Bridging Gaps in Remote Cancer Care: Commentary on the Adjuvant Abemaciclib Monitoring Model","authors":"Javed Iqbal , Brijesh Sathian , Syed Muhammad Ali , Ayesha parvaiz malik","doi":"10.1016/j.clbc.2025.10.005","DOIUrl":"10.1016/j.clbc.2025.10.005","url":null,"abstract":"","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 346-347"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437624","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 : 2026-01-01DOI: 10.1016/j.clbc.2025.08.014
Yufei Wang , Lingfeng Ma , Shijin Yuan , Zhuo Wang , Xian Wang
Background
Heterogeneity in triple-negative breast cancer (TNBC) leads to different responses to neoadjuvant chemotherapy (NAC). NAC-resistant TNBC is often associated with higher risk of recurrence and poor prognosis. This study developed and validated a novel radiomics-based model to predict pathological complete response (pCR) to NAC and reflect tumor heterogeneity in TNBC.
Methods
169 TNBC patients who underwent NAC between 2013 and 2023 were screened as a training cohort. A validation cohort and 2 cohorts containing RNA-seq data were also included. Radiomics features were extracted from dynamic contrast enhanced MRI (DCE-MRI) for model construction. Based on the model, we calculated the radiomics score (Rad-score) of each patient. The predictive capacity of the model was evaluated by area under receiver operating characteristic (ROC) curves. RNA-seq data was used to evaluate drug sensitivity, enriched pathways, and tumor microenvironment (TME) characteristics.
Results
The radiomics model can predict pCR in both the training cohort (AUC = 0.902) and validation cohort (AUC = 0.775). The high Rad-score subgroup exhibited better response to chemotherapy and better prognosis. Immune activation-related pathways were also enriched in the high-score subgroup. The low-score subgroup showed enrichment of TGF-β-related pathways and was more sensitive to TGF-β inhibitor. The model can also identify immune phenotypes (AUC = 0.85). The high Rad-score subgroup had abundant immune cell infiltration, while the low Rad-score subgroup was lacking immune cells in TME.
Conclusion
The model can effectively predict the pCR of TNBC and reflect tumor heterogeneity. Chemotherapy combined with targeting the TGF-β pathway is a potential strategy to overcome drug resistance in TNBC.
{"title":"Multiomics Analysis for Predicting Pathological Complete Response in Triple-Negative Breast Cancer and Reflecting Tumor Heterogeneity","authors":"Yufei Wang , Lingfeng Ma , Shijin Yuan , Zhuo Wang , Xian Wang","doi":"10.1016/j.clbc.2025.08.014","DOIUrl":"10.1016/j.clbc.2025.08.014","url":null,"abstract":"<div><h3>Background</h3><div>Heterogeneity in triple-negative breast cancer (TNBC) leads to different responses to neoadjuvant chemotherapy (NAC). NAC-resistant TNBC is often associated with higher risk of recurrence and poor prognosis. This study developed and validated a novel radiomics-based model to predict pathological complete response (pCR) to NAC and reflect tumor heterogeneity in TNBC.</div></div><div><h3>Methods</h3><div>169 TNBC patients who underwent NAC between 2013 and 2023 were screened as a training cohort. A validation cohort and 2 cohorts containing RNA-seq data were also included. Radiomics features were extracted from dynamic contrast enhanced MRI (DCE-MRI) for model construction. Based on the model, we calculated the radiomics score (Rad-score) of each patient. The predictive capacity of the model was evaluated by area under receiver operating characteristic (ROC) curves. RNA-seq data was used to evaluate drug sensitivity, enriched pathways, and tumor microenvironment (TME) characteristics.</div></div><div><h3>Results</h3><div>The radiomics model can predict pCR in both the training cohort (AUC = 0.902) and validation cohort (AUC = 0.775). The high Rad-score subgroup exhibited better response to chemotherapy and better prognosis. Immune activation-related pathways were also enriched in the high-score subgroup. The low-score subgroup showed enrichment of TGF-β-related pathways and was more sensitive to TGF-β inhibitor. The model can also identify immune phenotypes (AUC = 0.85). The high Rad-score subgroup had abundant immune cell infiltration, while the low Rad-score subgroup was lacking immune cells in TME.</div></div><div><h3>Conclusion</h3><div>The model can effectively predict the pCR of TNBC and reflect tumor heterogeneity. Chemotherapy combined with targeting the TGF-β pathway is a potential strategy to overcome drug resistance in TNBC.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 368-380"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102804","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 : 2026-01-01DOI: 10.1016/j.clbc.2025.07.022
Amparo Garcia-Tejedor , Carla Julià , Julia Ciria , Rodrigo Guevara-Peralta , Carlos Ortega-Expósito , Raul Ortega , Agostina Stradella , Héctor Pérez-Montero , Gabriel Reyes-Juncan , Ana Benitez , Anna Guma , Juan Azcarate , Miriam Campos , Maria J Plà , Evelyn Martinez , Sonia Pernas , Jordi Ponce , Catalina Falo
Purpose
To compare survival outcomes between patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma non-special type (NST) presenting with sentinel lymph node biopsy (SLNB)-detected macrometastases in early-stage breast cancer.
Materials and Methods
A retrospective cohort study was conducted including 364 cN0 breast cancer patients with SLNB-detected macrometastases who underwent surgical treatment between July 2011 and December 2023. Patients were categorized as NST (n = 250) or ILC (n = 108). SLNB was the primary axillary staging procedure, with axillary lymph node dissection (ALND) performed according to predefined clinical criteria. Univariate and multivariate Cox regression analyses were used to identify predictors of pN2–pN3. Survival outcomes were assessed using Kaplan-Meier curves and compared with log-rank tests.
Results
ILC patients presented with larger tumors, higher rates of multifocality, and greater axillary nodal involvement compared to NST. Surgery was more frequently mastectomy and ALND. pN2-N3 was identified in 12% of cases, with pT3 stage, ILC histology, and lymphovascular invasion as independent predictors. After a median follow-up of 7.6 years, the ILC group exhibited higher overall mortality (19.4% vs. 9.6%) and deaths attributed to systemic progression (57% vs. 29%). Ten-year distant disease-free survival and breast cancer-specific survival were significantly lower in the ILC cohort (63% vs. 87% and 65% vs. 93%, respectively; P < .05). Although 10-year overall survival was lower in ILC (54% vs. 79%), statistical significance was only observed in patients with advanced nodal disease (pN2–N3).
Conclusions
ILC is associated with more advanced axillary burden and significantly worse long-term oncologic outcomes compared to NST carcinoma when macrometastases are present at SLNB.
{"title":"Prognostic Outcomes by Axillary Approach in Lobular and Ductal Breast Cancer With Sentinel Node Macrometastases: A Retrospective Cohort Study","authors":"Amparo Garcia-Tejedor , Carla Julià , Julia Ciria , Rodrigo Guevara-Peralta , Carlos Ortega-Expósito , Raul Ortega , Agostina Stradella , Héctor Pérez-Montero , Gabriel Reyes-Juncan , Ana Benitez , Anna Guma , Juan Azcarate , Miriam Campos , Maria J Plà , Evelyn Martinez , Sonia Pernas , Jordi Ponce , Catalina Falo","doi":"10.1016/j.clbc.2025.07.022","DOIUrl":"10.1016/j.clbc.2025.07.022","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare survival outcomes between patients with invasive lobular carcinoma (ILC) and invasive ductal carcinoma non-special type (NST) presenting with sentinel lymph node biopsy (SLNB)-detected macrometastases in early-stage breast cancer.</div></div><div><h3>Materials and Methods</h3><div>A retrospective cohort study was conducted including 364 cN0 breast cancer patients with SLNB-detected macrometastases who underwent surgical treatment between July 2011 and December 2023. Patients were categorized as NST (<em>n</em> = 250) or ILC (<em>n</em> = 108). SLNB was the primary axillary staging procedure, with axillary lymph node dissection (ALND) performed according to predefined clinical criteria. Univariate and multivariate Cox regression analyses were used to identify predictors of pN2–pN3. Survival outcomes were assessed using Kaplan-Meier curves and compared with log-rank tests.</div></div><div><h3>Results</h3><div>ILC patients presented with larger tumors, higher rates of multifocality, and greater axillary nodal involvement compared to NST. Surgery was more frequently mastectomy and ALND. pN2-N3 was identified in 12% of cases, with pT3 stage, ILC histology, and lymphovascular invasion as independent predictors. After a median follow-up of 7.6 years, the ILC group exhibited higher overall mortality (19.4% vs. 9.6%) and deaths attributed to systemic progression (57% vs. 29%). Ten-year distant disease-free survival and breast cancer-specific survival were significantly lower in the ILC cohort (63% vs. 87% and 65% vs. 93%, respectively; <em>P</em> < .05). Although 10-year overall survival was lower in ILC (54% vs. 79%), statistical significance was only observed in patients with advanced nodal disease (pN2–N3).</div></div><div><h3>Conclusions</h3><div>ILC is associated with more advanced axillary burden and significantly worse long-term oncologic outcomes compared to NST carcinoma when macrometastases are present at SLNB.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 262-275"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944778","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 : 2026-01-01DOI: 10.1016/j.clbc.2025.07.021
Britt A M Jansen , Claudia A Bargon , Danny A Young-Afat , Annemiek Doeksen , Teun Teunis
Background
The smallest clinically relevant change (ie, minimal clinically important difference, MCID) for several valuable PROMs for women undergoing breast cancer surgery is unknown. Therefore, this study evaluated the smallest clinically relevant change for decision uncertainty, distress after traumatic events, body image, and health status in women diagnosed with breast cancer considering surgery.
Patients and methods
Between August 2020 and October 2022, we included 123 women with breast cancer considering surgical treatment. Women completed the decisional conflict scale (DCS), impact of event scale (IES), body image scale (BIS), and 36-Item Short Form (SF-36) after their first visit, and 4-6 weeks and 6 months after surgery. The MCID was calculated using the anchor-based method. For the MCID to be reliable, it needs to be greater than the minimum detectable change (MDC).
Results
The MCID for decision uncertainty (8.6) was smaller than the MDC (22). MCID values were 11 and 12 (MDC 8.4) for improvement in cancer-specific distress (IES), 2.5 and 6.5 (MDC 2.6) for deterioration in body image (BIS) and 27 and 14 (MDC 12) for deterioration in health status (SF-36) at 4 to 6 weeks and 6 months after surgery, respectively.
Conclusion
This study successfully determined MCIDs for several PROMs. For IES, BIS, and SF-36 the MCID seems reliable, while the DCS cannot reliably capture a clinically relevant change. The MCID values may be useful when assessing clinically relevant changes over time, interpreting treatment effects, and trial sample size determination.
{"title":"Minimal Clinically Important Differences in Scales Measuring Decision Uncertainty, Distress After a Traumatic Event, Body Image and Health Status Among Women With Breast Cancer Having Surgery","authors":"Britt A M Jansen , Claudia A Bargon , Danny A Young-Afat , Annemiek Doeksen , Teun Teunis","doi":"10.1016/j.clbc.2025.07.021","DOIUrl":"10.1016/j.clbc.2025.07.021","url":null,"abstract":"<div><h3>Background</h3><div>The smallest clinically relevant change (ie, minimal clinically important difference, MCID) for several valuable PROMs for women undergoing breast cancer surgery is unknown. Therefore, this study evaluated the smallest clinically relevant change for decision uncertainty, distress after traumatic events, body image, and health status in women diagnosed with breast cancer considering surgery.</div></div><div><h3>Patients and methods</h3><div>Between August 2020 and October 2022, we included 123 women with breast cancer considering surgical treatment. Women completed the decisional conflict scale (DCS), impact of event scale (IES), body image scale (BIS), and 36-Item Short Form (SF-36) after their first visit, and 4-6 weeks and 6 months after surgery. The MCID was calculated using the anchor-based method. For the MCID to be reliable, it needs to be greater than the minimum detectable change (MDC).</div></div><div><h3>Results</h3><div>The MCID for decision uncertainty (8.6) was smaller than the MDC (22). MCID values were 11 and 12 (MDC 8.4) for improvement in cancer-specific distress (IES), 2.5 and 6.5 (MDC 2.6) for deterioration in body image (BIS) and 27 and 14 (MDC 12) for deterioration in health status (SF-36) at 4 to 6 weeks and 6 months after surgery, respectively.</div></div><div><h3>Conclusion</h3><div>This study successfully determined MCIDs for several PROMs. For IES, BIS, and SF-36 the MCID seems reliable, while the DCS cannot reliably capture a clinically relevant change. The MCID values may be useful when assessing clinically relevant changes over time, interpreting treatment effects, and trial sample size determination.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 1","pages":"Pages 254-261.e3"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945038","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}
This study conducted to assess the knowledge, perceptions, attitudes, and barriers toward breast reconstruction (BR) among women who underwent mastectomy for a breast cancer primary and identify predictors of BR uptake.
Methods
A cross-sectional study was conducted at KHCC. Data were collected using a structured Arabic questionnaire. The questionnaire covered demographics, clinical background, knowledge, attitudes, and perceived barriers. Descriptive statistics, Chi-square tests, and multivariate regression models were used to analyze predictors of BR uptake.
Results
Of the 603 participants (mean age 49.5 years), 50.3% had undergone BR. Uptake was significantly higher among younger women (P < .001), those employed (P = .002), with higher education levels (P < .001), no chronic illness (P = .03), and premenopausal status (P = .001). While 70.8% had received BR information from physicians, 58.2% were unaware of BR before their diagnosis. Implants were more commonly recognized (87.2%) compared to autologous methods (39.5%). Though 69% believed BR improves quality of life, 72% viewed it as cosmetic rather than medically necessary. Regression analysis showed that younger age (OR = 0.94), employment (OR = 2.19), higher knowledge (OR = 1.29), and positive attitudes (OR = 1.25) significantly predicted BR uptake. Among those who had not undergone BR, barriers included fear of surgery (50%), misinformation, lack of interest, and financial constraints (39.5).
Conclusion
Despite clinical advancements, BR remains underutilized in Jordan due to knowledge gaps, limited counseling, and sociocultural misconceptions. Empowering patients through targeted education, integrating BR into oncologic care pathways, and enhancing provider communication are warranted to ensure equitable, informed, and holistic breast cancer survivorship.
{"title":"Knowledge, Awareness, Perceptions, and Attitudes Toward Breast Reconstruction Among Breast Cancer Women in Jordan: A Cross-Sectional Study","authors":"Saleh Abualhaj , Lina Alshadfan , Mosleh M. Abualhaj , Yasmin Safi , Mohammad Al-Share , Huda Alzagatit , Aseel Qandil , Tamara Abdalkader , Weam Sowan , Younis Hizzani , Zain aldeen Saleh , Yousef Albustanji , Mahmoud Al-Masri","doi":"10.1016/j.clbc.2025.12.008","DOIUrl":"10.1016/j.clbc.2025.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>This study conducted to assess the knowledge, perceptions, attitudes, and barriers toward breast reconstruction (BR) among women who underwent mastectomy for a breast cancer primary and identify predictors of BR uptake.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at KHCC. Data were collected using a structured Arabic questionnaire. The questionnaire covered demographics, clinical background, knowledge, attitudes, and perceived barriers. Descriptive statistics, Chi-square tests, and multivariate regression models were used to analyze predictors of BR uptake.</div></div><div><h3>Results</h3><div>Of the 603 participants (mean age 49.5 years), 50.3% had undergone BR. Uptake was significantly higher among younger women (<em>P</em> < .001), those employed (<em>P</em> = .002), with higher education levels (<em>P</em> < .001), no chronic illness (<em>P</em> = .03), and premenopausal status (<em>P</em> = .001). While 70.8% had received BR information from physicians, 58.2% were unaware of BR before their diagnosis. Implants were more commonly recognized (87.2%) compared to autologous methods (39.5%). Though 69% believed BR improves quality of life, 72% viewed it as cosmetic rather than medically necessary. Regression analysis showed that younger age (OR = 0.94), employment (OR = 2.19), higher knowledge (OR = 1.29), and positive attitudes (OR = 1.25) significantly predicted BR uptake. Among those who had not undergone BR, barriers included fear of surgery (50%), misinformation, lack of interest, and financial constraints (39.5).</div></div><div><h3>Conclusion</h3><div>Despite clinical advancements, BR remains underutilized in Jordan due to knowledge gaps, limited counseling, and sociocultural misconceptions. Empowering patients through targeted education, integrating BR into oncologic care pathways, and enhancing provider communication are warranted to ensure equitable, informed, and holistic breast cancer survivorship.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 59-69"},"PeriodicalIF":2.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035521","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 : 2025-12-29DOI: 10.1016/j.clbc.2025.12.009
Jennifer D Brooks, Kristina M Blackmore, Nguyet N M Ngo, Meghan J Walker, Amy Chang, Laurence Lambert-Côté, Annie Turgeon, Aisha K Lofters, Hermann Nabi, Antonis C Antoniou, Kathleen A Bell, Mireille J M Broeders, Tim Carver, Jocelyne Chiquette, Philippe Després, Douglas F Easton, Andrea Eisen, Laurence Eloy, D Gareth Evans, Samantha Fienberg, Yann Joly, Raymond H Kim, Shana J Kim, Bartha M Knoppers, Jean-Sebastien Paquette, Nora Pashayan, Amanda J Sheppard, Tracy L Stockley, Michel Dorval, Jacques Simard, Anna M Chiarelli
Background: Risk-stratified breast cancer screening has been proposed as an alternative to the age-based approach currently used by most screening programs. This study, part of the Canadian PERSPECTIVE I&I project, examined perceived advantages and disadvantages of learning your breast cancer risk category and associated screening plans.
Method: Women aged 40 to 69 from Ontario and Quebec (N = 3319) had multifactorial risk assessments using the CanRisk tool. Risk categories (average [78.9%], higher than average [16.4%], high [4.6%]) were communicated along with screening plans. Participants completed questionnaires on attitudes toward learning their risk before, at the time of, and 1 year later risk communication. Participant characteristics associated with these attitudes were assessed using multinomial logistic regression.
Results: At the time of risk communication, most participants (72.9%) perceived ``Easing worry'' as an advantage of learning their risk. However, participants at higher risk were more likely to report that it did not ease their worry. Visible minority participants (OR = 1.86, 95% CI, 1.16, 2.98) and those with lower education attainment were more likely to view "complicated information" as a disadvantage (College/Apprenticeship/Trades: OR = 1.54, 95% CI, 1.24, 1.92; High School or below: OR = 1.77, 95% CI, 1.29, 2.42). Ontario participants were more likely to view risk communication as "information I do not want to know" (OR = 0.44, 95% CI, 0.32, 0.59) compared to Quebec participants.
Conclusion: Most women responded positively to learning their breast cancer risk category and screening plan. Successful implementation of risk-stratified screening will require clear communication, healthcare provider support, and adaptation to regional resources.
{"title":"Canadian Women's Attitudes Toward Receiving Personalized Breast Cancer Risk Information: Insights From the PERSPECTIVE I&I Project.","authors":"Jennifer D Brooks, Kristina M Blackmore, Nguyet N M Ngo, Meghan J Walker, Amy Chang, Laurence Lambert-Côté, Annie Turgeon, Aisha K Lofters, Hermann Nabi, Antonis C Antoniou, Kathleen A Bell, Mireille J M Broeders, Tim Carver, Jocelyne Chiquette, Philippe Després, Douglas F Easton, Andrea Eisen, Laurence Eloy, D Gareth Evans, Samantha Fienberg, Yann Joly, Raymond H Kim, Shana J Kim, Bartha M Knoppers, Jean-Sebastien Paquette, Nora Pashayan, Amanda J Sheppard, Tracy L Stockley, Michel Dorval, Jacques Simard, Anna M Chiarelli","doi":"10.1016/j.clbc.2025.12.009","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.12.009","url":null,"abstract":"<p><strong>Background: </strong>Risk-stratified breast cancer screening has been proposed as an alternative to the age-based approach currently used by most screening programs. This study, part of the Canadian PERSPECTIVE I&I project, examined perceived advantages and disadvantages of learning your breast cancer risk category and associated screening plans.</p><p><strong>Method: </strong>Women aged 40 to 69 from Ontario and Quebec (N = 3319) had multifactorial risk assessments using the CanRisk tool. Risk categories (average [78.9%], higher than average [16.4%], high [4.6%]) were communicated along with screening plans. Participants completed questionnaires on attitudes toward learning their risk before, at the time of, and 1 year later risk communication. Participant characteristics associated with these attitudes were assessed using multinomial logistic regression.</p><p><strong>Results: </strong>At the time of risk communication, most participants (72.9%) perceived ``Easing worry'' as an advantage of learning their risk. However, participants at higher risk were more likely to report that it did not ease their worry. Visible minority participants (OR = 1.86, 95% CI, 1.16, 2.98) and those with lower education attainment were more likely to view \"complicated information\" as a disadvantage (College/Apprenticeship/Trades: OR = 1.54, 95% CI, 1.24, 1.92; High School or below: OR = 1.77, 95% CI, 1.29, 2.42). Ontario participants were more likely to view risk communication as \"information I do not want to know\" (OR = 0.44, 95% CI, 0.32, 0.59) compared to Quebec participants.</p><p><strong>Conclusion: </strong>Most women responded positively to learning their breast cancer risk category and screening plan. Successful implementation of risk-stratified screening will require clear communication, healthcare provider support, and adaptation to regional resources.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123890","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 : 2025-12-24DOI: 10.1016/j.clbc.2025.12.007
Eleanor Harris, Parima Daroui, Victor Gonzalez, Jason C Ye, Wendy Gao, Catherine Park, Amar Rewari, W Warren Suh, Kristina Novick, J Isabelle Choi
Ductal carcinoma in situ (DCIS) of the breast is a distinct biologic entity from invasive cancer with an excellent prognosis which represents about 20% of all mammographically detected breast neoplasms. The primary goal of treatment is to minimize the risk of invasive in-breast recurrence. The American Radium Society (ARS) Appropriate Use Criteria (AUC) expert panel examined the evidence for key questions in contemporary treatment of DCIS related to the benefit of radiation after lumpectomy, the established dose and fractionation radiation regimens and the use of predictive and prognostic assays in treatment management of DCIS. For patients undergoing breast conserving surgery, postoperative radiation to the breast reduces the risk of local recurrence by at least 50%. The absolute benefit depends upon the baseline risk of in breast recurrence based on clinicopathologic features identified in randomized or prospective clinical trials and meta-analyses. These features include age and menopausal status, grade, margin width, tumor size, receptor expression, and presence of comedonecrosis. Randomized and prospective studies have not identified a definitive cohort of patients who do not benefit from adjuvant radiation to reduce in breast recurrence. Margin width appears to be the most significant factor in local recurrence risk. Patients with close or positive margins demonstrate a higher local recurrence risk and benefit from dose escalation by use of a tumor bed boost. Recently developed biosignatures of DCIS in-breast recurrence risk have been validated and found to confer potential clinical utility in the decision-making process regarding recommendations to undergo treatment with adjuvant breast radiation.
{"title":"American Radium Society Appropriate Use Criteria Report on Radiation in the Management of Ductal Carcinoma in Situ (DCIS) of the Breast.","authors":"Eleanor Harris, Parima Daroui, Victor Gonzalez, Jason C Ye, Wendy Gao, Catherine Park, Amar Rewari, W Warren Suh, Kristina Novick, J Isabelle Choi","doi":"10.1016/j.clbc.2025.12.007","DOIUrl":"https://doi.org/10.1016/j.clbc.2025.12.007","url":null,"abstract":"<p><p>Ductal carcinoma in situ (DCIS) of the breast is a distinct biologic entity from invasive cancer with an excellent prognosis which represents about 20% of all mammographically detected breast neoplasms. The primary goal of treatment is to minimize the risk of invasive in-breast recurrence. The American Radium Society (ARS) Appropriate Use Criteria (AUC) expert panel examined the evidence for key questions in contemporary treatment of DCIS related to the benefit of radiation after lumpectomy, the established dose and fractionation radiation regimens and the use of predictive and prognostic assays in treatment management of DCIS. For patients undergoing breast conserving surgery, postoperative radiation to the breast reduces the risk of local recurrence by at least 50%. The absolute benefit depends upon the baseline risk of in breast recurrence based on clinicopathologic features identified in randomized or prospective clinical trials and meta-analyses. These features include age and menopausal status, grade, margin width, tumor size, receptor expression, and presence of comedonecrosis. Randomized and prospective studies have not identified a definitive cohort of patients who do not benefit from adjuvant radiation to reduce in breast recurrence. Margin width appears to be the most significant factor in local recurrence risk. Patients with close or positive margins demonstrate a higher local recurrence risk and benefit from dose escalation by use of a tumor bed boost. Recently developed biosignatures of DCIS in-breast recurrence risk have been validated and found to confer potential clinical utility in the decision-making process regarding recommendations to undergo treatment with adjuvant breast radiation.</p>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"105-112"},"PeriodicalIF":2.5,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099603","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 : 2025-12-22DOI: 10.1016/j.clbc.2025.12.004
Jacopo Nori Cucchiari , Federica Di Naro , Giuliano Migliaro , Sofia Elisabetta Baldi Giorgi , Francesca Pugliese , Tommaso Amadori , Giulia Bicchierai , Diego De Benedetto , Chiara Bellini , Sofia Vidali , Ermanno Vanzi , Cecilia Boeri , Verdiana Lamagna , Vittorio Miele , Tommaso Susini
Background
Breast cancer (BC) is the most common cancer among women. There has been growing interest in less invasive techniques for the treatment of breast lesions, with cryoablation emerging as promising option. We aimed to assess the safety and efficacy of cryoablation for the treatment of breast cancer tumor subtypes 12 months post-treatment.
Methods
This single-center prospective study included patients with biopsy-proven BC who underwent ultrasound-guided-cryoablation treatment during 2021-2023. Locoregional staging was performed using ultrasound and contrast-enhanced mammography (CEM). Follow-up included ultrasound at 1-, 3-, 6- and 12-months with additional CEM and biopsy at 12-months. Rate of complete ablation, tumor size and quality of life (QoL) were assessed. Primary endpoint was absence of residual tumor for BC at 12-month post cryoablation.
Results
Thirthy-six female patients (mean age, 84.5±6.7 years) with 39 biopsy-proven tumors (mean size 15.3±7.5 mm) underwent cryoablation. No device-related unexpected adverse events were reported. The 39 BCs were early-stage luminal A or B, invasive ductal carcinoma (IDC) or IDC + ductal carcinoma in situ. Complete ablation rates for BC ≤ 15 mm and BC >15 mm were 100% and 84.6%, respectively; Cryoablation positively impacted patient QoL as assessed by validated questionnaires.
Conclusions
With improved QoL, cryoablation emerges as a promising, safe, and effective treatment option for low-risk breast cancer.
Disclaimer/Publisher’s Note
The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
{"title":"Cryoablation for Treatment of Early-Stage Breast Cancer: Efficacy and Quality of Life Assessment","authors":"Jacopo Nori Cucchiari , Federica Di Naro , Giuliano Migliaro , Sofia Elisabetta Baldi Giorgi , Francesca Pugliese , Tommaso Amadori , Giulia Bicchierai , Diego De Benedetto , Chiara Bellini , Sofia Vidali , Ermanno Vanzi , Cecilia Boeri , Verdiana Lamagna , Vittorio Miele , Tommaso Susini","doi":"10.1016/j.clbc.2025.12.004","DOIUrl":"10.1016/j.clbc.2025.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) is the most common cancer among women. There has been growing interest in less invasive techniques for the treatment of breast lesions, with cryoablation emerging as promising option. We aimed to assess the safety and efficacy of cryoablation for the treatment of breast cancer tumor subtypes 12 months post-treatment.</div></div><div><h3>Methods</h3><div>This single-center prospective study included patients with biopsy-proven BC who underwent ultrasound-guided-cryoablation treatment during 2021-2023. Locoregional staging was performed using ultrasound and contrast-enhanced mammography (CEM). Follow-up included ultrasound at 1-, 3-, 6- and 12-months with additional CEM and biopsy at 12-months. Rate of complete ablation, tumor size and quality of life (QoL) were assessed. Primary endpoint was absence of residual tumor for BC at 12-month post cryoablation.</div></div><div><h3>Results</h3><div>Thirthy-six female patients (mean age, 84.5±6.7 years) with 39 biopsy-proven tumors (mean size 15.3±7.5 mm) underwent cryoablation. No device-related unexpected adverse events were reported. The 39 BCs were early-stage luminal A or B, invasive ductal carcinoma (IDC) or IDC + ductal carcinoma in situ. Complete ablation rates for BC ≤ 15 mm and BC >15 mm were 100% and 84.6%, respectively; Cryoablation positively impacted patient QoL as assessed by validated questionnaires.</div></div><div><h3>Conclusions</h3><div>With improved QoL, cryoablation emerges as a promising, safe, and effective treatment option for low-risk breast cancer.</div></div><div><h3>Disclaimer/Publisher’s Note</h3><div>The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 70-79"},"PeriodicalIF":2.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035567","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 : 2025-12-20DOI: 10.1016/j.clbc.2025.12.005
Iva M. Borisova Boyanova , Lidia Blay Aulina , Marta de la Iglésia , David López-Cano , Cristina Serra-Serra , Neus Ruiz-Edo , Maite Salcedo-Pujantell , Juan Francisco Julián Ibañéz , Sandra López Gordo
Background
Sentinel lymph node biopsy (SLNB) using Technetium-99 (Tc-99) is the standard technique for axillary staging in breast cancer. However, it has logistic issues, especially in hospitals without a nuclear medicine department (NMD). As the sensitivity and specificity of indocyanine green (ICG) are comparable to those of Tc-99, the aim of this study was to perform a cost-benefit analysis of the 2 methods.
Materials and Methods
A prospective observational cohort of patients undergoing breast cancer surgery was included. Tc-99 and ICG were administered during the same procedure for SLNB. Three clinical pathways were constructed: Tc-99 administration at hospitals without NMD (first clinical pathway), Tc-99 administration at hospitals with NMD (second), and the ICG method (third). A cost comparison between the pathways was performed using the monetary unit of Euros (€).
Results
Between April 2021 and April 2024, 112 patients with breast cancer underwent SLNB using Tc-99 and ICG detection. The total cost per patient for the first clinical pathway was €322.29, for the second, €308.29 and for the third, €61.35 per patient. The cumulative cost for 112 patients in the first and second clinical pathways (€37,216.48 and €34,528.48, respectively) resulted to be 5.2 times the cost of the ICG pathway (€6871.2). The use of ICG results in an average saving of approximately 80% of the Tc-99 expenses.
Conclusion
ICG is a cost-effective option as a tracer for sentinel lymph node biopsy in breast cancer. ICG also offers logistic advantages and it should be considered in clinical practice and protocols.
{"title":"Cost Analysis of Technetium-99m versus Indocyanine Green for Sentinel Lymph Node Biopsy in Breast Cancer","authors":"Iva M. Borisova Boyanova , Lidia Blay Aulina , Marta de la Iglésia , David López-Cano , Cristina Serra-Serra , Neus Ruiz-Edo , Maite Salcedo-Pujantell , Juan Francisco Julián Ibañéz , Sandra López Gordo","doi":"10.1016/j.clbc.2025.12.005","DOIUrl":"10.1016/j.clbc.2025.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Sentinel lymph node biopsy (SLNB) using Technetium-99 (Tc-99) is the standard technique for axillary staging in breast cancer. However, it has logistic issues, especially in hospitals without a nuclear medicine department (NMD). As the sensitivity and specificity of indocyanine green (ICG) are comparable to those of Tc-99, the aim of this study was to perform a cost-benefit analysis of the 2 methods.</div></div><div><h3>Materials and Methods</h3><div>A prospective observational cohort of patients undergoing breast cancer surgery was included. Tc-99 and ICG were administered during the same procedure for SLNB. Three clinical pathways were constructed: Tc-99 administration at hospitals without NMD (first clinical pathway), Tc-99 administration at hospitals with NMD (second), and the ICG method (third). A cost comparison between the pathways was performed using the monetary unit of Euros (€).</div></div><div><h3>Results</h3><div>Between April 2021 and April 2024, 112 patients with breast cancer underwent SLNB using Tc-99 and ICG detection. The total cost per patient for the first clinical pathway was €322.29, for the second, €308.29 and for the third, €61.35 per patient. The cumulative cost for 112 patients in the first and second clinical pathways (€37,216.48 and €34,528.48, respectively) resulted to be 5.2 times the cost of the ICG pathway (€6871.2). The use of ICG results in an average saving of approximately 80% of the Tc-99 expenses.</div></div><div><h3>Conclusion</h3><div>ICG is a cost-effective option as a tracer for sentinel lymph node biopsy in breast cancer. ICG also offers logistic advantages and it should be considered in clinical practice and protocols.</div></div>","PeriodicalId":10197,"journal":{"name":"Clinical breast cancer","volume":"26 2","pages":"Pages 50-58"},"PeriodicalIF":2.5,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028555","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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